Medical ultrasonography最新文献

Aim: Transcranial ultrasonography, including transcranial doppler (TCD) and transcranial colour-coded duplex/sonography (TCCD/TCCS), offers potential benefits in the evaluation of cerebrovascular patency, but its accuracy remains under scrutiny. Hence, this study aims to investigate the diagnostic accuracy of transcranial ultrasonography for detecting stenosis in acute ischaemic stroke patients.

Material and methods: We systematically reviewed the databases such as CINAHL, SCOPUS, EMBASE, MEDLINE, Cochrane Library, Google Scholar, and ScienceDirect from inception till June 2023. Studies were eligible if they compared the diagnostic role of transcranial ultrasonography with established techniques, and reported accuracy parameters such as sensitivity, specificity, positive and negative likelihood ratios. Subgroup analysis was performed for TCD and TCCD/TCCS.

Results: Seventeen studies involving 1496 participants were included. The pooled sensitivity and specificity of transcranial ultrasonography were 90% and 95% respectively. For TCD, the sensitivity and specificity were 87% and 93% respectively. TCCD/TCCS showed sensitivity 98% and specificity 97%. High clinical value was evident in both TCD and TCCD/TCCS, with heterogeneity across studies but no observable publication bias.

Conclusion: Transcranial ultrasonography, including both TCD and TCCD/TCCS, demonstrates high diagnostic accuracy in detecting stenosis in patients with acute ischaemic stroke. These findings support the utility of these methods as reliable, non-invasive tools for cerebrovascular assessment.

Aims: The study aims to assess the impact of bowel preparation on MRI scans in diagnosing rectosigmoid endometriosis (RSE) and to examine the level of agreement among investigators, including radiologists and clinicians with varying levels of MRI experience.

Material and methods: Fifty-eight patients underwent MRI scans, with 34 showing RSE and 24 without involvement, according to TVUS as the reference standard. The scans were conducted both with and without a bowel preparatory protocol (BPP).

Results: The highest concordance was observed in the group 4, which included patients with RSE and BPP, with a Kappa value of 0.47-0.52. In contrast, for groups with MRI scans without the BPP, there was no consistency among the investigators (Kappa <0.20). The sensitivity, specificity, positive predictive value, and negative predictive value were 0.72, 0.47, 0.72, and 0.47 without BPP, and increased to 0.82, 0.74, 0.85, and 0.74, respectively, after BPP.

Conclusions: The results reveal that the concordance between investigators in detecting RSE via MRI scan improves with the use of BPP. Additionally, the success rate of MRI and TVUS for detecting RSE can be comparable, but only if bowel preparatory techniques are utilized during MRI scans.

Metastases to the liver from gastroenteropancreatic neuroendocrine tumors are varied in their presentation and echogenicity on ultrasound. We present a case of adenocarcinoma of the pancreas with sporadic neuroendocrine differentiation and metastasis to the liver, referred for inclusion in a clinical study. Standard ultrasound showed two hypoechoic focal liver lesions. On contrast enhanced ultrasound (CEUS) the larger tumour bore an enhancement resemblance to that of a focal nodular hyperplasia (FNH). This result necessitated a histological confirmation, which indicated neuroendocrine, highly differentiated tumour tissue, compatible with metastasis from the patient's pancreatic cancer. This case showcases the role of histologically confirmed diagnosis in liver lesions with atypical imaging characteristics, especially in patients with a history of malignancy and potential oncological treatment.

Shear-Wave Elastography (SWE) has emerged as a promising non-invasive imaging technique for assessing the mechanical properties of tendons, particularly larger and more superficially located tendons of the body. Despite its potential, significant variability in SWE measurements exists due to differences in protocols, positioning, and equipment. Standardizing these factors, enhancing operator training, and reporting reliability metrics are crucial to improve the consistency and comparability of SWE data. This review aims to synthesize current knowledge and report on the existing practices in tendon SWE. By addressing the current challenges and variability, SWE has the potential to become a reliable tool for diagnosing and monitoring tendon pathologies, ultimately enhancing patient care and outcomes.

With the advancement of computer technology and imaging equipment, ultrasound has emerged as a crucial tool in breast cancer diagnosis. To gain deeper insights into the research landscape of ultrasound in breast cancer diagnosis, this study employed bibliometric methods for a comprehensive analysis spanning from 2004 to 2024, analyzing 3523 articles from 2176 institutions in 82 countries/regions. Over this period, publications on ultrasound diagnosis of breast cancer showed a fluctuating growth trend from 2004 to 2024. Notably, China, Seoul National University and Kim EK emerged as leading contributors in ultrasound for breast cancer detection, with the most published and cited journals being Ultrasound Med Biol and Radiology. The research spots in this area included "breast lesion", "dense breast" and "breast-conserving surgery", while "machine learning", "ultrasonic imaging", "convolutional neural network", "case report", "pathological complete response", "deep learning", "artificial intelligence" and "classification" are anticipated to become future research frontiers. This groundbreaking bibliometric analysis and visualization of ultrasonic breast cancer diagnosis publications offer clinical medical professionals a reliable research focus and direction.

Point-of-care ultrasound (POCUS) plays an essential role in pediatric emergency medicine by improving diagnostics and procedural safety. The role of POCUS in the care of pediatric patients in the emergency department has expanded considerably in recent years. Cranial and musculoskeletal imaging has significant potential, yet POCUS has also become a vital tool for common procedures, such as central and difficult peripheral intravenous access. The purpose of this article is to provide an overview of pediatric POCUS applications for cranial, small parts (head, eyes, nose, throat, and soft tissue), musculoskeletal, and common procedural applications, forming the third part of the series.

Aim: Numerous studies have evaluated elastography for the staging of liver fibrosis. Fewer studies were performed investigating the prognostic relevance using transient elastography (TE), although with promising results. This study was designed to evaluate the prognostic relevance of ARFI elastography.

Material and method: Patients receiving ARFI elastography in our ultrasound department between 2010 and 2012 were initially screened for an ARFI examination with a clinical follow-up of at least 5 years. The following events were recorded: liver related death, liver unrelated death, HCC, liver decompensation/ variceal bleeding.

Results: A total of 335 patients were included in the final analysis with an ARFI examination of the liver and a follow-up of 60 months. Within the observation interval the number of events with corresponding AUROCs (shown with 95% confidence interval) were: overall death (n=49, 0.76 [0.69 - 0.83]), liver related death (n=25, 0.85 [0.77 - 0.93]), liver unrelated death (n=24, 0.66 [0.55 - 0.77]), HCC (n=15, 0.80 [0.72 - 0.87]), liver related complications/variceal bleeding (n=34, 0.87 [0.82 - 0.93]). In the group of patients with ARFI values suggestive of cirrhosis (equal to or above 1.80 m/s; n=110) higher values (<2.5 m/s vs. >= 2.5 m/s) where associated with a significant decline in liver related survival (p=0.007).

Conclusion: ARFI elastography seems to have a good diagnostic accuracy for the prediction of liver related death and decompensation. Further it seems to allow a risk stratification in patients with cirrhosis suspicious elastography values.

Embedded or migratory ingested foreign bodies (FBs) may be a disaster when not found intraluminally and can be seriously life-threatening. Endoscopic ultrasound (EUS) has advantages of transmural, close range and real-time imaging. Under its guidance, minimally invasive endoscopic removal of FBs and abscess drainage become available and safe to avoid unnecessary surgery. However, relatively few diagnostic applications of EUS have been reported. Endoscopic removal and abscess drainage with or without EUS-guidance were even scarce. We found 21 cases of migratory FBs reported in which EUS was used to diagnose and/or treat including our case. We further summarized clinical characteristics and EUS manifestations of embedded or migratory FBs for future differentiation, and treatment strategies by endoscopy and EUS. EUS is a valuable tool in recognizing and differentiating embedded or migratory FBs. EUS-guided endoscopic removal is a minimally invasive, safe and innovative solution. EUS with novel device also assists in sufficient and secure drainage for FBs related abscess collections. A multidisciplinary team consult is sometimes mandatory for complicated cases. This would break a conceptual barrier in therapeutic endoscopy.

Point of Care Ultrasound (POCUS) can be useful as a tool before, during and after the performance of cardiopulmonary resuscitation (CPR). Before or after resuscitation it can help with monitoring unstable hemodynamics, has the potential to identify reversible causes if patient deteriorates. During resuscitation POCUS can help detect potentially treatable causes of the cardiac arrest. Performance of POCUS while resuscitation requires experienced sonologists and a good team structure to embed the examination in advanced cardiovascular life support (ACLS) algorithms. This article gives an overview and tips about how to detect potential reversible causes of patient deterioration in all three phases of CPR. We describe some special situations in which resuscitation could take place. Further we give a comment about sonographic education of physicians and nonacademic medical staf.

Reliable and reproducible measurement methods have been established, and reference values are used in almost all scientific disciplines. The knowledge of reference values is crucial to distinguish physiological from pathological processes and, therefore, subsequently, for the clinical management of patients. The image storage and documentation of measurements and normal findings should be part of quality assurance in imaging. This paper aims to review published literature and provide current knowledge of sonographic measurements of the spleen, examination techniques, and knowledge of normal values with their possible clinical implications. Moreover, the role of clinical influencing factors such as age, gender, or ethnicity is also analyzed.