Australasian Journal of Ultrasound in Medicine最新文献_第4页

Testicular Two-Dimensional Shear Wave Elastography, Peak Systolic Velocity, Volume and Epididymal Thickness: Establishment of Normal Reference Values and Discrimination From Orchitis in Adult Patients Presenting With Acute Scrotal Pain 睾丸二维横波弹性成像、峰值收缩速度、体积和附睾厚度：急性阴囊痛成人患者正常参考值的建立及与睾丸炎的鉴别

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2025-05-21 DOI: 10.1002/ajum.70002

Steven Abbott, Christopher J. Welman, Marilyn Zelesco, Glenn Boardman

Aim

To establish normal testicular stiffness reference values using two-dimensional shear wave elastography (2D-SWE) and together with volume, PSV and epididymal thickness to discriminate from inflammatory pathology, specifically orchitis, in adult patients presenting with acute scrotal symptoms.

Materials and Methods

Retrospective analysis of patients referred for scrotal ultrasonography for investigation of scrotal pain or discomfort. Evaluation of 494 testes included B-Mode, colour and pulsed wave (PW) Doppler, testicular volume, peak systolic velocity (PSV) and the median elasticity (SWE). Statistical evaluation was performed to identify stiffness threshold values to rule in normal.

Results

In normal testes, the median volume, PSV and SWE were 13.8 mL (10.3–17.2 mL), 6.3 cm/s (4.9–7.7 cm/s) and 2.5 kPa (2.15–2.85 kPa). The right testes were larger (right 14.4 mL, left 13.2 mL, p < 0.05) with both decreasing in size and increasing in stiffness with increasing age (> 60 years, p < 0.05). In patients with normal testes but extra-testicular pathology, the median volume, PSV and SWE were 13.3 mL (9.75–16.8 mL), 6.3 cm/s (4.55–8.05 cm/s) and 2.8 kPa (2.3–3.3 kPa), respectively. In patients with orchitis, the median volume, PSV and SWE were 18.1 mL (11.5–24.7 mL), 7.9 cm/s (2.8–13 cm/s) and 5.4 kPa (3.4–7.4 kPa), respectively. The PSV and SWE values in this group were age- and side-independent. Differentiating normal testes from orchitis using SWE had AUC, accuracy, sensitivity and specificity of 0.91, 0.801, 0.892 and 0.792.

Conclusion

Normal adult testes have a median stiffness of 2.5 kPa. A threshold cut-off median value of 3.6 kPa suggests the diagnosis of an inflammatory testicular pathology such as orchitis, with AUC, accuracy, sensitivity and specificity of 0.922, 0.840, 0.928 and 0.831. Caution is required in the presence of extra-testicular pathology, where there is a wider range of SWE and other parameters.

目的利用二维横波弹性成像（2D-SWE），结合体积、PSV和附睾厚度，建立正常睾丸硬度参考值，以鉴别急性阴囊症状的成年患者的炎症病理，特别是睾丸炎。材料与方法对经阴囊超声检查诊断阴囊疼痛或不适的患者进行回顾性分析。对494例睾丸进行b型、彩色和脉冲多普勒（PW）、睾丸体积、峰值收缩速度（PSV）和中位弹性（SWE）评估。进行统计评估，以确定刚度阈值，以规则在正常。结果正常睾丸中位容积、PSV和SWE分别为13.8 mL （10.3 ~ 17.2 mL）、6.3 cm/s （4.9 ~ 7.7 cm/s）和2.5 kPa （2.15 ~ 2.85 kPa）。右侧睾丸较大（右侧14.4 mL，左侧13.2 mL, p < 0.05），随着年龄的增长（60岁，p < 0.05），尺寸减小，硬度增加。睾丸正常但有睾丸外病变的患者中位体积13.3 mL (9.75 ~ 16.8 mL), PSV 6.3 cm/s (4.55 ~ 8.05 cm/s), SWE 2.8 kPa （2.3 ~ 3.3 kPa）。睾丸炎患者的中位容积、PSV和SWE分别为18.1 mL （11.5-24.7 mL）、7.9 cm/s （2.8-13 cm/s）和5.4 kPa （3.4-7.4 kPa）。该组的PSV和SWE值与年龄和侧面无关。SWE鉴别正常睾丸与睾丸炎的AUC、准确度、灵敏度和特异性分别为0.91、0.801、0.892和0.792。结论正常成年睾丸中位刚度为2.5 kPa。阈值截断中位数为3.6 kPa，诊断为睾丸炎等炎性睾丸病理，AUC、准确性、敏感性和特异性分别为0.922、0.840、0.928和0.831。在存在睾丸外病理时需要谨慎，其中SWE和其他参数的范围更广。

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引用次数: 0

Comparison of Carotid Artery Peak Systolic Velocity Measurement Guided by 2-Dimensional Versus 3-Dimensional X-Plane Colour Doppler Ultrasound 二维与三维x平面彩色多普勒超声引导下颈动脉峰值收缩速度测量的比较

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2025-05-21 DOI: 10.1002/ajum.70009

Jin Xu, Martin Necas, Mike Kittridge

Introduction

Characterisation of carotid artery stenosis by Doppler ultrasound relies on peak systolic velocity (PSV) measurements and velocity ratios. The site of PSV sampling is conventionally guided by 2-dimensional (2D) colour Doppler in the longitudinal plane only. The recently introduced Philips eXL14-3 MHz matrix array transducer (Philips Ultrasound, Bothell, WA, USA) allows visualisation of colour Doppler in longitudinal and transverse planes simultaneously (3D). We compared PSV measurements of the mid common carotid artery (mCCA) obtained using conventional 2D guidance versus 3D ultrasound guidance in a series of 100 carotid arteries.

Method

This was a single centre prospective study of 100 mCCA velocity measurements. All ultrasound examinations were performed by a single qualified vascular sonographer. 2D-guided and 3D-guided PSV measurements were made. Sample volume adjustments made by the sonographer were recorded.

Results

The average difference in PSV across the 100 sample sets was 0.3 ± 5.9 SD cms⁻¹. Comparing 3D versus 2D guided measurements, 45 samples showed an increase in PSV measurement, with an average of 5.0 cms⁻¹; 51 samples showed a decrease in PSV, with an average of −3.8 cms⁻¹ and 4 samples did not show any change. The fitted T- and normal distribution coefficients for the 2D and 3D samples for both the PSV and TAPV were equivalent. The F-tests of the horizontal and vertical adjustments of sample volume in 3D indicate there is little to no relationship between sample gate adjustment and resultant velocity measurements.

Conclusion

No significant difference was observed in PSV measurements of the mCCA when using 3D versus conventional 2D ultrasound guidance.

介绍颈动脉狭窄的多普勒超声特征依赖于峰值收缩速度（PSV）测量和速度比。传统上，PSV采样位置仅在纵向平面上由二维（2D）彩色多普勒引导。最近推出的Philips eXL14-3 MHz矩阵阵列传感器（Philips Ultrasound, Bothell， WA， USA）可以同时在纵向和横向平面上显示彩色多普勒（3D）。我们比较了100条颈动脉中颈总动脉（mCCA）的PSV测量值，采用传统的2D引导与3D超声引导。方法采用单中心前瞻性研究，对100个mCCA速度测量数据进行分析。所有超声检查均由一名合格的血管超声医师进行。进行了2d引导和3d引导的PSV测量。记录超声仪对样品体积的调整。结果100组样本间PSV的平均差异为0.3±5.9 SD cms−1。比较3D和2D引导测量，45个样本显示PSV测量增加，平均为5.0 cm−1；51个样本的PSV下降，平均为- 3.8 cm， 4个样本没有任何变化。PSV和TAPV的二维和三维样本的拟合T分布系数和正态分布系数是相等的。三维样品体积水平和垂直调整的f检验表明，样品闸门调整与合成速度测量之间几乎没有关系。结论三维超声引导与传统二维超声引导下mCCA的PSV测量无显著性差异。

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引用次数: 0

Learning Curve for Interpreting Transtracheal Ultrasound Images to Confirm Endotracheal Tube Placement Among Anaesthesia Residents in a Teaching Hospital 某教学医院麻醉住院医师解释经气管超声图像以确定气管插管位置的学习曲线

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2025-05-21 DOI: 10.1002/ajum.70011

Amber Gulamani, Hameed Ullah

Objectives

Airway ultrasound is a promising tool that can be used alongside capnography to confirm correct endotracheal tube (ETT) placement. This study aimed to quantify the practice required to achieve accurate interpretation of trans-tracheal ultrasound for identifying ETT placement during elective surgeries under general anaesthesia in a teaching hospital.

Methods

Thirty-six anaesthesia residents participated. A baseline ultrasound image interpretation test was conducted, followed by a short video tutorial on upper airway ultrasound. Participants then completed a post-test to identify 10 clips/images in a single attempt. Pre- and post-tutorial scores, time taken for interpretation and confidence levels were compared using Wilcoxon signed rank test. Statistical significance was set at p < 0.05.

Results

All 36 residents (55.6% female, mean age 29.1 ± 1.81 years) completed the study. After a video tutorial, the median interpretation score improved significantly from 3 (2) to 10 (0) (p < 0.001), and the median interpretation time decreased from 12.9 (4.7) to 4.6 (1.2) s (p < 0.001). Confidence levels also improved significantly. Proficiency was achieved by 91.7% (33/36) of participants after one practice attempt, with the remaining 8.3% succeeding after a second attempt.

Conclusions

A brief tutorial on airway ultrasound significantly improves anaesthesia residents' ability to interpret ultrasound images for endotracheal tube placement. It may serve as a valuable adjunct to traditional methods for ETT placement confirmation.

目的气道超声是一种很有前途的工具，可以与气管造影一起用于确认气管内插管的正确放置。本研究旨在量化教学医院在全麻下择期手术中准确解读经气管超声以确定ETT放置所需的实践。方法36名麻醉住院医师参与。进行了基线超声图像解释测试，随后进行了上呼吸道超声短视频教程。然后，参与者完成了一个后测试，在一次尝试中识别10个片段/图像。使用Wilcoxon符号秩检验比较教学前后的分数、解释时间和置信水平。p <； 0.05为统计学意义。结果36例患者全部完成研究，其中女性55.6%，平均年龄29.1±1.81岁。经过视频辅导后，中位口译分数从3(2)分显著提高到10(0)分（p < 0.001），中位口译时间从12.9（4.7）秒减少到4.6（1.2）秒（p < 0.001）。信心水平也显著提高。91.7%（33/36）的参与者在一次练习尝试后达到熟练程度，其余8.3%的参与者在第二次尝试后成功。结论对麻醉住院医师进行简短的气道超声指导，可显著提高其对气管内置管超声图像的理解能力。它可以作为确定ETT放置位置的传统方法的有价值的辅助手段。

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引用次数: 0

Prenatal Diagnosis of an Umbilical Cord Cyst Associated With Obstructed Umbilical Artery Flow: Case Report 产前诊断脐带囊肿与脐带动脉阻塞：1例报告

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2025-05-19 DOI: 10.1002/ajum.70006

James Miller, Lavinia Hallam, Debra Paoletti

Background

Umbilical cord cysts are rare and the reported associations with abnormal foetal outcomes present challenges in antenatal diagnosis and management.

Key Findings

We report a case of a large umbilical cord cyst detected in the second trimester, with no communication to the foetal bladder. Third trimester review demonstrated oedematous change in the umbilical cord and significantly reduced umbilical artery flow necessitating delivery by emergency caesarean section. Postnatally, the infant was found to have a patent urachus.

Discussion

This case underlines the importance of antenatal ultrasound surveillance in pregnancies complicated by umbilical cord cysts, limitations in definitive diagnosis and features of cord compression that have not been previously reported.

背景脐带囊肿是罕见的，与异常胎儿结局的相关报道在产前诊断和处理方面提出了挑战。我们报告一例在妊娠中期发现的大脐带囊肿，没有与胎儿膀胱沟通。妊娠晚期复查显示脐带水肿改变，脐动脉流量明显减少，需要紧急剖腹产分娩。出生后，婴儿被发现有一个未闭的输卵管。本病例强调了产前超声监测在合并脐带囊肿的妊娠中的重要性，明确诊断的局限性和脐带压迫的特征以前没有报道过。

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引用次数: 0

Central Serous Chorioretinopathy Diagnosed by Emergency Practitioner-Performed Ocular Point-Of-Care Ultrasonography 中枢性浆液性脉络膜视网膜病变诊断急诊医生进行眼点护理超声检查

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2025-04-14 DOI: 10.1002/ajum.70005

Christian P. Pappas, Matthew Watson, Christopher Harrington, Katherine Masselos

Introduction

Central serous chorioretinopathy (CSCR) is a common cause of acute, monocular vision loss amongst men aged 40–50 years. Diagnosis is typically multimodal, requiring advanced ophthalmic imaging. These techniques are not readily available in acute care settings.

Methods

We report the first case of CSCR diagnosed by an emergency practitioner–performed ocular point-of-care ultrasonography (POCUS).

Results

CSCR was identified by the presence of a dome-shaped, hypoechoic elevation of the neurosensory retina in association with a hypoechoic band posterior to the retinal pigment epithelium. The diagnosis was confirmed following ophthalmic referral. The patient was managed conservatively with routine observation and risk factor modification.

Conclusion

We describe the first reported use of emergency practitioner-performed ocular POCUS to identify findings suggestive of CSCR, a common cause of acute monocular vision loss among working-aged men. Although this case demonstrates the evolving utility of ocular ultrasound in emergent eye presentations, further research is needed to define the technique's role in the early evaluation of CSCR.

中枢性浆液性脉络膜视网膜病变（CSCR）是40-50岁男性急性单眼视力丧失的常见原因。诊断通常是多模式的，需要先进的眼科成像。这些技术在急症护理环境中并不容易获得。方法我们报告第一例CSCR诊断由急诊医生进行眼点超声检查（POCUS）。结果CSCR是通过在视网膜色素上皮后的神经感觉视网膜上出现一个圆顶状的低回声升高，并伴有低回声带来鉴别的。经眼科转诊确诊。通过常规观察和危险因素调整对患者进行保守治疗。结论：我们描述了首次使用急诊医生进行的眼部POCUS来识别CSCR的发现，CSCR是工作年龄男性急性单眼视力丧失的常见原因。尽管该病例表明了眼超声在紧急眼部表现中的不断发展的效用，但需要进一步的研究来确定该技术在CSCR早期评估中的作用。

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引用次数: 0

Simplified First-Trimester Fetal Cardiac Screening Protocol for Low-Risk Pregnancies: Enhancing Efficiency and Accuracy 简化早期妊娠胎儿心脏筛查方案低风险妊娠：提高效率和准确性

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2025-04-14 DOI: 10.1002/ajum.70000

Vanessa Pincham, Andrew McLennan, Jonathan Forsey, Ritu Mogra

Introduction

Congenital heart defects (CHDs) are among the most prevalent congenital anomalies and are frequently detected in pregnancies classified as low-risk, rather than in high-risk groups. Advancements in ultrasound technology have heightened the emphasis on first-trimester fetal cardiac screening. However, due to the small size of the fetal heart at this stage, significant challenges persist, underscoring the need for simplified and reproducible protocols that can be effectively applied on a population-wide scale.

Methods

This paper describes a screening approach centred on the four-chamber view (4CV) and three-vessel tracheal view (3VTV) with colour Doppler imaging. This includes optimisation of ultrasound machine settings and the use of transabdominal and transvaginal approaches to enhance visualisation.

Results

Evidence demonstrates a CHD detection rate of 76% in low-risk populations, with a 95% success rate in obtaining the necessary views.

Discussion and Conclusion

Operator expertise and familiarity with cardiac anomalies are critical for accurate detection. The early identification of CHDs enables informed decision-making regarding pregnancy management. A simplified protocol for first-trimester cardiac screening offers a promising tool for the early identification of CHDs, enabling timely referral and intervention. To optimise detection rates and clinical outcomes, continuous professional education and systematic auditing processes are indispensable for practitioners performing early fetal cardiac screening.

先天性心脏缺陷（CHDs）是最常见的先天性异常之一，通常在怀孕期间被发现为低风险，而不是高危人群。超声技术的进步提高了对妊娠早期胎儿心脏筛查的重视程度。然而，由于现阶段胎儿心脏的尺寸较小，仍然存在重大挑战，强调需要简化和可重复的方案，以便在全人群范围内有效应用。方法采用彩色多普勒成像，以四腔镜（4CV）和三血管气管镜（3VTV）为中心进行筛查。这包括优化超声机器设置和使用经腹和经阴道途径，以提高可视化。结果低危人群冠心病检出率为76%，获得必要检查的成功率为95%。讨论与结论操作人员的专业知识和对心脏异常的熟悉程度是准确检测的关键。早期发现冠心病有助于在妊娠管理方面做出明智的决策。一种简化的妊娠早期心脏筛查方案为早期识别冠心病提供了一种有希望的工具，能够及时转诊和干预。为了优化检出率和临床结果，持续的专业教育和系统的审计过程是必不可少的从业者进行早期胎儿心脏筛查。

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引用次数: 0

Ultrasound as a Diagnostic Tool in Detection of Maxillofacial Fractures at Level 1 Trauma Centre ED in India 超声在印度一级创伤中心ED检测颌面部骨折的诊断工具

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2025-03-14 DOI: 10.1002/ajum.70001

Afroz Fatima, Priyanka Modi, Tej Prakash Sinha, Sanjeev Bhoi, Atin Kumar, Sushma Sagar

Background

Injuries, especially maxillofacial fractures, pose a significant global health burden exacerbated by increasing traffic activities. Early detection is vital for preventing complications. This study assesses ultrasound's diagnostic efficacy, aiming to improve patient management and minimise treatment delays by detecting maxillofacial fractures promptly and accurately.

Objective

The main aim was to assess point-of-care ultrasound (POCUS) in diagnosing maxillofacial fractures against computed tomography (CT) scans. Secondary goals included identifying ocular injuries, mandibular fractures, assessing probe feasibility and comparing Le Fort classification via ultrasound and CT.

Methodology

Between January 2019 and February 2021, 150 trauma patients (136 male) with a mean age of 28.5 ± 5 years (range, 18–62 years) suspected of maxillofacial fractures were enrolled. A trained physician performed facial ultrasound, and findings were documented alongside CT scan results. Using the SPSS software, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of POCUS against CT scans were analysed.

Results

Among 150 patients, CT scans diagnosed 137 with maxillofacial fractures, primarily due to road traffic accidents. Zygomatic fractures were most common, followed by nasal bone and mandibular parasymphysial fractures. POCUS exhibited high sensitivity (98.9%), specificity (99.1%), PPV (92%), and NPV (99.8%) for overall facial fractures, varying by bone. Associated occult ocular injuries occurred in two patients. Sensitivity and specificity were high for mandibular fractures. 5–10 MHz frequency linear probe, footprint-50 mm was optimal for midfacial bones, but Le Fort fractures could not be reliably identified using ultrasound.

Conclusion

The study underscores the value of POCUS in the Emergency Department for detecting maxillofacial fractures, despite limitations such as anatomical challenges. POCUS showed high diagnostic accuracy, emphasising its potential in clinical practice, requiring further validation and exploration.

背景伤害，特别是颌面骨折，造成了严重的全球健康负担，而交通活动的增加加剧了这一负担。早期发现对预防并发症至关重要。本研究评估超声诊断的有效性，旨在通过及时准确地检测颌面部骨折，改善患者管理，最大限度地减少治疗延误。目的比较点护理超声（POCUS）与CT （computer tomography， CT）扫描对颌面部骨折的诊断价值。次要目标包括识别眼部损伤、下颌骨折、评估探头可行性、比较超声和CT Le Fort分类。方法2019年1月至2021年2月，纳入150例疑似颌面部骨折的创伤患者（136例男性），平均年龄28.5±5岁（18-62岁）。一位训练有素的医生进行了面部超声检查，并将检查结果与CT扫描结果一起记录下来。采用SPSS软件分析POCUS对CT扫描的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）及诊断准确性。结果在150例患者中，CT扫描诊断出137例颌面部骨折，主要由道路交通事故引起。颧骨骨折最常见，其次是鼻骨和下颌副膈骨骨折。POCUS对面部整体骨折的敏感性（98.9%）、特异性（99.1%）、PPV（92%）和NPV（99.8%）均较高，随骨不同而不同。2例患者发生隐蔽性眼损伤。该方法对下颌骨骨折的敏感性和特异性均较高。5-10 MHz频率线性探头，足迹-50 mm是面中骨的最佳选择，但Le Fort骨折不能可靠地使用超声识别。结论尽管存在解剖学上的局限性，但该研究强调了POCUS在急诊科检测颌面部骨折的价值。POCUS具有较高的诊断准确性，强调其在临床实践中的潜力，需要进一步的验证和探索。

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引用次数: 0

Ultrasound of the uterosacral ligaments: A reliability study for diagnosing endometriosis in Australian non-specialised medical imaging and radiology settings 子宫骶韧带超声：澳大利亚非专业医学成像和放射学诊断子宫内膜异位症的可靠性研究

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2025-02-18 DOI: 10.1002/ajum.12420

Shae Maple, Eva Bezak, K Jane Chalmers, Nayana Parange

Introduction/Background

Uterosacral ligaments (USL) are the most common sites of endometriosis. Transvaginal ultrasound (TVS) demonstrates high diagnostic accuracy for endometriosis of the USLs using standardised technique and characterisations. While high accuracy and reproducibility is established with these techniques by well-trained professionals, the question still remains if these techniques are reproducible in general settings. This study aims to assess the intra and interobserver agreement of TVS characteristics of USLs, between experienced and less experienced examiners in an Australian general ultrasound imaging practice, where sonographers are required to perform ultrasound for endometriosis.

Methods

Forty-two patients, with and without known endometriosis, underwent ultrasound imaging of the USLs. Images were obtained of uterosacral ligaments and collated for interobserver survey. Six professional observers independently reviewed the images, classifying characteristics such as echogenicity, echotexture, contour, thickness, and presence of nodules. Interobserver reliability was assessed using Gwet's agreement coefficients (AC1), and the correlation between USL thickness and endometriosis was analyzed using Spearman's correlation.

Results

Interobserver agreement for detecting USL endometriosis was substantial (AC1 = 0.63), with an overall agreement of (0.65) for the seven USL characteristics. Intraobserver agreement ranged from moderate (0.60) to almost perfect (0.96). Experience did not significantly affect intraobserver reliability. A strong positive correlation was found between USL thickness and endometriosis (r = 0.7965, P < 0.01).

Conclusion

This study demonstrates high inter and intraobserver agreement among sonographers and radiologists in a general imaging department for identifying USL characteristics and diagnosing USL endometriosis. Both experienced and less experienced operators can reliably assess USLs Consistency was shown in identifying thickened uterosacral ligaments however, there is no consensus on where uterosacral ligament be measured. Even so, a thickened USL can prompt further extension of the pelvic scan to look for other endometriosis markers.

子宫骶韧带（USL）是子宫内膜异位症最常见的部位。经阴道超声（TVS）使用标准化的技术和特征，对USLs子宫内膜异位症的诊断准确性很高。虽然训练有素的专业人员利用这些技术建立了高精度和可重复性，但这些技术在一般情况下是否可重复的问题仍然存在。本研究旨在评估在澳大利亚一般超声成像实践中，超声医师需要对子宫内膜异位症进行超声检查，在经验丰富和经验不足的检查人员之间，usl的TVS特征在观察者内部和观察者之间的一致性。方法对42例有或无子宫内膜异位症的患者行超声检查。获得子宫骶韧带的图像，并整理供观察者间调查。六名专业观察员独立审查图像，分类特征，如回声性、回声纹理、轮廓、厚度和结节的存在。采用Gwet一致系数（AC1）评估观察者间信度，采用Spearman相关分析USL厚度与子宫内膜异位症的相关性。结果在USL子宫内膜异位症的检测上，观察者间的一致性是显著的（AC1 = 0.63）， 7个USL特征的总体一致性为（0.65）。观察者内部的一致性范围从中等（0.60）到几乎完全（0.96）。经验对观察者内部信度没有显著影响。USL厚度与子宫内膜异位症呈正相关（r = 0.7965, P < 0.01）。结论：本研究表明，超声医师和放射科医师在诊断USL特征和诊断USL子宫内膜异位症方面，在观察间和观察内的一致性很高。经验丰富和经验不足的操作人员都可以可靠地评估USLs，在识别增厚的子宫骶韧带方面显示出一致性，然而，对于子宫骶韧带的测量位置尚无共识。即便如此，增厚的USL可以提示进一步扩大盆腔扫描以寻找其他子宫内膜异位症标志物。

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引用次数: 0

Hepatic abscess caused by foreign body ingestion: A case report 误食异物致肝脓肿1例

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2025-02-17 DOI: 10.1002/ajum.12422

Qingqing Li, Yujiang Liu

Introduction

Liver abscess is a common clinical condition caused by bacterial, fungal or parasitic infections, usually due to immunosuppression. In contrast, secondary liver abscesses are caused by specific factors such as foreign bodies, tumours, or appendicitis.

Methods

We admitted a patient with secondary liver abscess and found an intrahepatic foreign body after interventional drainage. Initially, a foreign body of medical origin was suspected, but after a multidisciplinary consultation, it was determined to be caused by a foodborne foreign body. Laparoscopic surgery was then chosen as the treatment.

Result

The liver abscess was caused by an alimentary foreign body, and the intrahepatic foreign body was identified as a fish bone measuring approximately 2.5 cm in length.

Discussion

Upon diagnosing either primary or secondary liver abscess, aggressive treatment of the abscess focus is essential. However, in cases of secondary liver abscess, addressing and removing the underlying cause is necessary for complete resolution. For patients with a previously healthy liver, comprehensive history-taking is crucial, and imaging studies play a significant role in diagnosis and treatment. Clinicians and radiologists should be vigilant for the possibility of foreign bodies, tumours, or unexpected intra-abdominal inflammation, regardless of the patient's history. When dealing with food-borne foreign bodies, endoscopic intervention should be considered first, followed by laparoscopy, and as a last resort, open surgery.

Conclusion

The diagnosis and treatment of liver abscess in clinical practice require a complete medical history and thorough imaging examinations. Ultrasound, as the initial imaging modality, allows real-time and dynamic observation of lesions. It is essential for ultrasonologists to consider the possibility of foreign body-induced liver abscess when diagnosing patients with liver abscess.

肝脓肿是一种常见的临床疾病，由细菌、真菌或寄生虫感染引起，通常是由于免疫抑制所致。相反，继发性肝脓肿是由特定因素引起的，如异物、肿瘤或阑尾炎。方法收治1例继发性肝脓肿患者，经介入引流后发现肝内异物。最初，怀疑是医学来源的异物，但经过多学科会诊后，确定是由食源性异物引起的。然后选择腹腔镜手术作为治疗方法。结果肝脓肿由消化道异物引起，肝内异物为长约2.5 cm的鱼骨。在诊断原发性或继发性肝脓肿时，积极治疗脓肿病灶是必不可少的。然而，在继发性肝脓肿的情况下，解决和消除根本原因是完全解决所必需的。对于先前肝脏健康的患者，全面的病史记录是至关重要的，影像学研究在诊断和治疗中起着重要作用。无论患者的病史如何，临床医生和放射科医生都应警惕异物、肿瘤或意外的腹腔炎症的可能性。在处理食源性异物时，应首先考虑内镜干预，其次是腹腔镜，最后采取开放手术。结论临床对肝脓肿的诊断和治疗需要完整的病史和彻底的影像学检查。超声作为最初的成像方式，可以实时、动态地观察病变。超声医师在诊断肝脓肿时，必须考虑异物诱发肝脓肿的可能性。

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引用次数: 0

An innovative hybrid training method for ultrasound in giant cell arteritis, polymyalgia rheumatica and large vessel vasculitis 一种创新的巨细胞动脉炎、风湿性多肌痛和大血管炎超声混合训练方法

Q3 Medicine

Australasian Journal of Ultrasound in Medicine

Pub Date : 2025-02-03 DOI: 10.1002/ajum.12417

Li-Ching Chew, Cassandra Hong, Bhaskar Dasgupta

We propose a novel hybrid physical and virtual training method, complemented by online learning, as an effective method to teach and acquire ultrasound skills. We aim to illustrate this through our experience with a remote ultrasound training module for giant cell arteritis scanning. The significance of this innovation is the ability to mitigate the challenges faced by ultrasound training during pandemic-times, including the need for physical distancing, group size limitation and overseas travel restrictions. Furthermore, the hybrid training provides an invaluable access to distant specialist cognitive and procedural expertise when conventional means may not be feasible. Although this form of ultrasound training has limitations, such as diminished face-to-face contact, we were able to resume training despite the unfavourable circumstances. By harnessing virtual technology for hands-on training, we can strive to reduce worldwide training inequalities, particularly in areas requiring highly specialised skills where expertise may not be available locally. Even as the world has moved out of ‘lockdown’, the pandemic has serendipitously provided novel ways of doing things; the lessons learnt here can be utilised for future hybrid training models, especially where hands-on experience is crucial.

我们提出了一种新的物理和虚拟混合训练方法，辅以在线学习，作为教授和获得超声技能的有效方法。我们的目的是说明这一点，通过我们的经验与远程超声训练模块巨细胞动脉炎扫描。这一创新的重要意义在于，它能够缓解大流行期间超声培训面临的挑战，包括保持身体距离的必要性、团体规模限制和海外旅行限制。此外，当传统方法可能不可行时，混合培训提供了宝贵的远程专家认知和程序专业知识。虽然这种形式的超声训练有局限性，比如减少面对面的接触，但我们能够在不利的情况下恢复训练。通过利用虚拟技术进行实践培训，我们可以努力减少世界范围内的培训不平等现象，特别是在需要高度专业化技能的领域，而当地可能无法获得专门知识。即使世界已经摆脱了“封锁”，这场大流行也意外地提供了新的做事方式；这里学到的教训可以用于未来的混合培训模式，特别是在实践经验是至关重要的。

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引用次数: 0