Medical ultrasonography 

About: Medical ultrasonography is an academic journal published by SRUMB - Romanian Society for Ultrasonography in Medicine and Biology. The journal publishes majorly in the area(s): Medicine & Ultrasound. It has an ISSN identifier of 1844-4172. It is also open access. Over the lifetime, 1030 publications have been published receiving 10692 citations.

Ultrasonography of superficial lymph nodes: benign vs. malignant.

Abstract: The aim of the paper is to review and illustrate the current status of the knowledge on the applications of ultrasonography in superficial lymph node disease diagnosis. The grey-scale and Doppler ultrasonographic signs pointing to benignity or malignancy are presented, illustrated and their diagnostic usefulness is discussed. Peculiar types of lymphadenopathy such as inflammatory, tuberculous, lymphoma and metastasis of different origins are also discussed. The paper briefly reviews the nodal applications of some recent technical developments such as contrast and sonoelastography.

Factors that influence the correlation of acoustic radiation force impulse (ARFI), elastography with liver fibrosis.

Abstract: Aim: To establish the influence of different factors on the correlation between liver stiffness (LS) measurements by ARFI and liver fibrosis, evaluated by liver biopsy (LB). We assessed the following factors: the success rate (SR) and interquartile range (IQR) interval, the place where ARFI was performed, liver steatosis, the quality of the specimen obtained by LB. Methods: We studied 471 patients: 82 with LB, 82 healthy volunteers and 307 with cirrhosis. We performed 10 valid ARFI measurements, a median value was calculated, expressed in meters/second. Results: Valid measurements were not obtained in 11 patients. There was a direct, strong, correlation (r=0.694) between ARFI and fibrosis (p 30% and/or SR≤60%: r=0.268 (p=0.0001). The quality of the liver specimen (2-3 cm long vs. >3 cm) did not influence the correlation of ARFI with fibrosis. Conclusions: To obtain the best correlation between ARFI and fibrosis, IQR must be <30% and SR≥60%. These technical parameters must be introduced to improve the ARFI value for LS evaluation.

Acoustic Radiation Force Impulse (ARFI)--a new modality for the evaluation of liver fibrosis.

Abstract: Aim: to assess the accuracy of transient elastography (TE) and Acoustic Radiation Force Impulse (ARFI) for liver fibrosis assessment, as compared to percutaneous liver biopsy (LB) in patients with chronic hepatitis. Patients and methods: Our study included 71 patients (P) (54 with HCV and 17 with HBV chronic hepatitis) in which we compared TE and ARFI to the LB (evaluated according to the Metavir scoring system). Results: On LB, from the 71P, 6P (8.4%) had F1, 25P (35.2%) had F2, 24P (33.8%) had F3 and 16P (22.5%) had F4. A direct, strong, linear correlation (Spearman r=0.707) was found between TE measurements and fibrosis (p<0.0001) and a weaker one, between ARFI and fibrosis (rho=0.469; p<0.0001). TE measurements were also correlated with ARFI measurements r=0.532, p<0.0001. By comparing the AUROC curves, TE and ARFI had similar predictive values for the presence of significant fibrosis (F≥2 Metavir): AUROC ARFI=0.649, AUROC TE=0.731 (p=0.476); and cirrhosis (F=4 Metavir): AUROC ARFI=0.868, AUROC TE= 0.936 (p=0.294) Conclusion: LS measurements assessed by means of TE correlate better than those assessed by means of ARFI to the histological fibrosis in patients with HBV and HCV chronic hepatitis. Both methods have excellent predictive values for the presence of cirrhosis.

The contribution of ultrasonography and sonoelastography in assessment of myositis.

Abstract: Aims: To analyze the utility of ultrasonography (US) in the assessment of inflammatory miopathies, and of sonoelastography in the assessment of the elasticity of skeletal muscle in myositis. Material and methods: The study group comprised 24 patients with musculoskeletal pathology examined using Hitachi 8500 EUB equipment with a 6.5-13 MHz transducer and software for elastography. The images were analyzed in conjunction with clinical and biochemical data. Using dedicated software for color information from the elastographic images, the average values for color intensity, hue and dispersion were calculated. Results: After the correlation of US images with clinical and paraclinical data the highest average values for color parameters were encountered on the superior third of the thigh. There was a proportional concordance between the average values of the color parameters and serum creatine kinase and serum lactic dehydrogenase and there was no significant agreement between the average values of the color parameters and the erythrocyte sedimentation rate, positive rheumatoid factor or positive antinuclear antibody. Conclusions: The correlation between the quantitative colour parameters from the elastographic images and the laborator studies suggest that sonoelastography could be an important tool in the management of the patients with myositis.

Ultrasound guided injections of Platelets Rich Plasma for muscle injury in professional athletes. Comparative study.

Abstract: Aim: Professional athletes require faster recovery after trauma. The aim of our study was to evaluate the efficacy of ultrasound guided platelets rich plasma (PRP) treatment for acute muscle injury comparing with traditional conservative therapy. Materials and methods: Thirty consecutive men (mean age 24 years old) professional athletes with acute local muscle injury were enrolled. All patients underwent US and sonoelastography examination. Patients were randomly assigned to 2 groups: group A received targeted PRP injection under US guidance and additionally conservative treatment and group B received conventional conservative treatment only. The pain was assessed according to visual analogue scale (0 to 10), muscle function according to pain on resisted flexion or strength, and range of motion. Both groups were further evaluated in the days 1, 7, 14, 21, and 28 after treatment starting. US criteria for regeneration were considered to be the disappearance of hypoechoic areas of muscle damage, fibrous tissue more stiff on sonoelastography, and neovascularity appearances. Results: The pain relief was more important in group A compared to group B starting from day 1 and continuing in the next 3 evaluation sessions (p 0.05). Assessing the physical evolution in the 7th and 14th days significant changes in strength (p 0.05) but the range of movement improved better in group A compared with group B (p< 0.05). Subjective global function scores improved significantly in group A compared with group B on the 28th day (p<0.05). The mean time for the physical recovery movement volume and the ability to practice sport was 10±1.2 days in group A and 22±1.5 days in group B. Conclusions: Injections of PRP under ultrasound guidance had asignificantly higher level of pain relief, physical recovery, and faster regeneration compared with conventional conservative treatment in acute muscle trauma in professional athletes