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The article is devoted to the multiparametric ultrasound techniques for prostate biopsy targeting. This literature review illustrates the variety of ultrasound-based targeting procedures and presents data concerning the diagnostic value of each. A special attention is given to every targeted technique limitations and the opportunity for the MTI-fusion.

Актуальность. Реактивные артриты являются важной проблемой в педиатрии, что связано с их наибольшим удельным весом (41–56 %) в структуре патологии суставов у детей. Важность проблемы обусловлена также возможностью хронизации воспалительного процесса и трансформации в ювенильный ревматоидный артрит и остеоартроз. В течении и исходе заболевания большую роль играет своевременная диагностика. Наряду с клинико-лабораторным обследованием важное значение в диагностике и дифференциальной диагностике патологии суставов у детей играет рентгенологический и ультразвуковой методы. Цель исследования: оптимизация диагностики реактивных артритов у детей путем сравнительной оценки информативности рентгенологического и ультразвукового методов исследования. Материалы и методы обследования. Обследовано 30 детей с диагнозом «реактивный артрит» в возрасте от 2 дo 16 лет. Наряду с общепринятым клинико-лабораторным и рентгенологическим обследованием всем пациентам проводилась ультрасонография суставов. Результаты. Изменения на рентгенограммах были зарегистрированы лишь у 10 (33,3 ± 8,7 %) детей в виде увеличения в объеме и уплотнения периартикулярных тканей, у 2 (6,7 ± 4,6 %) детей зафиксировано расширение суставной щели пораженного сустава. Чувствительность рентгенографии в качестве метода диагностики реактивных артритов у детей составила 40 %. Ультразвуковое исследование суставов зарегистрировало патологические изменения в 100 % случаев. Ультрасонография суставов зафиксировала изменения в суставах в виде синовита, утолщения синовиальных оболочек, расширения суставных щелей, тендинитов, бурситов. Заключение. В диагностике различных вариантов течения реактивных артритов большое значение приобретает ультразвуковой метод визуализации воспалительных изменений в суставах, обладающий 100% чувствительностью. Ультразвуковое исследование, являясь неинвазивным, доступным, не имеющим противопоказаний к проведению исследованием, является достоверно (р < 0,05) более чувствительным методом визуализации артрита у детей по сравнению с рентгенологическим методом исследования суставов.

Nearly thirty thousand incidences of primary and 300 thousand incidences of metastatic brain cancer are diagnosed in the USA each year. It has a high mortality rate and is often unresponsive to the standard of care, which includes surgical resection, radiation, and chemotherapy. These treatment strategies are also hindered by their invasiveness and toxic effects on healthy cells and tissues. Furthermore, the blood-brain/tumor barrier severely limits delivery of anti-cancer therapeutics administered intravenously to brain tumors, resulting in poor tumor response to the treatment. There is a critical need to develop new approaches to brain cancer therapy that can overcome these limitations. Focused ultrasound has emerged as a modality that addresses many of these limitations and has the potential to alter the treatment paradigm for brain cancer. Ultrasound transmitted through the skull can be focused on tumors and used for targeted ablation or opening the vascular barriers for drug delivery. This review provides insight on the current status of these unique ultrasound techniques, different strategies of using this technique for brain cancer, experience in preclinical models, and potential for clinical translation. We also debate the safety perspective of these techniques and discuss potential avenues for future work in noninvasive planning, monitoring, and evaluation of the ultrasonic neurointervention.

This article addresses the importance of anesthesiologists providing regional anesthesia techniques that are beneficial to the care of trauma patients in the field. It also discusses the advantages and risks associated with regional anesthesia in the field along with how to avoid those risks. In addition, it describes some of the benefits of modern ultrasound techniques compared with landmark techniques with stimulation and other important considerations when performing regional anesthesia in the field. The article gives the unique indications, risks, and key points of the most useful regional techniques for anesthesiologists operating in field environments.

Psoriatic arthritis is a heterogeneous disease characterized by the involvement of the axial skeleton and peripheral joints and / or entheses in the pathological process. The problems of diagnosing early psoriatic arthritis are not limited to the heterogeneity of clinical manifestations of the disease. Unlike rheumatoid arthritis, there are no biomarkers for the detection of early psoriatic arthritis, and therefore verification of the diagnosis depends on the identification of specific clinical signs. Finally, the absence of psoriasis in the presence of typical clinical signs of arthritis does not permit to confirm the diagnosis in the early stages. Considering numerous difficulties of clinical and laboratory diagnostics of psoriatic arthritis, great attention is paid to non-invasive instrumental methods for diagnosing the disease at early stages. The article provides up-to-date information on the potentials of ultrasound techniques in the diagnosis of early psoriatic arthritis.

In recent years, the implementation of contrast-enhanced ultrasound (CEUS) in clinical practice has opened new horizons in the arterial pathologies research field, since this technique is able to supply new sets of data that can be crucial in patient management. The main applications of CEUS in the arterial system are the detection, characterization, and follow-up of carotid plaques and endoleaks after EVAR. Other situations in which CEUS was demonstrated to be a useful tool are large vessel vasculitis, dissections, and untreated aneurysms. In carotid atherosclerosis CEUS is not only able to acquire quantitative data about stenosis but also to perform a qualitative assessment of the plaque. The most important plaque features that CEUS is able to depict are ulceration, neovascularization, and the presence of inflammatory infiltrates. All of these factors contribute to plaque vulnerability. Thus, CEUS is crucial in order to allow better risk stratification and management of patients. In follow-up after EVAR, CEUS shows sensitivity and specificity values similar to CTA while ensuring several advantages, such as lower cost and the absence of ionizing radiation and nephrotoxic agents. Moreover, CEUS is able to offer real-time evaluation of endoleaks and thus is a useful tool in cases that are ambiguous on CTA. Most limitations are patient-related and are the same as in all other ultrasound techniques, such as high BMI and meteorism. In den letzten Jahren hat der Einsatz des kontrastverstarkten Ultraschalls (CEUS) in der klinischen Praxis neue Horizonte auf dem Forschungsgebiet der arteriellen Pathologien eroffnet, da diese Technik neue Datensatze liefern kann, die von entscheidender Bedeutung fur das Patientenmanagement sein konnen. Die Hauptanwendungen von CEUS beim arteriellen System sind Nachweis, Charakterisierung und Verlaufskontrolle von Karotisplaques sowie von Endoleaks nach EVAR. Andere Falle, in denen sich CEUS als nutzliches Instrument erwiesen hat, betreffen die Vaskulitiden groser Gefase, Dissektionen und nicht behandelte Aneurysmen. Bei Arteriosklerose der A. carotis kann CEUS nicht nur quantitative Daten zur Stenose erfassen, sondern auch eine qualitative Beurteilung der Plaque durchfuhren. Die wichtigsten Plaque-Merkmale, die CEUS darstellen kann, sind Ulzeration, Neovaskularisation und das Vorhandensein von entzundlichen Infiltraten. Alle diese Faktoren tragen zur Vulnerabilitat der Plaque bei. Daher ist CEUS von entscheidender Bedeutung, um die Risikostratifizierung und das Management der Patienten zu verbessern. In der Nachsorge nach EVAR zeigt CEUS ahnliche Sensitivitats- und Spezifitatswerte wie die CTA und bietet gleichzeitig mehrere Vorteile, wie z. B. geringere Kosten sowie Verzicht auf Strahlenbelastung und auf nephrotoxische Substanzen. Daruber hinaus ermoglicht CEUS die Echtzeit-Evaluierung von Endoleaks, ein wertvolles Instrument fur Falle, in denen die CTA nicht eindeutig ist. Die meisten Einschrankungen sind patientenbezogen und bei allen anderen Ultraschalltechniken gleich, wie z. B. ein hoher BMI und Meteorismus.

BACKGROUND: Advanced carotid ultrasound techniques may be useful in characterizing plaque vulnerability, but comprehensive studies are still lacking. The aim of this study was to identify factors associated with vulnerable plaques using advanced ultrasound techniques. METHODS: This is a prospective observational study of patients with >50% internal carotid stenosis (ICA). All patients underwent conventional ultrasound, superb microvascular imaging (SMI) and shear wave elastography (SWE) examinations. Plaque size, echogenicity, stiffness and intraplaque neovascularization (IPN) were assessed and compared between symptomatic and asymptomatic groups. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of SWE and SMI of the vulnerable plaques. RESULTS: The final analysis included 123 patients (78.9% male; mean age, 66±8 years), 65 were enrolled in the symptomatic group, and 58 were enrolled in the asymptomatic group. The mean elasticity was 78.1±25.4 kPa for asymptomatic and 51.5±18.3 kPa for symptomatic plaques. Symptomatic plaques showed higher visual IPN grades on SMI than asymptomatic plaques (P

BACKGROUND Fascia blocks (eg, the transversus abdominis plane [TAP] block) target the intermuscular fascia layers. Ultrasound techniques have allowed peripheral blocks to be performed with accuracy and safety, however, with limitations. Optical coherence tomography (OCT) is based on low-coherence interferometry. In this study, we examined the ability of OCT to identify the TAP. METHODS A swept-source OCT probe was placed in a 17-gauge needle to obtain imaging. The needle was inserted within 2 different angle ranges (0°-30° and 30°-60°) on a slice of pork belly to assess imaging characteristics. A series of real-time OCT imaging of the muscle, fascia, and interfascial space was obtained. The tissue location of the needle tip was identified using near-infrared (NIR) imaging. In vivo OCT imaging was further done on 3 female 6-month-old native Chinese Landrance Duroc pigs. Real-time images of tissue layers were obtained with needle insertion. Ultrasound imaging of the OCT needle probe was also performed at the same time for needle trajectory guidance. After imaging, the OCT probe was removed, and 5 mL of normal saline was injected via the needle to confirm correct fascia plane identification. RESULTS In and ex vivo studies showed clear visual distinction of muscle, fascia, and interfascial layer with OCT, with limitations. Independent validation of OCT criteria for the muscle/fascia differentiation by 20 OCT readers for the in vivo data demonstrated the sensitivity = 0.91, specificity = 0.90, and accuracy = 0.89. Although the angle of needle entry affected the depth of OCT penetration in the muscle, the attenuation coefficient values of the fascia and muscle tissue were statistically different (P < .001) and with high area under the receiver operating characteristics (ROC) curve (AUC) (AUC = 0.93 in 0°-30° and AUC = 1 in 30°-60°) for fascia identification. CONCLUSIONS This study introduced a novel needle imaging probe method to identify the transversus abdominis fascia plane in real-time. Quantitative calculation of the attenuation coefficients can further aid objective identification by providing direct confirmation of the tip position, increasing the first-pass success rate, and decreasing the need for needle repositioning. Combining OCT and ultrasound may improve the accuracy of anesthetics placement.

This article is devoted to the problem of toxic impact of prostheses made of acrylic polymers on the tissues of the denture foundation areas and the search for ways to improve the physical and chemical parameters of polymeric base materials. For this purpose a new technique of polymerization of acrylates in the ultrasonic field is proposed. This technique will enable to increase the efficiency of prosthetic restoration for patients with partial and complete anodontia. According to the results of laboratory studies, the bases of removable plate prostheses, manufactured by using ultrasound technology, have 1.5 times higher strength, a 50% lower residual monomer level and a 40% lower water absorption rate. Investigation of the temperature of the mucous membrane can indicate changes in tissue trophism, the severity of pathological changes, and the process of adaptation to the denture. To study the effectiveness of the proposed technique for manufacturing bases of removable plate dentures, the parameters of the temperature of the mucous membrane of the denture foundation areas in the patients during the adaptation to the prostheses and at different periods of their wearing were studied. One month interval of wearing prosthesis, the temperature indices in the patients, whose were manufactured by applying ultrasound remained unchanged. The patients, who worn dentures manufactured by using conventional techniques, had temperature indices typical for inflammatory conditions and impaired thermoregulation. This was confirmed by microbiological research: the high temperature promoted the increase in the number of microorganisms both on the mucous membrane of denture foundation areas and on the denture base. The analysis of the results obtained has shown that wearing dentures with bases manufactured by applying ultrasound technique is characterized by slight inflammation, no impairment of thermoregulation, better process of mucosa self-cleaning. The results of thermometric studies have demonstrated that complete removable plate dentures made by applying polymerization techniques for treating base material have thinner denture base, do not impair the processes of trophic tissues, since they produce less pressure on the substrate tissues; do not deteriorate thermoregulation. All these factors promote better adaptation to denture, reduce negative effects of denture bases on the oral tissues. The analysis of clinical and laboratory findings has shown the best indicators of the functional quality of removable plate dentures manufactures by applying ultrasonic polymerization.

The performance of a lumbar puncture is generally associated with a high rate of success and a favorable risk profile. Nonetheless, the use of ultrasound for procedural guidance has been demonstrated to reduce the rate of failure and the risk of specific complications, especially in patients with difficult surface anatomy. Many individual ultrasound techniques have been described in the literature; this article presents a systematic approach for incorporating these tools into bedside practice and includes a series of illustrative figures and narrated video presentations to demonstrate the techniques described.

Background: Peripheral intravenous access is a common medical procedure, however, it can be difficult to perform in some patients. Success rates have proved greater with ultrasound guidance. Peripheral intravenous access using ultrasound requires specific training, especially for new ultrasound users. To overcome these difficulties, guidance devices on ultrasound probes are able to control the angle of penetration into tissues. We hypothesized that, and particularly for new ultrasound users, the use of a needle guide (NG) paired with the out-of-plane approach would facilitate puncture of a simulation model of vessel more effectively than similar free hand (FH) techniques. Methods: A prospective controlled randomized study was conducted of new ultrasound users using a guide wire introducer needle on gelatine phantom. After a 30-min lecture, one group performed the FH technique and the other group performed the NG technique both in an out-of-plane approach. The main criterion was the number of attempts before success of catheterization of this model of vessel. Results: Thirty-four nurse anesthetist students participated in the study. The number of attempts before success using the NG technique was significantly lower: 3.7 (±0.9) in the NG group versus 6.7 (±3.3) in the FH group ( p = 0.01). In the NG group, 100% of the participants achieved success after the sixth attempt. In the FH group, only 81.25% ( n = 13/16) reached success. Conclusion: NG technique has been proved to have a steeper learning curve compared with the FH technique. A study on a learning curve in clinical practice is needed to confirm these results.

Purpose : To evaluate the possibilities of ultrasound examination with contrast enhancement (CEUS) in assessing the effectiveness of treatment of patients with specific lesions of peripheral lymph nodes with lymphoproliferative lesions. Material and methods : To assess the capabilities of CEUS in assessing the effectiveness of treatment, a study was carried out for 15 patients with lesions of peripheral lymph nodes in lymphoma in dynamics before the treatment and after 2 or 3 courses of chemotherapy using a contrast agent SonoVue® in a volume of 4.8 ml. The results of the study were analyzed and compared with traditional ultrasound techniques. Ultrasound examination was performed using Siemens Acuson S2000 and Philips Affiniti 70 devices with high-frequency linear transducers from 5 to 12 MHz. Results : CEUS revealed a significant increase in the TTP parameter from 27 ± 12 s to 36 ± 13 s ( p = 0.0496) and a significant decrease in the PI parameter from 9 ± 5 dB to 4 ± 3dB ( p = 0.00047). Conclusions : CEUS at any stage of the treatment seems to be promising since it allows diagnosing of structural changes in the affected lymph nodes even after one cycle of chemotherapy.

The article presents the literature review of modern approaches in the diagnosis and treatment of squamous cell cancer of the oropharyngeal region and larynx. Various views on the treatment of patients with oropharyngeal tumors are presented. Special attention is paid to the ultrasound examination of patients with laryngeal tumors and to the possibilities of ultrasound in assessing the integrity of the laryngeal cartilage. Various ultrasound techniques for assessing the thickness and depth of invasion of oral tumors are highlighted. The features of regional anatomy that affect the informative value of visualization techniques are discussed. In the article presents criteria for assessing the prevalence of the tumor process in the adjacent organs and tissues, metastasis in regional lymph nodes.

The primary technique for detecting the presence and monitoring the development of carotid atherosclerotic plaque is ultrasound. The development of ultrasound techniques has made it possible to precisely visualise not only blood flow, but also vessel walls, including atherosclerotic plaque. Contrast-enhanced ultrasound examination enables one to make an objective observation of atherosclerotic plaque neovascularisation, clearly indicating active inflammation, which is an inherent feature of vulnerable (unstable) plaque. Depending on the examination method used, it is possible to precisely visualise different components of the plaque and its behaviour during blood flow through the vessel lumen or through the neovessels of the plaque, and, consequently, determine the possible presence of inflammation, which is a defining feature of plaque stability. The full utilisation of physical phenomena that underlie contrast-enhanced ultrasound will bring further enormous progress of diagnostic and probably also therapeutic methods for carotid atherosclerosis. The selection of the right examination method significantly accelerates diagnosis and adequate classification of plaque, and makes it possible to monitor the progression of atherosclerosis. However, one needs to bear in mind that ultrasound remains a very subjective method. The success of contrast-enhanced ultrasound also depends on the skills and experience of the examiner. Current attempts at increasing the objectivity of contrast-enhanced ultrasound examination using artificial intelligence will make it possible in the future to make a definitive evaluation of atherosclerotic plaque stability. This will allow one to assess the risk of ischaemic stroke adequately.

The plane of maximum curvature (PMC), end-apical-end vertebrae plane (EAEP), and best-fit plane (BFP) have been used to describe the three-dimensional (3D) features of scoliosis but no thorough analyses were conducted. This study aimed to systematically review these descriptors about their potential differences, measurement techniques, and applications in scoliosis. Articles were retrieved from six databases and Google Scholar search engine using the keywords “maximum spinal deformity” and “scoliosis” combined with “And”. BFP was found superior to EAEP and PMC in describing the 3D features of scoliosis; however, whether this advantage changes when BFP or EAEP orientation is simplified remains unknown. With the development of 3D reconstruction technique, radiographs and ultrasound images can be used to estimate maximum spinal deformity. The three descriptors have been applied in 3D assessment, progression monitoring, and classification of scoliosis, as well as evaluation of orthotic and surgical treatments but are rarely considered in major clinical decision-making. More evidence is needed to support the superiority of PMC and simplified EAE and BFP, the accuracy of radiographic and ultrasound techniques, and the application of these descriptors to clinical decision-making. Further studies are deserved.

To determine the feasibility of training otolaryngologists to perform head and neck ultrasound in low- and middle-income countries over a short timeframe.Prospective cohort evaluating an ultrasound training course for otolaryngologists in low- and middle-income countries.Surgical training camp for otolaryngologists in semirural Kenya.Participants were prospectively recruited to participate in an ultrasound training course during a 2-week surgical training camp. They performed baseline ultrasound exams (9-item test, 5-point scale) with no assistance, followed by didactic sessions teaching ultrasound techniques. Participating surgeons then performed head and neck ultrasound exams on patients in clinic or in the operating room with direct supervision. Postcourse ultrasounds were performed, and the results of these tests were compared to baseline exams.Eight surgeons were enrolled out of a total of 13 (62%). Three were attending surgeons (37.5%), 1 enrollee was a head and neck surgery fellow, and 4 were senior residents (50%). Six of 8 surgeons were from Kenya. The mean precourse test score was 25 (range 21-30) compared to a mean postcourse test score of 40 (range 37-45, p0.005). All participants significantly improved their scores, with a mean improvement of 16 points (range 10-23).Otolaryngologists are uniquely equipped to learn head and neck ultrasound given their familiarity with the anatomy and pathology in this region. Training physicians without prior experience can be done even over short timeframes. Early training should focus on ultrasound, with later stages of training focusing on pathology.

Clinical value of color Doppler ultrasound and two-dimensional ultrasound in the diagnosis of ovarian sex cord-stromal tumors (OSCSTs) were explored. A total of 91 patients with positive OSCSTs admitted to Sichuan Provincial Hospital for Women and Children from May 2014 to June 2018 were selected as research objects. There were 48 patients diagnosed by color Doppler ultrasound technology as the color Doppler group and 43 patients diagnosed by two-dimensional ultrasound technology as the two-dimensional ultrasound group. Results of ultrasound images in the two groups were compared, and the diagnostic value of two ultrasound techniques combined with detection of CA125 and CA199 for OSCSTs was compared. The real internal echo of color Doppler ultrasound was significantly higher than that of two-dimensional ultrasound (P

The regeneration of diclofenac saturated activated carbon was studied and compared by thermal, solvent and ultrasound techniques in this work. Thermal regeneration was performed at 673 K in atmospheric air for one hour. Different proportions of solvents (ethanol, ethyl acetate and H

Arterial catheterization is frequently performed in ICUs to facilitate hemodynamic monitoring and frequent blood sampling. Overall, arterial catheterization has high success and low complication rates, but in patients who are critically ill, the incidence of failure is higher because of hypotension, peripheral edema, and obesity. Ultrasound guidance significantly increases the likelihood of successful cannulation and decreases complications compared with traditional landmark-based techniques. Multiple ultrasound techniques for radial and femoral arterial catheter insertion have been described; this paper presents an approach for incorporating these tools into bedside practice, including illustrative figures and narrated video presentations to demonstrate the techniques described.

Ultrasonography (US) has the overwhelming advantages of not entailing radiation exposure and being a noninvasive, real-time, convenient, easy-to-perform, and relatively inexpensive imaging modality. It is used as the first-line imaging modality for screening, detection, and diagnosis of focal liver lesions (FLLs) [small hepatocellular carcinomas (HCCs), in particular]. However, with the increasing demand for accurate and early diagnosis of small HCCs, newer radiologic methods need to be explored to overcome certain limitations of US. For example, the imaging is easily negatively affected by the presence of gas, rib cage, and subcutaneous fat, and is insensitive for capturing the subtle but vital information on the blood flow. It was in response to this need that new promising technologies such as contrast-enhanced ultrasound and fusion imaging were introduced for the detection of liver lesions. This paper presents an overview of the epidemiology and mechanisms of the development of HCCs, with an emphasis on the application of US in the diagnosis and treatment of FLLs. The aim of this article is to provide the state-of-the-art developments in the imaging diagnosis of FLLs and evaluation of ablation treatment of early HCCs. By keeping abreast of these recent advances, we hope that doctors and researchers working in the field of diagnosis/treatment of liver diseases will be able to discriminate benign FLLs such as regenerative nodules and focal nodular hyperplasia from HCCs, so as to avoid unnecessary repeated tumor biopsies and overtreatment. In particular, we expect that small HCCs or precancerous nodules (such as dysplastic nodules) can be accurately diagnosed and appropriately treated even at an early stage.

Ultrasonography is the imaging technology of choice for the evaluation of the reproduction system and of pregnancy in both humans and animals. Over the past 10 years, there have been significant technological improvements of the equipment, while new technologies have been developed. Doppler, contrast-enhanced ultrasonography, elastography, and 3D/4D ultrasonography are advanced ultrasound techniques that have been designed as methods to increase the diagnostic sensitivity of two-dimensional (b-mode) ultrasound, and not as stand-alone tests. The basic physics as well as the advantages and limitations of these advanced ultrasound methods are briefly described. In the reproductive diagnostics of small animals, these techniques have gained an increased popularity as proved by the increased publication of several reports that are also briefly summarized in this review. Clinical applicability is to date limited because of a lack of research on the diagnostic value in concrete situations. Future research projects should focus also on standardization of the used techniques, on determination of thresholds to discriminate between healthy or diseases or fertile versus infertile and on the predictive value of advanced ultrasound findings. Continuing development and optimization of different ultrasound techniques as well as the increase of related scientific interest and worldwide research promises that the clinical interest on the use of advanced ultrasound techniques will increase in future.

Aim Current major guidelines recommend risk stratification of the thyroid nodules, after each diagnostic evaluation, in order to focus attention on potentially risky nodules. The main aim of our study was to evaluate the performance of combined advanced ultrasound techniques in this process, compared with conventional stratification models, in order to reduce unnecessary fine-needle biopsies, respectively, surgery. Material and methods We evaluated 261 cases (261 nodules) using conventional ultrasound (2B), real-time Doppler evaluation (4D) respectively, real-time elastography, using a linear multifrequency probe and a linear volumetric probe (Hitachi Prerius Machine, Hitachi Inc, Japan). All the nodules were classified using a risk stratification model comprising seven conventional US characteristics, two 4 D characteristics and a color map RTE aspect. The results were compared with the pathology results, considered the golden standard diagnosis. Results The prevalence of malignant nodules was 21.83% (57 cases). Conventional risk classification generated: 106 low-risk cases, 113 intermediate-risk and 42 high-risk cases. Our proposed risk classification changes the conventional risk classification with a risk upgrade in 27 cases and with a risk downgrade in 69 cases. The diagnostic quality of the combined risk stratification model was better, considering a low-risk category predictive for benignancy and a high category predictive for malignancy: Sensitivity: 80.88% versus 49.01%, respectively, Specificity: 91.22% versus 54.38. The diagnostic power differences were observed regardless of the nodule size. Conclusion Advanced ultrasound techniques did add diagnostic value in the presurgical risk assessment of the thyroid nodules.

BACKGROUND: The use of peripheral venous catheters is hampered by short dwell time and central venous catheters are often preferred for medium- to long-time intravenous treatment. Ultrasound techniques allow for easy catheter insertion into the major veins of the upper arm. A new generation of midline catheters, Powerglide Pro, utilises a one-hand Seldinger technique and can be inserted by one single operator without assistance. This study aimed to evaluate the clinical performance of the Powerglide Pro midline catheter.METHODS: Consecutively inserted midline catheters were followed in a prospective, observational quality control study. Endpoints were dwell time, the incidence of premature catheter removal, causes of catheter removal and the dwell time and incidence rates of predefined subgroups representing potential effect modifiers.RESULTS: 100 midline catheters, of which 98 were accessible to follow-up, were inserted in 70 patients. Median dwell time was eight days and 60 catheters were removed before the indication for intravenous therapy had ceased. The overall incidence for premature catheter removal was 71.8/1000 days and no significant effects of subgroups (sex, body mass index, catheter reinsertions, significant comorbidity, anticoagulant therapy, irritant infusions) were identified for either dwell time or the incidence rate for premature midline catheter removal. The most frequent reasons for premature catheter removal were pain during infusion, clotted catheter or signs of infection.CONCLUSION: The median dwell time of the midline catheters was 8 days with substantial variation whereas the incidence for premature catheter removal was 71.8/1000 catheter days. The majority of midline catheters were removed prematurely.

This work was aimed to investigate the concept of the valorization of apple processing by-products to produce a new preservation system based on apple pomace gels to encourage the viability of antimicrobial Lactobacillus strains. A high frequency (850 kHz) low power (1.3 W/cm2) ultrasound-stimulated cavitation was used for the structure modulating of gels under low-temperature (50 ℃) conditions. Medium esterified apple pectin was added to apple pomace to improve its texture properties and stability. The monitoring of the process of gelation was performed by using acoustic technique and method, based on the measurement of the distance (parameter h, mm) traveled by a free-falling module. The obtained data were then compared to gel texture measurements. The results suggest that low power ultrasound leads to a reduced jelly mass stickiness and increased gel hardness, compared to the thermally treated sample. The immobilization of probiotic cells in low pectin apple pomace gels did not sufficiently protect the microorganisms. The higher viability of immobilized Lactobacillus paracasei (54–77%) compared to L. plantarum (43–59%) was recorded after incubation at acidic conditions (pH 2.0). The most suitable system for preserving bacterial cells during storage can be the apple pomace–pectin gel containing up to 53% pectin as a stabilizer retaining 84% of viable cells after one-month storage at 4 ℃. The apple pomace–pectin hydrogels with gelation rate ( dh/ dt) of 0.03–0.05 mm/s can be used for the preservation of bacterial cells as a suitable functional ingredient for food.

This paper presents a condition monitoring technique for the identification and correction of faults in reciprocating machines by recording engine vibration signals arising from different processes. The proposed data acquisition set-up allows the analyst to record vibration signals from different locations, analyse them and make the appropriate decisions regarding predictive maintenance. Data are recorded before and after carrying out major overhauling to assess the effectiveness of the proposed condition monitoring technique. For a complete health assessment, vibration signals and ultrasonic signature with respect to the crank angle are recorded and interpreted. All of the data are obtained at constant engine speed to depict the mechanical condition of the components and indicate any poor performance. A scuffed main bearing and a broken piston ring are diagnosed successfully. Suspected components are replaced based upon the findings of the initial analysis and data are recorded again to verify the results. Post-evaluation data confirm a normal mechanical condition and satisfactory performance except for some initial friction. The main objective of this experimentation is the identification of major tasks related to maintenance prior to major overhauling. This work shows that the use of non-intrusive condition monitoring techniques can reduce the frequency of failures by identifying developing faults.

Grayscale ultrasound (US) is decisive in stratifying which thyroid nodules benefit from fine-needle aspiration to evaluate for malignancy. Unfortunately, a significant percentage of nodules remain indeterminate.Herein, we review the clinical considerations and diagnostic accuracy of advanced US, Doppler US, contrast-enhanced US, and US elastography techniques in the evaluation of indeterminate nodules.We conclude that these techniques may be used in combination with grayscale US to improve the assessment of lesion vascularity and tissue property.

The use of ultrasound techniques has brought additional surgical knowledge to increase the accuracy and effectiveness of peripheral nerve stimulation in the treatment of chronic pain syndromes. In this chapter, we will describe some basic aspects of peripheral nerve stimulation in the treatment of pain: history, indications, and device possibilities.

The use of ultrasound techniques has brought additional surgical knowledge to increase the accuracy and effectiveness of peripheral nerve stimulation in the treatment of chronic painful syndromes. In this chapter we will describe the use of ultrasound techniques for peripheral nerve stimulation in the upper body segment.

The use of ultrasound techniques has brought additional surgical knowledge to increase the accuracy and effectiveness of peripheral nerve stimulation in the treatment of chronic painful syndromes. In this chapter we will describe the use of ultrasound techniques for peripheral nerve stimulation in the trunk/pelvis segment.

The use of ultrasound techniques has brought additional surgical knowledge to increase the accuracy and effectiveness of peripheral nerve stimulation in the treatment of chronic painful syndromes. In this chapter we will describe the use of ultrasound techniques for peripheral nerve stimulation in the lower body segment.

Ultrasound plays a vital role in the evaluation of patients with chronic liver disease and in hepatocellular carcinoma (HCC) surveillance in populations at risk for developing HCC. Semiannual ultrasound for HCC surveillance is universally recommended by all liver societies around the world. Advanced ultrasound techniques, such as elastography and contrast-enhanced ultrasound, offer additional benefits in imaging evaluation of chronic liver disease. Major benefits of ultrasound include its high safety profile and relatively low cost.

1.1 Statement of the Problem Endo-neuro-sonography (ENS) has gained special attention in recent years. Its major advantages over traditional brain surgery are that it is a minimally invasive surgical technique and the endoscopic camera and ultrasound images provide useful information. Ultrasound images are inexpensive compared to tomographic and resonance magnetic images (which are very hard to obtain in an intraoperative setting) and allow surgeons to see beyond the tissues within the brain. Another way would be to extract three-dimensional (3D) information from the combined endoscopic and ultrasound images to help surgeons better locate brain structures (such as tumors). Some work has been done in this direction, mainly in the replacement of classic ultrasound (2D imaging methodology) by 3D ultrasound equipment (Unsgaard et al., 2006). We have focused our attention on using classic ultrasound techniques and endoscopic images to extract 3D information. We propose tracking the ultrasound probe in the endoscopic images and then computing the ultrasound probe’s pose in 3D space without an external method (optical or magnetic). We tested two alternative methods to track the ultrasound probe in endoscopic camera images as well as two methods to segment brain structures in ultrasound images, and then we compared the latter two types. We used conformal geometric algebra for the necessary geometric calculations and to put the results in 3D space.

The widespread use of ultrasound techniques throughout industry causes many workers to be exposed to airborne ultrasound at their workplaces. To measure and assess the exposure to airborne ultrasound at these workplaces, devices are required that allow reliable measurements of ultrasound levels and support occupational safety and health measures. However, the sound level meters available to date do not meet these requirements. Therefore, a research prototype of a sound level meter covering audible and ultrasonic frequencies was developed, paying particular attention to the suitability of the components in terms of their acoustical characteristics (such as directional patterns) in the ultrasonic frequency range. The prototype was tested based on the international standard for sound level meters IEC 61672-1, with extensions regarding the signal frequencies used. The results revealed that the sound level meter developed is suitable for application at most workplaces exposed to ultrasound, as reflected by, e.g., its frequency range (at least up to 47 kHz), upper level limits (up to 160 dB SPL), and measurement uncertainty (k = 2, GUM) of 1.15 dB. The prototype developed allows measurement and assessment of exposure at workplaces for occupational safety and health purposes. Moreover, it can serve as a basis for future developments of commercial ultrasound level meters.

We present a method to investigate the bulk propagation of a shock wave in a thick, opaque metallic plate. The shock wave is generated by laser-loading. An elastic plane probe wave, contra-propagative with respect to the shock, is emitted by means of a phase-array device. Shock propagation monitoring is performed by analyzing on the phase-array detection the acoustic elastic plane wave after its interaction with the shock. The time-space detection of the probe wave allows to evaluate the spatial distribution of the shock wave all along its propagation in the opaque structure, from near to far field. Applications range from fundamental wave science to laser-loading material science.