Journal of Medical Ultrasound RSS feed: Current Issue. The Journal of Medical Ultrasound is the peer-reviewed publication of the Asian Federation of Societies for Ultrasound in Medicine and Biology, and the Chinese Taipei Society of Ultrasound in Medicine. Its aim is to promote clinical and scientific research in ultrasonography, and to serve as a channel of communication among sonologists, sonographers, and medical ultrasound physicians in the Asia-Pacific region and wider international community. The Journal invites original contributions relating to the clinical and laboratory investigations and applications of ultrasonography. http://www.jmu-online.com/?rss=yesElsevier Inc.en © 2012 Published by Elsevier Inc. All rights reserved. Journal of Medical Ultrasound0929-6441201March 2012 © 2012 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.jmu-online.com/article/PIIS0929644112000136/abstract?rss=yesEditorial Board10.1016/S0929-6441(12)00013-6Journal of Medical Ultrasound 20, 1 (2012)2012-03-01Journal of Medical Ultrasound2012-03-01201S0929-6441(12)X0002-Xiihttp://www.jmu-online.com/article/PIIS0929644112000021/abstract?rss=yesBreast cancer (BC) has become a global disease among women. Cost-effective strategies in reducing mortality caused by BC are highly desirable. Here, we suggest a working program based on an overall evaluation of the shortcomings and advantages of the current strategy for BC screening in Taiwan. From 1995 to 2002, cervical cancer was the most frequent cancer in women in Taiwan. However, invasive BC has moved from the second-most to the most frequent cancer since 2003. The incidence of BC increased by 14.69% between 2003 and 2008. In the same time interval, the incidence of cervical cancer decreased by 4.59%. Age analysis for BC incidence showed that 11% were at a relatively young age (30–39 years) and the peak incidence was in the group aged 40–49 years. Furthermore, only 31% of patients were at stage I according to data for newly diagnosed patients at National Taiwan University Hospital for 2004–2009. With the increase in pregnancy at an advanced maternal age, obstetrician–gynecologists should be alert to the possibility of coexisting BC and pregnancy. To facilitate early detection of BC, a campaign for “Three points examined together” should be implemented. Obstetrician–gynecologists should perform breast examination including palpation and ultrasound examination at the same time as the annual Pap smear. Mammography should be performed every 2–3 years or when indicated. If suspicious lesions are found, patients should be referred to a breast imaging laboratory, where a definitive diagnosis can be established. For confirmed cases of BC, appropriate surgery, chemotherapy and radiotherapy should be provided. In short, active participation of obstetrician–gynecologists is a must in the campaign against BC in Taiwan.Strategy for Breast Cancer Screening in Taiwan: Obstetrician–Gynecologists Should Actively Participate in Breast Cancer ScreeningLi-Yun Chang, Ya-Ling Yang, Ming-Kwang Shyu, Hsiao-Lin Hwa, Fon-Jou Hsieh10.1016/j.jmu.2012.01.001Journal of Medical Ultrasound 20, 1 (2012)2012-02-20Journal of Medical Ultrasound2012-02-20201S0929-6441(12)X0002-XReview Articles17http://www.jmu-online.com/article/PIIS0929644112000094/abstract?rss=yesCapacitive micromachined ultrasonic tranducers (cMUTs) have recently emerged as an alternative to conventional piezoelectric transducers. They offer many advantages in terms of bandwidth, fabrication of layer arrays, efficiency, and sensitivity. This research presents the principles of operation, fabrication process steps, and application of the capacitive micromachined ultrasound transducer. The study also demonstrates in detail the collapse voltage design parameter of a cMUT membrane. Several important applications are presented to show the feasibility of using cMUTs which are demonstrated by imaging examples in immersion and air due to the cMUT capability of producing large bandwidth (123% fractional bandwidth) and lower impedance mismatch. Finally, the advantages of three-dimensional echographic images based on moving ultrasound linear array its technique are discussed in detail and compared with those of two-dimensional optical hand geometry.Capacitive Micromachined Ultrasonic Transducers: Technology and ApplicationMuhammed Sabri Salim, M.F. Abd Malek, R.B.W. Heng, K.M. Juni, Naseer Sabri10.1016/j.jmu.2012.02.001Journal of Medical Ultrasound 20, 1 (2012)2012-03-29Journal of Medical Ultrasound2012-03-29201S0929-6441(12)X0002-XReview Articles831http://www.jmu-online.com/article/PIIS0929644112000033/abstract?rss=yesMechanical dysfunction of left atrium (LA) could be documented by tissue Doppler and speckle tracking echocardiography in patients with congestive heart failure (CHF). This study included 28 CHF, 46 untreated hypertension (HT), and 52 normal (NM) individuals with normal sinus rhythm. LA volumes and emptying fraction (LAEF) were measured by biplane area-length method. Peak LA strain (LAS) and strain rate (LASR) measured from speckle tracking echocardiography were identified as the peak negative deflection after P-wave. Tissue velocity (LATV) and tissue Doppler-derived strain (LATS) of LA were also used as indices of LA mechanical function. LAEF, LAS, LASR, LATV, and LATS were significantly lower in CHF than in HT and NM. After multivariate analysis controlling for age and sex, LAS, LASR, and LATV were still significantly lower in CHF. LASR was significantly correlated with LAEF. In conclusion, LA mechanical function was decreased in patients with CHF.Decreased Mechanical Function of Left Atrium Assessed by Speckle Tracking and Tissue Doppler Echocardiography in Patients with Congestive Heart FailureWei-Chuan Tsai, Yen-Wen Liu, Yao-Yi Huang, Liang-Miin Tsai, Li-Jen Lin10.1016/j.jmu.2012.01.002Journal of Medical Ultrasound 20, 1 (2012)2012-02-27Journal of Medical Ultrasound2012-02-27201S0929-6441(12)X0002-XOriginal Article3242http://www.jmu-online.com/article/PIIS0929644112000057/abstract?rss=yesIncreased renal cortical echogenicity can be seen in patients with various underlying renal abnormalities. However, there are no reports of hyperechoic cortex associated with volume depletion until now. Here, we describe two cases of hyperechoic cortex caused by severe dehydration due to liver abscess and acute salmonellosis which lead to nausea, vomiting, and diarrhea. After administering large amounts of fluid supplements, the renal functions dramatically recovered and the echogenicity of the renal cortex returned to normal. Redistribution of renal blood flow and cortical ischemia may play a role in changes in echogenicity that occur in the renal cortex. Additionally, studies on increased renal cortical echogenicity and dehydration are reviewed.Transient Hyperechoic Renal Cortex Caused by Dehydration and Induced Acute Renal Failure in Two Patients with Intra-Abdominal InfectionChih-Chiang Chien, Yi-Hong Chou, Chui-Mei Tiu, Chih-Ching Lin, Wu-Chang Yang, Hsin-Kai Wang, Yi-Chen Lai, Hong-Jen Chiou10.1016/j.jmu.2012.01.004Journal of Medical Ultrasound 20, 1 (2012)2012-03-30Journal of Medical Ultrasound2012-03-30201S0929-6441(12)X0002-XCase Reports4346http://www.jmu-online.com/article/PIIS0929644112000069/abstract?rss=yesSubdermal contraceptive implants should be removed after the maximum duration of action or whenever desired. In some circumstances, such as improper insertion, migration, or fibrosis of the implant, the implant might become nonpalpable and the use of imaging techniques are required to localize and remove it. Ultrasonography with high-frequency transducers is recommended as the first-line method for localization. In this report, the ultrasonographic findings of a nonpalpable implant and the results of ultrasonography-guided skin localization are described.Detection and Localization of a Nonpalpable Subdermal Contraceptive Implant Using Ultrasonography: A Case ReportKamil Gurel, Kaan Gideroglu, Ata Topcuoglu, Safiye Gurel, Ibrahim Saglam, Sukru Yazar10.1016/j.jmu.2012.01.005Journal of Medical Ultrasound 20, 1 (2012)2012-02-27Journal of Medical Ultrasound2012-02-27201S0929-6441(12)X0002-XCase Reports4749http://www.jmu-online.com/article/PIIS0929644112000082/abstract?rss=yesPercutaneous retrieval of intravascular foreign body is a safe and effective procedure with the use of various imaging modalities. However, fluoroscopy is used extensively in most of the procedures, because the broken fragments which gets retained in intravascular compartments are radiopaque. In our case, the broken fragment, which was retained in the internal jugular vein, was radiolucent. Retrieval of a radiolucent foreign body under fluoroscopy is not only difficult but also can lead to serious sequelae during retrieval. We report such a case of real time ultrasound-guided retrieval of the foreign body in adjunct with fluoroscopy.Percutaneous Intraluminal Intravascular Retrieval of Foreign Body Under Ultrasound GuidanceKedar Gopal Sharbidre, Kishor Laddharam Rajpal, Vivek Kisan Ukirde, Rajashekar Gali10.1016/j.jmu.2012.01.007Journal of Medical Ultrasound 20, 1 (2012)2012-03-26Journal of Medical Ultrasound2012-03-26201S0929-6441(12)X0002-XCase Reports5053http://www.jmu-online.com/article/PIIS0929644112000070/abstract?rss=yesRosai-Dorfman disease (RDD) is a rare and benign histiocytic proliferative disorder of unknown etiology. It can affect all age groups, particularly young adults. The typical clinical manifestation is painless, bilateral, massive cervical lymphadenopathy with or without extra nodal involvement, along with fever, weight loss, and night sweats. However, thyroid involvement is very uncommon. The ultrasonographic manifestations of RDD are rarely reported. A case of RDD involving the thyroid that was recorded in our hospital PACS system during 2002–2010 is reported here, which was initially misdiagnosed as non-Hodgkin’s lymphoma (NHL). In our case, ultrasonography revealed diffuse enlargement of whole thyroid glands with heterogeneous hypoechogenicity. Areas of linear hyperechogenicity were noted on the sonograms with multiple enlarged nodes over the cervical, supraclavicular, and submandibular areas. Though not specific, in order to avoid unnecessary surgery or a total thyroidectomy, ultrasonography and ultrasonography-guided core needle biopsy should be performed to establish an accurate diagnosis.Sonographic Manifestation of Thyroid's Rosai-Dorfman DiseaseWen Wu Ling, Parajuly Shyam Sundar, Yan Luo, Yong Jiang, Di Ming Cai10.1016/j.jmu.2012.01.006Journal of Medical Ultrasound 20, 1 (2012)2012-02-27Journal of Medical Ultrasound2012-02-27201S0929-6441(12)X0002-XCase Reports5457http://www.jmu-online.com/article/PIIS0929644112000045/abstract?rss=yesAccurate distinction of internal carotid artery (ICA) severe stenosis from occlusion in patients with acute stroke is crucial because carotid revascularization may reduce the risk of recurrent stroke. We report a 68-year-old man who had acute onset of right hemiparesis and hemiparesthesia. Head magnetic resonance imaging (MRI) on the first day and computed tomography (CT) angiography the next day showed total occlusion or pseudo-occlusion of the left ICA. However, carotid ultrasonography at around the same time clearly demonstrated focal severe stenosis of the left ICA orifice and catheter carotid angiography later confirmed the findings. The patient received angioplasty and stenting of the left ICA 3 weeks after stroke, and his follow-up course was uneventful. The case report highlights the value of carotid ultrasonography in distinguishing critical stenosis from occlusion of the carotid artery in patients with acute ischemic stroke.Distinguishing Critical Stenosis from Occlusion of the Internal Carotid Artery by Carotid Duplex in a Patient with Acute Ischemic StrokeKai-Hsiang Chen, Chi-Chao Chao, Sung-Chun Tang, Jiann-Shing Jeng10.1016/j.jmu.2012.01.003Journal of Medical Ultrasound 20, 1 (2012)2012-02-20Journal of Medical Ultrasound2012-02-20201S0929-6441(12)X0002-XCase Reports5860http://www.jmu-online.com/article/PIIS0929644112000100/abstract?rss=yesA woman aged 27 years, gravida 2, para 1, was referred for genetic counseling at 27 weeks of gestation because of reduced fetal movement, scoliosis, and clubfoot detected by ultrasonography. She and her husband were nonconsanguineous and healthy and had a son aged 3 years. The woman did not abuse drugs, and she did not have any metabolic conditions or neuromuscular disorders, such as myasthenia gravis, during this pregnancy. Amniocentesis revealed a karyotype of 46,XY, and array comparative genomic hybridization analysis revealed no genomic imbalance. A level 2 ultrasound at 29 weeks of gestation revealed a singleton male fetus with fetal biometry equivalent to 29 weeks, reduced fetal movement, severe kyphoscoliosis, pulmonary hypoplasia, and arthrogryposis (). Magnetic resonance imaging (MRI) study additionally showed multiple pterygia (). The fetus had intrauterine fetal death, and a 1234-g fetus was delivered with down-slanting palpebral fissures, hypertelorism, a depressed nasal bridge, low-set ears, micrognathia, joint contractures, and multiple pterygia (). Radiographic studies showed kyphoscoliosis and a restrictive left chest (). Molecular analysis revealed no mutation in the genes of CHRNA1, CHRND, CHRNG, RAPSN, or DOK7.Prenatal Ultrasound and Magnetic Resonance Imaging Findings of Fetal Akinesia Deformation Sequence with Multiple Pterygium SyndromeChih-Ping Chen, Jin-Chung Shih, Chen-Yu Chen, Schu-Rern Chern, Jun-Wei Su, Wayseen Wang10.1016/j.jmu.2012.02.002Journal of Medical Ultrasound 20, 1 (2012)2012-03-27Journal of Medical Ultrasound2012-03-27201S0929-6441(12)X0002-XResearch Letter6163