Ultrasound Measurements Research Articles

The Relationship between Caesarean Scar Defect Ultrasound Measurements and Post-menstrual Spotting (RMT/AMT as a Powerful Predictor of Niche); A prospective Cohort Study

The Relationship between Caesarean Scar Defect Ultrasound Measurements and Post-menstrual Spotting (RMT/AMT as a Powerful Predictor of Niche); A prospective Cohort Study

Comparison of Ultrasound Findings Associated with Adverse Fetal, Obstetric, and Neonatal Outcomes in Pregestational Type 1 And Type 2 Diabetes: A Systematic Review.

We aimed to summarize the available evidence examining the association between prenatal ultrasound findings and adverse fetal, obstetric, and neonatal outcomes in pregnancies complicated by type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) and to evaluate whether the predictive value of ultrasound findings for adverse outcomes varies between T1DM and T2DM pregnancies. We conducted a systematic review of the existing literature through August 12, 2024. We included articles in English that reported associations between ultrasound findings and fetal, obstetric, and neonatal outcomes in pregnant people with T1DM and T2DM. Two independent reviewers examined articles at the abstract level and, if eligible, at the full-text level; disagreements were adjudicated by a third reviewer. Of the 2,088 unique citations reviewed, 12 studies met the inclusion criteria describing associations between ultrasound findings and fetal, obstetric, and neonatal outcomes among a total of 1,165 pregnant people with T1DM and 489 pregnant people with T2DM. Most studies (10/12) examined the association between ultrasound measures of growth, including estimated fetal weight (EFW) and its individual components, abdominal wall thickness, head circumference to abdominal circumference (HC/AC) ratio, and birthweight, large for gestational age (LGA) or small for gestational age (SGA). Studies did not examine stillbirth, neonatal demise, or maternal outcomes other than cesarean section. This systematic review synthesizes the available literature on ultrasound risk markers of adverse fetal, obstetric, and neonatal outcomes separately in pregnant people with T1DM and T2DM. We identified very few studies that distinguished between pregnant people with T1DM and T2DM, and the majority focused on surrogate outcomes (e.g., LGA, SGA) of morbidity. Our findings highlight the need for further studies investigating these distinct diseases to provide evidence for antenatal management recommendations.

Awareness of down syndrome screening among educated Muslim women is associated with a favorable attitude toward testing

ObjectiveThere is a general assumption that Muslim women refuse Down syndrome screening, and therefore, many health practitioners do not offer it or briefly discuss it with their participants. This study aims to objectively assess women’s awareness, knowledge, and attitudes toward Down Syndrome screening (D.S.S) in a Muslim-majority population.MethodsWe conducted a cross-sectional study among attendees of antenatal clinics at a major university hospital in Saudi Arabia, aiming for a sample size of at least 385 Muslim women. A semi-structured questionnaire assessed awareness of different D.S.S. options and the source of that information (2 items), specific knowledge of D.S.S. (14 items), and attitudes (4 items). The knowledge and attitudes scores were calculated using a five-level agreement Likert-type scale.ResultsAmong 434 participants, with an even distribution among all age groups and a majority of a college degree holder or higher (71%), 178 (41.0%) reported awareness of D.S.S. Factors associated with increased awareness were maternal age above 40 or those under 30, nulliparity, and extended family history of fetal congenital anomalies (P-value = 0.03,0.015, and 0.017, respectively). Recognized tests were ultrasound measurement of nuchal translucency (71.9%) and first-trimester serum screening (58.4%). The sources of knowledge were obstetricians (53.9%), followed by family and friends (27.0%). The overall mean ± SD knowledge score was 53.9 ± 8.7 out of 70, and the mean attitude score was 17.4 ± 2.9 out of 20. Having 1 or 2 children is associated with a higher knowledge score, and most participants who reported awareness of D.S.S. (51.7%) had a favorable attitude toward screening.ConclusionAwareness of D.S.S. among Muslim women is associated with favorable attitudes towards testing, contradicting the general assumption and highlighting the need for systematic education to increase awareness and subsequent testing uptake.

Endoscopic balloon dilatation of primary obstructive megaureter: An effective first line management in children

This study evaluates outcomes of endoscopic balloon dilatation (EBD) in the management of primary obstructive megaureter (POM) in children. Retrospective data between 2013 and 2023 from two tertiary paediatric surgical centres in the UK were reviewed. Pre and post-operative clinical and imaging parameters of children managed with EBD were assessed. Failure of procedure was defined as requiring further intervention due to persistent/recurrent symptoms, upper tract dilatation and/or obstruction on MAG3 over the follow up period. 55 children with 61 renal units were evaluated. Median age at treatment was 18 months with a median follow up of 24 months. There was significant reduction in upper tract ultrasound measurements following balloon dilatation but there was no significant difference between the pre and post-operative renal function on MAG3. No significance difference was demonstrated when the outcomes of cutting and non-cutting balloons were compared. No significant difference was shown when outcomes after EBD were compared between infants vs older children as well as ureteric dilatation less than or over 25mm (p=0.841). 87% were successfully treated with a single dilatation and this increased to 95% after second dilatation. The remaining 5% had ureteric re-implantation. Although a retrospective study, the patient population is relatively large. 87% success rate shown after EBD is comparable to similar studies. It has been suggested that children less than 12months and those with severe ureteric dilatation (>25mm) may not be suitable for EBD. No significant difference was demonstrated when the outcomes of these categories of children were compared to other children with POM. All of the patients that had repeat balloon dilatation required no further intervention, a finding that has so far not been well evaluated in available literature. This study demonstrates 87% success rate after single EBD in children with POM and this outcome increased to 95% following a second dilatation. EBD is shown to be an effective definitive surgical management option of POM. It can be safely offered as first line management in all patient groups and repeated if no initial response.

Evaluation of Sonographic Muscle Measurement Using Established Muscle Markers.

Loss of muscle quantity and function is associated with frailty and reduced quality of life. Sonography is a simple option to quantify muscle mass, which could be included into routine diagnostic workup. This study was designed to prospectively evaluate sonographic measurement and to compare it with established measurements of muscle quantity and function. Between March 2020 and May 2022, 723 patients were enrolled in the study. Psoas muscle area index (PMAI) and psoas muscle thickness height index (PMTI) were quantified. Thigh muscle thickness indices (TMTI) were either measured without compression (fTMTI) or under compression (cTMTI). Variation coefficient (VC) as well as intra- and inter-observer reliability were analyzed. The reliability and reproducibility of the sonographic morphometry were assessed using two examiners. Sonographic morphometry was compared with established measurements of muscle using computed tomography and hand grip strength, respectively. In 156 patients, sonographic indices were compared with corresponding CT indices. Of the 723 patients included, sonographic indices were compared with hand strength in 429 patients. Interobserver and intraobserver variability showed better results for the femur indices than for the psoas indices (correlation coefficient: 0.8697/0.9118 vs 0.7502/0.7319). Psoas muscle indices correlated best with the reference standard of the SMI. The optimal cut-off for each muscle index for determining muscle loss according to the SMI and hand grip strength was calculated. Sonography can simplify muscle measurement and should be used in the future. Sonographic muscle indices have the potential to simplify evaluation, especially in risk groups such as patients with liver cirrhosis or other wasting disorders.

Non-invasive assessment of esophageal and fundic varices in patients with primary biliary cholangitis.

The Baveno VII consensus recommends endoscopic screening for varicose veins in cases of liver stiffness measurement (LSM) ≥ 20 kPa or platelet count ≤ 150 × 109/L. Whether this approach was appropriate for patients with primary biliary cholangitis (PBC) remains uncertain. This study expanded the observed risk factors by adding analysis of ultrasound images as a non-invasive tool to predict the risk of esophageal or fundic varices. We enrolled 111 patients with PBC whose complete ultrasound images, measurement data, and LSM data were available. The value of the periportal hypoechoic band (PHB), splenic area, and LSM in determining the risk of varicose veins and variceal rupture was analyzed. A prospective cohort of 67 patients provided external validation. The area under the receiver operating characteristic curve (AUC) for predicting varicose veins using LSM > 12.1 kPa or splenic areas > 41.2 cm2 was 0.806 (95% confidence interval (CI): 0.720-0.875) and 0.852 (95% CI: 0.772-0.912), respectively. This finding could assist in avoiding endoscopic screening by 76.6% and 83.8%, respectively, with diagnostic accuracy surpassing that suggested by Baveno VII guidelines. The AUCs for predicting variceal rupture using splenic areas > 56.8 cm2 was 0.717 (95% CI: 0.623-0.798). The diagnostic accuracy of PHB for variceal rupture was higher than LSM and splenic areas (75.7% vs. 50.5% vs. 68.5%). We recommend LSM > 12.1 kPa as a cutoff value to predict the risk of varicosity presence in patients with PBC. Additionally, the splenic area demonstrated high accuracy and relevance for predicting varicose veins and variceal rupture, respectively. The method is simple and reproducible, allowing endoscopy to be safely avoided. The measurement of the splenic area and identification of the periportal hypoechoic band (PHB) on ultrasound demonstrated high accuracy and relevance for predicting the risk of esophageal or fundic varices presence and variceal rupture, respectively. Predicting varices in patients with primary biliary cholangitis (PBC) can reduce the morbidity and mortality of gastrointestinal hemorrhage. Transient elastography (TE) and ultrasound play an important role in predicting patients with PBC with varices. TE and ultrasound can predict varicose veins and variceal rupture. Liver stiffness measurement and splenic area measurements can allow endoscopy to be safely avoided.

Comparing Abdominal and Retroperitoneal Organ Sonographic Measurements to Postdissection Measurements: A Pilot Study

Objective: Variation in organ size can occur due to different sonographic scan planes used to make measurements. Diagnostic accuracy may be compromised due to the variations in organ measurement. Therefore, the aim of this study was to compare sonographic measurements and actual organ measurements, taken predissection and postdissection, to determine the accuracy of sonographic measurements, taken in various sonographic scan planes. Materials and Methods: Sonographic organ measurements were made of the liver, kidney, and spleen, prior to cadaver dissection. Liver length measurements were acquired in the midclavicular and intercostal sonographic scan planes. All kidney length, height, and width measurements were acquired scanning from the anterior and coronal planes. Spleen measurements were acquired using an intercostal sonographic scan plane, using longest dimension for length, and acquiring transverse measurements from both a 90-degree and a 180-degree transducer rotation. Descriptive statistics were reported using mean, standard deviation, median, and interquartile range. Results: Liver length, spleen length, right kidney length and width, and left kidney width showed no measurement differences. Sonographic measurements of right kidney height varied ( P < .0001). The sonographic left kidney length was more accurate when acquired in the coronal plane ( P = .006), and the height measurement was more accurate taken from the anterior plane ( P < .001). Spleen width varied between the 90-degree and 180-degree transducer rotation, and postdissection measures ( P = .0010). Conclusion: This pilot study would suggest that there is a need for the development of standardized sonographic organ measurement protocols.

What affects carotid intima media thickness more, diabetes or smoking: An ultrasound based study

AbstractBackgroundBoth diabetes mellitus (DM) and cigarette smoking have been implicated in affecting carotid intima‐media thickness (CIMT) and plaque formation. The study aimed to evaluate and compare the effects of these risk factors on CIMT.ObjectiveTo compare sonographically measured carotid arterial intima‐media thickness among non‐diabetic and non‐smoker control group with smokers and diabetics.Materials and MethodsThis cross‐sectional analytical study was conducted over 9 months. Sonographic measurement of CIMT was done in 143 participants, divided into three groups: non‐diabetic non‐smokers, diabetics, and smokers. Data were analyzed using MEDCALC.ResultsMean CIMT values differed significantly among the three groups (p value = .000001) bilaterally. CIMT correlated strongly positively with age in Group I (r = .38, p = .018) and Group III (r = .35, p = .008) but not in Group II (r = .002, p = .98).ConclusionThe study concludes that both smoking and diabetes contribute to the intimal thickening. However, smoking may have a more pronounced effect on CIMT thickening than diabetes. This underscores the importance of addressing smoking cessation in cardiovascular risk management.

Variability in Liver Size Measurements Using Different View Angles in Ultrasound Imaging.

The aim of this study was to compare liver size measurements in different conventional B-mode ultrasound image (US) field views using magnetic resonance imaging (MRI) measurement as a reference. After receiving Institutional Review Board approval and informed consent, three operators measured the largest sagittal and transverse dimensions of adult livers on three US image field views (90°, 120°, and 140°) with a single curvilinear transducer. We analyzed the differences in liver size across three image field views using one-way analysis of variance (ANOVA) and examined the correlations between MRI and ultrasound measurements using Spearman regression. We used 95% Bland-Altman limits of agreement (95% LOA) to analyze the confidence interval for liver size measurements between MRI and US. Intra-observer and inter-observer reliability in measuring liver size were assessed using intraclass correlation coefficient (ICC). Based on sagittal liver length, 28 adult participants (7 men and 21 women, mean age 43 years) were divided into Group 1 (<17 cm, n = 10) or Group 2 (≥17 cm, n = 18). There was a significant difference in the liver size measurements across the three image field views (P < .001) in both groups. The highest correlation in liver size measurements between MRI and US was with ultra-wide-view (R2 = .87 in sagittal; R2 = .79 in transverse). Bland-Altman LOA also indicated good agreement between MRI and ultra-wide-view measurements. Intra-observer and inter-observer reliability in measuring liver size were good (ICC = 0.82-0.98). The study suggests that ultrasound ultra-wide-view provides the most accurate liver size measurement and good intra- and inter-operator reliability.

Liver-related aspects of valoctocogene roxaparvovec gene therapy for hemophilia A: expert guidance for clinical practice

AbstractAdeno-associated virus–based gene therapy (valoctocogene roxaparvovec) is an attractive treatment for hemophilia A. Careful clinical management is required to minimize the risk of hepatotoxicity, including assessment of baseline liver condition to determine treatment eligibility and monitoring liver function after gene therapy. This article describes recommendations (developed by a group of hemophilia experts) on hepatic function monitoring before and after gene therapy. To prevent harmful liver-related effects, gene therapy is contraindicated in patients with uncontrolled liver infections, autoimmune hepatitis, liver stiffness ≥8 kPa, or cirrhosis. Before using gene therapy in patients with liver steatosis or other liver disorders, the risk of liver damage should be considered using a highly individualized approach. Treatment is not recommended in patients with abnormal liver enzymes, including alanine aminotransferase (ALT) at any level above the upper limit of normal (ULN). Therefore, pretreatment assessment of liver health should include laboratory tests, abdominal ultrasound, and liver stiffness measurements by transient elastography (TE). In the first year after therapy, ALT levels should be monitored 1 to 2 times per week to detect elevations ≥1.5× ULN, which may require immunosuppressant therapy. Patients with ALT elevation should receive prednisone 60 mg/d for 2 weeks, followed by stepwise tapering when ALT returns to baseline. ALT monitoring should continue long term (every 3-6 months), along with abdominal ultrasound (every 6 months) and TE (yearly) evaluations. When patients with good liver health are selected for treatment and closely monitored thereafter, ALT elevations can be promptly treated and are expected to resolve without long-term hepatic sequelae.

Structural and functional fetal cardiac imaging using low field (0.55 T) MRI.

This study aims to investigate the feasibility of using a commercially available clinical 0.55 T MRI scanner for comprehensive structural and functional fetal cardiac imaging. Balanced steady-state free precession (bSSFP) and phase contrast (PC) sequences were optimized by in utero studies consisting of 14 subjects for bSSFP optimization and 9 subjects for PC optimization. The signal-to-noise ratio (SNR) of the optimized sequences were investigated. Flow measurements were performed in three vessels, umbilical vein (UV), descending aorta (DAo), and superior vena cava (SVC) using the PC sequences and retrospective gating. The optimized bSSFP, PC and half-Fourier single shot turbo spin-echo (HASTE) sequences were acquired in a cohort of 21 late gestation-age fetuses (>36 weeks) to demonstrate the feasibility of a fetal cardiac exam at 0.55 T. The HASTE stacks were reconstructed to create an isotropic reconstruction of the fetal thorax, followed by automatic great vessel segmentations. The intra-abdominal UV blood flow measurements acquired with MRI were compared to ultrasound UV free-loop flow measurements. Using the parameters from 1.5 T as a starting point, the bSSFP sequences were optimized at 0.55 T, resulting in a 1.6-fold SNR increase and improved image contrast compared to starting parameters, as well as good visibility of most cardiac structures as rated by two experienced fetal cardiologists. The PC sequence resulted in increased SNR and reduced scan time, subsequent retrospective gating enabled successful blood flow measurements. The reconstructions and automatic great vessel segmentations showed good quality, with 18/21 segmentations requiring no or minor refinements. Blood flow measurements were within the expected range. A comparison of the UV measurements performed with ultrasound and MRI showed agreement between the two sets of measurements, with better correlation observed at lower flows. We demonstrated the feasibility of low-field (0.55 T) MRI for fetal cardiac imaging. The reduced SNR at low field strength can be effectively compensated for by strategically optimizing sequence parameters. Major fetal cardiac structures and vessels were consistently visualized, and flow measurements were successfully obtained. The late gestation study demonstrated the robustness and reproducibility at low field strength. MRI performed at 0.55 T is a viable option for fetal cardiac examination.

Ultrasonographic parameters of the liver, spleen and kidney in a healthy paediatric population in Bosnia and Herzegovina: a prospective study

&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Aim &amp;lt;/strong&amp;gt;To determine the normative range of ultrasound dimensions for the liver, spleen and kidneys in healthy children according to gender, age, body measurements, body surface area (BSA), and the influence of ethnicity on organ size.&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Methods &amp;lt;/strong&amp;gt;The prospective study included children, ranging from full-term neonates to children aged 15, with normal ultrasonographic (US) findings of the liver, spleen and kidney and no clinical evidence of a disease. Gender, age, as well as body measurements and BSA, were determined for each child along with US measurements, and normative ranges were established.&amp;amp;nbsp;&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Results &amp;lt;/strong&amp;gt;US images of the liver and spleen from 372 children and 366 US images of kidneys of 366 children were included. US measurements of the liver, spleen and kidney correlated well with gender, age, body weight and height, and often differed to a greater or lesser extent from the normal range of measurements (5th to 95th percentile) reported in other studies.&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Conclusion &amp;lt;/strong&amp;gt;Our results differed slightly from other reports conducted in Europe, but larger differences compared to measurements performed on children on other continents were found. Thus, our study confirmed that ethnically appropriate and modern tables of normal ultra-sound dimensions for the liver, spleen and kidneys should be used, and that the national nomogram is justified.&amp;lt;/p&amp;gt;

Efficacy, Safety, and Longevity of Hyaluronic Acid Filler Injection in Treating Temple Hollowness by Sonographic Identifying 17 Soft Tissue Layers.

Successful aesthetic interventions in upper-face aging require a profound understanding of the intricate anatomy of temporal. This study aimed to comprehensively evaluate the effect of hyaluronic acid (HA) injection in temple areas by combining quantitative analysis with detailed anatomical insights. Twenty-five women received HA injections for temple hollowness. The injections targeted the interfacial layer between superficial and deep temporal fascia. Three-dimensional scanning, hollowness examination, and sonographic measurements were conducted 3 and 6 months postprocedure. Sonography identified 17 soft tissue layers in the temple, each with distinct characteristics. The notable layers include the epidermis, dermis, superficial and deep temporal fasciae, innominate fasciae, and superficial and deep temporal fat compartments. Three-dimensional volume was 0.86 mL at 3 months and 0.72 mL at 6 months. The average thickness of HA was 3.82 mm (immediately), 3.00 mm (3 mo), and 2.51 mm (6 mo). The depression on the temple was 4.33 mm (preprocedure), 0.71 mm (3 mo), and 1.62 mm (6 mo). The grade improved by 2.41 and 1.74 levels at 3 and 6 months. Identifying detailed superficial and deep layers of the deep temporal fascia challenged traditional descriptions, with detailed dividing of superficial and deep temporal fascia in sonography. Innominate fascia was also distinguished. This study provided a comprehensive evaluation of the effects of HA injections in temple areas. Precise anatomical insights and quantitative assessments contribute to a deeper understanding of the structural changes induced by this procedure. Sonography is valuable for delineating distinct layers and guiding aesthetic interventions in the temporal region.

Predicting the fetal weight by ultrasonography for isolated polyhydramnios: Comparison of 14 formulas.

To recalculate the estimated fetal weight (EFW) based on ultrasound measurements in patients complicated with isolated polyhydramnios, using 14 current formulas to observe which formula better predicts the EFW. This study examined pregnant women who gave birth in the hospital between January 2015 and January 2020. Maximum vertical pocket (MVP) was classified as, mild, moderate, and severe polyhydramnios, and the patients' measurements were reanalyzed using 14 formulas. The estimation of birth weight (EBW) alongside observed birth weight (OBW) facilitated the computation of statistical indices, namely the mean absolute percentage error (MAPE) expressed as [(EBW - OBW)/OBW × 100], the mean percentage error (MPE) denoted as (EBW - OBW)/(OBW × 100), and their corresponding 95% confidence intervals. A total of 564 polyhydramnios patients were included in the study. When looking at the MAPE, the lowest rate (7.65) was found in the Hadlock 2 formula. Hadlock 1, Hadlock 3, and Shinozuka formulas demonstrated MAPE values most closely aligned with Hadlock 2. Weiner I and Thurnau were the formulas with the highest MAPE values. When the cut-off values for MAPE were taken as 10%, 4/14 of the formulas (Weiner I-II, Vintzleos and Thurnau) gave results above 10%. Among 14 formulas, 3 (21.4%) had positive (sonographic overestimation) (Hadlock 3, Shinozuka, and Vintzleos) and the other 11 (78.6%) had negative MPE (sonographic underestimation). The Hadlock 2 formula had the lowest MAPE in predicting birth weight in patients with polyhydramnios, closely followed by the Hadlock 1, Hadlock 3, and Shinozuka formulas.

The impact of cut-off values on the prevalence of short cervical length in pregnancy

BackgroundA prior study suggested that implementing a cut-off value of ≤30 mm for a short cervical length (CL) could potentially introduce selection bias and alter the distribution of CL measurements. As such, the objective of this study is to evaluate how CL distribution and incidence of short CL are affected when using different cut-off values for a short CL. Study designThis is a secondary analysis of the Quadruple P (QP) Screening study; a prospective cohort study that included low-risk patients with singleton pregnancies undergoing fetal anomaly scan at 18–22 weeks of gestation, including a CL measurement. Patients with a short cervix, defined as ≤35 mm, were subsequently counseled for the QP trial; a randomized controlled trial (RCT) comparing progesterone to cervical pessary for the prevention of preterm birth. If participation to the RCT was refused, patients with a CL ≤25 mm were advised to use progestogen. The primary objective of this current study was to assess the normal distribution of CL across the entire cohort and to assess the incidence of short CL when using the cut-off values of ≤35 and ≤25 mm. Normal distributions for CL were simulated based on mean and standard deviation(SD) of the original data. The Kolmogorov-Smirnov test was used to evaluate the distribution of the CL measurements. Moreover, to evaluate the motives behind ultrasound measurements around the cut-off value, sonographers were asked to fill out a qualitative questionnaire. ResultsThe total cohort included 19.171 eligible participants who underwent CL measurement, with a mean CL of 43.9 mm (±8.1 SD). The distribution of all CL observed measurements deviated significantly from the normal distribution (p < 0.001). A total of 1.852 (9.7%) patients had short CL ≤35 mm, which was significantly lower than expected when compared to the simulated normal distribution (n = 2.661, 13.9%; p < 0.001). The incidence of short CL ≤25 mm in our cohort statistically differed from the simulated normal distribution (238, 1.2% vs 177, 0.9%; p=0.003). When comparing our data to the simulated normal distribution, the difference in distributions is most pronounced when examining the difference between 35 and 36 mm. Results of the questionnaire reveal sonographers claimed not to be influenced by a cut-off value for study participation or progesterone treatment. ConclusionThis study demonstrates that using any cut-off value for a short CL influences the incidence and distribution of CL. When using a cut-off value of ≤35 mm for study inclusion, the incidence of measurements of a short CL is lower than the anticipated incidence compared to a normal distribution. However, when using a cut-off value of ≤25 mm for progesterone treatment, the frequency of CL measurements is higher than expected below this threshold compared to a normal distribution. This study highlights the risk of introducing selection bias, most likely unintentionally, when cut-off values for short CL are used, regardless of the specific value chosen. Therefore healthcare providers should measure the CL with caution if essential decisions depend on a specific cut-off value.

Association Between Longitudinal Changes in Patellar Tendon Abnormality and Land-Jump Biomechanics in Male Collegiate Basketball Players.

The relationship between self-reported symptoms and the severity of patellar tendon abnormality (PTA) as seen on magnetic resonance imaging and ultrasound is unclear, but biomechanical testing may resolve this. To (1) compare land-jump limb biomechanics between pre- and postseason timepoints, (2) assess whether seasonal changes in biomechanics are associated with seasonal changes in PTA and symptom severity, and (3) explore models that identify seasonal changes in PTA and symptoms with seasonal changes in biomechanics in collegiate basketball players. Cohort study; Level of evidence, 2. Victorian Institute of Sport Assessment Scale - Patellar Tendon (VISA-P) scores and bilateral measurements from 18 National Collegiate Athletic Association Division I and II male basketball players (n = 36 limbs) at the preseason (visit 1) and postseason (visit 2) timepoints were collected. PTA was graded with ultrasound and magnetic resonance imaging morphology measurements proximally and distally, and 3-dimensional lower extremity sagittal kinematics and kinetics were measured during a land-jump test. Multivariate and chi-square analyses assessed timepoint differences. The association of seasonal (Δ = visit 2 - visit 1) biomechanics with seasonal morphology (ΔPTA: no change/worsened) and symptoms (ΔVISA-P: improved/no change/worsened) was tested with multivariate models. Logistic regressions modeled the accuracy of seasonal biomechanics to classify seasonal PTA and symptoms. Three athletes (6 limbs) at visit 1 and 2 athletes (4 limbs) at visit 2 were symptomatic. VISA-P scores were not significantly different between preseason and postseason. Regarding PTA, multivariate analyses found differences among grouped ground-reaction force variables (P < .05); univariate analyses found that worsened PTA was associated with seasonal decreases in peak vertical jumping force and with seasonal increases in knee flexion velocity at contact and maximum knee flexion velocity (P < .05 for all). Regarding VISA-P scores, multivariate analyses found differences among grouped hip (P < .01) and ankle (P < .05) kinematic variables; univariate analyses found that worsened VISA-P was associated with seasonal increases in hip (P < .01) and knee (P < .01) flexion velocity at contact and seasonal increases in ankle range of motion (P < .05). The findings demonstrated an association between seasonal changes in dynamic lower extremity biomechanics and seasonal changes in patellar tendon imaging signals as well as self-reported symptoms.

Evaluation of optic nerve sheath diameter in patients undergoing laparoscopic surgery in the Trendelenburg position: a prospective observational study.

The Trendelenburg position and pneumoperitoneum may cause cerebral edema and increased intracranial pressure. Non-invasive measurement of the diameter of the optic nerve sheath by ultrasonography can provide early recognition of intracranial pressure. Evaluate the optic nerve sheath diameter (ONSD) changes in patients who undergo laparoscopic surgery in the Trendelenburg position and make indirect conclusions about changes in intracranial pressure. Prospective, observational. Laparoscopic surgeries. Patients aged 18-75 years who underwent laparoscopic surgery in the Trendelenburg position under general anesthesia were included in our study. The ONSD was measured four times: Immediately after tracheal intubation, in the neutral position (baseline value) (T0), 10 minutes after pneumoperitoneum and Trendelenburg position (T1), 60 minutes after pneumoperitoneum and Trendelenburg position (T2), and 10 minutes after the pneumoperitoneum is terminated and placed in the neutral position (T3). Compare ONSD measured by ultrasonography at different times of surgery. 40. Arterial carbon dioxide pressure increased with laparoscopy and Trendelenburg position in parallel with ONSD measurements and decreased again after returning to the neutral position. It was still higher than the baseline value at the T3. There was also a significant difference[a] between the measurement made at the T2 and the measurement made at T1. This difference showed that the prolongation of the Trendelenburg time was associated with an increase in ONSD. At the end of the operation it was observed that the decreased statistically significantly (T3) 10 minutes after the pneumoperitoneum was terminated and the position was corrected. However, the ONSD was still higher at the end of the operation (T3) compared to the baseline value measured at the beginning of the operation (T0). The ONSD increased in relation to Trendelenburg position and pneumoperitoneum. With these results, we think the ultrasonographic measurement of ONSD, a non-invasive method, can be used for clinical follow-up when performing laparoscopic surgery in the Trendelenburg position in cases requiring intracranial pressure monitoring. There may be variations in the measurement of ONSD, even in the measurements of the same practitioner, as in all imaging with an ultrasonography device.

Reliability testing of sonographic techniques in detecting lateral displacement of patellar tendon

ObjectivesPatellofemoral pain syndrome (PFPS), a common knee condition, is characterized as presence of peripatellar pain during activities especially during loading of the lower extremity. Gonzalez-Suarez et al. (2021) developed a sonographic technique that assessed patellar tendon displacement within the trochlear groove. This study aims to determine the reliability of this sonographic technique. MethodsIntra-rater and inter-rater reliability study of three sonologist on the lateral displacement of the patellar tendon using ultrasound. Patellar tendon displacement was assessed using the three novel sonographic measurement techniques: 1) region of trochlear groove where the patellar tendon midpoint is located, 2) distance between deepest portion of the trochlear groove and patellar tendon midpoint and 3) percentage of lateral displacement of the patellar tendon. The measurements were done with the patients in supine and standing. ResultsTen participants with a mean age of 27.6 ± 1.56 years were included in the study. Pilot studies were done to improve the sonographic technique. Intraclass correlation coefficients yielded good to excellent inter-rater and excellent intra-rater reliability (>0.75) in the supine and standing positions except the inter-rater reliability of the region of the trochlear groove where patellar tendon midpoint is in supine position. ConclusionThe sonographic techniques for measurement of lateral patellar tendon displacement showed good to excellent intra-rater and inter-rater reliability between sonologists of different levels of expertise using a well-defined scanning protocol.

Reliability of Rehabilitative Musculoskeletal Sonography for Measuring the Visible Cross-Sectional Area of Suboccipital Muscles.

Aims The primary aim of this study is to assess the reliability of rehabilitative sonography as a non-invasive imaging technique for measuring the visible cross-sectional area (CSA) of the deep suboccipital muscles. Objectives Objectives involve determining both the intra-rater and inter-rater reliability of sonographic measurements to ensure consistent and reproducible results across different sessions and examiners. The ultimate goal is to validate rehabilitative sonography as a reliable tool for clinical and research applications in the assessment and management of musculoskeletal (MSK) conditions involving the deep suboccipital muscles. Design and setting Seventeen participants, including nine women and eight men without neck or vertebral pain, were evaluated using MSK sonography. The visible CSA of suboccipital muscles was assessed using real-time B-mode sonography in a sitting position with a linear probe (5 cm, 7.5 MHz) aligned perpendicularly to the muscle fibers of the rectus capitis posterior minor (RCPM) in one sonogram and the obliquus capitis inferior (OCI) and rectus capitis posterior major (RCPMJ) in another. Two experienced examiners performed sonography measurements, and the procedure was repeated one hour and again one day later. Results Intra-class correlation coefficient (ICC) values for Examiner 1 were 0.84 and 0.79 for RCPM, 0.84 and 0.71 for RCPMJ, and 0.86 and 0.77 for OCI at the one-hour and one-day repetitions, respectively. ICC values for Examiner 2 were 0.86 and 0.77 for RCPM, 0.77 and 0.86 for RCPMJ, and 0.61 and 0.64 for OCI at the one-hour and one-day repetitions, respectively. Inter-rater ICC values were 0.77 for RCPM, 0.82 for RCPMJ, and 0.68 for OCI. Standard error of measurement (SEM) values for Examiner 1 were 11.63 and 13.92 mm² for RCPM, 10.30 and 7.91 mm² for RCPMJ, and 22.84 and 34.61 mm² for OCI. SEM values for Examiner 2 were 11.82 and 13.40 mm² for RCPM, 11.91 and 7.04 mm² for RCPMJ, and 39.20 and 37.73 mm² for OCI. SEM values between examiners were 13.74 mm² for RCPM, 10.36 mm² for RCPMJ, and 36.03 mm² for OCI. Conclusions These findings suggest that sonography is a reliable method for measuring the CSA of the RCPM, RCPMJ, and OCI muscles, provided that the examiners are well-trained and consistent in their techniques and that the average of three measurements is used.

Primerjava ultrazvočnega merjenja premera spodnje votle vene in merjenja sestave telesa z metodo bioelektrične impedance za oceno tekočinskega stanja pri novorojenčkih

Background: Neonatal medical conditions often disrupt the physiological processes that regulate fluid balance, so assessing fluid status in sick neonates is important for clinical management. In clinical practice we use clinical signs, which, however, on their own, do not provide a reliable assessment of fluid status. We aimed to compare two methods: i) diameters and collapsibility index of vena cava inferior (VCI) measured by ultrasonography and ii) analysis of body composition by bioelectrical impedance (BIA) and to evaluate their relation to changes in body mass. Methods: In a cohort-prospective clinical trial we included 27 neonates aged 1–7 days with various pathologies. Ultrasound measurements of VCI transversely and longitudinally, measurements of body composition by BIA and measurements of body mass were performed in each subject at least three times with an interval of 24–72 hours. Simultaneous measurements of the same subject were then analysed and evaluated. Results: The average proportion of total body water (TBW) decreased in the first days after birth, from 80.3% (Day 1) to 73.1% (Day 8) (p = 0.006). The decrease in the average proportion of extracellular water (ECW) in the first days after birth was not statistically significant. The association between ECW and body mass over time was statistically significant (p &lt; 0.001). The association between transversely measured large VCI diameter during inspiration, body mass, and ECW was statistically significant (p = 0.024). No statistically significant association with ECW or body mass was proven for the other ultrasound-measured variables. Conclusions: By measuring body composition with BIA, we confirmed the reduction of the average proportions of TBW after birth and the association between body mass, ECW, and transversely measured maximal diameter of VCI during inspiration. BIA is an appropriate method for monitoring fluid status in a newborn. Additional research on a larger number of subjects is needed to define the significance of VCI measurements for assessing fluid status.