Australasian Journal of Ultrasound in Medicine最新文献

{"title":"Ultrasound imaging of the dorsalis pedis artery as an early indicator of the precursory changes for rheumatoid vasculitis: A case series","authors":"Robyn Boman,&nbsp;Stefania Penkala,&nbsp;Rosa H. M. Chan,&nbsp;Fredrick Joshua,&nbsp;Roy Tsz Hei Cheung","doi":"10.1002/ajum.12373","DOIUrl":"10.1002/ajum.12373","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Clinical verification of rheumatoid vasculitis (RV) persists as a mid-to-late diagnosis with medical imaging or biopsy. Early and subclinical presentations of RV, in particular, can remain underdiagnosed in the absence of adequate diagnostic testing. In this study, the research demonstrated the precursory changes for RV in patients with rheumatoid arthritis (RA) using non-invasive ultrasound imaging of a peripheral vessel.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Six participants were recruited: three participants with (RA) and three age- and gender-matched healthy controls. All participants completed a Foot Health Survey Questionnaire (FHSQ), and participants with RA completed a Rheumatoid Arthritis Disease Activity Index-5 (RADAI-5). Bilateral B-mode and Doppler ultrasound of the dorsalis pedis artery (DPA) was performed. The degree of inflammation, lumen and artery diameters, lumen diameter-to-artery diameter ratio and peak systolic velocity in the proximal DPA were compared between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean RADAI-5 score (5.4 ± 0.8 out of 10) indicated moderate disease activity amongst participants with RA. Inflammation was observed in the DPA wall in all participants with RA, compared to no inflammation observed in the control group (Friedmans two-way analysis: χ² = 15.733, P = 0.003). Differences between groups for inflammation, lumen diameter and lumen diameter-to-artery diameter ratio were found (P &lt; 0.034), without differences for artery diameter and peak systolic velocity (P &gt; 0.605). DPA wall inflammation did not correlate with FHSQ scores (<i>r</i> = −0.770, P = 0.073).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite moderate RA disease activity, this is the first study to demonstrate the use of ultrasound to observe inflammation in small vessel disease. Our findings suggest ultrasound imaging may be a viable screening tool to demonstrate arterial wall inflammation, indicating the precursory changes of RV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 1","pages":"42-48"},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12373","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138966949","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":"Multifaceted uses for musculoskeletal ultrasound","authors":"Fred Joshua","doi":"10.1002/ajum.12372","DOIUrl":"https://doi.org/10.1002/ajum.12372","url":null,"abstract":"<p>This issue of the Australasian Journal of Ultrasound in Medicine highlights the use of ultrasound in musculoskeletal ultrasound. This area of medicine encompasses approximately 20% of presentations to primary care physicians.<span>^{1, 2}</span> Determining how to investigate and manage these problems is a major burden to society. This is a very large cost in both evaluation and treatment.<span>³</span> Ultrasound is increasingly the modality used to investigate musculoskeletal complaints as it is relatively cheaper, safer and more available, increasingly at the bedside.<span>⁴</span></p><p>Fenech describes the anatomy of the metacarpophalangeal joints and the use of real-time ultrasound to diagnose the injuries in Boxer's knuckle.<span>⁵</span> Fenech demonstrates both the normal anatomy and the tears of the sagittal bands of the dorsal hood and associated extensor tendon instability. This is an important article for teaching the clinical use of ultrasound to allow patients to be able identified so that they may move forward to improve from what can result in long-term disability from the loss of hand function. The treatment may require surgical repair.</p><p>Following on from this, Renfree <i>et al</i> describe the evaluation of flexor tendon surgical repair with differing ultrasound transducers.<span>⁶</span> The superficial nature of the flexor tendons of the hand allows high-frequency probes to be used for evaluation. This study highlights that improvements in transducer technology from 18 to 24 MHz do provide more information and may result in less re-operation. Another important aspect of ultrasound evaluation is how this study was performed using cadavers. Cadaveric evaluation of techniques for both procedures and education is an important aspect of how ultrasound can be used.<span>^{7, 8}</span></p><p>Finally, Magoon <i>et al</i>.<span>⁹</span> highlight the safe and accurate evaluation of diagnostic biopsy of soft-tissue lesions in the hand. Importantly, the study demonstrated that even small lesions (&lt;1 cm) are amenable to this, allowing a safer evaluation than open biopsy.<span>⁹</span> The article also highlights the high level of experience of all groups involved in the evaluation of the soft-tissue lesions from the ultrasound and radiology staff through to the pathologist involved.</p><p>These three articles highlight the scope of ultrasound use in musculoskeletal imaging. This includes the evaluation of injury, biopsy of lesions though to review of results of surgical treatments. Ultrasound has important roles in both the diagnosis and treatment of musculoskeletal conditions, and the increasing availability of the technology will only increase this in future. It is essential that we develop an evidence base, as these authors have done, to document the true benefit, if any of the technology.</p>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"26 4","pages":"215"},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12372","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138578109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point-of-care ultrasound to diagnose acute cholecystitis in the emergency department: A scoping review","authors":"Alexander Joyce,&nbsp;Peter J Snelling,&nbsp;Tarek Elsayed,&nbsp;Gerben Keijzers","doi":"10.1002/ajum.12371","DOIUrl":"10.1002/ajum.12371","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction/Purpose</h3>\u0000 \u0000 <p>Ultrasound is the first-line imaging modality for suspected acute cholecystitis. This can be radiology-performed ultrasound or point-of-care ultrasound (POCUS). POCUS can potentially streamline patient assessment in the emergency department (ED). The primary objective was to evaluate the literature for the diagnostic accuracy of POCUS performed for acute cholecystitis in the ED. Secondary objectives were to assess the effect of POCUS operator training on diagnostic accuracy for acute cholecystitis, utility of POCUS measurement of the common bile duct and POCUS impact on resource utilisation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic scoping review of articles was conducted using Medline, Embase, CENTRAL and CINAHL. Original studies of adults with POCUS performed for the diagnosis of acute cholecystitis in the ED were included. The study was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist (PRISMA-ScR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1090 publications were identified. Forty-six met the eligibility criteria. Studies were thematically grouped into categories according to specified objectives. Point-of-care ultrasound was of acceptable but variable accuracy, contributed to by the absence of a consistent reference standard and uniform training requirements. It may positively impact ED resource utilisation through reduced ED length of stay and radiology-performed imaging, whilst improving patient experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This review highlights the heterogeneity of existing research, emphasising the need for standardisation of training and reference standards in order to precisely define the utility of POCUS for acute cholecystitis in the ED and its benefits on ED resource utilisation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 1","pages":"26-41"},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138982833","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":"Role of contrast-enhanced ultrasound for differentiation of benign vs. malignant portal vein thrombosis in hepatocellular carcinoma – A systematic review a meta-analysis","authors":"Suprabhat Giri,&nbsp;Arun Vaidya,&nbsp;Dhiraj Agrawal,&nbsp;Jijo Varghese,&nbsp;Ranjan Kumar Patel,&nbsp;Taraprasad Tripathy,&nbsp;Ankita Singh,&nbsp;Swati Das","doi":"10.1002/ajum.12375","DOIUrl":"10.1002/ajum.12375","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction/Purpose</h3>\u0000 \u0000 <p>Patients with cirrhosis and hepatocellular carcinoma (HCC) can develop both benign and malignant portal vein thrombosis (PVT). Characterising the nature of PVT is important for planning an optimal therapeutic strategy. In the absence of typical findings or contraindications to computed tomography (CT) or magnetic resonance imaging (MRI), contrast-enhanced ultrasound (CEUS) could help in this differentiation. The present meta-analysis aimed to evaluate the performance of CEUS for characterising PVT in patients with HCC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Electronic databases of PubMed, Embase and Scopus were searched from inception to 31 December 2022 for studies analysing the role of CEUS in the differentiation of benign and malignant PVT in HCC. Using the bivariate random effect model, pooled sensitivity and specificity were calculated, and the summary receiver operating characteristic (sROC) curve was plotted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 12 studies with data from 712 patients were included in the meta-analysis. The pooled sensitivity and specificity of CEUS for the diagnosis of tumour in vein were 97.0% (95% CI: 93.0–98.7) and 96.8% (95% CI: 92.1–98.7), respectively, without significant heterogeneity. A sROC curve was plotted, and the area under the receiver operating characteristic was 0.99 (95% CI: 0.98–1.00). Despite the presence of publication bias, sensitivity analysis did not show any change in sensitivity and specificity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our meta-analysis summarises the accuracy data from 12 studies, including &gt;700 subjects. Contrast-enhanced ultrasound had excellent diagnostic accuracy with pooled sensitivity and specificity of 97.5% (95% CI: 93.5–99.1) and 98.2% (95% CI: 91.5–99.6), respectively, without any significant heterogeneity. Additionally, the pooled positive LR, negative LR and DOR were 54.6 (95% CI: 11.1–25.6), 0.02 (0.01–0.07) and 2186.8 (318.3–15022.2), respectively. A positive result increases the pretest probability of malignant PVT from 50% to 98%, whereas a negative result decreases it from 50% to 2%. Most of the studies included in our meta-analysis used identical techniques and 6–12-month follow-up scans to check for thrombus progression or regression. Our analysis showed no significant heterogeneity in the studies, and area under receiver operating characteristic curve (AUROC) with 95% CI was 1.00 (95% CI: 0.99–1.00). This critical meta-analysis thus propels CEUS to the forefront for differentiating benign from tumoural PVT and suggests routinely using CEUS in patients present","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 1","pages":"56-64"},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138585122","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":"Complete hydatidiform mole with concurrent fetus: Two cases of live, term birth coupled with spontaneous resolution of molar tissue","authors":"Emily M. Warton,&nbsp;Jan E. Dickinson,&nbsp;Scott W. White,&nbsp;Yee Leung,&nbsp;Bligh Berry","doi":"10.1002/ajum.12366","DOIUrl":"10.1002/ajum.12366","url":null,"abstract":"<p>Pregnancies with a complete hydatidiform mole and co-existing fetus (CMCF) are rare, but increasingly common due to the rising prevalence of assisted reproductive technology. They are frequently associated with adverse obstetric outcomes, providing women with the challenge of pregnancy termination or continuing the pregnancy at the risk of maternal-fetal morbidity and fetal mortality.</p><p>This report demonstrates two cases of CMCF pregnancy with excellent maternal-fetal outcomes, including spontaneous resolution of the molar tissue antenatally. It is helpful in counselling women who are diagnosed with this rare and frequently morbid condition in considering how to proceed with their pregnancy.</p>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 1","pages":"65-70"},"PeriodicalIF":0.0,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138586055","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":"Clinical audit of ultrasonography for detecting sialoliths in the submandibular gland in paediatric patients: A comparison to computed tomography and magnetic resonance imaging","authors":"Takahiro Hosokawa,&nbsp;Yutaka Tanami,&nbsp;Yumiko Sato,&nbsp;Nodoka Adachi,&nbsp;Hiroshi Asanuma,&nbsp;Eiji Oguma","doi":"10.1002/ajum.12370","DOIUrl":"10.1002/ajum.12370","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To compare the performance of ultrasonography with magnetic resonance imaging (MRI) and computed tomography (CT) for detecting submandibular sialoliths.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirteen patients with suspected submandibular sialoliths who underwent ultrasonography and CT or MRI were included. Sialoliths were diagnosed using CT (11 cases) or MRI (two cases). The submandibular duct was classified into distal and proximal ducts based on the point around the mylohyoid muscle. Sialoliths located in the proximal duct were difficult to differentiate from those located within the submandibular gland (SMG). Therefore, the location of the sialoliths was classified as follows: within the SMG/proximal duct and within the distal duct. The ultrasound results were compared with CT/MRI results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 13 patients included, two had sialoliths in both the SMG/proximal duct and the distal duct, three had sialoliths in the SMG/proximal duct, and five had sialoliths in the distal duct on CT or MRI. In this small cohort, all five sialoliths in the SMG/proximal duct were detected by ultrasoonography; however, of the seven cases with sialoliths located in the distal duct, only three could be detected by ultrasonography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The incidence of sialoliths in the distal duct was higher than that in the SMG/proximal duct. Ultrasonography showed a good performance compared with CT/MRI in the SMG/proximal duct but not in the distal duct.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 1","pages":"19-25"},"PeriodicalIF":0.0,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138585685","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":"Artificial intelligence as a teaching tool for gynaecological ultrasound: A systematic search and scoping review","authors":"Alison Deslandes,&nbsp;Jodie Avery,&nbsp;Hsiang-Ting Chen,&nbsp;Mathew Leonardi,&nbsp;George Condous,&nbsp;M. Louise Hull","doi":"10.1002/ajum.12368","DOIUrl":"10.1002/ajum.12368","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this study was to investigate the current application of artificial intelligence (AI) tools in the teaching of ultrasound skills as they pertain to gynaecological ultrasound.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A scoping review was performed. Eight databases (MEDLINE, EMBASE, EMCARE, CINAHL, Scopus, Web of Science, IEEE Xplore and ACM digital library) were searched in December 2022 using predefined keywords. All types of publications were eligible for inclusion so long as they reported the use of an AI tool, included reference to or discussion of teaching or the improvement of ultrasound skills and pertained to gynaecological ultrasound. Conference abstracts and non-English language papers which could not be adequately translated into English were excluded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The initial database search returned 481 articles. After screening against our inclusion and exclusion criteria, two were deemed to meet the inclusion criteria. Neither of the articles included reported original research (one systematic review and one review article). Neither of the included articles explicitly provided details of specific tools developed for the teaching of ultrasound skills for gynaecological imaging but highlighted similar applications within the field of obstetrics which could potentially be expanded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Artificial intelligence can potentially assist in the training of sonographers and other ultrasound operators, including in the field of gynaecological ultrasound. This scoping review revealed however that to date, no original research has been published reporting the use or development of such a tool specifically for gynaecological ultrasound.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 1","pages":"5-11"},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12368","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139258816","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":"Novel technique for ultrasound-guided needle tracking: An inexpensive reusable phantom model utilising a closed electrical circuit","authors":"Hillary J. McKinley,&nbsp;Isaak Jones,&nbsp;Madeline LaRochelle,&nbsp;Erik Christensen,&nbsp;Weeden Bauman,&nbsp;Peter Croft","doi":"10.1002/ajum.12367","DOIUrl":"10.1002/ajum.12367","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Purpose:There are a variety of commercially made ultrasound training phantoms available for educational purposes. A new concept in phantoms is presented that utilises a low-cost method to create a reusable phantom.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A closed electric circuit was combined with insulating material to create a novel phantom that can be used to practise needle tracking under ultrasound guidance on repeated occasions. A tricolour light-emitting diode (LED) illuminates when the needle (under ultrasound gudiance) contacts one of three metal objects embedded in the phatom material.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This prototype model provides a simple solution for trianing ultrasound needle guidance is particularly geared towards programmes with a high volume of users. This protoype provides a starting point for a new concept in educational phantom trainers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 2","pages":"120-123"},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139259577","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":"Prevalence of anomalies on the routine mid-trimester ultrasound: 3172 consecutive cases by a single maternal–fetal medicine specialist","authors":"Colin A. Walsh,&nbsp;Nicole Lees","doi":"10.1002/ajum.12369","DOIUrl":"10.1002/ajum.12369","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction/Purpose</h3>\u0000 \u0000 <p>The routine mid-trimester fetal anatomy ultrasound (FAS) is offered to every pregnant woman and remains critical in the detection of structural fetal anomalies. Our study aimed to determine the prevalence of abnormalities on routine FAS performed by a single operator, who is an experienced sub-specialist in maternal–fetal medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of all routine FAS performed a tertiary private obstetric ultrasound practice in metropolitan Sydney over a 7-year period, August 2015–July 2022. An advanced ultrasound protocol including detailed cardiac views was used in every case. Second opinion scans for suspected abnormalities were excluded. Fetal anomalies were classified into major and minor, based on the likely need for neonatal intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 14,908 obstetric ultrasound examinations, routine FAS were performed on 3172 fetuses by a single operator. More than 99% of women had screened low-risk for fetal aneuploidy. Structural anomalies were identified in 5% (157/3172) of fetuses; the prevalence of major anomalies was 1% (30/3172). Almost 60% of total anomalies were either cardiac or renal. No differences were identified in anomaly rates for singletons compared with twins (5.0% vs. 4.2%; P = 0.75). The prevalence of placenta previa and vasa previa was 10% and 0.1%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The prevalence of fetal anomalies on routine FAS by a single operator using a standardised protocol was higher in our practice (5%) than in previously published studies. Although most anomalies were minor, the rate of major abnormality was 1%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The routine mid-trimester FAS remains an integral component of prenatal ultrasound screening.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 1","pages":"12-18"},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139258417","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 lung ultrasound scoring systems for the prognosis of COVID-19 in the emergency department: An international prospective cohort study","authors":"Peter J Snelling,&nbsp;Philip Jones,&nbsp;Rory Connolly,&nbsp;Tomislav Jelic,&nbsp;Dan Mirsch,&nbsp;Frank Myslik,&nbsp;Luke Phillips,&nbsp;Gabriel Blecher,&nbsp;the COVID LUS Study Group","doi":"10.1002/ajum.12364","DOIUrl":"10.1002/ajum.12364","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this study was to evaluate whether the lung ultrasound (LUS) scores applied to an international cohort of patients presenting to the emergency department (ED) with suspected COVID-19, and subsequently admitted with proven disease, could prognosticate clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was an international, multicentre, prospective, observational cohort study of patients who received LUS and were followed for the composite primary outcome of intubation, intensive care unit (ICU) admission or death. LUS scores were later applied including two 12-zone protocols (‘de Alencar score’ and ‘CLUE score’), a 12-zone protocol with lung and pleural findings (‘Ji score’) and an 11-zone protocol (‘Tung-Chen score’). The primary analysis comprised logistic regression modelling of the composite primary outcome, with the LUS scores analysed individually as predictor variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between April 2020 to April 2022, 129 patients with COVID-19 had LUS performed according to the protocol and 24 (18.6%) met the composite primary endpoint. No association was seen between the LUS score and the composite primary end point for the de Alencar score [odds ratio (OR) = 1.04; 95% confidence interval (CI): 0.97–1.11; P = 0.29], the CLUE score (OR = 1.03; 95% CI: 0.96–1.10; P = 0.40), the Ji score (OR = 1.02; 95% CI: 0.97–1.07; P = 0.40) or the Tung-Chen score (OR = 1.02; 95% CI: 0.97–1.08).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Compared to these earlier studies performed at the start of the pandemic, the negative outcome of our study could reflect the changing scenario of the COVID-19 pandemic, including patient, disease, and system factors. The analysis suggests that the study may have been underpowered to detect a weaker association between a LUS score and the primary outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In an international cohort of adult patients presenting to the ED with suspected COVID-19 disease who had LUS performed and were subsequently admitted to hospital, LUS severity scores did not prognosticate the need for invasive ventilation, ICU admission or death.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 2","pages":"75-88"},"PeriodicalIF":0.0,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12364","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136157235","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}