Purpose:We retrospectively investigated cases with intussusception for determining new ultrasonographic findings that can predict failure of enema reduction in pediatric idiopathic intussusception.
Subjects and Methods:We retrospectively reviewed 51 consecutive patients with intussusception who underwent ultrasonography examinations before enema reduction at our institution between February 2003 and April 2018. We investigated several findings related to the size of the intussusceptum and compared these between the group with reduction success and the group with reduction failure to determine whether the findings could be significant predictors for the failure of nonoperative reduction.
Results and Discussion:All novel findings were not significant, but the previously reported finding of “trapped fluid” was significantly different between the groups. The severity of poor blood perfusion in the intussusceptum may be related to nonoperative reduction failure, and the finding of trapped fluid is associated with more severe perfusion failure than other factors. Our findings also indicated that larger mesenchymal tissue in the intussusceptum tended to be associated with reduction failure, although this was not significant.
Conclusion:Ultrasonographic findings related to the size of the intussusceptum were not significantly predictive for failure of intussusception reduction. However, the trapped fluid sign may be more indicative of poor perfusion in the intussusceptum than other findings.
Purpose: To investigate ultrasonographic findings of mammary fibromatosis.
Subjects and Methods: Seventeen lesions (eight patients) histopathologically diagnosed with mammary fibromatosis between January 2000 and December 2018 were examined. For mass lesions, the ultrasonographic findings that were determined are as follows: shape, margin, echogenic halo, internal echo, posterior acoustic features, architectural distortion, echogenic foci, and vascularity. For non-mass abnormalities, the findings that were evaluated are as follows: duct abnormalities, hypoechoic areas in the mammary gland, architectural distortion, multiple small cysts, echogenic foci without a hypoechoic area, posterior acoustic features, and vascularity.
Results and Discussion: Of the 17 lesions, 9 were mass lesions, whereas the other 8 were non-mass lesions. All nine mass lesions had an irregularly shaped and ill-defined hypoechoic mass with posterior acoustic shadowing and whirling architectural distortion. An echogenic halo was detected in only one lesion. All eight non-mass lesions showed an ill-defined hypoechoic area with posterior acoustic shadowing and architectural distortion. Of the 17 architectural distortions, 15 demonstrated twisted and swirling architectural distortion, reflecting the histopathological findings of collagenous fibrous tissues that were thrust into the surrounding breast tissue rather than retracted. Although vascularity was identified in 13 of the 16 lesions in which Doppler sonography was performed, blood flow was not abundant in most cases but rather only partial. These findings were similar to those of scirrhous carcinoma or invasive lobular carcinoma; however, the characteristic ultrasonographic findings of mammary fibromatosis were the absence of an echogenic halo; inclusion of a hyperechoic area that continued into the surrounding breast tissue, reflecting the involved breast tissue; and the accompaniment of a twisted and swirling architectural distortion. Younger age was also helpful for the diagnosis. Because metachronous and synchronous bilateral occurrences were observed in four and two patients, respectively, the contralateral breast should also be examined.
Conclusion: Characteristic ultrasonographic findings of mammary fibromatosis include an ill-defined hypoechoic mass or hypoechoic area with posterior acoustic shadowing, hyperechoic area connected to the surrounding breast tissue, and whirling architectural distortion, without an echogenic halo.
Purpose: Global longitudinal strain (GLS) assessed using the two-dimensional (2D) speckle tracking method is considered to be an accurate and reproducible measurement method for assessing the LV contractility. However, the measurement variability across different ultrasonography machines has been discussed. This study aimed to determine whether the measurement variability among newer echocardiographic machines is lower than that reported in previous studies.
Subjects and Methods: We enrolled 34 healthy volunteers. Apical images were acquired using three types of latest ultrasonography machines at the Tokushima University Hospital. The GLS values were assessed and compared using the latest version of the vendor-specific software and one vendor-independent software packages (EchoInsight ver. 18.104.22.1680, Epsilon).
Results and Discussion: The upgraded vendor-specific software showed good correlation in GLS [GE vs. Philips (r＝0.678, p＜0.001, Bias 1.1%, 2SD ±2.9%), GE vs. Canon (r＝0.690, p＜0.001, Bias 0.4%, 2SD ±2.5%), Philips vs. Canon (r＝0.551, p＜0.001, Bias 1.5%, 2SD ±3.2%)]. The GLS measured using vendor-independent software provided greater degree of correlation than that with each software alone.
Conclusion: The measurement variability of GLS between devices was superior than that reported previously. Moreover, the GLS measured using the images acquired using each device with EchoInsight showed good inter-device correlation.