- Research Article
- 10.1002/jcu.70192
- Jan 22, 2026
- Journal of clinical ultrasound : JCU
- Feifei Song + 2 more
Splenic angiosarcoma is an extremely rare and highly aggressive malignant vascular tumor with nonspecific clinical manifestations and variable imaging appearances. We report a case of a middle-aged male presenting with progressive upper abdominal discomfort and a large splenic mass accompanied by cardiophrenic lymphadenopathy and peritoneal involvement. Ultrasound, contrast-enhanced ultrasound (CEUS), computed tomography (CT), and magnetic resonance imaging (MRI) demonstrated aggressive imaging features highly suggestive of malignancy. Ultrasound-guided biopsies of both the splenic lesion and cardiophrenic lymph nodes revealed malignant vascular proliferation with spindle and epithelioid morphology, a high Ki-67 proliferation index, and diffuse endothelial marker positivity, confirming the diagnosis of splenic angiosarcoma. This case highlights the diagnostic value of CEUS combined with multimodal imaging in the early recognition and accurate diagnosis of malignant splenic vascular tumors.
- Research Article
- 10.1002/jcu.70183
- Jan 17, 2026
- Journal of clinical ultrasound : JCU
- Shuhao Song + 5 more
To evaluate the proposed explainable denoising deep learning model, Grouped Shared Convolutional Attention Vision Transformer (GSCAViT), for classifying normal fetal echocardiogram. A retrospective study was conducted on 358 fetal cardiac ultrasound exams with a total of 2501 images. GSCAViT utilized seven echocardiograms and was compared against baseline and enhanced models using metrics including accuracy, precision, recall, F1 score. The SHAP method clarified key image features, and the denoising guided GSCA module was assessed through visual comparisons and image quality metrics. GSCAViT achieved an accuracy of 97.1%, 99.4%, 81.3%, 72.9% on the validation and three test sets. In addition, GSCAViT achieved low error rates of 2.9%, 0.6%, 18.7%, and 27.1%. To improve upon existing Vision Transformer based models and denoising modules, we propose the GSCAViT, which integrates a novel denoising-guided GSCA module for enhanced image quality and interpretability. SHAP visualizations confirmed the model's ability to identify critical cardiac structures, while the denoising module enhanced image quality, yielding the highest contrast-to-noise ratioand peak signal-to-noise ratio values. GSCAViT outperformed baseline and several enhanced models in classifying seven types of normal fetal echocardiograms, SHAP visualization enhanced the interpretability of classification, comparisons of visual effectiveness and image parameters confirmed the efficacy of the GSCA module.
- Research Article
- 10.1002/jcu.70186
- Jan 15, 2026
- Journal of clinical ultrasound : JCU
- Xinxin Guo + 6 more
To evaluate the impact of lung ultrasound on the frequency of radiological examinations (chest X-ray and CT), radiation exposure, duration of illness, and hospitalization costs in pediatric pneumonia. A retrospective analysis was performed on pediatric pneumonia cases from two branches of Ordos Central Hospital-Dongsheng (n = 407, all underwent lung ultrasound) and Kangbashi (n = 155, none underwent lung ultrasound)-between January 2022 and June 2024. No significant differences in duration of illness or costs for mild cases (p > 0.05). For severe cases, DongSheng Hospital had a shorter median duration of illness (12 vs. 14 days, p = 0.021) and lower median costs (3485 vs. 4378 RMB, p = 0.003). The median number of chest X-rays (1 vs. 2) and CT scans (0 vs. 1) was lower at DongSheng compared to Kangbashi (p < 0.001). Age-stratified analysis revealed significantly lower dose-area product (DAP) from X-rays in mild cases (p < 0.001), with significantly lower dose-length product (DLP) from CT also observed in children aged ≥ 5 years (p < 0.05). In severe cases, significantly lower DAP was found (p < 0.05), while no significant differences were observed for DLP. Lung ultrasound reduces the frequency of radiological examinations, radiation exposure, shortens duration of illness in severe cases, and lowers hospitalization costs.
- Research Article
- 10.1002/jcu.70184
- Jan 15, 2026
- Journal of clinical ultrasound : JCU
- Juan Antonio Valera-Calero + 3 more
This report presents the case of the first author, an asymptomatic 31-year-old physiotherapy professor who explored himself using panoramic B-mode ultrasound imaging to prepare instructional materials for neck ultrasound-guided invasive interventions. The sonographic exploration demonstrated the unilateral presence of a nondescribed muscle in the posterolateral aspect of the neck, proposed to name this variant as "tellus colli" by the authors. To our knowledge, the presence of this muscle has not been previously described. This muscle arises from the external occipital tubercle and the nuchal ligament. It courses superficially to the upper trapezius and slides laterally as it approaches its insertion onto the anterolateral surface of the second rib (passing in the most superficial layer over the levator scapulae in this region). In accordance with the anatomical course of the muscle and the electromyographic findings, this muscle seems to contribute to forced inspiration and specific neck movements (contralateral rotation and neck extension). The presence of this accessory muscle is a casual finding which is not related to neck or neuropathic symptoms.
- Research Article
- 10.1002/jcu.70177
- Jan 12, 2026
- Journal of clinical ultrasound : JCU
- Rui Bao + 3 more
The incidence of pancreatic lesions is increasing. However, there was limited study on the efficacy and safety of percutaneous ultrasound-guided core needle biopsy (US-CNB) for diagnosing pancreatic lesions. This study aimed to evaluate the efficacy and safety of percutaneous US-CNB for diagnosing pancreatic lesions and to analyze the influencing factors. Patients who underwent percutaneous US-CNB for pancreatic lesions from 2016 to 2025 were retrospectively analyzed, and their clinical, imaging, pancreatic biopsy-related data and pathological diagnosis were recorded; subsequently, 777 patients were included. The sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV) of percutaneous US-CNB for diagnosing pancreatic lesions were calculated using surgical pathological findings or clinical diagnoses as the gold standard. Factors affecting accuracy were screened using univariate and logistic regression analyses. In total, 796 ultrasound-guided biopsies were successfully performed in 777 patients. Biopsy results were consistent with the final diagnosis in 753 cases (consistent group) and inconsistent in 43 cases (inconsistent group). The sensitivity, specificity, accuracy, PPV, and NPV were 94.99% (644/678), 92.37% (109/118), 94.60% (753/796), 98.62% (644/653), and 76.22% (109/143), respectively. Mild complications occurred in eight cases (8/796, 1.00%), and severe complications, in seven cases (7/796, 0.88%), which resolved on their own or with treatment. The tumor markers, location of lesion for biopsy, and longest diameter of the lesion were significant factors between groups (p < 0.05). Multivariate regression analysis showed that lesion location (p = 0.018) was an independent factor affecting diagnostic efficacy. Percutaneous US-CNB is safe and reliable for diagnosing pancreatic lesions, and its accuracy is better for diagnosing pancreatic body and tail lesions.
- Discussion
- 10.1002/jcu.70185
- Jan 12, 2026
- Journal of clinical ultrasound : JCU
- Jiro Ichikawa + 4 more
- Research Article
- 10.1002/jcu.70179
- Jan 10, 2026
- Journal of clinical ultrasound : JCU
- Takahiro Hosokawa + 6 more
To evaluate the diagnostic performance of ultrasonography in identifying the preduodenal portal vein and examine the factors influencing its diagnostic performance. Furthermore, we reviewed previously published case reports and series on this anomaly. We included 17 patients diagnosed with a preduodenal portal vein, confirmed by contrast-enhanced computed tomography and/or surgical findings. Patients were categorized into the following two groups: those in whom the anomaly was detected and those in whom it was not detected via initial ultrasonography. The presence or absence of intestinal malrotation, polysplenia/asplenia, and symptoms were compared using Fisher's exact tests. Of the 17 pediatric patients with a preduodenal portal vein, 10 were correctly diagnosed on initial ultrasonography, yielding a sensitivity of 58.8%. A significant difference was observed only in the presence of symptoms (detection group vs. nondetection group: 7/3 vs. 1/6, p = 0.049). No significant difference was found in the presence or absence of intestinal malrotation (6/4 vs. 5/2, p > 0.999) or splenic anomalies (polysplenia/asplenia: 4/5 vs. 5/2, p = 0.358; one patient had no splenic anomaly). The diagnostic performance of ultrasonography for the duodenal portal vein was more than 50%; however, this anomaly was more likely to be overlooked in asymptomatic patients than in symptomatic patients.
- Research Article
- 10.1002/jcu.70168
- Jan 8, 2026
- Journal of clinical ultrasound : JCU
- Teck Yon Lee + 1 more
Artificial intelligence (AI) interpretation of ultrasound (US) images is promising, yet its accuracy in diagnosing pleural effusions remains unclear. We conducted a comprehensive database search which identified 84 studies, of which 6 met eligibility criteria. We included 2951 patients with 58 392 images and 12 069 ultrasound clips. Bivariate analysis revealed a pooled sensitivity of 0.92 (95% CI: 0.85-0.96, p < 0.05) and specificity of 0.96 (95% CI: 0.88-0.99, p < 0.05), with a high AUC of 0.98 under the sROC curve, although included studies had significant heterogeneity, I2 > 99%. AI demonstrates high diagnostic accuracy in detecting pleural effusion on ultrasound.
- Research Article
- 10.1002/jcu.70175
- Jan 7, 2026
- Journal of clinical ultrasound : JCU
- Wenmin Chen + 2 more
This review was done to assess the diagnostic accuracy of transcranial Doppler (TCD) or electroencephalogram (EEG) accuracy for delayed cerebral ischemia (DCI) in adults with aneurysmal subarachnoid hemorrhage. MEDLINE, Embase, Cochrane CENTRAL, Scopus, and Web of Science were searched from inception to April 2025. Two reviewers independently screened studies, extracted 2 Ă— 2 diagnostic data, and assessed the risk of bias using QUADAS-2. Pooled sensitivity, specificity, positive and negative likelihood ratios (LR+, LR-), diagnostic odds ratios (DOR), and area under the hierarchical summary receiver-operating characteristic curve (AUROC) were estimated via bivariate random-effects models. Fifty-two studies (38 TCD; 14 EEG), encompassing 1278 DCI-positive and 3033 DCI-negative assessments, met inclusion. For TCD, pooled sensitivity was 0.79 (95% CI: 0.71-0.85) and specificity 0.82 (0.75-0.87), with LR+ 4.3 (3.1-6.1), LR- 0.26 (0.19-0.36), DOR 17 (9-31), and AUROC 0.87 (0.84-0.90). EEG yielded sensitivity 0.92 (0.83-0.97) and specificity 0.70 (0.58-0.80), with LR+ 3.1 (2.1-4.6), LR- 0.11 (0.05-0.27), DOR 27 (9-83), and AUROC 0.89 (0.86-0.91). Deek's tests showed no publication bias. TCD and EEG both demonstrate strong diagnostic accuracy for DCI after aneurysmal subarachnoid hemorrhage. EEG offers superior sensitivity and rule-out value, while TCD provides balanced rule-in and rule-out performance.
- Research Article
- 10.1002/jcu.70178
- Jan 7, 2026
- Journal of clinical ultrasound : JCU
- Yuren Zhang + 2 more
Fine-needle aspiration biopsy (FNAB) is the preferred pathological examination to exclude thyroid cancer. We describe two case studies of acute thyroid lytic hemorrhage and swelling with pain during FNAB. We observed hemorrhages with a crack-like appearance and swelling during the first needle prick, accompanied by pain, in two patients with no coagulation dysfunction. Symptoms were relieved after the intervention. Thyroid hemorrhage with a crack-like pattern is a rare acute hemorrhagic complication of FNAB. The cause is unclear, and an allergic reaction of the glands could not be excluded. Emergency measures must be prepared in advance, as unpredictable complications may occur during FNAB.