Use Of Ultrasound Imaging Research Articles

Traumatic Intracranial Arteriovenous Malformation

Introduction This report is the first of a traumatic intracranial arteriovenous malformation (AVM) identified with the use of ultrasound imaging. This case study involves a 49-year-old man with a traumatic intracranial arteriovenous malformation that was identified using transcranial imaging and spectral analysis studies. Methods Transcranial ultrasonic imaging with spectral analysis was performed, using a 2.5MHz hand-held probe identified the traumatic AVM. Correlated follow-up testing was conducted using magnetic resonance angiography and computed tomography scan. Results were correlated with ultrasound findings. Results Bilateral middle cerebral and anterior cerebral arteries were identified revealing normal waveforms and velocities. Left posterior cerebral artery could not be insonated or visualized whereas the right posterior cerebral artery revealed normal waveforms and velocities. A single area of “jet” flow was in the distal internal carotid artery (in the area of carotid cavernous sinus). A peak systolic velocity of 318 cm/sec and an end diastolic velocity of 152 cm/sec were identified in the “jet,” which is consistent with the clinical suspicion of an AVM. The magnetic resonance angiography demonstrated normal right internal carotid, middle cerebral, and anterior cerebral arteries. On the left, there was diffusion of signal in the region of the cavernous sinus. This flow signal extended anteriorly and laterally into the region of the lateral orbit. Also, a second channel of flow appeared extending up into the middle cerebral artery territory, suggesting some retrograde venous flow. Findings reported were consistent with AVM of the carotid artery at the cavernous sinus. Conclusion This report represents with the first reported incidence of diagnosis of traumatic AVM of intracranial vessels. Duplex scanning should be considered if concern exists for such an entity as it appears capable of actually identifying this pathology.

Is there clinical efficacy of the use of ultrasound imaging of epidural anaesthesia for labour pain ?

Is there clinical efficacy of the use of ultrasound imaging of epidural anaesthesia for labour pain ?

The Use of Ultrasound Imaging of the Abdominal Drawing-in Maneuver in Subjects With Low Back Pain

Randomized controlled trial among patients with low back pain (LBP). (1) Determine the reliability of real-time ultrasound imaging for assessing activation of the lateral abdominal muscles; (2) characterize the extent to which the abdominal drawing-in maneuver (ADIM) results in preferential activation of the transverse abdominis (TrA); and (3) determine if ultrasound biofeedback improves short-term performance of the ADIM in patients with LBP. Ultrasound imaging is reportedly useful for measuring and training patients to preferentially activate the TrA muscle. However, research to support these claims is limited. Thirty patients with LBP referred for lumbar stabilization training were randomized to receive either traditional training (n = 15) or traditional training with biofeedback (n = 15). Ultrasound imaging was used to measure changes in thickness of the lateral abdominal muscles. Differences in preferential changes in muscle thickness of the TrA between groups and across time were assessed using analysis of variance. Intrarater reliability measuring lateral abdominal muscle thickness exceeded 0.93. On average, patients in both groups demonstrated a 2-fold increase in the thickness of the TrA during the ADIM. Performance of the ADIM did not differ between the groups. These data provide construct validity for the notion that the ADIM results in preferential activation of the TrA in patients with LBP. Although, the addition of biofeedback did not enhance the ability to perform the ADIM at a short-term follow-up, our data suggest a possible ceiling effect or an insufficient training stimulus. Further research is necessary to determine if there is a subgroup of patients with LBP who may benefit from biofeedback.

The Use of Ultrasound Imaging of the Abdominal Drawing-in Maneuver in Subjects With Low Back Pain

The Use of Ultrasound Imaging of the Abdominal Drawing-in Maneuver in Subjects With Low Back Pain

Adult Echocardiography and Doppler

One of the first reports of cardiac ultrasound imaging occurred in 1954 by Elder and Hertz. They described the use of ultrasound imaging for displaying continuous recording of movement of heart walls. This was displayed by the use of A-mode and B-mode methods. In the late 1950s, continuous-wave Doppler was used in cardiac imaging. By the late 1960s, two-dimensional real-time B-mode imaging was performed using mechanical head transducers. In the mid-1970s, phased array transducers were being utilized. Also in the late 1970s, transesophageal echo was being tested. The 1980s have seen advances in computer technology that have made color flow Doppler imaging possible, along with better image quality through scan conversion and image processing. In the 1990s developing techniques included stress echocardiography, intravascular ultrasound, contrast echocardiography, digital acquisition, second harmonic imaging, ultrasonic tissue characterization, and three-dimensional echocardiography. More recently, echocardiography has seen advances in real-time 3D imaging, handheld echocardiography, and myocardial perfusion. Advances in technology, along with improved understanding of the equipment, have made the availability and demand of echocardiography invaluable.

Use of Ultrasound Imaging and Steroid Concentrations to Identify Maturational Status in Adult Steelhead

AbstractWe sought to develop a rapid, noninvasive, and accurate method for distinguishing prespawn (mature or maturing) adult steelhead (anadromous rainbow trout Oncorhynchus mykiss) from postspawn adults (kelts). Ultrasound images of gonads were collected, and levels of plasma testosterone (T), 11‐ketotestosterone (11‐KT), and 17α‐hydroxy‐20β‐dihydroxyprogesterone (DHP) were determined for adult steelhead before and after spawning. Results demonstrated that ultrasound images provided quantifiable selection criteria (number of eggs or gonad size) for the identification of prespawn versus postspawn adults. Mature females were easily identifiable by the presence of numerous, well‐developed eggs. Conversely, only a few mature eggs remained in the body cavities of female kelts. Ultrasound investigation of the maximum testis area demonstrated that testes undergo substantial size changes following spawning. Mean maximum testis area was 2.86 cm2 in prespawn males and 0.62 cm2 male kelts. Distributions of testis measurements between the two maturational types did not overlap, and results of a discriminant function analysis suggested that a classification criterion (threshold) of 1.25 cm2 could accurately distinguish prespawn males from kelts. Median concentrations of T, 11‐KT, and DHP were significantly higher in prespawn males (49.6, 78.4, and 13.0 ng/mL, respectively) than in kelts (<1.2, 6.6, and 1.6 ng/mL), providing an independent verification of the ultrasound technique. Despite the high degree of corroboration between ultrasound measurements of gonad size and plasma steroid levels, application of ultrasound imaging may result in some classification error (a few percentage points) if substantial gonad mass is retained in the body cavity after spawning. Use of ultrasound to accurately identify postspawn steelhead is an important first step towards development of effective kelt management practices in the Columbia River basin.

Use of Ultrasound Imaging to Determine Sex of Shovelnose Sturgeon

Abstract During November 2002, 51 shovelnose sturgeon Scaphirhynchus platorynchus were sexed by ultrasound imaging using a portable ultrasonograph. We identified males with 96% accuracy (N = 25) and females with 80% accuracy (N = 25); one hermaphroditic individual was misidentified as a male. Overall, ultrasound imaging was 86% accurate. Sex in postspawned females was difficult to determine, 60% being misidentified as males (N = 5). Ultrasonography is an effective noninvasive method for sex determination that can be applied to other species of Acipenseriformes. Modern portable equipment expands its utility to field studies.

Abdominal Ultrasound Imaging of Pelvic Floor Muscle Function in Individuals with Low Back Pain

Research reveals that the primary impairment of the muscular system in individuals with low back pain is not one of strength or functional capacity but rather one of motor control of the deep muscles of the trunk. These deep muscles include the transversus abdominis, the deep segmental fibers of lumbar multifidus, the pelvic floor, and the diaphragm. Advances in knowledge regarding load transfer in the lumbopelvic region have provided the orthopaedic manual therapist with the necessary tools to assess most components of lumbopelvic dysfunction with the exclusion of an evaluation technique for pelvic floor motor control. The use of ultrasound imaging to observe the real-time contraction of muscles is a valuable tool, specifically when the muscles of interest are deep and not readily observable. The author proposes a novel abdominal ultrasound imaging method to assess voluntary pelvic floor motor control and discusses the rationale for its application in a population with lumbopelvic dysfunction.

Handheld, portable ultrasound in the neonatal intensive care nursery: a new, inexpensive tool for the rapid diagnosis of common neonatal problems.

The use of ultrasound imaging in the neonatal intensive care unit (NICU) has become an essential part of the evaluation and delivery of care for most neonates. Until recently, ultrasound machines were large, expensive, and often not immediately available, particularly at night and during weekends. Additionally, serial studies to define the evolution of an acute clinical situation were often not practical because of the dedicated time required and the expense involved. The recent introduction into our NICU of a high-quality, reasonably priced, and completely portable neonatal ultrasound unit (Sonosite, Bothell, WA) has now made it possible for neonatologists to rapidly obtain the hour-by-hour information that can be extremely helpful in the evaluation of a critically ill neonate. This paper illustrates some of the capabilities of this simplified device, and the value of having continuous on-site ultrasound availability in the NICU.

Surgeon-performed ultrasound imaging in acute surgical disorders

As the role of the general surgeon continues to evolve, the surgeon's use of ultrasound imaging will surely influence practice patterns, particularly for the evaluation of patients in the acute setting. With the use of real-time imaging, the surgeon receives "instantaneous" information to augment the physical examination, to narrow the differential diagnosis, or to initiate an intervention. With select ultrasound examinations, the surgeon can rapidly evaluate adult and pediatric patients with an acute abdomen, especially those patients who are hypotensive. In the hands of the surgeon, this noninvasive, bedside tool can assess more accurately the presence, depth, and extent of an abscess, confirm complete aspiration, or diagnose wound dehiscence before it is apparent on physical examination. Ultrasound imaging is so accurate for the diagnosis of pyloric stenosis that it has essentially replaced the upper gastrointestinal series in most institutions. The surgeon's use of ultrasound imaging to detect a pleural effusion has virtually supplanted the lateral decubitus radiograph. Furthermore, an ultrasound-guided thoracentesis not only facilitates the procedure but improves its safety. As surgeons become more facile with ultrasound imaging, it is anticipated that other uses will develop to further enhance its value for the assessment of patients in the acute setting.

Advances in vascular access device placement: Use of ultrasound imaging and the modified seldinger technique

Advances in vascular access device placement: Use of ultrasound imaging and the modified seldinger technique

Intervertebral disc structure: observation by a novel use of ultrasound imaging

The internal structure of intervertebral discs is clinically important in the management of back pain. No current routine imaging modality is able to image disc structure satisfactorily. The aim of this work was to investigate and validate ultrasound imaging so that it might be applied to assessment of structural integrity and degree of degeneration. The optimum imaging technique was determined using a 3.5 MHz probe in one female subject. The applicability of this technique to investigate disc structure in the entire thoracolumbar spine was further investigated in 13 subjects. The optimum disc imaging technique was found to be a posterolateral approach, 1 to 2 cm lateral of the dorsal midline, that revealed structure within the disc not apparent using other approaches. It was demonstrated that posterolateral imaging introduces a smaller reproducibility error in measurements of linear dimensions close to the disc. It is possible to observe internal structure within the disc between T11 and L3 in at least 54% of individuals.

Ultrasound imaging of the leg in patients with chronic wounds

Background/aims:A non‐invasive method of studying the extent of tissue changes may be of use in evaluating healing therapies for chronic wounds. The aim of this study was to investigate the use of ultrasound imaging to study the appearance of tissue in the vicinity of lesions in the lower limb.Method:An ATL Apogee 800 Plus ultrasound system using a broadband 11 MHz linear array scanhead was used. The system was adjusted to allow discrimination in the appearance of dermal, adipose and muscle tissue on two healthy volunteers. For four patients with leg ulcers, scans were taken of the wound and areas around the wound, using an aseptic technique.Results:Differences on ultrasound images could be seen between wound and areas around the wound. In a patient with a unilateral wound, differences were seen on ultrasound imaging of the wound with respect to the contralateral unaffected limb.Conclusion:This preliminary study suggests that broadband ultrasound imaging may be of use in detecting tissue differences in lower limbs and thus may be of value in the study of wound healing.

Empyema thoracis: a role for open thoracotomy and decortication

BACKGROUNDThoracentesis and antibiotics remain the cornerstones of treatment in stage I empyema. The management of disease progression or late presentation is controversial. Open thoracotomy and decortication is perceived to be...

Use of real-time ultrasound imaging for feedback in rehabilitation

Summary Real-time ultrasound imaging is currently used extensively in medicine. It provides a safe, cost-effective and readily accessible method of examination of various organs and tissues. One area where ultrasonography has proved to be useful is investigation of musculoskeletal pathology. Tissues that can be imaged include muscles, tendons, joints, ligaments and bursae. One of the most useful features of real-time ultrasound imaging is that movement of anatomical structures can be observed as it actually occurs. This has allowed development of a new application of real-time ultrasound imaging for rehabilitation that involves observation of muscle contraction to provide feedback. An ability to image deep muscles is an advantage of the technique, and use of ultrasound imaging has been successfully incorporated in assessment and facilitation strategies for the transversus abdominis and multifidus muscles in low back pain (LBP) patients. The objective of this article is to provide a brief review of the principles, advantages and disadvantages of ultrasound imaging and to discuss this new application of real-time ultrasound to rehabilitation. The current use of real-time ultrasound imaging in LBP patients will be described, and future uses in rehabilitation and limitations discussed.

In Vivo Results with a New Device for Ultrasonic Monitoring of Pig Skin Cryosurgery: The Echographic Cryoprobe

One of the main difficulties encountered in cryosurgery is the uncertainty in the extent and depth of the tissue effectively treated during the freezing process. The objective of this study was to evaluate in vivo ultrasonic control of skin cryosurgery using a new echographic cryoprobe. An echographic cryoprobe, developed specifically for dermatology applications, combines a high-frequency (20 MHz) miniature ultrasonic transducer and a N2O-driven closed cryoprobe. Knowledge of the ultrasound velocity of frozen skin is a prerequisite for monitoring the iceball formation kinetics. Therefore, in a first study, we estimated the ultrasound velocity of frozen skin specimens. In a second step, the operation of the echographic cryoprobe was assessed, under in vivo conditions similar to those used in human therapeutics, on normal skin of three female "Large-White" pigs under anesthesia. The mean value of ultrasound velocity of frozen skin obtained by pooling the data from all the skin specimens included in this study was 2865 +/- 170 m per s. The average rates of growth (10(-2) mm per s) of the iceballs were found to be 12.2 +/- 1.0 (pig 1), 9.0 +/- 1.0 (pig 2), and 8.4 +/- 0.9 (pig 3). The echographic cryoprobe had a built-in high-frequency ultrasonic transducer that served two functions. It enabled in vivo real-time monitoring of depth penetration of the iceball and it gave important feedback to the operator or to the console relating to the rate of growth of the iceball. Automatic (i.e., operator-independent) detection of the echo signal from the freezing front and calculation of the depth penetration of the iceball was possible.

Diagnostic imaging in pediatric trauma.

In the head and neck, the futility of skull radiography is again reemphasized as a poorer predictor of intracranial injury than is a neurologic examination, though controversy continues as to which neurologic criteria should be the ones leading to a cranial computed tomography scan. Understanding the anatomic variations in the radiography of the cervical spine in small infants and children can help avoid overdiagnosis in this group and can obviate the need for additional unwarranted computed tomography studies and undue clinical concern. Magnetic resonance imaging can show anatomically exquisite portrayals of growing skull fractures for neurosurgical planning, but its routine use for imaging the cervical cord in shaken, abused infants without clinical abnormality appears unwarranted. Within the chest, the radiograph remains a highly accurate and low cost cornerstone in traumatized patients. The use of ultrasound imaging to detect pleural fluid is being investigated and has been found to be accurate but cannot compare to all of the information gleaned from the radiograph. The pericardium is clearly an exception. Abdominal trauma in children is triaged vastly differently from that of adults. Imaging of adults looks for signs to diagnose significant bleeding and need for operation, while pediatric trauma imaging has its greatest effect in reducing the intensity of care. Administration of oral contrast has not been very effective in aiding diagnosis of hollow visceral perforations and is being used less in blunt abdominal trauma computed tomography. Children with microscopic hematuria and no evidence of multiple system trauma seem to be helped little by imaging. The utility of finding and extracting subcutaneous foreign material, usually in extremities, by ultrasound imaging remains controversial. Experience, equipment, and effort all seem to play a role.

High frequency ultrasound imaging using an active optical detector

Optical detection of ultrasound has numerous advantages over traditional piezoelectric methods. These systems offer noncontact inspection, rapid scanning capabilities, fine spatial sampling, and large bandwidths. In addition, difficulties associated with conventional ultrasound imaging systems such as cross-talk between elements, electrical connections, and electromechanical resonances are greatly reduced or even eliminated. Because of this, high frequency phased arrays for ultrasound detection can be emulated by accurately positioning and focusing optical beams on a suitable surface, which defines array elements. However, optical systems have lower sensitivity than their piezoelectric counterparts, limiting their widespread use in ultrasound imaging. Active optical detection offers a solution. An active ultrasound detector consisting of a neodymium-doped glass waveguide laser with an optical demodulation system, was built demonstrating enhanced sensitivity while preserving the benefits of traditional passive optical detection.

Musculoskeletal ultrasound imaging: diagnostic and treatment aid in rehabilitation

Ultrasound imaging of the musculoskeletal system has been used for almost 30 years. This paper reviews the history and various applications of musculoskeletal ultrasound imaging, concentrating on those aspects pertinent to rehabilitation. The type of imaging described is real-time B-mode ultrasound. The importance of technical considerations in the use of ultrasound imaging is highlighted, and some practical guidance on the scanning procedure is given. The main areas of application are diagnosis of tissue damage to structures such as tendons, muscle, ligaments, bursae, etc; measurement of muscle size for assessing atrophy; and a potential use is characterization of muscle shape for assessing tone. Ultrasound can be used to monitor treatment effectiveness as well as provide visual feedback during treatment to aid muscle contraction and relaxation. The clinical areas where ultrasound has been used include sports medicine and orthopaedics, rheumatology, neurology, paediatrics and respiratory physiotherapy. The potential uses of ultrasound imaging are underexplored and further normal data are required. The main area of interest to physiotherapists identified to date is examination of muscle dimensions (size and shape) for assessing the effects of pathology on muscle dysfunction and for monitoring the effects of treatments.

Ultrasound anatomy of the normal male reproductive tract.

Ultrasound is being used with increasing frequency in the evaluation of the male reproductive tract. To detect abnormalities, it is important to have a comprehensive understanding of the normal anatomy and normal variations. In this article, the ultrasound anatomy of the scrotum, penis, prostate, and seminal vesicles is presented. Because ultrasound is a very visual process, the anatomy is presented not only with text, but also through the liberal use of ultrasound images and associated diagrams. Ultrasound is both an operator- and equipment-dependent procedure and, where appropriate, we have included technical discussions regarding ultrasound equipment and settings.