Abstract
Association between metformin prescription and growth rates of abdominal aortic aneurysms. Golledge J, Moxon J, Pinchbeck J et al. Br J Surg 2017; 104(11): 1486–1493.
Nearly 1700 patients with an abdominal aortic aneurysm (AAA) were monitored by this multicentre Antipodean collaboration and those prescribed metformin had a reduced likelihood of AAA growth. Maybe metformin will have a role in managing AAAs in the future.
Sex discordance identification following non-invasive prenatal testing. Richardson EJ, Scott FP and McLennan AC. Prenat Diagn 2017;37: 1298–1304. doi: 10.1002/pd.5184. [Epub ahead of print]
The increasing availability of non-invasive prenatal testing (NIPT) means more cases of genotype-phenotype discordance that would not normally be detected until puberty or adulthood are now being found in early pregnancy. This is posing a challenge for clinicians when it comes to offering already complex pre-NIPT counselling.
Contrast-enhanced ultrasound identifies hepatocellular carcinoma in cirrhosis: A large multicenter retrospective study. Terzi E, Lavarone M, Pompili M et al. J Hepatol 2017; DOI: 10.1016/j.jhep.2017.11.007
This Italian collaboration involving over a 1000 liver nodules in 848 patients advocates the use of the American College of Radiology’s contrast-enhanced ultrasound LI-RADS classifying scheme for reliable non-invasive diagnosis of hepatocellular carcinoma.
Should we perform in utero MRI on a fetus at increased risk of a brain abnormality if ultrasonography is normal or shows non-specific findings? Griffiths PD, Mooney C, Bradburn M, et al. Clin Radiol 2018;73: 123–134.
The role of MRI in antenatal care is undoubtedly growing, and in this review article the authors state that diagnostic accuracy significantly improves (70% for ultrasound, 92% for MRI) if in-utero MRI is used on fetuses at high risk of brain abnormalities even when ultrasound findings look normal.
The FAST D protocol: A simple method to rule out traumatic vascular injuries of the lower extremities. Montorfano MA, Montorfano LM, Perez Quirante F et al. Crit Ultrasound J 2017; 9(1):8.
A total of 140 patients with gunshot wounds to the leg(s) were examined using a two point fast Doppler (FAST D) technique that evaluated only posterior tibial and dorsalis pedis arterial flow. Impressive results show 100% sensitivity and specificity for vascular injury using this method.
Underutilization of routine ultrasound surveillance after endovascular aortic aneurysm repair. Mell MW, Garg T and Baker LC. Ann Vasc Surg 2017; 44: 54–58.
A team from Stanford, California found that CT continues to be the imaging modality of choice for uncomplicated post-EVAR surveillance despite the Society for Vascular Surgery recommending ultrasound. With ultrasound, there is no radiation of course, and it is significantly cheaper. Medicare could save millions.
Transcranial Doppler and lower extremity function in older adults: Einstein aging study. Ezzati A, Rundek T, Verghese J, et al. J Am Geriatr Soc 2017;65: 2659–2664.
Investigating 200 older people, this study concluded that there may be an association between reduced blood flow in the anterior and posterior cerebral circulation and reduced balance, leg strength and walking speed.
Importance of surgeon-performed ultrasound in the preoperative nodal assessment of patients with potential thyroid malignancy. Monteiro R, Han A, Etiwy M et al. Surgery 2018; 163: 112–117.
In this study of 92 patients, nearly half had neck nodes diagnosed by surgeons using ultrasound that were not identified on pre-referral imaging. The researchers explain the value of surgeon-performed ultrasound for accurate staging and warn against heavy reliance on earlier imaging studies.
Is lung ultrasound useful for diagnosing pneumonia in children? A meta-analysis and systematic review. Xin H, Li J and Hu HY. Ultrasound Q 2017; DOI: 10.1097/RUQ.0000000000000330
This meta-analysis has found good evidence to support the use of lung ultrasound rather than chest radiography for evaluating pneumonia in children. The four clinical signs observed most often were pleural effusion, abnormal pleural line, pulmonary consolidation and positive air bronchogram.
Critical care ultrasound: A national survey across specialties. Stowell JR, Kessler R, Lewiss RE et al. J Clin Ultrasound 2017; DOI: 10.1002/jcu.22559
An online questionnaire aimed at a range of clinicians found that training and education for using point-of-care ultrasound was patchy. Most respondents were from emergency medicine or pulmonary and critical care. While some had attended courses or received support in-house, over 17% had had only ‘self-guided learning’.