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0687: Live Sanning Workshop: Advanced Shoulder
S96
Ultrasound in Medicine and Biology
Volume 35, Number 8S, 2009
Fisher‘s exact test between the basal phenotype and non-basal phenotype of breast cancers. Results: There were twenty-seven (40%) of basal phenotype; CK5 or 6 positive, and 41(60%) of non-basal phenotype of breast cancer. The non-basal phenotype (35/41, 85%) were statistically significant with calcification compared to basal phenotype (17/27, 63%) on US. On mammography, the non-basal phenotype were significantly seen as a round shape mass (15/33[60%], p⬍0.05) or a spiculated mass (12/ 33[48%],p⬍0.05). There was no other characteristic imaging features between the basal phenotype and non-basal phenotype. Conclusion: The CK 5 or 6 positive basal phenotype of breast cancers showed less calcification on ultrasound and the non-basal phenotype of breast cancer were seen as a round or spiculated mass on mammography, compared with basal phenotype of breast cancers.
䡠 Competence Characteristics of venous thrombus 䡠 Partial or total incompressibility 䡠 Venous distension (acute) 䡠 Visualisation of thrombus 䡠 Abnormal spectral waveforms 䡠 Poor/absent colour filling Conclusion: Improvement in diagnosis and treatment of DVT depends on early, accurate diagnosis, recognition of risk factors and appropriate treatment. It is important for sonographers to have a good working knowledge of lower extremity venous anatomy and anatomical variations. Knowledge of risk factors, clinical implications, differential diagnosis, limitations and pitfalls of the study are also essential.
0687
0690
Live Sanning Workshop: Advanced Shoulder Chris Sykes, Mercy Private Hospital, Australia
Live Scanning Workshop: Scanning the Large Breast Lousie Smalley, Sydney Breast Clinic, Australia
Shoulder ultrasound is one of the most commonly performed musculoskeletal ultrasound examinations. In the appropriate setting, sonography of the shoulder is a reliable test that allows accurate, dynamic assessment of the rotator cuff. Individuals familiar with sonography of the shoulder should be familiar with the concepts of image acquisition and basic anatomy. It is important however that individuals strive to build on this knowledge and develop an understanding of the complexities of rotator cuff anatomy and pathology. Recent advances in ultrasound technology have provided an enhanced ability to identify structures in the rotator cuff that have previously been difficult to demonstrate sonographically. The ability to recognise normal anatomy is important to ensure that normal appearances are not misinterpreted as pathology. This workshop will discuss anatomic concepts regarding the rotator cuff and will concentrate on the practical scanning skills necessary to demonstrate the complexity of rotator cuff anatomy.
Your work in breast ultrasound will be primarily to investigate clinical findings or to localise and investigate a mammographic density. This task can be more difficult in the larger breast as there are additional limitations and pitfalls due to body habitus and breast density. This workshop is designed to demonstrate the strategies to systematically scan the larger breast to ensure appropriate clinical and mammographic correlation. There will also be the opportunity to discuss methods that can be employed to avoid the pitfalls and address the limitations of breast ultrasound in this type of patient.
0689 Live Scanning Workshop: Deep Vein Thrombosis Virginia Makeham, Royal Prince Alfred Hospital, Australia Introduction: Deep venous thrombosis (DVT) and its primary sequela, pulmonary embolism (PE) is associated with significant morbidity and mortality. The long- term sequelae of DVT may cause venous insufficiency. Purpose: The diagnosis of DVT based solely on clinical signs and symptoms is difficult and unreliable. Duplex imaging is the examination of choice of the lower extremity veins, and is performed to assess the deep and superficial venous system to detect or exclude the presence of venous thrombosis. Indications for Duplex 䡠 Symptomatic lower limb/s 䡠 Asymptomatic lower limbs with symptoms of PE 䡠 Asymptomatic lower limbs with risk factors 䡠 Surveillance of high risk patients 䡠 Surveillance of post thrombotic episode Duplex and Diagnostic Criteria Evaluation of the lower limb venous system utilises a combination of B Mode, spectral waveform analysis and colour. Characteristics of normal veins 䡠 Compressibility 䡠 Spontaneous flow 䡠 Phasic flow 䡠 Augmentable flow
0691 Imaging of Non-Obstetric Pain in the Pregnant Patient John McGahan, Davis Medical Centre, United States Some of the etiologies of pain in the pregnant patient includes trauma, pyelonephritis/ obstruction, appendicitis, cholecystitis, pancreatitis, and bowel obstruction. While CT is probably the best modality for diagnosing a number of these etiologies, CT uses ionizing radiation which has increase risk of malignancy and leukemia for both the mother and especially the unborn fetus. As such, other modalities such as Ultrasound and MRI have been advocated as safer methods of evaluation of the pregnant patient with abdominal pain. Ultrasound is often utilized as the first modality for evaluating a number of these entities such as acute cholecystitis, renal obstruction, and to a lesser extent trauma and appendicitis. MRI has also been show to very useful in diagnosing appendicitis as well as bowel obstruction in the pregnant patients. In instances where neither ultrasound nor MRI have been shown to be useful then CT, focused to area of interest, may be helpful in obtaining a precise diagnosis. This presentation will review different entities that may cause pain in the pregnant patient as well as the modality that is most useful in obtaining a correct diagnosis. 0692 Grey Scale & Colour Doppler Findings in Mesenteric Ischemia Nitin Chaubal, Jaslok Hospital, India Mesenteric Ischemia, because of its varied clinical presentations is most often difficult to diagnose. In many advanced countries, CT scan with contrast is “the” investigation for patients with acute abdomen. However, in majority of countries even today ultrasound is the first imaging modality in any patient presenting with acute abdomen. An alert sonologist can potentially think of mesenteric ischemia by observing several signs on grey scale and colour Doppler.
Ultrasound in Medicine and Biology
Volume 35, Number 8S, 2009
Fisher‘s exact test between the basal phenotype and non-basal phenotype of breast cancers. Results: There were twenty-seven (40%) of basal phenotype; CK5 or 6 positive, and 41(60%) of non-basal phenotype of breast cancer. The non-basal phenotype (35/41, 85%) were statistically significant with calcification compared to basal phenotype (17/27, 63%) on US. On mammography, the non-basal phenotype were significantly seen as a round shape mass (15/33[60%], p⬍0.05) or a spiculated mass (12/ 33[48%],p⬍0.05). There was no other characteristic imaging features between the basal phenotype and non-basal phenotype. Conclusion: The CK 5 or 6 positive basal phenotype of breast cancers showed less calcification on ultrasound and the non-basal phenotype of breast cancer were seen as a round or spiculated mass on mammography, compared with basal phenotype of breast cancers.
䡠 Competence Characteristics of venous thrombus 䡠 Partial or total incompressibility 䡠 Venous distension (acute) 䡠 Visualisation of thrombus 䡠 Abnormal spectral waveforms 䡠 Poor/absent colour filling Conclusion: Improvement in diagnosis and treatment of DVT depends on early, accurate diagnosis, recognition of risk factors and appropriate treatment. It is important for sonographers to have a good working knowledge of lower extremity venous anatomy and anatomical variations. Knowledge of risk factors, clinical implications, differential diagnosis, limitations and pitfalls of the study are also essential.
0687
0690
Live Sanning Workshop: Advanced Shoulder Chris Sykes, Mercy Private Hospital, Australia
Live Scanning Workshop: Scanning the Large Breast Lousie Smalley, Sydney Breast Clinic, Australia
Shoulder ultrasound is one of the most commonly performed musculoskeletal ultrasound examinations. In the appropriate setting, sonography of the shoulder is a reliable test that allows accurate, dynamic assessment of the rotator cuff. Individuals familiar with sonography of the shoulder should be familiar with the concepts of image acquisition and basic anatomy. It is important however that individuals strive to build on this knowledge and develop an understanding of the complexities of rotator cuff anatomy and pathology. Recent advances in ultrasound technology have provided an enhanced ability to identify structures in the rotator cuff that have previously been difficult to demonstrate sonographically. The ability to recognise normal anatomy is important to ensure that normal appearances are not misinterpreted as pathology. This workshop will discuss anatomic concepts regarding the rotator cuff and will concentrate on the practical scanning skills necessary to demonstrate the complexity of rotator cuff anatomy.
Your work in breast ultrasound will be primarily to investigate clinical findings or to localise and investigate a mammographic density. This task can be more difficult in the larger breast as there are additional limitations and pitfalls due to body habitus and breast density. This workshop is designed to demonstrate the strategies to systematically scan the larger breast to ensure appropriate clinical and mammographic correlation. There will also be the opportunity to discuss methods that can be employed to avoid the pitfalls and address the limitations of breast ultrasound in this type of patient.
0689 Live Scanning Workshop: Deep Vein Thrombosis Virginia Makeham, Royal Prince Alfred Hospital, Australia Introduction: Deep venous thrombosis (DVT) and its primary sequela, pulmonary embolism (PE) is associated with significant morbidity and mortality. The long- term sequelae of DVT may cause venous insufficiency. Purpose: The diagnosis of DVT based solely on clinical signs and symptoms is difficult and unreliable. Duplex imaging is the examination of choice of the lower extremity veins, and is performed to assess the deep and superficial venous system to detect or exclude the presence of venous thrombosis. Indications for Duplex 䡠 Symptomatic lower limb/s 䡠 Asymptomatic lower limbs with symptoms of PE 䡠 Asymptomatic lower limbs with risk factors 䡠 Surveillance of high risk patients 䡠 Surveillance of post thrombotic episode Duplex and Diagnostic Criteria Evaluation of the lower limb venous system utilises a combination of B Mode, spectral waveform analysis and colour. Characteristics of normal veins 䡠 Compressibility 䡠 Spontaneous flow 䡠 Phasic flow 䡠 Augmentable flow
0691 Imaging of Non-Obstetric Pain in the Pregnant Patient John McGahan, Davis Medical Centre, United States Some of the etiologies of pain in the pregnant patient includes trauma, pyelonephritis/ obstruction, appendicitis, cholecystitis, pancreatitis, and bowel obstruction. While CT is probably the best modality for diagnosing a number of these etiologies, CT uses ionizing radiation which has increase risk of malignancy and leukemia for both the mother and especially the unborn fetus. As such, other modalities such as Ultrasound and MRI have been advocated as safer methods of evaluation of the pregnant patient with abdominal pain. Ultrasound is often utilized as the first modality for evaluating a number of these entities such as acute cholecystitis, renal obstruction, and to a lesser extent trauma and appendicitis. MRI has also been show to very useful in diagnosing appendicitis as well as bowel obstruction in the pregnant patients. In instances where neither ultrasound nor MRI have been shown to be useful then CT, focused to area of interest, may be helpful in obtaining a precise diagnosis. This presentation will review different entities that may cause pain in the pregnant patient as well as the modality that is most useful in obtaining a correct diagnosis. 0692 Grey Scale & Colour Doppler Findings in Mesenteric Ischemia Nitin Chaubal, Jaslok Hospital, India Mesenteric Ischemia, because of its varied clinical presentations is most often difficult to diagnose. In many advanced countries, CT scan with contrast is “the” investigation for patients with acute abdomen. However, in majority of countries even today ultrasound is the first imaging modality in any patient presenting with acute abdomen. An alert sonologist can potentially think of mesenteric ischemia by observing several signs on grey scale and colour Doppler.