Journal of Clinical Ultrasound最新文献

{"title":"Sonographic Diagnosis and Anatomic Mapping of a Radial Artery Pseudoaneurysm Following Transradial Cardiac Catheterization.","authors":"Michael F Franco, Marco Rizzo, James B Meiling","doi":"10.1002/jcu.70451","DOIUrl":"https://doi.org/10.1002/jcu.70451","url":null,"abstract":"<p><p>Radial artery pseudoaneurysm is a rare complication of transradial catheterization. We report a 74-year-old woman on rivaroxaban who developed a pulsatile distal forearm mass 1 day after transradial cardiac catheterization. High-frequency ultrasound showed a rounded extra-arterial lesion (7.6 × 8.9 × 7.0 mm) not involving all wall layers, with thrombus, a discrete communicating neck, turbulent bidirectional \"yin-yang\" color Doppler, and preserved distal flow. Anatomic mapping showed the lesion abutting adjacent tendons and the palmar cutaneous branch of the median nerve. Surgical excision and microscopic repair succeeded. Sonographic characterization provided anatomic detail that, with clinical and surgical assessment, informed individualized management.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contrast-Enhanced Ultrasound in the Diagnosis of Parotid Gland Castleman Disease in a Child.","authors":"Sruthilatha Sakthi Velavan, Shanelle De Lancy, Diane W Chen, Boaz Karmazyn","doi":"10.1002/jcu.70445","DOIUrl":"https://doi.org/10.1002/jcu.70445","url":null,"abstract":"<p><p>Castleman disease is a rare lymphoproliferative disorder that infrequently involves the parotid gland. We report a 16-year-old girl with a 3-year history of slowly progressive, painless right cheek swelling. CT and MRI showed an avidly enhancing, markedly T2-hyperintense parotid lesion, suggesting a vascular malformation; fine-needle aspiration yielded reactive lymphoid tissue. Contrast-enhanced ultrasound (CEUS) demonstrated rapid, intense, homogeneous enhancement, confirming a hypervascular solid mass rather than a vascular malformation and raising suspicion for Castleman disease. Superficial parotidectomy confirmed unicentric hyaline-vascular Castleman disease. CEUS aided differentiation of a hypervascular solid lesion from a vascular malformation and narrowed the differential.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Echocardiogram-Based Ultrasound Radiomic Model Predicts Recovery of Coronary Artery Diameter in Kawasaki Disease.","authors":"Guowen Liu, Yan Sun, Hongju Zhang, Jiao Yang, Liyuan Xu, Li Xue, Hongqiang Yin, Ning Ma","doi":"10.1002/jcu.70447","DOIUrl":"https://doi.org/10.1002/jcu.70447","url":null,"abstract":"<p><strong>Objective: </strong>To develop a predictive model based on echocardiogram-based ultrasound radiomic features for the recovery of coronary artery diameter in Kawasaki disease (KD) with coronary artery lesions (CALs).</p><p><strong>Methods: </strong>A total of 206 children with acute KD and left CALs who underwent coronary ultrasound before and 8 weeks after treatment were retrospectively enrolled. The patients were randomly divided into training and testing sets at a 7:3 ratio. Ultrasound radiomic features were extracted from regions of interest delineated along the coronary artery wall on pretreatment ultrasound images. Machine learning models based on five different algorithms, including logistic regression (LR), support vector machine (SVM), random forest, extra trees, and light gradient boosting machine (LightGBM), were established to predict the recovery of coronary artery diameter. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficiency of the models, and the area under the curve (AUC), sensitivity, specificity, and accuracy were calculated. Decision curve analysis (DCA) was used to evaluate the clinical benefits of the use of the models.</p><p><strong>Results: </strong>Based on Z score normalization of coronary artery diameters, diameters returned to normal in 77 patients in the training set and 37 in the testing set, whereas 67 and 25 patients, respectively, showed no such recovery after treatment. A total of 1562 ultrasound radiomic features were extracted; following the use of feature selection processes, 9 optimally performing features were employed for machine learning model development. The LightGBM model showed the best diagnostic performance, with an AUC, sensitivity, and specificity of 0.867 (95% CI: 0.811-0.923), 59.7%, and 97.0%, respectively, in the training set and of 0.857 (95% CI: 0.756-0.958), 86.5%, and 76.0%, respectively, in the testing set. DCA revealed that over a threshold range of 0.4 ~ 0.8, the model offers good clinical benefits.</p><p><strong>Conclusion: </strong>Machine learning models can predict the recovery of coronary artery diameter in KD and thus may offer important value for clinical decision-making.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contralateral-Normalized Renal Morphometric Ratios as Imaging Markers of Hydronephrosis Severity in Children Undergoing Pyeloplasty for Ureteropelvic Junction Obstruction.","authors":"Hasan Demirkan, Fatma Gül Demirkan","doi":"10.1002/jcu.70450","DOIUrl":"https://doi.org/10.1002/jcu.70450","url":null,"abstract":"<p><strong>Objectives: </strong>Contralateral-normalized renal morphometric measurements may provide individualized assessment of renal morphology in children with ureteropelvic junction obstruction (UPJO). We aimed to evaluate longitudinal changes in these ratios following pyeloplasty and investigate their associations with hydronephrosis severity and postoperative outcome.</p><p><strong>Methods: </strong>Sixty-one children undergoing pyeloplasty for unilateral UPJO were retrospectively evaluated. Affected-to-contralateral kidney length and parenchymal thickness ratios were calculated from preoperative and postoperative ultrasonographic measurements. Morphometric parameters were compared according to hydronephrosis severity and anatomical outcome.</p><p><strong>Results: </strong>Following pyeloplasty, the median affected-to-contralateral kidney length ratio decreased from 1.16 to 1.05 and the parenchymal thickness ratio increased from 0.43 to 0.78 (both p < 0.001), corresponding to median changes of -16.0 mm (IQR, -22.6 to -10.0) in AP diameter and + 3.0 mm (IQR, 1.25-4.65) in parenchymal thickness. Compared with Grade 3 hydronephrosis, Grade 4 disease was associated with a significantly lower preoperative parenchymal thickness ratio (0.39 vs. 0.80, p < 0.001) and a higher kidney length ratio (1.22 vs. 1.05, p = 0.004). The preoperative parenchymal thickness ratio showed good discriminatory performance for identifying Grade 4 hydronephrosis (AUC 0.816, 95% CI [0.687-0.945], p < 0.001). No statistically significant association between the morphometric ratios and postoperative anatomical outcome was demonstrated.</p><p><strong>Conclusions: </strong>The contralateral-normalized parenchymal thickness ratio was associated with hydronephrosis severity and increased significantly following pyeloplasty, supporting its potential role as an adjunctive ultrasonographic measure of morphological change. No statistically significant association with postoperative anatomical outcome was demonstrated; however, outcome analyses were limited by the small number of adverse events. Further studies are required to validate the clinical utility of these measurements.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ipsilateral Versus Contralateral Femoral Access for Inferior Epigastric Artery Embolization: Impact of Patient Age on Procedural Efficiency.","authors":"Claudio Carrubba, Ernesto Punzi, Felice D Antuono, Francesco Giurazza, Fabio Corvino, Francesco Pane, Noemi Brignola, Giulio Lombardi, Raffaella Niola","doi":"10.1002/jcu.70444","DOIUrl":"https://doi.org/10.1002/jcu.70444","url":null,"abstract":"<p><strong>Purpose: </strong>Abdominal wall hematomas (AWHs) are relatively uncommon causes of acute abdominal pain but may represent potentially life-threatening vascular emergencies, particularly in elderly patients receiving anticoagulant therapy or in the setting of significant hemorrhage. Transcatheter arterial embolization of the inferior epigastric artery is the recommended first-line therapy. The contralateral femoral approach may be technically demanding in elderly patients with iliac tortuosity, calcifications, or diffuse atherosclerosis. This bicentric retrospective study compared ipsilateral versus contralateral femoral access for inferior epigastric artery embolization, evaluating procedural efficiency, radiation exposure, and clinical outcomes.</p><p><strong>Material and methods: </strong>A bicentric retrospective study included 48 patients treated in emergency settings for epigastric artery bleeding between June 2022 and June 2025. Patients were divided into ipsilateral (n = 23) or contralateral (n = 25) femoral access groups, with further stratification by age (< 60 vs. ≥ 60 years). Technical and clinical success, total angiographic procedure duration, fluoroscopic dose (Air Kerma, mGy), access-site complications, transfusion requirements, rebleeding, and 30-day/3-month survival were analyzed. A subgroup analysis in patients ≥ 60 years (n = 33) assessed the impact of vascular anatomy on procedural metrics.</p><p><strong>Results: </strong>Technical success was 100% in both groups, whereas clinical success was comparable between the contralateral and ipsilateral groups (96.00% vs. 95.65%, respectively). In patients ≥ 60 years, ipsilateral access significantly reduced procedure time (27.90 ± 6.40 vs. 33.30 ± 8.30 min, p = 0.046) and radiation dose (254.00 [IQR 219.00-272.00] vs. 283.50 [IQR 248.80-310.80] mGy, p = 0.023). No major complications or significant between-group differences in rebleeding or survival were observed. In exploratory multivariable analysis, ipsilateral access was associated with lower Air Kerma (β = -56.43 mGy; 95% CI, -91.91 to -20.95; p = 0.002), whereas the adjusted estimate for procedure duration was less precise and did not reach statistical significance.</p><p><strong>Conclusions: </strong>Both femoral access routes are safe and effective. In patients aged ≥ 60 years, ipsilateral access was associated with shorter procedure duration and lower radiation exposure in unadjusted analyses. Exploratory adjusted analyses suggested an association between ipsilateral access and lower radiation exposure, whereas the adjusted association with procedure duration was not statistically significant. These findings require confirmation in larger prospective cohorts.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complementary Value of Multimodal Contrast-Enhanced Ultrasound in Serial Evaluation of Rapidly Progressive Infant Cardiac Fibroma: A Fatal Case Report and Literature Review.","authors":"Zehang Hu, Jin Yu, Jingjing Ye","doi":"10.1002/jcu.70408","DOIUrl":"https://doi.org/10.1002/jcu.70408","url":null,"abstract":"<p><p>Infant cardiac fibroma is a rare fatal myocardial tumor with infiltrative growth, hard to distinguish from rhabdomyoma via routine imaging. We report a 3-month-old male infant prenatally diagnosed with left ventricular fibroma, who died of irreversible heart failure after subtotal resection. Serial contrast-enhanced ultrasound (CEUS) combined with transthoracic echocardiography (TTE) provided complementary perfusion information: it guided surgical strategy, detected microscopic residual tumor undetectable on unenhanced ultrasound, and identified early subclinical left ventricular dysfunction. However, CEUS failed to reverse the fatal clinical trajectory. This case demonstrates the auxiliary value and key limitations of CEUS for infant cardiac tumor assessment.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Bedside Hemodynamic Assessment and Monitoring of Venous Congestion With Venous Excess Ultrasound (VExUS): A Narrative Review.","authors":"Lucia Colavolpe, Deborah Blanca, Piero Tarantini, Nicola Mumoli","doi":"10.1002/jcu.70443","DOIUrl":"https://doi.org/10.1002/jcu.70443","url":null,"abstract":"<p><p>This review evaluates the venous excess ultrasound (VExUS) score as a bedside tool for quantifying systemic venous congestion and predicting congestive end-organ injury, particularly acute kidney injury (AKI). By assessing flow patterns in the hepatic, portal, and renal veins alongside inferior vena cava (IVC) size, VExUS enables serial monitoring of congestion trajectories. While highly prognostic in heart failure, its predictive performance varies in more heterogeneous populations. Ultimately, integrating VExUS with cardiac output indices may help clinicians identify specific hemodynamic phenotypes, guiding targeted, individualized therapeutic strategies.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Ultrasonographic Appearance of an Atypical Tendinous Variant of Popliteal Artery Entrapment Syndrome in an Adolescent.","authors":"Zeqing Zhao, Xiao Yang, Wei Ye, Jianchu Li","doi":"10.1002/jcu.70441","DOIUrl":"https://doi.org/10.1002/jcu.70441","url":null,"abstract":"<p><p>A 15-year-old boy presented with left fifth-toe ulceration, claudication, and rest pain. Computed tomography angiography demonstrated proximal-to-mid popliteal artery occlusion. Duplex ultrasonography revealed thrombotic occlusion and a slender tendon crossing the artery, which appeared more conspicuous longitudinally than transversely. Magnetic resonance imaging showed apparent continuity with the main tendon of the medial head of the gastrocnemius, supporting an atypical variant of popliteal artery entrapment syndrome. Surgery was declined. At 3 months, the ulcer had healed, and symptoms improved during medical therapy, although perfusion indices remained abnormal. Longitudinal ultrasonography may facilitate delineation of slender compressive tendons.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound Features of Adolescent Cribriform-Morular Variant Papillary Thyroid Carcinoma and Its Association With APC Gene Syndrome: A Case Report.","authors":"Fangting Li, Ting Zhou, Qiongzhu Liu, Lingcui Meng","doi":"10.1002/jcu.70436","DOIUrl":"https://doi.org/10.1002/jcu.70436","url":null,"abstract":"<p><p>We report the case of a 16-year-old female with cribriform-morular variant of papillary thyroid carcinoma (CMV-PTC) and a confirmed germline APC mutation, with a history of childhood medulloblastoma consistent with Turcot syndrome Type 2. Ultrasound revealed bilateral, multifocal, predominantly hypoechoic nodules with mixed cystic-solid components and well-defined margins, without microcalcifications. The nodules grew rapidly over 2 years of surveillance, prompting total thyroidectomy. Histopathology confirmed bilateral CMV-PTC with capsular invasion. At age 19, the patient developed cervical lymph node and pulmonary metastases. Previous reports have described CMTC/CMV-PTC as presenting with bilateral or multifocal hypoechoic nodules, relatively well-defined margins, and infrequent microcalcifications. Recognition of these features in a young patient should raise consideration of an underlying APC-related syndrome and prompt genetic evaluation, even in the absence of a family history.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal Diagnosis of Pulmonary Arteriovenous Malformation With 3D/4D STIC Fetal Echocardiography.","authors":"Amit Kumar Pandey, Balu Vaidyanathan","doi":"10.1002/jcu.70404","DOIUrl":"https://doi.org/10.1002/jcu.70404","url":null,"abstract":"<p><p>Pulmonary arteriovenous malformation (PAVM) is a rare congenital vascular anomaly characterized by direct communication between the pulmonary artery and vein, resulting in a right-to-left shunt. Prenatal diagnosis remains uncommon. We report a fetal PAVM diagnosed at 21 weeks' gestation on fetal echocardiography. Color Doppler with graphic flow imaging demonstrated turbulent swirling flow within the right pulmonary vein, while spectral Doppler showed an arterialized pulmonary venous waveform. High-definition color Doppler and 3D/4D spatiotemporal image correlation (STIC) rendering confirmed a fistulous communication between the right pulmonary artery and vein. Prenatal recognition of PAVM is essential for serial surveillance, parental counseling, multidisciplinary perinatal planning, and early neonatal intervention.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}