Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 47

Search results for: ultrasonography

47 Ultrasonographic Study of Normal Scapula in Horse

Authors: Mohamad Saeed Ahrari-Khafi, Abutorab Tabatabai-Naini, Niloofar Ajvadi

Abstract:

Scapular fracture is not common in horses, due to the proper protection of scapular muscles. However, if it happens, it can cause lameness in horses. Because of the overlapping of the scapula on the contralateral scapula and the thorax, usually radiography cannot be helpful in evaluation, except in small amount of its ventral part. Although ultrasonography is mainly used for diagnosis of soft tissue injuries, it also can be used for evaluation of bone surface abnormalities. This study was intended to document the normal ultrasonographic appearance of the equine scapula. Right forelimb of six horses was used. To facilitate the image assessment, a zoning system was developed. Ultrasonography was performed by using a 5-11 MHz linear array transducer. Ultrasonographic anatomy of scapula in different parts and planes was imaged and documented, hoping to help practitioners to diagnose fractures and injuries. Results showed that ultrasonography is capable to depict different parts of the scapula and regional muscles, and can be used for detecting fractures and other abnormalities.

Keywords: horse, scapula, scapular fracture, ultrasonography

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46 Ultrasonographic Evaluation of Tars and Metatars Region of Dromedary Camel

Authors: Aboozar Dehghan, S. Sharifi, A. Ardeshiri, F. Jafari, F. Samani

Abstract:

Ultrasonography is a safe, particular, available and easy to use method to evaluate soft tissues. Tendons play the main role to body locomotors system. Ultrasonography performed in tarsus and metatarsus region of rare limb of eight adult, Dromedary camels (camelus dromedaries) in both sex. Clinical examination and gate analysis was performed before slaughtering. From the tarsus to the 1st phalanx was divided to 4 equal region include 1a, 2a, 1b and 2b. Flexor surface was clipped and covered by enough ultrasonography gel. Ultrasonography was performed by linear phased array 8-12 Mhz transducer in transverse and longitudinal section and Superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT) and suspensory ligament (SL) were imaged. Echogenicity and diameter of these structures were recorded. Size of tendons and SL measured after necropsy too. statistical analysis obtained that SDFT diameter larger than others in all described regions and mean of DDFT diameter larger than suspensory ligament. Echogenicity of SL more than SDFT and DDFT. No Significant relationship was seen between left and right rare limb structures size. Between sex and tendons and SL diameter, significant relationship not seen.

Keywords: dromedary camel, tars and metatars, ultrasonography

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45 Pre-Processing of Ultrasonography Image Quality Improvement in Cases of Cervical Cancer Using Image Enhancement

Authors: Retno Supriyanti, Teguh Budiono, Yogi Ramadhani, Haris B. Widodo, Arwita Mulyawati

Abstract:

Cervical cancer is the leading cause of mortality in cancer-related diseases. In this diagnosis doctors usually perform several tests to determine the presence of cervical cancer in a patient. However, these checks require support equipment to get the results in more detail. One is by using ultrasonography. However, for the developing countries most of the existing ultrasonography has a low resolution. The goal of this research is to obtain abnormalities on low-resolution ultrasound images especially for cervical cancer case. In this paper, we emphasize our work to use Image Enhancement for pre-processing image quality improvement. The result shows that pre-processing stage is promising to support further analysis.

Keywords: cervical cancer, mortality, low-resolution, image enhancement.

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44 Measurement of Qashqaeian Sheep Fetus Parameters by Ultrasonography

Authors: Aboozar Dehghan, S. Sharifi, S. A. Dehghan, Ali Aliabadi, Arash Esfandiari

Abstract:

Ultrasonography is a safe, available and particular method in diagnostic imaging science. In ultrasonography most of body soft tissue imaged in B mode display. Iranian Qashqaeian sheep is an old and domestic breed in Zagros mountain area in central plateau of Iran. Population of this breed in Fars state (study location) is 250000 animals. Gestation age detection in sheep was performed by ultarasonography in Kivircik breed in 2010 in turkey. In this study 5 adult, clinically healthy, Iranian ewes and 1 Iranian ram were selected. We measured biparital diameter that thickened part of fetal skull include (BPD), trunk diameter (TD), fetal heart diameter(FHD), intercostals space of fetus (ICS) and fetal heart rate per minute (FHR) weekly after day 60 after pregnancy. Inguinal area in both sides shaved and cleaned by alcohol 70 degree and covered by enough copulating gel. Trans abdominal Ultarasonography was performed by a convex multi frequency transducer with 2.5-5 MHz frequency. Data were collected and analyzed by on way Annova method in Spss15 software. Mean of BPD, TD, FHD and ICS in day 60 were 14.58, 25.92, 3.53, 2.3mm. FHR can measure on day 109 to 150. TD after day 109 cannot displayed in 1 frame in scanning. Ultrasonography in sheep pregnancy is a particular method. Using this study can help in theriogeniologic disease that affected fetal growth. Differentiating between various sheep breed is a functional result of this study.

Keywords: qashqaeian sheep, fetometry, ultrasonography

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43 Morphometry of Female Reproductive Tract in Small Ruminants Using Ultrasonography

Authors: R. Jannat, N. S. Juyena, F. Y. Bari, M. N. Islam

Abstract:

Understanding anatomy of female reproductive organs is very much important to identify any variation in disease condition. Therefore, this study was conducted to determine the morphometry of female reproductive tract in small ruminant using ultrasonography. The reproductive tracts of 2l does and 20 ewes were collected, and both gross and ultrasonographic image measurements were performed to study morphometry of cervix, body of uterus, horn of uterus and ovary. Water bath ultrasonography technique was used with trans-abdominal linear probe for image measurements. Results revealed significant (P<0.001) variation among gross and image measurements of cervix, body of uterus and ovaries in does whereas, significant (P<0.001) variation existed between gross and image measurements of ovaries diameter in ewes. Gross measurements were proportionately higher than image measurements in both species. The mean length and width were found higher in right ovaries than those of left ovaries. In addition, the diameter of right ovaries was higher than those of left ovaries in both species. Pearson's correlation revealed a positive relation between two measurements. Moreover, it was found that echogenicity varied with reproductive organs. This is a model study. This study may help to identify female reproductive structures by trans-abdominal ultrasonography.

Keywords: female reproductive tract, morphometry, small ruminants, ultrasonography

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42 Edge Detection and Morphological Image for Estimating Gestational Age Based on Fetus Length Automatically

Authors: Retno Supriyanti, Ahmad Chuzaeri, Yogi Ramadhani, A. Haris Budi Widodo

Abstract:

The use of ultrasonography in the medical world has been very popular including the diagnosis of pregnancy. In determining pregnancy, ultrasonography has many roles, such as to check the position of the fetus, abnormal pregnancy, fetal age and others. Unfortunately, all these things still need to analyze the role of the obstetrician in the sense of image raised by ultrasonography. One of the most striking is the determination of gestational age. Usually, it is done by measuring the length of the fetus manually by obstetricians. In this study, we developed a computer-aided diagnosis for the determination of gestational age by measuring the length of the fetus automatically using edge detection method and image morphology. Results showed that the system is sufficiently accurate in determining the gestational age based image processing.

Keywords: computer aided diagnosis, gestational age, and diameter of uterus, length of fetus, edge detection method, morphology image

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41 Ultrasonographic Manifestation of Periventricular Leukomalacia in Preterm Neonates at Teaching Hospital Peradeniya, Sri Lanka

Authors: P. P. Chandrasekera, P. B. Hewavithana, S. Rosairo, M. H. M. N. Herath, D. M. R. D. Mirihella

Abstract:

Periventricular Leukomalacia (PVL) is a White Matter Injury (WMI) of preterm neonatal brain. Objectives of the study were to assess the neuro-developmental outcome at one year of age and to determine a good protocol of cranial ultrasonography to detect PVL. Two hundred and sixty four preterm neonates were included in the study. Series of cranial ultrasound scans were done by using a dedicated neonatal head probe 4-10 MHz of Logic e portable ultrasound scanner. Clinical history of seizures, abnormal head growth (hydrocephalus or microcephaly) and developmental milestones were assessed and neurological examinations were done until one year of age. Among live neonates, 57% who had cystic PVL (Grades2 and 3) manifested as cerebral palsy. In conclusion cystic PVL has permanent neurological disabilities like cerebral palsy. Good protocol of real time cranial ultrasonography to detect PVL is to perform scans at least once a week until one month and at term (40 weeks of gestation).

Keywords: cerebral palsy, cranial ultrasonography, Periventricular Leukomalacia, preterm neonates

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40 Prediction of Endotracheal Tube Size in Children by Predicting Subglottic Diameter Using Ultrasonographic Measurement versus Traditional Formulas

Authors: Parul Jindal, Shubhi Singh, Priya Ramakrishnan, Shailender Raghuvanshi

Abstract:

Background: Knowledge of the influence of the age of the child on laryngeal dimensions is essential for all practitioners who are dealing with paediatric airway. Choosing the correct endotracheal tube (ETT) size is a crucial step in pediatric patients because a large-sized tube may cause complications like post-extubation stridor and subglottic stenosis. On the other hand with a smaller tube, there will be increased gas flow resistance, aspiration risk, poor ventilation, inaccurate monitoring of end-tidal gases and reintubation may also be required with a different size of the tracheal tube. Recent advancement in ultrasonography (USG) techniques should now allow for accurate and descriptive evaluation of pediatric airway. Aims and objectives: This study was planned to determine the accuracy of Ultrasonography (USG) to assess the appropriate ETT size and compare it with physical indices based formulae. Methods: After obtaining approval from Institute’s Ethical and Research committee, and parental written and informed consent, the study was conducted on 100 subjects of either sex between 12-60 months of age, undergoing various elective surgeries under general anesthesia requiring endotracheal intubation. The same experienced radiologist performed ultrasonography. The transverse diameter was measured at the level of cricoids cartilage by USG. After USG, general anesthesia was administered using standard techniques followed by the institute. An experienced anesthesiologist performed the endotracheal intubations with uncuffed endotracheal tube (Portex Tracheal Tube Smiths Medical India Pvt. Ltd.) with Murphy’s eye. He was unaware of the finding of the ultrasonography. The tracheal tube was considered best fit if air leak was satisfactory at 15-20 cm H₂O of airway pressure. The obtained values were compared with the values of endotracheal tube size calculated by ultrasonography, various age, height, weight-based formulas and diameter of right and left little finger. The correlation of the size of the endotracheal tube by different modalities was done and Pearson's correlation coefficient was obtained. The comparison of the mean size of the endotracheal tube by ultrasonography and by traditional formula was done by the Friedman’s test and Wilcoxon sign-rank test. Results: The predicted tube size was equal to best fit and best determined by ultrasonography (100%) followed by comparison to left little finger (98%) and right little finger (97%) and age-based formula (95%) followed by multivariate formula (83%) and body length (81%) formula. According to Pearson`s correlation, there was a moderate correlation of best fit endotracheal tube with endotracheal tube size by age-based formula (r=0.743), body length based formula (r=0.683), right little finger based formula (r=0.587), left little finger based formula (r=0.587) and multivariate formula (r=0.741). There was a strong correlation with ultrasonography (r=0.943). Ultrasonography was the most sensitive (100%) method of prediction followed by comparison to left (98%) and right (97%) little finger and age-based formula (95%), the multivariate formula had an even lesser sensitivity (83%) whereas body length based formula was least sensitive with a sensitivity of 78%. Conclusion: USG is a reliable method of estimation of subglottic diameter and for prediction of ETT size in children.

Keywords: endotracheal intubation, pediatric airway, subglottic diameter, traditional formulas, ultrasonography

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39 Assessment of Breeding Soundness by Comparative Radiography and Ultrasonography of Rabbit Testes

Authors: Adenike O. Olatunji-Akioye, Emmanual B Farayola

Abstract:

In order to improve the animal protein recommended daily intake of Nigerians, there is an upsurge in breeding of hitherto shunned food animals one of which is the rabbit. Radiography and ultrasonography are tools for diagnosing disease and evaluating the anatomical architecture of parts of the body non-invasively. As the rabbit is becoming a more important food animal, to achieve improved breeding of these animals, the best of the species form a breeding stock and will usually depend on breeding soundness which may be evaluated by assessment of the male reproductive organs by these tools. Four male intact rabbits weighing between 1.2 to 1.5 kg were acquired and acclimatized for 2 weeks. Dorsoventral views of the testes were acquired using a digital radiographic machine and a 5 MHz portable ultrasound scanner was used to acquire images of the testes in longitudinal, sagittal and transverse planes. Radiographic images acquired revealed soft tissue images of the testes in all rabbits. The testes lie in individual scrotal sacs sides on both sides of the midline at the level of the caudal vertebrae and thus are superimposed by caudal vertebrae and the caudal limits of the pelvic girdle. The ultrasonographic images revealed mostly homogenously hypoechogenic testes and a hyperechogenic mediastinum testis. The dorsal and ventral poles of the testes were heterogeneously hypoechogenic and correspond to the epididymis and spermatic cord. The rabbit is unique in the ability to retract the testes particularly when stressed and so careful and stressless handling during the procedures is of paramount importance. The imaging of rabbit testes can be safely done using both imaging methods but ultrasonography is a better method of assessment and evaluation of soundness for breeding.

Keywords: breeding soundness, rabbit, radiography, ultrasonography

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38 Scattering Operator and Spectral Clustering for Ultrasound Images: Application on Deep Venous Thrombi

Authors: Thibaud Berthomier, Ali Mansour, Luc Bressollette, Frédéric Le Roy, Dominique Mottier, Léo Fréchier, Barthélémy Hermenault

Abstract:

Deep Venous Thrombosis (DVT) occurs when a thrombus is formed within a deep vein (most often in the legs). This disease can be deadly if a part or the whole thrombus reaches the lung and causes a Pulmonary Embolism (PE). This disorder, often asymptomatic, has multifactorial causes: immobilization, surgery, pregnancy, age, cancers, and genetic variations. Our project aims to relate the thrombus epidemiology (origins, patient predispositions, PE) to its structure using ultrasound images. Ultrasonography and elastography were collected using Toshiba Aplio 500 at Brest Hospital. This manuscript compares two classification approaches: spectral clustering and scattering operator. The former is based on the graph and matrix theories while the latter cascades wavelet convolutions with nonlinear modulus and averaging operators.

Keywords: deep venous thrombosis, ultrasonography, elastography, scattering operator, wavelet, spectral clustering

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37 Correlation of Strength and Change in the Thickness of Back Extensor Muscles during Maximal Isometric Contraction in Healthy and Osteoporotic Postmenopausal Women

Authors: Mohammad Jan-Nataj Zeinab, Kahrizi Sedighe, Bayat Noshin, Giti Torkaman

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According to the importance of the back extensor muscle strength in postmenopausal women, this study aimed to determine the relationship between strength and changes in the thickness of back extensor muscles during isometric contraction in healthy and osteoporotic postmenopausal women. Strength and thickness of the muscles of 42 postmenopausal women were measured respectively, using a handheld dynamometer and ultrasonography. Also, the Pearson correlation coefficient was used to analyze the relationship between the strength and thickness. The results indicated a high reproducibility dynamometer test and ultrasonography. The decrease of strength in people with osteoporosis, occurred more through changes in muscle structure such as reducing the number and size of muscle fibers than changes in the nervous system part.

Keywords: back extensor muscles, strength, thickness, osteoporosis

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36 Monitoring Vaginal Electrical Resistance, Follicular Wave and Hormonal Profile during Estrus Cycle in Indigenous Sheep

Authors: T. A. Rosy, M. R. I. Talukdar, N. S. Juyena, F. Y. Bari, M. N. Islam

Abstract:

The ovarian follicular dynamics, vaginal electrical resistance (VER) and progesterone (P4) and estrogen (E2) profiles were investigated during estrus cycle in four indigenous ewes. Daily VER values were recorded with heat detector. The follicles were observed and measured by trans-rectal ultrasonography. Blood was collected daily for hormonal profiles. Results showed a significant variation in VER values (P<0.05) at estrus in regards to ewes and cycles. The day difference between two successive lower values in VER waves ranged from 13-17 days which might indicate the estrus cycle in indigenous ewes. Trans-rectal ultrasonography of ovaries revealed the presence of two to four waves of follicular growth during the study period. Results also showed that follicular diameter was negatively correlated with VER values. Study of hormonal profiles by ELISA revealed a positive correlation between E2 concentration and development of follicle and negative correlation between P4 concentration and development of follicle. The concentrations of estradiol increased at the time of estrus and then fall down in a basal level. Development of follicular size was accompanied by an increase in the concentration of serum estradiol. Inversely, when follicles heed to ovulation concentration of progesterone starts to fall down and after ovulation it turns its way to the zenith and remains at this state until next ovulatory follicle comes to its maximum diameter. This study could help scientists to set up a manipulative reproductive technique for improving genetic values of sheep in Bangladesh.

Keywords: ovarian follicle, hormonal profile, sheep, ultrasonography, vaginal electrical resistance

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35 Anomalous Course of Left Ovarian Vein Associated with Pelvic Congestion Syndrome

Authors: Viyango Pandian, Kumaresh Athiyappan

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Pelvic congestion Syndrome (PCS) is usually seen in multiparous women who give history of chronic dull-aching pelvic pain. We report a case of a 17 year old unmarried female, who presented with acute onset of chronic dull-aching abdominal pain in the left iliac fossa, which particularly increased during menstruation and was finally diagnosed to be pelvic congestion syndrome. On ultrasonography, multiple tortuous and dilated veins were observed in the left adnexa. Both ovaries appeared normal in size, volume and echotexture. Computed tomography (CT) angiography was performed to precisely delineate the venous pathway and to assess any associated abnormality; which showed a dilated and tortuous left ovarian vein with an anomalous course around the left kidney and draining into the left renal vein. Clinical parameters and hormonal levels were within normal limits. This is a rare case of anomalous course of left ovarian vein associated with pelvic congestion syndrome.

Keywords: anomalous course of ovarian vein, computed tomography, pelvic congestion syndrome, ultrasonography

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34 Isolated Contraction of Deep Lumbar Paraspinal Muscle with Magnetic Nerve Root Stimulation: A Pilot Study

Authors: Shi-Uk Lee, Chae Young Lim

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Objective: The aim of this study was to evaluate the changes of lumbar deep muscle thickness and cross-sectional area using ultrasonography with magnetic stimulation. Methods: To evaluate the changes of lumbar deep muscle by using magnetic stimulation, 12 healthy volunteers (39.6±10.0 yrs) without low back pain during 3 months participated in this study. All the participants were checked with X-ray and electrophysiologic study to confirm that they had no problems with their back. Magnetic stimulation was done on the L5 and S1 root with figure-eight coil as previous study. To confirm the proper motor root stimulation, the surface electrode was put on the tibialis anterior (L5) and abductor hallucis muscles (S1) and the hot spots of magnetic stimulation were found with 50% of maximal magnetic stimulation and determined the stimulation threshold lowering the magnetic intensity by 5%. Ultrasonography was used to assess the changes of L5 and S1 lumbar multifidus (superficial and deep) cross-sectional area and thickness with maximal magnetic stimulation. Cross-sectional area (CSA) and thickness was evaluated with image acquisition program, ImageJ software (National Institute of Healthy, USA). Wilcoxon signed-rank was used to compare outcomes between before and after stimulations. Results: The mean minimal threshold was 29.6±3.8% of maximal stimulation intensity. With minimal magnetic stimulation, thickness of L5 and S1 deep multifidus (DM) were increased from 1.25±0.20, 1.42±0.23 cm to 1.40±0.27, 1.56±0.34 cm, respectively (P=0.005, P=0.003). CSA of L5 and S1 DM were also increased from 2.26±0.18, 1.40±0.26 cm2 to 2.37±0.18, 1.56±0.34 cm2, respectively (P=0.002, P=0.002). However, thickness of L5 and S1 superficial multifidus (SM) were not changed from 1.92±0.21, 2.04±0.20 cm to 1.91±0.33, 1.96±0.33 cm (P=0.211, P=0.199) and CSA of L5 and S1 were also not changed from 4.29±0.53, 5.48±0.32 cm2 to 4.42±0.42, 5.64±0.38 cm2. With maximal magnetic stimulation, thickness of L5, S1 of DM and SM were increased (L5 DM, 1.29±0.26, 1.46±0.27 cm, P=0.028; L5 SM, 2.01±0.42, 2.24±0.39 cm, P=0.005; S1 DM, 1.29±0.19, 1.67±0.29 P=0.002; S1 SM, 1.90±0.36, 2.30±0.36, P=0.002). CSA of L5, S1 of DM and SM were also increased (all P values were 0.002). Conclusions: Deep lumbar muscles could be stimulated with lumbar motor root magnetic stimulation. With minimal stimulation, thickness and CSA of lumbosacral deep multifidus were increased in this study. Further studies are needed to confirm whether the similar results in chronic low back pain patients are represented. Lumbar magnetic stimulation might have strengthening effect of deep lumbar muscles with no discomfort.

Keywords: magnetic stimulation, lumbar multifidus, strengthening, ultrasonography

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33 Automatic Differentiation of Ultrasonic Images of Cystic and Solid Breast Lesions

Authors: Dmitry V. Pasynkov, Ivan A. Egoshin, Alexey A. Kolchev, Ivan V. Kliouchkin

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In most cases, typical cysts are easily recognized at ultrasonography. The specificity of this method for typical cysts reaches 98%, and it is usually considered as gold standard for typical cyst diagnosis. However, it is necessary to have all the following features to conclude the typical cyst: clear margin, the absence of internal echoes and dorsal acoustic enhancement. At the same time, not every breast cyst is typical. It is especially characteristic for protein-contained cysts that may have significant internal echoes. On the other hand, some solid lesions (predominantly malignant) may have cystic appearance and may be falsely accepted as cysts. Therefore we tried to develop the automatic method of cystic and solid breast lesions differentiation. Materials and methods. The input data were the ultrasonography digital images with the 256-gradations of gray color (Medison SA8000SE, Siemens X150, Esaote MyLab C). Identification of the lesion on these images was performed in two steps. On the first one, the region of interest (or contour of lesion) was searched and selected. Selection of such region is carried out using the sigmoid filter where the threshold is calculated according to the empirical distribution function of the image brightness and, if necessary, it was corrected according to the average brightness of the image points which have the highest gradient of brightness. At the second step, the identification of the selected region to one of lesion groups by its statistical characteristics of brightness distribution was made. The following characteristics were used: entropy, coefficients of the linear and polynomial regression, quantiles of different orders, an average gradient of brightness, etc. For determination of decisive criterion of belonging to one of lesion groups (cystic or solid) the training set of these characteristics of brightness distribution separately for benign and malignant lesions were received. To test our approach we used a set of 217 ultrasonic images of 107 cystic (including 53 atypical, difficult for bare eye differentiation) and 110 solid lesions. All lesions were cytologically and/or histologically confirmed. Visual identification was performed by trained specialist in breast ultrasonography. Results. Our system correctly distinguished all (107, 100%) typical cysts, 107 of 110 (97.3%) solid lesions and 50 of 53 (94.3%) atypical cysts. On the contrary, with the bare eye it was possible to identify correctly all (107, 100%) typical cysts, 96 of 110 (87.3%) solid lesions and 32 of 53 (60.4%) atypical cysts. Conclusion. Automatic approach significantly surpasses the visual assessment performed by trained specialist. The difference is especially large for atypical cysts and hypoechoic solid lesions with the clear margin. This data may have a clinical significance.

Keywords: breast cyst, breast solid lesion, differentiation, ultrasonography

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32 Ultrasonic Assessment of Corpora lutea and Plasma Progesterone Levels in Early Pregnant and Non Pregnant Cows

Authors: Abdurraouf O. Gaja, Salah Y. A. Al-Dahash, Guru Solmon Raju, Chikara Kubota

Abstract:

Corpus luteum cross sectional (by ultrasonography) and plasma progesterone (by DELFIA) were estimated in early pregnant and non pregnant cows on days 14th and 20th to 23rd post insemination. On day 14th, corpus luteum sectional area was 348.43 mm2 in pregnant and 387.84mm2 in non pregnant cows. Within days 20th to 23rd, corpus luteum sectional area ranged between 342.06 and 367.90 mm2 in pregnant and between 193.85 and 270.69 mm2 in non pregnant cows. Plasma progesterone level was 2.43 ng/ml in pregnant and 2.46 ng/ml in non pregnant cows on day 14th, while during days 20th to 23rd the level ranged between 2.47 and 2,84 ng/ml in pregnant and between 0.53 and 1.17 ng/ml in non pregnant cows. Results of both luteal tissue areas as well as plasma progesterone levels were highly significantly deferent (P<0.01) between pregnant and non pregnant cows during days 20th to 23rd, but there were no significant differences on day 14th. The correlation between CL cross-sectional area and plasma progesterone level was 0.4 in pregnant cows and 0.99 in non pregnant cow. It is clear, from this study, that ultrasonic assessment of corpora lutea is a viable alternative to determine plasma progesterone levels for early pregnancy diagnosis in cows.

Keywords: progesterone, ultrasonography, corpus luteum, pregnancy diagnosis, cow

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31 Response of Diaphragmatic Excursion to Inspiratory Muscle Trainer Post Thoracotomy

Authors: H. M. Haytham, E. A. Azza, E.S. Mohamed, E. G. Nesreen

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Thoracotomy is a great surgery that has serious pulmonary complications, so purpose of this study was to determine the response of diaphragmatic excursion to inspiratory muscle trainer post thoracotomy. Thirty patients of both sexes (16 men and 14 women) with age ranged from 20 to 40 years old had done thoracotomy participated in this study. The practical work was done in cardiothoracic department, Kasr-El-Aini hospital at faculty of medicine for individuals 3 days Post operatively. Patients were assigned into two groups: group A (study group) included 15 patients (8 men and 7 women) who received inspiratory muscle training by using inspiratory muscle trainer for 20 minutes and routine chest physiotherapy (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Group B (control group) included 15 patients (8 men and 7 women) who received the routine chest physiotherapy only (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Ultrasonography was used to evaluate the changes in diaphragmatic excursion before and after training program. Statistical analysis revealed a significant increase in diaphragmatic excursion in the study group (59.52%) more than control group (18.66%) after using inspiratory muscle trainer post operatively in patients post thoracotomy. It was concluded that the inspiratory muscle training device increases diaphragmatic excursion in patients post thoracotomy through improving inspiratory muscle strength and improving mechanics of breathing and using of inspiratory muscle trainer as a method of physical therapy rehabilitation to reduce post-operative pulmonary complications post thoracotomy.

Keywords: diaphragmatic excursion, inspiratory muscle trainer, ultrasonography, thoracotomy

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30 Comparison between High Resolution Ultrasonography and Magnetic Resonance Imaging in Assessment of Musculoskeletal Disorders Causing Ankle Pain

Authors: Engy S. El-Kayal, Mohamed M. S. Arafa

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There are various causes of ankle pain including traumatic and non-traumatic causes. Various imaging techniques are available for assessment of AP. MRI is considered to be the imaging modality of choice for ankle joint evaluation with an advantage of its high spatial resolution, multiplanar capability, hence its ability to visualize small complex anatomical structures around the ankle. However, the high costs and the relatively limited availability of MRI systems, as well as the relatively long duration of the examination all are considered disadvantages of MRI examination. Therefore there is a need for a more rapid and less expensive examination modality with good diagnostic accuracy to fulfill this gap. HRU has become increasingly important in the assessment of ankle disorders, with advantages of being fast, reliable, of low cost and readily available. US can visualize detailed anatomical structures and assess tendinous and ligamentous integrity. The aim of this study was to compare the diagnostic accuracy of HRU with MRI in the assessment of patients with AP. We included forty patients complaining of AP. All patients were subjected to real-time HRU and MRI of the affected ankle. Results of both techniques were compared to surgical and arthroscopic findings. All patients were examined according to a defined protocol that includes imaging the tendon tears or tendinitis, muscle tears, masses, or fluid collection, ligament sprain or tears, inflammation or fluid effusion within the joint or bursa, bone and cartilage lesions, erosions and osteophytes. Analysis of the results showed that the mean age of patients was 38 years. The study comprised of 24 women (60%) and 16 men (40%). The accuracy of HRU in detecting causes of AP was 85%, while the accuracy of MRI in the detection of causes of AP was 87.5%. In conclusions: HRU and MRI are two complementary tools of investigation with the former will be used as a primary tool of investigation and the latter will be used to confirm the diagnosis and the extent of the lesion especially when surgical interference is planned.

Keywords: ankle pain (AP), high-resolution ultrasound (HRU), magnetic resonance imaging (MRI) ultrasonography (US)

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29 Effect of Extracorporeal Shock Wave Therapy on Post Burn Scars

Authors: Mahmoud S. Zaghloul, Mohammed M. Khalaf, Wael N. Thabet, Haidy N. Asham

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Background. Hypertrophic scarring is a difficult problem for burn patients, and scar management is an essential aspect of outpatient burn therapy. Post-burn pathologic scars involve functional and aesthetic limitations that have a dramatic influence on the patient’s quality of life. The aim was to investigate the use of extracorporeal shock wave therapy (ESWT), which targets the fibroblasts in scar tissue, as an effective modality for scar treatment in burn patients. Subjects and methods: forty patients with post-burn scars were assigned randomly into two equal groups; their ages ranged from 20-45 years. The study group received ESWT and traditional physical therapy program (deep friction massage, stretching exercises). The control group received traditional physical therapy program (deep friction massage, stretching exercises). All groups received two sessions per week for six successful weeks. The data were collected before and after the same period of treatment for both groups. Evaluation procedures were carried out to measure scar thickness using ultrasonography and Vancouver Scar Scale (VSS) was completed before and after treatment. Results: Post-treatment results showed that there was a significant improvement difference in scar thickness in both groups in favor of the study group. Percentage of improvement in scar thickness in the study group was 42.55%, while it was 12.15% in the control group. There was also a significant improvement difference between results obtained using VSS in both groups in favor of the study group. Conclusion: ESWT is effective in management of pathologic post burn scars.

Keywords: extracorporeal shock wave therapy, post-burn scars, ultrasonography, Vancouver scar scale

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28 Report of Glucagonoma in a Dog: Ultrasonographic Morphologic Imaging and Histopathologic Diagnosis

Authors: Javad Khoshnegah, Hossein Nourani, Ali Mirshahi

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A 12-year-old female Terrier presented with lethargy, decreased appetite, melena, polyuria and polydipsia. On physical examination skin lesions including crusting, erythema and pupolopustular lesions, were observed mainly on the abdomen. Based on blood examinations, ultrasonography, necropsy and histopathological findings, the condition was diagnosed as superficial necrolytic dermatitis. Gross necropsy revealed hepatomegaly (severe vacuolar change of the hepatocytes) and a 5×5 mass adjusent to mesenteric lymph nodes which is finally diagnosed as tumor. Immunohistochemical analysis of the neoplastic cells revealed that the tumor was a glucagonoma.

Keywords: dog, glucagonoma, immunohistochemistry, tumor

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27 ¹⁸F-FDG PET/CT Impact on Staging of Pancreatic Cancer

Authors: Jiri Kysucan, Dusan Klos, Katherine Vomackova, Pavel Koranda, Martin Lovecek, Cestmir Neoral, Roman Havlik

Abstract:

Aim: The prognosis of patients with pancreatic cancer is poor. The median of survival after establishing diagnosis is 3-11 months without surgical treatment, 13-20 months with surgical treatment depending on the disease stage, 5-year survival is less than 5%. Radical surgical resection remains the only hope of curing the disease. Early diagnosis with valid establishment of tumor resectability is, therefore, the most important aim for patients with pancreatic cancer. The aim of the work is to evaluate the contribution and define the role of 18F-FDG PET/CT in preoperative staging. Material and Methods: In 195 patients (103 males, 92 females, median age 66,7 years, 32-88 years) with a suspect pancreatic lesion, as part of the standard preoperative staging, in addition to standard examination methods (ultrasonography, contrast spiral CT, endoscopic ultrasonography, endoscopic ultrasonographic biopsy), a hybrid 18F-FDG PET/CT was performed. All PET/CT findings were subsequently compared with standard staging (CT, EUS, EUS FNA), with peroperative findings and definitive histology in the operated patients as reference standards. Interpretation defined the extent of the tumor according to TNM classification. Limitations of resectability were local advancement (T4) and presence of distant metastases (M1). Results: PET/CT was performed in a total of 195 patients with a suspect pancreatic lesion. In 153 patients, pancreatic carcinoma was confirmed and of these patients, 72 were not indicated for radical surgical procedure due to local inoperability or generalization of the disease. The sensitivity of PET/CT in detecting the primary lesion was 92.2%, specificity was 90.5%. A false negative finding in 12 patients, a false positive finding was seen in 4 cases, positive predictive value (PPV) 97.2%, negative predictive value (NPV) 76,0%. In evaluating regional lymph nodes, sensitivity was 51.9%, specificity 58.3%, PPV 58,3%, NPV 51.9%. In detecting distant metastases, PET/CT reached a sensitivity of 82.8%, specificity was 97.8%, PPV 96.9%, NPV 87.0%. PET/CT found distant metastases in 12 patients, which were not detected by standard methods. In 15 patients (15.6%) with potentially radically resectable findings, the procedure was contraindicated based on PET/CT findings and the treatment strategy was changed. Conclusion: PET/CT is a highly sensitive and specific method useful in preoperative staging of pancreatic cancer. It improves the selection of patients for radical surgical procedures, who can benefit from it and decreases the number of incorrectly indicated operations.

Keywords: cancer, PET/CT, staging, surgery

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26 Effect of Vitamin D3 on Polycystic Ovary Syndrome Prognosis, Anthropometric and Body Composition Parameters of Overweight Women: A Randomized, Placebo-Controlled Clinical Trial

Authors: Nahla Al-Bayyari, Rae’d Hailat

Abstract:

Vitamin D deficiency and overweight are common in women suffering from polycystic ovary syndrome (PCOS). Weight gain in PCOS is an important factor for the development of menstrual dysfunction and signs of hyperandrogenism and alopecia. Features of PCOS such as oligomenorrhea can be predicted by anthropometric measurements as body mass index (BMI). Therefore, the aim of this trial was to study the effect of 50,000 IU/week of vitamin D₃ supplementation on the body composition and on the anthropometric measurements of overweight women with PCOS and to examine the impact of this effect on ovaries ultrasonography and menstrual cycle regularity. The study design was a prospective randomized, double-blinded placebo-controlled clinical trial conducted on 60 overweight Jordanian women aged (18-49) years with PCOS and vitamin D deficiency. The study participants were divided into two groups; vitamin D group (n = 30) who were assigned to receive 50,000 IU/week of vitamin D₃ and placebo group (n = 30) who were assigned to receive placebo tablets orally for 90 days. The anthropometric measurements and body composition were measured at baseline and after treatment for the PCOS and vitamin D deficient women. Also, assessment of the participants’ picture of ovaries by ultrasound and menstrual cycle regulatory were performed before and after treatment. Results showed that there were no significant (p > 0.05) differences between the placebo and vitamin D group basal 25(OH)D levels, body composition and anthropometric parameters. After treatment, vitamin D group serum levels of 25(OH)D increased (12.5 ± 0.61 to 50.2 ± 2.04 ng/mL, (p < 0.001), and decreased (50.2 ± 2.04 to 48.2 ± 2.03 ng/mL, p < 0.001) after 14 days of vitamin D₃ treatment cessation. There were no significant changes in the placebo group. In the vitamin D group, there were significant (p < 0.001) decreases in body weight, BMI, waist, and hip circumferences and fat mass. In addition, there were significant increases (p < 0.05) in fat free mass and total body water. These improvements in both anthropometric and body composition as well as in 25(OH)D concentrations, resulted in significant improvements in the picture of PCOS women ovaries ultrasonography and in menstrual cycle regularity, where nearly most of them (93%) had regular cycles after vitamin D₃ supplementation. In the placebo group, there were only significant decreases (p < 0.05) in waist and hip circumferences. It can be concluded that vitamin D supplementation improving serum 25(OH)D levels and PCOS prognosis by reducing body weight of overweight PCOS women and regulating their menstrual cycle.

Keywords: anthropometric, overweight, polycystic ovary syndrome, vitamin D₃

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25 Isolated Hydatidosis of Spleen: A Rare Entity

Authors: Anshul Raja

Abstract:

Cystic lesions of the spleen are rare and splenic hydatid cysts account for only 0.5% to 8% of all hydatidosis. Authors hereby report a case where a 50-year-old female presented to our hospital with the complains of heaviness and pain over left upper abdomen over the past 8-10 years. On radiological examination, ultrasonography revealed findings consistent with isolated splenic hydatid cyst and was later on confirmed on Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). No other organ or system involvement was seen. The patient underwent splenectomy and hydatid cyst was confirmed on histopathology. Owing to its rarity, it offers a diagnostic challenge to physicians but can reliably be diagnosed with great confidence employing various imaging modalities like CT and MRI.

Keywords: gastrointestinal radiology, abdominal imaging, hydatid cyst, medical and health sciences

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24 Ultrasonography of Low Extremities Veins Before and After Replacement of Knee Joint by Endoprosthesis

Authors: A. V. Alabut, V. D. Sikilinda, N. J. Nelasov, O. L. Eroshenko, M. N. Morgunov, I. V. Koroleva

Abstract:

We have analyzed the results of treatment of 204 patients with knee prosthetic arthroplasty. For the purpose of active delineation of vascular pathology triplex sonography of arterial and venous vessels of low extremities was performed in all cases in the preoperative period. When it was necessary, reconstructive vascular surgery was implemented to improve peripheral circulation and reduce the hazard of thrombosis after knee replacement. The combination of specific and nonspecific methods of thromboprophylaxis was used in perioperative period. On 7-10 day and 2.5-3 month after prosthetic arthroplasty, all patients iteratively underwent triple sonography. In case of detection of floating thrombus, urgent venous ligation was performed. Active diagnostics of venous thrombosis gave the opportunity to avoid fatal pulmonary embolism.

Keywords: knee replacement, venous thrombosis, pulmonary embolism, vascular surgery

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23 Some Studies on Endometritis in Pure Arabian Mares

Authors: Khairi El Battawy, Monika Skalicki

Abstract:

The present investigation has been done on pure Egyptian Arabian mares that reared in private horse studs. Fifty non-pregnant mares were selected and examined to classify them as either being reproductively healthy or subfertile mares including clinical endometritis, early embryonic death, granulosa cell tumor, repeat breeder (post-breeding endometritis), and anoestrus mares. The purpose of the study was to assess oxidative/antioxidant biochemical metabolites, lipogram, trace elements and reproductive hormones throughout reproductive conditions in mares during regular estrous, anestrum, early pregnancy, granulose cell tumor, ovulation failure, and endometritis. Results showed intensification of the free radical-dependent process in the blood of infertile mare, especially mares with endometritis. Ultrasonography as a diagnostic tool diagnosis of endometritis in mares was an important step as it revealed much information concerning infertility problem.

Keywords: endometritis, ovulation, oxidative, mare

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22 Study on Discontinuity Properties of Phased-Array Ultrasound Transducer Affecting to Sound Pressure Fields Pattern

Authors: Tran Trong Thang, Nguyen Phan Kien, Trinh Quang Duc

Abstract:

The phased-array ultrasound transducer types are utilities for medical ultrasonography as well as optical imaging. However, their discontinuity characteristic limits the applications due to the artifacts contaminated into the reconstructed images. Because of the effects of the ultrasound pressure field pattern to the echo ultrasonic waves as well as the optical modulated signal, the side lobes of the focused ultrasound beam induced by discontinuity of the phased-array ultrasound transducer might the reason of the artifacts. In this paper, a simple method in approach of numerical simulation was used to investigate the limitation of discontinuity of the elements in phased-array ultrasound transducer and their effects to the ultrasound pressure field. Take into account the change of ultrasound pressure field patterns in the conditions of variation of the pitches between elements of the phased-array ultrasound transducer, the appropriated parameters for phased-array ultrasound transducer design were asserted quantitatively.

Keywords: phased-array ultrasound transducer, sound pressure pattern, discontinuous sound field, numerical visualization

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21 Appropriate Depth of Needle Insertion during Rhomboid Major Trigger Point Block

Authors: Seongho Jang

Abstract:

Objective: To investigate an appropriate depth of needle insertion during trigger point injection into the rhomboid major muscle. Methods: Sixty-two patients who visited our department with shoulder or upper back pain participated in this study. The distance between the skin and the rhomboid major muscle (SM) and the distance between the skin and rib (SB) were measured using ultrasonography. The subjects were divided into 3 groups according to BMI: BMI less than 23 kg/m2 (underweight or normal group); 23 kg/m2 or more to less than 25 kg/m2 (overweight group); and 25 kg/m2 or more (obese group). The mean ±standard deviation (SD) of SM and SB of each group were calculated. A range between mean+1 SD of SM and the mean-1 SD of SB was defined as a safe margin. Results: The underweight or normal group’s SM, SB, and the safe margin were 1.2±0.2, 2.1±0.4, and 1.4 to 1.7 cm, respectively. The overweight group’s SM and SB were 1.4±0.2 and 2.4±0.9 cm, respectively. The safe margin could not be calculated for this group. The obese group’s SM, SB, and the safe margin were 1.8±0.3, 2.7±0.5, and 2.1 to 2.2 cm, respectively. Conclusion: This study will help us to set the standard depth of safe needle insertion into the rhomboid major muscle in an effective manner without causing any complications.

Keywords: pneumothorax, rhomboid major muscle, trigger point injection, ultrasound

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20 The Implication of Augmentation Cystoplasty with Mitrofanoff Channel on Reproduction Age Group and Outcome of Pregnancy

Authors: Amal A. Qedrah, Sofia A. Malik, Madiha Akbar

Abstract:

The aim of this article is to share a rare clinical case of pregnancy and surgical delivery in a patient who has undergone augmentation cystoplasty with mitrofanoff channel in the past. Methods: This case report is about a woman who conceived naturally at the age of 27, previously underwent augmentation cystoplasty at the age of 10 years with mitrofanoff procedure using self-clean intermittent catheterization. Furthermore, this pregnancy was complicated by the presence of preeclampsia diagnosed at term and PROM. Following the failure of induction for intrapartum preeclampsia, the patient delivered a healthy baby via low transverse cesarean section at 38 weeks done at Latifa Hospital, Dubai. Conclusion: The procedure is done at a pediatric or young age, after which most patients reach reproductive age. There is no contraindication to pregnancy vaginally or surgically; however, this case was complicated by preeclampsia, due to which this patient was taken for a cesarean section. It is advisable to consult a urologist frequently along with taking regular bacteriological urine samples and blood samples with renal ultrasonography for the evaluation of the kidney. Antibacterial treatment or prophylaxis should be used during pregnancy if necessary and intermittent self-catherization is mostly performed routinely. It is also important to have a urologist on standby during the surgery in order to avoid and/or fix any complications that might come forth.

Keywords: augmentation cystoplasty, cesarean section, delivery, mitrofanoff channel

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19 Shunt Placement in Treatment of Hydrocephalus in Patients with Myelomeningocele

Authors: M. M. Akhmediev, J. R. Ashrapov, T. M. Akhmediev

Abstract:

Hydrocephalus frequently occurs with spina bifida, and up to 80% of such patients need to be shunted. Objective: It’s sought to improve the results of the surgical treatment of hydrocephalus in children with spina bifida. Methods: We have analyzed the results of the surgical treatment of 80 patients aged between 1 month and 1,5-year-old with hydrocephalus and myelomeningocele. All patients underwent surgery in the period of 2013-2018. Results: In all patients, spina bifida was associated with hydrocephalus with a predominant extension of the posterior horns of the lateral ventricles in the form of colpocephaly, Chiari malformation type 2. Based on the method “Choose right shunt” the determination of the point of critical deformation of the ventricular system was established, 47 (58.8%) patients for the 1st stage underwent ventriculoperitoneal (VP) shunt surgery with a low-pressure valve, 28 (35.0%) patients with medium pressure and 5 (6.2%) with high-pressure valve. Under or over drainage complications were not observed in the postoperative period. The 2nd stage of surgery for myelomeningocele repair was planned in 1-2 months with the follow-up head ultrasonography and electromyography study. Conclusion: The implantable shunt systems parameters chosen before surgery in the surgical management of hydrocephalus in children with myelomeningocele are important in the causes of under or over drainage states, cerebrospinal fluid leakage from the myelomeningocele sac. Management of hydrocephalus should be performed by considering myelomeningocele affecting craniospinal compliance.

Keywords: hydrocephalus, spina bifida, myelomeningocele, ventriculoperitoneal (VP) shunt

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18 Assessment of Transverse Abdominis Activation during Three Different Exercises in Low Back Pain Patients: Measurement with Real-Time Ultrasonography

Authors: Venus Pagare, Amit Kharat, Dhaval K. Thakkar, Tushar J. Palekar

Abstract:

Introduction: Chronic low back pain (CLBP) is a major public health problem and is the leading musculoskeletal cause of disability. Altered neuromuscular control of core muscles, particulary transverses abdominis (TrA) is thought to be a contributing factor for the development of CLBP. Therefore, various exercises targeting the TrA are commonly incorporated into the rehabilitation. Objectives: To investigate the effects of 3 different core exercises on activation capacity of TrA muscle in individuals with CLBP as compared with healthy controls. Methodology: Thickness of TrA muscle was measured by ultrasound imaging in 30 patients with CLBP and 30 healthy controls. Measurements were taken during 3 different TrA activation exercises i.e Abdominal drawing in maneuver (ADIM), Abdominal drawing in with straight leg raise (ADSLR) and breathe hold at maximum expiration (ME). Thickness of the muscle at rest (at the end of normal tidal expiration) was taken as a baseline measure. Results: There was a significant difference between the healthy subjects and patients with low back pain with regard to the thickness of TrA at rest and thickness during contraction. ADIM produced a significant increase in the thickness of TrA compared to ADSLR and ME (p<0.001). Also, increase in thickness of TrA was more in the control group than patients with low back pain. Conclusion: CLBP patients exhibited atrophy of TrA muscle with delayed activation. Also, of the various core exercises, ADIM can be an effective method for activation of TrA.

Keywords: LBP, CLBP, ADSLR, ADIM

Procedia PDF Downloads 227