Abstracts S17

W/cm2�20 s. 0.5 W/cm2�40 s. 1.0 W/cm2�10 s. 2.0 W/cm2�10 s. Inthe same intensity level of 0.5 W/cm2 and sonication time of 10 s, EPCsviability decreased with the increased bubble concentration as comparedwith control group. Most of the cells were observed adhere to the coverglasses by inverted microscope in control group, only a few suspendedliving cells, but a large number of suspended dead cells were observed inthe experiment group. Most of the attached EPCs differentiated wel. Withthe increase of the intensity of ultrasound , prolongation of sonication andconcentration of microbubbles, the intercellular space enlarged, the cellsbecame smaller and looked more round, showed some phenomenon aschromatin margination, karyopyknosis, nuclear fragmentation.Conclusion: EPCs could be isolated by density gradient centrifugation.The EPCs viability by microbubbles destruction is correlated with theintensity of ultrasound, prolongation of sonication and concentration ofmicrobubbles.

0082

Live Scanning Workshop: Brachial Plexus and Upper Limb NervesLisa Briggs, Premiere Orthopaedics, Australia

Ultrasound imaging of the brachial plexus is fast becoming the imagingmodality of choice when “locally” blocking the upper arm for rotatorcuff - shoulder surgery.As the brachial plexus innervates the upper extremity, and is relativelysuperficial , ultrasound can guide the anesthetist straight to the nervebundle ( brachial plexus ) to be “blocked”. This block is termed aninterscalene block and is the most proximal approach to the BrachialPlexus and the most suitable for proximal procedures on the arm andshoulder. The block is a paravertebral approach at the level of the cervicalroots in the neck and can provide both brachial and cervical nerve blocks.The anterior primary roots of the cervical nerves ( C5,6,7,8 T1) courseanterolaterally and inferiorly to lie between the anterior scalene and themiddle scalene muscles which, arise from the anterior and posteriortubercules of the cervical vertebrae. The prevertebral fascia covers boththe scalene muscles fusing laterally to enclose the brachial plexus in afascia sheath. This is easily identified with ultrasound as it presents asa bright echogenic structure ( sheath ) and a “bunch of grapes” imageas the nerve.Between the scalene muscles, these nerve roots unite to from threetrunks, which emerge from the interscalene groove to lie cephalopos-terior to the subclavian artery as it courses along the upper surface ofthe first rib. Once identified the needle ( 23G butterfly ) is introducedto the region in the transverse plane. The needle must be perpendicularto the ultrasound probe to demonstrate the tip and confirm the correctpositioning and angle required to anaethetise the brachial plexus.

0083

Live Scanning Workshop: WristLe-Anne Grimshaw, Mater Imaging, North Sydney, Australia

This will be a live scanning session demonstrating anatomy, techniqueand clinical assessment to help your ultrasound diagnosis be as accurateas possible. I will discuss how to narrow down your search when thepatient presents with vague generalised pain and what else to look forwith the targeted pain. Do your homework and learn your wrist anat-omy prior to this workshop to get the most out of it.

0084

Live Scanning Workshop: 18-20 Week ScanDelwyn Nicholls, Sydney Ultrasound for Women

The Australian Society of Ultrasound in Medicine (ASUM) providesguidelines for the satisfactory conduct and completion of the 18-20

week fetal morphology scan.

The objectives of the workshop include:� Discussion of how the maternal history and prior nuchal translucency/first trimester serology results may impact your approach to the assess-ment.� Describe the imaging planes required to perform routine fetal biom-etry.� Briefly discuss when you would extend your biometry examination,and what additional parameters are the most useful in this setting ofabnormal biometry.� Review the fetal heart imaging planes to assess the IVS, 4CH, RVOT,LVOT, DA, AA, arrow view and major venous channels.� Incorporate key image optimisation techniques that may assist in thedemonstration and documentation of normal and abnormal scan find-ings.� Imaging management of the morphology scan when the fetus hasadopted a poor imaging position, when fetal abnormality is encoun-tered, or when the scan is technically difficult due to maternal bodyhabitus.� Discuss the importance of assessing the location of the cord insertioninto the placenta, and recognition of velementous cord insertion andvasa praevia.� Review when to assess cervix morphology via a transvaginal ap-proach.

(Monday, 31 August 2009)

0202

Echocardiography in Search for Cardiac Source of EmboliChander Vanjani, P.D. Hinduja Hospital, India

Systemic embolisation resulting in transient ischemic neurologicalattack, embolic stroke or peripheral gangrene is a common entity seenin practice. Left heart along with aorta and carotids have been impli-cated in these patients. Echocardiographic examination provides auseful and definitive information in majority of these cases.Left atrial, appendicular and left ventricular thrombi, vegetations onnative or prosthetic valves, mitral valve prolapse, atrial septal aneu-rysm, annular calcifications, patent foramen ovale, septal defects, car-diac tumors, can all be imaged rapidly with routine transthoracic andtransesophageal examination.Protruding atheromatous plaques in aorta and carotids can be visualizedsuccessfully during the same examination.Intra-operative monitoring with transesophageal echo during deviceclosure procedures for PFO or septal defects can ensure the totalsuccess of the procedure.Echocardiography only demonstrates a potential cardiac source ofembolus. Negative finding does not rule out cardiogenic embolism,positive finding does not prove that it is the cause as some of theseconditions may be present is otherwise normal asymptomatic healthypopulation.

0204

Roles of Echo-Based Monitoring for Preventing NeurologicalComplications in Aortic SurgeryKazumasa Orihashi, Hiroshima University Hospital, JapanTaijiro Sueda, Hiroshima University Hospital, JapanKenji Okada, Hiroshima University Hospital, JapanKatsuhiko Imai, Hiroshima University Hospital, JapanTatsuya Kurosaki, Hiroshima University Hospital, JapanTaiichi Takasaki, Hiroshima University Hospital, JapanShinya Takahashi, Hiroshima University Hospital, Japan

Kiyohiko Morifuji, Hiroshima University Hospital, Japan