Journal of Clinical Ultrasound最新文献

This narrative review examines the integration of Artificial Intelligence (AI) in prenatal care, particularly in managing pregnancies complicated by Fetal Growth Restriction (FGR). AI provides a transformative approach to diagnosing and monitoring FGR by leveraging advanced machine-learning algorithms and extensive data analysis. Automated fetal biometry using AI has demonstrated significant precision in identifying fetal structures, while predictive models analyzing Doppler indices and maternal characteristics improve the reliability of adverse outcome predictions. AI has enabled early detection and stratification of FGR risk, facilitating targeted monitoring strategies and individualized delivery plans, potentially improving neonatal outcomes. For instance, studies have shown enhancements in detecting placental insufficiency-related abnormalities when AI tools are integrated with traditional ultrasound techniques. This review also explores challenges such as algorithm bias, ethical considerations, and data standardization, underscoring the importance of global accessibility and regulatory frameworks to ensure equitable implementation. The potential of AI to revolutionize prenatal care highlights the urgent need for further clinical validation and interdisciplinary collaboration.

Purpose: This study evaluates the effectiveness of lacrimal gland ultrasonography (LGUS) and shear wave elastography (SWE) in distinguishing primary Sjögren's syndrome (PSS) patients from healthy controls and examines their role in assessing disease activity and prognosis.

Methods: A total of 35 PSS patients and 23 age- and gender-matched healthy controls were included. LGUS was used to grade lacrimal gland structure, while SWE assessed gland elasticity. Disease activity and prognosis were evaluated using european league against rheumatism sjögren's syndrome disease activity index (ESSDAI) and serologic markers.

Results: Compared with healthy controls, LGUS, Emean, and shear wave velocity (SWV) were significantly higher in PSS patients. The optimal cut-off value of LGUS for diagnosis of PSS was 2 (area under the curve [AUC]: 0.832, sensitivity: 80.0%, specificity: 69.6%), the optimal thresholds for diagnosis of PSS using Emean and SWV values are 9.4 kPa (AUC: 0.768, sensitivity: 65.7%, specificity: 82.6%) and 1.7 m/s (AUC: 0.823, sensitivity: 71.4%, specificity: 91.3%), respectively. There are statistical differences in Emean and SWV between subgroups based on european league against rheumatism sjögren's syndrome disease activity index (ESSDAI); there are statistical differences in LGUS, Emean, and SWV between subgroups based on IgG levels and complement titers.

Conclusion: LGUS and SWE are accurate, noninvasive diagnostic tools for PSS and may serve as indicators of disease activity and prognosis.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is the classic phenotype of arrhythmogenic cardiomyopathy. ARVC in twins have been reported rarely. Herein, we report an unusual case of young monozygotic twins with early disease onset presenting different course of disease progression and clinical manifestations. Echocardiography with multiparameters was used for the diagnosis, screening, and follow-up of the disease for the family. Cardiac magnetic resonance revealed the fibrosis distribution in the right ventricular with late gadolinium enhancement. DSG2 mutation was found in the family members, which confirmed the final diagnosis of ARVC.

Background: Ultrasound lung surface motion measurement is valuable for the evaluation of a variety of diseases. Speckle tracking or Doppler-based techniques are limited by the loss of visualization as a tracked point moves under ribs or is dependent.

Methods: We developed a synthetic lateral phase-based algorithm for tracking lung motion to overcome these limitations. To validate the technique, we generated simulated lung motion images. We also obtained lung ultrasound cines from a healthy volunteer and a mechanically ventilated COVID-19 patient. In the healthy volunteer, the respiratory pattern varied between breath-hold, regular, and rapid shallow breathing.

Results: The measured displacement was within 3% of the ground truth for simulated cines. In both the healthy volunteer and COVID-19 patients, measured displacement was greatest in the lower and lateral zones of the lung when the ipsilateral side was compared. In the healthy volunteer, when the respiratory pattern was varied, measured displacement was greater in regular breathing compared to rapid shallow breathing and compared to breath-hold patterns in both the upper and lower lung zones.

Conclusion: Estimation of lung surface displacement using a synthetic lateral phase-based approach is feasible. Future human studies should validate this approach against a direct measurement of lung surface movement.

Cancer in pregnancy has an incidence of approximately 1:1000, and cases of sarcoma in pregnancy are rare, with only a few described in the literature. This case report describes a 32-year-old pregnant woman who noticed an approximately 3.0 cm nodule on her left flank in the second trimester of pregnancy. Initially, it was diagnosed as a lipoma. The lesion grew progressively and after 5 months, at 25 weeks' gestation, the lesion became painful, bulky, with areas of necrosis and infection, and emitted a foul odor. Magnetic resonance imaging described the lesion as a heterogeneous mass measuring 12.0 × 10.0 × 9.6 cm on the left posterolateral abdominal wall, involving subcutaneous tissue and abdominal muscles. Oncologic treatment with neoadjuvant chemotherapy was initiated, and 1 month later, at 29 weeks, obstetric ultrasound revealed fetal growth restriction (FGR). During one of the fetal vitality assessments, oligohydramnios and umbilical artery Doppler with reverse diastolic flow were observed, leading to an emergency cesarean section at 31 weeks. The newborn died 4 days after delivery. Chemotherapy continued, and after the third cycle, the lesion was completely excised. Anatomopathologic examination and immunohistochemistry were consistent with embryonal rhabdomyosarcoma. The patient was referred for adjuvant radiotherapy to supplement treatment. This case report discusses aspects related to the frequency of sarcoma in pregnancy, diagnostic difficulties, the frequency of fetal vitality assessments, and possible therapeutic approaches during pregnancy.

Objective: To explore the effectiveness of contrast-enhanced ultrasound (CEUS) and high-frequency ultrasound (HFUS) in evaluating the efficacy of wrist intervention for rheumatoid arthritis (RA) patients.

Methods: This prospective study enrolled rheumatoid arthritis (RA) patients experiencing wrist swelling and pain at the Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, over the period from October 2021 to June 2024. All patients were given 1 mL of compound betamethasone injection under ultrasound guidance, and the characteristics of wrist synovium CEUS and HFUS before and after treatment were compared.

Results: A total of 49 patients (37 females, 53.45 ± 14.9 years) were enrolled. Peak intensity (PI) was highly correlated with the 28-joint disease activity score (r = 0.798, p < 0.01). The display rate of CEUS for synovium of wrist joints was 100% 2 weeks after treatment, while the display rate of PDUS for synovial blood flow was reduced to 65.31% (p < 0.05). Receiver operating characteristic curve analysis revealed that the CEUS had an area under the curve (AUC) of 0.792 (95% CI: 0.666-0.918, p < 0.001) in predicting the therapeutic effect, with sensitivity and specificity of 52.2% and 96.2%, respectively. Moreover, HFUS had an AUC of 0.722 (95% CI: 0.577-0.867, p = 0.008) in predicting the therapeutic effect, with sensitivity and specificity of 56.5% and 84.6%, respectively.

Conclusion: CEUS and HFUS might be supplemental strategies in evaluating the therapeutic effect for RA patients.

Fibromuscular dysplasia (FMD) is a rare, non-atherosclerotic vascular disease affecting medium to large arteries, especially the renal and internal carotid arteries (ICAs). The string-of-beads appearance, indicative of alternating areas of stenosis and dilatation, is a key imaging feature typically observed in the distal ICAs. Diagnosing FMD in critically ill patients poses challenges due to the risks associated with traditional imaging methods such as computed tomography angiography (CTA), magnetic resonance angiography, and digital subtraction angiography. We report a case of a 74-year-old woman diagnosed with stroke who required mechanical ventilation in the intensive care unit. Initial Doppler ultrasound revealed a fibrolipid plaque at the left internal carotid artery but could not assess the distal ICAs. Using a transoral approach with an endocavitary transducer, we visualized the distal ICAs, revealing the classic string-of-beads pattern and elevated peak systolic velocities indicative of stenosis. CTA confirmed these findings. The transoral ultrasound approach offers a non-invasive, bedside alternative for assessing the distal portions of the ICAs, making it particularly beneficial in critically ill patients. This case underscores the potential of this technique for timely diagnosis of FMD, warranting further research into its broader applicability in routine evaluations of suspected cases.

We report the case of a 28-year-old female patient (gravida 2, para 1) who underwent a cesarean section after 33 weeks of pregnancy due to severe preeclampsia. The placenta was deeply embedded in the myometrium. Localized myometrial ischemia occurred following repair and suturing of the myometrium at the placental attachment site.

Purpose: The purpose of this study is to propose new ultrasound scores to assess inflammatory bowel disease (IBD) activity and to analyze their accuracy in assessing disease severity. In addition to this, to validate that intestinal ultrasound can be used as a follow-up tool for the assessment of IBD.

Methods: One hundred and thirty-six adult IBD patients who underwent intestinal ultrasound. Patients were divided into two groups based on colonoscopic findings: 93 patients with UC, 43 patients with CD. UC patients and CD patients were divided into active and inactive groups based on colonoscopic findings, respectively. After forming scores, cut-off values, sensitivity, and specificity were calculated using receiver operating characteristic (ROC) analysis, respectively.

Results: Both in UC patients and in CD patients, bowel wall thickness (BWT) and vascular index (VI) were much higher in the active group compared with the inactive group, CEUS mode III, IV, CDFI grades 3-4, fat wrapping, and lost stratification were more likely to imply active disease. In UC patients only, Young's modulus value was much higher in the active group compared with the inactive group.

Conclusion: The new intestinal ultrasound scores can be used to assess UC and CD activity and may be useful in identifying severe endoscopic activity in IBD.