PhysEmp :: Medicine :: Imaging :: Ultrasonography (10)

pubmed: 0278-4297

Angiomyofibroblastoma-like tumor of the inguinal canal.
de Souza LR, Filho EC, Braga WP, Martins PT, De Nicola H Related Articles Angiomyofibroblastoma-like tumor of the inguinal canal. J Ultrasound Med. 2009 Sep;28(9):1269-72 Authors: de Souza LR, Filho EC, Braga WP, Martins PT, De Nicola H PMID: 19710228 [PubMed - indexed for MEDLINE]
Imaging features of chest wall gossypiboma.
Le HB, Lee S, Malfair D, Munk PL Related Articles Imaging features of chest wall gossypiboma. J Ultrasound Med. 2009 Sep;28(9):1265-8 Authors: Le HB, Lee S, Malfair D, Munk PL PMID: 19710227 [PubMed - indexed for MEDLINE]
Diaphragmatic laceration after penetrating trauma: direct visualization and indirect findings on focused assessment with sonography for trauma in the emergency department.
Hoffmann B, Nguyen H, Hill HF Related Articles Diaphragmatic laceration after penetrating trauma: direct visualization and indirect findings on focused assessment with sonography for trauma in the emergency department. J Ultrasound Med. 2009 Sep;28(9):1259-63 Authors: Hoffmann B, Nguyen H, Hill HF PMID: 19710226 [PubMed - indexed for MEDLINE]
Clinical utility of low-volume ultrasound-guided interscalene blockade: contraindications reconsidered.
Smith HM, Duncan CM, Hebl JR Related Articles Clinical utility of low-volume ultrasound-guided interscalene blockade: contraindications reconsidered. J Ultrasound Med. 2009 Sep;28(9):1251-8 Authors: Smith HM, Duncan CM, Hebl JR OBJECTIVE: The purpose of this series is to describe cases in which ultrasound guidance was used to allow patients to receive the benefits of regional anesthesia while safely circumventing traditional contraindications to interscalene blockade (ISB). METHODS: Targeted low-volume ISB was performed in 3 patients in whom this procedure would typically be contraindicated because of phrenic nerve blockade or risk of local anesthetic toxicity. A patient with severe respiratory dysfunction, a patient undergoing bilateral shoulder surgery, and a patient requiring awake fiberoptic intubation underwent low-volume ultrasound-guided ISB. The ultrasound technique involved the use a low local anesthetic volume, anatomic identification of the brachial plexus trunk, needle placement opposite the phrenic nerve position, and control over local anesthetic spread. RESULTS: In both patients in whom diaphragmatic paralysis was a concern, postoperative respiratory parameters indicated successful regional analgesia without evidence of phrenic nerve blockade. In the patient requiring an additional regional anesthetic procedure, ISB was performed with a local anesthetic volume low enough to avoid exceeding toxic safety thresholds. CONCLUSIONS: Although further studies are warranted, we report on 3 cases in which ultrasound guidance was used to allow patients to receive the benefits of regional anesthesia while safely avoiding standard contraindications to ISB. Ultrasound technology may allow providers to perform low-volume brachial plexus blockade while avoiding issues related to phrenic nerve blockade and systemic local anesthetic toxicity. PMID: 19710225 [PubMed - indexed for MEDLINE]
High-resolution sonography is effective in detection of soft tissue foreign bodies: experience from a rural Indian center.
Saboo SS, Saboo SH, Soni SS, Adhane V Related Articles High-resolution sonography is effective in detection of soft tissue foreign bodies: experience from a rural Indian center. J Ultrasound Med. 2009 Sep;28(9):1245-9 Authors: Saboo SS, Saboo SH, Soni SS, Adhane V OBJECTIVE: Patients with penetrating trauma or field injuries are commonly encountered by emergency physicians. Clinical examination by inspection or palpation can detect superficial foreign bodies (FBs), and radiographs can detect radiopaque FBs. However, soft tissue FBs can be easily missed. The aim of our series was to evaluate the role of high-resolution sonography in detection of soft tissue FBs. METHODS: All patients referred to our center for sonographic evaluation of suspected soft tissue FBs from 1999 to 2008 were included in this analysis. Patients were scanned with an ultrasound machine using a 7.5-MHz transducer. The suspected area was scanned in both axial and sagittal planes. The nature of the FB, length, and depth from the surface were recorded and reported. The presence of an FB was confirmed by surgical excision. RESULTS: During the study period, 123 patients underwent sonography for a suspected FB, of which 12 were lost to follow-up and excluded from the analysis. The study group included 73.8% male patients; the mean age was 36.2 years. Wood fragments and wooden thorns were the most frequently observed FBs, at 46.2% and 36.2%, respectively. The surgeon was satisfied with the reported depth of the FB from the surface in most cases (89%). The overall sensitivity and specificity of sonography were 94.5% and 53.8%. CONCLUSIONS: High-resolution sonography is a very sensitive tool in diagnosis of soft tissue FBs. It also helps the surgeon with accurate localization, permitting easy removal. PMID: 19710224 [PubMed - indexed for MEDLINE]
Video analysis of accidental arterial cannulation with dynamic ultrasound guidance for central venous access.
Blaivas M Related Articles Video analysis of accidental arterial cannulation with dynamic ultrasound guidance for central venous access. J Ultrasound Med. 2009 Sep;28(9):1239-44 Authors: Blaivas M OBJECTIVE: Accidental arterial cannulation during ultrasound-guided central venous cannulation is rarely reported and should be much less likely with dynamic guidance. Although accidental arterial penetration with the needle may occur periodically without notice and with little harm, actual arterial dilation and line placement may result in serious complications. METHODS: This series reports 6 such cases of accidental arterial cannulation and central line insertion under dynamic ultrasound guidance. RESULTS: Two of the arterial cannulations resulted in airway loss, with 1 of these ending in death. The remaining 4 arterial lines led to serious local complications. Ultrasound video analysis of each line placement or postplacement analysis was reviewed, and common pitfalls were extracted. In 3 cases, a central line went directly through the internal jugular vein (IJ) and into the carotid artery. In 1 case, a cordis introducer sheath traveled through the posterior wall of the common femoral vein and into the deep femoral artery branch below. Each patient was hypotensive and hypoxic, making traditional safety checkpoints such as aspiration of bright red blood and pulsatile flow from the syringe hub less reliable in identifying accidental arterial cannulation. All ultrasound-guided cannulations were performed by a standard short-axis approach with high-resolution linear array ultrasound transducers on modern equipment. CONCLUSIONS: The short-axis approach, as seen in this series, can provide a false sense of security to the practitioner and allows for potentially dangerous accidental arterial cannulation. In the setting of critically ill patients, it may be prudent to not only visualize the entire path of the needle with the long-axis approach but also confirm correct cannulation by tracing the guide wire in the long axis before line placement. PMID: 19710223 [PubMed - indexed for MEDLINE]

ScienceDirect Publication: Ultrasound Clinics

Contents
Tue, 27 Oct 2009 22:35:34 -0000
Publication year: 2009Source: Ultrasound Clinics, Volume 4, Issue 2, April 2009, Pages v-vii[No author name available]
Forthcoming Issues
Tue, 27 Oct 2009 22:35:34 -0000
Publication year: 2009Source: Ultrasound Clinics, Volume 4, Issue 2, April 2009, Page viii[No author name available]
Accreditation Page
Tue, 27 Oct 2009 22:35:34 -0000
Publication year: 2009Source: Ultrasound Clinics, Volume 4, Issue 2, April 2009, Page ix[No author name available]

Journal of Clinical Ultrasound

Dicephalic parapagus conjoined twins: A rare second trimester sonographic diagnosis
Ahmet Mete, Fatma Bahar Cebesoy, Ebru D[idot]kensoy, [Idot]rfan Kutlar Wed, 18 Nov 2009 14:25:00 -0000
Conjoined twins are 1 of the rarest and most challenging congenital malformations. It occurs if twinning is initiated after the embryonic disc and rudimentary amniotic sac have been formed. We report a very rare case of dicephalic parapagus that was diagnosed by transabdominal sonography. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2010
A pseudoaneurysm within a subperiosteal collection in a patient with sickle cell disease
Faye Cuthbert, Manpreet Singh Gulati, Gabriel Constantinescu, Paula Robertson Wed, 18 Nov 2009 14:25:00 -0000
Sickle cell disease involves long bones in the form of infection or subperiosteal collections. Rare pseudoaneurysm/aneurysm formation is also known to occur in the intracranial and visceral territories. We report a small subperiosteal pseudoaneurysm that developed within a subperiosteal abscess in the tibia in a patient with sickle cell disease. This case adds to the known spectrum of musculoskeletal abnormalities resulting from this condition. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2010
Therapeutic options of caesarean scar pregnancy: Case series and literature review
A.J. Marjolein Bij de Vaate, Hans A.M. Brölmann, Johannes W. van der Slikke, Maurice G.A.J. Wouters, Roel Schats, Judith A.F. Huirne Mon, 09 Nov 2009 14:22:00 -0000
We describe our experience with the treatment of 4 caesarean scar pregnancies and provide an overview of current literature. Four women diagnosed with a caesarean scar pregnancy in our hospital between 1996 and 2007 were treated with local or systemic methotrexate and had a steady decline of the serum [beta]-hCG level. The uterus was preserved in all women and 3 of them had an uneventful subsequent pregnancy and delivery. We suggest that transcervical needle aspiration of amniotic fluid followed by intra-amniotic injection of methotrexate should be the treatment of choice, followed by surgical treatment only if methotrexate fails. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound 2010

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