Pub Date : 2023-09-01DOI: 10.1097/RUQ.0000000000000632
İlyas Dündar, Sercan Özkaçmaz, Murat Demir, Mesut Özgökçe, Fatma Durmaz, Ayşe Özkaçmaz, Kerem Taken, Cemil Göya
Abstract: This preliminary study aimed to evaluate the possible damage to the male reproductive system that the severe acute respiratory syndrome coronavirus 2 virus causes by quantitatively measuring and comparing the tissue stiffness of the testis and epididymis with acoustic radiation force impulse sonoelastography in patients who have COVID-19 with a healthy control group. This prospective study was conducted between February and July 2021 with 65 cases. We used sonoelastography to evaluate male patients 18 years or older, who had applied to the urology clinic with nontesticular complaints, and were found to not have any underlying testicular pathology after a clinical-laboratory evaluation. The clinical-laboratory imaging findings and reverse transcription-polymerase chain reaction test results of all patients diagnosed with COVID-19 were reviewed from the hospital database. We measured the shear wave velocity values of the epididymis and the testes of 31 proven severe acute respiratory syndrome coronavirus 2 patients and 34 healthy subjects and compared them with an independent t test. For the patient and control group subjects, the mean age was 37.55 ± 13.08 (23-71) and 40.5 ± 16.25 (18-81) years, respectively. The mean shear wave velocity values of the left-right and bilateral testes and epididymis of the patient group were statistically substantially higher ( P ˂ 0.05) than in the control group. In the receiver operating characteristic analysis, when the cutoff values for the bilateral testes and epididymis were determined as 1.39 and 1.64 m/s, respectively, the AUC was 77% to 73.4%, the sensitivity was 87% to 74%, and the specificity was 65% to 62%. Our findings show that testicular and epididymal tissue stiffness increased in patients with COVID-19. We recommend adding sonoelastography to urogenital examinations of male reproductive system in patients who are recovering from COVID-19.
{"title":"Radiological Evidence of Testicular Damage in Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A Sonoelastography's Potential Role.","authors":"İlyas Dündar, Sercan Özkaçmaz, Murat Demir, Mesut Özgökçe, Fatma Durmaz, Ayşe Özkaçmaz, Kerem Taken, Cemil Göya","doi":"10.1097/RUQ.0000000000000632","DOIUrl":"https://doi.org/10.1097/RUQ.0000000000000632","url":null,"abstract":"<p><strong>Abstract: </strong>This preliminary study aimed to evaluate the possible damage to the male reproductive system that the severe acute respiratory syndrome coronavirus 2 virus causes by quantitatively measuring and comparing the tissue stiffness of the testis and epididymis with acoustic radiation force impulse sonoelastography in patients who have COVID-19 with a healthy control group. This prospective study was conducted between February and July 2021 with 65 cases. We used sonoelastography to evaluate male patients 18 years or older, who had applied to the urology clinic with nontesticular complaints, and were found to not have any underlying testicular pathology after a clinical-laboratory evaluation. The clinical-laboratory imaging findings and reverse transcription-polymerase chain reaction test results of all patients diagnosed with COVID-19 were reviewed from the hospital database. We measured the shear wave velocity values of the epididymis and the testes of 31 proven severe acute respiratory syndrome coronavirus 2 patients and 34 healthy subjects and compared them with an independent t test. For the patient and control group subjects, the mean age was 37.55 ± 13.08 (23-71) and 40.5 ± 16.25 (18-81) years, respectively. The mean shear wave velocity values of the left-right and bilateral testes and epididymis of the patient group were statistically substantially higher ( P ˂ 0.05) than in the control group. In the receiver operating characteristic analysis, when the cutoff values for the bilateral testes and epididymis were determined as 1.39 and 1.64 m/s, respectively, the AUC was 77% to 73.4%, the sensitivity was 87% to 74%, and the specificity was 65% to 62%. Our findings show that testicular and epididymal tissue stiffness increased in patients with COVID-19. We recommend adding sonoelastography to urogenital examinations of male reproductive system in patients who are recovering from COVID-19.</p>","PeriodicalId":49116,"journal":{"name":"Ultrasound Quarterly","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10514175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1097/RUQ.0000000000000628
Serdar Akti, Eda Albayrak
Abstract: Familial Mediterranean fever (FMF) is an autoinflammatory disease and an important health problem in countries bordering the eastern Mediterranean, including Turkey. In this study, we aimed to evaluate possible tissue stiffness changes that may develop in the liver and spleen in adult FMF patients with shear wave elastography (SWE), and its usability as an auxiliary imaging method that will be able to provide additional advantage in clinical follow-up. Seventy-five adult FMF patients and 73 adult volunteer were included in the study. Examination was performed through an intercostal space where the liver and spleen were clearly visible. The parenchymal stiffness degrees of the liver and spleen were quantified by shear modulus values in kilopascals. Differences in stiffness values of the liver and spleen between the 2 groups were examined. Liver stiffness value (LSV) was found to be statistically significantly higher in the FMF group. Although the spleen stiffness value (SSV) was found higher in the FMF group, the difference between the groups was not statistically significant. Increased LSVs in patients with FMF can be quantitatively demonstrated by the 2-dimensional SWE method, and SWE may be useful as an auxiliary imaging method in the follow-up of patients with FMF for this purpose. The LSV and SSV obtained in this study may be useful as reference stiffness values for both healthy individuals and those with FMF.
{"title":"Evaluation of Liver and Spleen With Shear Wave Elastography in Adult Patients With Familial Mediterranean Fever.","authors":"Serdar Akti, Eda Albayrak","doi":"10.1097/RUQ.0000000000000628","DOIUrl":"https://doi.org/10.1097/RUQ.0000000000000628","url":null,"abstract":"<p><strong>Abstract: </strong>Familial Mediterranean fever (FMF) is an autoinflammatory disease and an important health problem in countries bordering the eastern Mediterranean, including Turkey. In this study, we aimed to evaluate possible tissue stiffness changes that may develop in the liver and spleen in adult FMF patients with shear wave elastography (SWE), and its usability as an auxiliary imaging method that will be able to provide additional advantage in clinical follow-up. Seventy-five adult FMF patients and 73 adult volunteer were included in the study. Examination was performed through an intercostal space where the liver and spleen were clearly visible. The parenchymal stiffness degrees of the liver and spleen were quantified by shear modulus values in kilopascals. Differences in stiffness values of the liver and spleen between the 2 groups were examined. Liver stiffness value (LSV) was found to be statistically significantly higher in the FMF group. Although the spleen stiffness value (SSV) was found higher in the FMF group, the difference between the groups was not statistically significant. Increased LSVs in patients with FMF can be quantitatively demonstrated by the 2-dimensional SWE method, and SWE may be useful as an auxiliary imaging method in the follow-up of patients with FMF for this purpose. The LSV and SSV obtained in this study may be useful as reference stiffness values for both healthy individuals and those with FMF.</p>","PeriodicalId":49116,"journal":{"name":"Ultrasound Quarterly","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10141955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1097/RUQ.0000000000000621
Tobias Kummer, Kelli J Mohn, Abigail J Bardwell, James H Boyum
Abstract: In this study, we investigated the feasibility of using contrast-enhanced ultrasound (CEUS) to detect active hemorrhage in patients presenting with soft-tissue hematomas. Adult patients with clinically suspected, actively bleeding hematomas were prospectively enrolled. Contrast-enhanced ultrasound was used to assess for contrast extravasation. Ultrasound results were compared with those of multidetector computed tomographic (MDCT) imaging, operative findings, and clinical course. Sixteen patients (9 women, 7 men; mean age, 69 [SD, 13] years) were enrolled. Thirteen patients underwent MDCT imaging during their initial visit, and for 11, CEUS and computed tomography (CT) findings were concordant. The remaining patients had a negative CEUS study that was consistent with their clinical course. In 8 patients, CT imaging showed active extravasation (6 arterial, 1 indeterminate, 1 slow venous). Contrast-enhanced ultrasound and CT findings were concordant for all cases of arterial bleeding. For 1 patient, CEUS provided superior diagnostic information by identifying a pseudoaneurysm. The 2 discrepant patient cases had a ≥3-hour delay between CT and CEUS, and in 1 patient, CEUS was limited by body habitus. The second patient had no active bleeding identified in the operating room. Compared with CT, CEUS had a sensitivity and specificity of 75% and 100%, respectively, and positive and negative predictive values were 100% and 71%, respectively. Diagnostic accuracy was 85% in this limited study. Contrast-enhanced ultrasound is a promising alternative to MDCT in select patients and may sometimes provide superior clinical information. Limiting factors are large hematoma size, unfavorable anatomic location, and body habitus.
{"title":"Evaluation of Soft-Tissue Hematomas With Real-Time, Contrast-Enhanced Ultrasound: A Pilot Study With Preliminary Findings.","authors":"Tobias Kummer, Kelli J Mohn, Abigail J Bardwell, James H Boyum","doi":"10.1097/RUQ.0000000000000621","DOIUrl":"https://doi.org/10.1097/RUQ.0000000000000621","url":null,"abstract":"<p><strong>Abstract: </strong>In this study, we investigated the feasibility of using contrast-enhanced ultrasound (CEUS) to detect active hemorrhage in patients presenting with soft-tissue hematomas. Adult patients with clinically suspected, actively bleeding hematomas were prospectively enrolled. Contrast-enhanced ultrasound was used to assess for contrast extravasation. Ultrasound results were compared with those of multidetector computed tomographic (MDCT) imaging, operative findings, and clinical course. Sixteen patients (9 women, 7 men; mean age, 69 [SD, 13] years) were enrolled. Thirteen patients underwent MDCT imaging during their initial visit, and for 11, CEUS and computed tomography (CT) findings were concordant. The remaining patients had a negative CEUS study that was consistent with their clinical course. In 8 patients, CT imaging showed active extravasation (6 arterial, 1 indeterminate, 1 slow venous). Contrast-enhanced ultrasound and CT findings were concordant for all cases of arterial bleeding. For 1 patient, CEUS provided superior diagnostic information by identifying a pseudoaneurysm. The 2 discrepant patient cases had a ≥3-hour delay between CT and CEUS, and in 1 patient, CEUS was limited by body habitus. The second patient had no active bleeding identified in the operating room. Compared with CT, CEUS had a sensitivity and specificity of 75% and 100%, respectively, and positive and negative predictive values were 100% and 71%, respectively. Diagnostic accuracy was 85% in this limited study. Contrast-enhanced ultrasound is a promising alternative to MDCT in select patients and may sometimes provide superior clinical information. Limiting factors are large hematoma size, unfavorable anatomic location, and body habitus.</p>","PeriodicalId":49116,"journal":{"name":"Ultrasound Quarterly","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10514177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract: The shear wave dispersion (SWD) slope has become available in the clinical practice and is related to tissue viscosity. However, clinical evaluation using SWD was not yet performed for obstructive jaundice. We aimed to evaluate the change of SWD values between before and after biliary drainage in patients with obstructive jaundice. This prospective observational cohort study evaluated 20 patients with obstructive jaundice who underwent biliary drainage. The SWD and liver elasticity values were measured before versus after biliary drainage, comparing between days -5 and 0 (day 0), days 1 and 3 (day 2), and days 6 and 8 (day 7). The mean ± SD values of SWD measured at day 0, day 2, and day 7 were 15.3 ± 2.7, 14.2 ± 3.3, and 13.3 ± 2.4 m/s/kHz, respectively. Dispersion slope values were decreased significantly from day 0 to day 2, from day 2 to day 7, and from day 0 to day 7 ( P < 0.05). Liver elasticity levels and serum hepatobiliary enzymes were additionally decreased significantly over time after biliary drainage. The correlations between SWD and liver elasticity values were strong ( r = 0.91, P < 0.01). In conclusion, t he SWD values decreased significantly over time after biliary drainage concomitant with liver elasticity.
摘要:横波色散(SWD)斜率与组织黏度有关,已广泛应用于临床。然而,尚未对阻塞性黄疸进行SWD临床评价。我们的目的是评价梗阻性黄疸患者胆道引流前后SWD值的变化。本前瞻性观察队列研究评估了20例接受胆道引流的梗阻性黄疸患者。分别在第-5天和第0天(第0天)、第1天和第3天(第2天)、第6天和第8天(第7天)测量胆道引流前后的SWD和肝脏弹性值。第0天、第2天和第7天测量的SWD的平均±SD值分别为15.3±2.7、14.2±3.3和13.3±2.4 m/s/kHz。离散斜率值在第0天至第2天、第2天至第7天、第0天至第7天显著降低(P < 0.05)。肝弹性水平和血清肝胆酶也随着胆道引流后的时间显著下降。SWD与肝弹性值相关性较强(r = 0.91, P < 0.01)。综上所述,在胆道引流伴肝弹性后,SWD值随时间显著下降。
{"title":"Significance of Shear Wave Dispersion Slope Values Before Versus After Biliary Drainage in Patients With Obstructive Jaundice: A Single-Center Prospective Observational Cohort Study.","authors":"Ryo Sugiura, Masaki Kuwatani, Mutsumi Nishida, Megumi Satoh, Kazumichi Kawakubo, Shin Kato, Koji Hirata, Masahito Nakajima, Hajime Hirata, Yunosuke Takishin, Naoya Sakamoto","doi":"10.1097/RUQ.0000000000000644","DOIUrl":"https://doi.org/10.1097/RUQ.0000000000000644","url":null,"abstract":"<p><strong>Abstract: </strong>The shear wave dispersion (SWD) slope has become available in the clinical practice and is related to tissue viscosity. However, clinical evaluation using SWD was not yet performed for obstructive jaundice. We aimed to evaluate the change of SWD values between before and after biliary drainage in patients with obstructive jaundice. This prospective observational cohort study evaluated 20 patients with obstructive jaundice who underwent biliary drainage. The SWD and liver elasticity values were measured before versus after biliary drainage, comparing between days -5 and 0 (day 0), days 1 and 3 (day 2), and days 6 and 8 (day 7). The mean ± SD values of SWD measured at day 0, day 2, and day 7 were 15.3 ± 2.7, 14.2 ± 3.3, and 13.3 ± 2.4 m/s/kHz, respectively. Dispersion slope values were decreased significantly from day 0 to day 2, from day 2 to day 7, and from day 0 to day 7 ( P < 0.05). Liver elasticity levels and serum hepatobiliary enzymes were additionally decreased significantly over time after biliary drainage. The correlations between SWD and liver elasticity values were strong ( r = 0.91, P < 0.01). In conclusion, t he SWD values decreased significantly over time after biliary drainage concomitant with liver elasticity.</p>","PeriodicalId":49116,"journal":{"name":"Ultrasound Quarterly","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10515202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1097/RUQ.0000000000000637
Shu-Jing Huang, Mei Huang, Xian-Lan Liu, Long-Cheng Hong, Yu-Qing Su, Yan-Ting Lin, Yan-Qing Wang, Jin-Rong Lin, Xiao-Dong Zhang, Ying Zhou, Yi-Ming Su
Abstract: We aimed to plot the growth curve of the fetal clavicle, identify gestational date-independent parameters. Using 2-dimensional ultrasonography, we obtained the clavicle lengths (CLs) from 601 normal fetuses between 12 and 40 gestational age (GA). The CL/fetal growth parameters ratio was calculated. Moreover, 27 cases of fetal growth restriction (FGR) and 9 cases of small for GA (SGA) were detected. In normal fetuses, the mean CL (mm) = -68.2 + 29.80 × ln(GA) ± Z × (1.07 + 0.02 × GA). A linear relationship was detected between CL and head circumference (HC), biparietal diameter, abdominal circumference and femoral length with R2 values of 0.973, 0.970, 0.962, and 0.972, respectively. The CL/HC ratio (mean value 0.130) showed no significant correlation with GA. Clavicle lengths in the FGR group significantly decreased compared with the SGA group ( P < 0.01). This study determined a reference range of fetal CL in a Chinese population. Furthermore, the CL/HC ratio, which is independent of GA, is a novel parameter for the evaluation of the fetal clavicle.
{"title":"The Ratio of Clavicle Length to Head Circumference: A Novel Date-Independent Clavicle Index.","authors":"Shu-Jing Huang, Mei Huang, Xian-Lan Liu, Long-Cheng Hong, Yu-Qing Su, Yan-Ting Lin, Yan-Qing Wang, Jin-Rong Lin, Xiao-Dong Zhang, Ying Zhou, Yi-Ming Su","doi":"10.1097/RUQ.0000000000000637","DOIUrl":"https://doi.org/10.1097/RUQ.0000000000000637","url":null,"abstract":"<p><strong>Abstract: </strong>We aimed to plot the growth curve of the fetal clavicle, identify gestational date-independent parameters. Using 2-dimensional ultrasonography, we obtained the clavicle lengths (CLs) from 601 normal fetuses between 12 and 40 gestational age (GA). The CL/fetal growth parameters ratio was calculated. Moreover, 27 cases of fetal growth restriction (FGR) and 9 cases of small for GA (SGA) were detected. In normal fetuses, the mean CL (mm) = -68.2 + 29.80 × ln(GA) ± Z × (1.07 + 0.02 × GA). A linear relationship was detected between CL and head circumference (HC), biparietal diameter, abdominal circumference and femoral length with R2 values of 0.973, 0.970, 0.962, and 0.972, respectively. The CL/HC ratio (mean value 0.130) showed no significant correlation with GA. Clavicle lengths in the FGR group significantly decreased compared with the SGA group ( P < 0.01). This study determined a reference range of fetal CL in a Chinese population. Furthermore, the CL/HC ratio, which is independent of GA, is a novel parameter for the evaluation of the fetal clavicle.</p>","PeriodicalId":49116,"journal":{"name":"Ultrasound Quarterly","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10495621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1097/RUQ.0000000000000645
Tao Liu, Miao Zhou, Huihui Yang, Weixiang Liang, Ruiming Cai, Mingjin Cai
Abstract: Endometrial injury is associated with poorer pregnancy outcomes. The purpose of this study was to evaluate the diagnostic efficacy of contrast-enhanced ultrasonography (CEUS) in the detection of endometrial injury. This study included women who underwent CEUS of the uterus at the author's hospital between April 2020 and January 2021. The diagnostic performances of the CEUS-derived parameters in the detection of severe endometrial injury were evaluated by receiver operating characteristic curve analyses. The study included 67 participants (healthy control, n = 14; mild endometrial injury, n = 24; severe endometrial injury, n = 29). Enhancement intensity (EI) and area under the time-intensity curve (AUC TIC ) were significantly lower in the severe endometrial injury patients than healthy and mild endometrial injury subjects for both endometrial and subendometrial regions ( P < 0.05). Correlations analysis showed that EI and AUC TIC were positively correlated with endometrial thickness ( r = 0.460, P = 0.01, and r = 0.555, P < 0.01, respectively) and subendometrial thickness ( r = 0.501, P < 0.01, and r = 0.438, P = 0.01, respectively). The area under the receiver operating characteristic curve, sensitivity, and specificity were 0.720 ( P = 0.002), 79.31%, and 66.67% for endometrial EI; 0.818 ( P < 0.001), 75.86%, and 79.17% for subendometrial EI; 0.917 ( P < 0.001), 72.41%, and 95.83% for endometrial AUC TIC ; and 0.810 ( P < 0.001), 89.66%, and 70.83% for subendometrial AUC TIC , respectively. Contrast-enhanced ultrasonography may have clinical utility in the prediction of endometrial injury in women of childbearing age.
子宫内膜损伤与妊娠结局不良相关。本研究的目的是评价超声造影(CEUS)对子宫内膜损伤的诊断效果。本研究包括在2020年4月至2021年1月期间在提交人所在医院接受子宫超声造影的妇女。通过受试者工作特征曲线分析评价超声诊断参数对重度子宫内膜损伤的诊断价值。该研究包括67名参与者(健康对照,n = 14;轻度子宫内膜损伤,n = 24;重度子宫内膜损伤(n = 29)。重度子宫内膜损伤患者的增强强度(EI)和时间-强度曲线下面积(AUC TIC)均显著低于健康和轻度子宫内膜损伤患者的子宫内膜和子宫内膜下区域(P < 0.05)。相关性分析显示,EI和AUC TIC与子宫内膜厚度(r = 0.460, P = 0.01, r = 0.555, P < 0.01)和子宫内膜下厚度(r = 0.501, P < 0.01, r = 0.438, P = 0.01)呈正相关。子宫内膜EI的受者工作特征曲线下面积、敏感性和特异性分别为0.720 (P = 0.002)、79.31%和66.67%;子宫内膜下EI分别为0.818 (P < 0.001)、75.86%和79.17%;子宫内膜AUC TIC分别为0.917 (P < 0.001)、72.41%、95.83%;子宫内膜下AUC TIC分别为0.810 (P < 0.001)、89.66%和70.83%。超声造影在预测育龄妇女子宫内膜损伤方面可能具有临床应用价值。
{"title":"Contrast-Enhanced Ultrasonography as a Diagnostic Strategy for Severe Endometrial Injury.","authors":"Tao Liu, Miao Zhou, Huihui Yang, Weixiang Liang, Ruiming Cai, Mingjin Cai","doi":"10.1097/RUQ.0000000000000645","DOIUrl":"https://doi.org/10.1097/RUQ.0000000000000645","url":null,"abstract":"<p><strong>Abstract: </strong>Endometrial injury is associated with poorer pregnancy outcomes. The purpose of this study was to evaluate the diagnostic efficacy of contrast-enhanced ultrasonography (CEUS) in the detection of endometrial injury. This study included women who underwent CEUS of the uterus at the author's hospital between April 2020 and January 2021. The diagnostic performances of the CEUS-derived parameters in the detection of severe endometrial injury were evaluated by receiver operating characteristic curve analyses. The study included 67 participants (healthy control, n = 14; mild endometrial injury, n = 24; severe endometrial injury, n = 29). Enhancement intensity (EI) and area under the time-intensity curve (AUC TIC ) were significantly lower in the severe endometrial injury patients than healthy and mild endometrial injury subjects for both endometrial and subendometrial regions ( P < 0.05). Correlations analysis showed that EI and AUC TIC were positively correlated with endometrial thickness ( r = 0.460, P = 0.01, and r = 0.555, P < 0.01, respectively) and subendometrial thickness ( r = 0.501, P < 0.01, and r = 0.438, P = 0.01, respectively). The area under the receiver operating characteristic curve, sensitivity, and specificity were 0.720 ( P = 0.002), 79.31%, and 66.67% for endometrial EI; 0.818 ( P < 0.001), 75.86%, and 79.17% for subendometrial EI; 0.917 ( P < 0.001), 72.41%, and 95.83% for endometrial AUC TIC ; and 0.810 ( P < 0.001), 89.66%, and 70.83% for subendometrial AUC TIC , respectively. Contrast-enhanced ultrasonography may have clinical utility in the prediction of endometrial injury in women of childbearing age.</p>","PeriodicalId":49116,"journal":{"name":"Ultrasound Quarterly","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10145677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1097/RUQ.0000000000000617
Seda Aladag Kurt, Ali Ergun Eryurekli, Yasemin Kayadibi, Cesur Samancı, Mehmet Velidedeoglu, Irem Onur, Serdar Arslan, Fusun Taskin
Abstract: The aim was to evaluate the effectiveness of superb microvascular imaging (SMI) in axillary lymph nodes (LNs).Benign and malignant LNs diagnosed via histopathological examination constituted the study subgroups. In addition to grayscale findings for morphological evaluation, vascular patterns and appearance of internal vessels were analyzed by both power Doppler ultrasound (PDUS) and SMI. The number of vascular branches was counted, and a vascularity index (VI) was calculated by SMI.Fifty-two LNs with suspicious findings in terms of metastasis (33 malignant and 19 benign) were evaluated. Diagnostic accuracy according to vascular patterns was 82% for PDUS and 92% for SMI. In the presence of asymmetric cortical thickening, there was a significant difference between benign and malignant LNs in the number of vascular branches of both thin and thick cortical sides ( P < 0.01). Mean VI was significantly higher in the malignant group ( P < 0.05). In differentiating malignancy, when a cutoff VI value was set to 9%, sensitivity was 69.7%, and specificity was 63.2%.Evaluating the vascularity of axillary LNs by SMI is a useful tool in determining the potential of axillary metastasis, especially in the absence of typical sonographic findings. Superb microvascular imaging can beneficially be used to select the most suspicious LN and suspicious area of the LN to sample.
{"title":"Diagnostic Performance of Superb Microvascular Imaging in Differentiating Benign and Malignant Axillary Lymph Nodes.","authors":"Seda Aladag Kurt, Ali Ergun Eryurekli, Yasemin Kayadibi, Cesur Samancı, Mehmet Velidedeoglu, Irem Onur, Serdar Arslan, Fusun Taskin","doi":"10.1097/RUQ.0000000000000617","DOIUrl":"https://doi.org/10.1097/RUQ.0000000000000617","url":null,"abstract":"<p><strong>Abstract: </strong>The aim was to evaluate the effectiveness of superb microvascular imaging (SMI) in axillary lymph nodes (LNs).Benign and malignant LNs diagnosed via histopathological examination constituted the study subgroups. In addition to grayscale findings for morphological evaluation, vascular patterns and appearance of internal vessels were analyzed by both power Doppler ultrasound (PDUS) and SMI. The number of vascular branches was counted, and a vascularity index (VI) was calculated by SMI.Fifty-two LNs with suspicious findings in terms of metastasis (33 malignant and 19 benign) were evaluated. Diagnostic accuracy according to vascular patterns was 82% for PDUS and 92% for SMI. In the presence of asymmetric cortical thickening, there was a significant difference between benign and malignant LNs in the number of vascular branches of both thin and thick cortical sides ( P < 0.01). Mean VI was significantly higher in the malignant group ( P < 0.05). In differentiating malignancy, when a cutoff VI value was set to 9%, sensitivity was 69.7%, and specificity was 63.2%.Evaluating the vascularity of axillary LNs by SMI is a useful tool in determining the potential of axillary metastasis, especially in the absence of typical sonographic findings. Superb microvascular imaging can beneficially be used to select the most suspicious LN and suspicious area of the LN to sample.</p>","PeriodicalId":49116,"journal":{"name":"Ultrasound Quarterly","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10052567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1097/RUQ.0000000000000601
Adam J Engel, Kyungmin Shin, Beatriz E Adrada, Tanya W Moseley, Savitri Krishnamurthy, Gary J Whitman
Abstract: This article reviews the ultrasound evaluation and staging of breast cancer with respect to the involvement of interpectoral (Rotter) lymph nodes. The primary objective is to demonstrate and assess the characteristic sonographic findings of interpectoral (Rotter) lymph nodes to help provide accurate nodal staging information. We aim to provide a comprehensive review and serve as an imaging guide for the identification and evaluation of Rotter lymph nodes. The detection of abnormalities and pathologic features of metastatic axillary nodal disease in the interpectoral region is reviewed, and the impact on clinical management and treatment is discussed. In the radiology literature, there is no comprehensive review of the sonographic appearance and evaluation of Rotter lymph nodes.
{"title":"Review of the Sonographic Features of Interpectoral (Rotter) Lymph Nodes in Breast Cancer Staging.","authors":"Adam J Engel, Kyungmin Shin, Beatriz E Adrada, Tanya W Moseley, Savitri Krishnamurthy, Gary J Whitman","doi":"10.1097/RUQ.0000000000000601","DOIUrl":"https://doi.org/10.1097/RUQ.0000000000000601","url":null,"abstract":"<p><strong>Abstract: </strong>This article reviews the ultrasound evaluation and staging of breast cancer with respect to the involvement of interpectoral (Rotter) lymph nodes. The primary objective is to demonstrate and assess the characteristic sonographic findings of interpectoral (Rotter) lymph nodes to help provide accurate nodal staging information. We aim to provide a comprehensive review and serve as an imaging guide for the identification and evaluation of Rotter lymph nodes. The detection of abnormalities and pathologic features of metastatic axillary nodal disease in the interpectoral region is reviewed, and the impact on clinical management and treatment is discussed. In the radiology literature, there is no comprehensive review of the sonographic appearance and evaluation of Rotter lymph nodes.</p>","PeriodicalId":49116,"journal":{"name":"Ultrasound Quarterly","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10118015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract: The clinical data of 15 cases that planned to receive totally laparoscopic associating liver partition and portal vein ligation for staged hepatectomy were retrospectively collected. Before the stage 1 operation, the size and number of the tumors in future liver remnant (FLR) and the presence of cancer embolus in the portal vein were assessed using contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT). Before the stage 2 operation, CEUS was performed to assess the presence of traffic blood flow between the diseased liver and FLR after round-the-liver ligation. Before the stage 1 operation, 5 cases with tumors in FLR were found by CEUS and 6 cases were found by CECT ( P > 0.05). Similarly, CEUS found 5 cases with cancer thrombus in portal vein, and CECT found 7 cases ( P = 0.500). The consistency between the 2 modalities was good (κ = 0.857, P < 0.05, κ = 0.727, P < 0.05, respectively). Before the stage 2 operation, CEUS confirmed that there were 7 cases without traffic blood flow between the diseased liver and FLR, and 3 cases with residual traffic blood flow. The daily growth rate of FLR in the group without traffic blood flow (mean rank = 7.00) was higher than that in the group with traffic blood flow (2.00) significantly ( P < 0.05). Contrast-enhanced ultrasound is a promising application in the preoperative evaluation of totally laparoscopic associating liver partition and portal vein ligation for staged hepatectomy.
{"title":"Preoperative Value of Contrast-Enhanced Ultrasound in Totally Laparoscopic Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy for Liver Tumors: A Preliminary Study.","authors":"Li-Long Xu, Ling Zhou, Xiao Liang, Lin-Lin Zheng, Hai-Shan Xu, Chao Chen, Peng Hu, Shi-Yan Li","doi":"10.1097/RUQ.0000000000000631","DOIUrl":"https://doi.org/10.1097/RUQ.0000000000000631","url":null,"abstract":"<p><strong>Abstract: </strong>The clinical data of 15 cases that planned to receive totally laparoscopic associating liver partition and portal vein ligation for staged hepatectomy were retrospectively collected. Before the stage 1 operation, the size and number of the tumors in future liver remnant (FLR) and the presence of cancer embolus in the portal vein were assessed using contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT). Before the stage 2 operation, CEUS was performed to assess the presence of traffic blood flow between the diseased liver and FLR after round-the-liver ligation. Before the stage 1 operation, 5 cases with tumors in FLR were found by CEUS and 6 cases were found by CECT ( P > 0.05). Similarly, CEUS found 5 cases with cancer thrombus in portal vein, and CECT found 7 cases ( P = 0.500). The consistency between the 2 modalities was good (κ = 0.857, P < 0.05, κ = 0.727, P < 0.05, respectively). Before the stage 2 operation, CEUS confirmed that there were 7 cases without traffic blood flow between the diseased liver and FLR, and 3 cases with residual traffic blood flow. The daily growth rate of FLR in the group without traffic blood flow (mean rank = 7.00) was higher than that in the group with traffic blood flow (2.00) significantly ( P < 0.05). Contrast-enhanced ultrasound is a promising application in the preoperative evaluation of totally laparoscopic associating liver partition and portal vein ligation for staged hepatectomy.</p>","PeriodicalId":49116,"journal":{"name":"Ultrasound Quarterly","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10053126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1097/RUQ.0000000000000624
Keith Feldman, Justin Baraboo, Deeyendal Dinakarpandian, Sherwin S Chan
Abstract: The aim of this study was to determine if machine learning can improve the specificity of detecting transplant hepatic artery pathology over conventional quantitative measures while maintaining a high sensitivity.This study presents a retrospective review of 129 patients with transplanted hepatic arteries. We illustrate how beyond common clinical metrics such as stenosis and resistive index, a more comprehensive set of waveform data (including flow half-lives and Fourier transformed waveforms) can be integrated into machine learning models to obtain more accurate screening of stenosis and occlusion. We present a novel framework of Extremely Randomized Trees and Shapley values, we allow for explainability at the individual level.The proposed framework identified cases of clinically significant stenosis and occlusion in hepatic arteries with a state-of-the-art specificity of 65%, while maintaining sensitivity at the current standard of 94%. Moreover, through 3 case studies of correct and mispredictions, we demonstrate examples of how specific features can be elucidated to aid in interpreting driving factors in a prediction.This work demonstrated that by utilizing a more complete set of waveform data and machine learning methodologies, it is possible to reduce the rate of false-positive results in using ultrasounds to screen for transplant hepatic artery pathology compared with conventional quantitative measures. An advantage of such techniques is explainability measures at the patient level, which allow for increased radiologists' confidence in the predictions.
{"title":"Machine Learning Algorithm Improves the Prediction of Transplant Hepatic Artery Stenosis or Occlusion: A Single-Center Study.","authors":"Keith Feldman, Justin Baraboo, Deeyendal Dinakarpandian, Sherwin S Chan","doi":"10.1097/RUQ.0000000000000624","DOIUrl":"https://doi.org/10.1097/RUQ.0000000000000624","url":null,"abstract":"<p><strong>Abstract: </strong>The aim of this study was to determine if machine learning can improve the specificity of detecting transplant hepatic artery pathology over conventional quantitative measures while maintaining a high sensitivity.This study presents a retrospective review of 129 patients with transplanted hepatic arteries. We illustrate how beyond common clinical metrics such as stenosis and resistive index, a more comprehensive set of waveform data (including flow half-lives and Fourier transformed waveforms) can be integrated into machine learning models to obtain more accurate screening of stenosis and occlusion. We present a novel framework of Extremely Randomized Trees and Shapley values, we allow for explainability at the individual level.The proposed framework identified cases of clinically significant stenosis and occlusion in hepatic arteries with a state-of-the-art specificity of 65%, while maintaining sensitivity at the current standard of 94%. Moreover, through 3 case studies of correct and mispredictions, we demonstrate examples of how specific features can be elucidated to aid in interpreting driving factors in a prediction.This work demonstrated that by utilizing a more complete set of waveform data and machine learning methodologies, it is possible to reduce the rate of false-positive results in using ultrasounds to screen for transplant hepatic artery pathology compared with conventional quantitative measures. An advantage of such techniques is explainability measures at the patient level, which allow for increased radiologists' confidence in the predictions.</p>","PeriodicalId":49116,"journal":{"name":"Ultrasound Quarterly","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10065041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}