LibGuides: DMS 101 Pathology: Home

Topics to Explore

These topics are suggested if you are still looking for a subject to explore. These are places in which a technician could do an ultrasound.

Reproductive organs
Muscles
Joints
Tendons

Bladder
Thyroid
Gallbladder
Spleen

Heart
Blood vessels
Pancreas

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EBSCO

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Nursing and Allied Health

Research full-text titles cited in CINAHL and other resources to support specialized care, treatment, and patient management.

Nursing Reference Center Plus

Evidence based resource designed for nurses. Features: disease and condition topics, drug information. care plans, continuing education modules, e-books, videos, and more.

Science Direct

Scholarly articles from a variety of journals in the health and life sciences.

Books to help with your research

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Articles to help with your research

This list of articles is based on the suggested topics to explore. It is not a comprehensive list of all available articles. You are encouraged to explore the databases these articles were accessed from to find more information related to the subject you are working on.

Frequency of Polycystic Ovarian Disease Detected on Ultrasound in Patients with Primary Infertility Polycystic ovary syndrome is an illness that mostly affects young women's reproductive systems and overall health, affecting at least one in every ten women of reproductive age. Polycystic ovarian syndrome is a significant risk factor for developing infertility. The production of male hormones in females with polycystic ovarian syndrome is more than the production in average female which affects the ovaries, the reproductive organs which release two hormones (estrogen and progesterone) that balance the menstrual cycle. This hormonal instability allows them to delay or miss a menstrual period which makes it difficult for them to hold pregnancy. Many thin, fluid-filled sacs grow within the ovaries in polycystic ovary syndrome. Basically, these sacs are follicles, each holding an immature egg. The eggs do not attain sufficient maturation to induce ovulation. Objective: To determine the role of ultrasound in the detection of polycystic ovarian disease or to determine the utility of ultrasound for detection of polycystic ovarian disease in female between 35-70 years. Materials & Methods: 116 patients were taken who underwent ultrasound for the evaluation of polycystic ovarian disease. The study was done at radiology department under ultrasound. Results: One hundred and sixteen patients, who fulfilled the inclusion criteria, were included in this study. Out of which 79(68.1%) were irregular bleeding, 68(58.6%) had heavy bleedimg, 72(62%) had acne problem, 81(69.8%) had gained the weight, 70(60.3% )had hirsutism and 49(42.2%) had darkening of skin. Conclusion: 60.2%were found to have polycystic ovarian disease as detected on pelvic ultrasound.
Determination of artificial insemination timing in Banteng based on follicle size and uterine enlargement The Banteng (Bos javanicus d'Alton 1823) is an endemic species in Indonesia that is threatened with extinction and whose population continues to decline in the wild. The aim of this study is to determine the timing of artificial insemination (AI) in the Banteng based on follicle size and uterine enlargement. For this study, two female Banteng were used in Taman Safari Indonesia, Cisarua, Bogor. Habituation was performed to facilitate data collection. Optimal timing for AI is determined by examining the reproductive organs using Ultrasonography (USG) to detect changes in the uterus and ovaries and monitor clinical signs of estrus. Follicle size and uterine examination was performed on days -1, 0, and +1 for 3 estrus cycles. Insemination was performed 2-3 times during estrus until ovulation occurred. The results showed that the average follicle size of both Banteng was 1.09 ± 0.02 cm on day -1, 1.31 ± 0.02 cm on day 0, and 1.33 ± 0.03 cm on day +1. Artificial insemination was performed with a double dose of frozen semen when the Banteng were still rideable, and the follicle size ranged from 1.23-1.38 cm. Pregnancy was examined by ultrasound on day 21 after mating; both Banteng females were pregnant after AI. It can be concluded that AI technique can be used in captive Banteng breeding program by studying the development of follicles and uterine enlargement.
Ultrasound Breast Morphotypes in Adolescent Girls Introduction. The knowledge of normal ultrasound (US) breast morphology is essential for any radiologist according to diagnostic and prognostic positions. In contemporary scientific literature, only US breast morphotypes of reproductive age women are described. Nevertheless, radiologists often experience numerous diagnostic difficulties with pubertal and adolescent patients in differentiating normal and pathological changes in the breast. The aim of this study was to analyze normal types of breast echo structure (US breast morphotypes) and to determine the diagnostic criteria for the differentiation of breast morphotypes in adolescent girls. Materials and methods. The study population consisted of 241 girls between 13 and 17 years of age, who were examined clinically, including standardized sonography (7.5-13 MHz, linear probe B-mode sonography). In the investigated group there were persons whose sexual development was appropriate to their age, who had no abnormalities of reproductive organs and menstrual dysfunctions and who claimed that they had no sexual contacts and did not use oral contraception. Results and discussion. Unexpectedly, in adolescent girls all US breast morphotypes typical of different periods of female ontogenesis were found: the juvenile morpho- type - the "early reproductive" morphotype - the "reproductive prime" morphotype - the "reproductive maturity" morphotype - the premenopausal morphotype - the postmenopausal morphotype. We consider the main criterion of US breast morpho- type diagnostics to be the progressive increase of the volumetric density of the fat lobules within glandular tissue. A gradiental increase of the thickness of pre- and retromammary fat layers is the second criterion of morphotype diagnostics. Conclusions. Under normal conditions of mammogenesis in adolescent girls it is possible to find a wide spectrum of US breast morphotypes.
A rare case of broad ligament fibroid in Mayer-Rokitansky-Kuster-Hauser syndrome Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is named after the four physicians German anatomist August Franz Josef Karl Mayer (1829), Austrian anatomist Carl von Rokitansky (1838), German gynaecologist Hermann Kuster (1910) and Swiss gynaecologist Georges Andre Hauser (1961) who over the period of 130 years thoroughly described the syndrome. (1) It is a congenital disorder of females affecting primarily the reproductive organs but may also involve other organ systems. It is associated with an absence or incomplete development of mullerian ducts. It is is characterized by congenital aplasia or hypoplasia of the uterus and the upper part (2/3) of the vagina in women showing normal development of secondary sexual characteristics and a normal 46, XX karyotype. It affects 1 in 4500 women globally.
Comparison of diagnostic accuracy of hysteroscopy and ultrasonography in relation to histopathology in cases of postmenopausal bleeding Postmenopausal bleeding (PMB) is one of the common presentations in the gynae OPD. The significance of the same with malignancies of reproductive organs is well established. (1) Apart from clinical examinations and Pap smear, ultrasound is one of the commonest non-invasive modalities usually planned before any invasive procedures like aspiration cytology/fractional curettage. (2) Hysteroscopy though ideal, use is limited because of either non-availability or being performed as minor surgical procedure in operation theatre even in the teaching tertiary care institutes like ours. This study was planned to evaluate the role of ultrasonography (USG) and hysteroscopy for determining the cause of PMB and to calculate sensitivity, specificity and positive predictive value (PPV), negative predictive value (NPV) and accuracy of these two modalities in relation to the diagnosis confirmed by histopathology reporting (HPR) in patients of postmenopausal bleeding.
Imaging Techniques in the Diagnostic Journey of Disorders of Sex Development Various disorders of sex development (DSD) result in an abnormal development of genitalia that may be recognized at prenatal ultrasonography, immediately after birth, or later in life. Because of the complex nature of DSD, the participation of a multidisciplinary team, including imaging or radiology technologists, is required to address the patient's medical needs. The first steps in the management of DSD are sex evaluation, which is based on factors such as the genotype, the presence, location, and appearance of reproductive organs, the potential for fertility, and the cultural background and beliefs of the patient's family. It is also important to ensure the detection of comorbidity (as in syndromes) and to define the etiology of DSD in order to offer the best prognosis. Ultrasonography is the primary modality for demonstrating internal organs, genitography is used to assess the urethra, vagina, and any fistulas, and magnetic resonance imaging is used as an additional modality to assess internal gonads and genitalia. This review presents the advantages and disadvantages and the sensitivity and specificity for each type of radiological imaging to help in the evaluation of DSD cases before and after birth.
Urogenital Epithelial Cells as Simple Markers of Estrogen Response in Infants: Methods and Applications Exposure to estrogen-mimicking chemicals during critical periods of development, such as infancy, may have adverse effects. However, these effects can be difficult to characterize in most epidemiologic studies. For example, growth of reproductive organs may be susceptible to estrogenic chemicals, but measuring it requires skilled ultrasound examination; timing of pubertal onset may be altered, but observing it requires long-term follow up. To address the need for a simple marker of response to estrogenic exposures in infants, we propose a novel application of a classic marker of estrogen response in adult women: cytological evaluation of urogenital epithelial cells. In this cross-sectional study of 34 female and 41 male infants, we demonstrate that epithelial cells can be obtained from swabs of the vaginal introitus (females) and urethral meatus (males), as well as from spun urine, and that these cells respond to differential estrogenic conditions, as indicated by the relative abundance of the superficial epithelial cell type. To model varying estrogen exposure, we sampled from infants who were either newborn (highly exposed to maternal estrogens), or 12 weeks old (12W) (negligibly exposed to estrogen). Newborns had a higher percentage of superficial cells (%S), as compared to 12W (mean ± standard error: 8.3 ± 1.8 vs. 0.9 ± 0.2) (p < 0.01), consistent with an estrogen response. This difference in %S from newborn to 12W was observed similarly for swab (-7.6 ± 1.7) and urine (-7.3 ± 2.6) specimens and for males (-9.6 ± 2.9) and females (-5.2 ± 2.1). Examination of urogenital epithelial cells can successfully demonstrate estrogen response in both sexes, using cell specimens collected from either swab or urine sampling. In future studies, this simple, non-invasive method may be applied to assess whether estrogen-mimicking chemicals produce an estrogenic response in infants.
Diagnostic value of risk of malignancy index in the clinical evaluation of ovarian mass In the present study, the Risk Malignancy Index (RMI) was calculated based on menopausal status, ultrasound (US) findings and serum biological cancer antigen 125 (CA-125) levels as a scoring system in Libyan females with ovarian masses (OMs) to differentiate between benign and malignant tumors. A total of 51 females with OMs referred to the Gynaecology Department of the National Cancer Institute in Misurata (Libya) between January 2019 and December 2020 were retrospectively reviewed for diagnostic testing. Clinicopathological and demographic data were obtained from patient records. A cut-off point of RMI=200 was used to differentiate between benign and malignant tumors. The mean age of the patients was 47 years (range, 19-90 years) and 60% of the patients were premenopausal. Examination of the four RMI indices and disease status indicated that the association with the US score (P
Predictive value of dynamic transvaginal ultrasound for evaluating pelvic organ mobility: surgical and reproductive implications To review the techniques of dynamic transvaginal ultrasound (TV-US) for evaluating pelvic organ mobility and demonstrate the components of a positive and negative ‘sliding sign’ with respect to deep infiltrating endometriosis (DIE) involving the Pouch of Douglas (POD). We will discuss the relative sensitivity and specificity of the ‘sliding sign’ for evaluating POD obliteration and summarize the surgical and reproductive implications of a negative sliding sign with regards to endometriosis-associated infertility and management of deep infiltrating endometriosis involving the posterior compartment of the pelvis.
Prevalence of endometrioma and deep infiltrating endometriosis at transvaginal ultrasound examination of subfertile women undergoing assisted reproductive treatment To estimate the prevalence of endometrioma and deep infiltrating endometriosis (DIE), assessed by systematic transvaginal ultrasound examination, in women with subfertility accepted for their first assisted reproductive treatment and to describe the prevalence of endometriotic lesions in different anatomical locations of the pelvis.
Three dimensional color Doppler transvaginal ultrasound morphologic features of uterine septum and residual cavity in women with reproductive failure To study the morphologic features of the uterine septum and the residual uterine cavity using 3D color Doppler transvaginal ultrasound and their relation to reproductive performance.

Ultrasound Measurements of Rotator Cuff Tendons in Male Adults Objective: To establish the normative ultrasound values of tendons of rotator cuff muscles in local healthy male population. Study Design: Cross sectional study. Place and Duration of Study: Department of Radiology, Combined Military Hospital Malir, from Oct 2019 to Mar 2020. Methodology: The sample of study was 456 shoulders of 228 patients. All the patients went under ultrasound shoulder in standard positions. Data were analyzed with statistical analysis program Statistical Package for the Social Sciences version 23. Results: In right dominance the mean thickness of the supraspinatus, infraspinatus, subscapularis and biceps tendons were tendon 4.63 ± 0.45 mm, 3.90 ± 0.73 mm, 4.55 ± 0.74 mm and 3.55 ± 0.54 mm respectively. The acromio-humeral interval was 12.63 ± 2.005 mm. In left dominance the mean thickness of the supraspinatus, infraspinatus, subscapularis and biceps tendons were 4.88 ± 0.69 mm, 4.17 ± 0.63 mm, 5.04 ± 0.26 mm and 3.62 ± 0.45 mm respectively. The acromio-humeral interval was 13.65 ± 2.98mm. Conclusion: The study showed that there was insignificant difference between the dominant and non-dominant shoulders.
Continuous versus pulsed ultrasound on myofascial pain syndrome: Randomized single blind controlled trial Background: Myofascial pain syndrome (MPS) is a complex pain syndrome characterized by myofacial trigger points (MTrPs) in skeletal muscles. Ultrasound (US) therapy is one of the main devices used in physical therapy, for the treatment of MTrPs in MPS. Purpose: This study aimed to compare continuous and pulsed ultrasound therapy with sham ultrasound in subjects with MTrPs in upper trapezius muscle. Subjects: Sixty subjects (37 males and 23 females) with active trigger points on the upper fibers of trapezius, aged 18 to 30 years participated in the study. Methods: Subjects were randomly divided into four equal groups, Group (A) was treated with continuous ultrasound (3MHz, 1W/cm2), Group (B) was treated with pulsed ultrasound (3MHz, 1W/cm2, 1:1 ratio), Group (C) was treated with pulsed ultrasound (3MHz, 1W/cm2, 1:4 ratio), and Group (D), the control group, was treated with sham ultrasound. All treatments applied 5 minutes for 5 days per week for 2 weeks. Pain, Pressure pain threshold, and quality of life evaluations were performed before and after 10 sessions of treatment. Results: There was a significant difference between group (A) and other groups according to PPT as p value (p
Dynamic Evaluation of the Rectus Abdominis Muscle before and after Delivery by Ultrasonography Objective. To evaluate the changes of rectus abdominis thickness and inter-rectus distance before and after delivery with high-frequency ultrasound. Methods. A total of 148 pregnant women at 12 weeks of gestation who underwent prenatal examination in our hospital from January 2019 to March 2020 were selected, and 140 of them cooperated with rectus abdominis examination. According to the results of rectus abdominis examination 42 days after delivery, 97 patients were divided into the DRA group with rectus abdominis isolated and 43 patients were divided into the normal group with rectus abdominis not isolated. At 12 weeks, 24 weeks, and 37 weeks of pregnancy, 3 days and 42 days after delivery, the thickness and spacing of the left and right rectus abdominis muscle were measured by high-frequency ultrasound along the white linea at three positions: 5 cm above the navel, 3 cm below the umbilical edge, and 3 cm below the navel. Results. The thickness of rectus abdominis at 5 cm above the navel, 3 cm below the navel, and at the navel margin of the abdominal white line in the pregnant women of the two groups was gradually decreased with the increase of the pregnancy cycle and gradually recovered after delivery. At 42 days after delivery, the thickness of rectus abdominis in the DRA group was significantly lower than that in the normal group, which was 5 cm above the umbilicus, 3 cm below the umbilicus, and the umbilical margin of the abdominal white line (P < 0.05). The space between rectus abdominis 5 cm above the navel, 3 cm below the navel, and the navel margin of the abdominal white line in the pregnant women of the two groups was gradually increased with the increase of the pregnancy cycle and gradually recovered after delivery. At 37 weeks of pregnancy, 3 days after delivery, and 42 days after delivery, the space of rectus abdominis along the umbilicus 5 cm above, 3 cm below the umbilicus, and the umbilicus border of the abdominal white line in the DRA group was significantly larger than that of the normal group (P < 0.05). Conclusion. Ultrasound can accurately measure the inter-rectus distance and rectus thickness, accurately evaluate the degree of DRA, and realize the one-stop evaluation from prenatal diagnosis and prediction to postpartum rehabilitation monitoring, so as to intervene during pregnancy and reduce the risk of postpartum DRA.
Relationship between the Degree of Illness in Elderly Patients with Rheumatoid Arthritis and Parameters of Musculoskeletal Ultrasound and Oswestry Dysfunction Index and Clinical Value Analysis Objective. The aim of the study is to explore the relationship between the degree of illness in elderly patients with rheumatoid arthritis (RA) and parameters of musculoskeletal ultrasound (MSUS) and Oswestry Dysfunction Index (ODI) and its clinical value. Methods. The clinical data of 100 elderly patients with RA admitted to our hospital from May 2016 to May 2022 were retrospectively analyzed. The patients were divided into four groups, including the remission group (DAS28 ≤ 2.6, n = 25), low activity group (2.6 ≤ DAS28 ≤ 3.2, n = 25), middle activity group (3.2 ≤ DAS28 ≤ 5.1, n = 25), and high activity group (DAS > 5.1, n = 25) according to the disease activity score-28 (DAS28). All patients underwent ultrasonic detection to compare the relationship between the degree of illness in elderly patients with RA and parameters of MSUS and ODI. Results. The total semiquantitative score of MSUS and ODI score in the remission group were obviously lower than those in the other three groups (P < 0.001). The degree of illness in elderly patients with RA was positively correlated with parameters of MSUS (r = 0.886, P < 0.001). The degree of illness in elderly patients with RA was positively correlated with ODI (r = 0.907, P < 0.001). Conclusion. The degree of illness in elderly patients with RA is closely related to parameters of MSUS and ODI, and the parameters of MSUS have a higher evaluation value for the degree of illness in elderly patients with RA, which are correlated with ODI.
Ultrasound-Guided Percutaneous Needle Electrolysis in Dancers with Chronic Soleus Injury: A Randomized Clinical Trial Damage to intramuscular tendons is very common in sports injuries, specifically in soleus muscle injuries. This study sought to compare the effects of applying ultrasound- (US-) guided percutaneous needle electrolysis (PNE) in combination with an eccentric exercise program on pain and functionality in dancers with chronic soleus injury, located in the central tendon. Thirty dancers with injured central tendon of the soleus muscle were randomly allocated to a PNE group (n = 10), an eccentric exercise group (n = 10), or a combined group (n = 10). Pain, ankle dorsiflexion range of motion (DROM), endurance, the heel raise test, the DFOS questionnaire, and the minimal clinically important difference (MCID) were analyzed at baseline and after treatment (four weeks). Over half (52%) of the dancers had a chronic soleus muscle injury. Variables for pain, DROM, the heel rise test, ADL, technique, DFOS total, and DFOS-subjective variables showed significant differences (P < 0.05) in pretreatment and posttreatment in all groups, whereas no significant differences were observed between intervention groups. However, the combined group showed a higher percentage of changes compared to the other groups, and these dancers had greater perceived changes (MCID = 4.70 ± 1.42). The conclusion of the study was that dancers with chronic soleus injury, located in the central tendon, treated with a combination of US-guided PNE and an eccentric exercise program displayed improved outcomes compared to the application of PNE therapy or eccentric exercise alone. The US-guided PNE, combined with an eccentric exercise program, is a useful therapeutic tool for the treatment of chronic soleus injury, located in the central tendon. The trial is registered with NCT04042012.
Diagnostic Accuracy and Agreement between Magnetic Resonance Imaging and Ultrasound Finding for the Diagnosis of Rotator Cuff Tears Objective: To determine the diagnostic accuracy and agreement between ultrasound and magnetic resonance (MR) imaging in determining rotator cuff tears. Study Design: Cross-sectional study. Place and Duration of the Study: Armed Forces Institute of Radiology and Imaging, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jul 2018 to Jan 2019. Methodology: Patients of either gender with a traumatic shoulder injury duration of less than 15 days were consecutively included. Rotator cuff tear on ultrasonography was diagnosed on the presence of a hypoechoic discontinuity in the tendon and accentuation of cartilage shadow, giving a 'double cortex' view while on MRI, the hyper-intense signal area within the tendon on T2W, fat-suppressed and GRE sequences, corresponding to fluid signal seen. Results: Of 88 patients, the mean age was 54.022±5.19 years. Ultrasound diagnosed rotator cuff tears in 42(47.7%) patients, and MRI diagnosed rotator cuff tears in 44(50.0%) patients. Diagnostic accuracy of ultrasound taking MR imaging as the gold standard showed sensitivity as 81.82%, specificity as 77.27%, negative predicted value as 78.26%, positive predicted value as 80.95%, and overall diagnostic accuracy as 79.55%. A moderate agreement was found between ultrasound and MRI findings (p-value=0.591). Conclusion: The findings of the current study showed significant moderate agreement between ultrasound and MR imaging in the determination of rotator-cuff tears.
The Role of Thoracic Ultrasound for Diagnosis of Diseases of the Chest Wall, the Mediastinum, and the Diaphragm—Narrative Review and Pictorial Essay The diagnostic capabilities of ultrasound extend far beyond the evaluation of the pleural space and lungs. Sonographic evaluation of the chest wall is a classic extension of the clinical examination of visible, palpable, or dolent findings. Unclear mass lesions of the chest wall can be differentiated accurately and with low risk by additional techniques such as color Doppler imaging, contrast-enhanced ultrasound, and, in particular, ultrasound-guided biopsy. For imaging of mediastinal pathologies, ultrasound has only a complementary function but is valuable for guidance of percutaneous biopsies of malignant masses. In emergency medicine, ultrasound can verify and support correct positioning of endotracheal tubes. Diaphragmatic ultrasound benefits from the real-time nature of sonographic imaging and is becoming increasingly important for the assessment of diaphragmatic function in long-term ventilated patients. The clinical role of thoracic ultrasound is reviewed in a combination of narrative review and pictorial essay.
Multi-Sensing Techniques with Ultrasound for Musculoskeletal Assessment: A Review The study of muscle contractions generated by the muscle-tendon unit (MTU) plays a critical role in medical diagnoses, monitoring, rehabilitation, and functional assessments, including the potential for movement prediction modeling used for prosthetic control. Over the last decade, the use of combined traditional techniques to quantify information about the muscle condition that is correlated to neuromuscular electrical activation and the generation of muscle force and vibration has grown. The purpose of this review is to guide the reader to relevant works in different applications of ultrasound imaging in combination with other techniques for the characterization of biological signals. Several research groups have been using multi-sensing systems to carry out specific studies in the health area. We can divide these studies into two categories: human–machine interface (HMI), in which sensors are used to capture critical information to control computerized prostheses and/or robotic actuators, and physiological study, where sensors are used to investigate a hypothesis and/or a clinical diagnosis. In addition, the relevance, challenges, and expectations for future work are discussed.
Diagnostic Musculoskeletal Ultrasound and Guided Injection: A Practical Guide This guide outlines methods for the use of ultrasound in the diagnosis and management of musculoskeletal and sports pathologies. It addresses local anesthetics and corticosteroids; the normal and common pathological appearance of tendons, joints, bursae, muscles, and nerves, as well as the use of ultrasound in interventional procedures; and diagnostic ultrasound and guided injection of the shoulder, elbow, wrist and hand, hip, knee, and ankle and foot.
Muscle ultrasound in patients with late-onset Pompe disease identified by newborn screening In this study, we aimed to evaluate if EI can identify characteristic patterns of muscle involvement in LOPD patients identified by NBS.
Assessment of the upper limb muscles in patients with Fukuyama muscular dystrophy: Noninvasive assessment using visual ultrasound muscle analysis and shear wave elastography Fukuyama-type congenital muscular dystrophy (FCMD) is severe, childhood-onset muscular dystrophy. Recently, our group has discovered a potential treatment using antisense oligonucleotides. Therefore, an effective, reliable, and objective method of assessing muscle is needed. Ultrasound is a minimally invasive tool that can be applied without radiation exposure or pain. Evaluating tissue stiffness by shear wave elastography (SWE) has especially recently attracted attention. Here, we aimed to evaluate SWE value of the upper limb muscles: biceps brachii, triceps brachii, brachioradialis, abductor pollicis brevis, and abductor finger muscle in patients with FCMD. Upper extremity function was evaluated by visual muscle ultrasound analysis (VMUA) and SWE in 13 patients with FCMD and 20 healthy controls. The motor function evaluation tool was used to evaluate motor function, and the correlation with the dynamics of the SWE was determined. VMUA scaled using the Heckmatt scale was higher in patients with FCMD. SWE was also significantly higher and stiffer in the biceps brachii and brachioradialis in patients with FCMD. Furthermore, the severity of FCMD symptoms was correlated with muscle stiffness. We conclude that VMUA and SWE can be useful tools for monitoring muscle atrophy and upper limb function in patients with FCMD.
Reliability of ultrasound in the assessment of muscle thickness in critically ill children Ultrasound has been used to quantify and qualify muscle morphology in critically ill children and can detect changes in muscle thickness. The aim of this study was to assess the reliability of ultrasound measurement of muscle thickness in critically ill children and to compare the assessments made by an expert with those made by inexperienced sonographers.

Ultrasound Evaluation of the Peroneal Tendons in an Asymptomatic Elite Military Population: A Prospective Cohort Study The purpose of this study was to identify the location of the peroneal tendons in relationship to the fibular groove in an asymptomatic population of elite U.S. Military Service members.
Ultrasound Diagnosis of a Patellar Tendon Rupture Many forward units are being deployed with portable ultrasound capability. We describe a case of a patient with a complete patellar tendon rupture that was diagnosed in the deployed environment using a portable ultrasound. Military physicians can benefit from sonographic evaluation of patients with musculoskeletal injuries in a deployed setting. The information they gain can assist them in giving better care to their patients and in making decisions on patient evacuation.
Relationship between ultrasound detected tendon abnormalities, and sensory and clinical characteristics in people with chronic lateral epicondylalgia To investigate the relationship between tendon structural changes determined by static ultrasound images (US) and sensory changes using quantitative sensory testing (QST), and clinical measures in lateral epicondylalgia.
Intra- and inter-rater reproducibility of ultrasound imaging of patellar and quadriceps tendons in critically ill patients Since the outset of body image reconstruction for diagnosis purposes, ultrasound has been used to investigate structural changes located in tendons. Ultrasound has clinical applications in the intensive care unit, but its utility for tendon imaging remains unknown. Thus, we aimed to determine intra- and inter-rater reproducibility of measures obtained by images generated through morphological tendon sonographic analysis recorded from critically ill patients. We designed a cross-sectional study to assess thickness, cross-sectional area, and echogenicity of patellar and quadriceps tendons in a convenience sample formed with 20 critically ill patients. Two independent raters (experienced and novice) recorded repeated measures, checking for agreement (Kappa statistics) and reliability (Intraclass coefficient Correlation-ICC and Bland-Altman). The quality of images acquired by the two independent raters substantially agreed (k = 0.571-1.000), regardless of the region on the patellar tendon or the studied tendon (patellar or quadriceps). Regardless of how much experience the rater had, their repeated records (intra-rater reliability) always demonstrated almost complete correlation, ICC ranging from 0.89 to 0.98 for both tendons in all outcomes. At the same way, the statistically significant inter-rater ICC ranging from 0.87 to 0.97. Both repeated measures by the raters (intra-rater) and the repeated single and double measures between the raters (inter-rater) presented a minimum measurement error constituting a predominant pattern of random variability. We conclude that ultrasound imaging acquisition performed by independent raters for tendon thickness, CSA, and echogenicity monitoring of critically ill patients are acceptable and are not influenced by rater experience.
Ultrasound Measurements of Rotator Cuff Tendons in Male Adults Objective: To establish the normative ultrasound values of tendons of rotator cuff muscles in local healthy male population. Study Design: Cross sectional study. Place and Duration of Study: Department of Radiology, Combined Military Hospital Malir, from Oct 2019 to Mar 2020. Methodology: The sample of study was 456 shoulders of 228 patients. All the patients went under ultrasound shoulder in standard positions. Data were analyzed with statistical analysis program Statistical Package for the Social Sciences version 23. Results: In right dominance the mean thickness of the supraspinatus, infraspinatus, subscapularis and biceps tendons were tendon 4.63 ± 0.45 mm, 3.90 ± 0.73 mm, 4.55 ± 0.74 mm and 3.55 ± 0.54 mm respectively. The acromio-humeral interval was 12.63 ± 2.005 mm. In left dominance the mean thickness of the supraspinatus, infraspinatus, subscapularis and biceps tendons were 4.88 ± 0.69 mm, 4.17 ± 0.63 mm, 5.04 ± 0.26 mm and 3.62 ± 0.45 mm respectively. The acromio-humeral interval was 13.65 ± 2.98mm. Conclusion: The study showed that there was insignificant difference between the dominant and non-dominant shoulders.
Partial Flexor Tendon Injury Causing Locking: Illustration of the Utility of Dynamic Ultrasound Clinical diagnosis of partial flexor tendon lacerations is challenging because tendon function may be preserved. Although some partial flexor tendon tears can be managed conservatively, pain, stiffness, and triggering/locking may result, requiring surgical management. The mechanism by which this occurs has been investigated in animal and cadaver studies but has not been demonstrated in patients with real-time, in vivo imaging. Here, we present a case of partial tendon tear presenting with severe pain and locking that was diagnosed before surgery and characterized with dynamic ultrasound.
A Cadaveric Study Examining the Accuracy of Wireless Hand-Held Guided Ultrasound Injections Versus Blind Injections in the Flexor Tendon Sheath Hand-held ultrasound (HHUS) is gaining popularity among clinicians. Although its use for procedural guidance could have several advantages in hand surgery, other surgeons may wonder about its added benefits. This cadaveric study aimed to examine the hypothesis of increased accuracy of wireless HHUS-guided injections versus that of blind injections into the flexor sheath.
Investigation of the relationship between tensile viscoelasticity and unloaded ultrasound shear wave measurements in ex vivo tendon Mechanical properties of biological tissues are of key importance for proper function and in situ methods for mechanical characterization are sought after in the context of both medical diagnosis as well as understanding of pathophysiological processes. Shear wave elastography (SWE) and accompanying physical modelling methods provide valid estimates of stiffness in quasi-linear viscoelastic, isotropic tissue but suffer from limitations in assessing non-linear viscoelastic or anisotropic material, such as tendon. Indeed, mathematical modelling predicts the longitudinal shear wave velocity to be unaffected by the tensile but rather the shear viscoelasticity. Here, we employ a heuristic experimental testing approach to the problem to assess the most important potential confounders, namely tendon mass density and diameter, and to investigate associations between tendon tensile viscoelasticity with shear wave descriptors. Small oscillatory testing of animal flexor tendons at two baseline stress levels over a large frequency range comprehensively characterized tensile viscoelastic behavior. A broad set of shear wave descriptors was retrieved on the unloaded tendon based on high frame-rate plane wave ultrasound after applying an acoustic deformation impulse. Tensile modulus and strain energy dissipation increased logarithmically and linearly, respectively, with the frequency of the applied strain. Shear wave descriptors were mostly unaffected by tendon diameter but were highly sensitive to tendon mass density. Shear wave group and phase velocity showed no association with tensile elasticity or strain rate-stiffening but did show an association with tensile strain energy dissipation.
Ultrasonography of fibroma of the tendon sheath in the hand and wrist The purpose of our study was to explore the sonographic characteristics of fibromas of the tendon sheath of the hand and wrist and to evaluate the value of high frequency ultrasound in the diagnosis of FTS.
Ultrasound and MRI of the peroneal tendons and associated pathology Lateral ankle pain is common with overuse and sports-related injuries and may cause considerable morbidity. The differential diagnosis of lateral ankle pain is extensive. Disorders of the peroneal tendons should be an important consideration during interpretation of a routine ankle magnetic resonance imaging (MRI) or ultrasound (US). This article presents a review of the common causes of peroneal tendon pathology with particular reference to anatomy, US, and MRI features. The importance of dynamic evaluation with ultrasound is also emphasized.

Comparative Effectiveness of Two Models of Point-of-Care Ultrasound for Detection of Post-Void Residual Urine during Acute Ischemic Stroke: Preliminary Findings of Real-World Clinical Application We conducted a comparative study of two models of point-of-care ultrasound devices for measuring post-void residual urine (PVRU). We prospectively enrolled 55 stroke inpatients who underwent both real-time B-mode ultrasound (Device A) and automated three-dimensional (3D) scanning ultrasound (Device B), with a total of 108 measurements. The median PVRU volume of Device B was 40 mL larger than that of Device A. The PVRU difference between the devices was positively and linearly correlated with PVRU. The correlation of PVRU volume between the devices was strong, but the agreement level was only moderate. Measurement deviations were observed in 43 (40%) and 11 (10%) measurements with Device B and Device A, respectively. The PVRU volume was low in spherical bladder shapes but sequentially increased in triangular, undefined, ellipsoid, and cuboid bladder shapes. Further comparison of 60 sets of PVRU without measurement deviations revealed higher agreements between the devices at correction coefficients of 0.52, 0.66, and 0.81 for PVRU volumes of 200 mL, respectively. The automated 3D scanning ultrasound is more convenient for learning and scanning, but it exhibits larger measurement deviations. Real-time B-mode ultrasound accurately visualizes the urinary bladder but tends to underestimate the urinary bladder when the PVRU volume is large. Hence, real-time B-mode ultrasound with automated PVRU-based adjustment of calculation formulas may be a better solution for estimating bladder volume.
Bladder Ultrasound: Avoiding Unnecessary Catheterizations The article presents information on urinary catheterization and infections of the urinary tract. Urinary catheterization is an invasive procedure that compromises the body's natural defense against infection. Normal bacteria flora surrounding the meatus or distal urethra can be introduced into the bladder during catheter insertion. Catheterizations can be uncomfortable, embarrassing, and risky for the patient; time consuming for the nurse; and costly for the institution. Studies have estimated that 40% of all hospital-acquired infections are of the urinary tract, and that the majority of these followed urinary catheterization.
Can the Vesical Imaging Reporting and Data System (VI-RADS) score be applied in conventional ultrasound and contrast-enhanced ultrasound to differentiate muscle-invasive bladder cancer? Aim: To investigate the value of vesical imaging reporting and data system (VI-RADS) score based on conventional ultrasound and contrast-enhanced ultrasound (CEUS) in differentiating muscle-invasive bladder cancer (MIBC). Material and methods: Thirty-eight patients who underwent conventional ultrasound and CEUS examinations at our ultrasound department between March 2021 and June 2022 were retrospectively included in this study. Two sonographers analyzed the conventional ultrasound and CEUS images of each patient separately and scored them in strict accordance with VI-RADS scoring system based on conventional ultrasound and CEUS. The VI-RADS score of each lesion was compared with the pathological findings to assess the diagnostic performance of VI-RADS. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the VI-RADS score in the diagnosis of MIBC were analyzed when the cutoff values were 3 and 4, respectively. Interobserver agreement was evaluated using the weighted-kappa coefficient (κ). Results: The final pathological results evidenced 25 (65.8%) non-muscle-invasive bladder cancers (NMIBCs) and 13 (34.2%) MIBCs. When the VI-RADS score ≥ 4, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the VI-RADS score for predicting muscle-invasive bladder cancer were 92.3%, 84.0%, 75.0%, 95.5%, and 86.8%, respectively. The area under the receiver operating curve for the VI-RADS score was 0.882 (95%CI:0.761-1). Inter-reader agreement for VI-RADS scores was good. Conclusion: The VI-RADS score based on conventional ultrasound and CEUS is useful in differentiating muscle-invasive bladder cancer.
Effectiveness of contrast-enhanced ultrasound for detecting the staging and grading of bladder cancer: a systematic review and meta-analysis The study retrospectively analysed the accuracy of preoperative contrast-enhanced ultrasound (CEUS) in differenti-ating stage Ta-T1 or low-grade bladder cancer (BC) from stage T2 or high-grade bladder cancer.Material and Methods: We systematically searched the literature indexed in PubMed, Embase, and the Cochrane Library for original diagnostic articles of bladder cancer. The diagnostic accuracy of CEUS was compared with cystoscopy and/or transurethral resection of bladder tumors (TURBT). The bivariate logistic regression model was used for data pooling, couple forest plot, diagnostic odds ratio (DOR) and summary receiver operating characteristic (SROC).Results: Five studies met the selection criteria; the overall number of reported bladder cancers patients were 436. The pooled-sensitivity (P-SEN), pooled-specificity (P-SPE), pooled-positive likelihood ratio (PLR+), pooled-negative likelihood ratio (PLR-), DOR, and area under the SROC curve were 94.0% (95%CI: 85%-98%), 90% (95%CI: 83%-95%), 9.5 (95%CI: 5.1-17.6), 0.06 (95%CI: 0.02-0.17), 147 (95%CI: 35-612) and 97% (95% CI: 95%-98%) respectively.Conclusion: CEUS reaches a high efficiency in discriminating Ta-T1 or low-grade bladder cancer from stage T2 or high-grade bladder cancer. It can be a promising method in patients to distinguish T staging and grading of bladder cancer because of its high sensitivity, specificity and diagnostic accuracy.
Diagnostic value of the combination of DAPK methylation in urinary sediment and B ultrasound for recurrent urinary bladder cancer Urinary bladder cancer (UBC) is the most common malignancy affecting the urinary system. This study aimed to investigate the diagnostic value of combining DAPK methylation in urinary sediment and B ultrasound in the detection of recurrent UBC.
Comparison of Ultrasound-Guided Nerve Block with Ultrasound-Guided Nerve Stimulation Technique for Obturator Nerve Block in Transurethral Resection of Bladder Tumour Transurethral resection of bladder tumour (TURBT) is a commonly performed surgery in urology theaters.1 Mostly the procedure is done under spinal anaesthesia as it offers many advantages, such as ease of operation, minimal bleeding and helps in early recognition of bladder perforation, which is associated with recurrence rates.2,3 The only major shortcoming of spinal anaesthesia is that it spares the obturator nerve, and stimulation of the obturator nerve can cause adductor muscle contractions during the procedure, which may cause bladder injury or rupture.
Point-of-Care Ultrasound in the Diagnosis and Management of Urosepsis in Infants Point-of-care ultrasound (POCUS) is an imaging technique performed at the patient's bedside by a treating medical doctor. It assists in the diagnosis, monitors changes in clinical conditions, and guides invasive procedures. (1) In critically ill patients, POCUS allows for rapid, focused, and integrated assessments of ultrasound images, technical skills, and clinical knowledge. Lately, the use of POCUS has expanded across many pediatric disciplines. (2) Bladder and renal ultrasound imaging analyses to identify hydronephrosis and the volume of urine are relevant applications to pediatric patients.
Contrast-enhanced ultrasound (CEUS) in the evaluation of bladder pathologies: Review Contrast-enhanced Ultrasound (CEUS) is an advanced ultrasound (US) technique that utilizes specific US contrast agents (UCAs) to provide a more detailed evaluation of anatomic structures and parenchymal vasculature. Although the use of CEUS has been well-established in echocardiography and imaging of focal liver lesions, the updated guidelines by WFUMB-EFSUMB from 2018 also talk about the use of CEUS in the urinary bladder under non-hepatic applications of CEUS. The most common application of CEUS in the urinary bladder is the differentiation between bladder cancer and benign lesions such as a hematoma in patients presenting with hematuria. CEUS is also a promising imaging modality that can be used to detect and stage bladder urothelial cancers. CEUS greatly improves the diagnostic accuracy of conventional US techniques in the detection of bladder cancer. It has been shown previously that low- and high-grade bladder cancers tend to behave differently on the time-intensity curves (TIC) of CEUS. Low-grade bladder cancers tend to show a TIC with an early peak enhancement with a slow plateau and a longer time taken for contrast disappearance, whereas high-grade bladder cancers tend to show a rapid and high peak enhancement with rapid contrast disappearance (fast wash-out phase). In patients presenting with hematuria, CEUS accurately differentiates the etiology as either malignant or benign (i.e., hematoma) as hematomas are non-vascular lesions and do not show any enhancement as opposed to bladder cancers which tend to be highly vascular. CEUS holds several advantages such as being widely available, quick, and cost-efficient. CEUS is also suitable for patients who have contraindications to undergo CT, MRI, and/or conventional cystoscopy. Additionally, CEUS can be safely performed in patients with renal failure as UCAs are not nephrotoxic and not deposited in tissues as they are blood pool agents and are metabolized and excreted via pulmonary breathing.
Where did that catheter go? A case report of Foley catheter placement in bladder diverticulum with point-of-care ultrasound Ultrasonography is an effective diagnostic tool for acute urinary retention despite the presence of a Foley catheter to ensure proper Foley location and function. However, there are several previously reported cases of misleading positioning of a Foley catheter balloon [1,3,5]. We report, to our knowledge, the first published case of the presence of a Foley catheter balloon inside a bladder diverticulum that seemingly appears as a bladder perforation on point-of-care ultrasound.
Can portable ultrasound bladder scanner be applied to young children less than three years old? The bladder scanner (BS), a portable ultrasound device specialized in bladder volume measurement, has been developed and applied to clinical assessment of postvoid residual urine, which is a requisite in evaluating patients with voiding dysfunction. However, experiences in the application of the BS to the pediatric population remain limited despite commonly encountered reluctance to catheterization. This prospective observational study aimed to evaluate the correlation and accuracy of the newly developed pediatric module of the BS (BioCon-900) in measuring bladder volume in children 0–6 years old.

Role of Ultrasound in Thyroid Pathologies Disorders of thyroid gland may result from developmental failures, abnormalities of hormone production and structural changes which may or may not be accompanied by changes in function. The normal thyroid gland consists of two lobes and a bridging isthmus. Thyroid size, shape and volume vary with age and sex. Ultrasound is the initial and the commonest modality to study the thyroid gland. The thyroid gland is slightly more echo-dense than the adjacent structures because of its high iodine content. It has a homogenous ground glass appearance that makes detection of focal cystic or hypoechoic thyroid lesions relatively easy. The aim of the present study was to assess the nature of pathologies of thyroid gland, differentiate between focal and diffuse pathology and perform a Sonographic interpretation with subsequent confirmation by FNAC. The present prospective observational study was carried out in the Department of Radio-Diagnosis, Government Medical College and Associated Hospitals Srinagar. A convenience sampling of all patients referred to the Department of Radio-Diagnosis from OPD, in-patient wards or Emergency wing for thyroid ultrasound scan were included in study. Detailed history was elicited; Study was done on Logic S8 Ultrasound using 12 MHz linear array transducer. Before the ultrasound guided FNAC, the neck was hyperextended and skin was cleaned with povidine - iodine (Betadine) solution. The male: female ratio was 1:2.3. Maximum number of patients, 42(84%) came with clinically thyroid enlargement followed by pain in 7 cases (14%), 6(12%) cases presented with pressure effects like dysphagia, dyspnoea and hoarseness of voice. 3(6%) cases presented with signs of hyperthyroidism like tremors, sweating and loss of weight. Lesser involvement was seen in Left Lobe (8%). Total number of cases with swellings (84%) was more than cases (16%) with no swellings. In the study, majority of lesions had hypoechoic echotexture (34%) followed by isoechoic (28%) and heterogenous (24%). In this study among malignant cases papillary carcinoma was most common lesion in 83.34% of cases followed by anaplastic carcinoma in 1(16.66%) case.
Impact of imaging cross-section on visualization of thyroid microvessels using ultrasound: Pilot study Non-invasive, contrast-free microvascular imaging of human thyroids can be potentially beneficial in reducing the large number of benign biopsies of suspicious nodules. However, motion incurred by thyroid due to its proximity to the pulsating carotid artery significantly impacts the visualization of blood flow in small vessels. Singular value based spatiotemporal clutter filtering (SVD-STF) improves the performance of tissue rejection in the presence of motion. However, despite effective clutter filtering, motion in thyroid imaging can impact coherent integration of the Doppler ensemble and degrade the visualization of the underlying vasculature. Recently studies have demonstrated that motion correction using 2D normalized cross-correlation based speckle tracking can address this issue, however, only in-plane motion can be tracked and corrected. Given the natural anatomical orientation of the rigid trachea, thyroid and the pulsating carotid artery, we hypothesize that imaging of thyroid microvessels may be more reliable in the longitudinal view than in the transverse. Specifically, distal presence of rigid trachea can limit out-of-plane motion in the longitudinal view. We tested this hypothesis on 48 acquisitions obtained from 24 thyroid patients having at least one suspicious nodule. In each patient, ultrasound images of the thyroid were acquired in both longitudinal and transverse views. Compounded plane-wave imaging was used to acquire the ultrasound images at high frame-rate, which is important for contrast-free small vessel blood flow imaging. Thyroid motion was tracked using 2D normalized cross-correlation based speckle tracking. Tissue clutter was rejected using singular value decomposition based spatiotemporal clutter filtering. The clutter-filtered Doppler ensemble was motion corrected prior to slow-time power Doppler integration. Signal-to-noise and contrast-to-noise ratios were computed to assess the improvement in quality of the power Doppler images. Out-of-plane motion was detected by estimating normalized ensemble cross-correlation coefficient. The results demonstrated that motion associated with the thyroid due to the carotid artery was primarily in the lateral direction, which could be estimated and corrected using 2D speckle tracking. However, the motion in the transverse view displayed increased speckle decorrelation. The average ensemble cross-correlation coefficient of the thyroid ultrasound images were significantly higher (p
Surgeon‐performed thyroid ultrasound—proving utility and credibility in selecting patients for fine needle aspiration according to the American thyroid association guidelines. A retrospective study of 500 patients Case series with chart review. Setting: Single academic centre. Participants: The data of all patients who underwent surgeon‐performed ultrasound (SUS) between 7/2009 and 9/2012 were retrospectively reviewed. Main outcome measures: A correlation between sonographic features and a non‐benign cytology\malignant pathology. Results: Four hundred ninety‐eight nodules were included. Solid texture, irregular margins, hypo‐echogenicity and intranodular vascularity were significantly associated with malignancy when benign to non‐benign cytology was compared, and when compared to malignant pathology. Lack of suspicious features was significantly associated with benign lesions, with a negative predictive value of 94%. Except for taller than wider shape, malignancy odds ratio was significantly higher for known suspicious features, reaching 4.81 for irregular borders (CI 2.42‐9.55, P < .001). Conclusions: SUS has proven to be a reliable and consistent tool to assess the thyroid nodule risk stratification. Surgeons should recognise the potential of this tool and its implementation.
Clinical value of grayscale ultrasound combined with real-time shear wave elastography nomogram in risk prediction of thyroid cancer This study constructed a nomogram based on grayscale ultrasound features and real-time shear wave elastography (SWE) parameters to predict thyroid cancer.
Ultrasound characteristics of follicular and parafollicular thyroid neoplasms: diagnostic performance of artificial neural network Ultrasound is the first-line imaging modality for detection and classification of thyroid nodules. Certain features observable by ultrasound have recently been equated with potential malignancy. This retrospective cohort study was conducted to test the hypothesis that radiomics of the four categorical divisions (medullary [MTC], papillary [PTC], or follicular [FTC] carcinoma and follicular thyroid adenoma [FTA]) demonstrate distinctive sonographic characteristics. Using an artificial neural network model for proof of concept, these sonographic features served as input.
Evaluation of the efficacy of ultrasound-guided radiofrequency ablation of papillary thyroid microcarcinoma after one year This study aims to evaluate the feasibility and safety of percutaneous radiofrequency ablation guided by ultrasound for treating papillary thyroid microcarcinoma.
Comparison of the diagnostic accuracy of K-TIRADS and EU-TIRADS guidelines for detection of thyroid malignancy on ultrasound This retrospective study compared the diagnostic accuracy of histopathologically proven thyroid nodules between the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and the European Thyroid Imaging Reporting and Data System (EU-TIRADS) guidelines for the management of thyroid nodules characterized by ultrasonography.
Effect of the location and size of thyroid nodules on the diagnostic performance of ultrasound elastography: A retrospective analysis Ultrasound-guided fine-needle aspiration biopsies are recommended for the detection of suspicious thyroid nodules. However, the best approach regarding suspicious ultrasound features for thyroid nodules is still unclear. This study aimed to evaluate the effect of location and size of thyroid nodules on the diagnostic performance of strain ultrasound elastography. In addition, this study evaluated whether ultrasound elastography predicts malignancy in thyroid nodules.
Use of ultrasound elastography in differentiating benign from malignant thyroid nodules: a prospective study Elastography is a real-time non-invasive ultrasonography modality wherein the tissue stiffness is evaluated by calculating the degree of tissue distortion in response to an external force. This study was undertaken to assess the diagnostic value of elastography in differentiating benign from malignant thyroid nodules.

Echogenic content in the fetal gallbladder. Ultrasound features and clinical outcome Introduction. It is rare to detect echogenic content in the fetal gallbladder. The etiology, natural course and prognosis of this condition remain unclear. In addition to providing a systematic review of this topic, we suggest a plan for patient follow-up. Methodology. Of a total of 100 database entries identified in PubMed, EMBASE and ICTRP reviews, we selected 34 studies in which we investigated the ultrasound features and the outcome of this condition. Results. There were 226 fetuses with gallbladder echogenic content identified. Seventy-two fetuses were found to have biliary sludge; 30 cases had a single hyperechogenic focus and 100 fetuses had multiple foci in the gallbladder. There were 16 cases of distal shadowing, 37 fetuses with comet tail and twinkling, and 26 cases with no acoustic artefacts. Eight cases of spontaneous resolution before birth have been documented; nine fetuses exhibited no echogenic content at birth, and 136 cases of resolution of echogenic content within the first year of life have been described. Conclusions. Typically, the condition resolves spontaneously during the postnatal period. After adequately reassuring the parents, the patients should be monitored for spontaneous resolution; medical or surgical intervention is not indicated. Asymptomatic patients can be managed with a wait-and-see strategy.
Ultrasound-Guided Percutaneous Transhepatic Gallbladder Drainage Improves the Prognosis of Patients with Severe Acute Cholecystitis The aim of this study was to investigate the clinical efficacy of ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGD) for the treatment of severe acute cholecystitis (AC). The data of 40 patients diagnosed with severe AC at our hospital between August 2020 and June 2021 were retrieved and classified into a PTGD group, open cholecystostomy (OC) group, laparoscopic cholecystectomy (LC) group, and conventional conservative treatment (CT) group. Before treatment and on days 1, 3, 5, and 7 after treatment, their serum levels of alanine aminotransferase (ALT), alkaline phosphatase (ALP), aspartate aminotransferase (AST), total bilirubin (TBIL), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), white blood cell count (WBC), IL-2, IL-4, IL-6, IL-8, and cancer antigen 19–9 (CA19-9) were measured. Additionally, clinical manifestations such as body temperature and pain score were monitored before treatment and at 24, 48, and 72 hours after treatment. The recovery time and complications/adverse reactions were statistically analyzed, and the Kaplan–Meier survival curve was plotted. After treatment, compared with the other three groups, the PTGD group had a significant reduction in serum indicators, including WBC and inflammatory factors, recovery time, pain score, and complications, and benefitted from better treatment efficacy and higher survival rate. Thus, ultrasound-guided PTGD was found to be more effective in treating severe AC patients and was associated with improved patient prognoses.
Optimization of diagnostic ultrasonography of the gallbladder based on own experience and literature Although transabdominal imaging of the gallbladder has become a gold standard, new light should be shed on some aspects, which will prove useful in everyday practice. Therefore, based on our own experience and the available literature, we would like to draw attention to those elements of gallbladder ultrasound imaging which may increase its diagnostic efficacy. The paper draws attention to the difficulty in assessing certain anatomical structures, such as the inferior wall, the bottom and the region of the neck of the gallbladder, and offers ways to improve their imaging. We also emphasized the negative effects of duodenal and transverse colon (along with their contents) adhesion to the bottom of the gallbladder on the correct diagnosis. Due to the importance of size in the management strategy for detected gallbladder polyps, we suggest their measurement on an image enlarged with the zoom function. This technique also allows for an accurate assessment of the shape and echostructure of these lesions. An enlarged image of a polyp makes it possible to trace its behavior in time. We also remind that the hepatic wall of the gallbladder is the only site allowing for a reliable wall thickness measurement. We also pointed to the importance of changing patient's position when assessing the mobility and the nature of lesions. Altering patient's position during examination may help detect anomalies in the form of a floating gallbladder, which may promote its torsion. Finally, pathologies whose diagnosis may be facilitated by color-coded blood flow imaging are also presented. The issues discussed in this paper are only a fraction of problems faced by an ultrasound operator in the field of gallbladder diagnostic imaging. However, the proposed ultrasound approaches should help solve some of these problems in everyday practice.
Accuracy of Surgeon-Performed Gallbladder Ultrasound in Identification of Acute Cholecystitis Background: Acute cholecystitis is a common cause of emergency hospital admission. Ultrasonography (US) plays a significant role in the prompt diagnosis of this medical condition. However, it is difficult to find a radiologist in attendance for performing gallbladder US 'beyond daytime and on weekends.' With this standpoint, we decided to assess prospectively the accuracy of surgeon-performed gallbladder US for identifying acute cholecystitis in patients with cholelithiasis. Materials and Methods: Seventy-one consecutive patients awaiting elective or acute gallbladder surgery were included in this study. The US findings of surgeons and radiologists are compared with the histopathology reports. The sensitivity, specificity, accuracy, PPV (positive predictive value), and NPV (negative predictive value) for acute cholecystitis by both surgeon-performed ultrasound (SPUS) and radiologist-performed ultrasound (RPUS) were evaluated. Results: Both radiologists and surgeons visualized the gallstones of each patient in all cases. The sensitivity, specificity, accuracy, and NPV for acute cholecystitis by SPUS were 84.2%, 92.1%, 90%, and 94%, respectively, whereas the sensitivity, specificity, accuracy, and NPV for acute cholecystitis by RPUS were 92.3%, 85.9%, 87.1%, and 98%, respectively. Conclusions: Both SPUS and RPUS had a high accuracy rate in electing the acute cholecystitis. Our data support the fact that the use of US by general surgeons is effective in the diagnosis of acute cholecystitis.
Gallbladder Polyps in Metachromatic Leukodystrophy Metachromatic leukodystrophy (MLD) is an autosomal recessive lysosomal storage disease, caused by a deficiency of arylsulfatase A, and leads to demyelination of the nervous system. A putative association between MLD and gallbladder pathology including malignancy is documented in the medical literature. Case report: A 10-year-old boy with MLD was found to have a papillary growth within a cystically dilated gallbladder. The lesion was confirmed to be papillomatosis/polyp with focal intestinal metaplasia. Dysplasia was not identified. Conclusion: MLD may be associated with a spectrum of gallbladder pathology including neoplastic conditions. Pathologists and clinicians should be aware of this association/risk. The patient may be offered regular ultrasound screening of the gallbladder.
Real-time contrast-enhanced ultrasound-guided percutaneous biopsy in the diagnosis of ovarian metastasis of gallbladder carcinoma: a case report Multiple-organ primary tumors can invade the ovary through lymphatic and hematogenous routes, presenting as ovarian Krukenberg tumors, but these rarely originate from the gallbladder. Krukenberg tumors can present similar to primary ovarian tumors; however, their treatments are completely different.
Therapeutic Endoscopic Ultrasound: Current Indications and Future Perspectives The transcendence of endoscopic ultrasound (EUS) from diagnostic to therapeutic tool has revolutionized management options in the field of gastroenterology. Through EUS-guided methods, pancreaticobiliary obstruction can now be utilized as an alternative to surgical and percutaneous approaches. This modality also allows for gallbladder drainage in patients who are not ideal operative candidates. By utilizing its unique imaging capabilities, EUS also allows for drainage access points in cases of gastric outlet obstruction as well as windows to ablate pancreatic cystic lesions. As technical progress continues to evolve, interventional gastroenterology continues to push the envelope of minimally invasive therapeutic procedures in a multidisciplinary setting. In this comprehensive review, we set out to describe current indications and innovations through EUS.
Endoscopic Ultrasound-Guided Gallbladder Drainage for Malignant Biliary Obstruction: A Systematic Review Endoscopic ultrasound-guided gallbladder drainage is emerging as an important technique for patients with malignant biliary obstruction where ERCP has failed. This meta-analysis is conducted to evaluate the efficacy and safety of this procedure. A comprehensive search of key databases was conducted, and all relevant studies were interrogated. A total of 7 studies were included in the final analysis with a total of 136 patients. The pooled clinical success rate of the procedure was 85%. Adverse events occurred in 13% of cases. No severe adverse events were reported. This meta-analysis supports the use of endoscopic ultrasound-guided drainage in malignant biliary obstruction when standard treatment has failed.
Differential diagnosis of gallbladder neoplastic polyps and cholesterol polyps with radiomics of dual modal ultrasound: a pilot study To verify whether radiomics techniques based on dual-modality ultrasound consisting of B-mode and superb microvascular imaging (SMI) can improve the accuracy of the differentiation between gallbladder neoplastic polyps and cholesterol polyps.
Ultrasound Surveillance of Small, Incidentally Detected Gallbladder Polyps: Projected Benefits by Gender, Age, and Comorbidity Level Incidentally detected gallbladder polyps are commonly encountered when performing upper abdominal ultrasound. Our purpose was to estimate the life expectancy (LE) benefit of ultrasound-based gallbladder surveillance in patients with small (6 to
Gallbladder Imaging Interpretation Pearls and Pitfalls: Ultrasound, Computed Tomography, and Magnetic Resonance Imaging Gallbladder disease is a common clinical problem in both emergent and nonemergent settings and includes both malignant and benign etiologies. Imaging evaluation of the right upper quadrant plays a key role in establishing the correct diagnosis. Clinical history, physical examination, and laboratory values are important in the accurate imaging assessment of the right upper quadrant. Significant overlap in imaging features of both benign and malignant etiologies can pose diagnostic dilemmas.

Contrast-enhanced ultrasound performance in predicting blunt splenic injuries requiring only observation and monitoring To assess contrast enhanced ultrasound (CEUS) performance in the prediction of non-operatively managed blunt spleen injuries requiring only observation and monitoring during follow-up and to evaluate if CEUS accuracy was higher than conventional ultrasound (US) in this field.
Determination of normal dimension of the spleen by ultrasound in an endemic tropical environment To determine the normal dimensions of spleen by ultrasonography in our environment exposed to endemic tropical infection and infestation. Materials and Methods: A prospective study of normal spleen ultrasound-based measurements in 200 Nigerian adults at the University of Benin Teaching Hospital Benin, Nigeria.
Splenic injury sustained during body hardening drills and the utility of ultrasound in a prehospital combat medical environment This report describes a case of intra-abdominal hemorrhage from body hardening drills in a U.S. soldier during Operation Iraqi Freedom. In body hardening, participants allow themselves to be repeatedly punched and kicked in an effort to impart physical resilience. Portable sonography was used to diagnose hemoperitoneum and to guide the decision for urgent surgical evacuation, ultimately resulting in splenectomy. The case illustrates the risks of body hardening, the medical challenges unique to a prehospital combat environment, and the utility of ultrasound in this setting.
Ultrasound Assessment of the Relevance of Liver, Spleen, and Kidney Dimensions with Body Parameters in Adolescents Ultrasound is a practical imaging modality for screening and identification of anomalies in the organs. This study used ultrasonography to examine the association between body parameters and dimensions of the normal liver, spleen, and kidney in adolescents based on ultrasound examination results.
Endoscopic ultrasound-guided fine needle aspiration in the diagnosis of non-Hodgkin's diffuse large B-cell lymphoma with pancreatic metastasis A 43-year-old female was admitted to our hospital with intermittent fever and left upper abdominal pain for one month. Enhanced computed tomography showed a hypodense lesion in the tail of pancreas and multiple lesions in the spleen, multiple swollen lymph nodes in the hepatic-gastric space, spleen-gastric space, mesentery and around the pancreas. Serum IGg4 and tumor markers were normal and endoscopic ultrasonography (EUS) was prepared.
Ultrasound Elastography in Children Ultrasound elastography is a novel ultrasound technique, being extensively researched in children in the last decade. It measures tissue elasticity with the observation of tissue response after an external stimulus. From research to clinical practice, ultrasound elastography has evolved significantly in liver fibrosis evaluation in children; however, several other applications of the technique are available in both clinical practice and research environments. Practically, in children any organ can be assessed, including the brain in early ages, along with muscle and connective tissue elasticity evaluation, spleen, kidney, skin, lymphatic tissue, etc. The elastography method, age, body mass index and technical points should be considered when performing ultrasound elastography. This review highlights its vast potential as a diagnostic tool in the pediatric population, where ultrasound is a dominant imaging tool; however, the indications and exam protocol for its clinical use in several fields in pediatrics have yet to be elucidated.
Intrapancreatic Accessory Spleen: A Diagnosis Not to Forget! A 69-year-old male patient was incidentally diagnosed with a 5-mm lesion in the pancreatic tail by endoscopic ultrasound (EUS). After contrast-enhanced EUS and EUS-elastography, all imaging features were highly suggestive of a benign pancreatic solid lesion such as an intrapancreatic accessory spleen (IPAS) or a benign neuroendocrine tumor. Interposition of the splenic artery precluded EUS-guided fine-needle aspiration (FNA). When an asymptomatic pancreatic mass is detected, IPAS diagnosis should be considered, and, if EUS-FNA is infeasible, contrast-enhanced EUS and EUS-elastography are useful tools to differentiate a pancreatic benign lesion as IPAS from a malignancy, with avoidance of unnecessary surgery.
Deep learning-based quality-controlled spleen assessment from ultrasound images Splenomegaly (abnormal splenic enlargement) is a potentially life-threatening condition that occurs in a range of clinical scenarios, including in patients suffering from Sickle cell disease (SCD). Therefore, spleen size assessments from ultrasound imaging are commonly performed in SCD clinics, and typically involve measuring the length of the spleen. However, the current workflow is prone to intra- and inter-observer variability and is dependent on the experience of the sonographer. Our objective was to automate the spleen length measurement process.
Ultrasound detection of spontaneous rupture of accessory spleen: A case report Accessory spleen rupture can induce acute abdominal bleeding following minimal trauma or by atraumatic mechanisms. Spleen rupture is more frequent in pediatric patients and those affected by hematological diseases. We described the case of a 59-year-old male patient affected by hereditary spherocytosis referred to the emergency department for abdominal left side pain. An early ultrasound performed in the emergency department allowed to diagnosed hemoperitoneum by spontaneous bleeding of hypertrophic accessory spleen. Although abdomen computed tomography is the diagnostic method of choice, ultrasound can early detect sign of emoperitoneum in the emergency setting in case of hemodinamically unstable patient.
The role of prehospital ultrasound in reducing time to definitive care in abdominal trauma patients with moderate to severe liver and spleen injuries The role of prehospital focused assessment sonography for trauma (FAST) is still under debate and no definitive recommendations are available in actual guidelines, moreover, the availability of ultrasound machines in emergency medical services (EMS) is still inhomogeneous. On the other hand, time to definitive care is strictly related to survival in bleeding trauma patients. This study aimed at investigating if a positive prehospital FAST in abdominal trauma patients could have a role in reducing door-to-CT scan or door-to-operating room (OR) time.

Correlation between Cardiac Ultrasound-Related Indicators and Cardiac Function in Patients with Coronary Heart Disease and Heart Failure The purpose of this paper is to analyse the correlation between cardiac ultrasound-related indicators and cardiac function in patients with coronary heart disease and heart failure. Methods. In this experiment, a total of 160 patients with coronary heart disease and heart failure who were diagnosed and treated in our hospital from June 2019 to March 2021 were recruited as the study group. All were examined by colour Doppler ultrasound instrument, SPSS statistical software was used to analyse the data obtained, and Spearman correlation was used to analyse the correlation between cardiac ultrasound-related indicators and cardiac function in patients with coronary heart disease and heart failure. Results. In the study group, there were 68 patients with grade II cardiac function, accounting for 42.50%; 74 patients with grade III, accounting for 46.25%; and 18 patients with grade IV, accounting for 11.25%. The ultrasound parameters of the patients in the study group were profiled and calculated, and then statistically analysed with cardiac function grading. Cardiac function classification was significantly positively correlated with LVMI, LAD, and LVEDd (r = 0.689/0.915/0.928, P = 0.001) and significantly negatively correlated with CI, LVFS, and LVEF (r = −0.689/−0.878/−0.912), P = 0.001). Conclusion. Cardiac ultrasound-related indicators are associated with patients with coronary heart disease and heart failure. With the decline of cardiac function in patients with coronary heart disease and heart failure, the patient's condition is aggravated. Therefore, cardiac ultrasound-related indicators play a major role in the diagnosis of clinical disease progression.
Diagnostic Value and Clinical Performance of Cardiac Ultrasound in Patients with Chronic Heart Failure with Hypertension To assess the diagnostic value and clinical performance of cardiac ultrasound in patients with chronic heart failure and hypertension. Methods. In this prospective study, between August 2017 and January 2020, 50 patients with chronic heart failure and hypertension were recruited and assigned to the study group and 50 healthy individuals during the same period after physical examinations were included in the control group. Cardiac ultrasound examinations were performed on the participants, and the results were compared and analyzed. Results. The study group had a higher left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF), and late diastolic peak flow velocity (A wave) and showed lower early diastolic peak flow velocity (E wave) and late diastolic peak flow velocity/lower early diastolic peak flow velocity (E/A) ratio levels than in the control group. The study group had 15 patients with grade I cardiac function (ultrasound detection rate of 100%), 18 patients with grade II cardiac function (ultrasound detection rate of 100%), and 17 patients with grade III cardiac function (ultrasound detection rate of 100%). Grade I cardiac function patients showed the lowest LVEDD, LVESD, and E/A and the highest LVEF than grade II patients, followed by grade III patients. The study group showed higher LVEF and echocardiographic estimation of the pulmonary arterial systolic pressure (PASP) and lower right ventricular lateral wall systolic excursion velocity and tricuspid annular plane systolic excursion (TAPSE) than the control group. Chronic heart failure with hypertension was associated with high levels of right atrial total emptying volume (RAVIt), right atrial passive emptying volume (RAVIp), right atrial active emptying volume (RAVIa), and right atrial active emptying fraction (RAVIaEF) and low levels of right atrial total emptying fraction (RAVItEF) and right atrial passive emptying fraction (RAVIpEF) versus the healthy status (all P < 0.05). Conclusion. Cardiac ultrasound is a noninvasive operation with low cost, high repeatability, and accurate detection, which can identify right heart function impairment at an early stage, assist clinical treatment, and improve patient prognosis, so it is worthy of promotion and application.
Ultrasound of Fetal Cardiac Function Changes in Pregnancy-Induced Hypertension Syndrome Pregnancy-induced hypertension syndrome (PIH) is a common pregnancy syndrome that could cause varying degrees of maternal and fetal organic damage and even endanger their lives. This study aimed to investigate ultrasound of fetal cardiac function changes in PIH. Totally 40 cases of gestational hypertension admitted to Cangzhou Central Hospital between October 2018 and September 2019 were enrolled in the hypertension group, and 40 women with healthy pregnancies during the same period were assigned to the normal group. Ultrasound results showed that PIH was associated with a significantly higher fetal cardiac septal thickness, fetal left ventricular end-diastolic area and end-systolic area, fetal right ventricular end-diastolic area and end-systolic area, fetal left ventricular systolic fraction 1 (VSF1), fetal left ventricular systolic fraction 2 (VSF2), fetal right VSF1, and fetal right VSF2 versus healthy pregnancy. The PIH fetuses had significantly lower neonatal weights versus healthy fetuses. Newborns of hypertensive pregnancies have larger hearts, faster heart rates, increased cardiac contractility, and lower weights versus newborns of healthy pregnancies.
Heart Failure with Reduced Ejection Fraction: The Role of Cardiovascular and Lung Ultrasound beyond Ejection Fraction Heart failure with reduced ejection fraction (HFrEF) is considered a major health care problem with frequent decompensations, high hospitalization and mortality rates. In severe heart failure (HF), the symptoms are refractory to medical treatment and require advanced therapeutic strategies. Early recognition of HF sub- and decompensation is the cornerstone of the timely treatment intensification and, therefore, improvement in the prognosis. Echocardiography is the gold standard for the assessment of systolic and diastolic functions. It allows one to obtain accurate and non-invasive measurements of the ventricular function in HF. In severely compromised HF patients, advanced cardiovascular ultrasound modalities may provide a better assessment of intracardiac hemodynamic changes and subclinical congestion. Particularly, cardiovascular and lung ultrasound allow us to make a more accurate diagnosis of subclinical congestion in HFrEF. The aim of this review was to summarize the advantages and limitations of the currently available ultrasound modalities in the ambulatory monitoring of patients with HFrEF.
The Role of the Piezo1 Mechanosensitive Channel in Heart Failure Mechanotransduction (MT) is inseparable from the pathobiology of heart failure (HF). However, the effects of mechanical forces on HF remain unclear. This review briefly describes how Piezo1 functions in HF-affected cells, including endothelial cells (ECs), cardiac fibroblasts (CFs), cardiomyocytes (CMs), and immune cells. Piezo1 is a mechanosensitive ion channel that has been extensively studied in recent years. Piezo1 responds to different mechanical forces and converts them into intracellular signals. The pathways that modulate the Piezo1 switch have also been briefly described. Experimental drugs that specifically activate Piezo1-like proteins, such as Yoda1, Jedi1, and Jedi2, are available for clinical studies to treat Piezo1-related diseases. The only mechanosensitive ion-channel-specific inhibitor available is GsMTx4, which can turn off Piezo1 by modulating the local membrane tension. Ultrasound waves can modulate Piezo1 switching in vitro with the assistance of microbubbles. This review provides new possible targets for heart failure therapy by exploring the cellular functions of Piezo1 that are involved in the progression of the disease. Modulation of Piezo1 activity may, therefore, effectively delay the progression of heart failure.
Point of care ultrasound impact in acute heart failure hospitalization: A retrospective cohort study Acute decompensated heart failure (ADHF) is one of the most frequent causes of emergency department (ED) visits. Point-of-Care Ultrasound (POCUS) is a reliable, easy-to-use, and available tool for an accurate diagnosis of ADHF. We aimed to analyze the impact of introducing POCUS as an additional tool to clinical standard diagnosis in clinical times of hospitalized heart failure patients.
Clinical Influence of Handheld Ultrasound, Supported by Automatic Quantification and Telemedicine, in Suspected Heart Failure Early and correct heart failure (HF) diagnosis is essential to improvement of patient care. We aimed to evaluate the clinical influence of handheld ultrasound device (HUD) examinations by general practitioners (GPs) in patients with suspected HF with or without the use of automatic measurement of left ventricular (LV) ejection fraction (autoEF), mitral annular plane systolic excursion (autoMAPSE) and telemedical support. Five GPs with limited ultrasound experience examined 166 patients with suspected HF (median interquartile range = 70 (63–78) y; mean ± SD EF = 53 ± 10%). They first performed a clinical examination. Second, they added an examination with HUD, automatic quantification tools and, finally, telemedical support by an external cardiologist. At all stages, the GPs considered whether the patients had HF. The final diagnosis was made by one of five cardiologists using medical history and clinical evaluation including a standard echocardiography. Compared with the cardiologists’ decision, the GPs correctly classified 54% by clinical evaluation. The proportion increased to 71% after adding HUDs, and to 74 % after telemedical evaluation. Net reclassification improvement was highest for HUD with telemedicine. There was no significant benefit of the automatic tools (p ≥ 0.58). Addition of HUD and telemedicine improved the GPs’ diagnostic precision in suspected HF. Automatic LV quantification added no benefit. Refined algorithms and more training may be needed before inexperienced users benefit from automatic quantification of cardiac function by HUDs.
Bedside ultrasound to assess acute central venous pressure change during treatment of decompensated heart failure Accurate volume status assessment is crucial for the treatment of acute decompensated heart failure (ADHF). Volume status assessment by physical exam is often inaccurate, necessitating invasive measurement with right heart catheterization (RHC), which carries safety, pragmatic (scheduling, holding anticoagulants, etc.), and financial burdens. Therefore, a reliable, non-invasive, cost-effective alternative is desired. Previously, we developed an ultrasound (US) based technique to measure internal jugular vein (IJV) compliance during RHC which was used for single time point central venous pressure (CVP) predictions. We now aim to apply this technique to track acute changes in CVP during diuresis for ADHF in patients with an in-dwelling pulmonary artery catheter (PAC).

Vascular Structure Identification in Intraoperative 3D Contrast-Enhanced Ultrasound Data In this paper, a method of vascular structure identification in intraoperative 3D Contrast-Enhanced Ultrasound (CEUS) data is presented. Ultrasound imaging is commonly used in brain tumor surgery to investigate in real time the current status of cerebral structures. The use of an ultrasound contrast agent enables to highlight tumor tissue, but also surrounding blood vessels. However, these structures can be used as landmarks to estimate and correct the brain shift. This work proposes an alternative method for extracting small vascular segments close to the tumor as landmark. The patient image dataset involved in brain tumor operations includes preoperative contrast T1MR (cT1MR) data and 3D intraoperative contrast enhanced ultrasound data acquired before (3D-iCEUS(start) and after (3D-iCEUS(end) tumor resection. Based on rigid registration techniques, a preselected vascular segment in cT1MR is searched in 3D-iCEUS(start) and 3D-iCEUS(end) data. The method was validated by using three similarity measures (Normalized Gradient Field, Normalized Mutual Information and Normalized Cross Correlation). Tests were performed on data obtained from ten patients overcoming a brain tumor operation and it succeeded in nine cases. Despite the small size of the vascular structures, the artifacts in the ultrasound images and the brain tissue deformations, blood vessels were successfully identified.
Handheld Real-Time LED-Based Photoacoustic and Ultrasound Imaging System for Accurate Visualization of Clinical Metal Needles and Superficial Vasculature to Guide Minimally Invasive Procedures Ultrasound imaging is widely used to guide minimally invasive procedures, but the visualization of the invasive medical device and the procedure’s target is often challenging. Photoacoustic imaging has shown great promise for guiding minimally invasive procedures, but clinical translation of this technology has often been limited by bulky and expensive excitation sources. In this work, we demonstrate the feasibility of guiding minimally invasive procedures using a dual-mode photoacoustic and ultrasound imaging system with excitation from compact arrays of light-emitting diodes (LEDs) at 850 nm. Three validation experiments were performed. First, clinical metal needles inserted into biological tissue were imaged. Second, the imaging depth of the system was characterized using a blood-vessel-mimicking phantom. Third, the superficial vasculature in human volunteers was imaged. It was found that photoacoustic imaging enabled needle visualization with signal-to-noise ratios that were 1.2 to 2.2 times higher than those obtained with ultrasound imaging, over insertion angles of 26 to 51 degrees. With the blood vessel mimicking phantom, the maximum imaging depth was 38 mm. The superficial vasculature of a human middle finger and a human wrist were clearly visualized in real-time. We conclude that the LED-based system is promising for guiding minimally invasive procedures with peripheral tissue targets.
Non-contrast agent based small vessel imaging of human thyroid using motion corrected power Doppler imaging Singular value based spatiotemporal clutter filtering (SVD-STF) can significantly improve the sensitivity of blood flow imaging in small vessels without using contrast agents. However, despite effective clutter filtering, large physiological motion in thyroid imaging can impact coherent integration of the Doppler signal and degrade the visualization of the underlying vasculature. In this study, we hypothesize that motion correction of the clutter filtered Doppler ensemble, prior to the power Doppler estimation, can considerably improve the visualization of smalls vessels in suspicious thyroid nodules. We corroborated this hypothesis by conducting in vivo experiments on 10 female patients in the age group 44-82 yrs, with at least one thyroid nodule suspicious of malignancy, with recommendation for fine needle aspiration biopsy. Ultrasound images were acquired using a clinical ultrasound scanner, implemented with compounded plane wave imaging. Axial and lateral displacements associated with the thyroid nodules were estimated using 2D normalized cross-correlation. Subsequently, the tissue clutter associated with the Doppler ensemble was suppressed using SVD-STF. Motion correction of the clutter-filtered Doppler ensemble was achieved using a spline based sub-pixel interpolation. The results demonstrated that power Doppler images of thyroid nodules were noticeably degraded due to large physiological motion of the pulsating carotid artery in the proximity. The resultant power Doppler images were corrupted with signal distortion, motion blurring and occurrence of artificial shadow vessels and displayed visibly low signal-to-background contrast. In contrast, the power Doppler images obtained from the motion corrected ultrasound data addressed the issue and considerabley improved the visualization of blood flow. The signal-to-noise ratio and the contrast-to-noise ratio increased by up to 15.2 dB and 12.1 dB, respectively. Across the ten subjects, the highest improvement was observed for the nodule with the largest motion. These preliminary results show the ability of using motion correction to improve the visualization of small vessel blood flow in thyroid, without using any contrast agents. The results of this feasibility study were encouraging, and warrant further development and more in vivo validation in moving tissues and organs.
Vascularization and perfusion of hepatocellular carcinoma: assessment with contrast-enhanced ultrasound using perflutren protein-type A microspheres To assess the vascularization and the perfusion within hepatocellular carcinoma (HCC) including treatment-related changes with contrast-enhanced (CE) ultrasound (US).
Ultrasound, a new adjuvant method for treating acute Monteggia fracture in children This study aims to evaluate the feasibility of using ultrasound-guided Kirschner wire or elastic intramedullary nail for fixation in the treatment of acute Monteggia fracture in children.
Diagnosis of thoracic outlet syndrome with the lower trunk compression of brachial plexus by high-frequency ultrasonography Thoracic outlet syndrome (TOS) with the lower trunk compression of brachial plexus (BP) is difficult to diagnosis. This study aimed to summarize the features of thoracic outlet syndrome (TOS) with the lower trunk compression of brachial plexus observed on high-frequency ultrasonography (HFUS).
A computer simulation model for Doppler ultrasound signals from pulsatile blood flow in stenosed vessels A computer simulation model based on an analytic flow velocity distribution is proposed to generate Doppler ultrasound signals from pulsatile blood flow in the vessels with various stenosis degrees. The model takes into account the velocity field from pulsatile blood flow in the stenosed vessels, sample volume shape and acoustic factors that affect the Doppler signals. By analytically solving the Navier–Stokes equations, the velocity distributions of pulsatile blood flow in the vessels with various stenosis degrees are firstly calculated according to the velocity at the axis of the circular tube. Secondly, power spectral density (PSD) of the Doppler signals is estimated by summing the contribution of all scatterers passing through the sample volume grouped into elemental volumes. Finally, Doppler signals are generated using cosine-superposed components that are modulated by the PSD functions that vary over the cardiac cycle. The results show that the model generates Doppler blood flow signals with characteristics similar to those found in practice. It could be concluded that the proposed approach offers the advantages of computational simplicity and practicality for simulating Doppler ultrasound signals from pulsatile blood flow in stenosed vessels.
Simulation study on acoustic streaming and convective cooling in blood vessels during a high-intensity focused ultrasound thermal ablation This study investigates the influence of blood vessels on temperature distribution during high-intensity focused ultrasound (HIFU) ablation of liver tumors. A three-dimensional acoustics-thermal-fluid coupling model is simulated to compute the temperature field in the hepatic cancerous region. The model is based on the linear Westervelt and bioheat equations as well as the non-linear Navier–Stokes equations for the liver parenchyma and blood vessels. The effect of acoustic streaming is also taken into account in the present HIFU simulation study. We found from this three-dimensional coupling study that in large blood vessel both the convective cooling and acoustic streaming can significantly change the temperature field and thermal lesion near blood vessels.
Contrast-Enhanced High-Frame-Rate Ultrasound Imaging of Flow Patterns in Cardiac Chambers and Deep Vessels Cardiac function and vascular function are closely related to the flow of blood within. The flow velocities in these larger cavities easily reach 1 m/s, and generally complex spatiotemporal flow patterns are involved, especially in a non-physiologic state. Visualization of such flow patterns using ultrasound can be greatly enhanced by administration of contrast agents. Tracking the high-velocity complex flows is challenging with current clinical echographic tools, mostly because of limitations in signal-to-noise ratio; estimation of lateral velocities; and/or frame rate of the contrast-enhanced imaging mode. This review addresses the state of the art in 2-D high-frame-rate contrast-enhanced echography of ventricular and deep-vessel flow, from both technological and clinical perspectives. It concludes that current advanced ultrasound equipment is technologically ready for use in human contrast-enhanced studies, thus potentially leading to identification of the most clinically relevant flow parameters for quantifying cardiac and vascular function.

Ultrasound examination of the normal pancreas The pancreas is a challenge for the beginner in ultrasonography, but patience, perseverance and experience will lead to a complete and correct evaluation of the organ in almost all cases. A correct examination of the pancreas requires the patient's fasting 7 to 8 hours before the examination. Transverse and longitudinal upper epigastric sections are used to visualize the pancreas, as well as oblique intercostal and subcostal sections (especially for the head and tail). The best ultrasound windows are obtained by using high epigastric sections (that avoid the colon), also by using transgastric sections and sections that use the left liver lobe as an acoustic window. In order to better visualize the pancreas, it is useful to invite the patient to drink 500-700 ml of still water 10-15 minutes before the examination. To highlight the pancreas, we will start by viewing the landmarks: posterior--the porto-splenic axis and anterior--the gastric antrum and/or the left liver lobe. The echogeneity of the normal pancreas can vary, from hypoechoic to hyperechoic, all normal, provided that the pancreatic parenchyma structure is fine and homogeneous. The Wirsung duct can be visualized in some of the cases, especially in thin patients, its normal maximum diameter should be < 2 mm. For a correct evaluation of the pancreas all its segments must be visualized: head, uncinate process, body, and tail - the latter being the most difficult to visualize.
A planning strategy for combined motion-assisted/gated MR guided focused ultrasound treatment of the pancreas To develop and evaluate a combined motion-assisted/gated MRHIFU heating strategy designed to accelerate the treatment procedure by reducing the required number of sonications to ablate a target volume in the pancreas. Methods: A planning method for combined motion-assisted/gated MRHIFU using 4D-MRI and motion characterization is introduced. Six healthy volunteers underwent 4D-MRI for target motion characterization on a 3.0-T clinical scanner. Using displacement patterns, simulations were performed for all volunteers for three sonication approaches: gated, combined motion-assisted/gated, and static. The number of sonications needed to ablate the pancreas head was compared. The influence of displacement amplitude and target volume size was investigated. Spherical target volumes (8, 15, 20 and 34 mL) and displacement amplitudes ranging from 5 to 25 mm were evaluated. For this case, the number of sonications required to ablate the whole target was determined.
Diagnosis of pancreatic solid pseudopapillary neoplasms using cell-blocks and immunohistochemical evaluation of endoscopic ultrasound-guided fine needle aspiration biopsy specimens Preoperative diagnostic imaging of pancreatic solid pseudopapillary neoplasms (SPNs) is challenging. A few studies have investigated the role of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for the diagnosis of SPN. We investigated the diagnostic yield of cell-blocks and immunohistochemistry (IHC) for SPN using EUS-FNA specimens without cytological evaluation.
Contrast-enhanced ultrasound of the transplant pancreas in the post-operative setting Vascular thrombosis is the most common cause of early graft loss after transplantation. Routine grayscale and Doppler ultrasound frequently fail to adequately visualize vascular compromise. Contrast-enhanced ultrasound is a novel approach to identifying these complications.
Endoscopic ultrasound-guided fine needle aspiration in the diagnosis of non-Hodgkin's diffuse large B-cell lymphoma with pancreatic metastasis A 43-year-old female was admitted to our hospital with intermittent fever and left upper abdominal pain for one month. Enhanced computed tomography showed a hypodense lesion in the tail of pancreas and multiple lesions in the spleen, multiple swollen lymph nodes in the hepatic-gastric space, spleen-gastric space, mesentery and around the pancreas. Serum IGg4 and tumor markers were normal and endoscopic ultrasonography (EUS) was prepared. EUS scanning showed a solid mass in the tail of the pancreas, adjacent to the spleen. Color doppler showed rich blood flow and contrast-enhanced harmonic EUS (CH-EUS) indicated homogeneous filling of contrast agent (Fig. 1A and B). Multiple hypoechoic lesions with a regular morphology were seen in the spleen, the largest one located in the upper pole of the spleen, and CH-EUS indicated homogeneous filling of contrast agent (Fig. 1C and D). Multiple swollen lymph nodes with clear boundaries were seen in the hilar of the liver (Fig. 1E and F). EUS-f ine needle aspiration (EUS-FNA) with a 19-gauge needle obtained samples of the pancreatic mass and two larger hepatic hilar lymph nodes. All samples were diagnosed as non-Hodgkin's diffuse large B-cell lymphoma by pathology and immunohistochemistry (Fig. 1G and H). The patient also had splenic metastasis, thus, lymphoma with multiple metastasis was considered. The patient received chemotherapy and her symptoms were relieved.
Relevance of Endoscopic Ultrasound in Endocrinology Today: Multiple Endocrine Neoplasia Type 1, Insulinoma, Primary Aldosteronism—An Expert’s Perspective Based on Three Decades of Scientific and Clinical Experience In endocrinology, endoscopic ultrasound is a useful and reliable diagnostic technique in the assessment of multiple endocrine neoplasia type 1, localizing insulinomas, and identifying aldosterone-producing adenomas. In endocrinology, endoscopic ultrasound (EUS) may be used to image the adrenals, the endocrine pancreas, and other organs where endocrine neoplasms may occur. During the recent decades, EUS has been established predominantly to assess multiple endocrine neoplasia type 1, to localize insulinomas, and to identify aldosterone-producing adenomas. EUS in endocrinology requires special skills and individual experience in order to provide reliable diagnostic information.
Endoscopic ultrasound (EUS) guided choledocoduodenostomy in a patient with irresecable pancreas cancer and biliar obstruction using a luminal apposing metal stent (LAMS) The endoscopic retrograde cholangiopancreatography (ERCP) is the election treatment of biliary obstruction. EUS-guided biliary drainage (EUS-BD) has emerged as an alternative to PTBD with a high technical and clinical success rate, low risk of complications and a better quality of life for the patient. Case presentation we present the first case in Colombia of EUS-guided biliary drainage using luminal apposing metal stent (LAMS) in a patient with unresectable pancreatic adenocarcinoma with biliary obstruction in who ERCP was failed due to neoplastic invasion of the Vater papilla. Discussion Transhepatic biliary drainage has been the most common procedure for treatment of malignant biliary obstruction in cases which ERCP fails due to tumor infiltration of the duodenum or the Vater papilla. During the last decade the development of endoscopic ultrasound (EUS) has implied an alternative for biliary drainage in cases of failed ERCP, demonstrating advantages over Trans hepatic biliary drainage Conclusion Considering that EUS-CD is a safe procedure, with a high rate of technical and clinical success, low risk of complications.
Endoscopic-ultrasound-guided cystogastrostomy for walled-off necrosis of the pancreas Walled-off necrosis of the pancreas is defined as a mature, encapsulated collection of pancreatic and/or peripancreatic necrosis that has developed a well-defined inflammatory wall. It usually occurs > 4 weeks after onset of necrotizing pancreatitis [1]. Minimally invasive techniques are thought to induce less physiological stress as compared with open surgical necrosectomy [2].

Choosing Articles

There may be too many resources or not enough resources depending on the search terms you are using. There are multiple ways you can adjust your searches to increase or decrease the sources you are receiving. You can choose to look at articles printed in a particular time frame. You can choose specific types of articles or choose different search terms. Generally, you will find the options for narrowing down the number of articles on the left hand side of each database. Remember, the most important part of the research process is writing down and using keywords. See below for a list of keywords based on the suggested topics listed on this page.

Reproductive Organs

Genitalia

Muscles and tendons

Rotator Cuff
Tendons
Musculoskeletal

Tendons

Skeletal
Hamstring
Ligament
Sinew
Tissue

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Thyroid

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Thyroid Gland

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APA Style Resource

APA Style from the American Psychological Association is what is commonly used by nursing or those in the social sciences. This is a list of resources that can help with citing and formatting your paper correctly.

APA Formatting and Style Guide - Purdue University (OWL)
APA Style Tutorials and Webinars - APA.org

You can also locate citations for articles directly on the database. Just remember to ensure the citation is accurate. See an example for where to locate each citation button on 3 of the databases that have been recommended in this guide: EBSCO, Gale, and Science Direct.

The EBSCO citation button can be found on the right hand side of your screen. It appears as a document.

The Gale citation button can be found at the top of your screen above the article, on the right hand side. It appears as a quotation mark.

Similar to Gale, the citation button in Science Direct appears as a quotation mark. You can find this just above the article script.

Publication Manual (OFFICIAL) 7th Edition of the American Psychological Association by American Psychological Association A WALL STREET JOURNAL, USA TODAY, AND PUBLISHERS WEEKLY BESTSELLER. The newest official release of the Publication Manual of the American Psychological Association, Seventh Edition includes four different formats--spiral-bound and tabbed, paperback, hardcover, and ebook, all of which are in full color. It is the official source for APA Style. With millions of copies sold worldwide in multiple languages, the Publication Manual of the American Psychological Association, Seventh Edition is the style manual of choice for writers, researchers, editors, students, and educators in the social and behavioral sciences, natural sciences, nursing, communications, education, business, engineering, and other fields.  Known for its authoritative, easy-to-use reference and citation system, the Publication Manual also offers guidance on choosing the headings, tables, figures, language, and tone that will result in powerful, concise, and elegant scholarly communication. It guides users through the scholarly writing process--from the ethics of authorship to reporting research through publication. The seventh edition is an indispensable resource for students and professionals to achieve excellence in writing and make an impact with their work.   The seventh edition has been thoroughly revised and updated to reflect best practices in scholarly writing and publishing. All formats are in full color, with a new tabbed spiral version Easy navigation, with topics divided into numbered sections to help users quickly location the information they need  Resources for students on writing and formatting annotated bibliographies, response papers, and other paper types, guidelines on citing course materials, and guidance on writing clearly, precisely, and concisely Dedicated chapter for new users of APA Style covering paper elements and format, including sample papers for both professional authors and student writers New chapter on journal article reporting standards (JARS) that includes updates to reporting standards for quantitative research and the first-ever qualitative and mixed methods reporting standards in APA Style Updated chapter on bias-free language guidelines for writing about people with respect and inclusivity in areas including age, disability, gender, participation in research, racial and ethnic identity, sexual orientation, socioeconomic status, and intersectionality  Updated chapter on essential style guidelines for scholarly writing, including punctuation, italics, capitalization, abbreviations, and numbers  More than 40 new sample tables and figures Expanded guidance on ethical writing and publishing practices, including how to ensure the appropriate level of citation, avoid plagiarism and self-plagiarism, and navigate the publication process More than 100 new reference examples covering periodicals, books, audiovisual media, social media, webpages and websites, legal resources, and many other document types  Guidelines that support accessibility for all users, including simplified reference, in-text citation, and heading formats as well as additional font options
Call Number: BF76.7 .P83 2020
ISBN: 9781433832154
Publication Date: 2019-10-01