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  1. TRANSRECTAL ULTRASOUND GUIDED PROSTATIC NERVE BLOCKADE FOR PAIN CONTROL DURING TRANSRECTAL PROSTATE BIOPSY

    Institute of Scientific and Technical Information of China (English)

    YANG Liu-ping; DENG Jun-hong; ZHONG Hong; HU Jian-bo; WEI Hong-ai; WANG Liang-sheng

    2005-01-01

    Objective: To assess the effect of transrectal ultrasound guided prostatic nerve blockade on the discomfort associated with systematic biopsy of the prostate. Methods: 73 patients receiving systematic 13 cores biopsy of the prostate were randomized into two groups. Group A(37 cases) received an injection of 5 ml 1% lidocaine into the prostatic neurovascular bundles on each side at the base of the prostate under ultrasound guidance and group B(36 cases) received 5 ml saline injection (0.9% sodium chloride) at the same site. Pain during biopsy was assessed by using a 10-point linear visual analog score (VAS) immediately after the biopsy. Results: The mean pain scores during transrectal prostate biopsy were significantly lower in group A than group B(1.1±0.6 versus 5.9±3.1, t=4.81, P<0.01). During this study no patient in either group had any adverse effect from the injection. Conclusion: Transcrectal ultrasound guided prostatic nerve blockade is a safe and efficacious method for providing satisfactory anesthesia in transrectal prostate biopsy. We recommend its routine administration in all patients during this procedure.

  2. Ultrasound-guided transrectal extended prostate biopsy: a prospective study

    Institute of Scientific and Technical Information of China (English)

    Mohammed Ahmed Al-Ghazo; Ibrahim Fathi Ghalayini; Ismail Ibrahim Matalka

    2005-01-01

    Aim: To evaluate the diagnostic value of the 10 systematic transrectal ultrasound-guided (TRUS) prostate biopsy compared with the sextant biopsy technique for patients with suspected prostate cancer. Methods: One hundred and fifty-two patients with suspected prostate cancer were included in the study. Patients were entered in the study because they presented with high levels of prostate specific antigen (PSA) (over 4 ng/mL) and/or had undergone an abnormal digital rectal examination (DRE). In addition to sextant prostate biopsy cores, four more biopsies were obtained from the lateral peripheral zone with additional cores from each suspicious area revealed by transrectal ultrasound. Sextant, lateral peripheral zone and suspicious area biopsy cores were submitted separately to the pathological department. Results: Cancer detection rates were 27.6% (42/152) and 19.7% (30/152) for the 10-core and sextant core biopsy protocols, respectively. Adding the lateral peripheral zone (PZ) to the sextant prostate biopsy showed a 28.6% (12/42) increase in the cancer detection rate in patients with positive prostate cancer (P < 0.01).The cancer detection rate in patients who presented with elevated PSA was 29.3% (34/116). When serum PSA was 4-10 ng/mL TRUS-guided biopsy detected cancer in 20.6%, while the detection rate was 32.4% and 47.0% when serum PSA was 10-20 ng/mL and above 20 ng/mL, respectively. Conclusion: The 10 systematic TRUS-guided prostate biopsy improves the detection rate of prostate cancer by 28.6% when compared with the sextant biopsy technique alone, without increase in the morbidity. We therefore recommend the 10-core biopsy protocol to be the preferred method for early detection of prostate cancer.

  3. Transrectal Ultrasound-guided Systematic 13-Core Prostate Biopsy to Diagnose Prostate Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Liuping Yang; Junhong Deng; Hong Zhong; Jianbo Hu; Hongai Wei; Liangsheng Wang

    2005-01-01

    OBJECTIVE To evaluate the clinical value of transrectal ultrasound guided systematic 13-core prostate biopsy.METHODS A total of 213 patients referred for abnormal digital rectal examination and/or with a prostate specific antigen of 4 ng/ml or greater underwent transrectal ultrasound guided systematic 13-core prostate biopsy. This procedure was conducted in addition to the standard sextant biopsies in which cores were taken from the far lateral and middle regions of the gland as described by Eskew. Fathological findings of the additional regions were compared with those of the sextant regions.RESULTS Of the 213 patients 31% had cancer on biopsy (66/213). Of the 66 patients with prostate cancer 14 (21%) had carcinoma only in the additional regions, which would have remained undetected had the sextant biopsy technique been used alone (P<0.05). No severe complications occurred among the patients who underwent transrectal ultrasound guided systematic 13-core prostate biopsy.CONCLUSION Our data demonstrated that transrectal ultrasound guided systematic 13-core prostate biopsy can significantly increase the cancer detection rate. It is safe and efficacious, and should be recommended for use clinically.

  4. The future perspectives in transrectal prostate ultrasound guided biopsy

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    Sung Il Hwang

    2014-12-01

    Full Text Available Prostate cancer is one of the most common neoplasms in men. Transrectal ultrasound (TRUS-guided systematic biopsy has a crucial role in the diagnosis of prostate cancer. However, it shows limited value with gray-scale ultrasound alone because only a small number of malignancies are visible on TRUS. Recently, new emerging technologies in TRUS-guided prostate biopsy were introduced and showed high potential in the diagnosis of prostate cancer. High echogenicity of ultrasound contrast agent reflect the increased status of angiogenesis in tumor. Molecular imaging for targeting specific biomarker can be also used using ultrasound contrast agent for detecting angiogenesis or surface biomarker of prostate cancer. The combination of TRUS-guided prostate biopsy and ultrasound contrast agents can increase the accuracy of prostate cancer diagnosis. Elastography is an emerging ultrasound technique that can provide the information regarding tissue elasticity and stiffness. Tumors are usually stiffer than the surrounding soft tissue. In two types of elastography techniques, shearwave elastography has many potential in that it can provide quantitative information on tissue elasticity. Multiparametric magnetic resonance imaging (MRI from high resolution morphologic and functional magnetic resonance (MR technique enables to detect more prostate cancers. The combination of functional techniques including apparent diffusion coefficient map from diffusion weighted imaging, dynamic contrast enhanced MR and MR spectroscopy are helpful in the localization of the prostate cancer. MR-ultrasound (US fusion image can enhance the advantages of both two modalities. With MR-US fusion image, targeted biopsy of suspicious areas on MRI is possible and fusion image guided biopsy can provide improved detection rate. In conclusion, with recent advances in multiparametric-MRI, and introduction of new US techniques such as contrast-enhanced US and elastography, TRUS-guided biopsy

  5. The future perspectives in transrectal prostate ultrasound guided biopsy.

    Science.gov (United States)

    Hwang, Sung Ii; Lee, Hak Jong

    2014-12-01

    Prostate cancer is one of the most common neoplasms in men. Transrectal ultrasound (TRUS)-guided systematic biopsy has a crucial role in the diagnosis of prostate cancer. However, it shows limited value with gray-scale ultrasound alone because only a small number of malignancies are visible on TRUS. Recently, new emerging technologies in TRUS-guided prostate biopsy were introduced and showed high potential in the diagnosis of prostate cancer. High echogenicity of ultrasound contrast agent reflect the increased status of angiogenesis in tumor. Molecular imaging for targeting specific biomarker can be also used using ultrasound contrast agent for detecting angiogenesis or surface biomarker of prostate cancer. The combination of TRUS-guided prostate biopsy and ultrasound contrast agents can increase the accuracy of prostate cancer diagnosis. Elastography is an emerging ultrasound technique that can provide the information regarding tissue elasticity and stiffness. Tumors are usually stiffer than the surrounding soft tissue. In two types of elastography techniques, shearwave elastography has many potential in that it can provide quantitative information on tissue elasticity. Multiparametric magnetic resonance imaging (MRI) from high resolution morphologic and functional magnetic resonance (MR) technique enables to detect more prostate cancers. The combination of functional techniques including apparent diffusion coefficient map from diffusion weighted imaging, dynamic contrast enhanced MR and MR spectroscopy are helpful in the localization of the prostate cancer. MR-ultrasound (US) fusion image can enhance the advantages of both two modalities. With MR-US fusion image, targeted biopsy of suspicious areas on MRI is possible and fusion image guided biopsy can provide improved detection rate. In conclusion, with recent advances in multiparametric-MRI, and introduction of new US techniques such as contrast-enhanced US and elastography, TRUS-guided biopsy may evolve toward

  6. Transrectal Ultrasound Guided Biopsy of the Prostate: Is the Information Accessible, Usable, Reliable and Readable?

    Science.gov (United States)

    Redmond, Ciaran E.; Nason, Gregory J.; Kelly, Michael E.; McMahon, Colm; Cantwell, Colin P.; Quinlan, David M.

    2015-01-01

    Background/Aims To evaluate the accessibility, usability, reliability and readability of Internet information regarding transrectal ultrasound (TRUS) guided biopsy of the prostate. Materials and Methods The terms “prostate biopsy”, “TRUS biopsy” and “transrectal ultrasound guided biopsy of the prostate” were separately entered into the each of the top 5 most accessed Internet search engines. Websites were evaluated for accessibility, usability and reliability using the LIDA tool – a validated tool for the assessment of health related websites. Website readability was assessed using the Flesch Reading Ease Score and the Flesch Kincaid Grade Level. Results Following the application of exclusion criteria, 82 unique websites were analyzed. There was a significant difference in scores depending on authorship categories (p ≤ 0.001), with health related charity websites scoring highest (mean 122.29 ± 13.98) and non-academic affiliated institution websites scoring lowest (mean 87 ± 19.76). The presence of advertisements on a website was associated with a lower mean overall LIDA tool score (p = 0.024). Only a single website adhered to the National Institutes for Health recommendations on readability. Conclusions This study demonstrates variability in the quality of information available to Internet users regarding TRUS biopsies. Collaboration of website design and clinical acumen are necessary to develop appropriate websites for patient benefit. PMID:26195961

  7. Effectiveness of stress management in patients undergoing transrectal ultrasound-guided biopsy of the prostate

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    Chiu LP

    2016-02-01

    Full Text Available Li-Pin Chiu,1,2 Heng-Hsin Tung,3 Kuan-Chia Lin,3 Yu-Wei Lai,1,4 Yi-Chun Chiu,1,4 Saint Shiou-Sheng Chen,1,4 Allen W Chiu1,4 1Division of Urology, Taipei City Hospital, 2University of Taipei, General Education Center, 3School of Nursing, Department of Care Management, National Taipei University of Nursing and Health Science, 4Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China Background: To assess the utilization of stress management in relieving anxiety and pain among patients who undergo transrectal ultrasound (TRUS-guided biopsy of the prostate.  Methods: Eighty-two patients admitted to a community hospital for a TRUS biopsy of the prostate participated in this case-controlled study. They were divided into an experimental group that was provided with stress management and a control group that received only routine nursing care. Stress management included music therapy and one-on-one simulation education. Before and after the TRUS biopsy, the patients’ state-anxiety inventory score, pain visual analogue scale (VAS, respiratory rate, heart rate, and blood pressure were obtained.  Results: There were no differences in baseline and disease characteristics between the two groups. The VAS in both groups increased after the TRUS biopsy, but the difference in pre- and postbiopsy VAS scores was significantly lower in the experimental group (P=0.03. Patients in both groups experienced mild anxiety before and after the biopsy, but those in the experimental group displayed a significantly greater decrease in postbiopsy state-anxiety inventory score compared to the control group (P=0.02.Conclusion: Stress management can alleviate anxiety and pain in patients who received a TRUS biopsy of the prostate under local anesthesia. Keywords: anxiety, pain, stress management, transrectal ultrasound-guided biopsy of the prostate

  8. Quinolone Prophylaxis in Transrectal Ultrasound Guided Prostate Biopsy: An Eight-Year Single Center Experience

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    Bing-Juin Chiang

    2013-01-01

    Full Text Available We retrospectively evaluated the efficacy of prophylaxis with pipemidic acid and levofloxacin in transrectal ultrasound guided prostate biopsy (TRUSP-Bx. From January 2002 to December 2004, patients receiving oral pipemidic acid 500 mg twice daily for three days with or without a preoperative intravenous cefazolin 1 gm injection comprised group A. Between January 2005 and December 2009, patients receiving oral levofloxacin 500 mg one hour before biopsy comprised group B. We calculated the annual febrile urinary tract infection (fUTI rates. Patients’ characteristics, including age, prophylactic antibiotics, biopsy core numbers, pathologic results, PSA, and the spectrums and susceptibility of pathogens, were also evaluated. A total of 1313 (35.5% patients belonged to group A, while 2381 (64.5% patients belonged to group B. Seventy-three patients experienced postoperative infectious complications. There was a significant difference in the fUTI rate between groups A and B (3.7% versus 1.0%, P<0.001. The yearly fUTI rates varied from 0.6 to 3.9% between 2002 and 2009. Of the 73 patients with fUTI, those receiving levofloxacin prophylaxis were more likely to harbor fluoroquinolone-resistant pathogens (P<0.001. E. coli was the most common pathogen in both groups. Levofloxacin remains effective and appears superior to pipemidic acid based prophylaxis.

  9. Safety of transrectal ultrasound-guided prostate biopsy in patients affected by Crohn’s disease

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    Lucio Dell'Atti

    2017-06-01

    Full Text Available Purpose: Crohn’s disease (CD is a chronic inflammatory condition of the gastrointestinal tract. It is usually considered a contraindication to transrectal ultrasound-guided prostate biopsy (TRUSBx. The aim of this study was to investigate the safety of TRUSBx in a small cohort of patients with CD. Methods: We queried our institutional database clinical data of patients with a diagnosis of CD undergoing TRUSBx, and a retrospective prospective study of 5 patients was planned. All patients enrolled were in the remission phase of CD and asymptomatic. They received the same antibiotic prophylaxis and a povidone-iodine aqueous solution enema before the procedure. A standardized reproducible technique was used with using a ultrasound machine equipped with a 5-9 MHz multifrequency convex probe “end-fire”. The patients were treated under local anaesthesia, and a 14-core biopsy scheme was performed in each patient as first intention. After the procedure each patient was given a verbal numeric pain scale to evaluate tolerability of TRUSBx. Results: TRUSBx was successfully completed in all patients. The number of biopsy cores was 14 (12-16. Of the 5 biopsy procedures performed 40% revealed prostatic carcinoma (PCa with a Gleason score 6 (3+3. No patients required catheterization or admission to the hospital for adverse events after the procedure. The most frequent adverse event was hematospermia (60%, while hematuria was present in 20% of patients and a minimal rectal bleeding in 20% of the patients. No patients reported severe or unbearable pain (score ≥ 8. Conclusions: This study suggests that CD may not be an absolute contraindication to TRUSBx for prostate cancer detection, but still requires a careful patients selection.

  10. Routine Ertapenem Prophylaxis for Transrectal Ultrasound Guided Prostate Biopsy does Not Select for Carbapenem Resistant Organisms: A Prospective Cohort Study.

    Science.gov (United States)

    Bloomfield, Maxim G; Page, Matthew J; McLachlan, Alice G; Studd, Rodney C; Blackmore, Timothy K

    2017-03-10

    Sepsis after transrectal ultrasound guided prostate biopsy is an increasing problem in this era of rising antibiotic resistance. Although ertapenem prophylaxis has proved effective at our institution to reduce this, it has raised local and regional antimicrobial stewardship concerns. We investigated the possible selective effect of single dose ertapenem prophylaxis on fecal colonization with carbapenem resistant Enterobacteriaceae. Patients underwent a rectal swab prior to receiving prebiopsy ertapenem prophylaxis. A second swab was obtained at followup 4 to 6 weeks later. Swabs were screened for carbapenem resistant Enterobacteriaceae using an enhanced CDC (Centers for Disease Control) method. Prebiopsy swabs were also screened for extended spectrum β-lactamase producing and ciprofloxacin resistant Enterobacteriaceae. Patients were monitored for post-biopsy sepsis. A total of 326 patients were enrolled in the study. At baseline 6.4% and 9.0% of patients had colonization with extended spectrum β-lactamase producing and ciprofloxacin resistant Enterobacteriaceae, respectively. Carbapenem resistant Enterobacteriaceae were not detected at baseline or followup in any patients. Colonization with nonfermentative organisms with intrinsic ertapenem resistance was detected in 29.4% of patients at baseline and followup (p = 1.0). Three cases (0.9%, 95% CI 0.2-2.8) of probable post-biopsy sepsis were identified during the study period. None was bacteremic or required intensive care unit admission. Single dose ertapenem prophylaxis did not appear to have a significant selective effect on fecal colonization with carbapenem resistant Enterobacteriaceae or other ertapenem resistant gram-negative organisms in this outpatient group. It is highly effective prophylaxis for transrectal ultrasound guided prostate biopsy. In the right setting ertapenem may represent a useful prophylactic option to prevent post-transrectal ultrasound guided prostate biopsy sepsis. Copyright © 2017

  11. Patient information leaflets for Transrectal Ultrasound guided prostate biopsy: Results of North Thames deanery survey

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    Phipps Claire

    2010-01-01

    Full Text Available Abstract Background We evaluated the quality of patient information leaflets for Trans-Rectal Ultrasound guided prostate biopsies (TRUS-Bx in North Thames region. TRUS-Bx information leaflets were requested from 24 hospitals in the region. All hospitals were contacted by telephone, and non-responders were followed-up by postal survey. Leaflets received were evaluated for a clear description of the procedure, directions to TRUS-Bx location, a clear description of the procedure, contact for queries/concerns, information about preparation prior to procedure, information about regular medication, information on how to obtain results, instructions for follow-up arrangements, analgesia used and risk of morbidity/mortality. Additionally, the leaflets were evaluated for diagrams to clarify the procedure and the anatomy, and sources of additional information, such as reference to published articles or prostate cancer patient support groups/internet websites. Findings In summary, a total of 17 leaflets (77% were received. Of these, the majority (94% had a clear description of the procedure, contact for queries/concerns (82%, information about preparation prior to TRUS-Bx (71%. Directions to TRUS-Bx location (29%, and analgesia used (35%, was very poorly described, and information on obtaining results and follow-up arrangements were described in only 12 (71% leaflets. Complications such as risks of infection, haematuria, haematospermia and rectal bleeding, were generally explained (71%-76% of leaflets, urinary retention was mentioned in only 5 (29% leaflets and mortality in only 1 case. Descriptive diagrams of the procedure and prostate anatomy were very rarely used, and sources of additional information were limited to 1 published article and reference to 1 prostate cancer support group. Conclusions This study demonstrates that there is large variation in the information supplied in TRUS-Bx patient information leaflets in the North Thames region, with

  12. Analgesic Efficacy of Intrarectal Instillation of Lidocaine Gel prior to Transrectal Ultrasound Guided Prostate Biopsy: A Prospective Randomized Trial

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    Yun, Tae Jin; Kim, Seung Hyup; Cho, Jeong Yeon [Seoul National University Hospital, Seoul (Korea, Republic of); Lee, Hak Jong; Lee, Sang Eun; Byun, Seok Soo [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Seong, Chang Kyu [Seoul National University Borame Hospital, Seoul (Korea, Republic of)

    2006-06-15

    To assess the analgesic efficacy of intrarectal lidocaine gel instillation prior to periprostatic nerve block during transrectal, ultrasound-guided prostate biopsies. Between March 2004 and October 2004, 203 consecutive patients for prostate biopsies were randomized into two groups. In 90 patients of group A, 10ml of 2% lidocaine gel was instilled intrarectally 10 minutes prior to periprostatic neurovascular bundle block, while 113 patients of group B received only periprostatic neurovascular bundle block without lidocaine gel instillation. Pain was assessed with the visual analogue pain scale, during periprostatic neurovascular bundle block (VAS 1), during the biopsy procedures (VAS 2) and 20 minutes after the procedure (VAS 3). The difference in VAS scores between patients in the two groups was evaluated with the unpaired t-test, with p < 0.05 considered significant. Patients in group A experienced statistically less pain during transrectal ultrasound guided prostate biopsy (VAS 2, 2.994 versus 3.903, p < 0.01). However, no significant difference in VAS values could be demonstrated during periprostatic neurovascular bundle block (VAS 1, 4.761 versus 5.133, p > 0.05) or at after 20 minutes after the procedure (VAS 3, 0.9778 versus 1.257, p > 0.05). Intrarectal instillation of lidocaine gel leads to significant additional analgesic efficacy during the biopsy procedure. It is a simple, safe and rapid technique that should be considered in all patients undergoing TRUS guided prostate biopsy

  13. Tolerance of local anesthetic for transrectal ultrasound-guided prostate biopsy: our experience and a literature review

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    Buckley, M.R.E.; Bryant, N.J.; Brown, J.A.; Tiwari, P.; Cooperberg, P.L.; Wong, A.D. [St Paul' s Hospital, Ultrasound Dept., Vancouver, British Columbia (Canada)]. E-mail: twong@providcencehealth.bc.ca

    2006-06-15

    To determine whether local anesthetic injection or gel reduced pain during transrectal ultrasound-guided prostate biopsies and whether there was significant difference between quadrant and apex-only anesthesia. Between September 2001 and May 2002, 240 male patients with elevated prostate-specific antigen and (or) abnormal digital rectal examination were randomized into 1 of 4 groups: 1) transrectal lidocaine gel, 2) quadrant lidocaine injections, 3) apex-only lidocaine injections, or 4) no local anesthetic. Patients scored their pain on a numerical rating scale where 0 indicated no pain and 10 indicated worst pain. We analyzed mean and standard deviations of scores, using a 1-way analysis of variance (ANOVA) and post hoc multiple comparisons with Tukey's honestly significant difference (HSD) studentized range test to determine whether there were significant differences across the groups. There was no significant difference between local anesthetic gel (mean 3.1, SD 1.9) and no anesthetic (mean 3.5, SD 1.9) or between quadrant (mean 1.7, SD 1.7) and apex-only (mean 2.0, SD 1.8) local anesthetic injections. There was significant difference between quadrant injections (mean 1.7, SD 1.7) and no local anesthetic (mean 3.5, SD 1.9) and between apex-only injections (mean 2.0, SD 1.8) and no local anesthetic (mean 3.5, SD 1.9). There was significant pain reduction with local anesthetic injections but not with gel, and since there was no significant difference in efficacy between quadrant and apex-only injections, we recommend apex-only local anesthetic injections for transrectal ultrasound-guided prostate biopsies because it simplifies the injection procedure. (author)

  14. A Prospective Comparison of Selective Multiparametric Magnetic Resonance Imaging Fusion-Targeted and Systematic Transrectal Ultrasound-Guided Biopsies for Detecting Prostate Cancer in Men Undergoing Repeated Biopsies

    DEFF Research Database (Denmark)

    Boesen, Lars; Nørgaard, Nis; Løgager, Vibeke

    2017-01-01

    + 3) cancers (14/64 vs. 41/74) and more patients with intermediate/high-grade cancers (GS ≥3 + 4) (50/64 vs. 33/74) using fewer biopsy cores compared with TRUS-bx (p targeted-only" approach in men with PI-RADS ≥3 lesions reduced the number of men requiring repeated biopsies......INTRODUCTION: The aim of the study was to compare the prostate cancer (PCa) detection rate of systematic transrectal ultrasound-guided biopsies (TRUS-bx) and multiparametric-MRI targeted biopsies (mp-MRI-bx) in a repeat biopsy setting and evaluate the clinical significance following an "MRI-targeted...... by 50%, decreased low-grade cancer diagnoses by 66%, and increased intermediate/high-grade cancer diagnoses by 52%. CONCLUSIONS: MRI-targeted biopsies have a high detection rate for significant PCa in patients with prior negative transrectal ultrasound-guided biopsies and preferentially detect...

  15. The Rectal Administration of Lignocaine Gel and Periprostatic Lignocaine Infiltration During Transrectal Ultrasound-Guided Prostate Biopsy Provides Effective Analgesia

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    Siddiqui, EJ; Ali, S; Koneru, S

    2006-01-01

    INTRODUCTION Transrectal ultrasound guided prostate needle biopsy (TRUS) is the standard procedure to diagnose or exclude prostate cancer. This procedure can be associated with significant discomfort, both on insertion of the ultrasound probe as well as on taking the biopsy. We evaluated a new technique for pain relief during TRUS biopsy. PATIENTS AND METHODS In Group 1 (n = 60), the biopsies were taken without any analgesia. In Group 2 (n = 60), 11 ml of Instillagel (2% lignocaine) was administered rectally prior to probe insertion and 5 ml of 1% lignocaine periprostatic injection was administered before taking the biopsy. The discomfort encountered during the procedure was graded by the patient on a scale ranging from no discomfort to mild, moderate and severe pain. RESULTS In Group 2, there was a marked reduction in the pain experienced during the procedure. The Chi-squared test for trend showed a significant association between the rectal administration of local anaesthetic gel and reduction in pain on probe insertion (P = 0.0001). There was also a significant association between the use of periprostatic lignocaine injection and reduction in pain on taking the biopsy (P < 0.0001). CONCLUSIONS The use of lignocaine gel prior to probe insertion and periprostatic infiltration of lignocaine before taking the needle biopsy significantly reduces the pain experienced by the patient during TRUS-guided prostate biopsy. PMID:16551424

  16. [Pain during transrectal ultrasound guided needle biopsy of the prostate: comparison of the use or not of lidocaine gel].

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    Díaz Pérez, Gilmer A; Meza Montoya, Luis; Morante Deza, Carlos; Pow-Sang Godoy, Mariela; Destefano Urrutia, Víctor

    2009-02-01

    The prostate biopsy guided by ultrasound is the method of choice for early diagnosis of prostate cancer, is a safe whose main trouble is that it feels discomfort during the procedure. From July 2004 until March 2005 we prospectively studied 114 patients who underwent transrectal ultrasound guided needle biopsy of the prostate, they were divided in two groups: in one group we used lidocaina gel 2% inside the rectum before the procedure and in the other group we did not use it. We compared the pain that patients felt during the procedure with a pain scale. We did not find differences between both groups, but the patients in whom we used a new needle felt less pain than the patients in whom we used a re-esterilized one. The use of lidocaine gel intrarectal 2% before a prostate biopsy guided by ultrasound did not diminish the sensation of pain from the procedure in our patients, which was increased by the use of sterilized needles.

  17. Lidocaine suppository for transrectal ultrasound-guided biopsy of the prostate: a prospective, double-blind, randomized study.

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    Goluza, Eleonora; Hudolin, Tvrtko; Kastelan, Zeljko; Peric, Mladen; Murselovic, Tamara; Sosic, Hrvoje

    2011-01-01

    To investigate analgesia using lidocaine suppositories for prostate biopsy. From 2007 to 2009, 160 patients underwent transrectal ultrasound-guided prostate biopsy at the Department of Urology, KBC Zagreb. 80 patients received a 60-mg lidocaine suppository intrarectally at different time points from 15 to 120 min before biopsy and 80 patients received a glycerin suppository as placebo. The pain level was evaluated using a visual analogue scale (VAS). There were no statistically significant differences between the groups, i.e. they were similar regarding patients' age, prostate-specific antigen levels, prostate volume and the incidence of diagnosis of malignancy on biopsy. The mean pain score in the lidocaine group (3 ± 1) was significantly lower than the mean pain score in the glycerin group (4.1 ± 1.3) (p suppository till the biopsy and the optimal time for performing biopsy starting approximately 1 h after placing the suppository. Lidocaine suppositories are an easy-to-use, self-applicable (by the patient) and cheap method of local analgesia, with acceptable results. Possible complications related to this procedure are insignificant. Copyright © 2011 S. Karger AG, Basel.

  18. [Use of intrarectal lidocaine gel in ultrasound-guided transrectal biopsies of the prostate].

    Science.gov (United States)

    García Mediero, J M; Martínez-Piñeiro Lorenzo, L; Núñez Mora, C; de Fata Chillón, F Ramón; Cruz Jimeno, J L; Alonso y Gregorio, S; de la Peña Barthel, J J

    2003-01-01

    To know in a quantitative manner the degree of discomfort and pain of the biopsies of the prostate and to evaluate the effectiveness of the transrectal lidocaine. We performed 140 transrectal biopsies of the prostate, Patients were included on a random basis into two arms: one of them received intrarectal lidocaine, 20 mg (group 1, n = 71) and the other group received placebo (group 2, n = 28) both of them ten minutes prior the proceeding. The global pain mean was 3.7 (0 no pain, 10 highest pain) and the global discomfort mean was 3.5. The group 1 patients showed a trend to feel less pain and discomfort although it did not reach the necessary statistic significance (p = 0.7 y p = 0.5 respectively). We do not achieve the good results obtained by other groups in order to decrease the degree of pain and discomfort with the use of intrarectal lidocaine. We did not find relationship between the PSA level, previous biopsies, intrarectal lidocaina and degree of information received and the degree of pain and discomfort.

  19. Efficacy and cost analysis of transrectal ultrasound-guided prostate biopsy under monitored anesthesia

    Institute of Scientific and Technical Information of China (English)

    Sung Gu Kang; Bum Sik Tae; Sam Hong Mine; Young Hwu Ko; Seok Ho Kang; Jeong Gu Lee; Je Jong Kim; Jun Cheon

    2011-01-01

    @@ Sedation may result in reduction in pain during transrectal ultrasound(TRUS)-guided prostate biopsies.We aimed to evaluate the efficacy and safety of a combination of propofol and remifentanil infusion during TRUS-guided prostate biopsy and the related increases in health care costs.From January to September 2010,100 men undergoing a transrectal prostate biopsy were randomized into two groups.In Group 1,[50]patients received a combined infusion of propofol and remifentanil; in Group 2,[50]patients received lidocaine jelly.After TRUS-guided biopsies were performed,pain and patient satisfaction were evaluated by a 10-point visual analog scale (VAS),and a cost-related patient satisfaction questionnaire was completed by all patients.Patients were also asked whether they would be willing to undergo repeat biopsy by the same method.Patients in Group 1 showed a significantly lower VAS score than those in Group 2 (mean VAS score: 0.9士1.1 versus 6.312.5; P<0.001).In addition,the patient satisfaction scale was significantly higher in Group 1(P=0.002).Although the overall cost was significantly higher in Group 1(P=0.006),patient satisfaction scales considering cost were also higher in this group (P=0.009).A combination of propofol and remifentanil is a safe and effective way to decrease patient pain and increase patient satisfaction during TRUS-guided prostate biopsy.Although the costs were higher in the group that received sedation,as expected,the patients exhibited heightened satisfaction and willingness to repeat biopsies by the same method.

  20. Transrectal ultrasound-guided biopsy of the prostate: aspirin increases the incidence of minor bleeding complications

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    Halliwell, O.T. [Department of Radiology, Southampton General Hospital, Southampton (United Kingdom)], E-mail: hallo99@doctors.org.uk; Yadegafar, G. [Public Health Sciences and Medical Statistics Division, School of Medicine, Southampton General Hospital, Southampton University, Southampton (United Kingdom); Lane, C.; Dewbury, K.C. [Department of Radiology, Southampton General Hospital, Southampton (United Kingdom)

    2008-05-15

    Aim: To assess whether patients taking aspirin were more likely to experience bleeding complications after transrectal ultrasound (TRUS)-guided prostate biopsy. Materials and methods: Three hundred and eighty-seven patients taking aspirin who underwent prostate biopsy over a 3.5 year period and 731 patients not taking aspirin over a 2 year period returned a questionnaire assessing the incidence and severity of bleeding complications. Results: Patients taking aspirin had a significantly higher cumulative incidence of haematuria and rectal bleeding, but not of haemospermia. They also had a longer mean duration of bleeding, but no increase in bleeding severity. Severe bleeding was very uncommon in both groups and no patients required intervention for bleeding complications. Conclusion: Aspirin exacerbates minor bleeding complications in patients undergoing TRUS guided biopsy of the prostate, but in this large group of aspirin-taking patients no dangerous bleeding complications were encountered. It may be that the risks associated with aspirin cessation outweigh the risks of haemorrhagic complications.

  1. Complications and risk factors in transrectal ultrasound-guided prostate biopsies

    Directory of Open Access Journals (Sweden)

    Carlos Márcio Nóbrega de Jesus

    Full Text Available CONTEXT AND OBJECTIVE: Prostate biopsy is not a procedure without risk. There is concern about major complications and which antibiotics are best for routine use before these biopsies. The objective was to determine the rate of complications and the possible risk factors in prostate biopsies. DESIGN AND SETTING: Prospective study, Faculdade de Medicina de Botucatu. METHODS: Transrectal ultrasound (TRUS guided prostate biopsies were carried out in 174 patients presenting either abnormality in digital rectal examinations (DRE or levels higher than 4 ng/ml in prostate-specific antigen (PSA tests, or both. RESULTS: Hemorrhagic complications were the most common (75.3%, while infectious complications occurred in 19% of the cases. Hematuria was the most frequent type (56%. Urinary tract infection (UTI occurred in 16 patients (9.2%. Sepsis was observed in three patients (1.7%. The presence of an indwelling catheter was a risk factor for infectious complications (p < 0.05. Higher numbers of biopsies correlated with hematuria, rectal bleeding and infectious complications (p < 0.05. The other conditions investigated did not correlate with post-biopsy complications. CONCLUSIONS: Post-biopsy complications were mostly self-limiting. The rate of major complications was low, thus showing that TRUS guided prostate biopsy was safe and effective. Higher numbers of fragments taken in biopsies correlated with hematuria, rectal bleeding and infectious complications. An indwelling catheter represented a risk factor for infectious complications. The use of aspirin was not an absolute contraindication for TRUS.

  2. Effectiveness of stress management in patients undergoing transrectal ultrasound-guided biopsy of the prostate.

    Science.gov (United States)

    Chiu, Li-Pin; Tung, Heng-Hsin; Lin, Kuan-Chia; Lai, Yu-Wei; Chiu, Yi-Chun; Chen, Saint Shiou-Sheng; Chiu, Allen W

    2016-01-01

    To assess the utilization of stress management in relieving anxiety and pain among patients who undergo transrectal ultrasound (TRUS)-guided biopsy of the prostate. Eighty-two patients admitted to a community hospital for a TRUS biopsy of the prostate participated in this case-controlled study. They were divided into an experimental group that was provided with stress management and a control group that received only routine nursing care. Stress management included music therapy and one-on-one simulation education. Before and after the TRUS biopsy, the patients' state-anxiety inventory score, pain visual analogue scale (VAS), respiratory rate, heart rate, and blood pressure were obtained. There were no differences in baseline and disease characteristics between the two groups. The VAS in both groups increased after the TRUS biopsy, but the difference in pre- and postbiopsy VAS scores was significantly lower in the experimental group (P=0.03). Patients in both groups experienced mild anxiety before and after the biopsy, but those in the experimental group displayed a significantly greater decrease in postbiopsy state-anxiety inventory score compared to the control group (P=0.02). Stress management can alleviate anxiety and pain in patients who received a TRUS biopsy of the prostate under local anesthesia.

  3. Rare complication after a transrectal ultrasound guided prostate biopsy: a giant retroperitoneal hematoma.

    Science.gov (United States)

    Chiancone, Francesco; Mirone, Vincenzo; Fedelini, Maurizio; Meccariello, Clemente; Pucci, Luigi; Carrino, Maurizio; Fedelini, Paolo

    2016-05-24

    Common complications related to transrectal ultrasound (TRUS) guided prostatic needle biopsy are hematuria, hematospermia, and hematochezia. To the best of our knowledge, we report the second case of a very large hematoma extending from the pelvis into the retroperitoneal space in literature.A 66-year-old man with a serum prostate-specific antigen (PSA) of 5.4 ng/ml was admitted to our department for a TRUS-guided prostatic needle biopsy. Laboratory values on the day before biopsy, including coagulation studies, were all normal. The patients did not take any anticoagulant drugs. No immediate complications were encountered. Nevertheless, 7 hours after the biopsy, the patient reached our emergency department with severe diffuse abdominal pain, hypotension, tachycardia, and confusional state. He underwent an ultrasonography and then a computed tomography (CT) scan that showed "a blood collection in the pelvis that extending to the lower pole of left kidney associated with a focus of active contrast extravasation, indicating active ongoing prostate bleeding." Consequently, he underwent a diagnostic angiography that showed no more contrast extravasation, without the need of embolization. Management of hematoma has been conservative and hematoma was completely reabsorbed 4 months later.

  4. Development and validation of a virtual reality transrectal ultrasound guided prostatic biopsy simulator

    Science.gov (United States)

    Chalasani, Venu; Cool, Derek W.; Sherebrin, Shi; Fenster, Aaron; Chin, Joseph; Izawa, Jonathan I

    2011-01-01

    Objective We present the design, reliability, face, content and construct validity testing of a virtual reality simulator for transrectal ultrasound (TRUS), which allows doctors-in-training to perform multiple different biopsy schemes. Methods This biopsy system design uses a regular “end-firing” TRUS probe. Movements of the probe are tracked with a micro-magnetic sensor to dynamically slice through a phantom patient’s 3D prostate volume to provide real-time continuous TRUS views. 3D TRUS scans during prostate biopsy clinics were recorded. Intrinsic reliability was assessed by comparing the left side of the prostate to the right side of the prostate for each biopsy. A content and face validity questionnaire was administered to 26 doctors to assess the simulator. Construct validity was assessed by comparing notes from experts and novices with regards to the time taken and the accuracy of each biopsy. Results Imaging data from 50 patients were integrated into the simulator. The completed VR TRUS simulator uses real patient images, and is able to provide simulation for 50 cases, with a haptic interface that uses a standard TRUS probe and biopsy needle. Intrinsic reliability was successfully demonstrated by comparing results from the left and right sides of the prostate. Face and content validity respondents noted the realism of the simulator, and its appropriateness as a teaching model. The simulator was able to distinguish between experts and novices during construct validity testing. Conclusions A virtual reality TRUS simulator has successfully been created. It has promising face, content and construct validity results. PMID:21470507

  5. The effectivity of periprostatic nerve blockade for the pain control during transrectal ultrasound guided prostate biopsy

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    Alper Otunctemur

    2013-06-01

    Full Text Available Aim: Transrectal ultrasound (TRUS guided prostete biopsy is accepted as a standard procedure in the diagnosis of prostate cancer. Many different protocoles are applied to reduce the pain during the process. In this study we aimed to the comparison of two procedure with intrarectal lidocaine gel and periprostatice nerve blockade respective- ly in addition to perianal intrarectal lidocaine gel on the pain control in prostate biop- sy by TRUS. Methods: 473 patients who underwent prostate biopsy guided TRUS between 2008-2012 were included in the study. 10-point linear visual analog pain scale(VAS was used to evaluate the pain during biopsy. The patients were divided into two groups according to anesthesia procedure. In Group 1, there were 159 patients who had perianal-intrarectal lidocaine gel, in Group 2 there were 314 patients who had periprostatic nerve blockade in addition to intrarectal lidocain gel. The pain about probe manipulation was aseesed by VAS-1 and during the biopsy needle entries was evalu- ated by VAS-2. Results were compared with Mann-Whitney U and Pearson chi-square test. Results: Mean VAS-2 scores in Group 1 and Group 2 were 4.54 ± 1.02 and 2.06 ± 0.79 respectively. The pain score was determined significantly lower in the Group 2 (p = 0.001. In both groups there was no significant difference in VAS-1 scores, patient’s age, prostate volume, complication rate and PSA level. Conclusion: The combination of periprostatic nerve blockade and intrarectal lidocain gel provides a more meaningful pain relief compared to group of patients undergoing intrarectal lidocaine gel.

  6. Multi-drug resistant E.coli urosepsis in physicians following transrectal ultrasound guided prostate biopsies--three cases including one death.

    Science.gov (United States)

    Carlson, William H; Bell, David G; Lawen, Joseph G; Rendon, Ricardo A

    2010-04-01

    Three male physicians underwent transrectal ultrasound guided prostate biopsies for elevated prostate-specific antigen levels or irregular digital rectal exam findings. All three of these patients developed urosepsis secondary to multi-drug resistant organisms despite antibiotic prophylaxis. There are increasing reports of infectious complications following prostate biopsy caused by multi-drug resistant organisms. These cases highlight the potentially lethal risks to healthcare workers who are more likely to harbor multi-drug resistant organisms than the general population. Further research into preoperative assessment and appropriate antibiotic prophylaxis in all potentially high risk patients is warranted.

  7. Morbidade da biópsia da próstata transretal guiada por ultrassonografia Morbidity of transrectal ultrasound guided prostate biopsy

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    Raphael Sandes Solha

    2013-04-01

    Full Text Available OBJETIVO: Avaliar a incidência de complicações pós-procedimento nos pacientes submetidos a biópsia prostática transretal guiada por ultrassom no setor de intervenção do Departamento de Diagnóstico por Imagem da Escola Paulista de Medicina - Universidade Federal de São Paulo. MATERIAIS E MÉTODOS: Foram avaliados, via contato telefônico, 132 pacientes submetidos a biópsia de próstata transretal guiada por ultrassom no período de abril/2011 a junho/2011, seguindo o protocolo padrão do nosso setor. RESULTADOS: As complicações pós-biópsia foram categorizadas em maiores e menores de acordo com a necessidade de avaliação médica adicional. Cinquenta e nove pacientes (61,8% apresentaram complicações, e desses, grande parte (86,4% apresentou sintomas leves e autolimitados, considerados menores. Oito pacientes (8,2% apresentaram complicações maiores, sendo que apenas um deles necessitou de tratamento sob regime de internação hospitalar. A retenção urinária foi a complicação maior mais incidente no nosso estudo. CONCLUSÃO: Corroborando outros estudos da literatura, nosso trabalho demonstrou baixa prevalência de complicações maiores após a biópsia prostática transretal.OBJECTIVE: To evaluate the incidence of postprocedural complications in patients submitted to transrectal ultrasound-guided prostate biopsy at the Unit of Intervention, Department of Imaging Diagnosis of Escola Paulista de Medicina - Universidade Federal de São Paulo. MATERIALS AND METHODS: Telephone interviews were conducted with 132 patients who had undergone transrectal ultrasound-guided prostate biopsy in the period from April 2011 to June 2011, according to the institution's protocol. RESULTS: Post-biopsy complications were categorized into two groups - minor and major complications, according to their need for further clinical evaluation. Complications were reported by 59 patients (61.8%, most of them (86.4% with mild and self-limited symptoms

  8. Role of information in preparing men for transrectal ultrasound guided prostate biopsy: a qualitative study embedded in the ProtecT trial.

    Science.gov (United States)

    Wade, Julia; Rosario, Derek J; Howson, Joanne; Avery, Kerry N L; Salter, C Elizabeth; Goodwin, M Louise; Blazeby, Jane M; Lane, J Athene; Metcalfe, Chris; Neal, David E; Hamdy, Freddie C; Donovan, Jenny L

    2015-02-28

    The histological diagnosis of prostate cancer requires a prostate needle biopsy. Little is known about the relationship between information provided to prepare men for transrectal ultrasound guided biopsy (TRUS-Bx) and how men experience biopsy. The objectives were a) to understand men's experiences of biopsy as compared to their expectations; and b) to propose current evidence-based information for men undergoing TRUS-Bx. Between February 2006 and May 2008, 1,147 men undergoing a standardised 10-core transrectal ultrasound guided biopsy protocol under antibiotic cover following a PSA 3.0-19.9 ng/ml in the Prostate Testing for Cancer and Treatment (ProtecT) trial, completed questionnaires about biopsy symptoms. In this embedded qualitative study, in-depth interviews were undertaken with 85 men (mean age 63.6 yrs, mean PSA 4.5 ng/ml) to explore men's experiences of prostate biopsy and how the experience might be improved. Interview data were analysed thematically using qualitative research methods. Findings from the qualitative study were used to guide selection of key findings from the questionnaire study in developing a patient information leaflet preparing men for biopsy. Although most men tolerated TRUS-Bx, a quarter reported problematic side-effects and anxiety. Side effects were perceived as problematic and anxiety arose most commonly when experiences deviated from information provided. Men who were unprepared for elements of TRUS-Bx procedure or its sequelae responded by contacting health professionals for reassurance and voiced frustration that pre-biopsy information had understated the possible severity or duration of pain/discomfort and bleeding. Findings from questionnaire and interview data were combined to propose a comprehensive, evidence-based patient information leaflet for TRUS-Bx. Men reported anxiety associated with TRUS-Bx or its side-effects most commonly if they felt inadequately prepared for the procedure. Data from this qualitative study and

  9. Pain during Transrectal Ultrasound-Guided Prostate Biopsy and the Role of Periprostatic Nerve Block: What Radiologists Should Know

    Energy Technology Data Exchange (ETDEWEB)

    Nazir, Babar [Dept. of Oncologic Imaging, National Cancer Centre, Singapore (Singapore)

    2014-10-15

    Early prostate cancers are best detected with transrectal ultrasound (TRUS)-guided core biopsy of the prostate. Due to increased longevity and improved prostate cancer screening, more men are now subjected to TRUS-guided biopsy. To improve the detection rate of early prostate cancer, the current trend is to increase the number of cores obtained. The significant pain associated with the biopsy procedure is usually neglected in clinical practice. Although it is currently underutilized, the periprostatic nerve block is an effective technique to mitigate pain associated with prostate biopsy. This article reviews contemporary issues pertaining to pain during prostate biopsy and discusses the practical aspects of periprostatic nerve block.

  10. Fluoroquinolone-resistant E. coli in intestinal flora of patients undergoing transrectal ultrasound-guided prostate biopsy--should we reassess our practices for antibiotic prophylaxis?

    Science.gov (United States)

    Steensels, D; Slabbaert, K; De Wever, L; Vermeersch, P; Van Poppel, H; Verhaegen, J

    2012-06-01

    Although the estimate of the incidence of sepsis following transrectal ultrasound-guided prostate biopsy (TRUSPB) is low, fluoroquinolone-resistant infections after prostate biopsy are being increasingly noted. This study was aimed at determining the prevalence of faecal carriage of fluoroquinolone-resistant Escherichia coli strains before TRUSPB and at evaluating potential predisposing risk factors. The incidence of sepsis after prostate biopsy was determined, and our routine practice for antibiotic prophylaxis for TRUSPB was evaluated. A prospective study was conducted in 342 consecutive patients undergoing prostate biopsy between December 2009 and July 2010. Before TRUSPB, a rectal swab was cultured. The correlation between the presence of fluoroquinolone-resistant strains and plausible risk factors was investigated by the use of a questionnaire. Of the 236 patients included, 22.0% (52/236) harboured ciprofloxacin-resistant E. coli strains. The use of fluoroquinolones in the 6 months before biopsy was associated with an increased risk of faecal carriage of fluoroquinolone-resistant E. coli strains (p fluoroquinolone-resistant E. coli strains was an important risk factor for infectious complications after TRUSPB (p fluoroquinolone-resistant E. coli strains (22.0%) before TRUSPB. The use of fluoroquinolones in the previous 6 months before biopsy is a risk factor for faecal carriage of fluoroquinolone-resistant E. coli strains and for infectious complications after TRUSPB. Hence, the universal administration of fluoroquinolones should be reconsidered. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.

  11. Application of transrectal ultrasound-guided repeat needle biopsy in the diagnosis of prostate cancer in Chinese population: A retrospective study

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    Yi Wang

    2016-01-01

    Full Text Available Background: Transrectal ultrasound-guided repeat needle biopsy (TUGRNB is widely used for diagnosis of prostate cancer (PCa. However, significance of TUGRNB in Chinese population was rarely reported. A retrospective study was conducted to evaluate the significance of TUGRNB applied in prediction of PCa in Chinese population. Materials and Methods: A total of 960 from January 2009 to December 2012 were included. Repeat needle biopsy rate and PCa positive detection rate were evaluated. Relationship between prostate specific antigen (PSA levels and PCa positive rates was analyzed. Results: PCa positive detection rate after initial needle biopsy was 28.4%, which was lower than the rate of repeat needle biopsy (40%. The rate for immediate transurethral resection (TUR, surgery after initial needle biopsy, was 27.1%, however with a low PCa positive detection rate (0.66%. The repeat needle biopsy rate was lower compared with the initial biopsy rate (P 20 ng/ml, PCa positive rate was significantly higher than those with PSA < 20 ng/ml (P < 0.05. Conclusion: PCa positive detection rate following repeat needle biopsy in Chinese population was higher, although the repeated needle biopsy rate was still in a low level. TUGRNB should attract more attention in the diagnosis of PCa.

  12. Postprostatectomy ultrasound-guided transrectal implantation of gold markers for external beam radiotherapy. Technique and complications rate

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    Langenhuijsen, J.F.; Kiemeney, L.A.L.M.; Witjes, J.A. [Radboud Univ. Nijmegen Medical Center, Nijmegen (Netherlands). Dept. of Urology; Donker, R. [Medical Center Alkmaar (Netherlands). Dept. of Radiation Oncology; McColl, G.M.; Lin, E.N.J.T. van [Radboud Univ. Nijmegen Medical Center, Nijmegen (Netherlands). Dept. of Radiation Oncology

    2013-06-15

    Background and purpose: Postprostatectomy radiotherapy (RT) improves survival in adjuvant and salvage settings. The implantation technique and complications rate of gold markers in the prostate bed for high-precision RT were analyzed. Patients and methods: Patients undergoing postprostatectomy RT for prostate-specific antigen (PSA) relapse or high-risk disease were enrolled in the study. Under transrectal ultrasound guidance, three fine gold markers were implanted in the prostate bed and the technical difficulties of insertion were documented. Patients received our self-designed questionnaires concerning complications and pain. The influence of anticoagulants and coumarins on bleeding was analyzed, as was the effect of potential risk factors on pain. Results: In 77 consecutive patients, failure of marker implantation or marker migration was seen in six cases. Rectal bleeding was reported by 10 patients and 1 had voiding complaints. No macroscopic hematuria persisting for more than 3 days was observed. Other complications included rectal discomfort (n = 2), nausea (n = 1), abdominal discomfort (n = 1), and pain requiring analgesics (n = 4). No major complications were reported. On a 0-10 visual analogue scale (VAS), the mean pain score was 3.7. No clinically significant risk factors for complications were identified. Conclusion: Transrectal implantation of gold markers in the prostate bed is feasible and safe. Alternatives like cone beam computed tomography (CBCT) should be considered, but the advantages of gold marker implantation for high-precision postprostatectomy RT would seem to outweigh the minor risks involved. (orig.)

  13. The Accuracy of Prostate Cancer Localization Diagnosed on Transrectal Ultrasound-Guided Biopsy Compared to 3-Dimensional Transperineal Approach

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    Kevin Krughoff

    2013-01-01

    Full Text Available Background. Prostate cancer is often understaged following 12-core transrectal ultrasound- (TRUS- guided biopsies. Our goal is to understand where cancers are typically missed by this method. Methods. Transperineal 3-dimensional mapping biopsy (3DMB provides a more accurate depiction of disease status than transrectal ultrasound- (TRUS- guided biopsy. We compared 3DMB findings in men with prior TRUS-guided biopsies to determine grade and location of missed cancer. Results were evaluated for 161 men with low-risk organ confined prostate cancer. Results. The number of cancer-positive biopsy zones per patient with TRUS was 1.38 ± 1.21 compared to 3.33 ± 4.06 with 3DMB, with most newly discovered cancers originating from the middle lobe and apex. Approximately half of all newly discovered cancerous zones resulted from anterior 3DMB sampling. Gleason upgrade was recognized in 56 patients using 3DMB. When both biopsy methods found positive cores in a given zone, Gleason upgrades occurred most frequently in the middle left and right zones. TRUS cancer-positive zones not confirmed by 3DMB were most often the basal zones. Conclusion. Most cancer upgrades and cancers missed from TRUS biopsy originated in the middle left zone of the prostate, specifically in anterior regions. Anterior sampling may lead to more accurate diagnosis and appropriate followup.

  14. Prostate biopsies guided by three-dimensional real-time (4-D) transrectal ultrasonography on a phantom: comparative study versus two-dimensional transrectal ultrasound-guided biopsies

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    Long, Jean-Alexandre; Moreau-Gaudry, Alexandre; Troccaz, Jocelyne; Rambeaud, Jean-Jacques; Descotes, Jean-Luc

    2007-01-01

    OBJECTIVE: This study evaluated the accuracy in localisation and distribution of real-time three-dimensional (4-D) ultrasound-guided biopsies on a prostate phantom. METHODS: A prostate phantom was created. A three-dimensional real-time ultrasound system with a 5.9MHz probe was used, making it possible to see several reconstructed orthogonal viewing planes in real time. Fourteen operators performed biopsies first under 2-D then 4-D transurethral ultrasound (TRUS) guidance (336 biopsies). The biopsy path was modelled using segmentation in a 3-D ultrasonographic volume. Special software was used to visualise the biopsy paths in a reference prostate and assess the sampled area. A comparative study was performed to examine the accuracy of the entry points and target of the needle. Distribution was assessed by measuring the volume sampled and a redundancy ratio of the sampled prostate. RESULTS: A significant increase in accuracy in hitting the target zone was identified using 4-D ultrasonography as compared to 2-D....

  15. Usefulness of transrectal ultrasound-guided 12 core biopsy method in patients with clinically suspected prostate cancer

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    Kwon, Se Hwan; Lim, Joo Won; Park, Seong Jin; Ko, Young Tae; Kim, Yoon Wha [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    2000-06-15

    To evaluate the improvement of prostate cancer detection provided by transrectal ultrasound (TRUS)-guided 12 core biopsy method compared with sextant biopsy method. Between June 1997 and February 1999, 29 patients with pathologically proven prostate cancer in 124 patients who underwent TRUS-guided 12 core biopsy method were evaluated. They had abnormal findings in prostate specific antigen (PSA), digital rectal examination (DRE) or TRUS findings. The prostate was diffusely enlarged in all patients on DRE findings and in 15 cases (15/29, 52%), hard nodule was palpated. The average of PSA and prostate specific antigen density (PSAD) is 229.33 ng/ml (1-2280) and 9.14 ng/ml/cm{sup 3} (0.048-142.5), respectively, 12 transrectal biopsy, including 2 transition zones, was performed in both lobe, 6 biopsies were located in both base, middle and apex. Then 2 biopsies were inserted between 3 biopsies in both peripheral zone and 2 biopsies were performed in both transition zone. Each specimen was pathologically examined. The results of pathology were compared with method 1 and 2, respectively. We defined the method 1 and 2 as different sextant biopsy method. The method 1 is that cores are taken from both base, middle and apex and method 2 is that cores are taken from both base, apex and transition zone. TRUS findings were analyzed by two radiologists. Of the 29 patients with prostate cancer, 3 (10%) had carcinomas only in the additional regions as compared with method. When compared with method 2,2 (7.0%) had carcinomas only in the additional regions. 2 patients were same in both cases. TRUS findings were abnormal in 21 cases in all patients whose 12 biopsy method was not helpful. 12 biopsy method was helpful in 2/8 (25%) whose TRUS findings were non-specific and 1/21 (4.8%) whose TRUS findings were abnormal. Small low echoic lesion was seen in one patients whose 12 biopsy method was helpful, but cancer was found in other area. TRUS-guided 12 core biopsy method may be superior

  16. Simple Use of the Suppository Type Povidone-Iodine Can Prevent Infectious Complications in Transrectal Ultrasound-Guided Prostate Biopsy

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    Dong Soo Park

    2009-01-01

    Full Text Available Purpose. To determine the effect of simple use of suppository povidone-iodine on infectious complications after transrectal ultrasonography-guided biopsy of the prostate. Methods. All 481 patients are included and received antibiotic prophylaxis. Among them, 360 patients received povidone-iodine suppository (Gynobetadine; 200 mg immediately prior to biopsy and 121 patients did not. Infectious complications were classified. To evaluate bactericidal effects, we counted bacterial colonies in the rectum, harvested from a rectal swab before insertion of the suppository and after biopsy. Aliquots of the suspended bacterial strains were added to Mueller-Hinton agar medium for incubation. Colony counts were determined. Results. Infectious complications developed in 1 case (0.3% in the rectal preparation group (Group 1 and in 8 cases (6.6% in the nonrectal preparation group (Group 2. One in Group 1 had a fever without sepsis. Two patients had sepsis and six had fever without sepsis in Group 2. Rectal preparation was a statistically significant risk factor influencing the development of infectious complications. In vitro experiments, the mean number of colony-forming units decreased 99.9% after the rectal povidone-iodine preparation. Conclusions. All through the biopsy, povidone-iodine melted into the rectum and decreased the bacterial colony count. Simple use of povidone-iodine suppository before prostate biopsy minimizes the risk of infectious complications.

  17. Documenting the location of systematic transrectal ultrasound-guided prostate biopsies: correlation with multi-parametric MRI

    Science.gov (United States)

    Xu, Sheng; Kruecker, Jochen; Locklin, Julia; Pang, Yuxi; Shah, Vijay; Bernardo, Marcelino; Baccala, Angelo; Rastinehad, Ardeshir; Benjamin, Compton; Merino, Maria J.; Wood, Bradford J.; Choyke, Peter L.; Pinto, Peter A.

    2011-01-01

    Abstract During transrectal ultrasound (TRUS)-guided prostate biopsies, the actual location of the biopsy site is rarely documented. Here, we demonstrate the capability of TRUS-magnetic resonance imaging (MRI) image fusion to document the biopsy site and correlate biopsy results with multi-parametric MRI findings. Fifty consecutive patients (median age 61 years) with a median prostate-specific antigen (PSA) level of 5.8 ng/ml underwent 12-core TRUS-guided biopsy of the prostate. Pre-procedural T2-weighted magnetic resonance images were fused to TRUS. A disposable needle guide with miniature tracking sensors was attached to the TRUS probe to enable fusion with MRI. Real-time TRUS images during biopsy and the corresponding tracking information were recorded. Each biopsy site was superimposed onto the MRI. Each biopsy site was classified as positive or negative for cancer based on the results of each MRI sequence. Sensitivity, specificity, and receiver operating curve (ROC) area under the curve (AUC) values were calculated for multi-parametric MRI. Gleason scores for each multi-parametric MRI pattern were also evaluated. Six hundred and 5 systemic biopsy cores were analyzed in 50 patients, of whom 20 patients had 56 positive cores. MRI identified 34 of 56 positive cores. Overall, sensitivity, specificity, and ROC area values for multi-parametric MRI were 0.607, 0.727, 0.667, respectively. TRUS-MRI fusion after biopsy can be used to document the location of each biopsy site, which can then be correlated with MRI findings. Based on correlation with tracked biopsies, T2-weighted MRI and apparent diffusion coefficient maps derived from diffusion-weighted MRI are the most sensitive sequences, whereas the addition of delayed contrast enhancement MRI and three-dimensional magnetic resonance spectroscopy demonstrated higher specificity consistent with results obtained using radical prostatectomy specimens. PMID:21450548

  18. Incidence of sepsis following transrectal ultrasound guided prostate biopsy at a tertiary-care medical center in Lebanon

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    Mohammed Shahait

    2016-02-01

    Full Text Available ABSTRACT Background Urosepsis is a rare but life-threatening complication following transrectal ultrasound (TRUS guided needle prostate biopsy. Despite the technological and pharmacological improvements, the problem of bacterial urosepsis after prostate biopsy remains. A strategy for preventing urosepsis following TRUS prostate biopsy in areas with high prevalence of resistant strains or patients presenting risk factors is lacking. Objectives The aim of this study was to assess the prevalence of urosepsis, as well its predictors, following TRUS guided needle biopsy of the prostate in a tertiary care medical center in Lebanon. Materials and Methods We carried out a retrospective study on all patients who underwent TRUS prostate biopsy at the American University of Beirut Medical Center between January 1, 2011 and June 31, 2013. Patients’ hospital charts were reviewed. Data collected included demographic information, pre-procedure disease specific information, as well as post-procedure information. Predictors of urosepsis following TRUS were assessed. Results In total, 265 patients were included in this study, where the prevalence of urosepsis following TRUS prostate biopsy was found to be 9.4%. The significant independent predictors of urosepsis were found to be: age with an OR=0.93 (95% CI: 0.88–1.00, p-value=0.03, and hypertension comorbidity with an OR=3.25 (95% CI: 1.19–8.85, p-value=0.02. Conclusion We found a high prevalence of urosepsis among patients who have undergone TRUS prostate biopsy, and identified two significant risk factors. The results of this study highlight the importance of implementing strategies for prevention of urosepsis following TRUS prostate biopsy.

  19. Ultrasound guided transrectal prostate biopsy:11-year experience%B超引导下经直肠前列腺穿刺临床分析

    Institute of Scientific and Technical Information of China (English)

    朱刚; 芦志华; 马宏; 闫伟; 万奔; 王建业

    2009-01-01

    Objective To summarize the experience in ultrasound guided transrectal prostate biopsy and analyze the influeneing factors of the biopsy results.Methods 687 patients with prostate specific antigen(PSA)>4μg,tubemles in prostate detected by digital rectal examination and/or prostate abnormality detected by magnetic resonance imaging,aged(70±8),underwent ultrasound guided transrectal 6-12 core prostate biopsy 1996-2007.Since 2006 the criteria for biopsy ineluded PSA of 4-10μg/ml,free PSA/total PSA ratio(F/T ratio)≤0.16,and PSA density>0.15.Results 269 of the 687 cases.witll the mean age of(72±8),were diagnosed as wlth pmstate cancer.294 and 121 of the 687patients(42.8%and 17.6%respectively)accepted prostate biopsy beeanse of elevated PSA or abnormality of DRE.The number of patients accepting prostate biopsy increased yearly(10 cases in 1996 to 98 cases in 2007).The positive biopsy rate was 39.8%.with the highest rate of 60.0%in 1999 and lowest rate of 30.4%in 2005.The highest number of prostate cancer diagnosed was the highest(42 cases)in 2007 and the lowest(4 cases)in 1996.PSA level was positively co-related with positive biopsy rate.The application of F/T ratio improved the positive biopsy rate in the patient with the PSA of 4-10μg/ml.The incidence rates of the main complications hematuria,bloody stool,and fever were 46.3%,8.7%,and 1.9%respectively.Conclusion Elevated PSA has become the most common resson for prostate biopsy.The combination with PSA.F/T ratio.and increased biopsy core number improve the positive biopsy rate.The ultrasound guided transrectal prostate biopsy is efficient and safe in the diagnosis of prostate cancer.%目的 总结B超引导下经直肠前列腺穿刺的经验并分析影响前列腺穿刺结果的因素.方法 统计卫生部北京医院1996-2007年行B超引导下经直肠前列腺穿刺病例.患者入选条件为前列腺特异抗原(PSA)>4μg/L,和(或)直肠指检发现前列腺结节,和(或)B超或磁共振成像(MRI)检

  20. Local anesthesia for pain control during transrectal ultrasound-guided prostate biopsy: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Yan P

    2016-10-01

    Full Text Available Pu Yan,* Xiao-yan Wang,* Wei Huang, Yong Zhang Beijing Tian Tan Hospital, Capital Medical University, Neurology Research Division, China National Clinical Research Center for Neurological Disease, Beijing, People’s Republic of China *These authors contributed equally to this work. Background: A meta-analysis was performed to evaluate the efficacy and safety of intrarectal local anesthestic (IRLA, periprostatic nerve block (PPNB, and the combined modalities in alleviating the pain during transrectal ultrasound (TRUS-guided prostate biopsy.Materials and methods: A literature review was performed to identify all published randomized controlled trials (RCTs about IRLA vs no anesthesia or placebo gel; PPNB vs no injection, periprostatic placebo injection, or IRLA; combined PPNB and IRLA vs PPNB alone; and combined PPNB and intraprostatic nerve block (IPNB vs PPNB alone before TRUS-guided biopsy. Sources included MEDILINE, EMBASE, and Cochrane Library from 1980 to 2016. The main outcomes were biopsy pain score, probe manipulation pain score, and anesthetic infiltration pain score assessed by the visual pain scale.Results: A total of 26 articles involving 36 RCTs were used in this analysis: Although IRLA can lead to pain reduction, the result was not statistically significant when compared with no anesthesia or placebo gel (weighted mean difference [WMD]: -0.22, 95% CI: -0.45 to 0, P=0.06. PPNB can lead to significantly lower biopsy pain scores when compared with no analgesia (WMD: -1.32, 95% CI: -1.68 to -0.95, P<0.00001, placebo injection (WMD: -2.62, 95% CI: -3.16 to -2.07, P<0.00001, or IRLA (WMD: -1.31, 95% CI: -1.40 to -1.22, P<0.00001. PPNB + IRLA can lead to significantly lower biopsy pain scores when compared with PPNB alone (WMD: -0.45, 95% CI: -0.62 to -0.28, P<0.00001. PPNB + IPNB can lead to significantly lower biopsy pain scores when compared with PPNB alone (WMD: -0.73, 95% CI: -0.92 to -0.55, P<0.00001. There were no severe

  1. Pathologic diagnosis and Gleason grading of prostatic carcinoma by transrectal ultrasound-guided prostate needle biopsy%穿刺活检前列腺癌72例病理形态学观察及Gleason分级

    Institute of Scientific and Technical Information of China (English)

    王云帆; 缪琦; 王淑芳; 饶晓松

    2013-01-01

    目的 观察经直肠超声引导的前列腺癌穿刺活检组织的病理形态学改变,进行系统的Gleason分级.方法 收集经直肠超声引导的前列腺穿刺活检诊断的前列腺癌72例,复习HE组织切片,并依据2005年国际泌尿病理学协会(ISUP)修订的前列腺癌Gleason分级系统进行分级.结果 72例前列腺癌中53例的主要及次要成分为3级结构(73.6%),59例主要及次要成分为4级结构(81.9%),12例主要及次要成分为5级结构(16.7%).结论 本组前列腺癌Gleason 4级结构与3级结构常常混合存在,而且4级结构相比3级结构更为常见.修订后的Gleason分级系统有助于对前列腺癌进行规范分级,以利于进一步研究,准确反映肿瘤的预后差异.%Objective To study the morphological diagnostic criteria and Gleason grading of prostatic carcinoma in transrectal ultrasound guided prostate needle biopsy. Methods 72 cases of prostatic needle biopsy guided by transrectal ultrasound were reviewed. Routine pathological examination was used in the study. Data with respect to Gleason grading were studied according to the refinements of the ISUP 2005 consensus conference on Gleason grading of needle biopsies. Results The results showed that Gleason pattern 3 was seen in 73. 61% ; pattern 4 in 81. 94% ; pattern 5 in 16. 67% among 72 cases of prostatic carcinoma. Conclusions Most of the tumors show at least two different patterns, and the pattern 4 is more common than pattern 3. The use of modified Gleason scoring leads to improves the prognostic value of the patients with prostate cancer and can be more accurately assessed in transrectal ultrasound guided prostate needle biopsy. Continued effort is required to refine biopsy strategies to Gleason grading of prostatic specimens.

  2. Ultrasound-Guided Breast Biopsy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound-Guided Breast Biopsy An ultrasound-guided breast biopsy ... limitations of Ultrasound-Guided Breast Biopsy? What is Ultrasound-Guided Breast Biopsy? Lumps or abnormalities in the ...

  3. Impact of preoperative screening for rectal colonization with fluoroquinolone-resistant enteric bacteria on the incidence of sepsis following transrectal ultrasound guided prostate biopsy

    Science.gov (United States)

    Farrell, John J; Hicks, Jennifer L; Wallace, Stephanie E; Seftel, Allen D

    2017-01-01

    With the universal adoption of antibiotic prophylaxis prior to prostate biopsy, the current risk of post-biopsy infection (including sepsis) is study of preoperative rectal cultures to screen for rectal colonization with fluoroquinolone-resistant bacteria using ciprofloxacin-supplemented MacConkey agar culture media. To evaluate the feasibility and practicality of this test, one provider used the results of rectal swab cultures collected during the preoperative outpatient evaluation to adjust each patient’s preoperative antibiotic prophylaxis when fluoroquinolone-resistant enteric bacteria were detected, whereas two other providers continued usual preoperative care and empiric antimicrobial prophylaxis. Rectal colonization with fluoroquinolone-resistant bacteria was detected in 19/152 (12.5%) of patients. In our intention-to-treat analysis (N=268), the rate of post-biopsy sepsis was 3.6% lower in the group that was screened for rectal colonization with fluoroquinolone-resistant bacteria prior to transrectal prostate biopsy. The observed risk reduction in the rectal screening group trended toward, but did not achieve, statistical significance. We suggest that preoperative screening for rectal colonization with fluoroquinolone-resistant enteric bacteria may be a useful step toward mitigating post-prostate biopsy sepsis. PMID:28280717

  4. Prostate cancer detection upon transrectal ultrasound-guided biopsy in relation to digital rectal examination and prostate-specific antigen level: what to expect in the Chinese population?

    Directory of Open Access Journals (Sweden)

    Jeremy YC Teoh

    2015-01-01

    Full Text Available We investigated the prostate cancer detection rates upon transrectal ultrasound (TRUS-guided biopsy in relation to digital rectal examination (DRE and prostate-specific antigen (PSA, and risk factors of prostate cancer detection in the Chinese population. Data from all consecutive Chinese men who underwent first TRUS-guided prostate biopsy from year 2000 to 2013 was retrieved from our database. The prostate cancer detection rates with reference to DRE finding and PSA level of 50 ng ml−1 were investigated. Multivariate logistic regression analyses were performed to investigate for potential risk factors of prostate cancer detection. A total of 2606 Chinese men were included. In patients with normal DRE, the cancer detection rates were 8.6%, 13.4%, 21.8%, 41.7% and 85.2% in patients with PSA 50 ng ml−1 respectively. In patients with abnormal DRE, the cancer detection rates were 12.4%, 30.2%, 52.7%, 80.6% and 96.4% in patients with PSA 50 ng ml−1 respectively. Older age, smaller prostate volume, larger number of biopsy cores, presence of abnormal DRE finding and higher PSA level were associated with increased risk of prostate cancer detection upon multivariate logistic regression analyses (P < 0.001. Chinese men appeared to have lower prostate cancer detection rates when compared to the Western population. Taking the different risk factors into account, an individualized approach to the decision of TRUS-guided biopsy can be adopted.

  5. Visual pain score during transrectal ultrasound-guided prostate biopsy using no anaesthesia or three different types of local anaesthetic application.

    Science.gov (United States)

    Gurbuz, Cenk; Canat, Lutfi; Bayram, Guner; Gokhan, Atis; Samet, Gungor; Caskurlu, Turhan

    2010-09-01

    To evaluate the pain score during transrectal ultrasound (TRUS)-guided prostate biopsy using three different anaesthetic applications and no anaesthesia. One-hundred men undergoing TRUS-guided prostate biopsy were prospectively enrolled in this study. Patients were randomized to four groups. Group 1 (n = 25) received no anaesthesia, group 2 (n = 25) was administered a perianal lidocaine injection, group 3 (n = 25) was administered a periprostatic lidocaine injection, and group 4 (n = 25) was administered a combination of perianal-intrarectal lidocaine-prilocaine cream. The anaesthetic application was given 5 min before the procedure. All patients were asked to indicate the level of pain experienced on a visual analogue scale (VAS) during three situations, including when the TRUS probe was inserted and 15 min and 2 weeks after biopsy. Mean pain scores were similar in all groups at the time of probe insertion. Mean pain scores showed statistically significant differences between group 1 and the other groups, except for group 4, 15 min after the procedure. Group 3 showed better pain control 15 min after biopsy and this difference was statistically significant (p biopsy may be advocated. The application of periprostatic lidocaine seems to be the most advantageous method for lowering the perception of pain.

  6. Listening to music during transrectal ultrasound-guided prostate biopsy decreases anxiety, pain and dissatisfaction in patients: a pilot randomized controlled trial.

    Science.gov (United States)

    Chang, Yun Hee; Oh, Tae Hoon; Lee, Jae Whan; Park, Seung Chol; Seo, Ill Young; Jeong, Hee Jong; Kwon, Whi-An

    2015-01-01

    To determine whether listening to music during transrectal ultrasound (TRUS)-guided 12-core needle prostate biopsy decreases anxiety, pain and dissatisfaction among patients and results in a more comfortable and better tolerated procedure. 76 male patients who underwent TRUS-guided prostate biopsy between March 2013 and June 2014 were randomized into the following groups: no music (group I, n = 38) or classical music (group II, n = 38) during the procedure. Before TRUS-guided prostate biopsy, lidocaine gel was instilled into the rectum. Patient anxiety levels were quantified using the State-Trait Anxiety Inventory. A visual analog scale (0-10) was used for self-assessment of satisfaction, discomfort and willingness among patients to have a repeat TRUS-guided prostate biopsy. Demographic characteristics, mean age, procedure duration and procedure indications did not differ statistically between the two groups. The mean anxiety level and mean pain score of group II were significantly lower than those of group I (p = 0.001 and p = 0.003, respectively). Group II also had a significantly higher mean satisfaction score than group I (p = 0.007). Before the procedure, heart rate and systolic blood pressure were similar in groups I and II; however, after the procedure, levels were lower in group II than in group I (heart rate, p = 0.014; systolic blood pressure, p = 0.011). Listening to music during TRUS-guided prostate biopsy significantly reduced patients' feelings of pain, discomfort and dissatisfaction. Music can serve as a simple, inexpensive and effective adjunct to sedation during TRUS-guided prostate biopsy. We recommend playing music during TRUS-guided prostate biopsy. 2014 S. Karger AG, Basel

  7. Single-dose versus multiple-dose ciprofloxacin plus metronidazole prophylaxis in transrectal ultrasound-guided biopsy of the prostate: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Zhoobin Heidari Bateni

    2014-09-01

    Full Text Available To investigate and compare the infectious and non-infectious complications of single-dose versus multiple-dose antibiotic therapy for trans-rectal ultrasound (TRUS-guided biopsy of the prostate. Patients were enrolled in a prospective randomized study that was designed to investigate the effects of single-dose versus multiple-dose antimicrobial prophylaxis regimen mainly on asymptomatic bacteriuria, urinary tract infection (UTI without fever, fever and urinary septicemia. The single-dose group received one ciprofloxacin 500 mg tablet and two metronidazole 250 mg tablets at 2 hours before the biopsy, while the multiple-doses group received those every 12 hours from 3 days before the biopsy. One-hundred and sixty patients were evaluated in two groups and bacteriuria in urinalysis was encountered in 12 patients (15% in the single-dose group and four patients (5% in the multiple-dose group, with a significant difference (P=0.035. UTI without fever occurred in six patients (7.5% in the single-dose group and one patient (1.25% in the multiple-dose group, with no significant difference (borderline P=0.053. After biopsy, three patients (3.75% returned with fever due to UTI and bacteremia in the single-dose group and none in the multiple-dose group, but with no significant difference (P=0.08. Regarding non-infectious complications, there were no significant differences between the two groups. Using prophylactic antibiotics for prostate biopsy in multiple doses, and at least 3 days before the procedure significantly reduces the rate of bacteriuria compared with a single-dose regimen.

  8. Impact of preoperative screening for rectal colonization with fluoroquinolone-resistant enteric bacteria on the incidence of sepsis following transrectal ultrasound guided prostate biopsy

    Directory of Open Access Journals (Sweden)

    Farrell JJ

    2017-02-01

    for rectal colonization with fluoroquinolone-resistant bacteria prior to transrectal prostate biopsy. The observed risk reduction in the rectal screening group trended toward, but did not achieve, statistical significance. We suggest that preoperative screening for rectal colonization with fluoroquinolone-resistant enteric bacteria may be a useful step toward mitigating post-prostate biopsy sepsis. Keywords: sepsis, gram-negative infections, antimicrobial stewardship, preoperative antibiotic prophylactic treatment 

  9. Magnetic resonance imaging-targeted, 3D transrectal ultrasound-guided fusion biopsy for prostate cancer: Quantifying the impact of needle delivery error on diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Martin, Peter R., E-mail: pmarti46@uwo.ca [Department of Medical Biophysics, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Cool, Derek W. [Department of Medical Imaging, The University of Western Ontario, London, Ontario N6A 3K7, Canada and Robarts Research Institute, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Romagnoli, Cesare [Department of Medical Imaging, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Fenster, Aaron [Department of Medical Biophysics, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Department of Medical Imaging, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Robarts Research Institute, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Ward, Aaron D. [Department of Medical Biophysics, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Department of Oncology, The University of Western Ontario, London, Ontario N6A 3K7 (Canada)

    2014-07-15

    Purpose: Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided “fusion” prostate biopsy intends to reduce the ∼23% false negative rate of clinical two-dimensional TRUS-guided sextant biopsy. Although it has been reported to double the positive yield, MRI-targeted biopsies continue to yield false negatives. Therefore, the authors propose to investigate how biopsy system needle delivery error affects the probability of sampling each tumor, by accounting for uncertainties due to guidance system error, image registration error, and irregular tumor shapes. Methods: T2-weighted, dynamic contrast-enhanced T1-weighted, and diffusion-weighted prostate MRI and 3D TRUS images were obtained from 49 patients. A radiologist and radiology resident contoured 81 suspicious regions, yielding 3D tumor surfaces that were registered to the 3D TRUS images using an iterative closest point prostate surface-based method to yield 3D binary images of the suspicious regions in the TRUS context. The probabilityP of obtaining a sample of tumor tissue in one biopsy core was calculated by integrating a 3D Gaussian distribution over each suspicious region domain. Next, the authors performed an exhaustive search to determine the maximum root mean squared error (RMSE, in mm) of a biopsy system that gives P ≥ 95% for each tumor sample, and then repeated this procedure for equal-volume spheres corresponding to each tumor sample. Finally, the authors investigated the effect of probe-axis-direction error on measured tumor burden by studying the relationship between the error and estimated percentage of core involvement. Results: Given a 3.5 mm RMSE for contemporary fusion biopsy systems,P ≥ 95% for 21 out of 81 tumors. The authors determined that for a biopsy system with 3.5 mm RMSE, one cannot expect to sample tumors of approximately 1 cm{sup 3} or smaller with 95% probability with only one biopsy core. The predicted maximum RMSE giving P ≥ 95% for each

  10. 经直肠前列腺穿刺活检术并发感染性休克和MODS的临床研究%Clinical Analysis of Septic shock and MODS following transrectal ultrasound-guided prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    唐普贤; 王建业; 刘明; 何清; 冯喆; 韦军民

    2012-01-01

    Objective To investigate the diagnosis and treatment of septic shock and multiple organ dysfunction syndrome (MODS) following transrectal ultrasound-guided prostate biopsy (TRUSPB). Methods We reported two cases,45 and 46 years old,of septic shock and MODS after TRUSPB from June 1996 to May 2011.10 cases like these two cases in literatures were acquired (3 cases in Chinese and 7 cases in English) from 1991 to 2011,and the causes of severe infections following transrectal prostate biopsy and its prophylactic procedures were discussed as well. Results The two cases,suffered postoperative septic shock and MODS 16 -40 h after being smoothly performed TRUSPB.One patient died four days after surgery and the other improved after five days antibiotic treatment.All the 12 cases had abrupt onsets and deteriorated rapidly,2 cases died and 1 case was performed amputation due to double lower limb gangrene,resulted in high mortality and morbidity.There are many risk factors,such as repeated puncture (4/12),diabetes (3/12),chronic infections (3/12) and used immune suppression (1/12),et al; blood culture was positive in 9 case and E.coli bacteria was the main bacteria(8/9),besides,half of them were multi-drug resistant (4/8) and other 2 cases were ESBLs ( + ) or 1 case was quinolone-resistant repectively.9 cases recovered after actively controlled infection using carbapenem and other treatment. Conclusions Transrectal ultrasound-guided prostate biopsy could cause serious complications such as septic shock,to which more attentions should be paid.Preoperative use of carbapenem should be recommended for patients with repeating biopsy or other risk factors.%目的 探讨B超引导下经直肠前列腺穿刺活检术(TRUSPB)并发感染性休克和多器官功能不全综合征(MODS)的诊断与治疗. 方法 1996年6月至2011年5月行TRUSPB并发感染性休克和MODS的患者2例,年龄分别为45、46岁,回顾2例患者的诊治经过,结合1991-2011年文献报道10

  11. Ultrasound-Guided Breast Biopsy

    Science.gov (United States)

    ... Professions Site Index A-Z Ultrasound-Guided Breast Biopsy An ultrasound-guided breast biopsy uses sound waves ... Guided Breast Biopsy? What is Ultrasound-Guided Breast Biopsy? Lumps or abnormalities in the breast are often ...

  12. Ultrasound guided supraclavicular block.

    LENUS (Irish Health Repository)

    Hanumanthaiah, Deepak

    2013-09-01

    Ultrasound guided regional anaesthesia is becoming increasingly popular. The supraclavicular block has been transformed by ultrasound guidance into a potentially safe superficial block. We reviewed the techniques of performing supraclavicular block with special focus on ultrasound guidance.

  13. 超声引导下经直肠前列腺系统12点穿刺活检术对早期前列腺癌的诊断价值%Transrectal ultrasound- guided 12- core biopsy for early diagnosis of prostate cancer: A report of 149 cases

    Institute of Scientific and Technical Information of China (English)

    李波; 宋永胜

    2011-01-01

    目的 评价经直肠超声引导下前列腺系统12点穿刺活检术的临床价值.方法 对临床高度怀疑前列腺癌149例患者进行经直肠超声引导下前列腺系统12点穿刺活检.结果 成功进行12点系统穿刺活检者149例,获取组织满意.病理诊断为前列腺癌36例,前列腺增生80例,不典型增生4例,前列腺内皮瘤4例,前列腺慢性炎症9例,鳞状上皮化生3例,结核1例.前列腺平滑肌肉瘤7例,前列腺囊肿5例.结论 经直肠超声定位下系统12点穿刺法成功率高,无严重并发症.在临床早期诊断前列腺癌很有价值.%Objective To evaluate the clinical value of 12 - core systemic prostate biopsy. Methods Prostatic puncture and biopsy guided by transrectal ultrasound was performed in 149 patients suspected of prostate cancer. Results 149 cases were under 12 cores transrectal ultrasound guided biopsy. The histologic study confirmed 36 cases with prostate cancer, 80 benign hyperplasia, 4 atypical hyperplasia, 4 endothelioma, 9 chronic inflammation, 3 squamous cellmetaplasia, 1 tu berculosiswere, 7 leiomyosarcoma and 5 cyst of prostate. Conclusion Transrectal ultrasound guided 12 - core systemic prostate biopsy can improve prostate cancer detection rate with high success. No patient had severe complications after biopsy. It is useful in the early clinical diagnosis of prostate cancer.

  14. 超声引导下前列腺10点加定点穿刺活检术诊断前列腺癌%Transrectal ultrasound-guided 10 cores plus fixed-point prostate biopsy for diagnosing prostate cancer

    Institute of Scientific and Technical Information of China (English)

    张利; 韩雪冰; 米振国; 郭荣荣

    2008-01-01

    目的 探讨经直肠彩色多普勒超声引导下前列腺穿刺活组织检查在前列腺癌诊断中的应用.方法 181例疑诊前列腺癌的患者进行血清总前列腺特异性抗原(T-PSA)检测,采用10点加前列腺癌可疑灶定点穿刺活检术.结果 181例中检出前列腺癌80例(44.2%),前列腺增生63例(34.8%).前列腺炎36例(19.9%),前列腺结核1例(0.6%),前列腺平滑肌瘤1例(0.6%).T-PSA水平>20μg/L组的前列腺癌发生率高于其他各组.随着T-PSA水平的升高,Gleason评分增加(P<0.001).结论 超声引导下10点加定点穿刺活检术诊断前列腺癌的阳性率高,对T-PSA>20μg/L的疑诊前列腺癌患者活检意义较大.%Objective To evaluate the clinical value of transrectal ultrasound-guided 10 cores plus fixed-point prostate biopsy for diagnosing prostate cancer.Methods The serum PSA level of 181 patients were determined with ELISA.AU the patients underwent 10 cores plus fixed-point prostate biopsy under the guidance of transrectal ultrasound.Resuits 80 cases with prostate cancer(44.2%),63 cases with benign prostatic hypertrophy (34.8%),36 cases with prostatitis(19.9%),1 cage with tuberculosis(0.6%),and 1 cage with prostate leiomyoma(0.6%).When PSA WaS more than 20 μg/L,the incidence rate of prostate cancer was significantly higher than other PSA levels.Meanwhile,Gleason scores were increased with the advance of PSA levels (P<0.001).Conclusion Transrectal ultrasound-guided systematic 10 cores plus fixed-point prostate biopsy could significantly enhance the prostate cancer detection rate, and it was important in diagnosing prostate cancer for patients,especially when PsA was more than 20 μg/L.

  15. [Ultrasound guided percutaneous nephrolithotripsy].

    Science.gov (United States)

    Guliev, B G

    2014-01-01

    The study was aimed to the evaluation of the effectiveness and results of ultrasound guided percutaneous nephrolithotripsy (PNL) for the treatment of patients with large stones in renal pelvis. The results of PNL in 138 patients who underwent surgery for kidney stones from 2011 to 2013 were analyzed. Seventy patients (Group 1) underwent surgery with combined ultrasound and radiological guidance, and 68 patients (Group 2)--only with ultrasound guidance. The study included patients with large renal pelvic stones larger than 2.2 cm, requiring the formation of a single laparoscopic approach. Using the comparative analysis, the timing of surgery, the number of intra- and postoperative complications, blood loss and length of stay were evaluated. Percutaneous access was successfully performed in all patients. Postoperative complications (exacerbation of chronic pyelonephritis, gross hematuria) were observed in 14.3% of patients in Group 1 and in 14.7% of patients in Group 2. Bleeding requiring blood transfusion, and injuries of adjacent organs were not registered. Efficacy of PNL in the Group 1 was 95.7%; 3 (4.3%) patients required additional interventions. In Group 2, the effectiveness of PNL was 94.1%, 4 (5.9%) patients additionally underwent extracorporeal lithotripsy. There were no significant differences in the effectiveness of PNL, the volume of blood loss and duration of hospitalization. Ultrasound guided PNL can be performed in large pelvic stones and sufficient expansion of renal cavities, thus reducing radiation exposure of patients and medical staff.

  16. Ultrasound-guided drainage of deep pelvic abscesses

    DEFF Research Database (Denmark)

    Lorentzen, Torben; Nolsøe, Christian; Skjoldbye, Bjørn

    2011-01-01

    The aim of this study was to demonstrate and evaluate the ultrasound-guided drainage of deep pelvic abscesses in which transabdominal percutaneous access could not be performed because of overlying structures. A retrospective analysis of 32 consecutive patients with 33 deep pelvic abscesses...... (median diameter 7 cm), 19 were treated with catheter drainage and 18 of these cases resulted in favorable clinical outcomes. Of the smaller abscesses (median diameter 4 cm), 14 were treated with needle drainage. In two of these cases, follow-up US showed that a repeat puncture and drainage was necessary...... and the subsequent in-dwelling catheter period, there were no serious complications related to the drainage procedures. We conclude that ultrasound-guided transrectal, transvaginal, transperineal and transgluteal drainage of deep pelvic abscesses are safe and effective treatment approaches. Based on our findings...

  17. Hemorrhagic complications and risk factors in transrectal ultrasound-guided prostate biopsies%经直肠超声引导前列腺穿刺引起出血并发症的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    李岩密; 唐杰; 徐丽; 杨敬春; 张舜欣; 费翔

    2008-01-01

    目的 探讨经直肠超声(TRUS)引导前列腺穿刺的出血性并发症及其有关的可能危险因素.方法 对252例行TRUS引导前列腺穿刺活检者进行病例对照研究,对比分析穿刺后出现出血事件者和非出血组的相关因素(年龄、病理诊断、前列腺体积、高血压、糖尿病、服用抑制血小板聚集及抗凝药物、穿刺针数),采用非条件Logistic回归进行多因素分析.结果 血尿是最常见的穿刺后出血事件(19.1%).特征分析年龄和前列腺体积在两组的构成情况有差异.多因素分析出血事件具有统计学意义的相关因素包括年龄(OR=0.97,95% CI:0.942 1.000)和前列腺的体积(OR=0.989,95% CI:0.979~0.999).穿刺后血尿具有统计学意义的相关因素有3个:前列腺癌患者(OR=0.479,95% CI:0.236~0.975)、前列腺体积(OR=0.987,95% CI:0.976~0.999)、穿刺前服用抑制血小板聚集及抗凝药物者(OR=3.589,95% CI:1.133~11.366).结论 TRUS引导前列腺穿刺活检是安全、有效的.年龄和前列腺体积与出血事件的发生率有关;前列腺癌患者及前列腺体积是穿刺后出现血尿的相关因素;服用抑制血小板聚集及抗凝药物是穿刺后出现血尿的危险因素.%Objective To determine the rate of hemorrhagic complications and the possible risk factors in transrectal ultrasound(TRUS)guided prostate biopsies.Methods TRUS guided prostate biopsies were carried out in 252 patients.Chi-aquare test,t test,conditional Logistic regression were used to comparatively analyze the risk factors(age,presence of prostate cancer,the volume of prostate,arterial hypertension,diabetes mellitus,use of acetylsalicylic acid and anticoagulant,number of samples)between hemorrhagic patients and non-hemorrhagic groups.Results Hematuria was the most frequent sing in all complications,corresponding to 19.1% of the cases.According to the general feature analysis between two groups,age and the volume of the prostate were significant

  18. Comparison of diffusion weighted imaging and transrectal ultrasound-guided biopsy in predicting aggressiveness of prostate cancer%比较MR扩散加权成像和经直肠超声引导穿刺Gleason评分评估前列腺癌侵袭性的差异

    Institute of Scientific and Technical Information of China (English)

    李春媚; 陈敏; 李飒英; 张晨; 王萱; 周诚

    2012-01-01

    目的 比较DWI ADC值和经直肠超声引导穿刺所得Gleason评分评估前列腺癌侵袭性的作用.方法 回顾性分析51例经穿刺活检确诊为前列腺癌,于1.5 TMR扫描仪上行前列腺DWI检查,并进行了前列腺癌根治术的患者资料.以前列腺癌根治术标本为参考,测量前列腺癌灶的ADC值,采用Pearson相关分析检验癌灶ADC值与前列腺癌根治术标本Gleason评分的相关性,以及穿刺活检所得Gleason评分与前列腺癌根治术标本Gleason评分的相关性,采用ROC曲线分析确定癌灶ADC值和穿刺活检所得Gleason评分区分前列腺低级别癌和中高级别癌的效能.结果 前列腺穿刺活检评估前列腺癌根治术标本Gleason评分的准确率为41.2% (21/51),11.8% (6/51)患者Gleason评分被高估,47.0% (24/51)患者GS被低估.51例患者前列腺癌灶的ADC值平均为(0.974±0.194)×10-3 mm2/s,35例中高级别前列腺癌平均ADC值为(0.907±0.160)×10-3 mm2/s,16例低级别前列腺癌平均ADC值为(1.121±0.185)×10-3 mm2/s.前列腺癌灶ADC值与前列腺癌根治术标本Gleason评分存在负相关性(r=-0.761,P<0.01),而穿刺活检所得Gleason评分与前列腺癌根治术标本Gleason评分不存在相关性(r=0.187,P=0.189).ADC值和穿刺活检所得Gleason 评分区分前列腺低级别癌和中高级别癌的ROC曲线下面积分别为0.827和0.689.结论 前列腺癌灶的ADC值预测前列腺癌侵袭性优于穿刺活检所得Gleason评分.%Objective To retrospectively evaluate the utility of apparent diffusion coefficient (ADC) values in predicting aggressiveness of prostate cancer.Comparison was made with transrectal ultrasound-guided biopsy Gleason scores (GS) and prostatectomy GS.Methods Diffusion weighted images of 51 patients with biopsy-proven prostate cancer were obtained using 1.5 T MR with a pelvic phased-array coil.Regions of interest (ROIs) were drawn on areas of the suspicious lesion and the ADC values were calculated

  19. The significance of transrectal ultrasound guided transperineal seminal vesicle biopsy in evaluating the clinical stage of prostate cancer%直肠超声引导下经会阴精囊腺穿刺活检术在评价前列腺癌临床分期中的意义

    Institute of Scientific and Technical Information of China (English)

    卢圣铭; 丁雪飞; 肖芹; 周广臣; 顾晓; 齐小康; 陈骥

    2015-01-01

    目的 探讨直肠超声引导下经会阴精囊腺穿刺活检术在评价前列腺癌临床分期中的可行性和安全性.方法 回顾性分析2010年7月至2015年1月收治的57例伴有精囊异常的疑似前列腺癌患者的临床资料.年龄50 ~ 78岁,平均(65±7)岁.血清总前列腺特异性抗原(tPSA)3.2 ~ 131.1 μg/L,平均(23.7±11.3) μg/L.22例直肠指检可触及前列腺结节.结合MRI检查结果,临床分期均为T3b期.局麻下,57例均行超声及模板引导下经会阴前列腺及精囊腺分区穿刺活检,前列腺分为11区,每区穿刺1~4针;两侧精囊腺分别自外侧向中央穿刺3针,尽量靠近膀胱底部.穿刺组织送病理检查.结果 57例均顺利完成穿刺.穿刺病理检查发现前列腺癌44例,Gleason评分6~10分.其中累及精囊腺32例(阳性组),肿瘤分期T3b期;未累及12例(阴性组),肿瘤分期T2期.阳性组中20例行根治性前列腺切除术,术后病理诊断均提示前列腺癌累及精囊腺,术后病理分期为T3b期.阴性组中11例行根治性前列腺切除术,2例术后病理诊断提示累及精囊腺,肿瘤分期为T3b期.精囊腺穿刺敏感性为91% (20/22),特异性为100% (9/9),阳性预测值为100%(20/20),阴性预测值为82% (9/11).57例穿刺后均无发热,发生肉眼血尿23例(40%)、血精20例(35%)、尿潴留1例(2%),对症处理后症状消失.结论 直肠超声引导下经会阴精囊腺穿刺安全、可靠,有助于提高前列腺癌术前临床分期的准确率.%Objective To explore the safty and feasibility of transrectal ultrasound guided transperineal seminal vesicle biopsy in the evaluation of clinical staging of prostate cancer.Methods Retrospectively study 57 suspected prostate cancer patients with seminal abnormality during 2010.7-2015.1,age ranged from 50 to 78 years,average 65 ±7 years,serum total prostate specific antigen (tPSA) 3.2-131.1 μg/L, average (23.7 ± 11.3) μg/L.Twenty-two cases had palpable prostate

  20. Biopsym : a learning environment for transrectal ultrasound guided prostate biopsies

    CERN Document Server

    Thomas, Janssoone; Vadcard, Lucile; Mozer, Pierre; Troccaz, Jocelyne

    2010-01-01

    This paper describes a learning environment for image-guided prostate biopsies in cancer diagnosis; it is based on an ultrasound probe simulator virtually exploring real datasets obtained from patients. The aim is to make the training of young physicians easier and faster with a tool that combines lectures, biopsy simulations and recommended exercises to master this medical gesture. It will particularly help acquiring the three-dimensional representation of the prostate needed for practicing biopsy sequences. The simulator uses a haptic feedback to compute the position of the virtual probe from three-dimensional (3D) ultrasound recorded data. This paper presents the current version of this learning environment.

  1. Estudo comparativo entre três técnicas de anestesia geral para biópsia de próstata dirigida por ultrassonografia transretal Estudio comparativo entre tres técnicas de anestesia general para biopsia de próstata dirigida por ultrasonido transrectal A comparative study among three techniques of general anesthesia for ultrasound-guided transrectal prostate biopsy

    Directory of Open Access Journals (Sweden)

    Ricardo Antônio Guimarães Barbosa

    2010-10-01

    ésicas en ese grupo de pacientes. MÉTODO: Fueron estudiados 45 pacientes divididos en tres grupos: 1- Propofol; 2- Propofol + Bloqueo de Plexo Prostático; 3- Propofol + Fentanil. Los pacientes fueron monitorizados con presión arterial no invasiva, electrocardioscopia continua, oximetría de pulso (SpO2 e Índice Bispectral. No recibieron medicación preanestésica. Se evaluaron los parámetros hemodinámicos en el intra y postoperatorio, índice bispectral en el intraoperatorio, el dolor por la escala numérica verbal (ENV en el postoperatorio inmediato y el uso de dipirona como tratamiento del dolor postoperatorio. RESULTADOS: No hubo diferencia significativa entre los tres grupos: en las variables antropométricas, cantidad de propofol, número de fragmentos y tiempo del examen. Los parámetros hemodinámicos y la SpO2 presentaron un comportamiento semejante en los tres grupos durante el estudio. En el grupo 1, el dolor evaluado por la ENV fue más elevado y hubo una mayor necesidad de aplicar la dipirona que en los otros grupos. CONCLUSIONES: La sedación con propofol aislado para la biopsia causa un mayor dolor e incomodidad en el postoperatorio que cuando se asocia al bloqueo del plexo prostático o al fentanil sistémico. Además de la hipnosis, se hace necesario realizar la analgesia intraoperatoria para garantizar la comodidad en el postoperatorioBACKGROUND AND OBJECTIVES: Ultrasound-guided transrectal prostate biopsy is a reference in the diagnosis of prostate neoplasias. The higher the number of samples, the greater is the pain and discomfort. The objective of this study was to compare three anesthetic techniques in this group of patients. METHODS: Forty-five patients were included in this study. Patients were divided into three groups: 1 - Propofol; 2 - Propofol + Prostatic Plexus Block; 3 - Propofol + Fentanyl. Patients were monitored with non-invasive blood pressure, continuous electrocardioscopy, pulse oximetry (SpO2, and Bispectral Index. Patients did not

  2. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

    Science.gov (United States)

    ... Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid An ultrasound-guided thyroid biopsy uses sound waves ... Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? During a fine needle aspiration biopsy of the ...

  3. [Ultrasound-guided peripheral catheterization].

    Science.gov (United States)

    Salleras-Duran, Laia; Fuentes-Pumarola, Concepció

    2016-01-01

    Peripheral catheterization is a technique that can be difficult in some patients. Some studies have recently described the use of ultrasound to guide the venous catheterization. To describe the success rate, time required, complications of ultrasound-guided peripheral venous catheterization. and patients and professionals satisfaction The search was performed in databases (Medline-PubMed, Cochrane Library, CINAHL and Cuiden Plus) for studies published about ultrasound-guided peripheral venous catheterization performed on patients that provided results on the success of the technique, complications, time used, patient satisfaction and the type of professional who performed the technique. A total of 21 studies were included. Most of them get a higher success rate 80% in the catheterization ecoguide and time it is not higher than the traditional technique. The Technical complications analyzed were arterial puncture rates and lower nerve 10%. In all studies measuring and comparing patient satisfaction in the art ecoguide is greater. Various professional groups perform the technique. The use of ultrasound for peripheral pipes has a high success rate, complications are rare and the time used is similar to that of the traditional technique. The technique of inserting catheters through ultrasound may be learned by any professional group performing venipuncture. Finally, it gets underscores the high patient satisfaction with the use of this technique. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  4. Strategies for prevention of ultrasound-guided prostate biopsy infections

    Directory of Open Access Journals (Sweden)

    Lu DD

    2016-07-01

    Full Text Available Diane D Lu, Jay D Raman Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA Abstract: Prostate cancer is the most common cancer in male patients and the second leading cause of cancer-related mortality in males. To confirm the diagnosis of prostate cancer, an ultrasound-guided needle biopsy is necessary to obtain prostate tissue sufficient for histologic analysis by pathologists. Ultrasound-guided prostate needle biopsy can be accomplished via a transperineal or transrectal approach. The latter biopsy technique involves placing an ultrasound probe into the rectum, visualizing the prostate located just anterior to it, and then obtaining 12–14 biopsies. Each biopsy core requires piercing of the rectal mucosa which can inherently contribute to infection. The increasing infectious risk of prostate needle biopsy requires refinement and re-evaluation of the process in which the technique is performed. Such processes include (but are not limited to prebiopsy risk stratification, antibiotic prophylaxis, use of rectal preparations, and equipment processing. In the subsequent review, we highlight the current available information on different strategies to reduce the risk of infection following prostate needle biopsy. Keywords: prostate cancer, prostate biopsy, urinary tract infection, sepsis, complications

  5. 前列腺周围神经阻滞麻醉对缓解经直肠超声引导下前列腺穿刺活检术疼痛的效果%Efficacy of periprostatic nerve block anesthesia for pain control in transrectal ultrasound-guided systematic prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    谢毅; 周芳坚; 李永红; 蒋丽娟; 吴志明; 秦自科; 韩辉; 刘卓炜

    2016-01-01

    目的:评估前列腺周围神经阻滞麻醉(PPNB)对缓解经直肠超声引导下前列腺穿刺活检术时疼痛的效果。方法回顾性分析我院2013年11月~2015年1月经直肠超声引导下前列腺12针系统穿刺患者111例,根据是否采用PPNB,将患者分成PPNB组(52例)和非PPNB组(59例)。PPNB组在经直肠超声引导下注射1%利多卡因阻滞麻醉前列腺周围神经,然后行穿刺活检;非PPNB组未采用任何麻醉方法。穿刺结束后采用视觉模拟评分法对直肠指检(DRE)、经直肠超声检查、穿刺过程进行疼痛评分;穿刺结束后7天随访患者穿刺并发症。结果两组患者的年龄、前列腺体积、总前列腺特异性抗原(TPSA)、游离前列腺特异性抗原(FPSA)、DRE异常比例差异无统计学意义。两组患者DRE疼痛评分(1.40∶1.39,P=0.997)、经直肠超声检查疼痛评分(2.10∶2.07,P=0.834)差异无统计学意义;然而,PPNB组穿刺疼痛评分更低(2.54∶3.07,P=0.033)。两组患者穿刺并发症差异无统计学意义。结论相对于无麻醉,采用前列腺周围神经阻滞麻醉可减轻经直肠超声引导下前列腺穿刺活检术时疼痛不适。%Objective To evaluate the efficacy of periprostatic nerve block anesthesia (PPNB) for pain relief in transrectal ultrasound-guided systematic prostate biopsy (PBx). Methods We reviewed the data of patients undergoing initial PBx at our center from November, 2013 to January, 2015. Only the patients with 12-core systemic PBx were included and 111 patients were eligible for this study, among whom 52 patients received PPNB and 59 did not. PPNB was achieved by an injection of 5 mL of 1%lidocaine at the angle between the seminal vesicle and base of the prostate on each side before biopsy. The DRE pain score, probe insert pain score, and biopsy pain score were assessed by visual analogue scale (VAS) immediately after the biopsy. The complications

  6. 老年男性前列腺特异抗原水平与直肠超声引导无痛前列腺穿刺结果的相关性分析%Relation of the prostate specific antigen level with the outcome of analgesic transrectal ultrasound-guided prostate biopsy by intravenous anesthesia in the older men

    Institute of Scientific and Technical Information of China (English)

    王振华; 魏金星; 张雪培

    2011-01-01

    Objective To investigate the relation of the prostate specific antigen (PSA) level with the outcome of analgesic transrectal ultrasound-guided prostate biopsy(ATUGPB) by intravenous anesthesia and clinical parameters in the older men with evaluated PSA. Methods The AUGPB with twelve cores by intravenous anesthesia were completed in 106 patients from September 2008 to August 2010 induding our outpatient and inpatient [mean age(68±7)years] with evaluated PSA(>4 ng/ml). According to the PSA level, the patients were divided into low-risk group(4 ng/ml20 ng/ml,24 cases). The parameters were recorded including biopsy time, visual analog pain scale score(VAS), prostate volume(PV), PSA density(PSAD), pathological outcome, anesthetic adverse events and complications. Results The mean biopsy time was(5.9±2.0)min, ninety eight cases(92%) had no pain(VAS=0)and no case occurred anesthetic adverse event. There were total 164 positive cores in 1272 cores, of which 36 cases were prostate cancer(Pca), 4 cases were prostate atypical hyperplasia and 4 cases were prostate intraepithelial neoplasia. The detection rate of Pca from low-risk group to high-risk group were respectively 10.9%, 33.3% and 87.5%, and that of benign prostatic hyperplasia(BPH) were 81.8%, 59.2% and 4.2%, the difference of them was significant(P4 ng/ml),平均年龄(68±7)岁,进行静脉麻醉下经直肠超声引导无痛前列腺12针系统首次穿刺.将PSA水平分为低危组(4 ng/ml20 ng/ml,24例).记录穿刺时间、视觉模拟疼痛评分(VAS)、PSA密度(PSAD)、前列腺体积(PV)、穿刺病理结果、麻醉不良事件.结果 平均穿刺时间(5.9±2.0)min,98例(92%)穿刺后无疼痛(VAS=0),无一例发生麻醉不良事件.共穿刺1272针,病理阳性164针,包括36例前列腺癌(Pca)、4例非典型增生、4例腺瘤样改变.低危、中危和高危组中Pca检出率分别为10.9%、33.3%和87.5%,良性前列腺增生(BPH)检出率分别为81.8%、59.2%和4.2%,

  7. Ultrasound-guided chest biopsies.

    Science.gov (United States)

    Middleton, William D; Teefey, Sharlene A; Dahiya, Nirvikar

    2006-12-01

    Pulmonary nodules that are surrounded by aerated lung cannot be visualized with sonography. Therefore, percutaneous biopsy must be guided with computed tomography or fluoroscopy. Although this restriction only applies to central lung nodules, it has permeated referral patterns for other thoracic lesions and has retarded the growth of ultrasound-guided interventions. Nevertheless, sonography is an extremely flexible modality that can expeditiously guide many biopsy procedures in the thorax. Peripheral pulmonary nodules can be successfully biopsied with success rates exceeding 90% and complications rates of less than 5%. Orienting the probe parallel to the intercostal space facilitates biopsies of peripheral pulmonary nodules. Anterior mediastinal masses that extend to the parasternal region are often easily approachable provided the internal mammary vessels, costal cartilage, and deep great vessels are identified and avoided. Superior mediastinal masses can be sampled from a suprasternal or supraclavicular approach. Phased array probes or tightly curved arrays may provide improved access for biopsies in this location. Posterior mediastinal masses are more difficult to biopsy with ultrasound guidance because of the overlying paraspinal muscles. However, when posterior mediastinal masses extend into the posterior medial pleural region, they can be biopsied with ultrasound guidance. Because many lung cancers metastasize to the supraclavicular nodes, it is important to evaluate the supraclavicular region when determining the best approach to obtain a tissue diagnosis. When abnormal supraclavicular nodes are present, they often are the easiest and safest lesions to biopsy.

  8. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid ... Needle Aspiration Biopsy of the Thyroid? What is Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? ...

  9. Antibiotic prophylaxis for transrectal prostate biopsy-a new strategy

    DEFF Research Database (Denmark)

    Antsupova, Valeria; Nørgaard, Nis; Bisbjerg, Rasmus

    2014-01-01

    BACKGROUND: Fluoroquinolones are extensively used as prophylaxis for transrectal ultrasound-guided biopsy of the prostate (TRUBP). Emerging fluoroquinolone resistance and selection of multiresistant organisms warrant new prophylactic strategies. Pivmecillinam and amoxicillin/clavulanic acid have...... pivmecillinam and amoxicillin/clavulanic acid was used (5.9%). CONCLUSIONS: The combination of pivmecillinam and amoxicillin/clavulanic acid is an attractive prophylaxis for TRUBP from a clinical, bacteriological and ecological point of view as compared with ciprofloxacin....

  10. Ultrasonographic-guided retrieval of cumulus oocyte complexes after super-stimulation in dromedary camel (Camelus dromedarius).

    Science.gov (United States)

    Wani, N A; Skidmore, J A

    2010-08-01

    In Experiment 1, studies were conducted to apply the transvaginal ultrasound guided ovum pick-up (OPU) technique in dromedary camels after their ovarian super-stimulation and in vivo oocyte maturation. In Experiment 2, the developmental potential of two commonly used oocyte types, i.e., in vivo matured oocytes collected by OPU and abattoir derived in vitro-matured oocytes was compared after their chemical activation. In Experiment 3, developmental competence of oocytes collected from super-stimulated camels by OPU, matured either in vivo or in vitro, was compared after their chemical activation. Mature female dromedary camels super-stimulated with a combination of eCG and pFSH were given an injection of 20 microg of the GnRH analogue, buserelin 24, 26, or 28 h before the scheduled OPU. For collection of cumulus oocyte complexes (COCs) the transducer was guided through the vulva into the cranial most portion of the vagina and 17-gauge, 55 cm single-lumen needle was placed in the needle guide of the ultrasound probe and advanced through the vaginal fornix and into the follicle. Follicular fluid was aspirated using a regulated vacuum pump into tubes containing embryo-flushing media. Aspirates were searched for COCs using a stereomicroscope, and they were then denuded of cumulus cells by hyaluronidase and repeated pipetting. The oocytes were classified as mature (with a visible polar body), immature (with no visible polar body), activated (with divided or fragmented ooplasm) and others (degenerated and abnormal). Overall an average of 12.12 +/- 7.9 COCs were aspirated per animal with an oocyte recovery rate from the aspirated follicles of about 77%. The majority (> 90%) of the collected COCs by OPU were with loose and expanded cumulus cells. The proportion of matured oocytes obtained at 28-29 h (91.2 +/- 4.1) and 26-27 h (82.1 +/- 3.4) were higher (P dromedary camels 26-28 h after GnRH administration. The developmental response, to chemical activation, of in vivo

  11. Ultrasound-guided removal of Implanon devices.

    LENUS (Irish Health Repository)

    Persaud, T

    2008-11-01

    Our study has shown that ultrasound-guided localisation and removal of Implanon rods is safe, practical and highly successful. Over a 4-year period, 119 patients had successful, uncomplicated removal of their subdermal devices.The technique is particularly useful for removal of the device when it is not palpable or when an attempt at removal of a palpable device has not been successful.

  12. Percutaneous ultrasound guided umbilical cord blood sampling

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Hyup; Choi, B. I.; Kim, C. W.; Youn, B. H.; Shin, H. C.; Kim, S. O. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1989-12-15

    This report describes a technique and the result of percutaneous ultrasound-guided umbilical cord blood sampling and its potential use in the management of diagnostic problems in the second and third trimester of pregnancy. This method has been employed in the prenatal assessment of 19 fetuses at risk for chromosomal disorders, fetal hypoxia and hematologic disorders. This simple and rapid procedure offers a safe access to the fetal circulation

  13. Ultrasound-guided sacroiliac joint injection technique.

    LENUS (Irish Health Repository)

    Harmon, Dominic

    2008-07-01

    We describe a case report and technique for using a portable ultrasound scanner and a curvilinear transducer (4-5MHz) (SonoSite Micromaxx SonoSite, Inc. 21919 30th Drive SE Bothwell W. A.) to guide sacroiliac joint (SIJ) injection. A 42-year-old male presented with chronic lower back pain centered on his left SIJ. His pain averaged 7 out of 10 (numerical rating scale). For the ultrasound-guided SIJ injection the patient was placed in the prone position. The ultrasound transducer was oriented in a transverse orientation at the level of the sacral hiatus. Here the sacral cornuae were identified. Moving the transducer laterally from here, the lateral edge of the sacrum was identified. This bony edge was followed in a cephalad direction with the transducer maintained in a transverse orientation. A second bony contour, the ileum, was identified. The cleft between both bony contours represented the sacroiliac joint. This was found at 4.5 cm depth. Real-time imaging was used to direct a 22G spinal needle into the SIJ, where solution was injected under direct vision. The patient\\'s pain intensity decreased to a 2 out of 10 (numerical rating scale). Function improved and the patient was able to return to work. These improvements were maintained at 16 weeks. Ultrasound guidance does not expose patients and personnel to radiation and is readily accessible. Ultrasound-guided SIJ injections may have particular applications in the management of chronic lower back pain in certain clinical scenarios (e.g. pregnancy). Future studies to demonstrate efficacy and reproducibility are needed.

  14. Ultrasound-guided botulinum toxin injections

    Directory of Open Access Journals (Sweden)

    S. E. Khatkova

    2016-01-01

    Full Text Available One of the key conditions for achieving the desirable result during botulinum toxin therapy for muscular dystonia, spasticity, and other diseases accompanied by spasm, pain, and autonomic dysfunction (dystonias, spasticity, etc. is the proper administration of the agent into the muscles directly involved in the pathological process. The exact entry of botulinum toxin into the target muscles is essential for successful and safe treatment because its injection into a normal muscle may cause side effects. The most common errors are the incorrect depth and incorrect direction of a needle on insertion. Therefore, the exact injection of the agent particularly into the shallow and deep muscles is a difficult task even for an experienced specialist and requires the use of controlling methods.The European Consensus on Botulinum Toxin Therapy points out that various injection techniques are needed for the better identification of necessary muscles. However, there are currently no reports on the clear advantage of any technique. In our country, injections using palpation and anatomical landmarks have been widely used in routine practice so far; electromyographic monitoring and electrostimulation have been less frequently applied. In recent years, the new method ultrasound-guided injection has continued to grow more popular. This effective, accessible, and easy-to-use method makes it possible to manage a real-time injection process and to ensure the exact entry of the agent into the muscle. This paper is dedicated to a comparative analysis of different injection methods and to a description of the ultrasound-guided technique and its advantages over others. 

  15. Ultrasound-guided endocavitary drainage of pelvic abscesses: Technique, results and complications

    Energy Technology Data Exchange (ETDEWEB)

    Ryan, R.S.; McGrath, F P.; Haslam, P.J.; Varghese, J.C.; Lee, M.J

    2003-01-01

    AIM: To evaluate the experience in our institution with ultrasound-guided transrectal and transvaginal (endocavitary) drainage of pelvic abscesses. MATERIALS AND METHODS: Eighteen patients (four male, 14 female; mean age 55 years, range 30-78 years) presenting with pelvic abscesses were referred to our institution for therapeutic drainage over a 4 year period. Patients received broad-spectrum antibiotics prior to drainage, which was performed by either the transvaginal or transrectal route under ultrasound guidance. Patients were given sedo-analgesia in the form of midazolam and fentanyl and local anaesthesia was also employed. Eight French catheters were inserted into the abscess cavities, and patients were subsequently monitored on a daily basis by a member of the interventional radiology team until such time as it was deemed appropriate to remove the catheter. RESULTS: Eighteen catheters were placed in 17 patients, and transvaginal aspiration alone was performed in one patient. Drainage was successful in 16 of 17 patients, but a transgluteal approach was ultimately required in the remaining patient to enable passage of a larger catheter into an infected haematoma. The mean duration of drainage was 5 days, mean time to defervesce 2 days. Spontaneous catheter dislodgement occurred in four patients associated with straining, but this did not have any adverse effect in three of the four patients. CONCLUSION: Endocavitary drainage is an effective method of treatment for pelvic abscesses. Spontaneous catheter dislodgement does not affect patient outcome.

  16. Transvaginal Ultrasound-Guided Aspiration of Pelvic Abscesses

    Directory of Open Access Journals (Sweden)

    P. J. Corsi

    1999-01-01

    Full Text Available Objective: To assess the utility of a less invasive approach to the care of women with a pelvic abscess, we retrospectively reviewed the outcome of women with pelvic abscesses managed by transvaginal ultrasound-guided aspiration.

  17. Transrectal Near-Infrared Optical Tomography for Prostate Imaging

    Science.gov (United States)

    2011-03-01

    2009. CA Cancer J Clin. 2009;59:225-249. 2. Hodge KK, McNeal JE, Stamey TA. Ultrasound guided transrectal core biopsies of the palpably abnormal...near-infrared spectroscopy: pilot results in the breast," Radiology 218, 261-266 (2001). [4] Tara Yates, Jeremy C Hebden, Adam Gibson, Nick ...digital rectal examination as screening tests for prostate carcinoma,” J Am Board Fam Pract.; 16(2):95- 101 (2003). 3. Hodge KK, McNeal JE, Stamey TA

  18. Safety of ultrasound-guided transrectal extended prostate biopsy in patients receiving low-dose aspirin

    Directory of Open Access Journals (Sweden)

    Ioannis Kariotis

    2010-06-01

    Full Text Available PURPOSE: To determine whether the peri-procedural administration of low-dose aspirin increases the risk of bleeding complications for patients undergoing extended prostate biopsies. MATERIALS AND METHODS: From February 2007 to September 2008, 530 men undergoing extended needle biopsies were divided in two groups; those receiving aspirin and those not receiving aspirin. The morbidity of the procedure, with emphasis on hemorrhagic complications, was assessed prospectively using two standardized questionnaires. RESULTS: There were no significant differences between the two groups regarding the mean number of biopsy cores (12.9 ± 1.6 vs. 13.1 ± 1.2 cores, p = 0.09. No major biopsy-related complications were noted. Statistical analysis did not demonstrate significant differences in the rate of hematuria (64.5% vs. 60.6%, p = 0.46, rectal bleeding (33.6% vs. 25.9%, p = 0.09 or hemospermia (90.1% vs. 86.9%, p = 0.45. The mean duration of hematuria and rectal bleeding was significantly greater in the aspirin group compared to the control group (4.45 ± 2.7 vs. 2.4 ± 2.6, p = < 0.001 and 3.3 ± 1.3 vs. 1.9 ± 0.7, p < 0.001. Multivariate logistic regression analysis revealed that only younger patients (mean age 60.1 ± 5.8 years with a lower body mass index (< 25 kg/m2 receiving aspirin were at a higher risk (odds ratio = 3.46, p = 0.047 for developing hematuria and rectal bleeding after the procedure. CONCLUSIONS: The continuing use of low-dose aspirin in patients undergoing extended prostatic biopsy is a relatively safe option since it does not increase the morbidity of the procedure.

  19. Safety of 12 core transrectal ultrasound guided prostate biopsy in patients on aspirin

    Directory of Open Access Journals (Sweden)

    Pawan Vasudeva

    2015-12-01

    Full Text Available Objective: To prospectively assess safety outcome of TRUS guided prostate biopsy in patients taking low dose aspirin. Materials and methods: Consecutive patients, who were planned for 12 core TRUS guided prostate biopsy and satisfied eligibility criteria, were included in the study and divided into two Groups: Group A: patients on aspirin during biopsy, Group B: patients not on aspirin during biopsy, including patients in whom aspirin was stopped prior to the biopsy. Parameters included for statistical analysis were: age, serum prostate specific antigen (PSA, prostate volume, hemoglobin (Hb %, number of hematuria episodes, number of patient reporting hematuria, hematuria requiring intervention, number of patient reporting hematospermia and number of patient reporting rectal bleeding. Results: Of 681 eligible patients, Group A and B had 191 and 490 patients respectively. The mean age, prostate volume, serum PSA and pre-biopsy hemoglobin were similar in both Groups with no significant differences noted between them. None of the post-biopsy complications, including number of hematuria episodes (p=0.83, number of patients reporting hematuria (p=0.55, number of patients reporting hematospermia (p=0.36 and number of patients reporting rectal bleeding (p=0.65, were significantly different between Groups A and B respectively. None of the hemorrhagic complication in either group required intervention and were self limiting. Conclusion: Continuing low dose aspirin during TRUS guided prostate biopsy neither alters the minor bleeding episodes nor causes major bleeding complication. So, discontinuation of low dose aspirin prior to TRUS guided prostate biopsy is not required.

  20. Is periprostatic nerve block a gold standard in case of transrectal ultrasound-guided prostate biopsy?

    Directory of Open Access Journals (Sweden)

    Ashok Kumar

    2013-01-01

    Conclusions: PNB provides better pain control in TRUS-guided prostate biopsy but still there is need of additional analgesic in the form of tramadol or INB. Tramadol has advantage of oral intake and analgesic effect at time of probe insertion and at nerve block. Both tramadol and INB may be used in combination along with PNB.

  1. Transrectal ultrasound-guided prostate biopsy in Taiwan: A nationwide database study

    Directory of Open Access Journals (Sweden)

    Tzu-Chun Wei

    2015-11-01

    Conclusion: The most frequent complication was postbiopsy voiding difficulty, followed by infection that required treatment and significant bleeding. The sepsis-related mortality rate was 0.13%. Significant risk factors for postbiopsy complications included age, diagnosis of prostate cancer, hospitalization, and the CCI value.

  2. Effectiveness of stress management in patients undergoing transrectal ultrasound-guided biopsy of the prostate

    OpenAIRE

    Chiu LP; Tung HH; Lin KC; Lai YW; Chiu YC; Chen SS; Chiu AW

    2016-01-01

    Li-Pin Chiu,1,2 Heng-Hsin Tung,3 Kuan-Chia Lin,3 Yu-Wei Lai,1,4 Yi-Chun Chiu,1,4 Saint Shiou-Sheng Chen,1,4 Allen W Chiu1,4 1Division of Urology, Taipei City Hospital, 2University of Taipei, General Education Center, 3School of Nursing, Department of Care Management, National Taipei University of Nursing and Health Science, 4Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China Background: To assess the utilization of stress mana...

  3. Bacteriology profile of febrile infectious complications after transrectal ultrasound-guided prostate biopsy

    Directory of Open Access Journals (Sweden)

    Tzu-Hao Huang

    2014-09-01

    Conclusion: Our study demonstrated an overall postbiopsy febrile complicating infection rate of 1.39%. E. coli was the most common pathogen. Fluoroquinolones or second generation cephalosporins are suggested as the initial choice in patients with postbiopsy fever.

  4. Current status of transrectal ultrasound-guided prostate biopsy in the diagnosis of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Raja, J. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom)]. E-mail: jowadraja@gmail.com; Ramachandran, N. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom); Munneke, G. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom); Patel, U. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom)

    2006-02-15

    In contemporary practice, most prostate cancers are either invisible on ultrasound or indistinguishable from concurrent benign prostatic hyperplasia. Diagnosis therefore rests on prostate biopsy. Biopsies are not simply directed at ultrasonically visible lesions, as these would miss many cancers; rather the whole gland is sampled. The sampling itself is systematic, using patterns based on prostate zonal anatomy and the geographical distribution and frequency of cancer. This review explains the evolution of the prostate biopsy technique, from the classical sextant biopsy method to the more recent extended biopsy protocols (8, 10, 12, >12 and saturation biopsy protocols). Extended protocols are increasingly being used to improve diagnostic accuracy, especially in those patients who require repeat biopsy. This trend has been facilitated by the ongoing improvement in safety and acceptability of the procedure, particularly with the use of antibiotic prophylaxis and local anaesthesia. The technical details of these extended protocols are discussed, as are the current data regarding procedure-related morbidity and how this may be minimized.

  5. Adaptation of a 3D prostate cancer atlas for transrectal ultrasound guided target-specific biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Narayanan, R; Suri, J S [Eigen Inc, Grass Valley, CA (United States); Werahera, P N; Barqawi, A; Crawford, E D [University of Colorado, Denver, CO (United States); Shinohara, K [University of California, San Francisco, CA (United States); Simoneau, A R [University of California, Irvine, CA (United States)], E-mail: jas.suri@eigen.com

    2008-10-21

    Due to lack of imaging modalities to identify prostate cancer in vivo, current TRUS guided prostate biopsies are taken randomly. Consequently, many important cancers are missed during initial biopsies. The purpose of this study was to determine the potential clinical utility of a high-speed registration algorithm for a 3D prostate cancer atlas. This 3D prostate cancer atlas provides voxel-level likelihood of cancer and optimized biopsy locations on a template space (Zhan et al 2007). The atlas was constructed from 158 expert annotated, 3D reconstructed radical prostatectomy specimens outlined for cancers (Shen et al 2004). For successful clinical implementation, the prostate atlas needs to be registered to each patient's TRUS image with high registration accuracy in a time-efficient manner. This is implemented in a two-step procedure, the segmentation of the prostate gland from a patient's TRUS image followed by the registration of the prostate atlas. We have developed a fast registration algorithm suitable for clinical applications of this prostate cancer atlas. The registration algorithm was implemented on a graphical processing unit (GPU) to meet the critical processing speed requirements for atlas guided biopsy. A color overlay of the atlas superposed on the TRUS image was presented to help pick statistically likely regions known to harbor cancer. We validated our fast registration algorithm using computer simulations of two optimized 7- and 12-core biopsy protocols to maximize the overall detection rate. Using a GPU, patient's TRUS image segmentation and atlas registration took less than 12 s. The prostate cancer atlas guided 7- and 12-core biopsy protocols had cancer detection rates of 84.81% and 89.87% respectively when validated on the same set of data. Whereas the sextant biopsy approach without the utility of 3D cancer atlas detected only 70.5% of the cancers using the same histology data. We estimate 10-20% increase in prostate cancer detection rates when TRUS guided biopsies are assisted by the 3D prostate cancer atlas compared to the current standard of care. The fast registration algorithm we have developed can easily be adapted for clinical applications for the improved diagnosis of prostate cancer. (note)

  6. Ultrasound-guided nerve block for inguinal hernia repair

    DEFF Research Database (Denmark)

    Bærentzen, Finn; Maschmann, Christian; Jensen, Kenneth;

    2012-01-01

    Open inguinal hernia repair in adults is considered a minor surgical procedure but can be associated with significant pain. We aimed to evaluate acute postoperative pain management in male adults randomized to receive an ultrasound-guided ilioinguinal and iliohypogastric nerve block administered...

  7. Ultrasound-guided renal biopsy with automated biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Pil Yeob; Kwon, Jae Soo [Masan Samsung Hospital, Masan (Korea, Republic of)

    1998-01-01

    To elevate the diagnostic yield and complications of percutaneous ultrasound-guided renal biopsy using a biopsy gun in patients with diffuse renal disease. Using an automated biopsy gun mounted with a 16 G needle, biopsies were performed on 90 patients with diffuse renal disease. In a total of 95 biopsies, diagnostic yield, the mean number of glomeruli and frequency of complication were retrospectively analysed. Tissue adequate for histological diagnosis was obtained in 92 % of procedures. Mean glomerular yield was 8.3, and complications were seen in 26% of the procedures, 25 % of these were minor, and 1% were major. For the diagnosis of diffuse renal disease, ultrasound-guided percutaneous renal biopsy using an automated biopsy gun is accurate and safe. (author). 25 refs., 1 tab.

  8. Ultrasound-guided surgical drainage of face and neck abscesses.

    Science.gov (United States)

    Yusa, H; Yoshida, H; Ueno, E; Onizawa, K; Yanagawa, T

    2002-06-01

    An ultrasound-guided surgical drainage technique in which grey-scale and colour Doppler ultrasonography were combined is described. The technique was performed for eight deep subcutaneous abscesses subsequent to odontogenic infection, and provided easy detection and accurate, reliable penetration of abscesses that were difficult to locate by physical examination. Colour Doppler ultrasonography is particularly useful for differentiating blood vessels from the static space of abscesses.

  9. Randomized controlled trial of antibiotic prophylaxis regimens for transrectai ultrasound-guided prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    CHAN Eddie Shu-yin; LO Ka-lun; NG Chi-fai; HOU See-ming; YIP Sidney Kam-hung

    2012-01-01

    Background A prior study showed significant antibioti resistance to quinotone in our poputation.In this study we aimed to evaluate and compare the efficacy of a single versus a combined prophylactic antibiotic regimen before transrectal ultrasound-guided prostate biopsy(TRUGPB).Methods A prospective randomized study was conducted at a university hospital.Patients undergoing TRUGPB were randomized into an amoicillin-clavulanate alone(1mg;one dose before and two doses after biopsy)or an amoxicllin-clavulanate+ciprofloxacin group(250mg;one dose before and two doses after biopsy).Patients were surveyed for infection symptoms by phine on days 3 and 30 after TRUGPB.We defined an infective complication as the iccurrence of symptoms including fever,chills or rigor within 30 days after prostate biopsy,requiring medical treatment or hospitalization,aided by a tertiory-wide etectronic medical record system.Results Between November 2007 and July 2009,367 patients were randomized to either amoxicillin-clavulanate alone or amoxicillin-caavulanate+ciprofloxacin group.The infection rates after TRUGPB were 3.9%in the former group(7 out of 179 patoents)versus 0.53%(1 out of 188 patients)in the latter.Sixty-three percent(5/8)of patients with infective complications needed hospitalization.There was no intensive care unit admission or mortality during the study period.Conclusions Combining prophylactic antibiotics with amoxicllin-clavulanate+soprofloxacin significantly reduced the in cidence of infective complications after TRUGPB.We recommended a combination regimen,especially in centre with high incidence of post-TRUGPB infection.

  10. Ultrasound-guided central venous access using Google Glass.

    Science.gov (United States)

    Wu, Teresa S; Dameff, Christian J; Tully, Jeffrey L

    2014-12-01

    The use of ultrasound during invasive bedside procedures is quickly becoming the standard of care. Ultrasound machine placement during procedures often requires the practitioner to turn their head during the procedure to view the screen. Such turning has been implicated in unintentional hand movements in novices. Google Glass is a head-mounted computer with a specialized screen capable of projecting images and video into the view of the wearer. Such technology may help decrease unintentional hand movements. Our aim was to evaluate whether or not medical practitioners at various levels of training could use Google Glass to perform an ultrasound-guided procedure, and to explore potential advantages of this technology. Forty participants of varying training levels were randomized into two groups. One group used Google Glass to perform an ultrasound-guided central line. The other group used traditional ultrasound during the procedure. Video recordings of eye and hand movements were analyzed. All participants from both groups were able to complete the procedure without difficulty. Google Glass wearers took longer to perform the procedure at all training levels (medical student year 1 [MS1]: 193 s vs. 77 s, p > 0.5; MS4: 197s vs. 91s, p ≤ 0.05; postgraduate year 1 [PGY1]: 288s vs. 125 s, p > 0.5; PGY3: 151 s vs. 52 s, p ≤ 0.05), and required more needle redirections (MS1: 4.4 vs. 2.0, p > 0.5; MS4: 4.8 vs. 2.8, p > 0.5; PGY1: 4.4 vs. 2.8, p > 0.5; PGY3: 2.0 vs. 1.0, p > 0.5). In this study, it was possible to perform ultrasound-guided procedures with Google Glass. Google Glass wearers, on average, took longer to gain access, and had more needle redirections, but less head movements were noted. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Ultrasound-guided drainage of a seroma following tumescent liposuction.

    Science.gov (United States)

    Stebbins, William G; Hanke, C William; Petersen, Jeffrey

    2011-01-01

    Of the complications that can occur following tumescent liposuction, seroma formation is unusual. It is a common practice for seromas to be aspirated blindly with a needle and syringe. We present a case of seroma formation following liposuction, with a subsequent step-by-step technical description of ultrasound-guided drainage of the seroma. Utilization of ultrasound provides a safe, effective method for aspirating seromas, allowing for accurate visualization and delineation of the seroma margins, proper needle placement, and monitoring of progress. It is a simple and useful tool in postprocedural management of patients undergoing liposuction. © 2011 Wiley Periodicals, Inc.

  12. Gelatin model for training ultrasound-guided puncture

    Directory of Open Access Journals (Sweden)

    Alexandre Campos Moraes Amato

    2015-09-01

    Full Text Available BACKGROUND: It is indispensable that members of the medical profession receive the technical training needed to enable them to rapidly obtain effective vascular access. Training procedures should be used judiciously to familiarize students with the technique. However, existing models are expensive or ineffective, and models need to be developed that are similar to what will be encountered in real patients.OBJECTIVES: To demonstrate creation and application of a gelatin model for training ultrasound-guided puncture.METHOS: The model was made using a mixture of colorless gelatin and water in a transparent plastic receptacle with two pairs of orifices of different diameters, through which two plastic tubes were inserted, to simulate blood vessels.RESULTS: The model was a close approximation to the real medical procedure in several aspects, since gelatin has a similar consistency to human tissues, providing a more faithful reproduction of the tactile sensation at the moment when the needle reaches the interior of a vessel and its contents are aspirated.CONCLUSIONS: The method proposed here can be used to easily construct a low-cost model using everyday materials that is suitable for large-scale training of ultrasound-guided puncture.

  13. Ultrasound-guided percutaneous core needle biopsy of splenic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Park, SangIk; Shin, Yong Moon; Won, Hyung Jin; Kim, Pyo Nyun; Lee, Moon Gyu [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2017-05-15

    To evaluate the safety and efficacy of ultrasound-guided percutaneous core needle biopsy of splenic lesions. This retrospective study included 30 patients who underwent percutaneous core needle biopsy of their splenic lesions using 18- or 20-gauge needles between January 2001 and July 2016 in a single tertiary care center. The characteristics of the splenic lesions were determined by reviewing the ultrasound and computed tomography examinations. Acquisition rate and diagnostic accuracy were calculated, using pathologic results of the splenectomy specimen, clinical course and/or imaging follow-up as a reference standard. Post-procedure complications were identified from electronic medical records, laboratory findings and computed tomography images. Seventy-three specimens were obtained from the 30 patients and splenectomy was performed in 2 patients. Twenty-nine of the 30 patients had focal splenic lesions, while the remaining patient had homogeneous splenomegaly. Acquisition rate and diagnostic accuracy were 80.0% (24/30) and 76.7% (23/30), respectively. Perisplenic hemorrhage without hemodynamic instability developed in one patient. Ultrasound-guided percutaneous core needle biopsy of splenic lesions is a safe method for achieving a histopathologic diagnosis and can be considered as an alternative to splenectomy in patients with a high risk of splenectomy-related complications.

  14. Ultrasound-guided drainage of subcutaneous abscesses on the trunk is feasible

    DEFF Research Database (Denmark)

    Kjær, Søren; Rud, Bo; Bay-Nielsen, Morten

    2013-01-01

    Subcutaneous trunk abscesses are frequent, and current treatment options generally involve incision. By contrast, the standard care for breast abcesses is ultrasound-guided drainage. The aim of this study was to evaluate the feasibility of ultrasound-guided drainage combined with antibiotics...... in the treatment of subcutaneous abscesses on the trunk....

  15. Endoscopic ultrasound guided fine needle aspiration versus endoscopic ultrasound guided fine needle biopsy in sampling pancreatic masses

    Science.gov (United States)

    Wang, Jing; Zhao, Shulei; Chen, Yong; Jia, Ruzhen; Zhang, Xiaohua

    2017-01-01

    Abstract Background: The comparison between endoscopic ultrasound guided fine needle aspiration (EUS-FNA) and endoscopic ultrasound guided fine needle biopsy (EUS-FNB) for the diagnosis of pancreatic masses is still controversial. Many factors can affect the final results. Methods: Databases, such as PubMed, EMBASE, Cochrane Library, and Science Citation Index updated from 2000 to 2016 were searched to include eligible articles. In the meta-analysis, the main outcome measurements were the diagnostic accuracy, number of needle passes, specimen adequacy, the rate of complications, and technical success. Results: Eight randomized controlled trials (RCTs) were identified, and a total of 921 cases were included in the meta-analysis. The diagnostic accuracy was not significantly different between the FNA and FNB groups. The specimen adequacy was higher in the FNB group compared with the FNA group. The number of needle passes to obtain sufficient tissue was lower in the FNB group. The rate of adverse events and technical success did not significantly differ between the 2 groups. But, the forest plot showed a trend toward lower technical success rate and a trend toward higher diagnostic accuracy in the FNB group, compared with FNA. Conclusion: We provide the evidence that FNB is comparable to FNA in terms of diagnostic accuracy, adverse events, and technical success. FNB gives higher specimen adequacy than that of FNA, despite performance of fewer needle passes. PMID:28700483

  16. Ultrasound-guided paravertebral block using an intercostal approach.

    Science.gov (United States)

    Ben-Ari, Alon; Moreno, Milena; Chelly, Jacques E; Bigeleisen, Paul E

    2009-11-01

    We describe an ultrasound-guided technique of continuous bilateral paravertebral block using an intercostal approach in 12 patients undergoing elective abdominal surgery. Postoperatively, each of the patient's paravertebral catheters was bolused with 10 mL lidocaine (15 mg/mL), and each of the patient's catheters was infused with 0.2% ropivacaine at 10 mL/h. Using a pinprick test, the median number of dermatomes blocked after the initial bolus was 5 (interquartile range, 4-6), and 23 of 24 catheters produced a local anesthetic block. The median verbal pain score on postoperative day 1 was 5.5 (interquartile range, 3.5-6), and median dose of IV hydromorphone consumed during the first 24 h after surgery was 1.9 mg (interquartile range, 0.7-5.05). All catheters were removed within 72 h after surgery.

  17. Ultrasound-guided piriformis muscle injection. A new approach.

    Science.gov (United States)

    Bevilacqua Alén, E; Diz Villar, A; Curt Nuño, F; Illodo Miramontes, G; Refojos Arencibia, F J; López González, J M

    2016-12-01

    Piriformis syndrome is an uncommon cause of buttock and leg pain. Some treatment options include the injection of piriformis muscle with local anesthetic and steroids. Various techniques for piriformis muscle injection have been described. Ultrasound allows direct visualization and real time injection of the piriformis muscle. We describe 5 consecutive patients, diagnosed of piriformis syndrome with no improvement after pharmacological treatment. Piriformis muscle injection with local anesthetics and steroids was performed using an ultrasound technique based on a standard technique. All 5 patients have improved their pain measured by numeric verbal scale. One patient had a sciatic after injection that improved in 10 days spontaneously. We describe an ultrasound-guided piriformis muscle injection that has the advantages of being effective, simple, and safe.

  18. Ultrasound-guided peripheral nerve blocks: what are the benefits?

    DEFF Research Database (Denmark)

    Nielsen, Zbigniew Jerzy Koscielniak

    2008-01-01

    BACKGROUND: Use of ultrasound by anaesthesiologists performing regional blocks is rapidly gaining popularity. The aims of this review were to summarize and update accumulating evidence on ultrasound-guided nerve blocks, with an emphasis on the clinical relevance of the results and to critically...... appraise changing standards in regional anaesthesia. METHODS: A search of MEDLINE and EMBASE (1966 to 31 December 2007) was conducted using the following free terms: 'ultrasound and regional anesthesia', 'ultrasound and peripheral block' and 'ultrasound and nerve and block'. These were combined......, the concomitant use of nerve stimulation offers no further advantage. However, several studies reported problems with obtaining satisfactory images in some patients. Ultrasound guidance significantly shortened the block performance time and/or reduced the number of needle passes to reach the target in all...

  19. Techniques for endoscopic ultrasound-guided fine-needle biopsy.

    Science.gov (United States)

    Panic, Nikola; Larghi, Alberto

    2014-01-01

    Although endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the method of choice to obtain samples to reach definitive diagnosis of lesions of the gastrointestinal tract and of adjacent organs, it cannot fully characterize certain neoplasms. The lack of cytology expertise has hindered the dissemination of EUS, limiting its widespread use. The obtainment of a tissue specimen through EUS fine-needle biopsy (EUS-FNB) may overcome the limitations of EUS-FNA. EUS-FNB is expected to move the practice of EUS from cytology to histology, expanding the use of EUS and facilitating targeted therapies and monitoring of treatment response in a more biologically driven manner. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. 3D versus 2D Systematic Transrectal Ultrasound-Guided Prostate Biopsy: Higher Cancer Detection Rate in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Alexandre Peltier

    2013-01-01

    Full Text Available Objectives. To compare prostate cancer detection rates of extended 2D versus 3D biopsies and to further assess the clinical impact of this method in day-to-day practice. Methods. We analyzed the data of a cohort of 220 consecutive patients with no prior history of prostate cancer who underwent an initial prostate biopsy in daily practice due to an abnormal PSA and/or DRE using, respectively, the classical 2D and the new 3D systems. All the biopsies were done by a single experienced operator using the same standardized protocol. Results. There was no significant difference in terms of age, total PSA, or prostate volume between the two groups. However, cancer detection rate was significantly higher using the 3D versus the 2D system, 50% versus 34% (P<0.05. There was no statistically significant difference while comparing the 2 groups in term of nonsignificant cancer detection. Conclusion. There is reasonable evidence demonstrating the superiority of the 3D-guided biopsies in detecting prostate cancers that would have been missed using the 2D extended protocol.

  1. Risk of prostate cancer diagnosis and mortality in men with a benign initial transrectal ultrasound-guided biopsy set

    DEFF Research Database (Denmark)

    Klemann, Nina; Røder, M Andreas; Helgstrand, J Thomas

    2017-01-01

    , and Dec 31, 2011, in Denmark were eligible for inclusion. Follow-up data were obtained on April 28, 2015. The primary endpoint was the cumulative incidence of prostate cancer-specific mortality, analysed in a competing risk setting, with death from other causes as the competing event. FINDINGS: Between...... information. The 20-year risk of prostate cancer-specific mortality in men with benign initial results is low. Our findings question whether men with low PSA concentration and a benign initial biopsy set should undergo further diagnostic assessment in view of the high risk of mortality from other causes...

  2. Intra-operative dosimetry of trans-rectal ultrasound guided 125I prostate implants using C-arm fluoroscopic images

    Directory of Open Access Journals (Sweden)

    Ravindran Paul

    2006-01-01

    Full Text Available Permanent implantation of radioactive seeds is a viable and effective therapeutic option widely used today for early-stage prostate cancer. The implant technique has improved considerably during the recent years due to the use of image guidance; however, real-time dose distributions would allow potential cold spots to be assessed and additional seeds added. In this study, we investigate the use of a conventional C-arm fluoroscopy unit for image acquisition and evaluation of dose distribution immediately after the implant. The phantom study indicates that it is possible to obtain seed positions within ±2 mm. A pilot study carried out with three patients indicated that it is possible to obtain seed positions and calculate the dose distribution with C-arm fluoroscopy and about 95% of the seeds were reconstructed within ±2 mm. The results could be further improved with better digital imaging.

  3. Optimizing prophylactic antibiotic regimen in patients admitted for transrectal ultrasound-guided prostate biopsies: A prospective randomized study

    Directory of Open Access Journals (Sweden)

    Ahmed Fahmy

    2016-09-01

    Conclusion: Determining the prevalence of fluoroquinolone resistance in rectal flora has important implications in the selection of targeted prophylactic antibiotic regimens. Antimicrobial profiles guided by rectal swabs may prove useful to optimize prophylaxis prior to TRUSBx; this strategy is effective at reducing the rates of infectious complications, including sepsis, especially in men at higher risk of infectious complications.

  4. Combined ciprofloxacin and amikacin prophylaxis in the prevention of septicemia after transrectal ultrasound guided biopsy of the prostate.

    Science.gov (United States)

    Kehinde, Elijah O; Al-Maghrebi, May; Sheikh, Mehraj; Anim, Jehoram T

    2013-03-01

    A steady increase in the incidence of septicemia after prostate biopsy in our unit between 2001 and 2005 prompted us to review our prophylactic antibiotic regimen. We compared the incidence of septicemia in patients undergoing prostate biopsy between 2001 and 2005 when only oral ciprofloxacin was used prophylactically (group 1) to the incidence among patients undergoing biopsy between 2006 and 2010 when a single dose of intravenous amikacin was added to ciprofloxacin (group 2). In group 1 the 300 patients were given 500 mg oral ciprofloxacin twice daily 1 day before and for 2 days after the biopsy while in group 2 the 897 patients, in addition to the ciprofloxacin previously mentioned, received 500 mg intravenous amikacin 30 minutes before the biopsy. Patients admitted to the hospital with septicemia after prostate biopsy had urine and blood culture and sensitivity tests. The number of patients in whom septicemia developed in each group after prostate biopsy and the microorganisms isolated from the urine and blood of such patients were compared using the chi-square test. Septicemia was seen in 24 of 300 (8%) and 15 of 897 (1.7%) patients in groups 1 and 2, respectively (p responsible for 33 of 39 (84.6%) septicemic cases. The addition of amikacin to ciprofloxacin prophylaxis significantly reduces the incidence of septicemia after prostate biopsy. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. NOTE: Adaptation of a 3D prostate cancer atlas for transrectal ultrasound guided target-specific biopsy

    Science.gov (United States)

    Narayanan, R.; Werahera, P. N.; Barqawi, A.; Crawford, E. D.; Shinohara, K.; Simoneau, A. R.; Suri, J. S.

    2008-10-01

    Due to lack of imaging modalities to identify prostate cancer in vivo, current TRUS guided prostate biopsies are taken randomly. Consequently, many important cancers are missed during initial biopsies. The purpose of this study was to determine the potential clinical utility of a high-speed registration algorithm for a 3D prostate cancer atlas. This 3D prostate cancer atlas provides voxel-level likelihood of cancer and optimized biopsy locations on a template space (Zhan et al 2007). The atlas was constructed from 158 expert annotated, 3D reconstructed radical prostatectomy specimens outlined for cancers (Shen et al 2004). For successful clinical implementation, the prostate atlas needs to be registered to each patient's TRUS image with high registration accuracy in a time-efficient manner. This is implemented in a two-step procedure, the segmentation of the prostate gland from a patient's TRUS image followed by the registration of the prostate atlas. We have developed a fast registration algorithm suitable for clinical applications of this prostate cancer atlas. The registration algorithm was implemented on a graphical processing unit (GPU) to meet the critical processing speed requirements for atlas guided biopsy. A color overlay of the atlas superposed on the TRUS image was presented to help pick statistically likely regions known to harbor cancer. We validated our fast registration algorithm using computer simulations of two optimized 7- and 12-core biopsy protocols to maximize the overall detection rate. Using a GPU, patient's TRUS image segmentation and atlas registration took less than 12 s. The prostate cancer atlas guided 7- and 12-core biopsy protocols had cancer detection rates of 84.81% and 89.87% respectively when validated on the same set of data. Whereas the sextant biopsy approach without the utility of 3D cancer atlas detected only 70.5% of the cancers using the same histology data. We estimate 10-20% increase in prostate cancer detection rates when TRUS guided biopsies are assisted by the 3D prostate cancer atlas compared to the current standard of care. The fast registration algorithm we have developed can easily be adapted for clinical applications for the improved diagnosis of prostate cancer.

  6. Proactive error analysis of ultrasound-guided axillary brachial plexus block performance.

    LENUS (Irish Health Repository)

    O'Sullivan, Owen

    2012-07-13

    Detailed description of the tasks anesthetists undertake during the performance of a complex procedure, such as ultrasound-guided peripheral nerve blockade, allows elements that are vulnerable to human error to be identified. We have applied 3 task analysis tools to one such procedure, namely, ultrasound-guided axillary brachial plexus blockade, with the intention that the results may form a basis to enhance training and performance of the procedure.

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

    Science.gov (United States)

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

    2016-06-01

    The purpose of this review is to discuss the rationale and indications for transvaginal ultrasound-guided biopsy. Transvaginal ultrasound-guided biopsy can be a helpful tool for diagnosis and treatment planning in the evaluation of pelvic masses, particularly when the anatomy precludes a transabdominal or posterior transgluteal percutaneous biopsy approach. A step-by-step summary of the technique with preprocedure and postprocedure considerations is included. © 2016 by the American Institute of Ultrasound in Medicine.

  8. Ultrasound-guided musculoskeletal interventions in American football: 18 years of experience.

    Science.gov (United States)

    Dave, Radhika B; Stevens, Kathryn J; Shivaram, Giri M; McAdams, Timothy R; Dillingham, Michael F; Beaulieu, Christopher F

    2014-12-01

    Myotendinous strains, contusions, and hematomas are common injuries in American football. Along with ligament sprains and inflammatory disorders, musculoskeletal injuries often result in lost participation time. This article summarizes 18 years of experience with 128 ultrasound-guided drainages and injections in 69 football players with 88 injuries. When performed by an operator with sufficient expertise in diagnostic and procedural skills, ultrasound-guided musculoskeletal interventions are minimally invasive, are safe, and can play an integral role in injury management.

  9. Ultrasound-guided interventional procedures around the shoulder.

    Science.gov (United States)

    Messina, Carmelo; Banfi, Giuseppe; Orlandi, Davide; Lacelli, Francesca; Serafini, Giovanni; Mauri, Giovanni; Secchi, Francesco; Silvestri, Enzo; Sconfienza, Luca Maria

    2016-01-01

    Ultrasound is an established modality for shoulder evaluation, being accurate, low cost and radiation free. Different pathological conditions can be diagnosed using ultrasound and can be treated using ultrasound guidance, such as degenerative, traumatic or inflammatory diseases. Subacromial-subdeltoid bursitis is the most common finding on ultrasound evaluation for painful shoulder. Therapeutic injections of corticosteroids are helpful to reduce inflammation and pain. Calcific tendinopathy of rotator cuff affects up to 20% of painful shoulders. Ultrasound-guided treatment may be performed with both single- and double-needle approach. Calcific enthesopathy, a peculiar form of degenerative tendinopathy, is a common and mostly asymptomatic ultrasound finding; dry needling has been proposed in symptomatic patients. An alternative is represented by autologous platelet-rich plasma injections. Intra-articular injections of the shoulder can be performed in the treatment of a variety of inflammatory and degenerative diseases with corticosteroids or hyaluronic acid respectively. Steroid injections around the long head of the biceps brachii tendon are indicated in patients with biceps tendinopathy, reducing pain and humeral tenderness. The most common indication for acromion-clavicular joint injection is degenerative osteoarthritis, with ultrasound representing a useful tool in localizing the joint space and properly injecting various types of drugs (steroids, lidocaine or hyaluronic acid). Suprascapular nerve block is an approved treatment for chronic shoulder pain non-responsive to conventional treatments as well as candidate patients for shoulder arthroscopy. This review provides an overview of these different ultrasonography-guided procedures that can be performed around the shoulder.

  10. Ultrasound-guided central venous catheterization in prone position

    Directory of Open Access Journals (Sweden)

    Sofi Khalid

    2010-01-01

    Full Text Available Central venous catheterization (CVC is a commonly performed intraoperative procedure. Traditionally, CVC placement is performed blindly using anatomic landmarks as a guide to vessel position. Real-time ultrasound provides the operator the benefit of visualizing the target vein and the surrounding anatomic structures prior to and during the catheter insertion, thereby minimizing complications and increasing speed of placement. A 22-year-old male underwent open reduction and internal fixation of acetabulum fracture in prone position. Excessive continuous bleeding intraoperatively warranted placement of CVC in right internal jugular vein (IJV, which was not possible in prone position without the help of ultrasound. Best view of right IJV was obtained and CVC was placed using real-time ultrasound without complications. Ultrasound-guided CVC placement can be done in atypical patient positions where traditional anatomic landmark technique has no role. Use of ultrasound not only increases the speed of placement but also reduces complications known with the traditional blind technique.

  11. Endoscopic ultrasound-guided celiac plexus block and neurolysis.

    Science.gov (United States)

    Yasuda, Ichiro; Wang, Hsiu-Po

    2017-02-03

    Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) is widely used for reducing pain originating from upper abdominal organs. It is mainly indicated to treat pancreatic cancer pain, but also to relieve pain as a result of chronic pancreatitis. Real-time guidance and color Doppler imaging by EUS made the procedure easier and safer, resulting in greater pain relief. Currently, two techniques are used for EUS-CPN. The classic approach, known as the central technique, involves injection of a neurolytic agent at the base of the celiac axis. In the bilateral technique, the neurolytic agent is injected on both sides of the celiac axis. In addition, EUS-guided direct celiac ganglia neurolysis (EUS-CGN) was introduced recently. Pain relief is achieved by EUS-CPN in 70-80% of patients with pancreatic cancer and in 50-60% of those with chronic pancreatitis. The bilateral technique may be more efficient than the central technique, although the central technique is easier and possibly safer. Moreover, EUS-CGN may provide greater pain relief than conventional EUS-CPN. Procedure-related complications include transient pain exacerbation, transient hypotension, transient diarrhea, and inebriation. Although most complications are not serious, major adverse events such as retroperitoneal bleeding, abscess, and ischemic complications occasionally occur.

  12. Ultrasound-guided fine needle aspiration versus core needle biopsy: comparison of post-biopsy hematoma rates and risk factors.

    Science.gov (United States)

    Chae, In Hye; Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Park, Vivian Y; Kwak, Jin Young

    2017-07-01

    To compare post-biopsy hematoma rates between ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy, and to investigate risk factors for post-biopsy hematoma. A total of 5304 thyroid nodules which underwent ultrasound guided biopsy were included in this retrospective study. We compared clinical and US features between patients with and without post-biopsy hematoma. Associations between these features and post-biopsy hematoma were analyzed. Post-biopsy hematoma rate was 0.8% (43/5121) for ultrasound guided-fine needle aspiration and 4.9% (9/183) for ultrasound guided-core needle biopsy (P fine needle aspiration, gender, age, size, presence of vascularity, and suspicious US features were not associated with post-biopsy hematoma according to experience level. Post-biopsy hematoma occurred significantly more with ultrasound guided-core needle biopsy (9/179, 5.0%) than with ultrasound guided-fine needle aspiration (9/1138, 0.8%) (P needle biopsy was the only significant risk factor for post-biopsy hematoma (adjusted Odds Ratio, 6.458, P biopsy hematoma occurred significantly more in ultrasound guided-core needle biopsy than in ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy was the only independent factor of post-biopsy hematoma in thyroid nodules.

  13. Ultrasound-guided genitourinary interventions: principles and techniques

    Directory of Open Access Journals (Sweden)

    Byung Kwan Park

    2017-10-01

    Full Text Available Ultrasound (US is often used to guide various interventional procedures in the genitourinary (GU tract because it can provide real-time imaging without any radiation hazard. Moreover, US can clearly visualize the pathway of an aspiration or biopsy needle to ensure the safety of the intervention. US guidance also helps clinicians to access lesions via the transabdominal, transhepatic, transvaginal, transrectal, and transperineal routes. Hence, US-guided procedures are useful for radiologists who wish to perform GU interventions. However, US-guided procedures and interventions are difficult for beginners because they involve a steep initial learning curve. The purpose of this review is to describe the basic principles and techniques of US-guided GU interventions.

  14. Ultrasound-guided interventional procedures around the shoulder

    Science.gov (United States)

    Messina, Carmelo; Banfi, Giuseppe; Orlandi, Davide; Lacelli, Francesca; Serafini, Giovanni; Mauri, Giovanni; Secchi, Francesco; Silvestri, Enzo

    2016-01-01

    Ultrasound is an established modality for shoulder evaluation, being accurate, low cost and radiation free. Different pathological conditions can be diagnosed using ultrasound and can be treated using ultrasound guidance, such as degenerative, traumatic or inflammatory diseases. Subacromial–subdeltoid bursitis is the most common finding on ultrasound evaluation for painful shoulder. Therapeutic injections of corticosteroids are helpful to reduce inflammation and pain. Calcific tendinopathy of rotator cuff affects up to 20% of painful shoulders. Ultrasound-guided treatment may be performed with both single- and double-needle approach. Calcific enthesopathy, a peculiar form of degenerative tendinopathy, is a common and mostly asymptomatic ultrasound finding; dry needling has been proposed in symptomatic patients. An alternative is represented by autologous platelet-rich plasma injections. Intra-articular injections of the shoulder can be performed in the treatment of a variety of inflammatory and degenerative diseases with corticosteroids or hyaluronic acid respectively. Steroid injections around the long head of the biceps brachii tendon are indicated in patients with biceps tendinopathy, reducing pain and humeral tenderness. The most common indication for acromion–clavicular joint injection is degenerative osteoarthritis, with ultrasound representing a useful tool in localizing the joint space and properly injecting various types of drugs (steroids, lidocaine or hyaluronic acid). Suprascapular nerve block is an approved treatment for chronic shoulder pain non-responsive to conventional treatments as well as candidate patients for shoulder arthroscopy. This review provides an overview of these different ultrasonography-guided procedures that can be performed around the shoulder. PMID:26313499

  15. Ultrasound-guided Thrombin Injection: An Alternative Treatment for Femoral Artery Pseudoaneurysm with Better Efficiency and Safety

    Institute of Scientific and Technical Information of China (English)

    Qinghai YAO; Hongliang CONG; Shangqin WU; Shan SUN; Qike DONG; Dongmei CHEN; Peng LI

    2008-01-01

    The aim of this study was to evaluate the efficiency and safety of ultrasound-guided thrombin injection on femoral pseudoaneurysm (FPA) as compared to ultrasound-guided local oppression. Eleven cases of FPA were enrolled and 7 cases received ultrasound-guide thrombin injection (injection group), and the remaining 4 cases were treated with local oppression (oppression group). Efficiency and safety were analyzed by ultrasound and subsequent follow-up. The results showed that 1 case relapsed in oppression group while no relapse occurred in thrombin injection group. Ultrasound-guided thrombin injection is better for treatment of FPA in terms of effectiveness and safety.

  16. Internal jugular vein cannulation: an ultrasound-guided technique versus a landmark-guided technique

    Directory of Open Access Journals (Sweden)

    Gurkan Turker

    2009-01-01

    Full Text Available OBJECTIVES: To compare the landmark-guided technique versus the ultrasound-guided technique for internal jugular vein cannulation in spontaneously breathing patients. METHODS: A total of 380 patients who required internal jugular vein cannulation were randomly assigned to receive internal jugular vein cannulation using either the landmark- or ultrasound-guided technique in Bursa, Uludag University Faculty of Medicine, between April and November, 2008. Failed catheter placement, risk of complications from placement, risk of failure on first attempt at placement, number of attempts until successful catheterization, time to successful catheterization and the demographics of each patient were recorded. RESULTS: The overall complication rate was higher in the landmark group than in the ultrasound-guided group (p < 0.01. Carotid puncture rate and hematoma were more frequent in the landmark group than in the ultrasound-guided group (p < 0.05. The number of attempts for successful placement was significantly higher in the landmark group than in the ultrasound-guided group, which was accompanied by a significantly increased access time observed in the landmark group (p < 0.05 and p < 0.01, respectively. Although there were a higher number of attempts, longer access time, and a more frequent complication rate in the landmark group, the success rate was found to be comparable between the two groups. CONCLUSION: The findings of this study indicate that internal jugular vein catheterization guided by real-time ultrasound results in a lower access time and a lower rate of immediate complications.

  17. Internal Jugular Vein Cannulation: An Ultrasound-Guided Technique Versus a Landmark-Guided Technique

    Science.gov (United States)

    Turker, Gurkan; Kaya, Fatma Nur; Gurbet, Alp; Aksu, Hale; Erdogan, Cuneyt; Atlas, Ahmet

    2009-01-01

    OBJECTIVES To compare the landmark-guided technique versus the ultrasound-guided technique for internal jugular vein cannulation in spontaneously breathing patients. METHODS A total of 380 patients who required internal jugular vein cannulation were randomly assigned to receive internal jugular vein cannulation using either the landmark- or ultrasound-guided technique in Bursa, Uludag University Faculty of Medicine, between April and November, 2008. Failed catheter placement, risk of complications from placement, risk of failure on first attempt at placement, number of attempts until successful catheterization, time to successful catheterization and the demographics of each patient were recorded. RESULTS The overall complication rate was higher in the landmark group than in the ultrasound-guided group (p < 0.01). Carotid puncture rate and hematoma were more frequent in the landmark group than in the ultrasound-guided group (p < 0.05). The number of attempts for successful placement was significantly higher in the landmark group than in the ultrasound-guided group, which was accompanied by a significantly increased access time observed in the landmark group (p < 0.05 and p < 0.01, respectively). Although there were a higher number of attempts, longer access time, and a more frequent complication rate in the landmark group, the success rate was found to be comparable between the two groups. CONCLUSION The findings of this study indicate that internal jugular vein catheterization guided by real-time ultrasound results in a lower access time and a lower rate of immediate complications. PMID:19841706

  18. Breast lesions with discordant results on ultrasound-guided core needle biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Jin Hee; Ko, Eun Young; Kim, Min Jeong; Lee, Kwan Seop; Lee Yul; Bae, Sang Hoon; Min, Soo Kee [Hallym University College of Medicine, Anyang (Korea, Republic of)

    2006-03-15

    We wanted to evaluate the characteristics of those lesions showing insufficient results on ultrasound-guided core needle biopsy. We retrospectively reviewed the pathologic results of 131 lesions from patients who underwent ultrasound-guided core needle biopsy following Mammotome or surgical excisional biopsy from January 2004 to December 2004. Compared with excisional biopsy, ultrasound-guided core needle biopsy showed 14 lesions with discordant results and 9 lesions with indeterminate results. 5 lesions were overestimated and 9 lesions were underestimated on the core needle biopsies. According to the histological tumor types, the papillary tumors showed 66.6% discordance or indetermination, and the phyllodes tumors showed 50% discordance or indetermination. On the results of core needle biopsy, discordant or indeterminate results were frequently reported for papillary and phyllodes tumor. Therefore, excisional biopsy is recommended for these types of tumor.

  19. Comparison of Ultrasound-Guided and Fluoroscopy-Assisted Antegrade Common Femoral Artery Puncture Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Slattery, Michael M.; Goh, Gerard S.; Power, Sarah; Given, Mark F.; McGrath, Frank P.; Lee, Michael J., E-mail: mlee@rcsi.ie [Beaumont Hospital, Department of Radiology (Ireland)

    2015-06-15

    PurposeTo prospectively compare the procedural time and complication rates of ultrasound-guided and fluoroscopy-assisted antegrade common femoral artery (CFA) puncture techniques.Materials and MethodsHundred consecutive patients, undergoing a vascular procedure for which an antegrade approach was deemed necessary/desirable, were randomly assigned to undergo either ultrasound-guided or fluoroscopy-assisted CFA puncture. Time taken from administration of local anaesthetic to vascular sheath insertion in the superficial femoral artery (SFA), patients’ age, body mass index (BMI), fluoroscopy radiation dose, haemostasis method and immediate complications were recorded. Mean and median values were calculated and statistically analysed with unpaired t tests.ResultsSixty-nine male and 31 female patients underwent antegrade puncture (mean age 66.7 years). The mean BMI was 25.7 for the ultrasound-guided (n = 53) and 25.3 for the fluoroscopy-assisted (n = 47) groups. The mean time taken for the ultrasound-guided puncture was 7 min 46 s and for the fluoroscopy-assisted technique was 9 min 41 s (p = 0.021). Mean fluoroscopy dose area product in the fluoroscopy group was 199 cGy cm{sup 2}. Complications included two groin haematomas in the ultrasound-guided group and two retroperitoneal haematomas and one direct SFA puncture in the fluoroscopy-assisted group.ConclusionUltrasound-guided technique is faster and safer for antegrade CFA puncture when compared to the fluoroscopic-assisted technique alone.

  20. Efficacy of ultrasound-guided percutaneous needle treatment of calcific tendinitis.

    Science.gov (United States)

    Vignesh, K Nithin; McDowall, Adam; Simunovic, Nicole; Bhandari, Mohit; Choudur, Hema N

    2015-01-01

    The purpose of this study was to conduct a systematic review of the efficacy of ultrasound-guided needle lavage in treating calcific tendinitis. Two independent assessors searched medical databases and screened studies for eligibility. Eleven articles were included. Heterogeneity among included studies precluded meta-analysis. Results of randomized controlled trials suggested no difference in pain relief between needle lavage and other interventions, but the studies were of low quality. Additional high-quality evidence is required to determine the relative efficacy of ultrasound-guided needle lavage in the management of calcific tendinitis of the rotator cuff.

  1. Septic bursitis after ultrasound-guided percutaneous treatment of rotator cuff calcific tendinopathy.

    Science.gov (United States)

    Sconfienza, Luca Maria; Randelli, Filippo; Sdao, Silvana; Sardanelli, Francesco; Randelli, Pietro

    2014-08-01

    Calcific tendinopathy of the rotator cuff is a common condition. Ultrasound-guided percutaneous aspiration is one of several options to treat this condition. The main advantages of this procedure are short duration, good outcome, and low cost. Furthermore, only minor complications have been reported in the literature, namely, vagal reactions during the procedure and mild postprocedural pain. We report the first case of septic bursitis after ultrasound-guided percutaneous treatment of calcific tendinopathy. Although this is generally considered a very safe procedure, a risk of infection should be taken into account. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  2. Endoscopic ultrasound-guided coeliac plexus neurolysis to reduce pain in patients with pancreatic cancer

    DEFF Research Database (Denmark)

    Vilmann, Andreas Slot; Karstensen, John Gésdal; Cherciu, Irina;

    2014-01-01

    Pain is among the most common symptoms in patients with pancreatic cancer and up to 80% require analgesics, most often as opioids. Unfortunately the analgesic effect is frequently insufficient, and increasing doses are required, resulting in unpleasant side effects. Endoscopic ultrasound......-guided neurolysis is a well established method to alleviate or reduce pain due to pancreatic cancer with a documented effect in 80% of patients. The aim of this review is to draw attention to endoscopic ultrasound-guided neurolysis and to discuss its potential which may not be fully utilized....

  3. Comparison of follicular dynamics, superovulatory response, and embryo recovery between estradiol based and conventional superstimulation protocol in buffaloes (Bubalus bubalis

    Directory of Open Access Journals (Sweden)

    Narinder Singh

    2015-08-01

    Full Text Available Aim: To evaluate the follicular dynamics, superovulatory response, and embryo recovery following superstimulatory treatment initiated at estradiol-17β induced follicular wave emergence and its comparison with conventional superstimulatory protocol in buffaloes. Materials and Methods: Six normal cycling pluriparous buffaloes, lactating, 90-180 days post-partum, and weighing between 500 and 660 kg were superstimulated twice with a withdrawal period of 35 days in between two treatments. In superstimulation protocol-1 (estradiol group buffaloes were administered estradiol-17β (2 mg, i.m. and eazibreed controlled internal drug release (CIDR was inserted intravaginally (day=0 at the random stage of the estrous cycle. On the day 4, buffaloes were superstimulated using follicle stimulating hormone (FSH 400 mg, divided into 10 tapering doses given at 12 hourly intervals. Prostaglandin F2α analogs (PGF2α was administered at day 7.5 and day 8, and CIDR was removed with the second PGF2α injection. In superstimulation protocol - 2 (conventional group buffaloes were superstimulated on the 10th day of the estrous cycle with same FSH dose regimen and similar timings for PGF2α injections. In both groups, half of the buffaloes were treated with luteinizing hormone (LH 25 mg and other half with 100 ug buserelin; gonadotrophin releasing hormone (GnRH analog at 12 h after the end of FSH treatment. All buffaloes in both protocols were inseminated twice at 12 and 24 h of LH/GnRH treatment. Daily ultrasonography was performed to record the size and number of follicles and superovulatory response. Results: Significantly higher number of small follicles (8 mm, corpora lutea, and transferable embryos was higher in buffaloes superstimulated at estradiol-induced follicular wave compared to the conventional protocol: Further the percentage of transferable embryos was significantly higher in buffaloes administered with LH compared to GnRH.

  4. Endoscopic ultrasound guided emergency coil and glue for actively bleeding duodenal varix after failed endoscopy

    Directory of Open Access Journals (Sweden)

    S Choudhary Narendra

    2015-01-01

    Full Text Available Management of ectopic variceal bleed may be difficult at times due to anatomical location or presence of collaterals. We present a case of an elderly cirrhotic male with acute upper gastrointestinal bleed due to a large duodenal varix successfully managed by endoscopic ultrasound guided coil placement along with glue (N-butyl-2-cyanoacrylate injection.

  5. Safety and Efficacy of Ultrasound-Guided Fiducial Marker Implantation for CyberKnife Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Hyun; Hong, Seong; Sook; Kim, Jung Hoon; Park, Hyun Jeong; Chang, Yun Woo; Chang, A Ram [Soonchunhyang University Seoul Hospital, Seoul (Korea, Republic of); Kwon, Seok Beom [Hallym University College of Medicine, Chuncheon (Korea, Republic of)

    2012-06-15

    To evaluate the safety and technical success rate of an ultrasound-guided fiducial marker implantation in preparation for CyberKnife radiation therapy. We retrospectively reviewed 270 percutaneous ultrasound-guided fiducial marker implantations in 77 patients, which were performed from June 2008 through March 2011. Of 270 implantations, 104 were implanted in metastatic lymph nodes, 96 were in the liver, 39 were in the pancreas, and 31 were in the prostate. During and after the implantation, major and minor procedure-related complications were documented. We defined technical success as the implantation enabling adequate treatment planning and CT simulation. The major and minor complication rates were 1% and 21%, respectively. One patient who had an implantation in the liver suffered severe abdominal pain, biloma, and pleural effusion, which were considered as major complication. Abdominal pain was the most common complication in 11 patients (14%). Among nine patients who had markers inserted in the prostate, one had transient hematuria for less than 24 hours, and the other experienced transient voiding difficulty. Of the 270 implantations, 261 were successful (97%). The reasons for unsuccessful implantations included migration of fiducial markers (five implantations, 2%) and failure to discriminate the fiducial markers (three implantations, 1%). Among the unsuccessful implantation cases, six patients required additional procedures (8%). The symptomatic complications following ultrasound-guided percutaneous implantation of fiducial markers are relatively low. However, careful consideration of the relatively higher rate of migration and discrimination failure is needed when performing ultrasound-guided percutaneous implantations of fiducial markers.

  6. Serial transvaginal ultrasound-guided biopsy of the porcine corpus luteum in vivo

    NARCIS (Netherlands)

    Björkman, S.; Yun, J.; Niku, M.; Oliviero, C.; Soede, N.M.; Peltoniemi, O.A.T.

    2016-01-01

    The aims of the present study was to develop and describe a transvaginal ultrasound-guided biopsy method for luteal tissue in the porcine and to evaluate the effects of the method on the reproductive tract, ovarian status and pregnancy status. Biopsies were performed in four multiparous sows on Days

  7. 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.

  8. A novel concept for continuous peripheral nerve blocks. Presentation of a new ultrasound-guided device

    DEFF Research Database (Denmark)

    Rothe, C; Steen-Hansen, C; Madsen, M H;

    2015-01-01

    to the sciatic nerve in the popliteal fossa. Circumferential spread of 3-ml isotonic saline around the sciatic nerve was observed on ultrasound images in both conditions. CONCLUSION: Preliminary proof of concept of this novel method demonstrates that precise in-plane ultrasound-guided initial placement...

  9. PLUS: open-source toolkit for ultrasound-guided intervention systems.

    Science.gov (United States)

    Lasso, Andras; Heffter, Tamas; Rankin, Adam; Pinter, Csaba; Ungi, Tamas; Fichtinger, Gabor

    2014-10-01

    A variety of advanced image analysis methods have been under the development for ultrasound-guided interventions. Unfortunately, the transition from an image analysis algorithm to clinical feasibility trials as part of an intervention system requires integration of many components, such as imaging and tracking devices, data processing algorithms, and visualization software. The objective of our paper is to provide a freely available open-source software platform-PLUS: Public software Library for Ultrasound-to facilitate rapid prototyping of ultrasound-guided intervention systems for translational clinical research. PLUS provides a variety of methods for interventional tool pose and ultrasound image acquisition from a wide range of tracking and imaging devices, spatial and temporal calibration, volume reconstruction, simulated image generation, and recording and live streaming of the acquired data. This paper introduces PLUS, explains its functionality and architecture, and presents typical uses and performance in ultrasound-guided intervention systems. PLUS fulfills the essential requirements for the development of ultrasound-guided intervention systems and it aspires to become a widely used translational research prototyping platform. PLUS is freely available as open source software under BSD license and can be downloaded from http://www.plustoolkit.org.

  10. Value of Artisanal Simulators to Train Veterinary Students in Performing Invasive Ultrasound-Guided Procedures

    Science.gov (United States)

    Hage, Maria Cristina F. N. S.; Massaferro, Ana Beatriz; Lopes, Érika Rondon; Beraldo, Carolina Mariano; Daniel, Jéssika

    2016-01-01

    Pericardial effusion can lead to cardiac tamponade, which endangers an animal's life. Ultrasound-guided pericardiocentesis is used to remove abnormal liquid; however, it requires technical expertise. In veterinary medical education, the opportunity to teach this procedure to save lives during emergencies is rare; therefore, simulators are…

  11. STUDY ON COMPARISON BETWEEN LANDMARK GUIDED (BRINKMAN'S TECHNIQUE ) AND ULTRASOUND GUIDED INTERNAL JUGULAR VEIN CANNULATION

    OpenAIRE

    Vinod; Sashi Walling

    2015-01-01

    Technique of cannulating the central veins , until recently has been based on landmark guided technique . Recently ultrasound machines with high frequency probes are being used to increase success rate and reducing complications. OBJECTIVE: In our study we compare landmark guided technique ( Brinkman's technique ) ( 1 ) with ultrasound guided technique. STUDY DESIGN: outcome was evaluated in terms of 1 ) Number of attempts 2 ) ...

  12. Bilateral Ultrasound Guided Supraclavicular Block in a Patient on Antiplatelet Drugs

    Directory of Open Access Journals (Sweden)

    Lokesh Kumar KS

    2015-04-01

    Full Text Available A 63 year old male hypertensive and diabetic patient, with coronary artery and chronic obstructive pulmonary disease, presented with bilateral both bone forearm fracture. Open reduction and internal fixation was done successfully with bilateral ultrasound guided supraclavicular block. The problems associated with peripheral nerve block in an Ischemic Heart Disease (IHD patient on antiplatelet therapy are discussed.

  13. Ultrasound-Guided Bipolar Umbilical Cord Occlusion in Complicated Monochorionic Pregnancies

    DEFF Research Database (Denmark)

    Schou, Katrine V; Jensen, Lisa N; Jørgensen, Connie

    2017-01-01

    INTRODUCTION: Ultrasound-guided bipolar umbilical cord occlusion (UCO) is used in complicated monochorionic multiple pregnancies in Denmark. The aim of this study was to assess a learning curve in the procedure of UCO. MATERIALS AND METHODS: One hundred and two monochorionic pregnancies treated...

  14. Efficacy of a single ultrasound-guided injection for the treatment of hip osteoarthritis.

    LENUS (Irish Health Repository)

    Atchia, Ismaël

    2011-01-01

    Intra-articular injection is effective for osteoarthritis, but the best single injection strategy is not known, nor are there established predictors of response. The objectives of this study were to assess and predict response to a single ultrasound-guided injection in moderate to severe hip osteoarthritis.

  15. Ultrasound-guided block of the axillary nerve: a volunteer study of a new method

    DEFF Research Database (Denmark)

    Rothe, C; Asghar, S; Andersen, H L;

    2011-01-01

    Interscalene brachial plexus block (IBPB) is the gold standard for perioperative pain management in shoulder surgery. However, a more distal technique would be desirable to avoid the side effects and potential serious complications of IBPB. Therefore, the aim of the present study was to develop a...... and describe a new method to perform an ultrasound-guided specific axillary nerve block....

  16. Serial transvaginal ultrasound-guided biopsy of the porcine corpus luteum in vivo

    NARCIS (Netherlands)

    Björkman, S.; Yun, J.; Niku, M.; Oliviero, C.; Soede, N.M.; Peltoniemi, O.A.T.

    2017-01-01

    The aims of the present study was to develop and describe a transvaginal ultrasound-guided biopsy method for luteal tissue in the porcine and to evaluate the effects of the method on the reproductive tract, ovarian status and pregnancy status. Biopsies were performed in four multiparous sows on Days

  17. Analgesic effect of ultrasound-guided transversus abdominis plane block after total abdominal hysterectomy

    DEFF Research Database (Denmark)

    Røjskjaer, Jesper O; Gade, Erik; Kiel, Louise B

    2015-01-01

    OBJECTIVE: To assess the effect of bilateral ultrasound-guided transversus abdominis plane block with ropivacaine compared with placebo as part of a multimodal analgesic regimen. DESIGN: A randomized, double-blind, placebo-controlled trial following the CONSORT criteria. SETTING: Hvidovre Univers...

  18. Feasibility of ultrasound-guided intraarticular contrast injection for MR arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Soo Jin; Lee, Jong Min; Kang, Duck Sick [Kyungpook National University School of Medicine, Daegu (Korea, Republic of)

    2005-07-15

    To assess the feasibility of ultrasound-guided intraarticular contrast injection using the posterior approach for MR arthrography. Between June 2002 and October 2004, 132 patients (29 female, 103 male: mean age, 33.6 years) underwent ultrasound-guided intraarticular contrast media injection (40 ml saline + 10 ml 2% lidocaine + 0.2 ml gadopentetate dimeglumine + 0.4 ml epinephrine) for MR arthrography. The patients were classified into four groups, viz. the no leakage group, the minor leakage with successful intraarticular injection group, the major leakage with unsuccessful intraarticular injection group, and the injection failure group. The 'no leakage' and 'minor leakage' groups were considered to be technical successes, while the 'major leakage' and 'injection failure' groups were regarded as technical failures. The technical success rate of ultrasound-guided intraarticular contrast injection using the posterior approach for MR Arthrography was 99.2% (131/132 patients) and one patients 0.7% (1/132 patients) was included in the 'major leakage' group. Ultrasound-guided intraarticular contrast injection using the posterior approach for MR arthrography was feasible with a high success rate.

  19. Ultrasound-guided synovial Tru-cut biopsy: indications, technique, and outcome in 111 cases.

    Science.gov (United States)

    Sitt, Jacqueline C M; Griffith, James F; Lai, Fernand M; Hui, Mamie; Chiu, K H; Lee, Ryan K L; Ng, Alex W H; Leung, Jason

    2017-05-01

    To investigate the diagnostic performance of ultrasound-guided synovial biopsy. Clinical notes, pathology and microbiology reports, ultrasound and other imaging studies of 100 patients who underwent 111 ultrasound-guided synovial biopsies were reviewed. Biopsies were compared with the final clinical diagnosis established after synovectomy (n = 43) or clinical/imaging follow-up (n = 57) (mean 30 months). Other than a single vasovagal episode, no complication of synovial biopsy was encountered. One hundred and seven (96 %) of the 111 biopsies yielded synovium histologically. Pathology ± microbiology findings for these 107 conclusive biopsies comprised synovial tumour (n = 30, 28 %), synovial infection (n = 18, 17 %), synovial inflammation (n = 45, 42 %), including gouty arthritis (n = 3), and no abnormality (n = 14, 13 %). The accuracy, sensitivity, and specificity of synovial biopsy was 99 %, 97 %, and 100 % for synovial tumour; 100 %, 100 %, and 100 % for native joint infection; and 78 %, 45 %, and 100 % for prosthetic joint infection. False-negative synovial biopsy did not seem to be related to antibiotic therapy. Ultrasound-guided Tru-cut synovial biopsy is a safe and reliable technique with a high diagnostic yield for diagnosing synovial tumour and also, most likely, for joint infection. Regarding joint infection, synovial biopsy of native joints seems to have a higher diagnostic yield than that for infected prosthetic joints. • Ultrasound-guided Tru-cut synovial biopsy has high accuracy (99 %) for diagnosing synovial tumour. • It has good accuracy, sensitivity, and high specificity for diagnosis of joint infection. • Synovial biopsy of native joints works better than biopsy of prosthetic joints. • A negative synovial biopsy culture from a native joint largely excludes septic arthritis. • Ultrasound-guided Tru-cut synovial biopsy is a safe and well-tolerated procedure.

  20. Ultrasound-guided core needle biopsy in the diagnosis of neuroblastic tumors in children: a retrospective study on 83 cases.

    Science.gov (United States)

    Zhao, Lihui; Mu, Jie; Du, Ping; Wang, Hailing; Mao, Yiran; Xu, Yong; Xin, Xiaojie; Zang, Fenglin

    2017-03-01

    Ultrasound-guided biopsy technique with the large-core needle has widely been applied in the diagnosis of adult abdominopelvic cavity, thyroid, and neck tumors. There are few reports on ultrasound-guided biopsy using large-core needle in pediatric abdominopelvic cavity tumors. This study was to evaluate the ultrasound features and the diagnostic value of ultrasound-guided core needle biopsy for pediatric neuroblastic tumors. The pediatric patients with neuroblastic tumor that underwent ultrasound examination and ultrasound-guided core needle biopsy from January 2009 to November 2015 were reviewed. A minimum of two cores in each case was obtained. The biopsy results were confirmed by subsequent surgical histopathology. The ultrasound features and the diagnostic accuracy of ultrasound-guided core needle biopsy were evaluated. Eighty-three patients were enrolled into the study. Conventional ultrasound examination showed irregular hypoechoic or mixed echo masses and calcification and liquefied necrosis. The diagnostic accuracy of ultrasound-guided core needle biopsy was 96.4% (80/83). Three cases were misdiagnosed because of inadequate tissue sample. No serious complication, infection, or needle track seeding occurred. Ultrasound-guided core needle biopsy seems to be an accurate, minimally invasive, and safe diagnostic method of pediatric neuroblastic tumor.

  1. Ultrasound-Guided 50% Ethyl Alcohol Injection for Patients With Malleolar and Olecranon Bursitis: A Prospective Pilot Study

    Science.gov (United States)

    Hong, Ji Seong; Lee, Jin Hyung

    2016-01-01

    Objective To evaluate the feasibility and effect of ultrasound-guided ethyl alcohol injection on malleolar and olecranon synovial proliferative bursitis. Methods Twenty-four patients received ultrasound-guided 50% diluted ethyl alcohol injection at the site of synovial proliferative bursitis after aspiration of the free fluid. Results Swelling and symptoms significantly decreased in 13 of the 24 patients without any complications. Eleven patients had partial improvement in swelling and symptoms. Conclusion Ultrasound-guided alcohol injection could be an alternative therapeutic option before surgery in patients with chronic intractable malleolar and olecranon synovial proliferative bursitis. PMID:27152282

  2. Percutaneous subclavian artery stent-graft placement following failed ultrasound guided subclavian venous access

    Directory of Open Access Journals (Sweden)

    Szkup Peter

    2006-05-01

    Full Text Available Abstract Background Ultrasound guidance for central and peripheral venous access has been proven to improve success rates and reduce complications of venous cannulation. Appropriately trained and experienced operators add significantly to diminished patient morbidity related to venous access procedures. We discuss a patient who required an arterial stent-graft to prevent arterial hemorrhage following inadvertent cannulation of the proximal, ventral, right subclavian artery related to unsuccessful ultrasound guided access of the subclavian vein. Case presentation During pre-operative preparation for aortic valve replacement and aorto-coronary bypass surgery an anesthetist attempted ultrasound guided venous access. The ultrasound guided attempt to access the right jugular vein failed and the ultrasound guided attempt at accessing the subclavian vein resulted in inappropriate placement of an 8.5 F sheath in the arterial system. Following angiographic imaging and specialist consultations, an arterial stent-graft was deployed in the right subclavian artery rather than perform an extensive anterior chest wall resection and dissection to extract the arterial sheath. The patient tolerated the procedure, without complication, despite occlusion of the right internal mammary artery and the right vertebral artery. There were no neurologic sequelae. There was no evidence of hemorrhage after subclavian artery sheath extraction and stent-graft implantation. Conclusion The attempted ultrasound guided puncture of the subclavian vein resulted in placement of an 8.5 F subclavian artery catheter. Entry of the catheter into the proximal subclavian artery beneath the medial clavicle, the medial first rib and the manubrium suggests that the operator, most likely, did not directly visualize the puncture needle enter the vessel with the ultrasound. The bones of the anterior chest impede the ultrasound beam and the vessels in this area would not be visible to ultrasound

  3. Transcriptome profile of one-month-old lambs’ granulosa cells after superstimulation

    Science.gov (United States)

    Wu, Yangsheng; Lin, Jiapeng; Li, Xiaolin; Han, Bing; Wang, Liqin; Liu, Mingjun; Huang, Juncheng

    2017-01-01

    Objective Superstimulatory treatment of one-month-old lambs can achieve synchronous development of numerous growing follicles. However, these growing follicles cannot complete maturation and ovulation. Oocyte maturation and competence are acquired during follicular development, in which granulosa cells play an essential role. Methods In this study, we applied RNA sequencing to analyze and compare gene expression between prepubertal and adult superstimulated follicle granulosa cells in sheep. Results There were more than 300 genes that significantly differed in expression. Among these differently expressed genes, many extracellular matrix genes (EGF containing Fibulin Like Extracellular Matrix Protein 1, pentraxin 3, adrenomedullin, and osteopontin) were significantly down-regulated in the superstimulated follicles. Ingenuity pathway and gene ontology analyses revealed that processes of axonal guidance, cell proliferation and DNA replication were expressed at higher levels in the prepubertal follicles. Epidermal growth factor, T-Box protein 2 and beta-estradiol upstream regulator were predicted to be active in prepubertal follicles. By comparison, tumor protein P53 and let-7 were most active in adult follicles. Conclusion These results may contribute to a better understanding of the mechanisms governing the development of granulosa cells in the growing follicle in prepubertal sheep. PMID:27189640

  4. Assessment and clinical factors associated with pain in patients undergoing transrectal prostate biopsy.

    Science.gov (United States)

    Gómez-Gómez, E; Ramírez, M; Gómez-Ferrer, A; Rubio-Briones, J; Iborra, I; J Carrasco-Valiente; Campos, J P; Ruiz-García, J; Requena-Tapia, M J; Solsona, E

    2015-09-01

    To quantify the degree of pain experienced by patients who undergo ultrasound-guided transrectal prostate biopsy in standard clinical practice and assess the clinical factors associated with increased pain. Analysis of a multicenter series of patients with prostate biopsy according to standard clinical practice. The biopsy was performed transrectally with a protocol of local anesthesia on the posterolateral nerve bundle. The pain was assessed at 20minutes into the procedure using the visual analog scale (0-10). The degree of pain was analyzed, and the association was studied using a univariate/multivariate analysis of selected clinical variables and the degree of pain. A total of 1188 patients with a median age of 64 years were analyzed. Thirty percent of the biopsies were diagnosed with a tumor. The median pain score was 2, with 65% of the patients reporting a pain score ≤2. The multivariate analysis showed that the prostate volume (RR, 1.34; 95% CI 1.01-1.77; P=.04), having a previous biopsy (RR, 2.25; 95% CI 1.44-3.52; P<.01), age (RR, .63; 95% CI .47-.85; P<.01) and feel palpation (RR, 1.95; 95% CI 1.28-2.96; P<.01) were factors independently associated with greater pain during the procedure. Transrectal biopsy with local anesthesia is a relatively painless technique. Factors such as age, a previous biopsy, pain on being touched and prostate volume were associated with the presence of greater pain during the procedure. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Targeted histology sampling from atypical small acinar proliferation area detected by repeat transrectal prostate biopsy

    Directory of Open Access Journals (Sweden)

    A. V. Karman

    2017-01-01

    Full Text Available Оbjective: to define the approach to the management of patients with the detected ASAP area.Materials and methods. In the time period from 2012 through 2015, 494 patients with previously negative biopsy and remaining suspicion of prostate cancer (PCa were examined. The patients underwent repeat 24-core multifocal prostate biopsy with taking additional tissue samples from suspicious areas detected by multiparametric magnetic resonance imaging and transrectal ultrasound. An isolated ASAP area was found in 127 (25. 7 % of the 494 examined men. All of them were offered to perform repeat target transrectal biopsy of this area. Targeted transrectal ultrasound guided biopsy of the ASAP area was performed in 56 (44.1 % of the 127 patients, 53 of them being included in the final analysis.Results. PCa was diagnosed in 14 (26.4 % of the 53 patients, their mean age being 64.4 ± 6.9 years. The average level of prostate-specific antigen (PSA in PCa patients was 6.8 ± 3.0 ng/ml, in those with benign lesions – 9.3 ± 6.5 ng/ml; the percentage ratio of free/total PSA with PCa was 16.2 ± 7,8 %, with benign lesions – 23.3 ± 7.7 %; PSA density in PCa patients was 0.14 ± 0.07 ng/ml/cm3, in those with benign lesions – 0.15 ± 0.12 ng/ml/cm3. Therefore, with ASAP area being detected in repeat prostate biopsy samples, it is advisable that targeted extended biopsy of this area be performed. 

  6. Comparative study between ultrasound guided tap block and paravertebral block in upper abdominal surgeries. Randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ruqaya M. Elsayed

    2017-01-01

    Conclusion: We concluded that ultrasound guided transversus abdominis plane block and thoracic paravertebral block were safe and effective anesthetic technique for upper abdominal surgery with longer and potent postoperative analgesia in thoracic paravertebral block than transversus abdominis block.

  7. Unilateral versus bilateral ultrasound-guided transversus abdominis plane blocks during ureteric shock wave lithotripsy: A prospective randomized trial

    Directory of Open Access Journals (Sweden)

    Ali Mohamed Ali Elnabtity

    2016-01-01

    Conclusion: Ultrasound-guided unilateral TAP block is as safe and effective analgesic technique as bilateral TAP blocks during unilateral ureteric SWL. It can be used as the sole analgesic technique during ureteric SWL.

  8. The role of ultrasound guided percutaneous needle aspiration and lavage (barbotage in the treatment of calcific tendinitis

    Directory of Open Access Journals (Sweden)

    Gamal Niazi

    2015-03-01

    Conclusion: Ultrasound guided aspiration and lavage (barbotage is a highly effective, less aggressive method of treatment in cases of calcific tendinosis, especially for cases with severe pain that does not respond to other conservative methods.

  9. Benefits and Pitfalls of Cadavers as Learning Tool for Ultrasound-guided Regional Anesthesia

    Science.gov (United States)

    Sawhney, Chhavi; Lalwani, Sanjeev; Ray, Bikash Ranjan; Sinha, Sumit; Kumar, Abhyuday

    2017-01-01

    Ultrasound-guided regional anesthesia (UGRA), like other basic skills, should be learnt in a simulation laboratory before performing on the patient. Cadavers provide an ideal tool for learning sonoanatomy and skills required for performing UGRA. On the basis of preservation technique used, the cadavers can be formalin embalmed cadavers, Thiel cadavers (soft cadavers), and fresh frozen cadavers. We compared three types of cadavers for performing ultrasound-guided upper and lower limb blocks. We observed that fresh frozen and Thiel cadavers were less smelling and had more realistic appearance as compared to formalin embalmed cadavers. It was seen that Thiel cadavers were more flexible and hence, rotation of neck, shoulder and knee was easier. Although images seen in most cadavers were comparable with live subjects but, Thiel cadavers provided more realistic model.

  10. Ultrasound-guided percutaneous injection of methylene blue to identify nerve pathology and guide surgery.

    Science.gov (United States)

    Osorio, Joseph A; Breshears, Jonathan D; Arnaout, Omar; Simon, Neil G; Hastings-Robinson, Ashley M; Aleshi, Pedram; Kliot, Michel

    2015-09-01

    OBJECT The objective of this study was to provide a technique that could be used in the preoperative period to facilitate the surgical exploration of peripheral nerve pathology. METHODS The authors describe a technique in which 1) ultrasonography is used in the immediate preoperative period to identify target peripheral nerves, 2) an ultrasound-guided needle electrode is used to stimulate peripheral nerves to confirm their position, and then 3) a methylene blue (MB) injection is performed to mark the peripheral nerve pathology to facilitate surgical exploration. RESULTS A cohort of 13 patients with varying indications for peripheral nerve surgery is presented in which ultrasound guidance, stimulation, and MB were used to localize and create a road map for surgeries. CONCLUSIONS Preoperative ultrasound-guided MB administration is a promising technique that peripheral nerve surgeons could use to plan and execute surgery.

  11. Surgery versus ultrasound-guided steroid injections for trigger finger disease

    DEFF Research Database (Denmark)

    Hansen, Rehne L; Lange, Jeppe

    2013-01-01

    -centre, randomised controlled trial with a one-year follow-up. Patients are randomly assigned to either ultrasound-guided corticosteroid injection (n = 83) or to open surgical release of A1-pulley (n = 83). Follow-up is conducted at 12 weeks and one year after treatment. The affected finger will be assessed using......INTRODUCTION: Trigger fingers have been reported in the literature for over a century; yet, the lack of trials comparing open surgery to corticosteroid injection is pronounced. At the initiation of the present study in 2010, no randomized controlled trials could be found comparing open surgery...... to corticosteroid injection. In the present randomized controlled trial, we plan to compare the efficacy of a single ultrasound-guided corticosteroid injection with conventional open surgery in terms of ability to correct the trigger finger. MATERIAL AND METHODS: The study is performed as an open-label single...

  12. Ultrasound-guided bilateral dual transversus abdominis plane block: a new four-point approach

    DEFF Research Database (Denmark)

    Neimann, Jens Dupont Børglum; Maschmann, C; Belhage, B;

    2011-01-01

    Background: We describe a new ultrasound-guided bilateral dual transversus abdominis plane block. Our hypothesis was that we could anaesthetize both the upper (Th6–Th9) and the lower (Th10–Th12) abdominal wall bilaterally using a four-point single-shot technique to provide effective post-operativ......Background: We describe a new ultrasound-guided bilateral dual transversus abdominis plane block. Our hypothesis was that we could anaesthetize both the upper (Th6–Th9) and the lower (Th10–Th12) abdominal wall bilaterally using a four-point single-shot technique to provide effective post...... scale 0–10) from a mean of 8.2 to a mean of 2.2 10 min after block performance (P

  13. Ultrasound guided electrochemotherapy for the treatment of a clear cell thymoma in a cat

    Science.gov (United States)

    Spugnini, Enrico Pierluigi; Menicagli, Francesco; Pettorali, Michela; Baldi, Alfonso

    2017-01-01

    A twelve-year-old male castrated domestic shorthair cat was presented for rapidly progressing respiratory distress. The cat was depressed, tachypneic and moderately responsive. Ultrasonography showed a mediastinal mass associated with a significant pleural effusion that needed tapping every five to seven days. Ultrasound guided biopsy yielded a diagnosis of clear cell thymoma upon histopathology. After complete staging procedures, the owner elected to treat the cat with electrochemotherapy (ECT) using systemic bleomycin. Two sessions of ultrasound guided ECT were performed at two week intervals with trains of biphasic electric pulses applied using needle electrodes until complete coverage of the area was achieved. The treatment was well tolerated and resulted in partial remission (PR). Additional sessions were performed on a monthly basis. The cat is still in PR after fourteen months. ECT resulted in improved local control and should be considered among the available adjuvant treatments in pets carrying visceral tumors. PMID:28331834

  14. Endoscopic ultrasound-guided fine needle aspiration cytology and biopsy in the evaluation of lymphoma

    Science.gov (United States)

    Gimeno-García, Antonio Z.; Elwassief, Ahmed; Paquin, Sarto C.; Sahai, Anand V.

    2012-01-01

    Accurate diagnosis and subtyping of lymphoma have important prognostic implications and are generally required for treatment planning. Histological assessment, immunophenotyping, and genetic studies are usually necessary. Endoscopic ultrasound guided-fine needle aspiration cytology (EUS-FNAC) is a minimally invasive technique widely used for the evaluation of deep-seated benign and malignant lesions. However, the value of cytological samples in lymphoma diagnosis is still a matter of debate. Endoscopic ultrasound guided-fine needle biopsy (EUS-FNAB) can provide tissue core samples that may help overcome the limitations of cytology. The aim of this review is to summarize the available literature regarding EUS-FNAC and EUS-FNAB for the diagnosis and subtyping of lymphoma. In addition, we discuss its usefulness in the management of primary extra-nodal lymphomas, as well as technical issues that may influence sample quality. PMID:24949331

  15. Endoscopic ultrasound-guided ethanol ablation ofpancreatic neuroendocrine tumours: A case study andliterature review

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Here we offer a review of the literature regardingendoscopic ultrasound-guided ethanol ablation forpancreatic neuroendocrine tumours and describe thecase of a cystic tumour completely ablated after amultisession procedure. A total of 35 PubMed indexedcases of treated functioning and non-functioningpancreatic neuroendocrinetumours resulted fromour search, 29 of which are well-documented andsummarised. Endoscopic ultrasound-guided ethanolablation appears as a local, minimallyinvasive treatmentof pancreatic neuroendocrinetumours, suitable forselected patients. This techniqueappears feasible,relatively safe and efficient, especiallywhen applied tosymptom relief in functioning tumours, aiming at loss ofendocrine secretion. For non-functioning tumours, wherethe goal is complete tissue ablation, eus guided ethanolablation can provide good results for patients whoare unfit for surgery or for those who refuse surgicalresection. Its role in "fit for surgery" patients requiresassessment through further studies.

  16. Ultrasound-guided Intraarticular Hip Injection for Osteoarthritis Pain in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Erik S Anderson

    2013-09-01

    Full Text Available Ultrasound-guided intraarticular hip corticosteroid injections may be useful for emergency care providers treating patients with painful exacerbations of osteoarthritis of the hip. Corticosteroid injection is widely recommended as a first-line treatment for painful osteoarthritis of the hip. Bedside ultrasound is readily available in most emergency departments; however, using ultrasound to guide therapeutic hip injections has not yet been described in emergency practice. Herein, we present the first description of a successful emergency physician-performed ultrasound-guided hip injection of local anesthetic and corticosteroid for pain control in a patient with an acute exacerbation of osteoarthritis. [West J Emerg Med. 2013;14(5:505–508.

  17. Ultrasound-Guided Perineural Injection at Guyon's Tunnel: An Anatomic Feasibility Study.

    Science.gov (United States)

    Meng, Stefan; Tinhofer, Ines; Grisold, Wolfgang; Weninger, Wolfgang J

    2015-08-01

    Compression of the ulnar nerve (UN) at the wrist causes neuropathy in the ulnar tunnel (UT), or Guyon's tunnel. In the absence of trauma and motor syndromes, primarily conservative treatment is considered. As in carpal tunnel syndrome, a perineural injection of corticosteroids may be beneficial. The aim of this study was to investigate the feasibility of ultrasound-guided injections at the UT. We performed ultrasound-guided injections of ink at the UN within the UT in 21 limbs from 11 non-embalmed cadavers. In all cases, we stained the perineural sheath of the superficial branch of the ulnar nerve within the UT. No ink was found inside the nerve or in adjacent structures such as blood vessels and tendons. In conclusion, perineural injection of the UN in the UT seems to be a technically feasible procedure. On the basis of these anatomic data, clinical trials are needed to prove the concept for routine use.

  18. Diagnosis of Giant Cell Tumor of Temporomandibular Joint with Ultrasound-guided Core Needle Biopsy

    Directory of Open Access Journals (Sweden)

    Chih Yung Yang

    2014-09-01

    Full Text Available Temporomandibular joint (TMJ tumors may initially present with symptoms similar to TMJ internal derangements and myositis of masticatory muscles. However, malignant tumors and specific types of benign tumors, such as giant cell tumors, may need aggressive surgical intervention. The current case is a 41-year-old man who initially presented with right preauricular pain. Computed tomography (CT revealed a destructive bone lesion over the right TMJ with temporal bone destruction. A biopsy conducted with an ultrasound-guided core needle confirmed that the lesion was a giant cell tumor. Giant cell tumors can eventually destroy the surrounding tissue. Magnetic resonance imaging and CT have been traditionally used to evaluate TMJ disorders, whereas ultrasonography provides real-time imaging for evaluating the joint structure, movement, and biopsy guidance. For a TMJ tumor, a precise diagnosis is necessary for adequate planning of treatment. Ultrasound-guided core needle biopsy is a safe and effective method for confirming a diagnosis.

  19. Transbiliary intravascular ultrasound-guided diagnostic biopsy of an inaccessible pancreatic head mass

    Directory of Open Access Journals (Sweden)

    Jeffrey Forris Beecham Chick, MD, MPH, DABR

    2017-06-01

    Full Text Available Percutaneous image-guided biopsies of pancreatic malignancies may prove challenging and nondiagnostic due to a variety of anatomic considerations. For patients with complex post-surgical anatomy, such as a Roux-en-Y gastric bypass, diagnosis via endoscopic ultrasound with fine-needle aspiration may not be possible because of an inability to reach the proximal duodenum. This report describes the first diagnostic case of transbiliary intravascular ultrasound-guided biopsy of a pancreatic head mass in a patient with prior Roux-en-Y gastric bypass for which a diagnosis could not be achieved via percutaneous and endoscopic approaches. Transbiliary intravascular ultrasound-guided biopsy resulted in a diagnosis of pancreatic adenocarcinoma, allowing the initiation of chemotherapy.

  20. Ultrasound-guided injection for the biceps brachii tendinitis: results and experience.

    Science.gov (United States)

    Zhang, Jingwei; Ebraheim, Nabil; Lause, Gregory E

    2011-05-01

    The purpose of this study was to identify the results of ultrasound-guided injection of corticosteroid for biceps brachii tendinitis. In this randomized and prospective study, we evaluated 45 patients who were treated by free-hand injection without ultrasound guidance (group A) and 53 patients who were treated by ultrasound-guided injection (group B). The mean age was 47 y (range, 28 to 72). The average follow-up was 33 weeks (range, 24 to 56). The visual analog scale score decreased from 7.1 ± 2.3 before injection to 4.2 ± 3.1 at follow-up in group A and from 6.9 ± 2.6 to 2.1 ± 1.9 in group B (p biceps brachii tendinitis.

  1. Comparison of the Effects of Ultrasound-Guided Interfascial Pulsed Radiofrequency and Ultrasound-Guided Interfascial Injection on Myofascial Pain Syndrome of the Gastrocnemius.

    Science.gov (United States)

    Park, So Min; Cho, Yun Woo; Ahn, Sang Ho; Lee, Dong Gyu; Cho, Hee Kyung; Kim, Sung Yup

    2016-10-01

    To investigate the comparative treatment effects of ultrasound-guided pulsed radiofrequency treatment (UG-PRF) in the gastrocnemius interfascial space and ultrasound-guided interfascial injection (UG-INJ) on myofascial pain syndrome. Forty consecutive patients with myofascial pain syndrome of the gastrocnemius were enrolled and were allocated to one of the two groups. Twenty patients were treated by UG-PRF delivered to the gastrocnemius interfascial space (UG-PRF group) and the other 20 patients were treated by interfascial injection (UG-INJ group). The primary outcome measure was the numeric rating score (NRS) for pain on pressing the tender point in the gastrocnemius, and the secondary outcome measure was health-related quality of life as determined by the Short Form-36 questionnaire (SF-36). NRSs were obtained at the first visit, immediately after treatment, and at 2 and 4 weeks post-treatment, and physical component summary scores (PCS) and mental component summary scores (MCS) of the SF-36 questionnaire were measured at the first visit and at 4 weeks post-treatment. Immediately after treatments, mean NRS in the UG-PRF group was significantly higher than that in the UG-INJ group (pmyofascial pain syndrome of the gastrocnemius.

  2. Ultrasound-Guided 50% Ethyl Alcohol Injection for Patients With Malleolar and Olecranon Bursitis: A Prospective Pilot Study

    OpenAIRE

    2016-01-01

    Objective To evaluate the feasibility and effect of ultrasound-guided ethyl alcohol injection on malleolar and olecranon synovial proliferative bursitis. Methods Twenty-four patients received ultrasound-guided 50% diluted ethyl alcohol injection at the site of synovial proliferative bursitis after aspiration of the free fluid. Results Swelling and symptoms significantly decreased in 13 of the 24 patients without any complications. Eleven patients had partial improvement in swelling and sympto...

  3. Cancer incidence of larger thyroid nodules and the diagnostic value of palpation and ultrasound guided fine needle aspiration biopsy

    OpenAIRE

    Umut Rıza Gündüz; Arif Aslaner; Rojbin Karakoyun Demirci; Hasan Çalış; Osman Zekai Öner; Nurullah Bülbüller

    2014-01-01

    In this prospective study, we aimed to determine the cancer incidence of thyroid nodules larger than 3cm and compare the efficacy of palpation and ultrasound guided fine needle aspiration biopsy (FNAB). The study was conducted at General Surgery Departments of Istanbul Okmeydanı and Antalya Training and Research Hospitals of Turkey from March 2008 to December 2011. In our clinics, between the years 2008 and 2011, both palpation and ultrasound guided FNAB were performed in all 55 patients havi...

  4. An estimation of the minimum effective anesthetic volume of 2% lidocaine in ultrasound-guided axillary brachial plexus block.

    LENUS (Irish Health Repository)

    O'Donnell, Brian D

    2009-07-01

    Ultrasound guidance facilitates precise needle and injectate placement, increasing axillary block success rates, reducing onset times, and permitting local anesthetic dose reduction. The minimum effective volume of local anesthetic in ultrasound-guided axillary brachial plexus block is unknown. The authors performed a study to estimate the minimum effective anesthetic volume of 2% lidocaine with 1:200,000 epinephrine (2% LidoEpi) in ultrasound-guided axillary brachial plexus block.

  5. A SA study on complications in ultrasound guided catheterization of the internal jugular vein

    Directory of Open Access Journals (Sweden)

    Henjarappa KS

    2015-06-01

    Full Text Available Background: With the advanced knowledge in medical monitoring, ever increasing value has been placed on the establishment of central venous catheter. During the past few years, monitoring of central venous pressure has become an important aid in the management of critically ill patients. Doppler ultrasound was first used to assist central venous catheter insertion in 1984. Ultrasound has been applied to describe the anatomy of the IJV and to evaluate various techniques for percutaneous cannulation. Real time sonography improves access to the vein compared with the traditional method. Ultrasound guided cannulation limits complications and also the decreases the cannulation time. For reducing the complication in traditional method we have conducted the study through ultrasound guide and observed the complications in new method. Methods: Thirty critical care patients were selected for IJV cannulation either by ultrasound guided technique. This study conducted in department of anesthesiology and critical care, M. S. Ramaiah medical college, Bangalore. Results: In our study there was 100% success rate for first attempt cannulation in USG technique. The mean access time in USG technique was 152.50 +/- 63.90 sec. in USG technique arrhythmias were noted in 1 (3.3% case during the study. No cases of haematoma, pneumothorax, haemothorax, nerve Injury, carotid artery puncture and catheter malposition were noted during the study in USG technique. Conclusion: Ultrasound guided technique improves the cannulation of the IJV with respect to safety, rapidity and comfort to the patient during the procedure. [Int J Res Med Sci 2015; 3(3.000: 693-697

  6. High-flow vascular malformation treatment using ultrasound-guided laser combined with polidocanol sclerotherapy.

    Science.gov (United States)

    Zhang, Yan; Zhou, Ping; Li, Lan; Li, Jia-le

    2015-07-01

    The current treatment for vascular malformations includes surgery, sclerotherapy, and embolization. However, each method has its limitations, such as recurrence, complications, scarring, and radiation exposure. Therefore, identifying an effective, minimally invasive treatment that reduces lesion recurrence is particularly important. We describe in detail a patient who received treatment with ultrasound-guided laser interruption of feeding vessels combined with polidocanol sclerotherapy after the recurrence of forearm high-flow vascular malformation.

  7. Ultrasound-guided Corticosteroid Injection for the Treatment of Athletic Pubalgia: A Series of 12 Cases

    OpenAIRE

    Jean Jose; Buller, Leonard T.; Alex Fokin Jr.; Ross Wodicka; Ty Subhawong; Bryson Lesniak

    2015-01-01

    Surgical treatment for athletic pubalgia is the standard of care, however, it poses risks. This study investigated the use of ultrasound-guided corticosteroid injections as an alternative treatment. Twelve consecutive patients underwent injections into the area of degeneration in the rectus abdominis and/or adductor longus aponeurosis. The Western Ontario and McMaster Universities (WOMAC) scores were used to evaluate treatment effectiveness. The average WOMAC score was 90.9. With a mean follo...

  8. Ultrasound-guided posterior approach to brachial plexus for the treatment of upper phantom limb syndrome.

    Science.gov (United States)

    Tognù, A; Borghi, B; Gullotta, S; White, P F

    2012-01-01

    The purpose of the case is to report the clinical value of the ultrasound-guided posterior approach to the brachial plexus in the treatment of phantom limb syndrome after an upper extremity amputation. The author experienced ultrasound guidance as sole technique to localize the brachial plexus for the purpose of placing a catheter for continuous infusion of a local anesthetic in a patient where standard landmark-based nerve stimulation for placement of a continuous perineural block was not possible.

  9. A case of spontaneous regression of hepatocellular carcinoma after ultrasound guided liver biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Jo, Jeong Hyun [Dept. of Radiology, Dong A University Hospital, Dong A University College of Medicine, Busan (Korea, Republic of)

    2014-10-15

    Spontaneous regression of hepatocellular carcinoma after liver biopsy has not been reported in the English literature. Herein, we present a case of partial spontaneous regression of hepatocellular carcinoma after ultrasound guided liver biopsy in a 64-year-old female. During 28 months, the tumor, which had been shrinking, showed no interval change. However, after 28 months, tumor showed regrowth, which led to a segmentectomy.

  10. Development of performance and error metrics for ultrasound-guided axillary brachial plexus block

    Directory of Open Access Journals (Sweden)

    Ahmed OM

    2017-04-01

    Full Text Available Osman M Ahmed,1 Brian D O’Donnell,1,2 Anthony G Gallagher,2 George D Shorten1,2 1Department of Anaesthesia and Intensive Care, University College Cork and Cork University Hospital, 2The ASSERT Center, University College Cork, Cork, Ireland Purpose: Change in the landscape of medical education coupled with a paradigm shift toward outcome-based training mandates the trainee to demonstrate specific predefined performance benchmarks in order to progress through training. A valid and reliable assessment tool is a prerequisite for this process. The objective of this study was to characterize ultrasound-guided axillary brachial plexus block to develop performance and error metrics and to verify face and content validity using a modified Delphi method. Methods: A metric group (MG was established, which comprised three expert regional anesthesiologists, an experimental psychologist and a trained facilitator. The MG deconstructed ultrasound-guided axillary brachial plexus block to identify and define performance and error metrics. Experts reviewed five video recordings of the procedure performed by anesthesiologists with different levels of expertise to aid task deconstruction. Subsequently, the MG subjected the metrics to “stress testing”, a process to ascertain the extent to which the performance and error metrics could be scored objectively, either occurring or not occurring with a high degree of reliability. Ten experienced regional anesthesiologists used a modified Delphi method to reach consensus on the metrics. Results: Fifty-four performance metrics, organized in six procedural phases and characterizing ultrasound-guided axillary brachial plexus block and 32 error metrics (nine categorized as critical were identified and defined. Based on the Delphi panel consensus, one performance metric was modified, six deleted and three added. Conclusion: In this study, we characterized ultrasound-guided axillary brachial plexus block to develop

  11. Ultrasound-guided continuous quadratus lumborum block for postoperative analgesia in a pediatric patient.

    Science.gov (United States)

    Chakraborty, Arunangshu; Goswami, Jyotsna; Patro, Viplab

    2015-02-01

    Quadratus lumborum block is a recently introduced variation of transversus abdominis plane block. In this report, we describe the use of ultrasound-guided continuous quadratus lumborum block for postoperative analgesia in a 7-year-old child scheduled to undergo radical nephrectomy (left-sided) for Wilms tumor. The result was excellent postoperative analgesia and minimal requirement for rescue analgesics. The modification described may allow easier placement of a catheter for continuous infusion of local anesthetic.

  12. Ultrasound-guided Transvaginal Aspiration in the Management of Actinomyces Pelvic Abscess

    OpenAIRE

    1996-01-01

    Background: Increasing reports of intrauterine device (IUD)-related abdominopelvic actinomycosis have been described recently. Surgical therapy has been the usual treatment when tubo-ovarian abscess is identified. Case: A 38-year-old woman suffering from Actinomyces pelvic abscess unresponsive to medical treatment underwent transvaginal ultrasound-guided needle aspiration. It resulted in marked improvement and avoided surgical treatment. Conclusion: Transvaginal needle aspiration of Actinomyc...

  13. Clinician-performed thyroid ultrasound-guided fine-needle aspiration.

    Science.gov (United States)

    Tsao, Gabriel J; Orloff, Lisa A

    2014-08-01

    Fine needle aspiration biopsy (FNA) is the key step in selecting most patients with thyroid nodules for or against surgery. Accurate acquisition of cytologic samples from suspicious lesions is achieved by adding ultrasound guidance to optimize targeting as well as to enable sampling from nonpalpable lesions. This article discusses the indications, variations, and technical details of ultrasound-guided FNA. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Ultrasound-guided core needle biopsy in diagnosis of abdominal and pelvic neoplasm in pediatric patients.

    Science.gov (United States)

    Wang, Hailing; Li, Fangxuan; Liu, Juntian; Zhang, Sheng

    2014-01-01

    Ultrasound-guided core needle biopsy of abdominal and pelvic masses in adults has gained tremendous popularity. However, the application of the same treatment in children is not as popular because of apprehensions regarding inadequate tissues for the biopsy and accidental puncture of vital organs. Data of the application of ultrasound-guided core needle biopsy in 105 pediatric patients with clinically or ultrasound-diagnosed abdominopelvic masses were reviewed. Diagnostic procedures were conducted in our institution from May 2011 to May 2013. The biopsies were conducted on 86 malignant lesions and 19 benign lesions. 86 malignant tumors comprised neuroblastomas (30 cases), hepatoblastomas (15 cases), nephroblastomas (11 cases), and primitive neuroectodermal tumors/malignant small round cells (6 cases). Among malignant tumor cases, only a pelvic primitive neuroectodermal tumor did not receive a pathological diagnosis. Therefore, the biopsy accuracy was 98.8 % in malignant tumor. However, the biopsies for one neuroblastomas and one malignant small round cell tumor were inadequate for cytogenetic analysis. Therefore, 96.5 % of the malignant tumor patients received complete diagnosis via biopsy. 19 benign tumors comprised mature teratoma (10 cases), hemangioendothelioma (3 cases), paraganglioma (2 cases), and infection (2 cases). The diagnostic accuracy for benign neoplasm was 100 %. Five patients experienced postoperative complications, including pain (2 patients), bleeding from the biopsy site (2 patients), and wound infection (1 patient). Ultrasound-guided core needle biopsy is an efficient, minimally invasive, accurate, and safe diagnostic method that can be applied in the management of abdominal or pelvic mass of pediatric patients.

  15. Ultrasound-guided percutaneous cholecysto-cholangiography for the exclusion of biliary atresia in infants

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Kyung Min; Ryeom, Hun Kyu; Choe, Byung Ho; Kim, Kap Cheol; Kim, Jong Yeol; Lee, Jong Min; Kim, Hye Jeong; Lee, Hee Jung [Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2006-08-15

    The aim of this study is to determine the feasibility and effectiveness of performing an ultrasound-guided percutaneous cholecysto-cholangiogram (PCC) for excluding biliary atresia as the cause of neonatal jaundice. Between Oct. 2003 and Feb. 2005, six ultrasound-guided PCC procedures were performed to five jaundiced infants (4 females and 1 male; mean age: 60 days old) for whom possibility of biliary atresia could not be ruled out by the DISIDA scan as the cause of their neonatal jaundice. Gallbladder puncture was performed under ultrasound guidance with a 23-gauge needle. Contrast material injection during fluoroscopic examination was performed after dilatation of the gallbladder lumen with normal saline under ultrasound guidance. The criteria used for excluding biliary atresia were complete visualization of the extrahepatic biliary trees and/or contrast excretion into the duodenum. The complications and final diagnosis was assessed according to the clinical and laboratory findings. The procedures were successful in all the patients without any complication. Biliary atresia could be ruled out in all the patients. The final diagnosis was neonatal cytomegalovirus hepatitis in two patients, total parenteral nutrition-associated cholestasis in two patients, and combined cytomegalovirus hepatitis and total parenteral nutrition-associated cholestasis in one patient. Ultrasound-guided PCC is a feasible and effective method for the early definitive exclusion of biliary atresia as the cause of neonatal jaundice. By the technique of injecting normal saline before contrast injection, PCC can be done even in a totally collapsed or very small gallbladder.

  16. Ultrasound-guided percutaneous drainage of meniscal cysts: preliminary clinical experience

    Energy Technology Data Exchange (ETDEWEB)

    MacMahon, P.J. [Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin (Ireland)]. E-mail: petermacmahon@yahoo.com; Brennan, D.D. [Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin (Ireland); Duke, D. [Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin (Ireland); Forde, S. [Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin (Ireland); Eustace, S.J. [Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin (Ireland)

    2007-07-15

    Aim: To evaluate the efficacy of ultrasound-guided percutaneous drainage of symptomatic meniscal cysts. Materials and methods: Patients with lateral knee joint tenderness and swelling and confirmed meniscal cyst on magnetic resonance imaging (MRI) were consecutively enrolled for ultrasound-guided percutaneous cyst aspiration. Cysts were injected with local anaesthetic and steroid before completion of procedure. All 18 patients (all male, average age 33 years) were subsequently followed up (average time 10 months) and meniscal cyst symptoms assessed by questionnaire. Fischer's exact test used to analyse the data. Results: In every case the procedure was well tolerated, and each patient indicated that they would be willing to have a repeat procedure in the future. Ten patients reported complete resolution of symptoms secondary to therapeutic cyst aspiration and had resumed participation in high-performance sport. Two patients reported a satisfactory sustained response, reporting only occasional 'twinges of pain'. In the remaining six patients, symptoms returned after an initial pain-free period. The pain-free period ranged from 1-8 weeks. In this study, patient outcome did not significantly correlate with any meniscal cyst characteristic. Conclusion: Ultrasound-guided percutaneous aspiration of meniscal cysts is a well-tolerated, simple, and safe procedure. In this small patient series, it was associated with positive early results with favourable outcomes in the mid to long-term. It should be considered in patients unsuitable for surgical debridement or as an interim therapy if surgery is delayed or postponed.

  17. Ultrasound guided transarterial coil placement in the internal and external carotid artery in horses.

    Science.gov (United States)

    Muñoz, Juan; Iglesias, Manuel; Chao, Eduardo Lloret; Bussy, Christian

    2015-04-01

    To assess ultrasound guided transarterial coil placement (UGTACP) for occlusion of the internal carotid artery (ICA) and external carotid artery (ECA) in horses. Cadaveric and in vivo study. Cadaveric horses (n = 10), healthy horses (3), and 1 clinical case. Cadaveric and in vivo (healthy horses): UGTACP was performed in the caudal part of the ICA and ECA. Coil placement in the rostral part of the ICA was performed blindly and controlled by conventional radiography. No coils were placed in the rostral part of the ECA. UGTACP of the ICA was in a horse with guttural pouch mycosis of the left guttural pouch. Accurate ultrasound-guided catheterization of the ICA and ECA was performed in all specimens. Ultrasound-guided coil placement was successfully performed in all cases except 1. No complications occurred in the in vivo study. The clinical case fully recovered and returned to its intended use. Based on our study, UGTACP of the ICA and ECA caudal part is a feasible alternative to fluoroscopy. An advantage of this technique is the accuracy with which you can catheterize both ICA and ECA and the ability to identify unusual branching at the origin of the ICA. Regarding the rostral part of the ICA, angiographic catheter guidance in this region is probably more precise using fluoroscopy as it is performed blindly. In a clinical situation, combination of US and fluoroscopy guidance can result in reduction of radiation exposure time. © Copyright 2014 by The American College of Veterinary Surgeons.

  18. Feasibility and accuracy of ultrasound-guided sacroiliac joint injection in dogs.

    Science.gov (United States)

    Jones, Jeryl C; Gonzalez, Luis M; Larson, Martha M; Freeman, Larry E; Werre, Stephen R

    2012-01-01

    Frozen cadaver specimens from three dogs were used to create a sectional anatomic atlas of the sacroiliac region. Frozen/thawed cadaver specimens from 12 dogs were used to develop an ultrasound-guided sacroiliac joint injection technique. Accuracy of the technique was tested in 15 additional canine cadaver specimens, using injectate containing blue dye and iodinated contrast medium. Sonoanatomic landmarks for consistently identifying a caudodorsal window into the canine sacroiliac joint space included the L7-S1 articular process joints, ilial wing, sacral wing, sacral lamina, and median sacral crest. Accuracy of ultrasound-guided sacroiliac joint injection was not significantly affected by operator, but was affected by the tissue location targeted and the reference standard used for calculations. Accuracy of the technique was good for placing injectate into either the synchondrosis component, dorsal sacroiliac ligament or ventral sacroiliac ligament; fair to poor for placing injectate into the synovial component; and poor for placing injectate into all four sacroiliac soft tissue structures. Concurrent placement of injectate into extraarticular tissues occurred frequently. We conclude that ultrasound-guided sacroiliac joint injection is feasible for evaluation as a treatment method for lumbosacral region pain in dogs, but is not sufficiently accurate for localizing pain to the sacroiliac joint alone.

  19. Ultrasound-guided cannulation of the internal jugular vein in robotic cardiac surgery

    Institute of Scientific and Technical Information of China (English)

    WANG Yao; WANG Gang; GAO Chang-qing

    2013-01-01

    Background Robotic assisted minimally invasive cardiac sugery is a new technique that uses small port sites and peripheral vessel cannulation for cardiopulmonary bypass (CPB) has been used.The right internal jugular vein (IJV)is commonly used for intraoperative venous access to the central circulation and identified with an external landmark.Previous studies have demonstrated the superiority of ultrasound guidance over external landmark technique in anaesthetic and intensive care settings.The aim of the present study was to delineate the utility of ultrasound-guided cannulation of the IJV during establishment of peripheral CPB in robotic cardiac surgery.Methods We prospectively studied 296 adult patients undergoing ultrasound-guided right IJV cannulation during establishment of peripheral CPB in robotic cardiac surgery at our institute from January 2007 to October 2012 (ultrasound group).The success rate,the first attempt success rate,access time and the complication rate of ultrasound-guided method were compared with the landmark-guided method used for 302 historical control patients (landmark group).Results In the ultrasound group,296 consecutive adult patients underwent ultrasound-guided right IJV cannulation during establishment of peripheral CPB in robotic cardiac surgery.In the landmark group,302 patients underwent right IJV cannulation using the landmark-guided technique.The success rate and the first attempt success rate in the ultrasound group were significantly higher than that in the landmark group (100% vs.88.1%,P <0.000 and 98.6% vs.38.4%,P <0.000).Average access time in the ultrasound group was shorter than that in the landmark group ((6.3±13.6) seconds;interquartile range (4-62) seconds vs.(44.5±129.5) seconds; interquartile range (5-986) seconds).The complication rate in the ultrasound group was significantly lower than that in the landmark group (0.3% vs.8.3%,P <0.000).Conclusion Compared with the landmark-guided approach,ultrasound-guided

  20. Ultrasound-guided percutaneous transhepatic biliary drainage: Experiences in 146 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jai Keun [Sohwa Children' s Hospital, Seoul(Korea, Republic of); Yu, Jeong Sik; Kim, Ki Whang; Chung, Soo Yoon; Jeong, Mi Gyoung [Yonsei University College of Medicine, Seoul (Korea, Republic of); Choi, Deuk Lin; Kwon, Gui Hyang; Lee, Hae Kyung [Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

    1999-03-15

    Percutaneous biliary drainage is an important technique for palliative therapy of obstructive biliary disease and diagnostic information. The purpose of this study is to review and evaluate the experiences of ultrasound-guided percutaneous transhepatic biliary drainage. Ultrasound-guided percutaneous transhepatic biliary drainage was performed on 146 occasions in 134 patients. The causes of biliary obstruction were: benign diseases (19 cases, 14.2%) such as bile duct stones or stricture, cholangiocarcinoma (37 cases, 27.6%), pancreatic carcinoma (35 cases, 26.1%), metastasis (22 cases, 16.5%), gall bladder cancer (14 cases, 10.4%), ampulla of Vater cancer (4 cases, 3.0%), hepatocellular carcinoma (3 cases, 2.2%). Retrospectively reviewing medical records, we found out frequency of external or external/internal biliary drainages, puncture of left or right hepatic duct, and presence of bileinfection. Ultrasound-guided percutaneous transhepatic biliary drainage was compared with conventional biliary drainage of previous reports on the basis of frequency of complications. External (124 procedures, 84.9%) and external/internal biliary drainage (22 procedures, 15.1%) were carried out by puncture of dilated right (59.6%) or left (40.4%) intrahepatic duct. Sixty-nine complications occurred in 47 patients. Catheter related complications (33/69, 47.8%) were most common: catheter dislodgement (17/69, 24.6%), malfunction (9/69, 13.1%), leakage (7/69, 10.1%). Other minor complications such as simple fever (16/69, 23.2%), cholangitis (7/69, 10.1%), hemobilia (4/69, 5.8%), biloma (2/69, 2.9%) and wound infection (1/69, 1.5%) occurred. Major complications including sepsis (4/69, 5.8%) and bile peritonitis (2/69, 2.9%) were also noted. Puncture-related complications such as hemobilia, biloma and bile peritonitis occurred in 8 cases (5.5%). Comparing with conventional X-ray guided drainage, ultrasound-guided percutaneous transhepatic biliary drainage is a safe procedure for

  1. Design and application of model for training ultrasound-guided vascular cannulation in pediatric patients.

    Science.gov (United States)

    Pérez-Quevedo, O; López-Álvarez, J M; Limiñana-Cañal, J M; Loro-Ferrer, J F

    2016-01-01

    Central vascular cannulation is not a risk-free procedure, especially in pediatric patients. Newborn and infants are small and low-weighted, their vascular structures have high mobility because of tissue laxity and their vessels are superficial and with small diameter. These characteristics, together with the natural anatomical variability and poor collaboration of small children, make this technique more difficult to apply. Therefore, ultrasound imaging is increasingly being used to locate vessels and guide vascular access in this population. (a) To present a model that simulates the vascular system for training ultrasound-guided vascular access in pediatrics patients; (b) to ultrasound-guided vascular cannulation in the model. The model consisted of two components: (a) muscular component: avian muscle, (b) vascular component: elastic tube-like structure filled with fluid. 864 ecoguided punctures was realized in the model at different vessel depth and gauge measures were simulated, for two medical operators with different degree of experience. The average depth and diameter of vessel cannulated were 1.16 (0.42)cm and 0.43 (0.1)cm, respectively. The average number of attempts was of 1.22 (0.62). The percentage of visualization of the needle was 74%. The most frequent maneuver used for the correct location, was the modification of the angle of the needle and the relocation of the guidewire in 24% of the cases. The average time for the correct cannulations was 41 (35.8)s. The more frequent complications were the vascular perforation (11.9%) and the correct vascular puncture without possibility of introducing the guidewire (1.2%). The rate of success was 96%. The model simulates the anatomy (vascular and muscular structures) of a pediatric patient. It is cheap models, easily reproducible and a useful tool for training in ultrasound-guided puncture and cannulation. Copyright © 2015 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  2. The Value of Hormone Receptor Assessment in Ultrasound Guided Core Needle Biopsy of the Breast.

    Science.gov (United States)

    Pal, Andrej; Milevcić, Drazen; Bosilj, Doroteja; Purković, Sandra; Cujzek, Ivana; Kopjar, Andrina; Radiković, Sandra

    2015-12-01

    Breast cancer is the most common cancer in women in Western countries after skin tumors. Successful treatment depends on many factors, relies on clinical examination, diagnostic procedures, pathologic evaluation, and good therapy decision. The Pathologic diagnosis should be the determining factor in the decision on therapeutic approach. There are several methods of obtaining tissue samples. The percutaneous ultrasound guided breast Core needle biopsy (CNB) is one of them. The Aim of this Study is to evaluate our experience in the accuracy of hormone receptors assessment in ultrasound guided CNB. In our institution, in last 12 month 60 women (with 67 lesions) underwent Breast CNB. The CNB was performed with 16 Gauge semiautomatic biopsy needle with 15 Gauge coordinated introducer needle. 3-6 specimen (mean 4) were taken during the procedure. We analyzed five factors (histological type, histological grade, estrogen and progesterone receptor status, and HER2 from the biopsied sample. All results were presented at the Multidisciplinary Oncology Team. In addition to demographic data and morphological features of the lesion, we analyzed five pathological factors (histological type, histological grade, estrogen and progesterone receptor status, and HER2 from the biopsied sample. All results were presented at the Multidisciplinary Oncology Team. Ultrasound-guided CNB has proven to be a reliable technique for performing a biopsy for breast. It is a good and reliable, complication free method, for preoperative staging, operative planning as well for prognostic value. It is a cost-effective method, can be performed quickly and in outpatient population, does not deform the breast and multiple lesions can be biopsied. This technique shows a high sensitivity value and offers many advantages over other imaging methods to guide a biopsy. All advantages have made this technique the most widespread used technique to perform a biopsy for a suspicious breast lesion.

  3. Analgesic efficacy of the ultrasound-guided blockade of the transversus abdominis plane - a systematic review

    Directory of Open Access Journals (Sweden)

    Javier Ripollés

    2015-08-01

    Full Text Available BACKGROUND: The transverse abdominal plan blockade is a block of abdominal wall that has diffused rapidly in the clinical practice as part of a multimodal analgesia for abdominal surgery. The performance of the ultrasound-guided technique has allowed the lowering of potential complications, as well as new approaches that were carried out according to the descriptions, and the prospective studies would make it possible to utilize the transverse abdominal plan blockade in different surgical interventions; however, the results obtained in randomized clinical trials are inconsistent.OBJECTIVES: To prepare a systematic review aiming to determine the efficacy of the ultrasound-guided transverse abdominal plan blockade for different surgical interventions, as well as the indications according to the approaches and their influences.METHODS: Two research approaches, one manual, and the other in Pubmed returned 28 randomized clinical trials where intervention with ultrasound-guided transverse abdominal plan blockades was performed to compare the analgesic efficacy in contrast to another technique in adults, published between 2007 and October 2013, in English or Spanish, with Jadad score > 1, according to the inclusion criteria for this review. The authors analyzed independently all the randomized clinical trials.CONCLUSIONS: The transverse abdominal plan blockades have been shown to be an effective technique in colorectal surgery, cesarean section, cholecystectomy, hysterectomy, appendectomy, donor nephrectomy, retropubic prostatectomy, and bariatric surgery. However, the data found in randomized clinical trial are not conclusive, and as a result, it is necessary to develop new and well designed randomized clinical trial, with enough statistical power to compare different approaches, drugs, doses, and volumes for the same intervention, aiming to answer the current questions and their effects in the habitual clinical practice.

  4. [Ultrasound-guided percutaneous insertion of implantable venous devices: a review of 102 patients].

    Science.gov (United States)

    Nguyen, V; Jarry, J; Farthouat, P; Bourilhon, N; Milou, F; Michel, P

    2013-02-01

    Techniques of insertion of implantable venous devices have been widely described. The use of ultrasound guidance is part of the good practice recommendations of the SOR 2008 but there are few data in the literature and recommendations are based only on expert agreement. To this end we conducted a prospective, single-center study from January 2008 to August 2009 on percutaneous ultrasound-guided insertion of implantable devices. In addition to age, sex, the therapeutic indication and the site of implantation, we identified the operative time and number of venipunctures performed for each procedure. We then identified the infectious complications at three months and thromboembolic complications at 1 year and a half. Our study examined 102 consecutive patients. The mean age was 61.8 years (28-90); 71% of patients were men. For 101 patients, the internal jugular vein was punctured, the subclavian vein in one patient. In 86% of cases, the implantable venous device was inserted into the right vein. The average length of procedure was 30 minutes (18-60) for a single-vein puncture. Among the 102 patients, the overall morbidity was 7.8% with four infections (3.9%) and four thromboses (3.9%). There were no immediate perioperative complications (arterial puncture, hematoma, pneumothorax). In conclusion, percutaneous ultrasound-guided insertion of implantable venous devices in the internal jugular vein is a safe, minimally invasive technique which complies with the 2008 SOR recommendations by preventing the risk of venous thrombosis and avoiding repeated venous puncture. Less invasive than the open surgical approach, ultrasound-guided insertion is safer than puncture based solely on anatomical landmarks. In summary, this is a reliable, simple and easily reproducible technique which limits iatrogenic risks and improves patient comfort.

  5. Analgesic efficacy of the ultrasound-guided blockade of the transversus abdominis plane - a systematic review.

    Science.gov (United States)

    Ripollés, Javier; Mezquita, Sandra Marmaña; Abad, Alfredo; Calvo, José

    2015-01-01

    The transverse abdominal plan blockade is a block of abdominal wall that has diffused rapidly in the clinical practice as part of a multimodal analgesia for abdominal surgery. The performance of the ultrasound-guided technique has allowed the lowering of potential complications, as well as new approaches that were carried out according to the descriptions, and the prospective studies would make it possible to utilize the transverse abdominal plan blockade in different surgical interventions; however, the results obtained in randomized clinical trials are inconsistent. To prepare a systematic review aiming to determine the efficacy of the ultrasound-guided transverse abdominal plan blockade for different surgical interventions, as well as the indications according to the approaches and their influences. Two research approaches, one manual, and the other in Pubmed returned 28 randomized clinical trials where intervention with ultrasound-guided transverse abdominal plan blockades was performed to compare the analgesic efficacy in contrast to another technique in adults, published between 2007 and October 2013, in English or Spanish, with Jadad score>1, according to the inclusion criteria for this review. The authors analyzed independently all the randomized clinical trials. The transverse abdominal plan blockades have been shown to be an effective technique in colorectal surgery, cesarean section, cholecystectomy, hysterectomy, appendectomy, donor nephrectomy, retropubic prostatectomy, and bariatric surgery. However, the data found in randomized clinical trial are not conclusive, and as a result, it is necessary to develop new and well designed randomized clinical trial, with enough statistical power to compare different approaches, drugs, doses, and volumes for the same intervention, aiming to answer the current questions and their effects in the habitual clinical practice. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda

  6. Long-term outcome of benign fibroadenomas treated by ultrasound-guided percutaneous excision.

    Science.gov (United States)

    Grady, Ian; Gorsuch, Heidi; Wilburn-Bailey, Shelly

    2008-01-01

    Surgical as well as conservative treatment has been described for fibroadenomas. Both have disadvantages. A minimally invasive treatment, ultrasound-guided, vacuum-assisted percutaneous excision has been shown to facilitate the removal of all imaged evidence of benign breast lesions, including fibroadenomas up to 3 cm in diameter. This study is performed to assess the long-term outcome of ultrasound-guided percutaneous excision as a minimally invasive treatment for fibroadenomas. A retrospective review of 69 consecutive fibroadenomas treated with ultrasound-guided percutaneous excision between May, 2001 and December, 2005 was carried out. All these lesions underwent percutaneous excision of all imaged lesion evidence. Clinical and sonographic follow-up was recommended for all patients every 6 months. Initial size, location, and patient age were recorded for each treated lesion. Of 69 lesions treated, 52 were available for follow-up. The median follow-up period was 22 months, with a range of 7 to 59 months. At 6 months, there were no fibroadenoma recurrences. Follow-up sonography demonstrated recurrences in 13 lesions distributed across eight patients. The overall recurrence rate was 15% (8/52) with an actuarial recurrence rate of 33% at 59 months. All of the recurrences were in lesions which were larger than 2 cm in size at initial presentation. Our data suggest that the mechanism of recurrence is the regrowth of retained lesion fragments too small to be detected by ultrasound--not the incomplete excision of all imaged lesion evidence. Despite successful percutaneous excision, fibroadenomas do recur. Lesions smaller than 2 cm in size, so treated, do not need additional therapy or surveillance. Fibroadenomas larger than 2 cm are prone to recurrence and require additional treatment.

  7. Ultrasound-guided sclerotherapy for benign non-thyroid cystic mass in the neck

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Hoon [Dept. of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2014-04-15

    Surgical excision has traditionally been the treatment of choice for benign non-thyroid cystic neck masses, including lymphatic malformation, ranula, branchial cleft cyst, thyroglossal duct cyst, and parathyroid cyst. However, there is a tendency toward recurrence after surgery, and surgery may be accompanied by complications, including nerve injuries, vascular injuries, and scar formation. Ultrasound-guided sclerotherapy using various agents has been challenged and successfully applied as an alternative treatment for benign non-thyroid cystic neck masses. This report reviews the available sclerosing agents and describes the applications of sclerotherapy to the treatment of benign cystic masses in the neck.

  8. Post biopsy Liver Hemorrhage Successfully Controlled by Ultrasound-guided Percutaneous Microwave Ablation

    Directory of Open Access Journals (Sweden)

    Ophelia Ka Heng Wai

    2016-01-01

    Full Text Available Percutaneous microwave coagulation therapy has been one of the major new developments in tumor ablation. Microwave ablation has also been used intraoperatively to achieve hemostasis at surgical margins in laparotomy. However, the use of microwave ablation for coagulation and hemostasis through percutaneous approach has not been described in the literature. Here, we report a case of hepatic amyloidosis with massive post biopsy liver hemorrhage, which could not be by transarterial embolization, and subsequently controlled by ultrasound-guided percutaneous microwave ablation. To the best of our knowledge, this is the first reported case of this technology application in human.

  9. BiopSym: a simulator for enhanced learning of ultrasound-guided prostate biopsy

    CERN Document Server

    Sclaverano, Stefano; Vadcard, Lucile; Mozer, Pierre; Troccaz, Jocelyne

    2008-01-01

    This paper describes a simulator of ultrasound-guided prostate biopsies for cancer diagnosis. When performing biopsy series, the clinician has to move the ultrasound probe and to mentally integrate the real-time bi-dimensional images into a three-dimensional (3D) representation of the anatomical environment. Such a 3D representation is necessary to sample regularly the prostate in order to maximize the probability of detecting a cancer if any. To make the training of young physicians easier and faster we developed a simulator that combines images computed from three-dimensional ultrasound recorded data to haptic feedback. The paper presents the first version of this simulator.

  10. Tension Pneumothorax After Ultrasound-Guided Interscalene Block and Shoulder Arthroscopy.

    Science.gov (United States)

    Li, Robert; Lall, Ajay; Lai, Everett; Gruson, Konrad I

    2015-10-01

    Interscalene brachial plexus anesthesia is commonly used for outpatient arthroscopic shoulder procedures. Ultrasound guidance has helped to minimize the cardiac, neurologic, and pulmonary complications associated with this block. Although rarely reported, pneumothorax may occur as a result of direct lung injury and even in a delayed fashion. We present a case of tension pneumothorax in a patient undergoing arthroscopic rotator cuff repair under both interscalene regional and general anesthesia. Surgeons and anesthesiologists must remain aware that ultrasound-guided interscalene blocks may be associated with pneumothorax and must initiate treatment expeditiously.

  11. Ultrasound-guided facet joint injection to treat a spinal cyst

    Directory of Open Access Journals (Sweden)

    Tung-Liang Lin

    2014-04-01

    Full Text Available Lumbar spinal cysts often present with backache and may be accompanied by lower extremity weakness as well as radiation pain if root compression occurs. The treatment regimens include anti-inflammatory drugs, physical therapy, procedures guided by fluoroscopy or computed tomography, and surgery. We report the case of a patient with a symptomatic lumbar spinal cyst at the L4–L5 facet joint. The symptoms immediately remitted after ultrasound-guided steroid–lidocaine injection into the L4–L5 facet joint. Magnetic resonance imaging follow up 4 months after injection showed complete resolution of the cyst.

  12. Anterior approach v. posterior approach - ultrasound-guided shoulder arthrogram injection

    Directory of Open Access Journals (Sweden)

    Merle Neethling-du Toit

    2008-11-01

    Full Text Available Anterior approach ultrasound guided arthrogram injections are a quick reliable way of injecting contrast prior to MRI scan. We did a retrospective study on patients, previously injected and scanned at our clinic, to compare the more manifested posterior approach with the anterior approach. The success rate for successful intra-articular injections for the anterior approach far outweighs the posterior approach. Also the anterior approach is more tolerable for patients as the injections are much quicker and seemingly less painful. In our knowledge it is thus far better to perform anterior approach shoulder arthrogram injections than posterior approach injections

  13. Ultrasound Guided Intercostobrachial Nerve Blockade in Patients with Persistent Pain after Breast Cancer Surgery

    DEFF Research Database (Denmark)

    Wijayasinghe, Nelun; Duriaud, Helle M; Kehlet, Henrik

    2016-01-01

    BACKGROUND: Persistent pain after breast cancer surgery (PPBCS) affects 25 - 60% of breast cancer survivors and damage to the intercostobrachial nerve (ICBN) has been implicated as the cause of this predominantly neuropathic pain. Local anesthetic blockade of the ICBN could provide clues...... determined the sonoanatomy of the ICBN and part 2 examined effects of the ultrasound-guided ICBN blockade in patients with PPBCS. SETTING: Section for Surgical Pathophysiology at Rigshospitalet, Copenhagen, Denmark. METHODS: Part 1: Sixteen unoperated, pain free breast cancer patients underwent systematic...

  14. Ultrasound-guided percutaneous renal biopsy-induced accessory renal artery bleeding in an amyloidosis patient

    Directory of Open Access Journals (Sweden)

    Zhang Qing

    2012-12-01

    Full Text Available Abstract Ultrasound-guided percutaneous renal biopsy is an important technique for diagnosis of glomerular diseases, and the biopsy-induced life-threatening bleeding rarely happens. Primary systemic amyloidosis is a rare disease which may lead to organ dysfunction including arterial stiffness. The accessory renal artery is a kind of renal vascular variation which goes into the renal parenchyma directly or via the renal hilum. Here we reported a rare case of percutaneous renal biopsy-induced accessory renal artery life-threatening bleeding in a renal amyloidosis patient, and our experience of successful rescue in this patient. Virtual Slides http://www.diagnosticpathology.diagnomx.eu/vs/1524207344817819

  15. Delayed hemorrhage from hepatic artery after ultrasound-guided percutaneous liver biopsy: A case report

    Institute of Scientific and Technical Information of China (English)

    Fen-Yu Ren; Xi-Xu Piao; Ailian Jin

    2006-01-01

    Percutaneous liver biopsy is considered one of the most important diagnostic tools to evaluate diffuse liver diseases. Pseudoaneurysm of hepatic artery is an unusual complication after ultrasound-guided percutaneous liver biopsy. Delayed hemorrhage occurs much less frequently. We report a case of pseudoaneurysm of the hepatic artery of a 46-year-old man who was admitted for abdominal pain after 4 d of liver biopsy. The bleeding was controlled initially by angiographic embolization.However, recurrent bleeding could not be controlled by repeat angiography, and the patient died 4 d after admission from multiorgan failure. The admittedly rare possibility of delayed hemorrhage should be considered whenever a liver biopsy is performed.

  16. Treatment of hepatic cysts by B-ultrasound-guided radiofrequency ablation

    Institute of Scientific and Technical Information of China (English)

    Xi-Lin Du; Qing-Jiu Ma; Tao Wu; Jian-Guo Lu; Guo-Qiang Bao; Yan-Kui Chu

    2007-01-01

    BACKGROUND:The traditional therapy for hepatic cysts has limited success because of recrudescence. Radiofrequency ablation (RFA) has become popular because of its advantages including little damage, therapeutic effect and reduced suffering. This report describes the effects and reliability of RFA in the treatment of 29 patients with hepatic cysts. METHODS:B-ultrasound-guided RFA was used to treat hepatic mono-cyst or multi-cysts of 29 patients (63 tumors). Ablative efifciency and complications were assessed by imaging and clinical symptoms. RESULTS:The tumors were abated completely in 34 cysts with a diameter CONCLUSION:RFA for the treatment of hepatic cysts is safe, and free from complications.

  17. Ultrasound-Guided Scraping for Chronic Patellar Tendinopathy: A Case Presentation.

    Science.gov (United States)

    Hall, Mederic M; Rajasekaran, Sathish

    2016-06-01

    Chronic patellar tendinopathy is a common complaint among athletes who repetitively stress the extensor mechanism of the knee. Multiple treatment options have been described, but evidence is lacking, specifically when eccentric loading has failed. Debate continues regarding the patho-etiology of chronic patellar tendon pain. There has been recent interest regarding the neurogenic influences involved in chronic tendinopathy, and interventions targeting neovessels and accompanying neonerves have shown promise. This is the first description of an ultrasound-guided technique in which the neovessels and accompanying neonerves in patellar tendinopathy were targeted using a needle scraping technique of the posterior surface of the patellar tendon.

  18. Ultrasound-guided sclerotherapy for benign non-thyroid cystic mass in the neck

    Directory of Open Access Journals (Sweden)

    Ji-hoon Kim

    2014-04-01

    Full Text Available Surgical excision has traditionally been the treatment of choice for benign non-thyroid cystic neck masses, including lymphatic malformation, ranula, branchial cleft cyst, thyroglossal duct cyst, and parathyroid cyst. However, there is a tendency toward recurrence after surgery, and surgery may be accompanied by complications, including nerve injuries, vascular injuries, and scar formation. Ultrasound-guided sclerotherapy using various agents has been challenged and successfully applied as an alternative treatment for benign non-thyroid cystic neck masses. This report reviews the available sclerosing agents and describes the applications of sclerotherapy to the treatment of benign cystic masses in the neck.

  19. Ultrasound-guided truncal blocks: A new frontier in regional anaesthesia

    Directory of Open Access Journals (Sweden)

    Arunangshu Chakraborty

    2016-01-01

    Full Text Available The practice of regional anaesthesia is rapidly changing with the introduction of ultrasound into the working domain of the anaesthesiologist. New techniques are being pioneered. Among the recent techniques, notable are the truncal blocks, for example, the transversus abdominis plane block, rectus sheath block, hernia block and quadratus lumborum block in the abdomen and the pectoral nerves (Pecs block 1 and 2, serratus anterior plane block and intercostal nerve block. This narrative review covers the brief anatomical discourse along with technical description of the ultrasound-guided truncal blocks.

  20. Ultrasound-guided truncal blocks: A new frontier in regional anaesthesia

    Science.gov (United States)

    Chakraborty, Arunangshu; Khemka, Rakhi; Datta, Taniya

    2016-01-01

    The practice of regional anaesthesia is rapidly changing with the introduction of ultrasound into the working domain of the anaesthesiologist. New techniques are being pioneered. Among the recent techniques, notable are the truncal blocks, for example, the transversus abdominis plane block, rectus sheath block, hernia block and quadratus lumborum block in the abdomen and the pectoral nerves (Pecs) block 1 and 2, serratus anterior plane block and intercostal nerve block. This narrative review covers the brief anatomical discourse along with technical description of the ultrasound-guided truncal blocks. PMID:27761032

  1. Intravascular ultrasound-guided stenting of left main stem dissection after Medtronic Corevalve implantation.

    Science.gov (United States)

    Van Mieghem, N M; de Jaegere, P P

    2013-08-01

    Transcatheter aortic valve implantation (TAVI) implies the introduction, positioning, and deployment of a stented bioprosthesis in the (calcified) native aortic valve. We report an at first glance uneventful TAVI with the Medtronic Corevalve System, which was followed by transient electrocardiographic changes suggesting acute left main stem disease. The diagnosis of acute left main stem dissection extending from the left coronary cusp was firmly established by intravascular ultrasound. The ostium of the left main stem was successfully treated with intravascular ultrasound-guided placement of a drug eluting stent. © 2013 Wiley Periodicals, Inc.

  2. Ultrasound-guided Transvaginal Aspiration in the Management of Actinomyces Pelvic Abscess

    Science.gov (United States)

    Rahav, Galiya; Hanoch, Josef; Shimonovitz, Shlomo; Yagel, Simcha; Laufer, Neri

    1996-01-01

    Background: Increasing reports of intrauterine device (IUD)-related abdominopelvic actinomycosis have been described recently. Surgical therapy has been the usual treatment when tubo-ovarian abscess is identified. Case: A 38-year-old woman suffering from Actinomyces pelvic abscess unresponsive to medical treatment underwent transvaginal ultrasound-guided needle aspiration. It resulted in marked improvement and avoided surgical treatment. Conclusion: Transvaginal needle aspiration of Actinomyces pelvic abscess may be an alternative to surgical therapy, thereby allowing the preservation of pelvic organs. PMID:18476111

  3. Ultrasound-guided sclerotherapy for benign non-thyroid cystic mass in the neck

    Science.gov (United States)

    2014-01-01

    Surgical excision has traditionally been the treatment of choice for benign non-thyroid cystic neck masses, including lymphatic malformation, ranula, branchial cleft cyst, thyroglossal duct cyst, and parathyroid cyst. However, there is a tendency toward recurrence after surgery, and surgery may be accompanied by complications, including nerve injuries, vascular injuries, and scar formation. Ultrasound-guided sclerotherapy using various agents has been challenged and successfully applied as an alternative treatment for benign non-thyroid cystic neck masses. This report reviews the available sclerosing agents and describes the applications of sclerotherapy to the treatment of benign cystic masses in the neck. PMID:24936500

  4. Effective volumes of 1.5% mepivacaine with different sodium concentration for ultrasound guided popliteal block.

    Science.gov (United States)

    López, Mercedes; Calvo, Miguel; Sancho, Azahara; Brogly, Nicolas; Guasch, Emilia; Gilsanz, Fernando

    2017-02-01

    To determine if a solution of 1.5% mepivacaine diluted with 5% dextrose, which decreases the sodium concentration by 30%, results in reduced volume requirements for a complete sensory block, in the case of an ultrasound guided popliteal nerve block. A randomized controlled study. Operating room. We included seventy ASA 1-3 patients, undergoing unilateral "hallux valgus" repair under ultrasound guided popliteal nerve block. An ultrasound guided popliteal nerve block was performed on all patients, with 1.5% mepivacaine using the normal dilution (ND group, thirty-five patients) or the 5% dextrose dilution (D5 group, thirty-five patients). Starting with 25ml in each group, increasing or decreasing it by 1ml on subsequent patients, depending on the success or failure in the previous one (Dixon's "up-and-down" sequential allocation). Effective dose in 50, 90, and 95% of patients (ED50, ED90, and ED95) of 1.5% mepivacaine in both groups. Onset time and duration of the blocks, side effects, and neurological complications. There were no statistically significant differences between ED50 in ND group (6.2ml; 95% confidence interval, 5.2-7.5), and D5 group (5.8ml; 95% CI, 5.1-7). Also no statistically significant differences in ED90 (7.7ml, 95% CI 6.9-8.1 in the D5 group; 7.8ml, 95% CI 7-8.1 in the ND) or in ED95 (7.9ml, 95% CI 7.1-8.2 in the D5 group; 8ml, 95% CI 7.2-8.2 in the ND) were found. Onset time for a complete sensory block in D5 group was 14min (95% CI, 12-17) and 15min in ND (95% CI, 13-18), p=0.66. Neither severe side effects, nor neurological complications were reported. A dilution of 1.5% mepivacaine with 30% less sodium concentration does not decrease volume requirement for ultrasound guided sciatic nerve block at popliteal level. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Learning curves for ultrasound guided lung biopsy in the hands of respiratory physicians

    DEFF Research Database (Denmark)

    Laursen, Christian; Naur, Therese Maria Henriette; Bodtger, Uffe

    2016-01-01

    Background: The aim of this study was to determine learning curves for ultrasound guided transthoracic needle biopsies (US-TTNB) performed by respiratory physicians after implementation at three different centers.Methods: During January 2012 to August 2014 patients were included if they had...... are depicted in figure 1. Six of the physicians had learning curves with a relatively downward or stable projection as a sign of developing competence. Three physicians, however, had learning curves with an upward projection indicating unacceptable competence in performing the procedure...

  6. Ultrasound-guided Percutaneous Lavage in the Treatment of Calcific Tendinopathy of Elbow Extensor Tendons: A Case Report

    Directory of Open Access Journals (Sweden)

    Abate M

    2016-07-01

    Full Text Available We report the efficacy of the ultrasound-guided percutaneous treatment in the management of elbow extensor tendons calcific tendinopathy. The ultrasound-guided percutaneous treatment is broadly used with positive results in patients suffering from rotator cuff calcific tendinopathy. However, this interventional method has been reported only in one patient in the medical literature. A 34 years-old female who complained pain, swelling and severe functional limitation of the right elbow was referred to our unit. Elbow radiographs and ultrasound examination showed a soft-fluid calcification above the origin of the extensor tendons. Ultrasound-guided percutaneous treatment was therefore performed. After one year, the patient reported no pain and regained complete range of elbow motion. This method, in well trained hands, is an alternative treatment in the management of the uncommon elbow calcific deposit.

  7. Randomized clinical trial comparing ultrasound-guided procedure with the Seldinger's technique for placement of implantable venous ports.

    Science.gov (United States)

    Miao, Jianzhong; Ji, Lijun; Lu, Jianjun; Chen, Jianqing

    2014-09-01

    The aim of this randomized controlled study was to compare ultrasound-guided procedure with the Seldinger's technique for placement of implantable venous ports. A total of 214 patients were randomized to receive TIAP placement by either ultrasound-guided procedure or the Seldinger's technique. Complications and pain perception were compared between these two groups. No severe perioperative or periinterventional complication occurred. Significantly (P venous thrombosis, fever of unknown origin, skin necrosis, and sepsis. In conclusion, both techniques, the TIAP implantation via ultrasound-guided jugular vein puncture and via Seldinger's technique subclavian vein puncture, are feasible and safe. Regarding intrainterventional pain perception and implantation-related complications, the jugular vein puncture under ultrasound guidance seems to be advantageous.

  8. Prevalence of Bleeding Complications Following Ultrasound-Guided Botulinum Toxin Injections in Patients on Anticoagulation or Antiplatelet Therapy.

    Science.gov (United States)

    LaVallee, Jeffrey; Royer, Regan; Smith, Geoffrey

    2017-06-16

    Patients on anticoagulation or antiplatelet therapy may be at higher risk for bleeding complications following intramuscular chemodenervation injections. Musculoskeletal ultrasound may be able to reduce the risk of bleeding complications by providing real-time visualization of vascular structures and postinjection monitoring. Limited data exist addressing the risk of bleeding complications following ultrasound-guided botulinum neurotoxin intramuscular chemodenervation procedures in the setting of anticoagulation or antiplatelet therapy. To provide initial outcome data regarding bleeding complications in patients on anticoagulation or antiplatelet therapy who have received ultrasound-guided botulinum neurotoxin intramuscular chemodenervation procedures. Retrospective, medical record review. Academic institution outpatient spasticity clinic. Total of 328 ultrasound-guided intramuscular botulinum toxin injections performed in 15 patients (mean age 53.8 years) with the predominant indication for chemodenervation being spastic paresis secondary to stroke. The medical records of all patients receiving ultrasound-guided intramuscular chemodenervation procedures performed between July 1, 2011, and October 16, 2015, were reviewed for demographic information, details regarding anticoagulation therapy, procedure specifics, and postinjection bleeding complications. All patients had a postinjection ultrasound to screen for hematoma. Prevalence of clinically significant bleeding complications and of sonographically documented subclinical bleeding complications following ultrasound-guided chemodenervation procedures in patients on anticoagulation or antiplatelet therapy. Of 328 procedures, only 2 subclinical hematomas were detected, resulting in a bleeding complication rate of 0.61% in this patient population. The target muscles in these cases were tibialis posterior and pronator teres, and both cases were in patients on anticoagulation therapy (as opposed to antiplatelet

  9. Physical exam in asymptomatic people drivers the detection of thyroid nodules undergoing ultrasound guided fine needle aspiration biopsy.

    Science.gov (United States)

    Singh Ospina, Naykky; Maraka, Spyridoula; Espinosa De Ycaza, Ana E; Ahn, Hyeong Sik; Castro, M Regina; Morris, John C; Montori, Victor M; Brito, Juan P

    2016-11-01

    Understanding epidemiology and the factors leading to thyroid nodule diagnosis might help alter the course of the thyroid cancer epidemic. Population-based study using the Rochester Epidemiology Project database between 2003 and 2006. Patients with thyroid nodules who underwent ultrasound guided fine needle aspiration biopsy were included. We identified 453 patients with 520 thyroid nodules undergoing ultrasound guided fine needle aspiration. Patients were mostly women (n: 349, 77 %) with a mean age of 52 (standard deviation 17) years. The age-adjusted and sex-adjusted incidence of ultrasound guided fine needle aspiration-thyroid nodules between 2003 and 2006 was 89 (95 % confidence interval, 80-97) per 100,000 person-years; the incidence in women was 130 (95 % confidence interval, 117-144), and for men 43 (95 % confidence interval, 35-52) per 100,000 person-years. The incidence of ultrasound guided fine needle aspiration-thyroid nodules increased by 42 %, from 68 (95 % confidence interval, 54-82) in 2003 to 97 (95 % confidence interval, 80-113) per 100,000 person-years in 2006. The group with the highest incidence was patients between 70 and 79 years of age, 258 per 100,000 person-years. Most ultrasound guided fine needle aspiration-thyroid nodules were found in asymptomatic patients (n: 371, 82 %) by physical examination (n: 197, 43 %) or on imaging studies performed for non-thyroid issues (n: 108, 24 %). Women were more likely to have nodules detected by palpation (45 %), whereas imaging and physical examination contributed similarly in men (39 and 38 %). There is a large and rapid increase in the ultrasound guided fine needle aspiration-thyroid nodules, particularly among women and elderly patients which mirrors the trends observed in thyroid cancer. Most thyroid nodules were found in asymptomatic patients as a result of routine physical examination or imaging.

  10. [Ultrasound-guided paravertebral block for pyloromyotomy in 3 neonates with congenital hypertrophic pyloric stenosis].

    Science.gov (United States)

    Mata-Gómez, Javier; Guerrero-Domínguez, Rosana; García-Santigosa, Marta; Ontanilla, Antonio

    2015-01-01

    Hypertrophic pyloric stenosis is a relatively common affection of gastrointestinal tract in childhood that results in symptoms, such as projectile vomiting and metabolic disorders that imply a high risk of aspiration during anesthetic induction. In this way, the carrying out of a technique with general anesthesia and intravenous rapid sequence induction, preoxygenation and cricoid pressure are recommended. After the correction of systemic metabolic alkalosis and pH normalization, cerebrospinal fluid can keep a state of metabolic alkalosis. This circumstance, in addition to the residual effect of neuromuscular blocking agents, inhalant anesthetics and opioids could increase the risk of postoperative apnea after a general anesthesia. We present the successful management in 3 neonates in those a pyloromyotomy was carried out because they had presented congenital hypertrophic pyloric stenosis. This procedure was done under general anesthesia with orotracheal intubation and rapid sequence induction. Then, ultrasound-guided paravertebral block was performed as analgesic method without the need for administrating opioids within intraoperative period and keeping an appropriate analgesic level. Local anesthesia has demonstrated to be safe and effective in pediatric practice. We consider the ultrasound-guided paravertebral block with one dose as a possible alternative for other local techniques described, avoiding the use of opioids and neuromuscular blocking agents during general anesthesia, and reducing the risk of central apnea within postoperative period. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  11. Ultrasound-guided paravertebral block for pyloromyotomy in 3 neonates with congenital hypertrophic pyloric stenosis.

    Science.gov (United States)

    Mata-Gómez, Javier; Guerrero-Domínguez, Rosana; García-Santigosa, Marta; Ontanilla, Antonio

    2015-01-01

    Hypertrophic pyloric stenosis is a relatively common affection of gastrointestinal tract in childhood that results in symptoms, such as projectile vomiting and metabolic disorders that imply a high risk of aspiration during anesthetic induction. In this way, the carrying out of a technique with general anesthesia and intravenous rapid sequence induction, preoxygenation and cricoid pressure are recommended. After the correction of systemic metabolic alkalosis and pH normalization, cerebrospinal fluid can keep a state of metabolic alkalosis. This circumstance, in addition to the residual effect of neuromuscular blocking agents, inhalant anesthetics and opioids could increase the risk of postoperative apnea after a general anesthesia. We present the successful management in 3 neonates in those a pyloromyotomy was carried out because they had presented congenital hypertrophic pyloric stenosis. This procedure was done under general anesthesia with orotracheal intubation and rapid sequence induction. Then, ultrasound-guided paravertebral block was performed as analgesic method without the need for administrating opioids within intraoperative period and keeping an appropriate analgesic level. Local anesthesia has demonstrated to be safe and effective in pediatric practice. We consider the ultrasound-guided paravertebral block with one dose as a possible alternative for other local techniques described, avoiding the use of opioids and neuromuscular blocking agents during general anesthesia, and reducing the risk of central apnea within postoperative period. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  12. Ultrasound-guided paravertebral block for pyloromyotomy in 3 neonates with congenital hypertrophic pyloric stenosis

    Directory of Open Access Journals (Sweden)

    Javier Mata-Gómez

    2015-08-01

    Full Text Available BACKGROUND AND OBJECTIVES: Hypertrophic pyloric stenosis is a relatively common affection of gastrointestinal tract in childhood that results in symptoms, such as projectile vomiting and metabolic disorders that imply a high risk of aspiration during anesthetic induction. In this way, the carrying out of a technique with general anesthesia and intravenous rapid sequence induction, preoxygenation and cricoid pressure are recommended. After the correction of systemic metabolic alkalosis and pH normalization, cerebrospinal fluid can keep a state of metabolic alkalosis. This circumstance, in addition to the residual effect of neuromuscular blocking agents, inhalant anesthetics and opioids could increase the risk of postoperative apnea after a general anesthesia.CASE REPORT: We present the successful management in 3 neonates in those a pyloromyotomy was carried out because they had presented congenital hypertrophic pyloric stenosis. This procedure was done under general anesthesia with orotracheal intubation and rapid sequence induction. Then, ultrasound-guided paravertebral block was performed as analgesic method without the need for administrating opioids within intraoperative period and keeping an appropriate analgesic level.CONCLUSIONS: Local anesthesia has demonstrated to be safe and effective in pediatric practice. We consider the ultrasound-guided paravertebral block with one dose as a possible alternative for other local techniques described, avoiding the use of opioids and neuromuscular blocking agents during general anesthesia, and reducing the risk of central apnea within postoperative period.

  13. Methylprednisolone versus triamcinolone in painful shoulder using ultrasound-guided injection.

    Science.gov (United States)

    Chávez-López, Mario Alfredo; Navarro-Soltero, Luis Alberto; Rosas-Cabral, Alejandro; Gallaga, Adán; Huerta-Yáñez, Guillermo

    2009-01-01

    There is little evidence about the comparative efficacy of corticosteroids in the treatment of painful shoulder. The main aim was to compare the efficacy of methylprednisolone (MTP) versus triamcinolone (TMC) in the treatment of painful shoulder using an ultrasound-guided injection. Patients with painful shoulder due to subacromial bursitis and partial or full-thickness rotator cuff tears demonstrated by musculoskeletal ultrasound received a guided-injection of MTP acetate 40 mg (12 patients) or TMC acetonide 40 mg (12 patients). Range of motion and pain visual analogue scale were registered at 10 and 30 min, 1 and 2 weeks postinjection. Two weeks postinjection, both groups reported a mean improvement in range of motion (33%) and relief of pain (61%). Relief of pain of 50% or more was observed in 92% of patients in MTP group and 50% of TMC group (p = 0.02). Two months postinjection, 50% of the patients in MTP group and 25% in TMC group reported total relief of pain (p = 0.3). Patients with painful shoulder receiving an ultrasound-guided injection of MTP or TMC have a rapid and sustained overall response. Relief of pain tends to be more rapid with MTP than TMC.

  14. Training and certification in endobronchial ultrasound-guided transbronchial needle aspiration.

    Science.gov (United States)

    Naur, Therese Maria Henriette; Konge, Lars; Nayahangan, Leizl Joy; Clementsen, Paul Frost

    2017-07-01

    Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) plays a key role in the staging of lung cancer, which is crucial for allocation to surgical treatment. EBUS-TBNA is a complicated procedure and simulation-based training is helpful in the first part of the long learning curve prior to performing the procedure on actual patients. New trainees should follow a structured training programme consisting of training on simulators to proficiency as assessed with a validated test followed by supervised practice on patients. The simulation-based training is superior to the traditional apprenticeship model and is recommended in the newest guidelines. EBUS-TBNA and oesophageal ultrasound-guided fine needle aspiration (EUS-FNA or EUS-B-FNA) are complementary to each other and the combined techniques are superior to either technique alone. It is logical to learn and to perform the two techniques in combination, however, for lung cancer staging solely EBUS-TBNA simulators exist, but hopefully in the future simulation-based training in EUS will be possible.

  15. Computer tomography urography assisted real-time ultrasound-guided percutaneous nephrolithotomy on renal calculus.

    Science.gov (United States)

    Fang, You-Qiang; Wu, Jie-Ying; Li, Teng-Cheng; Zheng, Hao-Feng; Liang, Guan-Can; Chen, Yan-Xiong; Hong, Xiao-Bin; Cai, Wei-Zhong; Zang, Zhi-Jun; Di, Jin-Ming

    2017-06-01

    This study aimed to assess the role of pre-designed route on computer tomography urography (CTU) in the ultrasound-guided percutaneous nephrolithotomy (PCNL) for renal calculus.From August 2013 to May 2016, a total of 100 patients diagnosed with complex renal calculus in our hospital were randomly divided into CTU group and control group (without CTU assistance). CTU was used to design a rational route for puncturing in CTU group. Ultrasound was used in both groups to establish a working trace in the operation areas. Patients' perioperative parameters and postoperative complications were recorded.All operations were successfully performed, without transferring to open surgery. Time of channel establishment in CTU group (6.5 ± 4.3 minutes) was shorter than the control group (10.0 ± 6.7 minutes) (P = .002). In addition, there was shorter operation time, lower rates of blood transfusion, secondary operation, and less establishing channels. The incidence of postoperative complications including residual stones, sepsis, severe hemorrhage, and perirenal hematoma was lower in CTU group than in control group.Pre-designing puncture route on CTU images would improve the puncturing accuracy, lessen establishing channels as well as improve the security in the ultrasound-guided PCNL for complex renal calculus, but at the cost of increased radiation exposure.

  16. Feasibility of eye-tracking technology to quantify expertise in ultrasound-guided regional anesthesia.

    Science.gov (United States)

    Harrison, T Kyle; Kim, T Edward; Kou, Alex; Shum, Cynthia; Mariano, Edward R; Howard, Steven K

    2016-06-01

    Ultrasound-guided regional anesthesia (UGRA) requires an advanced procedural skill set that incorporates both sonographic knowledge of relevant anatomy as well as technical proficiency in needle manipulation in order to achieve a successful outcome. Understanding how to differentiate a novice from an expert in UGRA using a quantifiable tool may be useful for comparing educational interventions that could improve the rate at which one develops expertise. Exploring the gaze pattern of individuals performing a task has been used to evaluate expertise in many different disciplines, including medicine. However, the use of eye-tracking technology has not been previously applied to UGRA. The purpose of this preliminary study is to establish the feasibility of applying such technology as a measurement tool for comparing procedural expertise in UGRA. eye-tracking data were collected from one expert and one novice utilizing Tobii Glasses 2 while performing a simulated ultrasound-guided thoracic paravertebral block in a gel phantom model. Area of interest fixations were recorded and heat maps of gaze fixations were created. Results suggest a potential application of eye-tracking technology in the assessment of UGRA learning and performance.

  17. Subacute posteromedial impingement of the ankle in athletes: MR imaging evaluation and ultrasound guided therapy

    Energy Technology Data Exchange (ETDEWEB)

    Messiou, Christina; Robinson, Philip; O' Connor, Philip J.; Grainger, Andrew [Leeds Teaching Hospitals, St. James University Hospital, Department of Radiology, Leeds (United Kingdom)

    2006-02-15

    To describe the use of MR imaging and efficacy of ultrasound-guided steroid injection in the diagnosis and management of athletes with clinical posteromedial impingement of the ankle. A retrospective analysis of imaging findings on MR was undertaken in nine elite athletes with clinical posteromedial ankle impingement. MR studies from six professional athletes with posterolateral pain were also reviewed as an imaging control group. The two reviewing radiologists were blinded to the clinical details and the proportion of control and study subjects. The nine study athletes also underwent diagnostic ultrasound and ultrasound-guided injection of steroid and anaesthetic into the posteromedial capsular abnormality. Follow-up was by telephone interview. Posteromedial capsular thickening was seen only in athletes with posteromedial impingement (7/9). Posteromedial synovitis was present in all athletes with posteromedial impingement; however, posterior and posterolateral synovitis was also seen in these athletes. Mild posteromedial synovitis was present in two control athletes. Ultrasound identified abnormal posteromedial soft tissue thickening deep to tibialis posterior between the medial malleolus and talus in all nine athletes. After injection all athletes returned to their previous level of sport, with eight of the nine not experiencing any residual or recurrent symptoms. If MR imaging excludes significant coexistent abnormality, ultrasound can localise posteromedial soft tissue abnormality and guide injection therapy, allowing return to athletic activity without surgical intervention. (orig.)

  18. Calcific tendinopathy of the shoulder with intraosseous extension: outcomes of ultrasound-guided percutaneous irrigation

    Energy Technology Data Exchange (ETDEWEB)

    Klontzas, Michail E. [University Hospital and Department of Radiology, University of Crete, Department of Medical Imaging, Heraklion, Crete (Greece); Imperial College London, Department of Chemical Engineering, London (United Kingdom); Vassalou, Evangelia E.; Karantanas, Apostolos H. [University Hospital and Department of Radiology, University of Crete, Department of Medical Imaging, Heraklion, Crete (Greece)

    2017-02-15

    Rotator cuff calcific tendinopathy (RCCT) with intraosseous extension is a rare complication of tendinous and peritendinous involvement. The purpose of our study is to evaluate the outcome of ultrasound-guided percutaneous irrigation of calcific tendinopathy (US-PICT) in patients with intraosseous involvement. From January 2011 to June 2014, patients with a clinical and imaging diagnosis of RCCT were prospectively categorised in two groups based on imaging findings: group A (10 patients) with intraosseous RCCT and group B (control group 35 patients) without osseous involvement. US-PICT followed by subacromial injection was applied to all patients in groups A and B. During a 1-year follow-up, treatment outcome in terms of pain and functional improvement was evaluated at 3 weeks, 3 months, 6 months, and 1 year, with the use of a four-grade scale. The study has been approved by our hospital's ethics committee. Mean improvement scores of group A were significantly lower than those of group B at all time points (p < 0.0001). Improvement of group B was noted mainly within the first 3 months post-treatment (p = 0.016). Outcomes of ultrasound-guided treatment in cases of RCCT with intraosseous extension are significantly less favourable than in purely tendinous or peritendinous disease. (orig.)

  19. Backscattering analysis of high frequency ultrasonic imaging for ultrasound-guided breast biopsy

    Science.gov (United States)

    Cummins, Thomas; Akiyama, Takahiro; Lee, Changyang; Martin, Sue E.; Shung, K. Kirk

    2017-03-01

    A new ultrasound-guided breast biopsy technique is proposed. The technique utilizes conventional ultrasound guidance coupled with a high frequency embedded ultrasound array located within the biopsy needle to improve the accuracy in breast cancer diagnosis.1 The array within the needle is intended to be used to detect micro- calcifications indicative of early breast cancers such as ductal carcinoma in situ (DCIS). Backscattering analysis has the potential to characterize tissues to improve localization of lesions. This paper describes initial results of the application of backscattering analysis of breast biopsy tissue specimens and shows the usefulness of high frequency ultrasound for the new biopsy related technique. Ultrasound echoes of ex-vivo breast biopsy tissue specimens were acquired by using a single-element transducer with a bandwidth from 41 MHz to 88 MHz utilizing a UBM methodology, and the backscattering coefficients were calculated. These values as well as B-mode image data were mapped in 2D and matched with each pathology image for the identification of tissue type for the comparison to the pathology images corresponding to each plane. Microcalcifications were significantly distinguished from normal tissue. Adenocarcinoma was also successfully differentiated from adipose tissue. These results indicate that backscattering analysis is able to quantitatively distinguish tissues into normal and abnormal, which should help radiologists locate abnormal areas during the proposed ultrasound-guided breast biopsy with high frequency ultrasound.

  20. Ultrasound-Guided Nerve Block with Botulinum Toxin Type A for Intractable Neuropathic Pain

    Directory of Open Access Journals (Sweden)

    Young Eun Moon

    2016-01-01

    Full Text Available Neuropathic pain includes postherpetic neuralgia (PHN, painful diabetic neuropathy (PDN, and trigeminal neuralgia, and so on. Although various drugs have been tried to treat neuropathic pain, the effectiveness of the drugs sometimes may be limited for chronic intractable neuropathic pain, especially when they cannot be used at an adequate dose, due to undesirable severe side effects and the underlying disease itself. Botulinum toxin type A (BoNT-A has been known for its analgesic effect in various pain conditions. Nevertheless, there are no data of nerve block in PHN and PDN. Here, we report two patients successfully treated with ultrasound-guided peripheral nerve block using BoNT-A for intractable PHN and PDN. One patient had PHN on the left upper extremity and the other patient had PDN on a lower extremity. Due to side effects of drugs, escalation of the drug dose could not be made. We injected 50 Botox units (BOTOX®, Allergan Inc., Irvine, CA, USA into brachial plexus and lumbar plexus, respectively, under ultrasound. Their pain was significantly decreased for about 4–5 months. Ultrasound-guided nerve block with BoNT-A may be an effective analgesic modality in a chronic intractable neuropathic pain especially when conventional treatment failed to achieve adequate pain relief.

  1. Looking into learning: visuospatial and psychomotor predictors of ultrasound-guided procedural performance.

    Science.gov (United States)

    Smith, Hugh M; Kopp, Sandra L; Johnson, Rebecca L; Long, Timothy R; Cerhan, Jane H; Hebl, James R

    2012-01-01

    Despite widespread use of ultrasound in regional anesthesia, little understanding of the psychomotor and visuospatial skills required to achieve and maintain procedural proficiency exists. Despite its procedural nature, anesthesiology lags behind other fields in assessing technical aptitude among practitioners and trainees. The goals of this study were to measure relevant visuospatial and psychomotor aptitudes of anesthesia residents-in-training and to evaluate the relationship between these skill sets and the performance of ultrasound-guided regional anesthesia. Forty residents from the Mayo Clinic Department of Anesthesiology were enrolled, and 39 (PGY-1 through PGY-4) voluntarily completed a demographic survey, 4 psychomotor and 4 visuospatial aptitude assessments, and an ultrasound-based performance assessment. The Block Design Test, a subtest of the Wechsler Adult Intelligent Scale - III, correlated with ultrasound guided skill performance (correlation coefficient, 0.47; P hand-eye coordination visual feedback (projected image) compared with direct hand-eye coordination (P hand dominance. This study reveals that visuospatial aptitude is a better predictor of ultrasound-based procedural performance than psychomotor ability. The type of real-time visual feedback (indirect versus direct) used for hand-eye coordination significantly impacts procedural performance and has implications for anesthesia and other procedural specialties. The learning effect noted during initial ultrasound skill trials suggests visuospatial assimilation and underscores the importance of early ultrasound instruction.

  2. Delphi Method Validation of a Procedural Performance Checklist for Insertion of an Ultrasound-Guided Internal Jugular Central Line.

    Science.gov (United States)

    Hartman, Nicholas; Wittler, Mary; Askew, Kim; Manthey, David

    2016-01-01

    Placement of ultrasound-guided central lines is a critical skill for physicians in several specialties. Improving the quality of care delivered surrounding this procedure demands rigorous measurement of competency, and validated tools to assess performance are essential. Using the iterative, modified Delphi technique and experts in multiple disciplines across the United States, the study team created a 30-item checklist designed to assess competency in the placement of ultrasound-guided internal jugular central lines. Cronbach α was .94, indicating an excellent degree of internal consistency. Further validation of this checklist will require its implementation in simulated and clinical environments.

  3. Endoscopic Ultrasound-Guided Fine Needle Aspiration versus Percutaneous Ultrasound-Guided Fine Needle Aspiration in Diagnosis of Focal Pancreatic Masses.

    Science.gov (United States)

    Okasha, Hussein Hassan; Naga, Mazen Ibrahim; Esmat, Serag; Naguib, Mohamed; Hassanein, Mohamed; Hassani, Mohamed; El-Kassas, Mohamed; Mahdy, Reem Ezzat; El-Gemeie, Emad; Farag, Ali Hassan; Foda, Ayman Mohamed

    2013-10-01

    Pancreatic carcinoma is one of the leading cancer morbidity and mortality world-wide. Controversy has arisen about whether the percutaneous approach with computed tomography/ultrasonography-guidance fine needle aspiration (US-FNA) or endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is the preferred method to obtain diagnostic tissue. Our purpose of this study is to compare between the diagnostic accuracy of EUS-FNA and percutaneous US-FNA in diagnosis of pancreatic cancer. A total of 197 patients with pancreatic masses were included in the study, 125 patients underwent US-FNA (Group 1) and 72 patients underwent EUS-FNA (Group 2). EUS-FNA has nearly the same accuracy (88.9%) as US-FNA (87.2%) in diagnosis of pancreatic cancer. The sensitivity, specificity, positive predictive value and negative predictive value for EUS-FNA was 84%, 100%, 100%, 73.3% respectively. It was 85.5%, 90.4%, 94.7%, 76% respectively for US-FNA. EUS-FNA had a lower complication rate (1.38%) than US-FNA (5.6%). EUS-FNA has nearly the same accuracy as US-FNA of pancreatic masses with a lower complication rate.

  4. Higher number of transrectal ultrasound guided prostate biopsy cores is associated with higher blood loss and perioperative complications in robot assisted radical prostatectomy.

    Science.gov (United States)

    Carneiro, A; Sivaraman, A; Sanchez-Salas, R; Nunes-Silva, I; Baghdadi, M; Srougi, V; di Trapani, E; Uriburu Pizzaro, F; Doizi, S; Barret, E; Rozet, F; Galiano, M; Cathelineau, X

    2017-04-01

    The local inflammatory process after prostate biopsies can have a negative impact on functional outcomes of radical prostatectomy. There is no evidence in literature demonstrating its impact on radical prostatectomy. To evaluate the impact of the number of TRUS core biopsies in the surgical morbidity and rate of positive margin on robot assisted radical prostatectomy (RARP). A prospectively maintained database of 2,054 RARPs in a single institution. Patients were further grouped into 2 groups based on the number of TRUS biopsy cores (G1≤12 cores; G2>12 cores). Multivariable logistic regression model was applied to analyze the impact of number of cores on complications. A total number of 1,042 patients in the group 1 (≤12 cores) and 1,012 patients in the group 2 (>12 cores) were included. The rate of perioperative complications increased with higher number of biopsies (G1 6.4 vs. G2 8.5%; P=.03), but high grade complication (Clavien 3-4) were similar (G1 1.4 vs. G2 2.2%; P=.16). Positive surgical margin rates were similar in both groups (G1 11.8 vs. 9.98%; P=.2). At the multivariable logistic regression analysis shown that G2 had a 39% (OR 0.645) higher rate to experience perioperative complications during RARP. Higher number of TRUS biopsy cores (>12) is associated to higher blood loss and perioperative complications during RARP. Careful preoperative evaluation for those patients underwent multiple biopsies or saturation protocols is mandatory. Application of longer intervals (>6 weeks) between biopsy and surgery may be advisable to minimize potential risks of surgical complications in patients may benefit from RARP. Further studies are still necessary to confirm these results. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Endorectal coil MRI and MR-spectroscopic imaging in patients with elevated serum prostate specific antigen with negative trus transrectal ultrasound guided biopsy

    Directory of Open Access Journals (Sweden)

    Farooq Ahmad Ganie

    2013-01-01

    Conclusion: Prostatic biopsy directed with endorectal coil MRI and MR-spectroscopic imaging findings in patients with elevated serum PSA and prior negative biopsy, improves the early diagnosis of prostatic carcinoma and accurate localization of prostate cancer within the gland.

  6. Ultrasound-guided therapeutic modulation of hepatocellular carcinoma using complementary microRNAs.

    Science.gov (United States)

    Mullick Chowdhury, Sayan; Wang, Tzu-Yin; Bachawal, Sunitha; Devulapally, Rammohan; Choe, Jung Woo; Abou Elkacem, Lotfi; Yakub, Butrus Khuri; Wang, David S; Tian, Lu; Paulmurugan, Ramasamy; Willmann, Jürgen K

    2016-09-28

    Treatment options for patients with hepatocellular carcinoma (HCC) are limited, in particular in advanced and drug resistant HCC. MicroRNAs (miRNA) are non-coding small RNAs that are emerging as novel drugs for the treatment of cancer. The aim of this study was to assess treatment effects of two complementary miRNAs (sense miRNA-122, and antisense antimiR-21) encapsulated in biodegradable poly (lactic-co-glycolic acid) nanoparticles (PLGA-NP), administered by an ultrasound-guided and microbubble-enhanced delivery approach in doxorubicin-resistant and non-resistant human HCC xenografts. Proliferation and invasiveness of human HCC cells after miRNA-122/antimiR-21 and doxorubicin treatment were assessed in vitro. Confocal microscopy and qRT-PCR were used to visualize and quantitate successful intracellular miRNA-loaded PLGA-NP delivery. Up and down-regulation of miRNA downstream targets and multidrug resistance proteins and extent of apoptosis were assessed in vivo in treated human HCC xenografts in mice. Compared to single miRNA therapy, combination therapy with the two complementary miRNAs resulted in significantly (P<0.05) stronger decrease in cell proliferation, invasion, and migration of HCC cells as well as higher resensitization to doxorubicin. Ultrasound-guided delivery significantly increased in vivo miRNA-loaded PLGA-NP delivery in human HCC xenografts compared to control conditions by 5-9 fold (P<0.001). miRNA-loaded PLGA-NP were internalized in HCC cells and anti-apoptotic proteins were down regulated with apoptosis in ~27% of the tumor volume of doxorubicin-resistant human HCC after a single treatment with complementary miRNAs and doxorubicin. Thus, ultrasound-guided delivery of complementary miRNAs is highly efficient in the treatment of doxorubicin- resistant and non-resistant HCC. Further development of this new treatment approach could aid in better treatment of patients with HCC.

  7. Pain management via Ultrasound-guided Nerve Block in Emergency Department; a Case Series Study.

    Science.gov (United States)

    Nejati, Amir; Teymourian, Houman; Behrooz, Leili; Mohseni, Gholamreza

    2017-01-01

    Pain is the most common complaint of patients referring to emergency department (ED). Considering the importance of pain management in ED, this study aimed to investigate the efficacy and feasibility of ultrasound-guided nerve blocks in this setting. 46 patients who came to the ED with injured extremities were enrolled in the study and received either femoral, axillary or sciatic nerve block depending on their site of injury (1.5 mg Bupivacaine per kg of patient's weight). Patients were asked about their level of pain before and after receiving the nerve block based on numerical rating scale. The difference between pre and post block pain severity was measured. Both patients and physicians were asked about their satisfaction with the nerve block in 5 tiered Likert scale. 46 patients with the mean age of 37.5 ± 12.5 years (8-82 years) received ultrasound-guided nerve block (84.8% male). 6 Sciatic, 25 axillary, and 15 femoral nerve blocks were performed. Mean pain severity on NRS score at the time of admission was 8.1 ± 1.4, which reduced to 2.04 ± 2.06 after block. 25 (54.3%) patients were highly satisfied (Likert scale 5), 15 (32.6%) were satisfied (Likert scale 4), 3 (6.5%) were neutral and had no opinion (Likert scale 3), 1 (2.1%) was not satisfied (Likert scale 2), and 2 (4.3%) were highly unsatisfied (Likert scale 1). There was no significant difference among the satisfaction scores within the three block locations (p = 0.8). There was no significant difference in physicians' level of satisfaction between the three block locations either (p = 0.9). 1 (2.1%) case of agitation and tachycardia and 1 (2.1%) case of vomiting were observed after the procedure. Ultrasound-guided nerve block of extremities is a safe and effective method that can be used for pain management in the ED. It results in high levels of satisfaction among both patients and physicians.

  8. Medial approach of ultrasound-guided costoclavicular plexus block and its effects on regional perfussion.

    Science.gov (United States)

    Nieuwveld, D; Mojica, V; Herrera, A E; Pomés, J; Prats, A; Sala-Blanch, X

    2017-04-01

    Ultrasound-guided infraclavicular block in the costoclavicular space located between the clavicle and the first rib, reaches the secondary trunks when they are clustered together and lateral to the axillary artery. This block is most often performed through a lateral approach, the difficulty being finding the coracoid process an obstacle and guiding the needle towards the vessels and pleura. A medial approach, meaning from inside to outside, will avoid these structures. Traditionally the assessment of a successful block is through motor or sensitive responses but a sympathetic fibre block can also be evaluated measuring the changes in humeral artery blood flow, skin temperature and/or perfusion index. To describe the medial approach of the ultrasound-guided costoclavicular block evaluating its development by motor and sensitive response and measurement of sympathetic changes. Description of the technique and administration of 20ml of contrast in a fresh cadaver model, evaluating the distribution with CT-scan and sagittal sections of the anatomic piece. Subsequently in a clinical phase, including 11 patients, we evaluated the establishment of motor, sensitive and sympathetic blocks. We evaluated the sympathetic changes reflected by humeral artery blood flow, skin temperature and distal perfusion index. In the anatomical model the block was conducted without difficulties, showing an adequate periclavicular distribution of the contrast in the CT-scan and in sagittal sections, reaching the interscalenic space as far as the secondary trunks. Successful blocks were observed in 91% of patients after 25minutes. All the parameters reflecting sympathetic block increased significantly. The humeral artery blood flow showed an increase from 108 ± 86 to 188±141ml/min (P=.05), skin temperature from 32.1±2 to 32.8±9°C (P=.03) and perfusion index from 4±3 to 9±5 (P=.003). The medial approach of the ultrasound-guided costoclavicular block is anatomically feasible, with high

  9. Palpation- and ultrasound-guided brachial plexus blockade in Hispaniolan Amazon parrots (Amazona ventralis).

    Science.gov (United States)

    da Cunha, Anderson F; Strain, George M; Rademacher, Nathalie; Schnellbacher, Rodney; Tully, Thomas N

    2013-01-01

    To compare palpation-guided with ultrasound-guided brachial plexus blockade in Hispaniolan Amazon parrots. Prospective randomized experimental trial. Eighteen adult Hispaniolan Amazon parrots (Amazona ventralis) weighing 252-295 g. After induction of anesthesia with isoflurane, parrots received an injection of lidocaine (2 mg kg(-1)) in a total volume of 0.3 mL at the axillary region. The birds were randomly assigned to equal groups using either palpation or ultrasound as a guide for the brachial plexus block. Nerve evoked muscle potentials (NEMP) were used to monitor effectiveness of brachial plexus block. The palpation-guided group received the local anesthetic at the space between the pectoral muscle, triceps, and supracoracoideus aticimus muscle, at the insertion of the tendons of the caudal coracobrachial muscle, and the caudal scapulohumeral muscle. For the ultrasound-guided group, the brachial plexus and the adjacent vessels were located with B-mode ultrasonography using a 7-15 MHz linear probe. After location, an 8-5 MHz convex transducer was used to guide injections. General anesthesia was discontinued 20 minutes after lidocaine injection and the birds recovered in a padded cage. Both techniques decreased the amplitude of NEMP. Statistically significant differences in NEMP amplitudes, were observed within the ultrasound-guided group at 5, 10, 15, and 20 minutes after injection and within the palpation-guided group at 10, 15, and 20 minutes after injection. There was no statistically significant difference between the two groups. No effect on motor function, muscle relaxation or wing droop was observed after brachial plexus block. The onset of the brachial plexus block tended to be faster when ultrasonography was used. Brachial plexus injection can be performed in Hispaniolan Amazon parrots and nerve evoked muscle potentials were useful to monitor the effects on nerve conduction in this avian species. Neither technique produced an effective block at the

  10. Ultrasound-Guided Fine-Needle Aspiration Biopsy of Multiple Thyroid Nodules

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Dae; Bae, Il Hun; Lee, Seung Young; Han, Gi Seok; Cha, Sang Hun; Kim, Sung Jin; Park, Kil Sun; Koong, Sung Soo; Lee, Ok Jun [Chungbuk National University College of Medicine, Cheongju (Korea, Republic of)

    2006-09-15

    To standardize the number of nodules which necessitates ultrasound-guided, fine-needle, aspiration biopsy in patients who have multiple thyroid nodules with the same sonographic characteristics as each other. From February, 2002 to March, 2004, among patients whose diagnosis was confirmed by ultrasound-guided, fine-needle, aspiration biopsy, 545 nodules of 203 patients were found in sonography with more than two thyroid nodules. Each thyroid gland nodule was classified on a score from 0 to 2 points on the basis of the following 5 characteristics: internal content, margin, echogenicity, shape and calcification in sonography. When the score of all characteristics was the same, by deciding on nodules with the same sonographic characteristics and with the score of at least one characteristic being different, we divided the nodules with different sonographic characteristics in a patient. By methods such as given in the preceding descriptions, patients with multiple thyroid nodules were separated into two groups: one in which all nodules had the same sonographic characteristics and another in which nodules have at least one different sonographic characteristic. Then, each pathologic result was searched for the same case and different case in each patient group. Among the 203 patients who were diagnosed with multiple thyroid nodules in ultrasonography, 79 patients (38.9%) had nodules with the same ultrasonographic characteristics and 124 patients (61.1%) had nodules with at least one different ultrasonographic characteristic. All 79 patient's nodules with the same ultrasonographic characteristics in each patient showed the same pathologic result in all cases (100.0%) and there was no case showing a different pathologic result. Otherwise, among the 124 patient's nodules with different ultrasonographic characteristics, each patient showed the same pathologic result in 111 (89.5%) and different pathologic result in 13 (10.5%). In patients who have multiple thyroid

  11. Efficacy evaluation of laparoscopy assisted ultrasound guided radiofrequency ablation in the treatment of hepatocellular carcinoma beneath the diaphragm

    Directory of Open Access Journals (Sweden)

    Song WANG

    2017-06-01

    Full Text Available Objective To explore the feasibility, safety and efficacy of laparoscopy assisted ultrasound guided radiofrequency ablation (RFA in the treatment of hepatocellular carcinoma (HCC beneath the diaphragm. Methods Twenty- three consecutive patients with solitary HCC beneath the diaphragm were treated by laparoscopy assisted ultrasound guided RFA in the Chinese PLA General Hospital from January 2013 to March 2016. We observed the perioperative complications and followed- up long-term effect. Results All the 23 patients successfully underwent laparoscopy assisted ultrasound guided radiofrequency ablation. No serious complications such as massive hemorrhage, biliary fistula and severe pleural effusion, hemopneumothorax occurred in the patients during perioperative period. CT examination 2-3 days after the operation revealed that the tumor was completely covered by the ablation area. Besides, the survival condition was satisfactory during follow-up period of 9-38 months. Conclusion Laparoscopy-assisted ultrasound-guided radiofrequency ablation is effective and safe for HCC beneath the diaphragm. DOI: 10.11855/j.issn.0577-7402.2017.05.16

  12. Novice performance of ultrasound-guided needle advancement: standard 38-mm transducer vs 25-mm hockey stick transducer.

    Science.gov (United States)

    Davies, T; Townsley, P; Jlala, H; Dowling, M; Bedforth, N; Hardman, J G; McCahon, R A

    2012-08-01

    The optimal method to develop expertise in ultrasound-guided regional anaesthesia is unknown. Studies of laryngoscopic expertise in novices demonstrate that the choice of laryngoscope affects performance. In this study, we aimed to compare the effect of two different linear array transducers (38-mm standard vs 25-mm hockey stick) on novice performance of ultrasound-guided needle advancement. Following randomisation, participants watched a video model of expert performance of ultrasound-guided needle advancement. Recruits performed the modelled task on a turkey breast model. The median (IQR [range]) composite error score was statistically significantly larger for participants in the hockey stick transducer group compared with the standard transducer group; 10.0 (7.3-14.3 [2.5-29.0]) vs 7.5 (4.5-10.0 [2.0-28.0]) respectively, (p = 0.01). This study has demonstrated that performance of ultrasound-guided needle advancement by novice operators after simple video instruction is better (as assessed using a composite error score) with a standard 38-mm transducer than with a 25-mm hockey stick transducer. Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland.

  13. The treatment of drooling by ultrasound-guided intraglandular injections of botulinum toxin type A into the salivary glands.

    NARCIS (Netherlands)

    Jongerius, P.H.; Joosten, F.B.M.; Hoogen, F.J.A. van den; Gabreëls, F.J.M.; Rotteveel, J.J.

    2003-01-01

    OBJECTIVE: The aim of the study was to present the background, procedure, and technique of bilateral ultrasound-guided, single-dose injections of botulinum toxin type A (BTX) into the salivary glands in patients with severe drooling. STUDY DESIGN: Clinical trial. METHODS: Initially, an in vitro stud

  14. Ultrasound-guided continuous suprascapular nerve block for adhesive capsulitis: one case and a short topical review

    DEFF Research Database (Denmark)

    Neimann, Jens Dupont Børglum; Bartholdy, Anne; Hautopp, H;

    2011-01-01

    We present a case with an ultrasound-guided (USG) placement of a perineural catheter beneath the transverse scapular ligament in the scapular notch to provide a continuous block of the suprascapular nerve (SSN). The patient suffered from a severe and very painful adhesive capsulitis of the left...

  15. The utility of ultrasound-guided thoracentesis and pleural biopsy in undiagnosed pleural exudates.

    Science.gov (United States)

    Koegelenberg, Coenraad Frederik N; Irusen, Elvis Malcom; von Groote-Bidlingmaier, Florian; Bruwer, Johannes Willem; Batubara, Enas Mansour A; Diacon, Andreas Henri

    2015-10-01

    We assessed the utility of ultrasound to guide the selection of closed pleural biopsy technique and site and to assess the respective contributions of repeat thoracentesis and closed pleural biopsy in 100 consecutive patients with undiagnosed pleural exudates. Thoracentesis was more likely to be diagnostic in TB than malignancy (77.8% vs 31.0%, p<0.001). The addition of ultrasound-guided biopsy increased the combined yield for all diagnoses from 48.0% to 90.0% (p<0.001), for malignancy from 31.0% to 89.7% (p<0.001) and for TB from 77.8% to 88.9% (p=0.688). Our findings suggest that this minimally invasive approach has a high diagnostic yield. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Ultrasound-guided procedures to treat sport-related muscle injuries

    Science.gov (United States)

    Orlandi, Davide; Corazza, Angelo; Arcidiacono, Alice; Messina, Carmelo; Serafini, Giovanni; Sconfienza, Luca M

    2016-01-01

    Ultrasound is well known as a low-cost, radiation-free and effective imaging technique to guide percutaneous procedures. The lower limb muscles represent a good target to perform such procedures under ultrasound guidance, thus allowing for clear and precise visualization of the needle during the whole procedure. The knowledge of guidelines and technical aspects is mandatory to act in the most safe and accurate way on target tissues that can be as small as a few millimetres. This review will focus above the local treatments of traumatic lower limb muscle injuries described in literature, focusing on new and promising approaches, such as platelet-rich plasma treatment of muscle tears in athletes. For each procedure, a brief how-to-do practical guide will be provided, emphasizing precautions and tricks based on day-by-day experience that may help to improve the outcome of percutaneous ultrasound-guided procedures around the lower limb muscles. PMID:26562097

  17. Diagnosis of iliotibial band friction syndrome and ultrasound guided steroid injection.

    Science.gov (United States)

    Hong, Ji Hee; Kim, Ji Sub

    2013-10-01

    A 64-year-old woman visited our pain clinic with the pain of right lateral side of thigh for one year. Her pain always started from knee and was radiated to buttock area when symptom was severe. She showed significant tenderness at knee lateral side and local tightness at lateral thigh. Magnetic resonance image of the knee was performed and we could identify high signal intensity of iliotibial band through coronal and axial view. In spite of medication and physical stretching exercise of iliotibial band for one month, she did not show any improvement of pain. To alleviate her symptom, ultrasound guided local corticosteroid injection targeting beneath the iliotibial band was performed. After the procedure, the reduction of pain was significant and there was no need for further management.

  18. Ultrasound-guided procedures around the wrist and hand: How to do

    Energy Technology Data Exchange (ETDEWEB)

    Orlandi, Davide; Corazza, Angelo [Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via L.B. Alberti 4, 16132 Genova (Italy); Silvestri, Enzo [Diagnostica per Immagini, Ospedale Evangelico Internazionale, Corso Solferino 29A, 16100 Genova (Italy); Serafini, Giovanni [Dipartimento di Diagnostica per Immagini, Ospedale Santa Corona, Via XXV Aprile 38, 17037 Pietra Ligure, Savona (Italy); Savarino, Edoardo Vincenzo [Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche, Università degli Studi di Padova, Via Giustiniani, Padova (Italy); Garlaschi, Giacomo [Dipartimento di Scienze per la Salute, Università degli Studi di Genova, Via L.B. Alberti 4, 16132 Genova (Italy); Mauri, Giovanni [Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, Milano (Italy); Cimmino, Marco Amedeo [Dipartimento di Medicina Interna, Università degli Studi di Genova, Via L.B. Alberti 4, 16132 Genova (Italy); Sconfienza, Luca Maria, E-mail: io@lucasconfienza.it [Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, Milano (Italy); Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Piazza Malan 2, San Donato Milanese, Milano (Italy)

    2014-07-15

    Ultrasound has emerged as a low-cost, radiation-free and effective imaging technique to detect joint abnormalities and to guide percutaneous procedures. Being superficial, wrist and hand tendons and joints represent a good target to perform such procedures using ultrasound guidance. This kind of approach allows for a clear and real-time visualization of the needles during their whole path. In this setting, the knowledge of technical aspects and tips is essential to act in the most accurate way on target tissues that can be as small as a few millimetres. The aim of this review is to summarize the local treatments of inflammatory and degenerative disease described in literature (such as treatment of De Quervain's tenosynovitis, trigger finger, trapezio-metacarpal joint osteoarthritis, etc.), emphasizing precautions and tricks based on day-by-day experience that may help to improve the outcome of percutaneous ultrasound-guided procedures around the wrist and hand.

  19. Ultrasound-guided Corticosteroid Injection for the Treatment of Athletic Pubalgia: A Series of 12 Cases

    Directory of Open Access Journals (Sweden)

    Jean Jose

    2015-06-01

    Full Text Available Surgical treatment for athletic pubalgia is the standard of care, however, it poses risks. This study investigated the use of ultrasound-guided corticosteroid injections as an alternative treatment. Twelve consecutive patients underwent injections into the area of degeneration in the rectus abdominis and/or adductor longus aponeurosis. The Western Ontario and McMaster Universities (WOMAC scores were used to evaluate treatment effectiveness. The average WOMAC score was 90.9. With a mean follow up of 8.7 months (range, 6–19 months, eight of the 12 patients reported complete symptom resolution. In conclusion, corticosteroid injections alleviate pain in patients with athletic pubalgia and provide an alternative to surgery.

  20. The advent of ultrasound-guided ablation techniques in nodular thyroid disease

    DEFF Research Database (Denmark)

    Papini, Enrico; Pacella, Claudio M; Misischi, Irene

    2014-01-01

    with radioactive iodine, which results in a better control of hyperthyroidism, also in the long-term, and fewer side-effects. Currently, minimally invasive treatment is also investigated for achieving local control of small size neck recurrences of papillary thyroid carcinoma in patients who are poor candidates...... minimally invasive treatments, directed towards office-based management of symptomatic nodules, without requiring general anaesthesia, and with negligible damage to the skin and cervical tissues, have been proposed during the past two decades. Today, ultrasound-guided percutaneous ethanol injection...... and thermal ablation with laser or radiofrequency have been thoroughly evaluated, and are accessible procedures in specialized centres. In clinical practice, relapsing thyroid cysts are effectively managed with percutaneous ethanol injection treatment, which should be considered therapy of choice. In solid...

  1. Learning Ultrasound-Guided Needle Insertion Skills through an Edutainment Game

    Science.gov (United States)

    Chan, Wing-Yin; Ni, Dong; Pang, Wai-Man; Qin, Jing; Chui, Yim-Pan; Yu, Simon Chun-Ho; Heng, Pheng-Ann

    Ultrasound-guided needle insertion is essential in many of minimally invasive surgeries or procedures, such as biopsy, drug delivery, spinal anaesthesia, etc. Accurate and safe needle insertion is a difficult task due to the high requirement of hand-eye coordination skills. Many proposed virtual reality (VR) based training systems put their emphasis on realistic simulation instead of pedagogical efficiency. The lack of schematic training scenario leads to boredom of repetitive operations. To solve this, we present our novel training system with the integration of game elements in order to retain the trainees' enthusiasm. Task-oriented scenarios, time attack scenarios and performance evaluation are introduced. Besides, some state-of-art technologies are also presented, including ultrasound simulation, needle haptic rendering as well as a mass-spring-based needle-tissue interaction simulation. These works are shown to be effective to keep the trainees up with learning.

  2. Ultrasound-guided Lateral Femoral Cutaneous Nerve Block in Meralgia Paresthetica.

    Science.gov (United States)

    Kim, Jeong Eun; Lee, Sang Gon; Kim, Eun Ju; Min, Byung Woo; Ban, Jong Suk; Lee, Ji Hyang

    2011-06-01

    Meralgia paresthetica is a rarely encountered sensory mononeuropathy characterized by paresthesia, pain or sensory impairment along the distribution of the lateral femoral cutaneous nerve (LFCN) caused by entrapment or compression of the nerve as it crossed the anterior superior iliac spine and runs beneath the inguinal ligament. There is great variability regarding the area where the nerve pierces the inguinal ligament, which makes it difficult to perform blind anesthetic blocks. Ultrasound has developed into a powerful tool for the visualization of peripheral nerves including very small nerves such as accessory and sural nerves. The LFCN can be located successfully, and local anesthetic solution distribution around the nerve can be observed with ultrasound guidance. Our successfully performed ultrasound-guided blockade of the LFCN in meralgia paresthetica suggests that this technique is a safe way to increase the success rate.

  3. [Endoscopic ultrasound-guided fine-needle aspiration in pulmonary medicine].

    Science.gov (United States)

    Claussen, M; Annema, J T; Welker, L; Rabe, K F

    2004-06-01

    Endoscopic ultrasound-guided fine-needle aspiration has significantly increased the capacity of pulmonary diagnostic procedures. Since this method was introduced, 1212 examinations have been performed at two centres of pulmonary medicine. Data on indications, procedures, findings, diagnostic yield and complications have been recorded. This paper describes the experiences thus gained regarding the possibilities and limitations of the method and assesses the current significance of the technique in pulmonary medicine according to previous studies. In primary diagnosis of mediastinal tissue alterations and in staging of malignant diseases the method offers a low-complication diagnostic measure which has a seminal impact on therapy in many cases, even though in daily practise the diagnostic accuracy of published studies is not always attained.

  4. Hepatic emphysema associated with ultrasound-guided liver biopsy in a dog.

    Science.gov (United States)

    Westgren, Frida; Hjorth, Tove; Uhlhorn, Margareta; Etterlin, Pernille E; Ley, Charles J

    2014-04-23

    An eleven-year-old Chinese Crested Powder Puff dog presented with polydipsia/polyuria, inappetence, diarrhea and vomiting underwent an ultrasound-guided percutaneous liver biopsy. Two days post-biopsy the clinical condition of the dog acutely deteriorated with fever, dyspnea, ataxia and subcutaneous emphysema. Radiographs and ultrasound showed focal severe hepatic emphysema in the region of the previous liver biopsy. Post-mortem examination revealed chronic hepatitis with dissecting fibrosis, acute hepatitis with hemorrhage and in the hindlimb musculature extensive hemorrhage and necrosis. Pure cultures of the gas producing bacteria Clostridium perfringens were isolated in samples from the hind limb musculature. We propose that the hepatic emphysema in the region of the biopsy site was a result of a clostridial infection.

  5. Ultrasound-guided greater auricular nerve block as sole anesthetic for ear surgery

    Directory of Open Access Journals (Sweden)

    Michael K. Ritchie

    2016-05-01

    Full Text Available A greater auricular nerve (GAN block was used as the sole anesthetic for facial surgery in an 80-year-old male patient with multiple comorbidities which would have made general anesthesia challenging. The GAN provides sensation to the ear, mastoid process, parotid gland, and angle of the mandible. In addition to anesthesia for operating room surgery, the GAN block can be used for outpatient or emergency department procedures without the need for a separate anesthesia team. Although this nerve block has been performed using landmark-based techniques, the ultrasoundguided version offers several potential advantages. These advantages include increased reliability of the nerve block, as well as prevention of inadvertent vascular puncture or blockade of the phrenic nerve, brachial plexus, or deep cervical plexus. The increasing access to ultrasound technology for medical care providers outside the operating room makes this ultrasound guided block an increasingly viable alternative.

  6. [Ultrasound-guided central venous access in adults and children: Procedure and pathological findings].

    Science.gov (United States)

    Scheiermann, P; Seeger, F H; Breitkreutz, R

    2010-01-01

    Central venous line placement is a standard procedure in critical care and peri-operative medicine. This procedure can be associated with severe complications. In contrast to the landmark technique, ultrasound-guided punctures can significantly reduce the rate of complications. Patients with a high risk for difficult vascular access include critical care and emergency patients as well as patients on anticoagulation medication and dialysis. Placement of central venous catheters can be difficult in ventilated patients and if there has been prior surgery in the puncture area. In children and small infants central venous access can also be challenging due to the anatomical relationship in the head and neck region. Puncture techniques are explained briefly by means of ultrasound anatomy. Typical ultrasonographic images visualize pathological findings in order to identify dangers and complications in central venous catheterization.

  7. Ultrasound-guided Lung Biopsy in the Hands of Respiratory Physicians

    DEFF Research Database (Denmark)

    Laursen, Christian B.; Naur, Therese M.H.; Bodtger, Uffe;

    2016-01-01

    Background: The aim of the study was to determine the diagnostic yield and prevalence of complications of ultrasound-guided transthoracic needle aspiration biopsies (US-TTNAB) performed by respiratory physicians after implementation of the procedure in an everyday clinical setting at 3 different...... centers. Methods: Patients were included if they during the period from January 2012 to August 2014 had a registered USTTNAB procedure code or if a US biopsy registration form had been filled out at either of the participating centers. Histology or cytology results were used as a reference test...... in which a primary USTTNAB had been performed were identified. The most common biopsy sites were lungs and pleurae with a total of 164 (76.3%) patients and 31 patients (14.4%), respectively. US-TTNAB diagnostic yield was 76.9% (95% CI, 70.3%-83.4%) for malignant diagnoses and 47.6% (95% CI, 31...

  8. Endoscopic ultrasound guided biopsy performed routinely in lung cancer staging spares futile thoracotomies

    DEFF Research Database (Denmark)

    Larsen, Soeren S; Vilmann, Peter; Krasnik, Mark;

    2005-01-01

    BACKGROUND: Up to 45% of operations with curative intent for non-small-cell lung cancer (NSCLC) can be regarded as futile, apparently because the stage of the disease is more advanced than expected preoperatively. During the past decade several studies have evaluated the usefulness of endoscopic...... ultrasound guided fine needle aspiration biopsy (EUS-FNA) in lung cancer staging with promising results. However, no randomised trials have been performed, in which a staging strategy with EUS-FNA performed in all patients is compared with a conventional workup. METHODS: Before surgery (i.e. mediastinoscopy.......3 years (range 0.2-2.4 years). Thoracotomy was regarded as futile if the patient had an explorative thoracotomy without tumour resection or if a resected patient had recurrent disease or died from lung cancer during follow-up. Analysis was by intention to treat. RESULTS: Fifty-three patients were randomly...

  9. Hypercalcemic crisis due to a mediastinal parathyroid cyst diagnosed by ultrasound-guided fine needle aspiration

    Institute of Scientific and Technical Information of China (English)

    ZHU Yan; MENG Yun-xiao; LI Nai-shi; LU Lin; CHEN Shi; XING Xiao-ping; MENG Xun-wu; GUAN Heng; TAN Li; LU Ke

    2010-01-01

    @@ Hypercalcemic crisis, generally accepted as serum calcium concentration greater than 3.5 mmol/L,constitues a life-threatening endocrinologic emergency,and is most frequently caused by either primary hyperparathyroidism (PHPT) or malignant diseases.Parathyroid cysts are uncommon lesions, most of that are located in the low part of the neck. By routine neck ultrasound scan investigation in a large series of 6621 patients, only 5 parathyroid cysts were detected, yielding a prevalence of 0.075% in setting of unselected patients.The parathyroid cysts in the mediastinum are much less frequently encountered, with only 106 cases reported in English literature.2,3 Moreover, less than half of these cases presented as functional with elevated serum calcium and parathyroid hormone, and only 10 cases were associated with hypercalcemic crisis.3 Herein, we present a rare case of mediastinal parathyroid cyst associated with recurrent hypercalcemic crisis, which diagnosed by ultrasound-guided fine needle aspiration (FNA).

  10. Endoscopic ultrasound guided thrombin injection of angiographically occult pancreatitis associated visceral artery pseudoaneurysms:Case series

    Institute of Scientific and Technical Information of China (English)

    Shivanand; Gamanagatti; Usha; Thingujam; Pramod; Garg; Surajkumar; Nongthombam; Nihar; Ranjan; Dash

    2015-01-01

    Pseudoaneurysm is a known complication of pancreatitis associated with significant mortality and morbidity. Imaging plays an important role in the diagnosis and management. Computed tomography(CT) helps localize the lesion and the severity of the background pancreatitis but digital subtraction angiography with coil embolization is recommended to avoid bleeding and inadvertent surgery. However, in cases where angiographic coil embolization is not feasible due to technical reasons, thrombin injection via CT or ultrasound guidance remains a viable option and often described in literature. In this series, effort has been made to highlight the role of endoscopic ultrasound guided thrombin instillation especially in patients with poorly visualized pseudoaneurysm on ultrasound thereby avoiding surgery and the associated mortality and morbidity.

  11. Ultrasound-Guided Ilioinguinal/Iliohypogastric Nerve Blocks for Persistent Inguinal Postherniorrhaphy Pain

    DEFF Research Database (Denmark)

    Bischoff, Joakim Mutahi; Koscielniak-Nielsen, Zbigniew J; Kehlet, Henrik

    2012-01-01

    -guided blocks of the ilioinguinal and iliohypogastric nerves with lidocaine.Methods:A randomized, double-blind, placebo-controlled, crossover trial in 12 patients with severe persistent inguinal postherniorrhaphy pain, including a control group of 12 healthy controls, was performed. Assessments included pain...... ratings under standardized conditions with numerical rating scale (0-10), sensory mapping to a cool roller, and quantitative sensory testing (QST), in the groin regions, before and after each ultrasound-guided block. A needle approach of 1 to 2 cm superior and medial to the anterior superior iliac spine...... was used. Outcomes were changes in pain ratings, sensory mapping, and QST compared with preblock values. Lidocaine responders were a priori defined by a pain reduction of =80% after lidocaine block and =25% after placebo block, nonresponders by pain reduction of 25% after placebo block.Results:One of 12...

  12. [Diagnostic value of ultrasound-guided core needle biopsy for soft tissue tumors].

    Science.gov (United States)

    Na, Jia; Fang, Zhi-wei; Zhao, Ai-lian; Li, Ji-you

    2013-03-01

    To study the diagnostic value and pitfalls of ultrasound-guided core needle biopsy (CNB) of soft tissue tumors. One hundred and six cases of CNB specimens encountered during the period from 2007 to 2012 were enrolled into the study. The pathologic diagnosis using CNB was compared with that using surgical specimens. Diagnostic accuracy was analyzed using Chi-square test, with respect to the histologic pattern (such as spindle cell and myxoid), biologic behavior (benign versus malignant) and immunohistochemical results. The 59 cases of sarcoma were subdivided into three grades according to FNCLCC grading system. Histologic diagnosis could be made in 84.0% (89/106) cases. Thirteen cases were non-diagnostic on CNB. There were 4 cases on CNB showing diagnostic discrepancy with surgical specimens. Four cases of "benign lesions" on CNB found to be myxoid liposarcoma and lipoma-like liposarcoma upon resection. In general, myxoid pattern (9/17) seen on CNB showed less diagnostic correlation with surgical specimens, as compared to spindle cell and other histologic patterns (P < 0.01). The rate of diagnostic correlation was 79.7% (49/59) for the 59 cases of sarcoma studied, with grade 2 and grade 3 sarcoma showing better correlation (in contrast to 7/17 for grade 1 sarcoma) (P < 0.01). Comparative analysis showed no significant difference between benign/borderline tumors and sarcomas. The application of immunohistochemical study did not result in significant improvement in diagnostic accuracy on CNB. Ultrasound-guided CNB is a reliable tool in pathologic diagnosis of soft tissue tumors and shows a high accuracy rate especially for high-grade sarcoma. Tumors with myxoid pattern, lipomatous tumors and grade 1 sarcomas are associated with lower diagnostic accuracy on CNB. Correlation with clinicoradiologic findings would also be helpful in diagnostic evaluation and surgical planning.

  13. Ultrasound-guided rectus sheath block in children with umbilical hernia: Case series

    Directory of Open Access Journals (Sweden)

    Abdul Hamid Alsaeed

    2013-01-01

    Full Text Available Background: Umbilical hernia repair, a common day-case surgery procedure in children, is associated with a significant postoperative pain. The most popular peripheral nerve blocks used in umbilical hernia repair are rectus sheath infiltration and caudal block. The rectus sheath block may offer improved pain relief following umbilical hernia repair with no undesired effects such as lower limb motor weakness or urinary retention seen with caudal block which might delay discharge from the hospital. Ultrasound guidance of peripheral nerve blocks has reduced the number of complications and improved the quality of blocks.The aim of this case series is to assess the post rectus sheath block pain relief in pediatric patients coming for umbilical surgery. Methods: Twenty two (22 children (age range: 1.5-8 years scheduled for umbilical hernia repair were included in the study. Following the induction of general anesthesia, the ultrasonographic anatomy of the umbilical region was studied with a 5-16 MHz 50 mm linear probe. An ultrasound-guided posterior rectus sheath block of both rectus abdominis muscles (RMs was performed (total of 44 punctures. An in-plain technique using Stimuplex A insulated facet tip needle 22G 50mm. Surgical conditions, intraoperative hemodynamic parameters, and postoperative analgesia by means of the modified CHEOPS scale were evaluated. Results: ultrasonograghic visualization of the posterior sheath was possible in all patients. The ultrasound guided rectus sheath blockade provided sufficient analgesia in all children with no need for additional analgesia except for one patient who postoperatively required morphine 0.1 mg/kg intravenously. There were no complications. Conclusions: Ultrasound guidance enables performances of an effective rectus sheath block for umbilical hernia. Use of the Stimuplex A insulated facet tip needle 22G 50mm provides easy, less traumatic skin and rectus muscle penetration and satisfactory needle

  14. Using an abdominal phantom to teach urology residents ultrasound-guided percutaneous needle placement

    Directory of Open Access Journals (Sweden)

    Pauline Filippou

    Full Text Available ABSTRACT Introduction: To assess the effect of a hands-on ultrasound training session to teach urologic trainees ultrasound-guided percutaneous needle placement. Materials and methods: University of California, San Francisco (UCSF urology residents completed a time trial, placing a needle into a phantom model target under ultrasound guidance. Participants were randomized into three educational exposure groups: Group 1's time trial occurred prior to any teaching intervention, group 2's after experiencing a hands-on training module, and group 3's after exposure to both the training module and one-on-one attending feedback. Needle placement speed and accuracy as well as trainees' perceived confidence in utilizing ultrasound were measured. Results: The study cohort consisted of 15 resident trainees. Seven were randomized to group 1, three to group 2, and five to group 3. All residents reported minimal prior ultrasound experience. Their confidence in using ultrasound improved significantly after completing the training module with the most significant improvement seen among junior residents. Time to needle placement was fastest after receiving attending feedback (46.6sec in group 3 vs. 82.7sec in groups 1 and 2, p<0.01. Accuracy also improved with attending feedback, though the number of repositioning attempts did not differ significantly between groups. Conclusions: A hands-on training module and use of an abdominal phantom trainer increased resident confidence and skill in their use of ultrasound to guide percutaneous needle positioning. Attending feedback is critical for improving accuracy in needle guidance toward a target. Ultrasound-guided needle positioning is a teachable skill and can be applicable to multiple urologic procedures.

  15. Ultrasound-guided radiofrequency ablation in the management of interdigital (Morton's) neuroma

    Energy Technology Data Exchange (ETDEWEB)

    Chuter, Graham S.J. [Darlington Memorial Hospital, Department of Orthopaedics, Darlington, County Durham (United Kingdom); Chua, Yeok Pin [University of Malaya, Department of Orthopaedic Surgery, Kuala Lumpur (Malaysia); Connell, David A. [Monash University, Department of Medicine, Melbourne (Australia); Blackney, Mark C. [The Park Clinic, East Melbourne, VIC (Australia)

    2013-01-15

    To identify the benefits of ultrasound-guided radiofrequency ablation of Morton's neuroma as an alternative to surgical excision. We studied a consecutive cohort of surgical candidates for Morton's neurectomy who we referred, instead, for radiofrequency ablation (RFA). Under local anaesthetic, RFA was performed under ultrasound guidance, by a single radiologist. This out-patient procedure was repeated after 4 weeks if necessary. We followed patients for a minimum of 6 months to assess their change in visual analogue pain scores (VAS), symptom improvement, complications and progression to surgical excision. Thirty feet in 25 patients were studied. There were 4 men and 21 women with an average age of 55 years (range 33-73 years). All had tried previous methods of conservative management. Forty percent presented with 2nd space neuromas and 60% with 3rd space ones. The average number of treatment sessions was 1.6 (range 1-3, mode 1). Prior to treatment, all patients had pain on activity (VAS average: 6.0, range 3-9). Post-treatment there was a statistically significant reduction in pain scores (post-RFA VAS average: 1.7, range 0-8, p < 0.001). The average overall symptom improvement was 76%. There was one minor complication of temporary nerve irritation. Three neuromas (10%) have progressed to surgical excision; 1 patient has ongoing, unchanged pain with no obvious cause. At 6 months, 26 out of 30 feet had a satisfactory outcome. Ultrasound-guided RFA has successfully alleviated patients' symptoms of Morton's neuroma in >85% of cases. Only 10% have proceeded to surgical excision in the short term. (orig.)

  16. Ultrasound-guided rectus sheath block in children with umbilical hernia: Case series.

    Science.gov (United States)

    Alsaeed, Abdul Hamid; Thallaj, Ahmed; Khalil, Nancy; Almutaq, Nada; Aljazaeri, Ayman

    2013-10-01

    Umbilical hernia repair, a common day-case surgery procedure in children, is associated with a significant postoperative pain. The most popular peripheral nerve blocks used in umbilical hernia repair are rectus sheath infiltration and caudal block. The rectus sheath block may offer improved pain relief following umbilical hernia repair with no undesired effects such as lower limb motor weakness or urinary retention seen with caudal block which might delay discharge from the hospital. Ultrasound guidance of peripheral nerve blocks has reduced the number of complications and improved the quality of blocks. The aim of this case series is to assess the post rectus sheath block pain relief in pediatric patients coming for umbilical surgery. Twenty two (22) children (age range: 1.5-8 years) scheduled for umbilical hernia repair were included in the study. Following the induction of general anesthesia, the ultrasonographic anatomy of the umbilical region was studied with a 5-16 MHz 50 mm linear probe. An ultrasound-guided posterior rectus sheath block of both rectus abdominis muscles (RMs) was performed (total of 44 punctures). An in-plain technique using Stimuplex A insulated facet tip needle 22G 50mm. Surgical conditions, intraoperative hemodynamic parameters, and postoperative analgesia by means of the modified CHEOPS scale were evaluated. ultrasonograghic visualization of the posterior sheath was possible in all patients. The ultrasound guided rectus sheath blockade provided sufficient analgesia in all children with no need for additional analgesia except for one patient who postoperatively required morphine 0.1 mg/kg intravenously. There were no complications. Ultrasound guidance enables performances of an effective rectus sheath block for umbilical hernia. Use of the Stimuplex A insulated facet tip needle 22G 50mm provides easy, less traumatic skin and rectus muscle penetration and satisfactory needle visualiza.

  17. Ultrasound-guided catheterization of the portal vein in 11 cows using the Seldinger technique.

    Science.gov (United States)

    Braun, U; Camenzind, D; Ossent, P

    2003-02-01

    Catheterization of the portal vein using the Seldinger technique [Acta Radiol. (1958) 38, 368] was performed in 11 cows. Ultrasound-guided percutaneous portocentesis, using a 25-cm, 14-gauge steel cannula, was performed from the 10th, 11th or 12th intercostal space on the right side. A stylet was placed through the cannula, which was then removed, and a polyurethane balloon-tipped catheter was advanced over the stylet into the portal vein and sutured to the skin (Seldinger, 1952). Blood samples were collected from the catheter at least once daily. The catheter was removed 9-15 days later when blood could no longer be aspirated. The cows were then slaughtered and a post-mortem examination was performed. During the study, appetite remained normal in nine of 11 cows. In three cows, the general behaviour and demeanour were mildly, but transiently, abnormal. Four cows had leucopoenia. The most frequently encountered problem was occlusion of the catheter, which usually was resolved by flushing with heparinized saline. The most common post-mortem lesion observed was an increase in fibrous connective tissue at the site of cannulation. In nine of 11cows, there was a thrombus in the portal vein at the site of catheterization. Generally, the severity of the lesions was mild. The results of this study demonstrated that ultrasound-guided percutaneous catheterization of the portal vein, using the Seldinger technique, is possible in cows. The catheter may be left in place for collection of blood samples for up to 15 days.

  18. Ultrasound-guided microwave ablation for abdominal wall metastatic tumors: A preliminary study

    Institute of Scientific and Technical Information of China (English)

    Cai Qi; Xiao-Ling Yu; Ping Liang; Zhi-Gang Cheng; Fang-Yi Liu; Zhi-Yu Han; Jie Yu

    2012-01-01

    AIM:To evaluate the feasibility,safety and efficacy of ultrasound-guided microwave (MW) ablation for abdominal wall metastatic tumors.METHODS:From August 2007 to December 2010,a total of 11 patients with 23 abdominal wall nodules (diameter 2.59 cm ±1.11 cm,range 1.3 cm to 5.0cm) were treated with MW ablation.One antenna was inserted into the center of tumors less than 1.7 cm,and multiple antennae were inserted simultaneously into tumors 1.7 cm or larger.A 21 gauge thermocouple was inserted near important organs which required protection (such as bowel or gallbladder) for real-timetemperature monitoring during MW ablation.Treatment outcome was observed by contrast-enhanced ultrasound and magnetic resonance imaging (MRI) [or computed tomography (CT)] during follow-up.RESULTS:MW ablation was well tolerated by all patients.Six patients with 11 nodules had 1 thermocouple inserted near important organs for real-time temperature monitoring and the maximum temperature was 56 ℃.Major complications included mild pain (54.5%),post-ablation fever (100%) and abdominal wall edema (25%).All 23 tumors (100%) in this group were completely ablated,and no residual tumor or local recurrence was observed at a median follow-up of 13 mo (range 1 to 32 mo).The ablation zone was well defined on contrast-enhanced imaging (contrast-enhanced CT,MRI and/or contrast-enhanced ultrasound)and gradually shrank with time.CONCLUSION:Ultrasound-guided MW ablation may be a feasible,safe and effective treatment for abdominal wall metastatic tumors in selected patients.

  19. Ultrasound guided percutaneous treatment for splenic abscesses: The significance in treatment of critically ill patients

    Institute of Scientific and Technical Information of China (English)

    Enver Zerem; Jacob Bergsland

    2006-01-01

    AIM: To analyze the results of ultrasound guided percutaneous needle aspiration (PNA) and percutaneous catheter drainage (PCD) in the treatment of splenic abscess.METHODS: Thirty-six patients (14 females and 22 males, with an average age of 54.1 ± 14.1 years) with splenic abscess were treated with ultrasound guided PNA and/or PCD. Patients with splenic abscess < 50 mm in diameter were initially treated by PNA and those with abscess ≥ 50 mm and bilocular abscesses were initially treated by an 8-French catheter drainage. The clinical characteristics, underlying diseases, organism spectra,therapeutic methods, and morality rates were analyzed.RESULTS: Twenty-seven patients had unilocular and 9 bilocular abscess. PNA was performed in 19 patients (52.8%), and 8 of them (42.1%) required PCD because of recurrence of abscess. In 17 patients (47.2%), PCD was performed initially. PCD was performed twice in six patients and three times in two. PNA was definitive treatment for 10 and PCD for 21 patients. One patient with PCD was referred for splenectomy, with successful outcome. In all 4 deceased patients, malignancy was the underlying condition. Twenty-one patients (58.3%)underwent 33 surgical interventions on abdomen before treatment. Cultures were positive in 30 patients (83.3%).Gram-negative bacillus predominated (46.7%). There were no complications related to the procedure.CONCLUSION: Percutaneous treatmnet of splenic abscess is an effective alternative to surgery, allowing preservation of the spleen. This treatment is especially indicative for the patients in critical condition postoperatively. We recommend PNA as primary treatment for splenic abscesses < 50 mm, and PCD for those ≥ 50 mm in diameter and for bilocular abscesses.

  20. Ultrasound-guided facet block to low back pain: a case report

    Directory of Open Access Journals (Sweden)

    Ana Ellen Q. Santiago

    2014-07-01

    Full Text Available BACKGROUND: Osteoarthrosis is a common cause of low back pain. The diagnosis is clinical and can be confirmed by imaging studies. Pain treatment and confirmation of diagnosis are made by intra-articular injection of corticosteroid and by local anesthetic use, due to clinical improvement. A direct monitoring of the procedure can be done under fluoroscopy, a classic technique, or else by an ultrasound-guided procedure. CASE REPORT: Female patient, 88 years old, 1.68 m and 72 kg, with facet osteoarthrosis at L2-L3, L3-L4 and L4-L5 for two years. On physical examination, she exhibited pain on lateralization and spinal extension. We opted in favor of an ultrasound-guided facet joint block. A midline spinal longitudinal scan was obtained, with identification of the desired joint space at L3-L4. A 25 G needle was inserted into the skin by the echographic off-plane ultrasound technique. 1 mL of contrast was administered, with confirmation by fluoroscopy. After aspiration of the contrast, 1 mL of solution containing 0.25% bupivacaine hydrochloride and 10 mg of methylprednisolone acetate was injected. Injections into L3-L4, L2-L3 and L1-L2 to the right were applied. CONCLUSIONS: The visualization of the facet joint by ultrasound involves minimal risk, besides reduction of radiation. This option is suitable for a large part of the population. However, fluoroscopy and computed tomography remain as monitoring techniques indicated for patients with specific characteristics, such as obesity, severe degenerative diseases and anatomical malformations, in which the ultrasound technique is still in need of further study.

  1. Ultrasound-guided core biopsy: an effective method of detecting axillary nodal metastases.

    LENUS (Irish Health Repository)

    Solon, Jacqueline G

    2012-02-01

    BACKGROUND: Axillary nodal status is an important prognostic predictor in patients with breast cancer. This study evaluated the sensitivity and specificity of ultrasound-guided core biopsy (Ax US-CB) at detecting axillary nodal metastases in patients with primary breast cancer, thereby determining how often sentinel lymph node biopsy could be avoided in node positive patients. STUDY DESIGN: Records of patients presenting to a breast unit between January 2007 and June 2010 were reviewed retrospectively. Patients who underwent axillary ultrasonography with or without preoperative core biopsy were identified. Sensitivity, specificity, positive predictive value, and negative predictive value for ultrasonography and percutaneous biopsy were evaluated. RESULTS: Records of 718 patients were reviewed, with 445 fulfilling inclusion criteria. Forty-seven percent (n = 210\\/445) had nodal metastases, with 110 detected by Ax US-CB (sensitivity 52.4%, specificity 100%, positive predictive value 100%, negative predictive value 70.1%). Axillary ultrasonography without biopsy had sensitivity and specificity of 54.3% and 97%, respectively. Lymphovascular invasion was an independent predictor of nodal metastases (sensitivity 60.8%, specificity 80%). Ultrasound-guided core biopsy detected more than half of all nodal metastases, sparing more than one-quarter of all breast cancer patients an unnecessary sentinel lymph node biopsy. CONCLUSIONS: Axillary ultrasonography, when combined with core biopsy, is a valuable component of the management of patients with primary breast cancer. Its ability to definitively identify nodal metastases before surgical intervention can greatly facilitate a patient\\'s preoperative integrated treatment plan. In this regard, we believe our study adds considerably to the increasing data, which indicate the benefit of Ax US-CB in the preoperative detection of nodal metastases.

  2. In vitro-production of embryos using immature oocytes collected transvaginally from superstimulated wood bison (Bison bison athabascae).

    Science.gov (United States)

    Cervantes, Miriam P; Palomino, J Manuel; Anzar, Muhammad; Mapletoft, Reuben J; Mastromonaco, Gabriela F; Adams, Gregg P

    2017-04-01

    Two experiments were done to test the hypothesis that morphologic characteristics of wood bison cumulus-oocyte complexes (COC) are reflective of the ability of the oocyte to develop to an advanced embryonic stage after in vitro maturation, fertilization and culture, and to determine the effect of prolonging the interval from the end of superstimulation treatment to oocyte collection (FSH starvation period). Experiments were done during the anovulatory season. In Experiment 1, ovarian superstimulation was induced in 10 bison with two doses of FSH given at 48 h intervals beginning at the time of follicular wave emergence. COC were collected 3 days (72 h) after the last dose of FSH by follicular aspiration and classified as compact, expanded or denuded. The COC were matured in vitro for 24 h before fertilization in vitro (Day 0). Embryo development was assessed on Days 3, 7 and 8. The blastocyst rate was 7/34, 2/10 and 0/3 in COC classified as compact, expanded and denuded, respectively; however, only compact COC resulted in embryos that reached the expanded blastocyst stage. In Experiment 2, COC were collected at either 3 or 4 days (72 or 96 h) after the last dose of FSH (n = 16 bison/group) to determine the effect of the duration of FSH starvation on oocyte competence. The COC were classified as compact good (>3 layers of cumulus cells), compact regular (1-3 layers of cumulus cells), expanded or denuded, and then matured, fertilized and cultured in vitro. Although follicles were larger (P vitro. Importantly, oocytes collected from superstimulated bison during the anovulatory season were competent to develop to the blastocyst stage following in vitro maturation, fertilization and culture. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Effects of prepartum lipid supplementation on FSH superstimulation and transferable embryo recovery in multiparous beef cows.

    Science.gov (United States)

    Bader, J F; Kojima, F N; Wehrman, M E; Lindsey, B R; Kerley, M S; Patterson, D J

    2005-01-01

    The objective of this experiment was to determine the effect of prepartum lipid supplementation on the number and quality of embryos recovered following ovarian super-ovulation in postpartum suckled beef cows. Mature cows (n = 40) were assigned to one of two treatments (lipid versus. no lipid) and supplemented for approximately 40 days prior to calving. Supplements provided to cows were isocaloric and isonitrogenous. The treatment group was fed 1.6 kg hd(-1) per day of whole soybeans (WSB; 19.8% ether extract, and 41.8% crude protein) and the control group received a supplement consisting of 1.8 kg hd(-1) day of a soybean meal and soy-hull combination (SBS; 2.15% EE and 36.81% CP). Cows were synchronized using a GnRH [Cystorelin((R)) 100 microg im]-GnRH-PGF(2alpha) [Lutalyse 25 mg im] protocol. Cows were administered two injections of GnRH seven days apart and PG seven days after the second GnRH injection. Twenty-eight cows (WSB, n = 15; SBS, n = 13) responded to estrus synchronization and were superstimulated. Super-ovulation was initiated on day 8-10 of the synchronized cycle by twice-daily injections of pFSH (Pluset) over four days in decreasing doses using a total of 608.4 IU per cow. Prostaglandin F(2alpha) was administered 96 and 108 h after super-stimulation was initiated with FSH. Days postpartum (WSB = 59 days; SBS = 57 days) at initiation of FSH treatments were similar (P > 0.10) for both treatments. Cows were monitored for estrus activity by the HeatWatch Estrus Detection System. Twenty-seven cows (WSB, n = 15; SBS, n = 12) exhibited estrus after FSH and inseminated at 0, 12, and 24 h after the onset of estrus with 1, 2, and 1 units of semen, respectively. Embryos were recovered and evaluated 7-8 days later. Only cows that responded to FSH and that were inseminated were used for statistical analysis. Data were analyzed using the General Linear Models Procedure of SAS. Body condition scores did not differ (P > 0.10) between treatments when cows were

  4. Controlled study of conventional surgery and ultrasound guided foam sclerotherapy for the treatment of primary SVI of lower limbs

    Institute of Scientific and Technical Information of China (English)

    Raguram Ganesamoni; Mazda Turel; Sunil Agarwalt; Edwin Stephen; Vinu Moses; Thomas Mam-men

    2009-01-01

    Objective: To compare conventional surgery and ultrasound guided foam sclerotherapy for primary superficial venous insufficiency(SVI) with respect to obliteration of superficial venous system, clinical outcome and cost. Methods: The study was conducted between September 2005 and March 2006, in Surgery department of Christian Medical College Hospital, Vellore. All patients with symptomatic primary venous insufficiency of lower limbs requiring definitive management were randomized to conventional surgery (n = 30) or ultrasound guided foam scleretherapy (n = 30). Obliteration of superficial venous system at 3 months, clinical outcome and costs were registered. Results: Superficial venous system was obliterated in all the patients of both the groups at 3 months. Improvement in clinical scores and complication rates was similar in both the groups. The foam scleretherapy group had less analgesic requirement, earlier return to work and lower cost. Conclusion: Foam sclerotherapy is a cheaper alternative to surgery for primary venous insufficiency with respect to early measures of clinical outcome.

  5. Ultrasound-guided femoral nerve block for pain control in an infant with a femur fracture due to nonaccidental trauma.

    Science.gov (United States)

    Frenkel, Oron; Mansour, Karim; Fischer, Jason W J

    2012-02-01

    A 3-month-old infant girl was transferred to our emergency department (ED) with a subtrochanteric femoral neck fracture due to nonaccidental trauma. She received multiple doses of parenteral analgesics both before arrival and in our ED. We performed an ultrasound-guided femoral nerve block using 2.0 mL of 0.25% bupivicaine (approximately 1.25 mg/kg) before placing the patient in a Pavlik harness. Successful pain control was achieved within 15 minutes of the procedure allowing pain-free manipulation of the affected extremity. The patient required only a single dose of parenteral narcotics during the ensuing 18 hours. To our knowledge, this is the first report of an ultrasound-guided femoral nerve block used in the ED for pain control in a pediatric patient.

  6. Ultrasound-guided percutaneous "push-introducer" gastrostomy is a valuable method for accessing the gastrointestinal tract

    Directory of Open Access Journals (Sweden)

    Stanislaw Klek

    2014-02-01

    Full Text Available Percutaneous endoscopic gastrostomy (PEG is the mosteffective and least invasive method for enteral nutrition (EN. The most common system for PEG is the 'pull' technique, which. It is not available in case endoscopy cannot be performed. The 'push' technique may be an option if effective identification of the abdominal structures can be achieved. X-ray or ultrasonography can be used for that purpose. The aim was to assess the clinical value of ultrasound-guided 'push' gastrostomy. A retrospective analysis of eleven patients (6 F, 5 M, mean age 65.1 including the procedure itself, complication rate, and cost was conducted. In all eleven patients the surgery was successful, and EN was introduced 4-6 hours afterwards. Complications included pain requiring removal of a supporting stitch (n = 1 and balloon deflation (n = 1. All patients were successfully fed enterally. Ultrasound-guided 'push' technique gastrostomy should become a method of choice if the 'pull' method is unavailable.

  7. Diagnostic utility of endoscopic ultrasound-guided fine-needle aspiration biopsy for glomus tumor of the stomach.

    Science.gov (United States)

    Kato, Shin; Kikuchi, Kaoru; Chinen, Kenji; Murakami, Takahiro; Kunishima, Fumihito

    2015-06-14

    A 52-year-old man was referred for further investigation of a gastric submucosal tumor on the greater curvature of the antrum. Endoscopic ultrasonography demonstrated a hypoechoic solid mass, which was primarily connected to the muscular layer of the stomach. We performed endoscopic ultrasound-guided fine-needle aspiration biopsy. The pathological examination showed proliferation of oval-shaped cells with nest formation, which stained strongly positive for muscle actin, and negative for c-kit, CD34, CD56, desmin, S-100, chromogranin, and neuron-specific enolase. Therefore, we performed laparoscopy and endoscopy cooperative surgery based on the preoperative diagnosis of glomus tumor of the stomach. The final histological diagnosis confirmed the preoperative diagnosis. Although preoperative diagnosis of glomus tumor of the stomach is difficult with conventional images and endoscopic biopsy, endoscopic ultrasound-guided fine-needle aspiration biopsy is an essential tool to gain histological evidence of glomus tumor of the stomach for early diagnosis.

  8. Ultrasound-guided diagnostic breast biopsy methodology: retrospective comparison of the 8-gauge vacuum-assisted biopsy approach versus the spring-loaded 14-gauge core biopsy approach

    OpenAIRE

    Jimenez Rafael E; Povoski Stephen P; Wang Wenle P

    2011-01-01

    Abstract Background Ultrasound-guided diagnostic breast biopsy technology represents the current standard of care for the evaluation of indeterminate and suspicious lesions seen on diagnostic breast ultrasound. Yet, there remains much debate as to which particular method of ultrasound-guided diagnostic breast biopsy provides the most accurate and optimal diagnostic information. The aim of the current study was to compare and contrast the 8-gauge vacuum-assisted biopsy approach and the spring-...

  9. Ultrasound-guided continuous thoracic paravertebral catheter management of acute rib pain secondary to cystic fibrosis exacerbation in a pediatric patient.

    Science.gov (United States)

    Cutshall, Chad; Hutchins, Jacob

    2015-02-01

    An ultrasound-guided thoracic paravertebral catheter was placed at T8 in a 15-year-old girl with cystic fibrosis and right-sided chest pain from avulsion of the eighth rib, secondary to coughing. She was discharged home after respiratory stabilization and returned to school with the catheter in place. We report the effective use of an ultrasound-guided continuous thoracic paravertebral block in the management of acute rib pain in a pediatric patient with cystic fibrosis.

  10. Iliohypogastric/ilioinguinal nerve block in inguinal hernia repair for postoperative pain management: comparison of the anatomical landmark and ultrasound guided techniques

    OpenAIRE

    Abdurrahman Demirci; Esra Mercanoglu Efe; Gürkan Türker; Alp Gurbet; Fatma Nur Kaya; Ali Anil; İlker Çimen

    2014-01-01

    Objectives: The purpose of this study is to compare the efficacy of iliohypogastric/ilioinguinal nerve blocks performed with the ultrasound guided and the anatomical landmark techniques for postoperative pain management in cases of adult inguinal herniorrhaphy. Methods: 40 patients, ASA I-II status were randomized into two groups equally: in Group AN (anatomical landmark technique) and in Group ultrasound (ultrasound guided technique), iliohypogastric/ilioinguinal nerve block was performed w...

  11. Case report: ultrasound-guided continuous thoracic paravertebral block for outpatient acute pain management of multilevel unilateral rib fractures.

    Science.gov (United States)

    Murata, Hiroaki; Salviz, Emine Aysu; Chen, Stephanie; Vandepitte, Catherine; Hadzic, Admir

    2013-01-01

    A 61-year-old man with multiple unilateral rib fractures (T3-T8) gained the ability to breathe deeply and to ambulate after ultrasound-guided continuous thoracic paravertebral block and was discharged home after being observed for 15 hours after the block. The ultrasound guidance was helpful in determining the site of rib fractures and the optimal level for catheter placement. This report also discusses the management of analgesia using continuous paravertebral block in an outpatient with trauma.

  12. Surgical vs ultrasound-guided drainage of deep neck space abscesses: a randomized controlled trial: surgical vs ultrasound drainage

    OpenAIRE

    2013-01-01

    Introduction Deep neck space abscesses (DNAs) are relatively common otolaryngology-head and neck surgery emergencies and can result in significant morbidity with potential mortality. Traditionally, surgical incision and drainage (I&D) with antibiotics has been the mainstay of treatment. Some reports have suggested that ultrasound-guided drainage (USD) is a less invasive and effective alternative in select cases. Objectives To compare I&D vs USD of well-defined DNAs, using a randomized control...

  13. Feasibility, repeatability, and safety of ultrasound-guided stimulation of the first cervical nerve at the alar foramen in horses.

    Science.gov (United States)

    Mespoulhès-Rivière, Céline; Brandenberger, Olivier; Rossignol, Fabrice; Robert, Céline; Perkins, Justin D; Marie, Jean-Paul; Ducharme, Norm

    2016-11-01

    OBJECTIVE To develop and assess the feasibility, repeatability, and safety of an ultrasound-guided technique to stimulate the first cervical nerve (FCN) at the level of the alar foramen of the atlas of horses. ANIMALS 4 equine cadavers and 6 clinically normal Standardbreds. PROCEDURES In each cadaver, the FCN pathway was determined by dissection, and any anastomosis between the first and second cervical nerves was identified. Subsequently, each of 6 live horses underwent a bilateral ultrasound-guided stimulation of the FCN at the alar foramen 3 times at 3-week intervals. After each procedure, horses were examined daily for 5 days. RESULTS In each cadaver, the FCN passed through the alar foramen; a communicating branch between the FCN and the accessory nerve and anastomoses between the ventral branches of the FCN and second cervical nerve were identified. The anastomoses were located in the upper third of the FCN pathway between the wing of the atlas and the nerve's entry in the omohyoideus muscle. Successful ultrasound-guided electrical stimulation was confirmed by twitching of the ipsilateral omohyoideus muscle in all 6 live horses; this finding was observed bilaterally during each of the 3 experimental sessions. No complications developed at the site of stimulation. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that ultrasound-guided stimulation of the FCN at the alar foramen appears to be a safe and straightforward procedure in horses. The procedure may have potential for use in horses with naturally occurring recurrent laryngeal neuropathy to assess reinnervation after FCN transplantation or nerve-muscle pedicle implantation in the cricoarytenoideus dorsalis muscle.

  14. Diagnostic impact of color Doppler ultrasound-guided core biopsy on fine-needle aspiration of anterior mediastinal masses.

    Science.gov (United States)

    Chen, Hung-Jen; Liao, Wei-Chih; Liang, Shinn-Jye; Li, Chia-Hsiang; Tu, Chih-Yen; Hsu, Wu-Huei

    2014-12-01

    Although lymphoma and thymoma are common etiologies of anterior mediastinal masses (AMMs), smaller percentages and numbers of patients with these diseases have been enrolled in previous ultrasound-guided biopsy studies. To date, there has been no study of color Doppler sonographic features to support the differentiation of AMMs. For this retrospective cohort study, a search of the database of the China Medical University Hospital using the clinical coding "ultrasound-guided biopsy" was conducted for the period December 2003 to February 2013. We selected patients diagnosed with AMMs (not cysts) using radiographic records. This search yielded a list of 80 cases. Real-time ultrasound-guided core needle biopsy (CNB) was performed in all but 5 patients without a sufficient safety range. In 89% (67/75) of these ultrasound-guided CNB cases, the diagnostic accuracy achieved subclassification. Fine-needle aspiration cytology achieved subclassification in only 10% of cases. On color Doppler sonography, 71% of lymphomas were characterized as "rich vascular with central/crisscross collocations" and 29% as "avascular or localized/scattered peripheral vessels." However, decreased proportions of "rich vascular with central/crisscross collocations" were found in lung cancer (4% [1/23], odds ratio = 0.018, 95% confidence interval: 0.002-0.154, p Fine-needle aspiration cytology itself cannot aid in the diagnosis. Color Doppler sonographic evaluation of AMMs followed by real-time CNB is a more efficient method. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  15. Role of ultrasound-guided continuous brachial plexus block in the management of neonatal ischemia in upper limb

    Directory of Open Access Journals (Sweden)

    Vrushali C Ponde

    2012-01-01

    Full Text Available Neonatal upper limb ischemia due to accidental arterial damage remains a major concern, which can lead to devastating complications if untreated. The primary objective of this case report is to emphasize the role of continuous infraclavicular brachial plexus block, the issues related with block performance in an ischemic hand, and the importance of ultrasound guidance in this particular case scenario. A 1.1 kg infant suffered from distal forearm ischemia due to accidental arterial damage, which was treated with brachial plexus block. An ultrasound-guided single shot block with 0.5 mL/kg of 0.25% bupivacaine was followed by ultrasound-guided catheter placement in the target area. A continuous infusion of 0.03% of bupivacaine at the rate of 0.5 mL/kg/hr (approx. 0.15 mg/kg/h of bupivacaine was administered for 36 h. This treatment resulted in reversal of ischemia. Permanent ischemic damage was eventually confined to the tips of 4 fingers. We conclude that ultrasound-guided continuous infraclavicular block has a therapeutic role to play in the treatment of hand ischemia due to arterial damage and subsequent arterial spasm in neonates with added benefits.

  16. MRI-guided vacuum-assisted breast biopsy: comparison with stereotactically guided and ultrasound-guided techniques

    Energy Technology Data Exchange (ETDEWEB)

    Imschweiler, Thomas; Freiwald, Bianka; Kubik-Huch, Rahel A. [Kantonspital Baden AG, Institute for Radiology, Baden (Switzerland); Haueisen, Harald [Kantonspital Aarau AG, Institute for Radiology, Aarau (Switzerland); Kampmann, Gert [Clinica Sant' Anna, Lugano, Sorengo (Switzerland); Rageth, Luzi [Adjumed Services AG, Zurich (Switzerland); Seifert, Burkhardt [Institute for Social and Preventive Medicine, University of Zurich, Division of Biostatistics, Zuerich (Switzerland); Rageth, Christoph [Breast Centre, Zurich (Switzerland)

    2014-01-15

    To analyse the development of MRI-guided vacuum-assisted biopsy (VAB) in Switzerland and to compare the procedure with stereotactically guided and ultrasound-guided VAB. We performed a retrospective analysis of VABs between 2009 and 2011. A total of 9,113 VABs were performed. Of these, 557 were MRI guided. MRI-guided VAB showed the highest growth rate (97 %) of all three procedures. The technical success rates for MRI-guided, stereotactically guided and ultrasound-guided VAB were 98.4 % (548/557), 99.1 % (5,904/5,960) and 99.6 % (2,585/2,596), respectively. There were no significant differences (P = 0.12) between the MRI-guided and the stereotactically guided procedures. The technical success rate for ultrasound-guided VAB was significantly higher than that for MRI-guided VAB (P < 0.001). There were no complications using MRI-guided VAB requiring open surgery. The malignancy diagnosis rate for MRI-guided VAB was similar to that for stereotactically guided VAB (P = 0.35). MRI-guided VAB is a safe and accurate procedure that provides insight into clinical breast findings. (orig.)

  17. Ultrasound-guided alcohol neurolysis of lateral femoral cutaneous nerve for intractable meralgia paresthetica: a case series.

    Science.gov (United States)

    Ahmed, Arif; Arora, Divesh; Kochhar, Amit Kumar

    2016-11-01

    Meralgia paresthetica is a rare sensory entrapment neuropathy which leads to burning, tingling and numbness in the antero-lateral aspect of thigh. Mostly it runs a benign course, and responds to conservative measures. We present a case series of six patients with intractable meralgia paresthetica with severe pain over antero-lateral thigh along the distribution of lateral cutaneous nerve of thigh which was further confirmed by nerve conduction study. These patients did not respond to the oral anti-neuropathic medications. The two successive diagnostic lateral femoral cutaneous nerve block not only had confirmed the diagnosis but also provided pain relief for a few days. Then the ultrasound-guided lateral femoral cutaneous nerve neurolysis was done using 50% alcohol. In all the patients, there were more than 50% decrease in pain intensity and improvement in quality of life after the procedure, and the relief and improvement were maintained for up to 12 weeks. This case series shows ultrasound-guided lateral femoral cutaneous nerve neurolysis is a safe and effective treatment for intractable meralgia paresthetica and also provides prolonged pain relief and is a good option in avoiding the surgery. Summary points The literature on neurolysis is rare, with only few case reports. This is the first case series on this topic, and it will greatly improve the evidence that ultrasound-guided neurolysis can also be used for intractable meralgia paresthetica patients who do not respond to conservative measures before proceeding to surgery.

  18. Ultrasound-guided percutaneous biopsy of digestive tract lesions; Biopsia percutanea de lesiones del tubo digestivo guiada por ecografia

    Energy Technology Data Exchange (ETDEWEB)

    Gil, S.; Martin, I.; Ballesteros, J. M.; Gomez, C. [Hospital General Universitario de Alicante (Spain); Marco, S. F.; Fernandez, P. [Hospital Gneral de Castellon (Spain)

    1999-07-01

    To present our experience in ultrasound-guided percutaneous biopsy of lesions located in the digestive tract. We performed ultrasound-guided percutaneous biopsy in 14 patients (10 men and 4 women) ranging in age from 7 to 71 years (mean; 519 years). The lesions were located throughout the digestive tract, from the pyriform sinus to the sigmoid colon. The biopsy was carried out with a 5 MHz convex probe equipped with a device to direct the needle. An 18G automatic needle or a 20G Chiba needle was used to obtain specimens for histological study in every case, and additional samples were collected with a 22G needle for cytological examination in 13 of the patients. The ultrasound images corresponded to pseudokidney in 9 cases and extrinsic masses in 5. The diagnosis was obtained from the histological examination in every case (100%) and from cytology in 6 (44.4%), the latter results were less specific. The only complication corresponded to a case of bilioperitoneum. Ultrasound-guided percutaneous biopsy is a suitable technique for the histological diagnosis of those lesions of the digestive tract that are visible in ultrasound images, but that for some reason can not be examined by endoscopic biopsy. (Author) 20 refs.

  19. MRI-guided vacuum-assisted breast biopsy: comparison with stereotactically guided and ultrasound-guided techniques.

    Science.gov (United States)

    Imschweiler, Thomas; Haueisen, Harald; Kampmann, Gert; Rageth, Luzi; Seifert, Burkhardt; Rageth, Christoph; Freiwald, Bianka; Kubik-Huch, Rahel A

    2014-01-01

    To analyse the development of MRI-guided vacuum-assisted biopsy (VAB) in Switzerland and to compare the procedure with stereotactically guided and ultrasound-guided VAB. We performed a retrospective analysis of VABs between 2009 and 2011. A total of 9,113 VABs were performed. Of these, 557 were MRI guided. MRI-guided VAB showed the highest growth rate (97 %) of all three procedures. The technical success rates for MRI-guided, stereotactically guided and ultrasound-guided VAB were 98.4 % (548/557), 99.1 % (5,904/5,960) and 99.6 % (2,585/2,596), respectively. There were no significant differences (P = 0.12) between the MRI-guided and the stereotactically guided procedures. The technical success rate for ultrasound-guided VAB was significantly higher than that for MRI-guided VAB (P VAB requiring open surgery. The malignancy diagnosis rate for MRI-guided VAB was similar to that for stereotactically guided VAB (P = 0.35). MRI-guided VAB is a safe and accurate procedure that provides insight into clinical breast findings. • Three vacuum-assisted breast biopsy (VAB) procedures were compared. • Technical success rates were high for all three VAB procedures. • Medical complications were relatively low using all three VAB procedures. • The use of MRI-guided vacuum-assisted breast biopsy is growing.

  20. Effectiveness of ultrasound-guided injections combined with shoulder exercises in the treatment of subacromial adhesive bursitis.

    Science.gov (United States)

    Gasparre, Giuseppe; Fusaro, Isabella; Galletti, Stefano; Volini, Silvia; Benedetti, Maria Grazia

    2012-05-01

    The aim of this study was to evaluate whether the association of exercises for the shoulder with ultrasound-guided injection into the bursa significantly improves the treatment outcome in adhesive bursitis. Two groups of 35 patients, one treated with ultrasound-guided injection (UGI) and the other one with ultrasound-guided injection and home exercise program (UGI-exercise) for 1 month, were assessed for pain and shoulder function before treatment, 1 and 3 months post-treatment. Fourteen patients in UGI group and 23 patients in the UGI-exercises group were completely free of pain after 1 month (p = 0.031). At 3 months' follow-up, patients in the UGI-exercise group showed a significant improvement with respect to the other group (p = 0.005). No differences were found in function assessment. The UGI combined with shoulder exercises in the treatment of subacromial adhesive bursitis is effective to ensure a more frequent complete pain relief in the medium term.

  1. Ultrasound-guided Breast Biopsy in the Resource-limited Setting: An Initial Experience in Rural Uganda

    Directory of Open Access Journals (Sweden)

    Christopher R. Stark

    2017-06-01

    Full Text Available Purpose: To describe the methodology and initial experience behind creation of an ultrasoundguided percutaneous breast core biopsy program in rural Uganda. Methods and Materials: Imaging the World Africa (ITWA is the registered non-governmental organization division of Imaging the World (ITW, a not-for-profit organization whose primary aim is the integration of affordable high-quality ultrasound into rural health centers. In 2013, ITWA began the pilot phase of an IRB-approved breast care protocol at a rural health center in Uganda. As part of the protocol’s diagnostic arm, an ultrasound-guided percutaneous breast core biopsy training curriculum was implemented in tandem with creation of regionally supplied biopsy kits. Results: A surgeon at a rural regional referral hospital was successfully trained and certified to perform ultrasound-guided percutaneous breast core biopsies. Affordable and safe biopsy kits were created using locally available medical supplies with the cost of each kit totaling $10.62 USD. Conclusion: Successful implementation of an ultrasound-guided percutaneous breast core biopsy program in the resource-limited setting is possible and can be made sustainable through incorporation of local health care personnel and regionally supplied biopsy materials. Our hope is that ITWA’s initial experience in rural Uganda can serve as a model for similar programs in the future.

  2. Breast cancer: determining the genetic profile from ultrasound-guided percutaneous biopsy specimens obtained during the diagnostic workups.

    Science.gov (United States)

    López Ruiz, J A; Zabalza Estévez, I; Mieza Arana, J A

    2016-01-01

    To evaluate the possibility of determining the genetic profile of primary malignant tumors of the breast from specimens obtained by ultrasound-guided percutaneous biopsies during the diagnostic imaging workup. This is a retrospective study in 13 consecutive patients diagnosed with invasive breast cancer by B-mode ultrasound-guided 12 G core needle biopsy. After clinical indication, the pathologist decided whether the paraffin block specimens seemed suitable (on the basis of tumor size, validity of the sample, and percentage of tumor cells) before sending them for genetic analysis with the MammaPrint® platform. The size of the tumors on ultrasound ranged from 0.6cm to 5cm. In 11 patients the preserved specimen was considered valid and suitable for use in determining the genetic profile. In 1 patient (with a 1cm tumor) the pathologist decided that it was necessary to repeat the core biopsy to obtain additional samples. In 1 patient (with a 5cm tumor) the specimen was not considered valid by the genetic laboratory. The percentage of tumor cells in the samples ranged from 60% to 70%. In 11/13 cases (84.62%) it was possible to do the genetic analysis on the previously diagnosed samples. In most cases, regardless of tumor size, it is possible to obtain the genetic profile from tissue specimens obtained with ultrasound-guided 12 G core biopsy preserved in paraffin blocks. Copyright © 2015 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  3. Ultrasound-guided trigeminal nerve block via the pterygopalatine fossa: an effective treatment for trigeminal neuralgia and atypical facial pain.

    Science.gov (United States)

    Nader, Antoun; Kendall, Mark C; De Oliveria, Gildasio S; Chen, Jeffry Q; Vanderby, Brooke; Rosenow, Joshua M; Bendok, Bernard R

    2013-01-01

    Patients presenting with facial pain often have ineffective pain relief with medical therapy. Cases refractory to medical management are frequently treated with surgical or minimally invasive procedures with variable success rates. We report on the use of ultrasound-guided trigeminal nerve block via the pterygopalatine fossa in patients following refractory medical and surgical treatment. To present the immediate and long-term efficacy of ultrasound-guided injections of local anesthetic and steroids in the pterygopalatine fossa in patients with unilateral facial pain that failed pharmacological and surgical interventions. Academic pain management center. Prospective case series. Fifteen patients were treated with ultrasound-guided trigeminal nerve block with local anesthetic and steroids placed into the pterygopalatine fossa. All patients achieved complete sensory analgesia to pin prick in the distribution of the V2 branch of the trigeminal nerve and 80% (12 out of 15) achieved complete sensory analgesia in V1, V2, V3 distribution within 15 minutes of the injection. All patients reported pain relief within 5 minutes of the injection. The majority of patients maintained pain relief throughout the 15 month study period. No patients experienced symptoms of local anesthetic toxicity or onset of new neurological sequelae. Prospective case series. We conclude that the use of ultrasound guidance for injectate delivery in the pterygopalatine fossa is a simple, free of radiation or magnetization, safe, and effective percutaneous procedure that provides sustained pain relief in trigeminal neuralgia or atypical facial pain patients who have failed previous medical interventions.

  4. Role of preoperative endoscopic ultrasound-guided fine-needle tattooing of a pancreatic head insulinoma

    Institute of Scientific and Technical Information of China (English)

    Pornchai; Leelasinjaroen; Wuttiporn; Manatsathit; Richard; Berri; Mohammed; Barawi; Frank; G; Gress

    2014-01-01

    Although insulinomas are rare, they are the most com-mon pancreatic neuroendocrine tumor, with an inci-dence of four cases per million population. Insulinomas are generally benign indolent intrapancreatic tumors. Surgical resection remains the main option for treat-ment. However, up to 67% of a pancreatic head insu-linomas are nonpalpable, thus surgical resection of the nonplapable insulinoma in this area could become prob-lematic resulting in prolonged surgical time, increased risk of pancreatic duct injury and need for pancreati-coduodenectomy. Endoscopic ultrasound-guided fine- needle tattooing(EUS-FNT), has been shown to have a crucial role for localization of pancreatic body and tail lesions, facilitating laparoscopic distal pancreatectomyand helping surgeons identify the location of the tumor. EUS-FNT might have a role for preoperative localiza-tion of pancreatic head insulinomas which are likely to be nonpalpable. We report a case of preoperative EUS-FNT for localization of a nonplapable pancreatic head insulinoma. This report demonstrates that EUS-FNT of pancreatic head insulinomas may facilitate surgical resection, reduce operative time and decrease surgical complications.

  5. Idiopathic pericardial effusion in 2 year old labrador managed with ultrasound-guided pericardiocentesis: Case report

    Directory of Open Access Journals (Sweden)

    JB Adeyanju

    2012-06-01

    Full Text Available A two-year old, 38kg-wt male Labrador was presented for management because of progressive exercise intolerance. At presentation, rectal temperature was 38.5oC, pulse rate was135 beats per minute (but weak. There was ascites along with oedema of the extremities. The heart sound was muffled and pulsus paradoxus was very mild. The patient was well hydrated. Thoracic radiography revealed a globoid shaped heart occupying most of the equatorial thoracic volume; there was loss of details of cardiac silhouette and there was dorsal deviation of trachea at carina. Ultrasonography revealed a distinct epicardium, pericardium and a very wide anechoic space in between. Blood picture was within normal findings. Idiopathic chronic pericardial effusion was diagnosed. Ultrasound-guided pericardiocentesis was carried out using a 16 gauge over the needle catheter attached to a 3-way stopcock and a 20mls syringe; about 65mls of clear effusate was aspirated. Laboratory analysis of the effusate revealed that it was a transudate. The patient was placed on 3mg/kg furosemide, twice daily for 5 days and the patient returned to gradual exercise during hospitalization. Oedema of the extremities and ascities decreased, the appetite improved and the dog became more active. Thoracic radiography fourth week post pericardiocentesis revealed a normal cardiac silhouette. The cause of pericardial effusion was not known.

  6. Can ultrasound-guided subcostal transverse abdominis plane block be used as sole anesthetic technique?

    Directory of Open Access Journals (Sweden)

    Pooja Bihani

    2017-01-01

    Full Text Available Subcostal transverse abdominis plane (TAP block anesthetizes area of the abdomen with cutaneous innervation of T6–T10 dermatomes. These abdominal field blocks become very advantageous when cardiac patient presents for noncardiac surgeries as sole anesthetic or as a part of multimodal anesthesia. A 58-year-male came for open surgical repair of subxiphoid incisional hernia developed post coronary artery bypass grafting (CABG. Echocardiography showed hypokinesia of left ventricle (LV in the left anterior descending (LAD artery territory, dilated LV, and ejection fraction of 30%, and coronary angiography after 6 months of CABG showed 70% stenosis of LAD. Surgery was successfully accomplished under ultrasound-guided bilateral subcostal TAP block except for a brief period of pain and discomfort when hernia was being reduced which required narcotic supplementation. The patient remained comfortable throughout the procedure as well as 24 h postoperatively without any analgesic supplementation. Thus, subcostal TAP block can be a safe alternative to neuraxial or general anesthesia for epigastric hernia repair in selected patients.

  7. Doppler ultrasound-guided percutaneous thrombin injection for treating femoral pseudoaneurysms

    Directory of Open Access Journals (Sweden)

    Frederico Celestino Miranda

    2008-12-01

    Full Text Available Objective: To evaluate the success rate of percutaneous injectionof thrombin, guided by Doppler ultrasound to treat femoralpseudoaneurysms. Methods: Twenty-three patients withfemoral pseudoaneurysms were treated with ultrasound-guidedthrombin injection, between September 2003 and October 2007.Pseudoaneurysm size, dose of thrombin used, result of therapy andcomplications were prospectively documented. Other aspects analyzedincluded the type of procedure that caused the pseudoaneurysm(diagnostic catheterization, angioplasty, stent placement, size ofendovascular introducer, use of hemostatic device and body massindex (BMI of patients. Results: A total of 27 injections of thrombinwere performed. The mean transverse diameter was 3.5 cm. Themean dose of thrombin injected was 666.7 IU. The primary successrate ranged from 19 to 23 (83%. Reperfusion occurred in onepseudoaneurysm. The rate of secondary thrombosis was four in four(100%. No thromboembolic, infectious or allergic complicationsoccurred. Conclusions: Ultrasound-guided percutaneous thrombininjection is the best method for treating femoral pseudoaneurysmscaused by endovascular procedures. It presents high rates of success,low recurrence rates and almost no complications.

  8. 3-D ultrasound-guided robotic needle steering in biological tissue.

    Science.gov (United States)

    Adebar, Troy K; Fletcher, Ashley E; Okamura, Allison M

    2014-12-01

    Robotic needle steering systems have the potential to greatly improve medical interventions, but they require new methods for medical image guidance. Three-dimensional (3-D) ultrasound is a widely available, low-cost imaging modality that may be used to provide real-time feedback to needle steering robots. Unfortunately, the poor visibility of steerable needles in standard grayscale ultrasound makes automatic segmentation of the needles impractical. A new imaging approach is proposed, in which high-frequency vibration of a steerable needle makes it visible in ultrasound Doppler images. Experiments demonstrate that segmentation from this Doppler data is accurate to within 1-2 mm. An image-guided control algorithm that incorporates the segmentation data as feedback is also described. In experimental tests in ex vivo bovine liver tissue, a robotic needle steering system implementing this control scheme was able to consistently steer a needle tip to a simulated target with an average error of 1.57 mm. Implementation of 3-D ultrasound-guided needle steering in biological tissue represents a significant step toward the clinical application of robotic needle steering.

  9. The accuracy of frozen section analysis in ultrasound- guided core needle biopsy of breast lesions

    Directory of Open Access Journals (Sweden)

    Riss Paul

    2009-09-01

    Full Text Available Abstract Background Limited data are available to evaluate the accuracy of frozen section analysis and ultrasound- guided core needle biopsy of the breast. Methods In a retrospective analysis data of 120 consecutive handheldultrasound- guided 14- gauge automated core needle biopsies (CNB in 109 consecutive patients with breast lesions between 2006 and 2007 were evaluated. Results In our outpatient clinic120 CNB were performed. In 59/120 (49.2% cases we compared histological diagnosis on frozen sections with those on paraffin sections of CNB and finally with the result of open biopsy. Of the cases 42/59 (71.2% were proved to be malignant and 17/59 (28.8% to be benign in the definitive histology. 2/59 (3.3% biopsies had a false negative frozen section result. No false positive results of the intraoperative frozen section analysis were obtained, resulting in a sensitivity, specificity and positive predicting value (PPV and negative predicting value (NPV of 95%, 100%, 100% and 90%, respectively. Histological and morphobiological parameters did not show up relevance for correct frozen section analysis. In cases of malignancy time between diagnosis and definitive treatment could not be reduced due to frozen section analysis. Conclusion The frozen section analysis of suspect breast lesions performed by CNB displays good sensitivity/specificity characteristics. Immediate investigations of CNB is an accurate diagnostic tool and an important step in reducing psychological strain by minimizing the period of uncertainty in patients with breast tumor.

  10. Steroid injection for painful shoulder: Usefulness of ultrasound-guided approach

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Min Hee [Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2004-03-15

    To evaluate the efficacy of steroid injection into the subacromial bursa and biceps tendon sheath for painful shoulders and the usefulness of ultrasound-guided approach. Seventeen shoulders of twelve patients with shoulder pain and limited motion were included, and these patient were clinically diagnosed as a painful arc syndrome. Under ultrasound guidance, steroid injection was performed into the subacormial bursa (13 cases) and biceps tendon sheath (4 cases). In 7 cases, 1 mL of steroid was used while the remaining six patients received a mixture of 1 mL of steroid and 1 ml of lidocaine. Both shoulders of two patients received 0.5 mL of steroid. The location of needle and injection duration of fluid were continuously monitored, and complications such as leakage of steroid were recorded. Medical records were reviewed for the presence of pain relief and increasing range of motion following the injection. On ultrasonogram, the needle within the subacromial bursa and biceps tendon sheath was seen as a linear echogenic structure, and injected fluid was identified. There was neither the leakage of steroid injection nor any other complications. In 16 (94%) of 17 shoulders, there was decreased intensity of shoulder pain while increased range of motion was noted in three patients following the injection. Steroid injection into the subacormial bursa and biceps tendon sheath is effective in treating shoulder pain and limited range of motion of the shoulder, and ultrasound is useful guiding method.

  11. Bench-top testing of suction forces generated through endoscopic ultrasound-guided aspiration needles.

    Science.gov (United States)

    Katanuma, Akio; Itoi, Takao; Baron, Todd H; Yasuda, Ichiro; Kin, Toshifumi; Yane, Kei; Maguchi, Hiroyuki; Yamazaki, Hajime; Sano, Itsuki; Minami, Ryuki; Manabu, Sen-yo; Ikarashi, Satoshi; Osanai, Manabu; Takahashi, Kuniyuki

    2015-05-01

    Adequate needle size and tissue acquisition techniques for endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) need further elucidation. Moreover, the actual negative pressure and suction forces of FNA needles remain unknown. We evaluated the suction forces of 19-gauge, 22-gauge, and 25-gauge conventional FNA needles and side hole aspiration needles using conventional negative pressure and the slow pull technique. Using a manometer, we determined the mean (SD) negative pressure and suction force for needle gauge, aspiration volume, and aspiration technique. We also evaluated the time to reach the maximum negative pressure. Suction force was comparatively higher in the 19-gauge needle when 50 ml of negative pressure was applied. Suction force using the slow pull method was very weak at 5% of pressure found with conventional methods. With the use of a 20-ml syringe, the time to reach the maximum negative pressure was 4 s in the 19-gauge needle, 11 s in the 22-gauge needle, and 80 s in the 25-gauge needle. Bench-top testing showed that suction force increases with a larger gauge needle and larger aspiration volume. The slow pull method produces a very weak suction force. The time to reach the maximum negative pressure was longest in the 25-gauge needle. © 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  12. Percutaneous Ultrasound-Guided Thrombin Injection in Iatrogenic Arterial Pseudoaneurysms: Effectiveness and Complications

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    Koh, Young Hwan [Boramae Hospital, Seoul (Korea, Republic of); Kim, Hak Soo; Kim, Hyung Sik; Min, Seung Kee [Gachon Medical School, Incheon (Korea, Republic of)

    2005-09-15

    To evaluate and describe the efficacy and side effects of a percutaneous thrombin injection under ultrasonography guidance for the treatment of iatrogenic pseudo aneurysms Eighteen consecutive iatrogenic pseudo aneurysm cases were treated with a thrombin injection. The thrombin was injected into the pseudo aneurysm cavity using a 22-gauge needle under ultrasonographic guidance. The causes of the pseudo aneurysms are as follows: post coronary angiography (9 cases), percutaneous coronary balloon angioplasty (5 cases), cerebral angiography (1 case), transhepatic chemo embolization (1 case), percutaneous trans femoral arterial stent insertion (1 case) and bone marrow aspiration for a marrow transplant (1 case). Only one case required a secondary thrombin injection due to recurrent flow in the pseudo aneurysm lumen, which was detected at the follow up Doppler ultrasound. Other seventeen cases were successfully treated on the first trial. There were no technical failures or complication related to the procedure. The average amount of thrombin injected was 733 IU. Nine out of 18 treated patients (50%) showed mild reactions to the thrombin including mild fever (4 cases), chilling sensation (3 cases), a chilling sensation with mild dyspnea (1 case), mild chest discomfort (1 case) after the thrombin injection. All these side effects were transient and improved several hours later. All the iatrogenic pseudo aneurysms were treated successfully with an ultrasound-guided percutaneous thrombin injection. There was a high rate of hypersensitivity to the bovine thrombin, which precaution should be taken to prevent more serious side effects

  13. Endoscopic ultrasound guided fine needle aspiration of non‐pancreatic lesions: an institutional experience

    Science.gov (United States)

    Anand, Dipti; Barroeta, Julieta E; Gupta, Prabodh K; Kochman, Michael; Baloch, Zubair W

    2007-01-01

    Background Endoscopic ultrasound guided fine needle aspiration biopsy (EUS‐FNA) has proven to be an effective diagnostic modality for the detection and staging of pancreatic malignancies. In recent years EUS‐FNA has also been used to diagnose lesions of non‐pancreatic sites such as structures in close proximity to the gut wall within the mediastinum, abdomen, pelvis and retro‐peritoneum. Aims To evaluate experience with EUS‐FNA of non‐pancreatic sites at a large university medical centre. Methods The study cohort included 234 patients who underwent EUS‐FNA of 246 lesions in non‐pancreatic sites (122 peri‐pancreatic and coeliac lymph nodes; 9 peri‐pancreatic masses; other sites: mediastinum 12, gastric 25, liver 27, oesophagus 17, duodenum/colon/rectum 15, retro‐peritoneum 8, lung 7, miscellaneous 4). Results The cytology diagnoses were classified as non‐neoplastic/reactive in 82 (33%), atypical/suspicious for malignancy in 25 (10%), malignant in 86 (35%) and non‐diagnostic in 53 (22%) cases. Surgical pathology follow‐up was available in 75 (31%) cases. Excluding the non‐diagnostic cases there were 7 false negative and 3 false positive cases. The sensitivity, specificity and positive predictive value of EUS‐FNA in the diagnosis of lesions of non‐pancreatic sites was 92%, 98% and 97%, respectively. Conclusions EUS‐FNA can be effectively used as a diagnostic modality in the diagnosis of lesions from non‐pancreatic sites. PMID:17220205

  14. Selective ultrasound guided pectoral nerve targeting in breast augmentation: How to spare the brachial plexus cords?

    Science.gov (United States)

    Desroches, Jean; Grabs, Ursula; Grabs, Detlev

    2013-01-01

    Subpectoral breast augmentation surgery under regional anesthesia requires the selective neural blockade of the medial and lateral pectoral nerves to diminish postoperative pain syndromes. The purpose of this cadaver study is to demonstrate a reliable ultrasound guided approach to selectively target the pectoral nerves and their branches while sparing the brachial plexus cords. After evaluating the position and appearance of the pectoral nerves in 25 cadavers (50 sides), a portable ultrasound machine was used to guide the injection of 10 ml of 0.2% aqueous methylene blue solution in the pectoral region on both sides of three Thiel's embalmed cadavers using a single entry point-triple injection technique. This technique uses a medial to lateral approach with the entry point just medial to the pectoral minor muscle and three subsequent infiltrations: (1) deep lateral part of the pectoralis minor muscle, (2) between the pectoralis minor and major muscles, and (3) between the pectoralis major muscle and its posterior fascia under ultrasound visualization. Dissection demonstrates that the medial and lateral pectoral nerves were well stained while leaving the brachial plexus cords unstained. We show that 10 ml of an injected solution is sufficient to stain all the medial and lateral pectoral nerve branches without a proximal extension to the cords of the brachial plexus. Copyright © 2012 Wiley-Liss, Inc.

  15. Ultrasound guided percutaneous nephrostomy for obstructive uropathy in benign and malignant diseases

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    G. Sood

    2006-06-01

    Full Text Available OBJECTIVE: Analyze the success rate, complications and overall benefit of ultrasound guided percutaneous nephrostomy (PCN for the relief of obstructive uropathy in benign and malignant diseases. MATERIALS AND METHODS: PCN was performed in 50 kidneys of 32 patients. It was performed in emergency rooms totally under ultrasound guidance by general surgeons. Seldinger technique was used in all cases. Changes in renal function after the procedure were analyzed using paired t-test. RESULTS: The procedure was successfully completed in 42 out of 50 kidneys (84%. There has been no major complication and 28% minor complications. The renal function improved significantly when PCN was performed for benign conditions (mean creatinine 3.52 mg/dL before and 2.18 mg/dL after PCN, however in malignancy there has been no significant improvement in renal function (before PCN mean creatinine 6.39 mg/dL and after PCN 5.41 mg/dL. CONCLUSION: We conclude that PCN can be effectively performed under ultrasound guidance and should be the initial procedure in acutely obstructed kidneys with pyonephrosis and poor renal function. In malignant cases, however, improvement in renal function is possible only if the procedure is carried out at an early stage.

  16. Ultrasound-guided percutaneous radiofrequency ablation of liver tumors: How we do it safety and completely

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    Kim, Jin Woong; Shin, Sang Soo; Heo, Suk Hee; Hong, Jun Hyung; Lim, Hyo Soon; Seon, Hyun Ju; Hur, Young Hoe; Park, Chang Hwan; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam National University Medical School, Gwangju (Korea, Republic of)

    2015-12-15

    Ultrasound-guided percutaneous radiofrequency (RF) ablation has become one of the most promising local cancer therapies for both resectable and nonresectable hepatic tumors. Although RF ablation is a safe and effective technique for the treatment of liver tumors, the outcome of treatment can be closely related to the location and shape of the tumors. There may be difficulties with RF ablation of tumors that are adjacent to large vessels or extrahepatic heat-vulnerable organs and tumors in the caudate lobe, possibly resulting in major complications or treatment failure. Thus, a number of strategies have been developed to overcome these challenges, which include artificial ascites, needle track ablation, fusion imaging guidance, parallel targeting, bypass targeting, etc. Operators need to use the right strategy in the right situation to avoid the possibility of complications and incomplete thermal tissue destruction; with the right strategy, RF ablation can be performed successfully, even for hepatic tumors in high-risk locations. This article offers technical strategies that can be used to effectively perform RF ablation as well as to minimize possible complications related to the procedure with representative cases and schematic illustrations.

  17. Ultrasound-Guided Transoral Videolaryngoscopic Surgery for Retropharyngeal Lymph Node Metastasis of Papillary Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Kazunori Fujiwara

    2017-07-01

    Full Text Available Background: Endoscopic-assisted transoral surgery, including transoral robotic surgery for metastatic retropharyngeal lymph node (RPN from well-differentiated thyroid cancer, has been reported to reduce the complications resulting from transcervical and transmandibular approaches. However, the narrow working space and difficulty identifying RPN are problematic. To solve these issues, several studies have used intraoperative ultrasound in endoscopic-assisted transoral surgery. However, the type of ultrasonography suitable for this purpose remains unclear. Case Presentation: A 60-year-old female with thyroid papillary carcinoma (T4aN1bM0 initially underwent total thyroidectomy and paratracheal and selective neck dissections (D2a, with resectional management of recurrent laryngeal nerve, trachea, and esophagus. Three years later, she was diagnosed with left retropharyngeal and upper mediastinal lymph node metastases of papillary thyroid cancer. Transoral videolaryngoscopic surgery was performed with a combination of ultrasonography with a flexible laparoscopic transducer manipulated with forceps for identifying RPN intraoperatively. Due to the transducer’s small size and thin, flexible cable, the transducer interrupted the procedure in spite of the narrowness of oral cavity. RPN was resected completely without adverse events. Conclusion: We performed intraoperative ultrasound-guided endoscopic transoral surgery for metastatic RPN from papillary thyroid cancer and achieved complete resection as well as preservation of swallowing function.

  18. Intralesional saline injection for effective ultrasound-guided aspiration of benign viscous cystic thyroid nodules

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    Ko, Eun Sook; Shin, Jung Hee [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Sung, Jin Yong [Dept. of Radiology, Thyroid Center, Daerim St. Mary' s Hospital, Seoul (Korea, Republic of)

    2014-04-15

    We aimed to evaluate the efficacy and safety of vigorous saline injection for viscous cystic thyroid nodules. Eighteen patients who underwent ultrasound-guided aspiration for viscous cystic thyroid nodules using a saline injection were included in our study. After failing to aspirate the cyst by the usual method, we vigorously injected saline into the cyst in multiple directions to break up and liquefy the viscous cystic contents to enable aspiration. The initial and the residual volume of the nodule were calculated, and the volume reduction rate and the time taken to perform the aspiration were recorded. The mean volume of the cystic nodules before aspiration was 11.0 mL (range, 1.2 to 26.0 mL), while the postaspiration volume was 4.2 mL (range, 0.2 to 14.5 mL). The mean aspirated volume was 63.7% of the initial volume. The mean procedure time was 12.4 minutes (range, 5 to 26 minutes). There were no significant complications related to the procedure. A vigorous saline injection followed by aspiration can be a useful method to aspirate viscous cystic thyroid nodules as a prestep for further intervention or simple management.

  19. Ultrasound guided percutaneous removal of wooden foreign bodies in the extremities with hydro-dissection technique

    Energy Technology Data Exchange (ETDEWEB)

    Park, HeeJin; Lee, So Yeon; Chung, Eun Chul; Rho, Myung Ho [Dept. of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul (Korea, Republic of); Lee, Sung Moon; Son, Eun Seok [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of); Lee, Sun Joo [Dept. of Radiology, Inje University College of Medicine, Busan Paik Hospital, Busan (Korea, Republic of)

    2015-12-15

    We described the technique of ultrasound (US)-guided percutaneous removal of the foreign bodies (FB) with hydro-dissection in the radiologic department and presented video files of several cases.Four patients referred to the radiology department for US evaluation and US-guided percutaneous removal of the FBs in the upper and lower extremities between November, 2006 and November, 2013 were included in this study. The procedures started with US evaluation for the exact location and shape of the FB. A 5 mm-sized skin incision was made at the site of the nearest point from the FB where no passing arteries or tendons were present. We adopted a hydro dissection technique to separate the FB from adjacent tissue using a 2% lidocaine solution. Injected anesthetics detached the FBs from surrounding tissue and thereby facilitated removal. After the tip of the mosquito forceps reached the FB, the wooden FBs were removed. The mean time required for the entire procedure was approximately 20 minutes. There were no significant complications during the US-guided removal or long-term complications after the procedure. All 4 FBs were successfully removed from the soft tissue under US guidance. Ultrasound-guided percutaneous removal of the FBs with hydro-dissection in the radiology department is a less invasive and safe method over surgical removal in the operating room. Additionally, the use of a guide wire and serial dilator may help minimize soft tissue injury and facilitate the introduction of forceps.

  20. Paraffin-gel tissue-mimicking material for ultrasound-guided needle biopsy phantom.

    Science.gov (United States)

    Vieira, Sílvio L; Pavan, Theo Z; Junior, Jorge E; Carneiro, Antonio A O

    2013-12-01

    Paraffin-gel waxes have been investigated as new soft tissue-mimicking materials for ultrasound-guided breast biopsy training. Breast phantoms were produced with a broad range of acoustical properties. The speed of sound for the phantoms ranged from 1425.4 ± 0.6 to 1480.3 ± 1.7 m/s at room temperature. The attenuation coefficients were easily controlled between 0.32 ± 0.27 dB/cm and 2.04 ± 0.65 dB/cm at 7.5 MHz, depending on the amount of carnauba wax added to the base material. The materials do not suffer dehydration and provide adequate needle penetration, with a Young's storage modulus varying between 14.7 ± 0.2 kPa and 34.9 ± 0.3 kPa. The phantom background material possesses long-term stability and can be employed in a supine position without changes in geometry. These results indicate that paraffin-gel waxes may be promising materials for training radiologists in ultrasound biopsy procedures.

  1. Efficacy of ultrasound-guided obturator nerve block in transurethral surgery

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    Ahmed Thallaj

    2011-01-01

    Full Text Available Background: During transurethral resection surgery (TUR, accidental stimulation of the obturator nerve can cause violent adductor contraction, leading to serious intraoperative complications. General anesthesia with muscle relaxation is currently the preferred technique for TUR surgery. Spinal anesthesia combined with obturator nerve block has also been used for TUR surgery in geriatric population. Blind, anatomical methods for identifying the obturator nerve are often unsatisfactory. Therefore, we conducted this prospective study to validate the efficacy of ultrasound-guided obturator nerve block (USONB during TUR procedures. Methods: Eighteen male patients undergoing TURP surgery under spinal anesthesia were included in the study. Bilateral USONB with maximum 20 ml of 1% lidocaine per patient was performed. An independent observer was present to monitor any adduction movements during the operation and to record patient and surgeon satisfactions. Results: In all patients, obturator nerve was visualized from the first attempt, requiring an average of 4.3 min for blocking of each side. USONB was successful (97.2% in preventing an adductor spasm in all except one patient. Patient′s and surgeon′s satisfaction were appropriate. In all patients, adductor muscle strength recovered fully within 2 h following the surgical procedure. Conclusions: USONB is safe and effective during TUR surgery. It provides optimal intra-and postoperative conditions.

  2. A serious game for learning ultrasound-guided needle placement skills.

    Science.gov (United States)

    Chan, Wing-Yin; Qin, Jing; Chui, Yim-Pan; Heng, Pheng-Ann

    2012-11-01

    Ultrasound-guided needle placement is a key step in a lot of radiological intervention procedures such as biopsy, local anesthesia and fluid drainage. To help training future intervention radiologists, we develop a serious game to teach the skills involved. We introduce novel techniques for realistic simulation and integrate game elements for active and effective learning. This game is designed in the context of needle placement training based on the some essential characteristics of serious games. Training scenarios are interactively generated via a block-based construction scheme. A novel example-based texture synthesis technique is proposed to simulate corresponding ultrasound images. Game levels are defined based on the difficulties of the generated scenarios. Interactive recommendation of desirable insertion paths is provided during the training as an adaptation mechanism. We also develop a fast physics-based approach to reproduce the shadowing effect of needles in ultrasound images. Game elements such as time-attack tasks, hints and performance evaluation tools are also integrated in our system. Extensive experiments are performed to validate its feasibility for training.

  3. Comparative Effectiveness of Single versus Combination Antibiotic Prophylaxis for Infections after Transrectal Prostate Biopsy.

    Science.gov (United States)

    Marino, Kaylee; Parlee, Anne; Orlando, Ralph; Lerner, Lori; Strymish, Judith; Gupta, Kalpana

    2015-12-01

    An increase in fluoroquinolone resistance and transrectal ultrasound-guided prostate (TRUS) biopsy infections has prompted the need for alternative effective antibiotic prophylaxis. We aimed to compare ciprofloxacin and other single-agent therapies to combination therapy for efficacy and adverse effects. Men who underwent a TRUS biopsy within the VA Boston health care system with documented receipt of prophylactic antibiotics periprocedure were eligible for inclusion. Postprocedure infections within 30 days were ascertained by chart review from electronic records, including any inpatient, outpatient, or urgent-care visits. Among 455 evaluable men over a 3-year period, there were 25 infections (5.49%), with sepsis occurring in 2.4%, urinary tract infections (UTI) in 1.54%, and bacteremia in 0.44% of patients. Escherichia coli was the most common urine (89%) and blood (92%) pathogen, with fluoroquinolone resistance rates of 88% and 91%, respectively. Ciprofloxacin alone was associated with significantly more infections than ciprofloxacin plus an additional agent (P = 0.014). Intramuscular gentamicin alone was also significantly associated with a higher infection rate obtained with all other regimens (P = 0.004). Any single-agent regimen, including ciprofloxacin, ceftriaxone, or gentamicin, was associated with significantly higher infection rates than any combination regimen (odds ratio [OR], 4; 95% confidence interval [CI], 1.47, 10.85; P = 0.004). Diabetes, immunosuppressive condition or medication, hospitalization within the previous year, and UTI within the previous 6 months were not associated with infection risk. Clostridium difficile infections were similar. These findings suggest that ciprofloxacin, ceftriaxone, and gentamicin alone are inferior to a combination regimen. Institutions with high failure rates of prophylaxis for TRUS biopsies should consider combination regimens derived from their local data.

  4. Biological characteristics of HCC by ultrasound-guided aspiration biopsy and its clinical application

    Institute of Scientific and Technical Information of China (English)

    Li-Wu Lin; Xue-Ying Lin; Yi-Mi He; Shang-Da Gao; Xiao-Dong Lin

    2003-01-01

    AIM: To probe the pathological biological characteristics of hepatocellular carcinoma (HCC) by the ultrasound-guided aspiration biopsy and assess the clinical application value of this method.METHODS: The biopsy and DNA analysis by flow cytometry (FCM) were taken in 46 cases with HCC nodules, including 26 cases and 20 cases with nodules ≤3 cm and >3 cm in diameters respectively, and 12 cases with intrahepatic benign hyperplastic nodules. They were taken in 22 cases of 46cases with HCC before and after the therapy. Fine-needles and automatic histological incised biopsy needles were used.The fresh biopsy tissue was produced into the single cell suspension, which was sent for DNA detection and ratio analysis of cell period. The ratio of each DNA period of cell proliferation of each group was calculated and compared with each other. The DNA aneuploid (AN) and apoptosis cell peak were observed and their percentages were calculated.RESULTS: The ratios of S and G2/M periods of DNA, which reflect cell hyperproliferation, in the group with HCC tumors >3 cm in diameter were markedly higher than those of the group with HCC nodules ≤3 cm in diameter and the group with the benign hyperplastic nodules (P<0.01 except A:B of S period, P<0.05). The ratios of the middle group were also apparently higher than those of the latter group (P<0.01).The ratio of DNA AN of 46 cases with HCC nodules was 34.8 % (16/46). None of the cases with the intrahepatic hyperplastic nodules appeared AN. The DNA AN appeared more apparently with the growth of the tumors. The AN ratio of the group with tumors >3 cm in diameter was 55 %(11/20), markedly higher than that of the group with tumors ≤3 cm in diameter which was 19.2 % (5/26) (P<0.01). The FCM DNA analysis of 22 specimens of hepatic carcinoma tissue before therapy showed that the aneuploid peaks appeared in 5 cases (22.7 %). The ratio of G1 period rose after therapy while the S period and G2/M ratios fell (P<0.01).The

  5. Ultrasound-guided brachial plexus block: a study on 30 patients

    Directory of Open Access Journals (Sweden)

    Amiri HR

    2009-05-01

    Full Text Available "n Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Successful brachial plexus blocks rely on proper techniques of nerve localization, needle placement, and local anesthetic injection. Standard approaches used today (elicitation of paresthesia or nerve-stimulated muscle contraction, unfortunately, are all "blind" techniques resulting in procedure-related pain and complications. Ultrasound guidance for brachial plexus blocks can potentially improve success and complication rates. This study presents the ultrasound-guided brachial plexus blocks for the first time in Iran in adults and pediatrics. "n"n Methods: In this study ultrasound-guided brachial plexus blocks in 30 patients (25 adults & 5 pediatrics scheduled for an elective upper extremity surgery, are introduced. Ultrasound imaging was used to identify the brachial plexus before the block, guide the block needle to reach target nerves, and visualize the pattern of local anesthetic spread. Needle position was further confirmed by nerve stimulation before injection. Besides basic variables, block approach, block time, postoperative analgesia duration (VAS<3 was considered as target pain control opioid consumption during surgery, patient satisfaction and block related complications were reported

  6. The Value of Ultrasound-Guided Tattooing Localization of Nonpalpable Breast Lesions

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    Ko, Kyung-Ran [National Cancer Center, Goyang (Korea, Republic of); Han, Boo-Kyung; Jang, Kyung-Mi; Choe, Yeon-Hyeon; Shin, Jung-Hee [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Yang, Jung-Hyun; Nam, Suk-Jin [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2007-08-15

    To investigate the value of ultrasound-guided tattooing localization (US-tattoo) using a charcoal suspension for breast lesions. One hundred sixty-four nonpalpable breast lesions in 134 patients (mean age 47 years; range 30 74 years) were marked with a charcoal suspension under US guidance. The medical records associated with the US-tattoo, the pathology results and the follow-up US results were reviewed. The average size of the localized lesions was 1.0 cm. The procedure time was < 5 minutes (range, 2 10 minutes) per lesion. The US-tattoo was well tolerated in all cases. The only technical difficulty encountered was a needle tip blockage caused by a large charcoal particle (4.9%). The surgeon easily identified the tattoo with the exception one case. In addition, surgery could be safely delayed from one to 57 days after the making US-tattoo. The pathology result was benign in 108 cases, borderline in five, and malignant in 51. The excised specimen was < 4 cm in 76.6% (82/107) of the benign cases (mean; 2.7 cm). The pathologist could identify the mass around the tattoo and was able to make a specific diagnosis in 81.3% (87/107) of benign lesions. The only complication encountered was residual charcoal marking along the incision scar (3.6%). All follow- up US documented the removal of the lesions. An US-tattoo for nonpalpable breast lesions is a very simple and accurate method that can help surgeons design and schedule an open biopsy.

  7. Consistent evaluation of an ultrasound-guided surgical navigation system by utilizing an active validation platform

    Science.gov (United States)

    Kim, Younsu; Kim, Sungmin; Boctor, Emad M.

    2017-03-01

    An ultrasound image-guided needle tracking systems have been widely used due to their cost-effectiveness and nonionizing radiation properties. Various surgical navigation systems have been developed by utilizing state-of-the-art sensor technologies. However, ultrasound transmission beam thickness causes unfair initial evaluation conditions due to inconsistent placement of the target with respect to the ultrasound probe. This inconsistency also brings high uncertainty and results in large standard deviations for each measurement when we compare accuracy with and without the guidance. To resolve this problem, we designed a complete evaluation platform by utilizing our mid-plane detection and time of flight measurement systems. The evaluating system uses a PZT element target and an ultrasound transmitting needle. In this paper, we evaluated an optical tracker-based surgical ultrasound-guided navigation system whereby the optical tracker tracks marker frames attached on the ultrasound probe and the needle. We performed ten needle trials of guidance experiment with a mid-plane adjustment algorithm and with a B-mode segmentation method. With the midplane adjustment, the result showed a mean error of 1.62+/-0.72mm. The mean error increased to 3.58+/-2.07mm without the mid-plane adjustment. Our evaluation system can reduce the effect of the beam-thickness problem, and measure ultrasound image-guided technologies consistently with a minimal standard deviation. Using our novel evaluation system, ultrasound image-guided technologies can be compared under equal initial conditions. Therefore, the error can be evaluated more accurately, and the system provides better analysis on the error sources such as ultrasound beam thickness.

  8. Diagnostic value of blood clot core during endobronchial ultrasound-guided transbronchial needle aspirate.

    Science.gov (United States)

    Amin, Emily N; Russell, Christopher D; Shilo, Konstantin; Islam, Shaheen; Wood, Karen L

    2013-06-01

    Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is being increasingly used in the sampling of pulmonary masses and mediastinal lymphadenopathy. The blood clot core (BCC) often obtained during EBUS-TBNA may not be a true core and therefore may not be submitted for histological analysis. The frequency in which the blood clot core is positive in patients with negative cytology undergoing EBUS-TBNA is not known. The purpose of this study was to evaluate the diagnostic role of the blood clot core obtained during EBUS-TBNA. An Institutional Review Board-approved retrospective chart review was performed from January through September 2011 for all patients who underwent EBUS-TBNA at The Ohio State University. The data collection included cytology and histology results for each procedure. Blood clot cores obtained from the EBUS-TBNA needle were sent in formalin for histological examination. Seventy patients underwent EBUS-TBNA and 51 (72.8 %) patients had procedures that yielded a BCC for histology and aspirate for cytology. Forty-nine percent of patients with a BCC were diagnosed with malignancy. Of those with a BCC obtained, five (9.8 %) patients diagnosed with malignancy were done so based only on the results of blood clot core alone with negative cytology. Blood clot cores obtained at EBUS-TBNA contain diagnostic material and should be subjected histopathological examination. When blood clot cores are sent for analysis, there is the potential to spare up to 10 % of patients more invasive diagnostic biopsy procedures.

  9. Ultrasound-guided dry needling with percutaneous paratenon decompression for chronic Achilles tendinopathy.

    Science.gov (United States)

    Yeo, Andrea; Kendall, Namita; Jayaraman, Sunderarajan

    2016-07-01

    Chronic Achilles tendinopathy is a common overuse injury. There are several modalities of treatment, reflecting difficulties in management. In particular, due to the well-recognised surgical morbidity, treatment has steered towards less invasive routes. Previous studies have targeted pathology either inside or outside the tendon in isolation with varying results. This study aimed to target both pathological sites by combining dry needling with percutaneous hydrostatic decompression as a novel treatment. Twenty-one patients with 26 chronic, non-insertional Achilles tendinopathy were prospectively enrolled. Ultrasound-guided dry needling of neovascular areas and small-volume hydrostatic paratenon decompression was performed 6-weekly. Sonographic assessment of tendon thickness and neovascularity was undertaken. Following treatment, a standardised physiotherapy regime was adopted. Visual analogue scores (VAS) were used as the primary outcome measure. Telephonic interviews were carried out 12 and 24 months post-treatment. Twenty-four tendons (in 19 patients) were successfully treated. The mean treatment session was 2. There was no significant change in neovascularity or tendon thickness. Therapeutic intervention led to a significant improvement in VAS at rest (42.4 ± 24.4 vs. 18.4 ± 26.0, p = 0.0005) and during activity (72.8 ± 16.0 vs. 33.7 ± 23.2, p 75 % of patients were highly satisfied with their outcome with nearly half reporting complete resolution of their symptoms. >85 % were also able to return to their sporting interests. Combined therapy of dry needling with percutaneous hydrostatic paratenon decompression under ultrasound guidance is a well-tolerated procedure with good short- and long-term pain and functional outcomes. Prospective case series, Level IV.

  10. Endobronchial ultrasound-guided transbronchial needle aspiration of undiagnosed mediastinal lymphadenopathy

    Institute of Scientific and Technical Information of China (English)

    TIAN Qing; CHEN Liang-an; WANG Hui-shuang; ZHU Bao-hua; TIAN Lei; YANG Zhen; AN Yang

    2010-01-01

    Background Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) can sample the enlarged mediastinal lymph nodes which are unreachable by conventional bronchoscopy.It is a relatively simple and safe method to see beyond the bronchial tree.We describe and discuss its initial application and our experience.Methods From July 2009 to December 2009, 52 patients with undiagnosed enlarged mediastinal lymph nodes were accessed with EBUS-TBNA in the People's Liberation Army General Hospital.Conventional bronchoscopy was performed before EBUS-TBNA, and patients with endobronchial lesions were excluded from this study.Smears fixed in 95% alcohol and histological specimens fixed in formalin were sent to Department of Pathology.Results EBUS-TBNA was diagnostic in 33 (63%) patients, with diagnosis of lung cancer in 23 patients (14 patients of small cell lung cancer, eight patients with adenocarcinoma, and one patient of squamous carcinoma).Four patients, who had negative EBUS-TBNA results, were later diagnosed with malignancy at thoracotomy.One patient with negative EBUS-TBNA results died of cancer cachexia.The sensitivity, specificity, and positive and negative predictive value of EBUS-TBNA for the diagnosis of neoplastic disease were 85%, 100%, 100%, and 50% respectively.Among the 16sarcoidosis patients, who were diagnosed by a combination of the clinical and radiological information as well as pathological results obtained by EBUS-TBNA, nine of them had granulomas and benign lymphoid cells detected by EBUS-TBNA.The sensitivity, specificity, and positive and negative predictive value of EBUS-TBNA for the diagnosis of sarcoidosis were 56%, 100%, 100%, and 13%, respectively.Five patients with no definite diagnosis from EBUS-TNBA examination are under close follow-up.Conclusions EBUS-TBNA can provide a safe and effective method to sample mediastinal leisions suspected of malignancy.It also adds pathological information needed to make the diagnosis of

  11. Contrast ultrasound-guided photothermal therapy using gold nanoshelled microcapsules in breast cancer

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    Wang, Shumin [Department of Ultrasonography, Peking University Third Hospital, Beijing 100083 (China); Ordos Center Hospital, Ordos, Inner Mongolia 017000 (China); Dai, Zhifei [Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871 (China); Ke, Hengte [Nanomedicine and Biosensor Laboratory, School of Life Science and Technology, Harbin Institute of Technology, Harbin 150001 (China); Qu, Enze [Department of Ultrasonography, Peking University Third Hospital, Beijing 100083 (China); Qi, Xiaoxu; Zhang, Kuo [Department of Laboratory Animal Science, Peking University Health Science Center, Beijing 100019 (China); Wang, Jinrui, E-mail: jinrui_wang@sina.com [Department of Ultrasonography, Peking University Third Hospital, Beijing 100083 (China)

    2014-01-15

    Objectives: The purpose of this study was to test whether dual functional gold nano-shelled microcapsules (GNS-MCs) can be used as an ultrasound imaging enhancer and as an optical absorber for photothermal therapy (PTT) in a rodent model of breast cancer. Methods: GNS-MCs were fabricated with an inner air and outer gold nanoshell spherical structure. Photothermal cytotoxicity of GNS-MCs was tested with BT474 cancer cells in vitro and non-obese diabetes-SCID (NOD/SCID) mice with breast cancer. GNS-MCs were injected into the tumor under ultrasound guidance and treated with near-infrared (NIR) laser irradiation. The photothermal ablative effectiveness of GNS-MCs was evaluated by measuring the surface and internal temperature of the tumor as well as the size of the tumor using histological confirmation. Results: NIR laser irradiation resulted in significant tumor cell death in GNS-MCs-treated BT474 cells in vitro. GNS-MCs were able to serve as an ultrasound enhancer to guide the intratumoral injection of GNS-MCs and ensure their uniform distribution. In vivo studies revealed that NIR laser irradiation increased the intratumoral temperature to nearly 70 °C for 8 min in GNS-MCs-treated mice. Tumor volumes decreased gradually and tumors were completely ablated in 6 out of 7 mice treated with GNS-MCs and laser irradiation by 17 days after treatment. Conclusion: This study demonstrates that ultrasound-guided PTT with theranostic GNS-MCs is a promising technique for in situ treatment of breast cancer.

  12. Ultrasound-guided percutaneous transhepatic cholangiography and drainage in patients with hilar cholangiocarcinoma.

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    Laméris, J S; Hesselink, E J; Van Leeuwen, P A; Nijs, H G; Meerwaldt, J H; Terpstra, O T

    1990-05-01

    The use of ultrasound-guided PTCD in 49 patients with hilar cholangiocarcinoma was evaluated. In 11 patients PTCD was performed as a preoperative measure either to outline tumor extension or to treat cholangitis. Postoperatively, the catheters were used to stent bilioenteric anastomoses and served to guide iridium wires for radiotherapy in nine patients with nonresectable tumor or tumor residue after resection. In 20 inoperable patients with tumor diameter smaller than 3 cm and in whom at least one catheter could be manipulated through the tumor, PTCD was combined with internal and external radiotherapy. The remaining 18 patients were palliated with PTCD only. In 29 patients (59%) complete drainage of the biliary system was achieved. Twenty-seven of these had complete internal drainage using endoprostheses. Two had a combination of an endoprosthesis and external catheter drainage. Of the 20 patients (41%) with incomplete drainage, 12 had endoprostheses, four had a catheter and an endoprosthesis, and in the remaining four external catheter drainage was the optimum result. PTCD was successful in treating eight of ten patients with cholangitis and 12 of 16 patients with pruritus. Procedure-related complication occurred in 11 patients (22%). With the exception of one, all complications could be classified as minor, requiring only conservative measures. A major complication was seen in a patient with ascitic fluid and severe cholangitis. PTCD caused a bacterial peritonitis, of which the patient died. The median survival of patients treated with PTCD alone only was 4 months. A significant increase in survival was noted in patients treated with PTCD and radiotherapy (median survival 8 months).(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Distribution of Platelet-rich Plasma after Ultrasound-Guided Injection for Chronic Elbow Tendinopathies

    Science.gov (United States)

    Park, Gi-Young; Kwon, Dong Rak; Cho, Hee Kyung; Park, Jinyoung; Park, Jung Hyun

    2017-01-01

    Characteristics of the spreads of platelet-rich plasma (PRP) are not widely known despite commonly use. This study aims to evaluate whether PRP stays within the injected area by using ultrasonography, to improve understanding of the spreads of intratendinous injected PRP. Thirty-nine patients (15 males, 24 females; mean age, 49.3 years), who had symptoms on their elbows (> 6 months) and diagnosed as lateral (25 elbows) or medial (14 elbows) tendinopathies of elbow, were included. The severity of tendon pathology was assessed by ultrasonography as tear or no tear. Immediately after ultrasound-guided PRP injection, ultrasound images were evaluated to assess the area of PRP distribution, which was defined as the presence of fluid or microbubbles. Ultrasound revealed that 13 elbows had tendon tear and 26 had no tear, respectively. Post-injection ultrasound confirmed the injected PRP was within the tendon in all cases. The mean distance of distribution from the injection site was 12.6 mm (5.0–26.0 mm). There was no difference in the distance of PRP distribution between tendon tear and no tear. Injected PRP spread to soft tissue outside the tendon in 20 of 39 cases. Intra-articular extension of PRP was observed in 5 cases. Although PRP remained intratendinous after the injection in all cases, some portion tended to spread outside from the injection site in a short space of time. Postinjection ultrasonographic imaging has a value for observing the spreading patterns of intratendinous PRP injection. Key points This study aims to evaluate whether PRP stays within the injected area by using ultrasonography, to improve understanding of the spreads of intratendinous injected PRP. Although PRP remained intratendinous after the injection in all cases, some portion tended to spread outside from the injection site in a short space of time. PMID:28344444

  14. Efficiency of the Ultrasound Guided Hydrostatic Reduction of Intussusception with Normal Saline

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    Azim Motamed Far

    2010-05-01

    Full Text Available Background/Objective: Conventional hydrostatic barium reduction or pneumatic reduction of intussusception is associated with considerable ionizing radiation. The aim of this study was to evaluate ultrasound guided hydrostatic reduction of childhood intussusceptions using water enema."nPatients and Methods: The reduction was attempted using a warm water reservoir at a height of 80-120 cm above the table. The vital signs and the abrupt accumulation of liquid in the abdomen were controlled during the procedure. Reduction of intussuscepted loops was controlled by sonography, the observed fluid surrounding the intussusception was gradually reduced through the ileocecal valve. The procedure was continued until the intussusceptum disappeared completely and the distal ileum was filled with water. The reduction was stopped for 10-15 minutes in those patients in whom the procedure failed after a 10-minute effort. Then the procedure was applied for maximum three times and manual abdominal palpation was applied in some patients to ease the reduction. After successful reduction, the abdomen was re-examined to detect any lead point or recurrence of intussusception. The patients were then transferred to the surgery ward and after 24 hours, the regular oral diet was started and the patients were discharged. Partially reduced cases of intussusception underwent surgical treatment. Fisher exact test was used for the assessment of the relation between intussusception sites and the hydrostatic reduction outcome and/or presence of gangrenous bowel."nResults: Complete reduction was achieved in 21 of 24 patients (87.5%. Hydrostatic reduction was impossible in three patients, bowel resection was performed in 2 patients and the intussusceptions were surgically reduced in one patient."nConclusion: Intussusception is the most common abdominal emergency of early childhood for which non-operative reduction is currently the treatment of choice."nKeywords: Intussusception

  15. An integrated ultrasound-guided high intensity focused ultrasound system for in-vivo experiment

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    Liu, Dalong; Ebbini, Emad S.

    2017-03-01

    We present the system architecture of an integrated Ultrasound-guided High Intensity Focused Ultrasound (USgHIFU) system for image-guided surgery and temperature tracking in vivo. The system is capable of operating with multiple frontends. Current implementation has a SonixRP for imaging and a custom designed dual mode ultrasound array (DMUA) system (32Tx/32Rx) for imaging/therapy. The highlights of the system include a fully-programmable, multiple data stream capable data processing engine, and an arbitrarily programmable high power array driver that is able to synthesize complex beam patterns in space and time. The data processing engine features a pipeline-style design that can be programmed on-the-fly by re-arranging the pre-verified GPU-accelerated high performance pipeline blocks, which cover an extensive range from basic functions such as filtering to specialized processing like speckle tracking. Furthermore, the pipeline design also has the option of bringing in MATLAB (Mathworks, Natick, MA, US) as part of the processing chain, thus vastly increase the capability of the system. By properly balancing the processing load between GPU-enabled routine and MATLAB script. This allows one to achieve a high degree of flexibility while meeting real-time constraints. Results are presented from in vivo rat experiment. Where low dose of therapeutic ultrasound was delivered into the hind limb of the Copenhagen rats using DMUA and temperature was tracked using a linear probe (HST, Ultrasonix). The data is processed in realtime with MATLAB in the loop to perform temperature regularization. Results show that we can reliably track the low temperature heating in the presence of motion artifacts (respiration and pulsation).

  16. Real-time ultrasound-guided PCNL using a novel SonixGPS needle tracking system.

    Science.gov (United States)

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

    2014-08-01

    SonixGPS is a successful ultrasound guidance position system. It helps to improve accuracy in performing complex puncture operations. This study firstly used SonixGPS to perform kidney calyx access in PCNL to investigate its effectiveness and safety. This was a prospectively randomized controlled study performed from September 2011 to October 2012. A total of 97 patients were prospectively randomized into two groups using random number generated from SAS software. 47 Patients were enrolled in conventional ultrasound-guided (US-guided) group and 50 patients were classified into SonixGPS-guided group. Nine patients were lost during follow-up. Hence, a total of 88 patients were qualified and analyzed. Preoperative examinations included urine analysis, urine culture, kidney function, coagulation profile and routine analysis of blood. Ultrasonography was used to evaluate the degree of hydronephrosis. The intraoperative findings, including blood loss, operating time, time to successful puncture, the number of attempts for successful puncture and hospital stay were recorded. The stone clearance rate and complications were analyzed. The present study showed no significant difference between the two groups in terms of demographic data, preoperative markers, stone clearance rate and the stone composition. However, the time to successful puncture, the number of trials for successful puncture, operating time and hospital length of stay were significantly decreased in the SonixGPS-guided group. Furthermore, the hemoglobin decrease was also obviously lower in the SonixGPS group than that in conventional US-guided group. SonixGPS needle tacking system guided PCNL is safe and effective in treating upper urinary tract stones. This novel technology makes puncturing more accuracy and can significantly decrease the incidence of relative hemorrhage and accelerate recovery.

  17. Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in various lung diseases

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    Mediha Gonenc Ortakoylu

    2015-10-01

    Full Text Available Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA is a new method for the diagnosis and staging of lung disease, and its use is increasing worldwide. It has been used as a means of diagnosing lung cancer in its initial stages, and there are data supporting its use for the diagnosis of benign lung disease. The aim of this study was to share our experience with EBUS-TBNA and discuss its diagnostic value. Methods: We retrospectively analyzed the results related to 159 patients who underwent EBUS-TBNA at our pulmonary medicine clinic between 2010 and 2013. We recorded the location and size of lymph nodes seen during EBUS. Lymph nodes that appeared to be affected on EBUS were sampled at least twice. We recorded the diagnostic results of EBUS-TBNA and (for cases in which EBUS-TBNA yielded an inconclusive diagnosis the final diagnoses after further investigation and follow-up. Results: We evaluated 159 patients, of whom 89 (56% were male and 70 (44% were female. The mean age was 54.6 ± 14.2 years among the male patients and 51.9 ± 11.3 years among the female patients. Of the 159 patients evaluated, 115 (84% were correctly diagnosed by EBUS. The diagnostic accuracy of EBUS-TBNA was 83% for benign granulomatous diseases and 77% for malignant diseases. Conclusions: The diagnostic value of EBUS-TBNA is also high for benign pathologies, such as sarcoidosis and tuberculosis. In patients with mediastinal disorders, the use of EBUS-TBNA should be encouraged, primarily because it markedly reduces the need for mediastinoscopy.

  18. Distribution of Platelet-rich Plasma after Ultrasound-Guided Injection for Chronic Elbow Tendinopathies

    Directory of Open Access Journals (Sweden)

    Gi-Young Park, Dong Rak Kwon, Hee Kyung Cho, Jinyoung Park, Jung Hyun Park

    2017-03-01

    Full Text Available Characteristics of the spreads of platelet-rich plasma (PRP are not widely known despite commonly use. This study aims to evaluate whether PRP stays within the injected area by using ultrasonography, to improve understanding of the spreads of intratendinous injected PRP. Thirty-nine patients (15 males, 24 females; mean age, 49.3 years, who had symptoms on their elbows (> 6 months and diagnosed as lateral (25 elbows or medial (14 elbows tendinopathies of elbow, were included. The severity of tendon pathology was assessed by ultrasonography as tear or no tear. Immediately after ultrasound-guided PRP injection, ultrasound images were evaluated to assess the area of PRP distribution, which was defined as the presence of fluid or microbubbles. Ultrasound revealed that 13 elbows had tendon tear and 26 had no tear, respectively. Post-injection ultrasound confirmed the injected PRP was within the tendon in all cases. The mean distance of distribution from the injection site was 12.6 mm (5.0–26.0 mm. There was no difference in the distance of PRP distribution between tendon tear and no tear. Injected PRP spread to soft tissue outside the tendon in 20 of 39 cases. Intra-articular extension of PRP was observed in 5 cases. Although PRP remained intratendinous after the injection in all cases, some portion tended to spread outside from the injection site in a short space of time. Postinjection ultrasonographic imaging has a value for observing the spreading patterns of intratendinous PRP injection.

  19. The effect of vessel depth, diameter, and location on ultrasound-guided peripheral intravenous catheter longevity.

    Science.gov (United States)

    Fields, J Matthew; Dean, Anthony J; Todman, Raleigh W; Au, Arthur K; Anderson, Kenton L; Ku, Bon S; Pines, Jesse M; Panebianco, Nova L

    2012-09-01

    Ultrasound-guided peripheral intravenous catheters (USGPIVs) have been observed to have poor durability. The current study sets out to determine whether vessel characteristics (depth, diameter, and location) predict USGPIV longevity. A secondary analysis was performed on a prospectively gathered database of patients who underwent USGPIV placement in an urban, tertiary care emergency department. All patients in the database had a 20-gauge, 48-mm-long catheter placed under ultrasound guidance. The time and reason for USGPIV removal were extracted by retrospective chart review. A Kaplan-Meier survival analysis was performed. After 48 hours from USGPIV placement, 32% (48/151) had failed prematurely, 24% (36/151) had been removed for routine reasons, and 44% (67/151) remained in working condition yielding a survival probability of 0.63 (95% confidence interval [CI], 0.53-0.70). Survival probability was perfect (1.00) when placed in shallow vessels (<0.4 cm), moderate (0.62; 95% CI, 0.51-0.71) for intermediate vessels (0.40-1.19 cm), and poor (0.29; 95% CI, 0.11-0.51) for deep vessels (≥1.2 cm); P < .0001. Intravenous survival probability was higher when placed in the antecubital fossa or forearm locations (0.83; 95% CI, 0.69-0.91) and lower in the brachial region (0.50; 95% CI, 0.38-0.61); P = .0002. The impact of vessel depth and location was significant after 3 hours and 18 hours, respectively. Vessel diameter did not affect USGPIV longevity. Cannulation of deep and proximal vessels is associated with poor USGPIV survival. Careful selection of target vessels may help improve success of USGPIV placement and durability. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Current status of ultrasound-guided surgery in the treatment of breast cancer.

    Science.gov (United States)

    Volders, José H; Haloua, Max H; Krekel, Nicole Ma; Meijer, Sybren; van den Tol, Petrousjka M

    2016-02-10

    The primary goal of breast-conserving surgery (BCS) is to obtain tumour-free resection margins. Margins positive or focally positive for tumour cells are associated with a high risk of local recurrence, and in the case of tumour-positive margins, re-excision or even mastectomy are sometimes needed to achieve definite clear margins. Unfortunately, tumour-involved margins and re-excisions after lumpectomy are still reported in up to 40% of patients and additionally, unnecessary large excision volumes are described. A secondary goal of BCS is the cosmetic outcome and one of the main determinants of worse cosmetic outcome is a large excision volume. Up to 30% of unsatisfied cosmetic outcome is reported. Therefore, the search for better surgical techniques to improve margin status, excision volume and consequently, cosmetic outcome has continued. Nowadays, the most commonly used localization methods for BCS of non-palpable breast cancers are wire-guided localization (WGL) and radio-guided localization (RGL). WGL and RGL are invasive procedures that need to be performed pre-operatively with technical and scheduling difficulties. For palpable breast cancer, tumour excision is usually guided by tactile skills of the surgeon performing "blind" surgery. One of the surgical techniques pursuing the aims of radicality and small excision volumes includes intra-operative ultrasound (IOUS). The best evidence available demonstrates benefits of IOUS with a significantly high proportion of negative margins compared with other localization techniques in palpable and non-palpable breast cancer. Additionally, IOUS is non-invasive, easy to learn and can centralize the tumour in the excised specimen with low amount of healthy breast tissue being excised. This could lead to better cosmetic results of BCS. Despite the advantages of IOUS, only a small amount of surgeons are performing this technique. This review aims to highlight the position of ultrasound-guided surgery for malignant breast

  1. Lean Six Sigma Applied to Ultrasound Guided Needle Biopsy in the Head and Neck.

    Science.gov (United States)

    Matt, Bruce H; Woodward-Hagg, Heather K; Wade, Christopher L; Butler, Penny D; Kokoska, Mimi S

    2014-07-01

    (1) Confirm the positive value stream of office-based ultrasound using Lean Six Sigma; (2) demonstrate how ultrasound reduces time to diagnosis, costs, patient inconvenience and travel, exposure to ionizing radiation, intravenous contrast, and laboratory tests. Case series with historical controls using chart review. Tertiary Veterans Administration Hospital (university-affiliated). Patients with a consult request or decision for ultrasound guided fine needle aspiration (USFNA) from 2006 to 2012. Process evaluation using Lean Six Sigma methodologies; years study conducted: 2006-2012; outcome measurements: type of diagnostic tests and imaging studies including CT scans with associated radiation exposure, time to preliminary and final cytopathologic diagnosis, episodes of patient travel. Value stream mapping prior to and after implementing office-based ultrasound confirmed the time from consult request or decision for USFNA to completion of the USFNA was reduced from a range of 0 to 286 days requiring a maximum 17 steps to a range of 0 to 48 days, necessitating only a maximum of 9 steps. Office-based USFNA for evaluation of head and neck lesions reduced costs, time to diagnosis, risks and inconvenience to patients, radiation exposure, unnecessary laboratory, and patient complaints while increasing staff satisfaction. In addition, office-based ultrasound also changed the clinical management of specific patients. Lean Six Sigma reduces waste and optimizes quality and accuracy in manufacturing. This is the first known application of Lean Six Sigma to office-based USFNA in the evaluation of head and neck lesions. The literature supports the value of office-based ultrasound to patients and health care systems. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  2. [Clinical evaluation of in-plane ultrasound-guided thoracic paravertebral block using laterally intercostal approach].

    Science.gov (United States)

    Xu, T; Li, M; Tian, Y; Song, J T; Ni, C; Guo, X Y

    2017-02-18

    To evaluate the feasibility and success rate of in-plane ultrasound-guided paravertebral block using laterally intercostal approach. In the study, 27 patients undergoing elective thoracic surgery were selected to do paravertebral block preoperatively. The fifth intercostal space was scanned by ultrasound probe which was placed along the long axis of the rib and 8 cm lateral to the midline of the spine. The needle was advanced in increments aiming at the space between the internal and innermost intercostal muscles. Once the space between the muscles was achieved, 20 mL of 0.5% (mass fraction) ropivacaine was injected and a catheter was inserted. Whether the tip of catheter was in right place was evaluated by ultrasound image. The block dermatomes of cold sensation were recorded 10, 20 and 30 min after the bolus drug was given. Then 0.2% ropivacaine was infused with 6 mL/h via the catheter by an analgesia pump postoperatively. The block dermatomes of cold sensation and pain score were recorded 1, 6, 24 and 48 h postoperatively. The first attempt success rate of catheteration was 81.48% (22/27); the tips of catheter were proved in right places after the second or third attempt in 5 patients. The median numbers of the block dermatomes 10, 20 and 30 min after the bolus drug was given were 2, 3, 4; the median numbers of block dermatomes were 5, 5, 5, 4, and of pain score were 1, 1, 2, 2 at 1, 6, 24, 48 h postoperatively; no case of bilateral block, pneumothorax or vessel puncture occurred. Thoracic paravertebral block using laterally intercostal approach is feasible, which has high success rate of block and low rate of complications.

  3. Ultrasound-Guided Fine-Needle Aspiration Biopsy in Infracentimetric Thyroid Nodules

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    Kim, Sang Su; In, Hyun Sin; Eun, Choong Ki [Busan Paik Hospital, Inje University School of Medicine, Busan (Korea, Republic of)

    2010-03-15

    The aim of this study is to determine the efficacy of ultrasound-guided fine-needle aspiration biopsy (US-FNAB) of thyroid nodules that are equal to or less than 1 cm at the maximum diameter. The US-FNABs performed on thyroid nodules from March to August 2009 were included in this study. We retrospectively evaluated the cytopathologic results as well as any complications associated with the procedure. Of the 241 thyroid nodules (range: 0.1 - 1.0 cm, mean size: 5.8 mm) in 184 patients (female: male = 164:20, mean age: 49.0 years, age range: 18 - 77 years old), the incidence of an inadequate sample was 14.1% (34/241) for the US-FNABs. Eighty six nodules were surgically removed in 62 patients, of which 15 were confirmed to be benign nodules and 71 were confirmed to be malignant nodules. The number of true positive, false positive, true negative and false negative results for US-FNAB were 59, 0, 10 and 3%, respectively, and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 95.2%, 100%, 100%, 76.9% and 95.8%, respectively. All the false negative cases were less than 3 mm at the maximal diameter. There were no serious complications in all the patients. US-FNAB was effective for the cases of thyroid nodule under 1 cm at the maximal diameter. However, a false negative result of US-FNAB should be considered for the cases of very small nodules that are less than 3 mm at the maximal diameter

  4. Diagnosis of metastatic fibrolamellar hepatocellular carcinoma by endoscopic ultrasound-guided fine needle aspiration

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    Amanda Crowe

    2011-01-01

    Full Text Available The fibrolamellar variant of hepatocellular carcinoma (FL-HCC is distinguished from other hepatocellular carcinomas (HCC by its unique clinical and pathologic features. Cytological features for this tumor on fine needle aspiration (FNA of primary tumors have been described earlier. We present here a unique case of metastatic FL-HCC diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA of mediastinal adenopathy. A 32-year-old woman with a history of oral contraceptive use presented with nausea and severe abdominal pain but no ascites or stigmata of cirrhosis. She had a past history of resection of a liver lesion. Serial computed tomography scans revealed mediastinal lymphadenopathy and the patient was referred for endoscopic ultrasound (EUS. A transesophageal EUS-FNA was performed and tissue was collected for cytological evaluation by an on-site pathologist with no knowledge of prior history. Based on morphology correlated with prior history received later, a final diagnosis of metastatic FL-HCC in the retrocardiac lymph node was rendered on the EUS-FNA samples. There are very few reports in the literature where a diagnosis of FL-HCC is rendered at unusual sites. This case highlights that EUS-FNA is a relatively non-invasive, rapid, accurate and effective modality in obtaining tissue from otherwise hard-to-reach areas. It also suggests that metastasis of FL-HCC can be observed in mediastinal nodes and that diagnosis based on cytological features can be rendered even when the tumor is identified at unusual locations.

  5. Analgesic efficacy of ultrasound-guided paravertebral block versus serratus plane block for modified radical mastectomy: A randomised, controlled trial

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    Kapil Gupta

    2017-01-01

    Full Text Available Background and Aims: Modified radical mastectomy (MRM may be associated with severe post-operative pain, leading to chronic pain syndrome. We compared the post-operative analgesic profile of two ultrasound-guided nerve blocks: Paravertebral block (PVB and serratus plane block (SPB. Methods: This double-blind, randomised study was conducted on fifty adult females, scheduled for MRM with axillary dissection. After inducing general anaesthesia with intravenous midazolam 1 mg, fentanyl 1.5 mcg/kg, propofol 1–2 mg/kg and vecuronium 0.1 mg/kg, patients were administered either ultrasound-guided thoracic PVB at T4 (n = 25 or SPB at 5th rib (n = 25 with 20 ml of 0.5% bupivacaine, both as a single level injection. Time to first rescue analgesia and morphine consumption in 4, 6, 24, 48 and 72 h by PCA pump, visual analogue scale score and any adverse effects were recorded. Quantitative variables were compared using the unpaired t-test or the Mann–Whitney U test between the two groups. Qualitative variables were compared using the Chi-square test or Fisher's exact test. Results: The duration of analgesia (mean ± Standard deviation [SD] was significantly longer in the PVB group compared to SPB group (346 ± 57 min vs. 245.6 ± 58 min, P< 0.001. The post-operative 24 h morphine consumption (mean ± SD was significantly higher in the SPB group (9.7 ± 2.1 mg compared to PVB group (6.5 ± 1.5 mg (P < 0.001. Conclusion: Ultrasound-guided SPB is an alternative analgesic technique to thoracic PVB for MRM although PVB provides a longer duration of analgesia.

  6. Ultrasound-guided foam sclerotherapy of great saphenous vein with 2% polidocanol – one-year follow-up results

    Science.gov (United States)

    Osęka, Marcin; Tworus, Robert; Gałązka, Zbigniew

    2016-01-01

    Introduction Ultrasound-guided foam sclerotherapy (UGFS) of varicose veins is a useful treatment option. It is a relatively safe method in the case of limited, small varicose veins. In theory, a justified concern could be raised that the injection of an active drug into the large superficial venous vessels may potentially cause life-threatening consequences. Aim To assess the safety and efficacy of UGFS using a 2% solution of polidocanol (Aethoxysklerol 2%) in the case of great saphenous vein incompetence. Material and methods Fifty-two patients with great saphenous vein incompetence underwent ultrasound-guided foam sclerotherapy. The efficacy criterion was the elimination of reflux measured ultrasonographically and withdrawal or decrease of complaints: 1 week, and 1, 3, 6 and 12 months after the treatment. Complications of sclerotherapy were reported during follow-up. Results Decrease or withdrawal of complaints of chronic venous insufficiency was reported in 96% of cases (50 patients). Disappearance or decrease of varicose veins was noted in all patients (100%). During examination after 12 months, full success of ultrasound was achieved in 38 (73%) cases, and 11 (21%) patients presented a partial desired effect according to the consensus from Tegernsee. Persistence of reflux longer than 1 s in the treated great saphenous vein was reported in 3 (6%) cases. Serious complications, such as deep vein thrombosis, pulmonary embolism, dyspnea, anaphylaxis, or neurological abnormalities, were not recorded. Conclusions Ultrasound-guided foam sclerotherapy of incompetent great saphenous vein and varicosities with 2% polidocanol was found to be an effective and safe method of treatment during 1 year of observation. However, longer observation is necessary. PMID:27458485

  7. [Anesthetic effect and safety of ultrasound-guided thoracic paravertebral blockade in sympathectomy for palmar hyperhidrosis: a randomized controlled trial].

    Science.gov (United States)

    Xu, Jin-Dong; Yu, Li-Na; Zhao, Da-Qiang; Xie, Liang; Zhou, Hai-Yu; Wang, Sheng

    2016-12-20

    To explore the anesthetic effect and safety of ultrasound-guided thoracic paravertebral blockade in video-assisted thoracoscopic sympathectomy for treatment of palmar hyperhidrosis. A total of 120 patients undergoing video-assisted thoracoscopic sympathectomy for moderate or severe hyperhidrosis were randomized to receive ultrasound-guided thoracic paravertebral blockade (group A, n=60) or general anesthesia with tracheal intubation (group B, n=60). In both groups routine monitoring and radial artery catheterization were used. The patients in group A were given oxygen inhalation via a nasal tube after thoracic paravertebral blockade, and those in group B had intratracheal intubation. Blood gas analyses were conducted 5 min before and 5 min after the operation and the clinical outcomes and complications were recorded in each group. All the patients completed the operations safely and none of the patients with thoracic paravertebral blockade required conversion to general anesthesia. Significant differences were recorded between groups A and B in anesthetic preparation time (6.26∓2.09 vs 46.32∓15.76 min), awakening time (6.26∓2.09 vs 46.32∓15.76 min), and mean hospitalization expense (6355.54∓426.00 vs 8932.25∓725.98 RMB Yuan). Compared with those in group B, the patients in group A showed a significantly lower rate of postoperative throat discomfort (0% vs 100%), a shorter monitoring time (2 h vs 12 h), and faster recovery time for food intake (2 h vs 6 h). The parameters of artery blood gas analysis both before and after the operation were similar between the two groups, but the postoperative variations differed significantly between the two groups in pH value and PaCO2 but not in PaO2. Ultrasound-guided thoracic paravertebral blockade is safe and effective in video-assisted thoracoscopic sympathectomy for palmar hyperhidrosis and is associated with less complications and better postoperative recovery.

  8. ULTRASOUND-GUIDED INJECTIONS IN HORSES WITH CRANIOVENTRAL DISTENSION OF THE COXOFEMORAL JOINT CAPSULE: FEASIBILITY FOR A CRANIOVENTRAL APPROACH.

    Science.gov (United States)

    Whitcomb, Mary Beth; Vaughan, Betsy; Katzman, Scott; Hersman, Jake

    2016-01-01

    Intrasynovial access to the equine coxofemoral joint (CFJ) is inherently challenging. Blind injection techniques rely upon inconsistently palpable landmarks, and ultrasound guidance requires expertise for needle placement into the coxofemoral articulation. Aspiration is recommended to confirm intrasynovial placement and avoid sciatic nerve anesthesia. The aim of this observational, descriptive, retrospective study was to evaluate the feasibility for an alternative ultrasound-guided approach in horses with cranioventral distention of the CFJ identified during pelvic ultrasound. Thirteen horses with cranioventral CFJ distention, including 12 with severe pathology, were recruited from 2009 to 2014. Seven were excluded as they were not injected or underwent ultrasound-guided injection using a dorsal approach. The remaining six horses underwent a total of nine injections into the cranioventral recess. With the exception of one foal, all were aged horses (15-29 years) of varying breeds and uses, with prominent lameness due to subluxation (three), luxation (two), and severe osteoarthritis (one). The cranioventral recess was imaged adjacent to the proximal femur using a low-frequency curvilinear transducer placed ventral to the cranial joint margins. Using aseptic technique, spinal needles were placed cranial to the transducer and advanced caudomedially into the distended cranioventral recess. Synovial fluid was retrieved in all cases with one needle placement. Findings indicated that, when distended, ultrasound-guided access to the cranioventral CFJ recess is a feasible alternative approach and may reduce the potential for extra-synovial placement. Distention in this sample of horses was accompanied by severe pathology, also supporting the use of this approach for therapeutic interventions.

  9. Technical communication: new teaching model for practicing ultrasound-guided regional anesthesia techniques: no perishable food products!

    Science.gov (United States)

    Liu, Yang; Glass, Nancy L; Power, Robert W

    2010-04-01

    There is a pronounced learning curve for the technique of ultrasound-guided regional anesthesia. Practicing with a simulator model has been shown to speed the acquisition of these skills for various ultrasound-guided procedures. However, commercial models for ultrasound-guided regional anesthesia may be too costly or not readily available. Models using turkey breasts or tofu blocks have the disadvantage of containing perishable food products that can be a source for infection. We describe an alternative inexpensive model that is made from nonperishable components readily available in the operating room. The materials required include 1 clean used 500-mL bag of IV fluids, a bottle of Premisorb (TYCO Healthcare Group, Mansfield, MA), and a piece of foam material approximately 0.3 cm in diameter and 5 cm in length trimmed from operating room foam pads. After filling the IV bag with tap water and inserting the foam into the IV bag from the outlet port of the IV bag, one-third of a bottle of Premisorb (approximately 15 g) is poured into the IV bag. The outlet port of the bag is then sealed by taping the rubber stopper that originally came with the bag. Premisorb, a solidifying agent frequently used to absorb irrigating fluids or blood in operating room suction canisters, produces a gel-like material in the IV bag. The foam inserted into the bag creates a relatively hyperechoic target. This gel-like substance in the bag will seal the holes created after multiple practice needle insertions, resulting in minimal leakage. The semitransparent nature of the gel allows the trainee to visualize the target directly and on the ultrasound screen. The model we describe is inexpensive and easy to make from materials readily available in the operating room with the advantages of being nonperishable, easy to carry, and reusable.

  10. Ultrasound guided percutaneous treatment and follow-up of Baker's cyst in knee osteoarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Koeroglu, Mert, E-mail: mertkoroglu@hotmail.com [Antalya Education and Research Hospital, Department of Radiology, Antalya (Turkey); Call Latin-Small-Letter-Dotless-I oglu, Mehmet, E-mail: mehmetcallioglu@hotmail.com [Sueleyman Demirel University, Faculty of Medicine, Department of Radiology, Isparta (Turkey); Eris, Hueseyin Naim, E-mail: drhneris@hotmail.com [Sueleyman Demirel University, Faculty of Medicine, Department of Radiology, Isparta (Turkey); Kayan, Mustafa, E-mail: drkayan32@hotmail.com [Sueleyman Demirel University, Faculty of Medicine, Department of Radiology, Isparta (Turkey); Cetin, Meltem, E-mail: meltemcetin2011@yahoo.com [Sueleyman Demirel University, Faculty of Medicine, Department of Radiology, Isparta (Turkey); Yener, Mahmut, E-mail: bahtiyaryener@yahoo.com [Sueleyman Demirel University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Isparta (Turkey); Guerses, Cemil, E-mail: cemilgurses@gmail.com [Antalya Education and Research Hospital, Department of Radiology, Antalya (Turkey); Erol, Bekir, E-mail: mertkoroglu@hotmail.com [Antalya Education and Research Hospital, Department of Radiology, Antalya (Turkey); Tuerkbey, Bar Latin-Small-Letter-Dotless-I s, E-mail: bturkbey@yahoo.com [Hacettepe University, Faculty of Medicine, Department of Radiology, Ankara (Turkey); Parlak, Ayse Eda, E-mail: drteda@yahoo.com [Antalya Education and Research Hospital, Department of Radiology, Antalya (Turkey); Akhan, Okan, E-mail: akhano@tr.net [Hacettepe University, Faculty of Medicine, Department of Radiology, Ankara (Turkey)

    2012-11-15

    Objective: Purpose of this study is to assess sonographic changes and clinical response in different subgroups of Baker's cyst patients with knee osteoarthritis after a single session of ultrasound-guided percutaneous aspiration and corticosteroid injection. Materials and methods: Thirty-two knee osteoarthritis patients (46-85 years, mean 58.97 {+-} 9.88) with symptomatic Baker's cyst diagnosed at ultrasonography were included in the study. To determine the grade of the symptoms, Visual Analogue Scale was applied. The patients were grouped in two, as simple (n = 24) and complex (n = 8) Baker's cyst. Thirty-two ultrasound-guided cyst aspirations concomitant 1 ml betamethasone injection (24 simple, 8 complex subgroups) were performed. Patients were followed clinically as well as via ultrasonography for 6 months after procedures. Results: A significant decrease in volume of the Baker's cysts after percutaneous treatment was accompanied by a significant clinical improvement. Moreover, the volume reduction of Baker's cyst after the treatment was significantly correlated with the clinical improvement (Pearson correlation coefficient = 0.542, p = 0.001). All 6 Baker's cysts relapsed at ultrasonography were complex type. Furthermore, a comparison of patients with simple Baker's cysts and those with complex Baker's cysts demonstrated no significant change in Visual Analogue Scale scores between two groups (p = 0.061, Mann-Whitney U). No complications (minor or major) occurred secondary to percutaneous treatment. Conclusion: Baker's cysts can be grouped as simple and complex groups via ultrasonography prior to the treatment. Cyst aspiration with ultrasound-guided corticosteroid injection yields clinical improvement and cyst volume reduction in all subgroups of patients with Baker's cyst secondary to knee osteoarthritis.

  11. Rapid induction of orthotopic hepatocellular carcinoma in immune-competent rats by non-invasive ultrasound-guided cells implantation

    Directory of Open Access Journals (Sweden)

    Pan Huay-Ben

    2010-07-01

    Full Text Available Abstract Background The fact that prognoses remain poor in patients with advanced hepatocellular carcinoma highlights the demand for suitable animal models to facilitate the development of anti-cancer medications. This study employed a relatively non-invasive approach to establish an orthotopic hepatocellular carcinoma model in immune-competent rats. This was done by ultrasound-guided implantation of cancer cells and the model was used to evaluate the therapeutic efficacy of short-term and low-dose epirubicin chemotherapy. Methods Rat Novikoff hepatoma cells were injected percutaneously into the liver lobes of Sprague-Dawley rats under the guidance of high resolution ultrasound. The implantation rate and the correlation between dissected and ultrasound-measured tumor sizes were evaluated. A similar induction procedure was performed by means of laparotomy in a different group of rats. Pairs of tumor measurement were compared by ultrasound and computerized tomography scan. Rats with a successful establishment of the tumor were divided into the treatment (7-day low-dose epirubicin group and the control group. The tumor sizes were non-invasively monitored by the same ultrasound machine. Blood and tumor tissues from tumor-bearing rats were examined by biochemical and histological analysis respectively. Results Ultrasound-guided implantation of Novikoff hepatoma cells led to the formation of orthotopic hepatocellular carcinoma in 60.4% (55/91 of the Sprague-Dawley rats. Moreover, tumor sizes measured by ultrasound significantly correlated with those measured by calipers after sacrificing the animals (P Conclusions Ultrasound-guided implantation of Novikoff hepatoma cells is an effective means of establishing orthotopic hepatocellular carcinoma in Sprague-Dawley rats. Short-term and low-dose epirubicin chemotherapy had perturbed tumor progression by inducing apoptosis and neovascularization blockade.

  12. Efficacy of ultrasound-guided transversus abdominis plane block for postoperative analgesia in patients undergoing inguinal hernia repair

    Directory of Open Access Journals (Sweden)

    Venkatraman R

    2016-01-01

    Full Text Available Rajagopalan Venkatraman, Ranganathan Jothi Abhinaya, Ayyanar Sakthivel, Govindarajan Sivarajan Department of Anaesthesia, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India Background and aim: Transversus abdominis plane block (TAP block is a novel procedure to provide postoperative analgesia following inguinal hernia surgery. The utilization of ultrasound has greatly augmented the success rate of this block and additionally avoiding complications. The aim of our study was to gauge the analgesic efficacy of ultrasound-guided TAP block in patients undergoing unilateral inguinal hernia repair. Materials and methods: Sixty patients scheduled for elective inguinal hernia repair were selected for the study. At the end of the surgical procedure, they were randomly divided into two groups. Ultrasound-guided TAP block was performed with 20 mL of ropivacaine 0.2% (group A or normal saline (group B. Visual analog scale (VAS scores were used to assess pain. Paracetamol was given if VAS >3 and tramadol was used when VAS >6. Patients were monitored for VAS scores and total analgesic consumption for the 24-hour period. Results: The TAP block with ropivacaine (group A reduced VAS scores at 4, 6, and 12 hours. There was no distinction in VAS scores at 0, 2, and 24 hours between the two groups. The duration of analgesia for TAP block with ropivacaine lasted for 390 minutes. Total analgesics consumption was also significantly reduced in group A than group B. No complication was reported to TAP block in both the groups. Conclusion: The ultrasound-guided TAP block provides good postoperative analgesia, reduces analgesic requirements, and provides good VAS scores with fewer complications following inguinal hernia surgery. Keywords: inguinal hernia repair, postoperative analgesia, ropivacaine, transversus abdominis block, ultrasound

  13. 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.

  14. Ultrasound-guided alcohol neurolysis and radiofrequency ablation of painful stump neuroma: effective treatments for post-amputation pain

    Directory of Open Access Journals (Sweden)

    Zhang X

    2017-02-01

    Full Text Available Xin Zhang, Yongming Xu, Jin Zhou, Shaofeng Pu, Yingying Lv, Yueping Chen, Dongping Du Pain Management Center, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, People’s Republic of China Background: Post-amputation pain (PAP is highly prevalent after limb amputation, and stump neuromas play a key role in the generation of the pain. Presently, PAP refractory to medical management is frequently treated with minimally invasive procedures guided by ultrasound, such as alcohol neurolysis and radiofrequency ablation (RFA.Objective: To record the immediate and long-term efficacy of alcohol neurolysis and RFA. We first used alcohol neurolysis and then, when necessary, we performed RFA on PAP patients.Study design: Prospective case series.Setting: Pain management center.Methods: Thirteen subjects were treated with ultrasound-guided procedures.Results: All patients were treated with neurolysis using alcohol solutions guided by ultrasound. Seven (54% of 13 subjects achieved pain relief after 1–3 alcohol injection treatments. The remaining 6 subjects obtained pain relief after receiving 2 administrations of ultrasound-guided RFA. After a 6-month follow-up evaluation period, pain quantities were also assessed. Both stump pain (including intermittent sharp pain and continuous burning pain and phantom pain were relieved. The frequency of intermittent sharp pain was decreased, and no complications were noted during the observation.Conclusion: The use of ultrasound guidance for alcohol injection and RFA of painful stump neuromas is a simple, radiation-free, safe, and effective procedure that provides sustained pain relief in PAP patients. In this case series, RFA was found to be an effective alternative to alcohol injection. Keywords: post-amputation pain, neuroma, ultrasound-guided, alcohol neurolysis, radiofrequency ablation

  15. Ultrasound guided injection of dexamethasone versus placebo for treatment of plantar fasciitis: protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Gilheany Mark F

    2010-07-01

    Full Text Available Abstract Background Plantar fasciitis is the most commonly reported cause of chronic pain beneath the heel. Management of this condition commonly involves the use of corticosteroid injection in cases where less invasive treatments have failed. However, despite widespread use, only two randomised trials have tested the effect of this treatment in comparison to placebo. These trials currently offer the best available evidence by which to guide clinical practice, though both were limited by methodological issues such as insufficient statistical power. Therefore, the aim of this randomised trial is to compare the effect of ultrasound-guided corticosteroid injection versus placebo for treatment of plantar fasciitis. Methods The trial will be conducted at the La Trobe University Podiatry Clinic and will recruit 80 community-dwelling participants. Diagnostic ultrasound will be used to diagnose plantar fasciitis and participants will be required to meet a range of selection criteria. Participants will be randomly allocated to one of two treatment arms: (i ultrasound-guided injection of the plantar fascia with 1 mL of 4 mg/mL dexamethasone sodium phosphate (experimental group, or (ii ultrasound-guided injection of the plantar fascia with 1 mL normal saline (control group. Blinding will be applied to participants and the investigator performing procedures, measuring outcomes and analysing data. Primary outcomes will be pain measured by the Foot Health Status Questionnaire and plantar fascia thickness measured by ultrasound at 4, 8 and 12 weeks. All data analyses will be conducted on an intention-to-treat basis. Conclusion This will be a randomised trial investigating the effect of dexamethasone injection on pre-specified treatment outcomes in people with plantar fasciitis. Within the parameters of this protocol, the trial findings will be used to make evidence-based recommendations regarding the use of corticosteroid injection for treatment of this

  16. Seeding after ultrasound-guided percutaneous biopsy of liver metastases in patients with colorectal or breast cancer

    DEFF Research Database (Denmark)

    Chen, Inna; Lorentzen, Torben; Linnemann, Dorte;

    2015-01-01

    BACKGROUND: Neoplasm seeding is a serious complication after liver metastases biopsy. Reported incidences vary between 10% and 19% for colorectal cancer (CRC) and are unknown for breast cancer (BC). The aim of this retrospective study was to determine the frequency of tumor seeding after ultrasound......-guided percutaneous biopsy of CRC and BC liver metastases. MATERIAL AND METHODS: Unselected liver biopsies performed in the period of 2005-2012 at our institution were extracted from the National Pathology Registry. Medical records including imaging from patients with biopsy-verified BC and CRC liver metastases were...

  17. 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, 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...

  18. 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).

  19. The value of mediastinal staging with endobronchial ultrasound-guided transbronchial needle aspiration in patients with lung cancer

    DEFF Research Database (Denmark)

    Ømark, Henrik; Eckardt, Jens; Hakami, Ardeshir

    2009-01-01

    OBJECTIVE: To evaluate the diagnostic yield, the learning curve and the safety of endobronchial ultrasound-guided transbronchial needle biopsy (EBUS-TBNA) in mediastinal staging of patients with lung cancer. METHODS: Mediastinal staging was performed with EBUS-TBNA according to the Danish nationa......-TBNA is in accordance with the yield of standard cervical mediastinoscopy reported in the literature. We do not find any indications in the present study of the recommended necessity for mediastinoscopy in all EBUS-TBNA-negative patients....

  20. Ultrasound-Guided Suprainguinal Fascia Iliaca Technique Provides Benefit as an Analgesic Adjunct for Patients Undergoing Total Hip Arthroplasty.

    Science.gov (United States)

    Bullock, W Michael; Yalamuri, Suraj M; Gregory, Stephen H; Auyong, David B; Grant, Stuart A

    2017-02-01

    Analgesia after total hip arthroplasty is often accomplished by the fascia iliaca compartment block, traditionally performed below the inguinal ligament, to anesthetize both femoral and lateral femoral cutaneous nerves. The course of the lateral femoral cutaneous nerve below the inguinal ligament is variable as opposed to consistent above the inguinal ligament in the pelvis. In this case series including 5 patients, we demonstrate that an ultrasound-guided suprainguinal fascia iliaca approach would consistently anesthetize the lateral femoral cutaneous nerve along with anterior cutaneous femoral nerve branches and provide cutaneous analgesia after total hip arthroplasty, as shown by decreased opioid consumption.

  1. Ultrasound guided neural stem cell transplantation through the lateral ventricle for treatment of cerebral palsy in children.

    Science.gov (United States)

    He, Sheng; Luan, Zuo; Qu, Suqing; Qiu, Xuan; Xin, Daqing; Jia, Wenkai; Shen, Yanhua; Yu, Zehui; Xu, Tao

    2012-11-15

    A total of 24 children with cerebral palsy were enrolled in this study and underwent ultrasound guided transplantation of neural stem cells through the lateral ventricle. Neural stem cells (3.8 × 10(6)-7.3 × 10(7)) were injected into the lateral ventricles. Mild injury of lateral ventricular blood vessels occurred in only two cases (8.3%). Seven cases (29.2%) experienced a fever. Clinical manifestations were improved to varying degrees in eight cases (28.0%) within 3 months after transplantation. Patient condition did not worsen, and no patient experienced severe adverse reactions.

  2. Practical guidelines for ultrasound-guided core needle biopsy of soft-tissue lesions: Transformation from beginner to specialist

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Yoon; Chung, Hye Won; Oh, Tack Sun; Lee, Jong Seok [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2017-04-15

    Ultrasound-guided core needle biopsy (US-CNB) is an important step in the diagnosis of musculoskeletal soft-tissue lesions. To maximize efficacy and minimize the complications of US-CNB, it is critical to collaborate with a multidisciplinary team and to understand the particular considerations of US-CNB for these lesions. The purpose of this article is to provide a systematic review and step-by-step tips for using US-CNB to diagnose musculoskeletal soft-tissue lesions.

  3. Ultrasound-guided percutaneous drainage and sclerotherapy in a patient with isolated autosomal dominant polycystic liver disease

    Directory of Open Access Journals (Sweden)

    Ana Barbado-Cano

    2015-03-01

    Full Text Available Isolated polycystic liver disease (IPLD is a rare genetic condition characterized by the presence of multiple liver cysts with no association with polycystic kidney disease. Most patients are asymptomatic and acute complications (cyst torsion, bleeding, infection are uncommon. Imaging techniques, including abdominal ultrasounds, computerized axial tomography, and magnetic resonance imaging, represent a vital diagnostic modality. They are also useful for therapy support in this disease. Below we report a peculiar case of a female patient recently diagnosed with IPLD who, having received treatment with ultrasound-guided percutaneous drainage and sclerotherapy for a giant liver cyst, showed symptom and laboratory improvement.

  4. Ultrasound guided neural stem cell transplantation through the lateral ventricle for treatment of cerebral palsy in children☆

    Institute of Scientific and Technical Information of China (English)

    Sheng He; Zuo Luan; Suqing Qu; Xuan Qiu; Daqing Xin; Wenkai Jia; Yanhua Shen; Zehui Yu; Tao Xu

    2012-01-01

    A total of 24 children with cerebral palsy were enrolled in this study and underwent ultrasound guided transplantation of neural stem cells through the lateral ventricle. Neural stem cells (3.8 × 106–7.3 × 107) were injected into the lateral ventricles. Mild injury of lateral ventricular blood vessels occurred in only two cases (8.3%). Seven cases (29.2%) experienced a fever. Clinical manifestations were improved to varying degrees in eight cases (28.0%) within 3 months after transplantation. Patient condition did not worsen, and no patient experienced severe adverse reactions.

  5. Magnetic resonance spectroscopic imaging 3T and prostate cancer: correlation with transperineal ultrasound guided prostate biopsy.

    Science.gov (United States)

    Castellucci, Roberto; Altieri, Vincenzo Maria; Marchioni, Michele; Castellan, Pietro; Pellegrini, Maurizio; Álvarez-Maestro, Mario; Sánchez-Gómez, Javier; De Francesco, Piergustavo; Ingrosso, Manuela; Tartaro, Armando; Tenaglia, Raffaele Lanfranco

    2015-06-01

    The aim of our study was to correlate the results obtained by 3T Magnetic Resonance Spectroscopic Imaging (MRSI3T) with those obtained by histological examination of samples of the trans-perineal ultrasound-guided prostate biopsy (TPUS-B). 34 patients were enrolled in the study. All patients had a clinical suspicion of cancer due to increased PSA and/or positive digital rectal examination. Patients were subjected to an MRSI 3T examination and subsequently to TPUS-B. Of the 22 (22/34) patients who presented abnormalities MRSI at 3T, 9 had a histological diagnosis of Prostate adenocarcinoma. Of the remaining 13 patients, 6 were found to be histologically positive for Benign Prostatic Hypertrophy and 7 Chronic Interstitial Inflammation or High Grade Prostatic Intraepithelial Neoplasia. 12 (12/34) patients found to have no peripheral alterations in their prostate on 3T MRSI, none were positive for ADK or inflammation on histology. The sensitivity, specificity, positive predictive value and negative predictive value were 100%, 48%, 40% and 100% respectively. In this study, we correlated the values obtained from 3T MRSI with the results of histologically examined prostate biopsies. Our work shows that 72.8% of the voxels in which there was a change in ratio of Cit/(Cho + Cr), corresponded to areas of prostate tissue disease. Of these, 73.2% were positive for ADK and 26.8% for CII or HG PIN. In literature, it is noted that PCa can be distinguished from areas of benign tissue, in the peripheral zone, on the basis of the values of the ratio Cit/(Cho + Cr) (17), although some benign conditions, such as prostatitis or PINHG, can alter these values (18-19). In conclusion, the use of MRSI 3T before performing prostate biopsies may represent a valid aid for the urologist in the diagnosis of PCa, allowing them to avoid unnecessary prostate biopsies that may be negative. Furthermore, it would also be possible to reduce the total number of biopsies, thus decreasing patient exposure

  6. Adapting Gel Wax into an Ultrasound-Guided Pericardiocentesis Model at Low Cost.

    Science.gov (United States)

    Daly, Robert; Planas, Jason H; Edens, Mary Ann

    2017-01-01

    Cardiac tamponade is a life-threatening emergency for which pericardiocentesis may be required. Real-time bedside ultrasound has obviated the need for routine blind procedures in cardiac arrest, and the number of pericardiocenteses being performed has declined. Despite this fact, pericardiocentesis remains an essential skill in emergency medicine. While commercially available training models exist, cost, durability, and lack of anatomical landmarks limit their usefulness. We sought to create a pericardiocentesis model that is realistic, simple to build, reusable, and cost efficient. We constructed the model using a red dye-filled ping pong ball (simulating the right ventricle) and a 250cc normal saline bag (simulating the effusion) encased in an artificial rib cage and held in place by gel wax. The inner saline bag was connected to a 1L saline bag outside of the main assembly to act as a fluid reservoir for repeat uses. The entire construction process takes approximately 16-20 hours, most of which is attributed to cooling of the gel wax. Actual construction time is approximately four hours at a cost of less than $200. The model was introduced to emergency medicine residents and medical students during a procedure simulation lab and compared to a model previously described by dell'Orto.1 The learners performed ultrasound-guided pericardiocentesis using both models. Learners who completed a survey comparing realism of the two models felt our model was more realistic than the previously described model. On a scale of 1-9, with 9 being very realistic, the previous model was rated a 4.5. Our model was rated a 7.8. There was also a marked improvement in the perceived recognition of the pericardium, the heart, and the pericardial sac. Additionally, 100% of the students were successful at performing the procedure using our model. In simulation, our model provided both palpable and ultrasound landmarks and held up to several months of repeated use. It was less expensive

  7. Balloon dilation versus Amplatz dilation during ultrasound-guided percutaneous nephrolithotomy for staghorn stones

    Institute of Scientific and Technical Information of China (English)

    Ren Minghua; Zhang Cheng; Fu Weijun; Fu Yiming; Ma Li; Zhao Weiming; Xu Wanhai

    2014-01-01

    Background Amplatz dilation and balloon dilation are different methods in creating the accesses during percutaneous nephrolithotomy (PCNL).The aim of this study was to review the surgical experiences of managing staghorn calculi by Amplatz dilation and balloon dilation for 3 years.Methods We retrospectively analyzed clinical data from 125 patients (129 kidneys)with staghorn kidney stones who underwent PCNL from January 2010 to December 2012,of whom 60 patients underwent Amplatz dilation (AD group) and 65 underwent balloon dilation (BD group) during PCNL.Results The AD and BD groups were similar in age,male-female ratio,stone burden,stone type,hydronephrosis,and proportion of patients who had undergone extracorporeal lithotripsy.However,these two groups showed significant differences in terms of duration of percutaneous access (15.1±3.6) minutes vs.(10.0±3.3) minutes,one-attempt success rate of dilation via a single access 88.9% (72/81) vs.97.8% (91/93),hemoglobin drop after surgery (3.5±0.9) g/dl vs.(1.7±0.9) g/dl,number of cases requiring intraoperative and postoperative blood transfusion 27.9% (n=17) vs.13.2% (n=9),changes of central venous pressure before and after surgery (2.3±1.2) cmH2O vs.(1.2±0.7) cmH2O,number of patients who experienced postoperative fever >37.5℃ 21 (34.4%) vs.13 (19.1%) (all P <0.05).No injury of adjacent organs,including pleura,liver,spleen,or bowel,was noted in patients.Conclusions During ultrasound-guided PCNL for staghorn stones,balloon dilation and Amplatz dilation are all effective and safe.Compared with Amplatz dilation,balloon dilation is a better choice,as it has a higher access creation success rate,shorter access creation time less blood loss,and lower proportions of circulatory overload and postoperative fever.

  8. FaceTime(®) for teaching ultrasound-guided anesthetic procedures in remote place.

    Science.gov (United States)

    Miyashita, Tetsuya; Iketani, Yasuhiro; Nagamine, Yusuke; Goto, Takahisa

    2014-04-01

    In isolated area in Japan, only one anesthesiologist must often do new anesthetic techniques such as ultrasound-guided procedures without receiving any teaching. One solution to this problem may involve teleanesthesia, by which experienced anesthesiologists teach novices in remote places, by utilizing information communication technologies. FaceTime™ (Apple, USA), which provides 120p of the resolution and 30 frames per second (fps) is an application of free visual communications using iPod Touch™, iPhone™ or iPad™ (Apple, USA). We investigated the delay time, the loss of the frames and the picture quality of iPad (as the device in the teaching site) in combination with iPod Touch, iPhone4 or iPhone5 (as the device in the isolated site) during FaceTime. At the operating rooms in Sado General Hospital (SGH) located in Sado Island (population; approximately 60,000), Japan, an anesthesiologist prepared 3 mobile devices (iPod Touch, iPhone4 or iPhone5). He called the other anesthesiologist at Yokohama City University Hospital (YCUH; approximately 300 km apart) by FaceTime using 1 of 3 mobile devices. The anesthesiologist at YCUH received the FaceTime call using iPad. After the connection was established, the display of the same cervical ultrasound image at SGH was sent to YCUH to evaluate the distinctness visually. Then we measured the delay time of every second (n = 60) and the loss of the frames (total frames = 30 fps × 60 s = 1,800) in each device for a minute. P iPod Touch; 0.14 ± 0.02 s, iPhone4; 0.13 ± 0.02 s, iPhone5; 0.19 ± 0.03 s), but clinically acceptable. The loss of the frames of iPhone5 (20; 1.1%) was significantly less than the others (iPhone4; 900, 50.0%, iPod Touch; 902, 50.1%). To teach anesthetic techniques in remote place by FaceTime, iPhone5 as the devise in isolate site was optimum compared with iPod Touch and iPhone4.

  9. Ultrasound guided percutaneous cholecystostomy in high-risk patients for surgical intervention

    Institute of Scientific and Technical Information of China (English)

    Huseyin Bakkaloglu; Hakan Yanar; Recep Guloglu; Korhan Taviloglu; Fatih Tunca; Murat Aksoy; Cemalettin Ertekin; Arzu Poyanli

    2006-01-01

    AIM: To assess the efficacy and safety of ultrasound guided percutaneous cholecystostomy (PC) in the treatment of acute cholecystitis in a well-defined high risk patients under general anesthesia.METHODS: The data of 27 consecutive patients who underwent percutaneous transhepatic cholecystostomy for the management of acute cholecystitis from January 1999 to June 2003 was retrospectively evaluated. All of the patients had both clinical and sonographic signs of acute cholecystitis and had comorbid diseases.RESULTS: Ultrasound revealed gallbladder stones in 25 patients and acalculous cholecystitis in two patients.Cholecystostomy catheters were removed 14-32 d (mean 23 d) after the procedure in cases where complete regression of all symptoms was achieved. There were statistically significant reductions in leukocytosis, (13.7× 103± 1.3× 103μg/L vs 13× 103± 1× 103μg/L,P<0.05 for 24 h after PC; 13.7 × 103 ± 1.3 × 103 μg/L vs8.3 × 103 ± 1.2 × 103 μg/L, P < 0.0001 for 72 h after PC), C -reactive protein (51.2 ± 18.5 mg/L vs 27.3 ±10.4 mg/L, P < 0.05 for 24 h after PC; 51.2 ± 18.5 mg/Lvs 5.4 ± 1.5 mg/L, P < 0.0001 for 72 h after PC), and fever (38 ± 0.35℃ vs 37.3 ± 0.32℃, P < 0.05 for 24h after PC; 38 ± 0.35℃ vs 36.9 ± 0.15℃, P < 0.0001 for 72 h after PC). Sphincterotomy and stone extraction was performed successfully with endoscopic retrograde cholangio-pancreatography (ERCP) in three patients.After cholecystostomy, 5 (18%) patients underwent delayed cholecystectomy without any complications.Three out of 22 patients were admitted with recurrent acute cholecystitis during the follow-up and recovered with medical treatment. Catheter dislodgement occurred in three patients spontaneously, and two of them were managed by reinsertion of the catheter.CONCLUSION: As an alternative to surgery, percutaneous cholecystostomy seems to be a safe method in critically ill patients with acute cholecystitis and can be performed with low mortality

  10. Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in intrapulmonary lesions

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    ZHAO Hui; XIE Zhen; ZHOU Zu-li; SUI Xi-zhao; WANG Jun

    2013-01-01

    Background Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is considered to have high value in the staging of mediastinal lymph nodes in lung cancer.The current study was conducted to investigate the diagnostic value of EBUS-TBNA in intrapulmonary lesions located near the central airway.Methods From September 2009 to March 2013,66 patients with pulmonary masses located close to the central airways suspected to be lung cancer were accessed by EBUS-TBNA.Conventional bronchoscopic biopsy before EBUS-TBNA was nondiagnostic in all cases.If EBUS-TBNA did not result in a formal pathological diagnosis of malignancy,patients were subsequently referred for a surgical procedure.Results Among the 66 cases,59 were confirmed as pulmonary malignancies by EBUS-TBNA,of which 48 cases were non-small cell lung cancer,nine were small cell lung cancer,and two were metastatic lung tumors.No evidence of malignancy was found by biopsy and histopathological examination in the other seven cases.Thoracoscopy or thoracotomy was subsequently undergone for them.Postoperative pathological examinations confirmed three cases of squamous cell carcinoma of the lung,one case of lymphoma,two cases of sclerosing hemangioma,and one case of pulmonary tuberculoma.The definitive diagnosis rate of EBUS-TBNA for intrapulmonary lesions near the central airway was 89.4%.The sensitivity,specificity,and accuracy of EBUS-TBNA in distinguishing benign from malignant intrapulmonary lesions were 93.7%,100.0%,and 93.9%,respectively.The positive and negative predictive values were 100.0% and 42.9%,respectively.The EBUS-TBNA procedures were well-tolerated by all patients.No associated complications were observed.Conclusions For intrapulmonary lesions near the central airway highly suspected of cancer,EBUS-TBNA has satisfactory diagnostic value.However,the negative predictive value of this technique is low,so negative results obtained by EBUS-TBNA should be confirmed by other

  11. The role of sedation in endobronchial ultrasound-guided transbronchial needle aspiration: Systematic review

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    Aswanetmanee, Pantaree; Limsuwat, Chok; Kabach, Mohamad; Alraiyes, Abdul Hamid; Kheir, Fayez

    2016-01-01

    Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure that has become an important tool in diagnosis and staging of mediastinal lymph node (LN) lesions in lung cancer. Adequate sedation is an important part of the procedure since it provides patient's comfort and potentially increases diagnostic yield. We aimed to compare deep sedation (DS) versus moderate sedation (MS) in patients undergoing EBUS-TBNA procedure. Methods: PubMed, EMBASE, MEDLINE, and Cochrane Library were searched for English studies of clinical trials comparing the two different methods of sedations in EBUS-TBNA until December 2015. The overall diagnostic yield, LN size sampling, procedural time, complication, and safety were evaluated. Results: Six studies with 3000 patients which compared two different modalities of sedation in patients performing EBUS-TBNA were included in the study. The overall diagnostic yield of DS method was 52.3%–100% and MS method was 46.1%–85.7%. The overall sensitivity of EBUS-TBNA of DS method was 98.15%–100% as compared with 80%–98.08% in MS method. The overall procedural times were 27.2–50.9 min and 20.6-44.1 min in DS and MS groups, respectively. The numbers of LN sampled were between 1.33–3.20 nodes and 1.36–2.80 nodes in DS and MS groups, respectively. The numbers of passes per LN were 3.21–3.70 passes in DS group as compared to 2.73–3.00 passes in MS group. The mean of LN size was indifferent between two groups. None of the studies included reported serious adverse events. Conclusions: Using MS in EBUS-TBNA has comparable diagnostic yield and safety profile to DS. The decision on the method of sedation for EBUS-TBNA should be individually selected based on operator experience, patient preference, as well as duration of the anticipated procedure. PMID:27803902

  12. Pathological fracture of the patella due to an atypical located aneurysmal bone cyst: verification by means of ultrasound-guided biopsy.

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    Plaikner, Michaela; Gruber, Hannes; Henninger, Benjamin; Gruber, Leonhard; Kosiol, Juana; Loizides, Alexander

    2016-03-01

    We report on a rare case of an atypical located aneurysmal bone cyst (ABC) in the patella presenting with pathological fracture after trauma. Using all available diagnostic modalities and by means of ultrasound-guided core-needle biopsy an unclear and suspected pathological fractured cystic bone lesion in the patella of a young man could be further clarified. The acquired images suggested the diagnosis of a pathological fractured aneurysmal bone cyst after mild trauma. However, due to the extraordinary location and clinical presentation the diagnosis was secured by means of ultrasound-guided biopsy through a small cortical gap. As shown in this rare case of an atypical aneurysmal bone cyst of the patella, the quite seldom but sometimes possible ultrasound-guided biopsy of intraosseous lesions can help to achieve the diagnostic clarification and should also be taken into account as a non-standard procedure.

  13. Transrectal Drainage of Deep Pelvic Abscesses Using a Combined Transrectal Sonographic and Fluoroscopic Guidance

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    Jeong, Kyung Soon; Lee, Eun Jung; Ko, Ji Ho; Joh, Young Duk [Gospel Hospital, Kosin University College of Medicine, Busan (Korea, Republic of); Jung, Gyoo Sik [Ulsan Hospital, Ulsan (Korea, Republic of)

    2005-09-15

    To evaluate the feasibility and clinical efficacy of transrectal drainage of a deep pelvic abscess using combined transrectal sonographic and fluoroscopic guidance. From March 1995 and August 2004, 17 patients (9 men; 8 women; mean age, 39 years) suffering from pelvic pain, fever and leukocytosis were enrolled in this retrospective study. Ultrasound (US) or computed tomography (CT), which was obtained prior to the procedure, showed pelvic fluid collections that were deemed unapproachable by the percutaneous trans abdominal routes. Transrectal drainage of the pelvic abscess was performed under combined transrectal sonographic and fluoroscopic guidance. The causes of the deep pelvic abscess were postoperative complications (n=7), complications associated with radiation (n=3) and chemotherapy (n=1) as well as unknown causes (n=6). A 7.5-MHz end-firing transrectal US probe with a needle biopsy guide attachment was advanced into the rectum. Once the abscess was identified, a needle was advanced via the biopsy guide and the abscess was punctured. Under US guidance, either a 0.018'or 0.035' guide wire was passed through the needle in the abscess. Under fluoroscopic guidance, the tract was dilated to the appropriate diameter with sequential fascial dilators, and a catheter was placed over the guide wire within the abscess. Clinical success of drainage was determined by a combination closure of the cavity on the follow up images and diminished leukocytosis. The technical and clinical success rate, complications, and patient's discomfort were analyzed. Drainage was technically successful in all patients and there were no serious complications. Surgery was eventually performed in two cases due to fistular formation with the rectum and leakage of the anastomosis site. The procedure was well tolerated in all but one patient who complained of discomfort while the catheter was inserted . The catheter did not interfere with defecation and there was no incidence of

  14. Robert's uterus: modern imaging techniques and ultrasound-guided hysteroscopic treatment without laparoscopy or laparotomy.

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    Ludwin, A; Ludwin, I; Martins, W P

    2016-10-01

    Robert's uterus is a unique malformation, described as a septate uterus with a non-communicating hemicavity, consisting of a blind uterine horn usually with unilateral hematometra, a contralateral unicornuate uterine cavity and a normally shaped external uterine fundus. The main symptom in affected young women is pelvic pain that becomes intensified near menses. We describe the case of a 22-year-old woman who was referred for diagnostic assessment and treatment of a congenital uterine anomaly. We used three-dimensional sonohysterography with volume-contrast imaging, HDLive rendering mode and automatic volume calculation (SonoHysteroAVC) for the diagnosis, surgical planning and postoperative evaluation. These imaging techniques provided a complete understanding of the internal and external uterine structures, enabling us to perform a minimally invasive hysteroscopic metroplasty, guided by transrectal ultrasound, and therefore avoiding the need for laparotomy/laparoscopy. The outcome of treatment was considered satisfactory; menstruation ceased to be painful and, after two hysteroscopic procedures, the communicating 0.3-cm(3) hemicavity was visualized as a 3.6-cm(3) normalized uterine cavity using the same imaging techniques. The findings of this case report raise questions about the embryological origin of Robert's uterus, the suitability of current classification systems, and the role of more invasive approaches (laparoscopy/laparotomy) and surgical procedures (horn resection/endometrectomy) that do not aim to improve uterine cavity shape and volume in women with this condition. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

  15. Feasibility and safety of ultrasound-guided nerve block for management of limb injuries by emergency care physicians

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    Sanjeev Bhoi

    2012-01-01

    Full Text Available Background: Patients require procedural sedation and analgesia (PSA for the treatment of acute traumatic injuries. PSA has complications. Ultrasound (US guided peripheral nerve block is a safe alternative. Aim: Ultrasound guided nerve blocks for management of traumatic limb emergencies in Emergency Department (ED. Setting and Design: Prospective observational study conducted in ED. Materials and Methods: Patients above five years requiring analgesia for management of limb emergencies were recruited. Emergency Physicians trained in US guided nerve blocks performed the procedure. Statistical analysis: Effectiveness of pain control, using visual analogue scale was assessed at baseline and at 15 and 60 minutes after the procedure. Paired t test was used for comparison. Results: Fifty US guided nerve blocks were sciatic- 4 (8%, femoral-7 (14%, brachial- 29 (58%, median -6 (12%, and radial 2 (4% nerves. No patients required rescue PSA. Initial median VAS score was 9 (Inter Quartile Range [IQR] 7-10 and at 1 hour was 2(IQR 0-4. Median reduction in VAS score was 7.44 (IQR 8-10(75%, 1-2(25% (P=0.0001. Median procedure time was 9 minutes (IQR 3, 12 minutes and median time to reduction of pain was 5 minutes (IQR 1,15 minutes. No immediate or late complications noticed at 3 months. Conclusion: Ultrasound-guided nerve blocks can be safely and effectively performed for upper and lower limb emergencies by emergency physicians with adequate training.

  16. Successful Treatment of Genitofemoral Neuralgia Using Ultrasound Guided Injection: A Case Report and Short Review of Literature

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    Harsha Shanthanna

    2014-01-01

    Full Text Available A young male patient developed chronic, severe, and disabling right sided groin pain following resection of his left testicular cancer. Since there is considerable overlap, ultrasound guided, selective diagnostic nerve blocks were done for ilioinguinal, iliohypogastric, and genitofemoral nerves, to determine the involved nerve territory. It was revealed that genitofemoral neuralgia was the likely cause. As a therapeutic procedure, it was injected with local anesthetic and steroid using ultrasound guidance. The initial injection led to pain relief of 3 months. Subsequent blocks reinforced the existing analgesia and were sufficient to allow for maintenance with the use of analgesic medications. This case report describes the successful use of diagnostic selective nerve blocks for the assessment of groin pain, subsequent to which an ultrasound guided therapeutic injection of genitofemoral nerve led to long term pain relief. As a therapeutic procedure, genitofemoral nerve block is done in patients with genitofemoral neuralgia. Ultrasound allows for controlled administration and greatly enhances the technical ability to perform precise localization and injection. There are very few case reports of such a treatment in the published literature. Apart from the case report, we also highlight the relevant anatomy and a brief review of genitofemoral neuralgia and its treatment.

  17. ANALYSIS OF FACTORS AFFECTING OUTCOME OF ULTRASOUND-GUIDED RADIOFREQUENCY HEAT ABLATION FOR TREATMENT OF PRIMARY HYPERPARATHYROIDISM IN DOGS.

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    Bucy, Daniel; Pollard, Rachel; Nelson, Richard

    2017-01-01

    Radiofrequency (RF) parathyroid ablation is a noninvasive treatment for hyperparathyroidism in dogs. There are no published data assessing factors associated with RF parathyroid ablation success or failure in order to guide patient selection and improve outcome. The purpose of this retrospective analytical study was to determine whether imaging findings, biochemical data, or concurrent diseases were associated with RF heat ablation treatment failure. For inclusion in the study, dogs must have had a clinical diagnosis of primary hyperparathyroidism, undergone cervical ultrasound and RF ablation of abnormal parathyroid tissue, and must have had at least 3 months of follow-up information available following the date of ultrasound-guided parathyroid ablation. Dogs were grouped based on those with recurrent or persistent hypercalcemia and those without recurrent or persistent hypercalcemia following therapy. Parathyroid nodule size, thyroid lobe size, nodule location, and presence of concurrent disease were recorded. Recurrence of hypercalcemia occurred in 9/32 dogs that had ablation of abnormal parathyroid tissue (28%) and one patient had persistent hypercalcemia (3%) following parathyroid ablation. Nodule width (P = 0.036), height (P = 0.028), and largest cross-sectional area (P = 0.023) were larger in dogs that had recurrent or persistent hypercalcemia following ablation. Hypothyroidism was more common in dogs with recurrent disease (P = 0.044). Radiofrequency ablation was successful in 22/32 (69%) dogs. Larger parathyroid nodule size and/or concurrent hypothyroidism were associated with treatment failure in dogs that underwent ultrasound-guided RF parathyroid nodule ablation.

  18. Ultrasound-Guided Miniscalpel-Needle Release versus Dry Needling for Chronic Neck Pain: A Randomized Controlled Trial

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    Yongjun Zheng

    2014-01-01

    Full Text Available Objective. To compare ultrasound-guided miniscalpel-needle (UG-MSN release versus ultrasound-guided dry needling (UG-DN for chronic neck pain. Methods. A total of 169 patients with chronic neck pain were randomized to receive either UG-MSN release or UG-DN. Before treatment and at 3 and 6 months posttreatment, pain was measured using a 10-point visual analogue scale (VAS. Neck function was examined using the neck disability index. Health-related quality of life was examined using the physical component score (PCS and mental component score (MCS of the SF-36 health status scale. Results. Patients in the UG-MSN release had greater improvement on the VAS (by 2 points at 3 months and 0.9 points at 6 months versus in the UG-DN arm; (both P<0.0001. Patients receiving UG-MSN release also showed significantly lower scores on the adjusted neck disability index, as well as significantly lower PCS. No severe complications were observed. Conclusion. UG-MSN release was superior to UG-DN in reducing pain intensity and neck disability in patients with chronic neck pain and was not associated with severe complications. The procedural aspects in the two arms were identical; however, we did not verify the blinding success. As such, the results need to be interpreted with caution.

  19. A COMPARATIVE STUDY BETWEEN ULTRASOUND GUIDED CATHETERIZATION OF THE INTERNAL JUGULAR VEIN AND CLASSICAL LAND MARK TECHNIQUE

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    Henjarappa K S

    2014-12-01

    Full Text Available Background: Catheterization of Internal Jugular Vein (IJV is commonly attempted to obtain central venous access for hemodynamic monitoring, long term administration of fluids, total parenteral nutrition and hemodialysis in critical care patients. The safe puncture of the IJV is achieved by using anatomical land marks on skin surface. Ultrasound guidance could be beneficial in placing central venous catheters by improving the success rate, reducing the number of needle passes, decreasing access time and decreasing complications. Material and Methods: Sixty critical care patients were selected for IJV cannulation either by land mark technique or by ultrasound guided technique in two groups of thirty each. Results: In our study there was 100% success rate for first attempt cannulation in USG technique and where as it was 83.3% in LMG technique. The mean access time in USG technique was 152.50 ± 63.90 sec as against 323.23 ± 146.19 sec in LMG group. Conclusion: Ultrasound guided technique improves the cannulation of the IJV with respect to safety, rapidity and comfort to the patient during the procedure.

  20. Comparison between long- and short-axis techniques for ultrasound-guided cannulation of internal jugular vein

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    Gentle Sunder Shrestha

    2016-01-01

    Full Text Available Context: Real-time ultrasound guidance for internal jugular (IJ vein cannulation enhances safety and success. Aims: This study aims to compare the long- and short-axis (LA and SA approaches for ultrasound-guided IJ vein cannulation. Subjects and Methods: Patients undergoing surgery and in intensive care unit requiring central venous cannulation were randomized to undergo either LA or SA ultrasound-guided cannulation of the IJ vein by a skilled anesthesiologist. First pass success, the number of needle passes, time required for insertion of guidewire, and complications were documented for each procedure. Results: The IJ vein was successfully cannulated in all patients. There are no significant differences between the two groups in terms of gender, diameter of IJ vein, margin of safety, and time required for insertion of guidewire. There was also no significant difference between the two groups in terms of side of IJ vein cannulated, patient on mechanical ventilation, number of skin puncture, number of needle redirections, first pass success, and carotid puncture. However, there is a significant relationship between the diameter of IJ vein with first pass (18.18 ± 4.72 vs. 15.21 ± 4.24; P < 0.004 and margin of safety with of incidence of carotid puncture (12.15 ± 4.03 vs. 6.59 ± 3.13; P < 0.016. Conclusions: Both techniques have similar outcomes when used for IJ vein cannulation.

  1. Intrathecal Spread of Injectate Following an Ultrasound-Guided Selective C5 Nerve Root Injection in a Human Cadaver Model.

    Science.gov (United States)

    Falyar, Christian R; Abercrombie, Caroline; Becker, Robert; Biddle, Chuck

    2016-04-01

    Ultrasound-guided selective C5 nerve root blocks have been described in several case reports as a safe and effective means to anesthetize the distal clavicle while maintaining innervation of the upper extremity and preserving diaphragmatic function. In this study, cadavers were injected with 5 mL of 0.5% methylene blue dye under ultrasound guidance to investigate possible proximal and distal spread of injectate along the brachial plexus, if any. Following the injections, the specimens were dissected and examined to determine the distribution of dye and the structures affected. One injection revealed dye extended proximally into the epidural space, which penetrated the dura mater and was present on the spinal cord and brainstem. Dye was noted distally to the divisions in 3 injections. The anterior scalene muscle and phrenic nerve were stained in all 4 injections. It appears unlikely that local anesthetic spread is limited to the nerve root following an ultrasound-guided selective C5 nerve root injection. Under certain conditions, intrathecal spread also appears possible, which has major patient safety implications. Additional safety measures, such as injection pressure monitoring, should be incorporated into this block, or approaches that are more distal should be considered for the acute pain management of distal clavicle fractures.

  2. Endoscopic Ultrasound-Guided Radiofrequency Ablation of the Pancreatic Tumors: A Promising Tool in Management of Pancreatic Tumors

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    Kinesh Changela

    2016-01-01

    Full Text Available Objective. Radiofrequency ablation is a well-established antitumor treatment and is recognized as one of the least invasive therapeutic modalities for pancreatic neoplasm. Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA delivery can be used to treat both pancreatic cancer and asymptomatic premalignant pancreatic neoplasms and may serve as a less invasive alternative to surgical resection. This is an appealing option that may result in less morbidity and mortality. The aim of this review was to summarize and evaluate the clinical and technical effectiveness of EUS-guided RFA of pancreatic neoplasms. Methods. A through literature review was performed to identify the studies describing this novel technique. In this review article, we have summarized human case series. The indications, techniques, limitations, and complications reported are discussed. Results. A total of six studies were included. Overall, a 100% technical success rate was reported in human studies. Complications related to endoscopic ultrasound-guided radiofrequency ablation delivery have been described; however, few cases have presented life-threatening outcomes. Conclusion. We believe that this novel technique can be a safe and effective alternative approach in the management of selected patients.

  3. Efficacy of ultrasound-guided core-needle biopsy in the diagnosis of hepatic alveolar echinococcosis: a retrospective analysis

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    Bulakci Mesut

    2016-01-01

    Full Text Available Background: This study retrospectively analyzed the clinical data, laboratory results, imaging findings, and histopathological features of 28 patients who underwent ultrasound-guided core-needle biopsy from a hepatic lesion and were diagnosed with alveolar echinococcosis. Results: Among 28 patients included in the study, 16 were females and 12 were males. The mean age of the studied population was 53 ± 16 years, and the age range was 18–79 years. The most common presenting symptom was abdominal pain, which was observed in 14 patients. A total of 36 lesions were detected in the patients’ livers, out of which 7 had a cystic appearance. Hepatic vascular involvement, bile duct involvement, and other organ involvement were depicted in 14, 5, and 7 patients, respectively. The average number of cores taken from the lesions was 2.7, ranging between 2 and 5. In histopathological evaluation, PAS+ parasitic membrane structures were visualized on a necrotic background in all cases. Regarding seven patients, who were operated, the pathological findings of preoperative percutaneous biopsies were in perfect agreement with the pathological examinations after surgical resections. None of the patients developed major complications after biopsy. Conclusion: Ultrasound-guided core-needle biopsy is a minimally invasive, reliable, and effective diagnostic tool for the definitive diagnosis of hepatic alveolar echinococcosis.

  4. Ultrasound-guided Interdigital Neuroma Injections: Short-term Clinical Outcomes after a Single Percutaneous Injection—Preliminary Results

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    Adler, Ronald S.; Ciavarra, Gina A.; Pavlov, Helene

    2006-01-01

    Purpose To describe the procedure of ultrasound-guided Morton’s neuroma and recurrent stump neuroma injections and early clinical outcomes after a single injection. Materials and Methods Retrospective review of 44 percutaneous ultrasound-guided neuroma injections in 24 patients who had completed clinical outcomes questionnaires. A 10-point pain scale [scale of 1 (no pain) to 10 (severe pain)] in a 7-day pain log format was distributed to patients at the time percutaneous neuroma injection was performed. Results Neuromas were clearly visualized with sonography as hypoechoic nodules and were distinguishable from other causes of forefoot pain, such as metatarsophalangeal joint synovitis and intermetatarsal bursae. The sizes of the neuromas injected ranged between 4 and 19 mm. Postinjection, all neuromas displayed increased echogenicity and/or the appearance of fluid surrounding it, confirming localization of the therapeutic mixture. We arbitrarily subdivided the pain ratings into symptomatic (greater than 4) and asymptomatic (less than or equal to 4) for statistical analysis. Average pain level pre injection was 5.2 and average pain level was 3.7 at 7 days post single injection, with 62% of the initially symptomatic patients asymptomatic on day 7 (p neuromas injected once were asymptomatic on day 7. Conclusion Ultrasound can be used to accurately target Morton’s neuromas and, therefore, appropriately direct therapeutic interventions, with good short-term clinical results. PMID:18751769

  5. Comparison of palpation-versus ultrasound-guided fine-needle aspiration biopsies in the evaluation of thyroid nodules

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    Peker Kamil

    2008-05-01

    Full Text Available Abstract Background The aim of this study was to compare the results of palpation-versus ultrasound-guided thyroid fine-needle aspiration (FNA biopsies. Findings Clinical data, cytology and histopathology results were retrospectively analyzed on all patients who underwent thyroid FNA biopsy in our outpatient endocrinology clinic between January 1998 and April 2003. The same investigators performed all thyroid FNAs (ASC and cytological evaluations (KP. Subjects in the ultrasound-guided group were older, otherwise there were no differences in baseline characteristics (gender, thyroid function, the frequency of multinodular goiter, nodule diameter and nodule location between groups. Cytology results in nodules aspirated by palpation (n = 202 versus ultrasound guidance (n = 184 were as follows: malignant 2.0% versus 2.7% (p = 0.74, benign 69.8% versus 79.9% (p = 0.02, indeterminate 1.0% versus 4.9% (p = 0.02, inadequate 27.2% versus 12.5% (p Conclusion We demonstrate that ultrasound guidance for thyroid FNA significantly decreases inadequate for evaluation category. We also confirm the high sensitivity and specificity of thyroid FNA biopsy in the diagnosis of thyroid cancer. Where available, we recommend universal application of ultrasound guidance for thyroid FNA biopsy as a standard component of this diagnostic technique.

  6. Ultrasound-guided alcohol neurolysis and radiofrequency ablation of painful stump neuroma: effective treatments for post-amputation pain

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    Zhang, Xin; Xu, Yongming; Zhou, Jin; Pu, Shaofeng; Lv, Yingying; Chen, Yueping; Du, Dongping

    2017-01-01

    Background Post-amputation pain (PAP) is highly prevalent after limb amputation, and stump neuromas play a key role in the generation of the pain. Presently, PAP refractory to medical management is frequently treated with minimally invasive procedures guided by ultrasound, such as alcohol neurolysis and radiofrequency ablation (RFA). Objective To record the immediate and long-term efficacy of alcohol neurolysis and RFA. We first used alcohol neurolysis and then, when necessary, we performed RFA on PAP patients. Study design Prospective case series. Setting Pain management center. Methods Thirteen subjects were treated with ultrasound-guided procedures. Results All patients were treated with neurolysis using alcohol solutions guided by ultrasound. Seven (54%) of 13 subjects achieved pain relief after 1–3 alcohol injection treatments. The remaining 6 subjects obtained pain relief after receiving 2 administrations of ultrasound-guided RFA. After a 6-month follow-up evaluation period, pain quantities were also assessed. Both stump pain (including intermittent sharp pain and continuous burning pain) and phantom pain were relieved. The frequency of intermittent sharp pain was decreased, and no complications were noted during the observation. Conclusion The use of ultrasound guidance for alcohol injection and RFA of painful stump neuromas is a simple, radiation-free, safe, and effective procedure that provides sustained pain relief in PAP patients. In this case series, RFA was found to be an effective alternative to alcohol injection. PMID:28223839

  7. Clinical Application of Ultrasound-Guided Thyroid Fine Needle Aspiration Biopsy and Thinprep Cytology Test in Diagnosis of Thyroid Disease

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    Wei, Ying; Lu, Yao; li, chenxi

    2016-10-01

    Purpose: To study the clinical application value of ultrasound guided thyroid fine needle aspiration biopsy and thinprep cytology testing in diagnosis of thyroid disease. Methods: A total of 78 patients with thyroid nodules were enrolled, 34 males and 44 females, aged 33-64 years old with mean age of 47.6 years. All underwent thyroid module fine needle puncture after surgery to assess cell pathology and histopathological features. Results: Sufficient specimens were obtained from all of 78 patients, the cytological results of 73 cases (93.6 %) being consistent with pathological results. While 20 cases (25.6 %) were malignant tumors, 44 (56.4 %) were benign and 9 (11.5 %) were non-tumor lesions. The sensitivity of benign and malignant thyroid nodule by thyroid fine needle puncture was 90.9 %, specificity was 98.1 % and the positive predictive value was 96.3 %. Conclusions: It is demonstrated that ultrasound-guided thyroid fine needle aspiration biopsy and thinprep cytology testing have diagnostic value in clinical application for thyroid disease,showing good diagnostic coincidence rates with histopathological examination. They can thus be regarded as safe and effective for preoperative diagnosis and providing an appropriate basis for selection of surgery. Creative Commons Attribution License

  8. Ultrasound-guided continuous femoral nerve block vs continuous fascia iliaca compartment block for hip replacement in the elderly

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    Yu, Bin; He, Miao; Cai, Guang-Yu; Zou, Tian-Xiao; Zhang, Na

    2016-01-01

    Abstract Background: Continuous femoral nerve block and fascia iliaca compartment block are 2 traditional anesthesia methods in orthopedic surgeries, but it is controversial which method is better. The objective of this study was to compare the practicality, efficacy, and complications of the 2 modalities in hip replacement surgery in the elderly and to assess the utility of a novel cannula-over-needle set. Methods: In this prospective, randomized controlled clinical investigation, 60 elderly patients undergoing hip replacement were randomly assigned to receive either continuous femoral nerve block or continuous fascia iliaca compartment block. After ultrasound-guided nerve block, all patients received general anesthesia for surgery and postoperative analgesia through an indwelling cannula. Single-factor analysis of variance was used to compare the outcome variables between the 2 groups. Results: There was a significant difference between the 2 groups in the mean visual analog scale scores (at rest) at 6 hours after surgery: 1.0 ± 1.3 in the femoral nerve block group vs 0.5 ± 0.8 in the fascia iliaca compartment block group (P fascia iliaca compartment block group had better analgesia on the lateral aspect of the thigh. There were no other significant differences between the groups. Conclusions: Both ultrasound-guided continuous femoral nerve block and fascia iliaca compartment block with the novel cannula-over-needle provide effective anesthesia and postoperative analgesia for elderly hip replacement patients. PMID:27759633

  9. Role of transrectal ultrasonography in evaluating the cause of azoospermia

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    Yassa, N.A.; Keesara, S. [Univ. of Southern California, Dept. of Radiology, Los Angeles, California (United States)

    2001-08-01

    To assess the role of transrectal ultrasonography in the investigation of azoospermia, a significant cause of infertility. Over a 2-year period, 35 patients with azoospermia underwent an infertility workup, which included transrectal ultrasonography. Sonograms of 10 of the 35 patients were normal; 8 patients had enlarged seminal vesicles containing cysts, 6 had ejaculatory duct dilation, 5 had seminal vesicle calcification, 3 had seminal vesicle atrophy-hypoplasia and 3 patients had midline prostatic cysts. Transrectal sonography is a useful modality to evaluate seminal duct abnormalities, some of which may cause azoospermia. (author)

  10. Relevant factors affecting the outcome of ultrasound guided foam sclerotherapy of the great saphenous vein

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    Giorgio Falaschi

    2013-09-01

    Full Text Available Ultrasound guided foam sclerotherapy (UGFS constitutes a valid ablative treatment for superficial vein diseases for the great saphenous vein (GSV, but no standardized protocol for its execution has yet been defined. Different variable factors involved in this procedure influence the final outcome and clinical results. The aim of our study was to analyze the respective influence on efficacy and side effects of three variable factors (foam volume, foam concentration, and contact time between the foam and the endothelium for UGFS procedures for GSV insufficiency in order to select the best protocol for treatment. A retrospective analysis was made of UGFS procedures (190 patients, 201 legs performed for GSV insufficiency in our institute from January 2007 to January 2010. All great saphenous veins included in our study exhibited a trans-ostial reflux and caliber range was 7-11 mm. In all cases, foam was prepared according to the Tessari method, using polidocanol (POL and a gas mixture of CO2 (70% and filtered room air (30%, in a proportion of 1:4. A single injection procedure in the GSV was performed under Doppler ultrasound guidance at mid to lower third of the thigh. Legs were randomly assigned to one of three different treatment protocols: - Group A (71 legs: POL 3%, mean foam volume 4.5 cc, intermittent groin pressure 5 min, supine bed rest 10 min; - Group B (61 legs: POL 2%, mean foam volume 9 cc, intermittent groin pressure 5 min, supine bed rest 10 min; - Group C (69 legs: POL 2%, mean foam volume 9 cc, continuous groin pressure 5 min followed by intermittent groin pressure 5 min, continuous leg compression 5 min, supine bed rest 10 min. Efficacy of treatment and occurrence of side effects were evaluated in each group at two weeks and again at two years after the procedure and the cumulative results compared. Analysis of outcomes did not show any significant difference between the complete obliteration rate (P=0.825 or occurrence of local

  11. PANCREATIC SPLENOSIS MIMICKING NEUROENDOCRINE TUMORS: microhistological diagnosis by endoscopic ultrasound guided fine needle aspiration

    Directory of Open Access Journals (Sweden)

    José Celso ARDENGH

    2013-03-01

    Full Text Available Context Pancreatic splenosis is a benign condition which can mimic a pancreatic neoplasm. Objective To describe the role of the endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA of pancreatic nodules suspicious for pancreatic splenosis. Method From 1997 to 2011, patients with pancreatic solid tumors suspicious for splenosis by computed tomography and/or magnetic resonance imaging were referred to EUS-FNA. Those cases with pancreatic splenosis confirmed by EUS-FNA or surgery were included. Endosonographic findings and clinicopathologic features were also analysed. Results A total of 2,060 patients with pancreatic solid tumors underwent EUS-FNA. Fourteen (0.6% cases with pancreatic splenosis were found. After applying exclusion criteria, 11 patients were selected. Most patients were male (7, young (mean age: 42 years and asymptomatic (8. Endoscopic ultrasound imaging alone suspected pancreatic splenosis in 6 cases, and neuroendocrine tumors in 5 cases. Pancreatic splenosis was found most commonly in the tail, was round, hypoechoic, with homogeneous pattern, regular borders, and with scintigraphy negative for somatostatin receptors. The average diameter of these nodules identified by endoscopic ultrasound was 2.15 cm. Microhistology obtained by EUS-FNA confirmed the diagnosis in 9/10 patients. Conclusion Pancreatic splenosis can be diagnosed by EUS-FNA. Microhistology prevents unnecessary surgeries, and reassures asymptomatic patients with hypoechoic, homogeneous, and well circumscribed pancreatic nodules. Contexto A esplenose pancreática é uma afecção benigna que pode mimetizar uma neoplasia pancreática. Objetivo Descrever o papel da ecoendoscopia associada à punção aspirativa com agulha fina ecoguiada (EE-PAAF dos nódulos de pâncreas suspeitos de esplenose pancreática. Método De 1997 a 2011, pacientes com tumores sólidos de pâncreas sugestivos de esplenose pancreática, conforme achados de exames de imagem por

  12. Endoscopic ultrasound-guided drainage of pelvic abscess: A case series of 8 patients

    Institute of Scientific and Technical Information of China (English)

    Muhammed; Hadithi; Marco; J; Bruno

    2014-01-01

    AIM: To show the safety and effectiveness of endo-scopic ultrasound(EUS)-guided drainage of pelvic ab-scess that were inaccessible for percutaneous drainage. METHODS: Eight consecutive patients with pelvic abscess that were not amenable to drainage under computed tomography(CT) guidance were referred for EUS-guided drainage. The underlying cause of the abscesses included diverticulitis in 4, postsurgical surgi-cal complications in 2, iatrogenic after enema in 1, and Crohn’s disease in 1 patient. Abscesses were all drained under EUS guidance via a transrectal or transsigmoidal approach. RESULTS: EUS-guided placement of one or two 7 Fr pigtail stents was technically successful and uneventful in all 8 patients(100%). The abscess was perisigmoidal in 2 and was multilocular in 4 patients. All procedures were performed under conscious sedation and without fluoroscopic monitoring. Fluid samples were success-fully retrieved for microbiological studies in all cases and antibiotic policy was adjusted according to cultureresults in 5 patients. Follow-up CT showed complete re-covery and disappearance of abscess. The stents were retrieved by sigmoidoscopy in only two patients and had spontaneously migrated to outside in six patients. All drainage procedures resulted in a favourable clinical outcome. All patients became afebrile within 24 h after drainage and the mean duration of the postprocedure hospital stay was 8 d(range 4-14). Within a median follow up period of 38 mo(range 12-52) no recurrence was reported. CONCLUSION: We conclude that EUS-guided drain-age of pelvic abscesses without fluoroscopic monitoring is a minimally invasive, safe and effective approach that should be considered in selected patients.

  13. Diclofenac Suppository as a Preemptive Analgesia in Ultrasound-guided Biopsy of Prostate: Randomized Controlled Trial.

    Science.gov (United States)

    Haroon, Naveed; Ather, M Hammad; Khan, Salma; Kumar, Pirkash; Salam, Basit

    2015-10-01

    To compare preprocedure Diclofenac suppository and Xylocaine gel with Xylocaine gel only in patients undergoing transrectal ultrasound (TRUS)-guided biopsy of prostate for pain. It is a randomized controlled trial conducted on patients undergoing TRUS-guided biopsy for clinical or biochemical suspicion of prostate cancer following a written informed consent and Ethics Review Committee approval. Patients were randomized into 2 groups. Group A included those patients who received Diclofenac suppository 2 hours before in combination with 10 mL of 2% Xylocaine gel 5 minutes before biopsy. Group B received Xylocaine gel only. A visual analog scale was used to measure the pain scores at the time of TRUS probe insertion, just after taking biopsy cores and 2 hours after biopsy. A total of 100 patients were recruited in the study with 50 patients each in group A and B. Mean age of group A was 69.1 ± 10 years and 67.3 ± 8.1 years for group B. The mean pain score for group A and B at the time of probe insertion was 0.08 ± 0.27 and 0.34 ± 0.63 (P = .032), immediately after taking biopsy cores was 1.46 ± 1.15 and 4.68 ± 0.77 (P = .000), and 2 hours after biopsy was 0.14 ± 0.45 vs 2.40 ± 0.81 (P = .000), respectively. The mean pain score at the time of TRUS probe insertion, immediately after taking biopsy cores, and 2 hours after biopsy is statistically significantly higher in group B. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Biopsy needle detection in transrectal ultrasound.

    Science.gov (United States)

    Ayvaci, Alper; Yan, Pingkun; Xu, Sheng; Soatto, Stefano; Kruecker, Jochen

    2011-01-01

    Using the fusion of pre-operative MRI and real time intra-procedural transrectal ultrasound (TRUS) to guide prostate biopsy has been shown as a very promising approach to yield better clinical outcome than the routinely performed TRUS only guided biopsy. In several situations of the MRI/TRUS fusion guided biopsy, it is important to know the exact location of the deployed biopsy needle, which is imaged in the TRUS video. In this paper, we present a method to automatically detect and segment the biopsy needle in TRUS. To achieve this goal, we propose to combine information from multiple resources, including ultrasound probe stability, TRUS video background model, and the prior knowledge of needle orientation and position. The proposed algorithm was tested on TRUS video sequences which have in total more than 25,000 frames. The needle deployments were successfully detected and segmented in the sequences with high accuracy and low false-positive detection rate.

  15. Local staging of prostate cancer with transrectal ultrasound

    DEFF Research Database (Denmark)

    Lorentzen, T; Nerstrom, H; Iversen, P;

    1992-01-01

    A literature review was undertaken to investigate whether transrectal ultrasound can predict the local stage of prostate cancer. Twelve papers were found which correlated ultrasound findings with surgical findings and another paper reported on strategic staging biopsies guided by transrectal...... ultrasound. Eleven of these papers reported on ultrasound findings in patients in whom digital rectal examination had defined localized disease. One paper compared ultrasound findings and digital rectal findings. One paper indicated that transrectal ultrasound, though not suited to patients with clinically...... localized disease defined by digital rectal examination, may be superior as the initial staging tool. We conclude that transrectal ultrasound has too low a specificity to upgrade the diagnostic results of digital rectal examination, but that it may be more useful as the primary staging tool and for guidance...

  16. Ultrasound-guided percutaneous neuroplasty of the lateral femoral cutaneous nerve for the treatment of meralgia paresthetica: a case report and description of a new ultrasound-guided technique.

    Science.gov (United States)

    Mulvaney, Sean W

    2011-01-01

    The lateral femoral cutaneous nerve (LFCN) can be visualized with ultrasound imaging using a high frequency linear transducer. The entrapment of the LFCN, often near the lateral aspect of the inguinal ligament, is accepted as an etiology of meralgia paresthetica (MP). This case report describes an ultrasound-guided, percutaneous technique that utilizes injected fluid to facilitate blunt dissection (or hydrodissection) to perform an external neuroplasty of the LFCN. This procedure resulted in immediate, long-term relief of pain associated with severe, chronic MP. This procedure may potentially represent an alternate treatment for patients with contraindications or partial contraindications to surgical neurolysis, nerve transection (usually described as being performed under general anesthesia), or corticosteroid injection, or in patients not responding to conservative treatment measures.

  17. Life-threatening meningitis resulting from transrectal prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    Zhou-Jun Shen; Shan-Wen Chen; Hua Wang; Xie-Lai Zhou; Ju-Ping Zhao

    2005-01-01

    After antibiotic prophylaxis with metronidazole and levofloxacin, a transrectal sextant biopsy was performed under the guide of transrectal ultrasonography (TRUS) for a 75-year-old suspicious patient with prostate adenocarcinoma.Although antibiotics were also given after this procedure, the patient still developed fever, anxious, agrypnia and headache. Blood cultures remained negative. Lumbar puncture was performed and was consistent with Escherichia coli bacterial meningitis.

  18. Successful treatment of de Quervain tenosynovitis with ultrasound-guided percutaneous needle tenotomy and platelet-rich plasma injection: a case presentation.

    Science.gov (United States)

    Peck, Evan; Ely, Erin

    2013-05-01

    De Quervain tenosynovitis is a disorder of the tendons of the first dorsal compartment of the wrist that causes pain and functional disability, which may be refractory to conservative treatments. We present a case of ultrasound-guided percutaneous needle tenotomy and platelet-rich plasma injection for the successful treatment of de Quervain tenosynovitis.

  19. Meta-analysis of ultrasound-guided biopsy of suspicious axillary lymph nodes in the selection of patients with extensive axillary tumour burden in breast cancer

    NARCIS (Netherlands)

    Wely, B.J. van; Wilt, J.H.W. de; Francissen, C.; Teerenstra, S.; Strobbe, L.J.A.

    2015-01-01

    BACKGROUND: Recent studies show that not all patients with breast cancer and positive axillary lymph nodes need additional axillary surgery. A systematic review and meta-analysis of the literature was performed to test the hypothesis that ultrasound-guided biopsy of suspicious nodes can be a useful

  20. Ultrasound-guided epidural anesthesia for a parturient with severe malformations of the skeletal system undergoing cesarean delivery: a case report

    Directory of Open Access Journals (Sweden)

    Luo LL

    2015-05-01

    Full Text Available LinLi Luo,* Juan Ni,* Lan Wu, Dong Luo Department of Anesthesiology, West China Second Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China  *These authors contributed equally to this work and should be considered co-first authors Abstract: Anesthetic management of patients with preexisting diseases is challenging and individualized approaches need to be determined based on patients' complications. We report here a case of ultrasound-guided epidural anesthesia in combination with low-dose ketamine during cesarean delivery on a parturient with severe malformations of the skeletal system and airway problems. The ultrasound-guided epidural anesthesia was performed in the L1–L2 space, followed by an intravenous administration of ketamine (0.5 mg/kg for sedation and analgesia. Satisfactory anesthesia was provided to the patient and spontaneous ventilation was maintained during the surgery. The mother and the baby were discharged 5 days after surgery, no complications were reported for either of them. Our work demonstrated that an ultrasound-guided epidural anesthesia combined with low-dose ketamine can be used to successfully maintain spontaneous ventilation and provide effective analgesia during surgery and reduce the risk of postoperative anesthesia-related pulmonary infection. Keywords: anesthesia, regional, cesarean delivery, ketamine, ultrasound-guided

  1. Thyroid Ultrasound-Guided Fine-Needle Aspiration: The Positive Influence of On-Site Adequacy Assessment and Number of Needle Passes on Diagnostic Cytology Rate

    NARCIS (Netherlands)

    Koster, E.J. de; Kist, J.W.; Vriens, M.R.; Rinkes, I.H.; Valk, G.D.; Keizer, B. de

    2016-01-01

    OBJECTIVE: Nondiagnostic cytology is the most important limitation of thyroid ultrasound-guided fine-needle aspiration (US-FNA). This study aimed to identify factors associated with the adequacy rate of thyroid US-FNA. STUDY DESIGN: Consecutive thyroid US-FNAs (2006-2013) were retrospectively

  2. Thyroid ultrasound-guided fine-needle aspiration : The positive influence of on-site adequacy assessment and number of needle passes on diagnostic cytology rate

    NARCIS (Netherlands)

    de Koster, Elizabeth J.; Kist, Jakob W.; Vriens, Menno R.; Rinkes, Inne H M Borel; Valk, Gerlof D.; De Keizer, Bart

    2016-01-01

    Objective: Nondiagnostic cytology is the most important limitation of thyroid ultrasound-guided fine-needle aspiration (US-FNA). This study aimed to identify factors associated with the adequacy rate of thyroid US-FNA. Study Design: Consecutive thyroid US-FNAs (2006-2013) were retrospectively includ

  3. Effect of local anesthetic concentration, dose and volume on the duration of single-injection ultrasound-guided axillary brachial plexus block with mepivacaine: a randomized controlled trial

    NARCIS (Netherlands)

    Fenten, M.G.E.; Schoenmakers, K.P.W.; Heesterbeek, P.J.C.; Scheffer, G.J.; Stienstra, R.

    2015-01-01

    BACKGROUND: In what way volume, concentration and dose affect block duration is controversial. The purpose of the present study is to investigate the effect of dose, volume and concentration of mepivacaine on the duration of sensory and motor blockade in ultrasound-guided single shot axillary

  4. Ultrasound-guided fine needle aspiration cytology as an addendum to sentinel lymph node biopsy can perfect the staging strategy in melanoma patients

    NARCIS (Netherlands)

    C. Voit (Christiane); S.L.M. Gooskens (Saskia); P. Siegel (Petra); G. Schaefer (Gregor); A. Schöngen (Alfred); J. Röwert (Joachim); A.C.J. van Akkooi (Alexander); A.M.M. Eggermont (Alexander)

    2014-01-01

    textabstractBackground Ultrasound guided fine needle aspiration cytology (US-guided FNAC) can identify microscopic involvement of lymph nodes as in breast cancer and avoid surgical sentinel node (SN). Its utility in melanoma patients is controversial and subject of this study. Methods Between 2001 a

  5. Fusion of freehand SPECT and ultrasound to perform ultrasound-guided fine-needle aspiration cytology of sentinel nodes in head and neck cancer

    NARCIS (Netherlands)

    De Bree, R.; Pouw, B.; Heuveling, D. A.; Castelijns, J. A.

    2015-01-01

    BACKGROUND AND PURPOSE: Criteria for ultrasound-guided fine-needle aspiration cytology (USgFNAC) for the detection of occult lymph node metastasis in patients with clinically negative head and neck cancer are based on the morphology of cervical lymph nodes. To improve the selection of lymph nodes fo

  6. Fusion of freehand SPECT and ultrasound to perform ultrasound-guided fine-needle aspiration cytology of sentinel nodes in head and neck cancer

    NARCIS (Netherlands)

    De Bree, R.; Pouw, B.; Heuveling, D. A.; Castelijns, J. A.

    2015-01-01

    BACKGROUND AND PURPOSE: Criteria for ultrasound-guided fine-needle aspiration cytology (USgFNAC) for the detection of occult lymph node metastasis in patients with clinically negative head and neck cancer are based on the morphology of cervical lymph nodes. To improve the selection of lymph nodes fo

  7. Clinical application of a 3D ultrasound-guided prostate biopsy system.

    Science.gov (United States)

    Natarajan, Shyam; Marks, Leonard S; Margolis, Daniel J A; Huang, Jiaoti; Macairan, Maria Luz; Lieu, Patricia; Fenster, Aaron

    2011-01-01

    Prostate biopsy (Bx) has for 3 decades been performed in a systematic, but blind fashion using 2D ultrasound (US). Herein is described the initial clinical evaluation of a 3D Bx tracking and targeting device (Artemis; Eigen, Grass Valley, CA). Our main objective was to test accuracy of the new 3D method in men undergoing first and follow-up Bx to rule out prostate cancer (CaP). Patients in the study were men ages 35-87 years (66.1 ± 9.9), scheduled for Bx to rule out CaP, who entered into an IRB-approved protocol. A total of 218 subjects underwent conventional trans-rectal US (TRUS); the tracking system was then attached to the US probe; the prostate was scanned and a 3D reconstruction was created. All Bx sites were visualized in 3D and tracked electronically. In 11 men, a pilot study was conducted to test ability of the device to return a Bx to an original site. In 47 men, multi-parametric 3 Tesla MRI, incorporating T2-weighted images, dynamic contrast enhancement, and diffusion-weighted imaging, was performed in advance of the TRUS, allowing the stored MRI images to be fused with real-time US during biopsy. Lesions on MRI were delineated by a radiologist, assigned a grade of CaP suspicion, and fused into TRUS for biopsy targeting. 3D Bx tracking was completed successfully in 180/218 patients, with a success rate approaching 95% among the last 50 men. Average time for Bx with the Artemis device was 15 minutes with an additional 5 minutes for MRI fusion and Bx targeting. In the tracking study, an ability to return to prior Bx sites (n=32) within 1.2 ± 1.1 mm SD was demonstrated and was independent of prostate volume or location of Bx site. In the MRI fusion study, when suspicious lesions were targeted, a 33% Bx-positivity rate was found compared with a 7% positivity rate for systematic, nontargeted Bx (19/57 cores vs. 9/124 cores, P=0.03). Use of 3D tracking and image fusion has the potential to transform MRI into a clinical tool to aid biopsy and improve current

  8. Fast-track, ambulatory ultrasound-guided Tru-Cut liver biopsy is feasible and cost-efficient

    DEFF Research Database (Denmark)

    Huang, Chenxi; Lorentzen, Torben; Skjoldbye, Bjørn

    2015-01-01

    INTRODUCTION: Most institutions perform percutaneous liver biopsy with a post-biopsy patient observation period lasting up to eight hours, which is resource-demanding. This study aimed to evaluate the safety of liver biopsy performed in a fast-track set-up with an only one-hour post-biopsy...... observation time. METHODS: Patients referred to our institution underwent fast-track ultrasound-guided 18-gauge Tru-Cut liver biopsy procedures. Each single biopsy procedure was followed by a post-procedure observational period of one hour and an additional focused assessment with sonography for trauma before...... patient discharge. All patients underwent a clinical follow-up programme at revisit in order to register any delayed onset of major complications. RESULTS: Out of 200 completed biopsy procedures, two major complications were registered post biopsy and they were treated appropriately. All patients were...

  9. Endobronchial ultrasound-guided transbronchial needle aspiration is a sensitive method to evaluate patients who should not undergo pulmonary metastasectomy†

    DEFF Research Database (Denmark)

    Eckardt, Jens; Licht, Peter Bjørn

    2015-01-01

    OBJECTIVES: Pulmonary metastasectomy is considered an effective treatment in selected patients with extrapulmonary cancer and oligometastatic disease. We know that the presence of mediastinal lymph node metastases reduces survival significantly, but the mediastinum is rarely evaluated before...... metastasectomy in these patients. We prospectively evaluated how endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) could identify metastases to the mediastinal lymph nodes in patients referred for pulmonary metastasectomy. METHODS: All patients with extrapulmonary cancer...... and oligometastatic disease confined to the lungs on positron emission tomography-computed tomography, and who were considered eligible for pulmonary metastasectomy, routinely underwent EBUS-TBNA of the mediastinal lymph nodes. If EBUS-TBNA did not reveal malignant spread, the patient subsequently underwent pulmonary...

  10. Cell-block procedure in endoscopic ultrasound-guided-fine-needle-aspiration of gastrointestinal solid neoplastic lesions

    Institute of Scientific and Technical Information of China (English)

    Antonio; Ieni; Valeria; Barresi; Paolo; Todaro; Rosario; Alberto; Caruso; Giovanni; Tuccari

    2015-01-01

    In the present review we have analyzed the clinical applications of endoscopic ultrasound-guided-fineneedle-aspiration(EUS-FNA) and the methodological aspects obtained by cell-block procedure(CBP) in the diagnostic approach to the gastrointestinal neoplastic pathology. CBP showed numerous advantages in comparison to the cytologic routine smears; in particular, better preservation of cell architecture, achievement of routine haematoxylin-eosin staining equivalent to histological slides and possibility to perform immunohistochemistry or molecular analyses represented the most evident reasons to choose this method. Moreover, by this approach, the differential diagnosis of solid gastrointestinal neoplasias may be more easily achieved and the background of contaminant nonneoplastic gastrointestinal avoided. Finally, biological samples collected by EUS-FNA CBP-assisted should be investigated in order to identify and quantify further potential molecular markers.

  11. Perisciatic Ultrasound-Guided Infiltration for Treatment of Deep Gluteal Syndrome: Description of Technique and Preliminary Results.

    Science.gov (United States)

    Rosales, Julio; García, Nicolás; Rafols, Claudio; Pérez, Marcelo; Verdugo, Marco A

    2015-11-01

    The objective of this study was to describe a perisciatic ultrasound-guided infiltration technique for treatment of deep gluteal syndrome and to report its preliminary clinical results. A mixture of saline (20 mL), a local anesthetic (4 mL), and a corticosteroid solution (1 mL) was infiltrated in the perisciatic region between the gluteus maximus and pelvitrochanteric muscles. Relative pain relief was achieved in 73.7% of the patients, with average preprocedural and postprocedural visual analog scale scores of 8.3 and 2.8, respectively. Fifty percent of patients reported recurrence of discomfort, and the average duration of the therapeutic effect in these patients was 5.3 weeks.

  12. Step-by-step of ultrasound-guided core-needle biopsy of the breast: review and technique

    Directory of Open Access Journals (Sweden)

    Rafael Dahmer Rocha

    2013-07-01

    Full Text Available Ultrasound-guided core-needle biopsy has high sensitivity in the diagnosis of breast cancer. The present study is aimed at detailing the main steps of such procedure, including indications, advantages, limitations, follow-up and description of the technique, besides presenting a checklist including the critical steps required for an appropriate practice of the technique. In the recent years, an increasing number of patients have required breast biopsy, indicating the necessity of a proportional increase in the number of skilled professionals to carry out the procedures and histological diagnoses. A multidisciplinary approach involving the tripod clinical practice-radiology-pathology is responsible for the highest rate of accuracy of the technique and must always be adopted.

  13. Unplanned pregnancy after ultrasound-guided percutaneous microwave ablation of uterine fibroids: A follow-up study.

    Science.gov (United States)

    Bing-song, Zhang; Jing, Zhang; Zhi-Yu, Han; Chang-tao, Xu; Rui-fang, Xu; Xiu-mei, Li; Hui, Liu

    2016-01-06

    A follow-up study was performed with 169 women of childbearing age who underwent ultrasound-guided percutaneous microwave ablation (UPMWA) therapy for symptomatic uterine fibroids in the Chinese PLA General Hospital from June 2007 to December 2014. This study aimed to observe the incidence of unplanned pregnancies in these women after UPMWA treatment in order to evaluate its effect on natural conception. Ten unplanned pregnancies in nine women were occurred. Of the nine patients, six did not want the pregnancy and chose for induced abortion to end the pregnancy at an early stage. Three chose to continue with the pregnancy and gave birth to a healthy term infant delivered by cesarean section (of these three patients, two had been previously diagnosed as infertility). None of the patients had any serious obstetric complications. After UPMWA treatment for uterine fibroids, patients may conceive naturally, the impact of the procedure on fertility and pregnancy outcomes is worthy of further prospective study in larger sample.

  14. Ultrasound-Guided, Percutaneous Needle Fascial Fenestration for the Treatment of Chronic Exertional Compartment Syndrome: A Case Report.

    Science.gov (United States)

    Finnoff, Jonathan T; Rajasekaran, Sathish

    2016-03-01

    Chronic exertional compartment syndrome (CECS) involves a painful increase in compartment pressure caused by exercise and relieved by rest. The most common site for CECS in the lower extremity is the anterior leg compartment. We report a case of a collegiate athlete with bilateral anterior and lateral leg compartment CECS who was successfully treated with an ultrasound-guided, percutaneous needle fascial fenestration of the affected compartments in both legs and was able to return to full, unrestricted activity within 1 week of the procedure. This case highlights the potential application of this procedure for the treatment of anterior and lateral leg CECS. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  15. Pleomorphic Adenoma of the Breast: A Diagnosis Using an Ultrasound-Guided Core-Needle Biopsy Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, In Wha; Yun, Jung Hyun; Kim, Tae Heon; Lee, Kyung Po; Jung, Hea Kyung; Ko, Kyung Hee; Lee, Jong Tae [CHA Bundang Medical Center, CHA University, College of Medicine, Seongnam (Korea, Republic of)

    2012-08-15

    Pleomorphic adenoma is a tumor rarely seen in the breast. To date, only about 70 cases have been reported in the literature. Many reports have used fine-needle aspiration biopsy in the preoperative diagnosis of these lesions. However, pleomorphic adenoma is sometimes mistaken for a malignant tumor because of its cytologic features. In this study, we present a 56-year-old woman with a palpable breast mass. Ultrasound indicated a 15 mm oval-shaped hypoechoic mass with complex echogenicity in the palpable region. Ultrasound-guided core needle biopsy (US-CNB) revealed a pleomorphic adenoma of the breast, which was confirmed through surgical excision. Although pleomorphic adenoma is rarely seen in the breast, results demonstrate the usefulness and accuracy of US-CNB in diagnosing pleomorphic adenoma of the breast.

  16. Diagnosis of invasive aspergillus tracheobronchitis facilitated by endobronchial ultrasound-guided transbronchial needle aspiration: a case report

    Directory of Open Access Journals (Sweden)

    Casal Roberto F

    2009-11-01

    Full Text Available Abstract Introduction Invasive pulmonary aspergillosis is the most common form of infection by Aspergillus species among immunocompromised patients. Although this infection frequently involves the lung parenchyma, it is unusual to find it limited to the tracheobronchial tree, a condition known as invasive aspergillus tracheobronchitis. Case presentation A 65 year-old Hispanic man from Bolivia with a history of chronic lymphocytic leukemia developed cough and malaise eight months after having an allogenic stem cell transplant. A computed tomography of the chest revealed an area of diffuse soft tissue thickening around the left main stem bronchus, which was intensely fluorodeoxyglucose-avid on positron emission tomography scanning. An initial bronchoscopic exam revealed circumferential narrowing of the entire left main stem bronchus with necrotic and friable material on the medial wall. Neither aspirates from this necrotic area nor bronchial washing were diagnostic. A second bronchoscopy with endobronchial ultrasound evidenced a soft tissue thickening on the medial aspect of the left main stem bronchus underlying the area of necrosis visible endoluminally. Endobronchial ultrasound-guided transbronchial needle aspiration performed in this area revealed multiple fungal elements suggestive of Aspergillus species. Conclusion We describe the first case of invasive aspergillus tracheobronchitis in which the diagnosis was facilitated by the use of endobronchial ultrasound guided trans-bronchial needle aspiration. To the best of our knowledge, we are also presenting the first positron emission tomography scan images of this condition in the literature. We cautiously suggest that endobronchial ultrasound imaging may be a useful tool to evaluate the degree of invasion and the involvement of vascular structures in these patients prior to bronchoscopic manipulation of the affected areas in an effort to avoid potentially fatal hemorrhage.

  17. Endovenous laser ablation of great saphenous vein with ultrasound-guided perivenous tumescence:early and midterm results

    Institute of Scientific and Technical Information of China (English)

    CHEN Jia-quan; XIE Hui; DENG Hao-yu; YUAN Kai; ZHANG Ji-wei; ZHANG Hao; ZHANG Lan

    2013-01-01

    Background Endovenous laser ablation (EVLA) is an improved method to treat varicose great saphenous veins (GSV)with a high satisfactory rate.This study aimed to evaluate the efficiency and safety of treatment by EVLA procedures with ultrasound-guided perivenous tumescence.Methods Thirty-one patients (31 limbs) with symptomatic varicose vein primary to chronic venous insufficiency (CVI) treated with EVLA were prospectively studied.The entire procedure was performed under ultrasound-guided tumescent local anesthesia.The patients were evaluated with a 18 month follow-up postoperation using clinical examination and venous duplex ultrasonography.Pain scores and quality of life (QOL) were recorded using visual analog scale (VAS) and the chronic venous insufficiency questionnaire (CIVIQ) at 1 week,1 month,and 12 months after operation.Results All patients tolerated EVLA procedure well.The overall success occlusion rates of GSV were 92%,94%,and 94% at 1,12,and 18 months follow-up,respectively.The score of CIVIQ one week preoperation was 69.14±11.44 while that of CIVIQ one month postoperation was 85.32±4.89.The life quality has significantly improved after the operation of EVLA (t=12.71,P <0.05).The VAS one month after treatment was lower than 1 week before therapy (t=8.048,P <0.05).Major complications such as deep vein thrombosis and skin bums were not found.Most of the complications were minor and improved quickly.Conclusions This refinement type of EVLA procedure is a safe and effective treatment with a high satisfaction rate; it displayed noteworthy features including shortening hospitalization,early ambulant activity,and preferable occlusion rates.

  18. Prospective study of ultrasound-guided percutaneous renal cryotherapy: case selection as an optimization factor for a technique.

    Science.gov (United States)

    Rodríguez-Faba, O; Palou, J; Rosales, A; de la Torre, P; Martí, J; Palazzetti, A; Villavicencio, H

    2015-01-01

    To evaluate the technical and oncological effectiveness of ultrasound-guided percutaneous renal cryotherapy (PRC) in a selected group of patients with renal cancer. We conducted a prospective study of 28 patients with posterior-facing T1a renal tumors with middle and inferior external borders. All patients underwent ultrasound-guided PRC. Follow-up was conducted with computed tomography at 1 month and then every 6 months, with a good result defined as the total absence of contrast incorporation. We performed a descriptive and survival study using the Kaplan-Meier estimator. The 28 patients had a mean age (SD) of 68.3 (10.1) years, and the group underwent 28 procedures. The mean (SD) size of the tumors was 25.5 (7.5) mm, the mean nephrometry score was 1.41 (0.52) and the mean preoperative creatinine level was 133.5 (144.1) mmol/L. There were no intraoperative complications. In terms of postoperative complications, there was only 1 case (3.5%) of a skin lesion resulting from treating a tumor in a transplanted kidney (Clavien II). The median follow-up was 25 months, and the mean (SD) postoperative creatinine level was 135.5 (110.3) mmol/L. Two cases presented radiological recurrence (93% efficacy), with a mean time to recurrence of 12 and 19 months, respectively. There were no tumor-related deaths. Our series (the largest on PRC in our country to date) shows that, with an appropriate selection of tumors, PRC is a safe technique with minimal morbidity. Ultrasonography enables the controlled performance of the procedure and saves the patient from radiation and reduces costs. Copyright © 2013 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Comparison of ultrasound-guided thrombin injection and compression repair in treatment of iatrogenic femoral arterial pseudoaneurysms

    Institute of Scientific and Technical Information of China (English)

    QIN Jun; GAO Yun-hua; ZHUO Zhong-xiong; HUANG Lan; LI Ai-min; SONG Yao-ming; JIN Jun; YU Xue-jun; GENG Zhao-hua; ZHOU Xia-bo; LIN Chun-mei

    2006-01-01

    Objective:To retrospectively compare the efficacy and safety of ultrasound-guided thrombin injection (UGTI) with ultrasound-guided compression repair (UGCR) in patients with postcatheterizational femoral arterial pseudoaneurysms (PSA). Methods: Thirty patients of this iatrogenic PSA [8males, 22 females, average age (66.5± 5.2) years] in our nstitution from 1997 to 2004 were retrospectively analyzed. Among them, 11 patients were treated with UGCR, 2 under continuous ultrasonographic (US) guidance and 9 under the guidance of femoral arterial bruit auscultation and dorsalis pedis artery palpation. Because UGCR was failed in 5 patients, consecutively 24 patients were treated with UGTI. Wine thrombin solution at a concentration of 200 U/ml was injected percutaneously using 22-25 gauge needles under color Doppler US. Demographics, clinical variables, pseudoaneurysm characteristics, and results of the 2 groups were compared by using Fisher's exact test and Student's t test. Results: The initial success rate of UGCR was 36.4% (4/11) nd the overall success rate was 45.5% (5/11). Ten of 11 patients suffered from local pain during the compression, but there was no any complication in UGTI group. The average dose of injected thrombin was (180±82) U for PSA of a single loculus and (315±150) U for multiloculated PSA. The initial success rate of UGTI was 89.5% (17/19) and the verall uccess rate was 100% (24/24). Conclusion:UGTI offers a safe, quick and effective means of definitively treating femoral pseudoaneurysms and seems superior to UGCR. The amount of thrombin applied on our people seems smaller compared with others' work.

  20. Intra-articular distribution pattern after ultrasound-guided injections in wrist joints of patients with rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Boesen, Mikael [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Copenhagen (Denmark)], E-mail: parker@frh.regioh.dk; Jensen, Karl Erik [State Hospital, Department of Radiology, MRI Division, Copenhagen (Denmark)], E-mail: karl.erik.Jensen@rh.regionh.dk; Torp-Pedersen, Soren [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Copenhagen (Denmark); Cimmino, Marco A. [Rheumatologic Clinic, Department of Internal Medicine, University of Genoa (Italy)], E-mail: cimmino@unige.it; Danneskiold-Samsoe, Bente; Bliddal, Henning [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Copenhagen (Denmark)

    2009-02-15

    Objective: To investigate the distribution of an ultrasound-guided intra-articular (IA) injection in the wrist joint of patients with rheumatoid arthritis (RA). Methods: An ultrasound-guided IA drug injection into the wrist joint was performed in 17 patients with 1 ml methylprednisolone (40 mg/ml), 0.5 ml Lidocaine (5 mg/ml) and 0.15 ml gadolinium (Omniscan 0.5 mmol/ml). The drug solution was placed in the central proximal part of the wrist between the distal radius and the lunate bone. Coronal and axial MRI sequences were performed after the injection to visualize the distribution. Carpal distribution (radio-carpal, inter-carpal, and carpo-metacarpal) as well as radio-ulnar distribution was recorded. Full distribution in one compartment was given the value 1, partial distribution 0.5 and no distribution 0. A sum of the total distribution for all four compartments was calculated and correlated to the clinical parameters and the MRI OMERACT scores. Results: No uniform pattern was seen in the distribution of the contrast. Only two patients had full contrast distribution to all four compartments, and the mean distribution count for all patients was 2.4 (range 0.5-4). The distribution count correlated with the MRI OMERACT synovitis score (r = 0.60, p = 0.014), but not with the erosions, bonemarrow oedema scores or any clinical parameters. Conclusion: The distribution of contrast on MRI showed patient specific and random patterns after IA injections in active RA wrist joints. The degree of distribution increased with the MRI synovitis score, while no association was found with the erosion- and bonemarrow oedema score. These results indicate that a single injection into a standard injection site in the proximal part of the wrist cannot be assumed to distribute - and treat - the whole joint.

  1. Ultrasound-guided diagnostic breast biopsy methodology: retrospective comparison of the 8-gauge vacuum-assisted biopsy approach versus the spring-loaded 14-gauge core biopsy approach

    Science.gov (United States)

    2011-01-01

    Background Ultrasound-guided diagnostic breast biopsy technology represents the current standard of care for the evaluation of indeterminate and suspicious lesions seen on diagnostic breast ultrasound. Yet, there remains much debate as to which particular method of ultrasound-guided diagnostic breast biopsy provides the most accurate and optimal diagnostic information. The aim of the current study was to compare and contrast the 8-gauge vacuum-assisted biopsy approach and the spring-loaded 14-gauge core biopsy approach. Methods A retrospective analysis was done of all ultrasound-guided diagnostic breast biopsy procedures performed by either the 8-gauge vacuum-assisted biopsy approach or the spring-loaded 14-gauge core biopsy approach by a single surgeon from July 2001 through June 2009. Results Among 1443 ultrasound-guided diagnostic breast biopsy procedures performed, 724 (50.2%) were by the 8-gauge vacuum-assisted biopsy technique and 719 (49.8%) were by the spring-loaded 14-gauge core biopsy technique. The total number of false negative cases (i.e., benign findings instead of invasive breast carcinoma) was significantly greater (P = 0.008) in the spring-loaded 14-gauge core biopsy group (8/681, 1.2%) as compared to in the 8-gauge vacuum-assisted biopsy group (0/652, 0%), with an overall false negative rate of 2.1% (8/386) for the spring-loaded 14-gauge core biopsy group as compared to 0% (0/148) for the 8-gauge vacuum-assisted biopsy group. Significantly more (P biopsy group (81/719, 11.3%) than in the 8-gauge vacuum-assisted biopsy group (18/724, 2.5%) were recommended for further diagnostic surgical removal of additional tissue from the same anatomical site of the affected breast in an immediate fashion for indeterminate/inconclusive findings seen on the original ultrasound-guided diagnostic breast biopsy procedure. Significantly more (P biopsy group (54/719, 7.5%) than in the 8-gauge vacuum-assisted biopsy group (9/724, 1.2%) personally requested further

  2. Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) in insulinomas: Indications and clinical relevance in a single investigator cohort of 47 patients.

    Science.gov (United States)

    Kann, Peter Herbert; Moll, Roland; Bartsch, Detlef; Pfützner, Andreas; Forst, Thomas; Tamagno, Gianluca; Goebel, Joachim N; Fourkiotis, Verena; Bergmann, Simona Raluca; Collienne, Maike

    2017-04-01

    This study was aimed to investigate the role and relevance of endoscopic ultrasound-guided fine-needle aspiration biopsy in the diagnostic work-up of insulinomas. We have analysed the frequency, clinical indications, success rate (obtaining diagnostic tissue), diagnostic accuracy (in comparison to the pathological diagnosis after surgery), complications, and tolerability of endoscopic ultrasound-guided fine-needle aspiration biopsy and the localization and size of the lesions in 47 consecutive patients (29 females, 18 males; 46 ± 15 years) who had surgery for insulinoma following fasting test and were explored by single investigator EUS 1994-2015. Endoscopic ultrasound-guided fine-needle aspiration biopsy was performed in 21 % (10/47) of the patients. The clinical indications for endoscopic ultrasound-guided fine-needle aspiration biopsy were non-conclusive result of fasting test (n = 7), missing toxicology (n = 2), suspected malignancy at EUS (n = 1), suspicious extra-pancreatic localization of the lesion (n = 1). The diagnostic success rate of the procedure was 80 % (8/10 cases), the diagnostic accuracy of the fine-needle aspiration biopsy 70 % (7/10 cases). The lesions undergoing endoscopic ultrasound-guided fine-needle aspiration biopsy were localized in the cauda (n = 5), corpus (n = 2), caput/processus uncinatus (n = 3), the diameter of the tumors was 21 ± 18 (10-70) mm. Only one accidental vascular puncture without any clinical complication occurred and all patients tolerated the procedure well. In the majority of cases, positive fasting test, negative toxicology, and detection of a typical pancreatic lesion at endoscopic ultrasound is sufficient for the diagnosis of insulinoma and the definition of the appropriate surgical strategy. Based on our data, we suggest including endoscopic ultrasound-guided fine-needle aspiration biopsy in the diagnostic work-up of organic hyperinsulinism in selected patients with

  3. Ultrasound-guided biopsy of greater omentum: An effective method to trace the origin of unclear ascites

    Energy Technology Data Exchange (ETDEWEB)

    Que Yanhong [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: quebaobao@yahoo.com.cn; Wang Xuemei [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: wxmlmt@yahoo.com.cn; Liu Yanjun [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: lyj7512@sina.com; Li Ping [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: liping7213@sina.com; Ou Guocheng [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: yang9951@126.com; Zhao Wenjing [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: awk999@163.com

    2009-05-15

    Objectives: Thickened greater omentum is encountered with high frequency in patients with ascites. The purpose of our study was to assess the utility of greater omentum biopsy under the guidance of ultrasound (US) in tracing the origin of unclear ascites and differentiating benign and malignant ascites. Materials and methods: We retrospectively reviewed our institutional database for all records of greater omentum biopsy cases. One hundred and ninety-four patients with unclear ascites and thickened greater omentum were included in the study. The sonograms of greater omentum were evaluated before undergoing the ultrasound-guided biopsy and a biopsy was considered successful if a specific benign or malignant diagnosis was rendered by the pathologist. Results: Successful biopsy was rendered for 182 biopsy procedures (93.8%, 182/194) including tuberculosis (n = 114), chronic inflammation (n = 3), metastases (n = 58), malignant mesothelioma (n = 6) and pseudomyxoma peritonei (n = 1). Twelve biopsies were non-diagnostic. According to the results of biopsy and follow-up, the sensitivity and specificity of biopsy in distinguishing malignant ascites from benign ascities were respectively 95.6% (65/68) and 92.9% (117/126). The greater omentum of 84 cases of tuberculous peritonitis showed 'cerebral fissure' sign and was well seen as an omental cake infiltrated with irregular nodules when involved by carcinomatosis. No 'cerebral fissure' sign was observed in peritoneal carcinomatosis. The sensitivity and specificity of this sign in indicating the existence of tuberculous peritonitis were 73.5% (89/121) and 100% (73/73). Moreover, if the specific 'cerebral fissure' sign was combined with the biopsy results, the specificity of biopsy in distinguishing malignant ascites from benign ascits increased to 96.8% (122/126). Conclusion: Ultrasound-guided biopsy of greater omentum is an important and effective method to diagnose the unclear ascites for

  4. Introducing a Fresh Cadaver Model for Ultrasound-guided Central Venous Access Training in Undergraduate Medical Education

    Directory of Open Access Journals (Sweden)

    Ryan Miller

    2016-05-01

    Full Text Available Introduction: Over the past decade, medical students have witnessed a decline in the opportunities to perform technical skills during their clinical years. Ultrasound-guided central venous access (USG-CVA is a critical procedure commonly performed by emergency medicine, anesthesia, and general surgery residents, often during their first month of residency. However, the acquisition of skills required to safely perform this procedure is often deficient upon graduation from medical school. To ameliorate this lack of technical proficiency, ultrasound simulation models have been introduced into undergraduate medical education to train venous access skills. Criticisms of simulation models are the innate lack of realistic tactile qualities, as well as the lack of anatomical variances when compared to living patients. The purpose of our investigation was to design and evaluate a life-like and reproducible training model for USG-CVA using a fresh cadaver. Methods: This was a cross-sectional study at an urban academic medical center. An 18-point procedural knowledge tool and an 18-point procedural skill evaluation tool were administered during a cadaver lab at the beginning and end of the surgical clerkship. During the fresh cadaver lab, procedure naïve third-year medical students were trained on how to perform ultrasound-guided central venous access of the femoral and internal jugular vessels. Preparation of the fresh cadaver model involved placement of a thin-walled latex tubing in the anatomic location of the femoral and internal jugular vein respectively. Results: Fifty-six third-year medical students participated in this study during their surgical clerkship. The fresh cadaver model provided high quality and lifelike ultrasound images despite numerous cannulation attempts. Technical skill scores improved from an average score of 3 to 12 (p<0.001 and procedural knowledge scores improved from an average score of 4 to 8 (p<0.001. Conclusion: The use of

  5. Role of endoscopic ultrasound-guided fine-needle aspiration in the diagnosis of space occupying lesions of the pancreas

    Directory of Open Access Journals (Sweden)

    S Palaniappan

    2014-01-01

    Full Text Available Introduction: Space occupying lesions (SOLs of the pancreas are commonly encountered in day to day practice either as an incidental finding or during evaluation of symptomatic patients. The aim of the present study was to compare the final diagnosis at follow-up with diagnosis made at computed tomography (CT/magnetic resonance imaging (MRI and endoscopic ultrasound (EUS. Materials and Methods: Retrospective analysis of EUS data of 131 patients referred for tissue diagnosis of SOL in pancreas was done. The lesions were classified as malignant, benign, and nonneoplastic by both CT/MRI and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA in conjunction with clinical presentation, biochemical parameters, and tumor markers. Follow-up cases with a final diagnosis alone were included for the comparative analysis. Statistical Analysis: Chi-square test, sensitivity, specificity, positive predictive value (PPV, and negative predictive values (NPV for CT/MRI and EUS-FNA were computed against the follow-up data. Results: Of the 131, there were 78 males (59.5%. The median age of presentation was 48 years (range: 11-82 years. Follow-up information on the final diagnosis was available for 54 patients. Confirmed diagnosis at follow-up was malignant lesion in 18, benign in 13 and 23 with a nonneoplastic lesion. When EUS-FNA outcome was compared with the definitive diagnosis of the 54 patients, it had a higher sensitivity for malignant (66.7% vs. 61.1% and nonneoplastic lesions (78.3% vs. 73.9% and was similar to CT/MRI for benign lesions (76.9% for both. EUS-FNA had a higher specificity (87.8% vs. 80.5% with a good PPV for benign lesions (66.7% vs. 55.6%. CT/MRI was less accurate than EUS-FNA in predicting benign (79.6% vs. 85.2% and nonneoplastic lesions (79.6% vs. 81.5% compared to malignant lesions wherein it was similar at 81.5%. The high NPV with a lower PPV for both EUS/FNA and CT/MRI suggests that follow-up definitive diagnosis was superior to

  6. Effect of Ultrasound Guided Rectus Sheath Block on Postoperative Analgesia after Laparotomy with Transverse Incision in Children

    Directory of Open Access Journals (Sweden)

    Aydin Halefoglu

    2015-09-01

    Material and Methods: Forty patients with ASA I-II physical status, aged 3-7 years and undergoing laparotomy with transverse incision were randomly allocated into two groups. Patients were administered general anesthesia and before the beginning of surgery ultrasound guided RSB with 0.2 mL/kg, 0.25% of levobupivacaine and thirty minutes before the surgery the loading dose of morphine of 0.1 mg/kg intravenously were received in group RSB and group M, respectively. Analgesic drug pump with 0.01 mg/kg bolus doses of morphine and 30 minutes lockout interval was set up postoperatively in both groups. Concentrations (% and consumed amounts (mL/h of sevoflurane during the surgery and systolic and diastolic blood pressure, heart rate, and peripheral oxygen saturation values were recorded both intraoperative and postoperative period in each groups. Analgesic consumption with postoperative analgesic drug pump, FLACC pain scores, sedation level, nausea, vomiting, supplemental analgesic requirement and side effects were also recorded. Results: Demographic data and hemodynamic parameters were similar in both groups excepting that systolic arterial pressure values were reduced in group RSB than in group M. Inhaled concentration and consumed amounts of sevoflurane were decreased in group RSB compared with group M. Averages of consumptions of sevoflurane were 18.7+/-2.1 mL/h and 21.5 +/-2.9 mL/h in group RSB and group M, respectively (p<0.001. Postoperative FLACC scores, sedation scores, and morphine consumption for 24 hours were lower in group RSB than in group M (p<0.001. Three patients had nausea in group M, however no nausea and vomiting was observed in group RSB and any patients did not need supplemental analgesia postoperatively. Conclusions: Ultrasound guided RSB is superior to intravenous morphine according to intraoperative anesthetic gas consumption and postoperative pain control in children undergoing abdominal surgery using transverse incision. [Cukurova Med J 2015; 40

  7. Management of pudendal neuralgia using ultrasound-guided pulsed radiofrequency: a report of two cases and discussion of pudendal nerve block techniques.

    Science.gov (United States)

    Hong, Myong-Joo; Kim, Yeon-Dong; Park, Jeong-Ki; Hong, Hyon-Joo

    2016-04-01

    Pudendal neuralgia is characterized by chronic pain or discomfort in the area innervated by the pudendal nerve, with no obvious cause. A successful pudendal nerve block is crucial for the diagnosis of pudendal neuralgia. Blind or fluoroscopy-guided pudendal nerve blocks have been conventionally used for diagnosis and treatment; however, ultrasound-guided pudendal nerve blocks were also reported recently. With regard to the achievement of long-term effects, although pulsed radiofrequency performed under fluoroscopic guidance has been reported, that performed under ultrasound guidance is not well reported. This report describes two cases of pudendal neuralgia that were successfully managed using ultrasound-guided pulsed radiofrequency and presents a literature review of pudendal nerve block techniques. However, in the management of chronic neuropathic pain, physicians should keep in mind that the placebo effect related to invasive approaches must not be neglected.

  8. A randomised, controlled, double-blind trial of ultrasound-guided phrenic nerve block to prevent shoulder pain after thoracic surgery

    DEFF Research Database (Denmark)

    Blichfeldt-Eckhardt, M R; Laursen, C B; Berg, H

    2016-01-01

    to receive an ultrasound-guided supraclavicular phrenic nerve block with 10 ml ropivacaine or 10 ml saline (placebo) immediately following surgery. A nerve catheter was subsequently inserted and treatment continued for 3 days. The study drug was pharmaceutically pre-packed in sequentially numbered identical......Moderate to severe ipsilateral shoulder pain is a common complaint following thoracic surgery. In this prospective, parallel-group study at Odense University Hospital, 76 patients (aged > 18 years) scheduled for lobectomy or pneumonectomy were randomised 1:1 using a computer-generated list...... that ultrasound-guided supraclavicular phrenic nerve block is an effective technique for reducing the incidence of ipsilateral shoulder pain after thoracic surgery....

  9. Endoscopic Ultrasound-Guided Drainage of Intra-Abdominal Abscess after Gastric Perforation in a Patient Receiving Ramucirumab and Paclitaxel for Advanced Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Koichiro Mandai

    2017-01-01

    Full Text Available Gastrointestinal perforation is a serious adverse event that occurs in approximately 1% of patients receiving ramucirumab and paclitaxel. A 67-year-old man with unresectable advanced gastric cancer was admitted to our hospital and treated with ramucirumab and paclitaxel. Gastric perforation occurred during the second cycle of chemotherapy. Although the patient’s condition improved without surgery, an abscess developed in the intra-abdominal fluid collection resulting from the perforation. We performed endoscopic ultrasound-guided abscess drainage. The patient improved and was discharged in satisfactory condition. Endoscopic ultrasound-guided drainage is a treatment option for patients with intra-abdominal abscess following gastric perforation due to ramucirumab.

  10. Transperineal seed-implantation guided by biplanar transrectal ultrasound

    DEFF Research Database (Denmark)

    Holm, Hans Henrik; Torp-Pedersen, S; Myschetzky, P

    1990-01-01

    A new method for precise transperineal placement of therapeutic sources in prostatic cancer is described. The method is a modification of the technique described in 1983 by Holm and coworkers. Insertion of needles is monitored by transverse as well as longitudinal transrectal ultrasound.......A new method for precise transperineal placement of therapeutic sources in prostatic cancer is described. The method is a modification of the technique described in 1983 by Holm and coworkers. Insertion of needles is monitored by transverse as well as longitudinal transrectal ultrasound....

  11. Ultrasound guided aspiration of hydrosalpinx fluid versus salpingectomy in the management of patients with ultrasound visible hydrosalpinx undergoing IVF-ET: a randomized controlled trial

    OpenAIRE

    Fouda, Usama M; Sayed, Ahmed M; Abdelmoty, Hatem I; Khaled A. Elsetohy

    2015-01-01

    Background The aim of this study was to compare the efficacy of ultrasound guided aspiration of hydrosalpinx fluid at the time of oocyte retrieval with salpingectomy in the management of patients with ultrasound visible hydrosalpinx undergoing IVF-ET. Methods One hundred and sixty patients with ultrasound visible hydrosalpinx were randomized into salpingectomy group and aspiration group using computer generated randomization list and sequentially numbered sealed envelopes containing allocatio...

  12. Ultrasound-Guided Needle Biopsy of Neck Lymph Nodes in Patients With Suspected Lung Cancer: Are the Specimens Sufficient for Complete Pathologic Evaluation to Guide Patient Management?

    Science.gov (United States)

    Duguay, Sean; Wagner, Jason M; Zheng, Wei; Ling, Johnny; Zhao, Lichao C; Allen, Karen S; North, Justin C; Deb, Subrato J

    2017-06-01

    The purpose of this study is to determine the ability of ultrasound guided needle biopsy of a neck lymph node to provide adequate tissue for complete pathologic evaluation of suspected metastatic lung cancer, including molecular testing for epidermal growth factor receptor gene mutations by pyrosequencing and anaplastic lymphoma kinase gene rearrangement by fluorescence in situ hybridization. Institutional review board approval was obtained and the requirement for informed consent was waived. All ultrasound guided neck biopsies performed July 1, 2011, to June 30, 2015, were retrospectively reviewed, and all biopsies performed for suspected lung cancer metastatic to supraclavicular and cervical lymph nodes were included. Forty patients with suspected lung cancer underwent ultrasound-guided needle biopsy of an abnormal appearing neck lymph node identified on preprocedure computed tomography or positron emission tomography/computed tomography. Thirty-seven patients were subsequently diagnosed with lung cancer and 3 were diagnosed with lymphoma. A definitive pathologic diagnosis was rendered in 95% of neck node biopsies (38/40; 95% confidence interval, 84%-99%). Of the 36 specimens diagnostic for lung cancer, 16 were considered for further molecular testing and the specimen was adequate for molecular testing in 15 (94%; 73%-100%) cases. Therefore, the neck node biopsy specimens were adequate for complete pathologic workup in 93% (37/40; 81%-98%). No complications related to the biopsies were observed. In patients presenting with suspected lung cancer and suspicious neck lymph nodes, ultrasound-guided needle biopsy frequently provides adequate tissue for complete pathologic evaluation and eliminates the need for more invasive procedures.

  13. The impact of in situ methotrexate injection after transvaginal ultrasound-guided aspiration of ovarian endometriomas on ovarian response and reproductive outcomes during IVF-cycles

    Directory of Open Access Journals (Sweden)

    H.E. Shawki

    2012-06-01

    Conclusion(s: In situ methotrexate injection after transvaginal ultrasound-guided aspiration was a simple, safe and successful method for treating ovarian endometriomas with minimal effects on ovarian response. Short term effects on reproductive outcomes, risk of fetal loss or anomaly were minimal. Six months was enough as washout period of the drug prior to conception and was advisable to prevent the small chance of chromosomal abnormalities in the offspring.

  14. Endoscopic ultrasound-guided fine needle aspiration and biopsy using a 22-gauge needle with side fenestration in pancreatic cystic lesions.

    Science.gov (United States)

    Barresi, Luca; Tarantino, Ilaria; Traina, Mario; Granata, Antonino; Curcio, Gabriele; Azzopardi, Neville; Baccarini, Paola; Liotta, Rosa; Fornelli, Adele; Maimone, Antonella; Jovine, Elio; Cennamo, Vincenzo; Fabbri, Carlo

    2014-01-01

    Cytologic diagnosis by endoscopic ultrasound-guided fine needle aspiration is associated with low sensitivity and adequacy. A newly designed endoscopic ultrasound-guided fine needle biopsy device, endowed with a side fenestration, is now available. We carried out a study with the aim of evaluating the feasibility, safety, and diagnostic yield of the 22-gauge needle with side fenestration for endoscopic ultrasound fine needle aspiration and biopsy of pancreatic cystic lesions. 58 patients with 60 pancreatic cystic lesions consecutively referred for endoscopic ultrasound guided-fine needle aspiration were enrolled in a prospective, dual centre study, and underwent fine needle aspiration and biopsy with the 22-gauge needle with side fenestration. Fine needle aspiration and biopsy was technically feasible in all cases. In 39/60 (65%) pancreatic cystic lesions, the specimens were adequate for cyto-histologic assessment. In lesions with solid components, and in malignant lesions, adequacy was 94.4% (p = 0.0149) and 100% (p = 0.0069), respectively. Samples were adequate for histologic evaluation in 18/39 (46.1%) cases. There were only 2 (3.3%) mild complications. Fine needle aspiration and biopsy with the 22-gauge needle with side fenestration is feasible, and superior to conventional endoscopic ultrasound-guided fine needle aspiration cytology from cystic fluid, particularly in pancreatic cystic lesions with solid component or malignancy, with a higher diagnostic yield and with no increase in complication rate. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  15. Efficacy and complications of ultrasound-guided percutaneous renal biopsy using 18 G automatic biopsy gun in diffuse renal disease: Analysis of 203 cases

    Energy Technology Data Exchange (ETDEWEB)

    Gwon, Dong Il; Lee, Kang Hoon; Song, Kyung Sup; An, Suk Joo; Son, Sang Bum; Kim, Hyeon Suk [The Catholic University of Korea, St. Paul' s Hospital, Seoul (Korea, Republic of); Kim, Jee Young; Kim, Won Young; Park, Young Ha [The Catholic University of Korea, St. Vincent' s Hospital, Suwon (Korea, Republic of)

    2000-12-15

    To evaluate the efficacy and complications of ultrasound-guided percutaneous renal biopsy using 18G automatic biopsy gun in patients with diffuse renal disease. 203 ultrasound-guided renal biopsies using 18G automatic biopsy gun were performed in 197 patients for the diagnosis of diffuse renal disease. The success and complication rates were retrospectively evaluated by analysis of pathologic and clinical records and post-procedure ultrasonograms of the patients. Out of 203 renal biopsies, adequate tissues for pathologic diagnosis were obtained in 184 (90.6%) biopsies. The mean number of needle passes was 2.08, and the mean number of retrieved glomeruli was 7.71 {+-} 4.23. Minor complications occurred in seven biopsies (3.45%) including asymptomatic macroscopic hematuria in five (2.45%) and small subcapsular hematomas in two (1%). No patients required transfusion or surgery because of biopsy-related complication. Ultrasound-guided percutaneous renal biopsy using 18G automatic biopsy gun was an effective method for the pathologic diagnosis of diffuse renal disease and safe with low complication rate related to the procedure.

  16. The Effectiveness of Ultrasound-Guided Steroid Injection for Femoroacetabular Impingement: A Comparison between the Extra-Articular and Intra-Articular Approaches

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Chang Ho; Lee, Joon Woo [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2013-03-15

    To assess the effectiveness of pain control using ultrasound-guided steroid injection by the extra-articular and intra-articular approaches to femoroacetabular impingement patients. From September through December 2010, 18 patients with clinical suspicion of femoroacetabular impingement syndrome underwent ultrasound-guided steroid and local anesthetics injection: a total of 20 cases, including 16 cases of ipsilateral and 2 cases of bilateral injection. Extra-articular or intra-articular approach was selected for each patient, randomly and alternately. Nine cases were performed by extra-articular approach and 11 cases were performed by intra-articular approach. Every patient was observed in the outpatient clinic and visual analogue scale (VAS) was taken and compared before and after the procedure in all patients. Pre-injection average VAS value of extra-articular approached cases was 5.22 {+-} 1.99 and post-injection average VAS value was 4.11 {+-} 1.96, which is statistically insignificant (p < 0.156). The average VAS value of intra-articular approached cases was decreased from 5.72 {+-} 2.15 to 2.91 {+-} 2.30 after injection, which is statistically significant (p < 0.006). Ultrasound guided intra-articular approached steroid and local anesthetics injection could be effective in controlling pain for patients with femoroacetabular impingement syndrome.

  17. Preoperative ultrasound-guided needle biopsy of 63 uterine tumors having high signal intensity upon T2-weighted magnetic resonance imaging.

    Science.gov (United States)

    Tamura, Ryo; Kashima, Katsunori; Asatani, Mina; Nishino, Koji; Nishikawa, Nobumichi; Sekine, Masayuki; Serikawa, Takehiro; Enomoto, Takayuki

    2014-07-01

    The differential diagnosis between uterine sarcoma and benign leiomyoma is difficult when made only by magnetic resonance imaging (MRI); it usually requires an additional preoperative diagnostic procedure. We report our results using ultrasound-guided needle biopsy for these types of uterine tumors. Ultrasound-guided needle biopsy was performed on 63 patients with uterine smooth muscle tumors suspected of malignancy by MRI. We compared the results of presurgical biopsy against the postsurgical pathology of the tumor. Among 63 patients with a high signal intensity of the uterine tumor on T2-weighted MRI (1 case was undetermined), 12 cases (19.3%) were diagnosed by the needle biopsy as malignant, and 51 cases (80.6%) were benign. Among the 12 diagnosed as malignant tumors, 11 had surgery performed, and one was treated with chemotherapy. Among the 51 patients diagnosed with a benign tumor, 27 had surgery performed, and 24 were put on a wait-and-see clinical follow-up schedule. One of the 27 surgical patients with a benign tumor had a postsurgical diagnosis of a low-grade endometrial stromal sarcoma. In the 38 cases where surgery was performed, we found the sensitivity, specificity, and the positive and negative predictive values of the needle biopsy were 91.7%, 100%, 100%, and 96.2%, respectively. Ultrasound-guided needle biopsy may be a reliable preoperative diagnostic procedure for uterine tumors with suspected malignancy.

  18. A prospective randomized study comparing 25-G and 22-G needles of a new platform for endoscopic ultrasound-guided fine needle aspiration of solid masses.

    Science.gov (United States)

    Carrara, Silvia; Anderloni, Andrea; Jovani, Manol; Di Tommaso, Luca; Rahal, Daoud; Hassan, Cesare; Ridola, Lorenzo; Federico, Davide; Loriga, Alessandra; Repici, Alessandro

    2016-01-01

    A new needle platform for endoscopic ultrasound-guided fine-needle aspiration biopsy has been developed that allows interchangeability of all needle sizes. To prospectively compare the efficacy of the new 25-G needles and 22-G needles for obtaining an adequate aspirate of solid masses. Randomized controlled trial of 144 patients referred for endoscopic ultrasound-guided fine-needle aspiration of solid pancreatic masses, intraparietal tumours, or lymph-nodes, randomized to the 25-G or 22-G needle arms. An adequate specimen was obtained from 74.3% of cases. The sample tended to be more adequate in the 25-G compared to the 22-G group (81% vs. 68%; p=0.09). Crossover was required in 14 (19%) and 12 (17%) cases in the 22-G and in the 25-G groups, respectively (p=0.7). The overall rate of adequacy improved from 74% before crossover to 90% after crossover (pneedle was superior to the 22-G needle for endoscopic ultrasound-guided fine-needle aspiration biopsy. The adequacy and diagnostic accuracy improved after crossover, reaching 90%. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  19. Ultrasound-guided needling combined with shock-wave therapy for the treatment of calcifying tendonitis of the shoulder.

    Science.gov (United States)

    Krasny, C; Enenkel, M; Aigner, N; Wlk, M; Landsiedl, F

    2005-04-01

    We carried out a prospective, randomised controlled trial on two groups of 40 patients with painful calcific tendonitis and a mean age of 48.4 years (32.5 to 67.3). All were to undergo arthroscopic removal of the calcific deposit within six months after randomisation. The 40 patients in group I received ultrasound-guided needling followed by high-energy shock-wave therapy and the 40 in group II had shock-wave therapy alone. In both groups one treatment consisting of 2500 impulses of shock waves with an energy flux density of 0.36 mJ/mm(2) was applied. The clinical and radiological outcome was assessed using the 100-point Constant shoulder scoring system and standardised radiographs. The mean follow-up was 4.1 months and no patient was lost to follow-up. Both groups had significant improvement in their Constant shoulder score. Radiographs showed disappearance of the calcific deposit in 60.0% of the shoulders in group I and in 32.5% of group II (p tendonitis, giving significantly higher rates of elimination of the calcium deposits, better clinical results and reduction in the need for surgery.

  20. Successful Localization of Abnormal Parathyroid Gland Using Ultrasound-Guided Methylene Blue Dye Injection in the Reoperative Neck.

    Science.gov (United States)

    Haciyanli, Mehmet; Koruyucu, Melike Bedel; Erdoğan, Nezahat Karaca; Dere, Ozcan; Sarı, Erdem; Kumkumoğlu, Yusuf; Tavusbay, Cengiz; Kamer, Erdinc

    2015-12-01

    Persistent or recurrent hyperparathyroidism is a challenging problem for endocrine surgeons. The aim of this study was to review our experience using ultrasound-guided (US-G) methylene blue dye injection for the localization and removal of abnormal parathyroid glands in patients having primary hyperparathyroidism and previous neck surgery. Between January 2012 and May 2013, six consecutive patients with primary hyperparathyroidism (PHPT) and previous neck surgery underwent focused parathyroidectomy with the use of US-G methylene blue dye injections to localize the presumed parathyroid adenoma were included in the study. We analyzed the data of six patients who underwent reoperative parathyroid surgery using US-G methylene blue dye injection retrospectively. The dye injection was performed just prior to surgery. All patients were successfully treated for their hyperparathyroidism which was confirmed by at least 50 % drop in intraoperative parathormone level 10 min after resection. There were no complications related with US-G dye injection or with surgery. US-G methylene blue dye injection is a cheap, safe, and effective method for localization of diseased parathyroid glands and guiding surgery in the reoperative neck.

  1. Perioperative and post-operative complications of transvaginal ultrasound-guided oocyte retrieval: prospective study of >1000 oocyte retrievals.

    Science.gov (United States)

    Ludwig, A K; Glawatz, M; Griesinger, G; Diedrich, K; Ludwig, M

    2006-12-01

    Although transvaginal ultrasound-guided oocyte retrievals (OR) are performed routinely worldwide, there is very little systematic data about its complications. We performed a prospective cohort study following the perioperative and post-operative complications of over 1058 ORs. Additionally, we assessed the pain experienced during the OR. A total of 1166 OR were performed during the study period, of which 1058 (90.7%) ORs were included prospectively. Incomplete data meant that the remaining 9.3% were excluded. No complications were caused by sedation or general anaesthesia. Vaginal bleeding was observed in 2.8% of procedures, without any cases of intra-abdominal bleeding. An injury of pelvic structures (a ureteral lesion) occurred in one case. No case of pelvic infection, but one case of unexplained fever, was observed. A severe ovarian hyperstimulation syndrome (OHSS) occurred in 2.7% of cases. Although most patients tolerated the OR well, 3% of patients experienced severe to very severe pain after the OR and 2% of patients were still suffering from severe pain 2 days after the procedure. The pain level increased with the number of oocytes retrieved. About 0.7% of patients required hospitalization for pain treatment. Patients can be reassured that overall OR is a safe procedure. However, patients have to be counselled about the minor risks of the OR. The literature on complications is reviewed in the article.

  2. Ultrasound-Guided Intercostobrachial Nerve Block for Intercostobrachial Neuralgia in Breast Cancer Patients: A Case Series.

    Science.gov (United States)

    Wisotzky, Eric M; Saini, Vikramjeet; Kao, Cyrus

    2016-03-01

    This case series describes 3 cases in which ultrasound-guided intercostobrachial perineural injection was used for intercostobrachial neuralgia, a common cause of postmastectomy pain syndrome. All cases had undergone modified radical mastectomy with axillary lymph node dissection for breast cancer. Two cases developed axillary and unilateral chest wall pain. The third case initially presented with axillary pain and lateral shoulder pain 1 year out from radical mastectomy. After a cervical epidural steroid injection, her lateral shoulder pain resolved, but she continued to have residual chest wall paresthesia. It was at this time, we decided to treat with an intercostobrachial nerve perineural injection. Injury to the intercostobrachial nerve is thought to be a common cause of postmastectomy pain. In our case series, all patients had pain relief after the intercostobrachial perineural injection. There is a relative dearth of published information on the treatment of postmastectomy pain and more specifically intercostobrachial neuralgia. We review the anatomy of the intercostobrachial nerve and its variants, etiologies of intercostobrachial neuralgia, and current indications and methods of an intercostobrachial perineural injection.

  3. Outcome of unintended pregnancy after ultrasound-guided high-intensity focused ultrasound ablation of uterine fibroids.

    Science.gov (United States)

    Qin, Juan; Chen, Jin-Yun; Zhao, Wen-Peng; Hu, Liang; Chen, Wen-Zhi; Wang, Zhi-Biao

    2012-06-01

    To evaluate the safety of ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation of uterine fibroids among women with unintentional pregnancy within 1 year of therapy. A retrospective analysis was conducted of 435 women who underwent USgHIFU therapy at Chongqing Medical University, China, between October 1, 2006, and October 1, 2009. Unplanned pregnancy was reported by 24 women within 1 year of USgHIFU ablation; 8 of these women had desired pregnancy before undergoing treatment. A total of 27 fibroids were detected, 24 of which were treated (mean volume 65.9±58.8 cm(3)). Pregnancy was continued by 7 women without any complications. One pregnant woman who had desired pregnancy before therapy underwent an induced abortion owing to concerns about the effects of USgHIFU on the fetus. Fourteen women without pregnancy intention before USgHIFU therapy chose to undergo induced abortion; 2 women experienced spontaneous abortion. No adhesion occurred after USgHIFU therapy. Furthermore, USgHIFU, labor, and abortion had no effect on subsequent menstruation or sexual activities. Pregnancy within 1 year after USgHIFU ablation of uterine fibroids appears safe; however, large scale studies are required to confirm these data. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  4. Slow pull versus suction in endoscopic ultrasound-guided fine-needle aspiration of pancreatic solid masses.

    Science.gov (United States)

    Nakai, Yousuke; Isayama, Hiroyuki; Chang, Kenneth J; Yamamoto, Natsuyo; Hamada, Tsuyoshi; Uchino, Rie; Mizuno, Suguru; Miyabayashi, Koji; Yamamoto, Keisuke; Kawakubo, Kazumichi; Kogure, Hirofumi; Sasaki, Takashi; Hirano, Kenji; Tanaka, Mariko; Tada, Minoru; Fukayama, Masashi; Koike, Kazuhiko

    2014-07-01

    Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic masses is an established procedure for obtaining a pathological specimen. However, application of suction during EUS-FNA is still controversial and the efficacy of the slow-pull technique was recently reported for new core biopsy needles. The purpose of this study was to compare the suction and slow-pull techniques using regular FNA needles. The diagnostic yield of the suction and slow-pull techniques was retrospectively studied for patients who underwent EUS-FNA for pancreatic solid lesions. A total of 367 passes (181 by suction and 186 by the slow-pull technique) were performed during 97 EUS-FNA procedures for 93 patients with pancreatic solid lesions. The slow-pull technique resulted in lower scores for cellularity (≥2 for 37.5 % vs. 76.7 %) but scores for contamination with blood were lower (≥2 for 25.0 % vs. 66.7 %) and sensitivity of diagnosis of malignancy was higher (90.0 % vs. 67.9 %) when a 25-gauge FNA needle was used. There were no significant differences between the two techniques when a 22-gauge needle was used. In multivariate analysis of 82 cases with malignancy, the slow-pull technique (odds ratio (OR) 1.92, P = 0.028), tumor size ≥25 mm (OR 4.64, P suction technique in EUS-FNA of pancreatic solid masses, especially with a 25-gauge FNA needle.

  5. Ultrasound-guided percutaneous core needle biopsy of abdominal viscera: Tips to ensure safe and effective biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Woong; Shin, Sang Soo [Chonnam National University Hospital, Chonnam National University Medical School, Gwangju(Korea, Republic of)

    2017-04-15

    Ultrasound-guided percutaneous core needle biopsy (USPCB) is used extensively in daily clinical practice for the pathologic confirmation of both focal and diffuse diseases of the abdominal viscera. As a guidance tool, US has a number of clear advantages over computerized tomography or magnetic resonance imaging: fewer false-negative biopsies, lack of ionizing radiation, portability, relatively short procedure time, real-time intra-procedural visualization of the biopsy needle, ability to guide the procedure in almost any anatomic plane, and relatively lower cost. Notably, USPCB is widely used to retrieve tissue specimens in cases of hepatic lesions. However, general radiologists, particularly beginners, find USPCB difficult to perform in abdominal organs other than the liver; indeed, a full understanding of the entire USPCB process and specific considerations for specific abdominal organs is necessary to safely obtain adequate specimens. In this review, we discuss some points and techniques that need to be borne in mind to increase the chances of successful USPCB. We believe that the tips and considerations presented in this review will help radiologists perform USPCB to successfully retrieve target tissue from different organs with minimal complications.

  6. Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage after failed endoscopic retrograde cholangiopancreatography: a meta-analysis

    Science.gov (United States)

    Baniya, Ramkaji; Upadhaya, Sunil; Madala, Seetharamprasad; Subedi, Subash Chandra; Shaik Mohammed, Tabrez; Bachuwa, Ghassan

    2017-01-01

    The failure rate of endoscopic retrograde cholangiopancreatography for biliary cannulation is approximately 6%–7% in cases of obstructive jaundice. Percutaneous transhepatic biliary drainage (PTBD) is the procedure of choice in such cases. Endoscopic ultrasound-guided biliary drainage (EGBD) is a novel technique that allows biliary drainage by echoendoscopy and fluoroscopy using a stent from the biliary tree to the gastrointestinal tract. Information in PubMed, Scopus, clinicaltrials.gov and Cochrane review were analyzed to obtain studies comparing EGBD and PTBD. Six studies fulfilled the inclusion criteria. Technical (odds ratio (OR): 0.34; confidence interval (CI) 0.10–1.14; p=0.05) and clinical (OR: 1.48; CI 0.46–4.79; p=0.51) success rates were not statistically significant between the EGBD and PTBD groups. Mild adverse events were nonsignificantly different (OR: 0.36; CI 0.10–1.24; p=0.11) but not the moderate-to-severe adverse events (OR: 0.16; CI 0.08–0.32; p≤0.00001) and total adverse events (OR: 0.34; CI 0.20–0.59; p≤0.0001). EGBD is equally effective but safer than PTBD. PMID:28408850

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

    Science.gov (United States)

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

    2016-01-01

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

  8. Ultrasound-guided continuous suprascapular nerve block for adhesive capsulitis: one case and a short topical review.

    Science.gov (United States)

    Børglum, J; Bartholdy, A; Hautopp, H; Krogsgaard, M R; Jensen, K

    2011-02-01

    We present a case with an ultrasound-guided (USG) placement of a perineural catheter beneath the transverse scapular ligament in the scapular notch to provide a continuous block of the suprascapular nerve (SSN). The patient suffered from a severe and very painful adhesive capsulitis of the left shoulder secondary to an operation in the same shoulder conducted 20 weeks previously for impingement syndrome and a superior labral anterior-posterior tear. Following a new operation with capsular release, the placement of a continuous nerve block catheter subsequently allowed for nearly pain-free low impact passive and guided active mobilization by the performing physiotherapist for three consecutive weeks. This case and a short topical review on the use of SSN block in painful shoulder conditions highlight the possibility of a USG continuous nerve block of the SSN as sufficient pain management in the immediate post-operative period following capsular release of the shoulder. Findings in other painful shoulder conditions and suggestions for future studies are discussed in the text.

  9. Visualization of molecular composition and functionality of cancer cells using nanoparticle-augmented ultrasound-guided photoacoustics

    Science.gov (United States)

    Mallidi, Srivalleesha; Kim, Seungsoo; Karpiouk, Andrei; Joshi, Pratixa P.; Sokolov, Konstantin; Emelianov, Stanislav

    2015-01-01

    Assessment of molecular signatures of tumors in addition to their anatomy and morphology is desired for effective diagnostic and therapeutic procedures. Development of in vivo imaging techniques that can identify and monitor molecular composition of tumors remains an important challenge in pre-clinical research and medical practice. Here we present a molecular photoacoustic imaging technique that can visualize the presence and activity of an important cancer biomarker – epidermal growth factor receptor (EGFR), utilizing the effect of plasmon resonance coupling between molecular targeted gold nanoparticles. Specifically, spectral analysis of photoacoustic images revealed profound changes in the optical absorption of systemically delivered EGFR-targeted gold nanospheres due to their molecular interactions with tumor cells overexpressing EGFR. In contrast, no changes in optical properties and, therefore, photoacoustic signal, were observed after systemic delivery of non-targeted gold nanoparticles to the tumors. The results indicate that multi-wavelength photoacoustic imaging augmented with molecularly targeted gold nanoparticles has the ability to monitor molecular specific interactions between nanoparticles and cell-surface receptors, allowing visualization of the presence and functional activity of tumor cells. Furthermore, the approach can be used for other cancer cell-surface receptors such as human epidermal growth factor receptor 2 (HER2). Therefore, ultrasound-guided molecular photoacoustic imaging can potentially aid in tumor diagnosis, selection of customized patient-specific treatment, and monitor the therapeutic progression and outcome in vivo. PMID:25893171

  10. Sentinel lymph node biopsy revisited: ultrasound-guided photoacoustic detection of micrometastases using molecularly targeted plasmonic nanosensors

    Science.gov (United States)

    Luke, Geoffrey P.; Myers, Jeffrey N.; Emelianov, Stanislav Y.; Sokolov, Konstantin V.

    2014-01-01

    Metastases rather than primary tumors are responsible for killing most cancer patients. Cancer cells often invade regional lymph nodes (LN) before colonizing other parts of the body. However, due to the low sensitivity and specificity of current imaging methods to detect localized nodal spread, an invasive surgical procedure - sentinel lymph node biopsy - is generally employed to identify metastatic cancer cells. Here we introduce a new approach for more sensitive in vivo detection of lymph node micrometastases, based on the use of ultrasound-guided spectroscopic photoacoustic (sPA) imaging of molecularly-activated plasmonic nanosensors (MAPS). Using a metastatic murine model of oral squamous cell carcinoma, we showed that MAPS targeted to the EGFR shifted their optical absorption spectrum to the red-near-infrared region after specific interactions with nodal metastatic cells, enabling their non-invasive detection by sPA. Notably, LN metastases as small as 50 μm were detected at centimeter-depth range with high sensitivity and specificity. Large sPA signals appeared in metastatic LN within 30 minutes of MAPS injection, in support of the clinical utility of this method. Our findings offer a rapid and effective tool to non-invasively identify micrometastases as an alternate to sentinal node biopsy analysis. PMID:25106426

  11. Evaluation of the incidence on insufficient cytology results comparing different ultrasound-guided aspiration techniques for thyroid nodules

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong Hyng; Park, Jun Hyun; Park, Ji Kang [Dept. of Radiology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of)

    2013-07-15

    We compared the incidence of insufficient thyroid cytology due to blood-stained materials or low cellularity in terms of aspiration technique, especially focusing on the degree of suction pressure and needle size. Three experienced radiologists performed ultrasound-guided aspiration for thyroid nodules in 1174 thyroid nodules consecutively. Three different techniques were used; (A) using a 25 gauge needle with mainly capillary technique in 269 nodules; (B) using a 25 gauge needle with 3 cc syringe and minimal suction pressure in 303 nodules; (C) using a 22-23 gauge needle with 10 cc syringe and aspirator in 602 nodules. The differences of the incidence of the insufficient cytology among the three aspiration techniques and relationships of the incidence and needle size/degree of suction pressure was statistically analyzed using the Mann-Whitney U test and the chi-square test with linear-by-linear association. Overall, the difference in insufficient cytology was significant across the three aspiration technique (p = 0.004), and the incidence tended to increase significantly with increase of needle size and degree of suction pressure (p < 0.001). A pairwise comparison of aspiration techniques found significant differences (p = 0.003) between techniques (A) and (C), and no differences between technique (B) and (C) (p 0.07) and between techniques (A) and (B) (p = 0.10). The incidence of insufficient cytology was significantly low in the capillary technique, and it increased significantly with the increase of needle size and degree of suction pressure.

  12. Comparison of needle aspiration and vacuum-assisted biopsy in the ultrasound-guided drainage of lactational breast abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Yun Dan; Kim, You Me [Dankook University College of Medicine, Cheonan (Korea, Republic of)

    2016-03-15

    The purpose of this study was to compare needle aspiration and vacuum-assisted biopsy in the ultrasound-guided treatment of lactational breast abscesses. Between January 2005 and December 2014, a total of 74 patients presented with lactational breast abscesses. Thirty of these patients underwent treatment with antibioticsalone, while the remaining 44 lactating women with breast abscesses were treated with needle aspiration (n=25) or vacuum-assisted biopsy (n=19). Age, duration of lactation, abscess diameter, pus culture results, the number of interventions, the healing time, and the cure rate were reviewed and compared between these two groups. The Student's t test and the chi-square test were used to compare the variables. No significant difference was found in the cure rate between the needle aspiration group (22/25, 88%) and the vacuum-assisted biopsy group (18/19, 94.7%) (P=0.441). However, the mean healing time was significantly shorter in the vacuum-assisted biopsy group (6.7 days) than in the needle aspiration group (9.0 days) (P=0.001). Vacuum-assisted biopsy is a viable option for the management of lactational breast abscesses and was found to lead to a shorter healing time than needle aspiration. However, further study is necessary to establish the clinical efficacy of vacuum-assisted biopsy in the management of lactational breast abscesses.

  13. A Case of Gastrointestinal Stromal Tumor That Underwent Endoscopic Ultrasound-Guided Aspiration with a 25-Gauge Biopsy Needle

    Directory of Open Access Journals (Sweden)

    Minoru Tomizawa

    2016-05-01

    Full Text Available Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA is performed to obtain specimens for pathological analysis. For this procedure, 19-gauge (19G, 22-guage (22G, and 25-guage (25G needles are available. The needles are classified into aspiration type and biopsy type. A 56-year-old woman underwent upper gastrointestinal endoscopy that showed a 38-mm-diameter submucosal tumor. The elevated lesion was diagnosed as a submucosal tumor of the stomach. Contrast-enhanced computed tomography showed a low-density area on the luminal surface of the gastric wall, which was covered with a thin layer of gastric mucosa. EUS showed a hypoechoic lesion in the submucosal layer. Color Doppler image showed a pulsating vascular signal extending into the center of the hypoechoic lesion from the periphery. EUS-FNA was performed with a 25G biopsy needle. The specimen tissue consisted of spindle-shaped cells. The cells were positive for CD117 and CD34. The submucosal tumor was diagnosed as a gastrointestinal stromal tumor.

  14. A Case of Gastrointestinal Stromal Tumor That Underwent Endoscopic Ultrasound-Guided Aspiration with a 25-Gauge Biopsy Needle.

    Science.gov (United States)

    Tomizawa, Minoru; Shinozaki, Fuminobu; Motoyoshi, Yasufumi; Sugiyama, Takao; Yamamoto, Shigenori; Ishige, Naoki

    2016-01-01

    Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is performed to obtain specimens for pathological analysis. For this procedure, 19-gauge (19G), 22-guage (22G), and 25-guage (25G) needles are available. The needles are classified into aspiration type and biopsy type. A 56-year-old woman underwent upper gastrointestinal endoscopy that showed a 38-mm-diameter submucosal tumor. The elevated lesion was diagnosed as a submucosal tumor of the stomach. Contrast-enhanced computed tomography showed a low-density area on the luminal surface of the gastric wall, which was covered with a thin layer of gastric mucosa. EUS showed a hypoechoic lesion in the submucosal layer. Color Doppler image showed a pulsating vascular signal extending into the center of the hypoechoic lesion from the periphery. EUS-FNA was performed with a 25G biopsy needle. The specimen tissue consisted of spindle-shaped cells. The cells were positive for CD117 and CD34. The submucosal tumor was diagnosed as a gastrointestinal stromal tumor.

  15. Management of Dupuytren contracture with ultrasound-guided lidocaine injection and needle aponeurotomy coupled with osteopathic manipulative treatment.

    Science.gov (United States)

    Sampson, Steven; Meng, Michael; Schulte, Adam; Trainor, Drew; Montenegro, Roberto; Aufiero, Danielle

    2011-02-01

    Dupuytren contracture is a debilitating disease that characteristically presents as a firm nodularity on the palmar surface of the hand with coalescing cords of soft tissue on the webs and digits. With few nonsurgical modalities providing clinical benefits, open surgical procedures are the standard of care for patients with this condition. However, recent studies have associated surgical intervention with many complications, necessitating further exploration of nonsurgical treatment options. We describe the case of a 64-year-old woman who presented with decreased extension of the fourth and fifth digits on the upper extremities bilaterally; previous conservative treatment regimens had been unsuccessful. After a diagnostic ultrasound, the patient was diagnosed as having Dupuytren contracture and underwent 5 treatments consisting of ultrasound-guided dry-needle aponeurotomy, lidocaine injections, and osteopathic manipulative treatment. During the fifth treatment session, the patient experienced dramatic relief of her symptoms after a palpable release during the manual manipulation portion of her therapeutic regimen. At 2-week follow-up, the patient was symptom-free. Based on this desirable outcome, the authors suggest future research be directed at minimally invasive therapeutic options in the management of Dupuytren contracture.

  16. Comparison of ultrasound-guided core biopsy versus fine-needle aspiration biopsy in the evaluation of salivary gland lesions.

    Science.gov (United States)

    Douville, Nicholas J; Bradford, Carol R

    2013-11-01

    Ultrasound-guided core biopsy provides many benefits compared with fine-needle aspiration cytology and has begun to emerge as part of the diagnostic work-up for a salivary gland lesion. Although the increased potential for tumor-seeding and capsule rupture has been extensively discussed, the safety of this procedure is widely accepted based on infrequent reports of tumor-seeding. In fact, a review of the literature shows only 2 cases of salivary tumor seeding following biopsy with larger-gauge needle characteristics, with 2 reported cases of salivary tumor seeding following fine-needle aspiration cytology. However, the follow-up interval of such studies (biopsy over fine-needle aspiration biopsy, which include both improved consistency and diagnostic accuracy, current studies lack adequate patient numbers and follow-up duration to confirm comparable safety profile to currently accepted fine-needle aspiration cytology. In this report we: (1) compare the relative benefits of each procedure, (2) review evidence regarding tumor seeding in each procedure, (3) discuss time course and patient numbers necessary to detect tumor recurrence, and (4) describe how these uncertainties should be factored into clinical considerations. Copyright © 2012 Wiley Periodicals, Inc.

  17. The Utility of Endoscopic Ultrasound Guided Fine Needle Aspiration in the Diagnosis of Infectious Diseases—Report of Three Cases

    Directory of Open Access Journals (Sweden)

    Mauro Ajaj Saieg

    2013-01-01

    Full Text Available Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA is a fast and minimally invasive methodology with a crucial impact on patients’ management. It has an important and established role in the diagnosis and staging of mediastinal and abdominal malignancies, but little is discussed in the literature on the usefulness of this technique in the diagnosis of infectious diseases. In the current report, we present three different cases where EUS was essential for reaching the diagnosis of tuberculosis and paracoccidiodomicosis in cases otherwise seen as malignant. In conclusion, EUS was successful not only in obtaining enough cells for morphological analysis, but also for the production of cell blocks and assessment of the presence of the microorganisms by special stains. EUS allied to fine needle biopsy was an important tool in determining diagnoses of enlarged lymph nodes, revealing the diagnosis of infectious diseases in cases otherwise seen as malignant. The wide use of this methodology in cases such as those reported here cannot only rule out malignancy, but also aid critically ill patients by installing early proper therapy without the need for aggressive interventions.

  18. In Vitro Embryo Production and Transfer of Bubaline Embryos using Oocytes Derived from Transvaginal Ultrasound-Guided Follicular Aspiration (TUFA

    Directory of Open Access Journals (Sweden)

    FP Aquino

    2014-06-01

    Full Text Available Transvaginal ultrasound-guided follicular aspiration (TUFA has become a popular tool for embryo production in vitro due to its high degree of repeatability in terms of recovering oocytes from live animals. In Study 1, the quantity and quality of oocytes from Bulgarian Murrah buffalo cows (n=10 of varying ages (Group 1, 8-12; and Group 2, 13-17 years were assessed. Group 1 buffalo donor cows yielded significantly higher (P<0.05 number of oocytes vs Group 2 buffalo donor cows (71 vs 29 oocytes, respectively, though in terms of oocyte quality, no difference was observed. In Study 2, oocytes collected (n=100 in Study 1 were matured, fertilized in vitro and the resulting zygotes were cultured which developed to blastocyst stage embryos. The maturation, fertilization and blastocyst development rates obtained were 53.0%, 40.0% and 32.5%, respectively. In Study 3, the viability of resulting blastocyst stage embryos was determined by transferring to recipient cows. Of 10 recipients 1 got pregnant and delivered a 35 kg male calf after 310 days gestation period. Overall, the results of the studies conducted demonstrated the potential of TUFA technology in the in vitro production of embryos which eventually could be used in the production of live offspring.

  19. Intrathecal opioid versus ultrasound guided fascia iliaca plane block for analgesia after primary hip arthroplasty: study protocol for a randomised, blinded, noninferiority controlled trial

    Directory of Open Access Journals (Sweden)

    Kinsella John

    2011-02-01

    Full Text Available Abstract Background Hip replacement surgery is increasingly common due to an ageing population, and rising levels of obesity. The provision of excellent pain relief with minimal side effects is important in order to facilitate patient mobilisation and rehabilitation. Spinal opioids provide excellent analgesia but are associated with adverse effects. The fascia-iliaca block is an alternative technique which provides analgesia to the nerves innervating the hip. The success of fascia iliaca blocks has been demonstrated to be superior when using ultrasound compared to landmark techniques. However, the clinical benefit of this improvement has yet to be investigated. The aim of this study is to compare the efficacy and safety of ultrasound guided fascia iliaca block with spinal morphine for hip replacement surgery. Methods/Design This study is a randomised, blinded, placebo-controlled, noninferiority trial. Patients scheduled to undergo unilateral primary hip arthroplasty will receive a study information sheet and consent will be obtained in keeping with the Declaration of Helsinki. Patients will be randomised to receive either; (i Ultrasound guided fascia iliaca block using levobupivacaine, plus spinal anaesthesia with hyperbaric bupivacaine containing no morphine, or (ii sham ultrasound guided fascia iliaca block performed with sterile saline, and spinal anaesthesia containing hyperbaric bupivacaine and 0.1 mg of spinal morphine. A total of 108 patients will be recruited. Primary outcome is post-operative morphine consumption in a 24 hour period. Secondary outcomes include; pain scores at 3, 6, 12, 24, 36 and 48 hours, episodes of respiratory depression, hypotension, nausea and vomiting, pruritus, sedation, time to first mobilisation and patient satisfaction. Conclusions There are no studies to date comparing ultrasound guided fascia iliaca block with spinal morphine for pain control after hip arthroplasty. If the ultrasound guided fascia iliaca

  20. The effect of timing of the induction of ovulation on embryo production in superstimulated lactating Holstein cows undergoing fixed-time artificial insemination.

    Science.gov (United States)

    Martins, C M; Rodrigues, C A; Vieira, L M; Mapletoft, R J; Bó, G A; Sá Filho, M F; Baruselli, P S

    2012-09-15

    Two experiments evaluated the effects of timing of the induction of ovulation in superstimulated lactating Holstein donor cows that were fixed-time artificially inseminated. Secondary objectives were to evaluate the effects of the timing of progesterone (P4) device removal (Experiment 1) or the addition of a second norgestomet implant (Experiment 2) during superstimulation. In Experiment 1, 12 cows were allocated to one of four treatment groups with the timing of P4 device removal (24 or 36 h) and pLH treatment (48 or 60 h), after the first PGF as main factors, in a Latin Square (cross-over) design. There was an interaction (P = 0.03) between time of P4 device removal and time of pLH treatment. Mean (± SEM) numbers of transferable embryos were higher when the P4 device was removed at 36 h and pLH was administered at 60 h after the first PGF (P36LH60 =6.3 ± 1.4) compared to other treatments (P24LH60 =3.7 ± 1.1; P24LH48 =2.4 ± 0.8; or P36LH48 =2.2 ± 0.7). In Experiment 2, 40 cows were randomly allocated into one of four treatments with the number of norgestomet implants (one or two) and the time of induction of ovulation with GnRH relative to the first PGF (48 vs. 60 h) as main effects. The mean number of transferable embryos was higher (P = 0.02) when GnRH was administered at 60 h (4.2 ± 1.3) compared to at 48 h (2.7 ± 0.8), and the number of freezable embryos was increased (P = 0.01) in cows receiving two (3.0 ± 1.0) rather than one norgestomet implant (1.5 ± 0.5). In summary, embryo production in lactating Holstein cows was increased when the ovulatory stimulus (pLH or GnRH) was given 60 h after the first PGF, particularly when the P4 device was removed 36 h after the first PGF and when two norgestomet ear implants were used during the superstimulation protocol.

  1. Ecoescleroterapia com microespuma em varizes tronculares primárias Microfoam ultrasound-guided sclerotherapy in primary trunk varicose veins

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    Marcondes Figueiredo

    2006-09-01

    Full Text Available OBJETIVO: Avaliar o tratamento de varizes tronculares primárias por ecoescleroterapia com microespuma. MÉTODOS: A amostra foi constituída de 25 membros de seis pacientes do sexo masculino e 19 do sexo feminino, com incompetência das veias safenas magna (21 membros ou parva (quatro membros. Eles foram avaliados de acordo com a classificação clínica, etiológica, anatômica e fisiopatológica (CEAP e classificados nos graus C³ (10 membros, C4 (seis membros, C5 (cinco membros e C6 (quatro membros. A microespuma (5 ml, preparada pela mistura de 1 ml de polidocanol a 3% e 5 ml de ar, era injetada na veia do paciente, em posição de Trendelenburg, com monitoração por ultra-sonografia com Doppler colorido. Os membros eram enfaixados com atadura inelástica por 3 dias; depois disso, os pacientes usavam meias elásticas, 30-40 mmHg, 3/4 ou 7/8, durante 3 meses. A eficiência do tratamento foi avaliada pelo escore clínico da classificação CEAP para dor, edema e claudicação e pelas alterações ultra-sonográficas 12 meses depois. Os escores clínicos antes e depois do tratamento foram comparados pelo teste de Wilcoxon. RESULTADOS: Houve diminuição significante nos escores clínicos (P OBJECTIVE: To evaluate the treatment of primary trunk varicose veins by microfoam ultrasound-guided sclerotherapy. METHODS: The sample was composed of 25 members of six male and 19 female patients, with incompetence of great saphenous vein (21 and short saphenous vein (4. Patients were assessed according to the clinical, etiologic, anatomical and pathophysiological (CEAP classification and divided into degrees C³ (10, C4 (6, C5 (5 and C6 (4. With the patients in the Trendelenburg position, microfoam (5 ml, prepared by mixture of 1 ml polidocanol at 3% and 5 ml of air, was injected in their vein and monitored by color-flow Doppler ultrasonography. The members were then swaddled with inelastic bandage for 3 days; afterward, the patients used 30-40 mmHg, 3

  2. Risk factors for aggressive nonfunctional pancreatic neuroendocrine tumors and the role of endoscopic ultrasound guided fine-needle aspiration

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    Ende, Alexander R.; Sedarat, Alireza; Shah, Pari; Jhala, Nirag; Fraker, Douglas L.; Drebin, Jeffrey A.; Metz, David C.; Kochman, Michael L.

    2016-01-01

    Background: Nonfunctional pancreatic neuroendocrine tumors (NF-pNETs) are increasingly being diagnosed but management, especially of small tumors, remains a clinical dilemma. Endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) is now routinely used for diagnosis of pancreatic neuroendocrine tumors (pNETs) but has not been well studied as a tool for identifying aggressive disease. Materials and Methods: A systematic search of the cytology database identified all patients at our center who underwent EUS-FNA from 1999 through 2011 and were diagnosed with NF-pNET. Results: A total of 50 patients were identified. Though patients with metastatic disease had a mean tumor size of 40 mm compared to 25 mm in patients without metastatic disease (P = 0.04), we also identified several patients with tumors 20 mm (P = 0.13). Using receiver operating characteristic (ROC) analysis, we found that using a cutoff point of 20 mm only led to a sensitivity of 85% in screening for metastases, while lowering the cutoff point to 18 mm allowed for a sensitivity of 95%. Conclusion: Currently, guidelines suggest that only patients with tumors greater than 20 mm undergo surgical resection, as tumors less than this size are thought to have low risk of metastases. Our analysis suggests that these recommendations could lead to undertreating patients with small tumors. Tumor size alone may be inadequate as a marker for aggressive NF-pNETs. Given this, other risk factors for aggressive pNETs should be studied to help identify the patients most likely to benefit from surgery. PMID:26879167

  3. Ultrasound guided foam sclerotherapy of recurrent varices of the great and small saphenous vein: 5-year follow up

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    Patrizia Pavei

    2014-11-01

    Full Text Available Ultrasound guided foam sclerotherapy (UGFS proved to be effective in recurrent varices. In this observational study from 2006 and 2012 we treated 142 neovascularization, 155 inguinal recurrence and 28 popliteal recurrent varices. For neovascularization 0.3-0.5% polidocanol (POL sclerosant foam (SF was injected for vein having diameter <3 mm and 0.5-1% POL or sodium tetradecylsulphate (STS SF for higher vein diameters. The patients with residual sapheno-femoral or sapheno-popliteal junctions were treated with 1% STS SF for diameter up to 5 mm, while for larger veins 3% STS was used. From 1 to 3 sessions were necessary in both groups with 4 to 10 ml injected per session. In the group of neovascularization the 3-5years follow up revealed good results in 90.8% of the cases. In the group of popliteal recurrences the 3-5 years follow up showed 60.7% of good results, while in the group of inguinal recurrences we observed 80% of good results at 3-5 years. We did not have major complication. As minor complications we had 0.2% of gastrocnemial vein thrombosis, 0.1% of minor neurological problems, 2.8% of superficial vein thrombosis, 3.9% of pigmentation and light to mild post-treatment pain in 16.5% of the cases. In conclusion our data show that UGFS is a well tolerate technique, preferred by previously operated patients, safe and easily repeatable with good medium-term results both in case of neovascularization and of recurrence from residual femoral or popliteal stump.

  4. Liu-stain quick cytodiagnosis of ultrasound-guided fine needle aspiration in diagnosis of liver tumors

    Institute of Scientific and Technical Information of China (English)

    Chi-Sin Changchien; Jing-Houng Wang; Sheng-Nan Lu; Chao-Hung Hung; Chien-Hung Chen; Chuan-Mo Lee

    2007-01-01

    AIM: To combine ultrasound-guided fine-needle aspiration (US-FNA) and Liu (Riu) stain to make a quick study on liver tumor lesions.METHODS: Two hundred and twenty-eight aspirations from 232 patients were completely studied. The operator himself made the quick cytodiagnosis of US-FNA smear stained by Liu method within thirty minutes. The US-FNA specimen was also sent to the pathological department for cytological study and cellblock histology. The result of our Liu-stain quick cytodiagnosis in each patient was confirmed by the final cytopathological diagnosis from pathological report.RESULTS: Among 228 samples, the quick cytodiagnosis revealed 146 malignancies, 81 benign lesions and one inadequate specimen. Cytopathological diagnosis from the pathological department revealed 150 malignancies,and 78 benign lesions. Four well-differentiated hepatocellular carcinomas (HCCs) were under-diagnosed by quick cytodiagnosis as benign and 3 benign lesions were over-diagnosed as well-differentiated HCCs. Compared with cytopathological diagnosis, quick cytodiagnosis correctly diagnosed 143 malignancies and 77 benign lesions. Except for the one inadequate specimen in quick cytodiagnosis, the accuracy of quick cytodiagnosis was 96.9% (220/227), and its sensitivity, specificity and positive and negative predictive values were 97.9%, 95.1%,97.3% and 96.3%, respectively.CONCLUSION: Liu-stain quick cytodiagnosis is a fast,convenient, safe and effective method for hepatologists in clinic practice to diagnose liver tumor. In few cases of well-differentiated HCC, Liu-stain quick cytodiagnosis has its limitation.

  5. Pethidine efficacy in achieving the ultrasound-guided oblique subcostal transversus abdominis plane block in laparoscopic cholecystectomy: A prospective study

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    Caius Mihai Breazu

    2017-02-01

    Full Text Available Pethidine is a synthetic opioid with local anesthetic properties. Our goal was to evaluate the analgesic efficacy of pethidine for achieving the ultrasound-guided oblique subcostal transversus abdominis plane (OSTAP block in laparoscopic cholecystectomy. This prospective, double-blind study included 79 patients of physical status I and II according to American Society of Anesthesiologists, scheduled for elective laparoscopic cholecystectomy. The patients were randomly allocated into three groups, depending on the drug used to achieve preoperative bilateral OSTAP block: 1 OSTAP-Placebo (treated with normal saline; 2 OSTAP-Bupivacaine (treated with 0.25% bupivacaine; and 3 OSTAP-Pethidine (treated with 1% pethidine. The efficacy of pethidine in achieving the OSTAP block was analyzed using visual analog scale (VAS, intraoperative opioid dose, opioid consumption in post anesthesia care unit, and opioid consumption in the first 24 postoperative hours. The pain scores assessed by VAS at 0, 2, 4, 6, 12, and 24 hours were significantly lower in OSTAP-Pethidine than in OSTAP-Placebo group (p < 0.001. The mean intraoperative opioid consumption was significantly lower in OSTAP-Pethidine compared to OSTAP-Placebo group (150 versus 400 mg, p < 0.001, as well as the mean opioid consumption in the first 24 hours (20.4 versus 78 mg, p < 0.001. Comparing VAS assessment between OSTAP-Bupivacaine and OSTAP-Pethidine groups, statistically significant differences were observed only for the immediate postoperative pain assessment (0 hours, where lower values were observed in OSTAP-Pethidine group (p = 0.004. There were no statistically significant differences in the incidence of postoperative nausea and vomiting (p = 0.131 between the groups. The use of 1% pethidine can be an alternative to 0.25% bupivacaine in achieving OSTAP block for laparoscopic cholecystectomy.

  6. Ultrasound-guided hydrosalpinx aspiration during oocyte collection improves pregnancy outcome in IVF: a randomized controlled trial.

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    Hammadieh, Nahed; Coomarasamy, Arri; Ola, Bolarinde; Papaioannou, Spyros; Afnan, Masoud; Sharif, Khaldoun

    2008-05-01

    Hydrosalpinges have adverse effects on IVF outcomes. Salpingectomy is effective in improving outcomes, but it is not always practical or safe. Ultrasound-guided aspiration of hydrosalpinges at oocyte collection is an option for those who develop hydrosalpinges during controlled ovarian stimulation; however, there is no randomized evidence to show whether this practice is effective. Between October 1999 and June 2003, consenting women of age

  7. Ultrasound-guided tissue fractionation by high intensity focused ultrasound in an in vivo porcine liver model.

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    Khokhlova, Tatiana D; Wang, Yak-Nam; Simon, Julianna C; Cunitz, Bryan W; Starr, Frank; Paun, Marla; Crum, Lawrence A; Bailey, Michael R; Khokhlova, Vera A

    2014-06-03

    The clinical use of high intensity focused ultrasound (HIFU) therapy for noninvasive tissue ablation has been recently gaining momentum. In HIFU, ultrasound energy from an extracorporeal source is focused within the body to ablate tissue at the focus while leaving the surrounding organs and tissues unaffected. Most HIFU therapies are designed to use heating effects resulting from the absorption of ultrasound by tissue to create a thermally coagulated treatment volume. Although this approach is often successful, it has its limitations, such as the heat sink effect caused by the presence of a large blood vessel near the treatment area or heating of the ribs in the transcostal applications. HIFU-induced bubbles provide an alternative means to destroy the target tissue by mechanical disruption or, at its extreme, local fractionation of tissue within the focal region. Here, we demonstrate the feasibility of a recently developed approach to HIFU-induced ultrasound-guided tissue fractionation in an in vivo pig model. In this approach, termed boiling histotripsy, a millimeter-sized boiling bubble is generated by ultrasound and further interacts with the ultrasound field to fractionate porcine liver tissue into subcellular debris without inducing further thermal effects. Tissue selectivity, demonstrated by boiling histotripsy, allows for the treatment of tissue immediately adjacent to major blood vessels and other connective tissue structures. Furthermore, boiling histotripsy would benefit the clinical applications, in which it is important to accelerate resorption or passage of the ablated tissue volume, diminish pressure on the surrounding organs that causes discomfort, or insert openings between tissues.

  8. "Hemosuccus pancreaticus"--primarily ultrasound-guided successful intervention using transcutaneous fibrin glue application and histoacryl injection.

    Science.gov (United States)

    Will, U; Mueller, A-K; Grote, R; Meyer, F

    2008-12-01

    There is a broad spectrum of causes for upper gastrointestinal (GI) bleeding that can be stopped by various approaches. On the basis of the report of an extraordinary case, the favorable minimally invasive approach of applying fibrin glue and histoacryl/lipiodol to the vascular basis of a bleeding pseudoaneurysm leading to "Hemosuccus pancreaticus" as a rare cause of recurrent bleeding in the upper GI tract and dangerous complications in the case of chronic pancreatitis is described. There were recurrent bleeding episodes within the upper GI tract in a 40-year-old female patient. Her medical history was significant for chronic pancreatitis and pseudocyst. Abdominal ultrasound plus duplex ultrasonography revealed a pseudoaneurysm within the tail of the pancreas as the cause of "Hemosuccus pancreaticus". Ultrasound guidance was used to repeatedly apply 2 ml of fibrin glue and 2 x 2 ml of the mixture of lipiodol and histoacryl to the basis of the pseudoaneurysm which led to complete and permanent cessation of the bleeding. Immediate and follow-up control duplex ultrasonographies (up to one year) demonstrated sufficient exclusion of the pseudoaneurysm but a preservation of the lienal artery with no disturbance of the blood perfusion in the splenic parenchyma. In conclusion, this is one of the first reports of the successful cessation of recurrent bleeding into a pseudocyst out of pseudoaneurysm ("Hemosuccus pancreaticus") by an ultrasound-guided transcutaneous fibrin glue and histoacryl/lipiodol application, which 1. is recommended as an alternative but feasible and safe therapeutic tool, 2. can provide sufficient and permanent cessation of bleeding but preserve the perfusion of the natural vessel as an initial step in the possible therapeutic algorithm, and 3. can avoid, in case of success, more invasive approaches such as angiography-guided embolization with coils or implantation of a prosthesis and even open surgical intervention, in particular, in high

  9. Staging the axilla in women with breast cancer:the utility of preoperative ultrasound-guided needle biopsy

    Institute of Scientific and Technical Information of China (English)

    Nehmat Houssami; Robin M.Turner

    2014-01-01

    Preoperative staging of the axilla in women with invasive breast cancer using ultrasound-guided needle biopsy (UNB) identiifes approximately 50% of patients with axillary nodal metastases prior to surgical intervention. Although moderately sensitive, it is a highly speciifc staging strategy that is rarely falsely-positive, hence a positive UNB allows patients to be triaged to axillary lymph-node dissection (ALND) avoiding potentially unnecessary sentinel node biopsy (SNB). In this review, we extend our previous work through an updated literature search, focusing on studies that report data on UNB utility. Based on data for 10,934 breast cancer patients, sourced from 35 studies, a positive UNB allowed triage of 1,745 cases (simple proportion 16%) to axillary surgical treatment: the utility of UNB was a median 19.8% [interquartile range (IQR) 11.6%-26.7%] across these studies. We also modelled data from a subgroup of studies, and estimated that amongst patients with metastases to axillary nodes, the odds ratio (OR) for high nodal disease burden for a positive UNB versus a negative UNB was 4.38 [95% confidence interval (95% CI): 3.13, 6.13],P<0.001. From this model, the estimated proportion with high nodal disease burden was 58.9% (95% CI: 50.2%, 67.0%) for a positive UNB, whereas the estimated proportion with high nodal disease burden was 24.6% (95% CI: 17.7%, 33.2%) if UNB was negative. Overall, axillary UNB has good clinical utility and a positive UNB can effectively triage to ALND. However, the evolving landscape of axillary surgical treatment means that UNB will have relatively less utility where surgeons have modiifed their practice to omission of ALND for minimal nodal metastatic disease.

  10. Endobronchial ultrasound-guided transbronchial needle aspiration rinse fluid polymerase chain reaction in the diagnosis of intrathoracic tuberculous lymphadenitis.

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    Boonsarngsuk, Viboon; Saengsri, Siriwan; Santanirand, Pitak

    2017-03-01

    Intrathoracic tuberculous (TB) lymphadenitis is a diagnostic challenge to the clinician. Although endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) can obtain a sample from the affected lymph node, the diagnosis of TB lymphadenitis by cytopathology remains inaccurate. To evaluate the efficacy of EBUS-TBNA rinse fluid TB polymerase chain reaction (PCR) assay for the diagnosis of intrathoracic TB lymphadenitis. A retrospective study was conducted on 102 patients who underwent EBUS-TBNA for diagnostic evaluation of intrathoracic lymphadenopathy. EBUS-TBNA specimens were evaluated by cytopathological examination. Rinse fluid of the needle was routinely submitted for acid-fast bacillus (AFB) staining, mycobacterial culture, and TB-PCR using the Anyplex(TM) MTB/NTM real-time detection kit. Of 102 patients, 16 were diagnosed with intrathoracic TB lymphadenitis by either microbiology, cytopathology, or on clinical grounds. The sensitivity, specificity, positive predictive value, and negative predictive value of rinse fluid TB PCR assay were 56.2%, 100.0%, 100.0%, and 92.5%, respectively. Using the area under the ROC curve (AUC) as a measure of a diagnostic performance, TB-PCR had the highest AUC, compared with mycobacterial culture, AFB smear, and finding of necrotizing granulomatous inflammation (0.78, 0.75, 0.56, and 0.72, respectively). A combination of TB PCR, mycobacterial culture, and finding of necrotizing granulomatous inflammation provided the best diagnostic performance (sensitivity, specificity, positive predictive value, negative predictive value, and AUC of 75.0%, 100.0%, 100.0%, 95.6%, and 0.88, respectively). EBUS-TBNA rinse fluid TB-PCR is useful in the diagnosis of intrathoracic TB lymphadenitis. Combining TB-PCR with mycobacterial culture and cytopathological findings improved the diagnosis performance.

  11. Endoscopic ultrasound and endobronchial ultrasound-guided fine-needle aspiration of deep-seated lymphadenopathy: Analysis of 1338 cases

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    Amberly L Nunez

    2012-01-01

    Full Text Available Background: We retrospectively studied 1338 samples of lymph nodes obtained by endoscopic and endobronchial ultrasound-guided fine needle aspiration biopsy (EUS and EBUS-FNAB with an objective of characterizing the utility of this diagnostic modality in the assessment of deep-seated lymphadenopathy. The secondary aims were to establish the utility in the diagnosis of lymphoma and to determine the number of passes required to obtain adequate cellularity for flow cytometric analysis. Materials and Methods: On-site assessment was performed by a cytopathologist using Diff-Quik (American Scientific Products, McGraw Park, IL stain. In addition, Papanicolaou and immunohistochemical stains were performed and additional samples were sent for flow cytometric analyses (n = 145. The final cytologic diagnosis was correlated with surgical pathology diagnosis and/or clinical follow-up. In select cases, fluorescence in situ hybridization analysis with specific probes was performed on Diff-Quik smears. Results: Both morphology as well as ancillary studies (flow cytometry or immunohistochemical stain and/or fluorescence in situ hybridization show that EUS and EBUS-FNA are effective techniques to detect and stage intrathoracic and intra-abdominal tumors. Operating characteristics show that these are highly sensitive (89% and specific (100% techniques for the diagnosis of lymphoma. At least two passes provided an average of 5.66 million cells (range, 0.12-62.32 million for lymphoma cases. Conclusions: EUS and EBUS-FNA are powerful modalities to stage malignancies and at least two passes can provide adequate cells for flow cytometric analysis. We also demonstrate that fluorescence in situ hybridization analysis can be performed on Diff-Quik-stained and mounted smears.

  12. Accuracy of ultrasound-guided fine-needle aspiration cytology for diagnosis of carcinoma in patients with multinodular goiter

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    Saif Al-Yaarubi

    2011-01-01

    Full Text Available Background: Fine-needle aspiration (FNA is a useful method for evaluating multinodular goiter; however, its role is still controversial. The aim of this study was to assess the utility of ultrasound-guided thyroid FNA in detecting malignancy in patients with multinodular goiter in Oman. Materials and Methods: This was a retrospective study where all patients with multinodular goiter seen at the Sultan Qaboos University Hospital endocrinology clinic in Oman in 2005 were evaluated. The thyroid FNA results were grouped into either malignancy (positive result or others (negative result. They were compared to those of final histopathological examination in order to calculate the value of the test in diagnosing malignancy. Analyses were evaluated using descriptive statistics. Results: A total of 272 patients were included in the study. The mean age was 39΁13 years with an age range from 5 to 85 years. The majority of the patients were females (n=236; 87%. The results of thyroid FNA revealed that 6% (n=15 of the patients had malignancies while histopathological results showed that the proportion of subjects with malignancies was 18% (n=49. Out of the 15 cases identified to have malignances by thyroid FNA, only 53% (n=8 of the subjects were confirmed to have malignancy by biopsy. Overall, the results of the tests were poor, revealing a sensitivity of 16%, specificity of 97% and a diagnostic accuracy of 82%, with a positive predictive value of 53% and a negative predictive value of 84%. Conclusion: Thyroid FNA is not a useful test in differentiating multinodular goiter from malignancy, as more than 80% of the malignancies go unnoticed.

  13. Ultrasound guided percutaneous microwave ablation of benign thyroid nodules: Safety and imaging follow-up in 222 patients

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    Yue, Wenwen [Binzhou Medical University, #346 Guan-hai Road, Lai-shan, Yantai, Shandong 264003 (China); Wang, Shurong, E-mail: 7762808@sina.com [Department of Ultrasound, Muping Area People' s Hospital, #629 Nan-hua Street, Mu-ping, Yantai, Shandong 264100 (China); Wang, Bin [Binzhou Medical University, #346 Guan-hai Road, Lai-shan, Yantai, Shandong 264003 (China); Xu, Qingling; Yu, Shoujun; Yonglin, Zhang; Wang, Xiju [Department of Ultrasound, Muping Area People' s Hospital, #629 Nan-hua Street, Mu-ping, Yantai, Shandong 264100 (China)

    2013-01-15

    Objective: Microwave ablation is a minimally invasive technique that has been used to treat benign and malignant tumors of liver, lung and kidney. Towards thyroid nodules, only a few cases are reported so far. The aim of the study was to investigate the effectiveness and safety of ultrasound-guided percutaneous microwave ablation in the treatment of benign thyroid nodules with a large sample. Materials and methods: A total of 477 benign thyroid nodules in 222 patients underwent microwave ablation in our department from July 2009 to March 2012. Microwave ablation was carried out using microwave antenna (16G) under local anesthesia. Nodule volume, thyroid function and clinical symptoms were evaluated before treatment and at 1, 3, more than 6 months. The study was ethics committee approved and written informed consents were obtained from all patients. Results: All thyroid nodules significantly decreased in size after microwave ablation. A 6-month follow-up was achieved in 254 of 477 nodules, and the mean decrease in the volume of thyroid nodules was from 2.13 ± 4.42 ml to 0.45 ± 0.90 ml, with a mean percent decrease of 0.65 ± 0.65. A volume-reduction ratio greater than 50% was observed in 82.3% (209/254) of index nodules, and 30.7% (78/254) of index nodules disappeared 6-month after the ablation. The treatment was well tolerated and no major complications were observed except pain and transient voice changes. Conclusions: Microwave ablation seems to be a safe and effective technique for the treatment of benign thyroid nodules. Further prospective randomized studies are needed to define the role of the procedure in the treatment of thyroid nodules.

  14. Endoscopic ultrasound-guided fine-needle aspiration diagnosis of secondary tumors involving the pancreas: An institution′s experience

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    Ahmed K Alomari

    2016-01-01

    Full Text Available Background: Pancreatic masses may seldom represent a metastasis or secondary involvement by lymphoproliferative disorders. Recognition of this uncommon occurrence may help render an accurate diagnosis and avoid diagnostic pitfalls during endoscopic ultrasound-guided fine needle aspiration (EUS-FNA. In this study, we review our experience in diagnosing secondary tumors involving the pancreas. Materials and Methods: The electronic database of cytopathology archives was searched for cases of secondary tumors involving the pancreas at our institution and a total of 31 cases were identified. The corresponding clinical presentations, imaging study findings, cytological diagnoses, the results of ancillary studies, and surgical follow-up, if available, were reviewed. Results: Nineteen of the patients were male and 12 female, with a mean age of 66 years. Twenty-three patients (74% had a prior history of malignancy, with the latency ranging from 6 months to 19 years. The secondary tumors involving the pancreas included metastatic carcinoma (24 cases, metastatic sarcoma (3 cases, diffuse large B-cell lymphoma (2 cases, and plasma cell neoplasm (2 cases. The most common metastatic tumors were renal cell carcinoma (8 cases and lung carcinoma (7 cases. Correct diagnoses were rendered in 29 cases (94%. The remaining two cases were misclassified as primary pancreatic carcinoma. In both cases, the patients had no known history of malignancy, and no ancillary studies were performed. Conclusions: Secondary tumors involving the pancreas can be accurately diagnosed by EUS-FNA. Recognizing uncommon cytomorphologic features, knowing prior history of malignancy, and performing ancillary studies are the keys to improve diagnostic performance and avoid diagnostic pitfalls.

  15. Fluoroscopy-assisted vs fluoroless endoscopic ultrasound-guided transmural drainage of pancreatic fluid collections: A comparative study.

    Science.gov (United States)

    Consiglieri, Claudia F; Gornals, Joan B; Busquets, Juli; Peláez, Nuria; Secanella, Lluis; De-La-Hera, Meritxell; Sanzol, Resurrección; Fabregat, Joan; Castellote, José

    2017-09-04

    The need for fluoroscopy guidance in patients undergoing endoscopic ultrasound-guided transmural drainage (EUS-TMD) of peripancreatic fluid collections (PFCs) remains unclear. The aim of this study was to compare general outcomes of EUS-TMD of PFCs under fluoroscopy (F) vs fluoroless (FL). This is a comparative study with a retrospective analysis of a prospective and consecutive inclusion database at a tertiary centre, from 2009 to 2015. All patients were symptomatic pseudocyst (PSC) and walled-off pancreatic necrosis (WON). Two groups were assigned depending on availability of fluoroscopy. The groups were heterogeneous in terms of their demographic characteristics, PFCs and procedure. The main outcome measures included technical and clinical success, incidences, adverse events (AEs), and follow-up. Fifty EUS-TMD of PFCs from 86 EUS-guided drainages were included during the study period. Group F included 26 procedures, PSC 69.2%, WON 30.8%, metal stents 61.5% (46.1% lumen-apposing stent) and plastic stents 38.5%. Group FL included 24 procedures, PSC 37.5%, WON 62.5%, and metal stents 95.8% (lumen-apposing stents). Technical success was 100% in both groups, and clinical success was similar (F 88.5%, FL 87.5%). Technical incidences and intra-procedure AEs were only described in group F (7.6% and 11.5%, respectively) and none in group FL. Procedure time was less in group FL (8min, p=0.0341). Fluoroless in the EUS-TMD of PFCs does not involve more technical incidences or intra-procedure AEs. Technical and clinical success was similar in the two groups. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  16. Cytological Results of Ultrasound-Guided Fine-Needle Aspiration Cytology for Thyroid Nodules: Emphasis on Correlation with Sonographic Findings

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    Lee, Mi-Jung; Hong, Soon Won; Chung, Woung Youn; Kwak, Jin Young; Kim, Min Jung

    2011-01-01

    Purpose To compare the cytological results of ultrasound-guided fine-needle aspiration (US-FNA) cytology of thyroid nodules to sonographic findings and determine whether US findings are helpful in the interpretation of cytological results. Materials and Methods Among the thyroid nodules that underwent US-FNA cytology, we included the 819 nodules which had a conclusive diagnosis. Final diagnosis was based on pathology from surgery, repeated FNA cytology or follow-up of more than one year. Cytological results were divided into five groups: benign, indeterminate (follicular or Hurthle cell neoplasm), suspicious for malignancy, malignant, and inadequate. US findings were categorized as benign or suspicious. Cytological results and US categories were analyzed. Results Final diagnosis was concluded upon in 819 nodules based on pathology (n=311), repeated FNA cytology (n=204) and follow-up (n=304), of which 634 were benign and 185 were malignant. There were 560 benign nodules, 141 malignant nodules, 49 nodules with inadequate results, 21 with indeterminate results, and 48 that were suspicious for malignancy. The positive and negative predictive values of the US categories were 59.1% and 97.0%, and those of the cytological results were 93.7% and 98.9%. The US categories were significantly correlated with final diagnosis in the benign (p=0.014) and suspicious for malignancy (pcytological result groups, but not in the inadequate and indeterminate cytological results groups. The false positive and negative rates of cytological results were 1.9% and 3.2%. Conclusion Sonographic findings can be useful when used alongside cytological results, especially in nodules with cytological results that are benign or suspicious for malignancy. PMID:21786450

  17. Ultrasound-Guided Pulsed Radiofrequency Application via the Pterygopalatine Fossa: A Practical Approach to Treat Refractory Trigeminal Neuralgia.

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    Nader, Antoun; Bendok, Bernard R; Prine, Jeremy J; Kendall, Mark C

    2015-01-01

    Although pharmacological therapy is the primary treatment modality for trigeminal neuralgia associated pain, ineffective analgesia and dose limiting side effects often prompt patients to seek alternative pharmacological solutions such as interventional nerve blockade. Blockade of the Gasserian ganglion or its branches is an effective analgesic procedure for trigeminal neuralgia, traditionally performed using fluoroscopy or CT imaging. Ultrasonography allows point of care and real time visualization of needle placement within the surrounding anatomical structures. The use of ultrasonography with pulsed radiofrequency therapy for trigeminal neuralgia has not been reported. Our case is a 66-year-old male suffering from trigeminal neuralgia for 4 years that was refractory to pharmacologic therapy. Neurological examination was normal with no sensory deficit. Imaging showed no vascular compression or mass involving the trigeminal nerve. A diagnostic ultrasound-guided trigeminal nerve block via the pterygopalatine fossa with 4 mL of bupivacaine 0.25% and 4 mg dexamethasone provided immediate pain relief (100%) with sustained analgesia >50% at 2 weeks. Pain relief was not sustained at one month, with return to pretreatment symptoms. A series of injections were performed with similar intermittent analgesic effectiveness. The decision was made that the patient was a suitable candidate for pulsed radiofrequency application in the pterygopalatine fossa. We successfully used an alternative approach through the pterygopalatine fossa to treat trigeminal neuralgia using ultrasound guidance in an office setting. Our case demonstrates the utility of ultrasound-guidance pulsed radiofrequency treatment in the pterygopalatine fossa as a potential alternative to other percutaneous techniques for patients with medical refractory trigeminal neuralgia.

  18. 22-gauge core vs 22-gauge aspiration needle for endoscopic ultrasound-guided sampling of abdominal masses.

    Science.gov (United States)

    Sterlacci, William; Sioulas, Athanasios D; Veits, Lothar; Gönüllü, Pervin; Schachschal, Guido; Groth, Stefan; Anders, Mario; Kontos, Christos K; Topalidis, Theodoros; Hinsch, Andrea; Vieth, Michael; Rösch, Thomas; Denzer, Ulrike W

    2016-10-21

    To compare the aspiration needle (AN) and core biopsy needle (PC) in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of abdominal masses. Consecutive patients referred for EUS-FNA were included in this prospective single-center trial. Each patient underwent a puncture of the lesion with both standard 22-gauge (G) AN (Echo Tip Ultra; Cook Medical, Bloomington, Indiana, United States) and the novel 22G PC (EchoTip ProCore; Cook Medical, Bloomington, Indiana, United States) in a randomized fashion; histology was attempted in the PC group only. The main study endpoint was the overall diagnostic accuracy, including the contribution of histology to the final diagnosis. Secondary outcome measures included material adequacy, number of needle passes, and complications. Fifty six consecutive patients (29 men; mean age 68 years) with pancreatic lesions (n = 38), lymphadenopathy (n = 13), submucosal tumors (n = 4), or others lesions (n = 1) underwent EUS-FNA using both of the needles in a randomized order. AN and PC reached similar overall results for diagnostic accuracy (AN: 88.9 vs PC: 96.1, P = 0.25), specimen adequacy (AN: 96.4% vs PC: 91.1%, P = 0.38), mean number of passes (AN: 1.5 vs PC: 1.7, P = 0.14), mean cellularity score (AN: 1.7 vs PC: 1.1, P = 0.058), and complications (none). A diagnosis on the basis of histology was achieved in the PC group in 36 (64.3%) patients, and in 2 of those as the sole modality. In patients with available histology the mean cellularity score was higher for AN (AN: 1.7 vs PC: 1.0, P = 0.034); no other differences were of statistical significance. Both needles achieved high overall diagnostic yields and similar performance characteristics for cytological diagnosis; histological analysis was only possible in 2/3 of cases with the new needle.

  19. Contemporary outcomes in the detection of prostate cancer using transrectal ultrasound-guided 12-core biopsy in Singaporean men with elevated prostate specific antigen and/or abnormal digital rectal examination

    Directory of Open Access Journals (Sweden)

    Alvin Lee

    2015-10-01

    Conclusion: In conclusion, using contemporary 12-core biopsy methods, the local prostate cancer detection rate based on serum PSA and DRE findings has increased over the past decade presumably due to multiple genetic and environmental factors. Post-biopsy sepsis remains an important complication worldwide.

  20. Comparison of trans-perineal ultrasound-guided pressure augmented saline colostomy distension study and conventional contrast radiographic colostography in children with anorectal malformation

    Directory of Open Access Journals (Sweden)

    Okechukwu Hyginus Ekwunife

    2016-01-01

    Full Text Available Background: In children with high and intermediate anorectal malformation, distal colostography is an important investigation done to determine the relationship between the position of the rectal pouch and the probable site of the neo-anus as well as the presence or absence of a fistula. Conventionally, this is done using contrast with fluoroscopy or still X-ray imaging. This, however, has the challenges of irradiation, availability and affordability, especially in developing countries. This study compared the accuracy of trans-perineal ultrasound-guided pressure augmented saline colostomy distension study (SCDS with conventional contrast distal colostography (CCDC in the determination of the precise location of the distal rectal pouch and in detecting the presence and site of fistulous communication between the rectum and the urogenital tract was studied. Materials and Methods: Trans-perineal ultrasound-guided pressure augmented SCDS, CCDC and intra-operative measurements were done sequentially for qualified infants with anorectal malformation and colostomy. Pouch skin distance and presence or absence of recto urinary or genital fistula was measured prospectively in each case. Statistical significance was inferred at P-value of 0.01. On its ability to detect presence or absence of a fistula: SCDS had a sensitivity of 50.0%, specificity of 100.0%, accuracy of 69.2%, negative predictive value of fistulas of 55.6% and a positive predictive value of fistulas of 100.0%. Conclusion: Ultrasound-guided pressure augmented SCDS can safely and reliably be used to assess the distal colonic anatomy and the presence of fistula in infants with Anorectal malformation who are on colostomy.

  1. Comparison of trans-perineal ultrasound-guided pressure augmented saline colostomy distension study and conventional contrast radiographic colostography in children with anorectal malformation.

    Science.gov (United States)

    Ekwunife, Okechukwu Hyginus; Umeh, Eric Okechukwu; Ugwu, Jideofor Okechukwu; Ebubedike, Uzoamaka Rufina; Okoli, Chinedu Christian; Modekwe, Victor Ifeanyichukwu; Elendu, Kelechi Collins

    2016-01-01

    In children with high and intermediate anorectal malformation, distal colostography is an important investigation done to determine the relationship between the position of the rectal pouch and the probable site of the neo-anus as well as the presence or absence of a fistula. Conventionally, this is done using contrast with fluoroscopy or still X-ray imaging. This, however, has the challenges of irradiation, availability and affordability, especially in developing countries. This study compared the accuracy of trans-perineal ultrasound-guided pressure augmented saline colostomy distension study (SCDS) with conventional contrast distal colostography (CCDC) in the determination of the precise location of the distal rectal pouch and in detecting the presence and site of fistulous communication between the rectum and the urogenital tract was studied. Trans-perineal ultrasound-guided pressure augmented SCDS, CCDC and intra-operative measurements were done sequentially for qualified infants with anorectal malformation and colostomy. Pouch skin distance and presence or absence of recto urinary or genital fistula was measured prospectively in each case. Statistical significance was inferred at P-value of CCDC is 0.19; and 0.06 when SCDS was compared with intra-operative measurements. Hence, there is no statistical difference as P > 0.01. On its ability to detect presence or absence of a fistula: SCDS had a sensitivity of 50.0%, specificity of 100.0%, accuracy of 69.2%, negative predictive value of fistulas of 55.6% and a positive predictive value of fistulas of 100.0%. Ultrasound-guided pressure augmented SCDS can safely and reliably be used to assess the distal colonic anatomy and the presence of fistula in infants with Anorectal malformation who are on colostomy.

  2. 超声引导下经皮肾穿刺活检的临床价值%The Clinical Value of Ultrasound Guided Percutaneous Renal biopsy

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Objective To investigate the clinical value of Ultrasound guided percutaneous renal biopsy. Methods Retrospective analysis of 115 cases of ultrasound guided percutaneous renal biopsy ultrasound positioning points, the puncture success rate, pathological findings and postoperative complications. Results In 115 cases, 1 case without success, the success rate was 99.1%,pathological results of IgA ephropathy and mesangial proliferative glomerulonephritis accounted for 72% of the total, postoperative complications accounted for 1.3% of gross hematuria, perirenal hematoma accounted for 1.7%, accounted for 43% of low back pain. Conclusions Ultrasound guided percutaneous renal puncture biopsy with high success rate, less complications, and is of high clinical value.%  目的探讨超声引导定位经皮肾穿刺活检的临床价值。方法回顾分析115例经超声引导定位经皮肾穿刺活检声像图定位要点,穿刺取材成功率,病理结果及术后并发症。结果115例中,1例未取材成功,取材成功率99.1%,病理结果IgA肾病及系膜增生性肾小球肾炎占总数的72%,术后并发症肉眼血尿占1.3%,肾周血肿占1.7%,腰痛占43%。结论超声引导定位经皮肾穿刺活检取材成功率高,并发症少,具有很高的临床价值。

  3. In-line positioning of ultrasound images using wireless remote display system with tablet computer facilitates ultrasound-guided radial artery catheterization.

    Science.gov (United States)

    Tsuchiya, Masahiko; Mizutani, Koh; Funai, Yusuke; Nakamoto, Tatsuo

    2016-02-01

    Ultrasound-guided procedures may be easier to perform when the operator's eye axis, needle puncture site, and ultrasound image display form a straight line in the puncture direction. However, such methods have not been well tested in clinical settings because that arrangement is often impossible due to limited space in the operating room. We developed a wireless remote display system for ultrasound devices using a tablet computer (iPad Mini), which allows easy display of images at nearly any location chosen by the operator. We hypothesized that the in-line layout of ultrasound images provided by this system would allow for secure and quick catheterization of the radial artery. We enrolled first-year medical interns (n = 20) who had no prior experience with ultrasound-guided radial artery catheterization to perform that using a short-axis out-of-plane approach with two different methods. With the conventional method, only the ultrasound machine placed at the side of the head of the patient across the targeted forearm was utilized. With the tablet method, the ultrasound images were displayed on an iPad Mini positioned on the arm in alignment with the operator's eye axis and needle puncture direction. The success rate and time required for catheterization were compared between the two methods. Success rate was significantly higher (100 vs. 70 %, P = 0.02) and catheterization time significantly shorter (28.5 ± 7.5 vs. 68.2 ± 14.3 s, P method as compared to the conventional method. An ergonomic straight arrangement of the image display is crucial for successful and quick completion of ultrasound-guided arterial catheterization. The present remote display system is a practical method for providing such an arrangement.

  4. Ultrasound-guided fine-needle aspiration biopsy of the thyroid: methods to decrease the rate of unsatisfactory biopsies in the absence of an on-site pathologist.

    Science.gov (United States)

    Naïm, Cyrille; Karam, Ramy; Eddé, Donald

    2013-08-01

    The rate of unsatisfactory samples from ultrasound-guided fine-needle aspirations of thyroid nodules varies widely in the literature. We aimed to evaluate our thyroid ultrasound-guided fine-needle aspiration biopsy technique in the absence of on-site microscopic examination by a pathologist; determine factors that affect the adequacy rate, such as the number of needle passes and needle size; compare our results with the literature; and establish an optimal technique. We performed a retrospective review of cytopathology reports from 252 consecutive thyroid ultrasound-guided fine-needle aspiration biopsies performed by a radiologist between 2005 and 2010 in our hospital's radiology department. Sample adequacy, the number of needle passes, and needle size were determined. There was an on-site cytologist who prepared slides immediately after fine-needle aspiration but no on-site microscopic assessment of sample adequacy to guide the number of needle passes that should be performed. Cytopathology biopsy reports were classified as either unsatisfactory or satisfactory samples for diagnosis; the latter consisted of benign, malignant, and undetermined diagnoses. Seventy-seven biopsies were performed with 1 needle pass, 124 with 2 needle passes, and 51 with 3 needle passes. The rates of unsatisfactory biopsies were 33.8%, 23.4% (odds ratio [OR] 0.599 [95% confidence interval {CI}, 0.319-1.123]; P = .110), and 13.7% (OR 0.312 [95% CI, 0.124-0.788]; P = .014), respectively. In a hospital in which there is no on-site pathologist, a 3-pass method increases the specimen satisfactory rate by 20% compared with 1 pass, achieves similar rates to the literature, and provides a basis for further improvement of our practice. Copyright © 2013 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  5. Brief reports: a clinical evaluation of block characteristics using one milliliter 2% lidocaine in ultrasound-guided axillary brachial plexus block.

    LENUS (Irish Health Repository)

    O'Donnell, Brian

    2010-09-01

    We report onset and duration of ultrasound-guided axillary brachial plexus block using 1 mL of 2% lidocaine with 1:200,000 epinephrine per nerve (total local anesthetic volume 4 mL). Block performance time, block onset time, duration of surgery, and block duration were measured. Seventeen consecutive patients were recruited. The mean (SD) block performance and onset times were 271 (67.9) seconds and 9.7 (3.7) minutes, respectively. Block duration was 160.8 (30.7) minutes. All operations were performed using regional anesthesia alone. The duration of anesthesia obtained is sufficient for most ambulatory hand surgery.

  6. A randomised cross-over comparison of the transverse and longitudinal techniques for ultrasound-guided identification of the cricothyroid membrane in morbidly obese subjects

    DEFF Research Database (Denmark)

    Kristensen, M S; Teoh, W H; Rudolph, S S;

    2016-01-01

    We compared the transverse and longitudinal approaches to ultrasound-guided identification of the cricothyroid membrane, to determine which was faster and more successful. Forty-two anaesthetists received a one-hour structured training programme consisting of e-learning, a lecture and hands......-on training, and then applied both techniques in a randomised, cross-over sequence to obese females with body mass index 39.0 - 43.9 kg.m(-2) . The mean (SD) time to identify the cricothyroid membrane was 24.0 (12.4) s using the transverse technique compared with 37.6 (17.9) s for the longitudinal technique...

  7. Successful treatment of athletic pubalgia in a lacrosse player with ultrasound-guided needle tenotomy and platelet-rich plasma injection: a case report.

    Science.gov (United States)

    Scholten, Paul M; Massimi, Stephen; Dahmen, Nick; Diamond, Joanne; Wyss, James

    2015-01-01

    Athletic pubalgia is a syndrome of persistent groin pain due to chronic repetitive trauma or stress involving the pelvic joints and many musculotendinous structures that cross the anterior pelvis. As a result, the differential diagnosis can be complex, but insertional tendinopathies are the most common. This case report describes a novel approach to the treatment of distal rectus abdominis tendinopathies with ultrasound-guided needle tenotomy and platelet-rich plasma (PRP) injection. After injection, the patient returned to pain-free play at his previous level of intensity. This suggests that PRP may be a useful treatment for this diagnosis.

  8. Percutaneous Ultrasound-Guided TOPAZ Radiofrequency Coblation: A Novel Coaxial Technique for the Treatment of Recalcitrant Plantar Fasciitis-Our Experience.

    Science.gov (United States)

    Shah, Amit; Best, Alistair J; Rennie, Winston J

    2016-06-01

    Various therapeutic options are available for treatment of recalcitrant plantar fasciitis. Studies using TOPAZ coblation (ArthroCare, Sunnyvale, CA) have had good early results. The current coblation technique involves a surgical incision or breach of the highly specialized plantar fat pad, which can be associated with risks. We describe a novel technique of ultrasound-guided percutaneous coblation with a lateral heel approach. Advantages include precise targeting of the plantar fascia by direct dynamic visualization of the coblation tip, a true percutaneous approach with a needle skin puncture (<5 mm), and preservation of the plantar fat pad by using a lateral heel approach.

  9. Imaging of foreign bodies in the face and ultrasound guided surgical removal; Diagnostico por imagem de corpos estranhos da face e retirada cirurgica guiada por ultra-sonografia

    Energy Technology Data Exchange (ETDEWEB)

    Lima, Claudio Marcio Amaral de Oliveira; Gambin, Moises; Ribeiro, Erica Barreiros; Amarante Junior, Jose Luiz de Medeiros [Hospital Naval Marcilio Dias, Rio de Janeiro, RJ (Brazil)]. E-mail: cmaol@br.inter.net; cmaolima@hotmail.com; Monteiro, Alexandra Maria Vieira [Pontificia Univ. Catolica do Rio de Janeiro (PUC/Rio), RJ (Brazil). Curso de Pos-Graduacao em Radiologia

    2006-10-15

    The identification and surgical removal of foreign bodies is a complex procedure in medical practice, principally when the involved material is radiolucent. The technological advent of the ultrasonography equipment comes enlarging the field of application of this method more and more, in medical practice. The authors describe a case of an ultrasound guided surgical removal of glass fragments from the face of a patient. The foreign bodies were previously diagnosed by ultrasound and computed tomography. The guided technic showed secure, less invasive and efficient, allowing the retreat of all the fragments. (author)

  10. Feasibility of telecytopathology for rapid preliminary diagnosis of ultrasound-guided fine needle aspiration of axillary lymph nodes in a remote breast care center

    OpenAIRE

    Kamal K. Khurana; Andra Kovalovsky; Deepa Masrani

    2012-01-01

    Background: In the recent years, the advances in digital methods in pathology have resulted in the use of telecytology in the immediate assessment of fine needle aspiration (FNA) specimens. However, there is a need for organ-based and body site-specific studies on the use of telecytology for the immediate assessment of FNA to evaluate its pitfalls and limitations. We present our experience with the use of telecytology for on-site evaluation of ultrasound-guided FNA (USG-FNA) of axillary lymph...

  11. Metastatic renal cell carcinoma from a native kidney of a renal transplant patient diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA biopsy

    Directory of Open Access Journals (Sweden)

    Yaseen Alastal

    2015-04-01

    Full Text Available Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA biopsy sampling of enlarged lymph nodes is increasingly used to diagnose metastatic tumors, especially of the gastrointestinal tract and the lungs. Herein, we describe the diagnosis of metastatic renal cell carcinoma from a native kidney of a 54 year-old male patient, who had a 5-years history of renal transplant, by EUS-FNA of mediastinal and celiac lymph nodes. Histological and immunohistochemical findings confirmed the origin of metastatic tumor. EUS-FNA with proper cytological evaluation can be useful in the diagnosis of metastatic renal cell carcinoma in renal transplant patients. 

  12. COMPLEX TRANSRECTAL US WITH COLOR FLOW MAPPING, DOPPLER SONOGRAPHY AND SONOELASTOGRAFIEY IN PROSTATE CANCER EVALUATION

    Directory of Open Access Journals (Sweden)

    А. I. Mukhomor

    2014-07-01

    Full Text Available Oncology statistics shows steady increase of prostate cancer, since early diagnosis and adequate treatment are crucial. Among prostate imaging modalities sonoelastography (SEG has a special value for identifying suspicious dense foci in prostate, however more studies are still required to establishing accuracy and specificity with different SEG techniques for updating the prostate cancer diagnostics protocol.The aim of study was to evaluate sonoelastography capabilities for ultrasound guided prostate biopsy, comparing with gray scale and Doppler modalities.512 consecutively selected patients were examined (mean age of 56 years, mean prostate volume was 54 cm3, the average PSA about 14.3 ng/ml. All patients underwent prostate cancer diagnostic algorithm, including direct rectal exam, PSA level, transrectal ultrasound (TRUS with Doppler and SEG identification of suspicious foci, mostly in peripheral zones, followed by 10-point biopsy guided by ultrasound. According to aim we assigned patients to 4 groups: group 1 (n = 327 underwent gray scale and Doppler US guided prostate biopsy; in patients of group 2 (n = 106 – additionally SEG was applied (3 patients of this group was also performed MRI and MRS of the prostate; in group 3 there were patients with high level of PSA and negative TRUS guided biopsy; group 4 – of 41 patiens with prostatectomy and biochemical recidive of prostate.Among 430 cases included to this study in 318 patients (74 % prostate adenocarcinoma was revealed, in 270 (63 % patients – benign hyperplasia (BH. In group 1 cancer was diagnosed in 236 (72.1 ± 2.4 % patients, in group 2 – in 84 (79.2 ± 3.8 %. 19 false negative and 6 false positive results were registered in SEG enchanced US guided prostate biopsy. Routine TRUS indicate lesions with mean sizes about 0.8 ± 0,21 sm in compare with 0,5 ± 0,08 sm which were diagnose by SEG. Locuses which were marked as benign byTRUS with SEG hade never conatained neoplastic cells

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

    Science.gov (United States)

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

    2016-01-01

    To compare the anesthetic techniques using propofol and fentanyl versus midazolam and remifentanil associated with a paracervical block with lidocaine in performing ultrasound-guided transvaginal oocyte aspiration. A randomized double-blind clinical trial (#RBR-8kqqxh) performed in 61 women submitted to assisted reproductive treatment. The patients were divided into two groups: anesthetic induction with 1mcg/kg of fentanyl associated with 1.5mg/kg of propofol (FP Group, n=32), in comparison with anesthetic induction using 0.075mg/kg of midazolam associated with 0.25mcg/kg/min of remifentanil, and paracervical block with 3mL of 2% lidocaine (MRPB Group, n=29). Main outcome measures: human reproduction outcomes, modified Aldrete-Kroulik index, hemodynamic parameters, and salivary cortisol. The results revealed a higher number of embryos formed in the FP Group (p50=2 versus 1; p=0.025), gestation rate two times higher in the FP Group (44.4% versus 22.2%; p=0.127), less time to reach AK=10 in the MRPB Group (p50=10 versus 2; panestesia com 1mcg/kg de fentanil associada com 1,5mg/kg de propofol (Grupo FP, n=32), em comparação com ao grupo submetido à indução da anestesia utilizando 0,075mg/kg de midazolam associada com 0,25mcg/kg/min de remifentanil, e bloqueio paracervical com 3mL de lidocaína a 2% (Grupo MRBP, n=29). Foram avaliados os resultados reprodutivos, índice modificado de Aldrete e Kroulik, parâmetros hemodinâmicos e cortisol salivar. Foi encontrado um número mais elevado de embriões formados no Grupo FP (p50=2 versus 1; p=0,025), taxa de gestação duas vezes mais elevada no Grupo FP (44,4% versus 22,2%; p=0,127), menos tempo para alcançar AK=10 no Grupo MRBP (p50=10 versus 2; panestesias (com fentanil e propofol, e com midazolam, remifentanil e bloqueio paracervical) ofereceram condições anestésicas satisfatórias na realização de procedimentos realizados em reprodução assistida, proporcionando conforto para o paciente e médico.

  14. Percutaneous ultrasound-guided ablation of BW7756-hepatoma using ethanol or acetic acid in a rat model

    Directory of Open Access Journals (Sweden)

    Galeotti Tommaso

    2007-12-01

    Full Text Available Abstract Background To compare tumor necrosis in hepatoma induced in rats by a single percutaneous injection of ethanol (PEI or acetic acid (PAI. Methods BW7756 hepatomas of 1 mm3 were implanted in the liver of 40 male healthy rats. After 14 days, the 36 surviving rats were treated, in a single session, by ultrasound-guided injection of 300 μl of 95% ethanol (n = 17 or 100 μl of 50% acetic acid (n = 19. They were sacrificed 14 days after treatment and explanted tumoral livers were examined. The same PAI procedure was repeated on 13 additional rats to exclude a suspected occurrence of technical failures during the experiment, due to a surprisingly high rate of deaths within 30 minutes after PAI. Results Four rats died within four days after tumor implantation; after PEI, 1/17 (6% died, whereas after PAI 9/19 (47% died. The remaining 26 rats, after 14 days post-percutaneous ablation, were sacrificed. Gross and microscopic examinations showed that the hepatoma's nodules treated with PEI had 45.3 ± 19.4% tumor necrosis compared to 49 ± 23.3% (P = NS for those treated with PAI. Complete tumor necrosis was not found in any animal. Peritoneal invasion was present in 4/16 (25% and 2/10 (20% rats treated with PEI or PAI, respectively (P = NS. Autopsy was performed in the 5 additional rats that died within 30 minutes after PAI. Conclusion Our results show that there is no significant difference in the percentage of tumor necrosis between two local ablation methods in spite of the different dosages used. However, mortality in the PAI-treated group was greater than in PEI-treated group, presumably due to greater acetic acid systemic diffusion and its metabolic side effects. In human subjects, HCC occurs in the setting of cirrhosis, where the non-tumoral tissue is firmer than the tumor structure, with consequent reduction of drug diffusion. This could be the reason why some human studies have concluded similar or even better safety and efficacy with PAI

  15. Oncological safety of ultrasound-guided laparoscopic liver resection for colorectal metastases: a case-control study.

    Science.gov (United States)

    Langella, Serena; Russolillo, Nadia; D'Eletto, Marco; Forchino, Fabio; Lo Tesoriere, Roberto; Ferrero, Alessandro

    2015-06-01

    Laparoscopic liver surgery has gained widespread acceptance and nowadays it is suggested even for malignant disease. Although the benefits on short-term outcomes have been proven, data on oncological safety are still lacking. The aim of this study is to assess oncologic results after ultrasound-guided laparoscopic liver resection (LLR) or open liver resection (OLR) for colorectal metastases. 37 consecutive patients undergoing LLR between 01/2004 and 03/2014 were matched at a ratio of 1:1 with 37 OLR. Matching criteria were male sex, number and diameter of liver metastases, segment location, synchronous presentation, site and stage of primary tumor, positive lymph nodes of the primary, and concomitant extrahepatic disease. Demographic characteristics were similar among groups. Parenchymal transection time was longer in the LLR group (68 ± 38.2 SD vs 40 ± 33.7 SD, p = 0.01). Mortality was nil in LLR and OLR. Overall morbidity was significantly lower in LLR (13.5 vs 37.8%, p = 0.02), although severe complications were similar among the two groups. Patients undergoing LLR were discharged earlier (5 ± 2.3 SD vs 8 ± 6.6 SD days, p resection was recorded in four LLR and three OLR (p = 1). Overall recurrences were similar among groups. Eight patients with hepatic or extrahepatic recurrence among LLR underwent surgery vs four of OLR (p = 0.03). After a median follow-up of 35.7 months in LLR and 47.9 months in OLR, 3-year overall survival was 91.8% LLR and 74.8% OLR (p = 0.14). 3-year disease-free survival was 69.1% LLR and 65.9% OLR (p = 0.53). Multivariate analysis showed that postoperative complications [HR 3.42 (95% CI 1.32-8.89)] and multiple metastases [HR 3.84 (95% CI 1.34-10.83)] were independent predictors of worse survival (p = 0.01). Ultrasound-LLR for colorectal hepatic metastases is safe, ensuring oncologic outcomes comparable to OLR.

  16. Efficacy and safety of fosfomycin-trometamol in the prophylaxis for transrectal prostate biopsy. Prospective randomized comparison with ciprofloxacin.

    Science.gov (United States)

    Lista, F; Redondo, C; Meilán, E; García-Tello, A; Ramón de Fata, F; Angulo, J C

    2014-01-01

    Prostate biopsy is the standardized diagnostic method for prostate cancer. However, although there is not a standardized protocol, there are recommendations in order to reduce the incidence of complications. The objective of the present work is to assess the efficacy and safety of antibiotic prophylaxis in the prostate biopsy by comparing two antibiotic regimes: two doses of fosfomycin-trometamol 3g (FMT) every 48 hours with 10 doses of oral ciprofloxacin 500 mg every 12 hours during 5 days. Randomized prospective study was performed with 671 patients who had undergone to walking transrectal ultrasound guided prostate biopsy. Patients of group A (n=312) were treated with ciprofloxacin, and patients of group B (n=359) with FMT. Efficacy and tolerability of two prophylactic regimes were compared. Urine culture was carried out at 2 weeks after biopsy. Initially, patients with asymptomatic bacteriuria were not treated with antibiotics; urine culture was repeated after 1 month, persistent bacteriuria was treated according to antibiogram. No differences between groups were found in age (P=.78), cancer presence (P=.9) or number of biopsy cylinders (P=.93). The mean number of cores obtained was 11.3 ± 3.25 (range 6-20). Digestive intolerance was observed for 9 patients (2.9%) of group A and 10 patients (2.8%) in group B. One patient (.3%) of group A showed severe allergic reaction. In total, 167 patients (24.6%) had complications: 16 (2.4%) fever, 47 (6.9%) hemospermia, 81 (11.9%) hematuria, 7 (1%) rectal bleeding and 16 (2.4%) urinary retention. No statistically differences between groups were observed (27.6% vs. 22.6%; P=.17). However, hemospermia was more frequent in group A (9.9% vs. 4.5%; P=.006). Bacteriuria after biopsy was detected in 44 patients (6.6%), being more frequent in group B patients (4.2% vs. 8.6%; P=.02) although a higher number of second treatment cycles were not needed (53.9% vs. 29%; P=.17). The likelihood of resistance to ciprofloxacin in patients

  17. Bloqueios nervosos guiados por ultra-som Bloqueos nerviosos guiados por ultrasonido Ultrasound-guided nerve blocks

    Directory of Open Access Journals (Sweden)

    Pablo Escovedo Helayel

    2007-02-01

    referencias anatómicas, menor volumenn de solución anestésica y una mayor seguridad. CONCLUSION: El artículo revisa los aspectos relativos a los mecanismos físicos para la formación de imágenes, la anatomía ultra sonográfica del neuro eje y de los plexos braquial y lumbo sacral, los equipos y materiales empleados en los bloqueos, los ajustes del aparato de ultrasonido para mejorar las imágenes, los planos de visualización de las agujas de bloqueo y las técnicas y el entrenamiento en bloqueos guiados por ultrasonido. CONCLUSIONES: Los pasos para obtener el éxito en anestesia regional incluyen la identificación exacta de la posición de los nervios, la localización precisa de la aguja, sin lesiones en las estructuras adyacentes y, finalmente, la inyección cuidadosa de anestésico local junto a los nervios. Aunque la neuro estimulación sea de gran ayuda en la identificación de los nervios, ella no logra, aisladamente, rellenar todas esas exigencias. A causa de eso, se cree que los bloqueos guiados por ultrasonido serán la técnica de elección para la anestesia regional en un futuro no muy distante.BACKGROUND AND OBJECTIVES: Ultrasound-guided nerve blocks are based on the direct visualization of nerve structures, needle, and adjacent anatomic structures. Thus, it is possible to place the local anesthetic precisely around the nerves and follow its dispersion in real time, obtaining, therefore, more effective blockades, reduced dependency on anatomic references, decreased anesthetic volume, and increased safety. CONTENTS: The aim of this paper was to review the physical mechanisms of image formation, ultrasound anatomy of the neuro axis and of the brachial and lumbosacral plexuses, equipment and materials used in the blockades, settings of the ultrasound equipment to improve the image, planes of visualization of the needles, the techniques, and training in ultrasound-guided nerve blocks. CONCLUSIONS: The steps for a successful regional block include the

  18. Comparison of sample adequacy, pain-scale ratings, and complications associated with ultrasound-guided fine-needle aspiration of thyroid nodules between two radiologists with different levels of experience.

    Science.gov (United States)

    Lee, Yoo Jin; Kim, Dong Wook; Jung, Soo Jin

    2013-12-01

    This study aimed to assess and compare the sample adequacy, patient pain ratings, and complications associated with ultrasound-guided fine-needle aspiration of thyroid nodules between two radiologists with different levels of experience. From March 2012 to May 2012, two radiologists performed ultrasound-guided fine-needle aspiration to diagnose thyroid nodules in consecutive patients using the same techniques. 157 patients were divided into two groups: group 1 consisted of 75 patients who underwent ultrasound-guided fine-needle aspiration by an experienced radiologist and group 2 consisted of 82 patients who underwent ultrasound-guided fine-needle aspiration by a less experienced radiologist. The sample adequacy, pain-scale ratings, and complications related to ultrasound-guided fine-needle aspiration were compared between the two groups. There was no statistical difference in sex, age, nodule size, or location between the two groups. There was no statistical difference (p = 0.710) in the prevalence of adequate cytology between group 1 (94.7 % [71/75]) and group 2 (96.3 % [79/82]). The mean ± standard deviation of pain-scale ratings was 1.99 ± 1.68 in group 1 and 2.30 ± 1.83 in group 2, but there was no statistical difference (p = 0.326). There were no significant complications related to the procedure and no sonographic changes on follow-up ultrasound for either group. The study results demonstrated good outcomes for ultrasound-guided fine-needle aspiration of thyroid nodules and no statistically significant differences in sample adequacy, pain-scale ratings, or complication rates between two radiologists with different levels of experience.

  19. Escherichia coli isolates from patients with bacteremic urinary tract infection are genetically distinct from those derived from sepsis following prostate transrectal biopsy.

    Science.gov (United States)

    Dan, Michael; Yair, Yael; Samosav, Alex; Gottesman, Tamar; Yossepowitch, Orit; Harari-Schwartz, Orna; Tsivian, Alexander; Schreiber, Rachel; Gophna, Uri

    2015-01-01

    Transrectal ultrasound-guided (TRUS) prostate biopsy is a very common procedure that is generally considered relatively safe. However, severe sepsis can occur after TRUS prostate biopsies, with Escherichia coli being the predominant causative agent. A common perception is that the bacteria that cause post-TRUS prostate biopsy infections originate in the urinary tract, but this view has not been adequately tested. Yet other authors believe on the basis of indirect evidence that the pathogens are introduced into the bloodstream by the biopsy needle after passage through the rectal mucosa. We compared E. coli isolates from male patients with bacteremic urinary tract infection (B-UTI) to isolates of patients with post prostate biopsy sepsis (PPBS), in terms of their sequence types, determined by multi-locus sequence typing (MLST) and their virulence markers. B-UTI isolates were much richer in virulence genes than were PPBS isolates, supporting the hypothesis that E. coli causing PPBS derive directly from the rectum. Sequence type 131 (ST131) strains and related strain from the ST131 were common (>30%) among the E. coli isolates from PPBS patients as well as from B-UTI patients and all these strains expressed extended spectrum beta-lactamases. Our finding supports the hypothesis that E. coli causing PPBS derive directly from the rectum, bypassing the urinary tract, and therefore do not require many of the virulence capabilities necessary for an E. coli strain that must persist in the urinary tract. In light of the increasing prevalence of highly resistant E. coli strains, a new approach for prevention of PPBS is urgently required. Copyright © 2015. Published by Elsevier GmbH.

  20. Efficacy and Complications of Ultrasound-Guided Percutaneous Renal Biopsy Using Automatic Biopsy Gun in Pediatric Diffuse Renal Disease: Analysis of 97 Cases

    Energy Technology Data Exchange (ETDEWEB)

    Han, Seung Min; Chung, Tae Woong; Yoon, Woong [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2007-09-15

    To evaluate the diagnostic efficacy and complications of ultrasound-guided percutaneous renal biopsy using automatic biopsy gun in patients with pediatric diffuse renal disease. Using an 18G automatic biopsy gun, biopsies were performed on 97 pediatric patients with clinically suspicious diffuse renal disease. The acquired tissue specimens were analyzed by photomicroscopy, immunofluorescence, and electron microscopy to support the diagnosis. In the 97 biopsies, the success of the histologic diagnosis, number of glomeruli, and complication rates were retrospectively evaluated by analyzing the variable exams and clinical records. Adequate tissue for histologic diagnosis was obtained in 91 of 97 biopsies (94%) and the mean number of glomeruli was 9.6. Complications such as minute pain, gross hematuria, and small perirenal hematoma presented in 22 of the 97 biopsies (23%), all of which either improved within 5-72 hours or did not need specific treatment. Ultrasound-guided percutaneous renal biopsy using 18G automatic biopsy gun is an effective and safe method for the histologic diagnosis of pediatric diffuse renal disease without any major complication