Journal of Clinical Ultrasound最新文献

Purpose: To explore the diagnostic value of miR-454-3p combined with Color Doppler ultrasonography (CDUS) in BC, hoping to provide new insights for breast cancer (BC) diagnosis.

Methods: A total of 205 female BC patients, 80 patients with benign breast diseases, and 50 healthy females were recruited. Serum miR-454-3p levels were measured by RT-qPCR, and all subjects underwent ultrasonic examination.

Results: BC patients had significantly higher rates of irregular morphology, unclear boundaries, spiculations, shadowing, microcalcifications, aspect ratio ≥ 1, and blood flow grades II-III. Blood flow characteristics (RI, PI, and V_max) were also notably elevated in BC compared to benign cases. miR-454-3p is significantly upregulated in both benign and BC groups. In BC patients, the expression levels of miR-454-3p were significantly elevated in those with larger tumors, higher histological grades, higher TNM stages, tumor lymph node metastasis, positive ER, and positive HER-2. The expression of miR-454-3p in BC patients was significantly correlated with ultrasound boundary, spiculated margins, echogenicity, aspect ratio, blood flow grading, and blood flow characteristics (RI, PI, and V_max). miR-454-3p can improve the accuracy of CDUS in diagnosing BC.

Conclusion: miR-454-3p has diagnostic value in BC, and its expression is significantly correlated with tumor deterioration. Combining miR-454-3p and CDUS can improve diagnostic accuracy, providing a reference for early clinical diagnosis of BC.

Adenomyomatosis of the gallbladder (ADM) is generally considered benign. The presented cases were initially diagnosed with ADM via ultrasound during an annual health check-up and monitored for several years without further investigations due to the absence of significant changes or symptoms. Subsequently, one case was diagnosed with pancreaticobiliary maljunction (PBM) with a non-dilated extrahepatic bile duct (EBD) after symptom onset, and underwent prophylactic laparoscopic cholecystectomy to avoid the risk of carcinogenesis. Although the other case remained asymptomatic, ultrasound later revealed far-advanced gallbladder carcinoma with direct invasion into the liver and hepatic metastases, and endoscopic retrograde cholangiopancreatography identified PBM with a non-dilated EBD. At laparotomy, she was found to have unresectable disease and died 4 months later. ADM associated with PBM has been recently reported. Consequently, evaluating the presence or absence of PBM is essential for determining an appropriate treatment strategy when diagnosing ADM.

Cerebral arteriovenous malformations (AVMs) are congenital vascular anomalies characterized by direct connections between arteries and veins, bypassing the capillary network. They can lead to serious complications such as intracranial hemorrhage, seizures, and elevated intracranial pressure. While imaging modalities such as computed tomography, magnetic resonance imaging, and digital subtraction angiography remain essential for diagnosis and treatment planning, brain point-of-care ultrasound (POCUS) offers a valuable complementary tool, particularly in emergency and critical care settings. This pictorial review highlights the role of different ultrasound modalities in the evaluation of AVMs. B-mode ultrasound is useful for identifying structural abnormalities and secondary effects such as hemorrhage and hydrocephalus. Color and power Doppler imaging allow visualization of abnormal vascular flow patterns within the nidus, while spectral Doppler provides hemodynamic information. Although limited by bone windows and operator dependency, brain POCUS offers a rapid, noninvasive bedside assessment that can aid in the early recognition and monitoring of AVMs and their complications.

Purpose: To analyze ultrasound findings and investigate the epidemiology, intervention efficacy, and associated factors of developmental dysplasia of the hip (DDH) in infants aged 0-6 months.

Methods: This retrospective study analyzed 6189 infants (3360 males, 54.3%) who underwent initial routine hip ultrasound at Shaoxing Maternal and Child Health Hospital (April 2022 to June 2024). Outcomes included DDH detection rate, Graf classification, laterality, and early intervention success rate (conversion to Graf Type I). Descriptive statistics summarized outcomes including detection rates, distributions, and intervention success rates while univariate and multivariate logistic regression identified influencing factors.

Results: The DDH detection rate was 3.2% (196/6189), primarily left-sided (64.73%), and Graf Type IIa/b (90.82%). The early intervention success rate was 98.95% (189/191). Female sex (aOR = 19.76, 95% CI: 11.91-32.81), breech delivery (aOR = 3.97, 95% CI: 2.47-6.39), family history (aOR = 1.54, 95% CI: 1.01-2.33), swaddling history (aOR = 2.44, 95% CI: 1.58-3.76), and gluteal fold asymmetry (aOR = 2.67, 95% CI: 1.86-3.84) were risk factors (all p < 0.05). First-born (aOR = 0.29, 95% CI: 0.20-0.42) and vaginal delivery (aOR = 0.25, 95% CI: 0.18-0.35) were protective.

Conclusion: This single-center study delineates the clinical profile of DDH, demonstrates a remarkably high success rate of early intervention, and identifies its independent influencing factors, providing evidence for risk-stratified screening while noting limited generalizability.

Purpose: In patients with intermediate-risk chest pain, a functional stress study is important for therapeutic strategies. However, many physicians encounter challenges in clinical decisions with biases of non-ischemic pain from resting-regional wall motion abnormality (RWMA) related to the prior myocardial scar. We aimed to use adenosine stress myocardial contrast echocardiography (MCE) to assess perfusion defects (PD) and predict cardiac events in these patients.

Methods: We retrospectively analyzed 496 patients, categorizing them into four groups based on resting-RWMA and PD on MCE. The study endpoint comprised coronary revascularization, worsening heart failure, and cardiac death.

Results: Patients with severe RWMA and PD were older and exhibited a higher prevalence of diabetes, atrial fibrillation, heart failure, coronary artery disease, and coronary intervention. Their echocardiography revealed increased cardiac chamber dilation, lower left ventricular ejection fraction, and reduced tissue Doppler velocities. Over a median follow-up of 38 months, a study outcome occurred in 54 (11%) patients. Multivariate analysis indicated a 13-fold increase in outcomes among patients with PD and resting-RWMA ≥ 2 segments, respectively. PD ≥ 2 segments, rather than resting-RWMA, independently carried an increased outcome on adjusted Kaplan-Meier analysis.

Conclusion: PD could complement resting-RWMA and be a robust predictor of cardiac events in intermediate-risk patients.

Double orifice mitral valve (DOMV) is a very rare cardiac lesion that presents primarily as a left ventricular inflow tract lesion, often combined with outflow tract lesions such as bicuspid aortic valve, aortic stenosis, and subaortic stenosis. However, reports involving DOMVs are rare. Echocardiography is the primary method of examination of DOMVs. This article focuses on describing the case of congenital double-orifice mitral valve combined with bicuspid aortic valve in an elderly patient.

Objective: This study aims to develop and validate a deep learning radiomics (DLR) model based on ultrasound images for non-invasively distinguishing the myometrial infiltration (MI) of patients with endometrial cancer (EC).

Methods: We retrospectively collected 310 patients with EC who underwent surgical resection from center 1 from September 2017 to January 2025, forming a training group and a validation group. An external testing group was comprised of 80 patients from center 2. We extracted deep learning (DL) features and radiomics features from ultrasound images, establishing a DLR model after dimensionality reduction. The receiver operating characteristic analysis was used to evaluate the practicality of the proposed model. The utility of the proposed model was evaluated using receiver operating characteristic, calibration, and decision curve analysis.

Results: A total of 390 EC patients were included in the study. In the validation set, the AUC of the radiomics model was 0.874 (0.774-0.949), and in the testing group, the AUC of the DL model was 0.844 (0.699-0.957). The DLR model was superior to radiomics models and DL models in interpreting images, and also outperformed the diagnostic performance of advanced ultrasound physicians.

Conclusion: The DLR model based on ultrasound images can accurately and non-invasively distinguish the MI depth of EC patients, assisting doctors in formulating more favorable treatment plans for patients.

Frozen shoulder (FS), or adhesive capsulitis, remains a challenging clinical entity due to its insidious onset, variable presentation, and diagnostic overlap with other shoulder pathologies. While FS is traditionally diagnosed clinically, musculoskeletal ultrasound (MSKUS) is emerging as a valuable adjunct tool capable of identifying early-stage structural and vascular changes. This review synthesizes the current evidence on MSKUS's diagnostic utility, highlighting its capacity to visualize characteristic features such as capsular thickening, rotator interval (RI) hypervascularity, and effusion in the long head of the biceps tendon (LHBT) sheath-particularly prominent in early or intermediate disease stages. Although MSKUS is highly operator-dependent and demands substantial training, its integration into clinical assessment may enhance diagnostic precision, particularly when FS is suspected early. As the field advances, combining MSKUS findings with metabolic and inflammatory biomarkers may support a pathophysiological classification of FS, paving the way for more personalized, algorithm-based interventions. In summary, MSKUS provides a safe, accessible, and dynamic modality for detecting capsuloligamentous changes in FS. Its role in early diagnosis, differential screening, treatment monitoring, and future integration with systemic biomarkers supports its growing clinical relevance in both orthopedic and interdisciplinary settings.

Adrenal teratoma, a rare germ cell neoplasm, is often clinically underrecognized due to nonspecific manifestations, complicating radiological characterization. This article summarizes its ultrasonographic and computed tomography (CT) features, establishes evidence-based differential diagnosis strategies, and presents a representative case.

Malignant melanoma exhibits high metastatic potential, yet metastasis to the gallbladder and pancreas is exceptionally rare. We report a 78-year-old male patient who developed epigastric discomfort 7 months after undergoing amputation for right-foot malignant melanoma. Imaging studies revealed space-occupying lesions in the gallbladder and pancreatic head, which were pathologically confirmed as melanoma metastases. This case underscores the importance of maintaining vigilance for metastases to unusual anatomical sites in melanoma patients presenting with gastrointestinal symptoms, and highlights the diagnostic value of multimodal imaging approaches in such scenarios.