Journal of Ultrasound in Medicine最新文献

{"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}

{"title":"Investigation of Phase-Change Droplets and Fast Imaging for Indicator Dilution Measurement of Flow.","authors":"Zachary Zajac, Brandon Helfield, Ross Williams, Paul Sheeran, Charles Tremblay-Darveau, Kimoon Yoo, Peter N Burns","doi":"10.1002/jum.16722","DOIUrl":"https://doi.org/10.1002/jum.16722","url":null,"abstract":"<p><strong>Objectives: </strong>The development of low boiling point liquid droplets as phase-change contrast agents allows for the local creation of microbubbles at a point of interest in vivo. Although there are many possible applications, few investigations have used selectively created microbubble boluses to measure volumetric flowrate. In this study, the flow ratio between two vessels is calculated by vaporizing droplets in each vessel individually.</p><p><strong>Methods: </strong>Proof of principle is demonstrated in vitro by an imaging sequence that vaporizes droplets using a high mechanical index pulse, then images the transit of the resulting microbubbles at a high frame rate using low mechanical index plane waves.</p><p><strong>Results: </strong>It is shown that a linear relationship exists between the concentration of droplets and enhancement of the resulting microbubble bolus. In vitro flow is measured with a mean error of 8% in a 0.66 cm diameter vessel and with a mean error of 33% in a 0.49 cm diameter vessel. The relative volumetric flow between two adjacent vessels is calculated with a mean percentage error of 25% when imaging the region of droplet vaporization for flow ratios between 0.25 and 4.</p><p><strong>Conclusions: </strong>This in vitro study demonstrates the feasibility of using a positive bolus tracer, induced by image-guided ultrasound excitation, to measure flow. Potential applications include measurement of the portal vein to hepatic artery flow ratio, known as the hepatic perfusion index.</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":"144094152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Cumulative Fluid Balance and the Degree of Venous Congestion According to VExUS Score in Critically Ill Patients in a General Intensive Care Unit.","authors":"Carmelo José Espinosa-Almanza, Héctor Andrés Ruiz-Ávila, Juan Esteban Gomez-Tobar, Estivalis Acosta-Gutiérrez","doi":"10.1002/jum.16709","DOIUrl":"https://doi.org/10.1002/jum.16709","url":null,"abstract":"<p><strong>Objectives: </strong>The Venous Excess Ultrasound Score (VExUS) assesses venous congestion using point-of-care ultrasound. While validated to predict acute kidney injury, its relationship with cumulative fluid balance and clinical edema remains unclear. This study aimed to evaluate these associations 72 hours after intensive care unit (ICU) admission.</p><p><strong>Methods: </strong>This analytical observational cohort study included adult ICU patients with Foley catheters inserted at admission for fluid balance quantification. Patients on dialysis or with cirrhosis or abdominal hypertension were excluded. The correlation between cumulative fluid balance, edema clinical grade, and VExUS grade was analyzed. Multivariate analysis identified factors associated with significant venous congestion (VExUS grade ≥2), with statistical significance set at P < .05.</p><p><strong>Results: </strong>A total of 123 patients were included, with a mean age of 60 years (SD ±19.2); 59.3% were male. Venous congestion (VExUS grade ≥1) was observed in 36.5% of patients, despite an average cumulative fluid balance of +0.88 L. Each liter of positive cumulative fluid balance increased the risk of significant congestion (VExUS grade ≥2) by 31% (OR = 1.31; 95% CI: 1.07-1.60). The correlation between clinical edema (Godet scale) and VExUS grade was weak (Spearman rho = 0.27), and clinical edema was not associated with significant congestion (OR = 3.22; 95% CI: 0.77-13.56).</p><p><strong>Conclusions: </strong>In ICU patients, fluid overload is an early contributor to significant venous congestion (VExUS grade ≥2) but does not correlate with clinical edema grades, highlighting the limitations of clinical edema in assessing venous congestion.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078582","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":"Incidence and Diagnostic Performance of Postnatal Ultrasound for Presacral Masses in Pediatric Patients with Anorectal Malformation.","authors":"Takahiro Hosokawa, Yumiko Sato, Yutaka Tanami, Kyoichi Deie, Hiroshi Kawashima, Eiji Oguma","doi":"10.1002/jum.16724","DOIUrl":"https://doi.org/10.1002/jum.16724","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the incidence of presacral masses in patients with anorectal malformations (ARMs) and evaluate the diagnostic performance of ultrasound to detect presacral masses during the neonatal period.</p><p><strong>Methods: </strong>Pediatric patients with ARM underwent ultrasonography during the neonatal period, and their magnetic resonance imaging (MRI) results were reviewed. The presence or absence of a presacral mass was assessed employing ultrasonography and compared with MRI results using the Clopper-Pearson method. The type of ARM (low/not-low) and the presence or absence of sacral anomalies were compared between patients with and without a presacral mass using Fisher's exact test.</p><p><strong>Results: </strong>The incidence of presacral masses in our study cohort was 4.6% (5/109). Ultrasound diagnostic performance for detecting presacral masses had an accuracy of 98.2% (95% confidence interval (CI): 93.5-99.8), sensitivity of 60% (95% CI: 14.7-94.7), specificity of 100% (95% CI: 96.5-100), positive predictive value of 100% (95% CI: 29.3-100), and negative predictive value of 98.1% (95% CI: 93.4-99.8). ARM type and presence or absence of sacral anomalies were significantly different between the presacral mass and without presacral mass groups (low/not-low = 5/0 vs 47/57, P = .022; and presence/absence of sacral anomalies = 3/2 vs 18/86, respectively, P = .048).</p><p><strong>Conclusions: </strong>The incidence of presacral masses in pediatric patients with ARM was low (5%). Although the positive predictive value was reliable, ultrasonography performed during the neonatal period was not sensitive. Therefore, sonographers should pay attention when evaluating patients with low-type ARMs accompanying sacral anomalies to avoid overlooking them.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078581","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":"Advancing Testicular Trauma Diagnosis: Insights From CEUS and Biomarker Analysis in Animal Models and Future Directions.","authors":"Jingdan Cheng, Xiaohui Wu, Chengqiang Jin","doi":"10.1002/jum.16719","DOIUrl":"https://doi.org/10.1002/jum.16719","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028661","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":"Does Ultrasound Guidance Provide Pain Relief During Intrauterine Contraceptive Device Insertion? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Jan Bosteels, William Spratt, Ben W Mol","doi":"10.1002/jum.16720","DOIUrl":"https://doi.org/10.1002/jum.16720","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021156","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}