Medical ultrasonography最新文献

VEXAS syndrome is a recently described condition characterized by systemic inflammation, predisposition to hematologic malignancy and a high rate of venous thrombosis. Here we report the case of an elderly male with erythema nodosumlike lesions, ankle arthralgia, and general symptoms. B-mode and Doppler ultrasound of the subcutis diagnosed superficial thrombophlebitis of the lower limbs, which turned out to be the manifestation of a paucisymptomatic VEXAS syndrome. VEXAS should be considered in any patient who presents with unexplained superficial thrombophlebitis, macrocytic anemia and unexplained systemic inflammation.

Aim: This study aimed to evaluate the correlation between the elasticity of the anterior and posterior walls of the radial artery in different sections using velocity vector imaging.

Material and methods: In this retrospective analysis, 30 healthy people who underwent physical examination in our hospital from January 2022 to January 2023 were analyzed offline by velocity vector imaging technology. The following parameters were assessed: peak systolic strain (Ss; %), peak diastolic strain (Sd; %), peak systolic strain rate (SRs; 1/s), and peak diastolic strain rate (SRd; 1/s). Elastic function was evaluated by analyzing the systolic and diastolic motion of the arterial walls.

Result: In the long-axis sections, there was a significant positive correlation between Ss, SRs, and SRd of both the anterior and posterior walls (r=0.531, r=0.803, and r=0.898, all p<0.01). Additionally, Sd showed a positive correlation (r=0.402, p<0.05). In the short-axis sections, there was a significant and positive correlation between SRs and SRd of both walls (r=0.762, r=0.667, both p<0.01). Furthermore, a positive correlation was found between SRd in the long-axis and short-axis sections of the anterior wall (r=0.382, p<0.05).

Conclusions: Velocity vector imaging is a valuable tool for assessing the elasticity of the radial artery in different sections, and the longitudinal SRd in the long-axis section may serve as a highly sensitive and accurate parameter for assessing changes in wall elastic function during the occurrence of radial artery lesions.

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In this series of articles with comments and illustrations on the World Federation for Medicine and Biology (WFUMB) guidelines on contrast-enhanced ultrasound (CEUS) the topics of very rare focal liver lesions (FLL) are discussed. Improving the detection and characterization of the most common FLL are the main topics of these guidelines. The focus of this review is on the many manifestations of cystic fibrosis-related liver disease (CFLD). These include focal biliary fibrosis, liver cirrhosis, vascular manifestations with nodular regenerative hyperplasia and portal hypertension with or without cirrhosis. This article describes the diverse changes of liver involvement in cystic fibrosis and their appearance on ultrasound, duplex sonography, and contrast enhanced ultrasonography. This knowledge and the imaging should help to recognize liver manifestations in time and enable a correct interpretation of ultrasound images in CF in the corresponding clinical situation.

The diagnosis or rare mesenchymal malignant lesions of the liver may be a challenge owing to the rarity of the disease and is usually made by histological confirmation. An ultrasound examination with, if required, color Doppler sonography and contrast-enhanced ultrasound, taking into account the clinical background of the patient, may help to focus the differential diagnosis. In this review, we describe the pathological and ultrasound features of several rare mesenchymal malignant liver lesions which include undifferentiated sarcoma of the liver, leiomyosarcoma, angiosarcoma, fibrosarcoma, liposarcoma, and epithelioid hemangioendothelioma.

Aim: To evaluate the contrast-enhanced ultrasound (CEUS) versus conventional ultrasound (US) in guided liver puncture biopsy through a systematic review and meta-analysis.

Material and methods: Comparative studies on CEUS and US in liver puncture biopsy were systematically searched from PubMed, Embase, Cochrane library, Chinese Biomedical Literature Database. Two researchers independently screened and extracted data, and RevMan 5.3 software was used for data analysis.

Results: The area under the curve (AUC) for CEUS and US in diagnosing liver biopsy was 0.98 (95%CI 0.99-0.97) and 0.95 (95%CI 0.97-0.93), respectively. CEUS demonstrated significantly higher single puncture success rate (38.0% vs 36.4%) [OR=2.67; 95% CI 1.38-5 .17; p=0 .003] and pathological diagnosis rate (95.6% vs 90.5%) [OR =4.35; 95%CI 2.25 -8.39; p<0 .001] compared to the US group. The diagnostic accuracy of the CEUS group was 95.6 % (1964/2054), while that of the US group was 90.5% (1729/1909). The combined analysis indicated significant advantages for CEUS over US [(OR = 2.36). 95 %CI 1.81-3.09, p<0.001].

Conclusions: CEUS is superior to US in the diagnostic performance, single puncture success rate, pathological diagnosis rate and diagnostic accuracy of liver biopsy in patients with liver lesions.

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Aims: This study aims to use deep learning (DL) to classify thyroid nodules as benign and malignant with ultrasonography (US). In addition, this study investigates the impact of DL on the diagnostic success of radiologists with different experiences. Material and methods: This study included 576 US images of thyroid nodules. The dataset was divided into 80% training and 20% test sets. Four radiologists with different levels of experience classified the images in the test set as benign-malignant. A DL model was then trained with the train set and predicted benign-malignant for the test set. Then, the output of the DL model for each nodule in the test set was presented to 4 radiologists, who were asked to make a benign-malignant classification again considering these DL results.

Results: The accuracy of the DL model was 0.9391. The accuracy for junior resident (JR) 1, JR 2, senior resident (SR), and senior radiologist (Srad) before DL-assisting were 0.7043, 0.7826, 0.8435, and 0.8522 respectively. The accuracy in DL-assisted classifications was 0.9130, 0.8696, 0.9304, and 0.9043 for JR 1, JR2, SR, and Srad, respectively. DL assistance changed the decisions of less experienced radiologists more than more experienced radiologists. Conclusion: The DL model has superior accuracy in classifying thyroid nodules as benign-malignant with US images than radiologists with different levels of experience. Additionally, all radiologists, and most notably less experienced radiology residents, increased their accuracy in DL-assisted predictions.

The use of gray-scale and color Doppler ultrasound as a first-line imaging modality for wrist pain can be advantageous, especially in cases of clinically suspected carpal tunnel syndrome. This report presents the case of a medical sonographer who exhibited acute wrist pain secondary to a thrombosed persistent median artery after excessive stress loading on her scanningwrist. Ultrasound is able to easily diagnose this rare condition, which may at times be associated with carpal tunnel symptoms due to mass effect from the expanded aberrant artery.