Objectives
The aims of this study were to determine the prevalence of work-related musculoskeletal disorders amongst practitioners of obstetric and gynaecology ultrasound worldwide, and to establish relevant aetiological factors.

Work-related repetitive strain injuries amongst practitioners of obstetric and gynaecological ultrasound worldwide.

Objective

To determine whether pulsed Doppler examination of the ductus venosus in rat fetuses could damage exposed tissue.



Methods

On gestational day 18, the livers of a mean of approximately five fetuses per mother (n = 5.14, SD = 1.6), in a cohort of 35 pregnant female rats, were exposed individually to pulsed Doppler and these were considered the ‘exposed group’. The remaining fetuses in each pregnant rat (n = 5.16, SD = 2.1) formed the ‘control group’. We tested for 600, 300, 60, 20, 15, 10 and 3 s of exposure of the fetal ductus venosus and the damage was evaluated measuring a cell death index of apoptotic activity at 7 h post-exposure (n = 16). In addition, subgroups of mothers were sacrificed at 2, 4, 5, 7, 12 and 24 h post-exposure to determine when the damage appeared and disappeared and whether this depended on the exposure time.



Results

After exposure of 20 s or more, we observed significant damage, as assessed by caspase 3 activity (a marker of apoptotic activity related to tissue damage), in all cases; after 15 s of exposure, some samples presented damage (P = 0.4); there was no damage after 10 s or 3 s of exposure (P = 0.87 and P = 0.3, respectively). There was a positive linear correlation between apoptotic index and pulsed Doppler exposure time, (Pearson's coefficient = 0.324, P 0.05 and P > 0.4).



Conclusions

We observed reversible damage after pulsed Doppler imaging in an in-vivo fetal liver tissue rat model and found that longer exposure times produced more tissue damage. We established that 10 s was the maximum exposure time to ensure absence of damage to tissue in this model. It would appear sensible to recommend expert supervision of pulsed Doppler imaging and to have intervals between subsequent examinations. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.

Ultrasound bioeffects in rats: quantification of cellular damage in the fetal liver after pulsed Doppler imaging

Purpose.
As a form of energy, diagnostic ultrasound has bioeffects on living tissues. The thermal index (TI), TIS (TI for soft tissue), TIB (TI for bone), TIC (TI for cranial bone) expresses the potential for rise in temperature at the ultrasound beam's focal point. The mechanical index (MI) indicates the potential for the ultrasound beam to induce inertial cavitation in tissues. The goal of this study was to characterize the acoustic output of clinical ultrasound instruments, as expressed by TI and MI, during routine first-trimester sonographic examinations.

Methods.
A prospective observational study was conducted. First-trimester patients were randomly selected from those scheduled for viability scans. An obstetrician collected data. Sonographers were blinded to the data being sought, which included gestational age, duration of the examination, and every variation in the MI and TI during each sonographic examination.

Results.
A total of 52 first-trimester examinations were evaluated. The mean gestational age was 8.9 ± 1.9 weeks. The mean duration of the sonographic examinations was 8.1± 1.4 minutes. During the examinations, there were 178 MI variations (mean ± SD, 0.9 ± 0.3) and 167 TI variations (mean ± SD, 0.2 ± 0.1).

Conclusion.
First-trimester sonographic examinations are associated with a negligible rise in TI. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2007

First-trimester sonography: is the fetus exposed to high levels of acoustic energy?

Four-dimensional sonographic assessment of inter-twin contact late in the first trimester.

A robust and efficient needle segmentation method used to localize and track the needle in 3-D trans-rectal ultrasound (TRUS)-guided prostate therapy is proposed. The algorithmic procedure begins by cropping the 3-D US image containing a needle; then all voxels in the cropped 3-D image are grouped into different line support regions (LSRs) based on the outer product of the adjacent voxels' gradient vector. Two different needle axis extraction methods in the candidate LSR are presented: least-squares fitting and 3-D randomized Hough transform. Subsequent local optimization refines the position of the needle axis. Finally, the needle endpoint is localized by finding an intensity drop along the needle axis. The proposed methods were validated with 3-D TRUS tissue-mimicking agar phantom images, chicken breast phantom images and patient images obtained during prostate cryotherapy. The results of the in vivo test indicate that our method can localize the needle accurately and robustly with a needle endpoint localization accuracy 84%, which are favorable for 3-D TRUS-guided prostate trans-perineal therapy.

Phase Grouping-Based Needle Segmentation in 3-D Trans-rectal Ultrasound-Guided Prostate Trans-perineal Therapy

Objective

Three-dimensional (3D) ultrasound is gaining popularity in prenatal diagnosis. While there are no studies regarding the safety of 3D ultrasound, it is now widely performed in non-medical facilities, for non-diagnostic purposes. The present study was aimed at comparing the acoustic output, as expressed by thermal index (TI) and mechanical index (MI), of conventional two-dimensional (2D) and 3D/4D ultrasound during pregnancy.



Methods

A prospective, observational study was conducted, using three different commercially available machines (iU22, Philips Medical Systems; Prosound Alfa-10, Aloka; and Voluson 730 Expert, General Electric). Patients undergoing additional 3D/4D ultrasound examinations were recruited from those scheduled for fetal anatomy and follow-up exams. Fetuses with anomalies were excluded from the analysis. Data were collected regarding duration of the exam, and each MI and TI during 2D and 3D/4D ultrasound exams.



Results

A total of 40 ultrasound examinations were evaluated. Mean gestational age was 31.1 ± 5.8 weeks, and mean duration of the exam was 20.1 ± 9.9 min. Mean TIs during the 3D (0.27 ± 0.1) and 4D examinations (0.24 ± 0.1) were comparable with the TI during B-mode scanning (0.28 ± 0.1, P = 0.343). The MIs during the 3D volume acquisitions were significantly lower than those in the 2D B-mode ultrasound studies (0.89 ± 0.2 vs. 1.12 ± 0.1, P = 0.018). The 3D volume acquisitions added 2.0 ± 1.8 min of actual ultrasound scanning time (i.e. not including data processing and manipulation, or 3D displays, which are all post-processing steps). The 4D added 2.2 ± 1.2 min.



Conclusions

Acoustic exposure levels during 3D/4D ultrasound examination, as expressed by TI, are comparable with those of 2D B-mode ultrasound. However, it is very difficult to evaluate the additional scanning time needed to choose an adequate scanning plane and to acquire a diagnostic 3D volume. Copyright © 2007 ISUOG. Published by John Wiley & Sons, Ltd.

https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1002/uog.3933

A comparison between acoustic output indices in 2D and 3D/4D ultrasound in obstetrics

Objectives

To investigate the specific complaints of physicians and technicians performing obstetric and gynecological ultrasound.



Methods

This was a cross-sectional retrospective survey. Questionnaires were distributed to members of the Israeli Society of Gynecological Ultrasound, including questions on gender and profession, number and type of scans performed, pain related to profession and any therapy undergone. Statistical analysis included chi-square or Fisher's exact test, Student's t-test, Pearson's correlation coefficient and logistic regression.



Results

Joint pain was reported by 51.7% (30/58) of the technicians compared with 25.3% (19/75) of the physicians (P = 0.002). It was more common in females than in males (P = 0.05) and it was more common among those who performed transabdominal sonography more frequently than they did transvaginal sonography (P = 0.004). There was a significant association between performing transabdominal ultrasound and back pain (P = 0.05). Although females reported pain more frequently, the rate of surgical procedures was higher among males (P < 0.05).



Conclusions

A technician is 3.5 times more likely to report joint pain than is a physician. Transabdominal sonography is a risk for both joint and back pain. There may be gender differences in pain perception. Copyright © 2006 ISUOG. Published by John Wiley & Sons, Ltd.

The hazards to practitioners of obstetric and gynecological ultrasound.

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A comparison between acoustic output indices in 2D and 3D/4D ultrasound in obstetrics

The hazards to practitioners of obstetric and gynecological ultrasound.