Abstract
Quality guidance from some expert clinicians gives essential advice on what to do with all those small incidentals found increasingly commonly on testicular ultrasound. This is a must-read for anyone performing scrotal ultrasound.
Researchers investigated indications for 903 fetal post-mortems. Five reasons were identified: malformations, intrauterine death, cystic hygroma/hydrops, isolated amniotic fluid abnormalities and IUGR. The highest diagnostic yield was in those with amniotic fluid abnormalities and IUGR, and lowest in fetuses with malformations. This information may be helpful when counselling parents and may aid their decision making in whether to give consent for the procedure.
This study complements the one by Puri et al. by demonstrating the accuracy of ultrasound. There was 97.9% agreement between prenatal ultrasound and post-mortem findings in 1029 terminations performed for fetal abnormality. There were no false-positives leading to termination. However, the researchers state that post-mortem examination remains an important part of the investigation process, especially in view of the trend for earlier termination.
Preliminary results from a small study of six able-bodied volunteers show promise when it comes to using ultrasound to map muscle deformation on contraction. Future clinical applications may include stroke rehabilitation and control of prosthetic hands.
This study aimed to differentiate between endometriomas and hemorrhagic cysts by using shear wave elastography. The researchers evaluated 78 ovarian cysts in 70 women and achieved a sensitivity and specificity of 82.1% and 79.2%, respectively. Endometriomas are much stiffer than hemorrhagic cysts. The clinical value is that unnecessary surgery may be avoided.
These researchers randomised 62 medical students on an emergency ultrasound course into two groups. One group had pre-course exposure to clinical cases delivered via e-learning. The other group did not. Those who had e-learning did much better when it came to the practical hands-on aspects of the course. However, scores from two further tests (OSCEs and multiple choice questions) showed no difference between the groups.
This extensive review concludes that MRI and ultrasound demonstrate prenatal brain abnormalities and delay in head growth in some subgroups of congenital heart defects. However, it also says that there are not enough long-term post-natal follow-up studies to inform counselling regarding prognosis and likely neurodevelopmental delay in these children.
Cutting edge stuff of which I have only a slender grasp. However, it’s exciting to learn that the effect of a new anti-cancer drug, OXi6197, may be measured using imaging techniques including colour Doppler and MRI. OXi6197 is an example of a vascular disrupting agent that works by damaging endothelial cells in tumour vessels. Here, it was tested on human lung cancer cells grown in rats. Results showed a significant reduction in tumour blood flow after administration.
An interesting study investigating 152 individuals at high risk for developing pancreatic cancer who underwent annual surveillance using MRI and endoscopic ultrasound. The researchers found that participants’ fears of developing pancreatic cancer reduced significantly over time as did the fear of undergoing repeated endoscopic ultrasound.
Non-surgical facelifts are increasingly popular and in this study two HIFU devices were tested on 20 Korean participants’ faces, one device applied to each side of the face. Blinded clinicians assessed pre- and post-treatment photographs along with further qualitative and quantitative tests. Mild to moderate improvement in skin tightening was seen, and the devices appear to be safe. Win win.
In the absence of national agreement on the optimum threshold value for endometrial thickness in symptomatic postmenopausal women, this study of over 1000 women suggests a thickness of 4 mm or above on transvaginal ultrasound will detect the majority of cancers with minimal unnecessary invasive investigations.
Continuing on the same theme as the last study, this investigation concurs with current opinion in the UK that endometrial thickness alone in asymptomatic postmenopausal women is an unreliable indicator for endometrial cancer.