3D Ultrasound Research Articles

Reference intervals for carotid artery intima-media thickness measurements in the multi-ethnic Asian population: relationship with cardiometabolic risk factors

Abstract Background Carotid artery intima-media thickness (cIMT) is an intermediate surrogate marker for cardiovascular disease (CVD). It has been reported that although the distribution of cIMT values is very heterogeneous and values vary widely between different ethnicity, geographic location, and ultrasound protocol, the prediction of vascular events with study-specific cIMT values is consistent across all ethnicities and regions (1). Hence, Consensus Statement from the American Society of Echocardiography suggests that cIMT greater than or equal to 75th percentile for the patient’s age, sex, and ethnicity is indicative of increased CVD risk (2). Aims We aimed to establish age, sex, and ethnic-specific reference intervals in the multi-ethnic Asian population comprising Chinese, Malays, and Indians. Methods We analysed data from 8762 healthy individuals who had a 3D carotid ultrasonography done as part of the Health for Life in Singapore study. Carotid ultrasonography measurements were taken from the distal common carotid artery (CCA) at both the lateral and posterior angles bilaterally during the end-diastolic phase. The mean of all 4 measurements were taken as average cIMT (avgcIMT). For this analysis, we excluded individuals on treatment for diabetes, hypertension, hyperlipidemia, and ischemic heart disease to derive a healthy population subset comprising of 6522 individuals (Chinese: 69%, Malays: 14%, Indians: 17%). We then assessed the 75th percentile as a marker of cardiovascular risk in all individuals, by testing associations with Framingham risk scores (locally adapted) and with cardiometabolic risk factors (3). Results Ethnic- and sex-specific 75th percentiles (95% CI) of CIMT for our Asian populations are summarised in Table 1. Compared to reference intervals reported in European and African American populations, the 75th centiles are lower in all Asian ethnic subgroups (p<0.05). Framingham risk score, BMI, LDL-C, HbA1c and systolic blood pressure were higher in Asians with cIMT more than 75th percentile (p<0.001), compared to Asians with normal cIMT. Conclusions We estimated race- and sex-specific 75th percentiles of avgcIMT across age in the multi-ethnic Asian population. The thresholds for Asian populations are substantially lower than reported in European and African populations. The 75th centiles identify people with raised cardiovascular risk factors, supporting the validity of cIMT as marker of vascular risk in the population. The 75th centiles will be useful in interpretation of cIMT measures obtained both in research and clinical settings in different ethnic populations in Asia. Longitudinal evaluation is needed to determine the prediction of our Asian specific thresholds for predicting hard cardiovascular outcomes.

Recent advances in three-dimensional ultrasound virtual cystoscopy in modeling and local staging for urothelial carcinoma with histopathological correlation: a cohort prospective study

Background: Bladder urothelial carcinoma is an alarming urologic malignancy. Complex factors like modelling and local staging can affect treatment strategy. However, local staging, particularly the muscle invasion status, significantly influences decisions regarding treatment strategies. Therefore, this study aims to evaluate the novel advances of three-dimensional (3D) ultrasound (US) imaging to assess local staging in comparison with conventional cystoscopy. Methods: Forty-three patients with painless haematuria and conventional cystoscopy findings of bladder mass underwent 3D US virtual cystoscopy. All specimens from conventional cystoscopy were processed histologically. Results: Out of 43 participants, 18 (41.9%) patients proved to have invasive urothelial carcinoma by histopathology. The 3D US had a sensitivity of 97.5% and a specificity of 100%; however conventional cystoscopy was accurate in only 53.5% of the studied cases. Furthermore, in the case of malignant ulcers, mural extension into both the submucosal and the muscle layers was more readily appreciated in multiplanar images. Conclusion: 3D US updates are promising for use in bladder tumour modelling and local staging; however, they can be of value in evaluating mural and extramural tumour extent and have proven accuracy.

Ultrasound Concave 2-D Ring Array for Retinal Stimulation.

An ultrasound concave 2-D ring array transducer was designed for applications in visual stimulation of the retina with a long-term goal to restore vision in individuals with intact neurons but suffering blindness due to retinopathies. The array was synthesized and has a frequency of 20 MHz (0.075-mm wavelengths in water), 18-mm focal length (the curvature of the concave array), 1004 elements (with a pitch of 4.0 wavelengths), and inner and outer diameters of 9 and 14 mm, respectively. Wave patterns produced with the array at the focal distance were simulated. Results show that the wave patterns obtained can achieve a full-width-at-half-maximum (FWHM) resolution of 0.147 mm that is very close to the FWHM diffraction limit (0.136 mm). In addition, a scaled experiment at a lower frequency of 2.5 MHz was performed. The result is very close to those obtained with the simulations.

Albuminuria Is Associated with Higher Carotid Plaque Volume Quantified by Novel 3D Ultrasound in Type 1 Diabetes

Albuminuria Is Associated with Higher Carotid Plaque Volume Quantified by Novel 3D Ultrasound in Type 1 Diabetes

Congenital Uterine Malformations and Diagnostic Methods: Diagnosis with 2D and 3D Ultrasonography

Congenital Uterine Malformations and Diagnostic Methods: Diagnosis with 2D and 3D Ultrasonography

Impaired gastric accommodation in patients with postprandial distress syndrome type of functional dyspepsia assessed by 2D ultrasonography.

The pathophysiology of postprandial distress syndrome includes impaired gastric accommodation, hypersensitivity to gastric distension and delayed gastric emptying. 2D-ultrasonography is one of the methods to assess gastric accommodation by measuring proximal gastric area and we evaluated its role in calculating proximal gastric area and thus assessing gastric accommodation in Indian patients with postprandial distress syndrome. In a hospital-based comparative analysis, proximal gastric area was measured with 2D-ultrasonography of postprandial distress syndrome(PDS) patients and compared with healthy controls. Five readings were measured every fiveminutes till 25minutes after 400mL of vegetable soup. The Patient Assessment of Upper Gastrointestinal Disorders-Quality of Life (PAGI-QOL score) and diets aggravating PDS symptoms were studied through detailed questionnaires. Sample size was calculated at 80% study power and alpha error of 0.05 to be 30 subjects in each group. The mean age of patients (18 males) vs. 30 healthy controls (25 males) was 40.8 ± 11.50years vs. 36.37 ± 7.58, respectively, (p = 0.084). Proximal gastric area was significantly lower in patients versus healthy controls at fiveminutes (22.54 ± 2.77 vs. 30.66 ± 2.55 cm2), 10minutes (23.03 ± 2.45 vs. 31.10 ± 2.06 cm2), 15minutes (23.06 ± 2.27 vs. 30.31 ± 2.11 cm2), 20minutes (22.21 ± 2.31 vs. 29.73 ± 1.71 cm2) and 25minutes (22.02 ± 2.33 vs. 28.39 ± 1.55 cm2); p < 0.001 at all intervals of time, indicating impaired gastric accommodation. The QOL was poor in all patients with PDS with mean PAGI-QOL score of 31.30 ± 15.05, median of 30, minimum score of 12 and maximum score of 66. Measurement of proximal gastric area with 2D-ultrasonography is simple and non-invasive. Proximal gastric area in patients was lower than controls, indicating impaired gastric accommodation. Poor quality of life was universal in patients with postprandial distress syndrome.

EP16.23: Effective diagnosis of uterine septum and retained placenta accreta using 3D ultrasonography

EP16.23: Effective diagnosis of uterine septum and retained placenta accreta using 3D ultrasonography

Effects of Recreational Therapy and 3D Ultrasonography for High-Risk Pregnancies on Psychological Well-Being during Hospitalization and in the Puerperal Phase.

Hospitalization during pregnancy often produces psychosocial distress for pregnant women. In this study, 3D ultrasound and recreational therapy were compared to the standard treatment for their influence on depressive symptoms and anxiety. In this prospective one-year intervention study, women who were admitted to the hospital for any pregnancy complication, other than psychiatric, were included. A control group, with standard clinical treatment, and two intervention groups, both additionally receiving either 3D ultrasound or recreational therapy, were established. Psychological well-being was assessed at defined times by the PHQ-health-questionnaire. A total of 169/211 women were included: control group n = 79, 3D ultrasound group n = 43, and crochet group n = 83. A higher than estimated underlying depression was seen for all women on admission. The intervention groups showed less depression (p = 0.02762). No difference was seen between the intervention groups (p = 0.23029). Anxiety decreased throughout intervention, but not significantly. On admission, all women showed similar results of underlying depression, indicating that hospitalization itself already causes mild psychological stress. Both interventions decreased depressive symptoms. Intervention with either recreational therapy or 3D ultrasound can prevent the development of mild and major depression and decrease anxiety disorders, and therefore has a positive effect on well-being during hospitalization. These results emphasize the need to implement forms of interventions to improve the well-being of women, as this might improve pregnancy and neonatal outcome.

Comparison between MRI and the Combination of 2D and 3D US in the Prenatal Diagnosis of Closed Spina Bifida

Introduction: Closed spina bifida (CSB) is a rare condition with a challenging prenatal diagnosis. Herein, we assess the conventional two-dimensional (2D) ultrasound (US) combined with three-dimensional (3D) ultrasound (US) and magnetic resonance imaging (MRI) in the prenatal diagnosis of CSB. Methods: In this retrospective study, we included 20 cases of fetal CSB confirmed by postnatal MRI, post-mortem pathological examination, or postpartum surgery. Prenatal 2D US complemented with the 3D US was performed in all fetuses to evaluate the characteristics of the conus, vertebral arch, and scoliosis. Moreover, MRI was performed to establish the split vertebrae, with or without a bulging mass. Thereafter, we compared the performance of the US and MRI. Results: Diagnosis accuracy of US was comparable with MRI (70% vs. 75%, κ = 0.62); US detected more cases with interpediculate distance ≥95% (55% vs. 35%, κ = 0.22) than MRI. On the other hand, MRI had a superior capacity for identifying vertebral arch fissures (20% vs. 35%, κ = 0.39). MRI and ultrasound had good agreement in the conus medullaris (65% vs. 70%, κ = 0.42) and scoliosis (45% vs. 35%, κ = 0.59). Both US and MRI detected 1 (5.0%) case with “lemon sign” and “banana sign.” The missed diagnosis rates of US and MRI were 15% (3/20) and 5% (1/20), respectively. The misdiagnosis rates of US and MRI were 15.0% (3/20) and 20.0% (4/20), respectively. Conclusion: Both MRI and 2D US combined with the 3D US had excellent performance in prenatal diagnosis of CSB.

Relationship of early brain growth pattern measured by ultrasound with neurological outcome at two years of age in very low birth weight infants

The purpose of this study is to define the impact of early brain growth trajectory in very low birth weight infants (VLBWI) on neurological prognosis at 2 years, assessed using sequential ultrasound (US) scans. This is a prospective cohort study with consecutive inclusion of VLBWI ≤ 32 weeks gestational age and ≤ 1500 g at birth. Total brain volume (TBV) was assessed using sequential 3D-US from birth to discharge. Prognosis at 2 years (corrected age) was assessed using the Bayley Scales of Infant and Toddler Development Third Edition. TBV showed slower growth with postmenstrual age (PMA) in those VLBWI who had an adverse cognitive prognosis compared to those with good cognitive prognosis (mean difference in TBV between prognostic groups from 4.56 cm3 at 28 weeks to 42.58 cm3 at 43 weeks) as well as in those with adverse language prognosis (mean difference in TBV from 2.21 cm3 at 28 weeks to 26.98 cm3 at 43 weeks) although other variables showed more impact than TBV on language prognosis (gestational age at birth, brain injury at term, and socioeconomic status). No association was found between TBV and motor prognosis. Brain growth rate was also significantly higher in those VLBWI who presented good cognitive scores (18.78 + (0.33 × (PMA-33)) cm3/week) compared to those with adverse cognitive outcome (13.73 + (0.64 × (PMA-33)) cm3/week). Conclusion: Early altered brain growth is associated with poor cognitive prognosis at 2 years of age. Using sequential US monitoring, we can detect early brain growth deviation in patients who will have adverse cognitive outcomes.What is known:• The prediction of neurodevelopmental outcome of VLBWI is mostly based on the presence of brain injury in US and structural magnetic resonance imaging (MRI) at term. • Some studies have related brain volume measured on MRI at term with neurodevelopment outcome.What is new:• VLBWI with adverse cognitive prognosis at two years of age present smaller brain volumes detectable by sequential US during NICU admission.• Brain volume can be estimated from 2D and 3D US and has prognostic value in VLBWI.

The role of Gestational Diabetes Mellitus and pelvic floor 3D-ultrasound assessment during pregnancy predicting urinary incontinence: a prospective cohort study

Postpartum urinary incontinence may have a severe impact on women’s health. Despite pregnancy and parturition being the most recognized risk factors, methods to identify new pregnant predictor risk factors are needed. Our study investigated the Gestational Diabetes Mellitus, clinical and pelvic floor 3D-ultrasound markers in pregnant women as predictors for 6–18 months of urinary incontinence. This prospective cohort study included nulliparous pregnant women submitted to Gestational Diabetes Mellitus screening in the second trimester. Pelvic floor 3D Ultrasound was performed at the second and third trimesters of gestation to evaluate the pelvic floor muscles and functions. Clinical data, the ICIQ-SF, and ISI questionnaires for urinary incontinence were applied in the third trimester and 6–18 months postpartum. Univariate analysis (P < .20) to extract risk factors variables and multivariate logistic regression analysis (P < .05) to obtain the adjusted relative ratio for urinary incontinence were performed. A total of 93 participants concluded the follow-up. Using the variables obtained by univariate analysis and after adjustments for potential confounders, multivariate analysis revealed that Gestational Diabetes Mellitus exposure was a solid and independent risk factor for 6–18 months of urinary incontinence (Adjusted RR 8.08; 95%CI 1.17–55.87; P:0.034). In addition, a higher Hiatal area observed in distension maneuver from the second to third trimester was negatively associated (Adjusted RR 0.96; 95%CI 0.93–0.99; P:0.023). In conclusion, Gestational Diabetes Mellitus was positively associated with 6–18 months of urinary incontinence, and higher Hiatal area distension was negatively associated.

Ultrasound Frame-to-Volume Registration via Deep Learning for Interventional Guidance.

Fusing intraoperative 2-D ultrasound (US) frames with preoperative 3-D magnetic resonance (MR) images for guiding interventions has become the clinical gold standard in image-guided prostate cancer biopsy. However, developing an automatic image registration system for this application is challenging because of the modality gap between US/MR and the dimensionality gap between 2-D/3-D data. To overcome these challenges, we propose a novel US frame-to-volume registration (FVReg) pipeline to bridge the dimensionality gap between 2-D US frames and 3-D US volume. The developed pipeline is implemented using deep neural networks, which are fully automatic without requiring external tracking devices. The framework consists of three major components, including one) a frame-to-frame registration network (Frame2Frame) that estimates the current frame's 3-D spatial position based on previous video context, two) a frame-to-slice correction network (Frame2Slice) adjusting the estimated frame position using the 3-D US volumetric information, and three) a similarity filtering (SF) mechanism selecting the frame with the highest image similarity with the query frame. We validated our method on a clinical dataset with 618 subjects and tested its potential on real-time 2-D-US to 3-D-MR fusion navigation tasks. The proposed FVReg achieved an average target navigation error of 1.93 mm at 5-14 fps. Our source code is publicly available at https://github.com/DIAL-RPI/Frame-to-Volume-Registration.

Miniaturized Endoscopic 2D US Transducer for Volumetric Ultrasound Imaging of the Auditory System.

In this paper, we focus on the carrying out and validation of minimally invasive three-dimensional (3D) ultrasound (US) imaging of the auditory system, which is based on a new miniaturized endoscopic 2D US transducer. This unique probe consists of a 18 MHz 24 elements curved array transducer with a distal diameter of 4 mm so it can be inserted into the external auditory canal. Typical acquisition is achieved by rotating such a transducer around its own axis using a robotic platform. Reconstruction of a US volume from the set of acquired B-scans during the rotation is then performed using scan-conversion. The accuracy of the reconstruction procedure is evaluated using a dedicated phantom that includes a set of wires as reference geometry. Twelve acquisitions obtained from different probe poses are compared to a micro-computed tomographic model of the phantom, leading to a maximum error of 0.20 mm. Additionally, acquisitions with a cadaveric head highlight the clinical applicability of this set up. Structures of the auditory system such as the ossicles and the round window can be identified from the obtained 3D volumes. These results confirm that our technique enables the accurate imaging of the middle and inner ears without having to deteriorate the surrounding bone. Since US is a real-time, wide available and non-ionizing imaging modality, our acquisition setup could facilitate the minimally invasive diagnosis and surgical navigation for otology in a fast, cost-effective and safe way.

Evaluation of fatty liver with grey scale 2D ultrasonography and ultrasound elastography and co-relation with lipid profile in adult patient in the state of Chhattisgarh attending Dr. Bhim Rao Ambedkar memorial hospital tertiary care centre Raipur

Background: Several noninvasive imaging techniques have been introduced for the assessment of liver fibrosis. Among these techniques real-time Point shear wave elastography has become a promising imaging modality for the measurement of liver stiffness. The advantage of this technique is that the elasticity displayed using a B-mode image, also a quantitative estimation of liver stiffness is performed. The present study evaluates the fatty liver in patients above 18 years age with grey scale 2D ultrasonography and ultrasound elastography and also study the correlation with lipid profile in patients attending Dr B.R.A.M hospital tertiary care center Raipur, Chhattisgarh. Methods: This was a hospital based observational study conducted in Department of Radio-diagnosis, Dr BRAM Hospital and Pt JNM Medical College, Raipur (C.G). A sample of 198 patient above 18-year age with fatty liver were taken. Grading and quantification of fatty liver was also done by Shear wave elastography. A p-value &lt;0.05 was considered statistically significant. Results: Mean age of study subjects was 48.47±15.21 years and 52.02% were female. 2D ultrasound technique diagnosed 75.25% grade-1 and 24.24% were in grade-II. Elastography technique diagnosed 57.58% with dysfunction (F1) liver stiffness, 28.28% fibrosis present (F2 or F3) and 13.64% normal. Increasing liver stiffness stages was significantly associated with increasing levels of serum VLDL (p=0.04). Conclusions: Ultrasound used in conjunction with elastography has shown utility in diagnosing and follow up of fatty liver patients. Liver stiffness was significantly associated with increasing levels of serum VLDL.

Quantitative validation of two model-based methods for the correction of probe pressure deformation in ultrasound.

The acquisition of good quality ultrasound (US) images requires good acoustic coupling between the ultrasound probe and the patient's skin. In practice, this good coupling is achieved by the operator applying a force to the skin through the probe. This force induces a deformation of the tissues underlying the probe. The distorted images deteriorate the quality of the reconstructed 3D US image. In this work, we propose two methods to correct these deformations. These methods are based on the construction of a biomechanical model to predict the mechanical behavior of the imaged soft tissues. The originality of the methods is that they do not use external information (force or position value from sensors, or elasticity value from the literature). The model is parameterized thanks to the information contained in the image. This is allowed thanks to the optimization of two key parameters for the model which are the indentation d and the elasticity ratio α. The validation is performed on real images acquired on a gelatin-based phantom using an ultrasound probe inducing an increasing vertical indentation using a step motor. The results showed a good correction of the two methods for indentations less than 4mm. For larger indentations, one of the two methods (guided by the similarity score) provides a better quality of correction, presenting a Euclidean distance between the contours of the reference image and the corrected image of 0.71mm. The proposed methods ensured the correction of the deformed images induced by a linear probe pressure without using any information coming from sensors (force or position), or generic information about the mechanical parameters. The corrected images can be used to obtain a corrected 3D US image.

Three-dimensional ultrasound image reconstruction based on 3D-ResNet in the musculoskeletal system using a 1D probe: ex vivo and in vivo feasibility studies

Objective. Three-dimensional (3D) ultrasound (US) is needed to provide sonographers with a more intuitive panoramic view of the complex anatomical structure, especially the musculoskeletal system. In actual scanning, sonographers may perform fast scanning using a one-dimensional (1D) array probe .at random angles to gain rapid feedback, which leads to a large US image interval and missing regions in the reconstructed volume. Approach. In this study, a 3D residual network (3D-ResNet) modified by a 3D global residual branch (3D-GRB) and two 3D local residual branches (3D-LRBs) was proposed to retain detail and reconstruct high-quality 3D US volumes with high efficiency using only sparse two-dimensional (2D) US images. The feasibility and performance of the proposed algorithm were evaluated on ex vivo and in vivo sets. Main r esults. High-quality 3D US volumes in the fingers, radial and ulnar bones, and metacarpophalangeal joints were obtained by the 3D-ResNet, respectively. Their axial, coronal, and sagittal slices exhibited rich texture and speckle details. Compared with kernel regression, voxel nearest-neighborhood, squared distance weighted methods, and a 3D convolution neural network in the ablation study, the mean peak-signal-to-noise ratio and mean structure similarity of the 3D-ResNet were up to 28.53 ± 1.29 dB and 0.98 ± 0.01, respectively, and the corresponding mean absolute error dropped to 0.023 ± 0.003 with a better resolution gain of 1.22 ± 0.19 and shorter reconstruction time. Significance. These results illustrate that the proposed algorithm can rapidly reconstruct high-quality 3D US volumes in the musculoskeletal system in cases of a large amount of data loss. This suggests that the proposed algorithm has the potential to provide rapid feedback and precise analysis of stereoscopic details in complex and meticulous musculoskeletal system scanning with a less limited scanning speed and pose variations for the 1D array probe.

A Comparative Study of Deep Learning Methods for Multi-Class Semantic Segmentation of 2D Kidney Ultrasound Images.

Ultrasound (US) imaging is a widely used medical imaging modality for the diagnosis, monitoring, and surgical planning for kidney conditions. Thus, accurate segmentation of the kidney and internal structures in US images is essential for the assessment of kidney function and the detection of pathological conditions, such as cysts, tumors, and kidney stones. Therefore, there is a need for automated methods that can accurately segment the kidney and internal structures in US images. Over the years, automatic strategies were proposed for such purpose, with deep learning methods achieving the current state-of-the-art results. However, these strategies typically ignore the segmentation of the internal structures of the kidney. Moreover, they were evaluated in different private datasets, hampering the direct comparison of results, and making it difficult to determination the optimal strategy for this task. In this study, we perform a comparative analysis of 7 deep learning networks for the segmentation of the kidney and internal structures (Capsule, Central Echogenic Complex (CEC), Cortex and Medulla) in 2D US images in an open access multi-class kidney US dataset. The dataset includes 514 images, acquired in multiple clinical centers using different US machines and protocols. The dataset contains the annotation of two experts, but 321 images with complete segmentation of all 4 classes were used. Overall, the results demonstrate that the DeepLabV3+ network outperformed the inter-rater variability with a Dice score of 78.0% compared to 75.6% for inter-rater variability. Specifically, DeepLabV3Plus achieved mean Dice scores of 94.2% for the Capsule, 85.8% for the CEC, 62.4% for the Cortex, and 69.6% for the Medulla. These findings suggest the potential of deep learning-based methods in improving the accuracy of kidney segmentation in US images.Clinical Relevance- This study shows the potential of DL for improving accuracy of kidney segmentation in US, leading to increased diagnostic efficiency, and enabling new applications such as computer-aided diagnosis and treatment, ultimately resulting in improved patient outcomes and reduced healthcare costs.1.

Implications of use of different intraoperative ultrasound modalities during glioma surgery – A comparative study of factors affecting outcomes

BackgroundThe main goal of glioma surgery is to remove the maximum amount of tumor without worsening the patient's neurological condition. Intraoperative ultrasound (US) imaging technologies (2D and 3D) are available to assist surgeons, providing real-time updates. Considering additional time, personnel, and cost, we investigate if comparable outcomes can be achieved using basic (2D) and advanced (3D) technology. ObjectiveWe propose predictive models for (i) glioma tumor resectability (ii) surgical outcome, and (iii) a model to predict the outcome of surgery aided with a particular ultrasound and compare outcomes between 2D and 3D US. MethodologyWe used real-world surgery data from a tertiary cancer centre. Three groups of cases were analyzed (2D US used, 3D US used, and no US used during resection). The data analysis uses hypothesis testing, bootstrap sampling, and logistic regression. ResultsThe preoperatively anticipated extent of tumor removal correlated with the postoperative MRI measurement of tumor removal for US-supported surgery (p=0.01) but not for no US-supported surgeries (p = 0.13). A combination of delineation, eloquence, and the multifocal/multicentric nature of the tumor effectively predicted resectability. The eventual outcome of surgery (actual extent of resection achieved) can be predicted by prior treatment status, delineation, eloquence, and satellite nodules. Based on our prediction model (training set of 350 cases and test of 40 cases of US-guided surgeries), we identify some cases where 3D US seems to offer superior EORs. ConclusionThe resectability of glioma tumors is crucial in determining surgical objectives, and the type of ultrasound used as support impacts tumor removal. The findings in this study aid informed decision-making and optimize imaging technology usage, providing a decision flow for selecting ultrasound based on tumor characteristics.

Cleft palate in fetuses: feasibility of early diagnosis by Crystal and Realistic Vue rendering 3D ultrasound technology in the first trimester.

This study aimed to evaluate the feasibility of direct visualization of a normal fetal palate and detect cleft palate in the first trimester with a novel three-dimensional ultrasound (3D US) technique, Crystal and Realistic Vue (CRV) rendering technology. Two-dimensional (2D) images and 3D volumes of healthy and cleft palate fetuses at 11-13+6 weeks were obtained prospectively. 2D ultrasound views included the coronal view of the retronasal triangle and the midsagittal view of the face. 3D-CRV views were analyzed by multiplanar mode display. The pregnancy outcomes of all fetuses were determined during the follow-up period. In our study, 124 fetuses were recruited, including 100 healthy fetuses and 24 cleft palate fetuses. The cleft palate with lip was observed in 23 fetuses (bilateral in 15, unilateral in 6, median in 2), and one cleft palate was only found in the abnormal group. The bilateral (n = 12) and median (n = 2) cleft palates with lips and the cleft palate alone (n = 1) were associated with other anatomical or chromosomal abnormalities, and one unilateral cleft palate with cleft lip had concomitant NT thickening. In the cleft palate fetus group, 16 fetuses suffered intrauterine death, which was associated with other structural or chromosomal abnormalities in 14 fetuses, seven cases were terminated after consultation, and one was delivered at term. The coronal view of the retronasal triangle and the midsagittal view was easily obtained in all fetuses. 3D-CRV images of palatal parts were clearly obtained in all cases. Unilateral, bilateral, and median cleft palates with cleft lips were visually demonstrated and classified by the 3D-CRV technique. It is feasible to identify the palate by 3D-CRV in the first trimester in both healthy and cleft palate fetuses. Together with 2D ultrasonography as a complementary diagnostic tool, 3D-CRV is helpful in classifying the cleft palate with a reasonable degree of certainty.

Inverse Correlation of Cholesterol Efflux Capacity with Peripheral Plaque Volume Measured by 3D Ultrasound.

Cardiovascular disease (CVD) is a systemic multifocal illness called atherosclerosis that causes artery constriction and blockage. By causing cholesterol to build up in the artery wall, hypercholesterolemia is a major factor in the pathophysiology of atherosclerotic plaque development. Reverse cholesterol transport is the process of transporting cholesterol from the periphery back to the liver through cholesterol efflux mediated by high-density lipoprotein (HDL). It was suggested that the cholesterol efflux capacity (CEC), which is inversely linked with cardiovascular risk, can serve as a stand-in measure for reverse cholesterol transport. In this work, we sought to investigate a potential link between the peripheral plaque volume (PV) and CEC. Since lipid-lowering therapy interferes with CEC, we performed a cross-sectional study of 176 patients (48.9% females) with one cardiovascular risk factor or known CVD that did not currently take lipid-lowering medication. CEC was determined using cAMP-treated 3H-cholesterol-labeled J774 cells. Cholesterol ester transfer protein (CETP)-mediated cholesterol ester transfer was measured by quantifying the transfer of cholesterol ester from radiolabeled exogenous HDL cholesterol to Apolipoprotein B-containing lipoproteins. PV in the carotid and the femoral artery, defined as the total PV, was measured using a 3D ultrasound system equipped with semi-automatic software. In our patients, we discovered an inverse relationship between high total PV and CEC (p = 0.027). However, there was no connection between total PV and low-density lipoprotein cholesterol, lipoprotein (a), or CETP-mediated cholesterol ester transfer. In patients not receiving lipid-lowering treatment, CEC inversely correlates with peripheral atherosclerosis, supporting its role in the pathophysiology of atherosclerosis.