Two-dimensional Ultrasonography Research Articles

Comparison of Two-Dimensional IOTA Simple Rules and Three-Dimensional Ultrasonography in Preoperative Assessment of Adnexal Masses

Abstract Objective Accurate preoperative characterization of adnexal masses is essential for optimal patient management. Two-dimensional ultrasonography (USG) based “International Ovarian Tumuor Analysis Simple Rules (IOTA-SR)” are used primarily in clinical practice. Three-dimensional (3D) USG is an emerging modality. The authors conducted this study to compare the performance of 3D USG with IOTA-SR for preoperative differentiation of benign and malignant adnexal masses. Methods This prospective observational study recruited 84 patients with adnexal masses undergoing surgical management. IOTA-SR and 3D USG with power Doppler examination were applied to characterize the masses and correlated with histopathology. Logistic regression analysis defined individual 2D and 3D USG parameters' significance in predicting malignancy. The receiver operating characteristic (ROC) curve was plotted for significant variables, and area under the curves (AUCs) with cutoff values were calculated using the Youden index. Results Out of the 84 adnexal masses, 41 were benign and 43 were malignant. IOTA-SR were conclusive in 88.1% (74/84) cases, with a sensitivity of 83.78% (95% confidence interval [CI]: 67.99–93.81%) and specificity of 89.19% (95% CI: 74.58–96.97%). The sensitivity and specificity of 3D USG with power Doppler were 84% and 88%, respectively, with an AUC of 0.96 (95% CI: 0.92–0.99). Ten cases were inconclusive by the IOTA-SR, and 3D USG could further correctly differentiate four of these cases. Conclusions The diagnostic performance of both techniques is comparable. With good diagnostic performance and easy applicability, IOTA-SR remain the standard of care. 3D USG, although a more objective assessment, requires further validation and standardization.

Hepatic Artery Delineation on Ultrasound Volumes Comparing B-Flow and Color Doppler for Postoperative Monitoring of Pediatric Liver Transplants.

(1) Background: Accurate hepatic artery (HA) depiction following pediatric liver transplantation (LT) is essential for graft surveillance but challenging on ultrasound (US). This study assesses if improved HA delineation can be achieved by recording two-dimensional US volumes in Color Doppler (CD) and B-flow technique. (2) Methods: Of 42 consecutive LT, 37 cases were included, and HA delineation was retrospectively rated using a four-point score (0 = HA not detectable, 3 = HA fully detectable, separable from portal vein) within 48 h post-LT (U1) and before discharge (U2). (3) Results: Adding B-flow compared with CD alone showed superior results at neohilar (U1: 2.2 ± 1.0 vs. 1.1 ± 0.8, p < 0.0001; U2: 2.5 ± 0.8 vs. 1.5 ± 0.9, p < 0.0001) and segmental levels (U1: 2.8 ± 0.6 vs. 0.6 ± 0.8, p < 0.0001; U2: 2.8 ± 0.6 vs. 0.7 ± 0.5, p < 0.0001). (4) Conclusions: Standardized US volume recordings combining B-flow and CD can effectively delineate the HA along its vascular course in pediatric LT. The technique should be further evaluated as a standard monitoring instrument to rule out vascular complications after LT.

Renal morphometric and doppler studies in different stages of canine chronic kidney disease &lt;b&gt;&lt;/b&gt;

Doppler ultrasound is a useful diagnostic tool to evaluate renal blood flow in canine chronic kidney disease (CKD). This study aimed to describe and compare renal blood flow in different stages of CKD dogs based on the ultrasonographic appearance of kidneys. The study included one hundred and three dogs with CKD confirmed clinically, hematologically, biochemically and ultrasonographically. Ten healthy dogs with no haematological and ultrasonographic abnormalities of kidneys were also included in the study as a control group. Based on SDMA levels, the dogs with CKD were divided into four groups viz., Stage I (n=17), Stage II ( n=15), Stage III ( n=25) and Stage IV ( n=46). The Renal volume was measured with two-dimensional ultrasonography. All the dogs were subjected to pulsed-wave Doppler to obtain hemodynamic parameters such as resistance index (RI) and pulsatility index (PI) which were significantly (P&lt;0.05) higher in CKD stage III and IV dogs than in control. However, no significant difference was reported in RI and PI values in dogs with CKD Stages I and II (P&gt;0.05). Hemodynamic parameters appear useful markers for understanding the pathological process and progression in dogs with CKD.

Assessment of The Accuracy of Incorporation of Fetal Thigh Circumference in The Formula of Estimating Birth weight Using Two-Dimensional Ultrasound

Assessment of The Accuracy of Incorporation of Fetal Thigh Circumference in The Formula of Estimating Birth weight Using Two-Dimensional Ultrasound

Improving Prenatal Diagnosis Precision for Congenital Clubfoot by Using Three-Dimensional Ultrasonography.

Prenatal diagnosis of clubfoot traditionally relied on two-dimensional ultrasonography. To enhance diagnosis and predict postnatal outcomes, we examined the parameters that differentiate pathological clubfoot using three-dimensional ultrasonography. In our retrospective study, we examined the findings of prenatal ultrasound and the postnatal outcomes of pregnancies with suspected congenital clubfoot between 2018 and 2021. Based on the three-dimensional perspective, we measured the angles of varus, equinus, calcaneopedal block, and forefoot adduction and compared the sonographic variables between the postnatal treated and non-treated groups. We evaluated 31 pregnancies (47 feet) with suspected clubfoot using three-dimensional ultrasonography. After delivery, a total of 37 feet (78.7%) underwent treatment involving serial casting only or additional Achilles tenotomy. The treated group showed significantly greater hindfoot varus deviation (60.5° vs. 46.6°, p = 0.026) and calcaneopedal block deviation (65.6° vs. 26.6°, p < 0.05) compared to the non-treated group. The calcaneopedal block had an area under the curve of 0.98 with a diagnostic threshold of 46.2 degrees (sensitivity of 97%, specificity of 90%, positive predictive value of 97%, and negative predictive value of 90%). During prenatal evaluation of clubfoot using three-dimensional ultrasonography, the calcaneopedal block deviation has the potential to predict postnatal treatment.

Differences of diaphragmatic muscle contraction between female patients with chronic neck pain and asymptomatic controls: A case-control study based on ultrasonography

BackgroundRecent systematic reviews and meta-analyses show that individuals with chronic neck pain (CNP) have altered respiratory muscle strength and abnormal respiratory mechanics. However, no study has investigated the diaphragmatic function in individuals with CNP compared to asymptomatic peers. ObjectivesThis study aimed to compare the respiratory muscle strength and diaphragmatic function between patients with CNP and asymptomatic controls. DesignObservational, case-control study. MethodsA total of 25 women with CNP and 23 asymptomatic controls participated in this case-control study. The visual analog scale and neck disability index were used to assess the pain and disability characteristics of the CNP group. Maximum inspiratory and expiratory pressures (MIP and MEP) were measured to determine respiratory muscle strengths. The diaphragmatic function (muscle thickness in deep inspiration, Tins; and at the end of calm expiration, Texp; muscle thickness change, ΔT; contraction ratio, CR) were evaluated by two-dimensional ultrasonography. ResultsThe MIP (p = 0.001, d = 1.11), ΔT (p = 0.033, d = 0.63), and CR (p = 0.012, d = 0.75) of the diaphragm were found significantly reduced in the CNP group compared to asymptomatic controls whilst MEP, Tins, and Texp of the diaphragm were similar between study groups (p > 0.05). The intensity of neck pain was moderately correlated with MIP (r = −0.48), Tins (r = −0.46), and ΔT (r = −0.42) while NDI (r = −0.42) had a moderate correlation with Tins (p < 0.05). ConclusionThe present findings revealed that women with CNP have altered diaphragmatic function. Thus, screening and targeting diaphragm may improve the rehabilitation process in CNP. However, further experimental studies regarding the efficacy of breathing exercise approaches are needed.

Shear wave elastography combined with two-dimensional ultrasonography for detecting optic nerve sheath: An effective tool for assessing preeclampsia.

This study aimed to investigate two-dimensional ultrasound and shear-wave elastography (SWE) in evaluating optic neuropathy in preeclampsia. Ninety-one singleton pregnant women (51 with preeclampsia [observation group]; 40 without complications [control group]) admitted between January 2022 and April 2022 participated in this study. Optic nerve sheath diameter (ONSD) and optic nerve stiffness measurement (ONSM) were measured using two-dimensional ultrasound and SWE, respectively, and compared between the two groups. Receiver operating characteristic curves were employed to evaluate the performance of ONSD, ONSM, and combination (ONSD + ONSM) for diagnosing preeclampsia. The observation (preeclampsia) group ONSD and ONSM were significantly higher than those in the control group (p < 0.05). Optimal diagnostic values for ONSD and ONSM were 4.10 mm and 11.20 kPa, respectively. Areas under the curve for diagnosing preeclampsia were 0.958 (95% confidence interval [CI], 0.926-0.990) for ONSD, 0.939 (95% CI, 0.894-0.985) for ONSM, and 0.982 (95% CI, 0.962-1.000) for ONSD + ONSM. There was no significant difference between ONSD and ONSM in diagnosing preeclampsia (p = 0.436). However, ONSD + ONSM was significantly advantageous over ONSD or ONSM alone in diagnosing preeclampsia (p = 0.033; p = 0.014). Ultrasonic evaluation of the optic nerve can quantitatively assess optic nerve changes in pregnant women with preeclampsia.

Early Prediction of Gestational Diabetes Mellitus Using Placental Strain Elastography and Subcutaneous Adipose Tissue Thickness.

The aim of this study is to investigate the efficacy of placental strain ratio values measured by real-time sonoelastography and maternal subcutaneous adipose tissue thickness measured by two-dimensional ultrasonography in predicting gestational diabetes mellitus in the first trimester. The population of the study consisted of the first 210 consecutive singleton pregnant women who applied for routine first-trimester screening between the 11th and 14th week of gestation.B-mode subcutaneous adipose tissue thickness sonography and real-time placental strain elastography scanning were performed.All patients underwent 75 g oral glucose tolerance test between the 24th and 28th week of gestation. American Diabetes Association criteria were used in the diagnosis of gestational diabetes mellitus. It was observed that body mass index (p<0.001), first-trimester fasting blood sugar (p<0.001), subcutaneous adipose tissue thickness (p<0.001), and placental strain ratio value (p<0.001) affected the development of gestational diabetes mellitus statistically. The multivariate analysis shown that subcutaneous adipose tissue thickness (odds ratio=1.271, 95% CI=1.142-1.416, p<0.001) and placental strain ratio value (odds ratio=3.664, 95% CI=1.927-6.969, p<0.001) were the independent risk factors affecting the development of gestational diabetes mellitus. The findings of this study indicated a positive correlation between 75 g oral glucose tolerance test application and first trimester subcutaneous adipose tissue thickness and placental strain ratio. Using the cut-off values of>11.5 mm for subcutaneous adipose tissue and>0.986 for placental strain ratio, the development of gestational diabetes mellitus may be predicted in the early weeks of pregnancy.

Three-dimensional ultrasound image reconstruction based on 3D-ResNet in the musculoskeletal system using a 1D probe: ex vivo and in vivo feasibility studies

Objective. Three-dimensional (3D) ultrasound (US) is needed to provide sonographers with a more intuitive panoramic view of the complex anatomical structure, especially the musculoskeletal system. In actual scanning, sonographers may perform fast scanning using a one-dimensional (1D) array probe .at random angles to gain rapid feedback, which leads to a large US image interval and missing regions in the reconstructed volume. Approach. In this study, a 3D residual network (3D-ResNet) modified by a 3D global residual branch (3D-GRB) and two 3D local residual branches (3D-LRBs) was proposed to retain detail and reconstruct high-quality 3D US volumes with high efficiency using only sparse two-dimensional (2D) US images. The feasibility and performance of the proposed algorithm were evaluated on ex vivo and in vivo sets. Main r esults. High-quality 3D US volumes in the fingers, radial and ulnar bones, and metacarpophalangeal joints were obtained by the 3D-ResNet, respectively. Their axial, coronal, and sagittal slices exhibited rich texture and speckle details. Compared with kernel regression, voxel nearest-neighborhood, squared distance weighted methods, and a 3D convolution neural network in the ablation study, the mean peak-signal-to-noise ratio and mean structure similarity of the 3D-ResNet were up to 28.53 ± 1.29 dB and 0.98 ± 0.01, respectively, and the corresponding mean absolute error dropped to 0.023 ± 0.003 with a better resolution gain of 1.22 ± 0.19 and shorter reconstruction time. Significance. These results illustrate that the proposed algorithm can rapidly reconstruct high-quality 3D US volumes in the musculoskeletal system in cases of a large amount of data loss. This suggests that the proposed algorithm has the potential to provide rapid feedback and precise analysis of stereoscopic details in complex and meticulous musculoskeletal system scanning with a less limited scanning speed and pose variations for the 1D array probe.

Naru-3 inhibits inflammation, synovial hyperplasia, and neovascularization in collagen-induced arthritis in rats.

Naru-3 is a prescribed formulation based on the theory of Mongolian medicine for the treatment of rheumatoid arthritis (RA). Naru-3 consists of three medicinal agents: Aconitum kusnezoffii Reichb (caowu), Terminalia chebula Retz (hezi), and Piper longum L (biba). These medicinal agents are widely distributed in the Mongolian area of China and have been used to treat rheumatism for centuries. Mongolian medicine Naru-3 is commonly prescribed to treat RA, but its mechanism of action is unknown. A rat collagen-induced arthritis (CIA) model was established to investigate the mechanism of Naru-3. Rats were treated with Naru-3, Etanercept (ETN), and sodium carboxymethylcellulose (CMC) for four weeks. After treatment was terminated, paw thickness, ankle diameter, and arthritis index (AI) were scored. Synovial hyperplasia was evaluated using hematoxylin and eosin (H&E) staining and two-dimensional ultrasonography. Synovitis and neovascularization were assayed using power Doppler imaging (PDI) and contrast-enhanced ultrasonography (CEUS). Levels of vascular endothelial growth factor (VEGF), interleukin (IL)-1, and CD31 in the serum or synovium were detected using ELISA and immunohistochemistry analyses. Naru-3 and ETN alleviated the symptoms of CIA as evidenced by diminished paw thickness, ankle diameter, and AI scores. Mechanistically, Naru-3 inhibited synovial hyperplasia, synovitis, and neovascularization by diminishing systemic and local inflammation, as indicated by the relative expression of VEGF and IL-1 in the serum and synovium. After four weeks of treatment, no significant neovascularization was observed in the Naru-3 group, but neovascularization and synovitis occurred in the ETN group, as demonstrated by H&E staining, PDI, and CEUS examination. Naru-3 inhibited inflammation, synovial hyperplasia, and neovascularization and alleviates RA in our CIA rat model. No symptom recurrence was observed four weeks after drug treatment.

Automatic measurement of kidney dimensions in two-dimensional ultrasonography is comparable to expert sonographers.

Length and width measurements of the kidneys aid in the detection and monitoring of structural abnormalities and organ disease. Manual measurement results in intra- and inter-rater variability, is complex and time-consuming, and is fraught with error. We propose an automated approach based on machine learning for quantifying kidney dimensions from two-dimensional (2D) ultrasound images in both native and transplanted kidneys. An nnU-net machine learning model was trained on 514 images to segment the kidney capsule in standard longitudinal and transverse views. Two expert sonographers and three medical students manually measured the maximal kidney length and width in 132 ultrasound cines. The segmentation algorithm was then applied to the same cines, region fitting was performed, and the maximum kidney length and width were measured. Additionally, single kidney volume for 16 patients was estimated using either manual or automatic measurements. The experts resulted in length of [95% CI: 80.0, 89.6] and a width of [49.9, 53.7]. The algorithm resulted a length of [81.5, 91.1] and a width of [43.6, 50.6]. Experts, novices, and the algorithm did not statistically significant differ from one another (). Bland-Altman analysis showed the algorithm produced a mean difference of 2.6mm (SD = 1.2) from experts, compared to novices who had a mean difference of 3.7mm (SD = 2.9mm). For volumes, mean absolute difference was 47mL (31%) consistent with error in all three dimensions. This pilot study demonstrates the feasibility of an automatic tool to measure in vivo kidney biometrics of length, width, and volume from standard 2D ultrasound views with comparable accuracy and reproducibility to expert sonographers. Such a tool may enhance workplace efficiency, assist novices, and aid in tracking disease progression.

The association between uterine scar defect (niche) and the presence of symptoms

Research questionIs there association between the presence of a uterine niche and the presence of symptoms? DesignThis cross-sectional study was conducted at a single tertiary medical centre. All women who underwent Caesarean section from January 2017 to June 2020 were invited to the gynaecological clinics, and requested to complete a questionnaire regarding symptoms related to the presence of a niche (heavy menstrual bleeding, intermenstrual spotting, pelvic pain, infertility). Transvaginal two-dimensional ultrasonography was performed to assess the uterus and uterine scar characteristics. The primary outcome was defined as the presence of a uterine niche, evaluated by length, depth, residual myometrial thickness (RMT) and ratio between the residual myometrial thickness (RMT) and adjacent myometrial thickness (AMT). ResultsOf 524 women who were eligible and scheduled for evaluation, 282 (54%) completed the follow-up; 173 (61.3%) were symptomatic and 109 (38.6%) asymptomatic. Niche measurements, including RMT/AMT ratio, were comparable between the groups. In a sub-analysis of each symptom, heavy menstrual bleeding and intermenstrual spotting were associated with reduced RMT (P = 0.02 and P = 0.04, respectively) compared with women with normal menstrual bleeding. An RMT less than 2.5 mm was significantly more prevalent in women reporting heavy menstrual bleeding (11 [25.6%] versus 27 [11.3%]; P = 0.01] and new infertility (7 [16.3%] versus 6 [2.5%]; P = 0.001]. In logistic regression analysis, infertility was the only symptom associated with an RMT less than 2.5 mm (B = 1.9; P = 0.002). ConclusionsA reduced RMT was found to be associated with heavy menstrual bleeding and intermenstrual spotting, while values below 2.5 mm were also associated with infertility.

Diagnostic Performance of Two-Dimensional Ultrasound, Two-Dimensional Sonohysterography and Three-Dimensional Ultrasound in the Diagnosis of Septate Uterus-A Systematic Review and Meta-Analysis.

The septate uterus is the most common congenital uterine anomaly, and hysteroscopy is the gold standard for diagnosing it. The goal of this meta-analysis is to perform a pooled analysis of the diagnostic performance of two-dimensional transvaginal ultrasonography, two-dimensional transvaginal sonohysterography, three-dimensional transvaginal ultrasound, and three-dimensional transvaginal sonohysterography for the diagnosis of the septate uterus. Studies published between 1990 and 2022 were searched in PubMed, Scopus, and Web of Science. From 897 citations, we selected eighteen studies to include in this meta-analysis. The mean prevalence of uterine septum in this meta-analysis was 27.8%. Pooled sensitivity and specificity were 83% and 99% for two-dimensional transvaginal ultrasonography (ten studies), 94% and 100% for two-dimensional transvaginal sonohysterography (eight studies), and 98% and 100% for three-dimensional transvaginal ultrasound (seven articles), respectively. The diagnostic accuracy of three-dimensional transvaginal sonohysterography was only described in two studies, and we did not calculate the pooled sensitivity and specificity for this method. Three-dimensional transvaginal ultrasound has the best performance capacity for the diagnosis of the septate uterus.

How to do a 3D uterus ultrasound?

Three-dimensional (3D) ultrasound is an invaluable tool in the detection and evaluation of many uterine anomalies and improves upon the traditional approach of two-dimensional (2D) ultrasonography. We aim to describe an easy way of assessing the uterine coronal plane using the basic three-dimensional ultrasound in everyday gynecological practice.

Ultrasound Assessment of the Fetal Optic Chiasm.

This article reviews the literature on different methods of prenatal ultrasound visualization of the optic chiasm (OC) and its applications. Prenatal imaging of the OC is feasible from 19 to 37 weeks of gestation. Evaluation of the OC has been shown crucial in differentiating isolated agenesis of the septum pellucidum from septo-optic dysplasia. Multiple methods can be applied for imaging of the OC, including three-dimensional and two-dimensional ultrasounds in different views, as well as color Doppler. According to the literature, both transabdominal and transvaginal routes produce equally acceptable images. OC visualization might be challenging but can be achieved by developing a standard scanning protocol and raising awareness.

The effects of Pilates training on abdominal muscle thickness and core endurance in patients with Parkinson's disease: a single-blind controlled clinical study.

This study aims at examining the effects of Pilates training on the transversus abdominis (TrA) and internal obliques (IO) muscle thickness and core endurance in different positions in patients with Parkinson's Disease. Patients were divided into 2 groups as Pilates training (n = 13) and control (n = 10) groups. Pilates training was performed twice a week for 6 weeks. The participants' muscle thickness and core endurance were measured at the beginning of the study (pretraining), and the effectiveness of Pilates training was then assessed in the 6th week (posttraining) and in the 12th-week follow-up. The thickness of the TrA and IO muscles was measured with a two-dimensional ultrasonography device. Core endurance was assessed with prone bridge and sit-ups tests. The assessments of the Pilates training group after the 6-week showed a statistically significant increase in the prone bridge and sit-ups test performances, and an increase in the thickness of the IO muscle [during resting in the supine position and abdominal drawing-in maneuver (ADIM) in standing position] and the TrA muscle (during ADIM in the standing position) (p < 0.05). Pilates exercises were also shown to have improved core muscle endurance and thickness (IO thickness during ADIM in the standing position and TrA thickness during resting in the supine position, ADIM in the supine and standing position) in the Pilates training group after a period of 18 weeks (p < 0.05). Pilates training has a favorable effect on the core endurance, and the TrA and IO muscle thickness of patients with Parkinson's disease and this effect can be maintained until three months after the training.

Deep Learning Based Two-Dimensional Ultrasound for Follicle Monitoring in Infertility Patients

Abstract Background: A two-dimensional (2D) ultrasound examination is the primary technique for follicle monitoring, but 2D ultrasound follicle monitoring has significant inter- and intra-observer variability in the measurement of follicle diameter. The aim of this study was to propose a novel deep learning-based automated model for accurate 2D ultrasound follicle monitoring and validate the reliability and repeatability in clinical practice. Methods: A prospective trial including 300 infertile women undergoing ovulation induction (single follicle cycles) or controlled ovarian hyperstimulation (multiple follicle cycles) was conducted in the reproductive center. After 2D ultrasound image acquisition, the mean diameter of each targeted follicle was measured using an automated model, experts, and a novice. Designating the expert assessment as the gold standard, the reliability and repeatability of the automated model for single and multiple follicle cycles were evaluated using the intraclass correlation coefficient and Bland-Altman plots. Results: A total of 228 and 1065 follicles from single and multiple follicle cycles, respectively, were included. The accurate recognition rate of follicle boundaries using the automated model was 0.931. The inter-observer variability of follicle mean diameter measurements in single and multiple follicle cycles were 0.970 and 0.984 for the automated model and experts, and 0.965 and 0.978 for a novice and experts, respectively. Bland-Altman plots showed that 95% limits of agreement for follicle diameter measurement between the automated model and experts (−2.02 to 2.39 mm and −0.68 to 1.50 mm) was lower than a novice and experts (−1.69 to 2.74 mm and −0.58 to 1.73 mm) for both single and multiple follicle cycles. The intraclass correlation (ICC) of follicle diameters ≥10 mm calculated by the automated model was significantly higher than follicle diameters &lt;10 mm in multiple follicle cycles (0.834 vs. 0.609). There were no significant differences between the two groups in single follicle cycles (0.967 vs. 0.970). Conclusion: A deep learning-based automated model provides an accurate and fast approach for novices to improve the reliability and receptivity of 2D ultrasound follicle monitoring, especially in multiple follicle cycles and for follicles with a mean diameter ≥ 10 mm.

Doppler Velocimetry of Uterine Artery in Bitches with Cystic Endometrial Hyperplasia-Pyometra Complex

Doppler ultrasound is a useful diagnostic tool to evaluate uterine blood flow in different canine reproductive states. The aim of this study was to describe and compare uterine blood flow in bitches suffering from pyometra according to the ultrasonographic appearance of uterus. Seventy-five bitches with pyometra confirmed clinically, haematologically and ultrasonographically were included in the study. Ten healthy bitches with no haematological and ultrasonographic abnormality of uterus were also included in the study as control group. The bitches with pyometra were divided into four groups based on the sonographic characterization of uterus and its luminal contents, viz., B (few small cysts, normal endometrial surface, anechoic uterine content, n=11), C (many large cysts, irregular surface and hypertrophic endometrium, n=24), DH (many large cysts, irregular surface and hypertrophic endometrium, hyperechoic content, n=31) and DA (many large cysts, irregular surface and atrophic endometrium, hyperechoic content, n=9). The uterine horn diameter and uterine wall thickness was measured with two-dimensional ultrasonography. With the use of pulsed-wave Doppler, flow velocity waveforms of uterine artery were obtained. Parameters of blood flow velocity such as peak systolic velocity (PSV), end diastolic velocity (EDV), as well as haemodynamic parameters such as resistance index (RI), pulsatility index (PI) and systolic-diastolic ratio (S/D) were calculated electronically. Peak systolic velocity and end diastolic velocity were significantly higher in pyometra group than control with highest velocities recorded in DA group (P&lt;0.05). The RI, PI and S/D were significantly lower in pyometra group than in control (P&lt;0.05). The RI was significantly lower in group C and DA compared to groups B and DH (P&lt;0.05). However, no significant difference was reported in PI and S/D among the groups of pyometra (P&gt;0.05). It was concluded that the uterine artery blood flow velocity of bitches suffering from pyometra differs, not only from normal bitches, but also varies with the type of pyometra with varying pathological nature. Furthermore, haemodynamic parameters appear as useful markers to differentiate uterine pathologic conditions and to understand the pathological type of pyometra.

Inter-observer and intra-observer reliability between manual segmentation and semi-automated segmentation for carotid vessel wall volume measurements on three-dimensional ultrasonography

Carotid vessel wall volume (VWV) measurement on three-dimensional ultrasonography (3DUS) outperforms conventional two-dimensional ultrasonography for carotid atherosclerosis evaluation. Although time-saving semi-automated algorithms have been introduced, their clinical availability remains limited due to a lack of validation, particularly an extensive reliability analysis. This study compared inter-observer and intra-observer reliability between manual segmentation and semi-automated segmentation for carotid VWV measurements on 3DUS. Thirty-one 3DUS volume datasets were prospectively acquired from 20 healthy subjects, aged >18 years, without previous stroke, transient ischemic attack, or cardiovascular disease. Five observers segmented all volume datasets both manually and semi-automatically. The process was repeated five times. Reliability was expressed by the intraclass correlation coefficient, supplemented by the coefficient of variation. Carotid VWV measurements using the common carotid artery (CCA) were more reliable than those using the internal carotid artery (ICA) or external carotid artery (ECA) for both manual and semiautomated segmentation (manual segmentation, CCA: inter-observer, 0.935; intra-observer, 0.934 to 0.966; ICA: inter-observer, 0.784; intra-observer, 0.756 to 0.878; ECA: inter-observer, 0.732; intraobserver, 0.919 to 0.962; semi-automated segmentation, CCA: inter-observer, 0.986; intra-observer, 0.954 to 0.993; ICA: inter-observer, 0.977; intra-observer, 0.958 to 0.978; ECA: inter-observer, 0.966; intra-observer, 0.884 to 0.937). Total carotid VWV measurements by manual (inter-observer, 0.922; intra-observer, 0.927 to 0.961) and semi-automated segmentation (inter-observer, 0.987; intra-observer, 0.968 to 0.989) were highly reliable. Semi-automated segmentation showed higher reliability than manual segmentation for both individual and total carotid VWV measurements. 3DUS carotid VWV measurements of the CCA are more reliable than measurements of the ICA and ECA. Total carotid VWV measurements are highly reliable. Semi-automated segmentation has higher reliability than manual segmentation.

Robotic system for accurate percutaneous puncture guided by 3D-2D ultrasound.

Ultrasound (US)-guided robotic systems can reduce the reliance on the experience and skills of surgeons and enable automatic and accurate percutaneous puncture. Two-dimensional (2D) and three-dimensional (3D) US guidance have various advantages and disadvantages. The planned puncture path in the US data directly affects the puncture quality and tissue injury risk. It is difficult to define the optimal path in 2D US images and achieve accurate and safe puncture under the guidance of 3D US volume. This study aims to propose a robotic system guided by 3D-2D US to realize accurate and safe percutaneous puncture. We proposed a 3D-2D US-guided percutaneous puncture robotic system by integrating a 3D US scanning robotic system and a 2D US-guided puncture robotic system. The optimal spatial puncture path that targets the lesion and avoids other important tissues was determined in the 3D US volume reconstructed through robotic US scanning. Thereafter, the puncture robot was placed at the puncture site determined according to the planned path. The optimal path was mapped to the 2D US image taken at the puncture site. Finally, the 2D US image and puncture path were used to guide the robot in performing an accurate and safe percutaneous puncture. The proposed robotic system based on the guidance of 3D-2D US exhibits the advantages of both 3D US and 2D US to improve the accuracy of percutaneous puncture and reduce the risk of tissue injury. The experimental results of phantom puncture demonstrate that the mean puncture accuracy of the system is 1.09 ± 0.35mm, and the puncture success rate with single needle insertion is 100%. A percutaneous puncture robotic system based on 3D-2D US guidance was proposed and tested successfully. The experimental results demonstrate the feasibility of the proposed system for achieving accurate and safe robotic percutaneous puncture.