Three-Dimensional Sonography of Biliary Tract Disorders

Web-Based GPU-Accelerated Application for Multiplanar Reconstructions from Conventional 2D Ultrasound

PURPOSE

 In ultrasound education there is a need for interactive web-based learning resources. The purpose of this project was to develop a web-based application that enables the generation and exploration of volumetric datasets from cine loops obtained with conventional 2D ultrasound.

MATERIALS AND METHODS

 JavaScript code for ultrasound video loading and the generation of volumetric datasets was created and merged with an existing web-based imaging viewer based on JavaScript and HTML5. The Web Graphics Library was utilized to enable hardware-accelerated image rendering.

RESULTS

 The result is a web application that works in most major browsers without any plug-ins. It allows users to load a conventional 2D ultrasound cine loop which can subsequently be manipulated with on-the-fly multiplanar reconstructions as in a Digital Imaging and Communications in Medicine (DICOM) viewer. The application is freely accessible at (http://www.castlemountain.dk/atlas/index.php?page=mulrecon&mulreconPage=sonoviewer) where a demonstration of web-based sharing of generated cases can also be found.

CONCLUSION

 The developed web-based application is unique in its ability to easily perform loading of one's own ultrasound clips and conduct multiplanar reconstructions where interactive cases can be shared on the Internet.

Ultrasound Image Based Human Gallbladder 3D Modelling along with Volume and Stress Level Assessment

Purpose

Three-dimensional (3D) gallbladder (GB) geometrical models are essential to GB motor function evaluation and GB wall biomechanical property identification by employing finite element analysis (FEA) in GB disease diagnosis with ultrasound systems. Methods for establishing such 3D geometrical models based on static two-dimensional (2D) ultrasound images scanned along the long-axis/sagittal and short-axis/transverse cross-sections in routine GB disease diagnosis at the beginning of emptying phase have not been documented in the literature so far.

Methods

Based on two custom MATLAB codes composed, two images were segmented manually to secure two sets of the scattered points for the long- and short-axis GB cross-section edges; and the points were best fitted with a piecewise cubic spline function, and the short-axis cross-section edges were lofted along the long-axis to yield a 3D geometrical model, then GB volume of the model was figured out. The model was read into SolidWorks for real surface generation and involved in ABAQUS for FEA.

Results

3D geometrical models of seven typical GB samples were established. Their GB volumes are with 15.5% and − 4.4% mean errors in comparison with those estimated with the ellipsoid model and sum-of-cylinders method but can be correlated to the latter very well. The maximum first principal in-plane stress in the 3D models is higher than in the ellipsoid model by a factor of 1.76.

Conclusions

A numerical method was put forward here to create 3D GB geometrical models and can be applied to GB disease diagnosis and GB shape analysis with principal component method potentially in the future.

Ultrasound findings in paediatric cholestasis: how to image the patient and what to look for

Paediatric biliary tract and gallbladder diseases include a variety of entities with a wide range of clinical presentations. Cholestasis represents an impaired secretion of bilirubin by hepatocytes, manifesting with high blood levels of conjugated bilirubin and jaundice. Various causes may be involved, which can be recognised analysing blood tests and hepatobiliary imaging, while sometimes liver biopsy or surgery may be necessary. High-resolution real-time ultrasonography is an important tool for differentiation of obstructive and non-obstructive causes of jaundice in infants and children. In this paper, we briefly review the normal anatomy and the ultrasound aspects of main pathologies affecting gallbladder and biliary tree in neonatal and paediatric age.

Superb microvascular imaging (SMI) findings of splenic artery pseudoaneurysm: a report of two cases

Splenic artery pseudoaneurysm (SAPA) is a relatively infrequently encountered but clinically important vascular change, because it carries a high risk of rupture that warrants prompt treatment regardless of its size. Thus, sufficient knowledge is indispensable when seeing chronic pancreatitis patients or post-traumatic patients. Here, we report two such cases. The first case was a 52-year-old woman known to have chronic pancreatitis who presented with hematemesis and hemodynamic instability in which X-ray computed tomography (CT) and color Doppler sonography (CDS) had difficulty visualizing slow blood flow in SAPA, but superb microvascular imaging (SMI) clearly demonstrated the slow blood flow in SAPA, prompting our therapeutic decision to perform rapid embolization. The second case was a 51-year-old woman with post-traumatic SAPA in which 3D SMI enabled us to understand more clearly the topographic relationship between multiple SAPAs as compared with conventional US, leading to a decision to provide immediate surgical treatment. SMI was thought to provide a new insight into the US diagnosis of SAPA. When examining patients suspected of having a SAPA, SMI is an indispensable diagnostic tool at present.