Medical ultrasonography最新文献

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Aim: In rheumatoid arthritis (RA), forefoot bursitis is prevalent, with limited studies comparing ultrasonography (US) and Magnetic Resonance Imaging (MRI). This study aims to evaluate these bursae, providing a comparative analysis of US and MRI, and explore associations with demographic, disease-related factors, pain, clinical examination, and baropodometryin RA patients.

Material and methods: Participants with RA were recruited from the day-hospital clinic. The forefeet were assessed clinically, and the selected foot was examined by US and MRI to evaluate intermetatarsal (IMB) and submetatarsal bursitis (SMB). Baropodometry assessed plantar pressures and contact surfaces.

Results: Thirty-five RA patients were enrolled, 85.7% females, mean age 59.2 (11.3) years, mean body mass index (BMI) 26.5 (5.7) kg/m2, median disease duration of 36.0 (16.5-114.0) months, and 34.3% with painful forefoot. A total of 140 intermetatarsal and 175 submetatarsal spaces were evaluated. Agreement between US and MRI was high (PA=97.14%, k=0.801, p<0.001), and interobserver reliability for both modalities was excellent (US: PA=98.73%, k=0.888, p<0.001; MRI: PA=98.41%, k=0.900, p<0.001). IMB was negatively associated with disease duration (the only independent predictor) and linked to clinical signs like the opening toes sign and hammer toe deformity. SMB showed an association with BMI and erosions. Baropodometric analysis indicated no significant differences in plantar pressures for IMB, and larger contact surfaces in SMB regions.

Conclusions: US and MRI are valuable tools for forefoot bursitis evaluation. IMB is associated with disease duration (negative association), the opening toes sign, and hammer toe deformity, while SMB correlates with BMI, erosions, and foot architectural deformity. Baropodometry revealed larger contact surfaces in regions with SMB.

Aims: The aim of this study is to investigate the diagnostic performances of Ultrasonography (US), Shear-wave Elastography (SWE), and Superb Microvascular Imaging (SMI) findings in the diagnosis of malignant thyroid nodules (MTNs) and to determine the US algorithm with the best diagnostic performance.

Material and methods: Eighty-one nodules in 77 patients who had underwent multimodal US with biopsy results, were evaluated. Echogenicity, nodule components, contours, presence and type of calcification, and size were analyzed with US. Nodule stiffness and vascular index (VI) measurements were performed via SWE and SMI. The power of the US algorithm in predicting malignancy was evaluated.

Results: Hypoechogenicity, irregular contour, aspect ratio (anteroposterior (AP)/transvers diameter) >1, and >43.9 kPa were the characteristicshad significant efficacy in the diagnosis of MTNs. Sensitivity, specificity, and AUC values were respectively 100%, 48.5%, and 0.742 for hypoechogenicity; 80%, 90.1%, and 0.855 for irregular contour; 60%, 71.2%, and 0.656 for aspect ratio >1; 60%, 72.7%, and 0.671 for >43.9 kPa; and 93.3%, 90.9%, and 0.921 for the US algorithm. VI did not show significant efficacy in diagnosis.

Conclusion: Some B-mode and SWE findings showed sufficient efficacy in differentiating benign and malign nodules on their own. However, diagnostic accuracy increased significantly when the US algorithm was applied.

Contrast enhanced ultrasound (CEUS) is well-established for the characterization of focal liver lesions (FLLs). By using intravenous ultrasound contrast agents, followed by specific low mechanical index examinations, CEUS enables a high spatial and temporal resolution as well as a dynamic assessment of macro- and microvascularization down to the capillaries. Nevertheless, CEUS has the disadvantage of being examiner-dependent, so quantitative analysis of time-intensity curves in dynamic CEUS (D-CEUS) could provide further information. The aim of this article is to provide a general review of the current literature regarding the usefulness of D-CEUS in the assessment of FLLs.

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Aims: Data regarding the treatment of hip osteoarthritis (OA) with collagen-based extracellular bio-scaffolds are lacking. We evaluated the treatment of hip OA with ultrasound guided intraarticular injections of Collagen-based Medical Device (CMD).

Material and methods: Forty-four patients with Kellgren-Lawrence grade (KLG) I or II were selected, and 20/44 randomly selected patients (CMD group), were treated with 2 weekly consecutive ultrasound guided intraarticular injections of CMD (MD-HIP, Guna S.p.a. Milan, Italy). An additional 24/44 patients were treated with oral non-steroidal anti-inflammatory drugs (NSAIDs) daily (NSAIDs group). Clinical assessment, X-rays and ultrasound evaluation were performed at baseline, and after 1 month in both groups, and after 3 months in the CMD group. Outcome measures were general pain VAS (0-10), the whole WOMAC score, and the WOMAC specific subscores.

Results: CMD and NSAIDs group were homogenous for age, gender, VAS pain and WOMAC scores. The CMD group had significant improvement of the VAS pain (p<0.0001), global WOMAC score (p<0.0001) and WOMAC function (p<0.0001) from baseline to the 1st month, with further improvement from the 1st to the 3rd month (p<0,001; p<0.01; p<0.03, respectively). Significant improvement in WOMAC pain (p<0.0001) and WOMAC stiffness (p<0.0001) was detected at 1st month, with no significant change at 3rd month. In the NSAIDs group significant improvement in WOMAC function was detected after 1 month (p=0.021) only. No adverse events were recorded in the CMD and NSAIDs group.

Conclusion: The ultrasound guided intraarticular hip injections of CMD resulted in significant improvement in VAS pain and WOMAC scores compared to treatment with oral NSAIDs.

In many patients with pancreatic cancer the definite pathological diagnosis is limited due to the lack of safe needle entry routes, the high risk of conventional ultrasound-guided puncture and the low positive rate of single needle. To solve the situations in which there are no safe path for pancreatic biopsy, we used water isolation technology combined with contrast-enhanced ultrasound to perform puncture biopsy in 3 patients with pancreatic mass occupying under the guidance of coaxial needle in this study and remarkable results were achieved. The water isolation technique was used to avoid the damage to theimportant organs in front of the occupying area.

With the Superb Micro-Vascular Imaging (SMI), the established Doppler technology has been extended by another mode. With this technique, microvascular structures with slow blood flow can now also be displayed in real time. As with the introduction of Doppler ultrasound, this new technique opens further diagnostic fields for the examiner, which were previously reserved for magnetic resonance imaging (MRI), computed tomography (CT) or contrast ultrasound (CEUS). Focal nodular hyperplasia (FNH) of the liver is characterized by a typical spoke-wheel vascular malformation (spoke-wheel sign, SWS) anda good example using SMI for the diagnostic profit of our patients. The aim of this report is to describe the use of SMI as a new non-invasive, quick, and probably cost-effective diagnostic imaging tool.

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