Ultrasound International Open最新文献

Purpose: To investigate the potential correlation of dynamic contrast-enhanced ultrasound (DCE-US) with angiogenesis activity of renal cell carcinoma (RCC).

Materials and methods: Patients with surgery resection and histopathologically proven RCC lesions were included. B-mode ultrasound (BMUS) and contrast-enhanced ultrasound (CEUS) were performed one week before surgery. SonoVue was injected as the contrast agent. VueBox (Bracco, Italy) was used for the quantitative analysis. According to the histopathological and immunohistochemical results, patients were classified into two groups: active angiogenesis and inactive angiogenesis. Time intensity curves (TICs) and quantitative parameters were compared between two groups.

Results: From July 2023 to November 2023, a total of 50 patients (13 females and 37 males, mean age 61.1±11.1 years) were included. The mean size of the lesions was 39.4±2.7 mm. Patients were classified into the active angiogenesis group (n=30) and the inactive angiogenesis group (n=20). On BMUS, 68.0% (34/50) of RCCs were visualized as hypoechoic lesions with ill-defined borders and irregular shapes (P>0.05). During cortical phase of CEUS, 72.6% (23/30) of RCCs with active angiogenesis were visualized with hyperenhancement (P=0.027). Only 30.0% (9/30) of RCCs with active angiogenesis showed hypo-enhancement in the parenchymal phase (P>0.05). Compared to the inactive angiogenesis group, TICs of the active angiogenesis group revealed faster and greater enhancement in the cortical phase, slower decline during the parenchymal phase, and an increased area under the curve. Among quantitative parameters, the active angiogenesis group showed the higher ratio of wash-in rate and wash-in perfusion index (P<0.05).

Conclusion: DCE-US analysis has potential value in predicting angiogenesis activity in RCC lesions.

[This corrects the article DOI: 10.1055/a-2318-6654.].

Purpose: This study aimed to measure the precise distance from the lowest boundary of a rectal tumor to the anal verge (DTAV) in patients with rectal cancer.

Materials and methods: A retrospective analysis was performed on clinical data from 70 rectal cancer patients. DTAV measurements were collected using transrectal biplane ultrasound, MRI, and colonoscopy.

Results: The difference in DTAV measurements between the mean DTAV value obtained by ultrasound (US _mean ) and colonoscopy exhibited a difference of 0.22 cm. In contrast, the difference between US _mean and MRI was 0.48 cm, while the difference between MRI and colonoscopy was -0.26 cm. The ICC for DTAV measurements demonstrated excellent agreement, with values of 0.948 between US _mean and MRI, 0.942 between US _mean and colonoscopy, and 0.943 between MRI and colonoscopy. The minimum DTAV value obtained by ultrasound (US _min ) was 5.05 cm, the middle DTAV value obtained by ultrasound (US _mid ) was 5.10 cm, and the maximum DTAV value obtained by ultrasound (US _max ) was 5.30 cm. Notably, the median values of the differences in DTAV measurements between US _max and US _min , US _max and US _mid , as well as US _mid and US _min , were 0.2 cm, 0.1 cm, and 0.1 cm, respectively. Furthermore, the consistency of DTAV measurements between US _min and US _mid , US _max and US _mid , as well as US _min and US _max was excellent, with all ICC values reaching 0.999. Additionally, the radiologist's reassessment of MRI DTAV data showed excellent consistency with the original results, with an ICC value of 0.985.

Conclusion: Transrectal biplane ultrasound utilizing EFOV imaging technology exhibited both accuracy and reproducibility for measuring DTAV. This approach provided a highly efficient and practical clinical tool for DTAV measurement.

Purpose: Little is known about the benefit and interpretation of fetomaternal Doppler sonography in GDM for the prediction of an adverse perinatal outcome (APO). The aim of this study was to examine the performance of fetomaternal Doppler for APO prediction in pregnancies with GDM at term.

Materials and methods: This is a retrospective cohort study of singleton, non-anomalous fetuses of women with GDM, who primarily had a vaginal delivery attempt. Study inclusion also required no other major fetomaternal abnormalities that make placental dysfunction likely. Data on fetomaternal Doppler sonography including umbilical artery pulsatility index (PI), middle cerebral artery (MCA) PI, cerebroplacental ratio (CPR), mean uterine artery PI, cerebro-placental-uterine ratio (CPUR) was collected from 37+0 weeks on. Multivariate logistic regression analyses were performed using maternal characteristics, neonatal characteristics, and Doppler ultrasound parameters as independent variables with CAPO as a binary outcome.

Results: A total of n=88 cases were included. Nulliparity (p=0.032) and CPUR (p=0.052) were independent predictors of CAPO. However, CPUR had borderline significance. All other Doppler indices were not independent predictors of CAPO. The ability of CPUR alone (AUC=0.65, 95% CI 0.51 to 0.80) to discriminate between GDM pregnancies with and without CAPO was poor.

Conclusion: This study shows that there is no significant clinical relationship between fetomaternal Doppler indices and CAPO among pregnancies with GDM. This raises the question regarding the extent to which fetomaternal Doppler indices, which reflect placental function, can be helpful for CAPO prediction in GDM pregnancies.

Purpose: Native X-ray, magnetic resonance imaging (MRI), and computed tomography (CT) are standard methods for determining head-neck offset (HNO) in femoro-acetabular impingement (FAI). Our hypothesis was that sonography-assisted determination of the offset in CAM deformity of the hip is a cheap, radiation-free, and reliable alternative to conventional alpha-angle determination.

Methods: Patients with hip pain and suspected CAM impingement who underwent anterior-longitudinal hip sonography according to DEGUM standard procedures and MRI were included in this single-center study between January 2015 and December 2019. Offset was determined three times on MRI and sonography by two independent investigators.

Results: 285 patients were screened and 110 patients (49 females, 61 males) met the inclusion criteria. The mean age at the time of investigation of 54 left and 56 right hip joints was 54.2 years. 1320 measurements were performed. No significant difference in HNO determination between MRI (6.11 mm+/-2.37) and sonography (5.93 mm+/-2.20) could be identified. The mean difference was 0.32 mm+/-0.32 mm (p>0.05) with a maximum deviation of 2.08 mm (outlier).

Conclusion: Sonography-assisted determination of head-neck offset is a reliable and reproducible method and is not inferior to determination with MRI. Sonography can be used initially as an alternative or additional tool for the qualitative determination of CAM deformity of the hip joint.

Background   Ultrasound (US) surveillance for transjugular intrahepatic portosystemic shunt (TIPS) dysfunction has yet to be standardized, as clear-cut criteria have not been conventionally defined. This study evaluated the role of US-based parameters in detecting hemodynamic TIPS dysfunction (HD). Methods   We included consecutive patients treated with TIPS. All patients were scheduled within the first six weeks after the procedure for TIPS revision, comprised of a Doppler US exam and invasive hemodynamic reassessment. Clinical TIPS dysfunction (CD) was defined as symptom recurrence, while HD was defined by a portal pressure gradient (PPG)≥12 mmHg. The predictive capabilities of Doppler US for predicting TIPS dysfunction were tested against the hemodynamic gold standard. Results   86 patients were included. Secondary prophylaxis of variceal bleeding was the main indication for TIPS in 72 patients (83.7%), while 27 (31.4%) had refractory ascites. HD occurred in 37 cases (43%), of which 25 patients (67.5%) had no CD. Patients with HD had a significantly lower portal vein velocity (PVV): 35 (20-45) cm/s vs. 40.5 (35-50) cm/s, p=0.02. Compared to the immediate post-TIPS assessment, the patients without HD had a ΔPVV of 6.08±19.8 cm/s vs. a decrease of - 8.2±20.2 cm/s in HD (p=0.04). Using a cut-off value of 40.5 cm/s, PVV had an AUROC of 0.705 for predicting HD, while the addition of ΔPVV (cut-off 9.5 cm/s) improved the AUROC to 0.78. Conclusion   Despite adequate symptom control, a considerable percentage of patients have a post-TIPS PPG≥12 mmHg. The dynamic assessment of PVV and its temporal dynamics can reliably predict TIPS dysfunction.

Purpose   To detect sonographic abnormalities of the supratentorial structures of the brain - future cavum septum pellucidum, cavum velum interpositum, third ventricle, ganglionic eminence and thalamus/hypothalamus - in fetuses with a crown-rump length of 45-84 mm in high-risk pregnancies. Materials and Methods   This study presents the retrospective analysis of transvaginally recorded 3D volumes of the fetal brain of 64 fetuses whose mothers consulted our ambulatory department for fetomaternal medicine for organic and/or genetic changes of their fetuses at GW 12-14. For this study we selected fetuses with 3D volume blocks of the fetal brain at best sonographic quality enabling detailed analysis and measurement of the supratentorial brain structures to correlate the results with the results of genetic analysis, ultrasound controls in later weeks of pregnancy, and fetal outcome. Results   Of 44 fetuses with genetic changes and 20 fetuses with syndromic changes, structural brain changes were found in 27 fetuses, analyzed by correlating the brain structures with the recently published structures of the brain at gestational week 12-14 in early pregnancy, presenting new details of early pathological brain development - migration disorders, milder variants of holoprosencephaly (lobar, MIH), corpus callosum agenesis, for the first time in early pregnancy. Conclusion   Supratentorial defects of the brain can be detected and analyzed in GW 12-14 in detail by direct analysis of sonopathology and visualization of pathological measurements using transvaginal 3D sonography in high quality.

Purpose We analyzed which contrast-enhanced ultrasound (CEUS) parameters are associated with reduced kidney function in the early postoperative period and are prognostic for kidney function six months after transplantation. Materials and Methods This prospective observational study included 74 patients in whom quantitative CEUS analysis and Doppler ultrasound were performed early after kidney transplantation (10±6 days). For each region of interest (ROI) the time-to-peak intensity (TTP) and the respective delta between ROIs within interlobar artery, cortex, and medulla were compared. Results were correlated with kidney function at the time of imaging and six months later. Results Patients with an eGFR<30 ml/min at the time of investigation had significantly slower cortical enhancement with a longer cortical TTP (cTTP: 16.1±0.9 vs. 11.7±0.7 sec, p<0.001), as well as a significant delay between the arterial and cortical phases (c-a), as shown in longer ∆TTP (c-a): 8.2±0.9 vs. 4.2 ± 0.5 sec, p<0.001. There was a significant negative correlation between cTTP and eGFR with a correlation coefficient of -0.37 (p<0.001), as well as between ∆TTP (c-a) and eGFR with a correlation coefficient of -0.40 (p<0.001). Reduced kidney function after 6 months correlated significantly with the findings of the initial CEUS examination (p=0.005, correlation coefficient -0.39). Conclusion CEUS revealed significant differences in temporal enhancement dynamics in patients with reduced kidney function after transplantation. Quantitative CEUS might therefore be able to depict graft function regarding microvascular damage and be of prognostic value regarding long-term renal outcomes.