Ultraschall in Der Medizin最新文献

{"title":"Clinical and ultrasound characteristics of uterine perivascular epithelioid cell tumors.","authors":"Stefano Ferla, Marisol Doglioli, Enrico Pazzaglia, Simona Palladino, Paolo Casadio, Biagio Paolini, Caterina Borso, Francesco Raspagliesi, Lucia De Meis, Renato Seracchioli, Valentina Chiappa, Diego Raimondo","doi":"10.1055/a-2898-6100","DOIUrl":"https://doi.org/10.1055/a-2898-6100","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the ultrasound characteristics of uterine perivascular epithelioid cell tumors (PEComas).</p><p><strong>Materials and methods: </strong>This retrospective multicenter case series included patients from two Italian academic centers specializing in oncological care. All women with histologically confirmed uterine PEComas between January 2013 and December 2024 and available clinical and ultrasound data were included. Ultrasound images were reviewed by three expert sonographers using Morphological Uterus Sonographic Assessment (MUSA) terminology.</p><p><strong>Results: </strong>Thirteen patients were identified, including 8 malignant and 5 benign PEComas. The median age was 54 years (IQR 46-65). Six patients (46%) were asymptomatic, five (38%) presented with abnormal uterine bleeding, one (8%) with pelvic pain, and one (8%) with abdominal bloating. Tumors originated from the cervix (38%), uterine corpus (46%), and isthmus (15%). On transvaginal ultrasound, most PEComas appeared as solitary, round, solid masses with regular margins (62%) and inhomogeneous echogenicity (69%), with a median diameter of 42 mm (IQR 23-66). Irregular cystic areas were observed in six cases (46%), while shadowing and hyperechoic islands were absent. Power Doppler assessment revealed moderate to rich vascularization (color score 3-4) in 9 cases (69%). Malignancy was suspected on initial ultrasound in only 4 cases (31%).</p><p><strong>Conclusion: </strong>Uterine PEComas commonly present as solitary, solid, round masses with regular margins, inhomogeneous echogenicity, and marked vascularization. Typical features such as shadowing or hyperechoic islands are absent. Despite these characteristics, malignancy is often underrecognized on initial ultrasound.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931630","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":"The Core Compendium of the European Society for Emergency Medicine Ultrasound Curriculum.","authors":"Effie Polyzogopoulou, Senad Tabakovic, Tim Harris, Rudolf Horn, Jim Connolly, Beatrice Hoffmann, Joseph Osterwalder","doi":"10.1055/a-2852-6050","DOIUrl":"10.1055/a-2852-6050","url":null,"abstract":"<p><strong>Abstract: </strong>The diversity of healthcare systems across Europe has predictably resulted in significant variations in point-of-care ultrasound (PoCUS) training and practice for emergency medicine (EM). To encourage a more synchronized approach and address these inconsistencies, the European Society for Emergency Medicine (EUSEM) chartered its Ultrasound Section to develop a comprehensive curriculum compendium that should serve as a foundational guide for European Emergency Medicine PoCUS clinical and educational guidelines and policies. Under the leadership of a dedicated task force, the EUSEM Ultrasound Section developed this compendium to provide a structured, tiered framework designed to meet the needs of physicians at every skill level, from novice to advanced users. The compendium emphasizes applications that are currently practiced in different and diverse emergency departments in Europe, including a broad range of topics. An important goal was allowing flexibility to accommodate the unique resources and challenges of different healthcare environments, so that EM physicians can achieve PoCUS competencies matching their local circumstances and needs. To achieve this goal, good educational and clinical stewardship throughout this process is a key part to the success of advancing PoCUS in European EM. This compendium is intended as a resource for creating standardized yet adaptable training pathways. It represents a major step toward harmonizing and advancing PoCUS practice in European EM.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388058","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":"Liebe Kolleginnen, liebe Kollegen, liebe Ultraschallbegeisterte.","authors":"Naglaa Mansour, Sabine Guth","doi":"10.1055/a-2735-2008","DOIUrl":"https://doi.org/10.1055/a-2735-2008","url":null,"abstract":"","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":"47 S 01","pages":"I"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931606","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":"Assessing focal liver lesions in Beckwith-Wiedemann Syndrome: Comparison of contrast-enhanced ultrasound and magnetic resonance imaging.","authors":"Laura May Davis, Aikaterini Ntoulia, Wondwossen T Lerebo, Jennifer M Kalish, Suzanne Macfarland, Rebecca Dennis, Lisa States, Kassa Darge, Susan J Back","doi":"10.1055/a-2890-9689","DOIUrl":"https://doi.org/10.1055/a-2890-9689","url":null,"abstract":"<p><strong>Purpose: </strong>Beckwith-Wiedemann Syndrome (BWS) predisposes children to hepatoblastoma and other cancers and requires tumor screening with abdominal ultrasound and magnetic resonance imaging (MRI) when lesions are seen. Contrast-enhanced ultrasound (CEUS) may offer an alternative to MRI, which often requires sedation. Our aim was to evaluate the diagnostic performance of CEUS compared to MRI in this group when evaluating liver lesions, to compare sedation requirements, and to assess imaging features correlated with malignancy.</p><p><strong>Materials and methods: </strong>This was a retrospective review of patients with molecular BWS and liver lesions who underwent MRI and CEUS within 6 months. Demographics, sedation requirement, and final diagnosis (pathology or follow-up imaging) were recorded. Two blinded radiologists per category classified lesions (benign/malignant/indeterminate) and detailed imaging features. Test performance and inter-rater reliability (Cohen's κ) were calculated.</p><p><strong>Results: </strong>12 patients (7 females, mean age 3 months) were included. A final diagnosis of 3 hepatoblastomas and 9 benign lesions was derived from pathology in 4 cases and from imaging follow-up in 8. Ten MRI examinations (83%) and no CEUS examinations required sedation. On consensus read, CEUS had a sensitivity of 67% and a specificity of 89%; κ = 0.70. MRI had a sensitivity of 75% and a specificity of 100%; κ = 0.25. Iso-enhancement and washout on CEUS and cystic change, necrosis, and diffusion restriction on MRI correlated with malignancy.</p><p><strong>Conclusion: </strong>Our findings suggest that CEUS has good diagnostic accuracy and high inter-rater reliability and allows sedation avoidance, suggesting that its use could allow MRI to be reserved for indeterminate or malignant lesions.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876429","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":"Prenatally diagnosed Ebstein's anomaly and tricuspid valve dysplasia: associated anomalies and predictors of outcome in a multicenter cohort study.","authors":"Aline Wolter, Lena Ritz, Jan Sebastian Wolter, Andrii Kurkevych, Josef Thul, Ivonne Bedei, Johanna Schenk, Josefine Theresia Königbauer, Alexander Weichert, Roland Axt-Fliedner","doi":"10.1055/a-2932-8445","DOIUrl":"https://doi.org/10.1055/a-2932-8445","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To describe associated anomalies and outcomes of prenatally diagnosed Ebstein's anomaly (EA)/tricuspid valve dysplasia (TVD) in a multicenter cohort and to identify predictors of adverse outcome (intrauterine or postnatal death).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;In this retrospective study, cardiothoracic ratio, aortic valve diameter (AVD), pulmonary and atrioventricular valve measurements, ventricular dimensions, vena contracta, chamber areas, Celemajer index, peak tricuspid regurgitation velocity (TR_max), and pulmonary flow direction between survivors and non-survivors were compared across three gestational intervals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 87 fetuses, 7 (8.0%) intrauterine deaths and 7 (8.0%) terminations occurred; 14 (16.1%) were lost to follow-up. Fifty-nine (67.8%) live births with follow-up were documented; 52 (88.1%) underwent active postnatal management, with a survival rate of 69.2% (36/52). Non-survivors more frequently had hydrops, earlier delivery, and lower birth weight. z-score AVD (zAVD) was lower and pulmonary flow more often retrograde in non-survivors before 32 weeks. TR_max was lower in interval 1 (&lt;24 weeks), and right atrial area and vena contracta were larger in interval 2 (24-32 weeks). No significant differences were observed after 32 weeks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This is one of the largest prenatal multicenter cohorts employing a longitudinal design, with echocardiographic data evaluation across three gestational intervals. Established predictors (pulmonary flow, TR_max) were confirmed and zAVD was identified as a simple, clinically applicable parameter, highlighting the relevance of left ventricular involvement in EA/TVD. Zusammenfassung: Ziel: Ziel dieser retrospektiven, multizentrischen Studie war es, assoziierte Anomalien und das Outcome bei pränatal diagnostizierter Ebstein-Anomalie /Trikuspidalklappendysplasie (EA/TVD) zu analysieren sowie Prädiktoren für ein ungünstiges Outcome (intrauteriner Fruchttod (IUFT), postnataler Tod) zu identifizieren.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material und methoden: &lt;/strong&gt;Retrospektiv wurden kardiothorakale Ratio, Aortenklappendurchmesser (AVD), pulmonale und atrioventrikuläre Klappen, Ventrikeldimensionen, Vena contracta, Vorhof-/Ventrikelflächen, Celemajer-Index, maximale Trikuspidalinsuffizienzgeschwindigkeit (TR_max) und Pulmonalflussrichtung zwischen Überlebenden und Nicht-Überlebenden in drei3 Gestationsintervallen verglichen. Ergebnisse: Von 87 Feten traten 7 (8,0%) IUFT auf, 7 (8,0%) Schwangerschaftsabbrüche erfolgten, 14 (16,1%) waren lost to follow-up. Insgesamt wurden 59/87 (67,8%) Lebendgeburten dokumentiert; 52 (88,1%) erhielten ein aktives postnatales Management mit einer Überlebensrate von 69,2% (36/52). Nicht-Überlebende zeigten häufiger Hydrops, frühere Entbindung und geringeres Geburtsgewicht. Der Z-Score des AVD (zAVD) war &lt;32 Wochen niedriger, der Pulmonalfluss häufiger retrograd. TR_max war &lt;24 Wochen nied","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800588","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":"Bedside trans-burr hole dynamic contrast-enhanced ultrasound (DCE-US) and ultrasound localization microscopy (ULM) in relapsed glioblastoma - a retrospective comparative case series.","authors":"Johannes Falter, Ernst Michael Jung, Henriette Grieshaber-Bouyer Mandelbaum, Felix Wachter, Johannes Gludowatz, Judith Anthofer, Janne Koskimäki, Ferdinand Knieling, Adrian Philip Regensburger, Martin Proescholdt, Nils Ole Schmidt","doi":"10.1055/a-2909-9981","DOIUrl":"10.1055/a-2909-9981","url":null,"abstract":"<p><strong>Purpose: </strong>Although contrast-enhanced ultrasound (CEUS) and dynamic CEUS (DCE-US) are well established in other oncologic entities, their use in neuro-oncology has been limited by the acoustic inaccessibility of the brain through the intact skull. This study investigates the feasibility of the use of DCE-US and ultrasound localization microscopy (ULM) in patients with glioblastoma multiforme (GBM), by utilizing the craniotomy burr hole as an acoustic window.</p><p><strong>Materials and methods: </strong>CEUS data from n=8 patients with newly diagnosed or relapsed GBM were retrospectively analyzed. All patients underwent CEUS via the craniotomy burr hole in the bedside setting, and perfusion analysis was conducted on stored cine loops. DCE-US parameters - time-to-peak (TTP), area under the curve (AUC), wash-in AUC, and washout AUC - were analyzed in three region-of-interest (ROI) zones: tumor center, margin, and adjacent normal brain. Next, ULM algorithms were applied to multiple frames to reconstruct the GBM tumor microvasculature.</p><p><strong>Results: </strong>Trans-burr hole imaging was feasible in all patients. Differences in TTP, AUC, washout AUC, and signal gradient were observed between the lesion center and both the margin and normal brain tissue, while the margin and the normal brain did not differ. Lesion-center AUC values were significantly higher in confirmed tumor recurrence (n=4) than in reactive gliosis (n=2). Recurrent tumors showed homogeneous, well-defined enhancement, whereas non-tumorous lesions appeared heterogeneous and ill-defined. ULM enabled quantification and visualization of directivity, velocity, and density maps corresponding to tumor anatomy and microbubble dynamics.</p><p><strong>Conclusion: </strong>DCE-US and ULM via the post-surgical burr hole offer a promising, noninvasive tool for perfusion assessment and relapse evaluation in GBM follow-up.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406653","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 Versus Contrast-Enhanced Computed Tomography in the Detection of Renal and Splenic Infarctions.","authors":"John Michael Hoppe, Sinan Deniz, Michael Czihal, Christian Lottspeich","doi":"10.1055/a-2908-8526","DOIUrl":"10.1055/a-2908-8526","url":null,"abstract":"<p><strong>Purpose: </strong>Intra-abdominal organ infarctions require prompt imaging for diagnosis. Contrast-enhanced computed tomography (CECT) is considered the gold standard but involves radiation, iodinated contrast, and logistical challenges in critically ill patients. Contrast-enhanced ultrasound (CEUS) enables real-time assessment of microvascular perfusion without ionizing radiation. The aim of this study was to evaluate the diagnostic performance of CEUS compared to CECT for detecting intra-abdominal organ infarctions.</p><p><strong>Materials and methods: </strong>This retrospective observational study included patients treated at a tertiary care center (2010-2024) who underwent both CEUS and CECT for suspected intra-abdominal organ infarction. With CECT as reference standard, diagnostic performance parameters and agreement (Cohen's kappa) were calculated.</p><p><strong>Results: </strong>24 patients (median age 60 years; 12 female) were included. CECT confirmed organ infarction in 16/24 patients (66.7%). CEUS correctly identified 15 of these cases (Sensitivity 93.8%; 95% confidence interval [CI]: 71.7-98.9%). Specificity was 75.0% (95% CI: 40.9-92.9%), with two false-positive CEUS findings. Positive and negative predictive values were 88.2% (95% CI: 65.7-96.7%) and 85.7% (95% CI: 48.7-97.4%), respectively. Agreement of CECT and CEUS was substantial (Cohen's κ = 0.71). Wedge-shaped perfusion defects were identified in 93.8% of CT-confirmed infarctions on both modalities.</p><p><strong>Conclusion: </strong>CEUS demonstrates high sensitivity and good agreement with CECT for the detection of intra-abdominal organ infarctions. CEUS represents a valuable imaging modality, particularly when CECT is contraindicated or not available. Prospective studies are warranted to further define its role in clinical practice.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425670","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":"Impact of Standardized Intraoperative Ultrasound on Re-excision Rates in Breast-Conserving Surgery.","authors":"Bettina Boeer, Felix Seltenreich, Birgitt Schönfisch, Selin Guergan, Ines Gruber, Jannik Kandzi, Mario Marx, Sara Y Brucker, Markus Hahn","doi":"10.1055/a-2908-7510","DOIUrl":"https://doi.org/10.1055/a-2908-7510","url":null,"abstract":"<p><strong>Introduction: </strong>The primary objective of breast-conserving surgery (BCS) is complete excision of the tumor with histologically negative margins (R0 resection). Intraoperative ultrasound (IOUS) has been shown to reduce re-excision rates (R1) for sonographically visible breast cancer. However, a standardized IOUS technique has not yet been established. This study aimed to evaluate whether standardization using the \"Tübingen Ultrasound Ruler\" can reduce R1 resection rates.</p><p><strong>Patients and methods: </strong>This retrospective study included 273 patients who underwent BCS between January 2020 and December 2023 for unilateral or bilateral ductal carcinoma in situ and/or invasive breast cancer, regardless of tumor biology, the presence of microcalcifications, or prior chemotherapy. All surgeries were performed by a single surgeon. Tumors were excised with a sonographically assessed margin of >10 mm in all directions. After specimen imaging, additional margin shavings were obtained when indicated.</p><p><strong>Results: </strong>A total of 282 specimens were analyzed, with a mean specimen weight of 110.5 g. Considering the main resection specimen alone, the R1 rate was 18.8%. Targeted IOUS-guided shavings significantly reduced the R1 rate to 8.5%. Compared with the mean R1 rate of the average figures of OnkoZert-certified breast centers reported between 2020 and 2023 (12.34%), the use of the \"Tübingen Ultrasound Ruler\" in combination with specimen imaging was associated with a significantly lower R1 rate (p = 0.043).</p><p><strong>Conclusion: </strong>Standardization of the IOUS technique combined with imaging-guided targeted shavings makes it possible to achieve a low R1 rate (8.5%) in breast-conserving surgery.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765953","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":"The Role of Google Gemini in the Interpretation of Ovarian Lesions.","authors":"Iason Psilopatis, Tibor A Zwimpfer, Viola Heinzelmann-Schwarz, Gwendolin Manegold-Brauer, Hubertina Reina","doi":"10.1055/a-2913-4208","DOIUrl":"https://doi.org/10.1055/a-2913-4208","url":null,"abstract":"<p><strong>Introduction: </strong>Multimodal large language models (LLMs) can process text and images to support diagnostic processes, yet their ability to apply standardized ovarian ultrasound classification systems remains unexplored. This study evaluates Google Gemini's performance with regard to interpreting ovarian ultrasound using the Ovarian-Adnexal Reporting and Data System (O-RADS) and International Ovarian Tumor Analysis (IOTA) criteria (IOTA simple rules) compared to expert evaluation.</p><p><strong>Methods: </strong>This retrospective study included 30 ultrasound examinations from the University Hospital of Basel: 10 normal ovaries, 10 benign lesions, and 10 malignant lesions. Each examination included B-mode and Doppler images. Google Gemini was prompted to assess normal ovarian images for pathology and apply the O-RADS categories and IOTA simple rules to pathologic cases. Two blinded experts independently evaluated responses using the Global Quality Score (GQS, 1-5 scale). The reference standard was histopathology for pathologic cases and expert assessment for normal ovaries.</p><p><strong>Results: </strong>Google Gemini achieved a mean GQS of 3 across all categories. The model mischaracterized 6/10 normal ovaries as pathologic. For benign lesions, 6/10 were incorrectly assigned to high-risk O-RADS categories (4-5) with frequent misidentification of malignant IOTA features. While 6/10 malignant cases were correctly identified (GQS 4-5), 3/10 were misclassified as benign (O-RADS 2, GQS 1). The remaining case of a mucinous borderline tumor was also misclassified by the LLM (O-RADS 3, GQS 1).</p><p><strong>Conclusion: </strong>Google Gemini seems to not be ready for independent clinical application in ovarian ultrasound interpretation. Critical inconsistencies including overdiagnosis and dangerous misclassification of malignancies indicate the need for specialized, domain-specific models with rigorous validation before clinical implementation.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765403","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":"Significance of high-resolution ultrasound imaging and elastography as early predictors of diabetic peripheral neuropathy.","authors":"Ahmed Elshimy, Ghada Elshimy, Ahmed Mohamed Abouelhoda, Ahmed Abdellatif Awad, Omar Farouk","doi":"10.1055/a-2589-8675","DOIUrl":"10.1055/a-2589-8675","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the significance of high-resolution ultrasound (HRUS) and shear wave elastography (SWE) in the diagnosis of diabetic peripheral neuropathy (DPN) to clarify their possible roles as early predictors of the occurrence of this important complication.</p><p><strong>Materials and methods: </strong>The study included 90 patients with diabetes mellitus with different clinical stages of DPN as well as 30 healthy controls. A full history, clinical examination, and assessment of both the Toronto Clinical Neuropathy Score (TCNS) and HbA_1c were performed, followed by real-time HRUS and SWE examinations of their right and left tibial and median nerves to assess their cross-sectional area (CSA) and nerve stiffness, respectively.</p><p><strong>Results: </strong>The CSA and stiffness of tibial and median nerves were significantly increased in patients with diabetes compared to controls, with higher values associated with the severity of their DPN. Both parameters were correlated with each other and with the duration of the disease, TCNS, and HbA_1c. The CSA cut-off value of both tibial and median nerves to detect DPN in patients was 13.5 mm², meanwhile, the SWE cut-off values were 68.5 and 61.5 KPa, respectively. SWE showed a higher AUC than CSA for the prediction of DPN.</p><p><strong>Conclusion: </strong>Measurement of the CSA and stiffness of the peripheral nerves could be a reliable tool for early detection of DPN. Therefore, we recommend adding these noninvasive diagnostic parameters as complementary diagnostic tools to the routine follow-up schedule of diabetic complications, especially in long-standing cases.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"407-416"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024417","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}