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PURPOSE: To evaluate the current evidence regarding the use of ultrasound elastography for assessing non-invasive, non-pharmacological interventions for eliciting changes in musculoskeletal stiffness. METHODS: A systematic search of MEDLINE, CINAHL, EMBASE, and Web of Science databases was performed in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Information on measurement and intervention procedures was extracted. Bias was assessed using Cochrane Risk of Bias or Risk of Bias In Non-randomised Studies of Interventions (ROBINS-I) tools for studies with true or quasi-experimental designs, respectively. Analyses were conducted for adequately powered subgroups based on intervention type, measurement site, and population assessed. RESULTS: Twenty-one studies were included in the review. Overall risk of bias was low for true experimental studies and moderate for quasi-experimental studies. Subgroup analyses indicated a large overall effect for interventions involving manual physiotherapy and taping/splinting for reducing masseter muscle stiffness in patients with masticatory muscle disorders (g = 1.488, 95% CI = 0.320-2.655, p = 0.013). Analyses for other intervention types and patient groups were underpowered. CONCLUSION: Ultrasound elastography demonstrates clinical applicability for assessing non-invasive, non-pharmacological interventions for musculoskeletal stiffness. However, the comparative efficacy of these interventions for modulating tissue stiffness remains inconclusive.
Elastography demonstrates clinical applicability for assessing non-invasive, non-pharmacological interventions for musculoskeletal stiffnessInterventions involving manual physiotherapy and taping/bracing showed a large overall effect for reducing masseter muscle stiffnessThe comparative efficacy of other interventions remains inconclusive.
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BACKGROUND: This study aimed to investigate the structural, morphological and passive mechanical properties of the medial gastrocnemius muscle among ambulating chronic stroke survivors using a computational model previously established in healthy individuals without stroke. METHODS: Individuals with chronic stroke (n = 14, age = 63.4 ± 6.0 years) and healthy controls (n = 15, age = 59.6 ± 8.4 years) participated in the study. The mechanical properties of the medial gastrocnemius were measured during continuous passive ankle motion using ultrasound elastography and a corresponding muscle mechanical property-angle curve was estimated where slack angle and elasticity were determined. Muscle thickness, fascicle length, pennation angle, and echo intensity were also assessed using B-mode ultrasound. FINDINGS: No significant differences in slack angle (paretic: -16.2° ± 6.13°, non-paretic: -16.93° ± 6.80°, p = 0.82), or slack elasticity (paretic: 4.36 ± 1.94 kPa, non-paretic: 4.54 ± 1.24 kPa, p = 0.64) were found between sides or groups. Lower muscle pennation angle (paretic: 13.6 ± 2.9°, non-paretic: 15.9 ± 2.0°, p = 0.019) and higher echo intensity (paretic: 80.5 ± 13.6, non-paretic: 63.4 ± 17.1, p = 0.003) were observed for paretic muscles. No significant between-sides differences were found for muscle thickness (paretic: 1.5 ± 0.3 cm, non-paretic: 1.6 ± 0.2 cm, p = 0.255) or fascicle length (paretic: 6.6 ± 1.9 cm, non-paretic: 7.1 ± 2.2 cm, p = 0.216). Significant between-groups difference was also observed for fascicle length [non-dominant side (control): 6.2 ± 0.8 cm, paretic side (stroke): 6.6 ± 1.9 cm, p = 0.017]. INTERPRETATION: Although muscle mechanical properties increased exponentially over the slack ankle, measures between paretic and non-paretic sides were similar in ambulating participants with chronic stroke. Side-to-side differences in structural and morphological measures suggest the impact of stroke was relatively more pronounced for these muscle parameters than for passive mechanical properties.
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Diagnóstico por Imagen de Elasticidad , Accidente Cerebrovascular , Anciano , Tobillo , Articulación del Tobillo/diagnóstico por imagen , Articulación del Tobillo/fisiología , Humanos , Persona de Mediana Edad , Músculo Esquelético/diagnóstico por imagen , Músculo Esquelético/fisiología , UltrasonografíaRESUMEN
This HR-pQCT study was conducted to examine bone properties of the distal tibia post-stroke and to identify clinical outcomes that were associated with these properties at this site. It was found that spasticity and gait speed were independently associated with estimated failure load in individuals with chronic stroke. PURPOSE: (1) To examine the influence of stroke on distal tibia bone properties and (2) the association between these properties and clinical outcomes in people with chronic stroke. METHODS: Sixty-four people with stroke (age, 60.8 ± 7.7 years; time since stroke, 5.7 ± 3.9 years) and 64 controls (age: 59.4 ± 7.8 years) participated in this study. High-resolution peripheral quantitative computed tomography (HR-pQCT) was used to scan the bilateral distal tibia, and estimated failure load was calculated by automated finite element analysis. Echo intensity of the medial gastrocnemius muscle and blood flow of the popliteal artery were assessed with ultrasound. The 10-m walk test (10MWT), Fugl-Meyer Motor Assessment (FMA), and Composite Spasticity Scale (CSS) were also administered. RESULTS: The percent side-to-side difference (%SSD) in estimated failure load, cortical area, thickness, and volumetric bone mineral density (vBMD), and trabecular and total vBMD were significantly greater in the stroke group than their control counterparts (Cohen's d = 0.48-1.51). Isometric peak torque and echo intensity also showed significant within- and between-groups differences (p ≤ 0.01). Among HR-pQCT variables, the %SSD in estimated failure load was empirically chosen as one example of the strong discriminators between the stroke group and control group, after accounting for other relevant factors. The 10MWT and CSS subscale for ankle clonus remained significantly associated with the %SSD in estimated failure load after adjusting for other relevant factors (p ≤ 0.05). CONCLUSION: The paretic distal tibia showed more compromised vBMD, cortical area, cortical thickness, and estimated failure load than the non-paretic tibia. Gait speed and spasticity were independently associated with estimated failure load. As treatment programs focusing on these potentially modifiable stroke-related impairments are feasible to administer, future studies are needed to determine the efficacy of such intervention strategies for improving bone strength in individuals with chronic stroke.
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Tibia , Velocidad al Caminar , Anciano , Densidad Ósea , Huesos , Humanos , Persona de Mediana Edad , Radio (Anatomía) , Tibia/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: To assess the test-retest reliability of diagnostic ultrasonography measurements of the bilateral biceps brachii (BB), brachial artery, medial gastrocnemius (MG), and popliteal artery in survivors of stroke and their convergent validity with related clinical comparators. DESIGN: Cross-sectional study. SETTING: All procedures were conducted in a university laboratory. PARTICIPANTS: Sixty-five community dwelling adults (N=65; 26 women, 39 men) with an average age of 60.9±7.7 years and stroke duration of 5.7±3.9 years participated in this study. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Measures of muscle structure (ie, thickness, cross-sectional area, fascicle length, pennation angle), stiffness, and intramuscular blood perfusion were conducted using B-mode, elastography and color flow Doppler ultrasonography modes, respectively. Convergent validity was assessed by examining correlations between ultrasonography measures and assessments of related constructs (ie, dynamic stiffness, isometric peak torque, spasticity, and systemic vascular function using myotonometry, dynamometry, the Composite Spasticity Scale, and the Ankle-Brachial Index, respectively). A 2-way random-effects intraclass correlation coefficient (ICC) model (ICC2,3) was used to determine agreement between intersession measures among a smaller cohort of participants with stroke (n=20). RESULTS: ICC estimates ranged from moderate to excellent for muscle stiffness (paretic: ICC=0.74-0.89; nonparetic: ICC=0.66-0.88), structure (paretic: ICC=0.87-0.99; nonparetic: ICC=0.81-0.98), and blood perfusion measures (paretic: ICC=0.74-0.84; nonparetic: ICC=0.73-0.88). Weak to moderate associations were found between myotonometry and elastography measures of the bilateral BB (r=0.29-0.52, P≤.05) and MG muscles (r=0.31-0.69, P≤.05). The correlations between elastography measures and spasticity scores for the paretic upper (r=0.35-0.63, P≤.05) and lower limbs (r=0.25-0.37, P≤.05) were also weak to moderate. CONCLUSIONS: Elastography demonstrated mostly weak to moderate correlation with measures of stiffness using myotonometry as well as scores of paretic upper and lower limb spasticity. The results also indicate acceptable intersession reliability for muscle and vascular measures using several ultrasonography modalities among individuals with chronic stroke.
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Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Adulto , Anciano , Daño Encefálico Crónico , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Espasticidad Muscular , Reproducibilidad de los Resultados , Ultrasonografía/métodosRESUMEN
OBJECTIVES: The incidence of work-related musculoskeletal disorder remains high in sonography. The aims of this study are to determine the changes in muscle stiffness with different arm abduction angles, and to investigate the effect of cushion support on reducing muscle load in the supraspinatus when sonographers scan with the arm abducted to different angles. METHODS: This is a prospective crossover study. Twenty-three healthy female subjects aged between 20 and 23 years were included. Subjects were instructed to simulate performing standardized abdominal ultrasound scans. The changes in muscle stiffness of supraspinatus, measured as shear modulus, at rest and at 30°, 45°, and 60° arm abduction angles with and without cushion support were evaluated using shear-wave elastography. Styrofoam support was used for the cushion support. RESULTS: Mean shear moduli of supraspinatus were 27.77 ± 5.84 kPa at rest and 41.63 ± 7.09 kPa, 63.88 ± 14.43 kPa, and 89.76 ± 16.55 kPa for 30°, 45°, and 60° arm abduction respectively, which corresponds to 53%, 116% increase in muscle stiffness when scanning arm abducted from 30° to 45° and 60° (p < .001). After applying cushion support, shear moduli dropped to 24.04 ± 5.60 kPa, 31.98 ± 6.06 kPa, 37.47 ± 5.61 kPa for arm abducted to 30°, 45°, and 60° respectively (p < .001). The muscle stiffnesses between 30° abduction without support and 60° abduction with support had no significant difference (p > .05). CONCLUSIONS: Muscle stiffness of supraspinatus increased with increasing arm abduction angle during ultrasound scanning. Utilizing cushion support underneath the arm was effective in reducing muscle stiffness in supraspinatus. Our results provide scientific justification on postural modifications for sonographers.
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Brazo , Diagnóstico por Imagen de Elasticidad , Manguito de los Rotadores , Brazo/fisiología , Estudios Cruzados , Femenino , Humanos , Estudios Prospectivos , Manguito de los Rotadores/fisiopatología , Adulto JovenRESUMEN
Bone health is often compromised after stroke and the distal radius is a common site of fragility fractures. The macro- and mircoproperties of bone tissue after stroke and their clinical correlates are understudied. The objectives of the study were to use High-Resolution peripheral Quantitative Computed Tomography (HR-pQCT) to investigate the bone properties at the distal radius, and to identify the correlates of estimated failure load for the distal radius in people with chronic stroke. This was a cross-sectional study of 64 people with stroke (age: 60.8 ± 7.7 years, stroke duration: 5.7 ± 3.9 years) and 64 age- and sex-matched controls. Bilateral bone structural, densitometric, geometric and strength parameters of the distal radius were measured using HR-pQCT. The architecture, stiffness and echo intensity of the bilateral biceps brachii muscle and brachial artery blood flow were evaluated using diagnostic ultrasound. Other outcomes included the Fugl-Meyer Motor Assessment (FMA), Motor Activity Log (MAL), and Composite Spasticity Scale (CSS). The results revealed a significant side (paretic vs non-paretic for the stroke group, non-dominant vs dominant for controls) by group (stroke vs control) interaction effect for estimated failure load, cortical area, cortical thickness, trabecular number and trabecular separation, and all volumetric density parameters. Post-hoc analysis showed percent side-to-side differences in bone outcomes were greater in the stroke group than the control group, with the exception of trabecular thickness and intracortical porosity. Among the HR-pQCT variables, percent side-to-side difference in trabecular volumetric bone mineral density contributed the most to the percent side-to-side difference in estimated failure load in the stroke group (R2 change = 0.334, ß = 1.106). Stroke-related impairments (FMA, MAL, CSS) were found to be significant determinants of the percent side-to-side difference in estimated failure load (R2 change = 0.233, ß = -0.480). This was the first study to examine bone microstructure post-stroke. We found that the paretic distal radius had compromised bone structural properties and lower estimated failure load compared to the non-paretic side. Motor impairment was a determinant of estimated bone strength at the distal radius and may be a potential intervention target for improving bone health post-stroke.
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Radio (Anatomía) , Accidente Cerebrovascular , Anciano , Densidad Ósea , Estudios Transversales , Humanos , Persona de Mediana Edad , Radio (Anatomía)/diagnóstico por imagen , Accidente Cerebrovascular/diagnóstico por imagen , TibiaRESUMEN
Cardiac output (CO) monitoring is useful for sports performance training, but most methods are unsuitable as they are invasive or hinder performance. The performance of PhysioFlow (PF), a portable noninvasive transthoracic bioimpedance CO monitor, was evaluated and compared with a reference Doppler CO monitor, USCOM, using a head-up tilt (HUT) test. With ethics committee approval, 20 healthy well-trained athletes were subjected to HUT in a fixed order of 0°, 70°, 30°, and 0° for 3 min each. Simultaneous hemodynamic measurements using PF and USCOM were made 30 s after a change in HUT and analyzed using t tests, ANOVA, and mountain plots. Heart rate (HR) and stroke volume (SV) from both monitors changed according to physiological expectation of tilt, but PF measurements of SV were higher with a positive bias (PF vs. USCOM, 0°: 87.3 vs. 54.0 mL, P < 0.001; 70°: 76.5 vs. 39.5 mL, P < 0.001; 30°: 81.4 vs. 50.1 mL, P < 0.001; 0°: 88.3 vs. 57.1 mL, P < 0.001). Relative changes in SV (∆SV) after each tilt measured using PF were lower with a negative bias (PF vs. USCOM, 0° to 70°: -12.3% vs. -26.3%, P = 0.002; 70° to 30°: +6.4% vs. +31.2%, P < 0.001; 30° to 0°: +9.2% vs. +15.8%, P = 0.280). CO measurements using PF at 70° were erroneous. Compared with USCOM, PF overestimated SV measurements but underestimated the ∆SV between HUT. Accuracy of the PF deteriorated at 70°, implying a gravitational influence on its performance. These findings suggested that the suitability of PF for sports use is questionable.NEW & NOTEWORTHY The use of impedance cardiography to monitor physiological changes in sports is rarely reported. Using head-up tilt test, we evaluated a portable noninvasive impedance cardiography device (PhysioFlow) by comparing it with a reference Doppler monitor (USCOM). Accuracy in tracking hemodynamic changes deteriorated with higher tilt, implying a gravitational influence on its performance. Stroke volume measurements were overestimated, but the changes were underestimated. Despite its convenient physical features, the suitability of PhysioFlow for sports use is questionable.
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Hemodinámica , Pruebas de Mesa Inclinada , Atletas , Gasto Cardíaco , Humanos , Volumen SistólicoRESUMEN
BACKGROUND: This study aimed to investigate the sonographic appearances of the thyroid glands in nasopharyngeal carcinoma (NPC) patients whose cervical lymph nodes were treated with conventional radiotherapy (RT) or intensity-modulated radiotherapy (IMRT). The post-RT sonographic appearances of the thyroid glands in NPC patients were also correlated with the thyroid function. METHODS: One hundred and three NPC patients who had completed RT of cervical lymph nodes using the anterior cervical field, 30 NPC patients who had completed RT of cervical lymph nodes using IMRT, and 61 healthy subjects were included in the study. Thyroid glands were sonographically assessed for their size, echogenicity, vascularity, and internal architecture. Thyroid function tests were also performed on each subject. RESULTS: In comparison with the patients with abnormal thyroid function, the thyroid glands of the patients with normal thyroid function tended to be homogeneous and to have greater volume and echogenicity index (p < 0.05). Compared with those of the healthy subjects, the thyroid glands of patients previously treated with IMRT and those treated with the anterior cervical field showed significantly lower thyroid volume, lower incidence and number of nodules, and higher vascularity index (p < 0.05). CONCLUSIONS: The patient's history of previous RT should be taken into consideration in the sonographic examination of the thyroid gland post-RT. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 43:210-223, 2015.
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PURPOSE: The purpose of this study was to investigate the sonographic (US) appearances of submandibular glands in patients with nasopharyngeal carcinoma after external beam radiotherapy (RT) and compare them with those of healthy subjects. METHODS: A total of 81 nasopharyngeal carcinoma patients treated with RT and 66 healthy subjects were recruited and underwent submandibular gland US. Bilateral submandibular glands were assessed for their size, echogenicity, echogenicity margin sharpness, and echotexture. RESULTS: The mean ± SD transverse dimension of submandibular glands in patients treated with RT (2.5 ± 0.4 cm) was significantly smaller than that of healthy subjects (3.3 ± 0.4 cm) (p < 0.05). Submandibular glands in patients treated with RT tended to be heterogeneous (72%) with hypoechoic areas (46%) and ill-defined margins (89%). However, there were no statistically significant differences in echogenicity and conspicuity of intraglandular ducts of submandibular glands between patients and healthy subjects. CONCLUSIONS: RT-induced changes of the submandibular glands were demonstrated on US.
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Neoplasias Nasofaríngeas/radioterapia , Glándula Submandibular/diagnóstico por imagen , Glándula Submandibular/efectos de la radiación , Adulto , Anciano , Carcinoma , Femenino , Humanos , Masculino , Persona de Mediana Edad , Carcinoma Nasofaríngeo , Resultado del Tratamiento , UltrasonografíaRESUMEN
OBJECTIVE: To evaluate the use of ultrasonography for thyroid gland assessment in healthy Indo-Pacific bottlenose dolphins (Tursiops aduncus), describe the ultrasonographic appearance of the thyroid gland and adjacent anatomic structures, and identify potential associations between variations in thyroid gland morphology and demographic features in this species. ANIMALS: 18 captive Indo-Pacific bottlenose dolphins. PROCEDURES: 1,404 ultrasonographic examinations of the thyroid gland and adjacent anatomic structures (eg, cervical lymph nodes, musculature, and vasculature) were performed during the > 3-year study period. Shape, echogenicity, and homogeneity of thyroid glands were assessed, and glands were categorized into morphological configurations on the basis of results of 2-D and 3-D ultrasonographic evaluation. Associations between demographic factors and thyroid gland morphology were assessed. RESULTS: Thyroid lobes appeared elliptical or fusiform in the transverse scan plane and round to oval in longitudinal scan planes; morphologically, glands comprised 2 lobes joined by an isthmus or a roughly diamond-shaped structure located on the ventral surface of the trachea. Major blood vessels and cervical lymph nodes were identified. Thyroid parenchyma was typically uniform and homogeneous, with echogenic reticulations and well-defined borders. Thyroid glands were hypoechoic or isoechoic relative to the sternocephalicus muscle; echogenicity was greater in adolescents than in adults. Thyroid gland volume differed between sexes, between sexually mature and immature dolphins, and among age groups and was positively correlated with body length and weight. CONCLUSIONS AND CLINICAL RELEVANCE: Ultrasonography provided a reliable and repeatable method for evaluation of thyroid glands and adjacent anatomic structures in live dolphins.
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Delfín Mular/anatomía & histología , Glándula Tiroides/diagnóstico por imagen , Envejecimiento , Animales , Delfín Mular/crecimiento & desarrollo , Femenino , Masculino , Músculo Esquelético/diagnóstico por imagen , Cuello/diagnóstico por imagen , Factores Sexuales , Maduración Sexual , Glándula Tiroides/crecimiento & desarrollo , UltrasonografíaRESUMEN
Physiologic changes occurring in the thyroid in response to the estrous cycle have been noted in companion animals. However, in bottlenose dolphins, the influence of different reproductive states on thyroid morphology remains unclear. Sonography was used to evaluate the variations of thyroid morphology for nine consecutive estrous cycles of four sexually mature, female Indo-Pacific bottlenose dolphins (Tursiops aduncus). The estrous cycle was divided into two phases for evaluation: the follicular and luteal phases. To compare changes associated with sex, thyroid volumes were measured in the different phases during the estrous cycle of female dolphins and were compared to the ultrasound examinations of the four male dolphins measured over a 2-mo period. In males, there was no significant difference in thyroid volume during the study period (P > 0.05). The thyroid volume measured in combining all estrous cycle phases of the female dolphins was significantly larger than that measured in the male dolphins (P < 0.05). A difference in thyroid volume during the estrous cycle was observed, with the thyroid volume during the follicular phase significantly smaller (P < 0.05) than that of the luteal phase, and is possibly related to the influence of female sex steroids. Thyroid volume variability during estrus should, therefore, be taken into account when examining the thyroid gland of female dolphins.
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Delfín Mular/fisiología , Ciclo Estral/fisiología , Glándula Tiroides/anatomía & histología , Glándula Tiroides/fisiología , Animales , Femenino , MasculinoRESUMEN
The assessment of thyroid volume plays an indispensable role in the diagnosis and management of different thyroid diseases. The present study evaluates the accuracy of dolphin thyroid volume measurement as determined by four two-dimensional (2D) ultrasound methods (A-D), with a standard of reference using three-dimensional (3D) ultrasound. The measurement accuracy for different recognized thyroid configuration is also evaluated. Inter- and intraoperator variability of the measurement methods was determined. Thyroid ultrasound examinations were conducted in 16 apparently healthy Indo-Pacific bottlenose dolphins (Tursiops aduncus) with 2D and 3D ultrasound under identical scanning conditions. All 2D ultrasound measurement methods yielded high accuracies (79.9-81.3%) when compared with the 3D ultrasound measurement, and had high measurement reproducibility (77.6-86.2%) and repeatability (78.1-99.7%). For 2D ultrasound measurements, Methods A and B were more accurate and reliable than Methods C and D, regardless of thyroid configuration. Ultrasound is useful in the measurement of thyroid volume in bottlenose dolphins. For the first time, a reliable ultrasound scanning protocol for measuring dolphin thyroid volume was developed, which provides a means to establish a normative reference for the diagnosis of thyroid pathologies and to monitor the thyroid volume during the course of treatment in living dolphins. Key words: 3D ultrasound, Indo-Pacific bottlenose dolphin, thyroid volume measurement, Tursiops aduncus.
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Delfín Mular/anatomía & histología , Glándula Tiroides/anatomía & histología , Glándula Tiroides/diagnóstico por imagen , Ultrasonografía/veterinaria , Animales , Ultrasonografía/instrumentación , Ultrasonografía/métodosRESUMEN
Measurement of thyroid size and volume is a useful clinical parameter in both human and veterinary medicine, particularly for diagnosing thyroid diseases and guiding corrective therapy. Procuring a fully-equipped clinical ultrasound unit (FCUS) may be difficult in most veterinary settings. The present study evaluated the inter-equipment variability in dolphin thyroid ultrasound measurements between a portable ultrasound unit (PUS) and a FCUS; for both units, repeatability was also assessed. Thyroid ultrasound examinations were performed on 15 apparently healthy bottlenose dolphins with both PUS and FCUS under identical scanning conditions. There was a high level of agreement between the two ultrasound units in dolphin thyroid measurements (ICCâ=â0.859-0.976). A high intra-operator repeatability in thyroid measurements was found (PUS: ICCâ=â0.854-0.984, FCUS: ICCâ=â0.709-0.954). As a conclusion, no substantial inter-equipment variability was found between PUS and FCUS in dolphin thyroid size measurements under identical scanning conditions, supporting further application of PUS for quantitative analyses of dolphin thyroid gland in both research and clinical practices at aquarium settings.
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Delfín Mular/anatomía & histología , Glándula Tiroides/anatomía & histología , Glándula Tiroides/diagnóstico por imagen , Ultrasonografía/métodos , Animales , Humanos , Reproducibilidad de los Resultados , Ultrasonografía/instrumentaciónRESUMEN
This study aimed to investigate and compare the sonographic appearances of parotid glands in nasopharyngeal carcinoma patients treated with conventional radiotherapy (RT) or intensity-modulated radiotherapy (IMRT), and to compare them with healthy subjects. Totally 43 patients treated with conventional RT, 38 patients treated with IMRT and 58 healthy subjects were recruited and underwent parotid ultrasonography. Parotid glands were assessed for their size, echogenicity and internal architectures. The mean transverse dimension of parotid glands in patients treated with conventional RT and those treated with IMRT were significantly smaller than that in healthy subjects (p < 0.05). Parotid glands of the IMRT group tended to be hyperechoic (93%), homogenous (62%), without hypoechoic areas (64%) and with marginally-seen intra-parotid ducts (89%), which are similar to those in healthy subjects. Parotid glands in the conventional RT group tended to be hypoechoic (51%), heterogeneous (98%), with hypoechoic areas (94%) and had obviously-seen intra-parotid ducts (64%). For accurate diagnosis, post-RT changes of parotid glands should be noted in ultrasound examination of patients with previous radiotherapy.
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Neoplasias Nasofaríngeas/radioterapia , Glándula Parótida/diagnóstico por imagen , Radioterapia de Intensidad Modulada , Adulto , Anciano , Carcinoma , Estudios de Casos y Controles , Diagnóstico por Imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Carcinoma Nasofaríngeo , Neoplasias Nasofaríngeas/diagnóstico por imagen , Tamaño de los Órganos , Glándula Parótida/patología , UltrasonografíaRESUMEN
The testes of sexually mature dolphins produce large quantities of sperm. Sperm are expelled in copious amounts of seminal fluid through repeated ejaculations that can occur within a short period of time. There is currently a lack of detail about the methodology of sequential ejaculate collection in dolphins and how the traits of individual ejaculates affect the assessment of reproductive capacity. The objectives of this study were to obtain series of ejaculates from 3 dolphins by following a well-defined collection protocol and then to characterize individual ejaculates. Semen was collected weekly for 1 year from 3 sexually mature Tursiops aduncus. The end of a collection session was marked by a lack of semen, in spite of effort, or micturition. Individual ejaculates were analyzed for volume, pH, and sperm concentration, count, motility, and viability following methods previously described for dolphin semen. The first ejaculate was typically higher in volume and sperm count but lower in sperm concentration, motility, and viability. The concentration of the second ejaculate was generally the highest. Sperm motility and viability of the second and subsequent ejaculates in a series were good (ie, >80%). Collection of the first ejaculate only can lead to underestimation of reproductive capacity. Sperm output fluctuated erratically from week to week, so it was difficult to assess any seasonal pattern. Results provide information for further investigation of male dolphin reproductive patterns and any effect of collection frequency on ejaculate characteristics.
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Delfín Mular/genética , Eyaculación/fisiología , Preservación de Semen/veterinaria , Animales , Masculino , Semen , Preservación de Semen/métodos , Recuento de Espermatozoides , Motilidad EspermáticaRESUMEN
This study was undertaken to evaluate the reliability of two-dimensional (2D) ultrasound in measuring testis size in dolphins, in vivo, with the subject presenting for examination under voluntary or trained behaviour. The testes of five bottlenose dolphins (Tursiops aduncus) were measured once by two operators to test inter-operator variability (reproducibility) and repeatedly measured by the same operator to test intra-operator variability (repeatability). Ultrasound examinations for each test were conducted on the same day to avoid measurement variability due to time difference. The evaluation of reproducibility and repeatability were conducted on separate days. In the ultrasound examination, the length, circumference, depth and width of both testes of the animal were measured. To prevent bias, measurements were not communicated between the operators on-site and repeated measurements were masked. Results showed that both reproducibility and repeatability of all the testis measurements were high (>90%). Overall, measurement variability of the technique was found to be of a satisfactory level. Ultrasound is a useful imaging tool for routine long-term monitoring of the testes in this species of animals. Sources of error due to movements as a result of the subject being in the water during examinations were inevitable and must be taken into account.