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Axial Spondyloarthritis
Published in Jason Liebowitz, Philip Seo, David Hellmann, Michael Zeide, Clinical Innovation in Rheumatology, 2023
Improved availability of ultrasound, proliferation of rheumatologists with comfort with musculoskeletal ultrasound, and standardization of definitions will likely enhance the utility and accuracy of this tool over the coming decades. Further, progressive enhancements to the tool itself may improve its accuracy. For example, contrast-enhanced ultrasound utilizes oscillation of microbubbles as a contrast agent, which accumulates in hypervascularized areas and increases echogenicity of inflamed tissues. This technique has been shown to increase detection of perientheseal hypervascularity and improve detection of enthesitis.81 Unfortunately, its utility is likely limited to only one area due to the short-lived nature of the contrast.
Radiology
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
As care of the severely injured patient has evolved over the past decades, greatly informed by the military experience in both Iraq and Afghanistan, so has trauma imaging as a result of an evolving evidence base and huge technological advances. The role of trauma CT is now firmly established as the mainstay of imaging in major trauma, and the role of plain radiographs has gradually and greatly diminished. The utility of ultrasound is largely confined to the emergency department, although novel techniques (for example, micro-bubble contrast enhanced ultrasound) are still emerging and being evaluated. MRI is the definitive modality for spinal cord imaging, and still has its place in imaging of the brain in trauma.
Ultrasound Physics
Published in Debbie Peet, Emma Chung, Practical Medical Physics, 2021
Ultrasound contrast agents: Vascular ultrasound contrast agents take the form of tiny “microbubbles” that are introduced to the blood stream to enhance the ultrasound signal from blood flow. Microbubbles can be generated through agitation of saline and are commercially available as vials of encapsulated microbubbles. Each vial contains millions of 1–10 µm diameter bubbles containing a biocompatible inert gas, encapsulated in a lipid shell. These improve the visibility of vessels and can potentially be targeted to adhere to thrombus or tumours. Contrast-enhanced ultrasound (CEUS) imaging is often used as an adjunct to conventional B-mode imaging to distinguish between benign and malignant tumours through identifying hypervascularity associated with tumour growth.
A radiomics nomogram model for predicting prognosis of pancreatic ductal adenocarcinoma after high-intensity focused ultrasound surgery
Published in International Journal of Hyperthermia, 2023
Changjie Shao, Juntao Zhang, Jing Guo, Liang Zhang, Yuhan Zhang, Leiyuan Ma, Chuanxin Gong, Yaqi Tian, Jingjing Chen, Ning Yu
The operation was performed with JC high-intensity focused ultrasound tumor treatment system produced by Chongqing HAIFU Medical Technology Co., Ltd. The system was mainly composed of airborne ultrasonic positioning system, ultrasonic power transmitting device, therapeutic head motion control system, medium water treatment, and circulating cooling system. To be well-prepared to be included in the study, patients were required to abstain from gas-producing food within 3 days before treatment and catharsis 10 h before treatment. The conventional treatment position is prone position. Before operation, the surgeon used the airborne ultrasound probe combined with the three-dimensional reconstruction image to determine the location, size, the shape of the tumor, and its relationship with the adjacent tissue, so as to ensure the safety of the sound channel. Each 5 mm layer, the focus was divided into multiple continuous sections and the ultrasonic power was selected according to the blood supply of the tumor. The target tumor was treated with point-line-surface-body three-dimensional therapy. During the operation, the operator could observe the overall gray increase or mass echo enhancement of the tumor in real time, until the predetermined target area was covered. Finally, contrast-enhanced ultrasound was routinely used to evaluate the therapeutic effect. If there was no obvious perfusion in the treatment area, the treatment ended; Otherwise, continue to treat the perfusion area. The treatment was completed after the second radiography reached the expected ablation.
Dosimetric analysis of ultrasound-guided high intensity focused ultrasound ablation for breast fibroadenomas: a retrospective study
Published in International Journal of Hyperthermia, 2022
Cai Zhang, Mengdi Liang, Tiansong Xia, Heng Yin, Hongwei Yang, Zhibiao Wang, Lian Zhang
To evaluate the therapeutic results, contrast-enhanced ultrasound using a microbubble agent (SonoVue, Bracco, Milan, Italy) was performed before and immediately after HIFU treatment. Briefly, a vial of 59 mg of SonoVue microbubble powder was reconstituted with 5 ml of normal saline. Then, the vial was vigorously shaken to let the microbubble powder fully dissolved. The contrast-enhanced ultrasound imaging was observed and recorded after intravenous injection 2 ml of SonoVue solution followed by 5 ml normal saline flushing. The contrast-enhanced ultrasound results were analyzed independently by two senior ultrasound doctors. Nonperfused volume (NPV), representing coagulative necrosis volume, was first measured in 3 dimensions and then calculated according to the above-mentioned equation. The NPV ratio was defined as NPV/fibroadenoma volume × 100%.
2022 Expert consensus on the use of laser ablation for papillary thyroid microcarcinoma
Published in International Journal of Hyperthermia, 2022
Lu Zhang, Wei Zhou, Jian Qiao Zhou, Qian Shi, Teresa Rago, Giovanni Gambelunghe, Da Zhong Zou, Jun Gu, Man Lu, Fen Chen, Jie Ren, Wen Cheng, Ping Zhou, Stefano Spiezia, Enrico Papini, Wei Wei Zhan
Key question 6: What clinical, laboratory and imaging evaluations should be requested before PLA is performed?Detailed medical history including current medical therapy, allergies, high blood pressure, diabetes, and any cardiovascular, brain, liver, lung or kidney diseases. Any underlying disease(s) should be effectively controlled before laser ablation. If the patient is receiving oral anticoagulants, discontinuation is recommended if their condition permits [26];Comprehensive evaluation of platelets count, coagulation and anticoagulation indicators;Preoperative confirmation of malignancy with FNA or core-needle biopsy (CNB) is mandatory [11,18];Complete blood count, viral serum indicators, complete thyroid function, calcitonin, electrocardiogram, laryngoscopy, and conventional US should be performed. Contrast-enhanced ultrasound (CEUS) should be performed only in selected cases according to local experience [11,18].