Elastography Improves the Accuracy of Ultrasound in the Preoperative Assessment of abdominal wall endometriosis.

PURPOSE: To assess the role of elastography in preoperative ultrasound assessment of abdominal wall endometriosis (AWE) location. MATERIALS AND METHODS: 33 patients qualified for surgical excision of AWE were included in the study. Preoperative assessment of AWE was performed transabdominally on a Samsung Medison V20 Prestige with a transvaginal probe and Elastoscan® option. The following B-mode settings were used: focus set to the lower end of the lesion, gain adjusted to obtain best image quality, tissue harmonic imaging activated. For elastographic examinations the color map from red (soft) to purple (hard) and the alpha blend option (a blend of B-mode and elastographic image) were used. AWE location was first assessed by B-mode ultrasound as: superficial (located in SCT only; SCT visible between the fascia and the lesion; intact fascia), intermediate (located in SCT or in RAM; no subcutaneous or muscle tissue between the lesion and the fascia; fascia infiltrated); or deep (located in RAM; muscle tissue visible between the lesion and the fascia; fascia intact). Then the AWE location was assessed by alphablend elastography as: superficial (hard lesion in soft SCT; soft SCT between the fascia and the lesion; no hard areas on the fascia); intermediate (hard lesion in soft SCT or soft RAM; no soft subcutaneous or muscle tissue between the lesion and the fascia; hard areas on the fascia); or deep (hard lesion located in RAM; soft muscle tissue between the fascia and the lesion; no hard areas on the fascia). These findings were verified during surgery. The surgeons were blinded to the results of elastography. The influence of obesity on the accuracy of ultrasound and elastography in assessing the location of AWE was evaluated. RESULTS: During surgery superficial AWE was found in 6, intermediate in 19 and deep in 8 patients. Preoperative ultrasound assessment was correct in 33.3 % of cases, while adding the elastography option improved the accuracy of AWE location assessment to 87.9 % (p < 0.05). The diagnostic accuracy of ultrasound alone, but not with the elastography option, was significantly decreased in the preoperative assessment of AWE location in overweight and obese patients. 4 patients required implantation of a mesh. In all cases the pathological examination confirmed the diagnosis of AWE. CONCLUSION: Elastography significantly improved the accuracy of ultrasound in evaluating the depth of infiltration of AWE, is not affected by increased BMI, and should be considered in patients qualified for surgical treatment of AWE.

Radon survey in the high natural radiation region of Niska Banja, Serbia.

A radon survey has been carried out around the town of Niska Banja (Serbia) in a region partly located over travertine formations, showing an enhanced level of natural radioactivity. Outdoor and indoor radon concentrations were measured seasonally over the whole year, using CR-39 diffusion type radon detectors. Outdoor measurements were performed at 56 points distributed over both travertine and alluvium sediment formations. Indoor radon concentrations were measured in 102 living rooms and bedrooms of 65 family houses. In about 50% of all measurement sites, radon concentration was measured over each season separately, making it possible to estimate seasonal variations, which were then used to correct values measured over different periods, and to estimate annual values. The average annual indoor radon concentration was estimated at over 1500 Bq/m3 and at about 650 Bq/m3 in parts of Niska Banja located over travertine and alluvium sediment formations, respectively, with maximum values exceeding 6000 Bq/m3. The average value of outdoor annual radon concentration was 57 Bq/m3, with a maximum value of 168 Bq/m3. The high values of indoor and outdoor radon concentrations found at Niska Banja make this region a high natural background radiation area. Statistical analysis of our data confirms that the level of indoor radon concentration depends primarily on the underlying soil and building characteristics.

Radon concentration in soil gas around local disjunctive tectonic zones in the Krakow area.

The purpose of this study was to investigate radon in the vicinity of geologic fault zones within the Krakow region of Poland, and to determine the influence of such formations on enhanced radon concentrations in soil. Radon ((222)Rn and (220)Rn) concentration measurements in soil gas (using ionization chamber AlphaGUARD PQ2000 PRO and diffusion chambers with CR-39 detectors), as well as radioactive natural isotopes of radium, thorium and potassium in soil samples (using gamma ray spectrometry with NaI(Tl) and HPGe detectors), were performed. Site selection was based on a geological map of Krakow. Geophysical methods (ground penetrating radar and shallow acoustic seismic) were applied to recognize the geological structure of the area and to locate the predicted courses of faults. Elevated levels of radon and thoron in soil gas were found in the study area when compared with those observed in an earlier survey covering Krakow agglomeration. For (222)Rn, the arithmetic mean of registered concentration values was 39 kBq/m(3) (median: 35.5 kBq/m(3)). For (220)Rn, the arithmetic mean was 10.8 kBq/m(3) and median 11.8 kBq/m(3).