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Journal of Ultrasonography
Number of Followers: 1 ![]() ISSN (Print) 2084-8404 - ISSN (Online) 2451-070X Published by Sciendo ![]() |
- Inflammatory pseudotumor of the omentum in contrast-enhanced ultrasound
Abstract: Aim of the studyInflammatory pseudotumor is a rare benign tumor that can occur at various body sites. Due to its rare occurrence and histological variety radiological data is heterogeneous and limited.Case descriptionWe present a case of a 71-year-old man with inflammatory pseudotumor of the omentum. Contrast-enhanced ultrasound perfusion pattern showed homogeneous, isoechoic enhancement in the arterial phase with a washout phenomenon in the parenchymal phase, mimicking a peritoneal carcinomatosis.ConclusionsInflammatory pseudotumor represents a rare, but important benign differential diagnostic option when considering a malignant disorder. Contrast-enhanced ultrasound is helpful in identifying vital tissue for a targeted biopsy for subsequent histological examination that is essential for the exclusion of malignancy.
PubDate: Tue, 28 Feb 2023 00:00:00 GMT
- Sonographic rectal enema (“hydrocolon”) for diagnosing large bowel
pathologies in infancy – pictorial review to demonstrate feasibility and
value
Abstract: Bowel pathologies encompass a large diversity of diseases with commonly confusing and overlapping clinical presentations. Sonography has a leading role in diagnosing these disorders, especially in small children. However, in some cases, baseline sonography does not deliver a satisfactory result on the suspected pathology. To increase the sensitivity and specificity of the standard bowel ultrasound technique, complimentary ultrasound enema may be performed, which is also referred to as “hydrocolon” in the literature. This paper summarizes the technique of sonographic enema, as well as some bowel pathologies from our case series where sonographic enema proved to be helpful in the diagnostic work-up.
PubDate: Tue, 28 Feb 2023 00:00:00 GMT
- Ultrasound-guided musculoskeletal interventional procedures around the
hip: a practical guide
Abstract: Several studies have shown that ultrasound guidance may contribute to improved safety, effectiveness and accuracy of musculoskeletal interventional procedures performed around the hip if compared to those performed with a landmark-guided technique. Different approaches and injectates can be used for treating hip musculoskeletal disorders. These procedures may involve injections in the hip joint, periarticular bursae, tendons, and peripheral nerves. Intra-articular hip injections are mostly used as a conservative approach for treating patients affected by hip osteoarthritis. Ultrasound-guided injection of the iliopsoas bursa is performed in patients with bursitis and/or tendinopathy, to treat those with painful prosthesis due to iliopsoas impingement, or when the lidocaine test is indicated to identify the iliopsoas as a source of pain. Ultrasound-guided interventions are routinely used in patients with greater trochanteric pain syndrome having as target the gluteus medius/minimus tendons and/or the trochanteric bursae. Ultrasound-guided fenestration and platelet-rich plasma injection are applied in patients with hamstring tendinopathy with good clinical outcomes. Last but not least, ultrasound-guided perineural injections can be used for peripheral neuropathies or blocks of the sciatic, lateral femoral cutaneous, and pudendal nerves. In this paper, we discuss the evidence and technical tips for musculoskeletal interventional procedures performed around the hip, highlighting the added value of ultrasound as an imaging guidance modality.
PubDate: Tue, 28 Feb 2023 00:00:00 GMT
- Radial ray anomaly with associated ventricular septal defect – case
report with review of literature
Abstract: Ultrasound examination is used for the assessment of abnormal findings on prenatal screening. Radial ray defect can be screened by using ultrasonography. Abnormal findings can be detected quickly by having the understanding of the etiology, pathophysiology and embryology. It is a rare congenital defect that may be isolated or associated with other anomalies including Fanconi’s syndrome and Holt-Oram syndrome. We report the case of a 28-year-old woman (G2P1L1) who presented for routine antenatal ultrasound at 25 weeks 0 days according to the last menstrual period. The patient did not have any level-II antenatal anomaly scan done. An ultrasound was performed, and the gestational age according to the ultrasound scan was 24 weeks and 3 days. In this paper, we present a brief review of embryology and critical practical points, and report a rare case of radial ray syndrome with associated ventricular septal defect.
PubDate: Tue, 28 Feb 2023 00:00:00 GMT
- Pulmonary cystic echinococcosis in contrast-enhanced ultrasound – a
case report
Abstract: Aim of the studyPulmonary cystic echinococcosis is a parasitic infection transmitted by dogs and occurring in livestock-raising areas. It is included among the neglected tropical diseases, according to the World Health Organization. Imaging plays a pivotal role in the diagnosis of this disease. While cross-sectional imaging modalities such as computed tomography and magnetic resonance imaging are preferred, lung ultrasound may be another feasible technique.Case descriptionWe report a case of pulmonary cystic echinococcosis in a 26-year-old woman who was examined by contrast-enhanced ultrasound, which showed marked annular enhancement around the hydatid cyst, mimicking a superinfected cyst.ConclusionsContrast-enhanced ultrasound examination in pulmonary cystic echinococcosis should be studied in a larger population to determine the value of additional contrast administration. In the present case report, no superinfected echinococcal cyst was seen despite marked annular contrast enhancement.
PubDate: Tue, 28 Feb 2023 00:00:00 GMT
- Towards refining breast cancer diagnosis on ultrasound
PubDate: Tue, 28 Feb 2023 00:00:00 GMT
- The role of intraoperative transesophageal echocardiography in the
management of renal cell carcinoma with atrial thrombus – case report
Abstract: Renal cell carcinoma is a common disease, and clear cell renal cell carcinoma is the most common histological type. Renal cell carcinoma has a tendency to infiltrate the venous system including the inferior vena cava and the right atrium of the heart. We present the cases of two patients with renal cell carcinoma with stage IV tumor thrombus according to the Mayo classification, who underwent surgery under transesophageal echocardiography guidance. Apart from standard imaging methods used in renal cancer with tumor thrombus reaching the right atrium of the heart, we consider transesophageal echocardiography to be a very useful tool in the diagnostic work-up, patient monitoring, and selection of appropriate surgical technique.
PubDate: Tue, 28 Feb 2023 00:00:00 GMT
- Diagnostic efficacy of ultrasonography, Doppler ultrasonography and
elastography in the evaluation of suspected malignant lymph nodes
Abstract: AimIn this prospective study, the efficiency of imaging findings was investigated by comparing the histopathological results of lymph nodes with Doppler and ultrasound features and elasticity scores.Material and methodA total of 100 cervical or axillary lymph nodes with a suspected malignancy or whose size did not decrease after treatment were examined. In addition to the demographic data of the patients, B-mode ultrasound, Doppler ultrasound, and elastography features of the lymph nodes were evaluated prospectively. The irregular shape, increased size, pronounced hypoechogenicity, presence of micro/macro calcification, short axis/long axis ratio >2, increased size of the short axis, increased cortex thickness, obliterated hilus or increased cortex thickness >3.5 mm were evaluated on ultrasound. Resistivity index, pulsatility index, acceleration rate and time were evaluated for intranodal arterial structures on color. Doppler ultrasound, strain ratio value and elasticity score were recorded on ultrasound elastography. After sonographic examination, patients underwent ultrasound-guided fine needle aspiration cytology or tru-cutting needle biopsy. Histopathological examination results of the patients were compared with the B-mode ultrasound, Doppler ultrasound, and ultrasound elastography.ResultsWhen the individual and combined effects of the ultrasound, Doppler ultrasound, and ultrasound elastography were evaluated, the combination of all three imaging methods was found to have the highest sensitivity and the highest overall accuracy (90.4% and 73.9%). As an individual method Doppler ultrasound had the highest specificity (77.8%). B-mode ultrasound was found to have the lowest accuracy (56.7%) both in individual and combined evaluations.ConclusionAddition of ultrasound elastography to the combination of B-mode and Doppler ultrasound findings increases diagnostic sensitivity and accuracy in the differentiation of benign and malignant lymph nodes.
PubDate: Tue, 28 Feb 2023 00:00:00 GMT
- Evaluation of the relationship between quantitative ultrasound findings
and morbidly adherent placenta
Abstract: AimThe accuracy of ultrasound findings in predicting the incidence of morbidly adherent placenta has been evaluated previously. In this study, we assessed the sensitivity and specificity of different quantitative findings of color Doppler and grayscale ultrasonography in predicting morbidly adherent placenta.Material and methodsIn this prospective cohort study, all pregnant women over 20 weeks of gestational age with anterior placenta and a history of previous cesarean section were evaluated for inclusion. Various ultrasound findings were measured. The non-parametric receiver operating characteristic curves, the area under the curve, and the cut-off values were assessed.ResultsA total of 120 patients were ultimately included for analysis, of whom 15 had morbidly adherent placenta. The two groups were significantly different regarding the number of vessels. Based on color Doppler ultrasonography, in predicting the morbidly adherent placenta, more than two intraplecental echolucent zones with color flow had 93% and 98% sensitivity and specificity, respectively. According to grayscale ultrasonography, more than thirteen intraplacental echolucent zones had the sensitivity and specificity of 86% and 80% in predicting morbidly adherent placenta, respectively. Echolucent zone >11 mm at non-fetal surface had a sensitivity of 93% and a specificity of 66% in detecting morbidly adherent placenta.ConclusionsAccording to the results, the quantitative findings of color Doppler ultrasound have considerable sensitivity and specificity in detecting morbidly adherent placenta. More than two echolucent zones with color flow are recommended as the main diagnostic parameter indicating the presence of morbidly adherent placenta with a sensitivity of 93% and a specificity of 98%.
PubDate: Tue, 28 Feb 2023 00:00:00 GMT
- Correlation of sonographic parameters with renal function in patients with
newly diagnosed chronic kidney disease
Abstract: AimsTo correlate sonographic renal parameters (mean renal cortical thickness, length and volume) with renal functions in patients with newly diagnosed chronic kidney disease. To predict the best renal parameter correlating with renal functions in patients with newly diagnosed chronic kidney disease.Material and methodsA hospital-based prospective cross-sectional study was conducted in the Department of Radiodiagnosis, Indira Gandhi Medical College and Hospital, Shimla, in 78 adults with newly diagnosed chronic kidney disease visiting the hospital from December 2019 to November 2020.ResultsA statistically significant positive correlation was found between eGFR and mean renal length, mean renal cortical thickness, and mean renal volume (p <0.001).The strongest correlation was shown between mean renal volume and eGFR (r = 0.90, r2 = 0.82; p-value <0.001).ConclusionsRenal volume and cortical thickness should be considered along with traditional renal parameters.
PubDate: Sat, 01 Oct 2022 00:00:00 GMT
- Role of high-resolution ultrasonography in the evaluation of the tibial
and median nerves in diabetic peripheral neuropathy
Abstract: AimTo evaluate and measure the mean cross-sectional area of the tibial and median nerves in patients with diabetic peripheral neuropathy, and to study the association between high-resolution ultrasonographic findings in diabetic peripheral neuropathy with the duration of illness, glycosylated haemoglobin values, random blood sugar levels, and aesthesiometry (using monofilament examination).Material and methodsA prospective observational study was conducted among 63 patients who were diagnosed with type 2 diabetes mellitus and underwent ultrasound and monofilament examinations. The cross-sectional area of the median nerve of the dominant hand and the tibial nerves was calculated on ultrasound examination.ResultsThe mean cross-sectional area of the median and tibial nerves was higher in patients with poor glycaemic control, with the mean cross-sectional area of the median nerve being 10.9, 12.8, 13.0, and 12.9 mm2 at various points in the leg in cases where the monofilament examination was negative, as compared to 7.30, 7.78, 7.91, 7.87 mm2 in patients with positive monofilament examination results. There was a significant positive correlation between the cross-sectional area of the tibial and median nerves and HbA1c, duration of diabetes, aesthesiometry, and random blood sugar levels. With an increase in HbA1c, duration of diabetes, and random blood sugar levels, there was a corresponding increase in the cross-sectional area of the nerves. These findings helped us to identify diabetic peripheral neuropathy.ConclusionsHigh-resolution ultrasonography along with aesthesiometry and HbA1c values can be an effective and easily available tool for detecting changes secondary to diabetic peripheral neuropathy. The method has a potential to replace or substitute nerve conduction tests in the near future.
PubDate: Sat, 01 Oct 2022 00:00:00 GMT
- Automated breast ultrasound (ABUS): A pictorial essay of common artifacts
and benign and malignant pathology
Abstract: Automated breast ultrasound is a three-dimensional ultrasonographic technique allowing the evaluation of women with dense glandular breast tissue. In this group of patients, mammography has a low sensitivity because dense breasts can obscure breast cancer on mammogram. On the other hand, women with dense breast tissue, types C and D on the BI-RADS scale, are at an increased risk of developing breast cancer compared to women with fatty breast tissue. Automated breast ultrasound is a standardized and reproducible ultrasound technique which improves breast cancer detection and is promising in the screening and diagnostic settings: it increases the detection of breast cancer, and helps to differentiate benign and malignant lesions. Unfortunately, automated breast ultrasound also has its limitations and disadvantages due to artifacts caused by poor positioning, and lesion and patient characteristics. Many artifacts can be avoided by training and experience of the performing technician. Furthermore, familiarity of the interpreting breast radiologist with these artifacts and pitfalls will decrease false negative diagnosis of true lesions.
PubDate: Sat, 01 Oct 2022 00:00:00 GMT
- Calcific enthesopathy of the superior extensor retinaculum – an unusual
cause of medial ankle pain
Abstract: Aim of the studyAnkle pain can present a clinical dilemma to the foot and ankle surgeons, with a multitude of entities to which the symptoms could potentially be attributed. Enthesopathy around the ankle joint could be due to overuse, injury, inflammation or infection. Calcific ligamentous enthesopathy around the ankle is a well-recognised condition with a spectrum of causes.Case descriptionTo our knowledge, a clinically symptomatic presentation of calcific enthesopathy specifically affecting the entheses of the superior extensor retinaculum has not been described in the literature. We report the first case of symptomatic calcific enthesopathy of the superior extensor retinaculum in a healthy young female, and highlight the role of radiological interventions in its diagnosis. The condition was managed successfully by ultrasound-guided barbotage.ConclusionsCalcific enthesopathy of the attachment of the superior extensor retinaculum is a rare condition that should be considered in the differential diagnosis of patients with medial ankle pain.
PubDate: Sat, 01 Oct 2022 00:00:00 GMT
- Common carotid artery hematoma following parathyroid adenoma FNA
Abstract: We present a rare case of a common carotid artery wall hematoma after ultrasound-guided parathyroid fine-needle aspiration. The hematoma was detected within seconds from needle insertion, extending along the common carotid artery wall from the lower neck to the common carotid artery bifurcation, and it was quickly restricted with firm pressure. The patient only reported mild discomfort. A follow-up assessment by a vascular surgeon two hours later showed no signs of ischemic events and complete absorption of the hematoma without further clinical consequences. Physicians performing parathyroid fine-needle aspiration must be aware of this rare complication, which may be easily overlooked. Continuous meticulous sonographic surveillance during the fine needle aspiration procedure is the only way to directly diagnose this complication and apply immediate pressure to restrict it.
PubDate: Sat, 01 Oct 2022 00:00:00 GMT
- A deep learning approach for masseter muscle segmentation on
ultrasonography
Abstract: AimDeep learning algorithms have lately been used for medical image processing, and they have showed promise in a range of applications. The purpose of this study was to develop and test computer-based diagnostic tools for evaluating masseter muscle segmentation on ultrasonography images.Materials and methodsA total of 388 anonymous adult masseter muscle retrospective ultrasonographic images were evaluated. The masseter muscle was labeled on ultrasonography images using the polygonal type labeling method with the CranioCatch labeling program (CranioCatch, Eskişehir, Turkey). All images were re-checked and verified by Oral and Maxillofacial Radiology experts. This data set was divided into training (n = 312), verification (n = 38) and test (n = 38) sets. In the study, an artificial intelligence model was developed using PyTorch U-Net architecture, which is a deep learning approach.ResultsIn our study, the artificial intelligence deep learning model known as U-net provided the detection and segmentation of all test images, and when the success rate in the estimation of the images was evaluated, the F1, sensitivity and precision results of the model were 1.0, 1.0 and 1.0, respectively.ConclusionArtificial intelligence shows promise in automatic segmentation of masseter muscle on ultrasonography images. This strategy can aid surgeons, radiologists, and other medical practitioners in reducing diagnostic time.
PubDate: Sat, 01 Oct 2022 00:00:00 GMT
- Seroma as a rare complication of autologous arteriovenous fistula creation
in the forearm of a hemodialysis patient: a case report
Abstract: Aim of the studySeromas are rarely reported as complications of autologous arteriovenous fistula creation.Case descriptionAn 89-year-old woman was hospitalized for hemodialysis and underwent an autologous arteriovenous fistula creation in the forearm. During cephalic vein expansion using a heparinized saline solution, leakage occurred. A suture was placed to control the leakage, and a Penrose drain was inserted. Serosanguineous drainage ceased on postoperative day two; however, a seroma occurred approximately two weeks after the surgery. Follow-up ultrasonography revealed no growth tendency; therefore, excision and aspiration were unnecessary.ConclusionThis seroma was associated with postoperative dead space, surgical technique, and patient clinical status. Sufficient preoperative ultrasonographic vascular mapping is required to avoid inappropriate handling of veins and prevent seroma formation. Postoperative ultrasonographic follow-up is recommended due to the future risk of fistula dysfunction and infection associated with seroma enlargement, which may necessitate surgical seroma excision.
PubDate: Sat, 01 Oct 2022 00:00:00 GMT
- Predictive value of left atrial remodeling for response to cardiac
resynchronization therapy
Abstract: AimResponse to cardiac resynchronization therapy varies significantly among patients, with one third of them failing to demonstrate left ventricular reverse remodeling after cardiac resynchronization therapy. Left atrial size and function is increasingly recognized as a marker of disease severity in the heart failure population. The aim of this study was to evaluate whether echocardiographic left atrial indices predict left ventricular reverse remodeling after cardiac resynchronization therapy.Materials and methodsNinety-nine cardiac resynchronization therapy candidates were prospectively included in the study and underwent echocardiography before and 3-months after cardiac resynchronization therapy implantation. Cardiac resynchronization therapy response was defined as a 15% relative reduction in left ventricular end-systolic volume. Indexed left atrial volume, left atrial reservoir strain, left ventricular end-diastolic volume, and left ventricular ejection fraction along with other known predictors of cardiac resynchronization therapy response (gender, etiology of heart failure, presence of typical left bundle branch block pattern, QRS duration >150 ms) were included in a multivariate logistic regression model to identify predictors for cardiac resynchronization therapy response.ResultsCardiac resynchronization therapy response occurred in n = 63 (64%) patients. The presence of a typical left bundle branch block (OR 4.2, 95 CI: 1.4–12.1, p = 0.009), QRS duration >150 ms (OR 4.2, 95 CI: 1.4–11.0, p = 0.029), and left atrial volume index (OR: 0.6, 95 CI: 0.4–0.9, p = 0.012) remained the only significant predictors for cardiac resynchronization therapy response after three months. None of the baseline left ventricular parameters showed an independent predictive value.ConclusionLeft atrial size at baseline is an independent predictor and is inversely proportional to left ventricular volumetric reverse remodeling in cardiac resynchronization therapy candidates.
PubDate: Thu, 01 Sep 2022 00:00:00 GMT
- Ultrasonographic diagnosis of osteochondroma of the mandible: a case
report
Abstract: Aim of the studyThe aim of the present paper is to determine the diagnostic features of the rare presentation of osteochondroma in the mandible. The unusual aspect in this case is that the diagnosis was not established with cone beam computer tomography, which is a commonly used radiographic technique in dentistry, but with the use of ultrasonography.Case descriptionUltrasonography is very useful for initial examinations, avoiding patient exposure to additional radiation and setting the diagnosis in debatable soft tissue involvement of various lesions. In the presented case, even though the clinical presentation was indicative, the cone beam computer tomography evaluation could not confirm the diagnosis, so the final diagnosis was made by ultrasonography.ConclusionsWith the latest advances in the applications of ultrasonography in the maxillofacial region, an examination of lesions on the floor of the mouth or in the neck area may set the diagnosis in cases where hard tissue imaging does not provide enough information.
PubDate: Thu, 01 Sep 2022 00:00:00 GMT
- Sonographic findings of a gynecological cause of acute pelvic pain –
a systematic review
Abstract: ObjectiveThe purpose of this study was to use ultrasonographic data to rule out and distinguish diseases that cause acute pelvic pain.Material and methodThe literature was reviewed using a systematic search of the databases Google Scholars and PubMed, as well as through hand searching. We looked through a total of 35 articles, but only 26 were selected after preliminary screening. Furthermore, 14 articles were left out because they required a membership, copyright clearance, or featured non-English references. There were a total of 12 articles included in the final revuew. Among all the study-related articles, only original research studies and one systematic review that sonographically explored the gynecological etiology of acute pelvic pain were selected.ResultsAcute pelvic pain in women might be difficult to identify between gynecologic and non-gynecologic causes based solely on patient history and examination. Advanced imaging, like ultrasound, aids in determining the reason. Pelvic inflammatory disease can be difficult to diagnose, and clinicians should use a low threshold for starting presumptive treatment in order to avoid significant long-term effects such as infertility.ConclusionsPelvic pain can be acute, chronic or functional. Imaging investigations such as CT, ultrasonography, and MRI can assist in establishing a diagnosis. Particularly ultrasound scanning makes it possible to arrive at a diagnosis with a high degree of precision.
PubDate: Thu, 01 Sep 2022 00:00:00 GMT
- B-mode and color Doppler imaging of different types of branchial cleft
cysts in children. A multicenter study and review of the literature
Abstract: AimThe term “branchial cleft cyst” refers to the lesions that can be considered synonymous with cervical lymphoepithelial cysts. Although relatively rare, they constitute the second major cause of head and neck pathologies in childhood. This study aimed to report the clinical presentations, diagnosis, and management of pediatric patients with the pathological diagnosis of branchial cleft cyst.Material and methodsThis study was a retrospective analysis of the records of 33 patients with the diagnosis of branchial cyst, in two different university hospitals, in two different populations.ResultsThirty-three cases of branchial cleft cysts were seen in 33 patients: 17 females and 16 males. The majority (16 patients) were 2nd branchial cleft cysts. Accurate diagnosis of branchial cleft malformation was made via imaging in 20 of the 21 (95%) patients that underwent preoperative surgical ultrasonographic imaging.ConclusionBranchial cleft cysts are frequently incorrectly diagnosed and ignored in the differential diagnosis. Thus, the diagnosis is often delayed, resulting in the mismanagement of affected patients. A branchial cyst should be suspected in any patient with a swelling in the lateral aspect of the neck, regardless of whether the swelling is solid or cystic, painful or painless. The use of ultrasonography can dramatically help clinicians with distinguishing branchial cleft cysts from other similar lesions of the head and neck.
PubDate: Thu, 01 Sep 2022 00:00:00 GMT