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2.
J Prim Care Community Health ; 15: 21501319241255576, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38773821

RESUMEN

Point-of-care ultrasound (POCUS) is a valuable clinical tool used at the patient bedside to rapidly assess a wide variety of symptoms and problems which would otherwise take hours or even days. Though it has become the standard of care in Emergency Medicine and is becoming so in hospital internal medicine, less uptake has been appreciated in the outpatient setting despite reported interest from clinicians practicing there. A number of common barriers have been cited to explain this gap in use, which usually include access to equipment, mentorship, and time. In this review we present a proposed framework for clinicians who have an interest in implementing POCUS in their outpatient practice which we hope can mitigate some of these barriers and provide a more streamlined pathway to their desired goals.


Asunto(s)
Atención Ambulatoria , Sistemas de Atención de Punto , Ultrasonografía , Humanos , Ultrasonografía/métodos , Atención Ambulatoria/métodos
3.
Front Endocrinol (Lausanne) ; 15: 1385836, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38774231

RESUMEN

Introduction: Ultrasound is instrumental in the early detection of thyroid nodules, which is crucial for appropriate management and favorable outcomes. However, there is a lack of clinical guidelines for the judicious use of thyroid ultrasonography in routine screening. Machine learning (ML) has been increasingly used on big data to predict clinical outcomes. This study aims to leverage the ML approach in assessing the risk of thyroid nodules based on common clinical features. Methods: Data were sourced from a Chinese cohort undergoing routine physical examinations including thyroid ultrasonography between 2013 and 2023. Models were established to predict the 3-year risk of thyroid nodules based on patients' baseline characteristics and laboratory tests. Four ML algorithms, including logistic regression, random forest, extreme gradient boosting, and light gradient boosting machine, were trained and tested using fivefold cross-validation. The importance of each feature was measured by the permutation score. A nomogram was established to facilitate risk assessment in the clinical settings. Results: The final dataset comprised 4,386 eligible subjects. Thyroid nodules were detected in 54.8% (n=2,404) individuals within the 3-year observation period. All ML models significantly outperformed the baseline regression model, successfully predicting the occurrence of thyroid nodules in approximately two-thirds of individuals. Age, high-density lipoprotein, fasting blood glucose and creatinine levels exhibited the highest impact on the outcome in these models. The nomogram showed consistency and validity, providing greater net benefits for clinical decision-making than other strategies. Conclusion: This study demonstrates the viability of an ML-based approach in predicting the occurrence of thyroid nodules. The findings highlight the potential of ML models in identifying high-risk individuals for personalized screening, thereby guiding the judicious use of ultrasound in this context.


Asunto(s)
Aprendizaje Automático , Nódulo Tiroideo , Ultrasonografía , Nódulo Tiroideo/diagnóstico por imagen , Nódulo Tiroideo/patología , Humanos , Femenino , Ultrasonografía/métodos , Masculino , Persona de Mediana Edad , Adulto , Glándula Tiroides/diagnóstico por imagen , Glándula Tiroides/patología , Medición de Riesgo/métodos , Anciano , Nomogramas , China/epidemiología
4.
J Tradit Chin Med ; 44(3): 629-632, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38767648

RESUMEN

Acupuncture is a typical example of Traditional Chinese Medicine and has been used in China for hundreds of years to treat a wide range of illnesses. However, in the clinic, issues and deficiencies were primarily seen in four areas: loss of accuracy in the operation process; difficulty understanding the depth of acupuncture; difficulty using reinforcing and reducing techniques; and lack of a clear dynamic effect of acupuncture points following acupuncture. Musculoskeletal ultrasonography may quantitatively evaluate the acupuncture location and display the distribution of small nerves near and within the fascia of the acupuncture point in real time. The subjects were asked how they felt about receiving Qi when the needle body reached different depths and different tissues. The Qi obtained from an acupuncture point and the connective tissue of the fascia can be further understood by combining the physiological response of the acupuncture point with the anatomical structure, which offers a new method for defining the nature of the acupuncture point and standardizing the acupuncture point.


Asunto(s)
Puntos de Acupuntura , Terapia por Acupuntura , Ultrasonografía , Humanos , Terapia por Acupuntura/métodos , Ultrasonografía/métodos , Sistema Musculoesquelético/diagnóstico por imagen
5.
Oral Oncol ; 153: 106823, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38701572

RESUMEN

Resection margins of oral squamous cell carcinoma (SCC) are often inadequate. A systematic review on clinical intraoperative whole-specimen imaging techniques to obtain adequate deep resection margins in oral SCC is lacking. Such a review may render better alternatives for the current insufficient intraoperative techniques: palpation and frozen section analyses (FSA). This review resulted in ten publications investigating ultrasound (US), four investigating fluorescence, and three investigating MRI. Both US and fluorescence were able to image the tumor intraorally and perform ex-vivo imaging of the resection specimen. Fluorescence was also able to image residual tumor tissue in the wound bed. MRI could only be used on the ex-vivo specimen. The 95 % confidence intervals for sensitivity and specificity were large, due to the small sample sizes for all three techniques. The sensitivity and specificity of US for identifying < 5 mm margins ranged from 0 % to 100 % and 60 % to 100 %, respectively. For fluorescence, this ranged from 0 % to 100 % and 76 % to 100 %, respectively. For MRI, this ranged from 7 % to 100 % and 81 % to 100 %, respectively. US, MRI and fluorescence are the currently available imaging techniques that can potentially be used intraoperatively and which can image the entire tumor-free margin, although they have insufficient sensitivity for identifying < 5 mm margins. Further research on larger cohorts is needed to improve the sensitivity by determining cut-off points on imaging for inadequate margins. This improves the number of adequate resections of oral SCC's and pave the way for routine clinical implementation of these techniques.


Asunto(s)
Carcinoma de Células Escamosas , Márgenes de Escisión , Neoplasias de la Boca , Humanos , Neoplasias de la Boca/diagnóstico por imagen , Neoplasias de la Boca/cirugía , Neoplasias de la Boca/patología , Carcinoma de Células Escamosas/cirugía , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/patología , Imagen por Resonancia Magnética/métodos , Ultrasonografía/métodos , Sensibilidad y Especificidad
6.
J Emerg Med ; 66(5): e614-e618, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38702244

RESUMEN

BACKGROUND: Left-sided intracardiac thrombi are most commonly seen in conditions with decreased cardiac flow, such as myocardial infarction or atrial fibrillation. They can be propagated into the systemic circulation, leading to a cerebrovascular accident. Identification of thrombus-in-transit via point-of-care ultrasound (POCUS) has the potential to change patient management given its association with high patient morbidity and mortality. CASE REPORT: An intubated 60-year-old man was transferred to our emergency department for management of altered mental status and seizure-like activity. The patient was markedly hypotensive on arrival, and cardiac POCUS was performed to identify potential causes of hypotension. A left ventricular thrombus-in-transit was identified. The thrombus was notably absent on a repeat POCUS examination < 10 min later, which led to concern for thrombus propagation. Furthermore, the patient's vasopressor requirements had significantly increased in that time period. Subsequent emergent neuroimaging revealed a large ischemic stroke in the left internal carotid and middle cerebral artery distribution. The patient was, unfortunately, deemed to not be a candidate for either thrombectomy or thrombolysis and ultimately expired in the hospital. Why Should an Emergency Physician Be Aware of This? Serial POCUS examinations identified the propagation of this patient's thrombus-in-transit, leading the physician to change the initial presumptive diagnosis and treatment course, and pursue further imaging and workup for ischemic stroke. Identification of a thrombus-in-transit is a clue to potentially underlying critical pathology and should be followed with serial POCUS examinations to assess for treatment efficacy and thrombus propagation.


Asunto(s)
Sistemas de Atención de Punto , Trombosis , Ultrasonografía , Humanos , Masculino , Persona de Mediana Edad , Trombosis/diagnóstico por imagen , Ultrasonografía/métodos , Servicio de Urgencia en Hospital/organización & administración , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/fisiopatología , Hipotensión/etiología , Cardiopatías/diagnóstico , Cardiopatías/complicaciones , Resultado Fatal
7.
J Emerg Med ; 66(5): e642-e644, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38702245

RESUMEN

BACKGROUND: Diagnosis of ectopic pregnancy can be complicated by nonspecific laboratory and radiographic findings. The multiple alternative diagnoses must be weighed against each other based on the entire clinical presentation. CASE REPORT: We present a case of a 20-year-old woman who arrived to the Emergency Department (ED) with abdominal pain and ended up being transferred for an Obstetrics evaluation of a possible heterotopic pregnancy. Her radiology-performed ultrasound had revealed an "intrauterine gestational sac" along with an adnexal mass near the right ovary. The patient was not undergoing assisted-reproductive fertilization, nor did she have meaningful risk factors for heterotopic pregnancy. The patient was managed expectantly over the ensuing week to see whether the intrauterine fluid was a true gestational sac. After multiple repeat ED visits, the diagnosis of ectopic pregnancy was made. Ultimately, the patient elected for surgical management of her ectopic pregnancy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case offers a reminder of the subtleties of radiographic identification of intrauterine pregnancies and the ever-present need to "clinically correlate."


Asunto(s)
Embarazo Ectópico , Humanos , Femenino , Embarazo , Embarazo Ectópico/diagnóstico , Adulto Joven , Dolor Abdominal/etiología , Ultrasonografía/métodos , Saco Gestacional/anomalías , Diagnóstico Tardío , Embarazo Heterotópico/diagnóstico , Adulto , Diagnóstico Diferencial , Servicio de Urgencia en Hospital/organización & administración
8.
Int J Nanomedicine ; 19: 4121-4136, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38736655

RESUMEN

Purpose: This study aims to broaden the application of nano-contrast agents (NCAs) within the realm of the musculoskeletal system. It aims to introduce novel methods, strategies, and insights for the clinical management of ischemic muscle disorders, encompassing diagnosis, monitoring, evaluation, and therapeutic intervention. Methods: We developed a composite encapsulation technique employing O-carboxymethyl chitosan (OCMC) and liposome to encapsulate NCA-containing gold nanorods (GNRs) and perfluoropentane (PFP). This nanoscale contrast agent was thoroughly characterized for its basic physicochemical properties and performance. Its capabilities for in vivo and in vitro ultrasound imaging and photothermal imaging were authenticated, alongside a comprehensive biocompatibility assessment to ascertain its effects on microcirculatory perfusion in skeletal muscle using a murine model of hindlimb ischemia, and its potential to augment blood flow and facilitate recovery. Results: The engineered GNR@OCMC-liposome/PFP nanostructure exhibited an average size of 203.18±1.49 nm, characterized by size uniformity, regular morphology, and a good biocompatibility profile. In vitro assessments revealed NCA's potent photothermal response and its transformation into microbubbles (MBs) under near-infrared (NIR) irradiation, thereby enhancing ultrasonographic visibility. Animal studies demonstrated the nanostructure's efficacy in photothermal imaging at ischemic loci in mouse hindlimbs, where NIR irradiation induced rapid temperature increases and significantly increased blood circulation. Conclusion: The dual-modal ultrasound/photothermal NCA, encapsulating GNR and PFP within a composite shell-core architecture, was synthesized successfully. It demonstrated exceptional stability, biocompatibility, and phase transition efficiency. Importantly, it facilitates the encapsulation of PFP, enabling both enhanced ultrasound imaging and photothermal imaging following NIR light exposure. This advancement provides a critical step towards the integrated diagnosis and treatment of ischemic muscle diseases, signifying a pivotal development in nanomedicine for musculoskeletal therapeutics.


Asunto(s)
Medios de Contraste , Oro , Isquemia , Músculo Esquelético , Nanotubos , Ultrasonografía , Animales , Oro/química , Nanotubos/química , Medios de Contraste/química , Medios de Contraste/farmacología , Ratones , Isquemia/diagnóstico por imagen , Isquemia/terapia , Músculo Esquelético/diagnóstico por imagen , Ultrasonografía/métodos , Miembro Posterior/irrigación sanguínea , Fluorocarburos/química , Fluorocarburos/farmacología , Liposomas/química , Quitosano/química , Quitosano/farmacología , Enfermedades Musculares/diagnóstico por imagen , Enfermedades Musculares/terapia , Terapia Fototérmica/métodos , Modelos Animales de Enfermedad , Humanos , Pentanos
9.
J Med Life ; 17(1): 116-122, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38737666

RESUMEN

Ultrasound can identify important characteristics in primary hypothyroidism and diffuse hyperthyroidism (Graves' disease). Therefore, sonologists are actively investigating ultrasound criteria to differentiate between these two conditions. Nevertheless, practice shows the absence of such ultrasonic landmarks. For the first time in the literature, three cases of primary hypothyroidism have demonstrated an ultrasound pattern identical to that of Graves' disease. This pattern includes the presence of goiter, marked total hypoechogenicity of the parenchyma, significantly or moderately increased blood flow intensity ('thyroid inferno'), and elevated peak systolic velocity of the superior thyroid arteries. These signs are less common in hypothyroidism compared to hyperthyroidism. Diagnostic data suggest that the pathogeneses of primary hypothyroidism and Graves' disease share the same mechanisms, leading to similar thyroid ultrasound patterns. One of these shared mechanisms is presumably thyroid overstimulation by the autonomic nervous system, which is adequate to the body's hormonal requirements in hypothyroidism but excessive in hyperthyroidism.


Asunto(s)
Enfermedad de Graves , Hipotiroidismo , Glándula Tiroides , Ultrasonografía , Humanos , Enfermedad de Graves/diagnóstico por imagen , Enfermedad de Graves/complicaciones , Hipotiroidismo/diagnóstico por imagen , Hipotiroidismo/complicaciones , Ultrasonografía/métodos , Glándula Tiroides/diagnóstico por imagen , Femenino , Persona de Mediana Edad , Adulto , Masculino
11.
World J Urol ; 42(1): 302, 2024 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-38720010

RESUMEN

PURPOSE: To evaluate the diagnostic performance of contrast-enhanced (CE) ultrasound using Sonazoid (SNZ-CEUS) by comparing with contrast-enhanced computed tomography (CE-CT) and contrast-enhanced magnetic resonance imaging (CE-MRI) for differentiating benign and malignant renal masses. MATERIALS AND METHODS: 306 consecutive patients (from 7 centers) with renal masses (40 benign tumors, 266 malignant tumors) diagnosed by both SNZ-CEUS, CE-CT or CE-MRI were enrolled between September 2020 and February 2021. The examinations were performed within 7 days, but the sequence was not fixed. Histologic results were available for 301 of 306 (98.37%) lesions and 5 lesions were considered benign after at least 2 year follow-up without change in size and image characteristics. The diagnostic performances were evaluated by sensitivity, specificity, positive predictive value, negative predictive value, and compared by McNemar's test. RESULTS: In the head-to-head comparison, SNZ-CEUS and CE-MRI had comparable sensitivity (95.60 vs. 94.51%, P = 0.997), specificity (65.22 vs. 73.91%, P = 0.752), positive predictive value (91.58 vs. 93.48%) and negative predictive value (78.95 vs. 77.27%); SNZ-CEUS and CE-CT showed similar sensitivity (97.31 vs. 96.24%, P = 0.724); however, SNZ-CEUS had relatively lower than specificity than CE-CT (59.09 vs. 68.18%, P = 0.683). For nodules > 4 cm, CE-MRI demonstrated higher specificity than SNZ-CEUS (90.91 vs. 72.73%, P = 0.617) without compromise the sensitivity. CONCLUSIONS: SNZ-CEUS, CE-CT, and CE-MRI demonstrate desirable and comparable sensitivity for the differentiation of renal mass. However, the specificity of all three imaging modalities is not satisfactory. SNZ-CEUS may be a suitable alternative modality for patients with renal dysfunction and those allergic to gadolinium or iodine-based agents.


Asunto(s)
Medios de Contraste , Compuestos Férricos , Hierro , Neoplasias Renales , Imagen por Resonancia Magnética , Óxidos , Tomografía Computarizada por Rayos X , Ultrasonografía , Humanos , Neoplasias Renales/diagnóstico por imagen , Neoplasias Renales/patología , Masculino , Femenino , Persona de Mediana Edad , Estudios Prospectivos , Ultrasonografía/métodos , Tomografía Computarizada por Rayos X/métodos , Imagen por Resonancia Magnética/métodos , Anciano , Diagnóstico Diferencial , Adulto , Anciano de 80 o más Años
12.
Saudi Med J ; 45(5): 525-530, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38734441

RESUMEN

OBJECTIVES: To compare vascular scanning parameters (vessel diameter, peak systolic velocity, end-diastolic velocity, and resistive index) and scanning time before and after breathing control training program for selected abdominal vessels. METHODS: This study was pre and post quasi-experimental. The researchers designed a breathing training program that gives participants instructions through a video describing breathing maneuvers. Data were collected at the ultrasound laboratory/College of Health and Rehabilitation Sciences in Princess Nourah bint Abdul Rahman University, Riyadh, Saudi Arabia from January 2023 to November 2023. About 49 volunteers at the university participated in the study. Scanning was performed two times for the right renal artery, upper abdominal aorta, inferior vena cava, and superior mesenteric artery. Scanning time was measured before and after the program as well. A paired sample t-test was used to compare the parameters means and time before and after the program. RESULTS: The program had a significant effect on the following parameters: right renal artery peak systolic velocity (p=0.042), upper abdominal aortic peak systolic velocity, and resistive index (p=0.014, p=0.014 respectively), superior mesenteric artery and inferior vena cava diameters (p=0.010 and p=0.020). The scanning time was reduced significantly (p<0.001). CONCLUSION: The breathing training program saves time and improves ultrasound measurement quality. Hospitals and health centers should consider the importance of breathing control training programs before abdominal scanning.


Asunto(s)
Aorta Abdominal , Arteria Renal , Ultrasonografía , Vena Cava Inferior , Humanos , Masculino , Ultrasonografía/métodos , Femenino , Adulto , Aorta Abdominal/diagnóstico por imagen , Vena Cava Inferior/diagnóstico por imagen , Arteria Renal/diagnóstico por imagen , Abdomen/diagnóstico por imagen , Abdomen/irrigación sanguínea , Arteria Mesentérica Superior/diagnóstico por imagen , Adulto Joven , Ejercicios Respiratorios/métodos , Velocidad del Flujo Sanguíneo , Arabia Saudita , Respiración
13.
Nat Commun ; 15(1): 4004, 2024 May 11.
Artículo en Inglés | MEDLINE | ID: mdl-38734697

RESUMEN

The current thyroid ultrasound relies heavily on the experience and skills of the sonographer and the expertise of the radiologist, and the process is physically and cognitively exhausting. In this paper, we report a fully autonomous robotic ultrasound system, which is able to scan thyroid regions without human assistance and identify malignant nod- ules. In this system, human skeleton point recognition, reinforcement learning, and force feedback are used to deal with the difficulties in locating thyroid targets. The orientation of the ultrasound probe is adjusted dynamically via Bayesian optimization. Experimental results on human participants demonstrated that this system can perform high-quality ultrasound scans, close to manual scans obtained by clinicians. Additionally, it has the potential to detect thyroid nodules and provide data on nodule characteristics for American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) calculation.


Asunto(s)
Robótica , Glándula Tiroides , Nódulo Tiroideo , Ultrasonografía , Humanos , Glándula Tiroides/diagnóstico por imagen , Ultrasonografía/métodos , Ultrasonografía/instrumentación , Robótica/métodos , Robótica/instrumentación , Nódulo Tiroideo/diagnóstico por imagen , Nódulo Tiroideo/patología , Teorema de Bayes , Femenino , Adulto , Masculino , Neoplasias de la Tiroides/diagnóstico por imagen
14.
Sensors (Basel) ; 24(9)2024 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-38732804

RESUMEN

In general, it is difficult to visualize internal ocular structure and detect a lesion such as a cataract or glaucoma using the current ultrasound brightness-mode (B-mode) imaging. This is because the internal structure of the eye is rich in moisture, resulting in a lack of contrast between tissues in the B-mode image, and the penetration depth is low due to the attenuation of the ultrasound wave. In this study, the entire internal ocular structure of a bovine eye was visualized in an ex vivo environment using the compound acoustic radiation force impulse (CARFI) imaging scheme based on the phase-inverted ultrasound transducer (PIUT). In the proposed method, the aperture of the PIUT is divided into four sections, and the PIUT is driven by the out-of-phase input signal capable of generating split-focusing at the same time. Subsequently, the compound imaging technique was employed to increase signal-to-noise ratio (SNR) and to reduce displacement error. The experimental results demonstrated that the proposed technique could provide an acoustic radiation force impulse (ARFI) image of the bovine eye with a broader depth-of-field (DOF) and about 80% increased SNR compared to the conventional ARFI image obtained using the in-phase input signal. Therefore, the proposed technique can be one of the useful techniques capable of providing the image of the entire ocular structure to diagnose various eye diseases.


Asunto(s)
Diagnóstico por Imagen de Elasticidad , Ojo , Relación Señal-Ruido , Transductores , Animales , Bovinos , Ojo/diagnóstico por imagen , Diagnóstico por Imagen de Elasticidad/métodos , Ultrasonografía/métodos
15.
Sensors (Basel) ; 24(9)2024 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-38732843

RESUMEN

As the number of electronic gadgets in our daily lives is increasing and most of them require some kind of human interaction, this demands innovative, convenient input methods. There are limitations to state-of-the-art (SotA) ultrasound-based hand gesture recognition (HGR) systems in terms of robustness and accuracy. This research presents a novel machine learning (ML)-based end-to-end solution for hand gesture recognition with low-cost micro-electromechanical (MEMS) system ultrasonic transducers. In contrast to prior methods, our ML model processes the raw echo samples directly instead of using pre-processed data. Consequently, the processing flow presented in this work leaves it to the ML model to extract the important information from the echo data. The success of this approach is demonstrated as follows. Four MEMS ultrasonic transducers are placed in three different geometrical arrangements. For each arrangement, different types of ML models are optimized and benchmarked on datasets acquired with the presented custom hardware (HW): convolutional neural networks (CNNs), gated recurrent units (GRUs), long short-term memory (LSTM), vision transformer (ViT), and cross-attention multi-scale vision transformer (CrossViT). The three last-mentioned ML models reached more than 88% accuracy. The most important innovation described in this research paper is that we were able to demonstrate that little pre-processing is necessary to obtain high accuracy in ultrasonic HGR for several arrangements of cost-effective and low-power MEMS ultrasonic transducer arrays. Even the computationally intensive Fourier transform can be omitted. The presented approach is further compared to HGR systems using other sensor types such as vision, WiFi, radar, and state-of-the-art ultrasound-based HGR systems. Direct processing of the sensor signals by a compact model makes ultrasonic hand gesture recognition a true low-cost and power-efficient input method.


Asunto(s)
Gestos , Mano , Aprendizaje Automático , Redes Neurales de la Computación , Humanos , Mano/fisiología , Reconocimiento de Normas Patrones Automatizadas/métodos , Ultrasonografía/métodos , Ultrasonografía/instrumentación , Ultrasonido/instrumentación , Algoritmos
16.
Zhonghua Zhong Liu Za Zhi ; 46(5): 457-460, 2024 May 23.
Artículo en Chino | MEDLINE | ID: mdl-38742359

RESUMEN

Objective: To analyze the ultrasonic features of tonsillar lymphoma to improve the diagnostic accuracy. Methods: The clinical, pathological and ultrasonic data of nine patients with tonsillar lymphoma confirmed by pathology at Tianjin Medical University Cancer Institute and Hospital during June 2015 and June 2022 were analyzed retrospectively, and the characteristics of their ultrasonic images were summarized. Results: All 9 cases of tonsil lymphoma were unilateral tonsil disease, including 4 cases on the left side and 5 cases on the right side. The average maximum diameter of tonsil lymphoma in 9 cases was 4.32 cm. There were 3 cases with simultaneous involvement of tonsil and cervical lymph nodes, all of which were ipsilateral lymph nodes. Gray scale ultrasound showed that the lesions were hypoechoic, with clear boundaries in 7 cases and unclear boundaries in 2 cases. The shape was full and irregular in 5 cases and oval in 4 cases. The echo was uniform in 7 cases and uneven in 2 cases. Color Doppler ultrasonography showed abundant internal blood flow signal in 1 case, a little dotted linear internal blood flow signal in 5 cases, and no obvious internal blood flow signal in 3 cases. Conclusions: The ultrasonic features of tonsillar lymphoma include hypoechoic area, clear boundary, full shape, irregular and uniform internal echo, no or low linear signal of internal blood flow. Ultrasonography is of great value in the diagnosis of this disease and can help clinical decision-making.


Asunto(s)
Neoplasias Tonsilares , Humanos , Neoplasias Tonsilares/diagnóstico por imagen , Neoplasias Tonsilares/patología , Estudios Retrospectivos , Ganglios Linfáticos/patología , Ganglios Linfáticos/diagnóstico por imagen , Ultrasonografía Doppler en Color , Linfoma/diagnóstico por imagen , Linfoma/diagnóstico , Ultrasonografía/métodos , Persona de Mediana Edad
17.
BMC Geriatr ; 24(1): 397, 2024 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-38704521

RESUMEN

BACKGROUND: Frailty is a geriatric syndrome that is characterized by increased vulnerability to intrinsic and extrinsic stressors due to decreased biologic reserves. Muscle ultrasound (US) is a valid and reliable method for assessing muscle quantity in older adults. The study aims to examine the relationship between frailty definitions and US-derived muscle parameters. METHODS: We conducted a cross-sectional study with type 2 diabetes mellitus outpatients in a tertiary hospital, and all participants underwent a comprehensive geriatric assessment. For frailty assessment, the Fried Frailty Phenotype (FFP), the Clinical Frailty Scale (CFS), and the Edmonton Frailty Scale (EFS) were performed. Muscle US measurements included Gastrocnemius Medialis (GM) muscle thickness, GM fascicle length, GM pennation angle, Rectus Femoris (RF) muscle thickness, Rectus Femoris cross-sectional area (RFCSA), Rectus Abdominis (RA) muscle thickness, External Oblique (EO) muscle thickness, Internal Oblique (IO) muscle thickness, and Transverse Abdominis (TA) muscle thickness. RESULTS: In all, 373 participants were included in the study. The median age of participants was 72.7 ± 5.9 years, and 64.6% of them were female. According to the FFP, 18.2% of the participants were living with frailty, 56% of them were pre-frail; 57.4% of them were living with frailty according to the CFS; 25.2% of them were living with frailty, and 20.6% of them were pre-frail according to the EFS. The FFP, CFS, and EFS scores were related to muscle thickness of GM, RF, and RA, fascicle length of GM, and pennation angle of GM and RFCSA. Particularly, GM pennation angle, RF muscle thickness, and RFCSA were associated with an increased risk of frailty. Besides muscle thickness of GM, RF, and RA, fascicle length of GM, pennation angle of GM, and RFCSA were significant for predicting the presence of frailty. CONCLUSIONS: US-derived regional muscle measurements are associated with frailty definitions (in both physical, cumulative deficit, and multidimensional models) in a diabetic geriatric population.


Asunto(s)
Diabetes Mellitus Tipo 2 , Fragilidad , Evaluación Geriátrica , Músculo Esquelético , Ultrasonografía , Humanos , Femenino , Anciano , Masculino , Diabetes Mellitus Tipo 2/diagnóstico por imagen , Estudios Transversales , Fragilidad/diagnóstico por imagen , Ultrasonografía/métodos , Evaluación Geriátrica/métodos , Músculo Esquelético/diagnóstico por imagen , Anciano Frágil , Anciano de 80 o más Años
18.
Front Endocrinol (Lausanne) ; 15: 1357580, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38706699

RESUMEN

Background and objective: Type 2 Diabetes Mellitus (T2DM) with insulin resistance (IR) is prone to damage the vascular endothelial, leading to the formation of vulnerable carotid plaques and increasing ischemic stroke (IS) risk. The purpose of this study is to develop a nomogram model based on carotid ultrasound radiomics for predicting IS risk in T2DM patients. Methods: 198 T2DM patients were enrolled and separated into study and control groups based on IS history. After manually delineating carotid plaque region of interest (ROI) from images, radiomics features were identified and selected using the least absolute shrinkage and selection operator (LASSO) regression to calculate the radiomics score (RS). A combinatorial logistic machine learning model and nomograms were created using RS and clinical features like the triglyceride-glucose index. The three models were assessed using area under curve (AUC) and decision curve analysis (DCA). Results: Patients were divided into the training set and the testing set by the ratio of 0.7. 4 radiomics features were selected. RS and clinical variables were all statically significant in the training set and were used to create a combination model and a prediction nomogram. The combination model (radiomics + clinical nomogram) had the largest AUC in both the training set and the testing set (0.898 and 0.857), and DCA analysis showed that it had a higher overall net benefit compared to the other models. Conclusions: This study created a carotid ultrasound radiomics machine-learning-based IS risk nomogram for T2DM patients with carotid plaques. Its diagnostic performance and clinical prediction capabilities enable accurate, convenient, and customized medical care.


Asunto(s)
Diabetes Mellitus Tipo 2 , Accidente Cerebrovascular Isquémico , Nomogramas , Ultrasonografía , Humanos , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/diagnóstico por imagen , Masculino , Femenino , Persona de Mediana Edad , Accidente Cerebrovascular Isquémico/diagnóstico por imagen , Accidente Cerebrovascular Isquémico/etiología , Accidente Cerebrovascular Isquémico/epidemiología , Anciano , Ultrasonografía/métodos , Factores de Riesgo , Aprendizaje Automático , Arterias Carótidas/diagnóstico por imagen , Arterias Carótidas/patología , Medición de Riesgo/métodos , Ultrasonografía de las Arterias Carótidas , Radiómica
19.
Neurol India ; 72(2): 326-333, 2024 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-38691477

RESUMEN

BACKGROUND: Currently, clinical assessment is the main tool for the evaluation of brachial plexus injury, complemented by electrophysiologic studies (EPS), and imaging studies whenever available. Imaging plays an important role as it enables the differentiation of pre-ganglionic and postganglionic injuries, and adds objectivity to presurgical evaluation. OBJECTIVES: The primary objective was to evaluate the utility of magnetic resonance imaging (MRI) and high-resolution ultrasonography (USG) in the localization and characterization of brachial plexus injury in infants. MATERIALS AND METHODS: In this prospective study, 34 infants with signs and symptoms of brachial plexus injury were evaluated by clinical examination, EPS, MRI, and USG. Imaging findings were correlated with intraoperative findings in infants who underwent surgical management. The association between EPS and MRI findings, and USG and MRI findings were assessed using Fisher's exact test. Semi-quantitative subjective analysis of various MRI sequences was done as well. RESULTS: The most common findings of preganglionic injury and postganglionic injury, in our study, were pseudomeningocele and nerve thickening, respectively. MRI detection of injuries had a significant association with EPS findings. All MRI-detected injuries had a muscle power of grade 3 or less. muscle. Three-dimensional (3D) short tau inversion recovery (STIR) sequence was found to be superior for detecting postganglionic injuries (P < 0.05). CONCLUSION: Imaging studies enable localization of the site of injury, determining the extent, and nature/morphology of injury. The gamut of findings obtained from MRI is far wider compared to that from USG. USG can be used as the first-line screening investigation.


Asunto(s)
Neuropatías del Plexo Braquial , Imagen por Resonancia Magnética , Centros de Atención Terciaria , Ultrasonografía , Humanos , Imagen por Resonancia Magnética/métodos , Lactante , Ultrasonografía/métodos , Estudios Prospectivos , Neuropatías del Plexo Braquial/diagnóstico por imagen , Masculino , Femenino , Plexo Braquial/diagnóstico por imagen , Plexo Braquial/lesiones
20.
Zhonghua Nei Ke Za Zhi ; 63(5): 439-461, 2024 May 01.
Artículo en Chino | MEDLINE | ID: mdl-38715481

RESUMEN

The evolution of critical care medicine is inextricably linked to the development of critical care procedures. These procedures not only facilitate diagnosis and treatment of critically ill patients, but also provide valuable insights into disease pathophysiology. While critical care interventions offer undeniable benefits, the potential for iatrogenic complications necessitates careful consideration. The recent surge in critical care ultrasound (US) utilization is a testament to its unique advantages: non-invasiveness, real-time bedside availability, direct visualization of internal structures, elimination of ionizing radiation exposure, repeatability, and relative ease of learning. Recognizing the need to optimize procedures and minimize complications, critical care utrasound study group of Beijing critical care ultrasound research assocition convened a panel of critical care experts to generate this consensus statement. This document serves as a guide for healthcare providers, aiming to ensure patient safety and best practices in critical care.


Asunto(s)
Cuidados Críticos , Ultrasonografía , Humanos , Cuidados Críticos/métodos , Ultrasonografía/métodos , Consenso
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