Intrasellar Ultrasound in Transsphenoidal Surgery

Neurosurgery ◽  
2010 ◽  
Vol 66 (1) ◽  
pp. 173-186 ◽  
Author(s):  
Ole Solheim ◽  
Tormod Selbekk ◽  
Lasse Løvstakken ◽  
Geir A. Tangen ◽  
Ole V. Solberg ◽  
...  
Keyword(s):  
Transsphenoidal Surgery ◽  
Color Doppler ◽  
Power Doppler ◽  
Intraoperative Ultrasound ◽  
Residual Tumor ◽  
Image Resolution ◽  
Technical Solution ◽  
Ultrasound Images ◽  
High Frequency Ultrasound ◽  
Clinical Magnetic Resonance Imaging

Abstract OBJECTIVE Residual tumor masses are common after transsphenoidal surgery. The risk of a residual mass increases with tumor size and parasellar or suprasellar growth. Transsphenoidal surgery is usually performed without image guidance. We aimed to investigate a new technical solution developed for intraoperative ultrasound imaging during transsphenoidal surgery, with respect to potential clinical use and the ability to identify neuroanatomy and tumor. METHODS In 9 patients with pituitary macroadenomas, intrasphenoidal and intrasellar ultrasound was assessed during transsphenoidal operations. Ultrasound B-mode, power-Doppler and color-Doppler images were acquired using a small prototype linear array, side-looking probe. The long probe tip measures only 3 × 4 mm. We present images and discuss the potential of intrasphenoidal and intrasellar and ultrasound in transsphenoidal surgery. RESULTS We present 2-dimensional, high-resolution ultrasound images. A small side-looking, high-frequency ultrasound probe can be used to ensure orientation in the midline for the surgical approach to identify important neurovascular structures to be avoided during surgery and for resection control and identification of normal pituitary tissue. The image resolution is far better than what can be achieved with current clinical magnetic resonance imaging technology. CONCLUSION We believe that the concept of intrasellar ultrasound can be further developed to become a flexible and useful tool in transsphenoidal surgery.

scholarly journals Differential Diagnosis of Malignant Melanoma and Benign Cutaneous Lesions by Ultrasound Analysis

2020 ◽  
Vol 2 (2) ◽  
pp. 100-107
Author(s):  
Michael Hambardzumyan ◽  
A. Hayrapetyan
Keyword(s):  
Differential Diagnosis ◽  
Malignant Melanoma ◽  
High Frequency ◽  
Color Doppler ◽  
Power Doppler ◽  
High Frequency Ultrasound ◽  
Cutaneous Lesions ◽  
Benign Pathology ◽  
Doppler Power ◽  
Circulatory Pattern

Background:  The purpose of the study is to evaluate the assessment of ultrasound analysis in the differential diagnosis of skin melanoma and benign cutaneous lesions. Objective: 61 patients (23 men and 38 women) between 17 and 87 years of age, with melanomas, atheromas, hemangiomas, keratoses, and naevi were studied. Methods: High-frequency gray-scale ultrasound analysis, color Doppler, power Doppler, advanced dynamic flow, strain Elastography, digital Dermoscopy were performed in all cases. Results: In malignant melanoma cases we have mainly: sharp margins, hypoechoic, homogenous structure, absent of posterior shadowing, central and disorganized circulatory pattern with multiple peduncles. In some benign pathology, several ultrasound criteria were exclusive: microcalcifications are only in atheroma, posterior shadowing, and circular rim - in keratosis. The incidence of other ultrasound criteria can vary in atheroma, hemangioma, keratosis, and nevus. Tumor longitudinal and thickness relation were higher (7.9±1.96) than in all benign pathologies (2.1-4.8). The Elastography stiffness of the 26 skin melanomas was 2.95±0.18 and was higher than the group of 35 patients with all benign skin pathology (0.96±0.59), including atheroma (2.0±0.78), hemangioma (0.55±0.21), keratosis (1.21±0.21) and nevus (0.78±0.45). Conclusion: Multimodal approaches to exploring high-frequency ultrasound analytic criteria can be helpful in the differential diagnosis of malignant melanoma and benign cutaneous lesions.

scholarly journals Recent advances in applications of multimodal ultrasound-guided photoacoustic imaging technology

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Shanshan Wang ◽  
Yunfeng Zhao ◽  
Ye Xu
Keyword(s):  
Near Infrared ◽  
Photoacoustic Imaging ◽  
Imaging Techniques ◽  
Color Doppler ◽  
Power Doppler ◽  
Infrared Region ◽  
Detection Methods ◽  
Imaging Mode ◽  
Nonlinear Imaging ◽  
The Relationship

Abstract Photoacoustic imaging (PAI) is often performed simultaneously with ultrasound imaging and can provide functional and cellular information regarding the tissues in the anatomical markers of the imaging. This paper describes in detail the basic principles of photoacoustic/ultrasound (PA/US) imaging and its application in recent years. It includes near-infrared-region PA, photothermal, photodynamic, and multimode imaging techniques. Particular attention is given to the relationship between PAI and ultrasonic imaging; the latest high-frequency PA/US imaging of small animals, which involves not only B-mode, but also color Doppler mode, power Doppler mode, and nonlinear imaging mode; the ultrasonic model combined with PAI, including the formation of multimodal imaging; the preclinical imaging methods; and the most effective detection methods for clinical research for the future.

scholarly journals Ultrasonological evaluation of acute scrotum

2018 ◽  
Vol 6 (1-2) ◽  
pp. 11-14
Author(s):  
Prakash Sharma ◽  
Merina Gyawali ◽  
Sristi Singh
Keyword(s):  
Statistical Analysis ◽  
Color Doppler ◽  
Descriptive Analysis ◽  
Power Doppler ◽  
Rank Correlation ◽  
Final Diagnosis ◽  
Acute Scrotum ◽  
Age Group ◽  
Scrotal Pain ◽  
Kendall Rank Correlation

Introduction: Acute scrotum is a common surgical condition. Ultrasound along with Doppler plays an important role in differentiating the various causes. Purpose of this study was to evaluate the role of ultrasound in identifying the various causes of acute scrotum.Methods: All patients with history of acute scrotum presenting to the Department of Radiology were included in the study. Scrotal ultrasound was performed with a linear 7.5 to 12-MHz transducer with abundant acoustic gel. Imaging was done in longitudinal and transverse planes with Power Doppler and Color Doppler. The testes, epididymis, spermatic cord, scrotal wall and inguinal region were evaluated. Kidney, Ureter and Bladder region was evaluated for possibility of calculus. Final diagnosis was made based on clinical outcome, follow up, intraoperative findings and histopathology when available. Statistical analysis was done using SPSS version 18 for windows. Descriptive analysis was done. Non parametric correlation between side and torsion was done using Kendall Rank Correlation Coefficient.Results: There were altogether 50 patients available for statistical analysis. Age of the patients ranged from 14 to 65 years with mean age of 34.7±14.7 years. Most common age group was 21 to 40 years. Inflammatory pathology was the most common pathology of actual scrotal pain. There was no significant correlation between side of pain and testicular torsion.Conclusion: Inflammatory pathology was the most common cause for actual scrotal pain. The most common age group was 21 to 40 years.

scholarly journals Uloga ultrazvuka u dijagnostici ranog reumatoidnog artritisa

2012 ◽  
Vol 4 (2) ◽  
Author(s):  
Siniša Ristić ◽  
Maja Račić
Keyword(s):  
Color Doppler ◽  
Power Doppler

Reumatoidni artritis je drugi po učestalosti hronični artritis. Pogađa približno1% odrasle populacije u svijetu, skraćuje stopu preživljavanja i značajnosmanjuje kvalitet života oboljelih osoba. To je sistemska, inflamatorna, autoimunskabolest vezivnog tkiva, a inflamacija primarno zahvata sinoviju.Brojne studije su pokazale da ultrazvučna dijagnostika ima visok stepensenzitivnosti u otkrivanju ranih inflamatornih lezija (sinovitis, tenosinovitisi bursitis) i ranih koštanih lezija (erozije), kao i u vizuelizaciji nepalpabilnogzadebljanja sinovije. Color doppler je senzitivnija metoda od power-doppler-ai standardnog ultrazvuka u procjeni indikatora inflamacije. Senzitivnostmagnetne rezonance i ultrazvuka je približno jednaka u dijagnostici promjenau zglobovima prstiju, koljena i kuka, međutim, ultrazvuk teže vizualizujeinflamatorne promjene složenih zglobova. Tokom dijagnostičke evaluacijereumatoidnog artritisa, neophodan je bilateralni ultrazvučni pregled metakarpofalangealnihi metatarzofalangealnih zglobova i zglobova doručja. Postojipotreba za iznalaženjem ultrazvučnog skora kojim bi se kvantifikovale uočeneinflamatorne promjene. Novi ultrazvučni sistem bodovanja sedam zglobova,(US7), jedini kombinuje mjerenje mekotkivnih i destruktivnih lezija, alise mogućnost njegove primjene u reumatološkoj praksi još uvijek istražuje.

Thyroid-stimulating hormone pituitary adenomas

2008 ◽  
Vol 109 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Michelle J. Clarke ◽  
Dana Erickson ◽  
M. Regina Castro ◽  
John L. D. Atkinson
Keyword(s):  
Radiation Therapy ◽  
Pituitary Adenomas ◽  
Anterior Pituitary ◽  
Transsphenoidal Surgery ◽  
Hormone Replacement ◽  
Residual Tumor ◽  
Thyroid Stimulating Hormone ◽  
Team Approach ◽  
Pituitary Dysfunction ◽  
Stimulating Hormone

Object Thyroid-stimulating hormone (TSH)–secreting pituitary adenomas are rare, representing < 2% of all pituitary adenomas. Methods The authors conducted a retrospective analysis of patients with TSH-secreting or clinically silent TSH-immunostaining pituitary tumors among all pituitary adenomas followed at their institution between 1987 and 2003. Patient records, including clinical, imaging, and pathological and surgical characteristics were reviewed. Twenty-one patients (6 women and 15 men; mean age 46 years, range 26–73 years) were identified. Of these, 10 patients had a history of clinical hyperthyroidism, of whom 7 had undergone ablative thyroid procedures (thyroid surgery/131I ablation) prior to the diagnosis of pituitary adenoma. Ten patients had elevated TSH preoperatively. Seven patients presented with headache, and 8 presented with visual field defects. All patients underwent imaging, of which 19 were available for imaging review. Sixteen patients had macroadenomas. Results Of the 21 patients, 18 underwent transsphenoidal surgery at the authors' institution, 2 patients underwent transsphenoidal surgery at another facility, and 1 was treated medically. Patients with TSH-secreting tumors were defined as in remission after surgery if they had no residual adenoma on imaging and had biochemical evidence of hypo-or euthyroidism. Patients with TSH-immunostaining tumors were considered in remission if they had no residual tumor. Of these 18 patients, 9 (50%) were in remission following surgery. Seven patients had residual tumor; 2 of these patients underwent further transsphenoidal resection, 1 underwent a craniotomy, and 4 underwent postoperative radiation therapy (2 conventional radiation therapy, 1 Gamma Knife surgery, and 1 had both types of radiation treatment). Two patients had persistently elevated TSH levels despite the lack of evidence of residual tumor. On pathological analysis and immunostaining of the surgical specimen, 17 patients had samples that stained positively for TSH, 8 for α-subunit, 10 for growth hormone, 7 for prolactin, 2 for adrenocorticotrophic hormone, and 1 for follicle-stimulating hormone/luteinizing hormone. Eleven patients (61%) ultimately required thyroid hormone replacement therapy, and 5 (24%) required additional pituitary hormone replacement. Of these, 2 patients required treatment for new anterior pituitary dysfunction as a complication of surgery, and 2 patients with preoperative partial anterior pituitary dysfunction developed complete panhypopituitarism. One patient had transient diabetes insipidus. The remainder had no change in pituitary function from their preoperative state. Conclusions Thyroid-stimulating hormone–secreting pituitary lesions are often delayed in diagnosis, are frequently macroadenomas and plurihormonal in terms of their pathological characteristics, have a heterogeneous clinical picture, and are difficult to treat. An experienced team approach will optimize results in the management of these uncommon lesions.

scholarly journals Visualization of lenticulostriate arteries during insular low-grade glioma surgeries by navigated 3D ultrasound power Doppler: technical note

2016 ◽  
Vol 125 (4) ◽  
pp. 1016-1023 ◽  
Author(s):  
Andrej Šteňo ◽  
Michaela Jezberová ◽  
Vladimír Hollý ◽  
Gabriela Timárová ◽  
Juraj Šteňo
Keyword(s):  
Power Doppler ◽  
Residual Tumor ◽  
3D Ultrasound ◽  
Technical Note ◽  
Minimal Amount ◽  
Low Grade ◽  
Brain Shift ◽  
Lenticulostriate Arteries ◽  
Grade Ii ◽  
Intraoperative Localization

OBJECTIVE Resection of insular gliomas is challenging. In cases of intraoperative injury to the lenticulostriate arteries (LSAs), the usual result is a dense hemiplegia. LSAs are usually localized just behind the medial tumor border but they can also be encased by the tumor. Thus, exact localization of these perforators is important. However, intraoperative localization of LSAs using conventional neuronavigation can be difficult due to brain shift. In this paper, the authors present a novel method of intraoperative LSA visualization by navigated 3D ultrasound (3DUS) power Doppler. This technique enables almost real-time imaging of LSAs and evaluation of their shift during insular tumor resections. METHODS Six patients harboring insular Grade II gliomas were consecutively operated on at the Department of Neurosurgery in Bratislava using visualization of LSAs by navigated 3DUS power Doppler. In all cases, the 3DUS data were repeatedly updated to compensate for the brain shift and display the actual position of LSAs and residual tumor. RESULTS Successful visualization of LSAs was achieved in all cases. During all surgeries, the distance between the bottom of the resection cavity and LSAs could be accurately evaluated; in all tumors the resection approached the LSAs and only a minimal amount of tissue covering these perforators was intentionally left in place to avoid injury to them. CONCLUSIONS Visualization of LSAs by navigated 3DUS power Doppler is a useful tool that may help to prevent injury of LSAs during removal of insular low-grade gliomas. However, reliability of this method has to be carefully evaluated in further studies.

Patient-specific model-based segmentation of brain tumors in 3D intraoperative ultrasound images

2018 ◽  
Vol 13 (3) ◽  
pp. 331-342 ◽  
Author(s):  
Elisee Ilunga-Mbuyamba ◽  
Juan Gabriel Avina-Cervantes ◽  
Dirk Lindner ◽  
Felix Arlt ◽  
Jean Fulbert Ituna-Yudonago ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Intraoperative Ultrasound ◽  
Specific Model ◽  
Patient Specific ◽  
Ultrasound Images ◽  
Model Based
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