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When Sterility is Indicated... There’sOnly OneChoice: Sterile Aquasonic®100 Ultrasound Transmission Gel. The World Standard for sterile ultrasound transmission. • Easy-to-open *Tyvek® overwrap Guarantees sterility of the inner foil pouch and the gel within • Consistent quality Aqueous, non-staining • Acoustically correct • Non-injurious to transducers • Available in 20 gram overwrapped foil pouches, 48 sterile pouches per box © 2014 Parker Laboratories, Inc. Give us your opinion and you could WIN $125 Visit www.parkerlabs.com/sa100q.php ISO 13485:2003 *Trademark of Dupont® Visit us at MEDICA 9D41 and RSNA #1711 European_Hospital_SterileA100_93014.qxp_EuropeanHospital_Sterile 10/6/14 12:20 PM Page 1 www.european-hospital.com ULTRASOUND A senior consultant at Caritas Hospital in Bad Mergentheim, Germany, since 2002, Christoph Frank Dietrich is also the current President of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). With a scholarship from the German National Academic Foundation, he studied at the Medical University Hannover and, in 1988, passed the US-American FMGEMS exam. A specialist physician for internal medicine since 1997, he received his habilitation in 1999. Professor Dietrich is also a certified specialist in several other disciplines such as gastroenterology and haematology/oncology. After gaining his medical degree and doctorate at the University of Cologne in 1994, Horst Kinkel began his career at Düren Hospital. He qualified as a specialist for internal medicine in 2001 and was awarded the Instructor Level II of the German Society of Ultrasound in Medicine in 2004. At the end of 2008 he became Assistant Director of Medical Clinic II at Düren Hospital, where his focus is on contrast ultrasound, interventional ultrasound, haepatology and chronic inflammatory bowel disease. Dr Kinkel is a member of numerous scientific societies, co-author of textbooks and of an interactive instructional CD for ultrasound. Refinements and advancements galore Continuity, consistency and clinical benefits on shear wave elastography exams of kidney, spleen and pancreas are promising, albeit requiring further research. Professor Dietrich: ‘With regard to the pancreas, real-time elastography has up to now a higher value, since we only have to find out whether a certain tissue region is harder or softer compared to surrounding tissue to be able to tell whether a tumour is present or not. Thus colour coding with blue indicating hard tissue and red indi- cating soft tissue is sufficient.’ In essence an upgraded flagship ultrasound scanner is a new system Microcirculation in a parathyroid adenoma with monochrome SMI (mSMI) Vascular architecture in a focal, nodular hyperplasia with mSMI Terminal ileitis in Crohn’s Disease with mSMI The Aplio, Toshiba’s flagship ultra- sound scanner, has been extensively advanced and essentially turned into a new system. The highly innova- tive Japanese company in imag- ing diagnostics has refined the successful Aplio series of scan- ners and introduced it internally in Frankfurt at the beginning of October. International clinicians who were given the opportunity to test the equipment before the launch were enthusiastic about the precise imaging, compact and smart design and the traditionally high process- ing quality. Gastroenterologist and liver specialist Dr Horst Kinkel, Assistant Director of the Medical Clinic II at Düren Hospital, con- firmed: ‘Compared to the previous version of the Aplio, the technology has become more sophisticated and powerful.’ With its innovative technologies, unique applications and a newly developed hardware and software architecture, Aplio raises the bar in ultrasound diagnostics. Precision imaging, differential imaging and other technologies based on high- density beamforming have advanced ultrasound imaging. The intuitive and flexible operational concept iStyle simplifies complex examina- tion processes. QuickScan facilitates fast patient- specific optimisation in the B-image and Doppler. The 3-D FlyThru Tool has been further perfected and is now prob- ably a competitor for hysteroscopy in gynaecological examinations. The real-time fusion of CT and MRI images with ultrasound scans has become faster and easier. The new advanced real-time appli- cations in turn expand the diagnos- tic spectrum and provide additional information to the user through parametric visualisation of tissue changes. The new shear-wave elas- tography function supports the localisation and assessment of stiff- ness of tissue inside the body with high precision, sensitivity and repro- ducibility. The different grades of elasticity can be visualised with colour coding in parametric images and, importantly, can also be quan- tified – an exciting technology to assess liver diseases such as fibrosis. SMI with and without contrast media With the help of special new algo- rithms the platinum version of the Aplio can show even the smallest amounts of contrast media selec- tively in the contrast-imaging mode, making it possible to visualise the finest vascular structures and sub- tle blood perfusion in lesions and organs. The new Superb Micro Vascular Imaging (SMI) on the other hand shows the blood flow in the vessels right down to sub-millimetre levels – without the addition of contrast media. With the addition of contrast media even in the smallest dose the resolution and sensitivity for blood flow is increased to levels previously unattainable. This facili- tates new opportunities for diagno- sis in different clinical applications. SMI visualises organ perfusion right down to the surface layers or the complete vascular architecture in lymph nodes and indeterminate space-occupying lesions.‘This means that, in the future, it will probably be possible to use contrast media more efficiently,’ Kinkel hopes. This obviously has financial but above all timesaving advantages: ‘All I have to do to utilise SMI is press a button. However, the administration of con- trast media, necessitates the avail- ability of syringes and emergency equipment.’ he adds. ‘The scanner shows me at the touch of a button whether there is something there or not – this is a big advantage in this technology. Therefore I rate this innovation so highly – it makes my daily clinical routine easier.’ Detail resolution provides diagnostic safety ‘SMI is a new Doppler-technology with the advantage that tissue arte- facts, which normally interfere with the colour Doppler image and make it unusable, can be extremely effi- ciently suppressed,’ he explains. ‘SMI facilitates high detail resolu- tion and a high frame rate. This provides the doctor with improved morphological understanding and therefore more assurance and safety in making a diagnosis. ‘The complex SMI algorithms make it possible to analyse echo signals and to achieve a distinct dif- ferentiation between blood flow and tissue artefact. ‘At the same time they make it possible to recognise the correla- tions of tissue structures more clear- ly, which helps, for example, in the diagnosis of patients with abscesses resulting from inflammatory bowel diseases, for example diverticulitis. ‘Now I can determine far more precisely whether there is oedema- tous tissue, or still healthy, perisig- moid tissue without the presence of abscesses; or I can recognise tissue that’s only of low echogenicity in the normal image despite being well perfused. This,’ Kinkel concludes, has a large impact on my treatment of patients.’ 7 European_Hospital_SterileA100_93014.qxp_EuropeanHospital_Sterile 10/6/1412:20 PM Page 1

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