Background: Central venous catheterization (CVC) insertion is a prevalent invasive procedure performed in critical care patients. Although this procedure is considered to provide better patient comfort and a lower infection risk compared to other methods, it has a higher risk of complications, such as pneumothorax, arterial puncture, nerve injury, and bleeding. Ultrasonography (USG)-guided subclavian catheterization has recently become a popular technique. This study retrospectively analyzed 50 patients in the intensive care unit (ICU) who underwent infraclavicular subclavian catheterization with the out-of-plane technique under USG guidance. Objectives: This study aimed to evaluate the effectiveness of subclavian catheterization applied with the out-of-plane technique in the ICU. Methods: This retrospective study included 50 patients who underwent subclavian CVC insertion via the out-of-plane technique under USG guidance in the ICU between March and December 2020. Age, gender, height, weight, body mass index, admission to the ICU, use of anticoagulant and/or anti-aggregant medicine, and coagulation parameters were recorded for each patient. The success of the procedure, the number of attempts, and the duration of the procedure were scanned retrospectively from the records. Malposition and complications were monitored using USG throughout the procedure and chest radiographs after the procedure. Results: The 50 patients comprised 27 (54%) men and 23 (46%) women, with a mean age of 72. 8±, 11. 8 years. In all patients, subclavian CVC insertion was successfully performed under USG guidance via the out-of-plane technique. The mean procedural time was 220. 90±, 60. 20 sec. The procedure was completed in a single session for 27 (54%), two sessions for 22 (44%), and three sessions for 1 (2%) patient. Only one complication (pneumothorax) developed in one patient, who underwent tube thoracostomy. No catheter malposition was observed in other patients. Conclusion: USG-guided subclavian catheterization is a safe technique to be performed by experienced practitioners.

Diagnosis of the cystic lesion of the neck in pediatric cases is challenging for radiologists. There are different cystic lesions in the neck region that can present themselves in various parts of this area. Some lesions may lie in the middle parts and some in the lateral areas,however, some cystic defects can be present in every part of the neck. Sonography is the first modality for the assessment of the cases, along with history and physical examination. Sonography is nearly accessible and is not expensive,however, it depends on the expertise of the sonographer. We reviewed sonography findings of various cystic lesions in the neck region and reported the findings with this regard.

Background: Traumatic peripheral nerve injuries (PNIs) caused by penetrating and lacerated trauma are among the most prevalent microsurgical injuries. Post-treatment follow-up and prognosis of patients undergoing repair are often based on clinical examinations and electrodiagnostic findings. Therefore, a reliable, inexpensive, useful, and rapidly accessible diagnostic method is necessary during the patient's follow-up. Objectives: This study aimed to assess the relationship between ultrasound imaging and treatment outcomes in patients with median peripheral nerve injury. Methods: In this cohort study, 21 eligible patients with symptoms of acute median nerve injury (MNI) caused by penetrating trauma in microsurgery were studied from June 2018 to June 2019. The patients underwent ultrasonography three months after repair and were followed up for at least nine months. The outcomes of the treatment were compared with those obtained six months after ultrasonography. Results: In all studied patients, mean thicknesses of the repaired nerve on the distal and the proximal sides were 2. 58± 0. 51 and 2. 51± 0. 61 mm2, respectively; 12 cases (57. 1%) recovered very well nine months after surgery and in nine cases (42. 9%) no nerve recovery was observed based on clinical electromyography (EMG) examinations and nerve conduction velocity (NCV). The amount of neuroma formed at the repair site was lower in well-recovered patients (1. 5± 0. 4 mm3) than those with no recovery (4. 9± 1. 5 mm3). No re-rupture was observed at the repair site. Each group underwent two-four repairs of flexor tendons. Conclusion: Ultrasound can be used as an effective and non-invasive method for assessment of PNI and follow-up of reconstructive surgery.

Urinary tract infection (UTI) is a common disorder in children with risk of renal scar formation and other well known complications. Dimercapto- Succinic Acid (DSMA) scan is a good tool for detecting renal scars, but is expensive and unavailable in most centers. In contrast, ultrasonography is inexpensive and available, but its role in detecting renal scars is controversial. This study was performed on children with UTI admitted in nephrology ward of Kermanshah Razi hospital during 1995-1996 to evaluate the strength of ultrasonography in comparison diagnosis of renal scar in comparison to DSMA scan.This clinical trial (diagnostic type) study took place on 141 kidneys with pyelonephritis. All of the kidneys examined with ultrasonography (3.5 MHZ probe) and DSMA scan. The sensitivity, specificity, positive predictive value and negative predictive value or ultrasonography in comparison to DSMIA scan as golden standard, were calculated.Seventhly one patient (17 boys and 54 girls) were studied. Range of age was between 1 month and 12 years. Among 133 kidneys included in the study, 33 kidneys had renal scars in DMSA scan. Ultrasonography was negative for renal scar In all or the cases. 

Background: Systemic sclerosis is an autoimmune connective tissue disorder which is characterised by cutaneous and internal organ fibrosis. Raynaud’s phenomenon is the earliest feature and may precede the onset of the disease by months to years. The heart, lungs, gastrointestinal tract, kidneys and other organs may be involved. Our aim was to evaluate skin thickness and echogenicity in systemic sclerosis patients by ultrasound and compare it with the healthy age and sex matched controls.Method: Our study included 15 successively admitted patients (14 females and 1 male) with systemic sclerosis and 15 healthy age and sex matched controls. All the patients met the ACR criteria of diagnosis. The age range of the patients was 25-55 years. The disease duration ranged from 1-8 years. A complete history and physical examination was done for each patient. Skin thickness and echogenicity were measured by a 20MHz ultrasound probe at 6 different anatomical sites which was compared with that of the controls.Result: Skin thickness was more in systemic sclerosis patients (significant p value) as compared to controls, and echogenicity was inversely proportional to the skin thickness.Conclusion: Skin ultrasonography is a noninvasive method which can reflect the severity of skin involvement and periodic assessment of skin thickness and echogenicity can help to monitor the progression of the disease.

Background: Ovarian immature teratoma is a very rare type of tumor associated with a high relapse rate and mortality. Correspondingly, early diagnosis is important for effective treatment. The goal of this study was to retrospectively analyze the ultrasound characteristics of 11 cases of immature teratomas.Materials and Methods: Between January 2002 and December 2010, 11 patients were diagnosed with pathologically confirmed immature teratomas. Patients enrolled in this study underwent a transabdominal ultrasound examination prior to surgery. Tumor size, shape, internal echo, calcification, cystic degeneration, and blood flow for each immature teratoma were analyzed. Levels of alpha fetal protein (aFP) were also evaluated.Results: The average tumor size was 8 cm (range, 4-13). Echo patierns obtained included mixed echo (n=7), solid echo (n=2), and cystic echo (n= 2). Coarse calcifications were detected in five cases, while blood flow signal was detected in one case, and ascites were detected in three cases. Only one case had elevated levels of aFP.Conclusion: Ultrasound imaging of immature teratomas detected large tumors that were predominantly involved mixedecho masses, cystic degeneration, and coarse calcification on the cavity wall. In some cases, blood flow signal was detected in the mass and ascites were present in the abdominal cavity.