Journal of Ultrasound最新文献

Objective: To explore the application of ultrasound derived fat fraction (UDFF) in evaluating metabolic associated fatty liver disease in obese polycystic ovary syndrome.

Method: This study included 124 obese PCOS patients and 106 age and body mass index (BMI) matched non PCOS control group women. The two groups of data were compared to determine the prevalence of metabolic associated fatty liver disease (MAFLD) in PCOS obese patients. The 124 obese PCOS patients were divided into MAFLD group (n = 64) and non MAFLD group (n = 60). Using ROC curve analysis to evaluate the diagnostic performance of UDFF and SWV values for MAFLD. The MAFLD group was divided into mild group (n = 16), moderate group (n = 24), and severe group (n = 24). Use Spearman correlation method to analyze the relationship between UDFF value, SWV value and the severity of MAFLD.

Result: MAFLD was more common in the obese PCOS group than in the control group (51.61 vs 27.36%) (χ² = 13.9583, P = 0.00019). The UDFF of obese PCOS patients was higher than those of the control group, while SWV was lower than those of the control group. ROC analysis showed that the AUC of UDFF for diagnosing MAFLD was 0.935, with sensitivity, specificity, and cut-off values of 92.2, 85.0, and 4.5%, respectively. UDFF was positively correlated with the severity of MAFLD (r = 0.603, P < 0.01). The AUC of SWE for diagnosing MAFLD was 0.728, with sensitivity, specificity, and cut-off values of 51.6, 93.3%, and 1.015 m/s, respectively. SWV was negatively correlated with the severity of MAFLD (r = - 0.551, P < 0.01).

Conclusion: The prevalence of MAFLD is significantly higher in obese PCOS patients, and UDFF technology can detect and quantitatively analyze liver fat infiltration in obese PCOS patients early. At the same time, auto-pSWE also has diagnostic significance for the progression of liver disease.

Background: Differentiating between uterine fibroids and leiomyosarcoma poses significant challenges, particularly in cases of atypical fibroid degeneration. Accurate diagnosis is crucial for appropriate treatment and patient outcomes.

Methods: We present two case reports to illustrate the complexities involved in distinguishing these conditions. Both cases involved patients with similar clinical presentations and imaging findings. The diagnostic process included trans-abdominal and trans-vaginal ultrasound, CT scans, and histopathological examination.

Results: In Case 1, the patient presented with worsening abdominal pain and imaging revealed multiple myomas. Histological examination confirmed benign fibroids following surgery. Case 2 involved a patient with an abdominal mass and CT findings suggestive of a fibroid. However, ultrasound characteristics raised suspicion of malignancy, and subsequent histopathological analysis confirmed leiomyosarcoma.

Conclusion: These case reports underscore the importance of combining clinical evaluation with advanced imaging techniques for accurate differentiation between uterine fibroids and leiomyosarcoma. While ultrasound plays a critical role, its effectiveness is enhanced by the experience of the sonographer and the integration of other diagnostic modalities. Future multicenter studies should focus on refining these diagnostic approaches to improve accuracy and patient outcomes.

This pictorial essay clarifies the complex anatomical and ultrasonographic features of the Achilles tendon. Utilizing high-frequency ultrasound probes (12-18 MHz), the study visualizes the tripartite segmentation of the tendon as it relates to anatomical fascicles. Notably, there is variability in the ultrasound visibility of fascicles and this partition influences biomechanical properties and susceptibility to injury. This essay not only enhances the understanding of Achilles tendon anatomy but also underscores the importance of anatomical knowledge for comprehending associated pathologies. The findings suggest potential areas for further research into tendon pathology, facilitating the development of targeted rehabilitation strategies.

Testicular epidermoid cysts (TECs) are rare, benign lesions that can also mimic malignant testicular masses. Accurate preoperative diagnosis is essential for proper management. A 13-year-old male presented with a painless solid mass in the left testicle. Serum tumor markers were normal. Ultrasound, CEUS and MRI findings were consistent with TEC. Surgical enucleation of the mass was performed, after ruling out malignancy through intraoperative frozen section examination. Histopathology confirmed diagnosis of keratin-filled epidermoid cyst. At 3-month follow-up, the patient is well-being and scrotal US is normal. This case highlights the importance of considering epidermoid cysts in the differential diagnosis of testicular masses in young males. Ultrasound is the first-line imaging modality in the assessment of any testicular masses. Other imaging modalities such as CEUS, elastography and MRI can be helpful to distinguish between benign and malignant lesions. Testis-sparing surgery can be safely performed, after ruling out malignancy through intraoperative frozen-section analysis.

Introduction: Post-stroke cognitive impairment (PSCI) and dementia affect short- and long-term outcome after stroke and can persist even after recover from a physical handicap. The process underlying PSCI is not yet fully understood. Transcranial Doppler ultrasound (TCD) is a feasible method to investigate cerebrovascular aging or dementia, through the pulsatility index (PI), the cerebrovascular reactivity (e.g. the Breath-Holding Index (BHI)) and the functional Transcranial Doppler sonography (fTCD). Aim of the study was to assess the usefulness of PI, BHI, Resistance Index (RI) and fTCD in evaluating the risk of cognitive impairment evolution in patients with minor stroke (MS), compared to patients with transient ischemic attack (TIA) and to healthy controls (HC).

Material and methods: PI, RI, BHI and fTCD were evaluated in the middle cerebral artery (MCA) of MS patients, TIA and HC. Patients with MS and TIA were enrolled within six days from the cerebrovascular event (acute phase) and the tests were repeated after 180±15 days from t0 (control phase). During the TCD recording, particular sections of MoCA test and FAB test were performed.

Results: 43 subjects were enrolled: 13 MS, 16 TIA and 14 HC. MFV analysis in the acute phase demonstrated no difference between MFVs at rest vs MFVs during MoCA/FAB tests in TIA and MS (acute phase), a significant increase of MFVs during MoCA/FAB tests vs MFVs at rest in HC (p<0.01), a statistically significant difference in the PI of MS vs HC at rest (p=0.048) and in BHI between HC vs MS (p<0.001) and HC vs TIA (p<0.01). In the control phase the absence of a statistically significant difference in MFVs was observed only in MS patients (MFVs at rest vs MFVs during MoCA) and PI and BHI values were in the normal range both in MS and TIA. No correlation was observed between MoCA test results and MFV, PI or RI, in any of the three groups.

Conclusion: A different cerebral vasoreactivity, in terms of no increase in MFV, was found when performing cognitive tasks in patients with MS and TIA compared to HC in the acute phase. TCD is a fundamental tool to study cerebral vasoreactivity.

Hepatic gas gangrene (HGG) is a rare but life-threatening condition typically caused by anaerobic bacteria such as Clostridium perfringens, though Gram-negative bacteria like Escherichia coli and Klebsiella species have also been implicated. Traditionally diagnosed via computed tomography (CT), point-of-care ultrasound (POCUS) has emerged as a valuable tool in critical care settings for its non-invasive, bedside utility. We report the case of a 51-year-old female with choledochal syndrome secondary to cholangiocarcinoma who developed HGG following left extended hepatectomy and biliary reconstruction. POCUS revealed free subhepatic fluid, hypoechogenicity in the right hepatic lobe, and comet-tail artifacts suggestive of intrahepatic gas, leading to prompt surgical intervention. Despite maximal supportive measures, the patient succumbed to refractory shock. This case underscores the utility of POCUS in the rapid diagnosis and management of HGG, offering a non-invasive alternative to traditional imaging, and highlights its potential as a primary diagnostic tool for HGG in critically ill patients.

Aim: o point out how novel analysis tools of AI can make sense of the data acquired during OL and OC diagnosis and treatment in an effort to help improve and standardize the patient pathway for these disease.

Material and methods: ultilizing programmed detection of heterogeneus OL and OC habitats through radiomics and correlate to imaging based tumor grading plus a literature review.

Results: new analysis pipelines have been generated for integrating imaging and patient demographic data and identify new multi-omic biomarkers of response prediction and tumour grading using cutting-edge artificial intelligence (AI) in OL and OC.

Description: deline the main AI methods used in OL and OC that we can try to standardize in the clinical radiological and medical practice to ameliorate the patients diagnosis and theraphy.

Conclusion: through new AI methods it's possible to combine research into a SwarmDeepSurv, generate new data flow channels, create medical imaging data channels of OL and OC using AI and identify new biomarkers of OL and OC. .

Objective: The aim of this work is to demonstrate how the chronicity of low back pain can modify the trophism of the paraspinal muscles, by performing an ultrasound and MRI evaluation of the paraspinal muscles in the lumbar spine and correlating it to the time of onset of low back pain.

Materials and methods: An ultrasound evaluation was carried out in the lumbar area with a 5-17 MHz linear probe of the paraspinal muscles of the lumbar region, compared with the MRI of the lumbar spine, in patients presented to our attention for chronic low back pain (> 6 months), from January 2021 to January 2023. In each patient, two series of images were analyzed, in the coronal and sagittal planes.

Results: Between January 2021 and January 2023, a total of 79 patients were retrospectively evaluated by ultrasound for chronic low back pain. The patients, including 46 men and 33 women, had an average age of 51.6 years (min 24-max 74). In the evaluation of the profile of the paravertebral muscles, 22 patients (27.8%) showed hypotrophy of the paravertebral muscles with a concave profile, while the measurement of the thickness of the fascia showed an average thickness of 2.19 mm with a range between 1, 3 and 3.2 mm and an interquartile range of 1.7-2.65 mm. 77.2% of patients with a concave profile showed a thickness of the FTL > 2.5 mm, and an average duration of symptoms of approximately 15.3 months, to demonstrate a correlation between muscle hypotrophy, thickness of the FTL and duration of onset of symptoms.

Conclusion: In the evaluation of chronic low back pain carried out with MRI and ultrasound, the paravertebral musculature profile and the thickness of the thoracolumbar fascia are two instrumental data which, associated with the proposed classification and correlated to the clinical picture, allow to determine the chronicity of the pathological picture.

Shoulder Injury Related to Vaccine Administration (SIRVA) is a complication caused by improperly administered vaccinations. It triggers an inflammatory cascade that damages shoulder structures, resulting in prolonged shoulder pain and restricted range of motion. Common diagnoses in SIRVA patients include shoulder bursitis (all classified as subacromial bursitis), adhesive capsulitis, and rotator cuff injuries such as tears or tendinopathy. Less frequent diagnoses include biceps tenosynovitis, shoulder synovitis, intramuscular hematoma, and polymyalgia rheumatica or polymyalgia rheumatica-like syndrome. We present a case of SIRVA with prominent subcoracoid bursitis, confirmed via ultrasound. Ultrasound plays a critical role in static and dynamic assessments, providing accurate diagnoses and valuable guidance for identifying associated pathologies and managing SIRVA.