Australasian Journal of Ultrasound in Medicine最新文献

{"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}

{"title":"Point-of-care ultrasonography—An essential skill for medical graduates?","authors":"Konstantin Yastrebov,&nbsp;Cartan Costello,&nbsp;Ben Taylor,&nbsp;Adrienne Torda","doi":"10.1002/ajum.12355","DOIUrl":"10.1002/ajum.12355","url":null,"abstract":"<p>The recent proliferation of point-of-care ultrasonography (POCUS) in the clinical practice of many medical specialties has exposed persistent barriers to education, training and standardisation. Specialist training curriculums are already overwhelming, having grossly insufficient time available for the specialist trainees and for the small number of available trainers alike to incorporate POCUS into postgraduate education. The logical solution to overcome these barriers could be to incorporate basic POCUS education and training into the undergraduate university curriculums, introducing longitudinal integration with other relevant medical sciences. The Australasian Society of Ultrasound in Medicine already has well-established educational programmes in POCUS with standardised assessment of competency, which could potentially offer the basis for symbiosis with the Australian and New Zealand medical schools.</p>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"26 4","pages":"272-274"},"PeriodicalIF":0.0,"publicationDate":"2023-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47282246","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":"A survey of paediatric difficult peripheral intravenous access in the emergency department and use of point-of-care ultrasound","authors":"Clayton Lam,&nbsp;Lucy Dunstan,&nbsp;Amy Sweeny,&nbsp;Stuart Watkins,&nbsp;Shane George,&nbsp;Peter J. Snelling","doi":"10.1002/ajum.12353","DOIUrl":"10.1002/ajum.12353","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction/Purpose</h3>\u0000 \u0000 <p>Peripheral intravenous catheter (PIVC) insertion can be challenging in children, with point-of-care ultrasound (POCUS) known to increase success rates. The objective of this study was to survey how emergency department (ED) clinicians identify and escalate paediatric patients with difficult intravenous access (DIVA), specifically the use of POCUS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study was conducted in an Australian academic mixed ED that surveyed resident medical officers (RMOs), registrars, consultants and senior paediatric nurses. A 15 multiple-choice questionnaire evaluated clinicians experience with paediatric PIVC insertion, approach to identifying and managing DIVA and the use of POCUS or other adjuncts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty clinicians (34.2% response rate) completed the survey. Poor vein palpability was rated the highest predictor of DIVA. Of the respondents, 19 consultants (86.4%), 28 registrars (90.3%) and 16 RMOs (64.0%) used POCUS as an adjunct for paediatric DIVA patients but 16 consultants (72.8%), 21 registrars (67.8%) and 20 RMOs (80.0%) would use this less than 25% of the time in clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This survey suggests more clinicians to prefer using objective factors when identifying paediatric DIVA patients, rather than subjectively using gestalt, which relies on clinician experience. Whilst clearly recognised as a useful tool in our study, POCUS was used infrequently for paediatric DIVA patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There is currently no consistent process for the identification and escalation of paediatric DIVA patients, including the use of adjuncts such as POCUS. Clinician awareness for these issues should be addressed, which should include the development of guidelines and clinician training in POCUS for PIVC insertion in children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"26 3","pages":"184-190"},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12353","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10233833","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":"Isolated small ventricular septal defects in utero: HDlive Flow with spatiotemporal image correlation and HDlive Silhouette case study","authors":"Toshiyuki Hata,&nbsp;Tomomi Kawahara,&nbsp;Miyu Konishi,&nbsp;Saori Bouno,&nbsp;Tomomi Yamanishi,&nbsp;Aya Koyanagi,&nbsp;Takahito Miyake","doi":"10.1002/ajum.12351","DOIUrl":"10.1002/ajum.12351","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To demonstrate shunt flow through small ventricular septal defects (VSDs) using HDlive Flow with spatiotemporal image correlation (STIC) and HDlive Silhouette.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four cases of isolated small VSDs were evaluated using colour Doppler, and HDlive Flow with STIC and HDlive Silhouette.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HDlive Flow with STIC and HDlive Silhouette can improve the ability to depict shunt flow through small VSDs compared with colour Doppler.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This technique provides information on spatial recognition of the shunt flow through isolated small VSDs in real time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"26 3","pages":"203-209"},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12351","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10232315","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":"Anatomical landmarks for ultrasound-guided rectus femoris diagnostic nerve block in post-stroke spasticity","authors":"Salvatore Facciorusso,&nbsp;Stefania Spina,&nbsp;Giulio Gasperini,&nbsp;Alessandro Picelli,&nbsp;Mirko Filippetti,&nbsp;Franco Molteni,&nbsp;Andrea Santamato","doi":"10.1002/ajum.12354","DOIUrl":"10.1002/ajum.12354","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction/Purpose</h3>\u0000 \u0000 <p>To determine the location of the rectus femoris (RF) motor branch nerve, as well as its coordinates with reference to anatomical and ultrasound landmarks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty chronic stroke patients with stiff knee gait (SKG) and RF hyperactivity were included. The motor nerve branch to the RF muscle was identified medially to the vertical line from anterior superior iliac spine and the midpoint of the superior margin of the patella (line AP) and vertically to the horizontal line from the femoral pulse and its intersection point with the line AP (line F). The point of the motor branch (M) was located with ultrasound, and nerve depth and subcutaneous tissue thickness (ST) were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The coordinates of the motor branch to the RF were 2.82 (0.47) cm medially to the line AP and 4.61 (0.83) cm vertically to the line F. Nerve depth and subcutaneous tissue thickness were 2.71 (0.62) cm and 1.12 (0.75) cm, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The use of specific coordinates may increase clinicians' confidence when performing RF motor nerve block. This could lead to better decision-making when assessing SKG in chronic stroke patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"26 4","pages":"236-242"},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12354","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47237521","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}