Ultrasonic Diagnostic Imaging Research Articles

Variability in Cross-Sectional Muscle Atrophy: Insights From the Central Rectus Femoris.

This study aimed to evaluate the non-uniformity of cross-sectional areas in atrophic musclesusing the central aponeurosis (CA) as a marker for the central region of the rectus femoris (RF). We enrolled 51 consecutively admitted patients (102 limbs) with aortic valve stenosis who were scheduled for elective surgical or catheter-based aortic valve replacement and were expected to have low physical activity-induced muscle atrophy. We obtained short-axis images of the mid-thigh using an ultrasonic diagnostic imaging system (with a 5-cm-wide probe) and measured the deviation of the central region of the rectus femoris from the body surface. Muscle thickness was measured using conventional morphological measurements on the body surface ("On Surface") and landmarks within the ultrasonographic image ("In Images"). Displacements ≥ 1.5 cm were observed in 56 (54.9%) limbs, and displacements ≥ 2.5 cm were observed in 34 (33%) limbs. The displacements were predominantly in the medial direction and ranged from 4 cm to 1.5 cm. Among the cases in which the deviation was ≥2.5 cm, "On Surface" measurements resulted in images in which the vastus lateralis overlapped with the rectus femoris. The thickness of the rectus femoris was significantly lower with "On Surface" measurements than with "In Images" measurements (right, p < 0.001; left, p = 0.007), with a maximum difference of 10.5 mm. In conclusion, it was observed that the rectus femoris at the center was often displaced medially, and the muscle thickness was thinner at the edge than at the center, showing a non-uniform morphology.

A study on the shape change of the rectus femoris muscle with knee flexion

Since the rectus femoris muscle is associated with trauma and disorders such as muscle strain, it is often a target for evaluation and treatment. However, in many studies, measurement results were obtained from only a part of the rectus femoris muscle and used as a representative value without considering the differences across the muscle. The rectus femoris muscle may change shape with knee flexion because the structure is complicated; it has an intramuscular tendon. The purpose of this study was to assess the changes in shape of the rectus femoris muscle during flexion of the knee joint in different directions. Twelve lower limbs of 12 male university students were analyzed. The rectus femoris muscle was divided into eight parts, and short-axis images were taken with an ultrasonic diagnostic imaging device at the knee joint; in extension; flexion at 30 °, 60 °, 90 °, and 120 °; muscle thickness; muscle width; and cross-sectional area. It was suggested that the thickness of the rectus femoris muscle increased from “A” to “F” due to knee flexion, and that this increase occurred because of stretching at the same site. In “G,” there was no difference between the angle conditions; conversely, in “H,” the muscle thickness decreased due to knee flexion. It should also be noted that D and E have the greatest muscle thickness when measuring in the knee flexion position.

Sonographic evaluation of renal changes among drug-dependent and drug-naive adult patients with human immunodeficiency virus/acquired immunodeficiency syndrome in Kano, Nigeria

Context: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) remains a major challenge globally. HIVassociated nephropathy is the third most common cause of endstage renal failure and more prevalent among AfricanAmericans with HIV compared with other races. Aims: This study evaluated sonographic renal changes in drugdependent and drugnaive patients with HIV/AIDS in Kano, Nigeria.Materials and Methods: A prospective and comparative study involving 190 each of drugdependent and drugnaive patients were conducted. Renal sonography was performed using digital ultrasonic diagnostic imaging system, equipped with a 3.5 MHz curvilinear transducer. Statistical analysis used: An independent ttest and Mann–Whitney Utest were used to compare the renal volume and mean rank of the renal parenchymal echogenicity between drugdependent and drugnaive patients. Statistical significance was considered at P

The prediction of fetal maturity and gestational age by ultrasonic measurement of distal femoral epiphyseal secondary ossification center

Objective: The aim of this study was to determine the diameters of the distal femoral epiphyseal secondary ossification center (DFOC) in the various gestational ages (GAs) as well as to create a novel equation, through which GA can be calculated from the measurement of DFOC. Materials and Methods: EDAN Digital ultrasonic diagnostic imaging system (model DUS 3 made by EDAN, Korea) and a 3.5MHz Convex transducer were used for the sonographic measurement. Ultrasonographic examinations were performed on 999 normal singleton pregnancies with GAs ranging from the 28th to the 41st weeks. Patients were recruited from the University of Calabar Teaching Hospital to Assurance Medical Diagnostic Center, where the ultrasonographic examinations were carried out. Images of the long axis of the fetal femur were taken. The DFOC was visualized as a small echogenic, ovoid structure lying adjacent to the distal femur. Three measurements of the DFOC diameter (in mm) were taken from outer to outer margins, and the largest diameter was recorded. Other measurements obtained include femur length, abdominal circumference biparietal diameter, head circumference, fetal weight (FW), and GA. Results: DFOC increased with GA. A strong positive relationship was observed between DFOC and GA with a correlation coefficient of r = 0.85. DFOC also increased with FW with a correlation coefficient of r = 0.83. The equation (GA = 30.84 + [1.25 × DFOC in mm]) relates GA to DFOC. Conclusion: The diameter of the distal femoral epiphyseal secondary ossification center is a useful parameter for estimating GA and assessment of fetal maturity in the third trimester.

Assessment of the skin tissue structure using an ultrasonic diagnostic imaging device in patients undergoing open surgery.

BackgroundPerioperative skin injury is a major issue; therefore, several preventative measures have been developed. However, no previous studies have visualized the effects of stromal edema caused by surgical invasion of skin tissue, and therefore, the details remain unknown. We used an ultrasonic diagnostic imaging device to clarify changes in the skin tissue structure of patients after open surgery.Materials and MethodsTwenty subjects who underwent open hepatectomy were enrolled. We selected the lateral abdomen, upper arms, and lower legs as ultrasonic imaging measurement sites. We performed measurements on the day before surgery and on postoperative days 1, 3, and 5. We calculated the epidermal/dermal tissue thickness, subcutaneous tissue thickness, and skin tissue thickness. We performed a one‐way analysis of variance with repeated measurements for each of the postoperatively measured values on the basis of the preoperative values. Significantly different variables were subjected to the Bonferroni method. We evaluated ultrasonic imaging findings and skin injury.ResultsEpidermal/dermal tissue thickness at all measurement sites exhibited sustained thickening on postoperative day 5 compared to that preoperatively. The lateral abdomen exhibited thickening of the subcutaneous tissue and skin tissue on postoperative day 1. In addition, increased echogenicity, increased opacity of the layer structure, and a cobblestone appearance occurred during the postoperative course. Postoperatively, 80% of subjects exhibited skin injury.ConclusionWe evaluated the effects of surgical invasion on skin tissue over time. Continual observation and protective skincare are necessary near the surgical wound, where significant invasiveness occurs. Prevention of skin injury due to skin tissue thickening requires further study.

Principle of Ultrasonic Diagnostic Imaging

Principle of Ultrasonic Diagnostic Imaging

Correlation between the dimensions of diaphragm movement, respiratory functions and pressures in accordance with the gross motor function classification system levels in children with cerebral palsy.

This study was executed as correlation study to investigate the correlation between the dimensions of diaphragm movement, and respiratory functions and pressures in accordance with the Gross Motor Function Classification System (GMFCS) levels on children with cerebral palsy as the participants. Forty-three children in the age range of 5–13 years diagnosed with cerebral palsy as the research participants were divided into three groups (levels I, II, and III) through systematic stratified random sampling in accordance with their GMFCS levels. Pearson correlation analysis was executed to examine the correlation between dimensions of diaphragm movement, and respiratory functions and pressures in accordance with the GMFCS levels of the participants. There was no significant correlation between the dimensions of diaphragm movement, and respiratory functions and pressures in all of the three groups in accordance with the GMFCS levels of the participants. Therefore, it is deemed that although measurement of the dimensions of diaphragm movement of children with cerebral palsy by using diagnostic ultrasonic M-mode imaging device can be considered as auxiliary tool in predicting the breathing capabilities, it cannot be used as independent measurement equipment.

Two Forces Are Better than One: Combining Chemical and Acoustic Propulsion for Enhanced Micromotor Functionality.

Engines and motors are everywhere in the modern world, but it is a challenge to make them work if they are very small. On the micron length scale, inertial forces are weak and conventional motor designs involving, e.g., pistons, jets, or flywheels cease to function. Biological motors work by a different principle, using catalysis to convert chemical to mechanical energy on the nanometer length scale. To do this, they must apply force continuously against their viscous surroundings, and because of their small size, their movement is "jittery" because of the random shoves and turns they experience from molecules in their surroundings. The first synthetic catalytic motors, discovered about 15 years ago, were bimetallic Pt-Au microrods that swim in fluids through self-electrophoresis, a mechanism that is apparently not used by biological catalytic nanomotors. Despite the difference in propulsion mechanisms, catalytic microswimmers are subject to the same external forces as natural swimmers such as bacteria. Therefore, they follow similar scaling laws, are subject to Brownian forces, and exhibit a rich array of biomimetic emergent behavior (e.g., chemotaxis, rheotaxis, schooling, and predator-prey behavior). It was later discovered, quite by accident, that the same metallic microrods undergo rapid autonomous movement in acoustic fields, converting excitation energy in the frequency (MHz) and power range (up to several W/cm2) that is commonly used for ultrasonic imaging into axial movement. Because the acoustic propulsion mechanism is fuel-free, it can operate in media that have been inaccessible to chemically powered motors, such as the interior of living cells. The power levels used are intermediate between those of ultrasonic diagnostic imaging and therapy, so the translation of basic research on microswimmers into biomedical applications, including in vivo diagnostics and drug delivery, is possible. Acoustic and chemical propulsion are applied independently to microswimmers, so by modulating the acoustic power one can achieve microswimmer functionalities that are not accessible with the individual propulsion mechanisms. These include motion of particles forward and backward with switching between chemical and acoustic propulsion, the assembly/disassembly equilibrium of particle swarms and colloidal molecules, and controllable upstream or downstream propulsion in a flowing fluid. This Account relates our current understanding of the chemical and acoustic propulsion mechanisms, and describes how their combination can be particularly powerful for imparting enhanced functionality to micromotors.

Feasibility of the maxillary sinus ultrasonic study in patients with iatrogenic sinusitis

Objective: to study the effectiveness of ultrasonic diagnostic imaging in the diagnostics of the iatrogenic maxillary sinusitis. Materials and Methods. 68 (100.0%) patients of iatrogenic maxillary sinusitis undergone Sonographic Study in B-mode (ultrasonic diagnostic apparatus FCUSON X 500, ATSmod.539 (SIEMENS, USA)). For this purpose, we used linear sensors with a working surface of 37 mm long with 7.10 MHz frequency regime. The findings were compared with the results of clinical (rhinoscopy, sinus lavage through perforation, diagnostic puncture) and radiological (cone-beam computed tomography) examination. The results were recorded according The accuracy of the two-dimensional sonography in the detection of pathological formations (polyps, cysts, foreign bodies), iatrogenic and inflammatory origin in the sinus was detected as lower than in clinical methods. Sensitivity of the two-dimensional sonography was 8.3%, specificity – 95.4% overall accuracy – 64.7%. Informativity of the cone beam tomography in the detection of exudation, effusion and thickening of the sinus mucosa during sinus iatrogenic sinusitis was detected as lower than in sonography. The sensitivity of the two-dimensional sonography in the detection of exudation in the sinus with iatrogenic maxillary sinus was 96.8%, specificity – 91.7% overall accuracy – 94.1%. The sensitivity of the cone beam tomography to thicken (sclerotic changes) mucosa was 37.5%, specificity – 92.8%, accuracy – 52.9%. Conclusions. Feasibility of the ultrasound sonography in patients with iatrogenic sinusitis is less than in computer tomography. Maxillary sinuses sonography in addition to CT will improve the quality of the examination in patients with iatrogenic maxillary sinusitis.

A Piezoelectric Micromachined Ultrasonic Transducer Using Piston-Like Membrane Motion

Piezoelectric micromachined ultrasonic transducer (pMUT) is a promising candidate for the next-generation 3-D diagnostic ultrasonic imaging. However, the transmitting sensitivity of reported pMUT is not satisfied so far. Enhancement of the transmitting sensitivity hence is always desirable. In this letter, we report a piston-like pMUT. With the help of etching holes in the membrane, the mode shape becomes from Gaussian-like to piston-like, which enables higher transmitted acoustic pressure. In addition, frequency of such pMUT does not decrease after etching holes are fabricated, but slightly increases. Higher frequency for ultrasonic imaging thus is practical, and the frequency can be predicted by well-established methods. Sensitivity of 73 nm/V at 2.31 MHz is achieved for the piston-like pMUT with three rows of etching holes. Benefited from the piston-like membrane motion, the space pressure level is 5.3 dB higher than the classical pMUT.

Nonlinear time reversal signal processing techniques applied to acousto-mechanical imaging of complex materials

Recent ten years have seen considerable development of experimental techniques for improving nonlinear NDT methods and harmonic imaging derived from Nonlinear Elastic Wave Spectroscopy (NEWS). Diagnostic ultrasonic imaging based on higher harmonics yields, among others, a better resolution in view of the decreased wavelength in comparison with the fundamental. Furthermore, using symmetry invariance, nonlinear Time Reversal (TR) and reciprocity properties, the classical NEWS methods are supplemented and improved by new excitations having the intrinsic property of enlarging frequency analysis bandwidth and time domain scales. The purpose of this paper is to present the extension of TR-NEWS for skin aging characterization using the Nonlinear Time Reversal signal processing tool known to localize, in a complex medium, sources of nonlinearity potentially responsible of complex material aging. Linear and nonlinear behavior of skin elasticity is measured locally thanks to an acousto-mechanical loading of the skin conducted with INSTRON loading machines specifically optimized for biomaterials. Hysteresis behavior coming from the complex loading of the skin has been identified with PM-space statistical approach, usually associated to aging process in NDT. Phenomenological hysteretic parameters extracted will be presented and associated to standard parameters used for skin characterization.

Examination of inner unit muscle function with a diagnostic ultrasonic imaging device

Examination of inner unit muscle function with a diagnostic ultrasonic imaging device

Reliability of measuring pelvic floor elevation with a diagnostic ultrasonic imaging device.

[Purpose] The purpose of this study was to investigate the reliability of measuring the amount of pelvic floor elevation during pelvic and abdominal muscle contraction with a diagnostic ultrasonic imaging device. [Subjects] The study group comprised 11 healthy women without urinary incontinence or previous birth experience. [Methods] We measured the displacement elevation of the bladder base during contraction of the abdominal and pelvic floor muscles was measured using a diagnostic ultrasonic imaging device. The exercise was a four-part operation undertaken with the subjects in the lateral position. The reliability analysis included use of the interclass correlation coefficient (ICC) was used to assess the reliability. [Results] ICC (1.1) values for the pelvic floor elevation measurement with a diagnostic ultrasonic imaging device were 0.98 [contraction of the transversus abdominis (TrA) muscle], 0.99 [contraction of pelvic floor muscles (PFMs)], 0.98 (co-contraction of the TrA and PFMs), and 0.98 (resistance of the TrA and PFMs). This study proved the reliability of the method because the coefficient of reliability was 0.97 or more for all of the measurements, even for those during exercise. [Conclusion] The diagnostic ultrasonic imaging device measures pelvic floor elevation with high reliability.

Benefits and challenges of employing elevated acoustic output in diagnostic imaging

The acoustic output levels used in diagnostic ultrasonic imaging in the US have been subject to a de facto limitation by guidelines established by the USFDA in 1976, for which no known bioeffects had been reported. These track-3 guidelines link the Mechanical Index (MI) and the Thermal Index (TI) to the maximum outputs as of May 28, 1976, through a linear derating process. Subsequently, new imaging technologies have been developed that employ unique beam sequences (e.g., harmonic imaging and ARFI imaging) which were not well developed when the current regulatory scheme was put in place, so neither the MI nor the TI takes them into account in an optimal manner. Additionally, there appears to be a large separation between the maxima in the track-3 guidelines and the acoustic output levels for which cavitation-based bioeffects are observed in tissues not known to contain gas bodies. In this presentation, we summarize the history of and the scientific basis for the MI, define an output regime and specify clinical applications under consideration for conditionally increased output (CIO), review the potential risks of CIO in this regime based upon existing scientific evidence, and summarize the evidence for the potential clinical benefits of CIO.

Spatial Compounding of Ultrasonic Diagnostic Images for Rotating Linear Probe with Geometric Parameter Error Compensation

In ultrasonic medical imaging, spatial compounding of images is a technique where ultrasonic beam is steered to examine patient tissues in multiple angles. In the conventional ultrasonic diagnostic imaging, the steering of the ultrasonic beam is achieved electronically using the phased array transducer elements. In this paper, a spatial compounding approach is presented where the ultrasonic probe element is rotated mechanically and the beam steering is achieved mechanically. In the spatial compounding, target position is computed using the value of the rotation axis and the transducer array angular position. However, in the process of the rotation mechanism construction and the control system there arises the inevitable uncertainties in these values. These geometric parameter errors result in the target position error, and the consequence is a blurry compounded image. In order to reduce these target position errors, we present a spatial compounding scheme where error correcting transformation matrices are computed and applied to the raw images before spatial compounding to reduce the blurriness in the compounded image. The proposed scheme is illustrated using phantom and live scan images of human knee, and it is shown that the blurriness is effectively reduced.

Effect of Carbon Dioxide in Carbonated Drinks on Linguapalatal Swallowing Pressure

This study aimed to investigate the influence of carbonated drinks with gas volumes (GV) of 0, 1.5, and 2.7 on linguapalatal swallowing pressure, intraoral carbonation perception, and maximum velocity of a bolus through the pharynx in healthy volunteers (N = 20, all female, age range; 20-21 years). The volunteers swallowed a 12-mL drink in the natural state. Linguapalatal swallowing pressure was measured using a special sensor sheet, and maximum velocity of the bolus through the pharynx was measured using ultrasonic diagnostic imaging equipment. Peak magnitude, integrated value, and duration of linguapalatal swallowing pressure and maximum velocity of a liquid bolus through the pharynx increased with an increase in carbon dioxide content in the carbonated drink. The total integrated values of carbonated drinks with GV of 1.5 and 2.7 were larger than that of the drink without carbon dioxide. These results suggest that the carbon dioxide dissolved in carbonated drinks influences the activity of taste receptors in the mouth and results in neuromotor responses.

견관절 등척성 수축을 동반한 복부 드로우-인 기법이 젊은 성인의 복근 두께에 미치는 효과

This study was conducted in order to examine whether abdominal draw-in maneuver (ADIM) with isometric shoulder flexion, extension, adduction, and abduction selectively contracted deep abdominal muscles. This study's subjects were 13 males 17 females. In order to evaluate the comparison of effects of ADIM and ADIM with isometric shoulder flexion, extension, adduction and abduction, measurements were made on transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) using a real-time ultrasonic diagnostic imaging system. Each position was repetitively measured three times with a real-time ultrasonic diagnostic imaging system and their mean values were used for analysis. The ADIM with isometric shoulder flexion, extension, adduction and abduction significantly increased the thickness of TrA relative to the ADIM only (p<.05). The ADIM with isometric shoulder abduction significantly increased the thickness of IO compared to the ADIM only (p<.05). The ADIM with isometric shoulder extension and abduction significantly decreased the thickness of EO compared to the ADIM only and the ADIM with isometric shoulder extension significantly decreased the thickness of EO relative to the ADIM with isometric shoulder adduction (p<.05). ADIM with isometric shoulder abduction is an effective method to selectively strengthen deep abdominal muscles and therefore may be employed as an intervention for trunk stabilization.

SYSTEM AND METHOD FOR THREE DIMENSIONAL HARMONIC ULTRASOUND IMAGING

An ultrasonic diagnostic imaging system and method are described which produce tissue harmonic images containing both fundamental and harmonic frequency components. Such a blended image takes advantage of the performance possible with the two types of ultrasonic echo information and can advantageously reduce near field clutter while improving signal to noise performance in the far field of the image.

GENERATION OF STANDARD PROTOCOLS FOR REVIEW OF 3D ULTRASOUND IMAGE DATA

An ultrasonic diagnostic imaging system (10) is described which records expert, review of a 3D image data set,, including image plane and view manipulation (36), annotation, and measurements, for the purpose of generating automated review protocols for 3D ultrasound image acquisitions. The ability to provide a standardised 3D review protocol has benefits such as guiding reviewers of all experience levels through the required steps to extract, key images and measurements from 3D image data, enabling automation to improve 3D review workflow and reduce review time, monitoring growth or therapy, and standardizing review presentations for easy comparison with prior examination results.

RETROSPECTIVE DYNAMIC TRANSMIT FOCUSING FOR SPATIAL COMPOUNDING

An ultrasonic diagnostic imaging system transmits a plurality of focused beams normal to the plane of a transducer aperture and receives multiple receive lines in response to each transmitted beam. Sub-apertures of the transducer aperture are defined by apodization and signals of the sub-apertures are aligned and combined to produce signals exhibiting the effect of transmit steering at different angles with respect to the sub-apertures. The steered signals are detected and the detected signals relating to common points in an image field are combined. The combined detected signals are used to produce an ultrasound image with reduced speckle.