• 제목/요약/키워드: Ultrasound imaging

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동적 초음파를 이용하여 진단한 주관절 척골 신경 아탈구 (Ulnar Nerve Subluxation Diagnosed by Dynamic Ultrasonography)

  • 지종훈;정재중;김영율;강현택;박상은;김동진
    • 대한정형외과 초음파학회지
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    • 제3권2호
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    • pp.79-83
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    • 2010
  • 근골격계 초음파는 오랜 기간 동안 다양한 정형외과적 질환의 진단을 위해 유용하고 간단한 방법으로 사용되어 왔다. 일반적으로 MRI가 해부학적 구조나 변이를 발견하기 위한 가장 좋은 방법으로 알려져 있으나 건이나 신경의 탈구 또는 아탈구 등과 같은 동적인 조건의 경우에는 초음파, 특히 동적 초음파의 유용성에는 미치지 못하는 것으로 알려져 있다. 본원에서는 주관 증후군 유사 증상을 보인 환자에서 동적 초음파 검사를 이용하여 척골 신경 아탈구를 확인한 후, 척골 신경 이전술을 시행하여 만족스러운 결과를 보여, 주관 증후군과 유사한 증상을 유발하는 척골 신경 아탈구 환자에게 동적 초음파의 이용은 매우 유용한 방법으로 생각하여 그 증례를 보고하고자 한다.

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압박성 신경병증 (Compression Neuropathy)

  • 김병성
    • 대한정형외과 초음파학회지
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    • 제1권2호
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    • pp.128-133
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    • 2008
  • 신경 압박의 원인은 외부로부터 가해지는 것도 있고, 신체 내부 병리가 발생하여 신경 주행에 따라 발생할 수 있다. 주관절 이하부에서 압박성 신경병증으로 정중 신경, 척골 신경, 요골신경병증이 있다. 정중 신경은 굴곡 지대부위에서 수근관 증후군이 대표적이며, 모든 신경 포착 증후군 가운데 가장 흔하다. 그 외 주관절 부위에서 스트러더스 인대, 상완 이두근 건막, 회내근, 천수지 굴근 기시부 그리고 비정상 근육들에 의한 회내근 증후군과 전 골간 신경 증후군이 있다. 척골 신경은 스트러더스 궁, 내측 상과 후방의 주관, 척수근 굴근 두 기시부 사이의 건막 등에서 눌리는 주관 증후군과, 수근부에서 결절종, 유구골 갈고리 골절 그리고 혈관성으로 오는 척골 관 증후군이 있다. 요골 신경의 심부 분지가 회외근속을 지나면서 만들어지는 부위에서 눌리는 경우 요골 관 증후군이라고 한다. 치료는 초기에는 소염제나 야간부목, 스테로이드 주사와 같은 보존적 치료를 시행할 수 있으며, 이에 호전되지 않을 경우 전기적 검사나 영상 검사에서 이상이 나타나면 수술적 감압술을 시행하여야 한다.

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초음파 전립선 영상에서 전립선 경계 분할을 위한 평균 형상 모델 (An Average Shape Model for Segmenting Prostate Boundary of TRUS Prostate Image)

  • 김상복;정주영;서영건
    • 정보처리학회논문지:소프트웨어 및 데이터공학
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    • 제3권5호
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    • pp.187-194
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    • 2014
  • 전립선암은 전립선에 나타나는 악성 종양이다. 현재 그 발병률이 높아지고 있다. 전립선암의 구조를 가장 정확하게 확인할 수 있는 검사 방법은 MRI를 이용하는 것이나, 그 비용 때문에 모든 환자에게 적용하기는 어려운 실정이다. 그래서 많은 환자들은 가격이 저렴한 초음파검사를 이용하여 전립선암을 진단하고 있다. 전통적으로 의사들은 영상을 눈으로 확인하여 전립선의 경계를 수동으로 분할하였다. 그러나 수동으로 분할하는 과정은 시간이 많이 소요되며, 의사에 따라서 그 경계가 일정하지 않게 얻어진다. 이 문제를 해결하기 위하여 전립선의 자동 분할에 관한 연구가 되었고, 환자들에게 신뢰를 줄 수 있었다. 본 연구는 초음파 전립선 영상에서 전립선의 경계를 분할하는데 평균 형상 모델을 적용하는 것이다. 먼저, 에지 분포를 이용하여 프로브를 찾고, 프로브와 연결된 두 직선을 찾는다. 이 후에 이 정보를 이용하여 전립선 영상 위에 평균 형상을 위치시킨다.

Comparing the effectiveness of ultrasound guided versus blind genicular nerve block on pain, muscle strength with isokinetic device, physical function and quality of life in chronic knee osteoarthritis: a prospective randomized controlled study

  • Cankurtaran, Damla;Karaahmet, Ozgur Zeliha;Yildiz, Sadik Yigit;Eksioglu, Emel;Dulgeroglu, Deniz;Unlu, Ece
    • The Korean Journal of Pain
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    • 제33권3호
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    • pp.258-266
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    • 2020
  • Background: The genicular nerve block (GNB) is demonstrated from several reports to alleviate pain and improve knee functionality in patients with chronic knee osteoarthritis (OA). Ultrasound (US)-guided GNB has been the most used imaging method. This study aimed to compare the effectiveness of US-guided versus blind GNB in the treatment of knee OA. Methods: This prospective, randomized clinical trial included patients with knee OA based on American College of Rheumatology diagnostic criteria. The patients were evaluated for clinical and dynamometer parameters at the baseline, 4 weeks after treatment, and 12 weeks after treatment. The patients underwent blind injection or US-guided injection. Results: When compared with the baseline, both groups showed significant improvement in pain, physical function, and quality of life parameters. Significant differences were observed between the groups for clinical parameters (30-second chair stand test, 6-minute walk test) in favor of the US-guided group. On the other hand, blind injection was more significantly effective on some parameters of the Nottingham Health Profile. There wasn't any significant improvement in isokinetic muscle strength for either group. Conclusions: This study demonstrated that both US-guided and blind GNB, in the treatment of knee OA, were effective in reducing symptoms and improving physical function. GNB wasn't an effective treatment for isokinetic muscle function. US-guided injections may yield more effective clinical results than blind injections.

치아외상 후 치아 변색과 치수 생활력의 변화 (Pulp vitality and coronal discoloration following traumatic injuries)

  • 윤태선;공형규;김의성
    • Restorative Dentistry and Endodontics
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    • 제35권6호
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    • pp.492-496
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    • 2010
  • 치관부 변색은 외상당한 치아에서 종종 관찰되는 현상이다. 아탈구에서의 치관부 변색은, 외상의 정도가 근단공을 지나는 동맥혈관을 파열시키기에 충분히 강하지 않으나 얇은 외벽을 가진 모세혈관을 절단 또는 폐쇄 시키는 경우에서 일어날 수 있다고 설명된다. 감염이 일어나지 않는다면 치수 회복의 과정이 일어날 수 있으며 그에 따라 치관부 변색은 완전하게, 또는 불완전한 상태로 회복되기도 한다. 그러나 이러한 치관부의 색 변화로 치수 괴사를 진단하기에는 불충분하며, 불필요한 치료를 야기할 우려가 있다. 이번 증례는 전치부의 외상 후, 치관부 변색의 과정과 이의 회복을, 초음파 도플러 그라피를 통하여 확인한 것을 나타낸다. 통상적인 냉검사나 전기치수검사로 치수 생활력을 판단하기 어려운 외상 치아의 진단에 있어 초음파 도플러 그라피의 사용은 보다 정확한 정보를 제공할 수 있을 것으로 평가된다.

Description of a novel ultrasound guided peribulbar block in horses: a cadaveric study

  • Leigh, Hannah;Gozalo-Marcilla, Miguel;Esteve, Vicente;Bautista, Alvaro Jesus Gutierrez;Gimenez, Tamara Martin;Viscasillas, Jaime
    • Journal of Veterinary Science
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    • 제22권2호
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    • pp.22.1-22.9
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    • 2021
  • Background: Standing surgery in horses combining intravenous sedatives, analgesics and local anaesthesia is becoming more popular. Ultrasound guided (USG) peribulbar nerve block (PB) has been described in dogs and humans for facial and ocular surgery, reducing the risk of complications versus retrobulbar nerve block (RB). Objective: To describe a technique for USG PB in horse cadavers. Methods: Landmarks and PB technique were described in two equine cadaver heads (Phase 1), with computed tomography (CT) imaging confirming contrast location and spread. In Phase 2, ten equine cadaver heads were randomised to two operators naive to the USG PB, with moderate experience with ultrasonography and conventional "blind" RB. Both techniques were demonstrated once. Subsequently, operators performed five USG PB and five RB each, unassisted. Contrast location and spread were evaluated by CT. Injection site success was defined for USG PB as extraconal contrast, and for RB intraconal contrast. Results: Success was 10/10 for USG PB and 0/10 for RB (p < 0.001). Of the RB injections, eight resulted in extraconal contrast and two in the masseter muscle (p = 0.47). Conclusions: The USG PB had a high injection site success rate compared with the RB technique; however, we cannot comment on clinical effect. The USG technique was easily learnt, and no potential complications were seen. The USG PB nerve block could have a wide application for use in horses for ocular surgeries (enucleations, eyelid, corneal, cataract surgeries, and ocular analgesia) due to reduced risk of iatrogenic damage. Further clinical studies are needed.

Quality Evaluation of Ultrasonographic Equipment Using an ATS-539 Multipurpose Phantom in Veterinary Medicine

  • Cho, Young-kwon;Lee, Youngjin;Lee, Kichang
    • 한국임상수의학회지
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    • 제39권3호
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    • pp.114-120
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    • 2022
  • The purpose of this study is to examine the status of quality control using multipurpose phantom of ultrasound equipment used in hospital of veterinary college in South Korea by using ATS-539 multipurpose phantom so as to examine quantitative and objective new image evaluation method. Specialists discussed and analyzed multipurpose phantom images acquired by using convex transducer of 10 ultrasound imaging devices, currently used in 9 veterinary colleges, at 4.0-6.0 MHz. Total 8 items that can be measured with ATS-539 multipurpose phantom including dead zone, vertical and horizontal measurement, axial/lateral resolution, sensitivity, focal zone, functional resolution and gray scale/dynamic range were evaluated. For qualitative evaluation, valid decisions were made based on dead zone, axial/lateral resolution, and gray scale/dynamic range which are resolution index, and coefficient of variation (COV) and blind referenceless image spatial quality evaluator (BRISQUE) were found to increase objectivity. As a result of experiment, all the targeted ultrasonic devices were found appropriate from qualitative evaluation items of dead zone, axial/lateral resolution, and gray scale/dynamic range. In other evaluation items, they were found to be appropriate from focal zone and vertical measurement of quantitative evaluation while inappropriate from horizontal measurement, sensitivity, and functional resolution. COV value was 0.12 ± 0.04, and BRISQUE value was 47.77 ± 2.77, both analysis results show that the noise level of all ultrasonic devices was located within tolerance range. Upon image examination using ATS-539 multipurpose phantom, they were 100% appropriate with inspection standards of dead zone, axial/lateral resolution, and gray scale/dynamic range, and besides, focal zone and functional resolution can be used as evaluation items. In the field of veterinary medicine, 8 standard items using ATS-539 multipurpose phantom and image evaluation items using COV and BRISQUE can be used as standards for quality control of ultrasonography machine.

Clinical and radiological outcomes of ultrasound-guided barbotage using a spinal needle and subacromial steroid injection for calcific tendinitis of the shoulder

  • Lee, Jun Pyo;Kim, Doo Sup;Han, Jin Young;Baik, Seung Hoon;Kwak, Ji Woong;Kim, Sung Hwa
    • Clinics in Shoulder and Elbow
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    • 제25권2호
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    • pp.140-144
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    • 2022
  • Background: Ultrasound (US)-guided techniques reported for the treatment of calcific tendinitis have mostly demonstrated good results. This study investigates the effect of US-guided barbotage using a spinal needle in patients with calcific tendinitis of the shoulder. Methods: Thirty-six patients with calcific tendinitis of the shoulder treated by US-guided barbotage with a spinal needle and subacromial steroid injection were included in the study. We evaluated clinical outcomes based on American Shoulder and Elbow Surgeons (ASES) score, Constant score, and visual analog scale (VAS) for pain score. Radiological outcomes were assessed by X-ray imaging at each visit. Results: Our results showed that US-guided barbotage and subacromial steroid injection produced good clinical and radiological outcomes in patients with calcific tendinitis of the shoulder. Of the 36 patients, only one required surgical treatment, while the others showed improvement without any complications. Compared to values before the procedure, calcific deposit size and VAS, ASES, and Constant scores showed significant improvement 6 weeks after the procedure. No significant correlation was found between the initial calcific deposit size and clinical outcomes at each time point. Conclusions: In patients with calcific tendinitis of the shoulder, US-guided barbotage using a spinal needle and subacromial steroid injection can yield satisfactory clinical and radiological results.

Effects of steroid injection during rehabilitation after arthroscopic rotator cuff repair

  • Ha, Joong-Won;Kim, Hyunkyo;Kim, Seong Hun
    • Clinics in Shoulder and Elbow
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    • 제24권3호
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    • pp.166-171
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    • 2021
  • Background: This study aims to compare the clinical outcomes of steroid injections during the rehabilitation period after arthroscopic rotator cuff repair (ACRC). Methods: Among patients who underwent ARCR, 117 patients who met the inclusion and exclusion criteria were enrolled. Pain and range of motion (ROM) recovery at the 3-, 6-, and 24-month follow-up visits and functional outcome at the 24-month follow-up were compared between 45 patients who received ultrasound-guided subacromial steroid injection at postoperative week 4 or 6 and 72 patients who did not. Functional outcome was assessed using the American Shoulder and Elbow Surgeons (ASES) score and Constant score. Healing of the repaired tendon and retear were observed at the 6-month follow-up via magnetic resonance imaging (MRI) or computed tomography (CT) arthrography. Results: At the 3-month follow-up, the steroid injection group showed lower visual analog scale scores than the control group (p<0.05) and showed faster recovery of forward flexion and internal rotation (p<0.05). From the 6-month follow-up, the two groups did not show differences in pain and ROM, and the ASES score and Constant score also did not significantly differ at the 24-month follow-up. The two groups did not differ in retear rate as determined by MRI or CT arthrography at the 6-month follow-up. Conclusions: This study demonstrated that ultrasound-guided subacromial steroid injection at 4 or 6 weeks after ARCR leads to quick pain reduction and ROM recovery until 3 months after surgery. Therefore, subacromial steroid injection is speculated to be an effective and relatively safe method to assist rehabilitation.

Inter-device agreement between spectral domain optical coherence tomography, ultrasound biomicroscopy, and gonioscopy in evaluating the iridocorneal angle in normotensive dogs

  • Su An Kim;Jaeho Shim;Seonmi Kang;Kangmoon Seo
    • Journal of Veterinary Science
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    • 제24권4호
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    • pp.34.1-34.12
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    • 2023
  • Background: There has not been a thoroughly reported study of the comparison between spectral domain-optical coherence tomography (SD-OCT) with both ultrasound biomicroscopy (UBM) and gonioscopy on the evaluation of the iridocorneal angle (ICA) in dogs. Objectives: To investigate the diagnostic value of SD-OCT for the early detection of narrowing ICA by comparing and assessing inter-device agreement in anterior chamber angle (ACA) measurements obtained by SD-OCT and UBM, and ICA evaluations by gonioscopy. Methods: A total of 28 eyes from 28 client-owned dogs with normal intraocular pressure were included for examination. The ACA and angle opening distance (AOD) were measured from the SD-OCT and UBM images, and gonioscopy images were analyzed using the ICA grade and ZibWest angle index. Results: The mean ACA and AOD for SD-OCT were 28.31° ± 5.37° and 658.42 ± 219.90 ㎛, and for UBM, 28.34° ± 5.82° and 859.29 ± 221.80 ㎛, respectively. The mean difference in ACA between the average values of SD-OCT and UBM measurements was 0.03° with a 95% limit of agreement (LoA) span of 16.2°, indicating positive agreement; that in AOD was 200.85 ㎛ with a 95% LoA span of 1,110.95 ㎛, indicating poor agreement. The Pearson correlation coefficient of the ACA of SD-OCT and ZibWest indices of gonioscopy was 0.624, indicating strong agreement; that of UBM and gonioscopy was 0.43, indicating moderate agreement. Conclusions: SD-OCT is well tolerated by canine patients due to its non-contact method and might be an alternative option for early screening of ICA narrowing in clinical settings.