Impact of endoscopic ultrasound-guided radiofrequency ablation in managing pancreatic malignancy

Pancreatic malignancy is still the most lethal gastrointestinal malignancy.It has a very poor prognosis with low survival rate.Surgery is still the main treatment option for pancreatic malignancy.Most patients already have locally advanced and even late stage disease due to non-specific abdominal symptoms.Even though some cases are still suitable for surgical treatment,due to its aggressiveness adjuvant chemotherapy is becoming the standard treatment for controlling the disease.Radiofrequency ablation(RFA)is a thermal therapy that has been used as one of the standard treatments for liver malignancy.It can also be performed intraoperatively.There are several reports on percutaneous RFA treatment for pancreatic malignancy using transabdominal ultrasound and guided by computed tomography scan.However,due to its anatomical location and the risk of high radiation exposure,these methods seem to be very limited.Endoscopic ultrasound(EUS)has been widely used for pancreatic abnormality evaluation due to its ability to detect more accurately,especially small pancreatic lesions,compared to other imaging modalities.By the EUS approach,it is easier to achieve good visualization of tumor ablation and necrosis as the echoendoscope position is closer to the tumor area.Based on studies and a recent meta-analysis,EUS-guided RFA is a promising treatment approach for most pancreatic malignancy cases,but most studies only collected data from a small sample size.Larger studies are needed before clinical recommendations can be made.

High-frequency Ultrasound Evaluation of Effects of Early Treatment with Metoprolol on Myocardial Inflammatory Cytokine Expression in Rats with Acute Myocardial Infarction

This study evaluated the effects of early treatment with β-adrenergic blocker metoprolol on ventricular remodeling and function after acute myocardial infarction (AMI) by using high frequency ultrasound.The relationship between the efficacy and the expression level of cardiac myocardial inflammatory cytokine was examined in rats.The rat model of AMI was induced by ligating the left ante-rior descending artery.The surviving rats were randomly assigned to two experimental groups:MI control (MI) group and MI metoprolol (MI-B) group,with the rats undergoing sham operation serving as normal control (Sham).MI-B group was given metoprolol for 4 weeks (refer to the CCS-2 protocol) and the other two groups received equal volume of saline via intragastric (i.g.) administation.The ventricular remodeling and function were evaluated by high frequency ultrasound 4 weeks after the treatment.Then all rats were sacrificed for pathological examination and immunohistochemistrical detection of inflammatory cytokines,including IL-1β,IL-6,IL-10 and TNF-α.Compared with the MI group,the left ventricular end-systolic dimension,end-diastolic dimension,end-systolic volume and end-diastolic volume of the MI-B group were significantly decreased (P<0.01),while the left ventricular anterior wall end-diastolic thickness,ejection fraction and fractional shortening were obviously increased (P<0.01).The conspicuous improvement in the left ventricular morphology and function was coincident with the markedly reduced TNF-α and IL-1β expression and the increased IL-10 expression.We are led to conclude that early metoprolol treatment for AMI can regulate myocardial inflammatory cytokine expression to improve cardiac function and the underlying mechanism might be that it decreases the level of pro-inflammatory cytokines and increases the level of its anti-inflammatory counterparts in cardiac myocytes.Our study also showed that echocardiography is a useful technique for the structural and functional assessment of left ventricle after acute myocardial infarction.

A Static Bioimpedance and Dynamic Acoustic Myography Preliminary Assessment of Low Frequency Therapeutic Ultrasound Treatment of the Shoulder Muscle Trapezius: An Equine Study

Background: In horses, therapeutic ultrasound has been shown to be beneficial for suspensory ligament injuries, and more generally to stimulate tissue repair and reduce localized pain. However, it has yet to be examined in relation to soft tissue injuries sustained during competition or in connection with rider/saddle interactions. Aim: The aim of the present study was to examine the efficacy of topical low-frequency therapeutic ultrasound on the shoulder muscles of injured horses. Methods: Muscle mass and cellular health was assessed for M. trapezius using non-invasive multi-frequency bioimpedance, and dynamic improvements in M. trapezius and M. latissimus dorsi were examined using acoustic myography (AMG). A total of 8 injured horses (painful to palpation and atrophied) were treated using an EQ Pro Therapy unit, following a set protocol that comprised treatment every other day for 10 treatments. Pre-treatment values were then compared with post-treatment measurements (1 & 6 months later). Results: The mfBIA results for M. trapezius showed a significant improvement (P < 0.05) of EQ Pro Therapy treatment for the membrane capacitance (Mc) and phase angle (PA) parameters when comparing the Pre vs Post 1 and Post 1 vs Post 2 measurements. Similar improvements were seen for the AMG measurements for M. trapezius and M. latissimus dorsi where statistically significant improvements in the muscle efficiency (E-score) and temporal summation (T-score) as well as the spatial summation (S-score) and mean of the ST-scores were noted (P < 0.05 to P < 0.01). Conclusion: The present findings suggest that EQ Pro Therapy treatment is efficacious in terms of equine cases involving soft tissue shoulder muscle injuries (painful to palpation and atrophied). The main improvements noted were not only increased muscle mass and cellular health but also improved force production, better coordination, and lateral balance, which persisted for at least six months after treatment.

Degradation of 4-Chlorophenol Solution by Synergetic Effect of Dual-frequency Ultrasound with Fenton Reagent

4-Chlorophenol (4-CP) solution was treated by dual-frequency ultrasound in conjunction with Fenton reagent, and obvious improvement in the 4-CP degradation rate was observed in this advanced oxidation process.Experimental results showed that ultrasonic intensity, saturating gas and pH value affected greatly the 4-CP removal rate. Among four different saturating gases (Ar, 02, air and N2), 4-CP degradation with Ar-saturated solution was the best. However, in the view of practical wastewater treatment, using oxygen as the saturating gas would be more economical. The addition of Fenton reagent followed the first-order kinetics and increased the 4-CP degradation rate.The 4-CP removal rate increased by around 126% within 15 rain treatment. The synergetic effect of dual-frequency ultrasound with Fenton reagent on 4-CP degradation was obviously observed.

Clinical Value of Transperineal 3D Volume Ultrasound Combined with 2D High Frequency Ultrasound in Anal Fistula

Objective: To explore the clinical diagnostic value of transperineal volume ultrasound combined with two-dimensional high-frequency ultrasound for anal fistula. Methods: A total of 52 patients with anal fistula admitted to the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from December 2017 to July 2018 were selected. They were all undergoing transperineal 3D volume ultrasound combined with 2D high-frequency ultrasound examination, and the diagnosis results were analyzed. The results of ultrasonography and surgical pathology were compared. Results: Among 52 patients, 3D volume ultrasound combined with 2D high-frequency ultrasound were used to diagnose 32 cases of anal fistula intersphincteric type, 14 cases of transsphincter type, 5 cases of supra-sphincter type, and 1 case of extra-sphincter type. T supervisor classification accuracy rate is 90%. The detection rate of branch pipes was 92%, and the compliance rate of internal fistula was 95%. Two-dimensional high-frequency ultrasound was used to diagnose 34 cases of anal fistula intersphincteric type, 14 cases of transsphincter type, 4 cases of supra-sphincter type, and 0 cases of extra-sphincter type. The detection rate of branch canals was 42%, and the accuracy of type classification was 90%. The coincidence rate was 95%. There was a statistically significant difference in the detection rate of the anal fistula branch and the coincidence rate of the internal fistula between the two methods (both P Conclusion: 1) The overall coincidence rate of three-dimensional volumetric ultrasound combined with two-dimensional high-frequency ultrasound in the diagnosis of anal fistula is high;2) Three-dimensional volumetric ultrasound technology has great application prospects in infants and anal fistulas.

Application Value of High-Frequency Ultrasound and Contrast-Enhanced Ultrasound in Patients with Knee Osteoarthritis with Different TCM Syndromes

Objective: To explore the application value of high-frequency ultrasound and contrast-enhanced ultrasound in different syndrome types of knee osteoarthritis, and to provide more imaging evidence for clinical diagnosis and treatment. Method: Sixty patients with KOA were selected according to TCM classification, which were mainly divided into Qi stagnation and blood stasis type and cold-dampness blockage type. All knee joints were routinely examined by high frequency ultrasound, and those with synovial hyperplasia were examined by contrast-enhanced ultrasound. High frequency ultrasound is the examination of synovium, cartilage and collateral ligament of knee joint based on two-dimensional ultrasound. Contrast-enhanced ultrasound (CEUS) refers to the contrast examination of synovium in knee joint patients with synovial hyperplasia. Result: Among them, the suprapatellar sac effusion and synovial thickening of Qi stagnation and blood stasis type were more obvious than those of cold-dampness arthralgia type (P < 0.05), and the degree of wear of the intercondylar cartilage of cold-dampness arthralgia type was more obvious than that of Qi stagnation. The blood stasis type is heavier and the meniscus bulge is higher (P < 0.05). The radiography of synovial hyperplasia showed that the area under the curve of Qi stagnation and blood stasis type was higher than that of cold dampness arthralgia type (P < 0.05), and the peak time was significantly shorter than that of cold dampness arthralgia type. There was no statistical difference in effective peak gradient and onset time of type (P > 0.05). Conclusion: To a certain extent, the high-frequency ultrasound and contrast-enhanced ultrasound performance of knee osteoarthritis can be used as a dialectical reference for different TCM syndrome types.

Breast Lump Recognition Algorithms Based on Ultrasound Radio-Frequency Signals

A method for evaluating the benign and malignant breast tumors based on radio?frequency(RF)data was explored by extracting the characteristic parameters of breast ultrasound RF signals.The breast biopsy data were used as the reference data for judging the lump benign or malignant.The extracted ultrasound RF data were reconstructed and segmented by computer aided method to obtain the breast tumor region of interest(ROI)and its characteristic parameters(entropy and standard deviation).The characteristic parameters were statistically analyzed to evaluate the relationship between characteristic parameters and benign or malignant breast tumors.The results indicate the entropy and standard deviation of normal region is much higher than that of lump region,which shows that the standard deviation and entropy characteristic parameters of ultrasonic RF signals are meaningful in the diagnosis of breast tumors.The proposed method provides a new direction for computer?aided diagnosis of benign and malignant breast tumors.

Generation of Ultrasound Based on the Frequency Response Characteristics of the “Koss Pro Headphone” with R. David Case Sound Wave Files’—A Case Study

The research aim of this work is to analyse the characteristics of R. David Case Sound waves that are posited to have positive effects on people suffering from tinnitus. Moreover, the participants who listened to these sound wave files using specific headsets or headphones of the Koss models (ktx Pro, ksc-75) showed improved health condition such as alleviating tinnitus that they are suffering from. Therefore, these discoveries have encouraged R. David Case to pursue positively his journey into finding out what is special about those sounds when being listened specifically with Koss models. In this research, we focus mainly on the technical aspects of R. David Case sound signals which he has recorded. These specific sound waves were analysed using time domain, frequency domain as well as the effect of using the Koss Pro headphone frequency response characteristics applied to the sound. Results obtained from the analysis demonstrated that the generation of ultrasound can be the underlying reason for the treatment of the tinnitus.

High Frequency Ultrasound in Determining the Causes of Acute Shoulder Joint Pain

Shoulder ultrasonography is approved as the examination of choice for rotator cuff abnormality in many centers around the world since it is an inexpensive and safe tool for investigation of rotator cuff abnormalities. The goal of this study was to determine the ultrasound findings in patients with acute shoulder joint pain, and also to identify possible predictors of shoulder pain, as well as to compare the ultrasound diagnostic performance to that of MRI in such condition. A total of 65 (mean age 28 ± 1.2 years) consequential patients were recruited for a period of six months between July 2015 and June 2016 in this study. Collected data were confined on age, medical history, and clinical symptoms. Shoulder ultrasound was performed with a linear array transducer (10 - 15 MHz) connected to HI vision Avius ultrasound unit;Hitachi. MRI for the shoulder joint was performed in all cases to confirm the ultrasound results, using 1.5-T MRI system (Magnetom Espree);Siemens. Statistical analysis was completed using the standard Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) version 20 for windows. Ultrasound manages to determine the causes of acute shoulder joint pain in 98% of the patients. Fitted achievement values for shoulder ultrasound in the diagnosis the causes of shoulder joint pain were 100% sensitivity and a range of 96% to 100% of accuracy. Ultrasound presents a high sensitivity and accuracy in diagnosis a wide spectrum of shoulder joint lesions, with a diagnostic performance near to that of MRI.

A FREQUENCY DOMAIN QUANTITATIVE MEASUREMENT METHOD FOR BLOOD FLOW VELOCITY WITH BIDIRECTIONAL DOPPLERULTRASOUND AVOIDING DOWN-BAND CHANNEL

ＡＦＲＥＱＵＥＮＣＹＤＯＭＡＩＮＱＵＡＮＴＩＴＡＴＩＶＥＭＥＡＳＵＲＥＭＥＮＴＭＥＴＨＯＤＦＯＲＢＬＯＯＤＦＬＯＷＶＥＬＯＣＩＴＹＷＩＴＨＢＩＤＩＲＥＣＴＩＯＮＡＬＤＯＰＰＬＥＲＵＬＴＲＡＳＯＵＮＤＡＶＯＩＤＩＮＧＤＯＷＮ－ＢＡＮＤＣＨＡＮＮＥＬＷａ...

The High Frequency (HF) Ultrasound as a Useful Imaging Technique for the Efficacy Assessment of Different Anti-Cellulite Treatments

The purpose of the research was to evaluate the role of high frequency ultrasound in monitoring and efficacy assessment of anti-cellulite treatments. A group of 66 women used 3 different types of anti-cellulite treatments;additionally a placebo group (n = 18) was created. The μ-Scan ultrasound device with a 35 MHz mechanical probe was used for the examinations. The following parameters were subjected to the ultrasound evaluation: epidermis thickness, dermis thickness, dermis echogenicity, the length and area of subcutaneous tissue bands projecting into the dermis (dermis-hypodermis junction), as well as the presence/absence of edema within the dermis. As a result of anti-cellulite treatment, the length and area of dermis-hypodermis junction significantly decreased, and dermis echogenicity significantly increased. Ultrasound imaging made it possible to evaluate the efficacy of the applied treatments. The high frequency ultrasound is a useful imaging technique for the application in aesthetic dermatology and cosmetology.

Development of a High-frequency Ultrasound System for High-speed Image Scanning

High-frequency image technique has been widely applied in medical diagnosis recently. For high voltage protection, high speed stage and trigger control circuitry are difficult to implement a high-frequency ultrasound imaging system. In this study, we utilized a linear servo with high noise tolerance and a novel multi-depth expression method to overcome those issues in developed high-speed image system. B-mode image of the chicken phantom by 25 MHz transducer shows the resolution of lateral and axial resolutions are up to 123 μm and 59 μm respectively. In addition, the experiment demonstrates that the axial resolution and depth of field (DOF) can be improved by time gain compensation(TGC) and multi-depth method. The results indicate that the proposed system could achieve over 24 fps for 1 mm scan distance and 100 lines per frame. In the future, the developed system is potential for other clinical applications such as ophthalmology and dermatology.

Dual Treatment Strategy by Venous Ulcers: Pilot Study to Dual-Frequency Ultrasound Application

We propose a new dual treatment strategy by venous ulcer, consisting in simultaneous modulation of matrix metalloproteinases (MMPs) and heat shock proteins (HSPs) in the wound. One treatment method which can efficiently modulate both these substances is based on the application of dual-frequency ultrasound (LDM). This strategy was checked in a pilot study on 10 patients with chronic venous ulcers and demonstrated excellent healing rate.

A Flexible and High Speed Digital Scan Converter for High Frequency Ultrasound Imaging

This paper presents a flexible and high speed digital scan converter (DSC) with the ability to handle high frequency ultrasound imaging in real-time. The characteristics in imaging system such as focus length of transducer, the swing radius and sampling length etc. could be changed easily in compliance with the researcher's application based on this flexible digital scan converter. Linear interpolation is employed to achieve the coordinate transformations algorithm. Custom-built software is programmed to preliminarily handle the algorithm according to different ultrasound imaging applications. High performance FPGA will implement high speed interpolation calculation based on the preliminary data which are stored in the DDR2 SDRAM from the software. 64 bit 66 MHz PCI is employed to accomplish high speed data transmission. Experiment has shown that more than 500 frame rate could be achieved based on this high speed digital scan converter. The designed flexible and high speed digital scan converter could be used in current FPGA based high frequency ultrasound imaging system.

Influence enhancement effect of bi-frequency ultrasonic irradiation by TA fluorescence method

Based on a previous research of cavitation effect under bi-frequency ultrasound irradiation, this paper studies bi-frequency irradiations with similar experimental settings. The additional irradiation sources with frequencies of 1.04MHz, 0.8MHz and 1.7MHz are individually combined with the main ultrasonic irradiation source with frequency of 28kHz to form bi-frequency ultrasonic irradiation. The intensity of 28kHz irradiation was fixed at 12.5W/cm^2, while the intensity of the ultrasound at the other three frequencies is varied from1 W/cm^2 to 18 W/cm^2. It turns out that under the influence of the bi-frequency irradiation, the fluorescence intensity is obviously greater than the sum of those at individual frequencies. So the frequency of the additional sonication strikingly influences the fluorescence enhancement effect. For example, the fluorescence enhancement effect of 1.04MHz is stronger than that of 1.7MHz, and the enhancement effect of 0.8MHz is further stronger than that of 1.04MHz. Under the sonic intensity of (7.9)W/cm^2, the fluorescence intensity of 1.04MHz is approximately twice that of 1.7MHz while the fluorescence intensity of 0.8MHz is approximately 1.5 times that of 1.04MHz.

The combined time-frequency analysis of the acoustic signals backscattered from ultrasonic contrast agents in the evaluation of the blood perfusion

Objective: To analyze the non-periodic, unstable and even chaotic echoes scattered from microbubbles which are extremely sensitive and may easily collapse, fragment or shrink when ultrasound contrast agents are exposed to ultrasound (US) irradiation. Methods: The combined time-frequency analysis was applied to the original signals instead of the traditional Fourier spectral analysis technique. Results: The results obtained from simulation as well as experiment showed that the subharmonic, 2nd harmonic and ultra harmonic of the microbubbles occurred during the oscillation and varied with time. The dependence on the incident ultrasonic amplitude and microbubble parameters were established. Conclusion: The transient echoes backscattered from the ultrasound agent in the evaluation of the blood perfusion can be analyzed thoroughly by the technique of combined-frequency analysis and the time detail of the frequency contents can be revealed.

Single-Frequency Matching Pursuits Based Time-of-Flight Measurement in Viscoacoustic Medium

Broadband ultrasound signals will produce distortion in viscoacoustic medium, which may influence the accuracy of time-of-flight (TOF) measurement. Under the condition of single-frequency acoustic source, the wave propagation process in viscoacoustic medium was analyzed and an approximate solution of the wave propagation was given. Instances of broadband ultrasound were analyzed and simulated based on the single-frequency results. A single-frequency matching pursuits (SFMP) algorithm was then introduced to solve the waveform distortion problem. Time-frequency decomposition was applied to extracting the single-frequency compositions from broadband ultrasound signals, and then these compositions were sent to the matching pursuits (MP) algorithm for calculating the TOF parameters. Compared with the broadband signals, the shapes of extracted single-frequency signals change more slightly as distance and attenuation coefficient increase. The residuals of SFMP were far less than those of MP algorithm. Experimental results show that the SFMP algorithm is able to eliminate waveform distortion of broadband ultrasound in viscoacoustic medium, which helps improve the accuracy of TOF measurement.

用于血管内超声成像的高频换能器研制

血管内超声(Intravascular Ultrasound,IVUS)成像技术可以精确评估血管腔口径、血管壁形态和其他相关血流和血管特性,在冠状动脉疾病的诊断、治疗指导和治疗后的评估中发挥着重要作用。文章设计并制备了一种用于血管内超声成像的高频超声换能器,并对换能器的电学和声学性能进行测试和表征。结果表明,所制备IVUS换能器的中心频率为38.9 MHz,-6 dB相对带宽为56.6%,在谐振频率42.3 MHz处的电阻抗为22.6Ω,在反谐振频率48.2MHz处的电阻抗为56.5Ω,有效机电耦合系数为0.48。使用该换能器进行线仿体成像实验的结果显示,换能器的纵向分辨率为54μm,横向分辨率为209μm。最后,将文中制备的超声换能器与国外同类型换能器进行比较,结果表明,该换能器的性能良好,能够满足血管内超声临床检测需求,未来有望能够突破技术瓶颈,实现国产替代。

高频超声对强直性脊柱炎亚临床附着点炎的筛查评估价值

目的 探讨高频超声对强直性脊柱炎(AS)不同部位亚临床附着点炎早期诊断的价值。方法 选取2017年1月~2023年11月甘肃省人民医院就诊的AS患者100例,依据2022年全球首个附着点炎筛查与评估临床实践指南进行分组:临床附着点炎患者50例(分为有主观症状和无主观症状但有压痛2组);亚临床附着点炎患者50例(无主观症状也无压痛,需借助MRI或超声识别确诊)及50例健康志愿者,分别对其近端足底筋膜、远端跟腱、远端髌韧带、近端髌韧带、远端股四头肌腱和肱三头肌腱附着点行高频超声检查,根据不同部位附着点的厚度、结构、钙化、骨侵蚀、滑囊的厚度及能量多普勒信号,分析超声检查的特异性、敏感度和准确性。结果 受检AS患者超声检查其中有主观症状异常附着点(阳性率为54%),以股四头肌腱附着点为著;无主观症状但有压痛异常附着点(阳性率为46%),以足底筋膜附着点为著;亚临床附着点炎AS患者异常附着点(阳性率为61%),以跟腱附着点为著。高频超声不同亚临床附着点超声检查病变情况显示,与临床检查相较,AS患者亚临床附着点炎的检出率更高(P<0.05);与正常对照组比较,高频超声对亚临床附着点检出率更高,阳性表现以肌腱增厚和滑囊增厚最为常见(P<0.05)。与临床检查比较,高频超声在AS不同部位亚临床附着点早期诊断中,特异性、敏感度、准确性均较高。结论 相较于单一的临床检查,高频超声在AS患者不同部位亚临床附着点早期诊断中,可有效提高检出率,提升诊断价值,弥补了临床检查一直以来对亚临床附着点炎的低估性。

便携式高频超声在肋骨骨折诊断中的价值

目的探讨便携式高频超声在肋骨骨折诊断中的价值。方法回顾性分析68例172处有肋骨骨折和18例54处无肋骨骨折的胸部创伤患者的便携式高频超声、胸部DR、64排双源CT检查结果,比较三者的肋骨骨折诊断效能。结果便携式高频超声共诊断出肋骨骨折160处,误漏诊16处;胸部DR诊断出肋骨骨折130处,误漏诊54处;64排双源CT检查出肋骨骨折165处,误漏诊10处。便携式高频超声(AUROC=0.93)和64排双源CT检查(AUROC=0.95)对肋骨骨折的诊断效能相近(P>0.05),均高于胸部DR检查(AUROC=0.77),差异有统计学意义(P<0.05)。结论便携式高频超声对肋骨骨折有很高诊断价值,是肋骨骨折的重要检查方法,在没有CT的医院可替代CT作为肋骨骨折的常规检查方法。