Journal of Medical Ultrasound最新文献

Background: Reliable quantification of stroke volume (SV) and left ventricular ejection fraction (LVEF) is essential for point-of-care assessment in hemodynamically compromised patients. Handheld echocardiography (HHE) equipment has entered the market a few years ago and is now available for clinical use. However, the performance of HHE for SV and LVEF quantification in comparison to cardiac magnetic resonance (CMR) imaging as golden standard is yet unknown.

Methods: Twenty volunteers were scanned with HHE, standard echocardiography (SE), and CMR. LVEF and SV were measured with each modality, and their accuracy and precision were evaluated.

Results: Bias and limits of agreement (LOA) between HHE and CMR were -0.21% (-2.89: 2.48) and 11.24% (-15.79: 15.59) for LVEF and 29.85 ml (22.13: 37.57) and 32.34 ml (-15.01: 44.86) for SV, respectively. Bias and LOA between SE and CMR were -0.60% (-3.74:2.55) and 13.16% (-18.85:18.26) for LVEF and 32.08 ml (24.61:39.54) and 31.34 ml (-11.29:43.37) for SV, respectively.

Conclusion: HHE versus CMR showed comparable accuracy and precision compared to SE versus CMR.

Arteriovenous hemodialysis fistulas play a critical role in maintaining life on hemodialysis. With the growing use of Doppler ultrasound in nephrology, its utility has expanded to improve the prognosis and quality of life of patients receiving hemodialysis. On a fistula care team, different health-care professionals, including nephrologists, dialysis technicians, and surgeons or vascular interventionalists, require different information. This review article comprehensively explains how Doppler ultrasound evaluation can be beneficial in the management of arteriovenous fistulas from different perspectives of health-care professionals. The article also introduces the pathophysiology of arteriovenous fistula disease and provides a thorough introduction to the use of Doppler ultrasound for the evaluation of arteriovenous fistulas and their associated diseases, addressing the need for a comprehensive understanding among ultrasound practitioners.

Background: Even with underlying risk factors and limitations, retrograde urethrography (RGU) is the most popular imaging modality in the assessment of anterior urethral stricture. Urethral sonography (SUG) is an able imaging modality in use for the last few years which evaluates anterior urethral stricture without these risks, though it is still not much popular due to its complexity. This prospective study was designed to compare the assessment made on SUG with the results of RGU and to analyze its impact on surgical decision-making when the results of SUG were taken into consideration with RGU.

Methods: Thirty patients with anterior urethral stricture were assessed for stricture location, length, and associated urethral pathologies with RGU and surgery planned accordingly. Later, all were reevaluated with SUG, results compared with that of RGU and surgery replanned, considering both RGU and SUG findings. All results were compared with operative findings.

Results: The mean stricture lengths on SUG, RGU, and surgery were 20.45 mm, 17.15 mm, and 20.38 mm, respectively. Overall sensitivity and specificity of SUG in actual stricture length prediction were 92.3% and 96.1%, whereas these were 78.9% and 85.1%, respectively, on RGU. Spongiofibrosis was assessed only with SUG, that too, with 85%-90% accuracy. Surgical plan was changed in 31% of cases when SUG findings were taken into account along with RGU findings.

Conclusion: SUG was found more precise modality in the measurement of stricture length and more informative and elaborative in providing added knowledge of degree of spongiofibrosis and associated pathologies of diseased urethra and periurethral tissue. For better preoperative planning of anterior urethral strictures, SUG should be added to work-up along with RGU.

We report multi-modality imaging (Ultrasound and Magnetic Resonance Imaging) findings of a rare complication in a multi-gravida patient with history of Asherman syndrome presenting with placenta increta in a cesarean scar ectopic pregnancy. The appropriate diagnosis was established with imaging and patient was managed surgically with total abdominal hysterectomy and bilateral salpingectomy. Asherman syndrome and its management of hysteroscopic adhesiolysis are associated with increased odds of placenta accreta spectrum and postpartum hemorrhage. Patients with Asherman syndrome are considered high risk in pregnancy and should be closely monitored for placental site abnormalities during current and subsequent pregnancies.

Glutaric acidemia type 1 (GA1) presents unique challenges in prenatal diagnosis, especially in cases with no family history. This review article aims to review and present the prenatal ultrasound and magnetic resonance findings of GA1 and consolidate key insights into the difficulties associated with GA1 prenatal diagnosis and the neuroimaging features that require careful differentiation during the diagnostic process.

Background: The lumbar plexus (LP) is a group of nerves located at the fourth lumbar vertebra level, between the anterior two-thirds and posterior one-thirds of the psoas muscle. In this study, the researchers aimed to investigate the spread of latex in injections of LP, suprainguinal fascia iliaca, and circum-psoas planes to assess the different regional techniques for blocking LP nerves (LPNs).

Methods: The study involved performing ultrasound-guided injections of three different colored latexes in six cadavers. The researchers observed and compared the spread of latex in each plane by taking cross sections at the levels of L4, anterior superior iliac spine (ASIS), and sacral foramina (SF). The spread of latex and LPN staining was documented and analyzed through photography.

Results: The results showed that the latex spread within the psoas muscle and fascia iliaca plane (FIP) during LP injections, whereas suprainguinal fascia iliaca injections showed latex dissemination in the FIP at both ASIS and SF levels. On the other hand, circum-psoas injections spread beneath the iliopsoas fascia at both levels and medially toward the external iliac vessels. Despite this spread, there was no communication between the three planes, and there was no mixing of latex from the different injections at any level.

Conclusion: There are distinct fascial planes, for the three approaches, with no communication between them. While latex diffused from LP plane to FIP, no mixing of dye was observed and also the reverse could not be achieved. These findings suggest that different regional techniques for blocking LPNs have their unique planes of action.

This technical note explores the diagnostic potential of ultrasound in assessing age-related changes in the soft tissues of the lower face and neck, with a primary focus on identifying causes of contour deformities and guiding minimally invasive rejuvenation procedures. Seventeen clinical patients with various age-related soft-tissue changes were subjected to ultrasound assessments, targeting issues such as soft-tissue sagging, supra- and subplatysmal adipose tissue excess, platysma thickness, and localization of ptotic platysma strands. The ultrasound examinations successfully identified specific anatomical features contributing to age-related soft-tissue changes in all 17 patients. This information guided tailored treatment plans, resulting in remarkable esthetic improvements in each case. The discussion emphasizes ultrasound's invaluable role as a diagnostic tool for precisely identifying soft-tissue alterations in the lower face and neck. The noninvasive nature and high spatial resolution of ultrasound make it particularly effective for this purpose. The corrective methods guided by ultrasound findings proved to be minimally invasive and yielded successful outcomes in all cases, promoting high levels of patient satisfaction. The study highlights the underutilization of ultrasound's diagnostic potential in clinical practice and highlights the importance of its incorporation into routine assessments. Ultrasound emerges as a cost-effective, noninvasive, and accessible means of accurately diagnosing age-related soft-tissue changes, empowering clinicians to tailor rejuvenation procedures to each patient's unique needs. The hope is that by emphasizing its utility, this study encourages the broader adoption of ultrasound in clinical practice.