Ultrasound最新文献

{"title":"Focused assessment with sonography for HIV/TB.","authors":"Giles Cattermole, Gabin Mbanjumucyo","doi":"10.1177/1742271X211033884","DOIUrl":"https://doi.org/10.1177/1742271X211033884","url":null,"abstract":"We were pleased to read Ahmed et al.’s paper supporting the use of ultrasound in pleural tuberculosis (TB). The diagnosis of TB is often difficult, and in resourcepoor settings, advanced techniques such as GeneXpertR might be unavailable. Extrapulmonary TB can be especially hard to diagnose, and there is increasing evidence that point of care ultrasound (POCUS) might be helpful. In the particular case described, although we agree with the authors that TB was probably the correct diagnosis, POCUS appeared to be limited to lung ultrasound, and the findings of pleural effusion and small consolidation were also consistent with an atypical pneumonia. Anti-TB treatment should be avoided in those who don’t have TB, so to increase the diagnostic yield of POCUS in suspected TB where gold standard methods are unavailable, we would strongly recommend the use of a more comprehensive FASH ultrasound protocol: focused assessment with sonography for HIV/TB. FASH is now a well-established tool in low-resource settings, where TB is often associated with HIV. The protocol employs similar probe positions to the eFAST examination in trauma. The right hepatorenal view assesses free peritoneal fluid, as well as microabscesses in the liver; the left splenorenal view for fluid and focal splenic abscesses; in each case the probe is also moved cephalad a few centimetres to assess for pleural effusion. The pelvic view assesses free fluid. The subxiphoid view looks for pericardial effusion, but the probe is then angled down to identify para-aortic lymph node enlargement. Lung ultrasound examines pleural pathology, pneumothorax or consolidation. Sincerely, Giles Cattermole and Gabin Mbanjumucyo ORCID iD","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"29 4","pages":"270"},"PeriodicalIF":0.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8579369/pdf/10.1177_1742271X211033884.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39712246","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":"Hazel Edwards","doi":"10.1177/1742271X211053452","DOIUrl":"https://doi.org/10.1177/1742271X211053452","url":null,"abstract":"","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"29 4","pages":"207"},"PeriodicalIF":0.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8579371/pdf/10.1177_1742271X211053452.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39624178","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":"Predictive value of the transcranial Doppler and mean arterial flow velocity for early detection of cerebral vasospasm in aneurysmal subarachnoid hemorrhage.","authors":"Ahmed Esmael,&nbsp;Mohamed E Flifel,&nbsp;Farid Elmarakby,&nbsp;Tamer Belal","doi":"10.1177/1742271X20976965","DOIUrl":"https://doi.org/10.1177/1742271X20976965","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to predict cerebral vasospasm in acute aneurysmal subarachnoid hemorrhage and to determine the cut-off values of the mean flow velocity by the use of transcranial Doppler.</p><p><strong>Methods: </strong>A total of 40 patients with acute aneurysmal subarachnoid hemorrhage were included in this study and classified into two groups. The first group was 26 patients (65%) with cerebral vasospasm and the second group was 14 patients (35%) without vasospasm. Initial evaluation using the Glasgow Coma Scale and the severity of aneurysmal subarachnoid hemorrhage was detected by using both the clinical Hunt and Hess and radiological Fisher grading scales. All patients underwent transcranial Doppler evaluations five times in 10 days measuring the mean flow velocities (MFV) of cerebral arteries.</p><p><strong>Results: </strong>Patients with cerebral vasospasm were associated with significantly higher mean Glasgow Coma Scale score (<i>p</i> = 0.03), significantly higher mean Hunt and Hess scale grades (<i>p</i> = 0.04), with significantly higher mean diabetes mellitus (<i>p</i> = 0.03), significantly higher mean systolic blood pressure and diastolic blood pressure (<i>p</i> = 0.02 and <i>p</i> = 0.005 respectively) and significantly higher MFVs measured within the first 10 days. Logistic regression analysis demonstrated that MFV ≥81 cm/s in the middle cerebral artery is accompanied by an almost five-fold increased risk of vasospasm (OR 4.92, <i>p</i> < 0.01), while MFV ≥63 cm/s in the anterior cerebral artery is accompanied by a three-fold increased risk of vasospasm (OR 3.12, <i>p</i> < 0.01), and MFV ≥42 cm/s in the posterior cerebral artery is accompanied by a two-fold increased risk of vasospasm (OR 2.11, <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Transcranial Doppler is a useful tool for early detection, monitoring, and prediction of post subarachnoid vasospasm and valuable for early therapeutic intervention before irreversible ischemic neurological deficits take place.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"29 4","pages":"218-228"},"PeriodicalIF":0.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1742271X20976965","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39712239","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":"Placenta accreta index and morbidly adherent placenta: Methodological issues on reliability, accuracy and prediction.","authors":"Siamak Sabour","doi":"10.1177/1742271X211038601","DOIUrl":"https://doi.org/10.1177/1742271X211038601","url":null,"abstract":"I read the paper by Agarwal S et al. published in the May 2021 issue of Ultrasound. The authors aimed to estimate the level of interobserver agreement in the calculation of placenta accreta index (PAI) as well as to evaluate the accuracy of PAI in prediction of morbidly adherent placenta. They included 45 pregnant women with at least one previous Caesarean section. The accuracy of the PAI and the level of interrater agreement was analyzed applying intraclass correlation efficient (ICC) and Cohen’s kappa. Based on their results, the PAI showed nearly 90% sensitivity, specificity and the predictive values. Interrater agreement in calculation of PAI by the two radiologists was perfect with an intraclass correlation efficient of 0.95. An easy-to-use morbid adherent placenta score was also predicted to simplify the results of PAI, which showed moderate agreement (j1⁄4 0.74). First, Cohen’s kappa to assess reliability has two important limitations as follows: the value of kappa extremely depends on the prevalence in each category, which means it can be possible to have different k values having the same percentage for both concordant and discordant cells. Table 1 shows that in both (a) and (b) situations, the prevalence of concordant cells are 90% and of discordant cells, 10%; however, we get different kappa values (0.4 as moderate and 0.8 as very good, respectively). Kappa value also depends on the number of categories. Second, sensitivity and specificity are appropriate indices in public health, and both positive and negative predictive values (PPV and NPV) are influenced by prevalence of the outcome. Therefore, I suggest the authors calculate the positive and negative likelihood ratios (LR), since they are not influenced by prevalence of the disease. Third, the aim of clinical prediction positively impacts clinical decision making and subsequent patient outcomes. For prediction of an outcome, we must assess the interactions between predictors. Without assessing interaction, any result is imprecise and consequently, diminishes the clinical value of prediction models. Finally, assessing internal and external validity is recommended. Using internal","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"29 4","pages":"268-269"},"PeriodicalIF":0.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8579364/pdf/10.1177_1742271X211038601.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39712245","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":"Ultrasound and alternative multimodality imaging of intra-abdominal and pelvic cystic masses in the newborn.","authors":"Weiyong Lee,&nbsp;Margaret Yw Lee,&nbsp;Harvey Teo","doi":"10.1177/1742271X20984814","DOIUrl":"https://doi.org/10.1177/1742271X20984814","url":null,"abstract":"<p><p><b>Introduction:</b> Ultrasound is used commonly to detect and diagnose intra-abdominal and pelvic cystic masses in the newborn as it is easily available, relatively low cost, and non-invasive. <b>Discussion:</b> The diagnosis can be made or narrowed down by determining the location, size, sonographic features, organ involvement, and internal vascularity. The differential diagnoses include hydronephrosis, multicystic dysplastic kidney, adrenal haemorrhage, cystic teratomas, ovarian cysts, enteric cysts, meconium cysts, and liver haemangiomas. With the appropriate radiological knowledge, the ultrasound practitioner can help obtain an accurate diagnosis. <b>Conclusion:</b> This pictorial essay will familiarise the reader with the different common causes of intra-abdominal and pelvic masses detected on ultrasound through a wide range of conditions. The role of ultrasound in the evaluation of these conditions will be discussed and alternative imaging correlates will be offered.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"29 4","pages":"241-251"},"PeriodicalIF":0.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1742271X20984814","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39712241","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":"BMUS journal club on Twitter: An analysis of the first #BMUS_JC discussions.","authors":"Ruth Reeve,&nbsp;Stephen Moore,&nbsp;Catherine Kirkpatrick","doi":"10.1177/1742271X21990056","DOIUrl":"https://doi.org/10.1177/1742271X21990056","url":null,"abstract":"<p><strong>Introduction: </strong>Journal clubs have evolved over recent years within healthcare to encourage continuing professional development. More recently, there has been a move from face-to-face group meetings to virtual groups utilising social media platforms. This article aims to explore the discussions and narrative following the inaugural BMUS journal club, highlighting the key discussions and themes from the participants and to provide a narrative for the future of ultrasound continuing professional development.</p><p><strong>Methods: </strong>The August 2020 journal club chat was focussed on the article featured in <i>Ultrasound</i>: \"Sonographers' level of autonomy in communication in Australian obstetric settings: Does it affect their professional identity?\" by Thomas et al. Data consisting of Twitter correspondence were extracted and analysed from the advanced search function on Twitter using #BMUS_JC thread. An initial review ensured related content was included. A second review and semantic thematic analysis was then conducted on the 123 tweets.</p><p><strong>Results: </strong>In total, seven overall themes were identified between the three sub-threads within the journal club discussions. Those participating in the Twitter discussion recognised the limitations and barriers for communicating results to patients, acknowledging that training, support and regulatory involvement is required for sonographers to change practice locally and internationally.</p><p><strong>Conclusion: </strong>The group discussions on Twitter highlight the ongoing issues for sonographers' professional identity worldwide. Furthermore, our analysis echo other contemporary studies which indicate that Twitter journal clubs act as a fruitful and dynamic source of continuing professional development, particularly in an era where social distancing is encouraged. The outcomes of the first BMUS journal club support the wider evidence that online journal clubs can provide a successful platform for professional discussion and debate.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"29 3","pages":"172-178"},"PeriodicalIF":0.8,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1742271X21990056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39451209","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":"Emphysematous epididymo-orchitis: An unusual case report.","authors":"Akshat Agrawal,&nbsp;Sudhansu Sekhar Mohanty,&nbsp;Kamal Kumar Sen","doi":"10.1177/1742271X20977040","DOIUrl":"https://doi.org/10.1177/1742271X20977040","url":null,"abstract":"<p><strong>Introduction: </strong>Emphysematous epididymo-orchitis in the young to middle age groups without any comorbidity like diabetes or metabolic disorders is an uncommon entity.</p><p><strong>Case report: </strong>We present a case of a nondiabetic young patient, diagnosed with emphysematous epididymo-orchitis as a sequela to urinary tract infection.</p><p><strong>Discussion: </strong>Clinically differentiating diagnoses of the acute scrotum may be difficult and ultrasound can be used reliably as the initial modality showing the presence of air for early diagnosis.</p><p><strong>Conclusion: </strong>Nondiabetic young patients without any metabolic disorder should also be suspected for emphysematous epididymo-orchitis in the setting of the acute scrotum. An ultrasound examination can predict its presence with confidence.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"29 3","pages":"199-202"},"PeriodicalIF":0.8,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1742271X20977040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39451213","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":"Giant haemorrhagic hepatic cyst with flame-like morphology in a patient with polycystic kidney and liver disease.","authors":"Ana Brusic,&nbsp;June Oo,&nbsp;Damien L Stella,&nbsp;Paul M Simkin,&nbsp;Benjamin Pt Loveday","doi":"10.1177/1742271X20987263","DOIUrl":"https://doi.org/10.1177/1742271X20987263","url":null,"abstract":"<p><strong>Introduction: </strong>Intracystic haemorrhage is a rare complication of hepatic cysts, and is often mistaken for a malignant lesion.</p><p><strong>Case report: </strong>A 55-year-old female with a history of polycystic kidney and liver disease presented with a six-month history of abdominal distension, abdominal pain, early satiety, shortness of breath and 5 kg of weight loss. Imaging revealed a 20 cm mixed solid-cystic hepatic lesion containing peripheral avascular mobile echogenic material with a flame-like morphology. After experiencing symptomatic relief from ultrasound-guided aspiration, the patient underwent cyst fenestration for more definitive treatment.</p><p><strong>Discussion: </strong>Haemorrhagic hepatic cysts are uncommon and may present on imaging as having lace-like retractile clot, internal layering or shading of separating blood products or avascular mobile flame-like excrescences. The presence of avascular mobile flame-like excrescences appears to be a unique feature of haemorrhagic hepatic cysts.</p><p><strong>Conclusion: </strong>While haemorrhagic hepatic cysts are rare and commonly mistaken for biliary cystadenomas or adenocarcinomas, the identification of particular features on high-resolution magnetic resonance imaging and contrast-enhanced ultrasound can lead to the correct diagnosis.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"29 3","pages":"187-192"},"PeriodicalIF":0.8,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1742271X20987263","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39451211","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":"Value of Doppler ultrasound in early detection of diabetic kidney disease: A systematic review and meta-analysis.","authors":"Heather Kilgour Venables,&nbsp;Yaw Amo Wiafe,&nbsp;Theophilus Kofi Adu-Bredu","doi":"10.1177/1742271X20977051","DOIUrl":"https://doi.org/10.1177/1742271X20977051","url":null,"abstract":"<p><p>The diagnosis of diabetic kidney disease can be delayed by limitations of primary biomarkers, which are microalbuminuria and estimated glomerular filtration rate. A number of Doppler ultrasound studies have associated an increase in intrarenal vascular resistance with the disease, which makes ultrasound a potential adjunct tool for early diagnosis. However, there is inadequate evidence to establish the effectiveness of including Doppler ultrasound in the diagnostic process. This systematic review was therefore conducted to determine the value of using Doppler ultrasound in early detection of diabetic kidney disease. Electronic literature searches were carried out in PubMed, CINAHL, Web of Science and EMBASE. All published prospective studies with records of intrarenal Doppler ultrasound, microalbuminuria and estimated glomerular filtration rate were obtained, and their relationship as parameters for diabetic kidney disease assessed. The meta-analysis of Doppler ultrasound versus albuminuria shows insignificant statistical difference between high resistive index of ≥ 0.7 and albuminuria, with the resistive index being the favoured parameter on the forest plot, making Doppler ultrasound highly comparable with albuminuria for the detection of diabetic kidney disease. Again, there was a significant statistical difference between high intrarenal resistive index of ≥ 0.7 and low estimated glomerular filtration rate of <i><</i> 60 mL/min/1.73 m², with the resistive index being the favoured parameter on the forest plot, making Doppler ultrasound a superior parameter compared with estimated glomerular filtration rate for early detection of diabetic kidney disease.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"29 3","pages":"141-149"},"PeriodicalIF":0.8,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1742271X20977051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39451206","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":"High resolution ultrasound in subclinical diabetic neuropathy: A potential screening tool.","authors":"Anupama Tandon,&nbsp;Tamanna Khullar,&nbsp;Siddharth Maheshwari,&nbsp;Shuchi Bhatt,&nbsp;Shiva Narang","doi":"10.1177/1742271X20958034","DOIUrl":"https://doi.org/10.1177/1742271X20958034","url":null,"abstract":"<p><strong>Introduction: </strong>Detection of subclinical neuropathy can aid in triage, timely intervention and dedicated care to reduce disease progression and morbidity. High resolution sonography has emerged as a promising technique for evaluation of peripheral nerves. The aim of the present study was to assess the utility of high resolution sonography in screening diabetic patients for subclinical neuropathy.</p><p><strong>Methods: </strong>A total of 70 adult patients with type 2 diabetes mellitus and 30 controls were enrolled; those with clinical features of neuropathy constituted the diabetic polyneuropathy group and those without symptoms/normal nerve conduction the non-diabetic polyneuropathy group. After institutional ethical committee approval and informed consent, high resolution sonography was performed by two musculoskeletal radiologists. Nerves studied were median (elbow and wrist), ulnar (cubital tunnel and Guyon's canal), common peroneal (fibular head) and posterior tibial nerve (medial malleolus).The size (cross sectional area), shape, echogenicity and morphology of nerve were assessed and compared between the groups.</p><p><strong>Results: </strong>The mean cross sectional area of all nerves was significantly higher both in diabetic polyneuropathy and non-diabetic polyneuropathy group compared to controls (p value < .001). Common peroneal nerve cross sectional area of 4.5 mm² had the highest sensitivity (93%) and specificity (86%) for detecting nerve changes in the non-diabetic polyneuropathy group. The nerves were more rounded, hypoechoic and had an altered morphology in both study groups.</p><p><strong>Conclusion: </strong>Presence of sonographic nerve changes in asymptomatic diabetics depicted that morphological alterations in nerves precede clinical symptoms. High resolution sonography detected nerve changes with a good accuracy, and thus, can be a potential screening tool for detection of subclinical diabetic polyneuropathy.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"29 3","pages":"150-161"},"PeriodicalIF":0.8,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1742271X20958034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39451207","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}