• Title, Summary, Keyword: Ultrasound-guided

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Usefulness of X-ray Guided Biopsy and Ultrasound Guided Biopsy in Breast Microcalcification Biopsy (유방 미세석회화 조직검사에서 X선 유도 하 조직검사와 초음파 유도 하 조직검사의 유용성)

  • Choi, Miseon;Song, Jongnam
    • Journal of the Korean Society of Radiology
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    • v.10 no.3
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    • pp.201-206
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    • 2016
  • Social interest in breast cancer has increased. The most basic exams for diagnosis include breast X-ray and breast ultrasound. In particular, breast microcalcification requires histological diagnosis, and breast microcalcification biopsy is commonly performed. Therefore, this study aimed to analyze and assess X-ray guided biopsy (needle localized open biopsy) and ultrasound guided biopsy (sono guided core needle biopsy), which are basics in diagnosis of microcalcification. Targeting 241 cases in which magnification mammography was performed for patients who visited the hospital due to breast microcalcification, age distribution and the location of lesions were analyzed in X-ray guided biopsy and ultrasound guided biopsy. By classifying exams performed after magnification mammography, the frequencies of X-ray guided biopsy and ultrasound guided biopsy were analyzed, and malignant and benign results were confirmed. The results showed that 64 cases(26.6%) were X-ray guided biopsy, which was 5.4 times higher than 12 cases(4.9%) of ultrasound guided biopsy. Due to development of ultrasound equipments, stereotactic vacuum-assisted biopsy, etc. the methods of histological diagnosis of microcalcification have become diverse, but when considering characteristics and limitations of each exam, X-ray guided biopsy is thought to be most accurate and useful.

The Validation of Ultrasound-Guided Target Segment Identification in Thoracic Spine as Confirmed by Fluoroscopy

  • Heo, Ju-Yeong;Lee, Ji-Won;Kim, Cheol-Hwan;Lee, Sang-Min;Choi, Yong-Soo
    • Clinics in Orthopedic Surgery
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    • v.9 no.4
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    • pp.472-479
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    • 2017
  • Background: The role of ultrasound in the thoracic spine has been underappreciated, partly because of the relative efficacy of the landmark-guided technique and the limitation of imaging through the narrow acoustic windows produced by the bony framework of thoracic spine. The aim of this study was to make a comparison between the 12th rib and the spinous process of C7 as a landmark for effective ultrasound-guided target segment identification in the thoracic spine. Methods: Ultrasonography of 44 thoracic spines was performed and the same procedure was carried out 1 week later again. The target segments (T3-4, T7-8, and T10-11) were identified using the 12th rib (group 1) or the spinous process of C7 (group 2) as a starting landmark. Ultrasound scanning was done proximally (group 1) or distally (group 2) toward the target transverse process and further medially and slightly superior to the target thoracic facet. Then, a metal marker was placed on the T3-4, T7-8, and T10-11 and the location of each marker was confirmed by fluoroscopy. Results: In the total 132 segments, sonographic identification was confirmed to be successful with fluoroscopy in 84.1% in group 1 and 56.8% in group 2. Group 1 had a greater success rate in ultrasound-guided target segment identification than group 2 (p = 0.001), especially in T10-11 (group 1, 93.2%; group 2, 43.2%; p = 0.001) and T7-8 (group 1, 86.4%; group 2, 56.8%; p = 0.002). The intrarater reliability of ultrasound-guided target segment identification was good (group 1, r = 0.76; group 2, r = 0.82), showing no difference between right and left sides. Ultrasound-guided target segment identification was more effective in the non-obese subjects (p = 0.001), especially in group 1. Conclusions: Ultrasound-guided detection using the 12th rib as a starting landmark for scanning could be a promising technique for successful target segment identification in the thoracic spine.

Ultrasonography and Ultrasound-guided Interventions of the Shoulder

  • Moon, Sang Ho;Ko, Kwang Pyo;Baek, Seung Il;Lee, Song
    • Clinics in Shoulder and Elbow
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    • v.18 no.3
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    • pp.172-193
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    • 2015
  • Nowadays shoulder ultrasound is commonly used in the assessment of shoulder diseases and is as accurate as magnetic resonance imaging in the detection of several pathologies. Operator dependence is the main disadvantage of shoulder ultrasound. After adhering to a strict examination protocol, good knowledge of normal anatomy and pathologic processes and an awareness of common pitfalls, it can be used as a focused examination providing rapid, real-time diagnosis, and treatment by ultrasound-guided interventions in desired clinical situations. Also shoulder ultrasound can help the surgeon decide whether treatment will be surgical or nonsurgical. If arthroscopy is planned, sonographic findings help to counsel patients regarding surgical and functional outcomes. If a nonsurgical approach is indicated, ultrasound can be used to follow patients. This review article presents the examination techniques, the normal sonographic appearances and the main pathologic conditions found in shoulder ultrasound. And also addresses a simplified approach to scanning and ultrasound-guided intervention. Knowledge of optimal techniques, normal anatomy, dynamic maneuvers, and pathologic conditions is essential for optimal performance and interpretation of images.

Diagnostic Approach of Hepatic Mass using Ultrasound Guided Fine Needle Aspiration in a Dog (개에서 초음파를 이용한 간 종괴의 세침흡인술 증례)

  • 최호정;이기창;최민철;윤정희
    • Journal of Veterinary Clinics
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    • v.21 no.2
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    • pp.181-183
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    • 2004
  • Hepatic mass was aspirated under the guidance with ultrasound in 9-year old female maltese with signs of anorexia, hematochezia, vomiting, depression, and abdominal distension. Radiographic and abdominal ultrasonographic examinations were performed, which revealed enlarged tubular shaped uterine mass and solitary, small round hyperechoic hepatic mass dorsal to gall bladder as an incidental finding. Ultrasound-guided fine needle aspiration was completed, but histologic confirmation should be made for definitive diagnosis by tissue core or wedge biopsy.

The Case Report of Posterior Headache Caused by Traffic Accident Treated with Musculoskeletal Ultrasound-guided Acupotomy Therapy (교통사고 후 발생한 후두통의 근골격계 초음파를 이용한 침도치료 임상증례)

  • Park, Man-Yong;Kim, Sung-Ha;Lee, Sang-Mi;Lee, Jong-Deok;Lim, Jin-Young;Kwon, So-Yeon;Jung, Il-Min;Kim, Sung-Chul
    • Journal of Acupuncture Research
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    • v.28 no.2
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    • pp.165-172
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    • 2011
  • Objectives : The objective of this case report was to observe the effect of musculoskeletal ultrasound-guided acupotomy therapy on posterior headache caused by traffic accident. Methods : Musculoskeletal ultrasound-guided acupotomy therapy was performed to two patients whose brain MRI or CT results were normal, but posterior headache did not improve with general eastern medical treatment. Results : One patient's VAS(visual analogue scale) of posterior headache was decreased for the first time after ultrasound-guided acupotomy therapy, and steadily reduced. The other patient's VAS was also decreased for the first time after musculoskeletal ultrasound-guided acupotomy therapy. Two patient's Korean HIT-6(Korean headache impact test-6) scores were decreased after one month. Conclusions : If general eastern medical treatment had little effect on traffic accident induced posterior headache, musculoskeletal ultrasound-guided acupotomy therapy can be applied.

A Randomized Comparative Study of Blind versus Ultrasound Guided Glenohumeral Joint Injection of Corticosteroids for Treatment of Shoulder Stiffness

  • Lee, Hyo-Jin;Ok, Ji-Hoon;Park, In;Bae, Sung-Ho;Kim, Sung-Eun;Shin, Dong-Jin;Kim, Yang-Soo
    • Clinics in Shoulder and Elbow
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    • v.18 no.3
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    • pp.120-127
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    • 2015
  • Background: We prospectively compared the response to blind and ultrasound-guided glenohumeral injection of corticosteroids for treatment of shoulder stiffness. Methods: A total of 77 patients with shoulder stiffness between April 2008 and March 2012 were recruited. Patients were randomized to receive either a blind (group 1, n=39) or ultrasound-guided (group 2, n=38) glenohumeral injection of 40 mg triamcinolone. The clinical outcomes and shoulder range of motion (ROM) before injection, at 3, 6, and 12 months after injection and at the last follow-up were assessed. The same rehabilitation program was applied in both groups during the follow-up period. Results: There was no significant difference in demographic data on age, sex, ROM, and symptom duration before injection between groups (p>0.05). There were no significant differences in ROM including forward flexion, external rotation at the side, external rotation at $90^{\circ}$ abduction, and internal rotation, visual analogue scale for pain and functional outcomes including American Shoulder and Elbow Surgeons score, Simple Shoulder test between the two groups at any time point (p>0.05). Conclusions: Based on the current data, the result of ultrasound-guided glenohumeral injection was not superior to that of blind injection in the treatment of shoulder stiffness. We suggest that ultrasound-guided glenohumeral injection could be performed according to the patient's compliance and the surgeon's preference. Once familiar with the non-imaging-guided glenohumeral injection, it is an efficient and reliable method for the experienced surgeon. Ultrasound could be performed according to the surgeon's preference.

Ultrasound-guided Evacuation of Spontaneous Intracerebral Hemorrhage in Basal Ganglia

  • Park, Seong-Keun;Lee, Jung-Kil;Shin, Seung-Ryeol;Lee, Je-Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.37 no.3
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    • pp.197-200
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    • 2005
  • Objective: Ultrasound can be used in the treatment of large intracerebral hematoma. The authors present our experiences with Ultrasound-guided catheter placement for lysis and drainage of ganglionic hematoma, with emphasis on technical aspects. Methods: The authors applied real-time ultrasonography for the aspiration of intracerebral hematoma in 6cases. Ultrasound-guided aspiration via a burrhole was performed under local anesthesia. We selected a temporal entry point instead of the frequently used precoronal approach in ganglionic hematoma. A burrhole was made 4 to 6cm posterior from posterior border of frontal process of the zygomatic bone at the level of 4 to 5cm above the external auditory meatus. Results: In all patients, the catheter was placed accurately into the hematoma target. All patients were irrigated with urokinase once to three times a day. The catheter could be removed within two or three days. The mean hematoma volume was reduced from initially 32mL to 5mL in an average of two days. There were no intraoperative complications related to the use of real-time ultrasonography and no postoperative infections were noted. Conclusion: Ultrasound allows an easy and precise localization of the hematoma and the distance from the surface to the target can be calculated. Ultrasound-guided catheter placement for fibrinolysis and hematoma drainage is a simple and safe procedure.

Ultrasound-guided Femorosciatic Nerve Block by Orthopaedist for Ankle Fracture Operation (족관절 골절 수술을 위한 정형외과 의사의 초음파 유도 대퇴좌골 신경 차단)

  • Kang, Chan;Hwang, Deuk-Soo;Kim, Young-Mo;Kim, Pil-Sung;Jun, You-Sun;Hwang, Jung-Mo;Han, Sun-Cheol
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.90-96
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    • 2010
  • Purpose: The purpose of this study is to investigate the usefulness of ultrasound-guided femorosciatic nerve block by orthopaedist to operate the fracture around ankle. Materials and Methods: Twenty-two patients, who had an operation for fracture around the ankle under a ultrasound-guided femorosciatic nerve block from January to April 2010, were the targets of this study. We measured the time spent for the ultrasound-guided femorosciatic nerve block, the time taken to start the operation after the nerve block, the time taken to deflate the tourniquet because of a tourniquet pain, the time passed until feeling a postoperative pain after the operation, etc. We also studied the complications and satisfaction of the anesthesia. Results: It took 6.2 (3 to 12) minutes for the nerve block, 46.1 (28 to 75) minutes to start the operation, 52.5 (22 to 78) minutes until feeling a tourniquet pain and 11.5 (7.5 to 19) hours until starting to feeing a postoperative pain. There was no complication by anesthesia and 21 people (95.5%) were satisfied with anesthesia by ultrasound-guided femorosciatic nerve block. Conclusion: Ultrasound-guided femorosciatic nerve block by orthopaedist in the fracture around ankle reduces anesthetic and nerve injury complication, and leads to high anesthetic success rate. Also it is considered as an effective method to alleviate postoperative pain.

Risk of Encountering Dorsal Scapular and Long Thoracic Nerves during Ultrasound-guided Interscalene Brachial Plexus Block with Nerve Stimulator

  • Kim, Yeon Dong;Yu, Jae Yong;Shim, Junho;Heo, Hyun Joo;Kim, Hyungtae
    • The Korean Journal of Pain
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    • v.29 no.3
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    • pp.179-184
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    • 2016
  • Background: Recently, ultrasound has been commonly used. Ultrasound-guided interscalene brachial plexus block (IBPB) by posterior approach is more commonly used because anterior approach has been reported to have the risk of phrenic nerve injury. However, posterior approach also has the risk of causing nerve injury because there are risks of encountering dorsal scapular nerve (DSN) and long thoracic nerve (LTN). Therefore, the aim of this study was to evaluate the risk of encountering DSN and LTN during ultrasound-guided IBPB by posterior approach. Methods: A total of 70 patients who were scheduled for shoulder surgery were enrolled in this study. After deciding insertion site with ultrasound, awake ultrasound-guided IBPB with nerve stimulator by posterior approach was performed. Incidence of muscle twitches (rhomboids, levator scapulae, and serratus anterior muscles) and current intensity immediately before muscle twitches disappeared were recorded. Results: Of the total 70 cases, DSN was encountered in 44 cases (62.8%) and LTN was encountered in 15 cases (21.4%). Both nerves were encountered in 10 cases (14.3%). Neither was encountered in 21 cases (30.4%). The average current measured immediately before the disappearance of muscle twitches was 0.44 mA and 0.50 mA at DSN and LTN, respectively. Conclusions: Physicians should be cautious on the risk of injury related to the anatomical structures of nerves, including DSN and LTN, during ultrasound-guided IBPB by posterior approach. Nerve stimulator could be another option for a safer intervention. Moreover, if there is a motor response, it is recommended to select another way to secure better safety.

Ultrasound-Guided Injections in the Lumbar and Sacral Spine (요추 및 천추부에 대한 초음파 유도하 중재 시술)

  • Ko, Kwang Pyo;Song, Jae Hwang;Kim, Whoan Jeang;Kim, Sang Bum;Min, Young Ki
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.185-195
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    • 2018
  • Study Design: Literature review. Objective: Ultrasound-guided injections are a common clinical treatment for lower lumbosacral pain that are usually performed before surgical treatment if conservative treatment fails. The aim of this article was to review ultrasound-guided injections in the lumbar and sacral spine. Summary of Literature Review: Ultrasound-guided injections, unlike conventional interventions using computed tomography or C-arm fluoroscopy, can be performed under simultaneous observation of muscles, ligaments, vessels, and nerves. Additionally, they have no radiation exposure and do not require a large space for the installation of equipment, so they are increasingly selected as an alternative method. Materials and Methods: We searched for and reviewed studies related to the use of ultrasound-guided injections in the lumbar and sacral spine. Results: In order to perform accurate ultrasound-guided injections, it is necessary to understand the patient's posture during the intervention, the relevant anatomy, and normal and abnormal ultrasonographic findings. Facet joint intra-articular injections, medial branch block, epidural block, selective nerve root block, and sacroiliac joint injections can be effectively performed under ultrasound guidance. Conclusions: Ultrasound-guided injections in the lumbar and sacral spine are an efficient method for treating lumbosacral pain.