Journal of Ultrasound in Medicine最新文献

{"title":"Errors Between Reported Equations and an Excel Calculator for Computing Cardiac Biometry and z-Scores Between 18 and 34 Weeks of Gestation.","authors":"Greggory R DeVore","doi":"10.1002/jum.16730","DOIUrl":"https://doi.org/10.1002/jum.16730","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173908","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":"Spinal Ultrasound Assessment of Correlation Between Intraventricular Hemorrhage Severity and Cerebrospinal Fluid Volume in Preterm Infants.","authors":"Belinda Chan, Dan York, Alison Ford, Susie Gleason, Ivah Floyd, Sasha Gordon, Yogen Singh","doi":"10.1002/jum.16727","DOIUrl":"https://doi.org/10.1002/jum.16727","url":null,"abstract":"<p><strong>Objectives: </strong>Intraventricular hemorrhage (IVH) affects >15% of preterm infants. Severe IVH disrupts cerebrospinal fluid (CSF) flow dynamics, causing post-hemorrhagic ventricular dilation (PHVD) and further brain injury. Although lumbar puncture (LP) may reduce CSF volume and intracranial pressure, its effectiveness depends on brain-to-spine CSF flow dynamics and spinal CSF volume, which remain underexplored. This study correlates IVH severity with spinal CSF volume of preterm infants using spinal ultrasound (SUS).</p><p><strong>Methods: </strong>This prospective study enrolled infants (<33 weeks gestational age [GA]) with head ultrasounds (HUS) done at 7-15 days of life. SUS was performed within 2 days of HUS and repeated if another HUS was done. Exclusion criteria were congenital, chromosomal, or spinal anomalies. Using SUS clips, an automated algorithm calculating the proportion of anechoic CSF area within the spinal canal at the L3-L4 intervertebral space, termed the CSF-to-Spinal Canal Index (CSCI) was developed. Clinical data and IVH grades were analyzed.</p><p><strong>Results: </strong>Twenty-five infants (mean GA: 28 ± 3 weeks) were enrolled, with 46 SUS studies performed. We found no correlation between IVH grade and CSCI (R² = 0.13, P = .57). The CSCI did not correlate with birth GA, birth weight, corrected GA, current weight, day of life, and previous 24-hour weight change at the time of SUS. The CSCI decreased after each LP in 4 infants with PHVD. Four infants needed surgical CSF diversion.</p><p><strong>Conclusions: </strong>SUS is a non-invasive method to estimate spinal CSF volume. The lack of correlation with IVH severity suggests multifactorial mechanisms besides previously proposed CSF outflow obstruction. Further research is necessary to understand the pathophysiology of PHVD.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159670","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":"A Novel Prenatal Pipeline for Three-Dimensional Hemodynamic Modeling of the Fetal Aorta.","authors":"Joanne Sarsam, Angela Desmond, Mehrdad Roustaei, Gary Satou, Yalda Afshar","doi":"10.1002/jum.16721","DOIUrl":"https://doi.org/10.1002/jum.16721","url":null,"abstract":"<p><strong>Objective: </strong>Congenital heart disease (CHD) is the most common birth defect and the leading cause of infant death from congenital anomalies. Limitations in standard-of-care fetal echocardiography lack hemodynamic insight. Cardiovascular computational modeling methods have been developed to simulate patient-specific morphology and hemodynamics, but are limited in applications for fetal diagnosis, as existing pipelines depend upon 3D CMR imaging data. There is no existing workflow for converting 2D echocardiograms into models of the fetal aorta. We aim to develop a methodology to create pulsatile 3D-aortic models from standard-of-care 2D echocardiograms to supplement fetal imaging with noninvasive predictions of hemodynamics in CHD diagnosis.</p><p><strong>Methods: </strong>Utilizing 2D fetal echocardiograms, edge detection algorithms are applied to delineate vessel boundaries. Cross-sectional diameters along the aortic arch and branch centerlines were segmented, integrated into 3D geometric models, and reconstructed using SimVascular. Patient-specific simulations were developed for three false-positive coarctation of the aorta (CoA) fetuses and 3 true positive CoA fetuses (postnatally confirmed), using echocardiogram and Doppler source data.</p><p><strong>Results: </strong>We propose a modeling methodology and set of boundary conditions that generate physiologically reasonable and cross-validated quantifications of fetal hemodynamics. Noninvasive predictions of fetal aortic pressures, flow streamlines, and vessel displacement offer insight into real-time hemodynamics and the stress of abnormal morphology on flow directions in the prenatal aorta.</p><p><strong>Conclusions: </strong>We present a clinically useful pipeline for generating simulations of flow in the fetal aorta that capture fluid-structure interactions and generate noninvasive predictions of diagnostic hemodynamic indicators that could not previously be captured prenatally. This pipeline integrates into clinical diagnosis and offers insight into patient-specific physiology beyond a visualization of cardiac morphology alone, offering the potential to enhance the diagnostic precision of CHDs.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159666","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":"Establishment of a Predictive Model for the Efficacy of High-Intensity Focused Ultrasound in the Treatment of Uterine Fibroids.","authors":"Huiqing Li, Yanlei Gao, Xiaoyan Zhang, Weili Hou, Yaru Ma, Rui Shi, Peng Ren","doi":"10.1002/jum.16718","DOIUrl":"https://doi.org/10.1002/jum.16718","url":null,"abstract":"<p><strong>Objectives: </strong>High-intensity focused ultrasound (HIFU) has demonstrated efficacy as a non-invasive treatment for uterine fibroids, though individual variability exists. This study aims to develop a risk scoring model using clinical and biochemical features to predict HIFU treatment outcomes.</p><p><strong>Methods: </strong>This study collected clinical data from patients receiving HIFU treatment, including demographic characteristics, clinical symptoms, treatment information, and biochemical indicators. A risk scoring model was constructed using the random forest analysis method, and its performance was evaluated. Meanwhile, the impact of risk models and other factors on the efficacy of HIFU was evaluated. Furthermore, the interrelationships between the risk model and other factors were explored through interaction analysis. Finally, a nomogram was developed to evaluate its clinical utility.</p><p><strong>Results: </strong>The risk model, 4 or more treatments, age, and tumor necrosis factor levels were identified as independent influencing factors, with the risk model demonstrating the best performance (area under the curve (AUC) = 0.693). Interaction analysis revealed a significant synergistic effect between the risk model and receiving 4 or more treatments. The nomogram analysis indicated that lower risk scores and fewer treatment sessions were associated with better HIFU treatment outcomes. The receiver operating characteristic curves and calibration curves in both the training and validation sets demonstrated good performance of the nomogram.</p><p><strong>Conclusions: </strong>This study successfully constructed a risk scoring model based on clinical features and biochemical indicators, which can effectively predict the efficacy of HIFU treatment for uterine fibroids. There is a significant interaction between the risk model and 4 or more treatments. The constructed nomogram provides strong support for individualized treatment.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150873","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 Findings of Bile Duct Involvement in Pediatric Langerhans Cell Histiocytosis.","authors":"Jiachao Wang, Xin Wei, Yu Wang, Yanxiu Hu, Xiaoman Wang","doi":"10.1002/jum.16723","DOIUrl":"https://doi.org/10.1002/jum.16723","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyze the ultrasound findings of bile duct involvement in pediatric Langerhans cell histiocytosis (LCH).</p><p><strong>Methods: </strong>We retrospectively analyzed 42 patients diagnosed with pediatric LCH by pathology at our hospital from December 2016 to December 2023. All patients had comprehensive clinical data and ultrasound findings indicating biliary abnormalities. This study analyzed intrahepatic and extrahepatic bile duct dilation, the extent of bile duct wall thickening, and surrounding abnormal echoes.</p><p><strong>Results: </strong>Among the 42 children, ultrasonography showed intrahepatic and extrahepatic bile duct dilation in 27 cases (64%), bile duct wall thickening in 21 cases (50%), hypoechoic areas along the intrahepatic bile ducts in 16 cases (38%), and thickening of the Glisson's capsule with decreased echogenicity around the bile ducts in 8 cases (19%).</p><p><strong>Conclusion: </strong>Ultrasonography revealing varying degrees of bile duct dilatation or stenosis, thickened bile duct walls, and abnormal echo patterns along the bile duct in the liver in pediatric patients with cholangitis should raise suspicion for LCH.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128025","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":"Enhancing the Clinical Applicability of Spectral Ultrasound for Axillary Staging in Breast Cancer: Key Considerations and Future Directions.","authors":"Victor Arthur Ohannesian, Guilherme Ciconelli Del Guerra, Victor Arantes Jabour, Miguel José Francisco Neto","doi":"10.1002/jum.16726","DOIUrl":"https://doi.org/10.1002/jum.16726","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128024","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":"Unraveling Endometrial Abnormalities: A Comprehensive Ultrasound Assessment During Frozen Embryo Transfer (FET) Maturation Cycles.","authors":"Kaia M Schwartz, David Selvaraj, Laura Detti","doi":"10.1002/jum.16725","DOIUrl":"https://doi.org/10.1002/jum.16725","url":null,"abstract":"<p><strong>Objective: </strong>To retrospectively analyze the ultrasonographic endometrial features of patients undergoing endometrial maturation for FET and correlate them with pregnancy outcomes.</p><p><strong>Methods: </strong>This is a retrospective study of endometrial echo images taken from women aged 18-45 planning a frozen embryo transfer (FET) at the Cleveland Clinic between April 1, 2021, through September 30, 2021. Endometrial assessment was performed via transvaginal ultrasound during endometrial maturation for planned FET. Abnormal endometria were diagnosed by the presence of polyps, cystic lesions, heterogeneous morphology (coexisting hypo- and hyperechoic areas), and homogeneous (non-trilaminar) morphology. Normal endometria were trilaminar and lacked the abnormalities of interest. Outcome measures were failed conception, early pregnancy loss/biochemical pregnancy, and ongoing pregnancy. We performed t-test comparison for continuous variables and chi-square test for the categorical variables (R statistical program version 4).</p><p><strong>Results: </strong>Exactly 128 endometrial echoes met inclusion criteria for analysis. Of those included, 53 (41.4%) were abnormal endometrium (AE) and 75 (58.5%) were normal endometrium (NE) and all patients underwent embryo transfer. Demographic characteristics were similar between the groups, including endometrial thickness and BMI. Mean age was 36.3 and 33.8 in the AE and NE groups, respectively (P = .001). After FET, 67.7% (n = 42) of the ongoing pregnancies were from the NE group versus 32.3% (n = 20) from the AE group. After adjusting for confounding factors like age, BMI, utilization of PGT-A, and endometrial thickness, proportional odds logistic regression demonstrated that the likelihood of an abnormal endometrium being associated with a poor pregnancy outcome is 12.06 times greater compared with a normal endometrium.</p><p><strong>Conclusion: </strong>In preparation for FET, the presence of any kind of endometrial abnormalities at ultrasound before starting progesterone supplementation had a significant correlation with poor cycle outcomes, and conception rates were decreased by >50%. This study underscores the clinical importance of ultrasound in the evaluation of the endometrium and prediction of FET cycle outcomes.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128026","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":"Early Pregnancy Loss Rate in In Vitro Fertilization Versus Non-IVF Pregnancies.","authors":"Peter M Doubilet, Carol B Benson, Elizabeth S Ginsburg","doi":"10.1002/jum.16728","DOIUrl":"https://doi.org/10.1002/jum.16728","url":null,"abstract":"<p><strong>Objectives: </strong>Compare early pregnancy loss (EPL) rates in in vitro fertilization (IVF) versus non-IVF pregnancies to determine whether IVF has an independent effect on first trimester outcome.</p><p><strong>Methods: </strong>Our study set consisted of all obstetrical ultrasounds at our institution over a 30-year period demonstrating a singleton intrauterine pregnancy (confirmed by either yolk sac but no embryo, or embryo <10 mm with cardiac activity), with known first trimester outcome. We assessed EPL rates based on mode of conception, maternal age, vaginal bleeding, and initial ultrasound finding (yolk sac only or embryo). We compared IVF versus non-IVF pregnancies with respect to EPL rate, maternal age, and vaginal bleeding. Most importantly, we used logistic regression analysis to determine whether IVF has an independent effect on loss rate, after controlling for age and bleeding.</p><p><strong>Results: </strong>Our study set consisted of 16,458 pregnancies, 1394 (8.5%) resulting from IVF and 15,064 (91.5%) non-IVF. Overall EPL rate was 3348/16,458 (20.3%) and was higher in IVF pregnancies, in women aged ≥35 years, and with vaginal bleeding (P < .001, all comparisons). IVF pregnancies had higher maternal ages and were less likely to have vaginal bleeding as an indication for sonography. Logistic regression of mode of conception, maternal age, and bleeding as predictors of outcome demonstrated that mode of conception had no independent effect on outcome (P = .33 for cases with yolk sac only, P = .30 for cases with embryo).</p><p><strong>Conclusions: </strong>IVF has no impact on first trimester outcome. A woman pregnant via IVF has the same likelihood of miscarriage as a comparable woman with a non-IVF pregnancy.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111097","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":"Cervical Length in Patients With Placenta Accreta Spectrum and Its Association With Unscheduled Delivery.","authors":"Elias Kassir, Edgar A Hernandez-Andrade, Farah H Amro, Cabrina I Becker, Eleazar E Soto-Torres, Ramesha Papanna, Han-Yang Chen, Sarah T Mehl, Lavanya H Palavalli Parsons, Sean C Blackwell, Baha M Sibai","doi":"10.1002/jum.16729","DOIUrl":"https://doi.org/10.1002/jum.16729","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the association between cervical length (CL) and unscheduled delivery in patients with placenta accreta spectrum (PAS).</p><p><strong>Methods: </strong>Retrospective cohort study of patients with suspected PAS from January 2018 to June 2024. Patients with suspected PAS underwent serial ultrasounds including transvaginal CL measurement every 4 weeks. The final CL measurement prior to delivery was analyzed. Unscheduled delivery was defined as urgent delivery prior to the scheduled date due to either bleeding or preterm contractions. A receiver operating characteristics (ROC) curve was created, the optimal CL associated with unscheduled delivery was selected, and associations and prediction analyses were performed.</p><p><strong>Results: </strong>Of 102 patients, 21 (20.6%) had an unscheduled delivery. Median gestational age at unscheduled delivery was 30w5d (IQR 29w0d-34w1d), and at scheduled delivery 34w0d (IQR 33w1d-34w4d, P = 0.001). CL was shorter in patients who had an unscheduled delivery compared to those with a scheduled delivery (mean [SD] 29.9 [10.2] mm versus 36.1 [10.3] mm, P = .02). CL was shorter (31.6 [SD 11.1] mm) among patients (n = 53) having a delivery <34w0d than those (n = 49) delivering ≥34.0w0d (38.5 [SD 8.6] mm, P < .001). ROC analysis showed a CL of 30 mm as the optimal cutoff for prediction of unscheduled delivery. A significant association between CL ≤30 mm with unscheduled delivery (adjusted relative risk [aRR] 2.33, 95% CI: 1.08-5.03, P = .03) was observed after adjusting for history of spontaneous preterm birth.</p><p><strong>Conclusions: </strong>In patients with PAS, a CL ≤30 mm is associated with a higher rate of unscheduled delivery and delivery ≤34 weeks.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111002","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 Ability of Transabdominal Ultrasonography for Appendiceal Diverticulitis.","authors":"Aya Sato, Yuki Kojima, Shiori Nakamura, Etsuko Maeoka, Yoshimi Nisaka, Masaharu Gunji, Junichi Takamizawa, Masahiko Fujino, Norihiro Yuasa","doi":"10.1002/jum.16713","DOIUrl":"https://doi.org/10.1002/jum.16713","url":null,"abstract":"<p><strong>Objectives: </strong>Appendiceal diverticulitis (AD) is frequently confused with acute appendicitis (AA); however, AD carries a higher risk of perforation and malignancy than AA. We aimed to evaluate the preoperative diagnostic ability of transabdominal ultrasonography (US) for AD.</p><p><strong>Methods: </strong>We included 74 patients who underwent appendectomy with a preoperative diagnosis of AA, AD, and US within a day of surgery. AD was diagnosed using US by identifying protruding, pouch-like hypoechoic structures beyond the appendiceal margin, whereas it was diagnosed using histopathology by identifying the invagination of the appendiceal epithelium into the muscularis propria.</p><p><strong>Results: </strong>The median patient age was 45 years (61% males). Among the patients with a US diagnosis of AD, 9 patients had histopathological AD, while one patient did not. The other 64 patients without a US diagnosis of AD did not have histopathological AD. US showed 100% sensitivity, 98% specificity, 90% positive predictive value, 100% negative predictive value, and 99% accuracy for AD. A retrospective review of US images showed that 8 patients exhibited high echoic rims at the border of the hypoechoic structures among the 9 patients with histopathological AD. When this finding was incorporated into the US diagnosis of AD, the specificity increased to 100%.</p><p><strong>Conclusions: </strong>The diagnostic accuracy of US for AD is high. Not only are protruding pouch-like hypoechoic structures specific for the US diagnosis of AD, but also highly echoic rims at the border.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094110","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}