Journal of Ultrasound in Medicine最新文献

{"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}

{"title":"ACR TI-RADS Modified by CEUS Features and Nodule Location for Diagnosis and Biopsy Decision in Thyroid Nodules of TR4 or Higher.","authors":"Shuo Wang, Xianquan Shi, He Ren, Ran Yi, Qiuya Yang, Taohua Gou, Lei Cai, Yan Zhang, Yukun Luo","doi":"10.1002/jum.70491","DOIUrl":"https://doi.org/10.1002/jum.70491","url":null,"abstract":"<p><strong>Objectives: </strong>To develop a modified American College of Radiology (ACR) thyroid imaging, reporting and data system (TI-RADS) incorporating contrast-enhanced ultrasound (CEUS) features and nodule location to improve diagnostic performance and fine-needle aspiration (FNA) recommendations for ACR TR4 or higher thyroid nodules.</p><p><strong>Methods: </strong>This prospective study enrolled patients who underwent ultrasound and CEUS at 3 hospitals between June 2024 and January 2026. CEUS and location features were analyzed using multivariable logistic regression to construct the modified system. Diagnostic performance and biopsy recommendation efficiency were compared with ACR TI-RADS.</p><p><strong>Results: </strong>Four hundred and eight patients with 442 nodules were included. Independent predictors included enhancement intensity, enhancement direction, ring enhancement, enhancement area and nodule location. In the training set (n = 334), the modified system achieved higher AUC and sensitivity than ACR TI-RADS (AUC: 0.90 [95% CI: 0.86-0.93] versus 0.75 [95% CI: 0.71-0.79]; sensitivity: 88.5% versus 60.3%; p < .01), higher accuracy of malignant nodule biopsies (AMB: 67.1% versus 49.4%), lower unnecessary biopsy rate (UBR: 32.9% versus 50.6%), and lower biopsy rate of benign nodules (BRB: 20.8% versus 31.2%), with no unsafe downgrading. Similar results were observed in the temporal validation set (n = 108): AUC 0.95 (95% CI: 0.90-0.99) versus 0.73 (95% CI: 0.66-0.79); sensitivity 87.0% versus 49.3%; AMB 83.3% versus 53.3%; UBR 16.7% versus 46.7%, and BRB 5.1% versus 17.9%.</p><p><strong>Conclusions: </strong>A modified ACR TI-RADS integrating CEUS features and nodule location improved diagnostic performance and FNA recommendations for ACR TR4 or higher nodules. Pending external validation, this system may provide a practical approach for refining risk stratification and reducing unnecessary biopsies.</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":"149182807","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":"Thoracoabdominal Cysts in the First Trimester as an Early Sonographic Sign of Congenital Diaphragmatic Hernia","authors":"Vu Nguyen Dinh MD,&nbsp;Van Giang Hoai MD,&nbsp;Linh Pham Vo Thuy MD,&nbsp;Thong Nguyen Van MD,&nbsp;Thi Le Anh MD","doi":"10.1002/jum.70407","DOIUrl":"10.1002/jum.70407","url":null,"abstract":"<p>First-trimester fetal abdominal cysts at the right thoracoabdominal border are typically regarded as benign findings. We report three cases in which such cysts, initially attributed to hepatic or pulmonary origin, subsequently evolved into right-sided congenital diaphragmatic hernia (CDH), providing additional sonographic evidence for a previously under-recognized pattern. Notably, cyst regression in the second trimester coincided with—rather than preceded—the development of intrathoracic hepatic herniation. Recognition of this pattern may facilitate earlier CDH diagnosis and improve perinatal counseling.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"45 11","pages":"2605-2610"},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700896","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 Assessment of the Fetal Pancreas in Normal and Abnormal Pregnancies: A Narrative Review","authors":"Hakan Golbasi MD","doi":"10.1002/jum.70357","DOIUrl":"10.1002/jum.70357","url":null,"abstract":"<p>Fetal pancreatic development is central to intrauterine glucose–insulin homeostasis and may influence lifelong metabolic risk. Advances in obstetric ultrasonography now allow in-utero assessment of pancreatic size, morphology, and echotexture, offering a non-invasive window into fetal metabolic adaptation across normal and high-risk pregnancies. A narrative review was conducted using electronic databases to identify human studies reporting sonographic evaluation of the fetal pancreas, including measurements of circumference, diameter, area, segmental lengths, derived ratios, and echogenicity grading, in relation to maternal metabolic status, fetal growth, and perinatal outcomes. Given methodological heterogeneity, a qualitative, theme-based synthesis was performed. Studies demonstrate that pancreatic biometry can be obtained reproducibly from mid-gestation, with strong correlations to gestational age, abdominal circumference, and estimated fetal weight. In diabetic pregnancies, pancreas size and echogenicity increase with maternal glycemic burden and are associated with fetal overgrowth and adverse neonatal outcomes. Mid-trimester pancreatic measurements and echogenicity show variable but promising performance for early gestational diabetes prediction. In contrast, most fetuses with established late-onset fetal growth restriction exhibit reduced pancreatic size, whereas novel diameter-based ratios may identify low-birthweight risk earlier. Targeted imaging aids diagnosis of structural and genetic pancreatic anomalies. Standardized ultrasound assessment of the fetal pancreas has evolved into a feasible, clinically informative adjunct to conventional biometry, reflecting the fetal response to diabetic exposure, growth restriction, and syndromic disease. Harmonized protocols, multicenter validation, and long-term metabolic follow-up are needed before pancreas-based parameters can be incorporated into routine prenatal risk stratification.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"45 11","pages":"2421-2430"},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352378","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":"Shear Wave Elastography of the Tibial Nerve and Lower Limb Nerve-Muscle-Tendon Complex in Diabetic Peripheral Neuropathy: Elastic Alterations and Clinical Implications.","authors":"Pengfeng Yang, Jianmei Huang, Yanhong Xiao, Jiaying Lin, Yu He","doi":"10.1002/jum.70502","DOIUrl":"https://doi.org/10.1002/jum.70502","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the associations among diabetic peripheral neuropathy (DPN), diabetic tendinopathy, and diabetic myopathy and their respective influencing factors using shear wave elastography (SWE).</p><p><strong>Methods: </strong>This study enrolled 65 diabetic patients (22 with DPN [PN-DM group], 43 without DPN [NPN-DM group]) and 35 healthy controls. Their general clinical data and laboratory indicators were collected. High-resolution ultrasound and SWE evaluated the morphology and elasticity of the tibial nerve (TN), Achilles tendon (AT), and medial head of gastrocnemius (MG). Parameters were compared among 3 groups.</p><p><strong>Results: </strong>Diabetic patients exhibited larger cross-sectional area (CSA) and transverse diameter (TD) of the TN than controls (all p < .05). Longitudinal TN shear wave velocity (SWV) progressively increased from controls to NPN-DM to PN-DM groups. The right TN Emax (cutoff: 3.87 m/s) demonstrated the highest diagnostic accuracy for DPN, with 90.9% sensitivity and 61.8% specificity. Diabetic patients displayed significantly reduced cross-sectional AT SWV, as well as lower absolute difference in pennation angle and SWV of the MG than controls (p < .01). The AT's SWV and MG's ΔSWV correlated positively (p < .001), but neither correlated with TN's SWV. HbA1c was independently associated with all 3 structures' elasticity (p < .05).</p><p><strong>Conclusions: </strong>TN's SWV increased significantly from the control to NPN-DM, and further to the PN-DM group. AT and MG's elasticity decreased significantly in diabetic patients with a positive correlation, but neither correlated with TN's elasticity. HbA1c was the solely independent risk factor common to the TN, AT, and MG elasticity.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166389","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":"AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Neonatal and Infant Spine, 2026 Revision.","authors":"","doi":"10.1002/jum.70507","DOIUrl":"https://doi.org/10.1002/jum.70507","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137205","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 Enlarged Fetal Thyroid: Sonographic and Clinical Findings.","authors":"Danielle M Richman, Sara Ahmadi, Sarah C Lassey, Carol B Benson, Mary C Frates","doi":"10.1002/jum.70513","DOIUrl":"https://doi.org/10.1002/jum.70513","url":null,"abstract":"<p><p>Retrospective review of our OB ultrasound database identified 17 fetuses with enlarged thyroid. Fourteen had a maternal risk factor, most commonly current or prior Graves' thyroiditis. In addition to the enlarged thyroid, abnormalities were identified in 6/17 (35.3%) fetuses. Treatment included adjusting the dose of propylthiouracil, methimazole, or levo-thyroxine, intraamniotic thyroxine, or nothing. Follow-up showed stable fetal thyroid size in 9 and decreased size in 5. Imagers should be aware that fetal goiter can result from maternal hyper- or hypothyroidism. Careful assessment and monitoring of mother and fetus are needed to determine the appropriate cause and treatment of fetal goiter.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137210","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":"Interpreting Transperineal Ultrasound Features of Perianal Fistula Activity in Pediatric Crohn's Disease.","authors":"Muhammad Aslam, Ayesha Tahreen, Minha Dureshahwar, Barkha","doi":"10.1002/jum.70506","DOIUrl":"https://doi.org/10.1002/jum.70506","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111549","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":"Serial Ultrasound in Suspected Choledocholithiasis: Measurement Conditions, Risk Categories, and the Incremental Yield Beyond Bilirubin.","authors":"Jie Shao, Jiawei Gu","doi":"10.1002/jum.70505","DOIUrl":"https://doi.org/10.1002/jum.70505","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111553","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":"Development and Validation of an Interpretable Machine Learning Model for Osteoporosis Prediction Using Multimodal Musculoskeletal Ultrasound and Clinical Features.","authors":"Huohu Zhong, Piaopiao Liu, Peifeng Huang, Jing Bai, Xihua Lian, Zhenhong Xu","doi":"10.1002/jum.70508","DOIUrl":"https://doi.org/10.1002/jum.70508","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to develop and validate an interpretable machine learning model for osteoporosis prediction based on multimodal ultrasound and clinical features.</p><p><strong>Methods: </strong>Participants with suspected osteoporosis were enrolled from 2 medical centers. Clinical variables and multimodal musculoskeletal ultrasound parameters, including muscle thickness, cross-sectional area, and shear wave elastography measurements, were collected. LASSO regression was used for feature selection. Eight machine learning algorithms, including logistic regression, decision tree, random forest, k-nearest neighbors, support vector machine, naïve Bayes, neural network, and XGBoost, were developed and compared. Model performance was evaluated in the training, internal validation, and external test cohorts using the area under curve (AUC), accuracy, and F1 score. Model interpretability was assessed using SHapley Additive exPlanations (SHAP).</p><p><strong>Results: </strong>The LASSO regression demonstrated that age, gastrocnemius medial head's muscle thickness (GmhMT), rectus femoris' cross-sectional area (RFCSA), gender, body mass index (BMI), and TibialisSWE were key features for osteoporosis. The XGBoost model demonstrated accuracy of 0.889, 0.825, and 0.773 in the training, validating, and testing sets. SHAP analysis revealed the importance ranking of factors as age, GmhMT, RFCSA, gender, BMI, and TibialisSWE. Personalized prediction explanations through SHAP values demonstrated the contribution of each feature to the final prediction, enhancing result interpretability.</p><p><strong>Conclusion: </strong>An interpretable machine learning model based on multimodal musculoskeletal ultrasound and clinical features demonstrated promising performance for osteoporosis prediction. That may provide a practical and explainable tool for early osteoporosis risk stratification and individualized assessment.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111532","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}