Medical ultrasonography最新文献

Aim: To evaluate the ultrasonographic features of male breast nodules classified as Breast Imaging Reporting and Data System category 4.

Material and methods: A retrospective analysis of 79 breast nodules from 77 male patients, classified as Breast Imaging Reporting and Data System category 4 after ultrasonography, was conducted. The ultrasonographic features of benign and malignant nodules were evaluated and compared. Independent risk factors for malignancy were identified by logistic regression analysis. In addition, we conducted a subgroup analysis comparing the ultrasonographic features of gynecomastia and malignant nodules in male breasts.

Results: Differences were found in age of onset, calcifications, aspect ratio greater than 1/2, Adler grading of blood flow, and axillary lymph nodes. The presence of calcifications was an independent risk factor for malignancy in males. The results of the comparison between gynecomastia and breast cancer were essentially consistent with the former. However, the differences in calcifications were not as significant as those observed in the former.

Conclusions: We identified differences in age of onset, calcification, aspect ratio greater than 1/2, blood flow, and axillary lymph nodes between benign and malignant male breast nodules classified as Breast Imaging Reporting and Data System category 4, with calcification being an independent risk factor for malignancy. These features can help determine the nature of the nodules and guide biopsy decisions.

Aims: To visualize the process of esophageal speech in patients who underwent laryngectomy using diagnostic ultrasound.

Material and methods: Three patients with different surgical reconstructions (total laryngectomy, pharyngo-laryngo-esophagectomy with gastric tube reconstruction, and pharyngo-laryngo-cervical-esophagectomy with free jejunal reconstruction) were studied. Ultrasound with a linear probe observed organ vibration and dimensions at the 5th-7th cervical vertebrae during rest, air swallowing, and phonation. Cross-sectional lateral and anteroposterior diameters were measured.

Results: Lateral diameters (mm) during rest, air swallowing, and sound production were 15, 18, and 15 for the esophagus; 24, 27, and 23 for the gastric tube; and 19, 32, and 20 for the jejunal graft, respectively. Longitudinal motion of the esophagus and gastric tube lumen coincided with artifact, while jejunal villi movements were noted. Air swallowing induced an oval organ shape, and lateral diameters shortened during sound production.

Conclusions: Vibratory activity spanning over 4 cm was observed at the 5th-7th cervical vertebrae. Each organ displayed distinct vibration patterns, with luminal shape changes during sound production. These findings offer new insights into the biomechanics of esophageal speech and understanding of postoperative rehabilitation.

Aims: This study aims to estimate the degree of sonographers as a source of systematic variance for Shear Wave Elastography (SWE) values.

Materials and methods: Two studies estimated variance in SWE measurements: 1) within-subjects and between-sonographer differences, and 2) between-sonographer differences alone. Both used a block design with six trained sonographers scanning six healthy liver volunteers using the same machine. Following training, each sonographer obtained ten SWE measurements from the right liver lobe for each volunteer per manufacturer guidelines.

Results: When patients were scanned on different days, intraclass correlation coefficient (ICC)=0.23 was achieved, and when scanned on the same day, ICC=0.83, indicating that 17% of the variability was due to differences between sonographers. This 17% inter-sonographer variability translated into statistical and potentially clinically significant differences between sonographers-one sonographer had a SWE value of (4.99) and another (5.43), p<0.01, almost passing a clinical threshold.

Conclusion: SWE values are influenced by a sonographer effect, highlighting the need to standardize protocols to minimize systematic variability between sonographers. Multiple scans are justified for patients with SWE values near clinical thresholds. Since healthy volunteers exceeded the manufacturer-defined threshold, inherent variability between sonographers could challenge the reliability of clinical thresholds in practice.

Aim: Caudal epidural injection is used for lumbosacral radicular pain but there is a risk of vascular injection. An ultrasound-guided catheter-over-needle technique was proposed to reduce this risk. This study compared the incidence of vascular injections between the catheter-over-needle and Tuohy needle methods for caudal epidural injections.

Material and methods:  This prospective, randomized clinical trial included patients aged ≥19 years with degenerative lumbar disease accompanied by radicular pain who were unresponsive to non-invasive treatments and scheduled for caudal epidural injection. The participants were randomized into two groups: catheter-over-needle and Tuohy needle groups. Under ultrasound guidance, the contrast medium was injected and observed in real time using fluoroscopy. An independent physician assessed the vascular injection rates.

Results: The incidence of vascular injection was significantly lower in the catheter-over-needle group (15.7%) than in the Tuohy needle group (37.5%; p=0.014). Chronic pain lasting >12 months was a significant risk factor for vascular injection (p=0.035). However, no statistically significant association was found between sacral opening depth and vascular injection, although the sacral opening depth was shorter in patients who received intravascular injections.

Conclusions: The catheter-over-needle technique significantly reduces the risk of vascular injection. The depth of the sacral opening may also influence vascular injection.

The value of an ultrasound prior to planned interventions is undisputed. Clinically relevant incidental findings are also among the reasons why abdominal ultrasound examinations should be considered part of the diagnostic evaluation during inpatient admission. We report here an interesting case of an unusual "three-headed" polypoid lesion on ultrasound, which histologically and pathologically revealed a saprophytic manifestation of local aspergillosis in the gallbladder without clinical signs of cholecystitis.

.

.