Saturday, October 26, 2013

MRI Guided Ultrasound Can Help With Knee Pains

An article on Sonoworld has piqued my interest again on the relationship between MRI and ultrasound.  It seems that MRI can guide therapeutic HIFU (high intensity focused ultrasound) to area of the knee, and potentially other areas to deliver nerve blocks.  I think the acronyms are silly.

medwireNews: Magnetic resonance-guided focused ultrasound (MRgFUS) is a potentially valuable noninvasive treatment for knee osteoarthritis, a pilot study suggests.
MRgFUS was associated with a reduction in pain intensity both immediately and at 6 months after treatment, supporting further evaluation of the technique.
MRgFUS is a way of delivering localized thermal ablation to precisely defined sites. It has recently been used to cause local bone denervation in cancer patients with bone metastases for pain palliation.

Thanks Sonoworld

Monday, October 14, 2013

Mindray Ultrasound Review

I had a very positive experience with a per-diem apps specialist from San Jose CA today.  His name is Joseph.  I will not give out a last name because his job is as a per-diem associate.  This laptop ultrasound machine was heavy.  But it busted me in all areas of ultrasound.  I was impressed. The promised DICOM transfers to the secure net are still being worked on.  I think we can get this sytem and others like it going in a few weeks.  We will work with Mindray to produce great quality ultrasound exams soon.  I seldom endorse a company.  I guess I just did.  The company is from China but has a base in Bothell, WA home to ATL, one of the early leaders in ultrasound tech in the 70's and 80's.

Pros: great configuration, and standard factory installs went smooth.  Echo presets made me sing.  Great color, and a darn sharp screen.  Color was great.. 300 gigs of storage, but no simultaneous storage to WI/Fi or thumb drives.  We mobile people need that. Calcs are actually understandable! The package has a 3-D 4-D package.  We did not purchase that. They must have had a Sonographer on the development team!  This is one of the best machines I have seen on the market in years.

Cons: No on-board tissue Doppler.  Perhaps this is because it was not purchased.  No real help with DICOM or internet security.  We all need that.  I will see if we can do wireless secure transfer soon.  Message to Mindray: be prepared to deal with upload issues and times.  We sonographers hate reading books while the files upload, but we HATE having to populate the echo preliminaries with M-Mode measurements and AVA area and LA volumes by hand!  Most cardiologists are lazy (Very lazy) and refuse to type in the measurements.  We need this issue to be resolved.

Bless you Joe, and have a nice trip back to CA.  and TYVM.

Thanks, TJW

Sunday, October 13, 2013

ASE New Guidelines For Pericarditis

The patient depicted to the left has hepatitis.  He also has pericarditis.  The echo diagnosis is pretty hazy.  We look at the pericardium, and usually look for anechoic space between the epicardium and the pericardium.  when we see a separation on M Mode or 2-D we call that out.  We have no idea what is going on until we do a pericardiocentesis.
here is a post to a link to the PDF that explains the new guidelines.  This is a must see for Echocardiographers, and Cardiologists.  Thanks ASE.  I am a Fellow there. :)

Be well all.  Here is the link.

Follow the link for the PDF file

Thanks ASE.  TJW

Monday, October 7, 2013

Contrast Enhanced Ultrasound Useful In Treating Children

I like this article!  It seems that contrast enhanced ultrasound (CEUS) is a better way of monitoring treatments in children, than CT or, perhaps MRI.  CT and MRI are costly, and CT uses X-rays that are not very good for a child.  I will applaud the efforts of the authors and say keep up the good work!.

Thanks ICUS and Bless you!

The Food and Drug Administration, physician groups and providers are concerned about increasing use of diagnostic imaging tools that expose patients to ionizing radiation, especially when alternative, radiation-free imaging options are available. Radiation exposure may increase a patient's risk of cancer and the effects are cumulative over a patient's lifetime.
This is the first pediatric study of CEUS using a sizeable number of patients. Thirty-four pediatric cancer patients received a total of 134 ultrasound contrast agent injections without any serious adverse effects. The initial phase of the study is now complete and a new clinical trial will be starting shortly at St. Jude's.
"Children, with their smaller body parts, make ideal candidates for CEUS," according to Dr. Kassa Darge, Pediatric Director of ICUS and a professor of radiology at Children's Hospital of Philadelphia. "Moreover, the absence of radiation makes it particularly safe, no sedation is required, it is well tolerated and it has the potential for lots of applications in pediatric oncology in the diagnosis and follow-up of solid tumors."
ABOUT ICUS: ICUS is an international, multidisciplinary, not-for-profit medical society that represents physicians, scientists and other professionals from over 55 countries who are interested in CEUS. For more information about ICUS, please visit