title: Quantitative ultrasound imaging of healthy and reconstructed cleft lip: a feasibility study.
abstract: OBJECTIVE
  To investigate the feasibility of echographic imaging of healthy and reconstructed cleft lip and to estimate tissue dimensions and normalized echo level.
  
  
  METHODS
  Echographic images of the upper lip were made on three healthy subjects and two patients using a linear array transducer (7 to 11 MHz bandwidth) and a noncontact gel coupling. Tissue dimensions were measured using calipers. Echo levels were calibrated and were corrected for beam characteristics, gel path, and tissue attenuation using a tissue-mimicking phantom.
  
  
  RESULTS
  At the central position of the philtrum, mean thickness (SD) of lip loose connective tissue layer, orbicularis oris muscle, and dense connective layer was 4.0 (0.1) mm, 2.3 (0.7) mm, and 2.2 (0.7) mm, respectively, in healthy lip at rest; and 4.1 (0.9) mm, 3.8 (1.7) mm, and 2.6 (0.6) mm, respectively, in contracted lip. Mean (SD) echo level of muscle and dense connective tissue layer with respect to echo level of lip loose connective tissue layer was -19.3 (0.6) dB and -10.7 (4.0) dB, respectively, in relaxed condition and -20.7 (1.5) dB and -7.7 (2.3) dB, respectively, in contracted state. Color mode echo images were calculated, showing lip tissues in separate colors and highlighting details like discontinuity of the orbicularis oris muscle and presence of scar tissue.
  
  
  CONCLUSIONS
  Quantitative assessment of thickness and echo level of various lip tissues is feasible after proper echographic equipment calibration. Diagnostic potentials of this method for noninvasive evaluation of cleft lip reconstruction outcome are promising.
authors.affiliation: Department of Orthodontics and Oral Biology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Nancy J M
authors.initials: NJ
authors.lastname: van Hees
authors.forename: Johan M
authors.initials: JM
authors.lastname: Thijssen
authors.forename: Rinske W
authors.initials: RW
authors.lastname: Huyskens
authors.forename: Gert
authors.initials: G
authors.lastname: Weijers
authors.forename: Maartje M
authors.initials: MM
authors.lastname: Nillesen
authors.forename: Chris L
authors.initials: CL
authors.lastname: de Korte
authors.forename: Christos
authors.initials: C
authors.lastname: Katsaros
mesh_terms: D000328:Adult; D002921:Cicatrix / Q000000981:diagnostic imaging*; D002971:Cleft Lip / Q000000981:diagnostic imaging* / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008046:Lip / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D008297:Male; D009119:Muscle Contraction / Q000502:physiology; D009126:Muscle Relaxation / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000592:standards*; D012016:Reference Values; D014463:Ultrasonography