Journal of Clinical Ultrasound最新文献

Purpose: The purpose of this research was to quantitatively evaluate the vascular supply and tissue stiffness of the salivary glands-namely, the submandibular and parotid glands-in pregnant individuals throughout the three trimesters, employing superb microvascular imaging (SMI) and shear wave elastography (SWE).

Methods: A longitudinal prospective study was executed involving 35 healthy pregnant women. Salivary gland ultrasonography was conducted during each trimester. The vascularization index (VI) was quantified using the two-dimensional SMI VI (2DcSMIVI) mode by manually delineating the glandular parenchyma. Glandular elasticity was measured through SWE in kilopascals (kPa) and meters per second (m/s). Statistical evaluations incorporated repeated measures ANOVA and the Friedman test (p < 0.05).

Results: Submandibular gland stiffness showed significant trimester-based variations, with kPa values peaking in the second trimester and declining in the third (F(2,68) = 5.31, p < 0.05, η² = 0.13). Likewise, m/s values were elevated in the second trimester relative to the third (X² = 7.79, p < 0.05). In contrast, the stiffness and VI values of the parotid gland exhibited consistency across trimesters (p > 0.05).

Conclusion: The dynamic shifts in submandibular gland stiffness, highlighted by a rise in the second trimester followed by a decrease in the third, most likely signify the hormonal and hemodynamic adaptations that come with pregnancy. These findings underscore the importance of monitoring salivary gland function in pregnant women and pave the way for future investigations into the diagnostic and prognostic implications of these changes. To the best of our knowledge, this represents the inaugural study demonstrating normative stiffness and vascularity parameters of salivary glands across each trimester of pregnancy.

Heterotopic pregnancy (HP) is a rare condition with an incidence of about 1 in 30 000 in natural conceptions and 1 in 100 in cases involving assisted reproductive techniques (ART). The diagnosis can be challenging and often underdiagnosed due to the presence of an intrauterine pregnancy. We aim to present a rare case of HP, characterized by the presence of intrauterine twin implantation. This case highlights the importance of maintaining a high index of suspicion for HP even in the presence of a viable intrauterine twin gestation, particularly following ovulation induction with clomiphene citrate.

This report documents the first serial sonographic progression of ganglionic eminence (GE) anomalies in pyruvate dehydrogenase complex deficiency (PDCD) from 12 to 28 weeks. Ultrasound revealed bilateral anterior hypoechoic foci (12 weeks), progressing to solid-cystic GE cavitations (22 weeks) and periventricular germinolysis-type pseudocysts (28 weeks). MRI confirmed concurrent callosal dysgenesis and cerebellar hypoplasia. A pathogenic PDHA1 variant (c.581A>G, p.Y194C) provided definitive molecular diagnosis after exclusion of common etiologies. This continuum serves as an early PDCD imaging indicator, guiding prenatal diagnosis of this lethal disorder.

We present a rare fetal case of aortopulmonary window (APW) accompanied by severe growth restriction and a complex chromosomal abnormality involving two pathogenic 15q copy number variants encompassing the IGF1R gene. Fetal echocardiography at 28 weeks confirmed the APW and a perimembranous ventricular septal defect. This co-occurrence suggests a more complex relationship between 15q aberrations and APW and warrants further study. Moreover, this case expands the phenotypic spectrum of 15q imbalances and underscores the need for integrated prenatal evaluation combining advanced cardiac imaging with genomic analysis, particularly in congenital heart disease accompanied by significant growth disturbance.

Purpose: Accurate evaluation of left ventricular (LV) dysfunction and infarct localization in acute myocardial infarction (AMI) remains challenging due to subjective variability in conventional echocardiographic analysis. This study validates an artificial intelligence (AI)-driven automated strain framework for standardized quantification of myocardial deformation and its correlation with clinical biomarkers.

Methods: A retrospective cohort of 102 first-onset ST-elevation AMI patients and 90 age-/sex-matched controls underwent 2D speckle-tracking echocardiography. A modified ResNet-18 architecture processed standardized apical views (112 × 112 pixels, 25-frame cycles) through dual-task learning: global/regional longitudinal strain (LPSS) quantification and infarct localization. Training employed a two-phase optimization-myocardial tracking followed by strain regression and infarct classification. Real-time augmentation included speckle noise and cardiac-phase variations. Statistical analyses assessed correlations between strain parameters, LV ejection fraction (LVEF), cardiac troponin T (cTnT), and ST-segment elevation.

Results: AI-derived global LPSS strongly correlated with LVEF (r = -0.609; p < 0.001), outperforming the wall motion score index (r = 0.291). Infarct-zone LPSS demonstrated the strongest associations with cTnT (r = 0.671; p < 0.001) and ST elevation (r = 0.321; p = 0.001). Remote myocardium exhibited compensatory hyperkinesis (LPSS = -17.93%). Bland-Altman analysis confirmed reproducibility (intra-observer bias: 0.7% ± 1.2%; interobserver: 1.1% ± 3.1%).

Conclusions: AI-driven strain analysis standardized LV functional assessment in AMI, providing quantitative correlations with enzymatic and electrophysiological injury markers. Its ability to localize infarcts and detect compensatory mechanisms supports clinical decision-making, bridging gaps between echocardiography and advanced imaging.

We present a case of a very rare benign ovarian tumor, a sclerosing stromal tumor (SST). In addition, we performed a review of the literature to describe the spectrum of sonographic findings of this tumor. Our case was a 43 year-old woman, referred for pelvic endometriosis evaluation. Transvaginal ultrasound showed a solid tumor with a maximum diameter of 30 mm arising from external pole of the right ovary. Color Doppler assessment showed a moderate/abundant vascularity. A diagnosis of presumed ovarian surface serous borderline tumor was established. Surgery was performed with tumor removal. Definitive histological diagnosis was benign sclerosing stromal ovarian tumor. In the literature review, we identified 81 cases describing sonographic findings of this tumor. This spectrum was wide, with most tumors reported as purely solid or predominantly solid with cystic areas (86.7%) and few cases were reported as multilocular-solid, unilocular-solid, multilocular and unilocular. Echogenicity was heterogeneous in 96.9% of the cases. When vascularity was described, 61% of the cases had moderate/abundant vascularization. Calcification and shadowing were rare. Ascites was reported in 16.0% of the cases. In conclusion, the spectrum of findings of SSTs may vary, but most cases were solid tumors. Our case fits this pattern.

We report a rare case of dual ductal-dependent systemic perfusion in type C interrupted aortic arch. Despite imaging confirmation, ductal closure led to cardiopulmonary failure, and surgery was declined. This case underscores the critical need for prenatal diagnosis and coordinated perinatal management to enable timely intervention.

Objective: This study investigates the blood supply distribution in pituitary macroadenomas with cavernous sinus invasion using dynamic contrast-enhanced MRI (DCE-MRI).

Materials and methods: Data from 44 patients treated between May 2018 and December 2021 were collected. DCE-MRI was conducted preoperatively. As a result, tumors in the sella turcica and cavernous sinus were distinguished based on cavernous sinus wall continuity on T2WI coronal views. Time-signal intensity curves were generated from DCE-MRI using a postprocessing workstation.

Results: Analysis revealed no significant difference (p > 0.05) in curve types between sella turcica and cavernous sinus tumor tissues. However, the volume transfer constant, reflux rate constant, and rT2WI in the sella turcica tumor tissue were significantly higher than those in the cavernous sinus (p < 0.05). Extracellular space volume fraction and initial area under the curve showed no significant difference (p > 0.05).

Conclusion: Pituitary adenomas in the sella turcica and cavernous sinus share the same blood supply artery. However, the tumor tissue in the sella turcica displays richer blood flow and microvascular generation than that in the cavernous sinus.

Objective: This study aimed to use shear wave elastography (SWE) to evaluate the effect of hemoperfusion (HP) on carotid artery elasticity in uremic patients treated with hemodialysis (HD).

Methods: Seventy-eight uremic patients were divided into Group B (using HP + HD) and Group C (using HD) according to the dialysis method the patients already used, while 40 healthy volunteers were included as Group A. The clinical data and biochemical indices were collected. Conventional carotid parameters, including carotid intima-media thickness (IMT), carotid artery inner diameter at the end of systole (D_s), carotid artery inner diameter at the end of diastole (D_d), and peak systolic flow velocity (PSV) were measured. The wall motion degree (∆D) and the stiffness coefficient (β) were calculated. SWE-derived elastic moduli (MEmean, MEmax, and MEmin) were measured. Ten-year cardiovascular disease risk (10-year ASCVD risk) was calculated using the Framingham risk score (FRS).

Results: There was no significant difference in the D_s, D_d, ∆D, and PSV among the three groups (all p > 0.05). Uremic groups exhibited elevated BUN, Scr, BUA, TG, LDL-C, IMT, β, SWE parameters, and 10-year ASCVD risk compared to controls (p < 0.05). Group C showed significantly higher BUN, Scr, BUA, TC, TG, LDL-C, SWE values, and 10-year ASCVD risk than Group B (p < 0.05), though IMT and β did not differ. SWE parameters correlated positively with LDL-C, IMT, β, and 10-year ASCVD risk (all r > 0.372, p < 0.01), and demonstrated superior diagnostic accuracy (AUCs: 0.919-0.953) compared to conventional measures.

Conclusion: These data suggest that SWE is helpful in quantitatively assessing the change in carotid artery elasticity. It could be a useful method for monitoring the progression of atherosclerosis in uremic patients undergoing HD with or without HP and may provide guidance for clinicians to identify individuals at heightened cardiovascular risk.

Background: Hepatocellular carcinoma (HCC) at the early stage frequently evades detection. Aberrant expression of miR-1233 has been reported in various malignancies, yet its level and potential clinical value in HCC remain unknown.

Objective: This study evaluated miR-1233 expression and potential diagnostic performance in HCC patients.

Materials and methods: This prospective study enrolled 100 individuals with benign hepatic tumors and 120 cases with HCC. They all underwent dual-source CT imaging and were confirmed pathologically. The miR-1233 level was quantified by qRT-PCR. The multivariate logistic regression analysis was employed to identify the underlying risk factors of HCC. Pearson correlation analysis was carried out to assess the association of miR-1233 with alpha fetoprotein (AFP) or des-gamma-carboxy prothrombin (DCP). After statistical analysis in SPSS, ROC curves were generated for significantly different miR-1233, dual-CT parameters, and the combination to compare their diagnostic performance in distinguishing HCC patients.

Results: Serum miR-1233 was up-regulated in HCC patients. The expression pattern of miR-1233 showed positive correlation to AFP and DCP indicators. In ROC curve of miR-1233, AUC reached 0.821, with a sensitivity of 73.33% and specificity of 76.67%. Combined with the differential dual-CT parameters, the AUC reached 0.944, with both sensitivity and specificity exceeding 90%.

Conclusion: Serum miR-1233 was significantly up-regulated in HCC patients. The diagnostic efficacy of miR-1233 combined with dual-source CT was superior to that of the single one in recognizing HCC individuals.