Aim: This meta-analysis aims to assess the accuracy of superb microvascular imaging (SMI) using the vascular index (VI) in the diagnosis of breast tumors.Material and methods: PubMed, Web of Science, Embase, Cochrane Library and Scopus were searched for relevant literature by two researchers until March 14, 2023. The Stata Version 16.0 software was utilized to compute the pooled values for sensitivity (Sen), specificity (Spe), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odd ratios (DOR). Heterogeneity among the included literature was assessed using the I2 statistic and Q test. Conducting influence analysis was used to ensure the robustness of the pooled conclusions and the Deeks’ funnel plot asymmetry test to assess publication bias. We also performed the summary receiver operating characteristic (SROC) curve.Results: Six studies included 1200 breast lesions. The ultimate results in the VI of SMI are as follows: The pooled Sen was 0.80 (95% confidence interval(CI), 0.75–0.85), the pooled Spe was 0.68 (95% CI 0.63–0.74), the pooled PLR was 2.54 (95% CI 2.07–3.12), the pooled NLR was 0.29 (95% CI 0.22–0.38), the pooled DOR was 8.91 (95% CI 5.62–14.13), and the area under the SROC (AUC) was 0.81.Conclusion: The application of SMI using VI may have the potential to benefit the patients and represents a valuable quantitative parameter of SMI for the diagnosis of breast neoplasms.

In this series of articles on comments and illustrations of the World Federation for Medicine and Biology (WFUMB) guidelines on contrast-enhanced ultrasound (CEUS), the topics on very rare focal liver lesions (FLL) are discussed. This article describes the diverse changes of focal liver lesions in peliosis hepatis and the typical changes in porphyria. Although the focus is on the appearance on ultrasound and CEUS, the clinical context is always considered. While peliosis may be a surprising finding on puncture, lesions in porphyria cutanea tarda may be typical visual diagnoses that obviate the need for biopsy. If only you knew. This article aims to sharpen the clinician’s eye. It provides knowledge of the clinical presentation and US and CEUS imaging of peliosis hepatis and porphyria.

A meaningful sonographic examination is decisively dependent on the B-scan quality of the ultrasound device. When selecting a suitable ultrasound device, B-scan quality should be an important purchase criterion. Although there is no generally accepted method to measure B-scan quality, we tried to evaluate comparable sonography devices from different manufacturers regarding B-scan quality. We systematically assessed the B-scan quality in ultrasound devices of seven different manufacturers from the mid-price segment. All 7 ultrasound units tested had comparable equipment features and the purchase value of approximately $20,000. We recorded video sequences and compared B-mode image quality. We used both physiological sectional images and pathological findings from abdominal ultrasound. We identified three ultrasound units that scored significantly better in measuring the B-scan quality than the other devices. The Canon Xario 200, the General Electric Logiq P7 and the Mindray DC70 (in alphabetical order) were the units that outperformed all others.The differences identified were found to be statistically significant. A subgroup analysis showed that the contrasts in quality were more pronounced in near-field examinations than in examinations with greater penetration depth. There are considerable qualitative discrepancies in B-scan ultrasound devices despite being similar in terms of equipment and price. Our findings show that these differences are statistically detectable and likely clinically relevant.

Skin ultrasound (US) is a relatively new imaging technique, for which interest has grown significantly in the last decade. Properties such as mobility, real-time imaging and lack of irradiation or sedation, have made it a useful tool in completing the clinical examination. The use of probes of different frequencies has managed to improve the US technique, offering the possibility of obtaining high quality images. Thus, by using high-frequency and ultra-high frequency US, subclinical information can be obtained with a wide applicability in dermatological pathology. In this paper we aim to discuss the main uses of skin US in non-tumoral pathology (inflammatory and autoimmune pathology).

Hepatocellular carcinoma (HCC) has an atypical onset of clinical symptoms and a rapid tumor progression. The majority of patients with HCC are already in the late stages of the disease when they are diagnosed, limiting them to the best available treatments. Contrast-enhanced ultrasound (CEUS) has achieved significant advances in the diagnosis of HCC, including the detection of small lesions, the investigation of more beneficial contrast agents, and the use of CEUS-based radiomics. The purpose of this review is to discuss the relevant research and future challenges of CEUS in the early detection of HCC, to advise more accurate therapy.

To investigate the musculoskeletal morphomechanical properties (i.e., the thickness and elastic modulus) and the total count of power Doppler signals near the sacroiliac joints in patients with ankylosing spondylitis (AS) and non-AS individuals. Twenty participants with AS [median age (interquartile range): 31.7 (11.04) years] and 19 controls [36.3 (10.5) years] with no AS history were recruited. Bilateral ultrasound image acquisition was performed, including the short posterior sacroiliac ligament, interosseous sacroiliac ligament, long posterior sacroiliac ligament, iliolumbar ligament, proximal piriformis muscle, and sacrotuberous ligament. The intraclass correlation coefficients (ICC) of ultrasound parameters, laboratory test results of human leukocyte antigen B27, C-reactive protein, and erythrocyte sedimentation rate, and self-reported physical and disease activity scores were also obtained. The ligaments and piriformis muscle were thicker and stiffer (greater elastic modulus) in participants with AS than in non-AS participants (all p<0.01). The measurements showed good or excellent reliability (all ICC(3,1) >0.85). The numbers of power Doppler signals detected in the iliolumbar ligament, proximal piriformis muscle, and sacrotuberous ligament were higher in participants with AS than in non-AS participants (all p<0.001). A correlation was identified between disease duration and the elastic modulus of the piriformis muscle (r=0.640, p=0.003). We conclude that the ligaments and proximal piriformis muscle of AS participants have increased thickness, elastic modulus, and power Doppler signal than those of non-AS individuals. These reliable findings may serve as potential markers for the early diagnosis of AS and for assessing medication effects.

To compare the accuracy of the optic nerve sheath diameter (ONSD) measured by ocular ultrasonography (US) versus magnetic resonance imaging (MRI) for the diagnosis of increased intracranial pressure (ICP). A systematic search of studies evaluating US ONSD or MRI ONSD for the diagnosis of increased ICP was performed. Data were extracted independently by two authors. We used the bivariate random-effects model to evaluate the diagnostic feasibility of measuring the ONSD in patients increased ICP. A summary receiver operating characteristic (SROC) graph was adopted to calculate sensitivity and specificity. Subgroup analysis was used to explore potential difference in US ONSD and MRI ONSD. A total of 31 studies were included, in which there were 1783 patients diagnosed with US ONSD and 730 patients diagnosed with MRI ONSD. Twenty studies reporting US ONSD were included for quantitative synthesis. The US ONSD had a high diagnostic accuracy, involving estimated sensitivity of 0.92 (95%CI 0.87-0.95), estimated specificity of 0.85 (95%CI 0.79-0.89), positive likelihood ratio (PLR) of 6.0 (95%CI 4.3-8.4), negative likelihood ratio (NLR) of 0.10 (95%CI 0.06-0.15) and Diagnostic Odds Ratio (DOR) of 62 (95%CI 33-117). The data of 11 studies adopting MRI ONSD was pooled. The MRI ONSD demonstrated estimated sensitivity of 0.70 (95%CI 0.60-0.78), estimated specificity of 0.85 (95%CI 0.80-0.90), PLR of 4.8 (95%CI 3.4-6.7), NLR of 0.35 (95%CI 0.27-0.47) and DOR of 13 (95%CI 8-22). The subgroup analysis showed that US ONSD demonstrated a higher sensitivity (0.92 versus 0.70; p<0.01) and almost equal specificity (0.85 vs. 0.85; p=0.67) compared with MRI ONSD. Measurement of ONSD can be a useful tool to predict raised ICP. The US ONSD demonstrated better accuracy than MRI ONSD for the diagnosis of increased ICP.

To investigate the feasibility of assessing the ecacy of non-surgical treatment for gastric lymphoma using oral contrast-enhanced ultrasound (OCEUS) and double contrast-enhanced ultrasound (DCEUS). A total of 27 patients with gastric lymphoma treated nonoperatively were included in this retrospective study. The ecacy was evaluated using OCEUS and CT, respectively, and the results were tested for kappa concordance. Sixteen of the 27 patients underwent multiple DCEUS examinations before and after treatment. Micro-perfusion of the lesion in DCEUS is represented by the Echo Intensity Ratio (EIR), (echo intensity of the lymphoma lesion/echo intensity of the normal gastric wall), and one-way ANOVA was used to compare the differences between groups in EIR values before and after treatment. OCEUS and CT were highly consistent in assessing the efficacy of gastric lymphoma, with a Kappa value of 0.758. During a median follow-up of 8.8 months, there was no statistical difference between the complete remission rate obtained by OCEUS and that obtained by endoscopic and CT (25.93% vs. 44.44%, p=0.154; 25.93% vs. 33.33%, p=0.766). There was also no statistical difference in the time to achieve complete remission using OCEUS assessment and endoscopy and CT (4.71±1.03 months vs. 6.01±2.14 months, p=0.088; 4.47±1.84 months vs. 6.01±2.14 months p=0.143). The difference in EIR between the groups before treat-ment and after different numbers of treatments was statistically signifficant (p<0.05), and post hoc analysis revealed this dif-ference as early as after the second treatment (p<0.05). Transabdominal OCEUS and CT are comparable in the assessment of gastric lymphoma treatment ecacy. DCEUS is a noninvasive, cost-effective, and widely available method for gastric lymphoma therapeutic effect evaluation. Therefore, transabdominal OCEUS and DCEUS have the potential to be used for the early assessment of the ecacy of the non-surgical treatment of gastric lymphoma.

Adenomyoma is an exceptionally rare hamartoma in the small intestine. Few data have been reported on the featuresof this rare disease. The aim of this study was to describe the ultrasound (US) characteristics of small intestinal adenomyomas.Material and methods: This retrospective study analyzed the clinical features and US data of 15 pediatric patients diagnosedas small intestinal adenomyomas in the age range between 1 day to 12 years in our hospital during 2014-2021. Theclinical manifestations of all the small intestinal adenomyomas were abdominal pain, vomiting or/and hemafecia. The smallintestinal adenomyoma usually acted as the lead point of secondary intussusception. They were identified in the ileum (n=11),jejunum (n=2), and Meckel's diverticulum (n=2). The diagnostic accuracy (the concordance rate between US diagnosis andpathological diagnosis) of small intestinal adenomyoma was 73.3%. The small intestinal adenomyoma had approximately1.0-3.0 cm, were typically located in the submucosal region, had the basal part wide and without a pedicle, and its boundarieswere clear. The mass protruded into the intestinal cavity, and showed oval hypoechoic polycystic echo nodules, containingmultiple small quasi-circular or irregular cysts of different sizes surrounded by solid hypoechoic mosaic areas. The colorDoppler US showed in the solid hypoechoic areas of the mass abundant or sparse blood flow signals.Conclusions The USfindings of small intestinal adenomyomas in children are characteristic, and US is valuable in the identification of intestinaladenomyomas in children.

Portal Venous Gas (PVG) provides an important differential diagnosis in the diagnose of intrahepatic reflexogenic structures. This review article is intended to provide an overview of the current literature on the detection of PVG, its special forms and important differential diagnoses, it also shows possibilities for the diagnostic procedure in the case of sonographic detection of PVG.