Medical ultrasonography最新文献

Aim: The aim of this study was to compare the measurement of periodontal pocket by ultrasound in comparison with gold standard measurements ex-vivo.

Material and methods: A total of 12 hemi-jaws were included in the study. Ultrasound measurements of the sulcus were performed and then, sulcus depth was measured by manual probing. The reading of the ultrasound images was carried using ImageJ software. Reference points are made allowing the measurement of this sulcular space. To assess the hypothesis of normality of the data, a Kolmogorov-Smirnov test was performed for each of the samples due to the size of their population (>50). To complete this test, Lin's concordance test was also applied.

Results: A total of 348 manual probing and 348 ultrasound imagines measurements were performed. The Lin concordance and correlation coefficients and their 95% confidence intervals obtained were 0.855 (95% CI [0.822; 0.855]). These data allow us to demonstrate the equivalence between the measurement of the depth of the periodontal pocket by ultrasound imaging and the measurement by manual probing.

Conclusion: This study shows that the use of an ultrasound probe for periodontal imaging was comparable to the current gold standard for measuring the sulcus area. These promising results must be confirmed by measurements in humans.

Pseudomyxoma peritonei (PMP) is a rare malignancy marked by mucinous ascites from neoplastic cell dissemination. We report a 50-year-old male with abdominal pain, weight loss, and ascites, initially suspected as hepatic metastases. Imaging revealed peritoneal implants and characteristic liver scalloping, but the percutaneous biopsy was inconclusive. Notably, contrast-enhanced ultrasound (CEUS) reproduced the hepatic scalloping typically seen on CT, helping distinguish mucinous peritoneal deposits from metastatic lesions. The patient's condition worsened and passed away. This case illustrates diagnostic difficulties, the limitations of biopsy, and the potential utility of CEUS in PMP.

Parasitic infections of the lungs and pleura are uncommon but clinically significant, affecting both endemic and non-endemic areas due to global travel and migration. While computed tomography (CT) remains the imaging modality of choice, thoracic ultrasound, particularly in peripheral and pleural lesions, offers a valuable, non-invasive complement. Beyond its traditional role in detecting effusions or consolidations, ultrasound now includes advanced techniques such as contrast-enhanced ultrasound (CEUS), which enhances lesion characterization. This review summarizes the most relevant pulmonary and pleural parasitic diseases, emphasizing their characteristic findings in B-mode and CEUS, and illustrates their diagnostic importance through selected clinical cases.

Aims: This study aimed to evaluate the diagnostic performance of shear wave elastography (SWE) in differentiating non-melanoma skin cancer (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), from benign skin lesions. A secondary objective was to assess the accuracy of high-resolution ultrasonography (HRUS) for preoperative tumormeasurement.

Material and methods: A prospective study was conducted on 106 patients with clinically suspected NMSC or benign lesions (nevi). Each lesion was evaluated with SWE and HRUS using an 18 MHz probe, followed by surgical excision and histopathological confirmation. Among the confirmed malignancies, 46 were BCC and 15 SCC. The control group included 35 nevi diagnosed clinically and dermatoscopically. SWE stiffness values were compared across lesion types. Tumor length and depth measured by HRUS were validated against pathology using The Student's t-test or Mann-Whitney U test, Bland-Altman analysis and the Intraclass Correlation Coefficient (ICC).

Results: SWE showed significantly higher stiffness in malignant versus benign lesions, with optimal thresholds of >13 kPa for BCC and >15 kPa for SCC. The area under the receiver operating characteristic curve (AUROC), was 0.95 for BCC and 0.99 for SCC. Differentiation between SCC and BCC was moderate (AUROC=0.70). HRUS accurately estimated tumor length (bias=1.31 mm, p>0.05; ICC=0.90), while depth was slightly overestimated (bias=0.87 mm, p<0.05; ICC=0.83).

Conclusion: SWE and HRUS offer complementary, non-invasive tools for the diagnosis and preoperative assessment of BCC and SCC. SWE demonstrated high diagnostic accuracy for distinguishing NMSC from benign lesions, particularly nevi, by applying stiffness thresholds between 13-15 kPa. HRUS proved effective in estimating tumor length with good agreement to histopathology, though it showed a tendency to overestimate tumor depth.

Aim: To perform a systematic review and meta-analysis of the consistency between ultrasonic cardiac output monitor (USCOM) and echocardiography in monitoring neonatal cardiac output.

Material and methods: PubMed, Embase, Web of Science, Cochrane, Wanfang, Chinese National Knowledge Infrastructure Database, and Chinese Science and Technique Journal Database were searched from the inception of the databases to November 2024. Two reviewers independently performed study selection, data extraction, and risk of bias assessment. Method-comparison studies evaluating USCOM versus echocardiography in neonates were included. Pooled mean bias (accuracy), standard deviation, and mean percentage error (precision) of the included studies were calculated using a fixed-effects model.

Results: Six of the 774 identified studies were included in the qualitative analysis, and four studies were included in the meta-analysis. The overall pooled bias and percentage error for left ventricular output measurements were -7.7±13.5 mL/kg/min (95% limit of agreement: -34.2 to 18.8 mL/kg/min) and 31.2%, respectively, while the overall pooled bias and percentage error for right ventricular output measurements were 40.5±21.3 mL/kg/min (95% limit of agreement: -1.2 to 82.2 mL/kg/min) and 35.1%, respectively.

Conclusion: USCOM may overestimate right ventricular output trend, while left ventricular output measurement agreement is slightly better.

Aims: To assess the viability and safety of radiofrequency ablation (RFA) for intrahepatic tumors in hepatocellular carcinoma (HCC) treatment, as well as percutaneous ethanol injection (PEI) for portal vein tumor thrombus (PVTT).

Materials and methods: From January 2010 to December 2020, a total of 25 HCC patients who underwent RFA for intrahepatic tumor combined with PEI for PVTT were enrolled. Treatment response (assessed using modified Response Evaluation Criteria in Solid Tumors [mRECIST] based on contrast-enhanced computed tomography [CECT] or contrast-enhanced ultrasound [CEUS]), overall survival (OS), progression-free survival (PFS), and safety profile were evaluated. Univariate and multivariate analyses were performed to identify the prognostic factors in predicting the OS and PFS.

Results: The overall response rate was 88%, including 12 (48%) patients achieving complete response (CR) and 10 (40%) patients achieving partial response (PR). Progressive disease (PD) was observed in 3 (12%) patients. The 1-, 3-, 6-, and 12- month PFS rates were 96%, 56%, 20%, and 4%, respectively. The OS rates at 6, 12, 24, 36, and 48 months were 96%, 52%, 28%, 8%, and 4%, respectively. The overall response was the only risk factor for the PFS in the univariate analysis (p=0.026), but not in the multivariate analysis (p=0.288). There was no independent prognostic factor of OS. No ablation-related mortality was observed. Major complication of liver abscess was observed in only 1 (4%) patient.

Conclusions: RFA combined with PEI is a feasible treatment for HCC patients with PVTT, which might reduce the tumor burden and create conditions for further adjuvant therapy.

Aim:  To determine the frequency and types of Müllerian anomalies (MA) in women with various reproductive disorders and demonstrate three-dimensional transvaginal ultrasound's (3D TVUS) capabilities in MA diagnosis.

Material and methods: A prospective, comparative, case-control study was conducted on 3,973 women aged 16 to 45 between 2019 and 2023. Among them, 2,394 women had primary infertility (Group I), 898 - recurrent pregnancy losses (Group II), 61 - primary amenorrhea (Group III), and 620 women with one or more full-term live births constituted control group (Group IV). All women underwent 2D TVUS and 3D TVUS examinations. Additionally, hysterosalpingography was conducted on 49 women, hystero-laparoscopy on 53 women, and magnetic resonance imaging (MRI) on 30 women.

Results:  The most common MA identified in Group I and Group II was a septate uterus. In diagnosing this condition, the 3D TVUS demonstrated sensitivity of 95.83% and specificity of 100% compared to MRI, with Kappa index of 0.978. Compared to hystero-laparoscopy, 3D TVUS exhibited sensitivity of 97.5% and specificity of 100%, with Kappa index of 0.987. Compared to hysterosalpingography, MRI, and hystero-laparoscopy, the 3D TVUS showed 100% sensitivity and specificity for all other anomalies.

Conclusion:  Three-dimentional ultrasonography is a rapid, cost-effective, non-invasive, and highly informative method for evaluating Müllerian anomalies. It demonstrated good concordance with the magnetic resonance imaging method.

Aims: To assess the impact of systemic sclerosis (SSc) and sarcopenia on muscle stiffness using shear wave elastography (SWE) in hand and forearm muscles, and to determine whether these conditions independently affect muscle mechanical properties.

Material and methods: This cross-sectional study included 39 patients with SSc and 90 controls. Sarcopenia was defined according to EWGSOP2 criteria, using fat-free mass index and handgrip strength. Muscle stiffness was measured by SWE in both relaxed and contracted states at three muscle sites: thenar eminence, flexor pollicis longus, and flexor digitorum profundus. Additional assessments included whole body dual-energy X-ray absorptiometry evaluation, clinical evaluation, and questionnaires. Multiple linear regression and propensity score matching were used to adjust for age, sex, and body mass index. Intra-rater reliability was evaluated using intraclass correlation coefficients (ICCs).

Results: SSc patients showed significantly higher muscle stiffness during contraction across all sites (p<0.05), independent of sarcopenia, age, or bodycomposition. No differences were observed at rest. Sarcopenia showed limited effect on SWE values. ICCs ranged from 0.858 to 0.935, indicating excellent intra-rater reliability.

Conclusions: Muscle stiffness during contraction is increased in SSc and appears to reflect fibrotic changes in the extracellular matrix rather than sarcopenia. SWE under standardized contraction may serve as a sensitive imaging biomarker for muscle involvement in systemic sclerosis. Further studies should include inter-rater reproducibility and clinical phenotyping to validate its diagnostic value.