BACKGROUND Ultrasound guide technology,which can provide real-time visualization of the needle tip and tissues and avoid many adverse events,is widely used in mini-mally invasive therapy.However,the studies on ultraso...BACKGROUND Ultrasound guide technology,which can provide real-time visualization of the needle tip and tissues and avoid many adverse events,is widely used in mini-mally invasive therapy.However,the studies on ultrasound-guided Lateral recess block(LRB)are limited,this is probably because there is no recognized standard method for ultrasound scanning.This study aimed to evaluate the effect of ultrasound-guided LRB in patients with lateral recess stenosis(LRS).CASE SUMMARY A 65-year-old patient complained of low back pain accompanied occasionally by pain and numbness in the left lower limb.Physical examination showed ten-derness on the spinous process and paraspinal muscles from L1 to S1,extensor hallucis longus and tibialis anterior weakness(muscle strength:4-),and a positive straight leg raising test in the left lower limb(60°).Magnetic resonance imaging showed L4–L5 disc degeneration with left LRS and nerve root entrapment.Subsequently,the patient was diagnosed with LRS.This patient was treated with a novel ultrasound-guided LRB approach.The patient’s symptoms significantly improved without any complications at 1 wk postoperatively and at the 3-month follow-up.CONCLUSION This is the first report on the LRS treatment with ultrasound-guided LRB from the contralateral spinous process along the inner side of the articular process by out-plane technique.Further studies are expected to investigate the efficacy and safety of ultrasound-guided LRB for patients with LRS.展开更多
BACKGROUND:We aimed to evaluate the utility of point-of-care ultrasound(POCUS)in the assessment of hand infections that present to the emergency department(ED)and its impact on medical decision making and patient mana...BACKGROUND:We aimed to evaluate the utility of point-of-care ultrasound(POCUS)in the assessment of hand infections that present to the emergency department(ED)and its impact on medical decision making and patient management.METHODS:We conducted a retrospective review of patients who presented to two urban academic EDs with clinical presentations concerning for skin and soft tissue infections(SSTI)of the hand between December 2015 and December 2021.Two trained POCUS fellowship physicians reviewed an ED POCUS database for POCUS examinations of the hand.We then reviewed patients’electronic health records(EHR)for demographic characteristics,history,physical examination findings,ED course,additional imaging studies,consultations,impact of POCUS on patient care and final disposition.RESULTS:We included a total of 50 cases(28 male,22 female)in the final analysis.The most common presenting symptoms and exam findings were pain(100%),swelling(90%),and erythema(74%).The most common sonographic findings were edema(76%),soft tissue swelling(78%),and fluid surrounding the tendon(57%).POCUS was used in medical decision making 68%of the time(n=34),with the use of POCUS leading to changes in management 38%of the time(n=19).POCUS use led to early antibiotic use(11/19),early consultation(10/19),and led to the performance of a required procedure(8/19).The POCUS diagnosis was consistent with the discharge diagnosis of flexor tenosynovitis 8/12 times,abscess 12/16 times,and cellulitis 14/20 times.CONCLUSION:POCUS is beneficial for evaluating of hand infections that present to the ED and can be used as an important part of medical decision making to expedite patient care.展开更多
Percutaneous ultrasound has been a longstanding method in the diagnostics and interventional procedures of liver diseases.In some countries,its use is restricted to radiologists,limiting access for other clinicians,su...Percutaneous ultrasound has been a longstanding method in the diagnostics and interventional procedures of liver diseases.In some countries,its use is restricted to radiologists,limiting access for other clinicians,such as gastroenterologists.Endoscopic ultrasound,as a novel technique,plays a crucial role in diagnosis and treatment of digestive diseases.However,its use is sometimes recommended for conditions where no clear advantage over percutaneous ultrasound exists,leaving the impression that clinicians sometimes resort to an endoscopic approach due to the unavailability of percutaneous options.展开更多
Introduction: Ultrasound is an essential component of antenatal care. Midwives provide most of the antenatal care but they do not perform ultrasound as it has been beyond their scope of practice. This leaves many wome...Introduction: Ultrasound is an essential component of antenatal care. Midwives provide most of the antenatal care but they do not perform ultrasound as it has been beyond their scope of practice. This leaves many women in Low and Middle-Income Countries without access to ultrasound scanning. The aim of this study was to identify competencies in ultrasound scanning in midwifery education. Methods: A desk review and needs assessment were conducted between July and October 2023. Articles and curricula on the internet, Google scholar and PubMed were searched for content on ultrasound scanning competencies. A Google form consisting of 20 questions was administered via email and WhatsApp to 135 participants. Descriptive statistics were used to analyse data. Results: The desk review showed that it is feasible to train midwives in ultrasound scanning. The training programs for midwives in obstetric ultrasound were conducted for 1 week to 3 months with most of them running for 4 weeks. Content included introduction to general principles of ultrasound, physics, basic knowledge in embryology, obstetrics, anatomy, measuring foetal biometry, estimating amniotic fluid and gestational age. Experts like sonographers trained midwives. Theory and hands on were the teaching methods used. Written and practical assessments were conducted. Needs assessment revealed that majority of participants 71 (53%) knew about basic ultrasound training for midwives. All participants (100%) said it is necessary to train midwives in basic ultrasound scan in Zambia. Some content should include, anatomy, measuring foetal biometry, assessing amniotic fluid level, and gestational age determination. Most participants 91 (67%) suggested that the appropriate duration of training is 4 - 6 weeks. Conclusion: Empowering every midwife with ultrasound scanning skills will enable early detection of any abnormality among pregnant women and prompt intervention to save lives.展开更多
BACKGROUND Non-invasive differential diagnosis between hepatocellular carcinoma(HCC)and other liver cancer(i.e.cholangiocarcinoma or metastasis)is highly challenging and definitive diagnosis still relies on histologic...BACKGROUND Non-invasive differential diagnosis between hepatocellular carcinoma(HCC)and other liver cancer(i.e.cholangiocarcinoma or metastasis)is highly challenging and definitive diagnosis still relies on histological exam.The patterns of enhancement and wash-out of liver nodules can be used to stratify the risk of malignancy only in cirrhotic patients and HCC frequently shows atypical features.Dynamic contrast-enhanced ultrasound(DCEUS)with standardized software could help to overcome these obstacles,providing functional and quantitative parameters and potentially improving accuracy in the evaluation of tumor perfusion.AIM To explore clinical evidence regarding the application of DCEUS in the differential diagnosis of liver nodules.METHODS A comprehensive literature search of clinical studies was performed to identify the parameters of DCEUS that could relate to histological diagnosis.In accordance with the study protocol,a qualitative and quantitative analysis of the evidence was planned.RESULTS Rise time was significantly higher in HCC patients with a standardized mean difference(SMD)of 0.83(95%CI:0.48-1.18).Similarly,other statistically significant parameters were mean transit time local with a SMD of 0.73(95%CI:0.20-1.27),peak enhancement with a SMD of 0.37(95%CI:0.03-0.70),area wash-in area under the curve with a SMD of 0.47(95%CI:0.13-0.81),wash-out area under the curve with a SMD of 0.55(95%CI:0.21-0.89)and wash-in and wash-out area under the curve with SMD of 0.51(95%CI:0.17-0.85).SMD resulted not significant in fall time and wash-in rate,but the latter presented a trend towards greater values in HCC compared to intrahepatic cholangiocarcinoma.CONCLUSION DCEUS could improve non-invasive diagnosis of HCC,leading to less liver biopsy and early treatment.This quantitative analysis needs to be applied on larger cohorts to confirm these preliminary results.展开更多
BACKGROUND The incidence and mortality of lung cancer have increased annually.Accurate diagnosis can help improve therapeutic efficacy of interventions and prognosis.Percutaneous lung biopsy is a reliable method for t...BACKGROUND The incidence and mortality of lung cancer have increased annually.Accurate diagnosis can help improve therapeutic efficacy of interventions and prognosis.Percutaneous lung biopsy is a reliable method for the clinical diagnosis of lung cancer.Ultrasound-guided percutaneous lung biopsy technology has been widely promoted and applied in recent years.AIM To investigate the diagnostic value of contrast-enhanced ultrasound(CEUS)-guided percutaneous biopsy in peripheral pulmonary lesions.METHODS We retrospectively collected data on 237 patients with peripheral thoracic focal lesions who underwent puncture biopsy at Wuxi People’s Hospital.The patients were randomly divided into two groups:The CEUS-guided before lesion puncture group(contrast group)and conventional ultrasound-guided group(control group).Analyze the diagnostic efficacy of the puncture biopsy,impact of tumor size,and number of puncture needles and complications were analyzed and compared between the two groups.RESULTS Accurate pathological results were obtained for 92.83%(220/237)of peripheral lung lesions during the first biopsy,with an accuracy rate of 95.8%(113/118)in the contrast group and 89.9%(107/119)in the control group.The difference in the area under the curve(AUC)between the contrast and the control groups was not statistically significant(0.952 vs 0.902,respectively;P>0.05).However,when the lesion diameter≥5 cm,the diagnostic AUC of the contrast group was higher than that of the control group(0.952 vs 0.902,respectively;P<0.05).In addition,the average number of puncture needles in the contrast group was lower than that in the control group(2.58±0.53 vs 2.90±0.56,respectively;P<0.05).CONCLUSION CEUS guidance can enhance the efficiency of puncture biopsy of peripheral pulmonary lesions,especially for lesions with a diameter≥5 cm.Therefore,CEUS guidance has high clinical diagnostic value in puncture biopsy of peripheral focal lung lesions.展开更多
This editorial discusses the manuscript by Di Maria et al,published in the recent issue of the World Journal of Cardiology.We here focus on the still elusive pathophysiological mechanisms underlying cardio-renal syndr...This editorial discusses the manuscript by Di Maria et al,published in the recent issue of the World Journal of Cardiology.We here focus on the still elusive pathophysiological mechanisms underlying cardio-renal syndrome(CRS),despite its high prevalence and the substantial worsening of both kidney function and heart failure.While the measure of right atrial pressure through right cardiac catheterization remains the most accurate albeit invasive and costly procedure,integrating bedside ultrasound into diagnostic protocols may substantially enhance the staging of venous congestion and guide therapeutic decisions.In particular,with the assessment of Doppler patterns across multiple venous districts,the Venous Excess Ultrasound(VExUS)score improves the management of fluid overload and provides insight into the underlying factors contributing to cardio-renal interactions.Integrating specific echocardiographic parameters,particularly those concerning the right heart,may thus improve the VExUS score sensitivity,offering perspective into the nuanced comprehension of cardio-renal dynamics.A multidisciplinary approach that consistently incorporates the use of ultrasound is emerging as a promising advance in the understanding and management of CRS.展开更多
Objective:To define the roles of gray-scale,color-Doppler ultrasound,and sonoelastography for the assessment of thyroid nodule to determine whether nodule size affects the differential diagnosis of benign and malignan...Objective:To define the roles of gray-scale,color-Doppler ultrasound,and sonoelastography for the assessment of thyroid nodule to determine whether nodule size affects the differential diagnosis of benign and malignant.Methods:A total of 243 consecutive subjects(214 women,29 men) with 329 thyroid nodules were examined by gray-scale,color-Doppler ultrasound,and sonoelastography in this prospective study.All patients underwent surgery and the final diagnosis was obtained from histopathological examination.Results:Three hundred and twenty-nine nodules(208 benign,121 malignant) were divided into small(SNs,5-10 mm,n=137) and large(LNs,>10 mm,n=192) nodules.Microcalcifications were more frequent in malignant LNs than in malignant SNs,but showed no significant difference between benign LNs and SNs.Poorly-circumscribed margins were not significantly different between malignant SNs and LNs,but were less frequent in benign LNs than in benign SNs.Among all nodules,marked intranodular vascularity was more frequent in LNs than in SNs.By comparison,shape ratio of anteroposterior to transverse dimensions(A/T) ≥1 was less frequent in LNs than in SNs.Otherwise,among all nodules,marked hypoechogenicity and elasticity score of 4-6 showed no significant difference between LNs and SNs.Conclusions:The predictive values of microcalcifications,nodular margins,A/T ratio,and marked intranodular vascularity depend on nodule size,but the predictive values of echogenicity and elastography do not.展开更多
Objective: To explore the value of percutaneous ultrasonography combined with transvenous ultrasonography for accurate localization of sentinel lymph nodes and diagnosis of metastatic lymph nodes in patients with brea...Objective: To explore the value of percutaneous ultrasonography combined with transvenous ultrasonography for accurate localization of sentinel lymph nodes and diagnosis of metastatic lymph nodes in patients with breast cancer. Methods: 18 cases of patients with breast cancer attending the Hainan General Hospital from May 2022 to June 2024 who were proposed to undergo axillary lymph node dissection were selected, and the ultrasonographic agent was injected subcutaneously through the areola on the 1st day before the operation, and the marker localization of the manifestation of the Sentinel lymph nodes and draw the lymphatic vessel alignment for drainage on the body surface, and record the manifestation of SLN by conventional ultrasound and dual ultrasonography. At the time of surgery, intraoperative melphalan localization was used to identify the SLN, the difference between the number of ultrasound and melphalan localization was observed, and resection was performed for pathological examination to determine whether they were metastatic or not. Results: There were 8 metastatic lymph nodes and 18 non-metastatic lymph nodes among 31 SLN. A total of 62 SLN were localized by intraoperative melphalan, of which 31 were consistent with ultrasound localization and 31 were not identified by ultrasound. The diagnostic sensitivity of SLN metastasis diagnosed by transcutaneous ultrasonography was 62.50%, specificity was 91.30%, positive predictive value was 71.43%, negative predictive value 87.50%, accuracy was 83.87%, and the AUC was 0.769;the diagnostic sensitivityof transvenous ultrasonography diagnosed was 75.00%, specificity was 75.00%, and the accuracy was 83.87%, 75.00%, specificity 91.30%, positive predictive value 75.00%, negative predictive value 91.30%, accuracy 87.10%, AUC 0.832;dual ultrasonography diagnostic sensitivity 87.50%, specificity 91.30%, positive predictive value 77.78%, negative predictive value 95.45%, accuracy 90.32%. The AUC was 0.894. Conclusion: Transcutaneous ultrasonography combined with transvenous ultrasonography can accurately localize sentinel lymph nodes and improve the sensitivity and accuracy of the diagnosis of metastatic SLN.展开更多
The gallbladder(GB)is a susceptible organ,prone to various pathologies that can be identified using different imaging techniques.Transabdominal ultrasound(TUS)is typically the initial diagnostic method due to its nume...The gallbladder(GB)is a susceptible organ,prone to various pathologies that can be identified using different imaging techniques.Transabdominal ultrasound(TUS)is typically the initial diagnostic method due to its numerous well-established advantages.However,in cases of uncertainty or when a definitive diagnosis cannot be established,computed tomography(CT)or magnetic resonance imaging may be employed to provide more detailed information.Nevertheless,CT scans may sometimes offer inadequate spatial resolution,which can limit the differentiation of GB lesions,particularly when smaller yet clinically relevant abnormalities are involved.Conversely,endoscopic ultrasound(EUS)provides higher frequency compared to TUS,superior spatial resolution,and the option for contrast-enhanced harmonic imaging,enabling a more comprehensive examination.Thus,EUS can serve as a supplementary tool when conventional imaging methods are insufficient.This review will describe the standard EUS examination of the GB,focusing on its endosonographic characteristics in various GB path-ologies.展开更多
Point-of-care ultrasound(POCUS)of the internal jugular vein(IJV)offers a noninvasive means of estimating right atrial pressure(RAP),especially in cases where the inferior vena cava is inaccessible or unreliable due to...Point-of-care ultrasound(POCUS)of the internal jugular vein(IJV)offers a noninvasive means of estimating right atrial pressure(RAP),especially in cases where the inferior vena cava is inaccessible or unreliable due to conditions such as liver disease or abdominal surgery.While many clinicians are familiar with visually assessing jugular venous pressure through the internal jugular vein,this method lacks sensitivity.The utilization of POCUS significantly enhances the visualization of the vein,leading to a more accurate identification.It has been demonstrated that combining IJV POCUS with physical examination enhances the specificity of RAP estimation.This review aims to provide a comprehensive summary of the various sonographic techniques available for estimating RAP from the internal jugular vein,drawing upon existing data.展开更多
Cirrhosis is frequently associated with sarcopenia,with reported rates of over 80%in patients with decompensated alcohol-related liver disease.Sarcopenia nega-tively impacts the prognosis of cirrhotic patients and aff...Cirrhosis is frequently associated with sarcopenia,with reported rates of over 80%in patients with decompensated alcohol-related liver disease.Sarcopenia nega-tively impacts the prognosis of cirrhotic patients and affects the response to treatment of patients with hepatocellular carcinoma(HCC).For these reasons,identifying an easy-to-perform method to assess sarcopenia in is a key element in the optimization of care in this patient population.Assessment of muscle mass by computed tomography is considered the standard of care for the diagnosis of sarcopenia,but exposure to radiation and high costs limit its application in this setting,especially for repeated assessments.We believe that ultrasound,a cheap and harmless technique also used for HCC screening in cirrhotic patients,could have an expanding role in the diagnosis and follow-up of sarcopenia in these patients.展开更多
In this editorial,we comment on the article by Peng et al.Palliative drainage for biliary obstruction resulting from unresectable malignant lesions includes internal and external drainage.The procedures of biliary dra...In this editorial,we comment on the article by Peng et al.Palliative drainage for biliary obstruction resulting from unresectable malignant lesions includes internal and external drainage.The procedures of biliary drainage are usually guided by fluoroscopy or transcutaneous ultrasound,endoscopic ultrasound(EUS),or both.Endoscopic retrograde cholangiopancreatography(ERCP)has been primarily recommended for the management of biliary obstruction,while EUS-guided biliary drainage and percutaneous transhepatic biliary drainage(PTBD)are alternative choices for cases where ERCP has failed or is impossible.PTBD is limited by shortcomings of a higher rate of adverse events,more reinterventions,and severe complications.EUS-guided biliary drainage has a lower rate of adverse events than PTBD.EUS-guided biliary drainage with electrocautery-enhanced lumen-apposing metal stent(ECE-LAMS)enables EUS-guided biliaryenteric anastomosis to be performed in a single step and does not require prior bile duct puncture or a guidewire.The present meta-analysis showed that ECELAMS has a high efficacy and safety in relieving biliary obstruction in general,although the results of LAMS depending on the site of biliary obstruction.This study has highlighted the latest advances with a larger sample-based comprehensive analysis.展开更多
In order to suppress the low-frequency ultrasound vibration in the broadband range of 20 k Hz—100 k Hz,this paper proposes and discusses an acoustic metamaterial with low-frequency ultrasound vibration attenuation pr...In order to suppress the low-frequency ultrasound vibration in the broadband range of 20 k Hz—100 k Hz,this paper proposes and discusses an acoustic metamaterial with low-frequency ultrasound vibration attenuation properties,which is configured by hybrid arc and sharp-angle convergent star-shaped lattices.The effect of the dispersion relation and the bandgap characteristic for the scatterers in star-shaped are simulated and analyzed.The target bandgap width is extended by optimizing the geometry parameters of arc and sharp-angle convergent lattices.The proposed metamaterial configured by optimized hybrid lattices exhibits remarkable broad bandgap characteristics by bandgap complementarity,and the simulation results verify a 99%vibration attenuation amplitude can be obtained in the frequency of20 k Hz—100 k Hz.After the fabrication of the proposed hybrid configurational star-shaped metamaterial by 3D printing technique,the transmission loss experiments are performed,and the experimental results indicate that the fabricated metamaterial has the characteristics of broadband vibration attenuation and an amplitude greater than 85%attenuation for the target frequency.These results demonstrate that the hybrid configurational star-shaped metamaterials can effectively widen the bandgap and realize high efficiency attenuation,which has capability for the vibration attenuation in the application of highprecise equipment.展开更多
BACKGROUND The maximum outer diameter(MOD)of the appendix is an essential parameter for diagnosing acute appendicitis,but there is space for improvement in ultrasound(US)diagnostic performance.AIM To investigate wheth...BACKGROUND The maximum outer diameter(MOD)of the appendix is an essential parameter for diagnosing acute appendicitis,but there is space for improvement in ultrasound(US)diagnostic performance.AIM To investigate whether combining the ratio of the cross diameters(RATIO)of the appendix with MOD of the appendix can enhance the diagnostic performance of acute appendicitis.METHODS A retrospective study was conducted,and medical records of 233 patients with acute appendicitis and 112 patients with a normal appendix were reviewed.The MOD and RATIO of the appendix were calculated and tested for their diagnostic performance of acute appendicitis,both individually and in combination.RESULTS The RATIO for a normal appendix was 1.32±0.16,while for acute appendicitis it was 1.09±0.07.The cut-off value for RATIO was determined to be≤1.18.The area under the receiver operating characteristic curve(AUC)for diagnosing acute appendicitis using RATIO≤1.18 and MOD>6 mm was 0.870 and 0.652,respectively.There was a significant difference in AUC between RATIO≤1.18 and MOD>6 mm(P<0.0001).When comparing the combination of RATIO≤1.18 and MOD>6 mm with MOD>6 mm alone,the combination showed increased specificity,positive predictive value(PPV),and AUC.However,the sensitivity and negative predictive value decreased.CONCLUSION Combining RATIO of the appendix≤1.18 and MOD>6 mm can significantly improve the specificity,PPV,and AUC in the US diagnosis of acute appendicitis.展开更多
Objectives: To demonstrate the contribution and relevance of ETFs through the study of 1000 examination reports carried out in the medical imaging departments of the OUAGADOUGOU CHU. Material and method: Analytical de...Objectives: To demonstrate the contribution and relevance of ETFs through the study of 1000 examination reports carried out in the medical imaging departments of the OUAGADOUGOU CHU. Material and method: Analytical descriptive study with retrospective collection, extended from 1st January 2020 to 1st January 2022. Results: Of the 1000 transfontanellar ultrasound reports, the mean age of patients was 7.61 +/ 7.5 days, with extremes of zero and 28 days. Sex was specified in 989 cases. Males accounted for 54.49% and females for 45.51%. 555 transfontanellar ultrasound were performed in 2020. 441 in 2021 and 4 in 2022. 61.9% of transfontanellar ultrasound were performed at the Bogodogo University Hospital, 205 at Charles de Gaulle and 176 at Tengandogo. Indications for transfontanellar ultrasound were dominated by neonatal distress (65.8%), followed by convulsions (10.2%) and prematurity (9.1%). Transfontanellar ultrasound was normal in 570 cases (57%) and abnormal in 430 cases (43%). Abnormalities were dominated by haemorrhage and ischaemic lesions in 66.28% (285) and 21.63% (93) of cases respectively. In the group of normal transfontanellar ultrasound, neonatal distress represented 59.65% of indications and prematurity 10.7% of indications. As for abnormal transfontanellar ultrasound, neonatal suffering accounted for 73.95% of indications and convulsions for 12.56%. The average age ofpatients with an abnormal transfontanellar ultrasound was 8.74 days +/ 7.89 days. The indication for investigations was relevant in 42.2% of cases and irrelevant in 57.8%;of the transfontanellar ultrasound with relevant indications, 0.71 were normal and 99.29 abnormal;of the transfontanellar ultrasound with irrelevant indications, the transfontanellar ultrasound was normal in 98.1% and abnormal in 1.9%. Conclusion: Transfontanellar ultrasound is an important part of ultrasound in current practice. Haemorrhage, anoxic-ischaemic lesions and hydrocephalus are the most frequent pathologies found by this technique in newborns. Whether or not the examinations were normal depended on the appropriateness of the prescription.展开更多
Background Deep convolutional neural networks have garnered considerable attention in numerous machine learning applications,particularly in visual recognition tasks such as image and video analyses.There is a growing...Background Deep convolutional neural networks have garnered considerable attention in numerous machine learning applications,particularly in visual recognition tasks such as image and video analyses.There is a growing interest in applying this technology to diverse applications in medical image analysis.Automated three dimensional Breast Ultrasound is a vital tool for detecting breast cancer,and computer-assisted diagnosis software,developed based on deep learning,can effectively assist radiologists in diagnosis.However,the network model is prone to overfitting during training,owing to challenges such as insufficient training data.This study attempts to solve the problem caused by small datasets and improve model detection performance.Methods We propose a breast cancer detection framework based on deep learning(a transfer learning method based on cross-organ cancer detection)and a contrastive learning method based on breast imaging reporting and data systems(BI-RADS).Results When using cross organ transfer learning and BIRADS based contrastive learning,the average sensitivity of the model increased by a maximum of 16.05%.Conclusion Our experiments have demonstrated that the parameters and experiences of cross-organ cancer detection can be mutually referenced,and contrastive learning method based on BI-RADS can improve the detection performance of the model.展开更多
Objective:Complete resection of malignant gliomas is often challenging.Our previous study indicated that intraoperative contrast-enhanced ultrasound(ICEUS)could aid in the detection of residual tumor remnants and the ...Objective:Complete resection of malignant gliomas is often challenging.Our previous study indicated that intraoperative contrast-enhanced ultrasound(ICEUS)could aid in the detection of residual tumor remnants and the total removal of brain lesions.This study aimed to investigate the survival rates of patients undergoing resection with or without the use of ICEUS and to assess the impact of ICEUS on the prognosis of patients with malignant glioma.Methods:A total of 64 patients diagnosed with malignant glioma(WHO grade HI and IV)who underwent surgery between 2012 and 2018 were included.Among them,29 patients received ICEUS.The effects of ICEUS on overall survival(OS)and progression-free survival(PFS)of patients were evaluated.A quantitative analysis was performed to compare ICEUS parameters between gliomas and the surrounding tissues.Results:The ICEUS group showed better survival rates both in OS and PFS than the control group.The univariate analysis revealed that age,pathology and ICEUS were significant prognostic factors for PFS,with only age being a significant prognostic factor for OS.In multivariate analysis,age and ICEUS were significant prognostic factors for both OS and PFS.The quantitative analysis showed that the intensity and transit time of microbubbles reaching the tumors were significantly different from those of microbubbles reaching the surrounding tissue.Conclusion:ICEUS facilitates the identification of residual tumors.Age and ICEUS are prognostic factors for malignant glioma surgery,and use of ICEUS offers a better prognosis for patients with malignant glioma.展开更多
Breast cancer detection heavily relies on medical imaging, particularly ultrasound, for early diagnosis and effectivetreatment. This research addresses the challenges associated with computer-aided diagnosis (CAD) of ...Breast cancer detection heavily relies on medical imaging, particularly ultrasound, for early diagnosis and effectivetreatment. This research addresses the challenges associated with computer-aided diagnosis (CAD) of breastcancer fromultrasound images. The primary challenge is accurately distinguishing between malignant and benigntumors, complicated by factors such as speckle noise, variable image quality, and the need for precise segmentationand classification. The main objective of the research paper is to develop an advanced methodology for breastultrasound image classification, focusing on speckle noise reduction, precise segmentation, feature extraction, andmachine learning-based classification. A unique approach is introduced that combines Enhanced Speckle ReducedAnisotropic Diffusion (SRAD) filters for speckle noise reduction, U-NET-based segmentation, Genetic Algorithm(GA)-based feature selection, and Random Forest and Bagging Tree classifiers, resulting in a novel and efficientmodel. To test and validate the hybrid model, rigorous experimentations were performed and results state thatthe proposed hybrid model achieved accuracy rate of 99.9%, outperforming other existing techniques, and alsosignificantly reducing computational time. This enhanced accuracy, along with improved sensitivity and specificity,makes the proposed hybrid model a valuable addition to CAD systems in breast cancer diagnosis, ultimatelyenhancing diagnostic accuracy in clinical applications.展开更多
Endoscopic ultrasound(EUS)with fine needle aspiration or fine needle biopsy is the gold standard for sampling tissue to diagnose pancreatic cancer and auto-immune pancreatitis or to analyze cyst fluid.The most common ...Endoscopic ultrasound(EUS)with fine needle aspiration or fine needle biopsy is the gold standard for sampling tissue to diagnose pancreatic cancer and auto-immune pancreatitis or to analyze cyst fluid.The most common reported adverse event of fine needle aspiration and/or fine needle biopsy is acute pancreatitis,which is likely induced by the same pathophysiological mechanisms as after en-doscopic retrograde cholangiopancreatography(ERCP).According to the current European Society of Gastrointestinal Endoscopy guideline,nonsteroidal anti-inflammatory drugs are administered prior to ERCP as a scientifically proven treatment to reduce post-ERCP pancreatitis incidence rate.A single suppository of diclofenac or indomethacin prior to EUS guided tissue acquisition(TA)is harm-less in healthy adults.Since it is associated with low costs and,most important,may prevent a dreadsome complication,we strongly recommend the adminis-tration of 100 mg diclofenac rectally prior to EUS-TA.We will explain this recom-mendation in more detail in this review as well as the risk and pathophysiology of post-EUS TA pancreatitis.展开更多
基金Supported by the National Natural Science Foundation of China,No.82305380The Postdoctoral Research Program,West China Hospital,Sichuan University,No.2020HXBH018.
文摘BACKGROUND Ultrasound guide technology,which can provide real-time visualization of the needle tip and tissues and avoid many adverse events,is widely used in mini-mally invasive therapy.However,the studies on ultrasound-guided Lateral recess block(LRB)are limited,this is probably because there is no recognized standard method for ultrasound scanning.This study aimed to evaluate the effect of ultrasound-guided LRB in patients with lateral recess stenosis(LRS).CASE SUMMARY A 65-year-old patient complained of low back pain accompanied occasionally by pain and numbness in the left lower limb.Physical examination showed ten-derness on the spinous process and paraspinal muscles from L1 to S1,extensor hallucis longus and tibialis anterior weakness(muscle strength:4-),and a positive straight leg raising test in the left lower limb(60°).Magnetic resonance imaging showed L4–L5 disc degeneration with left LRS and nerve root entrapment.Subsequently,the patient was diagnosed with LRS.This patient was treated with a novel ultrasound-guided LRB approach.The patient’s symptoms significantly improved without any complications at 1 wk postoperatively and at the 3-month follow-up.CONCLUSION This is the first report on the LRS treatment with ultrasound-guided LRB from the contralateral spinous process along the inner side of the articular process by out-plane technique.Further studies are expected to investigate the efficacy and safety of ultrasound-guided LRB for patients with LRS.
文摘BACKGROUND:We aimed to evaluate the utility of point-of-care ultrasound(POCUS)in the assessment of hand infections that present to the emergency department(ED)and its impact on medical decision making and patient management.METHODS:We conducted a retrospective review of patients who presented to two urban academic EDs with clinical presentations concerning for skin and soft tissue infections(SSTI)of the hand between December 2015 and December 2021.Two trained POCUS fellowship physicians reviewed an ED POCUS database for POCUS examinations of the hand.We then reviewed patients’electronic health records(EHR)for demographic characteristics,history,physical examination findings,ED course,additional imaging studies,consultations,impact of POCUS on patient care and final disposition.RESULTS:We included a total of 50 cases(28 male,22 female)in the final analysis.The most common presenting symptoms and exam findings were pain(100%),swelling(90%),and erythema(74%).The most common sonographic findings were edema(76%),soft tissue swelling(78%),and fluid surrounding the tendon(57%).POCUS was used in medical decision making 68%of the time(n=34),with the use of POCUS leading to changes in management 38%of the time(n=19).POCUS use led to early antibiotic use(11/19),early consultation(10/19),and led to the performance of a required procedure(8/19).The POCUS diagnosis was consistent with the discharge diagnosis of flexor tenosynovitis 8/12 times,abscess 12/16 times,and cellulitis 14/20 times.CONCLUSION:POCUS is beneficial for evaluating of hand infections that present to the ED and can be used as an important part of medical decision making to expedite patient care.
文摘Percutaneous ultrasound has been a longstanding method in the diagnostics and interventional procedures of liver diseases.In some countries,its use is restricted to radiologists,limiting access for other clinicians,such as gastroenterologists.Endoscopic ultrasound,as a novel technique,plays a crucial role in diagnosis and treatment of digestive diseases.However,its use is sometimes recommended for conditions where no clear advantage over percutaneous ultrasound exists,leaving the impression that clinicians sometimes resort to an endoscopic approach due to the unavailability of percutaneous options.
文摘Introduction: Ultrasound is an essential component of antenatal care. Midwives provide most of the antenatal care but they do not perform ultrasound as it has been beyond their scope of practice. This leaves many women in Low and Middle-Income Countries without access to ultrasound scanning. The aim of this study was to identify competencies in ultrasound scanning in midwifery education. Methods: A desk review and needs assessment were conducted between July and October 2023. Articles and curricula on the internet, Google scholar and PubMed were searched for content on ultrasound scanning competencies. A Google form consisting of 20 questions was administered via email and WhatsApp to 135 participants. Descriptive statistics were used to analyse data. Results: The desk review showed that it is feasible to train midwives in ultrasound scanning. The training programs for midwives in obstetric ultrasound were conducted for 1 week to 3 months with most of them running for 4 weeks. Content included introduction to general principles of ultrasound, physics, basic knowledge in embryology, obstetrics, anatomy, measuring foetal biometry, estimating amniotic fluid and gestational age. Experts like sonographers trained midwives. Theory and hands on were the teaching methods used. Written and practical assessments were conducted. Needs assessment revealed that majority of participants 71 (53%) knew about basic ultrasound training for midwives. All participants (100%) said it is necessary to train midwives in basic ultrasound scan in Zambia. Some content should include, anatomy, measuring foetal biometry, assessing amniotic fluid level, and gestational age determination. Most participants 91 (67%) suggested that the appropriate duration of training is 4 - 6 weeks. Conclusion: Empowering every midwife with ultrasound scanning skills will enable early detection of any abnormality among pregnant women and prompt intervention to save lives.
文摘BACKGROUND Non-invasive differential diagnosis between hepatocellular carcinoma(HCC)and other liver cancer(i.e.cholangiocarcinoma or metastasis)is highly challenging and definitive diagnosis still relies on histological exam.The patterns of enhancement and wash-out of liver nodules can be used to stratify the risk of malignancy only in cirrhotic patients and HCC frequently shows atypical features.Dynamic contrast-enhanced ultrasound(DCEUS)with standardized software could help to overcome these obstacles,providing functional and quantitative parameters and potentially improving accuracy in the evaluation of tumor perfusion.AIM To explore clinical evidence regarding the application of DCEUS in the differential diagnosis of liver nodules.METHODS A comprehensive literature search of clinical studies was performed to identify the parameters of DCEUS that could relate to histological diagnosis.In accordance with the study protocol,a qualitative and quantitative analysis of the evidence was planned.RESULTS Rise time was significantly higher in HCC patients with a standardized mean difference(SMD)of 0.83(95%CI:0.48-1.18).Similarly,other statistically significant parameters were mean transit time local with a SMD of 0.73(95%CI:0.20-1.27),peak enhancement with a SMD of 0.37(95%CI:0.03-0.70),area wash-in area under the curve with a SMD of 0.47(95%CI:0.13-0.81),wash-out area under the curve with a SMD of 0.55(95%CI:0.21-0.89)and wash-in and wash-out area under the curve with SMD of 0.51(95%CI:0.17-0.85).SMD resulted not significant in fall time and wash-in rate,but the latter presented a trend towards greater values in HCC compared to intrahepatic cholangiocarcinoma.CONCLUSION DCEUS could improve non-invasive diagnosis of HCC,leading to less liver biopsy and early treatment.This quantitative analysis needs to be applied on larger cohorts to confirm these preliminary results.
基金the Ethic Committee of Wuxi People's Hospital(No.KY17071).
文摘BACKGROUND The incidence and mortality of lung cancer have increased annually.Accurate diagnosis can help improve therapeutic efficacy of interventions and prognosis.Percutaneous lung biopsy is a reliable method for the clinical diagnosis of lung cancer.Ultrasound-guided percutaneous lung biopsy technology has been widely promoted and applied in recent years.AIM To investigate the diagnostic value of contrast-enhanced ultrasound(CEUS)-guided percutaneous biopsy in peripheral pulmonary lesions.METHODS We retrospectively collected data on 237 patients with peripheral thoracic focal lesions who underwent puncture biopsy at Wuxi People’s Hospital.The patients were randomly divided into two groups:The CEUS-guided before lesion puncture group(contrast group)and conventional ultrasound-guided group(control group).Analyze the diagnostic efficacy of the puncture biopsy,impact of tumor size,and number of puncture needles and complications were analyzed and compared between the two groups.RESULTS Accurate pathological results were obtained for 92.83%(220/237)of peripheral lung lesions during the first biopsy,with an accuracy rate of 95.8%(113/118)in the contrast group and 89.9%(107/119)in the control group.The difference in the area under the curve(AUC)between the contrast and the control groups was not statistically significant(0.952 vs 0.902,respectively;P>0.05).However,when the lesion diameter≥5 cm,the diagnostic AUC of the contrast group was higher than that of the control group(0.952 vs 0.902,respectively;P<0.05).In addition,the average number of puncture needles in the contrast group was lower than that in the control group(2.58±0.53 vs 2.90±0.56,respectively;P<0.05).CONCLUSION CEUS guidance can enhance the efficiency of puncture biopsy of peripheral pulmonary lesions,especially for lesions with a diameter≥5 cm.Therefore,CEUS guidance has high clinical diagnostic value in puncture biopsy of peripheral focal lung lesions.
文摘This editorial discusses the manuscript by Di Maria et al,published in the recent issue of the World Journal of Cardiology.We here focus on the still elusive pathophysiological mechanisms underlying cardio-renal syndrome(CRS),despite its high prevalence and the substantial worsening of both kidney function and heart failure.While the measure of right atrial pressure through right cardiac catheterization remains the most accurate albeit invasive and costly procedure,integrating bedside ultrasound into diagnostic protocols may substantially enhance the staging of venous congestion and guide therapeutic decisions.In particular,with the assessment of Doppler patterns across multiple venous districts,the Venous Excess Ultrasound(VExUS)score improves the management of fluid overload and provides insight into the underlying factors contributing to cardio-renal interactions.Integrating specific echocardiographic parameters,particularly those concerning the right heart,may thus improve the VExUS score sensitivity,offering perspective into the nuanced comprehension of cardio-renal dynamics.A multidisciplinary approach that consistently incorporates the use of ultrasound is emerging as a promising advance in the understanding and management of CRS.
文摘Objective:To define the roles of gray-scale,color-Doppler ultrasound,and sonoelastography for the assessment of thyroid nodule to determine whether nodule size affects the differential diagnosis of benign and malignant.Methods:A total of 243 consecutive subjects(214 women,29 men) with 329 thyroid nodules were examined by gray-scale,color-Doppler ultrasound,and sonoelastography in this prospective study.All patients underwent surgery and the final diagnosis was obtained from histopathological examination.Results:Three hundred and twenty-nine nodules(208 benign,121 malignant) were divided into small(SNs,5-10 mm,n=137) and large(LNs,>10 mm,n=192) nodules.Microcalcifications were more frequent in malignant LNs than in malignant SNs,but showed no significant difference between benign LNs and SNs.Poorly-circumscribed margins were not significantly different between malignant SNs and LNs,but were less frequent in benign LNs than in benign SNs.Among all nodules,marked intranodular vascularity was more frequent in LNs than in SNs.By comparison,shape ratio of anteroposterior to transverse dimensions(A/T) ≥1 was less frequent in LNs than in SNs.Otherwise,among all nodules,marked hypoechogenicity and elasticity score of 4-6 showed no significant difference between LNs and SNs.Conclusions:The predictive values of microcalcifications,nodular margins,A/T ratio,and marked intranodular vascularity depend on nodule size,but the predictive values of echogenicity and elastography do not.
文摘Objective: To explore the value of percutaneous ultrasonography combined with transvenous ultrasonography for accurate localization of sentinel lymph nodes and diagnosis of metastatic lymph nodes in patients with breast cancer. Methods: 18 cases of patients with breast cancer attending the Hainan General Hospital from May 2022 to June 2024 who were proposed to undergo axillary lymph node dissection were selected, and the ultrasonographic agent was injected subcutaneously through the areola on the 1st day before the operation, and the marker localization of the manifestation of the Sentinel lymph nodes and draw the lymphatic vessel alignment for drainage on the body surface, and record the manifestation of SLN by conventional ultrasound and dual ultrasonography. At the time of surgery, intraoperative melphalan localization was used to identify the SLN, the difference between the number of ultrasound and melphalan localization was observed, and resection was performed for pathological examination to determine whether they were metastatic or not. Results: There were 8 metastatic lymph nodes and 18 non-metastatic lymph nodes among 31 SLN. A total of 62 SLN were localized by intraoperative melphalan, of which 31 were consistent with ultrasound localization and 31 were not identified by ultrasound. The diagnostic sensitivity of SLN metastasis diagnosed by transcutaneous ultrasonography was 62.50%, specificity was 91.30%, positive predictive value was 71.43%, negative predictive value 87.50%, accuracy was 83.87%, and the AUC was 0.769;the diagnostic sensitivityof transvenous ultrasonography diagnosed was 75.00%, specificity was 75.00%, and the accuracy was 83.87%, 75.00%, specificity 91.30%, positive predictive value 75.00%, negative predictive value 91.30%, accuracy 87.10%, AUC 0.832;dual ultrasonography diagnostic sensitivity 87.50%, specificity 91.30%, positive predictive value 77.78%, negative predictive value 95.45%, accuracy 90.32%. The AUC was 0.894. Conclusion: Transcutaneous ultrasonography combined with transvenous ultrasonography can accurately localize sentinel lymph nodes and improve the sensitivity and accuracy of the diagnosis of metastatic SLN.
文摘The gallbladder(GB)is a susceptible organ,prone to various pathologies that can be identified using different imaging techniques.Transabdominal ultrasound(TUS)is typically the initial diagnostic method due to its numerous well-established advantages.However,in cases of uncertainty or when a definitive diagnosis cannot be established,computed tomography(CT)or magnetic resonance imaging may be employed to provide more detailed information.Nevertheless,CT scans may sometimes offer inadequate spatial resolution,which can limit the differentiation of GB lesions,particularly when smaller yet clinically relevant abnormalities are involved.Conversely,endoscopic ultrasound(EUS)provides higher frequency compared to TUS,superior spatial resolution,and the option for contrast-enhanced harmonic imaging,enabling a more comprehensive examination.Thus,EUS can serve as a supplementary tool when conventional imaging methods are insufficient.This review will describe the standard EUS examination of the GB,focusing on its endosonographic characteristics in various GB path-ologies.
文摘Point-of-care ultrasound(POCUS)of the internal jugular vein(IJV)offers a noninvasive means of estimating right atrial pressure(RAP),especially in cases where the inferior vena cava is inaccessible or unreliable due to conditions such as liver disease or abdominal surgery.While many clinicians are familiar with visually assessing jugular venous pressure through the internal jugular vein,this method lacks sensitivity.The utilization of POCUS significantly enhances the visualization of the vein,leading to a more accurate identification.It has been demonstrated that combining IJV POCUS with physical examination enhances the specificity of RAP estimation.This review aims to provide a comprehensive summary of the various sonographic techniques available for estimating RAP from the internal jugular vein,drawing upon existing data.
文摘Cirrhosis is frequently associated with sarcopenia,with reported rates of over 80%in patients with decompensated alcohol-related liver disease.Sarcopenia nega-tively impacts the prognosis of cirrhotic patients and affects the response to treatment of patients with hepatocellular carcinoma(HCC).For these reasons,identifying an easy-to-perform method to assess sarcopenia in is a key element in the optimization of care in this patient population.Assessment of muscle mass by computed tomography is considered the standard of care for the diagnosis of sarcopenia,but exposure to radiation and high costs limit its application in this setting,especially for repeated assessments.We believe that ultrasound,a cheap and harmless technique also used for HCC screening in cirrhotic patients,could have an expanding role in the diagnosis and follow-up of sarcopenia in these patients.
文摘In this editorial,we comment on the article by Peng et al.Palliative drainage for biliary obstruction resulting from unresectable malignant lesions includes internal and external drainage.The procedures of biliary drainage are usually guided by fluoroscopy or transcutaneous ultrasound,endoscopic ultrasound(EUS),or both.Endoscopic retrograde cholangiopancreatography(ERCP)has been primarily recommended for the management of biliary obstruction,while EUS-guided biliary drainage and percutaneous transhepatic biliary drainage(PTBD)are alternative choices for cases where ERCP has failed or is impossible.PTBD is limited by shortcomings of a higher rate of adverse events,more reinterventions,and severe complications.EUS-guided biliary drainage has a lower rate of adverse events than PTBD.EUS-guided biliary drainage with electrocautery-enhanced lumen-apposing metal stent(ECE-LAMS)enables EUS-guided biliaryenteric anastomosis to be performed in a single step and does not require prior bile duct puncture or a guidewire.The present meta-analysis showed that ECELAMS has a high efficacy and safety in relieving biliary obstruction in general,although the results of LAMS depending on the site of biliary obstruction.This study has highlighted the latest advances with a larger sample-based comprehensive analysis.
基金National Natural Science Foundation of China(Grant Nos.51821003,52175524,61704158)the Natural Science Foundation of Shanxi Province(Grant No.202103021224206)Shanxi"1331 Project"Key Subjects Construction to provide fund for conducting experiments。
文摘In order to suppress the low-frequency ultrasound vibration in the broadband range of 20 k Hz—100 k Hz,this paper proposes and discusses an acoustic metamaterial with low-frequency ultrasound vibration attenuation properties,which is configured by hybrid arc and sharp-angle convergent star-shaped lattices.The effect of the dispersion relation and the bandgap characteristic for the scatterers in star-shaped are simulated and analyzed.The target bandgap width is extended by optimizing the geometry parameters of arc and sharp-angle convergent lattices.The proposed metamaterial configured by optimized hybrid lattices exhibits remarkable broad bandgap characteristics by bandgap complementarity,and the simulation results verify a 99%vibration attenuation amplitude can be obtained in the frequency of20 k Hz—100 k Hz.After the fabrication of the proposed hybrid configurational star-shaped metamaterial by 3D printing technique,the transmission loss experiments are performed,and the experimental results indicate that the fabricated metamaterial has the characteristics of broadband vibration attenuation and an amplitude greater than 85%attenuation for the target frequency.These results demonstrate that the hybrid configurational star-shaped metamaterials can effectively widen the bandgap and realize high efficiency attenuation,which has capability for the vibration attenuation in the application of highprecise equipment.
文摘BACKGROUND The maximum outer diameter(MOD)of the appendix is an essential parameter for diagnosing acute appendicitis,but there is space for improvement in ultrasound(US)diagnostic performance.AIM To investigate whether combining the ratio of the cross diameters(RATIO)of the appendix with MOD of the appendix can enhance the diagnostic performance of acute appendicitis.METHODS A retrospective study was conducted,and medical records of 233 patients with acute appendicitis and 112 patients with a normal appendix were reviewed.The MOD and RATIO of the appendix were calculated and tested for their diagnostic performance of acute appendicitis,both individually and in combination.RESULTS The RATIO for a normal appendix was 1.32±0.16,while for acute appendicitis it was 1.09±0.07.The cut-off value for RATIO was determined to be≤1.18.The area under the receiver operating characteristic curve(AUC)for diagnosing acute appendicitis using RATIO≤1.18 and MOD>6 mm was 0.870 and 0.652,respectively.There was a significant difference in AUC between RATIO≤1.18 and MOD>6 mm(P<0.0001).When comparing the combination of RATIO≤1.18 and MOD>6 mm with MOD>6 mm alone,the combination showed increased specificity,positive predictive value(PPV),and AUC.However,the sensitivity and negative predictive value decreased.CONCLUSION Combining RATIO of the appendix≤1.18 and MOD>6 mm can significantly improve the specificity,PPV,and AUC in the US diagnosis of acute appendicitis.
文摘Objectives: To demonstrate the contribution and relevance of ETFs through the study of 1000 examination reports carried out in the medical imaging departments of the OUAGADOUGOU CHU. Material and method: Analytical descriptive study with retrospective collection, extended from 1st January 2020 to 1st January 2022. Results: Of the 1000 transfontanellar ultrasound reports, the mean age of patients was 7.61 +/ 7.5 days, with extremes of zero and 28 days. Sex was specified in 989 cases. Males accounted for 54.49% and females for 45.51%. 555 transfontanellar ultrasound were performed in 2020. 441 in 2021 and 4 in 2022. 61.9% of transfontanellar ultrasound were performed at the Bogodogo University Hospital, 205 at Charles de Gaulle and 176 at Tengandogo. Indications for transfontanellar ultrasound were dominated by neonatal distress (65.8%), followed by convulsions (10.2%) and prematurity (9.1%). Transfontanellar ultrasound was normal in 570 cases (57%) and abnormal in 430 cases (43%). Abnormalities were dominated by haemorrhage and ischaemic lesions in 66.28% (285) and 21.63% (93) of cases respectively. In the group of normal transfontanellar ultrasound, neonatal distress represented 59.65% of indications and prematurity 10.7% of indications. As for abnormal transfontanellar ultrasound, neonatal suffering accounted for 73.95% of indications and convulsions for 12.56%. The average age ofpatients with an abnormal transfontanellar ultrasound was 8.74 days +/ 7.89 days. The indication for investigations was relevant in 42.2% of cases and irrelevant in 57.8%;of the transfontanellar ultrasound with relevant indications, 0.71 were normal and 99.29 abnormal;of the transfontanellar ultrasound with irrelevant indications, the transfontanellar ultrasound was normal in 98.1% and abnormal in 1.9%. Conclusion: Transfontanellar ultrasound is an important part of ultrasound in current practice. Haemorrhage, anoxic-ischaemic lesions and hydrocephalus are the most frequent pathologies found by this technique in newborns. Whether or not the examinations were normal depended on the appropriateness of the prescription.
基金Macao Polytechnic University Grant(RP/FCSD-01/2022RP/FCA-05/2022)Science and Technology Development Fund of Macao(0105/2022/A).
文摘Background Deep convolutional neural networks have garnered considerable attention in numerous machine learning applications,particularly in visual recognition tasks such as image and video analyses.There is a growing interest in applying this technology to diverse applications in medical image analysis.Automated three dimensional Breast Ultrasound is a vital tool for detecting breast cancer,and computer-assisted diagnosis software,developed based on deep learning,can effectively assist radiologists in diagnosis.However,the network model is prone to overfitting during training,owing to challenges such as insufficient training data.This study attempts to solve the problem caused by small datasets and improve model detection performance.Methods We propose a breast cancer detection framework based on deep learning(a transfer learning method based on cross-organ cancer detection)and a contrastive learning method based on breast imaging reporting and data systems(BI-RADS).Results When using cross organ transfer learning and BIRADS based contrastive learning,the average sensitivity of the model increased by a maximum of 16.05%.Conclusion Our experiments have demonstrated that the parameters and experiences of cross-organ cancer detection can be mutually referenced,and contrastive learning method based on BI-RADS can improve the detection performance of the model.
基金funded by grants from the Natural Science Foundation of Hubei Province,China(No.2022CFB307)and the Foundation of Tongji Hospital(No.2020JZKT292).
文摘Objective:Complete resection of malignant gliomas is often challenging.Our previous study indicated that intraoperative contrast-enhanced ultrasound(ICEUS)could aid in the detection of residual tumor remnants and the total removal of brain lesions.This study aimed to investigate the survival rates of patients undergoing resection with or without the use of ICEUS and to assess the impact of ICEUS on the prognosis of patients with malignant glioma.Methods:A total of 64 patients diagnosed with malignant glioma(WHO grade HI and IV)who underwent surgery between 2012 and 2018 were included.Among them,29 patients received ICEUS.The effects of ICEUS on overall survival(OS)and progression-free survival(PFS)of patients were evaluated.A quantitative analysis was performed to compare ICEUS parameters between gliomas and the surrounding tissues.Results:The ICEUS group showed better survival rates both in OS and PFS than the control group.The univariate analysis revealed that age,pathology and ICEUS were significant prognostic factors for PFS,with only age being a significant prognostic factor for OS.In multivariate analysis,age and ICEUS were significant prognostic factors for both OS and PFS.The quantitative analysis showed that the intensity and transit time of microbubbles reaching the tumors were significantly different from those of microbubbles reaching the surrounding tissue.Conclusion:ICEUS facilitates the identification of residual tumors.Age and ICEUS are prognostic factors for malignant glioma surgery,and use of ICEUS offers a better prognosis for patients with malignant glioma.
基金funded through Researchers Supporting Project Number(RSPD2024R996)King Saud University,Riyadh,Saudi Arabia。
文摘Breast cancer detection heavily relies on medical imaging, particularly ultrasound, for early diagnosis and effectivetreatment. This research addresses the challenges associated with computer-aided diagnosis (CAD) of breastcancer fromultrasound images. The primary challenge is accurately distinguishing between malignant and benigntumors, complicated by factors such as speckle noise, variable image quality, and the need for precise segmentationand classification. The main objective of the research paper is to develop an advanced methodology for breastultrasound image classification, focusing on speckle noise reduction, precise segmentation, feature extraction, andmachine learning-based classification. A unique approach is introduced that combines Enhanced Speckle ReducedAnisotropic Diffusion (SRAD) filters for speckle noise reduction, U-NET-based segmentation, Genetic Algorithm(GA)-based feature selection, and Random Forest and Bagging Tree classifiers, resulting in a novel and efficientmodel. To test and validate the hybrid model, rigorous experimentations were performed and results state thatthe proposed hybrid model achieved accuracy rate of 99.9%, outperforming other existing techniques, and alsosignificantly reducing computational time. This enhanced accuracy, along with improved sensitivity and specificity,makes the proposed hybrid model a valuable addition to CAD systems in breast cancer diagnosis, ultimatelyenhancing diagnostic accuracy in clinical applications.
文摘Endoscopic ultrasound(EUS)with fine needle aspiration or fine needle biopsy is the gold standard for sampling tissue to diagnose pancreatic cancer and auto-immune pancreatitis or to analyze cyst fluid.The most common reported adverse event of fine needle aspiration and/or fine needle biopsy is acute pancreatitis,which is likely induced by the same pathophysiological mechanisms as after en-doscopic retrograde cholangiopancreatography(ERCP).According to the current European Society of Gastrointestinal Endoscopy guideline,nonsteroidal anti-inflammatory drugs are administered prior to ERCP as a scientifically proven treatment to reduce post-ERCP pancreatitis incidence rate.A single suppository of diclofenac or indomethacin prior to EUS guided tissue acquisition(TA)is harm-less in healthy adults.Since it is associated with low costs and,most important,may prevent a dreadsome complication,we strongly recommend the adminis-tration of 100 mg diclofenac rectally prior to EUS-TA.We will explain this recom-mendation in more detail in this review as well as the risk and pathophysiology of post-EUS TA pancreatitis.