Medical ultrasonography最新文献

Aims: This study aimed to investigate changes in the stiffness of thyroid nodules following fine needle aspiration biopsy (FNAB), using shear wave elastography (SWE), a non-invasive imaging technique utilized in thyroid nodule evaluation.

Material and methods: A total of 82 patients scheduled to undergo FNAB for the first time were included. Ultrasound and SWE examinations were performed before the procedure and again 8 to 10 weeks after FNAB. Nodule stiffness was measured in kilopascals (kPa) during both evaluations, and changes in elasticity were assessed.

Results: The mean SWE stiffness of the nodules significantly decreased from 21.80 ± 11.43 kPa before FNAB to 17.83 ± 9.98 kPa after FNAB (p = 0.001). Smoking status and serum free T3 levels were significantly associated with changes in SWE stiffness (p < 0.05). However, no significant difference was observed between TIRADS 3 and TIRADS 4 categories regarding the change in stiffness (p = 0.223).

Conclusion: This study demonstrates a significant reduction in thyroid nodule stiffness after FNAB as measured by SWE. These post-biopsy changes may lead to potential misinterpretations in subsequent elastographic evaluations, possibly affecting diagnostic accuracy and clinical decision-making.

Aim: To illustrate ultrasonographic characteristics of cervical lymph nodes in children with infectious mononucleosis (IM).

Material and methods: Ultrasonographic characteristics of cervical lymph nodes in 61 children with IM were retrospectively analyzed, including the location, long diameter (LD), short diameter (SD), short-to-long diameter ratio (S/L), boundary clarity, presence of lymphatic hilum, internal hyperechoic features, blood supply mode and vascular richness.

Results: The 61 children with IM comprised 41 males and 20 females, with an average age of 7.2±3.8 years. Bilateral enlargement of cervical lymph nodes was a typical ultrasonographic manifestation of IM. Lymph node enlargement was evenly distributed on both sides of the neck. All enlarged lymph nodes were in neck zone II, with an average S/L ratio of 0.37±0.07, long diameter 33.4±6.4 mm, and short diameter 12.1±2.5 mm. Other typical ultrasonographic characteristics of cervical lymph nodes in children with IM included clear borders (100%), beads-on-a-string (98.4%), smooth edges (98.4%), visible lymphatic hila (95.1%), loose arrangement of lymphatic hila (88.5%), central blood flow signals (96.7%), and vascular richness (82.0%). Conclusions: IM children present unique ultrasonographic characteristics of cervical lymph nodes, which may assist in the early and timely diagnosis of pediatric IM in clinical practice.

Aims: A computer-aided diagnosis (CAD) system for automated evaluation of developmental dysplasia of the hip (DDH) via ultrasound, integrating Deep Learning (DL) for anatomical segmentation and performing α&β angle calculations utilizing the Graf Method is presented. A custom image processing method excludes the inferior ilium's curvature during the baseline definition, enhancing accuracy and replicating radiologists' real-world workflow.

Materials and methods: Our dataset comprised 452 raw images from 370 newborns. For {'validation'+"test"}, {'nv=91'+"nte=45"}≡136 images were reserved (never augmented). Remaining 316 images were augmented to ntr=632 with (0%↔25%) random brightness manipulation for training. Totally (632+136)=768 images were annotated and split with the following true numbers and percentage: {'train',"validation",test}≡{'632',"91",45}≡{'82%',"12%",6%}. U-Net, MaskR-CNN, YOLOv8 and YOLOv11 were used for segmentation. α&β were measured using Method-I (centroid/orientation) and Method-II (Hough transform). An extended set of performance metrics-Precision, Recall, IoU, Dice, mAP-was calculated. Bland-Altman and Intraclass Correlation Coefficient (ICC) analyses compared CAD outputs with expert measurements.

Results: YOLOv11 showed the best segmentation performance (Precision:0.990, Recall:0.993, IoU:0.983, Dice:0.990, mAP:0.991). {ICCα, ICCβ} calculated using Method-I and Method-II were {0.895, 0.907} and {0.929, 0.952}, respectively, with Method-II outperforming Method-I.

Conclusion: A clinically-aligned-CAD-system that integrates anatomical segmentation and α&β measurement-a combination rarely addressed in literature is introduced. By providing a comprehensive and standardized set of metrics, this work overcomes a common bottleneck in DL studies, namely heterogeneity in metric reporting, enabling better cross-study comparisons. Following curvature exclusion, obtained ICCs outperformed previous studies, demonstrating improved inter-rater reliability and strong agreement with expert radiologists, offering both technical robustness and clinical applicability in DDH assessment.

Shear-Wave Elastography (SWE) has emerged as a promising non-invasive imaging technique for assessing the mechanical properties of tendons, particularly larger and more superficially located tendons of the body. Despite its potential, significant variability in SWE measurements exists due to differences in protocols, positioning, and equipment. Standardizing these factors, enhancing operator training, and reporting reliability metrics are crucial to improve the consistency and comparability of SWE data. This review aims to synthesize current knowledge and report on the existing practices in tendon SWE. By addressing the current challenges and variability, SWE has the potential to become a reliable tool for diagnosing and monitoring tendon pathologies, ultimately enhancing patient care and outcomes.

Aims: To investigate the diagnostic value of ultrasound features with dual-phenotype hepatocellular carcinoma (DPHCC). Material and methods: A retrospective analysis was conducted on patients diagnosed with hepatocellular carcinoma (HCC) confirmed by pathology results from October 2016 to December 2023. Patients were categorized into DPHCC and non-DPHCC (NDPHCC) groups based on immunohistochemical findings. Clinical baseline characteristics and ultrasound features were compared between these groups. Multivariable logistic regression was employed to identify predictive factors. A logisticregression model and nomogram were developed to predict DPHCC.

Results: This study included 219 HCC patients (average age: 55.84±9.00, 173 males), with 61 cases of DPHCC and 158 cases of NDPHCC. The results of multivariate logistic regression indicated that halo sign (OR=1.93, p=0.049), PVP hypo-enhancement (OR=2.73, p=0.002) and nodule-in-nodule sign (OR=4.23, p=0.003) were independent predictors of DPHCC. The model's AUC value was 0.73 (95%CI: 0.65-0.80). The calibration curve displayed good predictive accuracy.

Conclusions: Ultrasound features, including CEUS, may provide additional information for the non-invasive diagnosis of DPHCC.

Aims: To evaluate important imaging findings and prognostic factors of incidentally detected gallbladder cancer (IDGC). Materials and methods: Patients with surgically proven IDGC (n=85) and benign GB diseases (n=100) were retrospectively enrolled. All patients had preoperative CT and eighty-two patients had US images. Two radiologists independently assessed image findings and analyzed findings suggestive of IDGC and recurrence after surgery. Univariate and multivariate analyses were performed to identify significant predictors for IDGC and recurrence.

Results: 87% (74/85) of IDGC belonged to early cancer. On US, mucosal irregularity (odds ratio (OR), 26.29; 95% confidence interval (CI), 2.66-259.42; p=0.005) was a significant predictor of IDGC. Enhancement pattern of wall (OR, 7.78; 95% CI, 2.84-21.39; p<0.001), and maximum wall thickness (OR, 1.31; 95% CI, 1.11-1.55; p=0.002) were significant predictors of IDGC on CT. Twenty-two patients showed recurrence. For clinical factors, T-, N-stage were associated with recurrence (p<0.001). For imaging, focal wall thickening (OR, 8.74; 95% CI, 1.13-67.49, p=0.038) on US and lymph node enlargement (LNE) (OR, 8.93; 95% CI, 1.44-55.19, p=0.018) on CT were significant predictors of recurrence.

Conclusion: Image findings are useful to predict IDGC using mucosal disruption, maximum wall thickness, enhancement pattern of wall. In addition, focal wall thickening and LNE were useful for predicting recurrence.

Aim: This study aimed to compare the diagnostic performance,  interobserver reliability, and practical utility of two lacrimal gland ultrasound (LGUS) scoring systems - LGUS score I, a complex multi-parameter score, and LGUS score II, a simplified single-parameter score - for diagnosing primary Sjögren's syndrome (pSS). The additional role of two-dimensional shear wave elastography (2D-SWE) in assessing lacrimal gland stiffness was also evaluated.

Material and methods: This observational, cross-sectional study included 35 pSS patients and 35 age- and sex-matched healthy controls. LGUS score I incorporated four grey-scale ultrasound parameters, while LGUS score II relied solely on glandular homogeneity. Both scoring systems were evaluated for diagnostic accuracy and interobserver agreement. SWE measurements of lacrimal gland elasticity were also recorded and compared between groups.

Results: LGUS score II achieved diagnostic performance comparable to LGUS score I, with areas under the curve (AUC) of 0.831 and 0.829, respectively (p=0.961). Sensitivity was higher for LGUS score II (94.29%) than for LGUS score I (85.70%), with both scores demonstrating identical specificity (68.57%). Interobserver agreement was good for LGUS score II (κ=0.707) and moderate for LGUS score I (κ=0.553). SWE measurements showed no significant differences in mean elasticity values between the pSS and control groups (8.78±2.03 kPa vs. 9.27±2.07 kPa, p=0.158).

Conclusion: LGUS score II (glandular homogeneity) offers a reliable, time-efficient diagnostic approach for pSS, providing similar accuracy to the more complex LGUS score I with enhanced interobserver reliability, while the potential of 2D-SWE remains limited by methodological inconsistencies and requires further standardization.