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Positive Predictive Value for the Malignancy of Mammographic Abnormalities Based on the Presence of an Ultrasound Correlate. 基于超声相关存在的乳房x线造影异常的恶性肿瘤阳性预测值。
IF 3.2 Q2 Medicine Pub Date : 2022-07-15 eCollection Date: 2022-01-01 DOI: 10.1055/a-1832-1808
Taghreed Alshafeiy, James Patrie, Mohammad Al-Shatouri

Purpose To compare the outcomes of different mammographic lesions based on the presence of an ultrasound (US) correlate and to estimate how often targeted US can identify such lesions. Materials and Methods This retrospective study included all consecutive cases from 2010 to 2016, with Breast Imaging Reporting and Database System (BI-RADS) categories 4 & 5 who underwent US as part of their diagnostic workup. We compared the incidence of malignancy between lesions comprising a US correlate that underwent US-guided core needle biopsy (CNB) and those without a correlate that underwent stereotactic CNB. Results 833 lesions met the study criteria and included masses (64.3%), architectural distortion (19%), asymmetries (4.6%), and calcifications (12.1%). The CNB-based positive predictive value (PPV) was higher for lesions with a US correlate than for those without (40.2% [36.1, 44.4%] vs. 18.9% [14.5, 23.9%], respectively) (p<0.001). Malignancy odds for masses, asymmetries, architectural distortion, and calcifications were greater by 2.70, 4.17, 4.98, and 2.77 times, respectively, for the US-guided CNB (p<0.001, p=0.091, p<0.001, and p=0.034, respectively). Targeted US identified a correlate to 66.3% of the mammographic findings. The odds of finding a correlate were greater for masses (77.8%) than architectural distortions (53.8%) (p<0.001) or calcifications (24.8%) (p<0.001). Conclusion The success of targeted US in identifying a correlate varies significantly according to the type of mammographic lesion. The PPV of lesions with a US correlate was significantly higher than that of those with no correlate. However, the PPV of lesions with no US correlate is high enough (18.9%) to warrant a biopsy.

目的:比较基于超声(US)相关性存在的不同乳腺x线检查病变的结果,并估计靶向超声识别此类病变的频率。材料和方法本回顾性研究包括2010年至2016年所有连续病例,乳腺成像报告和数据库系统(BI-RADS)分类为4和5,接受了超声检查作为诊断工作的一部分。我们比较了包含US相关的病变接受US引导的核心针活检(CNB)和没有相关的病变接受立体定向CNB之间的恶性肿瘤发生率。结果833例病变符合研究标准,包括肿块(64.3%)、结构扭曲(19%)、不对称(4.6%)和钙化(12.1%)。有US相关性病变的基于cnb的阳性预测值(PPV)高于无US相关性病变(分别为40.2% [36.1%,44.4%]vs. 18.9%[14.5, 23.9%])(结论根据乳腺x线检查病变的类型,靶向US识别相关性的成功率有显著差异。有US相关性病变的PPV明显高于无US相关性病变。然而,与US无关的病变的PPV(18.9%)足够高,需要活检。
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引用次数: 0
Correction: Hands-On Time in Simulation-Based Ultrasound Training - A Dose-Related Response Study. 校正:基于模拟的超声训练的实际操作时间-剂量相关反应研究。
IF 3.2 Q2 Medicine Pub Date : 2022-07-06 eCollection Date: 2022-01-01 DOI: 10.1055/a-1885-5971
Oria Mahmood, Rikke Jeong Jørgensen, Kristina Rue Nielsen, Lars Konge, Lene Russell

[This corrects the article DOI: 10.1055/a-1795-5138.].

[这更正了文章DOI: 10.1055/a-1795-5138]。
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引用次数: 0
Hands-On Time in Simulation-Based Ultrasound Training - A Dose-Related Response Study. 模拟超声波培训中的动手时间--剂量相关反应研究。
IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2022-05-03 eCollection Date: 2022-01-01 DOI: 10.1055/a-1795-5138
Oria Mahmood, Rikke Jørgensen, Kristina Nielsen, Lars Konge, Lene Russell

Purpose Point of care ultrasound (POCUS) is widely used, but the sensitivity and specificity of the findings are highly user-dependent. There are many different approaches to ultrasound training. The aim of this study was to explore the effects of hands-on practice when learning POCUS. Methods Junior doctors with no or limited ultrasound experience were included in the study and divided into three groups. They all completed a Focused Assessment with Sonography for Trauma (FAST) course with different amounts of hands-on practice: 40 minutes (n=67), 60 minutes (n=12), and 90 minutes of hands-on time (n=27). By the end of the course, they all completed a previously validated test. Results More hands-on time improved the mean test scores and decreased the test time. The scores of the 40-, 60-, and 90-minute groups were 11.6 (SD 2.1), 12.8 (SD 2.5), and 13.7 (SD 2.5), respectively (p<0.001). The 90-minute group completed the test significantly faster than the other two groups (20 versus 26 minutes, p=0.003). A large inter-individual variation was seen. Conclusion The necessary amount of hands-on training is unknown. This study demonstrates that performance increases with prolonged hands-on time but the inter-individual variation among trainees is very large, thereby making it impossible to define the "optimal" time. This supports the use of the concept of mastery learning where each individual trainee can continue training until proficiency is reached.

目的 护理点超声检查(POCUS)应用广泛,但检查结果的灵敏度和特异性很大程度上取决于用户。超声培训有许多不同的方法。本研究旨在探讨学习 POCUS 时动手实践的效果。研究方法 将没有或仅有有限超声波检查经验的初级医生分为三组。他们都完成了创伤超声重点评估(FAST)课程,并进行了不同程度的动手练习:实践时间分别为 40 分钟(67 人)、60 分钟(12 人)和 90 分钟(27 人)。课程结束时,他们都完成了一项先前验证过的测试。结果 更多的动手时间提高了平均测试分数,减少了测试时间。40 分钟、60 分钟和 90 分钟组的得分分别为 11.6 分(标准差 2.1)、12.8 分(标准差 2.5)和 13.7 分(标准差 2.5)。本研究表明,实训时间越长,成绩越好,但受训者之间的个体差异非常大,因此无法确定 "最佳 "时间。这支持使用掌握学习的概念,即每个受训者都可以继续接受培训,直到达到熟练程度。
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引用次数: 0
Editorial. 社论。
IF 3.2 Q2 Medicine Pub Date : 2022-01-01 DOI: 10.1055/a-1834-2542
Caroline Ewertsen

It is my great pleasure to welcome the first issue of Ultrasound International Open in 2022 even though 2023 is approaching.

尽管2023年即将到来,但我很高兴欢迎2022年第一期《超声国际公开赛》。
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引用次数: 0
Transthoracic Vector Flow Imaging in Pediatric Patients with Valvular Stenosis - A Proof of Concept Study. 经胸矢量流成像在儿童瓣膜狭窄患者中的应用——一项概念验证研究。
IF 3.2 Q2 Medicine Pub Date : 2021-11-17 eCollection Date: 2021-08-01 DOI: 10.1055/a-1652-1261
Tin-Quoc Nguyen, Thor Bechsgaard, Michael Rahbek Schmidt, Klaus Juul, Ramin Moshavegh, Lars Lönn, Michael Bachmann Nielsen, Jørgen Arendt Jensen, Kristoffer Lindskov Hansen

Purpose Continuous wave Doppler ultrasound is routinely used to detect cardiac valve stenoses. Vector flow imaging (VFI) is an angle-independent real-time ultrasound method that can quantify flow complexity. We aimed to evaluate if quantification of flow complexity could reliably assess valvular stenosis in pediatric patients. Materials and Methods Nine pediatric patients with echocardiographically confirmed valvular stenosis were included in the study. VFI and Doppler measurements were compared with transvalvular peak-to-peak pressure differences derived from invasive endovascular catheterization. Results Vector concentration correlated with the catheter measurements before intervention after exclusion of one outlier (r=-0.83, p=0.01), whereas the Doppler method did not (r=0.49, p=0.22). The change in vector concentration after intervention correlated strongly with the change in the measured catheter pressure difference (r=-0.86, p=0.003), while Doppler showed a tendency for a moderate correlation (r=0.63, p=0.07). Conclusion Transthoracic flow complexity quantification calculated from VFI data is feasible and may be useful for assessing valvular stenosis severity in pediatric patients.

目的常规应用连续波多普勒超声检查心脏瓣膜狭窄。矢量流成像(VFI)是一种与角度无关的实时超声成像方法,可以量化流动的复杂性。我们的目的是评估流量复杂性的量化是否可以可靠地评估儿科患者的瓣膜狭窄。材料与方法对9例经超声心动图证实的儿童瓣膜狭窄患者进行研究。将VFI和多普勒测量值与有创血管内插管引起的经瓣膜峰对峰压差进行比较。结果排除1个异常值后,载体浓度与干预前导管测量值相关(r=-0.83, p=0.01),而多普勒法无相关性(r=0.49, p=0.22)。干预后载体浓度的变化与测得导管压差的变化呈强相关性(r=-0.86, p=0.003),多普勒呈中等相关性(r=0.63, p=0.07)。结论利用VFI数据定量计算经胸血流复杂性是可行的,可用于评估儿童瓣膜狭窄的严重程度。
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引用次数: 1
Development of a Standardized Semantic Feature-Based Reporting Proforma for Intraoperative Ultrasound Findings in Brain Tumors and Application in High-Grade Gliomas - A Preliminary Study. 基于标准化语义特征的脑肿瘤术中超声结果报告格式的开发及其在高级别胶质瘤中的应用——初步研究。
IF 3.2 Q2 Medicine Pub Date : 2021-11-17 eCollection Date: 2021-08-01 DOI: 10.1055/a-1637-9550
Prakash Shetty, Vikas Kumar Singh, Amit Choudhari, Aliasgar V Moiyadi

Purpose A semantic feature-based reporting proforma for intraoperative ultrasound findings in brain tumors was devised to standardize reporting. It was applied as a pilot study on a cohort of histologically confirmed high-grade supratentorial gliomas (Grade 3 and 4) for internal validation. Materials and Methods This intraoperative semantic ultrasound proforma was used to evaluate 3D ultrasound volumes using Radiant DICOM software by 3 surgeons. The ultrasound semantic features were correlated with histological features like tumor grade, IDH status, and MIB index. Results 68 patients were analyzed using the semantic proforma. Irregular crenated was the most common margin (63.2%) and lesions were heterogeneously hyperechoic (95.6%). Necrosis was commonly seen and noted as single (67.6%) or multiple (13.2%) in over 80% cases. A separate perilesional zone, which was predominantly hyperechoic in 41.8% and both hypo and hyperechoic in 12.7%, could be identified in 54.5% of cases. Grade 4 tumors were more likely to have an irregular crenated margin (71.2%) with a single large area of necrosis, while Grade 3 tumors were likely to have smooth (31.3%) or non-characterizable margins (31.2%) with no or multiple areas of necrosis. IDH-negative tumors were more likely to have a single large focus of necrosis. Among the GBMs (52 cases), MIB labelling index of>15% was associated with poorly delineated, uncharacterizable margins, when compared with MIB labelling index<15% (23.5 vs. 0%), (p=0.046). Conclusion A detailed semantic proforma was developed for brain tumors and was internally validated. A few ultrasound sematic features were identified correlating with histological features in high-grade gliomas. It will require further external validation for refinement and acceptability.

目的设计一种基于语义特征的脑肿瘤术中超声结果报告格式,以规范报告。它被应用于一组组织学证实的高级别幕上胶质瘤(3级和4级)的初步研究,以进行内部验证。材料与方法3位外科医生采用术中语义超声形式,利用Radiant DICOM软件对三维超声体积进行评估。超声语义特征与肿瘤分级、IDH状态、MIB指数等组织学特征相关。结果对68例患者进行语义形式分析。不规则圆齿是最常见的边缘(63.2%),病变呈异质高回声(95.6%)。坏死常见于单发(67.6%)或多发(13.2%),占80%以上。在54.5%的病例中可以发现一个单独的病灶周围区,41.8%的病例以高回声为主,12.7%的病例低回声和高回声并存。4级肿瘤更可能有不规则的圆齿状边缘(71.2%),伴有单个大面积坏死,而3级肿瘤可能有光滑的边缘(31.3%)或非特征性的边缘(31.2%),没有或多个坏死区域。idh阴性肿瘤更可能有单个大病灶坏死。与MIB标记指数相比,在52例GBMs中,>15%的MIB标记指数与描述不佳、无法表征的边缘相关。结论:为脑肿瘤开发了详细的语义形式,并进行了内部验证。在高级别胶质瘤中发现了一些与组织学特征相关的超声语义特征。它将需要进一步的外部验证以进行细化和可接受性。
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引用次数: 1
Pheochromocytoma and Adrenocortical Carcinoma: Morphological Characteristics in Endoscopic Ultrasound Imaging. 嗜铬细胞瘤和肾上腺皮质癌:内镜超声成像的形态学特征。
IF 3.2 Q2 Medicine Pub Date : 2021-11-17 eCollection Date: 2021-08-01 DOI: 10.1055/a-1626-1678
Neslihan Özkul, Peter Herbert Kann

Purpose Pheochromocytoma (PCC) and adrenocortical carcinoma (ACC) are two rare endocrine diseases. Early diagnosis is crucial to significantly reduce morbidity and mortality. In this study, we used endoscopic ultrasound (EUS) for high-resolution imaging to investigate the endosonographic morphology pattern of PCC and ACC. Materials and Methods This retrospective cohort study included 58 PCC/ACC lesions diagnosed by EUS imaging at two tertiary care centers between 1997 and 2015. The following groups were defined by histology or by the presence of a pheochromocytoma-associated syndrome without histological proof: bPCC (benign PCC), mPCC (malignant PCC), and ACC. Results In our cohort, mPCC tended to be larger at the time of diagnosis (n=5; 39.9±41.9 mm) than bPCC (n=46; 27.3 ±20.8 mm, P=0.548). ACC lesions were significantly larger (n=7; 50.6±14.8 mm) than bPCC and mPCC (n=51; 28.5±23.3 mm, P=0.002). In EUS, bPCC and ACC lesions frequently appeared to have a round shape and nodular structure. bPCC and ACC tended to be more hyperechoic (P=0.112 and P=0.558, respectively) and heterogeneous (P=0.501 and P=0.098, respectively) than mPCC. Compared to PCC, ACC did not show high hyperperfusion (P=0.022). In contrast to adenoma, all tumor entities showed hypo-/anechoic areas within the tumor (P<0.05). Conclusion No significant differences in EUS morphology were found to reliably distinguish benign from malignant PCC and ACC lesions. However, EUS may be a reasonable alternative or complementary method to conventional imaging techniques for the early detection of these tumor entities.

目的嗜铬细胞瘤(PCC)和肾上腺皮质癌(ACC)是两种罕见的内分泌疾病。早期诊断对于显著降低发病率和死亡率至关重要。在这项研究中,我们使用超声内镜(EUS)进行高分辨率成像来研究PCC和ACC的超声形态学特征。材料和方法本回顾性队列研究纳入了1997年至2015年在两个三级保健中心通过EUS成像诊断的58例PCC/ACC病变。根据组织学或有无嗜铬细胞瘤相关综合征而无组织学证据来定义以下组:bPCC(良性PCC)、mPCC(恶性PCC)和ACC。结果在我们的队列中,mPCC在诊断时趋向于较大(n=5;39.9±41.9 mm)比bPCC (n=46;27.3±20.8 mm, P=0.548)。ACC病变明显增大(n=7;50.6±14.8 mm)高于bPCC和mPCC (n=51;28.5±23.3 mm, P=0.002)。在EUS中,bPCC和ACC病变常表现为圆形和结节状结构。与mPCC相比,bPCC和ACC更倾向于高回声(P=0.112和P=0.558)和异质性(P=0.501和P=0.098)。与PCC相比,ACC未出现高灌注(P=0.022)。与腺瘤相比,所有肿瘤实体在肿瘤内均表现为低回声/无回声区(p结论EUS形态学无显著差异,可可靠区分PCC和ACC病变的良恶性。然而,EUS可能是早期发现这些肿瘤实体的一种合理的替代或补充方法,而不是传统的成像技术。
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引用次数: 1
Editorial. 社论。
IF 3.2 Q2 Medicine Pub Date : 2021-10-28 eCollection Date: 2021-04-01 DOI: 10.1055/a-1485-8014
Guntram Lock

Dear Colleagues, It is a special pleasure to introduce the first issue of Ultrasound International Open in a still difficult year - a year, in which many of us had concerns and clinical tasks reaching far beyond basic or clinical science on ultrasonography (US). Thus, I am delighted to draw your attention to some interesting and important new papers teaching us on various aspects of our every day's US practice.

在一个仍然困难的一年里,我们非常荣幸地介绍第一期《超声国际开放》——在这一年里,我们中的许多人都有远远超出超声基础或临床科学的关注和临床任务(美国)。因此,我很高兴地提请您注意一些有趣而重要的新论文,这些论文教授我们日常美国实践的各个方面。
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引用次数: 0
Double Reverse Flow of Orbitary Vessels Following Mechanical Thrombectomy in Acute Ischemic Stroke 急性缺血性脑卒中机械取栓后眼眶血管双逆流
IF 3.2 Q2 Medicine Pub Date : 2021-08-01 DOI: 10.1055/a-1714-0492
Elena Elvira Soler, Nicolás López Hernández, I. Beltrán-Blasco, B. Serrano Serrano
Duplex ultrasound is a noninvasive and rapid technique that offers information on cerebral vascular hemodynamics in real time, which is very useful in acute stroke. Specifically, the orbital study provides important information on collateralization in severe cases of cervical carotid stenosis, showing an inversion of the ophthalmic artery (OA). Less frequently evaluated, hemodynamic changes in the ophthalmic vein provide information on the presence of arteriovenous malformations or fistulas (Erickson SJ et al. Radiology 1989: 173 (2): 511–516). We report a case of ophthalmic artery and vein inversion simultaneously after mechanical thrombectomy (MT).
双工超声是一种无创、快速的技术,可提供实时的脑血管血流动力学信息,在急性脑卒中中非常有用。具体来说,眼眶研究提供了颈动脉狭窄严重病例侧支的重要信息,显示眼动脉内翻(OA)。眼静脉的血流动力学变化提供了是否存在动静脉畸形或瘘管的信息,但很少被评估(Erickson SJ等)。中华放射学杂志,1997,17(2):511-516。我们报告一例机械取栓术后眼球动静脉同时倒置的病例。
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引用次数: 0
Quadricuspid Aortic Valve: Report of a Case Combined with Moderate Ascending Aortic Dilatation. 四尖瓣主动脉瓣:合并中度升主动脉扩张1例报告。
IF 3.2 Q2 Medicine Pub Date : 2021-08-01 Epub Date: 2021-08-26 DOI: 10.1055/a-1543-9673
Boris Zrnic, Slavica Kovačić, Teodora Zaninovic Jurjevic, Marin Ostric
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引用次数: 1
期刊
Ultrasound International Open
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