Medical ultrasonography最新文献

Aim: To compare the diagnostic value of carotid colour Doppler ultrasound (CDO) and magnetic resonance angiography (MRA) in detecting carotid vascular stenosis, using digital subtraction angiography (DSA) as the gold standard.

Materials and methods: A total of 120 patients admitted between January 2022 and December 2024 were divided into two groups of 60 based on the initial imaging modality. The CDO group underwent carotid CDO followed by DSA for suspected stenosis, while the MRA group received MRA first, with DSA performed for confirmed cases. DSA served as the reference standard. Stenosis severity was graded using NASCET criteria, and sensitivity, specificity, accuracy and agreement (Kappa) with DSA were calculated.

Results: CDO showed excellent agreement with DSA (Kappa = 0.823), with 97.67% sensitivity, 88.24% specificity and 95.00% accuracy, demonstrating high consistency across all stenosis grades and occlusion. MRA showed moderate agreement with DSA (Kappa = 0.657), achieving 97.30% sensitivity, 65.22% specificity and 85.00% accuracy, with notable overestimation in mild stenosis.

Conclusion: Both CDO and MRA are valuable non-invasive tools for evaluating carotid vascular stenosis. CDO is simple, cost-effective and suitable for large-scale screening, whereas MRA provides detailed vascular anatomy and is better suited for confirmatory assessment of complex lesions. Appropriate selection or combined use can improve diagnostic accuracy and clinical decision-making.

Aim: To analyze the ultrasound characteristics of early glottic laryngeal cancer and evaluate their value in diagnosis and T-stage prediction.

Material and methods: A total of 154 patients with postoperative diagnosis of early glottic cancer were included. Ultrasonic findings were summarized, and factors influencing diagnosis and T staging were analyzed.

Results: Key findings included mucosal roughness, reduced echogenicity, vocal cord masses, and Adler grade III blood flow. Ultrasound showed 87.66% sensitivity. Adler grade and vocal cord mass were independent predictors of diagnosis. T-staging concordance was 74.51% for T1a, 72.73% for T1b, and 86.21% for T2, with no significant difference among stages. Adler grade and resistance index differed significantly across T stages, with resistance index and vocal cord mass being independent staging factors.

Conclusion: Ultrasound can clearly distinguish mucosal layer lesions on the vocal cords, and it has a certain value in the diagnosis and T staging of early glottic laryngeal cancer.

Aims: The aim of this study was to investigate the differences in clinical and ultrasound findings between alveolar rhabdomyosarcoma (ARMS) and non-ARMS in order to improve the accuracy of preoperative diagnosis of ARMS in children.

Material and methods: A retrospective study of 33 children with pathologically confirmed RMS (ARMS and non-ARMS groups) was realized.  Clinical features and ultrasound parameters were compared between ARMS and non-ARMS using Fisher 's exact test analysis. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were used to represent diagnostic performance.

Results: Among the clinical features, there were statistically significant differences between ARMS and non-ARMS groups in site (p=0.020), TNM stage (p=0.007), IRS stage (p=0.009), risk grade (p=0.011), and distant metastasis (p=0.020). There were statistical differences in necrosis (p= p0.039) and central hyperechoic fiber bundles (p<0.001) between the two groups. The combination of ultrasound and clinical characteristics demonstrated excellent predictive ability (AUC was 0.964).

Conclusions: Children with ARMS more often present with poor prognosis, and combined clinical and ultrasound features are helpful for preoperative identification of ARMS and providing imaging evidence for accurate clinical diagnosis and treatment.

Aims: To evaluate if internal jugular vein (IJV) diameter changes, assessed by bedside ultrasonography, are associated with the severity and prognosis of Chronic Obstructive Pulmonary Disease (COPD) exacerbations, and to determine their utility in guiding clinical management in the emergency department.

Material and methods: This prospective, observational pilot study included 45 patients presenting to the emergency department with a COPD exacerbation. Patients underwent right IJV ultrasonography at presentation and 2 hours post-treatment. IJV diameters (IJVMAX, IJVMIN, IJVCOMP) and derived collapsibility indices (INDEX1, INDEX2) were measured by a single, blinded physician. Outcomes analyzed were hospital/ICU admission and 1-month mortality.

Results: 45 patients (mean age 64.96 years) were included. Following treatment, IJVMIN decreased (p=0.026) and collapsibility (INDEX1) increased significantly (p=0.002). 1-month mortality (n=4) was associated with higher post-treatment IJVCOMP2 (p=0.041). Patients admitted to the ICU (n=9) had significantly higher IJV diameters and lower collapsibility indices (p<0.05). For predicting ICU admission, IJVMIN (cut-off ≥1,05cm) had an AUC of 0.861 with 86.1% specificity.

Conclusions: Bedside IJV ultrasonography helps predict severity and monitor treatment response in COPD exacerbations. IJV parameters are associated with ICU admission and mortality, suggesting they are valuable, non-invasive decision support tools for emergency physicians.

Aim: To identify clinical, biochemical, and ultrasonographic parameters that may serve as early predictors of gestational trophoblastic neoplasia (GTN) in patients initially diagnosed with complete hydatidiform mole (CHM).

Material and methods: This retrospective study included 47 patients with trophoblastic gestational disease, of whom 28 had CHM and 19 developed GTN. Clinical data, serum human chorionic gonadotropin (hCG) levels, and ultrasonographic parameters-including vascular index (VI) (MV-Flow®) and uterine artery pulsatility index (PI)-were collected and analyzed. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to assess predictive value.

Results: GTN patients had significantly higher rates of second uterine evacuation (47.4% vs. 7.1%, p=0.001), prolonged time to hCG normalization (92.0 vs. 40.0 days, p<0.001), and increased frequency of focal lesions (68.4% vs. 14.3%, p<0.001). VI values in the longitudinal, transverse, and mean uterine planes were significantly higher in GTN, while mean PI was significantly lower (1.61 vs. 3.13, p=0.001). ROC curves demonstrated good diagnostic performance for the mean VI (AUC=0.823) and mean PI (AUC=0.777).

Conclusion: The VI and uterine artery PI, in combination with serum hCG dynamics and focal lesion detection, may serve as useful parameters in the early identification of patients at increased risk for neoplastic progression following molar pregnancy.

Breast contrast-enhanced ultrasound (CEUS)has been used in clinical practice for nearly two decades. CEUS provides real-time assessment of microvascular perfusion, offering valuable functional information complementary to conventional ultrasound. Nonetheless, the lack of standardization in relevant techniques has hindered the widespread adoption and further development of this technology. As a specialized committee, Superficial Organs and Peripheral Vessels Committee of Chinese Association of Ultrasound in Medicine and Engineering has always been committed to standardizing the clinical application of ultrasound. This expert consensus aims to standardize examination procedures, image interpretation, and reporting for diagnostic settings. It outlines key indications and provides recommendations on acquisition techniques, qualitative and quantitative analysis of enhancement patterns, and standardized lexicon for reporting.

Aim: Liver steatosis is a growing global health concern with significant medical and economic implications. This study aimed to evaluate USFF (ultrasound fat fraction) for steatosis assessment as compared to controlled attenuation parameter (CAP).

Materials and methods: Liver steatosis was assessed in the same session by QUS (Samsung Medison RS85) and CAP (FibroScan Compact M530) in a cohort of 169 patients. For QUS, TAI and TSI measurements were acquired, then Fat Fraction (%) was calculated and displayed. The CAP cut-off values for S1, S2 and S3 were 248, 268 and 280 dB/m, respectively. ROC analysis was performed to identify the best cut-off values for USFF for each steatosis stage.

Results: Of the 169 patients, 52.6% had at least moderate steatosis by CAP. Moderate correlations were observed for TSI vs. CAP (r=0.66), TAI vs. CAP (r=0.83), and TSI vs. TAI (r=0.68), with good diagnostic performance (TSI AUROC=0.82, TAI AUROC=0.81). A strong correlation between USFF and CAP was also found (r=0.81, p<0.001). The best USFF cut-off value to identify at least mild steatosis in all patients was >5% with very good performance (AUROC=0.90) for moderate steatosis the cut-off value was >7.5% (AUROC=0.92) and for severe steatosis, >10% (AUROC=0.91).

Conclusion: USFF seems to be a promising tool for diagnosing liver steatosis, with a very good performance.

Reliable and reproducible sonographic measurements are essential for accurate liver assessment, both in daily clinical practice and in research. Reference values enable clinicians to differentiate between physiological and pathological findings and thus support diagnostic accuracy, follow-up, and therapeutic decision-making. This comprehensive review synthesizes current evidence on normal liver size as assessed by ultrasound, with a particular focus on measurement techniques, standard values, anatomical variants, and the clinical contexts in which these parameters are relevant. Special attention is given to the influence of patient-related factors such as body constitution, sex, age, and ethnicity. The role of right, left, and caudate lobe measurements is discussed in detail, outlining their relevance in conditions such as hepatomegaly, vascular disorders, or post-resection follow-up. Limitations of currently available data are acknowledged, especially regarding interobserver variability and lack of global uniformity. Future priorities include the establishment of consensus-based international reference standards and the integration of emerging technologies, such as artificial intelligence and advanced image analysis tools, to enhance reproducibility, reduce variability, and improve clinical utility. Ultimately, standardized liver measurements should form an integral part of multiparametric ultrasound examinations to optimize patient care.

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.

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.