Diagnostic Value Of Ultrasonography Research Articles

Diagnostic value of ultrasonography in knee osteoarthritis: A systematic review.

Knee osteoarthritis (KOA) is the most expected diagnosis for an arthropathy that causes discomfort and disability in older adults. Radiography is frequently used to assess patients with KOA and there have been few prior research evaluating the diagnostic efficacy of ultrasonography (US). The current study sought to assess the diagnostic efficacy of the US in identifying various characteristics of KOA in the scientific literature. This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta Analyses statement. A systematic search in PubMed, Web of Science, Scopus, and Embase databases was completed in March 2023. This study focused on the diagnostic value of US in KOA, including sensitivity, specificity, positive predictive value, and negative predictive value. The quality assessment was conducted using the Joanna Briggs Institute critical appraisal tools. Out of 552 records of database searches, finally, two studies met this systematic review's eligibility criteria and were included in the study. Both of the included studies were cross sectional studies. US demonstrated remarkable sensitivity with adequate specificity for the detection of radiographic knee OA; however, it was found not to be an appropriate method for the detection of early KOA. This study as the first systematic review aims to evaluate the diagnostic performance of US in detecting KOA. These findings shed light on the importance of investigating the different US features in the evaluation of KOA to reach appropriate sensitivity and specificity in the diagnosis.

Diagnostic Performance of Ultrasonography for Diabetic Foot Osteomyelitis.

Objective: This study aims to analyze the potential diagnostic capability of ultrasonography (US) in detecting diabetic foot osteomyelitis (DFO) in patients with diabetic foot ulcers (DFUs). Approach: A 1-year prospective study was conducted on 47 consecutive patients with active DFUs and suspicion of DFO at a specialized diabetic foot unit. The following ultrasonographic features were evaluated at baseline: (1) periosteal reaction; (2) periosteal elevation; (3) cortical disruption; (4) sequestrum; and (5) positive power Doppler. The primary outcome measure aimed to establish the effectiveness of ultrasonographic features compared with aseptic bone culture for diagnosing DFO. Receiver operating characteristic (ROC) curves were utilized to evaluate the diagnostic performance of ultrasonographic features. Sample size could not be determined as it is the first study to assess ultrasonographic features for the diagnosis of DFO. The research adhered to the guidelines for diagnostic accuracy studies (Standards for Reporting of Diagnostic Accuracy Studies [STARD] 2015). Results: All patients (n = 24) diagnosed with DFO exhibited positive power Doppler, resulting in a sensitivity (S) and specificity (SP) of 1 and an area under the curve (AUC) of 1 (p < 0.001 [1-1]). Cortical disruption was present in 23 patients (95.8%) with DFO, yielding an S of 0.93, SP of 1, and AUC of 0.96 (p < 0.001 [0.88-1]). Innovation: It validates the diagnostic value of US for DFO as it is the first and largest study of its kind to establish a clear reference standard to guide clinician decision-making. Conclusion: This study demonstrates the effectiveness of cortical disruption and positive power Doppler in assessing DFO through US.

Clinical features and imaging examination assessment of cervical lymph nodes for thyroid carcinoma

BackgroundsThe purpose of this study is to investigate the relationship between clinical characteristics and cervical lymph node metastasis (LNM) in patients with thyroid carcinoma, as well as estimate the preoperative diagnosis values of ultrasound (US) and contrast enhanced computed tomography (CECT) examinations on the neck for detection of cervical LNM in thyroid carcinoma.MethodsA retrospective analysis of 3 026 patients with surgically proven thyroid carcinoma was conducted. Patients’ clinical characteristics, including gender, age, tumor size, bilateral lesions, multifocality, adenomatous nodules, Hashimoto’s thyroiditis (HT), and extrathyroidal extension, were collected to explore their association with cervical LNM in thyroid carcinoma. Preoperative assessments for central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM) were conducted through US and CECT. The diagnostic value of US, CECT and US combined with CECT for detection of LNM located in various cervical compartments was estimated based on the pathological results.ResultsThe risk of cervical LNM was higher in thyroid cancer patients who were male, age < 55 years old, tumor size > 10 mm, bilateral lesions, and extrathyroidal extension, while multifocality, adenomatous nodules and HT had no significant effect on LNM. US, CECT and US combined with CECT all had a higher sensitivity to LLNM (93.1%, 57.8%, 95.4%) than to CLNM (32.3%, 29.0%, 43.4%). US and CECT had a high specificity to both CLNM and LLNM (94.3–97.8%).ConclusionPreoperative clinical characteristics and imaging examinations on patients with thyroid carcinoma are crucial to the evaluation of cervical lymph nodes and conducive to individualizing surgical treatments by clinicians. US combined with CECT are superior to single US or CECT alone in detection of CLNM and LLNM.

Ultrasound features and differential diagnosis for superficial nodular fasciitis.

Nodular fasciitis (NF) has nonspecific clinical manifestations and is often misdiagnosed as sarcoma. The investigations of imaging methods for NF were limited. To analyze the ultrasound (US) features of NF, and to evaluate the diagnostic value of US for NF. A total of 61 NF patients were recruited retrospectively, and 551 lesions in the subcutaneous fat layer were included for comparison. We evaluated the ultrasound features of the patients and divided the NF cases into three types. Chi-square test or Fisher exact test were conducted to detect the potential difference in the distributions of three types in the two groups. Among the 61 NF cases, 65.6% were in the upper extremities (n = 40). The proportion of type 1, 2, and 3 were 57.4%, 24.6%, and 18.0%, respectively. NF were significantly more likely locating in the upper extremities than the other soft tissue tumors (p < 0.001). Type 1 and type 2 of sonographic features were significantly more commonly observed in NF than other soft tissue tumors among the three types (p < 0.001). The type 1 and type 2 of US features can help to distinguish NF from other lesions. US has great potential to improve the diagnostic accuracy and reduce the unnecessary surgery.

Ultrasound-derived fat fraction for detection of hepatic steatosis and quantification of liver fat content.

To compare ultrasound (US) and US-derived fat fraction (UDFF) with magnetic resonance proton density fat fraction (MRI-PDFF) for the detection of hepatic steatosis and quantification of liver fat content. Between October and December 2022, 149 patients scheduled for an abdominal MRI agreed to participate in this study and underwent MRI-PDFF, US and UDFF. Inclusion criteria were: (a) no chronic liver disease or jaundice; (b) no MRI motion artifacts; (c) adequate liver examination at US. Exclusion criteria were: (a) alcohol abuse, chronic hepatitis, cirrhosis, or jaundice; (b) MRI artifacts or insufficient US examination. The median of 10 MRI-PDFF and UDFF measurements in the right hepatic lobe was analyzed. UDFF and MRI-PDFF were compared by Bland-Altman difference plot and Pearson's test. Sensitivity, specificity, positive and negative predictive values, accuracy, and area under the receiver-operator curve (AUC-ROC) of US and UDFF were calculated using an MRI-PDFF cut-off value of 5%. p values ≤ 0.05 were statistically significant. 122 patients were included (61 men, mean age 60years, standard deviation 15years). The median MRI-PDFF value was 4.1% (interquartile range 2.9-6); 37.7% patients had a median MRI-PDFF value ≥ 5%. UDFF and MRI-PDFF had high agreement (p = 0.11) and positive correlation (⍴ = 0.81, p < 0.001). UDFF had a higher diagnostic value than US for the detection of steatosis, with AUC-ROCs of 0.75 (95% CI 0.65, 0.84) and 0.53 (95% CI 0.42, 0.64), respectively. UDFF reliably quantifies liver fat content and improves the diagnostic value of US for the detection of hepatic steatosis.

The diagnostic value of ultrasonography and magnetic resonance imaging in missed hand tendon injuries.

Patients with hand tendon injuries may present to the hand surgery clinic in the late stage after being examined in emergency departments. Even if an approximate idea has been obtained in physical examination of these patients, diagnostic imaging is usually requested for reconstructive approach, correct planning of surgical incisions and medicolegal reasons. The primary purpose of this study was to determine the overall accuracy of Ultrasonography (USG) and Magnetic Resonance Imaging (MRI) in patients with late presentation of a tendon injury. The surgical findings and imaging reports of 60 patients (32 females, 28 males) who underwent surgical exploration, late secondary tendon repair or reconstruction with a diagnosis of late-presenting tendon injury in our clinic were evaluated. Comparisons were made of 47 preoperative USG images (18-874 days) and 28 MRI (19-717 days) results for 39 extensor and 21 flexor tendon injuries. The imaging reports were interpreted as partial rupture, complete rupture, healed tendon and adhesion formation and these were compared with the surgical reports in terms of accuracy. In extensor tendon injuries, the sensitivity and accuracy values were both 84% for USG and 44% and 47% for MRI, respec-tively. In flexor tendon injuries, the sensitivity and accuracy values were 100% for MRI and 50% and 53%, respectively, for USG. Of the 4 sensory nerve injuries, 4 were missed on USG and 1 on MRI. The results obtained with USG and MRI in the late-presenting patients in this study were lower than those reported in previous USG and MRI studies in the literature. Scar formation with tendon healing causes a change in anatomy, which could prevent accurate evaluation. There-fore, it would be beneficial for surgeons to start evaluating their patients with easily accessible ultrasonography; thus, surgical morbid-ity should be reduced.

Value of ultrasound and computed tomography in the diagnosis of acute appendicitis with histopathology as gold standard

Background To evaluate the value of ultrasound (US), computed tomography (CT) and laboratory testing in diagnosing acute appendicitis and to evaluate the impact on the treatment of acute appendicitis, keeping histopathology as the gold standard. Retrospective evaluation of all patients treated surgically for appendicitis from 1 January 2016 to 31 December 2018 at Sint-Andries Hospital, Tielt, Belgium. Methods For each patient, we recorded: age, sex, duration of hospitalization, type of radiological investigation, fever (>37.3 °C), C-reactive protein (CRP), leukocyte particle count (LPC), Alvarado score and the type of surgery. For US and CT sensitivity, specificity and negative appendectomy rate were evaluated. Results Over a period of 3 years, 304 appendectomies were performed. The overall prevalence of appendicitis was 95.1%. Mean age was 31 years. All patients underwent radiological examination. US was performed in 35.9% (109), CT in 50.3% (153) and CT after US in 13.8% (42) of all cases. The sensitivity and specificity of CT were 99.4% and 80.0%, respectively. For US, the respective figures were 74.8 and 62.5%. CRP and LPC were significantly higher in the appendicitis group, compared to the non-appendicitis group. The negative appendectomy rate was slightly higher in the CT after US group i.e. 7.1% (3/42) compared to 4.67% (5/107) in the US group and 4.50% (7/155) in the CT group. Conclusions The diagnostic value of US and CT are both very high. The diagnostic value of clinical features and biochemistry alone is quite low. By combining radiological examination, clinical examination and laboratory values, low negative appendectomy rates can be achieved.

MO110: Ultrasound Evaluation of Post-COVID Kidney Disease

Abstract BACKGROUND AND AIMS COVID can affect many organs including kidneys involving various possible pathophysiological mechanisms [1]. Post-COVID conditions require focused approach for diagnosis, personalized treatments and rehabilitation. Ultrasonography (US) can provide accurate information for detecting kidney disease [2]. Shear wave elastography (SWE) is a recognized ultrasound method, still having a limited use in nephrology, yet can be used for early detections of kidney abnormalities. The aim of this study was to evaluate semiotics and the added diagnostic value of US for post-COVID kidney disease. METHOD We included 20 cases to the study (23–68 years; 8 women) who underwent COVID-19 during last 3 months with signs of kidney disease (proteinuria, increased levels of creatinine, uric acid in blood, hypertension) and other clinical, laboratory symptoms of nephropathy after COVID-19 without specific data of previous history of kidney disease. The control group included 20 healthy individuals (9 women), with mean age 37 ± 7 years without clinical, laboratory signs of nephropathy according to disease history. All patients underwent general clinical, lab tests; abdominal US including precise multiparameter US of kidneys as in [2] measuring renal resistive index (RI), did SWE, and sensitive Doppler (B-flow and similar) in parenchyma and vessels using curved abdominal transducer of US systems: LOGIQ 9 (GE Healthcare), Toshiba Aplio and Hitachi Arietta. RESULTS We detected US changes in all age groups, both in females and males. Severe kidney disease signs included thinning, increasing echogenicity of kidney parenchyma (P &amp;lt; .05), detection of fibrotic changes and small hyperechoic inclusions, hilly margins, anaechoic strips under the capsule, RI increasing in segmental arteries over 0.75, and decreasing velocities under 25 cm/s. SWE showed increased parenchyma stiffness to 10 ± 1.7 kPa (6–13 kPa) versus 4.2 ± 1.2 kPa (P &amp;lt; .05). Moderate changes included mild decrease of kidney medullary differentiation, RI increasing in segmental arteries over 0.7; parenchyma stiffness increased to 7.2 ± 1.5 kPa (5–10 kPa), P &amp;lt; .05. In 16 patients we diagnosed hypertension; all patients had increased RI over 0.75; pyelonephritis was in 2 patients. Three patients had the following abnormalities: amyloid kidney after COVID-19 was in two patients (male 62 years and female 58 years) manifesting on US with increased echogenicity small kidney, decreased blood flow and increasing RI (Figure 1). One patient had collapsing glomerulopathy [3] manifesting with proteinuria; kidney biopsy with immunohistochemistry performed 1 month after beginning of COVID-19 showed collapsing focal segmental glomerulosclerosis; US symptoms were unspecific (Figure 2). CONCLUSION Multiparameter ultrasound is an effective method for early detection of various types of kidney disease in patients after coronavirus disease, potentially effective to distinguish signs of nephropathy associated to COVID-19. Evaluation of renal RI and increased stiffness of kidney parenchyma are reliable markers.

Performance comparison of ultrasonography and magnetic resonance imaging in their diagnostic accuracy of placenta accreta spectrum disorders: a systematic review and meta-analysis

ObjectivesAccurate prenatal diagnosis of placenta accrete spectrum disorder (PAS) remains a challenge, and the reported diagnostic value of ultrasonography (US) and magnetic resonance imaging (MRI) varies widely. This study aims to systematically evaluate the diagnostic accuracy of US as compared with MRI in the detection of PAS within the identical patient population.MethodsMedline, EMBASE, Google scholar and Cochrane library were searched. Pooled sensitivity, specificity, diagnostic odds ratio (DOR) and the area under the summary receiver operating characteristic (SROC) curve were calculated. Subgroup analysis was also performed to elucidate the heterogeneity of results.ResultsA total of 18 articles comprising 861 pregnancies were included in the study. The overall diagnostic accuracy of US for identification of PAS was as follows: sensitivity [0.90 (0.86–0.93)], specificity [0.83 (0.79–0.86)], DOR [39.5 (19.6–79.7)]. The overall diagnostic accuracy of MRI for identification of PAS was as follows: sensitivity [0.89 (0.85-0.92)], specificity [0.87 (0.83–0.89)], DOR [37.4 (17.0–82.3)]. The pooled sensitivity (p = 0.808) and specificity (p = 0.413) between US and MRI are not significantly different. SROC analysis revealed that there was no statistical difference (p = 0.552) in US and MRI for the overall predictive accuracy of PAS. Furthermore, in the subgroup analysis of between retrospective and prospective studies, between earlier and most recent studies, there was no statistical difference (p > 0.05) in diagnostic accuracy of US and MRI for the detection of PAS.ConclusionsBoth ultrasonography (US) and magnetic resonance imaging (MRI) showed comparable accuracy in the prenatal diagnosis of placenta accrete spectrum disorder (PAS). Routine employment of MRI with relatively high expense in the prenatal identification of PAS should not be recommended.

Blood volume flow in the superficial temporal artery assessed by duplex sonography: predicting extracranial-intracranial bypass patency in moyamoya disease.

Superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery is an important therapy for symptomatic moyamoya disease. Its success depends on bypass function, which may be impaired by primary or secondary bypass insufficiency. Catheter angiography is the current gold standard to assess bypass function, whereas the diagnostic value of ultrasonography (US) has not been systematically analyzed so far. The authors analyzed 50 STA-MCA bypasses in 39 patients (age 45 ± 14 years [mean ± SD]; 26 female, 13 male). Bypass patency was evaluated by catheter angiography, which was performed within 24 hours after US. The collateral circulation through the bypass was classified into 4 types as follows: the bypass supplies more than two-thirds (type A); between one-third and two-thirds (type B); or less than one-third (type C) of the MCA territory; or there is bypass occlusion (type D). The authors assessed the mean blood flow velocity (BFV), the blood volume flow (BVF), and the pulsatility index (PI) in the external carotid artery and STA by duplex sonography. Additionally, they analyzed the flow direction of the MCA by transcranial color-coded sonography. US findings were compared between bypasses with higher (types A and B) and lower (types C and D) capacity. Catheter angiography revealed high STA-MCA bypass capacity in 35 cases (type A: n = 22, type B: n = 13), whereas low bypass capacity was noted in the remaining 15 cases (type C: n = 12, type D: n = 3). The BVF values in the STA were 60 ± 28 ml/min (range 4-121 ml/min) in the former and 12 ± 4 ml/min (range 6-18 ml/min) in the latter group (p < 0.0001). Corresponding values of mean BFV and PI were 57 ± 21 cm/sec (range 16-100 cm/sec) versus 22 ± 8 cm/sec (range 10-38 cm/sec) (p < 0.0001) and 0.8 ± 0.2 (range 0.4-1.3) versus 1.4 ± 0.5 (range 0.5-2.4) (p < 0.0001), respectively. Differences in the external carotid artery were less distinct: BVF 217 ± 71 ml/min (range 110-425 ml/min) versus 151 ± 41 ml/min (range 87-229 ml/min) (p = 0.001); mean BFV 47 ± 17 cm/sec (range 24-108 cm/sec) versus 40 ± 7 cm/sec (range 26-50 cm/sec) (p = 0.15); PI 1.5 ± 0.4 (range 1.0-2.5) versus 1.9 ± 0.4 (range 1.2-2.6) (p = 0.009). A retrograde blood flow in the MCA was found in 14 cases (9 in the M1 and M2 segment; 5 in the M2 segment alone), and all of them showed a good bypass function (type A, n = 10; type B, n = 4). The best parameter (cutoff value) to distinguish bypasses with higher capacity from bypasses with lower capacity was a BVF in the STA ≥ 21 ml/min (sensitivity 100%, negative predictive value 100%, specificity 91%, positive predictive value 83%). Duplex sonography is a suitable diagnostic tool to assess STA-MCA bypass function in moyamoya disease. Hemodynamic monitoring of the STA by US provides an excellent predictor of bypass patency.

Diagnostic Value of Sonography in Detecting Hemothorax and Determining its Size in Blunt Trauma Patients

Background: Hemothorax is among the most prevalent complications after thoracic trauma. Extended focused assessment with sonography for trauma (e-FAST) is one of the diagnostic methods for hemothorax assessment. However, there are still limited data about its diagnostic value, especially in determining the size of the hemothorax. Objective: This study aimed to assess the diagnostic value of e-FAST in detecting hemothorax and determining its size among patients with blunt thoracic trauma. Methods: This cross-sectional diagnostic assessment study was conducted on 400 adult patients with blunt trauma who needed chest CT-scan. Chest X-ray (CXR), sonography and chest CT-scan were performed and hemothorax size was assessed with sonography and CT-scan. Sensitivity, specificity, and positive and negative predictive values of sonography and CXR were calculated. Hemothorax size on sonography was compared with the results of CT-scan as gold standard. Findings: Mean age of participants was 43.67±22.03. Based on CT-scan findings, 176 participants (44%) had a hemothorax. The sensitivity, specificity, positive and negative predictive values, and correct classification rate of sonography were 79%, 99.1%, 98.6%, 85.7%, and 90.2%, respectively. Sonography detected accurately 97.1% of small hemothoraxes, 46.9% of medium hemothoraxes and 33.3% of large hemothoraxes. Conclusion: Sonography is a sensitive diagnostic modality for the detection of hemothorax in multiple trauma patients, but tends to underestimate moderate to large sized hemothoraxes. Chest sonography can be an acceptable imaging modality, if CT-scan is not available or desired.

Diagnostic Value of Ultrasonography in Maxillofacial Practice

Ultrasonography or sonography is a rapidly evolving imaging technology, which uses high-frequency sound waves that are transmitted into the body and echoes from the tissue interfaces are detected and displayed on a monitor. In recent years, its application in maxillofacial practice has gained importance as a diagnostic tool. Therefore, the aim of this manuscript is to review the literature for narrative assessment of the diagnostic value of ultrasound in maxillofacial practice and to compare the significance of ultrasound to other diagnostic modalities. The PubMed CENTRAL, MEDLINE, Springerlink and Cochrane library databases were searched using the MeSH terms subject headings: Ultrasonography, maxillofacial practice, maxillofacial sonography, echogenicity, physics of ultrasonography, diagnostic ultrasonography, greyscale, Doppler and maxillofacial imaging. The search was restricted to free-full text and articles written in the English language published from 1989 to 2018. A total number of 36 articles retrieved were reviewed by the authors restricted to review paper, original research and case report which described the diagnostic modality of US in maxillofacial practice. US have become one of the valuable diagnostic imaging modalities in maxillofacial practice owing to its affordability, availability and safety to tissues as it employs non-ionising radiation.

Current aspects of diagnostics and surgical treatment of acute lung abscesses

Increasing number of lung diseases, unfavorable environmental factors, dissemination of infectious agents in a patient's body result in increased frequency of purulent-septic complications, thereby making the study on methods of their diagnosis and treatment relevant. Aim of the work: to examine the diagnostic value of lung ultrasound (US) and spiral computed tomography (SCT) in the diagnosis of acute abscesses and in determining the tactics of surgical treatment. Materials and methods. A prospective study of 40 cases of acute lung abscesses with diagnostic value of US and SCT examination to choose a surgical method in accordance with the type of acute lung abscess. Results. Male was dominated in the study (82.5 %). The median age was 52 (43.5; 60.0) years. SCT revealed an abscess with sequestration in 9 (22.5 %) of 40 patients, which was confirmed during surgery. A false negative result was obtained in 5 (35.7 %) patients out of 14. Lung US revealed sequestration in 14 (35.0 %) patients: 2 (14.3 %) of them were false positive. Transthoracic drainage was performed in 24 (92.3 %) of 26 patients without sequestration. In 2 (7.7 %) cases – video abscessoscopy (VAS). The median length of hospital stay was 34.5 (29.0; 43.0) days for patients without sequestration and 32.0 (26.0; 35.0) – with sequestration, Р = 0.16. Conclusions. Modern radiation imaging is an effective tool for the diagnosis of lung abscess. The sensitivity and specificity of computed tomography was 64.3 % and 100.0 %, sonography – 85.7 % and 92.3 %, respectively, in the study. The concurrent use of these diagnostic methods increases their information content: sensitivity up to 100.0 %, specificity up to 92.3 %. Video abscessoscopy with sequestrectomy is an effective method of treatment and etiological diagnosis of the process, which allows achieving the length of hospital stay comparable to patients without sequestration: 32.0 (26.0; 35.0) vs 34.5 (29.0; 43.0), Р = 0.16.

Diagnostic Value of Ultrasonography in Benign and Malignant Thyroid Lesions

Diagnostic Value of Ultrasonography in Benign and Malignant Thyroid Lesions

Diagnostic Value of Ultrasonography, Computed Tomography and Magnetic Resonance Imaging Methods in Ovarian Torsion

Amaç: Over torsiyonu tanısında kullanılan değişik görüntüleme yöntemlerinin tanısal güvenirlik ve doğruluğunu saptamak.&#x0D; Yöntem: Şubat 2010-Eylül 2018 tarihleri arasında over torsiyonu şüphesi ile tedavi edilen hastaların kayıtları retrospektif olarak tarandı. Hastaların gri skala ve renkli doppler ultrasonografi inceleme sonuçları torsiyon ile uyumlu ya da uyumsuz olarak kategorize edildi. Bilgisayarlı tomografi ve manyetik rezonans görünteleme tetkikleri deneyimli iki radyolog tarafından değerlendirilerek torsiyon var veya torsiyon yok şeklinde kesin bir karara varmaları istendi. Değişik görüntüleme yöntemlerinin tanısal güç değerlendirilmesi için duyarlılık, özgüllük, pozitif ve negatif prediktif değer, doğruluk analizleri yapıldı. Testler arası uyumu değerlendirmek için Cohen Kappa analizi kullanıldı.&#x0D; Bulgular: Over torsiyonu tanısıyla yatırılan 127 hastadan 91 kişi (%71,7) opere edildi. Toplamda 69 cerrahi ile kesin tanısı konmuş torsiyon hastası mevcuttu. 120 hastaya tanı için gri skala ve doppler ultrasonografi, 23 hastaya manyetik rezonans görüntüleme ve 20 hastaya bilgisayarlı tomografi işlemi gerçekleştirildi. 94 hasta için görüntüleme yöntemlerinden sadece bir tanesi kullanılırken, 30 hastada iki yöntem ve 3 hastada da üç yöntem aynı anda kullanıldı. Duyarlılık, özgüllük, pozitif prediktif değer, negatif prediktif değer ve doğruluk oranları sırasıyla ultrasonografi için %79,3, %84,2, %84,8, %78,7, %81,7, bilgisayarlı tomografi için %76,9, %85,1, %90,9, %66,7, %80, manyetik rezonans görüntüleme için %80, %66,6, %94,1, %33,3, %78,2 olarak bulundu. Görüntüleme yöntemleri arası uyum düşük örneklem sayısı sebebiyle net değerlendirilemedi.&#x0D; Sonuç: Bu çalışmada ultrasonografi ile literatüre oranla daha iyi ve bilgisayarlı tomografi ve manyetik rezonans görüntüleme ile benzer güvenilirlik ve doğrulukta sonuçlar elde edilmiştir.

Dynamic Ultrasonographic Measurement of Inferior Joint Capsule Thickness in Patients with Unilateral Frozen Shoulder.

The diagnostic value of ultrasonography (US) for frozen shoulder (FS) is not well established. This study aimed to assess the diagnostic value of US measurement of inferior joint capsule (IJC) thickness and evaluate changes in the thickness of the IJC by US depending on arm position. A total of 71 patients with clinically diagnosed unilateral FS who underwent bilateral US measurement of the IJC were enrolled in this study. The US measurement of the IJC was performed with a linear transducer positioned around the anterior axillary line with the shoulder 40° abducted and with neutral rotation of the glenohumeral joint (neutral position). We also measured the IJC thickness in the externally rotated and internally rotated positions with the shoulder 40° abducted. In the neutral position, as well as in the internally rotated and externally rotated positions, the thickness of the IJC on US was significantly higher in the affected shoulder than that in the unaffected shoulder (all p < 0.001). On both the affected and unaffected sides, the US thickness of the IJC in the neutral position was significantly higher than that in the externally rotated position (p < 0.001), but lower than that in the internally rotated position (p < 0.001). Regarding IJC thickness in the neutral position, a 3.2-mm cutoff value yielded the highest diagnostic accuracy for FS, with a sensitivity and specificity of 73.2% and 77.5%, respectively. The area under the curve for IJC thickness was 0.824 (95% confidence interval, 0.76–0.89). US measurement of the IJC in the neutral position yielded good diagnostic accuracy for FS. Because IJC thickness is affected by arm rotation, it is important to measure the IJC thickness in a standardized posture to ensure diagnostic value.

Diagnostic Value of Sonographic Features in Distinguishing Malignant Partially Cystic Thyroid Nodules: A Systematic Review and Meta-Analysis.

Ultrasonography (US) is one of the most important methods for the management of thyroid nodules, which can be classified as solid, partially cystic, or cystic by composition. The various Thyroid Imaging Reporting and Data System classifications pay more attention to solid nodules and have reported pertinent US features associated with malignancy. However, the likelihood of malignancy of partially cystic thyroid nodules (PCTNs) is 3.3–17.6%, and few studies have systematically discussed the value of US in differentiating such entities. Therefore, we deemed it necessary to perform a systematic evaluation of US features in recognizing malignant PCTNs. Our systematic review and meta-analysis aimed to assess the value of US features in predicting malignant PCTNs. We searched the PubMed/MEDLINE, Web of Science, and Cochrane Library databases to find studies that researched US features of PCTNs and that were published before June 2020. Review Manager 5.3 was used to summarize suspicious US features and calculate the sensitivity, specificity, and likelihood ratios. MetaDiSc 1.4 was used to estimate receiver operating characteristic curves and calculate areas under the curves (AUCs). Our review included eight studies with a total of 2,004 PCTNs. Seven features were considered to be associated with malignancy. High specificity (>0.9) was found in nodules with a taller-than-wide shape, those that were spiculated/microlobulated or with an ill-defined margin, those with microcalcification, and a non-smooth rim. Among US features, eccentric configuration, microcalcification, and marked or mild hypoechogenicity were more reliable in predicting malignancy (AUC: 0.9592, 0.8504, and 0.8092, respectively). After meta-analysis, we recommend combining PCTN US features including an eccentric internal solid portion, marked or mild hypoechogenicity, and presence of microcalcification to better identify malignant nodules. More studies are needed to explore and improve the diagnostic value of US in PCTNs.

Abdominal ultrasound in the diagnostic work-up of visceral leishmaniasis and for detection of complications of spleen aspiration.

Abdominal ultrasound (US) is increasingly used in the diagnostic work-up of infectious diseases, but studies on its diagnostic value in visceral leishmaniasis (VL) are lacking. US could help to identify complications of spleen aspiration (SA). We aimed to assess the diagnostic value of US and the evolution of findings after VL treatment; the incidence and degree of splenic injury; and the pain perceived during SA. We conducted a cross-sectional prospective study at the Leishmaniasis Research and Treatment Center, Gondar, Ethiopia between Oct 2017 and Dec 2018. We enrolled VL suspects undergoing tissue aspiration; US were conducted before and after SA, and at the end of VL treatment. Splenic injury was graded using the American association of surgery trauma injury scale (grade 1-4). The pain perceived during SA was graded using a visual analogue scale. Out of 392 VL suspects, 192 (49%) were confirmed VL cases. The median age was 25 years (IQR 21-30). Massive splenomegaly and hepatomegaly were the most common US findings. Splenic nodules were seen in 3.7% of the 190 VL cases and 1.5% of the 197 non-VL cases. Ascites was more common in VL (16.4%) than in non-VL cases (9.1%). The frequency of US abnormalities decreased with treatment. None of the US findings had sufficient sensitivity and specificity to justify its use as a diagnostic test. US detected splenic injury in four of the 318 patients who had post-SA US. All four patients remained clinically stable. Pain was perceived as moderate or severe in 51% of patients. The diagnostic value of abdominal US for VL was low but found useful to detect subclinical splenic injury. SA caries a risk of splenic injury and was perceived painful by most. Further research on less invasive diagnostic tools is needed.

Diagnostic Value of Ultrasonography and MR in Antenatal Diagnosis of Placenta Accreta Spectrum

AbstractThe aim of this study was to compare the accuracy of ultrasonography and magnetic resonance imaging (MR) in the antenatal diagnosis of placenta accreta. We also determined the most relevant sonographic and MR features associated with the diagnosis of placenta accreta. In a prospective observational study approved by the Ethical Board of the Radiology Department, 109 pregnant women who were at high risk for Placenta Accreta were enrolled. The placentas of all cases were scanned using both gray-scale and color Doppler transabdominal sonography. MR was performed when sonographic findings were equivocal or inconclusive. The sonographic and MR features were compared with the final pathologic or clinical findings. The sensitivity and specificity were calculated for both sonography and MR. The role of each sonographic and MR feature was calculated by logistic regression. P &lt; 0.05 was considered as the significance level. The sensitivity and specificity of ultrasonography for the diagnosis of Placenta Accreta spectrum were 87% and 85% (P &lt; 0.001), while those of MR were 100% and 42% (P = 0.1), respectively. In ultrasonography, myometrium thickness ≤ 1 mm with a sensitivity of 83% (95 CI: 0.765, 0.927) and loss of retroplacental clear space with a sensitivity of 81% (95 CI: 0.755, 0.920) had the best sensitivity for the detection of the placental invasion. On MR, the heterogeneous signal intensity of placenta and uterine bulging with a sensitivity of 87% (95 CI: 0.698, 1.04) had the best sensitivity. Placenta accreta can be successfully detected prenatally using ultrasound. MR is useful in equivocal cases.

The diagnostic value of ultrasonography in detection of different types of thyroid nodules

BackgroundThis article discusses the importance of high frequency ultrasonography in detection of different types of thyroid nodules considering only the histopathological examination of the surgical specimens as the final diagnosis. We studied 50 patients referred to ENT clinic with a thyroid nodule. Ultrasonography and ultrasound-guided fine-needle aspiration biopsy were done to all the patients. Thyroid surgery was done according to FNAB results.ResultFrom 50 thyroid specimens, the US could predict the malignancy in 18 specimens. By histopathology, only 16 specimens were malignant, and 34 were benign thyroid disease. The sensitivity, specificity, and accuracy of US were 100%, 94.12%, and 96% respectively. The most suspicious ultrasongraphic feature was microcalcification followed by taller than wider (T ˃ W).ConclusionHigh frequency ultrasound is a very important tool to predict the malignant possibility during thyroid nodule evaluation.