ultrasonography

摘要： Background: Transvaginal color Doppler sonography of the uterine artery has been reported useful for evaluation of abnormal uterine bleeding in peri-/post-menopausal women. It may differentiate physiological from malignant endometrial changes. Objective: Evaluating the endometrial thickness and uterine artery Doppler as an initial diagnostic tool to identify patients with abnormal endometrial pathology. Methods: This is a prospective case control study consisted of total 50 women with peri-(n = 35) and post-(n = 15) menopausal bleeding, with 20 women consisting control group (no bleeding) (peri-(n = 10) and post-menopausal (n = 10)). Double layer endometrial thickness and uterine-artery-Doppler waveforms were measured, with the latter being S/D ratio, RI and PI. These were related to histological findings (endometrial biopsy). Result: Patients with abnormal uterine bleeding (both peri- and postmenopausal) had a significantly higher mean endometrial thickness than the control women. Study group showed a significantly lower value of all Doppler indices (S/D ratio, RI and PI). In study group, patients with malignant endometrial pathology showed significantly thicker endometrium and significantly lower Doppler indices than those with benign pathology. Conclusion: The combination of endometrial thickness and uterine artery color Doppler pattern might predict uterine endometrial malignancy, although whether it can discriminate (screen) patients requiring endometrial biopsy is not evident. Further study is needed.

摘要： Introduction: Localised adiposity is one of the leading aesthetic alteration complaints. Tecar therapy has been used in clinical practice for the treatment of fat located in the abdominal region. Objective: The objective is to analyse the effect of Tecar therapy on abdominal adiposity. Methodology: This is a clinical trial in which the participants were 32 female volunteers who have flaccidity and fat located in the abdominal region. The volunteers were divided into three groups, which respectively received applications of the capacitive mode, the resistive mode, and combined therapy of the two modalities. We have performed ten applications and analysed the anthropometric measures, the ultrasonography of the adipose layer, and the level of satisfaction. Results: All groups presented a reduction in perimetry compared to the baseline (p = 0.001). The ultrasonography showed a significant reduction in the combined therapy group compared to the baseline (p = 0.04 and p = 0.03). The level of satisfaction was good in all groups, with few adverse responses. In the bodyweight and percentage of fat analyses, we observed an increase in measurements, probably due to the restriction measures related to the new coronavirus pandemic in 2020. Conclusion: In this present study, we have concluded that Tecar therapy resulted in a reduction of the fat located in the abdominal region.

摘要： Objective: Observe and correlate the funneling of upper cervical canal by ultrasound and likelihood of cervical incompetence and premature delivery in twin pregnancy. Materials and methods: Retrospective study in twin pregnancies deliveries in 1997, in king Faisal specialist hospital and research center, Riyadh, Saudi Arabia. A total of 67 twin pregnancies underwent routine ultrasound for fetal assessment, when the cervix closed, long;and short, funneling. The time of ultrasound was divided in three groups by gestational age: from 18 to 22 weeks;from 22 to 26 weeks and from 26 to 30 weeks. The gestational age at delivery was our outcome parameter and subdivided the patients in 4 groups, group 1: patients delivered before 24 weeks (n = 4);group 2: delivered between 24 and 34 weeks (n = 16);group 3: delivered between 34 weeks and 36 weeks and 6 days (n = 18);and group 4: delivered with gestational age equal or above 37 weeks (n = 29). The data was analyzed statistically using Pearson chi square method and p value below 0.05 was considered significant. Results: There was no significant difference among the 4 subgroups in maternal age, body mass index, parity, previous history of preterm delivery or presence of urinary/vaginal infection in actual pregnancy. There was stronger history of mid trimester abortion in patients delivered before 34 weeks of gestational age. Considering the cervical sonographic findings, the diagnosis of funneling between 18 - 22 weeks was higher among the group delivered before 34 weeks of gestational age (1 and 2) comparing to other groups (3 and 4) with p value equal to 0.016. The finding in ultrasound justifies the results of higher aggressive management in patients from groups 1 and 2 comparing with groups 3 and 4;admission to hospital (p = 0.007);emergency cerclage (p = 0.04), complete hospital bed rest (p = 0.002). Conclusion: Cervical assessment during routine ultrasound in twins pregnancy seems to be useful for prediction of preterm delivery and counseling the patient without risk factors regarding cervical cerclage. Because of restricted number of patients, especially group 1 (11 = 4), we suggest further study with bigger sample and prospective trial for valued conclusion.

摘要： Point-of-care ultrasonography(POCUS)for managing critically ill patients is increasingly performed by intensivists or emergency physicians.Results of needs surveys among intensivists reveal emphasis on basic cardiac,lung and abdominal ultrasound,which are the commonest POCUS modalities in the intensive care unit.We therefore aim to describe the key diagnostic features of basic cardiac,lung and abdominal ultrasound as practised by intensivists or emergency physicians in terms of accuracy(sensitivity,specificity),clinical utility and limitations.We also aim to explore POCUS protocols that integrate basic cardiac,lung and abdominal ultrasound,and highlight areas for future research.

摘要： Schistosomiasis mansoni is a neglected disease and key public health problem,mainly due to its high prevalence,the scarcity of public policies,and the severity of some clinical forms.Periportal fibrosis(PPF)is the commonest complication of chronic schistosomiasis mansoni and its diagnosis requires different techniques.Even though wedge biopsy of the liver is considered the gold standard,it is not justified in non-surgical patients,and percutaneous liver biopsy may be informative but does not have sufficient sensitivity.Noninvasive PPF tests mostly include biological(serum biomarkers or combined scores)or physical assessments(imaging assessment of fibrosis pattern or tissue stiffness).Moreover,imaging techniques,such as ultrasound,computed tomography,magnetic resonance imaging,and elastography are applied not only to support the diagnosis of schistosomiasis,but also to assess and detect signs of portal hypertension and organ damage due to chronic schistosomiasis.A combination between a comprehensive history and physical examination with biomarkers for liver fibrosis and imaging methods seems to offer the best approach for evaluating these patients.In addition,understanding their strengths and limitations will allow a more accurate interpretation in the clinical context and can lead to greater accuracy in estimating the degree of fibrosis in patients with Schistosomiasis mansoni(S.mansoni)infection.This review will discuss the different noninvasive methods that are currently available for the evaluation of PPF in S.mansoni infection,and their application,advantages,and limitations in clinical practice.

摘要： Contrast-enhanced ultrasound(CEUS)represents a great innovation for the evaluation of focal liver lesions(FLLs).The main advantage of CEUS is the realtime imaging examination and the very low toxicity in patients with renal failure.Liver cirrhosis has been recognized as a major risk factor for the onset of hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC).HCC in liver cirrhosis develops as the last step of a complex that leads to the gradual transformation from regenerative nodule through dysplastic nodule to HCC.In patients with liver cirrhosis,a surveillance program is recommended consisting of ultrasound(US)for detecting small focal lesions.A wide spectrum of benign and malignant lesions other than HCC may be found in the cirrhotic liver and their differentiation is important to avoid errors in staging diseases that may preclude potentially curative therapies.Several published studies have explored the value of CEUS in liver cirrhosis and they have been shown to have excellent diagnostic and prognostic performances for the evaluation of non-invasive and efficient diagnosis of FLLs in patients at high risk for liver malignancies.The purpose of this article is to describe and discuss CEUS imaging findings of FLLs including HCC and ICC,all of which occur in cirrhotic livers with varying prevalence.

摘要： BACKGROUND The incidence of cervical pregnancy is increasing due to the recent widespread application of assisted reproductive technology.Although hysterectomy has been a treatment option,high-sensitivity human chorionic gonadotropin testing and improved accuracy of transvaginal ultrasound imaging have increased possibility of uterine preservation.Dilation and curettage with methotrexate therapy and uterine artery embolization have been reported as treatments with fertility preservation;however,certain disadvantages limit their use.CASE SUMMARY In our two reported cases,we avoided massive bleeding and immediately resumed infertility treatment using ultrasound-guided local ethanol injection for cervical pregnancies with fetal heartbeats.CONCLUSION This treatment may be a new fertility-preserving option for cervical pregnancy.

摘要： BACKGROUND Inflammatory myofibroblastic tumors(IMTs)are defined as tumors composed of differentiated myofibroblastic spindle cells,usually accompanied by numerous plasma cells and lymphocytes,and classified as intermediate(occasionally metastatic)by the World Health Organization.Its pathogenesis and biological behavior have not yet been elucidated.Breast IMT is extremely rare,and prosthesis implantation combined with IMT has not been reported.This study reports a case of IMT following resection of a malignant phyllodes tumor of the left breast and implantation of a prosthesis.CASE SUMMARY A 41-year-old female presented to our hospital with a mass in the left breast for 3 mo.The patient had undergone resection of a large mass in her left breast pathologically diagnosed as a malignant phyllodes tumor and implantation of a prosthesis five years prior.Ultrasonic examination revealed an oval mass in the left breast,and the patient underwent left breast mass resection and prosthesis removal.Light microscopy revealed the spindle cells to be diffusely proliferated,with a large number of neutrophils,lymphocytes,and plasma cell infiltration.Immunohistochemical staining revealed that the spindle cells were partially positive for smooth muscle actin,which is positive for BCL-2 and cluster of differentiation(CD)99 but were negative for anaplastic lymphoma kinase,cytokeratin,S-100 protein,desmin,and CD34.The final diagnosis was IMT.No recurrence or metastasis was observed during the 5-year postoperative follow-up.CONCLUSION Prosthesis implantation may be one of the causes of IMT,but further investigation is necessary to prove it.

摘要： BACKGROUND Early scar pregnancy(CSP)in the lower uterine segment after cesarean section is a type of ectopic pregnancy that can cause major complications if left untreated.Transabdominal ultrasound is a common procedure but is influenced by external factors.Thus,intracavitary ultrasound may have better diagnostic efficiency for CSP.AIM To assess the value of intracavitary ultrasound for diagnosing CSP in the lower uterine segment after cesarean section.METHODS Patients diagnosed with CSP in our hospital from October 2019 to April 2021 were recruited.Transabdominal and intracavitary ultrasound examinations were performed to compare the diagnostic differences for CSP and its types.RESULTS Sixty-three patients were diagnosed during the study period.The diagnostic accuracy for CSP was higher in intracavitary ultrasound(96.83%)than in transabdominal ultrasound(84.13%)(P0.05).For the diagnostic rates for the CSP types,the rates for gestational sac(100.00%vs 90.48%),heterogeneous mass(93.75%vs 75.00%),and part of the uterine cavity(80.00%vs 60.00%)were higher in intracavitary ultrasound than in transabdominal ultrasound,but the difference was not statistically significant(P>0.05).For gestational sac CSP patients,intracavitary ultrasound showed that the gestational sac was located in the lower uterine segment scar with abundant peripheral blood flow;the distance between the gestational sac and the serosal layer was 2.42±0.50 cm.Intracavitary ultrasound for heterogeneous mass CSP patients indicated that the mass mainly occurred in the lower anterior uterine wall,protruding into the bladder,and was surrounded by abundant internal and peripheral blood flow;the distance between the mass and serosal layer was 1.79±0.30 cm.For CSP type partly located in the uterine cavity,the gestational sac was partly located in the lower uterine cavity and partly in the scar with abundant internal and peripheral blood flow;the distance between the gestational sac and the serosal layer was 2.29±0.28 cm.CONCLUSION Intracavitary ultrasound had a higher diagnostic accuracy and application value for diagnosing CSP than transabdominal ultrasound,with reduced risk of missed diagnoses and misdiagnosis,thereby preventing delayed treatment.

摘要： BACKGROUND Performing ultrasound during the current pandemic time is quite challenging.To reduce the chances of cross-infection and keep healthcare workers safe,a robotic ultrasound system was developed,which can be controlled remotely.It will also pave way for broadening the reach of ultrasound in remote distant rural areas as well.AIM To assess the feasibility of a robotic system in performing abdominal ultrasound and compare it with the conventional ultrasound system.METHODS A total of 21 healthy volunteers were recruited.Ultrasound was performed in two settings,using the robotic arm and conventional hand-held procedure.Images acquired were analyzed by separate radiologists.RESULTS Our study showed that the robotic arm model was feasible,and the results varied based on the organ imaged.The liver images showed no significant difference.For other organs,the need for repeat imaging was higher in the robotic arm,which could be attributed to the radiologist’s learning curve and ability to control the haptic device.The doctor and volunteer surveys also showed significant comfort with acceptance of the technology and they expressed their desire to use it in the future.CONCLUSIONThis study shows that robotic ultrasound is feasible and is the need of the hour during thepandemic.