{"title":"Multiparametric ultrasound evaluation of thyroid nodules.","authors":"Vito Cantisani, Jörg Bojunga, Cosimo Durante, Vincenzo Dolcetti, Patrizia Pacini","doi":"10.1055/a-2329-2866","DOIUrl":"10.1055/a-2329-2866","url":null,"abstract":"<p><p>Thyroid nodules are common incidental findings. Most of them are benign, but many unnecessary fine-needle aspiration procedures, core biopsies, and even thyroidectomies or non-invasive treatments have been performed. To improve thyroid nodule characterization, the use of multiparametric ultrasound evaluation has been encouraged by most experts and several societies. In particular, US elastography for assessing tissue stiffness and CEUS for providing insight into vascularization contribute to improved characterization. Moreover, the application of AI, particularly machine learning and deep learning, enhances diagnostic accuracy. Furthermore, AI-based computer-aided diagnosis (CAD) systems, integrated into the diagnostic process, aid in risk stratification and minimize unnecessary interventions. Despite these advancements, challenges persist, including the need for standardized TIRADS, the role of US elastography in routine practice, and the integration of AI into clinical protocols. However, the integration of clinical information, laboratory information, and multiparametric ultrasound features remains crucial for minimizing unnecessary interventions and guiding appropriate treatments. In conclusion, ultrasound plays a pivotal role in thyroid nodule management. Open questions regarding TIRADS selection, consistent use of US elastography, and the role of AI-based techniques underscore the need for ongoing research. Nonetheless, a comprehensive approach combining clinical, laboratory, and ultrasound data is recommended to minimize unnecessary interventions and treatments.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"14-35"},"PeriodicalIF":3.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146676","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}
Theresa Lüdke, Alexander Paliege, Anne Kluge, Falk-Tony Olesch, Gregor Hilger, Thomas Beleites, Max Kemper
{"title":"Low-cost simulation model for ultrasound-guided punch biopsy and puncture: Construction manual and photo examples.","authors":"Theresa Lüdke, Alexander Paliege, Anne Kluge, Falk-Tony Olesch, Gregor Hilger, Thomas Beleites, Max Kemper","doi":"10.1055/a-2292-0530","DOIUrl":"10.1055/a-2292-0530","url":null,"abstract":"<p><strong>Purpose: </strong>Ultrasound-guided puncture and punch biopsy pose a particular challenge in ultrasound examination training. These techniques should be learned and performed several times using a simulation model that is as realistic as possible before being applied to patients. While the use of agar-agar-based models is extensively documented in the literature, there is a discernible gap in publications specifically addressing their use in punch biopsy and puncture. The aim was to develop a cost-effective model for the simulation of ultrasound-guided interventions.</p><p><strong>Materials and methods: </strong>The developed simulation model is based on the vegetable gelatine agar-agar. The agar-agar powder is boiled in water and colored. Various objects are added to the mass. Blueberries, olives, tomatoes, and cornichons imitate solid structures. Liquid-filled balloons are used to simulate cystic structures. Adding stones can make the exercises more difficult due to hyperechoic reflexes with distal shadowing.</p><p><strong>Results: </strong>With the model, ultrasound-guided puncture and punch biopsies could be successfully simulated, and ultrasound images can be generated for this purpose. The cost of a single model is about 2 euros. Production takes less than 2 hours, including cooling. The pure processing time is 30 minutes. The durability of the models is limited by mold, which occurs after 5 days when stored at room temperature and after 5 weeks in the refrigerator.</p><p><strong>Conclusion: </strong>It was shown that it is possible to produce an inexpensive agar-agar-based ultrasound model in a short time and with easily available ingredients to learn ultrasound-guided puncture and punch biopsies.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":"86-92"},"PeriodicalIF":3.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186079","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 reliability and validity of superb microvascular imaging as a potential disease activity marker in rheumatoid arthritis.","authors":"Esin Kurtulus Ozturk, Saffet Ozturk, Ayse Bahar Kelesoglu Dincer","doi":"10.1055/a-2463-8297","DOIUrl":"10.1055/a-2463-8297","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is a systemic autoimmune disease of unknown etiology that causes progressive and destructive inflammation in the joints. Superb microvascular imaging (SMI) is a new ultrasound technique that allows visualization of slow blood flow in synovitis. This study aimed to report on the clinical value and utility of the SMI technique and its grading for monitoring RA by determining the correlation with clinical disease activity scores (DAS 28) and power Doppler ultrasound (PDUS).All RA patients with clinically apparent synovitis were assessed using DAS 28. Synovitis was investigated with PDUS and SMI and each joint was graded semi-quantitatively. All assessments were carried out at baseline and repeated at least at the 4-month follow-up. Correlations between scores were investigated using Spearman's correlation.60 RA patients with 552 affected joints were recruited. Clinical and sonographic scores were significantly improved at follow-up (p<0.001). SMI showed significantly more joint count and flow signal scores than clinical examination and PDUS. Moderate correlations were found between the SMI score and clinical scores (p<0.001, 0.586 for SMI score vs. DAS 28-CRP, p=0.001, 0.432 for SMI vs. DAS 28-ESR). There were also stronger correlations between the SMI score and PDUS score at both baseline and follow-up (p<0.001, r = 0.817, 0.842 respectively).SMI provides greater utility and ability to detect synovial vascularity and to monitor disease activity than PDUS. A new activity scoring system based on SMI and clinical objective findings is required to improve reliability and validity.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607163","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":"Sonography of Salivary Gland Tumors and Disorders.","authors":"Felix Johnson, Alessandro Bozzato, Naglaa Mansour, Konstantinos Mantsopoulos, Georgios Psychogios, Pamela Zengel, Benedikt Hofauer","doi":"10.1055/a-2481-7248","DOIUrl":"https://doi.org/10.1055/a-2481-7248","url":null,"abstract":"<p><p>Diseases of the salivary glands are as common as they are diverse and can have different causes. Clinicians can differentiate salivary gland changes based on chronic systemic diseases, congenital and vascular malformations, and benign and malignant tumors. Acute infectious pathologies can also arise as a result of obstructive pathologies. A large number of diseases with similar clinical presentations have to be differentiated. Due to the improved resolution of ultrasound technology over the last 20 years, it is now used as the first imaging modality to examine salivary gland pathologies. It allows a quick, dynamic, and non-invasive examination of the salivary glands and the soft tissue of the neck. In order to accurately diagnose and treat patients, a very good knowledge of these diseases and their appearance on sonography is required.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014915","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":"Best Practice Guidelines - DEGUM Recommendations on Breast Ultrasound.","authors":"Claudia Maria Vogel-Minea, Werner Bader, Jens-Uwe Blohmer, Volker Duda, Christian Eichler, Eva Fallenberg, André Farrokh, Michael Golatta, Ines Gruber, Bernhard-Joachim Hackelöer, Jörg Heil, Helmut Madjar, Ellen Marzotko, Eberhard Merz, Alexander Mundinger, Markus Müller-Schimpfle, Ralf Ohlinger, Uwe Peisker, Ruediger Schulz-Wendtland, Fritz Kw Schäfer, Christine Solbach, Mathias Warm, Dirk Watermann, Sebastian Wojcinski, Markus Hahn","doi":"10.1055/a-2481-6610","DOIUrl":"10.1055/a-2481-6610","url":null,"abstract":"<p><p>Breast ultrasound has been established for many years as an important method in addition to mammography for clarifying breast findings. The goal of the Best Practice Guidelines Part III of the DEGUM breast ultrasound working group is to provide colleagues working in senology with information regarding the specific medical indications for breast ultrasound in addition to the current ultrasound criteria and assessment categories published in part I and the additional and optional sonographic diagnostic methods described in part II. The value of breast ultrasound for specific indications including follow-up, evaluation of breast implants, diagnostic workup of dense breast tissue, diagnostic workup during pregnancy and lactation, and the diagnostic workup of breast findings in men is discussed. Each section after the general information section contains a description of specific pathologies followed by a short summary and DEGUM recommendations for the particular indications. The latest S3 guidelines and AGO guidelines were taken into consideration.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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":"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-2487-5111","DOIUrl":"10.1055/a-2487-5111","url":null,"abstract":"<p><p>Breast ultrasound has been established for many years as an important method in addition to mammography for clarifying breast findings. The goal of the Best Practice Guidelines Part III of the DEGUM breast ultrasound working group is to provide colleagues working in senology with information regarding the specific medical indications for breast ultrasound in addition to the current ultrasound criteria and assessment categories published in part I and the additional and optional sonographic diagnostic methods described in part II. The value of breast ultrasound for specific indications including follow-up, evaluation of breast implants, diagnostic workup of dense breast tissue, diagnostic workup during pregnancy and lactation, and the diagnostic workup of breast findings in men is discussed. Each section after the general information section contains a description of specific pathologies, followed by a short summary and DEGUM recommendations for the particular indications. The latest S3 guidelines and AGO guidelines were taken into consideration.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985238","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}
Marie Brandt, Martin Garset-Zamani, Alessandro Bozzato, Johannes M Weimer, Christoph Arens, Christoph F Dietrich, Tobias Todsen, Julian Künzel
{"title":"Endosonography in head and neck imaging and surgery.","authors":"Marie Brandt, Martin Garset-Zamani, Alessandro Bozzato, Johannes M Weimer, Christoph Arens, Christoph F Dietrich, Tobias Todsen, Julian Künzel","doi":"10.1055/a-2451-9373","DOIUrl":"10.1055/a-2451-9373","url":null,"abstract":"<p><p>This CME article explores the evolving role of endosonography in otorhinolaryngology and head and neck surgery. Endosonography offers significant potential to improve imaging inside the upper respiratory tract, particularly with advancements in probe technology and imaging resolution. The article will describe the sonoanatomy of the oral cavity, pharynx, and larynx and the selection of probes and scanning techniques used for the various anatomical sites. Transoral ultrasound can be used to improve the diagnosis of salivary gland diseases, oropharyngeal abscesses, and ultrasound-guided puncture and biopsy. Endoscopic endolaryngeal ultrasound is used especially for diagnosing small laryngeal cancer and determining infiltration status. The article highlights the role of endosonography in managing oncologic diseases, especially in oral tongue carcinoma, where it aids in surgical planning by assessing the depth of invasion. In cases of HPV-positive carcinoma of unknown primary, high-frequency endosonography is crucial for detecting small tumors in the oropharyngeal region. In summary, the article advocates the broader integration of endosonography in clinical practice, highlighting its potential to enhance diagnostic accuracy and improve patient outcomes in head and neck oncology.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873098","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}
JunYa Chen, Rong Zhu, Hong Pan, YiNan Ma, Ying Zhu, LiLi Liu, XinLin Hou, Karina Krajden Haratz
{"title":"Relationship between prenatal ultrasound signs and genetic abnormalities for fetal malformations of cortical development.","authors":"JunYa Chen, Rong Zhu, Hong Pan, YiNan Ma, Ying Zhu, LiLi Liu, XinLin Hou, Karina Krajden Haratz","doi":"10.1055/a-2467-3362","DOIUrl":"10.1055/a-2467-3362","url":null,"abstract":"<p><p>To explore the relationship between ultrasound signs of suspected fetal malformation of cortical development (MCD) and genetic MCD.The retrospective study involved fetuses with one of the following 10 neurosonography (NSG) signs: (A) abnormal development of the Sylvian fissure; (B) delayed achievement of cortical milestones; (C) premature or aberrant appearance of sulcation; (D) irregular border of the ventricular wall or irregular shape of the ventricle; (E) abnormal shape or orientation of the sulci; (F) hemispheric asymmetry; (G) non-continuous cerebral cortex; (H) intraparenchymal echogenic nodules; (I) persistent ganglionic eminence (GE) or GE cavitation; (J) abnormal cortical lamination.95 fetuses were included in the study. Chromosomal microarray (CMA) combined with exome sequencing (ES) was available in 40 fetuses, CMA was abnormal in nine and ES in 22. Sign C (7/7, 100%), sign H (2/2, 100%), sign A (18/19, 94.7%), and sign B (12/13, 92.3%) were the signs leading to the highest probability of genetic MCD. The incidence of genetic MCD for sign E, sign I, and sign D was 66.7-73.7%. Only one or none of the fetuses with sign J, sign F, or sign G underwent CMA+ES. The signs in the fetuses with FGFR3, CCND2, FLNA, or TSC2 mutations had the expected features. The other fetuses with different gene mutations showed several non-specific NSG signs.Several reliable signs for genetic MCD can be detected by NSG, and the probability varies with different signs. Most signs are not associated with a specific gene. Therefore, CMA combined with ES is preferred.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866059","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}
Yaakov Melcer, Marina Pekar-Zlotin, Michal Youngster, Itai Gat, Ron Maymon
{"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":"10.1055/a-2384-4254","url":null,"abstract":"<p><p>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.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.During the study period, a total of 14 women with proximal tubal occlusion underwent this procedure. Tubal patency was achieved in 92.8% of cases. No immediate and remote complications were observed. To date, 3 (21.4%) of the patients conceived after tubal catheterization and 1 had a live birth.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 allows volume capture of the required acquisition and subsequent post-imaging analysis, thus permitting further examination and study. Additional experience is needed to determine the feasibility of this innovative procedure and to identify the patient subgroups that would benefit the most from this approach.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","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":"Ultrasonography can be more informative than computed tomography for diagnosing radial head fractures: An illustrative case series.","authors":"Eckehart Schöll, Marcel Jakob, Werner Vach","doi":"10.1055/a-2445-3611","DOIUrl":"10.1055/a-2445-3611","url":null,"abstract":"<p><p>Ultrasonography is increasingly being discussed as an alternative to X-rays in emergency department settings. Systematic comparisons of the 2 modalities are often based on the use of computed tomography as a reference. When diagnosing patients with elbow trauma, the physicians at our emergency department experienced that ultrasonography can be more informative than cone beam computed tomography for identifying radial head fractures. Our goal is to share this experience with the scientific community.All patients diagnosed with a radial head fracture in our emergency department between January 2021 and November 2022 were identified. The images of 18 cases in which both point-of-care ultrasonography and cone beam computed tomography had been used were reviewed by us. Eight examples were selected illustrating the variation in coincidence or discrepancy between ultrasonography and computed tomography.The 8 examples illustrate that ultrasonography can be more informative than cone beam computed tomography or vice versa.The joint application of ultrasonography and computed tomography is advisable if a correct diagnosis of the extent and components of radial head fractures is of uttermost importance.</p>","PeriodicalId":49400,"journal":{"name":"Ultraschall in Der Medizin","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478962","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}