Medical ultrasonography最新文献

Femoral shaft fractures are commonly treated with intramedullary nailing; however, this procedure can lead to complications. This study explores the role of ultrasound in diagnosing femoral hardware impingement. We present the findings in two patients with persistent thigh pain after femoral intramedullary nailing. Ultrasound successfully identified hardware impingement. Removal of the offending screw led to symptom resolution, with a follow-up US confirming the absence of residual conflicts.

Aims: This study aimed to evaluate the diagnostic performance of shear wave elastography (SWE) in differentiating non-melanoma skin cancer (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), from benign skin lesions. A secondary objective was to assess the accuracy of high-resolution ultrasonography (HRUS) for preoperative tumormeasurement.

Material and methods: A prospective study was conducted on 106 patients with clinically suspected NMSC or benign lesions (nevi). Each lesion was evaluated with SWE and HRUS using an 18 MHz probe, followed by surgical excision and histopathological confirmation. Among the confirmed malignancies, 46 were BCC and 15 SCC. The control group included 35 nevi diagnosed clinically and dermatoscopically. SWE stiffness values were compared across lesion types. Tumor length and depth measured by HRUS were validated against pathology using The Student's t-test or Mann-Whitney U test, Bland-Altman analysis and the Intraclass Correlation Coefficient (ICC).

Results: SWE showed significantly higher stiffness in malignant versus benign lesions, with optimal thresholds of >13 kPa for BCC and >15 kPa for SCC. The area under the receiver operating characteristic curve (AUROC), was 0.95 for BCC and 0.99 for SCC. Differentiation between SCC and BCC was moderate (AUROC=0.70). HRUS accurately estimated tumor length (bias=1.31 mm, p>0.05; ICC=0.90), while depth was slightly overestimated (bias=0.87 mm, p<0.05; ICC=0.83).

Conclusion: SWE and HRUS offer complementary, non-invasive tools for the diagnosis and preoperative assessment of BCC and SCC. SWE demonstrated high diagnostic accuracy for distinguishing NMSC from benign lesions, particularly nevi, by applying stiffness thresholds between 13-15 kPa. HRUS proved effective in estimating tumor length with good agreement to histopathology, though it showed a tendency to overestimate tumor depth.

Aims: This study aimed to investigate changes in the stiffness of thyroid nodules following fine needle aspiration biopsy (FNAB), using shear wave elastography (SWE), a non-invasive imaging technique utilized in thyroid nodule evaluation.

Material and methods: A total of 82 patients scheduled to undergo FNAB for the first time were included. Ultrasound and SWE examinations were performed before the procedure and again 8 to 10 weeks after FNAB. Nodule stiffness was measured in kilopascals (kPa) during both evaluations, and changes in elasticity were assessed.

Results: The mean SWE stiffness of the nodules significantly decreased from 21.80 ± 11.43 kPa before FNAB to 17.83 ± 9.98 kPa after FNAB (p = 0.001). Smoking status and serum free T3 levels were significantly associated with changes in SWE stiffness (p < 0.05). However, no significant difference was observed between TIRADS 3 and TIRADS 4 categories regarding the change in stiffness (p = 0.223).

Conclusion: This study demonstrates a significant reduction in thyroid nodule stiffness after FNAB as measured by SWE. These post-biopsy changes may lead to potential misinterpretations in subsequent elastographic evaluations, possibly affecting diagnostic accuracy and clinical decision-making.

Aim: The anatomy and aspect of the thymus varies with age. In this study, our aim is to determine the mean stiffness and the average shear wave velocity (SWV) of the thymus gland using shear wave elastography (SWE) in healthy children and to establish reference values.

Materials and methods: Attention was paid to ensure that the thymus parenchyma was homogeneous in ultrasound (US) and that there was no abnormal vascularity in color Doppler US. Then, the thymus was examined by SWE. The tissue stiffness was evaluated and SWV was measured as m/s.

Results: In our study, a total of 385 healthy children, including 191 girls and 194 boys between 0-18 years were included. The mean SWV values we obtained in SWE examinations were 0.735±0.117 m/s (range 0.51-1.20 m/s) in girls, 0.734±0.122 m/s (range 0.51-1.11 m/s) in boys, and 0.735±0.120 m/s (range 0.51-1.20 m/s) in all children.

Conclusion: The SWE values we obtained can be used as reference values for healthy children. These results may be useful in the differential diagnosis of thymus pathologies and ET.

Gallbladder diverticulum is a rare developmental anomaly characterized by a herniation-like outpouching of the gallbladder wall. The reported incidence in autopsy studies ranges from 0.0008% to 9%. Most reported cases have been diagnosed postoperatively, and the role of ultrasonography in their detection remains uncertain. Based on our experience, we present a set of ultrasound features that may aid in the identification of gallbladder diverticula. Although often incidental, some diverticula may mimic cholecystitis or pose challenges during cholecystectomy. Despite limited literature representation, ultrasonography appears to be a reliable modality for their preoperative assessment. Greater awareness of this entity among sonographers may improve its recognition and reporting quality, enhancing diagnostic accuracy.

In addition to avoidance of radiation exposure, the main advantages of ultrasound diagnostics in inflammatory bowel disease (IBD) patients are its' immediate availability, also as a component of the physical examination (extended point of care), its' repeatability and its' high patient comfort. The fact that the examination is carried out directly by the treating physician and is not delegated to the radiologist increases compliance and therapy adherence of the patients.In the current series of papers a synopsis of recommendations for ultrasound in IBD guidelines, ultrasound parameters in inflammatory bowel disease including activities scores, the value of contrast enhanced ultrasound (CEUS), small intestinal contrast ultrasound (SICUS) and elastography, perineal ultrasound (PNUS), endoscopic ultrasound (EUS) including endorectal ultrasound (ERUS), interventional ultrasound (INVUS), detection of disease complications (stenoses, fistula, abscess), extraintestinal manifestations, differential diagnosis, evaluation of treatment response and outlook are discussed and illustrated.

Aim: This review was done to evaluate diagnostic accuracy of LUS against established ARDS reference standards in adult populations.

Material and methods: Four electronic databases were searched through June 2025 without language restrictions. Two reviewers independently screened studies, extracted data, and assessed quality using QUADAS‑2. Bivariate random‑effects models generated pooled sensitivity, specificity, likelihood ratios, diagnostic odds ratios (DORs), and hierarchical summary receiver‑operating characteristic (HSROC) curves. Subgroup analyses explored pattern‑ versus score‑based protocols and prospective study designs. Publication bias was assessed via Deeks' funnel‑plot test.

Results: Fourteen studies (531 ARDS-positive; 1354 ARDS-negative; pre‑test probability=28%) met inclusion criteria. Overall pooled sensitivity was 0.84 (95%CI: 0.69-0.92) and specificity 0.94 (95%CI: 0.83-0.98), with an AUROC of 0.95 (95%CI: 0.93-0.96). The positive likelihood ratio was 13.3 (95%CI: 5.0-35.9) and negative likelihood ratio 0.17 (95%CI: 0.09-0.34), corresponding to a DOR of 77 (95%CI: 26-227). Pattern‑based protocols achieved sensitivity 0.82 and specificity 0.96 (AUROC=0.96), while score‑based approaches yielded sensitivity 0.90 and specificity 0.83 (AUROC=0.93). Deeks' test indicated potential publication bias (p=0.004).

Conclusions: LUS demonstrates excellent rule‑in and rule‑out performance for ARDS in critically ill adults, rivalling CT accuracy without its drawbacks. Adoption of standardized LUS protocols and integration into ARDS diagnostic pathways could enhance early detection, optimize management, and reduce reliance on ionizing imaging.