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International Journal of Hyperthermia :... 2023This study compared the feasibility and efficacy of transabdominal ultrasound (TAU) and combined transabdominal and transvaginal ultrasound (TA/TV US)-guided...
OBJECTIVE
This study compared the feasibility and efficacy of transabdominal ultrasound (TAU) and combined transabdominal and transvaginal ultrasound (TA/TV US)-guided percutaneous microwave ablation (PMWA) for uterine myoma (UM).
METHOD
This study enrolled 73 patients with UM who underwent PMWA the transabdominal ultrasound-guided (TA group) or the combined transabdominal and transvaginal ultrasound-guided (TA/TV group) approaches. The intraoperative supplementary ablation rates, postoperative immediate ablation rates, lesion reduction rates and other indicators three months postoperatively were compared between the groups. The display of the needle tip, endometrium, uterine serosa, rectum and myoma feeding vessels under the guidance of TAU, transvaginal ultrasound (TVU) and TA/TV US were evaluated in the TA/TV group.
RESULTS
In the TA/TV group, the real-time position of the needle tip and the endometrium complete display rate of the same lesions with TVU guidance were significantly higher than those using TAU. TA/TV US guidance significantly improved the complete display rate of each indicator. The intraoperative supplementary ablation rate in the TA/TV group was lower than that in the TA group. Similarly, the postoperative immediate ablation and volume reduction rates of the lesions three months postoperatively were higher than those in the TA group, especially for lesions with a maximum diameter ≥6 cm.
CONCLUSION
TA/TV US is an effective monitoring method that can be used to improve imaging display. Its use is recommended in patients with obesity, poor transabdominal ultrasound image quality and large myoma volumes.
Topics: Female; Humans; Microwaves; Leiomyoma; Ultrasonography; Myoma; Ultrasonography, Interventional; Uterine Neoplasms
PubMed: 36535945
DOI: 10.1080/02656736.2022.2154576 -
Fetal Diagnosis and Therapy 2017Evaluation of the fetal heart at 11-13 + 6 weeks of gestation is indicated for women with a family history of congenital heart defects (CHD), a previous child with CDH,... (Review)
Review
Evaluation of the fetal heart at 11-13 + 6 weeks of gestation is indicated for women with a family history of congenital heart defects (CHD), a previous child with CDH, or an ultrasound finding associated with cardiac anomalies. The accuracy for early detection of CHD is highly related to the experience of the operator. The 4-chamber view and outflow tracts are the most important planes for identification of an abnormal heart, and can be obtained in the majority of fetuses from 11 weeks of gestation onward. Transvaginal ultrasound is the preferred route for fetal cardiac examination prior to 12 weeks of gestation, whereas, after 12 weeks, the fetal heart can be reliably evaluated by transabdominal ultrasound. Cardiac defects, such as ventricular septal defects, tetralogy of Fallot, Ebstein's anomaly, or cardiac tumors, are unlikely to be identified at ≤14 weeks of gestation. Additional ultrasound techniques such as spatiotemporal image correlation and the evaluation of volumes by a fetal-heart expert can improve the detection of congenital heart disease. The evaluation of the fetal cardiac function at 11-13 + 6 weeks of gestation can be useful for early identification of fetuses at risk of anemia due to hemoglobinopathies, such as hemoglobin Bart's disease.
Topics: Diagnostic Errors; Fetus; Heart; Heart Defects, Congenital; Humans; Nuchal Translucency Measurement
PubMed: 28675906
DOI: 10.1159/000477564 -
Acta Obstetricia Et Gynecologica... Jun 2021The role of intrapartum ultrasound as an ancillary method to instrumental vaginal delivery is yet to be determined. This study aimed to compare the use of transabdominal... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
The role of intrapartum ultrasound as an ancillary method to instrumental vaginal delivery is yet to be determined. This study aimed to compare the use of transabdominal and transperineal ultrasound with routine clinical care before performing an instrumental vaginal delivery, regarding the incidence of adverse maternal and neonatal outcomes.
MATERIAL AND METHODS
A randomized controlled trial was conducted between October 2016 and March 2019 in two tertiary care maternity hospitals in Lisbon, Portugal. Women at term, with full cervical dilatation, singleton fetuses in cephalic presentation, and with an established indication for instrumental vaginal delivery, were approached for enrollment. After informed consent was obtained, randomization into one of two groups was carried out. In the experimental arm, women underwent transabdominal ultrasound for determination of the fetal head position and transperineal ultrasound for evaluation of the angle of progression, before instrumental vaginal delivery. In the control arm, no ultrasound was carried out before instrumental vaginal delivery. Primary outcomes were composite measures of maternal and neonatal morbidity. Composite maternal morbidity consisted of severe postpartum hemorrhage, perineal trauma, and prolonged hospital stay. Composite neonatal morbidity consisted of low 5-minute Apgar score, umbilical artery metabolic acidosis, birth trauma, and neonatal intensive care unit admission.
RESULTS
A total of 222 women were enrolled (113 in the experimental arm and 109 in the control arm). No significant differences between the two arms were found in composite measures of maternal (23.9% in the experimental group vs 22.9% in the control group, odds ratio 1.055, 95% CI 0.567-1.964) or neonatal morbidity (9.7% in the experimental group vs 6.4% in the control group, odds ratio 1.571, 95% CI 0.586-4.215), nor in any of the individual outcomes.
CONCLUSIONS
In this small randomized controlled trial that was stopped for futility before reaching the required sample size, transabdominal and transperineal ultrasound performed just before instrumental vaginal delivery did not reduce the incidence of adverse maternal and neonatal outcomes, when compared with routine clinical care.
Topics: Adult; Female; Humans; Infant, Newborn; Labor Presentation; Labor Stage, Second; Obstetric Labor Complications; Pregnancy; Pregnancy Outcome; Ultrasonography, Prenatal; Umbilical Arteries; Vacuum Extraction, Obstetrical
PubMed: 33319355
DOI: 10.1111/aogs.14065 -
Canadian Journal of Surgery. Journal... Jun 2018Previous research has shown variable but generally poor accuracy of transabdominal ultrasonography in the diagnosis of gallbladder polyps. We performed a systematic... (Review)
Review
BACKGROUND
Previous research has shown variable but generally poor accuracy of transabdominal ultrasonography in the diagnosis of gallbladder polyps. We performed a systematic review of the literature with the aim of helping surgeons interpret and apply these findings in the preoperative assessment and counselling of their patients.
METHODS
We searched PubMed, MEDLINE and the Cochrane database using the keywords "gallbladder," "polyp," "ultrasound," "pathology" and "diagnosis" for English-language articles published after 1990 with the full-text article available through our institutional subscriptions. Polyps were defined as immobile features that on transabdominal ultrasonography appear to arise from the mucosa and that lack an acoustic shadow, and pseudopolyps were defined as features such as inflammation, hyperplasia, cholesterolosis and adenomyomatosis that convey no risk of malignant transformation.
RESULTS
The search returned 1816 articles, which were narrowed down to 14 primary sources involving 15 497 (range 23-13 703) patients who had preoperative transabdominal ultrasonography, underwent cholecystectomy and had postoperative pathology results available. Among the 1259 patients in whom a gallbladder polyp was diagnosed on ultrasonography, 188 polyps were confirmed as true polyps on pathologic examination, and 81 of these were found to be malignant. Of the 14 238 patients for whom a polyp was not seen on ultrasonography, 38 had a true polyp on pathologic examination, none of which were malignant. For true gallbladder polyps, transabdominal ultrasonography had a sensitivity of 83.1%, specificity of 96.3%, positive predictive value of 14.9% (7.0% for malignant polyps) and negative predictive value of 99.7%.
CONCLUSION
Transabdominal ultrasonography has a high false-positive rate (85.1%) for the diagnosis of gallbladder polyps. Further study of alternative imaging modalities and reevaluation of existing management guidelines are warranted.
Topics: Cholecystectomy; Gallbladder Diseases; Humans; Polyps; Sensitivity and Specificity; Ultrasonography
PubMed: 29806818
DOI: 10.1503/cjs.011617 -
Medicine Aug 2021Clinical discovery/staging of gastric cancer (GC) is crucial in designing the treatment strategies and largely decides GC patients' survival. Endoscopic ultrasonography... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Clinical discovery/staging of gastric cancer (GC) is crucial in designing the treatment strategies and largely decides GC patients' survival. Endoscopic ultrasonography (EUS) and computed tomography (CT) are 2 useful GC diagnosis tools. High doses of radiation associated with CT make its use limited, while the process of EUS is stressful, time-consuming, and challenging. Transabdominal ultrasound (TAUS) is a promising candidate to address these shortcomings. This study aimed to meta-analyze the diagnostic accuracy and sensitivity of TAUS in discriminating between advanced and early GCs, as well as compare its utility with other imaging techniques.Methods: Literature searches were conducted using PubMed, Web of Science, Embase, and Cochrane Library databases up to 2019. Data were analyzed using RevMan software (Cochrane Collaboration, Oxford, UK), and pooled estimates of accuracy, sensitivity, and other features were acquired. Seven papers were eventually selected for meta-analysis.
RESULTS
TAUS had distinct diagnostic efficacies for early and advanced GC patients. The accuracy and sensitivity were significantly higher in the advanced group. A high color Doppler vascularity index and a lesion larger than 1 cm were 2 features of advanced GC. Moreover, TAUS had a comparable (but slightly higher) accuracy than CT and EUS.
CONCLUSIONS
TAUS is more accurate and sensitive in diagnosing advanced GC compared to early GC. More features of advanced GC are required to improve the recognition ability. At least, TAUS can be considered as a complementary imaging diagnostic tool to CT and EUS.
Topics: Abdomen; Humans; Reproducibility of Results; Stomach Neoplasms; Ultrasonography
PubMed: 34397938
DOI: 10.1097/MD.0000000000026928 -
Journal of Ayub Medical College,... 2019Choledocholithiasis denotes to the presence of gallstones within the common bile duct. In patients with Gall stones, the precise incidence and prevalence of...
BACKGROUND
Choledocholithiasis denotes to the presence of gallstones within the common bile duct. In patients with Gall stones, the precise incidence and prevalence of choledocholithiasis are not known, but it has been estimated that 5-20 percent of patients have choledocholithiasis at the time of cholecystectomy, with the incidence increasing with age. The transabdominal ultrasound examination (US) is the most commonly used modality for symptoms attributable to gallstone disease. US can provide important evidence for presence of stones in CBD.
METHODS
This was a descriptive cross-sectional validation study which was conducted at PAEC General Hospital, Islamabad from February to July 2015. Patients with suspected choledocholithiasis attending radiology department for ultrasound abdomen were included in the study. Findings for dilatation of common bile duct, intrahepatic biliary channel dilatation and direct visualization of calculus in CBD were noted. Ultrasound findings were compared with subsequent ERCP which was considered gold standard.
RESULTS
Diagnostic accuracy of trans abdominal ultrasound in detection of choledocholithiasis came out to be 76.9% with sensitivity of 76.2% and specificity of 81.3%.
CONCLUSIONS
Ultrasound can be used as an initial and baseline tool for detection of CBD calculi as it is non-invasive, easily available, radiation free and cost effective.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Cholangiopancreatography, Endoscopic Retrograde; Choledocholithiasis; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Sensitivity and Specificity; Ultrasonography; Young Adult
PubMed: 31933314
DOI: No ID Found -
Journal of Ultrasound Jun 2021For solid pancreatic masses, ultrasound endoscopic fine-needle biopsy is suggested as the front-line investigation for tissue achievement, notwithstanding the optimal...
BACKGROUND
For solid pancreatic masses, ultrasound endoscopic fine-needle biopsy is suggested as the front-line investigation for tissue achievement, notwithstanding the optimal performance of transabdominal ultrasound (TUS)-guided biopsy.
PURPOSE
To reassess the efficacy and effectiveness of TUS-guided sampling and to determine the factors predictive of accurate histology.
METHODS
In total, 142 patients with an indication for a TUS-guided biopsy of a pancreatic mass were analyzed. A single pass of an 18-gauge Biomol needle was carried out by the Menghini technique. The accuracy, sensitivity, and specificity of the procedure in terms of correctly diagnosing an inflammatory or neoplastic lesion were determined. The patients' characteristics, the size and location of the mass, and the sonographers' experience in performing TUS were recorded.
RESULTS
The sampling was unsuccessful in 24 cases, owing to the deep localization of lesions (57%), bloating (33%), or low patient compliance (10%). The accuracy, sensitivity, and specificity of the 118 successful biopsies were 81%, 79%, and 100%, respectively. A biopsy core was obtained in 90 of the 118 patients (76%) in whom the procedure was attempted. In the multivariate analysis, lesion size (≤ 20 mm vs. > 20 mm) (OR = 5.3 [1.7-17.0]) and operator experience (OR = 4.4 [1.6-12.1]) predicted the acquisition of adequate samples. With an expert sonographer, the accuracy, sensitivity, and specificity were 87%, 85%, and 100%, respectively. Two adverse events were registered: mild abdominal pain and a hypotensive crisis.
CONCLUSIONS
The present investigation highlights the optimal performance of a TUS-guided biopsy of a pancreatic mass. Because of its simplicity and safety, the procedure needs to be included among the recommended investigative options.
Topics: Endoscopic Ultrasound-Guided Fine Needle Aspiration; Humans; Needles; Pancreas
PubMed: 33521888
DOI: 10.1007/s40477-020-00542-y -
RoFo : Fortschritte Auf Dem Gebiete Der... Jun 2014Three imaging modalities are available for the diagnosis of acute appendicitis: ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI).... (Review)
Review
UNLABELLED
Three imaging modalities are available for the diagnosis of acute appendicitis: ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). Transabdominal ultrasound should be the first-line imaging test. Abdominal CT is superior to US and is required immediately in patients with atypical clinical presentation of appendicitis and suspected perforation. However, low-dose unenhanced CT is equal to standard-dose CT with intravenous contrast agents in the detection of five signs of acute appendicitis (thickened appendiceal wall more than 2 mm, cross-sectional diameter greater than 6 mm, periappendicitis, abscess, and appendicolith). MRI is necessary in pregnant women and young adults. This review illustrates the principles of state-of-the-art imaging techniques and their clinical relevance.
KEY POINTS
• US is the basic diagnostic method in case of suspected appendicitis.• CT is necessary in patients with atypical presentation of appendicitis.• MRI should be the first-line imaging test in pregnant women.
Topics: Abdomen, Acute; Adult; Appendicitis; Appendix; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Pregnancy; Pregnancy Complications; Sensitivity and Specificity; Tomography, X-Ray Computed; Ultrasonography
PubMed: 24760428
DOI: 10.1055/s-0034-1366074 -
Medical Ultrasonography May 2017Adrenal gland ultrasonography is one of the corner stones of the abdominal ultrasonography examination for many medical specialties. The adrenal areas can be easily... (Review)
Review
Adrenal gland ultrasonography is one of the corner stones of the abdominal ultrasonography examination for many medical specialties. The adrenal areas can be easily overlooked though adrenal gland pathology is diverse. We present the normal aspects and various transabdominal ultrasonography findings of the adrenal glands, both common and rare. Even though ultrasound examination is operator and patient dependent, we consider the examination of the adrenal glands very important, due to relatively frequent incidental detection of an adrenal mass.
Topics: Adrenal Gland Diseases; Adrenal Glands; Humans; Ultrasonography
PubMed: 28845499
DOI: 10.11152/mu-978 -
Ultrasound in Obstetrics & Gynecology :... Apr 2010To systematically review the diagnostic accuracy of second-trimester transabdominal ultrasound in detecting orofacial clefts in low- and high-risk populations and to... (Review)
Review
OBJECTIVES
To systematically review the diagnostic accuracy of second-trimester transabdominal ultrasound in detecting orofacial clefts in low- and high-risk populations and to compare two-dimensional (2D) with three-dimensional (3D) ultrasound techniques.
METHODS
MEDLINE and EMBASE were searched for articles published in English, Dutch, French or German using the keywords 'cleft' and 'ultrasound' or 'screening' or 'sonogram' and 'prenatal' or 'antenatal' or 'fetus' to identify cohort studies and randomized trials in order to assess the detection rate by prenatal ultrasound of cleft lip and palate in high-risk and low-risk pregnant women.
RESULTS
Of 451 citations identified, 27 met the criteria for the systematic review, 21 involving unselected low-risk populations and six involving high-risk populations. In the selected studies there was diversity in the gestational age at which the ultrasound examination was performed and there was considerable variety in the diagnostic accuracy of 2D ultrasound in the low-risk women, with prenatal detection rates ranging from 9% to 100% for cleft lip with or without cleft palate, 0% to 22% for cleft palate only and 0% to 73% for all types of cleft. 3D ultrasound in high-risk women resulted in a detection rate of 100% for cleft lip, 86% to 90% for cleft lip with palate and 0% to 89% for cleft palate only.
CONCLUSIONS
2D ultrasound screening for cleft lip and palate in a low-risk population has a relatively low detection rate but is associated with few false-positive results. 3D ultrasound can achieve a reliable diagnosis, but not of cleft palate only.
Topics: Cleft Lip; Cleft Palate; Female; Gestational Age; Humans; Pregnancy; Ultrasonography, Prenatal
PubMed: 20235140
DOI: 10.1002/uog.7472