• Journal of Korean Neurosurgical Society
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• v.67 no.2
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• pp.194-201
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• 2024

Objective : This study aimed to evaluate the clinical feasibility of the combination of ultrasound and nerve stimulator guidance in transforaminal epidural steroid injections (TESIs) to manage lumbosacral chronic radicular pain. Methods : Using the combination of nerve stimulator and ultrasound guidance, TESIs were performed in 125 segments of 78 patients who presented with chronic lumbar radicular pain. Demographic characteristics and surgical outcomes were recorded on admission, pre-procedural and post-procedural for 1-week, 1-month, 3-month, and 6-month follow-ups. The result was measured using the Numeric rating scale (NRS) and Oswestry disability index (ODI). Results : Patients who received TESIs showed significant improvements on two evaluation tools (NRS, ODI), compared to that before procedure (p<0.001). No significant complications were observed for 6 months' follow-up. Conclusion : The result suggests that a combination of ultrasound and nerve stimulator guidance in transforaminal epidural injections is safe, reliable and effective for short-term management of lumbar disc herniation. It is a promising technique and has shown good results in providing intermediate pain relief.

• Journal of Biomedical Engineering Research
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• v.44 no.4
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• pp.255-263
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• 2023

Clinical ultrasound (US) is a widely used imaging modality with various clinical applications. However, capturing a large field of view often requires specialized transducers which have limitations for specific clinical scenarios. Panoramic imaging offers an alternative approach by sequentially aligning image sections acquired from freehand sweeps using a standard transducer. To reconstruct a 3D volume from these 2D sections, an external device can be employed to track the transducer's motion accurately. However, the presence of optical or electrical interferences in a clinical setting often leads to incorrect measurements from such sensors. In this paper, we propose a deep learning (DL) framework that enables the prediction of scan trajectories using only US data, eliminating the need for an external tracking device. Our approach incorporates diverse data types, including correlation volume, optical flow, B-mode images, and rawer data (IQ data). We develop a DL network capable of effectively handling these data types and introduce an attention technique to emphasize crucial local areas for precise trajectory prediction. Through extensive experimentation, we demonstrate the superiority of our proposed method over other DL-based approaches in terms of long trajectory prediction performance. Our findings highlight the potential of employing DL techniques for trajectory estimation in clinical ultrasound, offering a promising alternative for panoramic imaging.

• The Korean Journal of Pain
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• v.36 no.1
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• pp.98-105
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• 2023

Background: Ultrasound-guided first sacral transforaminal epidural steroid injection (S1 TFESI) is a useful and easily applicable alternative to fluoroscopy or computed tomography (CT) in lumbosacral radiculopathy. When a needle approach is used, poor visualization of the needle tip reduces the accuracy of the procedure, increasing its difficulty. This study aimed to improve ultrasound-guided S1 TFESI by evaluating radiological S1 posterior foramen data obtained using three-dimensional CT (3D-CT). Methods: Axial 3D-CT images of the pelvis were retrospectively analyzed. The radiological measurements obtained from the images included 1st posterior sacral foramen depth (S1D, mm), 1st posterior sacral foramen width (S1W, mm), the angle of the 1st posterior sacral foramen (S1A, °), and 1st posterior sacral foramen distance (S1ds, mm). The relationship between the demographic factors and measured values were then analyzed. Results: A total of 632 patients (287 male and 345 female) were examined. The mean S1D values for males and females were 11.9 ± 1.9 mm and 10.6 ± 1.8 mm, respectively (P < 0.001); the mean S1A 28.2 ± 4.8° and 30.1 ± 4.9°, respectively (P < 0.001); and the mean S1ds, 24.1 ± 2.9 mm and 22.9 ± 2.6 mm, respectively (P < 0.001); however, the mean S1W values were not significantly different. Height was the only significant predictor of S1D (β = 0.318, P = 0.004). Conclusions: Ultrasound-guided S1 TFESI performance and safety may be improved with adjustment of needle insertion depth congruent with the patient's height.

• Korean Journal of Radiology
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• v.24 no.4
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• pp.338-348
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• 2023

Objective: Patients with a history of ischemic stroke are at risk for a second ischemic stroke. This study aimed to investigate the relationship between carotid plaque enhancement on perfluorobutane microbubble contrast-enhanced ultrasonography (CEUS) and future recurrent stroke, and to determine whether plaque enhancement can contribute to risk assessment for recurrent stroke compared with the Essen Stroke Risk Score (ESRS). Materials and Methods: This prospective study screened 151 patients with recent ischemic stroke and carotid atherosclerotic plaques at our hospital between August 2020 and December 2020. A total of 149 eligible patients underwent carotid CEUS, and 130 patients who were followed up for 15-27 months or until stroke recurrence were analyzed. Plaque enhancement on CEUS was investigated as a possible risk factor for stroke recurrence and as a possible adjunct to ESRS. Results: During follow-up, 25 patients (19.2%) experienced recurrent stroke. Patients with plaque enhancement on CEUS had an increased risk of stroke recurrence events (22/73, 30.1%) compared to those without plaque enhancement (3/57, 5.3%), with an adjusted hazard ratio (HR) of 38.264 (95% confidence interval [CI]:14.975-97.767; P < 0.001) according to a multivariable Cox proportional hazards model analysis, indicating that the presence of carotid plaque enhancement was a significant independent predictor of recurrent stroke. When plaque enhancement was added to the ESRS, the HR for stroke recurrence in the high-risk group compared to that in the low-risk group (2.188; 95% CI, 0.025-3.388) was greater than that of the ESRS alone (1.706; 95% CI, 0.810-9.014). A net of 32.0% of the recurrence group was reclassified upward appropriately by the addition of plaque enhancement to the ESRS. Conclusion: Carotid plaque enhancement was a significant and independent predictor of stroke recurrence in patients with ischemic stroke. Furthermore, the addition of plaque enhancement improved the risk stratification capability of the ESRS.

• Parasites, Hosts and Diseases
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• v.52 no.5
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• pp.545-549
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• 2014

Sparganosis is an infection with a parasitic tapeworm larva that occurs by eating infected foods or drinking contaminated water. The larvae can migrate to a tissue or muscle in the chest, abdominal wall, extremities, eyes, brain, urinary tract, pleura, pericardium, spinal canal, or scrotum. Herein, we report a 5-month old infant with scrotal sparganosis who was initially suspected to have a scrotal inflammatory mass with a history of applying raw frog meat into the umbilicus. Preoperative ultrasound examinations and computed tomography (CT) scanning misdiagnosed the mass as a scrotal teratoma. The scrotal mass was surgically removed, and the histopathology proved it to be scrotal sparganosis. This case displays the youngest patient ever reported with scrotal sparganosis, and the first description of CT characteristics of scrotal sparganosis. A detailed medical history is necessary for patients with scrotal masses suspected of sparganosis. In addition, ultrasound and CT examinations are helpful to rule out other causes of a scrotal mass.

• 제어로봇시스템학회:학술대회논문집
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• 1995.10a
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• pp.248-251
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• 1995

Nowadays, the internal images of a human body can be easily provided by the ultrasound imaging, the X-ray CT, or the MRI device, among which the ultrasound imaging device has good resolution for soft tissues of a human body compared with the other devices. Furthermore, the use of ultrasound imaging devices will increase in future especially in the obstetrics, territory, since it does not give harm to the human body. Although several techniques have been investigated until now in order to extract organs from ultrasound images, very few of them have achieved satisfactory results because of low contrast and high noise nature of images. This paper proposes a technique for automatic extraction of the gall bladder area from ultrasound images. The proposed technique first extracts a small reliable area of a gall bladder from an ultrasound image employing smoothing, binarization, expanding and shrinking, and labeling, and then expands the area referring to the binarized version of the original image. The technique is examined its performance by real ultrasound images of a gall bladder and satisfactory results are obtained. Some problems to be solved are discussed finally.

• Journal of Biomedical Engineering Research
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• v.37 no.1
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• pp.31-38
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• 2016

For the patients with bladder dysfunction, measurement of urine volume inside the bladder is very critical to avoid bladder failure. In measuring urine volume inside a bladder, low-resolution 3D ultrasound images are widely used. However, urine volume estimation from 3D ultrasound images is prone to big errors and inconsistency because of low spatial resolution and low signal-to-noise ratio of ultrasound images. We developed a new robust volume estimation algorithm which is not computationally expensive. We tested the algorithm on a lab-built ultrasound bladder phantom and volunteers. The average error rate of the human bladder volume estimation was 5.9% which was better than the commercial machine.

• Journal of Chest Surgery
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• v.53 no.5
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• pp.313-316
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• 2020

Esophageal perforation after endoscopic ultrasound-guided fine-needle aspiration for mediastinal staging is a rare but severe complication. We report 2 cases of patients with esophageal perforation who were treated using video-assisted thoracoscopic surgery in combination with esophageal stenting. Through these cases, the feasibility of minimally invasive thoracic surgery was evaluated.

• 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.

• Journal of Biomedical Engineering Research
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• v.33 no.1
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• pp.32-38
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• 2012

Recently, several ultrasound imaging techniques for tissue characterization have been developed. Among them, ultrasound elastography is regarded as the most promising modality and has been rapidly developed. One of ultrasound elastography techniques is shear modulus imaging. Normal and cancerous tissues show big difference of shear moduli and they have good image contrast. However shear wave elastography requires more complicated hardware and more computations for image reconstruction algorithm. Therefore new efficient techniques are being developed. In this paper, we have developed a very flexible ultrasound system for elastography experiments. The developed system has capabilities to acquire ultrasound RF data of all channels and generate arbitrary ultrasound pulse sequences. It has a huge amount of memories for RF data acquisition and a simple and flexible pulse generator. We have verified the performance of the system showing conventional B-mode images and preliminary results of elastography. The developed system will be used to verify our own reconstruction algorithm and to develop more efficient elastography techniques.