Ultraschall in Der Medizin最新文献

Diseases of the salivary glands are as common as they are diverse and can have different causes. Clinicians can differentiate salivary gland changes based on chronic systemic diseases, congenital and vascular malformations, and benign and malignant tumors. Acute infectious pathologies can also arise as a result of obstructive pathologies. A large number of diseases with similar clinical presentations have to be differentiated. Due to the improved resolution of ultrasound technology over the last 20 years, it is now used as the first imaging modality to examine salivary gland pathologies. It allows a quick, dynamic, and non-invasive examination of the salivary glands and the soft tissue of the neck. In order to accurately diagnose and treat patients, a very good knowledge of these diseases and their appearance on sonography is required.

To investigate the associations between contrast-enhanced ultrasound imaging features and disease recurrence among patients with locally advanced breast cancer treated with neoadjuvant chemotherapy.In the study, pre- and post-neoadjuvant chemotherapy contrast-enhanced ultrasound images of 43 patients with breast cancer were retrospectively analysed. Post-acquisition image processing involved the placement of freehand-drawn regions of interest, followed by the generation of blood flow kinetics representing blood volume and velocity for these regions of interest. Qualitative and quantitative contrast-enhanced ultrasound parameters were compared to predict recurrence, and receiver operating characteristic analysis was used to evaluate predictive ability.Among the 43 patients, 10 (23%) exhibited disease recurrence (median [range]: 27 [4-68] months). Post-neoadjuvant chemotherapy peak enhancement, wash-in area under the curve, wash-out area under the curve, and wash-in and wash-out area under the curve (p=0.003, p=0.004, p=0.026, and p=0.014, respectively) differed between the no-recurrence and recurrence groups. The area under the receiver operating characteristic curve (0.88; 95% confidence interval: 0.75-1.00) for post-neoadjuvant chemotherapy peak enhancement was the highest among the contrast-enhanced ultrasound parameters, with a cut-off of 13.33 arbitrary units.Higher peak enhancement on post-neoadjuvant chemotherapy contrast-enhanced ultrasound images was associated with recurrence in women with locally advanced breast cancer and is a potential biomarker of tumor recurrence.

This study aims to investigate placental and fetal lung stiffness in pregnant women with and without gestational diabetes, considering the well-established delay in fetal lung maturation associated with gestational diabetes.This prospective cohort study was conducted at a tertiary center and included pregnant women who underwent a 75-gram oral glucose tolerance test between 24-28 weeks of gestation. Elastography measurements were performed using point shear wave elastography (pSWE).The study included 60 pregnant women diagnosed with gestational diabetes and 60 pregnant women in the control group. The SWE velocity of the peripheral placenta, central placenta, and lung was higher in the gestational diabetes group compared to the control group. Furthermore, the SWE velocity of the peripheral placenta, central placenta, and lung was higher in newborns with neonatal respiratory morbidity. Based on the ROC analysis of patients with gestational diabetes, the AUC for lung SWE velocity was 0.88 (cut-off 12.4 kPa, 95% CI: 0.77-0.99, p<0.001) with a sensitivity of 71.4% and specificity of 95.6% for predicting neonatal respiratory morbidity.Fetal placental and lung stiffness increase in fetuses of pregnant women with diabetes. Moreover, higher fetal lung stiffness during the fetal period is associated with increased neonatal respiratory morbidity.

Point-of-care ultrasound (PoCUS) has found its way into primary care in some, but not all, European countries. A prerequisite for achieving Europe-wide comparable diagnostic reliability of PoCUS performed by primary care physicians is high-quality training that is limited to relevant, frequently encountered PoCUS applications that are easy to learn and master. A European Federation of Societies for Ultrasound in Medicine (EFSUMB) task force performed a brainstorming exercise to identify all possible ultrasound examinations that could be performed in primary care. A 3-stage Delphi process was launched. The Delphi panelists were 95 primary care physicians from 28 European countries with more than 2 years of experience using and teaching ultrasound. Solely focusing on the complexity of performing PoCUS, the panelists reduced the brainstorming list in a stepwise manner to a basic core curriculum intended for primary care frontline physicians including 40 diagnostic PoCUS examinations within 13 different anatomical areas and no ultrasound-guided procedures. A 75% cut-off was used for agreement. Despite the great heterogeneity of the Delphi panel representing different views and contexts from across Europe, kappa statistics showed substantial or moderate agreement across Delphi rounds 2 and 3 for 85% of the 40 diagnostic PoCUS applications. The results of this study offer guidance for EFSUMB to establish training recommendations for a basic core curriculum that can be adapted to the needs of different regions of Europe and thus create a basis for PoCUS to become a reliable diagnostic tool in primary care across Europe, based on common quality standards.

Successful placentation is crucial for fetal development and maintaining a healthy pregnancy. Placental insufficiency can cause a variety of obstetric complications. Despite the many efforts to enhance diagnosing placental insufficiency, no imaging technique has proven satisfactory. A promising imaging technique is contrast-enhanced ultrasound (CEUS) using microbubbles which has proven capable of (micro)vascular imaging. Its use for placental vascularization assessment in human pregnancies remains constrained by limited evidence and safety concerns. This scoping review aims to demonstrate the safety of CEUS used in human pregnancy in the published literature to date.A systematic search using PubMed, Medline, Embase, and Cochrane databases was performed. All studies where contrast-enhanced ultrasound was used in pregnant humans were included. Studies, where there was a planned termination of pregnancy, were excluded. To assess the safety of CEUS during pregnancy, relevant outcomes were divided into the following 3 categories; fetal outcome, maternal outcome, and pregnancy and neonatal outcomes.A total of 13 articles were included, in which 256 women underwent CEUS during pregnancy. No clinically significant maternal or fetal adverse events or negative pregnancy or neonatal outcomes associated with CEUS were described.Based on our findings, we consider expanding the knowledge of this promising diagnostic technique in future larger clinical studies to be safe and relevant.

Breast ultrasound has been established for many years as an important method in addition to mammography for clarifying breast findings. The goal of the Best Practice Guidelines Part III of the DEGUM breast ultrasound working group is to provide colleagues working in senology with information regarding the specific medical indications for breast ultrasound in addition to the current ultrasound criteria and assessment categories published in part I and the additional and optional sonographic diagnostic methods described in part II. The value of breast ultrasound for specific indications including follow-up, evaluation of breast implants, diagnostic workup of dense breast tissue, diagnostic workup during pregnancy and lactation, and the diagnostic workup of breast findings in men is discussed. Each section after the general information section contains a description of specific pathologies followed by a short summary and DEGUM recommendations for the particular indications. The latest S3 guidelines and AGO guidelines were taken into consideration.