Journal of Clinical Ultrasound最新文献

The use of artificial intelligence (AI) platforms is revolutionizing the performance in managing metadata and big data. Medicine is another field where AI is spreading. However, this technological advancement is not amenable to errors or fraudulent misconducts. International organization and recently the European Union have released principles and recommendations for an appropriate use of AI in healthcare. In prenatal ultrasound diagnosis, the use of AI in daily practice is having a revolutionary impact. Notwithstanding, the diagnostic enhancement should be regulated, and AI applications should be developed to guarantee correct imaging acquisition and further postprocessing.

Purpose: Non-invasive tests are increasingly demanded for diagnosing and prognostication of chronic kidney disease (CKD). Shear-wave elastography (SWE), an emerging technique for measuring tissue stiffness, shows promise for distinguishing between individuals with different stages of renal fibrosis. This study aimed to compare the diagnostic accuracy of two-dimensional SWE (2D-SWE) and conventional ultrasound for detecting CKD, employing renal biopsy as the gold standard.

Methods: From May 2020 to October 2023, this prospective study included 30 healthy volunteers and 169 patients with CKD who had undergone 2D-SWE and conventional ultrasound of both kidneys. Cortical and medullary stiffness, cortical pixel intensity, renal length, parenchymal and cortical thickness, interlobar artery peak systolic velocity, end-diastolic velocity (EDV), and resistive index were measured. The diagnostic accuracy of 2D-SWE and conventional ultrasound was compared using the receiver operating characteristic curve (ROC) and Delong test.

Results: For diagnosing CKD, the area under the ROC (AUC) of cortical stiffness (0.96 [95% CI, 0.93, 0.99]) was significantly higher than that of all conventional ultrasound parameters, including EDV (0.78 [95% CI, 0.71, 0.86]) and cortical thickness (0.74 [95% CI, 0.67, 0.80]). The sensitivity of cortical stiffness (91%) was significantly higher than that of EDV (68%) and cortical thickness (53%). No significant difference was found in the specificity of cortical stiffness (96%) compared to that of EDV (79%) and cortical thickness (100%).

Conclusion: Two-dimensional SWE showed higher diagnostic accuracy than that of conventional ultrasound for detecting CKD.

This meta-analysis examined the diagnostic accuracy of Sonazoid-enhanced ultrasonography (SZ-CEUS) in discriminating malignant from benign focal liver lesions (FLLs) and HCC from non-HCC FLLs. Finding relevant studies required a rigorous PubMed, EMBASE, and other database search. To distinguish malignant from benign FLLs, SZ-CEUS had a pooled sensitivity of 94% (95% CI: 0.91-0.95) and specificity of 84% (95%: 0.78-0.89). HCC distinction had 83% sensitivity and 96% specificity (95% CI: 0.80-0.85 and 0.95-0.97). SZ-CEUS accurately distinguishes malignant from benign FLLs and HCC from non-HCC lesions, especially smaller HCC lesions.

This meta-analysis evaluated the effects of ultrasound-guided (USG) and landmark-guided (LMG) injections of corticosteroids into the shoulder joint cavity of patients with shoulder pain. The PubMed database was searched for articles (January 1, 2004-December 31, 2023) comparing USG and LMG injections of corticosteroids for the treatment of adult shoulder pain. Two authors independently performed data extraction and appraisal. The outcome measures collected were visual analogue scale (VAS) score and VAS score change at 1 and 6 weeks postinjection and range of motion (ROM) at 6 weeks postinjection. Thirteen studies including 656 patients were reviewed (USG and LMG groups, 328 patients each). The VAS score at 1 week postinjection and the ROM in abduction at 6 weeks postinjection were statistically different, but there were no statistically significant differences in other outcomes. This meta-analysis indicated that USG corticosteroid injection may have a better effect than LMG corticosteroid injection for early-stage shoulder pain and abduction in the mid- to long-term, but does not affect later shoulder pain or other ROMs.

Purpose: This study aims to investigate the interobserver variability in the quantitative assessment of liver fat content using ultrasound attenuation imaging technology (USAT).

Methods: This prospective, single-center study included 96 adult patients who were either diagnosed with or suspected of having metabolic dysfunction-associated steatotic liver disease. Independent observers, blinded to each other's assessments, evaluated hepatic steatosis visually and through USAT measurements. Separate measurements were taken at five intercostal and subcostal sites, and the median values of these measurements were recorded. The correlation between USAT measurements and visual steatosis grades was examined using Spearman's correlation test. Intraclass correlation coefficient (ICC) and Bland-Altman analysis were used to evaluate the interobserver variability of USAT measurements.

Results: Interobserver agreement for USAT measurements was excellent for the intercostal examination and good for the subcostal examination (p < 0.001). Body mass index did not significantly affect the level of interobserver agreement. Interobserver variability in Bland-Altman plots of USAT measurements was within the 95% limits of agreement. USAT measurements correlated very strongly with the visual degree of hepatic steatosis, both intercostal and subcostal (p < 0.001). USAT measurements were also significantly different between different visual degrees of hepatic steatosis (p < 0.001).

Conclusion: In the assessment of hepatic steatosis, USAT measurements obtained from the intercostal space showed excellent agreement in terms of interobserver reproducibility.

Aim: High-frequency ultrasound with an 18-MHz probe (18 MHz-HFUS) plays a relevant role in the evaluation of peripheral nerve injury (PNI). Ultrahigh-frequency ultrasound with a 70-MHz probe (70 MHz-UHFUS) offers higher spatial resolution and could allow a better detection of PNI. This study aimed to compare the diagnostic performance of HFUS and UHFUS in PNI detection.

Materials and methods: In this retrospective study, were selected, between July 2022 and April 2024, 61 patients underwent HFUS, UHFUS, and nerve conduction study (NCS) for clinical suspicion of traumatic forearm PNI. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of HFUS and UHFUS in PNI detection were calculated and compared. NCS was used as the reference standard. Nonparametric statistical tests were used. A p value of < 0.05 was considered statistically significant.

Results: Comparing the diagnostic performance in PNI detection, the 70 MHz-UHFUS showed a sensitivity and diagnostic accuracy significantly higher than 18 MHz-HFUS, respectively, 98.0% versus 82.4% (p = 0.0205) and 95.1% versus 82.0% (p = 0.0468). Otherwise, not significantly difference were in specificity, PPV, and NPV.

Conclusions: UHFUS compared to HFUS demonstrated a higher sensitivity and diagnostic accuracy in PNI detection.