Journal of Medical Ultrasonics最新文献

Purpose: To evaluate the role of ultrasound screening for fetal structural abnormalities at 20 and 30 weeks' gestation.

Methods: This retrospective study included women with singleton pregnancies who underwent routine ultrasound screening at our hospital between May 2014 and April 2021. Participants received two ultrasound screening examinations: at 20 and 30 weeks' gestation. We evaluated the frequency and details of fetal structural abnormalities identified during each examination.

Results: A total of 10,560 pregnant women underwent ultrasound screening at 20 and 30 weeks' gestation and delivered at our hospital. Structural abnormalities were observed in 142 (1.3%) women; of note, screening examinations at 20 and 30 weeks detected 42.3% and 23.9% of cases, respectively. Routine point-of-care ultrasound examinations performed between 20 and 30 weeks and beyond 30 weeks detected 8.5% and 6.3% of cases, respectively, with 19.0% of cases identified after birth. Cleft lip and palate and ventricular septal defects (VSDs) were the most common abnormalities detected at the 20-week ultrasound screening. At the 30-week ultrasound screening, in addition to hydronephrosis, VSD, and vascular rings, which were also detected at the 20-week ultrasound screening, diaphragmatic hernia, ovarian cysts, achondroplasia, duodenal atresia, and meconium peritonitis, which could be apparent later in pregnancy, were detected.

Conclusions: The 20-week ultrasound screening revealed common fetal structural abnormalities, and the 30-week ultrasound screening detected fetal structural abnormalities that failed to be detected during the 20-week ultrasound screening and became apparent later in pregnancy. Adding a 30-week ultrasound screening provides enhanced diagnostic details in comparison to 20-week screening.

Purpose: Medial meniscus extrusion compromises the ability of meniscus to distribute a load across the knee joint and is recognized as a risk factor for knee osteoarthritis. Despite a positive correlation between medial meniscus extrusion and medial tibial osteophyte width, the sequence of these pathological changes remains unclear. In this multicenter cross-sectional study, we aimed to clarify the relationship between osteophyte formation and medial meniscus extrusion by comparing extrusion distances in knees with and without medial tibial osteophytes.

Methods: We enrolled 207 Japanese patients with early-stage knee osteoarthritis, defined as Kellgren-Lawrence grade ≤ 2. Participants underwent radiography, magnetic resonance imaging, and ultrasonography (US). Knees were categorized into three groups based on the presence of osteophytes: N (no osteophytes), U (osteophytes detected only with US), and O (osteophytes detected with both radiography and US). The medial meniscus extrusion distance was assessed using US.

Results: Among the 211 knees evaluated, 89 were classified into the N group, 93 into the U group, and 29 into the O group. The medial meniscus extrusion distance was significantly greater in the O group (3.3 ± 1.3 mm) than in both the N (2.3 ± 1.1 mm, p < 0.001) and U (2.6 ± 0.9 mm, p = 0.004) groups. No significant difference was detected between the N and U groups (p = 0.27).

Conclusion: Medial meniscus extrusion was significantly associated with osteophyte formation in early-stage knee osteoarthritis.

Purpose: Hepatic steatosis is a hallmark of metabolic dysfunction-associated steatotic liver disease, and increased hepatic fat (or steatosis) is associated with liver inflammation, fibrosis, and adverse outcomes. While MRI-derived proton density fat fraction (MRI-PDFF) is an accurate noninvasive reference standard, ultrasound attenuation imaging (UAI) offers an accessible cost-effective alternative. We herein systematically review and meta-analyze the accuracy of UAI in grading hepatic steatosis.

Methods: We searched Embase, PubMed/Medline, Scopus, and Web of Science through December 22, 2024, for studies comparing UAI with MRI-PDFF. Data on diagnostic performance were extracted from eligible studies. Pooled diagnostic odds ratios (DOR), sensitivity, specificity, likelihood ratios, and areas under the curve (AUCs) were calculated using random-effects models, with heterogeneity assessed through I².

Results: Twelve studies with a total of 3344 patients were included. For differentiating grade 0 from grade ≥ 1 steatosis, the pooled AUC was 0.82 (95% CI 0.78-0.85) and DOR was 21.10 (I² = 67.2%), with sensitivity and specificity of 83%. For differentiating grades ≤ 1 from grade ≥ 2, the AUC was 0.80 (95% CI 0.73-0.86), DOR 19.87 (I² = 89%), sensitivity 84%, and specificity 80%. For differentiating grades ≤ 2 from grade 3, the AUC was 0.78 (95% CI 0.66-0.87), DOR 19.21 (I² = 85.3%), sensitivity 86%, and specificity 80%.

Conclusion: UAI exhibits good diagnostic accuracy for grading hepatic steatosis and offers a practical, noninvasive alternative to MRI-PDFF, being particularly well-suited for screening and patient follow-up. Standardized protocols and further multicenter studies are needed to promote its clinical application.

Purpose: Chronic autoimmune thyroiditis shows increased stiffness on elastography. The sternocleidomastoid (SCM) or strap muscles have been used as references in strain elastography in prior studies. We aimed to compare the effects of different reference points in strain elastography on its diagnostic performance.

Methods: Patients referred for thyroidectomy underwent strain elastography assessment of the non-tumor-bearing thyroid parenchyma. The strain ratio was determined using either the adjacent SCM muscle or the trachea at the same depth as reference points. Final pathological results served as the standard.

Results: A total of 174 patients were analyzed, with 39 (22%) diagnosed with autoimmune thyroiditis. Multivariate logistic regression identified thyroid peroxidase antibodies, thyroglobulin antibodies, and the strain ratio using the trachea as a reference as independent predictors of thyroiditis. The area under the receiver operating characteristic curve was significantly higher with the trachea as the reference compared to the SCM (0.854 vs. 0.611). Sensitivity analyses indicated that diagnostic performance was not affected by patient age or body habitus.

Conclusions: Different reference points in strain elastography significantly influence the predictability of autoimmune thyroiditis, and using the trachea as a reference improves diagnostic performance.