Ultrasound Application On Hp – 68Ga[Ga]-DOTATOC-Dependent Renal Function and Value of Peptide Receptor Radionuclide Therapy with 177Lu[Lu]-DOTATOC
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Ultrasound Application On Hp
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Received: 7 June 2021 / Published: 28 June 2021 / Accepted: 3 July 2021 / Published: 6 July 2021
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Over the years, there have been many improvements in ultrasound technology, including high-resolution ultrasonography, linear transducers, radiant flow, ultrasound, three-dimensional (3D/4D), speckle tracking of the fetal heart, and artificial intelligence. The objectives of this review are to evaluate the use of this advanced technology in conjunction with new indications and new intrauterine ultrasonography techniques. In particular, whether these technologies can increase the efficiency of the examination, performance evaluation, work flow and ergonomics of uterine ultrasound examinations will be discussed.
Ultrasound is widely used to detect fetal abnormalities in preventive measures, with the aim of further investigation including genetic testing and discussion of management options. In 2010, the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) published training guidelines for minimum and optional requirements for mid-trimester ultrasound scans. Recently, the American Institute of Ultrasound (AIUM) provides a detailed analysis of high-risk pregnancies in the second/third trimester (2) and fetal echocardiography in high-risk pregnancies. The ISUOG has published recent guidelines on the indications and procedures for obtaining neurosonography (4, 5). Although the introduction of prenatal cell-free DNA-Dune syndrome testing has changed the role of first-trimester screening, the latter should still be offered to women [6]. 50% of major defects can be seen in the first trimester [7]. In addition, a recent study showed that routine screening at 36 weeks of pregnancy resulted in 0.5% of undiagnosed fetal abnormalities, including fetal growth restriction (FGR) [8].
The detection rate of fetal abnormalities varies according to the anatomical examination protocol, ultrasound equipment and setting, among other things [9]. The quality of the ultrasound facilitates the diagnosis and early trimester diagnosis and allows to identify small or obscure objects [10, 11, 12]. Although accurate diagnostic testing is not required for all pregnant women, indications include a family history of miscarriage, maternal age 35 and older, gestational diabetes mellitus, artificial delivery technology, body mass index >=30, teratogenicity, fetal subluxation >=3mm. other conditions [2]. Among the growing questions of obstetric ultrasound examinations are the need to improve diagnostic skills, operative analysis, flow and ergonomics. Over the years there have been many improvements in ultrasound technology including high resolution ultrasonography, linear transducers, beam flow, three/four dimensional (3D/4D) ultrasound, fetal heart monitoring and artificial intelligence. The purpose of this review is to evaluate the use of these advanced technologies in defense.
High-resolution ultrasonography employs the use of a transducer and high-frequency image amplification and signal processing techniques, such as harmonic imaging (HI), spatial composite imaging (SCI), and speckle reduction imaging (SRI). Compared to a low-frequency (2 to 5 MHz) transducer, a high-frequency (5 to 9 MHz) transducer allows better resolution even with less tissue penetration. HI, using the physics of indirect propagation of ultrasound through body tissue, can produce high-resolution images with a small device. SCI can reduce angle-based artifacts by combining multiple lines of sight to create a single composite image from a real-time frame. The use of SRIS can reduce color or distortion from reflections projected from the ultrasound transducer.
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ISUOG recommends using a very high frequency transducer to perform fetal echocardiography with the aim of reducing the probability of detecting cardiac defects with acoustic acuity [10] (Figure 1a-d and See S1). The use of HI can improve the quality of ultrasound images, especially if the mother’s uterine wall is thick in the third trimester of pregnancy [11, 13].
For targeted neurosonographic examinations, the ISUOG recommends using transvaginal transducers as the highest quality. Another method is to use high quality abdominal transducers with a high frequency of around 8-9 MHz. Anatomy of the fetal brain in detail through a continuum of transverse, sagittal and coronal planes (Fig. 2a-d, See S2a, b).
Although prenatal detection of cleft lip is high, the detection of facial abnormalities such as deep or backward-turned ears, triangular face, downward-sloping palpebral fissure, or long and marked philtrum is low [14, 15]. These abnormalities may be subtle manifestations of rare but serious genetic disorders, such as 5p deletion syndrome or RASopathy, which require chromosomal microarray analysis or targeted sequencing of RAASopathy genes. Therefore, it is important to perform an ultrasound examination to evaluate the fetal face in the fetus, especially if there is a large NT, heart defects, or abnormal findings [14, 15]. High resolution ultrasonography allows a clear visualization of the shape of the face, lens, nose, lips, jaw and ears (Fig. 3a-d, see S3a, b). Recently, a new sonographic sign, the “superior line” sign, has been recommended for a second mouth assessment by looking at the vomeromaxillary junction in a midsagittal view of the mouth [16] (Figure 3a).
The larynx and its movements can be evaluated by prenatal ultrasound (Figure 4 and see S4). In vulnerable children, such as laryngeal atresia [17] and hernia in humans, prenatal ultrasound allows a systematic evaluation of the fetus, including the vocal cords to detect laryngeal abnormalities [17, 18].
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Transvaginal ultrasonography is used to detect pregnancy in an unknown location, which may be due to pregnancy, miscarriage or ectopic pregnancy. When using transvaginal sonography, it is important to avoid misdiagnosis of pregnancy by accurately measuring the mean sac diameter and umbilical length and by using a specific pregnancy definition for these measurements [19]. A recent study showed that the amniotic sac sign (the presence of an amniotic sac in the absence of a viable fetus) is a reliable sign of miscarriage [20]. While the presence of an ectopic gestational sac with a yolk sac and/or a fetus with or without cardiac activity suggests an ectopic pregnancy, a non-uniform adnexal mass (the ‘blob’ sign) or an ectopic sac-like structure (the ‘bagel’ sign) strongly suggests an ectopic tubal pregnancy. It is pleasant [21]. In women with premature cesarean section, ultrasound features of the cesarean scar should include minimal insertion of the gestational sac at or around the cesarean scar, as well as signs of preexisting placenta accreta spectrum disorders [22, 23].
ISUOG and more recently AIUM have published guidelines on first-trimester fetal ultrasound scans [24, 25]. High-resolution ultrasonography allows the diagnosis of early fetal body [11] (Fig. 5a-d, see S5a, b) and fetal defects [12]. The fetal heart can be examined at the end of the first trimester [26], especially with the use of color Doppler (video S5c, d). The ISUOG recommends the use of high frequency (6-12 MHz) transvaginal ultrasound to examine the fetal brain, especially if it is located in the posterior fossa and thick maternal abdominal wall [5].
Doppler ultrasound is widely used in obstetrics. The ISUOG proposed recommendations for Doppler ultrasonography of the fetoplacental circulation [27]. Late-onset wild growth restriction (FGR) is a difficult disease to diagnose. Although the third-trimester-cerebroplacental ratio (CPR = central cerebral artery pulsatile index/umbilical artery pulsatile index) is a predictor of miscarriage and maternal death [28], CPR shows lower predictors with central control or correction of fetal weight estimation. produces adverse results [29]. According to a meta-analysis, uterine abnormality (UTA) Doppler in the third trimester is used to predict pregnancy mortality in small pro-gestational-age fetuses. A recent study showed that the cerebral-placental-uterine ratio (CPUR = CPR divided by the UtA pulsatility index) better determined FGR than CPR or UtA Doppler alone [31].
The custom
What Are The 18 Most Popular Applications Of Ultrasound In Medicine
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