Journal of Ultrasound in Medicine最新文献

{"title":"A Hybrid CNN-Transformer Model With Crossover Boosted Cheetah Optimization for Prenatal Spina Bifida Identification From Ultrasound Images","authors":"Asha Rajasekaran PhD,&nbsp;S.S. Subashka Ramesh PhD","doi":"10.1002/jum.70347","DOIUrl":"10.1002/jum.70347","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Spina bifida is a birth defect caused by the incomplete closure of the neural tube around the spinal cord. Earlier, various deep learning-based models were developed, but they failed to capture the fine details from the ultrasound images that reduce the detection accuracy. Hence, to overcome these challenges, an automated and trustworthy deep learning framework is significant for accurate identification of spina bifida from second-trimester fetal ultrasound images.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This research proposes a novel hybrid convolutional neural network-transformer model for spina bifida identification, where convolutional neural network integration enables the model to extract local features and transformer encoder integration enables the model to capture global contextual dependencies. Further, spatial feature representation is enhanced by using the multi-resolution convolutional neural network blocks and positional encoding. On the other hand, clinically relevant regions are highlighted through the use of a self-attention mechanism within the proposed model. The hyperparameters of the proposed model are fine-tuned using a crossover boosted cheetah optimization algorithm, which integrates the strengths of the Cheetah optimizer and the Crossover Mechanism. Thereby, optimizing the performance of the proposed model and making the model robust to spina bifida identification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The proposed model achieves robust diagnostic performance, which attains an accuracy of 99.02%, an F1-score of 98.21%, and a lower inference time of 0.88 second, demonstrating its suitability in real-time prenatal ultrasound screening applications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The proposed model provides an efficient and clinically viable solution for automated prenatal spina bifida detection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"45 11","pages":"2533-2551"},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471490","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":"Single-Operator Stress Ultrasound Evaluation of Ulnohumeral Joint Instability Related to Medial Ulnar Collateral Ligament Injury","authors":"Benjamin F. Kopecky DO, MS,&nbsp;Brennan J. Boettcher DO,&nbsp;Christopher L. Camp MD,&nbsp;Jacob L. Sellon MD","doi":"10.1002/jum.70391","DOIUrl":"10.1002/jum.70391","url":null,"abstract":"<p>This article introduces a novel, single-operator stress ultrasound technique for evaluating medial ulnar collateral ligament (MUCL) integrity by assessing medial ulnohumeral joint (MUHJ) widening under valgus stress. Unlike prior methods requiring dual operators, specialized equipment, or the use of hand/wrist weights, this approach was designed for clinical efficiency, reproducibility, and patient comfort. By positioning the patient comfortably in a side-lying position with the elbow flexed to 50°, MUHJ width is measured at baseline (maximally apposed) and manually stressed positions, in a manner that may reduce muscular compensation, avoid viscoelastic creep, and facilitate consistency. While additional research is needed to evaluate clinical feasibility, assess reliability, and compare our technique with previously published methods of dynamic MUCL assessment, the aim of this manuscript is to describe our technique and provide a rationale for its potential utility in musculoskeletal ultrasound practice and research.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"45 11","pages":"2599-2604"},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.70391","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592415","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":"Assessing Treatment Efficacy in Alopecia Areata: A Combined High-Frequency Ultrasound and Superb Microvascular Imaging Study","authors":"Meng Yang MM,&nbsp;Chen Zhao MD,&nbsp;Jia Chen MD,&nbsp;Xin Ai MM,&nbsp;Shouqiang Li MD,&nbsp;Zhuo Wang MD,&nbsp;Zhinuo Li MM,&nbsp;Zhirou Di MM,&nbsp;Bingxue Bai PhD,&nbsp;Xiaoping Leng PhD","doi":"10.1002/jum.70299","DOIUrl":"10.1002/jum.70299","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The therapeutic goals for alopecia areata (AA) are to suppress local immune inflammation, restore hair follicle structure, and improve surrounding blood perfusion. However, current efficacy evaluations largely rely on subjective clinical observation and lack objective quantitative methods. High-frequency ultrasound (HFUS) can clearly display the location and morphology of hair follicles. Combined with microvascular assessment techniques, it enables quantitative detection of low-velocity blood flow and related parameters, providing an objective basis for evaluating AA treatment efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-five patients with AA who received intralesional therapy underwent HFUS (measuring epidermal/dermal thickness and hair follicle length/width) and ultrasound microvascular assessment, including spectral Doppler measurement of peak systolic velocity (PSV), resistance index (RI), and power Doppler measurement of vascular index (VI) before and after treatment. Patients were divided into a responder group (<i>n</i> = 37) and an ineffective group (<i>n</i> = 8) based on the reduction rate of the SALT score. The Mann–Whitney <i>U</i> test and Wilcoxon signed-rank test were used for comparisons between groups and within the responder group (pre-treatment versus post-treatment), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline characteristics showed no statistically significant differences (all <i>p</i> &gt; .05). Patients in the ineffective group exhibited poorer hair follicle morphology (shorter length, greater width, and lower length-to-width ratio), but higher PSV and VI compared to the responder group (<i>p</i> &lt; .05). In the responder group, treatment significantly improved hair follicle morphology, increased PSV and VI (<i>p</i> &lt; .05), but RI showed no change.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>(1) HFUS technology can observe changes in AA hair follicle structure during the diagnosis and treatment process, evaluating the effectiveness of treatment regimens in improving AA disease progression. (2) SMI combined with Doppler flow parameters can monitor changes in the perifollicular microcirculation in AA, reflecting the improvement of microcirculation during the diagnosis and treatment of AA. (3) The synergistic application of HFUS and SMI technologies can provide an objective imaging basis for the clinical evaluation of AA treatment efficacy, demonstrating promising clinical application prospects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"45 11","pages":"2431-2442"},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794883","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":"Point-of-Care Ultrasound M-Mode Analysis Using M.mode.ify","authors":"David Crockett MD,&nbsp;Elijah Wyatt MD,&nbsp;Benjamin C Smith MD,&nbsp;Jamal Jones MD,&nbsp;Jennifer Cotton MD,&nbsp;Christopher Kelly MD","doi":"10.1002/jum.70349","DOIUrl":"10.1002/jum.70349","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>M-mode ultrasound provides high temporal resolution imaging by rendering a single scan line over time, enabling precise measurement of rapidly moving structures. Traditional M-mode is limited to real-time acquisition and cannot be applied retrospectively. <i>M.mode.ify</i> is a novel software tool that generates M-mode-like tracings from video data, enabling post-acquisition analysis. This study evaluates the accuracy of <i>M.mode.ify</i> in measuring E-point septal separation (EPSS), a key echocardiographic parameter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 50 cardiac ultrasound studies from our institution's quality assurance database. Inclusion criteria required both a saved M-mode EPSS image and a parasternal long axis (PLAX) video clip. EPSS values from M-mode served as the reference standard. Two blinded reviewers independently measured EPSS using <i>M.mode.ify</i>. Inter-rater reliability and agreement with the standard were assessed using Pearson correlation coefficients. Absolute error was calculated to quantify measurement precision.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 50 analyzed studies, 9 were excluded due to inadequate anatomical visualization. Among the 41 included studies, inter-rater correlation was strong (<i>r</i> = 0.90), and agreement between <i>M.mode.ify</i> and standard M-mode measurements was excellent (r = 0.92). The mean absolute error was 2.38 mm (SD 1.71 mm).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p><i>M.mode.ify</i> demonstrates high accuracy and reliability in measuring EPSS retrospectively. This tool may expand the utility of ultrasound data by enabling post hoc analysis of M-mode parameters.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"45 11","pages":"2553-2557"},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.70349","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308751","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":"Comment on “Fetal Heart Rate at 12 Weeks' Gestation and the Risk of Preterm Birth”","authors":"Varshitha Hantur Dinakar MSc,&nbsp;Neeraj Singh MD,&nbsp;Monika Srivastav PhD","doi":"10.1002/jum.70283","DOIUrl":"10.1002/jum.70283","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"45 11","pages":"2613-2614"},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839500","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":"Double Contrast-Enhanced Ultrasonographic Features of Gastric Heterotopic Pancreas","authors":"Jiawen Dong BM,&nbsp;Chunyang Yu BM,&nbsp;Zhikang Xu MM,&nbsp;Minghai Yang BM,&nbsp;Wei Zhu MM,&nbsp;Bin Ying MM,&nbsp;Bin Xia MM,&nbsp;JianQiang Mao BM","doi":"10.1002/jum.70345","DOIUrl":"10.1002/jum.70345","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The purpose of this study was to analyze the features of double contrast-enhanced ultrasound (DCEUS) in gastric heterotopic pancreas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed the DCEUS images (grayscale, color Doppler, and CEUS) of patients diagnosed with gastric heterotopic pancreas based on B-mode endoscopic ultrasound (EUS) findings in our hospital between January 2017 and December 2025.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 30 patients were included during the study period (16 women and 14 men, aged from 7 to 73 years, with a mean age of 51.6 years). The lesions were predominantly located in the gastric antrum (23/30). On grayscale ultrasound, most lesions presented as flattened masses (23/30), showing hypoechoic (11/30), or isoechoic (16/30) echogenicity with clear boundaries (22/30), and most originated from the submucosal layer (22/30). Color Doppler ultrasound showed absent or only minimal intralesional blood flow in the vast majority of cases (28/30). On CEUS, all lesions demonstrated hyperenhancement, with a fast-in and slow-out enhancement pattern observed in most cases (24/30). Internal duct-like structures were seen in 12 patients (12/30), and central umbilication was observed in 6 patients (6/30).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Gastric heterotopic pancreas demonstrates relatively characteristic DCEUS features, which can provide non-invasive imaging evidence to support EUS-based diagnosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"45 11","pages":"2513-2520"},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148302171","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":"Impact of Hemoglobin Levels on Therapeutic Efficacy and Energy Dosage in Ultrasound-Guided HIFU Ablation of Uterine Fibroids","authors":"Meijie Yang PhD,&nbsp;Yaxuan Qiu MMed Candidate,&nbsp;Liang Hu PhD,&nbsp;Xue Zhou MMed Candidate,&nbsp;Renqiang Yu PhD,&nbsp;Jinyun Chen PhD","doi":"10.1002/jum.70326","DOIUrl":"10.1002/jum.70326","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate the impact of hemoglobin (HGB) levels on therapeutic efficacy and energy dosage during ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation of symptomatic uterine fibroids (UFs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 1196 patients who underwent USgHIFU for symptomatic UFs were retrospectively enrolled. Patients were stratified into 8 subgroups based on preprocedural HGB concentrations (g/L): &lt;60, 60–70, 70–80, 80–90, 90–100, 100–110, 110–120, and &gt;120. The energy efficiency factor (EEF) was used to quantify the ablation dose, and non-perfused volume ratio (NPVR) was adopted to evaluate ablation efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall median EEF was 3.96 J/mm³. EEF was significantly lower in the &lt;60 (3.63 J/mm³) and 60–70 g/L (4.75 J/mm³) groups than in the 80–90 g/L group (6.62 J/mm³), and the 80–90 g/L group had higher EEF than the &gt;120 g/L group. The proportion of T2-weighted imaging hyperintense fibroids (Funaki type 3) and NPVR was both higher in the 80–90 g/L group than in the &gt;120 g/L group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Lower preprocedural HGB levels correlate with higher NPVR. During moderate anemia, EEF increases with rising HGB, which may serve as useful reference evidence for individualized energy dose adjustment in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"45 11","pages":"2443-2451"},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258634","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":"Upper Airway Muscle Stiffness in Obstructive Sleep Apnea Assessed by Shear Wave Elastography.","authors":"Buğra Kerget, Mustafa Yeşilyurt, İsmail Çınar, Alperen Aksakal, Mustafa Buğra Coşkuner, Fatih Alper","doi":"10.1002/jum.70503","DOIUrl":"https://doi.org/10.1002/jum.70503","url":null,"abstract":"<p><strong>Objective: </strong>In obstructive sleep apnea (OSA), characterized by recurrent episodes of apnea and hypopnea, the activity of the upper airway dilator muscles is significant. In our study, we aimed to compare shear wave elastography (SWE) values of the genioglossus (GG), geniohyoid (GH), and mylohyoid (MH) muscles in patients with OSA.</p><p><strong>Methods: </strong>In this prospective study, 90 adults who underwent full-night polysomnography were included. Participants were classified as non-OSA (apnea-hypopnea index [AHI] <5, n = 32) or OSA (AHI ≥5, n = 58), and OSA patients were further divided by severity. SWE was used to assess the stiffness of the bilateral GG, bilateral MH, and GH muscles.</p><p><strong>Results: </strong>Bilateral GG and GH stiffness values were significantly higher in OSA patients than in non-OSA individuals, whereas bilateral MH measurements did not differ between groups (P < .001, .006, and .004, respectively). Among OSA subgroups, left GG stiffness was significantly higher in severe OSA than in mild-moderate OSA (P = .043). Right GG stiffness showed positive correlations with AHI and supine AHI (r = 0.392 and r = 0.491, respectively; both P < .001). Left GG stiffness was positively correlated with AHI and rapid eye movement-AHI (r = 0.338, P = .001; r = 0.423, P < .001). GH stiffness was positively correlated with both AHI and oxygen desaturation index (r = 0.313, P = .003; r = 0.302, P = .004).</p><p><strong>Conclusion: </strong>SWE may provide a useful non-invasive tool for evaluating upper airway muscle characteristics in OSA. Associations between upper airway muscle stiffness and polysomnographic parameters were observed; however, these cross-sectional findings should be considered exploratory and hypothesis-generating, requiring confirmation in larger studies.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182809","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":"Dynamic Maneuvers Improve Ultrasound Detection of Supraspinatus Tendon Tears","authors":"Gonzalo Serrano-Belmar MD,&nbsp;Giorgio Tamborrini MD,&nbsp;Marco Becciolini MD","doi":"10.1002/jum.70340","DOIUrl":"10.1002/jum.70340","url":null,"abstract":"<p>We describe new ultrasound dynamic maneuvers that can help clinicians to demonstrate a supraspinatus tendon tear. Images and video clips are provided with the latest generation of ultrasound machines and labeled for didactical purposes. We believe that incorporating these techniques into a standard ultrasound examination of the rotator cuff can significantly improve the diagnostic confidence in depicting supraspinatus tendon tears. A possible limitation of these maneuvers is that they seem less effective in articular-sided partial-thickness tears.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"45 11","pages":"2589-2598"},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148272163","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 Efficacy of Contrast-Enhanced Ultrasound for Breast Intraductal Lesions","authors":"Qiuya Yang MM,&nbsp;TaoHua Gou MM,&nbsp;Mingying Jia MM,&nbsp;Lei Cai MM,&nbsp;Shuo Wang MD,&nbsp;Ran Yi MM,&nbsp;Yiqiong Zheng MD,&nbsp;Yan Zhang MD,&nbsp;Yukun Luo MD","doi":"10.1002/jum.70333","DOIUrl":"10.1002/jum.70333","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To compare the diagnostic efficacy of 3 imaging modalities—conventional ultrasound (US), contrast-enhanced ultrasound (CEUS), and their combination (US + CEUS)—among physicians with varying experience levels in diagnosing breast intraductal lesions and to elucidate the adjunctive value of CEUS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included patients who underwent both US and CEUS for breast lesions and were subsequently pathologically confirmed to have intraductal breast lesions between January 2022 and September 2025. Using pathological findings as the gold standard, the efficacy of senior, mid-career, and junior physicians in differentiating benign from malignant intraductal lesions was calculated and compared across the 3 diagnostic modalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 205 cases were included, comprising 117 benign and 88 malignant lesions. The combined US + CEUS approach demonstrated significantly superior diagnostic efficacy and higher diagnostic confidence scores compared to either CEUS or US alone among physicians at all experience levels. The combined modality yielded optimal efficacy in the senior physician group (<i>p</i> &lt; .001), while the magnitude of improvement was greatest among junior physicians (<i>p</i> &lt; .001), particularly for easily missed lesions like atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS). For any given examination protocol, diagnostic efficacy exhibited a declining trend with decreasing physician experience (<i>p</i> &lt; .05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CEUS serves as a valuable adjunctive tool for diagnosing breast intraductal lesions and is particularly beneficial for junior and mid-career physicians. The combined diagnostic approach enhances overall diagnostic performance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"45 11","pages":"2463-2474"},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520715","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}