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1.
Significance of nuclear medicine scan in comparison with diethylenetriamine pentaacetic acid and ultrasound imaging in diagnosing renal disorders: An observational study.
Bafaraj, SM
Medicine. 2020;(36):e22038
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Abstract
The effectiveness of diethylenetriamine pentaacetic acid scan is regularly monitored for the assessment of any potential modifications in treatment responses or kidney functions in the pediatric population.This study attempts to compare the usefulness of diethylenetriamine pentaacetic acid and ultrasound imaging of renal disorders among paediatric patients.A retrospective observational study was conducted by enrolling 106 children. The demographic details such as: participant's age, gender, and the history of renal disease of each patient were recorded. Patients were administered radiopharmaceuticals in a fixed dose and were later subjected to computed tomography (CT) scan. The obtained data was analysed using descriptive statistics.Findings indicated increased sensitivity for CT (61.20%); whereas, a major decrease in specificity (23.68%) was observed. Comparison of Single-photon emission CT (SPECT) and CT findings revealed the increased sensitivity (90.90%) for ultrasound; whereas, there was a slight decrease in the specificity (40%) for SPECT. However, SPECT findings show 91% sensitivity among patients with 71.42% positive predictive value. Moreover, an increase in sensitivity for CT (61.20%), followed by a major decrease in specificity (23.68%) was observed.Ultrasonography has been proved to be the safest and the most effective method for the diagnosis and the treatment of most renal disorders, due to the higher predictive value of SPECT scans. It is thus suggested that patients with ureteral calculi should be diagnosed with renal scintigraphy and unenhanced helical computerized tomography.
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Association between ICS POP-Q coordinates and translabial ultrasound findings: implications for definition of 'normal pelvic organ support'.
Dietz, HP, Kamisan Atan, I, Salita, A
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2016;(3):363-8
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Abstract
OBJECTIVES Female pelvic organ prolapse is quantified on clinical examination using the pelvic organ prolapse quantification system of the International Continence Society (ICS POP-Q). Pelvic organ descent on ultrasound is strongly associated with symptoms of prolapse, but associations between clinical and ultrasound findings remain unclear. This study was designed to compare clinical examination and imaging findings, especially regarding cut-offs for the distinction between normal pelvic organ support and prolapse. METHODS This was a retrospective study using 839 archived datasets of women referred to a tertiary urogynecological center for symptoms of lower urinary tract and pelvic floor dysfunction between June 2011 and May 2013. The main outcome measures were the maximum downward displacement of the anterior vaginal wall (point Ba), the cervix (point C) and the posterior vaginal wall (point Bp), the length of the genital hiatus (Gh) and the length of the perineal body (Pb), as defined by the ICS POP-Q; explanatory parameters were measures of pelvic organ descent on translabial ultrasound, ascertained by offline volume data analysis at a later date, by an operator blinded to all other data. RESULTS Full datasets were available for 825 women. On clinical examination, 646 (78.3%) were found to have prolapse of at least POP-Q Stage 2. All coordinates on clinical examination were strongly associated with the ultrasound measurements of pelvic organ descent (P < 0.001). These relationships were almost linear, especially for the anterior compartment. CONCLUSIONS There is a near linear relationship between sonographic and clinical measures of prolapse. Previously proposed cut-offs to define 'significant prolapse' on ultrasound and POP-Q (Ba ≥ -0.5 and cystocele ≥ 10 mm below the symphysis pubis, C ≥ -5 and uterine position of 15 mm above the symphysis pubis, Bp ≥ -0.5 and rectocele ≥ 15 mm below the symphysis pubis) are plausible and mutually consistent. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
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Oral and I.V. contrast enhanced ultrasonography of the digestive tract--a useful completion of the B-mode examination: a literature review and an exhaustive illustration through images.
Neciu, C, Badea, R, Chiorean, L, Badea, AF, Opincariu, I
Medical ultrasonography. 2015;(1):62-73
Abstract
Contrast enhanced ultrasonography, using i.v. and/or oral/rectal contrast agents, represents a technical development of the US method, which has proved its applicability in the qualitative and quantitative assessment of the normal and pathological circulatory bed, as well as of the digestive lumen. The use of microbubbles and harmonics opens a new horizon in the detection and characterization of the inflammatory and tumoral conditions of the digestive tract. The interpretation of the data requires corroboration with the grey scale aspect of the examined lesion/area, as well as with the clinical context of the case and the results of other diagnosis techniques. The purpose of this paper is to review the main applications of CEUS in digestive tract pathology by analyzing the significant literature and guidelines in the light of our personal experience and demonstrating it through suggestive images.
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Double-contrast-enhanced sonography for diagnosis of rectal lesions with pathologic correlation.
Lu, M, Yan, B, Song, J, Ping, W, Yue, LX, Song, B
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 2014;(4):575-83
Abstract
OBJECTIVES Transabdominal sonography with a gastrointestinal contrast agent has been widely used in China for investigation of digestive disorders. Double-contrast-enhanced sonography combines a gastrointestinal luminal contrast agent with an intravenous contrast agent for imaging of lesions. The purpose of this pilot study was to assess the value of double-contrast-enhanced sonography for preoperative diagnosis of rectal lesions. METHODS We conducted a prospective single-center study using double-contrast-enhanced sonography of rectal lesions. Patients were administered both rectal and intravenous contrast agents, and imaging was performed transabdominally, transanally, and transrectally. Morphologic characteristics and perfusion parameters were compared between histologically proven adenocarcinomas, adenomas, and inflammatory masses. Perfusion parameters were analyzed with time-intensity curves, measuring the contrast arrival time, time to peak, peak intensity, and area under the curve of the lesions and normal rectal tissue. RESULTS From January 2009 to September 2012, 420 patients were recruited, with 227 patients meeting inclusion/exclusion criteria and having 232 rectal lesions analyzed (172 rectal adenocarcinomas, 45 adenomas, and 15 inflammatory masses). Adenocarcinomas had variable enhancement patterns. Adenomas were all hypoenhanced in a homogeneous pattern. Inflammatory masses had a hyperenhanced rim with no central enhancement. Time-intensity curve perfusion parameters (arrival time, time to peak, peak intensity, and area under the curve) of rectal adenocarcinomas, adenomas, and inflammatory masses were significantly different compared to normal rectal tissue (P < .05). The differences in the arrival time, peak intensity, and time to peak among the different lesions were also significant (P < .05). CONCLUSIONS Double-contrast-enhanced sonographic assessment of morphologic enhancement patterns combined with vascularity parameters may help differentiate benign and malignant rectal lesions.
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Role of dynamic contrast-enhanced sonography for characterization and monitoring of extramedullary myeloma: comparison with serologic data.
Pintoffl, JP, Weisel, K, Schulze, M, Maksimovic, O, Claussen, CD, Kramer, U, Horger, M
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 2013;(10):1777-88
Abstract
OBJECTIVE To measure blood perfusion in extramedullary myeloma by contrast-enhanced sonography, correlate it with specific hematologic parameters, and determine their utility for local and systemic response monitoring. METHODS Twenty-five consecutive patients (14 male and 11 female; median age, 68 years) with extramedullary myeloma were included. After intravenous administration of 2.4 mL of sulfur hexafluoride, extramedullary myeloma masses were examined for 60 seconds. All patients underwent contrast-enhanced sonography at baseline, and 15 were monitored additionally (3 weeks during therapy). Average peak perfusion, regional blood flow (RBF), and regional blood volume (RBV) were calculated. Baseline perfusion parameters were compared with short-term follow-up sonographic data and serologic biomarkers (M gradient). For validation of extramedullary myeloma and systemic myeloma, patients underwent midterm (<3 months) imaging and serologic diagnosis. RESULTS Patients with baseline β2-microglobulin (B2M) greater than 3.5 mg/L (n = 17) showed higher perfusion parameters compared with baseline B2M less than 3.5 mg/L (n = 8). At short-term follow-up, patients were classified by serologic criteria as responders (n = 9) and nonresponders (n = 6) and by sonographic criteria as responders (n = 10) and nonresponders (n = 5). In sonographic responders, mean peak, RBV, and RBF dropped from 59.13, 1446.09, and 71.52 (artificial units) at baseline to 29.30, 364.19, and 34.64 at follow-up (P < .05), whereas in nonresponders, perfusion parameters increased from 33.18, 789.82, and 36.92 at baseline to 51.14, 1491.06, and 65.34 at follow-up (P > .05). Prediction of a midterm course of systemic myeloma using serologic data yielded sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 0.66, 0.77, 0.66, and 0.77, whereas sonographic results (judged by RBV) yielded values of 0.66, 0.55, 0.5, and 0.71. Separate prediction of a local (extramedullary myeloma) response by sonography yielded sensitivity, specificity, PPV, and NPV of 0.8, 1.0, 1.0, and 0.71. CONCLUSIONS Contrast-enhanced sonography is a valuable tool for short-term monitoring of the treatment response in extramedullary myeloma.
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Comparison of Kupffer-phase Sonazoid-enhanced sonography and hepatobiliary-phase gadoxetic acid-enhanced magnetic resonance imaging of hepatocellular carcinoma and correlation with histologic grading.
Sugimoto, K, Moriyasu, F, Saito, K, Taira, J, Saguchi, T, Yoshimura, N, Oshiro, H, Imai, Y, Shiraishi, J
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 2012;(4):529-38
Abstract
OBJECTIVES To determine the relative wash-out of hepatocellular carcinomas and dysplastic nodules using Kupffer-phase sonography with Sonazoid (Daiichi-Sankyo, Tokyo, Japan) enhancement and hepatobiliary-phase gadoxetic acid-enhanced magnetic resonance imaging (MRI) in the evaluation of the histopathologic grades of individual nodules. METHODS This retrospective study included 66 consecutive patients with 78 histologically confirmed hepatocellular carcinomas and dysplastic nodules. In patients with carcinomas, 33 were well differentiated; 29 were moderately differentiated; and 11 were poorly differentiated; and there were 5 dysplastic nodules. All patients underwent both gadoxetic acid-enhanced MRI and Sonazoid-enhanced sonography. The interval between the two imaging examinations was less than 30 days. Six radiologists independently reviewed both images and rated the degree of relative wash-out between the tumorous and nontumorous areas on Kupffer- and hepatobiliary-phase images using a continuous rating scale. We compared these results with the histopathologic grade of each nodule, and the results were then analyzed with multireader multicase receiver operating characteristic analysis. RESULTS The average Kupffer-phase (P < .001) and hepatobiliary-phase (P = .004) rating scores increased as the carcinomas became less differentiated (Kruskal-Wallis test). The diagnostic accuracies of the average area under the receiver operating characteristic curve, which were estimated using the confidence levels of the relative wash-out of the Kupffer- and hepatobiliary-phase images, were 0.705 and 0.785 for dysplastic nodules versus well-, moderately, and poorly differentiated carcinomas (P = .517), 0.791 and 0.687 for dysplastic nodules and well-differentiated carcinomas versus moderately and poorly differentiated carcinomas (P = .093), and 0.871 and 0.716 for dysplastic nodules and well-and moderately differentiated carcinomas versus poorly differentiated carcinomas (P = .005), respectively. CONCLUSIONS Kupffer-phase Sonazoid-enhanced sonography and hepatobiliary-phase gadoxetic acid-enhanced MRI may be useful in estimating the histologic grade, although Kupffer-phase Sonazoid-enhanced sonography may be more accurate in distinguishing hepatocellular carcinomas, especially moderately and poorly differentiated types.
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[Contrast-enhanced ultrasound in musculoskeletal diseases].
Mouterde, G, Carotti, M, D'Agostino, MA
Journal de radiologie. 2009;(1 Pt 2):148-55
Abstract
Contrast-enhanced US (ultrasonography) can be used for the study of musculoskeletal diseases but this application still belongs to clinical research. Despite a theoretical value for the identification of microvascularity, the technical limitations of musculoskeletal US are challenging the use of contrast enhanced US. This can explain the slow development of this application and the reason why it remained limited to the assessment of Doppler signal intensity increase. However, the recent availability of real time contrast-enhanced US imaging and quantification data is very promising. The majority of published papers involves rheumatoid arthritis and demonstrates the value of this technique to improve diagnosis, stage the activity of the disease and follow the patients under therapy. These preliminary studies are extending to other disorders (inflammatory arthritides as well as degenerative disorders). Structures other than articular synovium are undergoing investigations (bone, enthesis). New applications are being developed such as contrast-enhanced US of muscular diseases. This new imaging technique appears to have great potentials for the assessment of musculoskeletal diseases.
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An update on contrast echocardiography.
Chelliah, R, Senior, R
Minerva cardioangiologica. 2009;(4):483-93
Abstract
Ultrasound contrast agents, used with contrast-specific imaging techniques, have an established role for diagnostic cardiovascular imaging in the echocardiography laboratory. The advent of tissue harmonic imaging, albeit a significant advancement in ultrasound technology, still fail to produce diagnostically useful images in a significant proportion of patients. This therefore, often leads to inaccurate assessment of left ventricular function, neccesitating the use of other more laborious and expensive imaging techniques purely for diagnostic purposes. Historically, contrast agents have not been an integral component of the echocardiography imaging laboratory. However the need for a more robust method for the assessment of left ventricular function facilitated the developement of a unique class of contrast agents composed of microbubbles, which together with ultrasound, produce opacification of the left ventricular cavity, thus enabling accurate quantification of its function. The use of these contrast agents have now gone beyond the assessment of wall motion and function to the assessment of myocardial perfusion. Myocardial contrast echocardiography has enabled the assessment of cardiac anatomy, function and perfusion, all in one sitting, by the bedside. Contrast ultrasound imaging has now been applied to even newer techniques such as real-time three-dimensional echocardiography and is also showing promise in the assessment of carotid ultrasound for intima-media thickness. Contrast agents therefore have a significant role in cardiovascular diagnostics and its use can only improve patient care.
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Contrast-enhanced ultrasonography versus computed tomographic angiography in the monitoring of patients after endovascular repair of abdominal aortic aneurysm -- preliminary experience.
Ustymowicz, A, Janica, J, Kowalewski, R, Lewszuk, A, Lukasiewicz, A, michalak, P, Waszczeniuk-Sobotko, O
Nuclear medicine review. Central & Eastern Europe. 2009;(2):95-8
Abstract
BACKGROUND Computed tomographic angiography (CTA) is routinely used in the monitoring of patients after endovascular repair of abdominal aortic aneurysm. The aim of the study was to determine if contrast-enhanced ultrasonography (CEUS) provides equivalent results to CTA in detection of endo-leaks in patients after abdominal aortic stentgraft placement. MATERIAL AND METHODS In a group of 7 patients (6 men and 1 woman; aged 71+/-7 years) after repair procedure, 16 CTA and 16 CEUS follow-up examinations were performed. Second-generation contrast agent (Sonovue) and low-mechanical index technique were used for ultrasonography imaging. RESULTS Computed tomographic angiography showed seven cases of type I, five cases of type II, and no endo-leaks in four examinations. In 15 out of 16 studies, the results of CEUS were consistent with the results of CTA. In one discrepant study, type II endo-leak was detected with CEUS while CTA was negative. CONCLUSIONS Contrast-enhanced ultrasonography and CTA examinations in patients after endovascular repair of abdominal aortic aneurysm provide comparable results. CEUS may be considered an alternative technique to CTA.
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Does hydration matter in ultrasound measurement of renal lengths in children?
Er, A, Aydin, B, Nayir, T
Pediatric nephrology (Berlin, Germany). 2008;(8):1371-2