{"title":"AIUM Practice Parameter for the Performance of Neurosonography in Neonates and Infants, 2024 Revision","authors":"","doi":"10.1002/jum.16551","DOIUrl":"10.1002/jum.16551","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"43 11","pages":"E50-E55"},"PeriodicalIF":2.1,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16551","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008986","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}
Rui Li MD, Wan Wang MS, Xia Qiu MS, Ting He MS, Xiaoqin Tang MS
Objective
To examine the effect of intrahepatic cholestasis of pregnancy (ICP) on fetal heart morphology.
Methods
This case–control study was conducted with 40 women with ICP and 54 pregnant controls. Fetal heart quantification based on speckle tracking technology was used to assess the morphology of the fetal right and left ventricles. Routine ventricular size parameters, global and 24-segment spherical indices (SIs) were measured and compared between groups.
Results
The routine fetal cardiac parameters, global and right-ventricular SIs did not differ between the ICP and control groups. The left-ventricular apical (segments 16-24) SIs were lower in the ICP group than in the control group (P < .05), with no significant difference in the other left-ventricular segments.
Conclusions
Subclinical morphological changes were observed in the left ventricular apical segments of the fetal hearts in women with ICP, which indicates an intrauterine environment with high bile acid concentrations. Twenty-four-segment SIs can be used to effectively evaluate these changes.
{"title":"Assessment of Fetal Ventricular Size and Shape in Women With Intrahepatic Cholestasis of Pregnancy Using Speckle Tracking","authors":"Rui Li MD, Wan Wang MS, Xia Qiu MS, Ting He MS, Xiaoqin Tang MS","doi":"10.1002/jum.16554","DOIUrl":"10.1002/jum.16554","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the effect of intrahepatic cholestasis of pregnancy (ICP) on fetal heart morphology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This case–control study was conducted with 40 women with ICP and 54 pregnant controls. Fetal heart quantification based on speckle tracking technology was used to assess the morphology of the fetal right and left ventricles. Routine ventricular size parameters, global and 24-segment spherical indices (SIs) were measured and compared between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The routine fetal cardiac parameters, global and right-ventricular SIs did not differ between the ICP and control groups. The left-ventricular apical (segments 16-24) SIs were lower in the ICP group than in the control group (<i>P</i> < .05), with no significant difference in the other left-ventricular segments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Subclinical morphological changes were observed in the left ventricular apical segments of the fetal hearts in women with ICP, which indicates an intrauterine environment with high bile acid concentrations. Twenty-four-segment SIs can be used to effectively evaluate these changes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"43 11","pages":"2187-2194"},"PeriodicalIF":2.1,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000296","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}
<p>The American Institute of Ultrasound in Medicine (AIUM) is a multidisciplinary association dedicated to advancing the safe and effective use of ultrasound in medicine through professional and public education, research, development of clinical practice parameters, and accreditation of practices performing ultrasound examinations.</p><p>The AIUM Practice Parameter for the Performance of Ultrasound of the Female Pelvis was developed and revised by the American Institute of Ultrasound in Medicine (AIUM) in collaboration with other organizations whose members use ultrasound for performing these examinations (see “Acknowledgments”). Recommendations for personnel requirements, the request for the examination, documentation, quality assurance, and safety may vary among the organizations and may be addressed by each separately.</p><p>This Practice Parameter is intended to provide the medical ultrasound community with recommendations for the performance and recording of high-quality ultrasound examinations. The parameter reflects what the AIUM considers the appropriate criteria for this type of ultrasound examination but is not intended to establish a legal standard of care. Examinations performed in this specialty area are expected to follow the Parameter with the recognition that deviations may occur depending on the clinical situation.</p><p>Physicians interpreting or performing this type of ultrasound examination should meet the specified AIUM Training Guidelines<span><sup>1</sup></span> in accordance with AIUM accreditation policies.<span><sup>2</sup></span></p><p>Sonographers performing the ultrasound examination should be appropriately credentialed<span><sup>3</sup></span> in the specialty area in accordance with AIUM accreditation policies.<span><sup>2</sup></span></p><p>Physicians not personally performing the examination must provide supervision, as defined by the Centers for Medicare and Medicaid Services Code of Federal Regulations 42 CFR §410.32,<span><sup>4</sup></span> which is available from the U.S. Government Publishing Office.</p><p>The written or electronic request for an ultrasound examination must originate from a physician or other appropriately licensed health care provider or under the provider's direction. The clinical information provided should allow for the performance and interpretation of the appropriate ultrasound examination and should be consistent with relevant legal and local health care facility requirements.</p><p>The following section details the examination to be performed for each organ and anatomic region in the female pelvis. All relevant structures should be identified by the transabdominal and/or transvaginal approach. A transrectal or transperineal approach may be useful in patients who are not candidates for introduction of a vaginal transducer and in assessing the patient with pelvic organ prolapse. More than one approach may be necessary.<span><sup>5, 6</sup></span></p><p>Accurate and complete documentat
{"title":"AIUM Practice Parameter for the Performance of Ultrasound of the Female Pelvis, 2024 Revision","authors":"","doi":"10.1002/jum.16556","DOIUrl":"10.1002/jum.16556","url":null,"abstract":"<p>The American Institute of Ultrasound in Medicine (AIUM) is a multidisciplinary association dedicated to advancing the safe and effective use of ultrasound in medicine through professional and public education, research, development of clinical practice parameters, and accreditation of practices performing ultrasound examinations.</p><p>The AIUM Practice Parameter for the Performance of Ultrasound of the Female Pelvis was developed and revised by the American Institute of Ultrasound in Medicine (AIUM) in collaboration with other organizations whose members use ultrasound for performing these examinations (see “Acknowledgments”). Recommendations for personnel requirements, the request for the examination, documentation, quality assurance, and safety may vary among the organizations and may be addressed by each separately.</p><p>This Practice Parameter is intended to provide the medical ultrasound community with recommendations for the performance and recording of high-quality ultrasound examinations. The parameter reflects what the AIUM considers the appropriate criteria for this type of ultrasound examination but is not intended to establish a legal standard of care. Examinations performed in this specialty area are expected to follow the Parameter with the recognition that deviations may occur depending on the clinical situation.</p><p>Physicians interpreting or performing this type of ultrasound examination should meet the specified AIUM Training Guidelines<span><sup>1</sup></span> in accordance with AIUM accreditation policies.<span><sup>2</sup></span></p><p>Sonographers performing the ultrasound examination should be appropriately credentialed<span><sup>3</sup></span> in the specialty area in accordance with AIUM accreditation policies.<span><sup>2</sup></span></p><p>Physicians not personally performing the examination must provide supervision, as defined by the Centers for Medicare and Medicaid Services Code of Federal Regulations 42 CFR §410.32,<span><sup>4</sup></span> which is available from the U.S. Government Publishing Office.</p><p>The written or electronic request for an ultrasound examination must originate from a physician or other appropriately licensed health care provider or under the provider's direction. The clinical information provided should allow for the performance and interpretation of the appropriate ultrasound examination and should be consistent with relevant legal and local health care facility requirements.</p><p>The following section details the examination to be performed for each organ and anatomic region in the female pelvis. All relevant structures should be identified by the transabdominal and/or transvaginal approach. A transrectal or transperineal approach may be useful in patients who are not candidates for introduction of a vaginal transducer and in assessing the patient with pelvic organ prolapse. More than one approach may be necessary.<span><sup>5, 6</sup></span></p><p>Accurate and complete documentat","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"43 11","pages":"E56-E64"},"PeriodicalIF":2.1,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16556","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000295","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}
Pancreatic steatosis (PS) and pancreatic fibrosis (PF) both show increased pancreatic echogenicity on conventional B-mode ultrasound. In this study, we assessed the applicability of two-dimensional shear-wave elastography (2D-SWE) for their discrimination.
Methods
We gathered data from 120 adults with valid 2D-SWE measurements, comprising 40 healthy individuals, 55 individuals diagnosed with PS via non-enhanced computed tomography (CT), and 25 patients clinically diagnosed with non-calcific chronic pancreatitis. The participants were divided into three groups: normal pancreas (NP), PS, and PF. pancreatic echogenicity, pancreatic stiffness, and CT values between groups were analyzed.
Results
The 2D-SWE and CT values among the NP, PS, and PF groups all showed significant differences (P < .001). For the diagnosis of PS and PF using 2D-SWE, the area under the curve (AUC) values were 0.9100 and 0.9940, respectively, with optimal cut-off values of 5.7 kPa for predicting PS and 8.2 kPa for predicting PF.
Conclusions
The 2D-SWE technique enabled rapid and quantitative assessment of the hardness of hyperechoic pancreas visualized on conventional B-mode ultrasound, which holds certain value in distinguishing PS from PF.
{"title":"Value of Two-Dimensional Shear-Wave Elastography in Differentiating Pancreatic Steatosis From Pancreatic Fibrosis","authors":"Zhenzhen Chen MS, Huiyang Wang MD, MS, Tian'an Jiang MD, PhD","doi":"10.1002/jum.16541","DOIUrl":"10.1002/jum.16541","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Pancreatic steatosis (PS) and pancreatic fibrosis (PF) both show increased pancreatic echogenicity on conventional B-mode ultrasound. In this study, we assessed the applicability of two-dimensional shear-wave elastography (2D-SWE) for their discrimination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We gathered data from 120 adults with valid 2D-SWE measurements, comprising 40 healthy individuals, 55 individuals diagnosed with PS via non-enhanced computed tomography (CT), and 25 patients clinically diagnosed with non-calcific chronic pancreatitis. The participants were divided into three groups: normal pancreas (NP), PS, and PF. pancreatic echogenicity, pancreatic stiffness, and CT values between groups were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 2D-SWE and CT values among the NP, PS, and PF groups all showed significant differences (<i>P</i> < .001). For the diagnosis of PS and PF using 2D-SWE, the area under the curve (AUC) values were 0.9100 and 0.9940, respectively, with optimal cut-off values of 5.7 kPa for predicting PS and 8.2 kPa for predicting PF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The 2D-SWE technique enabled rapid and quantitative assessment of the hardness of hyperechoic pancreas visualized on conventional B-mode ultrasound, which holds certain value in distinguishing PS from PF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"43 11","pages":"2119-2127"},"PeriodicalIF":2.1,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995981","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}
Mahsa Arab MSc, Ali Fallah PhD, Saeid Rashidi PhD, Maryam Mehdizadeh Dastjerdi PhD, Nasrin Ahmadinejad MD
Objectives
One of the most promising adjuncts for screening breast cancer is ultrasound (US) radio-frequency (RF) time series. It has the superiority of not requiring any supplementary equipment over other methods. This research aimed to propound a machine learning (ML) approach for automatically classifying benign, probably benign, suspicious, and malignant breast lesions based on the features extracted from the accumulated US RF time series.
Methods
In this article, 220 data of the aforementioned categories, recorded from 118 patients, were analyzed. The dataset, named RFTSBU, was registered by a SuperSonic Imagine Aixplorer medical/research system equipped with a linear transducer. The regions of interest (ROIs) of the B-mode images were manually selected by an expert radiologist before computing the suggested features. Regarding time, frequency, and time-frequency domains, 291 various features were extracted from each ROI. Finally, the features were classified by a pioneering technique named the reference classification method (RCM). Furthermore, the Lee filter was applied to evaluate the effectiveness of reducing speckle noise on the outcomes.
Results
The accuracy of two-class, three-class, and four-class classifications were respectively calculated 98.59 ± 0.71%, 98.13 ± 0.69%, and 96.10 ± 0.66% (considering 10 repetitions) while support vector machine (SVM) and K-nearest neighbor (KNN) classifiers with 5-fold cross-validation were utilized.
Conclusions
This article represented the proposed approach, named CCRFML, to distinguish between breast lesions based on registered in vivo RF time series employing an ML framework. The proposed method's impressive level of classification accuracy attests to its capability of effectively assisting medical professionals in the noninvasive differentiation of breast lesions.
目的：超声波（US）射频（RF）时间序列是筛查乳腺癌最有前途的辅助方法之一。与其他方法相比，它具有无需任何辅助设备的优越性。本研究旨在提出一种机器学习（ML）方法，根据从累积的 US 射频时间序列中提取的特征自动对良性、可能良性、可疑和恶性乳腺病变进行分类：本文分析了 118 名患者的 220 个上述类别的数据。数据集被命名为 RFTSBU，由配备线性传感器的 SuperSonic Imagine Aixplorer 医疗/研究系统登记。在计算所建议的特征之前，B 型图像的感兴趣区（ROI）由放射科专家手动选定。在时域、频域和时频域方面，从每个 ROI 提取了 291 个不同的特征。最后，采用一种名为 "参考分类法（RCM）"的开创性技术对这些特征进行分类。此外，还应用了李氏滤波器来评估减少斑点噪声对结果的影响：结果：利用支持向量机（SVM）和 K 近邻（KNN）分类器进行 5 倍交叉验证，计算出两类、三类和四类分类的准确率分别为 98.59 ± 0.71%、98.13 ± 0.69% 和 96.10 ± 0.66%（考虑到 10 次重复）：本文介绍了所提出的一种名为 CCRFML 的方法，该方法采用 ML 框架，根据登记的活体射频时间序列区分乳腺病变。该方法的分类准确率令人印象深刻，证明了它能有效地帮助医疗专业人员对乳腺病变进行无创区分。
{"title":"Computer-Aided Classification of Breast Lesions Based on US RF Time Series Using a Novel Machine Learning Approach","authors":"Mahsa Arab MSc, Ali Fallah PhD, Saeid Rashidi PhD, Maryam Mehdizadeh Dastjerdi PhD, Nasrin Ahmadinejad MD","doi":"10.1002/jum.16542","DOIUrl":"10.1002/jum.16542","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>One of the most promising adjuncts for screening breast cancer is ultrasound (US) radio-frequency (RF) time series. It has the superiority of not requiring any supplementary equipment over other methods. This research aimed to propound a machine learning (ML) approach for automatically classifying benign, probably benign, suspicious, and malignant breast lesions based on the features extracted from the accumulated US RF time series.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this article, 220 data of the aforementioned categories, recorded from 118 patients, were analyzed. The dataset, named RFTSBU, was registered by a SuperSonic Imagine Aixplorer medical/research system equipped with a linear transducer. The regions of interest (ROIs) of the B-mode images were manually selected by an expert radiologist before computing the suggested features. Regarding time, frequency, and time-frequency domains, 291 various features were extracted from each ROI. Finally, the features were classified by a pioneering technique named the reference classification method (RCM). Furthermore, the Lee filter was applied to evaluate the effectiveness of reducing speckle noise on the outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The accuracy of two-class, three-class, and four-class classifications were respectively calculated 98.59 ± 0.71%, 98.13 ± 0.69%, and 96.10 ± 0.66% (considering 10 repetitions) while support vector machine (SVM) and K-nearest neighbor (KNN) classifiers with 5-fold cross-validation were utilized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This article represented the proposed approach, named CCRFML, to distinguish between breast lesions based on registered in vivo RF time series employing an ML framework. The proposed method's impressive level of classification accuracy attests to its capability of effectively assisting medical professionals in the noninvasive differentiation of breast lesions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"43 11","pages":"2129-2145"},"PeriodicalIF":2.1,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976032","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}
Insertional Achilles tendinopathy is an umbrella medical term referring to pain and swelling on the posterior aspect of the calcaneus. High-resolution ultrasound imaging is commonly used in daily practice to assess the pathological changes of the Achilles tendon, cortical bone of the calcaneus, and soft tissues located inside the retrocalcaneal space to optimize the management of relevant patients. To the best of our knowledge, a standardized ultrasound protocol to evaluate the retrocalcaneal bursal complex is lacking in the pertinent literature. In this sense, our step-by-step sonographic approach is intended to be an easy and ready-to-use guide for sonographers/physicians in daily practice to assess this anatomical complex in patients with Achilles tendinopathy. Needless to say, the peculiar histological features of this V-shaped synovial/fibrocartilaginous bursa surrounding the posteroinferior wedge of the Kager's fat pad and the retrocalcaneal space make the examination challenging.
插入性跟腱病是一个总括性医学术语，指的是小腿后侧的疼痛和肿胀。高分辨率超声波成像通常用于评估跟腱、小腿皮质骨和跟骨后间隙内软组织的病理变化，以优化相关患者的治疗。据我们所知，相关文献中缺乏评估腓骨后滑囊复合体的标准化超声波方案。从这个意义上讲，我们的分步超声检查法旨在为超声技师/医生在日常工作中评估跟腱病患者的这一解剖复合物提供简便易行的指南。毋庸置疑，这个 V 形滑膜/纤维软骨囊的组织学特征非常特殊，围绕着卡格氏脂肪垫后内侧楔形区和跗骨后间隙，这使得检查具有挑战性。
{"title":"Histo-Anatomy and Sonographic Examination for the Retrocalcaneal Bursal Complex: EURO-MUSCULUS/USPRM Approach","authors":"Vincenzo Ricci MD, Giulio Cocco MD, PhD, Kamal Mezian MD, PhD, Ke-Vin Chang MD, PhD, Giorgio Tamborrini MD, Ondřej Naňka MD, PhD, Levent Özçakar MD","doi":"10.1002/jum.16544","DOIUrl":"10.1002/jum.16544","url":null,"abstract":"<p>Insertional Achilles tendinopathy is an umbrella medical term referring to pain and swelling on the posterior aspect of the calcaneus. High-resolution ultrasound imaging is commonly used in daily practice to assess the pathological changes of the Achilles tendon, cortical bone of the calcaneus, and soft tissues located inside the retrocalcaneal space to optimize the management of relevant patients. To the best of our knowledge, a standardized ultrasound protocol to evaluate the retrocalcaneal bursal complex is lacking in the pertinent literature. In this sense, our step-by-step sonographic approach is intended to be an easy and ready-to-use guide for sonographers/physicians in daily practice to assess this anatomical complex in patients with Achilles tendinopathy. Needless to say, the peculiar histological features of this V-shaped synovial/fibrocartilaginous bursa surrounding the posteroinferior wedge of the Kager's fat pad and the retrocalcaneal space make the examination challenging.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"43 11","pages":"2027-2038"},"PeriodicalIF":2.1,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16544","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971359","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}
Tian-gang Li MD, Wen-rui Wu MD, Bin Ma MD, Zhi-heng Yan MD, Ke-xiong Niu MD
Objective
This study aimed to assess the use of two-dimensional (2D) ultrasound combined with high-definition flow (HD-flow) render mode and spatiotemporal image correlation (STIC) in diagnosing and classifying fetal persistent left superior vena cava (PLSVC).
Methods
Overall, 114 cases of fetal PLSVC were diagnosed using 2D ultrasound combined with STIC, and 114 normal fetuses of the same gestational week were selected. These cases were retrospectively analyzed to evaluate the effectiveness of the diagnostic approach.
Results
All 114 PLSVC cases were diagnosed using 2D ultrasound combined with STIC. Although the diagnostic coincidence rate of PLSVC in the HD-flow combined with STIC was similar to that in the 2D ultrasound combined with HD-flow (96.8 vs 96.2%), 2D ultrasound with STIC enabled dynamic visualization of the PLSVC, furthering prenatal diagnosis. These cases were classified as type I PLSVC: 80 cases of type Ia, 29 cases of type Ib, and 5 cases of type Ic. Seventy isolated PLSVC cases (61.4%) were noted, whereas 44 cases (35.6%) were associated with concomitant structural abnormalities. Intracardiac structural malformations accounted for the highest proportion (n = 53, 58.89%), followed by single umbilical artery and facial/bodily abnormalities (n = 10, 11.11%).
Conclusion
Combining HD-flow and STIC complements 2D ultrasound in diagnosing and classifying fetal PLSVC, demonstrating significant clinical relevance.
研究目的该研究旨在评估二维（2D）超声结合高清血流（HD-flow）渲染模式和时空图像相关（STIC）在胎儿持续性左上腔静脉（PLSVC）诊断和分类中的应用：方法： 使用二维超声结合 STIC 诊断了 114 例胎儿持续性左上腔静脉（PLSVC），并选择了 114 例相同孕周的正常胎儿。对这些病例进行回顾性分析，以评估诊断方法的有效性：结果：所有114例PLSVC病例都是通过二维超声结合STIC诊断出来的。虽然高清血流联合 STIC 的 PLSVC 诊断吻合率与二维超声联合高清血流相似（96.8% vs 96.2%），但二维超声联合 STIC 可动态观察 PLSVC，从而进一步提高产前诊断的准确率。这些病例被分为 I 型 PLSVC：80 例 Ia 型、29 例 Ib 型和 5 例 Ic 型。其中 70 例（61.4%）为孤立的 PLSVC，44 例（35.6%）伴有结构异常。心内结构畸形所占比例最高（53 例，58.89%），其次是单脐动脉和面部/体型异常（10 例，11.11%）：结论：结合高清血流和 STIC 可补充二维超声诊断和分类胎儿 PLSVC，具有重要的临床意义。
{"title":"Prenatal Diagnosis of Persistent Left Superior Vena Cava Using High-Definition Flow Render Mode and Spatiotemporal Image Correlation","authors":"Tian-gang Li MD, Wen-rui Wu MD, Bin Ma MD, Zhi-heng Yan MD, Ke-xiong Niu MD","doi":"10.1002/jum.16550","DOIUrl":"10.1002/jum.16550","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to assess the use of two-dimensional (2D) ultrasound combined with high-definition flow (HD-flow) render mode and spatiotemporal image correlation (STIC) in diagnosing and classifying fetal persistent left superior vena cava (PLSVC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Overall, 114 cases of fetal PLSVC were diagnosed using 2D ultrasound combined with STIC, and 114 normal fetuses of the same gestational week were selected. These cases were retrospectively analyzed to evaluate the effectiveness of the diagnostic approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All 114 PLSVC cases were diagnosed using 2D ultrasound combined with STIC. Although the diagnostic coincidence rate of PLSVC in the HD-flow combined with STIC was similar to that in the 2D ultrasound combined with HD-flow (96.8 vs 96.2%), 2D ultrasound with STIC enabled dynamic visualization of the PLSVC, furthering prenatal diagnosis. These cases were classified as type I PLSVC: 80 cases of type Ia, 29 cases of type Ib, and 5 cases of type Ic. Seventy isolated PLSVC cases (61.4%) were noted, whereas 44 cases (35.6%) were associated with concomitant structural abnormalities. Intracardiac structural malformations accounted for the highest proportion (n = 53, 58.89%), followed by single umbilical artery and facial/bodily abnormalities (n = 10, 11.11%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Combining HD-flow and STIC complements 2D ultrasound in diagnosing and classifying fetal PLSVC, demonstrating significant clinical relevance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"43 11","pages":"2177-2185"},"PeriodicalIF":2.1,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971360","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}
Papri Sarkar MD, Adriana Vest MD, Marisa Baker MD, Lauri Silver Hochberg MD
Objective
To present a novel technique for office resection of pedunculated endometrial polyps under ultrasound guidance.
Methods
A prospective trial was conducted at an academic center where women with abnormal uterine bleeding (AUB) who were diagnosed an endometrial polyp following saline infusion sonogram (SIS), were offered polyp removal under ultrasound guidance using a universal grasping forceps (2.5 mm × 25 cm). The primary outcome was to evaluate the feasibility of this technique for complete removal of the polyp. The secondary outcomes were to evaluate the patients' pain score, satisfaction score using visual analogue score (VAS), and efficacy of the technique in alleviating symptoms in patients with AUB due to polyps.
Results
Thirty patients participated, with a mean age of 54.8 ± 11 years. Average polyp volume was 1.87 cm3 and mean duration for polypectomy was 11 minutes 31 seconds. The median pain score immediately post-procedure was 5 (0–9). We were unable to complete the procedure in two patients due to patient discomfort and poor visualization. Complete removal of polyp was ensured by checking for a thin endometrial echo at the end of the procedure and by performing SIS at 3-months post-procedure. Of the 22 patients who returned for follow-up, 19 (86.36%) showed no evidence of polyp on SIS and all reported resolution of AUB symptoms. The median satisfaction score at the follow-up was 10/10. Adequate pathology samples were obtained from all cases, diagnosing malignancy in one and endometrial hyperplasia in one patient.
Conclusion
This technique offers safe and effective removal of pedunculated endometrial polyps in an office setting, avoiding the need for general anesthesia. It can be offered as a therapeutic option at the initial point of contact, providing symptom relief and tissue diagnosis while reducing costs and patient visits.
{"title":"Ultrasound-Guided Polypectomy","authors":"Papri Sarkar MD, Adriana Vest MD, Marisa Baker MD, Lauri Silver Hochberg MD","doi":"10.1002/jum.16548","DOIUrl":"10.1002/jum.16548","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To present a novel technique for office resection of pedunculated endometrial polyps under ultrasound guidance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective trial was conducted at an academic center where women with abnormal uterine bleeding (AUB) who were diagnosed an endometrial polyp following saline infusion sonogram (SIS), were offered polyp removal under ultrasound guidance using a universal grasping forceps (2.5 mm × 25 cm). The primary outcome was to evaluate the feasibility of this technique for complete removal of the polyp. The secondary outcomes were to evaluate the patients' pain score, satisfaction score using visual analogue score (VAS), and efficacy of the technique in alleviating symptoms in patients with AUB due to polyps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty patients participated, with a mean age of 54.8 ± 11 years. Average polyp volume was 1.87 cm<sup>3</sup> and mean duration for polypectomy was 11 minutes 31 seconds. The median pain score immediately post-procedure was 5 (0–9). We were unable to complete the procedure in two patients due to patient discomfort and poor visualization. Complete removal of polyp was ensured by checking for a thin endometrial echo at the end of the procedure and by performing SIS at 3-months post-procedure. Of the 22 patients who returned for follow-up, 19 (86.36%) showed no evidence of polyp on SIS and all reported resolution of AUB symptoms. The median satisfaction score at the follow-up was 10/10. Adequate pathology samples were obtained from all cases, diagnosing malignancy in one and endometrial hyperplasia in one patient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This technique offers safe and effective removal of pedunculated endometrial polyps in an office setting, avoiding the need for general anesthesia. It can be offered as a therapeutic option at the initial point of contact, providing symptom relief and tissue diagnosis while reducing costs and patient visits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"43 11","pages":"2169-2175"},"PeriodicalIF":2.1,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971361","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}
<p>The American Institute of Ultrasound in Medicine (AIUM) is a multidisciplinary association dedicated to advancing the safe and effective use of ultrasound in medicine through professional and public education, research, development of clinical practice parameters, and accreditation of practices performing ultrasound examinations.</p><p>The AIUM Practice Parameter for the Performance of Vascular Ultrasound for Postoperative Assessment of Hemodialysis Access was revised by the American Institute of Ultrasound in Medicine (AIUM) in collaboration with other organizations whose members use ultrasound for performing this examination(s) (see “Acknowledgments”). Recommendations for personnel requirements, the request for the examination, documentation, quality assurance, and safety may vary among the organizations and may be addressed by each separately.</p><p>This Practice Parameter is intended to provide the medical ultrasound community with recommendations for the performance and recording of high-quality ultrasound examinations. The parameter reflects what the AIUM considers the appropriate criteria for this type of ultrasound examination but is not intended to establish a legal standard of care. Examinations performed in this specialty area are expected to follow the Parameter with the recognition that deviations may occur depending on the clinical situation.</p><p>As the number of patients with kidney failure requiring hemodialysis each year exceeds 660,000 patients, the initial creation and maintenance of functional hemodialysis access is an increasingly critical healthcare concern.<span><sup>1</sup></span> To improve the care of hemodialysis patients, the National Kidney Foundation established the Kidney Disease Outcomes Quality Initiative (KDOQI) in 2000 and updated it in 2006 and 2019.<span><sup>2-4</sup></span> The project set recommendations for placement and monitoring of hemodialysis access. Overall, there has been a movement toward earlier and more frequent hemodialysis in patients with chronic kidney disease, which in turn has resulted in more complications, requiring an estimated 68% increase in interventions to repair accesses.<span><sup>5</sup></span></p><p>The failure rate of hemodialysis access in the first year is high.<span><sup>6</sup></span> In 5.1% of patients, early thrombosis occurs within 18 days of arteriovenous fistula (AVF) creation and is associated with small arterial diameter, forearm location, small draining vein diameter, protamine use, female sex, surgeon frustration/concern during access creation procedure, and reduced or absent thrill at surgery.<span><sup>7</sup></span> After fistula maturation and use, subsequent failure is frequently associated with thrombosis secondary to underlying focal stenosis, most commonly at the anastomosis. Clinical monitoring of AVF function is recommended to detect deterioration in function before thrombosis occurs.<span><sup>8-10</sup></span> However, in arteriovenous grafts (AVGs
{"title":"AIUM Practice Parameter for the Performance of Vascular Ultrasound for Postoperative Assessment of Hemodialysis Access, 2024 Revision","authors":"","doi":"10.1002/jum.16549","DOIUrl":"10.1002/jum.16549","url":null,"abstract":"<p>The American Institute of Ultrasound in Medicine (AIUM) is a multidisciplinary association dedicated to advancing the safe and effective use of ultrasound in medicine through professional and public education, research, development of clinical practice parameters, and accreditation of practices performing ultrasound examinations.</p><p>The AIUM Practice Parameter for the Performance of Vascular Ultrasound for Postoperative Assessment of Hemodialysis Access was revised by the American Institute of Ultrasound in Medicine (AIUM) in collaboration with other organizations whose members use ultrasound for performing this examination(s) (see “Acknowledgments”). Recommendations for personnel requirements, the request for the examination, documentation, quality assurance, and safety may vary among the organizations and may be addressed by each separately.</p><p>This Practice Parameter is intended to provide the medical ultrasound community with recommendations for the performance and recording of high-quality ultrasound examinations. The parameter reflects what the AIUM considers the appropriate criteria for this type of ultrasound examination but is not intended to establish a legal standard of care. Examinations performed in this specialty area are expected to follow the Parameter with the recognition that deviations may occur depending on the clinical situation.</p><p>As the number of patients with kidney failure requiring hemodialysis each year exceeds 660,000 patients, the initial creation and maintenance of functional hemodialysis access is an increasingly critical healthcare concern.<span><sup>1</sup></span> To improve the care of hemodialysis patients, the National Kidney Foundation established the Kidney Disease Outcomes Quality Initiative (KDOQI) in 2000 and updated it in 2006 and 2019.<span><sup>2-4</sup></span> The project set recommendations for placement and monitoring of hemodialysis access. Overall, there has been a movement toward earlier and more frequent hemodialysis in patients with chronic kidney disease, which in turn has resulted in more complications, requiring an estimated 68% increase in interventions to repair accesses.<span><sup>5</sup></span></p><p>The failure rate of hemodialysis access in the first year is high.<span><sup>6</sup></span> In 5.1% of patients, early thrombosis occurs within 18 days of arteriovenous fistula (AVF) creation and is associated with small arterial diameter, forearm location, small draining vein diameter, protamine use, female sex, surgeon frustration/concern during access creation procedure, and reduced or absent thrill at surgery.<span><sup>7</sup></span> After fistula maturation and use, subsequent failure is frequently associated with thrombosis secondary to underlying focal stenosis, most commonly at the anastomosis. Clinical monitoring of AVF function is recommended to detect deterioration in function before thrombosis occurs.<span><sup>8-10</sup></span> However, in arteriovenous grafts (AVGs","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"43 11","pages":"E39-E49"},"PeriodicalIF":2.1,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16549","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971358","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}
Ladan Yazdani PhD, Sathiyamoorthy Selladurai PhD, Iman Rafati MSc, Manish Bhatt PhD, Emmanuel Montagnon PhD, Boris Chayer MSc, Damien Olivié MD, Jeanne-Marie Giard MD, MPH, Giada Sebastiani MD, Bich N. Nguyen MD, Guy Cloutier PhD, Eng, An Tang MD, MSc
Objective
To assess the reproducibility of six ultrasound (US)-determined shear wave (SW) viscoelastography parameters for assessment of mechanical properties of the liver in volunteers and patients with biopsy-proven metabolic dysfunction-associated steatotic liver disease (MASLD) or metabolic dysfunction-associated steatohepatitis (MASH).
Methods
This prospective, cross-sectional, institutional review board-approved study included 10 volunteers and 20 patients with MASLD or MASH who underwent liver US elastography twice, at least 2 weeks apart. SW speed (SWS), Young's modulus (E), shear modulus (G), SW attenuation (SWA), SW dispersion (SWD), and viscosity were computed from radiofrequency data recorded on a research US scanner. Linear mixed models were used to consider the sonographer on duty as a confounder. The reproducibility of measurements was assessed by intraclass correlation coefficient (ICC), coefficient of variation (CV), reproducibility coefficient (RDC), and Bland-Altman analyses.
Results
The sonographer performing the exam had no impact on viscoelastic parameters (P > .05). ICCs of SWS, E, G, SWA, SWD, and viscosity were, respectively, 0.89 (95% confidence intervals [CI]: 0.79-0.95), 0.81 (95% CI: 0.79-0.95), 0.90 (95% CI: 0.80-0.95), 0.96 (95% CI: 0.93-0.98), 0.78 (95% CI: 0.60-0.89), and 0.90 (95% CI: 0.80-0.95); CVs were 11.9, 23.3, 24.2, 10.1, 29.0, and 32.2%; RDCs were 33.0, 64.5, 66.9, 27.7, 80.3, and 89.2%, and Bland-Altman mean biases and 95% limits of agreement were −0.05 (−0.45, 0.35) m/s, −0.61 (−5.33, 4.10) kPa, −0.25 (−2.06, 1.56) kPa, −0.01 (−0.27, 0.26) Np/m/Hz, −0.09 (−7.09, 6.91) m/s/kHz, and −0.33 (−2.60, 1.94) Pa/s, between the two visits.
Conclusion
US-determined viscoelastography parameters can be measured with high reproducibility and consistency between two visits 2 weeks apart on the same ultrasound machine.
{"title":"Between-Visit Reproducibility of Shear Wave Viscoelastography in Volunteers and Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease","authors":"Ladan Yazdani PhD, Sathiyamoorthy Selladurai PhD, Iman Rafati MSc, Manish Bhatt PhD, Emmanuel Montagnon PhD, Boris Chayer MSc, Damien Olivié MD, Jeanne-Marie Giard MD, MPH, Giada Sebastiani MD, Bich N. Nguyen MD, Guy Cloutier PhD, Eng, An Tang MD, MSc","doi":"10.1002/jum.16538","DOIUrl":"10.1002/jum.16538","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the reproducibility of six ultrasound (US)-determined shear wave (SW) viscoelastography parameters for assessment of mechanical properties of the liver in volunteers and patients with biopsy-proven metabolic dysfunction-associated steatotic liver disease (MASLD) or metabolic dysfunction-associated steatohepatitis (MASH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective, cross-sectional, institutional review board-approved study included 10 volunteers and 20 patients with MASLD or MASH who underwent liver US elastography twice, at least 2 weeks apart. SW speed (SWS), Young's modulus (<i>E</i>), shear modulus (<i>G</i>), SW attenuation (SWA), SW dispersion (SWD), and viscosity were computed from radiofrequency data recorded on a research US scanner. Linear mixed models were used to consider the sonographer on duty as a confounder. The reproducibility of measurements was assessed by intraclass correlation coefficient (ICC), coefficient of variation (CV), reproducibility coefficient (RDC), and Bland-Altman analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The sonographer performing the exam had no impact on viscoelastic parameters (<i>P</i> > .05). ICCs of SWS, <i>E</i>, <i>G</i>, SWA, SWD, and viscosity were, respectively, 0.89 (95% confidence intervals [CI]: 0.79-0.95), 0.81 (95% CI: 0.79-0.95), 0.90 (95% CI: 0.80-0.95), 0.96 (95% CI: 0.93-0.98), 0.78 (95% CI: 0.60-0.89), and 0.90 (95% CI: 0.80-0.95); CVs were 11.9, 23.3, 24.2, 10.1, 29.0, and 32.2%; RDCs were 33.0, 64.5, 66.9, 27.7, 80.3, and 89.2%, and Bland-Altman mean biases and 95% limits of agreement were −0.05 (−0.45, 0.35) m/s, −0.61 (−5.33, 4.10) kPa, −0.25 (−2.06, 1.56) kPa, −0.01 (−0.27, 0.26) Np/m/Hz, −0.09 (−7.09, 6.91) m/s/kHz, and −0.33 (−2.60, 1.94) Pa/s, between the two visits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>US-determined viscoelastography parameters can be measured with high reproducibility and consistency between two visits 2 weeks apart on the same ultrasound machine.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"43 11","pages":"2095-2108"},"PeriodicalIF":2.1,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16538","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902181","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}
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