Journal of Clinical Ultrasound最新文献

Bullous pilomatricoma (BP), a rare variant of pilomatricoma, accounts for approximately 2% of pilomatricoma cases. We present the case of a 19-year-old male with a painless, blister-like lesion on the left upper arm, diagnosed as BP based on histopathological examination. This report emphasizes the multimodal ultrasound features of BP, incorporating grayscale ultrasound, color Doppler flow imaging (CDFI), and shear wave elastography (SWE). Notably, to our knowledge, this is the first case to detail the SWE characteristics of BP, demonstrating a mean stiffness value of 52.0 kPa. Our findings indicate that BP can exhibit deceptively high stiffness on elastography, unlike other benign skin masses that appear less stiff, highlighting the importance of integrating multiple sonographic techniques for accurate preoperative assessment of skin tumors.

Image denoising is a crucial pre-processing technique in retinal optical coherence tomography image compression, but existing methods struggle with signal-dependent noise and do not consider hybridized low-contrast residual noise (HLRN), failing to gather information from images. Thus, the novel Smooth Gyrated Texel Quadrivium Network (SGTQN) is proposed to reduce noise and collect self-sufficient information. In the SGTQN, the novel Additive Ascombe Smooth Sifter converts Poisson noise into Gaussian noise using the Ascombe Transform and removes unwanted Gaussian noise and the HLRN by hybridized noise removal, thus effectively gathering useful information from the image. After denoising, existing segmentation methodologies neglect the retinal nerve deviation value, creating a poor self-explanatory image. Thus, a novel Improvised Gyrated Alexa Net incorporates the Standardized Gyrated Layer, which considers the deviation values, thus generating a self-explanatory segmented image. Furthermore, many existing compression methods failed to achieve a higher quality image due to their non-uniform compression. The Texel Quadrivium Convolutional Network modifies the pooling layer into a Texel Quadrivium Layer to perform uniform compression and uses adjuvant vector coordinates to generate a high-resolution compressed image. This proposed model provides high-quality image compression with reduced noise, with a high accuracy of 95% and a lower mean square error of 0.02.

Background: This study aimed to analyze the correlations between echocardiographic parameters of left and right ventricular systolic function-including myocardial work indices-and invasively measured stroke work index (SWI) in patients with advanced heart failure being evaluated for heart transplantation.

Methods: Twenty-seven consecutive patients with advanced heart failure who were admitted to a tertiary heart hospital for left and right heart catheterization were included. Echocardiographic evaluations were performed on the same day, prior to catheterization. For the left ventricle (LV), the correlations of LV ejection fraction (LVEF) by Biplane Simpson method, LV global longitudinal strain (LV-GLS), LV global constructive work (LV-GCW), LV global work index (LV-GWI), LV global wasted work (LV-GWW), and LV global work efficiency (LV-GWE) with LV-SWI were assessed. For the right ventricle (RV), correlations of tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), RV-GCW, RV-GWI, RV-GWE, and RV-GWW with RV-SWI were analyzed. Correlations were evaluated using Spearman's correlation coefficient.

Results: LVEF and LV-GLS were significantly correlated with LV-SWI (r: 0.63, p < 0.001; r: -0.61, p < 0.001, respectively). Among all parameters, LV-GCW demonstrated the strongest correlation with LV-SWI, followed by LV-GWI (r: 0.71, p < 0.001; r: 0.69, p < 0.001, respectively). For the RV, RV-GWI and TAPSE showed moderate correlations with RV-SWI (r: 0.43, p: 0.02; r: 0.42, p: 0.02, respectively). Other RV parameters did not demonstrate significant correlations with RV-SWI.

Conclusion: Among LV and RV systolic function parameters, myocardial work indices provide a more accurate estimation of ventricular systolic function than standard echocardiographic measures in patients with advanced heart failure.

Splenic angiosarcoma is an extremely rare and highly aggressive malignant vascular tumor with nonspecific clinical manifestations and variable imaging appearances. We report a case of a middle-aged male presenting with progressive upper abdominal discomfort and a large splenic mass accompanied by cardiophrenic lymphadenopathy and peritoneal involvement. Ultrasound, contrast-enhanced ultrasound (CEUS), computed tomography (CT), and magnetic resonance imaging (MRI) demonstrated aggressive imaging features highly suggestive of malignancy. Ultrasound-guided biopsies of both the splenic lesion and cardiophrenic lymph nodes revealed malignant vascular proliferation with spindle and epithelioid morphology, a high Ki-67 proliferation index, and diffuse endothelial marker positivity, confirming the diagnosis of splenic angiosarcoma. This case highlights the diagnostic value of CEUS combined with multimodal imaging in the early recognition and accurate diagnosis of malignant splenic vascular tumors.

Objective: This study aims to identify risk factors and develop a predictive model for restenosis after ultrasound-guided percutaneous transluminal angioplasty (PTA) for arteriovenous fistula (AVF) stenosis.

Methods: A total of 100 patients undergoing PTA were categorized into restenosis (n = 39) and non-restenosis (n = 61) groups based on 12-month follow-up. Multivariable logistic regression identified independent risk factors, and a nomogram was constructed. Model performance was assessed using ROC analysis, calibration curves, and decision curve analysis (DCA).

Results: Diabetes (odds ratio [OR] = 1.94), type I stenosis (OR = 3.49), severe AVF stenosis (OR = 2.37), AVF functional time < 6 months (OR = 3.17), vascular calcification (OR = 4.34), and elevated High-Sensitivity C-Reactive Protein (OR = 2.82) were independent risk factors (all p < 0.05). The predictive model demonstrated good discrimination (area under the curve [AUC] = 0.820) and calibration (p = 0.3575). DCA confirmed clinical utility.

Conclusion: Key risk factors for restenosis were identified, and the predictive model showed strong performance, aiding clinical decision-making.

Purpose: To evaluate the proposed explainable denoising deep learning model, Grouped Shared Convolutional Attention Vision Transformer (GSCAViT), for classifying normal fetal echocardiogram.

Methods: A retrospective study was conducted on 358 fetal cardiac ultrasound exams with a total of 2501 images. GSCAViT utilized seven echocardiograms and was compared against baseline and enhanced models using metrics including accuracy, precision, recall, F1 score. The SHAP method clarified key image features, and the denoising guided GSCA module was assessed through visual comparisons and image quality metrics.

Results: GSCAViT achieved an accuracy of 97.1%, 99.4%, 81.3%, 72.9% on the validation and three test sets. In addition, GSCAViT achieved low error rates of 2.9%, 0.6%, 18.7%, and 27.1%. To improve upon existing Vision Transformer based models and denoising modules, we propose the GSCAViT, which integrates a novel denoising-guided GSCA module for enhanced image quality and interpretability. SHAP visualizations confirmed the model's ability to identify critical cardiac structures, while the denoising module enhanced image quality, yielding the highest contrast-to-noise ratio and peak signal-to-noise ratio values.

Conclusion: GSCAViT outperformed baseline and several enhanced models in classifying seven types of normal fetal echocardiograms, SHAP visualization enhanced the interpretability of classification, comparisons of visual effectiveness and image parameters confirmed the efficacy of the GSCA module.

Objective: To evaluate the impact of lung ultrasound on the frequency of radiological examinations (chest X-ray and CT), radiation exposure, duration of illness, and hospitalization costs in pediatric pneumonia.

Methods: A retrospective analysis was performed on pediatric pneumonia cases from two branches of Ordos Central Hospital-Dongsheng (n = 407, all underwent lung ultrasound) and Kangbashi (n = 155, none underwent lung ultrasound)-between January 2022 and June 2024.

Results: No significant differences in duration of illness or costs for mild cases (p > 0.05). For severe cases, DongSheng Hospital had a shorter median duration of illness (12 vs. 14 days, p = 0.021) and lower median costs (3485 vs. 4378 RMB, p = 0.003). The median number of chest X-rays (1 vs. 2) and CT scans (0 vs. 1) was lower at DongSheng compared to Kangbashi (p < 0.001). Age-stratified analysis revealed significantly lower dose-area product (DAP) from X-rays in mild cases (p < 0.001), with significantly lower dose-length product (DLP) from CT also observed in children aged ≥ 5 years (p < 0.05). In severe cases, significantly lower DAP was found (p < 0.05), while no significant differences were observed for DLP.

Conclusion: Lung ultrasound reduces the frequency of radiological examinations, radiation exposure, shortens duration of illness in severe cases, and lowers hospitalization costs.

This report presents the case of the first author, an asymptomatic 31-year-old physiotherapy professor who explored himself using panoramic B-mode ultrasound imaging to prepare instructional materials for neck ultrasound-guided invasive interventions. The sonographic exploration demonstrated the unilateral presence of a nondescribed muscle in the posterolateral aspect of the neck, proposed to name this variant as "tellus colli" by the authors. To our knowledge, the presence of this muscle has not been previously described. This muscle arises from the external occipital tubercle and the nuchal ligament. It courses superficially to the upper trapezius and slides laterally as it approaches its insertion onto the anterolateral surface of the second rib (passing in the most superficial layer over the levator scapulae in this region). In accordance with the anatomical course of the muscle and the electromyographic findings, this muscle seems to contribute to forced inspiration and specific neck movements (contralateral rotation and neck extension). The presence of this accessory muscle is a casual finding which is not related to neck or neuropathic symptoms.

Background: The incidence of pancreatic lesions is increasing. However, there was limited study on the efficacy and safety of percutaneous ultrasound-guided core needle biopsy (US-CNB) for diagnosing pancreatic lesions.

Aims: This study aimed to evaluate the efficacy and safety of percutaneous US-CNB for diagnosing pancreatic lesions and to analyze the influencing factors.

Methods: Patients who underwent percutaneous US-CNB for pancreatic lesions from 2016 to 2025 were retrospectively analyzed, and their clinical, imaging, pancreatic biopsy-related data and pathological diagnosis were recorded; subsequently, 777 patients were included. The sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV) of percutaneous US-CNB for diagnosing pancreatic lesions were calculated using surgical pathological findings or clinical diagnoses as the gold standard. Factors affecting accuracy were screened using univariate and logistic regression analyses.

Results: In total, 796 ultrasound-guided biopsies were successfully performed in 777 patients. Biopsy results were consistent with the final diagnosis in 753 cases (consistent group) and inconsistent in 43 cases (inconsistent group). The sensitivity, specificity, accuracy, PPV, and NPV were 94.99% (644/678), 92.37% (109/118), 94.60% (753/796), 98.62% (644/653), and 76.22% (109/143), respectively. Mild complications occurred in eight cases (8/796, 1.00%), and severe complications, in seven cases (7/796, 0.88%), which resolved on their own or with treatment. The tumor markers, location of lesion for biopsy, and longest diameter of the lesion were significant factors between groups (p < 0.05). Multivariate regression analysis showed that lesion location (p = 0.018) was an independent factor affecting diagnostic efficacy.

Conclusion: Percutaneous US-CNB is safe and reliable for diagnosing pancreatic lesions, and its accuracy is better for diagnosing pancreatic body and tail lesions.