Wyniki wyszukiwania - Biblioteka Nauki

1

The Use of Ultrasonography in the Diagnosis of Ambiguous Cases of Appendicitis in Adults

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Bielaczyc G. , Krasowski G. , Sokołowski D. , Tukiendorf A.

Polish Journal of Surgery

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2007

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tom 79

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nr 10

629-634

EN

Appendicitis inflicts diagnostic difficulties, particularly in ambiguous morbid symptoms defined in the scale ALVARDO in the section 4-6 pt.The aim of the study was the comparison of the diagnostic values of the classic method of recognizing appendicitis and those improved by ultrasonographic examination.Material and methods. Patients were classified in this investigation according to symptoms from the section compartment 4-6 pt of the ALVARADO scale. Qualification for the treatment was determined according to the medical investigation and laboratory examinations. Ultrasonography (US) was executed in all patients with the aim of the evaluation of the appendix. The percentage of correct recognitions by means of the classic diagnostics was compared to the percentage determined with the aid of US.Results. It was affirmed that in ambiguous clinical cases of appendicitis, the addition of US to the traditional investigational diagnostics improoves the percentage of correct recognitions of appendicitis from 62.8% to 86.2% (p<0.01).Conclusion. With the US supplementing the classic diagnostics, the percentage of correct recognitions of appendicitis enlarges in adult patients with the suspicion of appendicitis with so-called "grey zone" symptoms comprised in the scoring 4-6 pt of the ALVARADO scale.

2

Techniki obrazowania medycznego na przykładzie USG

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Długosz M. , Długosz T. , Dudziński K.

Przegląd Telekomunikacyjny + Wiadomości Telekomunikacyjne

|

2010

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tom nr 7

740-743

PL

Przedstawiono krótką charakterystykę ultrasonografii. Omówiono zasadę działania ultrasonografu, budowę oraz typy najpopularniejszych prezentacji.

EN

This paper presents short description of ultrasonography. Principle of operation of ultrasound scanner, it's construction and the most popular types of presentations were discussed.

3

Current standards in abdominal cavity ultrasound examination in children

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Brzewski M.

Journal of Ultrasonography

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2017

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tom 17

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nr 68

41-42

EN

Technological progress forces us to present after several years the updated standards in ultrasound examination of newborns, infants and older children. It should be emphasized that the examination of the youngest patients requires one to use high-class equipment. Lack of cooperation on the part of the child and imaging small structures constitute a huge challenge for the examiner. The work presents equipment requirements, the technology of examining the abdominal cavity in children and the manner of preparing the examination result. Moreover, modern expectations as regards ultrasound surgery equipment, where children are subject to examination have been presented. The minimum set of transducers the ultrasound apparatus should be equipped with has also been pointed out as well as the minimum requirements concerning image recording. Extending the scope of transducers over “minimum” significantly raises the imaging possibilities in pediatrics. Standard preparation of children for ultrasound has been discussed, taking into consideration the age of the patient and indications. It is essential to understand that it differs from standard preparation for examination in the case of adults. The technique of examining the abdominal cavity has been described, which enables the repeatability of examinations and ensuring making all the available structures visible. It proves imperative especially in the case of a large number of examinations. Attention should be paid particularly to the urinary system imaging – owing to the greatest incidence of congenital diseases in that system.

PL

Artykuł w wersji polskojęzycznej jest dostępny na stronie http://jultrason.pl/wydawnictwa/volume-17-no-68

4

Ultrasonic Synthetic Apertures: Review

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Nowicki A. , Gambin B.

Archives of Acoustics

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2014

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tom Vol. 39, No. 4

427--438

EN

In the paper the concept of synthetic aperture used for high resolution/high frame rate ultrasonic imaging is reviewed. The synthetic aperture technique allows building extended “virtual” apertures, synthesized from smaller real aperture resulting in improved lateral resolution along full penetration depth without sacrificing the frame rate. Especially, four methods, synthetic aperture focusing (SAF), multi-element synthetic aperture focusing (M-SAF), synthetic receive aperture (SRA) and synthetic transmit aperture (STA) are addressed. The effective aperture function, describing two-way, far field radiation is a useful tool in beam pattern analysis. Some basic notations, which are used to calculate the effective aperture are introduced in Appendix.

5

Nonlinearly coded signals for harmonic imaging

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Nowicki A. , Wójcik J. , Kujawska T.

Archives of Acoustics

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2009

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tom Vol. 34, No. 1

63-74

EN

In this paper a new method utilizing nonlinear properties of tissues to improve contrast-to-noise ratio is presented. In our novel method the focused circular transducer is excited with two-tone bursts (including the 2.2MHz fundamental and 4.4MHz second harmonic frequencies) with specially coded polarization of each tone. This new approach was named Multitone Nonlinear Coding (MNC) because the choice of both tones polarization and amplitude law, allowing optimization of the probe receiving properties, depends on nonlinear properties of tissue. The numerical simulations of nonlinear fields in water and in tissue-like medium with absorption coefficient of 7Np/(m MHz) are performed. The comparison between the proposed method and the Pulse Inverse (PI) method is presented. The concept of the virtual fields was introduced to explain properties of both the Pulse Inversion and MNC methods and to compare their abilities. It was shown that for the same on-source pressure an application of the MNC method allows to decrease the mechanical index about 40%, to improve lateral resolution from 10 to 30% and to gain the signal-to-noise ratio up to 8 times with respect to the PI method.

6

Mistakes in the ultrasound diagnostics of the abdominal cavity in pediatrics

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Brodzisz A.

Journal of Ultrasonography

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2017

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tom 17

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nr 68

66-72

EN

The diagnostics of the abdominal cavity in children, especially in the neonatal-infantile period, requires knowledge in the field of anatomical and physiopathological differences as well as clinical symptomatology and pathology at every stage of the child’s development. Errors and mistakes in ultrasound diagnostics of the abdominal cavity in children result from many factors, including lack of experience in examining children and the knowledge concerning most frequent ailments and pathologies as well as the incidence or no changes in the ultrasound image of the abdominal cavity organs. The assessment of the ultrasound image should be always based on clinical data of the patient, information on the past diseases, surgeries and the results of additional examinations and laboratory tests. Particular attention should be paid to the occurrence of congenital diseases and inflammations, which may have varied clinical manifestation – especially in the case of pediatric diagnostics. The variety and non-specific nature of clinical symptoms may also mask the developing neoplastic process. Mistakes in ultrasound diagnostics, especially among the youngest children, may also be caused by technical difficulties related to carrying out the examination. The above situation results from lack of cooperation with the child, who is uneasy, wailing, fails to perform orders, which may lead to overlooking the existing lesion or overinterpreting, e.g. a full stomach or residual stool in the intestines to be a pathology. It is also of high importance to have a good class of the ultrasound equipment and technical knowledge concerning its operation. When performing an ultrasound examination in children, it is necessary to apply a wide range of phased-array, convex and linear heads and appropriate applications, the so-called pediatric software (stomach, kidneys, true pelvis, organs at the surface).

PL

Błędy i pomyłki w diagnostyce ultrasonograficznej jamy brzusznej u dzieci wynikają z wielu czynników. Najpoważ- niejszym jest brak doświadczenia w badaniu dzieci i brak znajomości fizjologicznych procesów zachodzących w rozwijającym się organizmie, mających przełożenie na obraz ultrasonograficzny niektórych narządów. Różnorodność i niespecyficzność u dzieci objawów klinicznych, które mogą naśladować wady wrodzone, choroby zapalne, jak i maskować proces nowotworowy, stanowią kolejną przyczynę trudności w diagnostyce pediatrycznej. Bardzo ważna w procesie diagnostycznym jest korelacja obrazu ultrasonograficznego z danymi klinicznymi pacjenta, wynikami innych badań obrazowych oraz z zakresem wykonanego zabiegu operacyjnego(1). Artykuł w wersji polskojęzycznej jest dostępny na stronie http://jultrason.pl/wydawnictwa/volume-17-no-68

7

Sonographic assessment of the prevalence and evolution of fluid collections as a complication of kidney transplantation

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Kuczyńska M. , Piasek E. , Światłowski Ł. , Kuklik E. , Sobstyl J. , Drelich-Zbroja A. , Słomka T. , Pyra K. , Furmaga O. , Szczerbo-Trojanowska M.

Journal of Ultrasonography

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2018

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tom 18

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nr 73

126-132

EN

Aim of the study: The aim of this study is to assess the prevalence and evolution of perirenal fluid collections in a group of 488 patients who have undergone kidney transplantation. Material and methods: Sonographic documentation of 488 deceased-donor kidney recipients was evaluated for the prevalence of perirenal fluid collections and their evolution in time, depending on selected demographic features of the patients, time of detection, initial dimensions and precise position of the collection relative to the kidney and the location of the transplanted organ in the right or left iliac fossa. The collected data were used for statistical analysis to determine the strength of the potential relationships. Results: In 146 out of 488 subjects perirenal fluid collections were found. In 1/3 of the patients more than one fluid collection was diagnosed. Over 40% of fluid collections were detected within 10 days from the date of the first scan and 24.11% were detected within 10–20 days from the date of the first scan. The majority of fluid collections were located near the lower pole of the kidney. Perihilar collections were the least common. Collections encapsulating the kidney and subcutaneous collections were the largest in size on average. A statistically significant difference between the size of collections located on the surface and the size of those located near the upper pole of the transplanted kidney was demonstrated. However, no correlation was proven to exist between the persistence of the fluid collection and its position relative to the transplanted kidney and its initial size. Conclusions: The correct evaluation of a fluid collection’s dynamics of development and nature requires periodic follow-up of the recipient, preferably in a single clinical center. Ultrasonography is an inexpensive, non-invasive and repeatable method for the determination of the presence of fluid collections. However, the decision whether treatment is necessary requires the sonographic image to be compared with the laboratory signs of inflammation and biochemical analysis of the contents of fluid collections.

PL

Cel pracy: Celem niniejszego opracowania jest ocena występowania i ewolucji okołonerkowych zbiorników płynowych w grupie 488 pacjentów poddanych operacji transplantacji nerki. Materiał i metody: Dokumentacja ultrasonograficzna 488 biorców nerek od dawców zmarłych została poddana ocenie pod kątem częstości występowania okołonerkowych zbiorników płynowych i ich ewolucji w czasie, w zależności od wybranych cech demograficznych pacjenta, czasu wykrycia, początkowych rozmiarów i dokładnej lokalizacji zbiornika względem nerki oraz umiejscowienia przeszczepionego narządu – w prawym lub lewym dole biodrowym. Zgromadzone dane wykorzystano do analizy statystycznej w celu określenia siły ewentualnych zależności. Wyniki: U 146 na 488 badanych stwierdzono obecność okołonerkowych zbiorników płynowych, przy czym u niemal 1/3 pacjentów zdiagnozowano więcej niż jeden zbiornik. Przeszło 40% zbiorników wykryto przed upływem 10 dni od daty pierwszego badania,a 24,11% –w okresie 10–20 dni od daty pierwszego badania. Najwięcej kolekcji płynowych było zlokalizowanychw okolicy bieguna dolnego nerki. Najrzadziej występowały zbiorniki okołownękowe. Największy średni rozmiar osiągały zbiorniki opłaszczające nerkęi leżące podskórnie. Wykazano istotną statystycznie różnicę pomiędzy wymiarami zbiorników zlokalizowanych powierzchniowo orazw okolicy bieguna górnego przeszczepionej nerki. Nie dowiedziono jednak istnienia korelacji pomiędzy trwałością zbiornikaa jego lokalizacją względem przeszczepionej nerki lub początkowym wymiarem. Wnioski: Prawidłowa ocena dynamiki rozwojui charakteru zbiornika płynowego wymaga okresowej kontroli biorcy,najlepiejw jednym ośrodku klinicznym. Ultrasonografia jest tanią, nieinwazyjnąi powtarzalną metodą oceny występowania kolekcji płynowych. Decyzjao potrzebie leczenia wymaga jednak odniesienia obrazu sonograficznego do parametrów zapalnych oraz wyników analiz biochemicznych zawartości zbiorników.

8

Kontrola jakości w ultrasonografii

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Szewczyk M. , Weżgowiec M. , Pater E. , Banaszak A.

Inżynier i Fizyk Medyczny

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2012

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tom Vol. 1, nr 1

29--32

9

Safety evaluation of percutaneous ultrasound-guided thrombin injection into pseudoaneurysms

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Pająk M. , Hasiura R. , Stępień T.

Polish Journal of Surgery

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2019

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tom 91(2)

20-24

EN

Introduction: common application of endovascular procedures is frequently connected with increased risk of pseudoaneurysm at the site of the artery puncture. The most frequent method of treatment of aneurysms is percutaneous ultrasound-guided thrombin injection. The aim: The aim of this research was the safety evaluation of treatment of pseudoaneurysm by thrombin injection based on own experience. Methods and materials: 70 people (57% women, 43% men, average age 67,9 ± 10,5) with pseudoaneurysm and under ultrasound-guided thrombin injection treatment carried out between 2007 and 2018 in the Department of General and Vascular Surgery of Pirogow Hospital in Lodz were analyzed. Patients were qualified to treatment based on the aneurysm and channel morphology in ultrasound examination. Before application of medicine blood supply to the limb was clinically assessed and examined using sonography. The tip of the needle was imaged into the lumen of the aneurysm. Results: In the research group, the average aneurysm diameter was 29,9 mm (± 17,2 mm) within a range from 10 mm to 96 mm. The multi-chamber aneurysm was detected in 21% of patients. Mean channel length was 12 mm (±7,7 mm), mean width 3,5 mm (±1,4 mm), mean thrombin injected 1,7 ml (±0,7 mm) within the range from 0,5 ml to 4 ml. The treatment was successful in 94% of cases. Complications after thrombin injection occurred in 7% of cases (1 patient suffered from shock, 1 from thrombus in the saphenous vein, 3 from thrombus moving from aneurysm neck to femoral artery). No deterioration of blood supply in a limb was detected after the obliteration of the aneurysm. No relevant differences in aneurysm and channel dimensions were detected between groups with and without complications (p >0,05). Conclusions: Obliteration of the pseudoaneurysm by percutaneous ultrasound-guided thrombin injection is a highly effective method. This method is considered safe, however, it requires experience. Its application may cause complications of which some are clinically significant and may lead to health and life-threatening situations. In some specific cases, surgical treatment of choice should be considered.

10

Does abdominal ultrasound is a useful tool in appendicitis diagnosis?

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Kamiński M.

Polish Journal of Surgery

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2018

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tom 90(3)

13-18

EN

Introduction: Acute appendicitis is the most common acute abdominal illness. Despite progress in diagnosis, there is still a 20% negative appendectomy rate. The aim of the study was to determine the usefulness of abdominal sonography in the diagnosis of acute appendicitis. Materials and methods: Data were collected retrospectively from 326 patients operated with suspected appendicitis, who had undergone abdominal ultrasound prior to surgery. Appendicitis was confirmed by pathology reports. There were two variants of positive abdominal sonography. In the first, positive ultrasound was visualized inflamed appendix. In the second variant, the sonographic diagnosis of appendicitis was based on a visualized inflamed appendix or one of indirect signs of appendicitis – localized periappendiceal fluid collection, enlarged lymph nodes, thickening of the intestinal wall in the right iliac fossa. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were defined and compared. Results: 83.74% patients have appendicitis in their pathologic report. In 39.53% cases, the appendix was visualized via abdominal ultrasound. In 65.95% cases of sonography, there occurred indirect signs. In the first variant, sensitivity, specificity, PPV and NPV amounted to 47.99%, 79.25%, 92.25% and 22.83%, respectively. In the second variant, they amounted to 67.77%, 43.40%, 86.05% and 20.72%, respectively. In the second variant, sensitivity was significantly higher (p<0.001), however specificity was significantly lower (p<0.001). Conclusion: Limited sensitivity and specificity cannot be a confirmation of appendicitis. The typical clinical course with a negative ultrasound should not delay correct diagnosis and early surgical treatment.

11

The role of ultrasonography in methotrexate therapy for ectopic pregnancy

80%

Czuczwar P.

Journal of Ultrasonography

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2018

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tom 18

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nr 73

158-161

EN

Medical management of ectopic pregnancy with methotrexate, an antimetabolite of folic acid, is an important alternative to surgical treatment, as it ensures a similar outcome whilst being far less invasive. Ultrasound evaluation does not only facilitate an accurate diagnosis, but also helps to select patients most likely to benefit from methotrexate treatment, as opposed to those with a high likelihood of failure of medical management, who are thus eligible for primary surgical treatment. Ultrasound also allows to monitor the outcome of methotrexate therapy. This study is a review of literature regarding the management of ectopic pregnancy with methotrexate. Such ultrasound findings as the size of the ectopic mass, presence of fetal heart rate and free fluid have been confirmed as effective eligibility criteria for therapy with methotrexate. In the future, possibly also endometrial stripe thickness and the vascularity of the ectopic mass may be considered predictive of successful methotrexate therapy. The initial increase in size of the ectopic mass following methotrexate therapy confirms its effectiveness, and should not prompt concern.

PL

Leczenie ciąży pozamacicznej metotreksatem, antymetabolitem kwasu foliowego, stanowi istotną alternatywę dla postępowania chirurgicznego. Daje ono podobne efekty końcowe jak leczenie chirurgiczne, cechując się równocześnie znacznie mniejszym stopniem inwazyjności. Ultrasonografia pozwala nie tylko na potwierdzenie rozpoznania, lecz także na selekcję pacjentek, które mają największą szansę odnieść korzyść z leczenia metotreksatem, jak również tych, u których leczenie to ma niewielkie szanse powodzenia i które korzystniej jest pierwotnie kwalifikować do leczenia chirurgicznego. Ponadto ultrasonografia umożliwia monitorowanie efektu leczenia metotreksatem. W pracy dokonano przeglądu piśmiennictwa dotyczącego znaczenia ultrasonografii w leczeniu ciąży pozamacicznej metotreksatem. Takie ultrasonograficzne markery jak wielkość ciąży pozamacicznej, czynność serca płodu i obecność płynu w jamie brzusznej mają udowodnione znaczenie w kwalifikacji do leczenia metotreksatem. W przyszłości być może zostaną uwzględnione również grubość endometrium oraz unaczynienie ciąży pozamacicznej. Obserwowane w trakcie leczenia metotreksatem powiększenie ciąży pozamacicznej świadczy o skuteczności postępowania i nie powinno stanowić powodu do niepokoju.

12

Imaging of juvenile spondyloarthritis. Part II: Ultrasonography and magnetic resonance imaging

80%

Sudoł-Szopińska I. , Znajdek M. , Gietka P. , Vasilevska-Nikodinovska V. , Patrovic L. , Salapura V.

Journal of Ultrasonography

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2017

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tom 17

|

nr 70

176-181

EN

Juvenile spondyloarthropathies are mainly manifested by symptoms of peripheral arthritis and enthesitis. Early involvement of sacroiliac joints and spine is exceptionally rare in children; this usually happens in adulthood. Conventional radiographs visualize late inflammatory lesions. Early diagnosis is possible with the use of ultrasonography and magnetic resonance imaging. The first part of the article presented classifications and radiographic presentation of juvenile spondyloarthropathies. This part discusses changes seen on ultrasonography and magnetic resonance imaging. In patients with juvenile spondyloarthropathies, these examinations are conducted to diagnose inflammatory lesions in peripheral joints, tendon sheaths, tendons and bursae. Moreover, magnetic resonance also shows subchondral bone marrow edema, which is considered an early sign of inflammation. Ultrasonography and magnetic resonance imaging do not show specific lesions for any rheumatic disease. Nevertheless, they are conducted for early diagnosis, treatment monitoring and identifying complications. This article presents a spectrum of inflammatory changes and discusses the diagnostic value of ultrasonography and magnetic resonance imaging.

PL

Młodzieńcze spondyloartropatie manifestują się głównie objawami zapalenia stawów obwodowych i entez. Wyjątkowo rzadko u dzieci dochodzi do wczesnego zajęcia stawów krzyżowo-biodrowych i kręgosłupa; z reguły następuje to po osiągnięciu wieku dorosłego. Tradycyjne radiogramy obrazują późne zmiany zapalne. Wczesne rozpoznanie jest możliwe w badaniu ultrasonograficznym i rezonansem magnetycznym. W pierwszej części artykułu przedstawiono klasyfikacje oraz obraz radiograficzny młodzieńczych spondyloartropatii. W tej części omawiamy zmiany w badaniu ultrasonograficznym i rezonansie magnetycznym. U pacjentów z młodzieńczymi spondyloartropatiami badania te są wykonywane w diagnostyce zmian zapalnych stawów obwodowych, pochewek ścięgnistych i ścięgien oraz kaletek. W rezonansie widoczny jest ponadto obrzęk szpiku w warstwie podchrzęstnej, uznawany za wczesny objaw zapalenia. Zmiany widoczne w ultrasonografii i rezonansie nie są specyficzne dla konkretnych chorób reumatycznych. Badanie te są wykonywane na etapie wczesnej diagnostyki, monitorowania leczenia oraz rozpoznawania powikłań. W artykule przedstawiamy spektrum zmian zapalnych oraz dyskusje na temat wartości diagnostycznej ultrasonografii i rezonansu magnetycznego. Artykuł w wersji polskojęzycznej jest dostępny na stronie http://jultrason.pl/index.php/wydawnictwa/volume-17-no-70

13

Laparoscopic partial cystectomy for bladder endometriosis – case report

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Dominik Godlewski D. , Patryk Pszczółkowski P. , Tomasz Góra T. , Łukasz Futyma Ł. , Tadeusz Fedus T. , David Aebisher D.

European Journal of Clinical and Experimental Medicine

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2019

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nr 4

364-367

EN

Introduction. Endometriosis is defined as a presence of endometrial glands and stroma outside the uterus. Urinary track endometriosis is a rare occurrence (1-2%) usually associated with bladder involvement (85%). Aim. The diagnostic evaluation is not complicated but can be delay because of the lack of specific symptoms. Description of the case. We present a case of 20-years old female with bladder endometriosis localized on the posterior wall. The patient was effective treated with laparoscopic partial cystectomy Conclusion. The patient was effective treated with laparoscopic partial cystectomy

14

Extending penetration depth using coded ultrasonography

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Nowicki A. , Secomski W. , Trots I. , Litniewski J.

Bulletin of the Polish Academy of Sciences. Technical Sciences

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2004

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tom Vol. 52, nr 3

215-220

EN

The issue of maximizng penetration depth with concurrent retaining or enhancement of image resolution constitutes one of the time in variant challenges in ultrasound imaging. Concerns about potential and undesirable side effects set limits on the possibility of overcoming the frequency depended attuenuation effects by increasing peak acoustic amplitudes of the waves probing the tissue. To overcome this limitation a pulse compression technique employing 16 bits Complementary Golay Sequences (CGS) Code was implemented at 4 MHz. In comparison with other, erlier proposed excitation schemes, such as chirp, pseudo-random chirp and Barker codes, the CGS allowed virtually side lobe free operation. Experimental data indicate that the quality - resolution, signal penetration and contrast dynamics - of CGS images is better then the one obtain standard ultrasonography using short burst excitation.

15

High resolution ultrasonography of the tibial nerve in diabetic peripheral neuropathy

80%

Singh K. , Gupta K. , Kaur S.

Journal of Ultrasonography

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2017

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tom 17

|

nr 71

246-252

EN

Aim of the study: High-resolution ultrasonography of the tibial nerve is a fast and non invasive tool for diagnosis of diabetic peripheral neuropathy. Our study was aimed at finding out the correlation of the cross sectional area and maximum thickness of nerve fascicles of the tibial nerve with the presence and severity of diabetic peripheral neuropathy. Material and methods: 75 patients with type 2 diabetes mellitus clinically diagnosed with diabetic peripheral neuropathy were analysed, and the severity of neuropathy was determined using the Toronto Clinical Neuropathy Score. 58 diabetic patients with no clinical suspicion of diabetic peripheral neuropathy and 75 healthy non-diabetic subjects were taken as controls. The cross sectional area and maximum thickness of nerve fascicles of the tibial nerves were calculated 3 cm cranial to the medial malleolus in both lower limbs. Results: The mean cross sectional area (22.63 +/– 2.66 mm2 ) and maximum thickness of nerve fascicles (0.70 mm) of the tibial nerves in patients with diabetic peripheral neuropathy compared with both control groups was significantly larger, and statistically significant correlation was found with the Toronto Clinical Neuropathy Score (p < 0.001). The diabetic patients with no signs of peripheral neuropathy had a larger mean cross sectional area (14.40 +/– 1.72 mm2 ) and maximum thickness of nerve fascicles of the tibial nerve (0.40 mm) than healthy non-diabetic subjects (12.42 +/– 1.01 mm2 and 0.30 mm respectively). Conclusion: The cross sectional area and maximum thickness of nerve fascicles of the tibial nerve is larger in diabetic patients with or without peripheral neuropathy than in healthy control subjects, and ultrasonography can be used as a good screening tool in these patients.

PL

Cel pracy: Ultrasonografia wysokiej rozdzielczości nerwu piszczelowego jest szybką i nieinwazyjną metodą możliwą do wykorzystania w rozpoznaniu cukrzycowej neuropatii obwodowej. Celem naszej pracy było ustalenie, czy istnieje zależność pomiędzy polem przekroju poprzecznego oraz maksymalną grubością pęczków nerwu piszczelowego a występowaniem i zaawansowaniem cukrzycowej neuropatii obwodowej. Materiał i metoda: Badaniu poddano 75 pacjentów cierpiących na cukrzycę typu 2 z klinicznym rozpoznaniem cukrzycowej neuropatii obwodowej. Stopień zaawansowania neuropatii oceniany był za pomocą Klinicznej skali neuropatii Toronto (Toronto Clinical Neuropathy Score). Grupę kontrolną w badaniu stanowiło 58 pacjentów z cukrzycą bez objawów klinicznych cukrzycowej neuropatii obwodowej oraz 75 zdrowych osób. Pole przekroju poprzecznego oraz maksymalna grubość pęczków nerwu piszczelowego wyliczane były na wysokości 3 cm powyżej kostki przyśrodkowej w obu kończynach dolnych. Wyniki: Średnie pole przekroju poprzecznego (2,63 +/− 2,66 mm2) oraz maksymalna grubość pęczków nerwu piszczelowego (0,70 mm) u pacjentów z cukrzycową neuropatią obwodową były istotnie statystycznie większe niż u osób z obu grup kontrolnych. Stwierdzono także występowanie istotnej statystycznie zależności pomiędzy wielkością tych parametrów a stopniem zaawansowania cukrzycowej neuropatii obwodowej według Klinicznej skali neuropatii Toronto (p < 0,001). U pacjentów chorujących na cukrzycę bez występowania objawów klinicznych cukrzycowej neuropatii obwodowej pole przekroju poprzecznego (14,40 +/− 1,72 mm2) oraz maksymalna grubość pęczków nerwu piszczelowego (0,40 mm) były większe niż u zdrowych uczestników badania (odpowiednio 12,42 +/− 1,01 mm2 i 0,30 mm). Wnioski: Przekrój oraz maksymalna grubość pęczków nerwu piszczelowego są większe niż u osób zdrowych zarówno u pacjentów z cukrzycą cierpiących na cukrzycową neuropatię obwodową, jak i bez klinicznych objawów neuropatii. Ultrasonografia może być z powodzeniem wykorzystywana u chorych z cukrzycą jako badanie przesiewowe pod kątem występowania cukrzycowej neuropatii obwodowej. Artykuł w wersji polskojęzycznej jest dostępny na stronie http://jultrason.pl/index.php/wydawnictwa/volume-17-no-71

16

Asymptomatic hepatic echinococcosis. A case report

80%

Gościk E. , Kułak P. , Okurowska-Zawada B.

Progress in Health Sciences

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2013

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tom 3

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nr 2

183-186

EN

Echinococcosis, is a parasitic disease of tapeworms in the genus Echinococcus. We report an unusual case of a 17-year-old girl with asymptomatic hepatic echinococcosis. The patient was admitted to the hospital after a car accident to perform routine radiological exams. Abdominal ultrasonography revealed a cystic mass of size 65 × 52 mm in the right lobe of liver. Computed tomography (CT) confirmed the cystic mass of size 67 mm x 59 mm x 56 mm in the right lobe of the liver. A routine brain CT was normal. Laboratory tests revealed a high count of eosinophil count (6.9%). Serological tests confirmed Echinococcus granulosus. The patient was transferred to the department of infectious diseases for further treatment.

17

Selecting patients for embolization of varicoceles based on ultrasonography

80%

Światłowski Ł. , Pyra K. , Kuczyńska M. , Kuklik E. , Sobstyl J. , Sojka M. , Drelich-Zbroja A. , Pech M. , Powerski M. , Jargiełło T.

Journal of Ultrasonography

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2018

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tom 18

|

nr 73

90-95

EN

Aim: The aim of the study was to assess patient selection for embolization of varicoceles based on ultrasonography. An additional objective of the work was to evaluate the results of endovascular treatment. Material and methods: From January 2015 till August 2017, 53 patients with varicoceles diagnosed in an ultrasound examination underwent endovascular treatment in the Department of Interventional Radiology and Neuroradiology in Lublin, Poland. Each ultrasound examination was performed using the Logiq 7 GE Medical System with a linear probe at 6–12 MHz using the B-mode and Doppler functions. The study was performed in both the supine and standing position of the patient. The morphological structures of the scrotum and the width of the pampiniform venous plexus were assessed. Based on clinical signs and symptoms as well as ultrasound findings, the patients were selected for endovascular treatment. This procedure involved the implantation of coils in the distal and proximal parts of the testicular vein and administration of a sclerosing agent between the coils. Results: Varicoceles were confirmed in all patients during a color Doppler scan. Diagnostic venography confirmed venous stasis or retrograde flow in the testicular vein and widened vessels of the pampiniform venous plexus over 2 mm in diameter in all patients undergoing endovascular treatment. The diagnostic efficacy of ultrasound was 100%. The technical success of the procedure was 89%. One patient had a recurrence of varicose veins (2.2%). There were no complications in any of the patients. Conclusions: Ultrasound is the preferred method in the diagnosis of varicoceles and selection for their treatment. Testicular vein embolization is a minimally invasive procedure characterized by high efficacy and safety.

PL

Cel: Celem pracy jest ocena ultrasonograficznej kwalifikacji do zabiegu embolizacji żylaków powrózka nasiennego, a także ocena wyników zabiegu wewnątrznaczyniowego.Materiał i metoda: W okresie od stycznia 2015 do sierpnia 2017 roku w Zakładzie Radiologii Zabiegowej i Neuroradiologii w Lublinie poddano leczeniu zabiegowemu 53 chorych, u których rozpoznano w badaniu ultrasonograficznym żylaki powrózka nasiennego. Każde badanie ultrasonograficzne wykonywano aparatem Logiq 7 GE Medical System przy użyciu sondy linearnej o częstotliwości 6–12 MHz z wykorzystaniem opcji B-mode oraz dopplerowskich. Badanie przeprowadzono zarówno w pozycji leżącej, jak i stojącej chorego. Oceniano morfologiczne struktury worka mosznowego i szerokość naczyń splotu wiciowatego. Na podstawie objawów klinicznych i wyniku badania ultrasonograficznego chorzy byli kwalifikowani do leczenia wewnątrznaczyniowego. Zabieg polegał na implantacji spiral w odcinku dystalnym i proksymalnym żyły jądrowej i podawaniu pomiędzy spirale substancji obliterującej naczynie.Wyniki: U wszystkich chorych w wykonanym badaniu ultrasonograficznym z opcją kolorowego dopplera potwierdzono występowanie żylaków powrózka nasiennego. U wszystkich chorych poddanych zabiegowi embolizacji podczas diagnostycznej flebografii potwierdzono występowanie zastoju żylnego lub refluksu wstecznego w żyle jądrowej oraz poszerzone naczynia żylne, powyżej 2 mm średnicy. Skuteczność rozpoznania żylaków powrózka nasiennego za pomocą badania ultrasonograficznego wyniosła 100%. Powodzenie techniczne procedury wyniosło 89%. U jednego chorego nastąpił nawrót żylaków (2,2%). U żadnego chorego nie wystąpiły jakiekolwiek powikłania. Wnioski: Badanie ultrasonograficzne jest metodą z wyboru w rozpoznawaniu żylaków powrózka nasiennego i kwalifikowaniu chorych do zabiegu. Embolizacja żyły jądrowej to zabieg charakteryzujący się wysoką skutecznością i bezpieczeństwem w leczeniu żylaków powrózka nasiennego.

18

Outcomes of Endoscopic Totally Extraperitoneal (TEP) repair of clinically occult inguinal hernia diagnosed with ultrasonography

80%

Kebabci E. , Ozturk S. , Unver M.

Polish Journal of Surgery

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2021

|

tom 93

|

nr 4

11-14

EN

Inguinal hernias generally present with groin lump and pain. Although inguinal hernias can be diagnosed clinically in most cases, patients without a groin lump pose a considerable diagnostic challenge. The first-line diagnostic imaging tool in these cases is ultrasound (US) and the recommended surgical procedure is laparoscopic-endoscopic repair. This retrospective study aims at evaluating postoperative results and complication rates of TEP technique in patients with occult contralateral hernias diagnosed with US in comparison to patients with clinically diagnosed hernias. A retrospective study was conducted to evaluate the outcomes of TEP procedure in patients with radiologically diagnosed occult contralateral hernias in comparison to patients with clinically diagnosed hernias. All hernias included in this study were repaired by TEP technique and secured with an extraperitoneal mesh. Demographic data, patient characteristics and perioperative information were obtained by reviewing medical records. A total number of 109 patients were enrolled in the study. The majority of patients were male and the mean age was 48.9 ± 14.6 years. In 56 cases, hernias were repaired unilaterally, while the remaining 53 were repaired bilaterally. Right-sided hernias were more common than left-sided hernias. The morbidity rate was 7.1% in unilateral repairs and 3.8% in bilateral repairs. The recurrence rate was 3.6% for unilateral repairs and 5.7% for bilateral repair. Some studies report that the incidence of clinical contralateral inguinal hernias identified after primary unilateral surgery is approximately 10%. If these contralateral hernias were diagnosed prior to the primary surgery, the risk of performing another operation could be avoided. Laparoscopic surgery enables bilateral hernia repair without any additional incisions, presenting similar morbidity rates when compared to unilateral repair. There was no significant difference between unilateral and bilateral TEP repair in terms of intraoperative and postoperative surgical complications. These results suggest that laparoscopic inguinal hernia repair is a safe and effective surgical technique for both unilateral and bilateral procedures. In order to prevent second operation, all patients with suspected inguinal hernia should undergo an US examination before surgery.

19

The role of endoscopic ultrasound in diagnosing pancreatic neuroendocrine tumours

80%

Dyrla P. , Chmielewska M. , Mazur M. , Witek P.

OncoReview

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2018

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tom 8

|

nr 1

19-23

EN

Pancreatic tumour imaging poses one of the greatest challenges in gastroenteropancreatic tumour diagnostics. Though much less common than adenocarcinomas, tumours deriving from pancreatic islets are the second most common group of pancreatic tumours. The manifestations and growth rate of neuroendocrine tumours (NETs) differ from adenocarcinomas; thus, these tumour types require different diagnostic and therapeutic approaches. With its high sensitivity and specificity, endoscopic ultrasound (EUS) seems to be indispensable in pancreatic NET diagnostics. A negative EUS practically excludes the presence of a pancreatic tumour, while in definitive tumour cases, EUS is helpful in tumour staging, and in determining its precise anatomical location. One especially important benefit of EUS is the option of performing a biopsy for subsequent cytological and histopathological examinations. The use of contrast and additional computerized image analysis increases the diagnostic accuracy of EUS. This article presents current views on the use of EUS in pancreatic tumour diagnostics, with a particular emphasis on diagnosing NETs.

20

Endoscopic-Ultrasound Guided Drainage of the Pancreatic Pseudocyst

80%

Rembiasz K. , Bednarek M. , Budzyński P. , Poźniczek M. , Budzyński A.

Polish Journal of Surgery

|

2009

|

tom 81

|

nr 12

641-647

EN

The aim the study was the evaluation of the treatment results of the internal ultrasound and gastroscopy-guided pancreatic pseudocysts.Material and methods. From 1994-2008 at the 2nd Department of General Surgery UJ CM there were 126 patients (incl. 45 female and 81 male) treated for pancreatic pseudocyst. Mean age of the women was 41.05 years (25-81) while men 48 years (19-79). Ultrasound and gastroscopy-guided drainage by the means of insertion of double pig tail drain was attempted in 46 patients (17 female and 29 male). Mean diameter of the cyst was 11.02 cm (from 2.5-20 cm).Results. Out of 46 patients assigned to the internal ultrasound, gastroscopy guided drainage, the procedure was technically feasible in 39. Internal marsupialization was successful in 24 patients (52.17%). We did not observe serious complications mentioned in the literature incl. iatrogenic injuries of the intraabdominal organs or fistulas. Drain was removed after 5 month (1-9 month).Conclusions. Endoscopic drainage consists an interesting minimally invasive approach in the management of pancreatic pseudocyst. More precise inclusion criteria could increase its efficacy.