Journal of Ultrasound最新文献

{"title":"Contrast-enhanced ultrasound combined with diagnostic nerve block for differentiating cervical sympathetic ganglion from metastatic lymph node: a case report.","authors":"Tao Wu, Yuxin Zhang, Bowen Zheng, Tinghui Yin, Lei Tan, Yufan Lian, Yuting He, Nana Wang, Jie Ren","doi":"10.1007/s40477-026-01232-x","DOIUrl":"https://doi.org/10.1007/s40477-026-01232-x","url":null,"abstract":"<p><p>Differentiating cervical sympathetic ganglion (CSG) from metastatic lymph nodes in the central neck compartment remains a diagnostic challenge, particularly in patients with thyroid carcinoma. Conventional imaging modalities, including contrast-enhanced computed tomography (CT) and ultrasound, may yield indeterminate findings due to overlapping morphological characteristics. We present a case with papillary thyroid microcarcinoma that was referred for thermal ablation. Preoperative CT suggested a suspicious level VI lymph node. Contrast-enhanced ultrasound (CEUS) combined with diagnostic ultrasound-guided nerve block for differentiating cervical sympathetic ganglion from metastatic lymph node was performed. The appearance of Horner syndrome after nerve block indicates that this lesion is a sympathetic ganglion.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118205","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":"Quantitative analysis of tumor perfusion via contrast-enhanced ultrasound to predict the neoadjuvant chemotherapy efficacy for children with hepatoblastoma.","authors":"Meixi Chen, Yuanqi Wang, Yingqian Chen, Hong Jiang, Xiaoyan Xie, Xiaoli Wang, Wenying Zhou, Guangliang Huang, Luyao Zhou","doi":"10.1007/s40477-026-01235-8","DOIUrl":"https://doi.org/10.1007/s40477-026-01235-8","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the value of quantitative analysis of CEUS in predicting the neoadjuvant chemotherapy efficacy for hepatoblastoma.</p><p><strong>Methods: </strong>Thirty-five hepatoblastoma patients who require neoadjuvant chemotherapy and underwent liver CEUS in our hospital from January 2017 to July 2023 were enrolled. A CEUS examination was performed at baseline, and perfusion parameters were obtained via perfusion quantification software. Patients were classified into responder group and non-responder group after two courses. The differences in quantitative parameters between two groups were compared.</p><p><strong>Results: </strong>The MeanLin ratio (1.7 vs. 0.6 and 1.7 vs. 0.8), PE ratio (1.8 vs. 0.9 and 1.9 vs. 0.9), WiAUC ratio (1.3 vs. 0.6 and 1.3 vs. 0.6), WiPI ratio (1.9 vs. 0.8 and 2.0 vs. 0.9), WoAUC ratio (1.3 vs. 0.5 and 1.3 vs. 0.7), and WiWoAUC ratio (1.3 vs. 0.6 and 1.3 vs. 0.7) in the response group were significantly higher than those in the non-response group (all p < 0.05); when tumor's region of interest was the active area, the WiR ratio (3.1 vs. 1.4) of the responder group was significantly higher (p = 0.04). The proportion of lesions with liquefaction necrosis before chemotherapy was significantly higher in the response group (p = 0.049).</p><p><strong>Conclusion: </strong>Quantitative analysis of CEUS may have the potential to predict the neoadjuvant chemotherapy efficacy for hepatoblastoma.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118194","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":"Ultrasound features of visceral cat scratch disease: a rare case of granulomatous hepatosplenic bartonellosis in an immunocompetent patient.","authors":"Giorgia Russo, Elisabetta Biasini, Gabriele Missale","doi":"10.1007/s40477-026-01234-9","DOIUrl":"https://doi.org/10.1007/s40477-026-01234-9","url":null,"abstract":"<p><strong>Objective: </strong>To describe the pivotal role of conventional B-mode and contrast-enhanced ultrasound (CEUS) in identifying and characterizing rare visceral manifestations of Bartonella henselae infection in an immunocompetent individual.</p><p><strong>Case report: </strong>A 67-year-old immunocompetent female presented with a diffuse maculopapular exanthema, fever, and left inguinal lymphadenopathy following a cat scratch. Conventional ultrasound revealed multiple subcentimetric hypoechoic areas in both hepatic lobes and the spleen, along with a necrotic-colliquative nodal mass in the left Scarpa's triangle. CEUS demonstrated an inflammatory/necrotic perfusion pattern characterized by absence of contrast enhancement, appearing as avascular, non-enhancing necrotic cores suggestive of granulomatous lesions. The clinical suspicion was confirmed by positive Bartonella henselae serology. Clinical resolution was achieved after a 1-month course of doxycycline.</p><p><strong>Conclusions: </strong>Visceral cat scratch disease should be considered in the differential diagnosis of multiple hepatosplenic lesions even in fully immunocompetent hosts. Multiparametric ultrasound, particularly CEUS, represents an essential, non-invasive standard tool for early detection, definitive characterization, and radiation-free therapeutic monitoring.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118177","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 performance of ultrasound for gastric volvulus in pediatric patients.","authors":"Takahiro Hosokawa, Kyoichi Deie, Yumiko Sato, Hiroshi Kawashima, Eiji Oguma","doi":"10.1007/s40477-026-01233-w","DOIUrl":"https://doi.org/10.1007/s40477-026-01233-w","url":null,"abstract":"<p><strong>Purpose: </strong>In this study, we aimed to evaluate the diagnostic performance of ultrasound for gastric volvulus. The characteristics of patients with gastric volvulus were also evaluated.</p><p><strong>Methods: </strong>Thirty-seven pediatric patients with gastric volvulus, diagnosed based on an upper gastrointestinal series, were classified into two groups: organoaxial and mesenteroaxial. The diagnostic performance of ultrasound for gastric volvulus and its usefulness in the management of these patients were also examined. Age, symptom onset, and presence/absence of diaphragmatic elevation/hernia, scoliosis, and wandering spleen of the two groups were compared using Fisher's exact and the Mann-Whitney U test.</p><p><strong>Results: </strong>Among the 37 eligible patients, 28/9 had organoaxial/ mesenteroaxial gastric volvulus, respectively. Seven of these patients (18.9%) were correctly diagnosed using ultrasound. In 31/37 patients, ultrasound ruled out other disease-related symptoms indicative of gastric volvulus. Significant inter-group differences were observed for age (age (years) with organoaxial vs. mesenteroaxial gastric volvlulus = 2.24 ± 4.22 [0.01-14.98] vs.5.77 ± 4.45 [0.23-15.87], P = 0.010), acute/chronic onset of symptom (acute/chronic onset of symptom with organoaxial vs. mesentaroaxial gastric volvlulus = 5/23 vs. 5/4, P = 0.041), wandering spleen (present/absent of those with organoaxial vs. mesenteroaxial gastric volvulus = 0/28 vs. 6/3, P = 0.001), and scoliosis (present/absent of those with organoaxial vs, mesenteroaxial gastric volvulus = 1/27 vs. 3/6, P = 0.038).</p><p><strong>Conclusion: </strong>To our knowledge, this study is the first to demonstrate the diagnostic performance of ultrasound for gastric volvulus. Although small number of cases of gastric volvulus were diagnosed using ultrasound, its diagnostic performance was unreliable. However, ultrasound was useful in differentiating gastric volvulus from other diseases with similar symptoms.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118135","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":"Lung ultrasound: a new approach for detection of severity of COVID-19 viral pneumonia and associated mortality.","authors":"Chitrakshi Nagpal, Sanchit Kumar, Arvind Kumar, Mohd Usman, Kamaljeet Singh, Praful Pandey, Manraj Singh, Kapil Dev Soni, Richa Aggarwal, Anjan Trikha","doi":"10.1007/s40477-026-01229-6","DOIUrl":"https://doi.org/10.1007/s40477-026-01229-6","url":null,"abstract":"<p><strong>Background and objectives: </strong>Lung ultrasound has established itself as a dependable bedside imaging modality, with demonstrated concordance with computed tomography in the assessment of pulmonary abnormalities. Prior studies have also validated its utility in identifying COVID-19-associated lung pathology. In this context, the present study aims to evaluate the correlation between lung ultrasound findings and clinical parameters in order to determine its effectiveness in assessing disease severity and predicting mortality among patients with COVID-19 infection.</p><p><strong>Methods: </strong>This study enrolled hospitalized patients with microbiologically confirmed SARS-CoV-2 infection, who were clinically stratified into mild (absence of moderate or severe COVID-19 symptoms), moderate (respiratory rate ≥24/min or SpO₂ <94% on room air) and severe disease categories (respiratory rate ≥30/min, SpO₂ <90% on room air, or requirement for non-invasive/invasive mechanical ventilation). For systematic lung ultrasound evaluation, each lung was divided into 7 anatomical zones-comprising 2 anterior, 2 axillary and 3 posterior zones-resulting in a total of 14 assessed zones. The primary objective was to comprehensively evaluate the correlation between lung ultrasound profiles and established clinical parameters, including PF and SF ratios. Secondary objectives were to investigate the association of lung ultrasound findings with clinical disease severity and mortality, while also establishing optimal prognostic cut-off values for mortality prediction.</p><p><strong>Results: </strong>Among the total cohort of 60 patients, B-line abnormalities involving at least one lung zone were identified in 88.33% of cases. The total number of lung zones demonstrating ultrasonographic abnormalities (B/B' or C/C' profiles) showed a significant negative correlation with both PF ratio (ρ = - 0.7232, p < 0.0001) and SF ratio (ρ = - 0.6866, p < 0.0001). A simplified threshold of ≥10 abnormal lung zones demonstrated 71.43% sensitivity and 72.00% specificity in distinguishing severe from non-severe illness. The total B-line burden was significantly associated with mortality, with a cut-off of ≥35 B-lines yielding 65.38% sensitivity and 58.82% specificity for mortality prediction.</p><p><strong>Conclusion: </strong>A greater extent of pulmonary abnormalities detected on lung ultrasound demonstrates significant correlation with clinical severity and patient outcomes in COVID-19 pneumonia. These findings support the potential role of lung ultrasound in future prospective studies as an effective and safer modality for triaging and prognosticating patients with viral pneumonia other than COVID-19 in any resource-limited setting.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118212","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":"Development of a simplified 3-site ultrasound skin score in systemic sclerosis: a pilot study.","authors":"Gehad Maghraby, Eithar Seif Al-Nasr, Hala Elgendy, Youssef Mohamed Amin Soliman, Hossameldin Rezk, Sama Ayman Anwar","doi":"10.1007/s40477-026-01222-z","DOIUrl":"https://doi.org/10.1007/s40477-026-01222-z","url":null,"abstract":"<p><strong>Background: </strong>Skin fibrosis is the hallmark of systemic sclerosis (SSc). High-frequency ultrasound is promising, but optimal measurement parameters and site selection remain uncertain. This study aimed to quantify skin thickness across multiple anatomical sites in SSc and evaluate the performance of simplified ultrasound composite scores.</p><p><strong>Methods: </strong>A pilot study of 25 SSc patients and 25 controls was conducted at Cairo University. Modified Rodnan skin score (mRSS) and Medsger severity score were recorded. Using an 18-MHz probe, epidermal, dermal, and total skin thickness (TST) were measured at the finger, the hand, the dorsal forearm, the volar forearm, the arm, the leg, the thigh, and the back. Composite scores based on dermal thickness and TST were constructed. Inter-rater reliability was assessed using intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>Epidermal thickness was significantly increased in SSc at most sites. However, inter-rater reliability was poor, limiting its clinical utility. Dermal thickness showed limited discrimination between groups, whereas TST demonstrated consistent differences at the finger, the hand, and the forearm regions. While the upper back distinguished SSc from controls, reliability at this site was poor. Reduced-site composite scores outperformed extended scores, with the 3-site TST score (finger, hand, dorsal forearm) showing the best balance between diagnostic performance (AUC = 0.818) and reproducibility (ICC = 0.751). TST-based composite scores correlated positively with mRSS and Medsger severity score and differentiated diffuse from limited SSc.</p><p><strong>Conclusion: </strong>The simplified three-site composite score appears to offer a feasible and reasonably reproducible approach for skin assessment in SSc. These findings are exploratory and require validation in larger cohorts.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076638","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":"CEUS for the diagnosis of acute graft pyelonephritis in renal transplant recipients.","authors":"Andrea Boccatonda, Alice Brighenti, Valeria Tiraferri, Marco Musmeci, Daniela Agostinelli, Nicola Venturoli, Livia Masi, Attilio Barretta, Elisa Gessaroli, Giorgia Comai, Carla Serra","doi":"10.1007/s40477-026-01228-7","DOIUrl":"https://doi.org/10.1007/s40477-026-01228-7","url":null,"abstract":"<p><strong>Purpose: </strong>Acute graft pyelonephritis (AGPN) is a clinically relevant complication in renal transplant recipients, in whom diagnosis may be challenging because of nonspecific clinical and conventional ultrasound findings. Contrast-enhanced ultrasound (CEUS) enables real-time assessment of renal microvascular perfusion without nephrotoxic contrast agents. This study aimed to evaluate the diagnostic performance of CEUS for detecting AGPN in renal transplant recipients.</p><p><strong>Methods: </strong>This retrospective single-center study included 66 consecutive renal transplant recipients who underwent CEUS for clinically suspected AGPN. The final clinical diagnosis, based on the integration of clinical, laboratory, microbiological, and available imaging findings, was used as the reference standard. Conventional ultrasound findings and CEUS parenchymal perfusion abnormalities were assessed. Diagnostic performance was evaluated in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios.</p><p><strong>Results: </strong>AGPN was confirmed in 21/66 patients (31.8%). Fever was more frequent in patients with AGPN than in those without AGPN (100% vs. 73.3%, p=0.014). On conventional ultrasound, globular graft appearance (14.3% vs. 0%, p=0.029), cortical hyperechogenicity (23.8% vs. 0%, p=0.002), cortical hypoechogenicity (28.6% vs. 4.4%, p=0.010), perirenal fluid collection (38.1% vs. 11.1%, p=0.018), and ureteral wall thickening (42.9% vs. 8.9%, p=0.002) were significantly associated with AGPN. CEUS correctly identified 19/21 AGPN cases, with two false-negative and no false-positive examinations. Sensitivity was 90.5% (95% CI 69.6-98.8%), specificity 100% (95% CI 92.1-100%), PPV 100% (95% CI 82.4-100%), and NPV 95.7% (95% CI 85.5-99.5%).</p><p><strong>Conclusion: </strong>CEUS showed high diagnostic accuracy for AGPN in renal transplant recipients. By providing real-time assessment of graft parenchymal perfusion without nephrotoxicity or ionizing radiation, CEUS may represent a valuable complement to conventional ultrasound and potentially reduce the need for contrast-enhanced CT in selected patients. Larger prospective multicenter studies with standardized independent reference standards are warranted.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065885","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":"Effect of transducer scanning velocity during extended field of view imaging acquisition on pennate and fusiform muscles echo intensity.","authors":"Paulo Ricardo de David Evangelho, Bruno Turcatti-Mendez, Martina Weis Regert, Heinrich Leon Souza Viera, Marco Aurélio Vaz, Fábio Juner Lanferdini","doi":"10.1007/s40477-026-01231-y","DOIUrl":"10.1007/s40477-026-01231-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the effects of transducer scanning velocity on echo intensity (EI) of muscles with different architectures [biceps brachii (BB), vastus lateralis (VL), and tibialis anterior (TA)] and determined interrater reliability across velocities.</p><p><strong>Methods: </strong>Ideal transducer velocity for each muscle was determined by the ultrasound system and measured using reflective markers and video analysis. Fast and slow velocities were set at ±50% of the ideal velocity (i.e., control condition). Three images per velocity were collected in 40 participants, with speed controlled by a digital metronome. EI, adipose, and superficial tissue thicknesses were analyzed by two blinded raters using ImageJ^®. Repeated-measures ANOVA with Tukey post hoc test were applied for absolute and percentage values. Reliability was assessed using intraclass correlation coefficients (ICC), standard error of measurement (SEM), and minimum detectable change (MDC).</p><p><strong>Results: </strong>Interrater reliability was excellent for all muscles and velocities (r ≥ 0.933). Significant differences were observed only in TA. Slow velocity produced higher EI in TA's superior compartment compared with control and fast conditions (5% and 6%, respectively), and higher EI in the inferior compartment compared with fast velocity (4%). However, all differences were within the SEM and below the MDC. No significant differences were observed in BB or VL.</p><p><strong>Conclusion: </strong>Transducer scanning velocity affects EI measurements in TA compartments, particularly under slow conditions, although these differences may not represent true physiological changes. In contrast, BB and VL measurements were unaffected, and all velocities demonstrated excellent interrater reliability.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065917","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":"Conventional sonographic phenotype of thyroid oncocytic neoplasms: a pathology-confirmed comparative study.","authors":"Chuanyang Li, Tingyu Zhu, Xiaojuan Zheng, Zhuomin Chen, Chao Zhu, Yiying Li","doi":"10.1007/s40477-026-01227-8","DOIUrl":"https://doi.org/10.1007/s40477-026-01227-8","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the conventional sonographic features of oncocytic thyroid neoplasms (OTNs) and compare them with those of papillary thyroid carcinoma (PTC), nodular goiter (NG), and three follicular-pattern comparator groups: follicular adenoma (FA), follicular thyroid carcinoma (FTC), and follicular variant of papillary thyroid carcinoma (FVPTC).</p><p><strong>Methods: </strong>This retrospective study included 344 pathology-confirmed lesions: 41 OTNs, 110 PTCs, 90 NGs, 45 FAs, 24 FTCs, and 34 FVPTCs. Two radiologists independently re-reviewed stored preoperative ultrasound images while blinded to histopathologic diagnoses. Because the original reports did not consistently document C-TIRADS categories, they were reconstructed post hoc from feature-level descriptors. Feature-specific Firth logistic regression models adjusted for age, sex, and maximum lesion diameter, used size-matched sensitivity analyses; 1:1 matching with a 5-mm caliper.</p><p><strong>Results: </strong>OTNs were larger than PTC, NG, and FVPTC lesions (median maximum diameters: 25.0, 7.0, 9.0, and 10.0 mm, respectively; P < 0.001) but similar in size to FA and FTC lesions. They were commonly wider than tall (100.0%), had smooth margins (80.5%), were isoechoic (65.9%), and were hypervascular (70.7%). After adjustment, all six prespecified features were associated with OTN versus PTC. Compared with NG, smooth margins (aOR, 3.84; 95% CI, 1.30-13.14; P = 0.014) and is echogenicity (aOR, 3.36; 95% CI, 1.19-9.69; P = 0.022) remained associated with OTN. Compared with the pooled follicular-pattern comparator group (FA, FTC, and FVPTC), smooth margins and absence of focal echogenic foci remained associated with OTN (aORs, 3.71 and 2.55; P = 0.002 and 0.022, respectively), but these associations were attenuated after lesion-size matching.</p><p><strong>Conclusions: </strong>In this surgically selected cohort, OTNs showed several recurring conventional sonographic features, but their appearance overlapped substantially with follicular neoplasms and NG. Ultrasound may raise preoperative suspicion for an oncocytic phenotype but cannot distinguish oncocytic adenoma from oncocytic carcinoma.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026674","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":"Navigating coronary microvascular dysfunction: an echocardiographic triage algorithm for cardiac magnetic resonance and coronary computed tomography angiography.","authors":"Muhammed Emre Güleşir","doi":"10.1007/s40477-026-01226-9","DOIUrl":"https://doi.org/10.1007/s40477-026-01226-9","url":null,"abstract":"<p><p>The definitive diagnosis of coronary microvascular dysfunction (CMD) typically relies on invasive measurements, pointing to the pressing need for reliable noninvasive alternatives. An integrated, echocardiography-guided multimodality triage algorithm is proposed for early detection and risk stratification of suspected CMD. This framework employs frontline transthoracic echocardiography, combining global longitudinal strain (GLS) and the Doppler-derived coronary sinus flow (CSF) index, as the primary assessment tool. Patients with abnormal initial findings are selectively referred for cardiac magnetic resonance (CMR) imaging to achieve definitive tissue characterization and quantitative phase-contrast CSF validation. If CMR excludes structural cardiomyopathies but confirms significant microvascular flow impairment, the diagnostic pathway advances to coronary computed tomography angiography (CCTA) or invasive angiography to exclude obstructive epicardial disease. While standard cutoff values for the echocardiographic CSF index require further prospective validation, this multiparametric, multimodal approach bridges the gap between invasive microvascular physiology and routine noninvasive practice, providing a comprehensive strategy for early cardiovascular risk stratification.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026667","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}