Placental chorioangioma is a benign non-trophoblastic tumor of the placenta which is typically vascular and is derived from primitive chorionic mesenchyme. Chorioangiomas make up 1% of incidentally detected placental mass lesions. These are usually located on the fetal surface of the placenta. 1 Ultrasound with Doppler examination remains the gold standard investigation of choice for the diagnosis, and for differentiat-ing placental chorioangiomas from other placental masses which include degenerated fibroid, organized placental hematoma, partial hydatidiform mole and placental teratoma. Intense vascularity of placental chorioangioma on color Doppler may indicate possible risk of fetal complications. 2 Prenatal diagnosis of chorioangioma with appropriate management should include serial antenatal ultrasound scans with assessment of the placenta and fetus, pulse wave Doppler assessment of the umbilical cord and middle cerebral artery, and
{"title":"Prenatal diagnosis of placental chorioangioma on ultrasound","authors":"Ravikanth Reddy","doi":"10.1002/sono.12329","DOIUrl":"https://doi.org/10.1002/sono.12329","url":null,"abstract":"Placental chorioangioma is a benign non-trophoblastic tumor of the placenta which is typically vascular and is derived from primitive chorionic mesenchyme. Chorioangiomas make up 1% of incidentally detected placental mass lesions. These are usually located on the fetal surface of the placenta. 1 Ultrasound with Doppler examination remains the gold standard investigation of choice for the diagnosis, and for differentiat-ing placental chorioangiomas from other placental masses which include degenerated fibroid, organized placental hematoma, partial hydatidiform mole and placental teratoma. Intense vascularity of placental chorioangioma on color Doppler may indicate possible risk of fetal complications. 2 Prenatal diagnosis of chorioangioma with appropriate management should include serial antenatal ultrasound scans with assessment of the placenta and fetus, pulse wave Doppler assessment of the umbilical cord and middle cerebral artery, and","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"336 1","pages":"41 - 42"},"PeriodicalIF":0.4,"publicationDate":"2022-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80651480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jing Fang, Jacqui Robinson, Daniel Walkley, Alison Deslandes
Sonographers have joined surgeons, GP's and therapists as an integral part of the treatment and recovery journey of patients with hand, wrist, elbow and shoulder injuries. Contemporary treatment options for many injuries and conditions of the hand and upper limb rely on ultrasound imaging and the accuracy it provides for vital diagnostic and therapeutic purposes. This presentation will equip sonographers with the crucial examination skills required to assist surgeons and therapists in the diagnosis of conditions of the hand, wrist, elbow, and shoulder and will provide real-world examples of the importance of ultrasound in day-to-day clinical practice. This presentation will draw on the expertise of senior therapists and specialist upper limb surgeons in the use of ultrasound diagnostically and in treatment plans for the management of various upper limb conditions. It will highlight examples where ultrasound has been used clinically to successfully diagnose selective traumatic and non-traumatic conditions and detail how this has been used in the development of treatment options and patient recovery. It will also consider the higher success rate of ultrasound imaging for needle guidance pro-cedures, the evaluation of soft tissue masses, the identification of foreign bodies, the diagnosis of tendon injuries as well as compres-sion neuropathies and joint disease. This presentation is for the sonographer with little experience in ultrasound examination of the ankle. During the session, we will go through how to complete a basic ankle ultrasound protocol. Scanning of the ankle will be broken down into sections and will begin with the lateral aspect. It will then move to the anterior aspect and then through to the medial aspect. Attendees will leave with the knowledge of how to perform a basic ankle ultrasound and will be armed with a step-by-step process of how to locate and assess important ankle anatomy during their scan. There will be tips and tricks along the way as well as a chance at the end of the session to practice scanning any areas that attendees find problematic. when scanning the acute finger. The workshop will cover anatomy, scan techniques and expected sonographic findings with validation through the presenter's own case studies. Live scanning will reinforce the key concepts in real time and attendees are encouraged to participate through questions. This workshop offers something for all skill levels.
{"title":"Workshop presentations","authors":"Jing Fang, Jacqui Robinson, Daniel Walkley, Alison Deslandes","doi":"10.1002/sono.12324","DOIUrl":"https://doi.org/10.1002/sono.12324","url":null,"abstract":"Sonographers have joined surgeons, GP's and therapists as an integral part of the treatment and recovery journey of patients with hand, wrist, elbow and shoulder injuries. Contemporary treatment options for many injuries and conditions of the hand and upper limb rely on ultrasound imaging and the accuracy it provides for vital diagnostic and therapeutic purposes. This presentation will equip sonographers with the crucial examination skills required to assist surgeons and therapists in the diagnosis of conditions of the hand, wrist, elbow, and shoulder and will provide real-world examples of the importance of ultrasound in day-to-day clinical practice. This presentation will draw on the expertise of senior therapists and specialist upper limb surgeons in the use of ultrasound diagnostically and in treatment plans for the management of various upper limb conditions. It will highlight examples where ultrasound has been used clinically to successfully diagnose selective traumatic and non-traumatic conditions and detail how this has been used in the development of treatment options and patient recovery. It will also consider the higher success rate of ultrasound imaging for needle guidance pro-cedures, the evaluation of soft tissue masses, the identification of foreign bodies, the diagnosis of tendon injuries as well as compres-sion neuropathies and joint disease. This presentation is for the sonographer with little experience in ultrasound examination of the ankle. During the session, we will go through how to complete a basic ankle ultrasound protocol. Scanning of the ankle will be broken down into sections and will begin with the lateral aspect. It will then move to the anterior aspect and then through to the medial aspect. Attendees will leave with the knowledge of how to perform a basic ankle ultrasound and will be armed with a step-by-step process of how to locate and assess important ankle anatomy during their scan. There will be tips and tricks along the way as well as a chance at the end of the session to practice scanning any areas that attendees find problematic. when scanning the acute finger. The workshop will cover anatomy, scan techniques and expected sonographic findings with validation through the presenter's own case studies. Live scanning will reinforce the key concepts in real time and attendees are encouraged to participate through questions. This workshop offers something for all skill levels.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"22 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74394353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 77-year-old elderly woman of Indian ethnicity presented with complaints of gradual onset progressive increase in size of painless swelling initially noted 8 months back on the right side of face. On physical examination, there was evidence of facial asymmetry with the ovoid swelling being firm in consistency and non-tender measuring 5 6 cm in size. The patient was referred for ultrasonography which demonstrated evidence of a well-defined lobulated hypoechoic lesion measuring 2.6 2.8 cm with central vascularity in the superficial lobe of right parotid. Further, there was a similar hypoechoic lesion measuring 2.7 3.0 cm in the deep lobe (Figure 1). The remainder of the right parotid gland showed increased vascularity which was likely reactive (Figure 2). There was no involvement of ipsilateral submandibular gland and contralateral parotid gland. However, there was significant right level Ib cervical lymphadenopathy. Ultrasound imaging was performed using a Toshiba diagnostic ultrasound system (XarioTM 100, Toshiba Medical Systems Corporation, Tochigi, Japan) with a 5 MHz convex array probe. Pleomorphic adenoma, nerve sheath tumors of the facial nerve, and adenoid cystic carcinoma were considered as differentials. Fine needle aspiration cytology (FNAC) confirmed multifocal pleomorphic adenoma and the patient was referred to general surgery department for further management where she underwent total right parotidectomy.
一位77岁的印度裔老年妇女，主诉为8个月前在右侧面部出现无痛性肿胀，其大小逐渐增加。体格检查显示面部不对称，卵形肿胀坚固，无压痛，大小为5 - 6 cm。患者接受超声检查，结果显示右侧腮腺浅叶有一个轮廓清晰的分叶状低回声病灶，大小为2.6 2.8 cm，伴有中央血管。此外，在深叶有一个类似的2.7 3.0 cm的低回声病变(图1)。右侧腮腺的其余部分显示血管增多，可能是反应性的(图2)。同侧颌下腺和对侧腮腺未受累。然而，右侧Ib级宫颈淋巴结病变明显。超声成像采用东芝诊断超声系统(XarioTM 100, Toshiba Medical Systems Corporation, Tochigi, Japan)，带有5 MHz凸阵列探头。多形性腺瘤、面神经神经鞘瘤和腺样囊性癌可作为鉴别诊断。细针吸细胞学检查证实为多灶性多形性腺瘤，患者转至普外科接受进一步治疗，并行右侧腮腺全切除术。
{"title":"Unilateral multifocal pleomorphic adenoma of parotid gland with panlobular involvement—A diagnostic dilemma","authors":"Ravikanth Reddy","doi":"10.1002/sono.12328","DOIUrl":"https://doi.org/10.1002/sono.12328","url":null,"abstract":"A 77-year-old elderly woman of Indian ethnicity presented with complaints of gradual onset progressive increase in size of painless swelling initially noted 8 months back on the right side of face. On physical examination, there was evidence of facial asymmetry with the ovoid swelling being firm in consistency and non-tender measuring 5 6 cm in size. The patient was referred for ultrasonography which demonstrated evidence of a well-defined lobulated hypoechoic lesion measuring 2.6 2.8 cm with central vascularity in the superficial lobe of right parotid. Further, there was a similar hypoechoic lesion measuring 2.7 3.0 cm in the deep lobe (Figure 1). The remainder of the right parotid gland showed increased vascularity which was likely reactive (Figure 2). There was no involvement of ipsilateral submandibular gland and contralateral parotid gland. However, there was significant right level Ib cervical lymphadenopathy. Ultrasound imaging was performed using a Toshiba diagnostic ultrasound system (XarioTM 100, Toshiba Medical Systems Corporation, Tochigi, Japan) with a 5 MHz convex array probe. Pleomorphic adenoma, nerve sheath tumors of the facial nerve, and adenoid cystic carcinoma were considered as differentials. Fine needle aspiration cytology (FNAC) confirmed multifocal pleomorphic adenoma and the patient was referred to general surgery department for further management where she underwent total right parotidectomy.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"2 1","pages":"191 - 193"},"PeriodicalIF":0.4,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85369804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical practice guidelines (CPG) are a component of evidence‐based practice allowing standardisation across departments and individuals' skill levels. Australian Cardiac Sonographers (ACS) are not obliged to follow specific CPG when performing a transthoracic echocardiogram (TTE). This research aimed to determine guidelines/workplace protocols ACS follow when performing a TTE, and what attitudes, subjective norms and perceived behavioural controls exist that may prevent adherence to guidelines.
{"title":"Australian cardiac sonographers' use of industry guidelines when performing a transthoracic echocardiogram","authors":"Amy Maree Clark, A. Quinton, J. Alphonse","doi":"10.1002/sono.12319","DOIUrl":"https://doi.org/10.1002/sono.12319","url":null,"abstract":"Clinical practice guidelines (CPG) are a component of evidence‐based practice allowing standardisation across departments and individuals' skill levels. Australian Cardiac Sonographers (ACS) are not obliged to follow specific CPG when performing a transthoracic echocardiogram (TTE). This research aimed to determine guidelines/workplace protocols ACS follow when performing a TTE, and what attitudes, subjective norms and perceived behavioural controls exist that may prevent adherence to guidelines.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"os-29 1","pages":"156 - 165"},"PeriodicalIF":0.4,"publicationDate":"2022-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87213702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
current analysis, it is not clear that the number of operators and/or the presence of pathology predicts scan time, a subtle but essential difference. This may be the case but is not shown by the statistical analysis used. The authors would benefit by reassessing the types of variables used in the study and analysing their data using the GLM function in SPSS, which can investigate the actual effect between groups. The interpretation would be slightly different, as the output of this type of analysis provides coefficients with respect to a reference group (dummy variable). That is, the difference in scan time compared to one operator or the absence of pathology. So reporting the finding would follow something like ‘ when two operators attended the scan, on average, scan time increased by XX mins (95% CI: X (cid:1) X mins) compared to a single operator, after adjusting for the presence of pathology. ’ I hope this letter is of some assistance to the authors.
目前的分析还不清楚手术人员的数量和/或病理的存在是否能预测扫描时间，这是一个微妙但本质的区别。这可能是事实，但所使用的统计分析并没有显示出来。作者将受益于重新评估研究中使用的变量类型，并使用SPSS中的GLM函数分析他们的数据，该函数可以调查组之间的实际影响。解释将略有不同，因为这种分析的输出提供了相对于参考组(虚拟变量)的系数。也就是说，与一个操作员相比，扫描时间的差异或病理的缺失。因此，报告发现将遵循类似于“当两名操作员参加扫描时，在调整病理存在后，扫描时间平均比单个操作员增加XX分钟(95% CI: X (cid:1) X分钟)。”“我希望这封信对作者有所帮助。
{"title":"Interpreting model coefficients from regression analysis","authors":"Christopher Edwards","doi":"10.1002/sono.12307","DOIUrl":"https://doi.org/10.1002/sono.12307","url":null,"abstract":"current analysis, it is not clear that the number of operators and/or the presence of pathology predicts scan time, a subtle but essential difference. This may be the case but is not shown by the statistical analysis used. The authors would benefit by reassessing the types of variables used in the study and analysing their data using the GLM function in SPSS, which can investigate the actual effect between groups. The interpretation would be slightly different, as the output of this type of analysis provides coefficients with respect to a reference group (dummy variable). That is, the difference in scan time compared to one operator or the absence of pathology. So reporting the finding would follow something like ‘ when two operators attended the scan, on average, scan time increased by XX mins (95% CI: X (cid:1) X mins) compared to a single operator, after adjusting for the presence of pathology. ’ I hope this letter is of some assistance to the authors.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"26 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77936139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The patient was referred for ultrasound of both breasts to evaluate the mass further which revealed a well-defined mass lesion measuring 1.7 2.3 cm located at 9 to 10 O'clock position involving the breast parenchyma in the outer-upper quadrant of right breast approx. 2 cm from the nipple-areola complex with inhomogeneous internal sonographic appearance of the mass lesion and coarsened peripheral rim of dystrophic calcifications (Figure 1A). Colour Doppler ultrasound demonstrated no significant internal vascularity (Figure 1B). Rest of the quadrants of right breast and left breast demonstrated no focal lesions. Both axillae were unremarkable with no evidence of lymphadenopathy.
{"title":"Rare and unusual occurrence of atypical fibroadenoma on ultrasound","authors":"Ravikanth Reddy","doi":"10.1002/sono.12317","DOIUrl":"https://doi.org/10.1002/sono.12317","url":null,"abstract":"The patient was referred for ultrasound of both breasts to evaluate the mass further which revealed a well-defined mass lesion measuring 1.7 2.3 cm located at 9 to 10 O'clock position involving the breast parenchyma in the outer-upper quadrant of right breast approx. 2 cm from the nipple-areola complex with inhomogeneous internal sonographic appearance of the mass lesion and coarsened peripheral rim of dystrophic calcifications (Figure 1A). Colour Doppler ultrasound demonstrated no significant internal vascularity (Figure 1B). Rest of the quadrants of right breast and left breast demonstrated no focal lesions. Both axillae were unremarkable with no evidence of lymphadenopathy.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"150 1","pages":"194 - 195"},"PeriodicalIF":0.4,"publicationDate":"2022-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90145821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 53-year-old male with no relevant clinical history presented coma with a Glasgow coma scale of 3/15 requiring orotracheal intubation and mechanical ventilation support at the emergency room. During transfer to the intensive care unit (ICU), a brain computed tomography (CT) and CT angiography was carried out. Because in our ICU we routinely use the point-of-care ultrasound as an extension of the physical exam, TCCS was performed at the admission before looking at the brain CT to assess the cause of neurological impairment. It showed the presence of a rounded hypoechoic lesion in the proximal portion of the left middle cerebral artery (LMCA) with a positive color Doppler signal within that measured 18mm 12mm (Figure 1). Brain CT and CT angiography (CTA) showed left intra-parenchymal bleeding involving the basal ganglia, as well as bilateral subarachnoid bleeding, with involvement of peritroncal cisterns, and a fusiform-type
{"title":"A case of brain aneurysm diagnosed by transcranial color‐coded duplex sonography in the intensive care unit","authors":"Issac Cheong","doi":"10.1002/sono.12318","DOIUrl":"https://doi.org/10.1002/sono.12318","url":null,"abstract":"A 53-year-old male with no relevant clinical history presented coma with a Glasgow coma scale of 3/15 requiring orotracheal intubation and mechanical ventilation support at the emergency room. During transfer to the intensive care unit (ICU), a brain computed tomography (CT) and CT angiography was carried out. Because in our ICU we routinely use the point-of-care ultrasound as an extension of the physical exam, TCCS was performed at the admission before looking at the brain CT to assess the cause of neurological impairment. It showed the presence of a rounded hypoechoic lesion in the proximal portion of the left middle cerebral artery (LMCA) with a positive color Doppler signal within that measured 18mm 12mm (Figure 1). Brain CT and CT angiography (CTA) showed left intra-parenchymal bleeding involving the basal ganglia, as well as bilateral subarachnoid bleeding, with involvement of peritroncal cisterns, and a fusiform-type","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"50 1","pages":"146 - 147"},"PeriodicalIF":0.4,"publicationDate":"2022-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87840764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pneumothorax is a frequent problem in the intensive care unit. Lung ultrasound has demonstrated to be a useful method in its diagnosis with high sensitivity and specificity. The pattern observed in pneumothorax are the abolition of lung sliding and the lung point sign defined as an inspiratory-synchronized change from lung sliding to no lung sliding in a specific location on the chest wall in B and M-mode. We describe a case of pneumothorax diagnosed through a variant of the lung point sign at the left hemithorax: the heart point sign. 2 | CASE PRESENTATION
{"title":"A case of heart point sign by lung ultrasound in a patient with pneumothorax","authors":"Issac Cheong","doi":"10.1002/sono.12316","DOIUrl":"https://doi.org/10.1002/sono.12316","url":null,"abstract":"Pneumothorax is a frequent problem in the intensive care unit. Lung ultrasound has demonstrated to be a useful method in its diagnosis with high sensitivity and specificity. The pattern observed in pneumothorax are the abolition of lung sliding and the lung point sign defined as an inspiratory-synchronized change from lung sliding to no lung sliding in a specific location on the chest wall in B and M-mode. We describe a case of pneumothorax diagnosed through a variant of the lung point sign at the left hemithorax: the heart point sign. 2 | CASE PRESENTATION","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"40 1","pages":"196 - 197"},"PeriodicalIF":0.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91013809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Relevance of water‐lily sign of hepatic hydatid on ultrasound","authors":"Ravikanth Reddy","doi":"10.1002/sono.12315","DOIUrl":"https://doi.org/10.1002/sono.12315","url":null,"abstract":"","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"2 1","pages":"136 - 138"},"PeriodicalIF":0.4,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79862928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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