Ultrasonics

超声波
  • 文章类型: Journal Article
    通过阐明超声非肿块异常发现并共享概念,可以适当诊断非肿块异常。如果非肿块异常可以早期诊断,可治愈病例的数量可能会增加,导致更少的乳腺癌死亡。日本超声医学学会(JSUM)术语/诊断标准委员会已将非肿块异常分为五种亚型:乳腺低回声区,管道异常,建筑扭曲,多发小囊肿,和无低回声区的回声灶。我们在此定义了每种亚型的发现,并根据这些发现对JSUM指南中产生的乳房非肿块异常进行了总结。
    It is possible to appropriately diagnose non-mass abnormalities by elucidating ultrasound non-mass abnormality findings and sharing the concept. If non-mass abnormalities can be diagnosed early, the number of curable cases could increase, leading to fewer breast cancer deaths. The Japan Society of Ultrasonics in Medicine (JSUM) Terminology/Diagnostic Criteria Committee has classified non-mass abnormalities into five subtypes: hypoechoic area in the mammary gland, abnormalities of the ducts, architectural distortion, multiple small cysts, and echogenic foci without a hypoechoic area. We herein define the findings for each of these subtypes and present a summary of the JSUM guidelines on non-mass abnormalities of the breast generated based on those findings.
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  • 文章类型: Journal Article
    背景:超声神经刺激(USNS)是一种非侵入性神经调节技术,在治疗神经精神疾病方面具有非侵入性,穿透深度,和高分辨率。
    目的:我们在这项实验研究中寻求为小鼠初级运动皮层(M1)的成功超声神经刺激提供详细和优化的方案和方法,目的是针对年轻的研究人员/学生在超声神经刺激领域开始研究并遇到实际挑战。
    方法:在不同麻醉水平的C57BL/6小鼠中,在不同声压下,使用500kHz单元件换能器刺激初级运动皮质。为了进一步说明麻醉的效果,通过视频记录和肌电图验证的运动反应的实时视觉观察被用于评估刺激的成功和可靠性。
    结果:介绍了包括靶向和麻醉在内的成功刺激的详细实验程序。我们的研究表明,在麻醉冲洗期间,在330kPa至550kPa的声压范围内,我们可以实现高刺激成功率(91%至100%)。
    结论:这项研究显示了一种针对超声脑刺激主题初学者的小鼠成功USNS的可靠和详细的方法。我们展示了一个有效的USNS协议。我们提供了一种简单且一致的非侵入性技术来定位和定位大脑区域。此外,我们说明了声压和刺激成功的关系,并集中于麻醉水平对成功刺激的影响。
    BACKGROUND: Ultrasound neurostimulation (USNS) is a non-invasive neuromodulation technique that might hold promise for treating neuropsychiatric disorders with regards to its noninvasiveness, penetration depth, and high resolution.
    OBJECTIVE: We sought in this experimental study to provide detailed and optimized protocol and methodology for a successful ultrasonic neurostimulation of the Primary Motor Cortex (M1) in mice addressed to young researchers/students beginning their research in the field of ultrasonic neurostimulation and encountering practical challenges.
    METHODS: A 500 kHz single-element transducer was used for stimulating the primary motor cortex at different acoustic pressures in C57BL/6 mice at various anesthesia levels. To further illustrate the effect of anesthesia, real time visual observations of motor responses validated with video recordings as well as electromyography were employed for evaluating the success and reliability of the stimulations.
    RESULTS: Detailed experimental procedure for a successful stimulations including targeting and anesthesia is presented. Our study demonstrates that we can achieve high stimulation success rates (91 % to 100 %) at acoustic pressures ranging from 330 kPa to 550 kPa at anesthesia washout period.
    CONCLUSIONS: This study shows a reliable and detailed methodology for successful USNS in mice addressed to beginners in ultrasonic brain stimulation topic. We showed an effective USNS protocol. We offered a simple and consistent non-invasive technique for locating and targeting brain zones. Moreover, we illustrated the acoustic pressure and stimulation success relationship and focused on the effect of anesthesia level for successful stimulation.
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  • 文章类型: Journal Article
    今天,应重新考虑如何使用超声技术进行术中神经生理学监测,以改善患者预后,减少住院时间和费用.大量且快速增长的文献表明,经颅多普勒(TCD)超声神经监测(TCDNM)提供的基本血流动力学信息将为改善不同类型血管后的结局提供有效的监测方式。神经外科,骨科,心血管,心胸手术和一些血管内介入或诊断程序,比如心导管插入术或者脑血管造影.理解,避免,预防围手术期或术后并发症,包括上述手术后的神经功能缺损,血管内介入,或诊断程序,代表了对社会具有巨大公共和经济利益的领域,特别是考虑到人口老龄化。美国神经生理学监测协会和美国神经影像学协会指南委员会组成了一个联合工作组,并制定了更新的指南,以协助在外科和重症监护环境中使用TCDNM。具体来说,这些指南定义了(1)TCD监测的目标;(2)神经超声医师在监测期间的责任和行为;(3)仪器和采集参数;(4)安全考虑因素;(5)TCDNM的当代理由;(6)TCDNM观点;(7)主要建议.
    Today, it seems prudent to reconsider how ultrasound technology can be used for providing intraoperative neurophysiologic monitoring that will result in better patient outcomes and decreased length and cost of hospitalization. An extensive and rapidly growing literature suggests that the essential hemodynamic information provided by transcranial Doppler (TCD) ultrasonography neuromonitoring (TCDNM) would provide effective monitoring modality for improving outcomes after different types of vascular, neurosurgical, orthopedic, cardiovascular, and cardiothoracic surgeries and some endovascular interventional or diagnostic procedures, like cardiac catheterization or cerebral angiography. Understanding, avoiding, and preventing peri- or postoperative complications, including neurological deficits following abovementioned surgeries, endovascular intervention, or diagnostic procedures, represents an area of great public and economic benefit for society, especially considering the aging population. The American Society of Neurophysiologic Monitoring and American Society of Neuroimaging Guidelines Committees formed a joint task force and developed updated guidelines to assist in the use of TCDNM in the surgical and intensive care settings. Specifically, these guidelines define (1) the objectives of TCD monitoring; (2) the responsibilities and behaviors of the neurosonographer during monitoring; (3) instrumentation and acquisition parameters; (4) safety considerations; (5) contemporary rationale for TCDNM; (6) TCDNM perspectives; and (7) major recommendations.
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  • 文章类型: Journal Article
    OBJECTIVE: This study aimed to evaluate the impact of Collège National des Gynécologues et Obstétriciens Français (CNGOF) guidelines on the minimal sonographic reports generated by emergency department resident physicians.
    METHODS: This prospective observational study was conducted in the gynaecologic emergency unit of a teaching hospital from November 2016 to May 2017. We analysed sonographic reports generated by residents during gynaecological emergencies before and after training on the minimal report standards. An analysis of the evaluated items was carried out. We also compared residents according to their specialities and seniority.
    RESULTS: A total of 240 reports were analysed, 120 before and 120 after the training. Half of the reports concerned women with an early pregnancy while the others concerned women with negative hCG. All residents significantly improved their practice after the training, as shown by the increase in ratings of the evaluated items (38 % before training vs 44.8 % after, p < 0.01). General practitioners had greater improvement (48.1 % of evaluated items), whereas older residents reported fewer items before or after the training (43.5 %) than younger residents. Finally, all residents improved their practice with a conclusion that followed the guidelines in 92.5 % of cases (versus 68.3 % before the training; p < 0.01).
    CONCLUSIONS: Training on the CNGOF minimal sonographic report guidelines significantly improved the emergency sonographic reports generated by residents. Wider dissemination of this training, particularly to young residents, would probably improve the quality of sonographic reports performed at gynaecological emergencies.
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  • 文章类型: Journal Article
    Ultrasound is an essential tool in the management of the nephrological patient allowing the diagnosis, monitoring and performance of kidney intervention. However, the usefulness of ultrasound in the hands of the nephrologist is not limited exclusively to the ultrasound study of the kidney. By ultrasound, the nephrologist can also optimize the management of arteriovenous fistula for hemodialysis, measure cardiovascular risk (mean intimate thickness), implant central catheters for ultrasound-guided HD, as well as the patient\'s volemia using basic cardiac ultrasound, ultrasound of the cava inferior vein and lungs. From the Working Group on Interventional Nephrology (GNDI) of the Spanish Society of Nephrology (SEN) we have prepared this consensus document that summarizes the main applications of ultrasound to Nephrology, including the necessary basic technical requirements, the framework normative and the level of training of nephrologists in this area. The objective of this work is to promote the inclusion of ultrasound, both diagnostic and interventional, in the usual clinical practice of the nephrologist and in the Nephrology Services portfolio with the final objective of offering diligent, efficient and comprehensive management to the nephrological patient.
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  • 文章类型: Journal Article
    Ultrasound is becoming a fundamental first-line diagnostic tool for most medical specialties and an innovative tool to teach anatomy, physiology and pathophysiology to undergraduate and graduate students. However, availability of structured training programs during medical school is lagging behind and many physicians still acquire all their ultrasound skills during postgraduate training.There is wide variation in medical student ultrasound education worldwide. Sharing successful educational strategies from early adopter medical schools and learning from leading education programs should advance the integration of ultrasound into the university medical school curricula. In this overview, we present current approaches and suggestions by ultrasound societies concerning medical student educa-tion throughout the world. Based on these examples, we formulate a consensus statement with suggestions on how to integrate ultrasound teaching into the preclinical and clinical medical curricula.
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  • 文章类型: Journal Article
    The abdominal ultrasound (AU) is a diagnostic imaging modality that is yet to be established in most Gastrointestinal (GI) Units in Spain. This is largely due to the difficulties that GI specialists face with regard to the appropriate training received when starting the specialty. Insufficient resources have been allocated to develop AU units in many GI units where AUs are performed. The equipment is obsolete and there are no adaptations to the needs of the GI specialist to provide good medical care. Thus, due to all the above, the AU does not hold the position it deserves in our specialty. This probably stems from a lack of impulse and/or support to the technique, which has underestimated its usefulness and has limited the implementation of resources in the GI units. For the AU to overcome these obstacles, it needs to be considered as a process or a series of activities based on scientific evidence and the experience of professionals that achieves a result that covers the patients\' needs with minimal risk. In this article, we defend the need to boost AU as a key discipline for the diagnosis of digestive diseases. Quality is considered as the key aspect on which this transformation and improvement is founded.
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  • 文章类型: Journal Article
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  • 文章类型: Consensus Development Conference
    Ultrasound imaging has become integral to the practice of obstetrics and gynecology. With increasing educational demands and limited hours in residency programs, dedicated time for training and achieving competency in ultrasound has diminished substantially. The American Institute of Ultrasound in Medicine assembled a multisociety task force to develop a consensus-based, standardized curriculum and competency assessment tools for obstetric and gynecologic ultrasound training in residency programs. The curriculum and competency assessment tools were developed based on existing national and international guidelines for the performance of obstetric and gynecologic ultrasound examinations and thus are intended to represent the minimum requirement for such training. By expert consensus, the curriculum was developed for each year of training, criteria for each competency assessment image were generated, the pass score was established at, or close to, 75% for each, and obtaining a set of 5 ultrasound images with pass score in each was deemed necessary for attaining each competency. Given the current lack of substantial data on competency assessment in ultrasound training, the task force expects that the criteria set forth in this document will evolve with time. The task force also encourages use of ultrasound simulation in residency training and expects that simulation will play a significant part in the curriculum and the competency assessment process. Incorporating this training curriculum and the competency assessment tools may promote consistency in training and competency assessment, thus enhancing the performance and diagnostic accuracy of ultrasound examination in obstetrics and gynecology.
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  • 文章类型: Journal Article
    床边护理点超声(POCUS)越来越多地用于评估医疗患者。目前,对于什么POCUS课程适合内科住院医师培训计划,尚无共识。本文件详细介绍了加拿大内科超声(CIMUS)小组基于共识的建议,由39名成员组成,代表加拿大的14个机构。事先确定了选择课程内容的指导原则。共识被定义为至少80%的成员同意POCUS申请,认为适合于核心(内科研究生课程[PGY]1-3)和扩展(一般内科PGY4-5)培训计划的学员的教学和评估。我们建议为PGY1-3核心课程(下腔静脉,肺B线,胸腔积液,和腹腔游离液)和三个超声引导程序(中心静脉导管插入术,胸腔穿刺术,和穿刺)。对于扩展的PGY4-5课程,我们建议另外七种应用(颈内静脉,肺巩固,气胸,膝关节积液,左心室总收缩功能,心包积液,和右心室应变)和四个超声引导程序(膝关节穿刺术,动脉线插入,动脉血气采样,和外周静脉导管插入术)。这些建议将为国家一级的培训方案提供一个框架。
    Bedside point-of-care ultrasound (POCUS) is increasingly used to assess medical patients. At present, no consensus exists for what POCUS curriculum is appropriate for internal medicine residency training programs. This document details the consensus-based recommendations by the Canadian Internal Medicine Ultrasound (CIMUS) group, comprising 39 members, representing 14 institutions across Canada. Guiding principles for selecting curricular content were determined a priori. Consensus was defined as agreement by at least 80% of the members on POCUS applications deemed appropriate for teaching and assessment of trainees in the core (internal medicine postgraduate years [PGY] 1-3) and expanded (general internal medicine PGY 4-5) training programs. We recommend four POCUS applications for the core PGY 1-3 curriculum (inferior vena cava, lung B lines, pleural effusion, and abdominal free fluid) and three ultrasound-guided procedures (central venous catheterization, thoracentesis, and paracentesis). For the expanded PGY 4-5 curriculum, we recommend an additional seven applications (internal jugular vein, lung consolidation, pneumothorax, knee effusion, gross left ventricular systolic function, pericardial effusion, and right ventricular strain) and four ultrasound-guided procedures (knee arthrocentesis, arterial line insertion, arterial blood gas sampling, and peripheral venous catheterization). These recommendations will provide a framework for training programs at a national level.
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