Ultrasonography Imaging Research Articles

Applications of ultrasonography imaging techniques in different aspects of bovine reproduction

Applications of ultrasonography imaging techniques in different aspects of bovine reproduction

Resection of uterine arteriovenous fistula with temporary occlusion of the internal iliac arteries: Case series and literature review.

Uterine arteriovenous fistula (UAVF) is a rare vascular abnormality that can cause severe and potentially life-threatening hemorrhage. Uterine artery embolization is a common treatment that may affect ovarian and uterine perfusion and cause fertility problems. We herein report our experience treating 2 patients with UAVF who underwent resection after temporary occlusion of both internal iliac arteries. Both patients presented with a large UAVF after incomplete miscarriages in the second trimester. Magnetic resonance imaging revealed a UAVF measuring 3.6 × 2.6 × 2.1 cm over the myometrium of the posterior uterine in case 1, and a UAVF of 7.1 × 4.1 × 4.5 cm was identified in case 2. Uterine arteriovenous fistula, retained products of conception. The patients underwent resection of UAVF with temporary occlusion of the internal iliac arteries and hysteroscopic removal of the retained products of conception. Intraoperative bleeding were minimal. Neither patient exhibited abnormal uterine bleeding at the 6-month follow-up. Follow-up ultrasonography and magnetic resonance imaging showed normal uterine myometrium and endometrium and no residual disease. UAVF resection after temporary occlusion of the internal iliac arteries is a promising treatment approach for UAVF. This technique can reduce intraoperative bleeding and remove the potential hemorrhage-related lesion while preserving fertility.

Case Report of a Congenital Subglottic Cyst.

This article presents the case of a full-term newborn who underwent tracheal intubation after birth due to rapid breathing and cyanosis of the lips. Ultrasonography, computer tomography (CT), and magnetic resonance imaging revealed the presence of a subglottic cyst. The patient underwent cyst marsupialization via endoscopy under general anesthesia, with successful extubation on the second postoperative day. In the later follow-up, it was shown that the cyst recurred quickly. However, the special feature of this case is that during the follow-up, the size of the cyst remained unchanged, but suddenly disappeared spontaneously in the third year. As for the reason for the disappearance of the cyst, we can only make theoretical speculations. Whether other recurrent cases will also resolve spontaneously, there are currently no relevant reports.

Evaluation of Etiological Causes and Demographic Characteristics of Neonatal Seizure in Adiyaman University Training And Research Hospital, Türkiye: A Retrospective Study

Aim: Neonatal seizures are different from seizures seen at other ages in terms of etiology, clinical follow-up, treatment and prognosis. The purpose of this study was to determine the etiological causes and demographic characteristics of neonates admitted due to seizures in the neonatal intensive care unit. Methods: This is an original study involving newborns hospitalized for seizures in the neonatal intensive care unit at Adıyaman University Training and Research Hospital. The files of 40 patients followed up due to seizures between September 2016 and July 2021, were examined retrospectively. 40 out of 45 patients satisfied the inclusion criteria. The files of 40 patients were retrospectively analyzed in terms of age, sex, gestational age, birth weight, mode of delivery, APGAR score, seizure etiology, intervention and treatment, electroencephalography (EEG), trans fontanel ultrasonography (USG) and brain magnetic resonance imaging (MRI) findings, length of hospital stay, and mortality rates. Results: The study group consisted of 40 patients, 21 girls (52.5%) and 19 boys (47.5%). Twenty-seven (67%) of the patient group were born at term and 13 (33%) preterm. The mean birth week was 38, and the mean birth weight was 2900 g. The underlying seizure etiology was unknown in 37.5% (n = 15) of cases, while the most common known etiological cause was hypoxic ischemic encephalopathy, seen in 20% (n = 8). The mortality rate in our patient group was 22.5% (n = 9). Conclusion: Among the known causes of neonatal convulsions, hypoxic-ischemic encephalopathy in term babies and germinal matrix bleeding in preterm babies were found to be the most common causes. However, despite all kinds of examinations and evaluations, the cause of a significant portion of them has not been determined. Long-term follow-up of newborns with convulsions is required to detect early neurodevelopmental problems that may develop during follow-up.

Comparison of the Distance of the Erector Spinae Muscle from the Skin at Different Thoracal Levels and Different Positions Under Ultrasonography

Background: The erector spinae plane block can be executed at various thoracic levels and in different positions. Our study aimed to determine the optimal distance of the erector spinae muscle from the skin and to identify the best ultrasonography imaging quality across different thoracic levels and positions. Materials and Methods: The erector spinae muscle was located using a high-frequency 10-15 MHz linear ultrasound probe at distinct thoracic levels (T1-T2, T5-T6, T11-T12) and in various positions (lateral, sitting, and prone). Results: The proximity of the erector spinae muscle to the skin was found to be significantly closer at the T5-T6 level compared to the T1-T2 and T11-T12 levels (p = 0.001; p < 0.01). In the prone position, the distance of the erector spinae muscle to the skin was significantly lower than in the lateral and sitting positions (p = 0.001; p < 0.01). Conclusions: In an ESPB to be applied at the T5-T6 thoracal level and in the prone position, the erector spinae muscle is closer to the skin, and the ultrasound image is better.

Tumor size measurements predicted by digital mammography, ultrasonography, and magnetic resonance imaging in primary invasive breast cancer disease

Background and objective: The size of the tumor significantly influences the prognosis and treatment approach for breast cancer patients. The aim of this study was to find the most accurate imaging method for estimating pre-treatment tumor size in women with newly diagnosed primary invasive breast cancer by comparing the predicted tumor size obtained from mammography, ultrasonography, and magnetic resonance imaging with the pathologic size obtained from the surgical specimens. Methods: This cross-sectional study included 181 primary invasive breast cancer patients from September 2021 to March 2023. The difference in tumor size was evaluated based on imaging and pathological reports. Variables such as age, breast density, and tumor characteristics like histologic type, grade, location, and side were recorded and analyzed. The American College of Radiology Breast Imaging Reporting and Data System was used for reporting. Data analysis, performed using SPSS Statistics software, included descriptive statistics, Spearman's correlation coefficient, and Lin's index. The statistical significance level was set at P <0.05. Results: The mean tumor size was 29.68, 29.07, 28.37, and 27.7mm by mammography, ultrasonography, magnetic resonance imaging, and pathology, respectively. All diagnostic procedures revealed a statistically significant correlation with pathologic tumor size with the Spearman correlation test, P = 0.000. MRI had the highest Lin’s concordance correlation coefficient (0.93). Conclusion: The study determined that all imaging modalities were accurate in estimating tumor size when compared to the gold standard of pathological specimens and that magnetic resonance imaging outperformed digital mammography and ultrasonography.

Reconstructing Quadriceps Tendon Disruptions in Post Total Knee Arthroplasty Patients with an Autogenous Peroneal Tendon Graft: A Viable Alternative.

Quadriceps tendon disruption post-total knee arthroplasty (TKA) is rare. Existing reconstruction procedures use allografts or synthetic meshes with varied success. This study evaluates outcomes with autogenous peroneal tendon grafts, a cost-effective alternative, compared to synthetic polypropylene mesh for quadriceps reconstruction. 16 patients who underwent extensor mechanism reconstruction between 2017 and 2021were retrospectively analysed. Parameters evaluated included type of reconstruction, extensor lag, IKDC (International Knee Documentation Committee) Score and AOFAS-Hindfoot-score (American Orthopaedic Foot and Ankle Society). At final follow-up, extensor lag for peroneal autograft group was 6.6° ± 1.5 and for synthetic polypropylene mesh group, 7.2° ± 0.7. Both groups improved in IKDC score (p < 0.01) AOFAS-Hindfoot-score was comparable for peroneal autograft patients with opposite side (p = 0.15). Autogenous peroneal tendon graft for quadriceps reconstruction could be viable, cost-effective alternative to allografts or synthetic meshes, with good clinical outcomes. Graphical abstract depicting the harvesting of the peronei grafts and their passage through the quadriceps tendon. Sonographic image showing the preoperative presence of a gap in the quadriceps tendon which is reconstructed post-operatively. The online version contains supplementary material available at 10.1007/s43465-024-01247-8.

DC-UNet: Looking for follicles in the ovarian ultrasound images

The auspicious initiation of human reproduction starts by releasing the ovum through ovulation within the ovary. Ceaseless monitoring of the female reproductive organs has now become essential for combating fertility-related issues and for successful assisted reproduction. Cases of infertility and demands for assisted reproduction in our modern liberated society are rapidly increasing. External or Transvaginal ultrasound imaging of the ovary provides us with vital information about the number, size, and position of the follicles in the ovary and their cumulative response to biological stimuli. Manual screening of thousands of USG images having lacs of follicles is an extremely strenuous job and prone to humane error. This paper propounded a new deep-learning architecture named Double Contraction-UNet (DC-UNet) which makes follicle segmentation fully automatic. This model restructured the U-Net architecture by introducing two contracting paths to segment the follicular object with higher accuracy. The model was trained and tested on approximately forty two thousand annotated ovarian 2D ultrasonography images extracted from USOVA3D Training Set 1. The proposed model outperforms the other U-Net-based state-of-the-art models when trained and tested on the same dataset. The proposed model has achieved an accuracy rate of 97.82%, a precision rate of 97.54%, a Recall value of 94.34%, an F1 Score of 95.91%, a Dice Score of 0.76, and a Jaccard Similarity Index of 0.59.

Retrospective analysis of data on the prevalence of malignant neoplasms in dogs and cats

The article presents the results of a study on the primary incidence of malignant tumors in dogs and cats in Moscow over the period from January 1, 2023, to July 1, 2024. The study was conducted on the basis of the Department of Diseases of Small Domestic, Laboratory and Exotic Animals and the Research Laboratory of Oncology, Ophthalmology and Animal Biochemistry of the Russian Biotechnological University “ROSBIOTECH”. The study included 208 cats and 325 dogs with primary, spontaneous malignant tumors of various origins. To confirm the diagnosis, a comprehensive approach was used, including clinical examination, hematological tests, and special diagnostic techniques such as ultrasonography, radiography, computed tomography (CT), and magnetic resonance imaging (MRI). Verification of the tumor process was based on cytological and histological methods.The purpose of this work is to analyze the structure of the incidence of small domestic animals with malignant tumors. As a result, we identified the most common types of tumors in cats and dogs. In cats, breast carcinoma was the most common type (44.23%), followed by lymphoma (18.27%), sarcomas (13.46%) and carcinomas (13.94%), as well as squamous cell carcinoma (6.25%). In dogs, breast carcinoma also accounted for the majority of cases (37.23%), along with sarcomas (23.38%), mastocytomas (16.31%), and carcinomas (14.15%).

Comprehensive Management of Thrombosed Lower Extremity Venous Aneurysms: A Single-Center Retrospective Analysis and Insights Into Clinical Strategies.

Venous aneurysms are rare vascular abnormalities associated with venous thromboembolism. In this study, we presented our experience in managing thrombosed lower extremity venous aneurysms and evaluate the impact of vitamin D deficiency and genetic thrombophilic risk factors on patient management and outcomes. A single-center retrospective observational analysis was conducted on ten patients with thrombosed lower limb venous aneurysms who underwent surgical procedures at our hospital from July 2014 to February 2023. Collected data included venous duplex ultrasonographic imaging and laboratory tests including genetic thrombophilic risk factors and assessments of vitamin D levels. There were 5 males and 5 females. The mean age was 46.6 ± 12.1years. The aneurysms were located in the popliteal vein in three patients, the great saphenous vein in six, and the small saphenous vein in one. Venous duplex imaging revealed saccular aneurysms in eight patients and fusiform aneurysms in two, with a mean diameter of 37.2 ± 10.6mm, ranging from 23 to 52mm. Laboratory tests indicated vitamin D deficiency in all of the patients, and genetic thrombophilic risk factors were identified in two cases. Surgical interventions consisted of tangential excision with lateral venorrhaphy in three patients and total excision and ligation in seven patients. The postoperative period was favorable for all patients. Surgical treatment of thrombosed venous aneurysms in the lower extremities is essential to prevent complications such as thromboembolism. A comprehensive approach, including knowledge of genetic risk factors and vitamin D levels, may improve patient outcomes.

Ultrasonographic measurement of the prostatic dimension-to-aortic luminal diameter in healthy intact male dogs and dogs with benign prostatic hyperplasia.

To establish ultrasonographic measurements of the prostatic dimension-to-aortic luminal diameter ratios including the prostatic volume-to-aortic luminal diameter ratio in healthy, intact male dogs and compare these ratios between healthy dogs and dogs affected by benign prostatic hyperplasia. Healthy dogs (n = 75) and dogs affected by benign prostatic hyperplasia (n=104) were included in the study. Prostate length, width, average height and aortic luminal diameter were measured from ultrasonographic images. In addition, prostatic volume was calculated, and prostatic volume-to-aortic luminal diameter were also compared. In healthy dogs, aortic luminal diameter was significantly associated with bodyweight and the prostatic width while body condition scores, prostate length and prostatic average height were not associated. Prostatic dimension-to-aortic luminal diameter ratios and prostatic volume-to-aortic luminal diameter ratio was not significantly different among dogs with different body condition scores either in healthy dogs or dogs affected by benign prostatic hyperplasia, except prostatic volume-to-aortic luminal diameter ratio in benign prostatic hyperplasia. Prostatic dimension-to-aortic luminal diameter ratios were significantly higher in benign prostatic hyperplasia while prostatic volume-to-aortic luminal diameter ratio significantly higher in healthy dogs. Prostatic dimension-to-aortic luminal diameter ratios demonstrated medium to high sensitivity and specificity when distinguishing between healthy dogs and dogs affected by benign prostatic hyperplasia. Prostatomegaly, should be considered when the prostatic dimension-to-aortic luminal diameter ratios increase. The calculated cut-off values were 3.68, 4.46 and 3.06 for prostate length-to-aortic luminal diameter, prostatic width- to-aortic luminal diameter and prostatic average height-to-aortic luminal diameter, respectively. The prostatic dimension-to-aortic luminal diameter ratios could be useful to evaluate the size of the prostate in dogs, as it is unaffected by the body condition scores.

Usefulness of color Doppler and strain elastography adjunctive to B-mode ultrasonography in the diagnosis of non-mass abnormalities of the breast: results of the BC-07 multicenter study of 385 cases.

The concept of non-mass abnormalities of the breast has been employed in Japan for approximately 20years. Although B-mode findings are classified as non-mass abnormalities, the usefulness of adding color Doppler ultrasonography (US) and strain elastography to B-mode US is unclear. Therefore, we conducted a multicenter study (JABTS BC-07) to establish the diagnostic criteria for breast US, including color Doppler and elastography, for non-mass abnormalities of the breast and verify their diagnostic usefulness. We registered US images of non-mass abnormalities of the breast and their clinical and histopathological data from 13 institutions (202 malignant and 183 benign non-mass lesions). Furthermore, we evaluated the centralized image interpretation usefulness of the diagnostic criteria for B-mode and color Doppler US, as well as the sensitivity and specificity when color Doppler US and elastography were added to B-mode US. Echogenic foci in the mammary gland (odds ratio 3.45, 95% confidence interval [CI] 1.92-6.19, p < 0.0001) and the configuration of internal solid components of the ducts (odds ratio 0.056, 95% CI 0.005-0.591, p < 0.0165) significantly differentiated benign and malignant non-mass abnormalities. The sensitivity of B-mode alone (83.7%) was significantly improved by adding color Doppler US (93.1%) (p = 0.0004); however, adding color Doppler US and elastography to B-mode US made no significant difference in either sensitivity or specificity. Although adding color Doppler US and elastography to B-mode US improved sensitivity, the diagnostic significance was limited. Therefore, a comprehensive diagnostic method comprising mammography and magnetic resonance imaging is warranted.

Using texture analysis of ultrasonography images of neck lymph nodes to differentiate metastasis to non-metastasis in oral maxillary gingival squamous cell carcinoma

ObjectTo differentiate between metastatic neck nodes and non-metastatic neck nodes in oral maxillary gingival squamous cell carcinoma, textural analysis of these lymph nodes in ultrasound images was performed in this study. MethodsTwenty five metastatic neck nodes and 28 non-metastatic neck nodes were enrolled in this study. Seventy eight texture characteristics were retrieved from the US images using the LIFEx software.The Mann Whitney U test was measurably utilized to survey on the off chance that there was a measurably noteworthy distinction within the textural characteristics between metastatic neck nodes and non-metastatic neck nodes. The capacity of the surface highlights to recognize between metastatic neck nodes and non-metastatic neck nodes was illustrated utilizing the Receiver Operating Characteristic analysis curves (ROC). Youden's J statistic was used to determine the cut-off positions in each ROC curve that maximized sensitivity and specificity. ResultsZone size non uniformity (ZSNU) highlight appeared the foremost noteworthy contrast between these nodes (p < 0.001).Strength had Area Under the Curve (AUC) of 0.811, specificity of 0.821 and sensitivity of 0.8, when measured at the cutoff value of 896.344. ConclusionsOur results come about uncovered that quality highlight may be the finest surface highlight to distinguish from non-metastatic neck nodes and to anticipate metastatic neck nodes in oral maxillary gingival squamous cell carcinoma.

Updated solution for diagnosis and management of calcinosis cutis: A retrospective review.

Calcinosis cutis is classified into 5 main types: dystrophic, metastatic, idiopathic, iatrogenic, and calciphylaxis. However, it is occasionally misdiagnosed as a malignancy and its management remains challenging. Therefore, in this study, we report our diagnostic and treatment experiences with patients with calcinosis cutis and suggest strategies for improving patient care. This retrospective study included 7 patients (4 men, 3 women; 44.4 ± 32.0 years old) who visited our hospital between March 2013 and December 2022 and were diagnosed with calcinosis cutis through histopathological procedures. The patients underwent complete excision of the mass without a safety margin. Frozen biopsy was not performed during surgery. No significant intraoperative or postoperative complications were noted after the application of various imaging techniques for diagnosis and follow-up. All patients showed complete recovery. Follow-up showed no recurrence or complications in the 6 patients who completed 1 year of follow-up. Radiological tests such as plain radiography, ultrasonography, computed tomography, and magnetic resonance imaging are important for accurate diagnosis and treatment of calcinosis cutis. This approach can ensure precise assessment of preoperative lesions, leading to safe and less invasive patient treatment, recurrence prevention, and complications of calcinosis cutis.

Urinary Tract Endometriosis: A Review of Literature

Objective: Deep endometriosis (DE) is the most severe form of endometriosis. Bowel and urinary tract are the most common sites of intrapelvic DE. Urinary tract endometriosis (UTE) mainly involves the bladder and the ureters. The two mostly accepted theories explaining the pathophysiology of UTE are the “Retrograde Menstruation Theory” and the “Müllerian Remnants Theory”. The purpose of this paper is to provide a review of literature on the UTE, a rare form, affecting only 1–6% of patients with endometriosis. Mechanism: A literature review was conducted using keywords specific to UTE and DE to identify peer-reviewed, original research articles published between 1996 and 2024. Findings in Brief: When the bladder is involved, the patient presents lower urinary tract symptoms. Ureteral endometriosis is usually asymptomatic, thus delaying early diagnosis and efficient treatment leading to cases of chronic ureteral stricture. Clinical history and examination as well as questionnaires play an important role in guiding the clinician. Diagnostic modalities include conventional imaging such as ultrasonography and magnetic resonance imaging (MRI) as well as invasive techniques such as cystoscopy. As for all endometriotic lesions, definitive diagnosis should be confirmed by histopathology. Treatment modalities include medical hormonal treatments or surgical treatment. There are a multitude of surgical techniques that are more or less invasive depending on the location and the extent of the lesion. Conclusions: UTE, is an underdiagnosed form of endometriosis, and specialists should be aware of this important entity, due to the serious health implications for women.

To find the correlation between transverse cerebellar diameter measured by cranial ultrasound within 48 h of birth and gestational age as estimated by last menstrual period

Background: Gestational age (GA) may be assessed at any time during pregnancy, and several modes of assessment exist, each requiring better diagnostic techniques that may result in more precise estimates of GA, which could lead to quicker medical management of a pregnant patient. The largest diameter across both hemispheres, measured from outer to outer margin, is the transverse cerebellar diameter (TCD). Aims and Objectives: We aimed to predict the correlation between TCD measured by cranial ultrasound within 48 h of birth and GA as estimated by the last menstrual period. Materials and Methods: The present study was conducted in the Department of Pediatrics, Dr. S. N. Medical College, Jodhpur, Rajasthan. Ethical clearance was obtained from the Institutional Ethical Committee. It was a cross-sectional observational study and the duration of the study was 6 months. We split the population into three groups based on GA: (a) &lt;32 weeks of GA, (b) 32–36+6 days of GA, and (c) 37–42 weeks of GA. We enrolled 25 neonates from each group. Results: A very strong positive correlation between TCD and GA in infants was &lt;32 weeks of gestation age, in infants 32–36 weeks+6 days of gestation age, and in infants 37–42 weeks of gestation age. Regression analysis shows a very strongly significant relationship. Hence, the TCD is a better predictor of GA in the third trimester. Our study reported that there is a close relationship between TCD and GA, with TCD increasing linearly from &lt;32 weeks to 42 weeks. GA can be predicted to be 1.43 weeks by assessing TCD on neonatal cranial ultrasonography images. Conclusion: The TCD is a better predictor of GA in the third trimester. Our study reported that there is a close relationship between TCD and GA, with TCD increasing linearly from &lt;32 weeks to 42 weeks.

Usefulness of Picture Archiving and Communication System-Based Quantitative Ultrasound Measurements in Evaluation of Allograft Dysfunction in Patients With Liver Transplantation.

The aim of this study was to assess the usefulness of picture archiving and communication system (PACS)-based quantitative grayscale ultrasonography (US) measurements in detecting allograft dysfunction in posttransplant patients. In this retrospective study, 116 patients with liver transplantation who underwent biopsy for allograft evaluation were recruited from the database. All participants had US images prior to procedure. Normal, acute cellular rejection (ACR), recurrent hepatitis (Hep), or combined (ACR/Hep) groups were generated based on pathology results. Region of interests were drawn for liver and rectus abdominus muscle to perform quantitative US analysis. The liver/muscle mean ratio (L/M) and heterogeneity index (HI; liver standard deviation/liver mean) were obtained. The ratios of groups were compared, and receiver-operating-characteristic analysis was performed. There was a significant difference between normal (n = 16) and each of other groups (ACR, 39; Hep, 36; combined, 25) for L/M and HI (P < 0.05). No significant difference was detected between ACR, Hep, and combined groups. The areas under the curve for L/M and HI were 0.755 (moderate) and 0.817 (good), respectively. To differentiate abnormal (ACR, Hep, and combined) from normal allografts sensitivity, specificity, PPV, and NPV were 50.0%, 87.5%, 96.2%, and 21.9% for cut point of L/M ≥1 and 84.0%, 68.8%, 94.4%, and 40.7% for cut point of HI ≥0.2 with odds ratios of 7.52 (for L/M ≥1) and 13.10 (for HI ≥0.2), respectively (P < 0.01). L/M has moderate and HI has good discrimination of normal from abnormal allograft in liver transplant patients. PACS-based quantitative US measurements is an objective, easy to use, noninvasive auxiliary tool to discriminate hepatic allograft dysfunction.

Intra-neural Ewing Sarcoma of the Radial Nerve Presenting as Wrist

Abstract Intra-neural Ewing sarcoma is an extremely rare tumour and only a few isolated case reports exist in the literature. A 32-year-old South Asian male presented with wrist and finger drops of 3 months duration. Further evaluation with ultrasonography and magnetic resonance imaging revealed a tumour of the radial nerve in the arm. A wide excision of the tumour was performed, and the radial nerve was reconstructed with cabled nerve grafts. A diagnosis of extra-osseous Ewing sarcoma (EES) was made after histopathological evaluation using immunohistochemistry techniques. The patient subsequently received chemotherapy and after 5 months, he is disease-free and pain-free. However, there has been no motor recovery yet. Clinical findings and imaging can help and characterise the tumour, but histopathology and analysis for EWSR1 gene rearrangement are essential to confirm the diagnosis. Wide surgical excision and chemotherapy are the mainstay of managing neural EES.

Exploring serum amino acid signatures as potential biomarkers in Hashimoto's thyroiditis patients.

Hashimoto's thyroiditis (HT) is an autoimmune disease caused by the immune system attacking healthy tissues. However, the exact pathogenesis of HT remains unclear. Metabolomic analysis was performed to obtain information about the possible pathogenic mechanisms and diagnostic biomarkers of HT. The amino acid profile was analyzed using an LC-MS/MS method using serum samples obtained from 30 patients diagnosed with ultrasonographic imaging and laboratory markers (thyroid stimulating hormone) free thyroxine and thyroid peroxidase) and 30 healthy individuals. There were statistically significant changes in 27 amino acids out of 32 amino acids analyzed (p < 0.05). Based on the receiver operating characteristic curve analysis, the six amino acid (1-methylhistidine, cystine, norvaline, histidine, glutamic acid and leucine) biomarkers showed high sensitivity, specificity (area under the curve > 0.98), positive likelihood ratio and low negative likelihood ratio. Also, according to pathway analysis, degradation of phenylalanine, tyrosine and tryptophan biosynthesis was the highest metabolic pathway according to the impact value (p < 0.001 and impact value = 1.0). We provide serum amino acid profiles of patients with Hashimoto's thyroiditis and identify five potential biomarkers for early diagnosis by clinicians.

Diagnostic Accuracy of USG and MRI for the Detection of Rotator Cuff Injury.

Rotator cuff disease frequently causes shoulder pain and is diagnosed using various radiological methods alongside history and physical examination. Arthrography has traditionally been employed for this purpose, but newer non-invasive techniques such as ultrasonography (USG) and magnetic resonance imaging (MRI) are increasingly used. However, no single method is universally agreed upon as the best diagnostic tool, each having its own limitations. To evaluate how effectively ultrasound and MRIcan diagnose rotator cuff tears. Seventy patients suspected of having a rotator cuff tear underwent investigations at the Radiology Department of Krishna Vishwa Vidyapeeth (Deemed to be University), Karad. USG and MRI examinations were done on the same day, along with a detailed history. USG was conducted using a GE LOGIQ P9 machine with a high-frequency 3-12 MHz transducer. MRI was conducted using a 1.5T SiemensMagnetom Avanto scanner. Pain and stiffness are the most common complaints in rotator cuff tears. The predisposing factors include male predominance, increasing age, dominant hand use, and trauma history. The supraspinatus tendon is the most frequently injured, with partial tears, especially articular surface tears, being more common than full-thickness tears. Clinical examinations, USG, and MRI are valuable in diagnosing rotator cuff tears. Our findings indicate that USGmay not be as reliable in detecting rotator cuff tears as once believed. A positive ultrasound result is more trustworthy than a negative one. In contrast, MRIdemonstrates greater sensitivity and overall diagnostic accuracy compared to both ultrasonography and clinical assessment for detecting rotator cuff tears.