Ultrasonography最新文献

{"title":"LAD-NASH score using multiparametric ultrasound for identification of at-risk MASH: head-to-head comparison with the FAST score.","authors":"Seung-Seob Kim, Jae Seung Lee, Min Young Lee, Sunyoung Lee","doi":"10.14366/usg.26117","DOIUrl":"10.14366/usg.26117","url":null,"abstract":"<p><strong>Purpose: </strong>Noninvasive scores have been proposed to identify patients with at-risk metabolic dysfunction-associated steatohepatitis (MASH) who may benefit from pharmacologic therapy. The LAD-NASH (model combining attenuation coefficient, dispersion slope, and liver stiffness for identification of nonalcoholic steatohepatitis) score, a multiparametric ultrasound (US)-based model that combines the attenuation coefficient, dispersion slope, and liver stiffness to identify nonalcoholic steatohepatitis, was recently developed for this purpose. This study aimed to validate the LAD-NASH score for identifying at-risk MASH in patients with biopsy-proven metabolic dysfunction-associated steatotic liver disease (MASLD) and to compare its diagnostic performance with that of the FibroScan-aspartate aminotransferase (FAST) score.</p><p><strong>Methods: </strong>This study enrolled consecutive patients who underwent multiparametric US and liver biopsy on the same day between February 2023 and April 2024. At-risk MASH was defined as biopsy-confirmed MASH with a MASLD activity score of ≥4 and fibrosis stage of ≥F2. The diagnostic performance of the LAD-NASH and FAST scores was evaluated using the areas under the receiver-operating characteristic curves (AUROCs).</p><p><strong>Results: </strong>A total of 70 patients with biopsy-proven MASLD were included (median age, 44 years; 34 men; median body mass index, 28.7 kg/m²; at-risk MASH, 27.1%). The LAD-NASH and FAST scores demonstrated comparable diagnostic performance for identifying at-risk MASH (AUROCs, 0.740; 95% confidence intervals [CI], 0.621 to 0.838 vs. 0.739; 95% CI, 0.621 to 0.837; P=0.995). Using the rule-out cutoff of ≤0.264, the LAD-NASH score demonstrated 100% sensitivity and 100% negative predictive value for at-risk MASH.</p><p><strong>Conclusion: </strong>The LAD-NASH and FAST scores showed comparable diagnostic performance for identifying at-risk MASH. Because it is based solely on multiparametric US, the LAD-NASH score may be a useful noninvasive rule-out tool for at-risk MASH.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":"45 5","pages":"439-449"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Functional Impingement Subacromial Ultrasound (FISUN) test: a conceptual and methodological framework for functional assessment of the subacromial space.","authors":"Paweł Niewiadomy, Katarzyna Szuścik-Niewiadomy","doi":"10.14366/usg.26040","DOIUrl":"10.14366/usg.26040","url":null,"abstract":"<p><p>The purpose of this study was to present a standardized technical and methodological framework for functional ultrasound assessment of the subacromial space. This framework, the Functional Impingement Subacromial Ultrasound (FISUN) test, was designed to evaluate dynamic relationships between the greater tuberosity of the humerus and the acromion during functional arm elevation. The FISUN test is performed using real-time musculoskeletal ultrasound during functional arm elevation in the scapular plane under three sequential conditions with progressively increasing functional demands. The assessment is based on dynamic analysis of the relationship between the greater tuberosity of the humerus and the acromion during passive arm elevation, active arm elevation, and active arm elevation against resistance. A four-level classification system (levels 0-IV) is proposed to describe patterns of functional subacromial space behavior. The FISUN test provides a reproducible, clinically applicable framework for functional ultrasound assessment beyond static imaging and pain-provocation tests. By integrating standardized movement conditions with real-time dynamic ultrasound, the test allows subacromial space behavior to be evaluated in the context of motor control and functional loading. This Technical Note presents the methodological foundations of the FISUN test and provides a basis for future reliability studies.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":"45 5","pages":"519-526"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a noninvasive ultrasound-based model for predicting high-risk esophageal varices in hepatitis-related cirrhosis.","authors":"Xue-Dong Teng, Xian-Feng Pan, Hai-Zheng Wu, Jian-Shan Geng","doi":"10.14366/usg.26155","DOIUrl":"10.14366/usg.26155","url":null,"abstract":"<p><strong>Purpose: </strong>High-risk esophageal varices (HREVs) are a serious complication of cirrhosis, and reliable noninvasive tools are needed to improve endoscopic triage. This study aimed to develop and validate an ultrasound-based model for predicting HREVs in patients with hepatitis-related cirrhosis.</p><p><strong>Methods: </strong>This retrospective study included 293 patients who underwent endoscopy and noninvasive assessment between January 2019 and January 2023. Patients were assigned to training (n=210) and validation cohorts (n=83). Predictors were selected using univariable analysis, multivariable logistic regression, and Akaike information criterion-based backward selection. Discrimination, calibration, and clinical utility were evaluated using receiver operating characteristic analysis, calibration curves, decision curve analysis, and clinical impact curves.</p><p><strong>Results: </strong>Portal vein velocity (PVV) and spleen volume (SV) were retained in the final model. The model incorporated PVV as a linear term and SV as a restricted cubic spline term. The area under the receiver operating characteristic curve was 0.951 in the training cohort and 0.956 in the validation cohort. At a cutoff of 0.30, the model showed high diagnostic performance and outperformed the single predictors and the Baveno VI criteria. Calibration and decision curve analyses indicated good agreement and favorable clinical utility.</p><p><strong>Conclusion: </strong>This model provides a simple, noninvasive approach to individualized prediction of HREVs in patients with hepatitis-related cirrhosis.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":"45 5","pages":"471-481"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Questions regarding predictor directionality and outcome definition in ultrasound-based prediction of postoperative hypothyroidism.","authors":"Yakup Ozbay","doi":"10.14366/usg.26136","DOIUrl":"10.14366/usg.26136","url":null,"abstract":"","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":"45 5","pages":"527-528"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corpus callosum and subarachnoid space measurements in fetuses with congenital heart disease: a prospective case-control study.","authors":"Verda Alpay, Fırat Ersan, Barış Boza","doi":"10.14366/usg.25254","DOIUrl":"10.14366/usg.25254","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the associations of prenatally diagnosed congenital heart disease (CHD) with head circumference (HC) and supratentorial brain structures, specifically the corpus callosum (CC) and subarachnoid space (SAS), and determined whether these measurements varied according to expected fetal brain oxygen delivery.</p><p><strong>Methods: </strong>This prospective case-control study included 102 pregnancies at 32 to 36 weeks of gestation: 51 fetuses with CHD and 51 healthy controls. CHD cases were grouped according to expected fetal brain oxygen delivery as class A (n=26, reduced supply) or class B (n=25, normal supply). Measurements included CC length, the heights of the genu, body, and splenium, SAS, and HC.</p><p><strong>Results: </strong>Gestational age at delivery and birth weight were significantly lower in the CHD group than in controls (both P&lt;0.01). Total CC length and all segmental heights (genu, body, and splenium) were significantly reduced in both CHD subgroups (class A and class B) compared with healthy controls (all P&lt;0.01). However, no significant differences in CC parameters were observed between class A and class B (P&gt;0.99). SAS (P=0.267) and HC (P=0.083) measurements did not differ significantly among the three study groups.</p><p><strong>Conclusion: </strong>Fetuses with CHD exhibited significant structural reductions across all CC dimensions, independent of the expected cerebral oxygen delivery pattern, whereas global parameters (HC and SAS) did not differ significantly. These findings suggest that CHD-related prenatal brain alterations may involve white matter development even without measurable changes in global cranial parameters, supporting CC biometry as a potentially sensitive marker for early neurodevelopmental risk assessment.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":"45 5","pages":"482-490"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonography in 2025: impact, reach, and future directions.","authors":"Jung-Eun Cheon","doi":"10.14366/usg.26230","DOIUrl":"10.14366/usg.26230","url":null,"abstract":"","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":"45 5","pages":"423-425"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative liver ultrasound: current status and challenges.","authors":"Yunlin Huang, Yi Yu, Ying Wang, Yijie Qiu, Rui Cheng, Li Wei, Yi Dong","doi":"10.14366/usg.26148","DOIUrl":"10.14366/usg.26148","url":null,"abstract":"<p><p>Ultrasound is the most widely used imaging modality for liver evaluation because it is accessible, portable, affordable, and repeatable. Quantitative liver ultrasound should therefore be understood not as a single technology, but as a set of biomarker strategies at different stages of development. Ultrasound elastography is the most mature component of this field and has been incorporated into noninvasive pathways for fibrosis assessment. Ultrasound-based liver fat quantification is also advancing rapidly through attenuation, backscatter, and radiofrequency-based techniques. A newer area of investigation involves the evaluation of viscoelasticity and inflammatory activity using shear-wave dispersion and related biomarkers, particularly in metabolic dysfunction-associated steatotic liver disease. The future value of quantitative liver ultrasound will depend on integrating multiple parameters to support clinical triage, monitoring, and, increasingly, treatment decision-making.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":"45 5","pages":"426-438"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Energy sustainability of breast ultrasound: comparison of automated and handheld ultrasound systems.","authors":"Ji Young Lee, Jeong Taek Lee, Bo Kyoung Seo, Min Sun Bae, Yangin Moon, Hangseok Choi, Yeunggurl Yoon, Sungyun Choi","doi":"10.14366/usg.26043","DOIUrl":"10.14366/usg.26043","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated and compared energy consumption between automated breast ultrasound (ABUS) and handheld ultrasound (HHUS) systems during routine whole-breast ultrasound (US) examinations in clinical practice.</p><p><strong>Methods: </strong>This prospective observational study included 320 consecutive patients who underwent breast US between July and October 2025. Four systems were used: two ABUS systems, designated ABUS-1 and ABUS-2, and two HHUS systems, designated HHUS-1 and HHUS-2. HHUS examinations were performed by four radiologists. Energy consumption was measured using a real-time power meter synchronized with system log files. Power consumption was analyzed in active, idle, and off modes. Average power in each mode, examination duration, and energy consumption during active scanning were calculated. Data were analyzed using the independent-samples t-test or Mann-Whitney U test with Bonferroni correction.</p><p><strong>Results: </strong>In idle mode, ABUS systems consumed significantly less average power than HHUS systems (P&lt;0.001). In off mode, both ABUS systems consumed 0 W, whereas HHUS systems continued to consume residual power. During active scanning, ABUS systems had shorter examination durations than HHUS systems, with ABUS-1 showing the shortest duration. Energy consumption during active scanning was lowest for ABUS-1, which consumed approximately 47% less energy than HHUS-1 (P&lt;0.001). Across all radiologists, both ABUS systems consistently showed lower energy consumption than HHUS-1.</p><p><strong>Conclusion: </strong>Compared with HHUS, ABUS showed lower power use in idle and off modes and similar or lower energy consumption during active scanning. When clinically appropriate, preferential use of ABUS may improve energy sustainability while preserving clinical utility.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":"45 5","pages":"460-470"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiating hepatic hemangiomas from hepatocellular carcinomas using Sonazoid-enhanced ultrasonography: a proposed two-step diagnostic algorithm.","authors":"Taewon Han, Jeong Ah Hwang, Woo Kyoung Jeong, Seungchul Han, Seo-Youn Choi, Kyowon Gu","doi":"10.14366/usg.26140","DOIUrl":"10.14366/usg.26140","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop a diagnostic algorithm for differentiating hepatic hemangiomas from hepatocellular carcinoma (HCC) using Sonazoid-enhanced ultrasonography (SEUS).</p><p><strong>Methods: </strong>A retrospective analysis was conducted of SEUS examinations from 159 patients with 110 hemangiomas and 49 HCCs between January 2011 and December 2022. The evaluated imaging features included lesion hyperechogenicity, typical grayscale features of hemangioma, defined as a hyperechoic lesion or echogenic border without a hypoechoic rim or nodule-in-nodule appearance, and typical globular enhancement of hemangioma. In the Kupffer phase (KP), the lesion-to-liver ratio (KP ratio) was calculated, and receiver operating characteristic analysis was performed to determine the optimal KP ratio cutoff for predicting hemangioma. A two-step diagnostic algorithm was developed and compared with typical globular enhancement of hemangioma using the McNemar test.</p><p><strong>Results: </strong>The optimal KP ratio cutoff for predicting hemangioma was 0.85. The two-step algorithm first identified hemangiomas based on typical globular enhancement and then applied typical grayscale features and a KP ratio ≥0.85 to lesions without typical globular enhancement. The algorithm showed higher sensitivity than typical globular enhancement alone (90.0% vs. 81.8%, P=0.008) while maintaining 100% specificity. In hyperechoic lesions, the algorithm also showed higher sensitivity than typical globular enhancement alone (91.9% vs. 77.4%, P=0.008).</p><p><strong>Conclusion: </strong>The proposed two-step algorithm may improve sensitivity while maintaining specificity in clinical settings that require differentiation between hemangiomas and HCC.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":"45 5","pages":"491-502"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathologic determinants of shear-wave elastography stiffness in soft-tissue sarcomas.","authors":"Jiwoo Park, Sang Kyum Kim, Seung Hyun Kim, Seok Hahn, Young Han Lee","doi":"10.14366/usg.25268","DOIUrl":"10.14366/usg.25268","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate shear-wave elastography (SWE)-derived stiffness values and key histopathologic features of soft-tissue sarcomas and to assess the potential diagnostic value of SWE for differentiating sarcomas from non-sarcoma soft-tissue lesions.</p><p><strong>Methods: </strong>This retrospective study included 49 consecutive patients with clinically suspected soft-tissue tumors who underwent conventional ultrasonography (US) and SWE between April 2024 and March 2025. Quantitative SWE parameters, including mean and maximum stiffness values in kilopascals, were measured from at least four acquisitions for each lesion. Histopathologic grade was determined using the Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) system, and key histopathologic features relevant to SWE interpretation were assessed, including tumor necrosis, mitotic count, cellularity, and extent of myxoid stroma. Associations between SWE-derived stiffness values and histopathologic features were evaluated as the primary analysis, and diagnostic performance for sarcoma discrimination was evaluated as a secondary analysis. A P&lt;0.05 was considered to indicate statistical significance.</p><p><strong>Results: </strong>Microscopic necrosis was the only histopathologic feature significantly associated with SWE-derived stiffness; sarcomas without necrosis showed higher stiffness values than those with necrosis (P&lt;0.05). SWE stiffness values showed a nonlinear relationship with FNCLCC grade, increasing from grade 1 to grade 2 and then decreasing in grade 3 sarcomas. Conventional US showed high sensitivity (84.4%) but low specificity (35.3%) for sarcoma discrimination, whereas SWE-derived stiffness showed low sensitivity (21.9%-31.3%) but relatively high specificity (82.4%-88.2%).</p><p><strong>Conclusion: </strong>SWE-derived stiffness appears to be affected by intratumoral heterogeneity, particularly microscopic necrosis, which may help explain its nonlinear relationship with histologic grade. Although SWE alone showed limited sensitivity for sarcoma discrimination, its relatively high specificity may complement conventional US when markedly elevated stiffness is present.</p>","PeriodicalId":54227,"journal":{"name":"Ultrasonography","volume":"45 5","pages":"450-459"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}