Ultrasound in Medicine and Biology最新文献_第2页

Perioperative Detection of Cerebral Fat Emboli From Bone Using High-Frequency Doppler Ultrasound 利用高频多普勒超声在围手术期检测来自骨骼的脑脂肪栓子

IF 2.4 3区医学 Q2 ACOUSTICS

Ultrasound in Medicine and Biology

Pub Date : 2024-10-21 DOI: 10.1016/j.ultrasmedbio.2024.09.017

Anders Hagen Jarmund , Steinar Kristiansen , Martin Leth-Olsen , Christina Vogt , Ingunn Nervik , Hans Torp , Erik Waage Nielsen , Siri Ann Nyrnes

Objective

Fat embolism syndrome and cerebral fat emboli are rare yet serious conditions arising from systemic distribution of bone marrow emboli. Emboli are known to produce high-intensity transient signals (HITS) in a Doppler signal. We hypothesized that both intramedullary nailing in pigs and median sternotomy in human infants cause bone marrow release, that some of these cause cerebral emboli, and that these were detectable by a new cerebral doppler ultrasound monitoring system (NeoDoppler). We also aimed to describe the intensity of HITS generated during these procedures.

Methods

Specific pathogen-free Norwegian landrace pigs were allocated to either bilateral femoral nailing or injection of autologous bone marrow (positive controls). Testing was carried out under continuous Doppler monitoring. Presence of cerebral emboli was confirmed with histology. NeoDoppler data from infants undergoing sternotomy prior to cardiac surgery were investigated for comparison.

Results

Eleven of twelve pigs were monitored with cerebral Doppler ultrasound during femoral surgery. HITS were seen in five (45%). Brain biopsies demonstrated bone marrow emboli in 11 of the 12 (92%). Four positive control pigs received intraarterial injections of bone marrow, saline, or contrast, and strong HITS were detected in all pigs (100%). Median sternotomy in eight human infants was associated with a significant increase in embolic burden; the HITS intensity was lower than HITS in pigs.

Conclusion

High-frequency cerebral Doppler ultrasound is a valuable tool for perioperative monitoring that can detect emboli in real-time, but sensitivity and specificity for bone marrow emboli may be limited and size-dependent.

目的：脂肪栓塞综合征和脑脂肪栓塞是由于骨髓栓子分布于全身而引起的罕见但严重的疾病。众所周知，栓子会在多普勒信号中产生高强度瞬时信号（HITS）。我们假设猪的髓内钉和人类婴儿的胸骨正中切开术都会造成骨髓释放，其中一些会造成脑栓塞，而这些栓子可通过新型脑多普勒超声监测系统（NeoDoppler）检测到。我们的目的还在于描述在这些过程中产生的HITS的强度：方法：将特定的无病原体挪威陆地猪分配到双侧股骨钉或注射自体骨髓（阳性对照组）中。测试在连续多普勒监测下进行。通过组织学检查确认是否存在脑栓塞。为了进行比较，还调查了在心脏手术前接受胸骨切开术的婴儿的新多普勒数据：股骨手术期间，对 12 头猪中的 11 头进行了脑多普勒超声监测。五头猪（45%）出现 HITS。脑活检显示，12 头猪中有 11 头（92%）出现骨髓栓塞。四头阳性对照猪接受了骨髓、生理盐水或造影剂的动脉内注射，所有猪（100%）都检测到了强烈的HITS。8 名人类婴儿的胸骨中线切开术与栓塞负荷的显著增加有关；HITS 强度低于猪的 HITS：结论：高频脑多普勒超声是围手术期监测的重要工具，可实时检测栓子，但对骨髓栓子的敏感性和特异性可能有限，且取决于栓子的大小。

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引用次数: 0

Amplitude-Modulation Frequency Optimization for Enhancing Harmonic Motion Imaging Performance of Breast Tumors in the Clinic 优化振幅调制频率，提高乳腺肿瘤的临床谐波运动成像性能。

IF 2.4 3区医学 Q2 ACOUSTICS

Ultrasound in Medicine and Biology

Pub Date : 2024-10-19 DOI: 10.1016/j.ultrasmedbio.2024.09.021

Yangpei Liu , Md Murad Hossain , Xiaoyue Judy Li , Elisa E. Konofagou

Objective

Elastography images tissue mechanical responses and infers the underlying properties to aid diagnosis and treatment response monitoring. The estimation of absolute or relative tumor properties may vary with dimensions even when the mechanical properties remain constant. Harmonic motion imaging (HMI) uses amplitude-modulated (AM) focused ultrasound to interrogate the targeted tissue's viscoelastic properties. In this study, effects of AM frequencies on HMI were investigated in terms of inclusion relative stiffness and size estimation.

Methods

AM frequencies from 200 to 600 Hz in steps of 100 Hz were considered using a 5.3-kPa phantom with cylindrical inclusions (Young's modulus: 22, 31, 44, 56 kPa, and diameter: 4.8, 8.1, 13.6, 19.8 mm) to optimize the performance of HMI in characterizing tumors with the same mechanical properties and of different dimensions.

Results

Consistent displacement ratios (DRs) (17.5% variation) of the inclusion to background were obtained with 200-Hz AM for breast-tumor-mimicking inclusions albeit a suboptimal inclusion size estimation obtained. 400-Hz was otherwise used for small and low-contrast inclusions (4.8 mm, 22 or 31 kPa). A linear relationship (R² = 0.9043) was found between the inverse DR at these frequencies and the Young's modulus ratio. 400 Hz obtained the most accurate inclusion size estimation with an overall estimation error on the lateral dimension of 0.5 mm. In vivo imaging of breast cancer patients (n = 5) was performed at 200 or 400 Hz.

Conclusion

The results presented herein indicate that the HMI AM frequency could be optimized adaptively in cases of different applications, i.e., at 200 or 400 Hz, depending on whether aimed for consistent DR measurement for tumor response assessment or tumor margin delineation for surgical planning. HMI may thus be capable of predicting the pathologic endpoint of tumors in response to neoadjuvant chemotherapy (NACT) as early as 3 weeks into treatment.

目的：弹性成像技术可对组织的机械反应进行成像，并推断其基本特性，从而帮助诊断和监测治疗反应。即使机械特性保持不变，对肿瘤绝对或相对特性的估计也会随尺寸变化。谐波运动成像（HMI）使用调幅（AM）聚焦超声波来检测目标组织的粘弹性特性。在这项研究中，研究了 AM 频率对 HMI 的影响，包括相对硬度和尺寸估计：方法：使用带有圆柱形内含物（杨氏模量：22、31、44、56 kPa，直径：4.8、8.1、13.6、19.8 mm）的 5.3-kPa 模体，以 100 Hz 为步长，考虑了从 200 Hz 到 600 Hz 的 AM 频率，以优化 HMI 在表征具有相同机械特性和不同尺寸的肿瘤时的性能：结果：对于乳腺肿瘤模拟包涵体，使用 200Hz AM 可获得一致的包涵体与背景位移比 (DRs)（变化率为 17.5%），尽管对包涵体大小的估计不够理想。400Hz则用于小的低对比度内含物（4.8 毫米、22 或 31 千帕）。这些频率下的反 DR 与杨氏模量比之间存在线性关系 (R2 = 0.9043)。400 Hz 可获得最准确的包膜尺寸估计，横向尺寸的总体估计误差为 0.5 毫米。乳腺癌患者（n = 5）的活体成像在 200 或 400 Hz 下进行：本文介绍的结果表明，在不同的应用情况下，HMI 调幅频率可以进行自适应优化，即 200 或 400 Hz，具体取决于是以肿瘤反应评估的一致性 DR 测量为目标，还是以手术规划的肿瘤边缘划定为目标。因此，HMI 可以在治疗 3 周后预测肿瘤对新辅助化疗（NACT）反应的病理终点。

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引用次数: 0

Contrast-Enhanced Ultrasound of Mouse Models of Hindlimb Ischemia Reveals Persistent Perfusion Deficits and Distinctive Muscle Perfusion Patterns 后肢缺血小鼠模型的对比增强超声显示持续的灌注缺陷和独特的肌肉灌注模式

IF 2.4 3区医学 Q2 ACOUSTICS

Ultrasound in Medicine and Biology

Pub Date : 2024-10-18 DOI: 10.1016/j.ultrasmedbio.2024.08.013

Alyssa B. Becker , Lanlin Chen , John A. Hossack , Alexander L. Klibanov , Brian H. Annex , Brent A. French

Objective

Mouse models of hindlimb ischemia (HLI) are used to study peripheral arterial disease and evaluate novel therapies. Contrast-enhanced ultrasound (CEUS) is a noninvasive perfusion measurement technique that is increasingly being employed in these models. The objective of this study was to evaluate two models of severe HLI by CEUS to characterize perfusion recovery and muscle perfusion patterns.

Methods

Mice undergoing double femoral artery ligation were measured by CEUS and laser Doppler perfusion imaging (LDPI) at baseline and 1–150 d postsurgery. A second group undergoing femoral artery ligation and excision was measured 1–28 d postsurgery.

Results

By LDPI, both surgeries showed robust perfusion recovery by 14 d postsurgery. However, by CEUS only a ∼40% perfusion recovery plateau was reached in either group. These results are consistent with our previous work, employing a less severe single femoral artery ligation, that showed perfusion in the ischemic limb does not return to normal by 150 d postsurgery. Cluster analysis of muscle perfusion patterns indicated 3–5 different patterns at day 1 postsurgery. The double ligation model yielded significantly less variable perfusion patterns, suggesting that it can provide more reproducible results.

Conclusion

Contrary to LDPI, perfusion as measured by CEUS never fully recovers after hindlimb surgery, even when followed 28–150 d postsurgery. Individual mice can manifest different patterns of muscle perfusion to the same surgery, but these patterns are conserved within and between different surgical techniques. These results may have significant implications for the evaluation of novel therapeutics to treat PAD in mice.

目的：后肢缺血（HLI）小鼠模型用于研究外周动脉疾病和评估新型疗法。对比增强超声（CEUS）是一种无创灌注测量技术，越来越多地被用于这些模型中。本研究的目的是通过 CEUS 评估两种严重 HLI 模型，以确定灌注恢复和肌肉灌注模式的特征：方法：对接受双股动脉结扎的小鼠在基线和术后 1-150 d 通过 CEUS 和激光多普勒灌注成像（LDPI）进行测量。第二组接受股动脉结扎和切除术的小鼠在术后1-28 d接受测量：结果：通过 LDPI，两种手术在术后 14 d 都显示出强劲的灌注恢复。然而，通过 CEUS，两组患者的血流灌注恢复都只达到了 40% 左右。这些结果与我们之前采用较轻的单股动脉结扎术的研究结果一致，即缺血肢体的血流灌注在术后150 d仍未恢复正常。肌肉灌注模式的聚类分析显示，术后第1天有3-5种不同的模式。双结扎模型产生的灌注模式变化明显较少，这表明它能提供更多可重复的结果：结论：与 LDPI 相反，通过 CEUS 测定的灌注在后肢手术后从未完全恢复，即使在手术后 28-150 d 也是如此。个体小鼠对同一手术会表现出不同的肌肉灌注模式，但这些模式在不同手术技术内部和之间是一致的。这些结果可能对评估治疗小鼠PAD的新型疗法具有重要意义。

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引用次数: 0

Perfluorobutane-Enhanced CEUS in Intrahepatic Cholangiocarcinoma: Correlating Imaging Features With Liver Backgrounds and Tumor Sizes 全氟丁烷增强 CEUS 在肝内胆管癌中的应用：成像特征与肝脏背景和肿瘤大小的相关性

IF 2.4 3区医学 Q2 ACOUSTICS

Ultrasound in Medicine and Biology

Pub Date : 2024-10-18 DOI: 10.1016/j.ultrasmedbio.2024.09.009

Li Wei , Hyo-Jin Kang , Yun-Lin Huang , Jia-Ying Cao , Xiu-Yun Lu , Yi Dong , Jeong Min Lee

Objective

To investigate Sonazoid contrast-enhanced ultrasound (CEUS) features of intrahepatic cholangiocarcinoma (ICC) based on liver backgrounds and tumor sizes.

Methods

A retrospective analysis was conducted on patients with histopathologically diagnosed ICC at two centers. Patients underwent Sonazoid CEUS examination at a dose of 0.0165 mL/kg before surgery or biopsy. Continuous imaging was recorded for the first 70 s, followed by intermittent scanning every 15–20 s for 5 min, with a Kupffer phase captured after an 8-min delay. Patients were categorized by liver backgrounds and tumor sizes. Two ultrasound experts evaluated the enhancement patterns of ICCAs during the arterial, portal, delayed, and Kupffer phases according to current guidelines.

Results

From February 2019 to July 2022, a total of 85 ICC lesions were included. ICCs were categorized into normal liver (n = 24), chronic liver disease with fibrosis (n = 40), and cirrhosis (n = 21) groups based on different liver backgrounds, and into groups measuring ≤30 mm (n = 22), 31–50 mm (n = 32), and >50 mm (n = 31) based on tumor sizes. Most ICCs in liver fibrosis or liver cirrhosis tended to show non-rim enhancement in arterial phase (p = 0.022) and relatively later washout (39.9 ± 8.5 s vs. 39.7 ± 13.0 s) compared with those on a normal liver background (28.1 ± 5.6 s) (p < 0.001). Based on CEUS Liver Imaging Reporting and Data System, the diagnostic performance of LR-M criteria showed an accuracy of 100% in our high-risk populations. ICCs of ≤30 mm more commonly showed non-rim enhancement in arterial phase (p = 0.003) and relatively later washout (41.3 ± 12.5 s) compared with larger ICCs (p = 0.046). In the Kupffer phase, all ICCs showed marked washout with sharp margin delineation on Sonazoid CEUS, regardless of liver backgrounds and tumor sizes.

Conclusion

Sonazoid CEUS features of ICCs differ according to different liver backgrounds and tumor sizes. Arterial phase non-rim enhancement and relatively later washout were more commonly observed in ICCs on liver fibrosis or cirrhosis background or smaller ICCs (≤30 mm).

目的：根据肝脏背景和肿瘤大小研究肝内胆管癌（ICC）的 Sonazoid 对比增强超声（CEUS）特征：根据肝脏背景和肿瘤大小研究肝内胆管癌（ICC）的Sonazoid对比增强超声（CEUS）特征：对两个中心经组织病理学诊断为ICC的患者进行回顾性分析。患者在手术或活检前接受了剂量为 0.0165 mL/kg 的 Sonazoid CEUS 检查。在最初的70秒内进行连续成像记录，然后在5分钟内每隔15-20秒进行间歇扫描，并在延迟8分钟后采集Kupffer相。根据肝脏背景和肿瘤大小对患者进行分类。两位超声专家根据现行指南评估了 ICCAs 在动脉期、门脉期、延迟期和 Kupffer 期的增强模式：从2019年2月至2022年7月，共纳入85例ICC病变。根据不同的肝脏背景，将ICC分为正常肝脏组（24例）、慢性肝病伴肝纤维化组（40例）和肝硬化组（21例）；根据肿瘤大小，将ICC分为≤30毫米组（22例）、31-50毫米组（32例）和>50毫米组（31例）。大多数肝纤维化或肝硬化的 ICC 在动脉期倾向于显示非边缘强化（p = 0.022），与正常肝脏背景的 ICC 相比，冲洗时间相对较晚（39.9 ± 8.5 秒 vs. 39.7 ± 13.0 秒）（28.1 ± 5.6 秒）（p < 0.001）。根据 CEUS 肝脏成像报告和数据系统，LR-M 标准在高危人群中的诊断准确率为 100%。与较大的 ICC 相比，≤30 mm 的 ICC 在动脉期更常表现为非边缘强化（p = 0.003），且冲洗时间相对较晚（41.3 ± 12.5 秒）（p = 0.046）。在Kupffer期，无论肝脏背景和肿瘤大小如何，所有ICC在Sonazoid CEUS上都显示出明显的冲洗和清晰的边缘轮廓：结论：不同肝脏背景和肿瘤大小的ICC的Sonazoid CEUS特征各不相同。在肝纤维化或肝硬化背景的ICC或较小的ICC（≤30 mm）中，动脉期非边缘强化和相对较晚的冲洗更为常见。

{"title":"Perfluorobutane-Enhanced CEUS in Intrahepatic Cholangiocarcinoma: Correlating Imaging Features With Liver Backgrounds and Tumor Sizes","authors":"Li Wei , Hyo-Jin Kang , Yun-Lin Huang , Jia-Ying Cao , Xiu-Yun Lu , Yi Dong , Jeong Min Lee","doi":"10.1016/j.ultrasmedbio.2024.09.009","DOIUrl":"10.1016/j.ultrasmedbio.2024.09.009","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate Sonazoid contrast-enhanced ultrasound (CEUS) features of intrahepatic cholangiocarcinoma (ICC) based on liver backgrounds and tumor sizes.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on patients with histopathologically diagnosed ICC at two centers. Patients underwent Sonazoid CEUS examination at a dose of 0.0165 mL/kg before surgery or biopsy. Continuous imaging was recorded for the first 70 s, followed by intermittent scanning every 15–20 s for 5 min, with a Kupffer phase captured after an 8-min delay. Patients were categorized by liver backgrounds and tumor sizes. Two ultrasound experts evaluated the enhancement patterns of ICCAs during the arterial, portal, delayed, and Kupffer phases according to current guidelines.</div></div><div><h3>Results</h3><div>From February 2019 to July 2022, a total of 85 ICC lesions were included. ICCs were categorized into normal liver (n = 24), chronic liver disease with fibrosis (n = 40), and cirrhosis (n = 21) groups based on different liver backgrounds, and into groups measuring ≤30 mm (n = 22), 31–50 mm (n = 32), and >50 mm (n = 31) based on tumor sizes. Most ICCs in liver fibrosis or liver cirrhosis tended to show non-rim enhancement in arterial phase (<em>p</em> = 0.022) and relatively later washout (39.9 ± 8.5 s vs. 39.7 ± 13.0 s) compared with those on a normal liver background (28.1 ± 5.6 s) (<em>p</em> < 0.001). Based on CEUS Liver Imaging Reporting and Data System, the diagnostic performance of LR-M criteria showed an accuracy of 100% in our high-risk populations. ICCs of ≤30 mm more commonly showed non-rim enhancement in arterial phase (<em>p</em> = 0.003) and relatively later washout (41.3 ± 12.5 s) compared with larger ICCs (<em>p</em> = 0.046). In the Kupffer phase, all ICCs showed marked washout with sharp margin delineation on Sonazoid CEUS, regardless of liver backgrounds and tumor sizes.</div></div><div><h3>Conclusion</h3><div>Sonazoid CEUS features of ICCs differ according to different liver backgrounds and tumor sizes. Arterial phase non-rim enhancement and relatively later washout were more commonly observed in ICCs on liver fibrosis or cirrhosis background or smaller ICCs (≤30 mm).</div></div>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ex Vivo Demonstration of a Novel Dual-Frequency Ultrasound Method for Quantitative Measurements of Liver Fat Content 用于定量测量肝脏脂肪含量的新型双频超声波方法的体内演示

IF 2.4 3区医学 Q2 ACOUSTICS

Ultrasound in Medicine and Biology

Pub Date : 2024-10-18 DOI: 10.1016/j.ultrasmedbio.2024.09.019

Sigrid Berg , Naseh Amini , Stian Solberg , Rønnaug Astri Ødegård , Bård Eirik Kulseng , Reidar Fossmark , Sébastien Muller , Simon Nitter Dankel , Rolf K. Berge , Elin Rønne , Patricia Mjønes , Rune Hansen

Objective

The rise in metabolic dysfunction–associated steatotic liver disease prevalence, closely linked with metabolic syndromes and obesity, demands accurate, cost-effective diagnostic methods for early-stage fat quantification in the liver. Here we demonstrate a novel dual-frequency ultrasound method that enables the quantitative measurement of liver fat fraction ex vivo and its correlation with actual fat content.

Methods

A total of 24 Wistar rats were divided into four different groups, where three groups were given a high-fat diet for 2, 4, and 6 wk, and the last group was given a control diet for 6 wk. Livers were imaged with ultrasound ex vivo in a water bath with a dual-frequency ultrasound transducer and experimental imaging protocol implemented on the Verasonics Vantage research ultrasound scanner. Ultrasound data were post-processed to estimate the non-linear bulk elasticity parameter and the liver samples were analyzed with respect to fat fraction and triglycerides.

Results

Rats given a high-fat diet had increased mean levels of liver fat compared with the control group. More importantly, correlation between the ultrasound-based estimation of the non-linear bulk elasticity parameter and fat fraction and triglycerides on an individual level was found to be strong (R² = 0.81, p = 5.8 × 10^-9 and R² = 0.72, p = 3.6 × 10^-7, respectively).

Conclusion

This study demonstrates the potential of the novel dual-frequency ultrasound method for the quantitative measurement of liver fat fraction in excised rat livers, showing great promise for this method to become clinically relevant in the diagnosis and follow-up of patients with fatty liver disease.

目的：代谢功能障碍相关脂肪性肝病发病率的上升与代谢综合征和肥胖密切相关，因此需要准确、经济高效的诊断方法对肝脏进行早期脂肪定量。在此，我们展示了一种新颖的双频超声方法，该方法可实现体内肝脏脂肪分数的定量测量及其与实际脂肪含量的相关性：方法：将 24 只 Wistar 大鼠分为四组，其中三组分别给予高脂肪饮食 2、4 和 6 周，最后一组给予对照饮食 6 周。在水浴中使用双频超声换能器和在 Verasonics Vantage 研究超声扫描仪上实施的实验成像方案对肝脏进行体外超声成像。对超声波数据进行后处理，以估算非线性体积弹性参数，并分析肝脏样本中的脂肪比例和甘油三酯：结果：与对照组相比，摄入高脂肪饮食的大鼠肝脏脂肪平均水平升高。更重要的是，基于超声波估算的非线性体弹性参数与脂肪率和甘油三酯在个体水平上的相关性很强（R2 = 0.81，p = 5.8 × 10-9 和 R2 = 0.72，p = 3.6 × 10-7）：这项研究证明了新型双频超声方法在定量测量切除大鼠肝脏中的肝脏脂肪率方面的潜力，并显示了该方法在诊断和随访脂肪肝患者方面的临床应用前景。

{"title":"Ex Vivo Demonstration of a Novel Dual-Frequency Ultrasound Method for Quantitative Measurements of Liver Fat Content","authors":"Sigrid Berg , Naseh Amini , Stian Solberg , Rønnaug Astri Ødegård , Bård Eirik Kulseng , Reidar Fossmark , Sébastien Muller , Simon Nitter Dankel , Rolf K. Berge , Elin Rønne , Patricia Mjønes , Rune Hansen","doi":"10.1016/j.ultrasmedbio.2024.09.019","DOIUrl":"10.1016/j.ultrasmedbio.2024.09.019","url":null,"abstract":"<div><h3>Objective</h3><div>The rise in metabolic dysfunction–associated steatotic liver disease prevalence, closely linked with metabolic syndromes and obesity, demands accurate, cost-effective diagnostic methods for early-stage fat quantification in the liver. Here we demonstrate a novel dual-frequency ultrasound method that enables the quantitative measurement of liver fat fraction <em>ex vivo</em> and its correlation with actual fat content.</div></div><div><h3>Methods</h3><div>A total of 24 Wistar rats were divided into four different groups, where three groups were given a high-fat diet for 2, 4, and 6 wk, and the last group was given a control diet for 6 wk. Livers were imaged with ultrasound <em>ex vivo</em> in a water bath with a dual-frequency ultrasound transducer and experimental imaging protocol implemented on the Verasonics Vantage research ultrasound scanner. Ultrasound data were post-processed to estimate the non-linear bulk elasticity parameter and the liver samples were analyzed with respect to fat fraction and triglycerides.</div></div><div><h3>Results</h3><div>Rats given a high-fat diet had increased mean levels of liver fat compared with the control group. More importantly, correlation between the ultrasound-based estimation of the non-linear bulk elasticity parameter and fat fraction and triglycerides on an individual level was found to be strong (R<sup>2</sup> = 0.81, <em>p</em> = 5.8 × 10<sup>-9</sup> and R<sup>2</sup> = 0.72, <em>p</em> = 3.6 × 10<sup>-7</sup>, respectively).</div></div><div><h3>Conclusion</h3><div>This study demonstrates the potential of the novel dual-frequency ultrasound method for the quantitative measurement of liver fat fraction in excised rat livers, showing great promise for this method to become clinically relevant in the diagnosis and follow-up of patients with fatty liver disease.</div></div>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of Renal Masses Using Contrast-Enhanced Ultrasound with Sonovue and Sonazoid 利用 Sonovue 和 Sonazoid 的对比增强超声波评估肾脏肿块。

IF 2.4 3区医学 Q2 ACOUSTICS

Ultrasound in Medicine and Biology

Pub Date : 2024-10-18 DOI: 10.1016/j.ultrasmedbio.2024.09.016

Haixiang Zhang , Gang Guo , Run Zhu , Hua Wang , Peng Chen , Chi Qin , Yongyan Gao

Objective

To explore the differences between SonoVue and Sonazoid contrast-enhanced ultrasound (CEUS) in evaluating enhancement features of renal masses and determine the diagnostic value of CEUS in clear cell renal cell carcinoma (ccRCC).

Methods

A total of 57 eligible patients were enrolled and divided into the ccRCC, papillary renal cell carcinoma (pRCC), non-ccRCC and non-pRCC malignancy groups, and benign mass groups based on their postsurgical histopathologic diagnosis. The enhancement features of renal masses following SonoVue and Sonazoid CEUS in each group were analyzed. Diagnostic efficiencies of SonoVue and Sonazoid CEUS for ccRCC and non-ccRCC were determined.

Results

There were no significant differences in the enhancement features of renal masses with SonoVue and Sonazoid imaging in the four groups (p > .05). Both SonoVue CEUS and Sonazoid CEUS showed good diagnostic performance for the differential diagnosis of ccRCC and non-ccRCC, with sensitivities of 88.6% and 85.7%, specificities of 76.5% and 88.2%, accuracies of 84.6% and 86.5%, positive predictive values of 88.6% and 93.8%, and negative predictive values of 76.5% and 75%, respectively. There were no statistically significant differences in any of the diagnostic performance indices between the two methods (p > .05).

Conclusion

The CEUS features of SonoVue and Sonazoid in evaluating renal masses were similar in the vascular phase. Both SonoVue and Sonazoid CEUS showed good diagnostic performance for the differential diagnosis of ccRCC and non-ccRCC.

目的探讨SonoVue和Sonazoid对比增强超声（CEUS）在评估肾肿块增强特征方面的差异，并确定CEUS对透明细胞肾细胞癌（ccRCC）的诊断价值：共纳入57名符合条件的患者，并根据术后组织病理学诊断将其分为ccRCC、乳头状肾细胞癌（pRCC）、非ccRCC和非RCC恶性肿瘤组以及良性肿块组。分析了各组肾肿块在SonoVue和Sonazoid CEUS检查后的增强特征。确定SonoVue和Sonazoid CEUS对ccRCC和非ccRCC的诊断效率：结果：SonoVue 和 Sonazoid 成像对四组肾肿块的增强特征无明显差异（P > .05）。SonoVue CEUS和Sonazoid CEUS在鉴别诊断ccRCC和非ccRCC方面均表现出良好的诊断性能，敏感性分别为88.6%和85.7%，特异性分别为76.5%和88.2%，准确性分别为84.6%和86.5%，阳性预测值分别为88.6%和93.8%，阴性预测值分别为76.5%和75%。两种方法的诊断性能指标差异均无统计学意义（P > .05）：结论：SonoVue 和 Sonazoid 在血管期评估肾脏肿块的 CEUS 特征相似。SonoVue和Sonazoid CEUS在鉴别诊断ccRCC和非ccRCC方面均表现出良好的诊断性能。

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引用次数: 0

Attenuation Measuring Ultrasound Shearwave Elastography (AMUSE) as Noninvasive Imaging Biomarker for Liver Acute Cellular Rejection 衰减测量超声剪切波弹性成像（AMUSE）作为肝脏急性细胞排斥反应的无创成像生物标记。

IF 2.4 3区医学 Q2 ACOUSTICS

Ultrasound in Medicine and Biology

Pub Date : 2024-10-16 DOI: 10.1016/j.ultrasmedbio.2024.09.018

Luiz Vasconcelos , John Grady , Sara Aristizabal , Rebeca Oliveira , Matthew W. Urban , Shigao Chen , William Sanchez , James F. Greenleaf , Ivan Nenadic

Objective

There are over 9000 liver transplants in the United States per year, with acute cellular rejection (ACR) being a prevalent early post-transplant complication (20%–40%) treated using corticosteroids. Ischemia-reperfusion injury (IRI), another early post-transplant pathology, has similar laboratory results but typically resolves without therapy. ACR confirmation requires invasive liver biopsy, bearing risks like hemorrhage and pneumothorax. Attenuation Measuring Ultrasound Shearwave Elastography (AMUSE) assesses shear wave velocity (c) and attenuation (α) without rheological models and have shown potential for noninvasive tissue characterization.

Methods

We analyzed 58 transplanted livers suspected for ACR by comparing AMUSE measurements to biopsy findings. Thirteen patients underwent longitudinal tracking from ACR diagnosis on day 7 to therapy initiation and repeat biopsy on day 14. Statistical methods and support vector machine (SVM) were used for performance analysis.

Results

AMUSE measurements at 100, 200, and 300 Hz showed statistical significance (p < 0.001) for ACR presence, with 200 Hz exhibiting the highest Spearman correlation coefficients for c and α (0.68 and -0.83). High c (> 2.2 m/s) and low α (< 130 Np/m) at 200 Hz correlated with ACR diagnostic, while low c and high α indicated no ACR. Combining c and α into a single biomarker α/c improved patient differentiation, yielding an F1-score of 0.97. SVM was used to evaluate AMUSE ACR staging capabilities using all available frequencies, reaching 0.95 F1-score for categorical classification, with an AUROC of 0.99. When evaluating the presence of ACR the SVM reached 0.99 F1-score, with 1.00 sensitivity/recall.

Conclusion

These findings support the use of AMUSE potential for detection and staging of liver ACR.

目的：美国每年有 9000 多例肝脏移植手术，急性细胞排斥反应（ACR）是移植后早期并发症的常见病（20%-40%），使用皮质类固醇进行治疗。缺血再灌注损伤（IRI）是另一种移植后早期病理现象，其实验室结果类似，但通常无需治疗即可缓解。ACR 确认需要进行侵入性肝活检，存在出血和气胸等风险。衰减测量超声剪切波弹性成像（AMUSE）无需流变学模型即可评估剪切波速度（c）和衰减（α），已显示出无创组织特征描述的潜力：我们通过比较 AMUSE 测量值和活检结果，对 58 例疑似 ACR 的移植肝进行了分析。13 名患者接受了从第 7 天确诊 ACR 到开始治疗和第 14 天重复活检的纵向追踪。采用统计方法和支持向量机（SVM）进行性能分析：100、200 和 300 Hz 的 AMUSE 测量结果显示 ACR 存在的统计学意义（p < 0.001），其中 200 Hz 的 c 和 α 的 Spearman 相关系数最高（0.68 和 -0.83）。200 赫兹的高 c（> 2.2 m/s）和低 α（< 130 Np/m）与 ACR 诊断相关，而低 c 和高α则表示没有 ACR。将 c 和 α 合并为单一生物标志物 α/c 可提高患者分辨能力，其 F1 分数为 0.97。使用 SVM 评估 AMUSE ACR 分期能力时，使用了所有可用的频率，分类分类的 F1 分数为 0.95，AUROC 为 0.99。在评估是否存在 ACR 时，SVM 的 F1 分数为 0.99，灵敏度/召回率为 1.00：这些研究结果支持使用 AMUSE 电位对肝脏 ACR 进行检测和分期。

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引用次数: 0

Validation of Left Ventricular High Frame Rate Echo-Particle Image Velocimetry against 4D Flow MRI in Patients 左心室高帧率回波粒子图像测速仪与患者四维血流磁共振成像的验证。

IF 2.4 3区医学 Q2 ACOUSTICS

Ultrasound in Medicine and Biology

Pub Date : 2024-10-16 DOI: 10.1016/j.ultrasmedbio.2024.09.012

Yichuang Han , Daniel J. Bowen , Bernardo Loff Barreto , Robert. R. Zwaan , Mihai Strachinaru , Rob J. van der Geest , Alexander Hirsch , Annemien E. van den Bosch , Johan G. Bosch , Jason Voorneveld

Objective

Accurately measuring intracardiac flow patterns could provide insights into cardiac disease pathophysiology, potentially enhancing diagnostic and prognostic capabilities. This study aims to validate Echo-Particle Image Velocimetry (echoPIV) for in vivo left ventricular intracardiac flow imaging against 4D flow MRI.

Methods

We acquired high frame rate contrast-enhanced ultrasound images from three standard apical views of 26 patients who required cardiac MRI. 4D flow MRI was obtained for each patient. Only echo image planes with sufficient quality and alignment with MRI were included for validation. Regional velocity, kinetic energy (

KE

) and viscous energy loss (

\dot{EL}

) were compared between modalities using normalized mean absolute error (NMAE), cosine similarity and Bland–Altman analysis.

Results

Among 24 included apical view acquisitions, we observed good correspondence between echoPIV and MRI regarding spatial flow patterns and vortex traces. The velocity profile at base-level (mitral valve) cross-section had cosine similarity of 0.92 ± 0.06 and NMAE of (14 ± 5)%. Peak spatial mean velocity differed by (3 ± 6) cm/s in systole and (6 ± 10) cm/s in diastole. The

KE

and rate of

\dot{EL}

also revealed a high level of cosine similarity (0.89 ± 0.09 and 0.91 ± 0.06) with NMAE of (23 ± 7)% and (52 ± 16)%.

Conclusion

Given good B-mode image quality, echoPIV provides a reliable estimation of left ventricular flow, exhibiting spatial-temporal velocity distributions comparable to 4D flow MRI. Both modalities present respective strengths and limitations: echoPIV captured inter-beat variability and had higher temporal resolution, while MRI was more robust to patient BMI and anatomy.

目的：精确测量心内血流模式有助于深入了解心脏疾病的病理生理学，从而提高诊断和预后能力。本研究旨在验证回波粒子图像测速仪（echoPIV）与四维血流磁共振成像在体内左心室心内血流成像中的效果：我们从 26 名需要进行心脏磁共振成像的患者的三个标准心尖切面获取了高帧率对比增强超声图像。每个患者都获得了四维血流 MRI。只有质量足够高且与核磁共振成像对齐的回波图像平面才会被纳入验证范围。使用归一化平均绝对误差（NMAE）、余弦相似度和布兰-阿尔特曼分析比较了不同模式的区域速度、动能（KE）和粘性能量损失（EL˙）：在 24 次心尖视图采集中，我们观察到 echoPIV 和 MRI 在空间流动模式和涡流轨迹方面具有良好的对应性。基底（二尖瓣）横截面的速度曲线余弦相似度为 0.92 ± 0.06，NMAE 为 (14 ± 5)%。收缩期的峰值空间平均速度相差（3±6）厘米/秒，舒张期相差（6±10）厘米/秒。EL˙的KE和速率也显示出高度的余弦相似性（0.89 ± 0.09和0.91 ± 0.06），NMAE分别为(23 ± 7)%和(52 ± 16)%：结论：在 B 模式图像质量良好的情况下，echoPIV 可以可靠地估算左心室血流，其显示的时空速度分布与 4D 血流 MRI 相当。两种模式都有各自的优势和局限性：echoPIV能捕捉到搏动间的变异性，具有更高的时间分辨率，而磁共振成像对患者体重指数和解剖结构的影响更大。

{"title":"Validation of Left Ventricular High Frame Rate Echo-Particle Image Velocimetry against 4D Flow MRI in Patients","authors":"Yichuang Han , Daniel J. Bowen , Bernardo Loff Barreto , Robert. R. Zwaan , Mihai Strachinaru , Rob J. van der Geest , Alexander Hirsch , Annemien E. van den Bosch , Johan G. Bosch , Jason Voorneveld","doi":"10.1016/j.ultrasmedbio.2024.09.012","DOIUrl":"10.1016/j.ultrasmedbio.2024.09.012","url":null,"abstract":"<div><h3>Objective</h3><div>Accurately measuring intracardiac flow patterns could provide insights into cardiac disease pathophysiology, potentially enhancing diagnostic and prognostic capabilities. This study aims to validate Echo-Particle Image Velocimetry (echoPIV) for <em>in vivo</em> left ventricular intracardiac flow imaging against 4D flow MRI.</div></div><div><h3>Methods</h3><div>We acquired high frame rate contrast-enhanced ultrasound images from three standard apical views of 26 patients who required cardiac MRI. 4D flow MRI was obtained for each patient. Only echo image planes with sufficient quality and alignment with MRI were included for validation. Regional velocity, kinetic energy (<span><math><mtext>KE</mtext></math></span>) and viscous energy loss (<span><math><mover><mtext>EL</mtext><mi>˙</mi></mover></math></span>) were compared between modalities using normalized mean absolute error (NMAE), cosine similarity and Bland–Altman analysis.</div></div><div><h3>Results</h3><div>Among 24 included apical view acquisitions, we observed good correspondence between echoPIV and MRI regarding spatial flow patterns and vortex traces. The velocity profile at base-level (mitral valve) cross-section had cosine similarity of 0.92 ± 0.06 and NMAE of (14 ± 5)%. Peak spatial mean velocity differed by (3 ± 6) cm/s in systole and (6 ± 10) cm/s in diastole. The <span><math><mtext>KE</mtext></math></span> and rate of <span><math><mover><mtext>EL</mtext><mi>˙</mi></mover></math></span> also revealed a high level of cosine similarity (0.89 ± 0.09 and 0.91 ± 0.06) with NMAE of (23 ± 7)% and (52 ± 16)%.</div></div><div><h3>Conclusion</h3><div>Given good B-mode image quality, echoPIV provides a reliable estimation of left ventricular flow, exhibiting spatial-temporal velocity distributions comparable to 4D flow MRI. Both modalities present respective strengths and limitations: echoPIV captured inter-beat variability and had higher temporal resolution, while MRI was more robust to patient BMI and anatomy.</div></div>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Classification of Neoadjuvant Therapy Response in Patients With Colorectal Liver Metastases Using Contrast-Enhanced Ultrasound—With Histological Pathology as the Gold Standard 利用对比增强超声对结直肠肝转移患者的新辅助治疗反应进行分类--以组织学病理学为金标准

IF 2.4 3区医学 Q2 ACOUSTICS

Ultrasound in Medicine and Biology

Pub Date : 2024-10-15 DOI: 10.1016/j.ultrasmedbio.2024.09.013

Li Liu , Wen-Chao Cui , Yu Sun , Hong Wang , Zi-Nan Liang , Wei Wu , Kun Yan , Yong-Li Ji , Liang Dong , Wei Yang

Objective

To evaluate the response to neoadjuvant therapy in patients with colorectal liver metastases (CRLMs) using ultrasound(US) and contrast-enhanced ultrasound(CEUS), with correction to the tumor regression grade (TRG) of pathological results.

Methods

This study included patients with resectable CRLMs admitted from February to December 2022. After at least 4 cycles neoadjuvant therapy, all the patients received US and CEUS examinations within two weeks before hepatectomy. CEUS clips were postprocessed with color parameter imaging (CPI) and microflow imaging (MFI) analysis. Logistic regression analyses were used to develop an evaluation Nomogram. Ultrasound-based model was constructed to discriminate between the response (TRG1/2/3) and nonresponse (TRG4/5) groups at the lesion level. The model's predictive ability was evaluated using the C index and calibration curve, with decision curve analysis assessing the Nomogram's added value.

Results

The study analyzed 105 CRLM lesions (the lesion with the highest diameter analyzed for each patient), with 43.8% showing a response to therapy. Univariate analysis identified calcification on US (p = 0.039), CEUS enhancement degree (p < 0.001), CEUS enhancement pattern (p<0.001), CEUS washout type (p < 0.001), CEUS necrosis (p < 0.001), CPI feeding artery (p = 0.003) and MFI pattern (p < 0.001) were significantly associated with TRG. The multivariate analysis showed CEUS enhancement pattern (p = 0.026), CEUS washout type (p = 0.018) and CEUS necrosis (p = 0.005) were independently associated with the neoadjuvant therapy response. A Nomogram with the three independent predictors was developed, with an AUC of 0.898.

Conclusion

The ultrasound-based model provided accurate evaluation of pathological tumor response to preoperative chemotherapy in patients with CRLM, and may help to decide the individualized treatment strategy.

目的使用超声（US）和对比增强超声（CEUS）评估结直肠肝转移瘤（CRLMs）患者对新辅助治疗的反应，并对病理结果的肿瘤回归分级（TRG）进行校正：研究对象包括2022年2月至12月收治的可切除CRLM患者。经过至少4个周期的新辅助治疗后，所有患者均在肝切除术前两周内接受了US和CEUS检查。CEUS 片段经彩色参数成像（CPI）和微流成像（MFI）分析进行后处理。使用逻辑回归分析制定了评估提名图。构建了基于超声的模型，用于在病变水平上区分有反应组（TRG1/2/3）和无反应组（TRG4/5）。利用 C 指数和校准曲线评估了模型的预测能力，并通过决策曲线分析评估了 Nomogram 的附加值：研究分析了105个CRLM病变（分析了每位患者直径最大的病变），43.8%的病变对治疗有反应。单变量分析确定了 US 上的钙化（p = 0.039）、CEUS 增强程度（p < 0.001）、CEUS 增强模式（pConclusion）：基于超声的模型能准确评估CRLM患者的病理肿瘤对术前化疗的反应，有助于决定个体化治疗策略。

{"title":"Classification of Neoadjuvant Therapy Response in Patients With Colorectal Liver Metastases Using Contrast-Enhanced Ultrasound—With Histological Pathology as the Gold Standard","authors":"Li Liu , Wen-Chao Cui , Yu Sun , Hong Wang , Zi-Nan Liang , Wei Wu , Kun Yan , Yong-Li Ji , Liang Dong , Wei Yang","doi":"10.1016/j.ultrasmedbio.2024.09.013","DOIUrl":"10.1016/j.ultrasmedbio.2024.09.013","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the response to neoadjuvant therapy in patients with colorectal liver metastases (CRLMs) using ultrasound(US) and contrast-enhanced ultrasound(CEUS), with correction to the tumor regression grade (TRG) of pathological results.</div></div><div><h3>Methods</h3><div>This study included patients with resectable CRLMs admitted from February to December 2022. After at least 4 cycles neoadjuvant therapy, all the patients received US and CEUS examinations within two weeks before hepatectomy. CEUS clips were postprocessed with color parameter imaging (CPI) and microflow imaging (MFI) analysis. Logistic regression analyses were used to develop an evaluation Nomogram. Ultrasound-based model was constructed to discriminate between the response (TRG1/2/3) and nonresponse (TRG4/5) groups at the lesion level. The model's predictive ability was evaluated using the C index and calibration curve, with decision curve analysis assessing the Nomogram's added value.</div></div><div><h3>Results</h3><div>The study analyzed 105 CRLM lesions (the lesion with the highest diameter analyzed for each patient), with 43.8% showing a response to therapy. Univariate analysis identified calcification on US (<em>p</em> = 0.039), CEUS enhancement degree (<em>p</em> < 0.001), CEUS enhancement pattern (p<0.001), CEUS washout type (<em>p</em> < 0.001), CEUS necrosis (<em>p</em> < 0.001), CPI feeding artery (<em>p</em> = 0.003) and MFI pattern (<em>p</em> < 0.001) were significantly associated with TRG. The multivariate analysis showed CEUS enhancement pattern (<em>p</em> = 0.026), CEUS washout type (<em>p</em> = 0.018) and CEUS necrosis (<em>p</em> = 0.005) were independently associated with the neoadjuvant therapy response. A Nomogram with the three independent predictors was developed, with an AUC of 0.898.</div></div><div><h3>Conclusion</h3><div>The ultrasound-based model provided accurate evaluation of pathological tumor response to preoperative chemotherapy in patients with CRLM, and may help to decide the individualized treatment strategy.</div></div>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of High-intensity Continuous Ultrasound on Infrapatellar Fat Pad Stiffness and Gliding in Healthy Participants: A Randomized, Single-blind, Placebo-controlled Crossover Trial 高强度连续超声波对健康参与者髌下脂肪垫硬度和滑动的影响：随机、单盲、安慰剂对照交叉试验。

IF 2.4 3区医学 Q2 ACOUSTICS

Ultrasound in Medicine and Biology

Pub Date : 2024-10-15 DOI: 10.1016/j.ultrasmedbio.2024.09.006

Naoto Ikeda , Taizan Fukaya , Yui Sezaki , Sho Toyoshima , Yuka Yokoi , Katsuyuki Morishita

Objective

Ultrasound therapy effectively treats a joint range of motion limitation and pain originating from soft tissue in knee osteoarthritis (OA). Few interventional studies have focused on the infrapatellar fat pad (IFP), and the effects of high-intensity continuous ultrasound (HICUS) on IFP stiffness and gliding have not been investigated. Therefore, we aimed to determine the effects of HICUS on IFP stiffness and gliding.

Methods

This single-blind, randomized, controlled crossover study involved 24 healthy participants. The HICUS and placebo conditions were applied to the knee joint on 2 different days. HICUS was performed (1 MHz, 2.5 W/cm², duty cycle 100%, 5 min) using an ultrasound machine equipped with an applicator and adsorption-type fixed automatic rotation irradiation function. The main outcomes were IFP stiffness and gliding measured at 10 degrees and 120 degrees knee flexion. Gliding was measured as the difference between the patellar-tendon tibial angles at 10 degrees and 120 degrees knee flexion. Measurements were performed before (T1), immediately after (T2), and 15 min after (T3) treatment.

Results

Two-way repeated measures analysis of variance showed a significant interaction of IFP stiffness at 10 degrees knee flexion; post-test results showed that HICUS decreased stiffness at T2 and T3. There was no significant difference at 120 degrees. A significant interaction of gliding was observed under the HICUS condition. Post-tests showed that HICUS significantly improved gliding at T2 and T3.

Conclusion

HICUS is a simple, safe intervention for improving IFP stiffness and gliding in healthy participants, with sustained effects. Further studies are needed to evaluate its efficacy in patients.

目的超声波疗法能有效治疗膝关节骨关节炎（OA）中关节活动范围受限和软组织引起的疼痛。很少有干预性研究关注髌下脂肪垫（IFP），高强度连续超声（HICUS）对髌下脂肪垫僵硬度和滑动的影响也未进行过研究。因此，我们旨在确定 HICUS 对 IFP 硬度和滑动的影响：这项单盲、随机、对照交叉研究涉及 24 名健康参与者。HICUS和安慰剂分别在两天内作用于膝关节。HICUS使用配备有涂抹器和吸附式固定自动旋转照射功能的超声波机进行（1 MHz，2.5 W/cm²，占空比100%，5分钟）。主要结果是在膝关节屈曲 10 度和 120 度时测量 IFP 的硬度和滑动性。滑动度以膝关节屈曲 10 度和 120 度时髌腱胫骨角度的差值来衡量。测量分别在治疗前（T1）、治疗后（T2）和治疗后 15 分钟（T3）进行：结果：双向重复测量方差分析显示，膝关节屈曲 10 度时的 IFP 僵硬度存在显著的交互作用；后测试结果显示，HICUS 可降低 T2 和 T3 时的僵硬度。120度时没有明显差异。在 HICUS 条件下，滑行与膝关节僵硬度之间存在明显的交互作用。后测结果显示，HICUS 明显改善了 T2 和 T3 的滑行：结论：HICUS 是一种简单、安全的干预措施，可改善健康参与者的 IFP 僵硬度和滑行，并具有持续效果。需要进一步研究以评估其对患者的疗效。

{"title":"Effects of High-intensity Continuous Ultrasound on Infrapatellar Fat Pad Stiffness and Gliding in Healthy Participants: A Randomized, Single-blind, Placebo-controlled Crossover Trial","authors":"Naoto Ikeda , Taizan Fukaya , Yui Sezaki , Sho Toyoshima , Yuka Yokoi , Katsuyuki Morishita","doi":"10.1016/j.ultrasmedbio.2024.09.006","DOIUrl":"10.1016/j.ultrasmedbio.2024.09.006","url":null,"abstract":"<div><h3>Objective</h3><div>Ultrasound therapy effectively treats a joint range of motion limitation and pain originating from soft tissue in knee osteoarthritis (OA). Few interventional studies have focused on the infrapatellar fat pad (IFP), and the effects of high-intensity continuous ultrasound (HICUS) on IFP stiffness and gliding have not been investigated. Therefore, we aimed to determine the effects of HICUS on IFP stiffness and gliding.</div></div><div><h3>Methods</h3><div>This single-blind, randomized, controlled crossover study involved 24 healthy participants. The HICUS and placebo conditions were applied to the knee joint on 2 different days. HICUS was performed (1 MHz, 2.5 W/cm², duty cycle 100%, 5 min) using an ultrasound machine equipped with an applicator and adsorption-type fixed automatic rotation irradiation function. The main outcomes were IFP stiffness and gliding measured at 10 degrees and 120 degrees knee flexion. Gliding was measured as the difference between the patellar-tendon tibial angles at 10 degrees and 120 degrees knee flexion. Measurements were performed before (T1), immediately after (T2), and 15 min after (T3) treatment.</div></div><div><h3>Results</h3><div>Two-way repeated measures analysis of variance showed a significant interaction of IFP stiffness at 10 degrees knee flexion; post-test results showed that HICUS decreased stiffness at T2 and T3. There was no significant difference at 120 degrees. A significant interaction of gliding was observed under the HICUS condition. Post-tests showed that HICUS significantly improved gliding at T2 and T3.</div></div><div><h3>Conclusion</h3><div>HICUS is a simple, safe intervention for improving IFP stiffness and gliding in healthy participants, with sustained effects. Further studies are needed to evaluate its efficacy in patients.</div></div>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0