Echoes Estimation of fetal weight at peri-viable gestational ages: how inaccurate are we and does that impact risk of death? Stout M, Tuuli M, Macones G, et al. Am J Obs Gyn 2014;210 Suppl 1:S56 This small single-centre study found that in preterm deliveries at periviable gestational ages, there is poor correlation between estimated fetal weight using ultrasound and actual weight. Ultrasound significantly underestimates fetal weight regardless of maternal size. This may have an impact on management strategies. Carotid endarterectomy for symptomatic low-grade carotid stenosis. Ballotta E, Angelini A, Mazzalai F, et al. J Vasc Surg 2014;59:25–31 Another small single-centre study investigated the value of performing carotid endarterectomy on symptomatic stenoses of less than 50% (using NASCET criteria) and had good outcomes in those with unstable plaque. This study seems to fit with the current thinking of earlier intervention way before development of stenoses above 70%. Detection of risky esophageal varices by two-dimensional ultrasound: when to perform endoscopy. Mohammad Ali A, Mahfouz H, Afifi M, et al. Am J Med Sci 2014;347:28–33 This team from Egypt investigated over 1000 patients with portal hypertension to determine whether the intra-abdominal portion of the oesophagus could reveal information about the presence of oesophageal varices. They say oesophageal wall thickness may be a useful indicator for identifying high-risk varices but it is hard for me to see how they achieved accuracy to 1/100th of a millimetre using a 4-MHz transducer. Clinical applicability of real-time, prehospital image transmission for FAST (Focused Assessment with Sonography for Trauma). Song K, Shin S, Hong K. J Telemedicine & Telecare 2013;19:450–5 This team in South Korea investigated the feasibility of transmitting ultrasound clips produced by emergency technicians in ambulances to hospital-based physicians ahead of the patient’s arrival. It would make more sense to train the technicians to provide a clinical opinion rather than getting a doctor to judge second hand images but sadly this would constitute illegal medical practice in South Korea. Testicular microlithiasis – an ultrasound dilemma: survey of opinions regarding significance and management amongst UK ultrasound practitioners. Shetty D, Bailey A, Freeman S. BJR 2014;87:1034 Unsurprisingly, this survey of UK practice found that there is a wide variation on the significance attributed to
microlithiasis, follow-up and management. The authors state that the European Society of Urogenital Radiology is currently working on producing some guidelines. I have heard they are now complete, so let us hope they are published soon so that we can amend practice accordingly. Ultrasound demonstration of testicular microlithiasis in pediatric patients: is there an association with testicular germ cell tumors? Volokhina Y, Oyoyo U, Miller J. Ped Radiol 2014;44:50–5 On the same theme, this study involving 2266 boys found one germ cell tumour in 87 cases of microlithiasis, and eight germ cell tumours in 2179 boys without microlithiasis. The authors conclude that there is no association between microlithiasis and germ cell tumours. Bring on those ESUR guidelines! The fetal three-vessel and tracheal view revisited. Gardiner H, Chaoui R. Seminars in Fetal and Neonatal Medicine 2013;18:261–8 Here is a helpful educational refresher for practitioners already including the cardiac three vessel and trachea view (3VT) during the prenatal anomaly scan. For those trying to implement it, I like this paper for two reasons: it is well illustrated with lots of abnormal 3VT views and offers a nice summary of 10 practice points. The use of ultrasound to detect occult or unsuspected fractures in child abuse. Warkentine F, Horowitz R, Pierce M. Pediatric Emergency Care 2014;30:43–6 This team reports two cases where bedside ultrasound performed by a paediatric emergency medicine physician detected fractures in infants younger than 12 months. They suggest ultrasound may be a useful tool in cases of child abuse. High resolution ultrasound features of prostatic rib metastasis: a prospective feasibility study with implication in the high-risk prostate cancer patient. Lee K, De Smet A, Liu G, et al. Urologic Oncology 2014;32:24.e7–11 Still on the subject of the use of ultrasound for boney pathology, here is a study that investigated the ultrasound appearance of metastatic rib deposits in patients with either prostate or renal cell carcinoma. Different sonographic appearances may mean that ultrasound may be useful at characterising rib metastases once they have been found on a bone scan. Bedside ultrasound maximizes patient satisfaction.Howard Z, Noble V, Marill K. J Emerg Med 2014;46:46–53 Not only does point-of-care ultrasound expedite diagnosis and management but it also improves patient–physician Ultrasound 2014; 22: 129–130
130
Ultrasound
Volume 22
May 2014
.......................................................................................................................... relationships. Maybe some of our more curmudgeonly medics should take it up. Impact of lung ultrasound on clinical decision making in critically ill patients. Xirouchaki N, Kondili E, Prinianakis G, et al. Intensive Care Medicine 2014;40:57–65 This study of 253 examinations on 189 patients found that lung ultrasound on mechanically ventilated critically ill patients made a big difference to their management in nearly half of cases. In around 20% of cases, the ultrasound examination revealed findings which were not suspected by the physician. Prevalence of right-to-left shunts on transcranial Doppler in chronic migraine and medication-overuse headache. Guo S, Shalchian S, Gerard P, et al. Cephalalgia 2014;34:37–41 By analysing TCD studies in 159 patients from multiple centres, this team concluded that a patent foramen ovale is unlikely to be a causative factor in people experiencing chronic headache.
How ultrasound technologies have expanded and revolutionized research in reproduction in large animals. Ginther OJ. Theriogenology 2014;81:112–25 A fascinating paper reminding us of the massive contribution made by diagnostic ultrasound within the fertility setting but beyond applications for humans.
Hazel Edwards DOI: 10.1177/1742271X14527049
microlithiasis, follow-up and management. The authors state that the European Society of Urogenital Radiology is currently working on producing some guidelines. I have heard they are now complete, so let us hope they are published soon so that we can amend practice accordingly. Ultrasound demonstration of testicular microlithiasis in pediatric patients: is there an association with testicular germ cell tumors? Volokhina Y, Oyoyo U, Miller J. Ped Radiol 2014;44:50–5 On the same theme, this study involving 2266 boys found one germ cell tumour in 87 cases of microlithiasis, and eight germ cell tumours in 2179 boys without microlithiasis. The authors conclude that there is no association between microlithiasis and germ cell tumours. Bring on those ESUR guidelines! The fetal three-vessel and tracheal view revisited. Gardiner H, Chaoui R. Seminars in Fetal and Neonatal Medicine 2013;18:261–8 Here is a helpful educational refresher for practitioners already including the cardiac three vessel and trachea view (3VT) during the prenatal anomaly scan. For those trying to implement it, I like this paper for two reasons: it is well illustrated with lots of abnormal 3VT views and offers a nice summary of 10 practice points. The use of ultrasound to detect occult or unsuspected fractures in child abuse. Warkentine F, Horowitz R, Pierce M. Pediatric Emergency Care 2014;30:43–6 This team reports two cases where bedside ultrasound performed by a paediatric emergency medicine physician detected fractures in infants younger than 12 months. They suggest ultrasound may be a useful tool in cases of child abuse. High resolution ultrasound features of prostatic rib metastasis: a prospective feasibility study with implication in the high-risk prostate cancer patient. Lee K, De Smet A, Liu G, et al. Urologic Oncology 2014;32:24.e7–11 Still on the subject of the use of ultrasound for boney pathology, here is a study that investigated the ultrasound appearance of metastatic rib deposits in patients with either prostate or renal cell carcinoma. Different sonographic appearances may mean that ultrasound may be useful at characterising rib metastases once they have been found on a bone scan. Bedside ultrasound maximizes patient satisfaction.Howard Z, Noble V, Marill K. J Emerg Med 2014;46:46–53 Not only does point-of-care ultrasound expedite diagnosis and management but it also improves patient–physician Ultrasound 2014; 22: 129–130
130
Ultrasound
Volume 22
May 2014
.......................................................................................................................... relationships. Maybe some of our more curmudgeonly medics should take it up. Impact of lung ultrasound on clinical decision making in critically ill patients. Xirouchaki N, Kondili E, Prinianakis G, et al. Intensive Care Medicine 2014;40:57–65 This study of 253 examinations on 189 patients found that lung ultrasound on mechanically ventilated critically ill patients made a big difference to their management in nearly half of cases. In around 20% of cases, the ultrasound examination revealed findings which were not suspected by the physician. Prevalence of right-to-left shunts on transcranial Doppler in chronic migraine and medication-overuse headache. Guo S, Shalchian S, Gerard P, et al. Cephalalgia 2014;34:37–41 By analysing TCD studies in 159 patients from multiple centres, this team concluded that a patent foramen ovale is unlikely to be a causative factor in people experiencing chronic headache.
How ultrasound technologies have expanded and revolutionized research in reproduction in large animals. Ginther OJ. Theriogenology 2014;81:112–25 A fascinating paper reminding us of the massive contribution made by diagnostic ultrasound within the fertility setting but beyond applications for humans.
Hazel Edwards DOI: 10.1177/1742271X14527049
