All preoperative abdominal US examinations were performed using a convex probe (2–5 MHz) and/or a high-frequency linear probe (2–8 MHz), with the patient lying in the supine and/or left lateral decubitus position. US was performed using one of the following commercially available US units: LOGIQ E9 and LOGIQ 9, GE Healthcare; Aixplorer, SuperSonic Imagine; iU22, Philips Healthcare; and RS80A, Samsung Medison. For each patient, US was performed by one of the assigned radiologists with clinical experience in US ranging from two to 39 years. Before starting the examination, we carefully reviewed each patient’s clinical history, chief complaints, and previously obtained images. During the US examinations, GB was examined with the right intercostal and/or subcostal approach using a convex probe. The US parameters were as follows: frequency of 4 MHz, gain of 27%–33%, dynamic range of 69, and a frame rate of 30 to 45 pictures/s. GB was then evaluated using a high-frequency linear probe according to the operator’s requirements. To optimize GB evaluation, real-time spatial compound imaging (three to five compound beams per imaging frame) and speckle reduction techniques of a mild degree were used. Harmonic imaging techniques were used to improve penetration and spatial resolution.
Aixplorer
Manufactured by Philips
The Aixplorer is a medical imaging device designed for diagnostic and therapeutic applications. It utilizes ultrasound technology to capture real-time images of internal structures within the body. The core function of the Aixplorer is to provide healthcare professionals with a non-invasive tool for visualization and analysis of various organs and tissues.
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2 protocols using aixplorer
1
Comprehensive Gallbladder Ultrasound Protocol
2
Ultrasound Characterization of Gastric Lesions
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Color doppler ultrasonic diagnostic apparatus from Toshiba Aplio 500, Supersonic Aixplorer, and PHILIPS EPIQ5 was used. Transabdominal ultrasound was performed using a convex array probe and a line array probe. We conducted a retrospective review of the image data and selected two-dimensional (2D) ultrasound images in digital imaging and communications in medicine (DICOM) format that scanned by convex array probe, which clearly showed the largest cross-section of each lesion. The tumor location(gastric or extra-gastric),internal echo (hypoecho or isoecho), echo homogeneity (homogeneous or inhomogeneous), boundary (clear or unclear), shape (regular or irregular), blood flow signals of the lesion (according to the Alder blood flow classification, where grades 0 and 1 were merged as low blood supply, and grades 2 and 3 were merged as multiple blood supply), presence of necrotic cystic degeneration (necrotic areas were diagnosed from sharply demarcated anechoic areas), and maximum lesion diameter (≤5.0 cm or >5.0 cm) were recorded in detail.
In this study, the tumor outline at the largest cross-sectional area was manually drawn to indicate the region of interest (ROI) along the tumor margin using a free open-source software package (ITK-SNAP, version 3.8.0, University of Pennsylvania, Philadelphia, USA).
In this study, the tumor outline at the largest cross-sectional area was manually drawn to indicate the region of interest (ROI) along the tumor margin using a free open-source software package (ITK-SNAP, version 3.8.0, University of Pennsylvania, Philadelphia, USA).
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