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Role of ultrasonography to detect liver size
S96
Ultrasound in Medicine & Biology
Case 2 (Nipple adenoma) B-mode US showed a distinctly smooth and round boundary with nonparallel orientation in the nipple. CEUS showed that the whole tumor was strongly stained uniformly. Case 3 (Mucocele-like tumor) B-mode US showed clustered microcysts. CEUS showed the same range as B-mode US and the tumor was weakly and uniformly stained. Case 4 (Fibroadenoma) B-mode US showed a hypoechoic tumor whose boundary was somewhat rough and had posterior enhancement. CEUS showed that the tumor was stained; however, the boundary was not distinct from the surroundings. Case 5 (Fibrosis) B-mode US showed a hypoechoic mass with a lobular shape and a somewhat irregular shape. CEUS showed that the interior was hardly stained. Conclusion: We clarified that typical CEUS images of benign tumors had circular or elliptical shapes, were clearly delineated at the boundary, and were strongly stained with the same range as the B mode. Further, weak and uniform staining with the same range as the B mode, staining that is not distinct from the surroundings, and images that showed little staining were considered benign findings.
Role of ultrasonography to detect liver size Kamrul Islam Bangladesh Institute of Thyroid Medicine & Imaging Research, Dhanmondi, Dhaka, Bangladesh Introduction: The liver is the largest organ in the body and also the largest gland. It has been estimated that between birth and adulthood, there is at least a 10-fold increase in liver mass. The size of the liver increases with age, from an average span of 5 cm at the age of five years, to 15 cm in adulthood. The size of the normal liver also varies with sex and body size. The normal liver weighs 1.4 to 1.5 kg in men and 1.2 to 1.4 kg in women. Relative to body size, the liver is larger in the fetus (1/ 18 of total body weight) than in the adult (1/36 of total body weight). Objective: The aims and objective of this study was to evaluate the Liver size of Bangladeshi population using Ultrasound. Methods & Patients: A total of 40 subjects (23 females, 17 males; mean age 41.8 § 12.8 years) underwent sonographic examination of the liver in the midclavicular line to determine liver span. Subjects underwent physical examination and blood tests and completed a standardized interview questionnaire. Results: The average liver span in the midclavicular line for the overall collective was 15.0 § 1.5 cm; the average for females was 14.9 § 1.6 cm and 15.1 § 1.5 cm for males. Liver span exceeded 16 cm in 24.3% of subjects. Results of the multivariate analysis showed that, of the factors potentially influencing liver span, gender, age, body mass index, body height, fatty liver (p < 0.0001), waist-to-hip ratio (p = 0.015), and metabolic syndrome (p = 0.032) are significant. By contrast, diabetes mellitus, alcohol consumption, tobacco consumption, physical activity, and laboratory findings showed no influence. Conclusion: Sonographic measurement of liver span in the midclavicular line is a simple method for routine clinical use. Gender, age, body mass index, waist-to-hip ratio, body height, hepatic steatosis, and metabolic syndrome are factors associated with liver span.
Role of ultrasound in the diagnosis and management of gestational trophoblastic disease in Rwanda Rural health facilities- A case report Habimana Jean Felix Ruli District Hospital, Kigali, Ruli Sector, Rwanda Introduction: Gestational trophoblastic disease (GTD) is a rare kind of proliferative disorder of trophoblastic cells which develops from the
Volume 45, Number S1, 2019 placenta in early pregnancy and the complete hydatidiform mole (CHM) sub-type which limited to endometrium is most common. It has excellent prognosis if early appropriate diagnosis and management are done. A well performed ultrasound(US) play a primordial role in the diagnosis of maternal health disorders during routine prenatal care. This helps in avoiding complications and consequently aids in achieving the objectives of the Millennium Development Goals (MDGs) in Rwanda. Aim: To understand the definition of Gestational trophoblastic disease (GTD); To recognize key diagnostic findings of complete molar pregnancy on ultrasound and appropriate management in maternal follow up and To review the differential diagnosis for ultrasound findings seen with GTD. Methods: The case has been referred in ultrasound unit for scan from outpatient department and follow up US was ordered and done during management period while the patient lies on a bed while operator moves the 3,5 MHz lubricated transducer of frequency with gel on the abdomino- pelvic region with full urinary bladder and Mindray ultrasound Machine has been used. Results: There was a large moderately hyperechogenic mass completely filling the endometrial cavity with numerous small cystic spaces of different size. Post 5 days under treatment, anechoic area within endometrial cavity and myometrium well outlined was discharged and in 3rd medical visit after 2 weeks, US were normal. Conclusion: Ultrasound is the first modality to be used in all rural health facilities for diagnosis of suspected Gestational trophoblastic disease (GTD) for better results. It is available and free of radiation. Recommendation: -The US is the baseline modalities to be used in 1st trimester in pregnancy women with GTD suspicion bleeding. -All rural health facilities should have empowered and capable trained Medical imaging practitioners for appropriate carrying out the ultrasonographic investigation for better care service delivery on GTD (Medical imaging practitioners Role extension project after formal training by Prof. Kawooya).
A prospective evaluation of hepatic steatosis using quantitative ultrasonographic parameters using controlled attenuation parameter as the reference standard Sun Kyung Jeon, Ijin Joo Seoul National University Hospital, Seoul, South Korea Purpose: To investigate the diagnostic performance of quantitative ultrasonography (QUS) for the assessment of hepatic steatosis in patients with chronic liver disease using controlled attenuation parameter (CAP) as the reference standard. Materials and Methods: Our institutional review board approved this study, and informed consent was obtained from all of the patients. In this prospective study, we analyzed 216 patients with chronic liver disease who had reliable measurement results at both QUS and CAP. QUS parameters included center frequency shift (a slope of center frequency change according to depth) and Nakagami parameter (backscattered distribution). Correlation between QUS parameters and CAP was evaluated using the Pearson’s correlation analysis. In addition, based on the cut-off value of 288 dB/m on CAP, diagnostic performance of QUS parameters for hepatic steatosis was assessed using the receiver operating characteristics (ROC) curve analysis. Multiple regression analysis was performed to determine significant independent factors for the hepatic steatosis on CAP. Intra-operator reliability (repeatability) of QUS parameter measurements was assessed with intraclass correlation coefficients (ICCs). Results: Center frequency shift showed a moderate negative correlation with CAP (r = 0.66; 95% confidence interval (CI), 0.73 to
Ultrasound in Medicine & Biology
Case 2 (Nipple adenoma) B-mode US showed a distinctly smooth and round boundary with nonparallel orientation in the nipple. CEUS showed that the whole tumor was strongly stained uniformly. Case 3 (Mucocele-like tumor) B-mode US showed clustered microcysts. CEUS showed the same range as B-mode US and the tumor was weakly and uniformly stained. Case 4 (Fibroadenoma) B-mode US showed a hypoechoic tumor whose boundary was somewhat rough and had posterior enhancement. CEUS showed that the tumor was stained; however, the boundary was not distinct from the surroundings. Case 5 (Fibrosis) B-mode US showed a hypoechoic mass with a lobular shape and a somewhat irregular shape. CEUS showed that the interior was hardly stained. Conclusion: We clarified that typical CEUS images of benign tumors had circular or elliptical shapes, were clearly delineated at the boundary, and were strongly stained with the same range as the B mode. Further, weak and uniform staining with the same range as the B mode, staining that is not distinct from the surroundings, and images that showed little staining were considered benign findings.
Role of ultrasonography to detect liver size Kamrul Islam Bangladesh Institute of Thyroid Medicine & Imaging Research, Dhanmondi, Dhaka, Bangladesh Introduction: The liver is the largest organ in the body and also the largest gland. It has been estimated that between birth and adulthood, there is at least a 10-fold increase in liver mass. The size of the liver increases with age, from an average span of 5 cm at the age of five years, to 15 cm in adulthood. The size of the normal liver also varies with sex and body size. The normal liver weighs 1.4 to 1.5 kg in men and 1.2 to 1.4 kg in women. Relative to body size, the liver is larger in the fetus (1/ 18 of total body weight) than in the adult (1/36 of total body weight). Objective: The aims and objective of this study was to evaluate the Liver size of Bangladeshi population using Ultrasound. Methods & Patients: A total of 40 subjects (23 females, 17 males; mean age 41.8 § 12.8 years) underwent sonographic examination of the liver in the midclavicular line to determine liver span. Subjects underwent physical examination and blood tests and completed a standardized interview questionnaire. Results: The average liver span in the midclavicular line for the overall collective was 15.0 § 1.5 cm; the average for females was 14.9 § 1.6 cm and 15.1 § 1.5 cm for males. Liver span exceeded 16 cm in 24.3% of subjects. Results of the multivariate analysis showed that, of the factors potentially influencing liver span, gender, age, body mass index, body height, fatty liver (p < 0.0001), waist-to-hip ratio (p = 0.015), and metabolic syndrome (p = 0.032) are significant. By contrast, diabetes mellitus, alcohol consumption, tobacco consumption, physical activity, and laboratory findings showed no influence. Conclusion: Sonographic measurement of liver span in the midclavicular line is a simple method for routine clinical use. Gender, age, body mass index, waist-to-hip ratio, body height, hepatic steatosis, and metabolic syndrome are factors associated with liver span.
Role of ultrasound in the diagnosis and management of gestational trophoblastic disease in Rwanda Rural health facilities- A case report Habimana Jean Felix Ruli District Hospital, Kigali, Ruli Sector, Rwanda Introduction: Gestational trophoblastic disease (GTD) is a rare kind of proliferative disorder of trophoblastic cells which develops from the
Volume 45, Number S1, 2019 placenta in early pregnancy and the complete hydatidiform mole (CHM) sub-type which limited to endometrium is most common. It has excellent prognosis if early appropriate diagnosis and management are done. A well performed ultrasound(US) play a primordial role in the diagnosis of maternal health disorders during routine prenatal care. This helps in avoiding complications and consequently aids in achieving the objectives of the Millennium Development Goals (MDGs) in Rwanda. Aim: To understand the definition of Gestational trophoblastic disease (GTD); To recognize key diagnostic findings of complete molar pregnancy on ultrasound and appropriate management in maternal follow up and To review the differential diagnosis for ultrasound findings seen with GTD. Methods: The case has been referred in ultrasound unit for scan from outpatient department and follow up US was ordered and done during management period while the patient lies on a bed while operator moves the 3,5 MHz lubricated transducer of frequency with gel on the abdomino- pelvic region with full urinary bladder and Mindray ultrasound Machine has been used. Results: There was a large moderately hyperechogenic mass completely filling the endometrial cavity with numerous small cystic spaces of different size. Post 5 days under treatment, anechoic area within endometrial cavity and myometrium well outlined was discharged and in 3rd medical visit after 2 weeks, US were normal. Conclusion: Ultrasound is the first modality to be used in all rural health facilities for diagnosis of suspected Gestational trophoblastic disease (GTD) for better results. It is available and free of radiation. Recommendation: -The US is the baseline modalities to be used in 1st trimester in pregnancy women with GTD suspicion bleeding. -All rural health facilities should have empowered and capable trained Medical imaging practitioners for appropriate carrying out the ultrasonographic investigation for better care service delivery on GTD (Medical imaging practitioners Role extension project after formal training by Prof. Kawooya).
A prospective evaluation of hepatic steatosis using quantitative ultrasonographic parameters using controlled attenuation parameter as the reference standard Sun Kyung Jeon, Ijin Joo Seoul National University Hospital, Seoul, South Korea Purpose: To investigate the diagnostic performance of quantitative ultrasonography (QUS) for the assessment of hepatic steatosis in patients with chronic liver disease using controlled attenuation parameter (CAP) as the reference standard. Materials and Methods: Our institutional review board approved this study, and informed consent was obtained from all of the patients. In this prospective study, we analyzed 216 patients with chronic liver disease who had reliable measurement results at both QUS and CAP. QUS parameters included center frequency shift (a slope of center frequency change according to depth) and Nakagami parameter (backscattered distribution). Correlation between QUS parameters and CAP was evaluated using the Pearson’s correlation analysis. In addition, based on the cut-off value of 288 dB/m on CAP, diagnostic performance of QUS parameters for hepatic steatosis was assessed using the receiver operating characteristics (ROC) curve analysis. Multiple regression analysis was performed to determine significant independent factors for the hepatic steatosis on CAP. Intra-operator reliability (repeatability) of QUS parameter measurements was assessed with intraclass correlation coefficients (ICCs). Results: Center frequency shift showed a moderate negative correlation with CAP (r = 0.66; 95% confidence interval (CI), 0.73 to