ABSTRACTObjectiveTo develop a nomogram of fetal ear length (FEL) by gestational age in a healthy pregnant Southern European population and assess its potential as a prenatal ultrasound marker of chromosomal anomalies in this demographic.MethodsThis prospective, multicenter cohort study included low‐risk pregnancies from 11 + 2 to 34 + 6 gestational age. A nomogram was constructed based on gestational age for healthy fetuses with normal perinatal outcomes. Intraobserver and interobserver reliability were evaluated. To assess the efficacy of FEL as a marker of chromosomal anomalies, a multivariate logistic regression analysis was performed; sensitivity and specificity were calculated.ResultsA total of 1923 FEL measurements were obtained from 1331 singleton pregnancies. Using data from healthy fetuses, a nomogram was constructed through linear regression analysis. Measurement feasibility was excellent, with intra‐ and interobserver correlation coefficients of 0.996 (95% confidence interval [CI]: 0.995–0.997) and 0.998 (95% CI: 0.978–0.999), respectively. FEL achieved a sensitivity of 81.8% and a specificity of 49.8% in detecting chromosomal anomalies. Multivariate logistic regression indicated that FEL ≤ 5th percentile significantly increased the likelihood of detecting chromosomal anomalies (odds ratio = 3.11); although the wide 95% CI (1.92–10.7) suggests a cautious interpretation of this finding.ConclusionsWhile FEL demonstrates potential as a prenatal marker of chromosomal anomalies, its clinical utility remains limited due to moderate sensitivity and specificity. Further studies are warranted to refine its diagnostic value in routine screening practices.

ABSTRACTPurposeTargeted neonatal echocardiography (TNE) is increasingly utilized by neonatologists to assess hemodynamics, particularly when cardiology‐performed echocardiography (CPE) is unavailable. It is crucial that TNE screens and identifies structural abnormalities. This study evaluated the agreement between TNE and CPE in detecting significant congenital heart disease (CHD).MethodsThis retrospective, single‐center cohort study included infants who underwent TNE between 2015 and 2019 and had at least one complete CPE before discharge. Infants with a known CHD diagnosis prior to TNE were excluded. Atrial septal defects (ASD) < 3 mm, peripheral pulmonary stenosis, and patent ductus arteriosus were excluded. Agreement between TNE and CPE was assessed using correlation coefficients and kappa statistics.ResultsA total of 339 infants with 954 TNE scans were included. TNE identified CHD in 41 infants, with all but one (a false positive bicuspid aortic valve) confirmed by CPE. TNE missed CHD in 29 infants (31 lesions), mostly minor, with only one case (pulmonary stenosis) requiring intervention. The overall agreement was 91.15%, with a kappa of 0.68 (p < 0.0001).ConclusionTNE demonstrated good agreement with CPE in detecting significant CHD in a low‐risk neonatal population. Most missed lesions were minor, underscoring the importance of ongoing training and quality assurance.

ABSTRACTThis case report presents an atypical presentation of proximal intersection syndrome and provides ultrasound‐based evidence of extensor pollicis brevis muscle belly hypertrophy with associated edema in a non‐athletic population. While occupationally induced PIS has been previously documented, the patient's symptoms in this case were linked to repetitive lifting tasks involving prolonged extension of the first metacarpophalangeal joint with a wide grip. Dynamic ultrasound assessment revealed radial displacement of the second compartment tendons by the extensor pollicis brevis muscle during the aggravating movement. This finding suggests a novel pathomechanism, potentially driven by mechanical friction and stress between the first and second dorsal compartments, warranting further investigation.

ABSTRACTObjectiveThis study aims to investigate the predictive value of the ultrasound‐based Z score for the aortic valve (AV) diameter, pulmonary valve (PV) Z score, and the PV/AV ratio in diagnosing aortic stenosis (AS) in fetuses.MethodsA prospective study of 24 singleton fetuses with suspected AS who underwent two or more fetal echocardiograms was enrolled. Based on the pregnancy outcomes, the prenatal cases were divided into two groups: the AS group and the false‐positive group. Electronic spatiotemporal image correlation (eSTIC) technology was used to measure AV and PV of all fetuses, and the AV and PV Z scores, along with the PV/AV ratio, were calculated, compared, and analyzed.ResultsIn the AS group, significant differences were found between the first and second echocardiograms regarding the AV Z score, PV Z score, and PV/AV ratio. In the false‐positive group, only the PV Z score and PV/AV ratio showed significant differences. In the first echocardiogram, the AV Z score and PV/AV ratio significantly differed between the AS and false‐positive groups. In the second echocardiogram, only the AV Z score showed differences. An AV Z score < −2.46 showed high sensitivity (89.5%) and specificity (100%) for AS diagnosis. When combined with a PV/AV ratio > 1.64, the predictive value increased.ConclusionFetal echocardiography with an AV Z score <−2.46 and a PV/AV ratio > 1.64 provides a higher predictive value for diagnosing AS in fetuses.

ABSTRACTIntroductionUltrasound‐guided percutaneous kidney biopsy is a key diagnostic tool, but it carries a risk of complications. This study aimed to evaluate complication rates and identify associated clinical and procedural factors.MethodsThis retrospective study analyzed 627 patients who underwent ultrasound‐guided percutaneous kidney biopsy between January 2013 and December 2019. Logistic regression models were used to assess associations between complications and potential risk factors, adjusting for demographics, clinical characteristics, and procedural variables.ResultsComplications occurred in 75% of patients, with hematoma (69.7%) being the most frequent, followed by pain (14.5%). Older age (adjusted odds ratio [OR], 0.99; 95% confidence interval [CI], 0.97–1; p = 0.024). Obesity (adjusted OR, 0.5; 95% CI, 0.34–0.74; p < 0.001) and smoking (adjusted OR, 0.57; 95% CI, 0.36–0.9; p = 0.015) were associated with a reduced risk of complications.ConclusionsComplications were common following ultrasound‐guided percutaneous kidney biopsy; however, the majority were minor and clinically manageable. Older age, obesity, and smoking were independently associated with a lower risk of complications. These findings highlight the overall safety of the procedure and emphasize the importance of individualized risk assessment in clinical practice.

ABSTRACTPurposeLung ultrasound (LUS) has gained popularity in the emergency department (ED) and intensive care unit (ICU). However, little is known about its use, training, indications, and implementation barriers. Therefore, we performed a survey to evaluate the current practice of LUS among ED and ICU physicians with varying experience levels across regions in Switzerland.MethodsA 27‐question online survey was disseminated across 108 EDs and 75 ICUs using snowball sampling via department heads.ResultsOf all 198 participants from 183 invited departments (49.0% ED physicians, 42.3% ICU physicians, 8.7% from other specialties), 190 (95.5%) use ultrasound and 164 (82.8%) use LUS in their clinical practice. Predominantly, LUS is utilized for evaluating dyspnea (95.9%), shock (76.2%), and hypoxemia (73.5%). ICU physicians used LUS more for invasive procedures, while less experienced physicians had lower certification rates. Standardized protocols for LUS examination or documentation were reported by only 22.5% and 38.9% of responders, respectively. The main barriers identified were time constraints, lack of training opportunities, and underestimation of LUSs diagnostic value.ConclusionsLUS is widely adopted and considered highly relevant by ED and ICU physicians. However, disparities in usage and proficiency were observed between ICU and non‐ICU physicians, as well as between more and less experienced practitioners. Addressing the identified training gaps and promoting standardized protocol adoption are imperative for optimizing LUSs integration into patient care.