3601

Ultrasound-guided transthoracic biopsy of pleural and juxta-pleural lesionsYong HS, Woo OH, Oh Y-W, Kang E-Y, Korea University, GuroHospital, Korea; Korea University, Anam Hospital, Korea

Ultrasound-guided transthoracic biopsy is well suited for the samplingof those pleural, peripheral lung, and anterior mediastinal lesions thatprovide an adequate acoustic window. We included 28 patients (male:18, female:10, mean age: 57.8 y) who underwent US guided fine needleaspiration or cutting needle biopsy on pleural or juxta-pleural lesionswithout pleural effusion. These lesions consisted of pleural nodules(11), peripheral lung masses (13), and anterior mediastinal masses(four). Pleural, peripheral lung and anterior mediastinal lesions weregenerally hypoechoic relative to their surrounding tissues. All of thesepatients produced positive histologic results (100%). The histologicresults were tuberculosis (three), squamous cell carcinoma (three),adenocarcinoma (three), small cell carcinoma (five), metastatic carci-noma (five), bacterial pneumonia (five), neurogenic tumor (one), lym-phoma (one), large cell neuroendocrine carcinoma (one) and solitaryfibrous tumor of pleura (one). No procedure related complication suchas pneumothorax or bleeding was accompanied, despite using cuttingbiopsy. US-guided biopsy of pleural and juxta-pleural lesions is verysafe and accurate procedure to obtain histologic specimen.

3602

Carotid atherosclerosis, intracranial artery stenosis and cerebralwhite matter lesionsPark MH, Koh SB, Kim BJ, Park KW, Lee DH, Korea UniversityMedical College, Korea

Objectives: Intima-media thickness (IMT) of the carotid artery servesas a marker of general atherosclerosis and the association of IMT withischemic stroke has been documented. The purpose of this study is toevaluate the association of IMT, intracranial artery stenosis and cere-bral white matter lesions (WMLs).Methods: We collected data of B-mode ultrasound graphic measure-ments of carotid IMT and brain MRI and MRA from 712 acuteischemic stroke patients admitted to Korea University Ansan Hospitalbetween January 2003 and December 2004. The mean age was 64.3 �15.2 years and 60.1% were male. Based on MRI/MRA finding, intra-cranial artery stenosis was defined and WMLs were rated.Results: Sixty-one percent of patients had intracranial artery stenosison brain MRA. We found significant difference in age and carotid IMTbetween intracranial artery stenosis group and nonstenosis group. Withincreasing number of plaques in the carotid artery the severity ofWMLs increased (p � 0.005). The carotid IMT was 0.54 � 0.21 mmfor nonstenosis group and 0.88 � 0.24 mm for stenosis group (p �0.001). The age and carotid IMT were associated with intracranialstenosis independently on multivariate logistic regression test.Conclusions: This study suggest that certain pathogenetic mechanismsare involved in the association with carotid IMT, intracranial arterystenosis and WMLs.

3604

A comparative study of cytopathological diagnostic valuebetween tissue obtaining by EUS-guided fine needle aspirationand ERP for the management of pancreatic mass without biliarystrictureWakatsuki T, Irisawa A, Hikichi T, Takagi TJ, Shibukawa G,Takahashi Y, Imamura H, Sato A, Sato M, Obara K, FukushimaMedical University, Japan

Objectives: To determine the significance of EUS-FNA for the diagnosisof pancreatic mass without biliary stricture, we retrospectively comparedthe value of cytopathological diagnosis obtained by EUS-FNA with byERP, and the complications associated with these procedures.Methods: Fifty-three patients who were suspected to have the pancre-atic mass, excluding cystic mass, without biliary stricture on the con-ventional ultrasound and/or computed tomography were enrolled.EUS-FNA biopsy was performed in 32 patients and the cytologyutilizing ERP was performed in 21 patients.Results: The sampling rate of adequate specimen was 100% in bothgroups. In EUS-FNA group, overall results for the available sampleswere sensitivity 91.7% and accuracy 93.8%. On the other hand, InERCP group, overall results were sensitivity 35.3% and accuracy47.6%. There was a significant difference between the two groups (p �0.01 in each). With regard to the complication, there was a significantdifference in frequencies of post procedure pancreatitis between EUS-FNA group and ERP group (p � 0.01, 0% (0/34) versus 33.3% (7/21),respectively).Conclusions: EUS-FNA has been demonstrated to be safe and effec-tive in the cytopathological diagnosis for pancreatic abnormalitieswithout biliary stricture as compared with the cytology under ERP.

3606

A new method for ultrasound evaluation of the distal bicepsBrachii tendonBird SJ, Benson Radiology, Australia

Sonographic evaluation of the distal biceps brachii insertion is difficultusing the conventional sagittal approach via the antecubital fossa due tothe anatomical course of the tendon as it passes to the radial tuberosity.This course results in a tendon, which has a steep and deep course inthe proximal forearm with anisotropy artifact and refraction fromoverlying muscle edges causing image degradation. I describe a newsonographic technique utilizing the pronator teres muscle belly as anacoustic window, forearm supination and a steeply angled approachfrom the ulnar aspect. This technique allows excellent visualization ofthe entire tendon, insertion site and bicipitoradial bursa. The pronatorteres acoustic window avoids refraction artifact allowing perpendicularimaging of the tendon fibers free of anisotropy. Slight modification tothe technique produces excellent images of the median nerve as itpasses between the heads of the pronator teres, which is anothertechnically challenging area.

3607

A novel semi-intermodulated Doppler imaging with contrastagents: A preliminary study for myocardial perfusion imagingWu C-Y, Lu S-J, Chao W-H, Chou Y-H, Medical Group, ResearchCenter, Micro-Star Int’l Co., Ltd, Taiwan; Graduate Institute ofElectronics Engineering, National Taiwan University, Taipei,Taiwan; Department of Radiology, Veterans General Hospital-Taipei, and National Yang-Ming University, School of Medicine,Taiwan

In myocardial contrast echocardiography, the replenishment curve ofmyocardial opacification intensity is an important index to diagnoseseveral heart diseases. In traditional Doppler imaging, perfusion imag-ing is affected seriously by motion of tissue and interference of cardiacchambers. A new ultrasound contrast imaging technique, semiinter-modulated imaging (SII), utilizes nonlinear low-frequency response ofcontrast agents. SII has been proved to have a good contrast-to-tissueratio about 12 � 14 dB improvement over fundamental imaging inB-mode, and motion artifacts are significantly reduced in Dopplermode. Contrast agents in the blood stream or cardiac chambers will notbe destructed seriously in SII, and more pulses can be utilized in

P294 Ultrasound in Medicine and Biology Volume 32, Number 5S, 2006

Doppler processing to achieve higher SNR and better velocity estima-tion. They are very important factors in Doppler imaging, especially inimaging tiny vessels with slow velocity, e.g., myocardial perfusionimaging. Detailed results and graphs will be given in the conference.

3608

Scrotal masses in children: Sonographic findingsKim MH, Kim J-E, Kim JH, Yang DM, Gachon Medical College GilMedical Center, Korea; Samsung Medical Center, SungkyunkwanUniversity School of Medicine, Korea

Objectives: To illustrate the sonographic findings of the scrotal massesin children.Methods: A retrospective review was performed in patients withscrotal mass in children. All cases were confirmed by surgical resectionor radiological follow-up study.Results: The disease entities include torsion of appendiceal testis,intratesticular tumors including yolk sac tumor, teratoma, epidermoidcyst, embryonal carcinoma, mixed germ cell tumor and testicularmetastsis, extratesticular tumors such as paratesticular rhabdomyosar-coma. The sonographic findings of each disease were (1) torsion ofappendiceal testis: spherical shaped enlarged appendix testis withoutblood flow, (2) yolk sac tumor: irregular heterogeneous mass replacingentire testis, (3) teratoma: well-circumscribed complex mass, (4) epi-dermoid cyst: “onion skin” appearance with peripheral calcified rim,(5) embryonal carcinoma: heterogeneous hypoechoic mass with inva-sion of tunica albuginia, (6) mixed germ cell tumor: irregular orill-defined inhomogeneous echotexture, (7) testicular metastasis: mul-tiple hypoechoic or hyperechoic lesions and (8) paratesticular rhabdo-myosarcoma: large, fast-growing extratesticular mass.Conclusions: Knowledge of sonographic findings of scrotal massesmay be helpful for differential diagnosis of a variety of a diseaseprocess involving the scrotum.

3609

Value of four-dimensional ultrasonography in sonohysterographyguided biopsy of focal endometrial lesions: A preliminary clinicalexperienceLee EJ, Kim JM, Ajou University School of Medicine, Korea

The purpose of this study was to present the efficacy of four-dimensional(4-D) ultrasonography in performing sonohysterography (SH) guided bi-opsy of focal endometrial lesions. Twenty-three consecutive patients withfocal endometrial lesions underwent SH guided biopsy under 4-D ultra-sonography guidance. For the standard display method for real-time guid-ance during the biopsy, Multi Slice views of three orthogonal image planeswith a 3D-rendered image in the surface mode were used. 4-D SH guidedbiopsies were successfully performed in 20 of 23 patients. The pathologicdiagnoses included endometrial polyp (n � 12), hyperplasia (n � 3),carcinoma (n � 2), intracavitary leiomyoma (n � 2) and polypoid ade-nomyoma (n � 1). This technique was adequate for histologic diagnosis in16 patients. 4-D ultrasonography improves the safety and accuracy inperforming directed SH guided biopsies of focal endometrial lesions byenhancing the depiction and better understanding of the geometric rela-tionships of the biopsy devices to target lesions.

3610

Effects of low intensity ultrasound pretreatment on thechondrogenesis of rabbit mesenchymal stem cells in vitroLee HJ, Choi BH, Min B-H, Park SR, Department of BiomedicalEngineering, Ajou University, Korea; Research Institute for MedicalSciences, College of Medicine, Inha University, Korea; Cell TherapyCenter, School of Medicine, Ajou University, Korea; Department ofPhysiology, College of Medicine, Inha University, Korea

To date, 3D culture system and TGF-� are known as the most criticalfactors for chondrogenic differentiation of mesenchymal stem cells(MSCs). Recently, we showed that low-intensity ultrasound (LIUS)could induce the chondrogenesis of MSCs in vitro and in vivo. Here, weinvestigated the effect pretreatment of LIUS on the chondrogenicdifferentiation of rabbit MSCs in vitro. The LIUS pretreatment on theMSCs/3D alginate increased the following phenotypes in monolayerculture: (1) the formation of actin stress fibers, (2) the expression ofchondrogenic markers such as collagen type II, Aggrecan and Sox9 inRT-PCR analysis and (3) the level of collagen type II protein inWestern blot analysis. These results suggest that the LIUS pretreatmentbetter sustain the chondrogenic differentiation of MSCs in monolayerculture. Noninvasive LIUS as a potential chondrogenic stimulus couldprovide diverse experimental and clinical applications for cartilagerepair.

3611

Effects of low intensity ultrasound on viability and chondrogenicdifferentiation of human bone marrow mesenchymal stem cellsin alginate cultureLee HJ, Choi BH, Min B-H, Park SR, Department of BiomedicalEngineering, Ajou University, Korea Research Institute for MedicalSciences, College of Medicine, Inha University, Korea; Cell TherapyCenter, School of Medicine, Ajou University, Korea; Department ofPhysiology, College of Medicine, Inha University, Korea

Low-intensity ultrasound (LIUS) has been demonstrated to enhance therepair of articular cartilage and fracture healing in vitro and in animalmodels. Here, we hypothesized that the LIUS treatment could enhance notonly the differentiation potential but also the viability of MSCs in a 3Dalginate culture system. The effects of LIUS on the expression of chon-drogenic phenotypes and the cell viability in relation to apoptosis wereaddressed during the chondrogenic differentiation of hMSC. These find-ings demonstrate that LIUS enhanced the chondrogenic differentiation andviability of human bone marrow MSCs on the alginate culture system. Theincrease in the viability of hMSCs appeared to be mediated at least in partvia the inhibition of cell apoptosis by LIUS as evidenced by the TUNELassay and the decrease in the bax/bcl-2 ratio.

3612

3D fiber structure extraction technique from RF echo signal ofliver fibrosisYamaguchi T, Kamiyama N, Ebara M, Hachiya H, Dept. ofInformation and Image Sciences, Chiba University, Japan; ToshibaMedical Systems Corp., Japan; Medicine and Clinical Oncology,Chiba University, Japan; Research Center for Frontier MedicalEngineering, Chiba University, Japan

Objectives: Ultrasound is noninvasive and useful to evaluate liver diseasedespite its operator dependency. This study was conducted to quantita-tively assess liver fibrosis using statistical signal processing technique.Methods: Echo data were acquired as a set of hundreds of twodimensional plane of RF echo signal with US diagnostic equipmentfrom eight autopsy specimens of human liver and 79 patients. In oursignal processing technique, echo signal was suppressed to low ampli-tude if the probability density of echo amplitude obeys to Rayleighdistribution like normal liver. The ROI of statistical analysis of echosignal is designed in consideration of a sound field of transmitter signaland it has direction of three dimension.Results: In the result of ex vivo experiment, information that did notobey a Rayleigh distribution were extracted from the echo signal inmulti plane. The shape and characteristics of the 3D structure ofextracted information from echo signal agreed with the fiber tissuestructures, which were composed from a number of histological images

Abstracts P295