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Theses and dissertations (Health Sciences)

Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/12

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Subject: search.filters.subject.Diagnostic ultrasonic imaging

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    Shear wave ultrasound elastography of the shoulder joint tendons
    (2020-06-10) Ramdev, Harashalata; Govender, Nalini; Dludla, Zombuso
    Background: The assessment of tissue elasticity in clinical practice has not been well established. Shear wave ultrasound elastography is a recent technique which quantitatively estimates tissue elasticity. This study, therefore, aimed to assess the biomechanics of the rotator cuff and biceps tendons of the shoulder joint in asymptomatic participants, in order to establish a reference range for use in clinical practice. The objectives of this study were to measure the elasticity of the rotator cuff and biceps tendons (in kilopascals), using shear wave ultrasound elastography and to establish a shear wave ultrasound elastographic reference range of the rotator cuff and biceps tendons for use in clinical practice. Methods: This quantitative study included 260 asymptomatic participants aged between 21 and 45 years (mean age 34.52±7.75 years). The demographic data incorporated participants’ age, gender, race, weight, height, daily lifestyle activities, body mass index and medical history. Data was collected using a demographic questionnaire, B-Mode ultrasound and shear wave ultrasound elastography, using the GE Logiq E 9 equipment. The proximal, middle and distal sites of the biceps, subscapularis, and supraspinatus and infraspinatus tendons were imaged in both longitudinal and axial planes. The teres minor tendon was imaged in a single sagittal and axial plane. Results: The reference ranges of the rotator cuff and biceps tendons have been evaluated by finding 95% confidence intervals for the mean elasticity for each of the tendons. A 95% confidence interval provides a lower and upper limit into which 95% of tendon measurements would be expected to fall. The reference ranges for the mean tendon elasticity for the tendons were as follows: For the biceps tendon in sagittal and axial planes, the reference ranges are 102.52-108.34 kPa and 96.44-101.08 kPa respectively. For the subscapularis tendon in sagittal and axial planes, the reference ranges are 102.84-110.60 kPa and 110.60 kPa-108.02 kPa respectively. The supraspinatus tendon in sagittal and axial planes have reference ranges 106.83-114.54 kPa and 102.29-109.59 kPa, respectively. The infraspinatus tendon in sagittal and axial planes have reference ranges 102.39-111.87 kPa and 99.61-107.77 kPa respectively. The reference ranges for teres minor tendon in sagittal and axial planes are 96.90-101.20 kPa and 96.68- 101.09 kPa respectively. There was a statistically significant difference in the reference values observed between males and females for the proximal, middle and distal sites of the biceps tendon in the sagittal plane (p<0.05). The reference values ranged from 101.93±18.84 kPa-104.09±16.86 kPa (in females) and 109.40±18.15 kPa-109.41±19.07 kPa (in males). A statistically significant difference was also noted in the teres minor tendon in the sagittal and axial planes (p<0.05). The reference values ranged from 96.71±16.49 kPa (in females)-102.74±18.76 kPa (in males) in the sagittal plane and 97.03±18.29kPa (in females)-101.79±17.39 kPa (in males) in the axial plane. Conclusion: This study provided a non-invasive estimate of the elasticity of the rotator cuff and biceps tendons in kPa, using shear wave ultrasound elastography (SWUE). The results of our study have the potential to complement B-Mode ultrasound in the diagnosis, treatment and follow up of rotator cuff and biceps tendon pathology.
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    An evaluation of transvaginal ultrasound in the assessment of endometrial thickness in black South African patients presenting with postmenopausal uterine bleeding
    (2004) Moodley, Premla; Lachman, Nirusha
    The object of this study was to use Transvaginal ultrasound to evaluate the thickness of the endometrium to exclude endometrial abnormality in Black South African women with postmenopausal uterine bleeding. Transvaginal ultrasound is an excellent diagnostic method for assessing endometrial pathology. The study was carried out at the Gynaecological Ultrasound Department, King Edward VIII Hospital. The study included 76 Black women with postmenopausal uterine bleeding. The thickness of the endometrium was measured by Transvaginal ultrasound. The measurement included both endometrial layers (double-layer technique). The Transvaginal ultrasound measurement was compared with the histopathological diagnosis of the biopsy specimens. At the end of the investigation, findings obtained were 3.9% non-representative, 44.8% endometrial adenocarcinomas, 14.5% benign polyp, 3.9% chronic Endometritis, 17.1% benign endometrium, 5.3% endometrial hyperplasia, 9.2% atrophic endometrium, 3.9% myometrial invasion and 1.3% Malignant Mixed Mullerian Tumour. In this study, the thickness of the endometrial echo varied from 5mm to 35mm, with a mean of 18,2mm. When the thickness of the endometrial echo was compared with the histopathological results, the mean value for non-representative was 7.83mm, much lower than the thickness of an active endometrium (13.25mm). In cases with atrophic endometrium, the thickness ranged from 6mm to 30mm with a mean of 15.86mm. The mean value obtained for cases with endometrial adenocarcinoma was 20.32mm (range 11 to 35mm). The sensitivity, specificity and accuracy of Transvaginal ultrasound for detecting endometrial malignancy were 100% if the cutoff limit of 4mm was used In conclusion, this study using Transvaginal ultrasound demonstrated that a thickness limit greater than 8mm was considered in detecting malignancy. No malignant endometrium was thinner than 5mm. Therefore in women with postmenopausal uterine bleeding and an endometrium less than 4mm, it may be justified not to perform further investigations. Transvaginal ultrasound is a simple, well-tolerated safe and reliable method for identifying endometrial thickness in postmenopausal Black South African women.
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    Prevalence of gallstones in the black population of District 28 in relation to age, gender, diet and body mass index
    (2006) Mhlongo, Bhekithemba Goodlord; Naidoo, Subhadranalene
    This study aimed at determining and evaluating the prevalence of gallstones in the Black population of District 28 (D28) in relation to age, gender, diet and body mass index (BMI) in order to identify people at high risk and advise them so that they can avoid the complications and decrease the morbidity rate. Blacks are thought to have increased prevalence of gallstones but there has been no systematic evaluation of its prevalence in D28. METHODS AND MATERIALS 389 Black people from D28 were selected from referrals (for many different radiological examinations) coming to the X-ray and ultrasound departments. Some of the respondents were staff members who also met the selection criteria for the study. An interview was conducted at Ngwelezane hospital using a structured questionnaire on health, social and diet history of the respondents. All information was entered into the data sheet. All respondents were then scanned using Mid-range ultrasound machines to establish the presence of gallstones and this information was thereafter documented on the data sheet. SPSS version 11.5 (SPSS Inc, Chicago, III) was used for data analysis. Prevalence and 95% confidence intervals were calculated using the Epitable module of Epi Info version 6.04 (CDC, 2001). Pearson's Chi square tests were used to assess associations between categorical variables and gall stones. Logistic regression analysis was applied to assess the independent effects of multiple risk factors on the development of gallstones. Backwards elimination method based on likelihood ratios was used with entry and exit probabilities set at 0.05 and 0.1 respectively