Three-dimensional Ultrasonography Research Articles

Three-dimensional sonography has satisfied accuracy for detecting rotator cuff tears

BackgroundRotator cuff injuries and tears are common causes of shoulder pain and dysfunction, necessitating accurate diagnostic methods to guide clinical decision-making. This study evaluates the diagnostic utility of three-dimensional (3D) shoulder sonography in identifying rotator cuff injury and tear patterns.MethodsA comprehensive search across seven electronic databases, which included Cochrane Library, Embase, PubMed, Cochrane Library, China Biology Medicine (CBM) database, CNKI, Wanfang, and VIP database. These databases were utilized to retrieve articles that assess the diagnostic value of 3D shoulder sonography for identifying rotator cuff injuries and tear patterns. The effectiveness of 3D shoulder sonography was assessed in terms of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). For each parameter, the 95% confidence intervals were calculated. Additionally, summary receiver operating characteristic curves (SROCs) were constructed, allowing for a comprehensive evaluation of diagnostic accuracy, which is reflected in the area under the SROC curve (AUC).ResultsScreening of 8,508 identified nine literatures eligible for inclusion in the meta-analysis, encompassing a total of 366 patients. The analysis of detecting any rotator cuff tear revealed a sensitivity of 0.97 and specificity of 0.87, yielding a DOR of 90.03 and an AUC of 0.98. Furthermore, 3D shoulder sonography demonstrated satisfactory accuracy in detecting both full and partial-thickness rotator cuff tears (Sensitivity: 0.92 vs. 0.83, specificity: 0.94 vs. 097, and AUC: 0.96 vs. 0.95).ConclusionThis study indicates that three-dimensional sonography has satisfied accuracy for detecting rotator cuff tears.

Carotid plaque volume measurement in ischemic stroke: A pilot study

Objectives: Carotid atherosclerosis is a significant risk factor for acute ischemic stroke. Three-dimensional (3D) sonography is a new technique that can be used to analyze carotid plaque both quantitatively and qualitatively. The aim was to study carotid atherosclerosis in stroke patients and healthy controls in terms of plaque volume quantification by 3D ultrasound (US). Materials and Methods: An observational descriptive study was conducted in the stroke unit of a university referral hospital in South India. Patients with ischemic stroke between the ages of 20 and 70 years were studied, along with age- and sex-matched controls. Carotid sonography (2D and 3D) along with Doppler studies was done in all patients, using Philips Affiniti 50 US system. Vascular plaque quantification software was used to assess plaque volume. Results: Twenty-four subjects were recruited, and two were excluded from the study. Twelve were cases, and ten were controls. The mean carotid intima-media thickness (CIMT) (average CIMT in six sites in common carotid artery, three on each side) studied in patients was 0.65 ± 0.10 mm, while that for healthy subjects was 0.62 ± 0.06 mm. The mean plaque volume in patients with stroke or transient ischemic attack was 179.82 ± 310.3 mm3, and that in healthy subjects was 56.75 ± 69.6 mm3. Plaque heterogeneity, surface irregularity, and ulceration were found to be common in symptomatic carotid plaques. Conclusion: The 3D sonography is a non-invasive and simple feasible tool for the analysis of carotid plaque.

The Role of Sonography in the Case of Congenital Uterine Abnormality: Potential for an Improved Pregnancy Outcome

Three-dimensional (3D) sonography is a valuable imaging technique to evaluate the uterus and distinguish the different types of congenital uterine abnormalities. The provided case series demonstrates the unique diagnostic patient findings of a bicornuate uterus and an incompetent cervix. The patient presented over a series of multiple pregnancies that used cervical cerclage, to achieve an improved maternal-fetal outcome. In this patient, her uterine anomaly was diagnosed prior to pregnancy. During each gestation, close diagnostic attention was paid to the shape of the uterus, the location of the gestational, and the cervical length, by using transvaginal sonography. This imaging surveillance played an important diagnostic role in providing a better patient outcome for the patient’s multiple pregnancies. Continued research into the use of 3D sonography, for this specific diagnostic application, is needed to accelerate its use in determining the specific location of gestational sac(s).

Mechanical and electrical performances of ternary Cu-2.8%Ni-0.7%Si alloy modulated by ultrasonic solidification

One-dimensional (1D) and three-dimensional (3D) ultrasounds were introduced into the solidification process of ternary Cu-2.8wt%Ni-0.7wt%Si alloy together with the in-situ measurements of acoustic fields. In the case of 1D ultrasound, stable cavitation was the main form of acoustic energy transmission. The grain size of α-Cu dendrites was reduced because stable cavitation improved the wetting between impurities and alloy melt, which further promoted nucleation process. When 3D ultrasounds were applied, transient cavitation was the dominant mode of acoustic energy dissipation. This induced local high undercooling in alloy melt, causing a significant increase in bulk nucleation rates and the formation of numerous tiny α-Cu equiaxed grains. Meanwhile, as ultrasonic dimension increased, the strengthened acoustic streaming accelerated solute and thermal diffusion and weakened the preferred orientation of growing α-Cu grains. The proportion of low-angle grain boundaries (LAGBs) increased consequently, which suppressed the nucleation and growth of δ-Ni2Si discontinuous precipitates (DPs) during subsequent annealing treatment. The tensile strength and electrical conductivity of 3D ultrasonically solidified alloy after annealing reached 688.2 MPa and 2.7×107 S/m respectively, showing obvious advantages in synergetic mechanical and electrical performances.

Comparison of Two-Dimensional IOTA Simple Rules and Three-Dimensional Ultrasonography in Preoperative Assessment of Adnexal Masses

Abstract Objective Accurate preoperative characterization of adnexal masses is essential for optimal patient management. Two-dimensional ultrasonography (USG) based “International Ovarian Tumuor Analysis Simple Rules (IOTA-SR)” are used primarily in clinical practice. Three-dimensional (3D) USG is an emerging modality. The authors conducted this study to compare the performance of 3D USG with IOTA-SR for preoperative differentiation of benign and malignant adnexal masses. Methods This prospective observational study recruited 84 patients with adnexal masses undergoing surgical management. IOTA-SR and 3D USG with power Doppler examination were applied to characterize the masses and correlated with histopathology. Logistic regression analysis defined individual 2D and 3D USG parameters' significance in predicting malignancy. The receiver operating characteristic (ROC) curve was plotted for significant variables, and area under the curves (AUCs) with cutoff values were calculated using the Youden index. Results Out of the 84 adnexal masses, 41 were benign and 43 were malignant. IOTA-SR were conclusive in 88.1% (74/84) cases, with a sensitivity of 83.78% (95% confidence interval [CI]: 67.99–93.81%) and specificity of 89.19% (95% CI: 74.58–96.97%). The sensitivity and specificity of 3D USG with power Doppler were 84% and 88%, respectively, with an AUC of 0.96 (95% CI: 0.92–0.99). Ten cases were inconclusive by the IOTA-SR, and 3D USG could further correctly differentiate four of these cases. Conclusions The diagnostic performance of both techniques is comparable. With good diagnostic performance and easy applicability, IOTA-SR remain the standard of care. 3D USG, although a more objective assessment, requires further validation and standardization.

Association of Intrauterine Device Malposition With Previous Cesarean Delivery and Related Uterine Anatomical Changes.

We sought to determine the association between intrauterine device (IUD) malposition and previous cesarean delivery (CD) and related uterine anatomical changes. A retrospective cohort of all persons with an IUD presenting for two- and three-dimensional pelvic ultrasonography over 2 years, for any gynecologic indication, was compiled. IUD malposition was defined as IUD partially or completely positioned outside the endometrial cavity. Uterine position, uterine flexion, and cesarean scar defect (CSD) size were assessed. Patient characteristics and sonographic findings were compared between those with normally positioned and malpositioned IUD. Primary outcome was the rate of IUD malposition in persons with and without a history of CD. Logistic regression analysis was used to control for potential confounders. Two hundred ninety-six persons with an IUD had a pelvic ultrasound, 240 (81.1%) had a normally positioned IUD, and 56 (18.9%) had a malpositioned IUD. The most common location of IUD malposition was low uterine segment and cervix (67.9%). Malpositioned IUD was associated with referral for evaluation of pelvic pain (P = .001). Prior CD was significantly associated with a malpositioned IUD, after adjusting for confounders (aOR 3.50, 95% CI 1.31-9.35, P = .01). Among persons with prior CD, uterine retroflexion and a large CSD were independent risk factors for IUD malposition (aOR 4.1, 95% CI 1.1-15.9, P = .04 and aOR 5.4, 95% CI 1.4-20.9, P = .01, respectively). Prior CD is associated with significantly increased risk of IUD malposition. Among persons with previous CD, those with a retroflexed uterus and a large CSD are more likely to have a malpositioned IUD.

Prevalence of adenomyosis features in women scheduled for assisted reproductive treatment, using the Morphological Uterus Sonographic Assessment group definitions.

Studies that use standardized ultrasonographic criteria to diagnose adenomyosis in subfertile women are needed. These would improve the understanding of the disease burden and enable further studies on its impact on fertility and assisted reproductive treatment (ART) outcome. The aim of this study was to determine the prevalence of different features of adenomyosis in women scheduled for their first ART, diagnosed at two (2D) and three-dimensional (3D) transvaginal ultrasonography (TVUS) using the revised Morphological Uterus Sonographic Assessment (MUSA) group definitions. This was a prospective, observational cross-sectional study of subfertile women aged 25 to ≤39 years, that were referred to a university hospital for their first ART between December 2018 and May 2021. Of 1224 eligible women, 1160 women fulfilled the inclusion criteria and consented to participate in the study. All women underwent a systematic 2D and 3D TVUS examination. The primary outcome was the presence of direct and indirect features of adenomyosis, as proposed by the MUSA group. Secondary outcomes were to describe the ultrasonographic characteristics of the different features, as well as any difference in the diagnostics at 2D or 3D TVUS and any association with clinical characteristics such as endometriosis. At least one direct or indirect feature of adenomyosis was observed in 272 (23.4%, 95% confidence interval [CI] 21.0-25.9) women. Direct features that are pathognomonic for the disease were observed in 111 (9.6%, 95% CI, 7.9-11.3) women. Direct features were visible only at 3D TVUS in 56 (4.8%, 95% CI 3.6-6.1) women, that is, 56/111 (50.5%) of women with at least one direct adenomyosis feature. Direct features were more common in women with endometriosis (OR 2.8, 95% CI 1.8-4.3). We found than one in 10 women scheduled for ART had direct features of adenomyosis at ultrasound examination. The present study suggests that the use of 3D TVUS is an important complement to 2D in the diagnostics of adenomyosis. Our results may further improve the counseling of women scheduled for ART and enables future studies on the impact of different features of adenomyosis on subfertility, ART results and obstetric outcomes.

Application value of cranial ultrasonography in quantitative evaluation of neonatal intracranial hemorrhage.

Intracranial hemorrhage is a severe cranial disease in the perinatal period. We aimed to explore the feasibility and accuracy of three-dimensional (3D) ultrasonography for the quantitative evaluation of neonatal intracranial hemorrhage. A total of 374 neonates with suspected intracranial hemorrhage from January 2017 to December 2019 were selected to be primarily screened by cranial ultrasonography and then diagnosed by cranial CT scan. The examination results were compared to analyze the feasibility and accuracy of 3D ultrasonography in quantifying blood loss. CT scan showed that there were 102 cases of Papile grade I, 106 cases of grade II, 124 cases of grade III and 42 cases of grade IV. 3D ultrasonography showed that there were 108 cases of Papile grade I, 98 cases of grade II, 130 cases of grade III and 38 cases of grade IV. The diagnostic results of these two methods were not significantly different (P>0.05). The accuracies of CT scan for subventricular, intraventricular, subdural, subarachnoid and intraparenchymal hemorrhages were 47.33%, 31.24%, 94.62%, 91.73% and 91.35% respectively, and those of 3D ultrasonography were 98.74%, 96.37%, 91.51%, 90.41% and 97.64% respectively. The accuracies of 3D ultrasonography were significantly superior to those of CT scan for subependymal, intraventricular and intraparenchymal hemorrhages (P<0.05). Neonatal intracranial hemorrhage can be well diagnosed by cranial ultrasonography which timely provides evidence for clinicians, thereby elevating the cure rate and reducing the mortality rate and incidence rate of sequelae. 3D ultrasonography is feasible and accurate for the quantitative evaluation of neonatal intracranial hemorrhage, thus being of great significance to prognostic determination in clinical practice.

Learning curve for fusion magnetic resonance imaging targeted prostate biopsy and three-dimensional transrectal ultrasonography segmentation.

To report the learning curve of multiple operators for fusion magnetic resonance imaging (MRI) targeted biopsy and to determine the number of cases needed to achieve proficiency. All adult males who underwent fusion MRI targeted biopsy between February 2012 and July 2021 for clinically suspected prostate cancer (PCa) in a single centre were included. Fusion transrectal MRI targeted biopsy was performed under local anaesthesia using the Koelis platform. Learning curves for segmentation of transrectal ultrasonography (TRUS) images and the overall MRI targeted biopsy procedure were estimated with locally weighted scatterplot smoothing by computing each operator's timestamps for consecutive procedures. Non-risk-adjusted cumulative sum (CUSUM) methods were used to create learning curves for clinically significant (i.e., International Society of Urological Pathology grade ≥ 2) PCa detection. Overall, 1721 patients underwent MRI targeted biopsy in our centre during the study period. The median (interquartile range) times for TRUS segmentation and for the MRI targeted biopsy procedure were 4.5 (3.5, 6.0) min and 13.2 (10.6, 16.9) min, respectively. Among the 14 operators with experience of more than 50 cases, a plateau was reached after 40 cases for TRUS segmentation time and 50 cases for overall MRI targeted biopsy procedure time. CUSUM analysis showed that the learning curve for clinically significant PCa detection required 25 to 45 procedures to achieve clinical proficiency. Pain scores ranged between 0 and 1 for 84% of patients, and a plateau phase was reached after 20 to 100 cases. A minimum of 50 cases of MRI targeted biopsy are necessary to achieve clinical and technical proficiency and to reach reproducibility in terms of timing, clinically significant PCa detection, and pain.

Improving Prenatal Diagnosis Precision for Congenital Clubfoot by Using Three-Dimensional Ultrasonography.

Prenatal diagnosis of clubfoot traditionally relied on two-dimensional ultrasonography. To enhance diagnosis and predict postnatal outcomes, we examined the parameters that differentiate pathological clubfoot using three-dimensional ultrasonography. In our retrospective study, we examined the findings of prenatal ultrasound and the postnatal outcomes of pregnancies with suspected congenital clubfoot between 2018 and 2021. Based on the three-dimensional perspective, we measured the angles of varus, equinus, calcaneopedal block, and forefoot adduction and compared the sonographic variables between the postnatal treated and non-treated groups. We evaluated 31 pregnancies (47 feet) with suspected clubfoot using three-dimensional ultrasonography. After delivery, a total of 37 feet (78.7%) underwent treatment involving serial casting only or additional Achilles tenotomy. The treated group showed significantly greater hindfoot varus deviation (60.5° vs. 46.6°, p = 0.026) and calcaneopedal block deviation (65.6° vs. 26.6°, p < 0.05) compared to the non-treated group. The calcaneopedal block had an area under the curve of 0.98 with a diagnostic threshold of 46.2 degrees (sensitivity of 97%, specificity of 90%, positive predictive value of 97%, and negative predictive value of 90%). During prenatal evaluation of clubfoot using three-dimensional ultrasonography, the calcaneopedal block deviation has the potential to predict postnatal treatment.

Detection of uterine abnormalities using three-dimensional vaginal ultrasound in infertile women undergoing assisted reproductive techniques

Abstract Background: Uterine shape and cavity abnormalities form a common cause of subfertility, for which thorough assessment is considered as a core part in infertility evaluation. A variety of modalities (invasive and none invasive) such as hysterosalpingography, transvaginal sonography, diagnostic hysteroscopy, two-dimensional hysterosonography, and three-dimensional hysterosonography can be used for the diagnosis of uterine abnormalities. Objectives: To address the detection rate of uterine and endometrial abnormalities in infertile women undergoing assisted reproductive techniques (ART) using three-dimensional vaginal ultrasonography. Materials and Methods: A cross-sectional observational study that involved 211 subfertile women who were arranged to undergo ART for different causes of infertility. After taking their verbal consent for participation in this study, all women examined by 2D vaginal U/S for initial assessment of their pelvic anatomy then followed by three-dimensional U/S with or without saline infusion for further assessment of the uterine and endometrial cavity morphology. Women with ultrasound detected endometrial abnormalities further underwent hysteroscopic assessment, histopathological specimens were taken and were treated as recommended by their gynecologist. Results: Twenty-two percent of the studied group discovered to have uterine and/or endometrial abnormalities including endometrial polyps and uterine myomas are the most commonly detected abnormalities while congenital uterine malformation detected in 3.8% of the total patients using three-dimensional ultrasonography. Conclusion: Uterine and endometrial abnormalities are common in subfertile patients, the prevalence of uterine and endometrial abnormalities (endometrial polyps or irregularities, uterine myomas including submucous one) was 22%, whereas congenitally maldeveloped uteri were detected in 3.8% of women undergoing ART (using 3D U/S) which may have a negative impact on ART outcome.

Comparative Study Between Three-Dimensional Transvaginal Ultrasonography and Hysteroscopy In The Diagnosis Of Uterine Cavity Abnormalities In Infertile Women

Comparative Study Between Three-Dimensional Transvaginal Ultrasonography and Hysteroscopy In The Diagnosis Of Uterine Cavity Abnormalities In Infertile Women

Contemporary diagnosis and management of gallbladder polyps

Gallbladder (GB) polyps are present in 5%–10% of the general population and consist of true neoplastic polyps (adenomas) and pseudopolyps (predominantly cholesterol, inflammatory, hyperplastic, focal adenomyomatosis). True polyps, although relatively rare neoplastic lesions (0.5%) are considered an important factor in malignant transformation and cancer development (5%) when their size is ≥ 1 cm. Given that it is essential to diagnose GB adenocarcinoma at an early stage to optimize therapeutic management, controversy exists about whether cholecystectomy is always necessary. Their imaging characteristics, size ≥ 1 cm, age &gt; 50 years and genetic predisposition determine the indications for immediate cholecystectomy. In younger patients with polyps &lt; 1 cm in size and without a familial history of GB carcinoma, imaging follow-up by ultrasound (US) seems to be a reasonable recommended policy. A scoring system by multivariate analysis (cross-sectional area &gt; 123 mm2, positive blood flow signal, age &gt; 55.5 years, alanine aminotransferase (ALT) levels &gt; 50 U/L and an ALT/AST (aspartate aminotransferase) ratio &gt; 0.77) can accurately predict true polyps. The widely accepted size threshold for US follow-up is 7 mm, and for intervention, it is 10 mm. Computed tomography or better magnetic resonance imaging can overcome any misdiagnosis of conventional US incidental findings alone that may lead to potentially unnecessary operations. In challenging cases, high-resolution US, novel three-dimensional US, endoscopic US or contrast-enhanced endoscopic US could be helpful. Novel microflow imaging can safely predict polyps. Risk factors for malignancy include age &gt; 60 years, large gallstones, primary sclerosing cholangitis, Asian ethnicity and sessile polyps accompanied by focal gallbladder wall thickening &gt; 4 mm. For polyps sized 6–9 mm, the absence of growth at recommended follow-up (6 months, one year, and two years) indicates treatment discontinuation; however, it is not required for size &lt; 5 mm without risk factors. In addition to laparoscopic cholecystectomy, the standard management, novel interventional modalities preserving the GB in selected cases include per-oral transmural endoscopic resection of GB polyps after a bridge of endoscopic US-guided cholecystostomy or laparoscopic gallbladder-preserving polypectomy. Generally, there are still no precise and strong evidence-based guidelines; thus, the management policy of GB polyps should be individualized in ambiguous cases.

Three-dimensional freehand ultrasonography to measure muscle volume of the lumbar multifidus: Reliability of processing technique and validity through comparison to magnetic resonance imaging.

There is a growing interest in muscle characteristics of the lumbar multifidus related to low back pain, but findings between studies are inconsistent. One of the issues explaining these conflicting findings might be the use of two-dimensional measures of cross-sectional area and thickness of the lumbar multifidus in most studies, which might be a suboptimal representation of the entire muscle volume. A three-dimensional volumetric assessment, combined with standardized imaging and processing measurement protocols, is highly recommended to quantify spinal muscle morphology. Three-dimensional freehand ultrasonography is a technique with large potential for daily clinical practice. It is achieved by combining conventional two-dimensional ultrasound with a motion-tracking system, recording the position and orientation of the ultrasound transducer during acquisition, resulting in a three-dimensional reconstruction. This study investigates intra- and interprocessor reliability for the quantification of muscle volume of the lumbar multifidus based on three-dimensional freehand ultrasound and its validity, in 31 patients with low back pain and 20 healthy subjects. Two processors manually segmented the lumbar multifidus on three-dimensional freehand ultrasound images using Stradwin software following a well-defined method. We assessed the concurrent validity of the measurement of multifidus muscle volume using three-dimensional freehand ultrasound compared with magnetic resonance imaging in 10 patients with low back pain. Processing reliability and agreement were determined using intraclass correlation coefficients, Bland-Altman plots, and calculation of the standard error of measurement and minimal detectable change, while validity was defined based on correlation analysis. The processing of three-dimensional freehand ultrasound images to measure lumbar multifidus volume was reliable. Good to excellent intraclass correlation coefficients were found for intraprocessor reliability. For interprocessor reliability, the intraclass correlation coefficients were moderate to good, emphasizing the importance of processing guidelines and training. A single processor analysis is preferred in clinical studies or when small differences in muscle volume are expected. The correlation between magnetic resonance imaging and three-dimensional freehand ultrasound measurements of lumbar multifidus volume was moderate to good but with a systematically smaller multifidus volume measured on three-dimensional freehand ultrasound. These results provide opportunities for both researchers and clinicians to reliably assess muscle structure using three-dimensional freehand ultrasound in patients with low back pain and to monitor changes related to pathology or interventions. To allow implementation in both research and clinical settings, guidelines on three-dimensional freehand ultrasound processing and training were provided.

Cesarean Section Scar Niche Evaluation in Non-Pregnant Women Using Three-Dimensional Ultrasound

Cesarean Section Scar Niche Evaluation in Non-Pregnant Women Using Three-Dimensional Ultrasound

The advantages of utilizing different ultrasound imaging techniques on joints of human cadavers in the teaching of anatomy – A scoping review

BackgroundA common approach to define sonoanatomy is a reciprocal exchange of macroscopic and microscopic information in ultrasound imaging. High-resolution ultrasound has been long established and is crucial as an inexpensive and adaptable tool, not just in clinical settings but also while teaching anatomy. Early application of ultrasonography provides medical students with a couple of benefits: they acquire an improved understanding of anatomy and learn how to use it. MethodsA comprehensive literature review has been carried out, with relevant studies discovered in the following databases: MEDLINE, EMBASE, CENTRAL, BIOSIS Previews and Web of Science Core Collection. Gray literature was also considered in two different ways: (1) Regarding grey literature databases: National Gray Literature Collection. (2) For PhD theses and dissertations, the databases EThOS and Open Access Theses and Dissertations were screened for relevant studies by combining the keywords used in the search string.The reference lists of all relevant papers were scanned. Search process was performed on January 3rd, 2023. The search string was developed with the aid of and finally checked by a professional librarian.Only ultrasound studies on human cadavers were included, not animals or phantoms. If the studied subject was a joint, the article was included. Only B-Mode ultrasound was included, whereas Elastosonography, Doppler sonography and quantitative approaches including among others sound speed, backscatter attenuation were excluded. Intravascular, intraosseous, intraarticular, and three-dimensional or four-dimensional ultrasonography were also eliminated from the analysis. All appropriate information comprising articles, PhD theses, dissertations and chapters in textbooks were considered. There were solely English and German studies covered. There was no additional restriction on the publishing year.The included studies' general characteristics and ultrasound techniques were taken from them and examined. Using VOS viewer, a keyword analysis was also carried out. Results142 of the 8899 results that were returned by the search satisfied the requirements.With a quarter of the included studies, the knee joint was the most extensively studied joint, followed by the elbow joint (10.6%) and the shoulder joint (9.2%). The methodological analysis includes 125 studies. Both the sample size and the ultrasonographer's qualifications were diverse. The probe position and the ultrasound method were precisely documented so that a reader could duplicate them in about three-quarters of the included studies (72.8%). ConclusionThe current study, in our perspective, is the first scoping review to screen ultrasound studies on human cadaver joints. A heterogeneous field was shown by the methodological investigation. We suggest using a uniform method for conducting and presenting ultrasound examinations in future studies.

Combination of serum FOXR2 and transvaginal three-dimensional power Doppler ultrasonography in the diagnosis of uterine lesions.

Cervical carcinoma and endometrial carcinoma are the most common gynecologic cancers worldwide. Forkhead-box R2 (FOXR2) plays an important role in the progression of various malignant tumors. However, the effects of FOXR2 on the development of uterine lesions remain unclear. This prospective observational study aimed to investigate the diagnostic performance of FOXR2 and transvaginal three-dimensional power Doppler ultrasonography (3D-PDU) for malignant uterine lesions. This study included 404 uterine lesion patients and 200 healthy individuals who visited the hospital for a physical examination from April 2014 to May 2016. All patients received FOXR2 detection and 3D-PDU examination at admission. The demographic data and clinical data, including age, body mass index (BMI), and the International Federation of Gynecology and Obstetrics (FIGO) stage, were collected. All the patients were followed up for 5 years. The overall survival (OS) was analyzed using Kaplan-Meier (K-M) curve analysis. The diagnostic value of FOXR2 and 3D-PDU was evaluated using receiver operating characteristic (ROC) curves. Serum levels of FOXR2 mRNA were upregulated in patients with malignant uterine lesions. Patients with high expression of FOXR2 showed a higher expression of the cancer biomarkers CA125, CA199, CEA, and SCCA. It was also found that FOXR2 expression was associated with the clinical outcomes of patients with malignant uterine lesions. Moreover, higher expression of FOXR2 predicted a poor prognosis. The combined use of FOXR2 and 3D-PDU showed favorable potential for the diagnosis of malignant uterine lesions, especially for cervical carcinoma and endometrial carcinoma. The combination of serum FOXR2 and transvaginal 3D-PDU has a potential in the diagnosis of uterine lesions.

Impact of an accessory cavitated uterine mass on fertility: case presentation and review of the literature

We report a case of an accessory cavitated uterine mass (ACUM) in a patient with infertility and chronic pelvic pain. In addition, we summarize the literature to better characterize ACUM diagnosis and management. A comprehensive literature search using the PubMed database was performed through April 2023. Historical ACUM diagnostic criteria were applied as inclusion criteria. Descriptive statistics and statistical evaluation were reported. A 31-year-old nulligravid woman presented with chronic pelvic pain, dysmenorrhea, primary infertility, and history of endometriosis. Three-dimensional ultrasonography identified an ACUM and laparoscopic excision provided complete resolution of symptoms. Subsequently, she conceived without assistance twice with uncomplicated vaginal deliveries. A total of 154 articles were identified, 34 papers met inclusion criteria and were individually reviewed, consisting of 70 reported cases. The most common presenting complaints were dysmenorrhea (81.4%), chronic pelvic/abdominal pain (54.1%), and refractory pain (34.3%). Diagnostic imaging included magnetic resonance imaging (62.9%) and transvaginal ultrasound (55.7%). Management included resection via laparoscopy (75.7%) or laparotomy (18.6%), or hysterectomy (5.7%). Of cases with reported outcomes, 90.7% had complete relief of symptoms after surgery. ACUM often presents with dysmenorrhea, chronic pelvic pain, or abdominal pain and is identifiable on magnetic resonance imaging as a hyperenhancing mass. Three-dimensional transvaginal ultrasound can also accurately identify ACUM. A total of 90.7% of patients had complete relief of symptoms after intervention. It is important to identify ACUM early to relieve pain and reduce unnecessary interventions. Like our patient, other reports have demonstrated concomitant infertility and endometriosis. However, further investigation is needed to explore the association between infertility and ACUM.

Evaluation of meniscus extrusion during stair ambulation in healthy volunteers using dynamic ultrasonography: a feasibility study

PurposeThis study aimed to investigate the feasibility of evaluating medial meniscus extrusion (MME) during stair ambulation.MethodsTwenty healthy young participants (mean age, 22.4 ± 0.9 years) were recruited for this cross-sectional study. Synchronization between the three-dimensional motion system and ultrasonography was used to quantify the extent of meniscal extrusion and knee angles during different tasks, including gait, stair ascent, and stair descent. In particular, ultrasonography was used to record the movements of both the middle and posterior segments of the meniscus to obtain detailed information about these movements in relation to the knee angle. The difference between the maximum MME and the MME at the initial contact (ΔMME) was evaluated during each task in the stance phase.ResultsVisualization of the meniscus in the middle segment was limited with increasing knee flexion angle, whereas the posterior segments were visible during all tasks. ΔMME of the posterior segment during stair ascent and descent was higher than that during gait (gait: 0.68 ± 0.20 mm, ascent: 1.00 ± 0.39 mm, descent: 0.90 ± 0.27 mm, gait-ascent: p = 0.009, gait-descent: p = 0.004).ConclusionsEvaluation that includes the posterior segment enables visualization of the medial meniscus and detection of its specific behavior during stair ambulation. These findings demonstrate the feasibility of evaluating meniscus dynamics during stair ambulation, and could contribute to a better understanding of these dynamics.

Ultrasound in Female Urinary Incontinence.

Urinary incontinence (UI) is a common health condition that may interfere with the quality of life. A comprehensive evaluation of female UI helps with effective and safe treatments. Ultrasound has gained popularity to explore UI recently because it can collect crucial information for treatment planning and counseling. Translabial and introital approaches are commonly and reliably applied to ultrasound. The images can be obtained using two-dimensional and three-dimensional ultrasounds. Ultrasound is the only modality capable of confirming the presence or absence of a mid-urethral sling (MUS) and is able to demonstrate bulking agents as well. Although some of the ultrasound findings may only be incidental or supplementary to the patient's symptoms, ultrasound benefits for investigating the pathophysiology of UI and surgical outcomes of MUS procedures. It is anticipated that standardization in terminology, measurement techniques, and reporting can be established in the near future.