Journal of Ultrasound in Medicine最新文献

{"title":"Ultrasonographic Anatomy and Examination of the Subcutaneous Tissue (in Lymphedema).","authors":"Carmelo Pirri, Nina Pirri, Chiara Ferraretto, Lucia Petrelli, Veronica Macchi, Andrea Porzionato, Raffaele De Caro, Levent Özçakar, Carla Stecco","doi":"10.1002/jum.16742","DOIUrl":"https://doi.org/10.1002/jum.16742","url":null,"abstract":"<p><p>Lymphedema is the excessive accumulation of protein-rich lymphatic fluid within the (sub)cutaneous compartments. In recent years, ultrasound examination has emerged as an indispensable tool for its prompt diagnosis and management. This pictorial essay offers a focused review of the anatomical and histological features of the subcutaneous tissue, to provide better insight into understanding the sono-anatomy in lymphedema. By delineating distinct sono-histological patterns within the subcutaneous tissue (fluid, cobblestone, snowfall, lymphatic lakes and sclerotic), a streamlined and reproducible method is illustrated for optimal evaluation of lymphedema-related conditions that are often/otherwise subject to diagnostic inaccuracy in clinical practice.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285123","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":"Muscle Ultrasound: A Novel Noninvasive Tool for Early Detection of Developing Insulin Resistance and Lower Muscle Mass in Obesity.","authors":"Steven B Soliman, Olivia K Chugh, Jacob E Leuteneker, Becca Tuska, Wen Ye, Tao Zhang, Thomas Rode, Suzette M Howton, Eric D Buras, Jeffrey F Horowitz","doi":"10.1002/jum.16741","DOIUrl":"https://doi.org/10.1002/jum.16741","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the potential use of noninvasive muscle ultrasound (US) for detecting early-developing insulin resistance and lower muscle mass in adults with obesity.</p><p><strong>Methods: </strong>Twenty subjects with obesity, without type 2 diabetes mellitus or prediabetes (mean body mass index [BMI] 34.1 ± 3.1 kg/m², mean age 33 years, 65% male), and 5 healthy lean controls (mean BMI 21.7 ± 1.1 kg/m², mean age 27 years, 40% male) underwent US examinations of their deltoid and vastus lateralis muscles. Two trained research assistants each independently analyzed the 300 US images, blinded to subject demographics and study cohorts, measuring muscle echo intensity (MEI). In the obese cohort, peripheral insulin sensitivity was evaluated using hyperinsulinemic-euglycemic clamps, and dual-energy x-ray absorptiometry was performed to assess body composition and calculate sarcopenia indices. Statistical significance was defined as P < .05.</p><p><strong>Results: </strong>The obese cohort demonstrated significantly higher vastus lateralis and deltoid MEI (P < .001), with increased MEI effectively identifying insulin resistance and impaired insulin sensitivity. There was excellent interobserver agreement in MEI assessments for both the deltoid (95% confidence interval [CI] of intraclass correlation coefficient [ICC]: 0.96-0.997) and vastus lateralis muscles (95% CI of ICC: 0.986-0.999). Furthermore, MEI negatively correlated with muscle mass, as indicated by sarcopenia indices (r = -.76, P < .001), and did not positively correlate with BMI or body weight.</p><p><strong>Conclusions: </strong>Muscle US has the potential to be a simple, accurate, noninvasive, inexpensive, and radiation-free tool for detecting developing insulin resistance and lower muscle mass in at-risk individuals. This tool could have tremendous clinical impact by enabling earlier and more aggressive targeted interventions in metabolic and muscle dysfunction.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285122","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":"Unveiling the Potential and Pitfalls of Postnatal Ultrasound in Detecting Presacral Masses in Pediatric Anorectal Malformations.","authors":"Jingdan Cheng, Chengqiang Jin, Guodong Luo","doi":"10.1002/jum.16739","DOIUrl":"https://doi.org/10.1002/jum.16739","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266526","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":"\"Target Sign\" of Schwannoma on Contrast Enhanced Ultrasound.","authors":"Lu Yang, Li-Gang Cui","doi":"10.1002/jum.16737","DOIUrl":"https://doi.org/10.1002/jum.16737","url":null,"abstract":"<p><p>This case series investigates the \"Target sign\" in contrast-enhanced ultrasound (CEUS) of 11 pathologically confirmed schwannomas, characterized by early central hyperenhancement (mean TTP: 15.7 ± 3.2 s) surpassing peripheral regions (19.1 ± 2.8 s). CEUS demonstrated 100% detection of this sign, outperforming grayscale ultrasound (45%), correlating with histologic Antoni A (cellular) and B (myxoid) areas. Findings suggest CEUS improves diagnostic specificity for schwannomas, offering non-invasive microvascular mapping. Limitations include small sample size and retrospective design.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248524","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 Evaluation of the Fetal Tympanic Ring Using Transverse Transoccipital Ultrasonographic Sections: A Diagnostic Study.","authors":"Shanshan Wang, Mingli Wang, Ting Huang, Xiaoying Liu, Yuting Wan, Chenyang Zhao, Meng Zhou, Xu Li, Xuelei Li","doi":"10.1002/jum.16736","DOIUrl":"https://doi.org/10.1002/jum.16736","url":null,"abstract":"<p><strong>Objective: </strong>To establish normal fetal tympanic ring anterior-posterior diameter (TRAPD) references (12-31 + 6 weeks), analyze correlations with growth parameters, and validate TR's diagnostic utility for external auditory meatus (EAM) abnormalities.</p><p><strong>Methods: </strong>This retrospective study analyzed 722 fetuses (704 normal, 18 abnormal) undergoing prenatal ultrasound (July 2020-August 2024). TRAPD was measured via transverse transoccipital plane imaging. Normal group data were stratified by gestational age (GA) to develop TRAPD references. TRAPD trends and correlations with GA, biparietal diameter (BPD), head circumference (HC), and auricular dimensions (ear length [EL] and ear width [EW]) were analyzed. A predictive model for EAM abnormalities was constructed.</p><p><strong>Results: </strong>TRAPD increased nonlinearly with GA, stabilizing at 30 + 5 weeks. TRAPD correlated strongly with GA (r = 0.914), BPD (r = 0.893), EL (r = 0.904), and EW (r = 0.914; all P < .001). AUCs for TRAPD, EL, EW, and the combined model in predicting EAM anomalies were 1.000, 0.867, 0.922, and 1.000, respectively (99.78% accuracy). A bilateral TRAPD mean of <5.6 mm achieved 100% sensitivity and 99.8% specificity in diagnosing EAM anomalies at GA ≥22 weeks. All 15 EAM atresia cases lacked annular TR structure prenatally; three stenosis cases had TRAPD below the 1st percentile for GA-matched fetuses.</p><p><strong>Conclusions: </strong>TRAPD references and morphology enable reliable prenatal screening for EAM abnormalities, offering actionable clinical thresholds.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248525","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":"Visualization of the Fetal Corpus Callosum in Routine Second Trimester Screening Ultrasound Examinations.","authors":"Shehani Fernando, Ilona Lavender, Peter Coombs, Keith Van Haltren, Paul Lombardo, Melinda Goodyear, Daniel L Rolnik","doi":"10.1002/jum.16732","DOIUrl":"https://doi.org/10.1002/jum.16732","url":null,"abstract":"<p><strong>Objectives: </strong>The primary aim of this study was to determine the visualization rate of the corpus callosum (CC) in the mid-sagittal plane of ultrasound examinations performed between 18 and 22 weeks' gestation. The secondary aims were to compare this rate to that achieved 5 years earlier at the same center; assess the need for transvaginal ultrasound; identify fetal head positions most favorable for sagittal CC assessment; and evaluate the impact of maternal body mass index (BMI) and gestational age on CC visualization.</p><p><strong>Methods: </strong>A retrospective analysis of images from second trimester screening examinations of singleton pregnancies performed between January 2019 and June 2019 was undertaken. The mid-sagittal image of the CC was scored on a scale from 0 to 4, with one point assigned for the visualization of each anatomical part. A score of 4 indicated complete visualization, a score of 1 to 3 was considered partial visualization, and a score of 0 represented nonvisualization. The chi-squared test was used to compare the visualization rates to those achieved 5 years earlier and previously reported by our group.</p><p><strong>Results: </strong>A total of 999 second trimester screening examinations were included in the study. Complete CC visualization significantly improved from 71.3% at initial protocol implementation and training to 92.1% in the current study (P < .001). A transvaginal approach was required in 4.4% of cases. The craniocaudal fetal head position had the highest success rate (98.2%) for CC visualization. The odds of nonvisualization of the CC were 2.6 times higher before 20 weeks (7.4%) than at or after 20 weeks (3.0%) (odds ratio = 2.63, 95% confidence interval [1.20-5.76], P = .012). Higher maternal BMI (≥30.0 kg/m²) was associated with increased rates of nonvisualization in obesity classes I-III.</p><p><strong>Conclusion: </strong>Complete visualization of the CC in the mid-sagittal plane is achievable in routine second trimester morphology ultrasound examinations. Improvement in the quality of imaging is possible with a standardized protocol and training.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248526","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":"Letter to the Editor on \"Variability in Liver Size Measurements Using Different View Angles in Ultrasound Imaging\".","authors":"Hideaki Ishida, Hiroko Naganuma","doi":"10.1002/jum.16738","DOIUrl":"https://doi.org/10.1002/jum.16738","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225794","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":"Maternal Adiposity in the First Trimester Pregnancy as a Predictor of Gestational Diabetes Mellitus: A Prospective Cohort Study.","authors":"Nattraporn Srisovanna, Noppasin Khwankaew, Ninlapa Pruksanusak, Natthicha Chainarong, Thitima Suntharasaj, Chitkasaem Suwanrath, Savitree Pranpanus, Chusana Petpichetchian, Manaphat Suksai","doi":"10.1002/jum.16735","DOIUrl":"https://doi.org/10.1002/jum.16735","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the predictive ability of first-trimester ultrasound measurements of maternal adiposity for predicting gestational diabetes mellitus (GDM).</p><p><strong>Methods: </strong>Abdominal adiposity measurements by transabdominal ultrasound were performed, including subcutaneous fat thickness (SFT), visceral fat thickness (VFT), and preperitoneal fat thickness (PFT), measured at 3 specific regions: the umbilicus, suprapubic area, and anterior surface of the liver. Two additional values were calculated based on these measurements: total abdominal fat thickness (TAT), which was determined as the sum of SFT1 and VFT, and body fat index (BFI), which was calculated using the formula: BFI = PFT (mm) × SFT3 (mm)/maternal height (cm). Multiple logistic regression and receiver operating characteristic (ROC) analysis were used to evaluate the predictive ability.</p><p><strong>Results: </strong>A total of 330 pregnant women were enrolled with a prevalence of GDM of 23.0%. Multivariate logistic regression analysis showed that none of the fat parameters were significantly associated with GDM. However, for body mass index (BMI) ≥25 kg/m², only the BFI showed a statistically significant association with GDM (odds ratio [OR] 2.75 [1.54-4.92]), with an area under the ROC curve (AUC) of 0.677. In the subgroup with BMI < 23 kg/m², only SFT at the umbilicus was significantly associated with GDM (OR 3.21 [1.08-9.53]) using a cut-off value of ≥15.4 mm, with a sensitivity of 73.7%, a negative predictive value of 93.8%, and an AUC of 0.668.</p><p><strong>Conclusions: </strong>Both BFI and SFT at the umbilical region demonstrate moderate discriminatory predictive performance for this condition across BMI-stratified subgroups.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225795","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":"Construction of an Aggressiveness Diagnostic Model for Basal Cell Carcinoma Using Multimodal Ultrasound Features.","authors":"Ming-Chu Feng, Jian-Feng Liang, Yan-Xuan Chen, Jun-Ming Lu, Jing Wang","doi":"10.1002/jum.16734","DOIUrl":"https://doi.org/10.1002/jum.16734","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop a nomogram-based diagnostic model to assess basal cell carcinoma (BCC) aggressiveness by integrating clinical data and multimodal ultrasound imaging features, thereby establishing an evidence-based framework for clinical decision-making.</p><p><strong>Methods: </strong>A retrospective analysis of 120 pathologically confirmed BCC lesions (January 2017-December 2024) was conducted. Lesions were classified as high-risk BCCs (n = 30) or low-risk BCCs (n = 90) based on histopathology. Clinical and multimodal ultrasound features acquired using a 5- to 18-MHz linear array transducer were compared between groups. Logistic regression identified predictors of aggressiveness, and a nomogram was subsequently developed and validated.</p><p><strong>Results: </strong>Univariate analysis identified morphological configuration, infiltration level (IL), intralesional echoic pattern (IEP), distribution of hyperechoic foci, maximum infiltration depth (MID), and average elastic Young's modulus (Eave) as factors significantly associated with BCC aggressiveness (p < .05). Multivariate logistic regression analysis revealed that IL (p = .047), IEP (p = .020), MID (p = .047), and Eave (p = .023) were independent predictors of high-risk BCC. Receiver operating characteristic curve analysis demonstrated that the nomogram model exhibited robust predictive performance, with a concordance index (C-index) of 0.921 (95% confidence interval: 0.860-0.981).</p><p><strong>Conclusion: </strong>The multimodal ultrasound-based nomogram effectively predicts BCC aggressiveness, offering a noninvasive tool for clinical assessment and treatment planning.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216253","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":"Assessment of Ovarian Stiffness in Women With Polycystic Ovary Syndrome: A Tertiary Center Shear Wave Elastography Study.","authors":"Muradiye Yildirim, Sumeyya Duran Kaymak, Neval Cayonu Kahraman, Belgin Savran Ucok, Yaprak Engin-Ustun","doi":"10.1002/jum.16731","DOIUrl":"https://doi.org/10.1002/jum.16731","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate ovarian stiffness in polycystic ovary syndrome (PCOS) patients with and without metabolic syndrome (MetS) using acoustic pulse imaging.</p><p><strong>Methods: </strong>This case-control study was conducted in a tertiary center PCOS outpatient clinic. A total of 105 participants, 51 PCOS patients (20 MetS and 31 non-MetS) and 54 healthy women between the ages of 20 and 35 years, were included in the study. Laboratory and sonographic assessments were performed in the early follicular phase. The shear wave elastography (SWE) technique was used to measure ovarian tissue stiffness transvaginally.</p><p><strong>Results: </strong>Age and body mass index were found to be similar between PCOS and control groups. Mean SWE values were found to be 13.61 ± 2.2 kPa and 8.82 ± 1.62 kPa, in the PCOS and control groups, respectively; P < 0.001. The intraobserver intraclass correlation coefficient value for the mean SWE measurement (kPa) was found to be 0.811 (good reliability agreement). Using receiver operating curve analysis, an optimized cut-off point of SWE_mean 10.58 kPa was determined. Similar SWE values were found in PCOS subgroups with clinical and/or biochemical hyperandrogenism. In PCOS patients with and without MetS, SWE was 15.68 ± 1.36 kPa and 12.28 ± 1.50 kPa, respectively (P < 0.001). A moderate positive correlation was found with waist circumference, triglyceride and insulin resistance parameters, and a weak correlation was found with systolic and diastolic blood pressure.</p><p><strong>Conclusion: </strong>Ovulatory dysfunction and the fibroinflammatory environment in PCOS lead to quantitatively measurable changes in ovarian tissue elasticity. MetS exacerbates these changes. Ovarian elasticity values were found to be associated with clinical and laboratory markers.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199533","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}