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Thứ Hai, ngày 31 tháng 8 năm 2015

J MEDICAL ULTRASOUND Sept 2015



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Ultrasound and Retained Products of Conception
Accepted: March 2, 2015; Published Online: May 04, 2015
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Early pregnancy loss is a serious psychological emergency in obstetrics [1]. In this issue, Esmaeillou et al [2] offer a highly educative article entitled Accurate detection of retained products of conception after first- and second-trimester by color Doppler sonography. Making an accurate diagnosis of retained products of conception (RPOC) is a major clinical challenge. Because RPOC may cause prolonged bleeding, endometritis, and intrauterine adhesion—Asherman's syndrome—with subsequently impaired fertility in the future [3], therapeutic intervention is mandatory.
© 2015 Published by Elsevier Inc.
Renal Tumors
Received: February 12, 2015; Accepted: March 10, 2015; Published Online: June 18, 2015
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Renal tumors can be classified as benign or malignant. The former include angiomyolipoma, renal cell adenoma, and oncocytoma; the latter include renal cell carcinoma, urothelial cell carcinoma, and other less common primary or metastatic cancers [1,2]. This article addresses the renal tumors that are most commonly observed in a clinical setting: angiomyolipomas, renal cell carcinomas, and urothelial cell carcinomas.
© 2015 Published by Elsevier Inc.
Physician-performed Focused Ultrasound: An Update on Its Role and Performance
Received: February 13, 2015; Accepted: February 25, 2015; Published Online: March 26, 2015
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There is an increase in the use of focused ultrasound (US) by physicians because it offers the major benefit of reduction in time to diagnosis. Some of these physicians have received formal training on focused US, others have not received any such training. However, among the formal training given on focused US, there is inconsistency across the teaching protocols. This review presents performances of focused US commonly performed by physicians, compared with radiology US. The various teaching protocols are also discussed.
© 2015 Published by Elsevier Inc.
Ultrasound-guided Corticosteroid Injection for the Treatment of Athletic Pubalgia: A Series of 12 Cases
Received: August 5, 2014; Accepted: November 24, 2014; Published Online: February 24, 2015
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Surgical treatment for athletic pubalgia is the standard of care, however, it poses risks. This study investigated the use of ultrasound-guided corticosteroid injections as an alternative treatment. Twelve consecutive patients underwent injections into the area of degeneration in the rectus abdominis and/or adductor longus aponeurosis. The Western Ontario and McMaster Universities (WOMAC) scores were used to evaluate treatment effectiveness. The average WOMAC score was 90.9. With a mean follow up of 8.7 months (range, 6–19 months), eight of the 12 patients reported complete symptom resolution. In conclusion, corticosteroid injections alleviate pain in patients with athletic pubalgia and provide an alternative to surgery.
© 2014 Published by Elsevier Inc.
Evaluation of Therapeutic Effect of Contrast-enhanced Ultrasonography in Hepatic Carcinoma Radiofrequency Ablation and Comparison with Conventional Ultrasonography and Enhanced Computed Tomography
Received: November 4, 2014; Accepted: January 30, 2015; Published Online: March 24, 2015
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Objective
This paper aims to discuss the evaluation of the therapeutic effect of contrast-enhanced ultrasonography (CEUS) in radiofrequency ablation (RFA) for liver cancer and its application value.
Methods
A total of 80 patients (120 hepatic malignant tumor lesions) were treated using RFA, and CEUS was conducted on the liver before and after the treatment. Sixty-five patients (85/120 tumor lesions) had primary hepatic carcinoma and 11 (30/120 tumor lesions) had metastatic hepatic carcinoma (6 cases of 15 lesions had colorectal carcinoma, 3 cases of 8 lesions had lung carcinoma, and 2 cases of 7 lesions had gastric carcinoma). Four patients (5 lesions) had recurrence. Prior to the treatment, CEUS accurately guided the RFA of lesions, and after the treatment, the accuracy of CEUS was compared with conventional ultrasonography and enhanced computed tomography (CT).
Results
After the RFA, there were two cases of bile leakage, two cases of bleeding, and three cases of hydrothorax, and 20 cases had fever. In the CEUS performed after the operation, 114 of the 120 lesions (94.6%) were not filled with contrast agent in the arterial phase, venous phase, and delayed phase, indicating that the tumor lesions were totally inactivated. In the remaining six lesions, the arterial phase was enhanced partially on the edge, indicating suspected partial residues of tumor lesions. The final diagnosis was based on the aforementioned two kinds of imaging examinations in combination with the level of tumor markers, needle biopsy, and follow-up visits of over 1 month. Based on the therapeutic effects on the tumor after the operation with the final diagnosis as the standards, the accuracy of CEUS was 94.6%, whereas that of contrast-enhanced CT (CECT) and conventional ultrasonography was 93.4% and 60.5%, respectively. A comparative analysis was performed, which indicated that the difference between CEUS and conventional ultrasonography was of statistical significance (χ2 = 5.42, p < 0.05). A comparison between conventional ultrasonography and CECT was also of statistical significance (χ2 = 5.14, p < 0.05); however, the comparison between CEUS and CECT indicated no statistical significance (χ2 = 7.54, p > 0.05).
Conclusion
CEUS has important value of clinical application both prior to and after RFA operations. Prior to the operation, CEUS can accurately guide the RFA treatment, whereas after the operation, CEUS is an important method to evaluate the inactivation after the treatment, and can be an important means for follow-up visits for partial treatment of hepatic carcinoma.
© 2015 Published by Elsevier Inc.
Accuracy of Sonographic Fetal Weight Estimation in Bangladesh
Received: November 27, 2014; Accepted: February 16, 2015; Published Online: March 26, 2015
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Objective
This study was conducted to determine the accuracy of estimated fetal weight (EFW) by ultrasound, compared with birth weight (BW), in Bangladesh.
Methods
This is a prospective, cross-sectional study on well-dated singleton fetuses. The accuracy of weight-prediction formula is determined by assessing how well the formula works in a group of fetuses scanned close to delivery. Results of previous studies were compared with those of this study.
Results
A total of 73 infants were included in the analysis to determine the accuracy of EFW. The mean absolute difference between ultrasound EFW and BW was −64.5 (±218.5) g, and the mean relative difference or the mean percentage error of fetal weight estimation was −1.4% (±7.6%).
Conclusion
Ultrasound is a reliable modality for estimating fetal weight in a Bangladeshi population using the head circumference, femur length, and abdominal circumference formula of Hadlock.
© 2015 Published by Elsevier Inc.
Contrast-enhanced Ultrasound of Kidneys in Children with Renal Failure
Department of Diagnostic Imaging, National University Hospital, Singapore
Received: January 28, 2015; Accepted: April 15, 2015; Published Online: June 04, 2015
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Ultrasound (US) has been an important tool for evaluating and imaging renal pathology in children. Development of US contrast agents and dedicated software for the detection of microbubbles has given this radiological investigation a new dimension, especially in children with renal impairment. Application of contrast-enhanced US (CEUS) brings US into the domain historically occupied by computed tomography and magnetic resonance imaging. We retrospectively studied nine children who had undergone CEUS (age range 3–16 years). This pictorial essay draws on our experience and illustrates the safety and accurate depiction of enhancement pattern of focal renal lesions.
© 2015 Published by Elsevier Inc.
Discrepancy Between Duplex Sonography and Digital Subtraction Angiography When Investigating Extra- and Intracranial Ulcerated Plaque
Received: November 21, 2014; Accepted: January 5, 2015; Published Online: March 24, 2015
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Noninvasive color-coded duplex sonography has become a good, convenient, and reproducible screening tool for the general population when studying cerebral hemodynamics and atherosclerotic disease. Digital subtraction angiography (DSA) is still the gold standard for the diagnosis of carotid stenosis, although other noninvasive imaging tools are also available. At present, ultrasound scanning, followed by confirmatory DSA, is a cost-effective way to survey patients suspected of suffering from cerebral arterial stenosis. We report two patients who had cerebral ischemic symptoms due to high-grade stenosis of either the cervical internal carotid artery (ICA) or the middle cerebral artery (MCA), combined with an ulcerated plaque. Ultrasonographic Doppler analysis identified high-grade stenotic lesions as marked elevations in the turbulent flow of the cervical ICA in one patient and of the middle cerebral artery in the other patient. Subsequently, huge plaque ulceration was found by color B-mode scanning of the patient with cervical ICA stenosis. However, DSA was able to demonstrate only a mild–moderate degree of stenosis associated with the lesions. High-grade stenotic lesions of the ICA and the middle cerebral artery were reconfirmed by computed tomography angiography and magnetic resonance angiography. An atheromatous plaque with ulceration is believed to be the cause of this discrepancy between ultrasonography and DSA.
© 2015 Published by Elsevier Inc.
Ultrasound-guided Perineural Vitamin B12 Injection for Peripheral Neuropathy
Received: May 14, 2014; Accepted: January 27, 2015; Published Online: March 26, 2015
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The objective of this article is to present an innovative treatment for peripheral neuropathy using ultrasound-guided perineural vitamin B12 injection. A 37-year-old patient presented with a progressive dropped foot for 2 months. Preceding trauma was denied. On examination, severe weakness of ankle dorsiflexion was revealed. Ultrasound showed peroneal nerve swelling. Nerve conduction velocity and electromyography study showed results compatible with peroneal neuropathy. Under the diagnosis of peroneal neuropathy, the patient was given 500 μg of methylcobalamin around the peroneal nerve under ultrasound guidance two times, with an interval of 2 weeks. The patient showed improvement of muscle power within 2 weeks. Full muscle power was regained after 3 months. There was no adverse symptom after ultrasound-guided perineural vitamin B12 injection. Ultrasound-guided perineural vitamin B12 has the advantage of precise delivery of high-dose vitamin B12 directly around the defective nerve.
© 2015 Published by Elsevier Inc.
A Mass on the Right Fifth Middle Phalanx in a 48-year-old Man with Chronic Hyperuricemia
Published Online: January 07, 2015
A 48-year-old male with a history of hyperuricemia had a painful mass over his right fifth middle phalanx for 6 months, which made it difficult to flex his right little finger (Fig. 1A). Milk-like materials were occasionally released from a small pore on this mass. Ultrasound images of the mass in the short-axis view, in the long-axis view, and under the power Doppler mode are shown in Figs. 1B, 1C, and 1D, respectively.
Posterior Knee Pain and Swelling
Published Online: June 24, 2015
A 68-year-old woman presented with gradual onset of right knee pain for 2 weeks. She reported discomfort at the back of right knee and difficulty squatting. Initial physical examination showed swelling of the right posterior knee without redness (Figure 1). Knee flexion was limited at 130°. Sonographic images are shown in Figures 2A and 2B.What is the diagnosis?

Thứ Sáu, ngày 28 tháng 8 năm 2015

ASEF training echocardio at Bach mai Hospital for clinicians

ASE chooses Mindray for Vietnam humanitarian mission

By AuntMinnie.com staff writers

August 25, 2015 -- Medical equipment manufacturer Mindray Medical Internationalwas selected for the American Society of Echocardiography Education and Research Foundation's (ASEF) humanitarian mission in Hanoi, Vietnam, held August 17-22.



The firm provided six M7 portable cardiac ultrasound systems to the Vietnam National Heart Institute to support training and clinical programs.

The foundation's program consisted of multiple events, including hands-on training at the Vietnam National Heart Institute at Bach Mai Hospital, an educational symposium for clinicians based in local provinces, training of local healthcare providers, and a village screening program with more than 200 patients.

The event was led by Dr. Jose Banchs from MD Anderson Cancer Center and Dr. James Kirkpatrick from the University of Pennsylvania. One of the key goals of the program was to teach local clinicians how to properly acquire cardiovascular images and use compact echo in resource-poor areas.

Mindray has also sponsored similar missions in other countries in Asia, Africa, and Latin America.