bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasonographic Features of Focal Xanthogranulomatous Pyelonephritis
Authors: Kim Jongchul
Published: January 2017

Objective. To analyze the ultrasonographic features of focal xanthogranulomatous pyelonephritis. Methods. Ultrasonographic features of 15 patients with pathologically proved focal xanthogranulomatous pyelonephritis were retrospectively analyzed by 2 radiologists who reached a consensus, in terms of the location, margin, size, and echo texture of the mass, associated calculi, lymphadenopathy, or local extension, in comparison with computed tomographic and clinical findings. Results. At ultrasonography, 12 (80%) of 15 masses were well circumscribed. The maximal sizes of the masses ranged from 2.5 to 5.8 (mean, 3.8) cm. Thirteen solid masses (87%) were hyperechoic (n = 7), hypoechoic (n = 4), or isoechoic (n = 4) to the renal cortex, and the preoperative diagnosis was either renal cell carcinoma (n = 11) or Wilms tumor (n = 2). The preoperative diagnosis of the other 2 cystic lesions (13%) was renal abscess. Renal calculi were found in 1 case, but lymphadenopathy or local extension was not depicted. Clinical inflammatory signs were found in 11 of 15 patients. Conclusions. There were no specific ultrasonographic features that allow for the distinction between focal xanthogranulomatous pyelonephritis and renal tumors or abscesses. Focal xanthogranulomatous pyelonephritis should be considered when there are clinical signs of infection or inflammation and a focal solid mass is seen on ultrasonography.
Sonographic Appearances in Cysticercosis
Authors: Vijayaraghavan S. Boopathy
Published: January 2017

Objective. To describe the sonographic appearances of cysticercosis. Methods. Sonography was performed with both convex and linear array transducers in 4 patients with different symptoms. Results. In 2 patients, an intramuscular fluid collection was seen with a cysticercus cyst in it. In 1 patient, an irregular cyst with a small fluid collection on 1 side was seen. In the last patient, multiple elliptical millet seed–shaped calcifications were seen in the liver, mesentery, and retroperitoneal fat. Conclusions. Four different sonographic appearances of soft tissue cysticercosis are described.
Accuracy of Diagnosis of Retained Products of Conception After Dilation and Evacuation
Authors: Maslovitz Sharon , Almog Benjamin , Sheffer Mimouni Galit , Jaffa Ariel , Lessing Joseph B. , Many Ariel
Published: January 2017

Objective. Uterine re‐evacuation samples taken in cases of suspected residua after curettage are occasionally negative for gestational tissue. We aimed at evaluating the occurrence of such postcurettage re‐evacuation–negative samples and at exploring factors that may influence their occurrence. Methods. This was a cross‐sectional comparative retrospective study of 69 consecutive women who underwent uterine re‐evacuation for suspected postcurettage gestational remnants. Pathologic reports of samples drawn during re‐evacuations were reviewed to determine whether the extracted tissue contained gestational tissue. The presence of factors that may influence the rate of a positive or negative sample (eg, sonographic findings, gestational age at initial procedure, and presenting symptom) was noted and compared between women with and without histologically verified remnants. Results. Twenty‐eight (41%) of the re‐evacuation samples were histopathologically positive for gestational remnants. Residual tissue was more commonly found when the initial evacuation was performed at a more advanced gestational age (>15 weeks). Women referred by emergency department attendants had significantly fewer positive samples. Normal expert sonographic examination practically excluded yielding samples. Conversely, no negative samples were preceded by sonographic reports mentioning residua. Conclusions. Most re‐evacuation samples taken during a re‐evacuation procedure for suspected residua are negative for gestational tissue. Parameters that are likely related to histologically confirmed gestational residual tissue are advanced gestational age at initial evacuation, level of the sonographer's skill, persistent bleeding as the presenting symptom, and a sonographic report specifically mentioning retained gestational tissue.
Imaging of Adnexal Masses in Pregnancy
Authors: Chiang Gloria , Levine Deborah
Published: January 2017

Objective. To illustrate the imaging appearances of a variety of adnexal masses in pregnancy. Methods. Cases of adnexal masses in pregnancy were chosen to illustrate the appearance on ultrasonography and magnetic resonance imaging. Results. Adnexal masses in pregnancy have a wide spectrum of imaging characteristics and clinical manifestations. Sonography is important in diagnosing, monitoring, and determining the malignant potential of these masses. Common adnexal lesions seen in pregnancy include simple cysts, hemorrhagic cysts, leiomyomas, and hyperstimulated ovaries in patients who have undergone assisted fertility. Uncommon adnexal lesions specific to pregnancy include hyperreactio luteinalis, theca lutein cysts with moles, and luteomas. Adnexal masses associated with pain include ovarian torsion and heterotopic pregnancy. Adnexal lesions that are found incidentally include teratomas, endometriomas, hydrosalpinx, cystadenomas, and cystadenocarcinomas. When the diagnosis of the adnexal mass cannot be made on the basis of sonographic appearance alone, magnetic resonance imaging may help. Conclusions. Familiarity with the clinicopathologic and sonographic features of common and uncommon adnexal masses in pregnancy is important for diagnosis and treatment.
Second‐Trimester Sonographic Comparison of the Lower Uterine Segment in Pregnant Women With and Without a Previous Cesarean Delivery
Authors: Sambaziotis Hera , Conway Christine , Figueroa Reinaldo , Elimian Andrew , Garry David
Published: January 2017

Objective. To compare measurements of the lower uterine segment during a second‐trimester sonographic examination in women with and without a previous cesarean delivery. Methods. Women undergoing second‐trimester sonographic examination, 24 with a history of cesarean delivery and 30 control subjects with no history of cesarean delivery, were recruited for transvaginal sonographic evaluation of the lower uterine segment with a high‐frequency probe. The uterine niche or previous cesarean scar site was defined as a small triangular anechoic defect in the anterior wall of the uterus. The uterine wall thickness was measured successively at the level where the bladder dome meets the lower uterine segment. Measurements were obtained with cursors at the interface of the urine‐bladder and the amniotic fluid‐decidua. The study was approved by the Institutional Review Board, and P < .05 was considered significant. Results. The uterine niche was identified in 14 (58%) of 24 women with a previous cesarean delivery. The lower uterine segment was significantly thinner in women with a previous cesarean delivery compared with control subjects (mean ± SD, 4.7 ± 1.1 versus 6.6 ± 2.0 mm; P < .001). In the previous cesarean group, the mean lower uterine segment thickness was similar in the 5 women with 2 cesarean deliveries when compared with those with 1 cesarean delivery (4.6 ± 1.0 versus 4.7 ± 1.4 mm; P = .91). In a linear regression model, the only variable retaining significance in the prediction of uterine wall thickness was previous cesarean delivery (P = .002). Maternal age, parity, number of previous cesarean deliveries, and gestational age did not attain significance in the model. Conclusions. The lower uterine segment during a second‐trimester sonographic examination is significantly thinner in women with a previous cesarean delivery. Identification of the scar niche is possible in most of these women.
Sonography in the Diagnosis of Cervical Recurrence in Patients With Differentiated Thyroid Carcinoma
Authors: do Rosário Pedro Weslley Souza , Fagundes Tales Alvarenga , Maia Frederico Fernandes Ribeiro , Franco Ana Cristina Horta Messias , Figueiredo Manoela Bertozzi , Purisch Saulo
Published: January 2017

Objective. To determine the sensitivity of thyroglobulin (Tg), iodine scanning, and sonography in the diagnosis of cervical recurrence of thyroid cancer. Methods. This prospective study assessed 81 patients with cervical metastases or extrathyroid invasion at first appearance who underwent clinical examination, scanning, measurement of Tg after thyroxine withdrawal, and sonography about 8 months after thyroidectomy followed by radioiodine treatment. Only patients without distant metastases and without anti‐Tg antibodies were included. Results. Fifty patients showed persistence of the disease in the cervical region, with only 16% of them having had a suspicion on clinical examination, 33 with Tg levels of 2 ng/mL or greater (66% sensitivity), and 29 with positive scan findings (58% sensitivity). A combination of the 2 methods detected disease in 40 (80%) of 50 patients but failed to show 20% of cases that were identified by sonography and confirmed by fine‐needle aspiration. Sonography had sensitivity of 96%. Specificity values for Tg, iodine scanning, and sonography were 80.6%, 90.3%, and 87%, respectively. Conclusions. Classic follow‐up methods may not detect cervical disease in some patients with differentiated thyroid carcinoma, and sonography is necessary even in patients apparently free of the disease.
Validation of the Depletion Kinetic in Semiquantitative Ultrasonographic Cerebral Perfusion Imaging Using 2 Different Techniques of Data Acquisition
Authors: Eyding Jens , Wilkening Wilko , Krogias Christos , Hölscher Thilo , Przuntek Horst , Meves Saskia , Postert Thomas
Published: January 2017

Objective.To validate the potential of ultrasonographic depletion imaging for semiquantitatively visualizing cerebral parenchymal perfusion with contrast burst depletion imaging (CODIM) in comparison with phase inversion harmonic depletion imaging (PIDIM) in healthy volunteers. Methods.Thirteen healthy adults were examined with both CODIM and PIDIM in accordance with previously described criteria. In addition to the perfusion coefficient, the time to decrease image intensity to 10% above equilibrium intensity from the initial value and the relative error (deviation of measured data from the fitted model) were evaluated to compare the reliability of both techniques in 3 different regions of interest. Results.Perfusion coefficient values did not show significantly differing values in both groups (1.57–1.64 • 10−2 s−1 for CODIM and 1.42–1.58 • 10−2 s−1 for PIDIM). The relative error was significantly smaller in the PIDIM group (0.38–0.53 for CODIM and 0.18–0.25 for PIDIM; P < .002). Conclusions. Phase inversion harmonic depletion imaging proved to be more reliable than CODIM because values of the relative error were significantly lower in PIDIM even in this relatively small cohort. This is of interest because the underlying technique, phase inversion harmonic imaging, is more widely available than contrast burst imaging.
Three‐Dimensional Color‐Coded Duplex Sonography for Assessment of the Vertebral Artery Origin and Vertebral Artery Stenoses
Authors: Harrer Judith U. , Wessels Tiemo , Poerwowidjojo Sandra , Möller-Hartmann Walter , Klötzsch Christof
Published: January 2017

Objective. The aim of the study was to assess the potential of 3‐dimensional (3D) color‐coded duplex sonography (CDS) for evaluation of the vertebral artery origin and stenoses in this location. Methods. To compare 2‐dimensional (2D) and 3D CDS, both techniques were performed in 25 healthy volunteers and in 18 patients with 21 stenoses of the vertebral artery origin. Stenoses were graded in line with hemodynamic criteria on 2D CDS and according to North American Symptomatic Carotid Endarterectomy Trial criteria on 3D CDS. In 6 patients, digital subtraction angiography (DSA) was performed additionally. Stenoses were graded according to North American Symptomatic Carotid Endarterectomy Trial criteria and compared with 2D and 3D sonographic data. Results. Overall correlation of both sonographic techniques concerning the grading of the stenoses was good (r = 0.69; P < .01). The interobserver correlation for assessment of stenoses by means of 3D CDS was high (r = 0.94; P < .01). Three‐dimensional CDS correlated excellently with DSA in 3 of 6 patients but showed only intermediate or no correlation in the remaining 3 patients. In contrast, spatial information on the stenotic morphologic characteristics was always very comparable with the results obtained by DSA. Conclusions. Three‐dimensional CDS represents a valuable tool for assessment of the origin of the vertebral artery, allowing important morphologic information on stenoses in this location. For grading of stenoses of the vertebral artery origin, 3D information should be combined with hemodynamic criteria obtained by spectral Doppler imaging in 2D CDS. Three‐dimensional CDS could be a valuable tool before interventional procedures of the proximal vertebral artery, saving time and avoiding iodinated contrast agents.
Intraoperative Sonography of Intracranial Arteriovenous Malformations
Authors: Griffith Sara , Pozniak Myron A. , Mitchell Carol C. , Ledwidge Michael E. , Dempsey Robert , Peters Amy , Taylor Erin
Published: January 2017

Objective. We have advanced the application of intraoperative neurosonography by combining gray scale sonographic imaging with pulsed wave Doppler and color flow Doppler imaging to guide and confirm resection of arteriovenous malformations of the brain. We want to share our technique with the imaging community. Methods. We present a review of our scan technique as it has evolved over the 3 years during which we have been assisting our neurosurgical team. Results and Conclusions. Our experience has indicated that a combination of sonographic imaging and color and spectral Doppler imaging improves surgical resection of such lesions.
Torsion and Beyond
Authors: Dogra Vikram S. , Rubens Deborah J. , Gottlieb Ronald H. , Bhatt Shweta
Published: January 2017

Objective. To illustrate how spectral Doppler waveform analysis plays an adjunctive but very definite role in scrotal sonography. Methods. The cases illustrate a variety of testicular disorders that were collected at a referral tertiary care center. Results. Normal and a variety of pathologic conditions of the testes are discussed, along with their signature spectral waveforms. Conclusions. Analysis of the spectral waveform provides important additional information in various scrotal disorders with acute pain. Spectral waveform analysis is critical to diagnosing incomplete torsion when color and power Doppler examinations are indeterminate.
Dynamic Transurethral Sonography and 3‐Dimensional Reconstruction of the Rhabdosphincter and Urethra
Authors: Mitterberger Michael , Pinggera Germar-Michael , Mueller Tilko , Frauscher Ferdinand , Pallwein Leo , Gradl Johann , Peschel Reinhard , Bartsch Georg , Strasser Hannes
Published: January 2017

Objective. The purpose of this study was to evaluate the female urethra and the striated urinary sphincter, the rhabdosphincter (RS), by means of dynamic transurethral sonography and sonographic 3‐dimensional (3D) reconstructions. Methods. In 15 female patients with urinary stress incontinence (mean age, 67.5 years) and 5 continent women (mean age, 48.3 years), morphologic characteristics and function of the RS and urethra were examined with a 10‐MHz transurethral ultrasound transducer. With the help of a mechanical pullback system, the transducer was slowly retracted to scan the whole urethra and the RS from the bladder neck to the urethral orifice. Subsequently, 3D reconstructions of the urethra using an integrated computer system were performed. The RS as well as the length of the urethra were investigated under contracted and noncontracted conditions to measure contractility of the RS and dynamic changes of the lower urinary tract. Results. Partial or complete loss of RS function was detected in patients with stress incontinence. The findings on sonography were found to correlate well with the grade of incontinence. Furthermore, under contraction of the RS, a median increase in urethral length was observed. In incontinent patients, the increase in the urethral length was statistically significantly less (P = .04), which was related to the reduced contractility of the RS. Conclusions. Dynamic transurethral sonography with subsequent 3D reconstructions allows for assessment of function and morphologic characteristics of the RS and urethra. Normal contraction of the RS results in an elongation of the urethra.
Prenatal Diagnosis of Turner Syndrome
Authors: Papp Csaba , Beke Artur , Mezei Gabor , Szigeti Zsanett , Bán Zoltán , Papp Zoltan
Published: January 2017

Objective. This study was conducted to evaluate the diagnostic value of different sonographic signs of fetuses with Turner syndrome in the first and second trimesters of pregnancy. Methods. Between 1990 and 2004, Turner syndrome was found in 69 of 22,150 fetal karyotypings. Congenital anomalies detected by sonography were analyzed. Results. Of the 514 (2.3%; 514/22,150) chromosome aberrations that were diagnosed, 69 Turner syndrome cases were found (13.4%; 69/514). Twenty‐four fetuses had a 45,X karyotype (34.8%), and 45 fetuses were mosaic (65.2%). Forty‐seven fetuses (68.1%; 47/69) showed symptoms on sonography. A substantial proportion of fetuses with Turner syndrome showed early‐onset signs that could be detected in the first trimester (29.8%;14/69). The most common findings with sonography were hygroma colli (26.1%; 18/69), fetal hydrops (11.6%; 8/69), cardiac defects (13%; 9/69), and increased nuchal translucency (13%; 9/69). Among heart defects, coarctation of the aorta was the most common (44.4% of all cardial defects). Soft markers were also detected with relatively high frequency (23.2%; 16/69). Conclusions. The diagnosis of severe Turner syndrome is possible in early pregnancy. A search for soft markers during second‐trimester sonography and extensive use of echocardiography may increase the detection rate of Turner syndrome.
Women's Responses to Ultrasound Examinations During Routine Screens in an Obstetric Clinic
Authors: Boukydis C. F. Zachariah , Treadwell Marjorie C. , Delaney-Black Virginia , Boyes Kathleen , King Mary , Robinson Timberly , Sokol Robert
Published: January 2017

Objective. The primary purpose of this research was to evaluate the impact of prenatal ultrasound consultation on maternal‐fetal attachment, knowledge of fetal behavior, and development and reduction of anxiety in pregnant women scheduled for routine ultrasound screens. A standard depression screen was also used to evaluate depression levels of women undergoing these screens in the sonography clinic. Methods. To evaluate the impact of an ultrasound consultation, the following were undertaken: (1) a preliminary observational study of routine screens in the sonography clinic was performed; (2) an ultrasound consultation manual was developed and established as reliable; and (3) women undergoing evaluations between 16 and 26 weeks' gestational age were randomly assigned to a standard care group (n = 24; the standard clinical ultrasound screen) or an ultrasound consultation group (n = 28; the ultrasound consultation was done, including the standard screen with extended consultation on fetal development, maternal and familial responses, and maternal‐fetal interaction). Results. The ultrasound consultation group had a significant positive change in maternal‐fetal attachment scores, lower state anxiety scores, and more favorable responses to the sonographic examination (P .05). Women's depression scores did not differ between the ultrasound consultation and standard care groups and were similar to maternal prenatal depression levels in other studies. Conclusions. Ultrasound consultation was responsible for increasing maternal‐fetal attachment and reducing maternal anxiety. It may be an important component of more comprehensive prevention/intervention strategies. The implications for ultrasound consultation in clinical research and practice are discussed.
Role of Transcutaneous Perianal Ultrasonography in Evaluation of Fistulas In Ano
Authors: Domkundwar Shilpa V. , Shinagare Atul B.
Published: January 2017

Objectives

The purpose of this study was to evaluate the role of transcutaneous perianal ultrasonography in evaluation of fistulas in ano and to assess its possible role as a first‐line investigation, for follow‐up, and as a possible substitute for magnetic resonance imaging.

Methods

Transcutaneous perianal ultrasonography was performed in 30 patients with fistulas in ano with the use of a 3‐ to 6‐MHz sector probe, a 7‐ to 11‐MHz linear probe, and a 5‐ to 7‐MHz endocavitary probe. Patients were followed clinically and at surgery to assess the accuracy of transcutaneous perianal ultrasonography.

Results

A total of 43 fistulas, sinus tracts, or both were found in 26 patients. They appeared as hypoechoic tracts. Eleven of 30 patients had the presence of a collection or abscess, which appeared as hypoechoic areas. Twenty‐four of 29 patients with positive findings underwent surgery. In these, 35 of 39 tracts were surgically confirmed (positive predictive value, 90%). The positive predictive value for demonstration of an internal opening was 85% (22/26) when compared with direct visualization or probing. Sensitivity for detection of tracts was 100%, and that for demonstration of an internal opening was 96% (26/27). The negative predictive value for sinus/fistulous tracts was nearly 100%. Transcutaneous perianal ultrasonography could not adequately evaluate suprasphincteric‐type fistulas. However, it is a good, inexpensive modality in the evaluation of patients with fistulas in ano and also helps in follow‐up of these patients. It can also be used to select patients who need magnetic resonance imaging.

Conclusions

Transcutaneous perianal ultrasonography has the potential to become the first investigation in patients with perianal fistulas and abscesses.
Is Sonographic Assessment of Fetal Weight Influenced by Formula Selection?
Authors: Burd Irina , Srinivas Sindhu , Paré Emmanuelle , Dharan Vanita , Wang Eileen
Published: January 2017

Objective. Several published formulas exist for the determination of estimated fetal weight (EFW), with limited data on their comparative accuracies. The aims of our study were to assess and compare the performance of different EFW formulas in predicting actual birth weight (BW) in an urban population. Methods. Patients with an EFW determined within 7 days of delivery were considered eligible for the study. Fourteen published formulas, derived from populations comparable to ours, were used to recalculate EFWs from the same initial measurements. The accuracy of the EFWs obtained from the different formulas were compared by percentage error methods using bias and precision and Bland‐Altman limits of agreement methods. Sensitivity and specificity for prediction of being small for gestational age (SGA) were calculated. Results. Eighty‐one fetuses were included in the study. Formula C of Hadlock et al [Hadlock C; log10 BW = 1.335 − 0.0034(abdominal circumference [AC])(femur length [FL]) + 0.0316(biparietal diameter) + 0.0457(AC) + 0.1623(FL); Am J Obstet Gynecol 1985; 151:333–337] had the best performance according to the bias and precision method. Bland‐Altman limits of agreement confirmed these results. Among the formulas, the sensitivity for detection of SGA ranged from 72% to 100%, and specificity was 41% to 88%. Hadlock C had the optimal sensitivity/specificity trade‐off for detection of SGA. Conclusions. Fourteen formulas showed considerable variation of bias and precision in our population as well as a wide range of sensitivities and specificities for SGA. The choice of the appropriate formula for EFW in a given population should be based on objective and explicit criteria. Consideration of bias and precision for the formula in the population being assessed is critical and may affect clinical care.
Compact Ultrasound for Improving Maternal and Perinatal Care in Low‐Resource Settings
Authors: Harris Robert D. , Marks William M.
Published: January 2017

Objective. Ultrasound imaging, a front‐line diagnostic tool for perinatal care, is rarely available in the developing world, where maternal and newborn mortality rates are starkly higher than elsewhere. The development of portable and inexpensive medical ultrasound machines (compact ultrasound) offers the possibility of broader use of ultrasound. Our objective was to assess the potential benefits and challenges of deploying compact ultrasound in developing countries for improving obstetric health. Methods. Existing literature on perinatal care, compact ultrasound, and issues in the deployments of medical technology in low‐resource settings was reviewed. Anecdotal evidence was assessed, and the authors' field experiences in Nicaragua and Mali were evaluated as a template for wider deployments. Results. Few published studies directly concerned with compact ultrasound in low‐resource settings were found. These, however, in combination with available anecdotal data, support the view that compact ultrasound in less‐developed regions is feasible and would result in a relatively low‐cost improvement in perinatal care. Conclusions. The development of lightweight, portable, and relatively inexpensive ultrasound systems offers a great opportunity for reducing maternal and neonatal mortality in low‐resource settings. Evidence‐based analysis of compact ultrasound deployments as a public‐health response to obstetric needs in less‐developed countries has been hampered by limited data in 3 key areas: maternal and perinatal mortality and morbidity in these settings, evaluations of compact ultrasound systems as reliable alternatives to full‐sized systems, and the lack of outcomes data based on actual deployments of compact ultrasound for this purpose. Field trials of compact ultrasound on a scale commensurate with public health interventions should be undertaken.
Three‐Dimensional Ultrasonographic Depiction of Fetal Abdominal Blood Vessels
Authors: Gindes Liat , Pretorius Dolores H. , Romine Lorene E. , Kfir Menashe , D'Agostini Deborah , Hull Andrew , Achiron Reuven
Published: January 2017

Objective. The purpose of this study was to identify fetal abdominal vasculature with 3‐dimensional (3D) ultrasonography and to describe a systematic method for analysis of volume data sets. Methods. Three‐dimensional volumes of the fetal abdomen were acquired prospectively in 30 patients between 15 and 34 weeks' gestation with color Doppler, high‐definition (HD) flow, power Doppler, and B‐flow imaging. All volumes were analyzed offline by 2 examiners separately. The feasibility of identifying the fetal abdominal blood vessels was analyzed. A standardized approach was applied to identify specific vessels by correlating the images with known anatomic landmarks. Results. The volumes were rotated into an anatomic orientation in the multiplanar mode, and then the vessels were identified in the following order: aorta (30 of 30), celiac trunk (29 of 30), superior mesenteric vein (28 of 30 and 26 of 30 for readers 1 and 2, respectively), superior mesenteric artery (29 of 30), left renal artery (25 of 30 and 26 of 30), right renal artery (27 of 30), common iliac arteries (30 of 30), umbilical arteries (26 of 27), external iliac arteries (20 of 22), umbilical vein (29 of 30), ductus venosus (30 of 30), hepatic vein (29 of 30), right portal vein (29 of 30), inferior vena cava (28 of 30), adrenal artery (2 of 30), hepatic artery (24 of 30 and 23 of 30), splenic artery (24 of 30 and 23 of 30), gastric artery (14 of 30 and 9 of 30), splenic vein (19 of 30 and 15 of 30), and renal vein (1 of 30). A step‐by‐step systematic approach to identify the abdominal vasculature from the ultrasonographic volume data set was developed. Conclusions. Fetal abdominal vessels can be easily visualized when a systematic analysis is performed on 3D data set volumes. Visualization of the vessels was optimal when volumes were acquired with HD flow imaging.
Screening for Carpal Tunnel Syndrome Using Sonography
Authors: Roll Shawn C. , Evans Kevin D. , Li Xiaobai , Freimer Miriam , Sommerich Carolyn M.
Published: January 2017

Objectives

The use of sonography in musculoskeletal research and clinical applications is increasing; however, measurement techniques for diagnosing carpal tunnel syndrome with sonography continue to be inconsistent. Novel methods of measurement using internal comparisons to identify swelling of the median nerve require investigation and comparison to currently used techniques.

Methods

The flattening ratio of the median nerve, bowing of the flexor retinaculum, and cross‐sectional area of the median nerve were collected in the forearm, at the radiocarpal joint, and at the level of the pisiform in both symptomatic patients and asymptomatic control participants. Electrodiagnostic testing was completed in symptomatic patients as a diagnostic standard.

Results

Median nerve measurements were collected from 166 wrists of symptomatic and asymptomatic participants. The flattening ratio did not show any correlation to electrodiagnostic testing and was identical between both symptomatic and asymptomatic participants. Moderate to strong correlations were noted between electrodiagnostic testing results and sonographic measurements of the cross‐sectional area at the pisiform, retinacular bowing, and both the ratio and change of the cross‐sectional area between the forearm and pisiform. The area under the curve was large for all receiver operating characteristic curves for each measurement (0.759–0.899), and sensitivity was high (80.4%–82.4%).

Conclusions

Measurement of swelling through a ratio or absolute change had similar diagnostic accuracy as individual measurement of the cross‐sectional area within the carpal tunnel. These measures may be useful for improving accuracy in more diverse clinical populations. Further refinement of protocols to identify the largest cross‐sectional area within the carpal tunnel region and statistical methods to analyze clustered, multilevel outcome data are recommended to improve diagnostics.
Sensitivity of Convex Probe Endobronchial Sonographically Guided Transbronchial Needle Aspiration in the Diagnosis of Granulomatous Mediastinal Lymphadenitis
Authors: Çağlayan Benan , Salepçi Banu , Fidan Ali , Kıral Nesrin , Cömert Sevda Şener , Yavuzer Dilek , Demirhan Recep , Saraç Gülşen
Published: January 2017

Objectives

The purpose of this study was to investigate the sensitivity and diagnostic value of convex probe endobronchial sonographically guided transbronchial needle aspiration (EBUS‐TBNA) in the diagnosis of granulomatous mediastinal lymphadenitis.

Methods

Patients clinically and radiologically suspected to have granulomatous mediastinal disease and followed in our clinic between October 2008 and July 2010 were included. Convex probe EBUS with local anesthesia and under conscious sedation and EBUS‐TBNA from hilar and mediastinal lymph nodes were performed after physical examination, chest radiography, computed tomography of the thorax, and routine biochemical analysis. Detection of noncaseating/caseating granulomas was accepted as sufficient for diagnosis of sarcoidosis/tuberculosis in the presence of clinical and radiologic findings. For patients whose EBUS‐TBNA results were nondiagnostic, a definitive diagnosis was reached by invasive procedures. The sensitivity of EBUS‐TBNA in the diagnosis of granulomatous lymphadenitis and diagnostic accuracy in granulomatous hilar/mediastinal lymphadenopathies was calculated.

Results

Seventy‐two patients were included in study (20 male and 52 female; mean age ± SD, 46.22 ± 13.94 years). In 72 cases, 121 lymph node aspirations were performed. The average lymph node short axis was 1.96 cm. With EBUS‐TBNA among the 72 cases, 35 were diagnosed as sarcoidosis and 16 as tuberculous lymphadenitis. A definitive diagnosis could not be reached with EBUS‐TBNA in 21 cases. As a result, 9 of these EBUS‐TBNA–negative cases were diagnosed as reactive lymphadenitis, 9 as sarcoidosis, and 3 as tuberculosis by invasive procedures. The sensitivity values of EBUS‐TBNA for diagnosis of sarcoidosis, tuberculosis, and granulomatous diseases were 79.5%, 84.2%, and 80.9%, respectively. The diagnostic accuracy of EBUS‐TBNA for granulomatous diseases was 83.3%. No major complications occurred.

Conclusions

In the diagnosis of granulomatous lymphadenitis, EBUS‐TBNA, with high sensitivity and a minimum complication rate, is an alternative to mediastinoscopy.
High Venous Pressure in the Main Renal Vein Causing Development of Peritransplant Venous Collaterals in Renal Transplant Patients
Authors: McArthur Tatum A. , Lockhart Mark E. , Robbin Michelle L.
Published: January 2017

We will show the sonographic appearance of peritransplant venous collaterals in renal transplants with renal venous hypertension. Three cases of renal transplants with pericapsular vessels were identified at our institution. Two cases were related to renal vein thrombosis. The third case had pericapsular vessels secondary to venous hypertension from arterialization of the transplant renal vein by a preexisting right thigh arteriovenous graft. The development of high venous pressures in renal transplants leading to the collaterals' venous drainage has been rarely described. This finding should be recognized as a rare complication of renal transplants but does not necessarily lead to transplant failure.
Comparison of Sonography and Computed Tomography as Imaging Tools for Assessment of Airway Structures
Authors: Prasad Arun , Yu Eugene , Wong David T. , Karkhanis Reena , Gullane Patrick , Chan Vincent W. S.
Published: January 2017

Objectives

The aim of this study was to compare airway anatomic parameters as measured by sonography and computed tomography (CT).

Methods

Fifteen adult patients underwent CT followed by sonography of the anterior neck under standard conditions. A radiologist and an anesthesiologist with experience in airway imaging examined the scans and performed measurements of specific airway parameters: distance to the posterior surface of the tongue, thickness of the submental region, hyomental distance, depth of the epiglottis from skin (above and below the hyoid bone), thyrohyoid distance, depth of the arytenoid cartilage from skin, and fat pad thickness at the thyroid cartilage. After performing the measurements, they compared the images by the two modalities for descriptions of the structures. Means and SDs were calculated for the measurements, and a paired t test was performed to determine statistically significant differences in the measurements by sonography and CT.

Results

The means of all parameters were closely related except hyomental distance (sonography, 5.23 ± 0.58 cm; CT, 3.50 ± 0.42 cm). The paired t test showed that the mean values for depth of the epiglottis below the hyoid (3.89 versus 4.17 cm; P = .31), thyrohyoid distance (1.03 versus 1.02 cm; P = .95), and depth of the arytenoid cartilage (2.90 versus 2.66 cm; P = .21) were not significantly different as measured by sonography and CT, respectively.

Conclusions

The study shows that sonography can reliably image all of the structures visualized by CT, and in general, infrahyoid parameters agree well between the two modalities, as opposed to suprahyoid parameters, which may be affected by unintentional head extension.
Reference Values for the Length and Area of the Fetal Corpus Callosum on 3‐Dimensional Sonography Using the Transfrontal View
Authors: Júnior Edward Araujo , Visentainer Milena , Simioni Christiane , Ruano Rodrigo , Nardozza Luciano Marcondes Machado , Moron Antonio Fernandes
Published: January 2017

Objectives

The purpose of this study was to determine reference values for the length and area of the fetal corpus callosum between 20 and 33 weeks' gestation using 3‐dimensional sonography.

Methods

A cross‐sectional study was performed in 293 healthy pregnant women between 20 and 33 weeks' gestation. The length and area of the corpus callosum were obtained via the transfontal view with the metopic suture as an acoustic window using 3‐dimensional sonographic aquisitions. Linear and weighted polynomial regression models were used, which were adjusted by residual analysis and the R2 determination coefficient. Intraobserver and interobserver reproducibilities were analyzed by an intraclass correlation coefficient.

Results

The mean corpus callosum length ± SD varied from 19.52 ± 2.24 to 40.36 ± 2.87 mm, whereas the mean area varied from 0.44 ± 0.11 to 1.47 ± 0.21 cm2 at 20 and 33 weeks, respectively. The length and area were highly correlated with gestational age: corpus callosum length = −52.41 + 4.71 × gestational age – 0.06 × gestational age2 (R2 = 0.868); and corpus callosum area = −2.47 + 0.16 × gestational age – 0.000037 × gestational age2 (R2 = 0.765). The intraobserver and interobserver reproducibilities were excellent, with intraclass correlation coefficients of 0.98 and 0.94 for the length and 0.99 and 0.90 for the area, respectively.

Conclusions

Reference values for the length and the area of the fetal corpus callosum between 20 and 33 weeks' gestation were determined with high reproducibility.
Breast Sonographic Elastography Using an Advanced Breast Tissue‐Specific Imaging Preset
Authors: Jung Hyun Jin , Hahn Soo Yeon , Choi Hye-Young , Park Sung Hee , Park Heung Kyu
Published: January 2017

Objectives

The purpose of this study was to evaluate the interpretation criteria, such as the size ratio, stain ratio, and elasticity score, and to assess the diagnostic performance of sonographic elastography by using an advanced breast tissue‐specific imaging preset compared with that of conventional sonography for the differentiation of benign and malignant breast masses.

Methods

Conventional sonography and sonographic elastography with the tissue‐specific imaging preset were performed in 104 patients (age range, 17–76 years; mean age, 47.7 years) with 110 breast lesions (67 benign and 43 malignant; mean size, 1.69 cm). The data from the interpretation criteria of sonographic elastography were obtained. The pathologic results from surgical excision or vacuum‐assisted removal were used as a reference standard.

Results

The values for the area under the receiver operating characteristic curve were 0.959 (95% confidence interval [CI], 0.902–0.987) for conventional sonography and 0.901 (95% CI, 0.829–0.949), 0.796 (95% CI, 0.708–0.866), and 0.787 (95% CI, 0.699–0.859) for the strain ratio, size ratio, and elasticity score, respectively. When a strain ratio cutoff point of 4.215 was used, the sensitivity and specificity were 86.0% and 85.1%. With a best cutoff point for conventional sonography between Breast Imaging Reporting and Data System categories 4A and 4B, the sensitivity and specificity were 93.0% and 83.6%.

Conclusions

The strain ratio showed the best diagnostic performance among the interpretation criteria for sonographic elastography with the tissue‐specific imaging preset. The diagnostic performance was slightly higher for Breast Imaging Reporting and Data System categories than for the strain ratio. However, there was no statistical significance (P = .052).
Virtual Touch Tissue Quantification Using Acoustic Radiation Force Impulse Technology
Authors: Bai Min , Du Lianfang , Gu Jiying , Li Fan , Jia Xiao
Published: January 2017

Objectives

The purpose of this study was to investigate the clinical usage of Virtual Touch tissue quantification (VTQ; Siemens Medical Solutions, Mountain View, CA) implementing sonographic acoustic radiation force impulse technology for differentiation between benign and malignant solid breast masses.

Methods

A total of 143 solid breast masses were examined with VTQ, and their shear wave velocities (SWVs) were measured. From all of the masses, 30 were examined by two independent operators to evaluate the reproducibility of the results of VTQ measurement. All masses were later surgically resected, and the histologic results were correlated with the SWV results. A receiver operating characteristic curve was calculated to assess the diagnostic performance of VTQ.

Results

A total of 102 benign lesions and 41 carcinomas were diagnosed on the basis of histologic examination. The VTQ measurements performed by the two independent operators yielded a correlation coefficient of 0.885. Applying a cutoff point of 3.065 m/s, a significant difference (P < .001) was found between the SWVs of the benign (mean ± SD, 2.25 ± 0.59 m/s) and malignant (5.96 ± 2.96 m/s) masses. The sensitivity, specificity, and area under the receiver operating characteristic curve for the differentiation were 75.6%, 95.1%, and 85.6%, respectively. When the repeated non‐numeric result X.XX of the SWV measurements was designated as an indicator of malignancy, the sensitivity, specificity, and accuracy were 63.4%, 100%, and 89.5%.

Conclusions

Virtual Touch tissue quantification can yield reproducible and quantitative diagnostic information on solid breast masses and serve as an effective diagnostic tool for differentiation between benign and malignant solid masses.
I‐AIM
Authors: Bahner David P. , Hughes Daralee , Royall Nelson A.
Published: January 2017

This project was designed to use existing evidence in education and clinical quality improvement to design an educational and clinical model specific for physician‐performed focused sonography. The I‐AIM model (indication, acquisition, interpretation, and medical decision making) was created to serve as both a mnemonic and checklist. The model follows a stepwise logic for performing focused sonographic examinations and contains detailed subcomponent listings that cover specific areas to improve use and performance. Although validation and reliability studies will be required before implementation, the I‐AIM model represents the first effort to standardize and improve clinical and educational focused‐sonography.
Cobalt Assisted Synthesis of IrCu Hollow Octahedral Nanocages as Highly Active Electrocatalysts toward Oxygen Evolution Reaction
Authors: Kwon Taehyun , Hwang Hyeyoun , Sa Young Jin , Park Jongsik , Baik Hionsuck , Joo Sang Hoon , Lee Kwangyeol
Published: January 2017

Development of oxygen evolution reaction (OER) catalysts with reduced precious metal content while enhancing catalytic performance has been of pivotal importance in cost‐effective design of acid polymer electrolyte membrane water electrolyzers. Hollow multimetallic nanostructures with well‐defined facets are ideally suited for saving the usage of expensive precious metals as well as boosting catalytic performances; however, Ir‐based hollow nanocatalysts have rarely been reported. Here, a very simple synthetic scheme is reported for the preparation of hollow octahedral nanocages of Co‐doped IrCu alloy with readily tunable morphology and size. The Co‐doped IrCu octahedral nanocages show excellent electrocatalytic activity and long‐term durability for OER in acidic media. Notably, their OER activity represents one of the best performances among Ir‐based acidic OER catalysts.
Length Scale and Dimensionality of Defects in Epitaxial SnTe Topological Crystalline Insulator Films
Authors: Dagdeviren Omur E. , Zhou Chao , Zou Ke , Simon Georg H. , Albright Stephen D. , Mandal Subhasish , Morales‐Acosta Mayra D. , Zhu Xiaodong , Ismail‐Beigi Sohrab , Walker Frederick J. , Ahn Charles H. , Schwarz Udo D. , Altman Eric I.
Published: January 2017

Topological crystalline insulators (TCIs) are new materials with metallic surface states protected by crystal symmetry. The properties of molecular beam epitaxy grown SnTe TCI on SrTiO3(001) are investigated using scanning tunneling microscopy (STM), noncontact atomic force microscopy, low‐energy and reflection high‐energy electron diffraction, X‐ray diffraction, Auger electron spectroscopy, and density functional theory. Initially, SnTe (111) and (001) surfaces are observed; however, the (001) surface dominates with increasing film thickness. The films grow island‐by‐island with the [011] direction of SnTe (001) islands rotated up to 7.5° from SrTiO3 [010]. Microscopy reveals that this growth mechanism induces defects on different length scales and dimensions that affect the electronic properties, including point defects (0D); step edges (1D); grain boundaries between islands rotated up to several degrees; edge‐dislocation arrays (2D out‐of‐plane) that serve as periodic nucleation sites for pit growth (2D in‐plane); and screw dislocations (3D). These features cause variations in the surface electronic structure that appear in STM images as standing wave patterns and a nonuniform background superimposed on atomic features. The results indicate that both the growth process and the scanning probe tip can be used to induce symmetry breaking defects that may disrupt the topological states in a controlled way.
High‐Performance Large‐Scale Solar Steam Generation with Nanolayers of Reusable Biomimetic Nanoparticles
Authors: Liu Changxu , Huang Jianfeng , Hsiung Chia‐En , Tian Yi , Wang Jianjian , Han Yu , Fratalocchi Andrea
Published: January 2017

The harvesting of solar radiation for steam generation has drawn wide attention as a future sustainable technology for the renewable production of clean water worldwide. Here, a new super‐dark metasurface of 200 nm thickness is presented, which reaches a solar thermal efficiency of 87% when exposed to an intensity of only 2.3 sun, maintaining a stable efficiency of 90% at higher solar intensities. The metasurface is composed of extremely robust nanoparticles, which are up to 98% recyclable and can be produced on massively large scales by wet chemistry. By employing such reusable nanoparticles on an area of 1 m2, 1.2 kg of seawater can be purified within only 1 h under natural sunshine. With such excellent performances, this nanomaterial can open new applications of high‐performance solar steam.
Diagnostic work‐up of acute myeloid leukemia
Authors: Weinberg Olga K. , Sohani Aliyah R. , Bhargava Parul , Nardi Valentina
Published: January 2017

Acute myeloid leukemia (AML) is characterized by a clonal expansion of undifferentiated myeloid precursors resulting in impaired hematopoiesis and bone marrow failure. In 2016, the World Health Organization (WHO) published revisions to the classification of myeloid neoplasms and acute leukemias. Similar to the 2008 classification, the updated classification incorporates clinical features, morphology, immunophenotyping, and cytogenetics, with greater emphasis on molecular genetics, to define disease entities. This brief review addresses the various components of pathologic assessment to establish a diagnosis of AML and to help risk stratify patients, with an emphasis on newer techniques used in the detection of mutations with prognostic significance, as well as assays employed in the evaluation of minimal residual disease following treatment.
Irreversible Conversion of a Water–Ethanol Solution into an Organized Two‐Dimensional Network of Alternating Supramolecular Units in a Hydrophobic Zeolite under Pressure
Authors: Arletti Rossella , Fois Ettore , Gigli Lara , Vezzalini Giovanna , Quartieri Simona , Tabacchi Gloria
Published: January 2017

Turning disorder into organization is a key issue in science. By making use of X‐ray powder diffraction and modeling studies, we show herein that high pressures in combination with the shape and space constraints of the hydrophobic all‐silica zeolite ferrierite separate an ethanol–water liquid mixture into ethanol dimer wires and water tetramer squares. The confined supramolecular blocks alternate in a binary two‐dimensional (2D) architecture that remains stable upon complete pressure release. These results support the combined use of high pressures and porous networks as a viable strategy for driving the organization of molecules or nano‐objects towards complex, pre‐defined patterns relevant for the realization of novel functional nanocomposites.