Wendy Despain

Contrast-enhanced ultrasound of the carotid artery can identify the presence and degree of vascularization in atherosclerotic plaque, providing a noninvasive way to measure the existence and degree of atherosclerosis, according to a recent study.

Ultrasound-guided percutaneous ethanol injections hold up as a treatment for controlling neck recurrence of papillary thyroid carcinoma. They could be effective for patients who are poor candidates for surgery.

Transcranial B-mode sonography can be used as a test to identify restless legs syndrome, a difficult condition to diagnose. Doctors previously relied on a patient’s description of unmeasurable symptoms. Exams showed hypoechogenic substantia nigra, red nucleus, and brain stem raphe.

Transcranial brain sonography can exclude the diagnosis of Parkinson’s disease in patients experiencing sporadic symptoms. Using exams focused on the substantia nigra and lenticular nucleus, researchers found that the difference between idiopathic Parkinson’s disease and two other movement disorders is clearer in patients under 60 years old.

Hospitalists given focused training for conducting cardiac exams with hand-carried ultrasound systems still could not match echocardiography technicians at acquiring images, though they came closer at measurement and interpretation. Hand-carried ultrasound devices are growing in popularity, but training methods for noncardiologists have not been well defined.

Doppler ultrasound is accurate enough to equal the standard diagnostic test for temporal arteritis, which requires a biopsy of the temporal artery. This is a condition in which early diagnosis and treatment is crucial: 50% of patients with temporal arteritis lose their sight if untreated.

Transvaginal ultrasound is better at identifying cases of deep retrocervical and rectosigmoid endometriosis than MRI and clinical examination. It has better sensitivity, specificity, positive predictive value, negative predictive value, and accuracy, according to a recent study in Brazil.

Simple gray scale and color Doppler sonography can show differences between compensated liver cirrhosis and chronic viral hepatitis in patients with liver problems. Certain color Doppler indices can even help narrow down the stage of chronic viral hepatitis, reducing the need for biopsies.

Patient-controlled sedation and analgesia with a combination of propofol and fentanyl worked just as well as the standard gastroenterologist-administered midazolam and pethidine for upper gastrointestinal tract endoscopic ultrasound exams. Patients and endoscopists were equally satisfied with each method.

Doppler sonography and 3D power Doppler angiography can distinguish between endometrial cancer and hyperplasia, according to researchers in Spain. The standard measurement of endometrial thickness alone, however, did not significantly differentiate between the two conditions.

Researchers in Austria showed duplex ultrasound measurements of the carotid artery could demonstrate the progression of stenosis and predict which patients would suffer serious cardiovascular complications.

Doppler ultrasound breast tumor exams conducted prior to chemotherapy can reliably predict the outcome of treatment, according to research conducted in India. Most breast cancer is treated with chemotherapy prior to surgery. The traditional way to assess the success of this chemotherapy is to study tissue samples collected at surgery. In this study, researchers developed a scoring method using Doppler ultrasound to predict chemotherapy success.

Both ultrasound alone and ultrasound-guided fine-needle aspiration biopsy of lymph nodes are reliable ways to stage invasive lobular carcinoma, a form of breast cancer occurring in only 10% to 15% of cases. Although preoperative assessment can be quite challenging with this cancer, research from the University of Texas M.D. Anderson Cancer Center in Houston found ultrasound to be as effective for staging invasive lobular carcinoma as it is for the more common invasive ductal carcinoma.

Doing full fetal anatomical surveys during follow-up exams of low-risk pregnancies can identify unanticipated fetal anomalies, particularly if the exams are intended to monitor fetal growth.

Ultrasound could stand in for MRI in evaluating muscle atrophy in diabetic patients, with the advantage of being a bedside tool, according to Danish researchers.

Sonographic measurements of kidney length can provide valuable information about kidney function in transplant patients and donors, according to a study by Italian researchers. Kidney length correlated with glomerular filtration rate, the gold standard for measuring kidney function.

Ultrasound-guided radiofrequency is generally a safe treatment for liver masses and carries an acceptable level of risk, but patients with large tumors and baseline liver function impairment have a higher risk of complications, according to researchers in Taiwan.

Researchers in Japan have found contrast-enhanced ultrasound with advanced dynamic flow is a highly sensitive way of showing intestinal ischemia in patients with bowel obstruction and very useful for diagnosing the condition. They found diminished and absent color signals during ultrasound exams indicated the presence of intestinal ischemia.

Second-generation contrast agents reveal the healing process, as injured muscle tissue in professional athletes grows new blood vessels and repairs muscle damage. Ultrasound scans performed at regular intervals after injury allowed researchers to monitor the repair process and estimate when the athletes could safely return to full activity, potentially reducing relapses and complications.

Endoscopic ultrasound has been shown to provide better information than CT for the staging of esophageal carcinoma. Only certain tumors can be successfully removed, so knowing the stage of cancer is vital to preparing the most effective treatment plan, especially when considering neoadjuvant chemotherapy.

Traditional ultrasound has long been used to take bladder measurements of fetuses as early as 11 to 14 weeks gestation, including length and echogenicity. But measurement of bladder volume has tended to be inaccurate because of the limited algorithms for estimating volume using a 2D image. Fetal urine production rate can also be tricky to evaluate with 2D ultrasound.

Cervical length measured by transvaginal ultrasound is a better predictor of vaginal delivery within 60 hours after labor induction than the traditional Bishop score. Researchers in Spain compared the two methods in deciding when to use prostaglandin and oxytocin to induce labor.

Echocardiography is already widely accepted as a diagnostic test for infective endocarditis, but now researchers have proven it’s also a cost-effective option. Making decisions about early surgery for patients with significant stroke risk based on echocardiographic findings is ultimately more economical than standard care.

Intestinal parasites often cause no symptoms until they move into other parts of the body. Ascaris lumbricoides worms sometimes invade the biliary tract, a condition called biliary ascariasis. Identifying this problem can be difficult, but ultrasound was able to detect the worms in a study done in Yemen.

Intestinal parasites often cause no symptoms until they move into other parts of the body. Ascaris lumbricoides worms sometimes invade the biliary tract, a condition called biliary ascariasis. Identifying this problem can be difficult, but ultrasound was able to detect the worms in a study done in Yemen.

Real-time 3D echocardiography can measure mitral annular size and function as accurately as MRI, according to Egyptian researchers. They studied patients with both hypertrophic cardiomyopathy and dilated cardiomyopathy.

Ultrasound measurements of the inferior vena cava can predict shock in trauma patients entering the emergency room. While ultrasound is already used to identify sources of internal bleeding, researchers recommend adding measurement of the inferior vena cava to the standard focused assessment with sonography for trauma (FAST). This measurement can provide valuable information about how low blood volume has dropped, the key factor in hypovolemic shock.

Quantitative ultrasound, the standard method for measuring bone quality, also correlates with bone mineral density and biochemical markers for bone turnover in women aged 66 to 77, according to a study from Greece. Older women in rural areas and others who lack access to biochemical labs and dual-energy x-ray absorptiometry equipment, the standard for measuring bone density, could therefore be screened for complete bone status using ultrasound.

Ultrasound could make the diagnosis of rheumatoid arthritis considerably more accurate, aiding in recommendations for treatment. Treatment decisions can depend on how far the disease has progressed, and the only way to measure the progression of rheumatoid arthritisis to identify which of a patient’s joints show synovitis. Yet a recent study shows that doctors miss swelling in the shoulder joints of 30% of patients.

Hepatitis and related syndromes may be a stronger predictor of early atherosclerosis than such classic risk factors as insulin resistance, according to Italian researchers.