Presence Of Hypoechoic Areas Research Articles

DETERMINATION OF OVULATION TIME IN GAYO MARES BASED ON IMAGE OF PREOVULATORY FOLLICLE GROWTH

This study aimed to obtain the ultrasound image of preovulatory follicle growth in gayo mares to predict the ovulation time. This study used three Gayo mares and one gayo stallion for teaser aged 5-10 years and weighed 200-250 kg. Preovulatory follicle growth was observed using transrectal ultrasonography which was performed when the dominant follicle size was ≥ 3.5 cm. Observations were made for 3 consecutive estrous periods on gayo mares at relatively the same time. The absence of previous follicular appearance and the presence of hypoechoic area in the same ovary indicate that ovulation has occurred. The result revealed that the diameter of preovulatory follicle of gayo mares was 4.02±0.32 to 5.05±0.04 cm. There was no significant follicle growth in the last 48 hours before ovulation and the preovulatory follicle shape altered from spherical to pearshape. Many small follicles (2 cm in diameter) were observed in peripheral area of the ovary indicated the recruitment of follicles which form the first follicular wave. To conclude, the alteration in the size and pearshape of preovulatory follicle and the recruitment of small follicles can be used as a marker to determine the time of ovulation on gayo mares.

The importance of myofascial trigger points in chronic neck pain: An ultrasonography preliminary study.

Ultrasonographic evaluation of trigger points detected by physical examination in patients with myofascial pain syndrome is being used more frequently in clinical care. However, the sonographic appearance of trigger points, in association with pain and disability, has not been adequately described. To reveal the presence of trigger points with ultrasonography in those with myofascial pain syndrome and to determine if ultrasound images can help discriminate between demographic and disease characteristics. Fifty-two participants with chronic neck pain (NP) were in this cross-sectional study. The pain intensity was evaluated using a 0-10 cm visual analog scale (VAS). The neck disability index measured the NP-induced disability status of the participants. Ultrasonography was used to measure the thicknesses of the paraspinal muscles and the presence of hypoechoic areas within these muscles. There was a positive correlation between the VAS scores of the participants and the ultrasonographic detection of myofascial trigger points (MTPs) in the multifidus and middle trapezius muscles (right/left r = .30, p = .027; r = .29, p = .029; r = .32, p = .009, r = .30, p = .011, respectively). These features correlated with the disability levels of the participants and the MTPs on both the right and left sides of the splenius, multifidus, upper trapezius, and middle trapezius (r = .32, p = .028; r = .38, p = .013, r = .25, p = .027; r = .33, p = .016; r = .25, p = .025, r = .32, p = .018, r = .28, p = .013, r = .29, p = .016, respectively). A significant correlation was present between the detection of MTP at ultrasonography and decreased muscle thickness in the relevant muscles (between p = .001 and p = .034). The detection of MTPs with ultrasonography is associated with the severity of pain and disability in those with chronic NP. Features on ultrasound include hypoechoic changes within muscle and reduced muscle thickness associated with MTPs.

Role of shear wave elastography in the diagnostic evaluation of plantar fasciitis: a prospective case-control study.

To assess the advantage of the addition of shear wave elastography (SWE) to gray-scale sonography in the diagnosis of plantar fasciitis. 30 subjects between 18-60years of age with unilateral heel pain who were clinically suspected of having plantar fasciitis were included in this study. Their affected feet were taken as cases; while their contralateral feet served as controls. On gray-scale ultrasound, the thickness of plantar fascia, its echopattern, presence of hypoechoic areas, and perifasicular collections were recorded. SWE was done by placing seven ROIs within the plantar fascia; and the mean of their Young's modulus was taken in kPa. Plantar fascial thickening more than 4mm had 70% sensitivity and 66.7% specificity, echopattern had 90% sensitivity and 96.7% specificity, hypoechoic areas had 80% sensitivity and 96.7% specificity, and perifascial edema had 26.7% sensitivity and 100% specificity for diagnosing plantar fasciitis. Using the ROC curve, the cut-off value of Young's modulus for the diagnosis of plantar fasciitis was found to be ≤ 99.286kPa. This predicted plantar fasciitis with 97% sensitivity and 100% specificity. The primary diagnostic feature of ultrasound of plantar fascia thickness more than 4mm detected 21 out of 30 cases of plantar fasciitis; whereas elastography detected an additional 8 cases which would have been missed on B-mode ultrasound alone. SWE is a useful supplement and improves the diagnostic accuracy of gray-scale ultrasound in plantar fasciitis.

Ультразвукова діагностика характеру та давності травми живота

The purpose of the study was to study a complex of changes in ultrasound parameters of injured tissues of the liver, spleen, pancreas in mechanical trauma and their dependence on the nature and duration of injury. Materials and methods. Ultrasound examinations were performed in 60 injured patients (41 males and 19 females) aged 20 to 60 years old in the dynamics as for the 1st, 2nd, 3rd, 4th and 5th days after injury. Puncture, transverse and oblique scans from all possible accesses were used. The conditions of the liver, pancreas, spleen, kidneys were studied. Results and discussion. In the course of the studies, a high number of injuries to the abdominal and retroperitoneal organs was demonstrated; it was proved that isolated liver injuries were observed in 32%, in 68% the liver injury was combined with injuries of other abdominal organs. We observed isolated damage to the pancreas in 10%, in the remaining 90%, the injury to the pancreas was combined with damage to the liver, gallbladder and extrahepatic bile ducts, spleen, and intestines. Isolated injuries of the spleen were observed in 31% of patients; in other cases, the injury to the spleen was combined with injuries of other organs of the abdominal cavity. We observed isolated kidney damage in almost 15%. In 85% of cases, kidney damage was observed in combination with injuries of other parenchymal organs. It has been demonstrated that in the area of injured tissues of the liver, pancreas, spleen, and kidneys with blunt trauma to the abdomen in persons with no signs of alcohol intoxication, regular ultrasound changes are observed, which are in direct proportion to the time elapsed since the injury was caused. The main ultrasound signs of liver damage were ruptures of the parenchyma with the formation of intra-parenchymal or subcapsular hematomas. In general, for almost all the injured people the following sings were characteristic as an increase in liver size (often due to increased part of damage), heterogeneity of structure, blurred contours and their discontinuity, presence of hypo- and anechoic areas (hematomas) on the background of intact parenchyma. Characteristic ultrasound criteria of pancreatic damage in the first day are the lack of clear contours of the gland, their discontinuity, increase in the size of the gland, the presence of hypoechoic areas of different sizes. At ultrasound examination of the spleen, the main signs of its damage are the heterogeneity of the parenchyma and the presence of anechoic structure and free fluid in the abdominal cavity. In 69% of cases, the main sings were blurred and uneven contours of the spleen, as well as an increase in its size. Characteristic features of renal hematoma are an increase in their size, heterogeneity of structure with increasing echogenicity of the parenchyma, blurred contours and their discontinuity. Conclusion. It has been proven that it is advisable to use in a complex of changes in the parenchymal organs revealed by ultrasound examinations, both in cases of isolated organ trauma, and in cases of combined trauma of the abdominal cavity and retroperitoneal organs, to determine the time of causing damage, since it makes it possible to increase the objectivity of the results of establishing the duration of the injury

Role of Chronic Inflammation as a Predictor of Upstaging/Upgrading in Prostate Cancer: Finding a New Group Eligible for Active Surveillance.

We aimed to investigate the correlation between presence of inflammation and pathology upgrading/upstaging in patients with prostate cancer. A retrospective study was accomplished on 315 patients with prostate cancer, eligible for active surveillance except prostate-specific antigen (PSA) level (PSA<30ng/dL), who underwent radical prostatectomy between 2005 and 2015. Patients were divided into two groups based on needle biopsy: A; with evidence of inflammation (chronic prostatitis) and B; without inflammation. The frequency of upstaging and upgrading in both groups was compared in different ranges of PSA level (<10, 10-20 and 20-30ng/dL). Upgrading/Upstaging was defined as increase from one prognostic grade group to another. Statistical analyses were performed to investigate the relation between inflammation and upgrading/upstaging. The mean age of the patients was 68.2 years and the mean PSA level was 10.2 ng/mL. Chronic prostatitis was identified in 82 of 315 cases therefore upgrading/upstaging were seen in only three patients (3.7%) while 39 of 233 (16.7%) patients without inflammation had upgrading/upstaging in final pathology (P = 0.003). Other variables including the patient's PSA before surgery, PSA density, and the presence of hypoechoic areas in ultrasound had a significant relationship with the incidence of postoperative upgrading/upstaging. Among studied variables, presence of inflammation in biopsies was found to be the most important predictor of upstaging/upgrading (OR: 0.205). Our data demonstrated that patients with concurrent prostatitis and PCa may have a better prognosis even if the PSA level is higher than 10ng/mL.

Do adaptative changes occur in the achilles tendons of endurance runners?

Abstract Introduction and Aim Several studies associate tendinopathies with structural changes in the Achilles tendon (AT). However, few studies have demonstrated whether long distance running training can generate structural changes at the level of the AT. The aim of this study was to determine whether adaptive changes exist, both structural and functional, in the AT of asymptomatic endurance runners with no history of lesions to the AT. Material and Methods A cross-sectional descriptive study. In total, 14 subjects were selected and divided into two groups of 7 subjects each. The intervention group (IG) comprised all usual runners, running over 60 km per week, with no previous lesion to the AT. The control group (CG) included all active subjects but who did not perform competitive sports nor did they run more than 10 km per week. The ankle dorsal flexion (ADF) of each subject was measured together with the index of reactive force (IRF), and the width of the AT body was measured using ultrasound, together with the level of hypervascularization, the presence of hypoechoic areas and the presence of hyperechoic areas. To measure ADF, the validated measurement was used with the application (App) Dorsiflex for IPhone. To calculate IRF, the validated measure of the Drop Jump, test from the App My Jump 2 was used. The ultrasound assessment was always performed by the same examiner. The ultrasound machine was a General Electric, Logiq V2 model for measuring both feet: the width of the AT body, the degree of hyper vascularization, the presence of hypoechoic areas and the presence of calcifications. The subject was placed in prone, with the foot hanging off the table and the ankle was in 90° flexion. The examiner was placed on the same side as the lower limb examined. Results The means of the results obtained and p-values of significance were as follows: ADF = 46° CG 43.6° IG (p &gt; 0.005). IRF = 0.92 CG 1.07 IG (p &gt; 0.005) Ultrasound = CG 43% presence of vascularization outside the tendon; IG 83% presence of vascularization outside the tendon. Conclusions No significant evidence exists to support that the AT in endurance runners without a history of injuries, presents functional adaptations. However, it seems that in endurance runners, there is a greater presence of vessels in Kager's fat pad, although it is necessary to obtain data from a larger population to confirm and establish the possible relationships of these changes.

Ultrasound examination and patellar tendinopathy scores in asymptomatic college jumpers

ABSTRACTObjective: To investigate the prevalence of hypoechoic areas by US and its’ association with VISA-P scores among asymptomatic jumpers while highlighting sex comparisons.Design: Cross-sectional study.Setting: Pre-participation exam at a National Collegiate Athletic Association (NCAA) division I college.Participants: Thirty-one college athletes who engage in jumping sports.Main outcome measures: Hypoechoic images of patellar tendon captured by ultrasound examination were compared to a self-reported knee functional survey, the Victorian Institute of Sport Assessment for patellar tendinopathy (VISA-P) scale (0–100).Results: With a total of 31 athletes (13 males and 18 females), prevalence rate of the hypoechoic areas of patellar tendon was 19.4% (6/31) in the right knee and 29.0% (9/31) in the left knee. There was no proportional difference in a comparison of prevalence rate of hypoechoic area [(+) or (−)] by sex in either right or left knee. The VISA-P scores were significantly lower in US (+) than US (−) in the right knee (p = 0.003, Cohen’s d = 1.675), but not the left knee (p = 0.250, Cohen’s d = 0.512). The receiver operating characteristics curve analysis indicated the most sensitive and specific VISA-P values based on status [(+) or (−)] of hypoechoic area was 89.5 with 86.4% and 77.7% of sensitivity and specificity.Conclusion: In short, hypoechoic areas were detected by US examination among self-reported asymptomatic jumpers. There was an association between hypoechoic areas and VISA-P scores in the right knee, but not in left knee. VISA-P scores may be used as a screening tool for the presence of hypoechoic areas.

An ultrasonographic study of Peyronie's disease

A study was undertaken to determine the usefulness of ultrasonography as an investigative tool, and its role in deciding the management of Peyronie's disease. Fifteen patients with Peyronie's disease were studied by ultrasonography. The plaque could be demonstrated in all patients. The dimensions of the plaque varied from less than 1 cm to more than 7 cm in length and 2-4mm in thickness. The disease was active in 26% of the patients, as indicated by the presence of hypoechoic areas around a central region of hyperechoism. Ultrasonogram was more accurate than clinical assessment in delineating the extent of lesions. In one-third of the patients, sonography demonstrated the plaques to be more extensive than had been detected by clinical examination. Calcification and activity of disease (which are clearly defined by ultrasonogram) are determining factors in the management of Peyronie's disease. This information allows the surgeon to select the modality of treatment, the timing of surgery and extent of excision. Thus, ultrasonography plays a vital role in the preliminary investigation and management of Peyronie's disease.