Medical ultrasonography最新文献

Camptodactyly-arthropathy-coxa vara-pericarditis (CACP) syndrome is a rare genetic disorder characterized by a combination of congenital flexion contractures of the fingers (camptodactyly), non-inflammatory joint swelling (arthropathy), hip deformities (coxa vara), and recurrent pericarditis. In early childhood, the clinical presentation is dominated by the articular manifestations that can easily mimic juvenile idiopathic arthritis, often leading to delayed diagnosis and inappropriate treatments. Although not pathognomonic, ultrasound may provide specific ultrasound characteristics of joint involvement in CACP syndrome that help differentiate it from inflammatory arthropathies. This report aims to highlight the role of ultrasound in the initial assessment, differential diagnosis, and ongoing monitoring of CACP syndrome, drawing on both our patient series and a review of the literature.

Intraoperative ultrasonography (IOUS) has emerged as a pivotal imaging modality, enhancing surgical precision and patient outcomes across a wide spectrum of medical disciplines. This paper explores the technological advancements, clinical applications and potential limitations of IOUS. Additionally, it discusses the future potential and integration with other imaging modalities to foster minimally invasive and precision-guided surgery. By providing a detailed bibliometric and narrative review, this study aims to consolidate current knowledge while identifying areas for further research.

Aim: The objective was to assess chemotherapy-induced cardiotoxicity by comparing changes in myocardial work indices (MWI) using echocardiographic myocardial work (MW).

Material and method: A comprehensive search was performed in PubMed, Embase, and the Cochrane Library, covering literature up to June 2024.

Results: A total of 13 non-randomized experimental studies (n=1,373) assessed changes in MWI of cancer patients treated with anthracyclines, trastuzumab/pertuzumab, or immune checkpoint inhibitors. After chemotherapy, adecrease was observed in the left ventricular ejection fraction (LVEF) (Pooled standard mean difference [SMD] = -0.75, 95% CI: -1.18, -0.31, p=0.001, I 2= 95.9%), global longitudinal strain (GLS) (Pooled SMD = -2.38, 95% CI: -3.10, -1.66, p<0.001, I 2= 97.9%), global work index (Pooled SMD = -1.27, 95% CI: -1.68, -0.86, p<0.001, I2= 95.0%), global constructive work (GCW) (Pooled SMD = -1.55, 95% CI: -2.10, -0.99, p<0.001, I 2= 96.9%), and global work efficiency (Pooled SMD = -1.66, 95% CI: -2.39, -0.94, p<0.001, I2= 98.2%). Conversely, global wasted work (GWW) increased (Pooled SMD = 1.17, 95% CI: 0.44, 1.89, p=0.002, I 2= 98.2%). Post-chemotherapy, GCW and GLS were below normal ranges, GWW exceeded normal values, and LVEF remained within normal limits across all subgroups.

Conclusions: Echocardiographic MWI provides a non-invasive method for assessing cardiotoxicity induced by anthracyclines, trastuzumab / pertuzumab, or immune checkpoint inhibitors.

Aim: Ultrasound is frequently used to assess muscle mass adaptations in athletes, with measurements often collected across multiple training centers. Extended field of view (EFOV) technology provides a faster, safer, more accessible, and less expensive alternative to gold standard methods such as magnetic resonance imaging (MRI). However, the reliability and validity of portable ultrasound devices for EFOV imaging are not well established. This study aimed to: a) evaluate the validity of a portable ultrasound device compared to a commonly used clinical device, and b) assess the reliability of EFOV ultrasound measurements using both a validated clinical device and a portable device.

Material and methods: Twenty-four recreational athletes participated. EFOV images of the rectus femoris and vastus lateralis muscles were captured using both a clinical and portable device, and cross-sectional area (CSA) was measured at three regions of interest (ROIs).

Results: A strong correlation (r=0.989-0.999, p<0.001) between the two devices across all ROIs was found, with minimal mean differences. Both devices demonstrated high reliability, with low coefficients of variation (clinical=2.22%, portable=3.55%).

Conclusion: The portable device is a valid and reliable tool for EFOV ultrasound measurements, facilitating its use in multi-center studies by allowing comparison across different devices and training centers.

Aim: This study aimed to evaluate the diagnostic value of combining Ovarian-Adnexal Reporting and Data System (O-RADS), contrast-enhanced ultrasound (CEUS) scoring, and serum human epididymis protein 4 (HE4) in differentiating benign and malignant adnexal masses.

Material and methods: A retrospective analysis was performed on 41 surgically resected adnexal masses confirmed by pathology between May 2022 and July 2025. All patients underwent routine ultrasound, CEUS, and preoperative serum HE4 testing. Adnexal masses were classified using O-RADS and assessed with three CEUS qualitative scores (initial enhancement time, enhancement intensity, and washout pattern) alongside HE4 levels.

Results: O-RADS alone showed a sensitivity of 69.2% for borderline and malignant adnexal masses (AUC 0.794). Adding CEUS increased sensitivity to 88.5% (AUC 0.906), and including HE4 further raised it to 96.2% (AUC 0.947). CEUS parameters differed significantly between benign and malignant adnexal masses (p < 0.001). The combined model markedly improved classification of intermediate-risk adnexal masses and reduced misclassification. Interobserver agreement was excellent (Kappa >0.85).

Conclusion: The integration of O-RADS with CEUS scoring and HE4 testing significantly improves the diagnostic accuracy for adnexal masses. This improvement is particularly notable in intermediate-risk adnexal masses. Our findings support the clinical utility of this integrated approach for risk stratification and decision-making.

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: Currently, preoperative diagnostic accuracy for serous cystic neoplasms (SCNs) of the pancreas is still suboptimal. Endoscopic ultrasound (EUS) offers high-resolution imaging for pancreatic cystic lesions, enabling precise characterization supporting SCNs. We presented EUS features of distinct SCN subtypes, enhancing precise diagnosis preoperatively.

Material and methods: This single-center retrospective study was conducted at a tertiary center. We analyzed the clinical, radiological and EUS characteristics of patients with pathologically proved SCN from January 2019 to July 2024.

Results: A total of 18 patients were collected. The average age was 49.50 years. 15 out of 18 cases (83.3%) were identified incidentally. Microcystic type accounted for the majority (n=10, 55.6%), followed by macro-cystic type (n=5, 27.8%) and solid type (n=3, 16.6%). No significant differences in radiological imaging were observed among subtypes (p>0.05). EUS features including cyst wall thickening, intra-cystic echogenicity, intralesional vascularity and internal septations, demonstrated significant variations across SCN subtypes (p<0.05). Notably, the stellate scar was a hallmark feature for the microcystic subtype.

Conclusions: EUS demonstrates the superior capability in characterizing subtle SCN features, allowing for further subtype classification. Integration of EUS into preoperative diagnostic protocols should be considered for individualized surgical planning.

Aim: To investigate the artificial Intelligence (AI) landmark for guiding rotator cuff interval injections for adhesive capsulitis (AC).

Material and methods: One hundred fifty-five patients undergoing AI landmark-guided injections were prospectively enrolled (AI cohort). A 1:1 propensity-score matching was conducted for ultrasound (US) cohort receiving US-guided injections (n=149). The primary endpoint was shoulder pain and disability index (SPADI) scores at 1-month post-injections, with a defined superiority margin of a 10-point decrease. Secondary outcomes included needle insertions, procedure time, range off motion, quality of life (QoL) and adverse events.

Results: SPADI scores at 1-month follow-up was 32.81±18.16 and 44.53±11.74 in two cohorts with a mean difference of -11.72 (95%CI: -17.95, -10.48), confirming the superiority (p=0.025). Higher means were observed at 1-week and 3-month post-injections (p=0.018 and 0.033). Better improvements were observed in forward flexion (158.77±13.12 vs. 145.97±11.49, p=0.016), abduction (78.98±15.96 vs. 61.09±17.09, p=0.007) and external rotation (63.13±19.97 vs. 50.19±13.85, p=0.019) in AI cohort compared to US cohort at 1-week post-injections. AI cohort had fewer needle insertions, shorter procedure times and better QoL scores. Minor adverse events were observed.

Conclusions: AI approach facilitated the identification of shoulder landmarks and demonstrated superiority in relieving shoulder pain and improving function compared to ultrasound method.

Aim:  Ultrasound (US) is increasingly used for fracture diagnosis, yet the comparative performance of handheld and conventional US, particularly by novice users, remains unclear. This study evaluated their diagnostic accuracy using in vitro bone models.

Material and methods:  Five blinded junior sonographers examined seven bone samples (comprising four fractured, comminuted, transverse, obliquely displaced, and linear, as well as three intact samples) using both types of devices. Diagnostic sensitivity, specificity, and accuracy were calculated. McNemar's test evaluated differences in performance, Cohen's Kappa measured inter-device agreement, and McNemar's test along with mixed-effects logistic regression analysed the impact of fracture types. Inter-sonographer reliability was assessed using the intraclass correlation coefficient (ICC).

Results:  Both devices showed 85% sensitivity (95% CI: 61.1-96%). Specificity was low (conventional: 20.0%; handheld: 33.3%). Accuracy was moderate (conventional: 57.1%; handheld: 62.9%). No significant difference was found (p = .21), and inter-device agreement was poor (Kappa = 0.05±0.20). Comminuted fractures were significantly more detectable than intact bones (OR=2.25, p=0.03). Inter-operator reliability was low (ICC: 0.28-0.35).

Conclusion:  Handheld US showed slightly higher specificity and accuracy, but both systems demonstrated limited agreement and variable novice performance. These findings highlight the need for improved training and optimisation when using US for fracture detection.