Ultrasound Quarterly最新文献

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.

Abstract: Lung ultrasound has become a standard practice in acute care as an adjunct to the physical exam, providing valuable insights to guide clinical decision making at the point of care. Lung ultrasound can rapidly uncover anatomic detail, help resolve undifferentiated respiratory failure, and delineate equivocal findings on standard plain film without the need for transport to access additional diagnostic imaging. In the following review, basic concepts of lung ultrasound are reviewed including its role in detecting and assessing a variety of common problems.

Abstract: Extrathyroidal masses in the anterolateral neck are frequently encountered in the adult population and may represent a diagnostic dilemma. These neck masses can result from a diverse array of pathologies including congenital, inflammatory, infectious, and neoplastic causes. Relevant medical history and physical examination are essential to complement the imaging findings. Ultrasound (US) plays an important role in the initial evaluation of neck masses due to its reliability, availability, safety and cost-effectiveness. It can confirm or exclude the presence of a mass and initially characterize it as solid or cystic. Sonographically assessing the relationship of a mass to adjacent cervical anatomy can facilitate a more targeted differential diagnosis. US also effectively guides fine needle aspirations and/or biopsies of accessible lesions. Multimodality imaging is reserved for problem-solving complex cases and presurgical planning. The anterolateral neck masses are categorized into midline/paramedian lesions, salivary gland pathologies, and other soft tissue lesions. Midline and paramedian lesions include thyroglossal duct pathologies, ectopic thyroid tissue, and parathyroid adenomas. Salivary gland pathologies include obstructive/inflammatory processes, benign and malignant neoplasms, and systemic diseases. This pictorial essay presents clinical features and sonographic characteristics of extrathyroidal masses in the anterolateral neck with a brief discussion of other imaging modalities.

Abstract: Berry syndrome is a rare combination of cardiac malformations, which is characterized by the following malformations, including the aortopulmonary window, aortic right pulmonary origin, interrupted aortic arch or hypoplastic aortic arch or coarctation of the aorta, and an intact ventricular septum. There are few reviews on prenatal diagnosis of Berry syndrome by fetal echocardiography. We used sequential cross-sectional scanning from apex to bottom of the heart to find aortic right pulmonary origin, aortopulmonary window, and hypoplastic aortic arch. This process is like opening a Chinese scroll painting, and the picture gradually extends to reveal the whole picture. As far as we concerned, this is the first report of prenatal diagnosis with Berry syndrome through sequential cross-sectional scanning.