Ultraschall in Der Medizin最新文献

{"title":"Automated breast ultrasound features associated with diagnostic performance of Multiview convolutional neural network according to radiologists' experience.","authors":"Eun Jung Choi, Yi Wang, Hyemi Choi, Ji Hyun Youk, Jung Hee Byon, Seoyun Choi, Seokbum Ko, Gong Yong Jin","doi":"10.1055/a-2643-9818","DOIUrl":"https://doi.org/10.1055/a-2643-9818","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate automated breast ultrasound (ABUS) features affecting the use of Multiview convolutional neural network (CNN) for breast lesions according to radiologists' experience.</p><p><strong>Materials and methods: </strong>A total of 656 breast lesions (152 malignant and 504 benign lesions) were included and reviewed by six radiologists for background echotexture, glandular tissue component (GTC), and lesion type and size without as well as with Multiview CNN. The sensitivity, specificity, and the area under the receiver operating curve (AUC) for ABUS features were compared between two sessions according to radiologists' experience.</p><p><strong>Results: </strong>Radiology residents showed significant AUC improvement with the Multiview CNN for mass (0.81 to 0.91, P=0.003) and non-mass lesions (0.56 to 0.90, P=0.007), all background echotextures (homogeneous-fat: 0.84 to 0.94, P=0.04; homogeneous-fibroglandular: 0.85 to 0.93, P=0.01; heterogeneous: 0.68 to 0.88, P=0.002), all GTC levels (minimal: 0.86 to 0.93, P=0.001; mild: 0.82 to 0.94, P=0.003; moderate: 0.75 to 0.88, P=0.01; marked: 0.68 to 0.89, P<0.001), and lesions ≤10mm (≤5 mm: 0.69 to 0.86, P<0.001; 6-10 mm: 0.83 to 0.92, P<0.001). Breast specialists showed significant AUC improvement with the Multiview CNN in heterogeneous echotexture (0.90 to 0.95, P=0.03), marked GTC (0.88 to 0.95, P<0.001), and lesions ≤10mm (≤5 mm: 0.89 to 0.93, P=0.02; 6-10 mm: 0.95 to 0.98, P=0.01).</p><p><strong>Conclusion: </strong>With the Multiview CNN, the performance of ABUS in radiology residents was improved regardless of lesion type, background echotexture, or GTC. For breast lesions smaller than 10 mm, both radiology residents and breast specialists showed better performance of ABUS.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A core curriculum of point-of-care ultrasound examinations for frontline physicians in primary care: results from a European Delphi study.","authors":"Camilla Aakjær Andersen, Thomas Løkkegaard, Leizl Joy Nayahangan, Hazel Edwards, Mihai Sorin Iacob, Kristina Lebedevaite, Mateusz Kosiak, Elena Codruta Gheorghe, Adib Salim, Viktor Rüttermann, Caroline Ewertsen, Christian Jenssen","doi":"10.1055/a-2590-5242","DOIUrl":"10.1055/a-2590-5242","url":null,"abstract":"<p><p>Point-of-care ultrasound (PoCUS) has found its way into primary care in some, but not all, European countries. A prerequisite for achieving Europe-wide comparable diagnostic reliability of PoCUS performed by primary care physicians is high-quality training that is limited to relevant, frequently encountered PoCUS applications that are easy to learn and master. A European Federation of Societies for Ultrasound in Medicine (EFSUMB) task force performed a brainstorming exercise to identify all possible ultrasound examinations that could be performed in primary care. A 3-stage Delphi process was launched. The Delphi panelists were 95 primary care physicians from 28 European countries with more than 2 years of experience using and teaching ultrasound. Solely focusing on the complexity of performing PoCUS, the panelists reduced the brainstorming list in a stepwise manner to a basic core curriculum intended for primary care frontline physicians including 40 diagnostic PoCUS examinations within 13 different anatomical areas and no ultrasound-guided procedures. A 75% cut-off was used for agreement. Despite the great heterogeneity of the Delphi panel representing different views and contexts from across Europe, kappa statistics showed substantial or moderate agreement across Delphi rounds 2 and 3 for 85% of the 40 diagnostic PoCUS applications. The results of this study offer guidance for EFSUMB to establish training recommendations for a basic core curriculum that can be adapted to the needs of different regions of Europe and thus create a basis for PoCUS to become a reliable diagnostic tool in primary care across Europe, based on common quality standards.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contrast-enhanced ultrasound (CEUS) is helpful for the characterisation of solitary fibrous tumors of the pleura.","authors":"Ehsan Safai Zadeh, Christian Görg, Hajo Findeisen, Philip Eckwolf, Lea Dibon, Helmut Prosch","doi":"10.1055/a-2627-8336","DOIUrl":"https://doi.org/10.1055/a-2627-8336","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the perfusion patterns of solitary fibrous tumors of the pleura (SFTP) using contrast-enhanced ultrasound (CEUS).</p><p><strong>Materials and methods: </strong>Between November 2012 and 2024, six patients with histologically confirmed SFTP underwent B-mode ultrasound (B-US) and CEUS. Parameters from the arterial phase, including flow-in pattern, extent of enhancement (EE; marked or reduced/absent), and homogeneity of enhancement (HE; homogeneous or inhomogeneous) were retrospectively analyzed.</p><p><strong>Results: </strong>All six lesions displayed a flow-in perfusion pattern that originated from a peripheral point. Five lesions (83.3%) exhibited arterial hyperenhancement and one (16.7%) showed hypoenhancement. HE was inhomogeneous in five lesions (83.3%) and homogeneous in one (16.7%).</p><p><strong>Conclusion: </strong>On CEUS, all cases showed an arterial flow-in perfusion that originated from a peripheral point in an SFT, which could be a diagnostic clue for the non-invasive diagnosis of SFTPs. Given the risk of tumor seeding, a direct surgical resection may be preferable to biopsy in these cases. Ziel: Beschreibung der Perfusionsmuster solitärer fibröser Tumoren der Pleura (SFTP) mittels kontrastverstärkter Ultraschalluntersuchung (CEUS). Materialien und Methoden: Zwischen November 2012 und 2024 wurden sechs Patienten mit histologisch bestätigtem SFTP einer B-Modus-Ultraschalluntersuchung (B-US) und einer CEUS unterzogen. Retrospektiv wurden Parameter der arteriellen Phase, einschließlich Flow-in-Muster, Ausmaß des Enhancements (EE; ausgeprägt oder reduziert/abwesend) und Homogenität des Enhancements (HE; homogen oder inhomogen), analysiert. Ergebnisse: Alle sechs Läsionen zeigten ein Flow-in-Perfusionsmuster, das von einem peripheren Punkt ausging. Fünf Läsionen (83,3 %) wiesen ein arterielles Hyperenhancement auf, eine Läsion (16,7 %) zeigte ein Hypoenhancement. Das HE war in fünf Läsionen (83,3 %) inhomogen und in einer (16,7 %) homogen. Schlussfolgerung: Bei der CEUS zeigte sich in allen Fällen ein arterielles Flow-in-Perfusionsmuster, das von einem peripheren Punkt ausging, was ein diagnostischer Hinweis auf die nichtinvasive Diagnostik von SFTPs sein könnte. Aufgrund des Risikos einer Tumorseeding ist in diesen Fällen eine direkte chirurgische Resektion der Biopsie vorzuziehen.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"M-sign in middle cerebral artery Doppler in twin-to-twin transfusion syndrome - A retrospective cohort study.","authors":"Ladina Rüegg, Julia Zepf, Markus Gonser, Nicole Ochsenbein-Kölble, Ladina Vonzun","doi":"10.1055/a-2549-6161","DOIUrl":"https://doi.org/10.1055/a-2549-6161","url":null,"abstract":"<p><p>In twin-to-twin transfusion syndrome (TTTS), unbalanced vascular anastomoses lead to a net transfer of fluid from the donor to the recipient. This triggers compensatory mechanisms resulting in fetal vasoconstriction. Hemodynamic modelling has shown that the appearance of a second systolic peak P2, in addition to the main systolic peak P1, in the middle cerebral artery (MCA) Doppler waveform, thus creating a systolic M-sign, may indicate increased fetal vasoconstriction. Hence, the M-sign could be expected in twins with TTTS. The Quintero staging system has been used to stage TTTS. However, TTTS does not always develop in line with the Quintero stages and/or the criteria are not always fulfilled. This study investigates whether the M-sign could be an additional TTTS criterion indicating significant imbalance between the fetuses.38 women who underwent fetoscopic laser coagulation (FLC) for TTTS were included. The MCA Doppler waveforms were retrospectively analyzed for the presence of an M-sign. We subdivided the M-signs into 2 groups: Group A: the main systolic peak P1 dominates P2, i.e., P2/P1 <1; Group B: P2 exceeds P1: P2/P1 >1.Before FLC, an M-sign was found in 17/38 (45%) pregnancies. Both twins showed M-signs in 9 pregnancies, only the recipient in 6, and only the donor in 2. In 6 (35%) fetuses, an M-sign appeared before the Quintero criteria were fulfilled. Postoperatively, M-signs disappeared in all cases.The appearance of an M-sign could be an additional marker of cardiovascular imbalance in monochorionic-diamniotic twins with developing or already present TTTS. Postoperative M-sign disappearance may indicate fetal recovery.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of contrast-enhanced ultrasound using microbubbles in human pregnancy: A scoping review.","authors":"Sophie Dassen, Loes Monen, Guid Oei, Massimo Mischi, Judith van Laar","doi":"10.1055/a-2351-0747","DOIUrl":"10.1055/a-2351-0747","url":null,"abstract":"<p><p>Successful placentation is crucial for fetal development and maintaining a healthy pregnancy. Placental insufficiency can cause a variety of obstetric complications. Despite the many efforts to enhance diagnosing placental insufficiency, no imaging technique has proven satisfactory. A promising imaging technique is contrast-enhanced ultrasound (CEUS) using microbubbles which has proven capable of (micro)vascular imaging. Its use for placental vascularization assessment in human pregnancies remains constrained by limited evidence and safety concerns. This scoping review aims to demonstrate the safety of CEUS used in human pregnancy in the published literature to date.A systematic search using PubMed, Medline, Embase, and Cochrane databases was performed. All studies where contrast-enhanced ultrasound was used in pregnant humans were included. Studies, where there was a planned termination of pregnancy, were excluded. To assess the safety of CEUS during pregnancy, relevant outcomes were divided into the following 3 categories; fetal outcome, maternal outcome, and pregnancy and neonatal outcomes.A total of 13 articles were included, in which 256 women underwent CEUS during pregnancy. No clinically significant maternal or fetal adverse events or negative pregnancy or neonatal outcomes associated with CEUS were described.Based on our findings, we consider expanding the knowledge of this promising diagnostic technique in future larger clinical studies to be safe and relevant.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"259-269"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best Practice Guidelines - DEGUM Recommendations on Breast Ultrasound.","authors":"Claudia Maria Vogel-Minea, Werner Bader, Jens-Uwe Blohmer, Volker Duda, Christian Eichler, Eva Fallenberg, André Farrokh, Michael Golatta, Ines Gruber, Bernhard-Joachim Hackelöer, Jörg Heil, Helmut Madjar, Ellen Marzotko, Eberhard Merz, Alexander Mundinger, Markus Müller-Schimpfle, Ralf Ohlinger, Uwe Peisker, Ruediger Schulz-Wendtland, Fritz Kw Schäfer, Christine Solbach, Mathias Warm, Dirk Watermann, Sebastian Wojcinski, Markus Hahn","doi":"10.1055/a-2481-6610","DOIUrl":"10.1055/a-2481-6610","url":null,"abstract":"<p><p>Breast ultrasound has been established for many years as an important method in addition to mammography for clarifying breast findings. The goal of the Best Practice Guidelines Part III of the DEGUM breast ultrasound working group is to provide colleagues working in senology with information regarding the specific medical indications for breast ultrasound in addition to the current ultrasound criteria and assessment categories published in part I and the additional and optional sonographic diagnostic methods described in part II. The value of breast ultrasound for specific indications including follow-up, evaluation of breast implants, diagnostic workup of dense breast tissue, diagnostic workup during pregnancy and lactation, and the diagnostic workup of breast findings in men is discussed. Each section after the general information section contains a description of specific pathologies followed by a short summary and DEGUM recommendations for the particular indications. The latest S3 guidelines and AGO guidelines were taken into consideration.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"245-258"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Best Practice Guidelines - DEGUM Recommendations on Breast Ultrasound.","authors":"Claudia Maria Vogel-Minea, Werner Bader, Jens-Uwe Blohmer, Volker Duda, Christian Eichler, Eva Fallenberg, André Farrokh, Michael Golatta, Ines Gruber, Bernhard-Joachim Hackelöer, Jörg Heil, Helmut Madjar, Ellen Marzotko, Eberhard Merz, Alexander Mundinger, Markus Müller-Schimpfle, Ralf Ohlinger, Uwe Peisker, Ruediger Schulz-Wendtland, Fritz Kw Schäfer, Christine Solbach, Mathias Warm, Dirk Watermann, Sebastian Wojcinski, Markus Hahn","doi":"10.1055/a-2556-4952","DOIUrl":"10.1055/a-2556-4952","url":null,"abstract":"","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"e7"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of differentiating sonographic features between fibroadenomas and malignant tumors of the breast mimicking fibroadenomas: 10-year experience in 421 histologically verified cases.","authors":"Michael Swoboda, Johannes Deeg, Daniel Egle, Valentin Ladenhauf, Malik Galijasevic, Christoph Plöbst, Silke Haushammer, Birgit Amort, Mathias Pamminger, Leonhard Gruber","doi":"10.1055/a-2474-6617","DOIUrl":"10.1055/a-2474-6617","url":null,"abstract":"<p><p>Ultrasound is a highly effective imaging tool for assessing abnormalities within the breast. However, especially the identification of malignant tumors of the breast mimicking fibroadenomas (MTMF) by means of breast ultrasound can be challenging. This study aimed to identify reliable imaging characteristics of MTMF.This retrospective study was approved by the local ethics review board. After screening 623 patients, 421 cases with histologically verified fibroadenomas and MTMF between 2011 and 2021 were included. Sonographic features were compared to histopathological results and an algorithm-based quantitative ranking of predictors contributing most to the correct classification of malignant tumors was conducted.A total of 363 benign, 18 intermediate, and 40 malignant lesions were analyzed. Algorithm-based quantitative ranking showed that the most predictive features indicating malignancy were a hyperechoic rim (gain ratio merit 0.135 ± 0.004), an irregular border (0.057 ± 0.002), perilesional stiffening (0.054 ± 0.002), pectoral contact (0.051 ± 0.003), an irregular shape (0.029 ± 0.001), and irregular vasculature (0.027 ± 0.002).Ultrasound findings for fibroadenomas vary, making identification of MTMF challenging. Features such as indistinct margins and increased perilesional echogenicity are predictors for malignancy and should be considered during sonographic evaluation of fibroadenomas and MTMF.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"291-298"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal cardiovascular function in a late-onset SGA and FGR cohort: CURIOSA study.","authors":"Silvia M Lobmaier, Oliver Graupner, Christina Franke, Nadia Boess, Bernhard Haller, Renate Oberhoffer, Annette Wacker-Gussmann, Javier U Ortiz","doi":"10.1055/a-2390-2010","DOIUrl":"10.1055/a-2390-2010","url":null,"abstract":"<p><p>The measurement of fetal cardiovascular function parameters is not yet established in prenatal diagnostics. Now that the research field of fetal programming is becoming increasingly important, this might change. Fetal cardiovascular changes have been described above all in early/severe fetal growth restriction (FGR). The aim of this study was to investigate functional echocardiographic parameters in fetuses with late-onset small for gestational age (SGA)/FGR.A prospective cohort of SGA fetuses (including FGR) and a control group with similar distribution of gestational age were studied. Parameters of systolic, diastolic, and global cardiac function, morphometry and measurements of the fetal abdominal aorta were collected.A total of 149 SGA fetuses and 143 control fetuses were included from 32 weeks until term. The total SGA group was further divided into SGA 3rd-10th (fetuses between the 3rd and 10th weight percentile) and FGR subgroups. In the total SGA group, relative right and left ventricular wall thickness, left E/A ratio, isovolumetric contraction time and left myocardial performance index were significantly increased compared to controls after adjustment for gestational age. MAPSE, TAPSE, ejection time, left cardiac output, and abdominal aortic distensibility were significantly lower. The changes were more pronounced in the FGR subgroup.Even in a group of late-onset SGA/FGR, echocardiographic parameters are already altered in utero.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"270-277"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kaposiform haemangioendothelioma: ultrasonographic features and risk factors for the Kasabach-Merritt phenomenon.","authors":"Jing Zhao, Jian-Jun Yuan, Chang-Xian Dong, Xiangqin Zhang, Chuang Li, Qi Sun, Gang Wu","doi":"10.1055/a-2421-6047","DOIUrl":"10.1055/a-2421-6047","url":null,"abstract":"<p><p>Kaposiform hemangioendothelioma (KHE) is a rare, locally aggressive vascular tumor with high morbidity and mortality. The aim of this study was to evaluate ultrasonographic findings associated with KHE.The clinical and ultrasonographic findings of a cohort of 64 cases with pathologically proven KHE were retrospectively reviewed and analyzed between November 2014 and February 2021. Two subtypes were divided according to the presence or absence of the Kasabach-Merritt phenomenon (KMP). The KMP risk factors in patients with KHE were analyzed statistically.Among the 64 cases of KHE, 43 (67.2%) were accompanied by KMP. There was a positive correlation between the appearance of KMP and tumor size. KHEs had an increased risk of developing KMP if the lesions measured were >6 cm and if they belonged to the deep or mixed subtype. On ultrasonography, all KHE lesions were heterogeneous, and 81.3% were hypoechoic; 93.8% of KHEs exhibited ill-defined margins, 68.7% had strands branching into the adjacent tissue, and 84.4% presented marked hypervascularity. Elastography showed that central hypoechogenic lesion areas were hard, and surrounding hyperechogenic lesion areas were soft.KHEs can occur in different parts of childrens' bodies. On ultrasonography, the main findings are heterogeneous low erosions, indistinct margins, branching strangulation into adjacent tissues, and obvious hypervascularity. Patients with lesions larger than 6 cm or belonging to deep or mixed subtypes (musculoskeletal infiltrates) are at risk for developing KMP, and clinicians should be vigilant.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"278-284"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}