جستجوی مقالات مرتبط با کلیدواژه « Ultrasonography » در نشریات گروه « پزشکی »

Macroscopic tumor implants in the hernia sac are a very rare condition. They occur as a result of the implantation of malignant cells in the malignant ascites from the inguinal canal to the hernia sac. In this case report, we share the clinical and radiological findings of the macroscopic tumoral implants in the hernia sac at the level of the inguinal canal and scrotum in a male patient aged 65 years with a history of total gastrectomy for gastric adenocarcinoma and developing malignant ascites six months after the surgery.

The administration of antenatal corticosteroid is a standard treatment to reduce the rate of perinatal mortality and morbidity; however, there is limited evidence regarding the potential effects of betamethasone on the constriction of the ductus arteriosus (DA).

This study aimed to investigate the short-term effects of antenatal betamethasone on fetal cardiovascular and circulation status.

This quasi-experimental observational (before-after) study was conducted on 32 singleton fetuses. The participants were healthy pregnant women with a diagnosis of placenta accreta spectrum who were eligible for 2 doses of betamethasone and referred to prenatal care clinic, Vali-E-Asr hospital, Tehran, Iran from January 2021-May 2022. The results of fetal echocardiography and Doppler sonography were compared before and after the administration of antenatal corticosteroid therapy.

Following betamethasone injection, significant increases were observed in peak systolic and diastolic velocity of the DA without constriction of the DA (p < 0.001, p = 0.002 respectively). However, no significant changes were observed in right ventricular function, tricuspid valve function, Doppler of ductus venous, and peak systolic velocity of the aortic isthmus (p > 0.05). Doppler examination of the uterine, umbilical, and middle cerebral arteries also showed no significant changes (p > 0.05).

Considering the benefits of antenatal corticosteroid therapy, its administration seems reasonable in preterm births. The transient changes in ductal blood flow are not prohibitive.

Ectopic thyroid tissue is a rare congenital anomaly, with the presence of three simultaneous ectopic foci being exceedingly rare. We describe a case of a totally asymptomatic 26-year-old male discovered to have triple ectopic thyroid following incidental elevated thyroid-stimulating hormone (TSH) levels. Subsequent ultrasonography of the neck showed an absent thyroid gland in its conventional location. A Technetium-99m pertechnetate (Tc-99m) thyroid scan showed three distinct foci of radiotracer uptake in the upper cervical, lingual, and sublingual regions, corresponding to triple ectopic thyroid. An extensive review of the literature was conducted to provide a broader understanding and deeper insights into this uncommon condition. This case underscores the pivotal role of Technetium-99m thyroid scanning in diagnosing triple ectopic thyroid, particularly in instances where the orthotopic thyroid gland is absent. A comprehensive understanding of this rare entity is indispensable for radiologists and clinicians, enabling accurate diagnosis and informed decision-making regarding the appropriate therapeutic strategies.

Breast cancer is the most common female cancer and the second leading cause of death worldwide. The gold standard tool for screening breast cancer, mammography has limitations in some instances, such as patients with dense breast tissue. This study evaluates the correlation of Ultrasound (US) to mammography in breast lesions in BI-RADS.

This prospective cross-sectional study was conducted at a tertiary hospital during 2019-2021. Women who referred to the radiology department for mammography with abnormalities appearing in their mammograms, with a minimum age of 40 and older, underwent ultrasonography. The results of mammography and US evaluations compared according to BI-RADS category. Statistical software SPSS was used to analyze the form data.

In this study, 156 women with a mean age of 48/9 years registered. The US reports were equivalent to mammographic BI-RADS category 2 in 23 cases. All the 26 patients with mammographic BI-RADS category were categorized into BI-RADS 2 by US. Among 43 lesions with BI-RADS category 4 and 21 with BI-RADS category 5, 90/6% and 95/2% of sonography reports were similar to mammography findings. Based on the Pearson correlation coefficient of 0/68, there is a correlation between the results of US and mammography in this study.

This study reveals that US can be an excellent complement to mammography, particularly in identifying early-stage breast cancer in mammographic BI-RADS category 0 lesions. The mammographic-sonographic correlation should lead to more accurate diagnoses and better patient care.

 Ovarian cancers are increasing in incidence, and an accurate ultrasonographic diagnosis, along with a complete physical examination and history taking, is essential for prompt diagnosis and early reporting.
In this study, we aimed to evaluate the efficacy of ultrasonography (USG) in identifying ovarian lesions using histopathology as the gold standard.

This was a retrospective study conducted by evaluating the reports of patients in the menopausal age group who had undergone total hysterectomy or oophorectomy. Histopathological diagnoses were retrieved from the Department of Pathology, and ultrasonographic (USG) reports were obtained from the patients' medical records.

This study included the histopathological and ultrasonographic reports of 239 women, of which 95.4% of cases were benign, while borderline lesions and malignant lesions constituted 3.3% and 1.3%, respectively. USG showed sensitivities of 93.55%, 66.7%, and 33% in identifying benign, borderline, and malignant lesions, respectively. Specificities of 91.67%, 91.84%, and 99.46% were noted in classifying ovarian lesions as benign, borderline, and malignant, respectively.

Ultrasonography (USG) remains an important imaging tool for the early diagnosis of ovarian lesions, and a standardized reporting protocol should be implemented in every institution to increase the accuracy of USG and to reduce the inter-observer variability commonly encountered in ultrasound.

Utilizing the combination of fluoroscopy and ultrasonography during Percutaneous Nephrolithotomy (PCNL) to minimize radiation exposure.

In this randomized clinical trial, 118 patients with urinary stones who were candidates for PCNL surgery in the prone position were selected and divided into two groups (with an allocation ratio of 1:1). Cases were grouped according to whether ultrasonography was used for renal tract dilation and Amplatz sheath placement. The number of attempts to establish proper renal access, the time interval between access to the targeted calyx and nephroscope entrance, and the Clavien-Dindo score were collected.

The mean age of all patients was 46.12 ± 11.28 (45.6 ± 11.2 in the total fluoroscopy group and 46.5 ± 11.4 in the combined group) years (20-66). The intergroup differences in the baseline features were not significant. The mean duration of fluoroscopy time was significantly reduced in the combined guidance group (36.22 ± 10.73 vs. 23.05±8.94 seconds, (P-value = 0.001). Moreover, the difference in the distribution of Amplatz location on the nephroscopy time was meaningful (P-value = 0.016). However, intergroup differences in the number of attempts to successful puncture, length of hospitalization, recovery time, and postoperative complications, including gross hematuria duration, blood loss volume, pack cells requirement, pain score immediately and 6 hours after the surgery, and Clavien-Dindo score were not meaningful.

It can be concluded that the use of ultrasound with X-ray in prone PCNL compared to the use of X-rays alone can significantly reduce the duration of radiation without increasing the risk of intra-operative and postoperative detrimental events. 

The occurrence of ovarian hematoma during controlled ovarian stimulation (COS) is very rare. Until now, there is no such case reported in the literature. In this study, an attempt was made to discuss the possible mechanisms for the development of hematoma in such patients, the clinical presentation, monitoring, and management of these cases.

A rare case of periovarian hematoma was reported in a patient with a history of endometriosis undergoing ovarian stimulation for in vitro fertilization. On the seventh day of stimulation, the patient complained of severe pain in the abdomen. Her vitals and blood investigations were within normal limits. On abdominal examination, mild tenderness was noted in the left iliac fossa. On vaginal examination, fullness and tenderness were noted in the left fornix. On ultrasound, probe tenderness was present and a left ovarian hematoma measuring 2.0x1.81x1.55 cm was observed. She was managed conservatively. The hematoma exhibited a gradual reduction following the pick-up procedure and eventually resolved completely within a month.

Underlying endometriosis could be one of the possible causes of this periovarian hematoma. A conservative approach with close monitoring forms the first-line management in hemodynamically stable patients.

Background &  The administration of tamoxifen to post-menopausal patients with breast cancer may lead to vaginal bleeding, necessitating a thorough understanding of associated factors. Our objective was to investigate sonographic, hysteroscopic, and pathologic findings in breast cancer patients experiencing vaginal bleeding following tamoxifen use.Materials &  In this cross-sectional study, we evaluated women with post-menopausal breast cancer reporting vaginal bleeding while undergoing tamoxifen treatment for more than six months. Data collection involved a checklist encompassing ultrasonographic, hysteroscopic, and pathologic findings. The study included 100 patients with a mean age of 56.2 ± 2.9 years and a mean endometrial thickness of 14.5 ± 3.4 mm. Notably, 25% of the patients exhibited abnormally large uterine size. Ultrasonography revealed polyps and myomas in 36% and 15% of cases, respectively. Positive hysteroscopy findings were observed in 72%, comprising polyps in 36%, hyperplasia in 32%, and atrophy in 4%. Pathological assessment identified abnormal features in 31% as polyps, 34% as hyperplasia, 4% as atrophy, and 5% as cancerous lesions. Patients who received tamoxifen had high endometrial thickness due to endometrial polyp, it seems that clinicians can consider using hysteroscopy with dilation and curettage in these patients.

Testicular torsion (TT) necessitates emergent and proper intervention since it can affect sexual health and fertility. Ultrasonography is the gold standard modality for detecting TT. This study aimed to determine the long-term sonographic changes of the testicles in patients with a history of orchiopexy for testicular torsion in the pre-and post-operative stages who were referred to our tertiary pediatric referral emergency department in 2017-2018, northeast of Iran.

In this analytical cross-sectional study, we have collected patients referred to the urology department with acute scrotum complaints and followed up clinically and sonographically on the size of their testicles.

The left testicle was found to be torsified in 24 (72.7%) cases. In the control ultrasound, 12 (38.7%) cases of involvement of the left side of the testicle were reduced in size. In the post-operative stage, the percentage of involvement in the right testicle (0.87%) was higher than in the left (0.50%). The percentage of parenchymal involvement frequency before and after the operation was compared using Fisher's exact test, which had a significant difference (P=0.001). The testicular blood supply frequency before surgery was impaired in 19 (57.6%) cases. In control ultrasound, 15 (45.5%) testicular tissues had normal blood supply. These results were compared using Fisher's exact test, which has no significant difference (P=0.154).

However, the sonographic changes of testicles in the patients suffering from TT were variable over time, and these changes can be widely different; they are also significantly related to testicular dimensions when the patient presents with testicular torsion.

Doppler sonography parameters, particularly the resistive index (RI), have been identified as an essential tool for assessing renal transplant dysfunction (RTD). However, there is some ambiguity in the findings of previous research studies on this matter. Therefore, the objective of our study is to examine the relationship between changes in RI subsequent to RTD.

This was a systematic review and meta-analysis study. We searched three electronic databases PubMed, Web of Science, and Scopus, from the year 2000 to 10 May 2022. The main effect size was considered as the mean RI differences of cases with RTD confirmed by biopsy with control patients with no RTD. We used random effect models to pool the effect size.

Thirteen studies were included in our review. The pooled mean (95% CI) for the control group was calculated to be 0.71 (0,67, 0.75) and for patients with renal transplant dysfunction was 0.73 (0.68, 0.78), under a random effect model with high heterogeneity for both analyses (I2=98% and 97%, respectively). The pooled mean was significantly different between the control group and patients with RTD (P= 0.05), based on a t-test of pooled effect sizes.

Based on the result of our study, we showed that there is a significant difference between RI in patients with kidney transplant dysfunction and the control group. However, RI cannot substitute kidney biopsy in the management and diagnosis of RTD.

 This study seeks to evaluate the precision of ultrasonography in confirming orogastric tube placement among neonates in a Chinese neonatal intensive care unit (NICU).

 Radiological assessments initially gauged tube placement, followed by confirmation through ultrasonography. The agreement between the two methods was assessed using Cohen's kappa statistic, while diagnostic performance was analyzed through sensitivity and specificity calculations.

 Out of 156 orogastric tubes, 85.3% were accurately placed in the stomach according to radiological assessment, with ultrasonography confirming 88.5% of stomach placements. Accuracy rates were 67.3% for radiological evaluation and 60.3% for ultrasonography in determining the accurate position. The agreement assessment demonstrated a sensitivity of 68.6% and a specificity of 46.3%.

 While ultrasonography shows promise in reliably verifying orogastric tube placement in newborns, it does not entirely substitute current radiological assessments. Further research is essential to discern the optimal clinical utility of ultrasonography.

While neonatal pneumothorax (NP) is uncommon, it presents a serious condition requiring immediate and precise diagnosis and treatment. To achieve this, dependence on imaging techniques is crucial for detecting gas accumulation within the infant's thoracic cavity. Traditionally, diagnosing NP relies heavily on Chest X-ray (CXR) examinations, involving ionizing radiation exposure, a persisting concern. Conversely, lung ultrasonography (LUS) has gained widespread recognition due to its convenience, expediency, and radiation-free attributes. The debate over whether LUS can completely replace traditional CXR remains contentious. Our objective is to conduct a thorough analysis of the efficacy of LUS and CXR examinations in diagnosing NP, with the intention of offering additional references for clinicians to optimize medical care for infants, minimizing radiation exposure and ensuring comprehensive protection of their health and safety.

Magnetic Resonance Imaging (MRI) can guide the surgical strategy to identify brain tumors and monitor treatment response. It is possible to use transcranial Ultrasound (US) for periodical follow-ups. Ultrasound waves pass through the delicate areas of the skull called acoustic windows. In this study, the efficiency of ultrasound imaging was performed to diagnose glioblastoma brain tumors and the results were compared with MR images.

Male Wistar rats were anesthetized by intraperitoneal injection of Ketamine and Xylazine. A stereotaxic device was used to determine the injection coordinates. C6 GBM cell lines were injected into the brains of rats. After two weeks, the formation of a glioblastoma tumor was confirmed histopathologically. The brain of animals was imaged by B-mode ultrasound and MRI. The section with the largest tumor dimensions was selected and the dimensions of the skull and tumor were measured based on the pixel size of each of the imaging methods. Pearson coefficient of correlation and Limits Of Agreement (LOA) were calculated for comparisons of the skull and tumor dimensions.

The skull and the tumor dimensions showed a significant correlation between the B-mode ultrasound and the MRI measurements (R=0.99 and p<0.05). According to the Bland-Altman analysis, the mean difference was 0.31 mm (SD=0.20) for skull and tumor dimensions. The exact shape of the tumor is not completely clear in the ultrasound images, but it can be useful to detect the presence of the tumor and its approximate dimensions.

In conclusion, a glioblastoma tumor was produced in the male Wistar rat. The tumor dimensions were properly assessed by B-mode ultrasound image processing and compared with MR imaging.

Accurate assessment of intravascular volume status is a vital aspect of management of intensive care unit (ICU) patients. Inferior vena cava (IVC) diameter and IVC collapsibility index have surfaced as promising methods to accurately predict hypovolemia. But no such study has evaluated it’s their utility in postoperative patients.

The study aimed to assess the correlation between ultrasound guided IVC collapsibility index (IVC CI) and CVP for volume status in intensive care unit patients. Hundred spontaneously breathing patients receiving postoperative care in our surgical ICU between November 2019 to march 2021were enrolled into the study. Maximum IVC diameter (IVCdmax) at end-expiration, minimum IVC diameter at end-inspiration (IVCdmin) and IVC CI were measured. Simultaneous CVP recordings were obtained.

A positive correlation was noted between IVC maximum diameter and CVP (p = <0.001) and between IVC Minimum Diameter and CVP. (p = <0.001) A negative correlation between IVC CI and CVP was seen (p = <0.001). Mean IVC CI was highest in the hypovolemic group. The area under the ROC curve (AUROC) for IVC CI predicting hypovolemia was 0.943 (95% CI: 0.9 - 0.986), thus demonstrating excellent diagnostic performance. At a cut off of ≥58.416%, IVC CI predicts hypovolemia with a sensitivity of 93.8%, and a specificity of 84%.

IVC CI can be used to guide fluid therapy due to its excellent diagnostic accuracy in predicting hypovolemia in postoperative patients in ICU.

Unanticipated difficult intubation poses a challenge in routine practice for anaesthesiologists. A preoperative airway evaluation helps in the identification of a difficult airway. Airway assessment with ultrasound is a modality recently being used to predict difficult airway. In this study we evaluate ultrasonography parameters with conventional clinical parameters for predicting difficult airway in adults undergoing elective surgeries.

This cross sectional randomised clinical trial analyses ASA class 1 and 2 adults requiring endotracheal intubation for surgeries under general anaesthesia were enrolled following which Modified Mallampatti score and thyromental distance as well as ultrasound distance to epiglottis (DSE) and distance to hyoid bone (DSHB) were measured and based on Cormack Lehane grading they were categorised into easy and difficult airway groups.

DSE had the highest sensitivity of 90.48% whereas Modified Mallampatti grading had least sensitivity of 66.67%.

The results of this study showed that ultrasonographic measurements at the thyrohyoid and hyoid level have higher sensitivity and specificity than the clinical parameters for airway assessment.

Precise assessment of cervical conditions before labor induction is crucial for predicting the success of normal vaginal delivery. The cervix primary condition has a significant value in determining the succession of induction of labour. Traditionally, assessment of cervix before induction has been based on a cervix digital examination using Bishop's scoring method.This study compares transvaginal ultrasonographic (TVS) cervical assessment with the traditional Bishop score in nulliparous women undergoing labor induction, aiming to evaluate their predictive abilities for labor dystocia.

In a prospective observational study of 200 pregnant women at Al Hussein University Hospital between October 2022 and July 2023, cervical length, funneling, and posterior cervical angle were measured using transvaginal ultrasound. The Bishop score was recorded before induction. Statistical analyses, including Student's "t"-test and ROC curve, were conducted using SPSS.

68% delivered via normal vaginal delivery (NVD) and 32% via cesarean section (CS). The NVD group exhibited significantly higher Bishop scores (6.82±1.36 vs 3.70±0.94), lower cervical length (25.46±3.99 vs 37.34±2.09),and higher cervical angle (121.39±5.70 vs 89.01±6.09), than the CS group. ROC curve analysis revealed that a Bishop score ≥4.5 had 89% sensitivity and 87.5% specificity, a cervical angle ≥ 92.5 had 98.5% sensitivity and 95.3% specificity, and a cervical length ≥31.5 had 96.9% sensitivity and 97.1% specificity for predicting NVD.

The posterior cervical angle, alongside cervical length, proves to be a more sensitive indicator for predicting labor dystocia during induction compared to the traditional Bishop score.

The attentive management of rheumatoid arthritis (RA) has attracted particular attention. The German 7-joint Ultrasound (US-7) is the first scoring system that combines bone erosions and soft tissue lesions in a single composite scoring system. This study aimed to assess the correlation between US-7 and Disease Activity Score Using 28 Joint Counts (DAS28) in clinically active RA patients. The efficacy of a novel ultrasound score-based system, the US-9 score (joints assessed with US-7 plus knees), was also compared with the standard US-7 score.

All the RA patients referred to the outpatient rheumatology clinic of Ghaem Hospital, Mashhad, Iran, during 2019-2020 were included. 28 joints were clinically examined to calculate DAS28. Nine joints were assessed comprising the German US-7 plus knees using grayscale ultrasonography (GSUS) and power Doppler ultrasonography (PDUS). Retrieved data were analyzed by SPSS software, version 22. The Spearman Correlation test was used to find the correlation between DAS28 and ultrasonographic findings. The statistical significance level was set at P<0.05. 

This study was composed of thirty-five RA patients with a mean age of 49.1±12.0 years. US-7 synovitis scores in GSUS and PDUS were significantly correlated with DAS28 (P=0.02, r=0.38 and P=0.003, r=0.48, respectively). US-9 synovitis scores in GSUS and PDUS were also significantly correlated with DAS28 (P=0.003, r=0.49 and P=0.006, r=0.45, respectively). The synovitis score measured by GSUS was significantly correlated with the GSUS knee synovial score (P=0.01, r=0.42).

Ultrasound assessment of large joints such as knees can be an effective approach to determining RA severity. However, it can be proposed that adding more involved joints into the sonographic assessment does not necessarily provide a better clinical correlation.

Myometrial thickness has been expected to be a prognosticator for lower uterine segment function. Anabnormal function of the uterine muscle layer can cause common and important reproductive problems. This studyaimed to evaluate the relationship between the baseline myometrial thickness and assisted reproductive technologies(ART) outcomes. In this prospective cohort study, 453 infertile women undergoing ART cycles without anyobvious uterine pathology, participated in this prospective cohort study from February 2013 to May 2015. In order tomeasure the myometrial thickness in the anterior and posterior of the uterine, trans-vaginal ultrasounds were conducted ondays 2-4 of the cycle (menstrual phase) preceding ovarian stimulation and the day of human chorionic gonadotropin(hCG) injection. We defined three groups based on the baseline myometrial thickness in the anterior and posterior, including(A) <25 mm, (B) 25-29.9 mm and (C) ≥30 mm. Ovarian stimulation, oocyte retrieval and luteal phase support wereperformed in accordance with the standard long protocol. Two weeks after embryo transfer, the patients underwent apregnancy test by checking their serum β-hCG levels. The primary outcome measure was the clinical pregnancy rate. Secondaryoutcome measures were implantation rate, abortion rate and live birth rate. The clinical pregnancy (P=0.013) and implantation (P=0.003) rates were significantly lower in group A thanin two other groups. Although the live birth rate was lower in group A than two other groups, this decrease was not statisticallysignificant (P=0.058). The findings may be a way for clinicians to draw focus on providing therapeutic strategies and a specificsupportive care for women with a baseline myometrial thickness <25 mm in order to improve the reproductive outcomeof in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI).