Journal of Clinical Ultrasound最新文献

Objective: The aim of this study was to investigate the value and reliability of superb microvascular imaging (SMI) in detecting subclinical synovial inflammation in patients with inflammatory arthritis.

Methods: All patients with inflammatory arthritis who had achieved clinical remission were retrospectively analyzed and evaluated with SMI and power Doppler ultrasound (PDUS). Subclinical synovitis was graded by a semiquantitative score (0-3) for each imaging method. Imaging findings and synovitis scores were compared between the rheumatoid arthritis (RA) group and non-RA group.

Results: Eighty RA patients with 270 joints and 38 non-RA patients with 112 joints were recruited. In all patients, the remission rates of SMI and PDUS were 73.7% and 79.7%, respectively. The remission rates by SMI were found lower and the sensitivity of SMI was higher than PDUS in both RA and non-RA groups. Compared with PDUS, the number of joint count with synovial vascular flow signals was found to be significantly higher in SMI in each group (p < 0.001). Moreover, semiquantitative ultrasound scores were found significantly higher with SMI in each joint (p < 0.001).

Conclusion: SMI appears to be better than PDUS in detecting synovial signals in terms of joint number and vascularity scoring in monitoring disease activity in patients with inflammatory arthritis in clinical remission. Future research should focus on SMI and new ultrasound-based activity scores to identify and achieve true remission.

Objective: To investigate the value of two-dimensional (2D) ultrasound combined with three-dimensional power Doppler (3D-PD) in the prediction of macrosomia in early pregnancy.

Methods: A total of 171 singleton pregnant women who underwent prenatal ultrasound examination at 11⁺⁰-13⁺⁶ weeks of gestation in the First Affiliated Hospital of Shihezi University from October 2021 to October 2022 were selected as the research subjects. They were followed up until delivery. Their general data and Doppler ultrasound parameters were recorded and analyzed. The differences in ultrasound data between the two groups were compared, and the receiver operating characteristic (ROC) curve was drawn to evaluate the parameters.

Results: Compared with the normal group, the macrosomia group had significantly higher biparietal diameter, placental volume, and placental microvascular index (p < 0.05).

Conclusions: Increased placental vascular perfusion occurs in macrosomia during early pregnancy. The vascularization-flow index (VFI) had a high predictive value for macrosomia (AUC = 0.826), and 2D ultrasound combined with 3D-PD had the best predictive efficiency for macrosomia in early pregnancy (AUC = 0.926). Future studies should also consider combining maternal and fetal factors to predict macrosomia, to reduce the occurrence of adverse pregnancy outcomes.

Purpose: To assess agreement between a novice pediatric critical care fellow's interpretation of left and right ventricular (LV, RV) function using point-of-care ultrasound (POCUS) compared with assessments by pediatric cardiologists and echocardiography.

Methods: Echocardiographic clips (parasternal long axis, parasternal short axis, and apical four-chamber) and measurements for LV and RV functions (E-point septal separation, ejection fraction, and tricuspid annular plane systolic excursion) were obtained by PICU fellow in patients 0-18 years old with shock. A pediatric cardiologist reviewed the POCUS images. Agreement between the interpretations by the intensivist, cardiologist, and comprehensive echocardiograms were analyzed using Cohen's kappa.

Results: Thirty-one patients were included: 22 had comprehensive echocardiograms. The PICU fellow detected LV dysfunction with 100% sensitivity and > 85% specificity compared with the cardiologist's interpretation and formal echocardiography. Substantial agreement (κ = 0.62) was noted between the intensivist and cardiologist for interpretation of LV function and RV size and pressure (κ = 0.72). The intensivist's assessments showed perfect agreement (κ = 1.0) with echocardiography for LV and RV function. POCUS images ranged from 100% adequate in the parasternal long axis, 90% in the parasternal short axis, and 43% in apical four-chambered views.

Conclusions: A novice PICU fellow could reliably use POCUS to assess the cardiac function in pediatric patients with shock.

Aim: To determine the ultrasound shear wave elastography (SWE)-based prevalence of chronic liver disease in an adult Asian Indian population attending preventive radiology outpatient clinics in India.

Methods: Liver stiffness measures (LSMs) were ascertained using ultrasound SWE and interquartile range/median (IQR/M) ratio ≤ 30% kilopascal (kPa) units were considered a good quality measurement. Details of modifiable risk factors including comorbidity and personal risk behaviors were collected. The liver was graded based on the Society of Radiologists in Ultrasound Liver Elastography Consensus Statement and Grades 4 and 5 indicated compensated advanced chronic liver disease (cACLD) and clinically significant portal hypertension (CSPH). A multivariate logistic regression model was used to analyze associations with chronic advanced liver disease.

Results: The median LSM in the study participants (n = 1145) was 8.0 (IQR 6.5, 9.85) kPa units. 10.65% of the study population had advanced chronic liver disease (cACLD and CSPH) and 22.79% had LSM that was suggestive of cACLD. cACLD and CSPH were significantly associated with comorbidities, personal risk behaviors, and lean and obese body mass indices. Modifiable risk factors were present in 20%-50% of participants with LSM between 7 and 13 kPa.

Conclusion: Information on the prevalence of LSM-based cACLD and CSPH and modifiable risk factors in persons with LSM between 7 and 13 kPa will help to design preventative strategies using LSM as an objective imaging biomarker.

Objective: To explore the ultrasonic image characteristics of palatine tonsils in healthy children and the factors affecting image quality.

Methods: A total of 750 images of palatine tonsils were collected from 375 healthy children. According to ultrasonic image quality, the images were divided into three groups. Both systemic and local factors were analyzed among the different groups.

Results: The palatine tonsils showed quasi-circular or flat oval, low echo or light and dark band arrangement, a striped medium echo, and a clear boundary. Age, height, weight, body mass index, body surface area, distance from the skin to the posterior margin of the tonsils, thickness of the anterior soft tissue of the tonsils, and thickness of the anterior submandibular gland of the tonsils were significantly different among the different image quality groups (p < 0.05). Multivariate logistic regression analyses revealed that height, weight, thickness of the anterior soft tissue of the tonsils, and thickness of the anterior submandibular gland of the tonsils were independent factors affecting the quality of the ultrasonic images of the palatine tonsils.

Conclusions: There are characteristic ultrasonic image manifestations of the palatine tonsils. Tonsil ultrasound image quality is affected by individual and local factors.

We present the rare case of a 79-year-old female patient with the coexistence of gallbladder villous tubular adenoma and rectal villous tubular adenocarcinoma. She initially presented with blood in the stool, prompting a diagnosis of rectal cancer. Further examination revealed findings suggestive of a gallbladder pathology. Subsequent imaging and histopathological analyses confirmed the presence of a gallbladder villous tubular adenoma, high-grade intraepithelial neoplasia, and rectal villous tubular adenocarcinoma. Surgical interventions included laparoscopic radical resection of the rectal cancer and cholecystectomy. Immunohistochemical examination differentiated between the two distinct adenomatous conditions. This case underscores the importance of thorough evaluation and multidisciplinary approaches for accurate diagnosis and management of complex presentations of gastrointestinal neoplasms.

Introduction: Isolated abdominal aortic dissection (IAAD) has been reported to account for 1.1%-4.1% of all aortic dissections. If detected late, it is associated with a risk of aortic rupture. We investigated the risk factors and characteristic imaging findings of incidentally discovered IAAD using abdominal ultrasonography (AUS) during health check-up and hereby report our findings.

Methods: The study sample included 41 patients with abdominal aortic abnormalities identified by AUS performed during a health check-up at our hospital and who were diagnosed with IAAD by contrast-enhanced computed tomography (CT); in addition, 205 patients were included in the nonevent group. Furthermore, risk factors and characteristic imaging findings of IAAD were examined retrospectively.

Results: Compared with the nonevent group, smoking and fatty liver were observed significantly more frequently in the IAAD group. Ultrasound findings indicated an intimal flap in 35 cases (85.4%), whereas CT scan revealed displacement of intimal calcifications in 32 cases (78.0%).

Conclusion: Compared with the nonevent group, there were significantly more cases of fatty liver and smoking habits in the IAAD group. In older patients with risk factors for fatty liver and smoking habits, if IAAD is suspected, it is important to monitor the abdominal aorta using ultrasonography during health check-ups.

Lutembacher syndrome has been reported primarily in children and adults, but no prenatal cases have been reported. Our results indicated that lutembacher syndrome could be diagnosed by using prenatal ultrasound diagnosis. Accurate prenatal diagnosis of lutembacher syndrome is beneficial to neonatal prognosis and treatment options; it is very necessary to make a clear diagnosis in utero.

This systematic review examines educational strategies in clinician-performed abdominal point-of-care ultrasound (POCUS), a critical skill with increasing relevance in medical care. Analyzing 28 studies, we highlight the strategies as well as advantages and disadvantages of various theoretical and practical components, including, for example, e-learning and simulation in training programs. The findings emphasize the necessity of blending various educational methods to enhance effectiveness and adaptability in training environments. Ultimately, robust training frameworks are essential to maximize diagnostic accuracy and improve patient outcomes in abdominal POCUS.

Prenatal diagnosis of a true umbilical cord knot is challenging. However, prenatal diagnosis is clinically valuable because it allows preparation for fetal distress during labor. Here, we report a case of prenatal diagnosis of true umbilical cord knot, with a favorable delivery management.