Echo Sonography Research Articles

Anatomsko-morfološke karakteristike apendiksa u akutnom apendicitisu

Introduction: Echosonography of the appendix is the primary method in the diagnostic algorithm of acute appendicitis, after clinical and laboratory examination. Non-invasiveness, availability and easy performance are the advantages of this method in detecting acute appendicitis. Aim: The research aimed to determine the morphological characteristics of the appendix, as well as to evaluate the role of echo sonography in the exploration and visualization of pathological changes in the appendix in acute appendicitis. Material and methods: The cross-sectional study included 59 people who underwent appendectomy and echosonographic examination of the abdomen and pelvis within the Department of Radiological Diagnostics of UHC "Dr Dragisa Misovic-Dedinje" in Belgrade. Results: In 48 out of a total of 59 people (81.4%), there were echosonographic signs of acute appendicitis, of which incompressibility of the wall was present in 40 people (83%), diameter of the appendix over 6mm in 38 (79%), wall thickness over 3mm in 45 (94%), target sign in 33 (69%), hypervascularization of the wall in 28 (58%), as well as the presence of fecoliths with nonhomogeneous content intraluminally in 15 (31.2%) persons. The sensitivity of echosonographic examination for obtaining positive results in persons with acute appendicitis was 86.5%. The specificity of the echosonographic examination to obtain negative results in persons who do not have acute inflammation of the appendix was 57.1%. The positive predictive value (PPV) was 93.7%. The negative predictive value (NPV) was 36.4%. The accuracy of the method was 83.1%. Conclusion: Based on the high sensitivity values of the tests tested in this cross-sectional study, we estimate that echosonographic examination has a primary role in the diagnostic algorithm of a person with suspected acute appendicitis.

Comparison of diagnostic methods for hemodynamic treatment in unborn and pre-term infants using the measurement of vena cava, lactate, and clinical criteria

Introduction: There is no single criterion available to assess the hemodynamic state of new-born infants and preterm infants and the different variables in the group of newborns, such as gestational age, birth weight, and periods of birth. Methods: This is an epidemiological, cross-sectional, descriptive observational study with two patient cohorts. Newborn-to-term and preterm neonates assisted at the Neonatal Unit of the Pablo Arturo Suarez Hospital participated during the months between November 2019 to January 2020. Results: Ultrasound measurement of the vena cava (FVC) flow is useful for the management treatment of hemodynamically unstable neonatal patients. The sample was made up of 110 newborns treated in the Pablo Arturo Suarez Hospital's neonatology service from November 2019 to January 2020. Quito, Pichincha, Ecuador. The variables low birth weight and moder-ate prematurity have a statistically significant value for inotropic use. The other variables do not present statistically significant values. Heart rate, urinary output, mean blood pressure, lactic acid, capillary filling, upper vena cava flow, and lower vena cava flow had statistically significant values. FVCI and FVCS comparisons with heart rate, urinary output, mean blood pressure, lactic acid, and capillary filling had statistically significant values, except for capil-lary filling> 3 sec in FCVI. Multivariate analysis of categorical main components (CATPCA) was used to characterize the hemodynamic state and inotropic state, which were significant in the bivariate analysis. Dimension, one of the two-dimensional graphs, discriminates the use or not of inotropics and the categories of hemodynamic parameters TAM <35 mmHg, lactic acid, capillary filling, FVCI, and FVCS. Dimension II discriminates between the categories of urinary expenditure and HR. Conclusion: In term and preterm infants with low weight and adequate birth weight with hemodynamic instability in general, who were evaluated with ultrasonography to measure the flow of the vena cava, the agreement between the clinical criteria and the ultrasound assessment of the flow was 0.4 cm/sec in both methods. This situation means that the measurement of venous cava flows by echo sonography is useful for assessing neonatal patients' hemodynamic status.

English

BACKGROUND Chronic arterial insufficiency (CAI) results in stenotic-occlusive disease of vascularized arterial disorders of tissues and organs. CAI of the lower extremities represents a significant medical and socio-economic problem due to a high incidence of morbidity, invalidity and mortality. METHODS A cross sectional analytical study was conducted in a group of 100 patients, admitted at the Vascular Department of the Sri Venkateshwara Ramnaraian Ruia Government General Hospital, Tirupati during the period from September 2018 to August 2019, with evident symptoms and signs of different stages of lower extremities CAI verified by ultrasonography. In patients with lower extremity disorder of tissue arterial capillaries, SpO2 was determined by pulse oximetry. CAI of the lower extremity was determined on the basis of clinical findings and colour Doppler duplex scan echo sonography results. Using the conventional method (single-gate) and colour Doppler duplex scan (multi-gate), the presence and localization of stenosis, the segmental predominance (with multisegmental forms) and the degree of progression of stenotic-occlusive lesions were verified. RESULTS Results Using pulse oximetry, depending on the of stage of lower extremities CAI, we revealed a considerable difference in the stages of functional ischemia Mean SpO2: Fontaine I – 95.50 %, Fontaine II – 92.90; in stage critical ischemia SpO2: Fontaine III – 65.00 % and Fontaine IV – 49.87 %. In 29 patients with gangrenous foot and fingers SpO2 was immeasurable and progressive decrease in SpO2 of arterial capillaries (p<0.01 between stages). CONCLUSIONS Due to the reliability and simplicity of pulse oximetry it can be a routinely used diagnostic device for patients with early determined stage of lower extremities CAI. KEYWORDS Chronic Arterial Insufficiency, SPO2, Pulse Oximetry, Ischemia

Recent technological advancements in thermometry.

Thermometry is the key factor for achieving successful thermal therapy. Although invasive thermometry with a probe has been used for more than four decades, this method can only detect the local temperature within the probing volume. Noninvasive temperature imaging using a tomographic technique is ideal for monitoring hot-spot formation in the human body. Among various techniques, such as X-ray computed tomography, microwave tomography, echo sonography, and magnetic resonance (MR) imaging, the proton resonance frequency shift method of MR thermometry is the only method currently available for clinical practice because its temperature sensitivity is consistent in most aqueous tissues and can be easily observed using common clinical scanners. New techniques are being proposed to improve the robustness of this method against tissue motion. MR techniques for fat thermometry were also developed based on relaxation times. One of the latest non-MR techniques to attract attention is photoacoustic imaging.

Early Detection of Urinary Tract Anomaly - Prevention of Kidney Failure in Children (Case Report)

One of the numerous reasons for chronic kidney insufficiency among children is congenital anomaly of the urinary tract. Such anomalies are detected in the antenatal stage with echo sonography, but most of them are detected after birth, too. Some of them are placid and there is no need to operate on them, but some of them are serious, so, unless detected on time, they may lead to progressive decline of the kidney parenchyma. This refers to the obstructive anomalies that are mostly correctible through surgery.

A case report of primary fibrosarcoma of the liver

A 75-year-old woman was admitted to our hospital complaining of right hypochondrial pain. Echo sonography and computed tomography demonstrated a large tumor with irregular internal density in the right lobe of the liver. Angiography revealed a moderately hypervascular tumor. She was treated with transcatheter arterial embolization. Three weeks later, the tumor ruptured. She died of accompanying acute myocardial infarction seven months after the onset of the illness. Autopsy revealed primary fibrosarcoma of the liver. The tumor appearance varied from firm whitish to soft myxomatous. A part of the tumor showed hemorrhagic necrosis. There was no intrahepatic metastasis. The tumor tissue was composed of spindle shaped cells and immunohistochemically stained with vimentin.

Delayed left ventricular rupture after mitral valve replacement

Posterior left ventricular rupture (LVR) is a serious complication following mitral valve replacement (MVR), especially if occurring postoperatively with the chest already closed or the patient in the intensive care unit. Only one of the patients with this delayed type of LVR reported earlier has been treated successfully. Our experience consists of 4 such complications among 161 MVR patients, the incidence being 2.5%. Two of these patients survived. Mechanical factors seem to constitute the most important etiologic causes for this complication. Immediate reoperation must be performed, and extracorporeal circulation is generally mandatory for successful repair. The reconstruction of the ruptured posterior left ventricular wall in both surviving patients was performed from the epicardial surface of the heart using pledget sutures. The auricle of the left atrium was used to cover the site of the tear when bleeding was not stopped with pledget sutures. It usually seems possible to avoid this complication if all mechanical etiologic factors are taken into consideration. After successful correction, a pseudoaneurysm may arise and, for that reason, a cardiac echo sonography follow-up is recommended.

Stellenwert der hochauflösenden Real-Time-Sonographie beim Mammakarzinom

1015 women were examined via scanning echo sonography in the course of a prospective study. Histological results are available from 370 patients following sample excisions or breast amputations. 122 histologically established malignant findings were compared with the preoperatively effected tumour status prognosis obtained via echo mammography and x-ray mammography. In 60 of 122 cases (50%) we found that the patients had carcinomas of stage T1. The sonographic accuracy rate was high (49 out of 60 carcinomas = 81%), whereas x-ray mammography yielded an accuracy of only 77%, since 46 out of 60 cases only had been classified as malignant. The smallest carcinomas visualised by sonography had diameters of 4 mm, 5 mm and 6 mm. In accordance with the fine structure of the tissue, solid carcinomas were recognised most frequently, compared with all other carcinomas, the rate of detection being 96% (26 out of 27). In 64% of all carcinomas, a retrotumourous sonographic shadow was seen. In cases with solid carcinomas, this "sonographic shadow phenomenon", however, was actually present in 34.6% of the cases only, although the rate of identification was highest of all. The results show that echo mammography is the most important additive investigation method in diagnosis of diseases of the breast, besides x-ray mammography, which is of course also an important method. Echo mammography offers a high degree of accuracy in preoperative differential diagnostic assessment of tumour status in malignant processes of the breast.