Journal of Diagnostic Medical Sonography

Breast cancer is a leading cause of mortality in industrialized and developing countries. Mammography and a core needle biopsy are among the detection methods that are used to diagnose and confirm tumor subtypes.

A retrospective, noninterventional observational study was conducted in a tertiary center between January 2009 and December 2014. A total of 265 patients underwent ultrasonography (US)–guided core needle biopsy (CNB). A cohort of 147 patients met the inclusion criteria and data were subsequently extracted from their medical records.

From this cohort, US-CNB detected malignant lesions in 109 patients, with a total sensitivity and specificity for malignancy at 96.33% and 75.10%, respectively. The most frequent malignant tumor diagnosed with US-CNB was invasive ductal carcinoma. The most common benign masses detected were 38 (32.1%) fibroadenomas and fat necrosis. The positive and negative predictive values for US-CNB were 92.4% and 87.5%, respectively.

The findings would suggest that the use of US-CNB could play a major role in the identification and management of the breast lesions. It could also redeem any biopsy errors or operator inexperience. Sensitivity and specificity in detecting tumors, malignant or benign, using US-CNB could aid in efforts to provide an appropriate medical management plan.

This study developed a musculoskeletal ultrasound (MSUS) protocol to evaluate rehabilitation outcomes in systemic sclerosis.

Three MSUS methods (gray-scale, Doppler, strain elastography) and two acquisition techniques (long- vs short-axis; transducer on skin vs floating on gel) were examined in the forearm before and after rehabilitation treatment. For gray-scale, tissue thickness measures and intrarater and interrater reliability were calculated (intraclass correlation coefficients [ICCs]), and paired t tests examined differences among techniques.

Five people with diffuse cutaneous systemic sclerosis participated. The most valid and reliable gray-scale technique was with the transducer in long-axis, floating on gel. Doppler and strain elastography did not detect changes. Both dermal and subcutaneous thickness measurement error was small; intrarater and interrater reliability was good to excellent. Preliminary data indicate that treatment may lead to dermal thinning.

A replicable protocol was established and may be an adjunct to rehabilitation outcome measurement in systemic sclerosis.

To determine the use of sonography and test-feeding in the diagnosis of infantile hypertrophic pyloric stenosis (IHPS).

A total of 79 infants from 2 weeks up to 12 weeks presenting with clinical signs (projectile vomiting) of IHPS were included in the study while sent to sonography. The study duration was February 2014 to December 2019.

The mean age of patients was 5.18 ± 2.69 weeks ranging from 1 to 12 weeks. Male gender was predominant with 62 (78.5%) cases. Of the total 79 cases, 36 (54.6%) were suggested as positive cases of IHPS and 43 (54.4%) were as normal with sonography. Most of the cases of IHPS (23; 29.1%) were observed in firstborn babies. Mean pyloric length in normal and IHPS was 12.69 ± 0.87 and 20.78 ± 2.28 mm, respectively, and mean pyloric muscle thickness in the normal and IHPS was 2.24 ± 0.36 and 5.27 ± 0.82 mm, respectively, while mean pyloric diameter in normal and IHPS was 12.69 ±0.87 and 15.01± 2.52 mm, respectively.

The reliability of sonographic findings was better than test-feeding in the diagnosis of IHPS. Male infants, in this cohort, were five times more susceptible to develop IHPS, compared with females.

In pediatric sonography, mesenteric vessel abnormalities can be used as a sign of malrotation or volvulus. This study was aimed at evaluating the diseases associated with mesenteric vessel abnormalities in children, except for rotational anomalies.

From 2017 to 2020, pediatric patients with abdominal complaints were referred for a full abdominal sonogram and were evaluated for mesenteric vascular abnormalities. During this period, 62 children (aged <12 years), with mesenteric vessel abnormalities, were discovered with sonography. They were also examined for associated anomalies and were followed until a final diagnosis was determined.

Mesenteric vessel displacement was reported in 37 patients (60%); in 24 cases, the vein was located to the left of superior mesenteric artery (SMA), and in others (13 cases), in the anterior position. Abnormal pathways in mesenteric vessels were reported in 33 patients (53%); 18 cases showing a right side turn and 15 cases showing a left side turn. The whirlpool sign was seen in 16 patients (27%). These three patterns of vessel abnormality were associated with disorders such as diaphragmatic hernia, bowel obstruction, and space occupying lesions (masses). The location of the mesenteric abnormality was in the proximal part of mesenteric vessels in 45 cases (72.5%) and in its distal part in 17 cases (27.5%). Malrotation (eight cases), obstruction, and volvulus were the most common causes of a distal abnormality.

Mesenteric vessel abnormalities, noted with sonography, may not be exclusive to the diagnosis of malrotation and midgut volvulus. In this cohort, bowel obstruction, diaphragmatic hernia, and space occupying lesions were the other most common anomalies associated with mesenteric vessel abnormalities. In reviewing one-third of mesenteric vessels, abnormalities were only seen in the distal part of vessels; therefore, a thorough examination is warranted.

To determine whether the assessment of umbilical cord diameter (UCD) is a viable indicator of fetal growth and perinatal outcome.

A total of 652 singleton pregnancies between 10 and 40 weeks of gestation were reviewed for this study. The UCD was measured vertically in the longitudinal section, adjacent to its insertion at the fetal abdomen. Other fetal biometrics were measured according to standard measurement protocols. The perinatal outcome of each patient case was also recorded.

The UCD ranged between 0.73 and 1.68 cm, and correlated positively with gestational age, estimated fetal weight (r = 0.779, r = 0.639, P < .05), and other fetal biometrics. The UCD of 50 subjects was 2 standard deviations below the mean and correlated significantly (r = 0.712, P < .05) with poor fetal outcome in the first and second trimester. Observational studies of 50 subjects, whose UCD was 2 standard deviations below the mean, resulted in 21 cases of intrauterine fetal death, 10 cases of preeclampsia, 8 cases of oligohydramnios, and 11 cases of intrauterine growth restriction.

The UCD has the potential to serve as an important indicator of fetal growth, well-being, and perinatal outcome.

Neoadjuvant chemotherapy (NAC) is widely used to treat breast cancer. Sentinel lymph node biopsy has replaced axillary lymph node dissection in patients who convert to node-negative status, after NAC. However, few studies have evaluated the diagnostic performance of ultrasonography (US) and magnetic resonance imaging (MRI) in determining axillary lymph node status after NAC. The aim of this study was to evaluate the diagnostic performance of breast US and MRI in predicting a response to NAC, for breast cancer.

A systematic search, in PubMed, the Cochrane Library, and Web of Science, for original studies was performed. The Quality Assessment of Diagnostic Accuracy Studies 2 tool was used to assess the methodological quality of the included studies. Patient, study, and imaging characteristics were extracted, and sufficient data were used to reconstruct 2 × 2 tables. Data pooling, heterogeneity testing, forest plot construction, meta-regression analysis, and sensitivity analysis were performed using Meta-DiSc and Stata version 14.0 (StataCorp LP, College Station, TX, USA).

Nine studies met all the eligibility criteria and were included. The pooled sensitivity and specificity of MRI were 0.78 and 0.92, while the corresponding values for US were 0.80 and 0.90, respectively. The prevalence of pathologic complete response (pCR), among breast cancer patients, after neoadjuvant therapy was 26%. The prevalence of patients with estrogen receptor (ER)-, human epidermal growth factor receptor (HER)-, and progesterone receptor (PR)-positive tumors were 65%, 22%, and 37%, respectively.

These results showed that MRI and US have almost the same accuracy in predicting pCR in patients with breast cancer undergoing neoadjuvant surgery. There is still a need for further investigations to prove that US is not inferior to MRI for this diagnosis.

Sonography of the chest has traditionally been focused on chest wall and pleural space. Over time, clinicians have developed a practice of bedside lung ultrasonography (LUS) to supplement physical examination. In the wake of the SARS-COV-2 (COVID-19) pandemic, clinicians have increasingly turned to LUS as a tool to assess a patient’s condition.

A literature search was performed using Google Scholar with access to articles through a major Midwestern university.

Computed tomography (CT) and radiographs are not always available in all treatment centers. While LUS may be limited, it is important to correlate findings with compatible imaging modalities. This review summarizes lung pathologies and the sonographic appearance of lung abnormalities.

Radiology professionals have largely questioned the practice and findings of LUS. However, now, as the most qualified experts in the use of ultrasound, sonographers and radiologists have a duty to be educated in the use of LUS.