Ultraschall in Der Medizin最新文献

{"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":"https://doi.org/10.1055/a-2390-2010","url":null,"abstract":"<p><p>Purpose 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. Materials and methods 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. Results 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. Conclusion Even in a group of late-onset SGA/FGR situation, echocardiographic parameters are already altered in utero.   Zusammenfassung Ziel Die Messung fetaler kardiovaskulärer Funktionsparameter ist in der Pränataldiagnostik noch nicht etabliert. Nachdem das Forschungsgebiet der fetalen Programmierung einen immer höheren Stellenwert hat, könnte sich das bald ändern. Vor allem bei früher fetaler Wachstumsrestriktion (FGR) sind kardiovaskuläre Veränderungen beschrieben. Ziel dieser Studie war es dies bei Feten mit spät einsetzender FGR zu untersuchen. Material und Methode Eine prospektive Kohorte von Feten, die zu klein für das Gestationsalter (SGA) sind (einschließlich FGR) sowie eine Kontrollgruppe ähnlichen Gestionsalters wurden untersucht. Es wurden Parameter der systolischen, diastolischen sowie globalen Herzfunktion, der Morphometrie sowie Messungen der fetalen Aorta abdominalis erhoben. Ergebnisse Insgesamt wurden 149 SGA Feten sowie 143 Kontrollfeten ab 32 Schwangerschaftswochen eingeschlossen. Die Gesamt-SGA Gruppe wurde für eine Subgruppenanalyse weiterhin in eine SGA (SGA 3-10: Feten zwischen der 3. und 10. Gewichtsperzentile) sowie eine FGR Subgruppe unterteilt. In der Gesamt-SGA Gruppe zeigten sich im Vergleich zu den Kontrollen nach Adjustierung an das Gestationsalter die relative rechte sowie linke Ventrikelwanddicke, das linke E/A-Verhältnis, die isovolumetrische Kontraktionszeit und der linke myokardiale Performanceindex signifikant erhöht. MAPSE, TAPSE, die Ejektionszeit, das linke Herzzeitvolumen und die Beweglichkeit der Aorta abdominalis war","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-19","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":"Fallopian tube catheterization under 3D vaginal ultrasound guidance followed by highly selective hysterosalpingo-foam sonography: an outpatient procedure.","authors":"Yaakov Melcer, Marina Pekar-Zlotin, Michal Youngster, Itai Gat, Ron Maymon","doi":"10.1055/a-2384-4254","DOIUrl":"https://doi.org/10.1055/a-2384-4254","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the feasibility of our preliminary outpatient fallopian tube catheterization procedure under 3D vaginal ultrasound (US) guidance followed by highly selective hysterosalpingo-foam sonography (HyFoSy) in infertile women diagnosed with proximal tubal obstruction.</p><p><strong>Materials and methods: </strong>A prospective trial was conducted from October 2022 to December 2023. 3D vaginal US was used to establish the precise location of the tip of the selective salpingography catheter at the tubal ostium. A roadrunner was used to cannulate the occluded portion of the fallopian tube. After tubal cannulation, ExEm foam was injected under direct US guidance to confirm tubal recanalization and its passage through the fallopian tubes.</p><p><strong>Results: </strong>During the study period, a total of 14 women with proximal tubal occlusion underwent this procedure. Tubal patency was obtained in 92.8%. No immediate and remote complications were observed. To date three (21.4%) of the patients conceived after tubal catheterization and one had a live birth.</p><p><strong>Conclusion: </strong>Outpatient fallopian tube catheterization under 3D vaginal US guidance followed by selective HyFoSy can be successfully implemented for the diagnosis and treatment of patients with proximal tubal occlusion. The 3D modality enables volume capture of the required acquisitioning and the subsequent post imaging analysis permitting further examination and study. Additional experience is needed to consolidate the feasibility of this innovative procedure and identify the patient subgroups that would benefit the most from this approach.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972181","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":"Understanding confounding factors allows for accurate interpretation of liver stiffness measurements by ElastQ, a novel 2D shear wave elastography technique.","authors":"David Jm Bauer, Annalisa De Silvestri, Laura Maiocchi, Ambra Raimondi, Ruxandra Mare, Mattias Mandorfer, Ioan Sporea, Theresa Müllner-Bucsics, Giovanna Ferraioli, Thomas Reiberger","doi":"10.1055/a-2329-2801","DOIUrl":"https://doi.org/10.1055/a-2329-2801","url":null,"abstract":"<p><strong>Purpose: </strong>Liver stiffness measurement (LSM) using vibration-controlled transient elastography (VCTE) or two-dimensional shear wave elastography (2D-SWE) is recommended to assess the risk of liver fibrosis and advanced chronic liver disease. Even though both techniques measure liver stiffness, their numerical results often diverge. Confounders and reliability criteria for 2D-SWE have not been systematically investigated.</p><p><strong>Materials and methods: </strong>We prospectively recruited participants with paired LSM by VCTE and the novel 2D-SWE technique ElastQ (Philips) in three European tertiary centers. The following parameters were recorded: sex, age, body mass index (BMI), etiology, laboratory markers of liver damage and function, as well as cholestasis, LSM by VCTE and controlled attenuation parameter (CAP), interquartile range (IQR)/median for VCTE-LSM and ElastQ-LSM, and the skin-to-liver capsule distance.</p><p><strong>Results: </strong>We included 840 participants: 447 (53.2%) males; median age 57.0 [IQR:19.0] years; median BMI 25.4 [6.0] kg/m²; median VCTE-LSM 7.25 [9.2] kPa; median ElastQ-LSM 6.7 [5.4] kPa. On uni- and multivariable modeling (adjusted for LSM), we found that the discrepancy increased with liver stiffness and markers of disease severity. Skin-to-liver capsule distance and BMI affected VCTE-LSM more compared to ElastQ-LSM and significantly increased the discordance between the two measurements.</p><p><strong>Conclusion: </strong>The discrepancy of ElastQ-LSM to VCTE-LSM increases with liver stiffness and disease severity. BMI and skin-to-liver capsule distance increase the discrepancy between VCTE- and ElastQ-LSM but affect ElastQ-LSM less. The quality criterion IQR/median ≤ 30% indicates reliable ElastQ-LSM.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908161","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":"Technical assessment of resolution of handheld ultrasound devices and clinical implications.","authors":"Moritz Herzog, Maia Arsova, Katja Matthes, Julia Husman, David Toppe, Julian Kober, Tönnis Trittler, Daniel Swist, Edgar Manfred Gustav Dorausch, Antje Urbig, Gerhard Paul Fettweis, Franz Brinkmann, Nora Martens, Renate Schmelz, Nicole Kampfrath, Jochen Hampe","doi":"10.1055/a-2243-9767","DOIUrl":"10.1055/a-2243-9767","url":null,"abstract":"<p><strong>Purpose: </strong>Since handheld ultrasound devices are becoming increasingly ubiquitous, objective criteria to determine image quality are needed. We therefore conducted a comparison of objective quality measures and clinical performance.</p><p><strong>Material and methods: </strong>A comparison of handheld devices (Butterfly IQ+, Clarius HD, Clarius HD3, Philips Lumify, GE VScan Air) and workstations (GE Logiq E10, Toshiba Aplio 500) was performed using a phantom. As a comparison, clinical investigations were performed by two experienced ultrasonographers by measuring the resolution of anatomical structures in the liver, pancreas, and intestine in ten subjects.</p><p><strong>Results: </strong>Axial full width at half maximum resolution (FWHM) of 100µm phantom pins at depths between one and twelve cm ranged from 0.6-1.9mm without correlation to pin depth. Lateral FWHM resolution ranged from 1.3-8.7mm and was positively correlated with depth (r=0.6). Axial and lateral resolution differed between devices (p<0.001) with the lowest median lateral resolution observed in the E10 (5.4mm) and the lowest axial resolution (1.6mm) for the IQ+ device. Although devices showed no significant differences in most clinical applications, ultrasonographers were able to differentiate a median of two additional layers in the wall of the sigmoid colon and one additional structure in segmental portal fields (p<0.05) using cartwheel devices.</p><p><strong>Conclusion: </strong>While handheld devices showed superior or similar performance in the phantom and routine measurements, workstations still provided superior clinical imaging and resolution of anatomical substructures, indicating a lack of objective measurements to evaluate clinical ultrasound devices.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11293899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013483","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":"Contrast-enhanced ultrasonography for evaluating partial uterine necrosis after uterine artery embolization.","authors":"Rong Hu, Tian Tian, Yangmei Shen, Jingxin Wang, Fan Yang","doi":"10.1055/a-2254-7567","DOIUrl":"10.1055/a-2254-7567","url":null,"abstract":"","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139567577","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":"Simulation-based education in ultrasound - diagnostic and interventional abdominal focus.","authors":"Malene Roland Vils Pedersen, Mia Louise Østergaard, Leizl Joy Nayahangan, Kristina Rue Nielsen, Claudia Lucius, Christoph F Dietrich, Michael Bachmann Nielsen","doi":"10.1055/a-2277-8183","DOIUrl":"10.1055/a-2277-8183","url":null,"abstract":"<p><p>Simulation-based training (SBT) is increasingly acknowledged worldwide and has become a popular tool for ultrasound education. Ultrasound simulation involves the use of technology and software to create a virtual training setting. Simulation-based training allows healthcare professionals to learn, practice, and improve their ultrasound imaging skills in a safe learning-based environment. SBT can provide a realistic and focused learning experience that creates a deep and immersive understanding of the complexity of ultrasound, including enhancing knowledge and confidence in specific areas of interest. Abdominal ultrasound simulation is a tool to increase patient safety and can be a cost-efficient training method. In this paper, we provide an overview of various types of abdominal ultrasound simulators, and the benefits, and challenges of SBT. We also provide examples of how to develop SBT programs and learning strategies including mastery learning. In conclusion, the growing demand for medical imaging increases the need for healthcare professionals to start using ultrasound simulators in order to keep up with the rising standards.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186080","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":"Optimizing the number of valid measurements for the attenuation coefficient to assess hepatic steatosis in MAFLD patients: A study of 139 patients who underwent liver biopsy.","authors":"Xueqi Li, Xianjue Huang, Guangwen Cheng, Jing Liang, Luping Qiu, Jubo Zhang, Qiyuan Yao, Hong Ding","doi":"10.1055/a-2178-5022","DOIUrl":"10.1055/a-2178-5022","url":null,"abstract":"<p><strong>Purpose: </strong>We investigated the optimal number of valid measurements (VMs) for the attenuation coefficient (AC) to assess liver steatosis using attenuation imaging (ATI) and explored factors that may affect AC measurement in patients with metabolic dysfunction-associated fatty liver disease (MAFLD).</p><p><strong>Materials and methods: </strong>A total of 139 patients with MAFLD who underwent ATI and liver biopsy were enrolled. Hepatic steatosis was graded as S0-3 according to the SAF scoring system. The AC values from 1, 2, 3, 5, and 7 VMs were compared with the degree of liver steatosis. The correlation between AC values from different VMs was analyzed. The diagnostic performance of AC from different VMs at each steatosis grade was compared. The factors related to AC were identified using linear regression analysis.</p><p><strong>Results: </strong>The mean AC values from 1, 2, 3, 5, and 7 VMs were not significantly different between grades S0-3 (p=n.s. for all). Bland-Altman analysis showed the mean difference in AC values of 3 VMs and 7 VMs was 0.003 dB/cm/MHz, which was smaller compared with 2 VMs, and close to 5 VMs. The intraclass correlation coefficients of AC were all > 0.90 among different VM groups. AC values from different VMs all significantly predicted steatosis grade ≥S1, ≥S2, and S3 without significant statistical differences (p=n.s. for all). The multivariate analysis showed that the hepatic steatosis grade and triglyceride level were factors independently associated with AC.</p><p><strong>Conclusion: </strong>Three valid measurements of AC may be adequate to ensure the accuracy and reproducibility of hepatic steatosis assessment. The degree of liver steatosis and the triglyceride level significantly affected AC values.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11293898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812353","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":"Introducing Ultrasound to students - Is it useful or is it just \"fashion\"?","authors":"Alina Popescu, Ioan Sporea, Roxana Șirli","doi":"10.1055/a-2329-2521","DOIUrl":"https://doi.org/10.1055/a-2329-2521","url":null,"abstract":"","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876531","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":"Student ultrasound education - current views and controversies.","authors":"Christoph F Dietrich, Roxana Lucia Sirli, Gregor Barth, Michael Blaivas, Nils Daum, Yi Dong, Manfred Essig, Anna Maria Gschmack, Adrian Goudie, Tino Hofmann, Beatrice Hoffmann, Christian Jenssen, Michael Kallenbach, Thomas Karlas, Alexander Krutz, Axel Löwe, Claudia Lucius, Kathleen Möller, Ricarda Neubauer, Dieter Nurnberg, Michael Prats, Helmut Prosch, Florian Recker, Johannes P Ruppert, Sophie-Luise Sänger, Friederike Wangenheim, Johannes M Weimer, Susan Campbell Westerway, Constantinos Zervides","doi":"10.1055/a-2265-1070","DOIUrl":"10.1055/a-2265-1070","url":null,"abstract":"<p><p>As an extension of the clinical examination and as a diagnostic and problem-solving tool, ultrasound has become an established technique for clinicians. A prerequisite for high-quality clinical ultrasound practice is adequate student ultrasound training. In light of the considerable heterogeneity of ultrasound curricula in medical studies worldwide, this review presents basic principles of modern medical student ultrasound education and advocates for the establishment of an ultrasound core curriculum embedded both horizontally and vertically in medical studies.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132997","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":"Systematic, noninvasive endometriosis diagnosis in transvaginal sonography by the Swiss Society of Ultrasound in Medicine.","authors":"Julian Matthias Metzler, Leana Finger, Tilo Burkhardt, Markus Eugen Hodel, Gwendolin Manegold-Brauer, Sara Imboden, Janna Pape, Patrick Imesch, Isabell Witzel, Michael Bajka","doi":"10.1055/a-2241-5233","DOIUrl":"10.1055/a-2241-5233","url":null,"abstract":"<p><p>We present a new systematic, comprehensive, checklist-based sonographic assessment of endometriosis in the female true pelvis. Emphasis is placed on practical skills teaching. The newly introduced White Sliding Line (WSL) is the core structure. The WSL separates five compartments (anterior, central, posterior, and lateral right and left) containing dedicated endometriosis signs of mobility and morphology to be checked. This approach relies on the 2016 IDEA Consensus and further developments. It directly connects to the 2021 #ENZIAN Classification Standard. In practice, evaluation follows the proposed checklist in all compartments, judging first sliding mobility between organs and structures in a highly dynamic investigation. A rigorous search for deep endometriosis (DE) is then performed. We treat adhesions due to their great clinical importance and possible, reliable diagnosis by TVS as the fifth endometriosis unit, next to endometrioma, DE, adenomyosis, and superficial endometriosis. Including superficial (peritoneal) endometriosis is a future goal.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094539","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}