Ultrasonography

This paper presents a new manufacturing method to generate monodisperse microbubble contrast agents with polydispersity index (σ) values of <2% through microfluidic flow-focusing. Micronsized lipid shell-based perfluorocarbon (PFC) gas microbubbles for use as ultrasound contrast agents were produced using this method. The poly(dimethylsiloxane) (PDMS)-based devices feature expanding nozzle geometry with a 7 μm orifice width, and are robust enough for consistent production of microbubbles with runtimes lasting several hours. With high-speed imaging, we characterized relationships between channel geometry, liquid flow rate Q, and gas pressure P in controlling bubble sizes. By a simple optimization of the channel geometry and Q and P, bubbles with a mean diameter of <5 μm can be obtained, ideal for various ultrasonic imaging applications. This method demonstrates the potential of microfluidics as an efficient means for custom-designing ultrasound contrast agents with precise size distributions, different gas compositions and new shell materials for stabilization, and for future targeted imaging and therapeutic applications.

Ultrasound of the shoulder is a powerful and accurate method for the examination of the rotator cuff, biceps mechanism and the synovium. This article describes the anatomy, standard examination technique, indications, pitfalls and potential errors. It lists suggested imaging algorithms for a range of shoulder pathology.

Quantitative ultrasound has attracted significant interest in the evaluation of bone fracture healing. Animal and clinical studies have demonstrated that the propagation velocity across fractured bones can be used as an indicator of healing. Researchers have recently employed computational methods for modeling wave propagation in bones, aiming to gain insight into the underlying mechanisms of wave propagation and to further enhance the monitoring capabilities of ultrasound. In this paper, we review the relevant literature and present the current status of knowledge.

Purpose To compare two-dimensional ultrasonography (2D US) and three-dimensional ultrasonography (3D US) in the assessment of normal fetal lung volume. Methods A cross-sectional study was performed involving 50 normal pregnancies at 24-32 weeks' gestation. The following equations were used for lung volume calculation by 2D US: Eq(2D1) = 4.24 + {1.53 £ [(area of base of both lungs) £ 1/3 (height of right lung)]} and Eq(2D2) = [anteroposterior diameter (X) £ transverse diameter (Y) £ cranial-caudal diameter (Z) of the right lung £ 0.152 + (XЈ) £ (YЈ) £ (ZЈ) of the left lung £ 0.167]. For 3D US, the virtual organ computer-aided analysis (VOCAL) method was used with a 30° rotation angle and the total lung volume (V3D) was obtained by summing the volumes of each lung. Regression models (R 2) were devised to assess lung volume evolution over the course of the pregnancy. Pearson's correlation coeYcient (r) was used to assess correlation among the techniques, while Friedman's test was used for means comparisons. Results Strong correlation was observed among the three techniques [V3D vs. Eq(2D2) r = 0.856; V3D vs. Eq(2D1) r = 0.838 and Eq(2D2) vs. Eq(2D1) r = 0.964; all with P < 0.001]. Mean lung volumes were 37.05 § 9.67, 29.79 § 8.79 and 12.67 § 4.12 ml for V3D, Eq(2D1) and Eq(2D2), respectively (P < 0.001). Conclusions Strong correlation and signiWcant diVerence was observed among the three techniques of fetal lung volume assessment in normal fetuses.

Abdominoscrotal hydrocele is a very rare anomaly. Although various theories about this condition have been proposed, controversy still continues on the etiology of this lesion. The authors present two consecutive cases of abdominoscrotal hydrocele in infancy. On their first examination, these patients only had inguinoscrotal hydroceles. After a 2-month period of observation, these inguinoscrotal hydroceles developed into abdominoscrotal hydroceles. These findings also were confirmed by ultrasonography. The authors question the currently proposed theories of abdominoscrotal hydrocele development.

Purpose: The intrarenal resistive index is a physiological parameter that indirectly reflects the degree of resistance in the intrarenal vasculature. Resistive index measurements have been advocated for the diagnostic evaluation of several renal pathologies, including obstructive uropathy. However, despite extensive research in this field during the last decade clear guidelines on the use of resistive index measurements for discriminating obstructive from nonobstructive dilatation of the upper urinary tract remain elusive. Therefore, we reviewed the literature to clarify the proper role of resistive index measurements in the context of obstructive uropathy.

services can be found online on the World Wide Web at: The online version of this article, along with updated information and ISSN:0012-3692 ) http://chestjournal.chestpubs.org/site/misc/reprints.xhtml Objective: To define competence in critical care ultrasonography (CCUS). Design: The statement is sponsored by the Critical Care NetWork of the American College of Chest Physicians (ACCP) in partnership with La Socié té de Ré animation de Langue Française (SRLF). The ACCP and the SRLF selected a panel of experts to review the field of CCUS and to develop a consensus statement on competence in CCUS. Results: CCUS may be divided into general CCUS (thoracic, abdominal, and vascular), and echocardiography (basic and advanced). For each component part, the panel defined the specific skills that the intensivist should have to be competent in that aspect of CCUS. Conclusion: In defining a reasonable minimum standard for CCUS, the statement serves as a guide for the intensivist to follow in achieving proficiency in the field. (CHEST 2009; 135:1050 -1060) Abbreviations: ACCP ϭ American College of Chest Physicians; CCE ϭ critical care echocardiography; CCUS ϭ critical care ultrasonography; GCCUS ϭ general critical care ultrasonography; IVC ϭ inferior vena cava; LV ϭ left ventricle, ventricular; RV ϭ right ventricle, ventricular; SRLF ϭ La Société de Ré animation de Langue Française; TEE ϭ transesophageal echocardiography; TTE ϭ transthoracic echocardiography; 2D ϭ two-dimensional

Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT) presents with focal or diffuse nonenhancing MR imaging abnormalities in 50% of patients with SREAT during subacute exacerbation. Vasculitic changes in biopsy studies as well as the elevation of antithyroid antibodies and CSF protein suggests an inflammatory cause. We report the case of a patient with SREAT with changes on diffusion-weighted MR imaging, which improved with corticosteroid therapy and plasmapheresis, supporting the theory of inflammatory changes in exacerbation of presumptive SREAT.

We performed a retrospective study of 19 patients who had been operated on for hepatic hydatid disease with diaphragmatic or transdiaphragmatic (D-TD) thoracic involvement chosen from a total of 444 patients who underwent operations for hepatic hydatid disease. In all cases D-TD involvement was confirmed by ultrasonography, CT, or MRI scan. We propose a new classification (grades 1–5) based on the degree of development of D-TD involvement. Before 1984 exposure was obtained by thoracophrenolaparotomy (nine cases) and later by right subcostal incision. Only four patients required atypical pulmonary resection. In 13 cases the diaphragm was repaired, and all 24 hepatic cysts were treated with total (16 cases) or partial (8 cases) cystopericystectomy. There was no operative mortality, and the most serious morbidity consisted of a biliary fistula and a biliobronchial fistula. For treatment of these patients we recommended right subcostal incision and total or near-total cystopericystectomy as a first choice of surgical technique. Nous avons étudié rétrospectivement 19 patients opérés pour une hydaditose hépatique s'étendant soit vers le diaphragme, soit vers le thorax par extension transdiaphragmatique (TD) dans une série de 444 patients ayant été opérés. Dans tous les cas de TD, le diagnostic a été confirmé par l'échographie, la tomodensitométrie ou la résonance magnétique nucléaire. Nous proposons une nouvelle classification (grades 1 à 5), basée sur le degré de TD. Avant 1984, une thoracophrénolaparotomie a été la voie d'abord préférée (9 cas) puis on a utilisé la voie souscostale droite. Seulement quatre patients ont nécessité une résection pulmonaire atypique. Chez 13 patients, on a réparé immédiatement le diaphragme et tous les kystes hydatiques hépatiques (n=24) ont été traités par une périkystectomie soit totale (16 cas) soit partielle (8 cas). Il n'y a eu aucun décès et la complication la plus grave observée a été une fistule biliaire et bilio-bronchique. Nous recommandons la périkystectomie totale ou presque totale par une incision sous-costale droite prolongée chez ces patients. Hemos realizado un estudio retrospectivo de 19 pacientes operados por enfermedad hidatídica hepática con extensión diafragmática o transdiafragmática (E-TD) al toráx, dentro de un total de 44 pacientes sometidos a cirugía por enfermedad hidatídica del hígado. En la totalidad de los casos la extensión E-TD fue confirmada por ultrasonografía, TAC o resonancia magnética. Proponemos una nueva clasificación (grados 1 a 5) basada en el grado de desarrollo de la extensión E-TD. Con anterioridad a 1984, se hizo la exposición mediante toracofrenolaparotomía (9 casos) y más tarde por incisión subcostal derecha. Sólo 4 pacientes requirieron una resección pulmonar atípica. En 13 casos el diafragma fue reparado y todos los 24 quistes hepáticos fueron tratados mediante cistopericistectomía total (16 casos) o parcial (8 casos). No se registró mortalidad operatoria y la morbilidad más seria consistió en una fístula biliar y una broncobiliar. Para el tratamiento de este tipo de pacientes nosotros recomendamos una incisión subcostal derecha y una cistopericistectomía total o casi total como la técnica quirúrgica de primera escogencia.

The objective of this study was to investigate the feasibility of examining the fetal heart with Tomographic Ultrasound Imaging (TUI) using four-dimensional (4D) volume datasets acquired with spatiotemporal image correlation (STIC). Material and methods: One hundred and ninety-five fetuses underwent 4D ultrasonography (US) of the fetal heart with STIC. Volume datasets were acquired with B-mode (ns195) and color Doppler imaging (CDI) (ns168), and were reviewed offline using TUI, a new display modality that automatically slices 3D/4D volume datasets, providing simultaneous visualization of up to eight parallel planes in a single screen. Visualization rates for standard transverse planes used to examine the fetal heart were calculated and compared for volumes acquired with B-mode or CDI. Diagnoses by TUI were compared to postnatal diagnoses. Results: (1) The four-and five-chamber views and the three-vessel and trachea view were visualized in 97. 4% (190/195), 88.2% (172/195), and 79.5% (142/195), respectively, of the volume datasets acquired with Bmode; (2) these views were visualized in 98.2% (165/ 168), 97.0% (163/168), and 83.6% (145/168), respectively, of the volume datasets acquired with CDI;

Ultrasound is a sensitive tool for the diagnosis of cystic tumors in the lower pelvis of women. Most knowledge about the ultrasound image of such tumors is based on abdominal scanning. The value of vaginal sonography for evaluation of such tumors has, to the best of our knowledge, so far not been studied. This study was ahned at relating the vaginal sonographic image of tumors in the lower pelvis with the results of macro-and microscopic examination of the tumor. Special interest was paid to establishing ultrasound criteria for classifying unilocular tumors as benign or malignant. One hundred and eighty women who were operated on for pelvic tumors were inluded in the study. All women were evaluated by vaginal sonography the day before surgery. Ninety-four women were postmenopausal and eighty-six were still menstruating. Vaginal ultrasound charactized the tumor correctly as related to macroscopic examination in 96% (172/180). The sensitivity of vaginal sonography in identifying benign and malignant tumors was 82%, and the specificity, 92%. None of the unilocular tumors was malignant. Papillary formations on the inside of the cyst wall indicated an increased chance of the tumor's being malignant. There was a clear correlation between size of tumor and malignancy except for unilocular tumors. Vaginal sonography was shown to be accurate in characterizing cystic tumors in the lower pelvis. The present results also indicate that the probability that unilocular tumors less than 10 cm in diameter and without papillary formations, are malignant is low, irrespective of the woman's age. o 1990 Academic press, IX.

Background: A one-stop diagnostic service has been available .for women with symptomatic breast disease at St Bartholomew's Hospital for 5 years and was originally audited in May 1993. In re-auditing the one-stop service our aim was to see if our practice had improved following the original audit and to look at the impact which these changes in practice had made to the service offered to the patient.

Objective: despite recent advances in medical imaging, pre-operative evaluation of liver tumors, whether benign or malignant, is often lacking in accuracy and precision. With the development of surgical laparoscopy, the benefits of diagnostic laparoscopy have been combined with those of operative ultrasound. This article aims to describe the technique of laparoscopic ultrasound of the liver, and to define its applications

This study was conducted to test the safety of intra-articular tumor necrosis factor alpha (TNF-α) antagonists in small joints with arthritis. A dose of 2-8 mg etanercept was given intra-articularly guided by ultrasonography (US) in 26 patients with a flare of arthritis in a particular joint (16 wrists, two elbows, two ankles, six finger joints). Primary end points were imaging analyses by independent investigators: US-Doppler measurements were performed in all patients before and after the injection and MRI before and after were obtained in nine patients. The only adverse event was a case of swelling of the hand lasting 2 days after a wrist injection. Two patients had a supplementary glucocorticoid injection and were excluded from efficacy analysis after 4 days and 3 weeks, respectively. VAS for pain decreased after 1 week in 23 of 25 patients (median 0.62), and after 1 month in 14 of 24 patients (median 0.60). No significant changes were seen in erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP). On MRI, all nine cases tested had a reduction in synovial thickness (P = 0.008) and US Doppler signals diminished after treatment (resistance index (RI) P = 0.02, pixels P = 0.09). In conclusion, intra-articular injection of etanercept gave no noticeable adverse events.

Anterior sacral meningocele is characterized by the herniation of the thecal sac into the retroperitoneal space. A 33-year-old man was referred to our hospital with the complaints of a longlasting constipation and nonspecific lower abdominal pain. At ultrasound, a cystic mass was detected at the presacral space. Computed Tomography revealed a defect at the anterior aspect of the sacrum, together with a presacral cystic mass which showed a connection with the dural sac. At Magnetic Resonance Imaging, it was demonstrated that the cystic mass made an impression on the rectum, and did not possess any solid components. An anteroposterior pelvis radiogram demonstrated a sacral deformity and the scimitar sign. Upon these imaging findings, the patient got the diagnosis of an anterior sacral meningocele. The possibility of an anterior sacral meningocele must always be kept in mind in the differential diagnosis of a pelvic cystic mass.

Ultrasonography is a non-invasive method that can be used to assess sex and maturity of ®sh. This study was conducted to examine the feasibility of using ultrasound images to sex juvenile and mature halibut Hippoglossus hippoglossus (Linnaeus), mature winter Pleuronectes americanus (Walbaum) and yellowtail¯ounder Pleuronectes ferruginea (Storer) and mature haddock Melanogrammus aegle®nus (Linnaeus). In females, both immature and mature ovaries were relatively easy to distinguish, but in males only mature testes were consistently distinguishable. Ovarian maturation of haddock and ovulatory cycles of halibut may also be assessed using ultrasound.

In this study, we used a micro-ultrasound (microUS) system that we developed in-house as an alternative method for tumor growth calipers. In addition, microUS was combined with small-animal positron-emission tomography (microPET) for tumor metastatic assessment. MicroUS provides anatomical information that can be used for tumor volume measurements while microPET is a functional imaging method with positron-emitting radiophamaceuticals, such as 18F-labeled deoxyglucose, [18F]FDG. In this study, microUS and microPET were performed in a mouse tumor longitudinal study (2–8 weeks), both with 3D tumor segmentation and volume measurements. Compared with vernier calipers, microPET generally overestimated tumor volumes during weeks 2–4 due to its inadequate spatial resolution. During weeks 5–8, standard deviations of microPET results were large due to tumor hypoxia or necrosis. On the contrary, microUS tumor volume measurements were more reliable as they were less affected by these factors. ...

The prevalence of nephrolithiasis is considerably greater in patients with autosomal dominant polycystic kidney disease (ADPKD) than in the general population. We evaluated anatomic and metabolic factors that may be associated with an increased prevalence of nephrolithiasis in patients with ADPKD. We compared anatomic parameters among ADPKD patients with or without nephrolithiasis as diagnosed by ultrasonography, whereas metabolic factors were determined by 24-hour urinary chemical analysis. Patients with ADPKD and nephrolithiasis had more renal cysts (P F 0.05) and a larger predominant renal cyst size (P F 0.005) than patients without nephrolithiasis. Concurrently, individual stone-forming kidneys had a greater cyst number (P F 0.05) and a significantly larger predominant cyst size (P F 0.01) compared with kidneys without stones. Patients with ADPKD and nephrolithiasis had a significantly lower creatinine clearance than those without nephrolithiasis (68.7 ؎ 8.6 versus 94.8 ؎ 5.4 mL/min, respectively; P F 0.05). Twenty-four-hour urinary analysis showed that patients with ADPKD and nephrolithiasis had significantly lower urinary volumes (P F 0.05), and levels of urinary phosphate (P F 0.05), magnesium (P F 0.005), and potassium (P F 0.05). Although not statistically significant, patients with ADPKD with stones tended to have lower levels of urinary citrate, and both groups showed a high percentage (range, 49% to 60%) of patients with hypocitraturia. Our data are consistent with the hypothesis that patients with ADPKD who develop nephrolithiasis do so because of increased intrarenal anatomic obstruction, as well as lower levels of such urinary inhibitors of stones as magnesium and citrate.

Fetiform teratoma (homunculus) is a term that has been given to a rare form of ovarian teratoma that resembles a malformed fetus. There are very few reported cases of this entity in the English language literature. In this report, we document a case of fetiform teratoma in a 23-year-old woman, gravida 0, who initially presented with a chief complaint of dyspareunia. The clinical and pathologic aspects of this rare entity are presented here, with a review of the English literature. Differentiating fetiform teratoma from the more highly developed fetus-in-fetu and ectopic pregnancy is also discussed.

A case of breast cancer that metastasized to the cervix 10 years and 8 months after mastectomy is reported. The patient had undergone pancreaticoduodenectomy due to solitary metastasis to the head of the pancreas 4 years previously. The cervical metastasis was associated with abnormal genital bleeding. After pancreaticoduodenectomy the serum levels of CEA, CA15-3 and NCC-ST-439, which are markers of breast cancer, were within normal limits, but the serum level of CA15-3 had increased month by month. The patient had abnormal genital bleeding and presented to the department of gynecology at our hospital. The tumor was in the cervix, bled easily and 2.5 x 2.0 cm in size on ultrasonography. It was thought to be carcinoma of the cervix, but biopsy revealed the tumor to be an adenocarcinoma pathologically and CA15-3 was immunohistochemically demonstrated in the resected specimen, similar to lobular carcinoma of the breast. Abdominal CT scan revealed involvement of the ovaries and uterus, prompting hysterectomy with bilateral oophorectomy. After discharge, she received chemoendocrine therapy. However, she subsequently died due to peritoneal carcinomatosis.

Continuous wave Doppler ultrasound was uscd to examine the uteroplacental circulation of an unselected group o f 993 women between 16 and 24 weeks gestation. Reference ranges for resistance index (RI) were determined and throughout this gestation range thcrc was a significant fall in RI with increasing gestation. The RI was lower from placental than non-placental sites and from distal 'arcuate' than proximal 'uterine' sites. There i s a need to define fixed standardized sites for sampling and for normal ranges to account for variables such as placental site.

The aim of the present study was to assess and to compare the orbital and retinal vascular flow dynamics and resistance in patients with homozygous sickle cell disease with controls by means of duplex and color Doppler ultrasonography. Forty-six patients with homozygous sickle cell disease (SCD) and 20 healthy subjects were included in the study. None of the patients had objective signs of ocular involvement. Duplex and color Doppler ultrasonography of the ophthalmic, short posterior ciliary, and central retinal arterial flows of the both eyes were performed to assess peak systolic flow velocity (PSFV), end-diastolic flow velocity (EDFV), and mean flow velocity (MFV) through entire cardiac cycle with further calculation of resistive indices (RI) and pulsatility indices (PI). Ophthalmic arterial flow velocities were significantly increased in patients with SCD than in controls (P < 0.0001). Blood flow velocities of the central retinal artery were found to be significantly reduced (P < 0.0001) while RI and PI values were markedly higher (P < 0.02 and P < 0.03) in patients with SCD compared to controls. Reduction of retinal vascular flow velocities and increase of retinal vascular resistance were significantly related to the mean hemoglobin and hematocrit levels, red blood cell count, and mean corpuscular hemoglobin volume (P < 0.009, P < 0.01, P < 0.02, and P < 0.04, respectively). In conclusion, Doppler ultrasonography in patients with SCD who had no objective signs of ocular involvement allowed detection enhancement of ophthalmic flow velocities, reduced retinal flow velocities, and increased retinal vascular resistance, which are associated with haematological features. Am.

In the early 1970s an increased prevalence of gallstones was reported in adults and children with immunoglobulin deficiency. As the advent of ultrasonography has largely changed the diagnostic approach to gallstones, we have reevaluated the prevalence of cholelithiasis in a group including 37 patients with common variable immunodeficiency and seven patients with other forms of primary immunodeficiency. All patients were receiving intravenous gammaglobulin replacement since 1983 or, in more recent cases, soon after the diagnosis was made, and therefore had relatively few infections. All patients underwent a hepatobiliary ultrasonogram and blood sampling. Data were compared, after age and sex standardization, with those obtained by the GREPCO in a free-living population of 1239 men and 1081 women. Only two women with immunoglobulin deficiency had gallstones. One of these was obese and had had one pregnancy. Both were asymptomatic. None of the patients studied had a history of cholecystectomy or evidence of biliary sludge. Thus, the observed prevalence rates of gallstone disease were 8.7% in women and 0% in males, respectively, against expected values of 9.5% and 3.2%. Immunodeficient patients expressed several putative risk factors for gallstones in the low range (body mass index, total and HDL cholesterol, and blood glucose in both sexes, and triglycerides in men). We conclude that gallstone disease is not more frequent in patients with immunodeficiency syndromes undergoing immunoglobulin therapy than in the general population.

The vessel wall properties of the common carotid artery were studied noninvasively in normotensive and borderline hypertensive male volunteers of various ages with the use of a multi-gate pulsed Doppler system. In the younger age group (20-35 y) both distensibility and cross-sectional compliance were significantly less in the borderline hypertensive group. In the older borderline hypertensive subjects (50-69 y) distensibility (p less than 0.05) and cross-sectional compliance (p = 0.06) were also less than in the control subjects. The reduced distensibility and cross-sectional compliance likely result from a decrease in arterial wall elasticity because the relative increase in common carotid artery diameter during systole is diminished in borderline hypertensives, despite the fact that their pulse pressure is similar to or higher than that in control subjects. The less pronounced differences in vessel wall properties between borderline hypertensive and normotensive volunteers in the ...

many Study Objective: To assess the clinical use of ultrasonographic localization of the epidural space, and to evaluate the clinical efficacy of ultrasound diagnostics in obstetric anesthesia. Design: Randomized prospective study. Setting: University Clinic of Obstetrics and Gynecology. Patients: 300 parturients, 85 of whom had conventional delivery and 65 who underwent cesarean section. Interventions: Patients underwent ultrasonography for the identification of the intervertebral structures. Puncture depth and angle were measured to improve the placement of the Tuohy needle. Measurements: In the ultrasound group, additional puncture data, optimized puncture point, expected puncture depth, and angle were used to optimize the puncture technique. To control for side effects, we compiled data on the number of puncture attempts and the number of necessary puncture levels, visual analog scale (VAS) scores, the rate of side effects, and the patient acceptance of the technique. Main Results: The two groups were similar regarding demographic data. Using ultrasound for structure detection, the rate of puncture attempts were significantly (p Ͻ 0.013) reduced from 2.18 Ϯ 1.07 to 1.35 Ϯ 0.61. The mean rate of necessary puncture levels was 1.30 Ϯ 0.55 and with ultrasound detection 1.136 Ϯ 0.36 (p Ͻ 0.029). Complete analgesia was achieved in 147 patients with ultrasound detection versus 138 patients in the Control group (p Ͻ 0,03). The maximum VAS pain score in the control group was 1.3 Ϯ 2.1 versus 0.8 Ϯ 1.5 in the Ultrasound group (p Ͻ 0.006). The rate of side effects were reduced significantly: 99 patients in the Control group had no side effects compared with 120 patients from the Ultrasound group who were free of side effects. Patient acceptance of the technique in the Ultrasound group was significantly higher than in the Control group. Conclusion: The clinical use of ultrasound for epidural catheter placement may improve regional anesthesia. The use of ultrasound resulted in superior quality in all measured endpoints.

To analyse the effect of integrated orthodontic treatment, orthognathic surgery and orofacial myofunctional therapy on masseter muscle thickness in patients with class III dentofacial deformity three years after orthognathic surgery. A longitudinal study was conducted on 13 patients with class III dentofacial deformities, denoted here as group P1 (before surgery) and group P3 (same patients 3 years to 3 years and 8 months after surgery). Fifteen individuals with no changes in facial morphology or dental occlusion were assigned to the control group (CG). Masseter muscle ultrasonography was performed in the resting and biting situations in the three groups. Data were analysed statistically by a mixed-effects linear model considering a level of significance of P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05. Significantly higher values (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01) of masseter muscle thickness (cm) were detected in group P3 (right rest: 0.82 ± 0.16, left rest: 0.87 ± 0.21, right bite: 1 ± 0.22, left bite: 1.04 ± 0.28) compared to group P1 (right rest: 0.63 ± 0.19, left rest: 0.64 ± 0.15, right bite: 0.87 ± 0.16, left bite: 0.88 ± 0.14). Between P3 and CG (right rest: 1.02 ± 0.19, left rest: 1 ± 0.19, right bite: 1.18 ± 0.22, left bite: 1.16 ± 0.22) there was a significant difference on the right side of the muscle (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) in both situations and on the left side at rest. The proposed treatment resulted in improved masseter muscle thickness in patients with class III dentofacial deformity.

Disponible sur Internet le 30 octobre 2009 MOTS CLÉS Échinococcose ; Paroi thoracique ; Parties molles ; Os Résumé L'échinococcose (EC) de la paroi thoracique demeure rare même en pays d'endémie représentant 0,09 à 0,3 % des cas d'EC thoracique. Nous rapportons l'observation d'un patient âgé de 76 ans, opéré quatre ans auparavant pour carcinome colique et qui présente une masse de la paroi thoracique. À l'échographie, la masse présentait une échostructure mixte. Le diagnostic de métastase pariétale de la néoplasie colique a été suspecté. L'étude anatomopathologique de la masse a mis en évidence des membranes hydatiques. Le scanner thoracique était fortement évocateur d'un kyste hydatique costovertéral et des parties molles. Le traitement a consisté en une résection de deux arcs costaux et d'une apophyse transverse ainsi que des parties molles avoisinantes. L'albendazole a été prescrite en pré-et en postopératoire avec un recul d'un an sans manifestation clinique.

Prenatal diagnosis of congenital lung anomalies has increased in recent years as imaging methods have benefitted from technical improvements. The purpose of this pictorial essay is to illustrate typical imaging findings of a wide spectrum of congenital lung anomalies on prenatal US and MRI. Moreover, we propose an algorithm based on imaging findings to facilitate the differential diagnosis, and suggest a follow-up algorithm during pregnancy and in the immediate postnatal period.

Distal forearm fractures are the most common fracture type in children. Point-of-care-ultrasound (POCUS) is increasingly being used and preliminary studies suggest it offers an accurate approach to diagnosis. However, outcomes such as pain, satisfaction, and procedure duration have not been explored but may be salient to the widespread acceptance of this technology by caregivers and children. Our objectives were to examine the test performance characteristics of POCUS for non-angulated distal forearm injuries in children and compare POCUS to x-ray with respect to pain, caregiver satisfaction, and procedure duration. We conducted a cross-sectional study involving children aged 4-17 years with a suspected non-angulated distal forearm fracture. Participants underwent both x-ray and POCUS assessment. The primary outcome was sensitivity between POCUS and x-ray, the reference standard. Secondary outcomes included self-reported pain using the Faces Pain Scale - Revised, caregiver satisfact...

Ultrasonography is useful for assessing the morphology of the thyroid gland in hyperthyroid cats. Our aim was to describe the ultrasonographic changes of the thyroid gland in hyperthyroid cats after 131 I therapy. Ultrasonography was performed in 15 hyperthyroid cats at initial presentation and 6 months after 131 I using a multifrequency linear transducer set at 12 MHz. The following criteria were evaluated: length, width, height, volume, shape, homogeneity, and vascularity, using Power Doppler. Pretreatment, 10 cats had bilaterally abnormal thyroid lobes, four cats one abnormal lobe with the contralateral lobe being normal or reduced in size, and one cat with one normal lobe and one lobe not visible. Six months after 131 I therapy, there was a reduction in median volume from 819 to 210 mm 3 , reduced rounding, reduced heterogeneity, and decreased vascularity. In conclusion, ultrasonography may be used to monitor thyroid changes in order to assess 131 I treatment response. Further studies are necessary to determine whether ultrasonography could contribute to the detection of a relapsing course of hyperthyroidism. r

PURPOSE: The utility of Traube's space percussion in the bedside assessment of splenic enlargement was evaluated. The influence of meals and obesity on this sign were also assessed, because both are believed to interfere with the results of abdominal percussion. PATIENTS AND METEIODS The inpatient population of a tertiary care hospital was studied where cases and controls were selected according to the results of abdominal ultrasonographic examinations.

Purpose: Posterior transverse plication (PTP) has gained popularity as a technique to correct redundancy of the internal carotid artery during endarterectomy. The safety of this technique in large series of patients has not been extensively studied. We investigated 876 primary carotid endarterectomies (CEAs) performed at our institution over the last six years to determine the safety of this technique.

Introduction and hypothesis The aim of this study was to validate a technique to measure the vaginal wall thickness (VWT) using two-dimensional ultrasound. Methods Women were scanned by two independent operators and by the same operator at two separate visits at the level of the bladder neck, the apex of the bladder, the anterior fornix, the anorectal junction, rectum and posterior fornix. Fresh female cadavers were scanned and ultrasound thickness of the vagina was compared to histological thickness. Results Bland Altman analysis revealed a low mean difference between operators and between visits by the same operator. The 95% confidence intervals as a percentage of the mean vaginal wall thickness ranged between 2.8% and 7.4%. There was a low percentage difference between ultrasound and histological vaginal wall thickness. Conclusion Ultrasound vaginal wall thickness demonstrated good intra- and interoperator reliability, as well as consistency with histological measurement. It is a valid technique.

We studied the role of duplex Doppler ultrasonography in the diagnosis of renal obstruction caused by ureteral calculi. Using duplex Doppler sonography, we evaluated the intrarenal hemodynamics of 27 patients who presented to the emergency department with renal colic. We performed Doppler ultrasonography on patients in whom US did not reveal any pathology causing renal colic and calculated and compared mean RI values of normal and obstructed kidneys and ΔRI values of each group. Threshold levels for the diagnosis of urinary tract obstruction (mean RI ≥ 0.70 and ΔRI ≥ 0.08) were used to determine the sensitivity and specificity of Doppler sonography for the diagnosis of urinary tract obstruction. Patients were investigated for revealing calculi diagnosis either by stone excretion history, intravenous pyelography or non contrast enhanced urinary computed tomography. A total of 162 intrarenal arterial Doppler recordings were made on 54 kidneys. Of the 16 patients with urinary obstruction, 11 (68%) had sonographic evidence of pelvicalyceal dilatation. The mean RI of the 16 obstructed and 11 unobstructed kidneys was 0.69 ± 0.04 and 0.61 ± 0.06 (mean ± standard deviation), respectively. The difference between the mean RI values for each group was statistically significant (P P P 

Patellar tendinitis is an overuse syndrome affecting the origin of the patellar tendon and its underlying part. Ultrasonography is useful to investigate tendinous pathology. It describes the anatomical lesions and their extent. Surgical excision of irreversible lesions, demonstrated on ultrasonography, is a logical attitude which provides good results.