Ultrasound最新文献

{"title":"Evaluation of the departmental inter-rater reliability when scoring thyroid nodules according to the British Thyroid Association Ultrasound-classification model: Is there significant disagreement?","authors":"Nabil Rtam","doi":"10.1177/1742271x231215500","DOIUrl":"https://doi.org/10.1177/1742271x231215500","url":null,"abstract":"The British Thyroid Association Ultrasound-classification is a risk stratification model which grades thyroid nodules in U2–5 based on their sonographic appearance. Existence of variability between the ultrasound operators when U-scoring is reported in the literature with some evidence found in the author’s department. The aim of this study was to investigate whether there is significant disagreement in the department and identify potential reasons for variability. Eight operators, radiologists and sonographers, were recruited to grade 33 TNs and answer a tick box questionnaire using the British Thyroid Association lexicon. The inter-operator variability for the U-categories, indication for fine-needle aspiration biopsy and ultrasound features was assessed using Fleiss’ kappa and Gwet-AC1. The operators’ accuracy was measured against the most experienced operator in the department using Cohen’s kappa and percentage agreement. Fair agreement (Fleiss’ K = 0.21) was obtained between the participants when U-scoring (U2–5). Fair-to-moderate agreement was noted between sonographers ( K = 0.40). Significant variability was demonstrated between radiologists ( p > 0.05). Indication for fine-needle aspiration biopsy reached fair to almost substantial agreement (radiologists’ AC1 = 0.34, sonographers’ AC1 = 0.58, overall AC1 = 0.41). No significant variability measured for echogenicity ( K = 0.29), composition ( K = 0.33), shape ( K = 0.58), margin ( K = 0.45), halo ( K = 0.34) and vascularity ( K = 0.44). Accuracy reached fair agreement (mean Cohen’s K = 0.29) and moderate agreement (mean AC1 = 0.53) for the U-categories and fine-needle aspiration biopsy, respectively. Radiologists demonstrated lower accuracy. No significant inter-rater variability in U-scoring or recommending fine-needle aspiration biopsy was demonstrated between all the operators in the department. Radiologists showed significant variability in U-scoring and lower accuracy. Reliability and accuracy could be improved by addressing those problematic categories and features identified with this study.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"12 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139150174","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":"Adapting a communication coaching intervention for obstetric sonographers delivering unexpected news: A qualitative study.","authors":"Essie Kaur,&nbsp;Jane Arezina,&nbsp;Louise Bryant,&nbsp;Kathryn I Pollak,&nbsp;Gill Harrison,&nbsp;Ruth Bender Atik,&nbsp;Jen Coates,&nbsp;Natasha K Hardicre,&nbsp;Roxanne Sicklen,&nbsp;Karen Horwood,&nbsp;Teresa Lardner,&nbsp;Jon Arnold,&nbsp;Rebecca Wallace,&nbsp;Judith Johnson","doi":"10.1177/1742271X221147860","DOIUrl":"https://doi.org/10.1177/1742271X221147860","url":null,"abstract":"<p><strong>Introduction: </strong>Despite widespread recognition that communicating unexpected news during obstetric ultrasound examinations is challenging, there is a dearth of research investigating how to teach evidence-based communication to sonographers. Communication Coaching is a supportive, positive method that has previously been associated with improvements in communication, patient satisfaction, and reduced burnout in clinicians. However, to date, no study has coached sonographers. This study explored stakeholders' views on a proposed Communication Coaching intervention and used these data to adapt the intervention for use with qualified obstetric sonographers.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with people who have a vested interest in unexpected news delivery and thematic analysis was conducted on the data. Eight sonographers, six people with lived experience of receiving unexpected news and six representatives from third-sector organisations who support expectant parents were recruited (18 women; 2 men, aged between 21 and 75 years).</p><p><strong>Results: </strong>Participants viewed the planned Communication Coaching intervention favourably and suggested adaptations. The two main themes were (1) the practicalities of coaching, and (2) content. The first theme had four subthemes: (a) brief and flexible structure, (b) online modality, (c) sensitive and positive coach and (d) organisational awareness. The second theme had three subthemes: (a) specific language and behaviour recommendations, (b) adaptable to different service-users and situations and (c) confer relevant emotional skills and techniques.</p><p><strong>Conclusions: </strong>Communication Coaching could be a feasible and acceptable intervention for qualified sonographers if specific, limited adaptations are made as recommended by the stakeholders. Further evaluation of the intervention in practice is necessary.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"31 4","pages":"273-283"},"PeriodicalIF":0.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10621488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71486573","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":"Echoes","authors":"Allison Harris","doi":"10.1177/1742271x231203826","DOIUrl":"https://doi.org/10.1177/1742271x231203826","url":null,"abstract":"","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"38 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135320795","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":"Editorial.","authors":"Colin P Griffin","doi":"10.1177/1742271X231203825","DOIUrl":"10.1177/1742271X231203825","url":null,"abstract":"","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"31 4","pages":"243"},"PeriodicalIF":0.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10621492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71486577","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":"The reliability of clinical tools with and without ultrasound guidance to measure leg-length inequality","authors":"Richard Cahanin, Andre Fallavollita, Troy Burley, Samuel McQuiston","doi":"10.1177/1742271x231195741","DOIUrl":"https://doi.org/10.1177/1742271x231195741","url":null,"abstract":"Purpose: To determine and compare the reliability and efficiency of various methods of leg-length measurement. Methods: A total of 88 leg-lengths were measured among 50 subjects (79%–84% female, mean age = 30–33 years). Leg-lengths were measured in both supine and standing positions using multiple devices, including a tape measure, a LASER distance meter, and diagnostic ultrasound. Results: All methods of leg-length measurement using the middle of the femoral head as a reference point, identified via ultrasound, demonstrated excellent reliability (intraclass correlation coefficient = 0.95–1.00). Measurements performed in supine, using the anterior superior iliac spine as a reference point, with a tape measure, demonstrated good-to-excellent reliability (intraclass correlation coefficient = 0.86–0.95, standard error of the measurement = 16.1–19.9 cm). Standing measurements using the anterior superior iliac spine as a reference point, using a tape measure, demonstrated fair-to-excellent reliability (intraclass correlation coefficient = 0.71–0.95). Conclusion: Ultrasound-guided landmark identification appear to be a more reliable method compared to palpation of the anterior superior iliac spine for measurement of leg-length using clinical tools. When coupled with ultrasound guidance, a hand-held LASER distance meter/pitch locator apparatus or a retractable tape measure appears to be acceptable alternatives to a fixed LASER distance meter on a linear actuator for leg-length measurement.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135388652","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":"Ultrasound and computed tomography findings of hepatic portal venous gas associated with acute appendicitis in a paediatric patient: A case report","authors":"Takashi Furuta, Mayu Fujiwara, Takahiro Motonaga, Hironori Matsufuji, Hiroshi Tateishi, Soichi Nakada, Tsutomu Kanagawa, Masashi Uchida","doi":"10.1177/1742271x231195752","DOIUrl":"https://doi.org/10.1177/1742271x231195752","url":null,"abstract":"Introduction: Hepatic portal venous gas is a rare and life-threatening condition characterised by the presence of gas in the portal vein. Hepatic portal venous gas is frequently associated with intestinal ischaemia and necrosis. We present the case of a paediatric patient with acute appendicitis with hepatic portal venous gas detected using ultrasonography. Case report: A 5-year-old boy was admitted to our hospital with a respiratory tract infection. The boy started vomiting on day 2 of hospitalisation. He did not complain of any symptoms due to developmental retardation. We performed bedside point-of-care ultrasound, which detected hepatic portal venous gas, although the appendix could not be detected due to an acoustic shadow associated with bowel gas. Contrast-enhanced computed tomography revealed perforated appendicitis and pneumatosis intestinalis associated with paralytic ileus. An emergency laparoscopic appendectomy was performed. He was discharged on day 25 of hospitalisation after antibiotic therapy. Discussion: The present case suggests that the mechanism of hepatic portal venous gas was paralytic ileus, which caused gas-forming bacterial proliferation. The gas produced by bacteria and/or the gas-forming bacteria entered the bowel wall, which caused pneumatosis intestinalis. The bubbles in the intestinal wall floated in the portal system and were detected as hepatic portal venous gas. Perforated appendicitis and paralytic ileus seemed to be caused by a delayed diagnosis of appendicitis. The point-of-care ultrasound examination was useful for detecting hepatic portal venous gas and for helping establish the diagnosis of appendicitis. Conclusion: Hepatic portal venous gas is a rare finding associated with appendicitis in children. In addition, point-of-care ultrasound is useful for detecting hepatic portal venous gas in paediatric patients.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134957673","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":"Depth effect on point shear wave velocity elastography: Evidence in a chronic hepatitis C patient cohort","authors":"Leonardo Rizzo, Luca L’Abbate, Massimo Attanasio, Arturo Montineri, Salvatore Magliocco, Vincenza Calvaruso","doi":"10.1177/1742271x231183370","DOIUrl":"https://doi.org/10.1177/1742271x231183370","url":null,"abstract":"Background and Aims: This study investigated the depth-related bias and the influence of scan plane angle on performance of point-shear-wave elastometry in a chronic hepatitis C patient cohort. Materials and Methods: We included 104 patients affected by chronic liver disease related to the hepatitis C virus. Liver surface nodularity was the reference to diagnose cirrhosis. The ultrasound platform was the Siemens S2000, equipped with point-shear-wave elastometry software. Measurements were obtained in left lateral decubitus from the liver surface to the maximum depth of 8 cm in two orthogonal scan planes according to a standard sampling plane. Scatterplot and box plots explored the depth-related bias graphically. The area under the receiver operating characteristic was used to determine the point-shear-wave elastometry diagnostic performance at progressive depths according to liver surface nodularity. Results: Of the 104 patients, 68 were cirrhotics. Depth-related bias equally modified point-shear-wave elastometry in the two orthogonal scan planes. A better point-shear-wave elastometry diagnostic performance was observed between depths of 4 and 5 cm. The frontal scan plane assured better discrimination between cirrhotic patients and non-cirrhotic patients. Conclusion: Depth is crucial for point-shear-wave elastometry performance. Excellent diagnostic performance at a depth between 4 and 5 cm can also be obtained with a smaller number of measurements than previously recommended.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135397063","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":"Detection of moderate to severe middle cerebral artery atherosclerotic stenosis in stroke patients: Transcranial color-coded duplex sonography versus computed tomography angiography","authors":"Moussa Toudou-Daouda, Nicolas Chausson, Didier Smadja, Cosmin Alecu","doi":"10.1177/1742271x231195723","DOIUrl":"https://doi.org/10.1177/1742271x231195723","url":null,"abstract":"Background: Intracranial atherosclerotic stenosis is a common cause of ischemic cerebrovascular events and is associated with a high risk of stroke recurrence. This study aimed to assess the diagnostic accuracy of transcranial color-coded duplex sonography for moderate-to-severe middle cerebral artery stenosis in stroke patients. Methods: A retrospective analysis was carried out, including 31 patients aged ⩾18 years hospitalized for ischemic cerebrovascular event in whom middle cerebral artery stenosis ⩾30% was identified on computed tomography angiography. Transcranial color-coded duplex sonography findings were compared to the degree of stenosis blindly identified on the computed tomography angiography used as the reference method. Results: Overall, 27 patients had M1 stenosis and the other 4 had M2 stenosis. To detect M2 stenosis ⩾ 50% and ⩾ 70%, stenotic to pre-stenotic ratio ⩾ 2 and ⩾ 3 had a sensitivity of 100%, respectively. To detect M1 stenosis ⩾ 70%, peak systolic velocity ⩾ 300 cm/s had a sensitivity of 53.8% and specificity of 85.7% with area under the receiver-operating characteristic curve of 0.753 (95% confidence interval: 0.568–0.938; p = 0.026), and stenotic to pre-stenotic ratio ⩾ 3 had a sensitivity of 84.6% and a specificity of 78.6% (area under the curve = 0.854; 95% confidence interval: 0.707–1; p = 0.002). Middle cerebral artery/anterior cerebral artery velocity ratio < 0.7 had a sensitivity of 57.1% and specificity of 90% to detect dampened pre-stenotic flow in middle cerebral artery secondary to downstream M1 stenosis ⩾ 70% (area under the curve = 0.800; 95% confidence interval: 0.584–1; p = 0.040). This study showed that stenotic to pre-stenotic ratio ⩾ 3 was more sensitive than peak systolic velocity ⩾ 300 cm/s to screen M1 stenosis ⩾ 70%. Middle cerebral artery/anterior cerebral artery ratio < 0.7 was a good indirect sign to detect dampened pre-stenotic flow due to M1 stenosis ⩾ 70%.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"355 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135395632","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":"Lung ultrasound based prediction of CT-scan Severity Score in COVID-19","authors":"Panaiotis Finamore, Emanuele Gilardi, Moises Muley, Tommaso Grandi, Silvia Navarin, Michela Orrù, Chiara Bucci, Simone Scarlata, Francesco Travaglino, Federica Sambuco","doi":"10.1183/13993003.congress-2023.pa1819","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa1819","url":null,"abstract":"<b>Background:</b> CT-scan Severity Score (CT-SS) is the gold standard for the quantification of COVID-19 pneumonia, however CT-scan is not always available. <b>Aims and objectives:</b> Lung ultrasound (LU) is able to identify lung abnormalities, hence we hypothesize that can be used to predict CT-SS. Objectives are to determine whether it is possible to predict CT-SS from the LU score, and whether the change in LU score associates with a change in CT-SS during hospitalization. <b>Methods:</b> This is a retrospective observational study. Hospitalized patients with COVID-19 pneumonia who performed LU within 6 hours from CT-scan were included. Two LU scores, the <i>LU-Mean</i>, calculated by diving the sum of scores of explored chest areas for the total number of areas, and the <i>LU-Sum</i>, calculated as the sum of chest areas with a score ≥ 2, were derived and used to predict CT-SS using linear regression models. The agreement between fitted values and CT-SS was assessed using Bland-Altman plot. The correlation between the change in CT-SS and LU scores was reported using the Pearson correlation index. <b>Results:</b> The median CT-SS was 11 (IQR:6). <i>LU-Mean</i> and <i>LU-Sum</i> were linearly correlated with CT-SS (r_LU-Mean=0.78 and r_LU-Sum=0.79), with a Beta of 7.34 (P-value<0.001) and 0.94 (P-value<0.001), respectively. Two predictive models, based on LU scores and type of respiratory support, were developed, with an adjusted R-squared of 0.64 and 0.67, respectively. The correlation between the change of CT-SS and LU scores was 0.86 (P-value<0.001) for <i>LU-Mean</i> and 0.87 (P-value<0.001) for <i>LU-Sum</i>. <b>Conclusions:</b> CT-SS can be predicted from LU scores, and its change correlates with that of LU score. LU score can be used to predict CT-SS when CT-scan is not available.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136193679","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":"Assessing the accuracy of pleural puncture sites as determined by clinic-radiological examination versus Lung Ultrasound- a prospective study.","authors":"Naveen Dutt, Shahir Asfahan, Nishant Kumar Chauhan, Ramniwas -, Mahendra Kumar Garg, Pawan Kumar Garg, Gopal Krishna Bohra, Nitin Kumar Bajpai","doi":"10.1183/13993003.congress-2023.pa1829","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa1829","url":null,"abstract":"<b>Introduction:</b> Ultrasound is the gold standard for determination of pleural puncture sites. The utility of clinico-radiological examination and its performance with reference to ultrasound has not been&nbsp;studied&nbsp;extensively. Physical signs of pleural effusion have not been studied with respect to ultrasound. <b>Methods:</b> Patients were examined clinicoradiologically by multiple physicians and a pleural puncture site was proposed and was confirmed via ultrasound. Response was characterized as true positive, true negative, false positive, or false negative. Upper and lower limits of pleural effusions were mapped and the distance of the first appearance of physical signs consistent with pleural effusion from the upper limit of pleural effusion was noted as a percentage of the total distance. <b>Results:</b> We enrolled 115 patients and 345 physician observations. Overall accuracy of the clinico-radiological examination was 94.8% with a sensitivity, specificity, PPV, NPV of 96.8 %, 92.4%, 93.8% and of 96% respectively. BMI (OR - 1.19) and lower zone pleural effusions (OR – 4.99) demonstrated significant role when adjusted for age, gender, side of effusion, and experience of examining doctors. Least accuracy was seen in lower zone pleural effusions, loculated pleural effusion and mid-zone pleural effusion. <b>Conclusion:</b> Clinico-radiologic determination of pleural puncture sites have reasonable overall accuracy. BMI and lower zone pleural effusions are significant factors of accuracy. We suggest use of ultrasound in lower zones limited effusions and/or patients with BMI &gt; 23.15 kg/m2.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136194507","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}