Medical ultrasonography最新文献

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.

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.