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Focal Autoimmune Pancreatitis: A Simple Flow Chart for a Challenging Diagnosis. 局灶性自身免疫性胰腺炎:具有挑战性诊断的简单流程图
IF 3.2 Q2 Medicine Pub Date : 2020-12-01 Epub Date: 2021-01-19 DOI: 10.1055/a-1323-4906
Clara Benedetta Conti, Fabrizio Cereatti, Andrea Drago, Roberto Grassia

Autoimmune pancreatitis is a chronic fibroinflammatory autoimmune mediated disease of the pancreas. Clinically, obstructive painless jaundice and upper abdominal pain are the main symptoms. Focal AIP is characterized by segmental involvement of pancreatic parenchyma and it is often radiologically represented by a pancreatic mass. In these cases, the diagnosis can be very challenging, since it may be easily confused with pancreatic cancer. Therefore, we suggest a combined approach of imaging tests as the diagnostic workup. EUS study combined with CEUS and elastography, if available, increases the accuracy of the method to rule out cancer. Moreover, the lesion should always be sampled under EUS guidance to obtain a cyto/histological diagnosis. The diagnostic workup should also include the use of diagnostic clinical criteria (extrapancreatic lesions, steroid response) and laboratory findings (CA 19.9 and IgG4 evaluations).

自身免疫性胰腺炎是一种慢性纤维炎症性自身免疫性胰腺疾病。临床上以梗阻性无痛性黄疸和上腹部疼痛为主要症状。局灶性AIP的特征是胰腺实质的节段性受累,影像学上常表现为胰腺肿块。在这些病例中,诊断非常具有挑战性,因为它很容易与胰腺癌混淆。因此,我们建议结合影像学检查作为诊断检查。超声造影联合超声造影和弹性成像,如果可以的话,增加了排除癌症方法的准确性。此外,病变应始终在EUS指导下取样,以获得细胞/组织学诊断。诊断检查还应包括使用诊断临床标准(胰腺外病变,类固醇反应)和实验室结果(CA 19.9和IgG4评估)。
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引用次数: 3
Point Shear Wave Elastography and the Effect of Physical Exercise, Alcohol Consumption, and Respiration in Healthy Adults. 健康成人的点横波弹性成像及体育锻炼、饮酒和呼吸的影响。
IF 3.2 Q2 Medicine Pub Date : 2020-12-01 Epub Date: 2020-12-08 DOI: 10.1055/a-1298-9642
Victoria Taraldsen, Sunneva Tomasgard, MargretheThune Rudlang, OddHelge Gilja, Mette Vesterhus, AndersBatman Mjelle

Purpose Ultrasound elastography is a noninvasive method for liver stiffness measurement (LSM) with the aim of reflecting approximate liver fibrosis load. Despite minimal evidence, current guidelines recommend 10 min of rest and breath hold prior to measurements and offer no advice concerning recent alcohol consumption, leading to challenges in clinical practice. We aimed to investigate how LSM in healthy adults is influenced by physical exercise, recent alcohol consumption, and respiration. Materials and Methods 42 healthy subjects aged 21-36 years were included. LSM using point shear wave elastography (pSWE) was performed in five stages: baseline, after physical activity, after registration of alcohol consumption, and during breath hold compared to free breathing. Results LSM values were significantly increased following physical exercise compared to baseline values (4.1±0.8 vs. 3.8±0.8 kPa, p=0.01). Alcohol consumption during the last 72 h (0-27 alcohol units) did not significantly affect LSM. There was no significant difference between LSM during breath hold and free breathing. Conclusion In healthy subjects, LSM increased after recent physical exercise, while alcohol consumption 24-72 h prior to examination did not have a significant impact. There was no clinically significant effect of breath hold on LSM. Our study supports present guidelines recommending rest prior to LSM, while indicating that breath hold may not be mandatory. Recent moderate alcohol exposure may affect LSM to a lesser extent than commonly believed.

目的超声弹性成像是一种无创的肝刚度测量方法,旨在反映肝纤维化的近似负荷。尽管证据很少,但目前的指南建议在测量前休息10分钟并屏住呼吸,并没有对近期饮酒提出建议,这给临床实践带来了挑战。我们的目的是调查健康成人的LSM如何受到体育锻炼、最近饮酒和呼吸的影响。材料与方法选取年龄21 ~ 36岁的健康受试者42例。使用点横波弹性成像(pSWE)的LSM分为五个阶段:基线、体力活动后、饮酒登记后和屏气与自由呼吸比较期间。结果运动后LSM值较基线值显著升高(4.1±0.8 kPa vs. 3.8±0.8 kPa, p=0.01)。最后72小时内的酒精消耗(0-27酒精单位)对LSM没有显著影响。屏气与自由呼吸时LSM无显著性差异。结论健康受试者近期体育锻炼后LSM升高,而体检前24-72 h饮酒对LSM无显著影响。屏气对LSM无明显的临床影响。我们的研究支持目前的指导方针,建议在LSM之前休息,同时表明屏气可能不是强制性的。近期适度饮酒对LSM的影响程度可能比通常认为的要小。
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引用次数: 1
Editorial. 社论。
IF 3.2 Q2 Medicine Pub Date : 2020-12-01 Epub Date: 2021-04-15 DOI: 10.1055/a-1304-4111
Adrian Lim

During these difficult and unprecedented times, I am proud to introduce this quarters issue of Ultrasound International Open which is packed with high quality articles.

在这困难和前所未有的时刻,我很自豪地介绍这季度的《超声国际开放》,它充满了高质量的文章。
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引用次数: 0
Unclear Cystic Lesion of the Thumb: A Rare Case of a Mainly Cystic Digital Papillary Adenocarcinoma. 不清楚的拇指囊性病变:1例罕见的以囊性为主的指乳头状腺癌。
IF 3.2 Q2 Medicine Pub Date : 2020-09-01 Epub Date: 2020-11-03 DOI: 10.1055/a-1270-7851
Johannes Deeg, Alexander Loizides, Murat Okcu, Hannes Gruber
Digital papillary adenocarcinoma (DPA) is a malignant neoplasia of the eccrine glands primarily found at the fingers (A. ArsalanWerner et al. Handchirurgie, Mikrochirurgie, plastische Chirurgie 2013; 45: 287–292). It was first described by Helwig 1984 (E. B. Helwig. Journal of Cutaneous Pathology 1984: 11: 415-420). These tumors have metastatic potential (W. H. Duke et al. The American journal of surgical pathology 2000; 24: 775–784) and a high tendency to recur if not fully resected (T. Kobayashi et al. The American Journal of dermatopathology 2016; 38: 910–914). Clinically, these tumors normally present as a painless mass with no signs of inflammation and slow growth over months to years before patients seek medical attention. Imaging diagnosis of digital papillary adenocarcinomas is challenging because there are no specific imaging criteria. We present the case of a 68-year-old male with a local digital papillary adenocarcinoma of the right thumb with cystic appearance. Case Report
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引用次数: 0
Prenatal Diagnosis of FATCO Syndrome (Fibular Aplasia, Tibial Campomelia, and Oligosyndactyly) with 2D/3D Ultrasonography. 产前2D/3D超声诊断FATCO综合征(腓骨发育不全、胫骨扁平、并指少)
IF 3.2 Q2 Medicine Pub Date : 2020-09-01 Epub Date: 2020-10-15 DOI: 10.1055/a-1225-4388
Meisam Izadi, Nasim Salehnia
Introduction Fibular hemimelia is a congenital lower limb anomaly characterized by the partial or complete absence of the fibula. It includes a spectrum ranging from mild fibular hypoplasia to complete fibular aplasia. Although rare in occurrence, it is the most common congenital absence of long bone of the extremities 1.
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引用次数: 3
Collateral Activation of the Early Temporal Branch - A Neurosonological Sign of Distal M1 Middle Cerebral Artery Occlusion. 早期颞支侧支激活——大脑中动脉远端M1闭塞的神经音像学征象。
IF 3.2 Q2 Medicine Pub Date : 2020-09-01 Epub Date: 2020-10-07 DOI: 10.1055/a-1225-4357
Christoph Walter, Gebhard Schmid, Dan Meila, Jan Sobesky
In most cases large vessel occlusion (LVO) in the anterior circulation causes a severe stroke syndrome with a high National Institutes of Health Stroke Scale score (NIHSS). However, there is also a smaller group of patients (up to 10 % of all LVO) presenting with a minor stroke syndrome, transient or even absent neurological symptoms, who may develop early clinical deterioration. They may be candidates for thrombolysis and mechanical thrombectomy (MT). Due to low clinical suspicion, many of these patients are not included in the diagnostic fast track of a comprehensive stroke center with immediate vessel imaging by means of CTor MR-angiography. In this scenario neurosonography can be the first vessel imaging performed. We present such a clinical case and its neurosonographic findings of a distal M1 middle cerebral artery occlusion (MCA) with an emphasis on the early temporal branch (ETB) as an important M1-M2 collateral pathway (aside from established neurosonological signs).
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引用次数: 0
Editorial. 社论。
IF 3.2 Q2 Medicine Pub Date : 2020-09-01 Epub Date: 2020-12-10 DOI: 10.1055/a-1245-6348
Kai-Sven Heling

Dear Colleagues, Now you get a new Issue of Ultrasound International Open. As always you can find a mixture of different articles dealing with the main topic ultrasound.

各位同事,您收到了新一期的《超声国际杂志》。和往常一样,你可以找到各种不同的文章来讨论超声波的主要话题。
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引用次数: 0
Comparison of Chest Ultrasound and Standard X-Ray Imaging in COVID-19 Patients. COVID-19 患者胸部超声与标准 X 射线成像的比较。
IF 3.2 Q2 Medicine Pub Date : 2020-09-01 Epub Date: 2020-09-02 DOI: 10.1055/a-1217-1603
Evgenii Shumilov, Ali Seif Amir Hosseini, Golo Petzold, Hannes Treiber, Joachim Lotz, Volker Ellenrieder, Steffen Kunsch, Albrecht Neesse

Purpose: The COVID-19 pandemic poses new challenges for the medical community due to its large number of patients presenting with varying symptoms. Chest ultrasound (ChUS) may be particularly useful in the early clinical management in suspected COVID-19 patients due to its broad availability and rapid application. We aimed to investigate patterns of ChUS in COVID-19 patients and compare the findings with results from chest X-ray (CRX).

Materials and methods: 24 patients (18 symptomatic, 6 asymptomatic) with confirmed SARS-CoV-2 by polymerase chain reaction underwent bedside ChUS in addition to CRX following admission. Subsequently, the results of ChUS and CRX were compared.

Results: 94% (n=17/18) of patients with respiratory symptoms demonstrated lung abnormalities on ChUS. ChUS was especially useful to detect interstitial syndrome compared to CXR in COVID-19 patients (17/18 vs. 11/18; p<0.02). Of note, ChUS also detected lung consolidations very effectively (14/18 for ChUS vs. 7/18 cases for CXR; p<0.02). Besides pathological B-lines and subpleural consolidations, pleural line abnormality (89%; n=16/18) was the third most common feature in patients with respiratory manifestations of COVID-19 detected by ChUS.

Conclusion: Our findings support the high value of ChUS in the management of COVID-19 patients.

目的:COVID-19 大流行给医疗界带来了新的挑战,因为大量患者表现出不同的症状。胸部超声检查(ChUS)因其广泛普及和快速应用,在疑似 COVID-19 患者的早期临床管理中可能特别有用。我们的目的是研究 COVID-19 患者的胸部超声波检查模式,并将其结果与胸部 X 光检查(CRX)结果进行比较。随后,比较了 ChUS 和 CRX 的结果:结果:94%(n=17/18)有呼吸道症状的患者在 ChUS 检查中发现肺部异常。与 CXR 相比,ChUS 对 COVID-19 患者肺间质综合征的检测尤为有效(17/18 对 11/18;p):我们的研究结果支持 ChUS 在治疗 COVID-19 患者中的重要价值。
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引用次数: 0
Segmental Testicular Infarction - Is Conservative Management Feasible? 节段性睾丸梗死-保守治疗可行吗?
IF 3.2 Q2 Medicine Pub Date : 2020-09-01 Epub Date: 2020-11-10 DOI: 10.1055/a-1270-7795
Camilla Brinkmann Bak-Ipsen, Stine Degn, Linea Sandfeld Blichert-Refsgaard, Tommy Kjærgaard Nielsen, Henriette List, Ole Graumann
Segmental testicular infarction is a relatively uncommon and benign finding. It occurs predominantly in the second and third decade of life. The main symptoms are unilateral and scrotal as seen in more common conditions such as testicular torsion, epididymitis, orchitis, or blunt trauma. The primary testis investigation method is ultrasonography (US) with color Doppler. Normally segmental testicular infarction is seen as a round or wedge-shaped hypoechoic lesion within the testicle in combination with absent or low blood flow. In contrast, vascular testicular lesions are often malignant. However, US alone cannot rule out testicular neoplasms, since hypovascularity of testicular tumors has been described.
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引用次数: 5
Ultrasound Image Optimization ("Knobology"): B-Mode. 超声图像优化(“技术”):b模式。
IF 3.2 Q2 Medicine Pub Date : 2020-06-01 Epub Date: 2020-08-31 DOI: 10.1055/a-1223-1134
David Zander, Sebastian Hüske, Beatrice Hoffmann, Xin-Wu Cui, Yi Dong, Adrian Lim, Christian Jenssen, Axel Löwe, Jonas B H Koch, Christoph F Dietrich

Ultrasound is a ubiquitous and indispensable diagnostic and therapeutic tool in medicine. Due to modern equipment and automatic image optimization, the introduction of ultrasound imaging currently requires only little technical and physical knowledge. However, in-depth knowledge of the device functions and underlying mechanisms is essential for optimal image adjustment and documentation. From a medical as well as an aesthetic point of view, the goal should always be to achieve the best possible image quality. The first part of this article provides an overview of the handling of ultrasound systems, fundamental adjustments, and their optimization in B-mode ultrasound.

超声是医学中普遍存在的、不可缺少的诊断和治疗工具。由于现代化的设备和自动图像优化,引入超声成像目前只需要很少的技术和物理知识。然而,深入了解设备功能和潜在机制对于优化图像调整和文档是必不可少的。从医学和美学的角度来看,目标应该始终是实现最佳的图像质量。本文的第一部分概述了b型超声处理系统,基本调整及其优化。
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引用次数: 35
期刊
Ultrasound International Open
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