Journal of Clinical Ultrasound最新文献

{"title":"Effectiveness of Lung Ultrasound in Diagnosing Pediatric Pneumonia and Outcomes in Implementation of Its Quality Control System","authors":"Linlin Zhang,&nbsp;Xinhua Sun,&nbsp;Chengbo Jin,&nbsp;Haiyuan Wu","doi":"10.1002/jcu.70309","DOIUrl":"10.1002/jcu.70309","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aims to investigate the effectiveness of lung ultrasound (LUS) in diagnosing pediatric pneumonia and the outcomes of implementing a “personnel-equipment-operation-interpretation-feedback” quality control system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study was made on 479 pediatric patients with suspected pneumonia. The LUS, chest digital radiography (DR), and chest computed tomography (CT) were performed on the patients, and the sensitivity, specificity, positive predictive value, and negative predictive value (NPV) of the three inspection methods were compared using comprehensive clinical diagnosis as the reference standard. In addition, a “personnel-equipment-operation-interpretation-feedback” quality control system of LUS was constructed and implemented in 412 cases, and the diagnosis accordance rate, image qualification rate, and operation standardization rate of LUS before and after implementation of the quality control system were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The sensitivity, specificity, and NPV of LUS for pediatric pneumonia were significantly higher than those of CT and DR, respectively (<i>p</i> &lt; 0.05). After implementation of the quality control system, the diagnosis accordance rate, image qualification rate, and operation standardization rate of LUS significantly increased compared with before implementation of the quality control system (<i>p</i> &lt; 0.05). In addition, after implementation of the quality control system, its main items were significantly improved compared with before.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LUS has good diagnostic effectiveness for pediatric pneumonia. The construction and implementation of this multidimensional LUS quality control system can effectively improve the accuracy and reliability of diagnosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":"54 8","pages":"1967-1972"},"PeriodicalIF":1.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295121","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":"Detection of Patent Foramen Ovale: Transcranial Doppler and Echocardiography Are Not Equivalent to Define a Large Shunt","authors":"Thomas Codant,&nbsp;Pauline Renou,&nbsp;Georgios Papaioannou,&nbsp;Jean-Benoît Thambo,&nbsp;Carine Boulon,&nbsp;Damien Barcat,&nbsp;Joël Constans,&nbsp;Loubna Dari","doi":"10.1002/jcu.70278","DOIUrl":"10.1002/jcu.70278","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The decision to close patent foramen ovale (PFO) depends on the size of PFO, the coexistence of interatrial septum aneurysm, and the importance of right-to-left shunt assessed by the number of bubbles on transcranial Doppler (TCD) and echocardiography after saline or glucose injection. The interventional threshold for the number of bubbles is considered to be the same for trans-thoracic and trans-esophageal echocardiography (TTE and TEE) and TCD. Our objective was to study whether the same thresholds can be used for TCD and echocardiography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>In this comparative, observational study, we modeled a linear relationship between the number of bubbles on TCD and echocardiography, which suggests a different threshold between TCD and TTE/TEE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found a systematic difference between TTE/TEE and TCD for the number of bubbles in the same patient. From linear regression, we found the following equation: TCD_Estimate = (7.2 (95% CI: −2.36–16.8) + (2.67 (95% CI: 1.85–3.49, <i>p</i> &lt; 0.001)) × <i>TTE/TEE</i>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Different thresholds for the decision to close a PFO should be used for both techniques: 20 bubbles for echocardiography and 60 bubbles for TCD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":"54 8","pages":"1836-1841"},"PeriodicalIF":1.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148042402","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":"Perinatal Outcomes of Placental Chorangioma: A Single Center Study","authors":"Tseten Zangmu Bhutia,&nbsp;Saritha Redishetty,&nbsp;Smita Pawar,&nbsp;Arati Singh,&nbsp;Geeta Kolar,&nbsp;Suseela Vavilala","doi":"10.1002/jcu.70301","DOIUrl":"10.1002/jcu.70301","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To determine the incidence of placental chorangioma and evaluate its associated perinatal complications and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>A retrospective observational study was conducted at Fernandez Hospitals, Hyderabad, India, from March 2011 to March 2025. All singleton pregnancies with structurally normal fetuses diagnosed antenatally with placental chorangioma and delivered at our center, with postnatal confirmation by histopathological examination (HPE), were included in the study. The diagnosis was made using B-mode ultrasound examination and color Doppler flow imaging, demonstrating a well-circumscribed hypo or hyperechoic placental mass with a clearly identifiable vascular supply. Demographic details, prenatal sonographic findings, perinatal and neonatal outcomes were collected from electronic medical records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 20 cases were included, with an incidence of 9.8 per 100 000 pregnancies. Large chorangiomas (≥ 4 cm) accounted for 90% of cases, while small chorangiomas (&lt; 4 cm) accounted for 10%. The mean gestational age at diagnosis was 27.65 ± 5.27 weeks. Sixteen cases (80%) were managed conservatively, while four cases (20%) required prenatal intervention. Polyhydramnios was observed in 12 (60%) fetuses and cardiomegaly in 5 (25%). Fifteen fetuses (75%) were appropriate for gestational age, four (20%) had fetal growth restriction, and one (5%) was large for gestational age secondary to hydrops. Eleven pregnancies (55%) resulted in preterm birth. Nine neonates (45%) required admission to the neonatal intensive care unit (NICU), and eight (40%) experienced adverse neonatal outcomes. No neonatal deaths occurred despite the predominance of large chorangiomas in the study population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Serial ultrasound surveillance with meticulous fetal assessment enabled early identification of asymptomatic chorangiomas and timely intervention when required, resulting in favorable perinatal outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":"54 8","pages":"1904-1911"},"PeriodicalIF":1.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239212","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":"Application Value of Lung Ultrasound in Children With Macrolide-Unresponsive Mycoplasma pneumoniae Pneumonia","authors":"Jie Zhou,&nbsp;Xinxin Guo,&nbsp;Rong Wu","doi":"10.1002/jcu.70293","DOIUrl":"10.1002/jcu.70293","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The incidence of macrolide-unresponsive <i>Mycoplasma pneumoniae</i> pneumonia (MUMPP) has markedly increased, primarily owing to resistance mediated by mutations in the pathogen's 23S rRNA gene. Because macrolide susceptibility testing is impractical at admission, this study aimed to delineate the clinical characteristics of MUMPP in children and to evaluate the predictive utility of laboratory parameters and lung ultrasound features for identifying MUMPP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was performed on 163 children hospitalized with <i>Mycoplasma pneumoniae</i> pneumonia (MPP) at the Department of Pediatrics, Ordos Central Hospital, from January 1, 2023, to December 31, 2024. Patients were stratified into the MUMPP group (<i>n</i> = 49) and the macrolide-sensitive <i>Mycoplasma pneumoniae</i> pneumonia (MSMP) group (<i>n</i> = 114) according to their response to macrolide antibiotics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with the MSMP group, patients in the MUMPP group were older, had longer hospital stays, and had higher body temperatures. <span>d</span>-dimer levels and neutrophil-to-lymphocyte ratios (NLRs) were elevated in the MUMPP group. On lung ultrasound, the MUMPP group exhibited larger areas of lung consolidation at admission and after treatment, higher rates of pleural effusion, greater bilateral pulmonary involvement, and a higher proportion of consolidations without air bronchograms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Children with MUMPP present with more severe clinical features and lung ultrasound manifestations than those with MSMP. Early initiation of non-macrolide alternative therapies is therefore critical for effective management of MUMPP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":"54 8","pages":"1876-1884"},"PeriodicalIF":1.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205253","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":"Diagnostic Accuracy of Shear Wave Elastography for the Assessment of Congestive Liver Disease in Patients With Structural Heart Disease","authors":"Edinéia Camargo Dziadzio,&nbsp;Maria Angelica Jungles Malikoski,&nbsp;Eduardo Henrique Bonotto,&nbsp;Sandra Monica Tochetto,&nbsp;Marco Stephan Lofrano-Alves","doi":"10.1002/jcu.70283","DOIUrl":"10.1002/jcu.70283","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Shear wave elastography (SWE) is widely used to assess liver stiffness in chronic liver disease. Increased stiffness may also occur in congestive liver disease (CLD) due to hepatic venous congestion in patients with cardiovascular disease, but data on its diagnostic performance remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the diagnostic performance of SWE for detecting CLD in outpatients with structural heart disease undergoing investigation for liver disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Consecutive patients referred for SWE between 2018 and 2023 were retrospectively reviewed. CLD was defined by compatible liver imaging findings and structural heart disease on transthoracic echocardiography. Diagnostic performance was assessed using ROC analysis. Associations between liver stiffness and echocardiographic parameters were evaluated using correlation and partial correlation analyses, and determinants of liver stiffness were assessed using multiple linear regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>About 88 patients were included (17 with CLD). Liver stiffness was higher in CLD compared with non-CLD patients (8.4 [7.5–9.6] vs. 7.2 [6.5–8.2] kPa, <i>p</i> &lt; 0.001). A cutoff &gt; 7.54 kPa yielded an AUC of 0.757, with 81.2% sensitivity and 63.4% specificity. CLD was associated with right ventricular dilation and greater tricuspid regurgitation severity. Significant correlations were observed with right ventricular diameter, pulmonary artery systolic pressure, right atrial volume, and left atrial volume index. In multiple linear regression, CLD remained the only independent determinant of liver stiffness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SWE shows moderate diagnostic accuracy for detecting congestive hepatopathy in patients with structural heart disease. Liver stiffness appears to reflect systemic venous congestion rather than isolated hepatic structural disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":"54 8","pages":"1867-1875"},"PeriodicalIF":1.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcu.70283","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Ultrasonographic Transcerebellar Diameter for Gestational Age Estimation: A Systematic Review and Meta-Analysis","authors":"Ammar Elgadi,&nbsp;Mohammed Wagealla,&nbsp;Elwalid Idris,&nbsp;Abdullatif Yasir H. Eissa,&nbsp;Sara Altraifi,&nbsp;Hajir Altraifi,&nbsp;Eman Abdallah,&nbsp;Tibyan Noorallah,&nbsp;Eltayeb AbdAlla","doi":"10.1002/jcu.70300","DOIUrl":"10.1002/jcu.70300","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Accurate estimation of gestational age (GA) is essential in prenatal care and assessment of perinatal outcomes. Standard dating methods such as last menstrual period (LMP) or conventional ultrasound biometry may be limited by fetal position, late antenatal booking, or intrauterine growth restriction (IUGR). The transcerebellar diameter (TCD) has been proposed as a robust alternative for GA estimation, particularly in late gestation or when other methods are unreliable. This study systematically evaluates the accuracy of TCD-based GA estimation in the second and third trimesters in both normal and IUGR pregnancies.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methodology&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We conducted a systematic review and meta-analysis in accordance with the PRISMA guidelines. Databases including PubMed, Scopus, and ScienceDirect were searched from inception through July 2025 for studies assessing the correlation between TCD and GA. Google Scholar was also searched for relevant articles. Inclusion criteria were original studies reporting correlation coefficients between TCD and GA determined by LMP or first-trimester ultrasound. Data extraction and risk of bias assessments were performed independently by two reviewers. Meta-analyses were conducted using random-effects models in R.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In this meta-analysis of 47 studies comprising 24 825 participants, the pooled correlation between TCD and GA was consistently strong. In the third trimester, &lt;i&gt;r&lt;/i&gt; = 0.94 (95% CI: 0.89–0.97); in the second trimester, &lt;i&gt;r&lt;/i&gt; = 0.93 (95% CI: 0.87–0.96); and across the combined second or third trimester, &lt;i&gt;r&lt;/i&gt; = 0.98 (95% CI: 0.97–0.98). This was comparable to other fetal biometric parameters: BPD (&lt;i&gt;r&lt;/i&gt; = 0.97), HC (&lt;i&gt;r&lt;/i&gt; = 0.97), FL (&lt;i&gt;r&lt;/i&gt; = 0.98), and AC (&lt;i&gt;r&lt;/i&gt; = 0.97), with no statistically significant differences in pairwise comparisons (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). In pregnancies affected by IUGR, TCD correlation with GA (&lt;i&gt;r&lt;/i&gt; = 0.94, 95% CI: 0.89–0.97) was significantly higher than that of other biometric measures: BPD (&lt;i&gt;r&lt;/i&gt; = 0.69), HC (&lt;i&gt;r&lt;/i&gt; = 0.72), FL (&lt;i&gt;r&lt;/i&gt; = 0.80), and AC (&lt;i&gt;r&lt;/i&gt; = 0.78) (&lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;TCD is a reliable and highly reproducible parameter for gestational age estimation, with strong correlations in late pregnancy. In pregnancies affected by IUGR, TCD was superior to other parameters. Its short learning curve and standardized methodology support its clinical utility as a complementary or primary tool for GA assessment, particularly in late pregnancy or when standard methods are limited","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":"54 8","pages":"1942-1956"},"PeriodicalIF":1.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264608","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-Based Evaluation and Diagnostic Discordance in Pediatric Thyroglossal Duct Cysts","authors":"Neslihan Gulcin,&nbsp;Cengiz Gul,&nbsp;Mehmet Arpacik,&nbsp;Semih L. Mirapoglu,&nbsp;H. Banu Zoroglu,&nbsp;Aytekin Kaymakci,&nbsp;Ceyhan Sahin","doi":"10.1002/jcu.70282","DOIUrl":"10.1002/jcu.70282","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ultrasonography is the first-line imaging modality for evaluating thyroglossal duct cysts (TGDCs); however, its diagnostic accuracy in differentiating TGDCs from other congenital midline cystic neck lesions remains limited. This study aimed to evaluate the concordance between preoperative clinical and ultrasonographic diagnoses and final pathological findings in pediatric patients with presumed TGDC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective single-center study included pediatric patients who underwent surgery for a presumed TGDC between January 2015 and December 2025. Preoperative diagnosis was based on combined clinical examination and ultrasonographic findings. Demographic characteristics, presenting symptoms, imaging findings, pathological diagnoses, and postoperative outcomes were analyzed. Ultrasound findings were retrospectively assessed using the SIST scoring system. Comparisons were performed between patients with pathologically confirmed TGDC and those with non-TGDC pathology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 42 pediatric patients were included; 78.6% were male, and the mean age was 5.97 ± 3.79 years. Final pathological examination confirmed TGDC in 32 patients (76.2%), whereas 10 patients (23.8%) had alternative diagnoses. Preoperative SIST scores were significantly higher in patients with TGDC than in those with non-TGDC pathology (<i>p</i> = 0.028). Despite preoperative findings suggestive of TGDC in all patients, a substantial rate of diagnostic discordance was observed. Postoperative outcomes were favorable, with low complication and recurrence rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Ultrasonography plays a central role in the evaluation of pediatric TGDC; however, it has limitations in accurately distinguishing TGDCs from other midline cystic lesions. Structured ultrasound-based scoring systems such as SIST may improve diagnostic confidence but cannot fully predict final pathology. Clinical and intraoperative findings should therefore be considered alongside imaging in surgical decision-making.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":"54 8","pages":"1860-1866"},"PeriodicalIF":1.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054762","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":"Correlation Between RVOT VTI Measured via a Modified Subcostal View and LVOT VTI in Critically Ill Patients","authors":"Issac Cheong,&nbsp;Matías Brizuela,&nbsp;Francisco Marcelo Tamagnone,&nbsp;Pablo Martín Merlo","doi":"10.1002/jcu.70280","DOIUrl":"10.1002/jcu.70280","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Assessment of cardiac output by transthoracic echocardiography in critically ill patients commonly relies on measurement of the left ventricular outflow tract velocity-time integral (LVOT VTI). However, obtaining an adequate apical view is not always possible in the intensive care unit. We evaluated whether right ventricular outflow tract velocity-time integral (RVOT VTI), obtained from a modified subcostal view, correlates with LVOT VTI and whether it can identify patients with normal LVOT VTI values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a post hoc analysis of a prospective diagnostic accuracy study performed in two mixed medical-surgical intensive care units. Adult patients admitted between January and April 2022 were included when both RVOT and LVOT Doppler measurements were feasible. RVOT VTI was measured using a modified subcostal approach, whereas LVOT VTI was obtained from the apical five-chamber view.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-three patients were analyzed. RVOT VTI showed a strong positive correlation with LVOT VTI (Spearman <i>r</i> = 0.72, <i>p</i> &lt; 0.0001). Bland–Altman analysis demonstrated a mean bias of −4.3 cm, with wide limits of agreement (−11.6 to +2.9 cm). The area under the receiver operating characteristic curve for predicting an LVOT VTI ≥ 17 cm was 0.934 (95% CI 0.815–0.970). An RVOT VTI &gt; 14.6 cm predicted LVOT VTI ≥ 17 cm with 80.7% sensitivity (95% CI 62.5%–92.5%) and 100% specificity (95% CI 73.5%–100%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RVOT VTI measured from a modified subcostal view may be a useful alternative when standard LVOT VTI assessment cannot be obtained in critically ill patients. Although both measurements should not be considered interchangeable, RVOT VTI may help identify normal forward flow and follow hemodynamic changes at the bedside.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":"54 8","pages":"1854-1859"},"PeriodicalIF":1.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054799","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":"Frontal Anteroposterior Diameter and Derived Ratios Between 18 and 38 Weeks: Normative Curves for Fetal Neurosonography","authors":"Daniela Rocha Ramos,&nbsp;Olívia de Mendonça e Morais,&nbsp;Nicoly de Oliveira,&nbsp;Liliam Cristine Rolo,&nbsp;Edward Araujo Júnior,&nbsp;Gustavo Yano Callado,&nbsp;Gabriele Tonni,&nbsp;Alberto Borges Peixoto","doi":"10.1002/jcu.70299","DOIUrl":"10.1002/jcu.70299","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To establish gestational age-specific reference curves for the frontal anteroposterior diameter (FAPD) and its derived ratios—FAPD to occipitofrontal diameter (FAPD/OFD), FAPD to head circumference (FAPD/HC), and FAPD to transverse cerebellar diameter (FAPD/TCD)—in structurally normal fetuses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective, cross-sectional study conducted in three fetal medicine centers in Brazil. Ultrasound images of 495 structurally normal singleton fetuses between 18 and 38 weeks of gestation were analyzed. FAPD was measured in the transventricular plane, and the FAPD/OFD, FAPD/HC, and FAPD/TCD ratios were calculated. Polynomial regression models were used to construct reference curves and percentiles. Correlations between biometric parameters and gestational age were assessed using Pearson or Spearman coefficients, as appropriate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A strong and statistically significant positive correlation was observed between FAPD and gestational age (<i>r</i> = 0.93, <i>p</i> &lt; 0.001; <i>R</i>² = 0.87), with an average increase of 1.215 mm per week. The FAPD/OFD and FAPD/HC ratios remained relatively stable across gestation, showing no significant correlation. In contrast, a moderate and significant inverse correlation was found between FAPD/TCD and gestational age (<i>r</i> = −0.64, <i>p</i> &lt; 0.0001; <i>R</i>² = 0.41). Reference values for the 5th, 50th, and 95th percentiles were established for all parameters throughout the studied gestational range.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The reference curves developed for FAPD and its derived ratios reflect normative frontal lobe growth patterns and provide a reliable framework for prenatal ultrasonographic assessment. The stability of FAPD/OFD and FAPD/HC, combined with the gestational decline in FAPD/TCD, underscores the importance of region-specific brain measurements. These curves may aid in the early detection of atypical neurodevelopment and support future population-specific research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":"54 8","pages":"1894-1903"},"PeriodicalIF":1.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148218130","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":"The Effectiveness of a First-Trimester Combined Screening Model for Risk Stratification of Preeclampsia (PE).","authors":"Narayanasamy Saranya, Vellathussery Chakkalakkoombil Sunitha, Bobby Zachariah, Gowda Mamtha","doi":"10.1002/jcu.70413","DOIUrl":"https://doi.org/10.1002/jcu.70413","url":null,"abstract":"<p><strong>Aim: </strong>To ascertain the effectiveness of a first-trimester combined screening model for risk stratification of preeclampsia (PE) in a south Indian population.</p><p><strong>Methods: </strong>One hundred and sixty pregnant women were screened at 11-14 gestation weeks with routine antenatal ultrasound, mean uterine artery pulsatility index (UtA PI), mean arterial blood pressure (MAP), and serum placental growth factor (PlGF) assessments. Sensitivity, specificity, area under the receiver operator characteristic (AUC) curves, and diagnostic accuracy were ascertained for 1 in 50, 1 in 100, and 1 in 150 cutoff criteria.</p><p><strong>Results: </strong>PE and gestational hypertension developed in 18 (11.6%, 95% CI: 7.47-19.67) and 10 (6.5%, 95% CI: 3.54-11.74) screened women, respectively. The first-trimester combined screening model identified 26 (16.77%), 34 (21.94%), and 38 (24.52%) screen-positive women using a 1 in 50, 1 in 100, and 1 in 150 cut-offs, respectively and had an AUC of 0.85 (95% CI: 0.76, 0.93). The detection rates, AUC, and odds ratio were higher with the 1 in 150 cut-off criteria than the 1 in 100 or 1 in 50 cut-off, but there was a slight decrease in the specificity and diagnostic accuracy.</p><p><strong>Conclusion: </strong>The first-trimester combined screening model at 11-14 weeks differentiated pregnant women at high risk for preterm PE in this population. A risk stratification cutoff of 1 in 150 had a better AUC than a 1 in 100 or 1 in 50 cutoff.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110228","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}