Link to journal online
Perlas, Anahi ; Chan, Vincent W. S. ; Lupu, Catalin M. ; Mitsakakis, Nicholas ; Hanbidge, Anthony Ultrasound Assessment of Gastric Content and Volume.
Anesthesiology.
Status
Publish Ahead of Print, POST AUTHOR CORRECTIONS, 8 June 2009
Abstract
Background: Aspiration of gastric contents can be a serious perioperative complication, attributing up to 9% of all anesthesia-related deaths. However, there is currently no practical, noninvasive bedside test to determine gastric content and volume in the perioperative period.Methods: The current study evaluates the feasibility of using bedside ultrasonography for assessing gastric content and volume. In the pilot phase, 18 healthy volunteers were examined to assess the gastric antrum, body, and fundus in cross-section in five prandial states: fasting and after ingestion of 250 mL of water, 500 mL of water, 500 mL of effervescent water, and a solid meal. In the phase II study, the authors concentrated on ultrasound examination of the gastric antrum in 36 volunteers for whom regression analysis was used to determine the correlation between gastric volume and antral cross-sectional area.Results: The gastric antrum provided the most reliable quantitative information for gastric volume. The antral cross-sectional area correlated with volumes of up to 300 mL in a close-to-linear fashion, particularly when subjects were in the right lateral decubitus position. Sonographic assessment of the gastric antrum and body provides qualitative information about gastric content (empty or not empty) and its nature (gas, fluid, or solid). The fundus was the gastric area least amenable to image and measure.Conclusions: Our preliminary results suggest that bedside two-dimensional ultrasonography can be a useful noninvasive tool to determine gastric content and volume.
Showing posts with label Ultrasound. Show all posts
Showing posts with label Ultrasound. Show all posts
Friday, 3 July 2009
Monday, 8 June 2009
Articles from BJOG
Link to journal online
Song, Y a; Yang, J a; Liu, Z b; Shen, K a;
Preoperative evaluation of endometrial carcinoma by contrast-enhanced ultrasonography.
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):294-299, January 2009.
Abstract
Objective: To investigate the potential usefulness of contrast-enhanced ultrasonography in the preoperative evaluation of endometrial carcinoma and observe its enhancement pattern and time-intensity curve.Design: A prospective study.Setting: Gynaecological department of a college hospital.Population: A total of 35 women diagnosed with endometrial carcinoma.Methods: The patients were evaluated with real-time grey-scale contrast-enhanced ultrasonography. In 21 women, the parameters of time-intensity curve were compared between the endometrial lesion and normal myometrium. Findings about the depth of myometrial invasion on sonograms were compared with histological findings.Main outcome measures: Enhancement pattern, parameters of time-intensity curve, depth of myometrial invasion detected on sonograms.Results: In visual evaluation, the brightness of the power Doppler signal and the amount of recognisable vascular areas increased in each tumour after contrast agent administration. Feeding vessels of the tumour were shown in 77.1% (27/35) of women. The other 22.9% (8/35) of women revealed that the signals were first visualised in the central portion of the tumour. The arrival time and peak time of endometrial lesion tended to be shorter than normal myometrium. The tumours started to enhance earlier than or at the same time as myometrium in 90.5% (19/21) of women. The peak intensity, enhancement intensity, and rising rate were higher in endometrial lesion than normal myometrium. There was no myometrial invasion in eight women, inner half myometrial invasion in 19 women and the outer half myometrial invasion in eight women. The corresponding values for ultrasound were 9, 17, and 9. The sensitivity of contrast-enhanced ultrasonography in detecting deep invasion was 75.0%, while the specificity was 88.9%, and the accuracy was 85.7%. The overall accuracy of assessment of myometrial invasion was 68.6%.Conclusion: There is some benefit in contrast-enhanced ultrasonography of endometrial carcinoma. It may provide better information in tumour imaging. Large studies are needed to determine the appropriate use and benefit of this new procedure.
Rousian, M ; Verwoerd-Dikkeboom, C M ; Koning, A HJ ; Hop, W C et al
Early pregnancy volume measurements: validation of ultrasound techniques and new perspectives.
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):278-285, January 2009.
Abstract
Objective: To investigate accuracy and reliability of four different ultrasound-related volume-measuring methods.Design: Observational study.Setting: Both in vitro and in vivo.Population or Sample: Ten phantoms for in vitro measurements and 28 pregnancies with gestational ages ranging from 6 to 11 weeks for in vivo measurements were included.Methods: Three-dimensional (3D) ultrasound images of phantoms (with known variable contents) and yolk sacs were used to calculate volumes using four different methods: Virtual Organ Computed-Aided AnaLysis (VOCAL), inversion mode, Sono Automatic Volume Calculation (SonoAVC) and V-Scope. V-Scope is a newly developed 3D volume visualisation application using a Barco I-Space virtual reality system. Intra- and interobserver agreement was established by calculating intraclass correlation coefficients (ICC).Main outcome measure: Evaluation of accuracy and reliability by comparing the different techniques with true volumes (in vitro) and with each other (in vitro and in vivo).Results: In the in vitro study, volume measurements by VOCAL, inversion mode and V-Scope proved to be accurate. SonoAVC measurements resulted in a substantial systematic underestimation. Correlation coefficients of measured versus true volumes were excellent in all four techniques. For all techniques, an intra- and interobserver agreement of at least 0.91 was found. Yolk sac measurements by the different techniques proved to be highly correlated (ICCs > 0.91).Conclusions: We demonstrated that VOCAL, inversion mode and V-Scope can all be used to measure volumes of hypoechoic structures. The newly introduced V-Scope application proved to be accurate and reliable.
Vincent, K ; Moore, J ; Kennedy, S ; Tracey, I
Blood oxygenation level dependent functional magnetic resonance imaging: current and potential uses in obstetrics and gynaecology.[Review]
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):240-246, January 2009.
Abstract
Blood-oxygenation-level-dependent functional magnetic resonance imaging is a noninvasive technique that has become increasingly popular in the neurosciences. It measures the proportion of oxygenated haemoglobin in specific areas of the brain, mirroring blood flow and therefore function. Here we review how the findings from functional studies impact on areas of gynaecological practice as diverse as chronic pain, continence, and premenstrual dysphoric disorder. Finally we review some of the more novel applications of the technique, such as imaging of pelvic floor function and the effects of hypoxia on the fetus.
Louwers, J A ; Kocken, M ; Harmsel, W Ater ; Verheijen, R HM e
Digital colposcopy: ready for use? An overview of literature.[Review]
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):220-229, January 2009.
Abstract
The aims of this review were to summarise the various methods of digital colposcopy and to provide an overview of their efficacy. We conducted a literature search and focused on papers that described a technique for colposcopy, other than conventional colposcopy, and compared this with conventional colposcopy and/or histology and included digitalisation of the process. All papers have been classified in one of the following categories: digital imaging and telecolposcopy, spectroscopy, computerised colposcopy, optical coherence tomography and confocal microcolposcopy. Among the most promising developments is spectroscopy, allowing a more or less automated analysis and interpretation of the colposcopic image.
Song, Y a; Yang, J a; Liu, Z b; Shen, K a;
Preoperative evaluation of endometrial carcinoma by contrast-enhanced ultrasonography.
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):294-299, January 2009.
Abstract
Objective: To investigate the potential usefulness of contrast-enhanced ultrasonography in the preoperative evaluation of endometrial carcinoma and observe its enhancement pattern and time-intensity curve.Design: A prospective study.Setting: Gynaecological department of a college hospital.Population: A total of 35 women diagnosed with endometrial carcinoma.Methods: The patients were evaluated with real-time grey-scale contrast-enhanced ultrasonography. In 21 women, the parameters of time-intensity curve were compared between the endometrial lesion and normal myometrium. Findings about the depth of myometrial invasion on sonograms were compared with histological findings.Main outcome measures: Enhancement pattern, parameters of time-intensity curve, depth of myometrial invasion detected on sonograms.Results: In visual evaluation, the brightness of the power Doppler signal and the amount of recognisable vascular areas increased in each tumour after contrast agent administration. Feeding vessels of the tumour were shown in 77.1% (27/35) of women. The other 22.9% (8/35) of women revealed that the signals were first visualised in the central portion of the tumour. The arrival time and peak time of endometrial lesion tended to be shorter than normal myometrium. The tumours started to enhance earlier than or at the same time as myometrium in 90.5% (19/21) of women. The peak intensity, enhancement intensity, and rising rate were higher in endometrial lesion than normal myometrium. There was no myometrial invasion in eight women, inner half myometrial invasion in 19 women and the outer half myometrial invasion in eight women. The corresponding values for ultrasound were 9, 17, and 9. The sensitivity of contrast-enhanced ultrasonography in detecting deep invasion was 75.0%, while the specificity was 88.9%, and the accuracy was 85.7%. The overall accuracy of assessment of myometrial invasion was 68.6%.Conclusion: There is some benefit in contrast-enhanced ultrasonography of endometrial carcinoma. It may provide better information in tumour imaging. Large studies are needed to determine the appropriate use and benefit of this new procedure.
Rousian, M ; Verwoerd-Dikkeboom, C M ; Koning, A HJ ; Hop, W C et al
Early pregnancy volume measurements: validation of ultrasound techniques and new perspectives.
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):278-285, January 2009.
Abstract
Objective: To investigate accuracy and reliability of four different ultrasound-related volume-measuring methods.Design: Observational study.Setting: Both in vitro and in vivo.Population or Sample: Ten phantoms for in vitro measurements and 28 pregnancies with gestational ages ranging from 6 to 11 weeks for in vivo measurements were included.Methods: Three-dimensional (3D) ultrasound images of phantoms (with known variable contents) and yolk sacs were used to calculate volumes using four different methods: Virtual Organ Computed-Aided AnaLysis (VOCAL), inversion mode, Sono Automatic Volume Calculation (SonoAVC) and V-Scope. V-Scope is a newly developed 3D volume visualisation application using a Barco I-Space virtual reality system. Intra- and interobserver agreement was established by calculating intraclass correlation coefficients (ICC).Main outcome measure: Evaluation of accuracy and reliability by comparing the different techniques with true volumes (in vitro) and with each other (in vitro and in vivo).Results: In the in vitro study, volume measurements by VOCAL, inversion mode and V-Scope proved to be accurate. SonoAVC measurements resulted in a substantial systematic underestimation. Correlation coefficients of measured versus true volumes were excellent in all four techniques. For all techniques, an intra- and interobserver agreement of at least 0.91 was found. Yolk sac measurements by the different techniques proved to be highly correlated (ICCs > 0.91).Conclusions: We demonstrated that VOCAL, inversion mode and V-Scope can all be used to measure volumes of hypoechoic structures. The newly introduced V-Scope application proved to be accurate and reliable.
Vincent, K ; Moore, J ; Kennedy, S ; Tracey, I
Blood oxygenation level dependent functional magnetic resonance imaging: current and potential uses in obstetrics and gynaecology.[Review]
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):240-246, January 2009.
Abstract
Blood-oxygenation-level-dependent functional magnetic resonance imaging is a noninvasive technique that has become increasingly popular in the neurosciences. It measures the proportion of oxygenated haemoglobin in specific areas of the brain, mirroring blood flow and therefore function. Here we review how the findings from functional studies impact on areas of gynaecological practice as diverse as chronic pain, continence, and premenstrual dysphoric disorder. Finally we review some of the more novel applications of the technique, such as imaging of pelvic floor function and the effects of hypoxia on the fetus.
Louwers, J A ; Kocken, M ; Harmsel, W Ater ; Verheijen, R HM e
Digital colposcopy: ready for use? An overview of literature.[Review]
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):220-229, January 2009.
Abstract
The aims of this review were to summarise the various methods of digital colposcopy and to provide an overview of their efficacy. We conducted a literature search and focused on papers that described a technique for colposcopy, other than conventional colposcopy, and compared this with conventional colposcopy and/or histology and included digitalisation of the process. All papers have been classified in one of the following categories: digital imaging and telecolposcopy, spectroscopy, computerised colposcopy, optical coherence tomography and confocal microcolposcopy. Among the most promising developments is spectroscopy, allowing a more or less automated analysis and interpretation of the colposcopic image.
Tuesday, 24 March 2009
Article from Anesthesia & Analgesia
Link to journal online
Clendenen, Steven R. ; Riutort, Kevin ; Ladlie, Beth L. ; Robards, Christopher M. et al
Real-Time Three-Dimensional Ultrasound-Assisted Axillary Plexus Block Defines Soft Tissue Planes. [Report]
Anesthesia & Analgesia. 108(4):1347-1350, April 2009.
Abstract
Two-dimensional (2D) ultrasound is commonly used for regional block of the axillary brachial plexus. In this technical case report, we described a real-time three-dimensional (3D) ultrasound-guided axillary block. The difference between 2D and 3D ultrasound is similar to the difference between plain radiograph and computer tomography. Unlike 2D ultrasound that captures a planar image, 3D ultrasound technology acquires a 3D volume of information that enables multiple planes of view by manipulating the image without movement of the ultrasound probe. Observation of the brachial plexus in cross-section demonstrated distinct linear hyperechoic tissue structures (loose connective tissue) that initially inhibited the flow of the local anesthesia. After completion of the injection, we were able to visualize the influence of arterial pulsation on the spread of the local anesthesia. Possible advantages of this novel technology over current 2D methods are wider image volume and the capability to manipulate the planes of the image without moving the probe.
Clendenen, Steven R. ; Riutort, Kevin ; Ladlie, Beth L. ; Robards, Christopher M. et al
Real-Time Three-Dimensional Ultrasound-Assisted Axillary Plexus Block Defines Soft Tissue Planes. [Report]
Anesthesia & Analgesia. 108(4):1347-1350, April 2009.
Abstract
Two-dimensional (2D) ultrasound is commonly used for regional block of the axillary brachial plexus. In this technical case report, we described a real-time three-dimensional (3D) ultrasound-guided axillary block. The difference between 2D and 3D ultrasound is similar to the difference between plain radiograph and computer tomography. Unlike 2D ultrasound that captures a planar image, 3D ultrasound technology acquires a 3D volume of information that enables multiple planes of view by manipulating the image without movement of the ultrasound probe. Observation of the brachial plexus in cross-section demonstrated distinct linear hyperechoic tissue structures (loose connective tissue) that initially inhibited the flow of the local anesthesia. After completion of the injection, we were able to visualize the influence of arterial pulsation on the spread of the local anesthesia. Possible advantages of this novel technology over current 2D methods are wider image volume and the capability to manipulate the planes of the image without moving the probe.
Articles from Circulation
Link to full text of journal
Xie, Feng MD; Lof, John MS; Matsunaga, Terry PhD; Zutshi, Reena PhD; Porter, Thomas R.
Diagnostic Ultrasound Combined With Glycoprotein IIb/IIIa-Targeted Microbubbles Improves Microvascular Recovery After Acute Coronary Thrombotic Occlusions
Circulation.
Status
published online before print, 2 March 2009
Abstract
Background-: The high mechanical index (MI) impulses from a diagnostic ultrasound transducer may be a method of recanalizing acutely thrombosed vessels if the impulses are applied only when microbubbles are channeling through the thrombus.Methods and Results-: In 45 pigs with acute left anterior descending thrombotic occlusions, a low-MI pulse sequence scheme (contrast pulse sequencing) was used to image the myocardium and guide the delivery of high-MI (1.9 MI) impulses during infusion of either intravenous platelet-targeted microbubbles or nontargeted microbubbles. A third group received no diagnostic ultrasound and microbubbles. All groups received half-dose recombinant prourokinase, heparin, and aspirin. Contrast pulse sequencing examined replenishment of contrast within the central portion of the risk area and guided the application of high-MI impulses. Angiographic recanalization rates, resolution of ST-segment elevation on ECG, and wall thickening were analyzed. Pigs receiving platelet-targeted microbubbles had more rapid replenishment of the central portion of the risk area (80% versus 40% for nontargeted microbubbles; P=0.03) and higher epicardial recanalization rates (53% versus 7% for prourokinase alone; P=0.01). Replenishment of contrast within the risk area (whether with platelet-targeted microbubbles or nontargeted microbubbles) was associated with both higher recanalization rates and even higher rates of ST-segment resolution (82% versus 21% for prourokinase alone; P=0.006). ST-segment resolution occurred in 6 pigs (40%) treated with microbubbles who did not have epicardial recanalization, of which 5 had recovery of wall thickening.Conclusions-: Intravenous platelet-targeted microbubbles combined with brief high-MI diagnostic ultrasound impulses guided by contrast pulse sequencing improve both epicardial recanalization rates and microvascular recovery.
Xie, Feng MD; Lof, John MS; Matsunaga, Terry PhD; Zutshi, Reena PhD; Porter, Thomas R.
Diagnostic Ultrasound Combined With Glycoprotein IIb/IIIa-Targeted Microbubbles Improves Microvascular Recovery After Acute Coronary Thrombotic Occlusions
Circulation.
Status
published online before print, 2 March 2009
Abstract
Background-: The high mechanical index (MI) impulses from a diagnostic ultrasound transducer may be a method of recanalizing acutely thrombosed vessels if the impulses are applied only when microbubbles are channeling through the thrombus.Methods and Results-: In 45 pigs with acute left anterior descending thrombotic occlusions, a low-MI pulse sequence scheme (contrast pulse sequencing) was used to image the myocardium and guide the delivery of high-MI (1.9 MI) impulses during infusion of either intravenous platelet-targeted microbubbles or nontargeted microbubbles. A third group received no diagnostic ultrasound and microbubbles. All groups received half-dose recombinant prourokinase, heparin, and aspirin. Contrast pulse sequencing examined replenishment of contrast within the central portion of the risk area and guided the application of high-MI impulses. Angiographic recanalization rates, resolution of ST-segment elevation on ECG, and wall thickening were analyzed. Pigs receiving platelet-targeted microbubbles had more rapid replenishment of the central portion of the risk area (80% versus 40% for nontargeted microbubbles; P=0.03) and higher epicardial recanalization rates (53% versus 7% for prourokinase alone; P=0.01). Replenishment of contrast within the risk area (whether with platelet-targeted microbubbles or nontargeted microbubbles) was associated with both higher recanalization rates and even higher rates of ST-segment resolution (82% versus 21% for prourokinase alone; P=0.006). ST-segment resolution occurred in 6 pigs (40%) treated with microbubbles who did not have epicardial recanalization, of which 5 had recovery of wall thickening.Conclusions-: Intravenous platelet-targeted microbubbles combined with brief high-MI diagnostic ultrasound impulses guided by contrast pulse sequencing improve both epicardial recanalization rates and microvascular recovery.
Friday, 6 March 2009
Link to journal online
Marciniak, Bruno ; Fayoux, Pierre ; Hebrard, Anne ; Krivosic-Horber, Renee ; Engelhardt, Thomas et al
Airway Management in Children: Ultrasonography Assessment of Tracheal Intubation in Real Time
Anesthesia & Analgesia. 108(2):461-465, February 2009.
Abstract
BACKGROUND: Pediatric tracheal intubation requires considerable expertise and can represent a challenge to many anesthesiologists. Confirmation of correct tracheal tube position relies on direct visualization or indirect measures, such as auscultation and capnography. These methods have varying sensitivity and specificity, especially in the infant and young child. Ultrasonography is noninvasive and is becoming more readily available to the anesthesiologist. In this study, we investigated the characteristic real-time ultrasonographic findings of the normal pediatric airway during tracheal intubation and its suitability for clinical use.METHODS: Thirty healthy children with normal airways requiring tracheal intubation were studied. Ultrasonographic measurements of the pediatric airway during tracheal intubation under deep inhaled anesthesia were performed using a Sonosite Titan(R) (Sonosite, Bothell, WA) scanner while recording characteristic images during this process. Correct tracheal tube placement was further confirmed using auscultation and satisfactory end-tidal capnography.RESULTS: The mean (+/- sd) age of studied patients was 48 +/- 37 mo, weight was 19.7. +/- 8.6 kg and the sex ratio (m/f) was 1:2. Successful tracheal intubation was verified using the following criteria: 1) identification of the trachea and tracheal rings, 2) visualization of vocal cords, 3) widening of glottis as the tracheal tube passes through, and 4) tracheal tube position above carina and demonstration of movement of the chest wall visceroparietal pleural interface (i.e., sliding sign) after manual ventilation of the lungs. One esophageal intubation was readily recognized by visualization of the tube in the left paratracheal space.CONCLUSION: This study describes characteristic ultrasonographic findings of the pediatric airway during tracheal intubation. It suggests that ultrasonography may be useful for airway management in children
Marciniak, Bruno ; Fayoux, Pierre ; Hebrard, Anne ; Krivosic-Horber, Renee ; Engelhardt, Thomas et al
Airway Management in Children: Ultrasonography Assessment of Tracheal Intubation in Real Time
Anesthesia & Analgesia. 108(2):461-465, February 2009.
Abstract
BACKGROUND: Pediatric tracheal intubation requires considerable expertise and can represent a challenge to many anesthesiologists. Confirmation of correct tracheal tube position relies on direct visualization or indirect measures, such as auscultation and capnography. These methods have varying sensitivity and specificity, especially in the infant and young child. Ultrasonography is noninvasive and is becoming more readily available to the anesthesiologist. In this study, we investigated the characteristic real-time ultrasonographic findings of the normal pediatric airway during tracheal intubation and its suitability for clinical use.METHODS: Thirty healthy children with normal airways requiring tracheal intubation were studied. Ultrasonographic measurements of the pediatric airway during tracheal intubation under deep inhaled anesthesia were performed using a Sonosite Titan(R) (Sonosite, Bothell, WA) scanner while recording characteristic images during this process. Correct tracheal tube placement was further confirmed using auscultation and satisfactory end-tidal capnography.RESULTS: The mean (+/- sd) age of studied patients was 48 +/- 37 mo, weight was 19.7. +/- 8.6 kg and the sex ratio (m/f) was 1:2. Successful tracheal intubation was verified using the following criteria: 1) identification of the trachea and tracheal rings, 2) visualization of vocal cords, 3) widening of glottis as the tracheal tube passes through, and 4) tracheal tube position above carina and demonstration of movement of the chest wall visceroparietal pleural interface (i.e., sliding sign) after manual ventilation of the lungs. One esophageal intubation was readily recognized by visualization of the tube in the left paratracheal space.CONCLUSION: This study describes characteristic ultrasonographic findings of the pediatric airway during tracheal intubation. It suggests that ultrasonography may be useful for airway management in children
Monday, 27 October 2008
Negative Appendectomy and Imaging Accuracy
Link to journal
The SCOAP Collaborative. The SCOAP Collaborative included Joseph Cuschieri ; Florence, Michael ; Flum, David R. ; Jurkovich, Gregory J. ; Lin, Paul et al
Negative Appendectomy and Imaging Accuracy in the Washington State Surgical Care and Outcomes Assessment Program
Annals of Surgery. 248(4):557-563, October 2008.
Abstract
Objective: To evaluate negative appendectomy (NA) and the relationship of NA and computed tomography (CT) and/or ultrasound (US).Summary Background Information: NA may be influenced by the use and accuracy of preoperative CT/US. The Surgical Care and Outcomes Assessment Program (SCOAP) gathers chart-abstracted process of care data (such as CT/US accuracy) for general surgical procedures (including appendectomy) at most Washington State hospitals.Methods: We determined the prevalence of NA and CT/US concordance at the 15 SCOAP hospitals with >50 consecutive patients undergoing appendectomy (2006-2007).Results: The number of patients who underwent urgent appendectomies was 3540. The percentage of patients who had imaging (CT-91%) was 86% (women-89%, men-83%). The use of imaging ranged across hospitals from 56% to 97%. There was 91% agreement between imaging and pathology report findings (92.3%-CT and 82.4%-US). The overall rate of NA was 6% (women-8%, men-4%). The prevalence of NA was 9.8% among patients having no imaging, 8.1% among those having an US, and 4.5% in those having a CT. Among patients with NA, CT/US was obtained in 75%; correct in 10% and incorrect or ambiguous in 65%. Higher rates of NA were correlated with lower rates of CT/US concordance (r = -0.57). There was no significant difference in rates of perforation between those with (17%) and without (15%) imaging (P = 0.2). There were significant increases in the use of CT/US and decreases in NA over the time period
The SCOAP Collaborative. The SCOAP Collaborative included Joseph Cuschieri ; Florence, Michael ; Flum, David R. ; Jurkovich, Gregory J. ; Lin, Paul et al
Negative Appendectomy and Imaging Accuracy in the Washington State Surgical Care and Outcomes Assessment Program
Annals of Surgery. 248(4):557-563, October 2008.
Abstract
Objective: To evaluate negative appendectomy (NA) and the relationship of NA and computed tomography (CT) and/or ultrasound (US).Summary Background Information: NA may be influenced by the use and accuracy of preoperative CT/US. The Surgical Care and Outcomes Assessment Program (SCOAP) gathers chart-abstracted process of care data (such as CT/US accuracy) for general surgical procedures (including appendectomy) at most Washington State hospitals.Methods: We determined the prevalence of NA and CT/US concordance at the 15 SCOAP hospitals with >50 consecutive patients undergoing appendectomy (2006-2007).Results: The number of patients who underwent urgent appendectomies was 3540. The percentage of patients who had imaging (CT-91%) was 86% (women-89%, men-83%). The use of imaging ranged across hospitals from 56% to 97%. There was 91% agreement between imaging and pathology report findings (92.3%-CT and 82.4%-US). The overall rate of NA was 6% (women-8%, men-4%). The prevalence of NA was 9.8% among patients having no imaging, 8.1% among those having an US, and 4.5% in those having a CT. Among patients with NA, CT/US was obtained in 75%; correct in 10% and incorrect or ambiguous in 65%. Higher rates of NA were correlated with lower rates of CT/US concordance (r = -0.57). There was no significant difference in rates of perforation between those with (17%) and without (15%) imaging (P = 0.2). There were significant increases in the use of CT/US and decreases in NA over the time period
Tuesday, 16 September 2008
Articles from Circulation
Link to journal
Najem, Boutaina ; Lefrancq, Eve ; Unger, Philippe
Thrombus Trapped in Patent Foramen Ovale and Bilateral Pulmonary Embolism: A One-Stop Shop Ultrasound Diagnosis
Circulation. 118(11):e154-e155, September 9, 2008.
Najem, Boutaina ; Lefrancq, Eve ; Unger, Philippe
Thrombus Trapped in Patent Foramen Ovale and Bilateral Pulmonary Embolism: A One-Stop Shop Ultrasound Diagnosis
Circulation. 118(11):e154-e155, September 9, 2008.
Ultrasound in Obstetrics and Gynecology 32, 4 2008
Pages: 481-484
Intrauterine programming of the cardiovascular system
H. M. Gardiner
http://www3.interscience.wiley.com/cgi-bin/abstract/121385291/ABSTRACT
Pages: 485-487
Three-dimensional power Doppler derived vascular indices: what are we measuring and how are we doing it?
J. L. Alcßzar
http://www3.interscience.wiley.com/cgi-bin/abstract/121385315/ABSTRACT
Pages: 488-492
Screening for trisomy 18 by maternal age, fetal nuchal translucency, free ?-human chorionic gonadotropin and pregnancy-associated plasma protein-A
K. O. Kagan, D. Wright, N. Maiz, I. Pandeva, K. H. Nicolaides
http://www3.interscience.wiley.com/cgi-bin/abstract/121385320/ABSTRACT
Pages: 493-500
Prenatal detection of trisomy 21 by second-trimester ultrasound examination and maternal age in a non-selected population of 49 314 births in Norway
K. Offerdal, H.-G. K. Blaas, S. H. Eik-Nes
http://www3.interscience.wiley.com/cgi-bin/abstract/121370082/ABSTRACT
Pages: 501-505
Correlation between nuchal translucency and nuchal skin-fold measurements in Down syndrome and unaffected fetuses
R. Maymon, A. L. Zimerman, Z. Weinraub, A. Herman, H. Cuckle
http://www3.interscience.wiley.com/cgi-bin/abstract/119755409/ABSTRACT
Pages: 506-509
Prenatal diagnosis of isolated abnormal number of ribs
R. Hershkovitz
http://www3.interscience.wiley.com/cgi-bin/abstract/119816222/ABSTRACT
Pages: 510-514
Using virtual reality for evaluation of fetal ambiguous genitalia
C. M. Verwoerd-Dikkeboom, A. H. J. Koning, I. A. L. Groenenberg et al
http://www3.interscience.wiley.com/cgi-bin/abstract/120849037/ABSTRACT
Pages: 515-519
Photogrammetry of fetal breathing movements during the third trimester of pregnancy: observations in normal and abnormal pregnancies
J. Florido, M. C. Padilla, V. Soto, A. Camacho, G. Moscoso, L. Navarrete
http://www3.interscience.wiley.com/cgi-bin/abstract/121371211/ABSTRACT
Pages: 520-526
Abdominal and pelvic ultrasound findings within 24 hours following uneventful Cesarean section
M. Koskas, J. Nizard, L. J. Salomon, Y. Ville
http://www3.interscience.wiley.com/cgi-bin/abstract/121370639/ABSTRACT
Pages: 527-534
Ultrasonographic anatomy of perineal structures during pregnancy and immediately following obstetric injury
K. Mar, A. Herbst
http://www3.interscience.wiley.com/cgi-bin/abstract/121385335/ABSTRACT
Pages: 535-539
Detrusor wall thickness as a test for detrusor overactivity in women
O. Lekskulchai, H. P. Dietz
http://www3.interscience.wiley.com/cgi-bin/abstract/120756364/ABSTRACT
Pages: 540-550
Determining the relationship between three-dimensional power Doppler data and true blood flow characteristics: an in-vitro flow phantom experiment
N. J. Raine-Fenning, N. M. Nordin, K. V. Ramnarine, B. K. Campbell et al
http://www3.interscience.wiley.com/cgi-bin/abstract/121371212/ABSTRACT
Pages: 551-559
Evaluation of the effect of machine settings on quantitative three-dimensional power Doppler angiography: an in-vitro flow phantom experiment
N. J. Raine-Fenning, N. M. Nordin, K. V. Ramnarine, B. K. Campbell, J. et al
http://www3.interscience.wiley.com/cgi-bin/abstract/121385346/ABSTRACT
Pages: 560-564
Evaluation of volume vascularization index and flow index: a phantom study
M. J. N. C. Schulten-Wijman, P. C. Struijk, C. Brezinka, N. De Jong, E. A. P. Steegers
http://www3.interscience.wiley.com/cgi-bin/abstract/121385370/ABSTRACT
Pages: 565-572
Computer-aided diagnosis using morphological features for classifying breast lesions on ultrasound
Y.-L. Huang, D.-R. Chen, Y.-R. Jiang, S.-J. Kuo, H.-K. Wu, W. K. Moon
http://www3.interscience.wiley.com/cgi-bin/abstract/117949882/ABSTRACT
Pages: 573-578
Accuracy of classification of breast ultrasound findings based on criteria used for BI-RADS
J. Heinig, R. Witteler, R. Schmitz, L. Kiesel, J. Steinhard
http://www3.interscience.wiley.com/cgi-bin/abstract/118677467/ABSTRACT
Published Online: 18 Apr 2008
DOI: 10.1002/uog.5191
Pages: 579-581
Prenatal diagnosis of partial lumbar asoma by two- and three-dimensional ultrasound and computed tomography: embryological aspects and perinatal management
C. Huissoud, C. Bisch, K. Charrin, R.-C. Rudigoz, L. Guibaud
http://www3.interscience.wiley.com/cgi-bin/abstract/121385352/ABSTRACT
Pages: 582-586
Prenatal sonographic and MRI findings in a pregnancy complicated by uterine sacculation: case report and review of the literature
E. M. Gottschalk, J.-P. Siedentopf, I. Schoenborn, S. Gartenschlaeger et al
http://www3.interscience.wiley.com/cgi-bin/abstract/121359245/ABSTRACT
Pages: 587-591
Umbilical venous blood flow measurement: accuracy and reproducibility
F. Figueras, S. Fernandez, E. Hernandez-Andrade, E. Gratacs
http://www3.interscience.wiley.com/cgi-bin/abstract/120695175/ABSTRACT
Pages: 592-593
Prenatal diagnosis of anomalous origin of the right pulmonary artery from the ascending aorta with hypoplastic right ventricle and pulmonary stenosis
F.ztun, A. Gzelta?
http://www3.interscience.wiley.com/cgi-bin/abstract/120848258/ABSTRACT
Pages: 593-594
Tobacco pipe sign in the fetus: patent left superior vena cava with absent right superior vena cava
M. Freund, P. Stoutenbeek, H. ter Heide, L. Pistorius
http://www3.interscience.wiley.com/cgi-bin/abstract/121372603/ABSTRACT
Pages: 594-595
Cell-free fetal DNA in celomic fluid
G. Makrydimas, A. Gerovassili, A. Sotiriadis, A. Kavvadias, K. H. Nicolaides
http://www3.interscience.wiley.com/cgi-bin/abstract/120848259/ABSTRACT
Pages: 595-597
Sonographic findings of uterine sacculation during pregnancy
S. W. Lee, M. Y. Kim, J. H. Yang, M. H. Moon, J. Y. Cho
http://www3.interscience.wiley.com/cgi-bin/abstract/121385355/ABSTRACT
Pages: 597
Erratum: K. L. Shek, H. P. Dietz, A. Rane, S. Balakrishnan. Transobturator mesh for cystocele repair: a short- to medium-term follow-up using 3D/4D ultrasound. Ultrasound in Obstetrics and Gynecology 2008; 32: 82-86
http://www3.interscience.wiley.com/cgi-bin/abstract/121385353/ABSTRACT
Pages: 598-599
Tetralogy of Fallot: evaluation by 4D spatiotemporal image correlation
L. Gindes, R. Achiron
http://www3.interscience.wiley.com/cgi-bin/abstract/121385640/ABSTRACT
Intrauterine programming of the cardiovascular system
H. M. Gardiner
http://www3.interscience.wiley.com/cgi-bin/abstract/121385291/ABSTRACT
Pages: 485-487
Three-dimensional power Doppler derived vascular indices: what are we measuring and how are we doing it?
J. L. Alcßzar
http://www3.interscience.wiley.com/cgi-bin/abstract/121385315/ABSTRACT
Pages: 488-492
Screening for trisomy 18 by maternal age, fetal nuchal translucency, free ?-human chorionic gonadotropin and pregnancy-associated plasma protein-A
K. O. Kagan, D. Wright, N. Maiz, I. Pandeva, K. H. Nicolaides
http://www3.interscience.wiley.com/cgi-bin/abstract/121385320/ABSTRACT
Pages: 493-500
Prenatal detection of trisomy 21 by second-trimester ultrasound examination and maternal age in a non-selected population of 49 314 births in Norway
K. Offerdal, H.-G. K. Blaas, S. H. Eik-Nes
http://www3.interscience.wiley.com/cgi-bin/abstract/121370082/ABSTRACT
Pages: 501-505
Correlation between nuchal translucency and nuchal skin-fold measurements in Down syndrome and unaffected fetuses
R. Maymon, A. L. Zimerman, Z. Weinraub, A. Herman, H. Cuckle
http://www3.interscience.wiley.com/cgi-bin/abstract/119755409/ABSTRACT
Pages: 506-509
Prenatal diagnosis of isolated abnormal number of ribs
R. Hershkovitz
http://www3.interscience.wiley.com/cgi-bin/abstract/119816222/ABSTRACT
Pages: 510-514
Using virtual reality for evaluation of fetal ambiguous genitalia
C. M. Verwoerd-Dikkeboom, A. H. J. Koning, I. A. L. Groenenberg et al
http://www3.interscience.wiley.com/cgi-bin/abstract/120849037/ABSTRACT
Pages: 515-519
Photogrammetry of fetal breathing movements during the third trimester of pregnancy: observations in normal and abnormal pregnancies
J. Florido, M. C. Padilla, V. Soto, A. Camacho, G. Moscoso, L. Navarrete
http://www3.interscience.wiley.com/cgi-bin/abstract/121371211/ABSTRACT
Pages: 520-526
Abdominal and pelvic ultrasound findings within 24 hours following uneventful Cesarean section
M. Koskas, J. Nizard, L. J. Salomon, Y. Ville
http://www3.interscience.wiley.com/cgi-bin/abstract/121370639/ABSTRACT
Pages: 527-534
Ultrasonographic anatomy of perineal structures during pregnancy and immediately following obstetric injury
K. Mar, A. Herbst
http://www3.interscience.wiley.com/cgi-bin/abstract/121385335/ABSTRACT
Pages: 535-539
Detrusor wall thickness as a test for detrusor overactivity in women
O. Lekskulchai, H. P. Dietz
http://www3.interscience.wiley.com/cgi-bin/abstract/120756364/ABSTRACT
Pages: 540-550
Determining the relationship between three-dimensional power Doppler data and true blood flow characteristics: an in-vitro flow phantom experiment
N. J. Raine-Fenning, N. M. Nordin, K. V. Ramnarine, B. K. Campbell et al
http://www3.interscience.wiley.com/cgi-bin/abstract/121371212/ABSTRACT
Pages: 551-559
Evaluation of the effect of machine settings on quantitative three-dimensional power Doppler angiography: an in-vitro flow phantom experiment
N. J. Raine-Fenning, N. M. Nordin, K. V. Ramnarine, B. K. Campbell, J. et al
http://www3.interscience.wiley.com/cgi-bin/abstract/121385346/ABSTRACT
Pages: 560-564
Evaluation of volume vascularization index and flow index: a phantom study
M. J. N. C. Schulten-Wijman, P. C. Struijk, C. Brezinka, N. De Jong, E. A. P. Steegers
http://www3.interscience.wiley.com/cgi-bin/abstract/121385370/ABSTRACT
Pages: 565-572
Computer-aided diagnosis using morphological features for classifying breast lesions on ultrasound
Y.-L. Huang, D.-R. Chen, Y.-R. Jiang, S.-J. Kuo, H.-K. Wu, W. K. Moon
http://www3.interscience.wiley.com/cgi-bin/abstract/117949882/ABSTRACT
Pages: 573-578
Accuracy of classification of breast ultrasound findings based on criteria used for BI-RADS
J. Heinig, R. Witteler, R. Schmitz, L. Kiesel, J. Steinhard
http://www3.interscience.wiley.com/cgi-bin/abstract/118677467/ABSTRACT
Published Online: 18 Apr 2008
DOI: 10.1002/uog.5191
Pages: 579-581
Prenatal diagnosis of partial lumbar asoma by two- and three-dimensional ultrasound and computed tomography: embryological aspects and perinatal management
C. Huissoud, C. Bisch, K. Charrin, R.-C. Rudigoz, L. Guibaud
http://www3.interscience.wiley.com/cgi-bin/abstract/121385352/ABSTRACT
Pages: 582-586
Prenatal sonographic and MRI findings in a pregnancy complicated by uterine sacculation: case report and review of the literature
E. M. Gottschalk, J.-P. Siedentopf, I. Schoenborn, S. Gartenschlaeger et al
http://www3.interscience.wiley.com/cgi-bin/abstract/121359245/ABSTRACT
Pages: 587-591
Umbilical venous blood flow measurement: accuracy and reproducibility
F. Figueras, S. Fernandez, E. Hernandez-Andrade, E. Gratacs
http://www3.interscience.wiley.com/cgi-bin/abstract/120695175/ABSTRACT
Pages: 592-593
Prenatal diagnosis of anomalous origin of the right pulmonary artery from the ascending aorta with hypoplastic right ventricle and pulmonary stenosis
F.ztun, A. Gzelta?
http://www3.interscience.wiley.com/cgi-bin/abstract/120848258/ABSTRACT
Pages: 593-594
Tobacco pipe sign in the fetus: patent left superior vena cava with absent right superior vena cava
M. Freund, P. Stoutenbeek, H. ter Heide, L. Pistorius
http://www3.interscience.wiley.com/cgi-bin/abstract/121372603/ABSTRACT
Pages: 594-595
Cell-free fetal DNA in celomic fluid
G. Makrydimas, A. Gerovassili, A. Sotiriadis, A. Kavvadias, K. H. Nicolaides
http://www3.interscience.wiley.com/cgi-bin/abstract/120848259/ABSTRACT
Pages: 595-597
Sonographic findings of uterine sacculation during pregnancy
S. W. Lee, M. Y. Kim, J. H. Yang, M. H. Moon, J. Y. Cho
http://www3.interscience.wiley.com/cgi-bin/abstract/121385355/ABSTRACT
Pages: 597
Erratum: K. L. Shek, H. P. Dietz, A. Rane, S. Balakrishnan. Transobturator mesh for cystocele repair: a short- to medium-term follow-up using 3D/4D ultrasound. Ultrasound in Obstetrics and Gynecology 2008; 32: 82-86
http://www3.interscience.wiley.com/cgi-bin/abstract/121385353/ABSTRACT
Pages: 598-599
Tetralogy of Fallot: evaluation by 4D spatiotemporal image correlation
L. Gindes, R. Achiron
http://www3.interscience.wiley.com/cgi-bin/abstract/121385640/ABSTRACT
Wednesday, 18 June 2008
Laryngoscope May 2008
Link to journal
Abboud, Bassam; Sleilaty, Ghassan; Rabaa, Lara; Daher, Ronald et al
Ultrasonography: Highly Accuracy Technique for Preoperative Localization of Parathyroid Adenoma
Laryngoscope.
Publish Ahead of Print, POST AUTHOR CORRECTIONS, 9 May 2008
Abstract
Objectives/Hypothesis: This study evaluates the accuracy of ultrasonography in guided unilateral parathyroidectomy to treat primary hyperparathyroidism.Study Design: Retrospective study.Methods: Two hundred fifty-three patients with primary hyperparathyroidism underwent preoperative ultrasonography. Two groups were defined. Group 1 included the patients in whom the preoperative cervical ultrasound localized one abnormal parathyroid gland; these patients underwent unilateral surgical exploration of the neck under local anesthesia. Group 2 included the patients who had a bilateral neck exploration under general anesthesia when the preoperative examination was equivocal or failed to localize the lesion, when concomitant thyroid pathology indicated thyroidectomy, and when justified by the surgical findings.Results: Sensitivity and positive predictive value of ultrasonography in detecting abnormal parathyroid gland were 96% and 98%, respectively. Cervical ultrasound correctly identified, 96% and 85% of abnormal glands in groups 1 and 2, respectively. The presence of thyroid nodular disease did not affect ultrasonographic accuracy. Sonographic examination decreased the operative time of parathyroidectomy to an average of 15 minutes. Mediastinal and retroesophageal localizations of abnormal parathyroid gl and adversely affected the accuracy of the ultrasound. No cervical hematoma was noted. Transient recurrent laryngeal nerve palsy occurred in four patients. Twenty-three patients required postoperative calcium supplementation for 2 to 4 months, and all were normocalcemic at follow-up.Conclusions: Cervical ultrasound is a reliable preoperative exploration allowing parathyroidectomy via unilateral approach under local anesthesia.
Zald, Philip B. ; Hamilton, Bronwyn E. ; Larsen, Michael L. ; Cohen, James I.
The Role of Computed Tomography for Localization of Parathyroid Adenomas.
Laryngoscope.
Publish Ahead of Print, POST AUTHOR CORRECTIONS, 2 June 2008
Abstract
Objective/Hypothesis: The purpose of this study was to evaluate the use of computed tomography (CT) for localization of parathyroid adenomas (PA) when first-line imaging is indeterminate.Study Design: Retrospective case series.Methods: A search of operating room and radiology records identified 223 surgical explorations for primary hyperparathyroidism. Adenoma locations on CT, ultrasound, and nuclear scintigraphy were correlated with an independent review of operative records.Results: The presence of adenoma in the correct side and quadrant of the neck was predicted by CT in 89% and 77% of studies, respectively. When first-line studies were indeterminate, the positive predictive value of CT for localization of PA to the correct side and quadrant of the neck was 87% and 69%, respectively.Conclusions: When first-line localization studies are indeterminate in patients with primary hyperparathyroidism, CT is a valuable, rapid, and widely available imaging modality that can be used to localize PA.
Abboud, Bassam; Sleilaty, Ghassan; Rabaa, Lara; Daher, Ronald et al
Ultrasonography: Highly Accuracy Technique for Preoperative Localization of Parathyroid Adenoma
Laryngoscope.
Publish Ahead of Print, POST AUTHOR CORRECTIONS, 9 May 2008
Abstract
Objectives/Hypothesis: This study evaluates the accuracy of ultrasonography in guided unilateral parathyroidectomy to treat primary hyperparathyroidism.Study Design: Retrospective study.Methods: Two hundred fifty-three patients with primary hyperparathyroidism underwent preoperative ultrasonography. Two groups were defined. Group 1 included the patients in whom the preoperative cervical ultrasound localized one abnormal parathyroid gland; these patients underwent unilateral surgical exploration of the neck under local anesthesia. Group 2 included the patients who had a bilateral neck exploration under general anesthesia when the preoperative examination was equivocal or failed to localize the lesion, when concomitant thyroid pathology indicated thyroidectomy, and when justified by the surgical findings.Results: Sensitivity and positive predictive value of ultrasonography in detecting abnormal parathyroid gland were 96% and 98%, respectively. Cervical ultrasound correctly identified, 96% and 85% of abnormal glands in groups 1 and 2, respectively. The presence of thyroid nodular disease did not affect ultrasonographic accuracy. Sonographic examination decreased the operative time of parathyroidectomy to an average of 15 minutes. Mediastinal and retroesophageal localizations of abnormal parathyroid gl and adversely affected the accuracy of the ultrasound. No cervical hematoma was noted. Transient recurrent laryngeal nerve palsy occurred in four patients. Twenty-three patients required postoperative calcium supplementation for 2 to 4 months, and all were normocalcemic at follow-up.Conclusions: Cervical ultrasound is a reliable preoperative exploration allowing parathyroidectomy via unilateral approach under local anesthesia.
Zald, Philip B. ; Hamilton, Bronwyn E. ; Larsen, Michael L. ; Cohen, James I.
The Role of Computed Tomography for Localization of Parathyroid Adenomas.
Laryngoscope.
Publish Ahead of Print, POST AUTHOR CORRECTIONS, 2 June 2008
Abstract
Objective/Hypothesis: The purpose of this study was to evaluate the use of computed tomography (CT) for localization of parathyroid adenomas (PA) when first-line imaging is indeterminate.Study Design: Retrospective case series.Methods: A search of operating room and radiology records identified 223 surgical explorations for primary hyperparathyroidism. Adenoma locations on CT, ultrasound, and nuclear scintigraphy were correlated with an independent review of operative records.Results: The presence of adenoma in the correct side and quadrant of the neck was predicted by CT in 89% and 77% of studies, respectively. When first-line studies were indeterminate, the positive predictive value of CT for localization of PA to the correct side and quadrant of the neck was 87% and 69%, respectively.Conclusions: When first-line localization studies are indeterminate in patients with primary hyperparathyroidism, CT is a valuable, rapid, and widely available imaging modality that can be used to localize PA.
Thursday, 29 May 2008
BMJ 10 May 2008; Vol. 336, No. 7652
Imaging technology could be useful in poor countries
Judy Siegel-Itzkovich
Everyone’s a radiologist now [Feature article]
Jacqui Wise
Judy Siegel-Itzkovich
Everyone’s a radiologist now [Feature article]
Jacqui Wise
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