In May 2001, the world's first CT-XR hybrid suite for image guided therapy in paediatrics was put into operation. The new Centre for Image Guided Therapy (IGT) at The Hospital for Sick Children allows surgeons and interventional radiologists to do something that's never been done before - work side-by-side when diagnosing and treating children. A total of 4 interventional suites were equipped…
Most babies are born healthy, but there is still a small risk for all women to give birth to a baby with some type of anomaly. Ultrasound has proven to be one of the most reliable procedures to prenatally diagnose some of these conditions. Ultrasound can be used during the entire pregnancy, but in the first trimester ultrasound examinations are, as a rule, used to exactly calculate the pregnancy,…
Without doubt, the B-mode imaging is the most important examination method in prenatal ultrasound. Well over 90% of detectable congenital anomalies can be recognised using the two-dimensional realtime imaging method. Hence, paramount importance is certainly ascribed to the quality of the B-mode image in an ultrasound system. In addition, other ultrasound modalities help us to considerably enhance…
As part of a Welsh Assembly Government sponsored exercise for the replacement of radiology equipment within NHS Wales, Toshiba Medical Systems Limited was awarded a framework agreement for a 2-year period for the supply of ultrasound equipment until April 2005. Following an evaluation exercise undertaken by representative clinical staff within NHS Wales, Toshiba were chosen as the preferred…
Chromosomal abnormalities are major causes of perinatal death and childhood handicap. Consequently, the detection of chromosomal disorders constitutes the most frequent indication for invasive prenatal diagnosis. However, invasive testing, by amniocentesis, chorionicvillus sampling (CVS) or cordocentesis, is associated with a risk of miscarriage of about 1% and therefore these tests are carried…
Twenty years ago, during the construction of the Henri Duffaut Hospital in the community of Avignon, on the banks of the Durance, we transferred our radiology service at the Hospital St. Marthe (today the University Centre of Avignon, classified as a historical monument by the government) to the first floor of the new hospital. Over the years, our service has been restructured and adapted to the…
Since the beginning of the 90s, sonography has been a solid diagnostic pillar in ophthalmology centers, but it is also used by related medical disciplines, such as pediatrics, whose patients require ophthalmological treatment. For all age groups, the fundus of the eye, and especially the optic disk, is well-suited for high-frequency sonography with linear transducers. This type of examination…
The rare disease Takayasu's arteritis (TA) belongs to the vasculitis group of diseases and is also known as inflammatory aortic arch syndrome or as pulseless disease because of its typical clinical picture. The pathological-anatomical manifestations include inflammatory transformation of the media and adventitia with the appearance of giant cells, hence the term giant cell arteritis is also used.…
Ultrasound contrast agents (USCA) or echo enhancers consist of minute gas containing microbubbles that have a high reflectivity when exposed to an ultrasound field. The history of USCA started in the mid of the 1960s. The cardiologist Joyner performed echo cardiography during the injection of saline solution into the aortic root via a catheter. During the injection he observed bright signals on…
Xario, Toshiba's new ultrasound system, has been tested at the Charité University Hospital, Berlin, by Dr Thomas Fischer, radiologist and ultrasound specialist. In a VISIONS interview, we asked Dr Fischer for his observations.
In October 2004 Toshiba introduced Xario, its new, premium high-end ultrasound scanner to the market and exhibited the system at major congresses throughout Europe. The following article gives an overview of its features and functions and provides an insight into the latest technological developments for meeting the rapidly changing demands of today's challenging clinical practice.
It sounds quite far fetched to connect ultrasound examinations to dolphins or does it? In Europe there are about 300 dolphins under human care and with most of these animals ultrasound examinations are quite common.
Three-dimensional transrectal ultrasonography (3D-TRUS) allows accurate 3D examination of pathological structures and prediction of extracapsular tumor extension.
It has long been known that hypoxia at high altitudes leads to an increase of pulmonaryarterial pressure. For sensitive persons, one crucial factor for the development of HAPE is the overwhelming rise in pressure in the pulmonary circulation. Using right heart catheterization average pulmonary-arterial pressures of 60 mmHg were encountered in earlier studies of HAPE patients. A pressure increase…
Sonography is an increasingly used examination procedure for the diagnosis of illnesses of the hand, especially of the soft tissues. Sonoanatomic assessment of the functional structures (Tab. 1) sometimes allows the exclusion of various differential diagnoses. However, this requires quite a bit of experience on the part of the examiner. The assessment of the peripheral nerves can be difficult -…
Due to echogenicity differences in comparison with the surrounding liver tissue conventional B-mode-imaging sonography permits the unambiguous classification of the frequently occurring typical liver cysts (criteria: round, echo-free, smoothly demarcated, with edge shadows and sound through transmission) and calcifications (highly reflective, acoustic shadows). The detection and characterization…
The following two articles look at the advantages of a new ultrasound technique in prenatal diagnostics: Advanced Dynamic Flow (ADF). While the authors use ADF for different purposes - K. S. Heling applies ADF for general vascular imaging and R. Schmitz focuses on fetal liver tumours and a fetal aneurysm in the vein of Galen - they both arrive at remarkably similar conclusions. But read for…
Imaging of blood flow with colour Doppler sonography is an established method in prenatal medicine. Today, there are several techniques which offer colour visualisation whose quality is on a par with that of the B-mode. One example of such a technique is Advanced Dynamic Flow (ADF). Looking at two cases, we will describe the clinical use of ADF to visualise fetal vascular tumours. The quality of…
Echo-enhanced ultrasound is a newly available imaging modality for use in the differential diagnosis of pancreatic tumours. Ductal carcinomas are often hypovascularised compared with the surrounding tissue. On the other hand, neuroendocrine tumours ar hypervascularised lesions. Tumours associated with pancreatitis have a different vascularisation pattern depending upon their inflammation and…
For the last six months we have been using the Aplio system in sonography for children and adolescents. The following report describes our experiences with this system using a wide range of probe and special applications.
In 1981 the company embarked on a path of very rapid growth. Already in the first year of operation 30 million euro were realized mainly with ultrasound equipment. At that time, 150 people were working for the company which was active in several European countries.
It was the perfect tournament. The crowd cheered enthusiastically, the players gave their best, and there was no lack of celebrities. With a 93,000 strong audience, this year's Beach Volleyball A1 Grand Slam Tournament in Klagenfurt, Austria, proved to be a top-level sporting event. Top beach volleyball players such as Clemens Doppler delivered exciting games and ensured maximum audience…
In Germany, a comprehensive reimbursement system designed around Diagnosis Related Groups (DRGs) was introduced following the Health Reform Act of 2000. The previous method of payment, wherein the number of treatment days was multiplied by the amount allowed per treatment day, was discarded. The new DRG-based payment system requires the optimization of patient treatment, from admission to…
Ultrasound examination of the renal tract is one of the primary imaging methods to verify the presence of urinary obstruction, calculi, neoplasms, and other focal findings. This short article summarises important aspects of sonography for some typical renal abnormalities without claiming to be a comprehensive treatment. Since sonography is frequently nonspecific, clinical laboratory findings are…
In the last 25 years, fetal echocardiography has become established as an integral component of prenatal medicine. Structural heart defects are found in approx. 0.8% of all foetuses. They are consequently comparatively frequent and head the list of isolated fetal organ malformations. Routine screening of the four-chamber view and the outflow tract allows the experienced investigator to detect…