Ultrasound goes to the movies

New PACS software allows the storage of ultrasound cine-loops, which give surgeons an opportunity to better plan certain procedures based on ultrasound's functional evaluation of various organs. Dr. Peter Kovacs and colleagues from University Hospital in Innsbruck, Austria, reported their experience with loops at the 10th Congress of the World Federation for Ultrasound in Medicine and Biology in Montreal.

The researchers used the cine-loop function on an HDI-5000 ultrasound machine, which takes a sequence of 60 pictures. A separate 3D button allows the system to take more images. The pictures are sent to a PACS with software that allows them to be played in a movie sequence, and editing tools permit radiologists to highlight specific pathologies and views.

Kovacs's group used this technique in 36 patients with hernia, bowel obstruction, venous insufficiency, pseudoaneurysm, and tendon and joint disorders. The movie of the pseudoaneurysm, for example, showed a thrombosis, but the blood was confined to the femoral artery.

The obstructed bowel cine-loop revealed thickened mucosa and fluid moving in both directions. One movie showed a patient with a ruptured A2 anular pulley. The tendon separated from the bone on forced flexion. Another patient with a thumb injury had pain during extension only. In the ultrasound movie, the patient went from painless flexion to extension, revealing a nodule stuck under the A1 pulley.

In soft-tissue injuries, such as carpel tunnel syndrome, motion is even more important than static pictures, according to Kovacs.

"Ultrasound cine-loops together with dedicated PACS workstation software allow the direct demonstration of dynamic ultrasound studies to all medicating doctors," he said. "This is an important adjunct to modern ultrasound, but it warrants further investigation."