Journal of Ultrasound in Medicine最新文献_第7页

Reference Ranges and Z-Score Equations for 19 Fetal Cardiac Biometry Structures From 18 to 34 Weeks' Gestation 妊娠 18 至 34 周 19 种胎儿心脏生物测量结构的参考范围和 Z 值公式。

IF 2.1 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine

Pub Date : 2024-10-22 DOI: 10.1002/jum.16609

Márcio Fragoso Vieira MD, Nathalie Jeanne Bravo-Valenzuela PhD, Francisco Herlânio Costa Carvalho PhD, Luciane Alves da Rocha Amorim PhD, Edward Araujo Júnior PhD

Objective

To determine equations for calculating the Z-scores of fetal cardiac structures between 18⁺⁰ and 34⁺⁶ weeks of gestation, create percentile reference tables and curves for the structures, and assess the intra- and inter-observer reproducibility of the measurements.

Methods

A cross-sectional study was conducted involving 340 normal fetuses from singleton pregnancies between 18 and 34 weeks of gestational age (GA). Nineteen cardiac structures were evaluated: diameters of the mitral, tricuspid, aortic, and pulmonary valve annuli; length, diameter, and area of the left and right ventricles; cardiac area and circumference; and diameters of the ascending aorta, aortic isthmus, main pulmonary artery, right pulmonary artery, left pulmonary artery, and ductus arteriosus. Regression analysis was performed to determine the equations for the mean and standard deviation of all structures using GA, biparietal diameter (BPD), and femur length (FL) as independent variables.

Results

All equations had high coefficients of determination (R²). The best performance was achieved using the GA (R² .819–.944), followed by FL (R² .813–.937) and BPD (R² .792–.934). The structure that demonstrated the highest R² was the cardiac circumference and the smallest was the ductus arteriosus. Reference tables of percentiles 1, 5, 10, 50, 90, 95, and 99, and reference curves of Z-scores were created for all 19 cardiac structures, depending on the GA. All measurements demonstrated good and excellent reproducibility with an inter-observer intraclass correlation coefficient (ICC) of 0.774–0.972 and intra-observer ICC of 0.938–0.993.

Conclusions

Equations were produced to calculate Z-scores as well as percentile tables and curves for 19 fetal heart structures. All the measurements demonstrated good reproducibility.

目的确定妊娠 18+0 周至 34+6 周胎儿心脏结构 Z 评分的计算公式，创建结构百分位参考表和曲线，并评估测量结果在观察者内部和观察者之间的重现性：这项横断面研究涉及 340 名胎龄在 18 至 34 周之间的单胎正常胎儿。评估了 19 个心脏结构：二尖瓣、三尖瓣、主动脉瓣和肺动脉瓣环的直径；左心室和右心室的长度、直径和面积；心脏面积和周径；升主动脉、主动脉峡部、主肺动脉、右肺动脉、左肺动脉和动脉导管的直径。以GA、双顶径（BPD）和股骨长度（FL）为自变量进行回归分析，以确定所有结构的平均值和标准偏差的方程：所有方程的判定系数（R2）都很高。GA（R2.819-.944）的性能最佳，其次是 FL（R2.813-.937）和 BPD（R2.792-.934）。R2最高的结构是心脏周径，最小的是动脉导管。根据 GA，为所有 19 个心脏结构创建了百分位数 1、5、10、50、90、95 和 99 的参考表和 Z 值参考曲线。所有测量结果均显示出良好和极佳的重现性，观察者之间的类内相关系数（ICC）为 0.774-0.972，观察者内部的 ICC 为 0.938-0.993：通过公式计算出了19种胎儿心脏结构的Z分数、百分位表和曲线。所有测量结果均具有良好的重现性。

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引用次数: 0

Embryonic and Fetal Heart Development Before 12 Weeks of Gestation 妊娠 12 周前的胚胎和胎儿心脏发育。

IF 2.1 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine

Pub Date : 2024-10-21 DOI: 10.1002/jum.16605

Toshiyuki Hata MD, PhD, Miyu Konishi RMS, Aya Koyanagi RMS, Yasunari Miyagi MD, PhD, Takahito Miyake MD, PhD

Objective

To assess embryonic and fetal cardiac growth and development using transvaginal 2-dimensional sonography before 12 weeks of gestation.

Methods

Transvaginal scans for first-trimester dating were performed for 131 normal fetuses at 8–11 + 6 weeks of gestation. The basal-apical length (BAL), transverse length (TL), cardiac circumference (ECC), embryonic cardiac area (ECA), global sphericity index (GSI), and cardio-thoracic area ratio (CTAR) were able to be obtained in 105 normal embryos and fetuses.

Results

Nomograms for several cardiac parameters including BAL, TL, ECC, ECA, GSI, and CTAR were constructed. BAL, TL, ECC, and ECA increased curvilinearly with advancing gestation (R² = 0.97406, 0.980396, 0.978359, and 0.920705, respectively, P < .001). GSI (mean, 1.14; SD, 0.10) and CTAR (mean, 15.7%; SD, 3.3%) values were constant at 8–11 + 6 weeks of gestation. There were significant curvilinear correlations between BAL, TL, ECC, and ECA, and crown-rump length (CRL) (R² = 0.975976, 0.983482, 0.980673, and 0.929936, respectively, P < .001). GSI and CTAR values were not changed with the increase of CRL during this period.

Conclusion

Our results provide nomograms for several cardiac parameters which may improve the understanding of embryonic and fetal cardiac growth and development prior to 12 weeks of gestation.

目的方法：对 131 个孕 8-11+6 周的正常胎儿进行经阴道扫描，以确定其妊娠期第一胎的时间：方法：对妊娠 8-11+6 周的 131 个正常胎儿进行了经阴道扫描，以确定第一胎的胎儿性别。方法：对妊娠 8-11+6 周的 131 个正常胎儿进行了经阴道扫描，以确定第一胎的时间，并获得了 105 个正常胚胎和胎儿的心尖基底长度（BAL）、横向长度（TL）、心脏周长（ECC）、胚胎心脏面积（ECA）、球形指数（GSI）和心胸面积比（CTAR）：结果：构建了多个心脏参数的提名图，包括 BAL、TL、ECC、ECA、GSI 和 CTAR。BAL、TL、ECC 和 ECA 随着妊娠期的延长呈曲线上升（R2 分别为 0.97406、0.980396、0.978359 和 0.920705，P 2 分别为 0.975976、0.983482、0.980673 和 0.929936，P 结论：我们的研究结果提供了多个心脏参数的提名图：我们的研究结果提供了几个心脏参数的提名图，可提高对妊娠 12 周前胚胎和胎儿心脏生长发育的认识。

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引用次数: 0

The Role of Collaboration in Prenatal Congenital Heart Disease Diagnosis 合作在产前先天性心脏病诊断中的作用：母胎医学专家与儿科心脏病专家的工作表现比较。

IF 2.1 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine

Pub Date : 2024-10-19 DOI: 10.1002/jum.16606

Sanitra Anuwutnavin MD, Matinuch Kuichanuan MD, Nalat Sompagdee MD, Supaluck Kanjanauthai MD, Jarupim Soongswang MD

Objective

This study compared the accuracy of prenatal congenital heart disease (CHD) diagnosed by maternal-fetal medicine specialists (MFMs) and pediatric cardiologists (PCs), using postnatal cardiac findings as the reference standard.

Methods

This retrospective analysis at Siriraj Hospital, Bangkok, Thailand, involved 125 pregnancies with fetal CHD diagnosed by MFMs and evaluated by PCs later. Prenatal CHD diagnoses by either MFM or PC were compared with postnatal diagnoses obtained through echocardiography, cardiac surgery/catheterization, or autopsy. Diagnostic accuracy was classified as (A) correct diagnosis, (B) minor differences not impacting clinical management or outcomes, or (C) major differences affecting prognosis or treatment.

Results

Cardiac sonography by MFM achieved diagnostic accuracies of 73.6% (A), 16% (B), and 10.4% (C), while fetal echocardiography by PC resulted in accuracies of 72% (A), 20% (B), and 8% (C). No statistically significant differences were found between MFM and PC in each category (P = .375–.832). The MFMs' accuracy was highest for tetralogy of Fallot (94.4%; 95% CI, 72.7–99.9%) and lowest for right atrial isomerism (71.4%; 95% CI, 29–96.3%) and pulmonary atresia with ventricular septal defect (57.1%; 95% CI, 18.4–90.1%).

Conclusions

MFMs and PCs demonstrated high and comparable accuracy in prenatal CHD diagnosis. Although PCs tended to outperform MFMs in cases where misdiagnosis could significantly impact neonatal care and outcomes, MFMs can effectively perform primary screening for fetal CHD in all pregnancies. Collaboration with PCs remains essential when fetal CHD is suspected, particularly in complex cases.

目的：本研究比较了母胎医学专家（MFMs）和儿科心脏病专家（PCs）诊断产前先天性心脏病（CHD）的准确性，并以产后心脏检查结果作为参考标准：这项回顾性分析在泰国曼谷西里拉吉医院（Siriraj Hospital）进行，共涉及 125 例由母胎医学专家诊断为胎儿先天性心脏病的孕妇，随后由儿科心脏病专家对其进行评估。通过超声心动图、心脏手术/导管插入术或尸检获得的产前超声心动图或PC诊断结果与产后诊断结果进行了比较。诊断准确性分为：(A)诊断正确；(B)差异较小，不影响临床管理或结果；或(C)差异较大，影响预后或治疗：超声心动图的诊断准确率分别为 73.6%（A）、16%（B）和 10.4%（C），而 PC 胎儿超声心动图的诊断准确率分别为 72%（A）、20%（B）和 8%（C）。在每个类别中，超声心动图和 PC 超声心动图的差异均无统计学意义（P = .375-.832）。MFMs对法洛氏四联症的准确率最高（94.4%；95% CI，72.7-99.9%），对右心房异位症（71.4%；95% CI，29-96.3%）和肺动脉闭锁伴室间隔缺损（57.1%；95% CI，18.4-90.1%）的准确率最低：结论：MFMs 和 PCs 在产前诊断先天性心脏病方面表现出很高的准确性，而且两者的准确性不相上下。尽管在误诊可能严重影响新生儿护理和预后的病例中，PC 的表现往往优于 MFM，但 MFM 可以有效地对所有孕妇进行胎儿 CHD 初筛。在怀疑胎儿先天性心脏病时，尤其是在复杂病例中，与PC的合作仍然至关重要。

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引用次数: 0

The Prenatal Ultrasound Diagnosis and Perinatal Outcome of Polydactyly 多指畸形的产前超声诊断和围产期结局：2016-2023年回顾性队列研究》。

IF 2.1 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine

Pub Date : 2024-10-18 DOI: 10.1002/jum.16602

Xiaowei Xiong MD, Chenxiao Hou PhD, Shijing Song PhD, Wenjia Lei MD, Jingjing Wang MD, Qingqing Wu PhD

Objective

To determine the significance of polydactyly identified on prenatal ultrasonography and provide a detailed analysis of characteristics and perinatal outcomes of fetal polydactyly.

Methods

This is a retrospective cohort study of pregnancies with a postnatal diagnosis of fetal polydactyly between January 2016 and December 2023. The population was divided into 2 groups at postnatal diagnosis: the isolated polydactyly group and the nonisolated polydactyly group. Clinical data, prenatal ultrasonography, related genetic results, and postnatal outcomes were obtained.

Results

Our study cohort comprised 328 fetuses with polydactyly. The overall detection rate of polydactyly by prenatal ultrasound was 19.2%, and the first detection rate in the first-, second-, and third-trimester were 0.9%, 14.6%, and 3.7%, respectively. Preaxial polydactyly (PPD) of hand was the most common type and the most common type of foot polydactyly was postaxial polydactyly (PAP) both in the isolated group and in the nonisolated group; the central polydactyly is rare. Syndactyly was the most common abnormality complicated with polydactyly. Between the nonpolydactyly group, the isolatedpolydactyly group and the nonisolated polydactyly group, there was a significant difference in perinatal outcome (P < .001).

Conclusion

The second trimester is the best gestational age for prenatal ultrasound detection of polydactyly. Polydactyly of hand was more likely PPD, while polydactyly of foot was more likely PAP. When polydactyly is detected by routine prenatal ultrasound, detailed ultrasound examination and prenatal counseling should be performed to determine the possibility of an underlying genetic syndrome.

摘要确定产前超声波检查发现的多趾畸形的重要性，并详细分析胎儿多趾畸形的特征和围产期结局：这是一项回顾性队列研究，研究对象为2016年1月至2023年12月期间产后诊断为胎儿多指畸形的孕妇。人群在产后确诊时被分为两组：孤立性多指畸形组和非孤立性多指畸形组。我们获得了临床数据、产前超声波检查、相关遗传学结果和产后结局：我们的研究队列包括 328 个多趾畸形胎儿。产前超声检查的多趾畸形总检出率为 19.2%，第一、第二和第三孕期的首次检出率分别为 0.9%、14.6% 和 3.7%。在隔离组和非隔离组中，最常见的多指畸形类型是手的轴前多指畸形（PPD），最常见的多指畸形类型是足的轴后多指畸形（PAP），而中央多指畸形则很少见。合并多指畸形的畸形中最常见的是并指畸形。在非多指畸形组、孤立多指畸形组和非孤立多指畸形组之间，围产期结局有显著差异（P 结论：多指畸形的围产期结局与孤立多指畸形的围产期结局有显著差异：第二个孕期是产前超声检测多指畸形的最佳孕龄。手型多指畸形更可能是 PPD，而足型多指畸形更可能是 PAP。当常规产前超声检查发现多指畸形时，应进行详细的超声检查和产前咨询，以确定是否存在潜在的遗传综合征。

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引用次数: 0

Reliability and Availability of the 2017 EULAR-OMERACT Scoring System for Ultrasound Synovitis Assessment 2017年EULAR-OMERACT超声滑膜炎评估评分系统的可靠性和可用性：培训和阅读练习的结果。

IF 2.1 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine

Pub Date : 2024-10-18 DOI: 10.1002/jum.16607

Chenyang Zhao MD, Nan Zhuang MSc, Yusen Zhang MSc, Heng Lv MSc, Weiwei Zhang MSc, Yuzhou Shen MSc, Wangjie Wu MSc, Yun Tian MSc, Lu Xie MSc, Gengmin Zhou MSc, Haiyu Luo MSc, Li Qiu MSc, Desheng Sun MD, Haiqin Xie MD

Objective

To evaluate the availability and reliability of the European League Against Rheumatisms Outcome Measures in Rheumatology Synovitis (EULAR-OMERACT) scoring system among radiologists with different levels of musculoskeletal ultrasound (US) experience in assessing synovitis in patients with rheumatoid arthritis (RA).

Method

The patients with RA were retrospectively recruited from January 2020 to March 2022. Five radiologists with different levels of US experience were recruited for the reader study (R1–5), which included two parts. The participating radiologists first read 120 gray-scale (GS) and 120 Doppler US images twice, before and after a standard training program. In the first part, they semi-quantitatively scored the images from 0 to 3 based on the EULAR-OMERACT scoring system. In the second part, they read and scored 165 paired GS and Doppler images two times in 1 month using the EULAR-OMERACT scoring system. The correlation between the sum of the GSUS and power Doppler US (PDUS) image scores and the clinical scores was assessed.

Result

The intra-rater agreement of the five radiologists was good for the EULAR-OMERACT scoring system, with κ ranging from 0.72 to 0.94 for GSUS and from 0.81 to 0.97 for PDUS. The inter-rater agreement among the experts was good to very good in the EULAR-OMERACT scoring system (κ: 0.76–0.94 for GSUS and 0.80–0.96 for PDUS). The sum of the GSUS and PDUS scores in the EULAR-OMERACT scoring system was moderate to highly positively correlated with the clinical scores (ρ of GSUS: 0.58–0.79, ρ of PDUS: 0.57–0.70 for disease activity score in 28 joints C-reactive protein) after training.

Conclusion

The EULAR-OMERACT scoring system is a reliable method for evaluating synovitis in RA and shows potential for disease assessment and follow-up in patients with RA.

目的评估欧洲抗风湿病联盟风湿滑膜炎结果测量（EULAR-OMERACT）评分系统在具有不同水平肌肉骨骼超声（US）经验的放射科医生评估类风湿性关节炎（RA）患者滑膜炎时的可用性和可靠性：回顾性招募2020年1月至2022年3月的RA患者。招募了五名具有不同水平超声经验的放射科医生进行读者研究（R1-5），研究包括两部分。参与研究的放射科医生首先在标准培训计划前后两次阅读 120 张灰度（GS）和 120 张多普勒 US 图像。在第一部分中，他们根据 EULAR-OMERACT 评分系统对图像进行 0 至 3 分的半定量评分。在第二部分中，他们在一个月内两次使用EULAR-OMERACT评分系统对165张成对的GS和多普勒图像进行阅读和评分。评估了GSUS和动力多普勒超声（PDUS）图像评分总和与临床评分之间的相关性：结果：五位放射科专家对EULAR-OMERACT评分系统的评分内一致性良好，GSUS的κ值在0.72至0.94之间，PDUS的κ值在0.81至0.97之间。在EULAR-OMERACT评分系统中，专家之间的评分一致性良好至非常好（κ：GSUS为0.76-0.94，PDUS为0.80-0.96）。训练后，EULAR-OMERACT评分系统中GSUS和PDUS评分之和与临床评分呈中度至高度正相关（GSUS的ρ：0.58-0.79，PDUS的ρ：0.57-0.70，28个关节C反应蛋白的疾病活动度评分）：结论：EULAR-OMERACT评分系统是评估RA滑膜炎的可靠方法，在RA患者的疾病评估和随访方面具有潜力。

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引用次数: 0

Ultrasound Microvessel Imaging of the Human Placenta Demonstrates Altered Vessel Densities in Fetal Growth Restriction With Vascular and Immune Pathologies 人类胎盘超声微血管成像显示胎儿生长受限伴血管和免疫病变时的血管密度改变：一项试点病例对照研究。

IF 2.1 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine

Pub Date : 2024-10-18 DOI: 10.1002/jum.16604

U-Wai Lok PhD, Hannah M. Scott MBBS, Shanshan Tang PhD, Janelle Santos MD, Ping Gong PhD, Chengwu Huang PhD, Karina A. Pone DO, Michael K. Nienow RDMS, RVT, Krystal L. Ruka RDMS, Emily N. Breutzman RN, E. Heidi Cheek-Norgan MHS, PA(ASCP), Megan E. Branda MS, Rodrigo Ruano MD, PhD, Reade A. Quintin MD, Mauro H. Schenone MD, Shigao Chen PhD, Elizabeth Ann L. Enninga PhD

Objectives

Fetal growth restriction (FGR) is commonly associated with placental dysfunction, increasing perinatal morbidity and mortality. Visualizing placental vessels in utero would be advantageous for identifying functional FGR cause and determining proper management strategies. We aimed to utilize high-sensitivity ultrasound microvessel imaging (HUMI) for quantifying placental vessel density (VD) in pregnancies diagnosed with FGR.

Methods

This pilot case–control study enrolled subjects in the third trimester with a diagnosis of FGR (n = 40) and gestational age-matched controls with normal fetal growth (n = 20) at a 2:1 ratio, respectively. The Verasonics Vantage ultrasound system was used to perform HUMI on each participant at one timepoint. Scanning involved randomized singular value decomposition-based clutter filtering to identify the villous tree, followed by step-by-step scanning to acquire 3-dimensional-like data. Mean VD was calculated from three ultrasound measurements per subject. Additional clinical and pathology data were also collected and compared.

Results

Sixteen participants were utilized to establish the scanning protocol and 2 met exclusion criteria at delivery. Thus, VD was successfully measured on 42 pregnancies scanned at 35 weeks 5 days on average. In FGR (n = 24), placental VD was significantly reduced compared to controls (P < .01). VD measures were as good at predicting FGR as systolic/diastolic (S/D) ratios (area under the curve 0.86 versus 0.80). In a smaller cohort, VD in placentas with a diagnosis of inflammatory villitis (n = 10) by histology showed an increase in VD compared to those without inflammation (P = .01). Low VD was correlated with increased S/D ratios (P = .03).

Conclusions

HUMI is useful for identifying altered placental vascularization in utero for FGR. VD may be a valuable indicator for placental health and could lead to improved risk stratification methods considering underlying biology.

目的：胎儿生长受限（FGR）通常与胎盘功能障碍有关，会增加围产期的发病率和死亡率。对子宫内胎盘血管的可视化将有利于识别功能性 FGR 的病因并确定适当的管理策略。我们的目的是利用高灵敏度超声微血管成像（HUMI）来量化确诊为FGR孕妇的胎盘血管密度（VD）：这项病例对照试验研究以 2:1 的比例分别纳入了诊断为 FGR 的第三孕期受试者（n = 40）和胎儿发育正常的孕龄匹配对照组（n = 20）。Verasonics Vantage 超声系统用于在一个时间点对每位受试者进行 HUMI 扫描。扫描包括基于随机奇异值分解的杂波过滤，以识别绒毛树，然后逐步扫描以获取三维数据。每个受试者的平均 VD 值由三次超声测量结果计算得出。此外，还收集并比较了其他临床和病理数据：结果：16 名受试者参与了扫描方案的制定，2 名受试者在分娩时符合排除标准。因此，在平均 35 周 5 天扫描的 42 名孕妇中，成功测量了 VD。与对照组相比，FGR 胎儿（n = 24）的胎盘 VD 明显降低（P 结论：HUMI 可用于识别胎盘 VD：HUMI 可用于鉴别子宫内胎盘血管化改变是否与 FGR 有关。VD 可能是胎盘健康的一个有价值的指标，可改进考虑潜在生物学因素的风险分层方法。

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引用次数: 0

Comparison Between Ultrasonography and Radiography in the Detection of Epiphyseal Ossification Centers of the Knee in Infants With Permanent Congenital Hypothyroidism 在检测先天性永久性甲状腺功能减退症婴儿膝关节骺骨化中心方面，超声波成像与射线成像的比较

IF 2.1 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine

Pub Date : 2024-10-15 DOI: 10.1002/jum.16603

Charlotte Chiri MD, Daniela Rapilat MD, Freddy Avni MD, PhD, Christine Lefèvre MD, Julien Labreuche, Héloïse Lerisson MD, Céline Tillaux MD, Mohamed El Fayoumi MD, Nathalie Boutry MD, PhD

Objective

To demonstrate the usefulness of ultrasonography in detecting knee ossification centers in infants with permanent congenital hypothyroidism (PCH).

Methods

From 2011 to 2021, all infants with PCH referred for thyroid ultrasound also underwent left knee ultrasound and radiography on the same day. Knee radiographs were compared with knee sonograms. Two pediatric radiologists reviewed the consensus knee radiographs and sonograms to identify femoral and tibial epiphyseal ossification centers (presence/absence). The concordance between ultrasonography and radiography was assessed. Another radiologist conducted a second late review to evaluate interobserver agreement.

Results

We identified 125 patients (65 girls, 60 boys) with a mean age of 24 days (5 days–5 months). On scintigraphy, the thyroid was in place in 66.4%, ectopic in 24%, and absent in 9.6% of patients. The femoral center was observed in 108 patients (86.4%) via sonography and 106 patients (84.8%) via radiography. The tibial center was observed in 84 patients (67.2%) via sonography and radiography. Both femoral and tibial centers were present on sonography and radiography in 84 patients (67.2%). A single nucleus was present in 24 patients (19.2%) on sonography and 22 patients (17.6%) on radiography; it corresponded to the femoral center in all patients. The concordance between ultrasonography and radiography was 99% and 100%, respectively, for the detection of the femoral and tibial centers. Interobserver agreement was substantial to almost perfect for both ultrasonography and radiography.

Conclusion

Ultrasonography is as effective as radiography in detecting knee ossification centers in PCH. It can be performed at the same time as thyroid examination, in place of radiography.

目的证明超声波检查在检测永久性先天性甲状腺功能减退症（PCH）婴儿膝关节骨化中心方面的作用：方法：2011 年至 2021 年期间，所有转诊接受甲状腺超声检查的先天性甲状腺功能减退症患儿均在同一天接受了左膝超声检查和放射线检查。膝关节X光片与膝关节声像图进行比较。两名儿科放射科专家对一致同意的膝关节X光片和声像图进行审查，以确定股骨和胫骨骺骨化中心（存在/不存在）。评估了超声造影与射线造影之间的一致性。另一名放射科医生进行了第二次后期复查，以评估观察者之间的一致性：我们共发现了 125 名患者（65 名女孩，60 名男孩），平均年龄为 24 天（5 天-5 个月）。在闪烁扫描中，66.4%的患者甲状腺在位，24%异位，9.6%缺失。108名患者（86.4%）通过超声波检查观察到股骨中心，106名患者（84.8%）通过放射线检查观察到股骨中心。84名患者（67.2%）通过超声波检查和放射线检查观察到胫骨中心。有 84 名患者（67.2%）通过声波和射线检查同时发现股骨中心和胫骨中心。有 24 名患者（19.2%）通过超声波检查和 22 名患者（17.6%）通过放射线检查发现了单个髓核；所有患者的髓核都与股骨中心相对应。在股骨中心和胫骨中心的检测中，超声波和X光造影的一致性分别为99%和100%。结论：超声波检查和X光造影检查的观察者之间的一致性非常高，几乎达到完美：结论：在检测 PCH 患者膝关节骨化中心方面，超声造影与放射造影一样有效。结论：在检测 PCH 患者膝关节骨化中心方面，超声造影与射线造影一样有效，可在甲状腺检查时同时进行，以取代射线造影。

{"title":"Comparison Between Ultrasonography and Radiography in the Detection of Epiphyseal Ossification Centers of the Knee in Infants With Permanent Congenital Hypothyroidism","authors":"Charlotte Chiri MD, Daniela Rapilat MD, Freddy Avni MD, PhD, Christine Lefèvre MD, Julien Labreuche, Héloïse Lerisson MD, Céline Tillaux MD, Mohamed El Fayoumi MD, Nathalie Boutry MD, PhD","doi":"10.1002/jum.16603","DOIUrl":"10.1002/jum.16603","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To demonstrate the usefulness of ultrasonography in detecting knee ossification centers in infants with permanent congenital hypothyroidism (PCH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From 2011 to 2021, all infants with PCH referred for thyroid ultrasound also underwent left knee ultrasound and radiography on the same day. Knee radiographs were compared with knee sonograms. Two pediatric radiologists reviewed the consensus knee radiographs and sonograms to identify femoral and tibial epiphyseal ossification centers (presence/absence). The concordance between ultrasonography and radiography was assessed. Another radiologist conducted a second late review to evaluate interobserver agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 125 patients (65 girls, 60 boys) with a mean age of 24 days (5 days–5 months). On scintigraphy, the thyroid was in place in 66.4%, ectopic in 24%, and absent in 9.6% of patients. The femoral center was observed in 108 patients (86.4%) via sonography and 106 patients (84.8%) via radiography. The tibial center was observed in 84 patients (67.2%) via sonography and radiography. Both femoral and tibial centers were present on sonography and radiography in 84 patients (67.2%). A single nucleus was present in 24 patients (19.2%) on sonography and 22 patients (17.6%) on radiography; it corresponded to the femoral center in all patients. The concordance between ultrasonography and radiography was 99% and 100%, respectively, for the detection of the femoral and tibial centers. Interobserver agreement was substantial to almost perfect for both ultrasonography and radiography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Ultrasonography is as effective as radiography in detecting knee ossification centers in PCH. It can be performed at the same time as thyroid examination, in place of radiography.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 2","pages":"277-284"},"PeriodicalIF":2.1,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessment of Respiratory Muscles, Lung Parenchyma, and Cardiac Function by Ultrasound for Predicting Weaning Failure in Critically Ill Adults 通过超声波评估呼吸肌、肺实质和心脏功能以预测重症成人断奶失败：一项前瞻性观察研究

IF 2.1 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine

Pub Date : 2024-10-15 DOI: 10.1002/jum.16596

Sundara Kannan MD, DM, Puneet Khanna MD, FAGE, Bhavana Kayarat MD, Bikash Ranjan Ray MD, MNAMS, Rahul Anand MD, DNB, EDIC, Souvik Maitra MD, DNB, EDIC, Dalim Kumar Baidya MD, EDIC, Lokesh Kashyap MD

Objectives

The parasternal intercostal muscle activity, a marker of accessory muscle usage, is found to correlate inversely with the pressure-generating capacity of the diaphragm and level of support of mechanical ventilation. The primary objective of our study was to determine whether the parasternal intercostal muscle thickening fraction (PMTF) measured by ultrasonography can predict weaning. We also evaluated whether addition of lung ultrasound score and echocardiographic assessment can add on to predicting weaning failure.

Methods

This prospective observational study conducted in a mixed medical-surgical intensive care unit, included 60 adult patients who were eligible for a spontaneous breathing trial (SBT) after being invasively mechanically ventilated for more than 48 hours. Ultrasound of respiratory muscles, lung parenchyma, and echocardiographic assessment were performed before and after 120 minutes of SBT. Parasternal intercostal muscles were imaged with a high frequency linear probe on the right second intercostal space 5 cm lateral to the sternal margin. PMTF was calculated as (maximum-minimum thickness)/minimum thickness.

Results

Among 60 patients, SBT failure was seen in 11 patients and extubation failed in 8 patients. PMTF (%) was significantly higher in the weaning failure group (13.33 [8.33–19.05]) as compared to patients with successful weaning (6.67 [6.06–11.54]). Diaphragmatic thickening fraction (DTF) correlated inversely to PMTF in patients with weaning failure. A pre-SBT PMTF cut-off of ≥7.7% and post-SBT cut-off of ≥15.38% were good predictors of weaning failure and extubation failure, respectively.

Conclusions

PMTF has good discriminatory power to predict weaning outcomes (area under the receiver operating characteristic curve: 0.74 [0.59–0.88]). Pre-SBT PMTF had similar power as DTF to predict weaning failure.

目的：胸骨旁肋间肌活动是辅助肌使用的标志，它与膈肌的压力产生能力和机械通气的支持水平成反比。我们研究的主要目的是确定通过超声波测量的胸骨旁肋间肌增厚分数（PMTF）是否能预测断奶。我们还评估了肺部超声评分和超声心动图评估是否能增加预测断奶失败的能力：这项前瞻性观察研究在内外科混合重症监护病房进行，共纳入了 60 名接受有创机械通气超过 48 小时后符合自主呼吸试验（SBT）条件的成年患者。在 SBT 120 分钟前后对呼吸肌、肺实质进行了超声检查和超声心动图评估。使用高频线性探头对胸骨边缘外侧 5 厘米处的右侧第二肋间进行胸骨旁肋间肌成像。PMTF 的计算公式为（最大-最小厚度）/最小厚度：在 60 名患者中，11 名患者 SBT 失败，8 名患者拔管失败。与成功断奶的患者（6.67 [6.06-11.54]）相比，断奶失败组的 PMTF（%）明显更高（13.33 [8.33-19.05]）。断奶失败患者的膈肌增厚分数（DTF）与 PMTF 成反比。SBT前PMTF临界值≥7.7%和SBT后临界值≥15.38%分别是断奶失败和拔管失败的良好预测指标：PMTF 在预测断奶结果方面具有良好的鉴别力（接收者操作特征曲线下面积：0.74 [0.59-0.88]）。SBT前PMTF与DTF预测断奶失败的能力相似。

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引用次数: 0

Comparison of Two-Dimensional Shear Wave Elastography Between Two Different Instruments for Hepatocellular Carcinoma Patients 比较两种不同仪器对肝细胞癌患者进行二维剪切波弹性成像的效果

IF 2.1 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine

Pub Date : 2024-10-14 DOI: 10.1002/jum.16597

Jiayao Huang MD, Xiaoer Zhang MD, PhD, Liya Su MD, PhD, Ming Liu MD, PhD, Ming Xu MD, PhD, Bowen Zhuang MD, PhD, Baoxian Liu MD, PhD, Tongyi Huang MD, PhD, Hangtong Hu MD, PhD, Xiaohua Xie MD, PhD, Xiaoyan Xie MD, PhD, Manxia Lin MD, PhD

Objectives

This study aimed to investigate and compare 2-dimensional shear wave elastography (2D-SWE) measurements and influencing factors among 2 different devices and to evaluate the ability and influencing factors of these measurements to assess liver fibrosis.

Methods

From October 2022 to September 2023, 290 hepatocellular carcinoma (HCC) patients and 30 healthy volunteers were prospectively included. The 2D-SWE measurements were performed using AixPlorer V (SEmean) and APLIO i900 (CEmean). This study compared 2D-SWE measurements between instruments for evaluating the liver fibrosis stage and analyzed the potential influencing factors.

Results

The 2D-SWE measurements obtained by the 2 instruments were significantly different (P < .001), but the differences were significant only for patients with stage F4 liver fibrosis (P < .001) and not for volunteers or patients with stage F0–F3 liver fibrosis (all P > .050). Multivariate linear regression analysis revealed that the factors independently influencing the SEmean were alanine aminotransferase (ALT) (P = .034) and liver fibrosis stage (P < .001), while fibrosis stage (P = .028) was the only factor influencing the CEmean.

Conclusions

Although 2D-SWE from the 2 different instruments was capable of detecting liver fibrosis, it yielded varying results in HCC patients. These discrepancies were predominantly observed in patients with F4 liver fibrosis but not in healthy adults or patients with F0–F3 liver fibrosis. One potential contributing factor to the differences between instruments could be ALT levels.

研究目的本研究旨在调查和比较两种不同设备的二维剪切波弹性成像（2D-SWE）测量结果和影响因素，并评估这些测量结果评估肝纤维化的能力和影响因素：方法：自2022年10月至2023年9月，前瞻性地纳入了290名肝细胞癌（HCC）患者和30名健康志愿者。二维-SWE测量使用AixPlorer V（SEmean）和APLIO i900（CEmean）进行。本研究比较了不同仪器的二维-SWE测量结果，以评估肝纤维化分期，并分析了潜在的影响因素：结果：两种仪器获得的 2D-SWE 测量值差异显著（P .050）。多变量线性回归分析显示，独立影响 SEmean 的因素是丙氨酸氨基转移酶（ALT）（P = .034）和肝纤维化分期（P 结论：虽然两种仪器的 2D-SWE 测量值有显著差异（P.050），但它们对肝纤维化分期的影响是不同的：虽然两种不同仪器的 2D-SWE 能够检测肝纤维化，但在 HCC 患者中却产生了不同的结果。这些差异主要出现在F4肝纤维化患者身上，而在健康成人或F0-F3肝纤维化患者身上则没有观察到。造成仪器之间差异的一个潜在因素可能是 ALT 水平。

{"title":"Comparison of Two-Dimensional Shear Wave Elastography Between Two Different Instruments for Hepatocellular Carcinoma Patients","authors":"Jiayao Huang MD, Xiaoer Zhang MD, PhD, Liya Su MD, PhD, Ming Liu MD, PhD, Ming Xu MD, PhD, Bowen Zhuang MD, PhD, Baoxian Liu MD, PhD, Tongyi Huang MD, PhD, Hangtong Hu MD, PhD, Xiaohua Xie MD, PhD, Xiaoyan Xie MD, PhD, Manxia Lin MD, PhD","doi":"10.1002/jum.16597","DOIUrl":"10.1002/jum.16597","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to investigate and compare 2-dimensional shear wave elastography (2D-SWE) measurements and influencing factors among 2 different devices and to evaluate the ability and influencing factors of these measurements to assess liver fibrosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From October 2022 to September 2023, 290 hepatocellular carcinoma (HCC) patients and 30 healthy volunteers were prospectively included. The 2D-SWE measurements were performed using AixPlorer V (SEmean) and APLIO i900 (CEmean). This study compared 2D-SWE measurements between instruments for evaluating the liver fibrosis stage and analyzed the potential influencing factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 2D-SWE measurements obtained by the 2 instruments were significantly different (<i>P</i> < .001), but the differences were significant only for patients with stage F4 liver fibrosis (<i>P</i> < .001) and not for volunteers or patients with stage F0–F3 liver fibrosis (all <i>P</i> > .050). Multivariate linear regression analysis revealed that the factors independently influencing the SEmean were alanine aminotransferase (ALT) (<i>P</i> = .034) and liver fibrosis stage (<i>P</i> < .001), while fibrosis stage (<i>P</i> = .028) was the only factor influencing the CEmean.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although 2D-SWE from the 2 different instruments was capable of detecting liver fibrosis, it yielded varying results in HCC patients. These discrepancies were predominantly observed in patients with F4 liver fibrosis but not in healthy adults or patients with F0–F3 liver fibrosis. One potential contributing factor to the differences between instruments could be ALT levels.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 2","pages":"209-219"},"PeriodicalIF":2.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endoscopic Rectal Ultrasound-Based Radiomics Analysis for the Prediction of Synchronous Liver Metastasis in Patients With Primary Rectal Cancer 基于内镜直肠超声的放射组学分析预测原发性直肠癌患者的同步肝转移

IF 2.1 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine

Pub Date : 2024-10-11 DOI: 10.1002/jum.16601

Ying Zhou BM, Peifeng Li BM, Shanzhangyan Yao BM, Weina Kong BM

引用次数: 0