Journal of Clinical Ultrasound最新文献

Objectives: To evaluate the efficacy of ultrasound (US)-guided pulsed radiofrequency (PRF) treatment of posterior tibial nerve (PTN) in patients with painful diabetic peripheral neuropathy (PDPN) refractory to pharmacotherapy.

Methods: US-guided PTN-PRF treatment was applied for 240 s at a maximum temperature of 42°C with a pulse width of 20 ms in 55 patients with PDPN. The primary aim of this study was to evaluate the efficacy of US-guided PRF treatment of the PTN on pain scores using a Visual Analog Scale (VAS) in patients with type 2 diabetes mellitus who had pharmacotherapy-resistant PDPN. The secondary aims were to evaluate the impact of PRF on sleep quality using the Jenkins Sleep Scale (JSS), assess neuropathic pain severity using the PainDETECT Questionnaire (PDQ), and determine the incidence of procedure-related adverse events.

Results: US-guided PTN-PRF provided effective pain reduction at both 1 and 3 months compared with baseline. The VAS score reduction rate was 62.5% at 1 month and 37.5% at 3 months post-treatment. PTN-PRF improved sleep disorders by providing pain control. The JSS score reduction rate was 43.75% at 1 month and 25% at 3 months after treatment. No procedure-related adverse events were reported in any participants.

Conclusion: US-guided PTN-PRF treatment is an effective and safe method for pain control and sleep quality improvement in patients with PDPN refractory to pharmacological treatment.

Paratesticular rhabdomyosarcoma (RMS) is a rare pediatric malignancy often misdiagnosed as benign conditions like epididymitis. We report a 4-year-old boy with paratesticular RMS and retroperitoneal metastasis, initially mistaken for epididymitis. The diagnostic delay resulted in disease progression, necessitating radical inguinal orchiectomy, hemiscrotectomy, and complete multimodal therapy. Literature review identified nine similar misdiagnosed pediatric cases due to atypical presentation. Despite a generally favorable prognosis, early diagnosis, radical orchiectomy, and multidisciplinary management are essential to reduce morbidity and improve survival outcomes in children with paratesticular RMS. Clinicians should consider RMS in children with persistent or atypical scrotal masses to avoid treatment delays.

This was a retrospective observational study utilizing data from a single-specialist early-pregnancy unit. We evaluated the diagnostic accuracy of transvaginal ultrasound (TVS) in various morphological presentations of interstitial ectopic pregnancy (IEP) among women who underwent surgery. Based on the presence or absence of a gestational sac (GS), IEP morphology was classified as GS type or inhomogeneous solid (IS) type. During the study period, 27 patients with IEP underwent surgical intervention. In those with the GS type, we observed a strong correlation between preoperative ultrasonographic findings and surgical observations; the positive predictive value of TVS diagnosis for GS-type IEP was 100%. In contrast, it was 45.5% for IS-type IEP, which presents unique diagnostic challenges due to its complex ultrasonographic appearance. Additionally, we assessed the ultrasound characteristics of IS-type IEP and discussed its differential diagnosis.

Purpose: To study the diagnostic performance of ultrasound (US) in mild hip osteoarthritis (HOA) compared to conventional radiography (CR) and magnetic resonance imaging (MRI).

Methods: Fifty-eight patients referred to CR for suspected HOA with at least unilateral Kellgren-Lawrence (KL) 2 change in the CRs were recruited. Bilateral hip US and MRI (n = 116) were performed, and patients filled the Visual Analog Scale (VAS) bilaterally. A sum US score was formed, and its correlation to KL grades and VAS scores was tested. Descriptive statistics, Chi square and McNemar's test, Spearman correlation, and linear regression analysis were applied as statistical techniques.

Results: US and CR showed similar moderate diagnostic performance compared to MRI with moderate correlation (r = 0.449) between US sum score and KL grades. With pain associations, US sum score showed an OR = 1.725 (CI 1.169-2.546) and KL grades an OR = 2.058 (CI 1.038-4.082).

Conclusion: US and CR demonstrated similar moderate diagnostic capability in detecting mild HOA compared to MRI, and both the US sum score and KL grades were associated with increased hip pain. With US and CR demonstrating different aspects of HOA, our findings support the complementary role of US in evaluating patients with suspected HOA.

Tricuspid prosthetic valve thrombosis is a rare but serious complication of prosthetic valve replacement that can be lethal if not treated properly. Our case underscores that comprehensive echocardiography investigations should be performed day by day after stopping oral anticoagulants in patients with tricuspid valve replacement to prevent adverse outcomes.

This study presents a case of a giant aneurysm of the ascending aorta that evolved to rupture in a pediatric patient. The diagnosis was made possible through echocardiogram, which was subsequently confirmed by an aortic computed tomography (CT) angiography. The patient was referred for surgical intervention and demonstrated favorable outcomes. The authors describe the differential aspects of the clinical manifestations and immune response in Kawasaki disease. While the coronary arteries represent the main site of aneurysm formation in KD, they are not the sole location, and it is important to keep in mind that aortic aneurysms may occur. Despite the rarity of aortic aneurysms in KD, a take-home message to be learned from this case study is to consider KD in the context of acute onset ascending aortic aneurysm.

Background and aims: To our knowledge, no previous study has comprehensively examined the relationship between geniohyoid (GH) muscle characteristics and key functional outcomes in patients with stroke. We aimed to investigate the associations between ultrasonographic GH muscle indices and clinical outcomes, including quality of life, mobility, functionality, and disability, with a focus on an older subgroup.

Methods: In this prospective cross-sectional study, we enrolled patients who had a stroke with dysphagia. Quality of life, mobility, and functional status were evaluated using the Stroke-Specific Quality of Life Scale (SS-QOL), the Rivermead Mobility Index (RMI), and Brunnstrom Recovery Stages, respectively. Disability was assessed with the Modified Rankin Scale (mRS) and ambulation ability was determined using the functional ambulation classification (FAC). We measured GH muscle thickness (GHMT) and cross-sectional area (GHCSA) via ultrasonography.

Results: Fifty-seven patients (56.1% male) with a mean age of 65 ± 10.4 years were recruited. In the total group, GHMT was positively correlated with SS-QOL, RMI total, gross motor functions, leg and trunk, and FAC (p < 0.05) and negatively correlated with mRS (p = 0.026). The GHCSA was significantly associated with SS-QOL, all RMI subdomains, Brunnstrom hand stages, and FAC (p < 0.05). The SS-QOL and FAC scores were found to be independently associated with both GHMT and GHCSA even after multiple adjustments. In the older subgroup, GHCSA remained correlated with SS-QOL and RMI scores while GHMT showed no significant associations.

Conclusion: The GHCSA demonstrated significant correlations with quality of life and mobility in both total and older subgroups. As the first study, these findings suggest that GH muscle may serve as a potential biomarker for assessing poststroke quality of life and functional status.

Objective: A predictive model of cervical lymph node metastasis and metastasis volume was constructed based on a machine learning algorithm and ultrasound characteristics before surgery.

Methods: A retrospective analysis was conducted on 573 cases of PTC patients who underwent surgery in our institution, from 2017 to 2022. Patient demographic and clinical characteristics were systematically collected. Feature selection was performed using univariate analysis, Logistic regression (LR) analysis. Statistically significant variables were identified using a threshold of p < 0.05. Predictive models for cervical lymph node metastasis and metastatic volume in papillary thyroid carcinoma were constructed using advanced machine learning algorithms: K-Nearest Neighbors (KNN), Gradient Boosting Machine (XGBoost), and Support Vector Machine (SVM). Model performance was rigorously assessed using validation cohort data, evaluating area under the Receiver Operating Characteristic (ROC) curve, sensitivity, specificity, and accuracy.

Results: In this retrospective study of 573 patients (320 had lymph node metastasis, 127 had small volume lymph node metastasis, and 193 had medium-volume lymph node metastasis). In the model predicting the neck lymph node metastasis, the Gradient Boosting method exhibited the best performance, with an area under the ROC curve of 0.784, sensitivity of 76.2%, specificity of 70.6%, and accuracy of 73.8%. In the model predicting the metastatic volume in neck lymph nodes for PTC, the Gradient Boosting method also demonstrated the best performance, with an area under the ROC curve of 0.779, sensitivity of 71.7%, specificity of 75.9%, and accuracy of 74.4%.

Conclusion: Machine learning-based predictive models integrating preoperative ultrasound features demonstrate robust performance in stratifying neck lymph node metastasis risk for PTC patients. These models optimize surgical planning by guiding lymph node dissection extent and individualizing treatment strategies, potentially reducing unnecessary extensive surgeries. The integration of advanced computational techniques with clinical imaging provides a data-driven paradigm for preoperative risk assessment in thyroid oncology.

Background: Acute ischemic stroke (AIS) is characterized by high incidence, sudden onset, and often poor prognosis. Carotid atherosclerosis plays a crucial role in its pathogenesis, and ultrasound imaging offers a non-invasive method for evaluating carotid plaque characteristics. This study aimed to develop and validate a prediction model for AIS risk based on a novel ultrasound-based carotid plaque scoring system combined with clinical risk factors.

Methods: A retrospective case-control study was conducted, including 100 patients with carotid atherosclerosis who attended Hebei General Hospital from January 2022 to December 2023. Patients were divided into an AIS group (n = 60) and a non-AIS group (n = 40). Univariate and multivariable logistic regression analyses were used to identify significant ultrasound and clinical predictors of AIS. A carotid plaque ultrasound scoring system was constructed based on selected imaging features and integrated with clinical risk factors to establish a nomogram prediction model for AIS. The performance of the scoring system and the combined model was evaluated using receiver operating characteristic (ROC) curves, decision curve analysis (DCA), and calibration plots. Internal validation of the AIS prediction model was performed using the bootstrap resampling method.

Results: Independent predictors of AIS included plaque echogenicity, morphology, contrast-enhanced ultrasound score, history of hypertension, C-reactive protein (CRP), fasting blood glucose (FBG), and very-low-density lipoprotein (VLDL). The ultrasound scoring system alone yielded an area under the curve (AUC) of 0.88, while the integrated model incorporating clinical factors achieved an AUC of 0.94. Both calibration and decision curves demonstrated excellent agreement and clinical utility. Bootstrap validation confirmed the model's robustness and reliability.

Conclusions: The carotid plaque ultrasound scoring system provides a reliable method for AIS risk prediction. The AIS prediction model, developed using this scoring system combined with clinical risk factors, improves predictive accuracy and helps in the early identification of high-risk patients.