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Intra-articular injection is frequently used as an effective diagnostic and treatment tool for hip joint diseases. However, the underlying treatment mechanism remains unclear because of a lack of experimental animal models. A challenge facing researchers is how to accurately and consistently perform injections involving animal hip joints. The purpose of this study, then, was to establish an ultrasound (US)-guided intra-articular (IA) injection technique using rat hip joints and to evaluate its accuracy and feasibility versus a fluoroscopy (FL)-guided technique. For this study, 20 US-guided and 20 FL-guided IA injections were administered to separate groups of Sprague-Dawley rats. For each procedure, 50 μL of iohexol was injected into the hip joint using a 25G needle. The US-guided injections were performed using a linear probe, and the FL-guided IA injections were performed using C-arm X-ray fluoroscopy. All injections were verified by computed tomography imaging. The number of successful injections and needle repositions per injection, as well as operating times, were recorded, and the rats were observed for complications for 10 d after the injections. Statistical analysis was used to compare US-guided and FL-guided techniques with significance set at p < 0.05. The success rate was markedly higher for the US-guided interventions (90%) than for the FL-guided interventions (75%) (p

The objective was to quantify the index of reflectivity of the common carotid artery and surrounding structures, before and after 6 mo of microgravity. Our hypothesis was that structural changes in the insonated target would increase its index of reflectivity. The neck anterior muscle and common carotid artery (walls and lumen) were visualized by echography (17 MHz linear probe), and the radiofrequency signal along each vertical line was displayed. The limits of the radiofrequency data corresponding to each target (muscle, vessel wall) were determined from the B-mode image and radiofrequency trace. Each target's index of reflectivity was calculated as the proportion of backscattered energy to the whole backscattered energy along the line. After 6 mo in flight, the index of reflectivity increased significantly for both common carotid walls, while it remained unchanged for the neck muscle, carotid intima and lumen. The index of reflectivity provided additional information beyond traditional B-mode imaging.

Purpose. To evaluate the feasibility of measuring the transverse size of the eyeball by B-scan with a linear probe in patients with horizontal strabismus. Material and Methods. The study included 56 children (56 eyes) aged 2 to 15 years with previously not operated horizontal strabismus. Two independent operators used B-scan method to measure the axial length (for comparison with A-scan data) and the transverse size of the eyeball according to the proposed method. The accuracy of measurements was estimated by calculating the reproducibility limit, and indirectly by the forecast accuracy of the software system STRABO, which used the obtained values of the transverse size of the eyeball for individual dosing operations. Results. The B-scan technique was developed for measuring the transverse size of the eyeball using a contact linear probe. The measurement reproducibility limit was 0.22 mm (95% confidence interval is 0.18–0.25 mm), which does not exceed 1% of the average transverse size of the eyeball (22.03 mm). The results of the operations confirmed the accuracy of the prediction by the software system STRABO, since the correct eye position was obtained within 6 months in all cases, excluding 4 patients in whom the second stage of the surgery was postponed. That gave an indirect confirmation of the measurement accuracy of the transverse size of the eyeball using the proposed technique. Conclusion. The proposed ultrasound B-scan technique with a linear contact probe provides high accuracy and reproducibility of measurements of the transverse size of the eyeball and can be used in pediatric ophthalmological practice for calculating surgical procedures for strabismus using the individual dosing software system STRABO. Key words: transverse size of the eyeball, axial length, ultrasound B-scan, linear probe, horizontal strabismus, dosing.

Ultrasound is the best imaging modality for comprehensive evaluation of the thyroid. The thyroid is best imaged using a high-frequency linear probe with the patient in a supine position with the neck hyperextended. Normal thyroid is homogeneous in appearance without defining anatomic landmarks within the gland. A few anatomic variants can occur, and it is important for the sonographer and radiologist to be aware of these variants, to avoid misidentifying them as a pathology. This article provides a comprehensive review of ultrasound of the normal thyroid gland, including technique, normal anatomy, anatomic variants, imaging appearance, and technical pearls and pitfalls.

The ability to directly harvest thin and superthin perforator flaps without jeopardizing their vascularity depends on knowledge of the microsurgical vascular anatomy of each perforator within the subcutaneous tissue up to the dermis. In this paper, we report our experience with ultrahigh-frequency ultrasound (UHF-US) in the preoperative planning of thin and superthin flaps. Between May 2017 and September 2018, perforators of seven patients were preoperatively evaluated by both ultrasound (using an 18-MHz linear probe) and UHF-US (using 48- and 70-MHz linear probes). Thin flaps (two cases) and superthin flaps (five cases) were elevated for the reconstruction of head and neck oncologic defects and lower limb traumatic defects. The mean flap size was 6.5×15 cm (range, 5×8 to 7.5×23 cm). No complications occurred, and all flaps survived completely. In all cases, we found 100% agreement between the preoperative UHF-US results and the intraoperative findings. The final reconstructive outcomes were considered satisfactory by both the surgeon and the patients. In conclusion, UHF-US was found to be very useful in the preoperative planning of thin and superthin free flaps, as it allows precise anticipation of very superficial microvascular anatomy. UHF-US may represent the next frontier in thin, superthin, and pure skin perforator flap design.

The objective of this study was to validate and apply 2 different methods to record changes in teat tissue related to machine milking. Teat wall diameter was measured via B-mode ultrasound cross sectioning with a 7.5-MHz linear probe. Teat tissue thickness was measured using a cutimeter (spring-loaded caliper, spring constant 6.5 N/cm, 0.5 N at closed jaws). Both methods were applied at the teat barrel, 2 cm above the teat tip. In experiment 1, 24 teats from freshly slaughtered cows were used to perform ultrasound imaging (12 teats) or cutimeter measurements (12 teats) while the teat cisterns were filled with water to increase the intracisternal pressure from 0 to 30 kPa in steps of 1 kPa. Teat tissue thickness did not change at an intracisternal pressure from 0 to 10 kPa but increased with intracisternal pressure at levels >10 kPa. In contrast, teat wall diameter decreased with intracisternal pressure between 0 and 7 kPa but did not significantly change at a pressure ≥7 kPa up to 30 kPa. Significant Pearson correlation coefficients between intracisternal pressure and teat wall diameter were observed from 0 to 7 kPa (r = −0.38), and between intracisternal pressure and teat tissue thickness from 10 to 30 kPa (r = 0.45). In experiment 2, ultrasound and cutimeter measurements were performed in 12 lactating Holstein cows. Measurements before and during milking, immediately after cluster removal, with normal milking or with a 5-min overmilking, were performed and continued at 5-min intervals for 60 min and at 10-min intervals until 120 min. Additionally, with the 5-min overmilking treatment, measurements were continued at 60-min intervals up to 10 h after milking. Teat wall diameter decreased in response to milk ejection, followed by a continuous increase during the course of milking, with highest values after 5 min overmilking. Teat tissue thickness did not change during milking but was significantly increased after overmilking. Teat wall diameter and teat tissue thickness recovered to premilking levels within 35 min after normal milking and within 60 min after overmilking. Until 10 h after overmilking, the teat wall diameter decreased steadily, whereas teat tissue thickness was unfluctuating. In the physiologically relevant range of intramammary pressure, ultrasound measurements of the teat wall were affected by both intramammary pressure and mechanical forces, whereas cutimeter measurements were not affected by the intramammary pressure.

Background Hidradenitis suppurativa is a chronic inflammatory skin disease. An ultrasound staging (SOS-HS) using frequencies from 7 to 18 MHz has been proposed to evaluate the severity of the disease. Materials and methods We retrospectively evaluated the most significant lesions in 50 patients with hidradenitis suppurativa (32 females and 18 males, aged from 12 to 68 years old), who had undergone high-frequency ultrasound (HFUS) (18-22 MHz) and ultra-high frequency ultrasound (UHFUS) (48 and 70 MHz). A MyLab™ Touch system (Esaote) equipped with a 18-22 MHz linear probe was used for the HFUS, and a Vevo® MD (VisualSonics) was used for the UHFUS, equipped with two linear probes (70 and 48 MHz). Results A total of 116 lesions were observed, of which 66 were fluid collections, 32 were tunnels, 6 pseudocysts, 5 bridge scars, 5 tombstone comedones, and 2 granulation tissues. Structures that had already been described with HFUS were then observed with UHFUS but with a better definition. In addition, structures that had not been detected by HFUS were also observed with UHFUS such as drop-shaped hair follicles, micro-tunnels, and microcysts. Conclusion Ultra-high frequency ultrasound provides a better understanding of hidradenitis suppurativa. Patients can be monitored more effectively thereby preventing the most severe changes.

Cardiovascular diseases (CVD) are considered as the main cause of death representing more than 30% of worldwide casualties according to the World Health Organization [1]. The pulse wave velocity (PWV) is a relevant indicator of CVD [2] at an early stage but it requires specialized clinical tools for its monitoring. The versatility of ultrasound imaging thanks to the introduction of ultrafast imaging and recent progress in electronics and signal processing allow the measurement and the monitoring of this biomarker. The proposed hardware solution is a high-frequency ultrasound linear probe dedicated to superficial arteries imaging, PWV and arterial stiffness assessment. The probe allows simultaneous multiplane imaging thanks to three acoustic apertures adopting a H-topology: one 128-element acoustic aperture is placed at the center of the probe and two orthogonal 64-element acoustic apertures are placed on each side of the probe. This arrangement enables both longitudinal imaging of a small artery and cross-sectional imaging from either side.

Background: Arteriovenous fistula (AVF) is the best access for hemodialysis. The failure of arteriovenous fistula maturation is currently a major problem faced today. This study aims to assess whether an intraoperative bloodflow rate measured with Doppler ultrasound can be a predictor of the maturity of radiocephalic AVF. Subjects and Methods: Subjects were patients to be made radiocephalic AVF with USG mapping according to the standard. Shortly after, the anastomosis bloodflow rate was measured with a linear probe Doppler ultrasound. This study used cross sectional analytic design to obtain radiocephalic AVF maturation relationship with intraoperative bloodflow rate. Results: Radiocephalic AVF ( n = 71) in 71 patients were made and evaluated in 6 weeks. The mean intraoperative bloodflow rate in mature fistulas was significantly higher than those which did not mature (201.85 and 141.96 mL/min; P 165.5 mL/min has a good predictor value for radiocephalic AVF maturation, so it can be used as reference to determine whether the surgeon need for further assessment and revision intraoperatively, which in turn is expected to decrease the maturation failure rate of arteriovenous fistula. Keywords : arteriovenous fistula , bloodflow rate, maturity predictor

Systematic radial EUS imaging can provide a detailed evaluation of most of the liver segments, liver hilum, and hilar and intra-hepatic vascular and ductal anatomy. Innumerable scan planes are possible, and the endosonographers must reference the intra-hepatic vascular structures and ligaments, surface landmarks such as the gallbladder, and adjacent organs such as cardiac chambers and kidneys to define the liver segments. There is no strict demarcation between the adjacent segments, and all estimates are rough approximations. Radial EUS cannot sample detected lesions but can comprehensively evaluate the liver for any pathology. In particular, the superior part of the right anterior sector (S8), S4, and S6 are better seen with the radial than linear EUS probe. Unlike common belief, the liver hilum can also be well evaluated with the radial EUS probe from the mid and upper gastric body, similar to linear probe EUS imaging. Radial EUS imaging of the liver is carried out from three stations: gastroesophageal junction, upper-mid gastric body, and antrum-duodenal bulb. We describe a step-by-step approach to radial EUS description of liver anatomy in this pictorial review.

Purpose To assess the repeatability of, and measurement agreement between, four sonographic techniques used to quantify biceps femoris long head (BFlh) architecture: (i) static-image with linear extrapolation; extended field-of-view (EFOV) with linear ultrasound probe path (linear-EFOV), using either (ii) straight or (iii) segmented analyses; and (iv) EFOV with nonlinear probe path and segmented analysis (nonlinear-EFOV) to follow the complex fascicle trajectories. Methods Twenty individuals (24.4 ± 5.7 yr; 175 ± 0.8 cm; 73 ± 9.0 kg) without history of hamstrings strain injury were tested in two sessions separated by 1 h. An ultrasound scanner coupled with 6-cm linear probe was used to assess BFlh architecture in B-mode. Results The ultrasound probe was positioned at 52.0% ± 5.0% of femur length and 57.0% ± 6.0% of BFlh length. We found an acceptable repeatability when assessing BFlh fascicle length (ICC3,k = 0.86-0.95; SEM = 1.9-3.2 mm) and angle (ICC3,k = 0.86-0.97; SEM = 0.8°-1.1) using all sonographic techniques. However, the nonlinear-EFOV technique showed the highest repeatability (fascicle length ICC3,k = 0.95; fascicle angle, ICC3,k = 0.97). The static-image technique, which estimated 35.4% ± 7.0% of the fascicle length, overestimated fascicle length (8%-11%) and underestimated fascicle angle (8%-9%) compared with EFOV techniques. Also, the rank order of individuals varied by approximately 15% between static-image and nonlinear-EFOV (segmented) when assessing the fascicle length. Conclusions Although all techniques showed good repeatability, absolute errors were observed using static-image (7.9 ± 6.1 mm for fascicle length) and linear-EFOV (between 3.7 ± 3.0 and 4.2 ± 3.7 mm), probably because the complex fascicle trajectories were not followed. The rank order of individuals for fascicle length and angle were also different between static-image and nonlinear-EFOV, so different muscle function and injury risk estimates could likely be made when using this technique.

INTRODUCTION The aging process occurs in all anatomical layers of the face; therefore, rejuvenation should not be limited to the dermic signs of aging (Aesthet Surg J. 2018;38:73) The treatment with fillers in strategic points can reconstruct young anatomy, providing natural results (Aesthet Surg J. 2018;38:73). There are two instruments used for facial application of hyaluronic acid: cannula and needle. Both of them have advantages and disadvantages. OBJECTIVE In this study, we aim to compare the limitations of application with cannula by cutaneous ultrasound when compared to the needle by ultrasound, since some injectors suggest that one of the disadvantages would be the inability to reach certain application plans (periosteum). MATERIALS AND METHODS A 52-year-old female patient was treated with 22 mg/ml hyaluronic acid (Juvederm® Voluma), guided by high-frequency ultrasound (LogicE device, Logic brand (GE Healthcare), with high-frequency linear probe (L8-L18i-RS). The left hemiface was treated with a 27G needle and the right hemiface with a 5 cm 22G cannula (SoftFil®). CONCLUSION This study proved that, in the malar/zygomatic and the chin region, it is possible the cannula and needle reached the supraperiosteal region. In the temporal region, the cannula did not reach the supraperiosteal plane.

Background: Necrotizing enterocolitis (NEC) is among the most common and destructive diseases in the neonatal period. Imaging methods are important in the early diagnosis and treatment of such diseases. Ultrasound elastography (USE) is a fast and non-invasive imaging technique that deals with the viscoelastic properties of tissues. Objectives: The purpose of this study is to assess the effectiveness of USE, which determines tissue stiffness with grayscale and colored images, as an imaging tool in the diagnosis and treatment of NEC. Materials and Methods: Sixteen newborn Wistar albino gender rats were separated into two groups including eight rats each. The first group (G-I) was taken as a control group and was not exposed to any intervention. The second group (G-II) was exposed to 100% CO2 for 5 minutes and 4°C for 10 minutes. All these interventions were applied twice per day for 4 days. We observed elastographic data at 24, 48, and 96 hours. All rats were sacrificed on the fourth day. The combination of gray-scale US and elastography was performed by a 4-13 MHz with an average of 12 MHz bandwidth linear probe in Esaote Ultrasonography Systems, MyLab60 model, produced in Geneva, Italy; with ElaXto imaging application. Results: Statistically significant differences were detected in elastosonography ratios of terminal ileum at 24, 48, and 96 hours (P < 0.05). As ischemia period in NEC was prolonged, elastosonographic ratios of intestinum increased significantly. Conclusion: It was found that USE is a reliable technique with superior features in the assessment of the terminal ileum in the neonatal age group. It is due to its wide image window and better assessment of tissue stiffness with gray scale and color image. It has been observed that the USE technique is helpful in the diagnosis.

It has been proven that early breast cancer diagnosis increases the success rate of treatment. Thus, annual mammography exam is recommended for women over forty which is relatively expensive, painful, and the safety of the used radiation dose is still debated. In this work, we introduced an automatic, low cost, and less painful exam to pre-diagnose the tumors of the breast. The proposed imaging acquisition system uses a diagnostic ultrasound machine in B-mode, a linear probe, and a dedicated arm fixed below a bed in which all are controlled by a microcontroller. The breast is scanned underwater while patient is laid down on a bed in which the robotic arm guides the probe rotating to acquire a stack of 2D images. Then, we reconstructed the 3D image due to render the mammary volume, search for tumors, estimating the position, and volume size of them. We tuned and evaluated the imaging system using a control phantom made of paraffin-gel wax and deionized water, and a realistic breast phantom (Gphantom model), including eleven inclusions mimicking breast tumors. In addition, we scanned the phantoms by MRI and CT to evaluate the proposed method. Also, we scanned the breast of three invited volunteers and compared the results to their prior medical reports. The precision in volume estimation of the tumor in the control phantom was 96.89%. The proposed hardware setup and image reconstruction was capable of identifying simulated tumors in the breast phantom and real tumor in vivo studies.

AIM: To evaluate the diagnostic reliability of a new generation wireless point-of care ultrasound device for abdominal and thoracic findings. MATERIAL AND METHODS: 40 patients (16 females, 24 males 19 –80 years, on average 56.1 years) were scanned by an experienced examiner using the new wireless Vscan Air device for abdominal and thoracic findings. The probe frequencies were 2–5 MHz (convex probe) and 3–12 MHz for the linear probe. As a reference standard, all patients were also examined using high-end ultrasound (LOGIQ E9/LOGIQ E10). Results were interpreted independently by two examiners in consensus, also with regard to the image quality (0–4, from not assessable = 0, to excellent 4). RESULTS: In all 40 patients (100%) examination with conventional high-end ultrasound and the Vscan Air ultrasound device was feasible. Sensitivity, specificity, positive and negative predictive value for the diagnosis of abdominal and thoracic findings were 63.3%, 100%, 100%, and 40%, respectively. Most main diagnostic findings were detected using the mobile device compared to the high-end ultrasound. Limitations were found regarding characterization and classification of hepatic and renal tumorous lesions. Image quality revealed mostly minor diagnostic limitations for the mobile device, mean 2.9 (SD ± 0.300) and was excellent or with only minor diagnostic limitations for conventional high-end ultrasound, mean 3.25 (SD ± 0.438). CONCLUSION: Due to its easy application and its high diagnostic reliability, point-of-care ultrasound systems of the latest generation represent a valuable imaging method for the primary assessment of abdominal and thoracic findings, especially in patients on intensive care units or in emergency situations.

International guidelines do not recommend a specific probe for assessment of lung aeration using lung ultrasound (LUS). The aim of this study was to assess the concordance between linear and sector array probes of a handheld ultrasound device in assessment of lung aeration in invasively ventilated intensive care unit patients. This study included intensive care unit patients who were expected to be ventilated for longer than 24 h. A 12-region LUS exam was performed with a linear and a sector array probe. In each image, the LUS aeration score and number of B-lines were determined. Adding the LUS aeration scores of all regions resulted in a global LUS aeration score. Agreement between the two probes was calculated using intra-class correlation coefficients (ICCs). A total of 30 LUS exams were performed in 19 patients, resulting in a total of 328 pairs of images. Twenty-nine pairs of images were excluded from analysis because the images from the linear probe could not be scored. ICCs calculated for the remaining images revealed good concordance the LUS aeration scores for individual images (ICC = 0.73, 95% confidence interval 0.67-0.78), number of B-lines (ICC = 0.79, 95% confidence interval 0.72-0.83) and global LUS aeration score (ICC = 0.74, 95% confidence interval 0.52-0.87). In conclusion, there is good concordance between linear and sector array probes of a handheld ultrasound device in assessment of lung aeration patterns in mechanically ventilated intensive care unit patients. However, in roughly 10% of the images acquired using the linear probe, the aeration pattern could not be scored. (E-mail: m.r. smit@amsterdamumc.nl) (C) 2020 World Federation for Ultrasound in Medicine & Biology. All rights reserved.

Purpose To determine the feasibility and efficacy of intraoperative ultrasound imaging in maxillofacial surgery of depressed zygomatic arch fractures. To ensure the accurate and adequate reduction of the depressed zygomatic arch using high frequency ultrasound linear probe and provide a reproducible technique. Methods The authors evaluated 10 consecutive adult patients with zygomatic arch fractures who required a closed reduction of the fractured zygomatic arch between January 2019 and June 2020. The fractures were diagnosed with a CT scan and clinical findings of reduced mouth opening with visible depression were the most common indication. Intraoperative Ultrasound imaging was used for our patients who underwent closed surgical reduction of zygomatic arch fractures to visualize and confirm accurate reduction. Postoperative CT scan was done to evaluate the reduction. Results An intraoral approach was used to reduce the fractures with an elevator. In Nine cases the achieved reduction was a mirror image of the contralateral unfractured arch as evaluated with postoperative CT scan. In One case the posterior third of arch was found to be minimally displaced. Mouth opening and facial symmetry were improved and satisfactory in all the cases. Conclusions Intraoperative ultrasound assisted reduction of zygomatic arch improves the assessment of reduction and provides real time feedback to the surgeon. The results are promising and this modality is recommended for similar cases.

Background and objective Mycetoma of the foot, commonly referred to as Madura foot, is a chronic granulomatous infection, which impacts vascularization of the affected region. This study aimed to evaluate foot mycetoma using Doppler and sonography techniques to identify the principle sonographic features and blood flow patterns associated with the condition. Materials and methods This was a cross-sectional prospective single-center study conducted at the Mycetoma Research Center (MCR) in Khartoum State, Sudan. Sixty patients with Madura foot were examined using a Duplex ultrasound machine with a 7-10 MHZ linear probe. Data was analyzed using SPSS software. The distribution of demographic data was evaluated by simple descriptive statistics. Statistical tests was performed using Student's independent t-tests to compare different forms of mycetoma and Chi-square tests to examine differences in blood flow patterns between fungal (eumycetoma) and bacterial (actinomycetoma) forms of the infection. Results The presence of multiple cavities and aggregated grains were more common in eumycetoma than in actinomycetoma. The echotexture was significantly more heterogeneous in eumycetoma than in actinomycetoma (p = 0.03). Eumycetoma had higher vascularity than actinomycetoma. Conclusion Mycetoma has characteristic sonographic features and patterns of vascularity, which are essential to differentiate between the fungal and bacterial forms of mycetoma.

Objective The aim of this study was to compare the accuracy of cross-sectional area (CSA), resistive index (RI), and strain ratio (SR) in carpal tunnel syndrome (CTS). Design This prospective and case-control study included patients with a diagnosis of CTS and a healthy control group. The participants were examined with an ultrasound Doppler system equipped with a high-resolution (5-18 MHz) linear probe (Philips L18-5). CSA, RI, and SR values were compared. Results CSA, RI, and SR were found to be effective tools to detect the presence of CTS (regardless of severity). The cut-off value of 11.25 mm for CSA had a sensitivity and specificity of 97.2% and 88.0%, respectively. The cut-off value of 0.740 for RI had a sensitivity and specificity of 94.4% and 94.0%, respectively. The cut-off value of 1.95 for SR had a sensitivity and specificity of 97.2% and 84.0%, respectively. In respect of the severity of CTS, ultrasound was found to be an effective method to classify severe CTS cases only. Conclusion The CSA, SR, and RI seem to have excellent accuracy in the diagnosis of CTS. When the grading of severity is considered, ultrasound seems to be sensitive and specific in differentiating severe CTS cases from mild or moderate CTS cases.

Background: Ultrasonography (US) is a useful tool for imaging, which can be used for assessment of joints and per articular structures in all rheumatologic disorders. Ankle and foot sonography requires a linear high-frequency transducer; a 7.5 to 15 MHz probe is commonly used. The aim of this study was to evaluate ankle joint affection in active Rheumatoid arthritis and its value in assessment of disease activity by using US, and its correlation to disease duration, sex and age.Methods: A total of 63 patients with Rheumatoid arthritis according to the 2010 ACR/EULAR classification criteria. 20 age and sex matched control volunteers were included. Evaluation of disease activirty by DAS-28. US examination of both ankles were done for patients and controls. High frequency US with 12 MHZ linear probe was used.Results: Our results show that ankle synovitis was found significantly higher among RA patients (18.3%) compared to controls (2.5%); p value = 0.013. although tenosynovitis and erosions were higher among cases (27% and 8.7%; respectively) than controls (15% and 0%; respectively); the differences were non-significant. We found that ankle affection as seen by US was significantly related to the activity of RA. Patients with higher DAS-28 score were more like to have ankle affection and also to have bilateral ankle affection; both with significant differences.Conclusion: It can be stated that ankle evaluation by US should be considered more in RA assessment, and further studies should be done to uncover the under-etsimation of ankle involvement in RA patients.

Aim: Peyronie’s disease (PD) or plastic induration of the penis, require complete evaluation of plaques in order to decide the best therapeutic option for patient. The purpose of this study is to compare the findings of three-dimensional ultrasound (3D US) and two-dimensional ultrasound (2D US) in patients with PD.Materials and methods: Twenty patients with PD aged 30 to 72 years were included in study. The examination was performed with a 12 MHz linear probe, using 2D US and 3D US. Localization and size of plaques were determined and time needed for imagine acquisition was determined in every case.Results: 3D ultrasound permits the visualization of the entire plaque in the coronal plane of plaque with its precise measurements. No statistical difference in plaque dimensions and its surface area assessment using 3D US and 2D US was found (127.72 mm² vs. 128.74 mm², p>0.05). The possibility to perform detailed analysis of the acquired images using generated digital cube reduced the average duration of the acquisition to 69.8 seconds (median 64 seconds) for 3D US vs. 151.25 seconds (median 145.5 seconds) for 2D US (p

Background The capacitive micromachined ultrasound transducer (CMUT) is a new ultrasound (US) probe manufactured by state-of-the-art cutting-edge semi-conductor micromachined electro-mechanical systems (MEMS) technology. Purpose To demonstrate the peculiar characteristics of each probe and the limitations that should be improved. Material and Methods This study was performed from March to April 2018. The only inclusion criterion was the presence of disease, so all patients with musculoskeletal, skin, and subcutaneous pathology were included. A total of 66 patients entered this study. The exams of each patient, with both probes, were evaluated retrospectively and independently by three radiologists. Panoramicity of the images, the definition of superficial structures (2 cm), and Doppler signal were assessed. A 5-point scale was used for each parameter. Results A total of 89 pathologies were detected. The mean of score for 4G-CMUT was higher than L64 for the panoramicity of the images and the definition of the deep structures. Instead, the mean score for L64 was higher than for 4G-CMUT in the evaluation of superficial structures and Doppler signal. A statistically significant difference was found ( P Conclusion CMUT is a breakthrough in US technology. It allows the use of a single probe for different US examinations. The musculoskeletal, skin, and subcutaneous US can be evaluated with a piezoelectric linear transducer or CMUT. In the present study, the overall diagnostic performance was similar. Improvements in CMUT will provide even more dynamic and flexible imaging capabilities by a transducer, with a wider bandwidth.

Recently developed silicon probes have large numbers of recording electrodes on long linear shanks. Specifically, Neuropixels probes have 960 recording electrodes distributed over 9.6 mm shanks. Because of their length, Neuropixels probe recordings in rodents naturally span multiple brain areas. Typical studies collate recordings across several recording sessions and animals. Neurons recorded in different sessions and animals have to be aligned to each other and to a standardized brain coordinate system. Here we report a workflow for accurate localization of individual electrodes in standardized coordinates and aligned across individual brains. This workflow relies on imaging brains with fluorescent probe tracks and warping 3-dimensional image stacks to standardized brain atlases. Electrophysiological features are then used to anchor particular electrodes along the reconstructed tracks to specific locations in the brain atlas and therefore to specific brain structures. We performed ground-truth experiments, in which motor cortex outputs are labelled with ChR2 and a fluorescence protein. Recording from brain regions targeted by these outputs reveals better than 100 μm accuracy for electrode localization.

High affinity nucleic acid analogues such as gammaPNA (&gamma, PNA) are capable of invading stable secondary and tertiary structures in DNA and RNA targets but are susceptible to off-target binding to mismatch-containing sequences. We introduced a hairpin secondary structure into a &gamma, PNA oligomer to enhance hybridization selectivity compared with a hairpin-free analogue. The hairpin structure features a five base PNA mask that covers the proximal five bases of the &gamma, PNA probe, leaving an additional five &gamma, PNA bases available as a toehold for target hybridization. Surface plasmon resonance experiments demonstrated that the hairpin probe exhibited slower on-rates and faster off-rates (i.e., lower affinity) compared with the linear probe but improved single mismatch discrimination by up to a factor of five, due primarily to slower on-rates for mismatch vs. perfect match targets. The ability to discriminate against single mismatches was also determined in a cell-free mRNA translation assay using a luciferase reporter gene, where the hairpin probe was two-fold more selective than the linear probe. These results validate the hairpin design and present a generalizable approach to improving hybridization selectivity.

PURPOSE: Gel pad is an aqueous, flexible, easy available, disposable spacer used for the ultrasound (US) scan of superficial or difficult-to-visualize areas. In clinical practice, it is widely used in B-mode US approach of superficial lesions but, to date, no data have been provided as to its efficacy in the Doppler detection of superficial flows. The aim of our study was to demonstrate the role of stand-off gel pad in the detection of the otherwise-missed peri- or intra-lesional flow signals on Doppler imaging. MATERIALS AND METHODS: A total of 100 superficial lesions undergone to an US evaluation using a 7.5–12-MHz linear probe were evaluated prospectively with and without interposition of a gel stand-off pad to detect the presence or absence of vascularization and to classify the vascular pattern. RESULTS: Peri- or intra-lesional flow was demonstrated in 56% of cases without and in 84% of cases with interposition of a gel stand-off pad; moreover, a statistically significant difference (p value

Background:Ultrasonography (US) is a well established technique both for diagnosis and follow up in Rheumatoid Arthritis (RA) and Psoriatic Arthritis (PSA)1. To date, there is no consensus regarding a standardized US evaluation of joint involvement by a validated score to be used for differential diagnosis.Objectives:1) To differentiate the ultrasound features of patients affected by active RA or active PSA by using a 6-joints score2. 2) To analyze correlations between those findings and clinical patterns of PSA disease.Methods:68 RA and 38 PSA patients (divided in two equal subgroups according to the clinical involvement i.e. polyarticular or oligoarticular) were enrolled in a multi-center cross-sectional study. All patients underwent clinical evaluation including demographic data, disease characteristics, laboratory test and tender/swollen joints count. SDAI and DAPSA were calculated in accordance to the disease and standard of care. The sonographic evaluation of wrists, II MCFs and knees, was performed using a multifrequency linear probe (13-18 MHz) with power Doppler (7.5 MHz, PRF500 Hz). High-end equipment was used and the scanning technique as well as the lesion assessment was previously agreed among the participants, who performed a consensus session 100 images. A validated ultrasound score2, which included effusion, synovial hypertrophy and synovial hypervascularization at 6 joints sites was used. Those lesions were assessed according to OMERACT definitions and semi-quantitatively graded (0-3). By summing the scores obtained at each joint site and globally, a joint score for articular involvement, a score for the severity of each lesion and a global 6-joint score for all abnormalities were calculated.Results:Clinical evaluation showed no statistically significant differences between RA and PSA (table I). Ultrasound detected significant differences in the score of joint effusion (SE) (pConclusion:Ultrasound evaluation of 6 target joints might help to discriminate RA and PSA oligoarticular subset. The study of a limited number of joints is therefore a complementary tool to the clinic, fast and well integrated into the overall assessment of the arthritic patient.References:[1]Zabotti A. et al. Clin Exp Rheumatol. 2018; 36:519-525.[2]Perricone C et al. Rheumatology (Oxford) 2012; 51:866-73.Table 1.Dependent variablesStudy Populationp valuesUS_SEScoreRAPSA OLIGO.021PSA POLY.356PSARA.021OLIGOPSA POLY.014PSARA.356POLYPSA OLIGO.014US_SHScoreRAPSA OLIGO.001PSA POLY.336PSARA.001OLIGOPSA POLY.004PSARA.336POLYPSA OLIGO.004US_PDScoreRAPSA OLIGO.011PSA POLY.102PSARA.011OLIGOPSA POLY.006PSA POLYRA.102PSA OLIGO.006US_MCP2ScoreRAPSA OLIGO.000PSA POLY.276PSARA.000OLIGOPSA POLY.002PSA POLYRA.276PSA OLIGO.002US_WRISTScoreRAPSA OLIGO.032PSA POLY.610PSARA.032OLIGOPSA POLY.047PSA POLYRA.610PSA OLIGO.047US_KNEEScoreRAPSA OLIGO1.000PSA POLY.133PSA OLIGORA1.000PSA POLY.180PSA POLYRA.133PSA OLIGO.180US_KNEEScoreRAPSA OLIGO1.000PSA POLY.133PSARA1.000OLIGOPSA POLY.180PSA POLYRA.133PSA OLIGO.180US: ultrasound; SE synovial effusion; SH synovial hypertrophy;PD power Doppler; MCP metacarpophalangeal; PSA psoriatic arthritis;OLIGO oligoarticular; POLYpolyarticularDisclosure of Interests:Fabiana Figus: None declared, Luca Idolazzi: None declared, Porin Perić: None declared, Alen Zabotti Speakers bureau: Celgene, Janssen, Ilaria Tinazzi: None declared, Irene Azzolin: None declared, ERIKA MONTABONE: None declared, Tanya Sapundzhieva: None declared, Anastas Batalov: None declared, PLAMEN TODOROV: None declared, Rositsa Karalilova: None declared, Annamaria Iagnocco Grant/research support from: Abbvie, MSD and Alfasigma, Consultant of: AbbVie, Abiogen, Alfasigma, Biogen, BMS, Celgene, Eli-Lilly, Janssen, MSD, Novartis, Sanofi and Sanofi Genzyme, Speakers bureau: AbbVie, Alfasigma, BMS, Eli-Lilly, Janssen, MSD, Novartis, Sanofi

According to the different body parts to be scanned, the corresponding position in which patients feel comfortable and facilitates scanning is chosen without special preparation. A 10 MHz high-frequency linear probe is generally used for scanning, while a higher frequency probe is selected for superficial cutaneous nerves.

[EN] We explore the use of a beamforming method intended for large-area scanning in optical-resolution photoacoustic microscopy. It has been evaluated in a experimental setup that comprises a low-cost laser diode and a phase array with a 128-elements linear probe. Three different beamforming strategies are discussed: no-beamforming, static beamforming and dynamic beamforming. The method has been tested in gelatine-based phantoms as well as ex-vivo organs. Results show that, compared with the other two, dynamic beamforming increases up to 15dB and homogenizes signal-to-noise ratio (SNR) along images of roughly 1 cm2. The method and system presented here could be the baseline for more advanced array-based systems that leverage the low-cost laser sources for clinical applications., This research has been supported by the Spanish Ministry of Science, Innovation and Universities through grant Juan de la Cierva - Incorporacion (IJC2018-037897-I), and program Proyectos I+D+i 2019 (PID2019-111436RB-C22). Action co-financed by the European Union through the Programa Operativo del Fondo Europeo de Desarrollo Regional (FEDER) of the Comunitat Valenciana 2014-2020 (IDIFEDER/2018/022). A.C. received financial support from Generalitat Valenciana and Universitat Politecnica de Val ` encia through the grants APOSTD/2018/229 and program PAID-10-19, respectively.

This study aimed to determine ultrasound of uterine involution and postpartum ovarian dynamics on Ongole Crossbreed Heifer (PO) associated with postpartum estrus signs. This study used 6 PO cows which were divided into primiparous group and pluripara group. The observation of uterine involution and ovarian dynamics was started from the first day postpartum using ultrasonography (USG) with a linear probe rectally, while the reproductive organs images were recorded every 2 days. The results showed that the time needed for all reproductive organs of 3 primiparous groups to complete the uterine involution after parturition was 37.33±1.15 days when the diameter of the vagina, cervix uterine, corpus uterine, left cornua, and right cornua uterine were 3.14±0.00 cm, 2.86±0.00 cm, 3.20±0.06 cm, 4.66±0.01 cm, and 4.66±0.01 cm, respectively. The time needed for all reproductive organs of 3 pluripara groups to complete uterine involution postpartum was 38.67±1.15 days with the diameter of the vagina, cervix uterine, corpus uterine, left cornua, and right cornua uterine 3.18±0.00 cm, 2.70±0.02 cm, 3.08±0.02 cm, 4.42±0.01 cm, and 4.42±0.01 cm, respectively. The average times of the first and second ovulation of primiparous cattle were 27.67±1.15 and 47.67±1.15 days postpartum, whereas in pluripara group was 28.33±1.15 and 48.33±1.15 days postpartum. At first ovulation all cows were not accompanied by signs of estrus, while at the second ovulation 2 primiparous cows and 1 pluripara cow showed less obvious signs of estrus, 1 primiparous cow and 1 pluripara cow showed signs of medium estrus, and 1 pluripara cow showed clear estrus signs.

Gegenstand und Ziel: Die Arbeit beschreibt die Einsatzmoglichkeiten und den klinischen Nutzen der dreidimensionalen Sonographie am Voge lauge. Material und Methoden: Mithilfe des Ultraschallgerats Voluson i (GE Healthcare, Osterreich) wurden in Kombination mit einer hochauflosenden 18-MHz-Ultraschallsonde die gesunden Augen von 44 Vogelpatienten (sechs Greifvogel-, drei Papageien- und vier sonstige Spezies) untersucht. Es sollten physiologische Befunde dargestellt werden, um eine klinische Beurteilungsgrundlage fur pathologische Befunde am Auge zu erhalten. Zusatzlich wurde mittels dreidimensionaler Farbdopplersonographie der Blutfluss des Augenfachers (Pecten oculi) erfasst. Ergebnisse: Die dreidimensionale Sonographie ermoglichte erstmals eine raumliche Darstellung physiologischer Strukturen im Vogelauge. Zudem gelang die dreidimensionale Darstellung der vaskularen Flussverhaltnisse des Augenfachers. Schlussfolgerung und klinische Relevanz: Die dreidimensionale Sonographie stellt eine wertvolle Erganzung zur optisch basierten ophthalmologischen Untersuchung dar und wird unerlasslich, wenn sich das hintere Augensegment nicht einsehen lasst wie beispielsweise bei Trubungen des vorderen dioptrischen Apparats oder Einblutungen in die vordere Augenkammer. Das Verfahren kann zu einer raschen Diagnosestellung beitragen, insbesondere im Fall der bei Vogeln haufig vorkommenden traumatisch bedingten Einblutungen in das Auge sowie bei Netzhautablosungen und Augenfacherlasionen. Objective: The paper describes the possibilities and the clinical utility of three-dimensional (3D) ultrasonography in the avian eye. Material and methods: The healthy eyes of 44 patients (six various raptor, three psittacine bird and four other bird species) were examined using the Voluson i ultrasound unit (GE Healthcare, Austria) in combination with a high-resolution 18 MHz linear probe. Physiological findings should be demonstrated to obtain a clinical basis for the evaluation of pathological ocular findings. Additionally, the blood flow of the pecten oculi was assessed using 3D colour Doppler ultrasonography. Results: By means of 3D ultrasonography, the physiological structures in the avian eye could be demonstrated in their spatial context for the first time. In addition, the 3D appearance of the blood flow of the pecten oculi was shown. Conclusion and clinical relevance: 3D ultrasonography is a valuable diagnostic addition to classical optical-based ophthalmological examination of the avian eye and becomes essential when the posterior segment of the eye is obscured, as, for example, in opacities of the anterior dioptric apparatus or in patients with haemorrhage in the anterior eye chamber. The method may significantly enhance ophthalmological diagnostics in birds, particularly in situations with frequently occurring posttrauma intraocular haemorrhage as well as retinal detachment or lesions of the pecten oculi.

Background The extensor hallucis longus (EHL) is located in the anterior compartment of the leg, between the tibialis anterior muscle and extensor digitorum longus. The EHL is characterized by a number of morphological variations, concerning mainly the accessory bands and their insertion. The aim of our research was to evaluate the effectiveness of ultrasound in determining the anatomical variations of the EHL. Methods The morphology of the EHL was evaluated by ultrasound (high-frequency linear probe of Samsung RS80 apparatus) in 50 healthy volunteers. The types of EHL morphology were determined according to a threefold classification. Results Only two types of the threefold anatomical classification were observed: Type I in 76 limbs (76%) and Type IIa in 24 limbs (24%). The accessory bands of the EHL were found in 24% of cases, all of which demonstrated a course that was located medially in relation to the main tendon. Conclusion Ultrasound allows for visualization of the EHL; however, the potential recognition of morphological variance is limited. Level of evidence I - Clinical Research.

Context: Optic nerve sheath diameter (ONSD) has long been accepted as a reliable proxy of intracranial pressure especially in critical care and bedside settings. The present consensus is to measure ONSD in both eyes and take average value, which is cumbersome and a potential cause of discomfort to the patient. Aim: We aim to compare the values of ONSD of the right and left eye in a random sample as measured by bedside ocular ultrasonography (USG) in Indian adults. Settings and Design: This was a prospective study conducted from September 2012 to March 2013 in the Department of Internal Medicine of a tertiary care hospital situated at moderate high altitude (11,500 ft) in India. Materials and Methods: Patients admitted with high altitude pulmonary edema (HAPE) were recruited by convenience sampling. The ONSD of both eyes were measured 3 mm behind the globe using a 7.5 MHz linear probe on the closed eyelids of supine subjects. Statistical Analysis: Analysis was done using SPSS 17.0. Results: A total of 47 patients of HAPE were recruited to the study with daily ONSD recording of both eyes during the admission period. The mean ONSD of the left eye was 4.60 (standard deviation [SD] = 0.71) whereas the mean ONSD of right eye 4.59 (SD = 0.72). The ONSD of the right eye and left eye was strongly correlated (correlation coefficient = 0.98 with P < 0.0001). The mean difference in the ONSD of both eyes (right–left) was −0.0044 (SD = 0.11) which was not statistically significant (P = 0.533). Conclusion: Our results suggest that the difference in ONSD of both eyes is not statistically significant in disease or health. This study also suggests that the ONSD of either eye can be predicted by the other eye recordings. Based on these findings, it can be suggested that during ocular USG for routine bedside/research purposes it is sufficient to measure ONSD of any of the one eye to save time and avoid discomfort to the patient.

Objective: The study's primary objective was to determine army medics' accuracy performing bedside ultrasound (US) to detect radiolucent foreign bodies (FBs) in a soft-tissue hand model. Secondary objectives included the assessment of US stand-off pad effects on soft-tissue FB detection rates and assess established FB detectable lower limit size of 2 mm. Methods: Prospective, single blinded, observational study of US-naïve Army medics' abilities utilizing bedside US to detect wooden FBs in a chicken thigh model with or without an US stand-off pad. After a 2 h training period, medics' abilities to detect 1–3 mm FB utilizing a SonoSite® M-Turbo US and 13–6 MHz linear probe were assessed. Results: After a 2 h training period, 28 medics had a sensitivity and specificity of 73% and 78% detecting 1–3 mm FBs utilizing standard US equipment. The medics' sensitivity and specificity were both 78% in detecting radiolucent FBs 2 mm and larger without a stand-off pad. The sensitivity and specificity decreased to 48%, 62%, and 67% when utilizing a stand-off pad to detect 1, 2, and 3 mm soft-tissue FBs. Sub 2 mm detection rates decreased from 82% for 2 mm FB to 64% for 1 mm FBs without utilizing a stand-off pad. Conclusion: Army medics with minimal US experience successfully identified FBs embedded in hand models with accuracies similar to radiologists and emergency medicine physicians. However, radiolucent FB detection sensitivity and specificity decreased in US-naïve Army medics utilizing stand-off pads. In addition, this study reconfirmed the lower limit of FB detection rates at 2 mm. These results support Army medics' utilization of US to evaluate for superficial radiolucent FBs of the hand.