Journal of Medical Ultrasonics最新文献

Purpose: To investigate the clinical utility of a novel transperineal ultrasonographic (TUS) parameter, the TUS station, for assessing labour progression and predicting forceps delivery difficulty.

Methods: In this prospective cohort study, 384 TUS images from 144 participants who delivered vaginally between January 2019 and December 2021 were assessed for labour progression in a single tertiary perinatal center in Japan. Singleton cephalic pregnancies ≥ 37 weeks were included. The digital vaginal examination (DVE) findings, TUS station, and angle of progression (AoP), an ultrasound parameter commonly used for assessing labour progression, were obtained by individual obstetricians who were blinded to the results in all cases. The TUS station and DVE findings and AoP and DVE findings of the participants were compared. A second cohort requiring forceps delivery was analyzed to explore the relationship between TUS station and delivery difficulty.

Results: In the quantitative assessment of fetal head descent, the TUS station correlated with DVE findings. During the resting phase of labour, the TUS cut-off value for an easy forceps delivery was 2 cm, with a sensitivity of 85%; the maximum AUC value was 0.9 (95% confidence interval [CI]: 0.73-0.96). At the time of labour, the TUS cut-off value for an easy forceps delivery was 2.9 cm, with a sensitivity of 85%; the maximum AUC value was 0.8 (95% CI 0.65-0.96).

Conclusion: The TUS station may serve as a valuable and objective parameter for consideration in decisions regarding forceps delivery.

Contrast-enhanced ultrasound (CEUS) has become an important tool for the detection and characterization of solid renal lesions, complementing traditional B-mode US, which often struggles to distinguish between solid and cystic masses. CEUS enhances diagnostic accuracy by providing detailed vascularization information, helping to identify potentially malignant solid lesions and differentiate between pseudotumours and solid masses. Moreover, CEUS employs a contrast agent that is safe even for nephropathic patients and can be used without concern for kidney function, making it an advantageous method for renal imaging. In this narrative review, following the European Federation of Societies for Ultrasound in Medicine and Biology guidelines, the authors show its main indications: characterizing indeterminate renal lesions in patients with transplanted kidney, monitoring non-surgical lesions, diagnosing inflammatory-infectious renal pathologies, and assessing advanced renal lesions and masses in the surgical bed.

Purpose: The infrapatellar fat pad (IFP) absorbs mechanical stress in the knee joint owing to flexible morphological changes. The IFP is a key factor in knee osteoarthritis (OA); however, its dynamic feature during walking remains unknown. This study aimed to investigate whether the morphological changes in the IFP during walking involve specific features for patients with knee OA.

Methods: Twelve patients with knee OA, 12 healthy young volunteers, and 12 healthy elderly volunteers were recruited. The IFP was evaluated using ultrasonography, and dynamics were recorded in video mode during walking. The IFP value was identified as the thickness between the patellar tendon and proximal tibial line. The morphological change in the IFP (ΔIFP) was shown as the difference in IFP value between maximum and at initial contact on the waveform. Kinematics and kinetics data were evaluated using a three-dimensional motion analysis system synchronized with ultrasonography, and the knee flexion angle and its moment in the stance phase were evaluated.

Results: In the patients with knee OA, the ΔIFP was lower than that in healthy volunteers, but there was no difference between control groups (knee OA: 1.4 ± 0.3 mm, elderly control: 1.8 ± 0.2 mm, young control: 2.1 ± 0.5 mm, p < 0.05). In all the groups, there was no significant correlation between the IFP values and kinetic parameters, including the range of knee flexion angles and gait speed.

Conclusion: Insufficient morphological changes in the IFP during walking could be a feature of knee OA.