Journal of Clinical Ultrasound最新文献

Fetal liver calcifications (FLCs) are isolated or multiple areas of increased echogenicity in the fetal liver, with an estimated prevalence of 5-10 per 10 000 births. However, their clinical importance remains still unclear. Although they are often linked to infections, chromosomal disorders, thrombotic events, or tumors, isolated FLCs generally have a favorable outcome. This article aims to present a case of a 29-year-old pregnant woman with a low-risk cfDNA test, who presented for the first trimester screening scan at our hospital at 12 weeks of pregnancy. The morphology scan at 20 weeks and 5 days revealed a normal fetal size with areas of increased echogenicity in the liver. No other fetal issues were identified. The patient was monitored throughout her pregnancy at our center, receiving genetic counseling and tests for detecting cystic fibrosis, STORCH (syphilis, cytomegalovirus, herpes virus 1;2, rubella, and toxoplasma), fetal echocardiography, and MRI, all of which were normal. At 35 weeks and 6 days, the patient gave birth to a healthy male, and all subsequent postnatal examinations confirmed the baby's health. This article aims to offer comprehensive insights into the management and postnatal outcomes of isolated FLCs, based on a review of the literature.

Objective: To compare the effects of nifedipine and indomethacin, used for tocolytic purposes in the treatment of preterm labor (PTL), on fetal-maternal Doppler blood flows and perinatal outcomes.

Materials and methods: Eighty pregnant women between weeks 24 and 32 of gestation who used nifedipine (n = 40) and indomethacin (n = 40) as tocolytic treatments due to PTL were prospectively and consecutively included in the study. Sociodemographic, obstetric, and laboratory and Doppler flow parameters were compared between the groups.

Results: Statistically significant differences were observed between the groups in terms of gestational age at delivery and birth weight, Doppler flows (umbilical artery (UA) Pulsatility Index (PI), and UA Resistance Index (RI)) at 12, 24, and 48 h, middle cerebral artery RI at 12 h, and ductus venosus (DV) PI and DV-RI at 12, 24, and 48 h (p < 0.05).

Conclusions: The findings of this study showed that nifedipine and indomethacin used in the treatment of PTL had significant effects on UA-PI and UA-RI Doppler flows at 12, 24, and 24 h, MCA-RI Doppler flows at 12 h, and DV-PI and DV-RI Doppler flows at 12, 24, and 48 h. Further studies involving larger numbers of participants are now needed to support these results.

In this case, the bilateral brachial plexus, median nerve, ulnar nerve, radial nerve, sciatic nerve, tibial nerve, and common peroneal nerve of the patient all showed diffuse and uniform edema and thickening, with no segmental thickening changes in noncompression areas, consistent with the neuroultrasound findings of CMT1.

Purpose: The aim of this study was to describe in volunteers and cadavers the location of the vascular structures at risk for performing a new safe and effective ultra-minimally invasive ultrasound guided long head of the biceps tendon (LHBT) release.

Methods: First, with Doppler ultrasound, we defined the position of the acromial artery from our distal cutting point, on the posterior margin of the LHBT. Second, we performed an ultra-minimally invasive ultrasound guided LHBT release in cadavers. We described the stump and reported safety (no rotator cuff, vascular, or articular damages) and efficacy (tendon release rate).

Results: In 20 volunteers, the mean distance from the distal cutting point to the acromial artery was 0.9 ± 0.1 cm (range, 0.3-1.6). Ultra-minimally invasive LHBT release was safe and fully effective in the eight specimens. The proximal stump measured a mean of 2.8 cm (range, 1.9-4). There were no complications.

Conclusions: A safe and effective ultra-minimally invasive ultrasound guided LHBT release in cadavers is feasible through an anterior approach.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited disease characterized by progressive fibrofatty tissue replacement of the myocardium. Asymptomatic individuals can often present for the first time with acute cardiac symptoms, such as syncope and ventricular arrhythmias or sudden cardiac death (SCD), which can occur in young and athletic populations. In the field of inherited cardiomyopathies, ARVC is one of the most challenging to diagnose due to its variable expressivity, incomplete penetrance, and lack of specific, unique diagnostic criteria. Without additional clinical findings or context, current imaging modalities are unable to definitively distinguish ARVC from other disease entities. Right ventricular (RV) structural changes can lead to prominent ARVC features. An important component of the 2010 revised task force criteria (TFC) is the assessment of RV wall motion contraction by echocardiography; however, this can be difficult to assess. This case report explores the diagnostic criteria used for ARVC and the role of RV wall motion contraction in the diagnosis.

We report a case of a 65-year-old postmenopausal female patient who presented with 1 day of vaginal bleeding. Imaging studies diagnosed a uterine tumor lesion, and the patient underwent a total hysterectomy and bilateral salpingo-oophorectomy. The excised specimen was sent for pathological examination, and based on immunohistochemical analysis, the patient was ultimately diagnosed with Uterine tumor resembling ovarian sex cord tumor (UTROSCT). Postoperative adjuvant chemotherapy was administered, and the patient has been in good condition during the follow-up period.

Objectives: Ultrasound is a valuable tool for diagnosing septic arthritis and guiding the development of treatment plans. This study aimed to identify sonographic findings associated with complications in septic arthritis.

Methods: Twelve patients aged <5 years diagnosed with septic arthritis were classified into two groups: those with and without complications. Complications were defined as the destruction of the epiphyseal bone head and metaphysis bone cortex. The following sonographic findings were compared between the two groups using Fisher's exact test: synovial membrane thickness, joint effusion, diminished hyperechoic foci within the epiphyseal bone head, and diminished smooth metaphyseal bone cortex.

Results: Overall, 4 of 12 patients developed complications. Joint effusion and synovial membrane thickening were detected in all patients with septic arthritis. The incidence of diminished hyperechoic foci within the epiphyseal bone head was significantly different between the two groups (presence/absence in patients with complications vs. without = 3/1 vs. 0/8, p = 0.018). The incidence of diminished smooth metaphyseal bone cortex was higher in patients with complications than in those without; however, this difference was not statistically significant (presence/absence in patients with complications vs. without = 4/0 vs. 3/5, p = 0.081).

Conclusion: Ultrasound proved to be an effective diagnostic tool for septic arthritis and also demonstrated its potential in predicting complications of septic arthritis in the pediatric population.

This study explored echocardiography's role in diagnosing and managing pediatric pulmonary artery sling (PAS). Data from 145 patients (January 2017 to December 2023) were analyzed, including echocardiography, CT angiography, bronchoscopy, and surgical records. Results indicated echocardiography accurately diagnosed PAS in 98.62% cases, with 1.38% misdiagnosed. Tracheal compression was common (95.86%), along with intracardiac anomalies (73.79%). Combined vascular ring types were found, notably PAS with left aortic arch and aberrant right subclavian artery (LAA-ARSA) and PAS with double aortic arch (DAA). Echocardiography's effectiveness underscores its crucial role in clinical management and surgical planning for these complex conditions.

Background: Methotrexate (MTX) and leflunomide (LEF) play fundamental roles in rheumatoid arthritis (RA) treatment and require proper monitoring of side effects. Concerns about MTX/LEF-related liver fibrosis (LF) in patients with RA remain unclear. This study investigated liver stiffness using two-dimensional shear wave elastography (2D-SWE) in RA patients undergoing disease-modifying antirheumatic drug (DMARD) therapy. Moreover, 2D-SWE was employed to evaluate the correlations between liver stiffness, cumulative MTX and LEF doses and risk factors for substantial LF.

Methods: We recruited 222 participants from the Department of Rheumatology. The participants were divided into healthy controls (n = 78) and patients with RA (n = 144). Pearson's correlation analysis was performed to assess the correlations between liver stiffness and the cumulative dose of MTX/LEF and other clinical and laboratory variables.

Results: The mean elasticity modulus was 4.79 ± 0.92 kPa, excluding the presence of significant fibrosis. Mean 2D-SWE values were significantly lower in healthy controls than in RA treated with MTX and LEF. The cut-off ≥3.8 kPa 2D-SWE values with the sensitivity of 86.1%, specifity of 83.3%. 2D-SWE values were not significantly different across the strata of the cumulative MTX subgroups.

Conclusions: MTX and LEF increase liver stiffness but may be considered low risk for the development of LF.

Sirenomelia is a rare congenital caudal abnormality. We applied two-dimensional, three-dimensional, and color Doppler ultrasound to diagnose a fetus with sirenomelia at 12 + 6 weeks. The fetus exhibited on ultrasound fused lower limbs, two tibiae in lower legs, no fibulae, knees in retroflexion, pelvic hypoplasia, hypoplasia of the lower lumbar vertebrae and coccyx, bilateral renal agenesis, no bladder, and a single umbilical artery. The postnatal X-ray revealed a fetus with two femurs, two tibiae, and no fibula. The results of chorionic villus aspiration indicated that the fetus was male with a normal karyotype (46, XY), and the microarray results were normal.