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Esophageal Leiomyoma: Case Report. 食管子宫肌瘤:病例报告
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-02-08 eCollection Date: 2024-01-01 DOI: 10.1055/a-2221-6110
Olga Kharlamova, Maksym Zhayvoronok
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引用次数: 0
Bedside Clinical Hand-held Ultrasound in an Internal Medicine Department: The "Bed Med-Us" Experience of Codogno and its Clinical Utility in the Management of Diagnosis and Therapy in 1007 Patients. 内科床旁临床手持超声波:Codogno 的 "Bed Med-Us "经验及其在 1007 名患者的诊断和治疗管理中的临床实用性。
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-01-05 DOI: 10.1055/a-2196-1599
Francesco Giangregorio, Emilio Mosconi, Maria Grazia Debellis, Eliana Palermo, Stella Provini, Manuela Mendozza, Laura Ricevuti, Ciro Esposito

Purpose Handheld ultrasound (HH-US) answers simple clinical questions in emergencies. We performed conventional US with HH-US at the patient's bedside (BED) during a medical visit (MED) (BED MED-US). The purpose of this prospective study is to estimate BED MED-US reliability, its clinical impact in helping the clinician to formulate correct diagnoses, and its ability to save time and money. Materials and Methods 1007 patients (519 M; age:76.42) were assessed (from March 2021 to November 2022) in one or more districts. Final diagnosis was determined with clinical and reference tests (chest RX/CT, abdominal CT, endoscopy, etc.). Sensitivity, specificity, LR+ and LR-, and corresponding AUROC were evaluated. HH-US diagnoses were classified as: confirmation (HH-US revealed the sonographic signs that confirmed the clinical diagnosis) (CO), exclusion (HH-US excluded the presence of the ultrasound signs of other pathologies, in the clinical differential diagnosis) (EX), etiological (HH-US reaches diagnosis in clinically doubtful cases) (ET), or clinically relevant incidental (HH-US diagnoses that change the patient's process completely) (INC). Results HH-US reliability: true-pos: 752; true-neg: 242; false-pos: 7; false-neg: 6 (sens: 99.1%, spec: 97.6%, LR+: 98.5; LR-: 00.15, AUROC: 0.997); clinical impact: CO-diagnosis: 21%; EX: 25%; ET: 47%; INC: 7%; saved time and money: approximately 35,572 minutes of work and 9324 euros. Conclusion BED MED-US is a reliable clinical imaging system, with an important clinical impact both in diagnosis (etiological in 47%, incidental in 7%) and in the management of personnel resources.

目的 手持式超声波(HH-US)可解答急诊中的简单临床问题。我们在就诊期间(MED)在病人床边(BED)用 HH-US 进行了传统超声检查(BED MED-US)。这项前瞻性研究的目的是评估 BED MED-US 的可靠性、其在帮助临床医生做出正确诊断方面的临床效果以及其节省时间和金钱的能力。材料和方法 在一个或多个地区对 1007 名患者(519 名男性;年龄:76.42 岁)进行了评估(从 2021 年 3 月到 2022 年 11 月)。通过临床和参考检查(胸部 RX/CT、腹部 CT、内窥镜检查等)确定最终诊断。对敏感性、特异性、LR+ 和 LR- 以及相应的 AUROC 进行了评估。HH-US 诊断分为:确诊(HH-US 发现的超声波征象证实了临床诊断)(CO)、排除(HH-US 在临床鉴别诊断中排除了其他病变的超声波征象)(EX)、病因诊断(HH-US 在临床可疑病例中得出诊断)(ET)或临床相关附带诊断(HH-US 诊断完全改变了患者的病程)(INC)。结果 HH-US 可靠性:true-pos:真阳性:752 例;真阴性:242 例;假阳性:7 例;假阴性:6 例:7; false-neg: 6 (sens: 99.1%, spec: 97.6%, LR+: 98.5; LR-: 00.15, AUROC: 0.997);临床影响:临床影响:CO-诊断:21%;EX:25%;ET:47%;INC:7%;节省的时间和金钱:约 35,572 分钟的工作时间和 9324 欧元。结论 BED MED-US 是一种可靠的临床成像系统,在诊断(47% 为病因诊断,7% 为偶然诊断)和人力资源管理方面都具有重要的临床影响。
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引用次数: 0
Persistent Funic Presentation And Sonographic Assesment Of The Risk For Umbilical Cord Prolapse. 脐带脱垂风险的持续绒毛表现和超声评估
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-12-14 eCollection Date: 2023-01-01 DOI: 10.1055/a-2097-5143
Ioakeim Sapantzoglou, Alexandros Psarris, Panagiota Diamantopoulou, Antonis Koutras, Thomas Ntounis, Savia Pittokopitou, Ioannis Prokopakis, Panagiotis Antsaklis, Marianna Theodora, Michail Sindos, Ekaterini Domali, Alexandros Rodolakis, Georgios Daskalakis
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引用次数: 0
Structured Reporting of Head and Neck Sonography Achieves Substantial Interrater Reliability. 头颈部声像图的结构化报告实现了实质性的询问可靠性。
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-10-05 eCollection Date: 2023-01-01 DOI: 10.1055/a-2173-3966
Benjamin Philipp Ernst, Carla Dörsching, Alessandro Bozzato, Jennis Gabrielpillai, Sven Becker, Matthias Frank Froelich, Benedikt Kramer, Christoph Sproll, Mirco Schapher, Miguel Goncalves, Naglaa Mansour, Benedikt Hofauer, Wieland H Sommer, Felix von Scotti, Johannes Matthias Weimer, Julian Künzel

Purpose Ultrasound examinations are often criticized for having higher examiner dependency compared to other imaging techniques. Compared to free-text reporting, structured reporting (SR) of head and neck sonography (HNS) achieves superior time efficiency as well as report quality. However, there are no findings concerning the influence of SR on the interrater reliability (IRR) of HNS. Materials and Methods Typical pathologies (n=4) in HNS were documented by video/images by two certified head and neck ultrasound instructors. Consequently, structured reports of these videos/images were created by n=9 senior physicians at departments of otolaryngology or maxillofacial surgery with DEGUM instructors on staff. Reports (n=36) were evaluated regarding overall completeness and IRR. Additionally, user satisfaction was assessed by a visual analog scale (VAS). Results SR yielded very high report completeness (91.8%) in all four cases with a substantial IRR (Fleiss' κ 0.73). Interrater agreement was high at 87.2% with very good user satisfaction (VAS 8.6). Conclusion SR has the potential to ensure high-quality examination reports with substantial comparability and very high user satisfaction. Furthermore, big data collection and analysis are facilitated by SR. Therefore, process quality, workflow, and scientific output are potentially enhanced by SR.

目的超声检查经常被批评为与其他成像技术相比具有更高的检查依赖性。与自由文本报告相比,头颈部超声(HNS)的结构化报告(SR)实现了卓越的时间效率和报告质量。然而,还没有发现SR对HNS的参与者间可靠性(IRR)的影响。材料和方法HNS的典型病理(n=4)由两名经认证的头颈部超声讲师通过视频/图像记录。因此,这些视频/图像的结构化报告是由耳鼻喉科或颌面外科的n=9名高级医生在DEGUM教员的指导下创建的。对报告(n=36)的总体完整性和内部收益率进行了评估。此外,用户满意度通过视觉模拟量表(VAS)进行评估。结果SR在所有四个病例中都产生了非常高的报告完整性(91.8%),具有显著的IRR(Fleiss'κ0.73)。询问者一致性高达87.2%,用户满意度非常好(VAS 8.6)。结论SR有可能确保高质量的检查报告,具有实质性的可比性和非常高的用户满意度。此外,SR有助于大数据的收集和分析。因此,SR有可能提高流程质量、工作流程和科学产出。
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引用次数: 0
Caesarean Scar Pregnancy: Single Dose of Intrasac Ultrasound-Guided Methotrexate Injection Seems to be a Safe Option for Treatment. 剖腹产瘢痕妊娠:单剂量囊内超声引导甲氨蝶呤注射似乎是一种安全的治疗选择。
IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-09-18 eCollection Date: 2023-01-01 DOI: 10.1055/a-2137-8318
Angeliki Rouvalis, Panagiotis Vlastarakos, Georgios Daskalakis, Abraham Pouliakis, Sofoklis Stavrou, Maria Tsiriva, Maria Giourga, Angeliki Gerede, Kalliopi Pappa, Themos Gregoriadis, Dimitrios-Efthymios Vlachos, Alexandros Rodolakis, Ekaterini Domali

Objective: The purpose of the study was to assess the efficacy of local ultrasound-guided methotrexate injection in patients with caesarean section scar pregnancy, to chart the course of beta-human chorionic gonadotropin levels (HCG) after treatment, and to see if HCG levels are correlated with clinical presentation.

Methods: Between May 2018 and January 2021, data were collected retrospectively from the Early Pregnancy Unit of a tertiary hospital.

Results: Our clinic assessed 20 patients; one disputed terminating the pregnancy and was not included in the research. The remaining 19 patients, with a median age of 34 years, received intragestational sac methotrexate injection under ultrasound guidance. 7w3d was the median gestational age. These women had one to four previous caesarean sections, with a mean of 1.60±9. Patients with caesarean scar pregnancy most typically presented with spotting (42.1%), whereas 26.3% were asymptomatic. Except in cases of pain, the symptomatic women's HCG levels were lower than in the non-symptomatic women. The level of HCG in patients with pain was approximately double that of non-pain patients (p=0.2557). In our series, intragestational sac methotrexate injection was effective in 17/19 women, or 89.5% (95%CI: 75.7-100%). HCG levels were undetectable in 97.6±30 days on average (minimum: 42 days, maximum: 147 days).

Conclusion: Caesarean scar pregnancy is a rare possibly fatal condition with no consensus on the optimal treatment. An experienced Early Pregnancy Unit member performing local methotrexate injections under ultrasound guidance is a feasible and successful strategy in clinically stable patients.

目的:本研究旨在评估局部超声引导下注射甲氨蝶呤治疗剖宫产瘢痕妊娠的疗效,绘制治疗后β-人绒毛膜促性腺激素水平(HCG)的变化过程,并观察HCG水平是否与临床表现相关。方法:在2018年5月至2021年1月期间,从一家三级医院的早孕病房回顾性收集数据。结果:我们的诊所评估了20名患者;其中一人对终止妊娠提出了质疑,并没有被纳入研究。其余19名患者,中位年龄34岁,在超声引导下接受孕囊内注射甲氨蝶呤。7w3d为中位胎龄。这些妇女之前有一到四次剖腹产,平均值为1.60±9。剖腹产瘢痕妊娠患者最常见的是斑点(42.1%),而26.3%的患者没有症状。除疼痛外,有症状的妇女的HCG水平低于无症状的妇女。疼痛患者的HCG水平大约是非疼痛患者的两倍(p=0.2557)。在我们的系列中,孕囊内注射甲氨蝶呤对17/19名女性有效,或89.5%(95%可信区间:75.7-100%)。HCG水平平均在97.6±30天(最小:42天,最大:147天)内检测不到。经验丰富的早孕科成员在超声指导下进行局部甲氨蝶呤注射是临床稳定患者可行且成功的策略。
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引用次数: 0
Evaluation of IOTA-ADNEX Model and Simple Rules for Identifying Adnexal Masses by Operators with Varying Levels of Expertise: A Single-Center Diagnostic Accuracy Study. 评估IOTA-ADNEX模型和简单规则识别附件肿块由操作员具有不同水平的专业知识:单中心诊断准确性研究。
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-01-01 DOI: 10.1055/a-2044-2855
Maria Giourga, Abraham Pouliakis, Panagiotis Vlastarakos, Sofoklis Stavrou, Maria Tsiriva, Angeliki Gerede, Georgios Daskalakis, Charalampos Voros, Petros Drakakis, Ekaterini Domali

Objectives The discrimination of ovarian lesions presents a significant problem in everyday clinical practice with ultrasonography appearing to be the most effective diagnostic technique. The aim of our study was to externally evaluate the performance of different diagnostic models when applied by examiners with various levels of experience. Methods This was a diagnostic accuracy study including women who were admitted for adnexal masses, between July 2018 and April 2021, to a Greek tertiary oncology center. Preoperatively sonographic data were evaluated by an expert gynecologist, a 6 th and a 1 st year gynecology resident, who applied the International Ovarian Tumor Analysis (IOTA) Simple Rules (SR) and Assessment of Different NEoplasias in the adneXa (ADNEX) model to discriminate between benign and malignant ovarian tumors. The explant pathology report was used as the reference diagnosis. Kappa statistics were used for the investigation of the level of agreement between the examined systems and the raters. Results We included 66 women, 39 with benign and 27 with malignant ovarian tumors. ADNEX (with and without "CA-125") had high sensitivity (96-100%) when applied by all raters but a rather low specificity (36%) when applied by the 1st year resident. SR could not be applied in 6% to 17% of the cases. It had slightly lower sensitivity, higher specificity, and higher overall accuracy, especially when applied by the 1st year resident (61% vs. 92%), compared to ADNEX. Conclusion Both ADNEX and SR can be utilized for screening in non-oncology centers since they offer high sensitivity even when used by less experienced examiners. In the hands of inexperienced examiners, SR appears to be the best model for assessing ovarian lesions.

目的卵巢病变的鉴别是临床实践中的一个重要问题,超声检查是最有效的诊断方法。我们研究的目的是外部评估不同的诊断模型的性能时,审查员应用不同水平的经验。方法:这是一项诊断准确性研究,包括2018年7月至2021年4月期间因附件肿块入住希腊三级肿瘤中心的女性。术前超声资料由妇科专家、第6年和第1年妇科住院医师评估,他们应用国际卵巢肿瘤分析(IOTA)简单规则(SR)和不同肿瘤在adneXa (ADNEX)模型中的评估来区分卵巢良恶性肿瘤。外植体病理报告作为诊断参考。Kappa统计用于调查被检查系统和评分者之间的协议水平。结果66例女性,其中良性卵巢肿瘤39例,恶性卵巢肿瘤27例。ADNEX(带或不带CA-125)在所有评分者中均具有高灵敏度(96-100%),但在第一年住院医师中应用时特异性较低(36%)。6% ~ 17%的病例不能应用SR。与ADNEX相比,它的敏感性略低,特异性更高,总体准确性更高,特别是在第一年住院医生中应用时(61%对92%)。结论ADNEX和SR均可用于非肿瘤中心的筛查,因为即使由经验不足的检查人员使用,它们也具有较高的灵敏度。在没有经验的检查人员手中,SR似乎是评估卵巢病变的最佳模型。
{"title":"Evaluation of IOTA-ADNEX Model and Simple Rules for Identifying Adnexal Masses by Operators with Varying Levels of Expertise: A Single-Center Diagnostic Accuracy Study.","authors":"Maria Giourga,&nbsp;Abraham Pouliakis,&nbsp;Panagiotis Vlastarakos,&nbsp;Sofoklis Stavrou,&nbsp;Maria Tsiriva,&nbsp;Angeliki Gerede,&nbsp;Georgios Daskalakis,&nbsp;Charalampos Voros,&nbsp;Petros Drakakis,&nbsp;Ekaterini Domali","doi":"10.1055/a-2044-2855","DOIUrl":"https://doi.org/10.1055/a-2044-2855","url":null,"abstract":"<p><p><b>Objectives</b> The discrimination of ovarian lesions presents a significant problem in everyday clinical practice with ultrasonography appearing to be the most effective diagnostic technique. The aim of our study was to externally evaluate the performance of different diagnostic models when applied by examiners with various levels of experience. <b>Methods</b> This was a diagnostic accuracy study including women who were admitted for adnexal masses, between July 2018 and April 2021, to a Greek tertiary oncology center. Preoperatively sonographic data were evaluated by an expert gynecologist, a 6 <sup>th</sup> and a 1 <sup>st</sup> year gynecology resident, who applied the International Ovarian Tumor Analysis (IOTA) Simple Rules (SR) and Assessment of Different NEoplasias in the adneXa (ADNEX) model to discriminate between benign and malignant ovarian tumors. The explant pathology report was used as the reference diagnosis. Kappa statistics were used for the investigation of the level of agreement between the examined systems and the raters. <b>Results</b> We included 66 women, 39 with benign and 27 with malignant ovarian tumors. ADNEX (with and without \"CA-125\") had high sensitivity (96-100%) when applied by all raters but a rather low specificity (36%) when applied by the 1st year resident. SR could not be applied in 6% to 17% of the cases. It had slightly lower sensitivity, higher specificity, and higher overall accuracy, especially when applied by the 1st year resident (61% vs. 92%), compared to ADNEX. <b>Conclusion</b> Both ADNEX and SR can be utilized for screening in non-oncology centers since they offer high sensitivity even when used by less experienced examiners. In the hands of inexperienced examiners, SR appears to be the best model for assessing ovarian lesions.</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"9 1","pages":"E11-E17"},"PeriodicalIF":3.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e9/da/10-1055-a-2044-2855.PMC10446913.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10073083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quantification of Portal Vein Vascularization Using an Automated Post-Processing Video Analysis Tool. 使用自动后处理视频分析工具定量门静脉血管化。
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-01-01 DOI: 10.1055/a-1999-7818
Valentin Blank, Maria Heni, Thomas Karlas

Purpose Blood flow dynamics represent a diagnostic criterion for many diseases. However, no established reference standard is available. In clinical practice, ultrasound pulsed-wave Doppler (PW-Doppler) is frequently used to assess visceral blood flow, despite its well-known limitations. A quantitative analysis of conventional color Doppler patterns can be performed using an innovative ultrasound-based algorithm (pixel flow analysis, PFA). This tool already shows promising results in obstetrics, but the technique has not yet been evaluated for portal venous blood flow assessment. Methods This prospective exploratory research study evaluated the applicability of PFA in the portal venous system. Measurements of portal venous flow using PFA and PW-Doppler were compared in healthy volunteers (n=20) and in patients with hepatic steatosis (n=10) and liver cirrhosis (n=10). Results In healthy volunteers (60% female, mean age 23 years, BMI 21.5 kg/m 2 [20.4-23.8]), PFA and PW-Doppler showed a strong positive correlation in fasting conditions (r=0.69; 95% CI 0.36-0.87), recording a median blood flow of 834 ml/min (624-1066) and 718 ml/min (620-811), respectively. PFA was also applicable in patients with chronic liver diseases (55% female, age 65 years (55-72); BMI 27.8 kg/m 2 (25.4-30.8)), but the correlation between PFA and PW-Doppler was poor (r=- 0.09) in the subgroup with steatosis. A better correlation (r=0.61) was observed in patients with liver cirrhosis. Conclusion PFA and PW-Doppler assessment of portal venous vascularization showed high agreement in healthy volunteers and patients with liver cirrhosis. Therefore, PFA represents a possible alternative to conventional PW-Doppler sonography for visceral blood flow diagnostics and merits further evaluation.

目的血流动力学是许多疾病的诊断标准。然而,没有既定的参考标准。在临床实践中,超声脉冲波多普勒(PW-Doppler)经常用于评估内脏血流,尽管它众所周知的局限性。传统彩色多普勒模式的定量分析可以使用一种创新的基于超声的算法(像素流分析,PFA)进行。该工具已经在产科中显示出有希望的结果,但该技术尚未用于门静脉血流量评估。方法本前瞻性探索性研究评价PFA在门静脉系统中的适用性。我们比较了健康志愿者(n=20)和肝脂肪变性患者(n=10)和肝硬化患者(n=10)使用PFA和PW-Doppler测量门静脉流量的情况。结果在健康志愿者(60%为女性,平均年龄23岁,BMI 21.5 kg/ m2[20.4-23.8])中,PFA和PW-Doppler在空腹状态下呈强正相关(r=0.69;95% CI 0.36-0.87),记录中位血流量分别为834 ml/min(624-1066)和718 ml/min(620-811)。PFA也适用于慢性肝病患者(55%为女性,65岁(55-72岁);BMI 27.8 kg/ m2(25.4-30.8)),但脂肪变性亚组PFA和PW-Doppler相关性较差(r=- 0.09)。肝硬化患者的相关性更好(r=0.61)。结论PFA和pw -多普勒评价门静脉血管化在健康志愿者和肝硬化患者中具有较高的一致性。因此,PFA代表了常规pw -多普勒超声诊断内脏血流的可能替代方案,值得进一步评估。
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引用次数: 0
Doppler Ultrasound of Vascular Complications After Pediatric Liver Transplantation: Incidence, Time of Detection, and Positive Predictive Value. 儿童肝移植后血管并发症的多普勒超声:发生率、检测时间和阳性预测值。
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2022-11-01 DOI: 10.1055/a-1961-9100
Martijn V Verhagen, Ruben H J de Kleine, Hubert P J van der Doef, Thomas C Kwee, Robbert J de Haas

Purpose Doppler ultrasound (DUS) is widely used to detect vascular complications after pediatric liver transplantation (LT). This study aimed to assess the moment of first detection of vascular complications with DUS, and to determine the positive predictive value (PPV) of DUS. Materials and Methods Patients aged 0-18 years who underwent LT between 2015 and 2019 were retrospectively included. 92 LTs in 83 patients were included (median age: 3.9 years, interquartile range: 0.7-10.5). Patients underwent perioperative (intra-operative and immediately postoperative) and daily DUS surveillance during the first postoperative week, and at 1, 3, and 12 months. Vascular complications were categorized for the hepatic artery, portal vein, and hepatic veins. DUS findings were compared to surgical or radiological findings during the 1-year follow-up. Results 52 vascular complications were diagnosed by DUS in 35/92 LTs (38%). 15 out of 52 (28.8%) were diagnosed perioperatively, 29/52 (55.8%) were diagnosed on postoperative days 1-7, and 8/52 (15.4%) after day 7. The PPV for all vascular complications diagnosed with DUS was 92.3%. During the 1-year follow-up, 18/19 (94.7%) hepatic artery complications, 19/26 (73.1%) portal vein complications, and 7/7 (100%) hepatic vein complications were diagnosed perioperatively or during the first week. Conclusion The majority of vascular complications during the first year after pediatric LT were diagnosed by DUS perioperatively or during the first week, with a high PPV. Our findings provide important information regarding when to expect different types of vascular complications on DUS, which might improve DUS post-LT surveillance protocols.

目的多普勒超声(DUS)广泛应用于小儿肝移植术后血管并发症的检测。本研究旨在评估DUS首次发现血管并发症的时刻,并确定DUS的阳性预测值(positive predictive value, PPV)。材料和方法回顾性纳入2015 - 2019年间0-18岁接受肝移植的患者。纳入83例患者的92例LTs(中位年龄:3.9岁,四分位数范围:0.7-10.5)。患者在术后第一周、1个月、3个月和12个月接受围手术期(术中和术后立即)和每日DUS监测。血管并发症分为肝动脉、门静脉和肝静脉。在1年的随访期间,将DUS结果与手术或放射学结果进行比较。结果35/92例LTs中,DUS诊断血管并发症52例(38%)。52例患者中,围手术期确诊15例(28.8%),术后1 ~ 7天确诊29例(55.8%),术后7天确诊8例(15.4%)。DUS诊断的所有血管并发症的PPV为92.3%。1年随访中,围手术期或术后第一周诊断出肝动脉并发症18/19(94.7%),门静脉并发症19/26(73.1%),肝静脉并发症7/7(100%)。结论儿童LT术后第一年的血管并发症以围手术期或术后第一周的DUS诊断为主,且PPV较高。我们的研究结果提供了关于何时期望DUS出现不同类型血管并发症的重要信息,这可能会改善DUS后lt的监测方案。
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引用次数: 3
Correction: Doppler Ultrasound of Vascular Complications After Pediatric Liver Transplantation: Incidence, Time of Detection, and Positive Predictive Value. 修正:儿童肝移植后血管并发症的多普勒超声:发生率、检测时间和阳性预测值。
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2022-11-01 DOI: 10.1055/a-2061-8073
Martijn V Verhagen, Ruben H J de Kleine, Hubert P J van der Doef, Thomas C Kwee, Robbert J de Haas

[This corrects the article DOI: 10.1055/a-1961-9100.].

[此更正文章DOI: 10.1055/a-1961-9100.]。
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引用次数: 0
Diagnostic Accuracy of a Bespoke Multiorgan Ultrasound Approach in Suspected Pulmonary Embolism. 定制多器官超声入路诊断疑似肺栓塞的准确性。
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2022-11-01 DOI: 10.1055/a-1971-7454
Casper Falster, Gro Egholm, Rune Wiig, Mikael Kjær Poulsen, Jacob Eifer Møller, Stefan Posth, Mikkel Brabrand, Christian Borbjerg Laursen

Purpose The aims of this study were to prospectively assess the diagnostic accuracy of a bespoke multiorgan point-of-care ultrasound approach for suspected pulmonary embolism and evaluate if this model allows reduced referral to further radiation diagnostics while maintaining safety standards. Materials and Methods Patients with suspected pulmonary embolism referred for CT pulmonary angiography or ventilation/perfusion scintigraphy were included as a convenience sample. All patients were subject to blinded ultrasound investigation with cardiac, lung, and deep venous ultrasound. The sensitivity and specificity of applied ultrasound signs and the hypothetical reduction in the need for further diagnostic workup were calculated. Results 75 patients were prospectively enrolled. The Wells score was below 2 in 48 patients, between 2 and 6 in 24 patients, and above 6 in 3 patients. The prevalence of pulmonary embolism was 28%. The most notable ultrasound signs were presence of a deep venous thrombus, at least two hypoechoic pleural-based lesions, the D-sign, the 60/60-sign, and a visible right ventricular thrombus which all had a specificity of 100%. Additionally, a multiorgan ultrasound investigation with no findings compatible with pulmonary embolism yielded a sensitivity of 95.2% (95%CI: 76.2-99.9). CT or scintigraphy could be safely avoided in 70% of cases (95%CI: 63.0-83.1%). Conclusion The findings of our study suggest that implementation of a multiorgan ultrasound assessment in patients with suspected pulmonary embolism may safely reduce the need for CT or scintigraphy by confirming or dismissing the suspicion.

本研究的目的是前瞻性地评估一种定制的多器官点护理超声方法对疑似肺栓塞的诊断准确性,并评估该模型是否可以在保持安全标准的同时减少进一步放射诊断的转诊。材料与方法将行CT肺血管造影或通气/灌注显像的疑似肺栓塞患者作为方便样本。所有患者均接受心、肺、深静脉超声盲法检查。计算应用超声征象的敏感性和特异性以及减少进一步诊断检查的假设需要。结果前瞻性纳入75例患者。48例患者的Wells评分低于2分,24例患者在2 - 6分之间,3例患者在6分以上。肺栓塞的患病率为28%。最显著的超声征象是深静脉血栓、至少两个胸膜低回声病变、d征、60/60征和可见的右心室血栓,这些征象的特异性均为100%。此外,多器官超声检查未发现与肺栓塞相符的结果,敏感性为95.2% (95%CI: 76.2-99.9)。70%的病例可以安全避免CT或显像检查(95%CI: 63.0 ~ 83.1%)。结论我们的研究结果表明,对疑似肺栓塞的患者实施多器官超声评估可以通过确认或排除怀疑来安全减少对CT或显像的需求。
{"title":"Diagnostic Accuracy of a Bespoke Multiorgan Ultrasound Approach in Suspected Pulmonary Embolism.","authors":"Casper Falster,&nbsp;Gro Egholm,&nbsp;Rune Wiig,&nbsp;Mikael Kjær Poulsen,&nbsp;Jacob Eifer Møller,&nbsp;Stefan Posth,&nbsp;Mikkel Brabrand,&nbsp;Christian Borbjerg Laursen","doi":"10.1055/a-1971-7454","DOIUrl":"https://doi.org/10.1055/a-1971-7454","url":null,"abstract":"<p><p><b>Purpose</b> The aims of this study were to prospectively assess the diagnostic accuracy of a bespoke multiorgan point-of-care ultrasound approach for suspected pulmonary embolism and evaluate if this model allows reduced referral to further radiation diagnostics while maintaining safety standards. <b>Materials and Methods</b> Patients with suspected pulmonary embolism referred for CT pulmonary angiography or ventilation/perfusion scintigraphy were included as a convenience sample. All patients were subject to blinded ultrasound investigation with cardiac, lung, and deep venous ultrasound. The sensitivity and specificity of applied ultrasound signs and the hypothetical reduction in the need for further diagnostic workup were calculated. <b>Results</b> 75 patients were prospectively enrolled. The Wells score was below 2 in 48 patients, between 2 and 6 in 24 patients, and above 6 in 3 patients. The prevalence of pulmonary embolism was 28%. The most notable ultrasound signs were presence of a deep venous thrombus, at least two hypoechoic pleural-based lesions, the D-sign, the 60/60-sign, and a visible right ventricular thrombus which all had a specificity of 100%. Additionally, a multiorgan ultrasound investigation with no findings compatible with pulmonary embolism yielded a sensitivity of 95.2% (95%CI: 76.2-99.9). CT or scintigraphy could be safely avoided in 70% of cases (95%CI: 63.0-83.1%). <b>Conclusion</b> The findings of our study suggest that implementation of a multiorgan ultrasound assessment in patients with suspected pulmonary embolism may safely reduce the need for CT or scintigraphy by confirming or dismissing the suspicion.</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"8 2","pages":"E59-E67"},"PeriodicalIF":3.2,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/30/5e/10-1055-a-1971-7454.PMC9886498.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9209011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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Ultrasound International Open
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