Paul Mick, Katharina Sehmsdorf, Burkhard Lehner, Andreas Geisbüsch, Tobias Renkawitz, Mustafa Hariri, Julian Doll, Stefanos Tsitlakidis
{"title":"Perfusion-based malignancy assessment of soft-tissue tumors by contrast-enhanced ultrasound (CEUS): a comprehensive analysis of 187 cases.","authors":"Paul Mick, Katharina Sehmsdorf, Burkhard Lehner, Andreas Geisbüsch, Tobias Renkawitz, Mustafa Hariri, Julian Doll, Stefanos Tsitlakidis","doi":"10.1055/a-2549-6101","DOIUrl":"10.1055/a-2549-6101","url":null,"abstract":"<p><p>This study aimed to examine the perfusion characteristics of benign and malignant soft-tissue tumors (STT) using contrast-enhanced ultrasound (CEUS) and to correlate STT micro-perfusion with malignancy. Findings were compared with patient characteristics, clinical presentations, MRI findings, and histopathological outcomes.This prospective single-center study involved patients with unclear STTs who were scheduled for STT biopsy. Clinical assessments and preoperative MRI were conducted along with CEUS. Perfusion quantification was performed, and perfusion parameters (peak enhancement [PE], rise time, wash-in perfusion index, and washout rate) were calculated. Perfusion characteristics of different STTs were compared.187 patients were included in the final analysis. Significant differences in CEUS perfusion between benign and non-benign STTs were demonstrated. Non-benign tumors showed significantly higher tumor perfusion and differences were also significant when comparing semi-malignant, malignant, and metastatic STTs. (PE-benign 107.74 [34.65-345.62]; PE-semi-malignant 166.06 [60.14-374.47]; PE-malignant 1042.24 [358.15-4917.74]; PE-metastasis 2632.37 [2249.46-3788.94]. ROC analysis demonstrated a sensitivity of 80% and a PPV of 69% for malignant tumor detection using a cut-off value for peak enhancement of 137 [a.u.].CEUS appears to be a promising tool for primary STT evaluation in addition to MRI. Furthermore, it can detect vital areas within the tumor tissue and could be utilized to increase biopsy accuracy.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544072","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}
Xinyue Huang, Tianhong Wei, Jie Li, Letian Xu, Yangshuo Tang, Jin-Tang Liao, Bo Zhang
{"title":"Multimodal Ultrasound for Assessment of Renal Fibrosis in Biopsy-Proven Patients with Chronic Kidney Disease.","authors":"Xinyue Huang, Tianhong Wei, Jie Li, Letian Xu, Yangshuo Tang, Jin-Tang Liao, Bo Zhang","doi":"10.1055/a-2559-7743","DOIUrl":"https://doi.org/10.1055/a-2559-7743","url":null,"abstract":"<p><p>To establish a discriminant function model combining clinical data and multimodal ultrasound to predict the degree of renal fibrosis in patients with chronic kidney disease (CKD) and to explore the application value of the non-invasive assessment of renal fibrosis by new ultrasound techniques.Clinical data and ultrasonography, shear wave elastography, and angio planewave ultrasensitive imaging characteristics of patients with CKD were collected. The significant indicators were screened to establish discriminant function models to distinguish the degree of renal fibrosis, and the diagnostic efficacy was evaluated.The 158 patients were divided into 4 groups according to pathological results. The significant indicators among or within the 4 groups were mainly age, estimated glomerular filtration rate, serum creatinine, peak systolic velocity and resistance index of renal arteries, kidney elasticity, and arcuate artery vascular density (p<0.05). The discriminant function models exhibited good diagnostic efficiency and higher accuracy compared to any single indicator.The SWE elasticity value of the kidney increases with the degree of fibrosis, while AP can visualize microvascular conditions qualitatively and quantitatively. Multimodal ultrasound combined with clinical data is a non-invasive strategy for the assessment of renal fibrosis.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754914","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}
Elena Bertelli, Michele Vizzi, Lorenzo Lattavo, Ron Ruzga, Simona Giovannelli, Diletta Cozzi, Federico Valeri, Simone Agostini, Vittorio Miele
{"title":"Microvascular imaging versus CEUS in the characterization of renal masses: preliminary experience in a tertiary care referral university hospital.","authors":"Elena Bertelli, Michele Vizzi, Lorenzo Lattavo, Ron Ruzga, Simona Giovannelli, Diletta Cozzi, Federico Valeri, Simone Agostini, Vittorio Miele","doi":"10.1055/a-2532-6772","DOIUrl":"https://doi.org/10.1055/a-2532-6772","url":null,"abstract":"<p><p>Evaluation of the possible role of microvascular imaging (MI) for the detection of vascularization of renal lesions, while comparing it with contrast-enhanced ultrasound (CEUS).137 patients (160 renal lesions, 64 solid and 96 cystic) were enrolled in this single-center, retrospective, observational study. For solid masses, both the intralesional and the peripheral vascularization was analyzed and quantified by MI and then compared to peak enhancement on CEUS. Regarding cystic lesions, we evaluated the presence or absence of vascularization within the cystic wall and/or septa. MI results were compared with CEUS findings using Pearson's Chi square test. An optimal size cut-off for renal lesions was determined with the Youden test.For solid lesions, a statistically significant correlation (p <0.05) was observed between the MI parameters and the peak enhancement on CEUS. The detection rate (DR) for lesional vascularization on MI was 87.5%, while if we consider only lesions larger than the optimal cut-off (14mm), the DR increases to 98%. In cystic lesions, the MI showed a high specificity (93.9%) in predicting CEUS results and a high positive predictive value (84.2%). The concordance was 100% in Bosniak I lesions and 80% in Bosniak IV lesions, while it was lower for the other classes. Furthermore, we found a statistically significant correlation (p <0.05) between Bosniak grade and lesional vascularity on MI.Our preliminary study shows that MI cannot replace CEUS, but could reduce its use, especially in solid lesions larger than 14mm and in cysts classified as Bosniak IV, a goal that is particularly important in an active surveillance setting.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754913","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}
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
{"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":"https://doi.org/10.1055/a-2556-4952","url":null,"abstract":"","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-26","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}
Claudia M 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 K W Schäfer, Christine Solbach, Mathias Warm, Dirk Watermann, Sebastian Wojcinski, Markus Hahn
{"title":"Correction: Best Practice Guidelines - DEGUM Recommendations on Breast Ultrasound.","authors":"Claudia M 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 K W Schäfer, Christine Solbach, Mathias Warm, Dirk Watermann, Sebastian Wojcinski, Markus Hahn","doi":"10.1055/a-2556-4960","DOIUrl":"https://doi.org/10.1055/a-2556-4960","url":null,"abstract":"","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732537","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}
Ingo Gottschalk, Eva Christin Weber, Ivonne Bedei, Roland Axt-Fliedner, Brigitte Strizek, Christoph Berg
{"title":"Intrauterine Therapy.","authors":"Ingo Gottschalk, Eva Christin Weber, Ivonne Bedei, Roland Axt-Fliedner, Brigitte Strizek, Christoph Berg","doi":"10.1055/a-2524-5787","DOIUrl":"10.1055/a-2524-5787","url":null,"abstract":"<p><p>Since the first intrauterine interventions were carried out in the 1970 s under what today would be considered basic conditions, the range of prenatal interventions has steadily expanded, as has the frequency with which these interventions are carried out at specialized centers. Although most of these procedures are minimally invasive, they are invariably associated with considerable risks for the fetus and, depending on the surgical method, also for the expectant mother. For this reason, most centers worldwide limit themselves to interventions for fetal diseases which, if untreated, have a fatal course or experience a significant deterioration in the postnatal prognosis during the course of intrauterine development. This is all the more significant as only a small proportion of prenatal interventions have been successfully investigated in controlled clinical trials. The only exceptions are laser therapy for feto-fetal transfusion syndrome, intrauterine closure of spina bifida, and tracheal occlusion for diaphragmatic hernia with severe pulmonary hypoplasia. This article is intended to provide an overview of the fetal conditions that are candidates for intrauterine therapy and of the evidence for the individual interventions.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630903","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}
Yannick Alexander Schreiner, Johannes Lukas Schmidt, Meike Weis, Oliver Nowak, Thomas Kohl, Svetlana Hetjens, Neysan Rafat, Thomas Schaible
{"title":"Measurements of Lung Size in Ultrasound and Magnetic Resonance Imaging in Congenital Diaphragmatic Hernia - A Comparison of Prenatal Imaging Techniques.","authors":"Yannick Alexander Schreiner, Johannes Lukas Schmidt, Meike Weis, Oliver Nowak, Thomas Kohl, Svetlana Hetjens, Neysan Rafat, Thomas Schaible","doi":"10.1055/a-2525-6117","DOIUrl":"https://doi.org/10.1055/a-2525-6117","url":null,"abstract":"<p><p>To investigate the correlation between different prenatal imaging techniques in congenital diaphragmatic hernia (CDH) and their prognostic value.209 fetuses with CDH were enrolled in this retrospective cohort study. The prenatal ultrasound-based and MRI-based (MRI: magnetic resonance imaging) observed-to-expected lung-to-head ratio (o/e-LHR) and MRI-based relative fetal lung volume (rFLV) were evaluated and compared. Their prediction component with respect to clinical outcome was evaluated. Mean values were compared by two-sample t-tests or the Mann-Whitney U-test. The Chi-square or Fisher's exact test was used in order to compare qualitative parameters. Kappa coefficients, McNemar test, and Bowker's test were used to assess the degree of agreement.The study population included 183 fetuses with left-sided and 26 fetuses with right-sided CDH. Survival did not differ significantly (74.3% vs. 80.8%, p=0.053). For every imaging technique, incidences of extracorporeal membrane oxygenation (ECMO) and chronic lung disease decreased, and the probability of survival increased gradually reaching minima and maxima for o/e-LHR and rFLV above 35%. Outcome improved if rFLV was above 35% - compared to MRI-based measurement of o/e-LHR above 35%.Our data confirm the predictive value of o/e-LHR for CDH - irrespective of the diagnostic modality. MRI evaluation of o/e-LHR was not superior compared to sonography. MRI evaluation of rFLV correlated with morbidity and mortality which can be beneficial for fetuses with an otherwise good prognosis based on higher o/e-LHR as 2D imaging techniques can underestimate the fetuses' risk for pulmonary hypertension and ECMO.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617818","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}
Pedro Henrique Moraes, Maria Cristina Chammas, Felipe Brasileiro Vanderlei, Marcelo Violi Schelini, Carolina De Marqui Milani, Danielle Azevedo Chacon
{"title":"2D Shear Wave Elastography Increases Diagnostic Accuracy of the TIRADS-ACR and ATA Classification System in Thyroid Nodule Selection: Cyto- and Histological Correlation.","authors":"Pedro Henrique Moraes, Maria Cristina Chammas, Felipe Brasileiro Vanderlei, Marcelo Violi Schelini, Carolina De Marqui Milani, Danielle Azevedo Chacon","doi":"10.1055/a-2551-7774","DOIUrl":"https://doi.org/10.1055/a-2551-7774","url":null,"abstract":"<p><strong>Purpose: </strong>The aim was to evaluate whether elastography changes the accuracy of thyroid nodule malignancy risk classification by TI-RADS ACR and ATA systems.</p><p><strong>Materials and methods: </strong>This was a prospective study with 191 nodules (180 patients). Nodule assessments by B-mode ultrasonography (US) and two-dimensional shear wave elastography (2D-SWE) were compared with a) fine-needle aspiration biopsy cytological (Bethesda II) and post-resection histology results (Bethesda III to VI). Nodules were divided into benign and malignant. B-mode US evaluated: echogenicity, composition, dimensions, contours, limits, presence of halo and echogenic foci. Elastography classified nodules from I - completely softened to IV - completely hard; mean nodule deformation value (assessed in m/s and kPa); deformation ratio between nodule and thyroid parenchyma (TDR) and deformation ratio between nodule and prethyroid musculature (MDR).</p><p><strong>Results: </strong>Significant univariate parameters for B-mode: hypoechogenicity, halo, microcalcifications, irregular contours and ill-defined limits; for elastography, all parameters. MDR (in kPa) was the best elastographic parameter: nodules with MDRs> 1.53 exhibited a higher chance of malignancy (AUC-ROC=0.831). B-mode ACR-TIRADS performance had AUC: 0.678; 95% CI: 0.596-0.760 and ATA, AUC: 0.680; 95%: 0.597-0.763. Multivariable analysis indicated that combination of prognostic models with any elastographic parameter increased performance. ATA classification combined with elastogram pattern and MDR (in kPa), increased the AUC to 0.892; 95% IC: 0.845-0.939.</p><p><strong>Conclusion: </strong>2D-SWE can increase accuracy of the most widespread B-mode prognostic models - TI-RADS ACR and ATA.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568669","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}
Gábor Szabó, Attila Bokor, Veronika Fancsovits, Ezgi Darici Kurt, Theresa Hudelist, Gernot Hudelist
{"title":"Standardized measurement of the piriformis muscle and the proximal portion of the sacral nerve roots using transvaginal ultrasound.","authors":"Gábor Szabó, Attila Bokor, Veronika Fancsovits, Ezgi Darici Kurt, Theresa Hudelist, Gernot Hudelist","doi":"10.1055/a-2521-9321","DOIUrl":"10.1055/a-2521-9321","url":null,"abstract":"<p><p>To identify the sonomorphological appearance and to measure the thickness of the piriformis muscle (PM) and the proximal portion of the sacral nerve roots S1-S3 in healthy premenopausal women.This prospective multicentric observational study included a consecutive series of women undergoing transvaginal sonography (TVS) at 2 tertiary gynecological referral centers. Standardized assessment of the pelvic organs was performed, followed by an attempt to visualize the right and left PM and sacral nerve roots S1-S3 at their origin in proximity to the sacral neuroforamen. Visualization rates, diameters of the muscle and nerve thickness, and the time needed to identify the PM were recorded.305 patients were included in the study. In 293 women (96.1%), the PM was identified bilaterally. The median diameter of the PM was 18.3mm on the right side and 18.4mm on the left side. S1 nerve roots were successfully identified bilaterally in 224 (73.4%) patients. Their right and left median diameters were 4.8mm. Both S2 nerves were successfully identified in 215 (70.5%) patients. Their median diameter were 4.3mm on both sides. S3 nerve roots were successfully identified in 203 (66.6%) patients. Their median diameter were 3.2mm on both sides.We describe methods which allow consistent and rapid identification of the PM and the S1-S3 sacral nerve roots using TVS. Visualization of the PM and the proximal portion of the sacral plexus may be useful regarding identification of pathological changes in PM thickness and could help to distinguish perineural cysts from other gynecological pathologies.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014918","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}
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