Medical Ultrasonography最新文献

Aim: Contrast-enhanced harmonic endoscopic ultrasound (CEH-EUS) parameters may be used to predict prognosis of pancreatic ductal adenocarcinoma (PDAC) and pancreatic neuroendocrine tumors (pNET). The aim of this study was to investigate the association between several perfusion parameters on CEH-EUS performed before treatment and survival outcome in patients with PDAC or pNET.

Material and methods: Thirty patients with PDAC or pNET who underwent CEH-EUS and EUS-guided fine needle aspiration (EUS-FNA) were included. Quantitative analysis of tumor vascularity was performed using time-intensity curve (TIC) analysis-derived parameters, obtained from processing CEH-EUS recordings with a commercially available software (VueBox). Cox proportional hazards models were used to determine associations with survival outcome.

Results: Median overall survival (OS) for PDAC patients was 9.61 months (95% CI: 0.1-38.7) while the median OS for pNET patients was 15.81 months (95% CI: 5.8-24.75. In a multivariate model for OS, a lower peak enhancement (HR=1.76, p=0.02) and a lower wash-in area under the curve (HR=1.06, p=0.001) were associated with worse survival outcome for patients with PDAC.

Conclusions: CEH-EUS parameters may be used as a surrogate to predict PDAC aggressiveness and survival before treatment. After validation by large-scale studies, CEH-EUS perfusion parameters have the potential to be used in pretreatment risk stratification of patients with PDAC and in evidence-based clinical decision support.

Non-invasive tests have been developed to determine the severity of liver disease in patients with alcohol use disorder (AUD). We aimed to assess the severity of liver steatosis and liver fibrosis (LF) in a cohort of patients with AUD using liver elastography and biological scores.

Materials and methods: A prospective study was performed on 172 subjects, without previously known liver disease, with a positive AUDIT-C score, serum markers, and vibration-controlled transient elastography (VCTE) with Controlled Attenuation Parameter (CAP).

Results: From 172 subjects with positive AUDIT-C test, VCTE diagnosed advanced fibrosis (F3) in 13.9% (24/172) of the subjects and liver cirrhosis (F4) in 17.5% (30/172). Moderate and severe steatosis was found in 18.6% (32/172), respectively 52.3% (90/172). Significant correlations were found between liver stiffness and APRI (r=0.33, p=0.001), FIB-4(r=0.31, p=0.0012) and the age-platelet index (r=0.25, p=0.008). FIB-4 (p=0.01) and age-platelet index (p=0.03) were independently associated with the presence of advanced fibrosis. Age-platelet index (AUC- 0.82) performed significantly better than AST/ALT (AUC- 0.55) and APRI (AUC- 0.58) (p= 0.0001 and p= 0.0014, respectively), but no differences were found when compared to FIB-4 (AUC- 0.77) (p=0.35) for predicting advanced fibrosis.

Conclusion: In conclusion, in a cohort of patients with AUD, 70.9% presented moderate and severe liver steatosis and 17.5% were newly diagnosed with liver cirrhosis.

Ultrasound (US) imaging is part of conventional medical imaging in clinical practice that is low-cost, non-ionizing, portable and capable of real-time image acquisition and display. However, in certain cases, US has limited sensitivity and specificity in differentiating between malignant and benign lesions. Ultrasound-based radiomics, as a new branch of radiomics, can provide additional features such as heterogeneity of lesions that are invisible to the naked eye, alone or in combination with demographic, histological, genomic or proteomic data, thereby improving the accuracy of US in diagnosis of disease. This article provides an introduction to ultrasound-based radiomics, covering its workflow, the application of machine learning, and current research status. Current limitations of radiomics, such as consistency of image acquisition, parameter variations, and difficulty in calibrating quantitative methods in ultrasound, will also be covered.

Despite medical and interventional advances, the mechanical complications of acute myocardial infarction are associated with high mortality. Timely surgical therapy requires a prompt and accurate diagnosis. Multimodality imaging has become the standard of care in modern cardiology. Despite the widespread use and cost-effectiveness of cardiac ultrasound in the acute setting, the method is highly user-dependent. In complex cases a second imaging technique is often required. The case presents the key role of multimodal imaging in the evaluation of a patient with a very rare complication of an acute myocardial infarction, a pseudoaneurysm of the interventricular septum respectively. In addition to confirming the diagnosis assumed by echocardiography, cardiac computed tomography provides additional structural and functional information essential to proper management.

Desmoplastic small round cell tumour (DSRCT) is a rare and highly aggressive mesenchymal neoplasm with poor prognosis that develops in male adolescents and young adults. We report the case of a 32-year-old male admitted with abdominal distension and ascites. An ultrasonography (US) scan showed multiple peritoneal masses with large ascites. The dominant mass had a hypervascular homogenous aspect at contrast-enhanced ultrasound with wash-out in the venous phase. Thoracoabdominal CT, performed for staging the disease, confirmed the US aspect. The US-guided percutaneous biopsy revealed DSRCT of the peritoneum. Chemotherapy was then started with minimal clinical improvement, increase in tumoral burden and death after three months. US and US-guided biopsy played an essential role in diagnosing this case. The aggressive course of the disease and seeding at paracentesis sites are the particularities of the presented case.

Aims: Technique-related factors, patient-related factors, and localization determine the risk for complications in percutaneous endoscopic gastrostomy (PEG) tube placement. The objective of this study was to identify patient characteristics and ultrasonographic parameters after PEG tube placement concerning localization, which correlate with complications.

Material and methods: Patients undergoing PEG-tube placement were examined by abdominal ultrasound after dismissal from the endoscopic recovery room. Patient demographics, PEG characteristics, ultrasonographic parameters and complications were retrospectively analyzed.

Results: Of 64 enrolled patients, 59.4% were male and the mean age was 62.3 years. A significant negative correlation between complications at PEG placement and Body-Mass-Index (BMI; kg/m2) was observed (Spearman's Rho: -0.382; p=0.002). A low BMI <18 tended to be more frequent in the group with complication-related PEG removal compared to patients without (18.2% vs. 1.9%). Further descriptive analysis revealed that 4 patients (36.4% of N=11) with and 5 patients (9.4% of N=53) without PEG removal due to complications already had complications at the time of PEG placement. Of the patients with complications during follow-up, those with a peritoneal course (N=10) in ultrasound tended to have a lower BMI (mean ± standard deviation: 22.5±6.5 vs. 26.8±5.9) compared to those without (N=5). In all 4 patients with a triad of follow-up complications, peritoneal course, and complications at PEG placement, the tube was removed due to complications.

Conclusions: Post-PEG-placement ultrasonography can help to determine complications in specific procedure-related conditions. A low BMI was found to be a relevant predictor of PEG-related complications, substantiating the need for early intervention in potentially PEG-relevant indications.

Aims: Ultrasound (US) findings of epidermoid cyst (EC) are complex and diverse. Cases of misdiagnoses are high when EC is accompanied by inflammation. The aim of this study was to analyze the features of US diagnosis of EC with inflammation and explore the characteristic images which can improve the accuracy of ultrasound diagnosis.

Material and methods: A total of 241 cases were included and retrospectively analyzed. Complete clinical data of all cases were available. Lesions were examined by US before operation and the diagnosis was confirmed by histopathological examination. Based on pathological results ECs with/without acute and chronic inflammation and/or granuloma, all cases were divided into two groups: inflammation and non-inflammation group. The difference of clinical data and US features between groups was analyzed by univariate and multivariate logistic regression.

Results: Analysis of skin color, length/thickness, shape, boundary, CDFI and US diagnosis accuracy showed statistical differences between the two groups (p<0.05). Multivariate logistic regression model showed that indistinct boundaries and color Doppler signal were more frequent than those in ECs without inflammation (OR=4.72, 5.89, p<0.05).

Conclusion: Indistinct boundaries and color Doppler signal are important features for US diagnosis of EC with inflammation, which can help in improving the accuracy of diagnosis.

The history of the European Federation of Societies in Ultrasound in Medicine and Biology (EFSUMB) is closely related to the general history of ultrasound. In the presented paper the physical background and history of technologies including A-mode, Time motion or M-mode, 2D Imaging (B-mode) are summarized. In addition, ultrasound tissue characterization, Doppler ultrasound, 3D and 4D ultrasound, intracavitary and endoscopic ultrasound, interventional ultrasound, ultrasonic therapy, contrast enhanced ultrasound (CEUS) and key developments in echocardiography are discussed.