Ultrasound Quarterly最新文献

Abstract: Reliability of muscle thickness assessed in B-mode ultrasound has been confirmed in adults but remains a less direct assessment of muscle mass than muscle volume (MV). The aim of this prospective monocentric study was to assess the interday reliability of MV determined by the 2D-panoramic ultrasound in older hospitalized patients.Ten participants hospitalized in geriatric ward (mean age = 84) underwent 2 sessions of panoramic ultrasound scanning 1 week apart for MV assessment and DXA for leg lean mass (LLM) assessment when it was possible. The interday reliability of MV assessed using the intraclass correlation coefficient (ICC) was excellent, whatever was the muscle analyzed: ICC = 0.99 for tibialis anterior; ICC = 0.99 for vastus lateralis; ICC = 1 for rectus femoris. The pilot analysis of its association with leg lean mass revealed a good association between the vastus lateralis MV and LLM, but this needs to be confirmed on a larger number of participants (Pearson correlation coefficient = 0.91, P = 0.03).The 2D-panoramic ultrasound system for the determination of MV was reliable in older hospitalized patients with measurements performed on the patient's bed. MV seemed to be more correlated to LLM than muscle thickness. Future research will need to reduce the data processing time maybe with automation of data measurement.

Abstract: Cranial ultrasound (CUS) is an indispensable tool in the evaluation of intracranial pathology in premature and term neonates and older infants. Familiarity with standard cranial ultrasound techniques and parameters, normal anatomy, and commonly encountered abnormalities is crucial for providing appropriate care for these patients. This review provides a comprehensive overview of cranial ultrasound in clinical practice.

Abstract: This study aims to explore the value of real-time strain elastography (RTE) and contrast-enhanced ultrasonography (CEUS) in the diagnosis of breast BI-RADS 4 lesions. It collected 85 cases (totaling 85 lesions) diagnosed with breast BI-RADS 4 through routine ultrasound from October 2020 to December 2022 in Huangshan City People's Hospital. All lesions underwent RTE and CEUS examination before surgery, and the ImageJ software was used to measure the periphery of lesion images in the enhancement peak mode and grayscale mode to calculate the contrast-enhanced ultrasound area ratio. The diagnostic capabilities of single-modal and multimodal ultrasound examination for the malignancy of breast BI-RADS 4 lesions were compared using the receiver operating characteristic curve; the Spearman correlation analysis was adopted to evaluate the correlation between multimodal ultrasound and CEUS area ratio. As a result, among the 85 lesions, 51 were benign, and 34 were malignant. The areas under the curve (AUCs) of routine ultrasound (US), US + RTE, US + CEUS, and US + RTE + CEUS were 0.816, 0.928, 0.953, and 0.967, respectively, with the combined method showing a higher AUC than the single application. The AUC of the CEUS area ratio diagnosing breast lesions was 0.888. There was a strong positive correlation (r = 0.819, P < 0.001) between the diagnostic performance of US + RTE + CEUS and the CEUS area ratio. In conclusion, based on routine ultrasound, the combination of RTE and CEUS can further improve the differential diagnosis of benign and malignant lesions in breast BI-RADS 4.

Abstract: The objective of the study was to use a deep learning model to differentiate between benign and malignant sentinel lymph nodes (SLNs) in patients with breast cancer compared to radiologists' assessments.Seventy-nine women with breast cancer were enrolled and underwent lymphosonography and contrast-enhanced ultrasound (CEUS) examination after subcutaneous injection of ultrasound contrast agent around their tumor to identify SLNs. Google AutoML was used to develop image classification model. Grayscale and CEUS images acquired during the ultrasound examination were uploaded with a data distribution of 80% for training/20% for testing. The performance metric used was area under precision/recall curve (AuPRC). In addition, 3 radiologists assessed SLNs as normal or abnormal based on a clinical established classification. Two-hundred seventeen SLNs were divided in 2 for model development; model 1 included all SLNs and model 2 had an equal number of benign and malignant SLNs. Validation results model 1 AuPRC 0.84 (grayscale)/0.91 (CEUS) and model 2 AuPRC 0.91 (grayscale)/0.87 (CEUS). The comparison between artificial intelligence (AI) and readers' showed statistical significant differences between all models and ultrasound modes; model 1 grayscale AI versus readers, P = 0.047, and model 1 CEUS AI versus readers, P < 0.001. Model 2 r grayscale AI versus readers, P = 0.032, and model 2 CEUS AI versus readers, P = 0.041.The interreader agreement overall result showed κ values of 0.20 for grayscale and 0.17 for CEUS.In conclusion, AutoML showed improved diagnostic performance in balance volume datasets. Radiologist performance was not influenced by the dataset's distribution.

Methods: Twenty-three peer-reviewed articles on HRI measurements published between 2018 through 2023 were reviewed, and 11 were selected based on common subjects. The search terms included "hepatorenal index," "HRI," "HRI ultrasound," "hepatorenal ultrasound index," and "HRI ultrasound measurement."Three common subject areas were identified in the literature and synthesized down to 11 articles. The common subjects identified were HRI technique, HRI limitations, and HRI diagnostic accuracy. The matrix provided a quick overview of the general information in each piece, aiding in the paper's overall organization. Thirteen articles were rejected as not relevant or out of date. The research question leading this review was, "What does the literature say about the value of HRI in determining moderate to severe hepatic steatosis?"

Results: The literature revealed that HRI could be valuable in determining moderate to severe hepatic steatosis. HRI could not accurately determine normal or mild steatosis and has several limitations.

Conclusions: HRI is a more objective method for determining the degree of hepatic steatosis compared with traditional B-mode ultrasound scoring and does not require additional or specialized equipment. Many studies excluded patients with various liver diseases, which may not make HRI a practical tool for clinical usefulness. Further studies should be conducted with larger patient cohorts, a greater degree of hepatic steatosis, and determine specific standardized cutoff values.

Abstract: We aimed to develop and validate a nomogram based on conventional ultrasound (CUS) radiomics model to differentiate radial scar (RS) from invasive ductal carcinoma (IDC) of the breast. In total, 208 patients with histopathologically diagnosed RS or IDC of the breast were enrolled. They were randomly divided in a 7:3 ratio into a training cohort (n = 145) and a validation cohort (n = 63). Overall, 1316 radiomics features were extracted from CUS images. Then a radiomics score was constructed by filtering unstable features and using the maximum relevance minimum redundancy algorithm and the least absolute shrinkage and selection operator logistic regression algorithm. Two models were developed using data from the training cohort: one using clinical and CUS characteristics (Clin + CUS model) and one using clinical information, CUS characteristics, and the radiomics score (radiomics model). The usefulness of nomogram was assessed based on their differentiating ability and clinical utility. Nine features from CUS images were used to build the radiomics score. The radiomics nomogram showed a favorable predictive value for differentiating RS from IDC, with areas under the curve of 0.953 and 0.922 for the training and validation cohorts, respectively. Decision curve analysis indicated that this model outperformed the Clin + CUS model and the radiomics score in terms of clinical usefulness. The results of this study may provide a novel method for noninvasively distinguish RS from IDC.

Abstract: This study aims to evaluate the role of shearwave elastography (SWE) and superb microvascular imaging (SMI) for preoperative prediction of axillary lymph node metastasis (ALNM) in patients with breast cancer. In a cohort of 214 women with breast cancer, B-Mode ultrasonography (US), SMIvascular-index (SMIvi), and SWE (E-mean, E-ratio) values were recorded before tru-cut biopsy. Axillary fine-needle aspiration biopsy (FNAB) and sentinel lymph node sampling results were collected. Imaging findings and histopathological data were statistically compared. Receiver operating characteristic curve analysis was used to evaluate diagnostic performance. Reverse stepwise logistical regression analysis was conducted. Although ALNM was negative in 111 cases, it was positive in 103 patients. Axillary lymph node metastasis (+) group had larger size ( P < 0.001), higher vascularization (SMIvi: 8.0 ± 6.0 versus 5.0 ± 4.3, P < 0.001), and higher elasticity value (E-mean: 129 ± 31 kPa versus 117.3 ± 40 kPa, P = 0.014). Axillary lymph node metastasis was observed statistically more frequently in Her-2 positive cases ( P = 0.005). There was no significant difference between other B-mode US findings ( P > 0.05), SMI Adler ( P = 0.878), and E-ratio ( P = 0.212). The most appropriate cutoff value for the prediction of ALNM was 23.5 mm for size, 3.8 for SMIvi, and 138.5 kPa for E-mean. The most sensitive (77%) method was the SMIvi measurement, while the most specific (86%) finding was Her-2 positivity. The combined model (being Her-2 positive, >23.5 cm, and >3.8 SMIvi) increased the specificity (78%), PPV (71%), and accuracy (68%). Although the increased size is a previously studied parameter in predicting the risk of ALNM, Her-2 and data obtained by SWE, and SMI can be used to assist conventional US.

Abstract: The aim of our study was to compare the placental elasticity values between normal pregnancies and preeclamptic pregnancies and evaluate the utility of shear-wave elastography of the placenta as a predictor for preeclampsia in high-risk pregnancy. A prospective study was performed with 90 singleton high-risk pregnancies having any of the 7 risk factors for developing preeclampsia (primigravida, history of preeclampsia, family history of preeclampsia, history of pregestational diabetes, chronic hypertension, advanced maternal age [≥40 years], and body mass index ≥26 kg/m 2 ) were enrolled in the study. Shear-wave elastography was performed in all patients at 20 to 24 weeks' gestation and at 34 to 36 weeks' gestation, at 2 sites: center and edge of the placenta. The patients were divided into 2 groups: normal pregnancies (group A) or developed preeclampsia (group B). Women with posterior placentation, obstetric disorders other than preeclampsia, or multiple gestation were excluded from the study. Group comparisons were done using the χ2 test or Fisher exact test. Shear-wave elasticity values at 20 to 24 weeks' gestation for group B at the center of the placenta (21.73 vs 9.72 kPa) and at the edge of the placenta (21.6 kPa vs 10.15 kPa) were significantly higher than those for group A ( P < 0.05). Similar results were seen at 34 to 36 weeks' gestation. With a cutoff of 13.1 kPa, we attained sensitivity of 95.2%, specificity of 92.8% and diagnostic accuracy of 93.3% for predicting development of preeclampsia. Patients with preeclampsia have a significantly higher stiffness of the placenta. Shear-wave elastography is useful to evaluate placental function. Elastography can be used as a supplementary tool for prediction of preeclampsia.

Objectives: Sonoporation as a method of intracellular drug and gene delivery has not yet progressed to being used in vivo. The aim of this study was to prove the feasibility of sonoporation at a level practical for use in vivo by using a large amount of carbon dioxide micro-nano bubbles.

Methods: The carbon dioxide micro-nano bubbles and 100 mg of cisplatin were intra-arterially injected to the swine livers, and ultrasound irradiation was performed from the surface of the liver under laparotomy during the intra-arterial injection. After the intra-arterial injection, ultrasound-irradiated and nonirradiated liver tissues were immediately excised. Tissue platinum concentration was measured using inductively coupled plasma mass spectrometry. Liver tissue platinum concentrations were compared between the irradiated tissue and nonirradiated tissue using the Wilcoxon signed rank test.

Results: The mean (SD) liver tissue platinum concentration was 6.260*103 (2.070) ng/g in the irradiated liver tissue and 3.280*103 (0.430) ng/g in the nonirradiated liver tissue, showing significantly higher concentrations in the irradiated tissue ( P = 0.004).

Conclusions: In conclusion, increasing the tissue concentration of administered cisplatin in the livers of living swine through the effect of sonoporation was possible in the presence of a large amount of micro-nano bubbles.