Scale Ultrasound Imaging Research Articles

Radiologic imaging findings of pelvic aggressive angiomyxoma correlated with surgical and pathological features

BackgroundAggressive angiomyxoma is an infrequent benign tumor that usually occurs in the pelvic region. Pelvic masses have variety of differential diagnosis but some featured findings should prompt the diagnosis of aggressive angiomyxoma by the radiologist.Case presentationA 40-year-old female patient presented with a two-year history of perineal swelling. Radiological examination including gray scale and color Doppler ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) was consistent with the diagnosis of aggressive angiomyxoma. The patient underwent surgical operation that ensures total resection of the tumor.ConclusionIn the case of extensive pelvic soft tissue mass with characteristic imaging findings, the radiologists should take the diagnosis of aggressive angiomyxoma into consideration.

Diagnostic accuracy of gray scale muscle ultrasound screening for pediatric neuromuscular disease.

Gray scale ultrasound (US) has been demonstrated to be a sensitive and specific tool in the diagnosis of pediatric neuromuscular disease (NMD). With recent advances in genetic testing, the diagnostic work up for NMD has evolved. The purpose of this study was to compare the current diagnostic value of gray scale US to previously defined sensitivities and specificities to determine when this test can add value to a patient's diagnostic workup. Standardized quantitative gray scale US imaging was performed on 148 pediatric patients presenting for electrodiagnostic testing to evaluate for NMD. Patients were categorized as having an NMD, a non-NMD, or as "uncertain." The US results were defined as normal, borderline or abnormal based on echointensity values. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the test were calculated. Forty-five percent of the patients had an NMD, 54% a non-NMD, and in 1% the diagnosis remained uncertain. US was abnormal in 73% of myopathies, 63% of neuromuscular junction disorders, 60% of generalized neuropathies and 58% of focal neuropathies. After excluding patients in whom muscle US was not expected to be abnormal (eg, sensory neuropathy), sensitivity was 83%, specificity 79%, PPV 75%, NPV 86%, and accuracy 81%. Quantitative gray scale muscle US still has good diagnostic value as a screening tool in pediatric NMD. As with any diagnostic test, muscle US is best used in conjunction with history and physical examination to increase specificity and diagnostic yield.

The Role of Real-Time Tissue Elastography and Gray-Scale Ultrasound Histogram Analysis in the Diagnosis of Patients With Sjögren's Syndrome.

This study aims to evaluate gray-scale histogram analysis of B-mode ultrasound (US) images and US elastographic features of the parotid glands in patients with Sjögren's syndrome (SS) and to explore relationships with the ultrasonographic and disease activity scores in the light of histopathological findings. A total of 57 consecutive female patients (mean age 47.9±10.4 years; range 25 to 76 years) with a diagnosis of SS and 48 healthy female individuals (mean age 51.1±10.8 years; range 20 to 70 years) underwent parotid ultrasonography and real-time tissue elastography imaging. Quantitative measurements of gray-scale US images were performed using the histogram software of the scanner. The histogram ratios of the parotid glands from both sides were obtained (histogram ratio; mean gray-scale histogram parotid/mean gray-scale histogram fat). Strain ratio (SR; ratio of fat to gland parenchyma) was calculated from the color-coded images. Subjective B-mode US scoring of electronically recorded gray- scale US images was performed by two radiologists independently for intra- and inter-observer agreement. Subjective assessments, quantitative measurements, and clinical parameters were compared. The SR of the patient group (1.4±0.8 right side, 1.5±0.9 left side) was significantly higher than that of the control group (1.0±0.3 right side, 1.1±0.3 left side) (p<0.05). The gray-scale histogram ratio of the patient group (1.3±0.5 right side, 1.4±0.9 left side) was lower than that of the control group (1.8±0.7 right side, 1.9±0.7 left side) (p<0.05). Receiver-operating-characteristics curve yielded 66% sensitivity for both sides and 50% and 52% specificity for the right and left sides, respectively, for a cut-off SR of 1.02; 76% and 86% sensitivity for the right and left sides, respectively, and 63% specificity for both sides for a cut-off histogram ratio of 1.35. The quantitative histogram ratio method had a higher positivity rate for the diagnosis of abnormal parotid glands than subjective assessments of US images. Sonoelastography and gray-scale histogram analysis of the parotid glands may be used as auxiliary tools to detect parotid gland sonographic abnormalities in patients with SS.

The role of gray scale and color Doppler ultrasound imaging in cervical lymphadenopathy evaluation and differentiation

The role of gray scale and color Doppler ultrasound imaging in cervical lymphadenopathy evaluation and differentiation

Abstract P4-01-13: Fusion imaging using opto-acoustics and ultrasound to differentiate breast mass histopathology

Abstract Introduction: Opto-acoustics (OA) is a true fusion imaging technology that combines dual energy laser optic functional imaging with real time gray scale ultrasound morphologic imaging. The laser optic component uses two wavelengths that have been chosen to optimally demonstrate oxygenated and deoxygenated hemoglobin. The color-coded laser optic images are co-registered and temporally interleaved with real time gray scale images. OA fusion imaging benefits from the combination of the high contrast resolution of dual wavelength laser optics and the higher spatial resolution and penetration of gray scale ultrasound. OA can demonstrate both tumor neovascularity and the relative degrees of oxygenation-deoxygenation within breast mass and within the surrounding tissues. Methodology: A series of 68 prospective patients with undiagnosed breast masses going to biopsy were evaluated before biopsy with a handheld device combining ultrasound co-registered with OA for the visualization of pre-defined internal and external features. The internal features included vascularity (V), blush (BU), and blood (BL) accumulation while external features included boundary zone vascularity and blush (BZ) and peri-tumoral radiating vessels (RV); each were scored on a 0-5 ordinal scale and were summed to get a total internal score, total external score, and a total score. A two-sided exact Jonckheere-Terpstra test was used to test the relationship between increasing scores and higher cancer grade. Results: The study population consisted of 29 fibroadenomas (FAs) as well as 10 invasive ductal carcinoma (IDC), grade 1, 11 IDC grade 2, and 18 IDC grade 3 cases. OA Total (two-sided p = 3×10−8) and OA Total Internal (two-sided p = 6×10−9) were highly significant but OA Total External was not statistically significant; OA Total and OA Total Internal Features were highly related to histology with lower scores for FAs increasing progressively to highest scores for IDC 3. Moreover, all three internal OA features were highly significant: (1) V (two-sided p = 10−7), BU (two-sided p = 3×10−8), and BL (two-sided p = 5×10−6). Cumulative contribution of each internal feature to the total internal score was also assessed for each histopathology subgroup to confirm independent contribution to the OA Total Internal Score. Pairwise correlations explained no more than 56% of the total variance. Conclusions: We have established the prognostic value of OA Total and OA Internal Features as well as the validation of the contributions of each OA Internal Feature. Using the combination of individual internal and external OA features not only helps distinguish benign from malignant masses, but helps stratify malignant lesions by histologic grade. These abilities could be useful both for diagnosis and for monitoring non-surgical treatment of malignant masses. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-01-13.

A comparison of gray scale ultrasound and radionuclide imaging for the detection of focal hepatic lesions: Open shutter technique

A conventional B scan ultrasound unit was modified by the addition of a specially built logarithmic amplifier and a high resolution nonstorage oscilloscope, as suggested by Taylor and Carpenter. One hundred five consecutive patients submitted for radionuclide imaging of the liver were examined with ultrasound using a standardized scanning system. The ultrasound technique produced scans that were technically poor or inadequate in 37 per cent of the patients studied. In the studies in which there has been confirmation, the ultrasound diagnosis was accurate in 73 per cent and the radionuclide diagnosis was correct in 83 per cent. The combined accuracy of the two studies was 93 per cent. In 11 patients, ultrasound more clearly defined the lesions that were demonstrated by both techniques or demonstrated the nature of suspicious or equivocal areas on the radionuclide images. In 48 patients, the radionuclide scan imaged the liver more completely or demonstrated lesions more clearly than did the ultrasound examination. This specific approach to ultrasound gray scale imaging appears to be a valuable supplemental tool to radionuclide imaging, but at its present stage of development cannot replace it as a routine screening technique for hepatic disease.