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Ultrasound is a medical imaging technique that employs high-frequency sound waves to produce images of internal bodily structures. In the field of nursing, ultrasound serves as a valuable instrument for swiftly and non-invasively evaluating precise anatomical structures, such as venous cannulation, evaluating bowel peristalsis, and assessing the urinary bladder. The use of ultrasound imaging is widely accepted in the nursing profession globally, as shown by its extensive reference in the international scientific literature. [ABSTRACT FROM AUTHOR]

Podstawowym celem pracy było ustalenie przydatności endoskopowej ultrasonografii w wykrywaniu zmian podśluzówkowych oraz pogrubienia i nierównych zarysów ścian dwunastnicy. Przeanalizowano 41 pacjentów (22 kobiety i 19 mężczyzn) hospitalizowanych w latach 2009–2012 w Klinice Gastroenterologii Wojskowego Instytutu Medycznego z powodu patologii dwunastnicy stwierdzonej w badaniu gastroskopowym. U wszyst‑ kich chorych wykonano w kolejnym etapie badanie endosonograficzne, w którym stwierdzono w 32 (78,1%) przypadkach zmianę organiczną w zakresie ściany dwunastnicy, a u 9 (21,9%) pacjentów prawidłowe struk‑ tury położone poza przewodem pokarmowym. Na podstawie zaawansowania zmian w obrębie ściany dwu‑ nastnicy w badaniu endosonograficznym zakwalifikowano chorych do jednej z trzech metod terapii: endosko‑ powej, chirurgicznej lub onkologicznej. U 20 (48,8%) pacjentów zmiana była ograniczona do błony śluzowej i podśluzowej, a więc podlegała terapii/nadzorowi endoskopowemu. W pozostałych przypadkach rozpozna‑ no naciek przekraczający błonę mięśniową (n = 21; 51,2%), kwalifikując chorych do leczenia chirurgicznego lub onkologicznego. Badanie endosonograficzne odgrywa kluczową rolę w diagnostyce zmian podśluzówko‑ wych, umożliwiając prawidłową kwalifikację do odpowiedniej metody leczenia.

The ultrasound is now widely used in rapid noninvasive medical diagnostics. Progress forces palliative medicine physicians, learning techniques and possibilities ultrasound. Bedside ultrasound application increases both patient comfort and the attending doctor gravely ill. The paper presents possible to use proceedings and makes proposals FASP algorithm dedicated to hospice care in home and ambulatory services. [ABSTRACT FROM AUTHOR]

The paper presents an overview of possibilities given by high-frequency ultrasonography (USG) in clinical practice. Physical properties of this technique make it suitable basically for skin imaging, where we can see reflections from skin forming layers and certain skin diseases. Examples of examinations in morphea cases are presented: microsonographic images and diagnostically important parameters. Such parameters can be measured from images and be a basis of computer-aided objective diagnostic methods. [ABSTRACT FROM AUTHOR]

Ultrasound methods are more commonly applied in a daily clinical practice at intensive care units and emergency rooms. In the last few years a number of various protocols of ultrasound assessment has been developed especially for specialists working at the intensive or critical care units. The basic assumption of these protocols is the shortening and simplification of the ultrasound evaluation which allows quick finding or exclusion of potential causes of the haemodynamic instability. Such protocols include elements of echocardiography, pulmonary, abdominal, pelvic and vascular ultrasound evaluation. The current article presents the review of ultrasound protocols adapted for intensive care units requirements. [ABSTRACT FROM AUTHOR]

Wstęp. Przyjmuje się, że w Polsce przewlekłe zaburzenia żylne dotyczą łącznie około połowy populacji dorosłych. Powodują długotrwałe ograniczenie zdolności do pracy, a nierzadko są przyczyną trwałego kalectwa. W związku z tym prawidłowa oraz łatwo dostępna diagnostyka zaburzeń funkcjonowania układu żylnego, a co z tego wynika odpowiednia kwalifikacja do leczenia operacyjnego nabierają zasadniczego znaczenia wobec rosnącej roli tej patologii wśród chorób cywilizacyjnych. Celem pracy jest wykazanie, że ultrasonografia doplerowska stanowi referencyjną metodę badania układu żylnego kwalifikującą do leczenia operacyjnego żylaków kończyn dolnych. Materiał i metody. Badaniem objęto zarówno pacjentów, którzy zgłosili się do poradni z powodu dolegliwości bólowych, obrzęków oraz dyskomfortu w zakresie kończyn dolnych, jak i grupę osób zakwalifikowanych do leczenia operacyjnego na Oddziale Chirurgii Ogólnej i Onkologicznej, SPZOZ w Bolesławcu. Wyniki. W okresie od lipca 2008 r. do kwietnia 2010 r. na ultrasonograficzne badanie doplerowskie zgłosiły się 663 osoby (491 kobiet oraz 172 mężczyzn -- odpowiednio 74% kobiet i 26% mężczyzn) w wieku od 15 do 82 lat (średnia wieku 51 lat). U 126 pacjentów (19% badanej populacji) nie stwierdzono obecności patologii żylnej. Najczęstszą rozpoznawaną patologią wśród płci żeńskiej była niewydolność obu ujść i pni żyły odpiszczelowej (GSV) (125 badanych, co stanowi 25% pacjentek). Wśród mężczyzn natomiast największą grupę stanowiły osoby z niewydolnymi perforatorami podudzia (40 osób, czyli 23% mężczyzn). Do leczenia operacyjnego zakwalifikowano 227 osób (199 kobiet i 78 mężczyzn). Najmłodszy pacjent miał 16 lat (mężczyzna), najstarszy 81 lat (kobieta) -- średnia wieku 52 lata. Safenektomię wykonano u 166 kobiet i 70 mężczyzn, co stanowiło 85% wszystkich zabiegów. Wnioski. Ultrasonografia metodą podwójnego obrazowania umożliwia przeprowadzenie dokładnej diagnostyki patologii układu żylnego. Uzyskane w pracy wyniki potwierdzają dane epidemiologiczne dla krajów europejskich. Diagnostyka chorób żylnych, kwalifikacja do leczenia operacyjnego oraz możliwość zaplanowania zakresu zabiegu za pomocą ultrasonograficznego badania doplerowskiego metodą podwójnego obrazowania pozwalają na krótki okres hospitalizacji, co ma duże znaczenie, biorąc pod uwagę fakt dużej częstości występowania chorób żył w populacji (33% kobiet, 20% mężczyzn). Ze względu na nieinwazyjność badania, stosunkowo niski koszt oraz dużą dokładność badanie to powinno być metodą z wyboru w diagnostyce i kwalifikacji do leczenia operacyjnego żylaków kończyn dolnych. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study was to evaluate the usefulness of US in the diagnosis of posterior fossa abnormalities in neonates by posterolateral fontanelle as compared with the anterior fontanelle approach and MRI., Material and Methods: US studies were performed on 1337 neonates, including 512 preterm infants, through the anterior and posterolateral fontanelles. Abnormalities were detected in 134 patients. Among them, abnormalities in posterior fossa were visualized with the posterolateral approach in 14 neonates. MR images were obtained in that subgrqup., Results: The lesions consisted of cerebellar hemorrhage and congenital cerebellar malformations. Foci of hemorrhage were visualized by US in preterm neonates (n = 5), only through the posterolateral approach and on MRI. Dandy-Walker malformations (n = 2) were detected by US with both approaches and confirmed on MRI. In pontocerebellar hypoplasia (n =2), US with both approaches, showed hypoplastic cerebellar hemispheres and fluid in the posterior fossa. MRI, additionally visualized pontine hypoplasia. Fluid collection in the posterior fossa and translocation of cerebellar hemispheres were observed in the other 6 neonates by US with both approaches. MRI revealed arachnoid cysts (n = 2), mega cisterna magna (n = 3) and Blake's pouch (n = 1)., Conclusions: US using posterolateral fontanelle is the method of choice for the diagnosis of cerebellar hemorrhage. These lesions are not visualized through anterior fontanelle. US visualization of the abnormal structures in some cerebellar malformations has similar effectiveness for both approaches. MRI plays the crucial role in identification and differential diagnosis of these malformations.

In this article a new abilities of lower urinary tract diagnosis in three-dimensional sonography were shown. The examination's components, which allow us to estimate anatomical changes in patients with urinary incontinence were described.

This article presents suitability of two-dimensional sonography in lower urinary tract diagnostics. Examination components, allowing for a detailed evaluation of anatomical changes in patients with urinary incontinence, were described.

Objectives: Necrotizing enterocolitis (NEC) is a common cause of morbidity in the neonatal care units, especially in cases of preterm neonates with low and very low birth weight. Plain abdominal radiography remains to be the main diagnostic tool in the diagnosis and follow-up of NEC. However; it is sometimes impossible to depict all pathological findings in the radiographs. Furthermore, radiography exposes the youngest, most sensitive patients to consecutive episodes of radiation. Ultrasound examination seems to be an interesting alternative to current standard usage of radiography and its role is still underestimated. The aim of the paper was to assess the applicability of ultrasound examination in the diagnosis and monitoring of neonates suffering from NEC., Material and Methods: The study group consisted of 12 neonates (gestational age 25-36 weeks, weight 540-1900 g), suspected of NEC development. Abdominal radiographs obtained with the use of anterior-posterior and lateral projections, as well as ultrasound examination, were performed. During bowel sonography attention was paid to the presence of intraabdominal fluid, free intraperitoneal gas, bowel wall thickness and bowel wall perfusion. Intramural gas, free intraperitoneal gas and signs of bowel distension were evaluated on the radiographs., Results: Bowel distension was found in all patients. The presence of intraluminal gas was detected in 3 neonates, whereas the signs of bowel perforation were present in only 2 patients. Ultrasound evaluation revealed bowel wall thickening together with increased bowel wall perfusion in 9 patients. Only one neonate presented thinning of the bowel wall, decreased bowel wall perfusion and presence of free intraperitoneal fluid. These findings were connected with a poor outcome of that patient., Conclusions: Ultrasound examination can be extremely helpful for the initial diagnosis as well as the follow-up of patients developing NEC. It allows to depict the majority of pathological findings for NEC, even those not visible on plain abdominal radiography It is important to emphasize that abdominal sonography (with special reference to the bowel sonography), together with plain abdominal radiography should be considered as standard imaging modalities for the assessment of necrotizing enterocolitis.

Pregnancy is a risk factor for both pulmonary embolism (PE), and an incorrect diagnostic assessment in cases of suspected PE with potentially dangerous consequences for the mother and foetus. The major concern is ionising radiation utilized by diagnostic tests and its potential negative effect on foetal safety. This paper presents diagnostic difficulties encountered in a 31-year-old patient at 20 weeks of gestation who was admitted to hospital with non-specific chest pain and suspected PE as a complication of right lower limb venous thrombosis. The case study reminds of chest ultrasound as a useful tool in the diagnosis of PE. The official clinical practice guidelines do not recommend the use of chest ultrasound for diagnosing of PE due to lack of a sufficient number of published studies. This case report may encourage further, prospective studies in the hope to define whether and when chest ultrasound might find its place in the diagnostic strategy of PE, especially in pregnant women.

Color Doppler ultrasound examinations are effective and very useful to differentiate and diagnose ocular and orbital diseases. In the paper some aspects of these examinations are discussed: technique, examined vessels, blood flow parameters. Special attention is paid to patient's safety, drawbacks and limitations of presented technique.

Ultrasonografia Dopplerowska jest jednym z najlepszych sposobów diagnozy zmian miażdżycowych oraz szczegółowej kontroli patologii zmian ścian naczyń krwionośnych. Wykonanie badania wymaga szeregu czynności wykonywanych współbieżnie, m.in. analizy obrazów USG oraz ręcznego sporządzania notatek na potrzeby podsumowania badania. Analiza problemu wykazała, że przebieg badań ultrasonograficznych może zostać częściowo zautomatyzowany przez dedykowane oprogramowanie, co przedstawia niniejszy artykuł.

Wraz z postępem technologicznym pojawiają się coraz nowsze metody obrazowania dróg żółciowych, które umożliwiają precyzyjną ich ocenę, są mało inwazyjne, jednak niestety często niedostępne i kosztowne. Miogość metod obrazowania wykorzystujących odmienne zjawiska fizyczne sprawia, że bardzo trudno jest wypracować uniwersalny, możliwy do zastosowania w każdych warunkach, schemat postępowania diagnostycznego w żół­ taczce mechanicznej. Badaniem pierwszego rzutu ze względu na szeroką dostępność, nieinwazyjność oraz niski koszt wykonania jest ultrasonografia konwencjonalna przezbrzuszna (USG). Jeżeli na podstawie USG można zaproponować pacjentowi postępowanie terapeutyczne, dalsza diagnostyka nie jest konieczna. Jeśli jednak po wykonaniu badania USG nie można ustalić sposobu leczenia, wskazana jest dalsza diagnostyka, najlepiej z wykorzystaniem nowszych, nieinwazyjnych metod obrazowania, takich jak tomografia komputerowa (TK), rezonans magnetyczny (MR) czy endosonografia (EUS). W przypadku ich niedostępności w szczególnych sytuacjach dopuszcza się zastosowanie endoskopowej cholangiopankreatografii wstecznej (ECPW), jednak decydując się na takie postępowanie, zawsze należy bardzo dokładnie ocenić obecność czynników ryzyka wystą­ pienia powikłań oraz rozważyć korzyści i ryzyko wykonania zabiegu. Celem pracy była próba podsumowania podstawowych zasad na wszystkich szczeblach postępowania diagnostycznego, uwzględniającego wyżej wymienione aspekty, od rozpoznania żółtaczki w badaniu podmiotowym do zaproponowania postępowania diagnostyczno-terapeutycznego, w tym obejmującego możliwość interwencji na drogach żółciowych drogą endoskopową czy chirurgiczną lub metodami radiologii interwencyjnej.

Three-dimensional ultrasound tomography of the eye is a new advanced technique of ocular ultrasonography. The aim of this work was to present a new interesting ultrasound unit with possibility of three-dimensional ultrasound tomography, after half year experience with this system. The article describes scanning techniques using acommercial 3-D ultrasound system (OTI-Scan 1000) and presents how to assess the dimensions of intraocular structures anddocument them volumetrically.

This study considers diagnostic problems in the case of a 52 year old patient presenting with left sided headache and Horner's syndrome. Color Doppler sonography of the internal carotid artery with transcranial duplex sonography showed decreased blood flow velocity and increased impedance of flow in the left internal carotid artery. Flow velocity in the left middle cerebral artery was moderately decreased whereas flow in the proximal segment of the anterior cerebral artery and in the posterior communicans artery was re-directed towards the left internal carotid artery. These findings indicated the need for cerebral angiography which revealed that a vast section of the distal segment of the left internal carotid artery was dissected. Pharmacological treatment with low molecule heparine brought prompt resolution of the signs and symptoms as well as normalization of the blood flow parameters, as examined with Doppler ultrasonography Color Doppler ultrasonography would appear to have high utility in the initial diagnosis of internal carotid artery dissection and the usefulness of this method in the monitoring of treatment.

Thrombin injection is known as an efficient and safe method of femoral artery pseudoaneurysms treatment, however, it can be complicated by peripheral thrombosis to accidental casual thrombin injection into femoral artery. We present our own procedure modification. Before thrombin injection we inject into pseudoaneurysm a small volume of ultrasonographic contrast. Doppler signal enhancement confirms proper niddle position.

Conventional radiography is the widely accepted diagnostic method in patients after the sternal trauma, but the fracture cannot always be detected. Sonography, that is not able to demonstrate deeper portions of the bone, allows imaging its cortex proximal to the transducer as an intense hyperechoic interface with distal shadowing. Its disruption as a result of the trauma can be well seen, especially in flat bones. Authors present three cases, in which sonography made with a linear 7.5 MHz transducer allowed to reveal a sternal fracture in two patients and to exclude it in another patient, what couldn't be diagnosed on the lateral chest radiograms. Authors suggest using sonography in patients after the sternal fracture, not only with negative radiography.

Authors present the ability of ultrasonography and Color and power Doppler sonography in evaluation of the hand structures in patients with rheumatoid arthritis. Imaging of bony contours allows to identify bone erosions. Thickness, oedema and presence of increased blood flow (hyperaemia) in the synovium in joints and tendon sheaths are characteristic features of an active inflammation. Changes of the tendon structure indicate its damage. US allows to image the carpal tunnel structures, to visualise changes of the median nerve in the carpal tunnel syndrome and gives possibilities to find the cause of its compression.

Objective: To construct and cross-validate logistic regression models used for the prediction of ovarian malignancies in two groups of women with adnexal tumors., Materials and Methods: Preoperative clinical, gray-scale and color Doppler ultrasound data of 307 women treated in the Ist Dept of Gynecology of the Medical University in Lublin (group I) and 464 of women treated in the Dept of Surgical Gynecology, Medical University in Poznan (group II) were analyzed retrospectively. These data were used to construct predictive models which were developed for both groups separately and then cross-validated (12 cases in each group, six malignant and 6 benign) between the groups. Multiple logistic regression analysis was chosen to calculate probability of malignancy in each examined mass., Results: There were 228 (74.2%) benign tumors and 79 (25.7%) malignant tumors in group I. Group II consisted of 299 (64.4%) benign tumors and 165 (35.6%) malignant masses. Only six variables were included in the logistic regression model in group I. These were age, bilaterality, septae, papillary projections, volume and color score. In group II there were also 6 variables included in the regression model (menopausal status, septae, bilaterality, ascites, blood vessel localization and PI). At 50% probability of malignancy the model constructed for group I had a sensitivity and specificity of 74.6% i 94.7%, respectively. At the same probability level in group II sensitivity and specificity were 86.1% i 93.6%, respectively. Cross-validation of the predictive model constructed for group I in randomly selected cases from group II had sensitivity of 66.4% and specificity of 79.2%. Sensitivity and specificity of the group II model tested in cases from group I were 64.3% and 75.2%, respectively., Conclusions: We conclude that predictive models created with the use of multiple logistic regression analysis may be useful in preoperative discrimination of adnexal tumors. However, much better definition of diagnostic criteria, especially color Doppler score must be achieved before these models could be widely used in clinical practice.

Invasive ultrasound-guided procedures has recently become very popular. They proved to play important supplementary role in classic surgery, and now--in the era of "minimally invasive operative procedures"--became more frequently used. In 178 patients treated from 1995 to June 2002 in 2nd Department of Surgery in Cracow, different "interventional sonography" procedures were performed. High efficacy and low morbidity related to the method confirm our statement that "interventional sonography" being less invasive than "classical surgery" should become the method of choice in the treatment of particular groups of patients.

Transcranial Doppler sonography is commonly used for diagnosis of cerebral vasospasm. However, the overall diagnostic performance of this method in detection of arterial narrowing has not been established. Blood velocity threshold, diagnostic for vasospasm, has been proposed for conventional, "blind" transcranial Doppler sonography (TCD). Nevertheless it cannot be used for transcranial color Doppler sonography (TCCD), because in this method the obtained blood velocities in the major cerebral arteries are higher than are in TCD. The aim of this study was to estimate the accuracy of transcranial color Doppler sonography in detection of middle cerebral artery (MCA) narrowing by means of receiver operating characteristic curve analysis (ROC). One hundred thirty four patients were studied with TCCD immediately before cerebral angiography. There were 75 men and 59 women, age range from 18 to 74 years, mean age 49 years. Of the 268 MCAs examined, 227 arteries were finally included in the construction of the ROC curve. Angiographic vasospasm was graded as none, mild (equal to or less than 25% of vessel caliber reduction--16 patients) and moderate-to-severe (more than 25% of vessel caliber reduction--29 patients). The overall diagnostic performance of transcranial color Doppler sonography in the detection of moderate-to-severe vasospasm of middle cerebral artery was found to be very high. The value of associated area under the ROC curve was 0.94. The value of this area for all vasospasms was 0.85, and this indicates good accuracy of a test. The best performing TCCD parameter for the detection of MCA narrowing was revealed to be peak-systolic velocity. The optimal trade-off between sensitivity and specificity was achieved with a peak systolic velocity of 182 cm/s. Therefore this velocity threshold is proposed as most universal for the diagnosis of vasospasm in the middle cerebral artery.

Design: The purpose of the study was to estimate the diagnostic value of ultrasonic endometrium thickness measurement and estimation of ultrasonic endometrium qualitative features in detecting pathological changes in women in perimenopausal period., Materials and Methods: The group of the patients consist of 242 patients in age 45-86 years, with abnormal uterine bleeding or incorrect ultrasonographic image of endometrium. In all cases transvaginal ultrasonography (TVS) and hysteroscopy were performed., Results: The average thickness of endometrium in carcinoma (CA), hyperplasia (H) and polyps (P) group (properly 8.96 and 6.09 and 5.02 mm) showed essential differences in comparison with a group without changes in endometrium (3.38 mm). In group CA and H the greatest cumulation of abnormal features of ultrasonic image was ascertained., Conclusions: Ultrasonic measurement of endometrial thickness is a sensitive index in detecting cancer and pathological endometrial hyperplasia. The combination measurement of endometrial thickness and estimation of qualitative features of endometrial and uterine cavity TVS image improves results of detecting all of types of intrauterine pathology.

Background: Three-dimensional sonography is a novel diagnostic method proposed to be an additional non-invasive tool in the assessment of ovarian tumors., Objective: To study diagnostic potential of 3D sonography and power Doppler angiography in the preoperative differentiation of adnexal masses., Material and Methods: One hundred twenty-eight women with tumors thought to be of adnexal origin were examined preoperatively. Following morphological (papillae, septae, tumor size and volume) and color Doppler (PI, RI, Vmax and TAMX) assessment, 3D ultrasound of adnexal tumors according to Kurjak et al. (2000) was performed. Various scanners were used and included: ATL 5000 HDI (Phillips, USA) and Combison 530 and Voluson 730 (Kretztechnik, Austria) machines. Following variables were studied: inner wall structure, presence of papillae, thickening > 3 mm of septa as well as vascular branching pattern, number and localization of small blood vessels and the presence of vascular anastomoses., Results: Twenty-one tumors were malignant (3 FIGO stage I) and 101 masses were benign. Power Doppler combined with 3D sonography predicted malignancy with a sensitivity of 92.6% (25 of 27 patients). Commonly used morphological and Doppler criteria produced lower sensitivity, the values being in range of 45% to 87.5%. Negative predictive value of 97.2% was the highest for 3D sonography (> 7 points in Kurjak's scale)., Conclusions: Selective use of 3D ultrasound and power Doppler angiography could be used to better characterize adnexal tumors. Detailed 3D sonography may help to identify women who, if needed, may have less invasive surgical procedure such as laparoscopy or be referred to gynecological oncologist.

Our objective was to determine the practical usefulness of 3D transvaginal sonography in nuchal translucency (NT) measurements between 10th and 14th week of gestation. Thirty-six women (18 primiparas) were studied with the use of Kretz Voluson 530 and 730 scanners (Kretztechnik, Zipf, Austria). Two different volume scans were performed in all subjects according to the new 4 steps method proposed by Chung et al (2000). Nuchal translucency of the first and second scan were compared. In all but one (2.7%) cases good quality images were obtained. Mean value of NT of the first and second scan were 1.463 +/- 0.551 mm (SD) and 1.475 +/- 0.556 mm (SD), respectively. The differences as compared by two tailed t-test for paired measurements were not significant (p = 0.668). There was a significant correlation between first and second measurement (r = 0.96), also the interoperator variability was good. Our preliminary study indicates that 3D sonography is a useful tool in nuchal translucency measurements at the end of the first trimester of pregnancy. The results, however, need to be prospectively tested in larger population.