Role Of Ultrasound Research Articles

The Role of Ultrasonography and Elastography in Differentiating Benign From Malignant Breast Masses With Pathologic Correlation

Objective: Elastography has the potential in differentiating benign from malignant masses. The objectives of the study were to evaluate morphology of the breast masses with routine ultrasonography and elastography, to assess the role of elastography and conventional B-mode ultrasonography in differentiating benign from malignant breast masses and to correlate elastography and B-mode ultrasonography results with pathologic findings. Materials and Methods: This prospective observational study was conducted over a period of 18 months from January 2018 to June 2019 on 86 patients with 101 clinically palpable breast lumps who underwent B-mode ultrasonography and elastography of the breast. Baseline data, sonographic features, a modified color score, and mean strain ratio were recorded and compared with final diagnosis. Results: Sonography showed a sensitivity of 89.8%; specificity of 96.15%; positive predictive value (PPV) and negative predictive value (NPV) of 95.65% and 90.91%, respectively; and overall diagnostic accuracy of 93.07%. New modified dual color score showed sensitivity of 97.8%, specificity of 87.0%, PPV of 86.79%, and NPV of 87.08% with a diagnostic accuracy of 92.08%. The risk of missing a malignant case with the new modified dual color score was 2.1%. Mean strain ratio showed sensitivity of 100%; specificity of 98.11%; PPV and NPV of 97.96% and 100%, respectively; and diagnostic accuracy of 99.01%. Conclusion: This study demonstrates the promise of elastography in identifying possible breast malignancies, thus preventing unnecessary invasive procedures.

Sonography-Guided Carpal Tunnel Release.

During the past 2decades, increased powerful and quality ultrasound devices have contributed to developing ultrasound surgery more specifically for the hand. Carpal tunnel release under ultrasound now is available as a safe technique. The procedure uses a specific device. A detailed surgical technique is presented. The role of sonography is emphasized. This article discusses the results of the 150 first cases. The author's experience is compared with other ultrasound-guided carpal tunnel release procedures. Outcome quality optimized by the ultra-mini-invasive approach and ultrasound should increase its use.

Роль ультразвукового исследования в диагностике и мониторинге Эффективности лечения подагрического артрита

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Adrenal gland hematoma presenting as an acute scrotum in a neonate

The acute scrotum in a neonatal patients is an emergency. Its'etiology is variable, mostly represented by testicular torsion, trauma or adrenal hemorrhage. Previously, immediate scrotal exploration was considered imperative for diagnosis and treatment. With good imaging studies, some patients are conservatively managed. We report two cases of neonatal adrenal hemorrhage presenting as acute scrotum misguiding the clinician to rule out a local scrotal pathology. As the clinical examination is not reliable in a new-born, it definitely requires an imaging evaluation to establish the diagnosis. This case report tries to outline the importance of the correlation between acute adrenal hemorrhage and acute scrotum and the role of ultrasonography as a useful tool for differential diagnosis. A well performed ultrasound examination helps to identify an abdominal pathology as the cause of an acute scrotum and to specifically diagnose an adrenal hemorrhage in order to avoid unnecessary surgical exploration.

Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: new trends and role of ultrasonography

Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: new trends and role of ultrasonography

Role of Ultrasonography and Inflammatory Markers in Predicting Complicated Appendicitis.

Aim:The aim is to compare the diagnostic accuracy of laboratory investigations and ultrasonography (USG) in distinguishing complicated appendicitis (C-AA) from uncomplicated appendicitis (UC-AA).Materials and Methods:Forty-six children who underwent appendicectomy at our center between November 2018 and July 2020 were included. Based on intraoperative findings, they were divided into two groups – complicated (perforated, gangrenous, or associated with fecal peritonitis; n = 18) and UC-AA (n = 28). USG findings and inflammatory markers were compared in both groups at admission.Results:At admission, the mean values for total leukocyte count (TLC) (16090.56 vs. 11739.29 per mm3), high sensitivity C-reactive protein (hsCRP) (35.8 vs. 31.62 mg/L), and procalcitonin (PCT) (3.83 vs. 1.41 ng/mL) were significantly higher in C-AA. Visualization of a blind tubular aperistaltic structure was the only sonographic sign showing statistical significance – significantly lower in C-AA (50% vs. 90%). Independent predictors of C-AA were – duration of symptoms >48 h (odds ratio [OR] 6.3), free fluid/loculated collection in right iliac fossa (OR 3.75), TLC >11000/mm3 (OR 3.6), hsCRP >35 mg/L (OR 6.0), PCT >0.6 ng/mL (OR 4.02), and nonvisualization of appendix on USG (OR 8.33). Biochemical factors were sensitive (89%) and specific (55%) in differentiating C-AA from UC-AA but the addition of sonological parameters significantly improved the specificity of predicting complicated AA to 61% (P = 0.0036).Conclusion:Combining laboratory data with sonological findings significantly improves the predictive value for differentiating C-AA from UC-AA and can help decide operative approach and prognosticating.

Role of Ultrasonography and Strain Elastography Findings in Peripheral Nerve Sheath Tumor

Peripheral nerve imaging science is rapidly advancing, for early and robust diagnosis of many ill-health conditions, especially in detection of tumors. Radiological imaging techniques provide dynamic, real-time assessment of anatomy which either can help in diagnosis or prognosis in peripheral nerve disorders. Peripheral nerve tumors are often evaluated with magnetic resonance imaging, although there are many advantages offered with ultrasonography (USG). Strain elastography (SE), another technique, is well known for the diagnosis of soft-tissue tumors and is used to evaluate tissue stiffness. Hard lesions are more resistant to extrinsic compression and show smaller strain, whereas soft lesions show larger strain. The narrative review provides insight in functioning and utility of USG and SE techniques in peripheral nerve sheath tumor diagnosis.

Role of Ultrasonography in the Evaluation of Thyroid Nodule with Fine Needle Aspiration Cytology ( FNAC) Correlation

Introduction: Thyroid nodules are commonly encountered pathologies worldwide. High-resolution ultrasonography is the first-line investigation for the evaluation of thyroid nodules as it is a cheap, quick, non-invasive, easily accessible modality without radiation hazards. Our major concern is to select suspicious thyroid nodules and early detection of malignancy. Fine needle aspiration cytology (FNAC) when correlated with ultrasonographic imaging features helps inaccurate assessment of categorizing thyroid nodules. USG guided FNAC is a widely practiced procedure because it is a less time-consuming simple procedure and helps to locate suspicious sites more precisely to get a higher yield. Methods: Total 70 patients with thyroid nodules detected by ultrasonography dated from October 2020 till September 2021 were enrolled in the study. The enrolled patients had FNAC in the same settings. The ultrasonographic characteristics of thyroid nodules were assessed and correlated with cytology reports. Results: Amongst 70 patients, 84.3% were female and 15.7% were male with a male:female ratio of 1:1.8. The mean age was 48.6 ± 13.2 years. Out of 70 patients, 49 patients had benign nodules while 21 patients had malignant nodules. Nodules that have characteristics like ill-defined border, hypoechoic echotexture, having predominantly solid components, microcalcification, increased central vascularity, and absence of halo are good indicators of malignancy. The sensitivity, specificity, positive, negative predictive value, and accuracy of ultrasonography were 72%, 91.8%,78.9%, 88.2%, and 85.7 % respectively. Conclusion: Ultrasonography is the most accurate, sensitive, and specific modality in categorizing thyroid nodules. A significant correlation of p< 0.05 was observed between ultrasonography with FNAC resulting in good accuracy. There is less chance of missing malignancy which helps to reduce unnecessary surgeries and promotes surgical intervention.

Role of Ultrasonography and Conventional Radiography in the Detection of Maxillofacial Fractures: A Comparative Study

Objective: With the collaboration of the trauma department, our study was designed to compare the effectiveness of ultrasonography (USG) and conventional radiography in the detection of bony fractures related to oral and maxillofacial regions.
 Methodology: This comparative study was conducted from March 2020 to March 2021 by the Radiology department of Sarghoda medical college hospital with the collaboration of the trauma department. Ultrasonography was performed by using GE- USG machine along with a linear extraoral transducer (frequency range 7-15 MHZ). Patients were asked to sit in a seated position facing the sinologist. Transducers were placed over the site by applying the sterile gel.
 Results: The overall sensitivity and specificity rate of ultrasonography was reported as 83.33% and 98.88% respectively in all sites whereas the sensitivity and specificity rate of conventional radiographs were reported as 70.24%, 100%. The negative predictive value of USG was reported as 96.17% along with 94.59% positive predictive value. In the contrast, conventional radiography gave a better positive predictive value (100%) than USG In our study we found better results of ultrasonography in terms of sensitivity and negative predictive value.
 Conclusion: In conclusion, our study depicts that ultrasonography is an economical, useful diagnostic tool for examining the bony fractures of facial trauma with a better sensitivity rate when compared to conventional radiographs.

Sarcopenia: Diagnosis and Management, State of the Art and Contribution of Ultrasound.

Age-related muscle loss is a phenomenon that has been extensively studied in recent decades. Sarcopenia is a multisystem disease, which predisposes to muscle weakness and frailty. At around 50 years of age, an individual begins to lose muscle strength, although this becomes more evident after 70. Sarcopenia is a condition typically found in older adults but can also affect younger people. Sarcopenia is a preventable and treatable condition. In past years, methods and tools to recognize the condition early have been researched. For the development of therapeutic interventions, agreement on diagnosis is fundamental. In recent years, a possible role of ultrasonography in the diagnosis of sarcopenia has been evaluated, compared with the best-known techniques.

The AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Extracranial Cerebrovascular System.

The AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Extracranial Cerebrovascular System.

The Role of Ultrasonography in the Diagnosis and Decision Algorithm for the Management of Pneumothorax after Transbronchial Lung Cryobiopsy

Background: Pneumothorax is one of the main complications of transbronchial lung cryobiopsy (TBLC). Chest ultrasound (CUS) is a radiation-free alternative method for pneumothorax detection. Objective: We tested CUS diagnostic accuracy for pneumothorax and assessed its role in the decision algorithm for pneumothorax management. Secondary objectives were to evaluate the post-procedure pneumothorax occurrence and risk factors. Methods: Eligible patients underwent TBLC, followed by chest X-ray (CXR) evaluation 2 h after the procedure, as our standard protocol. Bedside CUS was performed within 30 min and 2 h after TBLC. Pneumothorax by CUS was defined by the absence of lung sliding and comet-tail artefacts and confirmed with the stratosphere sign on M-mode. Pneumothorax size was determined through lung point projection on CUS and interpleural distance on CXR and properly managed according to clinical status. Results: Sixty-seven patients were included. Nineteen pneumothoraces were detected at 2 h after the procedure, of which 8 (42.1%) were already present at the first CUS evaluation. All CXR-detected pneumothoraces had a positive CUS detection. There were 3 discordant cases (κ = 0.88, 95% CI: 0.76–1.00, p < 0.001), which were detected by CUS but not by inspiration CXR. We calculated a specificity of 97.5% (95% CI: 86.8–99.9) and a sensitivity of 100% (95% CI: 87.2–100) for CUS. Pneumothorax rate was higher when biopsies were taken in 2 lobes and if histology had pleural representation. Final diagnosis was achieved in 79.1% of patients, with the most frequent diagnosis being hypersensitivity pneumonitis. Regarding patients with large-volume pneumothorax needing drainage, the rate of detection was similar between CUS and CRX. Conclusion: CUS can replace CXR in detecting the presence of pneumothorax after TBLC, and the lung point site can reliably indicate its size. This useful method optimizes time spent at the bronchology unit and allows immediate response in symptomatic patients, helping to choose optimal treatment strategies, while preventing ionizing radiation exposure.

Role of ultrasonography in assessment of painful ankle

Abstract Background Ankle disorders are a relatively common pathological condition, and ankle injuries account for approximately 14% of sports-related orthopedic emergency visits. Various imaging modalities can be used to make a diagnosis in cases of ankle pain; however, ultrasound (US) has several benefits for the evaluation of ankle pain, especially in the tendons, ligaments, and nerves of the ankle. Aim of the work to assess the role of high resolution US as a valuable tool in the depiction of causes of ankle joint pain. Patient &amp; methods our study is a cross sectional descriptive screening study including 25 patients with ankle joint pain (acute or chronic), post traumatic or not with no age or sex predilection. Results The study included 15 (60%) males and 10 (40%) females. Their age ranged from 10 to 60 years with a mean age of 33.84±13.31years. Chronic ankle pain was the most common presenting symptom in 15 patients (60%) whereas 10 (40%) patients presented with acute ankle pain after trauma. The posterior ankle compartment was the most common affected compartment (24%) of cases. About 7 cases (28%) were presented by ankle swelling with or without pain. Conclusion In conclusion, MSK US is useful in detecting the underlying causes of ankle pain and still it has the potential to offer more valuable data if it is well mastered by the sonographers.

Ultrasonography and MR Arthrogram in detection of shoulder joint disorders

Abstract Purpose To know the role of Ultrasonography and MR Arthrogram in detection of shoulder joint disorders Methods and material Thirty patients with suspected shoulder joint disorders underwent US,MRI ,MR arthrography shoulder. Results All cases with ALAPSA, Bankert, reverse bankert, hillsachs, perthes and SLAP are diagnosed accurately by MR arthrography with sensitivity of (100%) in GLAD ,Supraspinatus tendenopathy ,Supraspinatus tendon tear and IGHL injury sensitivity was decreased to 75%,in cases of paraglenid cysts arthrography did not diagnose any of them as there are no communication between the cyst and the joint Conclusion MR arthrography shoulder has a golden rule in diagnosis ,classification of cases of shoulder dislocation ,SLAP injuries and rotator cuff impingement

Role of Ultrasonography and power Doppler of Wrist and Hand Joints in Diagnosis of Early Symptomatic Cases of Rheumatoid Arthritis.

Background: Rheumatoid arthritis disease is a chronic inflammatory disease, character­ized by development of synovitis, which damages cartilage, bone, ligaments and tendons. High resolution ultrasound has become an established imaging technique for the diagnosis and follow-up of patients with rheumatoid arthritis Objective: The study was conducted on early symptomatic cases of Rheumatoid Arthritis that referred to Radiology out clinic in Qena General Hospital, to evaluate the role of gray scale ultrasound and power Doppler in the diagnosis. Patients and methods: The total numberwas30 patients, 25 females and 5 males suffering from rheumatoid arthritis. Patients examined by GE LOGIQ P5 ultrasound machine using a near focused linear array transducer with color Doppler and by Plain X ray radiographs. Results: Results showed the following: Synovial thickening was detected in 22 patients (73%), active synovitis was detected by Doppler US in 13 patients (43%), Effusion was detected in 15 patients (50 %), and Bone erosions were detected in 5 patients (17%) and X-ray finding was detected in 4 patients (13 %). Conclusion: HRUS with PD is an efficient technique to assessment of (RA) patient and evaluation of vascularity, differentiate between inactive and active synovial hypertrophy and has the potential role in diagnosis, assessment and follow up of the patients with RA therapy.

Pachydermodactyly: the role of ultrasonography, superb microvascular imaging, and elastography in diagnosis

Pachydermodactyly is a rare and benign superficial fibromatosis characterized by painless and progressive swelling of periarticular soft tissues of the proximal interphalangeal (PIP) joints, most commonly of both hands. There is no tenderness, warmth, morning stiffness, or reduced range of motion associated. Our purpose is to highlight the diagnostic utility of ultrasonography, superb microvascular imaging (SMI), and elastography in pachydermodactyly. We report the case of a 15-year-old adolescent white boy, with a 6-month history of insidious and progressive, asymptomatic swelling of the lateral and dorsal regions of the metacarpophalangeal (MCP), and PIP joints of both hands. Articular ultrasonography showed thickening of the skin around the lateral regions of the PIP and MCP joints, with no synovitis, hydrarthrosis, or muscle, tendon, or bone changes. Strain elastography revealed lower elasticity in the aforementioned skin regions, corresponding to increased tissue hardness due to hyperkeratosis. No SMI or Doppler signals were detected in epidermal or dermal tissues, as well as in tendons, joints, and bone. This case report shows that ultrasonography, SMI, and elastography may play a significant role in the accurate diagnosis of pachydermodactyly and exclusion of alternative conditions. These imaging modalities have no ionizing radiation; they are fast, inexpensive, and performed on site. They do not require usage of contrast agents and thus can eliminate the need of invasive procedures such as skin biopsy. They also contribute to reduce health care costs with unnecessary complementary tests and inappropriate treatment.

A Role for Ultrasonography in the Diagnostic Evaluation of Lymphedema

A Role for Ultrasonography in the Diagnostic Evaluation of Lymphedema

Role of ultrasonography in early detection of hip joint infection in neonates

Introduction Septic arthritis of the hip requires urgent attention because it is not only a medical but also a surgical emergency. Even minimal delay in the diagnosis and treatment causes permanent disability, crippling, and lifelong hip deformity. Neonates are more susceptible to be affected with hip arthritis due to decreased immunity. Neonatal intensive care unit admission is a common risk factor. Not only effusion, but also the status of the intra-articular compartment, articular surface, joint capsule, and adjacent soft tissue can be examined using ultrasonography (US). US also allows for image-guided paracentesis of hip effusion as well as for monitoring the progress of the disease. Objective The main objective of this study is to evaluate the role of US as a screerning tool in early diagnosis of hip joint infection in neonates admitted at the neonatal intensive care unit at our center for different neonatal medical and surgical problems. Results This study included 260 neonates (520 hips), 67.3% of which were men. Using the US there was evidence of intra-articular infection and complications in only one hip. Conclusion Being a nonionizing, easily available, noninvasive, relatively cheap imaging technique, US is of great help in diagnosing early as well as late suspected cases of septic arthritis of the hip with well-defined sonographic signs in sagittal and coronal views. US also helps in differentiating intra-articular from extra-articular abnormalities. It is also helpful in monitoring the progress/resolution of the disease.

A Randomized Comparative Study of Ropivacaine 0.5% in Brachialplexus Block with Adjuvant as Dexamethasone vs Fentanyl

Background and Aim: Supraclavicular brachial plexus block is a well-known technique of giving analgesia and anaesthesia for upper limb, our study is aimed at comparing the efficacy of dexamethasone 8mg versus fentanyl 50µg in blockade characteristics and postoperative analgesia when added to 0.5% ropivacaine 30 ml in supraclavicular brachial plexus block. During the study we want to compare the sensory and motor block achieved. Methods: This was a prospective randomized double blind study of 60 cases. The selection of patients was carried out randomly, depending on the lists of operations submitted by the surgical team.A written informed consent was obtained from all patients. Groups were Randomized into Ropivacaine+Fentany group (RF) and Ropivacaine + Dexamethasone (RD) groups. Results: Duration of motor blockade was longer in RD group 793.67±75.143 compared to RF group 455.5±27.429. P value was 0.001 which is statistically significant. Duration of sensory blockade was longer in RD group 1181.67±75.59 compared to RF group 508.83. p value was 0.0001 which is statistically significant. Conclusion: Role of Ultrasonography in regional block need not be emphasized, Addition of dexamethasone prolongs the duration of motor block, enhances the duration of analgesia significantly when compared with fentanyl in supraclavicular brachial plexus block and dexamethasone group has 0 VAS scores for longer period compared to fentanyl group. Keywords: Supra clavicular Brachial Plexus; Ultrasound; Ropivacaine; Fentany; Dexamethasone.

The Role of Sonography in a Rare Case of Hepatic Artery Pseudoaneurysm: A Case Study Report

Hepatic artery pseudoaneurysms (HAPs) are rare, life-threatening complications that arise in response to liver trauma or underlying inflammatory processes. The risk of rupture necessitates prompt diagnosis and treatment. Sonography is an important imaging modality used to evaluate and characterize suspected HAPs. In the case described below, sonography played an important role in the diagnosis and successful treatment of a patient with a large, high-risk HAP.