Results 1 - 10 of 714
Results 1 - 10 of 714. Search took: 0.021 seconds
|Sort by: date | relevance|
[en] To evaluate the efficacy of parastermal ultrasonography (US) in diagnosing internal mammary lymph node (IMLN) metastases in breast cancer, an important site of occult metastases, adversely affecting the disease-free interval and long-term survival. The internal mammary artery and vein course adjacent and parallel to the lateral stermal border, deep to the costal cartilages. The internal mammary lymphatics accompany the vessels, extending from the first through the six anterior interspaces. The vessels and lymphatics together rest on the endothoracic fascia, deep to the pectoralis major and intercostals muscles. The internal mammary lymph nodes are very small, measuring 2-5 mm in diameter, may occur either medial or lateral to the vessels.
[en] The treatment of the choice of IPMT is a partial pancreatic resection with complete excision of this potentially malignant lesion, thus preserving sufficient pancreatic tissue to ensure endocrine and exocrine functions. This strategy, however, requires a reliable preoperative assessment of the highly variable extension of IPMT. We performed this study to determine the role of intraductal ultrasonography (IDUS) in predicting extension of IPMT and selecting the resection methods of pancreas. From January 1997 to August 2001, there were 12 consequent patients, including 5 men and 7 women, with a median age of 54 years (range, 37-66) who underwent a resection of IPMT. A preoperative assessment of IPMT by IDUS was performed in all patients. According to the preoperative localization of IPMT by IDUS, various type of limited pancreatic resections were planned. The frozen sectional histologic examination of pancreatic cut surface was performed in all patient. In the case of cut surface tumor positive, a modification of the planned resection was done.
[en] We evaluated the effectiveness of ultrasonography (US) in differential diagnosis of nonpalpable breast nodules. From January 2000 to June 2001, US-guided fine needle aspiration biopsy (FNAB) was performed in 610 nonpalpable breast nodules from 511 patients. Pre-biopsy US diagnosis was divided into 311 benign and 299 non-benign (malignant and indeterminate) categories. Diagnostic accuracy of Pre-biopsy US was calculated according to the size of lesion. All lesions were pathologically diagnosed by US-guided FNAB while excisional biopsy was performed in 12 cases. Overall, 136/143 FNAB-proven malignant nodules (95.1%) and 304/467 FNAB-proven benign nodules (65.1%) were correctly predicted by US. The overall diagnostic accuracy was 72.1% while the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were highest for the nodules sized between 1-2 cm in the longest diameter (98.1%, 70.1%, 47.7%, 99.2% and 76.2%, respectively). The number of false negative malignancies were seven (4.9%); four of them, smaller than 1 cm. False negative malignancies showed ovoid or round in shape, well defined margin and homogeneous echogenecity. Meanwhile, frequent US findings of indeterminate nodules included ill-defined margin, microlobulated border, angular margin and marked hypoechogenecity; however, 86% of them were proved to be benign. Ultrasonography is an effective diagnostic method in differential diagnosis of nonpalpable breast nodules, especially for 1-2 cm sized nodules. However, US characteristics suggestive of malignancy were also frequently seen in benign lesions.
[en] To evaluate prenatal ultrasonographic findings of limb-body wall complex and to correlate them with autopsy findings. From October 1995 to June 2000, a retrospectively review of prenatal ultrasonography (US) of 11 patients with pathologically proven limb-body wall complex was done. US findings were then compared with autopsy findings. Prenatal ultrasonography revealed thoraco-abdominoschists (n=7.64%), kyphoscoliosis (n=7.64%), cranial defect (n=5.45%), limb defect (n=4.36%), facial defect (n=1.10%), amniotic band (n=5.45%), and umbilical cord anomaly (n=3.27%). Meanwhile, autopsy findings showed thoraco-abdominoschisis (n=8.72%), limb defect (n=7.64%), facial defect (n=7.64%), kyphoscoliosis (n=5.45%), cranial defect (n=5.45%), amniotic band (n=5.45%) and umbilical cord anomaly (n=4.36%). The most common ultrasonography features of limb-body wall complex were thoraco-abdominoschisis and kyphoscoliosis while the thoraco-abdominoschisis and limb defects were the most frequent findings at autopsy.
[en] To evaluate the clinical significance of transient hyperechogenicity of the renal medulla in neonates by comparing the clinical features, urinalysis and follow-up ultrasonographic examination of the control group. One hundred ten neonates were divided into 2 groups, hyperechoic and normal renal medulla groups, and all of them underwent abdominal ultrasound with a 7.5 MHz linear transducer (Sonoace 8800MT, Medicine, Korea) from November 1999 to January 2000. Whether there was any difference in clinical features including birth weight, body surface area, gestational age, sex, date of examination and mode of delivery between two groups was evaluated. In addition, any difference in their urinary osmolarity, albumin, uric acid and calcium in 41 neonates who underwent urinalysis was evaluated. In ten neonates with hyperechoic renal medulla underwent follow-up study, the follow-up ultrasonographic findings were compared with the initial study. In 67 of 110 (61%) neonates, ultrasonography demonstrated hyperechoic renal medulla. There was no difference in clinical features between the hyperechoic renal medullary group and normal group. In 41 neonates, there was no significant difference in urinalysis between two groups. (Osmolarity=146.46 ± 68.4 mOsml/KgH2O in the hyperechoic renal medullary group vs. 149.8 ± 77.7 mOsml/KgH2O in the normal group; albumin=13.9 ± 10.2 mg/ml vs. 17.6 ± 13.6 mg/dl; uric acid=50.0 ± 23.3 mg/dl vs. 44.9 ± 34.1 mg/dl; calcium=1.38 ± 3.0 mg/ dl vs. 0.44 ± 0.07 mg/dl.) Ten neonates who underwent follow-up ultrasonography within 20 days after the initial study showed the normal medullary echogenicity. There were no significant difference between the hyperechoic renal medullary group and the normal echogenic group in their clinical features and urinalysis. Therefore, the hyperechoic renal medullar in neonate is considered as an usual and transient finding which disappears on follow-up study.
[en] To investigate the effects of various ultrasound parameters on the accuracy of volume measurement using three-dimensional ultrasound (3DUS) and virtual organ computer-aided analysis (VOCALTM). Voluson 730 US unit equipped with 4-8 MHz convex volume probe (Medison Kretztechnik AG, Seoul, Korea) and agar-based US phantom were used. The phantom contained 20 pieces of tumor-mimicking, round-carved harms whose true volume ranged from 8.6 to 10.5 ml. Initially, the center of each harm was placed 5 cm below the surface, and volume data was acquired in various focusing setting (2, 5, 8 cm deep), FOVs (8, 10,12 cm) and sweeping speeds of the probe (low, mid, high as preset on US unit). Change of only one parameter was done while the other parameters remained constant. The process was repeated with placing a harm 8 cm below the surface by adding agar under the same conditions and parameters as with 5 cm deep phantom to evaluate effect of object depth on volume measurement. The volume of each piece of ham was measured by using VOCALTM software (Kretztecink AG, Zipf, Austria) and was converted into % of the true volume, the statistical significance of the difference between volume measured with different US parameter setting was assessed by Wilcoxon signed-rank test and Friedmman test. Both location of focus and depth of ham significantly affected the measured volume of hams. In 5 cm deep phantom, the mean volume of 20 pieces of hams with the focus fixated at 2, 5, and 8 cm deep was 132.6 ± 3.5%, 127.0 ± 1.9%, and 135.3 ± 3.0%, respectively, showing the most accurate result when the depth of ham matched the focusing depth setting (p<0.01). The mean volume in 5 cm-deep phantom was 127.0± 1.9% while it was 138.8 ± 3.9% with 8 cm-deep phantom (p<0.01). FOVs and sweeping speeds did not affect the accuracy of volume measurement (p=0.22, 0.55). In order to obtain a more reliable assessment and comparison of the volume of lesion with 3DUS, it is essential that setting the focus at the same depth as the lesion while maintaining the constant transducer position and acoustic window throughout serial US examination.
[en] Vertebrobasilar ischemia has been attributed to a reduction of net vertebral artery flow volume. This study was to establish the reference values for the flow volume of the vertebral artery using color Doppler sonography in the normal Korea adults. Thirty five normal Korea adults without any underlying disease including hypertension, hyperlipidemia, diabetes, heart disease, obesity (body mas index>30), or carotid artery stenosis was included. There were 17 males and 18 females, age ranged from 20 to 53 years (average=32.86 years). Flow velocities and vessel diameters were recorded in the intertransverse (V2) segment, usually at C5-6 level, bilaterally. The flow volume (Q) was calculated. (Q=time averaged mean velocity x cross sectional area of vessel) A lower Flow velocity and smaller vessel diameter were measured on the right side compared to those of the left side, resulting in a lower flow volume. The calculated flow volumes using the equation were 77.0 ± 39.7 ml/min for the right side and 127.6 ± 71.0 ml/min for the left side (p=0.0001) while the net vertebral artery flow volume was 204.6 ± 81.8 ml/min. Decrease in the vertebral artery flow volume was statistically significant with advanced age. (r=-0.36, p=0.032). Vertebral artery blood flow volume was 191.20 ± 59.19 ml/min in male, and 217.28 ± 98.67 ml/min in female (p=0.6). The normal range for the net vertebral artery flow volume defined by the 5th to 95th percentiles was between 110.06 and 364.1 ml/min. The normal range for the net vertebral artery flow volume was between 110.06 and 364.1 ml/min. Vertebral artery flow volume decreased with the increase of age. However, gender did not affect the blood flow volume.
[en] The pattern of morphologic and functional status of the hemodialysis AV fistula was studied using doppler ultrasound to define the useful parameter and its normal range for detecting the initial dysfunctional. Sixty patients of chronic renal failure with radial artery-cephalic vein fistula for hemodialysis (50 clinically normal and 10 clinically abnormal functioning AV fistula) were studied by duplex ultrasound. The examination followed the feeding artery to the draining vein and observed the morphology and waveform of the vessels. Peak systolic velocity (PSV), End diastolic velocity (EDV) and Systolic/Diastolic ratio (S/D ratio) were measured in the feeding artery. In the draining vein, peak velocity was measured and the presence of arterial pulsation was observed. Normal range of these measuring parameters and its significance and reliability for detecting dysfunction AV fistula were studied. In normally functioning fistula, waveforms of flow in the feeding artery were monophasic, with PSV 0.5-3.48 m/sec (average 1.75 ± 0.79 m/sec), EDV 0.2-1.47 m/sec (average 0.82 ± 0.41 m/sec) and S/D ratio 1.44-3.48 (average 2.34 ± 0.56). The draining vein showed components of arterial pulsations with peak velocity of 0.21-1.20 m/sec (average 0.54 ± 0.23 m/sec). Of the 10 clinically dysfunctional AV fistula, two cases had arteriosclerous vessel wall calcification and showed normal function on doppler sonography. Two cases of focal stenotic lesion of the draining vein showed significantly increased PSV which were more than 4.0 m/sec. Six cases of venous thrombosis showed a high resistance pattern of reversed diastolic flow with a measured S/D ratio of more than 4.0 and the absence of flow was noted within the draining S/D ratio was statically very reliable parameter (P=0.003) for defining normal and abnormal functioning AV fistula, however PSV and EDVV were unreliable (P=0.459). Duplex ultrasound is a useful diagnostic method for interpretating function of the hemodialysis AV fistula. We believe PSV and S/D ratio are important parameters for diagnosis of the dysfunctional AV fistula. Knowledge of these characteristics and a more prospective accumulation of cases should aid in the identification of early abnormally functioning AV fistula.
[en] To evaluate the ultrasonographic findings of diffuse hepatocellular carcinoma (HCC) and to assess the feasibility of initial ultrasonography (US) as the diagnostic modality in the diagnosis of diffuse HCC. Among the patients with underlying liver cirrhosis (LC), ultrasonographic findings of thirty six cases with pathologically confirmed diffuse HCC were retrospectively reviewed. The ultrasonographic were evaluate with special emphasis on echogenicity, echotexture, hepatomegaly, portal venous thrombosis and signal on color doppler imaging if portal venous thrombosis was present. Changes in echogenicity was observed in thirty two cases (89%), and the echogenicity was increased in all thirty two cases when compared to the underlying cirrhotic liver parenchyma. Twenty nine cases (81%) showed different levels of coarseness from the neighboring liver parenchyma:twenty three cases (64%) with increased coarsence and six cases (17%) with decreased coarseness. Hepatomegaly was observed in twenty eight cases (78%), especially in the involving lobes or segments of the liver. Portal venous thrombosis was detected in thirty cases (83%), and eighteen (50%) of them had color doppler signal in their thrombi. When there are areas with a high echogenicity in contrast to the normal parenchyma, areas with different echotexture, hepatomegaly in spite of underlying LC and the presence of portal venous thrombosis with color doppler signals, a possibility of diffuse HCC should be taken into consideration on the initial ultrasonography of patients with LC.
[en] To evaluate the cardiovascular and splanchnic hemodynamic changes in patients with liver cirrhosis and to compare with those of the normal controls using doppler ultrasonography. A total of 129 patients including 23 of Child-Pugh class A, 24 of class A, 24 of class B, 30 of class C, and 52 of the control group were included. Cardiac output (CO), systemic vascular resistance index (SVRI), and blood flow and pulsatility index (PI) of the superior mesenteric artery (SMA) were evaluated and compared among each groups. CO and SMA blood flow in the cirrhotic group were significantly higher than those in the control group, and the increase in CO and SMA blood flow showed a statistically significant correlation with the degree of liver dysfunction (p<0.01). SVRI and SMA PI reflecting vascular resistance in the cirrhotic group were significantly lower than those in the control group, and the decrease in SVRI and SMA PI also showed a statistically significant correlation with the degree of liver dysfunction (p<0.01). SMA blood flow showed a statistically significant inverse relationship with SMA PI (R2=0.230). Hyperdynamic circulatory changes such as increases in CO and splanchnic blood flow were present in patients with liver cirrhosis. These changes may contribute to the development and maintenance of the portal hypertension due to an increase in portal blood flow an increase in portal blood flow.