Ultrasound最新文献

{"title":"Ultrasound imaging for sternoclavicular joint involvement in enthesitis-related arthritis: A closer look at capsular enthesitis.","authors":"Fiammetta Zunica, Martina Loiodice, Francesca Riccaboni, Patrizia Carlucci, Gian Vincenzo Zuccotti, Vincenzo Ricci","doi":"10.1177/1742271X241260248","DOIUrl":"10.1177/1742271X241260248","url":null,"abstract":"<p><strong>Introduction: </strong>Enthesitis-related arthritis is a specific subtype of juvenile idiopathic arthritis characterised by the co-presence of arthritis and enthesitis or the evidence of one of them coupled with at least two among sacroiliac joint tenderness, inflammatory back pain, presence of human leukocyte antigen-B27, acute symptomatic anterior uveitis, onset in a male child aged 6 years or older or history of spondyloarthropathy in a first-degree relative. Small joints like the sternoclavicular joint are rarely affected, and the prevalence of their involvement in enthesitis-related arthritis has been poorly assessed in the pertinent literature.</p><p><strong>Case report: </strong>The authors report an atypical case of left sternoclavicular joint arthritis/enthesitis in a 12-year-old male child with juvenile idiopathic arthritis. The B-mode sonographic findings of articular effusion, synovial hypertrophy and capsular bulging, coupled with the microvascular mapping with colour Doppler of the sternoclavicular joint, have been crucial to optimising the pharmacological approach in clinical practice. In this sense, the sonographic examination presented as a natural extension of the physical examination to accurately define the poor control of disease activity using first-line pharmacological agents.</p><p><strong>Discussion: </strong>The present case report can be considered the first to accurately report the B-mode and the colour Doppler findings of a pathological sternoclavicular joint in a patient enthesitis-related arthritis. Ultrasound imaging demonstrated intra-articular effusion, capsular bulging and synovial hypertrophy clearly defining sternoclavicular joint arthritis. Interestingly, the hypervascularisation involved both the synovial tissue and the capsule-bone interface - that is, the enthesis of the joint capsule - suggesting a potential co-existence of arthritis and enthesitis of the sternoclavicular joint in enthesitis-related arthritis patients.</p><p><strong>Conclusion: </strong>The high-resolution point-of-care ultrasound seems to be a potential 'game changer' in paediatrics to promptly optimise the pharmacological management in enthesitis-related arthritis patients. Indeed, unlike other imaging modalities such as magnetic resonance imaging, modern high-frequency ultrasound transducers guarantee a superior spatial resolution of superficial joints and allow an accurate mapping of small-size and low-flow vascular elements of synovial and capsular tissues optimising the grading of disease activity and avoiding the use of contrast agent.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X241260248"},"PeriodicalIF":0.8,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648754","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":"Misrepresented multiple endocrine neoplasia 2: Do the British Thyroid Association guidelines accurately predict thyroid cancer risk in high-risk groups with multiple endocrine neoplasia 2? A case series.","authors":"Arya Anthony Kamyab, Alex Weller, Kate Hulley, Gul Bano","doi":"10.1177/1742271X241260225","DOIUrl":"10.1177/1742271X241260225","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of thyroid nodules in the general population is around 40%. The British Thyroid Association U-grading has high sensitivity for identifying the common thyroid cancer subtypes (papillary and follicular). However, ultrasound features of the rarer medullary thyroid cancer differ, with lower sensitivity for ultrasound detection.Hereditary medullary thyroid cancer accounts for 25% of cases, forming part of the multiple endocrine neoplasia syndromes (multiple endocrine neoplasia 2) and is associated with RET proto-oncogene mutation, for which gene testing is increasingly available. This study aims to evaluate British Thyroid Association U-grading for thyroid cancer risk stratification in this high-risk population.</p><p><strong>Case report: </strong>This was a retrospective review of four multiple endocrine neoplasia 2 patients referred for thyroid ultrasound. A total of 10 thyroid nodules were graded as part of routine evaluation, taken from an endocrine and genetics tertiary referral centre. Patients with identifiable RET mutation from March 2017 to February 2023 were reviewed.</p><p><strong>Discussion: </strong>Six patients had 10 thyroid nodules, of which 8 were graded as U2, 2 graded U3-5 and 8 confirmed as medullary thyroid cancer. However, two patients had no pathology data at the time of writing. For this cohort, U-grading and genetics were discordant, with RET gene testing more effective than ultrasound in cancer detection. All nodules should be considered high risk for medullary thyroid cancer, regardless of U-grade.</p><p><strong>Conclusion: </strong>Our data demonstrate that British Thyroid Association U-score has limited value for medullary thyroid cancer detection in this high-risk group and cannot be used for risk stratification or surveillance. As a rarer thyroid cancer subtype, medullary thyroid cancer and the high-risk multiple endocrine neoplasia 2 population are under-represented in British Thyroid Association 2014 guidance and deserve consideration in future editions.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X241260225"},"PeriodicalIF":0.8,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649198","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":"Diagnosis of fetal isolated cleft palate using assessment of the posterior hard palate angle.","authors":"Iglika Ivancheva Simeonova-Brachot","doi":"10.1177/1742271X241260220","DOIUrl":"10.1177/1742271X241260220","url":null,"abstract":"<p><strong>Objective: </strong>The study aims to evaluate the role of the posterior hard palate angle in the prenatal diagnosis of cleft palate.</p><p><strong>Study design: </strong>Stored images of the axial transverse view of the fetal secondary palate, obtained at three-level obstetric ultrasounds, were used to evaluate the posterior border of the hard palate. The study population comprised 63 consecutive pregnancies of unaffected cases and 17 pregnancies suspected for a cleft palate without cleft lip, including 7 cases of cleft palate, 4 cases of high-arched palate, and 6 false-positive cases.</p><p><strong>Results: </strong>The posterior angle of the hard palate was significantly larger in the cleft palate group than in the healthy controls and false-positive cases: 227° (±51°) vs 160° (±16°), <i>p</i> < 0.0001; and 173° ± 18°, <i>p</i> < 0.0001, respectively. Regression analysis revealed that reflex angle remained an independent risk factor for cleft palate (odds ratio, 58.67 (95% confidence interval 10-341)). The sensitivity and specificity of the posterior angle assessment were 73% and 96%, respectively.</p><p><strong>Conclusions: </strong>The posterior hard palate angle could be an ultrasound marker of cleft palate without a cleft lip.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X241260220"},"PeriodicalIF":0.8,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142650533","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":"Developing preceptorship programmes by exploring the needs of newly qualified sonographers through the lens of experienced ultrasound preceptors.","authors":"Rita Phillips, Siobhan Alsop","doi":"10.1177/1742271X241249042","DOIUrl":"10.1177/1742271X241249042","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to explore the needs of newly qualified sonographers with respect to the requirements of preceptorship. This paper describes the first stage of research, with data obtained from a cohort of experienced preceptors. A second stage of research with data from newly qualified sonographers is pending synthesis with this work. The aim is to produce an evidenced-based tool to support departments in developing and implementing effective and robust preceptorship.</p><p><strong>Methods: </strong>Twelve experienced participants from eight trusts, with a range of clinical backgrounds and experience were recruited. Two focus groups were held with questions structured around known themes highlighted in current evidence regarding newly qualified sonographers. The interviews were recorded and transcribed, and the qualitative data were analysed using thematic analysis.</p><p><strong>Results: </strong>Four main themes with subthemes emerged. These were: (1) the gaps between qualification and proficiency, (2) the need for managerial investment and formalisation, (3) the preceptor and (4) tools to support the transition and prevent burnout. Frequency data and quotes are given as exemplars.</p><p><strong>Conclusion: </strong>Participants report that newly qualified sonographers require support in report writing, clinical reasoning and confidence, and this should be addressed within preceptorship while acknowledging individual needs. Managerial investment is essential in ensuring adequate support and protected time is available for important preceptorship activities, such as meeting for feedback and feedforward with opportunity to clearly document progression. Inadequate support may be damaging for the wellbeing of preceptor and preceptee and ultimately impact the standard of our ultrasound services and patient care.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X241249042"},"PeriodicalIF":0.8,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649155","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":"Sonographic imaging of the genicular nerves of the knee.","authors":"Michelle Fenech, Jerome Boyle, Bridie Roche","doi":"10.1177/1742271X241252297","DOIUrl":"10.1177/1742271X241252297","url":null,"abstract":"<p><strong>Introduction: </strong>The genicular nerves are sensory nerves around the knee. With the improvements in ultrasound imaging resolution, these nerves can be identified sonographically.</p><p><strong>Topic description: </strong>Due to their small size, genicular nerves are often underappreciated and overlooked during routine sonographic imaging. Chronic pain associated with knee osteoarthritis, or postsurgical knee pain can be relieved by ultrasound-guided radiofrequency ablations or nerve blockades targeting the genicular nerves.</p><p><strong>Discussion: </strong>To sonographically image these nerves, or guide nerve blocks or ablations, knowledge of the sonographic anatomy, technique and normal appearances of the genicular nerves and their surrounding structures is required and is unpacked in this pictorial essay.</p><p><strong>Conclusion: </strong>Enhanced knowledge of the anatomy and a systematic approach to sonographically image and assess the genicular nerves of the knee can enhance the diagnosis of pathology, nerve injury or entrapment, and sonographic guidance of interventional procedures for pain relief.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X241252297"},"PeriodicalIF":0.8,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648533","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":"Breast carcinoma metastasis to the submandibular gland: Clinical, sonographic and pathological findings of a rare entity.","authors":"Lamees Salman, Zainab Al Shiekh Ali, David C Howlett","doi":"10.1177/1742271X241249066","DOIUrl":"10.1177/1742271X241249066","url":null,"abstract":"<p><strong>Introduction: </strong>Metastatic disease to the submandibular gland is a rare phenomenon with limited information available on related imaging findings.</p><p><strong>Case presentation: </strong>We report a 59-year-old female who presented with a palpable nodule in the right submandibular gland 6 years after treatment for breast carcinoma. Ultrasound findings were concerning for distant metastatic disease from breast cancer recurrence. The histopathological analysis of the biopsied tissue confirmed infiltration of the right submandibular gland with an adenocarcinoma from a breast primary.</p><p><strong>Discussion: </strong>Metastatic spread to the major salivary glands is relatively uncommon with a predilection to the parotid gland owing to its extensive intraglandular lymphatic system. Conversely, metastasis to the submandibular gland, which lacks intraglandular lymph nodes, is rare. Ultrasound is the optimal first-line imaging modality to aid in the assessment of submandibular gland disease. Malignant lesions often appear hypoechoic with heterogenous internal architecture and ill-defined borders. However, some low-grade malignancies, can have apparently benign features particularly when smaller in size. Where a focal submandibular gland lesion is identified and neoplasm is suspected, the early use of ultrasound-guided core biopsy is recommended to improve diagnostic yield for histological assessment.</p><p><strong>Conclusion: </strong>While submandibular metastasis is rare, clinical assessment, sonographic findings and use of core needle biopsy aid in prompt diagnosis and management.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X241249066"},"PeriodicalIF":0.8,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649152","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":"Editorial.","authors":"Colin P Griffin","doi":"10.1177/1742271X241241843","DOIUrl":"https://doi.org/10.1177/1742271X241241843","url":null,"abstract":"","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"32 2","pages":"75"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11060117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869494","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":"Editorial.","authors":"Colin P Griffin","doi":"10.1177/1742271X231223558","DOIUrl":"10.1177/1742271X231223558","url":null,"abstract":"","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"32 1","pages":"3"},"PeriodicalIF":0.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681545","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":"Does matrix transducer technology improve quality and repeatability of four-dimensional tricuspid annular plane systolic excursion and mitral annular plane systolic excursion measurements?","authors":"Samantha Thomas, Anna Erenbourg, Melissa Chang, A. G. D. M. T. Ferreira, Gordon Stevenson, Alec Welsh","doi":"10.1177/1742271x231215501","DOIUrl":"https://doi.org/10.1177/1742271x231215501","url":null,"abstract":"Novel ultrasound technology and software processing allow offline evaluation of tricuspid annular plane systolic excursion and mitral annular plane systolic excursion measurements. We wished to compare both novel 4D matrix (eM6C) and conventional (RAB6-D) transducers with variable settings (electronic spatiotemporal image correlation, spatiotemporal image correlation and four-dimensional real time) to determine if there was a significant difference in absolute value, quality and repeatability of the resultant reconstructed image and M-mode trace. A blinded prospective cross-sectional study of normal fetuses from 23 to 38 weeks’ gestation were recruited. After routine sonography, four-dimensional volumes were stored and analysed using GE 4DView™ software. Statistical analysis explored variability, correlations and repeatability of the measurements with chi-square analysis, intraclass correlations and the Bland–Altman comparison plots. A scoring system was devised for image quality. Eighteen participants generated 282 data volumes. Absolute values demonstrated some inconsistencies for both tricuspid annular plane systolic excursion and mitral annular plane systolic excursion measurements with variations between transducers: the highest for the RAB6-D/spatiotemporal image correlation setting and the lowest for the four-dimensional real-time settings. The RAB6-D/spatiotemporal image correlation setting was the most repeatable combination (intraclass correlation coefficient = 0.85). Poorest image quality (M-mode trace, four-chamber view, annuli) came from the RAB6-D/four-dimensional real-time combination with the eM6C/electronic spatiotemporal image correlation and RAB6-D/spatiotemporal image correlation settings being nearly identical. We show that transducer and setting combinations influence absolute tricuspid annular plane systolic excursion/mitral annular plane systolic excursion measurements, so need to be articulated in future research. The transducer setting (electronic spatiotemporal image correlation/spatiotemporal image correlation/four-dimensional real time) was a more significant factor than the type of transducer (conventional vs matrix). Subjective image evaluation does not correlate well with repeatability of image acquisition. Further studies are needed to compare measurements using four-dimensional post-processing tools against conventional real-time measurements.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"51 37","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139441789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sonographic anatomy and technique to image the plantar digital nerves and aid identification of a Morton’s neuroma","authors":"Michelle Fenech","doi":"10.1177/1742271x231215716","DOIUrl":"https://doi.org/10.1177/1742271x231215716","url":null,"abstract":"The anatomy of the forefoot is complex, and the sonographic assessment to image the plantar digital nerves and exclude, diagnose or discriminate between a Morton’s neuroma and intermetatarsal bursitis can be challenging. A good appreciation of the sonographic anatomy, technique, normal and abnormal appearances is required to undertake a sonographic assessment of the forefoot and its interspaces, particularly the plantar digital nerves. This is unpacked in this paper with associated pictorial aids. Muscles, tendons, and ligaments of the interspaces and the nearby metatarsophalangeal joints and their associated soft-tissue structures are helpful sonographic landmarks to guide imaging and assessment of the common and proper plantar digital nerves and the intermetatarsal bursa. These need to be appreciated from both dorsal and plantar sonographic approaches, in both short- and long-axis imaging planes. Improved understanding of the anatomy and sonographic appearances of the interspace structures can enhance the sonographic assessment of the forefoot and improve diagnosis of a Morton’s neuroma and/or intermetatarsal bursitis when present to guide patient management.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"66 3","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139151830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}