Journal of Diagnostic Medical Sonography

Dual x-ray absorptiometry (DXA) is gold standard of bone densitometry, but quantitative ultrasound (QUS) of bone is less expensive and portable. This study was designed to assess its usefulness in secondary osteoporosis diagnosis.

There were 200 secondary osteoporosis cases (rheumatoid arthritis, hemodialysis, kidney transplant patients, and levothyroxine users) and of those, their phalanx QUS results were compared with normal controls. Also, the QUS and DXA results were compared to find any correlation of these methods for diagnosing osteoporosis.

There was not significantly different results compared with normal controls, except for those of hemodialysis patients (P = .00). Also, the comparison of QUS with DXA results showed no significant correlation except in hemodialysis patients, in both spinal and femoral regions (P = .023 and .21, respectively), as well as the levothyroxine group’s spinal region (P = .005).

These results suggest that QUS of phalanx may be useful in screening secondary osteoporosis but for establishment of diagnosis, DXA measurements are still needed.

Pericardial effusion is a frequent finding in patients who undergo cardiac surgery. There are currently limited data providing information regarding the factors that may contribute to postoperative pericarditis. The aim was to evaluate laboratory and echocardiographic features that may influence the presence of pericardial effusion 6 to 8 weeks following coronary artery bypass grafting (CABG).

This was a prospective cross-sectional study that included 90 patients after CABG operation who were divided into two groups. A total of 32 (35.56%) patients with pericardial effusion on follow-up echocardiography formed the first group and 58 patients without pericardial effusion the second group, which were compared in respect to components that were taken prior to the operation.

The groups did not differ regarding sex (males 65.62% vs 63.79%, P = .86) or age (59.59 ± 9.29 vs 61.69 ± 10.71, P = .35). Platelet count (184.74 ± 58.79 vs 222.62 ± 88.97, P = .03) and left ventricular (LV) global longitudinal strain (GLS) (−14.64 ± 6.86 vs −16.96 ± 4.1, P = .04) demonstrated statistical significance.

Prolonged postoperative pericardial effusion in small amounts may be found in patients, with preoperative lower thrombocyte count and LV GLS, which could be possible predisposing factors.

When measuring the liver sonographically, liver volume measurement (LVM) is not routinely performed, though considered the gold standard on CT. The objective of this study is to encourage the sonography community to obtain an LVM instead of a single linear measurement on ultrasound, so as not to subject patients to the potentially harmful radiation exposure of a CT scan when assessing liver size. This study compared the consistency and accuracy between expert and novice sonographers in obtaining an LVM on sonography.

Both groups obtained linear and LVM on 30 participants and calculated LVM using the formula Liver Volume (cc) = 343.71 + (0.84 × ABC).

Both groups took longer to obtain LVM than linear, P < .0001. Novices and experts obtained an LVM in a similar amount of time. More consistency was observed among experts when scanning participants in the lower BMI ranges. Novice sonographers’ LVMs were consistent with experts’ only in the lowest BMI range of this study.

Groups acquired LVM in similar amounts of time, showing LVM is easy to teach and learn, and has good inter-rater reliability. Difference for both groups to obtain LVM over linear was only 38 seconds. Consequently, it is prudent to incorporate LVM into abdominal ultrasound protocols.

Elastography has the potential in differentiating benign from malignant masses. The objectives of the study were to evaluate morphology of the breast masses with routine ultrasonography and elastography, to assess the role of elastography and conventional B-mode ultrasonography in differentiating benign from malignant breast masses and to correlate elastography and B-mode ultrasonography results with pathologic findings.

This prospective observational study was conducted over a period of 18 months from January 2018 to June 2019 on 86 patients with 101 clinically palpable breast lumps who underwent B-mode ultrasonography and elastography of the breast. Baseline data, sonographic features, a modified color score, and mean strain ratio were recorded and compared with final diagnosis.

Sonography showed a sensitivity of 89.8%; specificity of 96.15%; positive predictive value (PPV) and negative predictive value (NPV) of 95.65% and 90.91%, respectively; and overall diagnostic accuracy of 93.07%. New modified dual color score showed sensitivity of 97.8%, specificity of 87.0%, PPV of 86.79%, and NPV of 87.08% with a diagnostic accuracy of 92.08%. The risk of missing a malignant case with the new modified dual color score was 2.1%. Mean strain ratio showed sensitivity of 100%; specificity of 98.11%; PPV and NPV of 97.96% and 100%, respectively; and diagnostic accuracy of 99.01%.

This study demonstrates the promise of elastography in identifying possible breast malignancies, thus preventing unnecessary invasive procedures.

This research examined the effects of multiple combined competency-based methods on sonography students’ perceptions of adult echocardiography training components. In addition, clinical preceptor evaluation scores were compared with faculty objective structured clinical examination (OSCE) scores.

A quasi-experimental nonequivalent group research design was used to evaluate students enrolled in an adult cardiac Commission on Accreditation of Allied Health Education Programs (CAAHEP) accredited curriculum. Students’ perceptions pre and post multiple competency-based methods (formative assessment, OSCE, & simulation) intervention were recorded via course evaluations. Questions were analyzed individually using descriptive statistics and the Bonferroni correction. Students’ clinical evaluation and OSCE scores were analyzed using Spearman’s rank correlation.

The majority of students’ perceptions pre- and postintervention of multiple competency-based assessments demonstrated significant differences, or they primarily agreed that their echocardiography knowledge or skill set was enhanced. There was weak correlation between students’ clinical competency evaluation scores and OSCE scores—post implementation of multiple competency-based assessments, r_s(37) = −.01, P = .93.

These results suggest further evaluation of the credentialing process’s clinical assessment to ensure clinical competency.

The aim of this study was to explore the phenomenon of academic emotions experienced by sonography students.

In this hermeneutic phenomenological study, in-depth, semi-structured phenomenological interviews were conducted to learn about participants’ emotional experiences while learning sonography. Thematic analysis was utilized in an effort to understand participants’ experiences with the phenomenon.

This study yielded the following interpretive themes: (1) the classroom emotional climate impacts students’ thoughts about learning sonography, (2) academic emotions can either boost or detract from students’ interest, motivation, and enthusiasm for the course material, and (3) relationships with their teachers matter to sonography students.

An increased awareness of the interrelatedness of emotion and cognition in sonography education would benefit not only sonography educators and students but ultimately the patients whom those students will care for by improving the quality of education that students receive.

To assess the feasibility and reliability of incorporating quantitative shear wave elastography (SWE) data as an additional means of characterizing focal atheromata during routine carotid sonographic examinations when compared with conventional gray-scale Gray-Weale (GW) methods.

Inpatients and outpatients undergoing routine carotid examinations at a medical center were included in the pilot study. Patients with prior history of endarterectomy, interventional therapeutic procedures, or absence of plaque formation were excluded. All examinations were performed by registered vascular technologist using a Mindray Resona 7 ultrasound equipment system with an L9-3U transducer in a carotid examination mode. The images were later reviewed by two independent, blinded observers and correlated to GW characterization.

There were 41 atheromatous lesions evaluated during the pilot study. The range of absolute (low to high) average and median Young’s modulus (YM) kPa values vary widely across each plaque type; they nonetheless still exhibit evidence of increasing stiffness as the gray-scale sonographic appearance becomes denser. The same observation is true of the average kPa and median kPa values as increasing YM values indicate increasing stiffness of interrogated tissues.

This pilot study affirms the feasibility and reliability of incorporating quantitative SWE data as an additional means of characterizing focal atheromata during routine carotid sonographic examinations; further large-scale studies are needed to determine the sensitivity and specificity of individual kPa values associated with specific plaque types.