Journal of Clinical Ultrasound最新文献

Objective: To compare the effects of nifedipine and indomethacin, used for tocolytic purposes in the treatment of preterm labor (PTL), on fetal-maternal Doppler blood flows and perinatal outcomes.

Materials and methods: Eighty pregnant women between weeks 24 and 32 of gestation who used nifedipine (n = 40) and indomethacin (n = 40) as tocolytic treatments due to PTL were prospectively and consecutively included in the study. Sociodemographic, obstetric, and laboratory and Doppler flow parameters were compared between the groups.

Results: Statistically significant differences were observed between the groups in terms of gestational age at delivery and birth weight, Doppler flows (umbilical artery (UA) Pulsatility Index (PI), and UA Resistance Index (RI)) at 12, 24, and 48 h, middle cerebral artery RI at 12 h, and ductus venosus (DV) PI and DV-RI at 12, 24, and 48 h (p < 0.05).

Conclusions: The findings of this study showed that nifedipine and indomethacin used in the treatment of PTL had significant effects on UA-PI and UA-RI Doppler flows at 12, 24, and 24 h, MCA-RI Doppler flows at 12 h, and DV-PI and DV-RI Doppler flows at 12, 24, and 48 h. Further studies involving larger numbers of participants are now needed to support these results.

In this case, the bilateral brachial plexus, median nerve, ulnar nerve, radial nerve, sciatic nerve, tibial nerve, and common peroneal nerve of the patient all showed diffuse and uniform edema and thickening, with no segmental thickening changes in noncompression areas, consistent with the neuroultrasound findings of CMT1.

Objectives: Ultrasound is a valuable tool for diagnosing septic arthritis and guiding the development of treatment plans. This study aimed to identify sonographic findings associated with complications in septic arthritis.

Methods: Twelve patients aged <5 years diagnosed with septic arthritis were classified into two groups: those with and without complications. Complications were defined as the destruction of the epiphyseal bone head and metaphysis bone cortex. The following sonographic findings were compared between the two groups using Fisher's exact test: synovial membrane thickness, joint effusion, diminished hyperechoic foci within the epiphyseal bone head, and diminished smooth metaphyseal bone cortex.

Results: Overall, 4 of 12 patients developed complications. Joint effusion and synovial membrane thickening were detected in all patients with septic arthritis. The incidence of diminished hyperechoic foci within the epiphyseal bone head was significantly different between the two groups (presence/absence in patients with complications vs. without = 3/1 vs. 0/8, p = 0.018). The incidence of diminished smooth metaphyseal bone cortex was higher in patients with complications than in those without; however, this difference was not statistically significant (presence/absence in patients with complications vs. without = 4/0 vs. 3/5, p = 0.081).

Conclusion: Ultrasound proved to be an effective diagnostic tool for septic arthritis and also demonstrated its potential in predicting complications of septic arthritis in the pediatric population.

Background: This research aims to summarize the ultrasound features and pregnancy outcomes of incarceration of the gravid uterus (IGU), providing a basis for clinical management.

Methods: A retrospective cohort study was conducted on pregnant patients with IGU at Hunan Provincial Maternal and Child Health Care Hospital in China, spanning from September 30, 2016, to May 31, 2024. Data on maternal age, parity, medical history, risk factors, gestational age, clinical manifestations, ultrasound examination, treatment methods, time, and method for terminating pregnancy, and pregnancy outcomes were collected. We compared cases diagnosed before and after 20 gestational weeks.

Results: During the study period, 13 pregnant women were diagnosed with IGU, and 140 162 deliveries were recorded at our hospital. Two cases were referred from other hospitals and did not deliver in our hospital. Accordingly, the incidence of IGU was 0.08‰ (11/140, 162). The most prevalent risk factor for IGU was previous abdominal or pelvic surgery (61.54%, 8/13). Dysuria or even urinary retention was the primary symptom (38.46%, 5/13). Spontaneous resolution occurred in only one case (7.69%). All cases were detected using prenatal ultrasound examination with typical characteristics, including a retroverted uterus and the fundus located behind the cervix. No statistically significant differences between the two comparison groups were found in successful uterine reduction (p > 0.05).

Conclusion: The definition of IGU should include symptomatic cases of any gestational age. Despite a low prevalence of this pregnancy complication, the overall prognosis of IGU is good. In the absence of severe symptoms, regular monitoring may be an option. Typical ultrasound imaging features enable a definitive diagnosis of IGU.

Purpose: The aim of this study was to describe in volunteers and cadavers the location of the vascular structures at risk for performing a new safe and effective ultra-minimally invasive ultrasound guided long head of the biceps tendon (LHBT) release.

Methods: First, with Doppler ultrasound, we defined the position of the acromial artery from our distal cutting point, on the posterior margin of the LHBT. Second, we performed an ultra-minimally invasive ultrasound guided LHBT release in cadavers. We described the stump and reported safety (no rotator cuff, vascular, or articular damages) and efficacy (tendon release rate).

Results: In 20 volunteers, the mean distance from the distal cutting point to the acromial artery was 0.9 ± 0.1 cm (range, 0.3-1.6). Ultra-minimally invasive LHBT release was safe and fully effective in the eight specimens. The proximal stump measured a mean of 2.8 cm (range, 1.9-4). There were no complications.

Conclusions: A safe and effective ultra-minimally invasive ultrasound guided LHBT release in cadavers is feasible through an anterior approach.

Background: Lung edema is a significant factor in prolonged mechanical ventilation and extubation failure after cardiac surgery. This study assessed the predictive capability of point-of-care Lung Ultrasound (LUS) for the duration of mechanical ventilation and extubation failure in infants following cardiac procedures.

Methods: We conducted a prospective observational trial on infants under 1 year, excluding those with pre-existing conditions or requiring extracorporeal membrane oxygenation. LUS was performed upon intensive care unit (ICU) admission and prior to extubation attempts. B-line density was scored by two independent observers. The primary outcomes included the duration of mechanical ventilation and extubation failure, the latter defined as the need for reintubation or non-invasive ventilation within 48 h post-extubation.

Results: The study included 42 infants, with findings indicating no correlation between initial LUS scores and extubation timing. Extubation failure occurred in 21% of the patients, with higher LUS scores observed in these cases (p = 0.046). However, interobserver variability was high, impacting the reliability of LUS scores to predict extubation readiness.

Conclusions: LUS was ineffective in determining the length of postoperative ventilation and extubation readiness, highlighting the need for further research and enhanced training in LUS interpretation.