Journal of Clinical Ultrasound最新文献

Background: The incidence of pancreatic lesions is increasing. However, there was limited study on the efficacy and safety of percutaneous ultrasound-guided core needle biopsy (US-CNB) for diagnosing pancreatic lesions.

Aims: This study aimed to evaluate the efficacy and safety of percutaneous US-CNB for diagnosing pancreatic lesions and to analyze the influencing factors.

Methods: Patients who underwent percutaneous US-CNB for pancreatic lesions from 2016 to 2025 were retrospectively analyzed, and their clinical, imaging, pancreatic biopsy-related data and pathological diagnosis were recorded; subsequently, 777 patients were included. The sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV) of percutaneous US-CNB for diagnosing pancreatic lesions were calculated using surgical pathological findings or clinical diagnoses as the gold standard. Factors affecting accuracy were screened using univariate and logistic regression analyses.

Results: In total, 796 ultrasound-guided biopsies were successfully performed in 777 patients. Biopsy results were consistent with the final diagnosis in 753 cases (consistent group) and inconsistent in 43 cases (inconsistent group). The sensitivity, specificity, accuracy, PPV, and NPV were 94.99% (644/678), 92.37% (109/118), 94.60% (753/796), 98.62% (644/653), and 76.22% (109/143), respectively. Mild complications occurred in eight cases (8/796, 1.00%), and severe complications, in seven cases (7/796, 0.88%), which resolved on their own or with treatment. The tumor markers, location of lesion for biopsy, and longest diameter of the lesion were significant factors between groups (p < 0.05). Multivariate regression analysis showed that lesion location (p = 0.018) was an independent factor affecting diagnostic efficacy.

Conclusion: Percutaneous US-CNB is safe and reliable for diagnosing pancreatic lesions, and its accuracy is better for diagnosing pancreatic body and tail lesions.

Purposes: To evaluate the diagnostic performance of ultrasonography in identifying the preduodenal portal vein and examine the factors influencing its diagnostic performance. Furthermore, we reviewed previously published case reports and series on this anomaly.

Methods: We included 17 patients diagnosed with a preduodenal portal vein, confirmed by contrast-enhanced computed tomography and/or surgical findings. Patients were categorized into the following two groups: those in whom the anomaly was detected and those in whom it was not detected via initial ultrasonography. The presence or absence of intestinal malrotation, polysplenia/asplenia, and symptoms were compared using Fisher's exact tests.

Results: Of the 17 pediatric patients with a preduodenal portal vein, 10 were correctly diagnosed on initial ultrasonography, yielding a sensitivity of 58.8%. A significant difference was observed only in the presence of symptoms (detection group vs. nondetection group: 7/3 vs. 1/6, p = 0.049). No significant difference was found in the presence or absence of intestinal malrotation (6/4 vs. 5/2, p > 0.999) or splenic anomalies (polysplenia/asplenia: 4/5 vs. 5/2, p = 0.358; one patient had no splenic anomaly).

Conclusion: The diagnostic performance of ultrasonography for the duodenal portal vein was more than 50%; however, this anomaly was more likely to be overlooked in asymptomatic patients than in symptomatic patients.

Artificial intelligence (AI) interpretation of ultrasound (US) images is promising, yet its accuracy in diagnosing pleural effusions remains unclear. We conducted a comprehensive database search which identified 84 studies, of which 6 met eligibility criteria. We included 2951 patients with 58 392 images and 12 069 ultrasound clips. Bivariate analysis revealed a pooled sensitivity of 0.92 (95% CI: 0.85-0.96, p < 0.05) and specificity of 0.96 (95% CI: 0.88-0.99, p < 0.05), with a high AUC of 0.98 under the sROC curve, although included studies had significant heterogeneity, I² > 99%. AI demonstrates high diagnostic accuracy in detecting pleural effusion on ultrasound.

Fine-needle aspiration biopsy (FNAB) is the preferred pathological examination to exclude thyroid cancer. We describe two case studies of acute thyroid lytic hemorrhage and swelling with pain during FNAB. We observed hemorrhages with a crack-like appearance and swelling during the first needle prick, accompanied by pain, in two patients with no coagulation dysfunction. Symptoms were relieved after the intervention. Thyroid hemorrhage with a crack-like pattern is a rare acute hemorrhagic complication of FNAB. The cause is unclear, and an allergic reaction of the glands could not be excluded. Emergency measures must be prepared in advance, as unpredictable complications may occur during FNAB.

This review was done to assess the diagnostic accuracy of transcranial Doppler (TCD) or electroencephalogram (EEG) accuracy for delayed cerebral ischemia (DCI) in adults with aneurysmal subarachnoid hemorrhage. MEDLINE, Embase, Cochrane CENTRAL, Scopus, and Web of Science were searched from inception to April 2025. Two reviewers independently screened studies, extracted 2 × 2 diagnostic data, and assessed the risk of bias using QUADAS-2. Pooled sensitivity, specificity, positive and negative likelihood ratios (LR⁺, LR^-), diagnostic odds ratios (DOR), and area under the hierarchical summary receiver-operating characteristic curve (AUROC) were estimated via bivariate random-effects models. Fifty-two studies (38 TCD; 14 EEG), encompassing 1278 DCI-positive and 3033 DCI-negative assessments, met inclusion. For TCD, pooled sensitivity was 0.79 (95% CI: 0.71-0.85) and specificity 0.82 (0.75-0.87), with LR⁺ 4.3 (3.1-6.1), LR^- 0.26 (0.19-0.36), DOR 17 (9-31), and AUROC 0.87 (0.84-0.90). EEG yielded sensitivity 0.92 (0.83-0.97) and specificity 0.70 (0.58-0.80), with LR⁺ 3.1 (2.1-4.6), LR^- 0.11 (0.05-0.27), DOR 27 (9-83), and AUROC 0.89 (0.86-0.91). Deek's tests showed no publication bias. TCD and EEG both demonstrate strong diagnostic accuracy for DCI after aneurysmal subarachnoid hemorrhage. EEG offers superior sensitivity and rule-out value, while TCD provides balanced rule-in and rule-out performance.

Purpose: To correlate the spleen's shear wave elastography (SWE) with the severity of acute pancreatitis (AP) and the outcome.

Methods: In this IRB-approved prospective study, 38 patients with a diagnosis of AP were enrolled. Patients were taken up for 2D-SWE of the spleen, which was measured in kPa. Mean SWE values of the spleen were compared with the severity of AP according to the Modified Marshall score and intervention using the Kruskal-Wallis test.

Results: Splenic stiffness increased progressively with the severity of acute pancreatitis. Among the three splenic regions, the lower pole showed the most consistent association with disease severity, demonstrating significantly higher stiffness in patients with severe forms of pancreatitis (p = 0.042). Higher overall splenic SWE values were also observed in patients who required more invasive management, such as necrosectomy or surgical drainage, compared with those managed conservatively or with percutaneous drainage. No significant relationship was noted between splenic SWE and demographic factors, etiology of pancreatitis, or splenic vascular changes.

Conclusion: A significant positive association was seen between SWE values of the lower pole of the spleen and the severity of the Modified Marshall severity score. There was a significant positive association between the overall SWE values of the spleen and the nature of the intervention, which was highest in patients who underwent necrosectomy or surgical drainage.

A 27-year-old primigravida with monochorionic diamniotic (MCDA) twin pregnancy underwent fetoscopic laser photocoagulation at 17 + 1 weeks' gestation for Quintero stage II twin-twin transfusion syndrome (TTTS). On postoperative day 20, transabdominal ultrasound identified a cystic anechoic structure adjacent to the anterior uterine wall. Subsequent magnetic resonance imaging (MRI) demonstrated a 2-mm fistulous tract extending from the recipient twin's amniotic sac to the extrauterine cavity, consistent with amniotic sac herniation. Parental concerns prompted induced labor at 23 weeks, with follow-up imaging showing restoration of normal uterine architecture and uterine integrity. Due to contraceptive failure, the patient experienced an unplanned pregnancy and delivered a live infant vaginally within 1 year. The case highlights the critical role of comprehensive imaging modalities for diagnosing subtle postoperative complications. Advanced sonographic techniques and MRI facilitate the accurate detection of rare complications such as uterine dehiscence and amniotic sac herniation to optimize perinatal outcomes.

Prenatal diagnosis of unicuspid aortic valve (UAV) is exceptionally rare. UAV diagnosis can be achieved prenatally via ultrasound; however, it becomes challenging when UAV coexists with a large cardiac rhabdomyoma (CR) occupying significant left ventricular cavity space. The diagnosis of UAV deformity proves particularly challenging due to two compounding pathophysiological factors: altered hemodynamics prevent detection of characteristic high-velocity antegrade flow across the stenotic valve and mechanical compression exerted by a sizable rhabdomyoma further obscures typical diagnostic features. We report a case of fetal UAV associated with CR.

Metanephric adenoma (MA) is a rare primary renal epithelial tumor classified as a metanephric neoplasm. Its clinical symptoms and imaging features are non-specific, making preoperative diagnosis challenging and often leading to misdiagnosis as renal cell carcinoma (RCC). This report details the contrast-enhanced ultrasound (CEUS) findings of a 54-year-old male patient with a MA: 15 s after contrast agent injection, the lesion showed heterogeneous hypoenhancement, exhibiting progressive enhancement. The contrast agent began to fade at 50s, resulting in lower enhancement. Combined with a literature review, it aims to provide more comprehensive information for the imaging diagnosis of MA.