Journal of Ultrasonography最新文献

Aim: The aim of the study was to assess the effect of pelvic floor contraction on urethral mobility and the size of the urogenital hiatus, as well as to compare two ultrasonographic approaches for the assessment of urethral mobility: transperineal with a transabdominal probe and transvestibular with a transvaginal transducer.

Materials and methods: Modified Oxford Scale (MOS) was used for clinical evaluation of muscle contraction. The parameters obtained in both ultrasound approaches were assessed for all six Oxford grades. The values of ΔH, ΔD and vector, measured at rest and on pelvic floor muscle contraction, were used to evaluate urethral mobility parameters in both ultrasound methods. Patients with a history of urogynecological surgery, pelvic radiotherapy, significant pelvic prolapse (grade 2 or grater in at least one compartment), as well as those with unilateral or bilateral complete avulsion of the puborectalis muscle were excluded.

Results: A total of 272 women were included in the analysis. A statistically significant correlation was found between the contraction force and urethral mobility parameters ΔH and vector-positive and ΔD-negative, obtained in both ultrasound approaches. However, no correlation was demonstrated between the contraction force and changes in the analyzed hiatal parameters. The Bland-Altman analysis showed a high agreement of both measurement methods.

Conclusions: The force of pelvic floor muscle contraction, as measured with the Oxford Scale, correlated with urethral mobility in both ultrasound examinations. Assessment of urethral mobility using the three assessed parameters (ΔH, ΔD, vector) allows for the most comprehensive analysis. Only minor differences were found in the analyzed urethral mobility parameters between both ultrasonographic approaches. The impact of pelvic floor muscle contraction on the size of the urogenital hiatus was not confirmed.

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.

Introduction: The recognition of molecular subtypes of breast cancer has initiated a new regimen of targeted therapy. Early diagnosis is a key step in improving survival. Therefore, a cost-effective and widely available imaging tool is needed for the timely detection and prediction of the molecular profile of breast cancer.

Aim: To study the predictive value of ultrasonographic features in identifying the estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 neu (HER2/neu) expression status, and molecular subtypes of breast cancer.

Material and methods: We conducted a study on 51 histopathologically proven invasive breast carcinoma cases over a period of one and a half years. The patients underwent ultrasonography followed by tissue biopsy. Sonographic parameters were assessed based on BI-RADS imaging features. The molecular subtypes of breast cancer were grouped into four subtypes based on the St. Gallen International Expert Consensus Panel. The predictive value of ultrasonographic features was then studied in relation to the hormone receptor status and molecular subtypes of breast cancer.

Results: A significant association between posterior acoustic features and molecular subtypes was seen. Posterior acoustic shadowing was associated with progesterone receptor status with an odds ratio (OR) of 36.58, confidence interval (CI) of 5.527-866.1, and p <0.001. The luminal type A molecular subtype was significantly higher in the posterior acoustic shadowing group (10 cases; 52.63%) with an OR of 3.85, CI of 1.12-13.98, and p of 0.02. The proportion of patients with triple-negative molecular subtype (9 cases, 50%) was significantly higher in the posterior acoustic enhancement group, with an OR of 29.42, CI of 4.117-725.4, and p <0.001. Tumors with circumscribed margins were also highly suggestive of the triple-negative molecular subtype [OR of 5.12, CI of 1.16-24.85, and p of 0.03]. The association between the presence or absence of vascularity and its type with molecular subtypes failed to show statistical significance in our study, although vascularity was more frequently observed in triple-negative molecular subtype and luminal type B Her+ve cases.

Conclusion: Certain sonographic features are associated with the estrogen/progesterone receptor hormone receptor status and molecular subtypes of breast cancer. With validation of this association, ultrasound may serve as a basic imaging modality for predicting molecular subtypes of breast cancer even in remote areas, where immunohistochemistry hormone receptor and HER2 testing are not available.

Aim: The purpose of this study was to evaluate the diagnostic value of ultrasound compared to magnetic resonance imaging (MRI) as a reference in detecting peroneus brevis split ruptures.

Material and methods: We re-reviewed 112 ultrasound examinations performed between 2020 and 2021 by three musculoskeletal radiologists with 8-10 years of experience. Patients were referred due to pain lasting at least 8 months in the posterolateral ankle. Ultrasound was performed using a LOGIQ E9 General Electric device with a 6-15 MHz or 18 MHz probe. Sixty-three patients who underwent MRI within 8 months and were included in the study. Ultrasound and MRI findings were categorized as: a) no peroneus split, b) presence of peroneus split, or c) unspecific findings. MRI served as the reference standard. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated.

Results: Seven cases (11.1%) were false positives (diagnosed on ultrasound but not MRI) and 9 (14.3%) were false negatives (missed by ultrasound but detected on MRI). Six cases (9.5%) were true positives (identified on both ultrasound and MRI), and 41 patients (65.1%) were true negatives (negative on both modalities). Ultrasound showed a sensitivity of 40.0% and specificity of 85.4%. The positive predictive value (PPV) was 46.2%, while the negative predictive value (NPV) was 82.0%.

Conclusions: Ultrasound demonstrated limited sensitivity but high specificity in detecting peroneus brevis split ruptures.

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.