Ultrasonic Diagnosis Research Articles

Fluid accumulation in the fetal extracerebral spaces: External hydrocephalus or subdural hygromas?

External hydrocephalus is defined as enlargement of the subarachnoidal space with accumulation of cerebrospinal fluid (CSF). In adults, there are several reasons for external hydrocephalus, such as disruption of CSF resorption or meningeal inflammations. During fetal development the occurrence of external hydrocephalus is a very rare event and pathogenetic mechanism as well as neuropathological classification considerably differs from that of adults. Here we report on a 25th gestational week fetus with the ultrasonic diagnosis of an external hydrocephalus with macrocephalus and microencephaly. Neuropathological examination revealed extensive subdural hygroma, associated with chronic subdural haemorrhages. The central nervous system (CNS) showed a distinct microencephaly with pronounced neocortical migration defects and various stages of neuronal maturation. Due to our findings we were able to exclude the diagnosis of an external hydrocephalus. Instead, we suggest, that the atrophic hemispheres lead to a chronic stretch of the bridging veins with drainage of fluid into the subdural space.

Ultrasound elasticity imaging in real-time and semi-quantitative evaluation of deep vein thrombosis at different stages: a preliminary clinical study

Objective To use ultrasound elasticity imaging (UEI) technology for evaluating the elasticity changes of the deep vein thrombosis (DVT) at different stages.Methods Conventional ultrasonic diagnoses were performed in 49 patients with DVT and the patients were divided into acute stage,sub-acute stage,and chronic stage.The elastic image characteristics of the thrombosis were observed at different stages and the strain ratio (B/A) between the muscle tissue around the vein and the thrombosis was calculated.Results (1) In ultrasound elasticity image,the acute thrombosis was mainly red,the sub-acute thrombosis was green,and the chronic thrombosis was blue.(2)The strain ratio of the sub-acute thrombosis group and the chronic thrombosis group were significantly higher than that of the acute thrombosis group(P0.001,P0.05),and the strain ratio of the chronic thrombosis group was significantly higher than that of the sub-acute thrombosis group(P0.05).Conclusion UEI technology can be used to evaluate the elastic changes in different stages of the deep vein thrombosis,and it can help to select treatments for thrombosis and predicting the complications.

甲状腺腫瘍の超音波診断

全ての甲状腺の腫瘍に対して超音波検査を行う．乳頭癌は悪性の超音波所見を呈する．充実性パターン，不整形，境界粗雑，内部低エコー，不均質，微細多発高エコー，ドプラ法で血流シグナルあり，頸部リンパ節腫大がその所見である．甲状腺乳頭癌の特殊型には特別の超音波所見を呈し，良性所見を呈するタイプや，結節非形成のタイプがある．濾胞癌と濾胞腺腫の超音波所見はよく似ているので鑑別はかなり困難である．悪性リンパ腫はかなり特徴的な超音波所見を呈する．腺腫様甲状腺腫・腺腫様結節，嚢腫などについても説明する．嚢腫，腺腫様甲状腺腫・腺腫様結節，精査基準などについて説明する．超音波画像をみて臨床的判断が出来るように手術適応，経過観察，細胞診すべき部位などの事項も説明した．

Risk factors for carotid artery distensibility in middle-aged and elderly hemodialysis patients.

Carotid intima media thickness (CIMT) and stiffness are taken as useful surrogate markers of atherosclerosis. In China, the number of elderly patients undergoing hemodialysis has increased year by year, with the increase of dialysis-related cardiovascular events. This study was undertaken to examine carotid stiffness in elderly hemodialysis patients by the ultrasound techniques in order to find out the possible risk factors. From January 2006 to February 2010, a total of 87 patients (41 males and 46 females) treated with routine hemodialysis at the 97th Hospital of People's Liberation Army were enrolled in this study. The distensibility coefficient (DC) of the carotid artery was detected by Doppler ultrasonic diagnosis apparatus (Philips HBI5000, frequency 12 MHz) for evaluation of arterial stiffness. Serum albumin, total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride (TG), glucose, creatinine, calcium, phosphorus, and intact parathyroid hormone (iPTH) were examined with standard methods. The liner correlation and multiple stepwise regression analysis were used to find correlations between them. In this study, the systolic blood pressure was 153.33±25.98 mmHg, DBP 84.22± 10.39 mmHg, TC 4.39±1.05 mmol/L, TG 1.36±0.72 mmol/L, LDL 2.47±0.77 mmol/L, Cr 889.82± 207.38 Mmol/L, Glu 5.36±1.87 mmol/L, Ca I 2.00±2.19±0.21 mmol/L, and DC 13.39±5.32×10(-3)/kPa. DC was associated with age (r=-0.459, P<0.001), SBP (r=-0.527, P<0.001), and serum calcium (r=-0.273, P=0.011). The multiple stepwise regression analysis showed that SBP, age, increased serum calcium level, and diabetes were independent risk factors for decreasing DC. Systolic blood pressure, age, increased serum calcium level and diabetes in elderly hemodialysis patients are independent risk factors for increased carotid arterial stiffness.

Comparison between type-B ultrasonic and hysteroscopio diagnosis and treatment of endometrium lesions after menopause osused by taking tamoxifen following mastectomy

Objective To compare the application value between B ultrasonography and hysteroscopy in the diagnosis of endometrial diseases in postmenopausal patients taking tamoxifen with postoperative breast cancer. Methods 40 postmenopausal patients with post-operative breast cancer, taking tamoxifen for 1 year or more, were included in the study. All underwent evaluation of endometrial diseases by B ultrasonographic, hysteroscopy and endometrial biopsy. The sensitivity and specificity of B ultrasonography were compared with hysteroscopy. Results The comparison of sensitivities between B ultrasonographic and hysteroscopy were 80% vs. 95% (P=0.15l),and the specificities were 20% and 95% (P< 0.01), respectively, Conclusion Hysteroscopy was a more accurate method for the detection of endometrial diseases in postmenopausal patients taking tamoxifen with post-operative breast cancer than ultrasonography. Key words: Post -operative breast cancer; Tamoxifen; Endometrial diseases; B ultrasonography; Hysteroscopy

Cholecystoduodenal fistula: ultrasonographic diagnosis with oral gastrointestinal ultrasound contrast medium

To determine the value of ultrasonography in the diagnosis of cholecystoduodenal fistulas (CDFs). Twenty-three patients with calculous cholecystitis were suspected to have CDFs on pre-operative ultrasonography. Oral gastrointestinal (GI) ultrasound contrast medium was infused to dynamically observe the presence or absence of a CDF, and the results were compared with the operative findings. The criterion for ultrasonic diagnosis of CDF was dynamic observation of the contrast medium entering the gallbladder through the fistula orifice. Of the 23 enrolled patients, oral GI contrast medium in the duodenum was observed entering the gallbladder through the fistula orifice in 18 patients (78.3%), all of whom were later confirmed operatively to have a CDF. In the remaining 5 patients in whom no GI ultrasound contrast medium was observed entering the gallbladder, 2 were confirmed by surgery to have a CDF, and 3 were shown not to have a CDF. On the basis of routine ultrasonography, dynamic observation through oral infusion of GI ultrasound contrast medium is a simple, practical, non-invasive, and effective method of diagnosing CDF.

Comparison of ultrasonic diagnosis with pathological examination for benign and malignant breast lesions

Objective To analyze the features of breast neoplasms on two- dimensional highfrequency ultrasound, color Doppler flow imaging (CDFI), and ultrasonic elastography (UE) and to assess the values of these ultrasonic diagnosis. Methods The data on 113 patients with pathologically confirmed breast tumors were retrospectively analyzed. Features of benign and malignant lesions on two-dimensional ultrasound CDFI and UE were compared. Results There were significant differences between benign and malignant breast regarding appearance of the lesions including shape, edge, capsule,and existence of calcification. Metastasis to axillary lymph nodes was the sign of breast cancers. On CDFI,the detection rate of blood flow in small benign masses was 70.1%, mostly with a grade of 0 - I, while that in breast cancers was 82.6%, with a grade of Ⅱ - Ⅲ. 5-scoring systme was used for evaluation (score 4 or above for malignancy and score 3 or below for benign lesions)and the sensitivity, specificity and accuracy of UE was 84.8%, 92.5%, and 89.4%. Conclusions Comprehensive analysis of the features of breast tumors on two-dimensional ultrasound, color Doppler flow imaging , and ultrasonic elastography can markedly increase the diagnostic rate of breast cancer. Key words: Color Doppler; Ultrasonography elastography; Breast neoplasm

The diagnosis and surgical treatment of hepatolithiasis associated with cholangiocarcinoma

Objective To explore into the relationship between the hepatolithiasis and the intrahepatic cholangiocarcinoma, and summarize the experience of early diagnosis and surgical treatment of these disease. Methods A retrospective clinical analysis was made in 28 cases of hepatolithiasis complicated by intrahepatic cholangiocarcinoma from September 1998 to December 2008. Results It was found that the incidence of cholangiocarcinoma in hepatolithiasis was 5.9%. The correct rate of preoperative ultrasonic diagnosis was 57.15% ( 16/28 ) ,and that of CT diagnosis was 46.43 % ( 13/28), and that of MRCP diagnosis was 40.00% (6/15). 12 cases were radically resected,12 cases were treated by palliative therapy, and 4 cases were examined only with biopsy, and all cases were followed up. The 1-,2-,and 3-year survival rate in radical surgery were 83.34% ,58.34% ,25.00% respectively. And the 1-year,and 2-year survival rate in palliative surgery group were 66.67% ,8.33% respectively. And all the cases examined only with biosy died in 6 months after the biosy. Conclusion Cholangiocarcinoma is related to hepatolithiasis. In patients of hepatolithiasis who were older than 40 years and have a long history of recurrent cholangitis, weight-loss in a short period, progressive jaundice, or intractable abdominal pain,the possibility of accompanying cholangiocarcinoma should be considered. The key of improving the therapeutic effectiveness was early diagnosis ,early treatment and striving for radical operation. Key words: Hepatolithiasis; Cholangiocarcinoma; Diagnosis; Surgical treatment

Ultrasonic diagnoses of melting and degradation of poly(ethylene terephthalate)

The melting and thermo-mechanical degradation of poly(ethylene terephthalate) (PET) samples with different moisture levels were investigated in an internal mixer under different processing conditions. The investigation used an ultrasonic diagnosis system and a torque rheometer. The experiment results showed that: 1) a PET sample with a lower humidity level was more stable than that having higher water content under the same processing conditions; 2) higher temperatures and blade speeds accelerated melting and degradation rates. However, the transition point from a partially melted state of a PET sample to a completely melted state could only be identified by ultrasound and the onset of degradation was evident from the ultrasonic measurement as opposed to the torque measurement.

On the problem of ultrasonic diagnosis of a wrong formation of the hip joint in infants of the 1st year of life

The authors attracted attention to an insufficient level of training specialists in ultrasonic diagnostics and, proceeding from experience of Germany, suggest health care establishments concrete measures in order to eliminate defects in diagnosing the state of the hip joint in children, especially infants during their first year of life.

Experimental determination of the main characteristics ultrasonic diagnostic devices D - type

The article describes the basic principles of research performance characteristics of ultrasonic diagnostic devices: depth sensing, blood flow velocity, the radial resolution. We present experimental data obtained on the stand, allowing for the need for clinics in the laboratory does not conduct research on biological objects - man, and the appropriate models. For example, instead of blood vessels - in pipes of different diameter, made of polystyrene, through which a variable speed skipped several liquids close to the acoustic impedance of blood. The study can be used in the design of ultrasonic diagnosis of conversion, sensors.

Enhancement for breast ultrasound image and its application to breast cancer diagnosis

Objective To evaluate the performance of a computerized detection and classification with breast ultrasound images using the enhancement algorithm based on fuzzy logic and texture analysis.Methods Six hundred and three ultrasound images of 211 cases were analyzed including 109 benign lesionsand 102 malignant ones.The original and enhanced images were assessed by radiologists using double blind method.The pathological results were regarded as the golden standard.The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy were calculated by the areas under curves(AUC)of the receiver operating characteristic curves.Results After enhancement of the breast lesions on ultrasound images,the fine details of breast lesion features were preserved by the proposed approaches while avoiding noise amplification and overenhancement,the images became distinct,and the regions became more homogeneous,and the boundaries of the regions were much clearer,and more suitable for diagnosis.The sensitivity and specificity of breast lesions on ultrasound images could be raised from 75.4%to 89.6 %,from 66.7 % to 91.2%.respectively,the diagnostic accuracy was raised from 78.20%to 89.57%,and Az of ultrasonic diagnosis also increased from 0.842 to 0.914,Z=5.101,there were significant differences in the AUC between the originaI breast Iesions and enhanced ones on ultrasound images(P<0.001).Conclusions The enhancement algorithm on breast ultrasound images were proposed and it can increase the diagnostic accuracy in differentiating benign and malignant breast lesions and decrease the rate of missing and misdiagnosis of breast lesions greatly. Key words: Ultrasonography; Breast diseases; Image enhancement

Tissue Attenuation Estimation from Backscattered Ultrasound Using Spatial Compounding Technique - Preliminary Results

The pathological states of biological tissue are often resulted in attenuation changes. Thus, information about attenuating properties of tissue is valuable for the physician and could be useful in ultrasonic diagnosis. We are currently developing a technique for parametric imaging of attenuation and we intend to apply it for in vivo characterization of tissue. The attenuation estimation method based on the echoes mean frequency changes due to tissue attenuation dispersion, is presented. The Doppler IQ technique was adopted to estimate the mean frequency directly from the raw RF data. The Singular Spectrum Analysis technique was used for the extraction of mean frequency trends. These trends were converted into attenuation distribution and finally the parametric images were computed. In order to reduce variation of attenuation estimates the spatial compounding method was applied. Operation and accuracy of attenuation extracting procedure was verified by calculating the attenuation coefficient distribution using the data from the tissue phantom (DFS, Denmark) with uniform echogenicity while attenuation coefficient underwent variation.

Preoperative Evaluation of Cutaneous and Subcutaneous Lesions with MR Microscopy: Comparison with Clinical and Ultrasonic Diagnoses Based upon Pathological Diagnosis

Preoperative Evaluation of Cutaneous and Subcutaneous Lesions with MR Microscopy: Comparison with Clinical and Ultrasonic Diagnoses Based upon Pathological Diagnosis

Correlation between clinicopathological and ultrasonic diagnosis of small protuberant lesions of the gallbladder

Correlation between clinicopathological and ultrasonic diagnosis of small protuberant lesions of the gallbladder

Advances in ultrasonic diagnosis of hepatic fibrosis and early cirrhosis

Advances in ultrasonic diagnosis of hepatic fibrosis and early cirrhosis

Automatic Endocardium Contour Tracing Method Using Standard Left Ventricles Shape Model

The necessity of ultrasonic diagnosis tools increases every year. We propose an automatic endocardium tracing method by applying prepared “Standard Left Ventricles Shape Model (SLVSM)”. The cross section of heart wall in ultrasonic image is decided depending on the position and the angle of this probe. The initial contour is adaptively determined as crossing curve line between the SLVSM and the cross section. And the endocardium contour is extracted by active contour model(ACM) in two stages. In the first stage, an endocardium contour is detected using the result of an edge extraction based on the separability of image features. In the second stage, the endocardium contour is extracted using shape correction processing. “Mitral valve processing” not only detects the position of the mitral valve at the end diastolic period, but also corrects the detected contour after the first stage of ACM. Experimental results using one healthy case and three diseased cases have shown the effectiveness of the proposed method.

THE ULTRASONIC THREE-DIMENSIONAL FILTER FOR THE QUANTITATIVE DIAGNOSIS OF LIVER FIBROSIS

At present, percutaneous liver biopsy is the gold standard in assessing liver fibrosis such as hepatitis and cirrhosis, but there could be sampling error, and specimens might not represent the state of the whole liver accurately because only about 0.002% of the organ is sampled. In this research, we propose the three-dimensional fiber structure extraction echo filter to realize a quantitative ultrasonic diagnosis. The filter is designed based on a statistical theory, and it is possible to reduce the noise contained in a back scattered ultrasonic echo signal, and to visualize the structure of a fiber.

Value of ultrasound in diagnosing ductal carcinoma in situ

Objective To evaluate the value of ultrasound in diagnosing ductal carcinoma in situ (DCIS). Methods The sonographic characteristics of 12 DCIS which were confirmed by pathology were analyzed retrospectively. Results The ultrasound image of DCIS could be divided into four types;the solid mass nodule, mammary dysplasia, mix mass nodule, the dilated duct type. Micro calcification had high incidence rate. Ultrasonic diagnosis accordance rate was 50.0 %. On molybdenum target mammograms, the tumor appeared as a cluster of calcified spots in 8 cases, and the accuracy rate of diagnosis of was 66.7 %.Conclusion There are no typical characters of DCIS in ultrasound image. However, some characteristics are suggestive and can help to differentiate them from the benign tumors, such as small nodule, irregular shape,obscure boundary, and microcalcification. When sonography combine with molybdenum target mammography,the accuracy rate of diagnosis will be improved. Key words: Breast neoplasms; Ultrasound; Ductal carcinoma in situ; Intraductal carcinoma

A clinic value of ultrasonic diagnosis in breast carcinoma

Objective To probe into a meaning of ultrasonic diagnosis for galactophore cancer and a character of cancer ultrasonic image.Methods To analyze retrospectively 263 ultrasonic images with galactophore cancer,and to contrast with X molybdenum target photograph,and MRI.Results The discovering rate of ultrasonic for galactophore cacer was 87.45%(230/263).The ultrasonic images were numerous low echo of singleness focus,they were 96.58%(254/263),the edge of tumours were abnormity,the contours were fainmoss,they were like burr or crab legs(86.69%)(228/263);the edges were in order,the contours were in clarity but no envelopes 13.31%(35/263);the tumors in length and breadth＞1 were 90.49%(238/263);strong echo flecks in the tumors were 90.87%(239/263);the lymph node of armpit in 77.56%(204/263)patients were intumesce.The detection rate of galactophore cancer in X molybdenum target photograph was 96.74%(208/215),and MRI was 97.92%(47/48),they were all higher B ultrasonic(P＜0.01 or＜0.05).Conclusion The detection rate of galactophore cancer in ultrasonic is not as good as X molybdenum target photograph and MRI,but the ultrasonic is no-hurt,no-radioactivity and charge low so that it is a first way of galactophore cancer examination. Key words: Ultrasonic diagnosis; Breast cancer