Ultrasound Journal最新文献

{"title":"Undergraduate point-of-care ultrasound education in Northern Europe: A cross-sectional survey.","authors":"Jesse Järvinen, Kalle Mattila, Ossi Hannula, Anna Meuronen","doi":"10.5826/tuj.2026.18814","DOIUrl":"https://doi.org/10.5826/tuj.2026.18814","url":null,"abstract":"<p><p>Background Point-of-care ultrasound (POCUS) is increasingly recognized as a vital physician skill in acute care, yet its integration into undergraduate medical curricula in Europe remains inconsistent. This study aimed to assess the status of undergraduate POCUS education in Northern Europe and identify structural factors influencing its implementation. Methods A cross-sectional, web-based survey was distributed to accredited medical schools across the Nordic and Baltic countries. Faculty leads responsible for Emergency Medicine, Critical Care/Anesthesiology, or POCUS education were surveyed. The survey assessed curriculum integration, governance structures, resource barriers, and educator attitudes. Quantitative data were analyzed using descriptive statistics, while qualitative responses regarding implementation barriers underwent thematic analysis. Results Twenty-two institutions participated, yielding an 88% response rate. Established POCUS curricula were reported by 45% of schools, though integration levels varied between the Nordic and Baltic regions. Governance was frequently shared between Emergency Medicine and Radiology. Primary barriers were \"curriculum overcrowding\" (73%) and \"fragmented governance\" (68%). Notably, \"faculty shortage\" (64%) was cited more frequently than equipment limitations. Educator attitudes were universally positive; however, respondents from institutions without an established curriculum expressed a stronger need for standardized guidelines compared to those with active programs. Conclusions Undergraduate POCUS education in Northern Europe is expanding but remains limited by existing curricula and fragmented governance. Instructional capacity surpasses equipment availability as the main resource bottleneck. We suggest future efforts may benefit from a simplified European \"POCUS Core\" framework to steer early-stage implementation, alongside a strategic shift toward faculty development to ensure sustainable supervision.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18814"},"PeriodicalIF":3.6,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991691","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":"Virtual reality-based POCUS training improves short-term knowledge and learner experience in undergraduate medical students: An observational pre-post study.","authors":"Surentheran Surentheran, Eugene Wang, George Ming Da Yeo, Charlene Khoo, Zheng Ning Koh, Danella Foo, Ne Hooi Will Loh, Ashokka Balakrishnan, Gene Chan, Suresh Paranjothy","doi":"10.5826/tuj.2026.19177","DOIUrl":"https://doi.org/10.5826/tuj.2026.19177","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated short-term knowledge change and learner perceptions following a virtual reality (VR)-based point-of-care ultrasound (POCUS) training program for undergraduate medical students.</p><p><strong>Methods: </strong>A single-center observational pre-post educational evaluation was conducted within an undergraduate POCUS training course at the National University of Singapore. Students completed a self-directed online module followed by a VR simulation session covering cardiac, lung, and eFAST ultrasound. Knowledge was assessed using a 19-item multiple-choice questionnaire administered immediately before and after the VR session. Post-session survey responses assessed learner experience, usability, perceived learning benefit, and adverse effects.</p><p><strong>Results: </strong>Of 290 students who completed the pre-training assessment and participated in the VR session, 275 matched pre-post datasets were available for analysis. Mean MCQ score increased from 0.689 out of 1 (SD 0.162) before training to 0.809 out of 1 (SD 0.153) after training, corresponding to a mean paired improvement of 0.120, or approximately 2.3 additional correct answers out of 19 items (95% CI 0.104 to 0.135; p < 0.001; Cohen's dz = 0.93). Survey responses demonstrated favorable learner perceptions. Participants reporting adverse effects rated the session as less engaging than those without adverse effects.</p><p><strong>Conclusions: </strong>VR-based POCUS simulation, delivered within a blended learning pathway, was associated with improved immediate MCQ-assessed knowledge and favorable learner perceptions. Further studies should assess effectiveness by practical skills assessment and long-term knowledge retention.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"19177"},"PeriodicalIF":3.6,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866408","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":"The ultrasound gap in de-resuscitation trials: A systematic review of physiological assessment deficits.","authors":"Adrian Wong, Paulo Melo, Federico Stefanini, Kim Cheah, Eduardo Kattan, Mateusz Zawadka","doi":"10.5826/tuj.2026.18750","DOIUrl":"10.5826/tuj.2026.18750","url":null,"abstract":"<p><strong>Background: </strong>Fluid overload is associated with increased mortality in critically ill patients, yet de-resuscitation trials frequently report negative or inconclusive results. This systematic review examines the relationship between parameter objectivity, ultrasound utilization, and trial outcomes in de-resuscitation research.</p><p><strong>Methods: </strong>We conducted a comprehensive systematic review of randomized controlled trials investigating de-resuscitation interventions in critically ill adults. Risk of bias was evaluated using the Cochrane Risk of Bias 2 tool. Statistical analysis included comparison of ultrasound versus non-ultrasound studies and pooled outcome analysis.</p><p><strong>Results: </strong>13 studies were identified which randomised 2495 patients. Of the included studies, 4 (30.8%) performed some form of ultrasound assessment. However, only 1 study (7.7%) explicitly used ultrasound to guide de-resuscitation interventions. However, it did not achieve significant fluid separation between the control and interventional arm. No studies achieved positive hard clinical outcomes (mortality reduction or major morbidity reduction) from de-resuscitation interventions. However, several studies successfully achieved their stated primary endpoints: fluid balance separation was achieved in 7 of 13 studies (53.8%), feasibility objectives were met in 3 studies, and improvements in secondary endpoints including ventilator-free days and time to extubation were demonstrated in select studies. These findings suggest that achieving targeted fluid balance changes does not necessarily translate to improved clinical outcomes.</p><p><strong>Conclusions: </strong>Current research is characterized by a significant 'ultrasound gap,' where the theoretical benefits of POCUS are not yet integrated into interventional trials. Future research must bridge this gap using standardized, physiology-driven protocols.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18750"},"PeriodicalIF":3.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819794","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":"Seven Pillars for a Community-Led AI-POCUS Future - A WINFOCUS Manifesto.","authors":"Adrian Wong, Julina Noor, Francesco Corradi, Gabriele Via","doi":"10.5826/tuj.2026.18454","DOIUrl":"10.5826/tuj.2026.18454","url":null,"abstract":"<p><p>The rapid integration of Artificial Intelligence (AI) into Point-of-Care Ultrasound (POCUS) represents a transformative shift, offering the potential to democratize diagnostic expertise while simultaneously presenting significant risks regarding clinical validation, workforce preparedness, and health equity. Informed by a recent global survey indicating that while 81% of practitioners are optimistic about AI, major concerns remain regarding training and evidence gaps, the World Interactive Network Focused On Critical UltraSound (WINFOCUS) proposes a unified strategic framework. This manifesto outlines seven foundational pillars to guide the ethical and effective adoption of AI-augmented POCUS: (1) earning trust through rigorous, prospective evidence; (2) building an AI-literate workforce through evolved curricula; (3) championing global equity to prevent widening health disparities; (4) ensuring algorithmic transparency and accountability; (5) designing for seamless human-AI collaboration; (6) establishing a sustainable, privacy-centric data infrastructure; and (7) committing to continuous, patient-centered evaluation. We present this roadmap as a global call to action for clinicians, researchers, and industry partners to collectively shape a future where technology amplifies clinical wisdom and improves patient outcomes.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18454"},"PeriodicalIF":3.6,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702539","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":"Predicting preoperative lymph node metastasis of hilar cholangiocarcinoma based on deep learning radiomics.","authors":"Hui Shen, Jianming Shen, Lin Wang, Kehan Lin, Yi Zhang, Mingyue Xiao, Yang Tan, Tongyi Huang, Lili Wu, Xiaoyan Xie, Guangliang Huang, Baoxian Liu","doi":"10.5826/tuj.2026.18276","DOIUrl":"10.5826/tuj.2026.18276","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to evaluate whether deep learning radiomic (DLR) models utilizing B-mode ultrasound (BUS) and contrast-enhanced ultrasound (CEUS) could improve the preoperative prediction of lymph node metastasis (LNM) in patients with hilar cholangiocarcinoma (HCCA).</p><p><strong>Methods: </strong>The study included 110 HCCA patients from two clinical centers, divided into primary and external validation cohorts. Pathological verification of lymph node status was performed, and the ResNet101 architecture was used to extract deep learning features (DLFs) from BUS and CEUS images. The Genetic Programming-based Symbolic Regression (GPSR) algorithm was applied to integrate radiomic features (RadFs) and DLFs, generating deep learning radiomic features (DLRFs). DLR models were subsequently constructed using the eXtreme Gradient Boosting (XGBoost) algorithm.</p><p><strong>Results: </strong>Lymph node metastasis was identified in 48 out of 110 patients (43.64%). No significant differences in clinical characteristics were observed between LNM-positive and LNM-negative groups (P-values ranging from 0.14 to 0.98). A total of 837 RadFs and 4095 DLFs were initially extracted from each tumor region of interest (ROI). After feature selection, 10 RadFs (4 from BUS, 6 from CEUS) and 27 DLFs (5 from BUS, 22 from CEUS) were retained. Using the GPSR algorithm, 5 BUS-DLRFs, 10 CEUS-DLRFs, and 15 Combination-DLRFs were generated, leading to the development of three corresponding DLR models. In internal validation, the AUC values were 0.70 for the BUS-DLR model, 0.77 for the CEUS-DLR model, and 0.83 for the Combination-DLR model. In external validation, the AUC values were 0.66, 0.68, and 0.72, respectively. These results indicate that the integration of multiphasic CEUS and BUS data is essential for more comprehensively identifying LNM and achieving precise preoperative staging.</p><p><strong>Conclusions: </strong>The DLR models based on DLRFs demonstrated an enhanced ability to preoperatively predict LNM in HCCA patients, indicating that the integration of deep learning and RadFs from BUS and CEUS may offer improved predictive performance for LNM.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18276"},"PeriodicalIF":3.6,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449795","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":"Post-insertion outcomes of ultrasound-guided versus landmark peripheral intravenous catheters: a systematic review and meta-analysis.","authors":"Tai-An Lee, Yu-Ling Wang, Jen-Tao Lin, Po-Ming Chen, Chia-Ching Chen","doi":"10.5826/tuj.2026.19152","DOIUrl":"10.5826/tuj.2026.19152","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound-guided (USG) peripheral intravenous catheter (PIVC) insertion improves cannulation success, particularly in patients with difficult intravenous access. Whether USG also improves post-insertion outcomes, including catheter failure, dwell time, and complications, remains uncertain.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials and comparative cohort studies comparing USG with landmark-guided PIVC insertion and reporting at least one post-insertion outcome. PubMed, Embase, Cochrane CENTRAL, and CINAHL were searched from January 2000 to March 2026. Risk of bias was assessed using RoB 2 and the Newcastle-Ottawa Scale. Random-effects meta-analysis used the DerSimonian-Laird estimator; REML with Hartung-Knapp-Sidik-Jonkman adjustment was performed as a post-hoc sensitivity analysis because few studies contributed to pooled outcomes.</p><p><strong>Results: </strong>Fourteen studies (5 randomized trials, 9 cohort studies; 78,209 participants) were included. Catheter failure did not differ significantly between USG and landmark groups (k = 4; RR 1.23, 95% CI 0.99-1.51; p = 0.056), although the estimate was sensitive to model choice and exclusion of the largest study. Dwell time and extravasation were not pooled because of substantial heterogeneity (I² = 91.9% and 95.7%, respectively). Infiltration also showed no significant difference (k = 2; RR 0.68, 95% CI 0.12-3.83). Several studies reporting favorable USG outcomes were substantially confounded by systematic differences in catheter length or material between groups.</p><p><strong>Conclusions: </strong>Current evidence does not demonstrate a consistent post-insertion advantage of USG over landmark PIVC placement. Reported benefits in some studies may reflect catheter-specification differences rather than ultrasound guidance itself. Larger, well-controlled trials are needed.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"19152"},"PeriodicalIF":3.6,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449798","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":"A Guyton-based hypothesis for venous congestion.","authors":"Jon-Émile S Kenny, Per Werner Möller","doi":"10.5826/tuj.2026.19103","DOIUrl":"10.5826/tuj.2026.19103","url":null,"abstract":"<p><p>Despite much research and opinion, the underpinnings of venous congestion remain elusive. Many posit that elevated right atrial pressure (PRA) is the primum movens of venous congestion. However, a recent Geometrical model (GM) built from Guyton's framework advances that PRA is a dependent variable. The GM predicts that: 1.) venous Doppler patterns do not reflect volume state or responsiveness; 2.) venous congestion is not caused by PRA and, in fact, may occur with a low or normal PRA; and 3.) that venous Doppler patterns correspond to transmural rather than absolute PRA.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"19103"},"PeriodicalIF":3.6,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148398801","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":"Quantitative lung ultrasound spectroscopy: First comparison with gold standard computed tomography scan and standard lung ultrasound for diagnosis of pneumonia versus cardiogenic pulmonary edema.","authors":"Mattia Perpenti, Eleonora Balzani, Federico Mento, Claudia Marinaro, Giacomo Bellani, Tiziano Perrone, Libertario Demi","doi":"10.5826/tuj.2026.18605","DOIUrl":"10.5826/tuj.2026.18605","url":null,"abstract":"<p><strong>Background: </strong>Pneumonia (PNE) and cardiogenic pulmonary edema (CPE) are characterized by reduced air-spaces dimension and edema. Their distinction through gold standard computed tomography (CT) is challenging due to their pattern similarity. Lung Ultrasound (LUS) is a tool for monitoring the progression of lung pathologies. LUS is portable, real-time, and non-ionized; however, standard LUS (S-LUS) relies on the subjective visualization of imaging patterns, leading to poor reproducibility and lack of diagnostic specificity. To enhance LUS diagnostic utility, quantitative LUS (Q-LUS) was developed. Q-LUS quantifies imaging patterns and explores their correlation to different pathophysiological conditions. In literature, vertical artifacts (VA) quantification proved capable of differentiating PNE and CPE, however, this approach was never compared with gold standard.</p><p><strong>Methods: </strong>We statistically investigate and compare the clinical significance of CT, S-LUS, and Q-LUS, in differentiating PNE and CPE. From a cohort of 55 patients, CT, S-LUS, and Q-LUS data are acquired. CT and S-LUS data of each patient are evaluated to assign a semi-quantitative CT-score and S-LUS-score. Q-LUS radiofrequency data are acquired in multifrequency with convex (2, 3, and 4 MHz) and linear (3, 4, 5, and 6 MHz) probes. VA are manually segmented, quantified into three spectral quantities, and statistically analyzed to extract 15 features for each patient. The diagnostic significance of the scores is tested through Generalized Estimating Equation models.</p><p><strong>Results & conclusions: </strong>Results show areas under the curve of 74%, 72%, 65%, and 53% for Q-LUS linear, Q-LUS convex, CT-score, and S-LUS-score, respectively, highlighting Q-LUS as the most significant tool.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18605"},"PeriodicalIF":3.6,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220011","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":"Establishing reference values and evaluating diagnostic utility of scrotal ultrasound for azoospermia subtypes: A cross-sectional study in Guangdong, China.","authors":"Weibing Qin, Heran Cao, Zhixing Zhang, Hua Nie, Lu Han, Xiaohua Liu","doi":"10.5826/tuj.2026.18307","DOIUrl":"10.5826/tuj.2026.18307","url":null,"abstract":"<p><strong>Background: </strong>Male infertility is a significant health issue in East Asia, affecting over 12 million men, primarily due to non-obstructive and obstructive azoospermia. Although scrotal color Doppler ultrasonography is widely used to assess male reproductive health, existing diagnostic standards derived from European populations remain unvalidated for Chinese men. This study aimed to establish population-specific reference values and evaluate the diagnostic utility of ultrasonographic parameters in differentiating azoospermia subtypes.</p><p><strong>Methods: </strong>We enrolled 424 men aged 20-45 years, including 245 normozoospermic controls, 135 with non-obstructive azoospermia, and 44 with obstructive azoospermia from Guangdong Province, China. All participants underwent scrotal ultrasound following standardized protocols to measure testicular volume, epididymal dimensions, and hemodynamic parameters. Semen analysis and hormonal profiling were also performed.</p><p><strong>Results: </strong>Results showed that testicular volumes in fertile men from Guangdong Province, China were significantly smaller than European reference values. Testicular volume was inversely correlated with follicle-stimulating hormone and luteinizing hormone levels and positively correlated with sperm count and concentration, but not with motility or morphology. Men with non-obstructive azoospermia had significantly smaller testicular volumes, while those with obstructive azoospermia showed significant dilation of the epididymal caput.</p><p><strong>Conclusions: </strong>This study provides the first scrotal ultrasound reference standards for men from Guangdong Province, China and suggests that a two-parameter approach based on testicular volume and epididymal caput diameter may aid in non-invasive differentiation of azoospermia subtypes, potentially reducing the need for invasive biopsies.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18307"},"PeriodicalIF":3.6,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219976","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":"Impact of gaze deviation on the optic nerve sheath diameter metric: A prospective interventional study.","authors":"Giada Cucciolini, Gaia Mignani, Giulio Costanzo, Francesco De Masi, Francesco Forfori, Francesco Corradi","doi":"10.5826/tuj.2026.18767","DOIUrl":"10.5826/tuj.2026.18767","url":null,"abstract":"<p><strong>Background: </strong>Optic nerve sheath diameter (ONSD) is a widely used non-invasive surrogate marker of intracranial pressure. Current recommendations state that measurements should be obtained with a neutral gaze. However, the effect of gaze deviation on ONSD has never been investigated. We aimed to evaluate the reliability of ONSD in case of gaze deviation and quantify the associated measurement error. A secondary aim was to assess whether bed inclination has a significant effect on ONSD values.</p><p><strong>Methods: </strong>We conducted a prospective interventional study on 44 healthy volunteers during routine ocular ultrasound training. ONSD was measured bilaterally along the horizontal and vertical axes at 45° head-of-bed elevation in neutral and deviated gaze. After repositioning the bed to 0° and a 2-minute stabilization period, horizontal measurements were repeated. Measurements were performed according to current consensus recommendations and ALARA principles. Nonparametric analyses were used to analyse the results.</p><p><strong>Results: </strong>Gaze deviation significantly reduced ONSD values across all axes and both eyes, with a consistent median difference of 0.8-1.0 mm (all p < 0.001) and large effect sizes. In contrast, no significant differences were observed between measurements obtained at 45° and 0° (p > 0.5).</p><p><strong>Conclusions: </strong>Gaze deviation induces a predictable \"stretching\" effect on the optic nerve sheath, resulting in clinically relevant ONSD reduction. If confirmed in neurocritical populations, this systematic difference may allow estimation of neutral-gaze ONSD in non compliant patients and could form the basis for a dynamic test that estimates optic nerve sheath compliance.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18767"},"PeriodicalIF":3.6,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206489","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}