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Ultrasound International Open
Number of Followers: 2  Open Access journalISSN (Online) 2199-7152 Published by Thieme Publishing Group  [233 journals]
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- Persistent Funic Presentation And Sonographic Assesment Of The Risk For
Umbilical Cord ProlapseUltrasound Int Open 2023; 09: E33-E35
DOI: 10.1055/a-2097-5143
Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
Artikel in Thieme eJournals:
Ultrasound Int Open 2023; 09: E33-E352023-12-14T07:46:47+0100
Inhaltsverzeichnis open access Volltext
Issue No: Vol. 09, No. 01 (2023)
- Structured Reporting of Head and Neck Sonography Achieves Substantial
Interrater Reliability
Authors: Ernst; Benjamin Philipp, Dörsching, Carla, Bozzato, Alessandro, Gabrielpillai, Jennis, Becker, Sven, Froelich, Matthias Frank, Kramer, Benedikt, Sproll, Christoph, Schapher, Mirco, Goncalves, Miguel, Mansour, Naglaa, Hofauer, Benedikt, Sommer, Wieland H, von Scotti, Felix, Weimer, Johannes Matthias, Künzel, Julian
Pages: E26 - E32
Abstract: Purpose Ultrasound examinations are often criticized for having higher examiner dependency compared to other imaging techniques. Compared to free-text reporting, structured reporting (SR) of head and neck sonography (HNS) achieves superior time efficiency as well as report quality. However, there are no findings concerning the influence of SR on the interrater reliability (IRR) of HNS. Materials and Methods Typical pathologies (n=4) in HNS were documented by video/images by two certified head and neck ultrasound instructors. Consequently, structured reports of these videos/images were created by n=9 senior physicians at departments of otolaryngology or maxillofacial surgery with DEGUM instructors on staff. Reports (n=36) were evaluated regarding overall completeness and IRR. Additionally, user satisfaction was assessed by a visual analog scale (VAS). Results SR yielded very high report completeness (91.8%) in all four cases with a substantial IRR (Fleiss‘ κ 0.73). Interrater agreement was high at 87.2% with very good user satisfaction (VAS 8.6). Conclusion SR has the potential to ensure high-quality examination reports with substantial comparability and very high user satisfaction. Furthermore, big data collection and analysis are facilitated by SR. Therefore, process quality, workflow, and scientific output are potentially enhanced by SR.
Citation: Ultrasound Int Open 2023; 09: E26-E32
PubDate: 2023-10-05T09:57:28+01:00
DOI: 10.1055/a-2173-3966
Issue No: Vol. 09, No. 01 (2023)
- Caesarean Scar Pregnancy: Single Dose of Intrasac Ultrasound-Guided
Methotrexate Injection Seems to be a Safe Option for Treatment
Authors: Rouvalis; Angeliki, Vlastarakos, Panagiotis, Daskalakis, Georgios, Pouliakis, Abraham, Stavrou, Sofoklis, Tsiriva, Maria, Giourga, Maria, Gerede, Angeliki, Pappa, Kalliopi, Gregoriadis, Themos, Vlachos, Dimitrios-Efthymios, Rodolakis, Alexandros, Domali, Ekaterini
Pages: E18 - E25
Abstract: The purpose of the study was to assess the efficacy of local ultrasound-guided methotrexate injection in patients with caesarean section scar pregnancy, to chart the course of beta-human chorionic gonadotropin levels (HCG) after treatment, and to see if HCG levels are correlated with clinical presentation.Between May 2018 and January 2021, data were collected retrospectively from the Early Pregnancy Unit of a tertiary hospital.Our clinic assessed 20 patients; one disputed terminating the pregnancy and was not included in the research. The remaining 19 patients, with a median age of 34 years, received intragestational sac methotrexate injection under ultrasound guidance. 7w3d was the median gestational age. These women had one to four previous caesarean sections, with a mean of 1.60±9. Patients with caesarean scar pregnancy most typically presented with spotting (42.1%), whereas 26.3% were asymptomatic. Except in cases of pain, the symptomatic women’s HCG levels were lower than in the non-symptomatic women. The level of HCG in patients with pain was approximately double that of non-pain patients (p=0.2557). In our series, intragestational sac methotrexate injection was effective in 17/19 women, or 89.5% (95%CI: 75.7-100%). HCG levels were undetectable in 97.6±30 days on average (minimum: 42 days, maximum: 147 days).Caesarean scar pregnancy is a rare possibly fatal condition with no consensus on the optimal treatment. An experienced Early Pregnancy Unit member performing local methotrexate injections under ultrasound guidance is a feasible and successful strategy in clinically stable patients.
Citation: Ultrasound Int Open 2023; 09: E18-E25
PubDate: 2023-09-18T10:31:15+01:00
DOI: 10.1055/a-2137-8318
Issue No: Vol. 09, No. 01 (2023)
- Evaluation of IOTA-ADNEX Model and Simple Rules for Identifying Adnexal
Masses by Operators with Varying Levels of Expertise: A Single-Center
Diagnostic Accuracy Study
Authors: Giourga; Maria, Pouliakis, Abraham, Vlastarakos, Panagiotis, Stavrou, Sofoklis, Tsiriva, Maria, Gerede, Angeliki, Daskalakis, Georgios, Voros, Charalampos, Drakakis, Petros, Domali, Ekaterini
Pages: E11 - E17
Abstract: Objectives The discrimination of ovarian lesions presents a significant problem in everyday clinical practice with ultrasonography appearing to be the most effective diagnostic technique. The aim of our study was to externally evaluate the performance of different diagnostic models when applied by examiners with various levels of experience. Methods This was a diagnostic accuracy study including women who were admitted for adnexal masses, between July 2018 and April 2021, to a Greek tertiary oncology center. Preoperatively sonographic data were evaluated by an expert gynecologist, a 6th and a 1st year gynecology resident, who applied the International Ovarian Tumor Analysis (IOTA) Simple Rules (SR) and Assessment of Different NEoplasias in the adneXa (ADNEX) model to discriminate between benign and malignant ovarian tumors. The explant pathology report was used as the reference diagnosis. Kappa statistics were used for the investigation of the level of agreement between the examined systems and the raters. Results We included 66 women, 39 with benign and 27 with malignant ovarian tumors. ADNEX (with and without “CA-125”) had high sensitivity (96–100%) when applied by all raters but a rather low specificity (36%) when applied by the 1st year resident. SR could not be applied in 6% to 17% of the cases. It had slightly lower sensitivity, higher specificity, and higher overall accuracy, especially when applied by the 1st year resident (61% vs. 92%), compared to ADNEX. Conclusion Both ADNEX and SR can be utilized for screening in non-oncology centers since they offer high sensitivity even when used by less experienced examiners. In the hands of inexperienced examiners, SR appears to be the best model for assessing ovarian lesions.
Citation: Ultrasound Int Open 2023; 09: E11-E17
PubDate: 2023-08-23T07:59:37+01:00
DOI: 10.1055/a-2044-2855
Issue No: Vol. 09, No. 01 (2023)
- Quantification of Portal Vein Vascularization Using an Automated
Post-Processing Video Analysis Tool
Authors: Blank; Valentin, Heni, Maria, Karlas, Thomas
Pages: E2 - E10
Abstract: Purpose Blood flow dynamics represent a diagnostic criterion for many diseases. However, no established reference standard is available. In clinical practice, ultrasound pulsed-wave Doppler (PW-Doppler) is frequently used to assess visceral blood flow, despite its well-known limitations. A quantitative analysis of conventional color Doppler patterns can be performed using an innovative ultrasound-based algorithm (pixel flow analysis, PFA). This tool already shows promising results in obstetrics, but the technique has not yet been evaluated for portal venous blood flow assessment. Methods This prospective exploratory research study evaluated the applicability of PFA in the portal venous system. Measurements of portal venous flow using PFA and PW-Doppler were compared in healthy volunteers (n=20) and in patients with hepatic steatosis (n=10) and liver cirrhosis (n=10). Results In healthy volunteers (60% female, mean age 23 years, BMI 21.5 kg/m2 [20.4–23.8]), PFA and PW-Doppler showed a strong positive correlation in fasting conditions (r=0.69; 95% CI 0.36–0.87), recording a median blood flow of 834 ml/min (624–1066) and 718 ml/min (620–811), respectively. PFA was also applicable in patients with chronic liver diseases (55% female, age 65 years (55–72); BMI 27.8 kg/m2 (25.4–30.8)), but the correlation between PFA and PW-Doppler was poor (r=− 0.09) in the subgroup with steatosis. A better correlation (r=0.61) was observed in patients with liver cirrhosis. Conclusion PFA and PW-Doppler assessment of portal venous vascularization showed high agreement in healthy volunteers and patients with liver cirrhosis. Therefore, PFA represents a possible alternative to conventional PW-Doppler sonography for visceral blood flow diagnostics and merits further evaluation.
Citation: Ultrasound Int Open 2023; 09: E2-E10
PubDate: 2023-03-20T11:34:40+0100
DOI: 10.1055/a-1999-7818
Issue No: Vol. 09, No. 01 (2023)
- Visually navigated, ultrasound-guided, freehand percutaneous calyceal
puncture – preclinical evaluation of a novel device to simplify a
complex surgical task
Authors: Wakileh; Gamal Anton, Hohmann, Manuel, Rassweiler-Seyfried, Marie Claire, Klein, Jan Thorsten
Abstract: Purpose Freehand sonographic percutaneous puncture techniques for the renal calyceal system are on the rise. Much time and practice are required to master this technique. Navigation-supported puncture aids could help make percutaneous access easier and faster. The aim of this study was to determine whether navigated puncture is feasible, and whether it is easier and faster compared to the conventional sonographic procedure. Materials & Methods We performed prospective free-hand percutaneous puncture on a porcine kidney model embedded in gelatin using the Xperius ultrasound system in combination with needle tracking with a Stimuplex Onvision hollow needle, compared to the conventional freehand ultrasound puncture technique. Punctures were performed by 25 participants using the ultrasound machine with or without needle tracking mode. Results Compared to the conventional approach, the navigated approach reduced the number of puncture procedures by 0.2 attempts(8%) in the experienced group. The time to calyx access was reduced by 15 seconds (26%). In the novice group, navigated puncture required 1.2 fewer attempts (36%) and the time to access was 70 seconds faster (61%). Conclusion Puncture using the novel device is feasible. The number of punctures and the time needed for successful access of the calyceal system was reduced by use of navigation in both groups, although the trend was significant only in the novice group. Navigation using needle tracking seems to help beginners perform sonographic percutaneous puncture at a level similar to experienced users. For a more precise analysis and validation, further studies are needed.
Citation: Ultrasound Int Open 2024; 10: -
DOI: 10.1055/a-2324-7668
Issue No: Vol. 10, No. CP
- Introducing and Validating the Cranial-Dorsal-Hip Angle (∠CDH): A Method
for Accurate Fetal Position Assessment in the First Trimester and Future
AI Applications
Authors: Tan; Ying, Wen, Huaxuan, Peng, Guiyan, Wen, Huiying, Wen, Xin, Jiang, Yao, Fan, Jiaqi, Yuan, Ying, Luo, Dandan, Li, Shengli
Abstract: Purpose To introduce the cranial-dorsal-hip angle (∠CDH) as a novel quantitative tool for assessing fetal position in the first trimester and to validate its feasibility for future AI applications. Materials and Methods 2520 first-trimester fetal NT exams with 2582 CRL images (January-August 2022) were analyzed at a tertiary hospital as the pilot group. Additionally, 1418 cases with 1450 fetal CRL images (September-December 2022) were examined for validation. Three expert sonographers defined a standard for fetal positions. ∠CDH measurements, conducted by two ultrasound technicians, were validated for consistency using Bland-Altman plots and the intra-class correlation coefficient (ICC). This method allowed for categorizing fetal positions as hyperflexion, neutral, and hyperextension based on ∠CDH. Comparative accuracy was assessed against Ioannou, Wanyonyi, and Roux methods using the weighted Kappa coefficient (k value). Results The pilot group comprised 2186 fetal CRL images, and the validation group included 1193 images. Measurement consistency was high (ICCs of 0.993; P
Citation: Ultrasound Int Open 2024; 10: -
DOI: 10.1055/a-2337-0078
Issue No: Vol. 10, No. CP
- Contrast-enhanced ultrasound features of hepatic angiomyolipoma:
comparison with AFP-negative and non-viral hepatocellular carcinoma
Authors: Zhang; Yafang, Guo, Zhi-xing, Liao, Ying, Yu, Yiwen, Guo, Ruohan, Han, Xu, Lan, Lilong, Zhou, Jianhua
Abstract: Purpose This study aimed to compare contrast-enhanced ultrasound (CEUS) features of hepatic angiomyolipoma (HAML) and challenging cases of HCC, mainly those with no hepatitis infection but also with a low level of AFP (non-viral AFP- HCC). Materials and Methods The study included pathologically confirmed HAMLs and non-viral AFP- HCCs undergoing CEUS from 2012 to 2023. Sonovue (SV) CEUS and Sonazoid (SZ) CEUS characteristics of the two groups were compared. Results The study included 50 HAMLs (24% on SZ-CEUS) and 88 non-viral AFP- HCCs (21.6% on SZ-CEUS). The CEUS characteristics on SZ-CEUS were similar to those on SV-CEUS to a certain extent. HAMLs more frequently displayed no washout and partial washout with partial no washout, so-called PWNW, in the late phase and post-vascular phase, whereas HCCs more commonly exhibited mild washout. In the post-vascular phase, all non-viral AFP- HCCs exhibited washout, thereby facilitating differentiation from no-washoutHAMLs, superior to SV-CEUS, where some non-viral AFP- HCCs still exhibited no washout in late phase that could not be distinguished from HAMLs. It is noteworthy that PWNW was exclusively found in nodules exhibiting hyper- and hypoechoic separation of the nodules, and hyper- and hypoechoic separation of HAMLs in the post-vascular phase on SZ-CEUS demonstrated PWNW more frequently compared to the late phase, which can potentially help distinguish nodules with hyper- and hypoechoic separation as either HAML or non-viral AFP- HCC. Conclusion: This study highlighted the usefulness of SV- and SZ-CEUS for distinguishing HAML and non-viral AFP- HCC and filled in existing gaps regarding the SZ-CEUS features of HAML.
Citation: Ultrasound Int Open 2024; 10: -
DOI: 10.1055/a-2318-6654
Issue No: Vol. 10, No. CP
- Patient perception of meander-like versus radial breast ultrasound
Authors: Brasier-Lutz; Pascale, Jäggi-Wickes, Claudia, Schädelin, Sabine, Burian, Rosemarie, Schoenenberger, Cora-Ann, Zanetti-Dällenbach, Rosanna
Abstract: Background Radial breast ultrasound scanning (r-US) and commonly used meander-like ultrasound scanning (m-US) have recently been shown to be equally sensitive and specific with regard to the detection of breast malignancies. As patient satisfaction has a strong influence on patient compliance and thus on the quality of health care, we compare here the two US scanning techniques with regard to patient comfort during breast ultrasound (BUS) and analyze whether the patient has a preference for either scanning technique. Materials and Methods Symptomatic and asymptomatic women underwent both m-US and r-US scanning by two different examiners. Patient comfort and preference were assessed using a visual analog scale-based (VAS) questionnaire and were compared using a Mann-Whitney U test. Results Analysis of 422 VAS-based questionnaires showed that perceived comfort with r-US (r-VAS 8 cm, IQR [5.3, 9.1]) was significantly higher compared to m-US (m-VAS 5.6 cm, IQR [5.2, 7.4]) (p < 0.001). 53.8% of patients had no preference, 44.3% of patients clearly preferred r-US, whereas only 1.9% of patients preferred m-US. Conclusion: Patients experience a higher level of comfort with r-US and favor r-US over m-US. As the diagnostic accuracy of r-US has been shown to be comparable to that of m-US and the time required for examination is shorter, a switch from m-US to r-US in routine clinical practice might be beneficial. R-US offers considerable potential to positively affect patient compliance but also to save examination time and thus costs.
Citation: Ultrasound Int Open 2024; 10: -
DOI: 10.1055/a-2282-9193
Issue No: Vol. 10, No. CP
- Shoulder and Knee Arthroscopy Access Point: Prospective Comparison of
Sonographic and Palpatory Detection – Which Method is Better for
Novices'
Authors: Weimer; Andreas Michael, Weimer, Johannes M., Berthold, Svenja, Stein, Stephan, Müller, Lukas, Buggenhagen, Holger, Balser, Gerd, Stankov, Kay, Sgroi, Mirco, Schmidmaier, Gerhard, Kloeckner, Roman, Schamberger, Christian
Abstract: Purpose Arthroscopy is one of the most common interventions in orthopedics. Hence it is important to train users early in order to ensure the safest possible identification of access portals (AP). This prospective study aimed to compare a palpatory (PalpMethod) with a sonographic (SonoMethod) method for AP location in the shoulder and knee joints. Materials and Methods The study included trainee doctors (n=68) attending workshops (lasting approx. 90 minutes). In these workshops a teaching video initially demonstrated the PalpMethod and SonoMethod of AP identification. An experienced operator first marked the access portals on the test subject with a UV pen (determined ideal point [DIP]). Adhesive film was then affixed to the puncture regions. Subsequently participants marked on shoulders and knees first the point determined by palpation, then the point determined by sonography. Analysis involved DIP visualization with a UV lamp and employed a coordinate system around the central DIP. In addition, participants completed an evaluation before and after the workshop. Results The analysis included 324 measurements (n=163 shoulders and n= 161 knees). The majority of participants had not previously attended any courses on manual examination (87.9%) or musculoskeletal ultrasound (93.9%). Overall, the markings participants made on the shoulder using the SonoMethod were significantly closer to the DIP than those made by the PalpMethod (Palp 18.8mm ± 14.5mm vs. Sono 11.2mm ± 7.2mm; p
Citation: Ultrasound Int Open 2024; 10: -
DOI: 10.1055/a-2271-0098
Issue No: Vol. 10, No. CP
- Evidence-based Ultrasound Education' – A Systematic Literature Review of
Undergraduate Ultrasound Training Studies
Authors: Neubauer; Ricarda, Bauer, Claus Juergen, Dietrich, Christoph F., Strizek, Brigitte, Schäfer, Valentin Sebastian, Recker, Florian
Abstract: Despite a large number of studies previously conducted on educational concepts of ultrasound teaching in medical school, various controversial issues remain. Currently, recommendations for ultrasound curricula that aim to standardize ultrasound teaching are frequently based on expert panel advice instead of relying on valid evidence-based literature. In December 2022, a systematic literature review on the subject of undergraduate ultrasound education was conducted. All ultrasound studies listed in the PubMed and Google Scholar medical databases were filtered and analyzed with respect to various aspects of their methodological conduct and curricular implementation. A total of 259 publications were considered in the data synthesis, including 145 teaching studies in the field of undergraduate ultrasound education. The latter encompassed 58 (40%) studies that did not compare their ultrasound training to a control group. Furthermore, 84 (58%) of these studies did not assess knowledge prior to the applied ultrasound training, neglecting this factor’s potential influence on study outcomes. Despite a great interest in the development and further implementation of ultrasound education during medical school, this process is still compromised by significant deficiencies in studies that have been conducted in the past. In order to provide a valid basis for curricular decisions, teaching studies should fulfill essential methodological requirements despite the multifactorial framework in which they are conducted. In the future, a guide for the design of ultrasound studies could be a useful aid for ultrasound enthusiasts and promote scientific knowledge gain.
Citation: Ultrasound Int Open 2024; 10: -
DOI: 10.1055/a-2275-0702
Issue No: Vol. 10, No. CP
- Neurosonology Survey in Europe and Beyond
Authors: Baracchini; Claudio, Azevedo, Elsa, Walter, Uwe, Sargento-Freitas, João, Malojcic, Branko
Abstract: Purpose To provide an overview on education, training, practice requirements, and fields of application of neurosonology in Europe and beyond. Materials and Methods National representatives and experts in neurosonology were surveyed regarding neurosonology requirements and practice in their countries. Descriptive statistics were used to report the data. Results Between February 1 and March 31, 2023, 42/46 (91.3%) national representatives responded to our questionnaire and the completion rate was 100%. Most countries (71.4%) offer a neurosonology training program during neurology residency, but it is part of the undergraduate medical program only in 30.9%. National certification is available in 47.6% of the countries surveyed and most countries (76.2%) require certification to practice. In 50% of the countries, candidates are assessed by a board examination, while in 26.2% they just need to document their practice. There is no formal accreditation of neurosonology centers in 78.6% of the countries surveyed. Only a few require certified personnel and appropriate equipment. Adequate teaching and research activities are only rarely necessary elements for laboratory accreditation. Conclusion Our results indicate that there is a substantial need for transnational harmonization of neurosonological standards to guarantee uniformity and quality of performance. This survey will also provide guidance to promote an international accrediting council and create a quality-controlled laboratory network for implementing neurosonology in clinical trials.
Citation: Ultrasound Int Open 2024; 10: -
DOI: 10.1055/a-2243-9625
Issue No: Vol. 10, No. CP
- Esophageal Leiomyoma: Case Report
Ultrasound Int Open 2024; 10: -
DOI: 10.1055/a-2221-6110
Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
Artikel in Thieme eJournals:
Ultrasound Int Open 2024; 10: -
Inhaltsverzeichnis open access Volltext
Issue No: Vol. 10, No. CP
- Minimally Invasive Repositioning of a Frontal Sinus Anterior Wall Fracture
Using Intraoperative Sonographic GuidanceUltrasound Int Open 2024; 10: -
DOI: 10.1055/a-2223-5552
Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
Artikel in Thieme eJournals:
Ultrasound Int Open 2024; 10: -
Inhaltsverzeichnis open access Volltext
Issue No: Vol. 10, No. CP
- Bedside Clinical Hand-held Ultrasound in an Internal Medicine Department:
The "Bed Med-Us" Experience of Codogno and its Clinical Utility in the
Management of Diagnosis and Therapy in 1007 Patients
Authors: Giangregorio; Francesco, Mosconi, Emilio, Debellis, Maria Grazia, Palermo, Eliana, Provini, Stella, Mendozza, Manuela, Ricevuti, Laura, Esposito, Ciro
Abstract: Purpose Handheld ultrasound (HH-US) answers simple clinical questions in emergencies. We performed conventional US with HH-US at the patient’s bedside (BED) during a medical visit (MED) (BED MED-US). The purpose of this prospective study is to estimate BED MED-US reliability, its clinical impact in helping the clinician to formulate correct diagnoses, and its ability to save time and money. Materials and Methods 1007 patients (519 M; age:76.42) were assessed (from March 2021 to November 2022) in one or more districts. Final diagnosis was determined with clinical and reference tests (chest RX/CT, abdominal CT, endoscopy, etc.). Sensitivity, specificity, LR+ and LR-, and corresponding AUROC were evaluated. HH-US diagnoses were classified as: confirmation (HH-US revealed the sonographic signs that confirmed the clinical diagnosis) (CO), exclusion (HH-US excluded the presence of the ultrasound signs of other pathologies, in the clinical differential diagnosis) (EX), etiological (HH-US reaches diagnosis in clinically doubtful cases) (ET), or clinically relevant incidental (HH-US diagnoses that change the patient's process completely) (INC). Results HH-US reliability: true-pos: 752; true-neg: 242; false-pos: 7; false-neg: 6 (sens: 99.1%, spec: 97.6%, LR+: 98.5; LR-: 00.15, AUROC: 0.997); clinical impact: CO-diagnosis: 21%; EX: 25%; ET: 47%; INC: 7%; saved time and money: approximately 35,572 minutes of work and 9324 euros. Conclusion BED MED-US is a reliable clinical imaging system, with an important clinical impact both in diagnosis (etiological in 47%, incidental in 7%) and in the management of personnel resources.
Citation: Ultrasound Int Open 2024; 10: -
DOI: 10.1055/a-2196-1599
Issue No: Vol. 10, No. CP
