Ultraschall in Der Medizin最新文献

To investigate the role of ultra-microangiography (UMA) in evaluating Crohn's disease (CD) activity in pediatric patients.Pediatric patients diagnosed with CD were included in this prospective study. A Resona A20 ultrasound machine (Mindray Medical Systems, China) was used for all patients. The semiquantitative scores of color Doppler flow imaging (CDFI) and UMA on the thickest segments of bowel walls were assessed according to the Limberg score. The Pediatric Crohn's Disease Activity Index (PCDAI) was the reference standard to evaluate CD activity. ROC analysis was performed to compare the diagnostic efficiency of Limberg scores between CDFI and UMA.Sixty pediatric CD patients were included and divided into three groups according to PCDAI: Group 1, inactive CD (n = 37); Group 2, mild CD (n = 13); and Group 3, moderate to severe CD (n = 10). By UMA, significant differences in Limberg scores were found between Groups 1 and 3 (P < 0.001), Groups 2 and 3 (P = 0.044), and Groups 1 and 2 (P = 0.029). The combined AUROC of B-mode ultrasound (BMUS) features and UMA features in pediatric CD activity evaluation was 0.934, with sensitivity of 87.0% and specificity of 94.6%, which was significantly higher than that of the combined BMUS features and CDFI (P = 0.048).By sensitively depicting the low velocity blood flow signals and displaying microvascular morphologies of the bowel wall, UMA is an effective noninvasive imaging method enabling semiquantitative evaluation of the activity of CD in pediatric patients.

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Echocardiography is the most commonly used imaging method for evaluating the heart. It plays a central role in the cardiology routine and in acute and emergency situations, and is an essential component of the medical decision-making process. In spite of its high clinical relevance, national recommendations standardizing the examination procedure, equipment settings, and image documentation have been lacking. The present guidelines were created by the German Society for Ultrasound in Medicine and the German Cardiac Society in coordination with the German Society of Anesthesiology and Intensive Care Medicine, German Society of Internal Medicine, Professional Association of German Internists, and the German Association of Cardiologists in Private Practice. The recommendations were formulated in consensus, published as draft guidelines, and finalized by the participating professional associations after evaluation of the feedback. The document meets the criteria for S2k guidelines in accordance with the Association of Scientific Medical Societies in Germany and defines binding standards for performing transthoracic echocardiography. The guidelines define which images and measurements are required to ensure valid and reproducible findings. The main recommendations relate to device settings, image acquisition, the minimum dataset to be acquired, and the definition of focused cardiac ultrasound (FoCUS). The complete long version of the guidelines is available on the website of the Association of Scientific Medical Societies in Germany. NOTE : The short version of this guideline is being published simultaneously in the journals Ultraschall in der Medizin - European Journal of Ultrasound and Die Kardiologie.

Despite advances in diagnostic approaches, fetal anemia of unknown etiology continues to be observed in rare cases. This study aimed to assess the incidence of unexplained fetal anemia and to evaluate the associated perinatal outcomes.We conducted an observational retrospective cohort study of all fetuses that underwent fetal blood sampling (FBS) due to an MCA-PSV>1.5 MoM at a tertiary center between 2007 and 2024. Fetuses were included if they had moderate or severe anemia defined as a hemoglobin (Hgb) deviation of more than 20g/L below a gestational age adjusted mean, with a negative anemia workup. Prenatal and postnatal outcomes were obtained.Among 376 fetuses that underwent fetal blood sampling for anemia, 361 (96%) had an identified cause, while 15 (4%) had moderate to severe anemia of unknown etiology. Seven fetuses presented with non-immune hydrops and eight with other major structural anomalies not typically associated with anemia. Eleven (73%) of the 15 fetuses with unexplained anemia had thrombocytopenia, with platelets below 100000/µL in 8 cases and below 50000/µL in 6 cases. Seven cases (47%) resulted in perinatal death. Rare causes of anemia were elucidated in only 5 cases (33%) postnatally despite extensive investigations.Unexplained fetal anemia is uncommon and is associated with poor neonatal outcomes warranting close pre- and postnatal surveillance.

To evaluate fertility and obstetric and clinical outcomes following uterine artery embolization (UAE) for pregnancy-related symptomatic uterine arteriovenous malformations (AVMs).A retrospective case analysis was conducted at a single tertiary care center and included women diagnosed with symptomatic post-pregnancy uterine AVMs treated between January 2000 and April 2023. Clinical data, management strategies, and follow-up outcomes were extracted from institutional records. A follow-up phone survey was conducted to assess fertility and obstetric outcomes.Forty women with symptomatic uterine AVMs were identified. All presented with vaginal bleeding, the sole symptom in 35 cases (87.5%). Most (31/40, 77.5%) presented at the emergency department within 24 hours. Thirty-eight women (95%) required one UAE; no hysterectomies were performed. Twelve women (30%) experienced massive bleeding requiring transfusion. Of 35 women who responded to the fertility survey, 22 (62.8%) desired a future pregnancy. Of these, 20 (90.9%) achieved pregnancy, with 17 (85%) delivering at term. The median time to conception was under 6 weeks, and 65% conceived within 12 months. Ten women (50%) had multiple successful pregnancies; one had 5 consecutive pregnancies. Regarding post-UAE pregnancies, 4 women (23.5%) experienced abnormal placentation, but no AVM recurrences were reported.In this cohort, UAE for AVMs is highly effective and fertility-sparing, with most women conceiving and delivering successfully. Obstetric risks remain notable, underscoring the need for larger studies to confirm these findings and assess long-term risks.