Journal of Ultrasonography最新文献

{"title":"Application of artificial intelligence in the ultrasonographic diagnosis of thyroid nodules.","authors":"Agnieszka Żyłka, Mariusz Rafało, Marek Dedecjus, Katarzyna Sylwia Dobruch-Sobczak","doi":"10.15557/jou.2025.0022","DOIUrl":"10.15557/jou.2025.0022","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to assess whether integrating selected ultrasound features into a convolutional neural network improves its ability to differentiate benign from malignant thyroid nodules.</p><p><strong>Material and methods: </strong>A total of 242 patients (196 women, 46 men) with thyroid lesions were included in the study. All patients underwent surgical treatment and histopathological analysis. Thyroid ultrasonography was also performed for all participants. Images were recorded in DICOM and AVI formats, and archived in a local database. Thyroid lesions were assessed according to the EU-TIRADS classification. Convolutional neural network models were developed using established architectures, including DenseNet and VGG16, as well as custom-designed models tailored to the dataset. Hybrid models were created by incorporating selected ultrasound features into these architectures as additional inputs. Performance was compared between the baseline convolutional neural network models and their feature-supported hybrid counterparts.</p><p><strong>Results: </strong>Model performance was evaluated using several metrics, including sensitivity and area under the ROC curve. Baseline convolutional neural network models served as the reference, while hybrid variants included structured ultrasound features. The VGG model showed a sensitivity of 0.78, and DenseNet achieved a sensitivity of 0.80 with an AUC of 0.84, demonstrating low variability. Inception models performed similarly, with balanced positive predictive value (PPV) (0.83) and negative predictive value (NPV) (0.74). Custom models also reached AUC values over 0.80. Selected ultrasonography features improved AUC by up to 7%, with additional gains in sensitivity and NPV.</p><p><strong>Conclusions: </strong>Eight baseline convolutional neural network models used to differentiate benign from malignant thyroid nodules were enhanced by incorporating five expert-assessed ultrasound features. This hybrid approach improved classification performance across all models, yielding an average AUC increase of approximately 7%.</p>","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"25 102","pages":"20250022"},"PeriodicalIF":1.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907614","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":"Anatomical variations of the cervical vagus nerve on ultrasonography: a cross-sectional study.","authors":"Sukhmani Randhawa, Kunwar Pal Singh, Arvinder Singh, Pooja Pal, Sukhdeep Kaur","doi":"10.15557/jou.2025.0025","DOIUrl":"10.15557/jou.2025.0025","url":null,"abstract":"<p><strong>Aim: </strong>To identify anatomical variations in the cervical vagus nerve using ultrasonography and assess their relationship with age, sex, side, site, and proximity to the thyroid gland.</p><p><strong>Materials and methods: </strong>A cross-sectional observational study was conducted on 347 patients undergoing routine or clinically indicated neck ultrasonography. High-frequency linear ultrasound probes were used to scan the cervical region bilaterally. The cervical vagus nerve was identified relative to the common carotid artery and internal jugular vein, and its anatomical course was classified using a reference C-I axis. Anatomical variation types and proximity to the thyroid gland in potentially vulnerable configurations were recorded. Demographic factors, including age and sex, were analyzed in association with variation prevalence.</p><p><strong>Results: </strong>Anatomical variations of the cervical vagus nerve were observed in 132 of 347 participants (38%). There was a statistically significant left-sided predominance (67.1%) compared to right-sided variations (6%) (<i>p</i> <0.001). Eight patients had bilateral variations. The most common type was the anteromiddle variation, followed by anterolateral, anteromedial, and medial types. Variation prevalence increased with age and was higher in males than in females (46.6% vs. 34.4%, <i>p</i> = 0.033). In 69 cases, the cervical vagus nerve was located less than 2 mm from the thyroid gland, with 13 abutting it directly.</p><p><strong>Conclusion: </strong>Ultrasonography is a valuable, non-invasive imaging modality for identifying anatomical variations of the cervical vagus nerve. Awareness of these variations is essential for surgical planning and for preventing iatrogenic nerve injury, especially during procedures like thyroidectomy, vagus nerve stimulation, and radiofrequency ablation, particularly in older patients and on the left side of the neck. Preoperative mapping of the nerve using ultrasonography could, therefore, be considered as a routine measure.</p>","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"25 102","pages":"20250025"},"PeriodicalIF":1.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303936","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 assessment of patellar enthesopathy in patients with Ehlers-Danlos syndrome with and without concomitant axial spondyloarthropathy.","authors":"Tina Wang, Ana María Serrano-Ardila, Carmelo Pirri","doi":"10.15557/jou.2025.0029","DOIUrl":"10.15557/jou.2025.0029","url":null,"abstract":"<p><strong>Aim: </strong>Ehlers-Danlos syndromes (EDS) are connective tissue disorders characterized by joint hypermobility, skin hyperextensibility, and tissue fragility. When spondyloarthritis (SpA), an inflammatory arthritis, co-occurs with EDS, overlapping symptoms of joint pain may arise, making diagnosis and management challenging. The aim of this study was to investigate enthesopathic differences in the patellar tendon between patients with EDS and those with co-occurring SpA.</p><p><strong>Material and methods: </strong>Twenty-three participants with EDS and co-occurring SpA (SpA + EDS) and 14 participants with EDS without SpA (EDS-only) underwent ultrasound examination. Assessments were conducted at the inferior patellar pole, mid-patellar tendon, and tibial tuberosity to evaluate enthesopathic changes, including calcifications, enthesophytes, and tendon thickness. Statistical analyses were performed to identify significant differences between groups.</p><p><strong>Results: </strong>The most common tendon pathology was hypoechoic change at the level proximal to the tibial tuberosity and the inferior pole of the patella. Compared with the EDS-only group, tendon thickness at the patellar pole was significantly greater in the SpA + EDS group (<i>p</i> = 0.002).</p><p><strong>Conclusions: </strong>The presence of increased patellar tendon thickness in the SpA + EDS group suggests structural adaptations consistent with enthesopathic change in the context of coexisting inflammatory and connective tissue disorders. These findings highlight the potential role of ultrasound in the evaluation of tendon alterations in hypermobile patients, underscoring the need for longitudinal, multimodal studies to clarify the clinical relevance of these sonographic differences.</p>","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"25 102","pages":"20250029"},"PeriodicalIF":1.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907697","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":"Mucinous adenocarcinoma of the prostate: a rare tumor - case report and literature review.","authors":"Manuela Montatore, Laura Eusebi, Federica Masino, Marina Balbino, Giuseppe Guglielmi","doi":"10.15557/jou.2025.0027","DOIUrl":"10.15557/jou.2025.0027","url":null,"abstract":"<p><strong>Introduction: </strong>Prostate cancer is the most prevalent non-cutaneous malignancy in men. Mucinous adenocarcinoma is a rare histological variant, accounting for less than 0.5% of cases. Its distinctive imaging and histopathological features present unique diagnostic challenges.</p><p><strong>Case presentation: </strong>A 57-year-old male presented with sexual dysfunction, painful ejaculation, and hematuria. Clinical examination revealed a markedly enlarged prostate. Imaging studies, including scrotal and transrectal ultrasound, computed tomography, and multiparametric magnetic resonance imaging (MRI), demonstrated a complex, multilobulated prostatic mass with fluid-fluid levels and imaging features suggestive of mucin accumulation. Prostate biopsy confirmed adenocarcinoma with predominant mucinous features, including trabecular and cribriform patterns, and an ISUP grade group 4, indicating an aggressive tumor. On MRI, mucinous adenocarcinoma typically appears as a multicystic lesion with high T2 signal intensity and minimal diffusion restriction, which may delay diagnosis. These imaging characteristics differ from those of conventional prostate adenocarcinoma and can mimic benign cystic lesions.</p><p><strong>Discussion: </strong>Histopathological diagnosis is often challenging due to the extracellular mucin content. While treatment generally follows standard protocols for high-grade prostate cancer, including surgery, radiotherapy, and hormonal therapy, the rarity of this variant leaves many questions regarding prognosis and optimal management unanswered.</p><p><strong>Conclusion: </strong>Awareness of the distinct imaging and histopathological features of mucinous adenocarcinoma is crucial for accurate diagnosis and appropriate management. Further research is needed to better understand its clinical behavior and to establish evidence-based treatment guidelines.</p>","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"25 102","pages":"20250027"},"PeriodicalIF":1.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349138","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":"Standardized bilateral thoracic ultrasound image comparison as a tool for the diagnosis of pneumothorax: a pilot exploratory study.","authors":"Guido Levi, Chiara Rocchetti, Riccardo Maria Inciardi, Michela Bezzi, Laura Pini, Claudio Tantucci, Giampietro Marchetti","doi":"10.15557/jou.2025.0024","DOIUrl":"10.15557/jou.2025.0024","url":null,"abstract":"<p><strong>Aim: </strong>Pneumothorax is a potentially life-threatening condition whose diagnosis can be challenging. Ultrasound chest examination is generally fast and user-friendly, but in non-expert hands or with uncooperative patients, it may still be difficult and time-consuming. Adding another tool to support the suspicion of pneumothorax might be useful, potentially enhancing the diagnostic accuracy of standard ultrasound chest examination. We evaluated the feasibility of standardized bilateral ultrasound image comparison as a potential new tool for pneumothorax diagnosis.</p><p><strong>Materials and methods: </strong>We enrolled 60 subjects (30 with pneumothorax and 30 controls) and collected bilateral ultrasound images of their chests (each image contained one frame from the left lung and one from the right lung). Ten physicians (eight blinded to diagnosis) divided into five groups according to expertise evaluated the images for potential grayscale differences and/or horizontal artifacts between the two frames. All images were then analyzed with image analysis software for grayscale pixel assessment (one sub-analysis for the entire area under the pleural line, one for a 100-pixel-wide rectangle under the pleural line).</p><p><strong>Results: </strong>All clinicians achieved good results in terms of diagnostic accuracy and inter-operator reliability, even those unexperienced in ultrasound. Mean, range, and median grayscale pixel ratio between the pneumothorax side and the healthy side in a single patient proved to be the most reliable parameters, reaching excellent sensitivity and specificity. Combining these parameters proved to be an excellent diagnostic tool (ROC area under curve = 1.00, <i>p</i>-value = 0.02).</p><p><strong>Conclusions: </strong>Standardized bilateral thoracic ultrasound image comparison may be a potential new tool for the diagnosis of pneumothorax.</p>","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"25 102","pages":"20250024"},"PeriodicalIF":1.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309529","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":"Differentiation of triple-negative breast cancer and benign breast lesions using multiparametric ultrasonography.","authors":"Magdalena Gumowska, Katarzyna Sylwia Dobruch-Sobczak","doi":"10.15557/jou.2025.0023","DOIUrl":"10.15557/jou.2025.0023","url":null,"abstract":"<p><strong>Aim: </strong>Assessment of features of triple-negative breast cancer (TNBC) and benign breast lesions in multipara-metric ultrasonography, with an emphasis on the added value of sonoelastography.</p><p><strong>Material and methods: </strong>Forty-one women with TNBC and 51 with benign breast lesions, underwent sonographic evaluation at the Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, between 05.2020 and 11.2023. A retrospective analysis was conducted. The following features of the tumors were evaluated: B-mode characteristics, presence of vascularity, and tissue stiffness in shear wave elastography. Two sets of data were extracted from the database: the first encompassing the total group of tumors (TG), the second comprising small lesions (<20 mm, SG). Statistical analysis for both groups was run independently to investigate if and how the size of the tumor would influence the diagnostic accuracy of the sonographic evaluation. TNBCs and benign entities were compared with t-Student's test, Mann-Whitney U test, Pearson's chi-square test or Fisher's exact test. ROC analysis and logistic regression were conducted.</p><p><strong>Results: </strong>For TG, ultrasound showed high predictive accuracy (AUC >0.8) for the following single parameters: elastography other than soft (>80 kPa) and irregular shape. Adding 2 features improved performance, with the highest AUC (0.858) for non-circumscribed margins and irregular shape. For SG, single parameters with the best predictive effectiveness (AUC >0,8) were: irregular shape, elastography other than soft (>80 kPa), and noncircumscribed margins. Elastography other than soft revealed high specificity. Combinations of features with AUC >0.9 were: irregular shape and hypoechogenicity; non-circumscribed margins and hypoechogenicity; and non-circumscribed margins, irregular shape, and hypoechogenicity.</p><p><strong>Conclusions: </strong>Accurate assessment of shape and margins, enhanced by information about tissue stiffness, substantially improves differentiation between TNBC and benign breast lesions.</p>","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"25 102","pages":"20250023"},"PeriodicalIF":1.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907695","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":"Diagnosis of foot foreign bodies with ultrasound: a case series from the pediatric emergency department.","authors":"Altaf Ahmad Bhat, Rawan Mohammed AlRashed, Johara Alkhamash","doi":"10.15557/jou.2025.0030","DOIUrl":"10.15557/jou.2025.0030","url":null,"abstract":"<p><strong>Aim: </strong>Foot foreign body injuries are prevalent among pediatric populations, posing diagnostic and management challenges. X-ray examination is the first choice used by emergency physicians for localization and removal of foreign objects but it has limited value when the foreign body is not radiopaque, leading to missed diagnoses of non-radiopaque foreign bodies, we recommend simultaneous use of point-of-care ultrasound (POCUS) to rule out foreign body in every case especially when history and clinical exam highly suggestive of foreign body. This case series highlights the diagnostic utility of X-ray and POCUS in the emergency department and its sensitivity in detecting radiopaque and as well radiolucent foreign objects.</p><p><strong>Material and methods: </strong>We describe a case series of foot foreign bodies in children, highlighting the clinical characteristics, diagnostic challenges, and utility of POCUS in the pediatric emergency department. Some patients had delayed presentation in the emergency department due to missed diagnosis in the first place.</p><p><strong>Results: </strong>Patient with sharp foreign bodies, such as glass, typically present with more pain and refusal to bear weight, and POCUS was also difficult, as while probing the area they experienced severe pain. Soft-tissue foreign bodies such as wood, glass and plastic may remain undetected on radiography, but are easily detected by bedside POCUS.</p><p><strong>Conclusions: </strong>This case series underscores the importance of early recognition and utility of POCUS as well as proper exposure X-ray imaging as the first choice for emergency physicians for ruling out foreign bodies in the foot.</p>","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"25 102","pages":"20250030"},"PeriodicalIF":1.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907685","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":"3D ultrasound of fetal congenital heart disease: findings from virtual and physical models.","authors":"Caroline Oliveira Nieblas, Edward Araujo Júnior, Nathalie Jeanne Magioli Bravo-Valenzuela, Marcela Castro Giffoni, Maria Fátima Pereira Leite, Heron Werner","doi":"10.15557/jou.2025.0026","DOIUrl":"10.15557/jou.2025.0026","url":null,"abstract":"","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"25 102","pages":"20250026"},"PeriodicalIF":1.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349098","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 intercostal nerve blocks for acute zoster pain: a retrospective, propensity score-matched, non-inferiority study.","authors":"Wenxing Zhao, Liangliang He, Li Yue, Hong Yue, Liqiang Yang","doi":"10.15557/jou.2025.0021","DOIUrl":"10.15557/jou.2025.0021","url":null,"abstract":"<p><strong>Aim: </strong>To assess whether ultrasound (US)-guided intercostal nerve blocks (ICNBs) provide non-inferior efficacy in the management of acute zoster pain (ZAP) and potential prophylaxis for post-herpetic neuralgia as compared to conventional thoracic paravertebral blocks (TPVBs).</p><p><strong>Material and methods: </strong>A total of 192 patients with ZAP were reviewed. Their records were stratified into two cohorts: those who underwent US-guided TPVBs (TPVB cohort) and those who received US-guided ICNBs (ICNB cohort). The ICNB cohort was matched using a propensity score method in a 1:1 ratio. The primary endpoint was non-inferiority of <i>Herpes zoster</i> (HZ)-related illness burden within 30 days (HZ-BOI₃₀) post-procedure. Secondary outcomes included procedure time, rescue analgesic use, post-herpetic neuralgia occurrence, health-related quality of life, and adverse events.</p><p><strong>Results: </strong>Mean score of HZ-BOI₃₀ was 87.92 ± 21.84 and 85.64 ± 17.01 in the TPVB and ICNB cohorts, respectively, with a mean difference of 2.28 (95% confidence interval (CI): -5.68, 10.24). Non-inferiority was met, as the 95% CI for the absolute difference in HZ-BOI₃₀ fell within the predefined non-inferiority margin of 15 points. Comparable improvements in post-herpetic neuralgia incidence, EQ-5D-3L scores, and rescue analgesic requirements were observed in both cohorts across all follow-up time points (all <i>p</i> >0.05). In contrast, the ICNB approach was associated with shorter procedure times (<i>p</i> <0.001) and reduced discomfort and pain during needle insertion (<i>p</i> <0.001). There were no complications, including pneumothorax, nerve injury, or intravascular injection in either study cohort.</p><p><strong>Conclusions: </strong>US-guided ICNBs were non-inferior to TPVBs in alleviating ZAP and preventing post-herpetic neuralgia, while also demonstrating a favorable safety profile. These findings suggest that the ICNB technique might be a promising alternative for managing ZAP.</p>","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"25 102","pages":"20250021"},"PeriodicalIF":1.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875840","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 imaging in floppy eyelid syndrome: anatomical and clinical considerations.","authors":"Vasilios Batis, Efstathios Detorakis, Sophia Schiza, Emmanuel Prokopakis, Konstantinos Krasagakis, Elena Drakonaki","doi":"10.15557/jou.2025.0019","DOIUrl":"10.15557/jou.2025.0019","url":null,"abstract":"<p><strong>Aim of the study: </strong>Skin ultrasonography and elastography provide information on superficial tissue anatomy and elasticity. Floppy eyelid syndrome is characterized by eyelid hyperlaxity and is associated with several ophthalmic and systemic conditions, such as obstructive sleep apnea. This study evaluates the diagnostic role of ultrasonography and elastography in floppy eyelid syndrome.</p><p><strong>Methods: </strong>This is a prospective case-control study. Patients were recruited from the Oculoplastic Service of the Department of Ophthalmology at the University Hospital of Heraklion, Crete, Greece. The diagnosis of floppy eyelid syndrome was based on the eversion of the upper eyelid upon unassisted digital traction. Cataract surgery candidates without floppy eyelid syndrome were consecutively recruited as controls. Patients with a history of previous eyelid pathology or surgery were excluded. Ultrasound examination was performed using high-frequency linear probes (GE E9) for B-mode imaging and shear wave and strain elastography. Upper airway measurements included tongue thickness and upper airway length. Clinical and demographic findings were recorded.</p><p><strong>Results: </strong>Twenty-eight patients were included (14 with floppy eyelid syndrome, 14 controls). Orbicularis muscle elasticity in kPa was significantly higher in the floppy eyelid syndrome group, compared with controls (independent samples t-test score 2.64, <i>p</i> = 0.04). Tongue thickness and upper airway length were also significantly correlated with several eyelid B-mode and elastography parameters in patients with floppy eyelid syndrome, including subcutaneous fat and orbicularis muscle thickness and elasticity.</p><p><strong>Conclusions: </strong>Findings from this feasibility study imply that ultrasound and elastography parameters may be used in the evaluation of floppy eyelid syndrome and support an association between eyelid elasticity and upper airway anatomical parameters in this condition.</p>","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"25 101","pages":"20250019"},"PeriodicalIF":1.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650821","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}