Ultraschall in Der Medizin最新文献

{"title":"Imaging the fetal aortic arch and its branching pattern in a midtrimester screening population.","authors":"Manuela Tavares de Sousa, Bettina Hergert, Fatima Crispi, Olga Gomez, Kurt Hecher","doi":"10.1055/a-2548-2411","DOIUrl":"https://doi.org/10.1055/a-2548-2411","url":null,"abstract":"<p><p>Purpose Variants of the aortic arch branching have recently been found to have an impact for neonates undergoing surgical interventions of the thoracic aorta such as repair of aortic coarctation. They have been described prenatally in 6%, whereas they occur in up to 26% postnatally. To explore whether the branching variations might have been under-diagnosed in utero, we comprehensively assessed the aortic arch and its branching patterns in a low-risk population between 19 and 22 weeks of gestation. Material and Methods This prospective cohort study included 139 low-risk singleton pregnancies. During a standardized fetal echocardiography we investigated the aortic arch in a sagittal view according to predefined landmarks. Based on video clips, its branching pattern was categorized in normal branching or branching variants by two operators who were blinded to each other. Results Classification of the aortic arch branching was achieved in 127/139 (91.4%) cases. 103 cases (81.1%) showed a normal pattern and 24 cases (18.9%) a branching variant. Both operators agreed on 18 brachiobicephalic trunks \"(THE SO CALLED BOVINE ARCH)\": , 4 aberrant left vertebral arteries, one aortic arch with five branching vessels and in one case there was disagreement on the type of the variant. Conclusion Prenatal targeted echocardiography could identify a 18.9% prevalence of aortic arch branching variants in a low-risk population. Future studies are warranted to assess the clinical impact of our findings on neonates with congenital heart defects.</p><p><strong>Hintergrund: </strong>Gefäßvarianten der thorakalen Aortenabgänge wurden als Risikofaktoren für Neugeborene identifiziert, die eine Intervention der Aorta, zum Beispiel bei Aortenisthmusstenose, vor sich haben. Pränatal wurde die Häufigkeit mit bis zu 6% beschrieben, während sie postnatal in bis zu 26% gefunden wurden. Um zu untersuchen, ob die Varianten bisher in utero unterdiagnostiziert wurden, untersuchten wir den Aortenbogen und die Abgänge in einer Niedrigrisikogruppe zwischen 19 und 22 Schwangerschaftswochen.</p><p><strong>Material und methoden: </strong>Diese prospektive Kohortenstudie umfasste 139 Einlingsschwangerschaften mit niedrigem Risiko. Während einer standardisierten fetalen Echokardiografie untersuchten wir den Aortenbogen in sagittaler Ebene. Anhand von Videoclips wurden die Abgänge des Aorta von zwei Untersuchenden, die zueinander verblindet waren, entweder als normales Abgangsmuster oder als Variante klassifiziert.</p><p><strong>Ergebnisse: </strong>Die Klassifizierung des Abgänge der fetalen Aorta gelang in 127/139 (91,4 %) der Fälle. In 103 Fällen (81,1 %) wurde ein normales Abgangsmuster beobachtet, während in 24 Fällen (18,9 %) eine Variante vorlag. In 18 Fällen wurde ein Truncus brachiocephalicus (SOGENANNTER BOVINER AORTENBOGEN),: in 4 Fällen eine aberrante linke Vertebralarterie und in einem Fall ein Aortenbogen mit fünf abgehenden Gefäßen gefunden. In einem Fall waren die Untersuc","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524891","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":"Reliability of a Standardized Ultrasound Protocol for the Diagnosis of Thoracic Outlet Syndrome.","authors":"Emilia Stegemann, Jana Larbig, Irene Portig, Nadine Weiske, Thomas Bürger, Berthold Stegemann","doi":"10.1055/a-2532-4823","DOIUrl":"https://doi.org/10.1055/a-2532-4823","url":null,"abstract":"<p><p>Arterial thoracic outlet syndrome (aTOS) is a rare condition, but if undiagnosed, it can have serious consequences for affected patients, up to and including limb loss. Ultrasound could be used here as a widely available method for screening, but it is said to have very high investigator dependence. The fact that ultrasound can be used safely for diagnostic purposes has already been demonstrated. The aim of this study was to evaluate the repeatability of a standardized examination for the diagnosis of aTOS.We recruited inpatients with high-grade suspected arterial thoracic outlet syndrome who were evaluated for invasive therapy at our TOS center. Routine diagnostics were performed according to clinic standards. In addition, 2 sonographers, one highly experienced and one less experienced, performed ultrasound diagnosis according to a standardized protocol. Image acquisition and interpretation were performed independently, and sonographers were mutually blinded. For analysis, the experienced sonographer served as a reference. Agreement between assessors was analyzed using concordance analysis.51 consecutive patients (67% female) aged 39.3±13.0 years were included within 11 months. The standardized ultrasound protocol could be performed in all patients. The prevalence of TOS was high (79.4%; CI: 71.4-87.3%) in our cohort. Ultrasound inter-rater agreement using the standardized protocol was very good at 0.820 (CI: 0.624-1.000).Ultrasound diagnosis of TOS using a standardized protocol can be performed effectively and shows a high agreement between 2 sonographers.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494504","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":"Reply to Letter to the editor: 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-2479-7946","DOIUrl":"https://doi.org/10.1055/a-2479-7946","url":null,"abstract":"","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400244","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":"Performance of ultra-high-frequency ultrasound in the evaluation of skin atrophy in patients with long-term oral glucocorticoid therapy in a tertiary rheumatology center.","authors":"Timo Turowski, Martin Fleck, Boris Ehrenstein, Wolfgang Hartung, Florian Günther","doi":"10.1055/a-2479-8829","DOIUrl":"https://doi.org/10.1055/a-2479-8829","url":null,"abstract":"<p><p>Ultra-high-frequency ultrasound (UHF-US) allows visualization of the epidermis, dermis, and subcutis and precise measurement of skin thickness. The aim of this study was to assess the performance and interobserver reliability of UHF-US for measuring skin thickness in patients with long-term systemic glucocorticoid (GC) therapy compared to patients without GC therapy or treated for a shorter period.156 patients with known or suspected inflammatory rheumatic diseases underwent US evaluation for skin thickness by 3 experts in 3 anatomical sites (hand, distal, and proximal forearm). 87 patients were classified as \"frequent users\" who had received continuous oral GCs for at least one year or at least 3 years with various interruptions. 69 patients without any oral GC therapy in the past or treated for a shorter period were classified as \"non-frequent users\".UHF-US allowed a precise measurement of skin thickness. Skin thickness at all 3 anatomical sites was significantly decreased in \"frequent users\" of GCs compared to \"non-frequent users\" (distal and proximal forearm: p < 0.001; hand: p < 0.05). At all 3 anatomical sites, skin thickness was decreased in patients with clinically assessed parchment-like skin compared to patients without parchment-like skin (distal and proximal forearm: p < 0.001; hand: p < 0.05). Interobserver variability was excellent [hand intraclass correlation coefficient (ICC) = 0.99; proximal forearm ICC = 0.85; distal forearm ICC = 0.84].These data support the idea of UHF-US as an objective and reliable imaging tool for monitoring skin atrophy as adverse effects of GC therapy.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256935","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":"https://doi.org/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":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MPUS is a big step forward for small organs.","authors":"V Cantisani, C F Dietrich, C Jenssen, M Bertolotto, B Brkljačić, A De Silvestri, V Scotti","doi":"10.1055/a-2464-5428","DOIUrl":"https://doi.org/10.1055/a-2464-5428","url":null,"abstract":"","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":"46 1","pages":"8-13"},"PeriodicalIF":3.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256941","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":"Intraoperative contrast-enhanced ultrasound has an outcome-relevant impact on surgery of primary and metastatic liver lesions.","authors":"Florian Bitterer, Andreas Bauer, Gunther Glehr, Stefan Brunner, Katharina Schmidt, Hans Jürgen Schlitt, Ernst Michael Jung, Christina Hackl","doi":"10.1055/a-2249-6791","DOIUrl":"10.1055/a-2249-6791","url":null,"abstract":"<p><strong>Purpose: </strong>Complete resection of the affected tissue remains the best curative treatment option for liver-derived tumors and colorectal liver metastases. In addition to preoperative cross-sectional imaging, contrast-enhanced intraoperative ultrasound (CE-IOUS) plays a crucial role in the detection and localization of all liver lesions. However, its exact role is unclear. This study was designed to evaluate the clinical and oncological impact of using CE-IOUS in the surgical treatment of these diseases.</p><p><strong>Materials and methods: </strong>Over the three-year study period, 206 patients with primary liver tumors and hepatic metastases were enrolled in this prospective, monocentric study to evaluate the impact of CE-IOUS in liver surgery. Secondary outcomes included comparing the sensitivity and specificity of CE-IOUS with existing preoperative imaging modalities and identifying preoperative parameters that could predict a strategic impact of CE-IOUS. In addition, the oncological significance of CE-IOUS was evaluated using a case-cohort design with a minimum follow-up of 18 months.</p><p><strong>Results: </strong>CE-IOUS findings led to a change in surgical strategy in 34% of cases (n=70/206). The accuracy in cases with a major change could be confirmed histopathologically in 71.4% of cases (n=25/35). The impact could not be predicted using parameters assumed to be clinically relevant. An oncological benefit of a CE-IOUS adapted surgical approach was demonstrated in patients suffering from HCC and colorectal liver metastases.</p><p><strong>Conclusion: </strong>CE-IOUS may significantly increase R0 resection rates and should therefore be used routinely as an additional staging method, especially in complex liver surgery.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"49-56"},"PeriodicalIF":3.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139713263","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":"Prenatal detection of mild fetal ventriculomegaly - a systematic review of the modern literature.","authors":"Ioakeim Sapantzoglou, Georgios Asimakopoulos, Zacharias Fasoulakis, Konstantinos Tasias, Georgios Daskalakis, Panagiotis Antsaklis","doi":"10.1055/a-2375-0118","DOIUrl":"10.1055/a-2375-0118","url":null,"abstract":"<p><strong>Introduction: </strong>While mild fetal ventriculomegaly is frequently observed as an incidental and benign finding, it is also known to be linked with structural, genetic, and neurodevelopmental abnormalities. The objective of this study was to conduct a systematic review of the existing literature in order to evaluate the association between apparently isolated fetal mild ventriculomegaly with the presence of additional structural defects detected by fetal brain MRI, chromosomal or other genetic anomalies, and neurodevelopmental delay.</p><p><strong>Methods: </strong>This systematic review was designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Modern literature was searched from January 1, 2011, to July 31, 2023.</p><p><strong>Results: </strong>23 studies were included, comprising a total of 2590 patients. Nine studies assessed the association between fetal mild ventriculomegaly and neurodevelopmental impairment, including 536 cases, with normal neurodevelopmental outcomes ranging from 64% to 96.5%. Ten studies evaluated the additive value of fetal MRI, including 1266 fetuses, with the detection rate of additional brain defects that eventually altered the clinical management ranging from 0% to 19.5%. Seven studies investigated the association of mild ventriculomegaly with the presence of underlying chromosomal or genetic conditions, including 747 cases, with the rate ranging from 1.1% to 15.4%.</p><p><strong>Conclusion: </strong>The prevalence of aneuploidy and genetic abnormalities in ventriculomegaly, especially in isolated cases, is reported to be quite low and the incidence of neurodevelopmental delay appears to be similar to that of the general population in cases that are apparently and truly isolated.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"73-85"},"PeriodicalIF":3.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114061","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":"Firsttrimester Diagnosis and Therapy @ 11-13+6 Weeks of Gestation - Part 1.","authors":"Constantin von Kaisenberg, Peter Kozlowski, Karl-Oliver Kagan, Markus Hoopmann, Kai-Sven Heling, Rabih Chaoui, Philipp Klaritsch, Barbara Pertl, Tilo Burkhardt, Sevgi Tercanli, Jochen Frenzel, Christine Mundlos","doi":"10.1055/a-2280-4756","DOIUrl":"10.1055/a-2280-4756","url":null,"abstract":"<p><p>This extensive AWMF 085-002 S2e-guideline \"First Trimester Diagnosis and Therapy @ 11-13⁺⁶ Weeks of Gestation\" has systematically analyzed high-quality studies and publications and the existing evidence (evidence tables) and produced recommendations (level of recommendation, level of evidence, strength of consensus).This guideline deals with the following topics in the context of the 11-13⁺⁶ weeks scan: the legal basis, screening for anatomical malformations, screening for chromosomal defects, quality assessment and audit, screening for preeclampsia and FGR, screening for preterm birth, screening for abnormally invasive placenta (AIP) and placenta accreta spectrum (PAS), screening for velamentous cord insertion and vasa praevia, screening for diabetes mellitus and LGA.Screening for complications of pregnancy can best be carried out @ 11-13+6 weeks of gestation. The issues of how to identify malformations, chromosomal abnormalities and certain disorders of placentation (high blood pressure and proteinuria, intrauterine growth retardation) have been solved. The problem of how to identify placenta percreta and vasa previa has been partially solved. What is still unsolved is how to identify disorders of glucose metabolism and preterm birth.In the first trimester, solutions to some of these problems are available: parents can be given extensive counselling and the risk that a pregnancy complication will manifest at a later stage can be delayed and reduced. This means that screening is critically important as it helps in decision-making about the best way to manage pregnancy complications (prevention and intervals between follow-up examinations).If no treatment is available and if a termination of pregnancy is considered, the intervention can be carried out with far lower complications compared to the second trimester of pregnancy. In most cases, further examinations are not required and the parents can be reassured. A repeat examination at around week 20 of gestation to complete the screening for malformations is recommended. NOTE:: The guideline will be published simultaneously in the official journals of both professional societies (i.e. Ultraschall in der Medizin/European Journal of Ultrasound for the DEGUM and Geburtshilfe und Frauenheilkunde for the DGGG).</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"36-48"},"PeriodicalIF":3.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367183","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":"Thank you very much!","authors":"","doi":"10.1055/a-2513-7158","DOIUrl":"https://doi.org/10.1055/a-2513-7158","url":null,"abstract":"","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":"46 1","pages":"93-94"},"PeriodicalIF":3.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257114","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}