Vaccination into Dermal Compartment by Ultrasound

 

SWE and Sciatic Nerve Stiffness

 

MRI and TVS in Uterine Adenomyosis

 

The Nerve/Tendon Ratio in Carpal Tunnel Syndrome

 

Ultrasound platform effective evaluating hepatic steatosis

Amerigo Allegretto
Nov 14, 2023


Attendees will hear about the potential for ultrasound-derived fat fraction to be an alternative tool for MRI in assessing hepatic steatosis.

Yi Dong, MD, from Fudan University in Shanghai, China, will present findings that show how ultrasound-derived fat fraction can detect hepatic steatosis using MRI-derived proton density fat fraction as the reference standard.

Several ultrasound platforms now provide quantitative measures of hepatic steatosis. One of these is ultrasound-derived fat fraction, which combines attenuation and backscatter quantification. In their study, Dong and colleagues wanted to explore the role of this platform in detecting and assessing hepatic steatosis, with MRI-derived proton density fat fraction being used as the reference standard.

They included 113 participants in their prospective study. Of these, 39 had type 2 diabetes mellitus while 76 had nonalcoholic fatty liver disease. The team reported that the median ultrasound-derived fat fraction in the patients was 9.2%.


It also found good correlation between ultrasound-derived fat fraction and MRI-derived proton density fat fraction (p = 0.764, p < 0.001).

The researchers additionally reported that ultrasound-derived fat fraction had good accuracy in diagnosing nonalcoholic fatty liver disease, with an area under the curve (AUC) of 0.865, a sensitivity of 67.1%, and a specificity of 89.2%.

Finally, the team found that the inter- and intraobserver agreement of ultrasound-derived fat fraction were excellent and 0.948 and 0.904-0.969, respectively (p < 0.001 for both).

See what else the team had to say about this ultrasonic method in this session.

Ultrasound Elastography-free download

 

Hepatic Elastography Using US Waves- free download

 

Download from ultrasound training.com.au

Formal Training Leads to Improved POCUS Use for Surgeons

 

Abstract

Background

Despite its importance, there are no official guidelines for point of care ultrasound training during surgical critical care fellowship. The primary objective of this study was to evaluate the comfort and competency of fellows after implementation of a point of care ultrasound program.

Methods

Surgical critical care fellows (n = 7) participated in an ultrasound rotation (2021–2022), including dedicated lectures and training with interventional and echocardiography technicians. Pre and post self-assessments were administered evaluating comfort in point of care ultrasound for focused assessment with sonography for trauma, vascular access, drainage procedures, volume status, cardiac activity during arrest, and global cardiac function. Technicians assessed fellow skill in probe orientation, location, image manipulation, machine adjustment, and image quality. All questions were answered on a 7-point Likert scale (1, not-at-all; 7, yes/very much). Pre and post cohorts were compared using Wilcoxon signed-rank tests.

Results

After the rotation, fellows reported improvement in comfort level for ultrasound-guided technique for focused assessment with sonography for trauma, drainage procedures, volume status, and cardiac assessment. Technician evaluations demonstrated improvement in probe orientation (5 [4–6] vs 7 [7–7], P = .02) and location (5 [3–6] vs 7 [7–7], P = .02), image manipulation (5 [4–5] vs 7 [7–7], P = .02), machine adjustment (5 [4–5] vs 7 [7–7], P = .02), and overall image quality (4 [4–6] vs 7 [7–7], P = .02) after the rotation. All fellows reported the course significantly improved their skill, comfort level, and was worthwhile.

Conclusion

All fellows exhibited significant improvement in skill and comfort with point of care ultrasound after this rotation. This is the first study to describe a dedicated ultrasound curriculum for surgical critical care with significant skill acquisition.

The Euroson PoC-US School 4th Edition, 2023

 

EFSUMB COURSE BOOK 2nd Edition

https://efsumb.org/efsumb-course-book/

WFUMB ULTRASOUND BOOK  [flipbook] 2021

https://wfumb.info/wfumb-ultrasound-book/additional-pages/html5_output/index.html

34 topics, image download

Morphologic features on sonography predict metastasis

 

Highlights

• •
  Evaluating sonographic morphology of axillary nodes is vital for identifying abnormal nodes.
• •
  Cortical thickness >5mm and lack of a normal hilum have the highest PPV for malignancy.
• •
  The extent of cortical thickness of an axillary node is directly proportional to the risk of malignancy.
• •
  Most screening and incidentally detected nodes are benign. The criteria for selecting abnormal nodes in patients without any known malignancy should be different than cancer patients.
• •
  The risk of axillary metastasis is commensurate with the size of breast malignancy.

Abstract

Purpose

The purpose of this study was to evaluate various morphologic features of axillary nodes on ultrasound (US) in predicting malignancy and estimate the incidence of malignancy in axillary nodes based on their imaging mode of detection.

Methods and materials

A retrospective review of all percutaneous US-guided biopsies on axillary nodes performed at our institution between 1/1/2019–09/30/2021 was performed. Sonographic morphologic features of the biopsied node, imaging mode of detection and size of primary breast malignancy were correlated with malignancy.

Results

There were 224 malignancies detected in a total of 594 patients who underwent an axillary node biopsy. The positive predictive value (PPV) was significantly associated with the extent of nodal cortical thickening (p < 0.0001). The PPV of malignancy was significantly higher in nodes which lacked a normal hilum (0.61 vs 0.23). The PPV of malignancy in nodes detected on screening mammography (18.8%) or MRI (15.8%) was much lower than those detected on diagnostic imaging, by palpation or on CT/PET (48.4%, 43.8% and 65.3% respectively). Of all screening detected nodes in patients with no history of malignancy and mild cortical thickening, only 2 (4.3%) demonstrated malignancy.

Conclusions

Morphology of axillary nodes on sonography is vital in predicting nodal metastasis. Cortical thickness > 5 mm and/or absence of a normal hilum had the highest PPV for metastatic disease. Using clinical history in conjunction with imaging findings will help improve accuracy of axillary nodal biopsies, especially for incidental nodes detected on screening.