Medical Ultrasonography最新文献

Aims: Ultrasound guided nerve blocks have been shown to be an effective analgesia option for patients with hip fracture. An education program was developed to train Emergency Department doctors and it received positive feedback from partici-pants who demonstrated competency after the training. We aimed to evaluate the education program at the behavioral level of the Kirkpatrick Model by determining the translation of training to practice of ultrasound guided nerve blocks in patients with a hip fracture at the Emergency Department.

Materials and methods: A retrospective review of medical records was carried out from 18 August 2018 to 31 December 2020. Data on patient demographics, type of hip fracture, pain score, analgesia pro-vided and complications were collected using a standardized form and analyzed.

Results: Among 634 patients, their median age was 79 years old (Interquartile range (IQR): 70 to 85) and 416 (65.6%) were female. The median pain score was 6 (IQR: 5 to 8) and analgesia was provided for 561 (88.5%) patients. Analgesia was administered most frequently via the intravenous route (n=407, 72.5%) and tramadol (n=293, 52.2%) was most commonly used. Ultrasound guided nerve block was performed in 26 (4.7%) patients - all were performed successfully without complications. The utilization increased from 1.0% before to 4.7% after the conduct of the training workshops (p=0.16).

Conclusion: A significant gap still exists in the translation of training to practice. Barriers must be identified and overcome so that ultimately, the education program can bring about an organizational impact to benefit patients and improve their outcomes.

In this systematic review we analyzed the published articles related to the predictive value for flare of subclinical synovitis assessed by ultrasound (US) in juvenile idiopathic arthritis (JIA). Medline, Embase and Cochrane databases were searched from 1990 to 2020 by two authors, using PICO methodology. The study is built and reported according to PRISMA guidelines. Searches identified four articles comprising a total of 187 JIA patients in clinical remission from at least 3 months. Two of the articles found US subclinical signs of synovitis to be predictive for flare, with a five times higher risk (with Power Doppler signal as an important feature), while in the other two baseline US abnormalities did not predict a clinical flare. The articles differed for protocols, definitions, and length of follow-up. US has an expanding role in pediatric rheumatology, with interest-ing applications especially during the follow-up, potentially identifying subclinical inflammatory signs predictive of flare. However, the few studies available do not allow definite conclusions at this time.

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Very early-onset inflammatory bowel disease (VEO-IBD) is defined as IBD onset before 6 years of age and some cases are caused by unique monogenic disorders that require specific treatments such as stem cell transplantation. We identified three children with VEO-IBD of whom two had monogenic disorders. In cases 1 and 2, ultrasound revealed isolated colonic distribution and the loss of wall stratification. In case 3, mesentery inflammation was evident. Bowel ultrasound showed variable findings due to differences in the inflammation distribution within the bowel. In order to diagnose VEO-IBD, sonographersshould carefully evaluate the intestinal wall thickness and stratification and the distribution of inflammation in the intestine and mesentery. These findings may aid the diagnosis of VEO-IBD.

In this overview of vascular changes of the liver, variations in the liver vessels are discussed, in addition to congenital malformations such as Abernethy malformation, patent ductus venosus Arantii and hereditary hemorrhagic telangiectasia (OslerWeber-Rendu disease). Particular attention is paid to focal liver lesions, especially focal nodular hyperplasia (FNH), but also other solid tumours that develop as a result of altered liver vascularisation. The article focuses on the ultrasonic appearances and changes of the liver, depicted in B-mode sonography, Doppler studies and in contrast-enhanced ultrasonography (CEUS). The clinical manifestations of these conditions associated with other organ systems are also highlighted.

Aims: Ultrasonography is the preferred technique to evaluate the status of maternal and fetal health during pregnancy. Non-obstetric acute or chronic conditions occurring during pregnancy must be diagnosed as early as possible to permit timely and necessary treatment for the sake of maternal and fetal health. The purpose of this study was to evaluate the safety and value of contrast-enhanced ultrasonography (CEUS) during pregnancy.

Materials and methods: This prospective study included 14 pregnant women requiring pregnancy termination and six healthy pregnant women. The 14 pregnant women requiring pregnancy termination underwent CEUS prior to surgery to investigate the pattern of contrast agent diffusion. The six healthy pregnant women did not undergo CEUS. The structure of placentae with and without contrast agent injection were also compared by light microscopy.

Results: CEUS analysis failed to identify any signs of contrast agents in the umbilical cord blood and fetus. There were no obvious changes in the morphology of placentae with and without contrast agent injection under light microscope. CEUS identified the need for early treatment in one pregnant woman with an ovarian tumor.

Conclusions: Due to the protective effect of the placental barrier on the fetus, CEUS during pregnancy may represent a safe form of imaging technology that can provide valuable information for the diagnosis of non-obstetric acute or chronic disorders and to guide thefuture treatment of pregnant women.