Journal of Ultrasound in Medicine最新文献

{"title":"Refining the Accuracy of Pelvic Free Fluid Estimation in Pediatric Trauma","authors":"Liying Zheng MBBS","doi":"10.1002/jum.16677","DOIUrl":"10.1002/jum.16677","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573312","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":"Web-Based Deliberate Practice of Pediatric Point-of-Care Ultrasound Cases in Resource-Limited Settings","authors":"Angelo Ricci BCom, MMASC,&nbsp;Daniel Lindsay BSc,&nbsp;Carla Schwanfelder MD,&nbsp;Erin Stratta MD,&nbsp;Michelle Lee MD,&nbsp;Kathy Boutis MD, MSc","doi":"10.1002/jum.16679","DOIUrl":"10.1002/jum.16679","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The main objective of this study was to implement an online pediatric case-based point-of-care ultrasound (POCUS) course in low-resource medical settings and examine learning outcomes and feasibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a multicenter prospective cohort study conducted in a convenience sample of clinicians affiliated with Médecins Sans Frontières (MSF) training sites. MSF POCUS trainers provided the standard hands-on, on-site POCUS training and supplemented this with access to a web-based course. Participants provided diagnoses for 400 image-based POCUS cases from four common pediatric POCUS applications until they achieved the mastery learning standard of 90% accuracy, sensitivity (cases with pathology), and specificity (cases without pathology). Each participant also completed a course evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 10 MSF sites, 110 clinicians completed 82,206 cases. There were significant learning gains across the POCUS applications with respect to accuracy (delta 14.2%; 95% CI 13.1, 15.2), sensitivity (delta 13.2%; 95% CI 12.1, 14.2), and specificity (delta 13.8%; 95% CI 12.7, 15.0). Furthermore, 90 (81.8%) achieved the mastery learning standard in at least one application, and 69 (62.7%) completed a course evaluation on at least one application for a total of 231 evaluations. Of these, 206 (89.2%) agreed/strongly agreed that the experience had relevance to their practice, met expectations, and had a positive user design. However, 59/110 (53.6%) clinicians reported a lack of protected time, and 54/110 (49.0%) identified challenges with accessing internet/hardware.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In resource-limited MSF settings, implementing web-based POCUS case practice demonstrated successful learning outcomes despite approximately half of the participants encountering significant technical challenges.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 7","pages":"1231-1244"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573317","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":"Ventricular Free Wall and Septal Wall Displacement of the Fetal Heart","authors":"Greggory R. DeVore MD,&nbsp;Berthold Klas BS,&nbsp;Gary Satou MD,&nbsp;Mark Sklansky MD","doi":"10.1002/jum.16673","DOIUrl":"10.1002/jum.16673","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The purpose of this study was to measure the systolic displacement of the free and septal walls of the right (RV) and left (LV) ventricles using speckle tracking analysis in normal fetuses and those with cardiac abnormalities.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Two-hundred fetuses between 20 and 40 weeks of gestation were examined in which the 4-chamber view (4CV) of the fetal heart was imaged. Speckle tracking analysis of the RV and LV was used to measure the length of displacement between end-diastole and end-systole for each of 24 segments located on the free and septal walls from the base to the apex of each ventricle. The mean displacement length was computed for the base (segments 1–8), mid-chamber (segments 9–16), and the apex (segments 17–24) of the RV and LV free walls (RVfw, LVfw) and septal walls (RVsw, LVsw). Fractional polynomial regression analysis was used to compute the mean equation for the base, mid-chamber, and apex displacement lengths for the RV and LV free walls and septal walls using gestational age as the independent variable. The Kruskal–Wallis test with a Bonferroni correction was used to compare the mean values from the base, mid-chamber, and apex segments between the RVfw versus RVsw, LVfw versus LVsw, RVfw versus LVfw, and RVsw versus LVsw. In addition, the ultrasound program provided a graphic of the systolic segment length of the RV and LV free walls and septal walls. Four examples of cardiac pathology were used to illustrate abnormal free and septal wall segment displacement.&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;The mean segment end-systolic displacement lengths for the RVfw (base and mid-chamber), and LVfw (base, mid-chamber, and apex) increased with gestational age. However, The RVsw and LVsw segment lengths did not increase or increased minimally as a function of gestational age. The displacement lengths for the RVfw versus RVsw and LVfw versus LVsw were greater for the free wall than the septal wall for the base, mid-chamber, and apex. When comparing the RV with the LV, the segment lengths for the RVfw were significantly greater than the LVfw for the base. The segment lengths were significantly greater for the LVsw than the RVsw for the base, mid-chamber, and apex. The LVsw segments moved inward toward the LV chamber for the mid-chamber and apex. For the RVsw, the segment lengths moved between both the RV and LV chamber during systole. Four pathological cases graphically illustrated abnormal movement of the RVfw, LVfw, RVsw, and LVsw.&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;Speckle tracking analysis enabled quantitation of the systolic ve","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 7","pages":"1185-1200"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573315","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":"Thoracic Ultrasound in Pediatric Chest Trauma","authors":"Evangelia E. Vassalou MD, PhD,&nbsp;Iraklis Perysinakis MD, PhD,&nbsp;Eelco de Bree MD, PhD,&nbsp;Maria Raissaki MD, PhD","doi":"10.1002/jum.16672","DOIUrl":"10.1002/jum.16672","url":null,"abstract":"<p>Chest trauma in children may result in variable injuries. Although radiographs represent the mainstay modality for triage, ultrasound may prove to be a useful diagnostic tool, having the potential to supplement radiographic findings and tailor ionizing imaging. There is growing evidence demonstrating the high accuracy of ultrasound in assessing several conditions related to pediatric chest trauma. Familiarity with the scanning technique, together with an understanding of the sound properties of solid tissue, air, and fluid, is essential for image interpretation. Herein, we present tips regarding a detailed sonographic technique, landmarks relevant to normal anatomy, and abnormal findings encountered in children with accidental thoracic trauma.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 7","pages":"1291-1307"},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567482","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":"Pilot Study to Evaluate the Association Between Superb Microvascular Imaging (SMI) and Histologic Markers of Angiogenesis in Patients With Invasive Ductal Carcinoma","authors":"Yasemin Kayadibi MD,&nbsp;Osman Aykan Kargin MD,&nbsp;Seda Aladag Kurt MD,&nbsp;Tulin Ozturk MD,&nbsp;Mehmet Halit Yilmaz MD","doi":"10.1002/jum.16674","DOIUrl":"10.1002/jum.16674","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Increasing microvessel density and angiogenesis are linked to a poor prognosis in patients with invasive ductal carcinoma (IDC) of the breast. This study aims to investigate intratumoral and peritumoral microvascular flow using superb microvascular imaging (SMI) in patients with IDC and explore its association with histologic markers of tumoral angiogenesis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Fifty-four female patients with IDC (mean age 49.5 ± 14.8 years) were evaluated using SMI before biopsy. The quantitative and qualitative vascular parameters on SMI (Adler's classification, vascular index, morphology, distribution, and penetration) were assessed. Histologic markers of angiogenesis (VEGF, ERG, and CD34) were analyzed via immunohistochemical staining in both intratumoral and peritumoral compartments of biopsy specimens. The expression levels were categorized semi-quantitatively as low or high groups based on the Allred scoring system. The association between histological and SMI parameters was analyzed. Subgroup analysis was performed according to lesion size, axillary lymph node metastasis, and histological grade.&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;IDCs with higher expression of VEGF in the peritumoral region showed a higher vascular index (7 ± 6.4 [95% CI 5.2–8.8] versus 3.7 ± 0.9 [95% CI 2.3–5.2], &lt;i&gt;P&lt;/i&gt; = .003) on SMI. Likewise, high peritumoral ERG expression was linked to a higher vascular index (7.2 ± 6.3 [95% CI 5.4–9.0] versus 2.4 ± 1 [95% CI 1.1–3.8], &lt;i&gt;P&lt;/i&gt; &lt; .001), complex vessel morphology (66.7% versus 20%, &lt;i&gt;P&lt;/i&gt; = .024), penetrating vessels (63% versus 20%, &lt;i&gt;P&lt;/i&gt; = .037), and central vascularity (77.6% versus 20%, &lt;i&gt;P&lt;/i&gt; = .006). Tumors with higher intratumoral ERG expression demonstrated a more complex vessel morphology on SMI (85.7% versus 60%, &lt;i&gt;P&lt;/i&gt; = .047). The presence of axillary lymph node metastasis was associated with a higher vascular index (10 ± 7.6 [95%CI 6.7–13.2] versus 4.2 ± 3 [95%CI 3.1–5.3], &lt; .001), complex morphology (83.3% versus 53.3%, &lt;i&gt;P&lt;/i&gt; = .020), and penetrating vessels (63.2% versus 50%, &lt;i&gt;P&lt;/i&gt; = .027) on SMI, as well as higher peritumoral ERG expression (100% versus 83.3%, &lt;i&gt;P&lt;/i&gt; = .045).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In this pilot study, tumors with higher neo-angiogenic activity based on histological markers correlate with increased vascular index, complex vessel morphology, penetrating vessels, and central vascularity on SMI. Larger studies are needed to assess the diagnostic accuracy and utility of risk s","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 7","pages":"1201-1211"},"PeriodicalIF":2.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16674","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557145","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":"Isn't It Time for the Cardiac Sweep to Span From the Stomach to the Left Brachiocephalic Vein?","authors":"Oxana M. Zarudskaya MD, PhD,&nbsp;Erica Smith MD,&nbsp;Kam Szlachetka RDMS,&nbsp;Reem S. Abu-Rustum MD","doi":"10.1002/jum.16666","DOIUrl":"10.1002/jum.16666","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 6","pages":"1121-1124"},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542524","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 Levator Plate Architecture Is Altered in Women With Fecal Incontinence","authors":"Yael Baumfeld MD,&nbsp;Qi Wei PhD,&nbsp;Jittima Manonai MD, MHA,&nbsp;Jonia Alshiek MD, MSc,&nbsp;S. Abbas Shobeiri MD, MBA","doi":"10.1002/jum.16671","DOIUrl":"10.1002/jum.16671","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to assess the architecture of the levator plate and anal complex in women with fecal incontinence using 3-dimensional endoanal ultrasound (EAUS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study reviewed EAUS examinations performed on women with fecal incontinence. The anal complex and levator plate architecture were examined and compared to a control group of women without fecal incontinence. The anal canal was divided into 6 different areas, and the visibility of specific structures was recorded. Measurements of the external anal sphincter (EAS) length, levator plate length, and the distance between the EAS and the levator plate were taken.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 31 patients with fecal incontinence and 30 nulliparous controls. Significant differences were observed in the anal complex anatomy between the 2 groups. The fecal incontinence group had a higher prevalence of abnormal levator plate anatomy (84%) than the control group (3%). The EAS size was significantly smaller in the fecal incontinent group (16 versus 18 mm, <i>P</i> = .04), and there was a shorter distance between the EAS and the levator plate (22 versus 28 mm, <i>P</i> = .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Women with fecal incontinence exhibited significant changes in the anatomy of the anal canal, particularly in caudad structures of the anal sphincter complex. Additionally, a shorter distance between the levator plate and the EAS was observed in fecal incontinent patients. Sonographic assessment adds much to the evaluation of defecatory disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 7","pages":"1175-1183"},"PeriodicalIF":2.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542526","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":"Novel Three-Dimensional Printed Simulators for Ultrasound-Guided Prenatal Diagnostic Procedures","authors":"Nathan A. Keller MD,&nbsp;Allison E. Neuwirth MS,&nbsp;Frank I. Jackson DO,&nbsp;Insaf Kouba MD,&nbsp;Jolene Muscat MD,&nbsp;Luis A. Bracero MD,&nbsp;Matthew J. Blitz MD, MBA","doi":"10.1002/jum.16675","DOIUrl":"10.1002/jum.16675","url":null,"abstract":"<p>Amniocentesis and chorionic villous sampling (CVS) are essential ultrasound-guided diagnostic procedures in modern obstetrics, but their declining frequency poses challenges for clinician training. We present novel 3-dimensional (3D)-printed simulators designed to train practitioners in performing these procedures under ultrasound guidance. Our models combine 3D-printed components with medical gelatin to mimic the abdomen and pelvis of a pregnant patient. Customizable inserts enable realistic simulated needle targeting practice. This standardized, reproducible, and realistic training tool offers a valuable resource for improving ultrasound-guided procedural skills.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 7","pages":"1283-1290"},"PeriodicalIF":2.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542525","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":"Comparative Evaluation of Superb Microvascular Imaging and Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Differentiating Benign and Malignant Breast Masses","authors":"Ahmet Yasin Yitik MD,&nbsp;Nuran Sabir MD,&nbsp;Sevda Yılmaz MD","doi":"10.1002/jum.16664","DOIUrl":"10.1002/jum.16664","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Our study aims to compare the diagnostic performance of superb microvascular imaging (SMI) and dynamic contrast-enhanced magnetic resonance imaging (MRI) in differentiating benign from malignant breast masses, using histopathological findings as the reference standard.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective study was conducted from April 2022 to March 2024. A total of 112 breast lesions from 110 patients were evaluated using gray-scale ultrasonography, SMI, and dynamic contrast-enhanced MRI. The vascular index (VI) obtained during SMI examination and kinetic curve patterns from MRI were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Histopathological analysis revealed 62 benign and 50 malignant lesions. The VI showed a statistically significant difference between benign and malignant lesions, with a mean VI of 5.12 ± 4.66 in benign masses and 10.13 ± 5.48 in malignant masses (<i>P</i> &lt; .001). The ROC analysis demonstrated an AUC of 0.79 for SMI with a VI cut-off value of 4.15, yielding a sensitivity of 92%, specificity of 60%, and accuracy of 74%. A statistically significant correlation was found between VI values and MRI contrast enhancement kinetic curve types (<i>P</i> &lt; .05). MRI demonstrated superior diagnostic performance, with an AUC of 0.89 and sensitivity, specificity, and accuracy of 98, 80.65, and 88.39%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SMI, when used in conjunction with conventional ultrasonography and MRI, provides significant diagnostic value in differentiating benign from malignant breast masses. The study supports the potential integration of SMI into routine breast cancer diagnostic workflows, particularly in settings where MRI is less accessible.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 6","pages":"1047-1058"},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16664","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483572","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":"The Effect of Backscatter Anisotropy in Assessing Hepatic Steatosis Using Ultrasound Hepatorenal Index","authors":"Jing Gao MD,&nbsp;Ben Wilde DO,&nbsp;Oliver D. Kripfgans PhD,&nbsp;Johnson Chen MD,&nbsp;Jonathan M. Rubin MD, PhD","doi":"10.1002/jum.16669","DOIUrl":"10.1002/jum.16669","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To discuss challenges in assessing hepatic steatosis using ultrasound hepatorenal index (HRI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed HRI and liver magnetic resonance imaging-based proton density fat fraction (MRI-PDFF) in 134 adult participants (53 men and 81 women, mean age 55 years). The diagnostic performance of HRI for determining hepatic steatosis was tested by the area under the receiver operating characteristic curve (AUROC) using liver MRI-PDFF as the reference. Regression plots were employed to compare the sampling sites in liver and kidney that were used to calculate HRIs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 11 of 134 cases (8.2%), we failed to acquire HRI measurements. In the remaining 123 cases, AUROC for HRI (cutoff: 1.69 ± 0.13 [mean ± standard deviation]) for defining the HRI threshold for diagnosing hepatic steatosis was 0.83. In 60 of 123 cases (49%) with HRI measurement IQR/median &gt;0.3, slopes of the regression lines in the liver showed backscatter intensity changes consistent with signal attenuation. However, in the kidney, the backscatter intensity was inverted yielding position-dependent HRI cutoff values, mid-pole = 2.24 ± 0.20 and upper pole = 1.08 ± 0.16.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HRI is used to estimate liver steatosis based on backscattered ultrasound. In order to compensate for effects such as body habitus and transducer frequency, the liver backscatter is divided by backscatter from a corresponding region at the same depth in the right renal cortex. Theoretically, this compensation should make HRI sampling position independent. Yet, due to renal cortical backscatter anisotropy, this compensation method does not work in general, potentially producing inaccurate liver fat estimates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 6","pages":"1093-1101"},"PeriodicalIF":2.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458644","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}