Ultrasound最新文献

{"title":"Sonographic evaluation of low-lying gestational sac in the first trimester: A sonographer's guide to identify caesarean scar ectopic pregnancy.","authors":"Karen Letourneau, Amandeep Dusanj, Sarah Barrett","doi":"10.1177/1742271X261444869","DOIUrl":"10.1177/1742271X261444869","url":null,"abstract":"<p><strong>Introduction: </strong>Caesarean scar ectopic pregnancy (CSEP) is a potentially serious complication of caesarean section (C-section) which consists of the implantation of the gestational sac (GS) in the hysterotomy scar. All women with a history of C-section are at risk for CSEP. Early diagnosis and treatment are critical to avoid maternal morbidity and mortality. There is overlap in the sonographic appearance of CSEP, low-lying normal pregnancy, cervical ectopic pregnancy and miscarriage in progress. In 2022, a standardised sonographic evaluation and reporting system for CSEP in the first trimester was published to raise awareness of this entity. We aim to provide a practical guide to the sonographer by outlining the pertinent obstetric history, imaging findings and differential diagnoses in these patients.</p><p><strong>Case report: </strong>We report three cases of CSEP, diagnosed by ultrasonography in the first trimester. We also report three different conditions that may mimic CSEP. We include the clinical details, sonographic findings and patient outcomes.</p><p><strong>Discussion: </strong>The incidence of CSEP is suspected to be under-recognised and thus underreported. CSEP presents a substantial risk for severe maternal complications including uterine rupture, severe hemorrhage and placenta accreta spectrum disorders. This is complicated by challenges in securing an early diagnosis. When a first-trimester ultrasound reveals a GS in the lower third of the uterus, the sonographer must consider the differential diagnoses herein.</p><p><strong>Conclusion: </strong>We will present the recommended criteria using cases demonstrating the sonographic findings. Raising awareness of the four key sonographic markers of CSEP may improve sonographer detection rates, thus facilitating better patient management.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X261444869"},"PeriodicalIF":0.7,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13314669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point-of-care ultrasound diagnosis of ovarian torsion in prepubescent girls: A mini-case series.","authors":"David J McCreary, Ayesha Khalid, Milan Gopal, Niall Mullen","doi":"10.1177/1742271X261459028","DOIUrl":"https://doi.org/10.1177/1742271X261459028","url":null,"abstract":"<p><p>Ovarian torsion is a surgical emergency in which twisting of the ovarian vascular pedicle leads to ischaemia. Although an uncommon diagnosis in prepubescent girls, prompt recognition of this condition is essential in order to prevent ovarian necrosis, which can have long-term consequences in terms of fertility. Transabdominal ultrasound is the recommended imaging modality for diagnosing ovarian torsion; however, given the limited availability of paediatric-trained sonographers, patients may not obtain the necessary imaging in a timely manner. Point-of-care ultrasound performed by emergency department personnel has emerged as a useful adjunct to clinical examination and one that can help expedite specialist involvement. We describe two cases of prepubescent ovarian torsion presenting to our Paediatric Emergency Department, where point-of-care ultrasound played a key role in diagnosis and expediting definitive surgical management.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X261459028"},"PeriodicalIF":0.7,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13303267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diet, physical activity, and body mass index on gallbladder recovery time: An exploratory ultrasound pilot study.","authors":"Abdalmalek I Aburabee, Marina Muzaffa, Sook Sam Leong","doi":"10.1177/1742271X261454201","DOIUrl":"https://doi.org/10.1177/1742271X261454201","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the effects of dietary composition, physical activity, and body mass index on gallbladder recovery time following food consumption and to identify alternative scan preparation strategies for patients unable to fast before abdominal ultrasound.</p><p><strong>Methods: </strong>A quasi-experimental study involving 26 participants was conducted using four ultrasound sessions under different conditions: consumption of each dietary item with and without moderate physical activity. Gallbladder wall thickness and volume were measured hourly following standardised ultrasound protocols. Measurement reliability was assessed using the intraclass correlation coefficient on 30 randomly selected scans reviewed by two independent observers.</p><p><strong>Results: </strong>Recovery time significantly varied among meal types (χ²(2) = 18.42, <i>p</i> < .001), with wholemeal bread yielding the fastest and yogurt the slowest recovery. Physical activity significantly enhanced wall recovery (<i>p</i> = 0.002) but did not affect volume (<i>p</i> = 0.317). Body mass index showed no significant effect. Moderate and excellent intraclass correlation coefficients were achieved for gallbladder wall thickness (0.52) and volume (0.88), respectively.</p><p><strong>Conclusion: </strong>Wholemeal bread and postprandial physical activity serve as effective alternatives for ultrasound preparation when assessing gallbladder wall recovery. These findings promote patient-specific ultrasound protocols to improve diagnostic efficiency and comfort.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X261454201"},"PeriodicalIF":0.7,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13279239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing the successful acquisition and quality of three-dimensional souvenir obstetric ultrasound facial images: A narrative review and quantitative evaluation.","authors":"Ashanda Connor, Jacqueline Matthew, Emma Chung, Robert Wright, Mary A Rutherford","doi":"10.1177/1742271X261436619","DOIUrl":"https://doi.org/10.1177/1742271X261436619","url":null,"abstract":"<p><p>Three-dimensional prenatal ultrasound scans of a baby's facial features have become increasingly popular among parents in both private and clinical settings. Ultrasound practitioners often draw on their experience to identify factors that influence image quality when discussing scan outcomes with parents. This study aims to identify the maternal, fetal and technical factors that may affect the quality of three-dimensional souvenir face images during ultrasound scan. A retrospective quality review study was performed with data from a single-centre research study, including ultrasound videos of the fetal growth scans, three-dimensional facial ultrasound acquisitions and post-processing steps. A total of 342 three-dimensional surface-rendered images were attempted from 41 singleton pregnancy subjects, average gestational age 26.69 weeks, range: 21-30. The retrospective image quality for all images was assessed by two observers. Univariable ordinal regression test was used to investigate the associations between demographic/technical factors and the best image quality acheiveable. Of the 41 pregnancies, three-dimensional acquisition time was an average of 03:07 (mm:ss), (range: 01:22-5:31). In total, 49% of women had at least one good or moderate quality image, and 51% women had a poor quality or failed three-dimensional scan as the best quality possible. Image quality was associated with placenta site, explaining 18% of the variation (<i>p</i> < 0.05). We found a maternal-fetal factor which has a high impact on three-dimensional image quality of the prenatal face but nonetheless, sonographer skill, training and other technical factors may be employed to minimise the impact of detrimental factors.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X261436619"},"PeriodicalIF":0.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13259883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AFMD Master: An open-source software for automated extraction of artery flow-mediated dilation from vascular ultrasound videos with validation against manual analysis.","authors":"Alessandro Gentilin, Alice Gasparini, Enrico Tam, Laurent Mourot","doi":"10.1177/1742271X261451986","DOIUrl":"https://doi.org/10.1177/1742271X261451986","url":null,"abstract":"<p><strong>Introduction: </strong>Artery flow-mediated dilation (FMD) is a non-invasive method for assessing vascular endothelial function and cardiovascular disease risk. Flow-mediated dilation is calculated as the percentage increase in arterial diameter following a post-ischemic increase in blood flow through ultrasound analysis. Manual extraction of flow-mediated dilation scores is time-consuming, operator-dependent, and prone to variability. Automated software solutions for processing ultrasound data could enhance efficiency, accuracy, standardisation, and scalability for clinical and research applications, especially when distributed as free, open-source tools accessible even to non-coders. However, no current software tools reporting these features are available for automatic flow-mediated dilation extraction.</p><p><strong>Methods: </strong>We developed aFMD Master, a free, open-source software tool with an intuitive graphical interface designed for non-coders. The software is compatible with most of the videos from different ultrasound scanners, extracts arterial diameters, and outputs PDF reports and Excel datasheets with flow-mediated dilation scores. Validation was conducted by comparing software outputs with manually obtained data from 115 participants, using scatter plots, Bland-Altman analysis, and other appropriate statistical metrics.</p><p><strong>Results: </strong>Strong correlation between the software and manual methods was obtained (<i>R</i>² = 0.97, <i>p</i> < 0.01). The Bland-Altman analysis showed minimal bias (-0.0015%), with 95% limits of agreement between -0.28% and 0.28%. The software showed high accuracy, minimal bias, and low variability, with negligible impact of errors, reflecting strong precision, consistency, and reliability.</p><p><strong>Conclusions: </strong>Validation showed excellent agreement with manual analysis, confirming accuracy, low bias, and consistency. The aFMD Master offers an accessible and reliable solution for automated flow-mediated dilation analysis, showcasing significant potential for research and clinical applications.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X261451986"},"PeriodicalIF":0.7,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital portosystemic shunt: A case series.","authors":"Eva Koulaymi, Mayssaloun Khairallah, Cergika Veluppillai, Abbas Samaha, Khalil Khalil, Wael Abdallah","doi":"10.1177/1742271X261446197","DOIUrl":"https://doi.org/10.1177/1742271X261446197","url":null,"abstract":"<p><strong>Case presentations: </strong>Four patients underwent close follow-up after prenatal diagnosis of congenital portosystemic shunt, identified via ultrasound during the early third trimester. Among these cases, three were associated with fetal growth restriction, and one presented with bilateral talipes. Fetal hemodynamics were largely normal, except for one case with moderate biventricular hypertrophy. Induction of labor was performed in two cases for pre-eclampsia and in one case for severe fetal growth restriction. The fourth case underwent a repeat caesarean section at 37^+ 6 weeks. All newborns demonstrated good adaptation to extrauterine life, remained asymptomatic, and were clinically and hemodynamically stable. Spontaneous closure of the fistulas occurred without the need for surgical intervention.</p><p><strong>Discussion: </strong>Congenital portosystemic shunt is associated with a wide spectrum of postnatal outcomes, ranging from spontaneous closure to complications such as cardiac overload, metabolic disturbances, and pulmonary hypertension. Prenatal recognition allows appropriate postnatal surveillance and early detection of complications. In this series, all shunts were intrahepatic and closed spontaneously within the first year of life, with favorable clinical outcomes.</p><p><strong>Conclusion: </strong>Early detection of congenital portosystemic shunt through prenatal screening can lead to improved postnatal outcomes and prognosis. Prenatal Doppler ultrasound can identify congenital portosystemic shunt when careful attention is paid to hepatic vascular anatomy. Prenatal diagnosis of congenital portosystemic shunt is essential for optimising postnatal management.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X261446197"},"PeriodicalIF":0.7,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of cystic artery colour Doppler ultrasound indices in acute cholecystitis.","authors":"Alireza Abkhoo, Mina Behzadi, Narjes Mohamadzadeh, Niloofar Ayoobi Yazdi, Amir Ghasemlouei, Jayran Zebardast, Faeze Salahshour","doi":"10.1177/1742271X261434665","DOIUrl":"https://doi.org/10.1177/1742271X261434665","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic performance of cystic artery colour Doppler ultrasound indices in differentiating acute from chronic cholecystitis and to assess their added value over clinical and grayscale findings.</p><p><strong>Methods: </strong>In this prospective study, 101 adults with clinically suspected cholecystitis underwent ultrasound before cholecystectomy. Grayscale features and colour Doppler measurements of cystic and hepatic artery peak systolic velocity and resistive index were recorded; histopathology was the reference standard. Logistic regression models using clinical and grayscale variables alone and then with cystic artery peak systolic velocity were evaluated with receiver operating characteristic analysis.</p><p><strong>Results: </strong>In total, 33 patients had acute and 68 had chronic cholecystitis. Acute cholecystitis showed more abnormal grayscale features, including increased gallbladder size, wall thickening and pericholecystic change. Cystic artery peak systolic velocity was higher in acute than chronic disease (40.8 ± 14.9 vs 26.1 ± 15.5 cm/s; <i>p</i> < 0.001), as was hepatic artery peak systolic velocity (74.0 ± 24.4 vs 60.2 ± 22.4 cm/s; <i>p</i> = 0.006), whereas resistive index did not differ meaningfully. Cystic artery peak systolic velocity showed fair discrimination (area under the curve 0.78; cut-off 31.5 cm/s; sensitivity 0.91; specificity 0.71); hepatic artery peak systolic velocity performed more modestly (area under the curve 0.67). Adding cystic artery peak systolic velocity to a grayscale-only model produced negligible improvement in overall performance.</p><p><strong>Conclusion: </strong>Cystic artery peak systolic velocity is a useful adjunct for distinguishing acute from chronic cholecystitis when grayscale findings are equivocal, whereas resistive index adds little diagnostic value. Routine Doppler assessment is unlikely to change decisions when grayscale ultrasound is definitive.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X261434665"},"PeriodicalIF":0.7,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of shear-wave elastography in diagnosing severity of breast cancer-related lymphedema.","authors":"Hailing He, Jinjin Yu, Yuanhua Xiang, Ting Luo, Shuangshuang Tao","doi":"10.1177/1742271X261446207","DOIUrl":"https://doi.org/10.1177/1742271X261446207","url":null,"abstract":"<p><strong>Introduction: </strong>Up to 30% of breast cancer patients develop breast cancer-related lymphedema. Accurate staging is crucial for treatment selection. We aimed to evaluate the diagnostic accuracy of shear-wave elastography in differentiating International Society of Lymphology stage 1 from stage 2 breast cancer-related lymphedema through tissue stiffness quantification.</p><p><strong>Methods: </strong>From September 2024 to February 2025, this cross-sectional study included 120 unilateral breast cancer-related lymphedema patients (60 stage 1 and 60 stage 2) who underwent shear-wave elastography using an Acuson S3000 system. Shear-wave velocity (m/s) was measured in cutaneous/subcutaneous tissues of the forearm and upper arm. Staging followed International Society of Lymphology 2020 criteria, integrating clinical assessment, arm circumference difference (⩾2 cm indicative of stage 2), and bioimpedance spectroscopy (absolute value of the L-Dex score ⩾10 indicative of stage 2). Diagnostic performance was analysed via receiver operating characteristic curves, with the optimal shear-wave velocity cutoff determined by the Youden index.</p><p><strong>Results: </strong>Forearm cutaneous shear-wave velocity was significantly higher in stage 2 versus stage 1 (2.03 ± 0.25 m/s vs. 1.74 ± 0.17 m/s; <i>p</i> < 0.001). No significant differences were observed in forearm subcutaneous, arm cutaneous, or arm subcutaneous tissues (<i>p</i> = 0.063, <i>p</i> = 0.194, and <i>p</i> = 0.412, respectively). Receiver operating characteristic analysis for forearm cutaneous shear-wave velocity yielded an area under the curve of 0.80. At the optimal cut-off of 1.90 m/s, sensitivity was 76.7% and specificity was 71.7%.</p><p><strong>Conclusion: </strong>Shear-wave elastography-derived forearm cutaneous shear-wave velocity provides an objective biomarker for distinguishing International Society of Lymphology stage 1 and 2 breast cancer-related lymphedema, with good diagnostic accuracy. However, stiffness differences were not observed across all measured regions/layers. This non-invasive technique may guide personalised antifibrotic therapy by identifying advanced fibrosis.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X261446207"},"PeriodicalIF":0.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13229908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A collaborative radiologist-sonographer ultrasound-guided fine needle aspiration service in the head and neck: Experience from a tertiary centre.","authors":"Amjad Chamsi Basha, Peter Cantin, Shahed Chamsi Basha, Louise Darwich, Bradley J Storey, Catalina Poseletchi, Richard Chaytor, Abdul Gafoor","doi":"10.1177/1742271X261449465","DOIUrl":"https://doi.org/10.1177/1742271X261449465","url":null,"abstract":"<p><strong>Background: </strong>Fine-needle aspiration is a recommended, minimally invasive test that may be performed by radiologists and advanced practice sonographers to meet increasing service demands. Adequacy rates vary significantly in the published literature.</p><p><strong>Purpose: </strong>To assess the adequacy rate of ultrasound-guided fine needle aspiration in head and neck lesions between operator groups: radiologists and sonographers. Other factors that may potentially affect adequacy rates such as the number of passes, use of local anaesthetic, sample tissue type and needle gauge have also been investigated.</p><p><strong>Materials and methods: </strong>A retrospective review of the local radiology reporting system of all ultrasound-guided head and neck fine needle aspiration samples over a 3-year period was undertaken. Correlation was made with the final cytology report to assess for sample adequacy.</p><p><strong>Results: </strong>In total, 927 fine needle aspiration samples were included. Of these, 331 (35.7%) were taken by radiologists, and 596 (64.3%) were taken by sonographers. Both groups achieved similar adequacy rates (~84%), and no statistical difference was seen between operator type and adequacy rate.</p><p><strong>Conclusion: </strong>Our study provides a good example of a cohesive department where both radiologists and sonographers contribute to a consistent and equitable service.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X261449465"},"PeriodicalIF":0.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13229905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sonographers' perspectives towards the increase in medico-legal litigation: An exploratory qualitative study.","authors":"Megan Watkin-Bennett, Helen P White","doi":"10.1177/1742271X261442776","DOIUrl":"10.1177/1742271X261442776","url":null,"abstract":"<p><strong>Introduction: </strong>Medico-legal litigation is increasing within sonography, a profession already affected by high levels of occupational burnout and ongoing recruitment and retention challenges. Despite this trend, little research has explored how the possibility of litigation affects sonographers' well-being or influences their professional practice.</p><p><strong>Method: </strong>This qualitative descriptive study was conducted in the United Kingdom. Purposive voluntary sampling recruited six National Health Service sonographers via social media. Online semi-structured interviews explored their perspectives on rising medico-legal litigation. Data were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Four themes were identified: (1) The emotional and psychological burden, (2) The impact on sonography practices, (3) Work-related pressures, and (4) Supporting the sonographer. Litigation fear affected well-being and contributed to defensive behaviours, particularly in report writing. Participants also described systemic pressures, such as workload demands, limited appointment times, and misunderstandings about the sonographer's role that increased the perceived risk of error and potential litigation. While transparency and professional accountability was valued, many highlighted the need for clearer guidance, learning opportunities, and stronger organisational support.</p><p><strong>Conclusion: </strong>Sonographers reported fear and uncertainty surrounding medico-legal litigation, alongside pressures that shaped both practice and emotional well-being. Although these concerns were prominent, participants also recognised the importance of transparency and accountability when supported by fair processes. Enhancing guidance, training, and organisational support may help reduce litigation fear and contribute to a more sustainable sonography workforce.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X261442776"},"PeriodicalIF":0.7,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}