Journal of Ultrasonography最新文献

Purpose: To provide an overview of the normal anatomy of the knee using high-resolution ultrasonography.

Materials and methods: Normal ultrasound images were obtained from a healthy subject, and corresponding images of human anatomy and histology were acquired from body donors.

Results: Several high-resolution ultrasound, anatomical, and histological images were created to illustrate and comprehensively describe the basic standard scans in compliance with international standards. This atlas summarizes a selection of typical normal findings.

Conclusions: This overview explains the normal anatomy of the knee as seen by ultrasonography. High-resolution knee musculoskeletal ultrasonography aims to provide an accurate structural evaluation, which requires comprehensive knowledge of sonoanatomy. When used appropriately, contemporary high-resolution musculoskeletal ultrasonography enhances knee imaging by connecting anatomical cross-sections and intricate histology to specific anatomical features.

Aim: Abdominal obesity is recognized as the best predictor of cardiovascular disease risk. While body mass index has traditionally been used to measure obesity, recent evidence suggests that visceral adipose tissue may be a better indicator of cardiovascular disease risk. Various surrogate imaging markers of visceral adipose tissue have recently been described, such as posterior right perinephric fat thickness, preperitoneal fat thickness, and the abdominal wall fat index. This study aimed to examine the link between atherosclerosis through measurement of carotid intima-media thickness and markers of abdominal obesity using ultrasonography.

Material and methods: This was a hospital-based prospective observational study. Patients with a body mass index of 25-40 were included as cases and those with a body mass index 18.0-24.9 as controls. Posterior right perinephric fat thickness, preperitoneal fat thickness, and abdominal wall fat index were measured and compared with carotid intima-media thickness in cases.

Results: A total of 100 cases and 100 age- and sex-matched controls were included. Body mass index did not show any statistically significant correlations with carotid intima-media thickness in this study. Among the visceral adiposity markers, posterior right perinephric fat thickness was the most sensitive and specific predictor of carotid intima-media thickness, while the abdominal wall fat index was the least sensitive and specific.

Conclusions: Ultrasonographic markers of visceral adipose tissue, especially posterior right perinephric fat thickness and preperitoneal fat thickness, demonstrate a stronger association with carotid atherosclerosis than body mass index, making them useful predictors, particularly in individuals with high body mass index. These markers can be measured during routine abdominal ultrasounds to screen for atherosclerosis risk in patients with abdominal obesity.

Medial striate artery infarction is one of the manifestations of perforator stroke, which poses a risk for basal ganglia destruction. There is no general consensus regarding of origin of the striatal vessels. However, controlling the target brain tissue with available techniques, such as ultrasonography, seems to be the best option for newborns. This pictorial essay presents the ultrasonographic evolution of an infarct in the area of the left head of the caudate nucleus during the early stage and after 4 weeks of observation. Signs of reperfusion, changes in tissue echogenicity, and the occurrence of cystic lesions recorded in lag indicate an alteration. Angiographic magnetic resonance imaging performed at the end of the early follow-up period confirms these observations.

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.