Ultraschall in Der Medizin最新文献

During embryogenesis, the vertebrae begin development during the 6th week of gestation via two lateral chondrification centers per segment. It was assumed that when disruptions occur in the process of somitogenesis during membranous vertebral body formation, chondrification and ossification will follow the anomalous membranous vertebral body scaffolding, resulting in an anomalous vertebral formation, such as a hemivertebra. Another hypothesis is that hemivertebra may result from anomalous distribution of intersegmental arteries of the vertebral column. There is no description in the medical literature of "excess linear calcifications" of part of the fetal vertebra, characterized by the presence of linear calcifications in the vertebrae of a developing fetus. In the first two trimesters of pregnancy, the fetal vertebrae usually show three calcified points in an axial section: the vertebral body and two transverse processes. Premature linear vertebral calcification was defined as an anterior or posterior echogenic connection between two of the points (Fig. 1). In this study, we describe seven cases of premature fetal linear vertebral calcification.

The aim of this systematic review was to investigate the outcomes of pregnancies with fetal cerebral lateral ventricle asymmetry without dilation. We conducted a comprehensive literature search in the Embase, Medline, and Web of Science databases until April 29, 2024, of observational cohort studies that reported fetal ventricular asymmetry without dilation detected on ultrasound or magnetic resonance imaging. Of the 150 studies identified, 6 met the inclusion criteria. Among the cases of non-dilated ventricular asymmetry, 36.8-46.2% progressed to ventriculomegaly on follow-up by neurosonography or magnetic resonance imaging. Additional findings in the central nervous system were observed in 5.5-10.5% of cases, while 7.6% had additional fetal body findings. Abnormal genetic findings were present in 5.1% of cases. Postnatal follow-up indicated no abnormal developmental findings during the first year of life. By the age of 9-11 years, lower writing speed was observed, yet verbal fluency scores were higher than in the general population. In conclusion, non-dilated ventricular asymmetry in fetuses showed the potential for progression to ventriculomegaly, and linkage to genetic abnormalities. Larger prospective studies are essential to fully elucidate the condition's natural history and refine clinical management strategies.

In twin-to-twin transfusion syndrome (TTTS), unbalanced vascular anastomoses lead to a net transfer of fluid from the donor to the recipient. This triggers compensatory mechanisms resulting in fetal vasoconstriction. Hemodynamic modelling has shown that the appearance of a second systolic peak P2, in addition to the main systolic peak P1, in the middle cerebral artery (MCA) Doppler waveform, thus creating a systolic M-sign, may indicate increased fetal vasoconstriction. Hence, the M-sign could be expected in twins with TTTS. The Quintero staging system has been used to stage TTTS. However, TTTS does not always develop in line with the Quintero stages and/or the criteria are not always fulfilled. This study investigates whether the M-sign could be an additional TTTS criterion indicating significant imbalance between the fetuses.38 women who underwent fetoscopic laser coagulation (FLC) for TTTS were included. The MCA Doppler waveforms were retrospectively analyzed for the presence of an M-sign. We subdivided the M-signs into 2 groups: Group A: the main systolic peak P1 dominates P2, i.e., P2/P1 <1; Group B: P2 exceeds P1: P2/P1 >1.Before FLC, an M-sign was found in 17/38 (45%) pregnancies. Both twins showed M-signs in 9 pregnancies, only the recipient in 6, and only the donor in 2. In 6 (35%) fetuses, an M-sign appeared before the Quintero criteria were fulfilled. Postoperatively, M-signs disappeared in all cases.The appearance of an M-sign could be an additional marker of cardiovascular imbalance in monochorionic-diamniotic twins with developing or already present TTTS. Postoperative M-sign disappearance may indicate fetal recovery.

Ultrasound is a relevant tool in the diagnosis and characterization of gallbladder polyps. B-mode imaging can be used for the identification of echogenic formations attached to the gallbladder wall, while advanced techniques such as color Doppler, power Doppler, and micro-flow allow a thorough assessment of polyp vascularization. The integration of CEUS further improves diagnostic accuracy by confirming the integrity of the wall and the absence of pathological washout, which is characteristic of malignant lesions. In recent years, several guidelines have been published on the integrated clinical and ultrasound management of polypoid formations of the gallbladder. This review aims to summarize the main evidence regarding the ultrasound study of gallbladder polyps and to provide the sonographer with a clear and practical approach to the clinical management and follow-up of these patients.