Journal of Ultrasound in Medicine最新文献

{"title":"Transthoracic Ultrasound to Predict Exudative Pleural Effusion Etiology.","authors":"Wanling Huang, Chaofan Yuan, Kinner M Patel, Alice Mei, Kian Avilla, Xiaoyue Zhang, Sahar Ahmad","doi":"10.1002/jum.16687","DOIUrl":"https://doi.org/10.1002/jum.16687","url":null,"abstract":"<p><strong>Objectives: </strong>Pleural effusions often require invasive sampling to establish underlying etiologies. Transthoracic ultrasound (TUS) has shown promise in the diagnostics of pleural effusions; however, there lacks consensus regarding its clinical application. We evaluated the diagnostic utility of specific TUS findings for exudative effusions, specifically complex parapneumonic effusion and empyema.</p><p><strong>Methods: </strong>Ultrasound-guided pleural effusion drainage cases were retrospectively reviewed at a single university-based medical center from July 2015 to May 2023. Procedure-related images were reviewed for specific ultrasound findings: anechoic, fibrin, septation, loculation, plankton/swirl sign, hematocrit sign, jellyfish sign, and visceral pleura thickening. Exudative or transudative nature, underlying etiology, and other patient data were collected from chart review. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and positive likelihood ratio (LR+) were calculated for these findings, either individually or in combination, to predict nature and specific etiology for pleural effusion. A multivariable logistic regression model was constructed to analyze the association between TUS findings and complicated parapneumonic effusion and empyema.</p><p><strong>Results: </strong>A total of 389 cases included, 252 (64.8%) were exudative and 137 (35.2%) were transudative effusions. Findings of anechoic and jellyfish sign were more common in the transudative group, while septation, loculation, and pleural thickening appeared more commonly in exudative effusion (P < 0.05). Absence of all three signs of fibrin, septation, and loculation had 83% sensitivity (95% CI 77-90) and 78% NPV (95% CI 70-86) for transudative effusion. Septation and loculation had 98% specificity (95% CI 95-100) and 94% PPV (95% CI 88-100) for exudative effusion. Fibrin, loculation, and septation, when found concurrently, had 99% specificity (95% CI 98-100) and 96% PPV (95% CI 88-100) for exudative effusion. Multivariable logistic regression showed the presence of septation (odds ratio [OR] 5.3, 95% CI 1.7-16.3, P = 0.0038) and loculation (OR 3.3, 95% CI 1.1-10.0, P = 0.0327) were each independently associated with the likelihood of complicated parapneumonic and empyema cases.</p><p><strong>Conclusions: </strong>TUS features of loculation or septation are specific and predictive for exudative pleural effusion. The presence of septation and loculation was each associated with a higher likelihood of complicated parapneumonic effusion or empyema. Further studies are needed to validate diagnostic models that incorporate both TUS and clinical features to predict the nature and etiology of pleural effusions.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743315","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 Imaging and Guidance for Plantar Fascia Lesions: EURO-MUSCULUS/USPRM Approach.","authors":"Pelin Analay, Murat Kara, Ahmad J Abdulsalam, Berkay Yalçınkaya, Vincenzo Ricci, Giulio Cocco, Ondřej Naňka, Levent Özçakar","doi":"10.1002/jum.16694","DOIUrl":"https://doi.org/10.1002/jum.16694","url":null,"abstract":"<p><p>Plantar fascia (PF) lesions, such as plantar fasciitis, PF tear, and plantar fibromatosis (Ledderhose disease), are among the common causes of heel pain. The management of these lesions includes conservative treatments, minimally invasive treatments, and surgical interventions. When conservative treatments fail, minimally invasive injection therapies have been proposed as alternatives for managing PF lesions. Despite the availability of various injectable options, where and how to perform the injection is still controversial in the pertinent literature. In this article, considering the paramount role of ultrasound imaging in the diagnosis, interventions, and follow-up for PF pathologies, we demonstrated our sonographic approach to PF lesions for sonographers/physicians in daily clinical practice.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730600","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 Modifications in Management of Local Anesthetic Systemic Toxicity.","authors":"Fu-Liang Yang, Yan-Wen Li, Yuan-Fu Zhou, Liang He","doi":"10.1002/jum.16695","DOIUrl":"https://doi.org/10.1002/jum.16695","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730571","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":"Cesarean Scar Pregnancy Prognostic Classification System Based on Machine-Learning and Traditional Linear Scoring Models.","authors":"Xin Wang, Liyuan Ma, Siting Peng, Yuqing Yang, Jihao Wu, Na Su, Zhenhong Qi, Xinyan Liu, Qing Dai, Jianchu Li, Zhenzhen Liu","doi":"10.1002/jum.16688","DOIUrl":"https://doi.org/10.1002/jum.16688","url":null,"abstract":"<p><strong>Objectives: </strong>Cesarean scar pregnancy (CSP) refers to a special type of pregnancy with a variable prognosis. We aimed to establish a prognostic classification system using ultrasound and clinical features to provide a reference for management strategies.</p><p><strong>Methods: </strong>Exactly 230 patients with CSP were included and categorized into three groups based on treatment and prognosis: Group A (favorable prognosis), Group B (moderate prognosis), and Group C (poor prognosis). A total of 26 ultrasound features and 8 clinical features were collected for further analysis. Machine learning and traditional scoring models were then constructed for Group A and Group C and integrated to predict CSP prognosis using the significant features.</p><p><strong>Results: </strong>In the univariate analysis, 26 variables were significantly correlated with Group C, while 21 variables were significantly correlated with Group A. For Group C, a linear scoring model was established using three key features: the criteria length of the implantation portion (IMPL) ≥2.43 cm, the height of the gestational sac or mass protruding above the uterine cavity line (GSUCL) ≥1.4 cm, and absent residual myometrial thickness (RMT), achieving an area under the curve (AUC) of 0.939 (0.872, 1.000), which demonstrated comparable performance to the machine learning model (P = .814). For Group A, 13 significant univariate variables were utilized to construct the machine learning model with an AUC of 0.917 (0.842, 0.993).</p><p><strong>Conclusion: </strong>Multiple features were associated with CSP prognosis, such as GSUCL, IMPL, RMT, and the anterior-posterior diameter of the gestational sac at the level of the niche (GSSH). The CSP prognostic prediction can be achieved by integrating machine learning and linear scoring models to balance performance and interpretability, which can assist clinicians in treatment decisions.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710434","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":"SonoGif.com: A Free Online Tool to Remove Protected Health Information From Any Ultrasound Clip.","authors":"David Crockett, Benjamin C Smith, Christopher Kelly","doi":"10.1002/jum.16689","DOIUrl":"https://doi.org/10.1002/jum.16689","url":null,"abstract":"<p><strong>Background: </strong>The proliferation of online medical education, particularly in point-of-care ultrasound (POCUS), has been limited by challenges in removing protected health information (PHI) from imaging data. These challenges include PHI embedded in both metadata and within the ultrasound images themselves, complicating compliance with HIPAA standards.</p><p><strong>Objective: </strong>To describe the development and functionality of SonoGif.com, a free, browser-based tool designed to facilitate the de-identification and sharing of ultrasound clips without the need for specialized software.</p><p><strong>Methods: </strong>SonoGif was developed using JavaScript to run entirely within a web browser, preserving data privacy by ensuring ultrasound clips remain on the user's device during initial processing. DICOM files are parsed using the open-source dicomParser library, while standard video formats are rendered with native HTML5 Canvas APIs. Users can manually annotate images to obscure on-screen PHI. The resulting de-identified frames are transmitted to a secure server, where FFmpeg compiles them into shareable video formats.</p><p><strong>Results: </strong>Since its public release in 2019, SonoGif has been used to de-identify over 3000 ultrasound clips by users worldwide, including those in low-resource settings. Its accessibility, simplicity, and adherence to privacy regulations have made it a valuable tool for medical educators and clinicians seeking to share ultrasound media for teaching and research.</p><p><strong>Conclusion: </strong>SonoGif is a free web-based application that allows for easy and secure removal of PHI from ultrasound media. It broadens global access to ultrasound education by eliminating technical barriers and enabling safe image sharing across diverse clinical and educational environments. The platform is available at https://sonogif.com with source code accessible on GitHub.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710437","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":"Fetal Body Composition and Organ Volume Trajectories in Association With Maternal Perceived Stress or Depressive Symptoms in the Fetal 3D Study.","authors":"Alexandra Jean-Louis, Jessica L Gleason, Zhen Chen, Kathryn A Wagner, William A Grobman, Roger B Newman, Wesley Lee, Robert Gore-Langton, Seth Sherman, John Owen, Deborah A Wing, Daniel W Skupski, Jagteshwar Grewal, Katherine L Grantz","doi":"10.1002/jum.16680","DOIUrl":"https://doi.org/10.1002/jum.16680","url":null,"abstract":"<p><strong>Objectives: </strong>Evaluate associations between maternal perceived stress and depressive symptoms, and fetal body composition and organ volumes.</p><p><strong>Methods: </strong>In the NICHD Fetal 3D Study (2015-2019; n = 2457), stress and depressive symptoms were assessed at enrollment (10-13 weeks). High stress was defined as a Perceived Stress Scale (PSS) score ≥15 and high depressive symptoms, defined as an Edinburgh Postnatal Depression Scale (EPDS) score ≥10. Fetal body composition and organ volumes (cerebellar, lung, liver, and kidney) were measured up to five times between 15 and 40 weeks using three-dimensional (3D) ultrasound technology. Trajectories of body composition and organ volumes across pregnancy by high versus low PSS and EPDS were created using linear mixed models. Overall and weekly differences were compared after adjusting for covariates.</p><p><strong>Results: </strong>Six hundred (24.4%) women scored ≥15 on the PSS, and 334 (13.6%) scored ≥10 on the EPDS. Fetuses whose mothers had PSS ≥15 had 0.4-0.9 cm³ smaller fractional fat arm volumes between 33 and 37 weeks, 0.2-0.5 cm³ larger fractional fat thigh volumes between 26 and 29 weeks, 4.0-8.0 cm³ larger average lung volumes between 33 and 37 weeks, and 1.0 cm³ smaller liver volumes between 19 and 21 weeks; and for EPDS ≥10, fetuses had 2.0-3.0 cm³ larger cerebellar volumes between 35 and 38 weeks. Findings were statistically significant (P < .05) and similarly robust in sensitivity analyses.</p><p><strong>Conclusions: </strong>Greater maternal perceived stress and depressive symptoms early in pregnancy were associated with up to an 8.0 cm³ difference in fetal limb adiposity and organ volume growth. While health implications are unclear, our findings support current clinical practice guidelines for prenatal mental health screening.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700811","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 Ultrasound for Differentiating Malignant From Benign Cervical Lymphadenopathy in Children: A Systematic Review and Meta-Analysis.","authors":"Jayoung Moon, Jisun Hwang, Pyeong Hwa Kim","doi":"10.1002/jum.16686","DOIUrl":"https://doi.org/10.1002/jum.16686","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the diagnostic performance of ultrasound (US) features used to differentiate malignant from benign cervical lymphadenopathy in children.</p><p><strong>Methods: </strong>PubMed and EMBASE were searched for articles reporting the diagnostic performance of US features to differentiate benign and malignant cervical lymphadenopathy in children. Article quality was evaluated using the QUADAS-2 tool. Sensitivity and specificity were pooled using a bivariate random-effects model. Further sensitivity analyses and meta-regression were performed to determine the potential source of heterogeneity. The area under the receiver operating characteristic curve was calculated using the hierarchical summary receiver operating characteristic model.</p><p><strong>Results: </strong>Ten articles (1077 children) were included. Among the retrieved US features, abnormal vascularity, heterogeneous echogenicity, abnormal hilum echogenicity, and long-axis/short-axis (L/S) ratio were significantly associated with malignant lymphadenopathy, with pooled diagnostic odds ratios of 36 (95% confidence interval [CI]: 14-92), 17 (3-91), 16 (5-54), and 7 (5-9), respectively. The most sensitive US features were abnormal hilum echogenicity (0.86, 95% CI: 0.66-0.95) and heterogeneous echogenicity (0.84, 95% CI: 0.25-0.99). Abnormal vascularity (0.91, 95% CI: 0.82-0.97) was the most specific. Substantial heterogeneity was found in both sensitivity and specificity (I² > 50%; P < .01), although the source was not revealed.</p><p><strong>Conclusion: </strong>Among US features, abnormal vascularity, heterogeneous echogenicity, abnormal hilum echogenicity, and L/S ratio are useful for differentiating malignant from benign cervical lymphadenopathy in children, showing good diagnostic performance. These findings should be carefully interpreted due to unexplained heterogeneity, which may lower the validity of the pooled estimates.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692500","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":"Chorionic Bump: A Rare Case Series.","authors":"Pietro Cignini, Cristina Fabiani, Vincenzo Spina, Michele Carlo Schiavi, Lorenzo Campanella","doi":"10.1002/jum.16670","DOIUrl":"https://doi.org/10.1002/jum.16670","url":null,"abstract":"<p><p>Chorionic bump (CB) is a convex protrusion from the choriodecidual surface into the first trimester gestational sac. The etiology of CB is unknown, and clinicians face difficulties in diagnosing and managing cases of CB patients due to the small number of reported cases. We present three cases of chorionic bump and relative management in order to contribute to the understanding of a very uncommon ailment and how it may affect pregnancy outcomes. Further studies are needed to improve the knowledge about this rare ultrasound finding.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676958","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 Usefulness of High-Frequency Ultrasound in the Management of Patients with Giant Congenital Melanocytic Nevi: A Cohort Prospective Study.","authors":"Priscila Giavedoni, Said Fallas, Laura Serra, Teresa Torres, Pau Rosés-Gibert, Irene Fuertes de Vega, Asunción Vicente, Ximena Wortsman, Cristina Carrera","doi":"10.1002/jum.16684","DOIUrl":"https://doi.org/10.1002/jum.16684","url":null,"abstract":"<p><strong>Objectives: </strong>Congenital melanocytic nevi (CMN) exhibit various clinical presentations. Dermoscopy and confocal microscopy only assess the superficial dermis. Magnetic resonance imaging cannot evaluate skin layers comprehensively. High-frequency Doppler ultrasound (HFUS) can define the extent of melanocytic lesions and suggest patterns of potential complications. The objective of the study is to evaluate HFUS characteristics of patients with CMN and, secondarily, to study the utility of HFUS in evaluating proliferative nodules and enlarged lymph nodes.</p><p><strong>Methods: </strong>A prospective study of patients with multiple and non-small CMN between January 2016 and June 2021 was conducted. Clinical imaging and HFUS were routinely used to follow up on distinctive areas. A retrospective analysis of HFUS images and correlation with presentation was performed.</p><p><strong>Results: </strong>Seventy-one patients with CMN, 149 HFUS scans. Median age: 14 years (IQR: 8 months-79 years), 59% female. Large/giant nevi n = 44 (61.9%). CMN affected the epidermis/dermis in 51 (71.8%), hypodermis in 17 (24%), and muscle in 3 (4.2%). Thirteen patients (18.3%) had nodular lesions; 1 showed atypical vessels on HFUS, which was confirmed histologically as an atypical proliferative nodule.</p><p><strong>Limitations: </strong>Heterogeneity of patients and retrospective analysis.</p><p><strong>Conclusions: </strong>HFUS allows the characterization of non-small CMN by assessing depth and diagnosing complications such as melanomas and enlarged lymph nodes.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663842","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":"Revisiting Ultrasound of Fetal Abdominal Cysts; the Common, the Uncommon and the Rare: A Pictorial Review.","authors":"Bhumika Singh, Durr E Sabih, Bronshtein Moshe, Azer Ferec, Dong Nguyen, Lilit Hovsepyan, Yaron Zalel","doi":"10.1002/jum.16678","DOIUrl":"https://doi.org/10.1002/jum.16678","url":null,"abstract":"<p><p>Fetal abdominal cysts are rare. The significance of antenatally discovered abdominal cysts can range from an innocuous finding to serious conditions needing surgery. It is often difficult to arrive at a correct diagnosis based on ultrasonography, as different types of cysts can have similar appearances. A more specific diagnosis is possible if fetal sex, age at appearance, location of the cyst, shape and appearance of the walls, and contents are considered. This review presents an extensive spectrum of fetal abdominal cysts. The common as well as the very rare causes that have only a few reports are discussed. Ultrasound images of confirmed cases are also presented. An algorithmic approach that enables a more specific diagnosis in many cases has been developed.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657616","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}