WFUMB Ultrasound Open最新文献

The purpose of this study was to comparative analyze the diagnostic efficiency of Thyroid Imaging Reporting and Data System proposed by Kwak, American College of Radiology, the European Thyroid Association and the Chinese Medical Association, respectively (Kwak TI-RADS, ACR TI-RADS, EU-TIRADS and C-TIRADS, respectively) for malignant risk stratification of thyroid nodules. A total of 1142 thyroid nodules confirmed by cytological or surgical pathologies were retrospectively classified according to Kwak TI-RADS, ACR TI-RADS, EU-TIRADS and C-TIRADS. The area under the receiver operating characteristic curve (AUC), the diagnostic sensitivity, specificity, Youden index, and accuracy of each TI-RADS for nodules was calculated and compared. The diagnostic sensitivity of ACR TI-RADS was 85.5%, which was lowest (all P < 0.05). The diagnostic specificity of ACR TI-RADS was higher than that of Kwak TI-RADS and EU-TIRADS (all P < 0.05), but there was no significant difference compared with that of C-TIRADS (x² = 2.335, P = 0.126). The diagnostic accuracies of the four methods were more than 85%, and there were no significant differences (all P > 0.05). The AUC of C-TIRADS was highest among the four methods (all P < 0.05). The four methods have high diagnostic efficiency in malignant risk stratification of thyroid nodules, and the AUC of C-TIRADS was higher than that of the other three methods.

Background

Rheumatoid arthritis (RA) is an autoimmune connective tissue disease which affects joint function and multiple body systems. Poor foot health for people with RA has a negative impact on mobility, functional capacity, and quality of life. Additional to joint pain, people with RA may develop vascular disease e.g., vasculitis, which can have increasingly detrimental effects on foot health, quality of life and longevity. If identified early, adverse effects may be prevented. However, the link between foot health symptoms and ultrasound identified precursory changes for vasculitis is yet to be established.

Objectives

This study aimed to examine the association between foot health symptoms and the integrity of the dorsalis pedis artery (DPA).

Methods

We recruited 47 participants with RA and 47 characteristic-matched controls. All participants completed an online survey which included demographic questions and Foot Health Status Questionnaire (FHSQ). Ultrasound imaging measured participants’ proximal DPA in terms of degree of wall inflammation, lumen diameter, artery diameter, lumen-to-artery diameter ratio and peak systolic velocity.

Results

Significant differences (p < 0.001) were noted between groups for degree of wall inflammation, artery diameter and lumen to artery diameter ratio, while lumen diameter and peak systolic velocity demonstrated no statistical difference. Degree of wall inflammation demonstrated stronger association with FHSQ score (r = −0.454, p < 0.001) than artery diameter (r = −0.361, p < 0.001) and lumen-to-artery diameter ratio (r = 0.404, p < 0.001), while FHSQ score did not relate to lumen diameter (p = 0.798) nor peak systolic velocity (p = 0.258).

Conclusion

We identified specific vascular ultrasound parameters were associated with foot symptoms among people with RA. This non-invasive imaging technique may be a viable method to monitor foot health and disease management.

Quantitative approaches to improve lung ultrasound (LUS) vertical artifacts (VA) interpretation using total signal intensity (I_TOT) are not widely available for clinical practice. In this study, we aimed to i) develop a mathematical algorithm to extract I_TOT as a post-hoc LUS analysis and ii) confirm I_TOT utility by conducting laboratory VA research using an in vitro model with different acoustic channels.

The I_TOT was extracted from static and conventional LUS imaging recorded from in vitro models after varying the amount of water content or the pores size of the phantom, compared to a control condition.

The defined algorithm was able to calculate the I_TOT from all phantoms. Mean I_TOT showed statistically significantly different values across phantom categories.

We demonstrate that I_TOT may be able to differentiate the in vitro acoustic channels formed by increased water content from those with small size pores. However, the utility of this semi-quantitative tool in clinical practice or other LUS imaging data sets remains unclear.

The World Federation of Ultrasound in Medicine and Biology (WFUMB) has started a series of position papers highlighting the role of ultrasound techniques for diagnosis, risk assessment and follow-up of incidental imaging findings. Gallbladder and biliary tree are among the most frequent anatomical localizations of incidental findings. A first part of the position paper on incidental findings of gallbladder and bile ducts was related to gallbladder polyps and other incidental findings of the gallbladder wall. Based on a description of normal findings, this second part addresses congenital anomalies and variations of the gallbladder and the biliary tree, asymptomatic bile duct dilatation and “silent” gallstones. Based on evidence on prevalence and outcome and with a special focus on ultrasound techniques, the position paper makes recommendations regarding diagnostic work-up, follow-up and treatment of these incidental findings.

M-mode ultrasonography has been used in the assessment of diaphragm kinetics. The sonographic diaphragmatic parameters can provide valuable information in the assessment and follow-up of patients with diaphragmatic dysfunction, during ventilation, and can potentially help to understand post-operative pulmonary dysfunction or weaning failure from ventilation. We conducted a systematic review of literature concerning the clinical applications of diaphragmatic ultrasound in children. The morphological and functional evaluation of the diaphragm by ultrasound technique is becoming an increasingly widespread practice in intensive, medical and surgery category. Our systematic review shows how diaphragmatic ultrasonography finds indication in different areas. It requires a standardization of parameters and normal measurement values.

Ultrasound is an emerging tool for muscle-based measurements. However, the analysis of hyperechoic images (high muscle fat infiltration, as in type 2 diabetes [T2D]) can be challenging.

Objective

To evaluate the reliability of ultrasound image analysis of muscle thickness and echointensity in older adults with T2D and non-diabetic controls by experienced and novice analysts. We hypothesized that reliability would be high for the experienced analysts, and lower, but acceptable, for a novice analyst.

Methods

We recruited three groups: 1) adults >60 years with T2D; 2) age- and sex-matched normoglycemic controls; and 3) healthy adults 18–35 years. All participants underwent ultrasound imaging of the abdomen and anterior thigh. Ultrasound images were de-identified, randomized, and separately analyzed by two expert analysts (>3 years experience each). A subset of images was also analyzed by a novice analyst with no prior experience. Inter- and intra-rater reliability was assessed using coefficients of variation (CVs), intraclass correlation coefficients (ICCs), and Bland-Altman analysis.

Results

For the expert analysts, ICCs were >0.90 and CVs were <10 % for all measurements, regardless of participant group. For the novice analyst, all ICCs were >0.90, except for rectus abdominus thickness measurements in the T2D group (ICC: 0.659 [95%CI: -0.134, 0.911]). CVs were <10 % for all measurements, except for rectus abdominus thickness in the T2D group (CV: 12.7 %). Ultrasound image analysis of muscle thickness and echointensity by experienced analysts was highly reliable.

Conclusion

Novice and expert analysts produced comparable measurements, except for rectus abdominus thickness in images obtained from older adults with T2D.

Objectives

The fallopian tube (FT) has emerged as an important imaging target in the detection of early ovarian cancer, which has remained an evasive challenge in the field of medicine. Recent understanding of ovarian cancer has identified the distal FT as the site of early tumorigenesis. Evaluation of the FT poses challenges due to the small size and variable anatomic position. This study outlines image acquisition and analysis techniques for volumetric depiction of the FT lumen.

Methods

Women with BRCA+ ​mutations undergoing risk reduction salpingo-ophorectomy were imaged using contrast-enhanced 3D transvaginal ultrasound (n ​= ​7). Sono-salpingography was conducted with intraluminal contrast instilled through the cervix for improved imaging of the FT lumen. Three-dimensional volumetric data was collected for qualitative and quantitative image analysis. Pathologic correlation was conducted using the Sectioning and Extensively Examining the Fimbriated End Protocol (SEE-FIM).

Results

Study subjects underwent 3D imaging with trans-cervical FT lumen contrast enhancement at the time of our interim reporting. None of the subjects in our initial study had serous tubal intraepithelial carcinoma (STIC) lesions, however one had acute inflammation of the FT. The 3D quantitative image analysis demonstrated areas of luminal irregularity corresponding to the regions of inflammation on pathology.

Conclusions

Our study shows promise in the detailed evaluation of the FT lumen for the detection of luminal abnormalities. We continue to optimize image acquisition and analysis techniques for the detection of STIC lesions as we enroll additional patients.

The increasing availability of biomedical data has attracted the interest of many researchers to understand and perform analysis on extracted patterns from data. Stroke is considered as one of the main causes of deaths worldwide. A considerable amount of work has been performed related to the cause of stroke and other physiological effects. Cerebral emboli is considered as one of the main sources of stroke. Algorithms from one of the traditional subjects called signal processing have been used in cerebral emboli detection and lot of researchers have performed emboli detection and classification using Fourier transform based algorithms and different filtering approaches.

In this paper, we discuss the physics of Doppler ultrasound and perform review of cerebral emboli detection algorithms and some animal models used in understanding the behaviour, size, and composition of emboli development. Ranging from Fourier transform, wavelet transform based emboli detection to neural network architectures trained with Doppler signal spectra, we performed comprehensive review of signal processing based cerebral emboli detection works and provide some basic understanding of related terms in emboli detection. With natural arterial structural relation between humans and some animals, we highlight some of the animal models used for understanding the nature of emboli development process.

Introduction

Transcatheter aortic valve replacement (TAVR) is performed in selected patients with severe aortic valve stenosis, leading to immediate relief of left ventricular outflow obstruction. The purpose of this study was to evaluate the immediate hemodynamic effects of TAVR on left ventricular stroke volume (SV_LVOT) and common carotid artery stroke volume (SV_CCA).

Material and methods

Twenty-five TAVR patients were included in this prospective observational study. Patients were treated under either local, or general anesthesia. Echocardiographic, and carotid ultrasound measurements were performed in the operating room pre (T1), and post (T2) TAVR. Changes in SV_LVOT, SV_CCA, carotid peak systolic velocity (PSV), pulsatility index (PI) and other carotid Doppler parameters were evaluated.

Results

Following TAVR, the aortic valve area (AVA) increased from 0.8 [0.6–0.9] to 1.9 [1.6–2.3] cm² (p < 0.001), and the peak transvalvular gradient (PG_AV) decreased from 70 [65–81] to 15 [11-18] mm Hg (p < 0.001) from T1 to T2. SV_LVOT increased from 58 ± 17 to 69 ± 24 ml, p < 0.01, whereas SV_CCA remained unchanged (from 10 [7-11] to 10 [8-11] ml, p = 0.50). Δ SV_LVOT was 19 [7–31] % and Δ SV_CCA was 1 [-7-20] %, p < 0.05. PSV increased from 68 ± 17 to 81 ± 17 cm/s, p < 0.001, and PI increased from 1.7 [1.5–2.2] to 2.2 [1.7–2.6], p < 0.001.

Conclusion

Successful TAVR resulted in immediate improvement of left ventricular stroke volume, whereas carotid stroke volume remained unchanged.