A case of intra-abdominal gossypiboma diagnosed preoperatively by endoscopic ultrasound fine-needle-aspiration.

Gossypiboma is an extremely rare adverse event occurring post-surgery, where surgical gauze is left within the body. If aseptically retained, it can lead to the formation of granulation tissue through chronic inflammation and adhesion with surrounding tissues, potentially persisting asymptomatically for many years. While diagnosis of this condition has been reported through various imaging modalities such as abdominal ultrasound and computed tomography, cases not presenting with typical findings are difficult for preoperative diagnosis, and instances where it is discovered postoperatively exist. Particularly when in contact with the gastrointestinal tract within the abdominal cavity, differentiation from submucosal tumors of the digestive tract becomes problematic. This report describes the imaging characteristics of endoscopic ultrasound and the usefulness of endoscopic ultrasound-fine-needle-aspiration for tissue diagnosis in the preoperative diagnosis of intra-abdominal gossypiboma.

Radiomics analysis for prediction and classification of submucosal tumors based on gastrointestinal endoscopic ultrasonography.

Objectives: To identify and classify submucosal tumors by building and validating a radiomics model with gastrointestinal endoscopic ultrasonography (EUS) images. Methods: A total of 144 patients diagnosed with submucosal tumors through gastrointestinal EUS were collected between January 2019 and October 2020. There are 1952 radiomic features extracted from each patient's EUS images. The statistical test and the customized least absolute shrinkage and selection operator regression were used for feature selection. Subsequently, an extremely randomized trees algorithm was utilized to construct a robust radiomics classification model specifically tailored for gastrointestinal EUS images. The performance of the model was measured by evaluating the area under the receiver operating characteristic curve. Results: The radiomics model comprised 30 selected features that showed good discrimination performance in the validation cohorts. During validation, the area under the receiver operating characteristic curve was calculated as 0.9203 and the mean value after 10-fold cross-validation was 0.9260, indicating excellent stability and calibration. These results confirm the clinical utility of the model. Conclusions: Utilizing the dataset provided curated from gastrointestinal EUS examinations at our collaborating hospital, we have developed a well-performing radiomics model. It can be used for personalized and non-invasive prediction of the type of submucosal tumors, providing physicians with aid for early treatment and management of tumor progression.

Endoscopic ultrasound-guided tissue acquisition for focal liver lesions in patients with a history of multiple primary malignant neoplasms.

Objective: This study aimed to investigate the usefulness of endoscopic ultrasound-guided tissue acquisition (EUS-TA) for diagnosing focal liver lesions in patients with a history of multiple primary malignant neoplasms. Methods: Among patients who underwent EUS-TA for focal liver lesions between 2016 and 2022, those with a history of multiple malignant neoplasms were included. A histologically confirmed malignant tumor within the past 5 years before EUS-TA was defined as a history of malignant neoplasm. The primary outcomes were diagnostic ability and adverse events of EUS-TA. Results: This study included 16 patients (median age, 73 [33-90] years), the median tumor size was 32 (6-51) mm, 14 had a history of double malignant neoplasms, whereas two had triple malignant neoplasms. Malignant neoplasms were detected histologically or cytologically in all cases. Immunohistochemistry was performed in 75% (12/16), and the final diagnosis of EUS-TA was metastatic liver tumor in 12 patients, and primary malignant liver tumor in four patients. The primary site could be identified in 11 of 12 metastatic tumor cases. The diagnostic yield of EUS-TA was 100% (16/16) for differentiating benign and malignant tumors and 94% (15/16) for confirming the histological type including the primary site of metastatic lesions. No adverse events were associated with the procedure. Conclusion: EUS-TA is a useful diagnostic modality for focal liver lesions in patients with a history of multiple malignant neoplasms, allowing for the differential diagnosis of primary and metastatic tumors and identification of the primary site of metastatic lesions.

Automated Sonographic Assessment of Hashimoto's Thyroiditis Using Artificial Intelligence / Avaliação ultrassonográfica automatizada da tireoidite de Hashimoto usando inteligência artificial

Introduction: Thyroid ultrasound provides valuable insights for thyroid disorders but is hampered by subjectivity. Automated analysis utilizing large datasets holds immense promise for objective and standardized assessment in screening, thyroid nodule classification, and treatment monitoring. However, there remains a significant gap in the development of applications for the automated analysis of Hashimoto's thyroiditis (HT) using ultrasound. Objective: To develop an automated thyroid ultrasound analysis (ATUS) algorithm using the C# programming language to detect and quantify ultrasonographic characteristics associated with HT. Materials and Methods: This study describes the development and evaluation of an ATUS algorithm using C#. The algorithm extracted relevant features (texture, vascularization, echogenicity) from preprocessed ultrasound images and utilizes machine learning techniques to classify them as "normal" or indicative of HT. The model is trained and validated on a comprehensive dataset, with performance assessed through metrics like accuracy, sensitivity, and specificity. The findings highlight the potential for this C#-based ATUS algorithm to offer objective and standardized assessment for HT diagnosis. Results: The program preprocesses images (grayscale conversion, normalization, etc.), segments the thyroid region, extracts features (texture, echogenicity), and utilizes a pre-trained model for classification ("normal" or "suspected Hashimoto's thyroiditis"). Using a sample image, the program successfully preprocessed, segmented, and extracted features. The predicted classification ("suspected HT") with high probability (0.92) aligns with the pre-established diagnosis, suggesting potential for objective HT assessment. Conclusion: C#-based ATUS algorithm successfully detects and quantifies HT features, showcasing the potential of advanced programming in medical image analysis.

Introdução: A ultrassonografia da tireoide fornece informações valiosas para distúrbios da tireoide, mas é dificultada pela sua subjetividade. A análise automatizada utilizando grandes conjuntos de dados é uma grande promessa para avaliação objetiva e triagem padronizada, classificação de nódulos tireoidianos e monitoramento de tratamento. No entanto, permanece uma lacuna significativa no desenvolvimento de aplicações para a análise automatizada da tireoidite de Hashimoto (TH) por meio de ultrassonografia. Objetivo: Desenvolver um algoritmo automatizado da análise ultrassonográfica da tireoide (AUST) utilizando a linguagem de programação C# para detectar e quantificar características ultrassonográficas associadas à TH. Materiais e Métodos: Este estudo descreve o desenvolvimento e avaliação de um algoritmo AUST utilizando programação C#. O algoritmo extrai características relevantes (textura, vascularização, ecogenicidade) de imagens de ultrassonografia pré-processadas e utiliza técnicas de aprendizado de máquina para classificá-las como "normais" ou indicativas de TH. O modelo é treinado e validado em um conjunto de dados abrangente, com desempenho avaliado por meio de métricas como precisão, sensibilidade e especificidade. As descobertas destacam o potencial deste algoritmo AUST baseado em programação C# para oferecer avaliação objetiva e padronizada para o diagnóstico de TH. Resultados: O programa pré-processa imagens (conversão em escala de cinza, normalização, etc.), segmentos da tireoide, extrai características (textura, ecogenicidade) e utiliza um modelo pré-treinado para classificação ("normal" ou "suspeita de tireoidite de Hashimoto"). Usando uma imagem de amostra, o programa pré-processou, segmentou e extraiu recursos com sucesso. A classificação prevista ("suspeita de TH") com alta probabilidade (0,92) alinha-se ao diagnóstico pré-estabelecido, sugerindo potencial para avaliação objetiva da TH. Conclusão: O algoritmo AUST baseado em programação C# detectou e quantificou com sucesso as características da TH, mostrando o potencial da programação avançada na análise de imagens médicas.

Bioengineering approaches for patient-specific analysis of placenta structure and function.

The leading cause of perinatal mortality is fetal growth restriction (FGR), defined as in utero fetal growth below the 10th percentile. Insufficient exchange of oxygen and nutrients at the maternal-fetal interface is associated with FGR. This transport occurs through the vasculature of the placenta, particularly in the terminal villi, where the vascular membranes have a large surface area and are the thinnest. Altered structure of the placenta villi is thought to contribute to decreased oxygen exchange efficiency, however, understanding how the three-dimensional microstructure and properties decrease this efficiency remains a challenge. Here, a novel, multiscale workflow is presented to quantify patient-specific biophysical properties, 3D structural features, and blood flow of the villous tissue. Namely, nanoindentation, optical coherence tomography, and ultrasound imaging were employed to measure the time-dependent material properties of placenta tissue, the 3D structure of villous tissue, and blood flow through the villi to characterize the microvasculature of the placenta at increasing length scales. Quantifying the biophysical properties, the 3D architecture, and blood flow in the villous tissue can be used to infer changes in maternal-fetal oxygen transport at the villous membrane. Overall, this multiscale understanding will advance knowledge of how microvascular changes in the placenta ultimately lead to FGR, opening opportunities for diagnosis and intervention.

Hallazgos imagenológicos torácicos en seguimiento de pacientes con síndrome PostCovid-19 / Thoracic imagenological findings in follow-up of patients with Post-Covid-19 syndrome

Objetivo: Describir los hallazgos imagenológicos en radiografías de tórax y ecografías pulmonares de pacientes con síndrome post-COVID-19. Métodos: estudio descriptivo, prospectivo y transversal que incluyó pacientes con síndrome post-COVID-19, sometidos a radiografías de tórax y ecografías pulmonares en el Servicio de Neumonología Clínica del Hospital Dr. José Ignacio Baldo, entre enero y octubre de 2022, con la finalidad de establecer su evolución imagenológica pulmonar. Se utilizó estadística descriptiva, chi-cuadrado de Pearson y prueba kappa de concordancia, considerando significativo un valor de p < 0,05. Resultados: La muestra consistió en 58 pacientes con una edad media de 55 ± 13 años, predominando el sexo femenino (58,6%). El 60,3% mostró alteraciones en la radiografía de tórax; un 74,3% con patrón intersticial bilateral y un 25,7% con patrón intersticial unilateral. La ecografía reveló patrón intersticial en el 43,1% de los casos y se observaron dos microconsolidaciones subpleurales. Conclusiones: Las radiografías de tórax y las ecografías pulmonares son herramientas imagenológicas eficaces, accesibles y económicas para detectar alteraciones en pacientes con síndrome post-COVID-19. (AU)

Objective: To describe imaging findings in chest radiographs and lung ultrasounds of patients with post-COVID-19 syndrome. Methods: A descriptive, prospective, and cross-sectional study was carried out that included patients with post-COVID-19 syndrome, who underwent chest radiographs and lung ultrasounds at the Clinical Pneumonology Service of Dr. José Ignacio Baldo Hospital, between January and October 2022. Descriptive statistics, Pearson's chi-square, and kappa concordance test were used, considering a p-value < 0.05 significant. Results: The sample consisted of 58 patients with an average age of 55 ± 13 years, with a predominance of females (58.6%). 60.3% showed alterations in the chest radiograph; 74.3% with a bilateral interstitial pattern and 25.7% with a unilateral interstitial pattern. The ultrasound revealed an interstitial pattern in 43.1% of the cases and two subpleural microconsolidations were observed. Conclusions: Chest radiographs and lung ultrasounds are effective, accessible, and economical imaging tools to detect alterations in patients with post-COVID-19 syndrome. (AU)

Increased interest with the introduction of fast-track diagnostic pathway is associated with the regionally increased frequency of giant cell arteritis in Poland: a study based on POLVAS registry data.

Slavic populations, such as those in Poland, are considered to have a low prevalence of giant cell arteritis (GCA), although epidemiological data are sparse. The study aimed to compare the reported frequency of GCA in various regions of Poland and analyze the differences between them. We conducted a multicenter, retrospective study of all GCA patients included in the POLVAS registry-the first large multicenter database of patients with vasculitis in Poland. The data from the POLVAS registry were compared with the reported prevalence provided by national insurers from the corresponding regions. A 10-fold increase in the diagnostic rates of GCA was observed in Poland between 2008 and 2019, reaching 8.38 per 100,000 population > 50 years old. It may be attributed to increased interest accompanied by improved diagnostic modalities with the introduction of ultrasound-based, fast-track diagnostic pathways in some centers. However, regional inequities are present, resulting in 10-fold differences (from 2.57 to 24.92) in reported prevalence between different regions. Corticosteroid (CS) monotherapy was the main stem of treatment. Further cooperation and education are needed to minimize regional inequities. This observational study suggests some potential for further increase of the recognizability of GCA and wider use of other than CS monotherapy treatment regimens. We hope that the Polish experience might be interesting and serve as some guidance for the populations where GCA is underdiagnosed.

Automatic detection of pleural line and lung sliding in lung ultrasonography using convolutional neural networks.

Background: Lung ultrasonography (LUS) is a valuable diagnostic tool, but there is a shortage of LUS experts with extensive knowledge and significant experience in the field. Convolutional neural networks (CNNs) have the potential to mitigate this issue by facilitating computer-aided diagnosis. Methods: We propose computer-aided system by a CNN-based method for LUS diagnosis. As the first consideration, we investigated pleural line and lung sliding. The pleural line indicates the position of pleura in an ultrasound image, and LUS is performed after first confirming the position of pleural line. Lung sliding defined as the movement of the pleural line, and the absence of this feature is associated with pneumothorax. Results: Our proposed method accurately detected pleural line and lung sliding, demonstrating its potential to provide valuable diagnostic information on lung lesions.

The Diagnostic Value of Musculoskeletal Ultrasound in the Quantitative Evaluation of Skeletal Muscle in Chronic Thyrotoxic Myopathy: A Single-Center Study in China.

Objective: This study aimed to evaluate the quadriceps femoris in patients with chronic thyrotoxic myopathy (CTM) using musculoskeletal ultrasound and to explore its practical clinical value for the diagnosis of CTM. Methods: A total of 241 subjects recruited from the First Affiliated Hospital of Guangxi Medical University were surveyed for detailed medical history and underwent grip strength tests, fixed-distance walking, and quadriceps femoris ultrasound examinations. Differences in muscle parameters between the CTM, non-CTM, and healthy groups were analyzed. An Receiver operating characteristic (ROC) curve was established to analyze the predictive value of various ultrasound measurements for CTM, and Spearman correlation analysis and binary logistic regression were applied to explore the factors associated CTM. Results: The quadriceps femoris contraction index, muscle thickness, muscle cross-sectional area, and pennation angle in the CTM group were significantly lower than those in the non-CTM and healthy groups (p<0.01). The ROC curve prediction showed that the pennation angle had the best sensitivity and specificity for diagnosing myogenesis, with an area under the curve of 89%. Moreover, the pennation angle of the CTM group was positively correlated with step speed (r=0.245, p=0.031) and body surface area (r=0.276, p=0.014), but negatively correlated with age (r=-0.306, p=0.007). Regression analysis showed that the quadriceps femoris contraction index, muscle thickness, pennation angle, and cross-sectional area were factors that related the CTM. After adjusting for potential confounding factors, the association between Muscle Bundle Length and CTM became significant (OR=1.99, 95% CI: 1.22, 3.35, p=0.007). Muscular echo in patients was observed to varying degrees of enhancement. Conclusion: Musculoskeletal ultrasonography in the quantitative analysis of muscle parameters and muscle echo of the quadriceps femoris can provide essential imaging evidence for predicting CTM.

Ultrasound therapy for pain reduction in musculoskeletal disorders: a systematic review and meta-analysis.

Background: Ultrasound therapy is a non-invasive technique used to address a variety of health issues. Objectives: This systematic review and meta-analysis aim to assess the effectiveness of ultrasound therapy in alleviating pain associated with musculoskeletal diseases. Design: This study was conducted following PRISMA guidelines, with relevant articles identified through comprehensive searches in electronic databases. Data sources and methods: We conducted searches across multiple databases, including Scopus, PubMed, MEDLINE, ProQuest, Science Direct, CINAHL, AIM, and ELDIS. Two independent reviewers screened the titles and abstracts of the retrieved articles. We included randomized controlled trials (RCTs) and observational cohort studies published between 2010 and 2023 that evaluated ultrasound therapy for knee and shoulder skeletal disorders. The selected data were analyzed qualitatively and synthesized, with the risk of bias assessed using the RoB2 tool. Results: Initially, 117 articles were reviewed using the search strategy, and 10 trials that met the inclusion criteria were identified. In seven of these studies, the primary musculoskeletal disorder was osteoarthritis, while three studies focused on shoulder pain and impingement. Most studies indicated that ultrasound therapy significantly reduced pain. The meta-analysis showed that ultrasound therapy was significantly more effective than other interventions for knee disorders (I 2 = 51%, Z = 2.65, p = 0.008). However, for shoulder disorders, both ultrasound and other intervention methods were found to be ineffective (I 2 = 93%, Z = 0.73, p = 0.46). Conclusion: The current evidence supports the effectiveness of ultrasound therapy in reducing pain and aiding rehabilitation for knee conditions. However, there are mixed results regarding its efficacy for shoulder conditions, highlighting the need for further research in this area.

Validation of the follicular and ovarian thresholds by an 18-MHz ultrasound imaging in polycystic ovary syndrome: a pilot cutoff for North African patients.

Background: Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrinopathies among young women. Ultrasound evidence of polycystic ovaries is one of its crucial diagnostic criteria. Objectives: Our main objective is to study the contribution of ultrasound data in diagnosing PCOS. In addition, we aim to establish a new cutoff point for the use of ultrasound and to determine its sensitivity as well as its specificity. Design: It was a prospective study, including all patients presenting with clinical hyperandrogenism. Methods: The ultrasound examination of these patients was performed using a novel ultrasound machine (18 MHz) compared to an older ultrasound machine (2 Hz-8 MHz). Inclusion criteria encompassed adult female patients over 18 years presenting symptoms suggestive of PCOS, particularly hyperandrogenism and oligo-anovulation, meeting Rotterdam's diagnostic criteria. Prior to inclusion, assessments were conducted to eliminate other potential causes explaining hyperandrogenism or menstrual disorders in both groups. Results: We examined 92 patients diagnosed with PCOS. Menstrual disorders were the main symptoms, with amenorrhea being more frequent in the PCOS group (G1) (48.9% vs the control group (G2): 11.1%). The follicle number was significantly lower in the control group, as assessed by both ultrasound machines (p < 10-3). The accuracy of the new ultrasound device was evaluated compared to the old one using the receiver operating characteristic (ROC) curve, revealing a cutoff of 18 follicles (sensitivity of 68.1%, specificity of 100%) and an area under the curve of 0.955. We found a significant difference between the median values of the number of follicles (NF) by both ultrasound machines (18 vs 12). It was positively correlated with an index of r = 0.916. For the volume, it was distinctively higher in G1 (p < 10-3). ROC curve analysis revealed an ovarian volume cutoff of 9.25 ml with a sensitivity of 48.9% and a specificity of 100%. Both ultrasound machines were positively correlated with an index of r = 0.979 (p < 10-3). Conclusion: In conclusion, we were able to establish significant correlations between the new and the old ultrasound devices for both the NF and ovarian volume. Our study is distinctive as it represents the first on the African continent to re-evaluate the ultrasound criterion for PCOS.

BACKGROUND: Polycystic Ovary Syndrome (PCOS) is often diagnosed using ultrasound in North African women. Current ultrasound standards may not be accurate enough for this group. This study aimed to improve PCOS diagnosis by setting new standards for measuring ovarian sizes and follicle numbers. METHODS: We reviewed a new ultrasound method. We then established new measurement thresholds specific to North African women. These new standards were tested for accuracy in diagnosing PCOS. RESULTS: Our new measurement thresholds were more accurate in diagnosing PCOS. The improved standards led to better identification of PCOS in North African women. This suggests that current ultrasound methods might need adjustments based on population-specific data. CONCLUSIONS: Using ultrasound with new measurement standards can improve PCOS diagnosis in North African women. Adjusting diagnostic criteria to specific populations may enhance overall healthcare outcomes.

Validating ultrasound criteria for PCOS in North African patients In this study, we explored patients using ultrasound to better diagnose Polycystic Ovary Syndrome (PCOS) in North African women. Ovarian follicles are small sacs in a woman's ovaries that not only release eggs but also produce important hormones like estrogen and progesterone. These hormones regulate the menstrual cycle, prepare the body for pregnancy, and influence many aspects of a woman's health and well-being. We set new standards for measuring follicles and ovaries to improve diagnosis accuracy.

IgG4-Related Retroperitoneal Fibrosis in a Patient With B-Cell Lymphoproliferative Disorder.

We report an interesting case of a 25-year-old male patient who presented with a complaint of pain in the abdomen for six months, which was not associated with any other symptom, the patient was diagnosed with IgG4-related retroperitoneal fibrosis (RF) via endoscopic ultrasound (EUS)-guided biopsy. He was prescribed steroids and proton pump inhibitors. Due to the limited presentation and rarity of RF, diagnosis of this disease requires extensive diligence and care. In this case report, we underscore the importance of considering the differential diagnosis of RF or Ormond's disease when a patient presents with vague symptoms of pain in the abdomen. According to our knowledge, this is the first case of IgG4-related RF in a patient with B-cell lymphoproliferative disorder reported from Pakistan.

Mid-Ventricular Obliteration Diagnosed by Bedside-Focused Echocardiography in the Emergency Department in a Patient With Syncope and Associated Hypertrophic Cardiomyopathy: A Case Report.

Syncope is a common complaint encountered in emergency medicine practice with multiple potential etiologies to investigate. The utility of focused bedside echocardiography allows emergency physicians to diagnose acute cardiovascular causes in a time-sensitive fashion. In this case report, a 61-year-old female with mixed aortic valve disease presented to the emergency department after a syncopal episode. In addition to standard electrocardiogram and laboratory testing, investigation with focused echocardiography performed at the point of care revealed mid-ventricular obliteration due to hypertrophic myocardial remodeling, left ventricular underfilling, and hyperdynamic performance. Key echocardiographic findings that may assist emergency physicians in recognizing and managing this physiological entity were discussed.

Development of a Machine Learning-Based Model for Accurate Detection and Classification of Polycystic Ovary Syndrome on Pelvic Ultrasound.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder that disrupts reproductive function and hormonal balance. It primarily affects reproductive-aged women and leads to physical, metabolic, and emotional challenges affecting the quality of life. In this study, we develop a machine learning-based model to accurately identify PCOS pelvic ultrasound images from normal pelvic ultrasound images. By leveraging 1,932 pelvic ultrasound images from the Kaggle online platform (Google LLC, Mountain View, CA), we were able to create a model that accurately detected multiple small follicles in the ovaries and an increase in ovarian volume for PCOS pelvic ultrasound images from normal pelvic ultrasound images. Our developed model demonstrated a promising performance, achieving a precision value of 82.6% and a recall value of 100%, including a sensitivity and specificity of 100% each. The value of the overall accuracy proved to be 100% and the F1 score was calculated to be 0.905. As the results garnered from our study are promising, further validation studies are necessary to generalize the model's capabilities and incorporate other diagnostic factors of PCOS such as physical exams and lab values.

Transcranial ultrafast ultrasound Doppler imaging: A phantom study.

Ultrafast ultrasound Doppler imaging facilitates the assessment of cerebral hemodynamics with high spatio-temporal resolution. However, the significant acoustic impedance mismatch between the skull and soft tissue results in phase aberrations, which can compromise the quality of transcranial imaging and introduce biases in velocity and direction quantification of blood flow. This paper proposed an aberration correction method that combines deep learning-based skull sound speed modelling with ray theory to realize transcranial plane-wave imaging and ultrafast Doppler imaging. The method was validated through phantom experiments using a linear array with a center frequency of 6.25 MHz, 128 elements, and a pitch of 0.3 mm. The results demonstrated an improvement in the imaging quality of intracranial targets when using the proposed method. After aberration correction, the average locating deviation decreased from 1.40 mm to 0.27 mm in the axial direction, from 0.50 mm to 0.20 mm in the lateral direction, and the average full-width-at-half-maximum (FWHM) decreased from 1.37 mm to 0.97 mm for point scatterers. For circular inclusions, the average contrast-to-noise ratio (CNR) improved from 8.1 dB to 11.0 dB, and the average eccentricity decreased from 0.36 to 0.26. Furthermore, the proposed method was applied to transcranial ultrafast Doppler flow imaging. The results showed a significant improvement in accuracy and quality for blood Doppler flow imaging. The results in the absence of the skull were considered as the reference, and the average normalized root-mean-square errors of the axial velocity component on the five selected axial profiles were reduced from 17.67% to 8.02% after the correction.

Comparison of a handheld ultrasound device with cart-based ultrasound for the assessment of gout lesions in people with established gout.

OBJECTIVES: Use of handheld portable ultrasound is increasing and would improve access for people with rheumatic disease when conventional, cart-based ultrasound is unavailable. This study compared handheld and cart-based ultrasound for the assessment of gout lesions in people with gout. METHODS: The lower limbs of 21 participants with gout were independently scanned at six sites (1st and 2nd metatarsophalangeal joints, knee, patellar ligament, Achilles tendon, and peroneal tendons) using cart-based (LOGIQ P9) and handheld (Vscan Air™) ultrasound by two rheumatologists. One rheumatologist was randomized to scan the right or left leg first with the cart-based or handheld ultrasound. The other rheumatologist scanned the legs in the opposite order with the imaging devices reversed. Images were saved and blinded images scored for double contour, tophus, erosion and aggregates using OMERACT definitions by two rheumatologists experienced in gout ultrasound. RESULTS: On handheld ultrasound, 90% of participants had at least one site with double contour, tophus and erosions, and 100% had at least one site with aggregates. There were similar findings using cart-based ultrasound. However, site-level inter-device analysis showed only fair-good agreement: kappa (percentage agreement) for double contour 0.22 (67%), tophus 0.46 (77%), erosion 0.63 (83%) and aggregates 0.37 (75%). There were more aggregates detected by cart-based ultrasound in joints and more tophi detected by handheld ultrasound in ligaments and tendons. CONCLUSIONS: Handheld ultrasound can detect gout lesions in people with established gout. However, concordance between cart-based and handheld ultrasound in detection of some gout lesions is low, particularly double contour and aggregates.

Effects of ultrasonic waves of different powers on the physicochemical properties, functional characteristics, and ultrastructure of bovine liver peptides.

In recent years, ultrasound has emerged as a widely used technology for modifying proteins/peptides. In this study, we focused on the intrinsic mechanism of ultrasound-induced modification of bovine liver peptides, which were treated with ultrasound power of 0, 100, 200, 300, 400, and 500 W, and their physicochemical and functional properties, as well as ultrastructures, were investigated. The results show that ultrasound mainly affects hydrogen bonding and hydrophobic interactions to change the conformation of proteins and unfolds proteins through a cavitation effect, leading to an increase in biological activity. Fourier infrared spectroscopy showed that ultrasound inhibited the formation of hydrogen bonds and reduced intermolecular cross-linking. Molecular weight distribution showed that the antioxidant components of bovine liver polypeptides were mainly concentrated in fractions of 500-1,000 Da. Maximum values of ABTS (82.66 %), DPPH (76.02 %), chelated iron (62.18 %), and reducing power (1.2447) were obtained by treating bovine liver polypeptides with 500 W ultrasound. Combined with the scanning electron microscopy results, with the intervention of ultrasound, the impact force generated by ultrasonication may lead to the loosening of the protein structure, which further promotes the release of antioxidant peptides, and these findings provide new insights into the application of ultrasound in the release of antioxidant peptides from bovine liver.

Examination of the masseter muscle in patients with hemifacial microsomia using high-frequency ultrasound and shear wave elastography.

BACKGROUND: This study aimed to prospectively investigate the reference values for masseter muscle thickness and hardness using ultrasonography and shear wave elastography, respectively, in patients with hemifacial microsomia (HFM). METHODS: We enrolled 51 patients, aged 5-20 years, with HFM including 31 males and 20 females. The upper-lower, left-right, and anterior-posterior diameters of 102 masseter muscles and stiffness of 98 masseter muscles were determined by examining the unaffected and affected sides of each participant's face. RESULTS: The upper-lower, left-right, and anterior-posterior diameters of the masseter muscle were significantly smaller at rest (4.26 ± 0.83, 2.94 ± 0.75, and- 0.80 ± 0.25 cm, respectively) and during contraction (3.95 ± 0.78, 2.71 ± 0.78, and 0.87 ± 0.29 cm, respectively) in the affected side than those in the healthy side (5.45 ± 0.66, 3.87 ± 0.49, and 0.97 ± 0.20 cm, respectively, at rest and 4.99 ± 0.45, 3.49 ± 0.53, and 1.07 ± 0.23 cm, respectively, during contraction, p < 0.05). In the resting state, the hardness of the masseter muscle on the affected side (0.77 ± 0.66 m/s) was significantly greater than that on the healthy side (0.42 ± 0.41 m/s; p < 0.05). The magnitude of changes in the upper-lower, left-right, and anterior-posterior diameters of the biting muscle in the occlusal state were significantly smaller on the affected side (-0.30 ± 0.27, -0.23 ± 0.17, and 0.08 ± 0.08 cm, respectively) than those in the healthy side (-0.47 ± 0.38, -0.37 ± 0.25, and 0.10 ± 0.12 cm, respectively, p < 0.05). CONCLUSIONS: The knowledge of these values allows for better understanding of the disease characteristics of HFM, which may be used for its diagnosis, treatment, and prognosis. Patients experiencing different severity levels exhibited significant differences in the morphology and function of the masseter muscle on the affected-side (p < 0.05). EVIDENCE LEVEL: Level III.

A Systematic Review Comparing Radiofrequency versus Focused Ultrasound Pallidotomy in the Treatment of Parkinson's Disease.

INTRODUCTION: Focused ultrasound (FUS) pallidotomy is a promising new therapy for Parkinson's disease (PD). The efficacy, motor outcomes, and side effects of FUS pallidotomy compared to radiofrequency (RF) pallidotomy are unknown. METHODS: We performed a systematic review of the outcomes and side effect profiles of FUS versus RF pallidotomy in patients with PD. RESULTS: Across four RF reports and one FUS report, putative contralateral UPDRS III scores were not significantly different following RF versus FUS pallidotomy. Across 18 RF and 2 FUS reports, the mean failure rate was 14% following RF pallidotomy versus 24% following FUS pallidotomy. Across 25 RF and 3 FUS reports, cognitive deficit was significantly more prevalent following RF pallidotomy (p = 0.004). CONCLUSION: At present, limited data and heterogeneity in outcome reporting challenges comparisons of FUS and RF pallidotomy efficacy and safety. Available evidence suggests FUS pallidotomy may have broadly similar efficacy and a lower risk of cognitive impairment relative to RF pallidotomy. Standardized reporting of post-lesion outcomes in future studies would improve power and rule out potential confounders of these results.