Australasian Journal of Ultrasound in Medicine最新文献

{"title":"Transvaginal Ultrasound for the Diagnosis of Endometriosis: Current Practices and Barriers in Australian Sonographers","authors":"Xinyu Yang,&nbsp;Alison Deslandes,&nbsp;Teresa Cross,&nbsp;Jessie Childs","doi":"10.1002/ajum.70003","DOIUrl":"https://doi.org/10.1002/ajum.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction/Purpose</h3>\u0000 \u0000 <p>The 2016 consensus statement from the International Deep Endometriosis Analysis group (IDEA) outlined a transvaginal ultrasound (TVUS) approach specific for the sonographic assessment of endometriosis (eTVUS). However, eTVUS remains a nonroutine sonographic examination, and the reasons for this are not fully understood. This study aimed to explore the current performance of eTVUS among Australian sonographers and the barriers and facilitators encountered when learning and implementing eTVUS into routine practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An online cross-sectional survey was disseminated to Australian sonographers. Quantitative and qualitative questions were asked regarding demographic information, eTVUS performance and experiences encountered when learning and implementing eTVUS. Statistical and thematic analyses were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 127 responses were analysed, with 47.8% of respondents performing a full or partial eTVUS routinely. When a gynaecological ultrasound is referred, 18.4% of participants reported performing a full assessment of eTVUS, and 29.8% reported performing a partial assessment of eTVUS. When a partial eTVUS was performed, respondents indicated this mostly included an assessment of the sliding sign (94.6%) and ovarian mobility (97.3%), rather than a search for endometriotic nodules. Only 41.5% of all participants reported confidence in performing eTVUS.</p>\u0000 \u0000 <p>The main barriers that limited the uptake of eTVUS were limited supervision/mentors (42.3%), limited reporting of eTVUS (39.6%) and its steep learning curve (38.7%). The main facilitators included sonographers' desire to answer the clinical question for suspected endometriosis (84.0%), external education (38.7%), local department protocols (30.7%) and colleagues who perform eTVUS (30.7%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While eTVUS, or aspects of it, are being performed in most imaging practices, inconsistency exists for the anatomical structures assessed as part of an eTVUS. Although barriers exist, more education surrounding eTVUS for sonographers, reporting doctors, and referrers could help increase uptake into routine practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"28 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144117881","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":"Testicular Two-Dimensional Shear Wave Elastography, Peak Systolic Velocity, Volume and Epididymal Thickness: Establishment of Normal Reference Values and Discrimination From Orchitis in Adult Patients Presenting With Acute Scrotal Pain","authors":"Steven Abbott,&nbsp;Christopher J. Welman,&nbsp;Marilyn Zelesco,&nbsp;Glenn Boardman","doi":"10.1002/ajum.70002","DOIUrl":"https://doi.org/10.1002/ajum.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To establish normal testicular stiffness reference values using two-dimensional shear wave elastography (2D-SWE) and together with volume, PSV and epididymal thickness to discriminate from inflammatory pathology, specifically orchitis, in adult patients presenting with acute scrotal symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Retrospective analysis of patients referred for scrotal ultrasonography for investigation of scrotal pain or discomfort. Evaluation of 494 testes included B-Mode, colour and pulsed wave (PW) Doppler, testicular volume, peak systolic velocity (PSV) and the median elasticity (SWE). Statistical evaluation was performed to identify stiffness threshold values to rule in normal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In normal testes, the median volume, PSV and SWE were 13.8 mL (10.3–17.2 mL), 6.3 cm/s (4.9–7.7 cm/s) and 2.5 kPa (2.15–2.85 kPa). The right testes were larger (right 14.4 mL, left 13.2 mL, <i>p</i> &lt; 0.05) with both decreasing in size and increasing in stiffness with increasing age (&gt; 60 years, <i>p</i> &lt; 0.05). In patients with normal testes but extra-testicular pathology, the median volume, PSV and SWE were 13.3 mL (9.75–16.8 mL), 6.3 cm/s (4.55–8.05 cm/s) and 2.8 kPa (2.3–3.3 kPa), respectively. In patients with orchitis, the median volume, PSV and SWE were 18.1 mL (11.5–24.7 mL), 7.9 cm/s (2.8–13 cm/s) and 5.4 kPa (3.4–7.4 kPa), respectively. The PSV and SWE values in this group were age- and side-independent. Differentiating normal testes from orchitis using SWE had AUC, accuracy, sensitivity and specificity of 0.91, 0.801, 0.892 and 0.792.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Normal adult testes have a median stiffness of 2.5 kPa. A threshold cut-off median value of 3.6 kPa suggests the diagnosis of an inflammatory testicular pathology such as orchitis, with AUC, accuracy, sensitivity and specificity of 0.922, 0.840, 0.928 and 0.831. Caution is required in the presence of extra-testicular pathology, where there is a wider range of SWE and other parameters.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"28 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108996","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":"Comparison of Carotid Artery Peak Systolic Velocity Measurement Guided by 2-Dimensional Versus 3-Dimensional X-Plane Colour Doppler Ultrasound","authors":"Jin Xu,&nbsp;Martin Necas,&nbsp;Mike Kittridge","doi":"10.1002/ajum.70009","DOIUrl":"https://doi.org/10.1002/ajum.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Characterisation of carotid artery stenosis by Doppler ultrasound relies on peak systolic velocity (PSV) measurements and velocity ratios. The site of PSV sampling is conventionally guided by 2-dimensional (2D) colour Doppler in the longitudinal plane only. The recently introduced Philips eXL14-3 MHz matrix array transducer (Philips Ultrasound, Bothell, WA, USA) allows visualisation of colour Doppler in longitudinal and transverse planes simultaneously (3D). We compared PSV measurements of the mid common carotid artery (mCCA) obtained using conventional 2D guidance versus 3D ultrasound guidance in a series of 100 carotid arteries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This was a single centre prospective study of 100 mCCA velocity measurements. All ultrasound examinations were performed by a single qualified vascular sonographer. 2D-guided and 3D-guided PSV measurements were made. Sample volume adjustments made by the sonographer were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average difference in PSV across the 100 sample sets was 0.3 ± 5.9 SD cms⁻¹. Comparing 3D versus 2D guided measurements, 45 samples showed an increase in PSV measurement, with an average of 5.0 cms⁻¹; 51 samples showed a decrease in PSV, with an average of −3.8 cms⁻¹ and 4 samples did not show any change. The fitted T- and normal distribution coefficients for the 2D and 3D samples for both the PSV and TAPV were equivalent. The <i>F</i>-tests of the horizontal and vertical adjustments of sample volume in 3D indicate there is little to no relationship between sample gate adjustment and resultant velocity measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>No significant difference was observed in PSV measurements of the mCCA when using 3D versus conventional 2D ultrasound guidance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"28 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108997","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":"Learning Curve for Interpreting Transtracheal Ultrasound Images to Confirm Endotracheal Tube Placement Among Anaesthesia Residents in a Teaching Hospital","authors":"Amber Gulamani,&nbsp;Hameed Ullah","doi":"10.1002/ajum.70011","DOIUrl":"https://doi.org/10.1002/ajum.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Airway ultrasound is a promising tool that can be used alongside capnography to confirm correct endotracheal tube (ETT) placement. This study aimed to quantify the practice required to achieve accurate interpretation of trans-tracheal ultrasound for identifying ETT placement during elective surgeries under general anaesthesia in a teaching hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty-six anaesthesia residents participated. A baseline ultrasound image interpretation test was conducted, followed by a short video tutorial on upper airway ultrasound. Participants then completed a post-test to identify 10 clips/images in a single attempt. Pre- and post-tutorial scores, time taken for interpretation and confidence levels were compared using Wilcoxon signed rank test. Statistical significance was set at <i>p</i> &lt; 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All 36 residents (55.6% female, mean age 29.1 ± 1.81 years) completed the study. After a video tutorial, the median interpretation score improved significantly from 3 (2) to 10 (0) (<i>p</i> &lt; 0.001), and the median interpretation time decreased from 12.9 (4.7) to 4.6 (1.2) s (<i>p</i> &lt; 0.001). Confidence levels also improved significantly. Proficiency was achieved by 91.7% (33/36) of participants after one practice attempt, with the remaining 8.3% succeeding after a second attempt.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A brief tutorial on airway ultrasound significantly improves anaesthesia residents' ability to interpret ultrasound images for endotracheal tube placement. It may serve as a valuable adjunct to traditional methods for ETT placement confirmation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"28 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108998","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":"Prenatal Diagnosis of an Umbilical Cord Cyst Associated With Obstructed Umbilical Artery Flow: Case Report","authors":"James Miller,&nbsp;Lavinia Hallam,&nbsp;Debra Paoletti","doi":"10.1002/ajum.70006","DOIUrl":"https://doi.org/10.1002/ajum.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Umbilical cord cysts are rare and the reported associations with abnormal foetal outcomes present challenges in antenatal diagnosis and management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Findings</h3>\u0000 \u0000 <p>We report a case of a large umbilical cord cyst detected in the second trimester, with no communication to the foetal bladder. Third trimester review demonstrated oedematous change in the umbilical cord and significantly reduced umbilical artery flow necessitating delivery by emergency caesarean section. Postnatally, the infant was found to have a patent urachus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This case underlines the importance of antenatal ultrasound surveillance in pregnancies complicated by umbilical cord cysts, limitations in definitive diagnosis and features of cord compression that have not been previously reported.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"28 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085106","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":"Central Serous Chorioretinopathy Diagnosed by Emergency Practitioner-Performed Ocular Point-Of-Care Ultrasonography","authors":"Christian P. Pappas,&nbsp;Matthew Watson,&nbsp;Christopher Harrington,&nbsp;Katherine Masselos","doi":"10.1002/ajum.70005","DOIUrl":"https://doi.org/10.1002/ajum.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Central serous chorioretinopathy (CSCR) is a common cause of acute, monocular vision loss amongst men aged 40–50 years. Diagnosis is typically multimodal, requiring advanced ophthalmic imaging. These techniques are not readily available in acute care settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We report the first case of CSCR diagnosed by an emergency practitioner–performed ocular point-of-care ultrasonography (POCUS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CSCR was identified by the presence of a dome-shaped, hypoechoic elevation of the neurosensory retina in association with a hypoechoic band posterior to the retinal pigment epithelium. The diagnosis was confirmed following ophthalmic referral. The patient was managed conservatively with routine observation and risk factor modification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We describe the first reported use of emergency practitioner-performed ocular POCUS to identify findings suggestive of CSCR, a common cause of acute monocular vision loss among working-aged men. Although this case demonstrates the evolving utility of ocular ultrasound in emergent eye presentations, further research is needed to define the technique's role in the early evaluation of CSCR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"28 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826870","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":"Simplified First-Trimester Fetal Cardiac Screening Protocol for Low-Risk Pregnancies: Enhancing Efficiency and Accuracy","authors":"Vanessa Pincham,&nbsp;Andrew McLennan,&nbsp;Jonathan Forsey,&nbsp;Ritu Mogra","doi":"10.1002/ajum.70000","DOIUrl":"https://doi.org/10.1002/ajum.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Congenital heart defects (CHDs) are among the most prevalent congenital anomalies and are frequently detected in pregnancies classified as low-risk, rather than in high-risk groups. Advancements in ultrasound technology have heightened the emphasis on first-trimester fetal cardiac screening. However, due to the small size of the fetal heart at this stage, significant challenges persist, underscoring the need for simplified and reproducible protocols that can be effectively applied on a population-wide scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This paper describes a screening approach centred on the four-chamber view (4CV) and three-vessel tracheal view (3VTV) with colour Doppler imaging. This includes optimisation of ultrasound machine settings and the use of transabdominal and transvaginal approaches to enhance visualisation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Evidence demonstrates a CHD detection rate of 76% in low-risk populations, with a 95% success rate in obtaining the necessary views.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>Operator expertise and familiarity with cardiac anomalies are critical for accurate detection. The early identification of CHDs enables informed decision-making regarding pregnancy management. A simplified protocol for first-trimester cardiac screening offers a promising tool for the early identification of CHDs, enabling timely referral and intervention. To optimise detection rates and clinical outcomes, continuous professional education and systematic auditing processes are indispensable for practitioners performing early fetal cardiac screening.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"28 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826869","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 as a Diagnostic Tool in Detection of Maxillofacial Fractures at Level 1 Trauma Centre ED in India","authors":"Afroz Fatima,&nbsp;Priyanka Modi,&nbsp;Tej Prakash Sinha,&nbsp;Sanjeev Bhoi,&nbsp;Atin Kumar,&nbsp;Sushma Sagar","doi":"10.1002/ajum.70001","DOIUrl":"https://doi.org/10.1002/ajum.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Injuries, especially maxillofacial fractures, pose a significant global health burden exacerbated by increasing traffic activities. Early detection is vital for preventing complications. This study assesses ultrasound's diagnostic efficacy, aiming to improve patient management and minimise treatment delays by detecting maxillofacial fractures promptly and accurately.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The main aim was to assess point-of-care ultrasound (POCUS) in diagnosing maxillofacial fractures against computed tomography (CT) scans. Secondary goals included identifying ocular injuries, mandibular fractures, assessing probe feasibility and comparing Le Fort classification via ultrasound and CT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>Between January 2019 and February 2021, 150 trauma patients (136 male) with a mean age of 28.5 ± 5 years (range, 18–62 years) suspected of maxillofacial fractures were enrolled. A trained physician performed facial ultrasound, and findings were documented alongside CT scan results. Using the SPSS software, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of POCUS against CT scans were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 150 patients, CT scans diagnosed 137 with maxillofacial fractures, primarily due to road traffic accidents. Zygomatic fractures were most common, followed by nasal bone and mandibular parasymphysial fractures. POCUS exhibited high sensitivity (98.9%), specificity (99.1%), PPV (92%), and NPV (99.8%) for overall facial fractures, varying by bone. Associated occult ocular injuries occurred in two patients. Sensitivity and specificity were high for mandibular fractures. 5–10 MHz frequency linear probe, footprint-50 mm was optimal for midfacial bones, but Le Fort fractures could not be reliably identified using ultrasound.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study underscores the value of POCUS in the Emergency Department for detecting maxillofacial fractures, despite limitations such as anatomical challenges. POCUS showed high diagnostic accuracy, emphasising its potential in clinical practice, requiring further validation and exploration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"28 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612472","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 of the uterosacral ligaments: A reliability study for diagnosing endometriosis in Australian non-specialised medical imaging and radiology settings","authors":"Shae Maple,&nbsp;Eva Bezak,&nbsp;K Jane Chalmers,&nbsp;Nayana Parange","doi":"10.1002/ajum.12420","DOIUrl":"https://doi.org/10.1002/ajum.12420","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction/Background</h3>\u0000 \u0000 <p>Uterosacral ligaments (USL) are the most common sites of endometriosis. Transvaginal ultrasound (TVS) demonstrates high diagnostic accuracy for endometriosis of the USLs using standardised technique and characterisations. While high accuracy and reproducibility is established with these techniques by well-trained professionals, the question still remains if these techniques are reproducible in general settings. This study aims to assess the intra and interobserver agreement of TVS characteristics of USLs, between experienced and less experienced examiners in an Australian general ultrasound imaging practice, where sonographers are required to perform ultrasound for endometriosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-two patients, with and without known endometriosis, underwent ultrasound imaging of the USLs. Images were obtained of uterosacral ligaments and collated for interobserver survey. Six professional observers independently reviewed the images, classifying characteristics such as echogenicity, echotexture, contour, thickness, and presence of nodules. Interobserver reliability was assessed using Gwet's agreement coefficients (<i>AC1</i>), and the correlation between USL thickness and endometriosis was analyzed using Spearman's correlation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Interobserver agreement for detecting USL endometriosis was substantial (<i>AC1</i> = 0.63), with an overall agreement of (0.65) for the seven USL characteristics. Intraobserver agreement ranged from moderate (0.60) to almost perfect (0.96). Experience did not significantly affect intraobserver reliability. A strong positive correlation was found between USL thickness and endometriosis (r = 0.7965, P &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrates high inter and intraobserver agreement among sonographers and radiologists in a general imaging department for identifying USL characteristics and diagnosing USL endometriosis. Both experienced and less experienced operators can reliably assess USLs Consistency was shown in identifying thickened uterosacral ligaments however, there is no consensus on where uterosacral ligament be measured. Even so, a thickened USL can prompt further extension of the pelvic scan to look for other endometriosis markers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12420","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438876","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":"Hepatic abscess caused by foreign body ingestion: A case report","authors":"Qingqing Li,&nbsp;Yujiang Liu","doi":"10.1002/ajum.12422","DOIUrl":"https://doi.org/10.1002/ajum.12422","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Liver abscess is a common clinical condition caused by bacterial, fungal or parasitic infections, usually due to immunosuppression. In contrast, secondary liver abscesses are caused by specific factors such as foreign bodies, tumours, or appendicitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We admitted a patient with secondary liver abscess and found an intrahepatic foreign body after interventional drainage. Initially, a foreign body of medical origin was suspected, but after a multidisciplinary consultation, it was determined to be caused by a foodborne foreign body. Laparoscopic surgery was then chosen as the treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>The liver abscess was caused by an alimentary foreign body, and the intrahepatic foreign body was identified as a fish bone measuring approximately 2.5 cm in length.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Upon diagnosing either primary or secondary liver abscess, aggressive treatment of the abscess focus is essential. However, in cases of secondary liver abscess, addressing and removing the underlying cause is necessary for complete resolution. For patients with a previously healthy liver, comprehensive history-taking is crucial, and imaging studies play a significant role in diagnosis and treatment. Clinicians and radiologists should be vigilant for the possibility of foreign bodies, tumours, or unexpected intra-abdominal inflammation, regardless of the patient's history. When dealing with food-borne foreign bodies, endoscopic intervention should be considered first, followed by laparoscopy, and as a last resort, open surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The diagnosis and treatment of liver abscess in clinical practice require a complete medical history and thorough imaging examinations. Ultrasound, as the initial imaging modality, allows real-time and dynamic observation of lesions. It is essential for ultrasonologists to consider the possibility of foreign body-induced liver abscess when diagnosing patients with liver abscess.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423626","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}