Abstract
A new set of guidelines to help obstetric ultrasound departments with their protocols for follow-up scans when a maternal infection has been detected. It is also a useful reminder of the types of infection that can affect the developing fetus, the ultrasound appearances that may be found in these cases, and ongoing management.
If CEUS is available at the time of the initial ultrasound, the authors found that it can aid diagnosis in cases of scrotal trauma and may allow for testis-sparing surgery sometimes. Excellent use of greyscale images and the corresponding CEUS images to demonstrate the different appearances.
The author designs a work schedule which is fair to all the ultrasound practitioners and follows best practice guidelines for ergonomics, allowing a range of ultrasound scans on each list. There are no real answers for timing of examinations, but it is an interesting read which highlights differences in practice between Canada and the UK. There is inclusion of an audit tool, which could be useful in all departments, when rethinking ways of working.
Five phases that parents went through were identified by this review of the qualitative literature in breaking difficult or unexpected news: expectations, discovery, shock, decisions and planning, and adaptation. One outcome was that parents wanted immediate answers and written information, so that they could read about the condition when ready to take on more knowledge. As usual, the most difficult experiences for both the parents and the ultrasound practitioner came when findings were uncertain.
This article offers a practical guide to providing bedside lung ultrasound, written for obstetricians to extend their practice. It explains the scan technique and appearances associated with COVID-19. There is also a link to a useful video presentation of the article, which reinforces the learning and provides a checklist which could be helpful when reporting appearances.
This retrospective study of 107 neonates over a 15-year period reviewed the ultrasound images using strict criteria. The results showed that a thickened (>2 mm) and echogenic (brighter than the liver) gastric and duodenal wall was significant for neonates with congenital intrinsic duodenal anomalies (p < 0.0001) when compared to those with midgut malrotation. The authors propose that this could be assessed during all neonatal abdominal scans.
A clear explanation of different ways to classify thyroid nodules (U classification, TI-RADS and EU-TIRADS score) is given at the start of this paper. A retrospective study was performed using clinical details and ultrasound images from 1465 patients scanned in 2016 at a single centre. Over half (56.24%) the patients who had nodules on the ultrasound were not given a U classification on the report at the time of the scan, a reminder that classification is needed for patients to be followed up correctly. In the U3 group that did not have surgery and were followed up by ultrasound, no change in the nodule was found up to 274 days. It is proposed that with correct classification initially, follow-up can be made at 6–12 months.
This article explains the use of robotics to help prevent ultrasound practitioners obtaining work-related musculoskeletal disorders by using a tele-operated system. The ultrasound practitioner moves a probe and operates the ultrasound controls during the scan, the probe is connected to a haptic device and the robot arm mimics the scanning movements on the patient.
This cross-sectional study carried out a variety of ultrasound investigations on 250 women who had obstetric anal sphincter injury post-delivery. Unusually for this type of research, the investigations were carried out 6–12 weeks postpartum or in the next pregnancy (mean 23.6 months) after the initial injury. 3D endoanal ultrasound, as well as introital and transperineal ultrasound imaging was performed to give different views of the internal and external anal sphincter. Anal pressures were also measured and correlated with the ultrasound findings. Endoanal ultrasound was deemed the best method for diagnosis of anal incontinence and a low anal pressure was related to all sphincter defects.
This prospective study recruited 1271 women who attended one early pregnancy unit before 12 weeks’ gestation in a two-year period. The Bottomley score, which includes the ultrasound features of mean gestation sac size, mean yolk sac size, presence of fetal heart pulsation and some clinical factors, was calculated for each woman. The investigators were blinded to the score and treated the women using their local protocols. All patients were rescanned at 13–16 weeks, which the researchers had set as their viability limit. Women with a Bottomley score of ≥1 had >90% probability of having a viable pregnancy at 13–16 weeks. The authors proposed that this knowledge could be used to counsel patients who present to early pregnancy units.
This article gives results from 143 patients in three wards during one month, in one of the hospitals in Wuhan that treated patients with COVID-19, taking clinical details and ultrasound results for deep vein thrombosis (DVT). DVT was present in 46.1% of patients. These patients were more likely to be older (over 65 years), have more chronic illness with a high Padua prediction score and D-Dimer > 1 (µg/ml). Patients with DVT had poorer outcomes than the non-DVT group.
The authors analysed papers that used ultrasound elastography (UE) in patients with breast cancer and found that using UE was more sensitive in identifying malignant axillary lymph nodes over grey scale ultrasound. The use of real-time elastography (RTE) versus shear wave elastography (SWE) was also compared and SWE was found to be slightly better (sensitivity 0.82, specificity 0.83 and AUC 0.91).