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ABSTRACT: Herlyn-Werner-Wunderlich Syndrome is a very rare congenital malformation of the urogenital tract involving both the Mullerian and Wolffian ducts characterized by the triad uterine diadelphys, obstructed vagina, and unilateral renal agenesis. If not diagnosed on time it may progress to adverse gynecological complications making timely diagnosis and treatment crucial. We hereby present a 14-year girl with right flank pain diagnosed as Herlyn-Werner-Wunderlich Syndrome by ultrasound scan which was managed surgically with drainage of hydrocolpos and marsupialization of vaginal septum. On two weeks follow up patient had symptomatic improvement with no any complications.
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Hidrocolpos , Ductos Paramesonéfricos , Vagina , Humanos , Feminino , Adolescente , Hidrocolpos/diagnóstico , Hidrocolpos/complicações , Vagina/anormalidades , Vagina/cirurgia , Ductos Paramesonéfricos/anormalidades , Síndrome , Útero/anormalidades , Útero/cirurgia , Anormalidades Múltiplas , Ultrassonografia/métodos , Anormalidades Urogenitais/complicações , Anormalidades Urogenitais/diagnóstico , Anormalidades Urogenitais/cirurgia , Ductos Mesonéfricos/anormalidades , Drenagem/métodos , Dor no Flanco/etiologia , Rim/anormalidades , Rim/diagnóstico por imagemRESUMO
ABSTRACT: Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) also known as Müllerian agenesis, is caused by embryologic underdevelopment of the Mullerian duct, with resultant agenesis or atresia of the vagina, uterus, or both. Patients usually present with primary amenorrhea with normal growth and pubertal development. Here we present a case of a 29-year-old woman presented with primary amenorrhea. Secondary sexual characteristics and hormone evaluation were normal. Ultrasound and MRI were conducted and revealed complete absence of uterus, small vaginal canal. Bilateral renal fossa were empty and both the kidneys were located in the pelvic cavity fused to one-another with single renal pelvis giving pancake appearance.
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Transtornos 46, XX do Desenvolvimento Sexual , Anormalidades Congênitas , Rim Fundido , Ductos Paramesonéfricos , Humanos , Feminino , Adulto , Transtornos 46, XX do Desenvolvimento Sexual/diagnóstico , Transtornos 46, XX do Desenvolvimento Sexual/complicações , Ductos Paramesonéfricos/anormalidades , Anormalidades Congênitas/diagnóstico , Rim Fundido/complicações , Amenorreia/etiologia , Vagina/anormalidades , Imageamento por Ressonância Magnética , Útero/anormalidades , Ultrassonografia/métodos , Rim/anormalidades , Rim/diagnóstico por imagemRESUMO
Thoracic ultrasound (TUS) is a tool that has become increasingly essential in the daily practice of thoracic medicine. Driven by the need to assess patients during the COVID-19 pandemic, there has been an increase in the use of point-of-care TUS, which has demonstrated several benefits, either as a complement to clinical decision-making for diagnosis or as a real-time guide for procedures, whether as a predictor or measure of treatment response. Here, we present a review of TUS, based on the most recent scientific evidence, from equipment and techniques to the fundamentals of pulmonary ultrasound, describing normal and pathological findings, as well as focusing on the management of lung disease and guidance for invasive thoracic procedures at the bedside. Finally, we highlight areas of perspective and potential lines of research to maintain interest in this valuable tool, in order to improve the diagnostic process and expand the treatment arsenal.
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COVID-19 , Pneumopatias , Ultrassonografia , Humanos , COVID-19/diagnóstico por imagem , Ultrassonografia/métodos , Pneumopatias/diagnóstico por imagem , Sistemas Automatizados de Assistência Junto ao Leito , Pandemias , Pulmão/diagnóstico por imagem , SARS-CoV-2RESUMO
Objectives: Cancer screening aims to detect and treat malignant lesions at an early stage and to prolong patients' lifetime. There is still a lack of effective cancer screening programs in China. We initiated a screening project in 2018 and this study presented the cancer screening status in China. Methods: We conducted a cross-sectional study in one cancer-care medical center of China. The screening program included routine blood tests, plasma tumor markers, gastric endoscopy, colonoscopy, ultrasound, and computed tomography (CT) scans. Screening results were presented as sensitivity, specificity and positive predictive values (PPVs). Results: Twenty-three (1.46%) out of 1,576 participants were eventually diagnosed with malignant tumors or high-grade intraepithelial neoplasia (HGIN). A family history of malignancy (78.26% in diagnosed cancer and HGIN vs. 46.36% in the others) was the only statistically significant parameter associated with cancer detection (p = 0.002). None of the common tumor markers were associated with the cancers screened. Except for colonoscopy (50.00%) and ultrasound for renal cancer (66.67%), the sensitivities of most screening methods were 100%. The specificities of all the screening means were above 96%. Most PPVs ranged from 30-60%. Conclusion: We emphasized risk stratification for early cancer screening, such as a family history of cancer. The survey illustrated that gastric endoscopy, colonoscopy, ultrasound, and lung CT for early cancer screening had high specificity, reasonable sensitivity, and PPV. We anticipated this report would motivate larger-sample studies to estimate the risk-to-benefit ratio of cancer screening and urge the establishment of a native Chinese screening project and even guidelines.
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Detecção Precoce de Câncer , Humanos , Detecção Precoce de Câncer/métodos , China/epidemiologia , Estudos Transversais , Masculino , Pessoa de Meia-Idade , Feminino , Idoso , Adulto , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X , Neoplasias/diagnóstico , Neoplasias/epidemiologia , Neoplasias/diagnóstico por imagem , Biomarcadores Tumorais/sangue , Programas de Rastreamento/métodos , Colonoscopia/estatística & dados numéricos , Ultrassonografia/métodosRESUMO
BACKGROUND: Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain that affects patients' quality of life and functioning. The condition is often associated with tightness of the iliotibial band (ITB) and tendinopathy of the gluteus medius (GMed) tendon, which are subjected to excessive stress and inflammation. A traditional treatment for GTPS is conservative medical management (CMM), which includes but is not limited to physiotherapy, oral anti-inflammatory medication, and/or local steroid injections. Surgery is performed when these treatments fail. The failure of these techniques indicates that some treatments classified as CMM may not be feasible for some patients. OBJECTIVES: This study aimed to evaluate the efficacy and safety of combined GMed and ITB injections for a cohort of CMM-refractory GTPS patients. STUDY DESIGN: A retrospective chart review. SETTING: Single-center, academic hospital. METHODS: Between 01/01/2022 and 12/31/2022, a retrospective analysis of 68 hips that underwent combination GMed-ITB percutaneous ultrasound tenotomy (PUT) was performed. The primary outcome measure was a numeric rating scale (NRS) for hip pain, and the secondary outcome measures were VISA-G (Victorian Institute of Sports Assessment-Gluteal Tendinopathy) scores, sitting-to-standing and walking tolerance, and side-lying tolerance. RESULTS: The patients' NRS scores decreased, and the VISA-G scores and all functional measures increased one year after the procedure, indicating significant improvement in pain and functioning (P < 0.001). Treatment success, defined as 50% reduction in pain and side-lying tolerance, was achieved by 83% of the patients. No major complications were reported. LIMITATIONS: The lack of a comparable cohort reduces the data's interpretative significance. Having a control arm would have enabled a statistical comparison between treated and untreated patients to provide a valid assessment of the procedure's benefit. CONCLUSIONS: This study demonstrated the feasibility and efficacy of combined GMed-ITB PUT as a novel treatment for GTPS in patients who failed CMM. The results showed significant and durable improvement in pain, function, and quality of life at the one-year follow-up. Our study suggests that both ITB and GMed tendons are involved in the pathogenesis of GTPS. The present study compared favorably with previous studies that reported outcomes of either ITB PUT or GMed PUT alone, implying that combining the approaches may offer superior benefits. Furthermore, the study had several strengths, such as the use of a validated outcome measure (VISA-G), the elimination of bias by independent practitioners, and the inclusion of a difficult population with severe pain.
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Tenotomia , Humanos , Tenotomia/métodos , Estudos Retrospectivos , Estudos Longitudinais , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Tendinopatia/cirurgia , Nádegas/cirurgia , Ultrassonografia/métodos , AdultoRESUMO
BACKGROUND: B-mode ultrasound (US) medical imaging is very effective in localizing and describing Peyronie's disease (PD). Moreover, elastography is a new technique used to evaluate tissue elasticity to detect penile Peyronie's plaques that are not visible using standard B-mode US. OBJECTIVE: The main objective of this study was to evaluate the diagnostic efficacy of real-time elastography (RTE) in PD patients and to determine whether its combined use with standard US improved diagnostic accuracy. RTE is also known as strain elastography (SE). Additionally, this study aimed to assess whether RTE was useful for monitoring PD patients undergoing conservative treatment. METHODS: A group of 37 PD patients in the active phase was selected based on US examination showing isoechoic or hypo-isoechoic plaques, with or without associated hyperechoic or calcified plaque areas. All patients underwent traditional US combined with RTE before starting conservative treatment with antioxidants, during treatment and after treatment. After each examination with RTE, a specific "Strain Ratio"(SR) was used to identify the specific elasticity of the tissue. RESULTS: Using B-mode US with RTE, we detected all 13 non-palpable penile plaques present in the 37 PD patients (100% of cases). Using only B-mode US, we detected only 8 of the 13 non-palpable plaques (61.5% of cases). The DI of the plaque decreased during and after treatment in all cases, indicating that RTE is effective for monitoring conservative PD treatment. A statistically significant correlation was found between the DI and plaque volume in all patients (p=0.002). CONCLUSION: Our study has shown that the combination of US and RTE methods allowed for a more accurate diagnosis in PD patients.
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Técnicas de Imagem por Elasticidade , Induração Peniana , Humanos , Masculino , Induração Peniana/diagnóstico por imagem , Técnicas de Imagem por Elasticidade/métodos , Pessoa de Meia-Idade , Idoso , Ultrassonografia/métodos , Adulto , Tratamento ConservadorRESUMO
Knee pain is a common musculoskeletal symptom in the general population and results in significant disability, reducing the quality of life and inducing financial burden to the health care system. This cross-sectional, descriptive type of observational study was conducted with a total 52 patients having symptomatic knee joint disease in the Department of Radiology and Imaging, Mymensingh Medical College Hospital, Bangladesh from April 2019 to September 2020. This study was performed to find out the effectiveness of ultrasonography as a modality of investigation in the determination of knee joint pathologies with comparison to MRI, considering MRI as the gold standard. The majority of the patients 13(25.0%) were in the age group of 15-25 years with mean age was 39.88±15.308 years. In detecting synovial effusion, bursal collection, baker's cyst, tendinopathy and tumor pathologies ultrasound had 100.0% sensitivity, specificity and accuracy for each whether bursitis has 100.0%, 96.4% and 98.07% respectively. MCL tear had 100.0%, 97.8%, 98.07%. LCL tear detection showed 100.0%, 97.8%, 98.07%. PCL tear had 66.7%, 95.9%, 94.2%. ACL tear had 50.0%, 97.6%, 88.4% sensitivity, specificity and accuracy. Meniscal tear showed 66.7%, 97.8%, 88.4% sensitivity and accuracy. In all cases difference was statistically significant with a p value <0.0001 which strongly supported against null hypothesis. From this study, it is concluded that high-resolution USG showed high sensitivity, specificity and accuracy compared to MRI in detecting common knee abnormalities, and could be considered as the first-line imaging modality in the evaluation of knee pain.
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Articulação do Joelho , Imageamento por Ressonância Magnética , Ultrassonografia , Humanos , Imageamento por Ressonância Magnética/métodos , Ultrassonografia/métodos , Adulto , Masculino , Feminino , Estudos Transversais , Adolescente , Articulação do Joelho/diagnóstico por imagem , Pessoa de Meia-Idade , Adulto Jovem , Sensibilidade e Especificidade , Artropatias/diagnóstico por imagem , BangladeshRESUMO
BACKGROUND: The evaluation of lateral ankle laxity remains challenging when diagnosing chronic lateral ankle instability (CLAI). Several studies have reported that internal rotation of the talus as an indicator of rotational lateral ankle laxity (RLAL) increases in patients with CLAI. However, there is no established method for detecting and evaluating the RLAL. This study aimed to report a novel method for evaluating the RLAL in the gravity stress position by measuring the talofibular distance (TFD) using ultrasonography (US) and show the normative value of the TFD. METHODS: The TFDs in the subjects with healthy ankles were prospectively measured 10 mm distal to the ankle joint in the neutral ankle position and gravity stress position using US. The differences in the TFD between the two ankle positions were evaluated. The differences in the TFD by gender and ankle laterality were also evaluated. RESULTS: A total of 52 healthy ankles of 28 subjects (mean age, 24.0 ± 1.6; male/female, 12/16) were finally included. There was a significant difference in the TFD between the neutral ankle position (6.9 ± 0.9 mm) and gravity stress position (9.0 ± 0.9 mm) (p < 0.001). The mean difference in the TFD between the two ankle positions was 2.1 ± 0.6 mm. There were no significant differences in the TFD by gender and ankle laterality. CONCLUSIONS: The present study reported a novel US method for evaluating RLAL by applying gravity stress and the normative value of the TFD.
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Articulação do Tornozelo , Instabilidade Articular , Ultrassonografia , Humanos , Feminino , Masculino , Articulação do Tornozelo/diagnóstico por imagem , Ultrassonografia/métodos , Instabilidade Articular/diagnóstico por imagem , Instabilidade Articular/fisiopatologia , Adulto Jovem , Adulto , Estudos Prospectivos , Rotação , Gravitação , Voluntários Saudáveis , Amplitude de Movimento Articular/fisiologia , Valores de Referência , Ligamentos Laterais do Tornozelo/diagnóstico por imagemRESUMO
PURPOSE: The purpose was to evaluate the pathological nature of focal thyroid uptake seen in 11C-Choline PET/CT performed for prostate cancer. MATERIAL AND METHODS: The study was IRB-approved. All 11C-Choline PET/CT exam reports for studies performed between January 01, 2018, and July 30, 2021, in male patients with prostate cancer in our institution were retrospectively reviewed. Exams with "focal thyroid uptake" on their final report were selected. Patients with surgery or ablation in the thyroid prior to the PET/CT, proven parathyroid adenomas or absent thyroid ultrasound were excluded. Repeated PET/CT exams of same patient were excluded. PET images were analyzed visually and semi-quantitatively by measuring the maximum standardized uptake value (SUVmax) of the focal thyroid uptake. Available thyroid ultrasound images, cytology and pathology reports were reviewed. Statistical analyses were performed. RESULTS: Out of 10,047 sequential 11C-Choline PET/CT studies, 318 reports included "focal thyroid uptake." About 128 of these studies were repeat exams and were excluded. Additional 87 patients were excluded, because the uptake was determined to be adjacent, rather than confined to the thyroid gland. Out of the remaining 103 patients, 74 patients had focal thyroid uptake and concurrent thyroid sonographic evaluation. Out of the 74 focal uptakes evaluated with ultrasound, 21 were presumed benign thyroid nodules based on the ultrasound and 53 had further evaluation with biopsy. Sixty three nodules were benign (21 presumed benign on ultrasound and 42 cytology or surgical pathology-proven), 9 nodules were malignant and 2 remained indeterminate. There was no significant difference between the SUVs of the benign and malignant groups (P > .3). CONCLUSION: In this retrospective study of patients with prostate cancer who underwent 11C-Choline PET/CT, we identified a group of patients who underwent thyroid ultrasound for incidental finding of focal 11C-Choline thyroid uptake. Incidence of malignancy in this group was 12%. Therefore, further investigation with ultrasound and possibly ultrasound-guided biopsy may be warranted when a choline avid thyroid nodule is found incidentally on choline PET.
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Radioisótopos de Carbono , Colina , Achados Incidentais , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias da Próstata , Nódulo da Glândula Tireoide , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Masculino , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Colina/farmacocinética , Estudos Retrospectivos , Idoso , Pessoa de Meia-Idade , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Ultrassonografia/métodos , Idoso de 80 Anos ou mais , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Compostos Radiofarmacêuticos/farmacocinéticaRESUMO
We aimed to evaluate the effectiveness of transperineal ultrasound (TPUS) in diagnosing rectocele, rectal intussusception (RI), enterocele, perineal descent (PD), and cystocele in Chinese women with obstructed defecation syndrome (ODS), and to determine the grading of rectocele via TPUS. Between January 2019 and December 2021, 107 obstructed defecation syndrome patients, with a mean age of 49.76 years, received TPUS and defecation proctography (DEP). Both methods were used to diagnose anorectal angle, rectocele, RI, enterocele, and PD, while cystocele and uterine prolapse were diagnosed only through TPUS. Agreement between DEP and TPUS diagnostic results was compared using Cohen kappa statistics. Seventy-six rectoceles were reported following DEP and 72 after TPUS. DEP detected 7 enteroceles, 6 of which were diagnosed simultaneously by TPUS. 43 patients presented dyssynergic defecation (DD) upon DEP, while 51 upon TPUS. DEP and TPUS detected PD in 13 and 11 patients respectively, and RI in 82 and 73, respectively. Rectocele (kappaâ =â 0.738), RI (kappaâ =â 0.711), DD (kappaâ =â 0.774), enterocele (kappaâ =â 0.847), and PD (kappaâ =â 0.625) were obtained by Cohen kappa statistics, which indicated a good agreement between DEP and TPUS. The cutoff values for the diagnosis of moderate and severe rectocele with TPUS were 12.05 mm (AUC: 0.941) and 18.50 mm (AUC: 0.977), respectively. The DEP-determined and TPUS-determined anorectal angles were significantly correlated in the resting and Valsalva states (Pâ <â .01). Compared with DEP, while maintaining good agreement in detecting rectocele, RI, DD, enterocele, and PD, TPUS is a repeatable and noninvasive alternative. Threshold values of 12.05 mm and 18.50 mm on TPUS may diagnose moderate and severe rectocele, respectively.
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Constipação Intestinal , Defecação , Retocele , Ultrassonografia , Humanos , Feminino , Retocele/diagnóstico por imagem , Retocele/complicações , Pessoa de Meia-Idade , Ultrassonografia/métodos , Constipação Intestinal/diagnóstico por imagem , Constipação Intestinal/diagnóstico , Adulto , Defecação/fisiologia , China , Idoso , Defecografia/métodos , Intussuscepção/diagnóstico por imagem , Intussuscepção/diagnóstico , Períneo/diagnóstico por imagem , Síndrome , População do Leste AsiáticoRESUMO
Transarterial chemoembolization (TACE) is an image-guided minimally invasive treatment for liver cancer which involves delivery of chemotherapy and embolic material into tumor-supplying arteries to block blood flow to a liver tumor and to deliver chemotherapy directly to the tumor. However, the released drug diffuses only less than a millimeter away from the beads. To enhance the efficacy of TACE, the development of microbubbles electrostatically bound to the surface of drug-eluting beads loaded with different amounts of doxorubicin (0-37.5 mg of Dox/mL of beads) is reported. Up to 400 microbubbles were bound to Dox-loaded beads (70-150 microns). This facilitated ultrasound imaging of the beads and increased the release rate of Dox upon exposure to high intensity focused ultrasound (HIFU). Furthermore, ultrasound exposure (1 MPa peak negative pressure) increased the distance at which Dox could be detected from beads embedded in a tissue-mimicking phantom, compared with a no ultrasound control.
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Quimioembolização Terapêutica , Doxorrubicina , Sistemas de Liberação de Medicamentos , Microbolhas , Ultrassonografia , Doxorrubicina/administração & dosagem , Doxorrubicina/química , Sistemas de Liberação de Medicamentos/métodos , Quimioembolização Terapêutica/métodos , Ultrassonografia/métodos , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/terapia , Imagens de Fantasmas , Antibióticos Antineoplásicos/administração & dosagem , Antibióticos Antineoplásicos/química , MicroesferasRESUMO
PURPOSE: To undertake a global assessment of existing ultrasound practices, barriers to access, point-of-care ultrasound (POCUS) training pathways, and the perceived clinical utility of POCUS in Child Surgery. METHODS: An electronic survey was disseminated via the GICS (Global Initiative of Children's Surgery) network. 247 anonymized responses from 48 countries were collated. 71.3% (176/247) worked in child surgery. RESULTS: Ultrasound was critical to practice with 84% (147/176) of requesting one daily or multiple times per week. Only 10% (17/176) could access emergency ultrasound < 1 h from request. The main barrier was a lack of trained personnel. HIC surgeons were more likely to have ultrasound training (24/29; 82.8%) compared with LMICs (74/147; 50.3%) (p = .001319; CI 95%). Self-perceived POCUS competence was associated with regularity of POCUS use (p < 0.001; CI 95%). Those who already practice POCUS most commonly use it for trauma, intussusception, and ultrasound-guided procedures. Majority (90%; 159/176) of child surgeons would attend formal POCUS training if available. CONCLUSIONS: Ultrasound is critically important in children's surgery globally, however, many surgeons experience barriers to timely access. There is a strong interest in learning POCUS for relevant pediatric surgical applications. Further research is needed to evaluate the best methods of training, accreditation, and governance.
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Sistemas Automatizados de Assistência Junto ao Leito , Ultrassonografia , Humanos , Ultrassonografia/métodos , Criança , Inquéritos e Questionários , Pediatria/educação , Saúde Global , Padrões de Prática Médica/estatística & dados numéricosRESUMO
BACKGROUND: Perioperative reflux aspiration presents a grave concern during sedation or general anesthesia, particularly when solid gastric contents prompt acute upper respiratory obstruction, potentially resulting in fatal consequences for patients. Currently, there are limited means for promptly assessing solid gastric contents in clinical settings. Therefore, this study examined the efficacy of ultrasound assessment for solid gastric contents, offering a rapid and non-invasive approach for early detection and decision-making regarding interventions. METHODS: The study included 400 patients scheduled for upper endoscopy procedures, which encompassed both gastroscope and gastroscope combined colonoscopy examinations with sedation. Ultrasound scanning of the antrum was performed while patients were positioned semi-sitting or in the right lateral decubitus (RLD) posture. The evaluation of solid gastric contents relied on direct visual observation during endoscopy. Gastric volume measurement occurred subsequent to endoscopic suction of gastric contents. Receiver operating characteristic curves were utilized to assess the effectiveness of ultrasonography in discerning solid contents. RESULT: Seven patients undergoing gastroscope with sedation were found to have solid gastric contents. The sensitivity, specificity, positive predictive value, and negative predictive value of the ultrasound qualitative evaluation of solid contents were 85.7%, 99%, 60%, and 99.7%, respectively. CONCLUSION: Solid stomach contents can be evaluated qualitatively with reasonable accuracy using ultrasonography. Additionally, in patients undergoing upper endoscopy and assessed to have solid gastric contents with ultrasound, administration of mild sedation is recommended. TRIAL REGISTRATION: www.chictr.org.cn (ChiCTR2100048994); registered 19/07/2021.
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Conteúdo Gastrointestinal , Ultrassonografia , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Conteúdo Gastrointestinal/diagnóstico por imagem , Idoso , Ultrassonografia/métodos , Adulto , Sedação Consciente/métodos , Colonoscopia/métodos , Sensibilidade e Especificidade , Gastroscópios , Estudos ProspectivosRESUMO
In this study, we investigated the capability of the Nakagami transformation to detect changes in vastus lateralis muscle-tendon stiffness (k) during dynamic (and intense) contractions. k was evaluated in eleven healthy males using the gold-standard method (a combination of ultrasound and dynamometric measurements) during maximal and sub-maximal voluntary fixed-end contractions of the knee extensors (20, 40, 60, 80, and 100% of maximum voluntary force), while Nakagami parameters were analysed using the Nakagami transformation during the same contractions. Muscle-belly behaviour was investigated by means of B-mode ultrasound analysis, while Nakagami parameters were obtained in post-processing using radiofrequency data. k was calculated as the slope of the force-muscle-belly elongation relationship. Three contractions at each intensity were performed to calculate the intra-trial reliability and the coefficient of variation (CV) of the Nakagami parameters. At all contraction intensities, high values of intra-trial reliability (range: 0.92-0.96) and low CV (<9%) were observed. k and Nakagami parameters increased as a function of contraction intensity, and significant positive correlations were observed between these variables. These data suggest that changes in mechanical properties (e.g., stiffness) at the muscle level could be investigated by means of Nakagami parameters.
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Contração Muscular , Ultrassonografia , Humanos , Masculino , Adulto , Contração Muscular/fisiologia , Ultrassonografia/métodos , Adulto Jovem , Fenômenos Biomecânicos , Músculo Esquelético/fisiologia , Músculo Esquelético/diagnóstico por imagem , Tendões/fisiologia , Tendões/diagnóstico por imagem , Músculo Quadríceps/fisiologia , Músculo Quadríceps/diagnóstico por imagemRESUMO
Medical Speed-of-sound (SoS) imaging, which can characterize medical tissue properties better by quantifying their different SoS, is an effective imaging method compared with conventional B-mode ultrasound imaging. As a commonly used diagnostic instrument, a hand-held array probe features convenient and quick inspection. However, artifacts will occur in the single-angle SoS imaging, resulting in indistinguishable tissue boundaries. In order to build a high-quality SoS image, a number of raw data are needed, which will bring difficulties to data storage and processing. Compressed sensing (CS) theory offers theoretical support to the feasibility that a sparse signal can be rebuilt with random but less sampling data. In this study, we proposed an SoS reconstruction method based on CS theory to process signals obtained from a hand-held linear array probe with a passive reflector positioned on the opposite side. The SoS reconstruction method consists of three parts. Firstly, a sparse transform basis is selected appropriately for a sparse representation of the original signal. Then, considering the mathematical principles of SoS imaging, the ray-length matrix is used as a sparse measurement matrix to observe the original signal, which represents the length of the acoustic propagation path. Finally, the orthogonal matching pursuit algorithm is introduced for image reconstruction. The experimental result of the phantom proves that SoS imaging can clearly distinguish tissues that show similar echogenicity in B-mode ultrasound imaging. The simulation and experimental results show that our proposed method holds promising potential for reconstructing precision SoS images with fewer signal samplings, transmission, and storage.
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Algoritmos , Imagens de Fantasmas , Ultrassonografia , Ultrassonografia/métodos , Processamento de Imagem Assistida por Computador/métodos , Processamento de Sinais Assistido por Computador , HumanosRESUMO
OBJECTIVE: We assessed microvessel flow within peripheral nerves using nerve sonography in patients with peripheral neuropathy. METHODS: This study included consecutive patients with peripheral neuropathy who were admitted to our hospital. The patients were divided into two groups: inflammatory neuropathies for immune-mediated neuropathies, such as Guillain - Barré syndrome and chronic inflammatory demyelinating polyneuropathy, and the rest were defined as non-inflammatory neuropathies. We assessed nerve size and intraneural blood flow at four sites on each median and ulnar nerve. Blood flow was evaluated using color Doppler imaging, advanced dynamic flow (ADF), and superb microvascular imaging (SMI) techniques. RESULTS: Thirty-nine patients (median age, 60.0 years; 20 male) were enrolled in this study. An increase in intraneural blood flow was observed in five patients when evaluated by color Doppler, five patients by ADF, and 13 patients by SMI. An overall analysis of the three methods showed that intraneural blood flow was significantly higher in patients with inflammatory neuropathy than in those with non-inflammatory neuropathy (54.2% vs. 0%, p = 0.0005). CONCLUSIONS: Intraneural hypervascularization is more frequent in patients with inflammatory neuropathy than in those with non-inflammatory neuropathy. SIGNIFICANCE: Evaluation of microvessel flow within peripheral nerves may contribute to the diagnosis of peripheral neuropathy.
Assuntos
Microvasos , Doenças do Sistema Nervoso Periférico , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Microvasos/diagnóstico por imagem , Microvasos/fisiopatologia , Doenças do Sistema Nervoso Periférico/fisiopatologia , Doenças do Sistema Nervoso Periférico/diagnóstico por imagem , Adulto , Ultrassonografia/métodos , Ultrassonografia Doppler em Cores/métodos , Nervo Mediano/diagnóstico por imagem , Nervo Mediano/fisiopatologia , Nervo Ulnar/diagnóstico por imagem , Nervo Ulnar/fisiopatologia , Idoso de 80 Anos ou maisRESUMO
BACKGROUND: Liver fibrosis can progress to end-stage cirrhosis and liver cancer. Mesenchymal stem cells (MSCs) were considered the most promising therapeutic strategy, but most of the MSCs injected intravenously traditionally are trapped in the lungs, rapidly reducing their survival ability. MSC spheroids cultured in 3D have shown higher tolerance to fluid shear stress and better survival than dissociated MSCs. Simulating the route of orthotopic liver transplantation, transplanting MSC spheroids into the liver via hepatic portal vein may impact superior therapeutic effects. METHODS: In the present study, human umbilical cord-derived MSC spheroids (hUC-MSCsp) were transplanted into rhesus monkey models of liver fibrosis via B-ultrasound-guided percutaneous portal vein puncture with minimized body invasion. The therapeutic effect is evaluated through hematology, ultrasound, and pathology. To study the effect of hUC-MSCsp on gene expression in rhesus monkeys with liver injury, transcriptome sequencing analysis was performed on the livers of rhesus monkeys. The distribution of transplanted hUC-MSCsp was traced with RNA scope technology. RESULTS: We found that hUC-MSCsp significantly restored liver function, including ALT, AST, ALB, GLOB and bilirubin. hUC-MSCsp also significantly reduced liver collagen deposition and inflammatory infiltration, and promote dismission of liver ascites. Subsequently, the therapeutic effects were further validated in TGF-ß1/Smad pathway by global transcription profile. The distribution of transplanted hUC-MSCsp were also tracked, and we found that hUC-MSCsp distributed in the liver in a sphere status at 1 h after transplantation. After 16 days, the hUC-MSCsp were dispersed into dissociated cells that were predominantly distributed in the spleen, and a significant number of dissociated cells were still present in the liver. CONCLUSIONS: This study reveals the distributions of transplanted hUC-MSCsp after liver portal vein transplantation, and provides a novel approach and new insights into the molecular events of potential molecular events underlying the treatment of liver fibrosis with hUC-MSCsp.
Assuntos
Cirrose Hepática , Macaca mulatta , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais , Veia Porta , Cordão Umbilical , Animais , Humanos , Transplante de Células-Tronco Mesenquimais/métodos , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/citologia , Cordão Umbilical/citologia , Cirrose Hepática/terapia , Cirrose Hepática/patologia , Modelos Animais de Doenças , Esferoides Celulares/metabolismo , Ultrassonografia/métodos , Fígado/patologia , Fígado/metabolismoRESUMO
The gallbladder (GB) is a small pouch and a deep tissue placed under the liver. GB Cancer (GBC) is a deadly illness that is complex to discover in an initial phase. Initial diagnosis can significantly enhance the existence rate. Non-ionizing energy, low cost, and convenience make the US a general non-invasive analytical modality for patients with GB diseases. Automatic recognition of GBC from US imagery is a significant issue that has gained much attention from researchers. Recently, machine learning (ML) techniques dependent on convolutional neural network (CNN) architectures have prepared transformational growth in radiology and medical analysis for illnesses like lung, pancreatic, breast, and melanoma. Deep learning (DL) is a region of artificial intelligence (AI), a functional medical tomography model that can help in the initial analysis of GBC. This manuscript presents an Automated Gall Bladder Cancer Detection using an Artificial Gorilla Troops Optimizer with Transfer Learning (GBCD-AGTOTL) technique on Ultrasound Images. The GBCD-AGTOTL technique examines the US images for the presence of gall bladder cancer using the DL model. In the initial stage, the GBCD-AGTOTL technique preprocesses the US images using a median filtering (MF) approach. The GBCD-AGTOTL technique applies the Inception module for feature extraction, which learns the complex and intrinsic patterns in the pre-processed image. Besides, the AGTO algorithm-based hyperparameter tuning procedure takes place, which optimally picks the hyperparameter values of the Inception technique. Lastly, the bidirectional gated recurrent unit (BiGRU) model helps classify gall bladder cancer. A series of simulation analyses were performed to ensure the performance of the GBCD-AGTOTL technique on the GBC dataset. The experimental outcomes inferred the enhanced abilities of the GBCD-AGTOTL in detecting gall bladder cancer.