Journal of Clinical Ultrasound最新文献

{"title":"An Ultrasound Image-Based Deep Learning Radiomics Nomogram for Differentiating Between Benign and Malignant Indeterminate Cytology (Bethesda III) Thyroid Nodules: A Retrospective Study.","authors":"Lichang Zhong, Lin Shi, Weimei Li, Liang Zhou, Kui Wang, Liping Gu","doi":"10.1002/jcu.24058","DOIUrl":"https://doi.org/10.1002/jcu.24058","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>Our objective is to develop and validate a deep learning radiomics nomogram (DLRN) based on preoperative ultrasound images and clinical features, for predicting the malignancy of thyroid nodules with indeterminate cytology (Bethesda III).</p><p><strong>Materials and methods: </strong>Between June 2017 and June 2022, we conducted a retrospective study on 194 patients with surgically confirmed indeterminate cytology (Bethesda III) in our hospital. The training and internal validation cohorts were comprised of 155 and 39 patients, in a 7:3 ratio. To facilitate external validation, we selected an additional 80 patients from each of the remaining two medical centers. Utilizing preoperative ultrasound data, we obtained imaging markers that encompass both deep learning and manually radiomic features. After feature selection, we developed a comprehensive diagnostic model to evaluate the predictive value for Bethesda III benign and malignant cases. The model's diagnostic accuracy, calibration, and clinical applicability were systematically assessed.</p><p><strong>Results: </strong>The results showed that the prediction model, which integrated 512 DTL features extracted from the pre-trained Resnet34 network, ultrasound radiomics, and clinical features, exhibited superior stability in distinguishing between benign and malignant indeterminate thyroid nodules (Bethesda Class III). In the validation set, the AUC was 0.92 (95% CI: 0.831-1.000), and the accuracy, sensitivity, specificity, precision, and recall were 0.897, 0.882, 0.909, 0.882, and 0.882, respectively.</p><p><strong>Conclusion: </strong>The comprehensive multidimensional data model based on deep transfer learning, ultrasound radiomics features, and clinical characteristics can effectively distinguish the benign and malignant indeterminate thyroid nodules (Bethesda Class III), providing valuable guidance for treatment selection in patients with indeterminate thyroid nodules (Bethesda Class III).</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110989","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":"A Novel Noninvasive Approach for Evaluating Suspicious Cervical Lymph Nodes in Papillary Thyroid Carcinoma-Superb Microvascular Imaging.","authors":"Li-Long Xu, Ling Zhou, Xiao-Li Yu, Shi-Yan Li","doi":"10.1002/jcu.24087","DOIUrl":"https://doi.org/10.1002/jcu.24087","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the diagnostic performance of superb microvascular imaging (SMI) versus color Doppler flow imaging (CDFI) and fine-needle aspiration thyroglobulin (FNA-Tg) in detecting indeterminate cervical lymph nodes (CLNs) in papillary thyroid carcinoma (PTC) patients.</p><p><strong>Methods: </strong>We prospectively analyzed clinical and imaging data from 74 PTC patients with indeterminate CLNs undergoing FNA biopsy and Tg measurement. Analyses included: (1) univariate comparison of benign versus malignant CLNs; (2) Spearman correlation between imaging features and pathological findings; and (3) receiver operating characteristic curve assessment of diagnostic accuracy.</p><p><strong>Results: </strong>Among 43 benign and 31 malignant CLNs, significant differences were observed in gender (p = 0.026), age (p = 0.041), FNA-Tg levels (p < 0.001), and diagnostic outcomes for CDFI (p = 0.001) and SMI (p < 0.001). FNA-Tg (r = 0.946), SMI (r = 0.707), and CDFI (r = 0.403) correlated with pathology (all p < 0.001). FNA-Tg showed superior accuracy (AUC = 0.977) versus SMI (AUC = 0.856) and CDFI (AUC = 0.704). SMI detected more vessels than CDFI in benign (2.00 vs. 1.00) and malignant nodes (3.00 vs. 2.00) (p < 0.001), with higher overall counts (2.53 ± 1.47 vs. 1.50 ± 1.13, p < 0.001).</p><p><strong>Conclusion: </strong>SMI outperformed CDFI in microvascular visualization for indeterminate CLNs in PTC. Although FNA-Tg remained the most accurate diagnostic method, SMI served as a valuable noninvasive alternative, especially when FNA-Tg was contraindicated or inaccessible.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110987","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":"Postpartum Ovarian Vein Thrombosis: A Case Report of Diagnosis and Conservative Management.","authors":"Zongyu Zhang, Jinshuang Song, Jinmao Xu, Hongping Zheng, Jinghua Liu","doi":"10.1002/jcu.24070","DOIUrl":"https://doi.org/10.1002/jcu.24070","url":null,"abstract":"<p><p>Ovarian vein thrombosis (OVT) is a rare form of venous thromboembolism that most commonly affects postpartum women. It typically presents with abdominal pain and fever, and is often diagnosed through imaging techniques such as Doppler ultrasound. However, in cases of postpartum abdominal pain with or without fever, in addition to ultrasound examination, pelvic CT or MRI should be considered to rule out the possibility of pelvic thrombosis, especially when ultrasound results are inconclusive. This case report discusses a 29-year-old woman who developed right OVT 3 days postpartum, despite initial negative ultrasounds. The diagnosis was confirmed through subsequent imaging, which revealed a dilated ovarian vein with thrombus extending into the inferior vena cava. The patient was successfully treated with low-molecular-weight heparin for anticoagulation and antibiotics. Early diagnosis and treatment significantly improved the clinical outcome, emphasizing the importance of timely management to prevent complications. OVT should be considered in the differential diagnosis of postpartum women with abdominal pain and/or fever.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101758","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 Ultrasound Diagnosis of Fetal Type IV Intrahepatic Portosystemic Shunt: A Rare Case Report.","authors":"Zixian Wei, Wenle Zhang, Zhibin Tan, Sufen Zhou","doi":"10.1002/jcu.23994","DOIUrl":"https://doi.org/10.1002/jcu.23994","url":null,"abstract":"<p><p>Fetal intrahepatic portosystemic shunt (IPSS) is a rare vascular anomaly that poses significant postnatal risks. Paul et al. classified congenital IPSS into four types: (I) a single large tube connecting the right portal vein to the inferior vena cava; (II) a localized peripheral shunt with communications in one hepatic segment; (III) an aneurysmal shunt; (IV) multiple diffuse communications in both lobes. We report a unique case of Type IV IPSS diagnosed at 29 weeks of gestation using prenatal ultrasound and Doppler imaging. The shunt was characterized by tortuous portal vein branches draining into hepatic veins, accompanied by fetal growth restriction and mild tricuspid regurgitation. This case highlights the value of detailed prenatal imaging for accurate diagnosis, classification, and perinatal planning. Early identification and close monitoring of fetal IPSS can optimize neonatal outcomes and guide postnatal interventions.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101896","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":"Case Report: Two Cases of Subclavian Artery Steal Syndrome due to Aneurysm Diagnosed by Ultrasound.","authors":"Yulian Yan, Rong Liu","doi":"10.1002/jcu.23995","DOIUrl":"https://doi.org/10.1002/jcu.23995","url":null,"abstract":"<p><p>This article describes two women with subclavian artery steal syndrome due to an aneurysm. Case 1 was a 48-yearyear-old woman who was found to have a 25 × 18 mm aneurysmal dilatation of the proximal segment of the right subclavian artery during a physical examination, followed by a finding of partial reversal of blood flow in the right vertebral artery, and Case 2 was a young woman who was found to have an aneurysmal dilatation of the descending aorta on a cardiac ultrasound, and then a passing look at the vertebral artery revealed systolic tangential traces in the right vertebral artery, and finally an aneurysm was confirmed in both cases by CTA. This case report discusses the causes, staging, and imaging presentation and diagnosis of subclavian aneurysms.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093864","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":"Fetal Presence in the Bladder Detected on Ultrasound: A Case Report.","authors":"Saeid Sadeghi Joni, Sedigheh Ramezani, Mohammad-Ali Mohammadi-Vajari, Alireza Karimi Nasab, Erfan Mohammadi-Vajari, Milad Arezoumand, Mahsa Motiei","doi":"10.1002/jcu.24066","DOIUrl":"https://doi.org/10.1002/jcu.24066","url":null,"abstract":"<p><p>Vesicouterine fistula is a rare kind of fistula with significant complications. In this report, we present a pregnant 39-year-old woman (gestational age: 20 weeks) who had symptoms of hematuria and abdominal pain. In the pelvic examination, she had some fetal tissue exiting from the cervix, leading to misdiagnosis of preterm labor. Further ultrasonographic examination showed that the fetus's body was detached from the head and moved through the fistula to the bladder. This case highlights the importance of assessing the bladder in women with a history of cesarean deliveries and hematuria, even while observing fetal tissue outside the cervix.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093866","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 Fusion Imaging-Assisted Percutaneous Microwave Ablation for Hepatic Focal Nodular Hyperplasia: Technical Feasibility and Therapeutic Outcomes.","authors":"Qiqi Liu, Shuang Liang, Huahui Liu, Liping Luo, Cai Hu, Shanshan Wu, Sainan Guan, Ronghua Yan, Erjiao Xu","doi":"10.1002/jcu.24019","DOIUrl":"https://doi.org/10.1002/jcu.24019","url":null,"abstract":"<p><p>This study retrospectively evaluated the effectiveness and safety of ultrasound (US) fusion imaging-assisted microwave ablation (MWA) for focal nodular hyperplasia (FNH) in 13 patients. The patients included seven with large nodules (≥ 50 mm) and six with small nodules (< 50 mm). Both technical success and efficacy rates were 100%, with no local tumor progression (LTP) or major complications observed during follow-up. There was no significant difference in efficacy and safety between the large and small nodule groups. Additionally, 42.9% (3/7) of large nodules were treated with a single antenna for MWA.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078285","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 Imaging and Guidance for Medial Meniscus Pathology: Myth or Reality?","authors":"Vincenzo Ricci, Antonio Corvino","doi":"10.1002/jcu.23915","DOIUrl":"https://doi.org/10.1002/jcu.23915","url":null,"abstract":"","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078294","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":"Twin Reversed Arterial Perfusion (TRAP) Sequence Phenotypes: A Comprehensive Visual Analysis.","authors":"Gabriele Tonni, Gianpaolo Grisolia, Giosuè Giordano Incognito, Waldo Sepulveda, Rodrigo Ruano, Edward Araujo Júnior, Marcio Fragoso Vieira, Mario Lituania","doi":"10.1002/jcu.23988","DOIUrl":"https://doi.org/10.1002/jcu.23988","url":null,"abstract":"<p><p>Twin reversed arterial perfusion (TRAP) sequence is a rare and severe complication of monochorionic twins, occurring in approximately 1 in 35 000 pregnancies. It is characterized by the presence of a severely abnormal, nonviable acardiac twin and a structurally normal pump twin, which sustains the circulation of both fetuses through abnormal vascular placental anastomoses. This pictorial essay aims to illustrate the sonographic and Doppler findings associated with TRAP sequence, emphasizing the diagnostic prenatal features. Typical findings include the absence of cardiac activity in the acardiac twin, structural anomalies such as acardia, acrania, underdeveloped upper body, and paradoxical reversed flow patterns in the umbilical artery. Early diagnosis and close ultrasound monitoring are crucial for selecting antenatal treatment, including expectant management and fetal intervention. By presenting illustrative cases, this article provides a comprehensive overview to bolster the understanding of the different associated phenotypes and recognition of TRAP sequence amongst clinicians and sonographers.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078281","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":"CONGENITAL MEGALOURETHRA: Lower Urinary Tract Obstruction With \"The Sandwich Sign\".","authors":"Ishita Agarwal, Akshatha Prabhu, Srishti Chandra, Shobhna Sengar, Anita Kaul","doi":"10.1002/jcu.24078","DOIUrl":"https://doi.org/10.1002/jcu.24078","url":null,"abstract":"<p><p>Congenital megalourethra is a rare disorder that causes functional urinary tract obstruction. A multigravida at 16 weeks' gestation referred for an abdominal cyst was found to have a large urinary bladder along with another dilated cystic structure between the fetal legs (sandwich sign), bilateral echogenic kidneys, and anhydramnios, features suggestive of congenital megalourethra. Medical termination of pregnancy was performed. The male abortus was noted to have a massively distended bladder and a dilated penile urethra. Another patient referred in view of suspected bladder outlet obstruction was diagnosed to have a megalourethra on imaging at our center using the sandwich sign. In severe oligohydramnios the \"sandwich sign\" helps in \"ruling in\" the diagnosis of megalourethra and ruling out the common differential diagnosis of a posterior urethral valve.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078309","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}