Usefulness Of Transabdominal Ultrasonography Research Articles

Characteristics and usefulness of transabdominal ultrasonography in immune-mediated colitis.

The usefulness of ultrasonography (US) in diseases of the gastrointestinal tract has been reported recently. This prospective study aimed to determine the features of US findings in immune-mediated colitis (IMC), an adverse event induced by immune checkpoint inhibitor, and examine the correlation between US findings, colonoscopy (CS) findings, and severity of colitis. We studied patients examined using CS and US upon suspicion of IMC in Hokkaido University Hospital between April 2018 and February 2021. Endoscopic findings of IMC were assessed using the Ulcerative Colitis Endoscopic Index of Severity (UCEIS). The severity of US findings in IMC was evaluated using US grade, which is the ultrasonographic grading scale in ulcerative colitis. Bowel wall thickness and the intensity of the color Doppler signal were also analyzed. Severity of colitis was evaluated using Common Terminology Criteria for Adverse Events (CTCAE) grade version 5. Fourteen patients with IMC were enrolled. The US findings were bowel wall thickening, loss of stratification, ulceration and increased blood flow signal. The US grade was moderately correlated with the UCEIS (r=0.687, p=0.009) and CTCAE grade (r=0.628, p=0.035). Bowel wall thickness and UCEIS (r=0.628, p=0.020), as well as color Doppler signal grade and CTCAE grade (r=0.724, p=0.008), were significantly correlated. US findings in IMC were mainly similar to those of ulcerative colitis, but there were some findings that were characteristic only of IMC. Significant correlation was found between US findings, CS findings, and severity of colitis. Hence, US could be useful for the evaluation of IMC.

Transabdominal Ultrasonographic Evaluation of Enlarged Prostate with Histopathological Comparison

Introduction: The prostate is an accessory gland of the male reproductive system. It can be involved by a number of diseases ranging from inflammation to malignant diseases. Most common causes of prostatomegaly are benign prostatic hyperplasia, prostatitis, intraprostatic and periprostatic cyst, prostatic adenocarcinoma. Objectives: To evaluate the diagnostic usefulness of Transabdominal ultrasonography in enlarged prostate and compare the USG findings with the histopathological findings. Method: This cross sectional study was carried out in Radiology and Imaging Department of Sir Salimullah medical college and Mitford hospital, Dhaka, from January 2014 to December 2015 with clinically suspected enlarged prostate by department of Urology and referred to the Radiology and Imaging Department for proper evaluation whether benign or malignant by Trans-abdominal ultrasonography before treatment planning and further management. Results: In this study, mean age was 65. 8 years with standard deviation of mean ± 9. 7 years and the age ranged from 50 to 89 years. The most common symptoms associated with enlarged prostate were incomplete emptying 90%, frequency 84%, intermittency 80% urgency, 76%, weak stream, 70% straining 66%, nocturia 60%. Out of 50 patients, histopathological diagnosis of 44 (88%) was nodular hyperplasia, 2 (4%) was nodular hyperplasia with chronic prostatitis and rest of 4(8%) was adenocarcinoma of prostate. Conclusion: Ultrasonography is a non-invasive, available, radiation free procedure, which is used as a first line preliminary diagnostic procedure.

The Colon Wall Thickness Measured Using Transabdominal Ultrasonography Is Useful for Detecting Mucosal Inflammation in Ulcerative Colitis.

Objective Transabdominal ultrasonography (TUS) is a non-invasive procedure that is reportedly useful for managing ulcerative colitis (UC) and assessing bowel wall thickness (BWT), the most common measure of mucosal inflammation. However, the exact range of BWT that reflects disease activity remains undetermined. The present study clarified the BWT due to disease activity by comparing the use of TUS in each segment of the colon versus using colonoscopy (CS) and determined the usefulness of TUS in patients with UC. Methods We divided the colon into five segments and measured the BWT using TUS. The results were then compared to the Mayo endoscopic subscore (MES) classification to determine the accuracy of BWT measurement. Patients Eighty patients with UC who underwent TUS within 14 days of CS were retrospectively registered. Results We evaluated a total of 268 images depicting each segment among 80 patients with UC. The BWT was positively correlated with endoscopic activity (0.69, p＜0.0001). In each segment, the relationship between a BWT＞2 mm and an MES＞0 had the highest sensitivity, specificity, and accuracy (0.85-1.00, 0.67-0.92, and 0.81-0.97, respectively). Conclusion This study concluded that TUS was a useful method of detecting an MES＞0, which indicates the presence of inflammation and its location among UC patients. MES＞0 was found to be highly accurate when a BWT＞2 mm was considered positive. This non-invasive method may help control disease activity in patients with UC.

Usefulness of Ultrasonography in the Diagnosis of Peptic Ulcer Disease in Children.

PurposeThis study was performed to assess the clinical usefulness of transabdominal ultrasonography (TUS) in detecting peptic ulcer disease (PUD) in children.MethodsTwenty-four patients (19 boys, 5 girls; mean age, 10.6±4.5 years [range, 3.0–17.9 years]) who were admitted to the hospital for acute abdomen or gastrointestinal bleeding and diagnosed with PUD by endoscopy and who underwent TUS were included. Clinical data were retrospectively collected by reviewing patient medical records. Gastric ulcer (GU) was suspected when the gastric wall exceeded 8 mm in thickness and had lost its five-layer structure on TUS. Duodenal ulcer (DU) was suspected if the duodenal wall thickness exceeded 5 mm.ResultsSensitivity of TUS in diagnosing PUD was 66.7% for GU and 38.9% for DU. Mean age and body weight of the 11 patients suspected with PUD on TUS were 10.9±4.4 years and 38.1±17.2 kg, respectively. For 13 patients without suspected PUD, they were 12.1±4.1 years and 39.6±17.0 kg, respectively. There was a significant difference in height, weight, and body mass index between patients who were suspected to have PUD and those who were not suspected on TUS (p=0.014, 0.008, and 0.005, respectively). A significant difference in the sensitivity of TUS in diagnosing PUD was found between patients under 30 kg and those over 30 kg (88.9% and 20.0%, respectively; p=0.003).ConclusionTUS investigation of the stomach and duodenum is an efficient method for PUD detection in children with low body weight. TUS can be used in preliminary diagnostic work-up before further invasive tests.

P195 Usefulness of transabdominal ultrasonography in assessing ulcerative colitis

P195 Usefulness of transabdominal ultrasonography in assessing ulcerative colitis

Transabdominal Ultrasonography for Assessing the Depth of Tumor Invasion in Gastric Cancer

Although endoscopy and endoscopic ultrasonography are generally used to diagnose the depth of gastric tumor invasion, endoscopy is invasive and frequently results in patient discomfort. Transabdominal ultrasonography (TUS) is noninvasive and may be useful in determining this depth. We investigated the usefulness of TUS in determining the depth of tumor invasion in patients with gastric cancer. This retrospective study included 190 patients with gastric cancer and 200 lesions who underwent curative resection at the Department of Gastrointestinal Surgery of Tottori University Hospital from July 2007 to July 2015. The results of conventional diagnostic imaging and TUS were compared with those of pathological analysis obtained after surgery. Furthermore, the ruptured form of the third layer on TUS imaging was reviewed and investigated to differentiate between the SM2 and MP lesions. The accuracy of TUS was similar to that of conventional diagnostic imaging for all depths of tumor invasion. Eight lesions could not be assessed by TUS, including four that could not be identified and four in which TUS was unable to diagnose the depth. In cases where the ruptured form of the third layer could be determined in MP lesions, the forms were observed toward the inside of the gastric lumen. The results of this study suggested that the accuracy of TUS was equivalent to that of conventional diagnostic imaging in determining the depth of tumor invasion. TUS assessment criteria may be useful to classify this depth. Furthermore, the ruptured form of the third layer is believed to be important in distinguishing between early and advanced gastric cancer.

Role of ultrasonography in diagnosis of solid space occupying lesion in the liver correlation with FNAC.

This cross sectional study was carried enrolling 47 subjects with suspected solid liver mass, in the Department of Radiology and Imaging, Dhaka Medical College Hospital, Dhaka, over a period of twelve months. The aim of this study was to evaluate the diagnostic usefulness of transabdominal ultrasonography in the diagnosis of solid SOL in the liver. Majority of the respondents (42.55%) were found between 41-60 years of age. Five (10.63%) subjects were found below 20 years of age. There were 31 men (65.95%) and 16 women (34.05%). Majority of the metastasis were multiple (85%), hypoechoic (35%) and only 15% had internal calcifications. HCC was single lesion (61.53%) with hyperechoic (38.35%) echogenicity, with a central halo (76.92%) and 15.38% had internal calcifications. Majority of the cholangiocarcinoma were solitary (80%), hypoechoic (60%) and 60% had internal calcifications. Hepatoblastoma were solitary and had calcifications (60%) with mixed echogenicity (60%). Majority of the adenomas were solitary (80%), hypoechoic (60%) and only 20 % had internal calcifications. The validity of transabdominal sonography for the diagnosis of metastasis was confirmed by calculating sensitivity (100%), specificity (96.42%), accuracy (97.87%), positive (95%) and negative predictive (100%) values by using the standard formula given. The sensitivity, specificity, accuracy, positive and negative predictive values for HCC were 92.3%, 97.05%, 95.74%, 92.3% and 97.05% respectively. The sensitivity, specificity, accuracy, positive and negative predictive values for cholangiocarcinoma and hepatoblastoma were 80%, 97.61%, 95.74%, 80% and 97.61% respectively. Sensitivity, specificity, accuracy, positive and negative predictive values were 80%, 100%, 97.87%, 100% and 97.67% respectively for adenoma. From the study result it was concluded that transabdominal ultrasonography could be reliable, non- ionizing and relatively cheap procedure for diagnosis solid hepatic mass lesion.

Clinical usefulness of transabdominal ultrasonography prior to patency capsule for suspected small-bowel strictures

Objective: Patency capsule (PC) examination has made it possible to perform capsule endoscopy (CE) in patients with a suspected small-bowel stricture. However, PC has some drawbacks, so we assessed the usefulness of transabdominal ultrasonography (TUS) prior to PC in patients with suspected small-bowel strictures to avoid unnecessary PC examination. Patients and methods: Fifty-two patients who underwent TUS prior to PC were enrolled in this study. TUS findings were classified as follows: intestinal narrowing and distension at the oral side (Type A); extensive bowel wall thickening (Type B); focal bowel wall thickening (Type C) or no abnormality detected (Type D). We evaluated the TUS and PC findings for the detection of small-bowel strictures. Results: Double-balloon endoscopy (DBE) revealed small-bowel strictures in 13 of 50 patients (26%). TUS yielded Type B or C findings in 12 of 13 patients (92%), while PC revealed strictures in all 13 patients. In Crohn’s disease (CD) patients with Type B TUS findings, 8 of 9 (89%) had small-bowel strictures on DBE. However, only two of six non-CD patients (33%) with Type B TUS findings had small-bowel strictures. The incidence of Type B strictures was significantly higher in CD patients. Conclusions: CD patients with Type B TUS findings should not undergo PC or CE because of the high rate of small-bowel strictures. Non-CD patients diagnosed with Type B TUS strictures, as well as patients diagnosed with Type C or D strictures should undergo CE after confirming small-bowel patency using PC.

Usefulness of transabdominal ultrasonography in excluding adnexal disease.

To investigate the final diagnoses and examine the rate of detection of normal ovaries in patients with negative results for adnexa on transabdominal ultrasonography (TAUS) using current machines. Of 188 eligible patients who underwent TAUS to assess lower abdominal pain, 158 were subsequently evaluated using other imaging modalities, surgical procedures, follow-up, or questionnaire data. Of these patients, 135 patients with negative results for adnexa on TAUS were included in the investigation of the final diagnoses. The rate of detection of normal ovaries on TAUS was calculated on a per-ovary basis in these patients. One hundred thirty-three (98.5%) and two (1.5%) patients were finally diagnosed with non-adnexal diseases and adnexitis, respectively. The rate of detection of 270 ovaries in 135 patients was 38.9%, while that of 148 ovaries in 74 patients between 16 and 45 years of age was 66.2% and that of 122 ovaries in 61 patients over 45 years of age was 5.7% (P < 0.001). TAUS appears to be the first step for ruling out adnexal disease in patients with lower abdominal pain. The rate of detection of normal ovaries is good in younger patients.

Usefulness of Transabdominal Ultrasonography for Evaluating Lesion Area and Severity of Ulcerative Colitis

Usefulness of Transabdominal Ultrasonography for Evaluating Lesion Area and Severity of Ulcerative Colitis

Clinical usefulness of classification by transabdominal ultrasonography for detection of small-bowel stricture

Objective. To assess the clinical usefulness of transabdominal ultrasonography (TUS) for detection of small-bowel stricture. Patients and methods.Subjects were 796 patients undergoing double-balloon endoscopy (DBE), December 2003–October 2011. All underwent TUS prior to DBE. The TUS findings were classified by type as intestinal narrowing and distension at the oral side (Type A); extensive bowel wall thickening (Type B); focal bowel wall thickening (Type C) or no abnormality detected (Type D). We compared TUS findings against DBE findings with respect to small-bowel stricture, defined as failure of the enteroscope to pass through the small bowel. Results. Small-bowel stricture was detected by DBE in 11.3% (90/796) of patients. Strictures resulted from Crohn's disease (n = 36), intestinal tuberculosis (n = 24), malignant lymphoma (n = 9), ischemic enteritis (n = 6), NSAID ulcer (n = 5), radiation enteritis (n = 2), surgical anastomosis (n = 2) and other abnormalities (n = 6). Stricture was detected by TUS in 93.3% (84/90) of patients, and each such stricture fell into one of the three types of TUS abnormality. The remaining 6 strictures were detected only by DBE. DBE-identified strictures corresponded to TUS findings as follows: 100% (43/43) to Type A, 59.1% (29/49) to Type B, 14.8% (12/81) to Type C and 1% (6/623) to Type D. Correspondence between stricture and the Type A classification (vs. Types B, C and D) was significantly high, as was correspondence between stricture and Type B (vs. Types C and D). Conclusions.TUS was shown to be useful for detecting small-bowel stricture. We recommend performing TUS first when a small-bowel stricture is suspected.

Ultrasonographic study on intraductal papillary mucinous tumors of the pancreas

Objective To analyze the clinical and ultrasonographic features of intraductal papillary mucinous neoplasm (IPMN) of the pancreas and to assess the usefulness of transabdominal ultrasonography. Methods Twelve patients with IPMN underwent surgery, including 4 (33.3%)with adenoma and 8(66.7%) with adenocarcinoma. IPMN was classified into 3 categaries by the site of main duct,branch duct and combined type based on the ultrasonographic findings preoperatively. All the clinical presentations and the ultrasonographic imaging findings were analyzed and compared with the histologic diagnosis. Results Of malignant IPMNs,diabetes was presented in 5 cases,elevated CA19-9 was presented in 4 cases and steatorrhea was presented in 2 cases. But these was not presented in benigns. Transabdominal ultrasonography revealed all the cystic or cystic-solid lesions in this study. The mean diameter of the lesions with adenoma was (1.4 ± 0.8)cm (range,0.5 - 2.0 cm) and that with adenocarcinoma was (6.3 ± 6.0)cm (range, 2.0 - 20 cm). The mean diameters of the main duct for the cases with adenomas and adenocarcinomas were (1.0 ± 0.8) cm and ( 1.6 ± 1.0) cm, respectively. Among the adenomas, 3 cases were calssified as branch type and 2 were demonstrated with mural nodules and no colour signals was detected within them. Five of the malignancies were considered as main duct type and 3 were combined type. Seven cases were detected mural nodules and showed abundant colour flow signals within them. Conclusions Transabdominal ultrasonography revealed the pancreatic cystic lesions and dilated ducts of IPMN. Some characteristics should be considered for malignancy: clinical symptoms, tumor size and mural nodules with colour flow signals,which may be helpful for the diagnosis and management of IPMN. Key words: Ultrasonography; Pancreatic neoplasms; Adenocarcinoma,mucinous

Extracorporeal Ultrasound is an Effective Diagnostic Alternative to Endoscopic Ultrasound for Gastric Submucosal Tumours

Background: Although endoscopic ultrasonography (EUS) is the best modality in the diagnosis of gastric submucosal tumours (G-SMT), it is still invasive and expensive. We evaluated the usefulness of transabdominal ultrasonography (US) as an alternative to EUS in the assessment and clinical management of G-SMT. Methods: This is a prospective study of 156 successive patients who had been diagnosed with G-SMT by direct endoscopic visualization. For each patient, US was performed prior to EUS by an examiner who had not been informed about the site or the size of the patient's G-SMT beforehand. US diagnoses were compared with those ascertained by EUS. Diagnostic grade by US was divided into three groups: diagnosed (G-SMT was clearly demonstrated including location, site and type), detected (G-SMT was demonstrable but the type was not clear) and undetected (G-SMT was not demonstrated by US). Results: We found that US can be an alternative to EUS for: 1) diagnosis of extramural compression, 2) diagnosis of G-SMT with size > 30 mm in diameter, 3) detection and measurement of the size of a G-SMT from 21 to 30 mm in diameter, and 4) detection and measurement of the size of a G-SMT at both the gastric angle and cardia, regardless of the size of the tumour. Overall sensitivity and specificity for the detection of G-SMT were 82.5% and 100%, respectively. The diagnostic rates of G-SMT in each group were 60.1% (86/143) for diagnosed, 22.4% (32/143) for detected and 17.5% (25/143) for undetected. Approximate 95% (21/22) of G-SMT over 20 mm in diameter were at least detected, and 97% (30/31) of G-SMT over 30 mm in diameter were diagnosed by US. Conclusion: US can be an alternative method in the assessment of G-SMT, especially in the follow-up of patients already diagnosed.

Renal masses detected by general health checkup

A total of 60,604 persons underwent a general health checkup at Toma Hospital, Saitama, Japan, between January 1993 and June 1997, and transabdominal ultrasonography (US) was performed on all persons. We investigated the usefulness of transabdominal US in detecting renal tumors during general health checkups. A definite diagnosis was made in cases where the re-examination by US revealed calculus with acoustic shadow or a simple cyst. Computed tomography (CT) was conducted in patients suspected of having a renal tumor, and a diagnosis of renal angiomyolipoma (AML) was made if plain CT gave evidence of a fatty component. Patients diagnosed as having a renal cell carcinoma (RCC) with non-uniform enhancement underwent nephrectomy. If a definite diagnosis could not be made even by contrast CT, the monitoring by US and contrast CT once a year was continued. Of 97 (0.16%) patients whose transabdominal US findings indicated a diagnosis of suspected renal tumor, 58 underwent the re-examination by US; of these, CT was conducted in 47. Detailed US revealed a hyperechoic pattern in 44 patients, a mixed pattern in nine and an isohypoechoic pattern with internal echo in five. By plain CT, 24 patients were diagnosed as having AML, and two as having renal calcification. Contrast CT enabled a diagnosis of renal cyst to be made in two patients and renal tumor in 14. All 14 patients with RCC except one underwent nephrectomy, which provided pathologic evidence supporting the diagnosis. Five patients had a tumor unidentifiable by CT, with continuing periodic follow-up by US and CT. Eleven patients underwent no CT. Of the 60,604 persons who underwent a general health checkup, we found 14 cases of RCC and 24 cases of AML. As a small RCC has a favorable prognosis, patients greatly benefit from early detection; therefore, we should recognize the importance of identifying renal masses by US screening during general health checkups.

Endometrial assessment by transabdominal ultrasonography in postmenopausal women

We evaluated the usefulness of transabdominal ultrasonography (TAS) for endometrial abnormalities in postmenopausal women. A total of 232 postmenopausal women were examined by TAS and endometrial sampling. Abnormal findings, including endometrial hyperplasia, atypical hyperplasia and endometrial cancer, were noted in 0.7% ( 1 141 ) of sonographically measured endometrium < 2 mm and in 15.4% ( 14 91 ) of measurements ≥ 2 mm. Endometrial cancer was found in 5.9% in the postmenopausal bleeding group ( n = 85) and in 1.4% in the symptom-free group ( n = 147). With one exception, all endometrial abnormalities were in endometrial thickness ≥ 2 mm. We conclude that TAS has limitations as a technique but is useful in deciding which postmenopausal women require endometrial biopsy.

Ultrasonic diagnosis of 3,2′‐dimethyl‐4‐aminobiphenyl induced tumors in the urogenital organs of F344 rats

The usefulness of transabdominal ultrasonography in the diagnosis of 3,2'-dimethyl-4-aminobiphenyl- and testosterone propionate-induced tumors of the urogenital organs was evaluated in F344 rats. Seven mass lesions (1 ventral prostate, 1 dorsolateral prostate, 3 seminal vesicles, and 1 kidney) in the urogenital organs could easily be diagnosed concerning size and localization by ultrasound. Histological examination revealed a lesion in the ventral prostate to be an abscess and the other tumors to be malignant. Three hydronephroses by tumor invasion to the ureter, and six tumors in organs other than the urogenital organs could be detected by ultrasound. The threshold of malignant tumor detection by ultrasound was 7 mm in actual length. The size of the mass lesion estimated by ultrasound correlated well with the direct measurement (r = 0.96). Transabdominal ultrasonography is useful for diagnosing the localization of experimental tumors and accurately measuring their size in the urogenital organs of rats.