Ultrasonic Appearance Research Articles

Fibrillar matrix, Echogenicity, Contour, Thickness, and Suture (FECTS) vs. Global: A comparison of 2 scales developed to assess ultrasound images post rotator cuff repair.

Ultrasound is commonly used to assess rotator cuff repair (RCR), but no standardized criterion exists to characterize the tendon. The aims of this study were to (1) develop content validity for ultrasound specific criteria to grade the postoperative appearance of a tendon after RCR, (2) assess the reliability of the criteria, and (3) assess the feasibility to use these assessments. Following expert consultation and literature review for content validity, 2 scales were created: 1) the Fibrillar matrix, Echogenicity, Contour, Thickness, and Suture (FECTS) scale and 2) the Rotator Cuff Repair-Investigator Global Assessment (RCR-IGA). Aprospective cohort study was undertaken on patients who had received a RCR and serial B-mode ultrasound images. Four raters assessed the 64-ultrasound images using the scales created in a blinded fashion using intraclass correlation coefficients. The FECTS scale was a composite score with 5 key parameters and the RCR-IGA scale was a 5-point global score. The intrarater reliability for the FECTS scale was excellent for the most experienced rater (0.92) and fair for the rater with no experience (0.72). The intrarater reliability for the RCR-IGA scale was excellent for 3 of the 4 raters (0.80-0.87) and fair when used by the least experienced rater (0.56). Inter-rater testing for all the FECTS scale parameters had excellent reliability (0.82-0.92) except for Fibrillar matrix (0.73). The average time to complete the FECTS scale per image was 23seconds and 11seconds for the RCR-IGA scale. The FECTS scale and the RCR-IGA scale are reliable tools to assess the ultrasonic appearance of the repaired rotator cuff tendon. The FECTS scale was more reliable for less experienced assessors. The RCR-IGA scale was easier, more time efficient and reliable for those with experience.

Uterine issues in infertile queens: Nine cases

This prospective case series investigated potential uterine causes of infertility in queens. Purebred queens with infertility (failure to conceive, embryonic death, or failure to maintain pregnancy and produce viable kittens), but no other reproductive disorders were examined approximately 1–8 weeks before mating (Visit 1), 21 days after mating (Visit 2), and 45 days after mating (Visit 3) if pregnant at Visit 2. Investigations included vaginal cytology and bacteriology, urine bacteriology, and ultrasonography. At Visit 2 or 3, uterine biopsy or ovariohysterectomy was performed for histology. Of nine eligible queens, seven were non-pregnant by ultrasound at Visit 2 and two had lost pregnancies by Visit 3. Ovulation was confirmed by serum progesterone concentration in all queens. Ultrasonic appearance of the ovaries and uterus was compatible with a healthy status except for one queen with signs of cystic endometrial hyperplasia (CEH) and pyometra, a follicular cyst in another, and fetal resorptions in two queens. Six cats had histologic lesions of endometrial hyperplasia, including CEH (n=1). Only one cat had no histologic uterine lesions. Bacteria were cultured from vaginal samples in seven queens at Visit 1, (two were non-evaluable), and in five of seven queens sampled at Visit 2. Uterine cultures were negative except for the cat with pyometra. All urine cultures were negative. In summary, the most frequent pathology observed in these infertile queens was histologic endometrial hyperplasia, which can potentially inhibit embryo implantation and healthy placental development. This suggests that uterine disease might contribute substantially to infertility in purebred queens.

Diagnostic Accuracy of Doppler Scan of Portal Vein to Determine Early Cirrhosis of Hepatitis-C Patients in Gujranwala Population

Objective: The purpose of study is to establish accuracy of doppler sonography in diagnosis of early cirrhosis in hepatitis C positive patients, which is based on portal vein velocity and resistive index considering Histopathology as a gold level standard Student Design: It was a cross sectional comparative study (validation study). Place & Duration of Study: The student was held in Radiology department of District Headquarter Teaching Hospital Gujranwala from 1st July 2019 to 30th June 2020. Materials and Methods: The calculated sample size was 50 cases of anti-HCV anti bodies positive on their blood test fulfilling the inclusion criteria were examined for color Doppler ultrasound to see direction and average blood flow in the portal vein. All these cases were undergone core biopsy of liver and histopathology carried out. The results of histopathology were taken as superior quality / gold standard. Results: Mean age of the patients was found to be 42.5 years. The frequency of the hepatitis C in the different age group varied. Out of the 50 about 37 patients (74%) show decrease in the portal vein velocity towards lower limits regardless no ultrasonic appearance of the cirrhosis and remaining 13 patients (26%), show normal velocities towards upper limits. According to this study portal vein velocity in early cirrhosis is between 10-16 cm/sec and these initial cirrhotic changes confirmed on core liver biopsy (gold standard). Sensitivity was found to be 94.4%, specificity 78.5%, diagnostic accuracy 90.0%, both the NPV (negative predictive value) and PPV (positive predictive value) are high (NPV: 78.5%). Practical Implication: To best of our knowledge, there is very little information on this research topic in our area. The design of improved medical strategies to handle such situations and the improvement of their management will be made possible by the availability of such evidence. Conclusion: In our study, the maximum patients (38%) were suffering with this disease for more than 7 years but less than 9 years. 74% patients showed a decrease in the portal vein velocity towards the lower limit, and 26% patients showed normal velocity towards the upper limit. Keyword: Portal Vein, Doppler Ultrasound, Anti HCV, Core Liver Biopsy, Histopathology, Hepatitis C

Comments and illustrations of the WFUMB CEUS liver guidelines: rare congenital vascular pathology.

In this overview of vascular changes of the liver, variations in the liver vessels are discussed, in addition to congenital malformations such as Abernethy malformation, patent ductus venosus Arantii and hereditary hemorrhagic telangiectasia (OslerWeber-Rendu disease). Particular attention is paid to focal liver lesions, especially focal nodular hyperplasia (FNH), but also other solid tumours that develop as a result of altered liver vascularisation. The article focuses on the ultrasonic appearances and changes of the liver, depicted in B-mode sonography, Doppler studies and in contrast-enhanced ultrasonography (CEUS). The clinical manifestations of these conditions associated with other organ systems are also highlighted.

GAMBARAN ULTRASONOGRAFI TESTIS DAN EPIDIDIMIS KAMBING KACANG (Capra hircus) DI WILAYAH LAHAN KERING KEPULAUAN

This research aims to study testis and epididymis of dry land goat (Capra hircus) on B-mode ultrasound imaging. Twelve adult local male goats were examined to study normal testes and epididymis ultrasonic appearances. B-mode real time scanner with a 7.5 MHz, linear array transducer was used to evaluate the echotexture of the testicular parenchyma, mediastinum and the epididymis. The testicular parenchyma was represented uniformly homogenous and moderately echogenic with the mediastinum was more highly echogenic. The epididymal head appeared less echogenic but homogenous in structure, while the epididymal tail was more heterogeneous and less echogenic than the testis. Each structure in male reproductive organ, the testis, head and tail of epididymis can be differentiated using ultrasound imaging, but body epididymis was difficult to identify. It is concluded that ultrasound can be as a valuable diagnostic tool to investigate the health of male goat reproductive organ.

The Performance of Transvaginal Two-Dimensional Fundamental Sonosalpingography Combined with Saline Infusion Pelvic Sonosalpingography for Assessing Fimbrial Part's Morphology and Function of the Fallopian Tubes.

The purpose of this study was to evaluate the diagnostic efficacy of transvaginal two-dimensional fundamental sonosalpingography (2D-FS) combined with saline infusion pelvic sonosalpingography (SIPS) for assessing fimbrial part's morphology and function of the fallopian tubes. One hundred and sixty-nine cases underwent 2D-FS combined with SIPS. Among them, 18 cases received laparoscopy and dye test (LDT) within 3 months after the examination and the results were regarded as reference standard. Excluding proximal or middle segment obstructed tubes, the remaining fimbrial parts' display rate by using 2D-FS combined with SIPS was 75.1%. According to the ultrasonic appearance, the fimbrial parts were classified into 4 types: normal, abnormal, suspected abnormal, and unclassifiable. Normal fimbrial parts accounted for 73.8% when the tubes were patent; abnormal fimbrial parts accounted for 74.1% when the tubes were partial obstructed; all became abnormal when the tubes were distal complete obstructed. The fimbrial parts which had been classified by 2D-FS combined with SIPS were compared with LDT further. This combination's accuracy (ACC), sensitivity (SEN), specificity (SPE), positive predictive value (PPV), negative predictive value (NPV), and Youden's index (YI) were 86.4, 87.5, 85.7, 77.8, 92.3, and 0.73%, respectively. The result of consistency analysis showed the combination was essentially consistent with LDT result (Kappa=0.713). 2D-FS combined with SIPS can be a preferred method for assessment of the fimbrial part's morphology and function, with its advantages of non-invasive, intuition, and accuracy. This combination could provide an objective imaging basis for choosing clinical treatment strategies and predicting prognosis.

Middle-aged Man Recovering from COVID-19 Pneumonia

A 63-year-old man underwent follow-up after having coronavirus disease 2019 pneumonia. He was asymptomatic, with a respiratory rate of 16 breaths/min and oxygen saturation of 97% on room air. He had a number of fine scars on his back. While conducting the lung ultrasonographic examination with a convex probe, the physician observed some superficial unexpected vertical shadows and switched to a high-frequency linear probe. The physician detected a small horizontal hyperechogenic line in the subcutaneous tissue, approximately 1 cm below the skin surface, with posterior acoustic shadowing (Figure 1). There were multiple similar lesions in proximity to the scars. Interviewing the patient, we learned that he had undergone a hunting accident 20 years ago, and chest radiography confirmed the presence of multiple pellets (Figure 2).Figure 2Chest radiograph showing multiple millimetric round particles located throughout the thorax and with metallic density.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Shotgun pellets. In other case reports, lead shotgun pellets have been described as focal echogenicities with strong posterior reverberation echoes.1Amazeen P.G. Whitehead F. Questo W. Ultrasonic appearance of lead shotgun pellets in liver.J Clin Ultrasound. 1981; 9: A31-A32Crossref PubMed Scopus (3) Google Scholar,2Li Q. Deng D. Tao J. et al.Ultrasonic imaging of gunshot wounds in pig limb.Genet Mol Res. 2015; 14: 4291-4302Crossref PubMed Scopus (6) Google Scholar

Testicular microlithiasis in male infertility: prevalence, diagnosis and treatment algorithm

Aim of study. To estimate testicular microlithiasis (TM) prevalence in men seeking help for infertility in reproductive medicine center, and generate an algorithm for TM management according to patients choice to perform testicular biopsy or not.
 Materials and methods. We retrospectively reviewed charts of 143 consecutive adult male patients between 19 and 73 years (mean age 34.6 7.9) seeking help for infertility in International Center for Reproductive Medicine. Gray-scale and color Doppler were used to calculate testicular volume and to study a spectrum of scrotal disorders including testicular microlithiasis.
 Results. Testicular size varied from 0.5 to 33.3 ml (mean 12.3 5.8 ml), testicular hypoplasia, varicocele, hydrocele and epididymal cysts were detected in 88 (61.5%), 35 (24.5%), 9 (6.3%) and 50 (35%) patients respectively. TM signs were identified in 12 (8.4%) men, including 5 (42%) cases of classic TM and 7 (58%) cases of limited TM; 5 (42%) men had bilateral TM. One 1 (8%) patient with bilateral ТМ had ultrasonic appearance of non-palpable testicular tumor, radical surgical treatment was performed. Patients with TM had smaller testicles, higher prevalence of azoospermia and testicular tumor (p = 0.002, 0.013 and 0.085 respectively). All patients with TM were informed about their risks to harbor testicular cancer and taught self-examination technique. Testicular biopsy was offered to all men with concomitant risk factors for testicular cancer development, however none of the patients agreed. We have consequently developed algorithm for TM management according to patients choice to perform or to avoid testicular biopsy.
 Conclusion. ТМ is common in infertile men, scrotum ultrasound is indicated to detect it. The suggested algorithm for TM management is aimed towards early testicular cancer detection and successful treatment with fertility potential preservation.

The ultrasonic appearances of primary testicular lymphoma

Objective To explore the sonographic features of primary testicular lymphoma(PLT). Methods The sonographic features of 16 PLT patients confirmed by surgery and pathology were retrospectively analyzed. Results Sixteen PLT patients were typed into 3 ultrasonic patterns: ①The diffuse homogeneous echo type: 2 cases, the ultrasonic features were homogeneous sieve-like hypoechoic echo, the blood flow signal was rich and radially distributed, with interstisial fibrosis inapparently under-microscope. ②The diffuse uneven homogeneous echo type: 9 cases, the ultrasonic features lobulated or map-like heterogeneous hypoechoic features, the blood flow signal was rich in linear distribution, and interstisial fibrosis proliferated to form fibrous septa under-microscope. ③The focal nodular pattern echo type: 5 cases, the ultrasonic features were homogeneous hypoechoic nodules, the blood flow signal was few, interstisial fibrosis hyperplasia surrounding the tumor under-microscope. Conclusions Ultrasonic appearances of primary testicular lymphoma are closely related to its pathologic characteristics, the recognization of their relations contributes to improve the diagnostic value of ultrasound. Key words: Ultrasonograghy; Lymphoma, testis, primary

B-mode and contrast-enhanced ultrasonography of the mammary gland during the estrous cycle of dogs

Pathology of the mammary gland is a common health issue in dogs and includes neoplasia, cysts, inflammation and infection. The use of the B-mode (US) and contrast-enhanced (CEUS) ultrasonography may aid in the diagnosis. Previous studies are currently lacking of the ultrasonic images of the mammary gland of healthy bitches in different stages of the estrous cycle and associated normal blood perfusion patterns. The purpose, therefore, was to describe the normal B-mode US and CEUS images of the mammary gland and inguinal lymph node, in six intact female beagles during five different stages of the estrous cycle (proestrus, estrus, early and late diestrus and anestrus). Within the same stage of the estrous cycle, the size (thickness) of the caudal mammary glands increased. During early and late diestrus, all mammary glands increased in thickness and had an increased heterogeneous B-mode ultrasonic appearance. The mammary glands had a heterogeneous, disorganized perfusion pattern when assessed using CEUS. For the cranial abdominal mammary gland, the area under the curve and the mean transit time increased between estrus and late diestrus and decreased between late diestrus and anestrus. For the inguinal mammary gland, only the time to peak was longer during the periods of anestrus compared to estrus whereas all the other contrast parameters did not change during the estrous cycle. In conclusion, hormonal influences cause major changes in the size, appearance and blood perfusion of mammary glands during the estrous cycle and should be considered when evaluating pathological changes of mammary glands.

Ultrasonic appearances of epididymal spermatic granuloma

Objective To explore the relationship between ultrasonic appearances of epididymal spermatic granuloma and its pathologic characteristics. Methods The sonographic features of 32 cases of epididymal spermatic granuloma confirmed by pathology were retrospectively analyzed. Results A total of 34 epididymal spermatic granuloma nodules in 32 cases included 4 located in caput epididymidis and 30 located in cauda epididymidis, and maximum diameter of nodules were about 0.5-2.3 cm. Sonographic and pathologic appearances of nodules were: ①mostly low echo type, 21 nodules mostly showed the obscure boundary and quite abundant blood flow signals, early granulomas formed with interstitial fibrosis inapparently under-microscope; ②inhomogeneous echo type, 12 nodules mostly showed the barely clear boundary and blood flow signals from small amount to abundant amount, granulomas of different maturites distributed dispersedly with interstitial fibrosis of varying degrees under-microscope or single giant lesions formed; ③mostly high echo type, 1 nodule showed the obscure boundary and inapparent blood flow signals, center of the nodules distributed by a large amount of dense fibrous tissue under-microscope. Anechoic ethmoid sinus seen in 29 nodules was section of dilated epididymal ductus. Dotted strong echoes seen in 6 nodules were calcification of sperms in dilated epididymal ductus and necrotic tissue. Conclusions Ultrasonic appearances of epididymal spermatic granuloma are closely related to its pathologic characteristics. To recognize both relations contributes to improve the diagnostic value of ultrasound. Key words: Ultrasonography; Spermatic Granuloma; Epididymis

Anatomically realistic ultrasound phantoms using gel wax with 3D printed moulds

Here we describe methods for creating tissue-mimicking ultrasound phantoms based on patient anatomy using a soft material called gel wax. To recreate acoustically realistic tissue properties, two additives to gel wax were considered: paraffin wax to increase acoustic attenuation, and solid glass spheres to increase backscattering. The frequency dependence of ultrasound attenuation was well described with a power law over the measured range of 3–10 MHz. With the addition of paraffin wax in concentrations of 0 to 8 w/w%, attenuation varied from 0.72 to 2.91 dB cm−1 at 3 MHz and from 6.84 to 26.63 dB cm−1 at 10 MHz. With solid glass sphere concentrations in the range of 0.025–0.9 w/w%, acoustic backscattering consistent with a wide range of ultrasonic appearances was achieved. Native gel wax maintained its integrity during compressive deformations up to 60%; its Young’s modulus was 17.4 ± 1.4 kPa. The gel wax with additives was shaped by melting and pouring it into 3D printed moulds. Three different phantoms were constructed: a nerve and vessel phantom for peripheral nerve blocks, a heart atrium phantom, and a placental phantom for minimally-invasive fetal interventions. In the first, nerves and vessels were represented as hyperechoic and hypoechoic tubular structures, respectively, in a homogeneous background. The second phantom comprised atria derived from an MRI scan of a patient with an intervening septum and adjoining vena cavae. The third comprised the chorionic surface of a placenta with superficial fetal vessels derived from an image of a post-partum human placenta. Gel wax is a material with widely tuneable ultrasound properties and mechanical characteristics that are well suited for creating patient-specific ultrasound phantoms in several clinical disciplines.

Echography of clinically relevant disorders in the genital tract of female dromedary camels

The aim of this study was to characterize the clinically relevant genital tract disorders of dromedary camels. Reproductive tract examinations were performed via transrectal palpation, ultrasonography and vaginal exploration. The ultrasonic appearance of the reproductive pathology was described and compared with its morphology at laparotomy, after surgical removal, during postmortem examination or upon slaughter. Diagnosis was also confirmed by histopathology. The most frequently encountered follicular structures were larger than typical follicles (56/338, 16.6%) having three echo textures: 1) thin walls and clear hyperechogenic content (11.6%); 2) thick walls and few fibrous trabeculae (33.7%); and 3) thick walls and many echogenic transecting fibrinous strands (54.7%). Corpora lutea with non-echoic central cavity (5/31, 16.1%) were greater in diameter than those with no cavity (26/31, 83.9%) (P=0.03). A granulosa cell tumor (1/338, 0.3%) was multilocular and honeycombed in shape. Presence of a large, well-demarcated, hypoechogenic sac lateral to or beneath the uterine horn encasing the ovary was diagnostic for ovarian hydrobursitis (102/338, 30.2%). Hydrosalpinx and pyosalpinx (6/338, 1.8%) were beaded in appearance, with the ovary located outside these structures. Clinical endometritis/cervicitis (122, 36.1%) was characterized by changes in the homogeneity in about half of the cases. A greatly dilated uterus with clear, hypoechogenic or echogenic contents with signs of hydrometra and pyometra, respectively, was another categorization of a reproductive pathology (24/338, 7.1%). Highly reflective, linear structures were observed in cases with intrauterine fetal bone retention (1/338, 0.3%). In conclusion, reproductive pathologies in dromedary camels can be efficiently imaged by use of ultrasonic technologies, thus familiarizing the practitioner with these disorders and facilitating application of these technologies so that suitable treatment can occur is important in managing reproduction of dromedary camels.

Ultrasonic features of pediatric eosinophilic gastroenteritis of children

Objective To summarize the manifestation of pediatric eosinophilic gastroenteritis by ultrasound and discuss the diagnostic value of ultrasonography in pediatric eosinophilic gastroenteritis. Methods The ultrasonic appearances of 31 cases of pediatric eosinophilic gastroenteritis confirmed by clinics and pathology were reviewed and analyzed. Results Nineteen of 31 cases were observed in association with eosinophilic infiltration of other organs which were diagnosed as idiopathic hypereosinophilic syndrome. Eosinophilic cystitis was the most common among the complications(89.4%, 17/19). Twelve of 31 cases were diagnosed as eosinophilic gastroenteritis without complications. The endoscopic appearances of eosinophilic gastroenteritis were nonspecific which include erythematous, hyperemia edema, and partiality erosion changes. Endoscopy demonstrates increased numbers of eosinophils in the propria of stomach and the duodenum. Ultrasound features of the gastroenteritis appeared diffuse or the parts of gastrointestinal tract. The most common sites of eosinophilic gastroenteritis were the stomach and duodenum.Involvement of muscle layer and serosal layer showed wall thickening of cyclic annular and uniformity. Ultrasound might show nodular or irregular thickening of the folds in the gastric antrum when the submucosa were thickening. The mucosal layer involvement was not easy to be found by ultrasound. The echo of serous layer and submucosa associated with the disease stage. The thickening of surrounding omentum and mesenteric tissue, echo enhancement and nonspecific hyperplastic mesenteric lymph nodes infiltrated with eosinophils might be present.Eosinophilic ascites could often be detected. Conclusions Ultrasound has obvious advantages in the diagnosis of pediatric eosinophilic gastroenteritis, and the ultrasonic changes of pediatric eosinophilic gastroenteritis are characterized. Ultrasonography can provide the possible diagnosis when combined with inflammatory of other organs, especially cystitis inflammatory changes. Key words: Ultrasonography; Pediatric; Eosinophilic gastroenteritis

Ultrasonic Needle Tracking with a Fibre-Optic Ultrasound Transmitter for Guidance of Minimally Invasive Fetal Surgery.

Ultrasound imaging is widely used for guiding minimally invasive procedures, including fetal surgery. Visualisation of medical devices such as medical needles is critically important and it remains challenging in many clinical contexts. During in-plane insertions, a needle can have poor visibility at steep insertion angles and at large insertion depths. During out-of-plane insertions, the needle tip can have a similar ultrasonic appearance to the needle shaft when it intersects with the ultrasound imaging plane. When the needle tip is not accurately identified, it can damage critical structures, with potentially severe consequences, including loss of pregnancy. In this paper, we present a tracking system to directly visualise the needle tip with an ultrasonic beacon. The waves transmitted by the beacon were received by an external ultrasound imaging probe. Pairs of co-registered images were acquired in rapid succession with this probe: a photoacoustic image obtained with the system in receive-only mode, and a conventional B-mode ultrasound image. The beacon comprised a custom elastomeric nanocomposite coating at the distal end of an optical fibre, which was positioned within the lumen of a commercial 22 gauge needle. Delivery of pulsed light to the coating resulted in the photoacoustic generation of ultrasonic waves. The measured tracking accuracies in water in the axial and lateral dimensions were 0.39±0.19 mm and 1.85±0.29 mm, respectively. To obtain a preliminary indication of the clinical potential of this ultrasonic needle tracking system, needle insertions were performed in an in vivo fetal sheep model. The results demonstrate that ultrasonic needle tracking with a fibre-optic transmitter is feasible in a clinically realistic fetal surgery environment, and that it could be useful to guide minimally invasive procedures by providing accurate visualisation of the medical device tip.

Progesterone and ultrasonographic changes during aglepristone or cloprosternol treatment in queens at 21 to 22 or 35 to 38 days of pregnancy

Progesterone (P4) is a requirement for pregnancy development. Previous reports observed a maximal value of serum P4 concentration on 21 days after the first mating after which it slowly declines throughout the rest of pregnancy. Ultrasound examination should be performed to ensure that pregnancy interruption is complete. Limited information is available on the ultrasonic appearance of conceptuses during pregnancy termination in cats The objective was to study serum P4 concentration and ultrasonographic changes during aglepristone (ALI) or cloprostenol (CLO) treatment and to evaluate the fertility after treatment. Two experiments (EXP) were carried out to accomplish this aim. Sixty queens, 12- to 36-month-old, were used. On Days 21 to 22 of pregnancy (EXP I) or 35 to 38 of pregnancy (EXP II), queens were divided into three groups (G). Queens in G1 received ALI (10 mg/kg, sc; EXP I, n = 10; EXP II, n = 10) for 2 consecutive days. Queens in G2 received CLO (5 μg/kg, sc; EXP I, n = 10; EXP II = 10) for 3 consecutive days. Queens in G3 received 1 mL of saline solution (PLA, sc; EXP I, n = 10; EXP II = 10). Blood samples were taken before treatment (Day 0) and every day during 10 days after the treatment to measure serum P4 concentrations. Likewise, after treatment, queens were monitored daily by ultrasonography for 10 days and weekly until the end of gestation to obtain gestational sacs measurements (GS), fetal measurements, and fetal biophysical profile. Data were analyzed by ANOVA. Serum P4 concentrations were significantly different on Day 6 (EXP I) and on Day 1 (EXP II) in ALI and CLO groups compared with PLA group (P < 0.05 and P < 0.01; respectively). The ultrasonographic monitoring during treatment allowed assessing changes in the GS and fetal measurements, embryo-fetal viability, and risk of pregnancy loss. In conclusion, the results from this study reported changes in serum P4 concentration and in ultrasonography measurements during pregnancy interruption with ALI or CLO treatment. Also it was observed that ALI and CLO are safe drugs and can preserve posttreatment queen fertility. Therefore, the results obtained in our work will be applied in feline reproduction practice.

Diagnosis of prostate cancer by trans rectal ultrasound guided prostate biopsy; an observational study

Introduction Digital rectal examination (DRE) coupled with the measurement of prostate specific antigen (PSA) is widely used for the early diagnosis and monitoring of prostate cancer. In the case of abnormal DRE and/or suspicious PSA value (over 4ng/ml), trans-rectal ultrasound guided prostate biopsy is adopted. Objective was to correlate the ultrasonic appearance with the biochemical markers and histological findings. Methodology This observational study was conducted at the Department of Radiology of Colombo North Teaching Hospital from August 2012 to January 2014. An interviewer administered questionnaire was used to collect data from all patients undergoing biopsy. Demographic data, biochemical markers, ultrasonic appearance and histological findings were recorded. An 18-gauge biopsy needle loaded in a spring-action automatic biopsy device was used to procure six 1.5cm prostate biopsy specimens from both lobes. Results Data from 194 patients were analyzed. Out of patients 30.9% (60) had cancer on biopsy; 33.5% (65) had benign adenomatous hyperplasia(BPH) and 34.5%(67) had chronic prostatitis. Mean (SD) age positive for malignancy was 72.2 (7.6) years. Men with prostate cancer had mean prostate volume of 39.8 ml and mean PSA level of 102.6/dl. 65% (39) of malignant patients had focal lesions. Men with non malignant histology had mean prostate volume of 44.7 ml and mean PSA level of 23.8ng/dl. Ultrasonically focal lesions were identified in 19.7% (26/132) non-malignant males. Presence of focal lesions on imaging was significantly associated with malignancy (p Conclusion Men with prostate cancer were older, had smaller prostate and had higher PSA levels than men with negative biopsies. There is a significant association between finding focal lesion on ultrasound and being diagnosed as malignancy in histology.

Sonographic Features and Diagnostic Analysis of Benign Chronic Inflammatory Breast Lesions in Nonlactating Women.

Sonographic Features and Diagnostic Analysis of Benign Chronic Inflammatory Breast Lesions in Nonlactating Women.

Ultrasonic appearance and diagnostic criteria of peripheral neurilemmoma

Objective To investigate the ultrasonic appearance of peripheral neurilemmoma. Methods Ultrasonic appearances of 43 patients with 46 neurilemmomas confirmed by surgery and pathology were analyzed retrospectively and compared with their MRI and pathological features. Results Forty-five neurilemmomas were with regular shape and clear boundary, except one at the root of nerve C4 that was irregular in shape and unclear in boundary, like a dumbbell . Sonography showed that there were 30 neurilemmomas displaying as solid tumors, 15 as cystic and solid, and 1 as entirely cystic. Posterior echo-enhancement, target sign, rat tail sign and vessels accompanying sign were found in 39, 21, 23 and 17 neurilemmomas, respectively. There were 4 neurilemmomas with ultrasound blood flow grade 0, 9 with gradeⅠ, 22 with gradeⅡ, and 11 with grade Ⅲ. The target signs were found in 21 cases (21/46, 45.6%) and 26 cases (26/46, 56.5%) by ultrasound and MRI, respectively. The capability of ultrasound finding the target sign in neurilemmoma was comparable to MRI(Kappa=0.527, P<0.001). The diagnostic accuracy rate of neurilemmoma by ultrasonography was 73.9%(34/46). Conclusions The ultrasound has a relatively high detection of the target sign in neurilemmoma, which may provide a new basis for the ultrasonic diagnosis of neurilemmoma. Key words: Ultrasonography; Neurilemmoma

Prenatal ultrasound diagnosis of fetal diaphragmatic hernia

Objective : To evaluate the prenatal ultrasound detection in the diagnosis of fetal diaphragmatic hernia. Methods : After routine prenatal ultrasonic examination in pregnant women, the suspected fetal diaphragmatic hernia cases were taken thoracic and abdominal multidetector continuous scanning, focus on the following ultrasonic appearance: abnormal echo in thoracic cavity, image features and the blood supply of the echo, displacement of the heart, position and structure of abdominal organs. In order to determine the existence and the type of diaphragmatic hernia, other malformations screening was practiced simultaneously. Results : 25 cases with fetal diaphragmatic hernia were detected by ultrasonography and clinic approved with 26 cases, only 1 case missed. Among the 26 cases of fetal diaphragmatic hernia,there were 23 cases of left side diaphragmatic hernia（88.5%,23/26), 3 cases of right side diaphragmatic hernia（11.5%, 3/26）. 11 cases of fetal diaphragmatic hernia complicated with other organ abnormal(42.3%，11/26). 17 cases of fetaldiaphragmatic hernia complicated with polyhydramnios (65.4％，17/26）. Conclusions : Prenatal ultrasound can accurately diagnose the fetal diaphragmatic hernia, it is indeed valuable in clinical application.