Ultrasound Technique Research Articles

Extraction and characterization of phytochemicals from Bauhinia variegata flowers using ultrasound and microwave techniques

This research investigates the efficacy of three distinct extraction techniques; ultrasound-assisted extraction (UAE), microwave-assisted extraction (MAE), and conventional extraction (CE) for the isolation of phytochemicals from the flowers of Bauhinia variegata. The findings demonstrated that both UAE and MAE surpass CE, yielding higher concentrations of bioactive compounds while significantly reducing the extraction time. UAE demonstrated the highest extraction efficiency, followed by MAE. The UAE yielded significantly higher levels of total phenolic content (43.97 mg GAE/g), total flavonoid content (24.08 mg QE/g), total anthocyanin content (16.37 mg CGE/g), DPPH antioxidant activity (19.29 mg TE/g), and FRAP antioxidant activity (16.75 mg TE/g) compared to MAE and conventional extraction methods. GC-MS analysis revealed a diverse array of phytochemicals, including flavonoids, phenolic compounds, and terpenoids, with some compounds showing higher concentrations in UAE. Reverse phase HPLC profiling further confirmed the enhanced extraction of phenolic compounds using UAE, including gallic acid, caffeic acid, coumaric acid, quercetin, and kaempferol. This study reveals the efficiency, time-saving, and eco-friendliness of UAE for extracting valuable bioactive compounds from B. variegata flowers. The findings optimize extraction processes in the food, pharmaceutical, and nutraceutical industries.

Advanced multimodal ultrasound for pre-operative assessment of skin tumours: A case series.

Pre-operative assessment of non-melanoma skin cancers via advanced ultrasound techniques may potentially provide additional information to tumour margins and morphology compared to current assessment via dermoscopy or optical coherence tomography. In this case series, the findings of multimodal ultrasonography of non-melanoma skin cancer are described, with histological correlation. Consecutive patients with clinical suspicion of malignant skin lesions underwent multimodal ultrasonography, comprising B-mode, colour Doppler imaging, superb microvascular imaging, strain elastography, and shear-wave elastography, followed by surgical excision. Images were reviewed by two radiologists. There were 8 female and 3 male patients, whose age ranged from 66 to 98 years. A total of 11 malignant skin tumours (basal cell carcinoma, n = 6; squamous cell carcinoma, n = 5) were reviewed. Tumour depth measured via ultrasound assessment ranged from 1.20 to 7.00 mm (mean ± standard deviation: 4.35 ± 1.99 mm). Tumours were located within dermis (n = 1) and abutting subcutaneous layer (n = 10) sonographically. Where corresponding histological reports for tumour depth were available, ultrasound correlated well with histology. Ultrasound also correctly predicted the deepest layer of involvement for all lesions. The sonographic features observed in all malignant skin tumours (11/11:100%) are solid, hypoechoic, with abundant neovascularity on colour Doppler imaging and superb microvascular imaging, and appeared stiff on strain elastography and shear-wave elastography. In some cases, the microvascular network of intra-tumoural flow were better demonstrated on superb microvascular imaging. Multimodal ultrasound can potentially be a useful and quick adjunctive tool for the pre-operative assessment of skin cancer by delineating the tumour depth and deepest skin layer involvement, ensuring complete excision of tumour.

Using ultrafast angio planewave ultrasensitive and conventional doppler imaging techniques to assess intramuscular blood perfusion in older adults

BackgroundMicrovascular ultrasound imaging techniques such as Angio PLanewave UltraSensitive (Angio-PL.U.S.) have been used to detect microvascular blood flow in various organs and tissues. However, the advantage of Angio-PL.U.S. for assessing muscle microvascularity over other non-invasive imaging modalities has not been investigated. This cross-sectional study compared ultrafast Angio-PL.U.S. and conventional color Doppler flow imaging (CDFI) techniques for assessing intramuscular blood perfusion.MethodsForty-five older adults participated (age = 59.1 ± 7.6). The vascularity index (VI) was used to quantify intramuscular blood flow of the bilateral biceps brachii (BB) and medial gastrocnemius (MG). Intra-limb (difference in VI between CDFI and Angio-PL.U.S. techniques) and inter-limb differences [percent side-to-side differences (%SSD) in VI between dominant and non-dominant sides] were compared using Wilcoxon Signed Ranks and Mann-Whitney U tests, respectively. Associations between techniques were assessed using Spearman’s rho (ρ).ResultsNo significant differences were observed between dominant and non-dominant BB (p ≥ 0.053) and MG (p ≥ 0.756) for both CDFI-VI and Angio-PL.U.S.-VI. Only VI measures for the non-dominant BB demonstrated significant intra-limb difference between techniques (p = 0.002). A significant %SSD between techniques was observed for BB (p = 0.022) but not MG (p = 0.225). Strong to very strong correlations were observed between CDFI-VI and Angio-PL.U.S.-VI across all muscles (ρ = 0.616–0.814, p ≤ 0.001).ConclusionUltrafast Angio-PL.U.S. and conventional ultrasound imaging techniques were comparable when used in conjunction with the VI for quantifying resting intramuscular blood flow. Angio-PL.U.S. appeared to be more sensitive in detecting bilateral disparities in upper extremity muscles. However, further research is needed to validate these findings and investigate the potential clinical utility of this technique for characterizing disease progression in populations with global or unilateral musculoskeletal tissue alterations.

FORENSIC IMPLICATIONS OF CARPAL TUNNEL SYNDROME IN RELATION TO RADIOLOGICAL AND ORHOPEDITION

Carpal tunnel syndrome (CTS) is a common peripheral neuropathy with significant clinical and forensic implications. The condition is characterized by compression of the median nerve within the carpal tunnel, leading to pain, tingling, and functional impairment. Accurate diagnosis is crucial not only for clinical management but also for forensic evaluations, especially in cases of occupational claims and medico-legal disputes. Objective: The purpose of this research is to investigate the forensic consequences of carpal tunnel syndrome regarding radiographic and ophthalmic examinations. Methods: This prospective study included 180 individuals, aged 18 to 65 years, of both genders. This study was conducted at the Department of Forensic Medicine LUMHS from January 2023 to June 2023. Group I comprised 90 patients diagnosed with CTS, while Group II included 90 individuals without CTS, serving as controls. Demographic data, including age, sex, and BMI, were recorded. CTS was confirmed using ultrasonographic and other diagnostic modalities. The cross-sectional area of the carpal tunnel at the pisiform (CSAp) and the carpal tunnel at the hook of the hamate (CSAc) was measured. Delta CSA was calculated as the difference between CSAc and CSAp. Sensitivity and specificity for CTS diagnosis were evaluated. Statistical analysis was performed using SPSS Version 26.0. Results: The study found a predominance of females in both groups, with 63 (70%) females in Group I and 58 (64.4%) in Group II. The mean age in Group I was 47.34 ± 8.58 years with a mean BMI of 25.13 ± 10.49 kg/m², while Group II had a mean age of 49.53 ± 12.74 years and a BMI of 26.34 ± 11.61 kg/m². Group I demonstrated significantly higher CSAc values (18.5 ± 3.35 mm²) compared to Group II (9.8 ± 7.25 mm²; p < 0.004). The delta CSA was also higher in Group I (7.37 ± 8.32 mm²) compared to Group II (1.3 ± 2.13 mm²; p < 0.005). The CSAp values showed no significant differences between groups (Group I: 9.4 ± 3.6 mm²; Group II: 7.12 ± 9.6 mm²). A delta CSA threshold of 2 mm² demonstrated high diagnostic accuracy, yielding a sensitivity of 99.1% and specificity of 100% for Group I wrists. Conclusion: Delta CSA is a highly reliable parameter for diagnosing CTS, surpassing CSAc in accuracy. Advanced ultrasonographic techniques, including high-frequency probes and enhanced power Doppler imaging, represent the gold standard for CTS diagnosis, providing robust evidence for both clinical and forensic applications.

Efficacy of B - mode and elastography ultrasound technique in the prediction of Helicobacter pylori: a prospective study

BackgroundHelicobacter pylori (HP) affect nearly 50% of the world’s population and can colonize the submucosal and mucosal layers of the stomach wall, causing inflammation leading to a thickening of these layers. The study aimed to evaluate the application value of transabdominal ultrasonography combined with elastography in the prediction of HP using HP Fecal Antigen Test as gold standard.MethodThis prospective case-control study was conducted in 174 participants classified into three groups: Group A: Symptomatic patients with thickened stomach antral and evident HP infection on fecal antigen test results, Group B: Symptomatic patients with thickened antral and no evident HP infection on fecal antigen test results, and Group C: control group of asymptomatic individuals with negative HP screening to predict the diagnostic accuracy of B-mode ultrasound and elastography in the prediction of HP pylori.ResultsPositive HP patients had higher values of antral wall thickness (AWT), mucosal layer thickness (MLT), MLT/AWT ratio, SR (strain ratio), and a combination of AWT and SR: 5.57 ± 0.55 mm, 2.96 ± 0.45 mm, 0.53 ± 0.06 mm, 3.21 ± 0.43, and 8.79 ± 0.68 mm, respectively. In comparison, negative HP patients had values of 4.61 ± 0.47 mm, 2.05 ± 0.42 mm, 0.41 ± 0.08 mm, 2.51 ± 0.42 mm, and 7.13 ± 0.62 mm, respectively, and the control groups had values of 3.53 ± 0.36 mm, 1.47 ± 0.25 mm, 0.40 ± 0.06 mm, 1.81 ± 0.41, and 5.35 ± 0.55 mm, respectively (p < 0.001). The sensitivity of B-mode ultrasonography, elastography, and the combination of the two was 98%, 95.1%, and 98.4%, respectively, and the diagnostic accuracy was 98.4%, 98.3%, and 100%, respectively.ConclusionB-mode ultrasonography and elastography exhibit high discriminatory power in distinguishing symptomatic HP patients from normal individuals and differentiating + HP from - HP, with greater discriminatory power when combined both modes.

Cochineal (Dactylopius coccus Costa) Pigment Extraction Assisted by Ultrasound and Microwave Techniques

Carminic acid is a natural pigment typically found in several insect taxa, including specific insects such as “grana cochinilla fina” in Mexico (Dactylopius coccus Costa). Commercially, it is also referred to as carmine, which is a more concentrated solution presenting as at least 50% carminic acid. To date, this dye has been used in the pharmaceutical, food and cosmetic industries. Unfortunately, one of the main limitations has to do with establishing the appropriate extraction and purification protocol. Currently, there is growing interest in developing eco-friendly and efficient pigment extraction processes for various applications. In this study, we compare the ultrasound- and microwave-assisted extraction versus with a conventional method to obtain carminic acid from cochineal. To do this, we considered three factors that influence the extraction process as independent variables: solvent volume, temperature and irradiation time. The optimization was carried out using the response surface methodology, employing a three-factor and three-level Box–Behnken experimental design. Carminic acid contents were quantified by UV–Vis spectroscopy, and extracts were evaluated by infrared spectroscopy to verify the integrity of the carminic acid molecule. The yield obtained by ultrasound-assisted extraction was 49.2 ± 3.25, with an efficiency of 31.3 mg/min, while microwave-assisted extraction showed a yield of 40.89 ± 2.96, with an efficiency of 27.3 mg/min. Both methods exceeded the extract yield (31.9 ± 3.4%) and efficiency (10.6 mg/min) obtained with the conventional method, demostrating that ultrasound- and microwave-assisted extraction are viable alternatives for obtaining carminic acid, with the potential to be scaled up to an industrial level.

Evaluation of postoperative renal function in infants with congenital hydronephrosis using ROI from ultrasound technique in renography

The aim of this study was to assess the efficacy of GFR measured using ROI from ultrasound technique in diuretic renography for evaluating postoperative outcomes in infants under one year old with congenital hydronephrosis. A retrospective analysis was conducted on thirty infants who underwent abdominal ultrasound and diuretic renography before and after surgery, obtaining preoperative and postoperative gGFRs and uGFRs (measured using ROI from ultrasound technique) determined using the Gates method and ultrasonic-assisted drawing ROI technique, respectively. A comparative study was performed on total GFR as well as individual kidney GFR before and after intervention. The preoperative and postoperative total and single uGFRs were significantly lower than gGFRs, while the postoperative total and single renal function, along with relative renal function in the hydronephrotic kidneys, were also significantly higher than the preoperative results (p < 0.05). Among 30 infants, 23 cases exhibited substantial recovery of renal function in their hydronephrotic kidneys after surgery, 2 cases did not show significant improvement, while 5 cases continued to experience deterioration in renal function. The GFR measured using ROI from ultrasound technique provides a more accurate assessment of renal function changes before and after surgery in infants under one year old with congenital hydronephrosis, facilitating an effective evaluation of postoperative treatment efficacy.

Empowering junior doctors: A study on the feasibility and efficacy of ultrasound AAA screening in rural Australia

Purposes Abdominal Aortic Aneurysm (AAA) screening via ultrasound in Caucasian males aged 65 and older has proven cost-effective in metropolitan areas. Evidence suggests that with adequate training, individuals without prior sonography experience can achieve accurate aortic measurements. This study evaluates the capability of junior doctors, after brief training, to conduct reliable AAA ultrasound screenings in a rural hospital setting, addressing the gap in speciality surgical services. Methods Three junior doctors participated in a 2-hour practical ultrasound training, subsequently performing scans on both inpatients and community volunteers at a regional hospital. The analysis focused on measurement discrepancies within a 5 mm clinically acceptable difference, scanning efficiency, and aneurysm detection accuracy. Results A total of 71 participants were included. Among the screenings, 81.7% fell within the clinically acceptable discrepancy range, with 72.7% accuracy in inpatient scans and 95.5% in volunteer scans. Measurement reproducibility improved significantly with the standardisation of ultrasound techniques, and there was excellent agreement among operators in detecting aneurysms. Notably, scanning efficiency improved from the inpatient group to the volunteer group with statistical significance. Conclusions Junior doctors demonstrated the ability to efficiently and reproducibly measure the infrarenal aortic diameter at a level comparable to experienced sonographers after only 2 hours of training. A single day of supervised practice is recommended to ensure standardised ultrasound technique. This approach offers a practical, cost-effective supplement to specialist radiology services in rural areas, enhancing access to critical screening procedures without proposing the replacement of professional sonographers.

Sonographic localisation of lymph nodes suspicious of metastatic breast cancer to surgical axillary levels

AbstractThe axillary lymph node (LN) burden of breast cancer patients guides multidisciplinary management and treatment regimes. Sonographic imaging is used to identify the presence, number and location of axillary LNs suspicious of malignancy and used to guide nodal fine needle aspirations and biopsies. Axillary LNs suspicious of harbouring breast cancer metastasis can be localised to three surgical axillary levels, numbered according to their location relative to the pectoralis minor muscle and lymph flow. To sonographically identify and localise suspicious axillary LNs, an understanding of the axillary anatomy, muscular sonographic landmarks, surgical axillary levels, and the sonographic technique to image and distinguish between benign and suspicious LNs is required.

Abstract 4135035: Liver kinase B1 (LKB1) loss links vascular smooth muscle cell fate switch to aortic aneurysm formation

Background: Acquisition and maintenance of vascular smooth muscle cell (VSMC) fate are important for vascular development and homeostasis; however, little is known about the key determinant for VSMC fate and vascular homeostasis. Methods: Lkb1 flox/flox ; Tagln- Cre, Lkb1 flox /flox ; Myh11-Cre/ERT2 , and lineage tracing Lkb1 flox/flox ; Myh11-Cre/ERT2 ; ROSA mT/mG mice were generated to study the impact of Lkb1 on VSMC and vascular function in vivo . Single aortic cells isolated from wild-type and Lkb1 flox/flox ; Myh11-Cre/ERT2 mice were analyzed by single-cell RNA sequencing (sc-RNA seq). The dynamic changes of vascular morphology and VSMC fate were investigated using high-frequency ultrasound and various histological techniques. In addition, VSMC phenotype and molecular mechanisms were further explored by mouse arterial ring assay ex vivo , in cultured human aortic VSMC in vitro, and in human aneurysmal aortic tissues. Results: We found that SMC-specific Lkb1 ablation in Lkb1 flox/flox ; Tagln-Cre mice caused severe vascular abnormalities and embryonic lethality. SMC-specific deletion of Lkb1 in tamoxifen-inducible Lkb1 flox/flox ; Myh11-Cre/ERT2 mice spontaneously and progressively induced aortic/arterial dilation, aneurysm, rupture, and premature death. Sc-RNA seq and imaging-based lineage tracing showed that Lkb1 -deficient VSMCs transdifferentiated gradually from early modulated VSMCs to fibroblast-like and chondrocyte-like cells, leading to ossification and blood-vessel rupture. Moreover, we found that SMC-specific Lkb1 ablation resulted in decreased vascular contractility and hypotension in vivo . Mechanistically, Lkb1 regulates polypyrimidine tract binding protein 1 (Ptbp1) expression and controls alternative splicing of pyruvate kinase muscle (PKM) isoforms 1 and 2. Lkb1 loss in VSMC results in an increased PKM2/PKM1 ratio and alters the metabolic profile by promoting aerobic glycolysis. Treatment with PKM2 activator TEPP-46 rescues VSMC transformation and aortic dilation in Lkb1 flox/flox ; Myh11-Cre/ERT2 mice. Furthermore, we found that Lkb1 expression decreased in human aortic aneurysm tissue compared to control tissue, along with changes in markers of VSMC fate. Conclusions: Lkb1, via its regulation of Ptbp1-dependent alterative splicing of PKM, maintains VSMC in contractile states and sustains vascular homeostasis. Our findings have important implications for understanding the pathogenesis of aortic aneurysm.

DDDR-23. DECODING GLIOBLASTOMA DRUG RESISTANCE DYNAMICS USING NOVEL MICROFLUIDIC EX VIVO MODELS

Abstract Glioblastoma (GBM) is clinically challenging due to its aggressive nature and limited treatment options. Current standard of care involves surgical resection and chemoradiation with temozolomide (TMZ). GBM, however, often returns post-treatment fueled by its complex biology and the presence of resilient GBM stem cells. Compounding the issue is the blood-brain barrier, which poses a formidable obstacle to drug delivery into the brain. Understanding the molecular dynamics post-therapy within the brain, influenced by the tissue microenvironment, is key for developing more effective therapeutic strategies. Unfortunately, existing research models have fallen short in capturing the complexity of GBM and its response to treatment. While animal models have been a mainstay in GBM research, their ability to predict human responses has been called into question, highlighted by the disappointing results seen in clinical trials. We are therefore advancing bioprinting-based approaches for modeling various components of the tumor microenvironment to gain insight into mechanisms of drug resistance. We report on the development of three novel microfluidic platforms to investigate and interrogate GBM biology. First, we have developed a novel microfluidic model of GBM, termed GlioFlow-3D, produced through a combination of 3D printing methods. GlioFlow-3D mimics specific aspects of the perivascular niche, including protection from circulating TMZ. Second, we have adapted GlioFlow-3D as part of a platform to investigate advanced ultrasound techniques for delivering novel therapeutics into the human brain. Third, we are developing a novel approach aimed at exploring the relationship between the brain extracellular matrix and tumoral cells using bioprinting of living tumor organoids obtained from patients with a history of recurrence. By integrating bioprinting technologies with patient-derived models to create novel ex vivo platforms, we aim to obtain new insights into the intricate dynamics of drug resistance in GBM, ultimately paving the way for more effective therapeutic strategies. Funding: The Brain Tumor Center Research Award (UCGNI) The ARC Project - CCHMC and UC joint Research Award

The reliability and validity of superb microvascular imaging as a potential disease activity marker in rheumatoid arthritis.

Rheumatoid arthritis (RA) is a systemic autoimmune disease of unknown aetiology, that causes progressive and destructive inflammation in the joints. Superb microvascular imaging (SMI), a new ultrasound technique that allows visualizing slow blood flow in synovitis. This study aimed to report the clinical value and utility of the SMI technique and its grading for monitoring RA by determining the correlation with clinical disease activity scores (DAS 28) and power Doppler ultrasound (PDUS). All RA patients with clinically apparent synovitis were assessed using DAS 28. Synovitis were investigated with PDUS and SMI and each joint was graded semiquantitatively. All assessments were carried out at baseline and repeated at least 4-month follow-up. Correlations between scores were investigated using Spearman's correlation. Sixty RA patients with 552 affected joints were recruited. Clinical and sonographic scores were significantly improved at follow-up (p<0.001). SMI showed significantly more joint count and flow signal scores than clinical examination and PDUS. Moderate correlations were found between SMI score and clinical scores (p<0.001,0.586 for SMI score vs DAS 28-CRP, p=0.001,0.432 for SMI vs DAS 28-ESR). There were also stronger correlations between SMI score and PDUS score at both baseline and follow-up (p<0.001, r = 0.817, 0.842 respectively). SMI provides greater utility and ability to detect synovial vascularity and monitor disease activity than PDUS. A new activity scoring system based on SMI and clinical objective findings is required to improve reliability and validity.

Ultrasonographic technique and appearance of the coelomic organs in crocodilians

IntroductionCrocodilians have significant ecological, conservational, and economic roles. They are also commonly raised for commercial purposes and kept as zoological specimens. Although ultrasonography has been used in zoological contexts for health assessments of crocodilians, published studies on a detailed ultrasonography protocol and ultrasonographic anatomy are lacking. This study aimed to establish a standardized ultrasonography protocol and pictorial reference of the ultrasonographic appearances of the coelomic organs of crocodilians.MethodsA total of 7 crocodilians comprising 4 different species were included in this study. The crocodilians were manually restrained and underwent a non-contrasted and contrasted computed tomography (CT) scan, followed by an ultrasonography (USG) examination. Ultrasound fusion imaging technique enabled greater confidence in establishing a clear organ localization and correlation between modalities by visualizing the same anatomy from the same view angle.ResultsThe heart, caudal vena cava, liver, fat body (steatotheca), spleen, stomach, duodenal loops, pancreas, kidneys, testes, ovaries and cloaca were visualized in all species. Longitudinal and transverse images of the coelomic structures were acquired when possible. The ultrasonographic characteristics of the coelomic organs, including transducer positioning, acoustic window and approach, shape, size, marginations, and echo pattern were documented.DiscussionThe findings of this study provided a useful ultrasonographic protocol and anatomical reference of the coelomic organs in crocodilians. Invaluable insights into the practicality and adequacy of ultrasonography in evaluating the coelomic structures of crocodilians as part of health assessment and disease diagnosis were also discussed.

A novel step-by-step teaching method improves training outcomes in transvaginal ultrasound for postgraduate reproductive medicine students: an exploratory randomized controlled study

BackgroundTraditional methods of training in ultrasound technology make it difficult for postgraduate reproductive medicine students to rapidly develop into doctors who can perform clinical examinations independently. It is necessary to explore an efficient method for ultrasound training. The purpose of this study was to investigate whether the step-by-step (SBS) teaching improves the ultrasound diagnosis and clinical work level of reproductive medicine graduate students.MethodsA total of fifty postgraduate reproductive medicine students who participated in ultrasound room training were selected at random and divided into two groups: a traditional teaching control group and a stepwise teaching experimental group. A comparison was subsequently conducted between the two groups in terms of theoretical level, skill operation, comprehensive ability and teaching evaluation.ResultsIn terms of theory, skills, and comprehensive assessment, the experimental group exhibited superior performance compared to the control group (P < 0.05). The experimental group rated the instructors’ teaching ability and methods significantly better than did the control group (P < 0.05). The experimental group’s overall satisfaction with the training was better than that of the control group, but the difference was not statistically significant (P > 0.05).ConclusionsThe stepped teaching model has the potential to facilitate the acquisition of clinical ultrasound detection and diagnostic techniques by postgraduate reproductive medicine students, thereby enhancing their overall competence and satisfaction with the teaching process.

Poor correlation between diaphragm ultrasound and invasive gold standard technique derived respiratory muscle strength assessment in patients after hospitalization for COVID-19.

Individuals who survive acute coronavirus disease 2019 (COVID-19) might experience diaphragm muscle weakness. Diaphragm ultrasound may be an easy-to-obtain bedside tool for determining diaphragm function. However, twitch transdiaphragmatic pressure (twPdi) following magnetic stimulation (MS) of the phrenic nerves is the gold standard for non-volitional assessment of diaphragm strength. This study investigated whether diaphragm thickening ratio (DTR) measured on diaphragm ultrasound reflects diaphragm strength as measured by twPdi following MS of the phrenic nerves or other (volitional) invasively obtained pressure values and could therefore be used to accurately diagnose diaphragm weakness. One year after discharge, 50 individuals (14 female, age 58±12 years) who had been hospitalised and treated for moderate-severe COVID-19 underwent standard spirometry and diaphragm ultrasound. TwPdi following cervical MS of the phrenic nerve and volitional inspiratory manoeuvres (Sniff and Mueller manoeuvre) were measured using oesophageal and gastric balloon catheters after transnasal placement. At follow-up, no clinically meaningful restrictive lung function impairment was evident on spirometry. On diaphragm ultrasound, diaphragm dysfunction, i. e. an impaired diaphragm thickening ratio was detected in 24% (12/50) of participants. An objective diagnosis of diaphragm dysfunction, defined as twPdi <16 cmH2O, was made in 60% (30/50) of participants. The measurement results of the two methods did not agree, given that there were many false negative, but also false positive results, so diaphragm ultrasound diagnosed in parts other patients with diaphragm dysfunction than TwPdi. Diaphragm ultrasound had a sensitivity of 26.67% and a specificity of 80.0% in the detection of diaphragm dysfunction (Positive predictive value 66.67%, negative predictive value 42.10%). Diagnosis of diaphragm weakness in individuals who have recovered from COVID-19 cannot be made accurately on diaphragm ultrasound (via DTR), but requires twPdi as the gold standard for assessment of diaphragm strength.

In Vivo Imaging Techniques for the Human Scalp: A Systematic Review of the Literature.

Scalp inflammation and alopecia are distressing conditions for which patients regularly present to dermatology. Although some diagnoses can be made clinically, others require biopsy, which carries the risk of pain, infection, bleeding, and scarring. This review examines the existing literature regarding noninvasive in vivo imaging techniques and their evidence and utility in evaluating scalp pathology, with a focus on the diagnostics of hair conditions. A systematic literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines without timeframe restrictions. The PubMed and Clarivate (Web of Science) databases were searched using the terms ("imaging" OR "in-vivo imaging" OR "non-invasive imaging" OR "non-invasive in vivo imaging" "imaging," "in-vivo imaging) AND ("human scalp disorders" OR "scalp" OR "hair loss" OR "alopecia"). Peer-reviewed randomized control trials (RCTs), prospective studies, retrospective studies, and case series or reports discussing in vivo imaging of the scalp published before 2022 were selected. Forty-two studies were included and discussed; modalities included laser devices (n = 27), ultrasound (US) (n = 13), infrared thermography (n = 1), skin capacitance imaging (SCI), and ultraviolet light-enhanced visualization (ULEV) (n = 1). The most common laser devices used were reflectance confocal microscopy (RCM), multiphoton microscopy (MPM), and optical coherence tomography (OCT). US techniques included high-frequency US (HFUS) and US biomicroscopy (UBM). Quality imaging of the scalp in the setting of alopecic, neoplastic, and inflammatory diseases is highly sought after. Many of these noninvasive imaging techniques show promise, each with individual advantages and disadvantages in imaging-specific conditions. Ultimately, noninvasive imaging techniques may be used to optimize patient management and minimize morbidity associated with scalp biopsies.

Assessing Intensive Care Unit Acquired Weakness: An Observational Study Using Quantitative Ultrasound Shear Wave Elastography of the Rectus Femoris and Vastus Intermedius

IntroductionIntensive care unit-acquired weakness (ICUAW) is associated with unfavorable outcomes. The current diagnostic tools for ICUAW are invasive, yield delayed results, and lack precision. This study explored the potential of shear wave elastography (SWE), an innovative ultrasound technique, to evaluate the quality changes in the lower extremity muscles of ICU patients, potentially aiding the early detection of ICUAW. Materials and MethodsWe included adult patients diagnosed with ICUAW (average Medical Research Council score < 48) from December 2020 to October 2021. ICU patients were continuously monitored twice daily. Using ultrasonography, we measured the thickness (TH), cross-sectional area (CSA), pennation angle (PA), and SWE (SWE-values) modulus of the bilateral rectus femoris (RF) and vastus intermedius (VI). The diagnostic performance of each parameter was evaluated using sensitivity, specificity, and area under the receiver operating characteristic curve. ResultsUltrasound quantification assessments were performed in 47 patients, 24 with ICUAW and 23 without ICUAW. Notably, PA decreased (RF: 11.33%, VI: 10.51%), while muscle rigidity increased (RF: 22.39%, VI: 22.50%) in ICUAW patients compared with non-ICUAW patients. The sensitivity and specificity for PA in the RF were 79.17% and 91.30%, respectively, and those for PA in VI were 79.17% and 78.26%, respectively. The use of both combinations yielded 91.67% and 73.91% sensitivity and specificity, respectively. Employing the PA of RF and SWE-values of RF together, we observed a diagnostic prediction sensitivity of 91.67% and a specificity of 60.87%. ConclusionsICUAW patients exhibited increased rigidity of the lower extremity muscles during their hospital stay. Ultrasonic SWE emerged as a reliable and objective tool, offering significant diagnostic value for ICUAW.

Sex-based differences in hamstrings stiffness assessment in football players using ultrasound shear wave elastography.

Hamstring stiffness varies among individuals and can influence athletic performance and injury risk. Sex-based differences in hamstring stiffness among football players have not been thoroughly investigated. This study aimed to assess these differences using shear wave elastography (SWE), a non-invasive ultrasound technique that quantifies tissue stiffness. The study recruited 30 football players (15 male, 15 female) in June 2022 during their annual medical check-up. Participants were aged 18-40 years, engaged in regular training, and had no history of lower limb musculoskeletal injury in the six weeks preceding the study. SWE was used to measure shear wave velocity (SWV) in the hamstring muscles: semitendinosus (ST), semimembranosus (SM), and biceps femoris (BF). Independent t-tests were used to compare the SWV values of the hamstring muscles between sexes and between dominant and non-dominant legs. ST muscle had a statistically significant difference in SWV based on gender and leg dominance with marked differences particularly in the non-dominant leg across both genders (P=0.02; Bonferroni corrected P=0.05). SWV for ST in male group was significantly higher than that in female group; the mean elasticity of the male group for dominant and non-dominant leg were 3.8±1.5 and 4.1±1.2 m/s, respectively; and the mean elasticity of the female group for dominant and non-dominant leg were 2.9±0.7 and 2.8±0.7 m/s respectively. In contrast, SWV differences in the SM and BF muscles were not statistically significant(P=0.187 and 0.760, respectively). The study revealed significant sex-based differences in hamstring stiffness among football players, as assessed by SWE. ST muscle stiffness was associated with higher SWV in male group and show stronger correlation with non-dominance leg. These findings can contribute to individualized training programs and injury prevention strategies.

Application of 3D-printed resin guides for the removal of molar fiber posts

To evaluate the digital guide technique for removing fiber posts from molars and compare it with the conventional microscope-assisted ultrasound method. Two mandibular dentition models, each comprising six extracted molars, were prepared. Two thick and straight canals distributed separately in the distal and mesial roots of each molar were selected for placing the fiber posts. The 24 posts in the two dentition models were removed using 3D-printed resin guides, or a microscope and an ultrasonic device. The time taken to remove the fiber post from each tooth was recorded. The volume loss, deviation values (angular deviation and horizontal and vertical deviations of the tip), and formation of microcracks before and after fiber post removal were determined using micro-computed tomography images. The digital guide technique took significantly less time than the microscope-assisted ultrasound technique (p < 0.05). No significant differences in horizontal and vertical tip deviations were observed between the two groups. The angular deviation and volume loss in the guide group were significantly lower than those in the ultrasound group (p < 0.05). New dentin microcracks were formed in the ultrasound group but not in the digital guide group. Using a 3D-printed resin guide plate can shorten the fiber post removal time and improve the stability and safety compared to the microscope-assisted ultrasound technique. 3D-printed resin guides can reduce the fiber post removal time and provide better stability and safety than the conventional method.

Application of ultrasonic imaging technology in beef cattle breeding management

ObjectiveThe aim of this study was to explore in depth the application of ultrasonic imaging technology in beef cattle reproduction management in order to improve the efficiency and management of beef cattle reproduction. MethodsIn this study, ultrasonographic diagnostic techniques were used to follow up the follicles and corpus luteum in the uterus and ovaries of dairy cows at different stages of development as well as at different periods of gestation of dairy cows, and to detect the effects of different fattening conditions of the cows and the number of litters on the sitting rate. ResultsThe diameter of mature follicles was generally around 16 mm, and the majority of them were 11–20 mm in diameter. Ultrasonography was used to detect early pregnancy in cows at 33–55 d. Ultrasound was used to identify the sex of the foetus most easily at 70–80 d. The results of this study showed that the sex of the foetus was most easily identified in cows at 70–80 d. The fat of the cow and the number of births also had a significant impact on pregnancy rates. ConclusionUltrasound imaging technology has an important application value in the management of beef cattle reproduction, and in pregnancy detection, it can achieve early and accurate diagnosis, improve the accuracy of detection, and differentiate between heifers in estrus and pregnant heifers. In addition, it can also be used for foetal sex identification at a specific period of time, providing a basis for breeding programmes.