Ultrasonic Diagnosis Research Articles

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

Ultrasonic diagnosis of pediatric ovarian torsion

Objective To evaluate the value of ultrasonography in the diagnosis of pediatric ovarian torsion (OT). Methods Ultrasonography was performed in 38 OT, and 52 non-OT children. Bilateral ovarian area was measured. The larger area was defined as S1, whereas, the smaller area was defined as S2. S1/S2 ratio was calculated. Follicles around ovaries, ovarian blood flow, and pelvic effusion were also observed during the ultrasonographic scanning. ROC curve was employed to evaluate the clinical value of ultrasonography in pediatric OT diagnosis. Results ①S1/S2 ratio, incidence of follicles around ovaries and of no ovarian blood flow were all higher in OT compared to non-OT children (P=0.000). While pelvic effusion showed no significant difference between the two groups (P=0.004). ②Using S1/S2 ratio to diagnose OT, the area under the ROC curve was 0.925 (0.865-0.986), the best cutoff point was 1.6, sensitivity was 97% and specificity was 88%. Patients were divided into two groups based on the cutoff point of 1.6, the area under the ROC curve of S1/S2 was 0.924(0.847-0.969), of follicles around ovarian was 0.896(0.781-0.931), and of no ovarian blood flow was 0.911(0.831-0.961), indicating S1/S2 held the highest diagnostic value. Conclusions Ultrasonography is an accurate method in the early diagnosis of pediatric ovarian torsion, with S1/S2 ratio holding the highest diagnostic value in this application. Key words: Ultrasonography; Ovarian torsion; Child

非浸潤性乳管癌(DCIS)の鑑別における超音波フローイメージング分類の役割

非浸潤性乳管癌(DCIS)の鑑別における超音波フローイメージング分類の役割

Color Doppler ultrasonic diagnosis of thyroid microcarcinoma and analysis of misdiagnostic reasons

The misdiagnostic reason and sonographic features were retrospectively analyzed for 58 pathologically confirmed cases of thyroid microcarcinoma (TMC) at our hospital from January 2006 to January 2013. The ultrasonographic features of TMC included hypoechogenecity, distinct margin, irregular shape, ratio of anteroposterior axis and rectilinear axia ≥1, visible microcalcifications, posterior attenuation, blood flow signals with high resistance index on color Doppler and visible lymph node involvement in central neck area. And a coexistence of benign and malignant lesions should raise an alert for multiple thyroid nodules. Key words: Thyroid neoplasms; Ultrasonography

Two Cases of Unicuspid Aortic Valve That Could be Determined by an Ultrasonic Diagnosis

Two Cases of Unicuspid Aortic Valve That Could be Determined by an Ultrasonic Diagnosis

MODERN CAPABILITIES OF BREAST PATHOLOGY DIAGNOSTICS

Every year more than 1 million new cases of breast cancer are being recorded worldwide. Choice of appropriate tactics of treatment depends on the timely diagnosis and correct assessment of the prevalence of cancer. The algorithm of patient»s examination includes clinical examination, X-ray mammography and ultrasonic diagnosis of breast. However, this is not sufficient for a complete interpretation of the patient»s condition in case of non-palpable breast formations, ambiguous interpretation of imaging under structural changes, increased density of breast tissue, etc. In this regard, the introduction of new technologies and their evaluation in terms of practicality is a logical and developing method of early diagnosis of breast pathology. One of the methods that enables enhancing the information capability of ultrasonic diagnosis of breast is elastography. It allows for the differential diagnosis of benign and malignant changes not only in the breast tissue, but also in the areas of regional lymph drainage. Promising method of modern diagnostic breast care is digital mammography tomosynthesis. However, in spite of the first and very optimistic data, this technique is still far from standard. Complex diagnostics of breast pathology, in addition to clinical data and imaging results, are based on information obtained from biopsies. At the present stage core-biopsy is considered as the best way of verification, where the resulting material is subjected to immunohistochemical studies. Thus , the spectrum of diagnostic capabilities is constantly expanding. Highly informative techniques included in the daily practice today enable clinicians to achieve optimal results in curing even greater number of patients.

海员慢性酒精肝的超声诊断探析

目的：采用超声诊断在酒精肝疾病诊断中的临床应用价值进行系统性分析与研究。方法：从海员体检病例中选取100例腹部超声检查患者，其中男性有84例，女性有16例，他们的年龄在20~50岁之间。利用超声影像学特征分析的方法，对酒精肝患者的患病率与饮酒量、性别、年龄的关系进行对比性分析(P Objective: The clinical applied value of ultrasonic diagnosis in alcoholic liver disease is analyzed and researched. Methods: 100 cases were selected from the seafarers’ medical of patients with abdominal ultrasound examination, with 84 cases of men and women in 16 cases, their age between 20 to 50 years old. By using the method of ultrasonic imaging characteristics analysis, the relationship between prevalence rate with alcoholic liver and the drinking, sex, age is compared and analyzed (P < 0.05). Results: After a period of observation the study found that patients with alcoholic liver of male patients with 84 cases, occupied 84% of the total, while female patients with 16 cases, occupied 16% of the total; the contrast has obvious difference. The prevalence of three groups of patients with age 20 - 30, 31 - 40 and 41 - 50, has obvious difference. The prevalence rate of patients who drink a lot is higher than those who drink little (P < 0.05). Conclusion: Diagnosis of alcoholic liver patients by ultrasound examination helps to improve the effect of clinical diagnosis which has minimal positive influence on patients and has high value on clinical application and research.

Ultrasonic diagnosis and clinical analysis of eosinophilic cystitis in children

Objective To explore the ultrasound imaging and the clinical analysis of eosinophilic cystitis in children and to improve the understanding of this very rare clinical disease. Methods The ultrasound imaging of 9 patients who were diagnosed as eosinophilic cystitis in Nanjing Children's Hospital Affiliated to Nanjing Medical University from Jul.2007 to May 2013 were analyzed retrospectively, and the relevant literatures were reviewed. Results The ultrasound imaging of the 9 patients were described as follows: 4 cases showed a diffuse thickening bladder wall, 2 cases showed a localized mass-like thickening bladder wall, and 3 cases showed a markedly thickening anterior bladder wall and bilateral bladder wall.Laboratory studies showed that all the patients were presented with eosinophilia.Six patients underwent cystoscopy that showed an erythematous, and velvety appearance of the bladder mucosa.Histopathology disclosed a bladder mucosal tissue with dense interstitial eosinophilic infiltration consistent with eosinophilic cystitis. Three patients had clinical resolution under the treatment of anti-infections and urine alkalinization.Other 6 patients received prednisone at 0.5-1.0 mg/kg and an antihistamine treatment.Prednisone was eventually tapered off after 2-week reemission.Regular follow-up by urinary bladder ultrasound and urine routine did not show any disease recurrence in 9 children. Conclusions The combination of bladder wall thickening and peripheral eosinophilia may suggest the likely diagnosis of eosinophilic cystitis.Cystoscopy with bladder biopsy is the most important step in the diagnosis of eosinophilic cystitis.Anti-histamines and corticosteroids can be used as the primary management and have good results. Key words: Eosinophilic cystitis; Ultrasound imaging; Thickening of bladder wall

Ultrasonic quantitative diagnosis by estimation of scattering properties of tissue

Ultrasonic quantitative diagnosis by estimation of scattering properties of tissue

GW25-e3373 The ultrasonic diagnosis value for the diagnosis of congenital coronary artery fistula, compared with findings of surgery and/or coronary angiography

To evaluate the application of transthoracic echocardiography for the diagnosis of congenital coronary artery fistula. The echocardiographic appearances of 63 patients with coronary artery fistulas who had undergone coronary angiography and/or operation in our hospital, were analyzed

Ultrasound evaluation on cervical lymph nodes metastasis regions and characteristics in thyroid carcinoma

Objective To investigate the value of ultrasonic diagnosis on cervical lymph nodes metastasis regions and characteristics in thyroid carcinoma.Methods Ultrasound image of 290 patients with thyroid carcinoma were analyzed restrospectively.The cervical lymph node metastasis regions diagnosed by ultrasonography were compared with histopathologic results,and the ultrasound characteristics of metastasis lymph nodes were assessed.Results Among 290 patients,167 cases with cervical lymph node metastasis were comfirmed by pathology (57.6％),and 185 cases were detected by pre-operative ultrasound (63.8％).The region of thyroid carcinoma lymph node metastasis comfirmed by histopathology was most commonly the central region (54.1％),followed by the lateral neck (20.7％).The diagnostic rate of central region lymph node metastatic by pre-operative ultrasound was only 31.7％,which was sharply lower than that of lateral region (57.6％,P ＜0.05).However,the diagnostic specificity (72.8 ％) was apparently higher than lateral region (35.9％,P ＜0.05).The ultrasonic characteristics of metastatic cervical lymph nodes included rounded shape,absence of echogenic hilus,presence of calcitication,hyperechogenicity and cystic change.Conclusions The cervical central region is the predominant region for thyroid carcinoma lymph node metastasis,and ultrasound diagnosis on central region lymph node metastasis possesses positive specificity but negative sensitivity.Improving ultrasound diagnostic accuracy on central lymph nodes metastasis would be of important clinical significance. Key words: Ultrasonography; Thyroid neoplasms; Lymphatic metastasis

A retrospective analysis of ultrasonic diagnosis for 360 cases of extrahepatic obstructive jaundice

To retrospectively analyze the ultrasonic diagnosis of extrahepatic obstructive jaundice, discuss their ultrasonographic characteristics, technical procedures and misdiagnostic reasons and improve the diagnostic proficiency and qualitative accuracy of extrahepatic obstructive jaundice. Retrospective analyses were conducted for the causes, obstructive sites and ultrasonic characteristics of 360 cases of extrahepatic obstructive jaundice confirmed by surgical pathology during 10 years, including choledocholithiasis (n = 205), cholangiocarcinoma (n = 30), pancreatic head carcinoma (n = 44), gall bladder (n = 27), ampullary carcinoma (n = 24), cholangitis (n = 24) and biliary tract roundworm (n = 6). For locating extrahepatic obstructive jaundice, the accuracy of ultrasonic diagnosis was 93.6% and that of qualitative diagnosis 87.5%. As an economic, rapid, safe and noninvasive tool, ultrasound is valuable in the diagnosis of extrahepatic obstructive jaundice. It may be applied frequently in non-contraindicated and complication-free patients. However, the diagnostic accuracy is closely correlated with inspector experiences, operative techniques and patient conditions.

Automatic segmentation of breast lesions for interaction in ultrasonic computer-aided diagnosis

Breast cancer is one of the most commonly diagnosed cancer types among women. Sonography has been regarded as an important imaging modality for diagnosis of breast lesions. Due to the speckle and the variance in shape and appearance of sonographic lesions, fully automatic segmentation of the breast tumor regions still remains a challenging task. In this paper, we propose an automatic interaction scheme based on an object recognition method to segment the lesions in breast ultrasound images. In this scheme, a 2D ultrasound image is firstly filtered with a total-variation model to reduce the speckle noise. A robust graph-based segmentation method is then used to segment the image into a number of sub-regions. An object recognition method incorporating the procedures of image feature extraction, feature selection and classification is proposed to automatically identify the regions which are associated with breast tumors. Finally, an active contour model is used to refine the contours of the regions that are recognized as tumors. This scheme is validated on a database of 46 breast ultrasound images with diagnosed tumors. The experimental results show that our scheme can segment the breast ultrasound images automatically, indicating its good performance in real applications.

Coronary artery fistula: Comparison of diagnostic accuracy by echocardiography versus coronary arteriography and surgery in 63 patients studied between 2002 and 2012 in a single medical center in China

BackgroundCoronary artery fistula (CAF) is a rare congenital anomaly, which is conventionally diagnosed by coronary arteriography; however, the relation of the coronary artery fistulas to other structures, their origin and course may not be always apparent. MethodsThe echocardiograms of 63 patients with coronary artery fistulas, who had undergone coronary arteriography and/or surgery from June 2002 to December 2012 at the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, were analyzed retrospectively, and the results were compared with findings by coronary arteriography and at surgery. ResultsRight CAFs were detected in 33 of the 63 patients (52.4%); 11 had drainage to the right atrium, 10 to the right ventricle, 2 to the left ventricle, 9 to the main pulmonary artery, and 1 to the coronary sinus. Left CAFs were detected in 29 patients (46.0%); 6 had drainage to the right atrium, 12 to the right ventricle, 1 to the left atrium, 2 to the left ventricle, 7 to the main pulmonary artery, and 1 to the coronary sinus. One patient (1.6%) had the origin of the fistula in both coronary arteries. The entry point of the fistula was most often a single orifice (96.8%) and rarely multi-orificial (3.2%). 57 patients (90.5%) had isolated coronary fistulas (90.5%); 6 patients (9.5%) had other congenital cardiac malformations. The ultrasonic diagnosis of 60 patients was in line with findings at surgery and/or coronary arteriography. The diagnostic accuracy rate for coronary artery fistula was 95.2%. Preoperative transthoracic echocardiography missed the diagnosis of coronary artery fistula in three patients (4.8%). There is no difference (P>0.05) in diagnostic accuracy between echocardiography and coronary arteriography and/or surgery. ConclusionsTransthoracic echocardiography, in comparison with coronary arteriography and/or surgery, is much simpler, easier, less expensive, safer, readily repeatable, and more convenient with equal accuracy, and should be the first-line method for the diagnosis of congenital coronary artery fistula.

Effect of hepatic function on the EC50 of midazolam and the BIS50 at the time of loss of consciousness.

To explore the effect of hepatic function on loss of consciousness (LOC) and bispectral index (BIS) during sedation with midazolam (MDZ). Forty-five patients were assigned to three groups according to their liver function. Thirty of these patients with diagnoses of cholelithiasis were scheduled laparoscopic cholecystectomy, including 15 patients with normal liver function (normal group), and 15 patients with moderately abnormal liver function based on the results of ultrasonic diagnosis of a moderately fatty liver and elevated alanine transaminase levels of less than three times normal (moderate group). The other 15 patients with end-stage liver disease (severe group) underwent liver transplantation. Each patient was administered MDZ by way of target-controlled infusion to increase the concentration gradually. At the time of LOC, the BIS was recorded and a blood sample was withdrawn for measurement of the concentration of MDZ. The concentration of MDZ (EC50) and the BIS value (BIS50) at which 50% of patients lose consciousness were calculated using logistic regression. At the time of LOC, the EC50 of MDZ and the BIS50 were similar in the normal and moderate groups (P>0.05). LOC occurred at a lower EC50 of MDZ and at a higher BIS50 in the severe group, compared with the normal and moderate groups (P<0.01). Patients with end-stage liver disease were more sensitive to MDZ and this affected the prediction of their time of LOC following MDZ administration. There were no changes in response in patients with moderately abnormal hepatic function.

The diagnostic value of color Doppler ultrasound for breast tuberculosis

Objective To explore the diagnostic value of color Doppler ultrasound for breast tuberculosis . Methods 70 cases were found breast tumor for various reasons .The direct method of scanning application of 7.5 ~10MHz high frequency color Doppler , simultaneous detection of axillary lymph node size and acoustic imaging . Results The ultrasonic diagnosis of 70 cases of breast mass with an accuracy of 97.14%,for diagnosis of tuberculo-sis of the breast,the accurate rate was 100.00%.Conclusion High frequency ultrasonography and color Doppler flow imaging in diagnosis of breast mass has high accuracy ,good effect ,it is one of the best method to check currently . Key words: Breast diseases; Ultrasonography,Doppler,color; Diagnosis,differential

Ultrasonic diagnosis of hip dysplasia in rachitic pathology in infants (1180.14)

Objective: to identify the signs of hip dysplasia in a large clinical material along with the symptoms of rickets (sweating, alopecia of the occipital region of the head, muscular hypotonia, irritability child).Materials: 935 children were observed at the CCH No 2 in Astana for 2010 with hip joint pathology, of whom up to 6 months, 56.6% after 6 months ‐ 32,6% to be conservative treatment and 10.8% children received surgical treatment.Results: Ultrasonography in 35.8% children 2‐3 months of age revealed a sharp flattening of the bone and bone bay window roof (angle d ranged between 34 ‐39), cartilaginous portion of the acetabulum has been shifted cranial ossification nucleus head femur was missing. At the age of 4‐5 months during treatment in the stirrups Pavlik appeared signs of the formation of the femoral head in the form of separate small “clumps” in 46.5% children in the remaining 36.5%, these terms are shifted to 6‐7 months of age (the angle d 48‐52). Only by 9‐10 months gradually underwent a process of mergers and the formation of a homogeneous core of ossification center of the femoral head (the angle d approaching 56‐58), cartilaginous portion of the roof of the acetabulum was relatively short. By the year 33% of patients the size of the hip bone formation were reduced, and only 67% of patients taking shape hip well‐formed, bone bay took a rectangular shape, cartilaginous part of the femoral head is completely covered).

Ultrasonic diagnosis and vasoactive substances examination in patients with cirrhosis

ObjectiveTo investigate hemodynamic change of patients with cirrhosis by using Color Doppler ultrasound technique and to explore the significance of change in the content of vasoactive substances-plasma endothelin-1 (ET-1) and calcitonin gene-related peptide (CGRP). MethodsA total of 178 cases with cirrhosis were regarded as study groups, and were divided into three degrees: A, B and C according to child-pugh and meanwhile 60 cases were regarded as normal control group. Portal vein and splenic vein of patients were explored by adopting Color Doppler ultrasound technique, related indexes were recorded and the blood flow as well as their ration in the two groups was calculated. Radio immunoassay was adopted to detect the content of plasma ET-1 and CGRP in both study group and contrast group. ResultsCompared with the healthy cases in the contrast group, there was abnormal hemodynamics in the system of portal vein of patients with cirrhosis and the content of plasma ET-1 and CGRP was increased obviously. In the Child-Pugh liver function grades, the content of ET-1 and CGRP was increased as the degree of cirrhosis became more and more serious. There was no significant difference in the comparison between those without ascites and those in contrast group (P>0.05), the content of plasma ET-1 and CGRP in patients without ascites was increased remarkably. Besides, there was positive correlation between the content of plasma ET-1 and CGRP and Dpv, Dsv and Qsv. ConclusionDetection of abnormal hemodynamics of portal vein and splenic vein by Color Doppler ultrasound technique can be one of the means for diagnosis of hypertension. Plasma ET-1 and CGRP of patients with cirrhosis reflect the serious degree of the damage in live function and play an important role in the formation and development of portal hypertension.

An adaptive ultrasonic backscattered signal processing technique for instantaneous characteristic frequency detection.

Ultrasonic diagnosis that is convenient and nondestructive to the human body is widely used in medicine. In clinical, ultrasonic backscattered signals characteristics are utilized to acquire information of the human body tissues to perform diagnosis. In this paper, an adaptive ultrasonic backscattered signal processing technique for instantaneous characteristic frequency detection based on the marginal spectrum is presented. In the beginning, the ultrasonic backscattered signal is decomposed into a series of intrinsic mode functions (IMFs) by the Ensemble Empirical Mode Decomposition (EEMD) algorithm. Then the Hilbert spectrum is gained by the Hilbert transform on the IMFs decomposed and screened. Finally, the time-frequency information in the Hilbert spectrum is utilized to extract the instantaneous characteristic frequency based on the marginal spectrum features to detect the objective. With this technique, the spacing between tissues can be estimated for tissue characterization by processing multiple echoes even in the complicated environment. In the simulation study, comparing with the FFT, the technique presented shows its strong noise immunity and indicates its validity in instantaneous characteristic frequency detection.

Ultrasound Diagnosis of the Fetus In-Utero

Ultrasonic fetal diagnosis has been tremendously progressed in the real-time B-mode, transvaginal scan, Doppler ultrasound, 3D and 4D ultrasound, for the diagnoses of fetal development, genetic abnormalities, fetal sex, fetal behavior and various fetal diseases. Ultrasonic Doppler fetal monitoring promoted functional fetal diagnosis and the analysis of fetal movement using ultrasonic Doppler actocardiogram for the advanced monitoring, fetal behavior, and solution of problems in the cardiotocogram e.g. the differentiation of physiologic sinusoidal FHR. The rapid delivery was recommended before the loss of FHR variability from the actocardiographic studies on the development of FHR variations.