Şükran Doğru, Fatih Akkuş, Huriye Ezveci, Ülfet Sena Meti̇n, K. Gezginc
Omphalocele and gastroschisis are the most frequent congenital developmental abdominal wall defects. Prenatal diagnosis of omphalocele and gastroschisis is critical in the management of the pregnancy, affording patients the option of termination. This study aims to evaluate the prenatal diagnosis and postnatal outcomes of omphalocele and gastroschisis cases.The cases of gastroschisis and omphalocele diagnosed prenatally and followed up at our university were evaluated retrospectively between January 2019 and January 2022. Maternal demographic and clinical characteristics and perinatal outcomes were compared between the cases.This study evaluated 42 omphalocele and nine gastroschisis cases. All gastroschisis cases were isolated (p = .001). Additional anomalies were present in 61.9% of omphalocele cases. While two patients with gastroschisis refused the invasive procedure, the genetic results of the others were normal. The karyotype was abnormal in 42.9% of omphalocele cases (p = .008). Half of the omphalocele cases were terminated, and 38.1% (n = 8) of the terminated omphalocele cases were trisomy 18. The coexistence of multiple system anomalies and cystic hygroma was high in the terminated cases. In all cases of gastroschisis, only the intestines protruded from the abdominal wall into the amniotic fluid. The number of survivors of omphalocele was 23.8%. The median hospital stay was 25 and 14 days for gastroschisis and omphalocele, respectively.Prenatal diagnosis of omphalocele and gastroschisis is critical in pregnancy management. The presence of associated anomalies determines the prognosis of omphalocele and gastroschisis.
{"title":"Omphalocele and gastroschisis: An analysis of prenatal diagnosis and neonatal outcomes","authors":"Şükran Doğru, Fatih Akkuş, Huriye Ezveci, Ülfet Sena Meti̇n, K. Gezginc","doi":"10.1002/sono.12388","DOIUrl":"https://doi.org/10.1002/sono.12388","url":null,"abstract":"Omphalocele and gastroschisis are the most frequent congenital developmental abdominal wall defects. Prenatal diagnosis of omphalocele and gastroschisis is critical in the management of the pregnancy, affording patients the option of termination. This study aims to evaluate the prenatal diagnosis and postnatal outcomes of omphalocele and gastroschisis cases.The cases of gastroschisis and omphalocele diagnosed prenatally and followed up at our university were evaluated retrospectively between January 2019 and January 2022. Maternal demographic and clinical characteristics and perinatal outcomes were compared between the cases.This study evaluated 42 omphalocele and nine gastroschisis cases. All gastroschisis cases were isolated (p = .001). Additional anomalies were present in 61.9% of omphalocele cases. While two patients with gastroschisis refused the invasive procedure, the genetic results of the others were normal. The karyotype was abnormal in 42.9% of omphalocele cases (p = .008). Half of the omphalocele cases were terminated, and 38.1% (n = 8) of the terminated omphalocele cases were trisomy 18. The coexistence of multiple system anomalies and cystic hygroma was high in the terminated cases. In all cases of gastroschisis, only the intestines protruded from the abdominal wall into the amniotic fluid. The number of survivors of omphalocele was 23.8%. The median hospital stay was 25 and 14 days for gastroschisis and omphalocele, respectively.Prenatal diagnosis of omphalocele and gastroschisis is critical in pregnancy management. The presence of associated anomalies determines the prognosis of omphalocele and gastroschisis.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"68 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139230135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Teal Derboghossian, Samantha Hill, Samantha Peden, Tony Lightfoot
A case of non‐thrombotic intravascular pathology of the external jugular vein. The patient presented with a 5‐week history of a pain‐less lump on the right side of the neck. There was no history of trauma or associated signs or symptoms. Ultrasound imaging showed an intravenous mass that was excised and histopathologically diagnosed as an intravascular lobular capillary haemangioma (IVLCH). The rare tumour most commonly effects the neck, face, and upper extremities. Ultrasound is often the first‐line imaging in such cases, and IVLCH should be considered in the differential under specific circumstances.
{"title":"Intravascular lobular capillary haemangioma of the external jugular vein","authors":"Teal Derboghossian, Samantha Hill, Samantha Peden, Tony Lightfoot","doi":"10.1002/sono.12389","DOIUrl":"https://doi.org/10.1002/sono.12389","url":null,"abstract":"A case of non‐thrombotic intravascular pathology of the external jugular vein. The patient presented with a 5‐week history of a pain‐less lump on the right side of the neck. There was no history of trauma or associated signs or symptoms. Ultrasound imaging showed an intravenous mass that was excised and histopathologically diagnosed as an intravascular lobular capillary haemangioma (IVLCH). The rare tumour most commonly effects the neck, face, and upper extremities. Ultrasound is often the first‐line imaging in such cases, and IVLCH should be considered in the differential under specific circumstances.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"540 ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139249010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fibromyalgia syndrome (FMS) is a chronic disease of unknown pathophysiology in which inflammatory markers are not increased. The risk of cardiovascular disease is known to be raised in FMS. Determination of carotid intima‐media thickness (CIMT) is essential for the early detection of cardiovascular disease risk. In this study, we aimed to investigate how FMS affects CIMT and its relationship with disease duration.This study was planned prospectively and included 20 female FMS patients and 20 healthy female controls. Detailed medical histories were obtained. Persons with a known chronic disease (diabetes mellitus, hypertension, thyroid function disorder, rheumatic disease, etc.), known atherosclerotic condition, body mass index >30 and smokers were excluded. Laboratory values of FMS patients and the control group in the last 3 months were recorded. The patients' and control groups' right and left common carotid arteries were imaged with ultrasonography.There was no significant difference in laboratory values (although creatinine was different, it was within the normal range in both groups). The mean right common carotid artery intima‐media thickness was 0.5 (±0.07) mm in the patient group and 0.43 (±0.05) mm in the control group (p = .005). The mean left common carotid artery intima‐media thickness was 0.5 (±0.06) mm in the patient group and 0.43 (±0.05) mm in the control group (p = .001). Carotid intima‐media thickness values were significantly higher in the patient group than in the control group.Although FMS is not an inflammatory disease, it causes endothelial dysfunction and atherosclerosis.
{"title":"Subclinical atherosclerosis in fibromyalgia syndrome","authors":"Enes Gul, Bulent Yildiz, Irfan Atik, Ozlem Sahin","doi":"10.1002/sono.12386","DOIUrl":"https://doi.org/10.1002/sono.12386","url":null,"abstract":"Fibromyalgia syndrome (FMS) is a chronic disease of unknown pathophysiology in which inflammatory markers are not increased. The risk of cardiovascular disease is known to be raised in FMS. Determination of carotid intima‐media thickness (CIMT) is essential for the early detection of cardiovascular disease risk. In this study, we aimed to investigate how FMS affects CIMT and its relationship with disease duration.This study was planned prospectively and included 20 female FMS patients and 20 healthy female controls. Detailed medical histories were obtained. Persons with a known chronic disease (diabetes mellitus, hypertension, thyroid function disorder, rheumatic disease, etc.), known atherosclerotic condition, body mass index >30 and smokers were excluded. Laboratory values of FMS patients and the control group in the last 3 months were recorded. The patients' and control groups' right and left common carotid arteries were imaged with ultrasonography.There was no significant difference in laboratory values (although creatinine was different, it was within the normal range in both groups). The mean right common carotid artery intima‐media thickness was 0.5 (±0.07) mm in the patient group and 0.43 (±0.05) mm in the control group (p = .005). The mean left common carotid artery intima‐media thickness was 0.5 (±0.06) mm in the patient group and 0.43 (±0.05) mm in the control group (p = .001). Carotid intima‐media thickness values were significantly higher in the patient group than in the control group.Although FMS is not an inflammatory disease, it causes endothelial dysfunction and atherosclerosis.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"7 2","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139255299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joao Leote, Margarida Aguiar, Hugo Alexandre Ferreira
The authors have nothing to declare.
作者没有什么要申报的。
{"title":"Ultrasonography during bronchoalveolar lavage of lung cavities","authors":"Joao Leote, Margarida Aguiar, Hugo Alexandre Ferreira","doi":"10.1002/sono.12383","DOIUrl":"https://doi.org/10.1002/sono.12383","url":null,"abstract":"The authors have nothing to declare.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135392531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Extraosseous Ewing's sarcoma is a malignant mesenchymal tumor much rarer than skeletal Ewing's sarcoma. The synchronous or metachronous occurrence of advanced breast cancer with retroperitoneal Ewing's sarcoma is extremely rare. To date, only a few cases of extraosseous Ewing's sarcoma with contrast‐enhanced ultrasound findings have been reported. This study aims to report a case of a retroperitoneal Ewing's sarcoma in a 39‐year‐old woman with advanced breast cancer, where grayscale ultrasound, contrast‐enhanced ultrasound, and computed tomography findings were included. To our knowledge, this is the first reported case of ultrasound and contrast‐enhanced ultrasonography manifestation of retroperitoneal Ewing's sarcoma as a second primary tumor.
{"title":"Retroperitoneal Ewing's sarcoma in a woman with advanced breast cancer delineated by contrast‐enhanced ultrasound: A case report","authors":"Haiyu Luo, Yongqian Mo, Lizhang Zhu, Haiqin Xie, Desheng Sun, Jieyu Zhong, Zhengming Hu","doi":"10.1002/sono.12379","DOIUrl":"https://doi.org/10.1002/sono.12379","url":null,"abstract":"Abstract Extraosseous Ewing's sarcoma is a malignant mesenchymal tumor much rarer than skeletal Ewing's sarcoma. The synchronous or metachronous occurrence of advanced breast cancer with retroperitoneal Ewing's sarcoma is extremely rare. To date, only a few cases of extraosseous Ewing's sarcoma with contrast‐enhanced ultrasound findings have been reported. This study aims to report a case of a retroperitoneal Ewing's sarcoma in a 39‐year‐old woman with advanced breast cancer, where grayscale ultrasound, contrast‐enhanced ultrasound, and computed tomography findings were included. To our knowledge, this is the first reported case of ultrasound and contrast‐enhanced ultrasonography manifestation of retroperitoneal Ewing's sarcoma as a second primary tumor.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"293 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136158860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Introduction Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetic disease characterised by progressive fibrofatty tissue replacement of the myocardium. Several arrhythmogenic cardiomyopathy (ACM) phenotypes are now recognised, including right‐dominant, biventricular, and left‐dominant variants, which led to the development of the 2020 International criteria (Padua criteria). Raising awareness of these variants is crucial as their clinical entity can be concealed. This is particularly important in the athletic population. Exercise can promote the development of the phenotype and accelerate disease progression, resulting in left ventricular (LV) involvement and systolic dysfunction, which can cause ventricular arrhythmias and sudden death. Case Description A late adolescent male was escorted by paramedics to an emergency department following a medium‐speed motor vehicle accident. A multimodality approach was implemented involving a 12‐lead electrocardiogram (ECG), transthoracic echocardiography (ECHO) and cardiac magnetic resonance (CMR) imaging. An unknown cardiomyopathy was revealed with diagnostic clues suggesting biventricular ACM in a recreational soccer player, when using the Padua criteria. Conclusion ACM should be considered in the evaluation of an unexplained cardiomyopathy presenting with possible syncopal events. This case describes the clinical features of an ACM patient, emphasising the utility of ECG, ECHO and CMR in determining biventricular involvement. CMR is a powerful tool for the diagnosis of ACM and the identification of myocardial fibrosis with late gadolinium enhancement (LGE). The use of 12‐lead ECG and 2‐dimensional (2D) strain imaging may also raise suspicion of biventricular phenotypes and predict LV involvement with significant myocardial fibrosis.
{"title":"Undiagnosed cardiomyopathy: An incidental finding in a recreational soccer player—A case report and literature review","authors":"Richard P. Allwood","doi":"10.1002/sono.12382","DOIUrl":"https://doi.org/10.1002/sono.12382","url":null,"abstract":"Abstract Introduction Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetic disease characterised by progressive fibrofatty tissue replacement of the myocardium. Several arrhythmogenic cardiomyopathy (ACM) phenotypes are now recognised, including right‐dominant, biventricular, and left‐dominant variants, which led to the development of the 2020 International criteria (Padua criteria). Raising awareness of these variants is crucial as their clinical entity can be concealed. This is particularly important in the athletic population. Exercise can promote the development of the phenotype and accelerate disease progression, resulting in left ventricular (LV) involvement and systolic dysfunction, which can cause ventricular arrhythmias and sudden death. Case Description A late adolescent male was escorted by paramedics to an emergency department following a medium‐speed motor vehicle accident. A multimodality approach was implemented involving a 12‐lead electrocardiogram (ECG), transthoracic echocardiography (ECHO) and cardiac magnetic resonance (CMR) imaging. An unknown cardiomyopathy was revealed with diagnostic clues suggesting biventricular ACM in a recreational soccer player, when using the Padua criteria. Conclusion ACM should be considered in the evaluation of an unexplained cardiomyopathy presenting with possible syncopal events. This case describes the clinical features of an ACM patient, emphasising the utility of ECG, ECHO and CMR in determining biventricular involvement. CMR is a powerful tool for the diagnosis of ACM and the identification of myocardial fibrosis with late gadolinium enhancement (LGE). The use of 12‐lead ECG and 2‐dimensional (2D) strain imaging may also raise suspicion of biventricular phenotypes and predict LV involvement with significant myocardial fibrosis.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"448 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134908882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Video S1. For Figure 2. Video S2. For Figure 3. Video S3. For Figure 4. Video S4. For Figure 5. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
{"title":"Superior vena cava and tricuspid valve tumoral thrombosis in a 54‐year‐old female with metastatic colorectal adenocarcinoma: <scp>A</scp> rare case report","authors":"Soroush Mostafavi, Maryam Nabati, Laleh Vahedi Larijani, Homa Parsaee, Homina Saffar","doi":"10.1002/sono.12381","DOIUrl":"https://doi.org/10.1002/sono.12381","url":null,"abstract":"Video S1. For Figure 2. Video S2. For Figure 3. Video S3. For Figure 4. Video S4. For Figure 5. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135570002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The ongoing Coronavirus disease 2019 (COVID-19) global pandemic has resulted in over 6 million deaths worldwide.1 In addition to primary acute respiratory symptoms, COVID-19 has been demonstrated to have multisystem involvement.2 Cardiovascular system manifestations include thrombosis, acute coronary syndrome, arrhythmias, myocarditis, and evidence of subclinical myocardial dysfunction, with increased risk of mortality observed following myocardial injury.3 Cardiac magnetic resonance (CMR) imaging provides the highest diagnostic accuracy for acute myocarditis, however speckle tracking echocardiography (STE) derived strain analysis offers a more pragmatic alternative. STE examination has demonstrated reversible sub-clinical myocardial impairment of patients with only mild/moderate COVID-19 symptoms.4 This case describes a patient who suffered myocardial impairment following COVID-19 infection, whilst undergoing adjuvant chemotherapy for breast cancer. Current guidelines recommend cardioprotective therapy with potential cessation of chemotherapy if significant myocardial impairment is observed during treatment.5 A 48-year-old woman was diagnosed with right sided Grade 2 invasive breast carcinoma, no special type (NST), oestrogen receptor/progesterone receptor (ER/PR) negative and human epidermal growth factor receptor 2 (HER2) positive, in April 2021. She had received adjuvant chemotherapy with 4 cycles of anthracycline, 12 cycles of Paclitaxel, and 2 cycles of Trastuzamab chemotherapies, to be followed by bilateral mastectomy, adjuvant radiation, and on-going Trastuzumab. Prior to the initiation of chemotherapy (May, 2021), a transthoracic echocardiogram (TTE) demonstrated normal left ventricular (LV) systolic function, with left ventricular ejection fraction (LVEF) of 64% with a global longitudinal strain (GLS) of −21.8% (Figure 1A). She had routine cardiac surveillance as is clinical practice at our centre with a repeat TTE (August, 2021) after anthracycline therapy and prior to commencement of Trastuzamab (Figure 1B). This demonstrated LVEF of 59% with GLS of −19.9% (9% relative reduction and 1.9% absolute reduction in GLS compared to baseline). As is standard of care, a TTE is performed at 3 monthly intervals after commencement of Trastuzumab. Her next routine 3 monthly TTE (November 2021) demonstrated a further reduction in LVEF to 56% and GLS of −17.9% (relative reduction of 17.9% and absolute reduction of 3.9%) triggering review by a cardiologist (Figure 1C). There was no significant change in blood pressure, heart rate, LV volumes, LA volume or E/e' over this period. At cardiologist review, the patient reported no cardiovascular symptoms, in particular no dyspnoea, fatigue, or pedal oedema. She mentioned that she had COVID-19 infection (although having been vaccinated prior (×2 doses) in late September 2021) and had mild—moderate symptoms of dyspnoea and fatigue for approximately 3 weeks. She denied any chest pain or palpitations, she did
正在进行的2019冠状病毒病(COVID-19)全球大流行已导致全球600多万人死亡除了原发性急性呼吸道症状外，已证明COVID-19还涉及多系统心血管系统表现包括血栓、急性冠状动脉综合征、心律失常、心肌炎和亚临床心肌功能障碍的证据，心肌损伤后观察到死亡风险增加心脏磁共振(CMR)成像为急性心肌炎提供了最高的诊断准确性，然而斑点跟踪超声心动图(STE)衍生的应变分析提供了更实用的替代方案。STE检查显示，只有轻/中度COVID-19症状的患者存在可逆性亚临床心肌损害本病例描述了一位在接受乳腺癌辅助化疗期间感染COVID-19后心肌损伤的患者。目前的指南建议，如果在治疗期间观察到明显的心肌损害，则应进行心脏保护治疗，并可能停止化疗一名48岁女性于2021年4月被诊断为右侧2级浸润性乳腺癌，无特殊类型(NST)，雌激素受体/孕激素受体(ER/PR)阴性，人表皮生长因子受体2 (HER2)阳性。她接受了4个周期的蒽环类药物、12个周期的紫杉醇和2个周期的曲妥珠单抗化疗的辅助化疗，随后进行双侧乳房切除术、辅助放疗和持续的曲妥珠单抗。在化疗开始之前(2021年5月)，经胸超声心动图(TTE)显示左室(LV)收缩功能正常，左室射血分数(LVEF)为64%，整体纵向应变(GLS)为- 21.8%(图1A)。她在蒽环类药物治疗后和曲妥珠单抗开始前进行了常规心脏监测，这是我们中心的临床实践(2021年8月)。LVEF为59%，GLS为- 19.9%(与基线相比，GLS相对降低9%，绝对降低1.9%)。作为标准护理，在曲妥珠单抗开始后每3个月进行一次TTE。她的下一个常规3个月TTE(2021年11月)显示LVEF进一步降低至56%，GLS进一步降低至- 17.9%(相对降低17.9%，绝对降低3.9%)，这引发了心脏病专家的复查(图1C)。在此期间，血压、心率、左室容积、左室容积或E/ E′无显著变化。在心脏病专家复查时，患者报告无心血管症状，特别是无呼吸困难、疲劳或足部水肿。她提到，她感染了COVID-19(尽管之前已于2021年9月下旬接种了疫苗(×2剂量))，并出现了轻度至中度呼吸困难和疲劳症状，持续了大约3周。她否认有任何胸痛或心悸，她没有做任何血液检查(心脏生物标志物)，不需要住院治疗，也没有接受特异性抗病毒治疗。检查时，她的心率为每分钟60次，血压为124/78毫米汞柱，血压正常，心音正常，无杂音或摩擦。心电图示窦性心律，轴向正常，III导联和aVF导联非特异性T波反转。在曲妥珠单抗治疗期间，与基线研究相比，患者LVEF无症状下降9%，LV GLS相对降低17.9%，达到指南指导阈值(GLS降低bbb15 %)，开始心脏保护治疗(血管紧张素转换酶抑制剂±β受体阻滞剂治疗)5然而，鉴于患者在此期间有COVID-19感染史，随后症状得到缓解，我们决定在曲妥珠单抗治疗2个周期后继续使用曲妥珠单抗治疗并监测TTE，而不开始心脏保护治疗。随访时，患者无进一步症状，特别是无呼吸困难或疲劳。2022年1月的TTE显示LVEF改善了59%，GLS改善了- 18.6%(图1D)。随后，她在标准临床监测下继续使用曲妥珠单抗，未开始使用心脏保护剂。另外，由三名对治疗方案和彼此测量结果不知情的经认证的医学超声医师进行了GLS再现性评估。所有超声检查均发现了一致的趋势:GLS治疗前正常(- 21.2%±0.62)，蒽环类药物治疗后GLS小幅下降(- 18.4%±0.78)，曲妥珠单抗/ COVID-19感染后进一步下降(- 17.5%±0.59)，随访后改善(- 18.6%±0.68)。此外，与基线相比，曲妥珠单抗治疗期间，观察者间变异性的类内相关系数(ICC)为0.98 (95% CI 0.87-1.0)，平均相对GLS降低17.6% (95% CI 13.5%-21.7%)。
{"title":"A case of <scp>COVID</scp>‐19 masquerading as presumed Trastuzamab induced subclinical cardiotoxicity","authors":"Amy Maree Clark, Liza Thomas, Anita Boyd","doi":"10.1002/sono.12380","DOIUrl":"https://doi.org/10.1002/sono.12380","url":null,"abstract":"The ongoing Coronavirus disease 2019 (COVID-19) global pandemic has resulted in over 6 million deaths worldwide.1 In addition to primary acute respiratory symptoms, COVID-19 has been demonstrated to have multisystem involvement.2 Cardiovascular system manifestations include thrombosis, acute coronary syndrome, arrhythmias, myocarditis, and evidence of subclinical myocardial dysfunction, with increased risk of mortality observed following myocardial injury.3 Cardiac magnetic resonance (CMR) imaging provides the highest diagnostic accuracy for acute myocarditis, however speckle tracking echocardiography (STE) derived strain analysis offers a more pragmatic alternative. STE examination has demonstrated reversible sub-clinical myocardial impairment of patients with only mild/moderate COVID-19 symptoms.4 This case describes a patient who suffered myocardial impairment following COVID-19 infection, whilst undergoing adjuvant chemotherapy for breast cancer. Current guidelines recommend cardioprotective therapy with potential cessation of chemotherapy if significant myocardial impairment is observed during treatment.5 A 48-year-old woman was diagnosed with right sided Grade 2 invasive breast carcinoma, no special type (NST), oestrogen receptor/progesterone receptor (ER/PR) negative and human epidermal growth factor receptor 2 (HER2) positive, in April 2021. She had received adjuvant chemotherapy with 4 cycles of anthracycline, 12 cycles of Paclitaxel, and 2 cycles of Trastuzamab chemotherapies, to be followed by bilateral mastectomy, adjuvant radiation, and on-going Trastuzumab. Prior to the initiation of chemotherapy (May, 2021), a transthoracic echocardiogram (TTE) demonstrated normal left ventricular (LV) systolic function, with left ventricular ejection fraction (LVEF) of 64% with a global longitudinal strain (GLS) of −21.8% (Figure 1A). She had routine cardiac surveillance as is clinical practice at our centre with a repeat TTE (August, 2021) after anthracycline therapy and prior to commencement of Trastuzamab (Figure 1B). This demonstrated LVEF of 59% with GLS of −19.9% (9% relative reduction and 1.9% absolute reduction in GLS compared to baseline). As is standard of care, a TTE is performed at 3 monthly intervals after commencement of Trastuzumab. Her next routine 3 monthly TTE (November 2021) demonstrated a further reduction in LVEF to 56% and GLS of −17.9% (relative reduction of 17.9% and absolute reduction of 3.9%) triggering review by a cardiologist (Figure 1C). There was no significant change in blood pressure, heart rate, LV volumes, LA volume or E/e' over this period. At cardiologist review, the patient reported no cardiovascular symptoms, in particular no dyspnoea, fatigue, or pedal oedema. She mentioned that she had COVID-19 infection (although having been vaccinated prior (×2 doses) in late September 2021) and had mild—moderate symptoms of dyspnoea and fatigue for approximately 3 weeks. She denied any chest pain or palpitations, she did ","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135730561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The author declares no conflict of interest. VIDEO S1. Echo PLAX LV. VIDEO S2. CMR horizontal long axis 3ch. VIDEO S3. CMR horizontal long axis 4ch. VIDEO S4. Echo apical 4ch. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
{"title":"Evolving deformation patterns in a competitive swimmer with low <scp>QRS</scp> voltages on 12‐lead electrocardiogram","authors":"Richard P. Allwood","doi":"10.1002/sono.12377","DOIUrl":"https://doi.org/10.1002/sono.12377","url":null,"abstract":"The author declares no conflict of interest. VIDEO S1. Echo PLAX LV. VIDEO S2. CMR horizontal long axis 3ch. VIDEO S3. CMR horizontal long axis 4ch. VIDEO S4. Echo apical 4ch. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134975872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patrick Sepúlveda Barisich, Anita Soraya Irarrazaval Trigo, Adrián Gallardo
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{"title":"Metastatic testicular cancer presenting with dyspnoea: A case report on the utility of lung ultrasound in the emergency department","authors":"Patrick Sepúlveda Barisich, Anita Soraya Irarrazaval Trigo, Adrián Gallardo","doi":"10.1002/sono.12378","DOIUrl":"https://doi.org/10.1002/sono.12378","url":null,"abstract":"None.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135591379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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