Journal of Ultrasound最新文献

Purpose: To investigate the intrasession (test) and intersession (retest) reliability of rehabilitative ultrasound imaging (RUSI) in measuring the thickness of rectus capitis posterior major (RCPM) and oblique capitis superior (OCS) in patients with chronic non-specific neck pain (CNNP).

Methods: Thirty-three CNNP patients (age 35 $\pm$ 12.82 years, 24 women and 9 men) participated in the study. One examiner measured the thickness of the right and left RCPM and OCS in their resting position. For intrasession reliability, two measurements were conducted with an interval of 15 min. As for the intersession reliability, measurements were repeated with an interval of 3 to 4 days after the first session. Intraclass correlation coefficients (ICC), standard error of measurement (SEM), minimal detectable change (MDC), coefficient of variation (CV), and Bland-Altman plots were used for data analysis.

Results: The ICC results for intrasession and intersession reliability ranged from 0.89 to 0.95 and 0.84 to 0.91, respectively. The SEM ranged from 0.35 to 0.57, while the MDC ranged from 0.97 to 1.58. The Bland-Altman plots demonstrated good agreement and no bias.

Conclusion: The current study found RUSI to be a reliable instrument for measuring the thickness of RCPM and OCS in CNNP patients.

Purpose: To determine the pancreatic stiffness values in non-diabetics and diabetic patients using ultrasound shear wave elastography and to associate shear wave elastography values with the presence of diabetic microangiopathy.

Methods: The study included 133 adult participants with 50 non-diabetics and 83 diabetics. Among 83 diabetics, 42 were without and 41 were with diabetic microangiopathy. Pancreatic stiffness was assessed using 2D shear-wave elastography (SWE), with values expressed in kilopascals (kPa) and meters per second (m/s). Measurement reliability was ensured by maintaining an interquartile range-to-median ratio (IQR/M) of ≤ 30% for kPa and ≤ 15% for m/s.

Results: Pancreatic stiffness measured by 2D shear wave elastography was significantly higher in diabetic patients compared to non-diabetic participants, with further elevated values observed in those with microangiopathy. Stiffness values increased proportionally with the number of microangiopathies, with the highest values seen in patients with multiple microangiopathies. ROC curve analysis revealed cutoff values of pancreatic stiffness for predicting diabetes and microangiopathy, demonstra0ting high sensitivity and specificity, with higher stiffness thresholds correlating with the presence of microangiopathy.

Conclusion: These findings highlight the utility of 2D shear wave elastography as a valuable, non-invasive imaging tool for the assessment of pancreatic changes in diabetes and its associated microangiopathic complications.

Background: Loss of skin elasticity and youthful appearance is closely linked to reduced hyaluronic acid (HA) levels in the dermis. While topical HA products offer temporary effects, they do not address the root cause of HA depletion.

Objective: The present study aims to describe how to induce HA synthesis through fibroblast stimulation.

Materials and methods: Twelve sows were divided into two groups. One group (n = 9) received four consecutive Radiofrequency (RF) and Targeted Ultrasound (TUS) treatments, the other group (n = 3) received four RF treatments only. Samples were collected via punch biopsy from the treated area of each animal at the baseline, 1-month, and 2-month follow-up. Samples were then processed and prepared for enzyme-linked immunosorbent assay as well as hyaluronic acid binding protein with diaminobenzidine (HABP-DAP) staining, which allows for visualization of HA within tissue.

Findings: The group receiving RF + TUS treatment has demonstrated an increase from an average of 83.0 µg/g at the baseline to 163.0 µg/g at the 2-month follow-up of HA concentration in the skin. Histology samples clearly demonstrate higher tissue density with an increase of brown pigment due to the HABP-DAP stain, representing HA in the skin. In comparison, the RF standalone treatment group has shown no significant increase in HA concentrations.

Conclusion: Study results show no significant increase in HA production following the RF stand alone treatment. Whereas the RF + TUS treatment group induced a significant HA production response as well as histophysiological changes in the dermis.

Purpose: Focused ultrasound (FUS) is currently in the limelight of veterinary medicine as a novel treatment modality for companion animals, offering significant benefits over traditional techniques. In this study, the safety, feasibility, and efficacy of FUS for the treatment of various spontaneous canine and feline tumours was investigated.

Methods: Dogs and cats diagnosed with naturally occurring tumours were recruited in the study based on certain eligibility criteria. Fifteen dogs and cats with superficial tumours at various anatomical locations including the belly, chest, shoulder, rump, and neck were enrolled. Treated tumours in pets were mammary, sarcoma, pressure-point comedones and lipoma. Tumours in enrolled pets were treated using an in-house Magnetic Resonance Imaging guided FUS (MRgFUS) robotic system integrating a 2.75 MHz single-element spherically focused transducer. Partial FUS ablations were delivered to targeted tumours using sonication protocols tailored to tumour volume and location. Following FUS, the tumours were surgically excised and sent for histological examination.

Results: FUS treatments were well-tolerated with no significant adverse events or off-target damages, with only one canine case experiencing mild erythema and superficial skin ulceration at the treated site. Haematoxylin and Eosin (H&E)-stained slides revealed that well-demarcated areas of coagulative necrosis were effectively achieved at the targeted FUS regions in all treated cases.

Conclusion: Study findings demonstrate that FUS can be safely used for the management of various types of spontaneous canine and feline tumours, highlighting the promising potential of the technology as a valuable and versatile therapeutic approach for veterinary cancer patients.

Purpose: Idiopathic granulomatous mastitis (IGM) is a granulomatous condition with non-specific manifestations and a challenging diagnosis. This study aims to describe the appearance of biopsy-proven IGM lesions utilizing shear wave elastography (SWE) Young's modulus.

Methods: We performed a retrospective search for pretreatment ultrasounds of IGM referred to two tertiary breast clinics over five years. Patients with at least one pre-treatment ultrasound and pathologically-proven IGM entered the study. Ultrasound and SWE were performed and interpreted by a breast imaging fellowship-trained radiologist. The data were analyzed using SPSS software.

Results: Among 201 pretreatment ultrasound, non-mass lesions (76%) and intercommunicating channels (52%) were the most common findings. All the patients had BIRADS of 4. The BIRADS of 4a was the most common (75%). Among 138 SWE, dark blue was the most common color in the center and periphery, with 80% and 76%, respectively. The mean stiffness (kPa) of the center was significantly higher than that of the peripheral parts in IGM lesions (P < 0.001). None of the IGM lesions were hard enough to prevent sound waves from effective propagation.

Conclusion: Although IGM mostly presents in non-specific grayscale ultrasound patterns, SWE findings can provide more specificity to imaging findings and probably can help to reach an accurate diagnosis.

Intracerebral hemorrhage (ICH) is a common neurosurgical emergency that is associated with high morbidity and mortality. Minimally invasive or endoscopic hematoma evacuation has emerged in recent years as a viable alternative to conventional large craniotomies. However, accurate trajectory planning and placement of the tubular retractor remains a challenge. We describe a novel technique for handheld portable ultrasound-guided minimally invasive endoscopic evacuation of supratentorial hematomas. A 64-year-old male diagnosed right hematoma (48.5 mL) at the basal ganglia was treated with emergent ultrasound-guided endoscopic transtubular evacuation through a small craniotomy. Ultrasound-guidance facilitated optimal placement of the tubular retractor into the long axis of the hematoma, and allowed for near-total evacuation, reducing iatrogenic tissue damage by mitigating the need for wanding or repositioning of the retractor. The emergence of a new generation of small portable phased array ultrasound probes with improved resolution and clarity has broadened ultrasound's clinical applications.

Objective: To describe an innovative, dynamic ultrasound technique for detecting abdominal hernias using the Color Doppler effect, particularly in small hernias and those that are challenging to identify with conventional ultrasound methods.

Materials and methods: With the patient in a supine position, the ultrasound probe is positioned over the suspected hernia area without applying compression. The sonographer activates the Color Doppler box and instructs the patient to perform a Valsalva maneuver.

Results: During the Valsalva maneuver, the hernia sac becomes visible as a red Doppler signal moving toward the probe, clearly indicating its presence and motion. When the Valsalva maneuver is stopped and intra-abdominal pressure decreases, the hernia retracts back into the abdominal cavity, resulting in a blue signal moving away from the probe. The combination of the Color Doppler effect and the Valsalva maneuver enhances the detection of small hernias, where a narrow defect increases tissue velocity and generates clearer Doppler signals. This characteristic Doppler pattern is here proposed as a novel diagnostic indicator, referred to as the "Cocco Sign."

Conclusion: This dynamic ultrasound assessment using the Color Doppler effect may significantly enhance the identification of hernias-especially small ones that are challenging to visualize with conventional ultrasound techniques. This innovative approach has the potential to significantly enhance the diagnosis of hernias.

Temporalis muscle thickness (TMT) has gained increasing importance as a parameter for predicting sarcopenia, dysphagia, and functional outcomes, particularly in cranial pathologies such as stroke. However, the complex anatomy of the temporal fossa presents a significant challenge for the reliable assessment of TMT. This review aims to overcome this difficulty by providing a comprehensive analysis of the sonoanatomy and radiologic structure of the temporal fossa. Detailed anatomical relationship, including fascial planes, fat pads, and bony structures are presented with high-resolution images and videos. In addition to this thorough anatomical evaluation, the study introduces a novel, standardized TMT measurement technique designed to be applicable across CT, MRI, and ultrasound modalities. This technique aims to enhance the comparability of measurements and to support the use of TMT as a more effective biomarker in the evaluation and follow-up of sarcopenia, dysphagia, and other orofacial conditions.

Background: Intra-abdominal adhesions following caesarean sections pose significant challenges during repeat surgeries, leading to increased maternal morbidity. A reliable, non-invasive preoperative diagnostic tool such as the ultrasound (USG) sliding sign may help predict adhesions and improve surgical preparedness.

Objectives: To evaluate the diagnostic accuracy of the ultrasound sliding sign in predicting intra-abdominal adhesions in women undergoing repeat lower segment caesarean section (LSCS), and to correlate sonographic findings with intraoperative adhesion severity.

Methods: This prospective observational study was conducted on 250 pregnant women with a history of one or more previous LSCS. All participants underwent preoperative transabdominal ultrasound to assess the presence or absence of the sliding sign. Adhesion severity was classified intraoperatively using the Nair classification. Associations between adhesion severity and clinical variables such as age, BMI, number of previous LSCS, and gestational age were analysed using chi-square and ANOVA tests.

Results: A significant association was observed between the absence of the USG sliding sign and the presence of moderate to severe adhesions (p < 0.001). The sliding sign demonstrated a sensitivity of 72.88%, specificity of 85.86%, positive predictive value of 61.43%, and negative predictive value of 91.11% and an overall accuracy of 82.8%. The receiver operating characteristic (ROC) curve analysis showed an area under the curve (AUC) of 0.96, indicating excellent diagnostic accuracy. Mean intraoperative blood loss and time from skin incision to delivery significantly increased with higher adhesion grades (p < 0.001). A statistically significant correlation was also noted between the number of previous LSCS and adhesion severity (p = 0.022), whereas age, BMI, gestational age, and place of previous delivery were not significantly associated.

Conclusion: The ultrasound sliding sign is a simple, non-invasive, and effective tool for the preoperative prediction of intra-abdominal adhesions in women undergoing repeat caesarean sections. Its use may aid in surgical planning and reduce operative complications.