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PubMed1996

[Diagnosis of superficial-type early carcinoma of the gallbladder by endoscopic ultrasonography--comparison with ultrasonography].

The detectability of superficial-type carcinoma of the gallbladder by ultrasonography (US) and endoscopic ultrasonography (EUS) were investigated. Eight patients with such carcinoma of the gallbladder were reviewed. They had undergone both US and EUS previous to surgery. The tumor was detected in 3 patients by US, 2 patients with IIa + IIb-type carcinoma and 1 patient with IIa-type carcinoma. Those lesions were visualized as localized thickening of the gallbladder wall or as broad-based tumor. In 2 patients, lesions were not initially detected by US, but were shown by US after the examination by EUS. The tumor was detected by EUS also in 1 case of IIb + IIa-type carcinoma besides those 3 patients mentioned above. All four of these lesions were visualized as broad-based tumor by EUS. It was difficult to detect pure IIb-type or small IIa-type carcinoma even by EUS. In patients with concomitant acute cholecystitis or gallbladder stone, it was difficult to evaluate the abnormal findings of the gallbladder wall.

Aged↗
PubMed2006

Progress of endoscopic ultrasonography and intraductal ultrasonography in the diagnosis of malignant biliary diseases.

In recent years, ultrasound technology has made remarkable strides, and the application of these latest advances to endoscopic ultrasonography (EUS) and intraductal ultrasonography (IDUS) is crucially important. EUS equipped with electronic scanners (both radial and convex types) has been developed, and now EUS with the function of tissue harmonic imaging (THI) and color/power Doppler is applicable clinically. THI facilitates the acquisition of ultrasound images clearer than those of fundamental imaging, and color/power Doppler sonography demonstrates the precise hemodynamics with the use of a contrast agent. In addition, the progress of image processing technology has realized three-dimensional (3D) images in EUS and IDUS. Reconstruction of 3D images enables us to diagnose more objectively. Here we describe the roles of these new ultrasound technologies in the diagnosis of biliary malignancies.

Biliary Tract Diseases↗
PubMed2004

Endoscopic ultrasonography in detection of cholelithiasis in patients with biliary pain and negative transabdominal ultrasonography.

BACKGROUND: The aim of the study was to evaluate endoscopic ultrasonography (EUS) as a single method for diagnosing cholecystolithiasis in patients with a clinical suspicion of cholecystolithiasis, but with a normal transabdominal ultrasonography (TUS). METHODS: A prospective study was performed on patients with biliary type of colic and normal US of the gallbladder. All patients had at least one normal TUS examination (mean 2.1, range 1-5) performed by an experienced radiologist. All patients were subsequently examined with EUS. EUS examination was performed with either a mechanical radial scanning echo-endoscope (Olympus GF-UM20) or a linear echo-endoscope (Pentax FG32-UA or FG34-UA). Patients in whom EUS demonstrated cholecystolithiasis were offered laparoscopic cholecystectomy within 2 weeks. RESULTS: A total of 35 patients (31 F and 4 M) were included. In 18 out of 35 (52.4%) patients cholecystolithiasis was diagnosed by EUS. In 15 out of 17 patients the EUS diagnosis was verified by surgery. At follow-up after 12 months, 13 of the 15 patients (87%) with verified gallbladder stones had no abdominal discomfort, whereas 2 patients (13%) complained of persistent and unchanged abdominal pain. CONCLUSION: EUS seems to be a promising imaging method in the detection of microlithiasis in the gallbladder in patients with clear biliary colic and normal transabdominal US.

Abdomen↗
PubMed1994

[Comparison of the results of conventional ultrasonography and color doppler analysis in the evaluation of the nature of adnexal tumors. II. Color duplex doppler ultrasonography].

The author evaluates the possibilities of coloured Doppler vaginosonography for prebioptic evaluation of the nature of ovarian tumours. He investigated the site of vascularization of tumours and qualitatively the blood flow by assessing the vascular resistance (PI, RI) and character of the flow velocity curve. The results revealed a statistically significant (p < or = 0.05) trend of central vascularization of malignant tumours. A new parameter with a 100% sensitivity and 89% specificity proved to be the notch at the beginning of the diastolic part of the velocity curve which was not observed in any carcinomas but was present in 89% of benign lesions. The vascular resistance was significantly lower in malignant tumours. The cut off value of malignity of the pulsatility index PI = 0.7 had a 86% sensitivity and 100% specificity. The cut off value of the resistance index RI is 0.6 with a 100% sensitivity and 75% specificity. Comparison of the predictive values of malignity of conventional and coloured duplex ultrasonography revealed that for evaluation of the nature of ovarian tumours coloured duplex sonography with several parameters is more suitable. PI and RI alone can be considered rather as indicators of active growth.

Adult↗
PubMed2004

Practice, training, and assessment among experts performing musculoskeletal ultrasonography: toward the development of an international consensus of educational standards for ultrasonography for rheumatologists.

OBJECTIVE: To evaluate the training and practice of specialist practitioners in musculoskeletal ultrasonography (MUS) with the aim of developing an expert-derived consensus of educational standards for rheumatologists performing MUS. METHODS: A panel of worldwide experts in MUS was identified by literature review, consultation with members of training committees, and peer recommendation. Using a postal questionnaire, information was obtained about personal experience, current practice, training regimen, and participation in competency assessment. RESULTS: International experts in MUS were identified (57 in total: 37 radiologists, 20 rheumatologists). Response rate was 70%. Radiologists had been performing MUS for longer than rheumatologists. Both rheumatologists and radiologists conducted the same number of MUS sessions per week, although radiologists examined more patients. More radiologists performed MUS for muscle and ligament injury, nerve lesions, soft tissue masses, and of the groin (P <0.01). The number of training hours was similar. Approaches to training varied, although attending a training course and scanning with an expert was more common among rheumatologists (P <0.001). More than two-thirds of the group had not undergone any form of competency assessment. CONCLUSION: This study highlights differences in training and practice between individual expert ultrasonographers and between specialty backgrounds. In particular, there appears to be no formal training regimen and competency assessment is uncommon. The establishment of a core set of internationally applicable educational standards for MUS training for rheumatologists is required.

Internationality↗
PubMed1989

Evaluation of endoscopic ultrasonography for gastric tumors and presentation of three-dimensional display of endoscopic ultrasonography.

We have studied the usefulness of endoscopic ultrasonography (EUS) for: (1) differentiation between extragastric mural compression (EGMC) and submucosal tumors (SMT); (2) qualitative assessment of these lesions; (3) diagnosis of serosal invasion by malignant gastric tumors; (4) presentation of three-dimensional display of EUS findings. A total of 103 patients with submucosal lesions protruding into the gastric lumen on endoscopy were examined. Differentiation between EGMC and SMT could be made by EUS in all cases. Qualitative assessment of these lesions was made by observing their EUS findings, i.e. their internal and marginal echo pattern and their location in the gastric layers. The correct diagnosis was made in 88% (23/26) of EGMC. Of 50 patients with SMT, comprising myogenic tumor (32), aberrant pancreas (8), lipoma (3), gastric cyst (4) and malignant lymphoma (elevated type; 3), differentiation between malignant and benign myogenic tumors was impossible by EUS alone. In addition, 48 patients with advanced gastric cancer and malignant lymphoma were examined. Invasion to the serosal surface was diagnosed as interruption of the fifth layer of the gastric wall. Invasion to other organs was diagnosed by interruption and fusion of the fifth layer into the border of the adjacent structure. Serosal invasion was diagnosed accurately in 65% of 48 patients. Microscopic invasion was difficult to diagnose, and gastric stenosis by tumor was an obstacle to adequate scanning. EUS can be valuable in the differential diagnosis between EGMC and SMT and in the qualitative diagnosis of gastric lesions. It is also effective in detecting serosal invasion by gastric malignant tumors. Three-dimensional display of pathological lesions is new in EUS.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Graphics↗
PubMed2003

Temporomandibular joint osteoarthrosis diagnosed with high resolution ultrasonography versus magnetic resonance imaging: how reliable is high resolution ultrasonography?

The purpose of this study was to determine whether 12.5 MHz ultrasonography (US) could be used to assess the presence or absence of temporomandibular joint (TMJ) condylar osteoarthrosis. In 40 consecutive patients with TMJ disorders, 80 TMJs were investigated by US to analyse the condylar morphology. In order to compare the respective findings with those of a diagnostic method offering a high accuracy, coronal and sagittal magnetic resonance imaging was carried out immediately afterwards. With US showing a sensitivity of 87%, and a specificity of 20%, the data revealed US to be sensitive in detecting the presence, but insufficient in detecting the absence of osteoarthrosis. In addition, with a positive predictive value of 88%, and a negative predictive value of 18%, the results indicate that US may be valuable in diagnosing the presence, but insufficient in diagnosing the absence of osteoarthrosis. In view of the fact that the 12.5 MHz US technique proved to be a valuable diagnostic aid for the detection and prediction of abnormal condylar morphology, the results of this study should be of further interest and encourage research in its potential uses and diagnostic capabilities.

Adolescent↗
PubMed1993

Ultrasonography as a tool for monitoring in ovo chicken development. 2. Effects of eggshell alteration and ultrasonography on embryonic and posthatch development.

The influence of creating and closing acoustic windows on embryonic and posthatch development for the purpose of chicken embryogenesis monitoring by real-time ultrasonography (US) was evaluated at 2, 6, 9, 14, and 17 days of incubation. Acoustic windows were closed using either a porous dialysis film and tape (FM) or an eggshell allograft attached with collodion (CP). Results from eggs closed in each manner with and without concurrent nonsterile US examination were compared with two control groups. Window creation reduced hatchability. The hatchability reduction was caused primarily by bacterial contamination. Contamination was more common in the FM eggs than in the CP eggs and was greater in eggs that also underwent US. Hatchability increased and contamination decreased when US was performed closer to hatch. Egg weight loss was increased after Day 6 of incubation in FM + US eggs treated on Day 2 and after Day 9 in all eggs with windows except CP eggs treated on Day 9 and CP + US eggs treated on Days 6 and 9. Hatch weight decreased in chicks from eggs that had windows, particularly in FM eggs.

Animals↗
PubMed1989

Endoscopic ultrasonography of gastric myogenic tumor. A comparative study between histology and ultrasonography.

In order to find a correspondence between the sonographic findings of endoscopic ultrasonography (EUS) and the histology of gastric myogenic tumors, histologic specimens (24 cases) and preoperative ultrasonograms (10 cases) were examined. Histologically, the incidence of necrosis within the tumor was more frequent and the area of necrosis was larger in leiomyosarcoma than in leiomyoma. Liquefaction necrosis was observed only in leiomyosarcoma. By EUS, myogenic tumors originating from the proper muscle were delineated as clearly demarcated hypoechoic tumors arising from the fourth layer. Irregularly shaped sonolucent areas within the tumor corresponded to liquefaction necrosis. Thus, sonolucent areas may be indicative of leiomyosarcoma.

Female↗
PubMed2005

Atherosclerosis found on carotid ultrasonography is associated with atherosclerosis on coronary intravascular ultrasonography.

OBJECTIVE: Little has been reported on the relationship between left main coronary artery atherosclerosis and carotid ultrasonographic results. We evaluated the association between carotid and coronary atherosclerosis assessed by coronary intravascular ultrasonography (IVUS) in 45 patients. METHODS: We counted the number of plaques with intima-media thickness (IMT) greater than or equal to 1.1 mm and calculated a plaque score by summing all plaque thicknesses. With the use of IVUS, the percent plaque area was calculated at the proximal, middle, and distal sites of the left main coronary artery. The maximum percent plaque area and mean percent plaque area of the 3 sites were also calculated. Relationships among the degree of left main coronary artery atherosclerosis and carotid atherosclerosis and vascular risk factors were evaluated. RESULTS: The mean percent plaque area and maximum percent plaque area were increased in men and in patients with hypertension compared with women and those without hypertension (P < .1). Both the average of the maximum common carotid IMT and plaque number were correlated with both the mean percent plaque area and maximum percent plaque area (P < .05). Men, the presence of hypertension, and the average of the maximum common carotid IMT were correlated with both the mean percent plaque area and maximum percent plaque area by multiple linear regression analysis (P < .05). CONCLUSIONS: The average of the maximum common carotid IMT was significantly correlated with left main coronary artery atherosclerosis evaluated by IVUS.

Arteriosclerosis↗
PubMed1991

Ultrasonography of the kidney and prostate gland. Has gray-scale ultrasonography replaced contrast radiography?

Beginning in the late 1970s with the first reports of two-dimensional, gray-scale ultrasonography used to image small-animal abdominal organs, the question of whether to use contrast radiographic or ultrasonographic techniques for urogenital assessment has become increasingly important. In the last five to seven years, the volume of veterinary literature on ultrasonographic imaging equals or exceeds that on contrast radiographic imaging of the small-animal urogenital tract. While the advantages of ultrasonographic over contrast radiographic imaging are obvious for some situations (eg, renal failure or paraprostatic cyst), no overviews critically comparing these techniques have been published to our knowledge. With the increasing availability of ultrasonographic equipment in private veterinary practice, choices between these imaging techniques must be made. Imaging the kidney and the prostate gland are discussed because both techniques are applicable to these organs. Our intent was to determine which of these techniques would be appropriate for the common clinical conditions. This article addresses the advantages and disadvantages of both techniques for renal and prostatic imaging. The perspective provided is based on ten years of clinical experience with both techniques by each of the authors. Clinical scenarios and specific diseases are discussed and the consensus of the authors on the procedure(s) of choice for these situations are described.

Animals↗
PubMed1991

The future of ultrasonography. Report of the Ultrasonography Task Force. Council on Scientific Affairs, American Medical Association.

Future advances in ultrasonography will undoubtedly occur in three major areas: diagnostic capability, instrumentation, and clinical applications. In the area of diagnostic capability, spatial and contrast resolution offer excellent opportunities for improvement. Continued research into tissue characterization is worthwhile, even though efforts to date have been more frustrating than fulfilling. Blood flow studies and new contrast agents are among the more promising areas for future development. New techniques of signal detection, analysis, and display in Doppler imaging may overcome some present limitations, including those in color flow imaging.

American Medical Association↗
PubMed2006

Efficacy of 3-dimensional endorectal ultrasonography compared with conventional ultrasonography and computed tomography in preoperative rectal cancer staging.

BACKGROUND: This study was performed to verify reports of the decreased accuracy of endorectal ultrasonography (EUS) in preoperative staging of rectal cancer, and to compare the efficacy of 3-dimensional (3D) EUS with that of 2-dimensional (2D) EUS and computed tomography (CT). METHODS: Eighty-six consecutive rectal cancer patients undergoing curative surgery were evaluated by 2D EUS, 3D EUS, and CT scan. RESULTS: The accuracy in T-staging was 78% for 3D EUS, 69% for 2D EUS, and 57% for CT (P < .001-.002), whereas the accuracy in evaluating lymph node metastases was 65%, 56%, and 53%, respectively (P < .001-.006). Examiner errors were the most frequent cause of misinterpretation, occurring in 47% of 2D EUS examinations and in 65% of 3D EUS examinations. By eliminating examiner errors, the accuracy rates in T-staging and lymph node evaluation could be improved to 88% and 76%, respectively, for 2D EUS, and to 91% and 90%, respectively, for 3D EUS. Conical protrusions along the deep tumor border on 3D images were correlated closely with infiltration grade, advanced T-stage, and lymph node metastasis. CONCLUSIONS: We found that 3D EUS showed greater accuracy than 2D EUS or CT in rectal cancer staging and lymph node metastases. Concrete 3D images based on tumor biology appear to provide more accurate information on tumor progression.

Adult↗
PubMed2006

The use of endoluminal ultrasonography for preventing significant bleeding during endopyelotomy: evaluation of helical computed tomography vs endoluminal ultrasonography for detecting crossing vessels.

OBJECTIVE: To evaluate, in a prospective study, the efficiency of helical computed tomography (CT) and endoluminal ultrasonography (ELUS) for detecting significant crossing vessels, a major cause of bleeding complications when treating patients with pelvi-ureteric junction (PUJ) obstruction, and to compare our results using ELUS with those of an earlier multicentre study (not using ELUS), to see whether the complication rate decreased. PATIENTS AND METHODS: The study included 27 patients with a PUJ who had isotope renography, intravenous urography, helical CT and ELUS before surgery. Depending on the findings of ELUS, patients were treated with a pure lateral Acucise incision (Applied Medical, Irvine, CA, USA) an Acucise with changed cutting direction, or (later) a laparoscopic pyeloplasty. RESULTS: ELUS detected 15% more crossing vessels than helical CT; 16 patients had Acucise (seven lateral, nine other cutting direction), eight were treated with a laparoscopic pyeloplasty and three with other procedures. By contrast with earlier reports and as a consequence of using ELUS, there was no bleeding, vs 16% in the study not using ELUS. The success rate of 73% of the endourological approach is comparable with previous reports. CONCLUSION: ELUS is more sensitive in detecting relevant crossing vessels than helical CT and therefore the use of ELUS can better prevent bleeding complications. ELUS can also improve the success rate by helping in selecting the correct treatment. Because it is minimally invasive and safe, ELUS combined with Acucise (or other possible endourological techniques, like holmium laser incision) should be the first choice of treatment for PUJ stenosis.

Adolescent↗
PubMed1999

[Diagnosis of thyroid nodules by Doppler ultrasonography: a comparison between color Doppler and power Doppler ultrasonography].

The purpose of this study was to assess the usefulness of color and power Doppler imaging in thyroid nodules. The following 4 items were compared between malignant thyroid nodules (34 cases) and benign nodules (51 cases): 1) vascularity; 2) distribution of tumor vessels (none, marginal, peripheral, central); 3) nature of tumor vessels (tortuosity, interruption); and 4) FFT analysis. The distribution of tumor vessels on color Doppler images, nature of tumor vessels on power Doppler images, and the indices of PI, RI, and ATI in FFT analysis were useful in making the differential diagnosis between malignant and benign nodules. In terms of vascularity, including the distribution of tumor vessels on power Doppler images and nature of tumor vessels on color Doppler images, no statistically significant differences were found between malignant and benign nodules. Power Doppler images depicted tumor vessels in more detail than color Doppler images and were considered to extend the application of FFT analysis.

Diagnosis, Differential↗
PubMed1996

[Color duplex ultrasonography in the diagnosis of deficient perforating veins in comparison to cw-Doppler ultrasonography and clinical examination].

The study was conducted to investigate the accuracy and agreement between clinical examination, cw-Doppler ultrasound and color-duplex sonography in diagnosing incompetent perforating veins. Nineteen patients with chronic venous insufficiency (CVI) were examined clinically, by hand-held cw-Doppler ultrasound in combination with tourniquet compression and color-coded duplex sonography CDS. The accuracy of the clinical examination and the diagnosis of ICPV by cw-Doppler were surprisingly low. The specificity was 15% and sensitivity 29%, when CDS was taken as gold standard. Furthermore the results show clearly that the application of a tourniquet cannot provide reliable results. It is concluded that in patients with CVI clinical and cw-Doppler examinations are not sufficient for an accurate diagnosis of incompetent perforating veins. Color-duplex provides a new noninvasive approach for accurate anatomical and functional diagnosis, which is of great importance prior to surgical interventions and/or sclerotherapy.

Adult↗
PubMed2006

Contrast-enhanced ultrasonography to detect liver metastases : a prospective trial to compare transcutaneous unenhanced and contrast-enhanced ultrasonography in patients undergoing laparotomy.

BACKGROUND/AIMS: The advent of contrast-enhanced ultrasound (CEUS) has called into question the efficacy of standard ultrasonographic techniques. In this study, we evaluated B-mode and color-duplex imaging and CEUS in the detection of liver metastases, using intraoperative and histological findings as a reference. MATERIALS AND METHODS: Before laparotomy, 108 patients suspected of having liver metastases were prospectively examined with B-mode and color-duplex imaging, followed by contrast-enhanced ultrasound (2.4 ml SonoVue). Patients with unresectable tumors (n=8) were excluded from the analysis. The sonographic diagnosis in the remaining 100 patients was compared to the intraoperative and histological findings. RESULTS/FINDINGS: CEUS improved the sensitivity for detecting liver lesions from 56.3% (B-mode) to 83.8% (CEUS) (p=0.004). In particular, the contrast agent led to an improvement in ultrasonographic detection in the following cases: nodular metastases smaller than one centimeter; after adjuvant chemotherapy; for tumors near the surface of the liver; and for lesions situated around the ligamentum teres. INTERPRETATION/CONCLUSIONS: CEUS provides significant improvement in the detection of liver metastases, and should therefore, be performed routinely in the surveillance of cancer patients.

Adult↗