Journal of Medical Ultrasound最新文献

{"title":"A Male Patient with Severe Pain in the Right Hypochondrium","authors":"Rohit Ravindra Joat, Suresh Vasant Phatak, Azhar Shoaib Shaikh, Gajanan K. Wattamwar, Ganesh S. Narwane","doi":"10.4103/jmu.jmu_89_23","DOIUrl":"https://doi.org/10.4103/jmu.jmu_89_23","url":null,"abstract":"SECTION 1 – QUIZ Case A 45-year-old male presented with complaints of pain in the right hypochondrium for 6 months, which was aggravated in the last 10 days. There was no history of trauma. Ultrasound and computed tomography evaluation of the abdomen were performed [Figures 1-3].Figure 1: Grayscale ultrasound image of the liver and gallbladderFigure 2: Grayscale ultrasound image of the gallbladderFigure 3: Computed tomography image of the abdomenDeclaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published, and due efforts will be made to conceal the identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"50 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136311390","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":"Find the Piriformis Muscle Easily: From Anatomical Landmark to Sonographic Target","authors":"Mustafa Turgut Yildizgoren, Burak Ekici, Fatih Bagcier","doi":"10.4103/jmu.jmu_48_23","DOIUrl":"https://doi.org/10.4103/jmu.jmu_48_23","url":null,"abstract":"Dear Editor, Piriformis syndrome (PS) is a condition that is characterized by pain associated with the piriformis muscle. This syndrome encompasses various pathological changes of the piriformis muscle, such as those caused by myofascial pain, anatomical variations, muscle hypertrophy, trauma, and any external condition that causes pain similar to PS. PS can arise from a range of lesions, including herniated or degenerative lumbar discs, lumbar facet syndrome, trochanteric bursitis, sacroiliac joint dysfunction, and endometriosis.[1] The management of PS typically begins with pharmacotherapy and physical therapy. When the conservative regimen fails, injection can be applied to the piriformis muscle to relieve pain.[2] Piriformis muscle injections were conventionally performed without image guidance in clinics by physicians. However, due to the muscle's small size, deep location, and proximity to critical neurovascular structures, using image guidance has been suggested to enhance accuracy and minimize risk.[3] Beaton and Anson explained six distinct anatomical configurations involving the relationship between the sciatic nerve and the piriformis muscle. In >80% of the population, the sciatic nerve passes deep and exits inferiorly to the inferior edge of the muscle belly/tendon.[4] The success rate of blind injections is generally low, as evidenced by the various techniques that utilize different landmarks. A study conducted on cadavers comparing ultrasound-guided versus fluoroscopically-guided piriformis injections revealed a success rate of 95% with ultrasound guidance, whereas only a 30% success rate was observed with fluoroscopic guidance.[3] Identifying the piriformis muscle through palpation of anatomical landmarks can be challenging. We recommend a four-step ultrasound-guided approach for the piriformis muscle. To find the piriformis muscle easily under ultrasound guidance, the patient is positioned prone, and the lumbosacral area is aseptically prepared for injection. Using a low-frequency curvilinear probe, the transverse plane is examined with the medial border of the probe positioned on the posterior superior iliac spine (PSIS). All steps are performed by using the transverse ultrasonographic view: Step 1: The transducer is positioned transversely on the PSIS [Figure 1a] Step 2: The transducer is moved laterally until the iliac cortex and gluteus Maximus muscle are appeared [Figure 1b]. The iliac bone appears as a hyperechoic structure (curved line) Step 3: At this level, the transducer is moved in the caudal direction toward to obtain the axial sonographic view of the sciatic notch [Figure 1c]. Using Doppler imaging, the inferior gluteal artery can be visualized close to the sciatic nerve, while the superior gluteal artery is situated between the gluteus Maximus muscle and the piriformis muscle [Figure 1d] Step 4: Next, one end of the transducer is directed toward the greater trochanter to obtain the piriformis muscle. At this level, t","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"10 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136312294","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":"High-quality Agar and Polyacrylamide Tumor-mimicking Phantom Models for Magnetic Resonance-guided Focused Ultrasound Applications","authors":"Panagiotis Sofokleous, Christakis Damianou","doi":"10.4103/jmu.jmu_68_23","DOIUrl":"https://doi.org/10.4103/jmu.jmu_68_23","url":null,"abstract":"Abstract Background: Tissue-mimicking phantoms (TMPs) have been used extensively in clinical and nonclinical settings to simulate the thermal effects of focus ultrasound (FUS) technology in real tissue or organs. With recent technological developments in the FUS technology and its monitoring/guided techniques such as ultrasound-guided FUS and magnetic resonance-guided FUS (MRgFUS) the need for TMPs are more important than ever to ensure the safety of the patients before being treated with FUS for a variety of diseases (e.g., cancer or neurological). The purpose of this study was to prepare a tumor-mimicking phantom (TUMP) model that can simulate competently a tumor that is surrounded by healthy tissue. Methods: The TUMP models were prepared using polyacrylamide (PAA) and agar solutions enriched with MR contrast agents (silicon dioxide and glycerol), and the thermosensitive component bovine serum albumin (BSA) that can alter its physical properties once thermal change is detected, therefore offering real-time visualization of the applied FUS ablation in the TUMPs models. To establish if these TUMPs are good candidates to be used in thermoablation, their thermal properties were characterized with a custom-made FUS system in the laboratory and a magnetic resonance imaging (MRI) setup with MR-thermometry. The BSA protein's coagulation temperature was adjusted at 55°C by setting the pH of the PAA solution to 4.5, therefore simulating the necrosis temperature of the tissue. Results: The experiments carried out showed that the TUMP models prepared by PAA can change color from transparent to cream-white due to the BSA protein coagulation caused by the thermal stress applied. The TUMP models offered a good MRI contrast between the TMPs and the TUMPs including real-time visualization of the ablation area due to the BSA protein coagulation. Furthermore, the T2 -weighted MR images obtained showed a significant change in T2 when the BSA protein is thermally coagulated. MR thermometry maps demonstrated that the suggested TUMP models may successfully imitate a tumor that is present in soft tissue. Conclusion: The TUMP models developed in this study have numerous uses in the testing and calibration of FUS equipment including the simulation and validation of thermal therapy treatment plans with FUS or MRgFUS in oncology applications.","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"13 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136312317","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":"Plantar Fasciitis: An Updated Review","authors":"Wen‐Che Tseng, Yun-Chang Chen, Tsung-Min Lee, Wen-Shiang Chen","doi":"10.4103/jmu.jmu_2_23","DOIUrl":"https://doi.org/10.4103/jmu.jmu_2_23","url":null,"abstract":"Plantar fasciitis (PF) is a common musculoskeletal disease. Histologic findings of patients with PF showed mainly chronic degenerative processes rather than inflammation. In addition to mechanical factors, such as repetitive stress and reduced ankle dorsiflexion, PF is also linked to rheumatologic diseases and genetic factors. Ultrasound is becoming a standard imaging technique for assessing PF. Major sonographic findings included increased plantar fascia thickness and hypoechoic plantar fascia. In addition to traditional B-mode ultrasound, sonoelastography can also be utilized to diagnose PF. Ultrasound can also be used to guide therapeutic interventions. Over 80% of patients with PF improved under nonsurgical treatment. Treatment options for PF include physical therapy, modalities (laser, therapeutic ultrasound), extracorporeal shock wave therapy (ESWT), injections, transcatheter arterial embolization, and surgery. For injections, corticosteroid was mostly used in the past but has been replaced gradually by other techniques such as platelet-rich plasma or dextrose prolotherapy. There is also more and more evidence about ESWT in treating PF. Surgery serves as an option for recalcitrant PF cases, and endoscopic fasciotomy seemed to have good outcomes. Ultrasound plays an important role in diagnosing of PF and evaluating the treatment effect, and the use of sonoelastography in addition to traditional B-mode ultrasound may help in the early detection of PF and assessment of the treatment effect.","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"82 1 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139322279","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":"Imaging of Venolymphatic Malformation in a Child Extending from Inguinoscrotal Region to Thoracic Region: Case Report with Review of Literature.","authors":"Mohammad Ameen Abdus Salam Ansari, Avinash Parshuram Dhok, Pooja Giridhar Ladke, Nitin Shinde","doi":"10.4103/jmu.jmu_44_23","DOIUrl":"10.4103/jmu.jmu_44_23","url":null,"abstract":"<p><p>Vascular malformations (VM) are structural malformations of vascular development causing soft-tissue abnormality with functional and esthetic impairment. They are named by their predominant vessel type as arterial, venous, lymphatic, or mixed types. VM extending from the inguinoscrotal to the thoracic region are extremely rare presentation. We present a rare case of veno-lymphatic malformation in the inguinoscrotal region, which is extending superiorly up to the right thorax in a 14-year-old male child who presented with a large swelling in the bilateral inguinoscrotal region and reddish-brown colored skin patches over the right anterior and lateral thoracoabdominal region. The diagnosis was suggested by ultrasonography and confirmed by computed tomography and magnetic resonance imaging.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"32 4","pages":"345-347"},"PeriodicalIF":0.9,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972707","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":"Flow-mediated Dilation of the Brachial Artery in Women with Hypertensive Disorders of Pregnancy.","authors":"Babatunde Opeyemi Oguntade, Bolanle Olubunmi Ibitoye, Olufemiwa Niyi Makinde, Bukunmi Michael Idowu, Tolulope Adebayo Okedere","doi":"10.4103/jmu.jmu_10_23","DOIUrl":"https://doi.org/10.4103/jmu.jmu_10_23","url":null,"abstract":"<p><strong>Background: </strong>Hypertensive disorder of pregnancy (HDP) comprise chronic hypertension, gestational hypertension, preeclampsia/eclampsia, and preeclampsia superimposed on chronic hypertension. HDP complicate up to 10% of pregnancies worldwide and carry significant risks of maternal and perinatal morbidity and mortality. The aim of this study was to evaluate the derangement and characteristics of brachial artery flow-mediated dilation (BAFMD) in women with HDP.</p><p><strong>Methods: </strong>The BAFMD of the right brachial artery of 80 women with HDP (pregnant HDP), 80 normotensive pregnant women (pregnant non-HDP), and 80 healthy nonpregnant women (nonpregnant controls) was evaluated with B-mode ultrasound. The age, blood pressure, body mass index (BMI), brachial artery diameter, and BAFMD of the participants were compared. <i>P</i> ≤ 0.05 was statistically significant.</p><p><strong>Results: </strong>The pregnant HDP group had significantly lower mean BAFMD compared to pregnant non-HDP and nonpregnant controls (6.9% ± 2.53% vs. 8.32% ± 3.4% vs. 9.4% ± 2.68%; <i>P</i> < 0.001). There was no significant difference between the mean BAFMD of the pregnant HDP subgroups: preeclampsia (5.81% ± 1.7%) versus gestational hypertension (6.43% ± 3.02%); <i>P</i> = 0.57. BAFMD diminished with advancing gestational age in both the pregnant HDP and pregnant non-HDP groups. On regression analysis, BAFMD was a poor marker for HDP, while BMI was an independent predictor for HDP.</p><p><strong>Conclusion: </strong>Even though HDP were associated with significantly diminished BAFMD, it was not a good marker for HDP.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"32 1","pages":"48-54"},"PeriodicalIF":1.1,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11040488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872463","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":"Antenatal Hydrops Fetalis with Umbilical Vein Varix and Thrombosis - Ultrasound Imaging: A Rare Case.","authors":"Manasa Suryadevara, Roohi Gupta, Gaurav Vedprakash Mishra, Vadlamudi Nagendra, Pratik Jayprakash Bhansali","doi":"10.4103/jmu.jmu_11_23","DOIUrl":"10.4103/jmu.jmu_11_23","url":null,"abstract":"<p><p>Thrombosis of the umbilical vein/artery is a rare complication and is highly associated with fetal mortality. Varix of the fetal umbilical vein is a very rare anomaly and refers to the focal dilatation of the umbilical vein of the fetus. It appears as a round or fusiform cystic structure in the fetal abdomen. Here, in this case report, we hereby discuss a 28-year-old pregnant female with a gestational age of 26 weeks from last menstrual period, who on antenatal ultrasound had findings suggestive of umbilical vein varix with thrombosis and hydrops fetalis.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"32 4","pages":"337-340"},"PeriodicalIF":0.9,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972640","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":"Megacystis-microcolon-intestinal Hypoperistalsis Syndrome: Four Consecutive Pregnancies with Megacystis.","authors":"Susana Saraiva, M Solinho, C Lourenço, C Brito","doi":"10.4103/jmu.jmu_111_22","DOIUrl":"10.4103/jmu.jmu_111_22","url":null,"abstract":"<p><p>Megacystis-microcolon-intestinal hypoperistalsis syndrome is a rare congenital disease with a poor prognosis and life expectancy. We present the prenatal diagnosis of four consecutive cases in the same woman. After medical genetics consultation, the couple was advised to resort to medically assisted reproduction techniques with oocyte donation. This case report demonstrates the recurrence of a rare disease in four consecutive pregnancies and how prenatal diagnosis assumed a preponderant role in parental counseling.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"32 3","pages":"255-258"},"PeriodicalIF":0.9,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11414953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298162","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":"Study on the Correlation between 7-joint Ultrasound Score and Disease Activity in Patients with Rheumatoid Arthritis.","authors":"Xiaolong Yu, Qiang Wang, Lin Zhuang, Gaojun Cai, Zun Li, Min Ren, Zihan Jin, Jing Xi","doi":"10.4103/jmu.jmu_43_23","DOIUrl":"10.4103/jmu.jmu_43_23","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to investigate the correlation between the 7-joint ultrasound score (US7) and disease activity in patients with rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>Forty-four patients with active RA were assessed, and the correlation between US7 and disease activity indicators such as the disease activity score (DAS28), rheumatoid factor (RF), the erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) was analyzed. In addition, the proportions of US7 points accounted for by different joint regions and joint surfaces were analyzed.</p><p><strong>Results: </strong>RF, CRP, and ESR were significantly increased in the RA group compared with the control group (<i>P</i> < 0.05). In the RA group, DAS28 (<i>r</i> = 0.0.561, <i>P</i> < 0.01), RF (<i>r</i> = 0.635, <i>P</i> < 0.01), ESR (<i>r</i> = 0.585, <i>P</i> < 0.01), and CRP (<i>r</i> = 0.492, <i>P</i> < 0.01) were positively correlated with US7. In terms of contributions to US7, the most susceptible joint surface is the dorsal surface, and the most susceptible joint area is the dorsal wrist.</p><p><strong>Conclusion: </strong>US7 is positively correlated with disease activity indicators of RA, which can objectively reflect disease activity in RA patients and provide a reference for clinical diagnosis and efficacy evaluation.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"32 2","pages":"134-138"},"PeriodicalIF":1.1,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11175366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332181","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":"The Use of Shear Wave Elastography in the Diagnosis of Prestenotic Phase of Takayasu's Aortoarteritis.","authors":"Atul Kapoor, Aprajita Kapur, Goldaa Mahajan, Rohit Mahajan, Swapan Nagpal","doi":"10.4103/jmu.jmu_65_23","DOIUrl":"10.4103/jmu.jmu_65_23","url":null,"abstract":"<p><p>We report the use of shear wave elastography with dispersion imaging in diagnosing a case of prestenotic Takayasu's arteritis which presented with symptoms of fever of unknown origin with persistently raised C-reactive protein levels. Vessel wall inflammation was detected in the carotid arteries on dispersion and shear wave imaging along with increased wall stiffness which was characteristic of vasculitis seen in a prestenotic phase of Takayasu's disease. These findings preceded the sonographic finding of vessel wall thickening described as the earliest sign of the disease on routine ultrasonography and not only helped to make an early diagnosis in a patient with a fever of unknown origin but also in the posttreatment follow-up.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"32 4","pages":"348-351"},"PeriodicalIF":0.9,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972713","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}