scholarly journals Intraoperative high-resolution ultrasound and contrast-enhanced ultrasound of peripheral nerve tumors and tumorlike lesions

2015 ◽  
Vol 39 (3) ◽  
pp. E5 ◽  
Author(s):  
Maria Teresa Pedro ◽  
Gregor Antoniadis ◽  
Angelika Scheuerle ◽  
Mirko Pham ◽  
Christian Rainer Wirtz ◽  
...  
Keyword(s):  
High Resolution ◽  
Peripheral Nerve ◽  
Diffusion Tensor ◽  
Preoperative Evaluation ◽  
Pulse Sequences ◽  
Rare Tumor ◽  
Contrast Enhanced Ultrasound ◽  
High Frequency Ultrasound ◽  
Contrast Enhanced ◽  
Tumor Entities

The diagnostic workup and surgical therapy for peripheral nerve tumors and tumorlike lesions are challenging. Magnetic resonance imaging is the standard diagnostic tool in the preoperative workup. However, even with advanced pulse sequences such as diffusion tensor imaging for MR neurography, the ability to differentiate tumor entities based on histological features remains limited. In particular, rare tumor entities different from schwannomas and neurofibromas are difficult to anticipate before surgical exploration and histological confirmation. High-resolution ultrasound (HRU) has become another important tool in the preoperative evaluation of peripheral nerves. Ongoing software and technical developments with transducers of up to 17–18 MHz enable high spatial resolution with tissue-differentiating properties. Unfortunately, high-frequency ultrasound provides low tissue penetration. The authors developed a setting in which intraoperative HRU was used and in which the direct sterile contact between the ultrasound transducer and the surgically exposed nerve pathology was enabled to increase structural resolution and contrast. In a case-guided fashion, the authors report the sonographic characteristics of rare tumor entities shown by intraoperative HRU and contrast-enhanced ultrasound.

Utility of contrast-enhanced ultrasound in preoperative evaluation of primary hyperparathyroidism

2018 ◽  
Author(s):  
Paola Parra Ramirez ◽  
Patricia Martin Rojas Marcos ◽  
Antonio Santiago Hernando ◽  
Arturo Lisbona Catalan ◽  
Alejandro Casto Calvo ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Preoperative Evaluation ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced

scholarly journals 4.7-T diffusion tensor imaging of acute traumatic peripheral nerve injury

2015 ◽  
Vol 39 (3) ◽  
pp. E9 ◽  
Author(s):  
Richard B. Boyer ◽  
Nathaniel D. Kelm ◽  
D. Colton Riley ◽  
Kevin W. Sexton ◽  
Alonda C. Pollins ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
High Resolution ◽  
Peripheral Nerve ◽  
Nerve Injury ◽  
Peripheral Nerve Injury ◽  
Diffusion Tensor ◽  
Ex Vivo ◽  
Nerve Fibers ◽  
Nerve Transection ◽  
Nerve Injuries

Diagnosis and management of peripheral nerve injury is complicated by the inability to assess microstructural features of injured nerve fibers via clinical examination and electrophysiology. Diffusion tensor imaging (DTI) has been shown to accurately detect nerve injury and regeneration in crush models of peripheral nerve injury, but no prior studies have been conducted on nerve transection, a surgical emergency that can lead to permanent weakness or paralysis. Acute sciatic nerve injuries were performed microsurgically to produce multiple grades of nerve transection in rats that were harvested 1 hour after surgery. High-resolution diffusion tensor images from ex vivo sciatic nerves were obtained using diffusion-weighted spin-echo acquisitions at 4.7 T. Fractional anisotropy was significantly reduced at the injury sites of transected rats compared with sham rats. Additionally, minor eigenvalues and radial diffusivity were profoundly elevated at all injury sites and were negatively correlated to the degree of injury. Diffusion tensor tractography showed discontinuities at all injury sites and significantly reduced continuous tract counts. These findings demonstrate that high-resolution DTI is a promising tool for acute diagnosis and grading of traumatic peripheral nerve injuries.

Assessment of Disease Activity in Takayasu Arteritis: Potential Role of Contrast-Enhanced Ultrasound

2019 ◽  
Vol 40 (05) ◽  
pp. 638-645 ◽  
Author(s):  
Christian Lottspeich ◽  
Claudia Dechant ◽  
Anton Köhler ◽  
Maximilian Tischler ◽  
Karla Maria Treitl ◽  
...  
Keyword(s):  
High Resolution ◽  
Disease Activity ◽  
Takayasu Arteritis ◽  
Clinical Symptoms ◽  
Inactive Disease ◽  
Contrast Enhanced Ultrasound ◽  
Acute Phase Reactants ◽  
Contrast Enhanced ◽  
Assessment Of Disease Activity ◽  
Active Disease

Abstract Purpose To assess the diagnostic value of intima media thickness measurements and contrast-enhanced ultrasound (CEUS) of the supraaortic arteries in the assessment of disease activity in Takayasu arteritis (TA). Materials and Methods Patients with TA and involvement of the carotid and/or subclavian/axillary arteries underwent CEUS imaging in addition to B-mode and color duplex ultrasound. The maximum IMT (mIMT) was measured and high-resolution CEUS of the most prominently thickened vessel segment was performed. Two blinded readers reviewed the CEUS movies, with semiquantitative assessment of microbubble enhancement of the arterial wall (grade 0: no or minimal; grade 1: moderate; grade 2: pronounced). Clinical symptoms, acute phase reactants, and established indices of clinical disease activity (NIH criteria, ITAS score) were recorded. Results 40 examinations in 17 patients were analyzed. According to clinical judgement, 27 and 13 cases were classified as clinically inactive and active, respectively. An mIMT-cutoff of > 2.7 mm identified active disease with a sensitivity and specificity of 69.2 % and 88.9 %, respectively (area under the curve 0.83). The interobserver agreement of CEUS analysis was substantial (Cohen’s kappa 0.76). By consensus reading, 17, 15, and 8 cases were classified as uptake grade 0, grade 1 and grade 2, respectively. Grade 0 uptake was exclusively present in 17 clinically inactive patients. Grade 1 uptake was seen in 10 patients with clinically inactive disease and 5 patients with clinically active disease. Grade 2 uptake was exclusively present in 8 patients with active disease. Conclusion Both sonographic IMT measurements and high-resolution CEUS are promising in the ad-hoc assessment of disease activity in patients with TA.

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