Ultrasound in Medicine and Biology最新文献

Objective: This study aimed to evaluate the diagnostic performance and inter-observer consistency of contrast-enhanced ultrasound (CEUS) Thyroid Imaging Reporting and Data System (TI-RADS) for the risk stratification of thyroid nodules.

Methods: This study retrospectively included consecutive patients with thyroid nodules who underwent non-enhanced US and CEUS examinations from three medical centers between January 2022 and August 2022. Four readers evaluated the US features of these thyroid nodules and classified them according to the American College of Radiology (ACR) TI-RADS and CEUS TI-RADS. The diagnostic performance of CEUS TI-RADS and the unnecessary fine needle aspiration biopsy rate were assessed and compared with ACR TI-RADS. Intra-class correlation coefficients were used for assessing the multi-reader consistency.

Results: A total of 483 patients (mean age, 46.8 ± 12.8 years; 354 females) with 515 pathology-proven thyroid nodules (315 malignant) were included. CEUS TI-RADS had better diagnostic accuracy (85.6%-88.5% vs. 77.5%-84.5%, p<0.05) and specificity (68.0%-78.0% vs. 45.5%-62.5%, p<0.05), while obtaining a similar sensitivity as ACR TI-RADS (95.2%-97.1% vs. 97.8%-98.4%, p>0.05). The unnecessary biopsy rate of CEUS TI-RADS was lower than that of ACR TI-RADS (27.8% vs. 35.5%, p<0.05) for 1 cm or larger nodules. Excellent inter-reader consistency was gained in the assessment of the CEUS TI-RADS categories (with an intra-class correlation coefficient of 0.896). Meanwhile, moderate to good inter-reader consistency was obtained in the assessment of the CEUS features (with intra-class correlation coefficients ranging from 0.500 to 0.846).

Conclusion: With satisfactory inter-reader consistency, the CEUS TI-RADS criteria significantly improved diagnostic performance and fine needle aspiration biopsy recommendations for thyroid nodules.

Objective: Diabetes impairs intestinal barrier integrity and disrupts gut microbiota balance, exacerbating hyperglycemia. While low-intensity pulsed ultrasound (LIPUS) has been shown to alleviate inflammatory bowel disease (IBD), its role in diabetes-related gut dysfunction remains unclear. This study aimed to investigate whether LIPUS could improve intestinal barrier function, modulate gut microbiota, and mitigate hyperglycemia in type 1 diabetic (T1D) mice.

Methods: Streptozotocin-induced type 1 diabetic (T1D) mice received a daily 20-min abdominal LIPUS treatment (30 mW/cm²) for 6 wk. Body weight and blood glucose levels were monitored weekly throughout the intervention period. After sacrifice, the intestinal morphology was examined, and barrier integrity was systematically evaluated. The composition of the gut microbiota was analyzed, along with the quantification of microbial-derived metabolites.

Results: T1D mice exhibited weight loss, hyperglycemia, intestinal damage, and microbial dysbiosis. LIPUS treatment upregulated the intestinal mRNA expression of ZO-1 and Occludin, enhancing barrier function. LIPUS increased the abundance of beneficial bacteria (e.g., Lactobacillus, Intestinimonas) and the levels of short-chain fatty acids (acetate, propionate, butyrate), while reducing lipopolysaccharides. Crucially, LIPUS significantly lowered blood glucose levels in the diabetic mice.

Conclusion: These findings demonstrate that abdominal LIPUS restores gut barrier integrity and microbiota homeostasis, offering a novel therapeutic strategy for mitigating the progression of diabetes.

Objective: This study aimed to assess the inhibitory effects and underlying mechanisms of sonodynamic therapy (SDT) mediated by the novel sonosensitizer sinoporphyrin sodium (DVDMS) in oral squamous cell carcinoma (OSCC) cells exhibiting distinct TP53 genotypes.

Methods: Cytotoxicity, intracellular uptake and localization of DVDMS, reactive oxygen species (ROS) levels, apoptosis and autophagy were assessed in two OSCC cell lines (SAS and HSC-3). Expression levels of p53, Bax, Bcl-2 and LC3B proteins were analyzed. The p53 inhibitor pifithrin-α (PFT-α) was utilized to determine its modulatory effects on SDT-induced cellular responses in SAS cells.

Results: DVDMS-mediated SDT significantly inhibited cell proliferation in both SAS and HSC-3 lines. DVDMS predominantly accumulated in the mitochondria, with higher colocalization observed in SAS cells. SDT induced a marked elevation in intracellular ROS and mitochondrial apoptosis, particularly in SAS cells. After 2 h of SDT, there was a significant decrease in autophagic activity in SAS cells, whereas an increase was noted in HSC-3 cells. In SAS cells, SDT resulted in significant upregulation and nucleocytoplasmic translocation of p53 protein. Treatment with PFT-α partially attenuated apoptosis, reversed autophagy inhibition and suppressed p53 translocation in SAS cells.

Conclusion: DVDMS-mediated SDT elicited greater cytotoxic responses in OSCC cells harboring wild-type TP53 (SAS) compared to mutant TP53 (HSC-3) cells. The therapy induced mitochondrial apoptosis and modulated autophagy in both cell lines, with more pronounced responses observed in wild-type TP53 cells. These findings suggest that p53 plays a critical regulatory role in mediating SDT-induced mitochondrial apoptosis and autophagy under DVDMS sensitization in OSCC.

Objective: Acoustically activatable perfluoropropane droplets (PD) have been utilized to enhance the reperfused zone in acute myocardial infarction small animal models. Despite the correlation with infarct size, the enhanced area consistently overestimates infarct size. We hypothesized that the enhanced area correlates with risk area, and that hypo-enhanced areas (HEA) within the enhanced zone represent the ultimate infarct size.

Methods: Intravenous PD was administered in the reperfusion period following a 90 min period of ischemia in 30 pigs. Injections were given at either 30 min, 1 d or 7 d following reperfusion to determine what the enhanced regions within the reperfused zone following acoustic activation (AA) were detecting. Correlations of the enhanced and unenhanced regions with the infarct size using delayed enhancement magnetic resonance imaging (DE-MRI) were determined.

Results: AA within the reperfused zone was evident in 26 pigs (9/10 pigs injected at 30 min post-reperfusion, 9/10 pigs injected at 1 d and 8/10 pigs injected at 7 d). In the 26 pigs with AA, the extent of enhancement was significantly larger than the infarct size by DE-MRI, and correlated more closely with risk area (r = 0.55, p = 0.0002). A HEA within the enhanced region was observed in 21 of the 26 pigs with AA, and the spatial extent of HEA correlated with infarct size (r = 0.85; p < 0.0001).

Conclusion: AA of intravenous PD enhances the risk area following reperfusion. However, it is the extent of hypo-enhancement within the enhanced region that predicts infarct size irrespective of the time AA is performed following reperfusion.

Background: Accurate prediction of significant liver inflammation is critical for making clinical intervention decisions. This study aims to establish a predictive model for detection of significant liver inflammation and assess its diagnostic performance against established scoring systems.

Method: This study enrolled patients who underwent ultrasound-guided liver biopsy between July 26, 2024, and November 30, 2024. Demographic data, laboratory parameters, viscosity plane-wave ultrasound (Vi PLUS), mean values and histopathological inflammation grading, fibrosis stage were collected. A nomogram model was generated based on a multivariate logistic regression analysis to identify potential predictors associated with liver inflammation. The diagnostic performance was evaluated by receiver operating characteristic curve analysis, calibration plot and decision curve.

Result: A total of 140 participants were included in this study. 98 patients were classified into the significant inflammation group (≥G2), and 42 patients were categorized as mild inflammation (G0-G1). Based on univariate and multivariate logistic regression analyses, Vi PLUS mean (odds ratios [OR]: 9.060) and aspartate aminotransferase (AST) (OR: 2111.269) were identified as independent risk factors for inflammatory grade (p < 0.05). The area under the curve (AUC) of the nomogram constructed by Vi PLUS mean and AST was 0.941 (95% confidence intervals 0.898-0.983, sensitivity 92.9%, specificity 85.7%), outperforming AST to platelet ratio index (AUC = 0.897), Vi PLUS mean (AUC = 0.897), FIB-4 (AUC = 0.885), AST (AUC = 0.852) and gamma-glutamyl transpeptidase to platelet ratio (AUC = 0.755) (all p < 0.05). Furthermore, a well-fitted calibration curve and a good clinical application value were achieved in the nomogram. The cutoff value of 0.538 was determined to predict significant inflammation.

Conclusion: The nomogram exhibits high accuracy in predicting significant liver inflammation and provide a new approach for clinicians to better evaluate inflammatory activity.

Ultrasound shear wave elastography (SWE) enables the reliable assessment of tissue stiffness in vivo. Recently, SWE has emerged as a tool to study musculoskeletal tissue mechanics in healthy and pathological populations, such as individuals with knee osteoarthritis (KOA). No previous articles have explicitly reviewed the implementation of SWE methodology in KOA populations. Therefore, a scoping review of published literature was performed to investigate study equipment details, measurement protocols and participant/transducer positioning as they relate to SWE methodology. The databases PubMed, CINAHL, Scopus and Embase were searched for published literature, yielding n = 29 articles that met inclusion criteria. Results were summarized by tissue type under investigation (n = 7, muscle, tendon, adipose, multiple tissues, cartilage, nerve and joint capsule). Examined in over half of all included studies (55%), muscle was the predominant tissue under investigation, while relatively few studies focused on direct KOA-related structures, such as cartilage. Transducer type and orientation were the only relatively homogenous SWE methods, with 93% of all included studies using linear transducers and 91% of reporting studies using parallel orientation. Notable heterogeneity in SWE methods was present across device modes, settings, stiffness measures and body, knee and transducer positioning. These findings indicate that methodological variability remains a significant challenge for SWE research in KOA, potentially limiting the reproducibility and generalizability of the stiffness outcomes that drive our current understanding of tissue mechanics in this population. Collectively, these results highlight the need for tissue-specific SWE methodology standardization to enhance the reliability, comparability and clinical interpretability of SWE in KOA research.

Objective: This study aimed to explore the feasibility of a discriminative correlation filter network (DCFNet)-based algorithm for positioning inconspicuous focal liver lesions (FLLs) on conventional US by tracking surrounding anatomical landmarks (SALs).

Methods: We established an algorithm that exploits the relative position characteristics of SALs to achieve tracking of inconspicuous FLLs in real-time US. Multiple SALs were tracked simultaneously using DCFNet, a fast deep learning-based tracking framework. The proposed DCFNet-based algorithm could assist real-time FLLs tracking on US and further guide puncture or ablation. We designed US-visible and US-invisible liver tumor phantoms for tracking and puncture performance evaluation. Algorithm performance was evaluated via matching accuracy, precision and positional error. Puncture verification was assessed in terms of success rate and guidance time on US-invisible liver tumor phantoms.

Results: A total of 20 US-visible phantoms, 20 US-invisible phantoms, and initial clinical cases were included. the algorithm achieved a tracking accuracy of 93.2%, precision of 92.9% and mean tumor localization error of 0.7 ± 0.4 mm in US-visible phantoms. For US-invisible phantoms, the puncture success rate was 94.3% with an average duration of 4 (3-5) s.

Conclusion: The DCFNet-based algorithm could be used as a potential approach for locating and tracking inconspicuous FLLs on US, with preliminary clinical feasibility that warrants further large-scale validation.

Hibernation can significantly reduce energy consumption and prolong survival by decreasing the metabolic rate and body temperature. Understanding the brain regulatory mechanisms may help overcome challenges in applying hibernation techniques to humans. In this study, we induced hibernation-like state in mice using pharmacological agents and monitored the process within the brain using resting-state functional ultrasound imaging. During hibernation and recovery, we measured various physiological parameters, including heart rate, body temperature, and cerebral blood volume. Additionally, we observed cerebral hemodynamic metrics and brain functional connectivity (FC) patterns. The results revealed significant reductions in heart rate, body temperature, and cerebral blood volume during this state. Notably, cerebral blood flow (CBF) decreased by about 50% on average, with the thalamus showing a more pronounced and delayed decline compared to other examined regions, accompanied by corresponding alterations in FC. A strong correlation (r = 0.82) was observed between changes in CBF and brain FC. This study provides insights into the unique regulation of CBF during hibernation, offering a deeper understanding of the brain regulation in this process.