Journal of Medical Ultrasound最新文献

{"title":"Adhesions Detection and Staging Classification for Preoperative Assessment of Difficult Laparoscopic Cholecystectomies: A Prospective Case-Control Study.","authors":"Atul Kapoor,&nbsp;Bholla Singh Sidhu,&nbsp;Jasdeep Singh,&nbsp;Navjot Brar,&nbsp;Paramjit Singh,&nbsp;Aprajita Kapur","doi":"10.4103/jmu.jmu_36_22","DOIUrl":"https://doi.org/10.4103/jmu.jmu_36_22","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic cholecystectomy (LC) is the treatment of choice for cholelithiasis; however, there are procedural difficulties in determining preoperative detection of a difficult LC. The current methods using clinical and sonographic variables to identify difficult LCs have limitations to identify gallbladder adhesions which form the most common cause. We present a new method of evaluation using acoustic radiation force impulse (ARFI)-based virtual touch imaging (VTI) for the detection and classification of these patients.</p><p><strong>Methods: </strong>Fifty consecutive patients of cholelithiasis were evaluated preoperatively using conventional scoring system (CSS) and by new adhesion detection and staging (ADS) system, and patients were classified into three classes (I-III) with class I being easy, II and III being moderate-to-high difficulty LCs. Peroperative classification was done based on the difficulty level during surgery after visualization of gallbladder adhesions. The sensitivity, specificity, and area under the curves (AUCs) of both systems were compared.</p><p><strong>Results: </strong>Out of 50 patients, 72% and 54% of patients were in class I by CSS and ADS classification, while 28% and 46% were in class II and III, respectively, and were labeled as difficult LC cases; differences being two classifications were statistically significant (<i>P</i> = 0.02). Sensitivity, specificity, negative predictive value, and accuracy for ADS were 91%, 100%, 93.1%, and 96.0%, and for CSS, 60.9%, 100%, 75%, and 82% with AUCs of 1.0 and 0.63, respectively.</p><p><strong>Conclusion: </strong>ARFI-based VTI accurately detects gallbladder adhesions and can determine the difficult cases of LCs preoperatively using ADS classification and shows higher accuracy than CSS classification, which results in lower operative time and risk of complications.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"31 2","pages":"137-143"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/8f/JMU-31-137.PMC10413394.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9998736","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":"Focused Assessment with Sonography for Trauma (FAST).","authors":"Paulo Savoia,&nbsp;Shri Krishna Jayanthi,&nbsp;Maria Cristina Chammas","doi":"10.4103/jmu.jmu_12_23","DOIUrl":"https://doi.org/10.4103/jmu.jmu_12_23","url":null,"abstract":"<p><p>The main cause of death in traumas is hypovolemic shock. Physical examination is limited to detect hemopericardium, hemoperitoneum, and hemopneumothorax. Computed tomography (CT) is the gold standard for traumatic injury evaluation. However, CT is not always available, is more expensive, and there are transportation issues, especially in hemodynamically unstable patients. In this scenario, a rapid, reproducible, portable, and noninvasive method such as ultrasound emerged, directed for detecting hemopericardium, hemoperitoneum, and hemopneumothorax, in a \"point of care\" modality, known as the focused assessment with sonography for trauma (FAST) protocol. With decades of experience, spread worldwide, and recommended by the most prestigious trauma care guidelines, FAST is a bedside ultrasound to be performed when accessing circulation issues of trauma patients. It is indicated to hemodynamically unstable patients with blunt abdominal trauma, with penetrating trauma of the thoracoabdominal transition (where there is doubt of penetrating the abdominal cavity) and for any patient with the cause of the instability unknown. There are four regions to be examined in the traditional FAST protocol: pericardium (to detect cardiac tamponade), right upper abdominal quadrant, left upper abdominal quadrant, and pelvis (to detect hemoperitoneum). The called extended FAST (e-FAST) protocol also searches the pleural spaces for hemothorax and pneumothorax. It is important to know the false positives and false negatives of the protocol, as well as its limitations. FAST/e-FAST protocol is designed to provide a simple \"yes or no\" answer regarding the presence of bleeding. It is not intended to quantify the bleeding nor evaluate organ lesions due to its limited accuracy for these purposes. Moreover, the amount of bleeding and/or the identification of organ lesions will not change patient's management: Hemodynamically unstable patients with positive FAST must go to the operating room without delay. CT should be considered for hemodynamically stable patients.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"31 2","pages":"101-106"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/de/43/JMU-31-101.PMC10413405.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9998739","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":"Soft-Tissue Mass Lesion of the Foot - Synovial Sarcoma.","authors":"Reshma Varghese,&nbsp;Udit Chauhan,&nbsp;Pranoy Paul,&nbsp;Sonal Saran","doi":"10.4103/JMU.JMU_22_21","DOIUrl":"https://doi.org/10.4103/JMU.JMU_22_21","url":null,"abstract":"CAsE A 46-year-old male presented to the orthopedic outpatient clinic with a history of gradually progressive swelling and pain in the left foot for 2 years. The patient denied any history of trauma and any significant past medical or surgical history. On examination, the swelling was seen in the left foot involving the dorsal and medial aspect with tenderness on palpation. The overlying skin was stretched and showed hyperpigmentation with minimal scales and central depigmentation [Figure 1].","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"31 2","pages":"165-167"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7f/27/JMU-31-165.PMC10413395.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9989960","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":"Intestinal Ultrasound in Inflammatory Bowel Disease: A Novel and Increasingly Important Tool.","authors":"Wei-Chen Lin,&nbsp;Chen-Wang Chang,&nbsp;Ming-Jen Chen,&nbsp;Horng-Yuan Wang","doi":"10.4103/jmu.jmu_84_22","DOIUrl":"https://doi.org/10.4103/jmu.jmu_84_22","url":null,"abstract":"<p><p>New and efficacious medical therapies have become available that have greatly enhanced clinicians' ability to manage inflammatory bowel diseases (IBDs). IBD activity should be assessed regularly in scheduled examinations as the part of a treat-to-target strategy for IBD care. The gold-standard approach to investigating IBD is colonoscopy, but this is an invasive procedure. Intestinal ultrasound (IUS) has played a crucial role in recent years regarding the assessment of IBD activity because it is noninvasive, safe, reproducible, and inexpensive. IUS findings could inform changes in therapeutic interventions for IBDs; this would necessitate fewer endoscopies and enable faster decision-making processes. Furthermore, patients are accepting and tolerant of IUS examinations. This review outlines the current evidence and gives indication regarding the use of IUS in the management of IBDs.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"31 2","pages":"86-91"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a8/61/JMU-31-86.PMC10413392.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10371461","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":"Does the Presence of Extended Jugular Lymphatic Sacs Add More Risk to Nuchal Thickness for Genetic and Structural Abnormality?","authors":"Mehmet Obut,&nbsp;Arife Akay,&nbsp;Ibanoglu Can Müjde,&nbsp;Özge Yucel Çelik,&nbsp;Asya Kalayci Öncü,&nbsp;Zuat Acar,&nbsp;Erdal Seker,&nbsp;Erkan Saglam,&nbsp;Cantekin Iskender","doi":"10.4103/jmu.jmu_225_21","DOIUrl":"https://doi.org/10.4103/jmu.jmu_225_21","url":null,"abstract":"<p><strong>Background: </strong>The risks added by extended jugular lymphatic sacs (EJLS) to increased nuchal translucency (NT) including genetic and structural abnormalities and pregnancy outcomes have not been previously investigated, which this study aims to investigate.</p><p><strong>Methods: </strong>The data of 155 singleton pregnancies with increased fetal NT (≥95^th percentile) of these 20 with fetal EJLS were evaluated retrospectively. Patients were stratified according to NT thickness such that ≥95^th percentile - 3.5 mm, 3.6-4.4 mm, 4.5-5.4 mm, 5.5-6.4 mm, ≥6.5 mm, and grouped according to the presence of EJLS. Pregnancy outcomes, genetic and structural abnormalities were assessed by comparing EJLS with non-EJSL cases (n-EJLS).</p><p><strong>Results: </strong>Associated with NT, the incidence of the presence of EJLS increased with NT, from 4.5% at the ≥95^th percentile - 3.5 mm to 30.8% when NT ≥5.5 mm. In the n-EJLS group, the proportion of fetuses with structural and genetic abnormalities increased as the measurement of NT increased. This correlation was not observed in the EJLS group. Compared to n-EJLS, cases with EJLS had a higher rate of fetal structural (38.5% vs. 75%, <i>P</i> = 0.003) and genetic (18.5% vs. 45%, <i>P</i> = 0.005) anomalies and a lower term live birth rate (59.3% vs. 15%, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The increasing rate of EJLS was seen as NT increased. Compared to n-EJLS, the EJLS cases had a higher rate poor pregnancy outcomes and fetal genetic and structural abnormalities.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"31 2","pages":"119-126"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5a/a1/JMU-31-119.PMC10413408.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10371464","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 Placental Cyst Behind the Fetal Neck in the Mid-trimester Prenatal Sonography May Mimic a Fetal Cystic Hygroma.","authors":"Ching-Yu Chou,&nbsp;Li-Chan Lin","doi":"10.4103/jmu.jmu_123_22","DOIUrl":"https://doi.org/10.4103/jmu.jmu_123_22","url":null,"abstract":"Subchorionic placental cysts occur in up to 5% of pregnancies, and the etiology is still controversial. Small single subchorionic placental cysts are of no clinical importance and no obstetrical management should be altered. However, a placental cyst beside the fetal neck in the mid-trimester prenatal sonography may mimic a fetal cystic hygroma that was poor prognosis. We reported a case of a placental cyst behind the fetal neck posteriorly in the mid-trimester prenatal sonography. A cyst-like lesion measured about 42 mm behind the fetal neck was detected by ultrasonography [Figure 1a]. This placental cyst was mistaken as a fetal cystic hygroma at first. However, further well examination confirmed the diagnosis of a placental cyst. At 34 gestational weeks of prenatal examination, an ultrasound revealed normal fetal growth with an intact fetal neural tube, and an independent placenta cyst was detected by transabdominal ultrasonography examination. The cyst was approximately 75 mm × 65 mm in diameter, and the intracystic echolucent area had an echodensity equivalent to that of amniotic fluid [Figure 1b and c]. Blood flow was not detected in the cystic structure on color Doppler ultrasound, and the Doppler examination of the umbilical artery revealed normal velocity and pulsatility. At 38 weeks of gestation, the woman came to our delivery room due to the onset of labor, then, a live mature female baby was delivered through vertex position through the vagina, weighting 3180 gm, body length 47 cm, with Apgar score of 9 and 9 at 1 and 5 min, respectively. A placenta cyst measured about 5cm was noted and revealed as subchorionic cyst with extravillous trophoblast cells found within the lining of the inside of the cystic wall [Figure 1d]. There were few studies showed that cases with large placental cysts with complex patterns inside the cyst. There may be an intracystic hematoma or intracystic hemorrhage.[1,2] On the other hand, because of extensive use in prenatal sonography, many fetal neck masses were noted before delivery. Therefore, A Placental Cyst Behind the Fetal Neck in the Mid‐trimester Prenatal Sonography May Mimic a Fetal Cystic Hygroma","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"31 2","pages":"160-161"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/12/JMU-31-160.PMC10413397.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9989957","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":"Breast Pseudoaneurysm in a Woman after Core Biopsy: Intravascular Glue Embolization.","authors":"Jeong Ho Kim,&nbsp;Su Joa Ahn,&nbsp;Sang Yu Nam,&nbsp;Yunyeong Kim,&nbsp;Yong Soon Chun,&nbsp;Heung Kyu Park,&nbsp;Hye Young Choi","doi":"10.4103/jmu.jmu_168_21","DOIUrl":"https://doi.org/10.4103/jmu.jmu_168_21","url":null,"abstract":"<p><p>Core needle biopsy of breast masses is a common procedure for tissue diagnosis of breast lesions. The incidence of complications is low, with pseudoaneurysm (PA) after core biopsy has been described in the literature, and the subsequent need for surgical management. Ultrasonography is the most common modality used for not only diagnosis but also treatment of a PA. Color Doppler images show a heterogeneous echoic lesion with whirling flow inside of the lesion. We describe a patient whose breast PA that developed after core needle biopsy was successfully treated with sonographically-guided intravascular glue embolization.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"31 2","pages":"147-149"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/2e/JMU-31-147.PMC10413390.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9989959","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 34-Year-Old Female with Recurrent Abortions.","authors":"Shriya Goel,&nbsp;Sonal Saran","doi":"10.4103/jmu.jmu_101_21","DOIUrl":"https://doi.org/10.4103/jmu.jmu_101_21","url":null,"abstract":"","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"31 2","pages":"168"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ae/25/JMU-31-168.PMC10413407.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9993252","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 42-year-old Man with Posterior Thigh Pain.","authors":"Wei-Ting Wu,&nbsp;Ke-Vin Chang","doi":"10.4103/jmu.jmu_193_21","DOIUrl":"https://doi.org/10.4103/jmu.jmu_193_21","url":null,"abstract":"","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"31 2","pages":"169"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f4/7a/JMU-31-169.PMC10413396.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10044825","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":"CME Test.","authors":"","doi":"10.4103/0929-6441.378765","DOIUrl":"https://doi.org/10.4103/0929-6441.378765","url":null,"abstract":"","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"31 2","pages":"170"},"PeriodicalIF":1.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/21/7a/JMU-31-170.PMC10413401.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9993251","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}