Australasian Journal of Ultrasound in Medicine最新文献

{"title":"Prevalence of anomalies on the routine mid-trimester ultrasound: 3172 consecutive cases by a single maternal–fetal medicine specialist","authors":"Colin A. Walsh,&nbsp;Nicole Lees","doi":"10.1002/ajum.12369","DOIUrl":"10.1002/ajum.12369","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction/Purpose</h3>\u0000 \u0000 <p>The routine mid-trimester fetal anatomy ultrasound (FAS) is offered to every pregnant woman and remains critical in the detection of structural fetal anomalies. Our study aimed to determine the prevalence of abnormalities on routine FAS performed by a single operator, who is an experienced sub-specialist in maternal–fetal medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of all routine FAS performed a tertiary private obstetric ultrasound practice in metropolitan Sydney over a 7-year period, August 2015–July 2022. An advanced ultrasound protocol including detailed cardiac views was used in every case. Second opinion scans for suspected abnormalities were excluded. Fetal anomalies were classified into major and minor, based on the likely need for neonatal intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 14,908 obstetric ultrasound examinations, routine FAS were performed on 3172 fetuses by a single operator. More than 99% of women had screened low-risk for fetal aneuploidy. Structural anomalies were identified in 5% (157/3172) of fetuses; the prevalence of major anomalies was 1% (30/3172). Almost 60% of total anomalies were either cardiac or renal. No differences were identified in anomaly rates for singletons compared with twins (5.0% vs. 4.2%; P = 0.75). The prevalence of placenta previa and vasa previa was 10% and 0.1%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The prevalence of fetal anomalies on routine FAS by a single operator using a standardised protocol was higher in our practice (5%) than in previously published studies. Although most anomalies were minor, the rate of major abnormality was 1%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The routine mid-trimester FAS remains an integral component of prenatal ultrasound screening.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 1","pages":"12-18"},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139258417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of lung ultrasound scoring systems for the prognosis of COVID-19 in the emergency department: An international prospective cohort study","authors":"Peter J Snelling,&nbsp;Philip Jones,&nbsp;Rory Connolly,&nbsp;Tomislav Jelic,&nbsp;Dan Mirsch,&nbsp;Frank Myslik,&nbsp;Luke Phillips,&nbsp;Gabriel Blecher,&nbsp;the COVID LUS Study Group","doi":"10.1002/ajum.12364","DOIUrl":"10.1002/ajum.12364","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this study was to evaluate whether the lung ultrasound (LUS) scores applied to an international cohort of patients presenting to the emergency department (ED) with suspected COVID-19, and subsequently admitted with proven disease, could prognosticate clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was an international, multicentre, prospective, observational cohort study of patients who received LUS and were followed for the composite primary outcome of intubation, intensive care unit (ICU) admission or death. LUS scores were later applied including two 12-zone protocols (‘de Alencar score’ and ‘CLUE score’), a 12-zone protocol with lung and pleural findings (‘Ji score’) and an 11-zone protocol (‘Tung-Chen score’). The primary analysis comprised logistic regression modelling of the composite primary outcome, with the LUS scores analysed individually as predictor variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between April 2020 to April 2022, 129 patients with COVID-19 had LUS performed according to the protocol and 24 (18.6%) met the composite primary endpoint. No association was seen between the LUS score and the composite primary end point for the de Alencar score [odds ratio (OR) = 1.04; 95% confidence interval (CI): 0.97–1.11; P = 0.29], the CLUE score (OR = 1.03; 95% CI: 0.96–1.10; P = 0.40), the Ji score (OR = 1.02; 95% CI: 0.97–1.07; P = 0.40) or the Tung-Chen score (OR = 1.02; 95% CI: 0.97–1.08).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Compared to these earlier studies performed at the start of the pandemic, the negative outcome of our study could reflect the changing scenario of the COVID-19 pandemic, including patient, disease, and system factors. The analysis suggests that the study may have been underpowered to detect a weaker association between a LUS score and the primary outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In an international cohort of adult patients presenting to the ED with suspected COVID-19 disease who had LUS performed and were subsequently admitted to hospital, LUS severity scores did not prognosticate the need for invasive ventilation, ICU admission or death.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 2","pages":"75-88"},"PeriodicalIF":0.0,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12364","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136157235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hand and finger, ultrasound-guided, percutaneous core needle biopsies: A safe procedure with high diagnostic accuracy","authors":"Stephanie Magoon,&nbsp;Vanessa Peters,&nbsp;Felipe Ferreira de Souza,&nbsp;David Chen,&nbsp;Patrick Owens,&nbsp;Juan Pretell-Mazzini,&nbsp;Natalia Fullerton,&nbsp;Jean Jose,&nbsp;Andrew Rosenberg,&nbsp;Ty K. Subhawong","doi":"10.1002/ajum.12365","DOIUrl":"10.1002/ajum.12365","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction/Purpose</h3>\u0000 \u0000 <p>To determine the diagnostic accuracy and complication rates of ultrasound-guided, percutaneous core needle biopsies of soft tissue masses in the hand and fingers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Reports from all ultrasound-guided procedures between 21 May 2014 and 17 March 2022 were queried for keywords including “hand”, OR “finger”, AND “biopsy”. Patient demographics, lesion size and location, biopsy needle gauge and the number of cores obtained were recorded. The final pathology of the mass excision was then compared with the core needle biopsy (CNB) for each patient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-six records were reviewed, and 37 patients met inclusion criteria. Maximum lesion diameter averaged 1.45 cm with a range between 0.4 and 4.3 cm. The frequency of needle gauges used was 14G (14%), 16G (24%), 18G (38%), 20G (11%) and ‘not reported’ (14%). The mean number of tissue cores obtained was 2.9 (SD 1.2; range 1 to 6), excluding nine cases that reported ‘multiple’. The frequency of CNB diagnoses included tenosynovial giant cell tumour (TGCT) at 30%, ganglion cyst at 11% and epidermal inclusion cyst at 5%. CNB was 100% sensitive in detecting the three (8%) malignancies. Of the 37 tumours biopsied, 16 were surgically excised. One angiomyoma was originally diagnosed as a haemangioma on CNB, but all other histologic results were concordant for a diagnostic accuracy of 97%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Small soft tissue masses in the hands and fingers, even those less than 1 cm, are often amenable to ultrasound-guided CNB. Performance under image guidance facilitates retrieval of core specimens adquate for histologic diagnosis with relatively few passes using higher gauge needles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, ultrasound-guided CNB of the hand and fingers is safe and highly accurate in diagnosing soft tissue tumours. The accuracy is unrelated to the needle's gauge, the number of passes and the size of the lesions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"26 4","pages":"243-248"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12365","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135265698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Boxer's knuckle: Sonographic anatomy and assessment of sagittal band tears of the dorsal hood","authors":"Michelle Fenech","doi":"10.1002/ajum.12363","DOIUrl":"10.1002/ajum.12363","url":null,"abstract":"<p>Hand injuries are common in amateur and professional boxers and result in time lost from training and competition.<span>^1-3</span> Injuries to the dorsal hood account for 16% of all hand and wrist injuries in boxers.<span>^{1, 3}</span> ‘Boxer's knuckle’ describes a closed injury to the metacarpophalangeal joint (MCPJ) of the hand and is used synonymously to describe tears of the sagittal bands of the dorsal hood and associated extensor tendon instability.<span>^{4, 5}</span> It can result from a direct blow to the flexed MCPJ, commonly from boxing or punching, or from relatively low-energy repetitive injuries.<span>⁵</span> Patients typically present with a painful and swollen dorsal MCPJ, and the space between knuckles, with pain associated with forming a closed fist, loss of full extension and snapping of extensor tendons with MCPJ flexion.<span>^{6, 7}</span> Boxer's knuckle soft tissue injuries are less appreciated than boxer's fracture that typically involves a fracture of the fifth or fourth metacarpal neck with volar angulation and can occur from a similar mechanism of injury.<span>⁸</span></p><p>Tears of the sagittal bands of the dorsal hood can be clinically overlooked or underappreciated, as the symptoms can often be non-specific, and the associated tendon subluxation or dislocation may not always be observed.<span>^{9, 10}</span> If not diagnosed and treated adequately and in a timely manner, sagittal band tears can result in long-term persistent pain at the MCPJ and hand function impairment.<span>^11-13</span> Diagnostic imaging, including sonography, can play an important role in directly imaging the soft tissue structures surrounding the MCPJ and diagnosing sagittal bands tears and tendon instability; however, an appreciation of the mechanism of injury, sonographic anatomy, sonographic technique, and normal and abnormal sonographic appearances is required.</p><p>The anatomy of the extensor (dorsal) mechanism of digits 2–5 of the hand is complex and often overwhelming. It combines an array of dorsal soft tissue structures including extensor tendons, the dorsal plate and the dorsal hood (extensor expansion).<span>¹⁴</span> The dorsal hood is interrelated with intermetacarpal and palmar hand structures which aid in producing finger movement and MCPJ stability.<span>¹⁵</span> The intermetacarpal structures include collateral ligaments, lumbrical and interosseous muscles and their associated tendons. Palmar structures of the hand around the MCPJ include the palmar plate, A1 pulley, flexor tendons, the deep transverse metacarpal ligament (DTMCL) and the associated neurovascular structures.<span>¹⁵</span> The dorsal, intermetacarpal and palmar structures surrounding the MCPJ all need to be sonographically assessed in cases of suspected sagittal band tears.</p><p>Extension of the proximal interphalangeal joint (PIPJ) and distal in","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"26 4","pages":"216-229"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12363","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136014304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based innovation in ultrasound practice","authors":"Gillian Whalley","doi":"10.1002/ajum.12362","DOIUrl":"10.1002/ajum.12362","url":null,"abstract":"<p>I have recently returned from ASUM's annual New Zealand conference and am surprised by two things – how diverse ultrasound practice is and how much I enjoyed listening to presentations outside my speciality area. This is because some of the challenges we face in terms of developing an evidence base for our practice of, and justification for, our scanning approaches are similar. Many of us are facing the pressure of ‘getting through lists’: some are advocating for reducing scanning protocols or performing targeted examinations; others are advocating for extending scopes of practice outside traditional boundaries; whilst some are even advocating for skipping ultrasound and moving straight to other imaging modalities.</p><p>Whatever your innovative idea is, it should be evidence-based and proven to alleviate the problem at hand; whether it be workforce shortages, time poverty or a long waitlist. In this issue of AJUM, we focus on the areas of innovation and research that could enhance practice if adopted widely. And as you read these articles, I challenge you to think about whether similar issues exist in your speciality areas. Are there innovations that could be introduced? Or are there teaching tips that could enhance everyone's practice? Is there a way to streamline our practice and training? One of the key strategic goals of ASUM is <i>to deliver evidence-based standards and research</i>, and this issue of our society's journal should tick a continuing education box for many of you. I'm hopeful it will also stimulate you to undertake your own research in your area or practice.</p><p>Rocha <i>et al</i>.<span>¹</span> present an analysis of a large cohort of women investigated for endometriosis in which they evaluated the anatomical distribution of endometriosis with ultrasound and tested a recommended prediction model that used a patient-administered questionnaire from the World Endometriosis Research Foundation. They found the performance of the questionnaire added little clinical value and suggested further refinement of the questionnaire may be needed.</p><p>Samet <i>et al</i>.<span>²</span> present a small study where they investigated the difference between supine and prone patient positioning for identifying the popliteal fossa sciatic nerve and found supine positioning allowed for quicker identification with the potential to improve ultrasound-guided nerve block. Often, patient positioning is seen as a sonographer or patient preference, but quantifying one position's impact and potential benefit over another is useful and can inform future practice.</p><p>Another variation in practice is the choice of transducer. Lung ultrasound can be performed with either a curvilinear or phased array transducer, and preference may simply come down to which one is available at the time of the scan. There are reasons why operators may prefer one over the other, such as rib spaces or frequency, but many regard them as interchangeab","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"26 3","pages":"129-130"},"PeriodicalIF":0.0,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12362","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10223326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amniotic fluid volume and pregnancy outcomes in twin pregnancies: A systematic review and meta-analysis","authors":"Dayna Whitcombe,&nbsp;Everett Magann,&nbsp;Susan Steelman,&nbsp;Zhuopei Hu,&nbsp;Songthip Ounpraseuth","doi":"10.1002/ajum.12361","DOIUrl":"10.1002/ajum.12361","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To analyse amniotic fluid volume (AFV), specifically oligohydramnios or polyhydramnios, and associated pregnancy and neonatal outcomes in twin gestations through systematic review and meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We utilised systematic review methodology to identify items within published and grey literature resources. Prospective and retrospective studies with a control group were included. Inclusion criteria were as follows: studies in English, twin pregnancy in which AFVs and associated pregnancy and/or neonatal outcomes were evaluated. Exclusion criteria included the presence of an anomalous fetus, chromosome abnormality, monochorionic diamniotic twin pregnancy complicated by twin–twin transfusion syndrome or twin-reversed arterial perfusion, twin gestations undergoing therapeutic interventions (<i>i.e.</i> fetoscopic laser photocoagulation and serial amniocentesis) and monochorionic monoamniotic twin pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The literature search identified 1068 abstracts, only four met criteria for inclusion and analysis. The pooled data (two studies per outcome) revealed no significant difference in rate of pre-term delivery (OR: 2.94; CI: 0.20–43.81), pre-term delivery less than 32 weeks (OR: 1.97; CI: 0.43–9.12), umbilical cord pH &lt; 7 (OR: 2.66; CI: 0.22–32.51), rate of stillbirth (OR: 4.13; CI: 0.40–42.70), neonatal death (OR: 1.48; CI: 0.05–43.94), rate of NICU admission (OR: 1.38; CI: 0.61–3.11) or rate of small-for-gestational-age (SGA) infants (OR: 1.39; CI: 0.33–5.94).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Based on the pooled data (two studies per outcome), there was no difference in the fate of pre-term delivery, umbilical cord pH &lt; 7, stillbirth, neonatal death or SGA infants. What is disturbing is the lack of studies (1946–2020) that analysed the association between AFV and pregnancy outcomes in twin pregnancies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"26 4","pages":"249-257"},"PeriodicalIF":0.0,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48995653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative sensitivity and accuracy of 24 vs. 18 MHz ultrasound probes for the diagnosis of flexor tendon repair integrity","authors":"Sean Renfree,&nbsp;Nathaniel B. Hinckley,&nbsp;Nirvikar Dahiya,&nbsp;Nan Zhang,&nbsp;Kevin J. Renfree","doi":"10.1002/ajum.12359","DOIUrl":"10.1002/ajum.12359","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To determine whether a 24 MHz transducer significantly improves sensitivity, specificity and accuracy in evaluating flexor tendon repair integrity compared with an 18 MHz transducer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred and twelve cadaveric digits were randomised to an intact repair or simulated ‘failed’ repair, and to a two- or eight-strand repair of a flexor digitorum profundus laceration. A blinded sonologist evaluated specimens in static mode using 18 and 24 MHz transducers. Gaps were remeasured after scanning, and final gap width recorded. McNemar's exact test calculated differences between sensitivity, specificity and accuracy, and chi-squared test to compare sensitivity, specificity and accuracy between number of strands (2 vs. 8) and repair gap (≥4 mm).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 24 MHz transducer had higher sensitivity (81 vs. 59%), lower specificity (67 vs. 70%) and higher overall accuracy (74 vs. 64%), than the 18 MHz transducer. The difference for sensitivity was significant (P = 0.011), but not differences for specificity and overall accuracy (P &gt; 0.05). Pearson's correlation (<i>r</i> = 0.61) demonstrated a moderate-to-strong positive correlation between measured and true gap sizes. Increased number of suture strands (2 vs. 8) did not impair sensitivity, specificity nor accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Ultrasound may tend to overestimate gap width, and a slight risk that some intact repairs, or those with small, clinically insignificant gaps may undergo surgical exploration that may not be indicated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A 24 MHz transducer is a more sensitive and accurate transducer for assessing flexor tendon repair integrity and measuring small gaps.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"26 4","pages":"230-235"},"PeriodicalIF":0.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48697140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case series: The use of spermatic cord block in maximising patient comfort during ultrasound-guided percutaneous core-needle biopsy of the testicle","authors":"Michael Dunlay,&nbsp;Chris Gu,&nbsp;Daniel Adamo,&nbsp;Brian Welch,&nbsp;Annie Packard,&nbsp;Thomas Atwell","doi":"10.1002/ajum.12356","DOIUrl":"10.1002/ajum.12356","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction/Purpose</h3>\u0000 \u0000 <p>Percutaneous core-needle biopsy of the testicle has been shown to be a safe and effective method of obtaining tissue for histological analysis and can be considered in specific clinical scenarios. While the use of spermatic cord block has been shown to be effective in pain relief in the emergent setting and as an anaesthetic option for inguinal surgery, its use in percutaneous core-needle biopsy has not been well described. Through this case series, we present our experience and technique of ultrasound-guided percutaneous core-needle biopsy using spermatic cord block in the setting of indeterminant testicular masses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our departmental biopsy database was reviewed to identify patients who underwent percutaneous core-needle biopsy of the testicle from March 2010 to July 2022 and who also received spermatic cord block during the procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three patients were identified who met the search criteria. All three patients presented for the evaluation of indeterminant testicular mass and had a known non-testicular primary cancer diagnosis at the time of biopsy. All three biopsies were performed using a combination of spermatic cord block, moderate sedation, and local anaesthetic. Biopsies were obtained using an 18-gauge spring-loaded device with 4-5 core samples obtained during each procedure. All biopsies were well tolerated without significant pain or post-procedure complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Ultrasound-guided percutaneous core-needle testicular biopsy using spermatic cord block is a safe and effective option in sampling indeterminate testicular masses while maintaining patient comfort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The inclusion of a spermatic cord block in combination with local anaesthetic and moderate sedation has become standard practice in our institution, as we believe this maximises patient comfort and safety resulting in a better patient experience.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"26 4","pages":"267-271"},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135902855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pseudoaneurysms: Different ultrasound patterns, aetiologies and locations","authors":"Ralph Abou Diwan,&nbsp;Lea Kaadi,&nbsp;Samir Hachem,&nbsp;Tarek Smayra,&nbsp;Sami Slaba,&nbsp;Berthe Chalhoub,&nbsp;Kamal Hachem","doi":"10.1002/ajum.12348","DOIUrl":"10.1002/ajum.12348","url":null,"abstract":"<p>Pseudoaneurysms are frequent vascular anomalies. This review article aims to describe the unique specific aspect of pseudoaneurysm (PSA) that allows to make the diagnosis using different modalities: colour Doppler ultrasound, computed tomographic angiography, magnetic resonance angiography and conventional angiography. It is essential to know the various aetiologies of PSA: iatrogenic, traumatic, dissecting and anastomotic; different locations and the possible complications, information to help clinicians choose the best treatment. Our review is supported by illustrated series of cases.</p>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"26 4","pages":"258-266"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42013042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current practice of placental cord insertion documentation in Australia – A sonographer survey","authors":"Samantha Ward,&nbsp;Zhonghua Sun,&nbsp;Sharon Maresse","doi":"10.1002/ajum.12360","DOIUrl":"10.1002/ajum.12360","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>During pregnancy, the umbilical cord attaches to the placenta in a central, eccentric, marginal or velamentous location. Maternal and fetal complications are associated with marginal and velamentous cord insertions, the most clinically significant being perinatal mortality due to undiagnosed vasa praevia. Current literature describes a wide variation regarding regulation of placental cord insertion (PCI) documentation during antenatal ultrasound examinations. This prospective cross-sectional study aimed to assess the current practice of antenatal PCI documentation in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Members of the Australian Sonographer Accreditation Registry were invited to participate in an online survey which was distributed between February and March 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four hundred ninety sonographers met the inclusion criteria for the study of which 330 (67.3%) have more than 10 years' experience as a sonographer and 375 (76.5%) are employed primarily in a public or private setting offering general ultrasound. Most respondents (89.6%) indicated documentation of the PCI site is departmental protocol at the second trimester anatomy scan (17–22 weeks gestation), but PCI documentation is protocol in less than 50% of other obstetric ultrasound examinations listed in the survey. The PCI site is included in the formal ultrasound report at a rate significantly less than inclusion in the departmental protocol and the sonographer's worksheet.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Considering the potential maternal and fetal complications associated with abnormal PCI and the ease at which the PCI site is identified in the first and second trimesters, we believe that standard inclusion of the PCI site in departmental protocol and in the formal ultrasound report from 11 weeks gestation, regardless of whether it is normal or abnormal, would prove invaluable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"26 3","pages":"157-168"},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12360","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10233832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}