Isshiki A, Fujiwara K, Kondo T
… +3 more, Yoshida K, Yamaguchi T, Hirata S
J Med Ultrason (2001)
· 2025 Jan · PMID 39579195
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PURPOSE: Early detection and quantitative evaluation of liver steatosis are crucial. Therefore, this study investigated a method for classifying ultrasound images to fatty liver grades based on echo-envelope statistics (...PURPOSE: Early detection and quantitative evaluation of liver steatosis are crucial. Therefore, this study investigated a method for classifying ultrasound images to fatty liver grades based on echo-envelope statistics (ES) and convolutional neural network (CNN) analyses. METHODS: Three fatty liver grades, i.e., normal, mild, and moderate-to-severe, were defined using the thresholds of the magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF). There were 10 cases of each grade, totaling 30 cases. To visualize the texture information affected by the deposition of fat droplets within the liver, the maps of first- and fourth-order moments and the heat maps formed from both moments were employed as parametric images derived from the ES. Several dozen to hundreds of regions of interest (ROIs) were extracted from the liver region in each parametric image. A total of 7680 ROIs were utilized for the transfer learning of a pretrained VGG-16 and classified using the transfer-learned VGG-16. RESULTS: The classification accuracies of the ROIs in all types of the parametric images were approximately 46%. The fatty liver grade for each case was determined by hard voting on the classified ROIs within the case. In the case of the fourth-order moment maps, the classification accuracy of the cases through hard voting mostly increased to approximately 63%. CONCLUSIONS: The formation of parametric images derived from the ES and the CNN classification of the parametric images were proposed for the quantitative diagnosis of liver steatosis. In more than 60% of the cases, the fatty liver grade could be estimated solely using ultrasound images.
Takayama N, Sasanuma H, Rifu K
… +3 more, Nitta N, Akiyama I, Taniguchi N
J Med Ultrason (2001)
· 2025 Jan · PMID 39549135
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PURPOSE: Acoustic radiation force impulse (ARFI) elastography and contrast-enhanced ultrasonography (CEUS) are emerging techniques that are becoming common in ultrasound examinations. We previously reported that ARFI (pu...PURPOSE: Acoustic radiation force impulse (ARFI) elastography and contrast-enhanced ultrasonography (CEUS) are emerging techniques that are becoming common in ultrasound examinations. We previously reported that ARFI (push pulse) induced lung hemorrhage in rabbits, indicating that greater risks are associated with ARFI than with conventional ultrasound. In this study, we assessed the risk of lung hemorrhage under a combination of ARFI elastography and CEUS, considering potential exacerbation of ARFI-induced lung hemorrhage as a result of the ultrasound contrast agent (UCA) used in CEUS. METHODS: Twenty-three rabbits were divided into non-UCA and UCA groups. ARFI exposure parameters were set at six mechanical index (MI) levels (0.29, 0.45, 0.60, 0.88, 1.0, 1.39) in non-UCA groups and five MI levels (0.29, 0.66, 0.88, 0.97, 1.25) in UCA groups. Lung exposure was performed bilaterally through the intercostal space in each rabbit. Lung damage was assessed through macroscopic and microscopic observation post euthanasia. RESULTS: Lung hemorrhage was detected at MI levels of 0.88 or higher. Logistic regression analyses showed that MI was a statistically significant factor for occurrence of lung hemorrhage in both non-UCA and UCA groups, and the MI threshold (ED) for inducing lung hemorrhage was 0.68 and 0.71, respectively. However, multivariate logistic regression and linear regression analyses across all samples indicated that UCA did not significantly affect the occurrence or area of lung hemorrhage. CONCLUSION: This study demonstrates that UCA does not significantly worsen ARFI-induced lung hemorrhage in terms of occurrence or severity. However, risks and benefits of ARFI elastography on the lung should be considered, irrespective of UCA administration.
Zhang Y, Numata K, Nihonmatsu H
… +5 more, Funaoka A, Miwa H, Oishi R, Nozaki A, Maeda S
J Med Ultrason (2001)
· 2025 Jan · PMID 39549134
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PURPOSE: This retrospective study aimed to investigate the role of an additional high mechanical index (MI) setting scan during the post-vascular phase (PVP) in detecting deep-seated hepatocellular carcinoma (HCC) lesion...PURPOSE: This retrospective study aimed to investigate the role of an additional high mechanical index (MI) setting scan during the post-vascular phase (PVP) in detecting deep-seated hepatocellular carcinoma (HCC) lesions. METHODS: A total of 805 confirmed HCCs, which underwent Sonazoid-based contrast-enhanced ultrasound (CEUS) between January 2014 and October 2021, were included. Low MI scan was initially employed for lesion detection during the PVP, followed by high MI scan. Propensity score matching (PSM) was utilized to address confounding variables. RESULTS: Of the 805 study lesions, 668 were detected as perfusion defects at the initial low MI setting, while 137 remained undetected. Among these 137 undetected lesions, 77 were identified at the subsequent high MI setting, whereas 60 remained undetected. Lesions that were larger (18.69 ± 11.27 mm vs. 16.55 ± 7.42 mm, p = 0.006), more superficial (6.06 ± 2.41 cm vs. 7.40 ± 2.74 cm, p < 0.001), and hypoechoic (482/668 vs. 62/137, p < 0.001) were detectable at the initial low MI setting. Male patients benefited more from the additional high MI scan (63/97 vs. 14/40, p < 0.001). Lesions identified with additional high MI were larger (18.30 ± 8.76 mm vs. 14.30 ± 4.34 mm, p < 0.001) and deeper than undetected ones (8.48 ± 2.48 cm vs. 6.02 ± 2.43 cm, p < 0.001). After PSM, depth was shown to be an independent predictor in multivariate analysis (odds ratio: 1.557, 95% confidence interval: 1.249-1.941). The depth cutoff was 7.75 cm, with a sensitivity of 0.681, specificity of 0.851, and area under the curve of 0.774. CONCLUSIONS: The additional high MI setting scan during the PVP of Sonazoid-based CEUS leads to enhanced detection of deep-seated HCCs.
Hashiramoto S, Kaneko M, Takita H
… +3 more, Yamashita Y, Matsuoka R, Sekizawa A
J Med Ultrason (2001)
· 2025 Jan · PMID 39485582
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PURPOSE: Most studies on the performance of first-trimester cardiac screening have concentrated on comparing the detection rate between different protocols and not on the actual reason for false-negative results. Herein,...PURPOSE: Most studies on the performance of first-trimester cardiac screening have concentrated on comparing the detection rate between different protocols and not on the actual reason for false-negative results. Herein, we report the performance of first-trimester congenital heart disease (CHD) screening and factors that may affect the detection rate of CHDs. METHODS: This retrospective observational study included patients who underwent first-trimester screening and subsequently gave birth at our facility. We analyzed the performance of first-trimester screening for CHD and major CHD (CHD requiring cardiac surgery or interventional catheterization within 12 months of birth). RESULTS: Of the 6614 fetuses included, 53 had CHD and 35 had major CHD. For the prenatal diagnosis of CHD, the detection rate, specificity, positive predictive value, negative predictive value, and first-trimester detection rate for CHD were 64.1%, 99.9%, 94.4%, 99.7%, and 82.9%, respectively; the respective values for major CHD were 85.7%, 99.96%, 93.75%, 99.92%, and 85.7%. The detection rate was not significantly different when classified by crown-rump length or number of fetuses. A weak correlation was observed between low detection rate of major CHD and lower maternal body mass index (BMI) (correlation ratio: 0.17). The detection rate was significantly higher when the fetus was scanned with its spine at the 5-7 o'clock position (posterior spine) than at other positions (odds ratio: 3.82, 95% confidence interval: 1.16-12.5, p = 0.02). CONCLUSION: Posterior spine contributes to an improved diagnostic rate in first-trimester CHD screening. In addition, sonographers must recognize that low maternal BMI is a risk factor of false-negative results.
J Med Ultrason (2001)
· 2025 Jan · PMID 39432029
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Ultrasound (US) has high specificity and sensitivity, and it should be performed first for patients with suspicion of biliary tract cancer. However, the complicated anatomy in addition to the gas images makes it difficul...Ultrasound (US) has high specificity and sensitivity, and it should be performed first for patients with suspicion of biliary tract cancer. However, the complicated anatomy in addition to the gas images makes it difficult to delineate the entire extrahepatic bile duct (EHBD). The keys to depiction of EHBD are the "J" shape manipulation in the left lateral decubitus position and the use of magnified images with high-frequency transducers. Furthermore, indirect findings such as gallbladder (GB) distension, BD dilatation, and debris echo in the GB and BD are also important for detecting occult lesions, particularly in the ampullary region of Vater. For the differential diagnosis of BD wall thickening, the spreading pattern in the long and short axial directions should be assessed first. Then, the characteristics of the innermost hyperechoic layer (IHL) and outermost hyperechoic layer (OHL) should be evaluated. Asymmetrical wall thickening, absence of IHL, and presence of irregularity or discontinuity in OHL are characteristic patterns of cholangiocarcinoma (CCA). Because CCA is the most common BD polypoid lesion, it is important to diagnose tumor extension and depth invasion in addition to differential diagnosis. Nodular-type CCA is usually hypoechoic and more likely to invade vertically. In contrast, papillary-type CCA is often hyperechoic and extends laterally. Contrast‑enhanced US may be useful for evaluating these findings. However, if the possibility of CCA cannot be ruled out or a definitive diagnosis is needed, a transpapillary biopsy or endoscopic US-guided tissue acquisition should be considered.
Maruyama H, Minami Y, Sugimoto K
… +2 more, Funaoka A, Numata K
J Med Ultrason (2001)
· 2025 Jan · PMID 39395134
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Because of recent advances in energy device technology, ablation has become popular worldwide. It is less invasive and provides faster postoperative recovery compared to surgery, and therefore, it has come to be applied...Because of recent advances in energy device technology, ablation has become popular worldwide. It is less invasive and provides faster postoperative recovery compared to surgery, and therefore, it has come to be applied to a wide range of organs, such as liver, lung, kidney, thyroid, and bone/soft tissue tumors. In order to properly guide the needle to the target area, imaging support is necessary, and ultrasound, which has the advantages of high resolution and real-time capability, is the most frequently used modality. In other words, ablation can be said to be a therapeutic method that makes the most of the advantages of ultrasound. This article outlines the role of ultrasound in ablation for liver cancer and its specific usage.
Takemoto N, Takata Y, Shima Y
… +6 more, Goshima K, Shimozaki K, Kimura M, Kanayama T, Demura S, Nakase J
J Med Ultrason (2001)
· 2025 Jan · PMID 39365403
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PURPOSE: Blood flow signals (BFSs) through the bone cortex on ultrasonography (US) and bone marrow lesions (BMLs) detected on magnetic resonance imaging (MRI) can be used to assess bone lesions; however, no studies have...PURPOSE: Blood flow signals (BFSs) through the bone cortex on ultrasonography (US) and bone marrow lesions (BMLs) detected on magnetic resonance imaging (MRI) can be used to assess bone lesions; however, no studies have reported their relationship. Therefore, this study aimed to assess whether BFSs through the bone cortex on US can serve as a screening test for detecting BMLs on MRI in patients with early knee osteoarthritis (OA). METHODS: This study enrolled patients with knee joint pain who were diagnosed with early knee OA between January 2018 and January 2024. We targeted 77 patients who underwent MRI and in whom the presence or absence of BFSs through the bone cortex was confirmed on US. The association between BFSs and BMLs was evaluated using the chi-square test, and the sensitivity and specificity of BFSs for detecting BMLs on MRI were calculated. RESULTS: The chi-square test showed that BFSs and BMLs were significantly associated in the femur and tibia (femur: χ [1] = 52.9, p < 0.001; Tibia: χ [1] = 44.8, p < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of BFSs for detecting BMLs on MRI were 85.0%, 96.5%, 89.5%, and 94.8%, respectively, for the femur, and 84.0%, 92.3%, 84.0%, and 92.3%, respectively, for the tibia. CONCLUSION: BFSs through the bone cortex on US can be used as a screening test for detecting BMLs on MRI in patients with early knee OA.
J Med Ultrason (2001)
· 2025 Jan · PMID 39361106
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PURPOSE: Early diagnosis of a precursor lesion in the uterine cervix is an essential factor in uterine cervical cancer prevention. Although colposcopy is an established procedure for detecting high-risk patients, its acc...PURPOSE: Early diagnosis of a precursor lesion in the uterine cervix is an essential factor in uterine cervical cancer prevention. Although colposcopy is an established procedure for detecting high-risk patients, its accuracy and reproducibility are relatively low. Some supportive or alternative techniques to improve the early diagnosis of a precursor lesion have been studied, and correct diagnosis with high reliability using a minimally invasive, cost-effective technique has been pursued. This study aimed to examine the possibility of using photoacoustic (PA) imaging as a supportive technique to improve the accuracy of early diagnosis of cervical precursor lesions. METHODS: A PA imaging system for microvessels was used to detect angiogenesis in severe lesions. A total of 21 patients who underwent surgical treatment and 114 outpatients who visited our colposcopy clinic were examined. A retrospective evaluation of PA images was performed as follows: (i) pathological assessment of the specific PA findings and (ii) retrospective evaluation of the severe lesion detection rate through PA. RESULTS: PA image evaluation and pathological findings showed dense angiogenesis in a severe precursor lesion appearing as a "hot spot" in the PA image. A comparison with colposcopy findings was performed for accuracy evaluation, and the detection rate of severe lesions using PA was relatively high (positive predictive value, 84.5%; negative predictive value, 82.1%). CONCLUSION: Our results indicate the possibility of using PA imaging for early diagnosis of severe cervical precursor lesions. With its ability to yield quantitative information, PA imaging can improve ultrasound diagnosis.
Ultrasonography (US) is an essential tool in the clinical management of lower urinary tract dysfunction (LUTD), including lower urinary tract symptoms, overactive bladder, and benign prostatic hyperplasia, in which prost...Ultrasonography (US) is an essential tool in the clinical management of lower urinary tract dysfunction (LUTD), including lower urinary tract symptoms, overactive bladder, and benign prostatic hyperplasia, in which prostatic volume and post-void residual volume are routinely used to evaluate the pathophysiological characteristics of afflicted patients. US can also be employed to diagnose hydronephrosis and bladder calculus as complications of severe LUTD. Moreover, US is essential for identifying pathophysiological characteristics and surgical indications, predicting disease development and drug efficacy, and monitoring bladder function improvement by means of such parameters as bladder wall thickness, prostatic urethral length, intravesical prostatic protrusion, and prostatic urethral angulation/angle. Herein, I narratively review the recent advances in US approaches for the management of LUTD, especially in adult males.
Mizuno Y, Takata Y, Shima Y
… +9 more, Goshima K, Kuroda K, Kanayama T, Ishida Y, Takemoto N, Nishimura M, Sengoku T, Demura S, Nakase J
J Med Ultrason (2001)
· 2025 Jan · PMID 39322823
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PURPOSE: To characterize the ultrasonographic findings of patients with early knee osteoarthritis (KOA) and determine which findings were associated with the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscale....PURPOSE: To characterize the ultrasonographic findings of patients with early knee osteoarthritis (KOA) and determine which findings were associated with the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscale. METHODS: The study included 98 knees (35 men, 63 women, 60.3 ± 11.5 years) diagnosed with early KOA with no major deformity radiographically, but with pain during activity and tenderness in the medial knee. Synovial hyperplasia in the suprapatellar bursa, knee joint effusion, horizontal tear of the medial meniscus (MM), osteophytes of the medial condyle of the femur and tibia, blood flow signals in the synovium of the suprapatellar bursa, medial collateral ligament bursa, infrapatellar fat pad, MM extrusion (MME) in the supine and upright positions, and the amount of change in MME were observed using ultrasonography. RESULTS: Correlations (p < 0.05) were found between the presence of synovial hyperplasia of the suprapatellar bursa (r<-0.20) and amount of MME in the upright position (r< - 0.24) and all KOOS subscales. Presence of joint effusion and the four KOOS subscales except quality of life (QOL) were correlated (p < 0.05). Partial correlation coefficients showed correlations (p < 0.05) between knee joint effusion and symptoms (r = 0.299) and activities of daily living (ADL) (r = 0.254) of the KOOS subscales, and between MME in the upright position and symptoms (r= - 0.263), pain (r= - 0.256), and ADL (r= - 0.212). CONCLUSION: Quality and difficulty of life of patients with early KOA may be influenced by synovial hyperplasia in the suprapatellar bursa, joint effusion, and MME values in the upright position. Among them, synovial hyperplasia of the suprapatellar bursa and amount of MME in the upright position were independently associated with the KOOS subscales.
Ishii Y, Nakamae A, Akinori N
… +7 more, Hashizume T, Okinaka R, Sugimoto M, Matsumura K, Ishikawa M, Takahashi M, Adachi N
J Med Ultrason (2001)
· 2024 Oct · PMID 39223417
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PURPOSE: Some patients who undergo anterior cruciate ligament (ACL) reconstruction experience abnormal mechanical stress in the meniscus. Medial meniscal extrusion (MME) is reflected in the pathological condition of the...PURPOSE: Some patients who undergo anterior cruciate ligament (ACL) reconstruction experience abnormal mechanical stress in the meniscus. Medial meniscal extrusion (MME) is reflected in the pathological condition of the meniscus, which expands owing to repetitive mechanical stress. Thus, the effect of the reconstructed ACL on increasing MME under weight-bearing conditions remains unclear. This study investigated the effect of ACL reconstruction on meniscal extrusion under non-weight-bearing and weight-bearing conditions. METHODS: Seventeen patients who underwent unilateral ACL reconstruction (ACL group) and 20 age-matched healthy volunteers (control group) were enrolled. Ultrasonography was performed in the supine, standing, and walking positions in preoperative and postoperative ACL patients. MME during walking was evaluated based on the dynamic behavior of extrusion, and kinetic and kinematic data were synchronously obtained. Moreover, the ACL group underwent magnetic resonance imaging (MRI) evaluation at two points: preoperatively and 12 months postoperatively, and the ultrasound findings were compared. RESULTS: MME in the supine position measured using both ultrasonography and MRI was not significantly different preoperatively and postoperatively in the ACL group. However, postoperative MME and dynamic behavior of extrusion under standing and walking conditions were significantly higher than those in the preoperative state (dynamic behavior: 0.9 ± 0.4 mm preoperatively, 1.2 ± 0.4 mm postoperatively). Moreover, the deficits in knee extension during walking persisted postoperatively and were significantly higher than those in the control group. CONCLUSION: MME in patients with ACL reconstruction including meniscus repair was different under mechanical stress compared to the non-weight bearing condition.
J Med Ultrason (2001)
· 2024 Oct · PMID 39190239
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PURPOSE: This study aimed to establish criteria for defining "large" subchorionic hematoma (SCH) and assess its association with pregnancy complications. METHOD: This was a retrospective cohort study conducted at our ins...PURPOSE: This study aimed to establish criteria for defining "large" subchorionic hematoma (SCH) and assess its association with pregnancy complications. METHOD: This was a retrospective cohort study conducted at our institution between 2019 and 2020. We compared the size of SCH between the pregnancy-related complication and non-complication groups, using two measurement methods. Receiver operating characteristic (ROC) curve analysis determined cutoff values. Additionally, we compared the occurrence of pregnancy complications among three groups: large SCH group (above the cutoff value), non-large SCH group (below the cutoff value), and non-SCH group. RESULTS: Of 1305 singleton pregnancies managed during the study, 80 cases were diagnosed with SCH. Pregnancy complications occurred in 15 patients. The patients with pregnancy complications had significantly larger SCH sizes with both measurement methods. For each method, the cutoff values calculated from the ROC curve analysis were as follows: Method 1, 25% (area under the ROC curve [AUC], 0.662); Method 2, 30% (AUC, 0.624). In Method 1, we found a significantly higher occurrence of preterm delivery in the large SCH group (24.1%) than in the non-large SCH (4.2%) and non-SCH groups (5.3%; all p < 0.01). In Method 2, there was a significantly higher occurrence of preterm delivery in the large SCH group (33.3%) than in the non-large SCH (6.5%) and non-SCH groups (5.3%; all p < 0.01). CONCLUSION: Large SCHs may indicate a high risk of pregnancy-related complications. Among these, recognizing and managing cases that exceed the aforementioned cutoff value as high-risk cases may be beneficial for reducing pregnancy complications.