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2394
Abstracts tumors were studied in three patients. LIOUS allowed sharp localization of the tumors and degree of gastric wall infiltration. Conclusions: In our experience LIOUS was a valuable diagnostic procedure; it supplied relevant clinical information in 65% of the cases, and changed surgical approach in 32%. 2394 New criteria at contrast-enhanced intraoperative ultrasonography for differentiating the new lesions detected intraoperatively during hepatectomies for hepatocellular carcinoma Del Fabbro D, Palmisano A, Spinelli A, Marconi M, Donadon M, Montorsi M, Torzilli G, Istituto Clinico Humanitas, Italy Objectives: Contrast-enhanced intraoperative ultrasonography (CEIOUS) seems providing information not obtainable with conventional intraoperative ultrasonography (IOUS). The aim of this study is to validate a new classification of CE-IOUS findings in resective surgery for hepatocellular carcinoma (HCC). Methods: Sixty-two consecutive patients underwent liver resection using IOUS and CE-IOUS for HCC. Patients received intravenously 4.8 mL sulphur-hexafluoride microbubbles (SonoVue®, Bracco Imaging, Italy) for CEIOUS. Pattern of enhancement, and consequent treatment was classified in three categories: A1 (resection), A2 (resection), B (no treatment). Results: IOUS detected 52 new lesions; of them, 24 showed a Bpattern at CE-IOUS, and were not removed. The remaining 28 nodules resulted at CEIOUS A1 in eight and A2 in 20; they were removed, and at histology, six A1 type nodules and 12 A2 type were HCC. The remaining 10 nodules (2 A1 and 8 A2) were regenerative nodules (4) or low grade dysplastic lesion (4), biliary hamartoma (1), and necrotic lesion (1). Conclusions: In conclusion, CEIOUS improves IOUS accuracy with a significant impact on surgical strategy and radicality, but specificity of pattern of enhancement has to be still improved although intrinsic and probably not solvable drawbacks exist in the diagnostic criterion of tumor vascularity.
PACS AND COMPUTER APPLICATIONS IN US 2395 An ultrasound-focused second opinion cellular connection linking examiner and distanced expert using web-based information center and wireless mobile 3g connection Zoumpoulis PS, Pahos K, Vafiadis T, Dalakostas D, Korantzis A, Antsaklis A, Echonet: the Ultrasound Network www.echonet.gr, Greece; Hellenic Society For Ultrasound in Medicine and Biology, Greece Objectives: (1) To teach the radiologist how to use new technologies. (2) To learn the limitations of video transmission via cellular phones. (3) To facilitate a two-way line of communication featuring educational WebPages focused on ultrasound via mobile phones. Methods: Presenting a software/hardware package which connects physicians and sonographers of the Ultrasound Department in a hospital or clinic with those that are away from the examining unit via mobile telecommunication. The examiner has the ability to send still images, video display with real-time ultrasound images, Doppler signals and vocal input of the examiner. Communication is achieved via a webpage that supports the case study with commentary and posed questions. The receiver will view this case as a multi media message on his mobile phone screen, providing easy access and enabling a quick response to the sender.
P171
Results: An innovative mobile data communications service which connects physicians and sonographers of the Ultrasound Department with those that are away from the examining unit via mobile telecommunication. The simplest method to attain a credible second opinion from a distance. Conclusions: The Echonet Uploader is a versatile and easy-to-use package which allows for Ultrasound Images and videos to be sent to both mobile phones, PDAs and PCs. 2396 Percutaneous radiofrequency ablation of liver tumors: Feasibility and usefulness of a novel guidance technique with an integrated system of CT and sonographic images Minami Y, Tei H, Ueshima K, Fukunaga T, Inoue T, Ogawa C, Kudo M, Kinki University School of Medicine, Japan Objectives: We examined the feasibility and safety of percutaneous radiofrequency (RF) ablation guided by Real-time Virtual Sonography for hepatic malignancies. Methods: Between September 2004 and November 2004, nine patients with 15 nodules have been treated by using real-time virtual sonography. The patient population included seven men and two women, with a mean age of 65.6 y. RF ablation was used to treat primary liver cancer in seven patients (78%); two patients (23%) were treated for metastatic lesions. The maximum diameter of nodules ranged from 1.0 cm to 5.0 cm (mean; 1.8 cm). Real-time virtual sonography can display multi planar reconstruction (MPR) image, which indicates the same cross section as ultrasound image from CT volume data in real time. Therefore, it became possible to compare ultrasound image with MPR image in real time. Results: The relationship between tumor and surrounding vessels was easily recognized by referring the image of virtual sonography in all nodules. Complete tumor necrosis was achieved in a single session in 13 lesions (86%), while two sessions were required for the remaining two lesions (14%). No serious side effects or procedure-related complications were observed. Conclusions: Real-time virtual sonography-guided RF ablation could be used safely and successfully for hepatic masses. 2397 A novel software-based method of dynamic sonographic tissue perfusion measurement to evaluate renal cortical perfusion in healthy and insufficient kidneys Scholbach TM, Krogull I, Scholbach J, Children’s Hospital “St. Georg” Leipzig, Germany; Dept. of Mathematics and Informatics, University of Leipzig, Germany Objectives: Chronic renal insufficiency is characterized by a creeping loss of cortical microvasculature. We present the novel noninvasive Doppler sonographic technique of dynamic tissue perfusion measurement to describe this process quantitatively. Methods: We measured renal cortical perfusion with a specially designed software for dynamic perfusion measurement, PixelFlux (www.chameleon-software.de), in 102 healthy probands (0,4 to 18, mean 6 y) and 37 patients with chronic renal failure (0,5 to 20, mean 11 y) in three cortical layers: proximal 20%, proximal 50% and distal 50% of the cortex above the outer edge of medullary pyramids. Results: In renal insufficiency in all layers a highly significant decrease of perfusion intensity could be demonstrated (2,05 versus 0,84 cm/s in proximal 20%, 1,98 versus 0,87 cm/s in proximal 50% and 0,58 versus 0,39 cm/s in distal 50% p ⬍ 0,001 for each comparison, values represent mean flow velocity of the whole region of interest including nonperfused parts). Ratios of perfusion between the layers also differed significantly but not as clearly.
PACS AND COMPUTER APPLICATIONS IN US 2395 An ultrasound-focused second opinion cellular connection linking examiner and distanced expert using web-based information center and wireless mobile 3g connection Zoumpoulis PS, Pahos K, Vafiadis T, Dalakostas D, Korantzis A, Antsaklis A, Echonet: the Ultrasound Network www.echonet.gr, Greece; Hellenic Society For Ultrasound in Medicine and Biology, Greece Objectives: (1) To teach the radiologist how to use new technologies. (2) To learn the limitations of video transmission via cellular phones. (3) To facilitate a two-way line of communication featuring educational WebPages focused on ultrasound via mobile phones. Methods: Presenting a software/hardware package which connects physicians and sonographers of the Ultrasound Department in a hospital or clinic with those that are away from the examining unit via mobile telecommunication. The examiner has the ability to send still images, video display with real-time ultrasound images, Doppler signals and vocal input of the examiner. Communication is achieved via a webpage that supports the case study with commentary and posed questions. The receiver will view this case as a multi media message on his mobile phone screen, providing easy access and enabling a quick response to the sender.
P171
Results: An innovative mobile data communications service which connects physicians and sonographers of the Ultrasound Department with those that are away from the examining unit via mobile telecommunication. The simplest method to attain a credible second opinion from a distance. Conclusions: The Echonet Uploader is a versatile and easy-to-use package which allows for Ultrasound Images and videos to be sent to both mobile phones, PDAs and PCs. 2396 Percutaneous radiofrequency ablation of liver tumors: Feasibility and usefulness of a novel guidance technique with an integrated system of CT and sonographic images Minami Y, Tei H, Ueshima K, Fukunaga T, Inoue T, Ogawa C, Kudo M, Kinki University School of Medicine, Japan Objectives: We examined the feasibility and safety of percutaneous radiofrequency (RF) ablation guided by Real-time Virtual Sonography for hepatic malignancies. Methods: Between September 2004 and November 2004, nine patients with 15 nodules have been treated by using real-time virtual sonography. The patient population included seven men and two women, with a mean age of 65.6 y. RF ablation was used to treat primary liver cancer in seven patients (78%); two patients (23%) were treated for metastatic lesions. The maximum diameter of nodules ranged from 1.0 cm to 5.0 cm (mean; 1.8 cm). Real-time virtual sonography can display multi planar reconstruction (MPR) image, which indicates the same cross section as ultrasound image from CT volume data in real time. Therefore, it became possible to compare ultrasound image with MPR image in real time. Results: The relationship between tumor and surrounding vessels was easily recognized by referring the image of virtual sonography in all nodules. Complete tumor necrosis was achieved in a single session in 13 lesions (86%), while two sessions were required for the remaining two lesions (14%). No serious side effects or procedure-related complications were observed. Conclusions: Real-time virtual sonography-guided RF ablation could be used safely and successfully for hepatic masses. 2397 A novel software-based method of dynamic sonographic tissue perfusion measurement to evaluate renal cortical perfusion in healthy and insufficient kidneys Scholbach TM, Krogull I, Scholbach J, Children’s Hospital “St. Georg” Leipzig, Germany; Dept. of Mathematics and Informatics, University of Leipzig, Germany Objectives: Chronic renal insufficiency is characterized by a creeping loss of cortical microvasculature. We present the novel noninvasive Doppler sonographic technique of dynamic tissue perfusion measurement to describe this process quantitatively. Methods: We measured renal cortical perfusion with a specially designed software for dynamic perfusion measurement, PixelFlux (www.chameleon-software.de), in 102 healthy probands (0,4 to 18, mean 6 y) and 37 patients with chronic renal failure (0,5 to 20, mean 11 y) in three cortical layers: proximal 20%, proximal 50% and distal 50% of the cortex above the outer edge of medullary pyramids. Results: In renal insufficiency in all layers a highly significant decrease of perfusion intensity could be demonstrated (2,05 versus 0,84 cm/s in proximal 20%, 1,98 versus 0,87 cm/s in proximal 50% and 0,58 versus 0,39 cm/s in distal 50% p ⬍ 0,001 for each comparison, values represent mean flow velocity of the whole region of interest including nonperfused parts). Ratios of perfusion between the layers also differed significantly but not as clearly.