Ultrasonography最新文献

Purpose: Internal cervical os (ICO) stiffness is related to menstrual pain, a key symptom of endometriosis. The study evaluated whether women with endometriosis have a stiffer ICO than unaffected women.

Methods: A retrospective cross-sectional analysis was conducted using prospectively collected data from women with and without endometriosis, spanning from June 2020 to September 2022. Endometriosis was diagnosed through clinical and ultrasound evaluations, with histological confirmation in a subset of participants. Strain elastography (SE) was employed to measure tissue elasticity in four cervical regions of interest: the ICO and the anterior, posterior, and middle cervical compartments (ACC, PCC, and MCC, respectively). Tissue elasticity was quantified using a color-based scoring system ranging from 0.1 (blue, indicating less elasticity) to 3.0 (red, indicating greater elasticity).

Results: Overall, 287 women were included, with 157 diagnosed with endometriosis and 130 controls. On SE, women with endometriosis exhibited a lower color score (mean±standard deviation), indicating lower elasticity, for the ICO (0.56±0.28 vs. 0.70±0.26, P=0.001) and PCC (0.69±0.30 vs. 0.80±0.27, P=0.002). Additionally, they had a lower ICO/MCC ratio (0.45±0.28 vs. 0.60±0.32, P=0.001) and ICO/ACC ratio (0.68±0.42 vs. 0.85±0.39, P=0.001). Multiple logistic regression analysis revealed that endometriosis was associated with the ICO color score (odds ratio, 0.053; 95% confidence interval, 0.014 to 0.202; R2=0.358; P=0.001), even after adjusting for confounding factors like the presence of myomas (P=0.040) and the use of hormonal therapy (P=0.001). The results were corroborated in women with histologically confirmed endometriosis (n=71).

Conclusion: The findings suggest a potential relationship between a stiffer ICO and endometriosis.

The diagnosis and management of Bethesda III and IV thyroid nodules remain clinical dilemmas. Current guidelines from academic societies suggest active surveillance or diagnostic lobectomy. However, the extent of surgery is often inappropriate, and a considerable percentage of patients experience under- or over-treatment. Thermal ablation has gained popularity as a safe and effective alternative treatment option for benign thyroid nodules. This review explores the feasibility of thermal ablation for Bethesda III or IV thyroid nodules, aiming to preserve the thyroid organ and avoid unnecessary surgery. It emphasizes individualized management, the need to consider factors including malignancy risk, clinical characteristics, and sonographic features, and the importance of supplemental tests such as repeat fine needle aspiration cytology, core needle biopsy, molecular testing, and radioisotope imaging.

Purpose: This study aimed to determine whether micro-flow imaging (MFI) offers diagnostic performance comparable to that of contrast-enhanced ultrasonography (CEUS) in detecting segmental congestion among patients undergoing living donor liver transplantation (LDLT).

Methods: Data from 63 patients who underwent LDLT between May and December 2022 were retrospectively analyzed. MFI and CEUS data collected on the first postoperative day were quantified. Segmental congestion was assessed based on imaging findings and laboratory data, including liver enzymes and total bilirubin levels. The reference standard was a postoperative contrast-enhanced computed tomography scan performed within 2 weeks of surgery. Additionally, a subgroup analysis examined patients who underwent reconstruction of the middle hepatic vein territory.

Results: The sensitivity and specificity of MFI were 73.9% and 67.5%, respectively. In comparison, CEUS demonstrated a sensitivity of 78.3% and a specificity of 75.0%. These findings suggest comparable diagnostic performance, with no significant differences in sensitivity (P=0.655) or specificity (P=0.257) between the two modalities. Additionally, early postoperative laboratory values did not show significant differences between patients with and without congestion. The subgroup analysis also indicated similar diagnostic performance between MFI and CEUS.

Conclusion: MFI without contrast enhancement yielded results comparable to those of CEUS in detecting segmental congestion after LDLT. Therefore, MFI may be considered a viable alternative to CEUS.

Purpose: The aim of this study was to compare the diagnostic performance of the Gynecology Imaging Reporting and Data System (GI-RADS) and Ovarian-Adnexal Reporting and Data System (O-RADS) ultrasound (US) classification systems and assess their capacity to stratify the risk of malignancy in adnexal masses (AMs).

Methods: A comprehensive search of MEDLINE (PubMed), Scopus, Web of Science, and Google Scholar was conducted to identify articles published between January 2020 and August 2023. The quality of the studies, the risk of bias, and concerns regarding applicability were assessed using QUADAS-2.

Results: The search yielded 132 citations. Five articles, which included a total of 2,448 AMs, were ultimately selected for inclusion. The risk of bias was high in all articles regarding patient selection, low in four studies for the index test, and unclear in three papers for the reference test. For GI-RADS, the pooled sensitivity and specificity were 90.8% (95% confidence interval [CI], 86.0% to 94.0%) and 91.5% (95% CI, 89.0% to 93.0%), respectively. For O-RADS, the pooled sensitivity and specificity were 95.1% (95% CI, 93.0% to 97.0%) and 88.8% (95% CI, 85.0% to 92.0%), respectively. O-RADS demonstrated greater sensitivity for malignancy than GI-RADS (P<0.05). Heterogeneity was moderate for both sensitivity and specificity with respect to GIRADS; for O-RADS, heterogeneity was moderate for sensitivity and high for specificity.

Conclusion: Both GI-RADS and O-RADS US demonstrate good diagnostic performance in the preoperative assessment of AMs. However, the O-RADS classification provides superior sensitivity.

The cardiovascular system operates through complex hemodynamic processes involving pulsatile blood flow, varying viscosity, and the branching architecture of vessels. Interactions between blood flow and the vascular wall, which are characterized by shear and normal stress, along with wall stiffness, are crucial for maintaining vascular health. Doppler ultrasonography is a highly valuable noninvasive tool for assessing these hemodynamic parameters, enabling the measurement of key indices such as blood flow velocity, flow patterns, wall shear stress, and wall stiffness. This paper emphasizes the clinical significance of these indices and methods of measuring them using Doppler ultrasonography while addressing potential challenges. Accurate interpretation of these measurements is vital for reliable cardiovascular diagnostics and effective clinical decision-making.

Image-guided thermal ablation is a minimally invasive option for patients with early-stage hepatocellular carcinoma (HCC). However, the risk of local recurrence remains substantial because ultrasound (US) artifacts have a negative impact on the assessment of ablative margins during and immediately after ablation. Precise, real-time assessment of the ablation zone is key to reducing the risk of local tumor progression. With the advent of US image fusion technology, ablative margins can now be assessed three-dimensionally with greater accuracy. Therefore, US-US overlay fusion guidance has the potential to improve the local controllability of ablation in patients with HCC. This review discusses the US-US fusion guidance technique and its current clinical applications for hepatic interventions, with descriptions of its concept, methodology, and efficacy.

Purpose: The study aimed to compare the diagnostic performance of washout-parametric imaging (WOPI) with that of conventional contrast-enhanced ultrasound (cCEUS) in differentiating focal liver lesions (FLLs).

Methods: A total of 181 FLLs were imaged with contrast-enhanced ultrasound using Sonazoid, and the recordings were captured for 10 minutes in a prospective setting. WOPI was constructed from three images, depicting the arterial phase (peak enhancement), the early portal venous phase (1-minute post-injection), and the vasculo-Kupffer phase (5 or 10 minutes post-injection). The intensity variations in these images were color-coded and superimposed to produce a single image representing the washout timing across the lesions. From the 181 FLLs, 30 hepatocellular carcinomas (HCCs), 30 non-HCC malignancies, and 30 benign lesions were randomly selected for an observer study. Both techniques (cCEUS and WOPI) were evaluated by four off-site readers. They classified each lesion as benign or malignant using a continuous rating scale, with the endpoints representing "definitely benign" and "definitely malignant." The diagnostic performance of cCEUS and WOPI was compared using the area under the receiver operating characteristic curve (AUC) with the DeLong test. Interobserver agreement was assessed using the intraclass correlation coefficient (ICC).

Results: The difference in average AUC values between WOPI and cCEUS was 0.0062 (95% confidence interval, -0.0161 to 0.0285), indicating no significant difference between techniques. The interobserver agreement was higher for WOPI (ICC, 0.77) than cCEUS (ICC, 0.67).

Conclusion: The diagnostic performance of WOPI is comparable to that of cCEUS in differentiating FLLs, with superior interobserver agreement.

Purpose: This study aimed to evaluate the ability of ultrafast power Doppler (PD) to assess disease activity in rheumatoid arthritis (RA) by examining the correlations between variables from ultrafast PD perfusion imaging and clinical measures of disease activity.

Methods: Thirty-three RA patients underwent clinical assessments of disease activity and ultrasound scans of bilateral wrists using both ultrafast and conventional PD systems. A spatial singular value decomposition filter was applied to the ultrafast PD imaging. Singular vectors representing perfusion and fast flows were selected to produce perfusion images. All images were quantitatively analyzed with computer assistance and scored semiquantitatively (0-3) by a physician for synovial vascularity. The Pearson correlation coefficients between image variables and clinical indices were calculated.

Results: The correlation coefficients ranged from weakly to moderately positive between ultrafast PD variables and clinical indices (r=0.221-0.374, all P<0.05). The strongest correlations were observed for synovial PD brightness with the 28-joint Disease Activity Score based on C-Reactive Protein (DAS28-CRP) and the Simplified Disease Activity Index (SDAI). In patients within the deep clinical remission (dCR) subgroup, synovial PD brightness showed stronger correlations with DAS28-CRP, the Clinical Disease Activity Index, and SDAI (r=0.578-0.641, all P<0.001). The correlation coefficients between conventional PD variables and clinical indices were similar to those observed with ultrafast PD variables.

Conclusion: Ultrafast PD imaging effectively extracts capillary blood signals and generates perfusion images. In the RA population, ultrafast PD variables exhibit weak-to-moderate correlations with clinical indices, with these correlations being notably stronger in dCR patients.

Medial elbow pain is a common musculoskeletal problem among individuals engaging in repetitive activities. Medial epicondylitis is the predominant cause of this pain. However, other potential causes must be considered as part of the differential diagnosis. This article discusses several etiologies of medial elbow pain, including medial epicondylitis, ulnar neuropathy, snapping triceps syndrome, ulnar collateral ligament injury, medial antebrachial cutaneous neuropathy, and diseases of the elbow joint, with an emphasis on ultrasound (US) findings. Awareness of possible diagnoses and their US features can assist radiologists in establishing a comprehensive diagnosis for medial elbow pain.