Ultrasound Quarterly最新文献

The goal of this study is to evaluate the cost savings of consistently adhering to the 2017 American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) and the 2015 American Thyroid Association (ATA) criteria for the evaluation of thyroid nodules. In this retrospective study, 2 radiologists independently reviewed ultrasound (US) features of 291 cytology-proven thyroid nodules and scored them based on the ACR TI-RADS and ATA guidelines. The expected costs of strict adherence to recommendations based on the 2 risk stratification guidelines were calculated and compared with the actual cost to the health care system. Strict adherence to risk stratification guidelines can save the regional health care system up to $88,000 annually based on the 291 thyroid nodules examined. With retrospective application of ACR TI-RADS criteria, 51 nodules were recommended for follow-up US and 147 for fine-needle aspiration biopsy. With ATA criteria, 9 nodules were recommended for follow-up US, and 261 for fine-needle aspirations. Although fewer nodules were recommended for biopsy with TI-RADS criteria, the majority met criteria for follow-up US. Between the two guidelines, the ACR-TI-RADS offered slightly greater savings of ∼$3000 annually compared with ATA. Strict adherence to ACR TI-RADS and ATA guidelines can lead to substantial cost savings for the health care system by eliminating unnecessary thyroid biopsies. ACR TI-RADS is more cost-effective compared with ATA.

The purpose of this study was to evaluate bedside cranial ultrasound (CUS) and contrast-enhanced ultrasound (CEUS) for demonstrating changes in neonatal arterial ischemic stroke (NAIS). Fifteen newborns with symptomatic NAIS underwent a cranial ultrasound examination and subsequently confirmed by magnetic resonance imaging (MRI), were enrolled. Color Doppler Flow Imaging (CDFI) and Pulsed-Wave Doppler (PW) were performed to acquire data from 6 coronal, 5 sagittal, and 3 cerebellar planes through the anterior or mastoid fontanelle. For CEUS, a 2-minute wash-in cine clip and static images were captured. CUS showed all lesions in the blood-supplying region of the middle cerebral artery (MCA), with 10(66.7%) located on the left hemisphere, and on the right. CEUS was performed on 3 neonates to evaluate microvascular perfusion. Two cases showed a large area of non-enhancement on the lesion side, while the third case showed significantly higher enhancement on the lesion side. MRI confirmed all lesions in the MCA blood-supplying region, with 10 on the left hemisphere and 5 on the right. Magnetic resonance angiography (MRA) identified abnormalities in the trunk or branches of the MCA in 8 neonates. Our preliminary results suggest that CUS can evaluate NAIS in conjunction with MRI and CEUS metrics may have potential for clinical quantification, warranting future validation studies.

Acute diverticulitis, which arises from inflammation of a colonic diverticulum, is a prevalent cause of acute abdominal pain and hospitalization in developed countries. Although most cases respond to conservative treatment, serious complications such as perforation and formation of large abscesses and fistulas can arise, which would require urgent intervention. In the United States, computed tomography (CT) is the diagnostic standard, offering sensitivity and specificity >95%, but ultrasound has also proven effective in identifying uncomplicated cases of diverticulitis.

Endosalpingiosis is a rare, benign condition characterized by ectopic cystic glands lined with ciliated cuboidal epithelium, histologically resembling the fallopian tube. Its etiology remains uncertain but is hypothesized to result from either ectopic implantation of fallopian tube tissue or metaplastic transformation of multipotential peritoneal cells. While frequently misdiagnosed as endometriosis, endosalpingiosis coexists with endometriosis in ~35% to 40% of cases. The condition can affect both women of reproductive age and postmenopausal individuals, with a median age of diagnosis between 50 and 52 years. While often asymptomatic, patients may present with infertility, pelvic pain (including dysmenorrhea and dyspareunia), pelvic masses, or urinary symptoms such as hematuria or dysuria when lesions involve the urinary bladder. Lesions primarily localize to the peritoneal surfaces of the uterus, fallopian tubes, ovaries, and cul-de-sac but can rarely extend to the bladder, ureters, bowel serosa, omentum, lymph nodes, appendix, cervix, and even the skin. Endosalpingiosis is considered part of the spectrum of peritoneal serous lesions and may be associated with or progress to borderline or low-grade ovarian serous neoplasms. Sonographic evaluation typically reveals multiple small, anechoic, and avascular cystic structures forming a "bunch-of-grapes" pattern along pelvic and peritoneal surfaces.

Abstract: The purpose of this study was to compare size, morphologic features, and degree of suspicion between findings at second-look ultrasound (SL-US) and additional lesions with histological confirmation detected on breast magnetic resonance imaging (MRI). We performed an observational retrospective study including women who underwent SL-US between January 2021 and August 2022. Size, morphology according to Breast Imaging Reporting and Data System (BI-RADS) lexicon, and BI-RADS categories were analyzed for MRI and US findings. Two hundred twenty-four consecutive patients (aged 29-88 years; mean, 59.2 years) underwent SL-US to identify 235 additional lesions detected on MRI. US identified 173 (73.6%) findings. US- guided biopsy was performed in 148 (85.5%) of the detected lesions, proving 56 (37.8%) malignant and 92 (62.2%) benign. Mean size was 15.2 mm on MRI and 9.4 mm on US. Foci and masses showed good correlation, whereas nonmass enhancements tended to appear larger on MRI, and this difference was statistically significant (P = 0.0001). Morphology showed a higher agreement in the case of foci and masses than with nonmass enhancements. BI-RADS categories agreed in 66 cases (44.6%), whereas in 61 cases (41.2%), the degree of suspicion was higher for MRI, and in only 21 cases (14.2%) were lesions more suspicious on US than on MRI. In conclusion, lesions detected at SL-US show a higher agreement in size and morphologic features for foci and masses than with nonmass enhancements and similar or lower degree of suspicion than on MRI; therefore, decision to perform a biopsy should be based primarily on MRI findings.

Objective: Gonadotropin-releasing hormone (GnRH) stimulation testing is the gold standard for distinguishing central precocious puberty (CPP) from premature thelarche (PT). Due to the limitations of this test, previous studies have elucidated the clinical and laboratory factors that predict CPP. This study explored the diagnostic importance of pelvic ultrasound in girls with CPP.

Method: Between May 2023 and May 2024, 55 girls with suspected CPP underwent a GnRH stimulation test and pelvic ultrasonography (PU). Additionally, bone ages were evaluated using a left wrist x-ray.

Result: The multivariate analysis found that basal luteinizing hormone (bLH) > 0.67 IU/L, basal follicle-stimulating hormone (FSH) > 3.5 IU/L, basal estradiol > 7.5 pg/mL, uterine volume > 2.6 cm3, and longitudinal uterine diameter >35 mm were significantly associated with a pubertal response at the GnRH test. The 2 groups had no difference in bone age and bLH/basal FSH values. Peak LH/FSH ratio had the best diagnostic performance, with an area under the curve of 0.956 (95% confidence interval, 0.864-0.993), a sensitivity of 81.82%, a specificity of 96.97%, a positive predictive value of 94.7%, and a negative predictive value of 88.9%. The optimal cutoff value was >0.59 for the LH/FSH ratio.

Conclusions: Uterine long axis and uterine volume measurements are noninvasive data that help distinguish CPP from PT.

Abstract: Various thyroid diseases can lead to changes in the volume of the gland. Therefore, it is important to know the normal thyroid volume. The primary aim of this investigation was to establish normative values for thyroid gland volume using ultrasonography in children aged 0-18 years in Turkey.A retrospective analysis was conducted on thyroid ultrasound findings from 800 children (400 boys, 400 girls) between 2019 and 2020. Pediatric age groups were classified into 20 categories for children aged 0-18. Among these 20 groups, the initial 3 pertain to the 0-1 age range, encompassing infants aged 0-1 month, 1-6 months, and 6-12 months. Each age group consisted of 20 boys and 20 girls.The volume of each thyroid lobe was computed in milliliters using Brunn's formula, which involves multiplying the maximal anteroposterior diameter, mediolateral diameter, and craniocaudal diameter of the lobe by the correction factor 0.479.Data analysis employed the Statistical Package for the Social Sciences, SPSS version 24.0. All analyses were conducted at a 95% confidence interval, and significance was set at P < 0.05.Mean thyroid volumes of 800 children were determined for each age group. Thyroid volume exhibited a strong correlation with age. The Pearson correlation coefficient was 0.987 (P = 0.001).Given the scarcity of comprehensive studies in the literature focusing on thyroid volume in children aged 0-18 across various age groups, we believe that our findings for each age group can provide valuable insights for daily clinical practice.

Abstract: Patients with Bethesda III/IV thyroid nodules may benefit from molecular testing in order to determine the likelihood of malignancy. The goal is to avoid unnecessary surgery for these often-benign nodules. The decision to acquire samples for molecular testing is typically made after formal cytologic interpretation. This creates anxiety and inconvenience for patients who must return for a repeat biopsy. We explored the impact of routinely collecting "just-in-case" samples from each thyroid nodule. Thus, a minimum of 4 samples were acquired from each nodule: 2 for routine cytologic analysis and 2 for possible genomic sequencing. Nodules subsequently determined to be Bethesda III/IV, were further evaluated by sending the prospectively acquired aspirates for genomic sequencing. Over a 7-month period, there were 69 consecutive patients with ages ranging from 24 to 88 years. There were 16 males and 63 females. Six patients had 2 nodules sampled, yielding total of 75 nodules. Of the 75 nodules, 4 (5.3%) were Bethesda I, 37 (49.3%) Bethesda II, 30 (40%) Bethesda III, 0 (0%) Bethesda IV, 1 (1.3%) Bethesda V, and 3 (4%) Bethesda VI. Of the 30 Bethesda III, 18 (60%) were deemed benign (4% risk of malignancy) by genomic testing. Nine (30%) were deemed 50% or 75% suspicious for malignancy. Two (6.7%) yielded insufficient material for analysis and 1 (3.3%) analysis was canceled because of nonpayment. There were no patient complications. Just-in-case samples prevented call-back of 40% of sampled nodules and thus deemed worthwhile and efficient despite adding an estimated 10 minutes to overall procedure time.

Abstract: Ultrasonography is the gold standard for diagnosing acute epididymitis. However, it is not well understood if the simultaneous inflammation of the spermatic cord (funiculitis) is a helpful imaging finding in diagnosing acute epididymitis. This study aimed to investigate the frequency of funiculitis in cases of epididymitis and determine its sensitivity and specificity. This retrospective study included 50 consecutive patients with acute epididymitis. Funiculitis was defined as increased echogenicity of the spermatic cord fat with mass-like cord thickening. All scrotal ultrasound examinations were reviewed for the size of the spermatic cord and surrounding fat, indistinct margins between the spermatic cord and epididymis, similar findings on the contralateral side, and scrotal wall thickening. Spermatic cord inflammation was present in 96% (48/50) of patients with acute epididymitis, significantly higher than in the asymptomatic side (18%, n = 9/50, P < 0.0001). The presence of funiculitis had a sensitivity of 95.9% (confidence interval [CI] 86-99.5%), a specificity of 81.6% (CI 68-91.2%), a positive predictive value of 83.9% (CI 71.7-93%), and a negative predictive value of 95.2% (CI 84-99%) for diagnosing acute epididymitis. The sonographic presence of funiculitis in the setting of acute scrotal pain is a sensitive marker for concomitant acute epididymitis.

Abstract: In this study, 3D HD-live Flow was used to differentiate true and false knots. The study involved 9161 fetuses who underwent ultrasound during the 13th to 40th week of pregnancy. Among them, 38 cases of true knots of umbilical cord were found, with 24 cases correctly identified by 3D HD-live Flow, representing a detection rate of 63.2%. There were 19 cases of false knots of umbilical cord, with 13 cases correctly identified by 3D HD-live Flow, representing a detection rate of 68.4%.The detection rates of true knots of umbilical cord by 2D ultrasound and color Doppler ultrasound were significantly lower than that of 3D HD-live Flow (P < 0.05). However, there was no significant difference in detection rate between color Doppler ultrasound and 2D ultrasound (P > 0.05).This study demonstrates that 3D HD-live Flow is an effective imaging technique for distinguishing true and false knots of the umbilical cord in the prenatal period. It has the potential to improve the accuracy of diagnosis and provide valuable information for clinical management.