Journal of Ultrasound in Medicine最新文献

{"title":"A New Automated Ultrasound Quantification of Urethral Mobility for Stress Urinary Incontinence: A Feasibility Study.","authors":"Kourosh Kalayeh, J Brian Fowlkes, Bryan S Sack, Jennifer LaCross, Stephanie Daignault-Newton, Payton Schmidt, Haowei Tai, William W Schultz, James A Ashton-Miller, John O DeLancey","doi":"10.1002/jum.16676","DOIUrl":"https://doi.org/10.1002/jum.16676","url":null,"abstract":"<p><strong>Objectives: </strong>Stress urinary incontinence (SUI) is a prevalent condition that can significantly affect quality of life. Urethral mobility is an important factor in SUI and transperineal ultrasound (TPUS) imaging can provide clear visualization of this movement; however, its quantification has been limited. An automated system to track and quantify urethral movement could provide richer information and reduce inter-observer effects on measurements.</p><p><strong>Methods: </strong>As proof-of-concept for technique development, we used TPUS cine loops obtained on commercial scanners (GE Healthcare and Philips Healthcare) from consented research volunteers. We developed the tracking software based on fundamental concepts from computer vision, specifically corner detection and optical flow-based tracking algorithms. In doing so we account for inadvertent probe movements by using the symphysis pubis as a reference coordinate system.</p><p><strong>Results: </strong>The system successfully tracks the motion of the urethra during Valsalva maneuvers. It accurately captures and quantifies complex movements, including directional shifts, rotations, displacement vectors of different structures, and the trajectory of motion. These measurements are corrected for any probe movement. We demonstrated the system's efficiency and reliability in near real-time analysis across various ultrasound platforms and video formats. The intraclass correlation coefficients exceeded 0.89 and 0.5 for intra- and inter-rater reliability, respectively.</p><p><strong>Conclusions: </strong>By providing detailed, objective measurements of urogenital movement, this approach has potential to advance the understanding, diagnosis and treatment of SUI, which in turn, can help tailor more effective treatment strategies. This methodology paper confirms the feasibility of automated quantification of urethral mobility.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649590","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":"Advancements in Three-Dimensional Super-Resolution Ultrasound Imaging: A Narrative Review.","authors":"Debabrata Ghosh, Kenneth Hoyt","doi":"10.1002/jum.16682","DOIUrl":"10.1002/jum.16682","url":null,"abstract":"<p><p>The lack of sensibility of traditional ultrasound (US) imaging to the slow blood flow in small vessels resulted in the development of microbubble (MB) contrast agents. These MBs are given intravenously, and US imaging can detect them quite effectively. This noninvasive imaging method, known as contrast-enhanced US (CEUS), now makes it possible to accurately assess tissue perfusion and blood flow. Though CEUS offers several benefits, diffraction restricts the spatial resolution of all US imaging systems to length scales equal to roughly half the wavelength of the transmitted US beam. Based on individual MB detection and localization, the recently developed super-resolution US (SRUS) imaging method has shown unprecedentedly high spatial resolution exceeding the physical diffraction limit. It is now possible to visualize the microvasculature beyond the diffraction-limited resolution by localizing spatially isolated MBs across several frames. The highest resolution possible at clinical US frequencies can be on the order of several micrometers when tissue and probe motion are not present. Enhancing the functional study of tissue microvascular networks with structural data could lead to improved disease management. Through the localization and tracking of MBs, SRUS may reconstruct images of the microvasculature with resolution exceeding the diffraction limit in both 2-dimensional (2D) and 3-dimensional (3D) space. In contrast to the 2D approach, 3D SRUS imaging does not suffer from out-of-plane motion and can offer volumetric coverage with super-resolution in all three dimensions. Research has used two primary methods for 3D SRUS imaging including arrays that can electronically gather volumetric information or mechanically scanning the volume with a linear probe to produce a stack of 2D SRUS images. This manuscript aims to offer a comprehensive review of 3D SRUS imaging, clarifying methodologies, clinical applications, and notable challenges that could motivate future research and help facilitate clinical translation.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605353","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":"Reproducibility of Ulnar Nerve Displacement Prevalence in Youth Baseball Players: A Follow-Up Study.","authors":"Masashi Kawabata, Sohei Shimizu, Koji Saito, Yudai Nagano, Toru Miyata, Daichi Naoi, Takehiro Yamamoto, Kazuma Miyatake, Yohei Kusaba, Hiroyuki Watanabe, Naonobu Takahira","doi":"10.1002/jum.16681","DOIUrl":"https://doi.org/10.1002/jum.16681","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605358","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 Utility of Lung Ultrasound Scoring in Predicting Post-Extubation Respiratory Support After Congenital Heart Surgery","authors":"Yordan Hristov Georgiev MD,&nbsp;Bianca Haase MD,&nbsp;Felix Neunhoeffer MD,&nbsp;Johannes Nordmeyer MD, PhD,&nbsp;Ilias Tsiflikas MD,&nbsp;Jörg Michel MD,&nbsp;Maximilian Gross MD","doi":"10.1002/jum.16668","DOIUrl":"10.1002/jum.16668","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Lung ultrasound (LU) is effective in diagnosing the accumulation of extravascular lung water and assessing real-time fluid status in infants following congenital cardiac surgery with cardiopulmonary bypass. This study evaluated whether LU can be used as a prognostic marker for changes in noninvasive respiratory support after extubation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Infants with congenital heart disease (CHD) &lt;1 year of age requiring mechanical ventilation for more than 24 hours postoperatively were included. Using a linear probe, 3 scan fields from each hemithorax were assessed for B-lines and consolidations, with scores ranging from 0 to 3 assigned per area. LU scores were rated then by 4 independent operators. After extubation, patients were monitored for respiratory support modifications over the following 48 hours and were divided into 3 subgroups: steady state, escalation, and de-escalation, accordingly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this single-center observational pilot study, a total of 30 patients with a median age of 116 (interquartile range: 17–196) days were included in the prospective analysis between July 2022 and December 2023. LU scores differed significantly among groups: 3.47 ± 2.3 (steady state), 6.14 ± 2.55 (escalation), and 1.63 ± 1.41 (de-escalation), <i>P</i> = .002. ROC analysis identified a cut-off score of ≥5 as predictive of escalation risk with a sensitivity of 86% and specificity of 83%. A score &lt;2 suggested potential for de-escalation within 48 hours, with a sensitivity of 75% and specificity of 73%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>LU scoring may be a valuable tool for optimizing ventilator weaning and post-extubation respiratory strategies in infants undergoing congenital cardiac surgery. Further studies are warranted to validate these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 6","pages":"1085-1091"},"PeriodicalIF":2.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16668","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586208","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":"Refining the Accuracy of Pelvic Free Fluid Estimation in Pediatric Trauma: Insights on Physician Performance in FAST Imaging.","authors":"Liying Zheng","doi":"10.1002/jum.16677","DOIUrl":"https://doi.org/10.1002/jum.16677","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Web-Based Deliberate Practice of Pediatric Point of Care Ultrasound Cases in Resource-Limited Settings: A Multicenter Implementation and Effectiveness Study.","authors":"Angelo Ricci, Daniel Lindsay, Carla Schwanfelder, Erin Stratta, Michelle Lee, Kathy Boutis","doi":"10.1002/jum.16679","DOIUrl":"https://doi.org/10.1002/jum.16679","url":null,"abstract":"<p><strong>Objectives: </strong>The main objective of this study was to implement an online pediatric case-based POCUS course in low-resource medical settings and examine learning outcomes and feasibility.</p><p><strong>Methods: </strong>This was a multicenter prospective cohort study conducted in a convenience sample of clinicians affiliated with Médecins Sans Frontières (MSF) training sites. MSF POCUS trainers provided the standard hands-on, on-site POCUS training and supplemented this with access to a web-based course. Participants provided diagnoses for 400 image-based POCUS cases from four common pediatric POCUS applications until they achieved the mastery learning standard of 90% accuracy, sensitivity (cases with pathology), and specificity (cases without pathology). Each participant also completed a course evaluation.</p><p><strong>Results: </strong>From 10 MSF sites, 110 clinicians completed 82,206 cases. There were significant learning gains across the POCUS applications with respect to accuracy (delta 14.2%; 95% CI 13.1, 15.2), sensitivity (delta 13.2%; 95% CI 12.1, 14.2), and specificity (delta 13.8%; 95% CI 12.7, 15.0). Furthermore, 90 (81.8%) achieved the mastery learning standard in at least one application, and 69 (62.7%) completed a course evaluation on at least one application for a total of 231 evaluations. Of these, 206 (89.2%) agreed/strongly agreed that the experience had relevance to their practice, met expectations, and had a positive user design. However, 59/110 (53.6%) clinicians reported a lack of protected time, and 54/110 (49.0%) identified challenges with accessing internet/hardware.</p><p><strong>Conclusions: </strong>In resource-limited MSF settings, implementing web-based POCUS case practice demonstrated successful learning outcomes despite approximately half of the participants encountering significant technical challenges.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventricular Free Wall and Septal Wall Displacement of the Fetal Heart: A Quantitative and Qualitative Assessment.","authors":"Greggory R DeVore, Berthold Klas, Gary Satou, Mark Sklansky","doi":"10.1002/jum.16673","DOIUrl":"https://doi.org/10.1002/jum.16673","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to measure the systolic displacement of the free and septal walls of the right (RV) and left (LV) ventricles using speckle tracking analysis in normal fetuses and those with cardiac abnormalities.</p><p><strong>Methods: </strong>Two-hundred fetuses between 20 and 40 weeks of gestation were examined in which the 4-chamber view (4CV) of the fetal heart was imaged. Speckle tracking analysis of the RV and LV was used to measure the length of displacement between end-diastole and end-systole for each of 24 segments located on the free and septal walls from the base to the apex of each ventricle. The mean displacement length was computed for the base (segments 1-8), mid-chamber (segments 9-16), and the apex (segments 17-24) of the RV and LV free walls (RVfw, LVfw) and septal walls (RVsw, LVsw). Fractional polynomial regression analysis was used to compute the mean equation for the base, mid-chamber, and apex displacement lengths for the RV and LV free walls and septal walls using gestational age as the independent variable. The Kruskal-Wallis test with a Bonferroni correction was used to compare the mean values from the base, mid-chamber, and apex segments between the RVfw versus RVsw, LVfw versus LVsw, RVfw versus LVfw, and RVsw versus LVsw. In addition, the ultrasound program provided a graphic of the systolic segment length of the RV and LV free walls and septal walls. Four examples of cardiac pathology were used to illustrate abnormal free and septal wall segment displacement.</p><p><strong>Results: </strong>The mean segment end-systolic displacement lengths for the RVfw (base and mid-chamber), and LVfw (base, mid-chamber, and apex) increased with gestational age. However, The RVsw and LVsw segment lengths did not increase or increased minimally as a function of gestational age. The displacement lengths for the RVfw versus RVsw and LVfw versus LVsw were greater for the free wall than the septal wall for the base, mid-chamber, and apex. When comparing the RV with the LV, the segment lengths for the RVfw were significantly greater than the LVfw for the base. The segment lengths were significantly greater for the LVsw than the RVsw for the base, mid-chamber, and apex. The LVsw segments moved inward toward the LV chamber for the mid-chamber and apex. For the RVsw, the segment lengths moved between both the RV and LV chamber during systole. Four pathological cases graphically illustrated abnormal movement of the RVfw, LVfw, RVsw, and LVsw.</p><p><strong>Conclusion: </strong>Speckle tracking analysis enabled quantitation of the systolic ventricular free wall and septal wall segment displacement as well as a graphical display of displacement that can be used to identify pathological changes when abnormal cardiac function is present.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic Ultrasound in Pediatric Chest Trauma: Beyond the Basics.","authors":"Evangelia E Vassalou, Iraklis Perysinakis, Eelco de Bree, Maria Raissaki","doi":"10.1002/jum.16672","DOIUrl":"https://doi.org/10.1002/jum.16672","url":null,"abstract":"<p><p>Chest trauma in children may result in variable injuries. Although radiographs represent the mainstay modality for triage, ultrasound may prove to be a useful diagnostic tool, having the potential to supplement radiographic findings and tailor ionizing imaging. There is growing evidence demonstrating the high accuracy of ultrasound in assessing several conditions related to pediatric chest trauma. Familiarity with the scanning technique, together with an understanding of the sound properties of solid tissue, air, and fluid, is essential for image interpretation. Herein, we present tips regarding a detailed sonographic technique, landmarks relevant to normal anatomy, and abnormal findings encountered in children with accidental thoracic trauma.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot Study to Evaluate the Association Between Superb Microvascular Imaging (SMI) and Histologic Markers of Angiogenesis in Patients With Invasive Ductal Carcinoma.","authors":"Yasemin Kayadibi, Osman Aykan Kargin, Seda Aladag Kurt, Tulin Ozturk, Mehmet Halit Yilmaz","doi":"10.1002/jum.16674","DOIUrl":"https://doi.org/10.1002/jum.16674","url":null,"abstract":"<p><strong>Objectives: </strong>Increasing microvessel density and angiogenesis are linked to a poor prognosis in patients with invasive ductal carcinoma (IDC) of the breast. This study aims to investigate intratumoral and peritumoral microvascular flow using superb microvascular imaging (SMI) in patients with IDC and explore its association with histologic markers of tumoral angiogenesis.</p><p><strong>Methods: </strong>Fifty-four female patients with IDC (mean age 49.5 ± 14.8 years) were evaluated using SMI before biopsy. The quantitative and qualitative vascular parameters on SMI (Adler's classification, vascular index, morphology, distribution, and penetration) were assessed. Histologic markers of angiogenesis (VEGF, ERG, and CD34) were analyzed via immunohistochemical staining in both intratumoral and peritumoral compartments of biopsy specimens. The expression levels were categorized semi-quantitatively as low or high groups based on the Allred scoring system. The association between histological and SMI parameters was analyzed. Subgroup analysis was performed according to lesion size, axillary lymph node metastasis, and histological grade.</p><p><strong>Results: </strong>IDCs with higher expression of VEGF in the peritumoral region showed a higher vascular index (7 ± 6.4 [95% CI 5.2-8.8] versus 3.7 ± 0.9 [95% CI 2.3-5.2], P = .003) on SMI. Likewise, high peritumoral ERG expression was linked to a higher vascular index (7.2 ± 6.3 [95% CI 5.4-9.0] versus 2.4 ± 1 [95% CI 1.1-3.8], P < .001), complex vessel morphology (66.7% versus 20%, P = .024), penetrating vessels (63% versus 20%, P = .037), and central vascularity (77.6% versus 20%, P = .006). Tumors with higher intratumoral ERG expression demonstrated a more complex vessel morphology on SMI (85.7% versus 60%, P = .047). The presence of axillary lymph node metastasis was associated with a higher vascular index (10 ± 7.6 [95%CI 6.7-13.2] versus 4.2 ± 3 [95%CI 3.1-5.3], < .001), complex morphology (83.3% versus 53.3%, P = .020), and penetrating vessels (63.2% versus 50%, P = .027) on SMI, as well as higher peritumoral ERG expression (100% versus 83.3%, P = .045).</p><p><strong>Conclusions: </strong>In this pilot study, tumors with higher neo-angiogenic activity based on histological markers correlate with increased vascular index, complex vessel morphology, penetrating vessels, and central vascularity on SMI. Larger studies are needed to assess the diagnostic accuracy and utility of risk stratification of patients.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isn't It Time for the Cardiac Sweep to Span From the Stomach to the Left Brachiocephalic Vein?","authors":"Oxana M. Zarudskaya MD, PhD,&nbsp;Erica Smith MD,&nbsp;Kam Szlachetka RDMS,&nbsp;Reem S. Abu-Rustum MD","doi":"10.1002/jum.16666","DOIUrl":"10.1002/jum.16666","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 6","pages":"1121-1124"},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}