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Diagnostics
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Ultrasound Imaging in Medicine 2023
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Ultrasound Imaging in Medicine 2023

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 14873

Special Issue Editor

Prof. Dr. Michael Bachmann Nielsen

E-Mail Website
Guest Editor
Department of Diagnostic Radiology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
Interests: diagnostic radiology; cancer imaging; medical ultrasound; Doppler techniques; CT-scanning; medical presentations; musculoskeletal imaging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Ultrasound examinations are performed within almost all medical specialties, and are of paramount value in clinical medicine and as research tools. Diagnostic ultrasounds as well as ultrasound guidance for biopsy, drainage and tumor ablation have become an integral part of the clinical setting. The last ten years have seen an increase in new ultrasound techniques such as contrast-enhanced ultrasound (CEUS), elastography techniques, 3D ultrasound, image fusion with ultrasound and methods for flow visualization such as the vector Doppler method. In terms of the technical aspects, transducer technology has also evolved tremendously. This Special Issue invites submissions of both original and review papers, and technical as well as clinical papers within all aspects of ultrasound imaging.

Prof. Dr. Michael Bachmann Nielsen
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • 3D ultrasound
  • blood flow velocity
  • ultrasonography
  • contrast-enhanced ultrasound
  • elasticity imaging
  • endoscopic ultrasound
  • ultrasonography
  • ultrasonography
  • intervention

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Related Special Issues

Published Papers (8 papers)

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Research

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12 pages, 2617 KiB  
Article
Predictive Value of Sonographic Parameters on the Effects of Cranial Molding Helmet Therapy in Infants with Positional Plagiocephaly
by Maria Licci, Agnes Paasche, Alexandru Szathmari, Pierre-Aurélien Beuriat, Carmine Mottolese, Raphael Guzman and Federico Di Rocco
Diagnostics 2024, 14(13), 1407; https://doi.org/10.3390/diagnostics14131407 - 1 Jul 2024
Viewed by 1036
Abstract
Positional plagiocephaly is a deformational cranial flattening frequently treated in pediatric neurosurgical practice. Positional maneuvers and orthotic helmet therapy are preferred therapeutic options for moderate-to-severe forms. Treatment response seems to be age-dependent. Nevertheless, predictive data are vague, and cost-efficiency might be a limiting [...] Read more.
Positional plagiocephaly is a deformational cranial flattening frequently treated in pediatric neurosurgical practice. Positional maneuvers and orthotic helmet therapy are preferred therapeutic options for moderate-to-severe forms. Treatment response seems to be age-dependent. Nevertheless, predictive data are vague, and cost-efficiency might be a limiting factor for treatment. The purpose of this study was to investigate the early predictive value of sonographic parameters on the efficacy of orthotic helmet therapy through the assessment of changes in skull shape and correlation of the parameters with caliper cephalometry values and with age. A consecutive cohort of 49 patients < 10 months of age, undergoing orthotic helmet therapy for positional plagiocephaly, was recruited prospectively. The authors routinely assessed the patency of the lambdoid sutures by ultrasound and the following additional skull parameters were measured: suture width, adjacent full bone thickness, adjacent cortical bone thickness and occipital angle. Caliper cephalometric values, as well as demographic and clinical data were collected. Retrospective data analysis showed an inverse relation between both cortical and full skull bone thickness and early treatment efficacy, defined by a reduction in the occipital angle. The improvement of sonographic parameters correlated with the development of cranial caliper cephalometry values. In conclusion, the sonographic assessment of skull bone thickness is a safe and cost-effective tool to predict the early efficacy of orthotic helmet therapy in positional plagiocephaly and might, therefore, help the clinician to foresee the potential evolution of the deformity. Full article
(This article belongs to the Special Issue Ultrasound Imaging in Medicine 2023)
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11 pages, 1518 KiB  
Article
Assessing the Use of Telepresence-Guided Video-Based Head and Neck Ultrasound Training: A Step towards Minimizing Dependence on Human Resources?
by Philipp Kulas, Bernhard Schick, Johanna Helfrich, Alessandro Bozzato, Dietmar J. Hecker and Lukas Pillong
Diagnostics 2023, 13(17), 2828; https://doi.org/10.3390/diagnostics13172828 - 31 Aug 2023
Cited by 1 | Viewed by 992
Abstract
The acquisition of ultrasound skills is an essential part of any medical student’s education. University access restrictions in the context of the COVID-19 pandemic have highlighted the need for digitization in teaching. However, teaching manual skills in online courses has proven to be [...] Read more.
The acquisition of ultrasound skills is an essential part of any medical student’s education. University access restrictions in the context of the COVID-19 pandemic have highlighted the need for digitization in teaching. However, teaching manual skills in online courses has proven to be challenging, not least in terms of human resources. Therefore, the aim of this study was to set up a hybrid head and neck ultrasound course consisting of a preface of video-based self-study followed by supportive instruction by a tutor in telepresence and to evaluate the quality, effectiveness, and feasibility of this teaching method. Thirty-five students were shown video tutorials on systematic ultrasound of the neck course. Learning outcomes were analyzed using self-assessment questionnaires and external assessment by an experienced ultrasonographer. All participants demonstrated statistically significant learning improvement (p < 0.001) when comparing self-assessment scores before and after training. The mean self-assessment scores increased from 13.8 to 26.6 for the telepresence-guided group, from 16.6 to 27.3 for the web-based group, and from 14.0 to 26.2 for the in-person group. The external observer assessment also showed improvement, with mean scores of 46.7, 48.1, and 46.5, respectively. Overall results did not significantly differ when comparing different instruction modalities. A telepresence-guided video-based ultrasound course is well suited to teaching ultrasound skills similar to in-person courses and allows a more resource-efficient targeting of student needs. Full article
(This article belongs to the Special Issue Ultrasound Imaging in Medicine 2023)
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11 pages, 1317 KiB  
Article
Inter-Rater Agreement for Diagnosing Adenomyosis Using Magnetic Resonance Imaging and Transvaginal Ultrasonography
by Johanna K. Andersson, Raffaella Pozzi Mucelli, Margit Dueholm, Susanne Fridsten, Aristeidis Grigoriadis, Stefano Guerriero, Francesco Paolo Leone, Lil Valentin, Thierry Van Den Bosch, Nikolaos Voulgarakis, Kristina Gemzell-Danielsson and Elisabeth Epstein
Diagnostics 2023, 13(13), 2193; https://doi.org/10.3390/diagnostics13132193 - 28 Jun 2023
Cited by 1 | Viewed by 1663
Abstract
Our aim was to compare the inter-rater agreement about transvaginal ultrasonography (TVS) with magnetic resonance imaging (MRI) with regard to diagnosing adenomyosis and for assessing various predefined imaging features of adenomyosis, in the same set of women. The study cohort included 51 women, [...] Read more.
Our aim was to compare the inter-rater agreement about transvaginal ultrasonography (TVS) with magnetic resonance imaging (MRI) with regard to diagnosing adenomyosis and for assessing various predefined imaging features of adenomyosis, in the same set of women. The study cohort included 51 women, prospectively, consecutively recruited based on a clinical suspicion of adenomyosis. MRIs and TVS videoclips and 3D volumes were retrospectively assessed by four experienced radiologists and five experienced sonographers, respectively. Each rater subjectively evaluated the presence or absence of adenomyosis, as well as imaging features suggestive of adenomyosis. Fleiss kappa (κ) was used to reflect inter-rater agreement for categorical data, and the intraclass correlation coefficient (ICC) was used to reflect the reliability of quantitative data. Agreement between raters for diagnosing adenomyosis was higher for TVS than for MRI (κ = 0.42 vs. 0.28). MRI had a higher inter-rater agreement in assessing wall asymmetry, irregular junctional zone (JZ), and the presence of myometrial cysts, while TVU had a better agreement for assessing globular shape. MRI showed a moderate to good reliability for measuring the JZ (ICC = 0.57–0.82). For TVS, the JZ was unmeasurable in >50% of cases, and the remaining cases had low reliability (ICC = −0.31–0.08). We found that inter-rater agreement for diagnosing adenomyosis was higher for TVS than for MRI, despite the fact that MRI showed a higher inter-rater agreement in most specific features. Measurements of JZ in the coronal plane with 3D TVS were unreliable and thus unlikely to be useful for diagnosing adenomyosis. Full article
(This article belongs to the Special Issue Ultrasound Imaging in Medicine 2023)
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15 pages, 12844 KiB  
Communication
A Method for High-Frequency Mechanical Scanning Ultrasonic Flow Imaging with Motion Compensation
by Jiaming Heng, Chenxi Li, Tianxiang Chu, Yiwen Xu and Xiaohua Jian
Diagnostics 2023, 13(8), 1467; https://doi.org/10.3390/diagnostics13081467 - 18 Apr 2023
Cited by 1 | Viewed by 1742
Abstract
Mechanical scanning with a single transducer is an alternative method for high-frequency ultrasound imaging, which is simple in structure, convenient to implement, and low in cost. However, traditional mechanical scanning ultrasonic imaging introduces additional Doppler shift due to the movement of the transducer, [...] Read more.
Mechanical scanning with a single transducer is an alternative method for high-frequency ultrasound imaging, which is simple in structure, convenient to implement, and low in cost. However, traditional mechanical scanning ultrasonic imaging introduces additional Doppler shift due to the movement of the transducer, which brings a challenge for blood velocity measurement. An improved mechanical scanning system for high-frequency ultrasonic color Doppler flow imaging is developed in this paper. The mechanical scanning system has a scanning stroke range of 15 mm, a maximum scanning speed of 168 mm/s, and an imaging depth of 20 mm. Since the mechanical scanning of the system is not in uniform motion, motion compensation was applied to achieve high-precision imaging both in B-mode and Doppler mode. The experiment results show that the system imaging resolution can reach about 140 μm in B-mode imaging, the relative velocity error is less than 5% in color Doppler flow imaging at different flow rates, and the CNR of power Doppler flow imaging of this system is greater than 15 dB. The proposed mechanical scanning imaging system can achieve high-resolution structure imaging and color flow imaging, which can provide more diagnostic information for the practical diagnosis and broaden the application range of mechanical scanning ultrasound imaging. Full article
(This article belongs to the Special Issue Ultrasound Imaging in Medicine 2023)
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11 pages, 2469 KiB  
Article
Evaluation of Sciatic Nerve Stiffness Using Shear Wave Elastography in Patients with Unilateral Diabetic Foot Ulcers
by Shun-Ping Chen, Ting-Ting Ye, Jing Hong and Hong Zhu
Diagnostics 2023, 13(3), 547; https://doi.org/10.3390/diagnostics13030547 - 2 Feb 2023
Cited by 2 | Viewed by 2237
Abstract
Objective: To evaluate the stiffness of the sciatic nerve by shear wave elastography (SWE) and to determine whether SWE can be used to predict diabetic foot ulcer (DFU) in a patient with diabetic peripheral neuropathy (DPN). Methods: Sixteen patients (thirty-two lower limbs) with [...] Read more.
Objective: To evaluate the stiffness of the sciatic nerve by shear wave elastography (SWE) and to determine whether SWE can be used to predict diabetic foot ulcer (DFU) in a patient with diabetic peripheral neuropathy (DPN). Methods: Sixteen patients (thirty-two lower limbs) with unilateral DFU were studied retrospectively. The ultrasonographic parameters including cross-sectional area (CSA) of sciatic nerve, intraneural blood flow, peak systolic velocity (Vmax) and resistive index (RI) in the intraneural artery of the sciatic nerve, and the SWE stiffness value of the sciatic nerve were measured. The examinations of arteries of the lower limbs were also performed by ultrasound. According to the presence or absence of DFU, the 32 lower limbs were divided into two groups: the DFU group and the non-DFU group. The ultrasonographic parameters were compared between these two groups. Results: There was no significant difference (p > 0.05) between the two groups for CSA, intraneural blood flow, Vmax and RI in the intraneural artery of the sciatic nerve, and numbers of severe artery stenosis or full occlusion of the artery in the lower limbs. However, SWE stiffness values in the sciatic nerve in the DFU group are higher than the non-DFU group (p < 0.05). When the SWE stiffness values were used for prediction of DFU in patients with DPN, the area under the ROC curve (AUC) was 0.727 (95% CI: 0.541–0.868). When the best SWE stiffness value of 24.48 kPa was taken as a cutoff for prediction of DFU, the sensitivity was 62.50% (95% CI: 35.4–84.8%), and the specificity was 75% (95% CI: 47.6–92.7%). Conclusions: Sciatic nerve stiffness is significantly higher in lower limbs with DFU. SWE is a noninvasive imaging method that may be used to evaluate sciatic nerve stiffness, then potentially predict DFU in patients with DPN. Full article
(This article belongs to the Special Issue Ultrasound Imaging in Medicine 2023)
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15 pages, 689 KiB  
Article
Subjects Conceived through Assisted Reproductive Technologies Display Normal Arterial Stiffness
by Magdalena Langer, Pengzhu Li, Theresa Vilsmaier, Marie Kramer, Franziska Sciuk, Brenda Kolbinger, André Jakob, Nina Rogenhofer, Nikolaus Alexander Haas, Robert Dalla-Pozza, Christian Thaler and Felix Sebastian Oberhoffer
Diagnostics 2022, 12(11), 2763; https://doi.org/10.3390/diagnostics12112763 - 11 Nov 2022
Cited by 6 | Viewed by 1851
Abstract
Multiple studies reported signs of vascular dysfunction in subjects conceived through assisted reproductive technologies (ART). The assessment of arterial stiffness in this cohort seems beneficial for risk stratification. Regional arterial stiffness of the abdominal aorta (AAO) and the common carotid arteries (CCA) was [...] Read more.
Multiple studies reported signs of vascular dysfunction in subjects conceived through assisted reproductive technologies (ART). The assessment of arterial stiffness in this cohort seems beneficial for risk stratification. Regional arterial stiffness of the abdominal aorta (AAO) and the common carotid arteries (CCA) was evaluated sonographically using two-dimensional speckle tracking in subjects conceived through ART and spontaneously conceived peers. Global arterial stiffness was assessed utilizing an oscillometric blood pressure device. The cohorts of 67 ART subjects and 86 spontaneously conceived peers (11.31 (8.10–18.20) years vs. 11.85 (8.72–18.27) years, p = 0.43) did not differ significantly in parameters of regional and global arterial stiffness. In the sub-analysis of study participants ≥10 years of age, markers of arterial stiffness did not display significant differences between both groups. However, a higher tendency of brachial systolic blood pressure was demonstrated in the ART cohort compared to the control group (120.18 ± 9.57 mmHg vs. 116.55 ± 8.05 mmHg, p = 0.050). The present study displayed no significant differences in arterial stiffness between ART subjects and spontaneously conceived peers. Moreover, this study suggests that arterial stiffness does not elevate more profoundly in ART subjects with increasing age. Further studies are required for a more detailed cardiovascular risk stratification of the ART cohort. Full article
(This article belongs to the Special Issue Ultrasound Imaging in Medicine 2023)
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11 pages, 2462 KiB  
Article
A Novel Ultrasonographic Anthropometric-Independent Measurement of Median Nerve Swelling in Carpal Tunnel Syndrome: The “Nerve/Tendon Ratio” (NTR)
by Paolo Falsetti, Edoardo Conticini, Caterina Baldi, Emilio D’Ignazio, Suhel Gabriele Al Khayyat, Marco Bardelli, Stefano Gentileschi, Roberto D’Alessandro, Miriana D’Alessandro, Caterina Acciai, Federica Ginanneschi, Luca Cantarini and Bruno Frediani
Diagnostics 2022, 12(11), 2621; https://doi.org/10.3390/diagnostics12112621 - 28 Oct 2022
Cited by 2 | Viewed by 1707
Abstract
Background: There is little consensus on ultrasound (US) normative values of cross-sectional area of median nerve (MN-CSA) in carpal tunnel syndrome (CTS) because of its dependency on anthropometric parameters. We aim to propose a novel anthropometric-independent US parameter: MN-CSA/flexor radialis carpi CSA (FCR-CSA) [...] Read more.
Background: There is little consensus on ultrasound (US) normative values of cross-sectional area of median nerve (MN-CSA) in carpal tunnel syndrome (CTS) because of its dependency on anthropometric parameters. We aim to propose a novel anthropometric-independent US parameter: MN-CSA/flexor radialis carpi CSA (FCR-CSA) ratio (“Nerve Tendon Ratio”, NTR), in the diagnosis of clinically and electrodiagnostic (EDS)-defined CTS. Methods: 74 wrists of 49 patients with clinically defined CTS underwent EDS (scored by the 1–5 Padua Scale of electrophysiological severity, PS) and US of carpal tunnel with measurement of MN-CSA (at the carpal tunnel inlet), FCR-CSA (over scaphoid tubercle) and its ratio (NTR, expressed as a percentage). US normality values and intra-operator agreement were assessed in 33 healthy volunteers. Results: In controls, the mean MN-CSA was 5.81 mm2, NTR 64.2%. In 74 clinical CTS, the mean MN-CSA was 12.1 mm2, NTR 117%. In severe CTS (PS > 3), the mean MN-CSA was 15.9 mm2, NTR 148%. In CTS, both MN-CSA and NTR correlated with sensitive conduction velocity (SCV) (p < 0.001), distal motor latency (DML) (p < 0.001) and PS (p < 0.001), with a slight superiority of NTR vs. MN-CSA when controlled for height, wrist circumference and weight. In CTS filtered for anthropometric extremes, only NTR maintained a correlation with SCV (p = 0.023), DML (p = 0.016) and PS (p = 0.009). Diagnostic cut-offs were obtained with a binomial regression analysis. In those patients with a clinical diagnosis of CTS, the cut-off of MN-CSA (AUROC: 0.983) was 8 mm2 (9 mm2 with highest positive predictive value, PPV), while for NTR (AUROC: 0.987), the cut-off was 83% (100% with highest PPV). In patients with EDS findings of severe CTS (PS > 3), the MN-CSA (AUROC: 0.876) cut-off was 12.3 mm2 (15.3 mm2 with highest PPV), while for NTR (AUROC: 0.858) it was 116.2% (146.0% with highest PPV). Conclusions: NTR can be simply and quickly calculated, and it can be used in anthropometric extremes. Full article
(This article belongs to the Special Issue Ultrasound Imaging in Medicine 2023)
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14 pages, 887 KiB  
Systematic Review
Ultrasound-Guided vs. Fluoroscopy-Guided Interventions for Back Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Dmitriy Viderman, Mina Aubakirova, Anuar Aryngazin, Dinara Yessimova, Dastan Kaldybayev, Ramil Tankacheyev and Yerkin G. Abdildin
Diagnostics 2023, 13(22), 3474; https://doi.org/10.3390/diagnostics13223474 - 18 Nov 2023
Cited by 3 | Viewed by 1828
Abstract
The objective of this study was to compare the outcomes of the ultrasound- and fluoroscopy-guided techniques in the management of back pain. Using PubMed, Scopus, and the Cochrane Library, we searched randomized controlled trials (RCTs) published before May 2023, which reported relevant data [...] Read more.
The objective of this study was to compare the outcomes of the ultrasound- and fluoroscopy-guided techniques in the management of back pain. Using PubMed, Scopus, and the Cochrane Library, we searched randomized controlled trials (RCTs) published before May 2023, which reported relevant data on the topic. The effectiveness of the ultrasound-guided (US-guided) and fluoroscopy-guided (FL-guided) approaches for back pain management was compared in terms of postoperative pain intensity, postoperative functional outcomes, and postoperative complications. Subgroup analyses were conducted for different postoperative periods. Eight studies were included in the analysis. There was no significant difference in post-procedural pain relief at one week, two weeks, one month, two months, and three months between the US-guided and FL-guided interventions for back pain management (SMD with 95% CI is −0.01 [−0.11, 0.10]), p = 0.91, I2 = 0%). In terms of the postoperative functional outcomes assessed by the “Oswestry Disability Index” (ODI) functionality score, the model tends to favor the FL-guided injections over the US-guided injections (SMD with 95% CI: 0.13 [−0.00, 0.25], p = 0.05, I2 = 0). Finally, the US-guided and FL-guided injections did not show significantly different results in terms of postoperative complications (RR with 95% CI is 0.99 [0.49, 1.99], p = 0.97, I2 = 0). The subgroup analysis also did not demonstrate differences between the US-guided and FL-guided techniques in the following outcomes: vasovagal reaction, transient headache, and facial flushing. There was no significant difference between the US-guided and FL-guided injections for treating back pain in terms of postoperative pain intensity and complications. Still, the model tends to favor the FL-guided injections over the US-guided injections in terms of functionality. Full article
(This article belongs to the Special Issue Ultrasound Imaging in Medicine 2023)
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