This study aimed to use shear wave elastography (SWE) to evaluate the effect of hemoperfusion (HP) on carotid artery elasticity in uremic patients treated with hemodialysis (HD). Seventy-eight uremic patients were divided into Group B (using HP + HD) and Group C (using HD) according to the dialysis method the patients already used, while 40 healthy volunteers were included as Group A. The clinical data and biochemical indices were collected. Conventional carotid parameters, including carotid intima-media thickness (IMT), carotid artery inner diameter at the end of systole (Ds), carotid artery inner diameter at the end of diastole (Dd), and peak systolic flow velocity (PSV) were measured. The wall motion degree (∆D) and the stiffness coefficient (β) were calculated. SWE-derived elastic moduli (MEmean, MEmax, and MEmin) were measured. Ten-year cardiovascular disease risk (10-year ASCVD risk) was calculated using the Framingham risk score (FRS). There was no significant difference in the Ds, Dd, ∆D, and PSV among the three groups (all p > 0.05). Uremic groups exhibited elevated BUN, Scr, BUA, TG, LDL-C, IMT, β, SWE parameters, and 10-year ASCVD risk compared to controls (p < 0.05). Group C showed significantly higher BUN, Scr, BUA, TC, TG, LDL-C, SWE values, and 10-year ASCVD risk than Group B (p < 0.05), though IMT and β did not differ. SWE parameters correlated positively with LDL-C, IMT, β, and 10-year ASCVD risk (all r > 0.372, p < 0.01), and demonstrated superior diagnostic accuracy (AUCs: 0.919-0.953) compared to conventional measures. These data suggest that SWE is helpful in quantitatively assessing the change in carotid artery elasticity. It could be a useful method for monitoring the progression of atherosclerosis in uremic patients undergoing HD with or without HP and may provide guidance for clinicians to identify individuals at heightened cardiovascular risk.

Hepatocellular carcinoma (HCC) at the early stage frequently evades detection. Aberrant expression of miR-1233 has been reported in various malignancies, yet its level and potential clinical value in HCC remain unknown. This study evaluated miR-1233 expression and potential diagnostic performance in HCC patients. This prospective study enrolled 100 individuals with benign hepatic tumors and 120 cases with HCC. They all underwent dual-source CT imaging and were confirmed pathologically. The miR-1233 level was quantified by qRT-PCR. The multivariate logistic regression analysis was employed to identify the underlying risk factors of HCC. Pearson correlation analysis was carried out to assess the association of miR-1233 with alpha fetoprotein (AFP) or des-gamma-carboxy prothrombin (DCP). After statistical analysis in SPSS, ROC curves were generated for significantly different miR-1233, dual-CT parameters, and the combination to compare their diagnostic performance in distinguishing HCC patients. Serum miR-1233 was up-regulated in HCC patients. The expression pattern of miR-1233 showed positive correlation to AFP and DCP indicators. In ROC curve of miR-1233, AUC reached 0.821, with a sensitivity of 73.33% and specificity of 76.67%. Combined with the differential dual-CT parameters, the AUC reached 0.944, with both sensitivity and specificity exceeding 90%. Serum miR-1233 was significantly up-regulated in HCC patients. The diagnostic efficacy of miR-1233 combined with dual-source CT was superior to that of the single one in recognizing HCC individuals.

Lung ultrasound is increasingly used as a bedside imaging modality in critically ill patients with acute respiratory failure (ARF), but its overall diagnostic performance across diverse settings remains uncertain. We conducted a diagnostic test accuracy meta-analysis to evaluate the accuracy of lung ultrasound in identifying the thoracic cause of ARF in critically ill patients. We systematically searched MEDLINE, Embase, Web of Science, Scopus from inception to November 2025. Two reviewers independently performed study selection, data extraction, and QUADAS-2 quality assessment. Pooled sensitivity, specificity, and summary receiver operating characteristic (SROC) curves were estimated using a bivariate random-effects model; likelihood ratios, diagnostic odds ratio (DOR), Fagan nomogram, and Deek's funnel plot were derived. Twenty studies (3083 units; 1227 reference-positive, 1856 reference-negative) were included. Pooled sensitivity and specificity of lung ultrasound for thoracic cause of ARF were 0.89 (95% CI: 0.83-0.94) and 0.94 (95% CI: 0.90-0.97), respectively. Positive and negative likelihood ratios were 16.2 (95% CI: 9.1-28.9) and 0.11 (95% CI: 0.07-0.18), yielding DOR of 144 (95% CI: 63-330) and area under the SROC curve of 0.97 (95% CI: 0.95-0.98). Heterogeneity was substantial (I2 = 96%), but Deek's test did not show strong evidence of publication bias (p = 0.09). Lung ultrasound can be applied as rapid bedside adjunct to support early ARDS evaluation in ARF, potentially reducing delays associated with transport-dependent imaging. However, clinicians should interpret findings in context, as diagnostic performance may be attenuated when acoustic windows are limited (e.g., obesity) and when mechanical ventilation settings (e.g., high PEEP) alter lung aeration and artifact patterns.

We describe a case report of prenatal presentation of membranous aplasia cutis congenita on the vertex by magnetic resonance imaging, the conflict between the prenatal presentation, the postnatal features, and the long-term follow-up.

Ultrasound (US) imaging is well-known in determining subcutaneous fat thickness, which is associated with BMI and obesity, and therefore potentially impacts male fertility. Fat growth within the suprapubic area increases scrotal temperature, causing potential damage to sperm. This study investigates the role of US in evaluating a relationship between inguinal and suprapubic subcutaneous fat thicknesses and male fertility indices. US imaging was utilized to measure the thicknesses of subcutaneous adipose tissue (SAT) in the left and right inguinal and suprapubic regions on 88 individuals. Spermatic concentration and motility grades were recorded. Statistical correlation analysis was conducted across the study parameters. Significant correlations (moderate to strong) of BMI against inguinal and suprapubic thicknesses were identified. Furthermore, a non-statistically significant correlation between BMI and sperm metrics (r = -0.4) was observed, while stronger statistically significant correlations were observed between left inguinal thickness (r = -0.6), right inguinal thickness (r = -0.6), and male fertility indices. Strong correlations between US SAT thickness and spermatic characteristics when compared to BMI highlighting the potential role of US in evaluating male fertility.

Papillary thyroid carcinoma (PTC) is the predominant type of malignant thyroid tumor, with its incidence steadily rising in recent years. Timely diagnosis and intervention are crucial for minimizing metastasis and improving survival rates. This study aims to investigate miR-485-3p's diagnostic potential for PTC and its role in malignant progression, offering a novel biomarker for PTC. This study enrolled 150 benign thyroid nodule (BTN) patients and 200 PTC patients. All participants underwent color Doppler ultrasound (CDUS) to measure relevant parameters (RI, PI, and PSV). Serum miR-485-3p levels were quantified using RT-qPCR. ROC analysis was conducted to estimate the diagnostic efficacy of CDUS parameters and miR-485-3p. Functional experiments were performed to investigate the role of miR-485-3p in PTC cells. Additionally, dual-luciferase reporter assays were utilized to validate the direct targeting relationship between miR-485-3p and GCNT4. Elevated CDUS parameters could differentiate between patients with PTC and BTN. Serum miR-485-3p levels were markedly enhanced in PTC patients. The combination of miR-485-3p and CDUS parameters demonstrated superior diagnostic performance for PTC (AUC = 0.926), with sensitivity and specificity of 0.870 and 0.847. Inhibition of miR-485-3p remarkably suppressed the proliferative, migratory, and invasive capacities of PTC cells. Furthermore, mechanistic investigations revealed that miR-485-3p directly regulates GCNT4 expression, thereby modulating the malignant behavior of PTC cells. Preliminary results indicate that the biomarker panel combining serum miR-485-3p levels with CDUS parameters shows diagnostic potential for PTC. Invitro experiments confirmed the potential of the miR-485-3p/GCNT4 axis in modulating the malignant behavior of PTC cells.

Myocardial tuberculosis is uncommon, and myocardial tuberculosis presenting primarily as proliferative lesions is even rarer. This case report describes a highly unusual clinical presentation characterized by a solid cardiac space-occupying lesion. Both cardiac magnetic resonance imaging (MRI) and echocardiography supported the diagnosis of a cardiac tumor, while pathology confirmed tuberculosis. The patient exhibited no clinical symptoms of tuberculous toxicity, no pericardial thickening or calcification, and no signs or symptoms of pericardial effusion. Both clinical manifestations and ancillary investigations supported the diagnosis of a cardiac tumor, which were significant factors contributing to the preoperative misdiagnosis. This highlights the need for increased vigilance to reduce misdiagnosis and missed diagnosis.

Osteonecrosis of the tarsal navicular bone is a rare disorder of the foot and ankle that is often overlooked or misdiagnosed. When it occurs in children, the condition is known as Kohler disease. This article presents the case of a 9-year-old boy who experienced left foot pain, swelling, and a limp. Multimodal imaging revealed alterations in the morphology of the navicular bone, uneven bone density, and bone marrow edema, leading to a definitive diagnosis of Kohler disease. Due to its rarity, diagnosis requires careful correlation of clinical symptoms and imaging findings. Most affected children achieve full recovery through conservative management, including immobilization and restriction of weight-bearing. Early recognition is crucial to avoid unnecessary interventions.

To report the implementation across Fetal Medicine units and the agreement between first and second trimester referral scans in the identification of fetal anomalies in cases referred for the expert assessment of the fetal anatomy in the first trimester following the publication of the national guidelines in Italy. This multicenter, retrospective study aimed to evaluate the implementation and diagnostic performance of first-trimester referral ultrasound (US) in identifying fetal anomalies, following the introduction of national guidelines in Italy. The analysis included singleton pregnancies referred to nine specialized Fetal Medicine centers between 11+0 and 13+6 weeks' gestation due to increased risk for structural anomalies. Risk was defined as either a nuchal translucency (NT) measurement ≥ 3.5 mm or suspicion of a structural anomaly at initial screening. Only cases undergoing referral US within the specified gestational window were included. Diagnostic accuracy was assessed by comparing findings from first-trimester referral US with those from follow-up referral US performed either at 14-16 weeks or at 19-21 weeks. Out of 344 referred cases, 322 (93.6%) underwent first-trimester referral US within the appropriate timeframe. After excluding miscarriages and terminations, 136 cases were evaluated again at 19-21 weeks and 207 at 14-16 weeks. The agreement between the 11+0-13+6 week and 19-21 week scans was 85.3%, with a sensitivity of 82.0%, specificity of 88.0%, positive predictive value (PPV) of 84.7%, and negative predictive value (NPV) of 85.7%. Agreement between the early and 14-16 week scans was 91.3%, with sensitivity, specificity, PPV, and NPV of 90.7%, 92.1%, 93.9%, and 88.2%, respectively. The study demonstrates successful implementation of national first-trimester referral US guidelines in Italy. When performed by experienced operators using a standardized protocol, first-trimester anatomy assessment is feasible and provides high diagnostic accuracy, enabling early detection of structural fetal anomalies.