Journal of Ultrasound in Medicine最新文献

{"title":"Diagnostic Performance of Different Examination Types and Learning Curves of Radiologists for 5G-Based Robot-Assisted Tele-Ultrasonography","authors":"Tian He,&nbsp;Kai-Feng Yang,&nbsp;Guo-Chao Song,&nbsp;Hui Liu PhD,&nbsp;Guang Xu,&nbsp;Jing Wan,&nbsp;Hui Zhao,&nbsp;Qiao Wang PhD,&nbsp;Chang Liu,&nbsp;Chong-Ke Zhao PhD,&nbsp;Yi-Feng Zhang PhD,&nbsp;Le-Hang Guo PhD,&nbsp;Li-Ping Sun PhD,&nbsp;Hui-Xiong Xu PhD","doi":"10.1002/jum.16638","DOIUrl":"10.1002/jum.16638","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the feasibility of remotely providing routine ultrasound (US) examinations to patients using a fifth-generation-based robot-assisted tele-ultrasonography (RATU) system in a real-world setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between September 2020 and May 2021, we conducted a prospective and large-scale study using the RATU system to provide US examinations for patients on a limited-source island locate. An on-site radiologist on the island performed US examinations, which served as the reference diagnosis. Five tele-radiologists then remotely conducted RATU examinations from Central Shanghai. We compared the diagnostic performance of the RATU examinations to that of the on-site US examinations. Additionally, we assessed the learning curves of the various tele-radiologists. We also distributed 2 questionnaires to evaluate the usefulness of the clinical application.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 770 patients were enrolled in the study with a mean age of 55.46 ± 15.02 years (ranging from 19 to 80 years). Out of the total, 501 patients were men, and 269 were women. Across all examination types, the diagnosis in 84.3% (649/770) of RATU examinations was consistent with the on-site US examination. The learning curve was not significantly different between tele-radiologists of different seniority. Furthermore, 86.6% (667/770) of participants accepted the RATU examination, and 97.5% (751/770) of patients were willing to pay a fair price.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RATU's diagnostic performance is still helpful for patients in remote areas, even though it may be slightly inferior to on-site US examination.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 4","pages":"747-758"},"PeriodicalIF":2.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007571","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":"Evaluating Bone Fracture Healing in a Rabbit Model Using Doppler Imaging Modes, Shear Wave Elastography, X-Ray, and Dual-Energy X-Ray Absorptiometry","authors":"Priscilla Machado MD,&nbsp;Rachel Blackman BS,&nbsp;Ji-Bin Liu MD,&nbsp;Colleen Dempsey EdD,&nbsp;Flemming Forsberg PhD,&nbsp;Traci Fox EdD","doi":"10.1002/jum.16652","DOIUrl":"10.1002/jum.16652","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study investigated methods of evaluating the bone fracture healing process using superb microvascular imaging (SMI; two modes color SMI [cSMI] and monochromeSMI [mSMI]), and shear wave elastography (SWE), relative to X-ray, dual-energy X-ray absorptiometry (DXA), and platelet endothelial cell adhesion molecule 1 (PECAM-1) also know as cluster of differentiation 31 (CD-31) staining in a rabbit model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This IACUC-approved study involved eight rabbits that underwent a bilateral fibula osteotomy and were followed for 7 or 21 days (Groups 1 and 2 with 4 rabbits in each). Ultrasound examinations using cSMI, mSMI, and SWE were performed on Days 0, 4, 7, 14, and 21 post-surgery. At the final time point, rabbits had X-ray imaging followed by euthanasia and DXA scan. Finally, the fracture areas underwent decalcification, and specimens were stained with CD-31 for pathological analysis. Ultrasound and X-ray findings were compared using ANOVAs or paired <i>t</i>-tests with CD-31 stains and DXA was used as a reference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Comparing SMI ultrasound images between the last time points for Group 1 (Day 7) and Group 2 (Day 21) showed no statistical significance difference for cSMI (<i>P</i> = .14) and mSMI (<i>P</i> = .06), similarly when compared with CD-31 stains there was no statistical significance difference for cSMI in Group 2 (<i>P</i> = .13). The SWE ultrasound images from the last time points in Groups 1 and showed no statistical significance difference (<i>P</i> = .33), the same results were then compared with DXA and also showed no statistical significance difference (<i>P</i> = .14). When comparing results of the X-ray images from the last time points for Groups 1 and 2 a statistical significance difference was found (<i>P</i> = .01), and when X-ray images were compared with DXA there was a statistical significance difference (<i>P</i> &lt; .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Compared with CD-31 stains cSMI on Day 21 was not statistically significant (<i>P</i> = .13). Results comparing SWE with DXA were also not statistically significant (<i>P</i> = .14). These results indicate the potential of using certain ultrasound imaging techniques to monitor the bone fracture healing process.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 5","pages":"927-933"},"PeriodicalIF":2.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16652","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007576","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":"Study of Histotripsy With Subsequent Heating on In Vitro VX2 Cancer Cells","authors":"Qizheng Dai PhD,&nbsp;Lisa X. Xu PhD,&nbsp;Aili Zhang PhD,&nbsp;J. Brian Fowlkes PhD","doi":"10.1002/jum.16649","DOIUrl":"10.1002/jum.16649","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Focused ultrasound has emerged as a precise and minimally invasive modality for effective cancer treatment. In this study, we propose a novel method that integrates the mechanical effects of focused ultrasound, known as histotripsy, with heating to enhance both the immediate and sustained cytotoxic effects on cancer cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our investigation focused on VX2 cancer cells in suspension, examining five experimental groups: blank control, negative control, heating alone, histotripsy alone, and histotripsy with subsequent heating. B-mode ultrasound imaging was utilized to visualize cavitation bubble cloud formation and its motion during histotripsy. The suspension was contained in individually sealed compartments obtained from bubble wrap (referred to as bubble wrap compartments) embedded within the agarose phantom. Residual living cells were examined immediately after treatment and cultured for 96 hours to analyze the growth patterns. Additionally, CFDA SE staining was employed to assess cell proliferation. Furthermore, both intracellular and extracellular heat shock protein 70 (HSP70) levels were measured to investigate the potential initiation of an immune response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The combination of histotripsy and subsequent heating significantly reduced the normalized concentration of living cells immediately after treatment. It also decreased the proliferation rate of residual cells compared with the other experimental groups. Histotripsy with subsequent heating also increased the generation and release of HSP70, which might potentially enhance an innate anti-tumor immune response in vivo.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Histotripsy and subsequent heating improved the immediate lethal impact on VX2 cancer cells and curtailed the proliferation of residual cancer cells in suspension. This study presents a promising strategy for cancer therapy in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 5","pages":"883-902"},"PeriodicalIF":2.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007684","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":"Sensitivity of Lung Point-of-Care Ultrasound (POCUS) to Predict Oxygen Requirements in Emerging Viral Infections","authors":"Daniel L. Theodoro MD,&nbsp;Di Coneybeare MD,&nbsp;Penelope Lema MD,&nbsp;Nicholas Renz MD,&nbsp;Laura Wallace MD,&nbsp;Enyo Ablordeppey MD,&nbsp;Sean Stickles MD,&nbsp;Alek Rosenthal MD,&nbsp;Ian Holley MD,&nbsp;Sirivalli Chamarti MD,&nbsp;Josie Acuña MD,&nbsp;James Patterson MD,&nbsp;Rachel Ancona PhD,&nbsp;Srikar Adhikari MD","doi":"10.1002/jum.16647","DOIUrl":"10.1002/jum.16647","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The prognostic characteristics of lung point-of-care ultrasound (L-POCUS) to predict respiratory decompensation in patients with emerging infections remains unstudied. Our objective was to examine whether scored lung ultrasounds predict hypoxia among a nonhypoxic, ambulatory population of patients with COVID-19.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a diagnostic case–control study. Three academic emergency departments across the United States collected a convenience sample of nonhypoxic subjects with COVID-19, scored subjects' hemithorax at 7 locations using lung ultrasound, and followed outcomes for 40 days. We defined cases as hypoxia (≤91% by pulse oxygenation) from 2 hours after index presentation to day 40. Follow-up was by telephone plus home pulse oximeter and by chart review. We conducted a logistic regression to test the association between L-POCUS scores and hypoxia. To evaluate lung ultrasound score prediction of a hypoxic event, we calculated sensitivity and specificity at optimal cut off scores and report receiver operating characteristic curve and area under the curve.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We enrolled 163 subjects but excluded 15 (3 duplicate entries; 12 lost to follow up). Median age was 41 years (interquartile range [IQR] 31–56); 83 (56%) were female, and median body mass index was 29 (IQR 25–35). We classified 47 of 148 as hypoxic cases (32%, 95% confidence interval [CI]: 25–40), leaving 101 controls. L-POCUS scores associated with hypoxia by logistic regression (odds ratio = 1.05, 95% CI: 1.02–1.08), with a 5% increase in odds of hypoxia for each 1-unit increase in L-POCUS score. The optimal cut-off score was 15 (sensitivity, 0.60; specificity, 0.73) and the area under the curve was 0·66 (95% CI 0·58–0·75). The correctly classified proportion was 69% (95% CI: 61–76).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among nonhypoxic COVID-19 patients, higher L-POCUS rubric scores were associated with hypoxia but no scoring threshold strongly predicts hypoxia at 40 days.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 5","pages":"869-881"},"PeriodicalIF":2.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007591","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 Erosion of Rabbit Liver Induced by Locally Injected Phase-Shift Acoustic Droplets and With Lauromacrogol","authors":"Hui Li MS,&nbsp;Qingyue Deng MS,&nbsp;Zhiping Cai BMed,&nbsp;Qin Wang BMed,&nbsp;Leidan Huang MD,&nbsp;Yuejuan Gao MD,&nbsp;Xiaoxiao Dong MD,&nbsp;Litao Sun MD,&nbsp;Zheng Liu MD","doi":"10.1002/jum.16650","DOIUrl":"10.1002/jum.16650","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Our previous studies have found that low-frequency, low-pressure, weakly focused ultrasound (FUS) can induce acoustic droplet vaporization (ADV) of perfluoropentane (PFP) droplets and result in localized liver and prostate tissue controllable cavitation resonance and mechanical damage. To further investigate the mechanical erosion induced by ultrasound and locally injected phase-shift acoustic droplets in rabbit liver.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The liver of each rabbit was treated with perfluoromethylcyclopentane (PFMCP) alone, FUS combined with PFMCP (FUS + PFMCP), and FUS combined with PFP (FUS + PFP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two-dimensional ultrasound images showed that immediately after the completion of FUS + PFP group treatments, a high echogenicity bubble cloud could be observed, while there were no significant differences in the PFMCP and FUS + PFMCP group before and after treatment. The liver necrotic area in the FUS + PFP group was 6.2 times that of the FUS + PFMCP group (<i>P</i> &lt; .05), whereas no liver necrosis was observed in the PFMCP group. At the same time, the number of vacuoles in the liver in the FUS + PFP group was approximately 70 times that of the FUS + PFMCP group (<i>P</i> &lt; .001), whereas no vacuoles were observed in the PFMCP group (<i>P</i> &lt; .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both FUS + PFMCP and PFMCP alone have poor mechanical erosion in liver tissue, and may even cause no damage. Only PFP droplets combined with FUS can cause significant mechanical destruction of liver tissue, leading to tissue necrosis in the droplet injection area.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 5","pages":"903-914"},"PeriodicalIF":2.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007689","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":"Relationship Between Carotid Artery Remodeling Characteristics and Early Carotid Atherosclerosis","authors":"Yujia Yang MD,&nbsp;Yang Hua MD,&nbsp;Lingyun Jia MD, PhD","doi":"10.1002/jum.16651","DOIUrl":"10.1002/jum.16651","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study analyzed carotid artery remodeling characteristics in early carotid atherosclerosis (ECAS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The 1021 participants were evaluated using ultrasonography and categorized into three groups: Group A, 391 participants with increased intima-media thickness (IMT); Group B, 300 participants with atherosclerotic plaque only on the carotid bulb (CB); and the control group (330 participants). The ratios of the diameters in the CB to those in the common carotid artery (<i>D</i>_CCA) and internal carotid artery (<i>D</i>_ICA) were defined as carotid index1 (CI₁) and 2 (CI₂).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Group A had a higher <i>D</i>_CCA, <i>D</i>_CB, and CI₂ than the controls (<i>P</i> &lt; .05). Group B had a smaller <i>D</i>_CB, CI₁, and CI₂ than Group A, and higher <i>D</i>_CCA and smaller CI₁ than the controls (<i>P</i> &lt; .05). Logistic regression showed that CI₂ was a positive influencing factor for increased IMT (OR: 3.42, 95% CI: 1.74–6.70, <i>P</i> &lt; .001), and CI₁ was a negative independent factor for CB plaque formation (OR: 0.11, 95% CI: 0.04–0.28, <i>P</i> &lt; .001). Multiple linear regression showed that only in Group B, the vessel side had a significant influence on CI₁ (<i>β</i> = 0.055, <i>P</i> &lt; .05), while age, sex, body mass index, and cerebrovascular risk factors had no significant correlation with CI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The CB and common carotid artery showed positive remodeling with increased IMT, however, the CB showed negative remodeling with plaque formation. CI changes were consistent with CB remodeling. CI was an independent influencing factor for ECAS, and it was only affected by vessel side, providing an objective predictive parameter for ECAS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 5","pages":"915-925"},"PeriodicalIF":2.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16651","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007578","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":"Fetal Corpus Callosum Anomalies","authors":"Valeria Lanzarone MD,&nbsp;Elisenda Eixarch MD, PhD,&nbsp;Antoni Borrell MD, PhD","doi":"10.1002/jum.16639","DOIUrl":"10.1002/jum.16639","url":null,"abstract":"<p>Anomalies of the corpus callosum (CC) are amongst the most common fetal Central Nervous System (CNS) anomalies detectable on ultrasound. Underlying genetic disease plays an important part in defining prognosis. Associations with aneuploidy and submicroscopic chromosomal deletions or duplications have been well demonstrated using chromosomal microarray analysis. Next-generation sequencing techniques such as exome sequencing, have revolutionized the ability to detect monogenic disease in these fetuses. In the context of important recent publications on exome sequencing in prenatal populations, an updated review of genetic testing options in CC anomalies is presented.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 4","pages":"637-652"},"PeriodicalIF":2.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16639","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007577","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":"Influence of Ventilatory Support Intensity on Respiratory Muscle Ultrasonography Evaluation","authors":"Lydia Magdy Milad MD,&nbsp;Mina Adolf Helmy MD","doi":"10.1002/jum.16648","DOIUrl":"10.1002/jum.16648","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 5","pages":"965"},"PeriodicalIF":2.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971367","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 Performance of O-RADS US (Version 2019 and Version 2022) Incorporating Acoustic Shadowing by Junior Radiologists","authors":"CuiYi Wu MD,&nbsp;LiHong Wu PhD,&nbsp;JianHong Shang PhD,&nbsp;HongNing Xie PhD,&nbsp;Ruan Peng PhD","doi":"10.1002/jum.16644","DOIUrl":"10.1002/jum.16644","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Acoustic shadowing is an important benign ultrasound (US) feature for adnexal masses (AMs). To validate the diagnostic performance and interobserver agreement of the 2019 version and 2022 version of Ovarian-Adnexal Reporting and Data System Ultrasound (O-RADS US) and ascertain whether adding acoustic shadowing to O-RADS US v2019 as a benign ultrasound feature can enhance its diagnostic efficacy among junior radiologist.&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;This retrospective study included consecutive women with suspected adnexal masses who underwent ultrasound examinations between September 2022 and January 2024. One junior doctor (Reader 1, 2 years of experience) classified each AM according to the O-RADS US v2019 and the v2022. Lesions were reclassified according to the US features of acoustic shadowing based on the O-RADS US v2019: the O-RADS category was downgraded by one level with acoustic shadowing and remained unchanged without acoustic shadowing for categories 2–5. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of the two versions of O-RADS and the modified O-RADS model. Two independent junior radiologists (Reader 1 and Reader 2 with 3 years of experience) then classified the 200 AMs randomly selected for a test–retest analysis. Kappa (&lt;i&gt;к&lt;/i&gt;) statistics were used to assess the interobserver agreement.&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;Overall, 1015 women (range, 16–86 years) with 1061 AMs were evaluated. Of the lesions, 864 (81.4%) were benign and 197 (18.6%) were malignant. The area under the ROC curve (AUC) for O-RADS v2019 and v2022 were 0.920 (95% confidence interval [CI]: 0.902, 0.936, &lt;i&gt;P&lt;/i&gt; &lt; .001) and 0.924 (95% CI: 0.906, 0.939, &lt;i&gt;P&lt;/i&gt; &lt; .001), respectively. The modified model based on O-RADS v2019 incorporating acoustic shadowing as a benign US feature showed an improved AUC of 0.934 (95% CI: 0.917, 0.948, &lt;i&gt;P&lt;/i&gt; &lt; .001). A significant difference was observed between the AUCs of the modified O-RADS and two versions of O-RADS models (&lt;i&gt;P&lt;/i&gt; &lt; .005). The inclusion of acoustic shadowing increased specificity by 5.4% in predicting malignant adnexal masses, compared with the O-RADS US v2019 with a specificity of 76.2%. Using the modified O-RADS category 4 as the optimal cut-off value for predicting malignancy showed a sensitivity, specificity, positive predictive value, and negative predictive value were 94.4% (95% CI: 90.2%, 97.2%), 81.6% (95% CI: 78.8%, 84.1%), 53.9% (95% CI: 50.3%, 57.5%), and 98.5% (95% CI: 97.3%, 99.1%), respectively. The inter-observer agreement in the O-RADS category between these two junior radiologists was good (&lt;i&gt;κ&lt;/i&gt; = 0.74, &lt;i&gt;P&lt;/i&gt; &l","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 5","pages":"845-855"},"PeriodicalIF":2.1,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950758","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 Atrial Size, Shape, and Contractility in Growth-Restricted and Small-for-Gestational-Age Fetuses","authors":"Greggory R. DeVore MD,&nbsp;Manesha Putra MD,&nbsp;John C. Hobbins MD","doi":"10.1002/jum.16642","DOIUrl":"10.1002/jum.16642","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The size, shape, and contractility of the heart's atrial chambers have not been evaluated in fetuses with growth restriction (FGR) or who are small-for-gestational-age (SGA) as defined by the Delphi consensus protocol. This study aimed to examine the atrial chambers using speckle tracking analysis to identify any changes that may be specific for either growth disturbance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sixty-three fetuses were evaluated with an estimated fetal weight &lt;10th percentile who were classified as FGR or SGA based on the Delphi consensus protocol. The atrial cardiac cycle was defined as end-diastole, end-systole, and end-diastole, equivalent to ventricular end-systole, end-diastole, and end-systole. The atrial size, shape, and contractility were computed from 24 transverse segments and one length measurement identified from speckle tracking analysis of the endocardium at end-diastole and end-systole. The <i>z</i>-score for each atrial measurement was computed using the mean and standard deviation equations from a control group of 200 fetuses. The <i>z</i>-score values were compared between the control and FGR/SGA fetuses as well as between FGR and SGA fetuses using the Kruskal–Wallis test. A <i>P</i>-value of &lt;.05 was considered significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 63 fetuses with an estimated fetal weight (EFW) &lt;10th percentile, 60% (38/63) were classified as FGR and 40% (25/63) as SGA. The following abnormal atrial measurements were unique to FGR fetuses: decreased end-diastolic left atrial (LA) area, decreased LA base and mid-chamber end-diastolic width, decreased LA base sphericity index, decreased right atrial (RA) mid-chamber sphericity index, decreased LA ejection volume, and decreased LA emptying volume. The following were unique to the SGA fetuses: Increased RA mid-chamber length, decreased LA fractional area change, decreased RA reservoir strain, decreased RA basal-apical length fractional shortening, and decreased LA base width transverse fractional shortening. The significant difference was an increased LA mid-chamber length in the SGA fetuses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Fetuses with an EFW &lt;10th percentile who are classified as either SGA or FGR demonstrate unique abnormalities of atrial size, shape, and contractility, thus allowing the examiner to differentiate between FGR and SGA fetuses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 5","pages":"831-843"},"PeriodicalIF":2.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950756","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}