Acoustic Shadowing Research Articles

Low phospholipid-associated cholelithiasis syndrome, a not uncommon cause of biliary problems and hospital admissions.

biliary diseases are a major cause of morbidity and mortality for patients and a burden for the healthcare system. The genetic syndrome of low phospholipid-associated cholelithiasis (LPAC) is a little known and rare entity whose treatment with bile salts avoids symptoms, admissions and the need for surgery. The aim of this study was to determine its incidence and characteristics in our center. prospective study performed between February 2021 and September 2022. LPAC was diagnosed if at least two of the following were present: onset of biliary problems < 40 years of age, recurrence of symptoms after cholecystectomy, ultrasound image of hepatolithiasis (multiple echoic foci, comet-tail images, hepatolithiasis with acoustic shadow). Demographic, clinical, genetic (analysis of MDR3 gene mutations) and ultrasound characteristics and their incidence were analyzed in hospital admissions for biliary causes. thirty-six patients with LPAC were identified. Of these, six were among 237 admissions due to biliary causes in the previous nine months, with an incidence of 2.5 % (95 % CI: 1.17-5.41). By age subgroup, the incidence was 16.7 % in those admitted < 40 years of age and 9.1 % in those < 50. Considering females only, the incidence was 21 % in those admitted < 40 years and 15.8 % in those < 50 years. All patients remained asymptomatic after treatment with ursodeoxycholic acid and there were no new admissions. LPAC syndrome is not as uncommon as it may appear, especially in women < 50 years of age admitted with biliary problems. Its correct diagnosis based on simple criteria could avoid a significant number of hospital admissions and unnecessary cholecystectomies.

Hair Today, OR Tomorrow: A Multicenter Case Series of Gastric Bezoars in Children Diagnosed With Point-of-Care Ultrasound.

Point-of-care ultrasound (POCUS) can expedite the diagnosis of pediatric abdominal pathologies including appendicitis and intussusception. In this patient series, we present cases from multiple pediatric emergency departments that demonstrate the use of POCUS in the diagnosis of trichobezoars in children. POCUS findings include the presence of an intragastric hyperechoic mass or a hyperechoic arch and associated posterior acoustic shadowing. These findings in the appropriate clinical context should prompt further diagnostic imaging and/or surgical consultation for removal.

Role of Ultrasonographic and Clinicopathological Characteristics in Assessing Stromal Tumor-Infiltrating Lymphocyte Density in Triple-Negative Breast Cancer.

A high density of stromal tumor-infiltrating lymphocytes (sTILs) is positively correlated with the pathological complete response rate and favorable survival in patients with triple-negative breast cancer (TNBC). Heterogeneity in stromal lymphocyte distribution and limited tumor sampling may affect the accuracy of sTIL quantification in biopsy samples from patients receiving neoadjuvant therapy. Thus, identifying additional biomarkers to complement sTIL evaluation is essential. To identify biomarkers that could be used to complement sTILs evaluation. Retrospective cohort study. A total of 162 patients with invasive TNBC were enrolled in the study. The following data were gathered: sTIL density, Ki67, nuclear grades of cancer cells, lymphovascular invasion status, the American Joint Committee on Cancer stage, axillary lymph node metastasis status, and ultrasonographic parameters of the tumor (size, shape, orientation, margin, internal echo pattern, posterior feature, and vascularity). The relationship between sTIL density and ultrasonographic or clinicopathological characteristics was investigated using both continuous and categorical analyses. Posterior features of the primary tumors was associated with sTIL density (p = 0.038). Additionally, the Ki67 levels and nuclear grades were also associated with sTIL density (p < 0.001 and p = 0.024, respectively). When stratified according to a 20% cut-off of sTIL density, the posterior features of primary tumors, Ki67 levels, and nuclear grades significantly differed between the high and low sTIL density tumors. Tumors with high Ki67 levels were more likely to exhibit high sTIL density than low sTIL density [odds ratio (OR): 2.75, p = 0.021]. Furthermore, nuclear grade III tumors demonstrated significantly higher sTIL density than nuclear grade I-II tumors (OR: 2.49, p = 0.014). Additionally, tumors with posterior enhancement or no posterior features were more likely to exhibit high sTIL density than tumors with acoustic shadows (OR: 2.91, p = 0.028; OR: 2.74, p = 0.022, respectively). Low sTIL density is frequently observed in tumors exhibiting acoustic shadows on ultrasound. However, high sTIL density is more common in tumors with posterior enhancement or no posterior features. Furthermore, high Ki67 levels (> 40%) and high nuclear grades are positively correlated with high sTIL density. Our study findings highlight the need for closer surveillance of these biomarkers to complement sTIL evaluation in TNBC.

Ultrasound Imaging of Various Ingested Foreign Bodies in an Ex Vivo Intestinal Model.

Foreign body ingestion is an increasingly prevalent issue for children who are in the preverbal to early verbal stages of life. Foreign bodies lodged in the gastrointestinal tract can cause issues such as obstruction, perforation, and fistulae. Radiographic imaging can often locate most foreign bodies; however, radiolucent objects may be missed. Ultrasound is an alternative imaging modality that can be used to locate and track foreign objects as they pass through the bowel. The objective of this study was to characterize the sonographic appearance of various ingested foreign bodies of varying characteristics in an ex vivo gastrointestinal tract segment. A GE Logiq 9 ultrasound machine with a linear transducer at a frequency of 15 MHz was used to examine various ingested foreign bodies placed in a segment of pig intestinal tract. Imaged objects varied in visual appearance from echogenicity, texture, size, and shape; acoustic shadows and reverberation artifacts cast were particularly distinguishing characteristics. Ultrasound evaluation to assess foreign body ingestion in the pediatric population may provide a useful alternative or supportive imaging modality in confirming the location and real-time tracking of the ingested item. This may be especially useful for objects of varying radiodensities that cannot always be reliably seen in traditional radiographs.

Transvaginal sonographic appearance of Surgicel®: A case series report

BackgroundSurgicel® (oxidized regenerated cellulose) is widely used for hemostasis in gynecological surgery. Although intended to be absorbed within weeks, it can persist and be visualized on transvaginal ultrasound, potentially mimicking ovarian pathologies. The purpose of this study was to describe the appearance of Surgicel® on post-ovarian cystectomy and provide guidance on differentiating it from other conditions. MethodsWe retrospectively reviewed postoperative transvaginal sonographic examinations of 6 patients after laparoscopic ovarian cystectomy in which Surgicel® was used for hemostasis. Ultrasonographic evaluations were performed as part of routine postoperative assessment without any specific timing protocol. Sonographic examinations were performed up to 335 days after surgery. Images were reviewed for echogenicity, vascularization (color doppler) and acoustic properties. Surgical reports confirmed the use of Surgicel®in each patient. ResultsSurgicel® displayed varying ultrasonographic characteristics, lacking a uniform appearance. In all cases, it appeared as a hyperechoic, avascular lesion, sometimes with posterior acoustic shadowing and occasionally accompanied by a cystic component. In one patient, serial scans revealed a gradual reduction in size and changes in sonographic features over time. ConclusionSurgicel® can present with diverse ultrasound features. However, a hyperechoic avascular lesion is a key potential sign for distinguishing it from other conditions. Awareness of these sonographic appearances is essential to avoid misdiagnosis, highlighting the importance of collaboration between sonographers and surgeons to prevent unnecessary interventions.

Simulation of horizontal refraction of continental slope in the southern continental slope of the South China Sea

Abstract Sound waves are significantly influenced by boundaries during their propagation in certain environmental conditions. The extent of this impact is related to the complexity of the boundary, such as in the case of slopes and seamounts. In these areas, sound waves may deviate from their original paths, resulting in three-dimensional effects. Recent experiments and simulations have demonstrated that three-dimensional effects occur when sound waves propagate over seamounts in the South China Sea, leading to larger acoustic shadow regions. However, there are limited studies on 3D acoustic propagation based on measured slope topography or database topography. In this study, the topography of the South China Sea area database is selected, and the measured sound velocity profile and seabed acoustic parameters in the South China Sea are taken into considered. The FOR3D sound field calculation model is used to calculate the N×2D and 3D results. The simulation results show that in the southern continental slope region of the South China Sea, when the sound source frequency is 50 Hz, the acoustic wave exhibits significant horizontal refraction with a refraction angle of approximately 13°.

Establishing the Interrelations of the Laboratory Parameters in the Gut-Kidney Axis in Cats with Signs of Triple Phosphate Urolithiasis

Introduction. Efficient treatment of the feline urolithiasis much depends on the early diagnosis of the disease, however, the diagnostic algorithm of this type of pathology is extremely poor due to the various reasons, in particular, it does not take into account the interrelations in the gut-kidney axis. Analysis of the state of gastrointestinal tract functioning and the composition of the gut microbiota can improve the potential of diagnosing the urolithiasis, predict the risk, improve the prognosis and choose the correct treatment strategy. The aim of this publication is to establish the interrelations of the laboratory parameters in the gut-kidney axis in cats with struvite urolithiasis with the signs of cystolithiasis.Materials and Methods. The objects of the research were the outbred cats with the triple phosphate urolithiasis with the signs of cystolithiasis: 1st experimental group — females; 2nd experimental group — neutered males; the control group — clinically healthy animals of both sexes. The laboratory and clinical examinations of sick animals included: ultrasonography of abdominal organs; macroscopic and biochemical urine tests; microscopy of urine sediment and urine culture test without determination of antibiotic sensitivity; macroscopic, microscopic and simple chemical examinations of freshly excreted feces; bacteriological culture test of rectal flushes without determination of antibiotic sensitivity.Results. In the urine of cats of the experimental groups, under the activity of gram-negative microorganisms Escherichia coli (0.03±0.01×106 CFU (colony forming units) and 1.00±0.03×106 CFU) and gram-positive microorganisms Staphilococcus intermedius (1.05±0.07×106 CFU and 1.00±0.08×107 CFU) there were recorded within the microscope field of view: alkalization, development of hypersthenuria, proteinuria, hypercalciuria, hematuria, including microhematuria and leukocyturia, crystalluria. The results of coprological examinations in sick cats indicated the presence of stercobilin, well-digested muscle fibres, undigested and digested cellulose, extracellular and intracellular starch, as well as impurities of non-food origin (wool). The data of microbiological examinations of feces indicated the growth of Escherichia coli (1.00±0.05×105 CFU and 1.04±0.08×107 CFU). Along with the cystolytiasis, the acoustic shadowing of the gastrointestinal tract organs in the experimental animals revealed the hyperechogenicity of liver capsule and parenchyma and heterogeneity of the pattern.Discussion and Conclusion. The revealed character of the laboratory parameter changes in the experimental animals, such as the increase of protein and creatinine levels in urine and growth of Escherichia coli in feces, proved the existence of the pathogenetic relationship between the urogenital tract lesion caused by the gram-negative microorganisms and the gut microbiota in the gut-kidney axis. The results of our study of the sick animals’ urine indicated on the infection of the urogenital tract with the urease-producing microorganisms, which led to the alkalization of urine and formation of the infection struvite stones. Urolithiasis, in turn, had an impact on the gut microbiome due to the topographic proximity of the urogenital and gastrointestinal tracts: examination of feces in cats of the experimental group had confirmed the disorder of gastrointestinal tract functioning due to dysbiotic processes in the large intestine.

Acoustic Shadowing to Facilitate Ultrasound Guided Arterial Cannulation: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Ultrasound-guided arterial catheterization is a frequently performed procedure. Additional techniques such as acoustic shadowing-assisted ultrasound may be useful in improving success rate. This systematic review aimed to assess the efficacy of acoustic shadowing assisted ultrasound for arterial catheterization. PubMed, Medline, EMBASE, Cochrane Library, EMCARE, and MedNar were searched in January 2024. Randomized controlled trials comparing the first attempt success rate of arterial catheterization using acoustic shadowing ultrasound vs unassisted ultrasound were included. Data were pooled for risk ratios (RRs) using the random-effects model. Subgroup analysis was conducted based on a single or double acoustic line. Sensitivity analysis was undertaken after excluding pediatric data. The certainty of evidence (COE) was assessed using the GRADE framework. Six randomized controlled trials (n = 777) were included. A meta-analysis found the first attempt success rate is significantly higher in the acoustic ultrasound group (n = 6, RR: 0.47, 95% CI: 0.34-0.66, p ≤ 0.00001). Hematoma formation was significantly less in the acoustic ultrasound group (n = 6, RR: 0.52, 95% CI: 0.34-0.80, p = 0.003). First attempt success was significantly higher in the single acoustic line ultrasound (USG) group compared to the unassisted ultrasound group (n = 3, RR: 0.41, 95% CI: 0.28-0.59, p ≤ 0.00001). Sensitivity analysis after excluding pediatric data was similar to the primary analysis (n = 5, RR: 0.50, 95% CI: 0.33-0.70, p ≤ 0.00001). Certainty of evidence was "Moderate" for the first attempt cannulation. Acoustic shadowing-assisted ultrasound improved first-attempt arterial catheterization success rate and was associated with reduced hematoma formation. Mishra L, Rath C, Wibrow B, Anstey M, Ho K. Acoustic Shadowing to Facilitate Ultrasound Guided Arterial Cannulation: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Indian J Crit Care Med 2024;28(7):677-685.

A clinical ultrasound algorithm to identify uterine sarcoma and smooth muscle tumors of uncertain malignant potential in patients with myometrial lesions: the MYometrial Lesion UltrasouNd And mRi study

BackgroundDifferential diagnosis between benign uterine smooth muscle tumors and malignant counterpart is challenging. We evaluated the accuracy of a clinical and ultrasound based algorithm in predicting mesenchimal uterine malignancies (MUMs), including smooth muscle tumors of uncertain malignant potential (STUMPs). MethodsWe report the twelve-months follow-up of an observational, prospective, single-centre study that included women with at least one myometrial lesion ≥3 cm on ultrasound examination. These patients were classified according to a three-class diagnostic algorithm, using symptoms and ultrasound features. “White” patients underwent annual telephone follow-up for 2 years, “Green” patients underwent a clinical and ultrasound follow-up at 6, 12 and 24 months and “Orange” patients underwent surgery. We further developed a risk class system to stratify the malignancy risk. Findings2,268 women were included andtarget lesion was classified as benign in 2,158 (95.1%), as other malignancies in 58 (2.6%) an as mesenchymal uterine malignancies in 52 (2.3%) patients. At multivariable analysis, age (OR 1.05 (95% CI 1.03-1.07), tumor diameter >8 cm (OR 5.92 (95% CI 2.87-12.24), irregular margins (OR 2.34 (95% CI 1.09-4.98), color score=4 (OR 2.73 (95% CI 1.28-5.82), were identified as independent risk factors for malignancies, whereas acoustic shadow resulted in an independent protective factor (OR 0.39 (95% CI 0.19-0.82). The model, which included age as a continuous variable and lesion diameter as a dichotomized variable (cut-off 81 mm), provided the best AUC (0.87 (95% CI 0.82-0.91)). A risk class system was developed, and patients were classified as low-risk (predictive model value <0.39%: 0/606 malignancies, risk 0%), intermediate risk (predictive model value 0.40%-2.2%: 9/1,093 malignancies, risk 0.8%), high risk (predictive model value ≥2.3%: 43/566 malignancies, risk 7.6%). ConclusionThe preoperative three-class diagnostic algorithm and risk class system can stratify women according to risk of malignancy. Our findings, if confirmed in a multicentre study, will permit differentiation between benign and MUMs allowing a personalized clinical approach. FundingNothing to declare.

The Role of Computed Tomography in Ophthalmic Surgeon Tactics in Shrapnel Wounds to the Eyeball. Clinical Case

There is a clinical case of eyeball metallosis in the background of a foreign body of the posterior segment of the eye in the article. Patient N, 41, complained of a gradual decrease in vision of the right eye. A duration of open injury to the right eye about eight years ago. At the primary ophthalmic examination, the most corrected visual acuity of the right eye was 0.3. The visual acuity of the left eye was 1.0. Intraocular pressure according to pneumotonometry: OD — 13 mm Hg, OS — 14 mm Hg. According to biomicroscopy of the right eye, it was found: the skin of the eyelids is unchanged, the conjunctiva is hyperemic, the mixed reaction of the vessels, the cornea is transparent, spherical, shiny, the anterior chamber is transparent, uneven, the iris is changed in color, foci of stroma hyperpigmentation are observed, the pupil is deformed, narrowed, displaced along the meridian for 1 hour, artificial. Examination of the central and peripheral parts of the fundus is difficult due to deformation and narrowing of the pupil diameter. Due to difficulty performing ophthalmoscopy, the patient underwent the following studies: static perimetry, ultrasound biomicroscopy (UBM) of the anterior segment of the eyeball, electrophysiological examination, B-­scan, computed tomography of the eyeball and orbit. The static perimetry revealed a concentric narrowing of the OD field of view. According to the ultrasound biomicroscopy, the IOL dislocation was revealed anteriorly. В­-Scanning visualizes the blistering cystic edema of the retina, inside which the induration is determined, giving an acoustic shadow. The electrophysiological examination showed changes in the electrical sensitivity and lability of the retina. According to the results of CT in the vitreous cavity, a foreign body was detected in the lower segment along the meridian 6 hours. In accordance with this, the diagnosis was made: OD — metallosis of the eye. Foreign body of the eye.

Integrated Approach in Evaluating the Results of Cosmetic Procedures Using Ultrasonography and Magnetic Resonance Tomography (Clinical Study)

Aim. To investigate the capabilities of comprehensive assessment using ultrasound and magnetic resonance imaging (MRI) of the results of cosmetic procedures.Materials and Methods. A study of the soft tissues of the anterior abdominal wall of a 43-year-old woman complaining of skin atony and postpartum stretch marks using highresolution ultrasound and MRI.Results. At ultrasonography in the projection of injection of polylactic acid and calcium hydroxyapatite preparations and radiofrequency treatment, an increase in echogenicity of hypodermis with the presence of acoustic shadow was noted. On MRI at the level of derma and hypoderma of periumbilical region in the projection of radiofrequency treatment, injections of preparations based on polylactic acid on the left, calcium hydroxyapatite on the right in 3 months after subdermal injection, areas of hyperintense MR-signal in T2 weight image (WI) and STIR programs, hypointense in T1 WI, without diffusion limitation on DWI b=1000 were determined. In SWI mode, the focus of hypointense MR signal of rounded shape with clear and smooth contours was visualized on the right side of the image.Conclusion. The clinical study demonstrates the possibilities of an integrated approach in evaluating the results of cosmetic procedures using ultrasonography and MRI.

Factors Associated with False Positive Breast Cancer Results in the Real-Time Sonoelastography Evaluation of Solid Breast Lesions.

Background and Objectives: Breast cancer is one of the most widespread cancers among the female population around the world and is curable if diagnosed in an early stage. Consequently, breast cancer screening imaging techniques have greatly evolved and adjusted over the last decades. Alongside mammography, sonoelastography became an important tool for breast cancer detection. However, sonoelastography still has its limitations, namely, there is still a high occurrence of false positive results in the BIRADS 4 category. The aim of our study is to identify potential false positive predictors and to ascertain the factors influencing the quality of strain ultrasound elastography for the evaluation of suspicious solid breast lesions categorized as BIRADS 4B, 4C, and 5. Materials and Methods: We conducted a retrospective study in a single private medical center in Timisoara between January 2017 and January 2022 analyzing 1625 solid breast lesions by the sonoelastography strain using a standardized BIRADS-US lexicon. Results: Our study showed that most sonoelastography factors linked to incorrect and overdiagnosis were due to a nodule dimension (OR = 1.02 per unit increase), posterior acoustic shadowing (OR = 12.26), reactive adenopathy (OR = 6.35), and an increased TES score (TES3 OR = 6.60; TES4 OR = 23.02; TES5 OR = 108.24). Regarding patient characteristics, age (OR = 1.09 per unit increase), BMI, (OR = 1.09 per unit increase), and breastfeeding history (OR = 3.00) were observed to increase the likelihood of false positive results. On the other hand, the nodules less likely to be part of the false positive group exhibited the following characteristics: a regular shape (OR = 0.27), homogenous consistency (OR = 0.42), and avascularity (OR = 0.22). Conclusions: Older age, high BMI, patients with a breastfeeding history, and those who exhibit the following specific nodule characteristics were most often linked to false positive results: large tumors with posterior acoustic shadowing and high elasticity scores, accompanied by reactive adenopathy. On the other hand, homogenous, avascular nodules with regular shapes were less likely to be misdiagnosed.

Clinical and ultrasound characteristics of deep endometriosis affecting sacral plexus.

To describe the sonomorphological changes and appearance of deep endometriosis (DE) affecting the nervous tissue of the sacral plexus (SP). This was a retrospective study of symptomatic patients who underwent radical resection of histologically confirmed DE affecting the SP and who had undergone preoperative transvaginal sonography (TVS) between 2019 and 2023. Lesions were described based on the terms and definitions of the International Deep Endometriosis Analysis (IDEA), International Ovarian Tumor Analysis (IOTA) and Morphological Uterus Sonographic Assessment (MUSA) groups. A diagnosis of DE affecting the SP on TVS was made when the sonographic criteria of DE were visualized in conjunction with fibers of the SP and the presence of related symptoms corresponding to sacral radiculopathy. Clinical symptoms, ultrasound features and histological confirmation were analyzed for each patient included. Twenty-seven patients with DE infiltrating the SP were identified in two contributing tertiary referral centers. Median age was 37 (range, 29-45) years and all patients were symptomatic and presented one or more of the following neurological symptoms: dysesthesia in the ipsilateral lower extremity (n = 17); paresthesia in the ipsilateral lower extremity (n = 10); chronic pelvic pain radiating in the ipsilateral lower extremity (n = 9); chronic pain radiating in the pudendal region (n = 8); and motor weakness in the ipsilateral lower extremities (n = 3). All DE lesions affecting the SP were purely solid tumors in the posterior parametrium in direct contact with, or infiltrating, the S1, S2, S3 and/or S4 roots of the SP. The median of the largest diameter recorded for each of the DE nodules was 35 (range, 18-50) mm. Echogenicity was non-uniform in 23 (85%) of the DE nodules, with all but one of these nodules containing hyperechogenic areas. The shape of the lesions was irregular in 24 (89%) cases. Only one lesion exhibited a lobulated form, with all other irregular lesions showing a spiculated appearance. An acoustic shadow was produced in 20 (74%) of the nodules, all of which were internal. On color- or power-Doppler examination, 21 (78%) of the nodules showed no signal (color score of 1). The remaining six (22%) of the lesions showed a minimal color content (color score of 2). According to pattern recognition, most DE nodules were purely solid, non-uniform, hypoechogenic nodules containing hyperechogenic areas, with internal shadows and irregular spiculated contours, and were poorly vascularized on color/power-Doppler examination. The ultrasound finding of a parametrial, unilateral, solid, non-uniform, hypoechogenic nodule with hyperechogenic areas and possible internal shadowing, as well as irregular spiculated contours, demonstrating poor vascularization on Doppler examination in proximity to or involving the structures of the SP, indicates DE affecting the SP. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Investigation of Appropriate Scaling of Networks and Images for Convolutional Neural Network-Based Nerve Detection in Ultrasound-Guided Nerve Blocks.

Ultrasound imaging is an essential tool in anesthesiology, particularly for ultrasound-guided peripheral nerve blocks (US-PNBs). However, challenges such as speckle noise, acoustic shadows, and variability in nerve appearance complicate the accurate localization of nerve tissues. To address this issue, this study introduces a deep convolutional neural network (DCNN), specifically Scaled-YOLOv4, and investigates an appropriate network model and input image scaling for nerve detection on ultrasound images. Utilizing two datasets, a public dataset and an original dataset, we evaluated the effects of model scale and input image size on detection performance. Our findings reveal that smaller input images and larger model scales significantly improve detection accuracy. The optimal configuration of model size and input image size not only achieved high detection accuracy but also demonstrated real-time processing capabilities.

Application of ultrasonic diagnostics in the study of urogenital organs of birds

Ultrasound examination is one of the most accessible and having a high probability of competence of research of diagnostics of diseases of internal organs, which are carried out mainly in small pets. The aim of the study is to obtain information about parenchymatous organs in birds in norm and in case of pathologic changes for making or confirming clinical diagnosis. Material and methods. Ultrasound diagnostics of avian oviduct was carried out on ultrasonic diagnostic scanner ETS-D-05 "Raskan", ~ 220V, 50 Hz, 100 VA, class 1. The transducer is microconvex 7.5 MHz. Results. At ultrasound examination of the kidneys in the chicken, it was noted that the kidneys had smooth, clear boundaries. The echostructure of cortical and brain layers in the median plane is heterogeneous, echogenicity of parenchyma corresponds to the norm. The capsule is not visualized. The presence of lighter and darker areas in the parenchyma is clearly visible, which is associated with filtration of mineral substances contained in the blood. Ultrasound examination of the genitalia in the chicken was carried out in several stages. At the first stage, the presence of a mature follicle was noted. Localized volumetric formations of rounded shape - follicles at different stages of development were revealed. They have homogeneous echogenicity and echostructure of hyperechogenic character, giving a weak acoustic shadow. In the second stage of the study we noted the presence of yolk covered with vitelline shell, which is located in the central part of the albumen section of the oviduct, has a high density and good echogenicity. In the third stage, the yolk is located in the caudal part of the albumen section. At its periphery, the albumen with several layers is located. Protein section is displaced somewhat to the left, has strongly tortuous loops. The wall of the albumen is well structured, the expression of layers is weakly marked. In the cavity of the oviduct, the content of the oviduct is homogeneous with a small amount of content of liquid consistency. At the fourth stage of the study in the uterus of the oviduct, an anechogenic formation - an egg - is visualized on the echogram. In its center, a hypoechogenic structure with indistinct contours - yolk is detected. The contours of the egg are smooth, borders are indistinct. The egg completely fills the uterine cavity, the lumen between the egg and the uterine wall is absent, the uterine wall contours are clear and even with homogeneous echogenic structure, no nodular formations are detected, uterine vessels are not dilated.

Meta-analysis: Intestinal ultrasound to evaluate colonic contents and constipation.

Constipation can be diagnosed clinically using the Rome criteria. Ultrasound (US), which lacks the radiation exposure of conventional X-ray, holds promise as a non-invasive tool to evaluate colonic contents and constipation. To examine the role of US in the assessment of constipation. We performed a systematic search of Embase (OVID, 1984), Medline (Ovid, 1946), Cochrane Central, ClinicalTrials.gov and Australia New Zealand Clinical Trials Registry from database inception to 26 January 2024 according to PRISMA guidelines and prospectively registered with PROSPERO. All studies using US to assess constipation or colonic contents in either adults or children were included. Rectal diameter measurements were pooled in meta-analysis. Risk of bias was assessed using the Newcastle Ottawa Scales and Joanna Briggs Institute checklists. Of 12,232 studies screened, 51 articles (6084 patients; 3422 children) describing US to assess symptoms in patients with constipation were included. Most studies used Rome criteria to diagnose constipation. Rectal diameter was associated with clinical constipation in 29 paediatric studies (3331 patients). Meta-analysis showed the mean rectal diameter of constipated patients was significantly higher than controls (mean difference 12 mm, 95% confidence intervals (CI): 6.48, 17.93, p < 0.0001, n = 16 studies). Other features of constipation on US included posterior acoustic shadowing and echogenicity of luminal contents. US is an appealing imaging modality to assess luminal contents and constipation. Further well-designed studies are required to validate US metrics that accurately identify constipation.

Ultrasound features using MUSA terms and definitions in uterine sarcoma and leiomyoma: cohort study.

Timely and accurate preoperative diagnosis of uterine sarcoma will increase patient survival. The primary aim of this study was to describe the ultrasound features of uterine sarcoma compared with those of uterine leiomyoma based on the terms and definitions of the Morphological Uterus Sonographic Assessment (MUSA) group. A secondary aim was to assess the interobserver agreement for reporting on ultrasound features according to MUSA terminology. This was a retrospective cohort study of patients with uterine sarcoma or uterine leiomyoma treated in a single tertiary center during the periods 1997-2019 and 2016-2019, respectively. Demographic characteristics, presenting symptoms and surgical outcomes were extracted from patients' files. Ultrasound images were re-evaluated independently by two sonologists using MUSA terms and definitions. Descriptive statistics were calculated and interobserver agreement was assessed using Cohen's κ (with squared weights) or intraclass correlation coefficient, as appropriate. A total of 107 patients were included, of whom 16 had a uterine sarcoma and 91 had a uterine leiomyoma. Abnormal uterine bleeding was the most frequent presenting symptom (69/107 (64%)). Compared with leiomyoma cases, patients with uterine sarcoma were older (median age, 65 (interquartile range (IQR), 60-70) years vs 48 (IQR, 43-52) years) and more likely to be postmenopausal (13/16 (81%) vs 15/91 (16%)). In the uterine sarcoma cohort, leiomyosarcoma was the most frequent histological type (6/16 (38%)), followed by adenosarcoma (4/16 (25%)). On ultrasound evaluation, according to Observers 1 and 2, the tumor border was irregular in most sarcomas (11/16 (69%) and 13/16 (81%) cases, respectively), but regular in most leiomyomas (65/91 (71%) and 82/91 (90%) cases, respectively). Lesion echogenicity was classified as non-uniform in 68/91 (75%) and 51/91 (56%) leiomyomas by Observers 1 and 2, respectively, and 15/16 (94%) uterine sarcomas by both observers. More than 60% of the uterine sarcomas showed acoustic shadows (11/16 (69%) and 10/16 (63%) cases by Observers 1 and 2, respectively), whereas calcifications were reported in a small minority (0/16 (0%) and 2/16 (13%) cases by Observers 1 and 2, respectively). In uterine sarcomas, intralesional vascularity was reported as moderate to abundant in 13/16 (81%) cases by Observer 1 and 15/16 (94%) cases by Observer 2, while circumferential vascularity was scored as moderate to abundant in 6/16 (38%) by both observers. Interobserver agreement for the presence of cystic areas, calcifications, acoustic shadow, central necrosis, color score (overall, intralesional and circumferential) and maximum diameter of the lesion was moderate. The agreement for shape of lesion, tumor border and echogenicity was fair. A postmenopausal patient presenting with abnormal uterine bleeding and a new or growing mesenchymal mass with irregular tumor borders, moderate-to-abundant intralesional vascularity, cystic areas and an absence of calcifications on ultrasonography is at a higher risk of having a uterine sarcoma. Interobserver agreement for most MUSA terms and definitions is moderate. Future studies should validate the abovementioned clinical and ultrasound findings on uterine mesenchymal tumors in a prospective multicenter fashion. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

Ultrasound diagnosis and sialadenectomy confirming a mandibular salivary gland vegetative foreign body and chronic sialadenitis in a dog

AbstractA 2‐year‐old, female, neutered dog presented with a right‐sided, non‐painful, ventral neck mass approximately 2.5 cm in diameter. Although aspirates of the mass yielded a low volume of grossly purulent exudate, there was no response to antibiotic and non‐steroidal anti‐inflammatory medications. Cervical ultrasound examination revealed a straight hyperechoic structure with no associated distal acoustic shadowing in the right mandibular salivary gland, surrounded by a small volume of anechoic fluid, most consistent with migrating foreign material and focal sialadenitis. The surrounding subcutaneous tissues were hyperechoic with interspersed anechoic fluid material, consistent with cellulitis. Vegetative material was considered most likely due to the shape of the structure and absence of distal acoustic shadowing. Right mandibular and sublingual sialadenectomy was performed and vegetative material was retrieved from the mandibular salivary gland. Histopathology revealed chronic pyogranulomatous sialadenitis secondary to foreign body migration. Surgical excision achieved clinical resolution at 8 weeks follow‐up.

Bridge-Borne Noise Induced by High-Speed Freight Electric Multiple Units: Characteristics, Mechanisms and Control Measures

The high-speed freight electric multiple unit (EMU) is one of the important development directions for railway freight transportation. To investigate the bridge radiation noise induced by the freight EMU, a noise prediction model consisting of the containers–vehicle–track–bridge dynamic model, finite element model, and boundary element model are established and validated. Through simulation, the bridge radiation noise under different train loading conditions is compared, and the noise radiation mechanism is revealed. Moreover, the noise reduction effect of the noise wall is studied, and the influences of noise wall heights and sound absorption materials are investigated. Results indicate that the bridge sound power and the sound pressure levels (SPLs) of near-field points increase slightly with train loads in the frequency range below 20 Hz and above 125 Hz, with a maximum increase of about 6.8 dB. The structure resonance, intense local vibration, and high acoustic radiation efficiency cause strong bridge radiation noise. The noise wall can realize a good overall noise reduction effect in the sound shadow zone; nevertheless, SPLs increased in areas between the bridge and the noise wall. The ground reflection affects the superposition of transmitted, reflected, and diffracted sound waves, which causes nonlinear relationships of noise reduction effects with the noise wall height. From the perspective of human hearing sensitivity, the loudness levels of typical field points increase with the frequency in the range of 20~80 Hz, and SPLs below 25 Hz are less than the threshold of hearing. Setting the noise wall can effectively reduce the loudness levels, and the reduction effect increases with the noise wall height.

Diagnosis and management of trichobezoars in a sheep

AbstractThis paper describes the diagnosis, surgical treatment and resolution of trichobezoars in a Santander Creole sheep from Santander, Colombia. A 2‐month‐old female sheep was presented with bilateral abdominal distention, pain upon abdominal palpation indicating the presence of a spherical and malleable foreign body, absence of ruminal movements, soft and mucoid faeces and the presence of two radiopaque structures indicative of foreign bodies within the rumen. The ultrasound confirmed a marked acoustic shadow at the level of the right middle mesogastric quadrant. To resolve the condition, a rumenotomy was performed: the foreign bodies were extracted and the structure and diagnosis of trichobezoars were confirmed. The recommendation was to improve the nutritional needs of the herd to avoid these digestive disorders. To the best of our knowledge, this is the first report of a diagnosis and surgical treatment of trichobezoars in a Creole sheep from the Department of Santander, Colombia.