Journal of Ultrasound最新文献

{"title":"Optimizing the diagnosis of idiopathic granulomatous mastitis with shear wave elastography: insights from Young's modulus.","authors":"Sepideh Sefidbakht, Azadeh Hajati, Fariba Zarei, Fatemeh Kanaani Nejad, Vahid Zangouri, Sedigheh Tahmasebi, Parisa Pishdad, Lobat Ataei Rooyani, Bijan Bijan","doi":"10.1007/s40477-025-01079-8","DOIUrl":"https://doi.org/10.1007/s40477-025-01079-8","url":null,"abstract":"<p><strong>Purpose: </strong>Idiopathic granulomatous mastitis (IGM) is a granulomatous condition with non-specific manifestations and a challenging diagnosis. This study aims to describe the appearance of biopsy-proven IGM lesions utilizing shear wave elastography (SWE) Young's modulus.</p><p><strong>Methods: </strong>We performed a retrospective search for pretreatment ultrasounds of IGM referred to two tertiary breast clinics over five years. Patients with at least one pre-treatment ultrasound and pathologically-proven IGM entered the study. Ultrasound and SWE were performed and interpreted by a breast imaging fellowship-trained radiologist. The data were analyzed using SPSS software.</p><p><strong>Results: </strong>Among 201 pretreatment ultrasound, non-mass lesions (76%) and intercommunicating channels (52%) were the most common findings. All the patients had BIRADS of 4. The BIRADS of 4a was the most common (75%). Among 138 SWE, dark blue was the most common color in the center and periphery, with 80% and 76%, respectively. The mean stiffness (kPa) of the center was significantly higher than that of the peripheral parts in IGM lesions (P < 0.001). None of the IGM lesions were hard enough to prevent sound waves from effective propagation.</p><p><strong>Conclusion: </strong>Although IGM mostly presents in non-specific grayscale ultrasound patterns, SWE findings can provide more specificity to imaging findings and probably can help to reach an accurate diagnosis.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonographic features and clinical management of IgG4-related submandibular gland inflammation: a case report.","authors":"Wenhui Zhang, Nan Pang, Xu Wang, Peng Fang, Youjun Wang, Ruixue Lu","doi":"10.1007/s40477-025-01087-8","DOIUrl":"https://doi.org/10.1007/s40477-025-01087-8","url":null,"abstract":"<p><p>IgG4-related submandibular gland inflammation (IgG4-RSGI) is an immunologically mediated condition characterized by chronic fibroinflammatory lesions and elevated serum IgG4 levels. It often lacks specific clinical and imaging features, leading to misdiagnosis.We present a case of IgG4-RSGI to enhance clinical recognition and diagnostic accuracy. A patient presented with a four-month history of progressive bilateral submandibular gland enlargement. Ultrasonography revealed bilateral submandibular gland enlargement with heterogeneous internal echoes, a \"mesh-like\" pattern, and nodular hypoechoic areas. Color Doppler flow imaging (CDFI) showed increased vascularity. Ultrasound-guided biopsy confirmed the diagnosis, establishing ultrasound as a valuable initial diagnostic tool in the clinical assessment of IgG4-RSGI.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"POCUS for acute abdominal pain: practical scan protocols on gastrointestinal diseases and an evidence review.","authors":"Andrea Boccatonda, Alice Brighenti, Valeria Tiraferri, Marisol Doglioli, Luca Iazzetta, Lucia De Meis, Ehsan Safai Zadeh, Christoph Frank Dietrich, Carla Serra","doi":"10.1007/s40477-025-01088-7","DOIUrl":"https://doi.org/10.1007/s40477-025-01088-7","url":null,"abstract":"<p><p>Acute abdominal pain is a frequent emergency department presentation requiring prompt and accurate diagnosis to guide timely management. Ultrasound imaging plays a critical role in the differential diagnosis of this symptom, offering several advantages including wide availability, cost-effectiveness, and real-time assessment without ionizing radiation. Color and spectral Doppler further enhance diagnostic accuracy by allowing the assessment of blood flow and vascular patterns, which is crucial for identifying ischemic processes. Additionally, ultrasound can help distinguish between gynecological and non-gynecological conditions, such as appendicitis, urinary tract pathologies, or gastrointestinal abnormalities, thereby guiding more targeted investigative pathways or treatment modalities. The rapid, bedside application of ultrasound is especially valuable in unstable patients, ensuring expedited triage and intervention. In certain cases, a negative or inconclusive ultrasound may necessitate further imaging with computed tomography or magnetic resonance imaging. However, ultrasound remains the first-line modality, particularly in pregnant women, to minimize radiation exposure. By integrating ultrasound findings with clinical data and laboratory results, clinicians can establish a precise diagnosis, avoid unnecessary procedures, and initiate timely therapeutic interventions, ultimately improving patient outcomes.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic utility of the ultrasound sliding sign in predicting intra-abdominal adhesions in repeat caesarean delivery: a prospective study.","authors":"Keerthana Sugananthan, R Sajeetha Kumari, Sundara Raja Perumal, Anuradha Murugesan","doi":"10.1007/s40477-025-01078-9","DOIUrl":"https://doi.org/10.1007/s40477-025-01078-9","url":null,"abstract":"<p><strong>Background: </strong>Intra-abdominal adhesions following caesarean sections pose significant challenges during repeat surgeries, leading to increased maternal morbidity. A reliable, non-invasive preoperative diagnostic tool such as the ultrasound (USG) sliding sign may help predict adhesions and improve surgical preparedness.</p><p><strong>Objectives: </strong>To evaluate the diagnostic accuracy of the ultrasound sliding sign in predicting intra-abdominal adhesions in women undergoing repeat lower segment caesarean section (LSCS), and to correlate sonographic findings with intraoperative adhesion severity.</p><p><strong>Methods: </strong>This prospective observational study was conducted on 250 pregnant women with a history of one or more previous LSCS. All participants underwent preoperative transabdominal ultrasound to assess the presence or absence of the sliding sign. Adhesion severity was classified intraoperatively using the Nair classification. Associations between adhesion severity and clinical variables such as age, BMI, number of previous LSCS, and gestational age were analysed using chi-square and ANOVA tests.</p><p><strong>Results: </strong>A significant association was observed between the absence of the USG sliding sign and the presence of moderate to severe adhesions (p < 0.001). The sliding sign demonstrated a sensitivity of 72.88%, specificity of 85.86%, positive predictive value of 61.43%, and negative predictive value of 91.11% and an overall accuracy of 82.8%. The receiver operating characteristic (ROC) curve analysis showed an area under the curve (AUC) of 0.96, indicating excellent diagnostic accuracy. Mean intraoperative blood loss and time from skin incision to delivery significantly increased with higher adhesion grades (p < 0.001). A statistically significant correlation was also noted between the number of previous LSCS and adhesion severity (p = 0.022), whereas age, BMI, gestational age, and place of previous delivery were not significantly associated.</p><p><strong>Conclusion: </strong>The ultrasound sliding sign is a simple, non-invasive, and effective tool for the preoperative prediction of intra-abdominal adhesions in women undergoing repeat caesarean sections. Its use may aid in surgical planning and reduce operative complications.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transoral ultrasound for bedside diagnosis of vertebral artery dissection in ICU patients with limited cervical access: a case report.","authors":"Issac Cheong, José Alberto Feijóo, María Carla Carruega, Francisco Marcelo Tamagnone","doi":"10.1007/s40477-025-01086-9","DOIUrl":"https://doi.org/10.1007/s40477-025-01086-9","url":null,"abstract":"<p><strong>Introduction: </strong>Vertebral artery dissection (VAD) is a serious complication of cervical trauma. Standard imaging such as computed tomography angiography (CTA), magnetic resonance angiography (MRA), and duplex ultrasonography (DUS) may be limited in critically ill patients. This case report aims to describe the innovative application of transoral ultrasound (TOUS) for bedside diagnosis of VAD in an intubated intensive care unit (ICU) patient.</p><p><strong>Case presentation: </strong>A 75-year-old woman with C2 fractures and compromised cervical access was admitted after a motor vehicle accident. Standard cervical vascular ultrasound was technically limited due to the presence of an endotracheal tube and cervical immobilization. Bedside TOUS was performed by an intensivist with over 15 years of ultrasonography experience using a microconvex endocavitary probe (4-9 MHz, footprint 10 mm) with color and power Doppler, PRF range of 1-3 kHz, wall filter 50 Hz, and optimized gain settings. The patient was sedated and mechanically ventilated, allowing optimal tolerance. The left vertebral artery V2 segment demonstrated a high-resistance waveform proximally and a filiform Doppler signal distally, suggesting dissection. CTA performed subsequently confirmed VAD at C1-C2.</p><p><strong>Conclusion: </strong>Our case demonstrates that TOUS enables bedside detection of vertebral artery dissection via direct insonation of the distal vertebral artery. This approach is particularly feasible in intubated ICU patients and allows access to segments not visible with standard cervical windows. Limitations include the need for operator expertise and reduced tolerability in non-intubated patients. Overall, TOUS represents a practical and innovative tool for diagnosing VAD in critically ill trauma patients when conventional imaging is limited.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Veterinary pilot study on focused ultrasound treatment of spontaneous canine and feline tumours: technical and feasibility assessment.","authors":"Antria Filippou, Nikolas Evripidou, Kyriakos Spanoudes, Christakis Damianou","doi":"10.1007/s40477-025-01085-w","DOIUrl":"https://doi.org/10.1007/s40477-025-01085-w","url":null,"abstract":"<p><strong>Purpose: </strong>Focused ultrasound (FUS) is currently in the limelight of veterinary medicine as a novel treatment modality for companion animals, offering significant benefits over traditional techniques. In this study, the safety, feasibility, and efficacy of FUS for the treatment of various spontaneous canine and feline tumours was investigated.</p><p><strong>Methods: </strong>Dogs and cats diagnosed with naturally occurring tumours were recruited in the study based on certain eligibility criteria. Fifteen dogs and cats with superficial tumours at various anatomical locations including the belly, chest, shoulder, rump, and neck were enrolled. Treated tumours in pets were mammary, sarcoma, pressure-point comedones and lipoma. Tumours in enrolled pets were treated using an in-house Magnetic Resonance Imaging guided FUS (MRgFUS) robotic system integrating a 2.75 MHz single-element spherically focused transducer. Partial FUS ablations were delivered to targeted tumours using sonication protocols tailored to tumour volume and location. Following FUS, the tumours were surgically excised and sent for histological examination.</p><p><strong>Results: </strong>FUS treatments were well-tolerated with no significant adverse events or off-target damages, with only one canine case experiencing mild erythema and superficial skin ulceration at the treated site. Haematoxylin and Eosin (H&E)-stained slides revealed that well-demarcated areas of coagulative necrosis were effectively achieved at the targeted FUS regions in all treated cases.</p><p><strong>Conclusion: </strong>Study findings demonstrate that FUS can be safely used for the management of various types of spontaneous canine and feline tumours, highlighting the promising potential of the technology as a valuable and versatile therapeutic approach for veterinary cancer patients.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiofrequency and targeted ultrasound enhance natural hyaluronic production: a pilot porcine study.","authors":"Jan Bernardy, Klaus Fritz, Carmen Salavastru, Rea Jarosova, Natalie Kralova","doi":"10.1007/s40477-025-01083-y","DOIUrl":"https://doi.org/10.1007/s40477-025-01083-y","url":null,"abstract":"<p><strong>Background: </strong>Loss of skin elasticity and youthful appearance is closely linked to reduced hyaluronic acid (HA) levels in the dermis. While topical HA products offer temporary effects, they do not address the root cause of HA depletion.</p><p><strong>Objective: </strong>The present study aims to describe how to induce HA synthesis through fibroblast stimulation.</p><p><strong>Materials and methods: </strong>Twelve sows were divided into two groups. One group (n = 9) received four consecutive Radiofrequency (RF) and Targeted Ultrasound (TUS) treatments, the other group (n = 3) received four RF treatments only. Samples were collected via punch biopsy from the treated area of each animal at the baseline, 1-month, and 2-month follow-up. Samples were then processed and prepared for enzyme-linked immunosorbent assay as well as hyaluronic acid binding protein with diaminobenzidine (HABP-DAP) staining, which allows for visualization of HA within tissue.</p><p><strong>Findings: </strong>The group receiving RF + TUS treatment has demonstrated an increase from an average of 83.0 µg/g at the baseline to 163.0 µg/g at the 2-month follow-up of HA concentration in the skin. Histology samples clearly demonstrate higher tissue density with an increase of brown pigment due to the HABP-DAP stain, representing HA in the skin. In comparison, the RF standalone treatment group has shown no significant increase in HA concentrations.</p><p><strong>Conclusion: </strong>Study results show no significant increase in HA production following the RF stand alone treatment. Whereas the RF + TUS treatment group induced a significant HA production response as well as histophysiological changes in the dermis.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the clinical impact of integrating superb microvascular imaging and shear wave elastography into TI-RADS.","authors":"Melis Kosar Tunc, Rahmi Eren Ozkan, Atalay Aktuna, Senay Erdogan Durmus, Hakan Onder","doi":"10.1007/s40477-025-01080-1","DOIUrl":"https://doi.org/10.1007/s40477-025-01080-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the diagnostic contribution of Superb Microvascular Imaging (SMI), and Shear Wave Elastography (SWE) to TI-RADS in differentiating benign and malignant thyroid nodules.</p><p><strong>Materials and methods: </strong>This prospective study enrolled patients scheduled for thyroid fine-needle aspiration biopsy (FNAB). Grayscale ultrasound, SMI, and SWE of the nodules were performed before FNAB. TI-RADS categories, vascularity patterns, vascularity index, and elasticity indices were recorded. Diagnostic performance was analyzed using ROC curves, logistic regression, and the DeLong test.</p><p><strong>Results: </strong>A total of 478 thyroid nodules were analyzed, comprising 441 (92.2%) benign and 37 (7.7%) malignant cases (35 papillary and 2 medullary carcinomas). The mean age was significantly higher in the benign group (54.61 ± 11.54 years) compared to the malignant group (46.84 ± 15.38 years, p = 0.005). The most common vascularity type was type 3 (48.5% in benign and 81.1% in malignant). Malignancy rates were significantly higher in nodules with vascularity type 3 compared to type 2 (p < 0.001). ROC analysis identified an optimal SWE cut-off value of 36.9 kPa (p < 0.001), but the VI showed no significant difference (p = 0.662). The combined model consisting of TI-RADS score, SWE mean value, and vascularity distribution type demonstrated the highest diagnostic accuracy, with an AUC of 0.89.</p><p><strong>Conclusion: </strong>Combination of TI-RADS, SMI, and SWE improves diagnostic accuracy in thyroid nodule assessment. Vascularity type 3 and SWE index value are strong, independent predictors of malignancy. The clinical applicability of these tools has the potential to reduce the number of unnecessary biopsies and to improve the management of patients.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of the effectiveness and the diagnostic accuracy of intraoperative ultrasound in the resection of low-grade gliomas.","authors":"Athanasios Gkampenis, Ioannis Koukoulithras, Marios Lampros, Panagiota Zagorianakou, Spyridon Voulgaris, George A Alexiou","doi":"10.1007/s40477-025-01076-x","DOIUrl":"https://doi.org/10.1007/s40477-025-01076-x","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aims to evaluate the effectiveness of intraoperative ultrasound (iUS) in achieving gross total resections (GTR) and identifying tumor remnants in low-grade glioma (LGG) surgeries.</p><p><strong>Methods: </strong>A search of Medline, Cochrane, and Scopus databases until 8th August 2024 was performed to retrieve relevant studies, while reference lists were also scanned. Studies were selected based on predetermined inclusion and exclusion criteria, and their methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool.</p><p><strong>Results: </strong>Thirteen studies were included: 1 prospective randomized controlled trial, 10 prospective studies and 2 retrospective studies. Of these, five studies had a high risk of bias, and eight had significant concerns regarding applicability. One study provided only mean volumes of tumor remnants, while the remaining 12 studies included a total of 352 patients. Eight studies used 2D B-mode iUS, and five used 3D navigated iUS. There was considerable variability in iUS characteristics, reference methods, and outcome measures. Linear array iUS generally demonstrated superior characteristics, and 3D iUS showed promising potential. Sensitivity ranged from 21.05% to 100%, and GTR percentages varied from 10.71% to 100%, while specificity ranged from 66.67% to 100%. Data on remnant volumes were available from only three studies.</p><p><strong>Conclusions: </strong>From the available literature no safe assumptions on neither the diagnostic accuracy nor the efficacy of iUS in LGG resections can be made.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical cervical ectopic thymus located in the submandibular space: a case report.","authors":"Emma Liaci, Marcello Napolitano, Camilla Viglio, Gloria Pelizzo, Michelangelo Baldazzi, Rocco Minelli, Giuseppe Paviglianiti, Eugenio Rossi","doi":"10.1007/s40477-025-01082-z","DOIUrl":"https://doi.org/10.1007/s40477-025-01082-z","url":null,"abstract":"<p><p>Ectopic thymic tissue is a rare finding and a rare cause of lateral neck masses. Here, we present a case of a 3-month-old male infant with a painless left sided submandibular mass. The case highlights the diagnostic power of ultrasound in differentiating ectopic thymic tissue from other pediatric neck masses, often rendering more expensive or invasive imaging unnecessary or potentially counterproductive and allowing to avoid unnecessary procedures and possible complications.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}