Journal of Ultrasound in Medicine最新文献

Objectives: To assess the diagnostic performance of ultrasound attenuation analysis (USAT) in evaluating hepatic steatosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), with magnetic resonance imaging proton density fat fraction (MRI-PDFF) as the reference.

Methods: Participants were recruited. Each participant underwent both USAT and MRI-PDFF examinations on the same day. We employed MRI-PDFF thresholds to classify the stages of hepatic steatosis. Univariable and multivariable linear regression analyses were conducted to identify significant factors influencing USAT. Receiver operating characteristic (ROC) curve analysis was utilized to evaluate the diagnostic performance of USAT in predicting the grade of liver steatosis and compared with visual hepatic steatosis grade (VHSG) and clinical prediction models.

Results: A total of 145 patients took part in this study. The correlation coefficient between USAT and MRI-PDFF was 0.805 (p < .050). USAT varied significantly across different hepatic steatosis grade. Triglyceride (TG) and steatosis grade were significant determinant factors for USAT. The areas under the ROC curve of USAT for predicting steatosis ≥ S1, ≥ S2, and =S3 were 0.90 (cut-off value of 0.61 dB/cm/MHz), 0.92 (cut-off value of 0.71 dB/cm/MHz), and 0.92 (cut-off value of 0.82 dB/cm/MHz), respectively. The diagnostic performance of USAT was statistically better than that of VHSG, Hepatic steatosis index (HSI), and Framingham steatosis index (FSI).

Conclusion: USAT is a promising quantitative tool for the quantitative assessment of hepatic steatosis in patients with MASLD, demonstrating a stronger correlation with MRI-PDFF.

Objectives: This study aimed to develop and validate a multimodal nomogram that integrates ultrasound features, clinical risk factors, and systemic inflammatory markers to predict carotid vulnerable plaques (VPs), assess its precision in recognizing high-risk plaques associated with stroke, and offer personalized clinical interventions.

Methods: A total of 146 patients who underwent carotid endarterectomy (CEA) between April 2024 and May 2025 were enrolled in this prospective study and subsequently divided into a training cohort (n = 100) and a validation cohort (n = 46). The candidate variables comprised clinical characteristics, laboratory parameters, and multimodal ultrasound plaque features. The least absolute shrinkage and selection operator (LASSO) regression was utilized for robust variable selection to mitigate overfitting. A nomogram was developed based on the selected features, and its performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration curves, decision curve analysis (DCA), and clinical impact curve (CIC).

Results: The LASSO regression analysis identified 8 independent predictors for the nomogram: neutrophil-to-lymphocyte ratio (NLR), intraplaque neovascularization (IPN) grade, smoking history, neutrophil count, body mass index (BMI), plaque echogenicity, C-reactive protein (CRP), and plaque morphology. The nomogram exhibited excellent discriminative capacity, with an AUC of 0.911 (95% CI: 0.851-0.972) in the training cohort and 0.889 (95% CI: 0.786-0.992) in the validation cohort. Calibration curves demonstrated good concordance between predictions and observations, whereas DCA and CIC confirmed the model's favorable clinical utility.

Conclusions: The developed multimodal nomogram accurately predicts carotid VPs, facilitates patient risk stratification, and supports the initiation of targeted preventive therapies for those at the highest risk.

Objective: To report our experience in the state of Nevada with embedding fetal cardiologists in maternal-fetal-medicine (MFM) clinics and with the current prenatal detection of critical cardiovascular malformations (CCVMs).

Methods: We queried our databases for CCVMs, diagnosed pre- or postnatally, and undergoing fetal demise, elective termination, or born between August 2024 and August 2025. We defined CCVMs as those that required or would have required a therapeutic procedure in the first 60 days.

Results: We identified 70 cases. Of the 70, 66 (94%) had prenatal care. Of the 66 with prenatal care, 62 (94%) were diagnosed prenatally by embedded fetal cardiologists at MFM clinics. For the 62 pregnant women, the reasons for obstetric referrals to MFM care were: 34 (55%) with maternal comorbidities alone, 16 (25%) with maternal comorbidities and suspected fetal anomalies, 9 (15%) with suspected fetal anomalies alone, and 3 (5%) for initial fetal anatomical surveys without maternal comorbidities. For the 62 pregnant women, the indications for fetal cardiologist-attended fetal echocardiograms were: 53 (86%) with a suspected fetal cardiovascular malformation noted on a previous MFM perinatal sonographer's ultrasound, 4 (6%) with a suspected extracardiac fetal anomaly, 4 (6%) with previous poor visualization, and 1 (2%) with a family history of congenital heart disease.

Conclusions: In Nevada, the most recent prenatal detection of CCVMs was 94% statewide. Additionally, 95% of those prenatally diagnosed were products of high-risk pregnancies. Further, embedding fetal cardiologists in all MFM clinics has enhanced the skills of perinatal sonographers and maximized prenatal detection rates statewide.

The post-traumatic formation of myotendinous heterotopic ossification or myositis ossificans traumatica has been an unforeseen complication of muscle contusion-related hematoma in people with hemophilia and von Willebrand's disease. While ultrasound imaging has revolutionized the detection of hemarthrosis and hemarthropathy in bleeding disorders, its clinical use has expanded to the detection of inter- and intramuscular hematomas, as well as the formation of traumatically induced heterotopic ossification. This retrospective multi-center case series includes 29 cases of post-traumatic heterotopic ossification from 9 hemophilia treatment centers, highlighting the effectiveness of high-definition point-of-care ultrasonography for its early detection in people with bleeding disorders.

Objectives: Intra-amniotic sludge is an independent risk factor for preterm birth. It consists of a biophysical sonographic finding in the amniotic fluid, formed by dense echogenic particles near the cervical internal orifice, due to sterile or infectious inflammatory processes. High-risk pregnancies are usually marked by oxidative stress, which is one of the main triggers for 70 kDa-heat shock proteins (HSP70) expression and release. In the blood, eHSP70 marks cellular stress or damage and plays roles in immune-inflammatory responses. However, the association between sludge, oxidative stress and eHSP70 remained unclear until now. The objective of this study is to evaluate if plasma eHSP70 and redox parameters could distinguish subpopulations with sludge or not.

Methods: We recruited women seeking routine ultrasonography in the second trimester of gestation that met the inclusion criteria. They underwent transvaginal ultrasonography, completed the clinical survey, and provided blood samples for analysis.

Results: Women with sludge exhibited lower antioxidant defense, and eHSP70 levels. They also presented significant changes in the hemogram, suggesting an increase in immune tolerance. In this population, lower HSP70 is associated with a better immunological scenario and proper cervical length to the gestational age.

Conclusion: Blood parameters, oxidative parameters and eHSP70 can indicate intra-amniotic inflammation.

Abscesses are a common esthetic procedure complication that can lead to disfigurement and systemic complications. Accurately identifying the type of abscess is essential for early and appropriate treatment. In this context, the ultrasound (US) has become a pivotal tool for diagnosing and managing abscesses when combined with clinical and laboratory assessment. However, many professionals in the field still have limited knowledge of the subject, especially regarding abscess differentiation. Given this scenario, this article aims to address the US-standard to distinguish between common bacterial, nontuberculous mycobacterial, and sterile abscesses, highlighting the importance of integrating clinical presentation and laboratory findings for accurate differentiation.

Objectives: O-GlcNAcylation plays a key regulatory role in hepatic physiology, and its disruption leads to fibrosis in liver-specific OGT knockout mice (OGT^LKO), making this model valuable for studying advanced metabolic dysfunction-associated steatohepatitis (MASH). Our objective is to demonstrate that shear wave elastography (SWE) is a suitable non-invasive tool to characterize and follow this mouse model of liver injury.

Methods: We weekly monitored non-invasively liver fibrosis progression in OGT^LKO mice from 5 to 8 weeks of age, using SWE on both a high-frequency preclinical ultrasound system (VevoF2), and a clinical reference system (Aixplorer) and assuming the liver as homogeneous, isotropic and purely elastic. Stiffness measurements were then confronted with ex vivo liver histological scoring and major gene transcripts associated with the development of the pathology.

Results: Weekly liver stiffness measurements demonstrated a progressive increase, correlating strongly with histological fibrosis scores (R² > 0.78) and fibrosis-related gene expression (Col3a1, Col6a1). The high-resolution imaging capability of the VevoF2 allowed precise anatomical exploration while delivering SWE measurements consistent with the clinical device (Pearson r = 0.92).

Conclusion: Our study confirms that following liver stiffness fibrosis by SWE in a mouse model of liver injury is a valuable tool that correlates with ex vivo findings. This approach facilitates a better understanding of disease progression and therapeutic evaluation in preclinical models of MASH.