Journal of Ultrasound in Medicine最新文献

Objectives: Delivering bad or unexpected news is a challenging and potentially distressing task for radiologists. In developing nations, growing health literacy will likely drive more patients to be more interested in learning the details of their diagnosis. This study aimed to provide foundational insight into Ethiopian radiologists' and radiology residents' preferences and associated factors for breaking bad news during ultrasound examinations.

Methods: We conducted a nationwide online survey study among practicing radiologists and clinical radiology residents across 6 residency programs, with a target study population of approximately 500. We used a pretested, standardized, self-administered questionnaire. Descriptive analysis was performed using SPSS 26.

Results: The study achieved a response rate of 36.2% (181 respondents). 92 (50.8%) were radiologists and 89 (49.2%) were clinical radiology residents. Preference for breaking bad news was dependent on the severity of ultrasound findings; 105 respondents (58%) disagreed or strongly disagreed with communicating severe ultrasound findings, while only 18 (9.9%) and 23 (12.7%) would not communicate bad news if the ultrasound showed no or mild abnormalities, respectively.

Conclusion: The tendency to communicate bad news during ultrasound examination decreases as the severity of the diagnosis worsens. This points to a gap in handling difficult news in imaging practice. Agreement on communication roles, informed by research with patients and doctors, is needed. Structured training can strengthen trust, visibility, and patient-centered care.

Objective: To correlate the sonographic severity of adenomyosis, assessed with real-time ultrasound and a novel semi-quantified method (XI-VOCAL counting and categories) with adenomyosis-associated symptoms.

Methods: This observational study was conducted in a tertiary referral outpatient clinic. We consecutively included 115 participants with ≥1 direct ultrasonographic adenomyosis feature; those with dominant myoma, malignancy, pelvic infection, pregnancy, breastfeeding, inadequate imaging, postmenopause, or hormonal medication use were excluded. A routine clinical protocol was followed for anamnestic and ultrasound data. Menstrual bleeding was assessed subjectively (three-point scale) and with a pictorial blood loss analysis chart (PBAC). Dysmenorrhea, dyspareunia, and chronic pelvic pain were evaluated using a numeric rating scale (NRS). A retrospective questionnaire was sent for missing items. Real-time severity was scored by experienced gynecologists. XI-VOCAL-based severity was assessed independently and blinded to clinical data, providing two severity scores: XI-VOCAL counting and XI-VOCAL categories. Correlations with symptoms were analyzed using Jonckheere-Terpstra, linear and logistic regression.

Results: The real-time severity (severe vs mild) showed a strong correlation with adjusted PBAC (β 590.01, 95% CI 207.16-972.86, P < .01) and subjective blood loss assessment (OR 5.48, 95% CI 1.14-26.28, P < .05). Additionally, a strong correlation was found between XI-VOCAL counting and XI-VOCAL categories with adjusted PBAC score (XI-VOCAL counting: β 53.15, 95% CI 12.06-94.24, P < .05; XI-VOCAL categories (severe vs mild): β 627.36, 95% CI 165.92-1088.81, P < .05). No correlations were found with adjusted dysmenorrhea, chronic abdominal/pelvic pain, or dyspareunia.

Conclusion: Both real-time severity and XI-VOCAL-assessed severity correlate with adjusted PBAC scores and subjective blood assessment. XI-VOCAL appears more standardized, while real-time assessment may be influenced by symptom severity. Larger studies correcting for pain-related confounders are needed.

Objective: To evaluate the clinical application value of ultra micro angiography (UMA) in noninvasively differential diagnosis between benign and malignant renal tumors.

Methods: In this retrospective study, 65 patients diagnosed with solid renal tumors and intended for surgical resection in our hospital between December 2023 and March 2025 were enrolled. All patients underwent B mode ultrasound, color Doppler flow imaging (CDFI) and UMA 1 week before surgery resections. Adler semiquantitative analysis (Grades 0-3) and vascular morphology (patterns A-F) were used to assess the blood flow within the renal tumors. Based on histopathological results after surgery, patients were divided into benign and malignant groups. Using high-level blood flow signals (Grades 2 and 3) and hypervascular supply (patterns E and F) as diagnostic criteria for malignant renal tumors, the diagnostic efficiency of CDFI and UMA were analyzed and compared.

Results: According to surgical resection and histopathological results, patients were divided into benign group (n = 10) and malignant group (n = 55). On UMA, vascular morphology patterns and Adler grades in malignant group were significantly higher than those in benign group (P < .05). More high-level blood flow signals and more complex vascular morphology patterns were detected by UMA than CDFI for malignant renal tumors (91.3% vs. 54.4%, 64.9% vs. 19.3%), with the area under curve of characteristics of 0.71 vs. 0.59, and 0.73 vs. 0.50, respectively.

Conclusions: By sensitively displaying tiny and low-velocity blood flow signals, UMA has potential value in preoperative noninvasively differential diagnosis between benign and malignant renal tumors.

Objective: To investigate the value of transitional phase characteristics on Sonazoid contrast-enhanced ultrasound (S-CEUS) in the differential diagnosis of common focal liver lesions (FLLs).

Materials and methods: This prospective multicenter study enrolled 122 participants with FLLs from 8 medical centers between December 2023 and March 2025. The study comprised 43 cases of hepatic hemangioma (HH), 35 cases of hepatocellular carcinoma (HCC), and 44 cases of liver metastases (LM). All participants underwent standardized S-CEUS examinations. The enhancement characteristics and washout patterns during the transitional phase were analyzed for all participants.

Results: Significant differences were observed among the three types of lesions in terms of early arterial enhancement patterns, time to start of washout, and the degree of enhancement during the transitional phase (P < .01). The optimal diagnostic efficacy was achieved with the following criteria: washout start at 3.5 min for diagnosing HH (AUC = 0.974); mild hypoenhancement observed in 3 and 4 min for diagnosing HCC (AUC = 0.880 and 0.879); and marked hypoenhancement observed between 4 and 6 min for diagnosing LM (AUC = 0.911-0.916).

Conclusion: The dynamic characteristics of the transitional phase in S-CEUS can effectively differentiate common FLLs, providing a valuable basis for precise clinical diagnosis.

Chorionic villus sampling (CVS) is a crucial prenatal diagnostic tool, but a declining number of procedures makes training a challenge. Here we describe a transcervical CVS simulator made from ballistic gelatin. Ninety-three Maternal-Fetal Medicine providers used the simulators during hands-on workshops and completed surveys regarding their fidelity and usefulness in training. Surveys showed median scores of 5 (interquartile range: 4-5) for the fidelity of the ultrasound images, fidelity of the haptic feel, and its usefulness in training. This suggests the simulator will be an effective training tool and provide needed alternative training opportunities for MFM fellows.