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Fertility and Sterility May 2021
Topics: Oocyte Retrieval; Oocytes; Ultrasonography, Interventional
PubMed: 33933178
DOI: 10.1016/j.fertnstert.2021.02.038 -
The Journal of Maternal-fetal &... Oct 2019Vaginal examination is widely used to assess the progress of labor; however, it is subjective and poorly reproducible. We aim to assess the feasibility and accuracy of... (Observational Study)
Observational Study
Vaginal examination is widely used to assess the progress of labor; however, it is subjective and poorly reproducible. We aim to assess the feasibility and accuracy of transabdominal and transperineal ultrasound compared to vaginal examination in the assessment of labor and its progress. Women were recruited as they presented for assessment of labor to a tertiary inner city maternity service. Paired vaginal and ultrasound assessments were performed in 192 women at 24-42 weeks. Fetal head position was assessed by transabdominal ultrasound defined in relation to the occiput position transformed to a 12-hour clock face; fetal head station defined as head-perineum distance by transperineal ultrasound; cervical dilatation by anterior to posterior cervical rim measurement and caput succedaneum by skin-skull distance on transperineal ultrasound. Fetal head position was recorded in 99.7% (298/299) of US and 51.5% (154/299) on vaginal examination ( < .0001 ). Bland-Altman analysis showed 95% limits of agreement, -5.31 to 4.84 clock hours. Head station was recorded in 96.3% (308/320) on vaginal examination (VE) and 95.9% (307/320) on US ( = .79 ). Head station and head perineum distance were negatively correlated (Spearman's = -.57, < .0001). 54.4% (178/327) of cervical dilatation measurements were determined using US and 100% on VE/speculum ( < .0001). Bland-Altman analysis showed 95% limits of agreement -2.51-2.16 cm. The presence of caput could be assessed in 98.4% (315/320) of US and was commented in 95.3% (305/320) of VEs, with agreement for the presence of caput of 76% ( < .05). Fetuses with caput greater than 10 mm had significantly lower head station ( < .0001). We describe comprehensive ultrasound assessments in the labor room that could be translated to the assessment of women in labor. Fetal head position is unreliably determined by vaginal examination and agrees poorly with US. Head perineum distance has a moderate correlation with fetal head station in relation to the ischial spines based on vaginal examination. Cervical dilatation is not reliably assessed by ultrasound except at dilatations of less than 4 cm. Caput is readily quantifiable by ultrasound and its presence is associated with lower fetal head station. Transabdominal and transperineal ultrasound is feasible in the labor room with an accuracy that is generally greater than vaginal examinations.
Topics: Adolescent; Adult; Cervix Uteri; Delivery Rooms; Feasibility Studies; Female; Gynecological Examination; Head; Humans; Infant, Newborn; Labor Presentation; Labor Stage, First; Male; Perineum; Pregnancy; Prospective Studies; Reproducibility of Results; Ultrasonography, Prenatal; Young Adult
PubMed: 29712501
DOI: 10.1080/14767058.2018.1465553 -
Ethiopian Journal of Health Sciences May 2019The aim of this study was to assess the role of transabdominal ultrasonography in characterizing and determining the etiology of ascites in comparison with laboratory...
BACKGROUND
The aim of this study was to assess the role of transabdominal ultrasonography in characterizing and determining the etiology of ascites in comparison with laboratory ascitic fluid analysis and other methods used to establish the final diagnosis.
METHODS
A prospective descriptive study was conducted on 61 patients with ascites attending outpatient department (OPD) or admitted to wards of Tikur Anbesa Specialized Hospital (TASH) and referred to radiology department for imaging from June 2017 to November 2017. Data were collected following the internationally recommended scanning technique in consecutive bases. The data were analyzed using SPSS version 20. The comparison of ultrasound and laboratory findings with final clinical diagnosis was analyzed using Chi-square test (X).
RESULTS
Of 61 patients with ascites enrolled in this study, females were 35(57.4%) with age range of 16 to 75 and mean age of 43.2±14.11. The cause of ascites was established in 59 cases using a combination of clinical, pathological, imaging evidences and tumor markers. However there were two cases who had ascites with indeterminate cause. US suggested the diagnosis in 54(91.5%) patients. Excluding mixed and indeterminate cases, ultrasound characterized ascites correctly as exudate and transudate in 95% cases.
CONCLUSION
Ultrasound has significant accuracy to distinguish transudate and exudate ascites and in suggesting the underlying cause. It can be a valuable method of investigation of ascites in places where CT and MRI are not available, and it is the best complement for laboratory investigations on ascites in suggesting the etiology based on ascitic fluid texture and ancillary findings.
Topics: Adolescent; Adult; Aged; Ascites; Ascitic Fluid; Female; Humans; Male; Middle Aged; Prospective Studies; Ultrasonography; Young Adult
PubMed: 31447507
DOI: 10.4314/ejhs.v29i3.11 -
Acta Obstetricia Et Gynecologica... Jan 2024The clinical management of placenta accreta spectrum (PAS) depends on placental topography and vascular involvement. Our aim was to determine whether transabdominal and...
INTRODUCTION
The clinical management of placenta accreta spectrum (PAS) depends on placental topography and vascular involvement. Our aim was to determine whether transabdominal and transvaginal ultrasound signs can predict PAS management.
MATERIAL AND METHODS
We conducted a retrospective cohort study of consecutive prenatally suspected PAS cases in a single tertiary-care PAS center between January 2021 and July 2022. When PAS was confirmed during surgery, abdominal and transvaginal ultrasound scans were analyzed in relation to PAS management. The preferred surgical approach of PAS was one-step conservative surgery (OSCS). Massive blood loss and PAS topography in the lower bladder trigone necessitated cesarean hysterectomy. Transvaginal ultrasound-diagnosed intracervical hypervascularity was split into three categories based on their quantity. Anatomically, the internal cervical os is located at the level of the bladder trigone and was used as landmark for upper and lower bladder trigone PAS.
RESULTS
Ninety-one women underwent OSCS and 35 women underwent cesarean hysterectomy (total 126 women with PAS). Abdominal and transvaginal ultrasound features differed significantly between women that underwent OSCS and cesarean hysterectomy: decreased myometrial thickness (<1 mm), 82.4% vs. 100%, p = 0.006; placental bulge, 51.6% vs. 94.3%, p < 0.001; bladder wall interruption, 62.6% vs. 97.1%, p < 0.001; abnormal placental lacunae, 75.8% vs. 100%, p < 0.001; hypervascularity (large lacunae feeding vessels, 57.8% vs. 94.6%, p < 0.001; parametrial hypervascularity, 15.4% vs. 60%, p < 0.001; the rail sign, 6.6% vs. 28.6%, p = 0.003; three-dimensional Doppler intra-placental hypervascularity, 81.3% vs. 100%, p < 0.001; intracervical hypervascularity 60.4% vs. 94.3%, p < 0.001); and cervical length 2.5 ± 0.94 vs. 2.2 ± 0.73, p = 0.038. Other ultrasound signs were not significantly different. The results of multivariable logistic regression showed placental bulge (odds ratio [OR] 9.3; 95% CI 1.9-44.3; p = 0.005), parametrial hypervascularity (OR 4.1; 95% CI 1.541-11.085; p = 0.005), and intracervical hypervascularity (OR 9.2; 95% CI 1.905-44.056; p = 0.006) were weak predictors of OSCS. Intracervical hypervascularity Grade 1 (vascularity <50% of cervical tissue) was more present in OSCS than higher gradings two and three (91% vs. 27.6% vs. 14.3%; p < 0.001).
CONCLUSIONS
Cesarean hysterectomy is associated with the PAS signs of placental bulge and Grade 2 and 3 intracervical hypervascularity. OSCS is associated with intracervical hypervascularity Grade 1 on transvaginal ultrasound. Prospective validation is required to formulate predictors for PAS management.
Topics: Pregnancy; Female; Humans; Placenta; Placenta Accreta; Retrospective Studies; Ultrasonography; Myometrium; Placenta Previa; Ultrasonography, Prenatal
PubMed: 37968904
DOI: 10.1111/aogs.14715 -
World Journal of Gastroenterology Nov 2013The course and outcome is poor for most patients with pancreatic diseases. Advances in pancreatic imaging are important in the detection of pancreatic diseases at early... (Review)
Review
The course and outcome is poor for most patients with pancreatic diseases. Advances in pancreatic imaging are important in the detection of pancreatic diseases at early stages. Ultrasonography as a diagnostic tool has made, virtually speaking a technical revolution in medical imaging in the new millennium. It has not only become the preferred method for first line imaging, but also, increasingly to clarify the interpretation of other imaging modalities to obtain efficient clinical decision. We review ultrasonography modalities, focusing on advanced pancreatic imaging and its potential to substantially improve diagnosis of pancreatic diseases at earlier stages. In the first section, we describe scanning techniques and examination protocols. Their consequences for image quality and the ability to obtain complete and detailed visualization of the pancreas are discussed. In the second section we outline ultrasonographic characteristics of pancreatic diseases with emphasis on chronic pancreatitis. Finally, new developments in ultrasonography of the pancreas such as contrast enhanced ultrasound and elastography are enlightened.
Topics: Animals; Contrast Media; Elasticity Imaging Techniques; Endosonography; Humans; Image Interpretation, Computer-Assisted; Pancreas; Pancreatitis, Chronic; Predictive Value of Tests; Prognosis; Severity of Illness Index; Ultrasonography; Ultrasonography, Doppler
PubMed: 24259955
DOI: 10.3748/wjg.v19.i42.7247 -
International Journal of Hyperthermia :... 2019Adenomyosis is a relatively common disease among women of childbearing age. A minimally invasive alternative technique with low risks, faster recovery and decreased...
Adenomyosis is a relatively common disease among women of childbearing age. A minimally invasive alternative technique with low risks, faster recovery and decreased side effects is desired. We hypothesized that percutaneous microwave ablation (PMWA) under laparoscopic guidance would substantially reduce the risk of collateral thermal damage to the intestinal tract and relieve the pelvic adhesions. This study aimed to evaluate the feasibility, safety and efficacy of transvaginal ultrasound- and laparoscopy-guided PMWA for the treatment of adenomyosis. From May 2015 to October 2017, a total of 70 patients with symptomatic adenomyosis who underwent transvaginal ultrasound- and laparoscopy-guided PMWA were included in this study. The technical efficacy and complications of PMWA were assessed. Meanwhile, the uterine volume, lesion volume, symptom severity score (SSS) and visual analog scale (VAS) score before PMWA and at 1, 6 and 12 months after PMWA were recorded. PMWA was successfully performed with transvaginal ultrasound guidance and laparoscope assistance in all patients. No major complication was found after PMWA in any patients. The uterine volume, lesion volume, SSS and VAS were all decreased significantly at follow-up ( < .01). Transvaginal ultrasound- and laparoscopy-guided PMWA, which significantly decreased the uterine volume, lesion volume, SSS and VAS score, is a feasible minimally invasive technique for the treatment of adenomyosis.
Topics: Ablation Techniques; Adenomyosis; Adult; Female; Humans; Laparoscopy; Middle Aged; Ultrasonography; Vagina
PubMed: 31818163
DOI: 10.1080/02656736.2019.1690169 -
Journal of Ultrasound Dec 2020Contrast-enhanced ultrasonography (CEUS) is increasingly being performed in Italy and Europe, particularly in the field of hepato-gastroenterology. Initially, it was...
Contrast-enhanced ultrasonography (CEUS) is increasingly being performed in Italy and Europe, particularly in the field of hepato-gastroenterology. Initially, it was mainly carried out to characterize focal hepatic lesions, but, since then, numerous studies have demonstrated its efficacy in the differential diagnosis of focal pancreatic pathologies (D'Onofrio et al. in Expert Rev Med Devices 7(2):257-273, 2010; Vidili et al. in J Ultrasound 22(1):41-51, 2019). The purpose of this paper is to provide Italian Medical Doctors with recommendations and thereby practical guidelines on the management of these patients. The present paper reports the final conclusions reached by the SIUMB guideline commission. This paper addresses particularly percutaneous ultrasound (US) examination (transabdominal US) and is drawn up specifically for publication.
Topics: Contrast Media; Diagnosis, Differential; Humans; Image-Guided Biopsy; Pancreatic Cyst; Pancreatic Neoplasms; Ultrasonography
PubMed: 32886345
DOI: 10.1007/s40477-020-00522-2 -
World Journal of Gastroenterology Jul 2011Diagnosis of chronic inflammatory bowel diseases (IBD) is based on a combination of clinical symptoms, laboratory tests and imaging data. Imaging of the morphological... (Review)
Review
Diagnosis of chronic inflammatory bowel diseases (IBD) is based on a combination of clinical symptoms, laboratory tests and imaging data. Imaging of the morphological characteristics of IBD includes the assessment of mucosal alterations, transmural involvement and extraintestinal manifestations. No single imaging technique serves as a diagnostic gold standard to encompass all disease manifestations. Ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) allow cross-sectional imaging of the transmural alterations and extraintestinal manifestations. While in the USA the technique of choice is CT, in Europe the focus is more on MRI and ultrasound (US). Most patients with chronic IBD are diagnosed at a young age. After baseline diagnosis many of these young patients have to undergo repetitive imaging procedures during the variable clinical course of the disease, characterized by alternate periods of remission and active disease, and in monitoring the response to treatment. US has the advantage of being noninvasive, less costly, and easily repeatable, and thus can be very useful in following up patients with IBD. In addition, rising concern about radiation exposure in young adults indicates the demand for radiation-sparing techniques like US and MRI. This article focuses on the current clinical practice of US in IBD, describing the current technologies used in transabdominal intestinal US and the characteristic sonographic findings in Crohn´s disease and ulcerative colitis.
Topics: Blood Flow Velocity; Colitis, Ulcerative; Contrast Media; Crohn Disease; Gastroenterology; Humans; Image Processing, Computer-Assisted; Inflammation; Inflammatory Bowel Diseases; Intestines; Ultrasonography
PubMed: 21912467
DOI: 10.3748/wjg.v17.i27.3192 -
Ultrasound in Medicine & Biology Jul 2017The aim of this study was to assess the role of transabdominal ultrasound with cellulose-based oral contrast agent (TUS-OCCA) in the detection and surveillance of... (Clinical Trial)
Clinical Trial
The aim of this study was to assess the role of transabdominal ultrasound with cellulose-based oral contrast agent (TUS-OCCA) in the detection and surveillance of gastric ulcer. The study was approved by the institutional review board at Shengjing Hospital of China Medical University. A total of 124 consecutive patients with benign gastric ulcer diagnosed by gastroscopy and biopsy were enrolled. Serial TUS-OCCA (approximately 1 exam every 2 wk) was performed to monitor the effects of treatment, and additional interventions were planned according to the results. TUS-OCCA detected gastric ulcer in 76% of patients (94 of 124). The detection rates for lesions of ≤5 mm, lesions of 5-10 mm, lesions of 10-15 mm and lesions >15 mm were 32% (10 of 31), 77% (27 of 35), 96% (25 of 26) and 100% (32 of 32), respectively. The detection rates for lesions located in the antrum, angle and body were 70%, 84% and 85%, respectively. Among 30 undetected lesions, which ranged 2-13 mm in size, 11 were at the antrum, 9 at the angle, 3 in the body, 6 at the cardia and 1 at the fundus. During the follow-up period, patients underwent a mean of 3.8 TUS-OCCA examinations (range 2-7), and ulcers were healed after 8 wk (range 2-12 wk) of standard therapy in 76 patients. Eighteen patients who did not show improvement after standard therapy underwent repeat gastroscopy with biopsy. Repeat biopsy was positive for gastric cancer in 4 of these: 2 of the remaining 14 were diagnosed with gastric cancer at gastrectomy, and 12 were diagnosed with chronic benign ulcer. These results indicate that serial TUS-OCCA can be used for close monitoring during routine treatment of gastric ulcers that are detectable by TUS-OCCA and that monitoring by TUS-OCCA can guide additional interventions. A non-invasive follow-up program based on TUS-OCCA can also help to detect gastric cancers that have been misdiagnosed as benign ulcers at the initial endoscopic biopsy.
Topics: Abdomen; Administration, Oral; Adolescent; Adult; Aged; Aged, 80 and over; Algorithms; Cellulose; Contrast Media; Female; Humans; Image Enhancement; Male; Middle Aged; Reproducibility of Results; Sensitivity and Specificity; Stomach Ulcer; Ultrasonography; Watchful Waiting; Young Adult
PubMed: 28461064
DOI: 10.1016/j.ultrasmedbio.2017.02.008 -
Sensors (Basel, Switzerland) Jul 2020Ultrasound measurements of detrusor muscle thickness have been proposed as a diagnostic biomarker in patients with bladder overactivity and voiding dysfunction. In this...
Ultrasound measurements of detrusor muscle thickness have been proposed as a diagnostic biomarker in patients with bladder overactivity and voiding dysfunction. In this study, we present an approach based on deep learning (DL) and dynamic programming (DP) to segment the bladder sac and measure the detrusor muscle thickness from transabdominal 2D B-mode ultrasound images. To assess the performance of our method, we compared the results of automated methods to the manually obtained reference bladder segmentations and wall thickness measurements of 80 images obtained from 11 volunteers. It takes less than a second to segment the bladder from a 2D B-mode image for the DL method. The average Dice index for the bladder segmentation is 0.93 ± 0.04 mm, and the average root-mean-square-error and standard deviation for wall thickness measurement are 0.7 ± 0.2 mm, which is comparable to the manual ground truth. The proposed fully automated and fast method could be a useful tool for segmentation and wall thickness measurement of the bladder from transabdominal B-mode images. The computation speed and accuracy of the proposed method will enable adaptive adjustment of the ultrasound focus point, and continuous assessment of the bladder wall during the filling and voiding process of the bladder.
Topics: Automation; Humans; Specimen Handling; Ultrasonography; Urinary Bladder
PubMed: 32727146
DOI: 10.3390/s20154175