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Fundamentals of Medical Ultrasonics
This book sets out the physical and engineering principles of acoustics and ultrasound as used for medical applications. It covers the basics of linear acoustics, wave propagation, non-linear acoustics, acoustic properties of tissue, transducer components, and ultrasonic imaging modes, as well as the most common diagnostic and therapeutic applications. It offers students and professionals in medical physics and engineering a detailed overview of the technical aspects of medical ultrasonic imaging, whilst serving as a reference for clinical and research staff.
eBook
Diagnostic ultrasound imaging : inside out
Diagnostic Ultrasound Imaging provides a comprehensive introduction to and a state-of-the-art review of the essential science and signal processing principles of diagnostic ultrasound. The progressive organization of the material serves beginners in medical ultrasound science and graduate students as well as design engineers, medical physicists, researchers, clinical collaborators, and the curious. This it the most comprehensive and extensive work available on the core science and workings of advanced digital imaging systems, exploring the subject in a unified, consistent and interrelated manner. From its antecedents to the modern day use and prospects for the future, this it the most up-to-date text on the subject. Diagnostic Ultrasound Imaging provides in-depth overviews on the following major aspects of diagnostic ultrasound: absorption in tissues; acoustical and electrical measurements; beamforming, focusing, and imaging; bioeffects and ultrasound safety; digital imaging systems and terminology; Doppler and Doppler imaging; nonlinear propagation, beams and harmonic imaging; scattering and propagation through realistic tissues; and tissue characterization.
eBook
The Public Life of the Fetal Sonogram
In The Public Life of the Fetal Sonogram, medical anthropologist Janelle S. Taylor analyzes the full sociocultural context of ultrasound technology and imagery. Drawing upon ethnographic research both within and beyond the medical setting, Taylor shows how ultrasound has entered into public consumer culture in the United States. The book documents and critically analyzes societal uses for ultrasound such as nondiagnostic \"keepsake\" ultrasound businesses that foster a new consumer market for these blurry, monochromatic images of eagerly awaited babies, and anti-abortion clinics that use ultrasound in an attempt to make women bond with the fetuses they carry, inciting a pro-life state of mind.
This book offers much-needed critical awareness of the less easily recognized ways in which ultrasound technology is profoundly social and political in the United States today.
eBook
P77 A national survey of real-time ultrasound guidance use in pleural procedures in the United Kingdom
IntroductionPre-procedural thoracic ultrasound is a mainstay of pleural intervention, with evidence that its use reduces complication risk. However, there are currently two forms of standard clinical practice for ultrasound use during thoracocenteses and chest drain insertions. In the first, ‘real-time’ ultrasound guidance is used to visualise the inserted needles and tube throughout the procedure, and anaesthetic is administered with the needle tip seen adjacent to the parietal pleura. In the second, the operator inserts needles and the tube not under ‘real-time’ ultrasound guidance, and anaesthetic is injected at a depth approximating that of the external pleural lining. To date, there has been limited comparison of the two techniques, however there is some evidence that real-time ultrasound guidance improves success rates and reduces the likelihood of complications.1 The current use of real-time ultrasound guidance for pleural procedures in the United Kingdom (UK) is unclear.MethodsAn electronic survey (Jisc Online Surveys) was circulated via the UK Pleural Society and British Society of Thoracic Imaging newsletters, and through direct communication with centres undertaking pleural procedures.Results70 responses were received, predominantly from Respiratory Consultants (33%), Radiologists (30%) and Respiratory Registrars (29%). 50% of respondents ‘Never’ or ‘Rarely’ use real-time ultrasound guidance in pleural procedures, while 37% use it ‘Always’ or ‘Often’. Frequently highlighted reasons for not using real-time ultrasound guidance in pleural procedures included a lack of training, technical issues, increased procedure length and insufficient evidence that the technique improves outcomes. The majority of respondents (74%) indicated that they would use real-time ultrasound guidance more for thoracocentesis and chest drain insertions if the technique was shown to significantly reduce pain experienced by patients.Abstract P77 Figure 1[Image Omitted. See PDF.]DiscussionThere is significant variability in the use of real-time ultrasound guidance in pleural procedures across the UK. Most respondents indicated that they would increase use of the technique if it were shown to improve outcomes for patients. Randomised studies to assess outcomes of procedures performed under real-time ultrasound guidance are essential.ReferenceHelgeson SA, Fritz AV, Tatari MM, Daniels CE, Diaz-Gomez JL. Reducing iatrogenic pneumothoraces: using real-time ultrasound guidance for pleural procedures. Crit Care Med. 2019;47(7):903–909.
Journal Article
S158 Applications of lung ultrasound in interstitial diseases
IntroductionIn diffuse interstitial lung disease (ILD) the gold standard imaging technique is chest computed tomography (CT) but less invasive techniques such as ultrasound are being considered for screening and follow-up of these patients.AimTo analyse the first 54 ultrasounds in ILD performed in our Unit.MethodsPatients referred for ultrasound assessment (January 2023-July 2024). Data were collected from functional respiratory tests, radiological study with CT and the results obtained in the lung ultrasound. Patients were classified as mild, moderate and severe according to the Warrick scale for chest CT and the Bologna Ultrasound for Diffuse Alveolar Disease (BUDA) scale.Results54 patients (5.9% male), mean age 71±9 years. The table 1 shows the most frequent pathologies and ultrasound characteristics. Pulmonary function of our patients (averages): FVC 2283 ±877 ml, FVC% 71±18%, FEV1 1855±660 ml, FEV1% 76±18%, FEV1/FVC 82±9%, DLCO 3.29±1.65 ml/min/mmHg, DLCO% 49±21%. Radiologically 68.5% had a pattern compatible with UIP while 31.5% had a NINE pattern.When applying the Warrick index the patients were classified as: 11.1% mild, 50% moderate and 38.9% severe. When classified with the ultrasound score (BUDA index): 35.8% mild, 28.3% moderate and 35.8% severe.We found a moderate negative correlation between DLCO and average B lines (r = -0.408) and a slight negative correlation between DLCO and areas with irregular pleura (r = -0.292) and Warrick Score (r = -0.292), having statistical significance (<0.05).ConclusionsILD has a number of typical ultrasound features and can be used as a clinical tool for the diagnosis and follow-up due to its low cost, availability and absence of radiation, but further studies are needed to standardise the technique.The best radiological/ultrasound correlation is in cases of severe involvement.Abstract S158 Table 1Ultrasound characteristics according to interstitial pathology ILD (n=54) AVERAGE B LINES PER AREA AREA AREAS WITH IRREGULAR PLEURA PLEURAGE WITH REDUCED GLIDING Idiopathic pulmonary fibrosis (30) 4.1±2.7 4.5±2.6 11 patients (36.7%) Hypersensitivity pneumonitis (14) 4.8±2.7 3.1±2.1 3 p. (21.4%) Rheumatoid arthritis (6) 5.4±2.9 5.5±1.9 1 p. (16.7%) Fibroenfisema (1) 8.6 8 0 p. (0%) Sarcoidosis (1) 3.1 1 1 p. (100%) Unclassifiable (1) 6.5 5 0 p. (0%) Scleroderma (1) 5.8 4 1 p. (100%)
Journal Article
Workbook for Diagnostic Medical Sonography: A Guide to Clinical Practice, Obstetrics and Gynecology
Designed to accompany the 5th Edition of Susan Raatz Stephenson and Julia Dmitrieva's text, Workbook for Diagnostic Medical Sonography: A Guide to Clinical Practice, Obstetrics and Gynecology, 5th Edition, by Barbara Hall-Terracciano and Susan R. Stephenson, offers a full complement of self-study aids for active learning that enable you to assess and build your knowledge as you advance through the text. Most importantly, it helps you get the most out of your study time, with a variety of custom-designed exercises to help you master each objective.
eBook
P139 Ultrasound-guided interscalene block for reduction of shoulder dislocation
Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionBackground and AimsLimb dislocations are common pathologies requiring emergency treatment. In the United States, 24 shoulder dislocations are reported per year per 100,000 people, or nearly 80,000 dislocations. It most often occurs after a violent trauma. Young adults are most often affected; it is common in epileptics. Reduction of the dislocation is a trauma emergency All types of anesthesia can be used for shoulder dislocation reduction. The objective of this study was to evaluate the efficacy and safety of the interscalene block for shoulder dislocation reduction.MethodsProspective descriptive study conducted in Batna University Hospital during the 2023/2024. Inclusion criteria were adult patients admitted for shoulder dislocation. The interscalene block was performed under ultrasound guidance. Demographic data, block data (performance time, onset time, LA), success, and complications were recorded.ResultsTwenty patients were included during the study period. The mean age of our patients was 40 years (range, 19–83). Sex: 18 men/2 women. All patients fasted for more than 6 hours. All blocks were performed using the lateral in plane approach, except for one patient. For the first 6 cases, we used a mixture of lidocaine and bupivacaine, with a volume between 5 and 10 ml For the following 14 patients, we used 2% lidocaine alone with a volume between 5 and 17 ml. For the injection site: We injected 8 times around C5, 10 times between C5 and C6, and 2 times (7 ml) above C5. The block took 1–5 minutes to perform and the block onset time was 1–2 minutes. Only one complication was reported: paresthesias during a two-injection block. Success was 100% with a single attempt in 18 cases.ConclusionsThe interscalene block is an effective and safe technique for reducing shoulder dislocation; ultrasound guidance allows for reduced doses and a reduced risk of complications
Journal Article
EP081 A cadaveric study investigating the mechanism of action of the external oblique intercostal block
Background and AimsThe external oblique intercostal (EOI) blocks have been reported to provide analgesia to both the anterior and lateral upper abdominal wall. However, the spread of injectate and the mechanisms of action remain to be fully elucidated. This cadaveric study aimed to evaluate the injectate spread following ultrasound-guided EOI block in human cadaver models.MethodsUltrasound-guided EOI block injections were performed bilaterally (n=7) on four soft embalmed Thiel cadavers. Thirty milliliters of saline-soluble dye were injected between the external oblique and external intercostal muscles at the sixth intercostal space. Anatomical dissection was subsequently conducted to assess the extent and depth of injectate spread.ResultsIn all specimens, dye spread did not extend beyond the costal arch, and the anterior branches of the thoracoabdominal nerves were not stained. The dye infiltrated within the external oblique muscle, reaching its superficial layer across a median (IQR) of 3 (3–4) intercostal levels, but did not reach the site where the lateral cutaneous branches arise from the intercostal nerves along the mid-axillary line. Limited dye spread into the intercostal space was observed in 3 of 7 specimens.ConclusionsIn our cadaveric study, EOI block did not involve the anterior branches of the thoracoabdominal nerves. Our findings suggest that the EOI block may affect the lateral cutaneous branches of the intercostal nerves through the spread of injectate within the external oblique muscle. Future research is warranted to clarify the precise mechanisms of action and anesthetic coverage of the EOI block.Abstract EP081 Figure 1Ultrasound-guided right EOI block[Image Omitted. See PDF.]Abstract EP081 Figure 2Cadaveric finding showing the spread of blue dye following right EOI block injection. EO, External oblique muscle[Image Omitted. See PDF.]
Journal Article