Journal of Ultrasonography最新文献

Aim of the study: Inflammatory pseudotumor is a rare benign tumor that can occur at various body sites. Due to its rare occurrence and histological variety radiological data is heterogeneous and limited.

Case description: We present a case of a 71-year-old man with inflammatory pseudotumor of the omentum. Contrast-enhanced ultrasound perfusion pattern showed homogeneous, isoechoic enhancement in the arterial phase with a washout phenomenon in the parenchymal phase, mimicking a peritoneal carcinomatosis.

Conclusions: Inflammatory pseudotumor represents a rare, but important benign differential diagnostic option when considering a malignant disorder. Contrast-enhanced ultrasound is helpful in identifying vital tissue for a targeted biopsy for subsequent histological examination that is essential for the exclusion of malignancy.

We present a rare case of a common carotid artery wall hematoma after ultrasound-guided parathyroid fine-needle aspiration. The hematoma was detected within seconds from needle insertion, extending along the common carotid artery wall from the lower neck to the common carotid artery bifurcation, and it was quickly restricted with firm pressure. The patient only reported mild discomfort. A follow-up assessment by a vascular surgeon two hours later showed no signs of ischemic events and complete absorption of the hematoma without further clinical consequences. Physicians performing parathyroid fine-needle aspiration must be aware of this rare complication, which may be easily overlooked. Continuous meticulous sonographic surveillance during the fine needle aspiration procedure is the only way to directly diagnose this complication and apply immediate pressure to restrict it.

Aim of the study: Ankle pain can present a clinical dilemma to the foot and ankle surgeons, with a multitude of entities to which the symptoms could potentially be attributed. Enthesopathy around the ankle joint could be due to overuse, injury, inflammation or infection. Calcific ligamentous enthesopathy around the ankle is a well-recognised condition with a spectrum of causes.

Case description: To our knowledge, a clinically symptomatic presentation of calcific enthesopathy specifically affecting the entheses of the superior extensor retinaculum has not been described in the literature. We report the first case of symptomatic calcific enthesopathy of the superior extensor retinaculum in a healthy young female, and highlight the role of radiological interventions in its diagnosis. The condition was managed successfully by ultrasound-guided barbotage.

Conclusions: Calcific enthesopathy of the attachment of the superior extensor retinaculum is a rare condition that should be considered in the differential diagnosis of patients with medial ankle pain.

Aim of the study: Seromas are rarely reported as complications of autologous arteriovenous fistula creation.

Case description: An 89-year-old woman was hospitalized for hemodialysis and underwent an autologous arteriovenous fistula creation in the forearm. During cephalic vein expansion using a heparinized saline solution, leakage occurred. A suture was placed to control the leakage, and a Penrose drain was inserted. Serosanguineous drainage ceased on postoperative day two; however, a seroma occurred approximately two weeks after the surgery. Follow-up ultrasonography revealed no growth tendency; therefore, excision and aspiration were unnecessary.

Conclusion: This seroma was associated with postoperative dead space, surgical technique, and patient clinical status. Sufficient preoperative ultrasonographic vascular mapping is required to avoid inappropriate handling of veins and prevent seroma formation. Postoperative ultrasonographic follow-up is recommended due to the future risk of fistula dysfunction and infection associated with seroma enlargement, which may necessitate surgical seroma excision.

Aim: To evaluate and measure the mean cross-sectional area of the tibial and median nerves in patients with diabetic peripheral neuropathy, and to study the association between high-resolution ultrasonographic findings in diabetic peripheral neuropathy with the duration of illness, glycosylated haemoglobin values, random blood sugar levels, and aesthesiometry (using monofilament examination).

Material and methods: A prospective observational study was conducted among 63 patients who were diagnosed with type 2 diabetes mellitus and underwent ultrasound and monofilament examinations. The cross-sectional area of the median nerve of the dominant hand and the tibial nerves was calculated on ultrasound examination.

Results: The mean cross-sectional area of the median and tibial nerves was higher in patients with poor glycaemic control, with the mean cross-sectional area of the median nerve being 10.9, 12.8, 13.0, and 12.9 mm² at various points in the leg in cases where the monofilament examination was negative, as compared to 7.30, 7.78, 7.91, 7.87 mm² in patients with positive monofilament examination results. There was a significant positive correlation between the cross-sectional area of the tibial and median nerves and HbA_1c, duration of diabetes, aesthesiometry, and random blood sugar levels. With an increase in HbA_1c, duration of diabetes, and random blood sugar levels, there was a corresponding increase in the cross-sectional area of the nerves. These findings helped us to identify diabetic peripheral neuropathy.

Conclusions: High-resolution ultrasonography along with aesthesiometry and HbA_1c values can be an effective and easily available tool for detecting changes secondary to diabetic peripheral neuropathy. The method has a potential to replace or substitute nerve conduction tests in the near future.

Aims: To correlate sonographic renal parameters (mean renal cortical thickness, length and volume) with renal functions in patients with newly diagnosed chronic kidney disease. To predict the best renal parameter correlating with renal functions in patients with newly diagnosed chronic kidney disease.

Material and methods: A hospital-based prospective cross-sectional study was conducted in the Department of Radiodiagnosis, Indira Gandhi Medical College and Hospital, Shimla, in 78 adults with newly diagnosed chronic kidney disease visiting the hospital from December 2019 to November 2020.

Results: A statistically significant positive correlation was found between eGFR and mean renal length, mean renal cortical thickness, and mean renal volume (p <0.001).The strongest correlation was shown between mean renal volume and eGFR (r = 0.90, r² = 0.82; p-value <0.001).

Conclusions: Renal volume and cortical thickness should be considered along with traditional renal parameters.

Automated breast ultrasound is a three-dimensional ultrasonographic technique allowing the evaluation of women with dense glandular breast tissue. In this group of patients, mammography has a low sensitivity because dense breasts can obscure breast cancer on mammogram. On the other hand, women with dense breast tissue, types C and D on the BI-RADS scale, are at an increased risk of developing breast cancer compared to women with fatty breast tissue. Automated breast ultrasound is a standardized and reproducible ultrasound technique which improves breast cancer detection and is promising in the screening and diagnostic settings: it increases the detection of breast cancer, and helps to differentiate benign and malignant lesions. Unfortunately, automated breast ultrasound also has its limitations and disadvantages due to artifacts caused by poor positioning, and lesion and patient characteristics. Many artifacts can be avoided by training and experience of the performing technician. Furthermore, familiarity of the interpreting breast radiologist with these artifacts and pitfalls will decrease false negative diagnosis of true lesions.

Aim: Deep learning algorithms have lately been used for medical image processing, and they have showed promise in a range of applications. The purpose of this study was to develop and test computer-based diagnostic tools for evaluating masseter muscle segmentation on ultrasonography images.

Materials and methods: A total of 388 anonymous adult masseter muscle retrospective ultrasonographic images were evaluated. The masseter muscle was labeled on ultrasonography images using the polygonal type labeling method with the CranioCatch labeling program (CranioCatch, Eskişehir, Turkey). All images were re-checked and verified by Oral and Maxillofacial Radiology experts. This data set was divided into training (n = 312), verification (n = 38) and test (n = 38) sets. In the study, an artificial intelligence model was developed using PyTorch U-Net architecture, which is a deep learning approach.

Results: In our study, the artificial intelligence deep learning model known as U-net provided the detection and segmentation of all test images, and when the success rate in the estimation of the images was evaluated, the F1, sensitivity and precision results of the model were 1.0, 1.0 and 1.0, respectively.

Conclusion: Artificial intelligence shows promise in automatic segmentation of masseter muscle on ultrasonography images. This strategy can aid surgeons, radiologists, and other medical practitioners in reducing diagnostic time.

Aim: The aim of this study was to prepare normograms for the fetal stomach, urinary bladder, and stomach to urinary bladder index in healthy fetuses.

Material and methods: The study was conducted based on the data extracted from the database of our tertiary center in the years 2016-2019. The study group, comprising 867 fetuses, demonstrated normal biometry and normal heart structure, normal heart function, no extracardiac malformations, and no extracardiac anomalies. The stomach to urinary bladder index was analyzed in the study group. The examinations were performed with the use of the following ultrasound machines: Voluson E10, Philips and Voluson Expert, with convex transabdominal transducers. Linear regression analysis based on Microsoft Excel was used for statistical analysis.

Results: The average size of the stomach in healthy fetuses between the 14-40^th week of gestation was 18 mm (8-40 mm), the average urinary bladder measurement was 17 mm (15-42 mm), and the fetal stomach to urinary bladder index was constant: 1.26 (0.09-3.93).

Conclusions: The normograms for the stomach, urinary bladder and the stomach to urinary bladder index prepared based on our study group can contribute to an improvement in the accuracy of examination and provide an unified organization of the description of fetuses. These normograms constitute an additional marker for the assessment of fetal condition. A clear disproportion in the size of the urinary bladder and stomach can be helpful in terms of paying more attention to fetuses with untypical features in screening centers.

Aim: Response to cardiac resynchronization therapy varies significantly among patients, with one third of them failing to demonstrate left ventricular reverse remodeling after cardiac resynchronization therapy. Left atrial size and function is increasingly recognized as a marker of disease severity in the heart failure population. The aim of this study was to evaluate whether echocardiographic left atrial indices predict left ventricular reverse remodeling after cardiac resynchronization therapy.

Materials and methods: Ninety-nine cardiac resynchronization therapy candidates were prospectively included in the study and underwent echocardiography before and 3-months after cardiac resynchronization therapy implantation. Cardiac resynchronization therapy response was defined as a 15% relative reduction in left ventricular end-systolic volume. Indexed left atrial volume, left atrial reservoir strain, left ventricular end-diastolic volume, and left ventricular ejection fraction along with other known predictors of cardiac resynchronization therapy response (gender, etiology of heart failure, presence of typical left bundle branch block pattern, QRS duration >150 ms) were included in a multivariate logistic regression model to identify predictors for cardiac resynchronization therapy response.

Results: Cardiac resynchronization therapy response occurred in n = 63 (64%) patients. The presence of a typical left bundle branch block (OR 4.2, 95 CI: 1.4-12.1, p = 0.009), QRS duration >150 ms (OR 4.2, 95 CI: 1.4-11.0, p = 0.029), and left atrial volume index (OR: 0.6, 95 CI: 0.4-0.9, p = 0.012) remained the only significant predictors for cardiac resynchronization therapy response after three months. None of the baseline left ventricular parameters showed an independent predictive value.

Conclusion: Left atrial size at baseline is an independent predictor and is inversely proportional to left ventricular volumetric reverse remodeling in cardiac resynchronization therapy candidates.