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Study for imaging of inside bone using ultrasound
Abstracts plex-ultrasound (US) has been proposed as a non-invasive method, but reports have yielded inconsistent results. This study was aimed at developing duplex US score to assess TIPS dysfunction to save hemodynamic studies in these patients. Methods: We studied retrospectively 117 follow-up simultaneous duplex US and hemodynamic evaluations in 34 patients who underwent TIPS for variceal bleeding over a period of 3 years. TIPS dysfunction was defined as a PPG ⬎12 mmHg. The mean portal blood flow velocity (PFV), mean intrastent velocity, intrahepatic portal flow direction (FD), and presence of ascites were evaluated using duplex US. A predictive model was obtained with stepwise logistic regression analysis, and risk score cut-off values with a minimum sensitivity of 90% were selected from ROC curves. The model was then validated in an independent prospective sample of 64 paired duplex US/hemodynamic evaluations in 35 patients. Sensitivity and specificity in this sample, as well as the number of routine hemodynamic studies that could be saved using the duplex US criteria developed, were investigated. Results: TIPS dysfunction was diagnosed in 57 of the 117 studies in the retrospective study. Patients with TIPS dysfunction had lower PFV and more frequent hepatopedal flow than patients with patent TIPS (22 ⫾ 6 cm*s⫺1 vs 30 ⫾ 13 cm*s⫺1 and 46% vs 13%, respectively; both p⬍0.001). At multivariate analysis, both parameters were independent predictors of TIPS dysfunction. According to the regression equation, when flow is hepatopedal, a PFV⬍39 cm*s⫺1 indicates TIPS dysfunction, and if flow is hepatofugal, a PFV⬍28 cm*s⫺1 indicates dysfunction. When applied to the validation sample, this cut-off yielded a 82% sensitivity and 55% specificity for detecting TIPS dysfunction. Forty-five percent of the hemodynamic studies could have been saved by using this cut-off. Conclusions: Combination of portal vein velocity and intrahepatic portal flow direction has a very high sensitivity to detect TIPS dysfunction, and nearly half of routine hemodynamic studies may be saved by using this duplex US criteria.
32550 Spontaneous detorsion of appendix epididymis torsion during scrotal sonography: A case report Park S,*1 Lee H,1 Hong H,1 Joh J,1 Cha J,1 Kim H,1 Kim M,2 1. Radiology, Soonchunhyang University Bucheon Hospital, Bucheonshi, Gyeonggi-do, South Korea, and 2. Urology, Soonchunhyang University Bucheon Hospital, Bucheon-si, Gyeonggi-do, South Korea Description of case(s): A 13-year-old boy was visited with a 6-hour history of painful scrotal swelling. Physical examination revealed tender swelling on the left scrotal wall. At scrotal ultrasonography, an avascular mass corresponding to the appedix was evident. About 10 minutes delayed ultrasonography showed vascular flow in the previously avascular mass on initial ultrasonography and communicating vessels between the appendix epididymis and the epididymal head. Simultaneously, scrotal pain was completely relieved. We report one case of torsion of the appendix epididymis with spontaneous detorsion during scrotal ultrasonography. Proof of diagnosis: We described color Doppler findings and clinical improvement of the scrotal pain. Relevance: Torsion of the appendix epididymis is a rare entity representing acute scrotal pain. When torsion is acute, the appendix is increased in size, with increased or decreased echotexture. At Doppler ultrasonography, an avascular mass corresponding to the appendix is evident. Although the duration of symptoms from torsion of the appendix testis or epididymis may be shortened by operation, the torsion of the appendix is self-limited and surgery unnecessary, unlike in cases of spermatic cord torsion.
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32551 Study for imaging of inside bone using ultrasound Irie T,*1 Ohdaira E,2 Itoh K,3 1. R and D, Microsonic Co., Ltd., Tokyo, Japan, 2. Electronics and Communication Engineering, Musashi Institute of Technology, Tokyo, Japan, and 3. Clinical Laboratory Medicine, Jichi Medical School, Tochigi, Japan Objective: Society is aging at an ever-increasing pace. Osteoporosis, bone tumors, and other forms of bone morbidity increase with advancing age. X-rays and MRI have been used for diagnosis based on images of the internal structure of bones. However, both have drawbacks: X-ray imaging is invasive and MRI is expensive. On the other hand, ultrasonic imaging is non-invasive, easy to use, and inexpensive. We have measured the attenuation of ultrasound in animal bone in vitro, and determined successfully the correct dynamic range for the detection of echo signals from inside the bone. It was possible to display the B-mode image of sample bones using a high-frequency transducer (5 MHz). In this study, we report the improvement in sensitivity for the detection of echoes from inside the bone using the FM-chirp pulse compression technique. Methods: An ultrasonic wave generator that generates FM-chirp waves from 100 KHz to 5 MHz was fabricated. Results: Still more detailed information could be obtained by analyzing the frequency spectrum of signals (resonance waves and elastic waves, etc.) from sample bone (pig bone). Conclusions: It is suggested that this is useful for improving the ultrasonic image of inside the bone. 32553 The prevalence of the gallbladder stone and its associated ultrasound findings in an HCV/HBV endemic community Yu M,*2 Dai C,1 Lee L,1 Hsieh M,1 Hou N,2 Chen S,1 Lin Z,1 Hsieh M,1 Wang L,1 Chuang W,1 Chang W,1 1. Internal Medicine, HsioKung Municipal Hospital, Kaohsiung, Taiwan, and 2. Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan Objective: The aim of this study was to investigate prevalence of the gallbladder stone and its associated ultrasound (US) findings in a hepatitis C virus (HCV) and hepatitis B virus (HBV) endemic community in southern Taiwan. Methods: Tzu-Kuan village is a HCV/HBV endemic community located in southern Taiwan. In 2000, a total of 944 residents (M/F: 434/510, mean age of 42.6⫾23.0 years) participated in our screening project. They were examined by abdominal US and checked for serum alanine aminotransferase (ALT), HBsAg, and anti-HCV. Results: Of 944 patients, 181 (19.2%) and 316 (33.5%) residents were positive for HBsAg and anti-HCV, respectively. The US finding showed the prevalence of the GB stone, hepatic cyst, GB polyp, fatty liver, and intrahepatic calcified lesions (intrahepatic bile ducts stone or intrahepatic calcification) were 3.3%, 3.6%, 5.1%, 44.2%, and 7.6%, respectively. By univariate analysis, chronic HCV infection was associated with older age (p⬍0.001), higher prevalence of GB stone (p⬍0.005), and hepatic cyst (p⬍0.005). By using multivariate analyses, presence of GB stone and the age were significant factors associated with positive anti-HCV (odds ratio/95% confidence interval: 2.557/ 1.026 – 6.371 and 1.063/1.052–1.074). The mean age was significantly higher among residents with the GB stone than those without GB stone (p⬍0.01). The GB stone was more frequently found among residents who were, in addition to positive for anti-HCV, with the intrahepatic calcified lesions than those without intrahepatic calcified lesions (p⬍0.0001) and with the GB polyp than without GB polyp (p⬍0.01). No significant association between GBS and sex, positivity for HBsAg, FL, or mean ALT levels was found. By using multivariate analyses,
32550 Spontaneous detorsion of appendix epididymis torsion during scrotal sonography: A case report Park S,*1 Lee H,1 Hong H,1 Joh J,1 Cha J,1 Kim H,1 Kim M,2 1. Radiology, Soonchunhyang University Bucheon Hospital, Bucheonshi, Gyeonggi-do, South Korea, and 2. Urology, Soonchunhyang University Bucheon Hospital, Bucheon-si, Gyeonggi-do, South Korea Description of case(s): A 13-year-old boy was visited with a 6-hour history of painful scrotal swelling. Physical examination revealed tender swelling on the left scrotal wall. At scrotal ultrasonography, an avascular mass corresponding to the appedix was evident. About 10 minutes delayed ultrasonography showed vascular flow in the previously avascular mass on initial ultrasonography and communicating vessels between the appendix epididymis and the epididymal head. Simultaneously, scrotal pain was completely relieved. We report one case of torsion of the appendix epididymis with spontaneous detorsion during scrotal ultrasonography. Proof of diagnosis: We described color Doppler findings and clinical improvement of the scrotal pain. Relevance: Torsion of the appendix epididymis is a rare entity representing acute scrotal pain. When torsion is acute, the appendix is increased in size, with increased or decreased echotexture. At Doppler ultrasonography, an avascular mass corresponding to the appendix is evident. Although the duration of symptoms from torsion of the appendix testis or epididymis may be shortened by operation, the torsion of the appendix is self-limited and surgery unnecessary, unlike in cases of spermatic cord torsion.
S191
32551 Study for imaging of inside bone using ultrasound Irie T,*1 Ohdaira E,2 Itoh K,3 1. R and D, Microsonic Co., Ltd., Tokyo, Japan, 2. Electronics and Communication Engineering, Musashi Institute of Technology, Tokyo, Japan, and 3. Clinical Laboratory Medicine, Jichi Medical School, Tochigi, Japan Objective: Society is aging at an ever-increasing pace. Osteoporosis, bone tumors, and other forms of bone morbidity increase with advancing age. X-rays and MRI have been used for diagnosis based on images of the internal structure of bones. However, both have drawbacks: X-ray imaging is invasive and MRI is expensive. On the other hand, ultrasonic imaging is non-invasive, easy to use, and inexpensive. We have measured the attenuation of ultrasound in animal bone in vitro, and determined successfully the correct dynamic range for the detection of echo signals from inside the bone. It was possible to display the B-mode image of sample bones using a high-frequency transducer (5 MHz). In this study, we report the improvement in sensitivity for the detection of echoes from inside the bone using the FM-chirp pulse compression technique. Methods: An ultrasonic wave generator that generates FM-chirp waves from 100 KHz to 5 MHz was fabricated. Results: Still more detailed information could be obtained by analyzing the frequency spectrum of signals (resonance waves and elastic waves, etc.) from sample bone (pig bone). Conclusions: It is suggested that this is useful for improving the ultrasonic image of inside the bone. 32553 The prevalence of the gallbladder stone and its associated ultrasound findings in an HCV/HBV endemic community Yu M,*2 Dai C,1 Lee L,1 Hsieh M,1 Hou N,2 Chen S,1 Lin Z,1 Hsieh M,1 Wang L,1 Chuang W,1 Chang W,1 1. Internal Medicine, HsioKung Municipal Hospital, Kaohsiung, Taiwan, and 2. Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan Objective: The aim of this study was to investigate prevalence of the gallbladder stone and its associated ultrasound (US) findings in a hepatitis C virus (HCV) and hepatitis B virus (HBV) endemic community in southern Taiwan. Methods: Tzu-Kuan village is a HCV/HBV endemic community located in southern Taiwan. In 2000, a total of 944 residents (M/F: 434/510, mean age of 42.6⫾23.0 years) participated in our screening project. They were examined by abdominal US and checked for serum alanine aminotransferase (ALT), HBsAg, and anti-HCV. Results: Of 944 patients, 181 (19.2%) and 316 (33.5%) residents were positive for HBsAg and anti-HCV, respectively. The US finding showed the prevalence of the GB stone, hepatic cyst, GB polyp, fatty liver, and intrahepatic calcified lesions (intrahepatic bile ducts stone or intrahepatic calcification) were 3.3%, 3.6%, 5.1%, 44.2%, and 7.6%, respectively. By univariate analysis, chronic HCV infection was associated with older age (p⬍0.001), higher prevalence of GB stone (p⬍0.005), and hepatic cyst (p⬍0.005). By using multivariate analyses, presence of GB stone and the age were significant factors associated with positive anti-HCV (odds ratio/95% confidence interval: 2.557/ 1.026 – 6.371 and 1.063/1.052–1.074). The mean age was significantly higher among residents with the GB stone than those without GB stone (p⬍0.01). The GB stone was more frequently found among residents who were, in addition to positive for anti-HCV, with the intrahepatic calcified lesions than those without intrahepatic calcified lesions (p⬍0.0001) and with the GB polyp than without GB polyp (p⬍0.01). No significant association between GBS and sex, positivity for HBsAg, FL, or mean ALT levels was found. By using multivariate analyses,