Objective: We wanted to assess the usefulness of four-dimensional (4D) ultrasonography (US), i.e.... more Objective: We wanted to assess the usefulness of four-dimensional (4D) ultrasonography (US), i.e., real-time three-dimensional US, as an adjunct for performing various US-guided interventional procedures in superficial lesions. Materials and Methods: Thirty-three patients were referred for US-guided interventional procedures for superficial lesions, including core biopsy in 19, fineneedle aspiration in eight, therapeutic drug injection in four and needle puncture in two. The procedures were performed under 4D US guidance. We reviewed the pathologic/cytologic results of the core biopsies or needle aspirations, and also the outcomes of drug injection or needle puncture. Results: For all the patients who underwent 4D US-guided core biopsy, the specimens were adequate for making the pathological diagnosis, and specimens were successfully obtained for those patients who underwent 4D US-guided aspiration. The patients treated with 4D US-guided therapeutic drug injection or needle puncture had a good response. No major procedure-related complications occurred. The procedural times were similar to those procedural times with using two-dimensional US. Conclusion: Combining the two dimensional and 4D US techniques aids the physician when performing US-guided interventional procedures for the superficial lesions.
Breast cancer is the most common cancer and ranks fourth among cancer deaths in women in Taiwan. ... more Breast cancer is the most common cancer and ranks fourth among cancer deaths in women in Taiwan. In 2004, Taiwan's Bureau of Health Promotion, Department of Health and Radiology Society of Republic of China collaborated to implement a program to monitor the quality and trained the people involved in a nationwide biennially mammography screening program for women between 50 and 69 years of age, which was started from a small population trial in 2002. In this study, we assessed the effects of this program by comparing evaluations of the women's mammographic images obtained from Taiwan's Bureau of Health Promotion in Taiwan with whether or not they were listed on Taiwan's National Cancer Registry from 2004 to 2007, to which all pathology confirmed tumors are reported. A total of 311, 193 consecutive mammograms were performed over the four-year period. Although prevalence of confirmed breast cancer was found to 0.63% in the mammograms evaluated the first year (2004), our...
Choledochal cysts rarely present with acute pancreatitis. We report a patient with type I choledo... more Choledochal cysts rarely present with acute pancreatitis. We report a patient with type I choledochal cyst(s) who had concomitant acute frank hemorrhagic pancreatitis. A 14-year-old male noted with a history of recurrent abdominal pain, fever and jaundice. Ultrasonography (US) of abdomen at the Emergency Department depicted distended gall bladder with wall thickening. Apparently dilated intrahepatic ducts (IHDs) and fusiform dilatation of the common bile duct (CBD), and mild dilatation of the pancreatic duct were also noted, suggesting a type I choledochal cyst( ). Computed tomography (CT) demonstrated calcifications in the uncinate process of the pancreas in addition to the similar findings on US. He subsequently underwent choledochal cyst excision with a Roux-en-Y hepaticojejunostomy. After surgical treatment, he has been doing well for 3 years.
Journal of the Chinese Medical Association : JCMA, Apr 1, 2018
Ultrasound is a frequently used diagnostic tool for gallbladder diseases. Polypoid lesions are co... more Ultrasound is a frequently used diagnostic tool for gallbladder diseases. Polypoid lesions are commonly depicted at routine abdominal ultrasonography (US). The characteristics of these lesions vary. Since most early malignant tumors in the gallbladder are asymptomatic, differentiation between malignancy and benignity is crucial. Knowledge of gallbladder polypoid lesions is important so that they can be appropriately included in the differential diagnosis in patients presenting with intra-gallbladder nodules on US. This article summarizes the algorithmic approach to the diagnosis of these lesions and our recent experience with contrast-enhanced US. The clinical and imaging features of gallbladder polypoid lesions are reviewed.
Zhonghua yi xue za zhi = Chinese medical journal; Free China ed, 2001
There are only limited reports on the ultrasound (US) features of breast abscess. The purpose of ... more There are only limited reports on the ultrasound (US) features of breast abscess. The purpose of this paper is to review the US features of breast abscess with emphasis on "hypoechoic rim" sign which is more commonly seen in chronic abscess. In a period of 10 years, 20,998 patients were referred for breast US examinations. Medical records identified 204 patients in whom breast abscess was diagnosed. All patients were examined using high-resolution real-time US scanners. The initial ultrasound reports and hard copy images were all carefully reviewed. The grading of the echogenicity of the abscess was classified from grade 0 to grade 5. The contours of the lesions were described as smooth, macrolobulated, microlobulated, irregular, zigzag, spiculate or indistinct. The wall thickness was measured to document the presence of "hypoechoic rim" which denoted a wall thickness greater than 2 mm. The associated findings and other acoustic phenomena related to the lesion we...
Background: The risk of post-thrombotic syndrome and pulmonary embolism can be increased if there... more Background: The risk of post-thrombotic syndrome and pulmonary embolism can be increased if there is failure to diagnose deep venous thrombosis (DVT) promptly. Emergency physicians (EPs) need a quick and readily available test to diagnose, treat and help them decide whether to discharge or admit DVT patients in a timely manner. The aim of this study was to investigate the value of the non-compressibility ratio of thrombosed veins in DVT patients, and give EPs an objective value to aid them in their decision-making with regard to DVT patients in the emergency department. Methods: We reviewed 34 adult patients with DVT diagnosed by sonography in an emergency department. Medical records including demographic data and sonography results were retrospectively reviewed and analyzed. Results: Mean age was 72.9 ± 16.5 years. Group I comprised 14 patients (41.2%) who had DVT in the popliteal and femoral veins. Group II comprised 8 patients (23.5%) who had DVT isolated to the popliteal vein and 12 patients (35.3%) who had DVT isolated to the femoral vein. Group I had a significantly higher non-compressibility ratio than Group II (93.4 ± 6.2% vs. 80.1 ± 19.2%, p < 0.05). The area under the receiver operating characteristic curve of the non-compressibility ratio between discriminating groups was 0.711 (95% confidence interval, 0.527-0.854; p < 0.05). The clinical prognostic score of Group I was significantly higher than that of Group II (6.2 ± 1.8 vs. 4.1 ± 2.6, p < 0.05). There was a significant positive correlation between the non-compressibility ratio of the thrombosed vein and the clinical prognostic score (p = 0.001). Conclusion: The non-compressibility ratio of the thrombosed vein provides EPs with an objective test to evaluate the severity of DVT and to admit patients for consideration of adverse outcomes. [
Objective: We wanted to assess the usefulness of four-dimensional (4D) ultrasonography (US), i.e.... more Objective: We wanted to assess the usefulness of four-dimensional (4D) ultrasonography (US), i.e., real-time three-dimensional US, as an adjunct for performing various US-guided interventional procedures in superficial lesions. Materials and Methods: Thirty-three patients were referred for US-guided interventional procedures for superficial lesions, including core biopsy in 19, fineneedle aspiration in eight, therapeutic drug injection in four and needle puncture in two. The procedures were performed under 4D US guidance. We reviewed the pathologic/cytologic results of the core biopsies or needle aspirations, and also the outcomes of drug injection or needle puncture. Results: For all the patients who underwent 4D US-guided core biopsy, the specimens were adequate for making the pathological diagnosis, and specimens were successfully obtained for those patients who underwent 4D US-guided aspiration. The patients treated with 4D US-guided therapeutic drug injection or needle puncture had a good response. No major procedure-related complications occurred. The procedural times were similar to those procedural times with using two-dimensional US. Conclusion: Combining the two dimensional and 4D US techniques aids the physician when performing US-guided interventional procedures for the superficial lesions.
Breast cancer is the most common cancer and ranks fourth among cancer deaths in women in Taiwan. ... more Breast cancer is the most common cancer and ranks fourth among cancer deaths in women in Taiwan. In 2004, Taiwan's Bureau of Health Promotion, Department of Health and Radiology Society of Republic of China collaborated to implement a program to monitor the quality and trained the people involved in a nationwide biennially mammography screening program for women between 50 and 69 years of age, which was started from a small population trial in 2002. In this study, we assessed the effects of this program by comparing evaluations of the women's mammographic images obtained from Taiwan's Bureau of Health Promotion in Taiwan with whether or not they were listed on Taiwan's National Cancer Registry from 2004 to 2007, to which all pathology confirmed tumors are reported. A total of 311, 193 consecutive mammograms were performed over the four-year period. Although prevalence of confirmed breast cancer was found to 0.63% in the mammograms evaluated the first year (2004), our...
Choledochal cysts rarely present with acute pancreatitis. We report a patient with type I choledo... more Choledochal cysts rarely present with acute pancreatitis. We report a patient with type I choledochal cyst(s) who had concomitant acute frank hemorrhagic pancreatitis. A 14-year-old male noted with a history of recurrent abdominal pain, fever and jaundice. Ultrasonography (US) of abdomen at the Emergency Department depicted distended gall bladder with wall thickening. Apparently dilated intrahepatic ducts (IHDs) and fusiform dilatation of the common bile duct (CBD), and mild dilatation of the pancreatic duct were also noted, suggesting a type I choledochal cyst( ). Computed tomography (CT) demonstrated calcifications in the uncinate process of the pancreas in addition to the similar findings on US. He subsequently underwent choledochal cyst excision with a Roux-en-Y hepaticojejunostomy. After surgical treatment, he has been doing well for 3 years.
Journal of the Chinese Medical Association : JCMA, Apr 1, 2018
Ultrasound is a frequently used diagnostic tool for gallbladder diseases. Polypoid lesions are co... more Ultrasound is a frequently used diagnostic tool for gallbladder diseases. Polypoid lesions are commonly depicted at routine abdominal ultrasonography (US). The characteristics of these lesions vary. Since most early malignant tumors in the gallbladder are asymptomatic, differentiation between malignancy and benignity is crucial. Knowledge of gallbladder polypoid lesions is important so that they can be appropriately included in the differential diagnosis in patients presenting with intra-gallbladder nodules on US. This article summarizes the algorithmic approach to the diagnosis of these lesions and our recent experience with contrast-enhanced US. The clinical and imaging features of gallbladder polypoid lesions are reviewed.
Zhonghua yi xue za zhi = Chinese medical journal; Free China ed, 2001
There are only limited reports on the ultrasound (US) features of breast abscess. The purpose of ... more There are only limited reports on the ultrasound (US) features of breast abscess. The purpose of this paper is to review the US features of breast abscess with emphasis on "hypoechoic rim" sign which is more commonly seen in chronic abscess. In a period of 10 years, 20,998 patients were referred for breast US examinations. Medical records identified 204 patients in whom breast abscess was diagnosed. All patients were examined using high-resolution real-time US scanners. The initial ultrasound reports and hard copy images were all carefully reviewed. The grading of the echogenicity of the abscess was classified from grade 0 to grade 5. The contours of the lesions were described as smooth, macrolobulated, microlobulated, irregular, zigzag, spiculate or indistinct. The wall thickness was measured to document the presence of "hypoechoic rim" which denoted a wall thickness greater than 2 mm. The associated findings and other acoustic phenomena related to the lesion we...
Background: The risk of post-thrombotic syndrome and pulmonary embolism can be increased if there... more Background: The risk of post-thrombotic syndrome and pulmonary embolism can be increased if there is failure to diagnose deep venous thrombosis (DVT) promptly. Emergency physicians (EPs) need a quick and readily available test to diagnose, treat and help them decide whether to discharge or admit DVT patients in a timely manner. The aim of this study was to investigate the value of the non-compressibility ratio of thrombosed veins in DVT patients, and give EPs an objective value to aid them in their decision-making with regard to DVT patients in the emergency department. Methods: We reviewed 34 adult patients with DVT diagnosed by sonography in an emergency department. Medical records including demographic data and sonography results were retrospectively reviewed and analyzed. Results: Mean age was 72.9 ± 16.5 years. Group I comprised 14 patients (41.2%) who had DVT in the popliteal and femoral veins. Group II comprised 8 patients (23.5%) who had DVT isolated to the popliteal vein and 12 patients (35.3%) who had DVT isolated to the femoral vein. Group I had a significantly higher non-compressibility ratio than Group II (93.4 ± 6.2% vs. 80.1 ± 19.2%, p < 0.05). The area under the receiver operating characteristic curve of the non-compressibility ratio between discriminating groups was 0.711 (95% confidence interval, 0.527-0.854; p < 0.05). The clinical prognostic score of Group I was significantly higher than that of Group II (6.2 ± 1.8 vs. 4.1 ± 2.6, p < 0.05). There was a significant positive correlation between the non-compressibility ratio of the thrombosed vein and the clinical prognostic score (p = 0.001). Conclusion: The non-compressibility ratio of the thrombosed vein provides EPs with an objective test to evaluate the severity of DVT and to admit patients for consideration of adverse outcomes. [
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