Ultrasound

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Emergency medicine residents participating in a new study successfully performed a limited duplex ultrasound exam on patients with symptoms of acute deep vein thrombosis after just 90 minutes of training. Their conclusions were very similar to those of an experienced vascular technician examining the same patients.

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.

At a recent symposium on multislice CT, a physicist kicked off her lecture by presenting a big-screen image of a fetus inside a pregnant woman. Then she asked her audience a provocative question, "Is this a bad thing?"

In October 2006 the Society of Radiologists in Ultrasound brought diagnostic ultrasound's leadership together in San Francisco. Two days of lectures and debate led to a strategy statement defining a plan to maintain radiology's leadership over the modality.

Diagnostic ultrasound is ideal for many patients. No other imaging option gives them a real-time look at their own anatomy or so openly encourages discussion with the radiologist about their symptoms and the evidence of disease on the monitor.

The estimation of tissue hardness and masses by palpation during a physical examination is one of the oldest methods used in medical diagnosis. Palpation was practiced by Egyptian physicians as early as 2600 BCE.

Embryo transfer will more likely result in pregnancy if catheter placement is guided by ultrasound rather than clinical touch, according to a study analyzing research through August 2006.

A unique study documenting the prevalence of congenital heart disease in both adults and children in the same Québecois population found a striking increase in the number of adults with the condition. Investigators suggest that improved imaging and surgical techniques have helped children with congenital heart disease live longer.

Abdominal aortic aneurysms can be monitored more precisely and quickly using 3D ultrasound techniques than has been possible with 2D ultrasound. Researchers in the U.K. studied 30 consecutive patients with both methods and found almost no difference in the measurements of anteroposterior or transverse diameters. Three-D volume acquisition ultrasonography provided several advantages over traditional methods, however, including speed and the ability to compare new measurements with archived data.

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Pacific Coast Ultrasound of Los Alamitos, CA, operates at the nexus between medical need and self-indulgence, specializing in prenatal diagnostics and medically supervised 3D/4D prenatal elective ultrasounds. Throughout February, the center, which positions itself as a certified independent diagnostic facility, promotes a month-long tribute to Valentine’s Day.

Early 2007 has been a robust period for the publication of meaningful cardiac imaging research. The National Institute of Neurological Disorders and Stroke’s landmark comparison of noncontrast CT and MRI for stroke confirmed what many neuroradiologists suspected: MRI is the new gold standard for the initial diagnosis and subsequent evaluations of acute stroke. In another compelling study, Swedish researchers found that heart patients equipped with drug-eluting stents are more like to die in the three years following installation than patients who received bare metal stents.

Hypotensive patients with blunt abdominal trauma could skip the CT in the emergency department and go directly to exploratory laparotomy when they have positive focused abdominal sonography for trauma (FAST) findings, according to researchers from the University of California, Davis.

GE Medical Systems, SonoSite, and Zonare will drive hand-carried ultrasound to $1 billion in worldwide revenues in the next five years, according to long-standing ultrasound analyst Harvey Klein. He expected these three companies, the current leaders in this sector, to continue to lead in the years ahead. He put SonoSite at the top of the U.S. market in 2006 sales, followed closely by GE, and described the worldwide competition between these two companies in 2006 as very close.

The imaging industry in 2006 beat the previous year’s record number of FDA clearances, tallying 360 compared with 349 in 2005. Vendors scored 34 in September and 25 in October before surging with 46 clearances in November, then finished the year with 28 in December.

This first Ultrasound Source journal review includes a head-to-head comparison between MRI and sonography in patients with sphincter defects and an interesting study with a large patient population proposing FAST scanning as a reliable selection tool for patients needing laparotomy. We also recommend a study evaluating two ultrasound imaging techniques for ablation guidance; a trial comparing sonography, MRI, and CT to define surgical margins in patients with chest wall tumors; and an interesting British study using 3D sonography to gauge abdominal aortic aneurysms.

Contrast-enhanced ultrasound offers a viable alternative to CT imaging for evaluating and monitoring renal cell carcinoma, according to three papers presented at the 2006 RSNA meeting.

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Breast ultrasound is a highly useful tool in the hands of an expert, but it is notoriously operator-dependent. Systems that offer partial or full automation to minimize performance variability are gaining attention, as trial data accumulate and system designs evolve.

Siemens' P-10, a palm-sized ultrasound scanner shown for the first time at the RSNA meeting, is due out later this year. But radiologists probably won't be using the Blackberry-like device.

Over the years, we've had the privilege of checking the vital signs of many imaging modalities. Diagnostic Imaging served as a witness to the rise and fall of digital subtraction angiography and reported the PET crisis of the mid-1990s.

Contrast-enhanced lymphosonography finds more sentinel lymph nodes than can established nuclear medicine techniques, according to preliminary animal studies focusing on melanoma.

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Most radiologists surveyed by the Society for Radiologists in Ultrasound said they perform more than 10 thyroid aspirations each week. However, few of them used consistent criteria to determine which nodules were chosen for aspiration, according to data released at the RSNA meeting.