Journal of Ultrasound最新文献

{"title":"Reddish/bluish benign lesions evaluated by dermus SkinScanner.","authors":"Carmen Cantisani, Phyllida Kerstin Hamilton-Maikle, Mattia Di Segni, Andras Banvolgyi, Giovanni Paolino, Salvador Gonzales, Mehdi Boostani, Giovanni Pellacani, Gyorgy Paragh, Norbert Kiss","doi":"10.1007/s40477-025-01066-z","DOIUrl":"https://doi.org/10.1007/s40477-025-01066-z","url":null,"abstract":"<p><p>Angiomas and blue nevi are common benign skin lesions with overlapping clinical appearances that can mimic malignancy, such as melanoma. This study evaluates the role of dermoscopy-assisted high-frequency ultrasound (DA-HFUS) in characterizing these lesions. Five cases (2 angiomas, 3 blue nevi) were examined using the Dermus SkinScanner, a handheld 33 MHz device with integrated optical guidance. Dermoscopy revealed blue nevi as regular, slate blue or brown lesions, occasionally with white veils; angiomas appeared as blue-purple papules with homogeneous purple lacunes. On ultrasound, blue nevi were well-demarcated, hypoechoic lesions with occasional hyperechoic foci suggestive of fibrosis, while angiomas showed heterogeneous echotexture with mixed echogenicity reflecting vascular and fibrous components. Fibrotic blue nevi exhibited deep dermal extensions and hyperechogenic columns not visible on dermoscopy. These findings highlight the complementary role of DA-HFUS and dermoscopy in non-invasive diagnosis and structural assessment of benign pigmented lesions.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978018","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 comprehensive scoping review of existing carotid duplex ultrasound scanning and reporting protocols: identifying gaps and opportunities for standardization of practice in low-income countries.","authors":"Theonille Mukabagorora, Linda Mbonambi, Zarina Lockhat, Amiable Musafiri, Ramadimetja Mable Kekana","doi":"10.1007/s40477-025-01064-1","DOIUrl":"https://doi.org/10.1007/s40477-025-01064-1","url":null,"abstract":"<p><strong>Background: </strong>Duplex carotid ultrasound is a non-invasive imaging test that is essential for assessing carotid artery disease, particularly in determining the presence and severity of atherosclerosis and the risk of cerebrovascular events. However, the interpretation of ultrasound results can differ widely due to variations in diagnostic criteria, lack of standardization in scanning methods, and differing approaches to evaluating carotid intimal medial thickness (CIMT), plaques, and stenosis. These inconsistencies create challenges in clinical practice and the reproducibility of results. While various protocols for CIMT, plaque measurement, and stenosis grading are available in the literature, a standardized global protocol is still lacking. This article presents a scoping review of current carotid duplex ultrasound scanning and reporting protocols. It aims to identify existing protocols and guidelines for carotid ultrasound scanning and reporting, highlight variations, and propose a standardized approach to enhance diagnostic accuracy and clinical outcomes in carotid atherosclerosis.</p><p><strong>Methods: </strong>Using predefined search protocols developed in collaboration with the specialized librarian from the University of Pretoria, we searched different databases and gray literature to identify existing protocols on carotid ultrasound including scanning technique, carotid intimal medial thickness, carotid plaques, and carotid stenosis grading. Due to limitations in the length of the review, and the existence of a large number of protocols, this review focused on the protocols developed and published by institutions and professional societies rather than individual articles.</p><p><strong>Results: </strong>Among 2496 articles identified from databases and 22 from other sources, 17 articles met the criteria for this review. The most common criteria that was found following this review are those established by the Society of Radiologists in Ultrasound (SRU) in 2003. The researchers further noted that these criteria were, however, been criticized for relying heavily on peak systolic velocities, a measurement that, when used alone, can be misleading. Literature further demonstrated that other researchers and professional societies have called for consensus on unified criteria for the diagnosis of carotid atherosclerosis.</p><p><strong>Conclusion: </strong>While carotid ultrasound is an important, non-invasive, and widely available method for evaluating carotid atherosclerosis, the variations in scanning techniques, measurements, and cut-off values underscore the need for standardized diagnostic criteria. Standardization is essential to provide consistent patient care and ensure accurate examination in various clinical settings. This will lead to the reduction of stroke and cardiovascular incidence which are the leading causes of death worldwide and more prevalent in low-income countries.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977963","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-guided pericapsular nerve group (PENG) blocks are safe and effective.","authors":"John Hipskind, Eknoor Sandhu, Tyler Mitchell, Nolan Page","doi":"10.1007/s40477-025-01065-0","DOIUrl":"https://doi.org/10.1007/s40477-025-01065-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Ultrasound-guided pericapsular nerve group (PENG) blocks are a type of regional nerve block that has gained increasing popularity for providing effective analgesia in patients with hip fractures. This retrospective case series evaluated the safety and effectiveness of Ultrasound-Guided PENG blocks using Ropivacaine 0.2% performed by emergency physicians in a single institute. Patients were enrolled between May 2019 and June 2021. The procedure was performed by emergency medicine attendings and ultrasound fellows. The patients were part of a convenience sample, with the procedure performed when an attending physician or ultrasound fellow was present in the emergency department and available to perform the procedure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a single-center retrospective analysis of 13 PENG blocks performed by emergency medicine attendings and ultrasound fellows. This was done at our emergency department, which sees approximately 90,000 patients per year. All patients received between 1 and 3 mg/kg of Ropivacaine 0.2% with a max dosage of 120 mg (60 cc). Patient demographics, procedural details, complications, and pain outcomes were recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There is a significant mean (p = 0.007) reduction in pain level of 2.9 when comparing the post-test measurements to the pre-test measurements. This was confirmed by a non-parametric approach, which also found a significant reduction in the median difference (p = 0.009). This was further explained by a non-significant Shapiro-Wilk test, which found no significant evidence of non-normality (p = 0.499). (see Table 1). Among the 13 PENG blocks performed, there were no complications. Examples of known complications of regional nerve blocks include local anesthetic systemic toxicity (Barrington and Kluger 38:289-299, 2013;El-Boghdadly and 63:330-349, 2016;) paresthesias lasting more than 5 days &lt;sup&gt;3&lt;/sup&gt;; paresthesias lasting more than 6 months (Welch et al. 111:490-497, 2009); and permanent nerve injury&lt;sup&gt;3&lt;/sup&gt;. None of the 13 blocks performed at our institution had complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Our findings support the effectiveness and safety of ultrasound-guided PENG blocks performed by emergency physicians using Ropivacaine 0.2%. The high degree of pain relief and the absence of complications in our case series demonstrate that emergency physicians can perform PENG blocks with a high level of competency and safety.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This retrospective case series, conducted between May 2019 and June 2021, demonstrates the effectiveness and safety of ultrasound-guided PENG blocks performed by emergency physicians. The high rate of pain relief and lack of complications in our patients who received the PENG block demonstrates the benefits of this technique. We suggest that additional research and randomized controlled trials will help to validate these findings and support the increased","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978034","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 pictorial of rare artefacts in scrotal ultrasonography.","authors":"Irene Campo, Jeries P Zawaideh, Maura Valle, Michele Bertolotto, Lorenzo E Derchi","doi":"10.1007/s40477-025-01073-0","DOIUrl":"https://doi.org/10.1007/s40477-025-01073-0","url":null,"abstract":"<p><p>Although easily performed and with optimal clinical results, scrotal ultrasound examinations are not free from technical difficulties. Some artifacts are relatively frequent, their creation mechanisms are well known and are easily recognized; others are uncommon, produce images which can be difficult to recognize, and need modifications of scan planes and examination techniques to be properly understood. The aim of this paper is to describe some rare artifacts and pitfalls in scrotal ultrasound, trying to explain their genesis and how to avoid them. We describe four different artifacts (flow signals not related to blood flow, refraction phenomena causing appearance of testicular pseudo-masses, pseudo-thickening of the tunica vaginalis, testicular anomalous echogenicity from thickening of the scrotal wall) that can cause diagnostic difficulties during scrotal examinations.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978022","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":"ChatGPT: the essential patient's companion for transesophageal echocardiogram education.","authors":"Yuval Avidan, Hussein Sliman, Baruch Weizman, Orel Ben Court, Alexander Fuks, Salim Adawi, Amir Aker","doi":"10.1007/s40477-025-01071-2","DOIUrl":"https://doi.org/10.1007/s40477-025-01071-2","url":null,"abstract":"<p><strong>Purpose: </strong>Transesophageal echocardiography (TOE) necessitates meticulous patient preparation. Artificial intelligence (AI) chatbots, such as ChatGPT, hold promise in delivering medical information. This study sought to assess the suitability of the latest iteration, ChatGPT-4 Omni (GPT-4o), as a supplemental resource for providing information on topics related to TOE.</p><p><strong>Methods: </strong>Fifty questions pertaining to patient education, covering both fundamental knowledge (25) and management aspects (25) of TOE results, were submitted to GPT-4o in three separate sessions. Three senior echocardiographers systematically evaluated the responses using a four-point scale, focusing on their appropriateness, clarity, and consistency. Additionally, they assessed confabulations and the omission of relevant content on a binary scale.</p><p><strong>Results: </strong>Overall, 94% of GPT-4o's responses were rated as \"highly appropriate\" across 50 tasks, with 98% deemed \"highly comprehensible\". Responses related to basic knowledge were 96% appropriate and 100% comprehensible, while management-related responses were 92% appropriate and 96% comprehensible. In total, two responses (4%) were rated negatively as quite inappropriate. Minor inconsistencies were observed in 12% of regenerated responses, with relevant content missing in 6% of inquiries.</p><p><strong>Conclusions: </strong>GPT-4o demonstrated high accuracy and reliability in addressing patient inquiries related to TOE. These findings suggest that this AI platform could effectively supplement patient education and complement healthcare professionals' guidance, thereby reducing the workload of echocardiography lab staff.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978008","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":"Intra- and inter-rater reliability of swallowing-related muscle assessments using ultrasound devices.","authors":"Shota Ishino, Motoomi Nagasaka, Koki Kawamura, Yuto Masuda, Masaki Kamiya, Taku Iwase, Keisuke Maeda, Hitoshi Kagaya","doi":"10.1007/s40477-025-01069-w","DOIUrl":"https://doi.org/10.1007/s40477-025-01069-w","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the inter- and intra-assessor reliability of ultrasonographic assessment of swallowing-related muscle indices in healthy young adults.</p><p><strong>Methods: </strong>Three examiners conducted ultrasonographic evaluations on healthy young adults (n = 34, age: ≥ 20 years) examining the thickness and area of the geniohyoid muscle, anterior belly of the digastric muscle, tongue, and the mylohyoid, masseter, and depressor anguli oris muscles. To assess inter-rater reliability, each examiner evaluated each assessment item for one subject three times on the same day. Intra-rater reliability was assessed by rater No. 3 re-evaluating the participants 4-7 days after the initial measurement, using the retest method. Image analysis was conducted by a single examiner utilizing an ultrasonography measurement tool. Statistical analysis was performed using intraclass correlation coefficients (ICCs) for intra- and inter-rater reliability.</p><p><strong>Results: </strong>The study included 34 participants (male: 17, female: 17; age: 25 ± 2 years, body mass index: 20.3 ± 1.7 kg/m²). For intra-rater reliability for thickness of the geniohyoid muscle, ICC = 0.94 [95% CI (0.89, 0.97)], and ICC = 0.90 [95% CI (0.81, 0.93)] for the area of the anterior belly of the digastric muscle. For inter-rater reliability, ICC = 0.93 [95% CI (0.88, 0.96)] and 0.86 [95% CI (0.77, 0.92)] for the thickness of the geniohyoid muscle, and area of the anterior belly of the digastric muscle, respectively.</p><p><strong>Conclusions: </strong>The inter- and intra-assessor reliability of ultrasound assessments of swallowing-related indices in young healthy subjects was good, exhibiting particularly high accuracy for the geniohyoid muscle and the anterior belly of the digastric muscle.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977956","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":"Utilization of left ventricular outflow tract velocity time integral in the assessment of fluid responsiveness in adult patients with sepsis or septic shock - a systematic review.","authors":"Stephin Zachariah Saji, Olivia Murga, Swati Khurana, Bui Hung Phan, Bana Khalil, Amina Mustafa Nagra, Steysi Falcon Aragon, Deekksha Kolagatla, Victor Sebastian Arruarana, Domenica A Herrera, Samer Kottiech, Ernesto Calderón Martínez","doi":"10.1007/s40477-025-01072-1","DOIUrl":"https://doi.org/10.1007/s40477-025-01072-1","url":null,"abstract":"<p><strong>Background: </strong>Sepsis and septic shock are life-threatening conditions driven by dysregulated host responses to infection, resulting in multi-organ dysfunction. While early fluid resuscitation is essential, both fluid overload and under-resuscitation can worsen outcomes. Left Ventricular Outflow Tract Velocity Time Integral (LVOT VTI) has emerged as a non-invasive echocardiographic tool to assess fluid responsiveness. This systematic review evaluates the diagnostic performance, cutoff values, and limitations of LVOT VTI as a tool for assessing fluid responsiveness in adult patients with sepsis or septic shock.</p><p><strong>Methods: </strong>A systematic search of PubMed, Cochrane, Scopus, Web of Science, EMBASE, and CINAHL was conducted through April 13, 2025, following PRISMA 2020 guidelines (PROSPERO ID: CRD420251036927). Eligible studies used transthoracic or transesophageal echocardiography to measure LVOT VTI and assessed changes following passive leg raise (PLR) or volume expansion tests (VET). Fluid responsiveness was defined as a ≥ 10-15% increase in VTI.</p><p><strong>Results: </strong>Three observational studies including 199 adult patients (20 with sepsis, 179 with septic shock) met inclusion criteria. Two studies used VET (500 mL saline), and one used PLR. Optimal LVOT VTI cutoffs ranged from > 7% to 16%, with sensitivity 78-96%, specificity 91-100%, and AUCs 0.84-0.99. Based on the Newcastle-Ottawa Scale, two studies were rated good quality, and one was fair.</p><p><strong>Conclusion: </strong>LVOT VTI is a reliable, non-invasive parameter for assessing fluid responsiveness in sepsis and septic shock. Despite limited data, this review supports its integration into bedside fluid management protocols to guide individualized resuscitation strategies.</p><p><strong>Prospero registration id: </strong>CRD420251036927.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977984","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":"Pancreatic 2D SWE: a potential tool for non-invasive evaluation of diabetes and diabetic microangiopathy?","authors":"Lakshmi Shri Sivaraju, Rashmi Dixit, Anjali Prakash, Sandeep Garg, Paromita Dutta","doi":"10.1007/s40477-025-01070-3","DOIUrl":"https://doi.org/10.1007/s40477-025-01070-3","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the pancreatic stiffness values in non-diabetics and diabetic patients using ultrasound shear wave elastography and to associate shear wave elastography values with the presence of diabetic microangiopathy.</p><p><strong>Methods: </strong>The study included 133 adult participants with 50 non-diabetics and 83 diabetics. Among 83 diabetics, 42 were without and 41 were with diabetic microangiopathy. Pancreatic stiffness was assessed using 2D shear-wave elastography (SWE), with values expressed in kilopascals (kPa) and meters per second (m/s). Measurement reliability was ensured by maintaining an interquartile range-to-median ratio (IQR/M) of ≤ 30% for kPa and ≤ 15% for m/s.</p><p><strong>Results: </strong>Pancreatic stiffness measured by 2D shear wave elastography was significantly higher in diabetic patients compared to non-diabetic participants, with further elevated values observed in those with microangiopathy. Stiffness values increased proportionally with the number of microangiopathies, with the highest values seen in patients with multiple microangiopathies. ROC curve analysis revealed cutoff values of pancreatic stiffness for predicting diabetes and microangiopathy, demonstra0ting high sensitivity and specificity, with higher stiffness thresholds correlating with the presence of microangiopathy.</p><p><strong>Conclusion: </strong>These findings highlight the utility of 2D shear wave elastography as a valuable, non-invasive imaging tool for the assessment of pancreatic changes in diabetes and its associated microangiopathic complications.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977947","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":"B-flow imaging in abdominal ultrasound: a pictorial essay.","authors":"Marco Becciolini, Alice Brighenti, Valeria Tiraferri, Antonio Corvino, Andrea Boccatonda, Carla Serra","doi":"10.1007/s40477-025-01068-x","DOIUrl":"https://doi.org/10.1007/s40477-025-01068-x","url":null,"abstract":"<p><p>B-Flow technology represents a significant advancement in vascular ultrasound imaging, offering high-resolution visualization of blood flow without the limitations inherent in conventional Doppler techniques. By employing Coded Excitation and Tissue-Blood Equalization (TBE) technologies, B-Flow enhances the detection of low-velocity and microvascular blood flow while minimizing aliasing artifacts and angle dependency. This innovative technique proves especially useful in abdominal ultrasound, enabling the accurate assessment of vascularization in organs such as the liver, kidneys, pancreas, spleen, and bowel. B-Flow's ability to depict fine vascular details is particularly beneficial in evaluating focal lesions, vascular malformations, portal hypertension, and transplant perfusion. Furthermore, the technique's application extends to both parenchymal and vascular pathologies, demonstrating significant advantages over traditional Doppler methods in terms of spatial resolution and real-time flow visualization. This pictorial essay aims to describe the technological basis of the B-Flow technique, highlighting its advantages and disadvantages, as well as the main clinical applications in abdominal diagnostics.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977958","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":"Not only vascular lesions: a case report of infantile fibrosarcoma.","authors":"L Marone, A Masucci, F Barbato, F Ausiello, R Zeccolini, M E Errico, F Esposito","doi":"10.1007/s40477-025-01063-2","DOIUrl":"https://doi.org/10.1007/s40477-025-01063-2","url":null,"abstract":"<p><strong>Objectives: </strong>To present a rare case of congenital infantile fibrosarcoma (IFS) mimicking a vascular anomaly and to emphasize the diagnostic value of color Doppler and contrast-enhanced ultrasound (CEUS) in differentiating IFS from benign vascular tumors such as congenital hemangioma.</p><p><strong>Materials and methods: </strong>We present the case of a 4-month-old male with a congenital lumbosacral mass initially suggestive of congenital hemangioma. Ultrasound and Doppler examination demonstrated a highly vascularized lesion; however, the imaging findings remained equivocal for a definitive diagnosis of hemangioma. MRI confirmed a solid, hypervascular lesion without spinal involvement. Histopathology identified a spindle cell neoplasm consistent with IFS, likely driven by an NTRK rearrangement. The mass was surgically excised with a good postoperative recovery.</p><p><strong>Results: </strong>Doppler and CEUS findings showed vascular features atypical for congenital hemangiomas, which generally present with diffuse, centripetal enhancement and sustained contrast uptake. In contrast, this lesion exhibited an organized radial vascular pattern with early unidirectional enhancement and rapid washout. However, imaging findings remained equivocal for a definitive diagnosis of hemangioma, necessitating further histopathological evaluation, leading to timely surgical management.</p><p><strong>Conclusions: </strong>This case underscores the diagnostic challenge in distinguishing IFS from benign vascular tumors and highlights the importance of histological evaluation. Early recognition is essential, as IFS, though locally aggressive, has a favorable prognosis when promptly and properly managed.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823176","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}