Ultrasound Journal最新文献

{"title":"From concepts to evaluation: mapping approaches to POCUS training assessment in low- and middle-income countries - a systematic scoping review.","authors":"Friedrich Leopold Eppel, Friederike Hunstig, Benno Kreuels, Sabine Bélard","doi":"10.5826/tuj.2026.18295","DOIUrl":"10.5826/tuj.2026.18295","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care ultrasound (POCUS) training programs are increasingly implemented in low- and middle-income countries (LMICs) to strengthen diagnostic capacity. Qualitative and sustainable implementation of POCUS capacity requires evaluation of training concepts and programs. In this review we collate approaches of how POCUS training programs and trainee competencies are evaluated in LMICs.</p><p><strong>Methods: </strong>This review presents a secondary analysis of data from a previous systematic scoping review that included 53 original studies on POCUS training in LMICs, identified through July 2023. Reported evaluation methods for POCUS training were extracted and categorized according to the Donabedian (structure - process - outcome) and Miller/De Biasio (levels of competence) frameworks. Data synthesis focused on the type, timing, and scope of evaluation across structural, procedural, and outcome domains.</p><p><strong>Results: </strong>POCUS training evaluation approaches were highly heterogeneous, with most studies using multiple methods. Pre- and post-course assessments predominated, focusing mainly on knowledge and technical skills. Competence evaluations covered all levels of the Miller/De Biasio framework, though most targeted lower-order levels, while workplace-based assessments were infrequent. When mapped to Donabedian's model, outcome evaluations dominated, whereas structural and process assessments were inconsistently reported. Few studies demonstrated contextual adaptation, validity testing, or long-term evaluation of training outcomes.</p><p><strong>Conclusions: </strong>POCUS training evaluation in LMICs remains inconsistent and focuses primarily on short-term outcomes and basic competency levels. Applying Donabedian's and Miller/De Biasio's frameworks reveals critical evaluation deficiencies across system and learner dimensions and establishes a conceptional basis for more comprehensive and sustainable POCUS evaluation strategies.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18295"},"PeriodicalIF":3.6,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13335761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436417","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-guided lymph node biopsies: feasible and safe use of pathology services in a resource-limited, high TB/HIV prevalence setting.","authors":"Tapiwa Kumwenda, Veronica Phiri, Kelvin Rambik, Bianca Sossen, Tamiwe Tomoka, George Fedoriw, Mathews S Painschab, Ethel Rambiki, Claudia Wallrauch, Tom Heller","doi":"10.5826/tuj.2026.18321","DOIUrl":"10.5826/tuj.2026.18321","url":null,"abstract":"<p><strong>Background: </strong>Enlarged lymph nodes (LN) pose diagnostic challenges for people with HIV (PWH). While tuberculosis (TB) is a common cause in low-income settings, lymphomas and Kaposi's sarcoma must also be considered. Ultrasound and symptoms cannot distinguish between these conditions, and histology is often needed, but limited resources in low-income countries restrict sampling. To minimize the need for excisional biopsies, we introduced an algorithm for ultrasound-guided core-needle biopsies (CNB) after negative fine-needle aspiration (FNA) results by Xpert-Ultra (Cepheid, USA).</p><p><strong>Methods: </strong>At the Lighthouse clinic in Lilongwe, Malawi, patients with peripheral lymphadenopathy underwent an ultrasound-guided FNA. Negative Xpert-Ultra results prompted CNB using Tru-Cut needles, with samples sent for pathology. We retrospectively analyzed 12 months of cross-sectional data, including histology results and abdominal ultrasound findings.</p><p><strong>Results: </strong>In 2024, 53 CNBs were performed, 96%in PWH. No significant complications were observed. A conclusive diagnosis was reached in 77% of cases, with the most common diagnoses being hematological malignancies (54%), reactive LN (15%), Kaposi's sarcoma (12%) and metastatic carcinoma (10%). Infections, including granulomatous inflammation were found in 10% of cases. Hypoechoic spleen lesions were more frequent in patients with hematological diseases (p=0.03).</p><p><strong>Conclusion: </strong>Ultrasound-guided CNB of enlarged peripheral LN is a safe, effective addition to routine ART clinics. After negative Xpert-Ultra FNA, hematological malignancies were common. Abdominal ultrasound findings were frequently abnormal overall and hypoechoic spleen lesions were more common in patients with hematological abnormalities.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18321"},"PeriodicalIF":3.6,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13335721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355030","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":"On the interception of the optimal imaging plane for pleural line scanning with automatic robot assisted lung ultrasound: An experimental study.","authors":"Federico Mento, Libertario Demi","doi":"10.5826/tuj.2026.18302","DOIUrl":"10.5826/tuj.2026.18302","url":null,"abstract":"<p><strong>Background: </strong>Lung ultrasound (LUS) is nowadays an important tool to evaluate the state of lung surface. However, it is strongly operator-dependent, leading to reduced reproducibility of LUS analysis. Even though LUS acquisition protocols can improve LUS reproducibility and help standardizing LUS exams, human operators can guarantee only a limited precision in intercepting the optimal imaging plane. Hence, in this study, we assess the possibility to automatically intercept the optimal imaging plane in LUS examinations, i.e., the imaging plane perpendicular to the pleural plane (PP), by extracting three features, then utilized to guide a UR5e robotic arm handling an ultrasound probe.</p><p><strong>Methods: </strong>The main focus of this study consists on evaluating the potential of these three features in estimating the PP position with respect to the probe. To do so, we designed a simplified but highly controllable environment, where PP was mimicked with a steel plate (to simulate a highly reflective acoustic interface), while intercostal tissues were mimicked with a 2-cm-thick beef meat. The environment was imaged with a linear probe connected to an ULA-OP platform, which was held by an UR5e, programmed to explore 8 different paths of acquisitions with a rotational angle (RA) ranging from -20º to 20º (1º step size). This resulted in 328 positions that could be explored; each position with RA=0º corresponds to the optimal imaging plane. Radiofrequency data were acquired and post-processed to form normalized log-scale B-Mode images. A rectangular region of interest, defined to include PP, was considered to compute mean intensity at each depth of the region of interest, along lateral dimension. Mean intensity as a function of depth was then utilized to extract three different features, then fed to genetic algorithms to solve optimization problems to guide UR5e towards the optimal imaging plane.</p><p><strong>Results and conclusions: </strong>Genetic algorithms converged towards an average error < 1º after exploring only 18 positions, showing strong potential in automatic probe placement for LUS.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 S1","pages":"18302"},"PeriodicalIF":3.6,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445434","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":"Prenatal 2D/3D Ultrasound in Fetal Dural Sinus Malformations: Case Series and Prognostic Insights.","authors":"Ke-Xiong Niu, Jing-Jing Ye, Bin Ma, Zhi-Cheng Yue, Tian-Gang Li","doi":"10.5826/tuj.2026.18126","DOIUrl":"10.5826/tuj.2026.18126","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the benefit of three-dimensional (3D) ultrasound over two-dimensional (2D) imaging in diagnosing fetal dural sinus malformations (DSM) and to explore the correlation between sonographic features, such as thrombosis and sinus involvement, with perinatal and postnatal outcomes.</p><p><strong>Methods: </strong>This retrospective case series included 8 fetuses diagnosed with DSM at our center from 2020 to 2025. All cases underwent 2D and 3D ultrasound, with findings correlated to perinatal and postnatal outcomes. A literature review was conducted using PubMed, Embase, and Web of Science, with keywords: \"fetal dural sinus malformation,\" \"prenatal ultrasound,\" and \"3D ultrasound.\"</p><p><strong>Results: </strong>The median gestational age at diagnosis was 27 weeks (range 20-35). Lesions involved the torcular Herophili (4/8), torcular and superior sagittal sinus (2/8), superior sagittal sinus (1/8), and posterior fossa venous region (1/8). Associated anomalies included hydrocephalus, mild ventriculomegaly, fetal growth restriction (FGR), and pleural and peritoneal effusions. 2D ultrasound identified cystic or anechoic lesions (18 × 19 mm to 90 × 110 mm), with 62.5% showing thrombosis. 3D ultrasound enhanced lesion delineation, venous continuity, thrombus morphology, and confirmed the absence of arterialization. Genetic testing (cfDNA and/or CMA) was normal in all cases. Among the 8 pregnancies, two were terminated, one resulted in fetal demise, and five were liveborn. Four (50%) had favorable neurodevelopmental outcomes at 29-60 months.</p><p><strong>Conclusions: </strong>Combined 2D/3D ultrasound improves prenatal DSM assessment, with key features, particularly thrombosis, correlating with adverse outcomes. 3D ultrasound should be integrated into routine diagnostic protocols.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18126"},"PeriodicalIF":3.6,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285586","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":"Prediction of in-vitro fertilization outcome by ultrasound strain analysis and machine learning: A multi-center study.","authors":"Anyi Cheng, Yizhou Huang, Connie Rees, Celine Blank, Nikos Christoforidis, Dick Schoot, Lin Xu, Massimo Mischi","doi":"10.5826/tuj.2026.18257","DOIUrl":"10.5826/tuj.2026.18257","url":null,"abstract":"<p><strong>Background: </strong>In-vitro-fertilization (IVF) failure rates remain above 65% with unknown causes. Uterine receptivity, largely determined by uterine peristalsis, is believed to play a key role in the IVF success. Accurate assessment of uterine peristalsis holds the potential for improving the success rate of embryo implantation.</p><p><strong>Methods: </strong>This prospective study includes 62 IVF patients from multiple fertility centers under three different clinical settings. Four-minute B-mode transvaginal ultrasound (TVUS) scans were performed one hour before embryo transfer (ET). 25 features related to frequency, amplitude, power, velocity, and coordination were extracted using strain analysis from TVUS speckle tracking results. Three probabilistic classifiers, i.e., support vector machine (SVM), K-nearest neighbors (KNN), and adaptive boosting (AdaBoost), were employed to discriminate uterine activity as either favorable or adverse to clinical pregnancy rate. Prior to machine learning, feature selection was performed by categorized feature ranking and sequential forward selection. The proposed method was evaluated by a nested 8-fold cross validation.  Results: Our results suggest that features related to coordination and frequency of the uterine peristalsis are strongly associated with clinical pregnancy. SVM demonstrates the best classification performance between successful and unsuccessful pregnancies, with an average area under the ROC curve of 0.81.</p><p><strong>Conclusions: </strong>We developed a machine learning framework to improve the prediction of IVF outcome based on multi-center TVUS recordings. Our SVM model identified significant uterine motion features and demonstrated reliable and generalizable classification performance. This work can provide useful means to support clinicians for clinical decision-making prior to ET and possibly enhance IVF success rates.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"18 1","pages":"18257"},"PeriodicalIF":3.6,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285554","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":"Effectiveness of obstetric point-of-care ultrasound (POCUS) training: a systematic review and meta-analysis based on the ADDIE training model.","authors":"Yuxuan Li, Hao Wang, Kang Yuan, Xiaoding Zhou, Mengting Wang, Yiyang Huang, Xinyi Yu, Kun Tang","doi":"10.1186/s13089-025-00471-z","DOIUrl":"10.1186/s13089-025-00471-z","url":null,"abstract":"<p><strong>Aim: </strong>To identify the core components of obstetric point-of-care ultrasound (POCUS) training programs while simultaneously evaluating the effectiveness of these programs using the Analyze, Design, Develop, Implement, and Evaluate (ADDIE) model.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed a PROSPERO-registered protocol (CRD42024566260) and adhered to PRISMA2020, Cochrane Handbook, and JBI Manual guidelines. Comprehensive searches from database inception to September 22, 2024, covered international and Chinese databases to identify studies evaluating obstetric POCUS training. Two independent reviewers screened studies, assessed methodological quality with JBI tools, and extracted data on study, participant, intervention, and outcome characteristics. Training content was mapped to the ADDIE instructional design model via thematic and framework analyses. Meta-analyses of comparable quantitative outcomes used random-effects models. Integrating quantitative and qualitative findings, this review systematically evaluated the effectiveness and implementation of obstetric POCUS training programs.</p><p><strong>Results: </strong>Systematic synthesis showed that obstetric POCUS training significantly improved healthcare providers' competencies, including knowledge, skills, sustained use, and clinical decision-making. Training also increased antenatal care attendance and identification of high-risk pregnancies, while reducing referrals and optimizing resource use. However, limitations were noted in needs assessment, implementation flexibility, and outcome evaluation. Using thematic and framework analyses combined with the ADDIE model, we systematically organized training phases and key components to provide a scientific basis for program improvement and optimization.</p><p><strong>Conclusions: </strong>Obstetric POCUS training effectively enhances clinical competencies and improves maternal and neonatal health outcomes. Applying the ADDIE model offers a replicable, practical, and sustainable approach for developing standardized training programs. Future obstetric POCUS training should leverage the ADDIE model and adapt to local contexts to improve maternal and neonatal health globally.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"17 1","pages":"67"},"PeriodicalIF":2.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12756214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879066","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":"Estimate the severity of acute ischemic stroke by optic nerve sheath ultrasound.","authors":"Sara Esmaeili, Farzan Vahedifard, Fatemeh Ebrahimi, Hossein Nazarian, Arian Shahidi, Zahra Mirzaasgari, Mohammadreza Maghsoudi","doi":"10.1186/s13089-025-00465-x","DOIUrl":"10.1186/s13089-025-00465-x","url":null,"abstract":"<p><strong>Background: </strong>Timely diagnosis of acute ischemic stroke can aid optimal treatment. Optic nerve sheath diameter (ONSD) can determine increased intracranial pressure (ICP) in such cases. The purpose of this study is to determine the value of ONSD in estimating the severity of acute ischemic stroke.</p><p><strong>Methods: </strong>Patients with acute ischemic stroke who were referred to a stroke center were studied. The ONSD of both the right and left sides was measured by ultrasound on the day of admission. Ischemic stroke severity was determined based on the NIHSS.</p><p><strong>Results: </strong>A strong correlation was found between increased right and left ONSDs and severity of ischemic stroke determined by the initial NIHSS score. Based on ROC curve (receiver operating characteristic curve) analysis, both cut points of 5.65 mm for right ONSD (with 100% sensitivity of and 86% specificity) and 5.75 mm for left ONSD (with a 100% Sensitivity and 88% specificity) were able to predict severe stroke. The value of the right ONSD (Area Under the Curve = 0.959) and the left ONSD (Area Under the Curve = 0.942) indicated a strong predictive value.</p><p><strong>Conclusions: </strong>Ultrasound as a feasible and non-invasive modality might play a role in determining the severity of an acute ischemic stroke, and could be considered a promising first-line decision making tool.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"17 1","pages":"66"},"PeriodicalIF":2.9,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12686221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702272","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":"Optimizing IABP-patient interaction in VA-ECMO via transcranial doppler.","authors":"Andres Felipe Yepes-Velasco, Jeimy Lorena Moreno-Araque, Natalia Garzon-Posada","doi":"10.1186/s13089-025-00460-2","DOIUrl":"10.1186/s13089-025-00460-2","url":null,"abstract":"<p><strong>Background: </strong>Patients supported with veno-arterial extracorporeal membrane oxygenation may receive an intra-aortic balloon pump to reduce left ventricular afterload and improve aortic diastolic pressure. However, the effect of this combined mechanical support on cerebral hemodynamics is not uniform and can be influenced by intra-aortic balloon pump timing. Bedside transcranial Doppler offers a rapid, noninvasive way to detect maladaptive cerebral flow patterns and to guide patient-device interaction in real time.</p><p><strong>Case presentation: </strong>We describe a postcardiotomy adult patient on peripheral veno-arterial extracorporeal membrane oxygenation with concomitant intra-aortic balloon pump assistance (1:1) who developed a reduction in cerebral oximetry. Transcranial Doppler of the middle cerebral artery showed increased pulsatility and reduced diastolic velocity, findings consistent with a transient decrease in cerebral perfusion pressure and compatible with balloon deflation asynchrony. Temporary suspension of balloon assistance improved the waveform. Deflation was then synchronized with the electrocardiogram so that it was completed at the onset of systole. Repeat transcranial Doppler performed minutes later showed restoration of diastolic flow and a lower pulsatility index, while extracorporeal support was maintained unchanged and the patient remained hemodynamically stable.</p><p><strong>Conclusions: </strong>In patients receiving veno-arterial extracorporeal membrane oxygenation and intra-aortic balloon pump support, cerebral blood flow may deteriorate if balloon timing is not aligned with the native cardiac cycle. Transcranial Doppler can detect these timing-related neurohemodynamic alterations at the bedside and can confirm their reversibility after simple, ECG-guided optimization of deflation. Integrating transcranial Doppler into multiparametric monitoring may help personalize mechanical circulatory support and protect cerebral perfusion in this high-risk population.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"17 1","pages":"65"},"PeriodicalIF":2.9,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12680806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678949","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":"Application of three-dimensional Superb micro-vascular imaging (3D-SMI) combined with quantitative blood flow analysis in the noninvasive diagnosis of renal tumors.","authors":"Yiran Mao, Chunyang Yu, Tianqi Wang, Fangxuan Li, Wenjing Hou, Xi Wei, Jie Mu","doi":"10.1186/s13089-025-00464-y","DOIUrl":"10.1186/s13089-025-00464-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the diagnostic value of three-dimensional superb micro-vascular imaging (3D-SMI) combined with quantitative analysis of Area and VI in differentiating benign and malignant renal tumors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 256 renal lesions from 254 patients who underwent gray-scale ultrasound (Gray US), two-dimensional superb micro-vascular imaging (2D-SMI), and 3D-SMI examinations at Tianjin Medical University Cancer Institute and Hospital between January 2022 and June 2024 were retrospectively analyzed. The imaging features on Gray US, 2D-SMI and 3D-SMI were recorded. Based on 3D-SMI, Vascular Architecture were classified into five types: Type I (avascular), Type II (spotty flow), Type III (sparse flow), Type IV (encircling), and Type V (rich flow). The plane with the most abundant blood flow was selected, and the Area and VI were calculated using Image Pro Plus (IPP) software. Histopathology from surgery or biopsy served as the reference standard. The differences in Vascular Architecture, Area, and VI between benign and malignant renal tumors were compared, and their diagnostic performance was evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 256 lesions, 70 were benign and 186 were malignant. The interobserver agreement for Vascular Architecture classification was good (Kappa = 0.803), and the consistency for Area and VI was high (ICC = 0.835 and 0.864, respectively). Benign tumors Vascular Architecture were mainly type II or III, with mean Area and VI values of 945.87 ± 568.26 (range: 68-3125) and 5.93 ± 4.95 (range: 0.23-24.73), respectively. Malignant tumors were predominantly type IV or V, with mean Area and VI values of 3694.53 ± 2612.38 (range: 93-9965) and 18.21 ± 10.83 (range: 0.69-48.13), respectively. Significant differences were observed in Vascular Architecture, Area, and VI between benign and malignant lesions (all P &lt; 0.001). The area under the ROC curve (AUC) values for 3D-SMI Vascular Architecture, Area, VI, 2D-SMI, and Gray US were 0.813, 0.807, 0.859, 0.750, and 0.718, respectively. VI demonstrated the highest diagnostic performance, with a cutoff value of 8.19 (sensitivity: 82.26%; specificity: 85.51%). Among benign subtypes, there were no significant differences in Vascular Architecture or Area (P &gt; 0.05), while the VI of oncocytoma was significantly higher than epithelioid angiomyolipoma (EMAL), metanephric adenomas (MA), and angiomyolipoma (AML)(P &lt; 0.01). Among malignant subtypes, clear cell renal cell carcinoma (ccRCC) showed distinct Vascular Architecture compared with papillary renal cell carcinoma(pRCC), chromophobe renal cell carcinoma(chRCC), and Xp11.2 translocation/TFE3 fusion-associated renal cell carcinoma(tRCC) (P &lt; 0.01). The Area and VI of ccRCC were significantly higher than those of pRCC and chRCC (P &lt; 0.05), but not significantly different from tRCC (P &gt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;3D-SMI provides three-dimensional visualization of Vas","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"17 1","pages":"64"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12669463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649624","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":"Lung ultrasound for etiological diagnosis of pneumonia in the emergency department: correlation with bronchoalveolar lavage results.","authors":"Lorenzo Pelagatti, Iacopo Vannini, Francesca Mangani, Gian Maria Rossolini, Giovanni Volpicelli, Simone Vanni, Peiman Nazerian","doi":"10.1186/s13089-025-00470-0","DOIUrl":"https://doi.org/10.1186/s13089-025-00470-0","url":null,"abstract":"<p><strong>Background: </strong>Pneumonia is the leading cause of death from infectious diseases worldwide. Lung ultrasound (LUS) is highly accurate for chest infections diagnosis, yet its correlation with causative pathogens remains unclear. Respiratory cultures, combined with molecular techniques represent the gold standard, achieving etiological diagnosis in 90-95% of cases. We compared LUS findings with bronchoalveolar lavage (BAL) sample analyses; to our knowledge, no prior studies have investigated this in the emergency department (ED).</p><p><strong>Materials and methods: </strong>Bronchoalveolar lavage (BAL)-LUS is a prospective observational non-profit study conducted in the ED, aiming to assess whether there is a correlation between the LUS sonographic appearance, assessed blindly across 12 lung fields, and the etiopathogenetic agent of pneumonia (bacterial and viral) detected with molecular syndromic panels (MSPs) and respiratory cultures obtained with BAL.</p><p><strong>Results: </strong>64 patients were enrolled (mean age 73.3 ± 14.6) with 11 diagnosed as viral pneumonia and 53 as bacterial pneumonia. Bacterial pneumonias were more commonly associated with consolidation (2.9 ± 2.2 vs. 1.5 ± 0.9, p < 0.01) and a higher incidence of pleural effusion (0.9 ± 1.3 vs. 0.3 ± 0.6, p < 0.01). Viral pneumonias were more often associated with interstitial syndrome (4.9 ± 3.3 vs. 0.5 ± 1.3, p < 0.01) and small subpleural consolidations (0.9 ± 1.8 vs. 0.2 ± 0.6, p = 0.01). The mean LUS score was significantly higher in bacterial than in viral pneumonia with a AUC of 0.81 (95% CI 0.68-0.93).</p><p><strong>Conclusions: </strong>Viral pneumonia is usually associated with interstitial syndrome and small subpleural consolidations; on the other hand, bacterial pneumonia is usually associated with consolidation, and pleural effusion.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"17 1","pages":"63"},"PeriodicalIF":2.9,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12660545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640773","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}