Journal of Ultrasound最新文献

Ultrasound-guided core needle biopsy (CNB) is a highly effective technique for diagnosing tumoral and inflammatory/infectious diseases. The procedure provides real-time visualization of anatomical structures such as vessels and nerves, reducing complications and enhancing accuracy. Traditionally performed by interventional radiologists, CNB can also be safely and effectively conducted by another specialists, including general physicians, thanks to the widespread availability of Point-of-Care Ultrasound. This not only improves and expedites the diagnostic process but also facilitates access to minimally invasive interventions by clinical services, establishing ultrasound-guided CNB as an essential tool for general physicians.

Pulmonary hernias are typically a result of trauma, thoracic operations, or congenital defects. Spontaneous lung hernias without a prior overt injury are notably rare. The presence of spontaneous lung hernias has not been reported in post-polio syndrome. Post-polio syndrome is a late sequela of poliomyelitis that usually presents 30-40 years after the initial illness with new presentations of progressive muscle weakness, abnormal muscle fatigue, muscle atrophy, and myalgia. This case report describes the presentation and imaging of a post-polio patient with an atraumatic, spontaneous lung hernia. A discussion on pulmonary hernias, diagnostic imaging, and management is also included.

Superficial venous pseudoaneurysm is rare. Prompt diagnosis is essential to formulate management plan and decrease morbidity. We describe a novel Eccentric Ripple sign of BAARISh for diagnosing venous pseudoaneurysm.

The novel BAASIK (B-Botchu,Bipin, A-Agrawal, A-Ankit, S- Sindhura, I-Iyengar, K- Kapil) technique is a combined ultrasound-guided injection into the subacromial-subdeltoid (SASD) bursa and the biceps tendon sheath to treat shoulder pain associated with biceps tendonitis/tendinopathy, subacromial bursitis, rotator cuff impingement or to determine the source of shoulder pain. This technique aims in reducing shoulder pain, improving functional activities and enhancing treatment delivery. A single-entry supine ultrasound-guided injection of the subacromial-subdeltoid (SASD) bursa and biceps tendon sheath involves using a single needle insertion point to access both structures for therapeutic injection. This technique could become a favoured alternative technique, rather than  subjecting patients to two needlesticks and preparing two separate injections to address often concomitant pathologies.

Purpose: In term and preterm infants, liver size is important for assessing growth and detecting conditions such as hepatomegaly, infections, or cardiac failure. The German Society for Ultrasound in Medicine (DEGUM) recommends measuring craniocaudal liver length in two frontal planes: the midsternal line (MSL) and the right anterior axillary line (AAL). This study evaluated whether liver length measurements in the right AAL from a lateral view yield results comparable to the standard frontal view, as the lateral approach may be technically more accessible and less stressful for neonates.

Material and methods: In this prospective single-center study conducted in a level III neonatal intensive care unit, 62 term and preterm infants underwent 107 liver measurements between July and December 2024. Each measurement was performed in both the frontal and the alternative lateral AAL plane. Statistical analysis included Wilcoxon matched-pairs signed rank test, Pearson Correlation Coefficient, and Bland-Altman analysis.

Results: The median liver length was 4.7 cm in both methods (interquartile range 1.5 cm frontal, 1.4 cm lateral). The correlation between approaches was excellent (r = 0.9971), and Bland-Altman analysis showed a median difference of 0 cm, with 99.1% of measurements within the limits of agreement (- 0.3 cm to 0.2 cm).

Conclusion: Sonographic liver measurement in the lateral AAL yields results equivalent to the standard frontal method and may offer a practical alternative when standard access is limited. Supporting minimal handling of newborns, the approach is particularly relevant in neonatal intensive care and provides a methodological basis for further evaluation of the lateral view.

Purpose: This study aims to explore the relationship between ultrasound radiomics features and semantic features from BI-RADS classification in the preoperative differentiation of benign and malignant breast lesions, as well as the potential diagnostic advantages of radiomics features.

Methods: Retrospective analysis was performed on 147 female patients with pathologically confirmed breast lesions. Ultrasound images and clinical data were used to construct three diagnostic models: BI-RADS classification single factor diagnostic model, Radiomics diagnostic model, and a BI-RADS-radiomic combined model. Additionally, univariate radiomic models based on semantic features were developed to investigate the associations.

Results: The BI-RADS-Radiomics combined model demonstrated superior performance in both training and testing sets, with AUC values of 0.985 and 0.964, respectively. It also exhibited optimal diagnostic consistency and clinical net benefit. Significant correlations were observed between multiple radiomics features and specific semantic features (AUC range: 0.609-0.752).

Conclusion: Radiomics features effectively assist in breast cancer diagnosis via ultrasound and exhibit nonlinear associations with specific semantic features.

Purpose: We primarily assessed the capability of ultrasound quantitative microvascularity imaging (qMI) in identifying high risk thyroid nodules. In addition, the diagnostic performance of computer aided diagnosis (CAD) was evaluated and correlated with qMI and cytology results.

Methods: This single centre prospective study was carried out from 2023 to 2024 and included 165 target thyroid nodules,that were assessed by using CAD for semi-automatic EU-TIRADS classification and qMI, that. Subsequently, all nodules underwent Fine Needle Aspiration Biopsy and Cytology. CAD derived EU-TIRADS and qMI results (Vascularity Index - VI) were correlated with cytology results, that were used as a reference standard, using regression analyses.

Results: Target nodules showed mean size of 15.6 mm ± 9 (range 4-40 mm) and mean vascularity index of 29.03% ± 24.3 (range 0-98.7%)at qMI analysis. Mean vascularity index of 'benign' nodules (TIR2) and low risk nodules (TIR3A) was 35% (range 5-98.7%), that was significantly higher than that of high risk (TIR3B) and malignant nodules (TIR 4/5) (24.2%, p = 0.04.). However, within the malignant group, small nodules (< 10 mm) showed higher vascularity mean VI = 31.45%) than larger nodules (mean VI = 16.91%, p = 0.03). CAD showed very high overall sensitivity and specificity for all EU-TIRADS, allowing for EU-TIRADS 3 and 4 nodules.

Conclusion: Vascularity index showed a weak relationship with nodule size and cytology results. High vascularity may be observed more frequently in small malignant tumours and large benign tumours. Some EU-TIRADS 3 and 4 nodules may benefit of qMI assessment, as CAD shows lower accuracy.

Purpose: To evaluate the correlation between the degree of pulmonary compromise, as assessed by lung ultrasound, and the activation of the coagulation cascade in patients hospitalized with COVID-19 pneumonia.

Methods: A prospective observational study was conducted on 47 adult patients with confirmed COVID-19 pneumonia. Each patient underwent a systematic 12-zone LUS exam to calculate a total Lung Ultrasound Score (LUS score). Arterial blood gas analysis was performed to calculate the arterial partial pressure of oxygen to fraction of inspired oxygen (P/F) ratio and the alveolar-arterial (A-a) oxygen gradient. Laboratory tests included serum D-dimer and C-reactive protein (CRP).

Results: The LUS score correlated positively and significantly with D-dimer values (p = 0.019; ρ = 0.342), CRP (p < 0.001; ρ = 0.647), and the A-a gradient (p < 0.001; ρ = 0.640). It also displayed a significant negative correlation with the P/F ratio (p < 0.001; ρ = -0.614).

Conclusion: The degree of lung injury in COVID-19 pneumonia, as evaluated by LUS, correlates directly with elevated D-dimer levels, signifying increased coagulation activation. Lung ultrasound, as a bedside and noninvasive tool, could serve as a surrogate marker not only for pulmonary involvement but also for identifying patients at higher risk of thrombotic complications.