Journal of Medical Ultrasound最新文献

Background: The aim of the study was to investigate the correlation of three-dimensional (3D) and two-dimensional (2D) quantitative shear-wave elastography (SWE) with prognostic factors in invasive breast cancer.

Methods: Ninety-four female patients with 94 breast lesions were tested using B-mode ultrasound and SWE. 3D and 2D quantitative SWE characteristics, including elastic modulus standard deviation (E_SD) and maximum elasticity (E_max), were evaluated. The pathological prognostic indicators for breast cancer were assessed, encompassing factors such as tumor dimensions, histological grade, lymph node involvement, the status of histologic biomarkers, and the classification of tumor subtypes. Associations between 3D and 2D quantitative SWE values and prognostic factors of breast tumors were analyzed.

Results: The quantitative parameters E_max and E_SD exhibited a notable correlation with tumor size subgroups (3D: P = 0.002 and P = 0.024; 2D: P = 0.003 and P = 0.008), and had a positive correlation with tumor size (3D: E_max P = 0.379, P = 0.0002, E_SD P = 0.234, P = 0.023; 2D: E_max P = 0.398, P = 0.000, E_SD P = 0.361, P = 0.004). The E_max and E_SD of breast cancer patients exhibiting lymph node metastasis were markedly elevated in comparison to those without lymph node metastasis (3D: P = 0.024 and P = 0.036; 2D: P = 0.031 and P = 0.011). E_max and E_SD except for E_SD in 3D SWE were markedly elevated in Ki-67-positive breast cancers than in negatively expressed breast cancers (3D: P = 0.033 and P = 0.105; 2D: P = 0.044 and P = 0.029). Combined BIRADS and 3D and 2D quantitative parameters demonstrated moderate diagnostic efficacy in predicting lymph node metastasis (area under the curve = 0.714).

Conclusion: 3D and 2D quantitative parameters E_max and E_SD demonstrate significant associations with prognostic factors in invasive breast cancer, including tumor size, lymph node involvement, and Ki-67 expression.

The global rise in demand for minimally invasive esthetic procedures has underscored the need for enhanced precision and safety. This study presents a novel clinical algorithm integrating real-time ultrasound (US) guidance into facial and neck rejuvenation treatments to improve procedural outcomes. Conducted over four years with 56 patients, the study utilized high-frequency B-mode imaging, Doppler functionality, and superb microvascular imaging (SMI) to map anatomical structures, optimize treatment planning, and guide interventions. The algorithm follows a systematic, step-by-step protocol encompassing patient selection, anatomical assessment, procedure execution, and postoperative evaluation. Results indicated a significant improvement in procedural precision, with reduced complication rates and higher patient satisfaction. Notably, 85% of patients rated their outcomes as "much improved" or "very much improved" on the Global Aesthetic Improvement Scale (GAIS). The US-guided approach enabled more accurate filler placement, minimized vascular complications, and improved outcomes compared to traditional techniques. These findings support the integration of US diagnostics in esthetic practice to enhance safety, optimize results, and contribute to the evolving standards of care in non-surgical facial rejuvenation.

A 37-year-old woman was diagnosed with a fibroadenoma (FA) with concomitant extensive spreading of ductal carcinoma in situ (DCIS) and multifocal mucinous carcinomas in 2022. Previously, she was first diagnosed with a FA and received excision in 2016. The initial clinical presentation was a palpable mass in the left breast. During periodic breast ultrasound examination in 2020, another newly developed tumor was found in the same region. A core biopsy revealed a fibroepithelial lesion. The patient received wide excision surgery. The final pathology report indicated a phyllodes tumor (PT) with a clear margin. All three events occurred in the same region (left breast, at 2 O'clock and 3-5 cm from the nipple). Our patient had a relapsed FA, which progressed into a benign PT and FA concomitant with DCIS and multifocal mucinous carcinomas. We report this case to highlight the need for continuous follow-up for FA cases even after complete resection and the possibility of recurrence with other fibroepithelial tumors.

Background: Chronic appendicitis is an uncommon clinical entity. Unlike acute appendicitis, the presence of nonspecific clinical features makes it a challenging diagnosis. Imaging modalities such as ultrasonography and computed tomography (CT) scans aid in the diagnosis of chronic appendicitis. CT scan has been widely described as the investigation of choice in previous studies. However, ultrasonography of the abdomen is a readily available and cheap alternative which provides comparable results and protects from radiation hazards. The aim of this study was to identify the core imaging features of chronic appendicitis on ultrasonography, their correlation with histopathology findings and to establish the most sensitive parameters for radiological diagnosis of chronic appendicitis.

Methods: This was an observational research study which employed a descriptive study design. All patients suffering from chronic/recurrent abdominal pain in the epigastric, periumbilical region or right lower quadrant were included in the study. The patients were subjected to history taking and clinical examination. Ultrasonography was performed by graded compression technique with high-frequency linear transducer. The specimens of the patients undergoing open or laparoscopic appendectomy were sent for histopathology. The preoperative ultrasonography diagnosis was confirmed on histopathology examination.

Results: Based on the statistical analysis of various major and minor criteria that were described in this study, the presence of localized pain in the right iliac fossa coupled with the ultrasonography features of irregularity of appendiceal lumen (sensitivity = 84.2%) and loss of wall stratification (sensitivity = 96.5%), showed a combined sensitivity of more than 99%, which were determined to be the most sensitive parameters for clinicoradiological diagnosis of chronic appendicitis.

Conclusion: Chronic appendicitis has often been misdiagnosed due to atypical symptoms at the time of presentation. Radiological investigations are used in the evaluation of patients with a high degree of clinical suspicion. This article has demonstrated the superiority of ultrasonography over CT scan for imaging of chronic appendicitis due to its advantages such as similar efficacy rates, higher spatial resolution in identifying features of chronic appendicitis, lack of ionizing radiation, cost-effectiveness, and easy availability. However, a definitive diagnosis is achieved by demonstrating evidence of chronic inflammation in the appendectomy specimen at histopathology.

Pelvic floor hiatus (PFH) is the pelvic floor passage through which the pelvic organs pass. Proper PFH closure is essential to maintaining normal pelvic organ support. PFH can be explored with urogenital hiatus or levator hiatus, according to different anatomical definitions. Factors affecting PFH include age, ethnicity, body mass index, levator ani muscle integrity, resting tone, and contraction force of pelvic floor muscle. The ineffectiveness of PFH to stay adequately closed is not only associated with pelvic floor disorders including pelvic organ prolapse (POP) but also accountable for recurrent POP after pelvic floor repairs. Advancing our comprehension of the mechanism of an enlarged PFH and how PFH enlargement affects pelvic floor support would promote better prevention strategies and improved treatments.

Effective fluid management presents a significant challenge for pediatric intensivists. Enhanced ultrasound data that predict adverse outcomes, such as edema and venous congestion, can provide important information about optimal fluid management. The integration of bedside multiorgan ultrasound protocols (Multi-POCUS) mitigates the limitations of individual scoring systems, enabling more accurate fluid monitoring and management. The Tri-POCUS approach, described initially in adult patients, combines lung ultrasound, focused cardiac ultrasound, and venous excess ultrasound, and its application in the pediatric population is proposed. This study examines the Tri-POCUS approach from a pediatric perspective: we applied it to a cohort of critically ill pediatric patients with venous congestion admitted to a pediatric intensive care unit. Four cases are presented to demonstrate the bedside utility of the Tri-POCUS approach in critically ill children with the goal of monitoring venous congestion.

Ultrasound imaging has emerged as a valuable tool in the diagnosis and management of peripheral nerve disorders. The integration of deep learning with ultrasound technology has shown remarkable potential in enhancing diagnostic accuracy and efficiency. This review focuses on the application of deep learning-based approaches in ultrasound diagnostics for peripheral nerve diseases, with particular emphasis on median nerve segmentation in carpal tunnel syndrome. Structured to provide a clear and thorough understanding of the current landscape and future directions, the paper is organized into several key sections: (1) an overview of the current state of the field, (2) research objectives and notable achievements, (3) challenges in dataset utilization specific to medical imaging, (4) trends in the development of deep learning models tailored for ultrasound analysis, and (5) potential future directions for research and clinical application. This review seeks to bridge the gap between technological advancements and clinical practice, potentially paving the way for more accurate and efficient diagnosis and treatment in the field of peripheral nerve disorders.

The present study aimed to review the literature on clinical studies of extracorporeal magnetic innervation (ExMI) for female stress urinary incontinence (SUI). Studies were compiled from PubMed from 1998 to 2025. Clinical studies published in English were included. Nine studies evaluating the effect of ExMI on urinary incontinence were retrieved. Most of the studies are small-sized, single-arm, short-term, and moderate to limited in quality. The efficacy of ExMI to treat SUI is not conclusive throughout studies. Adverse events of ExMI are rarely reported. Well-founded evidence to recommend ExMI as standard treatment for female SUI is still not well established.