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Uterine arteriovenous malformations: from diagnosis to treatment
Abstracts were studied. A dose of 2.4 ml of SonoVue (Bracco, Italy) was infused intravenously within 30 sec. The enhancement level was monitored with a nonlinear scanning mode using an Acuson Sequoia-512 scanner with 6C-2, 4C-1 probes. The comparison examinations were performed with physical examination in all cases and with library examination in 16 patients before and after SonoVue injection. The histopathalogical diagnoses were obtained in 20 patients after SonoVue enhanced US examination. The other diagnoses were confirmed on CT, MRI, and DSA. Twenty patients had malignant liver lesions (16 hepatocellular carcinomas, 4 metastases), while 11 had benign lesions (4 hemangiomas, 2 focal nodular hyperplasias, 5 others). Results: 1) After SonoVue injection, the number of lesions without flow signal intralesions dropped from 15 to 2 with nonlinear scanning modes. 2) The positive diagnoses compared to the histopathalogical diagnoses increased after SonoVue in nonlinear scanning modes (p⬍0.05). 3) There was no difference in physical examination and library examinations before and after SonoVue injection. Conclusions: SonoVue is useful in visualizing tumor vessel and characterizing liver tumors. It is a safe, efficient ultrasound contrast agent and convenient for use. 32531 Enhanced color flows in ductal pancreatic adenocarcinoma Yang CC, Huang MH, Chen CH,* Yeh YH, Division of Gastroenterology, Changhua Show-Chwan Memorial Hospital, Changhua, Taiwan Objective: The aim of this study was to evaluate the color flows of ductal pancreatic adenocarcinomas before and after intravenous administration of Levovist. Methods: Seventeen consecutive tumors of ductal pancreatic adenocarcinoma proved after biopsy were evaluated by power Doppler echo before and after intravenous administration of Levovist. The contrast agent, Levovist, was intravenously administered by manually bolus injection in a dose of 2.5 g at a concentration of 300 mg/mL. Results: Power Doppler echo could not detect any signal in all the 17 tumors before intravenous Levovist injection. After Levovist injection, diffuse enhancement was found in 2 tumors, scanty vessel signals could be found in 1 tumor, and no enhanced effect was found in the remaining 14 tumors. Conclusions: In this preliminary study, most ductal pancreatic adenocarcinomas (82%) were not enhanced after Levovist injection. It needs further study to compare the difference of enhanced effect between adenocarcinoma and pancreatitis. 32537 Uterine arteriovenous malformations: From diagnosis to treatment O Brien PG,* Neyestani A, Chang S, Buckley A, Abdominal Radiology, Vancouver General Hospital, Vancouver, BC, Canada Objective: The aim of this study was to describe the clinical presentation, sonographic diagnosis, and radiological treatment of uterine arteriovenous malformations (AVMs). Methods: Gray scale, color, and spectral Doppler images of patients with uterine AVMs over a 2-year period were retrospectively evaluated. Results: 22 patients were diagnosed with uterine AVMs. Uterine AVMs cause both acute and chronic symptoms. The most common of these is menorrhagia or menometrorrhagia. The gray scale ultrasound appearance of uterine AVMs is nonspecific and often subtle. However, color and spectral Doppler features of AVMs are consistently identical and highly suggestive of the diagnosis. Color Doppler shows an intense
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vascular tangle, which is often larger than on gray scale alone, while spectral Doppler shows low resistance, high-velocity arterial flow. Conclusions: Recognition of uterine AVMs as the cause of haemorrhage is important as these abnormalities can be treated safely and effectively by transcatheter arterial embolisation but may be worsened by dilatation and curettage, precipitating massive intrauterine bleeding. This poster presentation illustrates the gray scale, color, and spectral Doppler appearance of uterine AVMs with correlative angiographic images in selected cases. Routine use of color and spectral Doppler ultrasound during examination of abnormal uterine bleeding is recommended. 32538 Vibrational resonance spectroscopy of turkey breast: Tissue differentiation from human muscle Lin G,*1 Garra BS,2 1. Advanced Imaging Associates, Fremont, CA, and 2. Radiology, University of Vermont, Burlington, VT Objective: The aim of this study was to investigate the pattern of vibrational resonance (VR) spectra in turkey breast for comparison to VR spectra in muscle of human volunteers. Vibrational resonance spectroscopy (VRS) is the frequency-dependent tissue vibrational response to externally applied audio-frequency vibration. It is sampled by means of power Doppler imaging with automated quantification of Doppler amplitude to generate a VR spectrum. Methods: The VRS apparatus consisted of an audio-frequency transducer attached to the ultrasound transducer and driven by a 2-watt audio amplifier and variable-frequency tone generator. Vibrations in the range of 10 – 400 Hz were applied to fresh and processed turkey breasts. In the case of thin sliced specimens, an acoustic standoff pad was used to image within the focal range of the transducer. Imaging was done with a 10-MHz flat linear array transducer, operating power Doppler at 6.0 MHz with gain set at 10 –15 dB below typical blood flow settings. Results: Raw and cooked turkey breast exhibited overall VR spectra consisting of a narrow primary peak at 130 –150 Hz with 35-Hz FWHM (full-width at half-maximum), a secondary peak at 230 –250 Hz (70-Hz FWHM, 30% amplitude of the primary peak), and a much smaller tertiary peak at 30 –50 Hz (3% amplitude of the primary peak). The depth of the spectral valley at 180 –200 Hz appeared to be increased by commercial cooking and processing. Scanning of specimens inside sealed plastic packaging did not appear to adversely affect results. Conclusions: Turkey breast exhibits VR spectra with peaks corresponding to those of human muscle, but displays a splitting of the primary peak into two distinct peaks. While the two types of muscle tissue are palpably similar, VRS reveals qualitative differences in their VR spectral signatures. This specificity may be useful in tissue differentiation. 32540 An ultrasound scoring for prediction of developing shock for Dengue hemorrhagic fever Rang NN, Paediatrics, An Giang Hospital, An Giang, Viet Nam Objective: The aim of this study was to develop an ultrasound scoring system for prediction of developing shock in DHF patients. Methods: Based on the frequency and the depth of fluid collections appearing in DHF patients on sonography, we developed the scoring system predicting the risks of DHF patients of developing shock. Afterward, we assessed the validity of our scoring system by plotting a receiver operating characteristic (ROC) curve, compared with ROC curve for hematocrit.
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vascular tangle, which is often larger than on gray scale alone, while spectral Doppler shows low resistance, high-velocity arterial flow. Conclusions: Recognition of uterine AVMs as the cause of haemorrhage is important as these abnormalities can be treated safely and effectively by transcatheter arterial embolisation but may be worsened by dilatation and curettage, precipitating massive intrauterine bleeding. This poster presentation illustrates the gray scale, color, and spectral Doppler appearance of uterine AVMs with correlative angiographic images in selected cases. Routine use of color and spectral Doppler ultrasound during examination of abnormal uterine bleeding is recommended. 32538 Vibrational resonance spectroscopy of turkey breast: Tissue differentiation from human muscle Lin G,*1 Garra BS,2 1. Advanced Imaging Associates, Fremont, CA, and 2. Radiology, University of Vermont, Burlington, VT Objective: The aim of this study was to investigate the pattern of vibrational resonance (VR) spectra in turkey breast for comparison to VR spectra in muscle of human volunteers. Vibrational resonance spectroscopy (VRS) is the frequency-dependent tissue vibrational response to externally applied audio-frequency vibration. It is sampled by means of power Doppler imaging with automated quantification of Doppler amplitude to generate a VR spectrum. Methods: The VRS apparatus consisted of an audio-frequency transducer attached to the ultrasound transducer and driven by a 2-watt audio amplifier and variable-frequency tone generator. Vibrations in the range of 10 – 400 Hz were applied to fresh and processed turkey breasts. In the case of thin sliced specimens, an acoustic standoff pad was used to image within the focal range of the transducer. Imaging was done with a 10-MHz flat linear array transducer, operating power Doppler at 6.0 MHz with gain set at 10 –15 dB below typical blood flow settings. Results: Raw and cooked turkey breast exhibited overall VR spectra consisting of a narrow primary peak at 130 –150 Hz with 35-Hz FWHM (full-width at half-maximum), a secondary peak at 230 –250 Hz (70-Hz FWHM, 30% amplitude of the primary peak), and a much smaller tertiary peak at 30 –50 Hz (3% amplitude of the primary peak). The depth of the spectral valley at 180 –200 Hz appeared to be increased by commercial cooking and processing. Scanning of specimens inside sealed plastic packaging did not appear to adversely affect results. Conclusions: Turkey breast exhibits VR spectra with peaks corresponding to those of human muscle, but displays a splitting of the primary peak into two distinct peaks. While the two types of muscle tissue are palpably similar, VRS reveals qualitative differences in their VR spectral signatures. This specificity may be useful in tissue differentiation. 32540 An ultrasound scoring for prediction of developing shock for Dengue hemorrhagic fever Rang NN, Paediatrics, An Giang Hospital, An Giang, Viet Nam Objective: The aim of this study was to develop an ultrasound scoring system for prediction of developing shock in DHF patients. Methods: Based on the frequency and the depth of fluid collections appearing in DHF patients on sonography, we developed the scoring system predicting the risks of DHF patients of developing shock. Afterward, we assessed the validity of our scoring system by plotting a receiver operating characteristic (ROC) curve, compared with ROC curve for hematocrit.