Journal of Clinical Ultrasound最新文献

Objective: To assess the diagnostic performance of contrast-enhanced ultrasound (CEUS) for detecting abdominal metastases in patients with gastrointestinal stromal tumors (GISTs), with a comparison to conventional ultrasonography (US) and contrast-enhanced computed tomography (CE-CT).

Methods: This retrospective study enrolled 53 patients with pathologically confirmed abdominal metastases from gastrointestinal stromal tumors (GISTs), who underwent US, CEUS, and CE-CT examinations at our institution between January 2022 and January 2025. The diagnostic performance of CEUS was systematically evaluated and compared with US and CE-CT according to pathological diagnostic criteria.

Results: CEUS showed significantly higher sensitivity than US (88.68% vs. 45.28%; p < 0.05). Notably, CEUS achieved comparable performance to CE-CT (sensitivity: 88.68% vs. 94.34%; p > 0.05). No statistically significant differences were observed between CEUS and CE-CT in lesion perfusion characteristics, including enhancement pattern (p > 0.05), intensity (p > 0.05), and homogeneity (p > 0.05).

Conclusions: CEUS demonstrates superior diagnostic performance to US in detecting abdominal metastases from GISTs, with efficacy comparable to CE-CT. Given its radiation-free nature and procedural simplicity, CEUS represents a valuable imaging modality for the clinical assessment of GIST metastases.

This study provides preliminary reference values for thyroid volume and stiffness in asymptomatic infants. Thyroid volume increased with age, while stiffness remained stable until 180 days and increased thereafter. Shear wave elastography may serve as a valuable, non-invasive tool for early thyroid assessment and monitoring in infancy.

Pulmonary artery intimal sarcoma (PAIS) is a rare and highly aggressive malignancy. Due to nonspecific clinical symptoms, imaging features, and laboratory findings, PAIS is frequently misdiagnosed as pulmonary embolism (PE), leading to delayed diagnosis and poor prognosis. Multimodal imaging, including echocardiography, Positron Emission Tomography-Computed Tomography (PET/CT), and histopathology, is critical for accurate diagnosis. We present a case of PAIS with atypical manifestations, aiming to improve early clinical recognition and emphasize the role of a multimodal approach in early diagnosis for PAIS patients.

Objectives: To retrospectively analyze the differences in imaging findings between benign and borderline ovarian serous/mucous tumors.

Methods: Imaging features of benign and borderline ovarian tumors were analyzed, including the tumor maximum diameter, laterality, tumor morphology, proportion of solid components, and the number of papillary processes in cystic solid tumors.

Results: A total of 189 tumors were evaluated, including 117 benign tumors and 72 borderline tumors. The mean maximum diameter of borderline tumors was higher than that of benign tumors (14.32 ± 9.93 vs. 8.62 ± 6.69, p < 0.05). Borderline tumors with solid components accounted for more than benign tumors (41.67% vs. 8.55%). The proportion of solid component volume/tumor volume > 15% in both benign and borderline tumors was very small (1.71%, 4.71%). In unilocular cysts and multilocular cysts, borderline tumors with diameters > 10 cm accounted for more than benign tumors. The sensitivity and specificity in distinguishing benign and borderline tumors of ultrasonography O-RADS are slightly lower than those of SR of IOTA (86.1% vs. 91.7%, 81.2% vs. 82.1%).

Conclusions: In conclusion, the borderline tumors are larger and have more solid components than the benign tumors. The sensitivity and specificity in distinguishing benign and borderline tumors of ultrasonography O-RADS are slightly lower than those of SR of IOTA.

Objectives: The preoperative identification of cervical lymph node metastasis in papillary thyroid carcinoma is essential in tailoring surgical treatment. We aim to develop an ultrasound-based handcrafted radiomics model, a deep learning radiomics model, and a combined model for better predicting cervical lymph node metastasis in papillary thyroid carcinoma patients.

Methods: A retrospective cohort of 441 patients was included (308 in the training set, 133 in the testing set). Handcrafted radiomics features, manually selected by physicians, were extracted using Pyradiomics software, whereas deep learning radiomics features were extracted from a pretrained DenseNet121 network, a fully automatic process that eliminates the need for manual selection. A combined model integrating radiomics signatures from the above models was developed. ROC analysis was used to evaluate the performance of three models. DeLong's tests were conducted to compare the AUC values of the different models in the training and testing sets.

Results: In the training set, the AUC value of the combined model (0.790) was significantly higher than that of the handcrafted radiomics (0.743, p = 0.021) and deep learning radiomics (0.730, p = 0.003) models. In the testing set, although the AUC value of the combined model (0.761) was higher than that of the handcrafted radiomics model (0.734, p = 0.368) and deep learning radiomics model (0.719, p = 0.228), statistical significance was not reached. The handcrafted radiomics model exhibited high accuracy in both the training and testing sets (0.714 and 0.707), while the deep learning radiomics model showed accuracy below 0.7 in both the training and testing sets (0.698 and 0.662).

Conclusions: The combined model based on conventional ultrasound images enhances the predictive performance compared to different radiomics models alone.

Herein, we present the case of a 56-year-old female with mechanical-type right knee pain and extension difficulty, ultimately diagnosed with mucoid degeneration (MD) of both the anterior and posterior cruciate ligaments-a rare coexistence. Ultrasound (US) revealed hypoechoic thickening of the cruciate ligaments and medial meniscal extrusion, prompting further evaluation. Magnetic resonance imaging (MRI) confirmed MD of both cruciate ligaments and a grade III posterior root tear of the medial meniscus. While MRI remains the gold standard for diagnosing MD, this case highlights the valuable role of US in early suspicion, dynamic assessment, and comparative evaluation of cruciate ligament pathology, even in deep-seated structures. A conservative treatment plan was initiated, and the patient remains under uneventful follow-up.

Objective: This study aimed to quantify the O-RADS classification using the ultrasound scoring method (USM) and explore its clinical application value.

Methods: A retrospective analysis was conducted on 205 patients with adnexal tumors (unilateral or bilateral), corresponding to 244 tumor cases, admitted to our hospital from 2018 to 2023. This cohort included 100 patients with malignant tumors (122 malignant lesions, comprising 34 borderline tumors, and 6 malignant tumors of the fallopian tubes) and 105 patients with benign tumors (122 benign lesions). All cases were confirmed by preoperative ultrasound examination and postoperative pathology. A senior ultrasound physician performed the O-RADS classification, while another ultrasound physician applied the USM. The scores were manually assigned, and the sensitivity, specificity, and area under the curve (AUC) of the USM and O-RADS classification in the differential diagnosis of adnexal tumors were determined through ROC curve analysis. The Delong test was used in R to compare the diagnostic performance of the two diagnostic methods. The optimal range of scores between different categories of O-RADS was calculated using by ROC curve.

Results: The sensitivity, specificity, and AUC of the USM (when the optimal cut-off value was ≥ 14 points) in the differential diagnosis of adnexal tumors were 0.951, 0.877, and 0.975 (95% CI: 0.960-0.990). The sensitivity, specificity, and AUC of O-RADS classification (when the optimal cut-off value was ≥ 4 categories) in the differential diagnosis of adnexal tumors were 0.984, 0.887, and 0.973 (95% CI: 0.955-0.992). The AUC comparison between O-RADS classification and USM revealed no statistically significant difference (p = 0.87, p > 0.05).

Conclusions: Both the USM and the O-RADS classification exhibit high diagnostic efficacy in the differential diagnosis of adnexal tumors. The quantification of O-RADS categories using the USM provides a more intuitive and convenient approach, suitable for ultrasound physicians at all levels. This method demonstrates strong generalizability and can effectively guide clinical diagnosis and treatment.

Background: Pachydermodactyly (PDD) is a rare benign fibromatosis that mimics inflammatory arthritis, posing diagnostic challenges in pediatric populations.

Case presentation: We report an 11-year-old female with unilateral proximal interphalangeal (PIP) joint swelling.

Imaging findings: Gray-scale ultrasound revealed symmetric dermal thickening (2.02 mm) with hypoechoic texture, while Doppler confirmed absent vascularity. Shear wave elastography demonstrated elevated tissue stiffness (shear wave velocity: 4.8 m/s).

Conclusion: This case underscores the utility of non-invasive multimodal ultrasonography in differentiating PDD from inflammatory arthropathies, avoiding unnecessary biopsies and therapies.

Objectives: This meta-analysis evaluated the diagnostic value of carotid contrast ultrasonography (CEUS) for disease activity in Takayasu arteritis (TAK).

Methods: Systematic reviews were conducted in PubMed, Embase, Cochrane Library, and Web of Science using the following search terms: Takayasu Arteritis, aortic arch syndrome, pulseless disease, contrast-enhanced ultrasound, contrast-enhanced ultrasonography, and CEUS. Studies published from the beginning up until October 2024 were collected. Two researchers performed screening, full-text review, and data extraction. The QUADAS-2 tool was used to assess the risk of bias. A random-effects model was used for the meta-analysis.

Results: Nine articles involving 498 patients and 704 carotid artery examinations were included in the study. The combined sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve of CEUS for detecting TAK disease activity were 0.80 (0.76-0.83), 0.71 (0.67-0.74), 3.87 (2.41-6.21), 0.31 (0.22-0.42), 21.87 (11.32-42.23), and 0.8941, respectively.

Conclusion: The assessment of TAK activity using CEUS has certain sensitivity and specificity; as a result, it can be used to judge the condition of patients with TAK and the treatment effect to provide a more comprehensive and reliable objective basis for clinical treatment.