Sarah Razaq;James Geffner;Asma Khan;Harry Mee;Cynthia Udensi;Fahim Anwar
Journal of Trauma and Injury
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v.36
no.3
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pp.269-275
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2023
A Morel-Lavallée lesion results from a degloving injury between the muscle fascia and the subcutaneous layer. It is most commonly found in the trochanteric area but can occur at other sites. The treatment of the condition varies according to the medical circumstances, as well as the size and chronicity of the condition. A case of large (18×6 and 10×5 cm) bilateral posttraumatic Morel-Lavallée lesions with no underlying bone fracture is presented; the case occurred in a 49-year-old male patient 4 weeks posttrauma. Ultrasound scans showed bilateral large collections of anechoic fluid, which were aspirated under ultrasound guidance and further managed by compression bandages. There were no further complications. The objective of this case report is to present this unique and educational case, as well as to provide an overview of the pathophysiology, diagnosis, and management of Morel-Lavallée lesions. We conclude by discussing the importance of having a high index of suspicion to ensure early detection and prompt treatment of such lesions to avoid complications.
Background: Sonoelastography (SE) is a new technique that can assess differences in tissue stiffness, the purpose of this study was to evaluate the ability of SE to assess the long head of biceps tendon alteration. Methods: Forty shoulders of 36 consecutively registered patients with clinical symptoms and conventional ultrasonography findings of biceps tendinitis or tendinosis, and 40 asymptomatic shoulders of 20 healthy volunteers were assessed with SE. Transverse and longitudinal images of long head of biceps tendon were obtained using SE. SE images were performed by one orthopedic surgeon and evaluated by two orthopedic surgeons using an experimentally proven color grading system. Results: The transverse images of SE showed a sensitivity of 87.5%, a specificity of 95.0% and a accuracy of 91.3%, the longitudinal images of SE showed a sensitivity of 92.5%, a specificity of 90.0% and a accuracy of 91.3%. Inter-observer reliability of SE was in 'almost perfect agreement' with a weighted kappa coefficient of 0.83. Conclusions: SE is valuable in the detection of the intratendinous and peritendinous alterations of biceps tendon, and has excellent accuracy and excellent correlation with conventional ultrasound findings.
Purpose: To assess parent perspectives of the current and potential future tests for their child with inflammatory bowel disease (IBD). Methods: New Zealand parents of a child with IBD were invited to complete an anonymous online survey. Experiences relating to their child's blood or faecal tests, medical imaging (abdominal ultrasound [US], abdominal computerised tomography [CT] and magnetic resonance enterography) and colonoscopy were collected. Perceived attitudes to potential future testing of urine, saliva, and breath, were sought. Results: Twenty-eight parents, 93% female completed the survey, and 86% were aged between 35 and 54 years. Baseline information was provided by parents for 27 of 28 children, 70.3% had Crohn's disease with a mean disease duration of 2.67 years. Blood tests were the most requested and completed tests, while CT was the least ordered and most refused test. Colonoscopy was rated as the least comfortable and generated the most worry. Explanation of test significantly improved parent's levels of understanding when their child had blood, faecal, imaging (US) or colonoscopy tests. Providing an explanation, test invasiveness and the impact of the blood results may have on their child's treatment significantly improved parents' comfort levels. However, explanation of colonoscopy generated a significant parental concerns. Saliva, urine and blood tests were chosen as the most preferred disease monitoring tests. Conclusion: Parents preferred any tests less invasive than colonoscopy for monitoring their child's IBD. Although providing explanation of their child's tests enhanced parents' understanding, it can also affect parents' levels of concern and comfort.
Sung-Hyun Kim;Kyungsu Lee;Si-Wook Lee;Jin Ho Chang;Jae Youn Hwang;Jihun Kim
The Journal of the Acoustical Society of Korea
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v.42
no.5
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pp.460-468
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2023
Developmental Dysplasia of the Hip (DDH) is a pathological condition commonly occurring during the growth phase of infants. It acts as one of the factors that can disrupt an infant's growth and trigger potential complications. Therefore, it is critically important to detect and treat this condition early. The traditional diagnostic methods for DDH involve palpation techniques and diagnosis methods based on the detection of keypoints in the hip joint using X-ray or ultrasound imaging. However, there exist limitations in objectivity and productivity during keypoint detection in the hip joint. This study proposes a deep learning model-based keypoint detection method using X-ray and ultrasound imaging and analyzes the performance of keypoint detection using various deep learning models. Additionally, the study introduces and evaluates various data augmentation techniques to compensate the lack of medical data. This research demonstrated the highest keypoint detection performance when applying the residual network 152 (ResNet152) model with simple & complex augmentation techniques, with average Object Keypoint Similarity (OKS) of approximately 95.33 % and 81.21 % in X-ray and ultrasound images, respectively. These results demonstrate that the application of deep learning models to ultrasound and X-ray images to detect the keypoints in the hip joint could enhance the objectivity and productivity in DDH diagnosis.
Background: A dense breast not only reduces the sensitivity of mammography but also is a moderate independent risk factor for breast cancer. The percentage of Western women with fat breast tissue is higher aged 40 years or older. To a certain extent, mammography as a first choice of screening imaging method for Western women of this group is reasonable. Hitherto, the frequency and age distribution of mammographic breast density patterns among Chinese women had not been characterized. The purpose of this study was to investigate the frequency and age distribution of mammographic breast density patterns among a group of Chinese screening women and breast cancer patients in order to provide useful information for age-specific guidelines for breast cancer screening in Chinese women. Methods: A retrospective review of a total of 3,394 screening women between August and December 2009 and 2,527 breast cancer patients between July 2011 and June 2012 was conducted. Descriptive analyses were used to examine the association between age and breast density. The significance of differences of breast density between the screening women and the breast cancer patients was examined using nonparametric tests. Results: There was a significant inverse relationship between age and breast density overall (r=-0.37, p< 0.01). Breast density of the breast cancer patients in the subgroups of 40-49 years old was greater compared with that of the screening women, the same in those aged 50-54 years and in those 55 years old or older, less than in the screening group. Conclusions: With regard to the Chinese women younger than 55 years old, the diagnostic efficiency of breast cancer screening imaging examinations may be potentially improved by combining screening mammography with ultrasound.
So Yeong Jeong;Jung Hwan Baek;Sae Rom Chung;Young Jun Choi;Dong Eun Song;Ki-Wook Chung;Won Woong Kim;Jeong Hyun Lee
Korean Journal of Radiology
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v.23
no.10
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pp.1019-1027
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2022
Objective: Thyroidectomy bed lesions frequently show suspicious ultrasound (US) features after thyroid surgery. Fine-needle aspiration (FNA) may not provide definitive pathological information about the lesions. Although core-needle biopsy (CNB) has excellent diagnostic performance in characterizing suspicious thyroid nodules, no published studies have evaluated the performance of CNB specifically for thyroidectomy bed lesions. Therefore, we aimed to evaluate the diagnostic performance and safety of CNB for characterizing thyroidectomy bed lesions. Materials and Methods: A total of 124 thyroidectomy bed lesions in 113 patients (79 female and 34 male; age, 23-85 years) who underwent US-guided CNB between December 2008 and December 2020 were included. We reviewed the US imaging features of the target lesions and the histories of previous biopsies. The pathologic results, diagnostic performance for malignancy, and complications of CNB were analyzed. Results: All samples (100%) obtained by CNB were adequate for pathological analysis. Pathological analysis revealed inconclusive results in two lesions (1.6%). According to the reference standard, 50 lesions were ultimately malignant (40.3%), and 72 were benign (58.1%), excluding the two inconclusive lesions. The performance of CNB for diagnosing malignant thyroidectomy bed lesions in the 122 lesions had a sensitivity of 98.0% (49/50), a specificity of 100% (72/72), positive predictive value of 100% (49/49), and negative predictive value of 98.6% (72/73). Eleven lesions were referred for CNB after prior inconclusive FNA results in thyroidectomy bed lesions, for all of which CNB yielded correct conclusive pathologic diagnoses. According to the pathological analysis of CNB, there were various benign lesions (58.9%, 73/124) besides recurrence, including benign postoperative lesions other than suture granuloma (32.3%, 40/124), suture granuloma (15.3%, 19/124), remnant thyroid tissue (5.6%, 7/124), parathyroid lesions (4%, 5/124), and abscesses (1.6%, 2/124). No major or minor complications were associated with the CNB procedure. Conclusion: US-guided CNB is accurate and safe for characterizing thyroidectomy bed lesions.
Kim, Hyo-Geun;Aowlad Hossain, A.B.M.;Lee, Soo-Yeol;Cho, Min-Hyoung
Journal of Biomedical Engineering Research
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v.32
no.2
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pp.158-164
/
2011
Breast cancer is the most frequently appearing cancer in women, these days. To reduce mortality of breast cancer, periodic check-up is strongly recommended. X-ray mammography is one of powerful diagnostic imaging systems to detect 50~100 um micro-calcification which is the early sign of breast cancer. Although x-ray mammography has very high spatial resolution, it is not easy yet to distinguish cancerous tissue from normal tissues in mammograms and new tissue characterizing methods are required. Recently ultrasound elastography technique has been developed, which uses the phenomenon that cancerous tissue is harder than normal tissues. However its spatial resolution is not enough to detect breast cancer. In order to develop a new elastography system with high resolution we are developing x-ray elasticity imaging technique. It uses the small differences of tissue positions with and without external breast compression and requires an algorithm to detect tissue displacement. In this paper, computer simulation is done for preliminary study of x-ray elasticity imaging. First, 3D x-ray breast phantom for modeling woman's breast is created and its elastic model for FEM (finite element method) is generated. After then, FEM experiment is performed under the compression of the breast phantom. Using the obtained displacement data, 3D x-ray phantom is deformed and the final mammogram under the compression is generated. The simulation result shows the feasibility of x-ray elasticity imaging. We think that this preliminary study is helpful for developing and verifying a new algorithm of x-ray elasticity imaging.
To evaluate the performance of ultrasound imaging system, we investigated the change of spatial resolution according to changing sonic velocity change parameter provided by ultrasound equipment. Ultrasound phantom images were obtained using a 3.0 ~ 5.0 MHz convex transducer in an ultrasound diagnostic device used at a medical institution located at Iksan. N-365 multi-purpose ultrasound phantom was used to measure longitudinal distance measurement accuracy and longitudinal and transverse resolution. In the same manner, the sonic velocity of the ultrasound equipment was changed from 1580 m/sec to 1400 m/sec in six steps, and the full width at half maximum(FWHM) was measured using the image J program to determine whether the measured values were different. As a result, lateral resolution was measured from 1.91 mm to 5.3 mm according to the speed change, and the smallest FWHM was 1.91 mm at 1420 m/sec. The axial resolution was measured from 1.03 mm to 1.14 mm according to the speed change, and the smallest FWHM was 1.03 mm at 1400 m/sec. The slower the sound velocity of the ultrasound equipment, the shorter the length of longitudinal measurement.
Purpose To design a scoring system to predict malignancy of additional MRI-detected lesions in breast cancer patients. Materials and Methods Eighty-six lesions (64 benign and 22 malignant) detected on preoperative MRI of 68 breast cancer patients were retrospectively included. The clinico-radiologic features were correlated with the histopathologic results using the Student's t-test, Fisher's exact test, and logistic regression analysis. The scoring system was designed based on the significant predictive features of malignancy, and its diagnostic performance was compared with that of the Breast Imaging-Reporting and Data System (BI-RADS) category. Results Lesion size ≥ 8 mm (p < 0.001), location in the same quadrant as the primary cancer (p = 0.005), delayed plateau kinetics (p = 0.010), T2 isointense (p = 0.034) and hypointense (p = 0.024) signals, and irregular mass shape (p = 0.028) were associated with malignancy. In comparison with the BI-RADS category, the scoring system based on these features with suspicious non-mass internal enhancement increased the diagnostic performance (area under the receiver operating characteristic curve: 0.918 vs. 0.727) and detected three false-negative cases. With this scoring system, 22 second-look ultrasound examinations (22/66, 33.3%) could have been avoided. Conclusion The scoring system based on the lesion size, location relative to the primary cancer, delayed kinetic features, T2 signal intensity, mass shape, and non-mass internal enhancement can provide a more accurate approach to evaluate MRI-detected lesions in breast cancer patients.
The Journal of the Convergence on Culture Technology
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v.8
no.5
/
pp.1-7
/
2022
Korean medical device industry has laid the foundation for full-fledged growth and development with the G7 medical engineering technology development project that started in 1995, and the medical device production in 2020 increased by 8.52 times and the export by 13.94 times, compared to those in 2001. In early years, electronic medical devices such as ultrasound imaging device contributed greatly to Korean medical industry, but top ranks in medical device production and export in Korea has shifted recently to in vitro diagnostic medical devices and dental implants. However, the share of imported medical devices in the Korean medical device market have not changed much; it still ranges in 60 to 70%, as the Korean medical device industry produces and exports mid- to low-priced medical devices, and technology-intensive and capital-intensive high-priced medical devices are mainly imported. In this paper, we compare the leading medical devices produced by major Korean companies and those by global top medical device companies to suggest strategies for the Korean medical device companies to enter the global market.
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