Diagnostics

Editorial

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8 pages, 217 KiB

Open AccessEditorial

Imaging the Micron: New Directions in Diagnosis with Ultra-High-Frequency Ultrasound

by Rossana Izzetti and Marco Nisi

Diagnostics 2024, 14(7), 735; https://doi.org/10.3390/diagnostics14070735 - 29 Mar 2024

Viewed by 393

Abstract

In recent decades, advancements in medical imaging technologies have revolutionized diagnostic and therapeutic approaches, enhancing the precision and efficacy of healthcare interventions [...] Full article

(This article belongs to the Special Issue Clinical Application of Ultra-High Frequency Ultrasound: Emerging Trends)

Research

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0 pages, 7475 KiB

Open AccessArticle

Evaluation of the Breastfeeding Dynamics of Neonates with Ankyloglossia via a Novel Ultrasonographic Technique

by Arzu Alan, Ayse Isil Orhan and Kaan Orhan

Diagnostics 2023, 13(22), 3435; https://doi.org/10.3390/diagnostics13223435 - 13 Nov 2023

Cited by 1 | Viewed by 833 | Correction

Abstract

To effectively address breastfeeding issues for neonates and mothers, one must understand the physiology of breastfeeding and the anatomical components involved in sucking, swallowing, and respiration. This study compared the tongue position and movement of neonates with tongue ties versus healthy controls during [...] Read more.

To effectively address breastfeeding issues for neonates and mothers, one must understand the physiology of breastfeeding and the anatomical components involved in sucking, swallowing, and respiration. This study compared the tongue position and movement of neonates with tongue ties versus healthy controls during sucking. A new objective ultrasonography diagnostic approach was also introduced for the orofacial region. This retrospective study evaluated B-mode and M-mode ultrasonography images from 30 neonates clinically diagnosed with tongue tie, and a control group of 30 neonates. B-mode ultrasound images were used to examine several characteristics to locate the nipple in the oral cavity during breastfeeding. Anatomic M-mode ultrasound images were used to assess tongue movement during sucking. The nipple moved farther from the intersection of the hard and soft palates during the sucking cycle in the ankyloglossia group than in the control group (p < 0.05). Compared to the control group, neonates with ankyloglossia have a lower capacity to lift the anterior tongue toward the palate when sucking (p < 0.05). There was no significant difference in tongue movement metrics between the two groups (p > 0.05). Our findings were consistent with earlier research. The novel measurement method will offer a new perspective on breastfeeding. Full article

(This article belongs to the Special Issue Clinical Application of Ultra-High Frequency Ultrasound: Emerging Trends)

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13 pages, 2068 KiB

Open AccessArticle

The Role of Ultra-High-Frequency Ultrasound in Pyoderma Gangrenosum: New Insights in Pathophysiology and Diagnosis

by Giammarco Granieri, Alessandra Michelucci, Flavia Manzo Margiotta, Bianca Cei, Saverio Vitali, Marco Romanelli and Valentina Dini

Diagnostics 2023, 13(17), 2802; https://doi.org/10.3390/diagnostics13172802 - 30 Aug 2023

Viewed by 803

Abstract

Pyoderma gangrenosum (PG) is a neutrophilic dermatological disease, whose pathogenesis is still poorly clarified. Because of the lack of validated criteria for diagnosis and response, PG treatment is still challenging and should be differentiated in the inflammatory and non-inflammatory phases. Our study aimed [...] Read more.

Pyoderma gangrenosum (PG) is a neutrophilic dermatological disease, whose pathogenesis is still poorly clarified. Because of the lack of validated criteria for diagnosis and response, PG treatment is still challenging and should be differentiated in the inflammatory and non-inflammatory phases. Our study aimed to provide a new semi-quantitative approach for PG diagnosis and monitoring, identifying ultra-high-frequency ultrasound (UHFUS) early biomarkers associated with the transition between the two phases. We enrolled 13 patients affected by painful PG lesions evaluated during the inflammatory phase (T0) and during the non-inflammatory phase (T1): pain was measured by the Visual Analogue Scale (VAS); clinical features were recorded through digital photography; epidermis and dermis ultrasound (US) characteristics were evaluated by UHFUS examination with a 70 MHz probe (Vevo MD^® FUJIFILM VisualSonics). In T1 UHFUS examination, the presence of hyperechoic oval structures was lower compared to T0 (p value < 0.05). An hyperechogenic structure within the oval structure, suggestive of a hair tract, was evident in T0 and absent in T1 (p value < 0.05). In T0, blood vessels appear as U-shaped and V-shaped anechoic structures with a predominance of U-shaped vessels (p value < 0.05) compared to the more regular distribution found in T1. Finding early biomarkers of the transition from the inflammatory to the non-inflammatory phase could provide new insight in terms of therapeutic decision making and response monitoring. The differences found by this study suggest a potential use of UHFUS for the development of an objective standardized staging method. Further investigations will be necessary to confirm our preliminary results, thus providing a turning point in PG early detection, differential diagnosis and treatment monitoring. Full article

(This article belongs to the Special Issue Clinical Application of Ultra-High Frequency Ultrasound: Emerging Trends)

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10 pages, 1026 KiB

Open AccessArticle

Ultra-High-Frequency Ultrasound as an Innovative Imaging Evaluation of Hyaluronic Acid Filler in Nasolabial Folds

by Giorgia Salvia, Nicola Zerbinati, Flavia Manzo Margiotta, Alessandra Michelucci, Giammarco Granieri, Cristian Fidanzi, Riccardo Morganti, Marco Romanelli and Valentina Dini

Diagnostics 2023, 13(17), 2761; https://doi.org/10.3390/diagnostics13172761 - 25 Aug 2023

Viewed by 991

Abstract

Dermal hyaluronic acid (HA) fillers are used for nasolabial fold correction, but no study is still available on the use of ultra-high-frequency ultrasound (UHFUS) with 70 MHz probes for the evaluation of HA distribution and wrinkle amelioration. We selected 13 patients who received [...] Read more.

Dermal hyaluronic acid (HA) fillers are used for nasolabial fold correction, but no study is still available on the use of ultra-high-frequency ultrasound (UHFUS) with 70 MHz probes for the evaluation of HA distribution and wrinkle amelioration. We selected 13 patients who received HA filler, evaluated before (Time (T) 0) and after injection (T1), and after 24 weeks (T2). The dermal thickness and distribution of HA were registered, as well as the Wrinkle Severity Rating Scale (WSRS), Global Aesthetic Improvement Scale (GAIS), and wrinkle 3D fullness. The UHFUS dermal thickness was increased by 11% for both sides at T1 and by 7.4% and 6.8% for the right and left side, respectively, at T2 (p < 0.01). The 3D wrinkle fullness showed a T1 increase (+0.59 cc and +0.79 cc for the right and left side, respectively) with a T2 maintenance of 45% of the T1 fullness (p-value < 0.001). The only clinical score significantly modified was WSRS, with a reduction of 56% at T1 and of 47.1% at T2 (p-value < 0.001). Our study then demonstrated the efficacy of UHFUS in the assessment of nasolabial fold correction, representing also the first multi-modal evaluation of HA persistence and its visual subsequent aesthetic results. Full article

(This article belongs to the Special Issue Clinical Application of Ultra-High Frequency Ultrasound: Emerging Trends)

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9 pages, 1485 KiB

Open AccessArticle

A Computer Program for Assessing Histoanatomical Morphometrics in Ultra-High-Frequency Ultrasound Images of the Bowel Wall in Children: Development and Inter-Observer Variability

by Tobias Erlöv, Tebin Hawez, Christina Granéli, Maria Evertsson, Tomas Jansson, Pernilla Stenström and Magnus Cinthio

Diagnostics 2023, 13(17), 2759; https://doi.org/10.3390/diagnostics13172759 - 25 Aug 2023

Viewed by 684

Abstract

Ultra-high-frequency ultrasound (UHFUS) has a reported potential to differentiate between aganglionic and ganglionic bowel wall, referred to as histoanatomical differences. A good correlation between histoanatomy and UHFUS of the bowel wall has been proven. In order to perform more precise and objective histoanatomical [...] Read more.

Ultra-high-frequency ultrasound (UHFUS) has a reported potential to differentiate between aganglionic and ganglionic bowel wall, referred to as histoanatomical differences. A good correlation between histoanatomy and UHFUS of the bowel wall has been proven. In order to perform more precise and objective histoanatomical morphometrics, the main research objective of this study was to develop a computer program for the assessment and automatic calculation of the histoanatomical morphometrics of the bowel wall in UHFUS images. A computer program for UHFUS diagnostics was developed and presented. A user interface was developed in close collaboration between pediatric surgeons and biomedical engineers, to enable interaction with UHFUS images. Images from ex vivo bowel wall samples of 23 children with recto-sigmoid Hirschsprung’s disease were inserted. The program calculated both thickness and amplitudes (image whiteness) within different histoanatomical bowel wall layers. Two observers assessed the images using the program and the inter-observer variability was evaluated. There was an excellent agreement between observers, with an intraclass correlation coefficient range of 0.970–0.998. Bland–Altman plots showed flat and narrow distributions. The mean differences ranged from 0.005 to 0.016 mm in thickness and 0 to 0.7 in amplitude units, corresponding to 1.1–3.6% and 0.0–0.8% from the overall mean. The computer program enables and ensures objective, accurate and time-efficient measurements of histoanatomical thicknesses and amplitudes in UHFUS images of the bowel wall. The program can potentially be used for several bowel wall conditions, accelerating research within UHFUS diagnostics. Full article

(This article belongs to the Special Issue Clinical Application of Ultra-High Frequency Ultrasound: Emerging Trends)

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13 pages, 683 KiB

Open AccessArticle

Ultra-High Frequency UltraSound (UHFUS) Assessment of Barrier Function in Moderate-to-Severe Atopic Dermatitis during Dupilumab Treatment

by Valentina Dini, Michela Iannone, Alessandra Michelucci, Flavia Manzo Margiotta, Giammarco Granieri, Giorgia Salvia, Teresa Oranges, Agata Janowska, Riccardo Morganti and Marco Romanelli

Diagnostics 2023, 13(17), 2721; https://doi.org/10.3390/diagnostics13172721 - 22 Aug 2023

Cited by 1 | Viewed by 1072

Abstract

Atopic dermatitis (AD) is a chronic multifactorial inflammatory disease characterized by intense itching and inflammatory eczematous lesions. Biological disease-modifying drugs, such as dupilumab are recommended for patients with moderate-to-severe AD, refractory to systemic immunosuppressive therapies. Disease monitoring is performed by clinical scores. Since [...] Read more.

Atopic dermatitis (AD) is a chronic multifactorial inflammatory disease characterized by intense itching and inflammatory eczematous lesions. Biological disease-modifying drugs, such as dupilumab are recommended for patients with moderate-to-severe AD, refractory to systemic immunosuppressive therapies. Disease monitoring is performed by clinical scores. Since 1970, however, the use of ultrasound and particularly high-frequency ultrasound (HFUS), has identified alterations in dermal echogenicity, called the subepidermal low-echogenic band (SLEB), that correlates with disease severity and response to treatment. We enrolled 18 patients with moderate-to-severe AD, divided into two groups: twelve patients in the dupilumab treatment (Group A) and six patients in standard treatment, from February 2019 to November 2019. We performed ultra-high frequency ultrasound (UHFUS) evaluation of lesional and non-lesional skin, focusing on SLEB average thicknesses measurement, epidermal thickness, and vascular signal in correlation with objective disease scores (EASI, IGA), patient’s reported scores (Sleep Quality NRS and Itch NRS), and TEWL and corneometry at baseline (T0), after 1 month (T1) and 2 months (T2). The SLEB average thickness measurement, vascular signal, and epidermal thickness showed a statistically significant reduction in lesional skin of the biological treatment group and no significant reduction in non-lesional skin in both groups. In the lesional skin of the standard treatment group, only epidermal thickness showed a statistically significant reduction. Our study demonstrates that SLEB measurement, vascular signals, and epidermal thickness could be used as objective parameters in monitoring the AD treatment response, while the presence of SLEB in non-lesional skin could be used as a marker of subclinical inflammation and could predict development of clinical lesions, suggesting a pro-active therapy. Further follow-up and research are needed to clarify the association of SLEB decrease/disappearance with a reduction of flares/prolongment of the disease remission time. Full article

(This article belongs to the Special Issue Clinical Application of Ultra-High Frequency Ultrasound: Emerging Trends)

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11 pages, 1240 KiB

Open AccessArticle

Assessment and Monitoring of Nail Psoriasis with Ultra-High Frequency Ultrasound: Preliminary Results

by Alessandra Michelucci, Valentina Dini, Giorgia Salvia, Giammarco Granieri, Flavia Manzo Margiotta, Salvatore Panduri, Riccardo Morganti and Marco Romanelli

Diagnostics 2023, 13(16), 2716; https://doi.org/10.3390/diagnostics13162716 - 21 Aug 2023

Viewed by 1066

Abstract

Psoriatic onychopathy is one of the clinical presentations of psoriasis and a well-known risk factor for the development of psoriatic arthritis. High-frequency ultrasounds (HFUS > 20 MHz) have recently been used to evaluate the nail apparatus of healthy and psoriatic subjects. The aim [...] Read more.

Psoriatic onychopathy is one of the clinical presentations of psoriasis and a well-known risk factor for the development of psoriatic arthritis. High-frequency ultrasounds (HFUS > 20 MHz) have recently been used to evaluate the nail apparatus of healthy and psoriatic subjects. The aim of our study was to detect by means of ultra-high-frequency ultrasound (UHFUS 70–100 MHz) alterations of the nail bed and matrix in patients with psoriatic onychopathy and to monitor these parameters during the treatment with monoclonal antibody (mAb). We enrolled 10 patients with psoriatic onychopathy and naive to previous biologic therapies. Patients were evaluated at baseline, after 1 month and after 3 months from the beginning of mAb therapy by a complete clinical assessment and US evaluation. A UHFUS examination with a 70 MHz probe was performed on the thumbnail (I), the index fingernail (II) and the nail with greater clinical impairment (W). The following measurements were analyzed: nail plate thickness (A), nail bed thickness (B), nail insertion length (C), nail matrix length (D) and nail matrix thickness (E). Among the various parameters analyzed, some measures showed a statistically significant decrease with p-value < 0.05 (t0 WA = 0.52 mm vs. t2 WA = 0.42 mm; t0 WB = 2.8 mm vs. t2 WB = 2.4 mm; t0 WE = 0.76 mm vs. t2 WE = 0.64 mm; t0 IIA = 0.49 mm vs. t2 IIA = 0.39 mm). In conclusion, UHFUS could represent a viable imaging technique for the real-time evaluation and monitoring of psoriatic onychopathy, thus supporting the clinical parameters and revealing any subclinical signs of early drug response. Full article

(This article belongs to the Special Issue Clinical Application of Ultra-High Frequency Ultrasound: Emerging Trends)

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11 pages, 1208 KiB

Open AccessArticle

Ultra-High-Frequency Ultrasonography of Labial Glands in Pediatric Sjögren’s Disease: A Preliminary Study

by Edoardo Marrani, Giovanni Fulvio, Camilla Virgili, Rossana Izzetti, Valentina Dini, Teresa Oranges, Chiara Baldini and Gabriele Simonini

Diagnostics 2023, 13(16), 2695; https://doi.org/10.3390/diagnostics13162695 - 16 Aug 2023

Viewed by 775

Abstract

Sjögren’s disease (SD) is a chronic autoimmune disease primarily affecting lacrimal and salivary glands. The diagnosis of pediatric SD mostly relies on clinical suspect, resulting in a significant diagnostic delay. Recently, ultrahigh-frequency ultrasound (UHFUS) of labial glands has been proposed as a diagnostic [...] Read more.

Sjögren’s disease (SD) is a chronic autoimmune disease primarily affecting lacrimal and salivary glands. The diagnosis of pediatric SD mostly relies on clinical suspect, resulting in a significant diagnostic delay. Recently, ultrahigh-frequency ultrasound (UHFUS) of labial glands has been proposed as a diagnostic method in adults with suspected SD. Until now, there have been no studies about UHFUS in pediatric diagnostic work-up. The aim of the study was to evaluate the potential role of UHFUS of minor salivary glands in pediatric SD. Consecutive pediatric patients with a diagnosis of pediatric SD seen at AOU Meyer IRCSS were evaluated. Intraoral UHFUS scan of the lip mucosa was performed with Vevo MD equipment, using a 70 MHz probe with a standardized protocol and the images were independently reviewed by two operators. Lip salivary glands were assessed by using a four-grade semiquantitative scoring system for parenchymal alteration and vascularization. Twelve patients were included. When applying UHFUS to this cohort of patients, all patients showed a UHFUS grade of ≥1 with 8/12 showing a mild glandular alteration (i.e., grade 1), 2/12 a moderate glandular alteration (i.e., grade 2) and finally 2/12 a severe glandular alteration (i.e., grade 3). Moderate intraglandular vascularization was seen in 9/12, with only 3/12 showing mild intraglandular vascularization. Due to limited size of the sample, the relationship between histological findings, autoantibodies status and UHFUS grade could not be performed. This preliminary study seems to report UHFUS as feasibility technique to identify salivary gland alterations in children with a clinical suspect of SD. Full article

(This article belongs to the Special Issue Clinical Application of Ultra-High Frequency Ultrasound: Emerging Trends)

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15 pages, 4597 KiB

Open AccessArticle

Design of a Pediatric Rectal Ultrasound Probe Intended for Ultra-High Frequency Ultrasound Diagnostics

by Maria Evertsson, Christina Graneli, Alvina Vernersson, Olivia Wiaczek, Kristine Hagelsteen, Tobias Erlöv, Magnus Cinthio and Pernilla Stenström

Diagnostics 2023, 13(10), 1667; https://doi.org/10.3390/diagnostics13101667 - 09 May 2023

Cited by 1 | Viewed by 2399

Abstract

It has been shown that ultra-high frequency (UHF) ultrasound applied to the external bowel wall can delineate the histo-anatomic layers in detail and distinguish normal bowel from aganglionosis. This would potentially reduce or lessen the need for biopsies that are currently mandatory for [...] Read more.

It has been shown that ultra-high frequency (UHF) ultrasound applied to the external bowel wall can delineate the histo-anatomic layers in detail and distinguish normal bowel from aganglionosis. This would potentially reduce or lessen the need for biopsies that are currently mandatory for the diagnosis of Hirschsprung’s disease. However, to our knowledge, no suitable rectal probes for such a use are on the market. The aim was to define the specifications of an UHF transrectal ultrasound probe (50 MHz center frequency) suitable for use in infants. Probe requirements according to patient anatomy, clinicians’ requests, and biomedical engineering UHF prerequisites were collected within an expert group. Suitable probes on the market and in clinical use were reviewed. The requirements were transferred into the sketching of potential UHF ultrasound transrectal probes followed by their 3D prototype printing. Two prototypes were created and tested by five pediatric surgeons. The larger and straight 8 mm head and shaft probe was preferred as it facilitated stability, ease of anal insertion, and possible UHF technique including 128 piezoelectric elements in a linear array. We hereby present the procedure and considerations behind the development of a proposed new UHF transrectal pediatric probe. Such a device can open new possibilities for the diagnostics of pediatric anorectal conditions. Full article

(This article belongs to the Special Issue Clinical Application of Ultra-High Frequency Ultrasound: Emerging Trends)

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11 pages, 3333 KiB

Open AccessArticle

A Hypothesis on the Progression of Insulin-Induced Lipohypertrophy: An Integrated Result of High-Frequency Ultrasound Imaging and Blood Glucose Control of Patients

by Jian Yu, Hong Wang, Meijing Zhou, Min Zhu, Jing Hang, Min Shen, Xin Jin, Yun Shi, Jingjing Xu and Tao Yang

Diagnostics 2023, 13(9), 1515; https://doi.org/10.3390/diagnostics13091515 - 23 Apr 2023

Cited by 2 | Viewed by 1259

Abstract

Aims: To put forward a scientific hypothesis about the progression of insulin-injection-induced lipohypertrophy (LH) according to the high-frequency ultrasonic imaging of insulin injection sites and the blood glucose control of patients. Methods: A total of 344 patients were screened for LH by means [...] Read more.

Aims: To put forward a scientific hypothesis about the progression of insulin-injection-induced lipohypertrophy (LH) according to the high-frequency ultrasonic imaging of insulin injection sites and the blood glucose control of patients. Methods: A total of 344 patients were screened for LH by means of high-frequency ultrasound scanning. The results of their ultrasound examination were described in detail and categorized into several subtypes. Seventeen patients with different subtypes of LH were followed up to predict the progression of LH. To further verify our hypothesis, the effects of different types of LH on glycemic control of patients were observed by comparing glycated hemoglobin A1c (HbA_1C) and other glycemic-related indicators. Results: LH was found in 255 (74.1%) patients. According to the high-frequency ultrasonic imaging characteristics, LH can be categorized into three subtypes in general. Among all the LHs, the most common type observed was nodular hyperechoic LH (n = 167, 65.5%), followed by diffuse hyperechoic LH (n = 70, 27.5%), then hypoechoic LH (n = 18, 7.0%). At the follow-up after six months, all 10 patients with nodular hyperechoic LH had LH faded away. Of the five patients with diffuse hyperechoic LH, two had inapparent LH, and three had diffuse hyperechoic parts which had shrunk under ultrasound. No obvious changes were observed in the two cases of hypoechoic LH. Compared with the LH-free group, the mean HbA_1C of the nodular hyperechoic LH group increased by 0.8% (9 mmol/mol) (95% CI:−1.394~−0.168, p = 0.005), that of the diffuse hyperechoic LH group increased by 2.0% (21 mmol/mol) (95% CI: −2.696~−1.20, p < 0.001), and that of the hypoechoic LH group increased by 1.5% (16 mmol/mol) (95% CI: −2.689~−0.275, p = 0.007). Conclusions: It was hypothesized that the earlier stage of LH is nodular hyperechoic LH. If nodular LH is not found in time and the patient continues to inject insulin at the LH site and/or reuse needles, LH will develop into a diffuse type or, even worse, a hypoechoic one. Different subtypes of LH may represent differences in severity when blood glucose control is considered as an important resolution indicator. Further studies are needed to confirm our hypothesis on the progression and reversion of insulin-induced lipohypertrophy. Full article

(This article belongs to the Special Issue Clinical Application of Ultra-High Frequency Ultrasound: Emerging Trends)

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12 pages, 1646 KiB

Open AccessArticle

Ultra-High Frequency Ultrasound Imaging of Bowel Wall in Hirschsprung’s Disease—Correlation and Agreement Analyses of Histoanatomy

by Tebin Hawez, Christina Graneli, Tobias Erlöv, Emilia Gottberg, Rodrigo Munoz Mitev, Kristine Hagelsteen, Maria Evertsson, Tomas Jansson, Magnus Cinthio and Pernilla Stenström

Diagnostics 2023, 13(8), 1388; https://doi.org/10.3390/diagnostics13081388 - 11 Apr 2023

Cited by 2 | Viewed by 1102

Abstract

Hirschsprung’s disease (HD) is characterized by aganglionosis in the bowel wall, requiring resection. Ultra-high frequency ultrasound (UHFUS) imaging of the bowel wall has been suggested to be an instantaneous method of deciding resection length. The aim of this study was to validate UHFUS [...] Read more.

Hirschsprung’s disease (HD) is characterized by aganglionosis in the bowel wall, requiring resection. Ultra-high frequency ultrasound (UHFUS) imaging of the bowel wall has been suggested to be an instantaneous method of deciding resection length. The aim of this study was to validate UHFUS imaging of the bowel wall in children with HD by exploring the correlation and systematic differences between UHFUS and histopathology. Resected fresh bowel specimens of children 0–1 years old, operated on for rectosigmoid aganglionosis at a national HD center 2018–2021, were examined ex vivo with UHFUS center frequency 50 MHz. Aganglionosis and ganglionosis were confirmed by histopathological staining and immunohistochemistry. Histoanatomical layers of bowel wall in histopathological and UHFUS images, respectively, were outlined using MATLAB programs. Both histopathological and UHFUS images were available for 19 aganglionic and 18 ganglionic specimens. The thickness of muscularis interna correlated positively between histopathology and UHFUS in both aganglionosis (R = 0.651, p = 0.003) and ganglionosis (R = 0.534, p = 0.023). The muscularis interna was systematically thicker in histopathology than in UHFUS images in both aganglionosis (0.499 vs. 0.309 mm; p < 0.001) and ganglionosis (0.644 versus 0.556 mm; p = 0.003). Significant correlations and systematic differences between histopathological and UHFUS images support the hypothesis that UHFUS reproduces the histoanatomy of the bowel wall in HD accurately. Full article

(This article belongs to the Special Issue Clinical Application of Ultra-High Frequency Ultrasound: Emerging Trends)

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Review

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26 pages, 3904 KiB

Open AccessReview

Quantitative Ultrasound Techniques Used for Peripheral Nerve Assessment

by Saeed Jerban, Victor Barrère, Michael Andre, Eric Y. Chang and Sameer B. Shah

Diagnostics 2023, 13(5), 956; https://doi.org/10.3390/diagnostics13050956 - 02 Mar 2023

Cited by 4 | Viewed by 2414

Abstract

Aim: This review article describes quantitative ultrasound (QUS) techniques and summarizes their strengths and limitations when applied to peripheral nerves. Methods: A systematic review was conducted on publications after 1990 in Google Scholar, Scopus, and PubMed databases. The search terms “peripheral nerve”, “quantitative [...] Read more.

Aim: This review article describes quantitative ultrasound (QUS) techniques and summarizes their strengths and limitations when applied to peripheral nerves. Methods: A systematic review was conducted on publications after 1990 in Google Scholar, Scopus, and PubMed databases. The search terms “peripheral nerve”, “quantitative ultrasound”, and “elastography ultrasound” were used to identify studies related to this investigation. Results: Based on this literature review, QUS investigations performed on peripheral nerves can be categorized into three main groups: (1) B-mode echogenicity measurements, which are affected by a variety of post-processing algorithms applied during image formation and in subsequent B-mode images; (2) ultrasound (US) elastography, which examines tissue stiffness or elasticity through modalities such as strain ultrasonography or shear wave elastography (SWE). With strain ultrasonography, induced tissue strain, caused by internal or external compression stimuli that distort the tissue, is measured by tracking detectable speckles in the B-mode images. In SWE, the propagation speed of shear waves, generated by externally applied mechanical vibrations or internal US “push pulse” stimuli, is measured to estimate tissue elasticity; (3) the characterization of raw backscattered ultrasound radiofrequency (RF) signals, which provide fundamental ultrasonic tissue parameters, such as the acoustic attenuation and backscattered coefficients, that reflect tissue composition and microstructural properties. Conclusions: QUS techniques allow the objective evaluation of peripheral nerves and reduce operator- or system-associated biases that can influence qualitative B-mode imaging. The application of QUS techniques to peripheral nerves, including their strengths and limitations, were described and discussed in this review to enhance clinical translation. Full article

(This article belongs to the Special Issue Clinical Application of Ultra-High Frequency Ultrasound: Emerging Trends)

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Other

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1 pages, 145 KiB

Open AccessCorrection

Correction: Alan et al. Evaluation of the Breastfeeding Dynamics of Neonates with Ankyloglossia via a Novel Ultrasonographic Technique. Diagnostics 2023, 13, 3435

by Arzu Alan, Ayse Isil Orhan and Kaan Orhan

Diagnostics 2024, 14(6), 608; https://doi.org/10.3390/diagnostics14060608 - 13 Mar 2024

Viewed by 381

Abstract

There were a few errors in the original publication [...] Full article

(This article belongs to the Special Issue Clinical Application of Ultra-High Frequency Ultrasound: Emerging Trends)

14 pages, 1808 KiB

Open AccessSystematic Review

The Reliability of Ultrasonographic Assessment of Depth of Invasion: A Systematic Review with Meta-Analysis

by Marco Nisi, Stefano Gennai, Filippo Graziani and Rossana Izzetti

Diagnostics 2023, 13(17), 2833; https://doi.org/10.3390/diagnostics13172833 - 01 Sep 2023

Viewed by 665

Abstract

Depth of invasion (DOI) has been recognized to be a strong prognosticator for oral squamous cell carcinoma (OSCC). Several diagnostic techniques can be employed for DOI assessment, however intraoral ultrasonography has been increasingly applied for the intraoral evaluation of OSCCs. The aim of [...] Read more.

Depth of invasion (DOI) has been recognized to be a strong prognosticator for oral squamous cell carcinoma (OSCC). Several diagnostic techniques can be employed for DOI assessment, however intraoral ultrasonography has been increasingly applied for the intraoral evaluation of OSCCs. The aim of the present study is to review the evidence on the application of intraoral ultrasonography to the assessment of DOI in patients affected by OSCC. A systematic electronic and manual literature search was performed, and data from eligible studies were reviewed, selected, and extracted. The studies had to report the correlation between DOI estimated with ultrasonography versus histopathology. A meta-analysis was conducted on the quantitative data available. Sixteen articles were included in the review following the screening of the initial 228 studies retrieved from the literature. The meta-analysis showed a significant correlation between ultrasonographic and histopathologic measurements (p < 0.01). The studies were all at low/moderate risk of bias. Ultrasonography appears a valuable tool for DOI assessment. Full article

(This article belongs to the Special Issue Clinical Application of Ultra-High Frequency Ultrasound: Emerging Trends)

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9 pages, 2766 KiB

Open AccessBrief Report

UHFUS: A Valuable Tool in Evaluating Exocrine Gland Abnormalities in Sjögren’s Disease

by Giovanni Fulvio, Rossana Izzetti, Giacomo Aringhieri, Valentina Donati, Francesco Ferro, Giovanna Gabbriellini, Marta Mosca and Chiara Baldini

Diagnostics 2023, 13(17), 2771; https://doi.org/10.3390/diagnostics13172771 - 26 Aug 2023

Viewed by 964

Abstract

Sjögren’s Disease (SjD) is a chronic autoimmune disorder that affects the salivary and lacrimal glands, leading to xerostomia and xerophthalmia. Ultrasonography of Major Salivary Glands (SGUS) is a well-established tool for the identification of the salivary glands’ abnormalities in SjD. Recently, a growing [...] Read more.

Sjögren’s Disease (SjD) is a chronic autoimmune disorder that affects the salivary and lacrimal glands, leading to xerostomia and xerophthalmia. Ultrasonography of Major Salivary Glands (SGUS) is a well-established tool for the identification of the salivary glands’ abnormalities in SjD. Recently, a growing interest has arisen in the assessment of the other exocrine glands with ultrasonography: lacrimal glands (LGUS) and labial salivary glands (LSGUS). The objective of this study is to explore the practical applications of ultra-high frequency ultrasound (UHFUS) in the assessment of lacrimal glands and labial salivary glands. Indeed, UHFUS, with its improved spatial resolution compared to conventional ultrasonography, allows for the evaluation of microscopic structures and has been successfully applied in various medical fields. In lacrimal glands, conventional high-frequency ultrasound (HFUS) can detect characteristic inflammatory changes, atrophic alterations, blood flow patterns, and neoplastic lesions associated with SjD. However, sometimes it is challenging to identify lacrimal glands characteristics, thus making UHFUS a promising tool. Regarding labial salivary glands, limited research is available with conventional HFUS, but UHFUS proves to be a good tool to evaluate glandular inhomogeneity and to guide labial salivary glands biopsy. The comprehensive understanding of organ involvement facilitated by UHFUS may significantly improve the management of SjD patients. Full article

(This article belongs to the Special Issue Clinical Application of Ultra-High Frequency Ultrasound: Emerging Trends)

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12 pages, 2067 KiB

Open AccessCase Report

High Intensity Focused Ultrasound Ablation for Juvenile Cystic Adenomyosis: Two Case Reports and Literature Review

by Xin Liu, Jingxi Wang, Yanglu Liu, Shuang Luo, Gaowu Yan, Huaqi Yang, Lili Wan and Guohua Huang

Diagnostics 2023, 13(9), 1608; https://doi.org/10.3390/diagnostics13091608 - 01 May 2023

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Abstract

Cystic adenomyosis is a rare type of uterine adenomyosis, mainly seen in young women, which is often characterized by severe dysmenorrhea. The quality of life and reproductive function of young women could be affected by misdiagnosis and delayed treatment. At present, there are [...] Read more.

Cystic adenomyosis is a rare type of uterine adenomyosis, mainly seen in young women, which is often characterized by severe dysmenorrhea. The quality of life and reproductive function of young women could be affected by misdiagnosis and delayed treatment. At present, there are no universal guidelines and consensus. We report two cases of patients with cystic adenomyosis in juveniles treated with high-intensity focused ultrasound (HIFU) ablation. In the first case, magnetic resonance imaging (MRI) indicated a cystic mass of 2.0 cm × 3.1 cm × 2.4 cm in the uterus. After she underwent HIFU treatment, her pelvic MRI showed a mass of 1.1 × 2.4 cm in size, and her dysmenorrhea symptoms gradually disappeared. In the second case, a pelvic MRI indicated a 5.1 cm × 3.3 cm × 4.7 cm cystic mass in the uterus. After she underwent HIFU and combined four consecutive cycles of GnRH-a treatment, the lesion shrunk 1.2 cm ×1.4 cm × 1.6 cm, without dysmenorrhea. Simultaneously, the report reviewed 14 cases of juvenile cystic adenomyosis over the last ten years. HIFU or HIFU-combined drugs were safe and effective in treating juvenile cystic adenomyosis, but multicenter and prospective studies may be necessary to validate this in the future. Full article

(This article belongs to the Special Issue Clinical Application of Ultra-High Frequency Ultrasound: Emerging Trends)

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Open AccessBrief Report

Multiparametric Skin Assessment in a Monocentric Cohort of Systemic Sclerosis Patients: Is There a Role for Ultra-High Frequency Ultrasound?

by Marco Di Battista, Simone Barsotti, Saverio Vitali, Marco Palma, Giammarco Granieri, Teresa Oranges, Giacomo Aringhieri, Valentina Dini, Alessandra Della Rossa, Emanuele Neri, Marco Romanelli and Marta Mosca

Diagnostics 2023, 13(8), 1495; https://doi.org/10.3390/diagnostics13081495 - 21 Apr 2023

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Abstract

Background: To assess skin involvement in a cohort of patients with systemic sclerosis (SSc) by comparing results obtained from modified Rodnan skin score (mRSS), durometry and ultra-high frequency ultrasound (UHFUS). Methods: SSc patients were enrolled along with healthy controls (HC), assessing [...] Read more.

Background: To assess skin involvement in a cohort of patients with systemic sclerosis (SSc) by comparing results obtained from modified Rodnan skin score (mRSS), durometry and ultra-high frequency ultrasound (UHFUS). Methods: SSc patients were enrolled along with healthy controls (HC), assessing disease-specific characteristics. Five regions of interest were investigated in the non-dominant upper limb. Each patient underwent a rheumatological evaluation of the mRSS, dermatological measurement with a durometer, and radiological UHFUS assessment with a 70 MHz probe calculating the mean grayscale value (MGV). Results: Forty-seven SSc patients (87.2% female, mean age 56.4 years) and 15 HC comparable for age and sex were enrolled. Durometry showed a positive correlation with mRSS in most regions of interest (p = 0.025, ρ = 0.34 in mean). When performing UHFUS, SSc patients had a significantly thicker epidermal layer (p < 0.001) and lower epidermal MGV (p = 0.01) than HC in almost all the different regions of interest. Lower values of dermal MGV were found at the distal and intermediate phalanx (p < 0.01). No relationships were found between UHFUS results either with mRSS or durometry. Conclusions: UHFUS is an emergent tool for skin assessment in SSc, showing significant alterations concerning skin thickness and echogenicity when compared with HC. The lack of correlations between UHFUS and both mRSS and durometry suggests that these are not equivalent techniques but may represent complementary methods for a full non-invasive skin evaluation in SSc. Full article

(This article belongs to the Special Issue Clinical Application of Ultra-High Frequency Ultrasound: Emerging Trends)

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