Journal of Ultrasonography最新文献

Aim: To investigate the changes in liver stiffness and immune-inflammatory markers associated with obesity and the degree of hepatic steatosis in obese children and adolescents.

Methods: A total of 76 obese children and adolescents aged 6-18 years, with body mass index percentiles >95th, were included in the study. Patients with metabolic syndrome, diabetes mellitus, and chronic liver disease were excluded. A control group of 44 patients of healthy and normal-weight children was included. Laboratory values from the past month were analyzed using patient records. Shear wave elastography and ultrasound examinations were performed on a single device by the same experienced radiologist.

Results: The systemic immune-inflammation index and pan-immune inflammation values were significantly higher in obese patients with hepatic steatosis compared to obese patients without hepatic steatosis (p <0.001). Liver stiffness values were significantly higher in steatotic patients compared to nonsteatotic patients (p <0.001). A significant difference was observed between hepatic steatosis grades in terms of immune-inflammation index and pan-immune inflammation value values (p <0.001). There was a strong, positive, statistically significant correlation between liver stiffness and immune-inflammation index and pan-immune inflammation value (p <0.05).

Conclusions: Immune-inflammatory biomarkers and shear wave elastography may provide valuable insights into the diagnosis and follow-up of inflammation and fibrosis in the evaluation of hepatic steatosis in obese children and adolescents.

Aim: Chronic hepatitis C virus infections can lead to liver fibrosis. Appropriate treatment of chronic hepatitis C may result in significant fibrosis reversal. The best method to assess liver fibrosis is an invasive hepatic biopsy. Among non-invasive options, one of the most recent methods is two-dimensional shearwave elastography, which allows real-time visualization of liver stiffness. The purpose of this study was to analyze changes in liver fibrosis among patients with hepatitis C virus receiving direct-acting antiviral therapy.

Material and methods: Five different elastographic measurements in kilopascals were performed in a group of 50 patients before direct-acting antiviral treatment, at the end of treatment, and 24 weeks after the end of treatment, using an Aixplorer® (Supersonic Imagine, France) ultrasound device. The results were correlated with biochemical serum tests, specifically the Fibrosis-4 and AspAT-to-platelet ratio indices.

Results: Time-dependent alterations of all of the parameters were observed, including a significant decrease in liver stiffness in comparison to baseline values (before treatment). A moderate correlation between liver stiffness measurement values and both Fibrosis-4 and AspAT-to-platelet ratio indices was observed. Interestingly, only liver stiffness and blood platelet count changed over time, regardless of the sex and age of the patient.

Conclusions: Two-dimensional shear-wave elastography combined with non-invasive serologic tests like Fibrosis-4 and AspAT-to-platelet ratio indices is a sufficient tool for evaluating liver fibrosis regression during and after direct-acting antiviral therapy.

Aim: This study aimed to examine the correlations between specific urethral function parameters observed in urodynamic testing and selected urethral characteristics evaluated by pelvic floor ultrasonography. Additionally, the presence of urethral funneling during straining was evaluated in female patients referred for surgical treatment of stress urinary incontinence.

Material and methods: A retrospective study was conducted on 192 female patients referred for surgical treatment of stress urinary incontinence with the use of retropubic tension-free vaginal tape. Maximum urethral closure pressure and functional urethral length were evaluated urodynamically during resting profilometry. Ultrasound measurements, along with the assessment of funneling, were performed as part of the pelvic floor examination, following the technique described by Kociszewski. Patients with clinically significant pelvic organ prolapse, a history of anterior compartment surgery, prior radiotherapy, or symptoms of overactive bladder were excluded from the analysis.

Results: The values obtained from urodynamic and ultrasound examinations were evaluated statistically. No correlation was identified between the analyzed urodynamic and ultrasound parameters. Long urethral funneling was confirmed in all patients with stress urinary incontinence assessed as eligible for the placement of tension-free vaginal tape.

Conclusions: The results indicate that urodynamic and ultrasound examinations assess distinct aspects of urethral anatomy and function, and therefore their findings cannot be used interchangeably. Long urethral funneling assessed during pelvic floor ultrasonography was noted in all patients with clinically and urodynamically confirmed stress urinary incontinence.

Ultrasonography is a reliable imaging technique for the accurate diagnosis and evaluation of musculoskeletal disorders. Recent developments in ultrasound technology have significantly increased image resolution, making it possible to see anatomical features at almost microscopic dimensions. Current standards for standardized shoulder ultrasonography mostly depend on outdated machine types and configurations that may not fully utilize these high-resolution imaging capabilities. In this article, we give a clear and comprehensive introduction to high-resolution shoulder sonography, using histological and anatomical images from cadavers for comparison. Images collected using contemporary technology are shown, and international standard practices are considered. The examination and normal results are presented in a methodical manner, beginning posteriorly, moving frontally, then more anteriorly, and concluding with a lateral and optional axillary examination. This article focuses on the anterior and lateral shoulder.

Aim: There is a need to evaluate the tissue deformation index of lateral abdominal muscles using M-mode ultrasound in a cohort of healthy subjects to establish a convenient reference point for clinical reasoning in patients. The aim of the study was to assess differences in the tissue deformation index between individual lateral abdominal muscles regardless of body side, compare these differences in the tissue deformation index on the right and left sides of the body, and evaluate side-to-side differences in the tissue deformation index within individual lateral abdominal muscles.

Material and methods: In a group of 126 healthy volunteers (59 females), the postural response of lateral abdominal muscles to external perturbation in the form of rapid arm abduction with load was recorded on both sides of the body, and the tissue deformation index was calculated.

Results: The mean values of the tissue deformation index form an increasing gradient from deep to superficial lateral abdominal muscles: 0.06%/ms for the transversus abdominis, 0.084%/ms for the internal oblique and 0.151%/ms for the external oblique (p <0.001). Side-to-side intra-muscle differences were significant only for the transverse abdominis (right: 0.047%/ms; left: 0.070%; p <0.01).

Conclusions: The tissue deformation index values differ significantly among individual lateral abdominal muscles and form a characteristic gradient: transversus abdominis < internal oblique < external oblique. The transversus abdominis muscle shows significant asymmetry in the tissue deformation index between the left and right sides of the body.

Aim: Aiming to offer a diagnostic tool to aid examiners with correct hip typing and decision-making about patient management, members of the Board of the International Interdisciplinary Consensus Committee on DDH Evaluation (ICODE - https://www.icode.expert), introduced the cross-platform mobile application (Android and iOS) called "ICODE Hip US Calculator".

Material and methods: The examination steps of Graf's hip sonography technique were converted into computer code and formed the basis for the development of a mobile phone application. An algorithmic approach, based on a series of conditional sentences, was followed for the development of the application (e.g. if … and … or … then). Coding of the algorithm was carried out by a Greek software development company.

Results: A cross-platform mobile phone application which calculates Graf's hip type (according to the date of birth, the date of examination, and the alpha and beta angles) was constructed. The calculated hip type is then linked to simple management recommendations (discharge, rescan, refer).

Conclusions: "ICODE Hip US Calculator" may be used by trained health professionals to help them decide upon the hip type and the management of the baby after the scan. Hip typing is precisely calculated, and management proposals are simple and straightforward. This means that the application may be used in screening settings to help with patient management, increase the examiner's confidence, and improve patient flow.

Aim: The Nordic hamstring curl appears effective in reducing the incidence of injury in physically active young adults, likely through its capacity as an eccentric exercise to increase muscle stiffness. Although eccentric exercises have been shown to increase muscle stiffness, medium- and long-term Nordic hamstring curl training programs have not demonstrated an effect on muscle stiffness. This study examined the acute effects of a single session of Nordic hamstring curls on the stiffness of the biceps femoris, semitendinosus, and semimembranosus muscles using ultrasound shear wave elastography, an accepted method for measuring passive muscle stiffness.

Material and methods: Twenty physically active adults (ages 19-27 years) were randomly assigned to either the Nordic hamstring curl group (n = 10) or the control group (n = 10). Shear wave elastography was performed on the dominant kicking leg for both groups. The exact location of the probe was marked to ensure the same area was assessed during post-testing. Both groups performed a 5-minute cycle ergometer warm-up followed by three 30-second standing static stretches. The Nordic hamstring curl group then performed three sets of six repetitions of the eccentric phase of the Nordic hamstring curl with 1-minute rest intervals between sets. All subjects then rested for five minutes before shear wave elastography was performed.

Results: Repeated measures ANOVA revealed no significant main effects or interactions for the biceps femoris or semitendinosus (p >0.05). However, analysis of the semimembranosus was inconclusive due to variability of measurement values.

Conclusions: These results are in agreement with findings indicating that long- and short-term Nordic hamstring curl training has no impact on hamstring stiffness, although the effects of Nordic hamstring curl on reducing the probability of hamstring injury are still valid.

Aim: This study aimed to evaluate the effects of diabetes mellitus and cervical dilatation on cesarean section scar healing.

Material and methods: This prospective study included pregnant women diagnosed with diabetes mellitus and healthy control pregnant women. The study group was divided into active labor and pre-active labor based on cervical dilatation, and the diabetic group was categorized into gestational diabetes and preexisting diabetes mellitus. Vaginal ultrasound was performed in the entire study group at six months postpartum, and the location of the cesarean scar was evaluated.

Results: There were 170 participants in the study; 85 were diabetic, and the remaining 85 were healthy controls. Niche frequency in diabetes mellitus cases was not different from that in healthy controls (p = 0.420). The mean residual myometrial thickness, proximal residual myometrial thickness, and distal residual myometrial thickness were lower in the diabetic group (p = 0.001). Residual myometrial thickness and niche presence in the diabetic group with active labor was not statistically different from the diabetic group without active labor (p >0.05). Additionally, residual myometrial thickness was thinner in the gestational diabetes mellitus group than in the preexisting diabetes mellitus group (3.61 ± 1.78 mm vs. 4.76 ± 2.82 mm, p = 0.032).

Conclusions: There was no significant difference in niche frequency between diabetic cases and healthy controls. When comparing the gestational diabetes mellitus group and the preexisting diabetes mellitus groups, there was no difference in the presence of niches. Niche presence was more common in diet-regulated diabetic patients compared with the insulin-regulated group. Cervical dilatation at the time of cesarean section did not affect niche presence in diabetic cases.

Aim: Diastasis recti is a common contour abnormality of the anterior abdominal wall, where an increased distance between the rectus abdominis muscles results in a visible or palpable bulge in this area. This study aimed to characterize this clinical entity in children.

Material and methods: Anatomy of the rectus abdominis muscles and the linea alba, with a special focus on the interrectus distance (distance between two bellies of the rectus abdominis muscles), was studied using ultrasound. Anthropometric and ultrasonographic assessments were performed on 38 children aged 7-12 years. According to the clinical definition of bulging in the epigastrium, diastasis was diagnosed in 12 children (31.6%), significantly more often in boys than in girls (50.0% vs. 6.3%). Other clinical and anthropometric variables, such as age, history of preterm birth, body mass, body mass index, waist circumference, and height, were not significantly associated with diastasis recti.

Results: Diastasis recti, defined by the ultrasonographic criterion of interrectus distance >20 mm, was found in 10 children (26.3%), with no significant differences between boys and girls. Still, there was a moderate agreement between these two modes of diagnosing diastasis: the Cohen's kappa coefficient was 0.49. This suggests that ultrasonographic measurement of the interrectus distance should not be considered an alternative and more precise method of diagnosing diastasis.

Conclusions: Our study indicates that diastasis recti is quite common in the pediatric population, especially among boys. However, more studies are needed in children to understand the functional relevance and natural course of this clinical entity.