Journal of Clinical Ultrasound最新文献

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.

Purposes: To evaluate the diagnostic performance of ultrasonography in identifying the preduodenal portal vein and examine the factors influencing its diagnostic performance. Furthermore, we reviewed previously published case reports and series on this anomaly.

Methods: We included 17 patients diagnosed with a preduodenal portal vein, confirmed by contrast-enhanced computed tomography and/or surgical findings. Patients were categorized into the following two groups: those in whom the anomaly was detected and those in whom it was not detected via initial ultrasonography. The presence or absence of intestinal malrotation, polysplenia/asplenia, and symptoms were compared using Fisher's exact tests.

Results: Of the 17 pediatric patients with a preduodenal portal vein, 10 were correctly diagnosed on initial ultrasonography, yielding a sensitivity of 58.8%. A significant difference was observed only in the presence of symptoms (detection group vs. nondetection group: 7/3 vs. 1/6, p = 0.049). No significant difference was found in the presence or absence of intestinal malrotation (6/4 vs. 5/2, p > 0.999) or splenic anomalies (polysplenia/asplenia: 4/5 vs. 5/2, p = 0.358; one patient had no splenic anomaly).

Conclusion: The diagnostic performance of ultrasonography for the duodenal portal vein was more than 50%; however, this anomaly was more likely to be overlooked in asymptomatic patients than in symptomatic patients.

Artificial intelligence (AI) interpretation of ultrasound (US) images is promising, yet its accuracy in diagnosing pleural effusions remains unclear. We conducted a comprehensive database search which identified 84 studies, of which 6 met eligibility criteria. We included 2951 patients with 58 392 images and 12 069 ultrasound clips. Bivariate analysis revealed a pooled sensitivity of 0.92 (95% CI: 0.85-0.96, p < 0.05) and specificity of 0.96 (95% CI: 0.88-0.99, p < 0.05), with a high AUC of 0.98 under the sROC curve, although included studies had significant heterogeneity, I² > 99%. AI demonstrates high diagnostic accuracy in detecting pleural effusion on ultrasound.

Fine-needle aspiration biopsy (FNAB) is the preferred pathological examination to exclude thyroid cancer. We describe two case studies of acute thyroid lytic hemorrhage and swelling with pain during FNAB. We observed hemorrhages with a crack-like appearance and swelling during the first needle prick, accompanied by pain, in two patients with no coagulation dysfunction. Symptoms were relieved after the intervention. Thyroid hemorrhage with a crack-like pattern is a rare acute hemorrhagic complication of FNAB. The cause is unclear, and an allergic reaction of the glands could not be excluded. Emergency measures must be prepared in advance, as unpredictable complications may occur during FNAB.