Journal of Clinical Ultrasound最新文献

This review aimed to evaluate accuracy of transvaginal ultrasonography (TVUS) in detecting parametrial invasion, stromal invasion, and metastasis of lymph nodes in patients with cervical cancer. We performed bivariate meta-analysis using STATA 14.2, calculating pooled sensitivity, specificity, diagnostic odds ratio (DOR), and likelihood ratios (LR+ and LR-). In total, 18 studies were included. TVUS showed pooled sensitivities of 82%, 82%, and 75% and specificities of 92%, 78%, and 96% for detecting parametrial invasion, stromal invasion, and lymph node metastasis, respectively. TVUS is reliable tool for confirming parametrial invasion and lymph node metastasis in cervical cancer, particularly, in resource-limited settings.

In the previous published reviews Part 1 and Part 2, we examined the association between placental and umbilical cord anomalies in relation to adverse perinatal outcomes. In this conclusive Part 3, only umbilical cord vascular anomalies are considered, together with the perinatal effects caused by maternal vascular malperfusion and the secondary fetal vascular malperfusion anomalies. Specifically, the review comprises the following umbilical cord pathologies: umbilical cord torsion/stricture, amniotic band syndrome and umbilical cord strictures/strangulation, umbilical cord hemorrhagic cyst, umbilical cord rupture/cord hemangioma, umbilical cord hematoma, and umbilical cord ulceration. A series of case presentations and a gallery of images have been included to illustrate this final review.

The aim of this second extended review is to describe the pathogenetic mechanisms underlying umbilical cord (UC) anomalies and their relationship with adverse perinatal outcomes. Review of the literature with case presentations to illustrate the relationship between UC pathologies and adverse perinatal outcomes are also reported. Prenatal ultrasound findings and perinatal care in these cases are presented. Our review confirms the ethiopathogenetic role and involvement of UC pathology in a wide variety of obstetric diseases that may jeopardize fetal well-being. Some of these specific pathologies are strongly associated with a high risk of poor perinatal outcomes.

Sex Cord Stromal Tumors are rare ovarian tumors, including Steroid Cell tumors, NOS, almost all benign, associated with hirsutism and virilization, with elevated serum testosterone levels, commonly unilateral and with small diameter compared to others. A 43-year-old woman was referred to our center with secondary amenorrhea, hirsutism, balding and clitoromegaly, high serum level of testosterone and free testosterone. Ultrasound examination showed a unilateral small solid rounded hypoechoic lesion, with regular margins, moderately to richly vascularized at power Doppler examination (CS 3/4). A laparoscopic right salpingo-oophorectomy was performed. Final pathology diagnosed a steroid cell tumor, NOS.

Pentalogy of Cantrell (POC) is rare in prenatal diagnosis. The diagnosis of POC can be made antenatally through the use of ultrasonography, although this is challenging in cases where the defects are minor. We have reported a case diagnosis of incomplete POC through sections of the four-chamber view and the left ventricular outflow tract view.

Introduction: Ultrasound provides an advantage for obtaining vascular access in deep peripheral veins. Short-axis imaging gives the spatial relationship between the needle and the blood vessel, while long-axis allows for visualization of the whole length of the needle. Biplane imaging allows for simultaneous visualization of both views.

Methods: Thirty participants were enrolled to assess whether biplane imaging provided an advantage for placing intravenous (IV) catheters in a commercially available phantom. Volunteers then performed 6 ultrasound guided attempts to place an IV, with the ultrasound view randomized between either biplane or single-plane imaging. Wilcoxon signed-rank tests and Spearman correlation analyses were used for data analysis by the study biostatistician using SAS software version 9.4 (Cary, NC).

Results: Only one participant had prior experience with the biplane modality. Across both imaging modalities, prior experience and comfort with placing IVs with ultrasound were correlated with better performance. Biplane imaging had significantly fewer mean needle redirections, 1.5 versus 2.1 (p = 0.002), and fewer mean posterior vessel wall penetration complications, 0.1 versus 0.3 (p = 0.03). There was no statistically significant difference in time to successful placement or the number of attempts between conditions.

Discussion: While there was no significant difference in time to IV placement, other outcomes were consistent with the study's hypothesis that biplane imaging would provide an advantage. Further studies are needed to evaluate if skills performed on phantoms are transferable to patient care.

Seminomas are malignant germ cell tumors originating from residual germ cells during embryonic development. About 1% of seminomas typically present outside the gonads, often around the body midline such as the retroperitoneum and mediastinum. This article describes the imaging manifestations of primary retroperitoneal seminomas, providing a basis for clinical diagnosis.

Purpose: This study aimed to assess the thickness and stiffness of the Achilles tendon in patients with primary hyperparathyroidism and compare these findings with those of healthy individuals.

Methods: Bilateral Achilles tendons of 28 patients with primary hyperparathyroidism and 28 healthy controls were evaluated using ultrasound (US) and shear wave elastography (SWE). Tendon thickness was measured with gray-scale US, while stiffness was assessed using SWE, expressed as shear wave velocity (SWV) in meters per second. US and SWE findings were statistically compared between the two groups.

Results: The mean Achilles tendon thickness in patients with primary hyperparathyroidism (right Achilles: 5.07 ± 0.84 mm, left Achilles: 5.16 ± 0.79 mm) did not differ significantly from that in healthy controls (right Achilles: 5.01 ± 0.50 mm, left Achilles: 4.96 ± 0.44 mm; p = 0.757 and p = 0.237 respectively). Similarly, no significant difference was observed in tendon SWV between patients (right: 8.00 ± 1.01 m/s, left: 7.85 ± 1.16 m/s) and controls (right: 7.71 ± 0.95 m/s, left: 7.36 ± 0.97 m/s; p = 0.270 and p = 0.089). Additionally, no correlation was found between serum parathyroid hormone or calcium levels and tendon stiffness (p = 0.889-p = 0.902).

Conclusion: Primary hyperparathyroidism does not appear to influence the thickness or stiffness of the Achilles tendon when compared to healthy individuals.

Introduction: Measurements of levator hiatal area (LHA) by pelvic floor ultrasound examination were shown to be associated with symptoms and signs of prolapse and urinary incontinence. Body mass index (BMI) is a modifiable risk factor which has shown to be related with urinary incontinence. Our aim in this study was to observe and to understand the relation between BMI and weight with LH and other transperineal ultrasound parameters such as bladder neck mobility and bladder-urethra angles in asymptomatic nulliparous women.

Materials and methods: This study was a cross-sectional study in a gynecology outpatient clinic of a tertiary center after receiving ethical approval. Nulliparous women presenting to the gynecology outpatient clinic without any uro-gynecological complaint were invited to participate.

Results: During study period, 167 women met the eligibility criteria. Our data showed that weight and BMI are correlated with hiatal dimensions, γ angle and bladder neck descent even in asymptomatic nulliparous women.

Discussion: These findings may explain why weight loss is associated with improvements in stress incontinence symptoms and why we should encourage women in weight control which is the only modifiable factor in the etiology of incontinence.

Objective: To investigate the morphology of the corpus callosum (CC) in fetuses of pregnant women with diabetes.

Materials and methods: This prospective study was conducted between February 2024 and August 2024 at a tertiary hospital and included a total of 81 pregnant women, divided into three groups: 27 with gestational diabetes (GDM), 27 with pregestational diabetes (PGDM), and 27 controls. For each patient, CC and cavum septum pellucidum (CSP) measurements, tela-choroidea-to-anterior-cerebral-artery distance (TACAD), and Doppler parameters of the anterior cerebral artery were examined.

Results: The mean CC length significantly differed among the three groups (p = 0.00). Post hoc Tukey analysis showed a significant difference between the control group and the PGDM group (p = 0.001), as well as between the control group and the GDM group (p = 0.002). No significant differences were found among the three groups in terms of CC width, TACAD, anterior cerebral artery Doppler parameters, or CSP width and length (p > 0.05). The CC/head circumference ratio was significantly different among the three groups (p = 0.000).

Conclusion: We found that fetal CC morphology was affected in pregnancies presenting with GDM and PGDM, likely due to increased transplacental transfer of nutrients caused by maternal hyperglycemia, which accelerates fetal growth.