Ultrasound-Guided Needle Electromyography for Assessing Diaphragmatic Myoclonus.
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ABSTRACT:
SUBMITTER: Chen KS
PROVIDER: S-EPMC7534001 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
Publications
Ultrasound-Guided Needle Electromyography for Assessing Diaphragmatic Myoclonus.
Chen Kai-Hsiang S KS Keng Li-Ta LT Kuo Yu-Ting YT Tai Yi-Cheng YC Chen Robert R
Movement disorders clinical practice 20200901 7
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Project description:BackgroundDiaphragmatic myoclonus is a rare disorder of repetitive diaphragmatic contractions, acknowledged to be a spectrum that includes psychogenic features. Electromyography has been the diagnostic tool most commonly used in the literature.MethodsTo test if we could perform a noninvasive technique to delineate the diaphragm as the source of abnormal movements and demonstrate distractibility and entrainability, we used B-mode ultrasound in a patient with diaphragmatic myoclonus.ResultsUltrasound imaging clearly delineated the diaphragm as the source of her abdominal movements. We were able to demonstrate entrainability of the diaphragm to hand tapping to a prescribed rhythm set by examiner.ConclusionWe recommend the use of ultrasound as a noninvasive, convenient diagnostic tool for further studies of diaphragmatic myoclonus. We agree with previous findings that diaphragmatic myoclonus may be a functional movement disorder, as evidenced by distractibility and entrainability demonstrated on real-time video with ultrasonography.
| S-EPMC4941981 | biostudies-literature
Project description:Introduction/aimsMeasuring the spatial dimensions of a single motor unit remains a challenging problem, and current techniques, such as scanning electromyography (EMG), tend to underestimate the true dimensions. In this study we aimed to estimate more accurately the dimensions of a single motor unit by developing a clinically applicable scanning EMG protocol that utilizes ultrasound imaging to visualize and target a transect through the center of a single motor unit.MethodsSingle motor unit twitches in the tibialis anterior muscles of healthy volunteers were elicited via stimulation of the fibular nerve, visualized with ultrasound, and targeted with an intramuscular EMG electrode. The electrode was moved by hand in small steps through the motor unit territory. Ultrasound video output was synchronized to EMG capture, and the needle position was tracked at each step.ResultsEight recordings from six participants were collected. The technique was quick and easy to perform (mean time, 6.1 minutes) with reasonable spatial resolution (mean step size, 1.85 mm), yielding motor unit territory sizes between 1.53 and 14.65 mm (mean, 7.15 mm).DiscussionUltrasound-guided motor unit scanning EMG is a quick and accurate method for obtaining a targeted motor unit transect. This combination of two readily available clinical tools provides insights into the dimensions and internal structure of the motor unit as a marker for neuromuscular conditions.
| S-EPMC9828660 | biostudies-literature
Project description: Not available
| S-EPMC8934051 | biostudies-literature
Project description:PurposeTo assess and compare two ultrasound-guided, minimally invasive procedures to release the A1-pulley (needle release and thread release) regarding efficacy and safety in an anatomical specimen model.Materials and methodsTwenty-one ultrasound-guided needle releases and 20 ultrasound-guided thread releases were performed on digits of Thiel-embalmed anatomical specimens. A scoring system was developed to assess ultrasound visibility, intervention outcome (incomplete, almost complete, or full transection of the A1 pulley), and injury to adjacent structures (neurovascular structures, tendons, A2 pulley). Statistical analysis was performed to compare the score of the two groups (group 1: needle release,group 2: thread release). A P-value of ≤ 0.05 was considered significant.ResultsNeedle release was completely successful in 15 cases (71.5%), almost complete release was achieved in four cases (19%), and incomplete transection occurred in two cases (9.5%). Thread release was completely successful in 17 cases (85%), and almost complete transection was observed in the remaining three cases (15%). In both procedures no neurovascular structures were harmed. Slight injury of flexor tendons occurred in two cases (9.5%) in needle release and in five cases (25%) in thread release. There were no significant statistical differences between the groups regarding ultrasound visibility, intervention safety and outcome, (P > 0.05).ConclusionUltrasound-guided needle release and ultrasound-guided thread release have similar success of release, both being effective and safe techniques for the release of the A1 pulley.
| S-EPMC11480152 | biostudies-literature
Project description:Ultrasound-guided renal access for percutaneous nephrolithotomy (PCNL) is a safe, effective, and low-cost procedure commonly performed worldwide, but a technique underutilized by urologists in the United States. The purpose of this article is to familiarize the practicing urologist with methods for ultrasound guidance for percutaneous renal access. We discuss two alternative techniques for gaining renal access for PCNL under ultrasound guidance. We also describe a novel technique of using the puncture needle to reposition residual stone fragments to avoid additional tract dilation. With appropriate training, ultrasound-guided renal access for PCNL can lead to reduced radiation exposure, accurate renal access, and excellent stone-free success rates and clinical outcomes.
| S-EPMC4761800 | biostudies-literature
Project description:ObjectivesEndobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is becoming the preferred method of mediastinal staging for lung cancer. We investigated the learning curve for EBUS-TBNA using risk-adjusted cumulative sum (Cusum).MethodsA retrospective study of EBUS-TBNA was performed at a single academic institution for patients with mediastinal or hilar lymphadenopathy in the setting of proven or suspected lung cancer. A sampling pass was defined as a full retraction and repositioning of the aspiration needle. Rapid on-site evaluation was not available. To track proficiency, risk-adjusted Cusum analysis was performed using acceptable and unacceptable failure rates of 10% and 20%, respectively. Failure was defined as false negative or nondiagnostic results.ResultsDuring the study period, 231 patients underwent EBUS-TBNA. Prevalence of mediastinal or hilar malignancy was 66.7% (154 out of 231). Sensitivity was 92.2% (142 out of 154), and negative predictive value was 87.9% (58 out of 66). Node size was identified as a significant predictor of EBUS-TBNA success by multiple regression. Risk-adjusted Cusum analysis demonstrated that the first and only unacceptable decision interval was crossed at 22 cases. Individual practitioner learning curves were highly variable, and the operator with the highest volume was the most consistently proficient.ConclusionsIn our experience, attainment of an acceptable failure rate for EBUS-TBNA required 22 cases. Node size is a predictor of EBUS-TBNA success. Risk-adjusted Cusum proved a powerful evaluative tool to monitor the training process of this new procedure.
| S-EPMC3981557 | biostudies-literature
Project description:Breast biopsy consists in the collection of cells or tissue fragments from a breast lesion and their analysis by a pathologist. There are several types of breast biopsy defined on the basis of the type of needle used: fine-needle aspiration and biopsy performed with a spring-based needle. This article focuses on fine-needle aspiration performed under sonographic guidance.It is used mainly to assess cysts that appear to contain vegetations or blood or that are associated with symptoms; lesions and solid nodules that are not unequivocally benign; and axillary lymph nodes that appear suspicious on physical examination and/or sonography.In addition to distinguishing between benign and malignant lesions, ultrasound guided fine-needle aspiration also plays an important role in tumor grading and in immunocytochemical identifying specific tumor markers. This article describes the technique used and the possible causes of false negative and false positive findings. Despite its limitations, fine-needle aspiration has become a fundamental tool for the identification and preoperative management of malignant breast lesions.
| S-EPMC3558104 | biostudies-literature
Project description: Not available
| S-EPMC7258635 | biostudies-literature
Project description:Ultrasound (US) guided access for percutaneous nephrolithotomy (PCNL) is gaining popularity in the urology community as it reduces radiation risk. The most popular technique involves manual image-needle alignment. A misaligned needle however needs to be retracted and reinserted, resulting in a lengthened operation time and complications such as bleeding. These limitations can be mitigated through the co-registration between the US array and needle. The through-hole array concept provides the primary solution, including a hole at the center of the array. Because of the central opening, the image-needle alignment is achieved inherently. Previous literature has described applications that are limited to superficial and intravascular procedures, suggesting that developing a through-hole array for deeper target applications would be a new breakthrough.ObjectiveHere, we present a dual-segment array with a central opening. As the prototype development, two segments of 32-element arrays are combined with an open space of 10 mm in length in between them.MethodWe conducted phantom and ex-vivo studies considering the target depth of the 80-100 mm range. The image quality and needle visibility are evaluated by comparing the signal-to-noise ratio (SNR), full width at half maximum (FWHM), and contrast-to-noise ratio (CNR) results measured with a no-hole linear array under equivalent conditions. An ex-vivo study is performed using porcine kidneys with ceramic balls embedded to evaluate the needle access accuracy.Results and conclusionThe mean needle access error of 20 trials is found to be 2.94 ±1.09 mm, suggesting its potential impact on realizing a simple and intuitive deep US image-guided access.
| S-EPMC10590177 | biostudies-literature
Project description:Endoscopic ultrasound-guided fine needle aspiration is a multistep procedure that involves proper clinical indication, correct selection of needles, adapting evidence-based techniques such as the fanning maneuver and not routinely using suction or the stylet for tissue sampling, and establishing reliable cytopathology support. Integrating cytopathology in the training curriculum and developing a more flexible platform of needles and echoendoscopes are likely to further advance the field of endosonography. This review aims to summarize the technical issues that are key to performing high-quality endoscopic ultrasound-guided fine needle aspiration.
| S-EPMC4115182 | biostudies-literature