Journal of Ultrasound in Medicine最新文献

{"title":"Relationship Between Cumulative Fluid Balance and the Degree of Venous Congestion According to VExUS Score in Critically Ill Patients in a General Intensive Care Unit.","authors":"Carmelo José Espinosa-Almanza, Héctor Andrés Ruiz-Ávila, Juan Esteban Gomez-Tobar, Estivalis Acosta-Gutiérrez","doi":"10.1002/jum.16709","DOIUrl":"https://doi.org/10.1002/jum.16709","url":null,"abstract":"<p><strong>Objectives: </strong>The Venous Excess Ultrasound Score (VExUS) assesses venous congestion using point-of-care ultrasound. While validated to predict acute kidney injury, its relationship with cumulative fluid balance and clinical edema remains unclear. This study aimed to evaluate these associations 72 hours after intensive care unit (ICU) admission.</p><p><strong>Methods: </strong>This analytical observational cohort study included adult ICU patients with Foley catheters inserted at admission for fluid balance quantification. Patients on dialysis or with cirrhosis or abdominal hypertension were excluded. The correlation between cumulative fluid balance, edema clinical grade, and VExUS grade was analyzed. Multivariate analysis identified factors associated with significant venous congestion (VExUS grade ≥2), with statistical significance set at P < .05.</p><p><strong>Results: </strong>A total of 123 patients were included, with a mean age of 60 years (SD ±19.2); 59.3% were male. Venous congestion (VExUS grade ≥1) was observed in 36.5% of patients, despite an average cumulative fluid balance of +0.88 L. Each liter of positive cumulative fluid balance increased the risk of significant congestion (VExUS grade ≥2) by 31% (OR = 1.31; 95% CI: 1.07-1.60). The correlation between clinical edema (Godet scale) and VExUS grade was weak (Spearman rho = 0.27), and clinical edema was not associated with significant congestion (OR = 3.22; 95% CI: 0.77-13.56).</p><p><strong>Conclusions: </strong>In ICU patients, fluid overload is an early contributor to significant venous congestion (VExUS grade ≥2) but does not correlate with clinical edema grades, highlighting the limitations of clinical edema in assessing venous congestion.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078582","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":"Incidence and Diagnostic Performance of Postnatal Ultrasound for Presacral Masses in Pediatric Patients with Anorectal Malformation.","authors":"Takahiro Hosokawa, Yumiko Sato, Yutaka Tanami, Kyoichi Deie, Hiroshi Kawashima, Eiji Oguma","doi":"10.1002/jum.16724","DOIUrl":"https://doi.org/10.1002/jum.16724","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the incidence of presacral masses in patients with anorectal malformations (ARMs) and evaluate the diagnostic performance of ultrasound to detect presacral masses during the neonatal period.</p><p><strong>Methods: </strong>Pediatric patients with ARM underwent ultrasonography during the neonatal period, and their magnetic resonance imaging (MRI) results were reviewed. The presence or absence of a presacral mass was assessed employing ultrasonography and compared with MRI results using the Clopper-Pearson method. The type of ARM (low/not-low) and the presence or absence of sacral anomalies were compared between patients with and without a presacral mass using Fisher's exact test.</p><p><strong>Results: </strong>The incidence of presacral masses in our study cohort was 4.6% (5/109). Ultrasound diagnostic performance for detecting presacral masses had an accuracy of 98.2% (95% confidence interval (CI): 93.5-99.8), sensitivity of 60% (95% CI: 14.7-94.7), specificity of 100% (95% CI: 96.5-100), positive predictive value of 100% (95% CI: 29.3-100), and negative predictive value of 98.1% (95% CI: 93.4-99.8). ARM type and presence or absence of sacral anomalies were significantly different between the presacral mass and without presacral mass groups (low/not-low = 5/0 vs 47/57, P = .022; and presence/absence of sacral anomalies = 3/2 vs 18/86, respectively, P = .048).</p><p><strong>Conclusions: </strong>The incidence of presacral masses in pediatric patients with ARM was low (5%). Although the positive predictive value was reliable, ultrasonography performed during the neonatal period was not sensitive. Therefore, sonographers should pay attention when evaluating patients with low-type ARMs accompanying sacral anomalies to avoid overlooking them.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078581","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":"Advancing Testicular Trauma Diagnosis: Insights From CEUS and Biomarker Analysis in Animal Models and Future Directions.","authors":"Jingdan Cheng, Xiaohui Wu, Chengqiang Jin","doi":"10.1002/jum.16719","DOIUrl":"https://doi.org/10.1002/jum.16719","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028661","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":"Does Ultrasound Guidance Provide Pain Relief During Intrauterine Contraceptive Device Insertion? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Jan Bosteels, William Spratt, Ben W Mol","doi":"10.1002/jum.16720","DOIUrl":"https://doi.org/10.1002/jum.16720","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021156","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":"Reply to the Comments on \"The Effect of Backscatter Anisotropy in Assessing Hepatic Steatosis Using Hepatorenal Index\".","authors":"Jonathan M Rubin, Oliver Kripfgans, Jing Gao","doi":"10.1002/jum.16717","DOIUrl":"https://doi.org/10.1002/jum.16717","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989746","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":"Explore the Effect of Low-Intensity Focused Ultrasound on Pain Relief in Patients With Diabetic Peripheral Neuropathy: A Pilot Randomized Trial.","authors":"Xiaoru Zhang, Yan Wang, Wei Peng, Zhiping Liu, Limei Liu, Xinbin Han, Chenghai Li, Faqi Li, Qian Ge","doi":"10.1002/jum.16716","DOIUrl":"https://doi.org/10.1002/jum.16716","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the efficacy of low-intensity focused ultrasound (LIFU) in alleviating pain in patients with painful diabetic peripheral neuropathy (PDPN).</p><p><strong>Methods: </strong>Between November 2022 and January 2024, a total of 50 participants diagnosed with PDPN were randomly assigned to either LIFU therapy or placebo therapy. Pain levels were assessed using the numeric pain rating scale (NRS), while neuropathic symptoms and signs were evaluated using the neuropathy symptom score (NSS) and neuropathy deficit score (NDS), respectively. Motor and sensory nerve conduction velocities were measured via electromyography (EMG).</p><p><strong>Results: </strong>After 7 days of treatment, both groups exhibited a reduction in NRS compared to baseline; however, the LIFU group demonstrated significantly lower NRS scores than the placebo group (3.96 ± 1.07 versus 2.76 ± 1.79, P < .05). Additionally, significant improvements in neuropathic symptoms, as measured by NSS, were observed in the LIFU group post-treatment. Notably, LIFU therapy did not alter the conduction velocities or amplitudes of the bilateral peroneal, tibial, and sural nerves.</p><p><strong>Conclusions: </strong>LIFU therapy was effective in reducing pain and improving neuropathic symptoms in patients with mild-to-moderate PDPN. Future studies should further investigate the long-term effectiveness and sustainability of this novel therapeutic approach across diverse patient populations.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027224","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 Molecular Imaging With VEGFR2-Targeted Microbubbles to Evaluate Intrauterine Adhesion After Endometrial Injury and Monitor the Therapeutic Effects.","authors":"Likang Hou, Zhili Guo, Shun Liu, Xiaowen Liang, Meng Du, Zhiyi Chen","doi":"10.1002/jum.16710","DOIUrl":"https://doi.org/10.1002/jum.16710","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the severity of intrauterine adhesion (IUA) after endometrial injury via ultrasound molecular imaging (USMI) of vascular endothelial growth factor receptor 2 (VEGFR2) expression on the uterine endothelium.</p><p><strong>Methods: </strong>MB_VEGFR2 was constructed via \"biotin-avidin-biotin\" bridging technology. A rat IUA animal model was constructed via chemical injury. Fourteen days after the model was constructed, MB_Con and MB_VEGFR2 contrast agents were injected into the standard group and the model group of rats, and simultaneous ultrasound molecular imaging was carried out and ultrasound molecular imaging was performed and the changes in ultrasound signals in vivo were normalized to differential targeted enhancement (dTE). In addition, immunohistochemistry was used to detect the expression levels of VEGFR2 and α-SMA in the uterine tissues of the rats in both groups.</p><p><strong>Results: </strong>Targeted-VEGFR2 microbubble (MB_VEGFR2) was successfully constructed, the average particle size of the targeted VEGFR2 microbubble contrast agent was 2309.6 ± 234.3 nm, with the average zeta potential -16.9 ± 0.15 mV and the dispersity coefficient less than 0.4. In addition, its essential performance and biosafety were examined, which revealed that the MB_VEGFR2 contrast agent had an appropriate size, stable imaging performance, good target adhesion, and good biocompatibility. In vivo, ultrasound imaging results revealed that after the injection of the targeted MB_VEGFR2, the contrast ultrasound signal intensity of uterine tissues in the model group (62.5 ± 17.9 dB) was higher than in the normal group (33.5 ± 12.5 dB), and the difference was statistically significant (P < .05). The immunohistochemistry results revealed that the expression of VEGFR2 and α-SMA in the uterine tissue of the model group was greater than that in the standard group (P < .05), further indicating that the signal intensity of the MB_VEGFR2 contrast agent can reflect the expression level of VEGFR2 molecules.</p><p><strong>Conclusions: </strong>Ultrasound molecular imaging based on MB_VEGFR2 can be used to evaluate the expression level of VEGFR2 in uterine vascular endothelial cells. This provides a potential approach for the early diagnosis and treatment monitoring of intrauterine adhesions after endometrial injury.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017301","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":"\"Triangle Method\" for Evaluating the Morphological Characteristics of the Aortic Arch in Healthy Mid-to-Late Pregnancy Fetuses.","authors":"Pan Yang, Shi Zeng, Ganqiong Xu, Yushan Liu, Yang Yang","doi":"10.1002/jum.16711","DOIUrl":"https://doi.org/10.1002/jum.16711","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to apply the 2-dimensional grayscale ultrasound \"triangle method\" to evaluate the morphology of the aortic arch in healthy mid-to-late pregnancy fetuses.</p><p><strong>Methods: </strong>A total of 317 healthy singleton fetuses at 20-38⁺⁶ weeks of gestation were assessed. Using the long-axis view of the aortic arch, the \"triangle method\" was employed to measure the aortic arch length (sum of the 2 sides of a triangle), width, height, and angle. The aortic arch tortuosity (length/width) and height-to-width ratio were calculated. Healthy reference values for these morphological parameters were established, and their relationship to gestational age (GA) and cardiac valve annuli was explored.</p><p><strong>Results: </strong>The length, width, and height of the aortic arch in healthy mid-to-late pregnancy fetuses increased significantly with GA (P < .05). Instead, no significant correlation was observed between GA or cardiac valve annuli and the aortic arch angle, tortuosity, or height-to-width ratio (P > .05), whose corresponding reference values were 69.2 ± 6.1°, 1.7 ± 0.1, and 0.7 ± 0.1, respectively.</p><p><strong>Conclusions: </strong>The aortic arch angle, tortuosity, and height-to-width ratio in healthy mid-to-late pregnancy fetuses remain relatively stable during development.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027223","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":"Mechanosensitive Channels Mediate Pancreatic β Cells Reactive Oxygen Species Formation and Downregulation of Essential Genes During Therapeutic Ultrasound Treatment.","authors":"Mallory Brayer, Vesna Zderic, Aleksandar Jeremic","doi":"10.1002/jum.16712","DOIUrl":"https://doi.org/10.1002/jum.16712","url":null,"abstract":"<p><strong>Objectives: </strong>Type 2 diabetes is partially caused by insufficient pancreatic β cell insulin secretion. Previous studies show therapeutic ultrasound (TUS) evokes insulin secretion from β cells as a potential treatment for type 2 diabetes; however, how β cells sense TUS and the broad effects of this treatment on cells remain unknown. Here, we identified mechanosensitive channels (MSC) expressed by β cells and TUS-mediated gene downregulation and reactive oxygen species (ROS) formation.</p><p><strong>Methods: </strong>For all experiments, 1 W/cm² intensity and 800 kHz frequency TUS were continuously applied for 5 minutes with a 100% duty cycle. RNA and protein isolation of human pancreatic islets and the rat insulinoma INS 832/13 cell line were used for rtqPCR and western blot, respectively, to determine MSC expression. INS cells treated with MSC agonists and/or antagonists during TUS were visualized via fluorescent microscopy to track ROS formation. Using the same treatments, rtPCR analysis of INS insulin and IAPP encoding insulin and islet amyloid polypeptide (IAPP), respectively, was performed. TUS treatments were replicated in rats from which pancreatic sections were collected for immunohistochemistry analysis.</p><p><strong>Results: </strong>We found the expression of TRPV2, TRPV5, and piezo1 in human islets and INS cells. TUS increased ROS formation in INS cells compared to sham-treated controls (P < .0001); however, modulation of MSC mitigated this effect (P < .001). TUS decreased the expression of the genes insulin and IAPP in INS cells compared to sham-treated controls (P < .001 and P < .01, respectively); however, complete MSC inhibition reversed this effect (P < .01 and P < .05, respectively). In our rat model, pancreatic and duodenal homeobox 1 (PDX1) expression was decreased by TUS compared to sham-treated controls (*P < .05); however, TUS did not decrease insulin or IAPP levels (P > .05).</p><p><strong>Conclusion: </strong>We report the expression of TRPV2, TRPV5, and piezo1 in human and rodent pancreatic β cells that are implicated in both TUS-mediated ROS formation and the downregulation of essential β cell genes.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028662","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":"Study on ABUS Applicability for Rural Women With Low Health Resources in China-Large-Scale Population, Non-Opportunistic Screening.","authors":"Meili Niu, Jie Zheng, Xiaoyang Feng, Huijiao Yan, Mengmeng Jia, Shuzhen Qi, Youlin Qiao, Fanghui Zhao, Xiangxian Feng, Zhifang Li","doi":"10.1002/jum.16708","DOIUrl":"https://doi.org/10.1002/jum.16708","url":null,"abstract":"<p><strong>Objectives: </strong>Comparing the screening performance of different breast cancer screening methods and exploring the applicability of automated breast ultrasonography (ABUS) in rural areas with low health resources in China.</p><p><strong>Methods: </strong>Women aged 35-64 underwent hand-held ultrasonography (HHUS) and ABUS in Zezhou County, Jincheng City, Shanxi Province, China from 2018 to 2021. Additionally, women aged 45-69 were also screened with mammography (MG). We compared the 3 methods' cancer detection rates, diagnostic accuracy, and overall screening performance, stratified by age groups and breast density. The chi-square test was used to analyze indicators such as sensitivity, specificity, and referral rate.</p><p><strong>Results: </strong>The mean age of the 9100 women studied was 45 ± 6.42 years, and 25 cases of breast cancer were identified (2.72‰). The proportion of dense breasts is higher among women aged 45-64 years (67.52%). Compared to the non-dense breast group, the detection rate of breast cancer by MG is significantly reduced in the dense breast group (3.42‰ versus 1.97‰). The diagnostic accuracy rate of ABUS and HHUS for lesions is higher than that of MG (P < .05). The kappa coefficient indicates moderate agreement in diagnostic results between HHUS and ABUS. However, the agreement between HHUS/ABUS and MG is poor. There were no statistical differences in sensitivity and specificity among the 3 screening methods. The referral rate and NNR for ultrasound were lower than those for MG (P < .05), but there were no statistically significant differences between ABUS and HHUS.</p><p><strong>Conclusions: </strong>Among women with denser breasts, ultrasound has a higher diagnostic accuracy rate compared to MG, and it avoids unnecessary biopsies. Compared to HHUS, ABUS can diagnose malignant tumors more objectively and standardized.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063888","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}