Ultrasound Journal最新文献

{"title":"Sonographic nystagmus: a case report of lateral semicircular canal benign paroxysmal positional vertigo.","authors":"Yuki Munekata, Chisato Matsumoto, Kento Sakoda, Yuki Takahashi","doi":"10.1186/s13089-025-00457-x","DOIUrl":"10.1186/s13089-025-00457-x","url":null,"abstract":"<p><strong>Background: </strong>Nystagmus, a critical diagnostic sign of vertigo and dizziness, reflects disturbances in the vestibular system. The accurate characterisation of nystagmus aids in distinguishing between peripheral and central causes, such as benign paroxysmal positional vertigo (BPPV) and stroke, respectively. Traditional methods for assessing nystagmus involve visual inspection or the use of Frenzel goggles. However, in cases where patients are unable to keep their eyes open owing to severe vertigo, such an evaluation becomes challenging. To date, sonographic imaging has not been used as a diagnostic method for nystagmus. We present a case in which ocular ultrasonography was used to assess nystagmus and aid in the diagnosis of BPPV.</p><p><strong>Case presentation: </strong>A 56-year-old woman presented with recurrent vertigo exacerbated by positional changes. Clinical examination revealed no spontaneous nystagmus or neurological deficits. Because the patient was unable to keep her eyes open during positional testing, ocular ultrasonography was performed using a 9-MHz linear transducer. Imaging revealed direction-changing horizontal nystagmus, consistent with the apogeotropic variant of lateral semicircular canal BPPV. The diagnosis was subsequently confirmed by an otolaryngologist using Frenzel goggles. The patient was conservatively managed.</p><p><strong>Conclusions: </strong>This is the first report on the use of ocular ultrasonography to assess nystagmus. Despite certain limitations, this technique may be a valuable supplementary tool, particularly in settings in which conventional examinations are hindered or unavailable. Ophthalmic sonography has the potential to enhance vestibular assessments in emergency and outpatient settings.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"17 1","pages":"51"},"PeriodicalIF":2.9,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287425","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":"Feasibility and clinical value of nurse-led point-of-care ultrasound screening for prethrombotic state in postoperative cardiac ICU patients: a cross-sectional study.","authors":"Jingjing Cheng, Lu Liu, Xuemei Tang, Chunlin Xiang, Yiwei Qin, Yi Zhang, Zhenjie Jiang, Xiaoting Zeng, Ying Wu, Xiaoyu Chen, Fengchun Liu, Xiaoxiao Wu, Yiping Wang","doi":"10.1186/s13089-025-00459-9","DOIUrl":"10.1186/s13089-025-00459-9","url":null,"abstract":"<p><strong>Background: </strong>Postoperative cardiac ICU patients are at increased risk of developing venous thromboembolism (VTE), yet early identification of prethrombotic state (PTS) remains challenging. Nurse-led point-of-care ultrasound (POCUS) offers a non-invasive, real-time tool for vascular screening that may enhance early risk stratification.</p><p><strong>Objectives: </strong>To determine the prevalence of PTS in postoperative cardiac ICU patients using a nurse-led POCUS protocol, identify associated clinical risk factors, and evaluate the feasibility and clinical value of integrating this screening model into routine nursing care within an interprofessional framework.</p><p><strong>Methods: </strong>This cross-sectional study included 123 adult patients following cardiac surgery. ICU nurses trained in POCUS independently performed bedside color Doppler scans to detect the \"blizzard\" sign in lower limb veins. Demographic, clinical, and laboratory data were collected. Multivariate logistic regression was used to identify independent predictors of PTS. The nurse-led POCUS protocol was implemented collaboratively with doctors, who provided image verification and clinical oversight as needed.</p><p><strong>Results: </strong>The \"blizzard\" sign was observed in 61.8% of patients, most commonly in the popliteal and posterior tibial veins. Nine patients developed deep vein thrombosis, all of whom had prior severe, diffuse-type \"blizzard\" signs. Independent predictors of PTS included prolonged bed rest (OR 1.016, P = 0.031), elevated peak platelet count (OR 1.007, P = 0.041), and increased postoperative C-reactive protein levels (OR 1.015, P < 0.001). The nurse-led POCUS protocol was implemented successfully with doctor oversight and demonstrated high feasibility and diagnostic yield.</p><p><strong>Conclusion: </strong>Nurse-led POCUS is a feasible, non-invasive approach for early identification of PTS in postoperative cardiac ICU patients. Embedding such screening protocols into nursing workflows may support timely thromboprophylaxis, expand nursing roles in advanced assessment, and enhance interprofessional ICU care delivery.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"17 1","pages":"52"},"PeriodicalIF":2.9,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287424","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-based assessment of spinal muscle thickness and elasticity in patients with idiopathic scoliosis.","authors":"Huangwei Lei, Lin Meng, Yifan Sun, Yanyun Gou","doi":"10.1186/s13089-025-00455-z","DOIUrl":"10.1186/s13089-025-00455-z","url":null,"abstract":"<p><strong>Purpose: </strong>Utilizing ultrasonic imaging technology, this study assessed and compared the thickness and elasticity features of the abdominal and spinal back muscles in patients with idiopathic scoliosis to those of healthy individuals. The objective was to elucidate the mechanical adaptations in spinal muscles among IS patients.</p><p><strong>Methods: </strong>This cross-sectional study included 38 patients diagnosed with idiopathic scoliosis and 33 healthy controls. Outcome measures comprised the Cobb angle, spinal curvature, muscle thickness, and muscle elasticity. Ultrasound elastography imaging was employed to assess the thickness and elasticity of the erector spinae, rectus abdominis, external oblique, and transverse abdominis muscles bilaterally at corresponding spinal levels. The objective was to document and compare the ultrasonic imaging characteristics of these muscles in individuals with idiopathic scoliosis and in the normal population.</p><p><strong>Results: </strong>The study findings indicated that idiopathic scoliosis patients had significantly lower body weight than the control group, with C7-CSVL notably greater in the idiopathic scoliosis group than in healthy individuals. Muscle thickness was substantially reduced on both the concave and convex sides at T6, T10, and L3 levels of the erector spinae, as well as in the rectus abdominis (RA) and transverse abdominis (TrA) muscles, relative to the normal cohort. Additionally, idiopathic scoliosis patients exhibited increased elasticity in the erector spinae muscle on the convex side at T6, while the elasticity of the erector spinae muscle on the concave side at L3 was significantly lower compared to healthy individuals.</p><p><strong>Conclusions: </strong>This study, utilizing ultrasound elastography imaging technology, unveiled distinct features in individuals with mild idiopathic scoliosis, including decreased muscle thickness in the erector spinae at T6, T10, and L3 levels, as well as heightened elasticity in the thoracic region and reduced elasticity in the lumbar region. The findings presented in this study provide insights for diagnostic strategies in individuals with early-stage scoliosis.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"17 1","pages":"50"},"PeriodicalIF":2.9,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287426","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":"Cerebrovascular reactivity metrics as predictors of cognitive performance in healthy ageing: insights from transcranial colour-coded ultrasound.","authors":"Joseph Amihere Ackah, Xiangyan Chen, Huixing Zeng, Jingxin Zhong, Jason Tsz Lok Chan, Michael Lung Cheung Lo, Jing Cai","doi":"10.1186/s13089-025-00445-1","DOIUrl":"10.1186/s13089-025-00445-1","url":null,"abstract":"<p><strong>Introduction: </strong>This study was designed to investigate the utility of cerebrovascular reactivity (CVR) metrics, derived from transcranial colour-coded Doppler ultrasound (TCCD). Three main CVR metrics were examined as potential markers for cerebrovascular risk associated with mild cognitive impairment (MCI), a stage between normal cognition and dementia.</p><p><strong>Methods: </strong>We investigated 122 eligible, stroke-free, healthy, community-based Chinese adults (mean age, 65.34 ± 6.86 years). Cognitive performance was assessed using the validated Hong Kong version of the Montreal Cognitive Assessment. On a scale of 0-30, participants with low scores < 26 (modelled according to level of education) were designated to have a mild neurocognitive disorder or MCI. Following the measurement of cerebrovascular conductance (CVC) derived from cerebral blood flow and mean arterial pressure, three physiologic CVR metrics were assessed. The CVR assessments were based on restricted 30 s breath-holding, 60 s hyperventilation, and an unrestricted breath-holding index (BHI), respectively quantified using transcranial colour-coded Doppler ultrasound. The predictabilities and associations between CVR metrics, haemodynamic parameters, and cognitive performance were statistically investigated.</p><p><strong>Results: </strong>Using TCCD, BHI emerged as the most accurate and robust metric of CVR for predicting mild cognitive disorders [AUC 0.827 (95% CI 0.725, 0.930)] and independently predicted overall cognitive performance, highlighting its clinical value for early identification of at-risk individuals. The three CVR metrics outperformed CVC in predicting mild cognitive impairment and were distinctively correlated. Although CVR measures by breath-holding and BHI were closely related (r = 0.704, 95% CI 0.598, 0.786, p < 0.001), Bland-Altman analysis revealed that they are not interchangeable, indicating the importance of metric selection for accurate cerebrovascular assessment.</p><p><strong>Conclusion: </strong>The BHI, derived from simple and clinically tolerable methods, demonstrates clear potential to enhance the prediction and early identification of vascular cognitive impairment in healthy adults. By leveraging insights from cerebral haemodynamics, TCCD-based cerebrovascular risk screening may enable more effective and targeted interventions, ultimately contributing to better long-term cognitive health outcomes.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"17 1","pages":"49"},"PeriodicalIF":2.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253139","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":"Intrarenal venous flow patterns and their association with successful fluid removal in critically ill patients: a prospective observational exploratory study.","authors":"Chailat Maluangnon, Apatsara Saokaew, Satit Rojwatcharapibarn, Ranistha Ratanarat","doi":"10.1186/s13089-025-00447-z","DOIUrl":"10.1186/s13089-025-00447-z","url":null,"abstract":"<p><strong>Background: </strong>Determining the optimal timing for fluid removal in critically ill patients remains a challenge. This study evaluated the utility of Doppler ultrasound, specifically intrarenal venous flow (IRVF) patterns and venous excess ultrasound (VExUS) scores, and their associations with fluid removal outcomes, hemodynamic parameters, and clinical endpoints.</p><p><strong>Methods: </strong>In this prospective observational exploratory study, 52 intensive care unit (ICU) patients who underwent fluid removal were enrolled. Baseline IRVF patterns and VExUS scores were assessed, with follow-up evaluations performed daily for three days. The primary outcome was to evaluate whether IRVF patterns were associated with successful fluid removal, defined as achieving a negative fluid balance for at least two consecutive days. Secondary outcomes included associations with central venous pressure (CVP), NT-proBNP, cumulative fluid balance, and clinical outcomes.</p><p><strong>Results: </strong>Thirty-one patients (59.6%) achieved successful fluid removal. A discontinuous baseline IRVF pattern was independently associated with successful fluid removal (adjusted odds ratio 4.31, 95% CI 1.02-18.18; P = 0.047). This pattern demonstrated high sensitivity of 87.1% (95% CI 70.2-96.4), moderate specificity of 42.9% (95% CI 21.8-66.0), and accuracy of 69.2% (95% CI 54.9-81.3). VExUS scores grades 2-3 demonstrated high specificity of 85.7% (95% CI 63.7-97.0) but low sensitivity of 29.0% (95% CI 14.2-48.0), with an accuracy of 51.9% (95% CI 37.6-66.0). An improvement in the IRVF pattern was significantly correlated with a reduction in NT-proBNP levels (P = 0.048). However, neither IRVF patterns nor VExUS scores improvements were associated with changes in fluid balance, CVP, or clinical outcomes such as 28-day mortality, ventilator-free days, or ICU length of stay.</p><p><strong>Conclusions: </strong>Discontinuous IRVF patterns at baseline were significantly associated with fluid removal success, representing a physiologically based marker for deresuscitation readiness. More large-scale studies are warranted to validate these findings and explore long-term implications. Trial registration ClinicalTrials.gov identifier NCT06216119. Registered 22 January 2024, https://clinicaltrials.gov/study/NCT06216119.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"17 1","pages":"44"},"PeriodicalIF":2.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233530","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 assessment of pulmonary effects of large patent ductus arteriosus in extremely preterm infants beyond the transitional period.","authors":"Thanaa Elhanafy, Nehad Nasef, Jenna Ibrahim, Rana Awadalla, Amish Jain, Adel Mohamed","doi":"10.1186/s13089-025-00450-4","DOIUrl":"10.1186/s13089-025-00450-4","url":null,"abstract":"<p><strong>Background: </strong>Several studies have suggested a positive association between elevated lung ultrasound scores (LUS) and large patent ductus arteriosus (L-PDA), although findings remain inconsistent. Lung ultrasound score, a semi-quantitative measure of pulmonary aeration loss, has been proposed as a surrogate marker of excessive lung fluid, which may reflect the hemodynamic burden of a significant PDA. The aim of this study was to assess the association between LUS and L-PDA in preterm neonates beyond the initial transitional period and examine its correlations with echocardiographic measures of ductal shunting. This is a cohort retrospective study that included preterm infants born at < 29 weeks' gestation who underwent LUS within 24 h of targeted neonatal echocardiography. Infants were categorized as having L-PDA (diameter ≥ 1.5 mm, left-to-right shunt) or no/small PDA (< 1.5 mm). Clinical characteristics, LUS, and echocardiographic parameters including PDA diameter, left atrial-to-aortic root (LA: Ao) ratio, and left ventricular output (LVO) were compared. Statistical analyses included univariate, multivariate, and correlation assessments.</p><p><strong>Results: </strong>Among 119 infants included in the analysis, 56 (47%) had L-PDA, and 63 (53%) had no or small PDA. Infants with L-PDA had significantly lower gestational age and higher rates of invasive ventilation.</p><p><strong>Lus, la: </strong>Ao ratio, and LVO were significantly elevated in the L-PDA group (all p < 0.001). LUS correlated with PDA diameter (r = 0.27, p = 0.003) and respiratory severity score (r = 0.49, p < 0.001). Furthermore, LUS was found to be independently predictive for L-PDA (adjusted OR 1.5; 95% CI: 1.1-1.9). Each 1-point increase in LUS was associated with a 0.14 mm increase in PDA diameter. Inter-rater reliability for LUS was strong (IRR = 0.86).</p><p><strong>Conclusion: </strong>Beyond the transitional period, LUS was significantly associated with PDA size and independently predicted L-PDA in extremely preterm infants.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"17 1","pages":"47"},"PeriodicalIF":2.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233538","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":"Contrast-enhanced ultrasound for fetal and placental assessment: evidence, safety, and a roadmap for clinical translation.","authors":"Alushika Jain, Rajasbhala P Dhande, Pratapsingh H Parihar, Shivali Kashikar, Nishant Raj, Amit Toshniwal","doi":"10.1186/s13089-025-00449-x","DOIUrl":"10.1186/s13089-025-00449-x","url":null,"abstract":"<p><strong>Background: </strong>Fetal growth restriction (FGR), preeclampsia, and other placental disorders are leading contributors to perinatal morbidity and mortality, primarily due to impaired uteroplacental perfusion. Existing imaging modalities, such as Doppler ultrasound and fetal MRI, provide indirect or limited functional insights into placental and fetal perfusion, constraining timely clinical intervention.</p><p><strong>Objective: </strong>To evaluate contrast-enhanced ultrasound (CEUS) as a promising, safe, and real-time tool for assessing placental perfusion and its potential application in maternal-fetal medicine through comprehensive analysis of methodological parameters, safety profiles, and emerging computational techniques.</p><p><strong>Methods: </strong>A comprehensive synthesis of preclinical and clinical studies was conducted, focusing on the safety, efficacy, and current use of CEUS in pregnancy. Key findings were drawn from animal models (rats, sheep, macaques) and human studies involving 256 pregnant individuals, with detailed analysis of imaging protocols, contrast agent characteristics, and quantification methods.</p><p><strong>Results: </strong>CEUS utilizes intravascular microbubble contrast agents (1-8 μm diameter) that do not cross the placental barrier, enabling safe maternal imaging. However, size distribution analysis reveals sub-micron populations (8-20% by number) requiring careful evaluation. Preclinical models confirm CEUS ability to detect placental perfusion Changes with 54% reduction in perfusion index following uterine artery ligation (p < 0.001). Human studies demonstrate zero clinically significant adverse events among 256 cases, though critical gaps exist including absent biomarker monitoring and long-term follow-up. Emerging AI-enhanced analysis achieves 73-86% diagnostic accuracy using ensemble deep learning architectures. Current limitations include significant protocol heterogeneity (MI 0.05-0.19, frequency 2-9 MHz) and absence of standardization.</p><p><strong>Conclusion: </strong>CEUS presents a compelling solution for perfusion imaging in pregnancy, offering functional, bedside imaging without fetal exposure to contrast agents. However, methodological limitations, knowledge gaps regarding long-term outcomes, and the distinction between conventional microbubbles and emerging nanobubble formulations demand systematic research investment. Clinical translation requires standardized protocols, comprehensive safety monitoring including biomarker assessment, ethical oversight, and long-term outcome studies to support integration into routine obstetric care.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"17 1","pages":"43"},"PeriodicalIF":2.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233591","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":"Evaluating deep learning approaches for AI-assisted lung ultrasound diagnosis: an international multi-center and multi-scanner study.","authors":"Mario Muñoz, Xi Han, Jorge Camacho, Tiziano Perrone, Andrea Smargiassi, Riccardo Inchingolo, Yale Tung-Chen, Libertario Demi","doi":"10.1186/s13089-025-00451-3","DOIUrl":"10.1186/s13089-025-00451-3","url":null,"abstract":"<p><p>Lung ultrasound (LUS) interpretation is often subjective and operator-dependent, motivating the development of automated, artificial intelligence (AI)-based methods. This international, multi-center study evaluated two distinct deep learning approaches for automated LUS severity scoring for pulmonary infections caused by COVID-19: a pre-trained classification model (CM) and a segmentation model based method (SM); assessing performance at video, exam, and prognostic levels. Two datasets were analyzed: one comprising data from multiple scanners and another using data from a single scanner. Results showed that the SM achieved prognostic-level agreement with expert clinicians comparable to that of the CM. Furthermore, at the exam level, over 84% of examinations were classified with acceptable error (≤ 10 score difference) across both models and datasets, reaching both methods an agreement higher than 95% on the dataset acquired by a single scanner. The obtained results demonstrate the potential of AI-assisted LUS for reliable prognostic assessment and highlight that image quality and acquisition technique are key factors in achieving consistent and generalizable model performance, as well as the potential for international clinical translations.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"17 1","pages":"45"},"PeriodicalIF":3.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233568","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":"Noninvasive assessment of hemodynamic profile and myocardial mechanics in pulsus alternans patients by multiple echocardiographic methods.","authors":"Rongrong Miao, Tingting Wu, Qilong Wu, Teng Ye, Hui Li, Shusheng Liao","doi":"10.1186/s13089-025-00448-y","DOIUrl":"10.1186/s13089-025-00448-y","url":null,"abstract":"<p><strong>Background: </strong>Pulsus alternans (PA) is an intriguing phenomenon and a clinically rare entity. Accurately assessing cardiac function in patients with PA remains challenging. This study aims to investigate the myocardial mechanical characteristics and non-invasive hemodynamic profiles of PA patients using multiple echocardiographic imaging modalities.</p><p><strong>Methods: </strong>Clinical and echocardiographic data were retrospectively analysed from 16 patients diagnosed with PA by echocardiography at our hospital between January 2021 and May 2025. In this study, the characteristics of PA were elaborated by multiple echocardiographic methods, and the non-invasive hemodynamic profile was determined by pulse-wave Doppler.</p><p><strong>Results: </strong>Sixteen patients were enrolled. Seven were classified as NYHA class III and six as class IV. Elevated levels of NT-proBNP and hs-cTNT were observed in most patients. Follow-up ranged from 1 to 44 months, and five patients experienced adverse outcomes, including heart transplantation, rehospitalisation, and death. Within this cohort, three patients exhibited biventricular PA, while 13 patients presented with left ventricular (LV) PA. Key hemodynamic parameters varied significantly: LVOT-VTI_{strong beat} ranged from 11.3 cm to 29.2 cm, LVOT-VTI_{weak beat} from 6.8 cm to 22.1 cm, and the variation rate between strong and weak beats (∆LVOT-VTI) ranged from 19 to 52%. Global longitudinal strain (GLS) was significantly reduced in 14 patients (range: - 1.2% to - 10.4%), while peak strain dispersion (PSD) increased (range: 47 ms to 117.5 ms). Two patients were excluded from strain analysis due to suboptimal imaging. Hemodynamic parameters (LVOT-VTI_{strong beat}, LVOT-VTI_{weak beat} and ∆LVOT-VTI) showed strong correlations with GLS in PA patients (r = 0.806, P = 0.001; r = 0.642, P = 0.018 and r = 0.611, P = 0.027, respectively). NT-proBNP was significantly positively related to adverse outcomes in PA patients (r = 0.669, P = 0.012).</p><p><strong>Conclusion: </strong>Echocardiography is essential for evaluating cardiac function in patients with PA. This study used multiple echocardiographic methods to delineate the characteristics of this intriguing clinical phenomenon. Non-invasive hemodynamic parameters are potentially important for prognosis assessment, and myocardial strain assessment provides valuable insights into myocardial mechanical features. A comprehensive analysis using multimodality imaging is crucial for accurately identifying this disease, potentially enhancing the understanding of the pathophysiological mechanism of PA.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"17 1","pages":"46"},"PeriodicalIF":2.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233613","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":"Pleura-ABCDE - a structured expert-based protocol for neonatal lung ultrasound documentation and interpretation.","authors":"Jan Sandig, Erik Küng, Lukas Aichhorn, Bernhard Schwaberger, Mathias Klemme, Natascha Wagner, Christoph Bührer, Fabian Sternal","doi":"10.1186/s13089-025-00442-4","DOIUrl":"10.1186/s13089-025-00442-4","url":null,"abstract":"<p><p>BACKGROUND: Neonatal lung ultrasound is a rapidly emerging imaging modality with increasing impact, but lacks standardized protocols and curricula, resulting in inconsistent dissemination and quality assurance. RESULTS: We present a structured protocol for documentation and interpretation of lung ultrasound. For each lung region, the acronym Pleura-ABCDE is used to analyze the pleura (sliding, morphology), A-Lines, B-Lines, Consolidation, Dynamics (lung point, double lung point) and Effusion. The structured documentation and interpretation could provide clues to differentiate respiratory diseases in newborns. CONCLUSION: The Pleura-ABCDE protocol provides structured documentation and interpretation support for lung ultrasound in neonates. In contrast to flowchart-based protocols, a pattern-based approach and link to clinical presentation allows an integrative perspective on the use of neonatal lung ultrasound. Therefore, with this expert-based proposal, we aim to improve documentation and thereby support diagnostic quality and reproducibility, as recommended by international ultrasound societies. </p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":"17 1","pages":"48"},"PeriodicalIF":3.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239940","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}