Ultrasound

Legislation proposing accreditation for most medical imaging modalities has been caught up in a fight between Capitol Hill and the White House over the renewal of federal healthcare insurance subsidies for poor children.

For nearly a decade, radiologists have used breast ultrasound as an adjunct to x-ray mammography to avoid unnecessary biopsies in equivocal cancer cases. Now ultrasound innovations that increase image resolution while decreasing operator dependence are reflected in a study published in the July issue of Radiology.

Volumetric imaging may be the key to an emerging opportunity for ultrasound in anesthesiology. Researchers at the Mayo Clinic in Jacksonville, FL, adapted real-time echocardiography to produce 3D images of nerves, clearing the way for faster and more accurate nerve blocks using local anesthesia.

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.

An advanced beamforming algorithm called the Time-domain Optimized Near-field Estimator (TONE) substantially improves the contrast and resolution of ultrasound images, according to its developers, a group of biomedical engineers at the University of Virginia School of Engineering and Applied Science.

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.

The American College of Radiology and the Society of Breast Imaging have walked away from the National Accreditation Program for Breast Centers, an ambitious effort to certify breast ultrasound and ultrasound-guided interventions backed by the American College of Surgeons. They disagree with the program’s accreditation standards, especially minimal physician qualifications for interpreting breast ultrasound and performing ultrasound-guided breast interventions.

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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.

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Despite a 2005 consensus statement on the management of thyroid nodules detected at ultrasound, research presented at the 2006 RSNA meeting found wide variation in the criteria used to determine which nodules were chosen for aspiration. That shouldn"t be too surprising as even the panel of radiologists, endocrine surgeons, and endocrinologists who hammered out the consensus statement could not do so in perfect harmony.

Groin pain, whether acute or chronic, is a common clinical presentation that can be caused by a diverse array of disorders involving different anatomic structures. This makes definitive diagnosis difficult for even the most experienced clinician. Imaging can be invaluable in both localizing and characterizing otherwise uncertain groin pathology.

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June will be remembered as the month in which the American Institute of Ultrasound in Medicine renewed its crusade to have contrast agents approved for use beyond the heart. The Institute’s Journal of Ultrasound in Medicine published several papers dedicated to this topic, including an editorial article by two leading sonologists and a white paper outlining the AIUM’s strategy to get FDA approval. The JUM also included original research papers exploring microbubble contrast applications, mostly in the liver.

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.

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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.

The first study of its type has found ultrasound to be acceptable alternative to invasive biopsy for the management of tumors hidden to x-ray mammography but diagnosed as probably benign by the ultrasound Breast Imaging Reporting and Data System, according to a study in the July issue of Radiology.

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The American Institute of Ultrasound in Medicine unveiled a new strategy aiming at final FDA approval of contrast media for clinical ultrasound applications outside cardiology. The white paper outlining the plan appears in the June issue of the Journal of Ultrasound in Medicine.

Neurosurgery depends heavily on the ability of the surgeon to navigate through what can be seen as well as what cannot. MR- and CT-guided neuronavigational tools lately have done much to fill in the blanks with 3D maps that provide the context for interventions. Now biomedical engineers at Duke University are researching how ultrasound might provide a real-time guide to such surgeries.

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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.

Research published in the June issue of the Journal of Nuclear Medicine suggests that radiolabeled recombinant tissue plasminogen activator can perform double duty for evaluations of deep vein thrombosis: It can diagnose the presence of DVT and distinguish between new and old thrombi. Peer-reviewed reports in the May medical literature reflect the growing value of medical imaging for diagnosing, assessing, and guiding the treatment of cardiovascular disease.

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