Medical ultrasonography最新文献

Aim: Presarcopenia represents the earliest stage of sarcopenia. While muscle ultrasound (US) and shear wave elastography (SWE) offer promise as a non-invasive tool, its role in detecting early muscle loss remains underexplored, especially in the upper limb. Therefore, the aim of this study was to characterize the flexor digitorum profundus (FDP) muscle in older adults with presarcopenia versus normal muscle mass, and to assess the diagnostic potential of grayscale echogenicity and SWE.

Material and methods: This cross-sectional study included 50 age- and sex-matched participants classified as presarcopenic (n=25) or normal muscle mass (n=25) based on dual-energy x-ray absorptiometry (DXA)-derived appendicular skeletal muscle mass index (ASMI). All underwent clinical evaluation and ultrasound assessment of the FDP. US parameters included cross-sectional area (CSA), muscle thickness (MT), pennation angle (PA), echogenicity, and SWE in relaxation and contraction. Logistic regression and ROC analysis were applied.

Results: Presarcopenic participants had significantly lower CSA (p=0.001) and higher grayscale echogenicity (p<0.001). MT and PA did not differ significantly. Echogenicity showed negative correlations with CSA, DXA measurements, and forearm circumference (FC). Grayscale cut-off values were proposed to differentiate visual echogenicity grades. Although SWE values were not significantly different in univariate analysis, SWE in relaxation emerged as an independent predictor in the regression model.

Conclusions: FDP grayscale echogenicity is a strong marker of early muscle decline. SWE in relaxation independently predicted presarcopenia, supporting its role in early diagnostic frameworks. Larger studies are warranted.

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.

Aims: This study aimed to develop and validate an effective nomogram combining clinical biomarkers and carotid plaque's superb microvascular imaging (SMI) features for predicting acute ischemic stroke.

Material and methods: In this study, 326 patients with carotid plaque were enrolled, and all patients were divided into two datasets for training and validation. We constructed an integrated nomogram combining clinical and ultrasound characteristics of carotid plaque using LASSO regression and multivariable logistic regression to predict acute ischemic stroke.

Results: LASSO regression combined with multivariate logistic regression indicated that smoking index, stroke duration, diabetes duration, monocytes/lymphocyte ratio, the surface condition and SMI neovascularization level of plaque were independently related to acute ischemic stroke. The area under the curve for the nomogram to predict AIS was 0.839 (95% CI,0.789-0.888) in the training cohort, 0.785 (95% CI, 0.669-0.901) in the validation cohort.

Conclusions: Our proposed acute ischemic stroke nomogram shows favorable predictive value to patients with carotid artery plaques and has positive clinical significance in individualized scientific management.

Sonopsychology refers to the multidimensional psychological interactions occurring before, during, and after ultrasound examinations. While the psychological effects of radiological examinations are documented, the unique context of ultrasound, marked by real-time imaging and close examiner-patient interaction, has not received equivalent attention. This review explores the psychological dynamics in various contexts-radiology, oncology, and interventional ultrasound-highlighting key domains such as communication, emotional attunement, examiner self-awareness, and the influence of environmental and procedural factors. The concept of Sonopsychology emphasizes that ultrasound is not merely a diagnostic tool or processes but also a human encounter. By integrating emotional intelligence and relational competencies into routine practice, examiners can enhance patient satisfaction, trust, and even clinical outcomes. Ultimately, this integrative approach reframes performance assessment emphasizing patient-centered outcomes, moving beyond a solely technical evaluation.

Aim: To evaluate the effectiveness of two large language models, ChatGPT-4 and Claude 3, in improving the accuracy of question responses by senior sonologist and junior sonologist.

Material and methods: A senior and a junior sonologist were given a practice exam. After answering the questions, they reviewed the responses and explanations provided by ChatGPT-4 and Claude 3. The accuracy and scores before and after incorporating the models' input were analyzed to compare their effectiveness.

Results: No statistically significant differences were found between the two models' responses scores for each section (all p>0.05). For junior sonologist, both ChatGPT-4 (p=0.039) and Claude 3 (p=0.039) significantly improved scores in basic knowledge. The responses provided by ChatGPT-4 also significantly improved scores in relevant professional knowledge (p=0.038), though their explanations did not (p=0.077). For all exam sections, both models' responses and explanations significantly improved scores (all p<0.05). For senior sonologist, both ChatGPT-4's responses (p=0.022) and explanations (p=0.034) improved scores in basic knowledge, as did Claude 3's explanations (p=0.003). Across all sections, Claude 3's explanations significantly improved scores (p=0.041).

Conclusion: ChatGPT-4 and Claude 3 significantly improved sonologist' examination performance, particularly in basic knowledge.

Aims: To investigate the multimodal ultrasonography (US) features of extramedullary plasmacytomas (EMPs) in patients with multiple myeloma (MM).

Material and methods: Nine patients with MM who were diagnosed EMPs and underwent multimodal ultrasonography were enrolled in this study. Clinical information and multimodal US results were retrospectively analyzed. The multimodal US with a standardized sonographic protocol including US, color Doppler flow imaging (CDFI), microvascular US, ultrasound elastography (UE) and contrast-enhanced ultrasound (CEUS) was performed on the enrolled patients.

Results: This study included both males (4 of 9) and females (5 of 9), with ages ranging from 48 to 72 years. The nine lesions were located in the skin/muscle (7 of 9) and pleura (2 of 9). On US images, all lesions showed inhomogeneous solid hypoechogenicity without calcification. Vascularity was abundant (hypervascularization). CEUS images confirmed this vascular pattern (9 of 9) and presented hyperenhancement with enlarged range. On elastographic images, the lesions presented with high elastic score (3-4).

Conclusions: An inhomogeneous hypoechoic soft tissue or visceral mass occurring in MM with increased vascularity, low elasticity, and hyperenhancement along with enlarged range can indicate the diagnosis of EMP on multimodal US images.