• 제목/요약/키워드: Ultrasound Needle

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갑상샘 초음파 검사에서 K-TIRADS 점수화 체계를 사용한 양성과 악성 갑상샘 결절의 감별진단 (Differential Diagnosis of Benign and Malignant Thyroid Nodules Using the K-TIRADS Scoring System in Thyroid Ultrasound)

  • 안현;임인철;이효영
    • 한국방사선학회논문지
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    • 제13권2호
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    • pp.201-207
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    • 2019
  • 본 연구는 갑상샘 초음파에서 K-TIRADS 분류와 K-TIRADS 분류에 따른 Different risk group의 조합을 이용한 방법이 양성과 악성 결절의 감별진단에 유용한지를 평가하였다. 갑상샘 초음파를 시행한 210명을 대상으로 하였으며, 세침흡인세포검사 결과를 바탕으로 후향적인 분석을 하였다. 갑상샘 결절의 양성과 악성에 따른 K-TIRADS와 Different risk group의 점수체계의 차이 분석은 카이제곱 검정을 하였다. ROC 곡선 분석을 통해 악성 결절의 예측을 위한 K-TIRADS 점수와 Different risk group의 최적 cut off 값을 결정하였다. 양성과 악성 결절 군의 분류에 따른 K-TIRADS와 Different risk group의 차이검증 결과에서 각각 통계적으로 유의한 차이를 보였다(p=.001). ROC 곡선 분석에서 양성과 악성 결절의 예측을 위한 K-TIRADS에 따른 점수분류에서는 AUC 0.786, Cut-off value> 2를 나타내었으며, Different risk group에서는 AUC 0.640, Cut-off value> 2로 결정되었다(p=.001). 갑상샘 초음파에서 결절을 발견했을 때 양성과 악성 갑상샘 결절을 감별하는 데 도움을 주는 K-TIRADS에 따른 분류체계가 Different risk group에 따른 분류체계보다 갑상샘 결절의 감별진단에 도움을 줄 것으로 생각하며 K-TIRADS에 따른 분류체계를 적용하면, 불필요한 세포 검사를 줄일 수 있고, 악성 결절의 조기발견에 도움이 될 것으로 생각된다.

한우에 있어서 초음파기기를 이용한 생체내 개체별 난자 채취 빈도 및 수정란 생산효율에 관한 연구 (Effect of Ovum Pick-up Frequency on In Vitro Production of Embryos in Hanwoo Cattle)

  • 박성재;양보석;임기순;성환후;양병철;장원경;정일정;정기화;심보웅
    • 한국수정란이식학회지
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    • 제15권1호
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    • pp.1-8
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    • 2000
  • The ultrasound-guided oocytes cllection (ovum pick-up ; OPU) has become a substitution for superovlation in cattle. The objective of this study was to examine the effect of OPU frequency on the in vitro production of embryos in Hanwoo cattle. Six cycling Hanwoo cows were distributed into two groups for either once or twice weekly OPU sessions. Oocytes were collected by ultrasound-guided follicle aspiration(SA600) using a 6.5HMz transducer and attached with 18 gauge needle, with vacuum pressure of 40 mmHg. The cumulus-oocyte complexes (COCs) collected from each donor were matured in TCM 199 supplemented with 10% fetal bovine serum at 5% CO2 in air at 38.5$^{\circ}C$ for 22h and in vitro matured oocytes were co-incubated with sperm(separated by Percoll gradient) for 6h. The zygotes were co-cultured on cumulus cell monolayer in 10ul droplets in the same culture medium and conditions used for IVM for 7 days. On Day 7 of culture, development to blastocysts was examined. Although the number of oocytes collected was variable depending on individuals, overall embryo production in the twice per week OPU sessions was better that in the once per week sessions(6~21 vs 2~7 blastocysts produced, respectively). Two cows(E, A) were good oocyte donors and embryo production was superior in cow C ; however, cow F was a poor donor as compared to the others. In conclusion, these results suggest that for embryo production, twice weekly OPU sessions were better than once per week for producing embryos in vitro from Hanwoo cattle.

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송아지 난소에서 초음파 유도에 의한 한우의 미성숙난자 채취시에 bST-FSH 처리효과에 관한 연구 (Effect of bST Co-Treatment with FSH on Transvaginal Ultrasound-Guided Oocyte Retrieval(TVR) in Calves)

  • 이병천;이강남;김남렬;황우석
    • 한국수정란이식학회지
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    • 제11권2호
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    • pp.103-109
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    • 1996
  • The aim of this study was to evaluate the effect of recombinant bovine somatotropin (bST; Boostin-S, LG Chem) treatment with FSH (Super OV) or PMSG on superovulatory response for transvaginal ultrasound-guided oocyte retrieval (TVR) in calves. Eight Korean Native Cattle(KNC) heifer calves; 150 to 240 days old; were randomly assigned to four treatment groups: 1) FSH(75 mg); 2) FSH (75 mg) + bST(500mg) 3) PMSG(1;000 IU); 4) PMSG(1, 000 IU) + bST(500 mg). Experimental calves in group 1 (n=2) and 2(n=2) were weekly superovulated for 4 consecutive weeks with daily injection of FSH for 3days and the next day subjected to TVR session. Animals in group 3 (n=2) and 4(n=2) were weekly stimulated for 4 consecutive weeks with a single dose of 1, 000 IU PMSG. TVR was performed on 72 hours after PMSG injection. Calves in group 2 and 4 was received injection of 500 mg of bST every 10 days. At each TVR session, follicle number and size were recorded; the oocytes collected and graded according to cumulus and cytoplasm investment. Collected oocyte were determined viable oocyte according to morphological quality with granulation of oocyte and number and status of cumlulus cells. IVM and IVF were performed and assessed cleavage rate on day 3 after fertilization. A Sonovet 600(Medison, Co., Ltd) realtime ultrasound scanner with a 6.5 MHz convex transducer, fixed at the tip of 500 mm estended handle equipped with a needle guide was used in collecting oocyte. Differences between groups were analysed by chi-square test. The population of large follicle ($\geq$5 nun) and aspiration rate were not significant different among the 4 groups. But, the number of small follicles (<5 mm) and aspirated oocyte in the KNC calves treated with bST were 1.3~1.6 times higher than in KNC calves treat with FSH or PMSG alone. In conclusion, the administration of bST with FSH or PMSG at superovulation for TVR in calves was increase the nurnber of small follicle which was influenced the number of aspiratable follicle.

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Role of interventional endoscopic ultrasound in a developing country

  • Hasan Maulahela;Nagita Gianty Annisa;Achmad Fauzi;Kaka Renaldi;Murdani Abdullah;Marcellus Simadibrata;Dadang Makmun;Ari Fahrial Syam
    • Clinical Endoscopy
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    • 제56권1호
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    • pp.100-106
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    • 2023
  • Background/Aims: Endoscopic ultrasound (EUS) has become an essential diagnostic and therapeutic tool. EUS was introduced in 2013 in Indonesia and is considered relatively new. This study aimed to describe the current role of interventional EUS at our hospital as a part of the Indonesian tertiary health center experience. Methods: This retrospective study included all patients who underwent interventional EUS (n=94) at our center between January 2015 and December 2020. Patient characteristics, technical success, clinical success, and adverse events associated with each type of interventional EUS procedure were evaluated. Results: Altogether, 94 interventional EUS procedures were performed at our center between 2015 and 2020 including 75 cases of EUS-guided biliary drainage (EUS-BD), 14 cases of EUS-guided pancreatic fluid drainage, and 5 cases of EUS-guided celiac plexus neurolysis. The technical and clinical success rates of EUS-BD were 98.6% and 52%, respectively. The technical success rate was 100% for both EUS-guided pancreatic fluid drainage and EUS-guided celiac plexus neurolysis. The adverse event rates were 10.6% and 7.1% for EUS-BD and EUS-guided pancreatic fluid drainage, respectively. Conclusions: EUS is an effective and safe tool for the treatment of gastrointestinal and biliary diseases. It has a low rate of adverse events, even in developing countries.

Cytomorphologic Patterns of Breast Lesions in Sudanese Patients: Lessons Learned from Fine Needle Aspiration Cytology

  • Almobarak, Ahmed Omer;Elhassan, Taiseer Mohamed;Elhoweris, Mohamed Hassan;Awadalla, Heitham Mohammed;Elmadhoun, Wadie Mohamed Yasin;Ahmed, Mohamed Hassan
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3411-3413
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    • 2014
  • Background: Cytology for breast lesions is a safe, rapid and cost-effective with a high specificity and sensitivity. Objective: To determine the cytomorphologic patterns of breast lesions identified among a group of Sudanese patients. Materials and Methods: This study included 759 patients undergoing either a fine needle aspiration FNA, nipple discharge (ND) smears or breast skin scraping (SS) at a cytology clinic in Khartoum. Clinical and demographic data were reviewed. Stained smears were categorized into: inadequate sample, normal breast, benign lesion, suspicious, or malignant neoplasm. Results: Of the 759 cases, 734 (96.71%) were FNA, 18 (2.37%) ND and 7 cases (0.92%) SS. For 28 cases, FNA was done under ultrasound guidance. Females were 720 (94.86%). Benign lesions were 423 (55.75%) and 248 (32.67%) were malignant and 77 (10.14%) of smears were normal without any detected abnormality. Ten (1.31%) cases were suspicious for malignancy, and only one case (0.13%) was reported as inadequate. Most lesions were observed among the age group 30 years and above. Conclusions: Most patients investigated have benign lesions, one third of cytological smears were malignant. FNAC is a useful tool for investigating breast lesions in limited-resource settings.

US-guided 14G Core Needle Biopsy: Comparison Between Underestimated and Correctly Diagnosed Breast Cancers

  • Kim, Hana;Youk, Ji Hyun;Kim, Jeong-Ah;Gweon, Hye Mi;Jung, Woo-Hee;Son, Eun Ju
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권7호
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    • pp.3179-3183
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    • 2014
  • Background: The purpose of study was to evaluate radiologic or clinical features of breast cancer undergoing ultrasound (US)-guided 14G core needle biopsy (CNB) and analyze the differences between underestimated and accurately diagnosed groups. Materials and Methods: Of 1,898 cases of US-guided 14G CNB in our institute, 233 cases were proven to be cancer by surgical pathology. The pathologic results from CNB were invasive ductal carcinoma (IDC) (n=157), ductal carcinoma in situ (DCIS) (n=40), high-risk lesions in 22 cases, and benign in 14 cases. Among high-risk lesions, 7 cases of atypical ductal hyperplasia (ADH) were reported as cancer and 11 cases of DCIS were proven IDC in surgical pathology. Some 29 DCIS cases and 157 cases of IDC were correctly diagnosed with CNB. The clinical and imaging features between underestimated and accurately diagnosed breast cancers were compared. Results: Of 233 cancer cases, underestimation occurred in 18 lesions (7.7%). Among underestimated cancers, CNB proven ADH (n=2) and DCIS (n=11) were diagnosed as IDC and CNB proven ADH (n=5) were diagnosed at DCIS finally. Among the 186 accurately diagnosed group, the CNB results were IDC (n=157) and DCIS (n=29). Comparison of underestimated and accurately diagnosed groups for BI-RADS category, margin of mass on mammography and US and orientation of lesion on US revealed statistically significant differences. Conclusions: Underestimation of US-guided 14G CNB occurred in 7.7% of breast cancers. Between underestimated and correctly diagnosed groups, BI-RADS category, margin of the mass on mammography and margin and orientation of the lesions on US were different.

자기공명영상 유도하 유방의 중재적시술: 조직생검술 및 침위치결정술 (MRI-Guided Breast Intervention: Biopsy and Needle Localization)

  • 박가은;이정민;강봉주;김성헌
    • 대한영상의학회지
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    • 제84권2호
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    • pp.345-360
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    • 2023
  • 국내에 자기공명영상의 보급의 증가와 함께 유방 자기공명영상의 건수도 지속적으로 증가하고 있다. 하지만 이에 비해 자기공명영상 유도하 조직생검술 및 침위치결정술과 같은 유방의 중재적 시술은 초음파 유도하 시술이나 입체정위생검술에 비해 많이 이루어지지 않는다. 유방 자기공명영상은 다른 유방 영상 검사들에 비해 높은 민감도를 보이는 검사법이지만 그 특이도는 제한되는 검사법이기 때문에, 자기공명영상에서만 발견된 병변들은 자기공명영상 유도하 조직생검술이나 자기공명영상 유도하 침위치결정술을 통한 수술적 절제를 통하여 병리적 진단이 이루어져야 한다. 이러한 배경을 바탕으로, 본 종설에서는 자기공명영상 유도하 유방의 중재적 시술들의 적응증, 시술 방법, 시술 과정에서의 여러 고려 사항 및 제한점들에 대해 다루고자 한다.

주요 혈관 근처의 췌장 또는 췌장 주위 병변에 대한 초음파 유도하 경피적 중심 바늘 생검의 안전성과 효율성 (Safety and Efficacy of Ultrasound-Guided Percutaneous Core Needle Biopsy of Pancreatic and Peripancreatic Lesions Adjacent to Critical Vessels)

  • 정선화;강현지;이효정;김진실;이정경
    • 대한영상의학회지
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    • 제82권5호
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    • pp.1207-1217
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    • 2021
  • 목적 췌장 및 췌장 주위의 주요 혈관에 인접한 병변에 대하여 초음파 유도하 경피적 중심 바늘 생검(ultrasound-guided percutaneous core needle biopsy; 이하 USPCB)의 안전성과 효능을 평가하였다. 대상과 방법 10년 동안 췌장(n = 98), 간문맥 근처 췌장 주위(n = 34), 또는 췌장 갈고리돌기 부위와 십이지장 제3부분과 인접한 대동맥주위(n = 30) 병변에 대하여 USPCB를 시행받은 162명의 환자의 검사 결과를 수집하였다. 초음파 유도하18게이지 바늘을 가진 자동 생검 총을 사용하였고, USPCB 결과는 수술 결과 또는 추적 관찰 영상과 비교하였다. USPCB의 진단 정확도 및 주요 합병증 비율을 계산했으며, 성공적인 생검의 예측을 위한 요인이 무엇인지 단변량 및 다변량 분석을 사용하여 평가하였다. 결과 USPCB에서 조직 병리학 진단은 149명(92%) 환자에서 일치했다. 주요 합병증은 장간막 혈종 4건과 십이지장 벽내혈종 1건이 발생했다(3%). 성공적인 생검을 위한 요인으로는 위 또는 장관을 통과하는 경로보다는 경장간막 경로를 이용할수록, 초음파상 표적 및 생검 경로가 잘 보일수록 등이 포함되었다. 또한 결과적으로 생검에 성공한 경우 생검 횟수가 더 적었다. 결론 USPCB는 주요 혈관에 인접한 췌장 및 간문맥 근처 췌장 주위 병변 또는 췌장 갈고리돌기 부위나 십이지장 제3부분과 인접한 대동맥 주위 병변의 조직학적 진단을 위한 높은 정확도 및 낮은 합병증 비율을 나타냈다.

젖소의 초음파 유도 채란율에 대한 FSH 전처리 효과의 비교 (Effect of FSH Pretreatment on Follicle Development and Oocyte Recovery by Ultrasound-guided Aspiration in Holstein Heifers)

  • 박충생;조성근;이정규;강태영;박성재;공일근;최민철
    • 한국가축번식학회지
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    • 제21권2호
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    • pp.147-156
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    • 1997
  • Ultrasound-guided follicular aspiration was performed in Holstein heifers once weekly with or without pretreatment of single or multiple decreasing doses using a total of 400 mg FSH. Oocytes were aspirated with a 6.5 MHz convex-array ultrasound trasducer designed for intravaginal use. All the visible follicles larger than 4 mm in diameter were punctured with a 17 gauge, 55 cm needle at each aspiration session and the follicular fluids containing oocytes were obtained by vacuum suction. The results obtained were as follows: As a preliminary experiment, the recovery rates of folicular oocytes by ultrasound-guided aspiration from the isolated ovaries of Korean native cows were compared between suction methods using manual syringe or vacuum pump. The recovery rate of oocytes using vacuum pump (80.7%) was significantly (P<0.05) higher than that using manual syringe (47.1%). The follicles were counted by their size in diameter with ultrasound image, and recovery rates and grades of follicular oocytes collected by ultrasound-guided aspiration were investigated in Holstein heifers pretreated with or without FSH. A group of heifiers were injected with multiple decreasing doses (twice a day for 3 days) of a total of 400 mg FSH. The other 2 groups were injected with a single dose of 400 mg FSH mixed with 25% PVP. Ultrasound observation of follicle population and/or ultrasound-guided transvaginal oocyte aspiration were performed 12 hrs following the last FSH injection in the multiple dose group, and 48 or 60 hrs after FSH injection in the single dose groups. Most of the visible follicles had small size of less than 3 mm in diameter in unstimulated heifers (71.0%), but medium size in all the heifers treated with FSH. (70.5 to 92.8%). The number of OPU follicles per session (4.6$\pm$1.9) were much less, compared to the vilsible follicle counts (9.7$\pm$2.2), in the nustimulated heifers due to the small dominant follicles. Among 4 goups of heifers the most visible as well as OPU follicles were observed in the heifers at 60 hrs following treatment of a single dose of 400 mg FSH (21.2$\pm$2.3 and 21.0$\pm$2.0), and the differences in both the follicle counts between the groups was found significant (P<0.05) The rates of oocyte recovery from the follicles by ultrasound-guilded aspiration were varied 46.3 to 75.0% in the heifers unstimulated and treated with a single dose of 400 mg FSH, but the group difference was not significant. The number of recovered oocytes per session a, pp.ared to be highest at aspiration at 60 hrs following single FSH (10.6$\pm$2.2) than at aspiration at 48 hrs after single FSH (7.8$\pm$2.7) or in the unstimulated heifers (3.4$\pm$3.0). The proportion of grade I and II oocytes to all oocytes collected was varied 31.8 to 64.0% between the groups. However, there was found no significant difference in both the number of oocytes recovered per session and the percentage and the percentage of grade I and II oocytes. From the above results it was concluded that the more oocytes of superior quality might be recovered economically by ultrasound-guided aspiration at 60 hrs following the pretreatment of a single dose of 400 mg FSH and by suction using a vacuum pump system of about negative pressure of 75 to 85 mmHg.

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Effect of Chlorhexidine Mouthrinse on Prevention of Microbial Contamination during EBUS-TBNA: A Study Protocol for a Randomized Controlled Trial

  • Kim, Na Young;Park, Jae Hyeon;Park, Jimyung;Kwak, Nakwon;Choi, Sun Mi;Park, Young Sik;Lee, Chang-Hoon;Cho, Jaeyoung
    • Tuberculosis and Respiratory Diseases
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    • 제84권4호
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    • pp.291-298
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    • 2021
  • Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard diagnostic method for mediastinal and hilar lymphadenopathy. Although rare, fatal infectious complications can occur following EBUS-TBNA. However, to date, there is a lack of effective preventive strategies to reduce these complications. We started a trial to investigate the effect of chlorhexidine mouthrinse on the prevention of microbial contamination during EBUS-TBNA. Methods: This study is a single-center, parallel-group, assessor-blinded randomized controlled trial (RCT). We will enroll 112 adult participants undergoing EBUS-TBNA using a convex probe, and randomly assign them to two groups at a 1:1 ratio. The intervention group will gargle for 1 minute with 100 mL of 0.12% chlorhexidine gluconate before EBUS-TBNA, while the control group will have no mouthrinse before the procedure. Immediately after completion of EBUS-TBNA on all targeted lesions with an aspiration needle, a needle wash sample will be taken by instilling 5 mL of sterile saline into the used needle. The primary outcome is colony forming unit (CFU) counts in aerobic cultures of the needle wash samples. Secondary outcomes are CFU counts in anaerobic cultures, fever within 24 hours after EBUS-TBNA, and infectious complications within 4 weeks after EBUS-TBNA. Conclusion: This trial was designed as the first RCT to investigate the effect of chlorhexidine mouthrinse on the prevention of microbial contamination during EBUS-TBNA. Results from this trial can provide clinical evidence for a simple, safe, and cost-effective strategy to prevent infectious complications following EBUS-TBNA (ClinicalTrials.gov ID: NCT04718922, registered on 22 January 2021).