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Objective to compare and contrast the diagnosis results on 2D and 3D Ultrasonogrpahy against MRI. Method A 2D Ultrasonography was applied during a conventional prenatal sonography checking with a 3D Sonography assessment subsequently conducted to follow up on 49 fetus suspected of brain malformation.Furthermore, a MRI scan was taken within 24 hours after the 3D Sonography checking in our hospital as a final test. Data collections from all three assessments were completed, and an analysis of the comparisons of these three methods were done. Results Among these 49 fetus with confirmed or suspected brain malformation, there were two cases of misdiagnoses of Dandy-Walker Malformation assessed by 2D sonography, with a misdiagnosis rate of 40％, (P ＜ 0.05) indicating a statistically significant result; misdiagnosis rate of Fetal Ventriculomegaly and Isolated Broadening Posterior Fossa were calculated as 26.7％ and 33.3％ respectively (P ＜0.05), a statistically significant result. Overall, there were two cases with Cerebellum Malformation, from in which one case was identified by MRI, and the other one was misdiagnosed, with a misdiagnosis rate of 50.0％.In total, there were 2 cases of Holoprosencephaly, in which one was identified by Prenatal MRI, and the other was misdiagnosed (P ＜ 0.05), a statistically significant result. Conclusions All three assessments of 2D ultrasonography, 3D ultrasonography and MRI have their own advantages and disadvantages. In short, 2D Sonography is suggested to be applied for screening out cases with brain malformation, together with 3D Sonography as a complementary assessment. MRI can also be an effective and significant complement for sonography in completing and readdressing the final ultrasonic results.
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A 35-year-old pregnant woman visited our department and had been treated with 100 microg of daily oral levothyroxine for hypothyroidism. An ultrasonography screening was performed at 25 weeks gestation and revealed a fetal goiter and an increased amniotic fluid volume. Fetal hypothyroidism was confirmed by cordocentesis and amniotic hormone levels at 26 weeks gestation. We treated the mother with 200 microg of daily oral levothyroxine to optimize the transplacental transfer. A total of four intra-amniotic injections of levothyroxine were administered, resulting in progressive reduction in the fetal thyroid volume of goiter as measured by 3D ultrasonography and increased amniotic fluid volume. Following birth, neonatal serum thyroid stimulating hormone level was within the normal range, but free T4 was reduced. Based on this case, we suggest that monitoring amniotic fluid thyroid hormone concentration and intra-amniotic levothyroxine injection can be used to reduce the thyroid volume of goiters and to prevent polyhydramnios.
Subject(s)
Adult , Female , Humans , Pregnancy , Amniotic Fluid , Cordocentesis , Goiter , Hypothyroidism , Mass Screening , Mothers , Parturition , Polyhydramnios , Pregnant Women , Reference Values , Thyroid Gland , Thyrotropin , Thyroxine , UltrasonographyABSTRACT
Background: It is of clinical importance to display the vasculature of transplanted kidney in three-dimensional (3D) and in non-invasive way. 3D color Doppler ultrasonographic imaging (3D-CDUI) is a non-invasive technique to display the 3D vasculature of living organs. Objective: Probe into characteristics of 3D vasculature of living transplanted kidney by 3D-CDUI, and evaluate the clinical value of 3D-CDUI on monitoring complications after operation of renal transplant. Methods: Nine patients who received allogeneic transplantation of kidney were monitored with 3D-CDUI. The instruments used included ACUSON Sequoia 512 and TomTec computer station of 3D-CDUI. Using magnetic positioning free-hand scanning, the 3D reconstruction and display of renal tissue structure and blood flow were performed off-line. Results: All patients underwent 3D-CDUI examinations without any side effect or complication. When acute rejection occurred, the 3D distribution change of renal blood flow signal could be observed clearly. During treatment of acute necrosis of renal tubules, changes of renal blood flow signal in 3D color Doppler images could be detected earlier compared with 2D color Doppler images. The position of embolized vassels could be diagnosed accurately by 3D-CDUI. Conclusion: The 3D-CDUI was helpful to improve diagnosis level of ultrasonography by monitoring complications after renal transplantation.
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OBJECTIVE: To compare to type and size of rotator cuff tear (RCT) in the transverse view before and after arthro-3D sonography. METHOD: Total 24 cases with rotator cuff tear were diagnosed according to ultrasonographic finding. All of patients were performed by a posterior-lateral approach for sono-guided intra-articular injection and underwent by both before and after arthro 3D sonogrpahy. We measured size (transverse, longitudinal, area) of RCT on the transverse scan in search of the largest lesion and the difference to type and size of RCT after arthrography. RESULTS: 3D ultrasonography detected full-thickness tear in 18 cases, partial-thickness tear in 6 cases before arthro-3D sonograhy. Change in the diagnosis of rotator cuff tear after arthro-3D sonogrphy; 3 partial-thickness tear were diagnosed as full-thickness tear. The size (transverse, longitudinal, area) of RCT was increased significantly after arthro-3D sonography compared with that before arthro 3D sonography. CONCLUSION: Arthro-3D sonography is useful for evaluation the configuration of RCT. Using this method, we can provide the objective and steric image of RCT.
Subject(s)
Humans , Arthrography , Injections, Intra-Articular , Rotator Cuff , TearsABSTRACT
Objectives To investigate the changes in the masseter muscle following osteotomy of the prominent mandibular angle using real-time three-dimensional (3D) ultrasonography, and to supply guidance for resection of the mandibular angle. Methods Real-time 3D ultrasonography was applied preand post-operatively (over a 6-month follow-up period) to 10 patients who underwent curved osteotomy with the following objectives: (1) to reconstruct the morphological changes of the masseter under different conditions; (2) to assess masseter muscle volume changes, and (3) to obtain the dynamic morphological changes of masseter during mouth opening and closing. Results The reconstructed 3D images revealed that longitudinal diameters of masseter muscle decreased and angle regions changed to be arc-shaped with significant thinning 6 months after operation. The mean volume of masseter muscle was (18. 222 ±3. 028) cm36 months post-operatively, compared with the pre-operation mass of (25. 480 ± 7. 113) cm3,the statistical difference was significant (P＜0.01). Transverse and longitudinal changes of the thickest masseter muscle section 6 months post-operatively were of no statistic difference (P＞0. 01) compared with pre-operation status during mouth opening and closing motions. Conclusion A certain extent of atrophy occurs primarily in the angle region of masseter muscle after mandibular angle ostectomy. However, these changes do not significantly impair masseter muscle function. Real-time 3D ultrasonography offers a novel, safe, and convenient technique for masseter muscle reconstruction and observation of masseter muscle movement.
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Antecedentes: La fisura labiopalatina (FLP) es la malformación facial más común, afectando a 1,8/1000 nacimientos. En sus inicios, la ultrasonografía 2D (US2D) diagnosticaba FLP en 5,3 por ciento de los casos, siendo actualmente el 71,5-95 por ciento. Se ha reportado la utilidad de la ultrasonografía 3D (US3D) y del doppler color (DC) para evaluar el compromiso palatino. Objetivo: Reportar la utilidad de US3D y del DC en el estudio de FLP durante el control fetal prenatal. Pacientes: Estudio de serie de casos de labio leporino pesquisados prenatalmente por US2D, que concurrieron a ecografía rutinaria del segundo trimestre del embarazo a la Clínica de la Mujer de Viña del Mar, entre enero de 1997 y abril de 2009. A todos se les realizó US3D por un operador. Se realizó consejo genético, apoyo psicológico y educación prenatal. Resultados: Se detectaron 7 casos de fetos con labio leporino, siendo confirmados al nacer. Uno presentó compromiso palatino. En un caso se realizó imagen DC, que permitió descartar la presencia de compromiso palatino, lo cual se correspondió con la US3D, siendo comprobado al nacimiento. Conclusión: La US3D permite estudiar la región facial, complementando la US2D en la observación del defecto labial y compromiso palatino. La detección prenatal de FLP disminuye el impacto psicológico que provoca en los padres.
Background: The cleft of lip and palate (CLP) are the commonest facial malformation, which affects 1.8/1000 births. In the beginning, CLP was detected in 5.3 percent by 2D ultrasonography (2DUS). This value had increased to 71.5-95 percent. 3D ultrasonography (3DUS) and color doppler (CD) utility had been reported to evaluate palate integrity. Objective: To report the utility of 3DUS and DC in CLP detection during prenatal evaluation. Patients: A case series study was conducted with review of prenatal screening CLP cases by 2DUS which perform routine second trimester ultrasonography in Clínica de la Mujer, Viña del Mar, between January 1997 and April 2009. All 3DUS were performed by one observer. Genetic counseling, psychology support and prenatal education were realized in all cases. Results: Seven cleft labial were detected, which was confirmed at birth. In one case was detected cleft palate. In one case, cleft palate was excluded with CD, which was supported by 3DUS. This finding was confirmed at birth. Conclusion: The 3DUS complements 2DUS in facial, labial and palate evaluation. The prenatal diagnosis decreases psychological impact in parents.
Subject(s)
Humans , Cleft Palate , Cleft Lip , Ultrasonography, Prenatal/methods , Imaging, Three-Dimensional , Ultrasonography, Doppler, ColorABSTRACT
Split hand malformation is a rare malformation with various presentations. The current report describes a case of split hand malformation detected using 2D and 3D ultrasonography at 16 weeks` gestation. 2D ultrasonographic findings were split hand malformation in the right hand and monodactyly in the left hand , and those findings were confirmed and further clarified using 3D imaging. Postmortem X ray findings were consistent with the ultrasonographic findings. We conclude that 3D ultrasonography can assist in clarifying 2D ultrasonography findings of hand malformations during the second trimester of pregnancy.
Subject(s)
Female , Humans , Pregnancy , Hand , Pregnancy Trimester, Second , Prenatal DiagnosisABSTRACT
OBJECTIVE: We wanted to assess the usefulness of four-dimensional (4D) ultrasonography (US), i.e., real-time three-dimensional US, as an adjunct for performing various US-guided interventional procedures in superficial lesions. MATERIALS AND METHODS: Thirty-three patients were referred for US-guided interventional procedures for superficial lesions, including core biopsy in 19, fine-needle aspiration in eight, therapeutic drug injection in four and needle puncture in two. The procedures were performed under 4D US guidance. We reviewed the pathologic/cytologic results of the core biopsies or needle aspirations, and also the outcomes of drug injection or needle puncture. RESULTS: For all the patients who underwent 4D US-guided core biopsy, the specimens were adequate for making the pathological diagnosis, and specimens were successfully obtained for those patients who underwent 4D US-guided aspiration. The patients treated with 4D US-guided therapeutic drug injection or needle puncture had a good response. No major procedure-related complications occurred. The procedural times were similar to those procedural times with using two-dimensional US. CONCLUSION: Combining the two dimensional and 4D US techniques aids the physician when performing US-guided interventional procedures for the superficial lesions.