Ultrasound Examination Research Articles

Role of Ultrasound Elastography versus Ultrasound Guided Biopsy in Detection of Cancer Prostate

Abstract Background Prostate cancer detection has evidently evolved through the past years. Ultrasound is already established in PCA diagnosis, with introduction of adjuvant techniques to ultrasonography promoting its capabilities in PCA diagnosis. Elastography technique was introduced for the first time in the 90s, it is an easy procedure with high capabilities in diagnosis and can be at same session with US increasing its specificity. Aim of the Work The aim of this study is to define the effect of US elastography in early detection of cancer prostate. Patients and Methods This study was prospectively carried on 22 male patients having prostatic lesions, (between June 2020 to November 2022), the mean age of all cases was 63.5 years, with a median of PSA of 30.6 ng/mL, a median prostatic volume of 65 mL. This study was performed in the ultrasound unit/ radiology department of the Police Medical Complex at New-Cairo. Patients were referred from the outpatient clinic of the urology department. Results We found that to differentiate between benign and malignant lesions the best stiffness cut-off value would be between 35 and 37 kPa, sensitivity 83.3%, specificity 70%, PPV 76.9% and NPV 77.7% and accuracy 77.2%. Conclusion Elastography is an easy procedure that provides diagnostic extra tool which can be easily done in the same session with the B-mode ultrasound examination and improves its specificity for detection of prostatic cancer. It has proven benefit in differentiating benign form malignant lesions and optimizing the results of prostate biopsies.

Pancreatic Ultrasound in High-risk Neonates

Pancreatic ultrasound is employed to assess the structure of the organ and diagnose various conditions. However, analyses of pancreatic images of high-risk newborn infants are scarce.Aim of the study: to investigate pancreatic echogenicity in high-risk neonates and evaluate the association between pancreatic echogenicity and clinical diagnosis.Materials and methods. This prospective observational case-control ultrasound study included 105 neonates admitted to the neonatal intensive care unit or outpatient. The patients were divided into two groups: group 1 (high-risk), which included 55 high-risk neonates, and group 2 (control), which included 50 neonates of comparable age with no history of high-risk pregnancy or delivery who were presented for medical consultation. Abdominal ultrasound examinations were performed, with a focus on the pancreas. Pancreatic echogenicity was classified as hyperechoic, isoechoic, or hypoechoic, relative to the liver.Results. No significant difference in pancreatic size was observed between the high-risk and control groups. A significant predominance of hyperechogenicity over hypoechogenicity or isoechogenicity was found in the high-risk group. A significant difference in echogenicity was found between the high-risk and control groups (P=0.0001). Neonates in the control group were more likely to have pancreatic isoechogenicity (60%) compared to hyperechogenicity (34%) or hypoechogenicity (6%). In the high-risk group, neonates had a higher frequency of pancreatic hyperechogenicity (72.72%) compared to hypoechogenicity (10.9%) or isoechogenicity (16.36%). Notably, 83.3% of infants born to diabetic mothers had a hypoechogenic pattern. Certain high-risk infants, such as preterm infants and those with perinatal asphyxia, had a higher frequency of hyperechogenicity (83.3%). The percentage of hypoechoic pattern was comparable in male and female newborns (50%); isoechoic pattern was more prevalent in females (77.3%) than in males (22.2%), while males had a more frequent hyperechoic pattern (57.5%).Conclusion. Evaluation of the pancreas in high-risk neonates and monitoring of long-term outcomes are of critical importance, especially in the infants of diabetic mothers.

A case of portal vein gas due to accidental ingestion of hydrogen peroxide: the importance of performing ultrasound examinations over time.

A case of portal vein gas due to accidental ingestion of hydrogen peroxide: the importance of performing ultrasound examinations over time.

Clinical and financial impact of a machine learning powered screening program for abdominal aortic aneurysms

ObjectiveOur health system recently implemented a machine learning (ML)-enhanced abdominal aortic aneurysm (AAA) screening program to identify and screen high-risk individuals. This program, which uses clinical data to identify the top 150 high-risk patients monthly, increased the number of AAA screening ultrasound examinations and positive diagnoses. The aim of this study was to quantify the clinical and financial impacts of a ML-enhanced AAA screening program in terms of lives saved, costs incurred, payments received, and incremental cost-effectiveness ratio. MethodsWe compared 900 high-risk individuals identified from February to July 2023 (intervention cohort) with 900 individuals from February to July 2022 (comparison cohort), assessing screening rates, positive diagnoses, and outcomes using both internal electronic health record data and external research statistics for long-term estimates. ResultsThis analysis demonstrated a 590% increase in AAA screening within the intervention cohort and a 238% increase in positive AAA diagnoses. The program decreased expected AAA deaths by 36%, primarily by increasing elective surgeries and decreasing emergency repairs. Financial analysis revealed an increase in costs and payments, improving hospital net income and return on investment. The incremental cost-effectiveness ratio of $5222 per quality-adjusted life year) compares favorably with other well-accepted screening initiatives. ConclusionsOverall, an ML-enhanced AAA screening program improves clinical outcomes and financial performance, demonstrating cost effectiveness and feasibility. Future research will refine these estimates and explore similar ML-based risk stratification programs for other conditions.

Standardized Ultrasound Protocol for Peripherally Inserted Central Catheters in Neonates: A Retrospective, X-ray Controlled Observational Study.

Objectives: Ultrasound (US) has been reported to be a reliable imaging modality for locating the tip of peripherally inserted central venous catheters (PICC) in neonates. However, its use requires a certain level of expertise, which may limit its application. Standardization of US examinations using designed protocols may improve their efficiency and ease of use. The objective of our study is to evaluate the effectiveness of introducing a standardized US protocol for PICC guidance. Methods: An expert panel was formed in order to develop a standardized US protocol for PICC assessment. Institutional review board agreement was obtained. This protocol was then used by participating clinicians to assess PICC position. Every assessment was followed by a radiographic control. The study group consisted of 262 US examinations of PICC lines in a level III neonatal intensive care unit (NICU) performed according to the designed protocol. Subsequent statistical analysis was made with the RStudio software, R version 4.3.1 (2023-06-16 ucrt). Results: Compared to the X-ray control, standardized US examinations showed 100% sensitivity, 81% specificity, an accuracy of 98% and a 98% precision for assessing catheter placement. The Cohen's Kappa value for the comparison of X-ray and US studies was 0.88, indicating good agreement between the two methods. Conclusions: Standardized US examinations have shown similar potential for evaluating the location of PICC lines when compared with radiographic studies. Implementing a standardized protocol in the NICU may facilitate the ultrasound assessment of PICC lines and reduce exposure to ionizing radiation.

A clinical case of gastrointestinal stromal tumor of the duodenum

Background. Gastrointestinal stromal tumors localized in the duodenum are very rare and account for only 4–5%. They can be asymptomatic, while reaching large sizes and causing dangerous complications. Gastrointestinal stromal tumors of the duodenum are a special problem for diagnosis and treatment. Therefore, it is relevant to highlight the issue of their detection and treatment on the example of the presented clinical case. Purpose – present a description of the literature and present a rare clinical case of gastrointestinal stromal tumor of the duodenum. Material and methods. The patient, a 49-year-old woman, was diagnosed with a tumor of the abdominal cavity during a routine preventive ultrasound examination. The patient underwent a laboratory and instrumental examination, which included determination of blood and urine parameters, video esophagogastroduodenoscopy, contrast x-ray examination of the gastrointestinal tract, contrast-enhanced computer tomography and contrast-enhanced magnetic resonance imaging of the abdominal cavity. Results. The patient underwent surgical resection of the tumor of the duodenum. During the immunohistochemical study, the tumor cells were positive for markers DOG-1, CD117. As a result, «Gastrointestinal stromal tumor of the wall of the duodenum of a low degree of malignancy pT2N0M0R0» was diagnosed. During the six-month follow-up of the patient, no data on tumor recurrence were found. The relatively rare frequency of gastrointestinal tumors of the duodenum leads to difficulties at the diagnostic stage. In this clinical case, the tumor was asymptomatic, was not visualized during video esophagogastroduodenoscopy and was suspected during ultrasound examination. This indicates the importance of preventive examinations. Oncological awareness of doctors is extremely important for early diagnosis of oncology. Conclusion. Based on the analysis of the literature, the data on the epidemiology, clinical picture, methods of diagnosis and treatment of this rare pathology are displayed.

Point-of-care ultrasound of the inflammatory bowel disease

Background. The widespread use of portable ultrasound scanners has advanced the concept of ultrasound diagnosis (POCUS), namely «ultrasound examination (US) is performed at the bedside and is interpreted directly by a physician». Pocus is not a substitute for complex ultrasound, but rather allows the ultrasound doctor to quickly access clinical images for rapid diagnosis and effective examination and treatment of patients. Purpose – the work to identify ultrasound signs of inflammatory bowel disease (IBD) using POCUS. Materials and Methods. 70 patients aged 18 to 39 years (24 men and 46 women, mean age – 30.3 ± 13.7 years). The first group of patients included 32 people with a morphologically confirmed CD diagnosis, the second group included 38 people with a morphologically confirmed UC diagnosis. The control group consisted of 2 8 patients with no clinical and laboratory data on gastrointestinal lesions. Results. It was shown that the ultrasound can assess the thickness of the intestinal wall with sensitivity – 90.3% and specificity – 87.1% and ROC – 0.882, differentiation of the wall layers, surrounding structures (omentum, mesentery, lymph nodes), as well as the localization of the affected intestinal segment. Color Doppler Mapping (CDM) method with a sensitivity of 86.5% and specificity of 81.5% and ROC of 0.852 allows not only to assume the presence of active inflammation in the wall of the affected intestinal segment, but also to monitor the dynamics of the process during treatment. Conclusion. In this work, the capabilities of POCUS for the diagnosis of IBD were evaluated. Correct and accurate interpretation of POCUS findings is not only an important diagnostic step, but also a complement to other radiation and endoscopic imaging techniques. The main advantage of POCUS over CT and MRI is its fast availability, low cost, and high level of safety. An experienced ultrasound doctor is needed to examine the gastrointestinal tract, so training with ultrasound doctors and mastering practical skills is key to ensuring the effective use of POCUS.

Пухлина Бреннера у жінок репродуктивного віку з ожирінням: клініко-морфологічний аналіз випадків із практики

Background. Brenner tumors are rare epithelial ovarian tumors, the incidence of which among all ovarian tumors ranges from 0.6 to 2%. Considering the rarity of the pathology and absence of specific clinical symptoms, the authors present an analysis of own cases from the practice of Brenner tumor. Purpose – familiarization of the medical community with the clinical and morphological features of Brenner tumor in obese women of reproductive age based on an analysis of own practice cases. Materials and Methods. A clinical and morphological analysis of cases from practice of Brenner tumor of different histological variants in obese women of reproductive age is provided. Results. In the first case, in patient V., 42 years old, with obesity, a morphological study of the surgical material was diagnosed a benign variant of the Brenner tumor in the left ovary, which clinically manifested by pain and was not diagnosed by ultrasound. In the second case, in patient G., 36 years old, with obesity, it was morphologically diagnosed a benign variant of Brenner tumor in the right ovary, and borderline variant of Brenner tumor in the left ovary against the background of a benign variant. Brenner tumor in patient G. manifested by pain, infertility in anamnesis, and the presence of cysts on ultrasound examination. The menstrual cycle disorders in women in both cases may be caused by the presence of leiomyomas in the uterus or Brenner tumors or a combination of these tumor pathology. Conclusions. Brenner tumors are rare epithelial ovarian tumors, the only diagnostic method for which is a morphological examination of surgical material. Literature data about the role of obesity in the genesis of the development of these epithelial ovarian tumors, the presence in the described cases from practice of an increased body mass index in women with benign and borderline variants of Brenner tumors actualize the conduct of complex morphological studies in order to search, firstly, the etiopathogenetic features of the development of these ovarian tumors in obese women, and secondly, the morphological differential diagnostic criteria for these epithelial ovarian tumors in women with and without obesity.

A rare case of primary angiosarcoma of breast with histopathology correlation

Primary angiosarcoma of the breast is a rare malignancy accounting for 0.05% of cases, seen in young females, and has atypical radiological presentation. We present a case of a 54-year-old female with complaints of a lump in the right breast for 5 months associated with pain, on and off fever. On ultrasound examination, the patient was found to have a BIRADS-IVb lesion. On further investigation using MRI, the lesion was found to have diffusion restriction with low ADC values, heterogenous enhancement, and type III enhancement curves, suggesting a malignant etiology. On histopathology, the lesion turned out to be angiosarcoma of intermediate grade and is positive for IHC CD 34.

TROCAR SITE CLOSURE WITH OMENTAL PLUG INSERTION IN LAPAROSCOPIC BARIATRIC OPERATIONS: EFFICACY, SAFETY, AND OUTCOMES

Introduction:Trocar site herniation (TSH) remains a significant complication following laparoscopic bariatric surgery. Conventional closure techniques often prove challenging and may lead to inadequate closure, increasing the risk of TSH. This study aimed to evaluate the effectiveness and safety of a novel omental plug technique for closing trocar sites in laparoscopic bariatric surgery. Methodology:A retrospective study included 256 patients who underwent laparoscopic bariatric surgery (LSG, OAGB, or RYGB) between 2019 and 2023 at Armed Forces Hospital, Taif, Saudi Arabia. We used an innovative omental plug technique to close trocar sites ≥10mm. The primary outcome was the incidence of TSH within 12 months postoperatively, assessed clinically and with an ultrasonography examination. Secondary outcomes included wound infections, seroma formation, and reoperation for trocar site complications. Results:We observed no cases of TSH, indicating significant efficacy in preventing this complication. Other postoperative complications were minimal, with only one case (0.4%) of a superficial wound infection. Conclusion:In laparoscopic bariatric surgery, the omental plug technique demonstrated promising results in preventing TSH and reducing postoperative complications. Its ease of use, safety profile, and potential biological advantages suggest it may be a valuable alternative to traditional fascial closure methods. We warrant future larger, multicentric studies with longer follow-up to confirm these findings.

Ultrasounds outperform magnetic resonance imaging in quantifying meniscal extrusion in patients with knee osteoarthritis.

The aim of this study was to quantify meniscal extrusion through ultrasound (US) evaluation in supine and standing positions and to compare the results with those documented through magnetic resonance (MR) imaging in patients affected by knee osteoarthritis (OA). Sixty patients (38 men, 22 women, mean age 60.8 ± 9.7 years) with knee OA were enrolled and underwent a 1.5 T MR evaluation and an US examination of the symptomatic OA knee for the evaluation of the medial and lateral meniscus extrusion both in the supine clinostatic position (clino-US) with the knee fully extended and in the standing weight-bearing orthostatic position (ortho-US). For the three imaging evaluations (MR, clino-US and ortho-US), both semi-quantitative and quantitative measurements were performed. The quantitative analysis documented higher values of medial meniscal extrusion at the ortho-US evaluation (5.2 ± 2.3 mm) compared to MR (4.2 ± 2.2, p < 0.0005) and clino-US (4.5 ± 2.3, p < 0.0005) and of the lateral meniscus at the ortho-US evaluation (4.3 ± 1.8) compared to MR (3.3 ± 1.6, p < 0.0005) and clino-US (3.8 ± 1.6, p < 0.0005). The semi-quantitative analysis confirmed the same trend for both menisci. Higher extrusion values were documented in women and more advanced OA, as well as in older patients with higher body mass index, the latter being underestimated the most by the MR approach. US outperforms MR imaging in quantifying meniscal extrusion in patients with knee OA. Moreover, the highest values of meniscal extrusion have been documented using US in standing position compared to the supine position, underlining the importance of the weight-bearing assessment of meniscal extrusion in knee OA patients. II.

Correlation of Immunological Variables of Interleukin-17 and Heat Shock Protein-70 In Ethnic Women with Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is a hormonal imbalance resulting from high levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in females, leading to immature eggs, ovarian cysts, irregular menstrual cycles, infertility, excessive facial hair growth, and acne. Objective: This study was conducted to follow up the therapeutic effect on some blood, hormonal, and immune variables of samples consisting of 35 patients with polycystic ovary syndrome (PCOS) from women suffering from infertility and infertility, and who visited Azadi Teaching Hospital and private laboratories in Kirkuk city, their ages ranged between (18 - 40 years). Materials and Methods: Sample collection and follow-up began by observing some clinical signs in addition to verifying the results of ultrasound examinations from early February 2023 to early November 2023. Each patient’s examinations were followed up before treatment and three months after taking the treatment. The results we obtained after three months of treatment were compared with the results of the examinations of the patients in the pre-treatment stage and the control group. The treatment plan was based on modifying the patient's dietary lifestyle by following a healthy diet and giving treatment consisting of oral contraceptives, fertility drugs and the use of sugar-reducing drugs such as Glucophage or Metformin, in addition to nutritional supplements such as antioxidants. Result: The results of the therapeutic effect on the patients' diagnostic clinical signs showed a significant decrease in their percentages after three months of treatment compared to the pre-treatment stage such as (ovulation disorders - menstrual disorders - obesity - hirsutism - acne -). The results of the statistical analysis of the study showed that the therapeutic effect showed a significant difference in the body mass index (BMI) after three months of treatment compared to the pre-treatment stage and the control group. The therapeutic effect of the immune factors for each Hast Shock protein 70 and Interleukin-17 also showed a significant decrease at the level (0.000 &gt; p) respectively after three months of taking the treatment compared to the pre-treatment stage and the control group. It was found that there is a significant positive correlation between the level of Heat Shock Protein 70 and the cellular kinetic IL-17.

Clinical and diagnostic evidence of benign endometrial pathology in postmenopausal patients

The objective: to study clinical and diagnostic features of the benign endometrial conditions in the postmenopausal women.Materials and method. 64 postmenopausal patients with various severity of postmenopausal vaginal bleeding were examined. All patients underwent clinical, radiological, laboratory and histological examinations, reproductive history data and body mass index indicators were evaluated. Of them 33 persons were diagnosed with complex endometrial hyperplasia without atypia, 16 women – endometrial polyp and 15 women – hyperplasia with atypia. Routine gynecological examination including abdominal and pelvic examination following transvaginal ultrasound examination for the determination of the uterine and ovarian volume as well, as the endometrial thickness were conducted. Patients included in the study underwent computer tomography and magnetic resonance imaging as indicated. All patients with endometrial pathology underwent endometrial biopsy by standard dilatation and curettage or Pipelle-biopsy with histological examination of the obtained material. The concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), dehydroepiandrosterone sulfate (DHEA-S), estradiol, estrone, progesterone, prolactin, and testosterone were determined in blood serum.Results. It was confirmed that in 87,5% of cases endometrial hyperplasia manifested with vaginal bleeding. Endometrial thickness in examined persons ranged from 14.1±1.6 mm in patients with atypical endometrial hyperplasia to 21.3±4.8 mm in patients with complex endometrial hyperplasia without atypia. The study of blood levels of hormones found that postmenopausal patients with endometrial hyperplasia have lower FSH concentration, LH/FSH ratio, estradiol, testosterone levels, with significantly high values of prolactin, DHEA-S and estrone. During the postmenopausal period, hyperplasia was developed in 10% of cases by the presence of bleeding, and 86.2% of cases by the presence of blood spotting. Conclusions. The study suggests that high body mass index, numerous artificial abortions, high blood levels of estrone, DHEA-S and prolactin as well as increased thickness of endometrium influence the frequency of endometrial hyperplasia in postmenopausal women.

Ascites of unknown origin in infant: a rare case report

Introduction. Ascites of unknown origin in infants are rare and diagnostically challenging. However, it can be associated with a poor prognosis if it is not treated promptly. Case presentation. A 3-month-old boy infant was admitted to the Dr. Soetomo General Academic Hospital, Surabaya because of a 2-week history of progressive abdominal distension with massive ascites following fever onset. Laboratory parameter measurement revealed increased liver function test, hypoalbuminemia, and prolonged coagulation factor. Hepatitis markers were negative. TORCH serological examination showed non-reactive. Urinalysis, renal function test, and echocardiography were normal. The ascitic fluid analysis showed SAAG &gt;1.1 g/dL. An abdominal ultrasound examination revealed ascites. MRCP showed hepatomegaly and ascites. A liver biopsy showed foci of polymorphonuclear and mononuclear inflammatory cell distribution among hepatocytes with no hepatic fibrosis. He was treated with antibiotics, steroids, diuretics, and albumin transfusion. There were no ascites and laboratory parameters were improved after treatment. Conclusion. Progressive and rapid hepatic inflammatory mechanisms may play a role in the development of ascites. Steroids may be considered in cases of unexplained ascites thought to be related to liver injury to prevent further liver fibrosis.

Ulcerative colitis and concomitant arterial hypertension (literature review)

ulcerative colitis is a complex disease that results from a complex interaction of genetic predisposition, environmental factors, which leads to dysregulation of the immune system, chronic intestinal inflammation with damage to the mucous membrane. Systemic chronic inflammation can cause the development of arterial hypertension, thereby complicating the course of the primary disease. However, the cause-and-effect relationship between these diseases is not fully understood. Early detection of high blood pressure in patients with ulcerative colitis, a multidisciplinary approach to diagnosis makes it possible to achieve optimal treatment results in a timely manner and prevent the occurrence of intestinal complications. The aim of this study was to provide a comprehensive review of diagnostic procedures such as colonoscopy, inflammatory biomarkers (faecal calprotectin, faecal lactoferrin, serum zonulin), and to study the features of the colon structure in ultrasound diagnostics in patients with ulcerative colitis and concomitant hypertension. The data from PubMed and Ukrainian scientific sources on the comorbidity of these diseases, the possibility of using non-invasive diagnostic methods to assess the condition of the intestine in patients with ulcerative colitis and arterial hypertension were analysed. The literature review includes 50 scientific sources. The main focus is on the pathophysiological relationships of diseases, peculiarities of non-invasive diagnosis of ulcerative colitis during follow-up and early detection of arterial hypertension, which makes it possible to prevent complications in ulcerative colitis. Given the literature review, it can be concluded that the problem of timely diagnosis of hypertension in patients with ulcerative colitis is relevant today. For a rational approach to the management of patients with ulcerative colitis and concomitant hypertension, it is necessary to carry out a set of diagnostic procedures, including outpatient blood pressure measurement, ultrasound examination of the intestinal wall, and the use of non-invasive inflammatory biomarkers.

The importance of ultrasonography examination in renal abscesses in pediatric patients

The importance of ultrasonography examination in renal abscesses in pediatric patients

Bilateral penetrating corneal transplantation in a patient with keratoconus and Stormorken Syndrome: a clinical case

Introduction. Keratoconus is a progressive corneal disease that results in thinning, curvature change, and refractive alterations, significantly impairing. visual acuity, even to the point of light perception. In advance stages, corneal transplantation may be necessary. Purpose. This publication aims to analyze a clinical case of corneal transplantation in a patient with keratoconus and Stormorken Syndrome, a rare genetic disorder caused by mutations in the STIM1 gene leading to calcium channelopathies. Case description. Patient Z., a 24-year-old male diagnosed with Stormorken Syndrome in childhood, was referred to the Moscow City Ophthalmological Centre. Comprehensive evaluations, including biomicroscopy, keratopachimetry, and ultrasound eye examination, confirmed keratoconus in both eyes. The patient underwent bilaterial penetrating keratoplasty due to disease progression. Postoperatively, visual acuity was 0.8 in the right eye, and 0.7 in the left eye. Additional clinical observations including bilateral myositis (resistant to medication), hypoinflammation, thrombocytopenia, dyslexia, and proximal muscles weakness, of the consistent with Stormorken Syndrome. Genetical testing confirmed a pathogenic STMI1 mutation. Conclusion. Despite the high volume of keratoplasty procedures at our clinic, this case is noteworthy. The currrent literature lacks reports on penetrating keratoplasty using native donor material in patients with Stormorken Syndrome, highlighting the uniqueness of this case.

Detecting thyroid nodules along with surrounding tissues and tracking nodules using motion prior in ultrasound videos

Ultrasound examination plays a crucial role in the clinical diagnosis of thyroid nodules. Although deep learning technology has been applied to thyroid nodule examinations, the existing methods all overlook the prior knowledge of nodules moving along a straight line in the video. We propose a new detection model, DiffusionVID-Line, and design a novel tracking algorithm, ByteTrack-Line, both of which fully leverage the prior knowledge of linear motion of nodules in thyroid ultrasound videos. Among them, ByteTrack-Line groups detected nodules, further reducing the workload of doctors and significantly improving their diagnostic speed and accuracy. In DiffusionVID-Line, we propose two new modules: Freq-FPN and Attn-Line. Freq-FPN module is used to extract frequency features, taking advantage of these features to reduce the impact of image blur in ultrasound videos. Based on the standard practice of segmented scanning by doctors, Attn-Line module enhances the attention on targets moving along a straight line, thus improving the accuracy of detection. In ByteTrack-Line, considering the characteristic of linear motion of nodules, we propose the Match-Line association module, which reduces the number of nodule ID switches. In the testing of the detection and tracking datasets, DiffusionVID-Line achieved a mean Average Precision (mAP50) of 74.2 for multiple tissues and 85.6 for nodules, while ByteTrack-Line achieved a Multiple Object Tracking Accuracy (MOTA) of 83.4. Both nodule detection and tracking have achieved state-of-the-art performance.

Reliability and Validity of Ultrasound in Identifying Anatomical Landmarks for Diagnosing A2 Pulley Ruptures: A Cadaveric Study.

Background/Objectives: Rock climbing is becoming more popular, leading to an increased focus on diagnosing and treating related injuries. Finger pulley and flexor tendon injuries are common among climbers, with the A2 pulley being the most frequently affected. High-resolution ultrasound (US) is the preferred method for detecting pulley injuries. This study aimed to determine the reliability and validity of US in identifying anatomical landmarks for diagnosing A2 pulley ruptures. Methods: This study was cross-sectional, involving 36 fingers from 4 cadaver arms. A Canon Aplio i800 US machine was used to measure two anatomical landmarks: the midpoint of the proximal phalanx and the distal edge of the A2 pulley. For the first anatomical landmark, the length of the proximal phalanx (PP distance), and for the second landmark, the distance between the distal edges of the proximal phalanx and the A2 pulley ("A" distance), were measured. Measurements were performed by two sonographers and compared to a digital caliper measurement taken post-cadaver dissection. Observers were blinded during measurements to ensure unbiased results. Results: Overall PP distance measured by US (O1: 37.5 ± 5.3 mm, O2: 37.8 ± 5.4 mm) tended to be shorter than caliper measurements (O3: 39.5 ± 5.5 mm). The differences between sonographers were minimal, but larger when compared to caliper measurements. High reliability for PP distance measurement was observed, especially between sonographers, with an ICC average of 0.99 (0.98, 1.00). However, reliability was lower for the "A" distance, with significant differences between US and caliper measurements. Regarding validity, US measurements were valid when compared to caliper measurements for PP distance, but not as reliable for the "A" due to wider confidence intervals. While US can substitute caliper measurements for PP distance (LR, Y:O2, X:O3, -0.70 (-3.28-1.38), 0.98 (0.93 ± 1.04)), its validity for "A" distance is lower (LR, Y:O2, X:O3, -2.37 (-13.53-4.83), 1.02 (0.62-1.75)). Conclusions: US is a reliable and valid tool in identifying anatomical landmarks for diagnosing A2 pulley ruptures, particularly for detecting the midpoint of the proximal phalanx. This is important to differentiate between complete and partial A2 pulley tears. However, the measurement of the "A" distance requires further refinement. These findings support efforts to standardize US examination protocols and promote consensus in diagnostic methodology, though further research is needed to address the remaining challenges.

Specific growth velocity reference charts for monochorionic twin pregnancies.

We aimed to create specific growth velocity reference charts for monochorionic (MC) twin pregnancies and provide additional information for assessing fetal growth in MC twins. This retrospective study collected data from uncomplicated MC twins with serial ultrasound parameters. The four ultrasound parameters, including biparietal diameter, femur length, head circumference, and abdominal circumference, were used to calculate the estimated fetal weight (EFW). Multilevel linear regression models were applied to fit growth velocity charts for each biometric parameter and EFW. Analysis of variance was used to examine differences in birthweight by whether EFW velocity and EFW values were <10th or ≥10th percentiles. The final analysis encompassed a total of 5956 ultrasound examinations conducted on 487 MC twins. The growth velocity of four biparietal diameters exhibited a gradual decrease in a nearly linear fashion progressing from 18 to 37 gestational weeks. The EFW velocity increased steadily from 18 to 36 gestational weeks, reaching a peak of 178.2 g/week, and then the velocity gradually decreased until delivery. At 32 weeks for illustration, the lightest birth weight was observed when both EFW and EFW velocity were <10th percentile (1899 g). The study also found that birth weight was higher when EFW velocity was ≥10th percentile compared with <10th percentile, regardless of EFW being below or above the 10th percentile (2263 and 1906 g, respectively; P < 0.001). We developed specific growth velocity reference charts for MC twins, which could provide a valuable reference point for a more precise evaluation of fetal growth in MC twins. Preliminary findings indicate that the inclusion of fetal growth velocity in monitoring fetal growth provides additional information beyond EFW alone.