The role of ultrasound imaging of temporomandibular joint condyle-disc complex disorders.

OBJECTIVE: This study aimed to determine the diagnostic value of ultrasonography (US) in internal derangements of temporomandibular joint (TMJ) and to compare its efficacy with magnetic resonance imaging (MRI). METHODS: Fifty patients with MRI indications due to a TMJ disorder were enrolled. Findings of the clinical examination, US examination and MRI examination were noted by seperate clinicians and the sensitivity, specificity and diagnostic accuracies of all examinations were compared. RESULTS: When compared with MRI, the sensitivity, specificity and diagnostic accuracy of the clinical examination for the internal derangements were 73%, 37%, and 70%, respectively and 75.7%, 33.3% and 73.0% for US examination, respectively. CONCLUSION: US can be considered as an alternative to MRI as it can be used to detect the disc position, internal derangements, intraarticular fluid accumulations and superficial condyle changes with minimally better results than clinical examination.

Reasons for Requesting Ultrasonography: A Retrospective Study.

OBJECTIVES: The aim of this study is to evaluate (i) the reasons for requesting ultrasonography (USG) in a dentistry faculty and (ii) the scanning regions, the type of probe used, and the use of Doppler USG. METHODS: USG request forms of patients who applied to our radiology clinic for USG were analyzed retrospectively. According to the clinical information of the patients in the request forms, the reasons for requesting USG were divided into four groups: soft tissue swelling, soft tissue calcification, lymph node, and other examinations. Data were statistically compared between sex (female and male) and age groups (≤40-years-old and ˃40-years-old). RESULTS: The USG request forms of 50 patients were obtained. The mean patient age was 45.06±14.50 years. Twenty-six patients were female (52%), while twenty-four patients were male (48%). Soft tissue swelling, soft tissue calcification, lymph node, and other examinations were noted as the reasons for requesting USG in 42%, 26%, 18%, and 14% of the patients, respectively. The most scanned regions were the submandibular (56%), parotid (16%), and cheek (10%) regions. Extraoral probe was used more frequently than intraoral probe (78% vs. 22%). Doppler USG was used in most patients (98%). A statistically significant difference was found between age groups and calcification examination (p<0.05). CONCLUSION: The reasons for requesting USG were mostly soft tissue swelling, soft tissue calcification, and lymph node examinations. The most commonly scanned region and used type of probe were the submandibular region and extraoral probe, respectively. Doppler USG was used in most patients.

Manejo de la enfermedad arterial periférica con uso de guía dúplex(salvamento de extremidad) en un hospital de tercer nivel de Bogotá (Colombia) / Management of peripheral arterial disease with the use of a duplex guide (limb salvage) in a hospital of third level in Bogota (Colombia)

Introducción: la enfermedad arterial periférica (EAP) se considera una patología infradiagnosticada que afecta a cerca de doscientos millones de personas y se asocia con una alta carga de morbimortalidad. En muchos casos, se prefiere el manejo endovascular sobre el quirúrgico abierto, especialmente en pacientes con múltiples comorbilidades, que limitan este último abordaje. Sin embargo, presenta limitaciones relacionadas con el uso de medio de contraste en pacientes que adicionalmente presentan múltiples comorbilidades, incluyendo enfermedad renal, que podría comprometer su patología de base. Por esto, surge la necesidad de implementar un método que limite el uso de contraste sin comprometer el éxito técnico del procedimiento. Objetivo: describir las características de las lesiones arteriales, los resultados posquirúrgicos y las complicaciones de los pacientes que recibieron manejo de la EAP vía endovascular bajo guía ultrasonográfica. Materiales y métodos: se realizó un análisis retrospectivo de los pacientes que recibieron tratamiento endovascular bajo guía ultrasonográfica para el tratamiento de EAP con amenaza de la extremidad y su resultado posoperatorio durante el periodo comprendido entre enero de 2018 y enero de 2022 en el Hospital Universitario Samaritana (Bogotá, Colombia). Resultados: se identificaron un total de 40 pacientes con 3 tipos de lesiones, incluyendo estenosis, oclusiones y lesiones mixtas, que fueron intervenidas con angioplastia con balón o con stent o trombectomías, todos bajo guía ultrasonográfica. La principal complicación asociada fue el pseudoaneurisma posterior a la retirada del catéter arterial en el 22,5 % de las ocasiones, seguida de la disección arterial, en el 13 % de las veces. Se consideró éxito posquirúrgico en el 92,7 % de los pacientes, evidenciado por mejoría en el porcentaje de velocidad pico sistólica final o en la morfología de la...(AU)

Introduction: peripheral arterial disease (PAD) is considered an underdiagnosed pathology that affects nearly 200 million people and is associated with a high burden of morbidity and mortality. In many cases, endovascular management is preferred over open surgery, especially in patients with multiple comorbidities that limit the latter approach. However, it has limitations related to the use of contrast medium in the context of patients who addi- tionally have multiple comorbidities, including kidney disease, which can compromise their underlying pathology. Therefore, the need arises to implement a method that limits the use of contrast, without compromising the technical success of the procedure. Materials and methods: a retrospective analysis of those patients who received endovascular treatment under ultrasonography guidance for the treatment of acute limb ischemia and their postoperative outcome. Objective: describe the characteristics of the arterial lesions, the post-surgical results and the complications of the patients who received management of arterial occlusive disease with extremity threat by endovascular approach under ultrasonographic guidance, at the University Hospital La Samaritana (Bogotá, Colombia) between 2018 - 2022. Results: a total of 40 patients were identified with 3 types of lesions including stenosis, and mixed lesions. Those patients received either balloon angioplasty, angioplasty with stent or thrombectomies. The main associated complication was pseudoaneurysm after arterial catheter removal in 22.5 %, followed by arterial dissection in 13 %. Post-surgical success was considered in 92.7 % of patients, evidenced either on the improvement in the percentage of final peak systolic velocity or in the morphology of the artery distal to the intervened segment.Conclusion: The use of ultrasonography as a guide for endovascular procedures is presented as an alternative to conventional angiography, with good success rates.(AU)

Markedly hypoechoic: a new definition improves the diagnostic performance of thyroid ultrasound.

OBJECTIVES: To determine the contribution of a modified definition of markedly hypoechoic in the differential diagnosis of thyroid nodules. METHODS: A total of 1031 thyroid nodules were included in this retrospective multicenter study. All of the nodules were examined with US before surgery. The US features of the nodules were evaluated, in particular, the classical markedly hypoechoic and modified markedly hypoechoic (decreased or similar echogenicity relative to the adjacent strap muscles). The sensitivity, specificity, and AUC of classical/modified markedly hypoechoic and the corresponding ACR-TIRADS, EU-TIRADS, and C-TIRADS categories were calculated and compared. The inter- and intraobserver variability in the evaluation of the main US features of the nodules was assessed. RESULTS: There were 264 malignant nodules and 767 benign nodules. Compared with classical markedly hypoechoic as a diagnostic criterion for malignancy, using modified markedly hypoechoic as the criterion resulted in a significant increase in sensitivity (28.03% vs. 63.26%) and AUC (0.598 vs. 0.741), despite a significant decrease in specificity (91.53% vs. 84.88%) (p < 0.001 for all). Compared to the AUC of the C-TIRADS with the classical markedly hypoechoic, the AUC of the C-TIRADS with the modified markedly hypoechoic increased from 0.878 to 0.888 (p = 0.01); however, the AUCs of the ACR-TIRADS and EU-TIRADS did not change significantly (p > 0.05 for both). There was substantial interobserver agreement (κ = 0.624) and perfect intraobserver agreement (κ = 0.828) for the modified markedly hypoechoic. CONCLUSION: The modified definition of markedly hypoechoic resulted in a significantly improved diagnostic efficacy in determining malignant thyroid nodules and may improve the diagnostic performance of the C-TIRADS. CLINICAL RELEVANCE STATEMENT: Our study found that, compared with the original definition, modified markedly hypoechoic significantly improved the diagnostic performance in differentiating malignant from benign thyroid nodules and the predictive efficacy of the risk stratification systems. KEY POINTS: • Compared with the classical markedly hypoechoic as a diagnostic criterion for malignancy, the modified markedly hypoechoic resulted in a significant increase in sensitivity and AUC. • The C-TIRADS with the modified markedly hypoechoic achieved higher AUC and specificity than that with the classical markedly hypoechoic (p = 0.01 and < 0.001, respectively).

Elastografía en musculoesquelético. ¿Herramienta o juguete? / Elastography in musculoskeletal imaging: a tool or a toy?

La elastografía es una novedosa técnica de imagen basada en los ultrasonidos que valora la deformabilidad de los tejidos para ayudar a caracterizar las lesiones. Su uso está muy extendido y ha sido validada en muchos tejidos (hígado, mama, tiroides, etc.). También se aplica en el estudio de la patología musculoesquelética, aunque con limitaciones debido a la variabilidad y heterogeneidad de los tejidos; no obstante, es una técnica muy prometedora. En este artículo trataremos de revisar su utilidad, posibles indicaciones, limitaciones y perspectivas de futuro.(AU)

Elastography is a novel imaging technique based on ultrasound that evaluates the deformability of tissues to help characterize lesions. It is widely used and has been validated in many tissues (e.g., liver, breast, thyroid). It is also used in the study of musculoskeletal disease. Although the use of elastography in musculoskeletal radiology is limited by the variability and heterogeneity of tissues, it is a very promising technique. In this article, we aim to review the usefulness, possible indications, limitations, and future perspectives of this technique in musculoskeletal radiology.(AU)

Elastography in musculoskeletal imaging: A tool or a toy?

Elastography is a novel imaging technique based on ultrasound that evaluates the deformability of tissues to help characterize lesions. It is widely used and has been validated in many tissues (e.g., liver, breast, thyroid). It is also used in the study of musculoskeletal disease. Although the use of elastography in musculoskeletal radiology is limited by the variability and heterogeneity of tissues, it is a very promising technique. In this article, we aim to review the usefulness, possible indications, limitations, and future perspectives of this technique in musculoskeletal radiology.

Avaliação ultrassonográfica de variações anatômicas entre vasos femorais realizada por estudantes de medicina / Ultrasonographic evaluation of anatomical variations in femoral vessels done by medical students

Introdução: A punção venosa central é um procedimento médico tradicionalmente realizado seguindo os marcadores anatômicos como referência para atingir o vaso, às cegas. No entanto, nem sempre o sucesso nessa técnica é alcançado, fato que se deve principalmente às variações anatômicas. A ultrassonografia point of care (US-POC) é utilizada para auxiliar a cateterização central por visualização direta do vaso, aumentando a segurança do procedimento. Objetivo: Avaliar a prevalência das variações anatômicas de vasos femorais através da utilização da US-POC por estudantes de medicina submetidos a curto período de treinamento. Material e Métodos: Cinco estudantes de medicina, sem experiência prévia em US-POC, foram submetidos a oito horas de treinamento teórico-prático. Foram avaliados os vasos femorais de cem voluntários. Resultados: A veia femoral direita foi encontrada mais frequentemente na posição medial (43%) em relação à artéria femoral direita. À esquerda, a posição posteromedial foi a mais observada (45%).Conclusão: A técnica tradicional de punção de acesso central se baseia em marcadores anatômicos e não leva em consideração as variações anatômicas existentes. Um treinamento de curto período para uso da US-POC é capaz de capacitar o profissional para reconhecer o posicionamento real dos vasos e evitar punções inadvertidas.

Introduction: Central vein puncture is a medical procedure traditionally done following anatomical landmarks as a reference to successfully achieving the vessel. However, this traditional technique is commonly unsuccessful due to anatomical variations that may be found. Point of care ultrasonography (POC-US) is used to assist central catheterization by directly visualizing the vessel, increasing procedure security and minimizing risks. Objective: Evaluate anatomical variations prevalence in femoral vessels, utilizing POC-US, done by medical students submitted to a short period of time training in ultrasonography. Material and Methods: Five medical students, without previous experience on the use of ultrasonography, were submitted to an eight-hour theorical practical training in POC-US. The students evaluated one hundred femoral vessels of volunteers. Results: The right limb femoral vein was found more frequently in the medial position (43%) in comparison to the right limb femoral artery. On the left limb, the posteromedial position was the most found (45%). Conclusion: The insertion of a central catheter following the traditional technique is based on anatomical landmarks, and does not take into account existing anatomical variations. With a short period of training, POC-US is capable of qualifying professionals to acknowledge the real location of the vessel and avoid inadvertent punctures and complications.

Effect of shear wave elastography in predicting pathological responses to neoadjuvant chemotherapy in patients with breast cancer / 中华超声影像学杂志

Objective:To investigate the clinical value of shear wave elastography (SWE) in predicting pathological responses to neoadjuvant chemotherapy in breast cancer.Methods:According to the postoperative pathological responses, 56 patients who received neoadjuvant chemotherapy followed by surgical excision in the Fujian Cancer Hospital from August 2019 to September 2020 were divided into responders and non-responders. The relative change rates of tumor maximum diameter(ΔD2, ΔD4) and SWE stiffness (ΔEmax2, ΔEmax4, ΔEmean2, ΔEmean4) were assessed before NAC and after different NAC cycles (t2, t4). Clinical information, including age, T, N stages, ER, PR, HER2, Ki67, and molecular subtype were also considered as the variables. The independent influencing factors of pathological responses after neoadjuvant chemotherapy were obtained by logistic regression analysis and diagnostic test was carried out.Results:There were 23 cases as responders (41.0%, 23/56), and 33 cases as non-responders (58.9%, 33/56). Results of multivariate analysis showed ΔEmax4 and HER2 index were independent influencing factors of pathological responses ( OR=1.11, P<0.001; OR=31.81, P=0.002). Area under curve of the ΔEmax4 (AUC: 0.869, 95% CI: 0.746-0.941) was higher than that of HER2 (AUC: 0.690, 95% CI: 0.545-0.834). The combination of ΔEmax4 and HER2 gave the best prediction of pathological responses (AUC 0.930, 95% CI: 0.829-0.981). the sensitivity, specificity, diagnostic accuracy, postive predictive value, and negative predictive value were 78.26%, 96.97%, 75.23%, 94.73%, and 86.49%, respectively. Conclusions:ΔEmax4 and HER2 are independent predictors of pathological responses after neoadjuvant chemotherapy for breast cancer. Combined ΔEmax4 and HER2 can improve the predictive diagnostic efficacy of pathological responses to chemotherapy for breast cancer.

Prenatal diagnosis of congenital mesoblastic nephroma: a case with poor prognosis.

Congenital mesoblastic nephromais a rare tumour found in neonates, with a very small number of cases diagnosed prenatally. We report a case of a fetal renal tumour suspected at 28 weeks' gestation on routine ultrasound. Prenatal follow-up revealed a severe polyhydramnios at 32 weeks' gestation subsequent amniodrainage was undertaken. She delivered at 34+5 weeks' gestation, after spontaneous premature rupture of membranes.

Clinical significance of ultrasound in the diagnosis of uterine adnexal mass / 中国基层医药

Objective@#To study and explore the clinical significance of ultrasound in the diagnosis of uterine adnexal mass.@*Methods@#From January 2014 to December 2016, 160 patients with uterine adnexal cystic lesions in our hospital were selected.All the patients received ultrasound examination, the kinds of lesions were judged, and according to the results of pathological diagnosis of operation, pathological diagnosis of biopsy and clinical follow-up, the consistency between ultrasonic diagnosis and confirmed diagnosis results was analyzed.@*Results@#Of 160 cases with adnexal cystic lesions, a total of 36 cases of endometrial ectopic cyst, 37 cases of ovarian cystadenoma, 19 cases of tubal ectopic pregnancy, 28 cases of inflammatory mass, 19 cases of ovarian cystadenocarcinoma, 21 cases of teratoma.After calculation, ultrasound examination of the uterus endometriosis cyst, cystadenoma of ovary, fallopian tube ectopic pregnancy, inflammatory mass, ovarian cyst, teratoma were 91.67%, 91.89%, 84.21%, 89.29%, 89.47%, 90.48%, respectively, and confirmed the consistency with the results, there were no statistically significant differences (χ2=0.166, 0.163, 0.291, 0.206, 0.125, 0.114, all P>0.05).@*Conclusion@#Ultrasound in the diagnosis of uterine adnexal cystic lesions can effectively detect and distinguish different types of lesions, it has high diagnostic value.

[Value of modified TI-RADS in the diagnosis of medullary thyroid carcinoma].

Objective: To investigate the value of modified thyroid imaging reporting and data system (TI-RADS) in the sonographic diagnosis of medullary thyroid carcinoma (MTC), and to evaluate the sonographic differences among MTC, papillary thyroid carcinoma (PTC) and benign nodules in order to improve the ultrasound diagnostic accuracy of MTC. Methods: 646 cases of thyroid lesions confirmed by pathology in our hospital were divided into the MTC group (64 cases), PTC group (414 cases) and benign group (168 cases). The ultrasonographic characteristics of these groups were retrospectively analyzed. All of the 646 cases were classified by modified TI-RADS grading criteria. The diagnostic accuracy of MTC and ultrasonic manifestations of MTC, PTC and benign nodular were assessed. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of modified TI-RADS for MTC were 87.5%, 89.9%, 72.6%, 88.8%, and 67.2%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of modified TI-RADS for PTC were 96.1%, 59.5%, 85.4%, 86.2% and 85.6%. The intraclass correlation coefficient (ICC) of three different physicians for thyroid nodules was 0.983 by the modified TI-RADS. MTC were mostly located in middle and upper parts of the thyroid (85.9%, 55/64), hypoechoic or extremely hypoechoic (89.1%, 57/64), with relatively smooth margin (35.9%, 23/64), aspect ratio<1 (53.1%, 34/64), abundant blood flow (31.2%, 20/64), and high lymph node metastasis rate (51.6%, 33/64). These differences were statistically significant when compared to PTC (P<0.05). Conclusions: Repeatability of modified TI-RADS for MTC was high, and is slightly lower than that for PTC. MTC had specific features: mostly located in middle and upper parts of the thyroid, hypoechoic or extremely hypoechoic, relatively smooth margin, aspect ratio<1, abundant blood flow and high lymph node metastasis rate.

Value of modified TI-RADS in the diagnosis of medullary thyroid carcinoma / 中华肿瘤杂志

Objective@#To investigate the value of modified thyroid imaging reporting and data system (TI-RADS) in the sonographic diagnosis of medullary thyroid carcinoma (MTC), and to evaluate the sonographic differences among MTC, papillary thyroid carcinoma (PTC) and benign nodules in order to improve the ultrasound diagnostic accuracy of MTC.@*Methods@#646 cases of thyroid lesions confirmed by pathology in our hospital were divided into the MTC group (64 cases), PTC group (414 cases) and benign group (168 cases). The ultrasonographic characteristics of these groups were retrospectively analyzed. All of the 646 cases were classified by modified TI-RADS grading criteria. The diagnostic accuracy of MTC and ultrasonic manifestations of MTC, PTC and benign nodular were assessed.@*Results@#The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of modified TI-RADS for MTC were 87.5%, 89.9%, 72.6%, 88.8%, and 67.2%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of modified TI-RADS for PTC were 96.1%, 59.5%, 85.4%, 86.2% and 85.6%. The intraclass correlation coefficient (ICC) of three different physicians for thyroid nodules was 0.983 by the modified TI-RADS. MTC were mostly located in middle and upper parts of the thyroid (85.9%, 55/64), hypoechoic or extremely hypoechoic (89.1%, 57/64), with relatively smooth margin (35.9%, 23/64), aspect ratio<1 (53.1%, 34/64), abundant blood flow (31.2%, 20/64), and high lymph node metastasis rate (51.6%, 33/64). These differences were statistically significant when compared to PTC (P<0.05).@*Conclusions@#Repeatability of modified TI-RADS for MTC was high, and is slightly lower than that for PTC. MTC had specific features: mostly located in middle and upper parts of the thyroid, hypoechoic or extremely hypoechoic, relatively smooth margin, aspect ratio<1, abundant blood flow and high lymph node metastasis rate.

Feasibility and pharmacokinetics of caudal blockade in children and adolescents with 30-50 kg of body weight.

BACKGROUND: Caudal blockade, although an important technique of pediatric regional anesthesia, is rarely used in children heavier than 30 kg. This reservation is due to anatomical concerns and lack of pharmacokinetic data. We therefore set out to evaluate, in pediatric patients weighing 30-50 kg, the feasibility of ultrasound-guided caudal blockade and the pharmacokinetics of caudally administered ropivacaine. METHODS: Twenty consecutive children were included. General anesthesia was used to ensure a secured airway. For the caudal punctures, we applied the same clinical standards as in smaller children, administering ropivacaine 3.1 mg·ml-1 for a volume of 1 ml·kg-1 via ultrasound guidance. Pharmacokinetic analysis was based on total plasma ropivacaine levels and included maximum concentration (Cmax ), time to Cmax (tmax ), terminal elimination half-life, area under the concentration-time curve for the 4-h sampling period, apparent total body clearance, and apparent volume of distribution. RESULTS: In all 19 cases of successful puncture, we identified the relevant anatomical structures (sacral cornua, sacral hiatus, dura mater) and verified correct administration of the local anesthetic by visualizing its cranial spread. Surgical blockade was successful in 18 of 20 cases (90%; one puncture was technically not possible and one child received intraoperatively 50 µg fentanyl). The pharmacokinetic profile of the administered ropivacaine 3.1 mg·ml-1 indicated plasma levels within safe ranges in pediatric patients weighing 30-50 kg. CONCLUSIONS: Based on our pharmacodynamic and pharmacokinetic results, we suggest that the body weight of 50 kg it is feasible to perform effective and safe caudal blockade in children up to 50 kg body weight.

A Retrospective Analysis of Ultrasonographic Misdiagnosis of Thyroid Multiple Nodules With Thyroid Carcinoma / 昆明医科大学学报

Objectives To explore the ultrasonic features in the differential diagnosis of thyroid multiple nodules with thyroid carcinoma and summarize the causes of misdiagnosis,and to improve the accuracy of ultrasonic diagnosis of thyroid carcinoma.Methods The ultrasound images from the 40 patients with thyroid carcinoma were selected,whose diagnosis of thyroid carcinoma was confirmed by the pathological examinations after surgery but misdiagnosed or not identified by ultrasound examination.These ultrasound images were retrospectively analyzed through observing the carcinomatous nodules in size,aspect ratio,shape,border,envelope,internal echo,calcification characteristics,posterior echo,acoustic halo,the distribution of blood flow,and the relationship with thyroid capsule and anterior organization,whether to transfer to neck or spraclavicular lymph nodes,and the performance of elasticity imaging,and then these features were compared with the ultrasonic features of the benign thyroid nodules.Results The ultrasonic features of thyroid multiple nodules with thyroid carcinoma were complicated and each nodule should be observed and analyzed individually.The ultrasonic features of carcinomatous nodules were:(1) irregnlar shape,(2)aspect ratio ≥ 1,(3)unclear border,(4)no capsule,(5)heterogeneous hypo echo inside of the carcinomatous nodules,(6)scattered distribution of clustered microcalcifications,(7)incomplete acoustic halo or absent,(8)blood supply to the centrality inside of the carcinomatous nodules,(9)invaded thyroid capsule and anterior organizations,(10)transformation to neck or supraclavicular lymph nodes in the minority of patients,(11) elasticity imaging score of 3 ～ 5.Conclusions It is quite difficult to identify the ultrasonic features of thyroid multiple nodules with thyroid carcinoma and it is with high misdiagnosis rate.A comprehensive analysis of sonographic features is essential in clinical practices,and it will contribute to improving the accuracy of the ultrasonic diagnosis of thyroid multiple nodules with thyroid carcinoma.

Effect of weight loss on bone mineral density determined by ultrasound of phalanges in obese women after Roux-en-y gastric bypass: conflicting results with dual-energy X-ray absorptiometry.

The rapid weight loss that occurs in obese patients submitted to Roux-en-y gastric bypass (RYGB) as well as the changes in dietary pattern and the intestinal malabsorption result in changes in bone mineral density (BMD). The objective of the present study was to assess the changes in BMD after the weight loss induced by RYGB using ultrasound of the phalanges and compare the results with those obtained by dual-energy X-ray absorptiometry (DXA). We conducted a 1-yr prospective longitudinal study on women with grade III obesity submitted to RYGB. Anthropometric (weight, height, body mass index, and abdominal circumference) and body composition measurements by electrical bioimpedance, assessment of food consumption by 24-h recall, biochemical evaluation, and assessment of BMD by ultrasonography of the phalanges and DXA (BMD values are from the 33% radius site) were performed during the preoperative period and 3, 6, and 12 mo after surgery. The mixed-effects linear regression model was used to analyze the effect of postoperative time on the variable of interest, and the kappa coefficient (p < 0.05) was used to compare the concordance of the methods used for BMD evaluation. Twenty-nine patients were included in the study. During the 1-yr follow-up, a reduction of 39 ± 8 kg (71 ± 15% of excess weight) and 29 ± 7 kg of fat mass was observed. Calcium and zinc concentrations were reduced after 12 mo. No difference in caffeine, calcium, or sodium consumption was observed between the preoperative and postoperative periods. Analysis of BMD by ultrasonography of the phalanges 1 yr after surgery showed increased values of amplitude-dependent speed of sound (2064.6 ± 59.4 vs 2154.7 ± 63 m/s; p < 0.001) and ultrasound bone profile index (0.73 ± 0.13 vs 0.76 ± 0.14; p < 0.001). Analysis of BMD by DXA showed a reduction of BMD values (0.6 ± 0.04 vs 0.57 ± 0.05 g/cm³; p < 0.001) in the sixth month and maintenance of the values from the sixth to the 12th month. At the end of the study, there was no concordance between the methods for BMD analysis. This study showed improvement in bone quality and quantity assessed by ultrasonography. However, the DXA results showed a reduction in BMD after 12 mo of RYGB. Thus, the BMD measurement methods were discordant.

Ecobiometria ocular de cães glaucomatosos / Ocular echobiometry in glaucomatosus dogs

Foram estudados olhos glaucomatosos de cães referidos no serviço de diagnóstico por imagem. Os pacientes foram submetidos à ultrassonografia em modo B de alta resolução para realização de biometria ocular, por meio da qual foram realizadas as seguintes medidas: espessura central da córnea, profundidade da câmara anterior, espessura da lente e profundidade da câmara vítrea. Para tal, foi realizada contenção física e instilado colírio anestésico. Foram aferidas a PIO e a paquimetria da córnea e, em seguida, foi realizada a ultrassonografia em modo B nos dois olhos. Além da diferença óbvia de PIO, maior nos bulbos glaucomatosos, os resultados mostraram-se estatisticamente significativos em dois parâmetros: aumento da profundidade da câmara vítrea nos casos de glaucoma crônico (1,24±0,26cm; P=0,01) quando se comparou aos olhos controle e aumento da espessura da córnea também nos casos de glaucoma agudo (0,987±0,28cm; P=0,027), quando se comparou aos olhos controle e aos olhos com glaucoma crônico. Observou-se que a câmara vítrea é a estrutura intraocular que mais contribui no processo de expansão de volume do bulbo (buftalmia) durante o glaucoma...

Dogs with glaucomatous eyes referred to the Diagnostic Image Service at the Veterinary Hospital in the Federal University of Parana were studied using B-mode ultrasonography. Patients were submitted to a high resolution B-mode ultrasonography examination in order to perform ocular echobiometry. The following measurements were performed: central corneal thickness, anterior chamber depth, lens thickness and vitreous chamber depth. Physical restraint was performed and anesthetic eye drops were used. Corneal pachymetry and IOP were evaluated first and then B-mode ultrasonography was carried out in both eyes. Besides an obvious difference in IOP, which is higher in glaucomatous eyes, vitreous chamber depth significantly increases in cases of chronic glaucomatous eyes (1.24±0.26cm P=0.01), when compared to control eyes; and corneal thickness also increases in cases of acute glaucoma (0.987±0.28cm P=0.027), when compared to control eyes and to chronic glaucomatous eyeballs as well. Vitreous chamber is the intraocular structure that most contributes to the process of volume expansion of the globe (buphthalmos)...

Value of ultrasound imaging on atherosclerosis of abdominal aorta in rabbits / 中华老年医学杂志

Objective To evaluate the agreement between contrast-enhanced ultrasound imaging and histopathology in rabbit model of abdominal aortic atherosclerosis (AS)in early and development period.Methods Twenty-four healthy Japanese white rabbits were randomly divided into three groups:control group,hypercholesterolemic diet group for 8 weeks and 16 weeks (each for 8 rabbits).Contrast-enhanced ultrasonography for abdominal aorta was performed using sonicated perfluorocarbon albumin contrast agent.Imaging characteristics of abdominal aorta plaque of rabbits were monitored by two-dimensional mode,ultrasound visual grades were analyzed quantitatively before and after injection of contrast agent.Histopathologic changes were observed by HE staining.Results Contrast-enhanced ultrasound imaging allowed early detection of AS and showed gradual progression of atherosclerosis over time.After contrast agent injected,intimal indentification and plaques checking-out ratio were improved.The ultrasound visual grades were increased after contrast imaging in hypercholesterolemic diet group for 8 weeks [(2.26± 0.27)vs.(1.79 ±0.25)] and 16 weeks [(3.54 ±0.43) vs.(3.20 ±0.25)] (all P＜0.05).The plaque detection rate was improved after contrast-enhanced ultrasound imaging than before angiography in hypercholesterolemic diet group for 8 weeks [77.8％ (7/9) vs.55.6％ (5/9)] and 16 weeks [88.2％ (15/17) vs.70.6％ (12/17)](P ＞ 0.05).The imaging of ultrasound agreed well with pathological examination results.Conclusions Contrast-enhanced ultrasonography can effectively improve intimal and plaque imaging,and increase the detection accuracy of early and progressive pathology.

Prediction of vesicoureteral reflux in children with first urinary tract infection by dimercaptosuccinic Acid and ultrasonography.

OBJECTIVE: Urinary tract infection (UTI) is one of the most common causes of febrile pediatric diseases. Also, vesicoureteral reflux (VUR) is a significant risk factor for UTI. Voiding cystourethrography (VCUG) is the method of choice for evaluation of VUR. This study was done to predict VUR by DMSA scan (technetium 99 m-labeled dimercaptosuccinic acid) and ultrasonography (US). METHODS: In a prospective study, all children with first time acute pyelonephritis were selected and evaluated by DMSA scan and US. Then VCUG was done with negative urine culture. All children with final diagnosis of obstructive congenital anomaly were excluded. The sensitivity, specifity, positive predictive values, negative predictive values, Confidence Interval of DMSA scan and US were calculated for prediction or exclusion of VUR. FINDINGS: Among 100 children with UTI diagnosis, VUR was detected in 39 children and 63 (31.5%) kidneys. DMSA scan was abnormal in 103 (51.5%) units, 45 units had VUR (PPV=44%), 79 units with normal DMSA scan had no VUR (NPV=81%). Of kidney units that were abnormal by DMSA or US, 51 units had VUR. PPV and NPV were 44% and 56%, respectively. CONCLUSION: DMSA scan alone or with US cannot predict VUR (especially low grade VUR). But according to NPV, it seems that absence of VUR can be predicted. So, more studies are needed to determine the usefulness of DMSA scan and US instead of VCUG for detection of VUR.

Effect of ultrasound-guided transverses abdominis plane block on efficacy of postoperative analgesia in patients undergoing abdominal hysterectomy / 中华麻醉学杂志

Objective To investigate the effect of ultrasound-guided transverses abdominis plane (TAP)block on the efficacy of postoperative analgesia in patients undergoing abdominal hysterectomy. Methods Sixty ASA Ⅰ - Ⅱ patients scheduled for abdominal hysterectomy under general anesthesia were randomly divided into 2groups (n = 30 each): ropivacaine group (group R) and normal saline (group NS). After induction of anesthesia,ultrasound-guided bilateral TAP block was performed, and 0.375% ropivacaine 40 ml was injected in group R,while the equal volume of normal saline was used instead in group NS. The patients received patient-controlled intravenous analgesia (PCIA) with sufentanil after operation. The VAS score was maintained ≤ 3, the level of sedation was evaluated with Ramsay sedation score, and the comfort level was evaluated with Bruggrmann comfort scale (BCS) score at 2, 6, 8, 12 and 24 h after operation. The hemodynamic parameters were recorded. The consumption of sufentanil during operation and within 24 h after operation, the number of successfully delivered doses ( D1 )and the number of attempts ( D2 ) within 24 h after operation were recorded. D1/D2 was calculated. The adverse reactions were also recorded. Results SP, DP, HR, SpO2 and RR were in the normal range and there was no significant differences between the two groups ( P ＞ 0.05). The consumption of sufentanil were significantly lower,while the BCS score and D1/D2 higher in group R than in group NS (P ＜ 0.05). There were no adverse reactions in both groups. Conclusion Ultrasound-guided TAP block reduces the perioperative sufentanil consumption and enhances the efficacy of postoperative analgesia in patients undergoing abdominal hysterectomy.

Evaluation of cystic renal mass with contrast enhanced ultrasonography / 中华泌尿外科杂志

Objective To investigate the value of contrast enhanced ultrasonography in evaluating cystic renal mass. Methods According to the imaging diagnosing standard, 29 cystic renal mass lesions were studied with contrast enhanced ultrasonography(CEUS), unenhanced ultrasonography (US), contrast enhanced CT(CECT) and then correlated their results with final histopathological results. The data were tested by receiver operating characteristic(ROC) curve. Results The area under ROC curve of CEUS and US was 0. 721, 0. 997, respectively. There was significant difference between the 2 groups (P=0. 003). The area under ROC curve of CEUS and CECT was 0. 997, 0. 997,respectively. There was no significant difference between the 2 groups (P= 1. 000). Conclusions CEUS is better than US and similar to CECT in evaluating cystic renal mass. CEUS with the Bosniak classification is useful for evaluating cystic renal mass.