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  1. Qurash MT, Yaacob NY, Azuan N, Khaleel YS, Zakaria R
    J Med Ultrasound, 2018 06 18;26(4):210-214.
    PMID: 30662153 DOI: 10.4103/JMU.JMU_40_18
    Interventional radiology procedures are becoming more challenging over time; thus, there is a need for excellent and reliable training methods. Training on live patients is neither safe nor an ethical solution. Alternatives are many and varied, but the most popular is ultrasound guided simulators. This report shows how a simple, homemade, low-cost phantom material, and construction modules can provide several advantages over ordinary gelatin phantoms. A new layering technique and target synthesis are described for the biopsy phantom, including tips on decreasing the needle pass artifact as well as controlling the mixture echogenicity.
  2. Noor NAM, Omar A, Rahman WIWA, Zainul AZ
    J Med Ultrasound, 2020 11 09;29(2):84-88.
    PMID: 34377637 DOI: 10.4103/JMU.JMU_91_19
    Background: Congenital hypothyroidism is the most common cause of treatable mental impairment and growth retardation in newborns. Early diagnosis requires measurement of serum thyroid-stimulating hormone (TSH) and free T4 coupled with an ultrasound of the thyroid gland. However, detailed sonographic evaluation of the thyroid gland requires comparison to the local thyroid normative volumetric values, which is currently lacking.

    Methods: A cross-sectional study was conducted from November 10, 2015, to April 18, 2018, recruiting 165 healthy neonates with normal TSH in their 1st week of life, from a single center in Northwest Malaysia. Ultrasound thyroid was done by a single ultrasonographer (κ = 0.86, percent agreement = 92.4), and the thyroid volume (TV) was calculated using the Brunn formula.

    Results: All measurements showed skewed distribution with no significant difference between the right and left lobes. The local normative values for neonatal total TV was 0.61 (interquartile range [IQR] = 0.230) cm3, 0.31 (IQR = 0.150) cm3 for right TV, and 0.28 (IQR = 0.110) cm3 for left TV. There was a strong correlation between the right and left TVs, r = 0.767, P < 0.001. There were also no differences in the total TV across different genders and races.

    Conclusion: The normative values for TV determined in our study may be used accordingly in clinical practice to evaluate thyroid hypoplasia or goiter by other Asian countries due to the similarly shared biodemography.

  3. Khammas ASA, Mahmud R
    J Med Ultrasound, 2020 10 01;29(1):26-31.
    PMID: 34084713 DOI: 10.4103/JMU.JMU_53_20
    Background: Ultrasonographic (USG) measurements of the liver length, gallbladder wall thickness (GBWT), diameters of the inferior vena cava (IVC), portal vein (PV), and pancreas are valuable and reliable in diagnosis hepatobiliary and pancreas conditions. This study is aimed to determine the normal values of liver length, GBWT, AP diameters of the IVC and PV, AP diameter of the head and body of the pancreas.

    Methods: A prospective cross-sectional study was carried out in this study. A total of the 408 participants were randomly recruited using a systematic method. According to the USG reports, the subjects who had normal USG report for liver, biliary system, and pancreas were described as normals, whereas the subjects who had hepatobiliary diseases such as fatty liver, liver cysts, hemangioma, cirrhosis, gallbladder wall thickening, acute cholecystitis, gallstones, and polyps were recorded as abnormal subjects.

    Results: Of the 408 participants with a mean of 52.6 ± 8.4 years old. Of those, 294 (72.1%) participants were normal and 114 (27.9%) subjects were reported as abnormal. More than half of the study population was males, 52.9% versus 47.1% of females. There was a significant difference of liver length, head, and body of the pancreas between genders (P = 0.004, 0.002, and P < 0.001, respectively). Moreover, the pancreatic body only was significantly correlated with age (P = 0.026). There also was a significant difference of the liver length, head, and body of the pancreas between normal and abnormal subjects (P < 0.001, P = 0.007, and P < 0.001).

    Conclusion: Liver length, diameter of the head, and body of the pancreas were significantly associated with gender and hepatobiliary diseases. In addition, only the diameter of the body of the pancreas was significantly correlated with age.

  4. Oglat AA, Matjafri MZ, Suardi N, Oqlat MA, Abdelrahman MA, Oqlat AA
    J Med Ultrasound, 2018 03 28;26(1):3-13.
    PMID: 30065507 DOI: 10.4103/JMU.JMU_11_17
    Medical Doppler ultrasound is usually utilized in the clinical adjusting to evaluate and estimate blood flow in both the major (large) and the minor (tiny) vessels of the body. The normal and abnormal sign waveforms can be shown by spectral Doppler technique. The sign waveform is individual to each vessel. Thus, it is significant for the operator and the clinicians to understand the normal and abnormal diagnostic in a spectral Doppler show. The aim of this review is to explain the physical principles behind the medical Doppler ultrasound, also, to use some of the mathematical formulas utilized in the medical Doppler ultrasound examination. Furthermore, we discussed the color and spectral flow model of Doppler ultrasound. Finally, we explained spectral Doppler sign waveforms to show both the normal and abnormal signs waveforms that are individual to the common carotid artery, because these signs are important for both the radiologist and sonographer to perceive both the normal and abnormal in a spectral Doppler show.
  5. Hassali MA, Nouri AI, Hamzah AA, Verma AK
    J Med Ultrasound, 2018 03 28;26(1):48-51.
    PMID: 30065514 DOI: 10.4103/JMU.JMU_9_18
    Penile fracture is defined as a traumatic rupture of either corpus cavernosum or the tunica albuginea; sometimes it can be both. It may be caused by exotic masturbation acts, sexual intercourse, or other trauma to this area. This can be accompanied by injury to the urethra, which is the cause of hematuria as a symptom for some patients. Typically, diagnosis of penile rupture or fracture depends on clinical examination and history told by the patients. We are stating the importance of medical imaging in the diagnosis of patients with penile fracture by presenting a case of patient suffered from penile fracture after a fall on his penis where it affected the erection of two-third of his penis. In which, the proper diagnosis by imaging studies and taking actions accordingly can save the patients from unnecessary surgeries that indeed increase the bill of the medical care directly and indirectly. Therefore, most patients can be diagnosed cost-effectively and treated surgically without a need to delay surgery, which is often the case if one was to resort to other investigations. Investigations such as retrograde urethrography for suspected urethral injury should only be used when the diagnosis of penile fracture is in doubt.
  6. Oglat AA, Matjafri MZ, Suardi N, Abdelrahman MA, Oqlat MA, Oqlat AA
    J Med Ultrasound, 2018 09 14;26(3):134-142.
    PMID: 30283199 DOI: 10.4103/JMU.JMU_7_18
    Background: To examine the blood flow and detection of the issues related to it by medical ultrasound, it is extremely important to have suitable blood mimicking fluid (BMF) to be used in vitro and to have a movable or portable Doppler flow phantom to use it as a standardizing tool. As known, the main drawbacks of the currently commercial BMF used in the research studies are high in cost and the long time needed for preparation, which is at least 5-7 h. Moreover, there are only two common scatter particles using in BMF as suspension materials such as nylon (Orgasol) and polystyrene. Thus, we need to prepare BMF with both a new mixture fluid and new scatter particle to be as a reflecting factor of ultrasonic waves, for evaluating the speed of sound of the blood flow in the same method like in the research study of ultrasound with relatively low-cost and less consuming time of preparation. However, both the acoustical and physical features of the Doppler flow phantom components (BMF and tissue mimicking material) must correspond the features of the human tissues to make the examination significance. In addition, the BMF must also represent the hemodynamic features of real human blood.

    Methods: In this experiment, a new adequate ternary mixture liquid for preparation of BMF applied and suspended with a new scatter particle material, this scatter particle material called poly (4-methylstyrene), it used to be adequate with the mixture density and for saving neutrally buoyant. This BMF was prepared for use in the test objects or Doppler flow phantom. The poly (4-methylstyrene) particles were applied for suspension in a mixture liquid or fluid based on three items, which were distilled water, propylene glycol (PG), and polyethylene glycol (PEG) (200 Mw). The diameter of poly (4-methylstyrene) particles is 3-8 μm, which determined by specific sieve in a unit of μm, and the density is 1.040 g/ml.

    Results: Speed of sound, viscosity, density, Backscatter power and attenuation features of mixture fluid or liquid which used for preparing a BMF were measured, discussed, and agreed with draft International Electrotechnical Commission values.

    Conclusions: There are three various types of ternary items of mixture fluid (water, PG, and PEG [200 Mw]), and a new type of scatter particle material poly (4-methylstyrene) was utilized for preparing the BMF. The scatter particles and mixture fluid prepared and measured at a temperature that simulates the body temperature 37°C. Moreover, one of the advantages of this new blood that is being cheaper than the commercially available BMF products because the PG and the polyethylene glycol (200 Mw) are much cheaper and more available than glycerol and the Dextran that used usually. In addition, new BMF needs less time for preparation compared to the commercial one.

  7. Ahmad MS, Suardi N, Shukri A, Mohammad H, Oglat AA, Alarab A, et al.
    J Med Ultrasound, 2020 01 28;28(1):7-16.
    PMID: 32368444 DOI: 10.4103/JMU.JMU_4_19
    Liver phantoms have been developed as an alternative to human tissue and have been used for different purposes. In this article, the items used for liver phantoms fabrication are mentioned same as in the previous literature reviews. Summary and characteristics of these materials are presented. The main factors that need to be available in the materials used for fabrication in computed tomography, ultrasound, magnetic resonance imaging, and nuclear medicine were analyzed. Finally, the discussion focuses on some purposes and aims of the liver phantom fabrication for use in several areas such as training, diagnoses of different diseases, and treatment planning for therapeutic strategies - for example, in selective internal radiation therapy, stereotactic body radiation therapy, laser-induced thermotherapy, radiofrequency ablation, and microwave coagulation therapy. It was found that different liver substitutes can be developed to fulfill the different requirements.
  8. Dakok KK, Matjafri MZ, Suardi N, Oglat AA, Nabasu SE
    J Med Ultrasound, 2021 05 14;29(3):157-166.
    PMID: 34729323 DOI: 10.4103/JMU.JMU_164_20
    Ultrasound imaging systems need tissue-mimicking phantoms with a good range of acoustic properties. Many studies on carotid artery phantoms have been carried out using ultrasound; hence this study presents a review of the different forms of carotid artery phantoms used to examine blood hemodynamics by Doppler ultrasound (DU) methods and explains the ingredients that constitute every phantom with their advantages and disadvantages. Different research databases were consulted to access relevant information on carotid artery phantoms used for DU measurements after which the information were presented systematically spanning from walled phantoms to wall-less phantoms. This review points out the fact that carotid artery phantoms are made up of tissue mimicking materials, vessel mimicking materials, and blood mimicking fluid whose properties matched those of real human tissues and vessels. These materials are a combination of substances such as water, gelatin, glycerol, scatterers, and other powders in their right proportions.
  9. Tan CY, Razali SNO, Goh KJ, Shahrizaila N
    J Med Ultrasound, 2021 04 03;29(3):181-186.
    PMID: 34729327 DOI: 10.4103/JMU.JMU_105_20
    Background: High-resolution nerve ultrasound provides morphological information of peripheral nerves. We aimed to determine the normal ultrasonographic reference values of nerve cross-sectional area (CSA) in multiethnic Malaysian healthy participants.

    Methods: Nerve ultrasound of the median, ulnar, radial, tibial, fibular, and sural nerves was performed in 84 healthy participants at anatomical-defined locations. The CSA at each scanned site was measured by tracing circumferentially inside the hyperechoic rim of each nerve. Comparisons were made between genders and ethnic groups. Correlations with age, ethnicity, gender, height, weight, and body mass index (BMI) were evaluated.

    Results: CSA values and reference ranges in healthy participants were generated. Nerve CSA was significantly different in different gender (P = 0.002-0.032) and ethnic groups (P = 0.006-0.038). Men had larger nerve CSA than women, and Malay participants had larger nerve CSA compared to other ethnic groups. Nerve CSA had significant correlations to age, height, weight, and BMI (r = 0.220-0.349, P = 0.001-0.045).

    Conclusion: This study provides normative values for CSA of peripheral nerves in a multiethnic Malaysian population, which serves as reference values in the evaluation of peripheral nerve disorders. The ethnic differences in nerve CSA values should be considered during nerve ultrasound.

  10. Oglat AA, Dheyab MA
    J Med Ultrasound, 2021 05 14;29(4):258-263.
    PMID: 35127405 DOI: 10.4103/JMU.JMU_166_20
    Background: Diagnostic ultrasound or sonography is an image which can provide valuable information for diagnosing and treating a variety of diseases and conditions. This experiment was done to check the performance and evaluate the ultrasonic imaging system. There were three tests performed in this experiment: dead zone (transducer ring-down), vertical measurement calibration, and horizontal measurement calibration.

    Methods: The evaluation was made by performed all the tests with different depth on two different multipurpose phantom model #539. The tests were also performed by two different probes which were curved and flat (linear probe). The images were taken, and the measurements were made by electronic calipers on the ultrasound machine system. Observations and evaluations were done via all images and measurements taken.

    Results: The images formed by two various probes were different. The penetration settings were different since the depths were different. The depth influenced the penetrations to the formed image. From the comparison of all results and measurements recorded were all under the accepted value of the standard that was given by the manufacture of the phantom.

    Conclusion: Therefore, it can be concluded that the measurements were all not exceeding 2% of the standard value given based on the result that we get.

  11. Oglat AA, Suardi N, Matjafri MZ, Oqlat MA, Abdelrahman MA, Oqlat AA
    J Med Ultrasound, 2018;26(2):68-76.
    PMID: 30065522 DOI: 10.4103/JMU.JMU_1_17
    Doppler ultrasound imaging system description and calibration need blood-mimicking fluids (BMFs) for the test target of medical ultrasound diagnostic tools, with known interior features and acoustic and physical properties of this fluid (BMF). Physical and acoustical properties determined in the International Electrotechnical Commission (IEC) standard are specified as constant values, the materials used in the BMF preparation should have values similar to the IEC standard values. However, BMF is ready-made commercially from a field of medical usage, which may not be appropriate in the layout of ultrasound system or for an estimate of novel imaging mechanism. It is often eligible to have the capability to make sound properties and mimic blood arrangement for specific applications. In this review, sufficient BMF materials, liquids, and measures are described which have been generated by utilizing diverse operation mechanism and materials that have sculptured a range of biological systems.
  12. Oglat AA, Matjafri MZ, Suardi N, Oqlat MA, Abdelrahman MA, Oqlat AA, et al.
    J Med Ultrasound, 2018;26(3):123-127.
    PMID: 30283197 DOI: 10.4103/JMU.JMU_13_17
    The wall-less flow phantoms with recognized acoustic features (attenuation and speed of sound), interior properties, and dimensions of tissue were prepared, calibrated, and characterized of Doppler ultrasound scanning demands tissue-mimicking materials (TMMs). TMM phantoms are commercially available and ready-made for medical ultrasound applications. Furthermore, the commercial TMM phantoms are proper for ultrasound purpose or estimation of diagnostic imaging techniques according to the chemical materials used for its preparation. However, preparing a desirable TMM for wall-less flow phantom using a specific chemical material according to the specific applications is required for different flow. In this review, TMM and wall-less flow phantoms prepared using different chemical materials and methods were described. The chemical materials used in Doppler ultrasound TMM and wall-less flow phantoms fabricated over the previous decades were of high interest in this review.
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