Medical ultrasonography最新文献

Emergency ultrasound, or point-of-care ultrasound (POCUS), has been established into daily patient care over the last decades. The use of abdominal and pelvic ultrasound in clinical practice has the potential to improve the efficiency and safety of pediatric emergency care. This article will provide a review of current applications of pediatric emergency abdominal and urogenital ultrasound, forming the second part of the series.

Aim: This study set out to access the performance of quantitative analysis of contrast-enhanced ultrasound (CEUS) in distinguishing between benign periablational enhancement (BPE) and residual tumor (RT) following radiofrequency ablation (RFA).

Materials and methods: 165 tumors from 124 patients with hepatocellular carcinoma between 2021 and 2023 underwent RFA, contrast-enhanced computed tomography (CECT), and CEUS in less than 24 hours. Analysis was done on the quantitative parameters from RT and BPE found by CEUS.

Results: Complete ablation was obtained in 89.1% of lesions. When compared to BPE, RT had significantly greater peak intensity (PI), time to peak (TTP), area under the curve (AUC), ratio of PI and base intensity (PI/BI), and enhanced intensity (EI) values (all p<0.05). PI, TTP, AUC, PI/BI, and EI had large areas under the receiver operating (ROC) curves. A binary logistic regression analysis, respectively, demonstrated that PI and PI/BI were independent favorable prognostic variables.

Conclusions: Multiple parameters of quantitative analysis of CEUS can aid in distinguishing immediately between RT and BPE lesions. PI and PI/BI may be a more promising parameter. Immediate CEUS evaluation following RFA may allow immediate retreatment of RT during the same operation time, which reduces patients' hospital stays and financial costs.

Aim: To determine the ultrasonographic (US) features that could help to distinguish between parathyroid masses abutting the thyroid gland and thyroid masses extending into the parathyroid area.

Materials and methods: Two blinded readers retrospectively evaluated the US images of 76 histopathologically confirmed parathyroid masses abutting the thyroid gland and 34 thyroid masses extending into the parathyroid area. Maximal diameter, transverse diameter/anterior-posterior diameter (T/AP) ratio, longitudinal diameter/AP diameter (L/AP) ratio, margin, shape, echogenicity, echotexture, and echogenic interface were evaluated and compared between the two groups.

Results: Echogenic interface (p<0.001) and L/AP ratio (p<0.001) were statistically significant US features that differentiated parathyroid and thyroid masses. Other US features did not show any significant differences between the two groups. Interobserver agreement was excellent for all US features. Sensitivity/specificity of the presence of echogenic interface and L/AP ratio >2.0 were 85.5%/100% and 43.2%/82.4% in distinguishing parathyroid from thyroid masses, respectively.

Conclusion: The presence of an echogenic interface and L/AP ratio >2.0 were useful US features for differentiating parathyroid masses abutting the thyroid gland from thyroid masses extending into theparathyroid area.

Aim: This meta-analysis evaluates the diagnostic accuracy of ultrasound (US) for bone fractures over the past 47 years, comparing it to established imaging standards.

Material and methods: We adhered to PRISMA 2020 guidelines to search Medline, EMBASE, and the Cochrane Library using tailored search strategies. The primary outcome, US diagnostic performance, was analyzed across various subgroups including clinical relevance, patient age, and anatomical considerations. The QUADAS-2 tool was employed to assess study quality and minimize bias.

Results: From 5,107 initially identified studies, 75 met the inclusion criteria, encompassing 7,769 participants and 3,575 diagnosed fractures. The majority of studies were prospective (79%) and compared US primarily with plain radiography (76%) and CT scans (19%). Of these, 61 studies were amenable to systematic analysis, revealing US to have a sensitivity and specificity of 91% (95% CI: 90%-92%) and 91.3% (95% CI: 90.5%-92.1%), respectively. Likelihood ratios were favorable, with a positive value of 9.955 and a negative value of 0.087, and an odds ratio of 132.67. The area under the curve stood at 0.9715, indicating high diagnostic accuracy despite significant heterogeneity (I²=81.3% for sensitivity, 89.3% for specificity).

Conclusion: The evidence supports US as a highly accurate diagnostic tool for bone fractures, rivalling standard imaging methods like CT and radiography. Its notable diagnostic efficacy, combined with advantages in reducing pain, wait times, and radiation exposure, advocates for its broader application. Further validation in large-scale, randomized trials is essential to integrate US more fully into clinical guidelines for fracture management.

In this series of articles on comments and illustrations of the World Federation for Medicine and Biology (WFUMB) guidelines on contrast-enhanced ultrasound (CEUS), the topics on very rare focal liver lesions (FLL) are discussed. This article describes the diverse changes of focal liver lesions in peliosis hepatis and the typical changes in porphyria. Although the focus is on the appearance on ultrasound and CEUS, the clinical context is always considered. While peliosis may be a surprising finding on puncture, lesions in porphyria cutanea tarda may be typical visual diagnoses that obviate the need for biopsy. If only you knew. This article aims to sharpen the clinician's eye. It provides knowledge of the clinical presentation and US and CEUS imaging of peliosis hepatis and porphyria.

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Preoperative diagnosis of gallbladder tuberculosis (TB) is difficult, and the contrast-enhanced ultrasound (CEUS) pattern has never been reported before. We present a case of TB in which CEUS had some special findings that were helpful for early diagnosis. The thickened gallbladder wall presented in the arterial phase of CEUS the "sandwich biscuit" sign with no enhancement in the middle layer and hyperenhancement in the inner and outer layers.

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