Journal of Medical Ultrasound最新文献

{"title":"Ultrasound Color Pattern of Colonic Hamartomatous Polyps.","authors":"Chih-Hsuan Chen,&nbsp;Yang-Yuan Chen,&nbsp;Hsu-Heng Yen","doi":"10.4103/jmu.jmu_161_21","DOIUrl":"https://doi.org/10.4103/jmu.jmu_161_21","url":null,"abstract":"<p><p>Colonic hamartomatous polyps are clinically benign tumors. Colonic hamartomas are polypoid lesions that are rare in adults and most commonly encountered in infants and children. We report an unusual case of giant colonic hamartomatous polyps that were found incidentally during a medical workup for acute lower gastrointestinal bleeding in a 26-year-old woman. We present the color Doppler ultrasound, computed tomography scan, and endoscopic pattern of colonic hamartomatous polyps.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":null,"pages":null},"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/63/66/JMU-31-144.PMC10413393.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10352044","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":"Adenomatoid Tumor of Epididymis Associated with Tubular Ectasia of Rete Testis: Sonographic Evaluation.","authors":"Suresh Vasant Phatak,&nbsp;Megha Manoj,&nbsp;Pratik Jayprakash Bhansali,&nbsp;Prasanthi Ghanta","doi":"10.4103/jmu.jmu_10_22","DOIUrl":"https://doi.org/10.4103/jmu.jmu_10_22","url":null,"abstract":"<p><p>Paratesticular tumors are a relatively rare group of mesenchymal tumors, accounting for 7%-10% of all intrascrotal tumors. Adenomatoid tumor of the epididymis is the most common epididymal tumor. It is difficult to distinguish intra- versus paratesticular tumors and to know the nature of the lesion (benign versus malignant) on clinical examination since they may have similar presentation; therefore, ultrasound examination of these lesions is required to demonstrate its extratesticular location and also to suggest its benign nature. Elastography can further help in characterizing the lesion by evaluating the stiffness of the tumor. Here, we present a case of adenomatoid tumor of the left epididymis with tubular ectasia of the rete testis.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":null,"pages":null},"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/a8/JMU-31-157.PMC10413400.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10371462","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":"Incorporating Multiorgan Point-of-care Ultrasound into Obstetric Emergency Treatment Protocols.","authors":"Po-Jen Cheng,&nbsp;Nin-Chieh Hsu","doi":"10.4103/jmu.jmu_35_23","DOIUrl":"https://doi.org/10.4103/jmu.jmu_35_23","url":null,"abstract":"introduCtion Medical history records and physical examinations involving the inspection, palpation, percussion, and auscultation of different organs play an essential role in the decision-making process for disease diagnosis, management, and intervention in clinical medicine. However, advances in biomedicine and mechanical technology have led to an increasing number of traditional clinical examination methods being replaced. For example, medical ultrasound is being increasingly applied in various medical specialties. Bedside point-of-care ultrasonography (POCUS) performed by a clinician is often used to answer focused clinical questions instantly and to support decision-making in patient management.[1] In emergency and critical care medical settings, POCUS applied for patient examination primarily includes cardiac, lung, and abdominal ultrasounds used for the clinical assessment of specific symptoms or signs such as hypotension, shock, dyspnea, or chest pain.[2] Numerous structured protocols incorporating multiorgan POCUS (MOPOCUS) have also been proposed to guide assessment processes. In obstetrics and gynecology, a high-risk pregnancy can quickly develop into an obstetric emergency requiring urgent intensive care. However, although medical ultrasound is extensively applied in clinical obstetrics for maternal–fetal health care, POCUS protocols established in this field are generally limited to only the imaging of the fetus and pelvic organs. The incorporation of maternal POCUS into critical obstetric settings has the potential for preventing cardiovascular-associated maternal mortality.[3] This thus indicates that maternal POCUS should be incorporated into baseline obstetric ultrasound to ensure the more efficient diagnosis, treatment, and evaluation of obstetric emergencies; doing so can ensure that high-risk pregnant women obtain the same standard of care as their nonpregnant critical counterparts. Accordingly, the objective of this article is to present an avant-garde perspective on the incorporation of MOPOCUS into structured routine care protocols for the management of major obstetric emergencies, including postpartum hemorrhage (PPH), preeclampsia, and maternal sepsis; this can help clinicians and researchers more clearly understand the applicability of MOPOCUS in the clinical decision-making process for the management of obstetric emergencies.","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":null,"pages":null},"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/1e/f6/JMU-31-83.PMC10413410.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9989958","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":"Update of Contrast-enhanced Ultrasound in Musculoskeletal Medicine: Clinical Perspectives - A Review.","authors":"Shao-Yu Chen,&nbsp;Yao-Wei Wang,&nbsp;Wen-Shiang Chen,&nbsp;Ming-Yen Hsiao","doi":"10.4103/jmu.jmu_94_22","DOIUrl":"https://doi.org/10.4103/jmu.jmu_94_22","url":null,"abstract":"<p><p>Contrast-enhanced ultrasound (CEUS) uses an intravascular contrast agent to enhance blood flow signals and assess microcirculation in different parts of the human body. Over the past decade, CEUS has become more widely applied in musculoskeletal (MSK) medicine, and the current review aims to systematically summarize current research on the application of CEUS in the MSK field, focusing on 67 articles published between January 2001 and June 2021 in online databases including PubMed, Scopus, and Embase. CEUS has been widely used for the clinical assessment of muscle microcirculation, tendinopathy, fracture nonunions, sports-related injuries, arthritis, peripheral nerves, and tumors, and can serve as an objective and quantitative evaluation tool for prognosis and outcome prediction. Optimal CEUS parameters and diagnostic cut off values for each disease category remain to be confirmed.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":null,"pages":null},"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/3a/fb/JMU-31-92.PMC10413398.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10371465","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":"In Utero Treatment of Obstructive Ureterocele.","authors":"Mariana Solinho,&nbsp;Susana Saraiva,&nbsp;Cátia Lourenço,&nbsp;Conceição Brito","doi":"10.4103/jmu.jmu_8_22","DOIUrl":"https://doi.org/10.4103/jmu.jmu_8_22","url":null,"abstract":"<p><p>Lower urinary tract obstruction consists of a heterogeneous group of conditions in which the normal urethral egress of urine from the fetal bladder is impaired. The most frequent diagnoses are posterior urethral valves, urethral atresia, and less common obstructive ureterocele. We report a case of a fetus with prenatal diagnosis of obstructive ureterocele who presented progressive bilateral hydronephrosis. A fetal cystoscopy with laser ablation was performed.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":null,"pages":null},"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/13/21/JMU-31-154.PMC10413404.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10371466","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":"Humeral Length versus Femur Length for Estimating Fetal Age in the Third Trimester Using Ultrasound among Saudi Fetuses.","authors":"Mahasin G Hassan","doi":"10.4103/jmu.jmu_26_22","DOIUrl":"https://doi.org/10.4103/jmu.jmu_26_22","url":null,"abstract":"<p><strong>Background: </strong>Ethnicity can influence organ measurements, so each ethnicity should provide normal references. The study was conducted to measure the normal ranges of humeral and femoral diaphysis lengths, to compare them during the third trimester of pregnancy in the Saudi population, and to identify their role in estimating fetal age.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among 60 normal singleton pregnant females in the third trimester. The fetal humeral length (HL) and femur length (FL) were taken during ultrasound scanning for follow-up. The IBM Statistical Package for the Social Sciences Version 23 was used to summarize the data and to compare both the lengths with the last menstrual period (LMP) using Pearson's correlation. The comparison was considered statistically significant if <i>P</i> < 0.05.</p><p><strong>Results: </strong>The mean humeral and femoral diaphysis lengths ± standard deviations were 4.84 ± 1 cm and 5.54 ± 1.2 cm, respectively. A positive linear correlation was present between the length and LMP. The correlation of HL with LMP (<i>r</i> = 0.828) was higher than that of FL with LMP (<i>r</i> = 0.770). HL and FL were correlated. They showed a Pearson's coefficient of 0.941. The study revealed that gender does not affect fetal HL and FL.</p><p><strong>Conclusion: </strong>Normal reference ranges for femur and humeral diaphysis lengths during the third trimester were provided. The humerus can be used to assess fetal age. Humerus and femur were correlated to each other among Saudi fetuses. Another study with a larger sample size is recommended.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":null,"pages":null},"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/a1/bc/JMU-31-133.PMC10413399.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9998735","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":"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":null,"pages":null},"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":null,"pages":null},"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":"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":null,"pages":null},"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":null,"pages":null},"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}