Ultrasound Imaging

Currently, the methods for assessing milk ejection in women include serial sampling of plasma oxytocin and measurement of intraductal pressure, both of which are invasive and may induce stress. We hypothesized that milk ejection would cause an increase in milk-duct diameter that could be observed noninvasively with ultrasound, and this could be used to investigate the physiology of milk ejection in women. One milk duct was scanned in the unsuckled breast in 2 groups of mothers: group BB (n = 21) for the beginning of a breastfeed and group EB (n = 24) for the entire breastfeed. A duct also was monitored for a 5-minute period on 2 separate days in the absence of factors that may induce milk ejection in group EB to provide a baseline duct diameter. Milk intake at a breastfeed was measured by test weighing. A significant increase in milk-duct diameter was observed when milk ejection was sensed and/or the infant changed its swallowing pattern in both groups. Multiple increases and decrea...

En este  trabajo, se desarrolló una interfaz  en MatLab preparada  para cuantificar de manera sistemática  el desempeño de  distintos algoritmos  para reconstruir imágenes médicas obtenidas por ultrasonido.  Los filtros  seleccionados  utilizan umbrales duros y blandos  aplicados a  los coeficientes wavelet de la imagen exportada del ecógrafo.  Las transformadas elegidas  son  transformadas discreta wavelet (DWT)  [26],  [59], transformadas Daubechies wavelets simétricas (SDW)  [54],  [55], onditas complejas de doble árbol (DT-CWT)  [47],  [66], phaselet  [28],  [29] y curvelet  [15][81]. Según el estado del arte actual, estas transformadas corresponden al conjunto de las que  obtienen mejores resultados de reducción de ruido tipo speckle. 
La plataforma integra distintas métricas objetivas que utilizan referencia externa (pico de relación señal ruido - PSNR), que utilizan referencia reducida (ganancia de contraste – CG) y que no necesitan referencia alguna (resolución lateral  - RL, resolución axial  - RA). Así mismo, la misma fue desarrollada para cuantificar estás métricas, no solo sobre la imagen total, sino también en entornos definidos por el usuario, variando posición y cantidad de pixeles. 
En este trabajo,  se propone un método  consistente  que  implica  obtener la imagen mediante la captura de un fantoma conocido (en este caso, un fantoma multipropósito comercial), con zonas de distintas impedancias y tamaños. De esta manera, generar la imagen utilizada como referencia a partir de las especificaciones técnicas brindadas por el fabricante.
Se realizaron pruebas  sobre  imágenes  obtenidas a partir de la captura  un fantoma Gammex 403 GS LE por un ecógrafo Esaote MyLabTM  25, aplicando umbrales duros y blandos a los coeficientes wavelet. Se compararon los distintos descriptores en entornos de objetivos infinitesimales y quistes de distinta impedancia. A partir de estas pruebas, se puede concluir que los valores de mejora sobre la PSNR no siempre reflejan una mejora en otros índices importantes.

ULTRASONOGRAPHIC EVALUATION OF OVULATION STIGMA AND PROGNOSIS OF GROWTH OUTCOMES OF THE DOMINANT FOLLICLE.
O.V. Bulavenko, V.V.Doschechkyn
Abstract
Study objective: To study the relationship of ultrasonographic changes in the walls of the dominant follicle with the outcomes of its growth – ovulation or persistence.
Study design: Prospective cross-sectional study. Patients, Methods, Settings: Upon results of sonographic one cycle pre-assessment, 96 women from subfertile couples were distributed into two groups. Main group – 78 women with documented ovulation. Comparison group consisted of eighteen women with various clinical forms of follicle persistence. Ovulation stigma identification was performed by transvaginal ultrasonography using the technique of Mobile Hydroacoustic Window (TVS+MHAW) with standard 6–10 MHz probes. Three sources of fluid were used for the building of mobile hydroacoustic window: antral fluid, contents of ovulation stigma and the fluid located close to ovary apex. Subtle structures of follicle walls were assessed at the interface of liquid and dense medium in the area of ovary apex.
Results, Discussion: In 52 cases (66.6%) two main types of ovulation stigma – Large Bleb-type and Small Flat-type were identified, in 48 (61.5%) and 4 (5.1%) cases, accordingly. In the rest of 26 (33.3%) ovulating women it was not possible to identify the stigma sonographically. In 18 (18.8%) cases anovulatory cycles were presented: LUF in 10 (10.4%) cases, follicular regression in 6 (6.3%) and hemorrhagic cysts developed in two cases (2.1%). Local thinning of follicular walls in the area of stigma (91%), appearance of small amount of fluid near the ovary apex (93.6%) and elongated or cone-like shape of the pre-ovulatory follicle (59%) were the most prevalent sonographic signs of stigma formation. Stages of sonographic changes of the structure of forming ovulation stigma were detected and described. New sonographic sign of ovulation stigma, – the phenomenon of Constriction Ring (30.8%), characterizing the closing stage of stigma formation was described. Mean growth and regression rates were calculated for dominant follicles. The increase of dominant follicle size beyond 28.5 mm is connected to high risk of its anovulation or persistence. It should also be taken into account that ovulation can occur at any stage of stigma formation, also without its sonographic appearance.
Conclusion: The study of phenotypic features of stigma formation by means of TVS + MHAW can be useful for timing of OPU in IVF natural cycles and prediction of high risk of follicle persistence/regression at intrauterine insemination

Introduction Across the last two decades, ultrasound services in many healthcare sectors have become increasingly pressurised as a consequence of upsurging demand and difficulties in recruiting viable clinicians. Indeed by 2013, the UK government’s Migration Advisory Committee had listed sonography as an official ‘shortage specialty’. Comparatively little research has to date, however, explored the impacts of this situation upon the departments themselves, and the individuals working therein. The core purpose of this study is, thus, to lend qualitative depth to current understandings of the frontline situation in the UK’s ultrasound units, many of which are understaffed, from the perspective of their managers. Methods Using a thematic analysis informed by a Straussian model of Grounded Theory, N = 20 extended accounts provided by ultrasound department leads in public ( n = 18) and private ( n = 2) units were explored. Results Four global themes emerged from the analysis of which the...

La thrombose veineuse ovarienne est une pathologie rare mais potentiellement mortelle.

Son diagnostic repose essentiellement sur les techniques d’imagerie, en particulier le CT et la résonance magnétique. Ces deux techniques d’imagerie sont en effet extrêmement sensibles et spécifiques dans cette situation.

Avec un traitement précoce associant antibiotiques et anticoagulants, les complications sont devenues exceptionnelles.

Jarak merupakan nilai pengukuran dari seberapa jauh sebuah titik atau objek. Umumnya mengukur jarak biasa digunakan menggunakan alat ukur seperti penggaris, meteran, dan lainnya. Ultrasonik adalah gelombang suara dengan frekuensi yang lebih tinggi daripada batas atas pendengaran manusia. Ultrasonik memiliki frekuensi gelombang diatas 20 kHz. Dalam hal ini, sensor ultrasonik dapat menjadi cara mudah dalam pengukuran jarak. Sensor ini juga cocok untuk pengukuran jarak antara benda bergerak atau tidak bergerak. Sensor ultrasonik mengukur jarak benda di udara tanpa melalui kontak fisik. Artinya, sensor ini mengukur jarak tanpa kerusakan dan mudah digunakan serta dapat diandalkan.

Medical ultrasound imaging systems have greatly improved the clinical diagnosis by improving the image quality thanks to more sensitive systems and post-processings. The scientific community has made a great effort of research on post-processing and on encoding the excitation. The methods of the optimal control have been neglected. Our work has focused on the optimal methods based on the feedback from output to input. We have transformed the complex problem of optimal control into an easier suboptimal parametric problem. We apply the principle of optimal control to the ultrasound imaging, the ultrasound harmonic imaging and to the constrast harmonic imaging with or without encoding. The simplicity of the method has allowed us to adapt it to harmonic imaging by a change in the cost function. This adaptation shows that our method can usually be applied to the ultrasound imaging. Nowadays, the stakes of the ultrasound imaging focus not only on the excitation processings or image processings but also on the sensors. This point naturally leads us to seek the optimal control of the capacitive transducers (cMUT) in order to adapt them to the encoded ultrasound imaging. Our compensation and encoding methods by optimal control provide very promising results that go beyond our expectations. The application scope of our methods of optimal control is large and we do not see all the limits yet. The main advantage of our approaches is the easiness of their use and of their implementation. Indeed, our approaches do not require any a priori knowledge on system and medium explored. Our system automatically adapts itself to the changes which may be related to sensor ageing or to the medium change.

The development of good quality and affordable ultrasound machines has led to the establishment and implementation of numerous point-of-care ultrasound (POCUS) protocols in various medical disciplines. POCUS for major infectious diseases endemic in tropical regions has received less attention, despite its likely even more pronounced benefit for populations with limited access to imaging infrastructure. Focused assessment with sonography for HIV-associated TB (FASH) and echinococcosis (FASE) are the only two POCUS protocols for tropical infectious diseases, which have been formally investigated and which have been implemented in routine patient care today. This review collates the available evidence for FASH and FASE, and discusses sonographic experiences reported for urinary and intestinal schistosomiasis, lymphatic filariasis, viral hemorrhagic fevers, amebic liver abscess, and visceral leishmaniasis. Potential POCUS protocols are suggested and technical as well as training aspects in the context of resource-limited settings are reviewed. Using the focused approach for tropical infectious diseases will make ultrasound diagnosis available to patients who would otherwise have very limited or no access to medical imaging.

A discrete membranous layer, “stratum membranosum”, in human subcutaneous tissue is classically described as confined to the lower anterior abdominal wall and perineum and referred to as Scarpa’s and Colles’ fasciae, respectively. Evidence for its existence elsewhere in the body is scanty and therefore the present study was undertaken. Dissection of six embalmed adult cadavers, along with ultrasound imaging on four living subjects, were carried out to determine the existence, topography, and thickness of the membranous layer of superficial fascia in different regions of the body. In all six cadavers, a continuous layer of fibrous membrane in the superficial fascia was found consistently in all the dissected regions of the body and was also confirmed by ultrasonography. The arrangement and thickness of this membranous layer varied according to body region, body surface, and gender. It was thicker in the lower than in the upper extremity, on the posterior than anterior aspect of the body, and in females than in males. The mean thickness of the membranous layer ranged from 39 to 189 μm, being thickest in the leg and thinnest over the dorsum of the hand. The membranous layer was observed to have two or even three components in regions such as the breast, back, thigh, and arm and was seen to split, forming special compartments around subcutaneous major veins of upper and lower extremities, with fibrous septa extending to attach to the vessel wall. Functionally, the membranous superficial fascia may play a role in the integrity of the skin and support for subcutaneous structures particularly veins, by ensuring their patency. Understanding the topographic anatomy of this fascial layer may help explain body-contour deformities and provide the anatomic basis for surgical correction.

Abstrak— Gambar ultrasound (USG) sering lebih dipilih daripada bentuk pencitraan lainnya karena bersifat non invasif, portable dan biaya yang murah. Namun, kelemahan utama gambar USG medis adalah buruknya kualitas gambar, yang sering kali diganggu oleh speckle noise. Dalam penelitian ini, noise pada gambar ultrasound medis dikurangi melalui difusi anisotropik dengan menggunakan dekomposisi wavelet dekomposisi. Sebagai langkah pertama dalam penelitian ini dilakukan proses gamma correction yang nilai gamma antara 0 dan 1. Citra hasil transformasi power-law (gamma) ini mempunyai sifat memetakan suatu range nilai gray level citra input yang kecil ke dalam level output dengan range yang lebih luas. Untuk mencari bagian yang paling kasar dimana noise berada, diperlukan proses dekomposisi wavelet sampai dengan level 3. Kemudian klasifikasi dari kasar sampai halus dilakukan ke setiap subband wavelet 2D untuk menentukan wilayah homogen dari noise tersebut. Selanjutnya, Speckle Reducing Anisotropic Diffusion (SRAD) dijalankan pada setiap subband wavelet yang digunakan untuk mendeteksi daerah speckle sebagai fungsi skala speckle. Selanjutnya untuk mengembalikan ukuran citra tersebut diperlukan inverse wavelet. Dan sebagai langkah terakhir untuk memetakan suatu range nilai gray level citra input yang besar dalam level output dengan range yang lebih kecil yang merupakan sifat kebalikan dari proses awal, dilakukan proses gamma correction, namun dengan nilai gamma yang lebih besar dari 1. Parameter terbaik yang dihasilkan dalam percobaan adalah dengan nilai gamma pada tahap awal=0.2, parameter pada tahap SRAD dengan fungsi difusi=2, konstanta gradient threshold K = 105, dan jumlah iterasi = 130. Hasil percobaan menunjukkan bahwa metode yang diusulkan efektif dalam pengurangan speckle serta tetap mempertahankan tepi. Kata Kunci— speckle noise, anisotropic difusi , wavelet.

Pulse compression theory and techniques were developed originally for radar systems but could be carefully adopted for ultrasound-specific problems. In past ten years a considerable amount of research has been done in the area of mismatched filtering for the purpose of its application in ultrasound. However, in a similar way to radar systems for distributed targets, pulse compression has not achieved a success of penetration in commercially available systems.

Imaging of coronary vasa vasorum may lead to assessment of the vulnerable plaque development in diagnosis of atherosclerosis diseases. Dual frequency transducers capable of detection of microbubble super-harmonics have shown promise as a new contrast-enhanced intravascular ultrasound (CE-IVUS) platform with the capability of vasa vasorum imaging. Contrast-to-tissue ratio (CTR) in CE-IVUS imaging can be closely associated with the low frequency transmitter performance. In this paper, transducer designs encompassing different transducer layouts, transmitting frequencies, and transducer materials are compared for optimization of imaging performance. In the layout selection, the stacked configuration showed superior super-harmonic imaging compared with the interleaved configuration. In the transmitter frequency selection, a decrease in frequency from 6.5 MHz to 5 MHz resulted in an increase of CTR from 15 dB to 22 dB when receiving frequency was kept constant at 30 MHz. In the material selection, the dual frequency transducer with the lead magnesium niobate-lead titanate (PMN-PT) 1-3 composite transmitter yielded higher axial resolution compared to single crystal transmitters (70 μm compared to 150 μm pulse length). These comparisons provide guidelines for design of intravascular acoustic angiography transducers.

Ultrasound is one of the diagnostic equipments to diagnose human internal organs, tendons, to capture their size and structure. Ultrasound is usually used for pregnancy, as the images for others' internal organs that are not very clear. The main objective of this paper was to study the enhancement of ultrasound image using filtering technique. The data analyzed by using MatLab program to enhance the contrast within the soft tissues, the gray levels in both enhanced and unenhanced images and noise variance. The main techniques of enhancement used in this study were Top-hat filtering and Deblurring Images Using the Blind Deconvolution Algorithm. In this paper, prominent constraints are firstly preservation of image's overall look; secondly preservation of the diagnostic content in the image and thirdly detection of small low contrast details in diagnostic content of the image.

Cystic echinococcosis (CE) is a chronic, complex, and neglected disease. Its
treatment depends on a number of factors, such as location, size, and stage of
the cysts, and availability of therapeutic options. Despite the wealth of scientific
literature on treatment for echinococcosis, the current management of the disease
is based on poor to moderate quality of evidence and recommendation
strength. In addition, therapeutic strategies have been developed over time
without systematic and adequate evaluation of their efficacy, effectiveness, and
safety. This is due to the lack of large, longitudinal, controlled studies, which in
turn is partly due to the chronicity of the disease which requires a follow-up of
many years. The lack of adequate funding makes these costly trials impossible to
implement. Although the recommended multidisciplinary and stage-specific approach
may be available in referral centers, this is often not the case in many
endemic countries, where the most affected populations have limited access to
diagnosis and therapy, and where the risks associated with invasive procedures

Prosiding Seminar Nasional dan Call For Papers Jurusan Teknik Radiodiagnostik dan Radioterapi, Poltekkes Kemenkes Jakarta II. Penerbitan prosiding ini merupakan dokumentasi karya ilmiah para mahasiswa, dosen dan Alumni dari disiplin ilmu Radiologi terutama Radiodiagnostik dan Radioterapi yang telah dipresentasikan pada tanggal 21 Juli 2020 secara online. Seminar Nasion Radiografi ini diselenggarakan yang pertama, dan merupakan kegiatan rutin tahunan di Jurusan Teknik Radiodiagnostik dan Radioterapi. Seminar dan Presentasi Ilmiah dilakukan  oleh ceramah umum 1 Dr. Achmad Yurianto (Direktur Jendral P2P Kemenkes RI) dengan judul TANTANGAN COVID-19 BAGI INDONESIA DAN DUNIA, ceramah umum 2 Dr. Raden Rara Diah Handayani Sp.P (K) (Department Pulmonologi dan Respiratori) dengan judul UPDATE PENANGANAN PASIEN COVID-19, ceramah umum 3 Eka Syarif Hidayat, S.Pd, M.kes. (Dosen Jurusan Teknik Radiodiagnostik dan Radioterapi Poltekkes Kemenkes Jakarta II) dengan judul PEMELIHARAAN ALAT CT SCAN PADA SAAT PENDEMI COVID-19, ceramah umum 4 Widy Harsanto, S.Si (Clinical Application Specialist CT GE Healthcare) dengan judul UPDATE PEMANFAATAN TEKNOLOGI CT PADA PENANGANAN COVID-19, ceramah umum 5 Samuel Mameasa M.Sc. (Oncology & CT Specialist Siemens Healthcare) dengan judul IMPLEMENTASI ARTIFICIAL INTELLIGENCE (AI) PADA CT . Di dalam buku prosiding ini berisi artikel ilmiah yang telah dipresentasikan dalam Seminar Nasional sebanyak 24 makalah yang disampaikan dalam presentasi ilmiah. tersebut berasal dari Poltekkes Kemenkes Jakarta II (1), Akademika Teknik Radiodiagnostik dan Radioterapi Nusantara (2). Prosiding ini telah melalui proses penilaian dan editing oleh dewan editor/penilai artikel ilmiah serta dilengkapi dengan diskusi dan tanya jawab pada saat seminar berlangsung. Semoga penerbitan prosiding ini dapat bermanfaat sebagai bahan acuan untuk lebih memacu dan mengembangkan penelitian dibidang radiografi yang akan datang.

Estimating the corneal elasticity can provide valuable information for corneal pathologies and treatments. Ophthalmologic pathologies will invariably cause changes to the elasticity of the cornea. For example, keratoconus and the phototoxic effects of ultraviolet radiation usually increase the corneal elasticity. This makes a quantitative estimation of the elasticity of the human cornea important for ophthalmic diagnoses. The present study investigated the use of a proposed high-resolution shear wave imaging (HR-SWI) method based on a dual-element transducer (comprising an 8-MHz element for pushing and a 32-MHz element for imaging) for measuring the group shear wave velocity (GSWV) of the human cornea. An empirical Young's modulus formula was used to accurately convert the GSWV to Young's modulus. Four quantitative parameters, bias, resolution, contrast, and contrast-to-noise ratio (CNR), were measured in gelatin phantoms with two different concentrations (3% and 7%) to evaluate the performance of HR-SWI. The biases of gelatin phantoms (3% and 7%) were 5.88% and 0.78%, respectively. The contrast and CNR were 0.76, 1.31 and 3.22, 2.43 for the two-side and two-layer phantoms, respectively. The measured image resolutions of HR-SWI in the lateral and axial directions were 72 and 140 µm, respectively. The calculated phase SWV (PSWV) and their corresponding Young's modulus from six human donors were 2.45 ± 0.48 m/s (1600 Hz) and 11.52 ± 7.81 kPa, respectively. All the experimental results validated the concept of HR-SWI and its ability for measuring the human corneal elasticity.

TRANSLABIAL ULTRASOUND: “THREE TRACKS” TECHNIQUE.
V.V. Doshchechkyn
Introduction:
there are various options for the application of an ultrasound transducer in transperineal sonography procedure (TPUS), starting from percutaneous scanning of the perineum area by sector transducers and ending with the use of transalabial (TLUS), transvaginal (TVUS) and transrectal access by the intracavitary transducers. In all these cases, it is necessary to identify the relationships of pelvic organs. The ultrasonic technique of the “three tracks” (TTT) allows real-time evaluation of the spatial ratio of the urethra, vagina and rectum, as well as adjacent subjects of the pelvis, visualizing them simultaneously in the same scanning plane.
Objective:
to present the “three track» technique used in the conduct of translabial ultrasonography, and to study the results of revealing the pathology in lower pelvis in comparison with routine transvaginal ultrasonography (TVUS).
Participants, settings, methods:
the study was conducted between January 18, 2016 and November 27, 2017 in the clinic for reproductive medicine “Remedi” (Odesa). Informed consent to the investigation was obtained from all females. 70 patients of the main group underwent translabial ultrasonography in the “three track” technique (TLUS + TTT). 71 women of comparative group underwent a routine transvaginal ultrasonography.
Results and discussion:
visualization of three tracks: urethra, vagina and rectum in one scan plane was achieved in 65 patients of the main group (93%). In addition, in the main group, approximately twice as often as in the comparison group, a rare pathology of the lower pelvis, such as Gartner duct cysts, the Bartolin cysts, the deep endometriosis of the rectovaginal septum and unclassified cysts of the vagina, were found. However, the insufficient number of obtained results does not allow confirming their reliability.
Conclusion:
the using of TTT during TLUS, extends the diagnostic opportunities of the examiner in the evaluation of the relationship of adjacent organs and tissues in the pelvic floor and lower pelvis. The method requires further research and can be used as an additional bonus to improve for accuracy and safety of diagnostic and surgical gynecological practice. There is no conflict of interest to declare.
Keywords: transperineal ultrasound, translabial ultrasound, TPUS, TVUS, TLUS, “three tracks” technique.