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Ultrasound Quarterly[JOURNAL]

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The Superior Mesenteric Artery Angle and Abdominal Main Vessel Diameters in Normovolemic Children: For Practical Sonographic Evaluation.

Keçeli M

Ultrasound Q · 2021 Dec · PMID 34855710 · Publisher ↗

BACKGROUND: Knowledge of the normal size of important abdominal vessels is important for determination of hydration status and intravascular volume. Knowing the normal value of superior mesenteric artery (SMA) exit angle... BACKGROUND: Knowledge of the normal size of important abdominal vessels is important for determination of hydration status and intravascular volume. Knowing the normal value of superior mesenteric artery (SMA) exit angle from the aorta (SMA angle) is necessary for the diagnosis of clinical pathologies caused by SMA compression. OBJECTIVES: The aim of this study was to determine the normal SMA angles and normal diameters of the main abdominal vascular structures of pediatric participants on ultrasonography (USG). METHODS: Between January 2019 and July March 2019, the USG examinations obtained from 210 participants (age range, 1-214 years; mean age, 83.5 [SD, 5.5] months; females 51%, males 49%) with normal abdominal examinations were prospectively evaluated. The participants were divided into 5 groups according to age. Body mass index values of the participants were kept equal. RESULTS: The diameters of the abdominal vascular structures increased with age, and the statistical differences among the age groups were significant. In all groups, no statistically significant difference was observed between sexes (P > 0.05). The SMA angle was between 17° and 58° (mean, 37.8° [SD, 8.5°]). A statistically significant difference was observed between the age groups in terms of SMA angle (P < 0.05). No statistically difference was found between sexes (P > 0.58-0.912). CONCLUSIONS: In our study, we think that the measurements obtained by USG provide normal values of the diameters of the abdominal main vessels and SMA angle. These values can be used as a reference for interpreting hydration status, vascular diameter assessment, and SMA compression syndromes.

Preoperative Evaluation of Central Lymph Nodes in Papillary Thyroid Carcinoma Using High-Resolution Ultrasound and Shear-Wave Elastography.

Liu Y, Li S, Yun M … +5 more , Lin X, Lin Y, Long X, Zhou J, Liu L

Ultrasound Q · 2021 Dec · PMID 34855709 · Publisher ↗

The aim of this study was to discuss the diagnostic value of high-resolution ultrasound and virtual touch tissue imaging quantification (VTIQ) for distinguishing metastatic and benign central lymph nodes (CLNs) in patien... The aim of this study was to discuss the diagnostic value of high-resolution ultrasound and virtual touch tissue imaging quantification (VTIQ) for distinguishing metastatic and benign central lymph nodes (CLNs) in patients with papillary thyroid carcinoma. This retrospective study involved 86 pathologically proven benign lymph nodes (LNs) and 118 metastatic LNs in patients with papillary thyroid carcinoma. We analyzed the sonographic features of CLNs (size, shape, distribution, hilum, echogenicity, cystic change, calcification, vascularity, shear-wave velocity [SWV]). The prevalence of sonographic features and the SWV was compared between metastatic and benign CLNs. The size, shape, margin, distribution, presence of hilum, echogenicity, calcification, and vascularity were significantly different between benign and metastatic CLNs (P < 0.05 for all). The mean maximum SWV for malignant CLNs was 3.139 ± 0.408 m/s, whereas that of benign CLNs was 2.418 ± 0.369 m/s (P < 0.05). The cutoff point of the SWV for differentiating benign and malignant LNs was 2.675 m/s. Logistic regression analysis showed that round or irregular shape, aggregation or fusion, calcification, and VTIQ value greater than 2.675 m/s of CLNs were independent risk factors for malignancy, with an odds ratio of 5.77, 3.05, 3.23, and 62.85, respectively. High-resolution ultrasound and VTIQ can provide valuable information for distinguishing metastatic from benign CLNs.

Interobserver Variability of Ultrasound Features Based on American College of Radiology Thyroid Imaging Reporting and Data System Lexicon in American College of Radiology Thyroid Imaging Reporting and Data System System: A Single-Center Study With Radiologists and Radiology Residents.

Özel A, Türkyılmaz Mut D, Ağrıdağ Üçpınar B … +4 more , Özdal Sayer A, Yanç U, von Bodelschwingh B, Gemalmaz A

Ultrasound Q · 2021 Dec · PMID 34855708 · Publisher ↗

The aim of this study is to evaluate the variability of selecting the ultrasound features used in American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) and in assigning the ACR-TIRADS level... The aim of this study is to evaluate the variability of selecting the ultrasound features used in American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) and in assigning the ACR-TIRADS level in a single center among radiologists and radiology residents. The study cohort consisted of 108 thyroid nodules in 102 patients who had definite cytology results after thyroid fine needle aspiration biopsy (Bethesda category II, VI) or surgery. Seven observers including 3 radiologists and 4 radiology residents evaluated the nodules according to 5 ultrasound feature categories. The evaluation process was performed after a joint meeting session, in which the "white papers" of the ACR-TIRADS committee were discussed regarding the thyroid ultrasound reporting lexicon, and final TIRADS system. Variability of ultrasound features and assigning ACR-TIRADS level was measured using Fleiss kappa statistics. Agreement for ultrasound features was "substantial" to "almost perfect" among all observers, with composition (κ = 0.86), macrocalcification (κ = 0.89) and peripheral calcification (κ = 0.92) at the highest level of agreement. The level of agreement for large comet tail artifacts and punctate echogenic foci was "moderate" in residents, whereas in radiologists, that level was "substantial." The agreement for assigning ACR-TIRADS level was moderate in resident as well as in radiologist subgroup. Agreement of thyroid ultrasound features was "substantial to almost perfect" among all observers. Although the level of agreement among resident group decreased to "moderate" level, ACR-TIRADS is a useful system in thyroid nodule management.

Advanced Ultrasound Techniques for Differentiation of Benign Versus Malignant Thyroid Nodules: A Review.

Saade-Lemus SM, Sridharan A, Smitthimedhin A … +4 more , Bauer A, Cahill AM, Darge K, Hwang M

Ultrasound Q · 2021 Dec · PMID 34855707 · Publisher ↗

Grayscale ultrasound (US) is decisive in stratifying which thyroid nodules benefit from fine-needle aspiration to evaluate for malignancy. Unfortunately, a significant percentage of nodules remain indeterminate.Herein, w... Grayscale ultrasound (US) is decisive in stratifying which thyroid nodules benefit from fine-needle aspiration to evaluate for malignancy. Unfortunately, a significant percentage of nodules remain indeterminate.Herein, we review the clinical considerations and diagnostic accuracy of advanced US, Doppler US, contrast-enhanced US, and US elastography techniques in the evaluation of indeterminate nodules.We conclude that these techniques may be used in combination with grayscale US to improve the assessment of lesion vascularity and tissue property.

Comments From the Editor.

Dubinsky TJ

Ultrasound Q · 2021 Dec · PMID 34855706 · Publisher ↗

Abstract loading — click title to view on PubMed.

An Exploratory Study Into a New Head Ultrasound Marker for Predicting Neurodevelopmental Outcomes in Preterm Infants.

Yuan J, Cao X, Deng Y

Ultrasound Q · 2021 Nov · PMID 34845178 · Publisher ↗

Preterm infants are at risk of neurological impairments and long-term developmental delay. Head ultrasound (HUS) is a promising tool for early detection of preterm brain injury and prediction of neurodevelopmental outcom... Preterm infants are at risk of neurological impairments and long-term developmental delay. Head ultrasound (HUS) is a promising tool for early detection of preterm brain injury and prediction of neurodevelopmental outcomes. We performed a retrospective analysis of data of 42 preterm infants with neurodevelopmental follow-up at 12 to 24 months corrected age. Corpus callosum length (CC length) and corpus callosum-fastigium length (CCF length) were measured on the HUS scans. Motor function and communication skills were assessed using evaluation scales. Corpus callosum length and CCF length were correlated with neurodevelopmental outcomes using Spearman correlation analysis. Neither CC length nor CCF length correlated with motor developmental outcomes. On early HUS, the CCF length was negatively correlated with symbolic composite percentile ranks (Spearman ρ = -0.49, P = 0.033) and total percentile ranks (Spearman ρ = -0.545, P = 0.016). On follow-up HUS scans, the CCF length was also found to be negatively correlated with social composite raw scores and percentile ranks (Spearman ρ = -0.615, P = 0.005; and Spearman ρ = -0.64, P = 0.003, respectively), symbolic composite raw scores and percentile ranks (Spearman ρ = -0.609, P = 0.006; and Spearman ρ = -0.657, P = 0.002, respectively) and total raw scores and percentile ranks (Spearman ρ = -0.472, P = 0.041; and Spearman ρ = -0.504, P = 0.028, respectively). Corpus callosum-fastigium length measurement on serial HUS is useful in predicting cognitive and behavioral outcomes at corrected age 12 to 24 months.

Construction and Validation of a Predictive Nomogram Based on Ultrasound for Lymph Node Metastasis of Papillary Thyroid Carcinoma in the Cervical Central Region.

Shen H, Lv G, Li T … +6 more , Wang Y, Chen K, Wang K, Li L, Zheng X, Yang S

Ultrasound Q · 2023 Mar · PMID 34743152 · Publisher ↗

To establish and validate a nomogram for predicting lymph node metastasis (LNM) of papillary thyroid carcinoma (PTC) in the cervical central region. This retrospective study included 287 PTC patients with 309 nodules tre... To establish and validate a nomogram for predicting lymph node metastasis (LNM) of papillary thyroid carcinoma (PTC) in the cervical central region. This retrospective study included 287 PTC patients with 309 nodules treated from December 2018 to May 2020 at our hospital. The cohort was divided randomly into a training set and a testing set according to a 7:3 ratio. The training set contained 216 nodules, and the testing set contained 93 nodules. The nomogram was developed using the training set, and the data of the testing set were used to validate the performance of nomogram. The predictive accuracy and discriminative ability of the nomogram were determined by concordance index (C-index) and calibration curve. The study showed multifocality, thyroid lesion size, and American College of Radiology Thyroid Imaging, Reporting and Data System (TI-RADS) score were significantly independently associated with LNM in the cervical central region. In the testing set, the calibration curve showed that the nomogram had good discrimination with a C-index of 0.775 (95% confidence interval, 0.680-0.869) and adequate calibration ( P = 0.808). By decision curve analysis and clinical impact curve analysis, the nomogram was shown to have a satisfactory net benefit between thresholds of 0.40 and 0.75. The nomogram can be used for predicting LNM of PTC in the cervical central region and may provide valuable guidance for planning the surgical treatment of PTC patients.

Clinical Ultrasound Education for Medical Students: Virtual Reality Versus e-Learning, a Randomized Controlled Pilot Trial.

Rosenfeldt Nielsen M, Kristensen EQ, Jensen RO … +3 more , Mollerup AM, Pfeiffer T, Graumann O

Ultrasound Q · 2021 Sep · PMID 34478430 · Publisher ↗

The primary aim was to evaluate the effect of immersive virtual reality learning for training medical students in basic clinical ultrasound. Secondary outcomes were to explore if virtual reality learning had an effect on... The primary aim was to evaluate the effect of immersive virtual reality learning for training medical students in basic clinical ultrasound. Secondary outcomes were to explore if virtual reality learning had an effect on hand-eye coordination skills and if the medical students wanted more virtual reality learning.This pilot study was a double-blind, parallel-group, block-randomized, controlled trial. Participants (n = 20) were blinded and randomized to virtual reality or e-learning for basic ultrasound education. Medical students with no previous ultrasound education were recruited voluntarily from the University of Southern Denmark. Data were collected during introductory courses on ultrasound from March to May 2019. Participants were assessed with Objective Structured Assessment on Ultrasound Skills. Assessing supervisors were blinded.The virtual reality group (n = 11) scored a significantly higher Objective Structured Assessment on Ultrasound Skills score (143 [95% confidence interval {CI}, 135 to 151]) compared with the e-learning group (n = 9; 126 [95% CI, 113 to 138]; mean difference, 17 points [95% CI, 4 to 30]; P < 0.01). No significant effect on the hand-eye score was found (mean difference, 3 points [95 % CI, -3 to 9]; P = 0.32). Ninety-one percent of the virtual reality group wanted more virtual reality learning.Immersive virtual reality learning improved medical students' ultrasound skills significantly compared with e-learning. The hand-eye score was higher in the virtual reality group, although not at a significant level. Students wanted more virtual reality learning. Further research is needed to clarify immersive virtual reality's educational role in the future.

Diagnostic Accuracy of Longitudinal Evaluation of Central Nervous System Sonoelastography in Preterm and Term Neonates.

Ozkan MB, Ozkan EÖ

Ultrasound Q · 2021 Sep · PMID 34478429 · Publisher ↗

OBJECTIVES: The objective of this study was to evaluate the brain elasticity of the central nervous system in preterm and term neonates. METHODS: Seventy-seven healthy preterm and term neonates (mean gestational age [GA]... OBJECTIVES: The objective of this study was to evaluate the brain elasticity of the central nervous system in preterm and term neonates. METHODS: Seventy-seven healthy preterm and term neonates (mean gestational age [GA], 37.5 weeks; range, 32.6-40.5 weeks) were included in the study. Periventricular and subcortical white matter, cortical gray matter, and ventricle and subdural spaces were examined with strain elastography ratios. Each patient underwent sonography evaluation twice. The mean age at the time of sonographic evaluation was 9 days (range, 4-15 days) for the first evaluation and 37 days (range, 31-47 days) for the second evaluation. The ratios were correlated with GA, birth weight. RESULTS: The caudate nucleus and cortical gray matter strain ratios were significantly higher than the periventricular and subcortical white matter strain ratios (P < 0.001). There was a positive relationship between GA and periventricular white matter elastographic scores on the two measurements (P = 0.022 and 0.018, respectively). The term neonates have higher strain rations compared with the preterm neonates at the first assessment (P < 0.01). At the evaluation of the area under the curve for the sonographic examination for the receiver operating characteristic curve, the periventricular white matter was 0.742 (95% confidence interval, 0.689-0.790), and it was 0.773 (95% confidence interval, 0.722-0.818) for the subcortical white matter. CONCLUSIONS: Neonatal brain development, maturation, and myelination can be assessed by strain elastography. These findings should be evaluated with further larger cohorts that could help to prevent neonatal brain damages.

Automated Segmentation of Fetal Ultrasound Images Using Feature Attention Supervised Network.

Liu P, Zhao H, Li P

Ultrasound Q · 2021 Sep · PMID 34478428 · Publisher ↗

Segmentation of anatomical structures from ultrasound images requires the expertise of an experienced clinician, but developing a machine automated segmentation process is complicated because of the existence of characte... Segmentation of anatomical structures from ultrasound images requires the expertise of an experienced clinician, but developing a machine automated segmentation process is complicated because of the existence of characteristic artifacts. In this article, we present a novel end-to-end network that enables automated measurements of the fetal head circumference (HC) and fetal abdomen circumference (AC) to be made from 2-dimensional (2D) ultrasound images during each pregnancy trimester. These measurements are necessary, because the HC and AC are used to predict gestational age and to monitor fetal growth. Automated HC and AC assessments are valuable for providing independent and objective results and are particularly useful for application in developing countries where trained sonographers are in short supply. We propose a scale attention expanding network that builds a feature pyramid inside the network, and the intermediate result of each scale is then concatenated to the feature with a fusion scheme for the next layer. Furthermore, a scale attention module is proposed for selecting the most useful scale and for reducing scale noise. To optimize the network, a deep supervision method based on boundary attention is employed. Results of experiments show that the scale attention expanding network obtained an absolute difference, Hausdorff distance, and dice similarity coefficient of 1.81 ± 1.69%, 1.22 ± 0.77%, and 97.94%, respectively, which were top results in the HC18 data set, and respective results on the abdomen set were 2.23 ± 2.38%, 0.42 ± 0.56%, and 98.04%. The experiments conducted demonstrate that our method provides a superior performance to existing fetal ultrasound segmentation methods.

Magnetic Resonance Prediction of Lung Maturity in Fetuses With Congenital Diaphragmatic Hernia.

Wiggins E, Zecevic M, Hippe DS … +3 more , Moshiri M, Winter T, Dubinsky TJ

Ultrasound Q · 2021 Sep · PMID 34478427 · Publisher ↗

To determine if lung to liver MR T2 signal ratio is predictive of neonatal outcome in fetuses with congenital diaphragmatic hernia (CDH).After Interal Review Board approval, the PACS systems at the University of Washingt... To determine if lung to liver MR T2 signal ratio is predictive of neonatal outcome in fetuses with congenital diaphragmatic hernia (CDH).After Interal Review Board approval, the PACS systems at the University of Washington and University of Utah were searched for cases having an in utero fetal MR examination diagnostic of CDH. Inclusion criteria were at least 1 prior ultrasound demonstrating a CDH and an MR obtained within 1 week of that prior ultrasound.A total of 69 patients from the University of Utah and 13 from the University of Washington satisfied the inclusion criteria for a total of 82. After adjusting for gestational age and contralateral lung volume, there was little apparent association between contralateral lung to liver MR T2 signal and 5-minute Apgar score and neonatal mortality When considering neonatal Apgar and mortality, increasing contralateral lung volume was significantly associated with lower risk (hazard ratio, 0.40 per doubling; 95% confidence interval, 0.24-0.69; P = 0.001) as expected.Our data demonstrate that the lung to liver MR signal ratio was not predictive of outcome. The measurement of contralateral lung area, and gestational age at the time of the examination (time of diagnosis) are still the best predictors of poor neonatal outcome.

Sonographic Evaluation of Pulmonary Interstitial Edema in Patient With Preeclampsia.

Gokkus H, Cosgun Z, Cosgun M … +2 more , Ekici MA, Kalaycioglu O

Ultrasound Q · 2021 Sep · PMID 34478426 · Publisher ↗

The aim of this study was to sonographically detect pulmonary edema, which is a major problem in pregnant women with preeclampsia, in the interstitial phase. We evaluated 41 preeclampsia patients and 21 control subjects... The aim of this study was to sonographically detect pulmonary edema, which is a major problem in pregnant women with preeclampsia, in the interstitial phase. We evaluated 41 preeclampsia patients and 21 control subjects prospectively. In the preeclampsia group, 26 patients had severe features, whereas the other 15 patients had none. To detect early fluid loading in lungs, sonographic B lines were counted from the intercostal space by using ultrasonography, and left ventricular loading findings were examined for corporation by using transthoracic echocardiography both before and after birth. In severe preeclampsia, the number of B lines before and after birth is statistically significant compared with the other groups. In addition, the total number of B lines calculated at 24 hours after delivery was significantly lower than that calculated before delivery (P < 0.018). In terms of prenatal E values, a statistically significant difference was found between all groups (P < 0.001). A strong positive and statistically significant relationship was found between B lines and prenatal E/e' (r = 0.768; P < 0.001). The overall accuracy rate of the prenatal E/e' and E value for estimation of the B line number classification is 0.791 (95% confidence interval, 0.674-0.908; P < 0.001) and 0.829 (95% confidence interval, 0.722-0.936; P < 0.001), respectively. Pulmonary edema is a serious complication in patients with severe preeclampsia and may be detected interstitially in some patients, even if it does not occur clinically.

The Impact of Lung Ultrasound on Coronavirus Disease 2019 Pneumonia Suspected Patients Admitted to Emergency Departments.

Öztürk Sönmez L, Katipoğlu B, Vatansev H … +4 more , Kaykisiz EK, Yüce N, Szarpak L, Evrin T

Ultrasound Q · 2021 Mar · PMID 34478425 · Publisher ↗

OBJECTIVE: The aim of this study was to identify the sensitivity and specificity of lung ultrasound (LUS) and show its place in diagnosing patients with known coronavirus disease 2019 (COVID-19) pneumonia, according to c... OBJECTIVE: The aim of this study was to identify the sensitivity and specificity of lung ultrasound (LUS) and show its place in diagnosing patients with known coronavirus disease 2019 (COVID-19) pneumonia, according to chest computed tomography and the COVID-19 reporting and data system (CO-RADS). METHODS: Nineteen patients who admitted to a single university hospital emergency department between March 5, 2020, and April 27, 2020, describing dyspnea were included in the study and underwent LUS by a single emergency specialist. The patient population was divided into 2 groups, COVID-19 positive and negative, and the sensitivity and specificity of LUS according to chest computed tomography were calculated for COVID-19 pneumonia diagnosis. In the subgroup analysis, the patient group was divided into real-time reverse transcription-polymerase chain reaction positive (n = 7) and negative (n = 12), and sensitivity and specificity were calculated according to the CO-RADS. RESULTS: According to the CO-RADS, significant differences were detected between the LUS positive and negative groups in terms of COVID-19 pneumonia presence. Only 1 patient was evaluated as CO-RADS 2 in the LUS positive group, and 2 patients were evaluated as CO-RADS 4 in the LUS negative group (P = 0.04). The sensitivity of LUS according to the CO-RADS for COVID-19 pneumonia diagnosis was measured to be 77.78% (95% confidence interval [CI], 39.9%-97.1%), specificity was 90% (95% CI, 55.5%-99.75%), positive predictive value was 87.5% (95% CI, 51.35%-97.8%), and accuracy was 84.21% (95% CI, 60.4%-96.62%; P = 0.004). CONCLUSIONS: In conclusion, LUS is easily used in the diagnosis of COVID-19 pneumonia because it has bedside application and is fast, easy to apply, reproducible, radiation free, safe for pregnant women, and cheap.

Ultrasound Studies of COVID-19-Positive Patients and Patient Under Investigation: Pandemic Experience of Body Imaging Division at a Tertiary Medical Center.

Gawande RS, Vadvala HV, Shan A … +1 more , Sheth S

Ultrasound Q · 2021 Sep · PMID 34478424 · Publisher ↗

This retrospective study shares our departmental experience of screening of ultrasound (US) requests, triaging of studies, and abbreviated US protocols implemented during the COVID-19 pandemic. For US studies requested i... This retrospective study shares our departmental experience of screening of ultrasound (US) requests, triaging of studies, and abbreviated US protocols implemented during the COVID-19 pandemic. For US studies requested in April and May 2020, the following data were collected: type of study, indication, COVID-19 status (positive or patient under investigation [PUI]), decision to perform study, US findings, and location of patient. A total of 196 US studies in 150 patients were included. The median age of patients was 60 years (female: 46.7% [70/150]). At the time of study request, 83 patients (55.3%) were COVID-19-positive and 67 (44.7%) were PUI, of which 8 (11.9%) tested positive after waiting for test result. The most frequently requested study was venous extremity Doppler (51%), followed by right upper quadrant (20.4%), renal (11.7%), and liver duplex (6.6%). After radiologist screening and triage of US requests, 156 studies were performed (79.6%), 15 were postponed until COVID test result (7.6%), and 40 were not performed after discussion with ordering provider (20.4%). Notably, 40.1% of studies performed on COVID-19-positive patients yielded pathological findings, most frequently deep venous thrombosis (18.1%), medical renal disease (7.6%), and gall bladder sludge (5.7%). Abbreviated US protocols were used in 29.4% of studies. In conclusion, US study screening and triage played an important role to optimize care of COVID-19 patients and PUIs.

Pulsatility and Resistance Indices of Uterine and Ovarian Arteries in Anovulatory Women With Polycystic Ovary Syndrome.

Doğulu FF, Aydoğmuş S, Gözüküçük M

Ultrasound Q · 2021 Sep · PMID 34478423 · Publisher ↗

We aimed to compare the ovarian and uterine artery blood flow of anovulatory patients with polycystic ovary syndrome (PCOS) with those of ovulatory women throughout the menstrual cycle using color Doppler ultrasound. Sev... We aimed to compare the ovarian and uterine artery blood flow of anovulatory patients with polycystic ovary syndrome (PCOS) with those of ovulatory women throughout the menstrual cycle using color Doppler ultrasound. Seventy-one women with PCOS, who were admitted to the infertility outpatient clinic of a training and research hospital, were included in the study. The patients were divided into 2 groups as anovulatory (group 1, n = 23) and ovulatory (group 2, n = 37). Each patient was followed up throughout her menstrual cycle and included in either group 1 or group 2. Anovulatory cycles were determined by consecutive ultrasound examinations, and the progesterone value was measured in the luteal period. Eleven patients were excluded from the study because they did not continue their follow-up. The uterine and ovarian artery pulsatility and resistance indices of all patients in both groups were evaluated 3 times throughout a menstrual cycle: 7th to 10th day, 13th to 17th day, and 21st to 25th day. It was observed that the uterine artery resistances of the patients with anovulatory cycles remained relatively high throughout the menstrual cycle compared with ovulatory cycles. Both pulsatility and resistance indices of uterine and ovarian arteries were significantly higher in anovulatory cycles compared with ovulatory cycles at all evaluation times throughout the menstrual cycle (P < 0.05). Ovarian artery resistance in anovulatory patients did not significantly change during the menstrual cycle. Anovulatory patients with PCOS have higher uterine and ovarian artery resistance than ovulatory artery resistance, and the former shows a significant decrease throughout the cycle.

Ultrasonographic Features of Hypertrophic Interureteral Cristae in Transabdominal and Transrectal Ultrasonography.

Wang X, Nie F, Li Y … +1 more , Li J

Ultrasound Q · 2021 Sep · PMID 34478422 · Publisher ↗

PURPOSE: The aim of this study was to determine the value of transrectal ultrasound in the definitive diagnosis of hypertrophic interureteral cristae and to provide a definitive diagnostic basis for clinical treatment. M... PURPOSE: The aim of this study was to determine the value of transrectal ultrasound in the definitive diagnosis of hypertrophic interureteral cristae and to provide a definitive diagnostic basis for clinical treatment. MATERIALS AND METHODS: When the patient's bladder fills moderately, the ultrasound physician uses the transabdominal ultrasound probe to examine the patient's bladder and prostate carefully, focusing on bilateral ureterovesical portals, a cord-like hyperechoic structure visible between the bilateral ureterovesical portals. For further detailed observation, transrectal probe was used to measure the size of Hypertrophic Interureteral Cristae and describe the shape and internal echo. After the examination, the residual urine volume of bladder was measured after one-time urination. RESULTS: Hypertrophic interureteral cristae was a trilinear structure with a "high-low-high" echo. All the 33 patients had bladder wall thickening. In 9 cases of overfilling of bladder, there were slightly dilated ureterovesical portals at both ends of hypertrophic interureteral cristae. Thirty cases of benign prostatic hyperplasia, 11 patients who had undergone prostate hyperplasia surgery, 26 cases with different degrees trabecular and reticular hyperplasia of bladder wall, there were 9 cases with bladder diverticulum and 23 cases with mild hydronephrosis. CONCLUSIONS: Transrectal ultrasound can confirm the diagnosis of Hypertrophic Interureteral Cristae.

Translabial Ultrasound for Assessment of Synthetic Midurethral Sling Complications.

Wermuth DE, Sheridan A, Oliver J … +4 more , Glanc P, Khatri G, Bagley A, Patel N

Ultrasound Q · 2021 Sep · PMID 34478421 · Publisher ↗

Translabial ultrasound (TLUS) is an inexpensive, noninvasive imaging modality traditionally used for assessment of pelvic organ prolapse. The utility of TLUS has recently been expanded to the evaluation of synthetic midu... Translabial ultrasound (TLUS) is an inexpensive, noninvasive imaging modality traditionally used for assessment of pelvic organ prolapse. The utility of TLUS has recently been expanded to the evaluation of synthetic midurethral slings (MUS) surgically implanted for management of stress urinary incontinence. The purpose of this article is to familiarize radiologists with translabial ultrasound technique and provide a technical protocol for TLUS execution because it can be optimized for imaging and assessment of MUS, including identification of MUS configuration and recognition of common complications. This article provides example images of transobturator and retropubic slings and their associated complications, as visualized on TLUS. Accurate imaging and assessment of MUS is helpful in the evaluation of the patient presenting with symptoms suspicious for sling-related complications and in the planning of surgical revision.

Obstructed Defecation Symptom Severity and Degree of Rectal Hypermobility and Folding Detected by Dynamic Ultrasound.

Routzong MR, Abramowitch SD, Chang C … +2 more , Goldberg RP, Rostaminia G

Ultrasound Q · 2021 Sep · PMID 34478420 · Publisher ↗

We used dynamic pelvic floor ultrasound to investigate the relationship between obstructed defecation symptom (ODS) severity and the degree of rectal hypermobility/folding. In this retrospective study, women who presente... We used dynamic pelvic floor ultrasound to investigate the relationship between obstructed defecation symptom (ODS) severity and the degree of rectal hypermobility/folding. In this retrospective study, women who presented with ODS from October 2017 to January 2019 and underwent an interview, pelvic examination, and pelvic floor ultrasound were recruited. Patients were diagnosed with abdominal constipation, dyssynergia, or pelvic constipation. Pelvic constipation patients were categorized based on their reported frequency of incomplete emptying of stool (<50% or ≥50% of bowel movements) representing mild and severe ODS, respectively. Using dynamic ultrasound, rectal hypermobility was quantified via rectovaginal septum length at rest and Valsalva and its compression ratio, where shorter lengths and larger compression ratios are indicative of increased rectal hypermobility. One hundred twenty-one patients (41 with abdominal constipation, 7 with dyssynergia, and 73 with pelvic constipation) were included. Compression ratios were higher in women with severe versus mild ODS (17.36 ± 16.89 vs 36.38 ± 25.82, P = 0.0039). The risk of having severe symptoms was 4 times greater (odds ratio = 4.2, 95% confidence interval = 1.4 to 12.6, P = 0.01) among those with a high compression ratio (≥20%) after controlling for age, body mass index, and levator plate descent angle. Incomplete emptying was weakly, positively, linearly correlated with rectal hypermobility/folding (r = -0.2724, -0.3767 to 0.3922, and P = 0.0197, 0.0010, 0.0006, respectively). Women with more severe ODS experienced more rectal hypermobility/folding as measured via dynamic ultrasound-a cheaper, effective alternative to magnetic resonance defecography for evaluation of obstructed defecation.

Sonographic Evaluation of Pelvic Venous Disorders.

Brahmbhatt A, Macher J, Shetty AN … +3 more , Chughtai K, Baah NO, Dogra VS

Ultrasound Q · 2021 Sep · PMID 34478419 · Publisher ↗

Pelvic venous disorders are a group of interrelated conditions characterized by venous incompetence. These conditions often manifest with nonspecific symptoms that overlap with many gynecological, gastrointestinal, and u... Pelvic venous disorders are a group of interrelated conditions characterized by venous incompetence. These conditions often manifest with nonspecific symptoms that overlap with many gynecological, gastrointestinal, and urologic diseases. Clinical diagnosis can be difficult, and imaging can play a vital role in differentiating etiology. Sonographic evaluation is often the first step in evaluating these symptoms. Special attention to possible underlying pelvic venous disorders can reveal characteristic findings, support diagnosis, and guide treatment. Here we review pelvic congestion syndrome, nutcracker syndrome, May-Thurner syndrome, and other venous disorders, with a specific focus on sonographic findings and considerations.

The Rare, the Odd, and the Atypical: A Pictorial Essay of Testicular and Paratesticular Diseases.

Houser M, Khati NJ

Ultrasound Q · 2021 Sep · PMID 34478418 · Publisher ↗

Understanding a variety of scrotal diseases is essential to developing an accurate differential diagnosis and is critical in providing optimal patient care. Ultrasound is the imaging modality of choice when evaluating fo... Understanding a variety of scrotal diseases is essential to developing an accurate differential diagnosis and is critical in providing optimal patient care. Ultrasound is the imaging modality of choice when evaluating for scrotal pathology, with the major purpose of locating such pathology to either the testis, or epididymis, or other intrascrotal structures, as well as characterizing lesions as solid or cystic. It is generally assumed that most solid intratesticular masses are more likely malignant, whereas most extratesticular ones are benign, although some exceptions to that rule exist. This pictorial essay will focus on rare and less commonly encountered benign and malignant testicular and paratesticular pathologies, which may pose a diagnostic dilemma for interpreting radiologists and treating physicians. Knowledge of their imaging characteristics will help narrow the differential diagnosis and assist in proper patient management and care.
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