Journal of Clinical UltrasoundVolume 51, Issue 5 p. 749-752 ISSUE INFORMATIONFree Access Issue Information First published: 01 June 2023 https://doi.org/10.1002/jcu.23228AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Volume51, Issue5June 2023Pages 749-752 RelatedInformation

The sonographic findings in four fetuses presenting with ventriculomegaly at first-trimester ultrasound that were subsequently diagnosed as having agenesis of the corpus callosum (ACC) are described. The diagnosis of early ventriculomegaly was suspected subjectively by identification of increased cerebrospinal fluid within the lateral ventricles and confirmed by measuring choroid plexus-to-lateral ventricle length and area ratios. Subsequent scans revealed complete ACC in two cases and partial ACC in the other two. This report adds to the increasing evidence suggesting that first-trimester ventriculomegaly is a strong sonographic marker of underlying brain anomalies, including less evident malformations such as ACC. Detailed second-trimester fetal neurosonography in those women continuing their pregnancies should be performed.

To explore the clinical features, multimodal ultrasound features and multimodal ultrasound imaging features in predicting lymph node metastasis in the central cervical region of papillary thyroid carcinoma. A total of 129 patients with papillary thyroid carcinoma (PTC) confirmed by pathology were selected from our hospital from September 2020 to December 2022. According to the pathological results of cervical central lymph nodes, these patients were divided into metastatic group and non-metastatic group. Patients were randomly sampled and divided into training group (n = 90) and verification group (n = 39) according to the ratio of 7:3. The independent risk factors for central lymph node metastasis (CLNM) were determined by least absolute shrinkage and selection operator and multivariate logistic regression. Based on independent risk factors to build a prediction model, select the best diagnostic effectiveness of the prediction model sketch line chart, and finally, the line chart calibration and clinical benefits were evaluated. A total of 8, 11 and 17 features were selected from conventional ultrasound images, shear wave elastography (SWE) images and contrast-enhanced ultrasound (CEUS) images to construct the Radscore of conventional ultrasound, SWE and CEUS, respectively. After univariate and multivariate logistic regression analysis, male, multifocal, encapsulation, iso-high enhancement and multimodal ultrasound imaging score were independent risk factors for cervical CLNM in PTC patients (p < 0.05). Based on independent risk factors, a clinical combined with multimodal ultrasound feature model was constructed, and multimodal ultrasound Radscore were added to the clinical combined with multimodal ultrasound feature model to form a joint prediction model. In the training group, the diagnostic efficacy of combined model (AUC = 0.934) was better than that of clinical combined with multimodal ultrasound feature model (AUC = 0.841) and multimodal ultrasound radiomics model (AUC = 0.829). In training group and validation group, calibration curves show that the joint model has good predictive ability for cervical CLNM of PTC patients; The decision curve shows that most of the net benefits of the nematic chart are higher than those of clinical + multimodal ultrasound feature model and multimodal ultrasound radiomics model within a reasonable risk threshold range. Male, multifocal, capsular invasion and iso-high enhancement are independent risk factors of CLNM in PTC patients, and the clinical plus multimodal ultrasound model based on these four factors has good diagnostic efficiency. The joint prediction model after adding multimodal ultrasound Radscore to clinical and multimodal ultrasound features has the best diagnostic efficiency, high sensitivity and specificity, which is expected to provide objective basis for accurately formulating individualized treatment plans and evaluating prognosis.

Cholangitis after liver transplantation may lead to bile duct necrosis. Early diagnosis is essential to prevent graft loss. We aimed to investigate cholangitis related hepatic arterial Doppler ultrasonography findings in liver transplants. Patients complicated with biopsy proven cholangitis in grafts were prospectively evaluated. Vascular complications were excluded. Doppler ultrasonography parameters including hepatic arterial diameter, resistive index, volume flow, and portal vein maximum velocity were measured twice: first during cholangitis and after full recovery. Data of two groups were compared using paired samples t test and Mann-Whitney U test. The mean hepatic arterial volume flow, resistive index, and diameter of 33 patients complicated with cholangitis was observed to decrease after recovery from 0.356 to 0.273 L/min (p = 0.007), from 0.64 to 0.60 (p < 0.001) and from 4.9 to 4.4 mm (p < 0.001), respectively. Portal vein maximum velocity alteration was not statistically significant (p = 0.6). Ultrasound follow-ups after liver transplantation can give us the clue of cholangitis initiation through some altering hepatic arterial Doppler parameters. Even though these are nonspecific findings that can also be observed in vascular complications, baseline Doppler data should be saved for future comparison and considered to prevent biliary associated graft loss.

This study evaluates the correlation between the sonographic features and the nodal fine-needle aspiration thyroglobulin (FNA-Tg) in papillary thyroid carcinoma (PTC) patients with the recurrent/persistent lymph node for the purpose of the reasonable selection of lymph nodes. This study prospectively contained PTC patients with the suspicious cervical lymph nodes in one medical center from April 2018 to January 2019. Each suspected lymph node was aspirated with a 22-gauge needle and the value of FNA-Tg was measured as well. There were 136 lymph nodes related to the disease involved. The FNA-Tg levels of 89 (65.44%) metastatic lymph nodes were significantly higher than those of the benign. The median value of the former was 631.550 ng/mL while the latter was 0.056 ng/mL (p = 0.000). The cut-off value of the metastatic lymph nodes diagnosed by FNA-Tg was 2.71 ng/mL, and 6.5 by FNA-Tg/sTg. The suspicious ultrasonographic features including cystic, hyperechoic content, and lack of hilum were closely related to the high level of FNA-Tg value (p < 0.05). However, the round shape (Solbiati index <2) and calcification were not significantly correlated with the positive FNA-Tg (p > 0.05). FNA-Tg is an effective supplement to fine-needle aspiration (FNA) cytology in the nodal metastasis diagnosis. The FNA-Tg level was much higher in the metastatic lymph nodes. The reliable sonographic features of lymph nodes suggested the positive FNA-Tg were cystic content, hyperechoic content and lack hilum. Solbiati index <2 and calcification did not show an exact correlation with the result of FNA-Tg.

The study aims to assess the diagnostic performance of convention ultrasound (US), Angio PLUS microvascular US imaging (AP), and shear-wave elastography (SWE) in differentiating malignant and benign non-mass-like (NML) breast lesions. Sixty patients aged 21-70 years with 60 NML lesions were recruited. All patients were examined by conventional US, AP, and SWE. According to the pathological results, the performances of the multimodal US strategies were analyzed, while the diagnostic efficiency of AP and SWE in serial and parallel was also explored. Age, together with posterior features, microcalcification, and architectural distortion were considered significant in evaluating NML lesions. The sensitivity, specificity, PPV, NPV, and accuracy of AP combined SWE in serial were 72.7, 96.3, 96.0, 74.3, and 83.3%, while those in parallel were 90.9, 63.0, 75.0, 85.0, and 78.3%, respectively. The two in serial indicated the highest specificity, PPV, accuracy, and AUC value, which could increase the true positive rate and reduce the chance of misdiagnosis, while the two in parallel exhibited the best sensitivity and NPV, which might serve as an effective tool to avoid excessive or nonessential biopsy. The multimodal US strategies could provide precise and reliable diagnostic results for NML breast lesions.

High-pressure injection injuries of the hand are uncommon accidents with potentially catastrophic complications. We present a case of a 49-years-old male with a high-pressure injection of motor oil in his left hand. Ultrasound accurately demonstrated soft tissue infiltration and late complications, playing a fundamental role in the treatment choice.

To analyze BE on ABUS using BI-RADS and a modified classification in association with mammographic density and clinical features. Menopausal status, parity, and family history of breast cancer were collected for 496 women who underwent ABUS and mammography. Three radiologists independently reviewed all ABUS BE and mammographic density. Statistical analyses including kappa statistics (κ) for interobserver agreement, Fisher's exact test, and univariate and multivariate multinomial logistic regression were performed. BE distribution between the two classifications and between each classification and mammographic density were associated (P < 0.001). BI-RADS homogeneous-fibroglandular (76.8%) and modified heterogeneous BE (71.3%, 75.7%, and 87.5% of mild, moderate, and marked heterogeneous background echotexture, respectively) tended to be dense. BE was correlated between BI-RADS homogeneous-fat and modified homogeneous background (95.1%) and between BI-RADS homogeneous-fibroglandular or heterogeneous (90.6%) and modified heterogeneous (86.9%) (P < 0.001). In multinomial logistic regression, age < 50 years was independently associated with heterogeneous BE (OR, 8.89, P=0.003, in BI-RADS; OR, 3.74; P=0.020 in modified classification). BI-RADS homogeneous-fat and modified homogeneous BE on ABUS was likely to be mammographically fatty. However, BI-RADS homogeneous-fibroglandular or heterogeneous BE might be classified as any modified BE. Younger age was independently associated with heterogeneous BE.