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Sample records for ultrasound guided femoral

  1. Ultrasound-guided approach for axillary brachial plexus, femoral nerve, and sciatic nerve blocks in dogs.

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    Campoy, Luis; Bezuidenhout, Abraham J; Gleed, Robin D; Martin-Flores, Manuel; Raw, Robert M; Santare, Carrie L; Jay, Ariane R; Wang, Annie L

    2010-03-01

    To describe an ultrasound-guided technique and the anatomical basis for three clinically useful nerve blocks in dogs. Prospective experimental trial. Four hound-cross dogs aged 2 +/- 0 years (mean +/- SD) weighing 30 +/- 5 kg and four Beagles aged 2 +/- 0 years and weighing 8.5 +/- 0.5 kg. Axillary brachial plexus, femoral, and sciatic combined ultrasound/electrolocation-guided nerve blocks were performed sequentially and bilaterally using a lidocaine solution mixed with methylene blue. Sciatic nerve blocks were not performed in the hounds. After the blocks, the dogs were euthanatized and each relevant site dissected. Axillary brachial plexus block Landmark blood vessels and the roots of the brachial plexus were identified by ultrasound in all eight dogs. Anatomical examination confirmed the relationship between the four ventral nerve roots (C6, C7, C8, and T1) and the axillary vessels. Three roots (C7, C8, and T1) were adequately stained bilaterally in all dogs. Femoral nerve block Landmark blood vessels (femoral artery and femoral vein), the femoral and saphenous nerves and the medial portion of the rectus femoris muscle were identified by ultrasound in all dogs. Anatomical examination confirmed the relationship between the femoral vessels, femoral nerve, and the rectus femoris muscle. The femoral nerves were adequately stained bilaterally in all dogs. Sciatic nerve block. Ultrasound landmarks (semimembranosus muscle, the fascia of the biceps femoris muscle and the sciatic nerve) could be identified in all of the dogs. In the four Beagles, anatomical examination confirmed the relationship between the biceps femoris muscle, the semimembranosus muscle, and the sciatic nerve. In the Beagles, all but one of the sciatic nerves were stained adequately. Ultrasound-guided needle insertion is an accurate method for depositing local anesthetic for axillary brachial plexus, femoral, and sciatic nerve blocks.

  2. Ultrasound-guided compression repair of pseudoaneurysms of brachial and femoral arteries - 2 cases-

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    Kim, Hak Soo; Choi, Yeon Hyeon; Kim, Ji Eun; Lee, Sang Hoon; Kim, Myung A; Kim, Tae Kyoung; Cho, Jae Min

    1994-01-01

    Ultrasound-guided compression repair of postcatherization pseudoaneurysm has been reported recently. We successfuly treated two cases of cardiac catherization-related pseudoaneurysms of brachial and femoral arteries with compression repair technique under color Doppler US-guidance. We regard US-guided compression repair as a saft and effective first-line treatment for catherization-related pseudoaneurysm

  3. Ultrasound-Guided Femoral Nerve Block to Facilitate the Closed Reduction of a Dislocated Hip Prosthesis

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    Edward Carlin

    2017-10-01

    Full Text Available Prosthetic hip dislocation is a common but unfortunate complication in patients who have undergone total hip arthroplasty. Successful closed reduction in the emergency department leads to a reduced length of stay and rate of hospitalization. 1, 2 The use of regional anesthesia by femoral nerve block represents a novel approach for controlling pain in patients with hip pathologies. 3 Ultrasound-guided approaches have been used with great success for controlling pain in patients with hip fractures. 4, 5 Here we report the case of a 90-year-old male who presented with a dislocated hip prosthesis, which was subsequently corrected with closed reduction following delivery of regional anesthesia to the femoral nerve under ultrasound guidance. To our knowledge, this represents the first reported use of an ultrasound-guided femoral nerve block to facilitate closed reduction of a dislocated prosthetic hip, and highlights a novel approach that avoids the use of procedural sedation in an elderly patient.

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

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    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.

  5. Novel needle guide reduces time to perform ultrasound-guided femoral nerve catheter placement: A randomised controlled trial.

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    Turan, Alparslan; Babazade, Rovnat; Elsharkawy, Hesham; Esa, Wael Ali Sakr; Maheshwari, Kamal; Farag, Ehab; Zimmerman, Nicole M; Soliman, Loran Mounir; Sessler, Daniel I

    2017-03-01

    Ultrasound-guided nerve blocks have become the standard when performing regional nerve blocks in anaesthesia. Infiniti Plus (CIVCO Medical Solutions, Kalona, Iowa, USA) is a needle guide that has been recently developed to help clinicians in performing ultrasound-guided nerve blocks. We tested the hypothesis that femoral nerve catheter placement carried out with the Infiniti Plus needle guide will be quicker to perform than without the Infiniti Plus. Secondary aims were to assess whether the Infiniti Plus needle guide decreased the number of block attempts and also whether it improved needle visibility. A randomised, controlled trial. Cleveland Clinic, Cleveland, Ohio, USA. We enrolled adult patients having elective total knee arthroplasty with a femoral nerve block and femoral nerve catheter. Patients, who were pregnant or those who had preexisting neuropathy involving the surgical limb, coagulopathy, infection at the block site or allergy to local anaesthetics were excluded. Patients were randomised into two groups to receive the ultrasound-guided femoral nerve catheter placement with or without the Infiniti Plus needle guide. The time taken to place the femoral nerve catheter, the number of attempts, the success rate and needle visibility were recorded. We used an overall α of 0.05 for both the primary and secondary analyses; the secondary analyses were Bonferroni corrected to control for multiple comparisons. The median (interquartile range Q1 to Q3) time to perform the femoral nerve catheter placement was 118 (100 to 150) s with Infiniti Plus and 177 (130 to 236) s without Infiniti Plus. Infiniti Plus significantly reduced the time spent performing femoral nerve catheterisation, with estimated ratio of means [(95% confidence interval), P value] of 0.67 [(0.60 to 0.75), P Infiniti Plus compared with no Infiniti Plus. However, Infiniti Plus had no effect on the odds of a successful femoral nerve catheter placement, number of attempts or percentage of perfect

  6. Successful Ultrasound-Guided Femoral Nerve Blockade and Catheterization in a Patient with Von Willebrand Disease

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    Youmna E. DiStefano

    2015-01-01

    Full Text Available Peripheral nerve blockade (PNB is superior to neuraxial anesthesia and/or opioid therapy for perioperative analgesia in total knee replacement (TKR. Evidence on the safety of PNB in patients with coagulopathy is lacking. We describe the first documented account of continuous femoral PNB for perioperative analgesia in a patient with Von Willebrand Disease (vWD. Given her history of opioid tolerance and after an informative discussion, a continuous femoral PNB was planned for in this 34-year-old female undergoing TKR. A Humate-P intravenous infusion was started and the patient was positioned supinely. Using sterile technique with ultrasound guidance, a Contiplex 18 Gauge Tuohy needle was advanced in plane through the fascia iliaca towards the femoral nerve. A nerve catheter was threaded through the needle and secured without complications. Postoperatively, a levobupivacaine femoral catheter infusion was maintained, and twice daily Humate-P intravenous infusions were administered for 48 hours; enoxaparin thromboprophylaxis was initiated thereafter. The patient was discharged uneventfully on postoperative day 4. Given documentation of delayed, unheralded bleeding from PNB in coagulopathic patients, we recommend individualized PNB in vWD patients. Multidisciplinary team involvement is required to guide factor supplementation and thromboprophylaxis, as is close follow-up to elicit signs of bleeding throughout the delayed postoperative period.

  7. How to achieve ultrasound-guided femoral venous access: the new standard of care in the electrophysiology laboratory.

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    Wiles, Benedict M; Child, Nicholas; Roberts, Paul R

    2017-06-01

    Bedside vascular ultrasound machines are increasingly available. They are used to facilitate safer vascular access across a number of different specialties. In the electrophysiology laboratory however, where patients are frequently anticoagulated and require the insertion of multiple venous sheaths, anatomical landmark techniques predominate. Despite the high number of vascular complications associated with electrophysiological procedures and the increasing evidence to support its use in electrophysiology, ultrasound remains underutilised. A new standard of care is required. A comprehensive technical report, providing a detailed explanation of this important technique, will provide other electrophysiology centres with the knowledge and justification for adopting ultrasound guidance as their standard practice. We review the increasing body of evidence which demonstrates that routine ultrasound usage can substantially improve the safety of femoral venous access in the electrophysiology laboratory. We offer a comprehensive technical report to guide operators through the process of ultrasound-guided venous access, with a specific focus on the electrophysiology laboratory. Additionally, we detail a novel technique which utilises real-time colour Doppler ultrasound to accurately identify needle tip location during venous puncture. The use of vascular ultrasound to guide femoral venous cannulation is rapid, inexpensive and easily learnt. Ultrasound is readily available and offers the potential to significantly reduce vascular complications in the unique setting of the electrophysiology laboratory. Ultrasound guidance to achieve femoral venous access should be the new standard of care in electrophysiology.

  8. Does ultrasound-guided lidocaine injection improve local anaesthesia before femoral artery catheterization?

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    Spiliopoulos, S.; Katsanos, K.; Diamantopoulos, A.; Karnabatidis, D.; Siablis, D.

    2011-01-01

    Aim: To present the results of a prospective, randomized, single-centre study investigating local anaesthesia before percutaneous common femoral artery (CFA) puncture and catheterization with the use of ultrasound-guided injection of lidocaine versus standard infiltration by manual palpation. Materials and methods: Patients scheduled to undergo diagnostic or therapeutic transfemoral catheter-based procedures gave informed consent and were randomized in two groups. In the first arm local anaesthesia with lidocaine hydrochloride 1% was performed under ultrasound guidance (group U/S), while in the second arm the standard method of manual artery palpation was applied (group M). In both groups, subsequent CFA catheterization was achieved under ultrasound guidance. The primary study endpoint was peri-procedural pain level evaluated with a visual-analogue scale (VAS score 0-10). Results: Between January 2009 and 2010, 200 patients (161 men, mean age 63 ± 12 years) were equally assigned to each group without any significant differences in baseline demographics. Patients in group U/S experienced significantly less pain during CFA catheterization in comparison with group M with a difference of three points in mean VAS score reported (1.6 ± 1.6 versus 4.6 ± 1.9, p < 0.0001). In addition, significantly less volume of lidocaine was used in group U/S compared to group M (16 ± 2.7 versus 19 ± 0.8 ml, p < 0.001).Total vascular access time was similar in both groups (4.4 ± 1.3 versus 4.5 ± 1.3 min). Overall complications included two small groin haematomas in each group. Conclusion: Ultrasound-guided local anaesthesia of the CFA prior to percutaneous transcatheter procedures is safe and achieves superior levels of analgesia with minimal patient pain and discomfort compared to the standard method of manual palpation.

  9. Does ultrasound-guided lidocaine injection improve local anaesthesia before femoral artery catheterization?

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    Spiliopoulos, S., E-mail: stavspiliop@upatras.g [Department of Diagnostic and Interventional Radiology, Patras University Hospital, School of Medicine, Patras (Greece); Katsanos, K.; Diamantopoulos, A.; Karnabatidis, D.; Siablis, D. [Department of Diagnostic and Interventional Radiology, Patras University Hospital, School of Medicine, Patras (Greece)

    2011-05-15

    Aim: To present the results of a prospective, randomized, single-centre study investigating local anaesthesia before percutaneous common femoral artery (CFA) puncture and catheterization with the use of ultrasound-guided injection of lidocaine versus standard infiltration by manual palpation. Materials and methods: Patients scheduled to undergo diagnostic or therapeutic transfemoral catheter-based procedures gave informed consent and were randomized in two groups. In the first arm local anaesthesia with lidocaine hydrochloride 1% was performed under ultrasound guidance (group U/S), while in the second arm the standard method of manual artery palpation was applied (group M). In both groups, subsequent CFA catheterization was achieved under ultrasound guidance. The primary study endpoint was peri-procedural pain level evaluated with a visual-analogue scale (VAS score 0-10). Results: Between January 2009 and 2010, 200 patients (161 men, mean age 63 {+-} 12 years) were equally assigned to each group without any significant differences in baseline demographics. Patients in group U/S experienced significantly less pain during CFA catheterization in comparison with group M with a difference of three points in mean VAS score reported (1.6 {+-} 1.6 versus 4.6 {+-} 1.9, p < 0.0001). In addition, significantly less volume of lidocaine was used in group U/S compared to group M (16 {+-} 2.7 versus 19 {+-} 0.8 ml, p < 0.001).Total vascular access time was similar in both groups (4.4 {+-} 1.3 versus 4.5 {+-} 1.3 min). Overall complications included two small groin haematomas in each group. Conclusion: Ultrasound-guided local anaesthesia of the CFA prior to percutaneous transcatheter procedures is safe and achieves superior levels of analgesia with minimal patient pain and discomfort compared to the standard method of manual palpation.

  10. Ultrasound-Guided Glue Injection as Alternative Treatment of Femoral Pseudoaneurysms

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    Aytekin, Cueneyt; Firat, Ali; Yildirim, Erkan; Kirbas, Ismail; Boyvat, Fatih

    2004-01-01

    The interventional angiographic techniques using the percutaneous femoral approach for endovascular revascularization are becoming increasingly more popular. These methods usually require larger sheaths, and most patients need postprocedural anticoagulation or antiplatelet therapy. As a consequence, the interventional procedure is associated with a higher rate of complications at the arterial entry site compared to diagnostic angiography. The reported incidence of iatrogenic pseudoaneurysm formation after coronary artery interventions ranges from 3.2% to 7.7%, and the rates noted after diagnostic angiography range from 0.2% to 1%. Peripheral pseudoaneurysms have traditionally been treated by surgical intervention, but nonsurgical alternatives, such as ultrasound (US)-guided compression, coil embolization, stent-graft placement, and percutaneous thrombin injection with or without balloon occlusion have also been documented. Of these alternatives, direct percutaneous embolization with embolic agents is the most popular method. The tissue adhesive n-butyl cyanoacrylate (NBCA) (Hystoacryl) (B. Braun, Melsungen, Germany) is one of the most popular occluding agents for neurovascular interventions, and has been widely used for more than 20 years [5,6]. In this study, we evaluated the efficacy and utility of direct percutaneous injection of NBCA for embolization of femoral pseudoaneurysms

  11. Ultrasound and nerve stimulator guided continuous femoral nerve block analgesia after total knee arthroplasty: a multicenter randomized controlled study

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    Fen Wang

    2015-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: Postoperative analgesia is crucial for early functional excise after total knee arthroplasty. To investigate the clinical efficacy of ultrasound and nerve stimulator guided continuous femoral nerve block analgesia after total knee arthroplasty. METHODS: 46 patients with ASA grade I-III who underwent total knee arthroplasty received postoperative analgesia from October 2012 to January 2013. In 22 patients, ultrasound and nerve stimulator guided continuous femoral nerve block were performed for analgesia (CFNB group; in 24 patients, epidural analgesia was done (PCEA group. The analgesic effects, side effects, articular recovery and complications were compared between two groups. RESULTS: At 6 h and 12 h after surgery, the knee pain score (VAS score during functional tests after active exercise and after passive excise in CFNB were significantly reduced when compared with PCEA group. The amount of parecoxib used in CFNB patients was significantly reduced when compared with PCEA group. At 48 h after surgery, the muscle strength grade in CFNB group was significantly higher, and the time to ambulatory activity was shorter than those in PCEA group. The incidence of nausea and vomiting in CFNB patients was significantly reduced when compared with PCEA group. CONCLUSION: Ultrasound and nerve stimulator guided continuous femoral nerve block provide better analgesia at 6 h and 12 h, demonstrated by RVAS and PVAS. The amount of parecoxib also reduces, the incidence of nausea and vomiting decreased, the influence on muscle strength is compromised and patients can perform ambulatory activity under this condition.

  12. Ultrasound-Guided Thrombin Injection Is a Safe and Effective Treatment for Femoral Artery Pseudoaneurysm in the Morbidly Obese.

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    Yoo, Taehwan; Starr, Jean E; Go, Michael R; Vaccaro, Patrick S; Satiani, Bhagwan; Haurani, Mounir J

    2017-08-01

    Ultrasound-guided thrombin injection (UGTI) is a well-established practice for the treatment of femoral artery pseudoaneurysm. This procedure is highly successful but dependent on appropriate pseudoaneurysm anatomy and adequate ultrasound visualization. Morbid obesity can present a significant technical challenge due to increased groin adiposity, resulting in poor visualization of critical structures needed to safely perform the procedure. We aim to evaluate the safety and efficacy of UGTI to treat femoral artery pseudoaneurysm in the morbidly obese. This is a retrospective cohort study in which all patients who underwent UGTI at The Ohio State University Ross Heart Hospital from 2009 to 2014 were analyzed for patient characteristics and stratified by body mass index (BMI). Patients with BMI ≥ 35 were considered morbidly obese and were compared to patients with a BMI injection. There were 41 nonmorbidly obese and 13 morbidly obese patients. Mean age was 64.5 years. The cohort was 44.4% male. There were 6 failures, of which 1 underwent successful repeat injection and 5 underwent open surgical repair. There was no statistically significant difference in failure between nonmorbidly obese and morbidly obese patients (9.8% vs 15.4%, P = .45). There were no embolic/thrombotic complications. Ultrasound-guided thrombin injection is a safe and effective therapy in the morbidly obese for the treatment of femoral artery pseudoaneurysm. In the hands of experienced sonographers and surgeons with adequate visualization of the pseudoaneurysm sac, UGTI should remain a standard therapy in the morbidly obese.

  13. A randomized comparison between neurostimulation and ultrasound-guided lateral femoral cutaneous nerve block.

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    Gupta, Gaurav; Radhakrishna, Mohan; Tamblyn, Isaac; Tran, D Q; Besemann, Markus; Thonnagith, Atikun; Elgueta, Maria Francisca; Robitaille, Marie Eve; Finlayson, Roderick J

    2017-01-01

    This prospective, randomized trial compared neurostimulation (NS) and ultrasound (US) guided lateral femoral cutaneous nerve (LFCN) block. We hypothesized that US would result in a shorter total anesthesia-related time (sum of performance and onset times). Twenty-one volunteers were enrolled. The right lower limb was randomized to an NS- or US-guided LFCN block. The alternate technique was employed for the left lower limb. With NS, paresthesias were sought in the lateral thigh at a stimulatory threshold of 0.6 mA (pulse width=0.3 ms; frequency=2 Hz) or lower. With US, local anesthetic was deposited under the inguinal ligament, ventral to the iliopsoas muscle. In both groups, 5 mL of lidocaine 2% were used to anesthetize the nerve. During the procedure of the block, the performance time and number of needle passes were recorded. Subsequently, a blinded observer assessed sensory block in the lateral thigh every minute until 20 minutes. Success was defined as loss of pinprick sensation at a point midway between the anterior superior iliac spine and the lateral knee line. The blinded observer also assessed the areas of sensory block in the anterior, medial, lateral, and posterior aspects of the thigh and mapped this distribution onto a corresponding grid. Both modalities provided comparable success rates (76.2%-95.2%), performance times (162.1 to 231.3 seconds), onset times (300.0 to 307.5 seconds) and total anesthesia related-times (480.1 to 554.0 seconds). However US required fewer needle passes (3.2±2.9 vs 9.5±12.2; P=.009). There were no intergroup differences in terms of the distribution of the anesthetized cutaneous areas. However considerable variability was encountered between individuals and between the 2 sides of a same subject. The most common areas of sensory loss included the central lateral two-eighths anteriorly and the central antero-inferior three-eighths laterally. Ultrasound guidance and NS provide similar success rates and total anesthesia

  14. Use of the cumulative sum method (CUSUM) to assess the learning curves of ultrasound-guided continuous femoral nerve block.

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    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.

  15. Ultrasound-guided block of sciatic and femoral nerves: an anatomical study.

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    Waag, Sonja; Stoffel, Michael H; Spadavecchia, Claudia; Eichenberger, Urs; Rohrbach, Helene

    2014-04-01

    The sheep is a popular animal model for human biomechanical research involving invasive surgery on the hind limb. These painful procedures can only be ethically justified with the application of adequate analgesia protocols. Regional anaesthesia as an adjunct to general anaesthesia may markedly improve well-being of these experimental animals during the postoperative period due to a higher analgesic efficacy when compared with systemic drugs, and may therefore reduce stress and consequently the severity of such studies. As a first step 14 sheep cadavers were used to establish a new technique for the peripheral blockade of the sciatic and the femoral nerves under sonographic guidance and to evaluate the success rate by determination of the colorization of both nerves after an injection of 0.5 mL of a 0.1% methylene blue solution. First, both nerves were visualized sonographically. Then, methylene blue solution was injected and subsequently the length of colorization was measured by gross anatomical dissection of the target nerves. Twenty-four sciatic nerves were identified sonographically in 12 out of 13 cadavers. In one animal, the nerve could not be ascertained unequivocally and, consequently, nerve colorization failed. Twenty femoral nerves were located by ultrasound in 10 out of 13 cadavers. In three cadavers, signs of autolysis impeded the scan. This study provides a detailed anatomical description of the localization of the sciatic and the femoral nerves and presents an effective and safe yet simple and rapid technique for performing peripheral nerve blocks with a high success rate.

  16. Comparison between ultrasound-guided compression and para-aneurysmal saline injection in the treatment of postcatheterization femoral artery pseudoaneurysms.

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    ElMahdy, Mahmoud Farouk; Kassem, Hussien Heshmat; Ewis, Essam Baligh; Mahdy, Soliman Gharieb

    2014-03-01

    Management of postcatheterization femoral artery pseudoaneurysm (FAP) is problematic. Ultrasound-guided compression (UGC) is painful and cumbersome. Thrombin injection is costly and may cause thromboembolism. Ultrasound-guided para-aneurysmal saline injection (PASI) has been described but was never compared against other treatment methods of FAP. We aimed at comparing the success rate and complications of PASI versus UGC. We randomly assigned 80 patients with postcatheterization FAPs to either UGC (40 patients) or PASI (40 patients). We compared the 2 procedures regarding successful obliteration of the FAP, incidence of vasovagal attacks, procedure time, discontinuation of antiplatelet and/or anticoagulants, and the Doppler waveform in the ipsilateral pedal arteries at the end of the procedure. There was no significant difference between patients in both groups regarding clinical and vascular duplex data. The mean durations of UGC and PASI procedures were 58.14 ± 28.45 and 30.33 ± 8.56 minutes, respectively (p = 0.045). Vasovagal attacks were reported in 10 (25%) and 2 patients (5%) treated with UGC and PASI, respectively (p = 0.05). All patients in both groups had triphasic Doppler waveform in the infrapopliteal arteries before and after the procedure. The primary and final success rates were 75%, 92.5%, 87.5%, and 95% for UGC and PASI, respectively (p = 0.43). In successfully treated patients, there was no reperfusion of the FAP in the follow-up studies (days 1 and 7) in both groups. In conclusion, ultrasound-guided PASI is an effective method for the treatment of FAP. Compared with UGC, PASI is faster, less likely to cause vasovagal reactions, and can be more convenient to patients and physicians. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. STUDY OF ULTRASOUND-GUIDED CONTINUOUS FEMORAL NERVE BLOCKADE WITH EPIDURAL ANALGESIA FOR PAIN RELIEF AFTER TOTAL KNEE REPLACEMENT

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    Srinivas Rapolu

    2016-11-01

    Full Text Available BACKGROUND Total knee replacement causes moderate-to-severe pain requiring effective analgesia. With use of ultrasound guidance, we may prove a more suitable approach compared with the epidural technique. Aim of this study is the comparison between Continuous Epidural Analgesia (CEA and Continuous Femoral Block (CFB techniques in Total Knee Replacement surgeries. MATERIALS AND METHODS This study was conducted on 60 adult male and female patients undergoing total knee replacement surgery for a period of 2 years. Patients were divided into 2 groups. Group - 1: Continuous epidural analgesia patients, Group - 2: Continuous femoral blockage patients. All patients were assessed clinically preoperatively and investigated to rule out any systemic disease. RESULTS The mean age of patient in Group - 1 was 66.54 ± 4.98 and in Group - 2 was 66.98 ± 5.02 years. P value was > 0.05, which was not significant. No significant differences in gender is observed between the groups. VAS scores were significantly high (P < 0.05 in the femoral group at 6 h, after which there was a declining trend and scores were essentially similar from 24 h. The use of rescue analgesic was also higher in the femoral group. Analysis of side-effects showed that all the five common sideeffects were twice as common in the epidural group than in the femoral study group. Only one patient in the femoral group had urinary retention when compared with four in the epidural group. The differences were not statistically significant. Muscle power at 48 h, time getting out of the bed and time stay in hospital (days are significant in comparison in 2 groups, range of movement is insignificant in groups. Patient satisfaction score was measured on a scale of 1 - 10. Patients in the Femoral group were slightly more satisfied with a mean ± SD score of 8.1 ± 1.2 when compared with the epidural group 7.3 ± 1.01. CONCLUSION Continuous femoral blockade using US guidance provides equivalent analgesia

  18. Comparison of Radial Access, Guided Femoral Access, and Non-Guided Femoral Access Among Women Undergoing Percutaneous Coronary Intervention.

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    Koshy, Linda M; Aberle, Laura H; Krucoff, Mitchell W; Hess, Connie N; Mazzaferri, Ernest; Jolly, Sanjit S; Jacobs, Alice; Gibson, C Michael; Mehran, Roxana; Gilchrist, Ian C; Rao, Sunil V

    2018-01-01

    This study was conducted to determine the association between radial access, guided femoral access, and non-guided femoral access on postprocedural bleeding and vascular complications after percutaneous coronary intervention (PCI). Bleeding events and major vascular complications after PCI are associated with increased morbidity, mortality, and cost. While the radial approach has been shown to be superior to the femoral approach in reducing bleeding and vascular complications, whether the use of micropuncture, fluoroscopy, or ultrasound mitigates these differences is unknown. We conducted a post hoc analysis of women in the SAFE-PCI for Women trial who underwent PCI and had the access method identified (n = 643). The primary endpoint of postprocedure bleeding or vascular complications occurring within 72 hours or at discharge was adjudicated by an independent clinical events committee and was compared based on three categories of access technique: radial, guided femoral (fluoroscopy, micropuncture, ultrasound), or non-guided femoral (none of the aforementioned). Differences between the groups were determined using multivariate logistic regression using radial access as the reference. Of the PCI population, 330 underwent radial access, 228 underwent guided femoral access, and 85 underwent non-guided femoral access. There was a statistically significant lower incidence of the primary endpoint with radial access vs non-guided femoral access; however, there was no significant difference between radial approach and femoral access guided by fluoroscopy, micropuncture, or ultrasound. This post hoc analysis demonstrates that while radial access is safer than non-guided femoral access, guided femoral access appears to be associated with similar bleeding events or vascular complications as radial access.

  19. Minimum Effective Concentration of Bupivacaine in Ultrasound-Guided Femoral Nerve Block after Arthroscopic Knee Meniscectomy: A Randomized, Double-Blind, Controlled Trial.

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    Moura, Ed Carlos Rey; de Oliveira Honda, Claudio A; Bringel, Roberto Cesar Teixeira; Leal, Plinio da Cunha; Filho, Gasper de Jesus Lopes; Sakata, Rioko Kinmiko

    2016-01-01

    Adequate analgesia is important for early hospital discharge after meniscectomy. A femoral nerve block may reduce the need for systemic analgesics, with fewer side effects; however, motor block can occur. Ultrasound-guided femoral nerve block may reduce the required local anesthetic concentration, preventing motor block. The primary objective of this study was to determine the lowest effective analgesic concentration of bupivacaine in 50% (EC50) and in 90% (EC90) of patients for a successful ultrasound-guided femoral nerve block in arthroscopic knee meniscectomy. This was a prospective, randomized, double-blind, controlled trial. This study was conducted at Hospital São Domingos. A total of 52 patients undergoing arthroscopic knee meniscectomy were submitted to ultrasound-guided femoral nerve block using 22 mL bupivacaine. The bupivacaine concentration given to a study patient was determined by the response of the previous patient (a biased-coin design up-down sequential method). If the previous patient had a negative response, the bupivacaine concentration was increased by 0.05% for the next case. If the previous patient had a positive response, the next patient was randomized to receive the same bupivacaine concentration (with a probability of 0.89) or to have a decrease by 0.05% (with a probability of 0.11). A successful block was defined by a numerical pain intensity scale score different evaluations. If the pain intensity score was = 4 (moderate or severe pain) at any time, the block was considered failed. General anesthesia was induced with 30 µg/kg alfentanil and 2 mg/kg propofol, followed by propofol maintanance, plus remifentanil if needed. Postoperative analgesia supplementation was performed with dipyrone; ketoprofen and tramadol were given if needed. The following parameters were evaluated: numerical pain intensity score, duration of analgesia, supplementary analgesic dose in 24 hours, and need for intraoperative remifentanil. The EC50 was 0.160 (95

  20. 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.

  1. Comparison of ultrasound-guided versus anatomical landmark ...

    African Journals Online (AJOL)

    Background Femoral vein cannulation may be required during major surgery in infants and children and may prove to be life saving under certain conditions. This study compared ultrasound (US)-guided cannulation of the femoral vein in infants with the traditional anatomical landmark-guided technique. Methods Eighty ...

  2. Bloqueio dos nervos femoral e isquiático guiados por ultrassom em paciente anticoagulado: case reports Bloqueo de los nervios femoral e isquiático guiados por ultrasonido en paciente anticoagulado Ultrasound-guided femoral and sciatic nerve blocks in an anticoagulated patient: relato de casos

    Directory of Open Access Journals (Sweden)

    Leonardo Henrique Cunha Ferraro

    2010-08-01

    cada vez más en una práctica frecuente. Con la menor probabilidad de promover lesiones vasculares, el ultrasonido se convierte en un instrumento interesante en la realización de bloqueos periféricos, especialmente en los pacientes que usan anticoagulantes o con disturbios de la coagulación. El objetivo de este estudio fue relatar dos casos en que se realizaron los bloqueos isquiático y femoral guiados por ultrasonido en pacientes anticoagulados. RELATO DE LOS CASOS: En el primer caso, la cirugía realizada consistió en la amputación del pie anterior izquierdo en función de una necrosis y de señales de infección. El segundo caso, fue una limpieza quirúrgica de la rodilla izquierda. Los pacientes presentaron disturbios de coagulación con una actividad de protrombina y tiempo de tromboplastina activado por encima de los valores normales. Los dos pacientes se sometieron al bloqueo femoral e isquiático guiado por ultrasonido, evolucionando sin alteración motora o sensitiva en los territorios de esos nervios y sin hematoma en la región local de la punción. CONCLUSIONES: La anticoagulación impone ciertas restricciones a la aplicación de las técnicas anestésicas regionales clásicas. Con el avance de los equipos y métodos de ultrasonido, hoy por hoy se puede identificar con alta precisión las estructuras vasculares y neurales. Eso posibilita que la punción guiada por ultrasonido sea más exacta, tanto para alcanzar el área de interés como para minimizar los riesgos de lesión vascular accidental. Hasta el presente momento, no se recomienda la realización de bloqueo periférico en pacientes anticoagulados o portadores de coagulopatías. Sin embargo, considerando que existen pocos relatos sobre bloqueos regionales con ultrasonido en situaciones de coagulopatías, la seguridad de tal técnica en esas condiciones todavía no se ha establecido.BACKGROUND AND OBJECTIVES: The use of the ultrasound to guide the puncture in peripheral nerve blocks has become

  3. Ultrasound-guided Radiofrequency Lesioning of the Articular Branches of the Femoral Nerve for the Treatment of Chronic Post-arthroplasty Hip Pain.

    Science.gov (United States)

    Kim, David J; Shen, Shiqian; Hanna, George M

    2017-02-01

    Total hip arthroplasty (THA) is a common surgical treatment for several conditions of the hip. While the majority of patients obtain satisfactory results, many develop chronic post-arthroplasty hip pain that can be difficult to treat. We evaluate the effectiveness of cooled (60°C) radiofrequency lesioning of the articular branches of the femoral nerve (ABFN) as a minimally invasive treatment for patients suffering from chronic post-arthroplasty hip pain. This treatment has never been described previously in this population. Case report. Center for Pain Medicine, Massachusetts General Hospital, Harvard Medical School. A 59-year-old woman with long-standing osteoarthritis of the right hip who underwent primary total hip arthroplasty and presented with chronic post-arthroplasty hip pain Intervention: Cooled (60°C) radiofrequency lesioning of the ABFN under ultrasound guidance Outcome Measure: Functional ability and numeric rating scale (NRS) scores at rest and with activity. Prior to intervention, the patient reported severe disruption in daily activities, sleep, and relationships; NRS scores at rest and with activity were 4/10 and 10/10, respectively. At 4 weeks following intervention, the patient reported significant improvement in functional ability and NRS scores decreased to 1/10 and 2/10, respectively. At 6 months, the patient's NRS scores at rest and with activity were 0/10 and 1/10, respectively. At 24-month follow-up, the patient continued to endorse significant pain relief with NRS scores at rest and with activity of 0 - 1/10 and 1 - 2/10, respectively. There were no side effects or complications including motor weakness, sensory loss, and neuralgias. Although the patient obtained good results from the intervention, the description of the study is from a single case report. Further study is necessary to investigate the widespread use of this technique and its outcomes. Cooled (60°C) radiofrequency lesioning of the ABFN under ultrasound guidance is both an

  4. [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.

  5. Correlation of ultrasound appearance, gross anatomy, and histology of the femoral nerve at the femoral triangle.

    Science.gov (United States)

    Lonchena, Tiffany K; McFadden, Kathryn; Orebaugh, Steven L

    2016-01-01

    Correlation between ultrasound appearance, gross anatomic characteristics, and histologic structure of the femoral nerve (FN) is lacking. Utilizing cadavers, we sought to characterize the anatomy of the FN, and provide a quantitative measure of its branching. We hypothesize that at the femoral crease, the FN exists as a group of nerve branches, rather than a single nerve structure, and secondarily, that this transition into many branches is apparent on ultrasonography. Nineteen preserved cadavers were investigated. Ultrasonography was sufficient to evaluate the femoral nerve in nine specimens; gross dissection was utilized in all 19. Anatomic characteristics were recorded, including distances from the inguinal ligament to femoral crease, first nerve branch, and complete arborization of the nerve. The nerves from nine specimens were excised for histologic analysis. On ultrasound, the nerve became more flattened, widened, and less discrete as it coursed distally. Branching of the nerve was apparent in 12 of 18 images, with mean distance from inguinal ligament of 3.9 (1.0) cm. However, upon dissection, major branching of the femoral nerve occurred at 3.1 (1.0) cm distal to the inguinal ligament, well proximal to the femoral crease. Histologic analysis was consistent with findings at dissection. The femoral nerve arborizes into multiple branches between the inguinal ligament and the femoral crease. Initial branching is often high in the femoral triangle. As hypothesized, the FN exists as a closely associated group of nerve branches at the level of the femoral crease; however, the termination of the nerve into multiple branches is not consistently apparent on ultrasonography.

  6. Investigation into the visual perceptive ability of anaesthetists during ultrasound-guided interscalene and femoral blocks conducted on soft embalmed cadavers: a randomised single-blind study.

    Science.gov (United States)

    Mustafa, A; Seeley, J; Munirama, S; Columb, M; McKendrick, M; Schwab, A; Corner, G; Eisma, R; Mcleod, G

    2018-04-01

    Errors may occur during regional anaesthesia whilst searching for nerves, needle tips, and test doses. Poor visual search impacts on decision making, clinical intervention, and patient safety. We conducted a randomised single-blind study in a single university hospital. Twenty trainees and two consultants examined the paired B-mode and fused B-mode and elastography video recordings of 24 interscalene and 24 femoral blocks conducted on two soft embalmed cadavers. Perineural injection was randomised equally to 0.25, 0.5, and 1.0 ml volumes. Tissue displacement perceived on both imaging modalities was defined as 'target' or 'distractor'. Our primary objective was to test the anaesthetists' perception of the number and proportion of targets and distractors on B-mode and fused elastography videos collected during femoral and sciatic nerve block on soft embalmed cadavers. Our secondary objectives were to determine the differences between novices and experts, and between test-dose volumes, and to measure the area and brightness of spread and strain patterns. All anaesthetists recognised perineural spread using 0.25 ml volumes. Distractor patterns were recognised in 133 (12%) of B-mode and in 403 (38%) of fused B-mode and elastography patterns; P<0.001. With elastography, novice recognition improved from 12 to 37% (P<0.001), and consultant recognition increased from 24 to 53%; P<0.001. Distractor recognition improved from 8 to 31% using 0.25 ml volumes (P<0.001), and from 15 to 45% using 1 ml volumes (P<0.001). Visual search improved with fusion elastography, increased volume, and consultants. A need exists to investigate image search strategies. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

  7. [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.

  8. An alternative noninvasive technique for the treatment of iatrogenic femoral pseudoaneurysms: stethoscope-guided compression.

    Science.gov (United States)

    Korkmaz, Ahmet; Duyuler, Serkan; Kalayci, Süleyman; Türker, Pinar; Sahan, Ekrem; Maden, Orhan; Selçuk, Mehmet Timur

    2013-06-01

    latrogenic femoral pseudoaneurysm is a well-known vascular access site complication. Many invasive and noninvasive techniques have been proposed for the management of this relatively common complication. In this study, we aimed to evaluate efficiency and safety of stethoscope-guided compression as a novel noninvasive technique in the femoral pseudoaneurysm treatment. We prospectively included 29 consecutive patients with the diagnosis of femoral pseudoaneurysm who underwent coronary angiography. Patients with a clinical suspicion of femoral pseudoaneurysm were referred to colour Doppler ultrasound evaluation. The adult (large) side of the stethoscope was used to determine the location where the bruit was best heard. Then compression with the paediatric (small) side of the stethoscope was applied until the bruit could no longer be heard and compression was maintained for at least two sessions. Once the bruit disappeared, a 12-hour bed rest with external elastic compression was advised to the patients, in order to prevent disintegration of newly formed thrombosis. Mean pseudoaneurysm size was 1.7 +/- 0.4 cmx 3.0 +/- 0.9 cm and the mean duration of compression was 36.2 +/- 8.5 minutes.Twenty-six (89.6%) of these 29 patients were successfully treated with stethoscope-guided compression. In 18 patients (62%), the pseuodoaneurysms were successfully closed after 2 sessions of 15-minute compression. No severe complication was observed. Stethoscope-guided compression of femoral pseudoaneurysms is a safe and effective novel technique which requires less equipment and expertise than other contemporary methods.

  9. US-Guided Femoral and Sciatic Nerve Blocks for Analgesia During Endovenous Laser Ablation

    International Nuclear Information System (INIS)

    Yilmaz, Saim; Ceken, Kagan; Alimoglu, Emel; Sindel, Timur

    2013-01-01

    Endovenous laser ablation may be associated with significant pain when performed under standard local tumescent anesthesia. The purpose of this study was to investigate the efficacy of femoral and sciatic nerve blocks for analgesia during endovenous ablation in patients with lower extremity venous insufficiency. During a 28-month period, ultrasound-guided femoral or sciatic nerve blocks were performed to provide analgesia during endovenous laser ablation in 506 legs and 307 patients. The femoral block (n = 402) was performed at the level of the inguinal ligament, and the sciatic block at the posterior midthigh (n = 124), by injecting a diluted lidocaine solution under ultrasound guidance. After the blocks, endovenous laser ablations and other treatments (phlebectomy or foam sclerotherapy) were performed in the standard fashion. After the procedures, a visual analogue pain scale (1–10) was used for pain assessment. After the blocks, pain scores were 0 or 1 (no pain) in 240 legs, 2 or 3 (uncomfortable) in 225 legs, and 4 or 5 (annoying) in 41 legs. Patients never experienced any pain higher than score 5. The statistical analysis revealed no significant difference between the pain scores of the right leg versus the left leg (p = 0.321) and between the pain scores after the femoral versus sciatic block (p = 0.7). Ultrasound-guided femoral and sciatic nerve blocks may provide considerable reduction of pain during endovenous laser and other treatments, such as ambulatory phlebectomy and foam sclerotherapy. They may make these procedures more comfortable for the patient and easier for the operator.

  10. Self-designed femoral neck guide pin locator for femoral neck fractures.

    Science.gov (United States)

    Xia, Shengli; Wang, Ziping; Wang, Minghui; Wu, Zuming; Wang, Xiuhui

    2014-01-01

    Closed reduction and fixation with 3 cannulated screws is a widely accepted surgery for the treatment of femoral neck fractures. However, how to obtain optimal screw placement remains unclear. In the current study, the authors designed a guide pin positioning system for femoral neck fracture cannulated screw fixation and examined its application value by comparing it with freehand guide needle positioning and with general guide pin locator positioning provided by equipment manufacturers. The screw reset rate, screw parallelism, triangle area formed by the link line of the entry point of 3 guide pins, and maximum vertical load bearing of the femoral neck after internal fixation were recorded. As expected, the triangle area was largest in the self-designed positioning group, followed by the general positioning group and the freehand positioning group. The difference among the 3 groups was statistically significant (P.05). The authors’ self-designed guide pin positioning system has the potential to accurately insert cannulated screws in femoral neck fractures and may reduce bone loss and unnecessary radiation.

  11. Post-operative analgesia following total knee arthroplasty: comparison of low-dose intrathecal morphine and single-shot ultrasound-guided femoral nerve block: a randomized, single blinded, controlled study.

    Science.gov (United States)

    Frassanito, L; Vergari, A; Zanghi, F; Messina, A; Bitondo, M; Antonelli, M

    2010-07-01

    Total knee arthroplasty often results in marked postoperative pain. A recent meta-analysis supports the use of femoral nerve block or alternatively spinal injection of morphine plus local anaesthetic for post-operative analgesia. On the other hand, the use of intrathecal morphine may be associated with a large number of distressing side effects (itching, urinary retention, nausea and vomiting, delayed respiratory depression). The aim of this study was to compare the effectiveness of femoral nerve block and low dose intrathecal morphine in post-operative analgesia after primary unilateral total knee arthroplasty. Fifty-two consecutive patients scheduled for primary unilateral total knee arthroplasty were allocated to the intrathecal morphine group (ITM group) or to the femoral nerve block group (FNB group). In ITM group a subarachnoid puncture was performed at the L3-L4 inter-vertebral space with hyperbaric bupivacaine 15 mg plus 100 mcg of preservative-free morphine. Patients allocated to the FNB group received a single-injection ultrasound-assisted femoral nerve block with ropivacaine 0.75% 25 ml before the spinal injection of hyperbaric bupivacaine 15 mg. All patients received postoperative patient-controlled-analgesia (PCA) morphine, using a 1-mg bolus and a 5-minute lockout period. Data were analyzed using Student t test or two-way analysis of variance (ANOVA) for repeated measures with time and treatment as the 2 factors. Post hoc comparisons were performed by Bonferroni test. Statistical significance for all test was a p value < 0.05. Patient characteristics were similar between the 2 groups. We found a statistically significant differences in postoperative pain between the two groups: ITM group had the lower visual analogic pain score (VAS) values. Morphine consumption was lower in the ITM group: average consumption within the first 6 hours was 0.9 mg in IT group compared to 3.1 mg in FNB group; at 12 h 4.2 mg vs 6.3 mg; at 24 h 6.9 mg vs 10.3 mg; at 48 h 9

  12. Ultrasound of the lateral femoral cutaneous nerve in asymptomatic adults

    Directory of Open Access Journals (Sweden)

    Zhu Jiaan

    2012-11-01

    Full Text Available Abstract Background To define the sites where the lateral femoral cutaneous nerve (LFCN is more easily visualized and to describe the anatomical variations of the LFCN. Methods A total of 240 LFCNs in 120 volunteers were evaluated with 18 MHz ultrasound; the intermuscular space between the tensor fasciae latae muscle and the sartorius was used as an initial sonographic landmark. The time taken to identify the nerve was recorded. The number of nerve branches at the level of the inguinal ligament (IL and the relationship between the LFCN and the IL was assessed. The nerve cross-sectional area (CSA of the LFCN and the distance between the LFCN and the anterior superior iliac spine was measured. Results Each nerve was identified using ultrasound in all participants. The mean time for identifying the nerve was 7s for unilateral LFCNs. The nerve passed under the IL in 198 cases, whereas in 44 cases, it passed through to the IL. The LFCN consisted of 1–4 branches just after its passage under or through the IL. The CSA of the LFCN was 1.04±0.44 mm2, and the mean distance between the LFCN and the anterior superior iliac spine was 15.6 ± 4.2 mm. Conclusions It is easier to identify the LFCN if the intermuscular space between the tensor fasciae latae muscle and the sartorius is used as an initial sonographic landmark. The anatomical variation of the LFCN can be viewed with high-frequency ultrasound.

  13. Ultrasound guided synovial biopsy of the wrist

    NARCIS (Netherlands)

    van Vugt, R. M.; van Dalen, A.; Bijlsma, J. W.

    1997-01-01

    Seven patients (4 female and 3 male, mean age 46) with arthritis of the wrist (n = 7) without known etiology were evaluated. High-definition ultrasound equipment was used for localization of synovial hypertrophy, suitable for ultrasound guided biopsy without risk. A 18-gauge diameter Tru-cut biopsy

  14. Evaluation of two different dosages of local anesthetic solution used for ultrasound-guided femoral nerve block for pain relief and positioning for central neuraxial block in patients of fracture neck of the femur

    Directory of Open Access Journals (Sweden)

    Abhijit A Karmarkar

    2017-01-01

    Full Text Available Introduction: Surgical management of the fracture femur is preferred so as to prevent complications associated with prolonged immobilization. Central neuraxial blockade (CNB is an attractive option for these patients, and an optimal positioning of the patient is a definite requirement. Owing to the pain associated with movement of the fractured limb, it becomes difficult for the patients to give suitable positioning. Femoral nerve block (FNB features as a rescue analgesia so as to provide adequate analgesia for facilitation of satisfactory positioning. Aim: This study aims to compare analgesic effect of two different dosages of local anesthetic (LA solution administered for ultrasonography (USG-guided FNB given to facilitate optimal positioning for conduct of CNB. Materials and Methods: After taking permission from the institutional review board, eighty patients were enrolled in the study to find out the efficacy of dosage of LA solution for FNB in providing pain relief caused by movement of fractured limb during conduct of regional anesthesia. Informed consent was taken. All patients were given USG-guided FNB. Patients were randomized using a computer-generated random number table, into two groups of forty patients each. Group A patients received USG-guided 12 ml of LA solution containing 10 ml lignocaine solution without preservative (2% plus 2 ml normal saline (NS, while Group B patients received USG-guided 15 ml of LA solution containing 13 ml lignocaine solution without preservative (2% plus 2 ml NS for positioning before combined spinal epidural. Results: A total of eighty patients, divided randomly into two groups, were enrolled in the study. Demographics (age, sex, weight, and American Society of Anesthesiologists grades were similar in both groups. No statistical significance was found in the numeric rating scale scores at baseline, zero minutes, 5, and 15 min in both the groups. Conclusion: USG-guided FNB with 12 ml of LA solution was

  15. [Endoscopic ultrasound guided rendezvous for biliary drainage].

    Science.gov (United States)

    Knudsen, Marie Høxbro; Vilmann, Peter; Hassan, Hazem; Karstensen, John Gésdal

    2015-04-27

    Endoscopic retrograde cholangiography (ERCP) is currently standard treatment for biliary drainage. Endoscopic ultrasound guided rendezvous (EUS-RV) is a novel method to overcome an unsuccessful biliary drainage procedure. Under endoscopic ultrasound guidance a guidewire is passed via a needle from the stomach or duodenum to the common bile duct and from there on to the duodenum enabling ERCP. With a relatively high rate of success EUS-RV should be considered as an alternative to biliary drainage and surgical intervention.

  16. Development of a method for measuring femoral torsion using real-time ultrasound

    International Nuclear Information System (INIS)

    Hafiz, Eliza; Hiller, Claire E; Nightingale, E Jean; Eisenhuth, John P; Refshauge, Kathryn M; Nicholson, Leslie L; Clarke, Jillian L; Grimaldi, Alison

    2014-01-01

    Excessive femoral torsion has been associated with various musculoskeletal and neurological problems. To explore this relationship, it is essential to be able to measure femoral torsion in the clinic accurately. Computerized tomography (CT) and magnetic resonance imaging (MRI) are thought to provide the most accurate measurements but CT involves significant radiation exposure and MRI is expensive. The aim of this study was to design a method for measuring femoral torsion in the clinic, and to determine the reliability of this method. Details of design process, including construction of a jig, the protocol developed and the reliability of the method are presented. The protocol developed used ultrasound to image a ridge on the greater trochanter, and a customized jig placed on the femoral condyles as reference points. An inclinometer attached to the customized jig allowed quantification of the degree of femoral torsion. Measurements taken with this protocol had excellent intra- and inter-rater reliability (ICC 2,1  = 0.98 and 0.97, respectively). This method of measuring femoral torsion also permitted measurement of femoral torsion with a high degree of accuracy. This method is applicable to the research setting and, with minor adjustments, will be applicable to the clinical setting. (paper)

  17. Valsalva and gravitational variability of the internal jugular vein and common femoral vein: Ultrasound assessment

    Energy Technology Data Exchange (ETDEWEB)

    Beddy, P. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland)]. E-mail: pbeddy@eircom.net; Geoghegan, T. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Ramesh, N. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Buckley, O. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); O' Brien, J. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Colville, J. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Torreggiani, W.C. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland)

    2006-05-15

    Purpose: Central venous cannulation via the common femoral vein is an important starting point for many interventions. The purpose of this study was to determine the optimum conditions for cannulation of the femoral vein and to compare these with the relative changes in the internal jugular vein. Methods: High-resolution 2D ultrasound was utilised to determine variability of the calibre of the femoral and internal jugular veins in 10 healthy subjects. Venous diameter was assessed during the Valsalva manoeuvre and in different degrees of the Trendelenburg position. Results: The Valsalva manoeuvre significantly increased the size of the femoral and internal jugular veins. There was a relatively greater increase in femoral vein diameter when compared with the internal jugular vein of 40 and 29%, respectively. Changes in body inclination (Trendelenburg position) did not significantly alter the luminal diameter of the femoral vein. However, it significantly increased internal jugular vein diameter. Conclusions: Femoral vein cannulation is augmented by the Valsalva manoeuvre but not significantly altered by the gravitational position of the subject.

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

    Science.gov (United States)

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

  19. Evaluation of a patient specific femoral alignment guide for hip resurfacing.

    Science.gov (United States)

    Olsen, Michael; Naudie, Douglas D; Edwards, Max R; Sellan, Michael E; McCalden, Richard W; Schemitsch, Emil H

    2014-03-01

    A novel alternative to conventional instrumentation for femoral component insertion in hip resurfacing is a patient specific, computed tomography based femoral alignment guide. A benchside study using cadaveric femora was performed comparing a custom alignment guide to conventional instrumentation and computer navigation. A clinical series of twenty-five hip resurfacings utilizing a custom alignment guide was conducted by three surgeons experienced in hip resurfacing. Using cadaveric femora, the custom guide was comparable to conventional instrumentation with computer navigation proving superior to both. Clinical femoral component alignment accuracy was 3.7° and measured within ± 5° of plan in 20 of 24 cases. Patient specific femoral alignment guides provide a satisfactory level of accuracy and may be a better alternative to conventional instrumentation for initial femoral guidewire placement in hip resurfacing. Crown Copyright © 2014. All rights reserved.

  20. Ultrasound- and MRI-Guided Prostate Biopsy

    Science.gov (United States)

    ... assistance of a nurse and an MR imaging technologist. As with the ultrasound procedure, you may receive antibiotics, sedatives and pain medication before the biopsy. The MRI-guided procedure may use contrast ... A nurse or technologist will insert an intravenous (IV) catheter into a ...

  1. Ultrasound-guided forceps for pleural biopsy

    Directory of Open Access Journals (Sweden)

    Gamal Agmy

    2014-04-01

    Clinical implications: Ultrasound-guided forceps for pleural biopsy can overcome many of the limitations of the conventional needle biopsy procedures, provides multiple biopsy specimens of the parietal pleura that are inaccessible to the biopsy needle, and can be carried out easily and safely even in sick and obese patients. The diagnostic yield is nearly similar to thoracoscopy.

  2. Ultrasound guided local steroid injection versus extracorporeal ...

    African Journals Online (AJOL)

    Nayera Saber

    2011-12-17

    Dec 17, 2011 ... Results: There was a statistically significant reduction in plantar fascia .... Several previous studies evaluate the effects of either local ... The choice of ultrasound guided technique of steroid injection was related to the accuracy of application and supe- ..... chronic proximal plantar fasciitis: a meta analysis.

  3. Outcomes of ultrasound guided renal mass biopsies.

    Science.gov (United States)

    Sutherland, Edward L; Choromanska, Agnieszka; Al-Katib, Sayf; Coffey, Mary

    2018-06-01

    The purpose of this study was to evaluate the rate of nondiagnostic ultrasound-guided renal mass biopsies (RMBs) at our institution and to determine what patient, procedural, and focal renal mass (FRM) factors were associated with nondiagnostic ultrasound-guided RMBs. Eighty-two ultrasound-guided renal mass biopsies performed between January 2014 and October 2016 were included in our study. Biopsy outcomes (diagnostic vs. nondiagnostic) and patient, procedural, and FRM characteristics were retrospectively reviewed and recorded. Univariate statistical analyses were performed to identify biopsy characteristics that were indicative of nondiagnostic biopsy. Ultrasound-guided RMBs were diagnostic in 70 out of 82 cases (85%) and non-diagnostic in 12 cases (15%). Among the diagnostic biopsies, 54 (77%) were malignant cases, 94% of which were renal cell carcinoma (RCC). Of the 12 nondiagnostic cases, the final diagnosis was RCC in 4 cases and angiomyolipoma in one case; seven of the nondiagnostic cases were lost to follow-up. A weak association (p = 0.04) was found between the number of needle passes and the biopsy outcome. None of the remaining collected RMB characteristics showed a significant correlation with a diagnostic or nondiagnostic RMB. Six patients (7%) experienced complications. Ultrasound-guided renal mass biopsy is a safe and effective method for the diagnosis of renal masses with a low rate of nondiagnostic outcomes. A nondiagnostic biopsy should not be treated as a surrogate for a diagnosis since a significant number of patients with nondiagnostic biopsies have subsequently been shown to have renal malignancies. Repeat biopsy should be considered in such cases.

  4. 3D-Printed Patient-Specific ACL Femoral Tunnel Guide from MRI.

    Science.gov (United States)

    Rankin, Iain; Rehman, Haroon; Frame, Mark

    2018-01-01

    Traditional ACL reconstruction with non-anatomic techniques can demonstrate unsatisfactory long-term outcomes with regards instability and the degenerative knee changes observed with these results. Anatomic ACL reconstruction attempts to closely reproduce the patient's individual anatomic characteristics with the aim of restoring knee kinematics, in order to improve patient short and long-term outcomes. We designed an arthroscopic, patient-specific, ACL femoral tunnel guide to aid anatomical placement of the ACL graft within the femoral tunnel. The guide design was based on MRI scan of the subject's uninjured contralateral knee, identifying the femoral footprint and its anatomical position relative to the borders of the femoral articular cartilage. Image processing software was used to create a 3D computer aided design which was subsequently exported to a 3D-printing service. Transparent acrylic based photopolymer, PA220 plastic and 316L stainless steel patient-specific ACL femoral tunnel guides were created; the models produced were accurate with no statistical difference in size and positioning of the center of the ACL femoral footprint guide to MRI ( p =0.344, p =0.189, p =0.233 respectively). The guides aim to provide accurate marking of the starting point of the femoral tunnel in arthroscopic ACL reconstruction. This study serves as a proof of concept for the accurate creation of 3D-printed patient-specific guides for the anatomical placement of the femoral tunnel during ACL reconstruction.

  5. 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.

  6. 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.

  7. CT and Ultrasound Guided Stereotactic High Intensity Focused Ultrasound (HIFU)

    Science.gov (United States)

    Wood, Bradford J.; Yanof, J.; Frenkel, V.; Viswanathan, A.; Dromi, S.; Oh, K.; Kruecker, J.; Bauer, C.; Seip, R.; Kam, A.; Li, K. C. P.

    2006-05-01

    animals and humans for HIFU-induced ablation and drug delivery. Integrated CT-guided focused ultrasound holds promise for tissue ablation, enhancing local drug delivery, and CT thermometry for monitoring ablation in near real-time.

  8. Endoscopic Ultrasound-Guided Biliary Drainage

    International Nuclear Information System (INIS)

    Artifon, Everson L.A.; Ferreira, Fla'vio C.; Sakai, Paulo

    2012-01-01

    To demonstrate a comprehensive review of published articles regarding endoscopic ultrasound (EUS)-guided biliary drainage. Review of studies regarding EUS-guided biliary drainage including case reports, case series and previous reviews. EUS-guided hepaticogastrostomy, coledochoduodenostomy and choledoantrostomy are advanced biliary and pancreatic endoscopy procedures, and together make up the echo-guided biliary drainage. Hepaticogastrostomy is indicated in cases of hilar obstruction, while the procedure of choice is the coledochoduodenostomy or choledochoantrostomy in distal lesions. Both procedures must be performed only after unsuccessful ERCPs. The indication of these procedures must be made under a multidisciplinary view while sharing information with the patient or legal guardian. Hepaticogastrostomy and coledochoduodenostomy or choledochoantrostomy are feasible when performed by endoscopists with expertise in biliopancreatic endoscopy. Advanced echo-endoscopy should currently be performed under a rigorous protocol in educational institutions.

  9. Endoscopic Ultrasound-Guided Biliary Drainage

    Energy Technology Data Exchange (ETDEWEB)

    Artifon, Everson L.A.; Ferreira, Fla& #x27; vio C.; Sakai, Paulo [University of Saeo Paulo, Saeo Paulo (Brazil)

    2012-02-15

    To demonstrate a comprehensive review of published articles regarding endoscopic ultrasound (EUS)-guided biliary drainage. Review of studies regarding EUS-guided biliary drainage including case reports, case series and previous reviews. EUS-guided hepaticogastrostomy, coledochoduodenostomy and choledoantrostomy are advanced biliary and pancreatic endoscopy procedures, and together make up the echo-guided biliary drainage. Hepaticogastrostomy is indicated in cases of hilar obstruction, while the procedure of choice is the coledochoduodenostomy or choledochoantrostomy in distal lesions. Both procedures must be performed only after unsuccessful ERCPs. The indication of these procedures must be made under a multidisciplinary view while sharing information with the patient or legal guardian. Hepaticogastrostomy and coledochoduodenostomy or choledochoantrostomy are feasible when performed by endoscopists with expertise in biliopancreatic endoscopy. Advanced echo-endoscopy should currently be performed under a rigorous protocol in educational institutions.

  10. Ultrasound-guided supra-acetabular pin placement in pelvic external fixation: description of a surgical technique and results.

    Science.gov (United States)

    Chana-Rodríguez, Francisco; Cuervas-Mons, Manuel; Rojo-Manaute, José; Mora, Félix; Arnal, Juan; Vaquero-Martín, Javier

    2017-11-01

    Pelvic fracture in trauma patients can lead to hemodynamic instability. External fixation is a treatment capable of stabilizing these injuries in the context of damage control surgery. Supra-acetabular pin offers the greater biomechanical stability but requires the use of intraoperative fluoroscopy. The aim of this study was to analyze our results for an ultrasound-guided supra-acetabular pinning. Cross-sectional study with cadaveric specimens. Ultrasound-guided pin placement assessed by fluoroscopy and dissection. Fourteen ultrasound-guided supra-acetabular pins were placed in seven cadaveric specimens. Excellent placement in all cases, evaluated with radiological control. Good qualitative bone fixation after dissection. One femoral cutaneous nerve was not found during anatomic dissection and was assumed injured. Ultrasound-guided supra-acetabular pin placement is a feasible and effective technique. Our study indicates that pin placement without intraoperative fluoroscopy is feasible without compromising the reliability of its placement. © 2017 Elsevier Ltd. All rights reserved.

  11. Existing Evidence on Ultrasound-Guided Injections in Sports Medicine.

    Science.gov (United States)

    Daniels, Eldra W; Cole, David; Jacobs, Bret; Phillips, Shawn F

    2018-02-01

    Office-based ultrasonography has become increasingly available in many settings, and its use to guide joint and soft tissue injections has increased. Numerous studies have been conducted to evaluate the use of ultrasound-guided injections over traditional landmark-guided injections, with a rapid growth in the literature over the past few years. A comprehensive review of the literature was conducted to demonstrate increased accuracy of ultrasound-guided injections regardless of anatomic location. In the upper extremity, ultrasound-guided injections have been shown to provide superior benefit to landmark-guided injections at the glenohumeral joint, the subacromial space, the biceps tendon sheath, and the joints of the hand and wrist. Ultrasound-guided injections of the acromioclavicular and the elbow joints have not been shown to be more efficacious. In the lower extremity, ultrasound-guided injections at the knee, ankle, and foot have superior efficacy to landmark-guided injections. Conclusive evidence is not available regarding improved efficacy of ultrasound-guided injections of the hip, although landmark-guided injection is performed less commonly at the hip joint. Ultrasound-guided injections are overall more accurate than landmark-guided injections. While current studies indicate that ultrasound guidance improves efficacy and cost-effectiveness of many injections, these studies are limited and more research is needed.

  12. Relationship of femoral artery ultrasound measures of atherosclerosis with chronic kidney disease.

    Science.gov (United States)

    Hsu, Simon; Rifkin, Dena E; Criqui, Michael H; Suder, Natalie C; Garimella, Pranav; Ginsberg, Charles; Marasco, Antoinette M; McQuaide, Belinda J; Barinas-Mitchell, Emma J; Allison, Matthew A; Wassel, Christina L; Ix, Joachim H

    2017-12-22

    Chronic kidney disease (CKD) is strongly associated with peripheral artery disease (PAD). Detection of subclinical PAD may allow early interventions for or prevention of PAD in persons with CKD. Whether the presence of atherosclerotic plaque and femoral intima-media thickness (IMT) are associated with kidney function is unknown. We performed a cross-sectional observational study of 1029 community-living adults. We measured superficial and common femoral artery IMT and atherosclerotic plaque presence by ultrasound. Estimated glomerular filtration rate (eGFR; continuous) and eGFR <60 mL/min/1.73 m 2 (binary) were evaluated as outcomes. Mean age was 70 ± 10 years, mean eGFR was 78 ± 17 mL/min/1.73 m 2 , and 156 (15%) individuals had eGFR <60 mL/min/1.73 m 2 ; 260 (25%) had femoral artery plaque. In models adjusted for demographics and cardiovascular risk factors, individuals with femoral artery plaque had mean eGFR approximately 3.0 (95% confidence interval, -5.3 to -0.8) mL/min/1.73 m 2 lower than those without plaque (P < .01). The presence of plaque was also associated with a 1.7-fold higher odds of eGFR <60 mL/min/1.73 m 2 (95% confidence interval, 1.1-2.8; P < .02). Associations were similar in persons with normal ankle-brachial index. The directions of associations were similar for femoral IMT measures with eGFR and CKD but were rendered no longer statistically significant with adjustment for demographic variables and cardiovascular disease risk factors. Femoral artery plaque is significantly associated with CKD prevalence in community-living individuals, even among those with normal ankle-brachial index. Femoral artery ultrasound may allow evaluation of relationships and risk factors linking PAD and kidney disease earlier in its course. Copyright © 2017 Society for Vascular Surgery. All rights reserved.

  13. Ultrasound-Guided Multiple Peripheral Nerve Blocks in a Superobese Patient

    Directory of Open Access Journals (Sweden)

    Alper Kilicaslan

    2014-01-01

    Full Text Available The number of obese patients has increased dramatically worldwide. Morbid obesity is associated with an increased incidence of medical comorbidities and restricts the application choices in anesthesiology. We report a successfully performed combined ultrasound-guided blockade of the femoral, tibial, and common peroneal nerve in a superobese patient. We present a case report of a 31-year-old, ASA-PS II, super obese man (190 kg, 180 cm, BMI: 58 kg/m2 admitted to the emergency department with a type II segmental tibia shaft fracture and ankle dislocation after a vehicle accident. After two failed spinal anesthesia attempts, we decided to apply a femoral block combined with a sciatic block. Femoral blocks were successfully performed with US guided in-plane technique. Separate blocks of the tibial and common peroneal nerves were planned after the sciatic nerve could not be located due to the thick subcutaneous tissue. We performed a tibial nerve block at 2 cm above the popliteal crease and common peroneal nerve at the level of the fibular head with US guided in-plane technique. The blocks were successful and no block-related complications were noted. Ultrasound guidance allows new approaches for multiple peripheral nerve blocks with low local anesthetic doses in obese patients.

  14. Ultrasound guided pleural biopsy in undiagnosed exudative pleural effusion patients

    Directory of Open Access Journals (Sweden)

    Adel S. Ahmed

    2016-04-01

    In conclusion: Thoracic ultrasound (TUS guided pleural biopsy had a diagnostic yield which was slightly lower but comparable to both CT guided pleural biopsy and medical thoracoscopic pleural biopsy (MT.

  15. Removal of a broken guide wire entrapped in a fractured femoral neck

    Directory of Open Access Journals (Sweden)

    ZHU Qing-hua

    2013-08-01

    Full Text Available 【Abstract】Guide wire plays an important role in the fixation of femoral neck fracture with dynamic hip screw (DHS. Breakage of a guide wire during operation is a very rare condition. We met such a dilemma in DHS fixation of a 54-year-old male patient who sustained Garden type IV frac-ture of the right femoral neck. The distal end of the guide wire broke and was entrapped in the fractured femoral neck. We tried to get the broken part out by a cannulated drill. Reaming was started with the cannulated drill slowly rotat-ing around the guide K-wire until the reamer fully contained the target under fluoroscope. A bone curette was used to get the broken wire out but failed, so we had to use the cannuated drill to dredge this bone tunnel. Finally the bro-ken wire end was taken out, mixed with blood and bone fragments. Through the existing drilling channel, DHS fixa-tion was easily finished. The patient had an uneventful re-covery without avascular necrosis of femoral head or non-union of the fracture at one year’s follow-up. A few methods can be adopted to deal with the broken guide wire. The way used in our case is less invasive but technically challenging. When the guide wire is properly positioned, this method is very practical and useful. Key words: Femoral neck fractures; Bones wires; Complications

  16. Comparison of Ultrasound-Guided Thrombin Injection of Iatrogenic Pseudoaneurysms Based on Neck Dimension.

    Science.gov (United States)

    Yang, Ethan Y; Tabbara, Marwan M; Sanchez, Priscila G; Abi-Chaker, Andrew M; Patel, Jaimin; Bornak, Arash; Jones, Keith M; Rey, Jorge

    2018-02-01

    Ultrasound-guided thrombin injection (UGTI) of femoral artery pseudoaneurysms after endovascular procedures is an effective therapy. There is controversy in the literature regarding injecting pseudoaneurysms with short and/or wide necks. This article reports our experience in UGTI of pseudoaneurysms in 1 hospital regarding the efficacy of this treatment in all pseudoaneurysms regardless of the size of the necks. A retrospective review of 46 patients diagnosed between 2011 and 2016 with groin pseudoaneurysms using established duplex ultrasound criteria. Mean age was 68 years (range 27-87). Ten pseudoaneurysms thrombosed spontaneously, 5 were thrombosed by ultrasound-guided compression, and 2 were treated surgically due to disqualifying criteria. In this retrospective review, we analyzed the remaining 29 pseudoaneurysms regarding the dimensions of their neck lengths and outcomes after attempting thrombin injection. The mean aneurysm neck length and width were 1.03 ± 0.9 cm and 0.30 ± 0.1 cm, respectively. All 29 patients were evaluated with respect to pseudoaneurysm size, neck length, neck width, and complexity. Successful treatment of 29 pseudoaneurysms (2 external iliac, 20 common femoral, 2 deep femoral, and 5 superficial femoral) with UGTI was achieved without complications in 100% of the cases, regardless of pseudoaneurysm size, neck dimensions, or complexity. Anticoagulation status did not affect the efficacy of the procedure. Nine of the 29 pseudoaneurysms (31.0%) had neck length less than 0.5 cm. This study demonstrates the safety and efficacy of UGTI in treating iatrogenic pseudoaneurysm in 29 of 29 patients, even in patients with pseudoaneurysm with short neck lengths. Our experiences support injecting all pseudoaneurysms irrespective of dimension. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Ultrasound guided electrochemotherapy for the treatment of a clear ...

    African Journals Online (AJOL)

    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 ...

  18. Percutaneous antegrade pyelgraphy guided by ultrasound

    International Nuclear Information System (INIS)

    Kim, Jin Gyoo; Chung, Chun Phil; Lee, Suk Hong; Sol, Chang Hyo; Kim, Byung Soo

    1985-01-01

    The authors performed percutaneous antegrade pyelography guided by ultrasound on 33 patients, from June 1982 to October 1984, at the Department of Radiology, Busan National University Hospital. The results obtained were as follows: 1. Of the 31 cases, 17 cases (51.5%) were female and 16 cases (48.5%) were male, and age distribution was nearly even, but most prevalent age group was third decade. 2. Comparing intravenous pyelographic findings with ultrasonographic findings, pyelographically nonvisualized kidney 15 cases (45.5%) were hydronephrosis 12 cases, multiple cysts 2 cases, and intrarenal cystic mass 1 case, ultrasonographically. Pyelographically hydronephrosis 9 cases (27.3%) were all hydronephrosis, ultrasonographically. Intrarenal mass 5 cases (15.2%) were all intrarenal cystic mass, NVK with air kidney 1 case (3.0%) was air in perirenal space, partial NVK 1 case (3.0%) was perirenal fluid, suprarenal mass 1 case (3.0%) was suprarenal intrarenal and huge perirenal cystic masses, ultrasonographically. 3. On technical reliability of antegrade pyelography under ultrasound guide, 31 cases (93.9%) could be done fluid aspiration and visualization, and 2 cases (6.1%) could be only done fluid aspiration but failed visualization. 31 successful cases were visualization of collecting systems 23 cases, visualization of cyst 6 case, and visualization of perirenal space 2 cases. 2 partical successful cases were perirenal injection 1 case and parenchymal injection 1 case. 4. On fluid aspiration, 22 cases (66.7%) were clear, but 11 cases (33.3%) were not clear, which were pus 7 cases, turbid urine 2 cases, bloody urine 1 case, and bloody pus and air 1 case. 5. Comparing ultrasonographic findings with antegrade pyelographic findings, ultrasonographiclly hydronephrosis 21 cases revealed obstruction in 16 cases, antegrade pyelographicaaly, which were consisted of ureteral stricture 14 case, ureteral stone 1 case, and ureteral mass 1 case, non-obstruction in 4 cases, which

  19. 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. 

  20. Ultrasound method applied to characterize healthy femoral diaphysis of Wistar rats in vivo

    International Nuclear Information System (INIS)

    Fontes-Pereira, A.; Matusin, D.P.; Rosa, P.; Schanaider, A.; Krüger, M.A. von; Pereira, W.C.A.

    2014-01-01

    A simple experimental protocol applying a quantitative ultrasound (QUS) pulse-echo technique was used to measure the acoustic parameters of healthy femoral diaphyses of Wistar rats in vivo. Five quantitative parameters [apparent integrated backscatter (AIB), frequency slope of apparent backscatter (FSAB), time slope of apparent backscatter (TSAB), integrated reflection coefficient (IRC), and frequency slope of integrated reflection (FSIR)] were calculated using the echoes from cortical and trabecular bone in the femurs of 14 Wistar rats. Signal acquisition was performed three times in each rat, with the ultrasound signal acquired along the femur's central region from three positions 1 mm apart from each other. The parameters estimated for the three positions were averaged to represent the femur diaphysis. The results showed that AIB, FSAB, TSAB, and IRC values were statistically similar, but the FSIR values from Experiments 1 and 3 were different. Furthermore, Pearson's correlation coefficient showed, in general, strong correlations among the parameters. The proposed protocol and calculated parameters demonstrated the potential to characterize the femur diaphysis of rats in vivo. The results are relevant because rats have a bone structure very similar to humans, and thus are an important step toward preclinical trials and subsequent application of QUS in humans

  1. 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.

  2. Imaging the femoral sulcus with ultrasound, CT, and MRI: reliability and generalizability in patients with patellar instability

    Energy Technology Data Exchange (ETDEWEB)

    Toms, Andoni P.; Cahir, John [Norfolk and Norwich University Hospital, Departments of Radiology, Norwich, Norfolk (United Kingdom); Swift, Louise [University of East Anglia, School of Medicine, Health Policy and Practice, Norwich, Norfolk (United Kingdom); Donell, Simon T. [Norfolk and Norwich University Hospital, Institute of Orthopedics, Norwich, Norfolk (United Kingdom)

    2009-04-15

    Recent advances in surgical intervention for patellar instability have led to a need for long-term radiological monitoring. The aim of this study is to determine whether or not magnetic resonance imaging (MRI) or ultrasound (US) can replace computed tomography (CT) as the standard of care for the evaluation of the femoral sulcus. This was a prospective study comparing the reliability of CT, magnetic resonance (MR), and US for measuring the femoral sulcus in patients with patellar instability. Twenty-four patients were recruited to undergo a CT, MR, and US examination of each knee. Two observers independently measured femoral sulcus angles from subchondral bone and hyaline cartilage on two occasions. Intraclass correlations and generalizability coefficients were calculated to measure the reliability of each of the techniques. Thereafter, two observers measured the femoral sulcus angle from ultrasound images recorded by two independent operators to estimate interobserver and interoperator reliability. Forty-seven knees were examined with CT and US and 44 with MRI. The sulcus angle was consistently smaller when measured from subchondral bone compared to cartilage (5-7 ). Interobserver reliability for CT, MR, and US measurements from subchondral bone were 0.87, 0.80, and 0.82 and from cartilage 0.80, 0.81, and 0.50. Generalizability coefficients of measurements from subchondral bone for CT, MR, and US were 0.87, 0.76, and 0.81 and for cartilage 0.76, 0.73, and 0.05. Most of the variability in the US occurred at image acquisition rather than measurement. In patients with patellar instability, CT and MR are reliable techniques for measuring the femoral sulcus angle but US, particularly of the articular cartilage, is not. MR is therefore the most suitable tool for longitudinal studies of the femoral sulcus. (orig.)

  3. Acupuncture sensation during ultrasound guided acupuncture needling

    Science.gov (United States)

    Park, Jongbae J.; Akazawa, Margeaux; Ahn, Jaeki; Beckman-Harned, Selena; Lin, Feng-Chang; Lee, Kwangjae; Fine, Jason; Davis, Robert T; Langevin, Helene

    2014-01-01

    Background Although acupuncture sensation (also known as de qi) is a cornerstone of traditional acupuncture therapy, most research has accepted the traditional method of defining acupuncture sensation only through subjective patient reports rather than on any quantifiable physiological basis. Purpose To preliminarily investigate the frequency of key sensations experienced while needling to specific, quantifiable tissue levels (TLs) guided by ultrasound (US) imaging. Methods Five participants received needling at two acupuncture points and two control points at four TLs. US scans were used to determine when each TL was reached. Each volunteer completed 32 sets of modified Southampton Needle Sensation Questionnaires. Part one of the study tested sensations experienced at each TL and part two compared the effect of oscillation alone versus oscillation + rotation. Results In all volunteers, the frequency of pricking, sharp sensations was significantly greater in shallower TLs than deeper (p=0.007); the frequency of sensations described as deep, dull and heavy, as spreading, and as electric shocks was significantly greater in deeper TLs than shallower (p=0.002). Sensations experienced did not significantly differ between real and control points within each of three TLs (p>0.05) except TL 4 (p=0.006). The introduction of needle rotation significantly increased deep, dull, heavy sensations, but not pricking and sharp sensations; within each level, the spectrum of sensation experienced during both oscillation + rotation and oscillation alone did not significantly differ between acupuncture and control points. Conclusion The preliminary study indicates a strong connection between acupuncture sensation and both tissue depth and needle rotation. Furthermore, the new methodology has been proven feasible. A further study with an objective measurement is warranted. PMID:21642648

  4. A review of transrectal ultrasound guided prostate biopsies: Is there ...

    African Journals Online (AJOL)

    Objective: We compared our institution's initial experience with transrectal ultrasound-guided (TRUS) prostate biopsies in a single arm prospective study to a historical cohort of finger guided (FG) biopsies. The primary outcome measure was prostate cancer detection. We documented our findings on TRUS including the ...

  5. ultrasound-guided shoulder arthrogram injection

    African Journals Online (AJOL)

    2008-10-15

    Oct 15, 2008 ... Using an aseptic technique and without moving the ultrasound transducer from the desired transverse plane, the needle is advanced into the joint space through the rotator cuff interval, using real-time ultrasound guidance (Fig.2). The needle is inserted into the shoulder approximately midway between the ...

  6. Usefulness of ultrasound-guided mammotome biopsy for microcalcification

    International Nuclear Information System (INIS)

    Kim, You Me; Park, Hee Boong; Ryu, Jin Woo

    2005-01-01

    To evaluate the usefulness of ultrasound-guided mammotome biopsy for microcalcification and to suggest a new approach for the localization of microcalcifications which are not detected on ultrasound. Twenty-one calcific lesions in 21 women (aged 33-56 years) underwent ultrasound-guided, vacuum-assisted, mammotome biopsy and a mean of 14 specimens per lesion were obtained. Calcification retrieval was defined as identification of calcifications on specimen radiographs. In the 13 cases of calcifications which were not detected on ultrasound imaging, mammotome biopsy was performed after localization of one or two needles at the microcalcifications under mammography-guidance. Radiographs of the specimens and histologic findings were reviewed and scheduled follow-up imaging was performed for evaluation of the complications of biopsy. Ultrasound-guided, vacuum-assisted, mammotome biopsy removed all calcifications in 21 lesions. Eight (38%) lesions showed visible calcification on the ultrasound while 13 (62%) lesions were invisible, which underwent mammotome biopsy after needle localization under mammography-guidance. Surgery revealed DCIS in 1 (4.8%) of 21 lesions, infiltrating ductal carcinoma in two (9.5%), fibroadenomas with calcifications in 6 (28.6%), fibroadenmas with adenosis in 2(9.5%), and fibrocystic change with calcifications in 10 (47.6%). Clinical significant complications did not occur on follow-up examination in any of the cases. Ultrasound-guided, vacuum-assisted, mammotome biopsy was an effective method for microcalcifications on mammogram. The results suggested that mammotome biopsy after mammogram-guided, needle localization is a good alternative method for the diagnosis of microcalcifications which are undetectable in the ultrasound images

  7. Usefulness of ultrasound-guided mammotome biopsy for microcalcification

    Energy Technology Data Exchange (ETDEWEB)

    Kim, You Me [Dankook University Hospital, Seoul (Korea, Republic of); Park, Hee Boong [Park Breast Clinic, Seoul (Korea, Republic of); Ryu, Jin Woo [Cheonan Choongmu Hospital, Cheonan (Korea, Republic of)

    2005-08-15

    To evaluate the usefulness of ultrasound-guided mammotome biopsy for microcalcification and to suggest a new approach for the localization of microcalcifications which are not detected on ultrasound. Twenty-one calcific lesions in 21 women (aged 33-56 years) underwent ultrasound-guided, vacuum-assisted, mammotome biopsy and a mean of 14 specimens per lesion were obtained. Calcification retrieval was defined as identification of calcifications on specimen radiographs. In the 13 cases of calcifications which were not detected on ultrasound imaging, mammotome biopsy was performed after localization of one or two needles at the microcalcifications under mammography-guidance. Radiographs of the specimens and histologic findings were reviewed and scheduled follow-up imaging was performed for evaluation of the complications of biopsy. Ultrasound-guided, vacuum-assisted, mammotome biopsy removed all calcifications in 21 lesions. Eight (38%) lesions showed visible calcification on the ultrasound while 13 (62%) lesions were invisible, which underwent mammotome biopsy after needle localization under mammography-guidance. Surgery revealed DCIS in 1 (4.8%) of 21 lesions, infiltrating ductal carcinoma in two (9.5%), fibroadenomas with calcifications in 6 (28.6%), fibroadenmas with adenosis in 2(9.5%), and fibrocystic change with calcifications in 10 (47.6%). Clinical significant complications did not occur on follow-up examination in any of the cases. Ultrasound-guided, vacuum-assisted, mammotome biopsy was an effective method for microcalcifications on mammogram. The results suggested that mammotome biopsy after mammogram-guided, needle localization is a good alternative method for the diagnosis of microcalcifications which are undetectable in the ultrasound images.

  8. Ultrasound-guided core needle biopsy for breast cancer

    International Nuclear Information System (INIS)

    Naqvi, S.Q.H.; Solangi, R.A.; Memon, M.; Solangi, R.A.

    2008-01-01

    To evaluate the efficacy of ultrasound-guided core needle biopsy (US-CNB) as a preoperative diagnostic modality for breast cancer. Females with solid and/or intermediate breast lesions visualized on ultrasonography. Apart from clinical work-up, all the above mentioned patients underwent ultrasound-guided core needle biopsy and excisional biopsy of their breast lesions. The histopathological diagnosis on ultrasound-guided core needle biopsy was then compared with the findings of the excisional biopsy. Out of the total 93 cases, 47(50.5%) had benign lesions on ultrasound; US-CNB showed 24 as fibroadenomata, four with chronic non-specific mastitis, five chronic suppurative mastitis, one tuberculosis, four fat necrosis, two lactational adenoma and seven cases with benign ductal hyperplasia without atypia. Nine (9.7%) cases showed suspicious abnormality on ultrasound; US-CNB revealed five cases with atypical ductal hyperplasia, one ductal carcinoma in situ and three invasive ductal carcinoma. Thirty seven (39.8%) cases were highly suggestive of malignancy on ultrasound; US-CNB showed 34 as invasive ductal carcinoma, two invasive lobular and one medullary carcinoma. Excisional biopsy confirmed the diagnosis of ultrasound-guided core needle biopsy in all cases except four; one case of chronic suppurative mastitis was diagnosed as that of tuberculosis and three cases of atypial ductal hyperplasia as invasive ductal carcinoma. Hence there was no false positive case, but four (4.3%) false negative cases. The sensitivity of the US-CNB was thus 100% and specificity 91.1%. Ultrasound guided core needle biopsy is a satisfactory procedure for the histopathological diagnosis of breast lesions. Any unsatisfactory, suspicious or atypical change on US-CNB should be followed by an open biopsy. (author)

  9. Ultrasound-guided drug delivery in cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chowdhury, Sayan Mullick; Lee, Tae Hwa; Willmann, Jugen K. [Dept. of Radiology, Stanford University School of Medicine, Stanford (United States)

    2017-07-15

    Recent advancements in ultrasound and microbubble (USMB) mediated drug delivery technology has shown that this approach can improve spatially confined delivery of drugs and genes to target tissues while reducing systemic dose and toxicity. The mechanism behind enhanced delivery of therapeutics is sonoporation, the formation of openings in the vasculature, induced by ultrasound-triggered oscillations and destruction of microbubbles. In this review, progress and challenges of USMB mediated drug delivery are summarized, with special focus on cancer therapy.

  10. Ultrasound-guided drug delivery in cancer

    Directory of Open Access Journals (Sweden)

    Sayan Mullick Chowdhury

    2017-07-01

    Full Text Available Recent advancements in ultrasound and microbubble (USMB mediated drug delivery technology has shown that this approach can improve spatially confined delivery of drugs and genes to target tissues while reducing systemic dose and toxicity. The mechanism behind enhanced delivery of therapeutics is sonoporation, the formation of openings in the vasculature, induced by ultrasound-triggered oscillations and destruction of microbubbles. In this review, progress and challenges of USMB mediated drug delivery are summarized, with special focus on cancer therapy.

  11. The future perspectives in transrectal prostate ultrasound guided biopsy

    Directory of Open Access Journals (Sweden)

    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

  12. Femur ultrasound (FemUS)-first clinical results on hip fracture discrimination and estimation of femoral BMD

    DEFF Research Database (Denmark)

    Barkmann, R; Dencks, S; Laugier, P

    2010-01-01

    has been introduced yet. We developed a QUS scanner for measurements at the femur (Femur Ultrasound Scanner, FemUS) and tested its in vivo performance. METHODS: Using the FemUS device, we obtained femoral QUS and DXA on 32 women with recent hip fractures and 30 controls. Fracture discrimination......A quantitative ultrasound (QUS) device for measurements at the proximal femur was developed and tested in vivo (Femur Ultrasound Scanner, FemUS). Hip fracture discrimination was as good as for DXA, and a high correlation with hip BMD was achieved. Our results show promise for enhanced QUS...... and the correlation with femur bone mineral density (BMD) were assessed. RESULTS: Hip fracture discrimination using the FemUS device was at least as good as with hip DXA and calcaneal QUS. Significant correlations with total hip bone mineral density were found with a correlation coefficient R (2) up to 0...

  13. Ultrasound-controlled neuronavigator-guided brain surgery.

    Science.gov (United States)

    Koivukangas, J; Louhisalmi, Y; Alakuijala, J; Oikarinen, J

    1993-07-01

    The development of a unique neurosurgical navigator is described and a preliminary series of seven cases of intracerebral lesions approached with the assistance of this neuronavigation system under ultrasound control is presented. The clinical series included five low-grade astrocytomas, one chronic intracerebral hematoma, and one porencephalic cyst. Management procedures included biopsy in all cases, drainage of the hematoma, and endoscopy and fenestration for the cyst. The features of the neuronavigation system are interactive reconstructions of preoperative computerized tomography and magnetic resonance imaging data, corresponding intraoperative ultrasound images, versatility of the interchangeable end-effector instruments, graphic presentation of instruments on the reconstructed images, and voice control of the system. The principle of a common axis in the reconstructed images served to align the navigational pointer, biopsy guide, endoscope guide, ultrasound transducer, and surgical microscope to the brain anatomy. Intraoperative ultrasound imaging helped to verify the accuracy of the neuronavigator and check the results of the procedures. The arm of the neuronavigation system served as a holder for instruments, such as the biopsy guide, endoscope guide, and ultrasound transducer, in addition to functioning as a navigational pointer. Also, the surgical microscope was aligned with the neuronavigator for inspection and biopsy of the hematoma capsule to rule out tumor etiology. Voice control freed the neurosurgeon from manual exercises during start-up and calibration of the system.

  14. Ultrasound guided percutaneous fine needle aspiration biopsy ...

    African Journals Online (AJOL)

    )-guided percutaneous fine needle aspiration biopsy (PFNAB)/US-guided percutaneous needle core biopsy (PNCB) of abdominal lesions is efficacious in diagnosis, is helpful in treatment choice, to evaluate whether various other investigations ...

  15. Guiding tissue regeneration with ultrasound in vitro and in vivo

    Science.gov (United States)

    Dalecki, Diane; Comeau, Eric S.; Raeman, Carol H.; Child, Sally Z.; Hobbs, Laura; Hocking, Denise C.

    2015-05-01

    Developing new technologies that enable the repair or replacement of injured or diseased tissues is a major focus of regenerative medicine. This paper will discuss three ultrasound technologies under development in our laboratories to guide tissue regeneration both in vitro and in vivo. A critical obstacle in tissue engineering is the need for rapid and effective tissue vascularization strategies. To address this challenge, we are developing acoustic patterning techniques for microvascular tissue engineering. Acoustic radiation forces associated with ultrasound standing wave fields provide a rapid, non-invasive approach to spatially pattern cells in three dimensions without affecting cell viability. Acoustic patterning of endothelial cells leads to the rapid formation of microvascular networks throughout the volumes of three-dimensional hydrogels, and the morphology of the resultant microvessel networks can be controlled by design of the ultrasound field. A second technology under development uses ultrasound to noninvasively control the microstructure of collagen fibers within engineered tissues. The microstructure of extracellular matrix proteins provides signals that direct cell functions critical to tissue regeneration. Thus, controlling collagen microfiber structure with ultrasound provides a noninvasive approach to regulate the mechanical properties of biomaterials and control cellular responses. The third technology employs therapeutic ultrasound to enhance the healing of chronic wounds. Recent studies demonstrate increased granulation tissue thickness and collagen deposition in murine dermal wounds exposed to pulsed ultrasound. In summary, ultrasound technologies offer noninvasive approaches to control cell behaviors and extracellular matrix organization and thus hold great promise to advance tissue regeneration in vitro and in vivo.

  16. Technical success of the ultrasound-guided supra-inguinal fascia iliaca compartment block in older children and adolescents for hip arthroscopy.

    Science.gov (United States)

    Eastburn, Elizabeth; Hernandez, Maria A; Boretsky, Karen

    2017-11-01

    Hip arthroscopic surgery is performed on older pediatric patients. Fascia iliaca compartment block has proven efficacy in providing analgesia following hip surgery and can be performed with target location of local anesthetic below or above the inguinal ligament. The reported success of ultrasound-guided infra-inguinal fascia iliaca compartment block is lower when compared to traditional landmark technique, while the reliability of supra-inguinal fascia iliaca compartment block is unreported. The primary aim was to report the results in obtaining sensory changes in the distribution of the femoral and lateral femoral cutaneous nerves following supra-inguinal fascia iliaca compartment block in patients undergoing arthroscopic hip surgery. Secondary outcomes are the ability to find echogenic landmarks and to report pain scores and opioid consumption. We reviewed the electronic medical record and regional anesthesia database of patients receiving ultrasound-guided fascia iliaca compartment block for arthroscopic hip surgery. Sensory changes to the femoral and lateral femoral cutaneous nerves were determined. Identification of echogenic landmarks was quantified. Pain scores and opioid consumption were determined. Seventeen patients of mean age 15.4 years old (SD 1.3; range 13-17 years) were included. Sensory changes to both the femoral and lateral femoral cutaneous nerves occurred in 94% of patients (95% CI: 82%-100%). The average volume of ropivacaine 0.2% was 0.53 mL/Kg (SD 0.11 mL/Kg). Echogenic landmarks were identified in all patients. Pain scores and opioid consumption were generally low. A supra-inguinal location for the deposition of local anesthetic when performing fascia iliaca nerve block for hip surgery is reliable in anesthetizing the femoral and lateral femoral cutaneous nerves and should encourage investigation into the clinical efficacy. © 2017 John Wiley & Sons Ltd.

  17. Ultrasound guided reduction of childhood intussusception

    International Nuclear Information System (INIS)

    Yoon, Chong Hyun; Kim, Han Suk

    1986-01-01

    Following on from diagnosis using ultrasound, hydrostatic reduction using saline enema under ultrasound guidance was tried in 20 cases of childhood intussusception. The conclusions were as follows: 1. Success rates of saline enema under ultrasound guidance during a first-8 month period (P1) and a second-10 month period (P2) were 55.6% (5/9) and 54.5% (6/11) respectively. Average success rate was 55% (11/20). 2. During the periods of P1 and P2, no case was reduced by barium enema in 6 cases of failed reduction with saline enema. 3. During the period of P2, 5 cases of successful reduction with saline enema were confirmed by clinical follow-up without barium enema. 4. During the periods of P1 and P2, 9 cases of failed reduction with saline enema were operated, resulting in 6 cases of segmental resection and 3 cases of manual reduction. 5. The obvious advantages of this method are: 1. No radiation hazard. 2. No fear of barium peritonitis. 3. Detection of leading point. 6. With above results, this method could completely replace barium enema. And ultrasonography should be the initial study in the evaluation of intussusception in children and then if necessary, saline enema under ultrasound guidance should be done.

  18. 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.)

  19. Ultrasound-guided percutaneous biopsy of digestive tract lesions

    International Nuclear Information System (INIS)

    Gil, S.; Martin, I.; Ballesteros, J. M.; Gomez, C.; Marco, S. F.; Fernandez, P.

    1999-01-01

    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

  20. Amoebic liver abscess: Drained by ultrasound guided percutaneous ...

    African Journals Online (AJOL)

    Summary: Amoebic Liver Abscess in a 20-month-old child: A case of amoebic liver abscess in a Nigerian child is presented. Management consisted of 10days course of Metronidazole and 5days course of Tinidazole without improvement. This was followed by four sessions of ultrasound guided percutaneous needle ...

  1. Ultrasound-guided wire localization of lesions detected on ...

    African Journals Online (AJOL)

    Background: Wire localization for planned surgical treatment in the management of breast cancer is underutilized in our environment. The objective of this study is to assess the role of ultrasound-guided wire localization of breast masses detected on screening mammography and its impact on biopsy and breast ...

  2. Ultrasound-guided endoscopic transgastric drainage of a post ...

    African Journals Online (AJOL)

    Despite of a number of techniques in the armentarium of the paediatric surgeon, the management of pancreatic pseudocysts remains a challenge. We report on a case of a 5-year-old child with a post-traumatic pancreatic pseudocyst who was successfully treated with endoscopic ultrasound-guided transgastric approach.

  3. Practice guidelines for endoscopic ultrasound-guided celiac plexus neurolysis

    DEFF Research Database (Denmark)

    Wyse, Jonathan M; Battat, Robert; Sun, Siyu

    2017-01-01

    OBJECTIVES: The objective of guideline was to provide clear and relevant consensus statements to form a practical guideline for clinicians on the indications, optimal technique, safety and efficacy of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN). METHODS: Six important clinical...

  4. Practice guidelines for endoscopic ultrasound-guided celiac plexus neurolysis

    NARCIS (Netherlands)

    Wyse, J.M. (Jonathan M.); Battat, R. (Robert); Sun, S. (Siyu); A. Saftoiu (Adrian); Siddiqui, A.A. (Ali A.); Leong, A.T. (Ang Tiing); Arias, B.L.A. (Brenda Lucia Arturo); Fabbri, C. (Carlo); Adler, D.G. (Douglas G.); Santo, E. (Erwin); Kalaitzakis, E. (Evangelos); Artifon, E. (Everson); Mishra, G. (Girish); Okasha, H.H. (Hussein Hassan); J.-W. Poley (Jan-Werner); Guo, J. (Jintao); Vila, J.J. (Juan J.); Lee, L.S. (Linda S.); Sharma, M. (Malay); Bhutani, M.S. (Manoop S.); M. Giovannini (Marcello); Kitano, M. (Masayuki); Eloubeidi, M.A. (Mohamad Ali); Khashab, M.A. (Mouen A.); Nguyen, N.Q. (Nam Q.); Saxena, P. (Payal); Vilmann, P. (Peter); Fusaroli, P. (Pietro); Garg, P.K. (Pramod Kumar); Ho, S. (Sammy); Mukai, S. (Shuntaro); Carrara, S. (Silvia); Sridhar, S. (Subbaramiah); S. Lakhtakia (S.); Rana, S.S. (Surinder S.); Dhir, V. (Vinay); Sahai, A.V. (Anand V.)

    2017-01-01

    textabstractObjectives: The objective of guideline was to provide clear and relevant consensus statements to form a practical guideline for clinicians on the indications, optimal technique, safety and efficacy of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN). Methods: Six important

  5. A retrospective analysis of ultrasound-guided large core needle ...

    African Journals Online (AJOL)

    A retrospective analysis of ultrasound-guided large core needle biopsies of breast lesions at a regional public hospital in Durban, KwaZulu-Natal, South Africa. ... Objective: To assess the influence of technical variables on the diagnostic yield of breast specimens obtained by using US-LCNB, and the sensitivity of detecting ...

  6. Ultrasound-guided continuous phrenic nerve block for persistent hiccups.

    NARCIS (Netherlands)

    Renes, S.H.; Geffen, G.J. van; Rettig, H.C.; Gielen, M.J.M.; Scheffer, G.J.

    2010-01-01

    BACKGROUND: Phrenic nerve block can be performed and repeated if necessary for persistent hiccups, when conservative and pharmacological treatment is unsuccessful. We report the first description of an in-plane ultrasound (US)-guided phrenic nerve block (PhNB) with a catheter, after US investigation

  7. 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...

  8. Ultrasound-guided needle aspiration of parotid abscess

    Directory of Open Access Journals (Sweden)

    André Takahashi

    2012-01-01

    Full Text Available Ultrasound (US has been used as a tool for parotid abscess diagnosis and treatment. The present article aimed to report a case of 72-year-old woman with parotid abscess treated by US-guided needle aspiration and conventional surgical drainage. Along with the clinical report, indications, advantages, and limitations of the method are discussed.

  9. Ultrasound guided percutaneous fine needle aspiration biopsy ...

    African Journals Online (AJOL)

    2011-06-15

    Jun 15, 2011 ... guided PFNAB/US-guided PNCB was the diagnostic test in 23.33% cases. It confirmed a highly ..... provides guidance in multiple axial, longitudinal and .... Source of Support: Nil, Con.ict of Interest: None declared. Gani, et al.

  10. Feasibility and safety of ultrasound-guided nerve block for management of limb injuries by emergency care physicians

    Directory of Open Access Journals (Sweden)

    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.

  11. Ultrasound probe and needle-guide calibration for robotic ultrasound scanning and needle targeting.

    Science.gov (United States)

    Kim, Chunwoo; Chang, Doyoung; Petrisor, Doru; Chirikjian, Gregory; Han, Misop; Stoianovici, Dan

    2013-06-01

    Image-to-robot registration is a typical step for robotic image-guided interventions. If the imaging device uses a portable imaging probe that is held by a robot, this registration is constant and has been commonly named probe calibration. The same applies to probes tracked by a position measurement device. We report a calibration method for 2-D ultrasound probes using robotic manipulation and a planar calibration rig. Moreover, a needle guide that is attached to the probe is also calibrated for ultrasound-guided needle targeting. The method is applied to a transrectal ultrasound (TRUS) probe for robot-assisted prostate biopsy. Validation experiments include TRUS-guided needle targeting accuracy tests. This paper outlines the entire process from the calibration to image-guided targeting. Freehand TRUS-guided prostate biopsy is the primary method of diagnosing prostate cancer, with over 1.2 million procedures performed annually in the U.S. alone. However, freehand biopsy is a highly challenging procedure with subjective quality control. As such, biopsy devices are emerging to assist the physician. Here, we present a method that uses robotic TRUS manipulation. A 2-D TRUS probe is supported by a 4-degree-of-freedom robot. The robot performs ultrasound scanning, enabling 3-D reconstructions. Based on the images, the robot orients a needle guide on target for biopsy. The biopsy is acquired manually through the guide. In vitro tests showed that the 3-D images were geometrically accurate, and an image-based needle targeting accuracy was 1.55 mm. These validate the probe calibration presented and the overall robotic system for needle targeting. Targeting accuracy is sufficient for targeting small, clinically significant prostatic cancer lesions, but actual in vivo targeting will include additional error components that will have to be determined.

  12. Introducing a Fresh Cadaver Model for Ultrasound-guided Central Venous Access Training in Undergraduate Medical Education.

    Science.gov (United States)

    Miller, Ryan; Ho, Hang; Ng, Vivienne; Tran, Melissa; Rappaport, Douglas; Rappaport, William J A; Dandorf, Stewart J; Dunleavy, James; Viscusi, Rebecca; Amini, Richard

    2016-05-01

    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. 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. 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 (pcadaver model prevented extravasation of fluid, maintained ultrasound-imaging quality, and proved to be an effective educational model allowing third-year medical

  13. Ultrasound-guided biopsy and drainage

    International Nuclear Information System (INIS)

    Ott, R.C.; Wellauer, J.

    1985-01-01

    This book discusses the ultrasound (US) biopsy techniques, cytology, histology, and physics. The emphasis is on use of US guidance, as the authors find that virtually all lesions are visible at US scanning and they thus save valuable time on the computer tomographic scanner. The authors present in great detail their considerable work in designing needles that are readily visible at US scanning and can also collect good cytologic and histologic material. Biopsy techniques are discussed separately for each organ system. The accuracy of these techniques in over 3,000 of the author's cases is presented

  14. 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.

  15. Nerve stimulator-guided sciatic-femoral nerve block in raptors undergoing surgical treatment of pododermatitis.

    Science.gov (United States)

    d'Ovidio, Dario; Noviello, Emilio; Adami, Chiara

    2015-07-01

    To describe the nerve stimulator-guided sciatic-femoral nerve block in raptors undergoing surgical treatment of pododermatitis. Prospective clinical trial. Five captive raptors (Falco peregrinus) aged 6.7 ± 1.3 years. Anaesthesia was induced and maintained with isoflurane in oxygen. The sciatic-femoral nerve block was performed with 2% lidocaine (0.05 mL kg(-1) per nerve) as the sole intra-operative analgesic treatment. Intraoperative physiological variables were recorded every 10 minutes from endotracheal intubation until the end of anaesthesia. Assessment of intraoperative nociception was based on changes in physiological variables above baseline values, while evaluation of postoperative pain relied on species-specific behavioural indicators. The sciatic-femoral nerve block was feasible in raptors and the motor responses following electrical stimulation of both nerves were consistent with those reported in mammalian species. During surgery no rescue analgesia was required. The anaesthesia plane was stable and cardiorespiratory variables did not increase significantly in response to surgical stimulation. Iatrogenic complications, namely nerve damage and local anaesthetic toxicity, did not occur. Recovery was smooth and uneventful. The duration (mean ± SD) of the analgesic effect provided by the nerve block was 130 ± 20 minutes. The sciatic-femoral nerve block as described in dogs and rabbits can be performed in raptors as well. Further clinical trials with a control groups are required to better investigate the analgesic efficacy and the safety of this technique in raptors. © 2014 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

  16. Endobronchial ultrasound elastography: a new method in endobronchial ultrasound-guided transbronchial needle aspiration.

    Science.gov (United States)

    Jiang, Jun-Hong; Turner, J Francis; Huang, Jian-An

    2015-12-01

    TBNA through the flexible bronchoscope is a 37-year-old technology that utilizes a TBNA needle to puncture the bronchial wall and obtain specimens of peribronchial and mediastinal lesions through the flexible bronchoscope for the diagnosis of benign and malignant diseases in the mediastinum and lung. Since 2002, the Olympus Company developed the first generation ultrasound equipment for use in the airway, initially utilizing an ultrasound probe introduced through the working channel followed by incoroporation of a fixed linear ultrasound array at the distal tip of the bronchoscope. This new bronchoscope equipped with a convex type ultrasound probe on the tip was subsequently introduced into clinical practice. The convex probe (CP)-EBUS allows real-time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) of mediastinal and hilar lymph nodes. EBUS-TBNA is a minimally invasive procedure performed under local anesthesia that has been shown to have a high sensitivity and diagnostic yield for lymph node staging of lung cancer. In 10 years of EBUS development, the Olympus Company developed the second generation EBUS bronchoscope (BF-UC260FW) with the ultrasound image processor (EU-M1), and in 2013 introduced a new ultrasound image processor (EU-M2) into clinical practice. FUJI company has also developed a curvilinear array endobronchial ultrasound bronchoscope (EB-530 US) that makes it easier for the operator to master the operation of the ultrasonic bronchoscope. Also, the new thin convex probe endobronchial ultrasound bronchoscope (TCP-EBUS) is able to visualize one to three bifurcations distal to the current CP-EBUS. The emergence of EBUS-TBNA has also been accompanied by innovation in EBUS instruments. EBUS elastography is, then, a new technique for describing the compliance of structures during EBUS, which may be of use in the determination of metastasis to the mediastinal and hilar lymph nodes. This article describes these new EBUS

  17. Ultrasound Guided Percutaneous Nephrostomy: Experience at ...

    African Journals Online (AJOL)

    Background: Obstructive uropathy is a common problem in urologic practice; temporary relief of obstruction in the upper tract poses a significant challenge. Ultrasound‑guided percutaneous nephrostomy (PCN) is an option for upper tract drainage; compared to fluoroscopic guidance, it is readily available, affordable, and not ...

  18. A micro-architectural evaluation of osteoporotic human femoral heads to guide implant placement in proximal femoral fractures.

    Science.gov (United States)

    Jenkins, Paul J; Ramaesh, Rishikesan; Pankaj, Pankaj; Patton, James T; Howie, Colin R; Goffin, Jérôme M; Merwe, Andrew van der; Wallace, Robert J; Porter, Daniel E; Simpson, A Hamish

    2013-10-01

    The micro-architecture of bone has been increasingly recognized as an important determinant of bone strength. Successful operative stabilization of fractures depends on bone strength. We evaluated the osseous micro-architecture and strength of the osteoporotic human femoral head. 6 femoral heads, obtained during arthroplasty surgery for femoral neck fracture, underwent micro-computed tomography (microCT) scanning at 30 μm, and bone volume ratio (BV/TV), trabecular thickness, structural model index, connection density, and degree of anisotropy for volumes of interest throughout the head were derived. A further 15 femoral heads underwent mechanical testing of compressive failure stress of cubes of trabecular bone from different regions of the head. The greatest density and trabecular thickness was found in the central core that extended from the medial calcar to the physeal scar. This region also correlated with the greatest degree of anisotropy and proportion of plate-like trabeculae. In the epiphyseal region, the trabeculae were organized radially from the physeal scar. The weakest area was found at the apex and peripheral areas of the head. The strongest region was at the center of the head. The center of the femoral head contained the strongest trabecular bone, with the thickest, most dense trabeculae. The apical region was weaker. From an anatomical and mechanical point of view, implants that achieve fixation in or below this central core may achieve the most stable fixation during fracture healing.

  19. The comparative study of CT guided and ultrasound guided percutaneous ethanol injection in the treatment of intra-abdominal cyst

    International Nuclear Information System (INIS)

    Li Heping; Yang Jianyong; Chen Wei; Zhuang Wenquan; Huang Yulian; Chen Jianye

    2005-01-01

    Objective: An comparative study of the interventional approach of CT guided and ultiasound guided percutaneous ethanol injection(PEI) in the treatment of intra-abdominal cyst. Methods: CT guided PEI was performed in the treatment of intra-abdominal cyst in 38 patients while ultrasound guided PEI was performed in 45 cases. Results: The puncture procedure of CT guided PEI was totally performed 83 times in treating 56 intra-abdominal cysts in 38 patients and CT guided PEI was unsuccessful in 6 patients. The puncture procedure of ultrasound guided PEI were performed 87 times in treating 71 intra-abdominal cysts in 55 patients and ultrasound guided PEI only failed only in 1 patient. Conclusion: Ultrasound guided PEI is superior to CT guided PEI in the treatment of intra-abdominal cyst. (authors)

  20. A new adjustable parallel drill guide for internal fixation of femoral neck fracture: a developmental and experimental study

    OpenAIRE

    Yuenyongviwat, Varah; Tuntarattanapong, Pakjai; Tangtrakulwanich, Boonsin

    2016-01-01

    Background Internal fixation is one treatment for femoral neck fracture. Some devices and techniques reported improved accuracy and decreased fluoroscopic time. However, these are not widely used nowadays due to the lack of available special instruments and techniques. To improve the surgical procedure, the authors designed a new adjustable drill guide and tested the efficacy of the device. Methods The authors developed a new adjustable drill guide for cannulated screw guide wire insertion fo...

  1. Pre-puncture ultrasound guided epidural insertion before vaginal delivery.

    Science.gov (United States)

    Nassar, Mahmoud; Abdelazim, Ibrahim A

    2015-10-01

    Palpation method is widely used in clinical practice to identify the puncture site during combined spinal-epidural (CSE) blocks. Tuffier's line, is an anatomical landmark between two iliac crests (inter-cristal), which is widely used to identify the puncture site during CSE blocks is not always an indicator for specific vertebral level or inter-vertebral space. One hundred and Ten (110) women were scheduled for normal vaginal delivery and were randomized into two equal groups; palpation group and an ultrasound guided group to detect the efficacy of puncture ultrasound before CSE blocks to increase chances of successful CSE procedure on the first attempt and to reduce the number of attempts or punctures during insertion of CSE catheter. There were no significant differences between two studied groups regarding; maternal age, weight and height, while, there was a significant difference between two studied groups regarding; parity. Percentage of successful CSE procedure on the first attempt was significantly higher (67.27%) in ultrasound compared to palpation group (40%). Number of punctures (attempts) were significantly less in ultrasound (1.2 ± 0.6) compared to palpation group (2.3 ± 0.8) and the number of redirections was also significantly less in ultrasound (1.4 ± 0.5) compared to palpation group (2.8 ± 1.6). Although, time to identify puncture site was significantly longer in ultrasound compared to palpation group and total procedure time was longer in ultrasound (9.1 ± 1.5 min) compared to palpation group (6.2 ± 1.2 min), there was no significant difference between two studied groups regarding; time to identify puncture site and total procedure time. Two cases of dural puncture in palpation versus no cases in ultrasound group and two cases of intravascular catheter placement (one in each group), with no significant difference between two groups. Pre- puncture ultrasound guided epidural insertion before vaginal delivery, increases the chance of a

  2. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part IV - EUS-guided interventions

    DEFF Research Database (Denmark)

    Jenssen, C; Hocke, M; Fusaroli, P

    2016-01-01

    The fourth part of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound describes general aspects of endoscopic ultrasound-guided diagnostic and therapeutic interventions and assesses the evidence for endoscopic ultrasound-gu...

  3. Ultrasound-guided interventional therapy for recurrent ovarian chocolate cysts.

    Science.gov (United States)

    Wang, Lu-Lu; Dong, Xiao-Qiu; Shao, Xiao-Hui; Wang, Si-Ming

    2011-10-01

    The aim of this study was to determine the effectiveness of ultrasound-guided interventional therapy in the treatment of postoperative recurrent chocolate cysts. The 198 patients enrolled in this study were divided into three groups. In group 1, the saline washing group, the cavity of the cyst was washed thoroughly with warm saline. In group 2, the ethanol short-time retention group, after washing with saline, the cyst was injected with 95% ethanol with a volume of half of the fluid aspirated from the cyst. Ten minutes later, the rest of the ethanol was aspirated. In group 3, the ethanol retention group, the procedures were the same as with the ethanol short-time retention group, except that 95% of the ethanol was retained in the cyst. An ultrasound examination was performed in the third, sixth and 12th months after therapy. The chocolate cyst cure rate was significantly higher in the ethanol retention group (96%, 66/69) than in the ethanol short-time retention group (82%, 56/68) and no case was cured in the first group (saline washing). We conclude that ultrasound-guided injection and 95% ethanol retention are an effective therapy for the treatment of postoperative recurrent chocolate cysts. Copyright © 2011 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  4. Ultrasound guided aspiration cytology of neck mass except thyroid mass

    International Nuclear Information System (INIS)

    Kim, Myeong Jin; Lee, Jong Tae; Yoo, Hyung Sik; Suh, Jung Ho; Park, Cheong Soo; Lee, Gwang Gil

    1988-01-01

    Results of ultrasound guided aspiration cytology of extrathyroidal neck masses of 73 patients were reviewed. Included cases were 23 malignant lesions; 16 metastatic tumors, 4 lymphomas, 3 salivary gland tumors and 50 benign lesions: 24 tuberculous lymphadenites, 15 abscess, 3 benign lymph node hyperplasias, etc. There were one case of false negative and none of false positive result for malignancy. In two cases of malignancy, insufficient cellular material was obtained. In one case of lymphoma, and a benign lymph node hyperplasia, it was difficult to distinguish between benignancy and malignancy on cytologic smear. For the malignant lesions, sensitivity was 83%, specificity was 98%, and overall accuracy was 93%. There were none who had suffered adverse effect from the procedure. Ultrasound guided aspiration cytology seems to be simple, accurate and safe diagnostic modality for neck masses especially in condition that malignancy can not be excluded

  5. Ultrasound-guided antegrade pyelography of renal transplants

    International Nuclear Information System (INIS)

    Wernecke, K.; Heckemann, R.; Rehwald, U.; Ringert, R.H.; Essen Univ.

    1983-01-01

    The indications for, and technique of, ultrasound-guided antegrade pyelography of renal transplants are illustrated by eight patients. Because of the detailed anatomical information which the antegrade method provides, it is superior to other diagnostic methods for the investigation of ureteric obstruction or fistulae. The severity of renal pelvis dilatation as shown by sonography must not be taken as a criterian for the grade of obstruction, since transplants may show dilated collecting systems, even in the absence of obstruction. In our view, real time sonography with a suitable probe provides the best means of achieving successful puncture of the renal pelvis. The combination of ultrasound-guided puncture and radiological contrast examination of the ureter is the best diagnostic method available and lead, in all eight cases, to immediate and definitive treatment. (orig.)

  6. 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.

  7. An ultrasound needle insertion guide in a porcine phantom model.

    Science.gov (United States)

    Whittaker, S; Lethbridge, G; Kim, C; Keon Cohen, Z; Ng, I

    2013-08-01

    We compared nerve blockade with and without the Infiniti(TM) needle guide in an ultrasound in-plane porcine simulation. We recruited 30 anaesthetists with varying blockade experience. Using the guide, the needle tip was more visible (for a median (IQR [range]) of 67 (56-100]) % of the time; and invisible for 2 (1-4 [0-19]) s) than when the guide was not used (respectively 23 (13-43 [0-80]) % and 25 (9-52 [1-198]) s; both p < 0.001). The corresponding block times were 8 (6-10 [3-28]) s and 32 (15-67 [5-225]) s, respectively; p < 0.001. The needle guide reduced the block time and the time that the needle was invisible, irrespective of anaesthetist experience. Anaesthesia © 2013 The Association of Anaesthetists of Great Britain and Ireland.

  8. Ultrasound-guided genitourinary interventions: principles and techniques

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Kwan [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2017-10-15

    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.

  9. Clinical accuracy of a patient-specific femoral osteotomy guide in minimally-invasive posterior hip arthroplasty.

    Science.gov (United States)

    Schneider, Adrian K; Pierrepont, Jim W; Hawdon, Gabrielle; McMahon, Stephen

    2018-04-01

    Patient specific guides can be a valuable tool in improving the precision of planned femoral neck osteotomies, especially in minimally invasive hip surgery, where bony landmarks are often inaccessible. The aim of our study was to validate the accuracy of a novel patient specific femoral osteotomy guide for THR through a minimally invasive posterior approach, the direct superior approach (DSA). As part of our routine preoperative planning 30 patients underwent low dose CT scans of their arthritic hip. 3D printed patient specific femoral neck osteotomy guides were then produced. Intraoperatively, having cleared all soft tissue from the postero-lateral neck of the enlocated hip, the guide was placed and pinned onto the posterolateral femoral neck. The osteotomy was performed using an oscillating saw and the uncemented hip components were implanted as per routine. Postoperatively, the achieved level of the osteotomy at the medial calcar was compared with the planned level of resection using a 3D/2D matching analysis (Mimics X-ray module, Materialise, Belgium). A total of 30 patients undergoing uncemented Trinity™ acetabular and TriFit TS™ femoral component arthroplasty (Corin, UK) were included in our analysis. All but one of our analysed osteotomies were found to be within 3 mm from the planned height of osteotomy. In one patient the level of osteotomy deviated 5 mm below the planned level of resection. Preoperative planning and the use of patient specific osteotomy guides provides an accurate method of performing femoral neck osteotomies in minimally invasive hip arthroplasty using the direct superior approach. IV (Case series).

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

    International Nuclear Information System (INIS)

    Koh, Young Hwan; Kim, Hak Soo; Kim, Hyung Sik; Min, Seung Kee

    2005-01-01

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  12. Faculty staff-guided versus self-guided ultrasound training for internal medicine residents.

    Science.gov (United States)

    Alba, George A; Kelmenson, Daniel A; Noble, Vicki E; Murray, Alice F; Currier, Paul F

    2013-11-01

    Ultrasonography is of growing importance within internal medicine (IM), but the optimal method of training doctors to use it is uncertain. In this study, the authors provide the first objective comparison of two approaches to training IM residents in ultrasonography. In this randomised trial, a simulation-based ultrasound training curriculum was implemented during IM intern orientation at a tertiary care teaching hospital. All 72 incoming interns attended a lecture and were given access to online modules. Interns were then randomly assigned to a 4-hour faculty-guided (FG) or self-guided (SG) ultrasound training session in a simulation laboratory with both human and manikin models. Interns were asked to self-assess their competence in ultrasonography and underwent an objective structured clinical examination (OSCE) to assess their competence in basic and procedurally oriented ultrasound tasks. The primary outcome was the score on the OSCE. Faculty-guided training was superior to self-guided training based on the OSCE scores. Subjects in the FG training group achieved significantly higher OSCE scores on the two subsets of task completion (0.9-point difference, 95% confidence interval [CI] 0.27-1.54; p = 0.008) and ultrasound image quality (2.43-point difference, 95% CI 1.5-3.36; p training groups demonstrated an increase in self-assessed competence after their respective training sessions and there was little difference between the groups. Subjects rated the FG training group much more favourably than the SG training group. Both FG and SG ultrasound training curricula can improve the self-reported competence of IM interns in ultrasonography. However, FG training was superior to SG training in both skills acquisition and intern preference. Incorporating mandatory ultrasound training into IM residencies can address the perceived need for ultrasound training, improve confidence and procedural skills, and may enhance patient safety. However, the optimal training method

  13. Endoscopic ultrasound-guided transmural drainage of postoperative pancreatic collections.

    Science.gov (United States)

    Tilara, Amy; Gerdes, Hans; Allen, Peter; Jarnagin, William; Kingham, Peter; Fong, Yuman; DeMatteo, Ronald; D'Angelica, Michael; Schattner, Mark

    2014-01-01

    Pancreatic leak is a major cause of morbidity after pancreatectomy. Traditionally, peripancreatic fluid collections have been managed by percutaneous or operative drainage. Data for endoscopic ultrasound (EUS)-guided drainage of postoperative fluid collections are limited. Here we report on the safety, efficacy, and timing of EUS-guided drainage of postoperative peripancreatic collections. This is a retrospective review of 31 patients who underwent EUS-guided drainage of fluid collections after pancreatic resection. Technical success was defined as successful transgastric deployment of at least one double pigtail plastic stent. Clinical success was defined as resolution of the fluid collection on follow-up CT scan and resolution of symptoms. Early drainage was defined as initial transmural stent placement within 30 days after surgery. Endoscopic ultrasound-guided drainage was performed effectively with a technical success rate of 100%. Clinical success was achieved in 29 of 31 patients (93%). Nineteen of the 29 patients (65%) had complete resolution of their symptoms and collection with the first endoscopic procedure. Repeat drainage procedures, including some with necrosectomy, were required in the remaining 10 patients, with eventual resolution of collection and symptoms. Two patients who did not achieve durable clinical success required percutaneous drainage by interventional radiology. Seventeen (55%) of 31 patients had successful early drainage completed within 30 days of their operation. Endoscopic ultrasound-guided drainage of fluid collections after pancreatic resection is safe and effective. Early drainage (collections was not associated with increased complications in this series. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Ultrasound-guided peripheral and truncal blocks in pediatric patients

    Directory of Open Access Journals (Sweden)

    Mohamed Bilal Delvi

    2011-01-01

    Full Text Available Ultrasound has added a feather in the cap of the anesthesiologists as real-time nerve localization and drug deposition around the nerve structure under real-time guidance is now a reality, as the saying "seeing is believing" has been proven true with the advent of ultrasound in anesthesia. Pediatric patients are a unique group regarding their anatomical and physiological features in comparison with adults; regional blocks in adults with the anatomical landmark and surface marking are almost uniform across the adult population. The landmark technique in pediatric patients is not reliable in all patients due to the variability in the age and size; the advent of ultrasound in assisting nerve localization has changed the way regional blocks are achieved in children and the range of blocks performed on adults can now be performed on pediatric patients; with advances in the technology and dexterity of ultrasound equipment, the chances of success of blocks has increased with a smaller dose of the local anesthetic in comparison to the traditional methods. Anesthesiologists are now able to perform blocks with more accuracy and avoid complications like intravascular injection and injury to the pleura and peritoneum during routine practice with the assistance of high-frequency transducers and top of the range portable ultrasound machines; catheters can be inserted to provide a continuous analgesia in the postoperative period. This review article describes the common peripheral blocks in pediatric patients; the readers are encouraged to gain experience by attending workshops, hands-on practice under supervision, and conduct random controlled trials pertaining to ultrasound-guided blocks in the pediatric age group. The recent literature is encouraging and further research is promising; a wide range of blocks being described in detail by many prominent experts from all over the world.

  15. In Vivo Quantitative Ultrasound Image Analysis of Femoral Subchondral Bone in Knee Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Jana Podlipská

    2013-01-01

    Full Text Available A potential of quantitative noninvasive knee ultrasonography (US for detecting changes in femoral subchondral bone related to knee osteoarthritis (OA was investigated. Thirty-nine patients referred to a knee arthroscopy underwent dynamic noninvasive US examination of the knee joint. The subchondral bone was semiautomatically segmented from representative US images of femoral medial and lateral condyles and intercondylar notch area. Subsequently, the normalized mean gray-level intensity profile, starting from the cartilage-bone interface and extending to the subchondral bone depth of ~1.7 mm, was calculated. The obtained profile was divided into 5 depth levels and the mean of each level, as well as the slope of the profile within the first two levels, was calculated. The US quantitative data were compared with the arthroscopic Noyes’ grading and radiographic Kellgren-Lawrence (K-L grading. Qualitatively, an increase in relative subchondral bone US gray-level values was observed as OA progressed. Statistically significant correlations were observed between normalized US mean intensity or intensity slope especially in subchondral bone depth level 2 and K-L grading (r=0.600, P<0.001; r=0.486, P=0.006, resp. or femoral arthroscopic scoring (r=0.332, P=0.039; r=0.335, P=0.037, resp.. This novel quantitative noninvasive US analysis technique is promising for detection of femoral subchondral bone changes in knee OA.

  16. A novel ultrasound-guided shoulder arthroscopic surgery

    Science.gov (United States)

    Tyryshkin, K.; Mousavi, P.; Beek, M.; Chen, T.; Pichora, D.; Abolmaesumi, P.

    2006-03-01

    This paper presents a novel ultrasound-guided computer system for arthroscopic surgery of the shoulder joint. Intraoperatively, the system tracks and displays the surgical instruments, such as arthroscope and arthroscopic burrs, relative to the anatomy of the patient. The purpose of this system is to improve the surgeon's perception of the three-dimensional space within the anatomy of the patient in which the instruments are manipulated and to provide guidance towards the targeted anatomy. Pre-operatively, computed tomography images of the patient are acquired to construct virtual threedimensional surface models of the shoulder bone structure. Intra-operatively, live ultrasound images of pre-selected regions of the shoulder are captured using an ultrasound probe whose three-dimensional position is tracked by an optical camera. These images are used to register the surface model to the anatomy of the patient in the operating room. An initial alignment is obtained by matching at least three points manually selected on the model to their corresponding points identified on the ultrasound images. The registration is then improved with an iterative closest point or a sequential least squares estimation technique. In the present study the registration results of these techniques are compared. After the registration, surgical instruments are displayed relative to the surface model of the patient on a graphical screen visible to the surgeon. Results of laboratory experiments on a shoulder phantom indicate acceptable registration results and sufficiently fast overall system performance to be applicable in the operating room.

  17. 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.

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

    International Nuclear Information System (INIS)

    Park, SangIk; Shin, Yong Moon; Won, Hyung Jin; Kim, Pyo Nyun; Lee, Moon Gyu

    2017-01-01

    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

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

    Science.gov (United States)

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

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

  20. Guided interventions in musculoskeletal ultrasound: what's the evidence?

    International Nuclear Information System (INIS)

    Davidson, J.; Jayaraman, S.

    2011-01-01

    Increasing histological and radiological understanding of the processes involved in soft-tissue injury is leading to novel targeted treatments. A number of reviews have recommended that these treatments should be performed with image guidance. This review describes current ultrasound-guided interventions and injections, together with the level of evidence for these. Discussion of guided interventions will include; percutaneous lavage (barbotage), brisement, dry needling, electrocoagulation, and of guided injections; corticosteroids, autologous substances (blood and platelet rich plasma), sclerosants, and prolotherapy (hyperosmolar dextrose). Representative imaging illustrating some of these techniques is included for correlation with the methods described. As these procedures are often performed in sportspeople, it is essential that the radiologist is aware of prohibited substances and methods outlined in an annual publication from the World Anti-Doping Association (WADA). Finally, future directions, including the use of autologous substances, mesenchymal and stem cells will be discussed.

  1. Ultrasound-guided injection for plantar fasciitis: A brief review

    Directory of Open Access Journals (Sweden)

    A S Nair

    2016-01-01

    Full Text Available Plantar fasciitis (PF is a distressing condition experienced by many patients. Although self-limiting, it tends to become a chronic ailment if the precipitating factors are not addressed. One of the modality of treating PF is intra-lesional corticosteroid injection. This was done using palpation technique earlier but nowadays many specialists use ultrasound (US imaging as a guide to give injection accurately instead of inadvertently damaging the plantar fascia or injecting into surrounding soft tissue, both of which can have serious implications. We did a literature search in Medline, Scopus, and Embase databases to find out articles describing US-guided corticosteroid injection for treating PF and whether guided injection was effective than injection given by palpation.

  2. Combined ultrasound and MR imaging to guide focused ultrasound therapies in the brain

    Science.gov (United States)

    Arvanitis, Costas D.; Livingstone, Margaret S.; McDannold, Nathan

    2013-07-01

    Several emerging therapies with potential for use in the brain, harness effects produced by acoustic cavitation—the interaction between ultrasound and microbubbles either generated during sonication or introduced into the vasculature. Systems developed for transcranial MRI-guided focused ultrasound (MRgFUS) thermal ablation can enable their clinical translation, but methods for real-time monitoring and control are currently lacking. Acoustic emissions produced during sonication can provide information about the location, strength and type of the microbubble oscillations within the ultrasound field, and they can be mapped in real-time using passive imaging approaches. Here, we tested whether such mapping can be achieved transcranially within a clinical brain MRgFUS system. We integrated an ultrasound imaging array into the hemisphere transducer of the MRgFUS device. Passive cavitation maps were obtained during sonications combined with a circulating microbubble agent at 20 targets in the cingulate cortex in three macaques. The maps were compared with MRI-evident tissue effects. The system successfully mapped microbubble activity during both stable and inertial cavitation, which was correlated with MRI-evident transient blood-brain barrier disruption and vascular damage, respectively. The location of this activity was coincident with the resulting tissue changes within the expected resolution limits of the system. While preliminary, these data clearly demonstrate, for the first time, that it is possible to construct maps of stable and inertial cavitation transcranially, in a large animal model, and under clinically relevant conditions. Further, these results suggest that this hybrid ultrasound/MRI approach can provide comprehensive guidance for targeted drug delivery via blood-brain barrier disruption and other emerging ultrasound treatments, facilitating their clinical translation. We anticipate that it will also prove to be an important research tool that will

  3. Combined ultrasound and MR imaging to guide focused ultrasound therapies in the brain

    International Nuclear Information System (INIS)

    Arvanitis, Costas D; McDannold, Nathan; Livingstone, Margaret S

    2013-01-01

    Several emerging therapies with potential for use in the brain, harness effects produced by acoustic cavitation—the interaction between ultrasound and microbubbles either generated during sonication or introduced into the vasculature. Systems developed for transcranial MRI-guided focused ultrasound (MRgFUS) thermal ablation can enable their clinical translation, but methods for real-time monitoring and control are currently lacking. Acoustic emissions produced during sonication can provide information about the location, strength and type of the microbubble oscillations within the ultrasound field, and they can be mapped in real-time using passive imaging approaches. Here, we tested whether such mapping can be achieved transcranially within a clinical brain MRgFUS system. We integrated an ultrasound imaging array into the hemisphere transducer of the MRgFUS device. Passive cavitation maps were obtained during sonications combined with a circulating microbubble agent at 20 targets in the cingulate cortex in three macaques. The maps were compared with MRI-evident tissue effects. The system successfully mapped microbubble activity during both stable and inertial cavitation, which was correlated with MRI-evident transient blood–brain barrier disruption and vascular damage, respectively. The location of this activity was coincident with the resulting tissue changes within the expected resolution limits of the system. While preliminary, these data clearly demonstrate, for the first time, that it is possible to construct maps of stable and inertial cavitation transcranially, in a large animal model, and under clinically relevant conditions. Further, these results suggest that this hybrid ultrasound/MRI approach can provide comprehensive guidance for targeted drug delivery via blood–brain barrier disruption and other emerging ultrasound treatments, facilitating their clinical translation. We anticipate that it will also prove to be an important research tool that

  4. Endoscopic ultrasound-guided radiofrequency ablation of the pancreas

    DEFF Research Database (Denmark)

    Silviu, Ungureanu Bogdan; Daniel, Pirici; Claudiu, Mărgăritescu

    2015-01-01

    ultrasound (EUS)-guided radiofrequency ablation (RFA) probe through a 19G needle in order to achieve a desirable necrosis area in the pancreas. Radiofrequency ablation of the head of the pancreas was performed on 10 Yorkshire pigs with a weight between 25 kg and 35 kg and a length of 40-70 cm. Using an EUS...... analysis revealed increased values of amylase, alkaline phosphatase, and gamma-glutamyl transpeptidase on the 3rd day but a decrease on the 5th day. After necropsy and isolation of the pancreas, the ablated area was easily found, describing a solid necrosis. The pathological examination revealed...

  5. First Clinical Investigations of New Ultrasound Techniques in Three Patient Groups: Patients with Liver Tumors, Arteriovenous Fistulas, and Arteriosclerotic Femoral Arteries

    DEFF Research Database (Denmark)

    Hansen, Peter Møller

    In this PhD project two newer ultrasound techniques are for the first time used for clinical scans of patients with malignant liver tumors (Study I), arteriovenous fistulas for hemodialysis (Study II) and arteriosclerotic femoral arteries (Study III). The same commercial ultrasound scanner was us...... of the new ultrasound techniques in selected groups of patients. For all three studies the results are promising, and hopefully the techniques will find their way into everyday clinical practice for the benefit of both patients and healthcare practitioners.......In this PhD project two newer ultrasound techniques are for the first time used for clinical scans of patients with malignant liver tumors (Study I), arteriovenous fistulas for hemodialysis (Study II) and arteriosclerotic femoral arteries (Study III). The same commercial ultrasound scanner was used...... in all three studies. Study I was a comparative study of B-mode ultrasound images obtained with conventional technique and the experimental technique Synthetic Aperture Sequential Beamforming (SASB). SASB is a datareducing version of the technique synthetic aperture, which has the potential to produce...

  6. Closed retrograde retrieval of the distal broken segment of femoral cannulated intramedullary nail using a ball-tipped guide wire.

    Science.gov (United States)

    Metikala, Sreenivasulu; Mohammed, Riazuddin

    2011-07-01

    Extracting broken segments of intramedullay nails from long bones can be an operative challenge, particularly from the distal end. We report a case series where a simple and reproducible technique of extracting broken femoral cannulated nails using a ball-tipped guide wire is described. This closed technique involves no additional equipment or instruments. Eight patients who underwent the described method were included in the study. The technique involves using a standard plain guide wire passed through the cannulated distal broken nail segment after extraction of the proximal nail fragment. The plain guide wire is then advanced distally into the knee joint carefully under fluoroscopy imaging. Over this wire, a 5-millimeter (mm) cannulated large drill bit is used to create a track up to the distal broken nail segment. Through the small knee wound, a ball-tipped guide wire is passed, smooth end first, till the ball engages the end of the nail. The guide wire is then extracted along with the broken nail through the proximal wound. The method was successfully used in all eight patients for removal of broken cannulated intramedullary nail from the femoral canal without any complications. All patients underwent exchange nailing with successful bone union in six months. None of the patients had any problems at the knee joint at the final follow-up. We report a technique for successful extraction of the distal fragment of broken femoral intramedullary nails without additional surgical approaches.

  7. Iatrogenic femoral artery pseudoaneurysms - A review of current methods of diagnosis and treatment

    Energy Technology Data Exchange (ETDEWEB)

    Ahmad, F. [Department of Interventional Radiology, Royal Berkshire NHS Foundation Trust, Reading (United Kingdom)], E-mail: farhan@doctors.org.uk; Turner, S.A.; Torrie, P.; Gibson, M. [Department of Interventional Radiology, Royal Berkshire NHS Foundation Trust, Reading (United Kingdom)

    2008-12-15

    The common femoral artery is commonly used as arterial access for a wide range of radiological and cardiological procedures. Pseudoaneurysm formation is the most common arterial complication of femoral artery catheterization, and is diagnosed using colour Doppler ultrasound. Ultrasound-guided thrombin injection has replaced ultrasound-guided compression as the first-line treatment. The practicalities of thrombin injection (technique and types of thrombin available) and other treatment options are discussed. Awareness of pseudoaneurysm formation and the treatment options allows prompt diagnosis and successful treatment.

  8. Iatrogenic femoral artery pseudoaneurysms - A review of current methods of diagnosis and treatment

    International Nuclear Information System (INIS)

    Ahmad, F.; Turner, S.A.; Torrie, P.; Gibson, M.

    2008-01-01

    The common femoral artery is commonly used as arterial access for a wide range of radiological and cardiological procedures. Pseudoaneurysm formation is the most common arterial complication of femoral artery catheterization, and is diagnosed using colour Doppler ultrasound. Ultrasound-guided thrombin injection has replaced ultrasound-guided compression as the first-line treatment. The practicalities of thrombin injection (technique and types of thrombin available) and other treatment options are discussed. Awareness of pseudoaneurysm formation and the treatment options allows prompt diagnosis and successful treatment

  9. Models to teach lung sonopathology and ultrasound-guided thoracentesis

    Directory of Open Access Journals (Sweden)

    Jacek A. Wojtczak

    2014-12-01

    Full Text Available Lung sonography allows rapid diagnosis of lung emergencies such as pulmonary edema, hemothorax or pneumothorax. The ability to timely diagnose an intraoperative pneumothorax is an important skill for the anesthesiologist. However, lung ultrasound exams require an interpretation of not only real images but also complex acoustic artifacts such as A-lines and B-lines. Therefore, appropriate training to gain proficiency is important. Simulated environment using ultrasound phantom models allows controlled, supervised learning. We have developed hybrid models that combine dry or wet polyurethane foams, porcine rib cages and human hand simulating a rib cage. These models simulate fairly accurately pulmonary sonopathology and allow supervised teaching of lung sonography with the immediate feedback. In-vitro models can also facilitate learning of procedural skills, improving transducer and needle positioning and movement, rapid recognition of thoracic anatomy and hand – eye coordination skills. We described a new model to teach an ultrasound guided thoracentesis. This model consists of the experimenter’s hand placed on top of the water-filled container with a wet foam. Metacarpal bones of the human hand simulate a rib cage and a wet foam simulates a diseased lung immersed in the pleural fluid. Positive fluid flow offers users feedback when a simulated pleural effusion is accurately assessed.

  10. Ultrasound-guided high-intensity focused ultrasound treatment for abdominal wall endometriosis: Preliminary results

    International Nuclear Information System (INIS)

    Wang Yang; Wang Wei; Wang Longxia; Wang Junyan; Tang Jie

    2011-01-01

    Purpose: To evaluate the safety and therapeutic efficacy of ultrasound (US)-guided high-intensity focused ultrasound (HIFU) ablation for the treatment of abdominal wall endometriosis (AWE). Materials and methods: Twenty-one consecutive patients with AWE were treated as outpatients by US-guided HIFU ablation under conscious sedation. The median size of the AWE was 2.4 cm (range 1.0-5.3 cm). An acoustic power of 200-420 W was used, intermittent HIFU exposure of 1 s was applied. Treatment was considered complete when the entire nodule and its nearby 1 cm margin become hyperechoic on US. Pain relief after HIFU ablation was observed and the treated nodule received serial US examinations during follow-up. Results: All AWE was successfully ablated after one session of HIFU ablation, the ablation time lasted for 5-48 min (median 13 min), no major complications occurred. The cyclic pain disappeared in all patients during a mean follow-up of 18.7 months (range 3-31 months). The treated nodules gradually shank over time, 16 nodules became unnoticeable on US during follow-up. Conclusion: US-guided HIFU ablation appears to be safe and effective for the treatment of AWE.

  11. Ultrasound-guided high-intensity focused ultrasound treatment for abdominal wall endometriosis: Preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Wang Yang [Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China); Wang Wei, E-mail: wangyang301301@yahoo.com.cn [Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China); Wang Longxia; Wang Junyan; Tang Jie [Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China)

    2011-07-15

    Purpose: To evaluate the safety and therapeutic efficacy of ultrasound (US)-guided high-intensity focused ultrasound (HIFU) ablation for the treatment of abdominal wall endometriosis (AWE). Materials and methods: Twenty-one consecutive patients with AWE were treated as outpatients by US-guided HIFU ablation under conscious sedation. The median size of the AWE was 2.4 cm (range 1.0-5.3 cm). An acoustic power of 200-420 W was used, intermittent HIFU exposure of 1 s was applied. Treatment was considered complete when the entire nodule and its nearby 1 cm margin become hyperechoic on US. Pain relief after HIFU ablation was observed and the treated nodule received serial US examinations during follow-up. Results: All AWE was successfully ablated after one session of HIFU ablation, the ablation time lasted for 5-48 min (median 13 min), no major complications occurred. The cyclic pain disappeared in all patients during a mean follow-up of 18.7 months (range 3-31 months). The treated nodules gradually shank over time, 16 nodules became unnoticeable on US during follow-up. Conclusion: US-guided HIFU ablation appears to be safe and effective for the treatment of AWE.

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

    DEFF Research Database (Denmark)

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

    2000-01-01

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

  14. Microwave ablation of liver metastases guided by contrast-enhanced ultrasound

    DEFF Research Database (Denmark)

    Lorentzen, T; Skjoldbye, B O; Nolsoe, C P

    2011-01-01

    The aim of our study was to evaluate the efficacy of microwave (MW) ablation of liver metastases guided by B-mode ultrasound (US) and contrast-enhanced US (CEUS).......The aim of our study was to evaluate the efficacy of microwave (MW) ablation of liver metastases guided by B-mode ultrasound (US) and contrast-enhanced US (CEUS)....

  15. 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....

  16. Precise placement of lag screws in operative treatment of trochanteric femoral fractures with a new guide system.

    Science.gov (United States)

    Poyanli, Oguz S; Soylemez, Salih; Ozkut, Afsar T; Uygur, Esat; Kemah, Bahattin; Unal, Omer K

    2015-11-01

    We assessed the accuracy of a new guide system that we developed to place lag screws in the proper position with the minimum number of attempts for operative treatment of trochanteric femoral fractures. A total of 55 consecutive trochanteric femoral fractures were treated with a cephalomedullary nail. The first 27 consecutive patients were treated with the standard operation (group A), while the new guide system was used in the last 28 consecutive patients (group B). The numbers of attempts to place K wires and the duration of surgery were noted. Accuracy of lag screw placement was evaluated by measuring the angle of deviation from the central axis of the femoral head. Deviation values ranged from -11̊ to +15̊ for the 27 cases in group A, with a median absolute deviation of 8̊±6̊. That in the 28 cases after the introduction of the new guide system (group B) ranged from -5̊ to +6̊, with a median absolute deviation of 0.5̊±3̊ (Pfractures. The present study indicated that this new guide system and nail facilitate accurate placement of lag screws in the appropriate position with the minimum number of attempts. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Technical tips to perform safe and effective ultrasound guided steroid joint injections in children.

    Science.gov (United States)

    Parra, Dimitri A

    2015-01-01

    The aim of this article is to describe the technique used to perform ultrasound guided steroid joint injections in children in a group of joints that can be injected using ultrasound as the only image guidance modality. The technique is described and didactic figures are provided to illustrate key technical concepts. It is very important to be familiar with the sonographic appearance of the pediatric joints and the developing bone when performing ultrasound-guided joint injections in children.

  18. 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.

  19. The relationship of lateral anatomic structures to exiting guide pins during femoral tunnel preparation utilizing an accessory medial portal.

    Science.gov (United States)

    Farrow, Lutul D; Parker, Richard D

    2010-06-01

    Anatomic reconstruction of the anterior cruciate ligament through an accessory medial portal has become increasingly popular. The purpose of this study is to describe the relationship of guide pin exit points to the lateral anatomic structures when preparing the anterior cruciate ligament femoral tunnel through an accessory medial portal. We utilized seven fresh frozen cadaveric knees. Utilizing an anteromedial approach, a guide wire was placed into the center of each bundle's footprint. Each guide wire was advanced through the lateral femoral cortex. The guide pins were passed at 90, 110, and 130 degrees of knee flexion. The distances from each guide pin to the closest relevant structures on the lateral side of the knee were measured. At 90 degrees the posterolateral bundle guide pin was closest to the lateral condyle articular cartilage (mean 5.4 +/- 2.2 mm) and gastrocnemius tendon (mean 5.7 +/- 2.1 mm). At 110 degrees the posterolateral bundle pin was closest to the gastrocnemius tendon (mean 4.5 +/- 3.4 mm). At 130 degrees the posterolateral bundle pin was closest to the gastrocnemius tendon (mean 7.2 +/- 5.5 mm) and lateral collateral ligament (mean 6.8 +/- 2.1 mm). At 90 degrees the anteromedial bundle guide pin was closest to the articular cartilage (mean 2.0 +/- 2.0 mm). At 110 degrees the anteromedial bundle pin was closest to the articular cartilage (mean 7.4 +/- 3.5 mm) and gastrocnemius tendon (mean 12.3 +/- 3.1 mm). At 130 degrees the AM bundle pin was closest to the gastrocnemius tendon (mean 8.2 +/- 3.2 mm) and LCL (mean 15.1 +/- 2.9 mm). Neither guide pin (anteromedial or posterolateral bundle) put the peroneal nerve at risk at any knee flexion angle. At low knee flexion angles the anteromedial and posterolateral bundle guide pins closely approximated multiple lateral structures when using an accessory medial arthroscopic portal. Utilizing higher flexion angles increases the margin of error when preparing both femoral tunnels. During preparation of

  20. Ultrasound guided core biopsy of suspicious mammographic calcifications using high frequency and power Doppler ultrasound

    International Nuclear Information System (INIS)

    Teh, W.L.; Wilson, A.R.M; Evans, A.J.; Burrell, H.; Pinder, S.E.; Ellis, I.O.

    2000-01-01

    AIM: The pre-operative diagnosis of suspicious mammographic microcalcifications usually requires stereotactic needle biopsy. The aim of this study was to evaluate if high frequency 13 MHz ultrasound (HFUS) and power Doppler (PD) can aid visualization and biopsy of microcalcifications. MATERIALS AND METHODS: Forty-four consecutive patients presenting with microcalcifications without associated mammographic or palpable masses were examined with HFUS and PD. Ultrasound-guided core biopsy (USCB) was performed where possible. Stereotactic biopsy was carried out when US-guided biopsy was unsuccessful. Surgery was performed if a diagnosis of malignancy was made on core biopsy or if the repeat core biopsy was non-diagnostic. RESULTS: Forty-one patients (93%) had ultrasound abnormalities corresponding to mammographic calcification. USCB was performed on 37 patients. In 29/37, USCB obtained a definitive result (78.4%). USCB was non-diagnostic in 4/9 benign (44.4%) and 4/28 (14.3%) malignant lesions biopsied. The complete and absolute sensitivities for malignancy using USCB were 85.7% (24/28) and 81% (23/28), respectively. USCB correctly identified invasive disease in 12/23 (52.2%) cases. There was no significant difference in the presence of abnormal flow on PD between benign and malignant lesions. However, abnormal PD vascularity was present in 43.5% of invasive cancer and was useful in directing successful biopsy in eight cases. CONCLUSION: The combination of high frequency US with PD is useful in the detection and guidance of successful needle biopsy of microcalcifications particularly where there is an invasive focus within larger areas of DCIS. Teh, W.L. (2000)

  1. The Effect of Femoral Cutting Guide Design Improvements for Patient-Specific Instruments

    Directory of Open Access Journals (Sweden)

    Oh-Ryong Kwon

    2015-01-01

    Full Text Available Although the application of patient-specific instruments (PSI for total knee arthroplasty (TKA increases the cost of the surgical procedure, PSI may reduce operative time and improve implant alignment, which could reduce the number of revision surgeries. We report our experience with TKA using PSI techniques in 120 patients from March to December 2014. PSI for TKA were created from data provided by computed tomography (CT scans or magnetic resonance imaging (MRI; which imaging technology is more reliable for the PSI technique remains unclear. In the first 20 patients, the accuracy of bone resection and PSI stability were compared between CT and MRI scans with presurgical results as a reference; MRI produced better results. In the second and third groups, each with 50 patients, the results of bone resection and stability were compared in MRI scans with respect to the quality of scanning due to motion artifacts and experienced know-how in PSI design, respectively. The optimized femoral cutting guide design for PSI showed the closest outcomes in bone resection and PSI stability with presurgical data. It is expected that this design could be a reasonable guideline in PSI.

  2. A new adjustable parallel drill guide for internal fixation of femoral neck fracture: a developmental and experimental study.

    Science.gov (United States)

    Yuenyongviwat, Varah; Tuntarattanapong, Pakjai; Tangtrakulwanich, Boonsin

    2016-01-11

    Internal fixation is one treatment for femoral neck fracture. Some devices and techniques reported improved accuracy and decreased fluoroscopic time. However, these are not widely used nowadays due to the lack of available special instruments and techniques. To improve the surgical procedure, the authors designed a new adjustable drill guide and tested the efficacy of the device. The authors developed a new adjustable drill guide for cannulated screw guide wire insertion for multiple screw fixation. Eight orthopaedic surgeons performed the experimental study to evaluate the efficacy of this device. Each surgeon performed guide wire insertion for multiple screw fixation in six synthetic femurs: three times with the new device and three times with the conventional technique. The fluoroscopic time, operative time and surgeon satisfaction were evaluated. In the operations with the new adjustable drill guide, the fluoroscopic and operative times were significantly lower than the operations with the conventional technique (p level of satisfaction of this device was also statistically significantly better (p = 0.02) than the conventional technique. The fluoroscopic and operative times with the new adjustable drill guide were reduced for multiple screw fixation of femoral neck fracture and the satisfaction of the surgeons was good.

  3. Prostate Ultrasound

    Medline Plus

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

  4. Evaluation of ultrasound-guided vascular access in dogs.

    Science.gov (United States)

    Chamberlin, Scott C; Sullivan, Lauren A; Morley, Paul S; Boscan, Pedro

    2013-01-01

    To describe the technique and determine the feasibility, success rate, perceived difficulty, and time to vascular access using ultrasound guidance for jugular vein catheterization in a cardiac arrest dog model. Prospective descriptive study. University teaching hospital. Nine Walker hounds. A total of 27 jugular catheterizations were performed postcardiac arrest using ultrasound guidance. Catheterizations were recorded based on the order in which they were performed and presence/absence of a hematoma around the vein. Time (minutes) until successful vascular access and perceived difficulty in achieving vascular access (scale of 1 = easy to 10 = difficult) were recorded for each catheterization. Mean time to vascular access was 1.9 minutes (95% confidence interval, 1.1-3.4 min) for catheterizations without hematoma, versus 4.3 minutes (1.8-10.1 min) for catheterizations with hematoma (P = 0.1). Median perceived difficulty was 2 of 10 (range 1-7) for catheterizations without hematoma, versus 2 of 10 (range 1-8) for catheterizations with hematoma (P = 0.3). A learning curve was evaluated by comparing mean time to vascular access and perceived difficulty in initial versus subsequent catheterizations. Mean time to vascular access was 2.5 minutes (1.0-6.4 min) in the initial 13 catheterizations versus 3.3 minutes (1.5-7.5 min) in the subsequent 14 catheterizations (P = 0.6). Median perceived difficulty in the first 13 catheterizations (3, range 1-8) was significantly greater (P = 0.049) than median perceived difficulty in the subsequent 14 catheterizations (2, range 1-6). Ultrasound-guided jugular catheterization is associated with a learning curve but is successful in obtaining rapid vascular access in dogs. Further prospective studies are warranted to confirm the utility of this technique in a clinical setting. © Veterinary Emergency and Critical Care Society 2013.

  5. MR-guided focused ultrasound: a potentially disruptive technology.

    Science.gov (United States)

    Bradley, William G

    2009-07-01

    A disruptive technology is a technological innovation that overturns the existing dominant technologies in a market. Magnetic resonance (MR)-guided focused ultrasound (MRgFUS) is a noninvasive procedure based on the combination of real-time MR anatomic guidance, MR thermometry, and high-intensity focused ultrasound. Several hundred transducer elements become convergent at a point under MR guidance, leading to heating and coagulation necrosis. Outside the focal point, there is no significant heating. There is no need to break the skin for procedures in the body or to perform a craniotomy for procedures in the brain. This lack of invasiveness is what makes MRgFUS so disruptive compared with surgery. At present, MRgFUS has been used for the ablation of uterine fibroids, breast tumors, painful bony metastases, and liver tumors. In the brain, it has been used for the ablation of glioblastomas and for functional neurosurgery. Phantom and animal studies suggest future applications for prostate cancer and acute stroke treatment.

  6. Laparoscopic Ultrasound-Guided Radiofrequency Ablation of Uterine Fibroids

    International Nuclear Information System (INIS)

    Milic, Andrea; Asch, Murray R.; Hawrylyshyn, Peter A.; Allen, Lisa M.; Colgan, Terence J.; Kachura, John R.; Hayeems, Eran B.

    2006-01-01

    Four patients with symptomatic uterine fibroids measuring less than 6 cm underwent laparoscopic ultrasound-guided radiofrequency ablation (RFA) using multiprobe-array electrodes. Follow-up of the treated fibroids was performed with gadolinium-enhanced magnetic resonance imaging (MRI) and patients' symptoms were assessed by telephone interviews. The procedure was initially technically successful in 3 of the 4 patients and MRI studies at 1 month demonstrated complete fibroid ablation. Symptom improvement, including a decrease in menstrual bleeding and pain, was achieved in 2 patients at 3 months. At 7 months, 1 of these 2 patients experienced symptom worsening which correlated with recurrent fibroid on MRI. The third, initially technically successfully treated patient did not experience any symptom relief after the procedure and was ultimately diagnosed with adenomyosis. Our preliminary results suggest that RFA is a technically feasible treatment for symptomatic uterine fibroids in appropriately selected patients

  7. Ultrasound guided transrectal catheter drainage of pelvic collections.

    Science.gov (United States)

    Thakral, Anuj; Sundareyan, Ramaniwas; Kumar, Sheo; Arora, Divya

    2015-01-01

    The transrectal approach to draining deep-seated pelvic collections may be used to drain The transrectal approach to draining deep-seated pelvic collections may be used to drain intra-abdominal collections not reached by the transabdominal approach. We discuss 6 patients with such pelvic collections treated with transrectal drainage using catheter placement via Seldinger technique. Transrectal drainage helped achieve clinical and radiological resolution of pelvic collections in 6 and 5 of 6 cases, respectively. It simultaneously helped avoid injury to intervening bowel loops and neurovascular structures using real-time visualization of armamentarium used for drainage. Radiation exposure from fluoroscopic/CT guidance was avoided. Morbidity and costs incurred in surgical exploration were reduced using this much less invasive ultrasound guided transrectal catheter drainage of deep-seated pelvic collections.

  8. Ultrasound-guided block of the axillary nerve

    DEFF Research Database (Denmark)

    Rothe, C; Lund, J; Jenstrup, M T

    2012-01-01

    The specific blocking of the axillary nerve has never been investigated clinically. We present four cases illustrating potential applications of the axillary nerve block in the perioperative setting and discuss possible directions for future research in this area. The axillary nerve blocks were all...... performed using a newly developed in-plane ultrasound-guided technique. In one patient undergoing arthroscopic shoulder surgery, we used the axillary nerve block as the only analgesic combined with propofol sedation and spontaneous breathing. Chronic shoulder pain was eliminated after the axillary nerve...... block in two patients. The pain score after arthroscopic shoulder surgery in these two patients remained low until termination of the nerve block. In a fourth patient, severe post-operative pain after osteosynthesis of a displaced proximal humerus fracture was almost eliminated after performing...

  9. Inexpensive homemade models for ultrasound-guided vein cannulation training.

    Science.gov (United States)

    Di Domenico, Stefano; Santori, Gregorio; Porcile, Elisa; Licausi, Martina; Centanaro, Monica; Valente, Umberto

    2007-11-01

    To test the hypothesis that low-cost homemade models may be used to acquire the basic skills for ultrasound-guided central vein puncture. Training study. University transplantation department. Training was performed using three different homemade models (A, B, and C). Segments of a common rubber tourniquet (V1) and Silastic tube (V2) were used to simulate vessels within agar-based models. Overall cost for each model was less than 5 euro (US$7). For each test (test I, A-V1; II, A-V2; III, B-V1; IV, C-V2), the number of punctures and attempts needed to locate the needle inside the lumen were recorded. Each test was considered completed when participants punctured the vessels at the first attempt for three consecutive times. In test I, the mean number of punctures and attempts were 3.85 +/- 1.26 and 4.95 +/- 3.05; in test II, 4.60 +/- 1.14 and 6.30 +/- 2.51; in test III, 4.80 +/- 1.06 and 4.65 +/- 2.21; and in test IV, 4.45 +/- 1.23 and 6.05 +/- 2.92, respectively. For each test, no statistical difference was found by comparison of number of punctures and attempts for anesthesiologists versus nonanesthesiologists, men versus women, or previous experience versus no experience with central vein cannulation (CVC). Video game users obtained better results than did nonusers in test I (punctures, P = 0.033; attempts, P = 0.038), test II (punctures, P = 0.052; attempts, P = 0.011), and test IV (punctures, P = 0.001; attempts, P = 0.003). A posttraining questionnaire showed favorable opinions about the clarity of the instructions, aptness of the models, and adequacy of the training. In our operative unit, the use of ultrasound guidance for CVC increased from 2% to 23% in the first month after training. Low-cost homemade models are useful in acquiring basic coordination skills for ultrasound-guided CVC.

  10. Ultrasound guided versus landmark guided corticosteroid injection in patients with rotator cuff syndrome: Randomised controlled trial.

    Science.gov (United States)

    Bhayana, Himanshu; Mishra, Puneet; Tandon, Anupama; Pankaj, Amite; Pandey, Rohit; Malhotra, Raskesh

    2018-03-01

    Impingement syndrome is the most common differential in a patient presenting to an orthopaedic OPD with shoulder pain. Impingement syndrome is often managed with subacromial corticosteroid injection, which can be instilled using either landmark guided (LMG) approach or with the assistance of ultrasound (US). This study was envisaged to enquire whether ultrasound assistance improves the accuracy, efficacy or safety profile of the injection. 60 patients of rotator cuff syndrome underwent diagnostic ultrasound. They were randomly assigned to receive subacromial injection of 2 ml (40 mg/ml) methylprenisolone and 2 ml of 1% lignocaine combination either by US assistance (n = 30) or using LMG assistance (n = 30). The patients were evaluated before injection and on follow up visits at day 5, week 3, week 6 and 3rd month by a single assessor. The assessor was blinded of the treatment group to which patient belonged. Clinical assessment included demographic and clinical data, accuracy of injection, VAS (0-100) for pain, Constant score with goniometer evaluation of range of motion, patient's self assessment proforma and post injection side effects if any. Initial demographic, clinical and US findings in the groups exhibited no significant differences. The accuracy of US guided injections (100%) was more when compared from LMG injection (93.3%). Both VAS and Constant score showed significant improvement following steroid injection up to 3 months of follow up. However the differences in the two groups were not significant suggesting comparable efficacy of the two approaches. (Mean VAS score decrease: 27.23 for US and 25.16 for LMG, p guided injections have a higher accuracy of drug placement in the subacromial bursa, there is no difference in terms of clinical outcomes or safety profile of either of the method. Hence US guided injections seems to be unjustified, when compared to equally efficacious and cost effective LMG steroid injection.

  11. Anatomic landmarks of fluoroscopy guided puncture of the pulseless femoral artery

    International Nuclear Information System (INIS)

    Jeon, Min Hee; Han, Gi Seok; Kim, Sung Jin; Park, Kil Sun; Cha, Sang Hoon; Bae, Il Hun; Lee, Seung Young

    2006-01-01

    We wanted to improve puncturing the pulseless femoral artery by evaluating the anatomic landmarks that suggest the course of the femoral artery on fluoroscopy. We analyzed 37 hemipelvis spot images that were centered on the arterial sheath after puncture of the femoral artery. The inguinal angles were measured between the inguinal line connecting the anterior superior iliac spine and the symphysis pubis, and the line of the arterial sheath. Inguinal ligament ratios were measured as the distance from the symphysis pubis to the arterial sheath to the length of the inguinal ligament on the inguinal line. The femoral head ratios were measured as the distance from the medial margin of the femur head to the arterial sheath to the transverse length of the femur head. The mean inguinal angle was 66.5 and the mean inguinal ligament ratio was 0.42 (± 0.03). The mean femoral head ratio was 0.08 (± 0.18). In comparing the men and women, there was no significant difference in the inguinal angle and the femoral head ratio, but the inguinal distance ratio was larger in women (men: 0.41 ± 0.033, women: 0.44 ± 0.031, ρ < 0.05). The femoral artery generally courses just lateral to the medial margin of the femur head (femoral head ratio: 0.08) and the medial 40% of the inguinal ligament (inguinal ligament ratio: 0.42). So, consideration of these relations may be helpful for puncturing the pulseless femoral artery

  12. [Efficacy and safety of ultrasound-guided or neurostimulator-guided bilateral axillary brachial plexus block].

    Science.gov (United States)

    Xu, C S; Zhao, X L; Zhou, H B; Qu, Z J; Yang, Q G; Wang, H J; Wang, G

    2017-10-17

    Objective: To explore the efficacy and safety of bilateral axillary brachial plexus block under the guidance of ultrasound or neurostimulator. Methods: From February 2012 to April 2014, 120 patients undergoing bilateral hand/forearm surgery in Beijing Jishuitan Hospital were enrolled and anaesthetized with bilateral axillary brachial plexus block. All patients were divided into two groups randomly using random number table: the ultrasound-guided group (group U, n =60) and the neurostimulator-guidedgroup (group N, n =60). The block was performed with 0.5% ropivacaine. Patients' age, sex and operation duration were recorded. Moreover, success rate, performance time, onset of sensor and motor block, performance pain, patient satisfaction degree and the incidence of related complications were also documented. Venous samples were collected at selected time points and the total and the plasma concentrations of ropivacaine were analyzed with HPLC. Results: The performance time, the onset of sensor block and the onset of motor block of group U were (8.2±1.5), (14.2± 2.2)and (24.0±3.5)min respectively, which were markedly shorter than those in group N( (14.6±3.9), (19.9±3.8), (28.8±4.2)min, respectively), and the differences were statistically significant( t =11.74, 10.09, 6.73, respectively, all P 0.05). No analgesic was superadded and no other anesthesia methods were applied. No complications were detected perioperatively. Conclusions: The bilateral axillary brachial plexus block under the guidance of ultrasound or neurostimulator are both effective and safe for bilateral hand/forearm surgery. However, the ultrasound-guided block may be more clinically beneficial because of its shorter performance time, rapid onset and higher patient satisfaction degree.

  13. Ultrasound- versus palpation-guided injection of corticosteroid for plantar fasciitis: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Zonghuan Li

    Full Text Available It is controversial whether ultrasound-guided injection of corticosteroid is superior to palpation-guided injection for plantar fasciitis. This meta-analysis was performed to compare the effectiveness of ultrasound-guided and palpation-guided injection of corticosteroid for the treatment of plantar fasciitis.Databases (MEDLINE, Cochrane library and EMBASE and reference lists were searched from their establishment to August 30, 2013 for randomized controlled trials (RCTs comparing ultrasound-guided with palpation-guided injection for plantar fasciitis. The Cochrane risk of bias (ROB tool was used to assess the methodological quality. Outcome measurements were visual analogue scale (VAS, tenderness threshold (TT, heel tenderness index (HTI, response rate, plantar fascia thickness (PFT, hypoechogenicity and heel pad thickness (HPT. The statistical analysis was performed with software RevMan 5.2 and Stata 12.0. When I2<50%, the fixed-effects model was adopted. Otherwise the randomized-effects model was adopted. The Grading of Recommendations Assessment, Development and Evaluation (GRADE system was used to assess the quality of evidence.Five RCTs with 149 patients were identified and analyzed. Compared with palpation-guided injection, ultrasound-guided injection was superior with regard to VAS, TT, response rate, PFT and hypoechogenicity. However, there was no statistical significance between the two groups for HPT and HTI.Ultrasound-guided injection of corticosteroid tends to be more effective than palpation-guided injection. However, it needs to be confirmed by further research.

  14. Ultrasound- versus Palpation-Guided Injection of Corticosteroid for Plantar Fasciitis: A Meta-Analysis

    Science.gov (United States)

    Yu, Aixi; Qi, Baiwen

    2014-01-01

    Background It is controversial whether ultrasound-guided injection of corticosteroid is superior to palpation-guided injection for plantar fasciitis. This meta-analysis was performed to compare the effectiveness of ultrasound-guided and palpation-guided injection of corticosteroid for the treatment of plantar fasciitis. Methods Databases (MEDLINE, Cochrane library and EMBASE) and reference lists were searched from their establishment to August 30, 2013 for randomized controlled trials (RCTs) comparing ultrasound-guided with palpation-guided injection for plantar fasciitis. The Cochrane risk of bias (ROB) tool was used to assess the methodological quality. Outcome measurements were visual analogue scale (VAS), tenderness threshold (TT), heel tenderness index (HTI), response rate, plantar fascia thickness (PFT), hypoechogenicity and heel pad thickness (HPT). The statistical analysis was performed with software RevMan 5.2 and Stata 12.0. When I2<50%, the fixed-effects model was adopted. Otherwise the randomized-effects model was adopted. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to assess the quality of evidence. Results Five RCTs with 149 patients were identified and analyzed. Compared with palpation-guided injection, ultrasound-guided injection was superior with regard to VAS, TT, response rate, PFT and hypoechogenicity. However, there was no statistical significance between the two groups for HPT and HTI. Conclusion Ultrasound-guided injection of corticosteroid tends to be more effective than palpation-guided injection. However, it needs to be confirmed by further research. PMID:24658102

  15. Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology

    DEFF Research Database (Denmark)

    Dumonceau, J-M; Polkowski, M; Larghi, A

    2011-01-01

    This article is part of a combined publication that expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) about endoscopic ultrasound (EUS)-guided sampling in gastroenterology, including EUS-guided fine needle aspiration (EUS-FNA) and EUS-guided trucut biopsy (EU...

  16. Percutaneous ultrasound-guided renal biopsy: A Libyan experience

    Science.gov (United States)

    Mishra, A.; Tarsin, R.; ElHabbash, B.; Zagan, N.; Markus, R.; Drebeka, S.; AbdElmola, K.; Shawish, T.; Shebani, A.; AbdElmola, T.; ElUsta, A.; Ehtuish, E. F.

    2010-01-01

    This study was done to assess the safety and efficacy of ultrasound-guided percutaneous renal biopsy (PRB), to ascertain the risk factors for complications and determine the optimal period of observation. The radiologist (A.M.) at the National Organ Transplant Centre, Central Hospital, Tripoli, Libya, performed 86 PRBs between February 1, 2006, and January 31, 2008, using an automated biopsy gun with 16-gauge needle. Coagulation profile was done in all the patients. All patients were kept on strict bed rest for six hours post-procedure. Eighty six renal biopsies were performed on 78 patients referred from rheumatology department and eight post-kidney transplant recipients; 23 were males with age range 15 – 56 years and 63 females with age range 16 – 66 years. A mean of 17.5 glomeruli were present in each specimen. A glomerular yield of less than five glomeruli was seen in four biopsies. Class I lupus nephritis (LN) was seen in 1 patient, class II lupus nephritis in 7 patients, class III LN in 13 patients and class IV LN in 29 patients. All the eight renal allografts were diagnosed as acute tubular necrosis or acute interstitial rejection. The risk of post-biopsy bleeding was higher in women, older patients and higher PTT. The overall complication rate was 5.8%. Three complications were observed within six hours of biopsy. No late complication was seen. PRB under real-time ultrasound-guidance is a safe and efficacious procedure to establish the histological diagnosis and should be done as out-patient procedure. Observation time of six hours post-biopsy is optimal. PMID:20835320

  17. Ultrasound-guided lumpectomy of nonpalpable breast cancer versus wire-guided resection: a randomized clinical trial.

    NARCIS (Netherlands)

    Rahusen, F.D.; Bremers, A.J.A.; Fabry, H.F.; Taets van Amerongen, A.H.; Boom, R.P.; Meijer, S.

    2002-01-01

    BACKGROUND: The wire-guided excision of nonpalpable breast cancer often results in tumor resections with inadequate margins. This prospective, randomized trial was undertaken to investigate whether intraoperative ultrasound (US) guidance enables a better margin clearance than the wire-guided

  18. A simple tissue model for practicing ultrasound guided vascular ...

    African Journals Online (AJOL)

    Introduction: The use of ultrasound in anaesthetic practice continues to be more established and the use of ultrasound guidance in establishing vascular access is recommended by various groups. We have developed a tissue model for the practice and skills development in ultrasound vascular access. Method: The tissue ...

  19. Image-guided focused ultrasound ablation of breast cancer: current status, challenges, and future directions

    NARCIS (Netherlands)

    Schmitz, A.C.; Gianfelice, D.; Daniel, B.L.; Mali, W.P.T.M.; Bosch, M.A.A.J. van den

    2008-01-01

    Image-guided focussed ultrasound (FUS) ablation is a noninvasive procedure that has been used for treatment of benign or malignant breast tumours. Image-guidance during ablation is achieved either by using real-time ultrasound (US) or magnetic resonance imaging (MRI). The past decade phase I

  20. Musculoskeletal ultrasound: how to treat calcific tendinitis of the rotator cuff by ultrasound-guided single-needle lavage technique.

    Science.gov (United States)

    Lee, Kenneth S; Rosas, Humberto G

    2010-09-01

    The purpose of this video article is to illustrate the ultrasound appearance of calcium deposition in the rotator cuff and provide a detailed step-by-step protocol for performing the ultrasound-guided single-needle lavage technique for the treatment of calcific tendinitis with emphasis on patient positioning, necessary supplies, real-time lavage technique, and steroid injection into the subacromial subdeltoid bursa. Musculoskeletal ultrasound is well established as a safe, cost-effective imaging tool in diagnosing and treating common musculoskeletal disorders. Calcific tendinitis of the rotator cuff is a common disabling cause of shoulder pain. Although most cases are self-limiting, a subset of patients is refractory to conservative therapy and requires treatment intervention. Ultrasound-guided lavage is an effective and safe minimally-invasive treatment not readily offered in the United States as an alternative to surgery, perhaps because of the limited prevalence of musculoskeletal ultrasound programs and limited training. On completion of this video article, the participant should be able to develop an appropriate diagnostic and therapeutic algorithm for the treatment of calcific tendinitis of the rotator cuff using ultrasound.

  1. Comparative study between ultrasound guided TAP block and paravertebral block in upper abdominal surgeries

    Directory of Open Access Journals (Sweden)

    Ruqaya M Elsayed Goda

    2017-01-01

    Conclusion: We concluded that ultrasound guided transverses 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 transverses abdominis block.

  2. Ultrasound-Guided Intervention for Treatment of Trigeminal Neuralgia: An Updated Review of Anatomy and Techniques

    Directory of Open Access Journals (Sweden)

    Abdallah El-Sayed Allam

    2018-01-01

    Full Text Available Orofacial myofascial pain is prevalent and most often results from entrapment of branches of the trigeminal nerves. It is challenging to inject branches of the trigeminal nerve, a large portion of which are shielded by the facial bones. Bony landmarks of the cranium serve as important guides for palpation-guided injections and can be delineated using ultrasound. Ultrasound also provides real-time images of the adjacent muscles and accompanying arteries and can be used to guide the needle to the target region. Most importantly, ultrasound guidance significantly reduces the risk of collateral injury to vital neurovascular structures. In this review, we aimed to summarize the regional anatomy and ultrasound-guided injection techniques for the trigeminal nerve and its branches, including the supraorbital, infraorbital, mental, auriculotemporal, maxillary, and mandibular nerves.

  3. 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.

  4. Size and Ultrasound Features Affecting Results of Ultrasound-Guided Fine-Needle Aspiration of Thyroid Nodules.

    Science.gov (United States)

    Dong, YiJie; Mao, MinJing; Zhan, WeiWei; Zhou, JianQiao; Zhou, Wei; Yao, JieJie; Hu, YunYun; Wang, Yan; Ye, TingJun

    2017-11-09

    Our goal was to assess the diagnostic efficacy of ultrasound (US)-guided fine-needle aspiration (FNA) of thyroid nodules according to size and US features. A retrospective correlation was made with 1745 whole thyroidectomy and hemithyroidectomy specimens with preoperative US-guided FNA results. All cases were divided into 5 groups according to nodule size (≤5, 5.1-10, 10.1-15, 15.1-20, and >20 mm). For target nodules, static images and cine clips of conventional US and color Doppler were obtained. Ultrasound images were reviewed and evaluated by two radiologists with at least 5 years US working experience without knowing the results of pathology, and then agreement was achieved. The Bethesda category I rate was higher in nodules larger than 15 mm (P 20 mm) with several US features tended to yield false-negative FNA results. © 2017 by the American Institute of Ultrasound in Medicine.

  5. MR-guided focused ultrasound surgery, present and future

    Energy Technology Data Exchange (ETDEWEB)

    Schlesinger, David, E-mail: djs9c@virginia.edu [Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia 22908 and Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia 22908 (United States); Benedict, Stanley [Department of Radiation Oncology, University of California Davis, Davis, California 95817 (United States); Diederich, Chris [Department of Radiation Oncology, University of California San Francisco, San Francisco, California 94115 (United States); Gedroyc, Wladyslaw [Department of Medicine, Imperial College, London SW7 2AZ (United Kingdom); Klibanov, Alexander [Departments of Medicine, Cardiovascular Medicine, and Biomedical Engineering, University of Virginia, Charlottesville, Virginia 22908 (United States); Larner, James [Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia 22908 (United States)

    2013-08-01

    MR-guided focused ultrasound surgery (MRgFUS) is a quickly developing technology with potential applications across a spectrum of indications traditionally within the domain of radiation oncology. Especially for applications where focal treatment is the preferred technique (for example, radiosurgery), MRgFUS has the potential to be a disruptive technology that could shift traditional patterns of care. While currently cleared in the United States for the noninvasive treatment of uterine fibroids and bone metastases, a wide range of clinical trials are currently underway, and the number of publications describing advances in MRgFUS is increasing. However, for MRgFUS to make the transition from a research curiosity to a clinical standard of care, a variety of challenges, technical, financial, clinical, and practical, must be overcome. This installment of the Vision 20/20 series examines the current status of MRgFUS, focusing on the hurdles the technology faces before it can cross over from a research technique to a standard fixture in the clinic. It then reviews current and near-term technical developments which may overcome these hurdles and allow MRgFUS to break through into clinical practice.

  6. MR-guided focused ultrasound surgery, present and future

    International Nuclear Information System (INIS)

    Schlesinger, David; Benedict, Stanley; Diederich, Chris; Gedroyc, Wladyslaw; Klibanov, Alexander; Larner, James

    2013-01-01

    MR-guided focused ultrasound surgery (MRgFUS) is a quickly developing technology with potential applications across a spectrum of indications traditionally within the domain of radiation oncology. Especially for applications where focal treatment is the preferred technique (for example, radiosurgery), MRgFUS has the potential to be a disruptive technology that could shift traditional patterns of care. While currently cleared in the United States for the noninvasive treatment of uterine fibroids and bone metastases, a wide range of clinical trials are currently underway, and the number of publications describing advances in MRgFUS is increasing. However, for MRgFUS to make the transition from a research curiosity to a clinical standard of care, a variety of challenges, technical, financial, clinical, and practical, must be overcome. This installment of the Vision 20/20 series examines the current status of MRgFUS, focusing on the hurdles the technology faces before it can cross over from a research technique to a standard fixture in the clinic. It then reviews current and near-term technical developments which may overcome these hurdles and allow MRgFUS to break through into clinical practice

  7. MRI-guided cryoablation of the posterior femoral cutaneous nerve for the treatment of neuropathy-mediated sitting pain

    Energy Technology Data Exchange (ETDEWEB)

    Joshi, Dharmdev H.; Thawait, Gaurav K.; Fritz, Jan [Johns Hopkins University School of Medicine, Section of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Del Grande, Filippo [Johns Hopkins University School of Medicine, Section of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Ospedale Regionale di Lugano, Servizio di Radiologia, Lugano, Ticino (Switzerland)

    2017-07-15

    Neuropathy of the posterior femoral cutaneous nerve may manifest as pain and paresthesia in the skin over the inferior buttocks, posterior thigh, and popliteal region. Current treatment options include physical and oral pain therapy, perineural injections, and surgical neurectomy. Perineural steroid injections may provide short-term pain relief; however, to our knowledge, there is currently no minimally invasive denervation procedure for sustained pain relief that could serve as an alternative to surgical neurectomy. Percutaneous cryoablation of nerves is a minimally invasive technique that induces a sustained nerve conduction block through temporary freezing of the neural layers. It can result in long-lasting pain relief, but has not been described for the treatment of neuropathy-mediated PFCN pain. We report a technique of MR-guided cryoablation of the posterior femoral cutaneous nerve resulting in successful treatment of PFCN-mediated sitting pain. Cryoablation of the posterior femoral cutaneous nerve seems a promising, minimally invasive treatment option that deserves further investigation. (orig.)

  8. MRI-guided cryoablation of the posterior femoral cutaneous nerve for the treatment of neuropathy-mediated sitting pain

    International Nuclear Information System (INIS)

    Joshi, Dharmdev H.; Thawait, Gaurav K.; Fritz, Jan; Del Grande, Filippo

    2017-01-01

    Neuropathy of the posterior femoral cutaneous nerve may manifest as pain and paresthesia in the skin over the inferior buttocks, posterior thigh, and popliteal region. Current treatment options include physical and oral pain therapy, perineural injections, and surgical neurectomy. Perineural steroid injections may provide short-term pain relief; however, to our knowledge, there is currently no minimally invasive denervation procedure for sustained pain relief that could serve as an alternative to surgical neurectomy. Percutaneous cryoablation of nerves is a minimally invasive technique that induces a sustained nerve conduction block through temporary freezing of the neural layers. It can result in long-lasting pain relief, but has not been described for the treatment of neuropathy-mediated PFCN pain. We report a technique of MR-guided cryoablation of the posterior femoral cutaneous nerve resulting in successful treatment of PFCN-mediated sitting pain. Cryoablation of the posterior femoral cutaneous nerve seems a promising, minimally invasive treatment option that deserves further investigation. (orig.)

  9. Ultrasound-guided versus computed tomography-scan guided biopsy of pleural-based lung lesions.

    Science.gov (United States)

    Khosla, Rahul; McLean, Anna W; Smith, Jessica A

    2016-01-01

    Computed tomography (CT) guided biopsies have long been the standard technique to obtain tissue from the thoracic cavity and is traditionally performed by interventional radiologists. Ultrasound (US) guided biopsy of pleural-based lesions, performed by pulmonologists is gaining popularity and has the advantage of multi-planar imaging, real-time technique, and the absence of radiation exposure to patients. In this study, we aim to determine the diagnostic accuracy, the time to diagnosis after the initial consult placement, and the complications rates between the two different modalities. A retrospective study of electronic medical records was done of patients who underwent CT-guided biopsies and US-guided biopsies for pleural-based lesions between 2005 and 2014 and the data collected were analyzed for comparing the two groups. A total of 158 patients underwent 162 procedures during the study period. 86 patients underwent 89 procedures in the US group, and 72 patients underwent 73 procedures in the CT group. The overall yield in the US group was 82/89 (92.1%) versus 67/73 (91.8%) in the CT group (P = 1.0). Average days to the procedure was 7.2 versus 17.5 (P = 0.00001) in the US and CT group, respectively. Complication rate was higher in CT group 17/73 (23.3%) versus 1/89 (1.1%) in the US group (P guided biopsy is similar to that of CT-guided biopsy, with a lower complication rate and a significantly reduced time to the procedure.

  10. Review of magnetic resonance-guided focused ultrasound in the treatment of uterine fibroids

    Directory of Open Access Journals (Sweden)

    Pedro Felipe Magalhães Peregrino

    Full Text Available Uterine leiomyoma is the most frequently occurring solid pelvic tumor in women during the reproductive period. Magnetic resonance-guided high-intensity focused ultrasound is a promising technique for decreasing menorrhagia and dysmenorrhea in symptomatic women. The aim of this study is to review the role of Magnetic resonance-guided high-intensity focused ultrasound in the treatment of uterine fibroids in symptomatic patients. We performed a review of the MEDLINE and Cochrane databases up to April 2016. The analysis and data collection were performed using the following keywords: Leiomyoma, High-Intensity Focused Ultrasound Ablation, Ultrasonography, Magnetic Resonance Imaging, Menorrhagia. Two reviewers independently performed a quality assessment; when there was a disagreement, a third reviewer was consulted. Nineteen studies of Magnetic resonance-guided high-intensity focused ultrasound-treated fibroid patients were selected. The data indicated that tumor size was reduced and that symptoms were improved after treatment. There were few adverse effects, and they were not severe. Some studies have reported that in some cases, additional sessions of Magnetic resonance-guided high-intensity focused ultrasound or other interventions, such as myomectomy, uterine artery embolization or even hysterectomy, were necessary. This review suggests that Magnetic resonance-guided high-intensity focused ultrasound is a safe and effective technique. However, additional evidence from future studies will be required before the technique can be recommended as an alternative treatment for fibroids.

  11. Development and Implementation of an Ultrasound-Guided Peripheral Intravenous Catheter Program for Emergency Nurses.

    Science.gov (United States)

    Edwards, Courtney; Jones, Jodi

    2018-01-01

    Emergency medical care often necessitates placement of peripheral intravenous (PIV) catheters. When traditional methods for obtaining PIV access are not successful, ultrasound guidance is a rescue technique for peripheral vascular placement that improves the quality of patient care. The aim of this training program was to develop a process where emergency nurses would be competent to perform ultrasound guided PIV to improve the quality of patient care delivered while reducing throughput time. Administrative program development required creating a nursing practice statement, procedure guideline, operational plan, and competency validation. A training program comprising both didactic and hands-on training was developed and provided by emergency medicine physicians with formal ultrasound fellowship training. In determining whether the training program was adequate in preparing the student to place an ultrasound-guided PIV, 92.9% of students "agreed" or "strongly agreed." In having confidence in their ability to obtain an ultrasound guided PIV catheter placement, 35.7% of respondents "agreed" and 64.3% "strongly agreed." In finding it difficult to be successful in achieving ultrasound guided PIV catheter placement, 71.4% of students "strongly disagreed" and 14.3% "disagreed." All students (100%) felt it was a feasible task to train nurses to successfully place ultrasound-guided PIV catheters and 71.4% of students strongly support continuing to provide this training program and competency validation. Establishment of an effective didactic and hands-on training program resulted in emergency department nurses becoming competent in placement of ultrasound guided PIV catheters to provide optimal patient care. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  12. Glenohumeral joint injection: a comparative study of ultrasound and fluoroscopically guided techniques before MR arthrography.

    NARCIS (Netherlands)

    Rutten, M.J.; Collins, J.M.; Maresch, B.J.; Smeets, J.H.R.; Janssen, C.M.; Kiemeney, L.A.L.M.; Jager, G.J.

    2009-01-01

    To assess the variability in accuracy of contrast media introduction, leakage, required time and patient discomfort in four different centres, each using a different image-guided glenohumeral injection technique. Each centre included 25 consecutive patients. The ultrasound-guided anterior (USa) and

  13. Ultrasound Guided Nerve Root Injection in Patients with Cervical Spondylytic Radicular Pain

    Directory of Open Access Journals (Sweden)

    LT Choong

    2009-05-01

    Full Text Available Selective cervical nerve root injection using a mixture of corticosteroid and lignocaine is a treatment option for managing cervical radiculopathic pain. The procedure is usually performed under image guided fluoroscopy or Computerized Tomograhy. Ultrasound-guided cervical nerve root block does not expose the patients and personnel to radiation. During injection, the fluid is mostly visualized in a real-time fashion. This retrospective study reviewed the effectiveness of ultrasound in guiding cervical peri-radicular injection for pain relief in patients with recalcitrant cervical radiculopathy. There were no complications reported in this series.

  14. Success of ultrasound-guided versus landmark-guided arthrocentesis of hip, ankle, and wrist in a cadaver model.

    Science.gov (United States)

    Berona, Kristin; Abdi, Amin; Menchine, Michael; Mailhot, Tom; Kang, Tarina; Seif, Dina; Chilstrom, Mikaela

    2017-02-01

    The objectives of this study were to evaluate emergency medicine resident-performed ultrasound for diagnosis of effusions, compare the success of a landmark-guided (LM) approach with an ultrasound-guided (US) technique for hip, ankle and wrist arthrocentesis, and compare change in provider confidence with LM and US arthrocentesis. After a brief video on LM and US arthrocentesis, residents were asked to identify artificially created effusions in the hip, ankle and wrist in a cadaver model and to perform US and LM arthrocentesis of the effusions. Outcomes included success of joint aspiration, time to aspiration, and number of attempts. Residents were surveyed regarding their confidence in identifying effusions with ultrasound and performing LM and US arthrocentesis. Eighteen residents completed the study. Sensitivity of ultrasound for detecting joint effusion was 86% and specificity was 90%. Residents were successful with ultrasound in 96% of attempts and with landmark 89% of attempts (p=0.257). Median number of attempts was 1 with ultrasound and 2 with landmarks (p=0.12). Median time to success with ultrasound was 38s and 51s with landmarks (p=0.23). After the session, confidence in both US and LM arthrocentesis improved significantly, however the post intervention confidence in US arthrocentesis was higher than LM (4.3 vs. 3.8, p<0.001). EM residents were able to successfully identify joint effusions with ultrasound, however we were unable to detect significant differences in actual procedural success between the two modalities. Further studies are needed to define the role of ultrasound for arthrocentesis in the emergency department. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Ultrasound-guided injection of triamcinolone and bupivacaine in the management of De Quervain's disease.

    Science.gov (United States)

    Jeyapalan, Kanagaratnam; Choudhary, Surabhi

    2009-11-01

    The aim of this study was to describe the technique and usefulness of ultrasound-guided intrasynovial injection of triamcinolone and bupivacaine in treatment of de Quervain's disease. A total of 17 patients with symptomatic De Quervain's disease were included in this study. The procedure involved confirmation of diagnosis with ultrasound followed by guided injection of a mixture of 20 mg of triamcinolone (40 mg/ml) and 1 ml of 0.5% bupivacaine. Ultrasound guidance with a high resolution 15-Mhz footprint probe was used for injection into the first dorsal extensor compartment tendon sheath (E1). The response to ultrasound-guided injection was ascertained at the post procedure outpatient clinic appointment according to the follow-up clinic notes. There were 14 female and 3 male patients aged 29 to 74 years. Mean duration of symptoms was 8.9 months. One patient had an atypical septum in the first extensor compartment and the extensor pollicis brevis alone was involved. The mean post-injection follow-up was at 6.75 weeks. One patient was lost to follow-up. Fifteen out of 16 patients had significant symptomatic relief (93.75%). There were no immediate or delayed complications. Recurrence of symptoms was seen in 3 (20%) patients. Ultrasound-guided injection of triamcinolone and bupivacaine is safe and useful in controlling symptoms of De Quervain's disease. Correct needle placement with ultrasound guidance avoids intratendinous injection as well as local complications like fat atrophy and depigmentation.

  16. 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.

  17. Ultrasound-guided radiofrequency neurotomy in cervical spine: sonoanatomic study of a new technique in cadavers

    International Nuclear Information System (INIS)

    Lee, S.-H.; Kang, C.H.; Lee, S.-H.; Derby, R.; Yang, S.N.; Lee, J.E.; Kim, J.H.; Kim, S.S.; Lee, J.-H.

    2008-01-01

    Aim: To develop an ultrasound-guided technique for radiofrequency (RF) cervical medial branch neurotomy and to validate the accuracy of this new method. Materials and methods: Five non-embalmed, fresh cadavers were used; three male and two female cadavers with a median age at death of 67.2 years (range 50-84 years). This study was conducted in two parts. First, two of the cadavers were used to define the sonographic target point for RF cervical medial branch neurotomy using high-resolution ultrasound (12 to 5 MHz). The needles were guided to five consecutive cervical medial branches in the cadavers under ultrasound guidance. Subsequently, the position of the ultrasound-guided needle was verified using C-arm fluoroscopy. Ultrasound-guided RF neurotomy was performed to the C5 medial branches in all five cadavers. In the three cadavers not used in the first part of the study, ultrasound-guided RF neurotomy without C-arm fluoroscopic confirmation was performed to the C3-C7 medial branches. The accuracy of neurotomy was assessed by pathological examination of the cervical medial branches obtained through cadaver dissection. Results: In all five cadavers, the sonographic target point was identified in all C3-C7 segments with the 12 to 5 MHz linear transducer. In all 20 needle placements for the first and second cadavers, C-arm fluoroscopy validated proper needle tip positions. In all five cadavers, successful neurotomy was pathologically confirmed in 30 of 34 cervical medial branches. Conclusions: Ultrasound-guided cervical medial branch neurotomy was successfully performed in 30 of 34 cervical medial branches in five cadavers. However, before eliminating fluoroscopic validation of final needle tip positioning, the technique should be validated in symptomatic patients

  18. A long arm for ultrasound: a combined robotic focused ultrasound setup for magnetic resonance-guided focused ultrasound surgery.

    Science.gov (United States)

    Krafft, Axel J; Jenne, Jürgen W; Maier, Florian; Stafford, R Jason; Huber, Peter E; Semmler, Wolfhard; Bock, Michael

    2010-05-01

    Focused ultrasound surgery (FUS) is a highly precise noninvasive procedure to ablate pathogenic tissue. FUS therapy is often combined with magnetic resonance (MR) imaging as MR imaging offers excellent target identification and allows for continuous monitoring of FUS induced temperature changes. As the dimensions of the ultrasound (US) focus are typically much smaller than the targeted volume, multiple sonications and focus repositioning are interleaved to scan the focus over the target volume. Focal scanning can be achieved electronically by using phased-array US transducers or mechanically by using dedicated mechanical actuators. In this study, the authors propose and evaluate the precision of a combined robotic FUS setup to overcome some of the limitations of the existing MRgFUS systems. Such systems are typically integrated into the patient table of the MR scanner and thus only provide an application of the US wave within a limited spatial range from below the patient. The fully MR-compatible robotic assistance system InnoMotion (InnoMedic GmbH, Herxheim, Germany) was originally designed for MR-guided interventions with needles. It offers five pneumatically driven degrees of freedom and can be moved over a wide range within the bore of the magnet. In this work, the robotic system was combined with a fixed-focus US transducer (frequency: 1.7 MHz; focal length: 68 mm, and numerical aperture: 0.44) that was integrated into a dedicated, in-house developed treatment unit for FUS application. A series of MR-guided focal scanning procedures was performed in a polyacrylamide-egg white gel phantom to assess the positioning accuracy of the combined FUS setup. In animal experiments with a 3-month-old domestic pig, the system's potential and suitability for MRgFUS was tested. In phantom experiments, a total targeting precision of about 3 mm was found, which is comparable to that of the existing MRgFUS systems. Focus positioning could be performed within a few seconds

  19. 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

  20. The effect of ultrasound-guided compression immediately after transrectal ultrasound-guided prostate biopsy on postbiopsy bleeding: a randomized controlled pilot study.

    Science.gov (United States)

    Park, Bong Hee; Kim, Jung Im; Bae, Sang Rak; Lee, Yong Seok; Kang, Sung Hak; Han, Chang Hee

    2017-08-01

    To evaluate whether ultrasound-guided compression performed immediately after transrectal ultrasound (TRUS)-guided prostate biopsy decreases bleeding complications. We prospectively evaluated a total of 148 consecutive patients who underwent TRUS-guided prostate biopsy between March 2015 and July 2016. Systematic 12-core prostate biopsy was performed in all patients. Of these, 100 patients were randomly assigned to one of two groups: the compression group (n = 50) underwent TRUS-guided compression on bleeding biopsy tracts immediately after prostate biopsy, while the non-compression group (n = 50) underwent TRUS-guided prostate biopsy alone. The incidence rate and duration of hematuria, hematospermia, and rectal bleeding were compared between the two groups. The incidence rates of hematuria and hematospermia were not significantly different between the two groups (60 vs. 64%, p = 0.68; 22 vs. 30%, p = 0.362, respectively, for compression vs. non-compression group). The rectal bleeding incidence was significantly lower in the compression group as compared to the non-compression group (20 vs. 44%, p = 0.01). However, there were no significant differences in the median duration of hematuria, hematospermia, or rectal bleeding between the two groups (2, 8, and 2 days vs. 2, 10, and 1 days, p > 0.05, respectively, for compression vs. non-compression group). TRUS-guided compression [p = 0.004, odds ratio (OR) 0.25] and patient age (p = 0.013, OR 0.93) were significantly protective against the occurrence of rectal bleeding after prostate biopsy in multivariable analysis. Although it has no impact on other complications, ultrasound-guided compression on bleeding biopsy tracts performed immediately after TRUS-guided prostate biopsy is an effective and practical method to treat or decrease rectal bleeding.

  1. Urinary morbidity following ultrasound-guided transperineal prostate seed implantation

    International Nuclear Information System (INIS)

    Gelblum, Daphna Y.; Potters, Louis; Ashley, Richard; Waldbaum, Robert; Wang Xiaohong; Leibel, Steven

    1999-01-01

    Purpose: To assess the urinary morbidity experienced by patients undergoing ultrasound-guided, permanent transperineal seed implantation for adenocarcinoma of the prostate. Methods and Materials: Between September 1992 and September 1997, 693 consecutive patients presented with a diagnosis of clinically localized adenocarcinoma of the prostate, and were treated with ultrasound-guided transperineal interstitial permanent brachytherapy (TPIPB). Ninety-three patients are excluded from this review, having received neoadjuvant antiandrogen therapy. TPIPB was performed with 125 I in 165 patients and with 103 Pd in 435 patients. Patients treated with implant alone received 160 Gy with 125 I (pre TG43) or 120 Gy with 103 Pd. One hundred two patients received preimplant, pelvic external beam radiation (XRT) to a dose of either 41.4 or 45 Gy because of high-risk features including PSA ≥ 10 and/or Gleason score ≥ 7. Combined modality patients received 120 Gy and 90 Gy, respectively for 125 I or 103 Pd. All patients underwent postimplant cystoscopy and placement of an indwelling Foley catheter for 24-48 h. Follow-up was at 5 weeks after implant, every 3 months for the first 2 years, and then every 6 months for subsequent years. Patients completed AUA urinary symptom scoring questionnaires at initial consultation and at each follow-up visit. Urinary toxicity was classified by the RTOG toxicity scale with the following adaptations; grade 1 urinary toxicity was symptomatic nocturia or frequency requiring none or minimal medical intervention such as phenazopyridine; grade 2 urinary toxicity was early obstructive symptomatology requiring alpha-blocker therapy; and grade 3 toxicity was considered that requiring indwelling catheters or posttreatment transurethral resection of the prostate for symptom relief. Log-rank analysis and Chi-square testing was performed to assess AUA score, prostate size, isotope selection, and the addition of XRT as possible prognosticators of

  2. General Ultrasound Imaging

    Medline Plus

    Full Text Available ... guide biopsy of breast cancer ( see the Ultrasound-Guided Breast Biopsy page . diagnose a variety of heart ... Articles and Media Angioplasty and Vascular Stenting Ultrasound-Guided Breast Biopsy Obstetric Ultrasound Ultrasound - Prostate Biopsies - Overview ...

  3. A practical guide to ultrasound in obstetrics and gynecology

    International Nuclear Information System (INIS)

    Sauerbrei, E.E.; Nguyen, K.T.; Nolan, R.L.

    1986-01-01

    This book reviews the indications for ultrasound during pregnancy and establishes guidelines for conducting obstetrical ultrasound examinations. A selection of scans follows. These scans depict normal female pelvic anatomy; the nongravid uterus; the ovaries and adnexae; early pregnancy (the embryonic period); the placenta; the membranes, amniotic fluid, and umbilical cord; the uterus and adnexae in pregnancy; and the fetus. The book contains information on making accurate fetal measurements and calculations

  4. A successful model to learn and implement ultrasound-guided venous catheterization in apheresis.

    Science.gov (United States)

    Gopalasingam, Nigopan; Thomsen, Anna-Marie Eller; Folkersen, Lars; Juhl-Olsen, Peter; Sloth, Erik

    2017-12-01

    Apheresis treatments can be performed with peripheral venous catheters (PVC), although central venous catheters (CVC) are inserted when PVCs fail or patient with history of difficult vascular access prior to the apheresis. Ultrasound guidance for PVC has shown promising results in other settings. To investigate if ultrasound guidance for PVC could be implemented among apheresis nurses. Second, how implementation of ultrasound guidance affected the number of CVCs used for apheresis per patient. Apheresis nurses completed a systematic training program for ultrasound-guided vascular access. All independent catheterizations were registered during the implementation stage. The number of CVCs in the pre- and postimplementation stages of the ultrasound guidance was compared. Six nurses completed the training program within a median of 48 days (range 38-83 days). In 77 patients, 485 independent ultrasound-guided PVC placements were performed during the implementation stage. All apheresis treatments (485/485) were accomplished using PVCs without requiring CVC as rescue. During the preimplementation stage, 125 of 273 (45.8%) procedures required a CVC for completion of apheresis procedures; during the postimplementation stage only 30 of 227 (13.2%) procedures required a CVC (p < 0.001). In the postimplementation stage, no CVCs were placed as rescue caused by failed PVCs but were only placed for patients where the ultrasound machine was unavailable. It indicates an effective success rate of 100% for ultrasound-guided PVC use. This study showed that ultrasound guidance could be implemented among apheresis nurses as a routine tool eliminating the need of CVC as a rescue. © 2017 Wiley Periodicals, Inc.

  5. Noninvasive Label-Free Detection of Micrometastases in the Lymphatics with Ultrasound-Guided Photoacoustic Imaging

    Science.gov (United States)

    2015-10-01

    imaging can be used to guide dissection. We have also successfully integrated a programmable ultrasound machine ( Verasonics Vantage ) and tunable pulsed...Mobile HE) with the programmable ultrasound machine ( Verasonics Vantage ). We have synchronized the signals to enable interleaved acquisition of US...transducer (L11-4v, Verasonics Inc.) and build a housing which effectively couples fiber optic light delivery. o What opportunities for training and

  6. Standards of the Polish Ultrasound Society – update. Ultrasound examination of thyroid gland and ultrasound-guided thyroid biopsy

    Directory of Open Access Journals (Sweden)

    Anna Trzebińska

    2014-03-01

    Full Text Available Ultrasonography is a primary imaging technique in patients with suspected thyroid disease. It allows to assess the location, size and echostructures of the thyroid gland as well as detect focal lesions, along with indication of their size, echogenicity, echostructure and vascularity. Based on these features, ultrasound examination allows to predict abnormal focal lesions for biopsy and monitor the biopsy needle track. This paper presents the standards of thyroid ultrasound examination regarding ultrasound apparatus technical requirements, scanning techniques, readings, measurements, and the description of the examination. It discusses the ultrasound features of increased malignancy risk in focal lesions (nodules found in the thyroid gland. It presents indications for fine needle aspiration biopsy of the thyroid gland for the visibility of single nodules (focal lesions and numerous lesions as well as discusses contraindications for thyroid biopsy. It describes the biopsy technique, possible complications and rules for post-biopsy monitoring of benign lesions. The paper is an update of the Standards of the Polish Ultrasound Society issued in 2011. It has been prepared on the basis of current literature, taking into account the information contained in the following publications: Thyroid ultrasound examination and Recommendations of the Polish Ultrasound Society for the performance of the FNAB of the thyroid.

  7. Ultrahigh-resolution ultrasound characterization of access site trauma and intimal hyperplasia following use of a 7F sheathless guide versus 6F sheath/guide combination for transradial artery PCI: Results of the PRAGMATIC trial.

    Science.gov (United States)

    Batchelor, Wayne; Dahya, Vishal; McGee, Dan; Katopodis, John; Dixon, William; Campbell, James; Meredith, Ashley; Knap, Patty; Parkin, Mathew; Noel, Thomas

    2018-04-01

    There exist limited data on the relative degree of acute injury and late healing of the radial artery after transradial artery (TRA) percutaneous coronary intervention (PCI) with a 7F sheathless guide catheter compared with a 6F sheath/guide combination. We used ultrahigh-resolution (55 MHz) vascular ultrasound to compare intimal-medial thickening (IMT) and early and late radial artery (RA) injury resulting from a sheathless 7F guide catheter versus a 6F sheath/guide combination for TRA-PCI. Forty-one consecutive consenting patients undergoing elective nonemergent TRA-PCI at a single institution from June 2016 to December 2016 were included. Patients were randomized (stratified by sex) to undergo TRA-PCI using a 7F sheathless guide catheter versus a 6F sheath/6F guide combination. Ultrahigh-resolution vascular ultrasound (55MHz) of the RA access site was performed at 24hours and 90days post-TRA-PCI. The primary outcome of the study was a noninferiority comparison of radial artery IMT thickness at 90days. PCI success rates, fluoroscopy times, number of guides used, and crossover rates to a femoral approach were also compared. Baseline characteristics were similar between groups. Radial arterial IMT (mm) was similar between the 7F sheathless and 6F sheath/guide groups at 24hours (0.27 vs 0.29, respectively; P=.43) and at 90days (0.35 vs 0.34, respectively; P=.96). The P value for the noninferiority testing of a 0.07-mm limit was .002. Limited access site intimal tears were relatively common in both groups at 24hours (4 vs 5, P=.53) but often healed by 90days. Radial artery occlusion was infrequent at 90days (2 vs 1, P=.10), and no frank dissections were noted. PCI success rates (100% vs 95%, P=.59), fluoroscopy times (16 vs 12minutes, P=.17), number of guides used (1.1 vs 1.2, P=.48), and femoral crossover rates (0% vs 0%) were similar between the 2 respective groups. A 7F sheathless approach to TRA-PCI results in no more IMT and early or late RA trauma than a

  8. Ultrasound-guided thoracenthesis: the V-point as a site for optimal drainage positioning.

    Science.gov (United States)

    Zanforlin, A; Gavelli, G; Oboldi, D; Galletti, S

    2013-01-01

    In the latest years the use of lung ultrasound is increasing in the evaluation of pleural effusions, because it makes follow-up easier and drainage more efficient by providing guidance on the most appropriate sampling site. However, no standardized approach for ultrasound-guided thoracenthesis is actually available. To evaluate our usual ultrasonographic landmark as a possible standard site to perform thoracenthesis by assessing its value in terms of safety and efficiency (success at first attempt, drainage as complete as possible). Hospitalized patients with non organized pleural effusion underwent thoracenthesis after ultrasound evaluation. The point showing on ultrasound the maximum thickness of the effusion ("V-point") was chosen for drainage. 45 ultrasound guided thoracenthesis were performed in 12 months. In 22 cases there were no complications; 16 cases of cough, 2 cases of mild dyspnea without desaturation, 4 cases of mild pain; 2 cases of complications requiring medical intervention occurred. No case of pneumothorax related to the procedure was detected. In all cases drainage was successful on the first attempt. The collected values of maximum thickness at V-point (min 3.4 cm - max 15.3 cm) and drained fluid volume (min 70 ml - max 2000 ml) showed a significative correlation (p measure of the maximum thickness at V-point provides high efficiency to ultrasound guided thoracentesis and allows to estimate the amount of fluid in the pleural cavity. It is also an easy parameter that makes the proposed method quick to learn and apply.  

  9. [An easy, safe and affective method for the treatment of intussusception: ultrasound-guided hydrostatic reduction].

    Science.gov (United States)

    Ülger, Fatma Esra Bahadır; Ülger, Aykut; Karakaya, Ali Erdal; Tüten, Fatih; Katı, Ömer; Çolak, Mustafa

    2014-03-01

    Intussusception is one of the important causes of intestinal obstruction in children. Hydrostatic reduction under ultrasound guidance is a popular treatment method for intussusception. In the present study, we aimed to explain the demographic characteristics of and treatment approaches in patients diagnosed with intussusception by ultrasound. Forty-one patients diagnosed with intussusception by ultrasound between August 2011 and May 2013 were retrospectively analyzed. Twenty-four of these patients who had no contraindications had been treated with ultrasound-guided hydrostatic reduction. Twenty-four of the patients were male and 17 were female, a 1.4/1 male-to-female ratio. The majority of the patients were between the ages of 6-24 months and 2-5 years. The mean age was 31.12±26.32 months (range 3-125). Patients were more frequently diagnosed in April and May. Seventeen patients who had clinical contraindications enrolled directly for surgery. In 20 of the 24 patients who underwent ultrasound-guided hydrostatic reduction, reduction was achieved. Three experienced recurrence. In two of these patients, successful reduction was achieved with the second attempt. The remaining patient was enrolled for surgery. Hydrostatic reduction was performed 26 times on these 24 patients, and in 22, success was achieved (84.6%). No procedure-related complications occurred in the patients. Ultrasound-guided hydrostatic reduction, with its high success rates and lack of radiation risk, should be the first choice therapeutic approach for children diagnosed with intussusception.

  10. Contrast-enhanced ultrasound-guided radiofrequency ablation in inconspicuous hepatocellular carcinoma on B-mode ultrasound.

    Science.gov (United States)

    Kim, Eui Joo; Kim, Yun Soo; Shin, Seung Kak; Kwon, Oh Sang; Choi, Duck Joo; Kim, Ju Hyun

    2017-11-01

    B-mode ultrasound (US) has difficulty targeting small hepatocellular carcinomas (HCCs) with poor conspicuity during radiofrequency ablation (RFA). Contrast-enhanced ultrasound (CEUS) can improve visualization of small or inconspicuous HCCs. This study was conducted to evaluate the effectiveness of CEUS-guided RFA electrode insertion during the arterial phase in inconspicuous HCCs. Ninety-three treatment-naïve HCCs from 80 patients treated with RFA from August 2012 to December 2014 were retrospectively reviewed. Seventy-five HCCs from 65 patients underwent B-mode US-guided RFA, and 15 HCCs from 14 patients that were inconspicuous on B-mode US underwent CEUS-guided RFA during the arterial phase after injection of sulfur hexafluoride microbubbles (SonoVue®). Technical success was assessed by contrast-enhanced computed tomography within 1 week and 3 months after the procedure. The mean size of HCCs treated with CEUS-guided RFA was smaller than that of HCCs treated with B-mode US-guided RFA (1.17±0.36 vs. 1.63±0.55 cm, p=0.003). Technical success rates of CEUS-guided RFA within 1 week and 3 months were 100% (15/15) and 93.3% (14/15), respectively. Technical success rates of B-mode US-guided RFA were 97.3% (73/75) and 94.5% (69/73), respectively. CEUS-guided RFA is highly efficacious for ablation of very small and inconspicuous HCCs.

  11. 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.

  12. 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.

  13. Disinfection of a probe used in ultrasound-guided prostate biopsy.

    Science.gov (United States)

    Rutala, William A; Gergen, Maria F; Weber, David J

    2007-08-01

    Transrectal ultrasound (TRUS)-guided prostate biopsies are among the most common outpatient diagnostic procedures in urology clinics and carry the risk of introducing pathogens that may lead to infection. To investigate the effectiveness of procedures for disinfecting a probe used in ultrasound-guided prostate biopsy. The effectiveness of disinfection was determined by inoculating 10(7) colony forming units (cfu) of Pseudomonas aeruginosa at the following 3 sites on the probe: the interior lumen of the biopsy needle guide, the outside surface of the biopsy needle guide, and the interior lumen of the ultrasound probe where the needle guide passes through the transducer. Each site was investigated separately. After inoculation, the probe was immersed in 2% glutaraldehyde for 20 minutes and then assessed for the level of microbial contamination. The results demonstrated that disinfection (ie, a reduction in bacterial load of greater than 7 log(10) cfu) could be achieved if the needle guide was removed from the probe. However, if the needle guide was left in the probe channel during immersion in 2% glutaraldehyde, disinfection was not achieved (ie, the reduction was approximately 1 log(10) cfu). Recommendations for probe disinfection are provided and include disassembling the device and immersing the probe and the needle guide separately in a high-level disinfectant.

  14. Ultrasound Guided Needle Aspiration versus Surgical Drainage in the management of breast abscesses: a Ugandan experience

    Directory of Open Access Journals (Sweden)

    Chandika Alphonce B

    2012-01-01

    Full Text Available Abstract Background Despite breast abscess becoming less common in developed countries, it has remained one of the leading causes of morbidity in women in developing countries. A randomized controlled trial was conducted at Mulago hospital complex in Kampala Uganda to establish whether ultrasound guided needle aspiration is a feasible alternative treatment option for breast abscesses. Results A total of 65 females with breast abscess were analyzed, of these 33 patients were randomized into the ultrasound guided needle aspiration and 32 patients in the Incision and drainage arm. The mean age was 23.12, most of them were lactating (66.2%, primipararous (44.6% with peripheral abscesses (73.8% located in the upper lateral quadrant (56%.The mean breast size was 3.49 cm. The two groups were comparably in demographic characteristic and breast abscess size. Survival analysis showed no difference in breast abscess healing rate between the two groups (Log rank 0.24 df 1 and P = 0.63. Incision and drainage was found to be more costly than ultrasound guided aspiration (cost effective ratio of 2.85. Conclusion Ultrasound guided needle aspiration is therefore a feasible and cost effective treatment option for both lactating and non lactating breast abscesses with a diameter up to 5 cm by ultrasound in an immune competent patient

  15. Ultrasound guided TAP block versus ultrasound guided caudal block for pain relief in children undergoing lower abdominal surgeries

    Directory of Open Access Journals (Sweden)

    Wafaa Mohamed Alsadek

    2015-04-01

    Conclusion: TAP block and caudal block under ultrasound guidance proved to be safe with no recorded complications either intra or postoperatively. Patient and parent satisfaction was markedly observed in case of TAP block.

  16. Comparison of the femoral neck bone density, quantitative ultrasound and bone density of the heel between dominant and non-dominant side

    Energy Technology Data Exchange (ETDEWEB)

    Meszaros, Szilvia [First Department of Internal Medicine, Faculty of Medicine, Semmelweis University, Koranyi Sandor Str. 2/a, Budapest H-1083 (Hungary); Ferencz, Viktoria [First Department of Internal Medicine, Faculty of Medicine, Semmelweis University, Koranyi Sandor Str. 2/a, Budapest H-1083 (Hungary); Csupor, Emoke [Health Service, Budavar Local Authorities, Budapest (Hungary); Mester, Adam [Department of Radiology and Oncotherapy, Faculty of Medicine, Semmelweis University, Budapest (Hungary); Hosszu, Eva [Second Department of Paediatrics, Faculty of Medicine, Semmelweis University, Budapest (Hungary); Toth, Edit [Department of Reumatology, Ferenc Flor County Hospital, Kerepestarcsa (Hungary); Horvath, Csaba [First Department of Internal Medicine, Faculty of Medicine, Semmelweis University, Koranyi Sandor Str. 2/a, Budapest H-1083 (Hungary)]. E-mail: horcsa@bel1.sote.hu

    2006-11-15

    Our study was initiated to evaluate whether there are differences between the two sides, depending on hand dominance, in densitometry values and quantitative ultrasound parameters (QUS) of the lower limb. One hundred and six women and 44 men were involved. The hand dominance was determined by interview. The bone mineral density (BMD) of the left and the right femoral necks and the calcanei were measured by dual-energy X-ray absorpiometry (DXA). The QUS examination consisted of measuring the attenuation (BUA), the speed of the ultrasound (SOS) and quantitative ultrasound index (QUI) transversing the left and right calcanei. The density of the neck of femur of the non-dominant side did not differ from that of the dominant side. On the other hand, BMD, BUA and the QUI of the calcaneus were higher on the non-dominant side in both genders (p < 0.05 for each parameter). No similar differences were seen for the SOS values. Our study has confirmed the side-to-side differences of the calcaneus in both genders, lower values were found on the dominant side. No similar differences were seen on the femur. The AUC values seemed to be higher on the dominant side, however, these differences were not strictly significant. In the case of peripheral site (heel) measurements, the practical significance of our observations is that they raise the possibility of performing peripheral DXA and QUS examinations of the calcaneus on the dominant side of the patient according to handedness.

  17. Spread of Injectate Around Hip Articular Sensory Branches of the Femoral Nerve in Cadavers

    DEFF Research Database (Denmark)

    Nielsen, Niels Dalsgaard; Greher, Manfred; Moriggl, Bernhard

    2018-01-01

    of the femoral nerve. Methods: Fifteen cadaver sides were injected with 5 mL dye in the iliopsoas plane guided by ultrasound. Dissection was performed to verify the spread of injectate around the hip articular branches of the femoral nerve. Results: In 10 dissections (67% [95% confidence interval: 38.......2-32%]) adhesions partially obstructed the spread of dye. Conclusion: An injection of 5 mL in the iliopsoas plane spreads around all hip articular branches of the femoral nerve in 10 of 15 cadaver sides. If these findings translate to living humans, injection of local anaesthetic into the iliopsoas plane could...

  18. Targeted Ultrasound-Guided Perineural Hydrodissection of the Sciatic Nerve for the Treatment of Piriformis Syndrome.

    Science.gov (United States)

    Burke, Christopher J; Walter, William R; Adler, Ronald S

    2018-05-01

    Piriformis syndrome is a common cause of lumbar, gluteal, and thigh pain, frequently associated with sciatic nerve symptoms. Potential etiologies include muscle injury or chronic muscle stretching associated with gait disturbances. There is a common pathological end pathway involving hypertrophy, spasm, contracture, inflammation, and scarring of the piriformis muscle, leading to impingement of the sciatic nerve. Ultrasound-guided piriformis injections are frequently used in the treatment of these pain syndromes, with most of the published literature describing injection of the muscle. We describe a safe, effective ultrasound-guided injection technique for the treatment of piriformis syndrome using targeted sciatic perineural hydrodissection followed by therapeutic corticosteroid injection.

  19. Ultrasound guided percutaneous fine needle aspiration biopsy of the liver with focal lesion

    International Nuclear Information System (INIS)

    Ko, Gang Seok; Yang, Hyun Cheol; Park, Byoung Lan; Kim, Byoung Geun; Sohn, Jang Sihn

    1985-01-01

    The ultrasound-guided fine needle aspirations were performed in order to diagnose a suspected neoplastic or infectious disease in 52 patients with focal liver disease. Of these, neoplastic lesions were suspected in 31 patients and infectious lesions in 21 patients ultrasonically and/or clinically. The overall accuracy for both suspected malignant and infectious disease was 79% (41/52). The primary indication for fine needle aspiration was to document the presence of malignancy and to avoid a diagnostic laparotomy, and to drain hepatic abscess. Consequently we were convinced that the ultrasound-guided percutaneous fine needle aspiration biopsy in the focal liver disease is the best method for a conclusive diagnosis

  20. 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.

  1. Ultrasound-guided hydrostatic reduction of intestinal intussusception: description of three cases

    Directory of Open Access Journals (Sweden)

    Martha Hanemann Kim

    2008-09-01

    Full Text Available With the objective of reporting the technique of ultrasound-guided hydrostatic reduction of intestinal intussusception, three cases with confirmed diagnosis of the disease submitted to reduction with this technique are described. All cases had successful reductions with no complications. One patient experienced a recurrence of the invagination eight days after treatment, which was surgically corrected. The technique of hydrostatic reversal of intestinal intussusception guided by ultrasound may be used in place of the conventional barium enema, since it is a minimally invasive and safe method, with high rates of success and few complications.

  2. Ultrasound-Guided Single-Injection Infraclavicular Block Versus Ultrasound-Guided Double-Injection Axillary Block: A Noninferiority Randomized Controlled Trial.

    Science.gov (United States)

    Boivin, Ariane; Nadeau, Marie-Josée; Dion, Nicolas; Lévesque, Simon; Nicole, Pierre C; Turgeon, Alexis F

    2016-01-01

    Single-injection ultrasound-guided infraclavicular block is a simple, reliable, and effective technique. A simplified double-injection ultrasound-guided axillary block technique with a high success rate recently has been described. It has the advantage of being performed in a superficial and compressible location, with a potentially improved safety profile. However, its effectiveness in comparison with single-injection infraclavicular block has not been established. We hypothesized that the double-injection ultrasound-guided axillary block would show rates of complete sensory block at 30 minutes noninferior to the single-injection ultrasound-guided infraclavicular block. After approval by our research ethics committee and written informed consent, adults undergoing distal upper arm surgery were randomized to either group I, ultrasound-guided single-injection infraclavicular block, or group A, ultrasound-guided double-injection axillary block. In group I, 30 mL of 1.5% mepivacaine was injected posterior to the axillary artery. In group A, 25 mL of 1.5% mepivacaine was injected posteromedial to the axillary artery, after which 5 mL was injected around the musculocutaneous nerve. Primary outcome was the rate of complete sensory block at 30 minutes. Secondary outcomes were the onset of sensory and motor blocks, surgical success rates, performance times, and incidence of complications. All outcomes were assessed by a blinded investigator. The noninferiority of the double-injection ultrasound-guided axillary block was considered if the limits of the 90% confidence intervals (CIs) were within a 10% margin of the rate of complete sensory block of the infraclavicular block. At 30 minutes, the rate of complete sensory block was 79% in group A (90% CI, 71%-85%) compared with 91% in group I (90% CI, 85%-95%); the upper limit of CI of group A is thus included in the established noninferiority margin of 10%. The rate of complete sensory block was lower in group A (proportion

  3. 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 core needle biopsy (9/179, 5.0%) than with ultrasound guided-fine needle aspiration (9/1138, 0.8%) (P core needle biopsy was the only significant risk factor for post-biopsy hematoma (adjusted Odds Ratio, 6.458, P 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.

  4. The role of ultrasound-guided triamcinolone injection in the treatment of de Quervain's disease: treatment and a diagnostic tool?

    NARCIS (Netherlands)

    Hajder, E.; de Jonge, M. C.; van der Horst, C. M. A. M.; Obdeijn, M. C.

    2013-01-01

    The purpose of this study was to describe the technique and usefulness of ultrasound-guided intrasheath injection of triamcinolone in the treatment of de Quervain's disease (dQD). Our study was retrospective in design. Seventy-one wrists of 62 patients who were treated with an ultrasound-guided

  5. An Evaluation of Complications in Ultrasound-Guided Central Venous Catheter Insertion in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Engin OZAKIN

    2014-06-01

    Full Text Available SUMMARY: Objectives: In emergency departments, emergency physicians frequently have to perform central venous access. In cases where peripheral venous access is not possible, central venous access is required for dialysis, fulfillment of urgent fluid need, or central venous pressure measurement. This study was carried out to evaluate the emergence of complications in the process of and in the 15 days following the insertion of central venous catheter under ultrasound guidance in the emergency department. Methods: For this study, patients who presented to the emergency department over a period of eight months with an urgent need for central catheter were examined prospectively. Age, gender, and accompanying diseases of patients as well as the type, time, duration, and indication of the venous access were recorded. Furthermore, the amount of experience of the physician was taken into consideration. Results: In the emergency department, physicians performed ultrasound-guided central venous catheter insertion for 74 patients (40 men and 34 women. For access, internal jugular vein was used in 65 (87.8% patients, and femoral vein was used in 9 (12.2% patients. The reason for access was urgent dialysis need in 55 (74.3%, CVP measurement in 3 (4.1%, fluid support due to severe hypovolemia in 6 (8.1%, and difficulty of peripheral venous access in 10 (13.5% patients. None of the patients developed complications in the process of or after the insertion. Patients did not have infections related to the catheter in 15 days following the insertion. Conclusions: Central venous access is frequently required in emergency departments. The risk of complication is little if any in ultrasonographyguided access carried out under appropriate conditions. ÖZET: Amaç: Acil servislerde acil tıp hekimlerince santral damar yolu işlemi sık uygulanır. Periferik damar yolu açılamadığı hallerde, diyaliz, acil sıvı ihtiyacı veya santral venöz basınç

  6. 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.

  7. Yield and Safety Profile of Ultrasound Guided Fine Needle Aspiration Cytology (FNAC) of Lymph Nodes

    International Nuclear Information System (INIS)

    Sattar, A.; Wahab, S.; Javed, A.; Shamim, S. H.

    2016-01-01

    Objective: To determine the re-biopsy rate, positive yield and safety profile of ultrasound guided fine needle aspiration cytology (FNAC) in cervical lymph nodes in terms of its complications and repeat procedures. Study Design: An analytical study. Place and Duration of Study: Department of Vascular and Interventional Radiology, Dow University Hospital, Dow University of Health Sciences, Karachi, from June to December 2013. Methodology: Eighty neck swellings, which were found to be lymph nodes on ultrasound, underwent ultrasound guided FNAC, from outpatients. Lymph nodes which were included in the study were those that were not easily palpable, located near major blood vessels, where patient refused of direct palpation and wanted image guided FNAC, those directly sent by physician for image guided FNAC and where blind biopsy remained inconclusive. Patients who refused on explanation or did not give consent were excluded. Complications and repeat biopsy were noted. Result: This study consisted of 80 cases, of which 51 cases (63.75 percentage) were female and 29 cases (36.25 percentage) were male. Repeat biopsy was required in 1 case (1.6 percentage). There were no procedure-related complications. A total of 44 cases (55 percentage) revealed evidence suggesting or confirming the existence of tuberculosis. Rest of the others showed other benign lesions, reactive lymphadenopathy and malignancy. Conclusion: Ultrasound guided FNAC is a safe procedure with low re-biopsy rate that aids diagnosis. The predominant cause of cervical lymphadenopathy in this study was tuberculous lymphadenitis. (author)

  8. Evaluating imaging-pathology concordance and discordance after ultrasound-guided breast biopsy

    Science.gov (United States)

    2018-01-01

    Ultrasound (US)-guided breast biopsy has become the main method for diagnosing breast pathology, and it has a high diagnostic accuracy, approaching that of open surgical biopsy. However, methods for confirming adequate lesion retrieval after US-guided biopsy are relatively limited and false-negative results are unavoidable. Determining imaging-pathology concordance after US-guided biopsy is essential for validating the biopsy result and providing appropriate management. In this review article, we briefly present the results of US-guided breast biopsy; describe general aspects to consider when establishing imaging-pathology concordance; and review the various categories of imaging-pathology correlations and corresponding management strategies. PMID:29169231

  9. Role of Ultrasound Guided Biopsy of Thoracic Lesions | Elameen ...

    African Journals Online (AJOL)

    Objective: This prospective study is to evaluate and enhance the role of ultrasound in biopsy guidance of thoracic lesions. Methods: 55 patients were subjected for fine needle aspiration (FNA) and/or core needle biopsy (CNB) from peripheral chest lesions in Ribat University Hospital during the period from April 2011 and ...

  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....

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

    DEFF Research Database (Denmark)

    Nielsen, Zbigniew Jerzy Koscielniak

    2008-01-01

    with the MESH terms 'nerve block' and 'ultrasonography'. The following limits were applied: studies with abstracts, only in humans, published in core clinical journals. Trial type: meta-analysis, randomized-controlled trial and clinical trial. RESULTS: When peripheral nerves are adequately imaged by ultrasound...

  12. Variables determining the success of ultrasound-guided hydrostatic ...

    African Journals Online (AJOL)

    Department of Pediatric Surgery, Faculty of Medicine, Tanta University Hospitals,. Tanta, Egypt ... Ultrasound was performed using warm normal saline 0.9% through a Foley's catheter that was passed into the rectum. Irritable infants received slow intrave- nous diazepam ... duplication cyst) and resection (13.6%) Table 4.

  13. Ultrasound-guided cryoablation of breast fibroadenoma: a pilot trial.

    Science.gov (United States)

    Golatta, Michael; Harcos, Aba; Pavlista, David; Danes, Jan; Klein, Rafi; Simovich, Paola; Gruber, Ines; Hahn, Markus

    2015-06-01

    The aim of the study was to evaluate cryoablation (CA) under ultrasound guidance in the office setting with liquid nitrogen system for patients with fibroadenoma (FA). For this prospective multicenter trial, an office-based cryosurgical system was used to treat histological confirmed benign FA with a maximum dimension of 3 cm. Sixty CA procedures were performed under ultrasound guidance. A freeze-thaw-freeze treatment cycle was performed according to the size of the FA. During the CA procedure continuous ultrasound monitoring was performed, verifying engulfment of the FA. Patients attended four follow-up visits at 1 week, 3, 6 months and 1 year and underwent ultrasound, physical examination and photography. Data were collected and analyzed in 60 cases. 59 of 60 FA (98 %) were fully engulfed by the ice ball. No serious adverse events occurred related to the IceSense3 system. At the 1-year follow-up, the FAs were gone in 93% of the cases. Prior to CA procedure, 76% of the FAs were palpable. Afterwards in some cases (22%), a scar/cryo lesion was palpable. 28% of the patients reported pain, described as mild or moderate, compared to 2% after 1 year. Cosmetic results at 12 months follow-up were reported as good or excellent in 100% by physician and in 97% by patients. The cryodestruction of the FA using liquid nitrogen system proved functional and safe, while showing meaningful reduction in volume, palpability, pain and cosmetic satisfying outcomes.

  14. Transperineal seed-implantation guided by biplanar transrectal ultrasound

    International Nuclear Information System (INIS)

    Holm, H.H.; 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

  15. Ultrasound/Magnetic Resonance Image Fusion Guided Lumbosacral Plexus Block – A Clinical Study

    DEFF Research Database (Denmark)

    Strid, JM; Pedersen, Erik Morre; Søballe, Kjeld

    2014-01-01

    in a double-blinded randomized controlled trial with crossover design. MR datasets will be acquired and uploaded in an advanced US system (Epiq7, Phillips, Amsterdam, Netherlands). All volunteers will receive SSPS blocks with lidocaine added gadolinium contrast guided by US/MR image fusion and by US one week......Background and aims Ultrasound (US) guided lumbosacral plexus block (Supra Sacral Parallel Shift [SSPS]) offers an alternative to general anaesthesia and perioperative analgesia for hip surgery.1 The complex anatomy of the lumbosacral region hampers the accuracy of the block, but it may be improved...... by guidance of US and magnetic resonance (MR) image fusion and real-time 3D electronic needle tip tracking.2 We aim to estimate the effect and the distribution of lidocaine after SSPS guided by US/MR image fusion compared to SSPS guided by ultrasound. Methods Twenty-four healthy volunteers will be included...

  16. Neurologic Outcomes After Low-Volume, Ultrasound-Guided Interscalene Block and Ambulatory Shoulder Surgery.

    Science.gov (United States)

    Rajpal, Gaurav; Winger, Daniel G; Cortazzo, Megan; Kentor, Michael L; Orebaugh, Steven L

    2016-01-01

    Postoperative neurologic symptoms after interscalene block and shoulder surgery have been reported to be relatively frequent. Reports of such symptoms after ultrasound-guided block have been variable. We evaluated 300 patients for neurologic symptoms after low-volume, ultrasound-guided interscalene block and arthroscopic shoulder surgery. Patients underwent ultrasound-guided interscalene block with 16 to 20 mL of 0.5% bupivacaine or a mix of 0.2% bupivacaine/1.2% mepivacaine solution, followed by propofol/ketamine sedation for ambulatory arthroscopic shoulder surgery. Patients were called at 10 days for evaluation of neurologic symptoms, and those with persistent symptoms were called again at 30 days, at which point neurologic evaluation was initiated. Details of patient demographics and block characteristics were collected to assess any association with persistent neurologic symptoms. Six of 300 patients reported symptoms at 10 days (2%), with one of these patients having persistent symptoms at 30 days (0.3%). This was significantly lower than rates of neurologic symptoms reported in preultrasound investigations with focused neurologic follow-up and similar to other studies performed in the ultrasound era. There was a modest correlation between the number of needle redirections during the block procedure and the presence of postoperative neurologic symptoms. Ultrasound guidance of interscalene block with 16- to 20-mL volumes of local anesthetic solution results in a lower frequency of postoperative neurologic symptoms at 10 and 30 days as compared with investigations in the preultrasound period.

  17. 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.

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

    International Nuclear Information System (INIS)

    Shin, Kyung Min; Ryeom, Hun Kyu; Choe, Byung Ho; Kim, Kap Cheol; Kim, Jong Yeol; Lee, Jong Min; Kim, Hye Jeong; Lee, Hee Jung

    2006-01-01

    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

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

    International Nuclear Information System (INIS)

    Messiou, Christina; Robinson, Philip; O'Connor, Philip J.; Grainger, Andrew

    2006-01-01

    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.)

  20. Intravascular ultrasound guided directional atherectomy versus directional atherectomy guided by angiography for the treatment of femoropopliteal in-stent restenosis

    Science.gov (United States)

    Krishnan, Prakash; Tarricone, Arthur; K-Raman, Purushothaman; Majeed, Farhan; Kapur, Vishal; Gujja, Karthik; Wiley, Jose; Vasquez, Miguel; Lascano, Rheoneil A.; Quiles, Katherine G.; Distin, Tashanne; Fontenelle, Ran; Atallah-Lajam, Farah; Kini, Annapoorna; Sharma, Samin

    2017-01-01

    Background: The aim of this study was to compare 1-year outcomes for patients with femoropopliteal in-stent restenosis using directional atherectomy guided by intravascular ultrasound (IVUS) versus directional atherectomy guided by angiography. Methods and results: This was a retrospective analysis for patients with femoropopliteal in-stent restenosis treated with IVUS-guided directional atherectomy versus directional atherectomy guided by angiography from a single center between March 2012 and February 2016. Clinically driven target lesion revascularization was the primary endpoint and was evaluated through medical chart review as well as phone call follow up. Conclusions: Directional atherectomy guided by IVUS reduces clinically driven target lesion revascularization for patients with femoropopliteal in-stent restenosis. PMID:29265002

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

    International Nuclear Information System (INIS)

    Orlandi, Davide; Corazza, Angelo; Silvestri, Enzo; Serafini, Giovanni; Savarino, Edoardo Vincenzo; Garlaschi, Giacomo; Mauri, Giovanni; Cimmino, Marco Amedeo; Sconfienza, Luca Maria

    2014-01-01

    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

  2. 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.

  3. Minimally Invasive Ultrasound-Guided Carpal Tunnel Release: Preliminary Clinical Results.

    Science.gov (United States)

    Henning, P Troy; Yang, Lynda; Awan, Tariq; Lueders, Daniel; Pourcho, Adam M

    2018-04-02

    Ultrasound-guided carpal tunnel release was performed on 14 patients (18 wrists) using dynamic expansion of the transverse safe zone. Our patient population included able-bodied patients and those with impairments. The first 8 cases (12 wrists) underwent the procedure in an operating room, the remainder in an outpatient setting. No complications occurred, and all patients were able to immediately resume use of their hands without therapy. Improvements in the Quick Form of the Disabilities of the Arm, Shoulder, and Hand Index and Boston Carpal Tunnel Questionnaire at 3 months were comparable to results reported with mini-open and endoscopic release. Our results show that ultrasound-guided carpal tunnel release can be safely and effectively performed in an outpatient setting. © 2018 by the American Institute of Ultrasound in Medicine.

  4. Efficacy of Ablation Therapy for Secondary Hyperparathyroidism by Ultrasound Guided Percutaneous Thermoablation.

    Science.gov (United States)

    Zhao, Junfeng; Qian, Linxue; Zu, Yuan; Wei, Ying; Hu, Xiangdong

    2016-05-01

    The objective of this study was to explore the value of ultrasound-guided percutaneous microwave thermoablation to treat secondary hyperparathyroidism (SHPT). One hundred and thirty-eight parathyroid glands from 56 patients with SHPT were ablated in this study. All the parathyroid glands were evaluated by real-time contrast-enhanced ultrasound before, during and after ablation. Changes in serum parathyroid hormone (sPTH) levels were measured before treatment and at 1 h, 1 wk, 1 mo and 6 mo after thermoablation treatment. All 56 cases had a 1-mo follow-up, and 34 cases had a 6-mo follow-up. The sPTH level of the 54 cases 1 mo after ablation was significantly lower than that before (p 0.05). Ultrasound-guided percutaneous microwave thermoablation is a feasible and effective non-surgical alternative treatment for SHPT patients. Copyright © 2016. Published by Elsevier Inc.

  5. Feasibility of contrast-enhanced ultrasound-guided biopsy of sentinel lymph nodes in dogs.

    Science.gov (United States)

    Gelb, Hylton R; Freeman, Lynetta J; Rohleder, Jacob J; Snyder, Paul W

    2010-01-01

    Our goal was to develop and validate a technique to identify the sentinel lymph nodes of the mammary glands of healthy dogs with contrast-enhanced ultrasound, and evaluate the feasibility of obtaining representative samples of a sentinel lymph node under ultrasound guidance using a new biopsy device. Three healthy intact female adult hounds were anesthetized and each received an injection of octafluoropropane-filled lipid microspheres and a separate subcutaneous injection of methylene blue dye around a mammary gland. Ultrasound was then used to follow the contrast agent through the lymphatic channel to the sentinel lymph node. Lymph node biopsy was performed under ultrasound guidance, followed by an excisional biopsy of the lymph nodes and a regional mastectomy procedure. Excised tissues were submitted for histopathologic examination and evaluated as to whether they were representative of the node. The ultrasound contrast agent was easily visualized with ultrasound leading up to the sentinel lymph nodes. Eight normal lymph nodes (two inguinal, one axillary in two dogs; two inguinal in one dog) were identified and biopsied. Lymphoid tissue was obtained from all biopsy specimens. Samples from four of eight lymph nodes contained both cortical and medullary lymphoid tissue. Contrast-enhanced ultrasound can be successfully used to image and guide minimally invasive biopsy of the normal sentinel lymph nodes draining the mammary glands in healthy dogs. Further work is needed to evaluate whether this technique may be applicable in patients with breast cancer or other conditions warranting evaluation of sentinel lymph nodes in animals.

  6. Ultrasound guided aspiration of breast abscess as an alternative to surgical incision and drainage

    International Nuclear Information System (INIS)

    Naper, M.A.; Shaikh, M.S.; Dholia, K.R.

    2017-01-01

    To evaluate the outcome and assess the success rate of ultrasound guided aspiration of breast abscess as an alternative to surgical incision and drainage. Methodology: A prospective descriptive study was carried out at Department of Surgery, Chandka Medical College Hospital, Larkana, Pakistan, from January 2015 to December 2015. A total of 111 patients of breast abscess who underwent ultrasound guided aspiration without anesthesias with oral antibiotic cover were studied. Females with breast abscess within seven days, and the abscess size was <3cm were included in the study. Males, antibioma and inflammatory carcinoma were excluded from the study. Outcome of success or failure was observed within two weeks and recorded. Results: Out of 111 patients, 68.46% were lactating and 31.53% were non-lactating women, with ages ranging from 18 to 60 years (mean 36.5 years). The successful rate with complete resolution after ultrasound guided aspiration was observed in 94.5%. 80.82% responded after single aspiration, 12.38% after two times aspiration, and 6.66% after multiple aspirations, while 5.4% of patients required incision and drainage. Conclusion: Ultrasound guided aspiration of breast abscess is an effective treatment option with a diameter of <3cm, which can be recommended as a routine outpatient procedure. (author)

  7. 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...

  8. Distal infrared thermography and skin temperature after ultrasound-guided interscalene brachial plexus block

    DEFF Research Database (Denmark)

    Asghar, Semera; Bjerregaard, Lars S; Lundstrøm, Lars H

    2014-01-01

    thermographic imaging of the hand before and at 1 min intervals for 30 min after an ultrasound-guided IBPB with 20 ml ropivacaine 7.5 mg ml. Cooling of both hands was performed to standardise measurements. MAIN OUTCOME MEASURES: Thermographic changes in skin temperature on the dorsum of the hand. RESULTS: Forty...

  9. 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.

  10. Endoscopic ultrasound-guided hepaticogastrostomy for advanced cholangiocarcinoma after failed stenting by endoscopic retrograde cholangiopancreatography

    Directory of Open Access Journals (Sweden)

    Sukij Panpimanmas

    2013-10-01

    Conclusion: Endoscopic-ultrasound-guided hepaticogastrostomy is safe and can be a good palliative option for advanced malignant biliary obstruction because it drains internally and is remote from the tumor site, promoting a long patency period of prosthesis and better quality of life.

  11. 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.

  12. Ultrasound-guided lateral infraclavicular block evaluated by infrared thermography and distal skin temperature

    DEFF Research Database (Denmark)

    Asghar, Semera; Lundstrøm, Lars Hyldborg; Bjerregaard, Lars Stryhn

    2014-01-01

    of the 2nd and 5th digits. METHODS: We performed an ultrasound-guided lateral infraclavicular block in 45 patients undergoing upper limb surgery. The contralateral hand served as control and we obtained infrared thermographic images of both hands before the block and during the following 30 min. We defined...

  13. Update on the role of ultrasound guided radiofrequency ablation for thyroid nodule treatment

    DEFF Research Database (Denmark)

    Radzina, Maija; Cantisani, Vito; Rauda, Madara

    2017-01-01

    Thyroid nodules can be frequently detected in general population, most of them are benign, however malignant cases are rising in the past decades. Ultrasound (US) is the most common imaging modality to assess thyroid nodular lesions, plan patient work-up and guide minimally invasive treatment...

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

    International Nuclear Information System (INIS)

    Baek, Soo Jin; Lee, Jong Min; Kang, Duck Sick

    2005-01-01

    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

  15. Perioperative ultrasound-guided wire marking of calcific deposits in calcifying tendinitis of the rotator cuff.

    Science.gov (United States)

    Sigg, Andreas; Draws, Detlev; Stamm, Axel; Pfeiffer, Michael

    2011-03-01

    The identification of a calcific deposit in the rotator cuff can often cause difficulties. A new technique is described to identify the calcific deposit perioperatively with a ultrasound-guided wire. The technique allows a safe direct marking of calcific deposits making the procedure faster especially in difficult cases.

  16. 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...

  17. Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology

    DEFF Research Database (Denmark)

    Dumonceau, Jean-Marc; Deprez, Pierre H; Jenssen, Christian

    2017-01-01

    For pancreatic solid lesions, ESGE recommends performing endoscopic ultrasound (EUS)-guided sampling as first-line procedure when a pathological diagnosis is required. Alternatively, percutaneous sampling may be considered in metastatic disease.Strong recommendation, moderate quality evidence.In ...

  18. 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…

  19. 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.

  20. Ultrasound guided double injection of blood into cisterna magna: a rabbit model for treatment of cerebral vasospasm.

    Science.gov (United States)

    Chen, Yongchao; Zhu, Youzhi; Zhang, Yu; Zhang, Zixuan; Lian, Juan; Luo, Fucheng; Deng, Xuefei; Wong, Kelvin K L

    2016-02-06

    Double injection of blood into cisterna magna using a rabbit model results in cerebral vasospasm. An unacceptably high mortality rate tends to limit the application of model. Ultrasound guided puncture can provide real-time imaging guidance for operation. The aim of this paper is to establish a safe and effective rabbit model of cerebral vasospasm after subarachnoid hemorrhage with the assistance of ultrasound medical imaging. A total of 160 New Zealand white rabbits were randomly divided into four groups of 40 each: (1) manual control group, (2) manual model group, (3) ultrasound guided control group, and (4) ultrasound guided model group. The subarachnoid hemorrhage was intentionally caused by double injection of blood into their cisterna magna. Then, basilar artery diameters were measured using magnetic resonance angiography before modeling and 5 days after modeling. The depth of needle entering into cisterna magna was determined during the process of ultrasound guided puncture. The mortality rates in manual control group and model group were 15 and 23 %, respectively. No rabbits were sacrificed in those two ultrasound guided groups. We found that the mortality rate in ultrasound guided groups decreased significantly compared to manual groups. Compared with diameters before modeling, the basilar artery diameters after modeling were significantly lower in manual and ultrasound guided model groups. The vasospasm aggravated and the proportion of severe vasospasms was greater in ultrasound guided model group than that of manual group. In manual model group, no vasospasm was found in 8 % of rabbits. The ultrasound guided double injection of blood into cisterna magna is a safe and effective rabbit model for treatment of cerebral vasospasm.

  1. Ultrasound guided pleural biopsy in undiagnosed exudative pleural effusion patients

    OpenAIRE

    Adel S. Ahmed; Mostafa I. Ragab; Alaa eldin M. Elgazaar; Nagwan A. Ismail

    2016-01-01

    Introduction: Pleural biopsy for pathological confirmation is the standard diagnostic procedure for pleural diseases, transthoracic ultrasonography (TUS) has evolved as an important imaging tool for diagnosing pleural and pulmonary conditions. Aim of the study: To assess the diagnostic yield of TUS guided pleural biopsy versus both CT guided and thoracoscopic pleural biopsy in the diagnosis of undiagnosed exudative pleural effusion. Patients and methods: The study was conducted at chest...

  2. Endogenous Catalytic Generation of O2 Bubbles for In Situ Ultrasound-Guided High Intensity Focused Ultrasound Ablation.

    Science.gov (United States)

    Liu, Tianzhi; Zhang, Nan; Wang, Zhigang; Wu, Meiying; Chen, Yu; Ma, Ming; Chen, Hangrong; Shi, Jianlin

    2017-09-26

    High intensity focused ultrasound (HIFU) surgery generally suffers from poor precision and low efficiency in clinical application, especially for cancer therapy. Herein, a multiscale hybrid catalytic nanoreactor (catalase@MONs, abbreviated as C@M) has been developed as a tumor-sensitive contrast and synergistic agent (C&SA) for ultrasound-guided HIFU cancer surgery, by integrating dendritic-structured mesoporous organosilica nanoparticles (MONs) and catalase immobilized in the large open pore channels of MONs. Such a hybrid nanoreactor exhibited sensitive catalytic activity toward H 2 O 2 , facilitating the continuous O 2 gas generation in a relatively mild manner even if incubated with 10 μM H 2 O 2 , which finally led to enhanced ablation in the tissue-mimicking PAA gel model after HIFU exposure mainly resulting from intensified cavitation effect. The C@M nanoparticles could be accumulated within the H 2 O 2 -enriched tumor region through enhanced permeability and retention effect, enabling durable contrast enhancement of ultrasound imaging, and highly efficient tumor ablation under relatively low power of HIFU exposure in vivo. Very different from the traditional perfluorocarbon-based C&SA, such an on-demand catalytic nanoreactor could realize the accurate positioning of tumor without HIFU prestimulation and efficient HIFU ablation with a much safer power output, which is highly desired in clinical HIFU application.

  3. Toward a real-time system for temporal enhanced ultrasound-guided prostate biopsy.

    Science.gov (United States)

    Azizi, Shekoofeh; Van Woudenberg, Nathan; Sojoudi, Samira; Li, Ming; Xu, Sheng; Abu Anas, Emran M; Yan, Pingkun; Tahmasebi, Amir; Kwak, Jin Tae; Turkbey, Baris; Choyke, Peter; Pinto, Peter; Wood, Bradford; Mousavi, Parvin; Abolmaesumi, Purang

    2018-03-27

    We have previously proposed temporal enhanced ultrasound (TeUS) as a new paradigm for tissue characterization. TeUS is based on analyzing a sequence of ultrasound data with deep learning and has been demonstrated to be successful for detection of cancer in ultrasound-guided prostate biopsy. Our aim is to enable the dissemination of this technology to the community for large-scale clinical validation. In this paper, we present a unified software framework demonstrating near-real-time analysis of ultrasound data stream using a deep learning solution. The system integrates ultrasound imaging hardware, visualization and a deep learning back-end to build an accessible, flexible and robust platform. A client-server approach is used in order to run computationally expensive algorithms in parallel. We demonstrate the efficacy of the framework using two applications as case studies. First, we show that prostate cancer detection using near-real-time analysis of RF and B-mode TeUS data and deep learning is feasible. Second, we present real-time segmentation of ultrasound prostate data using an integrated deep learning solution. The system is evaluated for cancer detection accuracy on ultrasound data obtained from a large clinical study with 255 biopsy cores from 157 subjects. It is further assessed with an independent dataset with 21 biopsy targets from six subjects. In the first study, we achieve area under the curve, sensitivity, specificity and accuracy of 0.94, 0.77, 0.94 and 0.92, respectively, for the detection of prostate cancer. In the second study, we achieve an AUC of 0.85. Our results suggest that TeUS-guided biopsy can be potentially effective for the detection of prostate cancer.

  4. 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.

  5. Treatment of Partial Rotator Cuff Tear with Ultrasound-guided Platelet-rich Plasma

    Directory of Open Access Journals (Sweden)

    Vetrivel Chezian Sengodan

    2017-01-01

    Full Text Available Background: The treatment of symptomatic partial rotator cuff tear has presented substantial challenge to orthopaedic surgeons as it can vary from conservative to surgical repair. Researches have established the influence of platelet rich plasma in healing damaged tissue. Currently very few data are available regarding the evidence of clinical and radiological outcome of partial rotator cuff tear treated with ultrasound guided platelet rich plasma injection in English literature. Materials and Methods: 20 patients with symptomatic partial rotator cuff tears were treated with ultrasound guided platelet rich plasma injection. Before and after the injection of platelet rich plasma scoring was done with visual analogue score, Constant shoulder score, and UCLA shoulder score at 8 weeks and third month. A review ultrasound was performed 8 weeks after platelet rich plasma injection to assess the rotator cuff status. Results: Our study showed statistically significant improvements in 17 patients in VAS pain score, constant shoulder score and UCLA shoulder score. No significant changes in ROM were noted when matched to the contra-lateral side (P < 0.001 at the 3 month follow-up. The study also showed good healing on radiological evaluation with ultrasonogram 8 weeks after platelet rich plasma injection. Conclusion: Ultrasound guided platelet rich plasma injection for partial rotator cuff tears is an effective procedure that leads to significant decrease in pain, improvement in shoulder functions, much cost-effective and less problematic compared to a surgical treatment.

  6. 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.

  7. The clinical value of trans-vaginal ultrasound-guided puncture in the treatment of pelvic abscess

    International Nuclear Information System (INIS)

    Wang Ping; Gong Wei

    2008-01-01

    Objective: To investigate the clinical value of trans-vaginal ultrasound-guided (TVS) puncture in the treatment of pelvic abscess. Methods 30 cases with pelvic abscess were treated by transvaginal ultrasound-guided puncture. The long-dated effects were followed-up. Results: 29 cases were cured by TVS puncture. Operation was performed in 1 patient because of invalid effect. The cure rate was 97%. Conclusion: Ultrasound-guided puncture is a safe and convenient method in the treatment of pelvic abscess. (authors)

  8. 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

  9. Fluoroscopy- vs ultrasound-guided aspiration techniques in the management of periprosthetic joint infection: which is the best?

    Science.gov (United States)

    Randelli, Filippo; Brioschi, Marco; Randelli, Pietro; Ambrogi, Federico; Sdao, Silvana; Aliprandi, Alberto

    2018-01-01

    Fluid samples obtained from an affected joint still play a central role in the diagnosis of periprosthetic joint infection (PJI). It is the only preoperative test able to discover the causative microbiological agent. In the hip, fluid aspiration can be performed through fluoroscopy, ultrasound, or, less commonly, computed tomography. However, there is still a lack of consensus on which method is preferable in terms of efficacy and costbenefit. We, therefore, asked whether (1) the benefits in terms of sensitivity and specificity and (2) the costs were comparable between fluoroscopy- and ultrasound-guided joint aspirations in a suspicious of hip PJI. Between 2013 and 2016, 52 hip aspirations were performed on 49 patients with clinical, radiological, or serological suspicion of PJI, waiting for a revision surgery. The patients were divided in two groups: fluoroscopy- (n = 26) vs ultrasound-guided hip aspiration group (n = 26). These groups were also divided in control and infected patients. The criteria of MusculoSkeletal Infection Society (MSIS) were used, as gold standard, to define PJI. (1) Ultrasound-guided aspiration revealed valid sensitivity (89% vs 60%) and specificity (94% vs 81%) in comparison with fluoroscopic-guided aspiration. (2) The cost analysis was also in favor of ultrasound-guided aspiration (125.30€) than fluoroscopic-guided aspiration (343.58€). We concluded that ultrasound-guided hip aspiration could represent a valid, safe, and less expensive diagnostic alternative to fluoroscopic-guided aspiration in hip PJI.

  10. General Ultrasound Imaging

    Medline Plus

    Full Text Available ... inserted into a man's rectum to view the prostate. Transvaginal ultrasound. The transducer is inserted into a ... Stenting Ultrasound-Guided Breast Biopsy Obstetric Ultrasound Ultrasound - Prostate Biopsies - Overview Images related to General Ultrasound Videos ...

  11. Carotid and femoral B-mode ultrasound intima-media thickness measurements in adult post-coarctectomy patients

    NARCIS (Netherlands)

    Vriend, J. J. W.; de Groot, E.; Kastelein, J. J. P.; Mulder, B. J. M.

    2004-01-01

    Aim. Cardiovascular and cerebrovascular morbidity and mortality in adult post-coarctectomy patients is increased even after successful surgical repair of the aorta. B-mode ultrasound intima-media thickness (IMT), a validated marker for atherosclerosis and vascular disease risk, was used to measure

  12. Analysis of "dry" mesothelioma with ultrasound guided biopsies

    NARCIS (Netherlands)

    Stigt, Jos A.; Boers, James E.; Groen, Harry J. M.

    2012-01-01

    Background: Image-guided sampling of the thickened pleura is a sensitive approach in patients with malignant pleural mesothelioma with pleural effusion. Malignant pleural mesothelioma presenting without effusion however is more of a diagnostic challenge. In this study we report the diagnostic yield

  13. MR-guided focused ultrasound. Current and future applications

    International Nuclear Information System (INIS)

    Trumm, C.G.; Peller, M.; Clevert, D.A.; Stahl, R.; Reiser, M.; Napoli, A.; Matzko, M.

    2013-01-01

    High-intensity focused ultrasound (synonyms FUS and HIFU) under magnetic resonance imaging (MRI) guidance (synonyms MRgFUS and MR-HIFU) is a completely non-invasive technology for accurate thermal ablation of a target tissue while neighboring tissues and organs are preserved. The combination of FUS with MRI for planning, (near) real-time monitoring and outcome assessment of treatment markedly enhances the safety of the procedure. The MRgFUS procedure is clinically established in particular for the treatment of symptomatic uterine fibroids, followed by palliative ablation of painful bone metastases. Furthermore, promising results have been shown for the treatment of adenomyosis, malignant tumors of the prostate, breast and liver and for various intracranial applications, such as thermal ablation of brain tumors, functional neurosurgery and transient disruption of the blood-brain barrier. (orig.) [de

  14. [MR-guided focused ultrasound. Current and future applications].

    Science.gov (United States)

    Trumm, C G; Napoli, A; Peller, M; Clevert, D-A; Stahl, R; Reiser, M; Matzko, M

    2013-03-01

    High-intensity focused ultrasound (synonyms FUS and HIFU) under magnetic resonance imaging (MRI) guidance (synonyms MRgFUS and MR-HIFU) is a completely non-invasive technology for accurate thermal ablation of a target tissue while neighboring tissues and organs are preserved. The combination of FUS with MRI for planning, (near) real-time monitoring and outcome assessment of treatment markedly enhances the safety of the procedure. The MRgFUS procedure is clinically established in particular for the treatment of symptomatic uterine fibroids, followed by palliative ablation of painful bone metastases. Furthermore, promising results have been shown for the treatment of adenomyosis, malignant tumors of the prostate, breast and liver and for various intracranial applications, such as thermal ablation of brain tumors, functional neurosurgery and transient disruption of the blood-brain barrier.

  15. A comparison of complications between ultrasound-guided prostate brachytherapy and open prostate brachytherapy

    International Nuclear Information System (INIS)

    Benoit, Ronald M.; Naslund, Michael J.; Cohen, Jeffrey K.

    2000-01-01

    Purpose: Prostate brachytherapy has reemerged during the 1990s as a treatment for clinically localized prostate cancer. The renewed popularity of prostate brachytherapy is largely due to the use of transrectal ultrasound of the prostate, which allows for more accurate isotope placement within the prostate when compared to the open approach. The present study investigates whether this improved cancer control is at the expense of increased morbidity by comparing the morbidity after transrectal ultrasound-guided prostate brachytherapy to the morbidity after prostate brachytherapy performed via an open approach. Methods and Materials: All men in the Medicare population who underwent prostate brachytherapy in the year 1991 were identified. These men were further stratified into those men who underwent prostate brachytherapy via an open approach and the men who underwent prostate brachytherapy with ultrasound guidance. All subsequent inpatient, outpatient, and physician (Part B) Medicare claims for these men from the years 1991-1993 were then analyzed to determine outcomes. Results: In the year 1991, 2124 men in the Medicare population underwent prostate brachytherapy. An open approach was used in 715 men (33.7%), and ultrasound guidance was used in 1409 men (66.3%). Mean age for both cohorts was 73.7 years with a range of 50.7-92.8 years for the ultrasound group and 60.6-92.1 years for the open group. A surgical procedure for the relief of bladder outlet obstruction was performed in 122 men (8.6%) in the ultrasound group and in 54 men (7.6%) in the open group. An artificial urinary sphincter was placed in 2 men (0.14%) in the ultrasound group and in 2 men (0.28%) in the open group. A penile prosthesis was implanted in 10 men (0.71%) in the ultrasound group and in 4 men (0.56%) in the open group. A diagnosis code for urinary incontinence was carried by 95 men (6.7%) in the ultrasound group and by 45 men (6.3%) in the open group. A diagnosis code for erectile dysfunction

  16. Ultrasound

    Science.gov (United States)

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

  17. Ultrasound-Guided Angioplasty of Dysfunctional Vascular Access for Haemodialysis. The Pros and Cons

    Energy Technology Data Exchange (ETDEWEB)

    García-Medina, J., E-mail: josegmedina57@gmail.com [“Reina Sofia” University Hospital, Vascular and Interventional Radiology Unit, Department of Radiology (Spain); García-Alfonso, J. J., E-mail: juanjozarandieta@gmail.com [University of Murcia, Faculty of Medicine (Spain)

    2017-05-15

    PurposeTo describe the benefits and the disadvantages of angioplasty in dialysis fistulas using only ultrasound guidance.Materials and MethodsThis is a prospective study in 132 failing or non-maturing arteriovenous accesses that underwent 189 ultrasound-guided balloon angioplasties. The technical success was defined as non-use of X-ray fluoroscopy during the procedure.Results127 procedures (67%) were successfully completed without fluoroscopy. Most failures were due to difficulty to traverse aneurismal segments, as well as anastomotic stenoses. Including initial failures, the primary patency rates at 6, 12 months and 2 years were 75 ± 3, 41 ± 3 and 14 ± 2%, respectively.ConclusionEndovascular repair of the dysfunctional vascular access for haemodialysis under ultrasound guidance is feasible and safe in roughly two-thirds of cases.

  18. Technical guide to evaluate upper limb joints (shoulder, elbow and wrist) by ultrasound

    International Nuclear Information System (INIS)

    Obregon Baez, Luis Rafael

    2014-01-01

    A guideline to follow is offered to radiologists and residents of radiology service of medical imaging, when evaluating by ultrasound the shoulder joints, elbow, wrist. The importance to performing of musculoskeletal ultrasound by its pathology variable is established. The use of appropriate equipment and effective application of the techniques exposed of echography exploration have made enable the valuation of many pathologies with high sensitivity and specificity. The echography has been the musculoskeletal imaging technique that more rapidly has evolved. Currently, this technique has been replaced by magnetic resonance imaging in various clinical fields and also serves as a complement to other techniques. Exposed techniques have been of great benefit for radiologists medical and residents, obtaining with its use a quick guide for the realization of upper limb musculoskeletal ultrasounds. The appropriate and easy techniques are better known for the evaluation of these structures, and so document both sports injuries, as joint and rheumatic diseases [es

  19. Derivation of a Performance Checklist for Ultrasound-Guided Arthrocentesis Using the Modified Delphi Method.

    Science.gov (United States)

    Kunz, Derek; Pariyadath, Manoj; Wittler, Mary; Askew, Kim; Manthey, David; Hartman, Nicholas

    2017-06-01

    Arthrocentesis is an important skill for physicians in multiple specialties. Recent studies indicate a superior safety and performance profile for this procedure using ultrasound guidance for needle placement, and improving quality of care requires a valid measurement of competency using this modality. We endeavored to create a validated tool to assess the performance of this procedure using the modified Delphi technique and experts in multiple disciplines across the United States. We derived a 22-item checklist designed to assess competency for the completion of ultrasound-guided arthrocentesis, which demonstrated a Cronbach's alpha of 0.89, indicating an excellent degree of internal consistency. Although we were able to demonstrate content validity for this tool, further validity evidence should be acquired after the tool is used and studied in clinical and simulated contexts. © 2017 by the American Institute of Ultrasound in Medicine.

  20. Endoscopic Ultrasound-guided Drainage of Pancreatic Pseudocysts

    DEFF Research Database (Denmark)

    Ng, Pui Yung; Nytoft Rasmussen, Ditlev; Vilmann, Peter

    2013-01-01

    or by telephonic interview. RESULTS: A total of 61 procedures were performed. The symptoms that indicated drainage were abdominal pain (n = 43), vomiting (n = 7) and jaundice (n = 5). The procedure was technically successful in 57 of the 61 procedures (93%). The immediate complication rate was 5%. At a mean follow......-up of 45 weeks, the treatment success was 75%. The medium term complications appeared in 25% of cases, which included three cases each of stent clogging, stent migration, infection and six cases of recurrence. There was no mortality. CONCLUSION: EUS-guided drainage is an effective treatment for PPC...... with a successful outcome in most of patients. Most of the complications require minimal invasive surgical treatment or repeated EUS-guided drainage procedures....

  1. Evaluation of a Standardized Program for Training Practicing Anesthesiologists in Ultrasound-Guided Regional Anesthesia Skills.

    Science.gov (United States)

    Mariano, Edward R; Harrison, T Kyle; Kim, T Edward; Kan, Jack; Shum, Cynthia; Gaba, David M; Ganaway, Toni; Kou, Alex; Udani, Ankeet D; Howard, Steven K

    2015-10-01

    Practicing anesthesiologists have generally not received formal training in ultrasound-guided perineural catheter insertion. We designed this study to determine the efficacy of a standardized teaching program in this population. Anesthesiologists in practice for 10 years or more were recruited and enrolled to participate in a 1-day program: lectures and live-model ultrasound scanning (morning) and faculty-led iterative practice and mannequin-based simulation (afternoon). Participants were assessed and recorded while performing ultrasound-guided perineural catheter insertion at baseline, at midday (interval), and after the program (final). Videos were scored by 2 blinded reviewers using a composite tool and global rating scale. Participants were surveyed every 3 months for 1 year to report the number of procedures, efficacy of teaching methods, and implementation obstacles. Thirty-two participants were enrolled and completed the program; 31 of 32 (97%) completed the 1-year follow-up. Final scores [median (10th-90th percentiles)] were 21.5 (14.5-28.0) of 30 points compared to 14.0 (9.0-20.0) at interval (P < .001 versus final) and 12.0 (8.5-17.5) at baseline (P < .001 versus final), with no difference between interval and baseline. The global rating scale showed an identical pattern. Twelve of 26 participants without previous experience performed at least 1 perineural catheter insertion after training (P < .001). However, there were no differences in the monthly average number of procedures or complications after the course when compared to baseline. Practicing anesthesiologists without previous training in ultrasound-guided regional anesthesia can acquire perineural catheter insertion skills after a 1-day standardized course, but changing clinical practice remains a challenge. © 2015 by the American Institute of Ultrasound in Medicine.

  2. 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.

  3. 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.

  4. The Usefulness of Intensivist-Performed Bedside Drainage of Pleural Effusion via Ultrasound-Guided Pigtail Catheter

    Directory of Open Access Journals (Sweden)

    Joo Won Min

    2014-08-01

    CONCLUSIONS: Intensivist-performed bedside drainage of pleural effusion via ultrasound (US-guided pigtail catheter is useful and safe and may be recommended in some patients in an intensive care unit.

  5. Compensated Row-Column Ultrasound Imaging System Using Multilayered Edge Guided Stochastically Fully Connected Random Fields.

    Science.gov (United States)

    Ben Daya, Ibrahim; Chen, Albert I H; Shafiee, Mohammad Javad; Wong, Alexander; Yeow, John T W

    2017-09-06

    The row-column method received a lot of attention for 3-D ultrasound imaging. By reducing the number of connections required to address the 2-D array and therefore reducing the amount of data to handle, this addressing method allows for real time 3-D imaging. Row-column still has its limitations: the issues of sparsity, speckle noise inherent to ultrasound, the spatially varying point spread function, and the ghosting artifacts inherent to the row-column method must all be taken into account when building a reconstruction framework. In this research, we build on a previously published system and propose an edge-guided, compensated row-column ultrasound imaging system that incorporates multilayered edge-guided stochastically fully connected conditional random fields to address the limitations of the row-column method. Tests carried out on simulated and real row-column ultrasound images show the effectiveness of our proposed system over other published systems. Visual assessment show our proposed system's potential at preserving edges and reducing speckle. Quantitative analysis shows that our proposed system outperforms previously published systems when evaluated with metrics such as Peak Signal-to-Noise Ratio, Coefficient of Correlation, and Effective Number of Looks. These results show the potential of our proposed system as an effective tool for enhancing 3-D row-column imaging.

  6. Point-of-Care Ultrasound-Guided Percutaneous Cannulation of Extracorporeal Membrane Oxygenation: Make it Simple.

    Science.gov (United States)

    Ahn, Hong Joon; Lee, Jun Wan; Joo, Ki Hyuk; You, Yeon Ho; Ryu, Seung; Lee, Jin Woong; Kim, Seung Whan

    2017-12-30

    Cannulation of the great vessels is required for extracorporeal membrane oxygenation (ECMO). Currently, there is no guideline for optimal imaging modalities during percutaneous cannulation of ECMO. The purpose of this study was to describe percutaneous cannulation guided by point-of-care ultrasound (POCUS) for ECMO and compare it with fluoroscopy and landmark guidance. Three groups (POCUS-, fluoroscopy-, and landmark-guided) of percutaneous cannulation for ECMO were analyzed retrospectively in a tertiary academic hospital. In the POCUS-guided group, visual confirmation of guidewire and cannula by ultrasound in both the access and return cannula were essential for successful cannulation. Fluoroscopy- and landmark-guided groups were cannulated with the conventional technique. A total of 128 patients were treated by ECMO during the study period, of which 94 (73.4%) cases were venoarterial ECMO. This included 56 cases of extracorporeal cardiopulmonary resuscitation. Also, there were 30 (23.4%) cases of venovenous ECMO and 4 (3.1%) cases of venoarteriovenous ECMO. A total of 71 (55.5%) patients were cannulated under POCUS guidance, and 43 (33.6%) patients were cannulated under fluoroscopy guidance and 14 (10.9%) patients were cannulated by landmark guidance. No surgical cut downs were required. Misplacement of cannula occurred in 3 (2.3%) cases. All three occurred in the landmark-guided group. POCUS-guided cannulation is comparable to fluoroscopy-guided cannulation in terms of avoiding cannula misplacement. In our experience, POCUS-guided cannulation is a useful strategy over fluoroscopy- and landmark-guided cannulation during peripheral ECMO. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Optimizing MR imaging-guided navigation for focused ultrasound interventions in the brain

    Science.gov (United States)

    Werner, B.; Martin, E.; Bauer, R.; O'Gorman, R.

    2017-03-01

    MR imaging during transcranial MR imaging-guided Focused Ultrasound surgery (tcMRIgFUS) is challenging due to the complex ultrasound transducer setup and the water bolus used for acoustic coupling. Achievable image quality in the tcMRIgFUS setup using the standard body coil is significantly inferior to current neuroradiologic standards. As a consequence, MR image guidance for precise navigation in functional neurosurgical interventions using tcMRIgFUS is basically limited to the acquisition of MR coordinates of salient landmarks such as the anterior and posterior commissure for aligning a stereotactic atlas. Here, we show how improved MR image quality provided by a custom built MR coil and optimized MR imaging sequences can support imaging-guided navigation for functional tcMRIgFUS neurosurgery by visualizing anatomical landmarks that can be integrated into the navigation process to accommodate for patient specific anatomy.

  8. MR-Guided Focused Ultrasound for the Treatment of Uterine Fibroids

    International Nuclear Information System (INIS)

    Hesley, Gina K.; Gorny, Krzysztof R.; Woodrum, David A.

    2013-01-01

    Magnetic resonance imaging–guided focused ultrasound (MRgFUS) ablation of uterine fibroids provides a minimally invasive outpatient technique for targeting and treating symptomatic uterine fibroids. Magnetic resonance imaging provides a guidance platform that has high temporal and spatial resolution for guiding, as well as thermal monitoring of the procedure. The high-intensity focused ultrasound provides a mechanism for delivering large amounts of energy directly into the fibroid without causing detrimental effects to the nontarget tissues. Early and intermediate follow-up of patients treated with MRgFUS provided promising results on the efficacy of the technique for providing symptom relief to patients. As more long-term follow-up data are published, the efficacy of this technique can be compared to more invasive surgical and minimally invasive catheter treatments.

  9. Ultrasound-Guided Percutaneous Drainage of Neonatal Pyometrocolpos Under Local Anesthesia

    International Nuclear Information System (INIS)

    Algin, Oktay; Erdogan, Cuneyt; Kilic, Nizamettin

    2011-01-01

    Hydrometrocolpos is an uncommon congenital disorder with cystic dilatation of the vagina and uterus that occurs as a result of accumulated secretions from the reproductive tract due to distal genital tract obstruction. Secondary infection may also occur, resulting in pyometrocolpos, a potentially lethal disease. Immediate drainage of the cystic mass in patients determined to have pyometrocolpos is required to prevent or treat uropathy and septicemia until definitive corrective surgery can be performed. We report an unusual cause of obstructive uropathy in three infants: pyometrocolpos due to lower genital tract atresia. Ultrasound-guided percutaneous drainage of the pyometrocolpos resulted in dramatically improved clinical and laboratory findings in these patients. Ultrasound-guided percutaneous drainage under local anesthesia is a simple, minimally invasive, safe, and effective procedure that facilitates later successful corrective surgery and avoids the need for more complex drainage procedures.

  10. Ultrasound-Guided Drainage of Supralevator Hematoma in a Hemodynamically Stable Patient.

    Science.gov (United States)

    Mukhopadhyay, Debjani; Jennings, Paul E; Banerjee, Mamta; Gada, Ruta

    2015-12-01

    Paravaginal hematomas can be life-threatening. In patients with intact vaginal walls and perineum, they may pose a diagnostic and therapeutic challenge. Supralevator hematomas are much less common than infralevator hematomas. We present a case of puerperal hemorrhagic shock after a normal vaginal delivery in a low-risk parous woman resulting from an occult supralevator hematoma. Because the woman was hemodynamically unstable initially, she underwent a vaginal surgical drainage. A week later, the supravaginal hematoma reformed. At this time the patient was hemodynamically stable, and ultrasound-guided drainage was performed, which resulted in complete resolution of the hematoma within 10 days. In a clinically stable puerperal patient, ultrasound-guided drainage of a supralevator hematoma resulted in rapid and complete resolution of symptoms.

  11. Efficacy of ultrasound-guided thoracentesis catheter drainage for pleural effusion

    Science.gov (United States)

    Cao, Weitian; Wang, Yi; Zhou, Ningming; Xu, Bing

    2016-01-01

    The factors influencing the efficacy of ultrasound-guided thoracentesis catheter drainage were investigated in the present study. A retrospective analysis of clinical data from 435 patients who presented with a pleural effusion was performed. Patients were divided into a control group and an intervention group. Thirty-seven patients in the control group were given standard care using pleural puncture to draw the excess fluid. The 398 patients in the intervention group were treated using ultrasound-guided thoracentesis catheter drainage. The rate of successful drainage of a pleural effusion was significantly higher (Ppleural effusion. The efficacy of the procedure is related to the separation of pleural effusion, drainage tube type and tube diameter. PMID:28105155

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

    Directory of Open Access Journals (Sweden)

    Enrico Pierluigi Spugnini

    2017-03-01

    Full Text Available 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.

  13. Novel ultrasound-responsive chitosan/perfluorohexane nanodroplets for image-guided smart delivery of an anticancer agent: Curcumin.

    Science.gov (United States)

    Baghbani, Fatemeh; Chegeni, Mahdieh; Moztarzadeh, Fathollah; Hadian-Ghazvini, Samaneh; Raz, Majid

    2017-05-01

    Ultrasound-responsive nanodroplets are a class of new emerging smart drug delivery systems which provide image-guided nano-therapy of various diseases, especially cancers. Here, we developed multifunctional smart curcumin-loaded chitosan/perfluorohexane nanodroplets for contrast-ultrasound imaging and on-demand drug delivery. The nanodroplets were synthesized via nanoemulsion process. The optimal formulation with the size of 101.2nm and 77.8% curcumin entrapment was chosen for release study and cytotoxicity evaluation. Sonication at the frequency of 1MHz, 2W/cm 2 for 4min triggered the release of 63.5% of curcumin from optimal formulation (Cur-NDs-2). Ultrasound aided release study indicated that the concentration of perfluorohexane and the degree of acoustic droplet vaporization play important role in ultrasound-active drug release. B-mode ultrasound imaging confirmed strong ultrasound contrast of chitosan nanodroplets even at low concentrations via droplet to bubble transition. Finally, cytotoxicity of the ultrasound-responsive nanodroplets in the presence of ultrasound was evaluated in-vitro on 4T1 human breast cancer cells. Cell growth inhibitory effects of curcumin-loaded nanodroplets significantly increased by ultrasound exposure. According to the obtained results, these ultrasound responsive curcumin-loaded chitosan/perfluorohexane nanodroplets have a great potential for imaged-guided cancer therapy. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Real-time ultrasound-guided spinal anaesthesia: a prospective observational study of a new approach.

    LENUS (Irish Health Repository)

    Conroy, P H

    2013-01-01

    Identification of the subarachnoid space has traditionally been achieved by either a blind landmark-guided approach or using prepuncture ultrasound assistance. To assess the feasibility of performing spinal anaesthesia under real-time ultrasound guidance in routine clinical practice we conducted a single center prospective observational study among patients undergoing lower limb orthopaedic surgery. A spinal needle was inserted unassisted within the ultrasound transducer imaging plane using a paramedian approach (i.e., the operator held the transducer in one hand and the spinal needle in the other). The primary outcome measure was the success rate of CSF acquisition under real-time ultrasound guidance with CSF being located in 97 out of 100 consecutive patients within median three needle passes (IQR 1-6). CSF was not acquired in three patients. Subsequent attempts combining landmark palpation and pre-puncture ultrasound scanning resulted in successful spinal anaesthesia in two of these patients with the third patient requiring general anaesthesia. Median time from spinal needle insertion until intrathecal injection completion was 1.2 minutes (IQR 0.83-4.1) demonstrating the feasibility of this technique in routine clinical practice.

  15. TU-B-210-00: MR-Guided Focused Ultrasound Therapy in Oncology

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    MR guided focused ultrasound (MRgFUS), or alternatively high-intensity focused ultrasound (MRgHIFU), is approved for thermal ablative treatment of uterine fibroids and pain palliation in bone metastases. Ablation of malignant tumors is under active investigation in sites such as breast, prostate, brain, liver, kidney, pancreas, and soft tissue. Hyperthermia therapy with MRgFUS is also feasible, and may be used in conjunction with radiotherapy and for local targeted drug delivery. MRI allows in situ target definition and provides continuous temperature monitoring and subsequent thermal dose mapping during HIFU. Although MRgHIFU can be very precise, treatment of mobile organs is challenging and advanced techniques are required because of artifacts in MR temperature mapping, the need for intercostal firing, and need for gated HIFU or tracking of the lesion in real time. The first invited talk, “MR guided Focused Ultrasound Treatment of Tumors in Bone and Soft Tissue”, will summarize the treatment protocol and review results from treatment of bone tumors. In addition, efforts to extend this technology to treat both benign and malignant soft tissue tumors of the extremities will be presented. The second invited talk, “MRI guided High Intensity Focused Ultrasound – Advanced Approaches for Ablation and Hyperthermia”, will provide an overview of techniques that are in or near clinical trials for thermal ablation and hyperthermia, with an emphasis of applications in abdominal organs and breast, including methods for MRTI and tracking targets in moving organs. Learning Objectives: Learn background on devices and techniques for MR guided HIFU for cancer therapy Understand issues and current status of clinical MRg HIFU Understand strategies for compensating for organ movement during MRgHIFU Understand strategies for strategies for delivering hyperthermia with MRgHIFU CM - research collaboration with Philips.

  16. 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.

  17. Ultrasound-guided microwave ablation in the treatment of benign thyroid nodules in 435 patients.

    Science.gov (United States)

    Liu, Yu-Jiang; Qian, Lin-Xue; Liu, Dong; Zhao, Jun-Feng

    2017-09-01

    The objective of the present study was to investigate the effectiveness and safety of ultrasound-guided microwave ablation in the treatment of benign thyroid nodules. A total of 474 benign thyroid nodules in 435 patients who underwent ultrasound-guided microwave ablation from September 2012 to August 2015 were included. Nodule volume and thyroid function were measured before treatment and at 1, 3, 6, and 12 months and subsequently after every 6 months. The nodule volume reduction rate and changes of thyroid function were evaluated. The volume of all thyroid nodules significantly decreased after ultrasound-guided microwave ablation. The average volume was 13.07 ± 0.95 ml before treatment, and 1.14 ± 0.26 ml at 12-months follow-up. The mean volume reduction rate was 90% and the final volume reduction rate was 94%. The volume reduction rate of mainly cystic nodules was significantly higher than that of simple solid and mainly solid nodules (all P microwave ablation is an effective and safe technique for treatment of benign thyroid nodules, and has the potential for clinical applications. Impact statement Ultrasound-guided MWA is an effective and safe technique for the treatment of benign thyroid nodules. It can significantly reduce the nodule volume, improve the patients' clinical symptoms, has less complication, guarantees quick recovery, meets patients' aesthetic needs, and shows less interference on the physiological and psychological aspects of the body. MWA should be a good complement to traditional open surgery and has potentials in clinical applications.

  18. Routine ultrasound guided evacuation of first trimester missed abortion versus blind evacuation

    OpenAIRE

    Mostafa Abdulla Elsayed

    2014-01-01

    Background: The clinical management of miscarriage has changed little over the years and many women undergo surgical uterine evacuation. Surgical evacuation of the uterine contents in missed abortion is a challenge to the obstetrician as it is done blindly. The current study recommends the use of ultrasound guided surgical evacuation. It serves two important advantages; the first is to complete evacuation without the need of additional step. The second is to protect against uterine perforatio...

  19. Safety of Ultrasound-Guided Botulinum Toxin Injections for Sialorrhea as Performed by Pediatric Otolaryngologists.

    Science.gov (United States)

    Shariat-Madar, Bahbak; Chun, Robert H; Sulman, Cecille G; Conley, Stephen F

    2016-05-01

    To evaluate incidence of complications and hospital readmission as a result of ultrasound-guided botulinum toxin injections to manage sialorrhea. Case series with chart review. Children's Hospital of Wisconsin. A case series with chart review was performed of all cases of ultrasound-guided injection of botulinum toxin by pediatric otolaryngologists from March 5, 2010, to September 26, 2014,. Primary outcomes included complications such as dysphagia, aspiration pneumonia, and motor paralysis. Secondary outcomes included hospitalization, intubation, and nasogastric tube placement. There were 48 patients, 111 interventions, and 306 intraglandular injections identified. Botulinum toxin type A and type B were utilized in 4 and 107 operative interventions, respectively. Type A was injected into 4 parotid and 4 submandibular glands, utilizing doses of 20 U per parotid and 30 U per submandibular gland. Type B was injected into 98 parotid and 200 submandibular glands, with average dosing of 923 U per parotid and 1170 U per submandibular gland, respectively. There were 2 instances of subjectively worsening of baseline dysphagia that self-resolved. No cases were complicated by aspiration pneumonia or motor paralysis. No patients required hospital readmission, intubation, or nasogastric tube placement. Prior published data indicated 16% complication incidence with ultrasound-guided injection of botulinum toxin. Our study found a low complication rate (0.6%) with ultrasound-guided injections of botulinum toxin to manage sialorrhea, without cases of aspiration pneumonia or motor paralysis. Of 306 intraglandular injections, there were 2 cases of worsening baseline subjective dysphagia that self-resolved. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  20. Ultrasound-guided interstitial laser photocoagulation of an autonomous thyroid nodule

    DEFF Research Database (Denmark)

    Døssing, Helle; Bennedbaek, Finn Noe; Hegedüs, Laszlo

    2003-01-01

    effects and often necessitates multiple treatment sessions. We present a case of a 17-year-old female successfully treated with ultrasound (US)-guided percutaneous interstitial laser photocoagulation (ILP) for an AFTN. Initially, she had a serum thyrotropin (TSH) of 0.01 mU/L and normal peripheral thyroid.......9 mL (40% reduction) without further alterations during an additional 9 months of follow-up. Side effects were transient thyrotoxicosis and local pain as seen with PEI. To our knowledge, this is the first reported case of ILP used in a patient with a pretoxic thyroid nodule. US-guided thermic tissue...

  1. Magnetic resonance–guided interstitial high-intensity focused ultrasound for brain tumor ablation

    Science.gov (United States)

    MacDonell, Jacquelyn; Patel, Niravkumar; Rubino, Sebastian; Ghoshal, Goutam; Fischer, Gregory; Burdette, E. Clif; Hwang, Roy; Pilitsis, Julie G.

    2018-01-01

    Currently, treatment of brain tumors is limited to resection, chemotherapy, and radiotherapy. Thermal ablation has been recently explored. High-intensity focused ultrasound (HIFU) is being explored as an alternative. Specifically, the authors propose delivering HIFU internally to the tumor with an MRI-guided robotic assistant (MRgRA). The advantage of the authors’ interstitial device over external MRI-guided HIFU (MRgHIFU) is that it allows for conformal, precise ablation and concurrent tissue sampling. The authors describe their workflow for MRgRA HIFU delivery. PMID:29385926

  2. 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

  3. 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

  4. Ultrasound guided needle biopsy of skeletal muscle in neuromuscular disease

    DEFF Research Database (Denmark)

    Lindequist, S; Schrøder, H D; Larsen, C

    1990-01-01

    Guided by ultrasonography percutaneous needle biopsy of skeletal muscle was performed in 24 patients, using the one hand held Biopty system and a 2 mm Tru-Cut needle. The specimens were graded with regard to diagnostic quality and utility and almost all specimens (96%) were of highest quality. Th....... The use of ultrasonography was helpful in selecting a suitable area for the biopsy and vascular structures could be avoided. The procedure was well tolerated and easy to perform, and no complications were recorded....

  5. Comparison of two ultrasound-guided injection techniques targeting the sacroiliac joint region in equine cadavers.

    Science.gov (United States)

    Stack, John David; Bergamino, Chiara; Sanders, Ruth; Fogarty, Ursula; Puggioni, Antonella; Kearney, Clodagh; David, Florent

    2016-09-20

    To compare the accuracy and distribution of injectate for cranial (CR) and caudomedial (CM) ultrasound-guided injections of equine sacroiliac joints. Both sacroiliac joints from 10 lumbosacropelvic specimens were injected using cranial parasagittal (CR; curved 18 gauge, 25 cm spinal needles) and caudomedial (CM; straight 18 gauge, 15 cm spinal needles) ultrasound-guided approaches. Injectate consisted of 4 ml iodinated contrast and 2 ml methylene blue. Computed tomographical (CT) scans were performed before and after injections. Time for needle guidance and repositioning attempts were recorded. The CT sequences were analysed for accuracy and distribution of contrast. Intra-articular contrast was detected in sacroiliac joints following 15/40 injections. The CR and CM approaches deposited injectate ≤2 cm from sacroiliac joint margins following 17/20 and 20/20 injections, respectively. Median distance of closest contrast to the sacroiliac joint was 0.4 cm (interquartile range [IQR]: 1.5 cm) for CR approaches and 0.6 cm (IQR: 0.95 cm) for CM approaches. Cranial injections resulted in injectate contacting lumbosacral intertransverse joints 15/20 times. Caudomedial injections were perivascular 16/20 times. Safety and efficacy could not be established. Cranial and CM ultrasound-guided injections targeting sacroiliac joints were very accurate for periarticular injection, but accuracy was poor for intra-articular injection. Injectate was frequently found in contact with interosseous sacroiliac ligaments, as well as neurovascular and synovial structures in close vicinity of sacroiliac joints.

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

    International Nuclear Information System (INIS)

    MacMahon, P.J.; Brennan, D.D.; Duke, D.; Forde, S.; Eustace, S.J.

    2007-01-01

    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

  7. In-Plane Ultrasound-Guided Knee Injection Through a Lateral Suprapatellar Approach: A Safe Technique.

    Science.gov (United States)

    Chagas-Neto, Francisco A; Taneja, Atul K; Gregio-Junior, Everaldo; Nogueira-Barbosa, Marcello H

    2017-06-01

    This study aims to describe a technique for in-plane ultrasound-guided knee arthrography through a lateral suprapatellar approach, reporting its accuracy and related complications. A retrospective search was performed for computed tomography and magnetic resonance reports from June 2013 through June 2015. Imaging studies, puncture descriptions, and guided-procedure images were reviewed along with clinical and surgical history. A fellowship-trained musculoskeletal radiologist performed all procedures under sterile technique and ultrasound guidance with the probe in oblique position on the lateral suprapatellar recess after local anesthesia with the patient on dorsal decubitus, hip in neutral rotation, and 30 to 45 degrees of knee flexion. A total of 86 consecutive subjects were evaluated (mean, 55 years). All subjects underwent intra-articular injection of contrast, which was successfully reached in the first attempt in 94.2% of the procedures (81/86), and in the second attempt in 5.8% (5/86) after needle repositioning without a second puncture. There were no postprocedural reports of regional complications at the puncture site, such as significant pain, bleeding, or vascular lesions. Our study demonstrates that in-plane ultrasound-guided injection of the knee in semiflexion approaching the lateral suprapatellar recess is a safe and useful technique to administer intra-articular contrast solution, as an alternative method without radiation exposure.

  8. Outcome of ultrasound-guided small-bore catheter drainage in exudative pleural effusions.

    Science.gov (United States)

    Kiranantawat, Nantaka; Sungsiri, Jitpreedee; Geater, Sarayut L

    2014-05-01

    To evaluate the outcome and safety of ultrasound-guided percutaneous catheter drainage of exudative pleural effusion. The present study was a retrospective analysis of 412 pleural effusions from 373 patients that underwent ultrasound-guided small-bore catheter drainage in exudative pleural effusions between 2004 and 2009. The two most common causes for drainage were parapneumonic effusion or empyema (52.2%) and malignant effusion (30.3%), while the remains were trauma, iatrogenic, and others. Overall clinical success rate was 76.5%. The success rate was lower among malignant pleural effusion (p = 0.003). Causes of effusion were the only independent predictors related to success. Only five (1.2%) patients developed complication during the procedure. Seventy-five of 412 effusions (15.8%) developed complication during the period of drainage; the majority were drain blockage (9%) and accidental dislodgment (4.1%). Ultrasound-guided small-bore catheter drainage was a safe and efficient procedure for exudative pleural effusions.

  9. Diagnostic efficacy of ultrasound-guided core-needle biopsy of peripheral lymph nodes in sarcoidosis.

    Science.gov (United States)

    Boussouar, S; Medjhoul, A; Bernaudin, J F; Tayebjee, O; Soussan, M; Uzunhan, Y; Nunes, H; Kambouchner, M; Martin, A; Valeyre, D; Brillet, P Y

    2015-09-14

    Core-needle biopsy guided by ultrasound can be performed for investigating peripheral lymph node (PLN). The aim of this study was to determine the efficacy of this technique in sarcoidosis. Retrospective review of files of all patients in the database of the radiology department of Avicenne university hospital who underwent PLN biopsies guided by ultrasound from January 2008 to June 2011 (n=292). Cases with either granulomas at histology with the procedure or with a final diagnosis of sarcoidosis were included in the study. The histological specimens were adequate in 282 out of 292 cases (96%) showing non-caseating granulomas in 22 cases (n=20 patients with a final diagnosis of sarcoidosis and n=2 patients with tuberculosis). After reviewing clinical files of the 282 patient, 22 were confirmed to have sarcoidosis, at initial presentation (n=19) or later during flare-up or relapse (n=3) with only 2 patients having no granuloma on PLN biopsy. PLN were palpable in 18 cases and only detected by (18F)FDG-PET/CT showing increased PLN uptake in 4 cases. The sensitivity and specificity of adequate biopsy were 91 and 99% and the positive and negative predictive values were 91 and 99%, respectively. Core-needle biopsy guided by ultrasound has a high efficacy for evidencing granulomas in sarcoidosis patients with PLN involvement either clinically palpable or in the presence of (18F)FDG-PET/CT uptake.

  10. Ultrasound guided electrical impedance tomography for 2D free-interface reconstruction

    Science.gov (United States)

    Liang, Guanghui; Ren, Shangjie; Dong, Feng

    2017-07-01

    The free-interface detection problem is normally seen in industrial or biological processes. Electrical impedance tomography (EIT) is a non-invasive technique with advantages of high-speed and low cost, and is a promising solution for free-interface detection problems. However, due to the ill-posed and nonlinear characteristics, the spatial resolution of EIT is low. To deal with the issue, an ultrasound guided EIT is proposed to directly reconstruct the geometric configuration of the target free-interface. In the method, the position of the central point of the target interface is measured by a pair of ultrasound transducers mounted at the opposite side of the objective domain, and then the position measurement is used as the prior information for guiding the EIT-based free-interface reconstruction. During the process, a constrained least squares framework is used to fuse the information from different measurement modalities, and the Lagrange multiplier-based Levenberg-Marquardt method is adopted to provide the iterative solution of the constraint optimization problem. The numerical results show that the proposed ultrasound guided EIT method for the free-interface reconstruction is more accurate than the single modality method, especially when the number of valid electrodes is limited.

  11. Ultrasound guided electrical impedance tomography for 2D free-interface reconstruction

    International Nuclear Information System (INIS)

    Liang, Guanghui; Ren, Shangjie; Dong, Feng

    2017-01-01

    The free-interface detection problem is normally seen in industrial or biological processes. Electrical impedance tomography (EIT) is a non-invasive technique with advantages of high-speed and low cost, and is a promising solution for free-interface detection problems. However, due to the ill-posed and nonlinear characteristics, the spatial resolution of EIT is low. To deal with the issue, an ultrasound guided EIT is proposed to directly reconstruct the geometric configuration of the target free-interface. In the method, the position of the central point of the target interface is measured by a pair of ultrasound transducers mounted at the opposite side of the objective domain, and then the position measurement is used as the prior information for guiding the EIT-based free-interface reconstruction. During the process, a constrained least squares framework is used to fuse the information from different measurement modalities, and the Lagrange multiplier-based Levenberg–Marquardt method is adopted to provide the iterative solution of the constraint optimization problem. The numerical results show that the proposed ultrasound guided EIT method for the free-interface reconstruction is more accurate than the single modality method, especially when the number of valid electrodes is limited. (paper)

  12. Neuroprotective effects of ultrasound-guided nerve growth factor injections after sciatic nerve injury

    Directory of Open Access Journals (Sweden)

    Hong-fei Li

    2015-01-01

    Full Text Available Nerve growth factor (NGF plays an important role in promoting neuroregeneration after peripheral nerve injury. However, its effects are limited by its short half-life; it is therefore important to identify an effective mode of administration. High-frequency ultrasound (HFU is increasingly used in the clinic for high-resolution visualization of tissues, and has been proposed as a method for identifying and evaluating peripheral nerve damage after injury. In addition, HFU is widely used for guiding needle placement when administering drugs to a specific site. We hypothesized that HFU guiding would optimize the neuroprotective effects of NGF on sciatic nerve injury in the rabbit. We performed behavioral, ultrasound, electrophysiological, histological, and immunohistochemical evaluation of HFU-guided NGF injections administered immediately after injury, or 14 days later, and compared this mode of administration with intramuscular NGF injections. Across all assessments, HFU-guided NGF injections gave consistently better outcomes than intramuscular NGF injections administered immediately or 14 days after injury, with immediate treatment also yielding better structural and functional results than when the treatment was delayed by 14 days. Our findings indicate that NGF should be administered as early as possible after peripheral nerve injury, and highlight the striking neuroprotective effects of HFU-guided NGF injections on peripheral nerve injury compared with intramuscular administration.

  13. 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.

  14. Determination of optimal ultrasound planes for the initialisation of image registration during endoscopic ultrasound-guided procedures.

    Science.gov (United States)

    Bonmati, Ester; Hu, Yipeng; Gibson, Eli; Uribarri, Laura; Keane, Geri; Gurusami, Kurinchi; Davidson, Brian; Pereira, Stephen P; Clarkson, Matthew J; Barratt, Dean C

    2018-06-01

    Navigation of endoscopic ultrasound (EUS)-guided procedures of the upper gastrointestinal (GI) system can be technically challenging due to the small fields-of-view of ultrasound and optical devices, as well as the anatomical variability and limited number of orienting landmarks during navigation. Co-registration of an EUS device and a pre-procedure 3D image can enhance the ability to navigate. However, the fidelity of this contextual information depends on the accuracy of registration. The purpose of this study was to develop and test the feasibility of a simulation-based planning method for pre-selecting patient-specific EUS-visible anatomical landmark locations to maximise the accuracy and robustness of a feature-based multimodality registration method. A registration approach was adopted in which landmarks are registered to anatomical structures segmented from the pre-procedure volume. The predicted target registration errors (TREs) of EUS-CT registration were estimated using simulated visible anatomical landmarks and a Monte Carlo simulation of landmark localisation error. The optimal planes were selected based on the 90th percentile of TREs, which provide a robust and more accurate EUS-CT registration initialisation. The method was evaluated by comparing the accuracy and robustness of registrations initialised using optimised planes versus non-optimised planes using manually segmented CT images and simulated ([Formula: see text]) or retrospective clinical ([Formula: see text]) EUS landmarks. The results show a lower 90th percentile TRE when registration is initialised using the optimised planes compared with a non-optimised initialisation approach (p value [Formula: see text]). The proposed simulation-based method to find optimised EUS planes and landmarks for EUS-guided procedures may have the potential to improve registration accuracy. Further work will investigate applying the technique in a clinical setting.

  15. 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.

  16. Ultrasound-guided pigtail catheters for drainage of various pleural diseases.

    Science.gov (United States)

    Liu, Yi-Heng; Lin, Yu-Chao; Liang, Shinn-Jye; Tu, Chih-Yen; Chen, Chia-Hung; Chen, Hung-Jen; Chen, Wei; Shih, Chuen-Ming; Hsu, Wu-Huei

    2010-10-01

    Little is known about the efficacy and safety of ultrasound-guided pigtail catheters for the management of various pleural diseases in the emergency department, ward, and intensive care unit. We conducted a retrospective study in a university hospital during a 1-year interval. A total of 276 patients (178 men and 98 women) underwent 332 pigtail catheters (the drain size ranged from 10F to 16F) under ultrasound guidance. The mean ± SEM patient age was 59 ± 18 years, and mean duration of drainage was 6.1 ± 2 days. A total of 64 drains (19.2%) were inserted for pneumothoraces; 98 drains (29.5%), for malignant effusions; 119 drains (35.8%), for parapneumonic effusions/empyemas; and 38 drains (11.4%), for massive transudate pleural effusions. The overall success rate was 72.9%. The success rate was highest when the drain was used to treat massive transudate effusions (81.6%) and malignant pleural effusions (75.5%), followed by parapneumonic effusions/empyemas (72.2%), hemothoraces (66.6%), and pneumothoraces (64.0%). Only 10 (3.0%) drains had complications due to the procedure, including infection (n = 4, 1.2%), dislodgment (n = 4, 1.2%), wound bleeding at the pigtail catheter puncture area complicated with hemothoraces (n = 1, 0.3%), and lung puncture (n = 1, 0.3%). There was no significant difference in success rate when different catheter sizes were used to treat pleural diseases. Ultrasound-guided pigtail catheters provide a safe and effective method of draining various pleural diseases. We strongly suggest that ultrasound-guided pigtail catheters be considered as the initial draining method for a variety of pleural diseases. Copyright © 2010 Elsevier Inc. All rights reserved.

  17. 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.

  18. Preliminary study of ergonomic behavior during simulated ultrasound-guided regional anesthesia using a head-mounted display.

    Science.gov (United States)

    Udani, Ankeet D; Harrison, T Kyle; Howard, Steven K; Kim, T Edward; Brock-Utne, John G; Gaba, David M; Mariano, Edward R

    2012-08-01

    A head-mounted display provides continuous real-time imaging within the practitioner's visual field. We evaluated the feasibility of using head-mounted display technology to improve ergonomics in ultrasound-guided regional anesthesia in a simulated environment. Two anesthesiologists performed an equal number of ultrasound-guided popliteal-sciatic nerve blocks using the head-mounted display on a porcine hindquarter, and an independent observer assessed each practitioner's ergonomics (eg, head turning, arching, eye movements, and needle manipulation) and the overall block quality based on the injectate spread around the target nerve for each procedure. Both practitioners performed their procedures without directly viewing the ultrasound monitor, and neither practitioner showed poor ergonomic behavior. Head-mounted display technology may offer potential advantages during ultrasound-guided regional anesthesia.

  19. Contrast-Enhanced Ultrasound Guided Biopsy of Undetermined Abdominal Lesions: A Multidisciplinary Decision-Making Approach

    Directory of Open Access Journals (Sweden)

    Feng Mao

    2017-01-01

    Full Text Available Aim. To investigate the value of contrast-enhanced ultrasound (CEUS guided biopsy of undetermined abdominal lesions in multidisciplinary treatment (MDT decision-making approach. Methods. Between Jan 2012 and Dec 2015, 60 consecutive patients (male, 37; female, 23; mean age, 51.3 years ± 14.6 who presented with undetermined abdominal lesions were included. CEUS and core needle percutaneous biopsy was performed under real-time CEUS guidance in all lesions. Data were recorded and compared with conventional ultrasound (US guidance group (n=75. All CEUS findings and clinical data were evaluated in MDT. Results. CEUS enabled the delimitation of more (88.3% versus 41.3% and larger (14.1 ± 10.7 mm versus 32.3 ± 18.5 mm nonenhanced necrotic areas. More inner (20.0% versus 6.7% and surrounding (18.3% versus 2.7% major vessels were visualized and avoided during biopsies. CEUS-guided biopsy increased the diagnostic accuracy from 93.3% to 98.3%, with correct diagnosis in 57 of 60 lesions (95.0%. The therapeutic plan was influenced by CEUS guided biopsies findings in the majority of patients (98.3%. Conclusion. The combination of CEUS guided biopsy and MDT decision-making approach is useful in the diagnostic work-up and therapeutic management.

  20. Contrast-Enhanced Ultrasound Guided Biopsy of Undetermined Abdominal Lesions: A Multidisciplinary Decision-Making Approach.

    Science.gov (United States)

    Mao, Feng; Dong, Yi; Ji, Zhengbiao; Cao, Jiaying; Wang, Wen-Ping

    2017-01-01

    Aim. To investigate the value of contrast-enhanced ultrasound (CEUS) guided biopsy of undetermined abdominal lesions in multidisciplinary treatment (MDT) decision-making approach. Methods. Between Jan 2012 and Dec 2015, 60 consecutive patients (male, 37; female, 23; mean age, 51.3 years ± 14.6) who presented with undetermined abdominal lesions were included. CEUS and core needle percutaneous biopsy was performed under real-time CEUS guidance in all lesions. Data were recorded and compared with conventional ultrasound (US) guidance group ( n = 75). All CEUS findings and clinical data were evaluated in MDT. Results. CEUS enabled the delimitation of more (88.3% versus 41.3%) and larger (14.1 ± 10.7 mm versus 32.3 ± 18.5 mm) nonenhanced necrotic areas. More inner (20.0% versus 6.7%) and surrounding (18.3% versus 2.7%) major vessels were visualized and avoided during biopsies. CEUS-guided biopsy increased the diagnostic accuracy from 93.3% to 98.3%, with correct diagnosis in 57 of 60 lesions (95.0%). The therapeutic plan was influenced by CEUS guided biopsies findings in the majority of patients (98.3%). Conclusion. The combination of CEUS guided biopsy and MDT decision-making approach is useful in the diagnostic work-up and therapeutic management.

  1. Evolution of Robot-assisted ultrasound-guided breast biopsy systems

    Directory of Open Access Journals (Sweden)

    Mustafa Z. Mahmoud

    2018-01-01

    Full Text Available Robot-assisted ultrasound-guided breast biopsy combines ultrasound (US imaging with a robotic system for medical interventions. This study was designed to provide a literature review of a robotic US-guided breast biopsy system to delineate its efficacious impact on current medical practice. In addition, the strengths and limitations of this approach were also addressed. Articles published in the English language between 2000 and 2016 were appraised in this review. A wide range of systems that bind robotics with US imaging and guided breast biopsy were examined in this article. The fundamental safety and real-time imaging capabilities of US, together with the accuracy and maneuverability of robotic devices, is clearly an effective association with unmatched capabilities. Numerous experimental systems have obvious benefits over old-fashioned techniques, and the future of robot-assisted US-guided breast biopsy will be characterized by increasing levels of automation, and they hold tremendous possibility to impact doctor achievement, patient recovery, and clinical management.

  2. Ultrasound-guided identification of cardiac imaging windows.

    Science.gov (United States)

    Liu, Garry; Qi, Xiu-Ling; Robert, Normand; Dick, Alexander J; Wright, Graham A

    2012-06-01

    Currently, the use of cine magnetic resonance imaging (MRI) to identify cardiac quiescent periods relative to the electrocardiogram (ECG) signal is insufficient for producing submillimeter-resolution coronary MR angiography (MRA) images. In this work, the authors perform a time series comparison between tissue Doppler echocardiograms of the interventricular septum (IVS) and concurrent biplane x-ray angiograms. Our results indicate very close agreement between the diastasis gating windows identified by both the IVS and x-ray techniques. Seven cath lab patients undergoing diagnostic angiograms were simultaneously scanned during a breath hold by ultrasound and biplane x-ray for six to eight heartbeats. The heart rate of each patient was stable. Dye was injected into either the left or right-coronary vasculature. The IVS was imaged using color tissue Doppler in an apical four-chamber view. Diastasis was estimated on the IVS velocity curve. On the biplane angiograms, proximal, mid, and distal regions were identified on the coronary artery (CA). Frame by frame correlation was used to derive displacement, and then velocity, for each region. The quiescent periods for a CA and its subsegments were estimated based on velocity. Using Pearson's correlation coefficient and Bland-Altman analysis, the authors compared the start and end times of the diastasis windows as estimated from the IVS and CA velocities. The authors also estimated the vessel blur across the diastasis windows of multiple sequential heartbeats of each patient. In total, 17 heartbeats were analyzed. The range of heart rate observed across patients was 47-79 beats per minute (bpm) with a mean of 57 bpm. Significant correlations (R > 0.99; p windows. The mean difference in the starting times between IVS and CA quiescent windows was -12.0 ms. The mean difference in end times between IVS and CA quiescent windows was -3.5 ms. In contrast, the correlation between RR interval and both the start and duration of the x

  3. The role of ultrasound and ultrasound-guided fine needle aspiration biopsy of lymph nodes in patients with skin tumours

    International Nuclear Information System (INIS)

    Solivetti, Francesco Maria; Elia, Fulvia; Santaguida, Maria Giulia; Guerrisi, Antonino; Visca, Paolo; Cercato, Maria Cecilia; Di Carlo, Aldo

    2014-01-01

    The primary aim of this study was to evaluate the diagnostic accuracy of ultrasound (US) in the study of superficial lymph nodes during the follow-up of patients surgically treated for skin tumours. The secondary objective was to compare positive cytological results with histological reports. From 2004 to 2011, 480 patients (male/female: 285/195; median age 57 years; prevalent skin tumour: melanoma) underwent US-guided fine-needle aspiration biopsy (FNAB) of suspicious recurrent lymph nodes. An expert radiologist first performed US testing of the lymph nodes, expressing either a negative or positive outcome of the test. Subsequently, US-guided FNAB was performed. FNAB positive patients were subjected to lymphadenectomy; the patients who tested negative underwent the follow-up. The size of lymph nodes was ≤ 2 cm in 90% of cases. Out of the 336 (70%) US “positive” patients, 231 (68.8%) were FNAB positives. Out of the 144 (30%) US “negatives”, 132 (91.7%) were FNAB negatives. The sensitivity and specificity of the US were 95% and 55.7%, respectively; the negative predictive value was 91.7% and the positive predictive value was 68.8%. Definitive histological results confirmed FNAB positivity in 97.5% of lymphadenectomies. US is a sensitive method in the evaluation of superficial lymph nodes during the follow-up of patients with skin tumours. High positive predictive value of cytology was confirmed

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

    Science.gov (United States)

    Biron, Vincent L; Kurien, George; Dziegielewski, Peter; Barber, Brittany; Seikaly, Hadi

    2013-02-26

    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. To compare I&D vs USD of well-defined DNAs, using a randomized controlled clinical trial design. The primary outcome measure was effectiveness (length of hospital stay (LOHS) and safety), and the secondary outcome measure was overall cost to the healthcare system. Patients presenting to the University of Alberta Emergency Department with a well-defined deep neck space abscess were recruited in the study. Patients were randomized to surgical or US-guided drainage, placed on intravenous antibiotics and admitted with airway precautions. Following drainage with either intervention, abscess collections were cultured and drains were left in place until discharge. Seventeen patients were recruited in the study. We found a significant difference in mean LOHS between patients who underwent USD (3.1 days) vs I&D (5.2 days). We identified significant cost savings associated with USD with a 41% cost reduction in comparison to I&D. USD drainage of deep neck space abscesses in a certain patient population is effective, safe, and results in a significant cost savings to the healthcare system.

  5. Image-guided ultrasound phased arrays are a disruptive technology for non-invasive therapy.

    Science.gov (United States)

    Hynynen, Kullervo; Jones, Ryan M

    2016-09-07

    Focused ultrasound offers a non-invasive way of depositing acoustic energy deep into the body, which can be harnessed for a broad spectrum of therapeutic purposes, including tissue ablation, the targeting of therapeutic agents, and stem cell delivery. Phased array transducers enable electronic control over the beam geometry and direction, and can be tailored to provide optimal energy deposition patterns for a given therapeutic application. Their use in combination with modern medical imaging for therapy guidance allows precise targeting, online monitoring, and post-treatment evaluation of the ultrasound-mediated bioeffects. In the past there have been some technical obstacles hindering the construction of large aperture, high-power, densely-populated phased arrays and, as a result, they have not been fully exploited for therapy delivery to date. However, recent research has made the construction of such arrays feasible, and it is expected that their continued development will both greatly improve the safety and efficacy of existing ultrasound therapies as well as enable treatments that are not currently possible with existing technology. This review will summarize the basic principles, current statures, and future potential of image-guided ultrasound phased arrays for therapy.

  6. Improving needle tip identification during ultrasound-guided procedures in anaesthetic practice.

    Science.gov (United States)

    Scholten, H J; Pourtaherian, A; Mihajlovic, N; Korsten, H H M; A Bouwman, R

    2017-07-01

    Ultrasound guidance is becoming standard practice for needle-based interventions in anaesthetic practice, such as vascular access and peripheral nerve blocks. However, difficulties in aligning the needle and the transducer can lead to incorrect identification of the needle tip, possibly damaging structures not visible on the ultrasound screen. Additional techniques specifically developed to aid alignment of needle and probe or identification of the needle tip are now available. In this scoping review, advantages and limitations of the following categories of those solutions are presented: needle guides; alterations to needle or needle tip; three- and four-dimensional ultrasound; magnetism, electromagnetic or GPS systems; optical tracking; augmented (virtual) reality; robotic assistance; and automated (computerised) needle detection. Most evidence originates from phantom studies, case reports and series, with few randomised clinical trials. Improved first-pass success and reduced performance time are the most frequently cited benefits, whereas the need for additional and often expensive hardware is the greatest limitation to widespread adoption. Novice ultrasound users seem to benefit most and great potential lies in education. Future research should focus on reporting relevant clinical parameters to learn which technique will benefit patients most in terms of success and safety. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

  7. WE-H-209-00: Carson/Zagzebski Distinguished Lectureship: Image Guided Ultrasound Therapy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    Focused ultrasound has been shown to be the only method that allows noninvasive thermal coagulation of tissues and recently this potential has been explored for image-guided drug delivery. In this presentation, the advances in ultrasound phased array technology for energy delivery, exposure monitoring and control will be discussed. Experimental results from novel multi-frequency transmit/receive arrays will be presented. In addition, the feasibility of fully electronically focused and steered high power arrays with many thousands of transducer elements will be discussed. Finally, some of the recent clinical and preclinical results for the treatment of brain disease will be reviewed. Learning Objectives: Introduce FUS therapy principles and modern techniques Discuss use of FUS for drug delivery Cover the technology required to deliver FUS and monitor therapy Present clinical examples of the uses of these techniques This research was supported by funding from The Canada Research Chair Program, Grants from CIHR and NIH (no. EB003268).; K. Hynynen, Canada Foundation for Innovation; Canadian Institutes of Health Research; Focused Ultrasound Surgery Foundation; Canada Research Chair Program; Natural Sciences and Engineering Research Council of Canada; Ontario Research Fund; National Institutes of Health; Canadian Cancer Society Research Institute; The Weston Brain Institute; Harmonic Medical; Focused Ultrasound Instruments.

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

    International Nuclear Information System (INIS)

    Lee, Min Hee

    2004-01-01

    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.

  9. 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.

  10. Ultrasound-guided intraarticular injection for MR arthrography of the shoulder

    International Nuclear Information System (INIS)

    Schaeffeler, Christoph; Bruegel, M.; Waldt, S.; Rummeny, E.J.; Woertler, K.

    2010-01-01

    Purpose: To evaluate ultrasound guidance for intraarticular contrast injection via an anterolateral approach in comparison with fluoroscopic guidance. Materials and Methods: Contrast agent injection was performed in 40 consecutive patients, 20 under sonographic guidance and 20 under fluoroscopic guidance. None of the patients had previous shoulder surgery. The procedure time was measured and the efficiency of joint distension, incidence of extravasation and intraarticular air on the consecutive MR arthrograms were assessed by three blinded radiologists with musculoskeletal radiology experience. Statistical analysis was performed using the Kruskal-Wallis test. Results: Intraarticular contrast injection was successfully accomplished in all 40 patients. Subsequent MR arthrograms did not show any significant difference between sonographic and fluoroscopic guidance with respect to diagnostic quality, joint distension (p = 0.6665), intraarticular air bubbles (p = 0.1567) and occurrence of contrast extravasation (p = 0.8565). The mean duration of ultrasound-guided injection was 7:30 min compared to a shorter procedure time of 4:15 min for fluoroscopic guidance. In both groups, no procedural complications were observed. Conclusion: Ultrasound-guided injection for MR arthrography of the shoulder via an anterolateral approach represents a simple, safe, and effective technique which yields comparable results to those of injection under fluoroscopic guidance, but is slightly more time-consuming. (orig.)

  11. Feasibility of MRI-guided Focused Ultrasound as Organ-Sparing Treatment for Testicular Cancer

    Science.gov (United States)

    Staruch, Robert; Curiel, Laura; Chopra, Rajiv; Hynynen, Kullervo

    2009-04-01

    High cure rates for testicular cancer have prompted interest in organ-sparing surgery for patients with bilateral disease or single testis. Focused ultrasound (FUS) ablation could offer a noninvasive approach to organ-sparing surgery. The objective of this study was to determine the feasibility of using MR thermometry to guide organ-sparing focused ultrasound surgery in the testis. The testes of anesthetized rabbits were sonicated in several discrete locations using a single-element focused transducer operating at 2.787MHz. Focal heating was visualized with MR thermometry, using a measured PRF thermal coefficient of -0.0089±0.0003 ppm/° C. Sonications at 3.5-14 acoustic watts applied for 30 seconds produced maximum temperature elevations of 10-80° C, with coagulation verified by histology. Coagulation of precise volumes in the testicle is feasible with MRI-guided focused ultrasound. Variability in peak temperature for given sonication parameters suggests the need for online temperature feedback control.

  12. Effectiveness of imaging-guided intra-articular injection: a comparison study between fluoroscopy and ultrasound.

    Science.gov (United States)

    Furtado, Rita Nely Vilar; Pereira, Daniele Freitas; da Luz, Karine Rodrigues; dos Santos, Marla Francisca; Konai, Monique Sayuri; Mitraud, Sonia de Aguiar Vilela; Rosenfeld, Andre; Fernandes, Artur da Rocha Correa; Natour, Jamil

    2013-01-01

    Compare the effectiveness of ultrasound and fluoroscopy to guide intra-articular injections (IAI) in selected cases. A prospective study in our outpatient clinics at the Rheumatology Division at Universidade Federal de São Paulo (UNIFESP), Brazil, was conducted to compare the short-term (4 weeks) effectiveness of ultrasound and fluoroscopy-guided IAI in patients with rheumatic diseases. Inclusion criteria were: adults with refractory synovitis undergoing IAI with glucocorticoid. All patients had IAI performed with triamcinolone hexacetonide (20mg/ml) with varying doses according to the joint injected. A total of 71 rheumatic patients were evaluated (52 women, 44 whites). Mean age was 51.9 ± 13 years and 47 of them (66.2%) were on regular DMARD use. Analysis of the whole sample (71 patients) and hip sub-analysis (23 patients) showed that significant improvement was observed for both groups in terms of pain (P < 0.001). Global analysis also demonstrated better outcomes for patients in the FCG in terms of joint flexion (P < 0.001) and percentage change in joint flexion as compared to the USG. Likert scale score analyses demonstrated better results for the patients in the USG as compared to the FCG at the end of the study (P < 0.05). No statistically significant difference between groups was observed for any other study variable. Imaging-guided IAI improves regional pain in patients with various types of synovitis in the short term. For the vast majority of variables, no significant difference in terms of effectiveness was observed between fluoroscopy and ultrasound guided IAI.

  13. Radiofrequency ablation guided by contrast-enhanced ultrasound for hepatic malignancies: Preliminary results

    International Nuclear Information System (INIS)

    Dong, Y.; Wang, W.-P.; Gan, Y.-H.; Huang, B.-J.; Ding, H.

    2014-01-01

    Aim: To evaluate whether contrast-enhanced ultrasound (CEUS)-guided radiofrequency ablation (RFA) can be performed effectively in small hepatic malignancies that are invisible or poorly visualized at traditional grey-scale ultrasonography (US). Materials and methods: The institutional ethics committee approved the study, and all patients provided written informed consent before their enrolment. The study focused on 55 patients (43 men, 12 women, age 57.4 ± 10.9 years) with 60 hepatic lesions from May 2010 to March 2011. All lesions were treated with multipolar radiofrequency ablation (RFA). During the RFA procedure, with the injection of ultrasound contrast agent (sulphur hexafluoride; SonoVue, Bracco Imaging Spa, Milan, Italy), RFA was conducted under CEUS guidance when the optimal depiction of a lesion was obtained. Artificial pleural effusions were used in those cases obstructed by the lungs. Twenty-four hours after RFA, contrast-enhanced MRI was used as the reference standard to evaluate the primary effectiveness rate and complete tumour necrosis. The follow-up time was 12–24 months (median 15 months). Results: Among 60 hepatic malignancies, CEUS detected 57 lesions (95%), which was higher than that at US (26.6%). Artificial pleural effusions were performed in three cases, resulting in the detection of three additional lesions. The insertion of RFA electrodes was monitored by CEUS in all lesions. Immediately after RFA, complete tumour necrosis were achieved in all 60 lesions as apparent at MRI, for a primary effectiveness rate of 100%. Conclusion: CEUS-guided RFA is a promising technique for targeting and improving the efficiency of treatment of hepatic malignancies. - Highlights: • CEUS guided RFA improved the detectability of hepatic malignancies indistinctive on gray-scale ultrasound. • Pre-operation CEUS helped localization of indistinctive hepatic malignancies. • CEUS guided RFA of hepatic malignancies achieved a more complete ablation

  14. Guided interventions in musculoskeletal ultrasound: what's the evidence?

    Energy Technology Data Exchange (ETDEWEB)

    Davidson, J., E-mail: jdavidson@doctors.org.u [St Richard' s Hospital, Spitalfield Lane, Chichester, West Sussex (United Kingdom); Jayaraman, S. [St Richard' s Hospital, Spitalfield Lane, Chichester, West Sussex (United Kingdom)

    2011-02-15

    Increasing histological and radiological understanding of the processes involved in soft-tissue injury is leading to novel targeted treatments. A number of reviews have recommended that these treatments should be performed with image guidance. This review describes current ultrasound-guided interventions and injections, together with the level of evidence for these. Discussion of guided interventions will include; percutaneous lavage (barbotage), brisement, dry needling, electrocoagulation, and of guided injections; corticosteroids, autologous substances (blood and platelet rich plasma), sclerosants, and prolotherapy (hyperosmolar dextrose). Representative imaging illustrating some of these techniques is included for correlation with the methods described. As these procedures are often performed in sportspeople, it is essential that the radiologist is aware of prohibited substances and methods outlined in an annual publication from the World Anti-Doping Association (WADA). Finally, future directions, including the use of autologous substances, mesenchymal and stem cells will be discussed.

  15. Magnetic Resonance-Guided High-Intensity-Focused Ultrasound for Palliation of Painful Skeletal Metastases: A Pilot Study.

    Science.gov (United States)

    Chan, Michael; Dennis, Kristopher; Huang, Yuexi; Mougenot, Charles; Chow, Edward; DeAngelis, Carlo; Coccagna, Jennifer; Sahgal, Arjun; Hynynen, Kullervo; Czarnota, Gregory; Chu, William

    2017-10-01

    Bone is one of the most common sites of metastases, with bone metastases-related pain representing a significant source of morbidity among patients with cancer. Magnetic resonance-guided focused ultrasound is a noninvasive, outpatient modality with the potential for treating painful bone metastases. The aim of this study is to report our initial experience with magnetic resonance-guided focused ultrasound in the treatment of bone metastases and our preliminary analysis of urinary cytokine levels after therapy. This was a single-center pilot study of 10 patients with metastatic cancer to investigate the feasibility of magnetic resonance-guided focused ultrasound for primary pain control in device-accessible skeletal metastases. Treatments were performed on a clinical magnetic resonance-guided focused ultrasound system using a volumetric ablation technique. Primary efficacy was assessed using Brief Pain Inventory scores and morphine equivalent daily dose intake at 3 time points: before, day 14, and day 30 after the magnetic resonance-guided focused ultrasound treatment. Urine cytokines were measured 3 days before treatment and 2 days after the treatment. Of the 10 patients, 8 were followed up 14 days and 6 were followed up 30 days after the treatment. At day 14, 3 patients (37.5%) exhibited partial pain response and 4 patients (50%) exhibited an indeterminate response, and at day 30 after the treatment, 5 patients (83%) exhibited partial pain response. No treatment-related adverse events were recorded. Of the urine cytokines measured, only Transforming growth factor alpha (TGFα) demonstrated an overall decrease, with a trend toward statistical significance ( P = .078). Our study corroborates magnetic resonance-guided focused ultrasound as a feasible and safe modality as a primary, palliative treatment for painful bone metastases and contributes to the limited body of literature using magnetic resonance-guided focused ultrasound for this clinical indication.

  16. Ultrasound-Guided Versus Landmark-Guided Local Corticosteroid Injection for Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Babaei-Ghazani, Arash; Roomizadeh, Peyman; Forogh, Bijan; Moeini-Taba, Seyed-Mohammad; Abedini, Amin; Kadkhodaie, Mona; Jahanjoo, Fateme; Eftekharsadat, Bina

    2018-04-01

    To review the literature and assess the comparative effectiveness of ultrasound-guided versus landmark-guided local corticosteroid injections in patients with carpal tunnel syndrome (CTS). Cochrane Central Register of Controlled Trials, MEDLINE (PubMed), Embase (Ovid), and Web of Science (from inception to February 1, 2017). Randomized controlled trials (RCTs) comparing ultrasound-guided injection with landmark-guided injection in patients with CTS were included. Two authors independently screened abstracts and full texts. The outcomes of interest were Symptom Severity Scale (SSS) and Functional Status Scale (FSS) scores of the Boston Carpal Tunnel Questionnaire and 4 electrodiagnostic parameters, including compound muscle action potential (CMAP), sensory nerve action potential (SNAP), distal motor latency (DML), and distal sensory latency (DSL). Overall, 569 abstracts were retrieved and checked for eligibility; finally, 3 RCTs were included (181 injected hands). Pooled analysis showed that ultrasound-guided injection was more effective in SSS improvement (mean difference [MD], -.46; 95% confidence interval [CI], -.59 to -.32; P.99), DML (MD, .05; 95% CI, -.30 to .39; P=.80), or DSL (MD, .00; 95% CI, -.65 to .65; P>.99). This review suggested that ultrasound-guided injection was more effective than landmark-guided injection in symptom severity improvement in patients with CTS; however, no significant differences were observed in functional status or electrodiagnostic improvements between the 2 methods. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. Ultrasound-guided Placement of a Foley Catheter Using a Hydrophilic Guide Wire

    Directory of Open Access Journals (Sweden)

    Mark Huber

    2018-03-01

    Full Text Available Acute urinary retention is a common problem in the emergency department. Patients can present in significant distress, necessitating the placement of a urinary catheter. Foley catheter placement can be difficult to accomplish depending on the etiology of the retention and the degree of the obstruction. In the case presented here, we used ultrasound guidance, a guidewire, and a Foley catheter to successfully relieve a patient’s urinary retention after multiple failed attempts.

  18. Pseudoaneurysm of the deep femoral artery caused by a guide wire following femur intertrochanteric fracture with a hip nail: A case report

    Directory of Open Access Journals (Sweden)

    Ji Wan Kim

    2017-05-01

    Full Text Available An 85-year-old woman developed severe swelling and pain in the proximal thigh after internal fixation of an intertrochanteric fracture of the femur with a hip nail. In order to identify the causes and determine the effective treatment, angiography was performed. The results of the angiography revealed a pseudoaneurysm of a branch of deep femoral artery. Endovascular embolization was used to treat the pseudoaneurysm. After reviewing all possible causes, we found a mistake in insertion of a guide wire for hip nail. Using intraoperative fluoroscopic images, we found the mal-positioned guide wire located posterior to trochanter on lateral view of hip. This case study reminds us that pseudoaneurysm can occur in a guide wire during hip nailing. Surgeons can avoid this complication with confirmation of lateral and anteroposterior view of hip.

  19. Protocol for the realization of transrectal prostatic biopsy guided by ultrasound

    International Nuclear Information System (INIS)

    Arce Montero, Jairo

    2013-01-01

    A general protocol is proposed for the realization of the ultrasound-guided prostatic biopsy in patients with positive screening. The screening should be performed taking into account risk antecedents, rectal examination and prostate-specific antigen (PSA) levels in the patients. However, patients that have presented without alteration in the PSA and suspect rectal examination, should be considered for biopsy endorectal with ultrasound guidance even more with positive risk factors. The generalities of prostate cancer are described. The general prostatic anatomy and echographic are reviewed. The echographic technique is analyzed in the exploration endorectal. The echographic findings suspects of prostate cancer are characterized. The different biopsy sampling techniques are described; and based on appropriate knowledge of prostatic echographic anatomy, could increase the effectiveness in the early detection of prostate cancer in patients with positive screening. The complications derived from the process are enumerated. The final recommendations are noted on the protocol described [es

  20. 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.

  1. A novel graphical user interface for ultrasound-guided shoulder arthroscopic surgery

    Science.gov (United States)

    Tyryshkin, K.; Mousavi, P.; Beek, M.; Pichora, D.; Abolmaesumi, P.

    2007-03-01

    This paper presents a novel graphical user interface developed for a navigation system for ultrasound-guided computer-assisted shoulder arthroscopic surgery. The envisioned purpose of the interface is to assist the surgeon in determining the position and orientation of the arthroscopic camera and other surgical tools within the anatomy of the patient. The user interface features real time position tracking of the arthroscopic instruments with an optical tracking system, and visualization of their graphical representations relative to a three-dimensional shoulder surface model of the patient, created from computed tomography images. In addition, the developed graphical interface facilitates fast and user-friendly intra-operative calibration of the arthroscope and the arthroscopic burr, capture and segmentation of ultrasound images, and intra-operative registration. A pilot study simulating the computer-aided shoulder arthroscopic procedure on a shoulder phantom demonstrated the speed, efficiency and ease-of-use of the system.

  2. 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.

  3. Feasibility of ultrasound-guided high intensity focused ultrasound ablating uterine fibroids with hyperintense on T2-weighted MR imaging

    International Nuclear Information System (INIS)

    Zhao, Wen-Peng; Chen, Jin-Yun; Zhang, Lian; Li, Quan; Qin, Juan

    2013-01-01

    Purpose: To retrospectively investigate whether uterine fibroids with hyperintense on pretreatment T2-weighted magnetic resonance imaging (MRI) could be treated with ultrasound-guided high intensity focused ultrasound (USgHIFU). Materials and methods: 282 patients with 282 symptomatic uterine fibroids who underwent USgHIFU treatment were retrospectively analyzed. Based on the signal intensity of T2-weighted MRI, uterine fibroids were classified as hypointense, isointense and hyperintense. Hyperintense fibroids were subjectively further subdivided into heterogeneous hyperintense, slightly homogeneous hyperintense and markedly homogeneous hyperintense based on the signal intensity of fibroid relative to myometrium and endometrium on T2-weighted MRI. Enhanced MRI was performed within one month after HIFU treatment. Non-perfused volume (NPV, indicative of successful ablation) ratio, treatment time, treatment efficiency, energy effect ratio and adverse events were recorded. Results: The median volume of uterine fibroids was 70.3 cm 3 (interquartile range, 41.1–132.5 cm 3 ). The average NPV ratio, defined as non-perfused volume divided by the fibroid volume after HIFU treatment, was 76.8 ± 19.0% (range, 0–100%) in the 282 patients. It was 86.3 ± 11.9% (range, 40.9–100.0%) in the group with hypointense fibroids, 77.1 ± 16.5% (range, 32.2–100.0%) in isointense fibroids, and 67.6 ± 23.9% (range, 0–100.0%) in hyperintense fibroids. The lowest NPV ratio, lowest treatment efficiency, more treatment time, more sonication energy and pain scores were observed in the slightly homogeneous hyperintense fibroids, and the NPV ratio was 55.8 ± 26.7% (range, 0–83.9%) in this subgroup. Conclusion: Based on our results, the heterogeneous and markedly homogeneous hyperintense fibroids were suitable for USgHIFU, and only the slightly homogeneous hyperintense fibroids should be excluded

  4. Effect of adding magnesium sulphate to bupivacaine on the clinical profile of ultrasound-guided thoracic paravertebral block in patients undergoing modified radical mastectomy

    Directory of Open Access Journals (Sweden)

    Mohamed Elsayed Hassan

    2015-01-01

    Conclusion: Adding magnesium sulphate to bupivacaine in ultrasound-guided paravertebral block resulted in more efficient analgesia and opioid-sparing in female patients undergoing modified radical mastectomy.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. [Arthroscopy-guided core decompression and bone grafting combined with selective arterial infusion for treatment of early stage avascular necrosis of femoral head].

    Science.gov (United States)

    Guo, Hao-Shan; Tian, Yi-Jun; Liu, Gang; An, Long; Zhou, Zhan-Guo; Liu, Huan-Zhen

    2018-01-25

    To observe the clinical effects of arthroscopy-guided core decompression and bone grafting combined with selective arterial infusion for early stage avascular necrosis of femoral head. From January 2010 to December 2014, 76 patients(76 hips) diagnosed as Ficat II stage avascular necrosis of femoral head were randomly divided into experimental group and control group. In the experimental group, there were 27 males and 8 females aged from 24 to 55 years old with an average of (43.96±6.81) years, treated with arthroscopic-guided core decompression and bone grafting combined with selective arterial infusion. Along the direction of the femoral neck, an 8 mm-diameter tunnel to necrotic areas was drilled, then curettage of necrotic bone was performed under arthroscope, and the iliac bone was grafted. In the control group, there were 29 males and 12 females aged from 26 to 56 years old with an average of (44.62±7.33) years, treated with percutaneous core decompression combined with selective arterial infusion. The preoperative and postoperative Harris scores were recorded and the changes of X-rays were analyzed. All the patients were followed up with an average of 30 months. Postoperative follow-up at 12 months showed that there was significant difference in imaging outcome between two groups( P 0.05), but there was significant difference in postoperative Harris score( P necrosis are effective. Using arthroscopic-guided core decompression method, the necrotic bone can be positioned and scraped more accurately, and can obtain better results. Copyright© 2018 by the China Journal of Orthopaedics and Traumatology Press.

  7. A method for the measurement of dispersion curves of circumferential guided waves radiating from curved shells: experimental validation and application to a femoral neck mimicking phantom

    Science.gov (United States)

    Nauleau, Pierre; Minonzio, Jean-Gabriel; Chekroun, Mathieu; Cassereau, Didier; Laugier, Pascal; Prada, Claire; Grimal, Quentin

    2016-07-01

    Our long-term goal is to develop an ultrasonic method to characterize the thickness, stiffness and porosity of the cortical shell of the femoral neck, which could enhance hip fracture risk prediction. To this purpose, we proposed to adapt a technique based on the measurement of guided waves. We previously evidenced the feasibility of measuring circumferential guided waves in a bone-mimicking phantom of a circular cross-section of even thickness. The goal of this study is to investigate the impact of the complex geometry of the femoral neck on the measurement of guided waves. Two phantoms of an elliptical cross-section and one phantom of a realistic cross-section were investigated. A 128-element array was used to record the inter-element response matrix of these waveguides. This experiment was simulated using a custom-made hybrid code. The response matrices were analyzed using a technique based on the physics of wave propagation. This method yields portions of dispersion curves of the waveguides which were compared to reference dispersion curves. For the elliptical phantoms, three portions of dispersion curves were determined with a good agreement between experiment, simulation and theory. The method was thus validated. The characteristic dimensions of the shell were found to influence the identification of the circumferential wave signals. The method was then applied to the signals backscattered by the superior half of constant thickness of the realistic phantom. A cut-off frequency and some portions of modes were measured, with a good agreement with the theoretical curves of a plate waveguide. We also observed that the method cannot be applied directly to the signals backscattered by the lower half of varying thicknesses of the phantom. The proposed approach could then be considered to evaluate the properties of the superior part of the femoral neck, which is known to be a clinically relevant site.

  8. Ultrasound-guided biopsy of transplanted pancreas: evaluation of 20 cases

    Directory of Open Access Journals (Sweden)

    Marcel Vieira da Nóbrega

    2009-03-01

    Full Text Available Objective: To report the experience with percutaneous biopsies of pancreatic grafts guided by ultrasonography. Methods: Series of cases referred from outpatient’s clinic for biopsy of pancreas transplant, between December 2006 and March 2008. Data were collected from medical electronic records for age, sex and histopathology. The indication for the procedure was obtained from medical and laboratory records. Doppler ultrasonography was performed for control and to guide biopsy in real time. Rresults: Twenty patients referred for biopsy of their transplanted pancreas over a one-year period were evaluated. In one patient, biopsy was not performed for having no safe access for ultrasound. It was used 18 gauge needles, mostly automatic-cut type. The main indications were increased blood glucose and pancreatic enzyme levels as well as reduction of urinary amylase. The sonographic aspect of the pancreatic graft was normal in 18 cases. In all 19 biopsies performed, satisfactory samples for histopathological study were obtained. There were no complications. Cconclusions: This series of cases demonstrated low sensitivity and specificity of ultrasound in diagnosis of pancreatic transplants disorders, but showed to be very useful to guide transplanted pancreas biopsies. Although no complications occurred in this experience, the risk-benefit relation should always be assessed for every patient.

  9. The effects of hypnotherapy during transrectal ultrasound-guided prostate needle biopsy for pain and anxiety.

    Science.gov (United States)

    Hızlı, Fatih; Özcan, Osman; Selvi, İsmail; Eraslan, Pınar; Köşüş, Aydın; Baş, Okan; Yıkılmaz, Taha Numan; Güven, Oğuz; Başar, Halil

    2015-11-01

    Several studies evaluating the tolerance of transrectal ultrasound (TRUS)-guided needle biopsies showed that moderate-to-severe pain was associated with the procedure. Additionally, prebiopsy anxiety or rebiopsy as a result of a prior biopsy procedure is mentioned as factors predisposing to higher pain intensity. Thus, in this study, we investigated the effects of hypnotherapy during transrectal ultrasound-guided prostate needle biopsy for pain and anxiety. Sixty-four patients presenting for TRUS-guided prostate needle biopsy were randomly assigned to receive either 10-min presurgery hypnosis session (n = 32, mean age 63.5 ± 6.1, p = 0.289) or a presurgery control session (n = 32, mean age 61.8 ± 6.8, p = 0.289). The hypnosis session involved suggestions for increased relaxation and decreased anxiety. Presurgery pain and anxiety were measured using visual analog scales (VAS), Beck Anxiety Inventory (BAI), and Hamilton Anxiety Scale (HAS), respectively. In our statistics, p < 0.05 was considered statistically significant. Postintervention, and before surgery, patients in the hypnosis group had significantly lower mean values for presurgery VAS [mean 1 (0-8); p = 0.011], BAI (6.0 vs 2.0; p < 0.001), and HAS (11.0 vs 6.0; p < 0.001). The study results indicate that a brief presurgery hypnosis intervention can be an effective means of controlling presurgical anxiety, and therefore pain, in patients awaiting diagnostic prostate cancer surgery.

  10. Individualized laparoscopic B-ultrasound-guided microwave ablation for multifocal primary liver cancer.

    Science.gov (United States)

    Xu, Zhifeng; Yang, Zhangwei; Pan, Jianghua; Hu, Yiren

    2018-03-01

    Liver cancer is one of the most common malignancies of the digestive system. Minimally invasive ablation procedures have become one of the major means for treating unresectable multifocal liver cancer and have been extensively applied in primary and metastatic liver cancer treatment. Laparoscopic B-ultrasound-guided microwave ablation is an example of the progress made in this field. To analyze and summarize the results of and experience with laparoscopic B-ultrasound-guided microwave ablation for multifocal primary liver cancer; moreover, the ablation effects were compared between tumors of different sizes. Laparoscope-guided needle ablation was conducted on 84 lesions from 32 patients with primary liver cancer based on tumor size, quantity, and location. Moreover, the perioperative data, ablation effects according to tumor size, and long-term follow-up results were analyzed. Among the 84 nodules treated via microwave ablation, tumors measuring ≤ 3 cm demonstrated complete ablation upon imaging analysis conducted 1 month after surgery. Moreover, 5 of the tumors measuring > 3 cm demonstrated incomplete ablation. In these cases, a second procedure was performed, until imaging studies confirmed that complete ablation was achieved. Laparoscopic microwave ablation allows for precise puncture positioning, an effective ablation range, and safe and feasible surgery, which is especially suitable for liver tumors located in sites difficult to access.

  11. The transabdominal chorionic villus sampling puncture guided by color Doppler ultrasound during early pregnancy

    International Nuclear Information System (INIS)

    Liang Weixiang; Chen Zhiyi; Yuan Wenlin; Cai Kuan; Zhu Junlin; Wang Weiqun; Chen Xia

    2008-01-01

    Objective: To study the operation of chorionic villus sampling (CVS) guided by color Doppler ultrasound (CDU) via abdomen puncture during early pregnancy and investigate the advertences during the operation. Methods: CVS guided by CDU probe via abdomen puncture were operated on 28 pregnant women who had the indications of antenatal diagnosis. CDU was used to observe the implantation position of the fo1iaceous villis and help setting mark of the puncture point and puncture range on body surface before operation. The needle was punctured under real-time ultrasound guidance and villis were aspirated during the operation: The choice of the right time of puncture and the operation skills were emphasized in the study. Results: The CVS puncture approach should be set through CDU ob servation, which attend to avoid the surrounding blood vessels, intestinal canal and surrounding important organs. The puncture point should be chosen in a point where lobif0rmed villis distributed wider and with a larger scope. The operations were performed from 10 to13 weeks of pregnancy, with an average of 11 weeks. Among these 28 cases, 9.6 were successfully drawn materials in one time, 1 in twice and l failure, with the total ratio of achievement was 96.4%. For all the cases, fetal heart pulsating could be seen by real-time CDU observation fight after the operation, and no larger hematoma echo in the placental site occurred. Ultrasound reexamined one week after the operation, fetal heart pulsation could be found in all cases, and no abortion cases occurred after regular follow-up in 25 continued pregnant patients. Conclusion: Abdominal CVS puncture guided by CDU probe is conveniently operated, safe and available in clinic. It is an important method for antenatal diagnosis during early pregnancy. The puncture localization, skills and the time are the key points for the success in obtaining the materials. (authors)

  12. 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.

  13. Ultrasound guided percutaneous treatment and follow-up of Baker's cyst in knee osteoarthritis

    International Nuclear Information System (INIS)

    Köroğlu, Mert; Çallıoğlu, Mehmet; Eriş, Hüseyin Naim; Kayan, Mustafa; Çetin, Meltem; Yener, Mahmut; Gürses, Cemil; Erol, Bekir; Türkbey, Barış; Parlak, Ayşe Eda; Akhan, Okan

    2012-01-01

    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.

  14. A comparison of ultrasound guided fine needle aspiration cytology and core needle biopsy in evaluation of palpable breast lesions

    International Nuclear Information System (INIS)

    Altaf, H.N.; Farooqui, F.

    2015-01-01

    Objective: To compare ultrasound guided fine-needle aspiration cytology (FNAC) and core needle biopsy (CNB) in patients presenting with palpable breast lumps (PBLs), in terms of sensitivity and specificity, taking final histopathology as gold standard. Methodology: This cross-sectional study was conducted at Holy Family Hospital, Rawalpindi, Pakistan. Ultrasound guided FNAC and CNB were taken of all female patients with PBLs. The results were compared with final histopathology as gold standard. Data analysis was performed using SPSS software and chi-square test. Results: A total of 60 patients were included in the study. The mean age was 33.8 yrs. The sensitivity and specificity of ultrasound guided FNAC were 68.7% and 93.1%, respectively. The sensitivity and specificity of ultrasound guided CNB was 93.7% and 100%. The accuracy of FNAC was 86.2% and that of core needle biopsy was 98.3%. Conclusion: The ultrasound guided core needle biopsy can be used as an initial diagnostic test for the evaluation of all PBLs. Because of high negative predictive value core needle biopsy can replace surgical excision biopsy for benign lesions. (author)

  15. Noninvasive treatment of focal adenomyosis with MR-guided focused ultrasound in two patients

    International Nuclear Information System (INIS)

    Polina, Laveena; Nyapathy, Vinay; Mishra, Anindita; Yellamanthili, Himabindu; Vallabhaneni, Mythri P

    2012-01-01

    Adenomyosis is a common benign gynecological disorder presenting with dysmenorrhea, menorrhagia, and pressure symptoms. Magnetic resonance imaging–guided focused ultrasound surgery (MRgFUS) utilizes precisely focused USG waves to generate and maintain high temperatures within the targeted tissue to achieve protein denaturation and coagulative necrosis. The heat generated is monitored using MRI images acquired in real-time in three planes. We present two cases of focal adenomyosis treated with MRgFUS showing good symptomatic relief at 3 and 6 months follow-up

  16. Endoscopic ultrasound-guided fine-needle tissue acquisition - A review and update of literature

    Directory of Open Access Journals (Sweden)

    Benjamin Tharian

    2015-01-01

    Full Text Available Ever since the first endoscopic ultrasound-guided fine needle aspiration (FNA was done in 1992, the procedure has evolved to become an indispensable tool for tissue acquisition in patients with gastrointestinal tumors and periluminal lesions. With the growing evidence of neoadjuvant therapy and research into intratumoral therapy, the need to obtain tissue diagnosis for tumors is quite apparent. This review provides an overall perspective to the endosonographer on various issues that are a key for best practices in FNA, in addition to being an update for practicing experienced endosonographers.

  17. 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...

  18. 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.

  19. 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.

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

    International Nuclear Information System (INIS)

    Kim, Ji Hoon

    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.

  1. Ultrasound-Guided real-time pterygopalatine block for analgesia in an oral cancer patient

    Directory of Open Access Journals (Sweden)

    Nishkarsh Gupta

    2018-01-01

    Full Text Available Oral cancers are one of the most common cancers in India. These patients have pain during the course of the disease. Various drugs including opioid and nonsteroidal anti-inflammatory drug have been used to manage pain. However, these are associated with side effects such as constipation and vomiting. An early interventional block may decrease the requirement for analgesics and improve the overall quality of life. We describe a case of oral carcinoma successfully managed with ultrasound-guided pterygopalatine block.

  2. Magnetic resonance guided focalized ultrasound thermo-ablation: A promising oncologic local therapy

    International Nuclear Information System (INIS)

    Iannessi, A.; Doyen, J.; Leysalle, A.; Thyss, A.

    2014-01-01

    Pain management of bone metastases is usually made using systemic and local therapy. Even though radiations are nowadays the gold standard for painful metastases, innovations regarding minimally invasive treatment approaches have been developed because of the existing non-responder patients [1]. Indeed, cementoplasty and thermo-ablations like radiofrequency or cryotherapy have shown to be efficient on pain [2-4]. Among thermo-therapy, magnetic resonance guided focalized ultrasound is now a new non-invasive weapon for bone pain palliation. (authors)

  3. Asian EUS Cup-05: Successful management of peripancreatic tumors by endoscopic ultrasound-guided radiofrequency ablation

    OpenAIRE

    Oh, Dongwook; Seo, Dong Wan

    2017-01-01

    Background: Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) could be used as an effective alternative treatment for peripancreatic tumor. Herein, we reported a case of adrenal adenoma which was treated by EUS-RFA. Case Report: A 38-year-old woman presented with ?moon face,? ?buffalo hump,? and weight gain of 9 kg in 12 months. Initial contrast-enhanced abdominal computed tomography showed a 2.8 cm left adrenal mass, and the patient was diagnosed with Cushing?s syndrome due to l...

  4. 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

    non-functioning thyroid nodules that grow or become symptomatic, trained operators may safely induce, with a single session of laser ablation treatment or radiofrequency ablation, a 50% volume decrease and, in parallel, improve local symptoms. In contrast, hyperfunctioning nodules remain best treated...... 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...

  5. Endoscopic Ultrasound-Guided Perirectal Abscess Drainage without Drainage Catheter: A Case Series

    Directory of Open Access Journals (Sweden)

    Eun Kwang Choi

    2017-05-01

    Full Text Available A perirectal abscess is a relatively common disease entity that occurs as a postsurgical complication or as a result of various medical conditions. Endoscopic ultrasound (EUS-guided drainage was recently described as a promising alternative treatment. Previous reports have recommended placement of a drainage catheter through the anus for irrigation, which is inconvenient to the patient and carries a risk of accidental dislodgement. We report four cases of perirectal abscess that were successfully treated with only one or two 7 F double pigtail plastic stent placements and without a drainage catheter for irrigation.

  6. NMR guided focused ultrasound for myoma therapy - results from the first radiology-gynecology expert meeting

    International Nuclear Information System (INIS)

    Beck, A.; Charite Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Berlin; David, M.; Kroencke, T.; Charite Universitaetsmedizin Berlin, Campus Charite Mitte, Berlin

    2013-01-01

    The contribution on the results from the first radiology-gynecology expert meeting concerning NMR guided focused ultrasound (MRgFUS) for myoma therapy covers the following topics: structural prerequisites for MRgFUS therapy; required examinations before MRgFUS therapy; indication for MRgFUS therapy; success criteria for the MRgFUS therapy; contraindications; MRgFUS therapy for patients that want to have children; side effects and complications of MRgFUS therapy; post-examination after MRgFUS therapy.

  7. Percutaneous cryoablation of prostate cancer guided by rectal ultrasound: a retrospectively analysis of 42 cases

    International Nuclear Information System (INIS)

    Xing Wenge; Guo Zhi; Wang Haitao; Liu Fang; Li Baoguo; Yu Haipeng; Li Yong

    2008-01-01

    Objective: To evaluate the effectiveness and safety of rectal ultrasound-guided agon-hilium percutaneous cryoablation in treatment of patients with median and or late-stage prostate cancer patients. Methods: Retrospectively analysis of 42 cases of with stage C and D prostate cancer patients treated by rectal ultrasound-guided argon-hilium percutaneous cryoablation during the follow-up of 1-12 months. The prostate specific antigen (PSA), biochemical progression-free survival (bPFS), PSA objective response, transrectal ultrasound of the prostate (TRUS), TRUS-guided biopsy of the prostate, the maximum urinary flow rate(MFR), MRI examination at before, and 3,6,12 months after cryoablation were recorded and evaluated. The results were statistically evaluated by using variance analysis. Results: The PSA value at before and 3,6, 12 months after cryoablation were (4.48±1.35), (3.54±1.67), (3.18±1.76), (2.87±1.89) μg/L, respectively; TRUS-measured prostate volumes at before and 3, 6,12 months after cryoablation were (59.7± 8.2), (46.9±8.3), (26.2±3.9), (25.9±3.7) mm 3 , respectively; MFR before and 3, 6,12 months after cryoablation were (10.4±0.8), (14.3±1.2), (18.3±1.3), (18.9±1.3) ml/s, respectively; Compared with before cryoablation, the differences between before and after cryoablation was statistically significant (F= 53.93,747.92,3843.03, respectively, P<0.01). The bPFS rates in 3 months,6 months and 12 months were 95.2% (40/42), 95.2% (40/42), and 90.5% (38/42), respectively. According to the PSA response, the total effective rate (CR 16 cases, PR 15 cases) at 12 months was 73.8%, and SD was 16.7% (7/42), PD was 9.5% (4/42). Complications included temporary incontinence 2.4% (1/42), Penile tingling/numbness 2.4% (1/42), pelvic pain 4.9% (2/41) and Scrotum Edema 2.4% (1/42). There was no case with severe complications such as severe infection or urethrorectal fistula, etc. Conclusions: Rectal ultrasound-guided agon-hilium percutaneous cryoablation showed

  8. Ultrasound-Guided Intermediate Site Greater Occipital Nerve Infiltration: A Technical Feasibility Study.

    Science.gov (United States)

    Zipfel, Jonathan; Kastler, Adrian; Tatu, Laurent; Behr, Julien; Kechidi, Rachid; Kastler, Bruno

    2016-01-01

    Two studies recently reported that computed tomography (CT) guided infiltration of the greater occipital nerve at its intermediate site allows a high efficacy rate with long-lasting pain relief following procedure in occipital neuralgia and in various craniofacial pain syndromes. The purpose of our study was to evaluate the technical feasibility and safety of ultrasound-guided intermediate site greater occipital nerve infiltration. Retrospective study. This study was conducted at the imaging department of a 1,409 bed university hospital. Local institutional review board approval was obtained and written consent was waived. In this retrospective study, 12 patients suffering from refractory occipital neuralgia or craniofacial pain syndromes were included between April and October 2014. They underwent a total of 21 ultrasound-guided infiltrations. Infiltration of the greater occipital nerve was performed at the intermediate site of the greater occipital nerve, at its first bend between obliqus capitis inferior and semispinalis capitis muscles with local anestetics and cortivazol. Technical success was defined as satisfactory diffusion of added iodinated contrast media in the fatty space between these muscles depicted on control CT scan. We also reported first data of immediate block test efficacy and initial clinical efficacy at 7 days, one month, and 3 months, defined by a decrease of at least 50% of visual analog scale (VAS) scores. Technical success rate was 95.24%. Patients suffered from right unilateral occipital neuralgia in 3 cases, left unilateral occipital neuralgia in 2 cases, bilateral occipital neuralgia in 2 cases, migraine in one case, cervicogenic headache in one case, tension-type headache in 2 cases, and cluster headache in one case. Block test efficacy was found in 93.3% (14/15) cases. Clinical efficacy was found in 80% of cases at 7 days, in 66.7% of cases at one month and in 60% of cases at 3 months. No major complications were noted. Some of the

  9. Ultrasound

    Science.gov (United States)

    ... completed. Young children may need additional preparation. When scheduling an ultrasound for yourself or your child, ask ... of Privacy Practices Notice of Nondiscrimination Manage Cookies Advertising Mayo Clinic is a not-for-profit organization ...

  10. Ultrasound

    Science.gov (United States)

    ... reflect off body structures. A computer receives the waves and uses them to create a picture. Unlike with an x-ray or CT scan, this test does not use ionizing radiation. The test is done in the ultrasound ...

  11. Is ultrasound-guided injection more effective in chronic subacromial bursitis?

    Science.gov (United States)

    Hsieh, Lin-Fen; Hsu, Wei-Chun; Lin, Yi-Jia; Wu, Shih-Hui; Chang, Kae-Chwen; Chang, Hsiao-Lan

    2013-12-01

    Although ultrasound (US)-guided subacromial injection has shown increased accuracy in needle placement, whether US-guided injection produces better clinical outcome is still controversial. Therefore, this study aimed to compare the efficacy of subacromial corticosteroid injection under US guidance with palpation-guided subacromial injection in patients with chronic subacromial bursitis. Patients with chronic subacromial bursitis were randomized to a US-guided injection group and a palpation-guided injection group. The subjects in each group were injected with a mixture of 0.5 mL dexamethasone suspension and 3 mL lidocaine into the subacromial bursa. The primary outcome measures were the visual analog scale for pain and active and passive ranges of motion of the affected shoulder. Secondary outcome measures were the Shoulder Pain and Disability Index, the Shoulder Disability Questionnaire, and the 36-item Short-Form Health Survey (SF-36). The primary outcome measures were evaluated before, immediately, 1 wk, and 1 month after the injection; the secondary outcome measures were evaluated before, 1 wk, and 1 month after the injection. Of the 145 subjects screened, 46 in each group completed the study. Significantly greater improvement in passive shoulder abduction and in physical functioning and vitality scores on the SF-36 were observed in the US-guided group. The pre- and postinjection within-group comparison revealed significant improvement in the visual analog scale for pain and range of motion, as well as in the Shoulder Pain and Disability Index, Shoulder Disability Questionnaire, and SF-36 scores, in both groups. The US-guided subacromial injection technique produced significantly greater improvements in passive shoulder abduction and in some items of the SF-36. US is effective in guiding the needle into the subacromial bursa in patients with chronic subacromial bursitis.

  12. Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis

    Science.gov (United States)

    Takenaka, Mamoru; Kamata, Ken; Yoshikawa, Tomoe; Nakai, Atsushi; Omoto, Shunsuke; Miyata, Takeshi; Yamao, Kentaro; Imai, Hajime; Sakamoto, Hiroki; Kitano, Masayuki; Kudo, Masatoshi

    2018-01-01

    The most common symptom in patients with advanced pancreatic cancer is abdominal pain. This has traditionally been treated with nonsteroidal anti-inflammatory drugs and opioid analgesics. However, these treatments result in inadequate pain control or drug-related adverse effects in some patients. An alternative pain-relief modality is celiac plexus neurolysis, in which the celiac plexus is chemically ablated. This procedure was performed percutaneously or intraoperatively until 1996, when endoscopic ultrasound (EUS)-guided celiac plexus neurolysis was first described. In this transgastric anterior approach, a neurolytic agent is injected around the celiac trunk under EUS guidance. The procedure gained popularity as a minimally invasive approach and is currently widely used to treat pancreatic cancer-associated pain. We focus on two relatively new techniques of EUS-guided neurolysis: EUS-guided celiac ganglia neurolysis and EUS-guided broad plexus neurolysis, which have been developed to improve efficacy. Although the techniques are safe and effective in general, some serious adverse events including ischemic and infectious complications have been reported as the procedure has gained widespread popularity. We summarize reported clinical outcomes of EUS-guided neurolysis in pancreatic cancer (from the PubMed and Embase databases) with a goal of providing information useful in developing strategies for pancreatic cancer-associated pain alleviation. PMID:29462851

  13. Ultrasound-Guided Percutaneous Electrolysis and Eccentric Exercises for Subacromial Pain Syndrome: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    José L. Arias-Buría

    2015-01-01

    Full Text Available Objective. To compare effects of ultrasound- (US- guided percutaneous electrolysis combined with an eccentric exercise program of the rotator cuff muscles in subacromial pain syndrome. Methods. Thirty-six patients were randomized and assigned into US-guided percutaneous electrolysis (n=17 group or exercise (n=19 group. Patients were asked to perform an eccentric exercise program of the rotator cuff muscles twice every day for 4 weeks. Participants assigned to US-guided percutaneous electrolysis group also received the application of galvanic current through acupuncture needle on each session once a week (total 4 sessions. Shoulder pain (NPRS and disability (DASH were assessed at baseline, after 2 sessions, and 1 week after the last session. Results. The ANOVA revealed significant Group∗Time interactions for shoulder pain and disability (all, P<0.01: individuals receiving US-guided percutaneous electrolysis combined with the eccentric exercises experienced greater improvement than those receiving eccentric exercise alone. Conclusions. US-guided percutaneous electrolysis combined with eccentric exercises resulted in small better outcomes at short term compared to when only eccentric exercises were applied in subacromial pain syndrome. The effect was statistically and clinically significant for shoulder pain but below minimal clinical difference for function. Future studies should investigate the long-term effects and potential placebo effect of this intervention.

  14. The role of ultrasound-guided vacuum-assisted removal of gynecomastia

    Energy Technology Data Exchange (ETDEWEB)

    Kim, You Me [Dankook University Hospital, Cheonan (Korea, Republic of)

    2008-02-15

    To evaluate the role of performing ultrasound (US)-guided vacuum-assisted breast biopsies for the treatment (mammotome excision) of gynecomastia. Between November 2005 and December 2006, nine male patients underwent US-guided mammotome excision for eleven cases of true gynecomastia. The patient ages ranged from 14 to 55 years (mean age, 32.3 years). US-guided mammotome excision was performed with an 11-gauge needle in seven cases and an 8-gauge needle in four cases. After the procedure, the cigarette method using gauze packing was performed. The number of samples, procedure time and presence of complications were evaluated. Scheduled follow-up physical and US examinations were performed after three and six months. For 11 cases of US-guided mammotome excision of gynecomastia, the number of samples ranged from 12-126 (mean, 66) and the procedure time ranged from 10-42 minutes (mean time, 25.1 minutes). Clinical significant complications did not occur immediately after the procedure and complications were not seen after a follow-up examination in any of the cases. At the 3-and 6-month follow up examinations, all of the patients showed a normal male physical appearance on a physical examination and there was no evidence of hypoechoic glandular tissues as seen on ultrasonograms. US-guided mammotome excision is effective for the treatment of small, glandular true gynecomastia and is suggested as a new modality to replace the need for surgery or liposuction.

  15. 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.

  16. 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. Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  17. MRI-Guided Focused Ultrasound as a New Method of Drug Delivery

    Directory of Open Access Journals (Sweden)

    M. Thanou

    2013-01-01

    Full Text Available Ultrasound-mediated drug delivery under the guidance of an imaging modality can improve drug disposition and achieve site-specific drug delivery. The term focal drug delivery has been introduced to describe the focal targeting of drugs in tissues with the help of imaging and focused ultrasound. Focal drug delivery aims to improve the therapeutic profile of drugs by improving their specificity and their permeation in defined areas. Focused-ultrasound- (FUS- mediated drug delivery has been applied with various molecules to improve their local distribution in tissues. FUS is applied with the aid of microbubbles to enhance the permeability of bioactive molecules across BBB and improve drug distribution in the brain. Recently, FUS has been utilised in combination with MRI-labelled liposomes that respond to temperature increase. This strategy aims to “activate” nanoparticles to release their cargo locally when triggered by hyperthermia induced by FUS. MRI-guided FUS drug delivery provides the opportunity to improve drug bioavailability locally and therefore improve the therapeutic profiles of drugs. This drug delivery strategy can be directly translated to clinic as MRg FUS is a promising clinically therapeutic approach. However, more basic research is required to understand the physiological mechanism of FUS-enhanced drug delivery.

  18. 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.

  19. Failed common bile duct cannulation during pregnancy: Rescue with endoscopic ultrasound guided rendezvous procedure.

    Science.gov (United States)

    Singla, Vikas; Arora, Anil; Tyagi, Pankaj; Sharma, Praveen; Bansal, Naresh; Kumar, Ashish

    2016-01-01

    Common bile duct (CBD) stones can lead to serious complications and require intervention with either endoscopic retrograde cholangiopancreatography (ERCP) or laparoscopic techniques for urgent relief. On an average 10%-20% of the patients with gall bladder stones can have associated CBD stones. CBD stones during pregnancy can be associated with hazardous complications for both the mother and the fetus. Failed cannulation while performing ERCP during pregnancy is a technically demanding situation, which requires immediate rescue with special techniques. Conventional rescue techniques may not be feasible and can be associated with hazardous consequences. Endoscopic ultrasound (EUS) guided rendezvous technique has now emerged as a safe alternative, and in one of our patients, this technique was successfully attempted. To the best of our knowledge, this is the first case report in the literature on EUS-guided rendezvous procedure during pregnancy.

  20. Mediastinal abscess after endobronchial ultrasound-guided transbronchial needle aspiration: a case report and literature review.

    Science.gov (United States)

    Leong, Steven C; Marshall, Henry M; Bint, Michael; Yang, Ian A; Bowman, Rayleen V; Fong, Kwun M

    2013-10-01

    Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique that allows lung cancer nodal staging and biopsy of parabronchial and paratracheal tissue. Its simplicity, high diagnostic yield, ability to diagnose both benign and malignant conditions, and exceedingly low complication rate has resulted in rapid widespread adoption by surgeons and physicians. EBUS-TBNA-related complications, however, do occur and need to be considered when assessing the risk-benefit profile of performing the procedure, and if the patient represents with unexpected symptoms after the procedure. We describe a 64-year-old woman who presented with a mediastinal abscess 5 days after EBUS-TBNA. This case demonstrates the importance of considering EBUS-TBNA-related complications to guide relevant imaging decisions and antibiotic choices. We review the published literature regarding infective complications of EBUS-TBNA and propose possible pathophysiologies. These complications are likely to increase in frequency as the technique is more widely adopted.

  1. Brief reports: ultrasound-guided obturator nerve block: a proximal interfascial technique.

    Science.gov (United States)

    Taha, Ahmad Muhammad

    2012-01-01

    In this report, I describe and evaluate a proximal ultrasound (US)-guided obturator nerve block technique using an interfascial local anesthetic (LA) injection deep to the pectineus muscle. The pectineus muscle was identified and followed, while the US probe was tilted cranially until the superior pubic ramus was visualized. In this plane, LA was injected interfascially between the pectineus and obturator externus. The median time required to identify the injection site was 4 seconds (95% confidence interval, 3-5 seconds). The median motor block onset was 4 minutes (95% confidence interval, 3-5 minutes). Both obturator nerve branches were blocked successfully in all patients (100%). The US-guided obturator nerve block using interfascial LA injection inferior to the superior pubic ramus, between the pectineus and obturator externus muscles, was shown to be a simple and successful technique.

  2. Approach to treatment for obstructive jaundice of PTCD guided by combining ultrasound with X-ray scan

    International Nuclear Information System (INIS)

    Tang Huanliang; Cao Haoqian; Fei Jianguo

    2008-01-01

    Objective: To investigate the technical and clinical value of PTCD in patients with obstructive jaundice by the guiding of ultrasound combined with X-ray scan. Methods PTCD was performed in 58 patients with obstructive jaundice, with 47 patients malignant diseases and 11 patients benign diseases, guided by combining ultrasound and X-ray scan. 51 patients were punctured to right bile ducts and 7 cases were left bile ducts. Cholangiography was routinely used. Results: Technical success was obtained in all patients. No bleeding and biliary peritonitis were found after procedures. The bilirubin was reduced by 75.4ummol/L one week after operation. Conclusion: The technique of PTCD guided by combining ultrasound with X-ray scan was safe, simple, cost saving and less complications for obstructive jaundice. (authors)

  3. Ultrasound-Guided Peripheral Intravenous Access in the Emergency Department: Patient-Centered Survey

    Directory of Open Access Journals (Sweden)

    Keith Boniface

    2011-05-01

    Full Text Available Introduction: To assess characteristics, satisfaction, and disposition of emergency department (ED patients who successfully received ultrasound (US-guided peripheral intravenous (IV access. Methods: This is a prospective observational study among ED patients who successfully received US-guided peripheral IV access by ED technicians. Nineteen ED technicians were taught to use US guidance to obtain IV access. Training sessions consisted of didactic instruction and hands-on practice. The US guidance for IV access was limited to patients with difficult access. After successfully receiving an US-guided peripheral IV, patients were approached by research assistants who administered a 10-question survey. Disposition information was collected after the conclusion of the ED visit by accessing patients’ electronic medical record. Results: In total, 146 surveys were completed in patients successfully receiving US-guided IVs. Patients reported an average satisfaction with the procedure of 9.2 of 10. Forty-two percent of patients had a body mass index (BMI of greater than 30, and 17.8% had a BMI of more than 35. Sixty-two percent reported a history of central venous catheter placement. This patient population averaged 3 ED visits per year in the past year. Fifty-three percent of the patients were admitted. Conclusion: Patients requiring US-guided IVs in our ED are discharged home at the conclusion of their ED visit about half of the time. These patients reported high rates of both difficult IV access and central venous catheter placement in the past. Patient satisfaction with US-guided IVs was very high. These data support the continued use of US-guided peripheral IVs in this patient population. [West J Emerg Med. 2011;12(4:475–477.

  4. Combined CT- and fluoroscopy-guided nephrostomy in patients with non-obstructive uropathy due to urine leaks in cases of failed ultrasound-guided procedures

    International Nuclear Information System (INIS)

    Sommer, C.M.; Huber, J.; Radeleff, B.A.; Hosch, W.; Stampfl, U.; Loenard, B.M.; Hallscheidt, P.; Haferkamp, A.; Kauczor, H.U.; Richter, G.M.

    2011-01-01

    Aim: To report our experience of combined CT- and fluoroscopy-guided nephrostomy in patients with non-obstructive uropathy due to urine leaks in cases of failed ultrasound-guided procedures. Patients and methods: Eighteen patients (23 kidneys) with non-obstructive uropathy due to urine leaks underwent combined CT- and fluoroscopy-guided nephrostomy. All procedures were indicated as second-line interventions after failed ultrasound-guided nephrostomy. Thirteen males and five females with an age of 62.3 ± 8.7 (40–84) years were treated. Urine leaks developed in majority after open surgery, e.g. postoperative insufficiency of ureteroneocystostomy (5 kidneys). The main reasons for failed ultrasound-guided nephrostomy included anatomic obstacles in the puncture tract (7 kidneys), and inability to identify pelvic structures (7 kidneys). CT-guided guidewire placement into the collecting system was followed by fluoroscopy-guided nephrostomy tube positioning. Procedural success rate, major and minor complication rates, CT-views and needle passes, duration of the procedure and radiation dose were analyzed. Results: Procedural success was 91%. Major and minor complication rates were 9% (one septic shock and one perirenal abscess) and 9% (one perirenal haematoma and one urinoma), respectively. 30-day mortality rate was 6%. Number of CT-views and needle passes were 9.3 ± 6.1 and 3.6 ± 2.6, respectively. Duration of the complete procedure was 87 ± 32 min. Dose-length product and dose-area product were 1.8 ± 1.4 Gy cm and 3.9 ± 4.3 Gy cm 2 , respectively. Conclusions: Combined CT- and fluoroscopy-guided nephrostomy in patients with non-obstructive uropathy due to urine leaks in cases of failed ultrasound-guided procedures was feasible with high technical success and a tolerable complication rate.

  5. Prostate Ultrasound

    Medline Plus

    Full Text Available ... patient. Because ultrasound images are captured in real-time, they can show the structure and movement of ... test result. difficulty urinating. Because ultrasound provides real-time images, it also can be used to guide ...

  6. Prostate Ultrasound

    Medline Plus

    Full Text Available ... Ultrasound provides real-time imaging, making it a good tool for guiding minimally invasive procedures such as ... bowel (rectum) removed during prior surgery are not good candidates for ultrasound of the prostate gland because ...

  7. Prostate Ultrasound

    Medline Plus

    Full Text Available ... ultrasound images are captured in real-time, they can show the structure and movement of the body's ... Because ultrasound provides real-time images, it also can be used to guide procedures such as needle ...

  8. Temporal regularization of ultrasound-based liver motion estimation for image-guided radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    O’Shea, Tuathan P., E-mail: tuathan.oshea@icr.ac.uk; Bamber, Jeffrey C.; Harris, Emma J. [Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS foundation Trust, Sutton, London SM2 5PT (United Kingdom)

    2016-01-15

    Purpose: Ultrasound-based motion estimation is an expanding subfield of image-guided radiation therapy. Although ultrasound can detect tissue motion that is a fraction of a millimeter, its accuracy is variable. For controlling linear accelerator tracking and gating, ultrasound motion estimates must remain highly accurate throughout the imaging sequence. This study presents a temporal regularization method for correlation-based template matching which aims to improve the accuracy of motion estimates. Methods: Liver ultrasound sequences (15–23 Hz imaging rate, 2.5–5.5 min length) from ten healthy volunteers under free breathing were used. Anatomical features (blood vessels) in each sequence were manually annotated for comparison with normalized cross-correlation based template matching. Five sequences from a Siemens Acuson™ scanner were used for algorithm development (training set). Results from incremental tracking (IT) were compared with a temporal regularization method, which included a highly specific similarity metric and state observer, known as the α–β filter/similarity threshold (ABST). A further five sequences from an Elekta Clarity™ system were used for validation, without alteration of the tracking algorithm (validation set). Results: Overall, the ABST method produced marked improvements in vessel tracking accuracy. For the training set, the mean and 95th percentile (95%) errors (defined as the difference from manual annotations) were 1.6 and 1.4 mm, respectively (compared to 6.2 and 9.1 mm, respectively, for IT). For each sequence, the use of the state observer leads to improvement in the 95% error. For the validation set, the mean and 95% errors for the ABST method were 0.8 and 1.5 mm, respectively. Conclusions: Ultrasound-based motion estimation has potential to monitor liver translation over long time periods with high accuracy. Nonrigid motion (strain) and the quality of the ultrasound data are likely to have an impact on tracking

  9. A review of the benefits and pitfalls of phantoms in ultrasound-guided regional anesthesia.

    Science.gov (United States)

    Hocking, Graham; Hebard, Simon; Mitchell, Christopher H

    2011-01-01

    With the growth of ultrasound-guided regional anesthesia, so has the requirement for training tools to practice needle guidance skills and evaluate echogenic needles. Ethically, skills in ultrasound-guided needle placement should be gained in a phantom before performance of nerve blocks on patients in clinical practice. However, phantom technology is varied, and critical evaluation of the images is needed to understand their application to clinical use. Needle visibility depends on the echogenicity of the needle relative to the echogenicity of the tissue adjacent the needle. We demonstrate this point using images of echogenic and nonechogenic needles in 5 different phantoms at both shallow angles (20 degrees) and steep angles (45 degrees). The echogenicity of phantoms varies enormously, and this impacts on how needles are visualized. Water is anechoic, making all needles highly visible, but does not fix the needle to allow practice placement. Gelatin phantoms and Blue Phantoms provide tactile feedback but have very low background echogenicity, which greatly exaggerates needle visibility. This makes skill acquisition easier but can lead to false confidence in regard to clinical ability. Fresh-frozen cadavers retain much of the textural feel of live human tissue and are nearly as echogenic. Similar to clinical practice, this makes needles inserted at steep angles practically invisible, unless they are highly echogenic. This review describes the uses and pitfalls of phantoms that have been described or commercially produced. Copyright © 2011 by American Society of Regional Anesthesia and Pain Medicine

  10. 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.

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

    Science.gov (United States)

    Konge, Lars; Nayahangan, Leizl Joy; Clementsen, Paul Frost

    2017-01-01

    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. PMID:28840013

  12. The diagnostic value of ultrasound-guided fine-needle aspiration biopsy in breast masses

    International Nuclear Information System (INIS)

    Lee, Nam Hee; Lim, Hyun Yang; Park, Noh Kyong; Tae, Seok; Shin, Kyung Ja; Lee, Sang Chun

    1993-01-01

    Real-time ultrasound-guided fine-needle aspiration biopsy in 137 solid breast masses was performed. Sonographic findings were categorized into three groups and aspirates were categorized into three cytologic groups. The cytologic results was reported benign masses (cytologic group 1) in 71 cases (52%). malignant masses (cytologic group 2 and 3) in 44 cases (32%) and insufficient specimens in 22 case (16%). Insufficient specimens were treated as benign masses. Excisional biopsy in 44 malignant masses and 3 benign masses according to cytologic results, clinical findings and follow up study was performed. The result was reported 41 malignant masses and 6 benign masses. Based on cytologic criteria, sensitivity for detection of malignancy was 93% and specificity was 94%. In conclusion, the high specificity provided by ultrasound-guided fine-needle aspiration biopsy could markedly reduce unnecessary surgical excisions for benign masses and it should be routinely performed, since it can give physical and emotional benefits to patients and lead to earlier and cost effective diagnosis of breast cancer

  13. Percutaneous Ultrasound-Guided Carpal Tunnel Release: Study Upon Clinical Efficacy and Safety

    Energy Technology Data Exchange (ETDEWEB)

    Petrover, David, E-mail: dpetrover@yahoo.fr; Silvera, Jonathan, E-mail: silvera.jonathan@gmail.com [Imagerie Médicale Paris Centre Bachaumont-clinique Blomet RamsayGDS, Department of Interventional Radiology (France); Baere, Thierry De, E-mail: Debaere@igr.fr [Gustave Roussy Institute (France); Vigan, Marie, E-mail: marie.vigan@gmail.com [Association pour la recherche en chirurgie de l’épaule et du coude, clinique Drouot (France); Hakimé, Antoine, E-mail: thakime@yahoo.com [Imagerie Médicale Paris Centre Bachaumont-clinique Blomet RamsayGDS, Department of Interventional Radiology (France)

    2017-04-15

    ObjectivesTo evaluate the feasibility and 6 months clinical result of sectioning of the transverse carpal ligament (TCL) and median nerve decompression after ultra-minimally invasive, ultrasound-guided percutaneous carpal tunnel release (PCTR) surgery.MethodsConsecutive patients with carpal tunnel syndrome were enrolled in this descriptive, open-label study. The procedure was performed in the interventional radiology room. Magnetic resonance imaging was performed at baseline and 1 month. The Boston Carpal Tunnel Questionnaire was administered at baseline, 1, and 6 months.Results129 patients were enrolled. Significant decreases in mean symptom severity scores (3.3 ± 0.7 at baseline, 1.7 ± 0.4 at Month 1, 1.3 ± 0.3 at Month 6) and mean functional status scores (2.6 ± 1.1 at baseline, 1.6 ± 0.4 at Month 1, 1.3 ± 0.5 at Month 6) were noted. Magnetic resonance imaging showed a complete section of all TCL and nerve decompression in 100% of patients. No complications were identified.ConclusionsUltrasound-guided PCTR was used successfully to section the TCL, decompress the median nerve, and reduce self-reported symptoms.

  14. The diagnostic value of ultrasound-guided fine-needle aspiration biopsy in breast masses

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Nam Hee; Lim, Hyun Yang; Park, Noh Kyong; Tae, Seok; Shin, Kyung Ja; Lee, Sang Chun [Seoul Red Cross Hospital, Seoul (Korea, Republic of)

    1993-05-15

    Real-time ultrasound-guided fine-needle aspiration biopsy in 137 solid breast masses was performed. Sonographic findings were categorized into three groups and aspirates were categorized into three cytologic groups. The cytologic results was reported benign masses (cytologic group 1) in 71 cases (52%). malignant masses (cytologic group 2 and 3) in 44 cases (32%) and insufficient specimens in 22 case (16%). Insufficient specimens were treated as benign masses. Excisional biopsy in 44 malignant masses and 3 benign masses according to cytologic results, clinical findings and follow up study was performed. The result was reported 41 malignant masses and 6 benign masses. Based on cytologic criteria, sensitivity for detection of malignancy was 93% and specificity was 94%. In conclusion, the high specificity provided by ultrasound-guided fine-needle aspiration biopsy could markedly reduce unnecessary surgical excisions for benign masses and it should be routinely performed, since it can give physical and emotional benefits to patients and lead to earlier and cost effective diagnosis of breast cancer.

  15. 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.)

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

    International Nuclear Information System (INIS)

    Klontzas, Michail E.; Vassalou, Evangelia E.; Karantanas, Apostolos H.

    2017-01-01

    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.)

  17. Power cavitation-guided blood-brain barrier opening with focused ultrasound and microbubbles

    Science.gov (United States)

    Burgess, M. T.; Apostolakis, I.; Konofagou, E. E.

    2018-03-01

    Image-guided monitoring of microbubble-based focused ultrasound (FUS) therapies relies on the accurate localization of FUS-stimulated microbubble activity (i.e. acoustic cavitation). Passive cavitation imaging with ultrasound arrays can achieve this, but with insufficient spatial resolution. In this study, we address this limitation and perform high-resolution monitoring of acoustic cavitation-mediated blood-brain barrier (BBB) opening with a new technique called power cavitation imaging. By synchronizing the FUS transmit and passive receive acquisition, high-resolution passive cavitation imaging was achieved by using delay and sum beamforming with absolute time delays. Since the axial image resolution is now dependent on the duration of the received acoustic cavitation emission, short pulses of FUS were used to limit its duration. Image sets were acquired at high-frame rates for calculation of power cavitation images analogous to power Doppler imaging. Power cavitation imaging displays the mean intensity of acoustic cavitation over time and was correlated with areas of acoustic cavitation-induced BBB opening. Power cavitation-guided BBB opening with FUS could constitute a standalone system that may not require MRI guidance during the procedure. The same technique can be used for other acoustic cavitation-based FUS therapies, for both safety and guidance.

  18. Ultrasound-guided hydrostatic reduction of intussusception with saline: Safe and effective.

    Science.gov (United States)

    Karadağ, Çetin Ali; Abbasoğlu, Latif; Sever, Nihat; Kalyoncu, Meltem Kaba; Yıldız, Abdullah; Akın, Melih; Candan, Mustafa; Dokucu, Ali İhsan

    2015-09-01

    The study was undertaken to assess the efficacy of ultrasound-guided saline enema in reducing intussusception and to determine the role of age and duration of symptoms on this event. The case records of patients who were treated for intussusception at our institutions over the past 10 years were retrospectively analyzed. A total of 419 patients were treated for intussusception and 375 of them were included into the study. Patients were excluded if they had symptoms and signs of acute abdominal disease and required surgery as an initial treatment. Hydrostatic reduction was successful in 313 of the 375 patients (83.46%). The procedure-related complication rate was nil. There were 29 episodes of recurrences in 23 patients, and recurrence rates did not differ between patients who responded to hydrostatic reduction and those who required surgery. Younger age [median (range); 11 months (3-108 months) vs. 20 months (1-180 months); phydrostatic reduction. Ultrasound-guided hydrostatic reduction is an easy, safe and effective method for the treatment of intussusception in the absence of acute abdominal findings. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Percutaneous Ultrasound-Guided Carpal Tunnel Release: Study Upon Clinical Efficacy and Safety

    International Nuclear Information System (INIS)

    Petrover, David; Silvera, Jonathan; Baere, Thierry De; Vigan, Marie; Hakimé, Antoine

    2017-01-01

    ObjectivesTo evaluate the feasibility and 6 months clinical result of sectioning of the transverse carpal ligament (TCL) and median nerve decompression after ultra-minimally invasive, ultrasound-guided percutaneous carpal tunnel release (PCTR) surgery.MethodsConsecutive patients with carpal tunnel syndrome were enrolled in this descriptive, open-label study. The procedure was performed in the interventional radiology room. Magnetic resonance imaging was performed at baseline and 1 month. The Boston Carpal Tunnel Questionnaire was administered at baseline, 1, and 6 months.Results129 patients were enrolled. Significant decreases in mean symptom severity scores (3.3 ± 0.7 at baseline, 1.7 ± 0.4 at Month 1, 1.3 ± 0.3 at Month 6) and mean functional status scores (2.6 ± 1.1 at baseline, 1.6 ± 0.4 at Month 1, 1.3 ± 0.5 at Month 6) were noted. Magnetic resonance imaging showed a complete section of all TCL and nerve decompression in 100% of patients. No complications were identified.ConclusionsUltrasound-guided PCTR was used successfully to section the TCL, decompress the median nerve, and reduce self-reported symptoms.

  20. 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.

  1. Ultrasound-guided plantar fascia release technique: a retrospective study of 46 feet.

    Science.gov (United States)

    Vohra, Praveen K; Japour, Christopher J

    2009-01-01

    Ultrasound-guided plantar fascia release offers the surgeon clear visualization of anatomy at the surgical site. This technique uses small arthroscopic dissecting instruments through a 0.5-cm incision, allowing the surgeon to avoid the larger and more tissue-disruptive incision that is traditionally used for plantar heel spur resection and plantar fascia releases. Forty-one patients (46 feet) were selected for the study. The mean patient age was 47 years. Twenty-nine were considered obese with a body mass index greater than 30 kg/m(2). Patients were functionally and subjectively evaluated 4 weeks after surgery using the American Orthopedic Foot and Ankle Society Ankle and Hindfoot Rating Scale. Results from the study show a significant improvement (P = .05 confidence level) 4 weeks postoperatively for the 41 patients (46 feet), compared to their preoperative condition. The mean pretest score was 33.6 (range 10-52); this score improved to 88.0 (range 50-100), 4 weeks postoperatively. There were no postoperative infections or complications. The ultrasound-guided plantar fascia release technique is a practical surgical procedure for the relief of chronic plantar fascia pain because the surgeon is able to clearly visualize the plantar fascia by ultrasound. In addition, there is minimal disruption to surrounding tissue because small instruments are passed through a small 0.5-cm incision. The traditional open method of heel spur surgery, in contrast, uses a larger skin incision of 3 to 5 cm, followed by larger instruments to dissect to the plantar fascia.

  2. An inexpensive, easily constructed, reusable task trainer for simulating ultrasound-guided pericardiocentesis.

    Science.gov (United States)

    Zerth, Herb; Harwood, Robert; Tommaso, Laura; Girzadas, Daniel V

    2012-12-01

    Pericardiocentesis is a low-frequency, high-risk procedure integral to the practice of emergency medicine. Ultrasound-guided pericardiocentesis is the preferred technique for providing this critical intervention. Traditionally, emergency physicians learned pericardiocentesis in real time, at the bedside, on critically ill patients. Medical education is moving toward simulation for training and assessment of procedures such as pericardiocentesis because it allows learners to practice time-sensitive skills without risk to patient or learner. The retail market for models for pericardiocentesis practice is limited and expensive. We have developed an ultrasound-guided pericardiocentesis task trainer that allows the physician to insert a needle under ultrasound guidance, pierce the "pericardial sac" and aspirate "blood." Our model can be simply constructed in a home kitchen, and the overall preparation time is 1 h. Our model costs $20.00 (US, 2008). Materials needed for the construction include 16 ounces of plain gelatin, one large balloon, one golf ball, food coloring, non-stick cooking spray, one wooden cooking skewer, surgical iodine solution, and a 4-quart sized plastic food storage container. Refrigeration and a heat source for cooking are also required. Once prepared, the model is usable for 2 weeks at room temperature and may be preserved an additional week if refrigerated. When the model shows signs of wear, it can be easily remade, by simply recycling the existing materials. The self-made model was well liked by training staff due to accessibility of a simulation model, and by learners of the technique as they felt more at ease performing pericardiocentesis on a live patient. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. Ultrasound-guided approach to the paravertebral space for catheter insertion in infants and children.

    Science.gov (United States)

    Boretsky, Karen; Visoiu, Mihaela; Bigeleisen, Paul

    2013-12-01

    Paravertebral perineural blocks are used to prevent pain in the thoracoabdominal dermatomes. Traditionally, a landmark-based technique is used in children, while ultrasound-guided (UG) techniques are being employed in adult patients. To describe an UG technique for placement of thoracic paravertebral nerve block (TPVNB) catheters in pediatric patients. Retrospective chart review of a series of 22 pediatric patients' ages 6 months to 17 years with weights from 6.25 kg to 135 kg using a transverse in-plane technique. Catheters were placed both bilateral and unilateral for a variety of thoracic and abdominal procedures. A linear ultrasound transducer was used in all cases with frequency of oscillation and transducer length chosen based on individual patient characteristics of age, weight, and BMI. The median pain scores at 12, 24, 36, and 48 h were 1.2 (interquartile range, 4.5), 0.84 (interquartile range 3.0), 1.6 (interquartile range 2.9), and 0.83 (interquartile range 1.74), respectively. The median dose of opioid expressed as morphine equivalents consumed during the first 24 h after surgery was 0.14 mg·kg(-1) (interquartile range, 0.78 mg·kg(-1) ) and from 24 to 48 h the median dose was 0.11 mg·kg(-1) (interquartile range 0.44 mg·kg(-1) ). No complications were noted, and catheters were left an average of 3 days with a range of 1-5 days with good pain relief. This technical description demonstrates the feasibility of placing PVNB catheters using a transverse in-line ultrasound-guided technique in a wide range of pediatric patients. © 2013 John Wiley & Sons Ltd.

  4. Ultrasound-Guided Percutaneous Dilational Tracheostomy: A Systematic Review of Randomized Controlled Trials and Meta-Analysis.

    Science.gov (United States)

    Gobatto, André L N; Besen, Bruno A M P; Cestari, Mino; Pelosi, Paolo; Malbouisson, Luiz M S

    2018-01-01

    Percutaneous dilational tracheostomy (PDT) is a common and increasingly used procedure in the intensive care unit (ICU). It is usually performed with bronchoscopy guidance. Ultrasound has emerged as a useful tool in order to assist PDT, potentially improving its success rate and reducing procedural-related complications. To investigate whether the ultrasound-guided PDT is equivalent or superior to the bronchoscopy-guided or anatomical landmarks-guided PDT with regard to procedural-related and clinical complications. A systematic review of randomized clinical trials was conducted comparing an ultrasound-guided PDT to the control groups (either a bronchoscopy-guided PDT or an anatomical landmark-guided PDT) in patients undergoing a PDT in the ICU. The primary outcome was the incidence of major procedural-related and clinical complication rates. The secondary outcome was the incidence of minor complication rates. Random-effect meta-analyzes were used to pool the results. Four studies fulfilled the inclusion criteria and they were analyzed. The studies included 588 participants. There were no differences in the major complication rates between the patients who were assigned to the ultrasound-guided PDT when compared to the control groups (pooled risk ratio [RR]: 0.48; 95% confidence interval [CI]: 0.13-1.71, I 2 = 0%). The minor complication rates were not different between the groups, but they had a high heterogeneity (pooled RR: 0.49; 95% CI 0.16-1.50; I 2 = 85%). The sensitivity analyzes that only included the randomized controlled trials that used a landmark-guided PDT as the control group showed lower rates of minor complications in the ultrasound-guided PDT group (pooled RR: 0.55; 95% CI: 0.31-0.98, I 2 = 0%). The ultrasound-guided PDT seems to be safe and it is comparable to the bronchoscopy-guided PDT regarding the major and minor procedural-related or clinical complications. It also seems to reduce the minor complications when compared to the anatomical

  5. A novel lumen-apposing metal stent for endoscopic ultrasound-guided drainage of pancreatic fluid collections

    DEFF Research Database (Denmark)

    Walter, Daisy; Will, Uwe; Sanchez-Yague, Andres

    2015-01-01

    BACKGROUND AND STUDY AIMS: A novel large-diameter, lumen-apposing, self-expanding metal stent with bilateral flanges was recently developed for endoscopic ultrasound (EUS)-guided transmural drainage of symptomatic pancreatic fluid collections (PFCs). The aim of this study was to evaluate the effi......BACKGROUND AND STUDY AIMS: A novel large-diameter, lumen-apposing, self-expanding metal stent with bilateral flanges was recently developed for endoscopic ultrasound (EUS)-guided transmural drainage of symptomatic pancreatic fluid collections (PFCs). The aim of this study was to evaluate...

  6. Ultrasound-guided transversus abdominis plane (TAP) block: a useful adjunct in the management of postoperative respiratory failure.

    Science.gov (United States)

    Singh, Mandeep; Chin, Ki Jinn; Chan, Vincent

    2011-06-01

    The ultrasound-guided transversus abdominis plane (TAP) block is a useful tool in controlling postoperative pain following abdominal surgery. The bilateral ultrasound-guided TAP blocks successfully managed the pain of a patient presenting with hypoxemia and respiratory failure in the Post-anesthesia Care Unit, following a laparotomy for small bowel obstruction during general anesthesia. The TAP block reduced systemic opioid requirements and opioid-induced sedation and respiratory depression, improved patient compliance with non-invasive positive pressure ventilation, and prevented the need for intubation and ventilation in the intensive care unit. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Intra-articular distribution pattern after ultrasound-guided injections in wrist joints of patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Boesen, Mikael; Jensen, Karl Erik; Torp-Pedersen, Søren

    2007-01-01

    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...... 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...

  8. 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. © The Author(s) 2014.

  9. 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

  10. 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.

  11. Realtime ultrasound guided percutaneous tracheostomy in emergency setting: the glass ceiling has been broken.

    Science.gov (United States)

    Ravi, Parli Raghavan; Vijai, M N; Shouche, Sachin

    2017-01-01

    In recent years ultrasound guided percutaneous tracheostomy (USPCT) has become a routine practice in critical care units. Its safety and superiority over conventional percutaneous tracheostomy and bronchoscopic guided PCT is proven to be non-inferior in elective cases. However its role in emergency percutaneous tracheostomy has never been studied, since percutaneous tracheostomy itself remains an enigma in accessing emergency airway. There is no report of use of ultrasound guided percutaneous tracheostomy in emergency setting so far in the literature. We report our early experience with USPCT in emergency setting. Sixteen adult patients who required access to an emergency surgical airway after failure to accomplish emergency oro-tracheal intubation were the study population. Their airway was accessed by USPCT. Recorded data included clinical and demographic data including time taken to perform the procedure and complications. Short term and long term follow ups for a period of 2 years were done for the survivors. Twelve male and four female patients underwent the procedure and the average time of the procedure was 3.6 min with no failures nor conversions to surgical tracheostomy and no complications. The average oxygen saturation was 86% and average Glasgow coma scale was 8.4. This time period included the oxygen insufflation time. 10 patients were decannulated while six patients died due to the pathology of the disease itself. There were no complications in either short term or long term follow up. USPCT has a definitive role in emergency both in trauma and non-trauma setting. It is safe, feasible and faster in experienced hands. Use of USPCT in emergency setting has further narrowed the list of contraindications of percutaneous tracheostomy.

  12. Combined ultrasound and fluoroscopy guided port catheter implantation-High success and low complication rate

    International Nuclear Information System (INIS)

    Gebauer, Bernhard; El-Sheik, Michael; Vogt, Michael; Wagner, Hans-Joachim

    2009-01-01

    Purpose: To evaluate peri-procedural, early and late complications as well as patients' acceptance of combined ultrasound and fluoroscopy guided radiological port catheter implantation. Materials and methods: In a retrospective analysis, all consecutive radiological port catheter implantations (n = 299) between August 2002 and December 2004 were analyzed. All implantations were performed in an angio suite under analgosedation and antibiotic prophylaxis. Port insertion was guided by ultrasonographic puncture of the jugular (n = 298) or subclavian (n = 1) vein and fluoroscopic guidance of catheter placement. All data of the port implantation had been prospectively entered into a database for interventional radiological procedures. To assess long-term results, patients, relatives or primary physicians were interviewed by telephone; additional data were generated from the hospital information system. Patients and/or the relatives were asked about their satisfaction with the port implantion procedure and long-term results. Results: The technical success rate was 99% (298/299). There were no major complications according to the grading system of SIR. A total of 23 (0.33 per 1000 catheter days) complications (early (n = 4), late (n = 19)) were recorded in the follow-period of a total of 72,727 indwelling catheter days. Infectious complications accounted for 0.15, thrombotic for 0.07 and migration for 0.04 complications per 1000 catheter days. Most complications were successfully treated by interventional measures. Twelve port catheters had to be explanted due to complications, mainly because of infection (n = 9). Patients' and relatives' satisfaction with the port catheter system was very high, even if complications occurred. Conclusion: Combined ultrasound and fluoroscopy guided port catheter implantation is a very safe and reliable procedure with low peri-procedural, early and late complication rate. The intervention achieves very high acceptance by the patients and

  13. Effects of arthroscopy-guided suprascapular nerve block combined with ultrasound-guided interscalene brachial plexus block for arthroscopic rotator cuff repair: a randomized controlled trial.

    Science.gov (United States)

    Lee, Jae Jun; Hwang, Jung-Taek; Kim, Do-Young; Lee, Sang-Soo; Hwang, Sung Mi; Lee, Na Rea; Kwak, Byung-Chan

    2017-07-01

    The aim of this study was to compare the pain relieving effect of ultrasound-guided interscalene brachial plexus block (ISB) combined with arthroscopy-guided suprascapular nerve block (SSNB) with that of ultrasound-guided ISB alone within the first 48 h after arthroscopic rotator cuff repair. Forty-eight patients with rotator cuff tears who had undergone arthroscopic rotator cuff repair were enrolled. The 24 patients in group 1 received ultrasound-guided ISB and arthroscopy-guided SSNB; the remaining 24 patients in group 2 underwent ultrasound-guided ISB alone. Visual analogue scale pain score and patient satisfaction score were checked at 1, 3, 6, 12, 18, 24, and 48 h post-operatively. Group 1 had a lower visual analogue scale pain score at 3, 6, 12, 18, 24, and 48 h post-operatively (1.7  6.0, 6.2 > 4.3, 6.4 > 5.1, 6.9 > 5.9, 7.9 > 7.1). Six patients in group 1 developed rebound pain twice, and the others in group 1 developed it once. All of the patients in group 2 had one rebound phenomenon each (p = 0.010). The mean timing of rebound pain in group 1 was later than that in group 2 (15.5 > 9.3 h, p  4.0, p = 0.001). Arthroscopy-guided SSNB combined with ultrasound-guided ISB resulted in lower visual analogue scale pain scores at 3-24 and 48 h post-operatively, and higher patient satisfaction scores at 6-36 h post-operatively with the attenuated rebound pain compared to scores in patients who received ultrasound-guided ISB alone after arthroscopic rotator cuff repair. The combined blocks may relieve post-operative pain more effectively than the single block within 48 h after arthroscopic cuff repair. Randomized controlled trial, Level I. ClinicalTrials.gov Identifier: NCT02424630.

  14. Acesso venoso central guiado por ultrassom: qual a evidência? Ultrasound-guided central venous catheterization: what is the evidence?

    Directory of Open Access Journals (Sweden)

    Felippe Leopoldo Dexheimer Neto

    2011-06-01

    access, ultrasonography, and adults. The search was conducted on September 24, 2010, and selected meta-analyses, randomized clinical trials and reviews, retrieving 291 papers. The 21 most important papers were analyzed in this review. The internal jugular vein is the most studied ultrasound-guided puncture site, with meta-analysis showing lower relative risks of failure and complications. In addition, the largest available randomized clinical trial demonstrated a reduced central venous catheter-associated blood stream infection rate. There are few studies involving subclavian vein puncture; however, ultrasound was shown to be beneficial in two meta-analyses (however, with small numbers of patients. Regarding the femoral venous site, only one randomized clinical trial (20 patients was identified, showing positive findings. In a British cost-effectiveness study, ultrasound use lead to resource savings for different sites of venous puncture. There is strong evidence for ultrasound benefit for internal jugular vein puncture. Although the method appears attractive for the other sites, the data are not sufficient to support any recommendation.

  15. Ultrasound-Guided Greater Occipital Nerve Blocks and Pulsed Radiofrequency Ablation for Diagnosis and Treatment of Occipital Neuralgia

    OpenAIRE

    VanderHoek, Matthew David; Hoang, Hieu T; Goff, Brandon

    2013-01-01

    Occipital neuralgia is a condition manifested by chronic occipital headaches and is thought to be caused by irritation or trauma to the greater occipital nerve (GON). Treatment for occipital neuralgia includes medications, nerve blocks, and pulsed radiofrequency ablation (PRFA). Landmark-guided GON blocks are the mainstay in both the diagnosis and treatment of occipital neuralgia. Ultrasound is being utilized more and more in the chronic pain clinic to guide needle advancement when performing...

  16. The ultrasound-guided retrolaminar block: volume-dependent injectate distribution

    Directory of Open Access Journals (Sweden)

    Damjanovska M

    2018-02-01

    Full Text Available Marija Damjanovska,1 Tatjana Stopar Pintaric,1,2 Erika Cvetko,2 Kamen Vlassakov3 1Clinical Department of Anesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia; 2Institute of Anatomy, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; 3Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA Purpose: The ultrasound-guided retrolaminar block is one of the newer and simpler alternatives to the traditional, often technically challenging, paravertebral (PV block. Its feasibility, safety, and efficacy have already been clinically demonstrated in patients with multiple rib fractures using higher volumes of local anesthetic, when compared with the traditional approach. The primary aim of this observational anatomical study was to assess the spread of local anesthetic from the retrolaminar injection point to the PV space and its volume dependence. Second, we assessed the incidence of epidural and contralateral PV spread in the both groups.Methods: Ten fresh porcine cadavers were randomized into 2 groups (n=5 each to receive ultrasound-guided retrolaminar injections at Th4-Th5 level with either 10 mL (low-volume group or 30 mL (high-volume group of 2% lidocaine and methylene blue mixture. After the procedure, the cadavers were dissected and frozen. Cross-section cuts (~1 cm thick were performed to evaluate the injectate spread.Results: In the high-volume group, injectate spread from the retrolaminar to the PV space was observed in all specimens (5 out of 5; 100%, while in the low-volume group, no apparent spread to the PV space was found (0 out of 5; 0%. No epidural or contralateral PV spread was observed in any of the specimens.Conclusion: Following ultrasound-guided retrolaminar injections in fresh porcine cadavers, injectate spread from the retrolaminar tissue plane to the PV space is strongly volume dependent

  17. A randomized comparison between costoclavicular and paracoracoid ultrasound-guided infraclavicular block for upper limb surgery.

    Science.gov (United States)

    Leurcharusmee, Prangmalee; Elgueta, Maria Francisca; Tiyaprasertkul, Worakamol; Sotthisopha, Thitipan; Samerchua, Artid; Gordon, Aida; Aliste, Julian; Finlayson, Roderick J; Tran, De Q H

    2017-06-01

    This two-centre randomized trial compared costoclavicular and paracoracoid ultrasound-guided infraclavicular brachial plexus block in patients undergoing upper limb surgery. We hypothesized that both techniques would result in similar onset times and designed the study as an equivalence trial. Ninety patients undergoing upper limb surgery at or distal to the elbow were randomly allocated to receive a costoclavicular (n = 45) or paracoracoid (n = 45) ultrasound-guided infraclavicular brachial plexus block. Both groups received a 35-mL mixture of 1% lidocaine-0.25% bupivacaine with epinephrine 5 µg·mL -1 . In the costoclavicular group, local anesthetic was injected into the costoclavicular space in the middle of the three cords of the brachial plexus. In the paracoracoid group, local anesthetic was deposited dorsal to the axillary artery in the lateral infraclavicular fossa. A blinded observer recorded the block onset time (primary endpoint), success rate (i.e., surgical anesthesia), block-related pain scores, as well as the incidence of hemidiaphragmatic paralysis. Performance time and the number of needle passes were also recorded during the performance of the block. The total anesthesia-related time was defined as the sum of the performance and onset times. The mean (SD) onset times were comparable between the costoclavicular and paracoracoid groups [16.0 (7.5) min vs 16.8 (6.2) min, respectively; mean difference, 0.8; 95% confidence interval, -2.3 to 3.8; P = 0.61]. Furthermore, no intergroup differences were found in terms of performance time (P = 0.09), total anesthesia-related time (P = 0.90), surgical anesthesia (P > 0.99), and hemidiaphragmatic paralysis (P > 0.99). The paracoracoid technique required marginally fewer median [interquartile range] needle passes than the costoclavicular technique (2 [1-4] vs 2 [1-6], respectively; P = 0.048); however, procedural pain was comparable between the two study groups. Costoclavicular and paracoracoid ultrasound-guided

  18. Minimum Effective Volume of Lidocaine for Ultrasound-Guided Costoclavicular Block.

    Science.gov (United States)

    Sotthisopha, Thitipan; Elgueta, Maria Francisca; Samerchua, Artid; Leurcharusmee, Prangmalee; Tiyaprasertkul, Worakamol; Gordon, Aida; Finlayson, Roderick J; Tran, De Q

    This dose-finding study aimed to determine the minimum effective volume in 90% of patients (MEV90) of lidocaine 1.5% with epinephrine 5 μg/mL for ultrasound-guided costoclavicular block. Using an in-plane technique and a lateral-to-medial direction, the block needle was positioned in the middle of the 3 cords of the brachial plexus in the costoclavicular space. The entire volume of lidocaine was deposited in this location. Dose assignment was carried out using a biased-coin-design up-and-down sequential method, where the total volume of local anesthetic administered to each patient depended on the response of the previous one. In case of failure, the next subject received a higher volume (defined as the previous volume with an increment of 2.5 mL). If the previous patient had a successful block, the next subject was randomized to a lower volume (defined as the previous volume with a decrement of 2.5 mL), with a probability of b = 0.11, or the same volume, with a probability of 1 - b = 0.89. Success was defined, at 30 minutes, as a minimal score of 14 of 16 points using a sensorimotor composite scale. Patients undergoing surgery of the elbow, forearm, wrist, or hand were prospectively enrolled until 45 successful blocks were obtained. This clinical trial was registered with ClinicalTrials.gov (ID NCT02932670). Fifty-seven patients were included in the study. Using isotonic regression and bootstrap confidence interval, the MEV90 for ultrasound-guided costoclavicular block was estimated to be 34.0 mL (95% confidence interval, 33.4-34.4 mL). All patients with a minimal composite score of 14 points at 30 minutes achieved surgical anesthesia intraoperatively. For ultrasound-guided costoclavicular block, the MEV90 of lidocaine 1.5% with epinephrine 5 μg/mL is 34 mL. Further dose-finding studies are required for other concentrations of lidocaine, other local anesthetic agents, and multiple-injection techniques.

  19. [Clinical application of ultrasound guided Fogarty balloon catheter in arterial crisis].

    Science.gov (United States)

    Li, Xiaodong; Wang, Pei; Yu, Changyu; Yan, Xiaowei; Yin, Jing

    2017-10-01

    To explore the effectiveness of arterial crisis after replantation of limb treated by ultrasound guided Fogarty balloon catheter. Between January 2012 and July 2016, 27 patients suffered from arterial crisis after replantation of limb were treated with ultrasound guided Fogarty balloon catheter combined with thrombolytic anticoagulant. There were 18 males and 9 females with the age of 19-51 years (mean, 32 years). The limb mutilation position was at knee joint in 3 cases, lower limb in 9 cases, ankle joint in 6 cases, elbow joint in 2 cases, forearm in 4 cases, and wrist joint in 3 cases. The arterial crisis happened at 2.5-18 hours (mean, 7.5 hours) after limb replantation surgery. Color doppler ultrasonography was used to diagnose the arterial thrombosis, finally the anastomotic thrombosis were found in 16 cases, non-anastomotic thrombosis in 7 cases, and combined thrombosis in 4 cases. All the thrombosis were deteced in the arteries with the length of 0.8-3.9 cm. No complication such as vascular perforation, rupture, air embolism, thromboembolism, wound infection, or sepsis happened after operation. Arterial crisis occurred again in 3 cases at 1.5-13.5 hours after limb replantation and treated by arterial exploration, 1 case was treated successfully; 2 cases had arterial occlusion and partial necrosis of limb, and got amputation treatment at last. The rest 24 cases survived with the incision healing by first stage. In the 24 cases, 1 case suffered from acute myonephropathic metabolic syndrome and corrected after hemodialysis; 1 case suffered from acute liver functional damage and corrected by comprehensive treatment of internal medicine. The 24 patients were followed up 7-38 months (mean, 11 months). At last follow-up, blood supply of the limb was good with normal skin temperature and improved sense of feeling, activity, and swelling. According to Chinese Medical Association of hand surgery to the upper extremity function assessment standard, the results were

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

    International Nuclear Information System (INIS)

    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

    2006-01-01

    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 nodules

  1. MO-DE-202-01: Image-Guided Focused Ultrasound Surgery and Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Farahani, K. [National Cancer Institute (United States)

    2016-06-15

    At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

  2. MO-DE-202-01: Image-Guided Focused Ultrasound Surgery and Therapy

    International Nuclear Information System (INIS)

    Farahani, K.

    2016-01-01

    At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

  3. Elaboration of protocols as a guide in musculoskeletal ultrasound for radiology service of the Hospital Doctor Rafael A. Calderon Guardia

    International Nuclear Information System (INIS)

    Campos Hernandez, Luis Diego

    2010-01-01

    A protocol to guide residents and attending physicians at the Hospital Dr. Rafael Angel Calderon Guardia has been provided for regulating the work in the field the ultrasound of muscles, tendons and sonography. The staff has handled the ultrasound devices must understand the basis of the interaction of acoustic energy to the tissues and to know the methods and instruments have been used to produce and improve the quality of the image obtained. The guide ultrasound normal locomotor allowed to have a model for service members and medical imaging radiology hospital; it has been prepared through a comprehensive literature review based on textbooks and current articles concerning the most important theoretical bases of the Doppler study, which covers the assessment of shoulder, elbow, wrist, knee and ankle. The data obtained in the study process, facilitated access to printed and digital information, which has led to diagnostic certainty and reliability of results. (author) [es

  4. Pneumothorax and the Value of Chest Radiography after Ultrasound-Guided Thoracocentesis

    International Nuclear Information System (INIS)

    Pihlajamaa, K.; Bode, M.K.; Puumalainen, T.; Lehtimaeki, A.; Marjelund, S.; Tikkakoski, T.

    2004-01-01

    Purpose: To determine the incidence, the operator's experience, and other variables that may influence the development of pneumothorax or re-expansion edema after ultrasound (US)-guided thoracocentesis. Material and Methods: The medical records of 264 procedures in 212 patients who had undergone US-guided thoracocentesis in our radiology department or intensive care unit during the period 1996-2001 were retrospectively reviewed. Results: Post-thoracocentesis pneumothorax occurred in 11 cases, the incidence being 4.2% (11/264). None of the pneumothoraces occurred in the 10 mechanically ventilated patients. All but one patient with pneumothorax were asymptomatic or had only minor symptoms. Chest tube drainage was needed in one patient with a large pneumothorax. No re-expansion edema was recorded, although 1500 ml or more pleural fluid was aspirated in 29 patients. The operator's experience had no effect on the complication rate. Needle size was the only significant variable that contributed to the pneumothorax rate. Conclusion: US-guided thoracocentesis can be done equally as safely by residents as by senior radiologists. The safety and feasibility of the method are evident among mechanically ventilated intensive care patients. Our results do not support the routine use of post-thoracocentesis chest radiography

  5. A framework for continuous target tracking during MR-guided high intensity focused ultrasound thermal ablations in the abdomen

    NARCIS (Netherlands)

    Zachiu, Cornel; Denis de Senneville, Baudouin; Dmitriev, Ivan D.; Moonen, Chrit T.W.; Ries, Mario

    2017-01-01

    Background: During lengthy magnetic resonance-guided high intensity focused ultrasound (MRg-HIFU) thermal ablations in abdominal organs, the therapeutic work-flow is frequently hampered by various types of physiological motion occurring at different time-scales. If left un-addressed this can lead to

  6. Imprint cytology from ultrasound-guided core biopsies: accurate and immediate diagnosis in a one-stop breast clinic

    International Nuclear Information System (INIS)

    Jones, L.; Lott, M.F.; Calder, C.J.; Kutt, E.

    2004-01-01

    AIM: To investigate whether imprint cytology from ultrasound-guided core biopsy specimens was adequate for the National Health Service Breast Screening Programme (NHSBSP) guidelines. METHODS: We prospectively audited imprint cytology from ultrasound-guided core biopsy specimens. The performance indicators for imprint cytology specimens from 111 consecutive ultrasound-guided core biopsy were compared with standards set by the NHSBSP for fine-needle aspiration cytology (FNAC). RESULTS: Imprint cytology fulfilled the 'preferred' targets for absolute and complete sensitivity, specificity, positive predictive value, false-positive and false-negative rates, inadequate rate and inadequate rate from cancers. It also satisfied the minimum target for suspicious rate. The complete sensitivity was 97%, full specificity 78%, with 100% positive predictive value for C5 cytology and an inadequate rate from cancers of 1.5%. CONCLUSION: Imprint cytology from ultrasound-guided core biopsy allows same-day diagnosis and the collection of data regarding the grade of the carcinoma for treatment decisions from a single needle test

  7. Ultrasound-guided fine needle aspiration in the diagnosis of peripheral nerve sheath tumors in 4 dogs

    Science.gov (United States)

    da Costa, Ronaldo C.; Parent, Joane M.; Dobson, Howard; Ruotsalo, Kristiina; Holmberg, David; Duque, M. Carolina; Poma, Roberto

    2008-01-01

    Ultrasound-guided fine needle aspiration was used in establishing the diagnosis in 4 cases of malignant peripheral nerve sheath tumor. Sonographic and cytologic characteristics are discussed. Because of its availability and ease of use, axillary ultrasonography with fine needle aspiration can be an initial diagnostic step for suspected brachial plexus tumors. PMID:18320983

  8. Histopathology of breast cancer after magnetic resonance-guided high-intensity focused ultrasound and radiofrequency ablation

    NARCIS (Netherlands)

    Knuttel, Floor; Waaijer, Laurien; Merckel, LG; van den Bosch, Maurice A A J; Witkamp, Arjen J.; Deckers, Roel; van Diest, Paul J.

    AIMS: Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) ablation and radiofrequency ablation (RFA) are being researched as possible substitutes for surgery in breast cancer patients. The histopathological appearance of ablated tissue has not been studied in great detail. This

  9. Effects of magnetic resonance-guided high-intensity focused ultrasound ablation on bone mechanical properties and modeling

    NARCIS (Netherlands)

    Yeoh, S.Y.; Arias Moreno, A.J.; Rietbergen, van B.; Hoeve, ter N.D.; Diest, van P.J.; Grull, H.

    2015-01-01

    Background Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) is a promising technique for palliative treatment of bone pain. In this study, the effects of MR-HIFU ablation on bone mechanics and modeling were investigated. Methods A total of 12 healthy rat femurs were ablated

  10. Gestrinone combined with ultrasound-guided aspiration and ethanol injection for treatment of chocolate cyst of ovary.

    Science.gov (United States)

    Wu, Xiaoyun; Xu, Yun

    2015-05-01

    The aim of this study was to determine clinical performance of gestrinone combined with ultrasound-guided aspiration and ethanol injection in treating chocolate cyst of ovary. Sixty-eight patients enrolled in this study were randomly divided into two groups: control group and combination treatment group. In the control group, 34 patients were treated with ultrasound-guided aspiration and ethanol injection. In the combination treatment group, 34 patients received gestrinone p.o. following ultrasound-guided aspiration and ethanol injection. The recurrence rate of chocolate cyst was 10-fold lower in the combination treatment group (2.94%, 1/34) than in the control group (29.4%, 10/34) at 12 months. The effective rate for reduction of chocolate cyst was significantly higher in the combination treatment group (94.12%, 32/34) than in the control group (64.71%, 22/34) (P = 0.009). Gestrinone combined with ultrasound-guided aspiration and ethanol injection therapy is an effective treatment for ovarian chocolate cyst with low recurrence rate. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  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. Ultrasound-guided, vacuum-assisted biopsy in evaluation of breast lesions

    International Nuclear Information System (INIS)

    Luczynska, E.; Kocurek, A.; Dyczek, S.; Skotnicki, P.; Stelmach, A.; Herman, K.

    2008-01-01

    Aim. Evaluation of the efficacy of ultrasound-guided vacuum-assisted biopsy for the verification of breast lesions. Introduction. Ultrasound breast examination is a noninvasive method of breast imaging. It is adjunct to mammography and physical examination and, in women under 30 years of age, pregnant and lactating, it is the basic examination used for the detection and diagnosing of breast diseases. It allows also to obtain cells or tissue samples with such minimally invasive techniques as fine-needle biopsy, core needle biopsy or vacuum-assisted biopsy. Material and methods. The study group consisted of 138 women, aged from 20 to 76 years, who underwent ultrasound guided vacuum-assisted biopsy between March and December 2006. Because double lesions were diagnosed in 6 patients, this resulted in 144 performed procedures. Each patient underwent ultrasound examination, performed with a 10-12 MHz transducer. Biopsies were guided by a 12 MHz transducer and performed with the Mammotome System using an 11G or an 8G needle, depending upon the size and site of the lesion. Obtained data were compared using the Chi-square test; p values of less than 0.05 were considered indicative of a significant difference. Results. The average size of the biopted lesions was estimated as 11±3,8 mm (range: 4-30 mm). However, lesions described by radiologists as apparently suspicious were not qualified for the vacuum-assisted biopsy, in the tested material 4 lesions appeared to be carcinomas (3 were invasive breast carcinomas and 1 was ductal carcinoma in situ). When compared with other changes, these lesions were most frequently equivocal (3 vs 1 determined as benign, p=0.014). There was no statistically significant difference in echogenicity (3 hypoechoic vs 1 with mixed echogenicity) nor in the shape (1 oval change, 2 lobulated and 1 irregular). Pathological examination revealed 86 cases of fibroadenoma within the tested material. Those lesions were mostly benign (77 vs 9 equivocal

  13. 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

  14. Sonoanatomical Change of Phrenic Nerve According to Posture During Ultrasound-Guided Stellate Ganglion Block.

    Science.gov (United States)

    Joeng, Eui Soo; Jeong, Young Cheol; Park, Bum Jun; Kang, Seok; Yang, Seung Nam; Yoon, Joon Shik

    2016-04-01

    To evaluate the risk of phrenic nerve injury during ultrasound-guided stellate ganglion block (US-SGB) according to sonoanatomy of the phrenic nerve, and determine a safer posture for needle insertion by assessing its relationship with surrounding structure according to positional change. Twenty-nine healthy volunteers were recruited and underwent ultrasound in two postures, i.e., supine position with the neck extension and head rotation, and lateral decubitus position. The transducer was placed at the anterior tubercle of the C6 level to identify phrenic nerve. The cross-sectional area (CSA), depth from skin, distance between phrenic nerve and anterior tubercle of C6 transverse process, and the angle formed by anterior tubercle, posterior tubercle and phrenic nerve were measured. The phrenic nerve was clearly identified in the intermuscular fascia layer between the anterior scalene and sternocleidomastoid muscles. The distance between the phrenic nerve and anterior tubercle was 10.33±3.20 mm with the supine position and 9.20±3.31 mm with the lateral decubitus position, respectively. The mean CSA and skin depth of phrenic nerve were not statistically different between the two positions. The angle with the supine position was 48.37°±27.43°, and 58.89°±30.02° with the lateral decubitus position. The difference of angle between the two positions was statistically significant. Ultrasound is a useful tool for assessing the phrenic nerve and its anatomical relation with other cervical structures. In addition, lateral decubitus position seems to be safer by providing wider angle for needle insertion than the supine position in US-SGB.

  15. Experimental investigations of an endoluminal ultrasound applicator for MR-guided thermal therapy of pancreatic cancer

    Science.gov (United States)

    Adams, Matthew; Salgaonkar, Vasant; Jones, Peter; Plata, Juan; Chen, Henry; Pauly, Kim Butts; Sommer, Graham; Diederich, Chris

    2017-03-01

    An MR-guided endoluminal ultrasound applicator has been proposed for palliative and potential curative thermal therapy of pancreatic tumors. Minimally invasive ablation or hyperthermia treatment of pancreatic tumor tissue would be performed with the applicator positioned in the gastrointestinal (GI) lumen, and sparing of the luminal tissue would be achieved with a water-cooled balloon surrounding the ultrasound transducers. This approach offers the capability of conformal volumetric therapy for fast treatment times, with control over the 3D spatial deposition of energy. Prototype endoluminal ultrasound applicators have been fabricated using 3D printed fixtures that seat two 3.2 or 5.6 MHz planar or curvilinear transducers and contain channels for wiring and water flow. Spiral surface coils have been integrated onto the applicator body to allow for device localization and tracking for therapies performed under MR guidance. Heating experiments with a tissue-mimicking phantom in a 3T MR scanner were performed and demonstrated capability of the prototype to perform volumetric heating through duodenal luminal tissue under real-time PRF-based MR temperature imaging (MRTI). Additional experiments were performed in ex vivo pig carcasses with the applicator inserted into the esophagus and aimed towards liver or soft tissue surrounding the spine under MR guidance. These experiments verified the capacity of heating targets up to 20-25 mm from the GI tract. Active device tracking and automated prescription of imaging and temperature monitoring planes through the applicator were made possible by using Hadamard encoded tracking sequences to obtain the coordinates of the applicator tracking coils. The prototype applicators have been integrated with an MR software suite that performs real-time device tracking and temperature monitoring.

  16. Theranostic Gd(III)-lipid microbubbles for MRI-guided focused ultrasound surgery.

    Science.gov (United States)

    Feshitan, Jameel A; Vlachos, Fotis; Sirsi, Shashank R; Konofagou, Elisa E; Borden, Mark A

    2012-01-01

    We have synthesized a biomaterial consisting of Gd(III) ions chelated to lipid-coated, size-selected microbubbles for utility in both magnetic resonance and ultrasound imaging. The macrocyclic ligand DOTA-NHS was bound to PE headgroups on the lipid shell of pre-synthesized microbubbles. Gd(III) was then chelated to DOTA on the microbubble shell. The reaction temperature was optimized to increase the rate of Gd(III) chelation while maintaining microbubble stability. ICP-OES analysis of the microbubbles determined a surface density of 7.5 × 10(5) ± 3.0 × 10(5) Gd(III)/μm(2) after chelation at 50 °C. The Gd(III)-bound microbubbles were found to be echogenic in vivo during high-frequency ultrasound imaging of the mouse kidney. The Gd(III)-bound microbubbles also were characterized by magnetic resonance imaging (MRI) at 9.4 T by a spin-echo technique and, surprisingly, both the longitudinal and transverse proton relaxation rates were found to be roughly equal to that of no-Gd(III) control microbubbles and saline. However, the relaxation rates increased significantly, and in a dose-dependent manner, after sonication was used to fragment the Gd(III)-bound microbubbles into non-gas-containing lipid bilayer remnants. The longitudinal (r(1)) and transverse (r(2)) molar relaxivities were 4.0 ± 0.4 and 120 ± 18 mM(-1)s(-1), respectively, based on Gd(III) content. The Gd(III)-bound microbubbles may find application in the measurement of cavitation events during MRI-guided focused ultrasound therapy and to track the biodistribution of shell remnants. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. A non-disruptive technology for robust 3D tool tracking for ultrasound-guided interventions.

    Science.gov (United States)

    Mung, Jay; Vignon, Francois; Jain, Ameet

    2011-01-01

    In the past decade ultrasound (US) has become the preferred modality for a number of interventional procedures, offering excellent soft tissue visualization. The main limitation however is limited visualization of surgical tools. A new method is proposed for robust 3D tracking and US image enhancement of surgical tools under US guidance. Small US sensors are mounted on existing surgical tools. As the imager emits acoustic energy, the electrical signal from the sensor is analyzed to reconstruct its 3D coordinates. These coordinates can then be used for 3D surgical navigation, similar to current day tracking systems. A system with real-time 3D tool tracking and image enhancement was implemented on a commercial ultrasound scanner and 3D probe. Extensive water tank experiments with a tracked 0.2mm sensor show robust performance in a wide range of imaging conditions and tool position/orientations. The 3D tracking accuracy was 0.36 +/- 0.16mm throughout the imaging volume of 55 degrees x 27 degrees x 150mm. Additionally, the tool was successfully tracked inside a beating heart phantom. This paper proposes an image enhancement and tool tracking technology with sub-mm accuracy for US-guided interventions. The technology is non-disruptive, both in terms of existing clinical workflow and commercial considerations, showing promise for large scale clinical impact.

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

    International Nuclear Information System (INIS)

    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

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

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    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.

  20. Ultrasound-Guided Hyaluronic Acid Injections for Trigger Finger: A Double-Blinded, Randomized Controlled Trial.

    Science.gov (United States)

    Liu, Ding-Hao; Tsai, Mei-Wun; Lin, Shan-Hui; Chou, Chen-Liang; Chiu, Jan-Wei; Chiang, Chao-Ching; Kao, Chung-Lan

    2015-12-01

    To investigate the effects of ultrasound-guided injections of hyaluronic acid (HA) versus steroid for trigger fingers in adults. Prospective, double-blinded, randomized controlled study. Tertiary care center. Subjects with a diagnosis of trigger finger (N=36; 39 affected digits) received treatment and were evaluated. Subjects were randomly assigned to HA and steroid injection groups. Both study medications were injected separately via ultrasound guidance with 1 injection. The classification of trigger grading, pain, functional disability, and patient satisfaction were evaluated before the injection and 3 weeks and 3 months after the injection. At 3 months, 12 patients (66.7%) in the HA group and 17 patients (89.5%) in the steroid group exhibited no triggering of the affected fingers (P=.124). The treatment results at 3 weeks and 3 months showed similar changes in the Quinnell scale (P=.057 and .931, respectively). A statistically significant interaction effect between group and time was found for visual analog scale (VAS) and Michigan Hand Outcome Questionnaire (MHQ) evaluation (Pinjection (steroid 0.5±1.1 vs HA 2.7±2.4; Pinjection of HA demonstrated promising results for the treatment of trigger fingers. The optimal frequency, dosage, and molecular weight of HA injections for trigger fingers deserve further investigation for future clinical applications. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  1. 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.

  2. Multi-Channel RF System for MRI-Guided Transurethral Ultrasound Thermal Therapy

    Science.gov (United States)

    Yak, Nicolas; Asselin, Matthew; Chopra, Rajiv; Bronskill, Michael

    2009-04-01

    MRI-guided transurethral ultrasound thermal therapy is an approach to treating localized prostate cancer which targets precise deposition of thermal energy within a confined region of the gland. This treatment requires a system incorporating a heating applicator with multiple planar ultrasound transducers and associated RF electronics to control individual elements independently in order to achieve accurate 3D treatment. We report the design, construction, and characterization of a prototype multi-channel system capable of controlling 16 independent RF signals for a 16-element heating applicator. The main components are a control computer, microcontroller, and a 16-channel signal generator with 16 amplifiers, each incorporating a low-pass filter and transmitted/reflected power detection circuit. Each channel can deliver from 0.5 to 10 W of electrical power and good linearity from 3 to 12 MHz. Harmonic RF signals near the Larmor frequency of a 1.5 T MRI were measured to be below -30 dBm and heating experiments within the 1.5 T MR system showed no significant decrease in SNR of the temperature images. The frequency and power for all 16 channels could be changed in less than 250 ms, which was sufficiently rapid for proper performance of the control algorithms. A common backplane design was chosen which enabled an inexpensive, modular approach for each channel resulting in an overall system with minimal footprint.

  3. Percutaneous ultrasound-guided radiofrequency ablation for kidney tumors in patients with surgical risk

    International Nuclear Information System (INIS)

    Salagierski, Marek; Salagierski, Maciej; Sosnowski, Marek; Salagierska-Barwinska, Anna

    2006-01-01

    The aim of this study was to describe our experience with percutaneous ultrasound-guided radiofrequency ablation of kidney tumors. From July 2002 to August 2005, 45 radiofrequency ablations (RFA) in 42 selected patients with kidney tumor were performed. The patients had either contraindications to surgery procedures or had a solitary kidney. The average tumor size was 37.5 mm (range, 18-59 mm) with the mean age of 68 years (range, 28-83 years). RFA were performed based on radiographic findings. Needle biopsy was made only twice. Monopolar Cool-tip Tyco or bipolar Celon Olympus radiofrequency devices were used. The procedure was performed under conscious sedation with local anesthesia. Treatment efficacy was assessed by computed tomography and by Doppler ultrasound. The absence of contrast enhancement on computed tomography was considered to be a successful treatment. The average follow up was 14 months (range, 3-36 months). In 42 tumors (93%), total absence of contrast enhancement was obtained after the initial RFA and in three tumors (7%) after the second ablation session. There were no complications following 41 procedures, including all ablations in small (<35 mm) renal masses. In four procedures, minor complications were observed. All patients are alive. There has been no need for chronic hemodialysis and, until now, we have not observed any local recurrences with the exception of one metastasis to an ipsilateral adrenal gland. RFA of kidney tumors is a promising alternative treatment which could be considered for patients who are not suitable for surgery. (author)

  4. Endobronchial ultrasound-guided transbronchial needle aspiration for lung cancer staging: early experience in Brazil*,**

    Science.gov (United States)

    Figueiredo, Viviane Rossi; Cardoso, Paulo Francisco Guerreiro; Jacomelli, Márcia; Demarzo, Sérgio Eduardo; Palomino, Addy Lidvina Mejia; Rodrigues, Ascédio José; Terra, Ricardo Mingarini; Pego-Fernandes, Paulo Manoel; Carvalho, Carlos Roberto Ribeiro

    2015-01-01

    Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, safe and accurate method for collecting samples from mediastinal and hilar lymph nodes. This study focused on the initial results obtained with EBUS-TBNA for lung cancer and lymph node staging at three teaching hospitals in Brazil. Methods: This was a retrospective analysis of patients diagnosed with lung cancer and submitted to EBUS-TBNA for mediastinal lymph node staging. The EBUS-TBNA procedures, which involved the use of an EBUS scope, an ultrasound processor, and a compatible, disposable 22 G needle, were performed while the patients were under general anesthesia. Results: Between January of 2011 and January of 2014, 149 patients underwent EBUS-TBNA for lymph node staging. The mean age was 66 ± 12 years, and 58% were male. A total of 407 lymph nodes were sampled by EBUS-TBNA. The most common types of lung neoplasm were adenocarcinoma (in 67%) and squamous cell carcinoma (in 24%). For lung cancer staging, EBUS-TBNA was found to have a sensitivity of 96%, a specificity of 100%, and a negative predictive value of 85%. Conclusions: We found EBUS-TBNA to be a safe and accurate method for lymph node staging in lung cancer patients. PMID:25750671

  5. Endobronchial ultrasound-guided transbronchial needle aspiration for lung cancer staging: early experience in Brazil,

    Directory of Open Access Journals (Sweden)

    Viviane Rossi Figueiredo

    2015-02-01

    Full Text Available Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA is a minimally invasive, safe and accurate method for collecting samples from mediastinal and hilar lymph nodes. This study focused on the initial results obtained with EBUS-TBNA for lung cancer and lymph node staging at three teaching hospitals in Brazil. Methods: This was a retrospective analysis of patients diagnosed with lung cancer and submitted to EBUS-TBNA for mediastinal lymph node staging. The EBUS-TBNA procedures, which involved the use of an EBUS scope, an ultrasound processor, and a compatible, disposable 22 G needle, were performed while the patients were under general anesthesia. Results: Between January of 2011 and January of 2014, 149 patients underwent EBUS-TBNA for lymph node staging. The mean age was 66 ± 12 years, and 58% were male. A total of 407 lymph nodes were sampled by EBUS-TBNA. The most common types of lung neoplasm were adenocarcinoma (in 67% and squamous cell carcinoma (in 24%. For lung cancer staging, EBUS-TBNA was found to have a sensitivity of 96%, a specificity of 100%, and a negative predictive value of 85%. Conclusions: We found EBUS-TBNA to be a safe and accurate method for lymph node staging in lung cancer patients.

  6. Endobronchial ultrasound-guided transbronchial needle aspiration for lung cancer staging: early experience in Brazil.

    Science.gov (United States)

    Figueiredo, Viviane Rossi; Cardoso, Paulo Francisco Guerreiro; Jacomelli, Márcia; Demarzo, Sérgio Eduardo; Palomino, Addy Lidvina Mejia; Rodrigues, Ascédio José; Terra, Ricardo Mingarini; Pego-Fernandes, Paulo Manoel; Carvalho, Carlos Roberto Ribeiro

    2015-01-01

    Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, safe and accurate method for collecting samples from mediastinal and hilar lymph nodes. This study focused on the initial results obtained with EBUS-TBNA for lung cancer and lymph node staging at three teaching hospitals in Brazil. This was a retrospective analysis of patients diagnosed with lung cancer and submitted to EBUS-TBNA for mediastinal lymph node staging. The EBUS-TBNA procedures, which involved the use of an EBUS scope, an ultrasound processor, and a compatible, disposable 22 G needle, were performed while the patients were under general anesthesia. Between January of 2011 and January of 2014, 149 patients underwent EBUS-TBNA for lymph node staging. The mean age was 66 ± 12 years, and 58% were male. A total of 407 lymph nodes were sampled by EBUS-TBNA. The most common types of lung neoplasm were adenocarcinoma (in 67%) and squamous cell carcinoma (in 24%). For lung cancer staging, EBUS-TBNA was found to have a sensitivity of 96%, a specificity of 100%, and a negative predictive value of 85%. We found EBUS-TBNA to be a safe and accurate method for lymph node staging in lung cancer patients.

  7. Ultrasound-Guided Interscalene Catheter Complicated by Persistent Phrenic Nerve Palsy

    Directory of Open Access Journals (Sweden)

    Andrew T. Koogler

    2018-01-01

    Full Text Available A 76-year-old male presented for reverse total shoulder arthroplasty (TSA in the beach chair position. A preoperative interscalene nerve catheter was placed under direct ultrasound-guidance utilizing a posterior in-plane approach. On POD 2, the catheter was removed. Three weeks postoperatively, the patient reported worsening dyspnea with a subsequent chest X-ray demonstrating an elevated right hemidiaphragm. Pulmonary function testing revealed worsening deficit from presurgical values consistent with phrenic nerve palsy. The patient decided to continue conservative management and declined further invasive testing or treatment. He was followed for one year postoperatively with moderate improvement of his exertional dyspnea over that period of time. The close proximity of the phrenic nerve to the brachial plexus in combination with its frequent anatomical variation can lead to unintentional mechanical trauma, intraneural injection, or chemical injury during performance of ISB. The only previously identified risk factor for PPNP is cervical degenerative disc disease. Although PPNP has been reported following TSA in the beach chair position without the presence of a nerve block, it is typically presumed as a complication of the interscalene block. Previously published case reports and case series of PPNP complicating ISBs all describe nerve blocks performed with either paresthesia technique or localization with nerve stimulation. We report a case of a patient experiencing PPNP following an ultrasound-guided placement of an interscalene nerve catheter.

  8. Magnetic Resonance Imaging-Guided Focused Ultrasound Surgery for the Treatment of Symptomatic Uterine Fibroids

    Directory of Open Access Journals (Sweden)

    Laura Geraci

    2017-01-01

    Full Text Available Uterine fibroids, the most common benign tumor in women of childbearing age, may cause symptoms including pelvic pain, menorrhagia, dysmenorrhea, pressure, urinary symptoms, and infertility. Various approaches are available to treat symptomatic uterine fibroids. Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS represents a recently introduced noninvasive safe and effective technique that can be performed without general anesthesia, in an outpatient setting. We review the principles of MRgFUS, describing patient selection criteria for the treatments performed at our center and we present a series of five selected patients with symptomatic uterine fibroids treated with this not yet widely known technique, showing its efficacy in symptom improvement and fibroid volume reduction.

  9. [Ultrasound-guided cutaneous intercostal branches nerves block: A good analgesic alternative for gallbladder open surgery].

    Science.gov (United States)

    Fernández Martín, M T; López Álvarez, S; Mozo Herrera, G; Platero Burgos, J J

    2015-12-01

    Laparoscopic cholecystectomy has become the standard treatment for gallbladder diseases. However, there are still some patients for whom conversion to open surgery is required. This surgery can produce significant post-operative pain. Opioids drugs have traditionally been used to treat this pain, but side effects have led to seeking alternatives (plexus, nerve or fascia blocks or wound). The cases are presented of 4 patients subjected to ultrasound-guided intercostal branches blocks in the mid-axillary line from T6 to T12 with levobupivacaine as an analgesic alternative in open surgery of gallbladder, with satisfactory results. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. 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

    positioning as well as during later in-plane readjustment of the catheter. We tested the system in the popliteal region of two fresh cadavers in a preliminary proof of concept study. RESULTS: Both initial placement and secondary readjustment were precise, judged by the catheter orifices placed close......BACKGROUND: Existing techniques for placing and maintaining the position of peripheral nerve catheters are associated with variable success rates and frequent secondary failures. These factors may affect the clinical efficacy and usefulness of peripheral nerve catheters. METHODS: We developed a new...... concept and prototype for ultrasound-guided in-plane positioning and readjustment of peripheral nerve catheters (patent pending). The integrated catheter-needle prototype comprises three parts: a curved needle, a catheter with clear echogenic markings attached to the needle tail and a detachable hub...

  11. Ultrasound-Guided Cannulation: Time to Bring Subclavian Central Lines Back

    Directory of Open Access Journals (Sweden)

    Talayeh Rezayat, DO, MPH

    2016-03-01

    Full Text Available Despite multiple advantages, subclavian vein (SCV cannulation via the traditional landmark approach has become less used in comparison to ultrasound (US guided internal jugular catheterization due to a higher rate of mechanical complications. A growing body of evidence indicates that SCV catheterization with real-time US guidance can be accomplished safely and efficiently. While several cannulation approaches with real-time US guidance have been described, available literature suggests that the infraclavicular, longitudinal “in-plane” technique may be preferred. This approach allows for direct visualization of needle advancement, which reduces risk of complications and improves successful placement. Infraclavicular SCV cannulation requires simultaneous use of US during needle advancement, but for an inexperienced operator, it is more easily learned compared to the traditional landmark approach. In this article, we review the evidence supporting the use of US guidance for SCV catheterization and discuss technical aspects of the procedure itself.

  12. A Case of Horner's Syndrome following Ultrasound-Guided Infraclavicular Brachial Plexus Block.

    Science.gov (United States)

    Walid, Trabelsi; Mondher, Belhaj Amor; Mohamed Anis, Lebbi; Mustapha, Ferjani

    2012-01-01

    Horner's syndrome results from paralysis of the ipsilateral sympathetic cervical chain (stellate ganglion) caused by surgery, drugs (mainly high concentrations of local anesthetics), local compression (hematoma or tumor), or inadequate perioperative positioning of the patient. It occurs in 100% of the patients with an interscalene block of the brachial plexus and can also occur in patients with other types of supraclavicular blocks.In this case report, we presented a case of Horner's syndrome after performing an ultrasound-guided infraclavicular brachial plexus block with 15 mL of bupivacaine 0.5%. It appeared 40 minutes after the block with specific triad (ptosis, miosis, and exophtalmia) and quickly disappears within 2 hours and a half without any sequelae. Horner's syndrome may be described as an unpleasant side effect because it has no clinical consequences in itself. For this reason anesthesiologists should be aware of this syndrome, and if it occurs patients should be reassured and monitored closely.

  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...... to pathophysiological mechanisms as well as aiding diagnosis and treatment of PPBCS but has never been attempted. OBJECTIVES: To assess the feasibility of ICBN blockade and assess its effects on pain and sensory function in patients with PPBCS. STUDY DESIGN: This prospective pilot study was performed in 2 parts: Part 1...

  14. 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

    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......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...... a registered US-TTNB procedure at any of the three centers. The US-TTNB was defined as being successful if the result was diagnostic and otherwise as being unsuccessful. Histology or cytology results and clinical follow-up were used as a reference tests. The learning curves for physicians having performed...

  15. Hoarseness of voice after supraclavicular ultrasound-guided subclavian perivascular brachial plexus block

    Directory of Open Access Journals (Sweden)

    Monika Gupta

    2017-01-01

    Full Text Available Supraclavicular brachial plexus nerve block is ideal for surgical procedures at or distal to the elbow. Ultrasound (USG continues to grow in popularity as a method of nerve localization, and for the supraclavicular block, it has the advantage of allowing real-time visualization of the plexus, pleura, and vessels along with the needle and local anesthetic spread, but it may conversely create a false sense of security. The incidence of the recurrent laryngeal nerve (RLN block occurring with supraclavicular approach is 1.3% of patients.[10] Incidence of RLN block with USG-guided supraclavicular block is not known. In this case report, we discuss a rare complication of RLN block which occurred while performing a supraclavicular perivascular block performed under USG guidance.

  16. [Novel echogenic needle for ultrasound-guided peripheral nerve block "Hakko type CCR"].

    Science.gov (United States)

    Takayama, Wataru; Yasumura, Rie; Kaneko, Takehiko; Kobayashi, Yoshiro; Kamada, Takaaki; Yoshikawa, Tamotsu; Aoyama, Yasuhiko

    2009-04-01

    A novel echogenic insulated nerve block needle (CCR-needle: Echogenic Needle Type CCR; Hakko, Japan) is commercially available since 2006 in Japan. This needle has three echogenic dimples, namely corner cube reflectors (CCR) on its tip. The CCR-needle will potentially provide a significant advantage for detecting the needle tip. In this report, we firstly evaluated this new disposable echogenic needle in simulation phantom, and demonstrated improved visibility of the needle tip. Afterwards, an interscalene brachial plexus block was performed on a male patient undergoing shoulder surgery. The needle insertion procedure was the "out of plane" ultrasound-guided technique using simultaneous electrical nerve stimulation. The surgery was successfully conducted without any complications.

  17. 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.

  18. Magnetic Resonance Imaging-Guided Focused Ultrasound Surgery for the Treatment of Symptomatic Uterine Fibroids.

    Science.gov (United States)

    Geraci, Laura; Napoli, Alessandro; Catalano, Carlo; Midiri, Massimo; Gagliardo, Cesare

    2017-01-01

    Uterine fibroids, the most common benign tumor in women of childbearing age, may cause symptoms including pelvic pain, menorrhagia, dysmenorrhea, pressure, urinary symptoms, and infertility. Various approaches are available to treat symptomatic uterine fibroids. Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) represents a recently introduced noninvasive safe and effective technique that can be performed without general anesthesia, in an outpatient setting. We review the principles of MRgFUS, describing patient selection criteria for the treatments performed at our center and we present a series of five selected patients with symptomatic uterine fibroids treated with this not yet widely known technique, showing its efficacy in symptom improvement and fibroid volume reduction.

  19. Endoscopic ultrasound-guided evaluation of the pleura and cases of pleural effusion.

    Science.gov (United States)

    Sharma, Malay; Rameshbabu, Chittapuram Srinivasan

    2017-01-01

    The most efficient and cost-effective approach for the diagnosis of pleural exudates remains uncertain and is a subject of controversy. Essential factors to be considered include the respective diagnostic yields of thoracocentesis, closed pleural biopsy, and thoracoscopy. The role of endoscopic ultrasound (EUS) of the esophagus as a modality for the evaluation of pleural exudates has not yet been evaluated. The applied anatomy of the pleura has been discussed. The techniques involved in the EUS imaging of different aspects of the pleura in normal cases and in cases with pleural effusion are elaborated. The practical application of this knowledge can be useful in EUS-guided sampling of the pleural wall, pleural nodules, and in cases of pleural effusion.

  20. Virtual reality, ultrasound-guided liver biopsy simulator: development and performance discrimination

    Science.gov (United States)

    Johnson, S J; Hunt, C M; Woolnough, H M; Crawshaw, M; Kilkenny, C; Gould, D A; England, A; Sinha, A; Villard, P F

    2012-01-01

    Objectives The aim of this article was to identify and prospectively investigate simulated ultrasound-guided targeted liver biopsy performance metrics as differentiators between levels of expertise in interventional radiology. Methods Task analysis produced detailed procedural step documentation allowing identification of critical procedure steps and performance metrics for use in a virtual reality ultrasound-guided targeted liver biopsy procedure. Consultant (n=14; male=11, female=3) and trainee (n=26; male=19, female=7) scores on the performance metrics were compared. Ethical approval was granted by the Liverpool Research Ethics Committee (UK). Independent t-tests and analysis of variance (ANOVA) investigated differences between groups. Results Independent t-tests revealed significant differences between trainees and consultants on three performance metrics: targeting, p=0.018, t=−2.487 (−2.040 to −0.207); probe usage time, p = 0.040, t=2.132 (11.064 to 427.983); mean needle length in beam, p=0.029, t=−2.272 (−0.028 to −0.002). ANOVA reported significant differences across years of experience (0–1, 1–2, 3+ years) on seven performance metrics: no-go area touched, p=0.012; targeting, p=0.025; length of session, p=0.024; probe usage time, p=0.025; total needle distance moved, p=0.038; number of skin contacts, p<0.001; total time in no-go area, p=0.008. More experienced participants consistently received better performance scores on all 19 performance metrics. Conclusion It is possible to measure and monitor performance using simulation, with performance metrics providing feedback on skill level and differentiating levels of expertise. However, a transfer of training study is required. PMID:21304005

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

    Directory of Open Access Journals (Sweden)

    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

  2. Monitoring the reflection from an artificial defect in rail track using guided wave ultrasound

    Science.gov (United States)

    Loveday, Philip W.; Taylor, Rebecca M. C.; Long, Craig S.; Ramatlo, Dineo A.

    2018-04-01

    Guided wave ultrasound has the potential to detect relatively large defects in continuously welded rail track at long range. As monitoring can be performed in near real time it would be acceptable to only detect fairly large cracks provided this is achieved prior to complete rail breakage. Heavy haul rail lines are inspected periodically by conventional ultrasound and sections with even relatively small cracks are removed; therefore, no sizable defects are available to demonstrate monitoring in the presence of realistic environmental operating conditions. Instead, we glued a small mass to the rail to simulate reflection from a crack and monitored the guided wave signals as the glue joint deteriorated over time. Data was collected over a two week period on an operational heavy haul line. A piezoelectric transducer mounted under the head of the rail was used in pulse-echo mode to transmit and receive a mode of propagation with energy confined mainly in the head of the rail. The small mass was attached under the head of the rail, at a distance of 375m from the transducer, using a cyanoacrylate glue, which was not expected to remain intact for long. Pre-processing of the collected signals involved rejection of signals containing train noise, averaging, filtering and dispersion compensation. Reflections from aluminothermic welds were used to stretch and scale the signals to reduce the influence of temperature variations. Singular value decomposition and independent component analysis were then applied to the signals with the aim of separating the reflection caused by the artificial defect from the background signal. The performance of these techniques was compared for different time spans. The reflection from the artificial defect showed unanticipated fluctuations.

  3. 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.

  4. Ultrasound-Guided Cervical Medial Branch Radiofrequency Neurotomy: Can Multitined Deployment Cannulae Be the Solution?

    Science.gov (United States)

    Finlayson, Roderick J; Thonnagith, Atikun; Elgueta, Maria Francisca; Perez, Jordi; Etheridge, John-Paul B; Tran, De Q H

    Novel multitined cannulae constitute an attractive option for ultrasound-guided radiofrequency neurotomy of cervical medial branches. The deployment tines increase the cannula's active area, thus altering its lesion size. Despite their theoretical benefits, multitined cannulae have not been assessed. In this bench study, we sought to investigate the lesions produced by a standard 18-gauge and 2 commercially available multitined deployment cannulae. We created ex vivo models to evaluate lesion morphology at a periosteal interface using approach angles likely to be encountered during an ultrasound-guided technique. Two ex vivo models were assembled using chicken breast tissue and bovine tibia. Monopolar lesions were carried out with 3 commercially available cannulae (18-gauge curved [S], 17-gauge with laterally deploying tines [N], and 18-gauge with distally deploying tines [T]). All cannulae were positioned at 0, 25, 45, and 90 degrees to the periosteal plane. For each angulation and cannula, 2 series of measurements were recorded to document lesion morphology in the axial and sagittal planes. Data collected included the lesion's surface area, shape, and dimensions relative to the needle tip. A total of 240 lesions were analyzed. The performances of S and N cannulae were significantly affected by approach angle, with lesion size decreasing as the angle increased. In contrast, T cannulae displayed similar lesion surface areas at 0 and 90 degrees. The multitined N and T cannulae produced the largest lesions at 0/25 and 90 degrees, respectively. Lesion height varied inversely according to approach angle for S and N cannulae, whereas T cannulae displayed stable characteristics. Unlike their S and N counterparts, T cannulae demonstrated stable lesion characteristics at varying approach angles.

  5. Ultrasound guided implantation of chest port systems via the lateral subclavian vein

    International Nuclear Information System (INIS)

    Zaehringer, M.; Hilgers, J.; Krueger, K.; Strohe, D.; Bangard, C.; Neumann, L.; Lackner, K.; Warm, M.; Reiser, M.; Toex, U.

    2006-01-01

    Purpose: Retrospective analysis of the success and complication rates of chest port implantation via the lateral subclavian vein. Materials and methods: Between January 2003 and June 2004, the lateral subclavian vein in 271 patients (186 women, 85 men, mean age 53.2 years) was punctured guided by ultrasound. This access was used to insert a port system, and the catheter tip was placed at the cavoatrial junction. The port reservoir was implanted in a subcutaneous infraclavicular pocket and fixed to the fascia of the pectoralis muscle. Indications for port implantation were chemotherapy (n=239), total parenteral nutrition (n=2) and intravenous medication (n=30). The patient follow-up was mainly performed either by the oncology division of the department of gynecology or by the department of internal medicine. Results: A chest port catheter system was successfully implanted in all patients. The catheter remained in place for a mean duration of 269.4 days (SD 192.3 days). No complications occurred during implantation. In the post-interventional period, 6 catheter dysfunctions were found (thrombotic 0.09 per 1000 catheter days; mechanic 0.05 per 1000 catheter days). While one local infection occurred in the early post-interventional period, 3 local and 15 systemic infections were independent of the port catheter placement (0.39 per 1000 catheter days). The rate of port catheter explantations due to dysfunction or infection was 0.07 per 1000 catheter days. Conclusion: Ultrasound-guided puncture of the lateral subclavian vein is a safe procedure for the insertion of central venous port catheter systems and had a very low complication rate in our study. For further evaluation of our port placement technique, prospective studies compared to placement through the internal jugular vein are necessary. (orig.)

  6. Development of an ultrasound-guided technique for pudendal nerve block in cat cadavers.

    Science.gov (United States)

    Adami, Chiara; Angeli, Giovanni; Haenssgen, Kati; Stoffel, Michael H; Spadavecchia, Claudia

    2013-10-01

    The objective of this prospective experimental cadaveric study was to develop an ultrasound-guided technique to perform an anaesthetic pudendal nerve block in male cats. Fifteen fresh cadavers were used for this trial. A detailed anatomical dissection was performed on one cat in order to scrutinise the pudendal nerve and its ramifications. In a second step, the cadavers of six cats were used to test three different ultrasonographic approaches to the pudendal nerve: the deep dorso-lateral, the superficial dorso-lateral and the median transperineal. Although none of the approaches allowed direct ultrasonographical identification of the pudendal nerve branches, the deep dorso-lateral was found to be the most advantageous one in terms of practicability and ability to identify useful and reliable landmarks. Based on these findings, the deep dorso-lateral approach was selected as technique of choice for tracer injections (0.1 ml 1% methylene blue injected bilaterally) in six cat cadavers distinct from those used for the ultrasonographical study. Anatomical dissection revealed a homogeneous spread of the tracer around the pudendal nerve sensory branches in all six cadavers. Finally, computed tomography was performed in two additional cadavers after injection of 0.3 ml/kg (0.15 ml/kg per each injection sites, left and right) contrast medium through the deep dorso-lateral approach in order to obtain a model of volume distribution applicable to local anaesthetics. Our findings in cat cadavers indicate that ultrasound-guided pudendal nerve block is feasible and could be proposed to provide peri-operative analgesia in clinical patients undergoing perineal urethrostomy.

  7. Magnetic resonance imaging-guided focused ultrasound to increase localized blood-spinal cord barrier permeability.

    Science.gov (United States)

    Payne, Allison H; Hawryluk, Gregory W; Anzai, Yoshimi; Odéen, Henrik; Ostlie, Megan A; Reichert, Ethan C; Stump, Amanda J; Minoshima, Satoshi; Cross, Donna J

    2017-12-01

    Spinal cord injury (SCI) affects thousands of people every year in the USA, and most patients are left with some permanent paralysis. Therapeutic options are limited and only modestly affect outcome. To address this issue, we used magnetic resonance imaging-guided focused ultrasound (MRgFUS) as a non-invasive approach to increase permeability in the blood-spinal cord barrier (BSCB). We hypothesize that localized, controlled sonoporation of the BSCB by MRgFUS will aid delivery of therapeutics to the injury. Here, we report our preliminary findings for the ability of MRgFUS to increase BSCB permeability in the thoracic spinal cord of a normal rat model. First, an excised portion of normal rat spinal column was used to characterize the acoustic field and to estimate the insertion losses that could be expected in an MRgFUS blood spinal cord barrier opening. Then, in normal rats, MRgFUS was applied in combination with intravenously administered microbubbles to the spinal cord region. Permeability of the BSCB was indicated as signal enhancement by contrast administered prior to T1-weighted magnetic resonance imaging and verified by Evans blue dye. Neurological testing using the Basso, Beattie, and Breshnahan scale and the ladder walk was normal in 8 of 10 rats tested. Two rats showed minor impairment indicating need for further refinement of parameters. No gross tissue damage was evident by histology. In this study, we have opened successfully the blood spinal cord barrier in the thoracic region of the normal rat spine using magnetic resonance-guided focused ultrasound combined with microbubbles.

  8. Design and Production of an Articulating Needle Guide for Ultrasound-Guided Needle Block Manufactured With a Three-Dimensional Printer: Technical Communication.

    Science.gov (United States)

    Bigeleisen, Paul E

    2017-05-15

    Needle guides may allow the practitioner to align the needle with the probe when ultrasound-guided nerve block is performed. The author's goal was to design and fabricate an inexpensive ($1.90), disposable, needle guide that could articulate over a range from 85 degrees to 0 degrees with a three-dimension printer. Three-dimensional representations of an L50, L25, and C 60 ultrasound probe (Sono Site, Bothell, WA) were created using a laser scanner. Computer-aided design software (Solid Works, Waltham, MA) was used to design a needle bracket and needle guide to attach to these probes. A three-dimensional printer was used to fabricate the needle bracket and guide with acrylonitrile polybutadiene polystyrene. An echogenic needle was held in plane with the needle guide. The author performed a supraclavicular block in a morbidly obese patient. The needle was easily visualized. Similar guides that are commercially available cost as much as $400. A knowledge of computer-aided design is necessary for this work.

  9. Ultrasound-guided lumbar puncture in pediatric patients: technical success and safety.

    Science.gov (United States)

    Pierce, David B; Shivaram, Giri; Koo, Kevin S H; Shaw, Dennis W W; Meyer, Kirby F; Monroe, Eric J

    2018-06-01

    Disadvantages of fluoroscopically guided lumbar puncture include delivery of ionizing radiation and limited resolution of incompletely ossified posterior elements. Ultrasound (US) allows visualization of critical soft tissues and the cerebrospinal fluid (CSF) space without ionizing radiation. To determine the technical success and safety of US-guided lumbar puncture in pediatric patients. A retrospective review identified all patients referred to interventional radiology for lumbar puncture between June 2010 and June 2017. Patients who underwent lumbar puncture with fluoroscopic guidance alone were excluded. For the remaining procedures, technical success and procedural complications were assessed. Two hundred and one image-guided lumbar punctures in 161 patients were included. Eighty patients (43%) had previously failed landmark-based attempts. One hundred ninety-six (97.5%) patients underwent lumbar puncture. Five procedures (2.5%) were not attempted after US assessment, either due to a paucity of CSF or unsafe window for needle placement. Technical success was achieved in 187 (95.4%) of lumbar punctures attempted with US guidance. One hundred seventy-seven (90.3%) were technically successful with US alone (age range: 2 days-15 years, weight range: 1.9-53.1 kg) and an additional 10 (5.1%) were successful with US-guided thecal access and subsequent fluoroscopic confirmation. Three (1.5%) cases were unsuccessful with US guidance but were subsequently successful with fluoroscopic guidance. Of the 80 previously failed landmark-based lumbar punctures, 77 (96.3%) were successful with US guidance alone. There were no reported complications. US guidance is safe and effective for lumbar punctures and has specific advantages over fluoroscopy in pediatric patients.

  10. Nonfluoroscopic endoscopic ultrasound-guided transmural drainage of pancreatic pseudocysts at atypical locations

    Directory of Open Access Journals (Sweden)

    Surinder Singh Rana

    2016-01-01

    Full Text Available Background: Pancreatic pseudocysts (PP at atypical locations are a therapeutic challenge and are usually managed surgically. Objective: We evaluated safety and efficacy of nonfluoroscopic endoscopic ultrasound (NF-EUS-guided transmural drainage in the management of PP at atypical locations. Patients and Methods: Retrospective analysis of 11 patients (all males; age range: 28-46 years with PP at atypical locations who were treated with NF-EUS-guided transmural drainage during the last 18 months was done. Results: Four patients had intra/peri-splenic, three patients had mediastinal, three patients had intrahepatic, and one patient had renal PP. Nine patients had chronic pancreatitis whereas two patients had acute pancreatitis. Alcohol was the etiology of pancreatitis in ten patients. The size of PP ranged from 4 to 10 cm. All patients had abdominal pain, and two patients had fever whereas one patient with mediastinal PP also had dysphagia. NF-EUS-guided transmural drainage could be done successfully in all patients. 7 Fr transmural stent (s was/were placed in six patients whereas single-time complete aspiration of PP was done in five patients. On endoscopic retrograde pancreatography, six patients had partial duct disruption whereas five patients had complete disruption. Bridging transpapillary stent (5 Fr was placed in all patients with partial disruption. All PP healed in 10/11 (91% patients within 2-4 weeks, and there has been no recurrence in 9 of these patients during a follow-up period of 4-18 months. One patient with splenic PP needed surgery for gastrointestinal bleed. Conclusion: PP at atypical locations can be effectively and safely treated with NF-EUS-guided transmural drainage.

  11. Feasibility of MRI-guided high intensity focused ultrasound treatment for adenomyosis

    Energy Technology Data Exchange (ETDEWEB)

    Fan, Tien-Ying [State Key Laboratory of Ultrasound Engineering in Medicine, Department of Biomedical Engineering, Chongqing Medical University, Chongqing 400016 (China); Zhang, Lian; Chen, Wenzhi [Clinical Center of Tumor Therapy of 2nd Affiliated Hospital of Chongqing Medical University, Chongqing 400010 (China); Liu, Yinjiang; He, Min; Huang, Xiu [State Key Laboratory of Ultrasound Engineering in Medicine, Department of Biomedical Engineering, Chongqing Medical University, Chongqing 400016 (China); Orsi, Franco [Interventional Radiology Unit, European Institute of Oncology, 435 Via Ripamonti, 20141 Milan (Italy); Wang, Zhibiao, E-mail: wangzhibiao@haifu.com.cn [State Key Laboratory of Ultrasound Engineering in Medicine, Department of Biomedical Engineering, Chongqing Medical University, Chongqing 400016 (China); Clinical Center of Tumor Therapy of 2nd Affiliated Hospital of Chongqing Medical University, Chongqing 400010 (China)

    2012-11-15

    Highlights: Black-Right-Pointing-Pointer We tested the feasibility of MRIgHIFU ablation for adenomyosis. Black-Right-Pointing-Pointer Patients were treated with MRIgHIFU under conscious sedation. Black-Right-Pointing-Pointer Patient symptoms were assessed using SSS and UFS-QOL. Black-Right-Pointing-Pointer The mean SSS and UFS-QOL showed significant improvements at follow up. Black-Right-Pointing-Pointer No serious complications were observed 62.5 {+-} 21.6. -- Abstract: Purpose: To test the feasibility of MRI-guided high intensity focused ultrasound ablation for adenomyosis. Materials and methods: Patients with symptomatic adenomyosis were treated with MRI-guided high intensity focused ultrasound (MRIgHIFU). Under conscious sedation, MRIgHIFU was performed by a clinical MRI-compatible focused ultrasound tumour therapeutic system (JM15100, Haifu{sup Registered-Sign} Technology Co. Ltd., Chongqing, China) which is combined with a 1.5 T MRI system (Magnetom Symphony, Siemens Healthcare, Erlangen, Germany). MRI was used to calculate the volume of the uterus and lesion. Non-perfused volume of the targeted lesions was evaluated immediately after MRIgHIFU. Patient symptoms were assessed using symptom severity score (SSS) and uterine fibroids symptoms and quality of life questionnaire (UFS-QOL). Results: Ten patients with mean age of 40.3 {+-} 4 years with an average lesion size of 56.9 {+-} 12.7 mm in diameter were treated. Non-perfused volume and the percentage of non-perfused volume obtained from contrast-enhanced T1 Magnetic resonance images immediately post-treatment were 66.6 {+-} 49.4 cm{sup 3} and 62.5 {+-} 21.6%, respectively. The mean SSS and UFS-QOL showed significant improvements of 25%, 16% and 25% at 3, 6 and 12 months follow up, respectively, to pre-treatment scores. No serious complications were observed. Conclusion: Based on the results from this study, MRIgHIFU treatment appears to be a safe and feasible modality to ablate adenomyosis lesion and

  12. Detection of the Single-Session Complete Ablation Rate by Contrast-Enhanced Ultrasound during Ultrasound-Guided Laser Ablation for Benign Thyroid Nodules: A Prospective Study

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    Shuhua Ma

    2016-01-01

    Full Text Available This study aimed to investigate the single-session complete ablation rate of ultrasound-guided percutaneous laser ablation (LA for benign thyroid nodules. LA was performed in 90 patients with 118 benign thyroid nodules. Contrast-enhanced ultrasound (CEUS was used to evaluate complete nodule ablation one day after ablation. Thyroid nodule volumes, thyroid functions, clinical symptoms and complications were evaluated 1, 3, 6, 12, and 18 months after ablation. Results showed that all benign thyroid nodules successfully underwent LA. The single-session complete ablation rates for nodules with maximum diameters ≤2 cm, 2-3 cm and ≥3 cm were 93.4%, 70.3% and 61.1%, respectively. All nodule volumes significantly decreased than that one day after ablation (P0.05. Three patients had obvious pain during ablation; one (1.1% had recurrent laryngeal nerve injury, but the voice returned to normal within 6 months after treatment. Thus, ultrasound-guided LA can effectively inactivate benign thyroid nodules. LA is a potentially viable minimally invasive treatment that offers good cosmetic effects.

  13. The feasibility of trans-abdominal biopsy by ultrasound guiding during uterine artery embolization for benign diseases of uterus

    International Nuclear Information System (INIS)

    Guo Wenbo; Yang Jianyong; Chen Wei; Zhuang Wenquan; Li Heping; Yao Shuzhong

    2006-01-01

    Objective: To investigate the feasibility of trans-abdominal biopsy by ultrasound guiding during uterine artery embolization (UAE) for uterine fibroids and adenomyosis. Methods: Trans-abdominal biopsies by ultrasound guiding were performed in 62 cases of uterine fibroids or adenomyosis diagnosed pre-UAE. Multi-points in focus were punctured in single lesion and multi-points in every focus of multiple lesions were punctured. The diagnosis before UAE was made according to clinical symptoms, pelvic ultrasound and pelvic magnetic resonance imaging (MRI). The pathological diagnosis by biopsy was comparative to its clinical diagnosis before biopsy. The complications were also observed. Results: Biopsies were performed successfully in 60 cases with pathological examination, including 52 uterine fibroids and 8 adenomyosis cases. The clinical diagnosis of uterine fibroids or adenomyosis was coincident with the pathology except 2 cases of fibroids diagnosed before biopsy were failed to puncture. Conclusion: Trans-abdominal biopsy by ultrasound guiding in uterine artery embolization for benign diseases of uterus is safe and feasible. (authors)

  14. 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.

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

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    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.

  16. 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.

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

    International Nuclear Information System (INIS)

    Halliwell, O.T.; Yadegafar, G.; Lane, C.; Dewbury, K.C.

    2008-01-01

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    Brunner, Andreas H; Sagmeister, Thomas; Kremer, Jolanta; Riss, Paul; Brustmann, Hermann

    2009-01-01

    Limited data are available to evaluate the accuracy of frozen section analysis and ultrasound- guided core needle biopsy of the breast. 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. 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. 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

  20. 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.

  1. Ultrasound guided injection of dexamethasone versus placebo for treatment of plantar fasciitis: protocol for a randomised controlled trial

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    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

  2. A compact mechatronic system for 3D ultrasound guided prostate interventions

    International Nuclear Information System (INIS)

    Bax, Jeffrey; Smith, David; Bartha, Laura; Montreuil, Jacques; Sherebrin, Shi; Gardi, Lori; Edirisinghe, Chandima; Fenster, Aaron

    2011-01-01

    Purpose: Ultrasound imaging has improved the treatment of prostate cancer by producing increasingly higher quality images and influencing sophisticated targeting procedures for the insertion of radioactive seeds during brachytherapy. However, it is critical that the needles be placed accurately within the prostate to deliver the therapy to the planned location and avoid complications of damaging surrounding tissues. Methods: The authors have developed a compact mechatronic system, as well as an effective method for guiding and controlling the insertion of transperineal needles into the prostate. This system has been designed to allow guidance of a needle obliquely in 3D space into the prostate, thereby reducing pubic arch interference. The choice of needle trajectory and location in the prostate can be adjusted manually or with computer control. Results: To validate the system, a series of experiments were performed on phantoms. The 3D scan of the string phantom produced minimal geometric error, which was less than 0.4 mm. Needle guidance accuracy tests in agar prostate phantoms showed that the mean error of bead placement was less then 1.6 mm along parallel needle paths that were within 1.2 mm of the intended target and 1 deg. from the preplanned trajectory. At oblique angles of up to 15 deg. relative to the probe axis, beads were placed to within 3.0 mm along a trajectory that were within 2.0 mm of the target with an angular error less than 2 deg. Conclusions: By combining 3D TRUS imaging system to a needle tracking linkage, this system should improve the physician's ability to target and accurately guide a needle to selected targets without the need for the computer to directly manipulate and insert the needle. This would be beneficial as the physician has complete control of the system and can safely maneuver the needle guide around obstacles such as previously placed needles.

  3. Validation of a Low Cost, Disposable, and Ultrasound-guided Suprapubic Catheter Insertion Trainer.

    Science.gov (United States)

    Nonde, James; Adam, Ahmed; Laher, Abdullah Ebrahim

    2018-02-27

    To validate the newly designed ultrasound-guided suprapubic catheter insertion trainer (US-SCIT) model against the real life experience by enrolling participants with prior confidence in the technique of US-guided suprapubic catheter (SPC) insertion. The US-SCIT was self-constructed from common disposables and equipment found in the emergency department. A validation questionnaire was completed by all participants after SPC insertion on the US-SCIT model. Fifty participants enrolled in the study. Each participant had reported confidence in the SPC insertion technique, prior to participation in this study. There were 13 "super-users" (>65 previous successful real life SPC insertions) in the study. The total material cost per US-SCIT unit was 1.71 USD. The US-SCIT's value in understanding the principals of US-guided SPC insertion had a mean score of 8.86 (standard deviation [SD] 1.03), whereas its value in simulating contextual anatomy had a mean score of 8.26 (SD 1.48). The mean score of the model's ability to provide realistic sensory feedback was 8.12 (SD 1.78), whereas that of realism of initial urine outflow was 9.06 (SD 1.20). Simulation with the model compared well with real life SPC insertion, with a mean score of 8.30 (SD1.48). The US-SCIT model performed well in various spheres developed to assess its ability to simulate real life SPC insertion. We are confident that this low-cost, validated, US compatible SPC trainer, constructed from common material present in the ED, will be a valuable learning asset to trainees across the globe. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Central lung tumors with obstructive pneumonitis; ultrasonographic findings and usefulness of ultrasound-guided biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong An; Kim, Sun Su; Seon, Young Seok; Lee, Kyoung Rok; Kim, Byoung Geun; Park, Byung Ran; Kim, Se Jong [Kwangju Christian Hospital, Kwangju (Korea, Republic of)

    2001-02-01

    To determine the ultrasonographic findings and assess the usefulness of ultrasound (US)-guided biopsy of central lung tumors in patients with obstructive pneumonitis. Fourteen patients with central lung tumors causing obstructive pneumonitis, as seen on chest radiographs and chest CT scans, were examined between January 1997 and January 2000. In no patient conclusive histologic diagnosis obtained by means of bronchoscopic biopsy or sputum cytology. Eleven patients were men and three were women, and their ages ranged from 45 to 83 (mean, 64) years. For all examinations, real-time, linear-array, convex US units with a 3.75-and a 5.0-MHz transducer were used. The images obtained were analyzed for evidence of consolidation or atelectasis in the lung, demonstrable tumors, and tumor size and echogenicity. For US-guided percutaneous transthoracic biopsy, 19.5G automatic biopsy devices, were employed. Lung consolidation due to a wedge-shaped, homogeneous, hypoechoic lesion was revealed by sonographic fluid bronchograms, air bronchograms, air alvelograms, and visualization of intraparenchymal pulmonary vessels, which showed appropriate motion with respiration. The tumor presumed to be causing obstruction was seen as a hypoechoic nodule near the hilum or as a well-defined hyperechoic mass inside the partially consolidated lung. Pleural effusion was observed in one case. The cytologic findings indicated the presence of squamous cell carcinoma (n=4), adenocarcinoma (n=4), small cell carcinoma (n=3), non-small cell carcinoma (n=2) and large cell carcinoma (n=1). The success rate was 100%, and there were no complications. In patients with central lung tumors causing obstructive pneumonitis, chest ultrasonography and US-guided biopsy are useful adjunctive diagnostic modalities and techniques.

  5. Contrast-enhanced versus systematic transrectal ultrasound-guided prostate cancer detection: An overview of techniques and a systematic review

    International Nuclear Information System (INIS)

    Heijmink, Stijn W.T.P.J.; Barentsz, Jelle O.

    2007-01-01

    An overview is given of the current conventional and contrast-specific transrectal ultrasound (TRUS) techniques for prostate imaging that may be used for guiding biopsy. Subsequently, a systematic literature search resulted in inclusion of four studies that directly compared systematic and contrast-enhanced-targeted TRUS-guided biopsy of the prostate. All four studies revealed that contrast-enhanced-targeted TRUS-guided biopsy significantly improved the positive biopsy core rate. In the largest study, the mean Gleason score of the contrast-enhanced-targeted TRUS-guided biopsies was significantly higher than that of the systematic biopsies. Future randomized clinical trials, preferably in a non-academic multi-institutional set-up, will have to be performed to confirm the value of contrast-enhanced-targeted TRUS-guided biopsy in regular clinical practice

  6. Cost-Effectiveness Comparison of Imaging-Guided Prostate Biopsy Techniques: Systematic Transrectal Ultrasound, Direct In-Bore MRI, and Image Fusion

    NARCIS (Netherlands)

    Venderink, W.; Govers, T.M.; Rooij, M. de; Futterer, J.J.; Sedelaar, J.P.M.

    2017-01-01

    OBJECTIVE: Three commonly used prostate biopsy approaches are systematic transrectal ultrasound guided, direct in-bore MRI guided, and image fusion guided. The aim of this study was to calculate which strategy is most cost-effective. MATERIALS AND METHODS: A decision tree and Markov model were

  7. Interventional ultrasound

    International Nuclear Information System (INIS)

    VanSonnenberg, E.

    1987-01-01

    This book contains 12 chapters and several case studies. Some of the chapter titles are: The Interplay of Ultrasound and Computed Tomography in the Planning and Execution of Interventional Procedures: Ulltrasound Guided Biopsy; Interventioal Genitourinary Sonography; Diagnosis and Treatment of Pericardial Effusion Using Ultrasonic Guidance; and New Ultrasound-Guided Interventional Procedures--Cholecystostomy, Pancreatography, Gastrostomy

  8. Post-General Anesthesia Ultrasound-Guided Venous Mapping Increases Autogenous Access Placement Rates.

    Science.gov (United States)

    Png, C Y Maximilian; Korayem, Adam; Finlay, David J

    2018-04-18

    This study investigates the impact of introducing a post-general anesthesia ultrasound mapping (PAUS) on the type of vascular access chosen for hemodialysis in patients without previous accesses. 203 of 297 consecutive patients met inclusion criteria and were reviewed. Within-subjects analysis was performed on patients with both an outpatient ultrasound-guided vein mapping and a PAUS using sign tests and Wilcoxon signed ranked tests. Further, a between-subjects analysis added patients with only the outpatient vein mapping; demographic and comorbidity data were analyzed using t-tests and chi-squared tests. An ordinal logit regression was run for the type of access placed, while a bivariate logit regression was used to compare rates of autogenous access maturation. 165 (81%) patients received both a standard outpatient vein mapping and a PAUS. At the outpatient vein mapping, 130 (79%) patients had suitable veins for an autogenous access while 35 (21%) patients did not have suitable veins for an autogenous access and were planned for a prosthetic access. During PAUS, all 165 (100%) patients were found to have suitable veins for autogenous access formation (P<0.001). When comparing specific autogenous access configurations, Wilcoxon signed rank testing showed significantly more preferable access configurations in the PAUS group compared to the outpatient mapping (P<0.001); Outpatient mapping resulted in 81 (47%) radiocephalic accesses, 10 (6%) radiobasilic accesses, 20 (12%) brachiocephalic accesses, 19 (12%) brachiobasilic accesses and 35 (21%) prosthetic accesses planned, in contrast to 149 (90%) radiocephalic accesses, 3 (2%) radiobasilic accesses, 10 (6%) brachiocephalic accesses, 3 (2%) brachiobasilic accesses and 0 prosthetic accesses when the same patients were analyzed using PAUS. With the analysis expanded to include the 38 (19%) patients with only the outpatient vein mapping (without-PAUS), the Wilcoxon-Mann-Whitney test showed no significant differences

  9. Ultrasound-guided fine-needle aspiration biopsy of the thyroid.

    Science.gov (United States)

    Tambouret, R; Szyfelbein, W M; Pitman, M B

    1999-10-25

    We reviewed the Massachusetts General Hospital experience with ultrasound-guided fine-needle aspiration biopsies (FNABs) of the thyroid to determine the indications, rate of unsatisfactory smears, correlation with excisional biopsy results, and verification of efficient use of personnel time. All radiologically guided FNABs of the thyroid from January 1993 through June 1997 were reviewed. As a measure of efficient use of technologist time, a sample of times spent by the technologist during the procedure for 20 cases in 1993 and 1997 was compared with that of an equal number of random nonthyroid image guided FNABs. Two hundred-ninety FNABs were identified in 251 patients, representing 12% of all thyroid FNABs and 11% of all radiologically guided FNABs. Indications in the 251 patients included multiple nodules (78), solitary nodules (61), complex nodules (39), prior failed FNAB (39), thyroid bed abnormalities post-thyroidectomy (21), difficult access (7), and investigation of recurrent tumor in residual thyroid lobe (6). Available records indicated 118 lesions were palpable and 45 were nonpalpable; the physical examination characteristics of the remainder (88) were not stated. Diagnoses included 44 unsatisfactory cases (15%), 103 macrofollicular lesions, 20 microfollicular lesions, 26 mixed macro/microfollicular lesions, 5 oxyphilic lesions, 1 trabecular pattern, 15 nonspecific follicular cell pattern, 9 follicular cell atypia, 30 cysts, 11 thyroiditis, 23 malignant tumors, and 3 other (1 parathyroid, 2 lymph node). Eighty-nine FNABs from 76 patients had subsequent surgical biopsy. Excisional biopsies in 14 unsatisfactory FNABs were benign. In the remaining 75 FNABs from 67 patients, 18 malignancies on FNAB were correctly diagnosed, but 3 other papillary carcinomas were only qualified as atypical follicular cells on cytology. No false-positive cases occurred. Of 15 macrofollicular lesions on cytology, 10 were adenomas on excision, only 2 of which were microfollicular

  10. A simulation model for predicting the temperature during the application of MR-guided focused ultrasound for stroke treatment using pulsed ultrasound

    Science.gov (United States)

    Hadjisavvas, V.; Damianou, C.

    2011-09-01

    In this paper a simulation model for predicting the temperature during the application of MR-guided focused ultrasound for stroke treatment using pulsed ultrasound is presented. A single element spherically focused transducer of 5 cm diameter, focusing at 10 cm and operating at either 0.5 MHz or 1 MHz was considered. The power field was estimated using the KZK model. The temperature was estimated using the bioheat equation. The goal was to extract the acoustic parameters (power, pulse duration, duty factor and pulse repetition frequency) that maintain a temperature increase of less than 1 °C during the application of a pulse ultrasound protocol. It was found that the temperature change increases linearly with duty factor. The higher the power, the lower the duty factor needed to keep the temperature change to the safe limit of 1 °C. The higher the frequency the lower the duty factor needed to keep the temperature change to the safe limit of 1 °C. Finally, the deeper the target, the higher the duty factor needed to keep the temperature change to the safe limit of 1 °C. The simulation model was tested in brain tissue during the application of pulse ultrasound and the measured temperature was in close agreement with the simulated temperature. This simulation model is considered to be very useful tool for providing acoustic parameters (frequency, power, duty factor, pulse repetition frequency) during the application of pulsed ultrasound at various depths in tissue so that a safe temperature is maintained during the treatment. This model could be tested soon during stroke clinical trials.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Ultrasound guided percutaneous cholecystostomy in high-risk patients for surgical intervention.

    Science.gov (United States)

    Bakkaloglu, Huseyin; Yanar, Hakan; Guloglu, Recep; Taviloglu, Korhan; Tunca, Fatih; Aksoy, Murat; Ertekin, Cemalettin; Poyanli, Arzu

    2006-11-28

    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. 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. 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 x 10(3)+/-1.3 x 10(3) microg/L vs 13 x 10(3)+/-1 x 10(3) microg/L, P 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. 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 and morbidity. Delayed cholecystectomy and ERCP, if needed, can be performed after the acute period has been resolved by percutaneous cholecystostomy.

  13. Highly directional transurethral ultrasound applicators with rotational control for MRI-guided prostatic thermal therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ross, Anthony B [Thermal Therapy Research Group, UCSF Radiation Oncology, San Francisco, CA (United States); Diederich, Chris J [Thermal Therapy Research Group, UCSF Radiation Oncology, San Francisco, CA (United States); Nau, William H [Thermal Therapy Research Group, UCSF Radiation Oncology, San Francisco, CA (United States); Gill, Harcharan [Department of Urology, Stanford University, Stanford, CA (United States); Bouley, Donna M [Department of Comparative Medicine, Stanford University, Stanford, CA (United States); Daniel, Bruce [Department of Radiology, Stanford University, Stanford, CA (United States); Rieke, Viola [Department of Radiology, Stanford University, Stanford, CA (United States); Butts, R Kim [Department of Radiology, Stanford University, Stanford, CA (United States); Sommer, Graham [Department of Radiology, Stanford University, Stanford, CA (United States)

    2004-01-21

    Transurethral ultrasound applicators with highly directional energy deposition and rotational control were investigated for precise treatment of benign prostatic hyperplasia (BPH) and adenocarcinoma of the prostate (CaP). Two types of catheter-based applicators were fabricated, using either sectored tubular (3.5 mm OD x 10 mm) or planar transducers (3.5 mm x 10 mm). They were constructed to be MRI compatible, minimally invasive and allow for manual rotation of the transducer array within a 10 mm cooling balloon. In vivo evaluations of the applicators were performed in canine prostates (n 3) using MRI guidance (0.5 T interventional magnet). MR temperature imaging (MRTI) utilizing the proton resonance frequency shift method was used to acquire multiple-slice temperature overlays in real time for monitoring and guiding the thermal treatments. Post-treatment T1-weighted contrast-enhanced imaging and triphenyl tetrazolium chloride stained tissue sections were used to define regions of tissue coagulation. Single sonications with the tubular applicator ) produced coagulated zones covering a wedge of the prostate extending from 1-2 mm outside the urethra to the outer boundary of the gland (16 mm radial coagulation). Single sonications with the planar applicator (15-20 W, 10 min, {approx}8 MHz) generated thermal lesions of {approx}30 extending to the prostate boundary. Multiple sequential sonications (sweeping) of a planar applicator (12 W with eight rotations of 30 each) demonstrated controllable coagulation of a 270 contiguous section of the prostate extending to the capsule boundary. The feasibility of using highly directional transurethral ultrasound applicators with rotational capabilities to selectively coagulate regions of the prostate while monitoring and controlling the treatments with MRTI was demonstrated in this study.

  14. [Percutaneous ultrasound-guided drainage in the surgical treatment of acute severe pancreatitis].

    Science.gov (United States)

    Delattre, J-F; Levy Chazal, N; Lubrano, D; Flament, J-B

    2004-11-01

    To report results of percutaneous ultrasound-guided drainage, performed by a surgeon, in the treatment of complications of acute pancreatitis (AP), and to determine the role of this technique in the therapeutic armamentarium of severe AP. From 1986 to 2001, 59 patients were included in this retrospective study. All patients initially had severe necrotizing AP (mean Ranson score = 4.1 ; range : 2-7). Anatomical lesions included pancreatic abscess in 6 patients and necrosis in 53 (17 stage D and 36 stage E according to Balthazar's classification). Necrosis was infected in 42 and sterile in 11 respectively. Drainage was performed under ultrasound guidance and local anaesthesia using small-diameter drains (7-14 French). Drainage was performed on average 23 days after onset of AP. Infection was proven by fine-needle aspiration in 47 (80 %) patients (41 infected necrosis and 6 localized abscess). In one patient, culture of aspirated fluid was negative but necrosis was infected (one false negative). Culture of aspirated fluid was negative and necrosis was sterile in 11 patients. Nineteen (32%) patients healed without subsequent surgery: 7 (16%) in the infected necrosis group, 6(55%) in the sterile necrosis group, and 6 (100%) in the abscess group. Forty (68%) patients had subsequent necrosectomy including 8 (14%) who died. Twenty (34 %) digestive fistulas healed spontaneously, except one treated by diversion stomia. Of the 16 (27 %) pancreatic fistulas, 6 needed subsequent interventional treatment. In selected patients, percutaneous drainage can represent an alternative to surgery with a 14% mortality rate. The high rate of subsequent necrosectomy suggests that drains with larger diameter, possibly associated with continuous irrigation, should be used.

  15. Treatment of cervical pregnancy with ultrasound-guided local methotrexate injection.

    Science.gov (United States)

    Yamaguchi, M; Honda, R; Erdenebaatar, C; Monsur, M; Honda, T; Sakaguchi, I; Okamura, Y; Ohba, T; Katabuchi, H

    2017-12-01

    Cervical pregnancy (CP) is a rare type of ectopic pregnancy. While methotrexate (MTX) is generally the first-line method of choice for clinically stable women, there is still no consensus on the most appropriate treatment for this abnormal pregnancy. The aim of this study was to investigate the efficacy of a single local MTX injection under transvaginal ultrasound guidance for the initial treatment of CP and to assess post-treatment fertility. We reviewed retrospectively 15 patients with CP treated with local MTX injection under transvaginal ultrasound guidance. In all patients, the serum human chorionic gonadotropin (hCG) levels were monitored and the gestational sac was evaluated using ultrasonography after treatment. Magnetic resonance imaging (MRI) was performed as necessary. We evaluated the patients' clinical characteristics and clinical course after treatment, the efficacy of the treatment and the post-treatment fertility in patients desiring subsequent pregnancy. The median estimated gestational age at the time of MTX injection was 6 + 2 (range, 5 + 2 to 11 + 0) weeks. All 15 patients were treated successfully, without the need for blood transfusion or surgical procedures; however, three patients required an additional local MTX injection due to a poor decline in serum hCG level following the initial injection, while one patient required uterine artery embolization due to persistent vaginal bleeding and an enlarging gestational sac with blood vessels visible on contrast-enhanced MRI. The mean time following initial MTX injection for hCG normalization was 43.8 (95% CI, 33.3-54.3) days and for resumption of menses was 68.4 (95% CI, 51.9-84.9) days. Seven of the 10 women desiring subsequent pregnancy following treatment had uneventful pregnancy, one became pregnant but miscarried spontaneously at 8 weeks of gestation, one was treated by laparoscopic surgery after diagnosis of a tubal pregnancy and one did not conceive. A single, ultrasound-guided

  16. [Cost analysis of ultrasound-guided transrectal needle biopsy in prostatic carcinoma].

    Science.gov (United States)

    Bissoli, E; Fandella, A; La Torre, E; Faggiano, L; Anselmo, G; Frasson, F

    1998-04-01

    The literature mortality and morbidity rates from prostatic carcinoma prompt to the better use of some routine diagnostic tools such as transrectal ultrasound-guided biopsy. We evaluated the overall cost of transrectal ultrasound biopsy (TRUSB) of the prostate and investigated the economic impact of the procedures currently used to diagnose prostatic carcinoma. The total cost of TRUSB was calculated with reference to 247 procedures performed in 1996. The following cost factors were evaluated: personnel, materials, maintenance-equipment depreciation, energy consumption and hospital overheads. A literature review was also carried out to check if our extrapolated costs corresponded to those of other authors worldwide and to consider them in the wider framework of the cost effectiveness of the strategies for the early diagnosis of prostatic cancer. The overall cost of TRUSB was Itl. 249,000, obtained by adding together the costs of: personnel (Itl. 160,000); materials (Itl. 59,000); equipment maintenance and depreciation (Itl. 12,400); energy consumption (Itl. 100); hospital overheads (Itl. 17,500). The literature review points out TRUSB as a clinically invasive tool for diagnosing prostatic carcinoma whose cost-effectiveness is debated. Cadaver studies report the presence of cancer cells in the prostate of 50% of 70-year-old men, while extrapolations calculate a morbidity from prostatic carcinoma in 9.5% of 50-year-old men. It is therefore obvious that randomized prostatic biopsies, methods apart, are very likely to be positive. This probability varies with the patient's age, the level of prostate specific antigen (PSA), the density of PSA/cm3 of prostate volume (PSAD), and the positivity of exploration and/or transrectal ultrasound findings. Despite the strict application of all these criteria and the critical assessment of the patient's general conditions, TRUSB is indicated for 16% of the male population over 50, with obvious implications. It has been recently

  17. Are ultrasound-guided ophthalmic blocks injurious to the eye? A comparative rabbit model study of two ultrasound devices evaluating intraorbital thermal and structural changes.

    Science.gov (United States)

    Palte, Howard D; Gayer, Steven; Arrieta, Esdras; Scot Shaw, Eric; Nose, Izuru; Lee, Elizabete; Arheart, Kristopher L; Dubovy, Sander; Birnbach, David J; Parel, Jean-Marie

    2012-07-01

    .5 minutes). A secondary analysis of temporal temperature differences between the orbital-rated and nonorbital transducers revealed statistically significant differences (Bonferroni-adjusted P < 0.05) in the cornea at 3.5 minutes, the lens at 2.5 minutes, and the vitreous at 4.0 minutes. Light microscopy and histology failed to elicit ocular injury in either group. The nonorbital-rated ultrasound machine (Sonosite Micromaxx) increases the ocular tissue temperature. A larger study is needed to establish safety. Until then, ophthalmic ultrasound-guided blocks should only be performed with ocular-rated devices.

  18. Comparison of clinical marking and ultrasound-guided injection of Botulinum type A toxin into the masseter muscles for treating bruxism and its cosmetic effects.

    Science.gov (United States)

    Quezada-Gaon, Natacha; Wortsman, Ximena; Peñaloza, Osvaldo; Carrasco, Juan Eduardo

    2016-09-01

    Botulinum toxin type A has been used for treating the hypertrophy of the masseter muscles and its cosmetic effects. Ultrasound is increasingly used in dermatology, along with the guidance of mini-invasive procedures. To evaluate the role of ultrasound for guiding the application of Botulinum A toxin in patients with cosmetic alterations due to bruxism, correlate the clinical landmarks with the ultrasound findings, and study the effect on the symptoms, cosmetics, and quality of life. Twenty individuals with bruxism and cosmetic alterations underwent an ultrasound-guided injection of Botulinum toxin type A in each masseter muscle. Clinical and ultrasound marking of the procedure was compared. Clinical and sonographic evaluation was performed at the time of injection and 3 months later. Ten normal individuals underwent ultrasound of the masseter muscles as a control group. Up to 65% of individuals showed anatomical variants of the salivary glands. The method for clinically marking the skin showed a frequently erroneous location of the anterior point (up to 40% of cases) that was proven by ultrasound to be out of the muscle. In 20% of cases, ultrasound showed that the needle should be longer to enter the muscle. After injection, most of the patients demonstrated a decrease of the symptoms and cosmetic and quality of life improvements. Ultrasound can be a potent tool for guiding the injection of Botulinum toxin into the masseter muscles. It may contribute to a more personalized procedure, better cosmetic results, and help to avoid potential complications. © 2016 Wiley Periodicals, Inc.

  19. 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

  20. Long-term follow-up of ultrasound-guided botulinum toxin-A injections for sialorrhea in neurological dysphagia.

    Science.gov (United States)

    Barbero, Pierangelo; Busso, Marco; Tinivella, Marco; Artusi, Carlo Alberto; De Mercanti, Stefania; Cucci, Angele; Veltri, Andrea; Avagnina, Paolo; Calvo, Andrea; Chio', Adriano; Durelli, Luca; Clerico, Marinella

    2015-12-01

    Literature provides reports only of a limited follow-up single injection of botulinum toxin-A (BoNT-A) in patients with sialorrhea. The aim of our study is to evaluate the long-lasting efficacy and safety of ultrasound-guided BoNT-A injections for severe sialorrhea secondary to neurological dysphagia. We enrolled 38 severe adult sialorrhea patients referred consecutively to the neurology unit and performed bilateral parotid and submandibular gland BoNT-A injections under ultrasound guidance. The outcomes of the study were reduction of sialorrhea, duration of therapeutic effect, and subjective patient- and caregiver-reported satisfaction. A total of 113 BoNT-A administrations were given during the study period with a mean duration of follow-up of 20.2 ± 4.4 months. We observed a significant decrease from baseline in mean number of daily aspirations and a significant improvement in patient- and caregiver-reported outcomes following ultrasound-guided BoNT-A injections (p < 0.001 vs baseline for all comparisons) and the mean duration of the efficacy was 5.6 ± 1 months. No major treatment-related adverse events occurred and a low incidence of minor adverse events was reported. This study confirms the long-lasting efficacy and safety of ultrasound-guided BoNT-A injections for sialorrhea, regardless of the causative neurological disorder. These results should encourage the use of BoNT-A in the treatment of severe sialorrhea and highlight the role of ultrasound guidance to obtain optimal results in terms of safety and reproducible outcomes.

  1. Sexual potency following interactive ultrasound-guided brachytherapy for prostate cancer

    International Nuclear Information System (INIS)

    Stock, Richard G.; Stone, Nelson N.; Iannuzzi, Christopher

    1996-01-01

    Purpose: The effect of a therapeutic modality on sexual potency is often an important consideration for patients choosing a treatment for prostate cancer. We prospectively assessed patients' penile erectile function before and following interactive ultrasound-guided transperineal permanent radioactive seed implantation to determine its effect on sexual function. Methods and Materials: Eighty-nine patients underwent permanent radioactive seed implantation from June 1990 to April 1994 for localized prostate cancer (T1-T2) and were followed for a median of 15 months (1.5-52 months). 125 I seeds were implanted in 73 patients with a combined Gleason grade of 2-6, and 103 Pd seeds were implanted in 16 patients with higher grade lesions. The sexual potency of these patients was assessed prior to, at 3 and 6 months, and every 6 months after implantation. Erectile function was graded using a numerical score of 0 to 3 (0 = impotent (no erections), 1 = ability to have erections but insufficient for vaginal penetration, 2 = erectile function sufficient for vaginal penetration but suboptimal, 3 = normal erectile function). The pretreatment potency scores were as follows: 0 in 24 patients, 1 in 6 patients, 2 in 22 patients, and 3 in 37 patients. Results: The actuarial impotency rates (score = 0) following implantation for those patients possessing some degree of erectile function prior to implantation (65 patients) were 2.5% at 1 year and 6% at 2 years. The actuarial decrease in sexual function rates (a drop in score of at least one point) were 29% at 1 year and 39% at 2 years. Only two patients became impotent following treatment and this occurred at 1 year and 16 months. The time period for a decrease in erectile function to occur ranged from 1.8 months to 32.7 months, with a median of 6.8 months. Patients with higher grade tumors showed a greater decrease in potency score compared to patients with lower grade tumors. Conclusion: Interactive ultrasound-guided transperineal

  2. New quantitative ultrasound techniques for bone analysis at the distal radius in hip fracture cases: differences between femoral neck and trochanteric fractures.

    Science.gov (United States)

    Horii, Motoyuki; Fujiwara, Hiroyoshi; Sakai, Ryo; Sawada, Koshiro; Mikami, Yasuo; Toyama, Syogo; Ozaki, Etsuko; Kuriyama, Nagato; Kurokawa, Masao; Kubo, Toshikazu

    2017-01-01

    Ample evidence on etiological and pathological differences between femoral neck and trochanteric fracture cases suggests the possibility of individualized treatment. There are many issues related to areal bone mineral density and other quantitative computed tomography parameters of the proximal femur. Although osteoporosis is a systemic problem, little has been reported regarding differences in bone structural parameters, including bone mineral density, between them in regions other than the proximal femur. Participants were consecutive female patients >50 years of age admitted to the Saiseikai Suita Hospital (Osaka prefecture, Japan) for their first hip fracture between January 2012 and September 2014. Cortical thickness (CoTh, mm), volumetric trabecular bone mineral density (TBD, mg/cm 3 ), and elastic modulus of trabecular bone (EMTb, GPa) were obtained as the new QUS parameters using the LD-100 system (Oyo Electric, Kyoto, Japan). The mean values of these parameters were compared between femoral neck and trochanteric fracture cases. In addition, correlations between age and each QUS parameter were investigated for each fracture type. A receiver operating characteristic (ROC) curve analysis was performed to examine the degree of effect each parameter on the fracture types. The area under the curve (AUC) for each parameter was compared to the AUC for age. There were 63 cases of femoral neck fracture (mean age, 78.2 years) and 37 cases of trochanteric fracture (mean age, 85.9 years). Mean TBD and EMTb were significantly higher for femoral neck fractures. There were significant negative correlations between QUS parameters and age for femoral neck fractures (P fractures were above those for trochanteric fractures for TBD and EMTb. AUCs were 0.72 for age, and 0.61, 0.65, and 0.65 for CoTh, TBD, and EMTb, respectively. The new QUS parameters indicated that TR fracture cases were more osteoporotic than were FN fracture cases, even at the distal radius. There might be

  3. Endoscopic ultrasound-guided fine-needle aspiration cytology in the evaluation of suspected tuberculosis in patients with isolated mediastinal lymphadenopathy

    DEFF Research Database (Denmark)

    Puri, R.; Vilmann, P.; Sud, R.

    2010-01-01

    Patients with suspected tuberculosis without pulmonary lesions and with mediastinal lymphadenopathy often pose a diagnostic challenge. Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) cytology is an established modality to evaluate mediastinal and abdominal lesions. The aim...

  4. Case study: Solitary intra-cystic papilloma - Advances in consultant radiographic practitioner led ultrasound guided mammotome excisional biopsy

    International Nuclear Information System (INIS)

    Lawson, Sarah

    2008-01-01

    Working practices in Breast Radiology have changed and advanced in the past few years, resulting in an increase in the number of small, indeterminate, non-palpable breast lesions detected. One such lesion is the breast papillary lesion which is essentially an epithelial proliferation with an associate increased risk of breast carcinoma. The current management of an intra-cystic breast papilloma diagnosed by 14 g core biopsy is highly contentious as traditionally management is by surgical biopsy. Recent advances have demonstrated that excision by 8 or 11-gauge Ultrasound guided Mammotomy can be a safe alternative, allowing non-operative removal. The consultant radiographic practitioner role has been integral in establishing the policies needed to support and establish ultrasound guided Mammotome excisional biopsy

  5. Effects of using simulation versus CD-ROM in the performance of ultrasound-guided regional anesthesia.

    Science.gov (United States)

    Gasko, John; Johnson, Arthur; Sherner, John; Craig, John; Gegel, Brian; Burgert, James; Sama, Samuel; Franzen, Thomas

    2012-08-01

    The purpose of this study was to determine which method of teaching, CD-ROM, simulation, or a combination of both, was more effective in increasing the performance of ultrasound-guided regional anesthesia. No studies have investigated these methods. The framework for this study was critical thinking. The study was a prospective, mixed (between and within) subjects, experimental design. The sample consisted of 29 student registered nurse anesthetists randomly assigned to 1 of 3 groups: CD-ROM (n = 11), simulation (n = 11), and combination (n = 7). All groups were evaluated by the us