Medical ultrasonography
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Medical ultrasonography · Sep 2016
ReviewValue of ultrasound elastography in the diagnosis of native kidney fibrosis.
In the last decade, ultrasound elastography, an already widely used technique in the diagnosis of hepatic fibrosis, has raised the attention of nephrologists as a potential valuable noninvasive tool for the diagnosis of renal fibrosis. Due to renal deep location and anatomic complexity, the shear wave techniques are the most appropriate elastography methods for exploring native kidneys. Recent research offers promising results, but further larger studies are required for a better standardization of this method and also for establishing reference values of normal kidney elasticity. This article reviews the studies conducted for exploring the native kidney, highlighting the advantages and limitations of ultrasound elastography for assessing fibrosis development in chronic kidney diseases.
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Medical ultrasonography · Jun 2016
Assessment of the arterial stiffness in patients with acute ischemic stroke using longitudinal elasticity modulus measurements obtained with Shear Wave Elastography.
Arterial wall elasticity including the circumferential and longitudinal modulus is a measure of sub-clinical cardiovascular disease; the circumferential modulus is increased in acute ischemic stroke (AIS). There are still no reports of non-invasive measurement of longitudinal elastic modulus of arterial wall and its prospect of clinical application. In this study, the longitudinal elastic modulus of the arterial wall was assessed using real-time shear wave elastography in patients with AIS. The technique's feasibility and its related factors were studied initially. ⋯ SWE could measure non-invasively the longitudinal elastic modulus of the arterial wall and evaluate the arterial stiffness. It was equivalent to the PWV which showed circular elastic modulus of arterial wall on evaluating AIS. Age, systolic blood pressure, pulse wave velocity, and low-density lipoprotein were independent risk factors for longitudinal elastic modulus. SWE may be effective in the assessment of arterial stiffness and offer a potential clinical benefit.
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Neuraxial blockade is still largely performed as a blind procedure. Despite of developments in the type of needles used and drugs administered, the process of locating the epidural or intra-thecal space is still limited to identification of landmarks by palpation and reliance on tactile feedback of the operator. Ultrasound has provided the long needed "eye" to the procedure and has already shown promise of improving the safety and efficacy or neuraxial blocks. This review focuses on understanding the sonoanatomy of the neuraxial space, performing a systematic pre-procedural ultrasound scan, and reviewing the available evidence.
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Pleural ultrasonography (US) represents nowadays a useful diagnostic tool in the management of pleural diseases. Detection and evaluation of pleural effusions, pneumothorax and pleural-based lesions can be performed with US, which has the advantages of wide availability, low cost, absence of radiation exposure, and portability. ⋯ US of the thorax is an operator dependent technique demanding an experienced operator in order to obtain reliable results. This pictorial essay presents various ultrasound findings of the diseases which concern the pleura.