Pub Date : 2024-06-01Epub Date: 2024-01-19DOI: 10.1007/s40477-023-00841-0
Antonio Alessandro Crispino, Anna Maria Musolino, Danilo Buonsenso, Mimma Caloiero, Daniela Concolino
Aims: Respiratory complications in Cystic Fibrosis (CF) are still the leading cause of death nowadays in these patients. High-Resolution Computed Tomography is the gold standard method for staging lung disease in CF. In this study we assessed lung ultrasound findings in asymptomatic preschool patients affected by CF.
Methods: This is a case-control study with a total of 70 enrolled patients (20 patients affected by CF, 50 healthy controls) aged from 31 to 6 years. All included patients were without intercurrent lung problems and without antibiotic therapy in the last 30 days. For each patient a lung Point of Care Ultrasound (POCUS) of lung was performed.
Results: B lines < 3 and sub-pleural consolidations < 1 cm were statistically more frequent in CF patients, both in terms of number of affected patients (p 0.02 and p 0.0001 respectively) and frequency (p 0.0181 and p 0.0001 respectively); the prevalence of B lines < 3 in control group was high (47.73%) however the prevalence of sub-pleural consolidations was very low (2.27%). In both groups coalescent B lines affected a greater number of infants and were in higher number of findings than patients aged between 2 and 6 years.
Conclusions: The presence of multiple subpleural pulmonary consolidations < 1 cm in asymptomatic preschool children could be a ultrasound markers of subclinical pulmonary disease such as CF. POCUS of lung is confirmed as a useful tool for the clinician as confirmation of a clinical suspicion, help reduce the use of ionizing radiation.
{"title":"Point of care lung ultrasound in preschool children with cystic fibrosis: a case-controlled, prospective, pilot study.","authors":"Antonio Alessandro Crispino, Anna Maria Musolino, Danilo Buonsenso, Mimma Caloiero, Daniela Concolino","doi":"10.1007/s40477-023-00841-0","DOIUrl":"10.1007/s40477-023-00841-0","url":null,"abstract":"<p><strong>Aims: </strong>Respiratory complications in Cystic Fibrosis (CF) are still the leading cause of death nowadays in these patients. High-Resolution Computed Tomography is the gold standard method for staging lung disease in CF. In this study we assessed lung ultrasound findings in asymptomatic preschool patients affected by CF.</p><p><strong>Methods: </strong>This is a case-control study with a total of 70 enrolled patients (20 patients affected by CF, 50 healthy controls) aged from 31 to 6 years. All included patients were without intercurrent lung problems and without antibiotic therapy in the last 30 days. For each patient a lung Point of Care Ultrasound (POCUS) of lung was performed.</p><p><strong>Results: </strong>B lines < 3 and sub-pleural consolidations < 1 cm were statistically more frequent in CF patients, both in terms of number of affected patients (p 0.02 and p 0.0001 respectively) and frequency (p 0.0181 and p 0.0001 respectively); the prevalence of B lines < 3 in control group was high (47.73%) however the prevalence of sub-pleural consolidations was very low (2.27%). In both groups coalescent B lines affected a greater number of infants and were in higher number of findings than patients aged between 2 and 6 years.</p><p><strong>Conclusions: </strong>The presence of multiple subpleural pulmonary consolidations < 1 cm in asymptomatic preschool children could be a ultrasound markers of subclinical pulmonary disease such as CF. POCUS of lung is confirmed as a useful tool for the clinician as confirmation of a clinical suspicion, help reduce the use of ionizing radiation.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11178747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-03-08DOI: 10.1007/s40477-024-00875-y
Zhang Ludi, Matthias Yi Quan Liau, Bryan Song Jun Yong, Amanda Sze Yen Auyong, Quah Hui Ting Lynette, Samuel Jianjie Yeo, Khin Swee Elizabeth Tan, Sreenivasulu Reddy Mogali, Ramya Chandrasekaran, Vivek Perumal, Ranganath Vallabhajosyula
Purpose: The aim of this systematic review is to evaluate the usefulness of sural nerve ultrasonography in diagnosing diabetes mellitus (DM) and diabetic polyneuropathy (DPN), the latter of which is a common long-term complication for diabetic patients that frequently involves the sural nerve.
Methodology: A meta-analysis of the cross-sectional areas (CSAs) of sural nerves in healthy individuals and patients with diabetes mellitus based on a total of 32 ultrasonographic-based studies from 2015 to 2023 was performed. Sub-analyses were performed for factors such as geographical location and measurement site.
Results: The meta-analysis showed that the mean CSA of the sural nerve was significantly larger in DM patients with DPN only compared to healthy individuals across all regions and when pooled together. An age-dependent increase in the CSA of healthy sural nerves is apparent when comparing the paediatric population with adults.
Conclusion: Sural nerve ultrasonography can distinguish diabetic adults with DPN from healthy adults based on cross-sectional area measurement. Future studies are needed to clarify the relationships between other parameters, such as body metrics and age, with sural nerve CSAs. Cut-offs for DPN likely need to be specific for different geographical regions.
{"title":"Morphometry of the sural nerve in diabetic neuropathy: a systematic review.","authors":"Zhang Ludi, Matthias Yi Quan Liau, Bryan Song Jun Yong, Amanda Sze Yen Auyong, Quah Hui Ting Lynette, Samuel Jianjie Yeo, Khin Swee Elizabeth Tan, Sreenivasulu Reddy Mogali, Ramya Chandrasekaran, Vivek Perumal, Ranganath Vallabhajosyula","doi":"10.1007/s40477-024-00875-y","DOIUrl":"10.1007/s40477-024-00875-y","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this systematic review is to evaluate the usefulness of sural nerve ultrasonography in diagnosing diabetes mellitus (DM) and diabetic polyneuropathy (DPN), the latter of which is a common long-term complication for diabetic patients that frequently involves the sural nerve.</p><p><strong>Methodology: </strong>A meta-analysis of the cross-sectional areas (CSAs) of sural nerves in healthy individuals and patients with diabetes mellitus based on a total of 32 ultrasonographic-based studies from 2015 to 2023 was performed. Sub-analyses were performed for factors such as geographical location and measurement site.</p><p><strong>Results: </strong>The meta-analysis showed that the mean CSA of the sural nerve was significantly larger in DM patients with DPN only compared to healthy individuals across all regions and when pooled together. An age-dependent increase in the CSA of healthy sural nerves is apparent when comparing the paediatric population with adults.</p><p><strong>Conclusion: </strong>Sural nerve ultrasonography can distinguish diabetic adults with DPN from healthy adults based on cross-sectional area measurement. Future studies are needed to clarify the relationships between other parameters, such as body metrics and age, with sural nerve CSAs. Cut-offs for DPN likely need to be specific for different geographical regions.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11178711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2023-12-15DOI: 10.1007/s40477-023-00835-y
Domenico Albano, Carmelo Messina, Salvatore Gitto, Stefano Fusco, Luca Maria Sconfienza, Alberto Bellelli
Purpose: To test the feasibility of US/CT fusion imaging to guide lumbar intradiscal O2/O3 therapy to treat discogenic degenerative low back pain due to lumbar disc herniation (LDH).
Methods: We retrospectively included consecutive patients affected by low back pain and/or sciatica due to LDH resistant to conservative therapies, who underwent to lumbar intradiscal O2/O3 injection under CT/US fusion imaging guidance (Fusion Group) and standard CT guidance (Control Group). For each procedure, we collected procedure operative time, room utilization time, number of CT passes, complications, and O2/O3 intradiscal diffusion adequacy. Technical success was defined as the ability to complete the procedure as initially planned to reach the disc. Technical efficacy was based on O2/O3 intradiscal diffusion adequacy, as demonstrated by the last CT scan.
Results: Six patients (4 males; mean age: 68 ± 15 years) were included in the Fusion group, six (4 males; mean age: 66 ± 12 years) in Control group. No complications were observed in both groups. In Fusion group we found significantly lower room utilization time (30 ± 6 min vs. 46 ± 10 min, p = 0.008), procedure operative time (14 ± 3 min vs. 24 ± 6 min, p = 0.008), and number of CT passes (2 [2,2] vs. 3 [3,3], p = 0.006) than in Control Group, respectively. Technical success and efficacy were 100% in both Groups.
Conclusion: CT/US fusion imaging seems to be a feasible and safe guidance for intradiscal O2/O3 injections, allowing decrease of procedure time and number of CT passes.
{"title":"US/CT fusion imaging and virtual navigation to guide lumbar intradiscal oxygen-ozone therapy: a pilot study.","authors":"Domenico Albano, Carmelo Messina, Salvatore Gitto, Stefano Fusco, Luca Maria Sconfienza, Alberto Bellelli","doi":"10.1007/s40477-023-00835-y","DOIUrl":"10.1007/s40477-023-00835-y","url":null,"abstract":"<p><strong>Purpose: </strong>To test the feasibility of US/CT fusion imaging to guide lumbar intradiscal O<sub>2</sub>/O<sub>3</sub> therapy to treat discogenic degenerative low back pain due to lumbar disc herniation (LDH).</p><p><strong>Methods: </strong>We retrospectively included consecutive patients affected by low back pain and/or sciatica due to LDH resistant to conservative therapies, who underwent to lumbar intradiscal O<sub>2</sub>/O<sub>3</sub> injection under CT/US fusion imaging guidance (Fusion Group) and standard CT guidance (Control Group). For each procedure, we collected procedure operative time, room utilization time, number of CT passes, complications, and O<sub>2</sub>/O<sub>3</sub> intradiscal diffusion adequacy. Technical success was defined as the ability to complete the procedure as initially planned to reach the disc. Technical efficacy was based on O<sub>2</sub>/O<sub>3</sub> intradiscal diffusion adequacy, as demonstrated by the last CT scan.</p><p><strong>Results: </strong>Six patients (4 males; mean age: 68 ± 15 years) were included in the Fusion group, six (4 males; mean age: 66 ± 12 years) in Control group. No complications were observed in both groups. In Fusion group we found significantly lower room utilization time (30 ± 6 min vs. 46 ± 10 min, p = 0.008), procedure operative time (14 ± 3 min vs. 24 ± 6 min, p = 0.008), and number of CT passes (2 [2,2] vs. 3 [3,3], p = 0.006) than in Control Group, respectively. Technical success and efficacy were 100% in both Groups.</p><p><strong>Conclusion: </strong>CT/US fusion imaging seems to be a feasible and safe guidance for intradiscal O<sub>2</sub>/O<sub>3</sub> injections, allowing decrease of procedure time and number of CT passes.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11178682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-03-23DOI: 10.1007/s40477-024-00874-z
Michele Domenico Spampinato, Andrea Portoraro, Soccorsa M Sofia, Francesco Luppi, Marcello Benedetto, Luca D'Angelo, Giorgio Galizia, Irma Sofia Fabbri, Teresa Pagano, Benedetta Perna, Matteo Guarino, Giulia Passarini, Rita Pavasini, Angelina Passaro, Roberto De Giorgio
Purpose: Pulmonary Embolism (PE) is the third leading cause of cardiovascular death, following myocardial infarction and stroke. The latest European Society of Cardiology (ESC) guidelines on PE recommend short-term prognostic stratification based on right ventricular (RV) overload detected by transthoracic echocardiography (TTE) or contrast-enhanced chest CT. The aim of the study is to find out which of the signs of right ventricular dysfunction best predicts in-hospital mortality (IHM).
Methods: This is a monocentric, retrospective study including adult patients admitted from the emergency department with a c-e cCT confirmed diagnosis of PE between January 2018 and December 2022 who underwent a TTE within 48 h.
Results: 509 patients (median age 76 years [IQR 67-84]) were included, with 7.1% IHM. At univariate analysis, RV/LV ratio > 1 (OR 2.23, 95% CI 1.1-4.5), TAPSE < 17 mm (OR 4.73, 95% CI 2.3-9.8), the D-shape (OR 3.73, 95% CI 1.71-8.14), and LVEF < 35% (OR 5.78, 95% CI 1.72-19.47) resulted significantly correlated with IHM. However, at multivariate analysis including also haemodynamic instability, PESI class > II, and abnormal hs-cTnI levels, only LVEF < 35% (OR 5.46, 95% CI 1.32-22.61) resulted an independent predictor of IHM.
Conclusion: Despite the recognised role of TTE in the early management of patients with circulatory shock and suspected PE, signs of RV dysfunction have been shown to be poor predictors of IHM, whereas severely reduced LVEF is an independent risk factor for in-hospital death.
目的:肺栓塞(PE)是继心肌梗塞和中风之后导致心血管疾病死亡的第三大原因。欧洲心脏病学会(ESC)关于肺栓塞的最新指南建议,根据经胸超声心动图(TTE)或对比增强胸部 CT 检测到的右心室(RV)负荷过重情况进行短期预后分层。本研究旨在找出哪种右心室功能障碍体征最能预测院内死亡率(IHM):这是一项单中心回顾性研究,包括2018年1月至2022年12月期间急诊科收治的经C-E cCT确诊为PE的成年患者,这些患者在48小时内接受了TTE检查:共纳入 509 名患者(中位年龄 76 岁 [IQR 67-84]),其中 7.1% 为 IHM。在单变量分析中,RV/LV 比值 > 1 (OR 2.23, 95% CI 1.1-4.5)、TAPSE II 和 hs-cTnI 水平异常,只有 LVEF 结论:尽管 TTE 的作用已得到认可,但其对心血管疾病的影响仍不容忽视:尽管 TTE 在循环休克和疑似 PE 患者的早期管理中发挥着公认的作用,但 RV 功能障碍的体征已被证明是 IHM 的不良预测因素,而 LVEF 严重降低则是院内死亡的独立危险因素。
{"title":"The role of echocardiography in pulmonary embolism for the prediction of in-hospital mortality: a retrospective study.","authors":"Michele Domenico Spampinato, Andrea Portoraro, Soccorsa M Sofia, Francesco Luppi, Marcello Benedetto, Luca D'Angelo, Giorgio Galizia, Irma Sofia Fabbri, Teresa Pagano, Benedetta Perna, Matteo Guarino, Giulia Passarini, Rita Pavasini, Angelina Passaro, Roberto De Giorgio","doi":"10.1007/s40477-024-00874-z","DOIUrl":"10.1007/s40477-024-00874-z","url":null,"abstract":"<p><strong>Purpose: </strong>Pulmonary Embolism (PE) is the third leading cause of cardiovascular death, following myocardial infarction and stroke. The latest European Society of Cardiology (ESC) guidelines on PE recommend short-term prognostic stratification based on right ventricular (RV) overload detected by transthoracic echocardiography (TTE) or contrast-enhanced chest CT. The aim of the study is to find out which of the signs of right ventricular dysfunction best predicts in-hospital mortality (IHM).</p><p><strong>Methods: </strong>This is a monocentric, retrospective study including adult patients admitted from the emergency department with a c-e cCT confirmed diagnosis of PE between January 2018 and December 2022 who underwent a TTE within 48 h.</p><p><strong>Results: </strong>509 patients (median age 76 years [IQR 67-84]) were included, with 7.1% IHM. At univariate analysis, RV/LV ratio > 1 (OR 2.23, 95% CI 1.1-4.5), TAPSE < 17 mm (OR 4.73, 95% CI 2.3-9.8), the D-shape (OR 3.73, 95% CI 1.71-8.14), and LVEF < 35% (OR 5.78, 95% CI 1.72-19.47) resulted significantly correlated with IHM. However, at multivariate analysis including also haemodynamic instability, PESI class > II, and abnormal hs-cTnI levels, only LVEF < 35% (OR 5.46, 95% CI 1.32-22.61) resulted an independent predictor of IHM.</p><p><strong>Conclusion: </strong>Despite the recognised role of TTE in the early management of patients with circulatory shock and suspected PE, signs of RV dysfunction have been shown to be poor predictors of IHM, whereas severely reduced LVEF is an independent risk factor for in-hospital death.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11178708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140195049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2023-07-29DOI: 10.1007/s40477-023-00805-4
Anastasia Antoniou, Marios Stavrou, Nikolas Evripidou, Elena Georgiou, Ioanna Kousiappa, Andreas Koupparis, Savvas S Papacostas, Kleopas A Kleopa, Christakis Damianou
Purpose: Amyloid-β (Aβ) peptides, the main component of amyloid plaques found in the Alzheimer's disease (AD) brain, are implicated in its pathogenesis, and are considered a key target in AD therapeutics. We herein propose a reliable strategy for non-invasively delivering a specific anti-Aβ antibody in a mouse model of AD by microbubbles-enhanced Focused Ultrasound (FUS)-mediated Blood-brain barrier disruption (BBBD), using a simple single stage MR-compatible positioning device.
Methods: The initial experimental work involved wild-type mice and was devoted to selecting the sonication protocol for efficient and safe BBBD. Pulsed FUS was applied using a single-element FUS transducer of 1 MHz (80 mm radius of curvature and 50 mm diameter). The success and extent of BBBD were assessed by Evans Blue extravasation and brain damage by hematoxylin and eosin staining. 5XFAD mice were divided into different subgroups; control (n = 1), FUS + MBs alone (n = 5), antibody alone (n = 5), and FUS + antibody combined (n = 10). The changes in antibody deposition among groups were determined by immunohistochemistry.
Results: It was confirmed that the antibody could not normally enter the brain parenchyma. A single treatment with MBs-enhanced pulsed FUS using the optimized protocol (1 MHz, 0.5 MPa in-situ pressure, 10 ms bursts, 1% duty factor, 100 s duration) transiently disrupted the BBB allowing for non-invasive antibody delivery to amyloid plaques within the sonicated brain regions. This was consistently reproduced in ten mice.
Conclusion: These preliminary findings should be confirmed by longer-term studies examining the antibody effects on plaque clearance and cognitive benefit to hold promise for developing disease-modifying anti-Aβ therapeutics for clinical use.
{"title":"FUS-mediated blood-brain barrier disruption for delivering anti-Aβ antibodies in 5XFAD Alzheimer's disease mice.","authors":"Anastasia Antoniou, Marios Stavrou, Nikolas Evripidou, Elena Georgiou, Ioanna Kousiappa, Andreas Koupparis, Savvas S Papacostas, Kleopas A Kleopa, Christakis Damianou","doi":"10.1007/s40477-023-00805-4","DOIUrl":"10.1007/s40477-023-00805-4","url":null,"abstract":"<p><strong>Purpose: </strong>Amyloid-β (Aβ) peptides, the main component of amyloid plaques found in the Alzheimer's disease (AD) brain, are implicated in its pathogenesis, and are considered a key target in AD therapeutics. We herein propose a reliable strategy for non-invasively delivering a specific anti-Aβ antibody in a mouse model of AD by microbubbles-enhanced Focused Ultrasound (FUS)-mediated Blood-brain barrier disruption (BBBD), using a simple single stage MR-compatible positioning device.</p><p><strong>Methods: </strong>The initial experimental work involved wild-type mice and was devoted to selecting the sonication protocol for efficient and safe BBBD. Pulsed FUS was applied using a single-element FUS transducer of 1 MHz (80 mm radius of curvature and 50 mm diameter). The success and extent of BBBD were assessed by Evans Blue extravasation and brain damage by hematoxylin and eosin staining. 5XFAD mice were divided into different subgroups; control (n = 1), FUS + MBs alone (n = 5), antibody alone (n = 5), and FUS + antibody combined (n = 10). The changes in antibody deposition among groups were determined by immunohistochemistry.</p><p><strong>Results: </strong>It was confirmed that the antibody could not normally enter the brain parenchyma. A single treatment with MBs-enhanced pulsed FUS using the optimized protocol (1 MHz, 0.5 MPa in-situ pressure, 10 ms bursts, 1% duty factor, 100 s duration) transiently disrupted the BBB allowing for non-invasive antibody delivery to amyloid plaques within the sonicated brain regions. This was consistently reproduced in ten mice.</p><p><strong>Conclusion: </strong>These preliminary findings should be confirmed by longer-term studies examining the antibody effects on plaque clearance and cognitive benefit to hold promise for developing disease-modifying anti-Aβ therapeutics for clinical use.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11178731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9889726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2023-10-06DOI: 10.1007/s40477-023-00832-1
Valentina Brusciano, Miriam Lecce
Vascular access in neonates and small infants is often challenging. Ultrasound (US) screening and guidance improves its safety and efficacy. The advantages of a pre-implantation ultrasound examination are intuitive; it is a practical and safe technique that doesn't use radiation, allowing static and dynamic evaluations to be carried out and identifying anatomical variations, the caliber and depth of the vessel, the patency of the entire course and attached structures (nerves, etc.). Optimization of the image is a crucial aspect in achieving a clear view of all anatomical structures while avoiding complications. The goal of this review was to look into the benefits of using US in invasive catheter insertion procedures, especially in pediatric patients. Ultrasonography is used to visualize vessels and related structures in two dimensions (2D), sometimes with the help of color Doppler to detect the presence of intraluminal thrombi by applying gentle compression to assess vessel collapse and evaluate morphologic changes in the internal jugular vein (IJV) who had undergone central venous catheter (CVC) insertion during the neonatal period (Montes-Tapia et al. in J Pediatr Surg 51:1700-1703, 2016).
{"title":"Advantages of the use of ultrasound in newborn vascular access: a systematic review.","authors":"Valentina Brusciano, Miriam Lecce","doi":"10.1007/s40477-023-00832-1","DOIUrl":"10.1007/s40477-023-00832-1","url":null,"abstract":"<p><p>Vascular access in neonates and small infants is often challenging. Ultrasound (US) screening and guidance improves its safety and efficacy. The advantages of a pre-implantation ultrasound examination are intuitive; it is a practical and safe technique that doesn't use radiation, allowing static and dynamic evaluations to be carried out and identifying anatomical variations, the caliber and depth of the vessel, the patency of the entire course and attached structures (nerves, etc.). Optimization of the image is a crucial aspect in achieving a clear view of all anatomical structures while avoiding complications. The goal of this review was to look into the benefits of using US in invasive catheter insertion procedures, especially in pediatric patients. Ultrasonography is used to visualize vessels and related structures in two dimensions (2D), sometimes with the help of color Doppler to detect the presence of intraluminal thrombi by applying gentle compression to assess vessel collapse and evaluate morphologic changes in the internal jugular vein (IJV) who had undergone central venous catheter (CVC) insertion during the neonatal period (Montes-Tapia et al. in J Pediatr Surg 51:1700-1703, 2016).</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11178713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2023-11-25DOI: 10.1007/s40477-023-00834-z
Vincenzo Ricci, Giorgio Tamborrini, Fiammetta Zunica, Ke-Vin Chang, Murat Kara, Giacomo Farì, Ondřej Naňka, Levent Özçakar
Objective: The aim of the present study was to illustrate the (potential) diagnostic role of high resolution US images in assessing the elementary lesions of dactylitis.
Methods: Using high-frequency US machines/probes, we matched the micro-anatomical cadaveric architecture of the digit with multiple sonographic findings of dactylitis. High-sensitive color/power Doppler assessments have also been performed to evaluate the digital microvasculature.
Discussion: Modern US equipment/features guarantee prompt and in-depth B-mode and color/power Doppler imaging of tiny anatomical structures of the digit which are usually not properly visible with standard US machines. More specifically, hypervascularization of the digital subcutaneous tissue, fibrous pulleys of flexor tendons, dorsal synovial pads as well as pathological changes of the distal entheseal anchorage network can be accurately detected.
Conclusion: In clinical practice, high-end US equipment can be used to accurately assess the digits in patients with dactylitis. This way, simple and convenient sonographic diagnosis of different elementary lesions can be timely established.
{"title":"High-resolution ultrasound imaging of elementary lesions in dactylitis.","authors":"Vincenzo Ricci, Giorgio Tamborrini, Fiammetta Zunica, Ke-Vin Chang, Murat Kara, Giacomo Farì, Ondřej Naňka, Levent Özçakar","doi":"10.1007/s40477-023-00834-z","DOIUrl":"10.1007/s40477-023-00834-z","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the present study was to illustrate the (potential) diagnostic role of high resolution US images in assessing the elementary lesions of dactylitis.</p><p><strong>Methods: </strong>Using high-frequency US machines/probes, we matched the micro-anatomical cadaveric architecture of the digit with multiple sonographic findings of dactylitis. High-sensitive color/power Doppler assessments have also been performed to evaluate the digital microvasculature.</p><p><strong>Discussion: </strong>Modern US equipment/features guarantee prompt and in-depth B-mode and color/power Doppler imaging of tiny anatomical structures of the digit which are usually not properly visible with standard US machines. More specifically, hypervascularization of the digital subcutaneous tissue, fibrous pulleys of flexor tendons, dorsal synovial pads as well as pathological changes of the distal entheseal anchorage network can be accurately detected.</p><p><strong>Conclusion: </strong>In clinical practice, high-end US equipment can be used to accurately assess the digits in patients with dactylitis. This way, simple and convenient sonographic diagnosis of different elementary lesions can be timely established.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11178685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138441723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-28DOI: 10.1007/s40477-024-00900-0
Christy B Pomeranz, Michael Baad, Arzu Kovanlikaya, Lee K Collins
Congenital portosystemic shunts (CPSS) are a rare developmental anomaly diverting blood flow from the portal venous system and the liver to the systemic venous system. This case series examines the sonographic imaging findings, shunt classification, ultrasound shunt ratios, and outcomes in nine children (5 females, 4 males) admitted to our institution between 2015 and 2022 were included in this study. The shunts were initially categorized by the Parks classification and were followed by serial ultrasounds. Clinical presentation, clinical course, laboratory data, shunt ratios, and time to shunt closure were all followed on subsequent ultrasounds. The most common type of CPPS was the Type 3 shunt. In cases where shunt ratios were measured, the shunt ratio gradually decreased in tandem with decreasing ammonia levels until spontaneous closure was achieved. Predictors of lack of shunt closure included high shunt ratios and Type 4 shunts. Patients with CPPS can be followed with the shunt ratio calculation obtained from sonographic imaging, which may correlate to ammonia levels and indicate risk of hepatic encephalopathy as well as predict speed and timing of closure.
{"title":"Imaging features, classification and clinical features of intrahepatic congenital portosystemic shunts.","authors":"Christy B Pomeranz, Michael Baad, Arzu Kovanlikaya, Lee K Collins","doi":"10.1007/s40477-024-00900-0","DOIUrl":"https://doi.org/10.1007/s40477-024-00900-0","url":null,"abstract":"<p><p>Congenital portosystemic shunts (CPSS) are a rare developmental anomaly diverting blood flow from the portal venous system and the liver to the systemic venous system. This case series examines the sonographic imaging findings, shunt classification, ultrasound shunt ratios, and outcomes in nine children (5 females, 4 males) admitted to our institution between 2015 and 2022 were included in this study. The shunts were initially categorized by the Parks classification and were followed by serial ultrasounds. Clinical presentation, clinical course, laboratory data, shunt ratios, and time to shunt closure were all followed on subsequent ultrasounds. The most common type of CPPS was the Type 3 shunt. In cases where shunt ratios were measured, the shunt ratio gradually decreased in tandem with decreasing ammonia levels until spontaneous closure was achieved. Predictors of lack of shunt closure included high shunt ratios and Type 4 shunts. Patients with CPPS can be followed with the shunt ratio calculation obtained from sonographic imaging, which may correlate to ammonia levels and indicate risk of hepatic encephalopathy as well as predict speed and timing of closure.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1007/s40477-024-00901-z
Stefania Laura Calvisi, Diana Olarte, Marco Meloni, Stefano Bianchi
Intra-articular fractures of the base of the first metacarpal (Bennet fractures) are prone to dislocation and require surgical reduction and fixation to prevent secondary degenerative joint disease and chronic dysfunction. Therefore, a prompt diagnosis is necessary, mostly achieved by conventional roentgenograms. We report the case of a 62-year-old man in whom a Bennet fracture was highly suspected on ultrasound (US) examination realized after a fall. Standard radiographs, obtained after US to confirm the diagnosis, were interpreted as normal. A computed tomography was then performed showing a typical Bennet fracture. This case report demonstrates that a careful assessment of bones must be an integral part of any routine musculo-skeletal US examination, particularly in post-traumatic patients. US can detect bone fractures where radiograph is not discriminating.
第一掌骨基部的关节内骨折(贝内特骨折)很容易发生脱位,需要进行手术复位和固定,以防止继发关节退行性病变和慢性功能障碍。因此,有必要进行及时诊断,而大多数诊断都是通过传统的 X 光检查来实现的。我们报告了一例 62 岁男性的病例,他在摔倒后接受超声波(US)检查时高度怀疑是 Bennet 骨折。为了确诊,在超声波检查后拍摄了标准的 X 光片,但结果显示正常。随后进行的计算机断层扫描显示出典型的贝内特骨折。该病例报告表明,对骨骼进行仔细评估必须是任何常规肌肉骨骼超声检查不可或缺的一部分,尤其是在创伤后患者中。US 可以检测出射线照相无法分辨的骨折。
{"title":"Sonographic diagnosis of radiographically undetectable bennet fracture.","authors":"Stefania Laura Calvisi, Diana Olarte, Marco Meloni, Stefano Bianchi","doi":"10.1007/s40477-024-00901-z","DOIUrl":"https://doi.org/10.1007/s40477-024-00901-z","url":null,"abstract":"<p><p>Intra-articular fractures of the base of the first metacarpal (Bennet fractures) are prone to dislocation and require surgical reduction and fixation to prevent secondary degenerative joint disease and chronic dysfunction. Therefore, a prompt diagnosis is necessary, mostly achieved by conventional roentgenograms. We report the case of a 62-year-old man in whom a Bennet fracture was highly suspected on ultrasound (US) examination realized after a fall. Standard radiographs, obtained after US to confirm the diagnosis, were interpreted as normal. A computed tomography was then performed showing a typical Bennet fracture. This case report demonstrates that a careful assessment of bones must be an integral part of any routine musculo-skeletal US examination, particularly in post-traumatic patients. US can detect bone fractures where radiograph is not discriminating.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-29DOI: 10.1007/s40477-024-00902-y
Paula Andrea Forero, Andrés Felipe Herrera Ortiz, Andrés Vásquez Perdomo, Nelson Bedoya
{"title":"Inflammatory bowel disease in children: finding the best diagnostic tool.","authors":"Paula Andrea Forero, Andrés Felipe Herrera Ortiz, Andrés Vásquez Perdomo, Nelson Bedoya","doi":"10.1007/s40477-024-00902-y","DOIUrl":"https://doi.org/10.1007/s40477-024-00902-y","url":null,"abstract":"","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}