Journal of Ultrasound in Medicine最新文献

{"title":"The Levator Plate Architecture Is Altered in Women with Fecal Incontinence.","authors":"Yael Baumfeld, Qi Wei, Jittima Manonai, Jonia Alshiek, S Abbas Shobeiri","doi":"10.1002/jum.16671","DOIUrl":"https://doi.org/10.1002/jum.16671","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the architecture of the levator plate and anal complex in women with fecal incontinence using 3-dimensional endoanal ultrasound (EAUS).</p><p><strong>Methods: </strong>A retrospective cohort study reviewed EAUS examinations performed on women with fecal incontinence. The anal complex and levator plate architecture were examined and compared to a control group of women without fecal incontinence. The anal canal was divided into 6 different areas, and the visibility of specific structures was recorded. Measurements of the external anal sphincter (EAS) length, levator plate length, and the distance between the EAS and the levator plate were taken.</p><p><strong>Results: </strong>The study included 31 patients with fecal incontinence and 30 nulliparous controls. Significant differences were observed in the anal complex anatomy between the 2 groups. The fecal incontinence group had a higher prevalence of abnormal levator plate anatomy (84%) than the control group (3%). The EAS size was significantly smaller in the fecal incontinent group (16 versus 18 mm, P = .04), and there was a shorter distance between the EAS and the levator plate (22 versus 28 mm, P = .001).</p><p><strong>Conclusions: </strong>Women with fecal incontinence exhibited significant changes in the anatomy of the anal canal, particularly in caudad structures of the anal sphincter complex. Additionally, a shorter distance between the levator plate and the EAS was observed in fecal incontinent patients. Sonographic assessment adds much to the evaluation of defecatory disorders.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542526","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":"Novel Three-Dimensional Printed Simulators for Ultrasound-Guided Prenatal Diagnostic Procedures.","authors":"Nathan A Keller, Allison E Neuwirth, Frank I Jackson, Insaf Kouba, Jolene Muscat, Luis A Bracero, Matthew J Blitz","doi":"10.1002/jum.16675","DOIUrl":"https://doi.org/10.1002/jum.16675","url":null,"abstract":"<p><p>Amniocentesis and chorionic villous sampling (CVS) are essential ultrasound-guided diagnostic procedures in modern obstetrics, but their declining frequency poses challenges for clinician training. We present novel 3-dimensional (3D)-printed simulators designed to train practitioners in performing these procedures under ultrasound guidance. Our models combine 3D-printed components with medical gelatin to mimic the abdomen and pelvis of a pregnant patient. Customizable inserts enable realistic simulated needle targeting practice. This standardized, reproducible, and realistic training tool offers a valuable resource for improving ultrasound-guided procedural skills.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542525","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":"Comparative Evaluation of Superb Microvascular Imaging and Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Differentiating Benign and Malignant Breast Masses","authors":"Ahmet Yasin Yitik MD,&nbsp;Nuran Sabir MD,&nbsp;Sevda Yılmaz MD","doi":"10.1002/jum.16664","DOIUrl":"10.1002/jum.16664","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Our study aims to compare the diagnostic performance of superb microvascular imaging (SMI) and dynamic contrast-enhanced magnetic resonance imaging (MRI) in differentiating benign from malignant breast masses, using histopathological findings as the reference standard.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective study was conducted from April 2022 to March 2024. A total of 112 breast lesions from 110 patients were evaluated using gray-scale ultrasonography, SMI, and dynamic contrast-enhanced MRI. The vascular index (VI) obtained during SMI examination and kinetic curve patterns from MRI were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Histopathological analysis revealed 62 benign and 50 malignant lesions. The VI showed a statistically significant difference between benign and malignant lesions, with a mean VI of 5.12 ± 4.66 in benign masses and 10.13 ± 5.48 in malignant masses (<i>P</i> &lt; .001). The ROC analysis demonstrated an AUC of 0.79 for SMI with a VI cut-off value of 4.15, yielding a sensitivity of 92%, specificity of 60%, and accuracy of 74%. A statistically significant correlation was found between VI values and MRI contrast enhancement kinetic curve types (<i>P</i> &lt; .05). MRI demonstrated superior diagnostic performance, with an AUC of 0.89 and sensitivity, specificity, and accuracy of 98, 80.65, and 88.39%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SMI, when used in conjunction with conventional ultrasonography and MRI, provides significant diagnostic value in differentiating benign from malignant breast masses. The study supports the potential integration of SMI into routine breast cancer diagnostic workflows, particularly in settings where MRI is less accessible.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 6","pages":"1047-1058"},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16664","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483572","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":"The Effect of Backscatter Anisotropy in Assessing Hepatic Steatosis Using Ultrasound Hepatorenal Index","authors":"Jing Gao MD,&nbsp;Ben Wilde DO,&nbsp;Oliver D. Kripfgans PhD,&nbsp;Johnson Chen MD,&nbsp;Jonathan M. Rubin MD, PhD","doi":"10.1002/jum.16669","DOIUrl":"10.1002/jum.16669","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To discuss challenges in assessing hepatic steatosis using ultrasound hepatorenal index (HRI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed HRI and liver magnetic resonance imaging-based proton density fat fraction (MRI-PDFF) in 134 adult participants (53 men and 81 women, mean age 55 years). The diagnostic performance of HRI for determining hepatic steatosis was tested by the area under the receiver operating characteristic curve (AUROC) using liver MRI-PDFF as the reference. Regression plots were employed to compare the sampling sites in liver and kidney that were used to calculate HRIs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 11 of 134 cases (8.2%), we failed to acquire HRI measurements. In the remaining 123 cases, AUROC for HRI (cutoff: 1.69 ± 0.13 [mean ± standard deviation]) for defining the HRI threshold for diagnosing hepatic steatosis was 0.83. In 60 of 123 cases (49%) with HRI measurement IQR/median &gt;0.3, slopes of the regression lines in the liver showed backscatter intensity changes consistent with signal attenuation. However, in the kidney, the backscatter intensity was inverted yielding position-dependent HRI cutoff values, mid-pole = 2.24 ± 0.20 and upper pole = 1.08 ± 0.16.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HRI is used to estimate liver steatosis based on backscattered ultrasound. In order to compensate for effects such as body habitus and transducer frequency, the liver backscatter is divided by backscatter from a corresponding region at the same depth in the right renal cortex. Theoretically, this compensation should make HRI sampling position independent. Yet, due to renal cortical backscatter anisotropy, this compensation method does not work in general, potentially producing inaccurate liver fat estimates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 6","pages":"1093-1101"},"PeriodicalIF":2.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458644","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":"Differences in the Sonographic Features of Adenomyosis and Concurrent Endometriosis Compared to Isolated Adenomyosis","authors":"Ran Matot MD,&nbsp;Ophir Blickstein MD,&nbsp;Gideon Leibner MD,&nbsp;Uval Bar-Peled MD,&nbsp;Adi Borovich MD,&nbsp;Yossi Geron MD,&nbsp;Yinon Gilboa MD,&nbsp;Haim Krissi MD,&nbsp;Sharon Perlman MD","doi":"10.1002/jum.16667","DOIUrl":"10.1002/jum.16667","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine whether the co-occurrence of endometriosis affects the sonographic features of adenomyosis based on the revised Morphological Uterus Sonographic Assessment (MUSA) criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective cohort study utilized data from a tertiary referral center collected between 2010 and 2022. Non-pregnant women aged 20–53 years who presented with symptoms potentially related to adenomyosis and underwent pelvic ultrasound scans were included. Diagnoses were based on the revised MUSA criteria, which distinguish between direct features (endometrial cysts, hyperechogenic islands, echogenic sub-endometrial lines, and buds) and indirect features (globular shape of the uterus, asymmetrical uterine wall thickening, irregular junctional zone, fan-shaped shadowing, translesional vascularity, and interrupted junctional zone). Patients were categorized into 2 groups: 1) concurrent adenomyosis and endometriosis and 2) isolated adenomyosis. Demographic and clinical characteristics were retrospectively collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-four patients were diagnosed with adenomyosis. Of these, 24 (27%) had concurrent endometriosis, while 70 had isolated adenomyosis. The most frequent sonographic features were globular uterine configuration (52%), myometrial cysts (44%), and asymmetrical myometrial thickening (33%). The isolated adenomyosis group had a higher proportion of direct features (29%) and both direct and indirect features (33%) compared to the concurrent group, which predominantly exhibited indirect features (71%) (<i>P</i> &lt; .05). Direct features of myometrial cysts were significantly more frequent in the isolated adenomyosis group (51%) compared to the concurrent group (21%, <i>P</i> = .01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Utilizing the revised MUSA criteria revealed significant differences in the sonographic features of adenomyosis in symptomatic patients with concurrent endometriosis compared to isolated adenomyosis. This highlights the necessity for standardized diagnostic methods and enhances understanding of the complex relationship between adenomyosis and endometriosis, underscoring the importance of accurate diagnosis in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 6","pages":"1077-1084"},"PeriodicalIF":2.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16667","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449247","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":"Advancing Osteoporosis Assessment Through a Numerical Study Utilizing Ultrasonic Waves in Femur Bone Evaluation","authors":"Mohammadhossein Gandomkar MSc,&nbsp;Mohammadhossein Soorgee PhD,&nbsp;Hossein Habibi PhD,&nbsp;Mehdi Mehdizadeh kafash PhD","doi":"10.1002/jum.16659","DOIUrl":"10.1002/jum.16659","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Osteoporosis, a musculoskeletal condition characterized by bone density loss, significantly heightens the risk of fractures. Early detection of this condition is paramount in both its prevention and effective treatment. Traditionally, osteoporosis diagnosis relies heavily on dual X-ray absorptiometry. However, this research demonstrates an initiative by utilizing quantitative ultrasound as a cost-effective, noninvasive alternative, particularly advantageous in certain scenarios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>By applying the finite element method, we simulate ultrasound propagation within intricate femur head models, incorporating both healthy and osteoporotic conditions. Through meticulous analysis, we unveil novel speed-based and amplitude-based indices derived from ultrasound signals, offering insights of high resolution into bone evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our findings illuminate a paradigm shift: as osteoporosis advances, there is a discernible decrease in speed of sound values, while ultrasound amplitude exhibits intriguing fluctuations, dependent on intricate tissue interactions such as diverse acoustic impedance at tissues' interface and echo reflections within the bone models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The approach used in this study promises to reshape osteoporosis assessment, paving the way to revolutionize prevention and treatment strategies. The associated results of our study also could open up new avenues for investigating ultrasound propagation in three-dimensional bone models.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 6","pages":"991-1006"},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441130","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":"Diagnosis of Thyroid Nodule Malignancy Using Peritumoral Region and Artificial Intelligence","authors":"Ali Abbasian Ardakani PhD,&nbsp;Afshin Mohammadi MD,&nbsp;Chai Hong Yeong PhD,&nbsp;Wei Lin Ng MD,&nbsp;Aik Hao Ng PhD,&nbsp;Kasturi Nair Tangaraju MD,&nbsp;Selda Behestani MD,&nbsp;Mohammad Mirza-Aghazadeh-Attari MD,&nbsp;Revathy Suresh BSc,&nbsp;U. Rajendra Acharya PhD, DEng, DSc","doi":"10.1002/jum.16665","DOIUrl":"10.1002/jum.16665","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To develop, test, and externally validate a hybrid artificial intelligence (AI) model based on hand-crafted and deep radiomics features extracted from B-mode ultrasound images in differentiating benign and malignant thyroid nodules compared to senior and junior radiologists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 1602 thyroid nodules from four centers across two countries (Iran and Malaysia) were included for the development and validation of AI models. From each original and expanded contour, which included the peritumoral region, 2060 handcrafted and 1024 deep radiomics features were extracted to assess the effectiveness of the peritumoral region in the AI diagnosis profile. The performance of four algorithms, namely, support vector machine with linear (SVM_lin) and radial basis function (SVM_RBF) kernels, logistic regression, and K-nearest neighbor, was evaluated. The diagnostic performance of the proposed AI model was compared with two radiologists based on the American Thyroid Association (ATA) and the Thyroid Imaging Reporting &amp; Data System (TI-RADS™) guidelines to show the model's applicability in clinical routines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-five hand-crafted and 36 deep radiomics features were considered for model development. In the training step, SVM_RBF and SVM_lin showed the best results when rectangular contours 40% greater than the original contours were used for both hand-crafted and deep features. Ensemble-learning with SVM_RBF and SVM_lin obtained AUC of 0.954, 0.949, 0.932, and 0.921 in internal and external validations of the Iran cohort and Malaysia cohorts 1 and 2, respectively, and outperformed both radiologists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The proposed AI model trained on nodule+the peripheral region performed optimally in external validations and outperformed the radiologists using the ATA and TI-RADS guidelines.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 6","pages":"1059-1074"},"PeriodicalIF":2.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425520","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":"Reliability of Physician Estimation of Pelvic Free Fluid Volume on the Pediatric Focused Assessment With Sonography for Trauma","authors":"Ashkon Shaahinfar MD, MPH,&nbsp;Jennifer Rosin Wiebelhaus MD,&nbsp;Newton Addo BS,&nbsp;Ronald A. Cohen MD,&nbsp;Pinar Karakas-Rothey MD,&nbsp;Aaron E. Kornblith MD","doi":"10.1002/jum.16661","DOIUrl":"10.1002/jum.16661","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the reliability of physician gestalt estimation of pelvic free fluid volume on pediatric Focused Assessment with Sonography for Trauma (FAST). To determine a reliable cut-off volume and characteristics associated with small pelvic free fluid.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our study assessed the ability of 2 ultrasound-trained pediatric emergency medicine (PEM) physicians and 2 pediatric radiologists to characterize pelvic free fluid in a retrospective convenience sample of archived FAST from a Level 1 pediatric trauma center, April 2018–June 2020. Inter- and intra-rater reliability were measured to determine the most reliable volume cut-off. Chi-squared and Fisher's exact tests determined characteristics associated with physiologic fluid and fluid volume.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-one (10.2%) of 797 FAST had pelvic fluid and met inclusion criteria. Volume estimates using none/trace/small versus moderate/large classifications were moderately reliable by the PEM physicians (κ = 0.65 [95% CI, 0.63–0.66]; raw agreement = 92%) and radiologists (κ = 0.48 [95% CI, 0.47–0.49]; raw agreement = 91%). This volume cut-off demonstrated higher reliability for both groups and greater agreement for PEM physicians than none/trace versus small/moderate/large. Girls (<i>P</i> = .005), isoechoic (<i>P</i> = .045), and location posterior to bladder (<i>P</i> &lt; .001) were associated with physiologic fluid and hyperechoic (<i>P</i> = .019) with non-physiologic fluid. Hyperechoic (<i>P</i> &lt; .001), anterior (<i>P</i> &lt; .001), lateral (<i>P</i> = .04), or “other” location (<i>P</i> &lt; .001) relative to the bladder were associated with moderate/large volume.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ultrasound-trained PEM physicians and pediatric radiologists can reliably use gestalt estimation to distinguish moderate or large fluid from smaller pelvic fluid volumes on pediatric FAST.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 6","pages":"1017-1025"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16661","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408159","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":"Prenatal Diagnosis and Classification of Type I Persistent Left Superior Vena Cava","authors":"Tian-gang Li MD,&nbsp;Chuan-min Wei MD,&nbsp;Wen-rui Wu MD,&nbsp;Yu-Wu Sheng MD","doi":"10.1002/jum.16663","DOIUrl":"10.1002/jum.16663","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to assess the utility of two-dimensional (2D) ultrasonography in diagnosing and classifying fetal type I persistent left superior vena cava (PLSVC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The diameter (D₁) of the coronary sinus (CS) was measured in the four-chamber view and the diameter (D₂) of the PLSVC was measured in the three-vessel trachea view; the ratio of the diameter of CS to PLSVC (D₁/D₂) and the ratio of gestational week (GA)/D₁ and GA/D₂ were calculated to analyze the correlation between measurement and classification of type I PLSVC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared the parameter of Ia and Ib Group, the differences in D₁, D₂, GA/D₁, and GA/D₂ were statistically significant (<i>P</i> &lt; .05). D₁ and D₂ are independent factors for the differential diagnosis of type I PLSVC, with odds ratios (OR) of 5.397 and 2.661, respectively, and both are statistically significant (<i>P</i> &lt; .05). The nomogram model exhibited superior performance in diagnosing type I PLSVC, with the highest AUC value of 0.853, a sensitivity of 96.55%, and a specificity of 66.25%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The combination of D₁, D₂, GA/D₁, and GA/D₂ is valuable for diagnosing and classifying fetal type I PLSVC, demonstrating significant clinical application value.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 6","pages":"1033-1043"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407723","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":"Are the Risk Factors for Developing Type 1 and Type 2 Cesarean Scar Pregnancy Different?","authors":"Yunhui Tang MD, PhD,&nbsp;Cuifeng Qian MD, PhD,&nbsp;Man Li MD, PhD,&nbsp;Min Zhao MD, PhD,&nbsp;Qi Chen MD, PhD","doi":"10.1002/jum.16662","DOIUrl":"10.1002/jum.16662","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Cesarean scar pregnancy (CSP) is a life-threatening complication of pregnancy. Early termination of pregnancy is recommended because of the potential risks of uterine rupture if the pregnancy continues. CSP is clinically divided into type 1 and type 2, based on the site of embryo implantation and grow direction of the gestational sac. The clinical risk and treatment options may vary between these subtypes. Identifying the differences and potential factors impacting the development of each type could contribute to improved clinical management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 143 women with type 1 CSP and 200 women with type 2 CSP women, diagnosed between January 2020 and July 2023. The primary objective was to analyze the differences in clinical characteristics between the 2 CSP subtypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Body mass index, the number of previous CSPs, elective abortions, gravidity, and parity were not significantly different between the 2 subtypes. Similarly, the interval between the last cesarean section and the current CSP was not associated with developing the 2 subtypes. However, women with more than 3 prior cesarean sections had an increased risk of developing type 1 CSP. In contrast, vaginal bleeding before diagnosis was more frequently associated with type 2 CSP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study with a large sample size found that despite type 2 CSP involving deeper myometrial invasion, the 2 subtypes share many clinical characteristics. Moreover, the clinical risk factors for distinguishing between type 1 and type 2 CSP are limited. Future research to identify predictors for CSP classification is required.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 6","pages":"1027-1032"},"PeriodicalIF":2.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16662","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399490","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}