Journal of Clinical Ultrasound最新文献

Objective: To investigate the potential clinical value of shear wave elastography (SWE) for quantitatively assessing carotid artery elasticity in uremic patients with different left ventricular configurations.

Methods: According to different left ventricular configurations, 133 patients diagnosed with uremia were divided into four groups: group B (normal configuration, NG, n = 37), group C (centripetal remodeling, CR, n = 37), group D (centripetal hypertrophy, CH, n = 38), and group E (eccentric hypertrophy, EH, n = 21). Additionally, a control group (group A) consisting of 40 healthy volunteers was selected. None of the subjects exhibited plaque formation in their carotid arteries. Conventional carotid ultrasound was used to assess the intima-media thickness (IMT), peak systolic velocity (PSV), and the systolic and diastolic diameters (Ds and Dd) of the left common carotid artery. Moreover, the wall motion degrees (ΔD) and arterial stiffness coefficient (β) were calculated. The maximum elastic modulus (MEmax), mean elastic modulus (MEmean), and minimum elastic modulus (MEmin) of the carotid artery anterior wall intima-media were obtained using SWE.

Results: Compared with group A, the IMT and β values in groups B and C were increased; however, the differences among the three groups were not statistically significant (p > 0.05). In contrast, groups D and E exhibited markedly elevated IMT and β values, which were significantly different from those in groups A, B, and C (p < 0.05). Groups B through E exhibited significantly elevated MEmax, MEmean, and MEmin values in comparison to group A. Statistically significant intergroup differences were identified (p < 0.05), reflecting a stepwise increase in the order of E > D > C > B > A. The linear regression analysis revealed a statistically significant association between different left ventricular configurations and SWE parameters in patients with uremia (p < 0.05).

Conclusion: SWE can quantitatively assess carotid artery elasticity in uremic patients with different left ventricular configurations.

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: Trousseau syndrome (TS)-related nonbacterial thrombotic endocarditis (NBTE) caused by ovarian cancer has rarely been reported. Although primary tumors and cardiac lesions can be treated surgically, there has been a rising concern regarding the use of anticoagulants in the treatment of TS.

Method: The clinical data and course of Trousseau syndrome-related NBTE in a case of mucinous ovarian carcinoma treated in Shenzhen People's Hospital in 2023 were retrospectively analyzed, and the relevant literature was reviewed.

Conclusions: We report a rare case of Trousseau syndrome-related nonbacterial thrombotic endocarditis attributable to mucinous ovarian carcinoma. Timely and accurate diagnosis and treatment can improve the prognosis.

Aim: To assess the utility of three-dimensional speckle-tracking echocardiography (3D-STE) in detecting coronary artery microcirculation dysfunction (CMCD) with non-obstructive coronary artery (INOCA) disease.

Materials and methods: Twenty-one patients diagnosed with INOCA were enrolled and underwent echocardiography and [¹⁸F]fluorodeoxyglucose positron emission tomography/computed tomography ([¹⁸F]FDG PET/CT) myocardial metabolic imaging, which is used as the gold standard for diagnosing CMCD. Further, a total of 357 myocardial segments across these 21 participants were categorized into the control group and the CMCD group according to the results of [¹⁸F]FDG PET/CT. Subsequently, 2D regional systolic peak longitudinal strain (2D-RLS), 2D regional systolic peak circumferential strain (2D-RCS), regional systolic peak 3D main strain (R3D strain), longitudinal strain (3D-RLS), circumferential strain (3D-RCS), and radial strain (3D-RRS) of the left ventricle were assessed. At last, the receiver operating characteristic (ROC) curves of 3D-STE parameters were calculated to evaluate the diagnostic value of 3D-STE for CMCD.

Results: The absolute value of total R3D strain is decreased in the CMCD group (p < 0.05). In addition, R3D and 3D-RLS in the CMCD group exhibited a significant reduction in the basal, middle, and apical segments compared to the control group (p < 0.05). No difference was observed in 2D strain parameters between the CMCD group and the control group. Among all strain parameters, the R3D strain in the apical segments had the highest diagnostic efficacy, with an optimal cutoff of -41.5 (sensitivity, 88.4%; specificity, 80.5%).

Conclusion: Our findings indicate that the 3D-STE could serve as an advantageous diagnostic instrument for discriminating individuals with CMCD.

Herein, we present the case of a 56-year-old female with mechanical-type right knee pain and extension difficulty, ultimately diagnosed with mucoid degeneration (MD) of both the anterior and posterior cruciate ligaments-a rare coexistence. Ultrasound (US) revealed hypoechoic thickening of the cruciate ligaments and medial meniscal extrusion, prompting further evaluation. Magnetic resonance imaging (MRI) confirmed MD of both cruciate ligaments and a grade III posterior root tear of the medial meniscus. While MRI remains the gold standard for diagnosing MD, this case highlights the valuable role of US in early suspicion, dynamic assessment, and comparative evaluation of cruciate ligament pathology, even in deep-seated structures. A conservative treatment plan was initiated, and the patient remains under uneventful follow-up.

Objectives: To retrospectively analyze the differences in imaging findings between benign and borderline ovarian serous/mucous tumors.

Methods: Imaging features of benign and borderline ovarian tumors were analyzed, including the tumor maximum diameter, laterality, tumor morphology, proportion of solid components, and the number of papillary processes in cystic solid tumors.

Results: A total of 189 tumors were evaluated, including 117 benign tumors and 72 borderline tumors. The mean maximum diameter of borderline tumors was higher than that of benign tumors (14.32 ± 9.93 vs. 8.62 ± 6.69, p < 0.05). Borderline tumors with solid components accounted for more than benign tumors (41.67% vs. 8.55%). The proportion of solid component volume/tumor volume > 15% in both benign and borderline tumors was very small (1.71%, 4.71%). In unilocular cysts and multilocular cysts, borderline tumors with diameters > 10 cm accounted for more than benign tumors. The sensitivity and specificity in distinguishing benign and borderline tumors of ultrasonography O-RADS are slightly lower than those of SR of IOTA (86.1% vs. 91.7%, 81.2% vs. 82.1%).

Conclusions: In conclusion, the borderline tumors are larger and have more solid components than the benign tumors. The sensitivity and specificity in distinguishing benign and borderline tumors of ultrasonography O-RADS are slightly lower than those of SR of IOTA.

Myeloid sarcoma (MS) is a rare solid malignant tumor formed by the proliferation and infiltration of primitive granulocytes or immature myeloid cells in extramedullary tissues. MS is usually associated with acute myeloid leukemia. MS can occur in any part of the body, and this case involves multiple occurrences in the lower leg. There are currently few reports on the ultrasonic manifestations of MS. In this case, the initial ultrasound findings suggested a benign lesion, which was inconsistent with the patient's known history of AML. However, the decision to perform a biopsy led to the correct diagnosis of MS. This case highlights the deceptive ultrasound features of MS and underscores the critical importance of histological confirmation in cancer patients with any new mass, regardless of its benign imaging appearance.

Purpose: Ebstein anomaly (EA) is a congenital heart disease that can cause intrauterine fetal death. Pulmonary valve stenosis or atresia (PS/PA) and retrograde ductus arteriosus flow (RDAF) are important factors leading to a poor prognosis, but the causes of its formation are still unclear. This study aimed to assess the correlation between left and right ventricular function and PS/PA and RDAF in fetuses with EA using MAPSE and TAPSE Z-score values measured by free angle M-mode (FAM) echocardiography.

Methods: This retrospective cohort study of 34 EA and 68 normal fetuses was enrolled. Differences in Z-score values were compared between the control, EA with and without PS/PA groups, and between EA-PS/PA with and without RDAF group. Correlation analysis was performed between Z-score values with the ratio of inner diameter of the pulmonary to the aortic valve annulus (PA/AO) and RDAF.

Results: The differences in Z-score values were significant (p < 0.001) between three groups. Z-score values were lower in EA-PS/PA with RDAF compared to the without RDAF group (p < 0.05). Z-scores were all positively correlated with PA/AO in the EA group (p < 0.05), and negatively correlated with RDAF in the EA-PS/PA group (p < 0.05).

Conclusion: Decreased ventricular function of EA fetus is related to the formation of PS/PA. After the formation of PS/PA, the degree of damage to ventricular function is not related to the diameter of the pulmonary artery; it is related to the formation of RDAF.