WFUMB Ultrasound Open最新文献

Background

Breathing pattern disorders (BPD) are commonly managed by physiotherapists. As no gold-standard assessment diagnostic tools are currently available, diagnosis is challenging. Ultrasound imaging has become popular in physiotherapy. This research examined diaphragm thickness using ultrasound imaging in females with BPD and healthy female controls to ascertain if diaphragm thickness at different measurement points related with reduced diaphragm thickness.

Methods

Observational cross-sectional design was used. Two female groups were recruited from an outpatient setting: BPD group (n = 19) and control group (n = 18) with normal body mass index (BMI). BPD inclusion criteria assessment included: Nijmegen Questionnaire (NQ) score, respiratory rate, Hi-Lo test, and breath hold time. USI measured diaphragm thickness at the measurement points of: tidal exhalation (Tvex), tidal inhalation (Tvin), maximum inhalation (Tmax) and exhalation to residual volume (Tmin); diaphragm thickening fraction (TF) was calculated.

Results

Results indicated significant differences of diaphragm thickness between the BPD and control groups at Tvex, Tvin, Tmax and TF on the left and Tvex and Tvin on the right side (P < 0.05).

Conclusion

Diaphragm thickness is reduced in females with BPD when compared with healthy controls. Diaphragm measurement undertaken by USI may provide a useful assessment tool in BPD. Further research is required to validate this assessment and to broaden its use in BPD.

Endometriosis is a common chronic gynecological disorder presenting with cyclical pain and infertility in premenopausal females. In some patient's endometrial lesions can be advanced and infiltrate deep into the peritoneum (deep infiltrating endometriosis (DIE)) and pelvic organs, and cases can be challenging for management. Posterior compartment endometriosis, in particular involvement of the recto-sigmoid can be challenging for surgeons, and presurgical detection and proper characterization of involvement on imaging is prudent. Ultrasound and MR are the main modalities to evaluate pelvic endometriosis. Imaging evaluation requires identifying the number, location, and size of the lesions, as well as the degree of depth and circumferential involvement of the rectum. To better explain imaging evaluation and characterization of rectal endometriosis, in this paper we have elaborated pictorial review of 14 surgically proven rectal endometriosis cases. We have also mentioned about the rectal endometriosis reporting guidelines set by Society of Abdominal Radiology (SAR). To our knowledge presently there are no dedicated pictorial reviews specific to rectal endometriosis encompassing both US, MR and SAR guidelines in the English literature.

Background and aim

Hysterosalpingo contrast sonography (HyCoSy) is a well-tolerated diagnostic tool to examine the uterus, ovaries, fallopian tubes, and pelvis. It has some advantages over other techniques, such as X-ray hysterosalpingography (HSG), laparoscopy, and dye intubation. This prospective study aimed to investigate the use of 2D/3D/4D HyCoSy, using lignocaine gel and normal saline as a contrast agent, to assess tubal patency and uterine abnormalities in infertile women.

Method

More than 5000 infertile cases were evaluated by HyCoSy 2D/3D/4D test using lignocaine gel as a contrast agent during the period of 2016–2022 at Shilpa Scanning Center, Andhra Pradesh. Among the subjects studied, a total of 850 cases were randomly selected to assess tubal patency. Of 850 patients, 54 had X-ray HSG reports that were reassessed using 2D/3D/4D HyCoSy. During the test, we also assess the intensity of the pain.

Results

Out of 850 infertile patients, 603 (70.94%) had primary infertility, and 247 (29.06%) had secondary infertility. The fallopian tubes were found to be patent in 702 (82.59%) of these patients, while 80 (9.41%) had unilateral occlusion and 68 (8%) had bilateral occlusion. Among the 54 patients with previous reports of X-ray HSG, three were misdiagnosed as bilateral obstruction and six as unilateral obstruction, and these misdiagnoses were confirmed by 2D/3D/4D HyCoSy using lignosal contrast and laparoscopic dye testing. During the HyCoSy procedure, 772 women (90.82%) reported mild pain that was less severe than menstrual pain.

Conclusions

The 2D/3D/4D-HyCoSy with lignosal gel as a contrast agent could be a promising tool for detecting fallopian tube patency and uterine abnormalities.

Introduction

In general, there is a lack of technical quality assurance (TQA) in ultrasound, which threatens patients. This study aimed to map the level of ultrasound quality assurance in Danish Radiology Departments, assess the intra- and interrater reliability of the in-air method for evaluating transducer quality, and determine the prevalence of faulty transducers.

Methods

From October to November 2021, an anonymous survey focused on the extent of TQA was e-mailed to clinicians (via managers) responsible for ultrasound TQA. The six-item survey included both closed and open-ended questions. In addition, a sample of 63 ultrasound b-mode reverberation images was collected from four Danish Radiological Departments, later rated by two blinded radiographers on a dichotomous scale.

Results

A total of 46 participants responded to the survey. In the survey, 15 respondents reported not having a TQA procedure, while six thought a procedure existed but were uncertain. Various methods were reported for the respondents who answered that TQA was performed (n = 13).

Half of the respondents (n = 23, 50%) reported experiencing transducer malfunctions, and seven said they did not find the lack of regular testing problematic.

The interrater reliability was κ = 0.75 (95% CI.: 0.61–0.89), and the inter-rater reliability was κ = 0.84 (95% CI.: 0.70–0.98). Based on the agreement between the two raters, 20 out of 50 (40%) transducers were flawed.

Conclusion

This study demonstrates the general deficiency of TQA in Danish Radiological Departments, with 21 clinicians responsible for ultrasound TQA responding either not having a TQA procedure or being uncertain if one exists. Furthermore, the study reveals that the in-air method for assessing transducer quality demonstrates moderate to almost perfect reliability and that nearly half of the transducer tested exhibits visual faults.

The peak velocity variation within the carotid artery (ΔVpeak_CCA) and left ventricular outflow tract (ΔVpeak_LVOT) is derived from the pulsed wave Doppler waveform and may predict fluid responsiveness. The aim of this study was to evaluate ΔVpeak_CCA and ΔVpeak_LVOT against calibrated stroke volume variation (SVV) and pulse pressure variation (PVV). Therefore, eighteen cardiac surgery patients were included in this prospective observational study. Doppler measurements were performed after induction of anesthesia, after a passive leg raise, and at the end of surgery. Simultaneously, SVV and PPV were measured by pulse-contour-analysis (PiCCO). The correlation, methodological agreement, concordance, and clinical agreement between Doppler and PiCCO measurements were assessed. The correlation between SVV and ΔVpeak_CCA was strong (ρ = 0.88). Bland-Altman analysis demonstrated a bias of 0.01%, and LOA +/− 4.6%, acceptable concordance (93%), and close to acceptable clinical agreement (88%). For PPV and ΔVpeak_CCA correlation was also strong (ρ = 0.73), bias was −0.2%, LOA +/− 7.6%, with intermediate acceptable concordance (90%), and low clinical agreement (72%). Analysis of ΔVpeak_LVOT measurements demonstrated poor statistical agreement with SVV and PPV. In conclusion, in cardiac surgery patients ΔVpeak_CCA, as opposed to ΔVpeak_LVOT, has acceptable statistical and clinical agreement with SVV measurements. ΔVpeak_CCA may qualify as a potential tool for non-invasive assessment of fluid responsiveness.

The increasing use of Point of Care Ultrasonography (POCUS) in medicine and healthcare prompted this pilot study, which aims to gain insight into the feasibility of online, self-directed POCUS training in the Physician Assistant (PA) curriculum. A mixed-method approach was used, gathering and analyzing data obtained from two cohorts of students in their didactic phase of training. Students completed a baseline survey, followed by the completion of several self-directed POCUS training modules, after which a post-survey was obtained. Seventy-six percent of the students had never used POCUS before. At the completion of the training, students demonstrated an increased level of confidence and comfort level using POCUS. The self-directed, self-paced, online format was not very favorable among the students. The recommendations for modifications, to incorporate live hands-on instruction were well received. It is important for PA programs to evaluate all aspects of a proposed POCUS training, including students’ perception, for a more meaningful learning experience.

Objectives

The purpose of this study was to develop a severity rating scale for lung ultrasound pathology in lower respiratory tract infection based on multicenter expert consensus, and to test inter-rater reliability.

Methods

Ten point-of-care ultrasound experts from three academic institutions developed the scale iteratively through literature review, expert opinion, and pilot testing. Clips were prospectively collected from adults suspected of COVID-19 using a 14-zone scanning protocol. Blinded reviewers independently rated four data subsets. The rating scale was refined through eight consensus-building discussions reviewing challenging cases from the first three subsets. The final scale consisted of a set of ordinal scores from 0 to 4, for five sonographic findings: B-lines, pleural line abnormalities, consolidations, pleural effusions, and overall lung aeration. Ratings from the fourth subset were analyzed to determine reliability based on intraclass correlation coefficient (ICC). A total of 11,126 cine clips from 220 patients were acquired.

Discussion

After excluding uninterpretable clips, the test dataset contained 81 clips and yielded an average ICC of 0.70 across the five sonographic findings (0.76 for B-lines, 0.52 for pleural line abnormalities, 0.71 for consolidations, 0.80 for pleural effusions, and 0.70 for overall lung aeration). Improvements in agreement were observed with each successive review session and dataset rating.

Conclusion

The lung ultrasound severity scale established by multicenter expert consensus achieved moderate to good inter-rater reliability. The scale could be used clinically to standardize assessment of lower respiratory tract infection and in future studies to develop methods for automated interpretation of lung ultrasound pathology.