Ultrasound

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The Children’s Health and Medicare Protection Act of 2007 may look like straightforward legislation to reauthorize a popular healthcare insurance program for poor children, but major reforms directed at medical imaging and the healthcare system as a whole are embedded in the bill passed by the House of Representatives Aug. 1.

Big-ticket items are suffering this year as reimbursement cuts resulting from the Deficit Reduction Act have had a wider and longer lasting effect than initially expected. Particularly hard hit has been PET/CT. The hybrid juggernaut had defied the odds for several years, marching forward with ever higher sales despite utilization rates at individual sites that allowed plenty of unused capacity.

The 2007 International Society for Magnetic Resonance in Medicine meeting looked backed at past accomplishments and forward to innovations that will define future MRI practice. The meeting, jointly sponsored with the European Society for Magnetic Resonance in Medicine and Biology, was held in Berlin May 19 to 25, two months after the death of Paul Lauterbur, Ph.D., a key figure in the invention of MRI.

Plaque rupture is the main cause of acute coronary syndromes, which are associated with high mortality and morbidity. The prevalence of plaque rupture in acute coronary syndrome is more than 70%.1 Rupture-prone plaques are characterized by a large core of extracellular lipid with a thin fibrous cap (Figure 1). Inflammation, particularly in the plaque shoulder, causes the fibrous cap to thin and results in disruption of the atherosclerotic plaque.

righam and Women's Hospital researchers have shown that MR-guided focused ultrasound surgery reduces the painful symptoms of uterine leiomyomas for at least a year after treatment. Better technique and growing experience with the minimally invasive procedure have improved its effectiveness and safety while helping physicians with patient selection.

New research suggests ultrasound won’t cut it as a substitute adjunct study for screening women at high risk for breast cancer.

Parenteral drug abuse is relatively uncommon in Singapore compared with other forms of substance abuse.1 The recent trend, however, of addicts injecting self-dissolve tablets with other drugs, bringing risk of serious limb morbidity, is causing concern.

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Endoscopic ultrasound has been shown to provide better information than CT for the staging of esophageal carcinoma. Only certain tumors can be successfully removed, so knowing the stage of cancer is vital to preparing the most effective treatment plan, especially when considering neoadjuvant chemotherapy.

Legislation proposing accreditation for most medical imaging modalities has been caught up in a fight between Capitol Hill and the White House over the renewal of federal healthcare insurance subsidies for poor children.

For nearly a decade, radiologists have used breast ultrasound as an adjunct to x-ray mammography to avoid unnecessary biopsies in equivocal cancer cases. Now ultrasound innovations that increase image resolution while decreasing operator dependence are reflected in a study published in the July issue of Radiology.

Volumetric imaging may be the key to an emerging opportunity for ultrasound in anesthesiology. Researchers at the Mayo Clinic in Jacksonville, FL, adapted real-time echocardiography to produce 3D images of nerves, clearing the way for faster and more accurate nerve blocks using local anesthesia.

Traditional ultrasound has long been used to take bladder measurements of fetuses as early as 11 to 14 weeks gestation, including length and echogenicity. But measurement of bladder volume has tended to be inaccurate because of the limited algorithms for estimating volume using a 2D image. Fetal urine production rate can also be tricky to evaluate with 2D ultrasound.

An advanced beamforming algorithm called the Time-domain Optimized Near-field Estimator (TONE) substantially improves the contrast and resolution of ultrasound images, according to its developers, a group of biomedical engineers at the University of Virginia School of Engineering and Applied Science.

Cervical length measured by transvaginal ultrasound is a better predictor of vaginal delivery within 60 hours after labor induction than the traditional Bishop score. Researchers in Spain compared the two methods in deciding when to use prostaglandin and oxytocin to induce labor.

The American College of Radiology and the Society of Breast Imaging have walked away from the National Accreditation Program for Breast Centers, an ambitious effort to certify breast ultrasound and ultrasound-guided interventions backed by the American College of Surgeons. They disagree with the program’s accreditation standards, especially minimal physician qualifications for interpreting breast ultrasound and performing ultrasound-guided breast interventions.

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Echocardiography is already widely accepted as a diagnostic test for infective endocarditis, but now researchers have proven it’s also a cost-effective option. Making decisions about early surgery for patients with significant stroke risk based on echocardiographic findings is ultimately more economical than standard care.

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Despite a 2005 consensus statement on the management of thyroid nodules detected at ultrasound, research presented at the 2006 RSNA meeting found wide variation in the criteria used to determine which nodules were chosen for aspiration. That shouldn"t be too surprising as even the panel of radiologists, endocrine surgeons, and endocrinologists who hammered out the consensus statement could not do so in perfect harmony.

Groin pain, whether acute or chronic, is a common clinical presentation that can be caused by a diverse array of disorders involving different anatomic structures. This makes definitive diagnosis difficult for even the most experienced clinician. Imaging can be invaluable in both localizing and characterizing otherwise uncertain groin pathology.