Related Terms: Doppler ultrasound, Sonogram
Another radiology test that is proving useful in the diagnosing and understanding of lymphedema is the ultrasound.
For example ultrasound imaging studies of lymphedema-affected upper extremities have focused upon estimating the thickness of the dermis and subcutis areas.
The Doppler ultrasound looks at blood flow and pressure by bouncing high-frequency sound waves (ultrasound) off red blood cells. Ultrasound can be helpful in finding obstructions.
“Ultrasound uses high-frequency sound waves to look at organs and structures inside the body. Health care professionals use them to view the heart, blood vessels, kidneys, liver and other organs. During pregnancy, doctors use ultrasound tests to examine the fetus. Unlike x-rays, ultrasound does not involve exposure to radiation.
During an ultrasound test, a special technician or doctor moves a device called a transducer over part of your body. The transducer sends out sound waves, which bounce off the tissues inside your body. The transducer also captures the waves that bounce back. Images are created from these sound waves.” (1)
Why it is done:
Evaluate a fetus Diagnose gallbladder disease Evaluate flow in blood vessels Guide a needle biopsy Guide the biopsy and treatment of a tumor Check your thyroid gland Study your heart Diagnose some forms of infection Diagnose some forms of cancer Reveal abnormalities in the scrotum and prostate Evaluate abnormalities of the muscles and tendons
For we patients, the good thing about ultrasounds is that they are safe procedures that have no direct risks from the tests. It is also a very painless procedure.
There are no special preparations for many ultrasounds, while others make require not eating or drinking for up to six hours before the exam. Your doctor or radiologist can provide you with anny preparation neccesary for your tests.
Types of Ultrasounds:
Heart Ultrasound (Echocardiography)
see also: Fetal Echocardiography/Fetal Ultrasound
Transesophageal echocardiogram. The transducer is inserted into your esophagus to obtain images of the nearby heart. Such exams are typically performed along with sedation.
Transvaginal ultrasound. A small, specialized transducer is inserted into a woman's vagina to view her uterus and ovaries.
Your physician will go over the results of your tests. These results are generally back to the doctor within a week of the test.
Doppler ultrasound is a noninvasive test that can be used to measure your blood flow and blood pressure by bouncing high-frequency sound waves (ultrasound) off circulating red blood cells. A regular ultrasound uses sound waves to produce images, but can't show blood flow.
A Doppler ultrasound may help diagnose many conditions, including:
Blood clots Poorly functioning valves in your leg veins, which can cause blood or other fluids to pool in your legs (venous insufficiency) Heart valve defects and congenital heart disease A blocked artery (arterial occlusion) Decreased blood circulation into your legs (peripheral artery disease) Bulging arteries (aneurysms) Narrowing of an artery, such as those in your neck (carotid artery stenosis) (2)
Measurement of lymphedema using ultrasonography with the compression method. Jun 2011
Lim CY, Seo HG, Kim K, Chung SG, Seo KS.
Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea.
Lymphedema is swelling of soft tissues by accumulation of lymphatic fluid due to failure of the lymphatic drainage system. Although most measures for lymphedema focus on change of volume or size of the extremity, the physical properties of the tissue such as resistance to compression are also of clinical importance because they affect the quality of life of lymphedema patients. In this study, we aimed to compare the thickness and resistance to compression of the skin and subcutis between the affected and unaffected arms of patients with lymphedema by using ultrasonography together with the compression technique, and we also investigated the factors that have an influence on the results. Thirty-nine patients with post-mastectomy lymphedema participated in this study. All ultrasonographically-assessed thicknesses of skin and subcutaneous tissue in affected upper arms and forearms were significantly larger than the contralateral (p < 0.05) while all resistances to compression values were significantly lower (p < 0.05). These results suggest that measuring the resistance to compression and thickness using the compression method with ultrasonography may be a valuable tool for evaluating lymphedema after breast cancer surgery.
5th Medical Clinic, “Iuliu Haţieganu” University of Medicine and Pharmacy, Str.Tăbăcarilor 11, 400139 Cluj-Napoca, Romania; Email: firstname.lastname@example.org.
duplex ultrasonography , common carotid artery , external carotid artery , internal carotid artery
Carotid duplex ultrasonography is a noninvasive technique for hemodynamically significant stenosis detection and cardiovascular risk estimation. Anatomic information of carotid arteries is provided by B-mode scanning. Hemodynamic features are displayed color-flow and pulsed Doppler imaging. Examination technique, normal carotid anatomy and flow pattern, and potential limitations are presented.
Power Doppler breast ultrasound: association of vascularization and ER/c-erbB-2 co-expression in invasive breast carcinoma.
Chen ST, Kuo SJ, Wu HK, Chen LS, Chen DR. Source Comprehensive Breast Cancer Center, Changhua Christian Hospital, 135 Nanhsiao Street, Changhua, 500, Taiwan. Abstract BACKGROUND: Angiogenesis is a fundamental component of oncogenesis. In this study we provided morphologic evidence of vascularization by using power Doppler ultrasound to correlate the clinicopathologic features of tumorigenesis, ER/c-erbB-2 expression, and tumor grade in invasive breast carcinoma.
METHODS: Three indices (VI, vascularization index; FI, flow index; VFI, vascularization flow index) were used to analyze 3D power Doppler ultrasound images from 168 patients with malignant breast carcinoma and to correlate their clinicopathologic features.
RESULTS: VI (the mean tumor vascularity) was correlated with ER negativity (p < 0.0029) and VFI (the overall perfusion) was correlated with ER positivity (p < 0.0029). HER2 positivity was statistically significantly correlated with tumor vasculature (VI, VFI) and tumor size/volume. FI (the mean blood flow volume) was significantly correlated with tumor size/volume, but VI was not. The univariate or multivariate logistic regression analysis also showed the reverse correlations between ER expression and tumor vascularity, and positive correlations between HER2 expression and tumor vascularity as well as tumor volume.
CONCLUSIONS: This morphologic evidence of vascularization is correlated with tumor angiogenesis and ER/c-erbB-2 co-expression, which could clarify the biology of breast cancer.
Chronic cerebrospinal venous insufficiency: does ultrasound really distinguish multiple sclerosis subjects from healthy controls?
Kantarci F, Albayram S, Demirci NO, Esenkaya A, Uluduz D, Uysal O, Saip S, Siva A.
Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, 34300 Kocamustafapasa, Istanbul, Turkey, email@example.com. Abstract
To investigate the differences between multiple sclerosis (MS) and control subjects by using extracranial venous grey-scale, colour and spectral Doppler ultrasound.
The study included 62 subjects with a definitive diagnosis of MS and 54 control subjects. The cross sectional area (CSA), reflux during Valsalva manoeuvre, presence or absence of flow in the internal jugular vein (IJV) were assessed in upright and supine positions. The IJV and vertebral vein (VV) flow volumes (BFV) were also studied.
Reflux in the IJV, an upright CSA greater than a supine CSA, and the presence or absence of flow in the IJV were not different between MS and control subjects. A CSA ≤ 0.3 cm(2) was observed to be significantly higher in MS subjects. The IJV BFV was not significantly different between the groups; however, the VV BFV was significantly higher on the right side and lower on the left side in MS subjects.
Our use of ultrasound criteria reported in the literature for MS reveals differences between healthy controls and MS subjects that also overlap. Our experience suggests that Doppler ultrasound may not be clinically reliable and more studies are needed to clarify its role, if any. Key Points • Chronic cerebrospinal venous insufficiency is a controversial topic in multiple sclerosis. • Ultrasound assessment of extracranial veins has yielded different results in the literature. • These differences may be due to dependence on Doppler and selection bias. • We found variations in vertebral vein flow in patients with multiple sclerosis.
First in vivo use of a capacitive micromachined ultrasound transducer array-based imaging and ablation catheter.
Stephens DN, Truong UT, Nikoozadeh A, Oralkan O, Seo CH, Cannata J, Dentinger A, Thomenius K, de la Rama A, Nguyen T, Lin F, Khuri-Yakub P, Mahajan A, Shivkumar K, O'Donnell M, Sahn DJ.
Department of Pediatric Cardiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, L608, Portland, OR 97239-3098 USA., firstname.lastname@example.org
Objectives The primary objective was to test in vivo for the first time the general operation of a new multifunctional intracardiac echocardiography (ICE) catheter constructed with a microlinear capacitive micromachined ultrasound transducer (ML-CMUT) imaging array. Secondarily, we examined the compatibility of this catheter with electroanatomic mapping (EAM) guidance and also as a radiofrequency ablation (RFA) catheter. Preliminary thermal strain imaging (TSI)-derived temperature data were obtained from within the endocardium simultaneously during RFA to show the feasibility of direct ablation guidance procedures.
Methods The new 9F forward-looking ICE catheter was constructed with 3 complementary technologies: a CMUT imaging array with a custom electronic array buffer, catheter surface electrodes for EAM guidance, and a special ablation tip, that permits simultaneous TSI and RFA. In vivo imaging studies of 5 anesthetized porcine models with 5 CMUT catheters were performed.
Results The ML-CMUT ICE catheter provided high-resolution real-time wideband 2-dimensional (2D) images at greater than 8 MHz and is capable of both RFA and EAM guidance. Although the 24-element array aperture dimension is only 1.5 mm, the imaging depth of penetration is greater than 30 mm. The specially designed ultrasound-compatible metalized plastic tip allowed simultaneous imaging during ablation and direct acquisition of TSI data for tissue ablation temperatures. Postprocessing analysis showed a first-order correlation between TSI and temperature, permitting early development temperature-time relationships at specific myocardial ablation sites.
Conclusions Multifunctional forward-looking ML-CMUT ICE catheters, with simultaneous intracardiac guidance, ultrasound imaging, and RFA, may offer a new means to improve interventional ablation procedures.
Biliary Papillomatosis and New Ultrasound Imaging Modalities.
Cui XW, Ignee A, Braden B, Woenckhaus M, Dietrich CF.
Caritas-Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany.
Biliary papillomatosis (BP) is a rare disorder of the biliary tract with a significant risk of malignant transformation and a high recurrence rate after operation due to the diffuse distribution of the disease. Preoperative diagnosis is difficult also by reason of the low sensitivity and specificity of conventional ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangiography (ERC) and positron emission tomography (PET). Therefore, the introduction of new diagnostic imaging methods is of importance to improve the preoperative diagnosis of this originally as benign described disease which is reflected in the term of “benign papillomatosis of the biliary tree”. The present review summarizes the literature and discusses new sonographic imaging techniques including contrast-enhanced ultrasound (CEUS), contrast-enhanced low mechanical endoscopic ultrasound (CELMI-EUS) and endoscopic ultrasound elastography.
Assessment of substantia nigra echogenicity in german and filipino populations using a portable ultrasound system. Feb 2012
Go CL, Frenzel A, Rosales RL, Lee LV, Benecke R, Dressler D, Walter U.
Department of Neurology, University of Rostock, Gehlsheimer Strasse 20, D-18147 Rostock, Germany., email@example.com.
Objectives Transcranial sonography of the substantia nigra for diagnosing premotor stages of Parkinson disease has been attracting increasing interest. Standard reference values defining an abnormal increased echogenic size (hyperechogenicity) of the substantia nigra have been established in several populations using high-end stationary ultrasound systems. It is unknown whether a portable ultrasound system can be appropriately used and how the Filipino population would compare with the well-studied white population.
Methods We prospectively studied substantia nigra echogenic sizes and third ventricle widths in 71 healthy adult German participants and 30 age- and sex-matched Filipino participants using both a well-established stationary ultrasound system (in the German cohort) and a recently distributed portable ultrasound system (in both ethnic cohorts).
Results Mean substantia nigra echogenic sizes, cutoff values defining abnormal hyperechogenicity, and intra-rater reliability were similar with both systems and in both ethnic cohorts studied. The Filipino and German participants did not differ with respect to the frequency of insufficient insonation conditions (each 3%) and substantia nigra hyperechogenicity (10% versus 9%; P = .80). However, third ventricle widths were smaller in the Filipino than the German participants (mean ± SD, 1.6 ± 1.1 versus 2.4 ± 1.0 mm; P = .004).
Conclusions The frequency of substantia nigra hyperechogenicity appears to be homogeneous in white and Asian populations. Screening for this feature may well be performed with a present-day portable ultrasound system.
From a basic website on lymphedema, our outreach has continued to expand to where now we offer a full range of support groups, blogs and glossaries on all types of lymphatic conditions.
Index of Resources: