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Abstract Establishing prediction models of pregnancy outcomes for recurrent pregnancy loss women at specific gestational weeks will provide patients and physicians with more precise information, ultimately leading to time and cost savings associated with unnecessary revisits. Therefore, our aim was to develop a prediction model for first trimester pregnancy loss in RPL patients. We used ultrasound indices during the first trimester of pregnancy in combination with demographic characteristics and commonly used serum markers. The independent risk factors for each week were as follows: age and P in the fifth week; age, mGSD and CRL in the sixth week; age, hCG and CRL in the seventh week; CRL in the eighth week; mGSD and CRL in ninth week. The corresponding AUC was 0.671, 0.796, 0.872, 0.871, 0.813, respectively. There is a linear relationship between age and first trimester pregnancy loss. hCG 48.3 mm in ninth gestational week was associated with a higher risk of pregnancy loss. These models and thresholds may help physicians and patients make more informed decisions together. Further studies are needed to confirm the results.

Establishing prediction models of pregnancy outcomes for recurrent pregnancy loss women at specific gestational weeks will provide patients and physicians with more precise information, ultimately leading to time and cost savings associated with unnecessary revisits. Therefore, our aim was to develop a prediction model for first trimester pregnancy loss in RPL patients. We used ultrasound indices during the first trimester of pregnancy in combination with demographic characteristics and commonly used serum markers. The independent risk factors for each week were as follows: age and P in the fifth week; age, mGSD and CRL in the sixth week; age, hCG and CRL in the seventh week; CRL in the eighth week; mGSD and CRL in ninth week. The corresponding AUC was 0.671, 0.796, 0.872, 0.871, 0.813, respectively. There is a linear relationship between age and first trimester pregnancy loss. hCG < 69,636.6 mIU/ml was associated with a higher risk of pregnancy loss in the seventh gestation week. An mGSD < 18.3 mm, adjusted for age, BMI, and previous pregnancy loss in the sixth week, was linked to an increased risk of first trimester pregnancy loss. A small CRL measurement (less than 2.4 mm, 9.9 mm, 16.9 mm, and 18.6 mm) in the sixth, seventh, eighth and ninth week was closely correlated with higher risk of first trimester pregnancy loss. Furthermore, an mGSD < 33.3 mm and > 48.3 mm in ninth gestational week was associated with a higher risk of pregnancy loss. These models and thresholds may help physicians and patients make more informed decisions together. Further studies are needed to confirm the results. [ABSTRACT FROM AUTHOR]

Studies have suggested the potential roles of serum macronutrients such as calcium and magnesium in the development of uterine fibroids. The primary objective was to assess the association between serum magnesium and calcium levels and the prevalence of uterine fibroids in women of reproductive age. A cross-sectional study of 194 parity-matched women with or without a sonographic diagnosis of uterine fibroids enrolled at a university teaching hospital in Lagos, Southwest Nigeria. Participants' sociodemographic, ultrasound, and anthropometric information as well as the estimated serum levels of calcium and magnesium were collected for statistical analyses. This study found significant negative associations between low serum calcium levels and uterine fibroids (adjusted odds ratio = 0.06), uterine size, and the number of fibroid nodules. However, no significant association was observed between serum magnesium levels and uterine fibroids. This study found significant inverse associations between low serum calcium levels and uterine fibroids, uterine size, and the number of fibroid nodules. [ABSTRACT FROM AUTHOR]

Background: Acute appendicitis is a global surgical emergency. Radiographic modalities usually identify acute appendicitis, although radiographers' competence is questionable. This study examines how clinical radiographers' education and experience affect their ability to identify acute appendicitis using computed tomography (CT), magnetic resonance imaging (MRI) and ultrasonography (USG) characteristics. The study also aimed to determine which variable strongly influences their knowledge level. Methods: The study surveyed radiographers with a four-part self-administered questionnaire containing demographic information and eight knowledge-based questions about the appearance of acute appendicitis in MRI, CT and USG, separately. Before distribution, the questionnaire was validated and checked the reliability. Results: Clinical radiographers' knowledge about using MRI to diagnose acute appendicitis was strongly affected by education and experience (η² = 0.13 and 0.14; P < 0.05), with bachelor's degree holders scoring higher regardless of experience. Radiographers with more than 5 years of experience knew more about CT and USG features to identify acute appendicitis (η² = 0.40 and 0.27; P < 0.05). Radiographers with a bachelor's degree and greater experience had higher overall knowledge of MRI, CT and USG to diagnose acute appendicitis (η² = 0.51 and 0.11; P < 0.05). With adjusted R² = 54% (F [2, 44] = 27.94; P < 0.001), education and experience highly predicted the overall knowledge level. Conclusion: The study found gaps in radiographers' knowledge of the radiographic appearance of acute appendicitis. Clinical radiographers' education level and years of experience substantially affect their knowledge level. In addition, experience is a good predictor than education level for overall knowledge level. Therefore, the study emphasises the importance of continuing education and training for radiographers to diagnose acute appendicitis quickly and accurately. [ABSTRACT FROM AUTHOR]

Purpose: Developmental dysplasia of the hip (DDH) joint is a complex condition that may lead to severe problems. Ultrasound scan (USS) in the first four-to-six weeks of life is considered the gold-standard for diagnosis while the Pavlik harness (PH) is a widely utilized method as first-line treatment. The purpose of this study is to compare clinical outcomes of infants with DDH in relation to the timing and frequency of USS following application of the PH. Methods: Retrospective data were collected over a 5-year period from February 2017 to February 2022. We included patients who underwent the first USS post-diagnosis and PH application in two, three, four and six weeks. Two-hundred-twenty-five patients were included and divided in four groups according to timing of the first follow-up: week-2, n = 13; week-3, n = 66; week-4, n = 95; and week-6, n = 51. For every patient Graf classification, treatment length and number of follow-ups were documented. Results: Week-3 and week-4 groups displayed a statistically significant shorter treatment length compared to week-6 group (p value < 0.001), while also demonstrating a lower number of sonographic follow-ups per patient compared to both week-6 (p value < 0.001) and week-2 (p value = 0.002 vs week-3; p value < 0.001 vs week 4). Week-4 group presented the highest treatment completion (56%) on first visit post-diagnosis. Conservative treatment with PH failed in 1.8% (4/225) and displayed no significant difference among all subgroups. Conclusions: Differences in timing of first USS post-DDH diagnosis and initiation of treatment can lead to discrete outcomes with implications to the clinical outcome and cost effectiveness. [ABSTRACT FROM AUTHOR]

Background: Acute appendicitis is classified into simple (SA) and complicated (CA). Ultrasound scans (USS) can be useful in clinically equivocal cases, by visualising primary and secondary signs. This study explores the utility of sonographic signs to diagnose and differentiate appendicitis in children. Methods: Single-centre retrospective cohort study over a 2-year period. Consecutive USS for suspected appendicitis were included; sonographic signs were extracted from standardised institutional worksheets. USS results were compared with pre-defined intraoperative criteria for SA and CA, confirmed with histological analysis. Data are reported as median [interquartile range], percentages (number), area under the curve (AUC), conventional diagnostic formulae and adjusted odds ratios following multiple logistic regression (p < 0.05 considered significant). Results: A total of 934 USS were included, with median age 10.7 [8.0–13.4] years, majority were female (54%). One quarter (n = 226) had SA, 12% (n = 113) had CA, 61% (n = 571) had no appendectomy and 3% (n = 24) had negative appendicectomy. Appendix visualisation rate on USS was 61% (n = 569), with 62% (n = 580) having a conclusive report. Sonographic signs suggesting appendicitis included an appendiceal diameter > 7 mm (AUC 0.92, [95% CI: 0.90–0.94]), an appendicolith (p = 0.003), hyperaemia (p = 0.001), non-compressibility (p = 0.029) and no luminal gas (p = 0.004). Secondary sonographic signs included probe tenderness (p < 0.001) and peri-appendiceal echogenic fat (p < 0.001). Sonographic signs suggesting CA over SA comprised a diameter > 10.1 mm (AUC 0.63, [95% CI: 0.57–0.69]), an appendicolith (p = 0.003) and peri-appendiceal fluid (p = 0.004). Conclusion: Presence of specific sonographic signs can aid diagnosis and differentiation of simple and complicated appendicitis in children. [ABSTRACT FROM AUTHOR]

Objective: Fetal growth surveillance includes assessment of size as well as rate of growth, and various definitions for slow growth have been adopted into clinical use. The aim of this study was to evaluate the effectiveness of different models to identify stillbirth risk, in addition to risk represented by the fetus being small‐for‐gestational age (SGA). Methods: This was a retrospective analysis of a routinely collected and anonymized dataset of pregnancies that had two or more third‐trimester ultrasound measurements of estimated fetal weight (EFW). SGA was defined as EFW < 10th customized centile, and slow growth was defined according to five published models in clinical use: (1) a fixed velocity limit of 20 g per day (FVL20); (2) a fixed > 50 centile drop, regardless of scan‐measurement interval (FCD50); (3) a fixed > 30 centile drop, regardless of scan interval (FCD30); (4) growth trajectory slower than the third customized growth‐centile limit (GCL3); and (5) EFW at second scan below the projected optimal weight range (POWR), based on partial receiver‐operating‐characteristics‐curve‐derived cut‐offs specific to the scan interval. Results: The study cohort consisted of 164 718 pregnancies with 480 592 third‐trimester ultrasound scans (mean ± SD, 2.9 ± 0.9). The last two scans in each pregnancy were performed at an average gestational age of 33 + 5 and 37 + 1 weeks. At the last scan, 12 858 (7.8%) EFWs were SGA, and of these, 9359 were also SGA at birth (positive predictive value, 72.8%). The rate at which slow growth was defined varied considerably (FVL20, 12.7%; FCD50, 0.7%; FCD30, 4.6%; GCL3, 19.8%; POWR, 10.1%), and there was varying overlap between cases identified as having slow growth and those identified as SGA at the last scan. Only the POWR method identified additional non‐SGA pregnancies with slow growth (11 237/16 671 (67.4%)) that had significant stillbirth risk (relative risk, 1.58 (95% CI, 1.04–2.39)). These non‐SGA cases resulting in stillbirth had a median EFW centile of 52.6 at the last scan and a median weight centile of 27.3 at birth. Subgroup analysis identified methodological problems with the fixed‐velocity model because it assumes linear growth throughout gestation, and with the centile‐based methods because the non‐parametric distribution of centiles at the extremes does not reflect actual difference in weight gain. Conclusion: Comparative analysis of five clinically used methods to define slow fetal growth has shown that only the measurement‐interval‐specific POWR model can identify non‐SGA fetuses with slow growth that are at increased risk of stillbirth. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Lyudmyla Bezpalko,1 Andriy Filipskiy2 1Plastic and Aesthetic Surgery Department, Clinical Hospital of Lviv Railway, Lviv, Ukraine; 2Radiology Department, Postgraduate Faculty, Danylo Halytsky Lviv National Medical University, Revive Aesthetic Medicine Clinic, Lviv, UkraineCorrespondence: Lyudmyla Bezpalko, Plastic and Aesthetic Surgery Department, Clinical Hospital of Lviv Railway, Ivana Ohiienka St. 5, Lviv, Lviv Oblast, Lviv, Ukraine, 79000, Tel +380322264308, Fax +380322264308, Email bezpalkolu@gmail.comIntroduction: Nowadays patients want to get an immediate result from skin rejuvenation techniques without sign of injections and consequent limitations in social life. Therefore, the least traumatic, more effective, and longer lasting treatment approach for skin quality improvement should be favored.Purpose: Assess skin quality outcomes by clinical examination and self-reporting in patients treated with two non-crosslinked hyaluronic acid (HA) products, injected by cannula. Investigate the skin thickness and the longevity of dermal fillers in soft tissues by ultrasound examination.Patients and Methods: Fifteen female patients (mean age 41 years) were selected for injection with two non-crosslinked HA products (one for each hemiface and hemi neck). Subdermal injections were performed bilaterally and the retrograde linear fanning technique with a 25G 50 mm cannula from three entry points was used. An ultrasound examination of the skin layers thickness was carried out before the procedure and every 6– 7 days up to three weeks, when patients skin quality improvement was assessed by GAIS (Global Aesthetic Improvement Scale) and patients asked about their satisfaction level.Results: On the right hemiface, the use of the non-crosslinked HA-product with lidocaine was not associated with pain in the sites of injection. On both face sides, the signs of bruising or edema were minor and not associated with downtime or social life limitation after the procedure. After three weeks, despite both injected products could not be detected by ultrasound technique, signs of skin stimulation and skin layers hydration were still observed: The dermis became thicker on both hemifaces while the epidermis became thinner but showed more pronounced radiance and densification effect on the right hemiface.Conclusion: Subdermal injections of non-crosslinked HA “skin boosters” could be a good option for minimal traumatic and effective 3-week lasting skin quality improvement.Keywords: HA, skin booster, lidocaine, tissue longevity, ultrasound scan, skin tone, skin texture

Hydrops foetalis (HF) is the excessive fluid accumulation in at least two foetal body cavities, including pleural, pericardial, and peritoneal cavities, with associated soft tissue oedema. Most cases of hydrops foetalis were due to severe erythroblastosis foetalis, secondary to Rhesus isoimmunization. However, other variants include non-immune hydrops foetalis (NIHF). Foetal cystic hygroma, which occurs due to lymphatic obstruction, is commonly associated with immune hydrops foetalis (IHF). A combination of the conditions in a foetus tends to portend an abysmal prognosis because it can lead to abortion, intrauterine foetal death (IUFD) and early neonatal death (ENND). We report a case of a 22-year-old woman with a prenatal ultrasound diagnosis of a combination of NIHF and foetal cystic hygroma at 20 weeks of gestation. Therefore, there is a need for early diagnosis of the anomalies so that early termination of pregnancy can be performed if the patient desires.

While upper limb lymphoedema following breast and axillary surgery is well established in the literature, breast lymphoedema is rarely documented. Our primary objective was to identify risk factors of breast lymphoedema, and our secondary aim was to assess the possibility of using a breast ultrasound scan to assess breast lymphoedema. This study was a case series analysis, including patients who had wide local excision for primary breast cancer treatment between January 2013 and January 2018. Patients' demographics, including age, weight, body mass index (BMI), breast volume, tumour characteristics, and histological findings, were noted. All patients had a clinical assessment and ultrasound scan 6 months and 12 months after surgery, comparing ipsilateral to the contralateral breast skin, subcutaneous thickness, as well as parenchymal changes. We have included two hundred eighty-six breast cancer; the mean age was 54.7 years SD 17.3, the mean weight was 76.5 kg SD 12.6, the mean BMI was 31.5 SD 5.2, and the mean breast volume was 1223 ml SD 179. This study identified breast lymphoedema in patients with clinically detected skin oedema in the absence of radiotherapy skin changes; skin and subcutaneous 5 mm added thickness more than the contralateral side, and based on that, 22 patients (7.7%) were found to have breast lymphoedema. We have also found that patients with high BMI, larger breast volume, upper outer quadrant tumours, and patients who had axillary lymph node clearance had an increased incidence of breast lymphoedema. The incidence of breast lymphoedema in this cohort was 7.7%. We suggest that breast lymphoedema should be considered if skin and subcutaneous thickness are 5 mm more than the contralateral side in the absence of severe radiotherapy skin changes. Also, we have found that high body mass index (BMI), larger breast volume, upper outer quadrant tumours, and patients who had axillary lymph node clearance are associated with an increased incidence of breast lymphoedema. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to determine the feasibility of the novel technique of intra‐cavitary saline‐aided ultrasound (US) guided transoral biopsy or excision of retropharyngeal nodes. Methods: We followed the IDEAL 2a framework to develop this technique. Procedures were performed between July 2020 and July 2022 at a tertiary head and neck center. Results: Five patients in total underwent an ultrasound‐guided biopsy of a retropharyngeal node. They underwent seven procedures between them: three transoral robotic surgery (TORS) procedures, three fine needle aspirations (FNA) and/or core biopsy procedures, and one US assessment under general anesthetic. The six patients with histology taken (three TORS and three FNA/core biopsies) all had diagnostically adequate samples enabling appropriate treatment planning. There were no significant complications from the procedure. Conclusion: Saline‐aided US‐guided biopsy of a retropharyngeal node is a safe and useful tool enabling accurate tissue sampling and tumor excision and ongoing appropriate treatment planning. [ABSTRACT FROM AUTHOR]

Objectives: Testing pregnant women as early as in the first trimester has multiple advantages. Firstly, the first trimester screening combining ultrasound and serum marker testing (PAPP-A and free β-hCG) offers the highest currently possible -- except for expensive tests using cell-free DNA biomarkers from the mother's blood (ccf DNA) -- detectability of aneuploid fetuses. Secondly, nuchal translucency (NT) measurement helps determine the risk of numerous abnormalities other than aneuoploidies. Lastly, nearly complete ultrasound assessment of fetal anatomy can be performed as early as in the first trimester of pregnancy. Material and methods: This study is based on prospective analysis. Study subjects were 236 pregnant women. One hundred thirty-one patients with a single pregnancy were qualified into the study group and had a combined ultrasound and biochemical screening for Down's syndrome performed between 11 + 0 and 13 + 6 weeks of gestation, with the measured PAPP-A value at ≤ 0.50 MoM (multiples of the median). The control group comprised 105 pregnant women with PAPP-A value at a similar stage of pregnancy at > 0.5 MoM. Results: The average observed value of the PAPP-A in the study group was 0.35 MoM while in the control group 1.29 MoM. Moreover, combined observation of infant birth weights in both groups compared to the PAPP-A MoM values has shown a significant relationship between those characteristics (r = 0.15, p = 0.0184). Conclusions: The results showed that pregnant women with low PAPP-A MoM value measured during the first trimester have a higher risk of giving birth to a low-birth-weight infant (which is the value below 2500 g), than the pregnant women whose PAPP-A MoM value in the first trimester did not meet this criterion. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the residual acetabular dysplasia in Graf type II hips after Pavlik harness treatment with a radiographic follow-up at 2 years of age. Methods: We retrospectively reviewed the developmental dysplasia of the hip patients who were treated with the Pavlik harness between March 2018 and February 2022. Patients with Graf type II hip dysplasia who had at least one radiographic follow-up after 2 years of age were included. The following information, sex, laterality, affected side, age at harness initiation, treatment duration, α angle, and the morphology of bony roof, was collected and studied. We evaluated the radiographic acetabular index at the last follow-up and defined the value of greater than 2 standard deviations as residual acetabular dysplasia. Results: A total of 33 patients (53 hips) met the criteria. The mean initial α angle was 53.4°; the mean age at Pavlik harness initiation was 10.9 weeks. The mean treatment duration was 10 weeks. The mean α angle at the last ultrasound follow-up was 64.9°. The mean age of the last radiographic follow-up was 2.6 years, and 26 hips had a residual acetabular dysplasia with acetabular indexes greater than 2 standard deviations above the mean. The morphology of the acetabular bony rim (odds ratio = 4.333, P = 0.029) and age of initial treatment <12 weeks (odds ratio = 7.113, P = 0.014) were seen as significant predictors for a higher acetabular index more than 2 years of age. Conclusions: A notable incidence of residual acetabular dysplasia after Pavlik harness treatment in Graf type II hips, wherein the acetabular bony roof with a blunt rim at the end of treatment and initial age after 12 weeks were independent predictors associated with residual acetabular dysplasia. Levels of evidence: Therapeutic studies, IV. [ABSTRACT FROM AUTHOR]

A 45-year-old man presented to our health facility with a three-month history of right breast mass and bloody nipple discharge. Prior to presentation he was at a peripheral hospital where he was wrongly diagnosed and managed for furunculosis. Breast ultrasound scan and mammography done at our health facility revealed a lobulated right retro-areolar complex mass with spiculated margins, encroaching adjacent breast parenchyma. A Radiological diagnosis of right breast BIRADS 5 Lexicon category lesion was made. He had Auchincloss modified radical mastectomy of the right breast, and the histology of the excised specimen confirmed the diagnosis of right breast mucinous carcinoma. Following satisfactory surgical wound healing, he was further managed with post-operative radiotherapy, chemotherapy and hormonal therapy. He has been on regular follow-up for five over years now, and his response to management is satisfactory. [ABSTRACT FROM AUTHOR]

Abstract Background Bilateral ectopic pregnancy is extremely rare, with a tremendous maternal mortality and morbidity risk, requiring rapid diagnosis and management. This condition is usually diagnosed during surgery, as radiologists may not pay enough attention to the contralateral side of interest. Therefore, reminding of this rare but emergent situation can be beneficial for both radiologists and gynecologists. Here we report a case of bilateral ectopic pregnancy, which was first diagnosed with ultrasound and was confirmed during laparoscopy. Case presentation A 34 years old woman complaining of light vaginal bleeding at 6 weeks of gestation by her last menstrual period presented to our institute. The serum β-HCG levels were analyzed and followed during patient’s admission. Unfortunately, serum levels weren’t decreasing and blood test titration before surgery were as: 851,894,975 IU/l (checked daily and not every 48 h because of patient’s status and being bilateral). There was no evidence of intrauterine pregnancy at the transvaginal ultrasound, but heterogeneous adnexal masses were seen at both adnexa, suspected of bilateral ectopic pregnancy. She underwent laparoscopic exploration, which confirmed the diagnosis. Bilateral salpingostomy was done to preserve fertility, and the patient’s recovery was uneventful. Conclusions Even with a unilateral report of ectopic pregnancy preoperatively in ultrasonography, surgeons should always be aware of the probability of bilateral ectopic pregnancies anytime facing susceptible cases, especially in patients with known risk factors. Also, it is an important reminder for radiologists to check both adnexa when facing a unilateral adnexal mass resembling ectopic pregnancy.

Internal jugular vein tumor thrombus is an extremely rare condition in thyroid carcinoma, but it does exist. Correlated with greater aggressiveness with a higher incidence of distant metastases at diagnosis and a higher recurrence rate, this important prognostic element should be systematically investigated by ultrasound operators in all patients presenting with thyroid carcinoma. The patient’s follow-up must be careful. This can be a trap that surgeons must look for in their preoperative checklist. We report the case of a 58-year-old woman with an IJV thrombus associated with multiple bone metastases. She underwent successful surgical treatment, and postoperative pathology showed a poorly differentiated follicular carcinoma of the thyroid and a tumor thrombus in the internal jugular vein.

Rectal ectopic pregnancy (REP) is one of the most extremely rare forms of ectopic pregnancy that strongly leads to maternal mortality higher than common types. An early diagnosis of unruptured REP remains a challenge and its management ought to be individualized depending on the clinical scenario. Currently, owing to the paucity of data, there are no practical guidelines for an appropriate treatment until today. We hereby present a very unusual case at our maternity care center. A 30-year-old pregnant woman (gravidity: 2, parity: 2) complained with abdominal pain and retard menstrual cycle. After serum beta-human chorionic gonadotropin (β-hCG) levels and ultrasonic examinations, a diagnosis of ovarian ectopic pregnancy was established. Thus, the patient underwent explanatory laparoscopy for confirming the diagnosis and for the treatment. However, on the 5th day postoperative course, her β-hCG level continued to increase every 48 hours. By magnetic resonance imaging and pelvic ultrasonography, a gestational sac adherent to the rectal wall was clearly detected. After counseling with multidisciplinary team, a minimally invasive laparoscopy followed by a local injection of methotrexate under ultrasound guidance for gestational sac access and a systemic multidose methotrexate regimen were indicated. In result, her serum β-hCG declined substantially. Although it is very rare, extrauterine pregnancy involving the rectum may be presented. Early diagnosis helps in avoiding the fatal complications and a proper management should be counseled carefully. Conservative treatment with minimally surgical intervention could be an alternative option in appropriate condition. Further data are required to summarize this occult entity. [ABSTRACT FROM AUTHOR]

Although ultrasound (US) scan or diagnosis became widely employed in the 20th century, it still plays a crucial part in modern medical diagnostics, serving as a diagnostic tool or a therapy process guide. This review provides information on current wearable technologies and applications used in external ultrasound scanning. It offers thorough explanations that could help build upon any project utilizing wearable external US devices. It touches on several aspects of US scanning and reviews basic medical procedure concepts. The paper starts with a detailed overview of ultrasound principles, including the propagation speed of sound waves, sound wave interactions, image resolution, transducers, and probe positioning. After that, it explores wearable external US mounts and wearable external US transducers applied for sonograph purposes. The subsequent section tackles artificial intelligence methods in wearable US scanners. Finally, future external US scan directions are reported, focusing on hardware and software. [ABSTRACT FROM AUTHOR]

Background: Post-void residual urine (PVR) estimation is an important examination in patients with benign prostate hyperplasia. Urethral catheterization has been the mainstay of post-void residual urine measurement however discomfort, risk of urinary tract infection and trauma were incessantly recorded in patients. Thus, this study evaluated the accuracy of conventional ultrasound scan versus urethral catheterization for the assessment of post-void residual volume in males with benign prostatic hyperplasia. Materials and methods: A cross-sectional study which recruited ninety-five men with benign prostatic hyperplasia at the surgical out-patient clinic of Aminu Kano Teaching Hospital, Kano Nigeria. Postvoid urine volume was determined serially by ultrasound scan and after bladder emptying with urethral catheter. Data collected was analyzed using Statistical Package for Social Sciences version 20.0. The reliability of postvoid ultrasound was determined using Cronbach’s reliability test while the validity was measured by calculating the test specificity, sensitivity and accuracy from a 2x2 contingency table. Results: The age of the respondents ranged from 45 to 89 years with a mean age of 65 ± 11.4 years. Ultrasound scan was found to be 96.7% reliable in estimating residual volume with values of 141.45±89.54 ml by US and of 193.54±107.22 ml by urethral catheterization. The specificity, sensitivity and accuracy of ultrasound scan for estimating residual volume was found to be 100%, 80% and 60% respectively. Conclusion: Post-void residual volume estimation by conventional ultrasound scan demonstrated reliable validity compared to urethral catheterization and can be used in a clinical setting as a noninvasive measure technique of determining post-void residual volume.

Background: Bilateral ectopic pregnancy is extremely rare, with a tremendous maternal mortality and morbidity risk, requiring rapid diagnosis and management. This condition is usually diagnosed during surgery, as radiologists may not pay enough attention to the contralateral side of interest. Therefore, reminding of this rare but emergent situation can be beneficial for both radiologists and gynecologists. Here we report a case of bilateral ectopic pregnancy, which was first diagnosed with ultrasound and was confirmed during laparoscopy. Case presentation: A 34 years old woman complaining of light vaginal bleeding at 6 weeks of gestation by her last menstrual period presented to our institute. The serum β-HCG levels were analyzed and followed during patient's admission. Unfortunately, serum levels weren't decreasing and blood test titration before surgery were as: 851,894,975 IU/l (checked daily and not every 48 h because of patient's status and being bilateral). There was no evidence of intrauterine pregnancy at the transvaginal ultrasound, but heterogeneous adnexal masses were seen at both adnexa, suspected of bilateral ectopic pregnancy. She underwent laparoscopic exploration, which confirmed the diagnosis. Bilateral salpingostomy was done to preserve fertility, and the patient's recovery was uneventful. Conclusions: Even with a unilateral report of ectopic pregnancy preoperatively in ultrasonography, surgeons should always be aware of the probability of bilateral ectopic pregnancies anytime facing susceptible cases, especially in patients with known risk factors. Also, it is an important reminder for radiologists to check both adnexa when facing a unilateral adnexal mass resembling ectopic pregnancy. [ABSTRACT FROM AUTHOR]

Problem Statement: Muscle injuries such as tears often occur when the tendon in the muscle does not properly stretch. The effects of static stretching (SS) on the fascicle length (FL) of the medial gastrocnemius muscle (MG) have not been adequately studied. Earlier investigations on the impact of SS on FL in different muscles have yielded contradictory results. Purpose: The study aims to determine the association between FL displacement and muscle thickness (MT) variation of MG after SS. Additionally, the study aims to provide a more detailed understanding of how SS affects the muscle elongation (ME), MT, FL and pennation angle (PA) of MG before and after stretching. So, the study provides a more thorough understanding of how stretching affects the mechanical properties of muscles and how it can benefit athletes, the elderly, and patients with certain diseases. Approach: 20-25 years old 32 healthy males were involved in this experimental study. The variables were measured using ultrasonography equipment with a 15-MHz linear transducer and 38-mm field of view. Data were collected before and after a self-administered SS task of 30 seconds, and five stretching sets were completed. Results: The results of the linear regression of the study showed that MT strongly influences FL in MG after SS, R2 = 51%, =.71, p <.001. A centimetre increment in MT increases FL by approximately 1.18 to 2.54 centimetres. Furthermore, SS statistically significantly impacts MG's FL, MT, and PA (p<.001). Conclusions: This research investigated the relationship between muscle thickness (MT) and fascicle length (FL) following self-administered static stretching (SS). MT predicted FL significantly, which affects muscle function and performance. SS increased muscle length, FL, and flexibility, but MT and PA decreased significantly. The study's shortcomings encourage more investigation into SS's long-term effects on muscle properties in diverse populations. These findings influence injury prevention, rehabilitation, and performance enhancement in athletes and physically active people. [ABSTRACT FROM AUTHOR]

Internal jugular vein tumor thrombus is an extremely rare condition in thyroid carcinoma, but it does exist. Correlated with greater aggressiveness with a higher incidence of distant metastases at diagnosis and a higher recurrence rate, this important prognostic element should be systematically investigated by ultrasound operators in all patients presenting with thyroid carcinoma. The patient's follow-up must be careful. This can be a trap that surgeons must look for in their preoperative checklist. We report the case of a 58-year-old woman with an IJV thrombus associated with multiple bone metastases. She underwent successful surgical treatment, and postoperative pathology showed a poorly differentiated follicular carcinoma of the thyroid and a tumor thrombus in the internal jugular vein. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus is a chronic disease process affecting millions of people worldwide. Its prevalence is forecasted to reach a value of 7.7% by 2030. It carries severe morbidities and even mortality. Hyperglycemia and increased formation of advanced glycosylation end products causes the majority of soft tissue changes seen among diabetics. The effects are observed particularly in the heel pad and plantar fascia where thinning or thickening, fibre disorganization, calcification and hypoechoic foci are among the changes seen. Methods: This cross-sectional descriptive study was carried out at the Department of Radiology, OAUTHC, Ile Ife, Osun state, Southwest Nigeria. 40 years old and above subjects with Type 2 diabetes mellitus were recruited from the diabetic clinic of the institution and Ultrasound evaluation of the heel fat pad and plantar fascia were subsequently performed for those who met the criteria using ultrasound machine equipped with a 7.5- 12.0 MHz high frequency linear array transducer. Results: The mean heel pad thickness on the right feet was greater than that of the left in the study subjects. There was statistical significant difference in the heel fat pad thickness of diabetic subjects and the control group, in both feet. (P=0.000). The heel pad thickness is higher in diabetic subject than in non-diabetic control subjects. However, there was no statistical significant difference in the right and left heel fat pad thickness of the participants of this study (P value 0.6062). Only HPT was a statistically significant predictor of foot ulcers among other variables after binary regression was computed. Using Spearman's rank correlation to test the relationship between the BMI of diabetic subjects and mean heel pad thickness, it revealed a moderate positive correlation, with good statistically significance (Spearman's rho = 0.4397, P=0.0000). The relationship between the BMI of diabetic subjects and mean plantar fascia thickness showed a weak positive correlation, with good statistical significance (Spearman's rho = 0.2635, P=0.0008). Conclusion: The duration of diabetes mellitus did not determine the heel pad thickness and plantar fascia thickness. The findings in the study suggested that history of foot ulcer in the diabetic predispose them to have reduce HPT and further foot ulcers. Sonographic measurement of heel pad thickness can therefore be an additional imaging modality to evaluate and be used in the management of the diabetic patients' feet.

Introduction: Sciatica is a common reason for a medical consultation throughout the population. Piriformis pyomyositis is a rare cause of these symptoms. Its probable etiology is transient bacteraemia co-existing temporarily with a muscle injury. Aim: The aim of the study is to present a method for treating a piriformis muscle abscess with transabdominal ultrasound-guided transrectal drainage. Case study: A 14-year old boy, previously healthy, was admitted with symptoms of sciatica that appeared after intense physical exertion. Laboratory tests revealed elevated inflammatory parameters and positive blood culture results indicating Staphylococcus aureus. Antibiotic therapy was implemented. MRI of the small pelvis revealed a forming abscess of the right piriformis muscle. On day 6 of the antibiotic therapy, in the absence of improvement, it was decided to perform transrectal drainage under ultrasound guidance. Clinical improvement was achieved, and the inflammatory parameters decreased. Results and discussion: Co-existence of sciatica symptoms and signs of an inflammatory condition should prompt the consideration of piriformis pyomyositis. The mainstay of treatment for piriformis pyomyositis is antibiotic therapy. The abscess formation reduces its effectiveness, which necessitates surgical intervention. The authors present the application of transrectal drainage under transabdominal ultrasound guidance as the shortest route of abscess evacuation. Conclusions: Transrectal drainage of piriformis pyomyositis is an effective and safe method. Concomitant use of ultrasound scans reduces the patient’s exposure to ionising radiation. However, the widespread use of this method requires more in-depth research and broadened experience. [ABSTRACT FROM AUTHOR]

BACKGROUND: Standard planes (SPs) are crucial for the diagnosis of fetal brain malformation. However, it is very time-consuming and requires extensive experiences to acquire the SPs accurately due to the large difference in fetal posture and the complexity of SPs definitions. OBJECTIVE: This study aims to present a guiding approach that could assist sonographer to obtain the SPs more accurately and more quickly. METHODS: To begin with, sonographer uses the 3D probe to scan the fetal head to obtain 3D volume data, and then we used affine transformation to calibrate 3D volume data to the standard body position and established the corresponding 3D head model in 'real time'. When the sonographer uses the 2D probe to scan a plane, the position of current plane can be clearly show in 3D head model by our RLNet (regression location network), which can conduct the sonographer to obtain the three SPs more accurately. When the three SPs are located, the sagittal plane and the coronal planes can be automatically generated according to the spatial relationship with the three SPs. RESULTS: Experimental results conducted on 3200 2D US images show that the RLNet achieves average angle error of the transthalamic plane was 3.91±2.86°, which has a obvious improvement compared other published data. The automatically generated coronal and sagittal SPs conform the diagnostic criteria and the diagnostic requirements of fetal brain malformation. CONCLUSIONS: A guiding scanning method based deep learning for ultrasonic brain malformation screening is firstly proposed and it has a pragmatic value for future clinical application. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate whether the quality scores validated for second-trimester ultrasound scan can be used for third-trimester ultrasound scan., Methods: Prospective multicenter ancillary study using data from the RECRET study. Nulliparous women, with no reported history, with second- and third-trimester ultrasound examinations performed by the same ultrasonographer and using the same ultrasound machine were recruited. The global score and the individual score of each ultrasound image were compared between second- and third-trimester ultrasound scan. The sample size was calculated for a non-inferiority (one-sided) paired Student t test., Results: 103 women with 1606 anonymized ultrasound images were included. The median term at second- and third-trimester ultrasound scan was 22.2 weeks gestation (22.0-22.7) and 31.6 weeks gestation (30.7-34.7), respectively. The mean global score of ultrasound images was comparable between the second- and the third-trimester ultrasound examination (32.37 ± 2.62 versus 31.80 ± 3.27, p = 0.13). Means scores for each biometric parameters i.e. head circumference, abdominal circumference, and femur diaphysis length were comparable. The scores for the four-chamber view (5.11 ± 0.91 versus 5.36 ± 0.75, p = 0.02) and the spine (4.18 ± 1.17 versus 5.22 ± 1.02, p < 0.001) were significantly lower in the third trimester compared to the second trimester. The score for the kidney image was significantly higher for third trimester images compared to second trimester images (4.73 ± 0.51 versus 4.32 ± 0.67, p < 0.001., Conclusions: Biometrics parameters quality scores images previously validated for the second trimester ultrasound scan can be also used for the third trimester scan. However, anatomical quality scores images performances may vary between the second and the third trimester scan., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Objective: Fetal growth assessment is central to good antenatal care, yet there is a lack of definition of normal and abnormal fetal growth rate which can identify pregnancies at risk of adverse outcome. The aim of this study was to develop and test a model for defining normal limits of growth velocity which are specific to the fetal weight measurement interval. Methods: The cohort consisted of 102 138 singleton pregnancies which underwent at least two third‐trimester measurements of ultrasound estimated fetal weight (EFW), usually carried out because routine early‐pregnancy risk assessment had indicated an increased risk of fetal growth restriction. We projected the EFW from the first of each consecutive measurement pair along its own centile rank to the gestational age of the second scan. Normal growth was defined as the second EFW being within a weight range based on limits derived by partial receiver‐operating‐characteristics‐curve (pROC) analyses for small‐for‐gestational‐age (SGA; < 10th centile) and large‐for‐gestational‐age (LGA; > 90th centile) birth weight. The limits were measurement‐interval specific and calculated for a fixed false‐positive rate (FPR) of 10%. The resultant normal, slow and accelerated growth rates calculated from consecutive EFW pairs were evaluated against the following predefined perinatal outcome measures: stillbirth, neonatal death, SGA and LGA at birth, 5‐min Apgar score < 7 and admission to the neonatal intensive care unit. Slow growth based on the last two scans was compared with SGA fetal weight (EFW < 10th centile) at the last scan and association with stillbirth risk was assessed, expressed as relative risk (RR) with 95% CI. Results: The optimal cut‐off limits for normal growth rate between consecutive scans varied according to the length of the measurement interval, with an average of –8.0% for slow growth and + 9.3% for accelerated growth at a fixed FPR of 10%. Slow growth between random consecutive scan pairs was associated significantly with all predefined outcome measures including stillbirth (RR, 2.19; 95% CI, 1.84–2.53) and neonatal death (RR, 2.28; 95% CI, 1.60–3.13). Accelerated growth was associated with LGA at birth (RR, 2.15; 95% CI, 2.10–2.20), while normal growth was protective of all adverse outcome measures. Slow growth between the last two scans (which were performed at a median gestational age of 33 + 1 to 36 + 4 weeks) and SGA at the last scan were each predictors of stillbirth, and stillbirth risk was highest when both were present (RR, 2.65; 95% CI, 1.67–4.20). However, 66.2% of pregnancies with slow growth were not SGA at the last scan and these cases also had an increased risk of stillbirth (RR, 2.07; 95% CI, 1.40–3.05). Conclusion: Fetal growth velocity defined by projected, measurement‐interval specific fetal weight limits is associated independently with perinatal outcome and should be used for antenatal surveillance in addition to assessment by fetal size. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus is a chronic disease process affecting millions of people worldwide. Its prevalence is forecasted to reach a value of 7.7% by 2030. It carries severe morbidities and even mortality. Hyperglycemia and increased formation of advanced glycosylation end products causes the majority of soft tissue changes seen among diabetics. The effects are observed particularly in the heel pad and plantar fascia where thinning or thickening, fibre disorganization, calcification and hypoechoic foci are among the changes seen. Methods: This cross-sectional descriptive study was carried out at the Department of Radiology, OAUTHC, Ile Ife, Osun state, Southwest Nigeria. 40 years old and above subjects with Type 2 diabetes mellitus were recruited from the diabetic clinic of the institution and Ultrasound evaluation of the heel fat pad and plantar fascia were subsequently performed for those who met the criteria using ultrasound machine equipped with a 7.5- 12.0 MHz high frequency linear array transducer. Results: The mean heel pad thickness on the right feet was greater than that of the left in the study subjects. There was statistical significant difference in the heel fat pad thickness of diabetic subjects and the control group, in both feet. (P=0.000). The heel pad thickness is higher in diabetic subject than in non-diabetic control subjects. However, there was no statistical significant difference in the right and left heel fat pad thickness of the participants of this study (P value 0.6062). Only HPT was a statistically significant predictor of foot ulcers among other variables after binary regression was computed. Using Spearman's rank correlation to test the relationship between the BMI of diabetic subjects and mean heel pad thickness, it revealed a moderate positive correlation, with good statistically significance (Spearman's rho = 0.4397, P=0.0000). The relationship between the BMI of diabetic subjects and mean plantar fascia thickness showed a weak positive correlation, with good statistical significance (Spearman's rho = 0.2635, P=0.0008). Conclusion: The duration of diabetes mellitus did not determine the heel pad thickness and plantar fascia thickness. The findings in the study suggested that history of foot ulcer in the diabetic predispose them to have reduce HPT and further foot ulcers. Sonographic measurement of heel pad thickness can therefore be an additional imaging modality to evaluate and be used in the management of the diabetic patients' feet. [ABSTRACT FROM AUTHOR]

Background: The carotid arteries serve as major blood supply to the head and neck region of the body. Understanding their structure and function in the pathogenesis of stroke and in interventional neuroradiology due to luminal stenosis, atherosclerosis and wall stiffness is paramount. Doppler ultrasound scan plays key role in the early diagnosis of the pathologies of the arteries as it is an affordable, accessible, reliable and non-invasive clinical tool. Knowing normal average diameter of the carotid arteries among healthy individuals is important in making correct clinical diagnosis in any population. The aim of the study was to determine mean diameters of the carotid arteries among healthy adult Nigerians for reference.Materials and Methods: This was a prospective study involving 104 healthy Nigerians within the ages of 18 and 65 years who had their carotid arteries scanned on both sides and each diameter was measured. A 95% confidence level was used; a p-value of < 0.05 was significant.Results: Of the studied population, 62 were males and 42 were females, and the average age of the subjects was 28.32 ± 9.09 years. From this study, the average luminal diameter of the common carotid artery = 0.61 ± 0.08 cm, internal carotid artery = 0.60 ± 0.08 cm and external carotid artery = 0.49 ± 0.10 cm. The results showed that although, there are differences in measurements between the two sexes (males slightly higher than females in common carotid artery) and between right and left sides (with right side slightly higher), they are not statistically significant.Conclusions: This sonographic study on healthy Nigerian adults has given us normal reference values of the luminal diameters of the carotid arteries among Nigerians, which clinicians can make reference to, when assessing carotid artery diameters of patients in Nigeria. [ABSTRACT FROM AUTHOR]

Background: The study aims to establish the pattern of fetal heart rates in the first and second trimesters and determine whether there is a statistically significant difference in the first-trimester fetal heart rate (FHR) of males and females. Methods: This retrospective observational research is a study of FHRs measured at 11+0-13+6 wk and 18+0-23+6 wk, and ultrasound scan-diagnosed fetal sex at 18+0-23+6 wk. Singleton fetuses with nonambiguous external genitalia were recruited. The FHR was measured in B or M mode with Pulsed Wave Doppler, while ultrasound appearance of external genitalia determined the fetal sex at 18+0-23+6 weeks. Student's t-test and Chi-square test were used for data analysis, and statistical significance was set at p < 0.05. Results: A total of 2437 pregnancies meeting the study criteria were analyzed. The fetal sexes were 1398 (57.4%) males and 1039 (42.6%) females. There was no statistically significant difference in the first-trimester FHR between males and females (p = 0.74). However, females had higher mean FHR in both the first and second trimesters (First trimester: 165.4 ± 18.2 bpm vs 163.2 ± 17.1 bpm and Second trimester: 150.9 ±22.6 bpm vs 141.9 ±23.1 bpm). The FHR reduces with the increase in gestational age. Conclusion: There is no statistically significant difference in the first-trimester FHRs between sexes. [ABSTRACT FROM AUTHOR]

Background: Association between second trimester ultrasound findings and twin pregnancy outcome is still unclear. Study aimed to evaluate the performance of second trimester ultrasound scan in the prediction of monochorionic diamniotic twin pregnancies outcomes. Methods: Prospective-cohort study of all consecutive healthy women with monochorionic twin pregnancies followed-up and delivered in five years was undertaken. During second trimester screening (16–18 weeks) fetal biometry was measured (biparietal diameter–BPD, abdominal circumference–AC, femur length–FL, estimated fetal weight–EFW) and inter-twin discordance noted. Amniotic fluid amount was determined. Pregnancy outcomes were having live-born twins, Apgar sores and birth-weights, pregnancy complications and gestational week of delivery. Results: Receiver operating characteristics (ROC) analysis showed that BPD (p = 0.018), AC (p = 0.019) and FL (p = 0.015) were good predictors of having live-born twins. Regression analysis showed that the most important factors influencing twins’ survival to term were inter-twin AC, BPD and FL differences. Fetal discordance in BPD, AC and FL explained correctly 76.3%, 76.5% and 58% of pregnancy outcomes. If second trimester inter-twin BPD difference was

Objective. To determine the presence of microlithiasis in bulls from the Costa Chica, Guerrero, Mexico, and to assess the sperm quality of the bulls affected by this pathology. Methodology. Seventy-seven bulls were assessed in four municipalities of the state of Guerrero, Mexico. Bull testicles were subjected to an ultrasonography test and, in the event of microlithiasis, they were classified according to the number of points observed. In addition, semen was collected by electroejaculation. Sperm concentration (-106 sperm mL-1) and individual motility (%) were quantified from the samples. Microlithiasis results are expressed as a percentage of the total number of assessed animals. Seminal characteristics were subjected to an ANOVA and the means were compared using the Tukey test. Results. Approximately 25% of the assessed individuals showed microlithiasis. About 60% of such cases were classified as grade 2 (-5, -25 points). Three microlithiasis grades were identified in Brown Swiss bulls, while in Gyr bulls no grade was identified. Regarding seminal characteristics, in average, the overall sperm concentration was 992.5-106 sperm mL-1 and the overall individual motility was 75.5%. The bull breed variable did not generate statistical differences in the seminal quality variables. Conclusion. The presence of microlithiasis was identified in bulls from the Costa Chica region in Guerrero; however, sperm concentration and individual motility were not affected. [ABSTRACT FROM AUTHOR]

Background: The Doppler scan serves as an early and non-invasive diagnostic tool for carotid artery disease due to its location, which is significant for cerebrovascular accidents. The carotid diameter has been associated with hypertension just as a sexual variation in hypertensives is documented. However, the difference among healthy individuals with normal pressure and body weight with relation to the diameter of the carotid is not proven among healthy Nigerians. Objective: The objective of the study is to identify a sexual dimorphism in the diameter of the carotid artery and its association with body mass index and blood pressure among normotensive Nigerians. Materials and Methods: A total of 104 were sampled with the average age of 28 years comprising 62 males and 42 females. Doppler ultrasound scans of common, internal, and external carotid arteries were made by an experienced radiologist using a linear transducer with a frequency of 7.0 Mhz. Diameter measurements were taken in end-diastolic alongside blood pressure, pulse, height, weight, and neck and waist circumference. Results: The total diameter measurements of the common carotid artery for male and female were 0.62 ± 0.09 and 0.60 ± 0.07 cm, respectively, internal carotid artery were 0.60 ± 0.08 and 0.61 ± 0.08 cm, respectively, and external carotid artery were 0.48 ± 0.11 and 0.50 ± 0.08 cm, respectively. Although the differences were not statistically significant, their associations with the measured biophysical and clinical parameters showed significant differences in both sexes. Conclusion: we opine that sexual dimorphism should not be ruled out by the mere absence of significant difference in the descriptive analysis but also in the associations with other parameters.

Background Ultrasound (US) is an investigation available in many acute care settings. Thrombocytopenia is a well-described complication of dengue infection and has been shown to correlate with disease severity. The purpose of this study was to assess the utility of admission ultrasonography in predicting thrombocytopenia and disease severity in patients infected with dengue virus. Methods Data were collected prospectively on 176 patients (male, n=86; female, n=90) admitted to the Nawaloka Hospital, Sri Lanka with dengue infection between December 2016 and August 2018. All patients had an US scan on admission and disease severity was determined using the World Health Organization 2009 classification. Results There were 106 (60.2%) cases of dengue with/without warning signs and 70 (39.8%) cases of severe dengue. Patients with an abnormal US on admission were more likely to have severe dengue. Gallbladder wall thickening was the most common US abnormality. Abnormal US findings significantly correlated with more pronounced thrombocytopenia from day 2 of admission. Conclusions An abnormal US scan on admission can aid in identification of patients at risk of developing severe dengue and can be used as a novel clinical tool to identify patients at risk of severe thrombocytopenia. [ABSTRACT FROM AUTHOR]

Although ultrasound (US) scan or diagnosis became widely employed in the 20th century, it still plays a crucial part in modern medical diagnostics, serving as a diagnostic tool or a therapy process guide. This review provides information on current wearable technologies and applications used in external ultrasound scanning. It offers thorough explanations that could help build upon any project utilizing wearable external US devices. It touches on several aspects of US scanning and reviews basic medical procedure concepts. The paper starts with a detailed overview of ultrasound principles, including the propagation speed of sound waves, sound wave interactions, image resolution, transducers, and probe positioning. After that, it explores wearable external US mounts and wearable external US transducers applied for sonograph purposes. The subsequent section tackles artificial intelligence methods in wearable US scanners. Finally, future external US scan directions are reported, focusing on hardware and software.

Umbilical venous catheter insertion is a common procedure in the neonatal units performed for rapid vascular access. Though relatively safe and easy to perform, suboptimal position of the catheter tip is frequently encountered and can lead to wide range of complications from venous thrombosis, catheter extravasation with extravasation of infusate to intraperitoneal or intrapericardial space, liver injury and cardiac arrhythmias. Identification of catheter extravasation may be difficult and often confused with catheter related infection or necrotising enterocolitis. We present a series of three cases of intraperitoneal extravasation of umbilical venous catheter in the premature neonate with widely varying presentation from subtle biochemical changes to critical clinical signs with rapid and progressive deterioration. [ABSTRACT FROM AUTHOR]

Background: The highlight of the British Elbow and Shoulder Society pathway for the management of traumatic anterior shoulder instability is early imaging in patients aged over 40 years to assess rotator cuff integrity and early repair, if indicated to optimise function. The senior author set up a protocol in our institute to streamline the diagnostic process for this cohort of patients. This was a retrospective analysis from a prospectively collected database to highlight the importance of early specialist imaging. Methods: Our protocol is to perform urgent ultrasound scans for all suitable patients above 40 years after first-time traumatic shoulder dislocation. Demographics, associated injuries, ultrasound scan results, operations and functional outcomes were collated. Results: One year following the introduction of our protocol, 40 patients with a mean age of 67 (range, 42–89; SD = 13.1) had ultrasound. The incidence of full-thickness rotator cuff tears was 57.5% (n = 23). Eleven patients with confirmed full-thickness rotator cuff tears underwent surgery. The mean age of surgical patients was significantly younger than the non-surgical group (p = 0.004). Discussion: The use of early diagnostic imaging demonstrated a high incidence of full-thickness rotator cuff tears in this cohort of patients. This allowed early surgical repair to optimise function. [ABSTRACT FROM AUTHOR]

To conduct a systematic literature review of the current evidence on the effect of diabetes mellitus on gastric volume observed during a preoperative ultrasound examination. Using the results of this systematic literature review, a meta-analysis was performed to investigate whether there was an association between diabetes mellitus and an increased risk of presenting with a high-risk stomach (gastric volume associated with an increased risk of pulmonary aspiration). Review article and meta-analysis. Review of published literature. A total of 3366 patients underwent surgery. Gastric ultrasound examination. Data for the meta-analysis and literature review were collected from the PubMed/Medline, Embase, Web of Science, and Google Scholar databases of the National Library of Medicine from the date of inception to January 2023. All included studies measured the gastric antral cross-sectional area and/or gastric residual volume in patients with diabetes and those without diabetes. The data utilized in the meta-analysis included all studies that evaluated the incidence of high-risk stomachs based on ultrasonographic measurements of the gastric antral cross-sectional area or gastric residual volume. Most collated studies revealed that diabetes mellitus was associated with increased antral cross-sectional area and gastric residual volume. A meta-analysis of published reports indicated that patients with diabetes have an increased rate of high-risk stomachs. Diabetes mellitus is associated with an increased rate of high-risk stomachs. The authors recommend large prospective trials to ascertain the safety of the current fasting guidelines for patients with diabetes undergoing surgery. • Ultrasonography is an easy test to measure gastric volume in the preoperative area. • Diabetic patients have increased gastric residual volume compared to non-diabetics. • Diabetes mellitus is associated with increased incidence of high-risk stomach. [ABSTRACT FROM AUTHOR]

Abstract Background Myotonic dystrophy (DM1), a neuromuscular disease related to DMPK gene mutations, is associated to endocrine disorders and cancer. A routine endocrine work-up, including thyroid ultrasound (US), was conducted in 115 genetically-proven DM1 patients in a neuromuscular reference center. The aim of this study was to determine the prevalence and the causes of US thyroid abnormalities in DM1. Results In the whole population (age 45.1 ± 12.2 years, 61.7% female), palpable nodules or goiters were present in 29.2%. The percentage of US goiter (thyroid volume > 18 mL) and US nodules were, respectively, 38.3 and 60.9%. Sixteen of the 115 patients had a thyroidectomy, after 22 fine-needle aspiration cytology guided by thyroid imaging reporting and data system (TIRADS) classification. Six micro- (1/6 pT3) and 3 macro-papillary thyroid carcinoma (PTCs) (2/3 intermediate risk) were diagnosed (7.9% of 115). Thyroid US led to the diagnosis of 4 multifocal and 2 unifocal (including 1 macro-PTC) non-palpable PTCs. Ultrasound thyroid volume was positively correlated to body mass index (BMI) (p = 0.015) and parity (p = 0.036), and was inversely correlated to TSH (p

Holoprosencephaly (HPE) is a congenital malformation of the central nervous system (CNS) that is produced by the lack of segmentation of the prosencephalon in the two cerebral hemispheres. This defect occurs between the days 18th and 28th of gestation and affects both the telencephalon and the structures of the face. In 1964, De Myer classified holoprosencephaly according to the degree of severity into lobar, semilobar, allobar and mid-hemispheric. The etiology of HPE is heterogeneous. Chromosomal abnormalities are found in up to 60% of those affected, mainly trisomy of chromosome 13. The prognosis is bad, in most cases. Prenatal diagnosis of HPE is feasible during the three trimesters of pregnancy. In the first trimester it is performed through the finding of the fusion of the frontal horns of the lateral ventricles and the absence of the sign of the butterfly in a transthalamic axial section of the fetal head. From the second trimester, the findings show a single ventricle, absence of midbrain line and thalamus fused to the midbrain. In addition, other facial defects in the midline can be recognized. The aim of this work is to present a case of allobar HPE and to describe its main clinical features. Likewise, it is intended to show the relevance of recognizing the normal fetal anatomy by ultrasonography in order to detect early developmental alterations. This is a case of a 16 year-old, primigest patient, with a 27.1 week gestation, who consulted for polyhydramnios and fetal alterations evident in the last obstetric ultrasound. A new ultrasound scan is carried out which reports a single fetus with the following alterations: holoprosencephaly, cyclopia, proboscis, arrinia and absence of gastric chamber, findings compatible with trisomy 13. Finally, the pregnancy is terminated by cesarean section, obtaining a deceased newborn. Prenatal and early diagnosis, based on the recognition of normal and abnormal anatomical structures in an ultrasonographic study, allow progress to be made in the diagnostic algorithm and often leads to confirmatory tests (of trisomy, for example) through a prenatal genetic study such as the karyotype. This also makes it possible to carry out individualized attention in a Perinatal Health, High Obstetric Risk or Fetal Medicine unit and eventually make appropriate decisions, according to the legal framework, together with the family. [ABSTRACT FROM AUTHOR]

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Objective: To compare the clinical and ultrasound characteristics of cesarean scar pregnancy (CSP) and other lower uterine segment pregnancies (LUSPs) to enable differential diagnosis of the two pathologies in the first trimester. Methods: A retrospective analysis of early pregnancies with a gestational sac located in the lower uterine segment with cesarean section history in our hospital from December 2011 to February 2018 was performed. According to the diagnoses, the patients were divided into the CSPs group and the other LUSPs group. The clinical and ultrasound features were compared. Results: A total of 38 patients were enrolled with 16 (42.1%) CSPs and 22 (57.9%) other LUSPs. Compared to the other LUSPs group, the CSPs group had thinner lower uterine myometrium (0.16 ± 0.11 cm versus 0.32 ± 0.14 cm, p =.000), larger maximum diameter of the gestational sac (5.14 ± 2.08 cm versus 3.77 ± 1.24 cm, p =.028); the distribution of the villous chorion sites (p =.001) and the main blood supply sites (p =.000) of the gestational sac were different between the two groups. Surgical bleeding volume during the termination of gestation was higher in the CSPs group than in the other LUSPs group (p =.028). Conclusion: Patients with CSPs and other LUSPs have different imaging characteristics on ultrasound. The prognosis of these patients also differs. Ultrasound feature is very useful in the differential diagnosis of these two clinical-mimicking pathologies. [ABSTRACT FROM AUTHOR]

Background The clinical diagnosis of acute appendicitis (AA) can be challenging. This study aimed to evaluate the significance of this diagnosis amidst technological progress. It compared clinical diagnosis to radiology-aided diagnostic outcomes and negative appendicectomy rates (NAR). Methodology This study conducted a single-center retrospective and prospective cohort observational study on all adult patients presenting with suspected AA in 2018 at a major tertiary teaching hospital in Perth, Western Australia. Key demographics, clinicopathological, radiology, and operative reports were reviewed. Data were analyzed using SPSS v.27. Results Of 418 patients with suspected AA, 234 (56%) were in the retrospective group. The median age was 35 (IQR=26), and 224 (54%) were female. The overall NAR was 18.6% (95% CI (14.8-22.4)) and 20.8% for clinical diagnosis. Notably, the NAR for ultrasound (USS)-reported AA (false positive) was 17.6% (95% CI (10.6-27.4)). Three-quarters of the patients, 298 (71.3%), had radiological imaging. The most common modality was CT 176 (59.1%), and 33 (7.9%) had both CT and USS imaging performed. Compared with final histopathology, no significant difference was found in the accuracy of clinically diagnosed and USS-diagnosed cases, with rates of 83.5% and 82.5%, respectively (p=0.230). CT had the best positive predictive value at 82.1%. Single-modality imaging did not cause a significant surgical delay (p=0.914), but multi-modal imaging showed a non-significant trend toward delay (p=0.065). When surgeons assessed an appendix as normal, 54 (12.9%), the histopathological assessment revealed pathology in 28 (51.9%). The inter-observer agreement was only fair to moderate, Kappa=0.46 (95% CI (0.33-0.58); p<0.001). The intraoperative identification of a normal appendix inversely correlated to the grade of the primary surgeon, which was likely related to the number of surgical personnel in the theater (p<0.001). Conclusion This study showed that clinical diagnosis matches the diagnostic accuracy of imaging technologies. Utilizing diagnostic imaging methods promptly and appropriately did not lead to considerable delays in surgery. Surgeons' capability to diagnose appendicitis during surgery is moderately accurate. Most patients underwent imaging, with CT scans being the most common. Moving forward, practitioners must minimize excessive reliance on imaging techniques as this can be resource-intensive, especially in developing countries. Future clinical practice should balance embracing technological advancements and preserving essential clinical diagnostic expertise, for medicine is both a science and an art., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. North Metropolitan Safety, Quality Improvement, and Governance Office issued approval 21673. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Wang et al.)