• Title/Summary/Keyword: ultrasonographic measurement

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Value of Ultrasonography in the Diagnosis of Carpal Tunnel Syndrome : Correlation with Electrophysiological Abnormalities and Clinical Severity

  • Kim, Min-Kyu;Jeon, Hong-Jun;Park, Se-Hyuck;Park, Dong-Sik;Nam, Hee-Seung
    • Journal of Korean Neurosurgical Society
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    • v.55 no.2
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    • pp.78-82
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    • 2014
  • Objective : To investigate a diagnostic value of ultrasonography in carpal tunnel syndrome (CTS) patients and to evaluate a correlation of sonographic measurements with the degree of electrodiagnostic abnormalities and clinical severity. Methods : Two-hundred-forty-six symptomatic hands in 135 patients and 30 asymptomatic hands in 19 healthy individuals as control group were included. In ultrasonographic study, we measured the cross-sectional area (CSA) and flattening ratio (FR) of the median nerve at the pisiform as well as palmar bowing (PB) of the flexor retinaculum. Sensitivity and specificity of ultrasonographic measurements were evaluated and ultrasonographic data from the symptomatic and control hands were compared to the grade of electrodiagnostic and clinical severity. Results : The mean CSA was $13.7{\pm}4.2mm^2$ in symptomatic hands and $7.9{\pm}1.3mm^2$ in asymptomatic hands. The mean FR was $4.2{\pm}1.0$ in symptomatic hands and $3.4{\pm}0.4$ in asymptomatic hands. The mean PB was $3.5{\pm}0.5$ mm in symptomatic hands and $2.6{\pm}0.3$ mm in asymptomatic hands. Statistical analysis showed differences of the mean CSA, FR and PB between groups were significant. A cut-off value of $10mm^2$ for the mean CSA was found to be the upper limit for normal value. Both the mean CSA and PB are correlated with the grade of electrophysiological abnormalities and clinical severity, respectively. Conclusion : Ultrasographic measurement of the CSA and PB is helpful to diagnose CTS as a non-invasive and an alternative modality for the evaluation of CTS. In addition, ultrasonography also provides a reliable correlation with the grade of electrodiagnostic abnormalities and clinical severity.

Prenatal Ultrasonographic Diagnosis of Fetal Macroglossia (거대설의 산전 초음파 진단에 대한 고찰)

  • Seo, Mi Hyun;Kim, Soung Min;Myoung, Hoon;Lee, Jong Ho;Choi, Jin Young
    • Korean Journal of Cleft Lip And Palate
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    • v.15 no.2
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    • pp.83-88
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    • 2012
  • Macroglossia is a relatively uncommon condition that occurs in pediatric patients for several reasons and contributes to variety of functional problems. Most of macroglossia arises from tissue overgrowth and tongue muscle hypertrophy. There are no definite guideline in prenatal management or diagnosis in this conditions. However, macroglossia is often associated with syndrome or congenital disease, prenatal diagnosis is important in early detection. There are difficulty in measurement of tongue size, and standardization. Macroglossia can be risky in some aspects, such as airway obstruction. In this review, the author suggest prenatal ultrasonographic findings of macroglossia, investigate differential diagnosis of conditions associated with macroglossia, and management in clinical situation. Macroglossia, when present, can cause a number of functional and aesthetic problems for individuals. Treatment of this problem is challenging and controversial.

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Pressure Measurement in Carpal Tunnel Syndrome : Correlation with Electrodiagnostic and Ultrasonographic Findings

  • Ahn, Seong-Yeol;Hong, Youn-Ho;Koh, Young-Hwan;Chung, Yeong-Seob;Lee, Sang-Hyung;Yang, Hee-Jin
    • Journal of Korean Neurosurgical Society
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    • v.46 no.3
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    • pp.199-204
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    • 2009
  • Objective : This study was done to evaluate the correlation between carpal tunnel pressure (CTP), electrodiagnostic and ultrasonographic findings in patients with carpal tunnel syndrome (CTS). Methods : CTP was measured during endoscopic carpal tunnel release (ECTR) for CTS using Spiegelberg ICP monitoring device with parenchymal type catheter. Neurophysiologic severity and nerve cross sectional area were evaluated using nerve conductive study and ultrasonography (USG) before ECTR in all patients. Results : Tests were performed in a total of 48 wrists in 39 patients (9 cases bilateral). Maximum CTP was $56.7{\pm}19.3$ mmHg ($Mean{\pm}SD$) and $7.4{\pm}3.3$ mmHg before and after ECTR, respectively. No correlation was found between maximum CTP and either neurophysiologic severity or nerve cross sectional area, whereas we found a significant correlation between the latter two parameters. Conclusion : CTP was not correlated with neurophysiologic severity and nerve cross sectional area. Dynamic, rather than static, pressure in carpal tunnel might account for the basic pathophysiology of CTS better.

Ultrasonographic Appearance of the Gestational Structures throughout Pregnancy in Pet Dogs II. Estimation of Gestational Age and Prediction of Parturition Day by Measurement of the Gestational Structu (애완견에서 임신일령에 따른 임신구조물의 초음파상 II. 임신구조물의 측정에 의한 임신일령의 판정과 분만일의 예시)

  • 손창호;강병규;최한선;서동호;신창록;박인철
    • Journal of Veterinary Clinics
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    • v.14 no.2
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    • pp.287-296
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    • 1997
  • Serial ultrasonographic examinations were daily performed on 8 bitches (5 Maltese and 3 Yorkshire terrier) from day 15 until parturition to determine the size of gestational structures. Gestational age was timed from the day of ovulation (day 0), which was estimated to occur when plasma progesterone concentration was first increased above 4.0 ng/ml. When the size of fetal and extra-fetal structures according to gestational age was measured, there was a difference between Maltese and Yorkshire terrier in extra-fetal structures (P<0.001), and no difference in fetal structrures (P<0.001). The correlations between the gestational age and the growth in fetal and extra-fetal structures were examined by regression analysis. The extra-fetal structure which showed high correlation from day 20 to 35 was inner chorionic cavity diameter in two breeds. The fetal structures which showed high correlation from day 36 until parturition was fetal head diameter in two breeds. In conclusions inner chorionic cavity diameter was the most accurate for estimation of gestational age and prediction of whelping day from day 20 to 35, and fetal head diameter from day 36 to parturitions respectively. Ultrasonography is very useful tool to evaluate the gestational age and to predict the whelping day in pet dogs.

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Utility of Pyloric Length Measurement for Detecting Severe Metabolic Alkalosis in Infants with Hypertrophic Pyloric Stenosis

  • Hyun Jin Kim
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.2
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    • pp.88-94
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    • 2024
  • Purpose: Infantile hypertrophic pyloric stenosis (IHPS) is a common gastrointestinal disease in neonates and hypochloremia metabolic alkalosis is a typical laboratory finding in affected patients. This study aimed to analyze the clinical characteristics of infants with IHPS and evaluate the association of clinical and laboratory parameters with ultrasonographic findings. Methods: Infants diagnosed with IHPS between January 2017 and July 2022 were retrospectively evaluated. Results: A total of 67 patients were included in the study. The mean age at diagnosis was 40.5±19.59 days, and the mean symptom duration was 11.97±9.91 days. The mean pyloric muscle thickness and pyloric canal length were 4.87±1.05 mm and 19.6±3.46 mm, respectively. Hyponatremia and metabolic alkalosis were observed in five (7.5%) and 36 (53.7%) patients, respectively. Serum sodium (p=0.011), potassium (p=0.023), and chloride levels (p=0.015) were significantly lower in patients with high bicarbonate levels (≥30 mmol/L). Furthermore, pyloric canal length was significantly higher in patients with high bicarbonate levels (p=0.015). To assess metabolic alkalosis in IHPS patients, the area under the receiver operating characteristic curve of pyloric canal length was 0.910 and the optimal cutoff value of the pyloric canal length was 23.5 mm. Conclusion: We found a close association between laboratory and ultrasonographic findings of IHPS. Clinicians should give special consideration to patients with pyloric lengths exceeding 23.5 mm and appropriate fluid rehydration should be given to these patients.

Quantitative Evaluation of Median Nerve Motor Function in Carpal Tunnel Syndrome Using Load Cell : Correlation with Clinical, Electrodiagnostic, and Ultrasonographic Findings

  • Kim, Dong Hwan;Park, Sung Bae;Lee, Sang Hyung;Son, Young-Je;Chung, Gih Sung;Yang, Hee-Jin
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.232-235
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    • 2013
  • Objective : Major complaints of carpal tunnel syndrome (CTS) are sensory components. However, motor deficit also impedes functional status of hand. Contrary to evaluation of sensory function, the objective, quantitative evaluation of median nerve motor function is not easy. The motor function of median was evaluated quantitatively using load cell and its correlation with findings of electrodiagnostic study (EDS) was evaluated. Methods : Objective motor function of median nerve was evaluated by load cell and personal computer-based measurement system. All of the measurement was done in patients diagnosed as having idiopathic CTS by clinical features and EDS findings. The strength of thumb abduction and index finger flexion was measured in each hand three times, and the average value was used to calculate thumb index ratio (TIR). The correlation of TIR with clinical, EDS, and ultrasonographic findings were evaluated. Results : The TIR was evaluated in 67 patients (119 hands). There were 14 males and 53 females, mean age were 57.6 years (range 28 to 81). The higher preoperative nerve conductive studies grade of the patients, the lower TIR was observed [p<0.001, analysis of variance (ANOVA)]. TIR of cases with thenar atrophy were significantly lower than those without (p<0.001, t-test). TIR were significantly lower in patients with severe median nerve swelling in ultrasonography (p=0.042, ANOVA). Conclusion : Measurements of median nerve motor function using load cell is a valuable evaluation tool in CTS. It might be helpful in detecting subclinical motor dysfunction before muscle atrophy develops.

The Value of Ultrasonographic Endometrial Measurement in the Prediction of Pregnancy Outcome in In Vitro Fertilization (체외수정시술 주기에서 자궁내막발달과 착상에 관한 연구)

  • Kim, Sun-Haeng
    • Clinical and Experimental Reproductive Medicine
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    • v.20 no.2
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    • pp.117-123
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    • 1993
  • The condition of the endometrium is an important factor which may influence the success or failure in IVF-ET. This study was undertaken for evaluation of the value of endometrial growth as an early predictor for the success of IVF. Ultrasonographic endometrial measurement were performed in 43 IVF cycles that conceived, 101 cycles that did not with an IVF-ET There was no significant difference in the endometrial thickness and the serum concentration of estradiol in the pregnant versus nonpregnant group(10.4 vs. 9.9 mm: 2348 vs. 2017 pg/ml no hCG administration day). No correlation was found between the ultrasound image and serum estradiol levels around the time of hCG administration(r=0.54, p=0.13 no Day 2; r=0.45, p=0.14 no Day 1). The duration of gonadotropin treatment, number of follicles, number of oocytes retrieved, and fertilization rate were not statistically different in the two groups, however, there was a significant difference in the number of embryos in the pregnant versus nonpregnant group)p< 0.05). A higher pregnancy rate and ongoing pregnancy rate occured with an endometrial thickness over 11 mm compared with below 7mm(p< 0.05, p< 0.005). however, no significant differences were noted in the implantation rate and abortion rate among the groups that classified according to their endmetrial thickness. The endometrial growth(${\Delta}$) from hCG administration day(DO) to D6 was greater in the women who achieved pregnancy than in the nonpregnant group(p< 0.01). There were no significant differences in serum estradiol levels, implantation rate, pregnancy rate, and abortion rate among the groups that classified according to the pattern of echogenesity of endometrium, however, significantly higher ongoing pregnancy rate was noted in group A, B compared with group C.(p< 0.0001, p< 0.001) These results suggest that there were no ultrasonographically detectable differences in the patterns of endometrial growth and development around the time of hCG administration in patients who conceive versus those that do not in IVF-ET.

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Ultrasonographic Measurement of the Ligamentum Flavum Depth : Is It a Reliable Method to Distinguish True and False Loss of Resistance?

  • Pak, Michael Hae-Jin;Lee, Won-Hyung;Ko, Young-Kwon;So, Sang-Young;Kim, Hyun-Joong
    • The Korean Journal of Pain
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    • v.25 no.2
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    • pp.99-104
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    • 2012
  • Background: Previous studies have shown that if performed without radiographic guidance, the loss of resistance (LOR) technique can result in inaccurate needle placement in up to 30% of lumbar epidural blocks. To date, no study has shown the efficacy of measuring the depth of the posterior complex (ligamentum flavum, epidural space, and posterior dura) ultrasonographically to distinguish true and false LOR. Methods: 40 cervical epidural blocks were performed using the LOR technique and confirmed by epidurograms. Transverse ultrasound images of the C6/7 area were taken before each cervical epidural block, and the distances from the skin to the posterior complex, transverse process, and supraspinous ligament were measured on each ultrasound view. The number of LOR attempts was counted, and the depth of each LOR was measured with a standard ruler. Correlation of false and true positive LOR depth with ultrasonographically measured depth was also statistically analyzed. Results: 76.5% of all cases (26 out of 34) showed false positive LOR. Concordance correlation coefficients between the measured distances on ultrasound (skin to ligamentum flavum) and actual needle depth were 0.8285 on true LOR. Depth of the true positive LOR correlated with height and weight, with a mean of $5.64{\pm}1.06cm$, while the mean depth of the false positive LOR was $4.08{\pm}1.00cm$. Conclusions: Ultrasonographic measurement of the ligamentum flavum depth (or posterior complex) preceding cervical epidural block is beneficial in excluding false LOR and increasing success rates of cervical epidural blocks.

Ultrasonographic Features of Medullary Thyroid Carcinoma: Do they Correlate with Pre- and Post-Operative Calcitonin Levels?

  • Cho, Kyung Eun;Gweon, Hye Mi;Park, Ah Young;Yoo, Mi Ri;Kim, Jeong-Ah;Youk, Ji Hyun;Park, Young Mi;Son, Eun Ju
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3357-3362
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    • 2016
  • Purpose: To correlate ultrasonographic (US) features of medullary thyroid carcinoma (MTC) with preoperative and post-operative calcitonin levels. Materials and Methods: A total of 130 thyroid nodules diagnosed as MTC were evaluated. Two radiologists retrospectively evaluated preoperative US features according to size, shape, margin, echogenicity, type of calcification, and lymph node status. Postoperative clinical and imaging follow-up (mean duration $31.9 {\pm} 22.5$ months) was performed for detection of tumor recurrence. US features, presence of LN metastasis, and tumor recurrence were compared between MTC nodules with and without elevated preoperative calcitonin (>100 pg/mL). Those with normalized and non-normalized postoperative calcitonin levels groups were also compared. Results: Common US features of MTCs were solid internal content (90.8%), irregular shape (44.6%), circumscribed margin (46.2%), and hypoechogenicity (56.2%). Comparing MTC nodules with and without elevated preoperative calcitonin levels, the size and shape of MTC nodule and lymph node metastasis showed statistical significance (p<0.05). Postoperative calcitonin normalization correlated with US features of tumor size (p=0.002), margin (p=0.034), shape ($p{\leq}0.001$), and presence of calcification (p=0.046). Tumor recurrence and LN metastasis were more prevalent in patients without normalization of postoperative calcitonin than in those with normalization (p=0.001). Conclusions: Serum calcitonin measurement is helpful for early diagnosis and predicting prognosis. Postoperative calcitonin measurement is also important for postoperative US follow up, especially in cases with larger nodule size, presence of calcification, irregular shape, and irregular margin.