Research

18 pages, 3269 KiB

Open AccessArticle

Inter-System Variability of Eight Different Handheld Ultrasound (HHUS) Devices—A Prospective Comparison of B-Scan Quality and Clinical Significance in Intensive Care

by Johannes Matthias Weimer, Diana Beer, Christoph Schneider, Masuod Yousefzada, Michael Gottwald, Tim Felix Züllich, Andreas Weimer, Christopher Jonck, Holger Buggenhagen, Roman Kloeckner and Daniel Merkel

Diagnostics 2024, 14(1), 54; https://doi.org/10.3390/diagnostics14010054 - 26 Dec 2023

Viewed by 873

Abstract

Background: the use of handheld ultrasonography (HHUS) devices is well established in prehospital emergency diagnostics, as well as in intensive care settings. This is based on several studies in which HHUS devices were compared to conventional high-end ultrasonography (HEUS) devices. Nonetheless, there is [...] Read more.

Background: the use of handheld ultrasonography (HHUS) devices is well established in prehospital emergency diagnostics, as well as in intensive care settings. This is based on several studies in which HHUS devices were compared to conventional high-end ultrasonography (HEUS) devices. Nonetheless, there is limited evidence regarding potential variations in B-scan quality among HHUS devices from various manufacturers, and regarding whether any such differences hold clinical significance in intensive care medicine settings. Methods: this study included the evaluation of eight HHUS devices sourced from diverse manufacturers. Ultrasound videos of five previously defined sonographic questions (volume status/inferior vena cava, pleural effusion, pulmonary B-lines, gallbladder, and needle tracking in situ) were recorded with all devices. The analogue recording of the same pathologies with a HEUS device served as gold standard. The corresponding findings (HHUS and HEUS) were then played side by side and evaluated by sixteen intensive care physicians experienced in sonography. The B-scan quality and the clinical significance of the HHUS were assessed using a five-point Likert scale (5 points = very good; 1 point = insufficient). Results: both in assessing the quality of B-scans and in their ability to answer clinical questions, the HHUS achieved convincing results—regardless of the manufacturer. For example, only 8.6% (B-scan quality) and 9.8% (clinical question) of all submitted assessments received an “insufficient” rating. One HHUS device showed a significantly higher (p < 0.01) average points score in the assessment of B-scan quality (3.9 ± 0.65 points) and in the evaluation of clinical significance (4.03 ± 0.73 points), compared to the other devices. Conclusions: HHUS systems are able to reliably answer various clinical intensive care questions and are—while bearing their limitations in mind—an acceptable alternative to conventional HEUS devices. Irrespective of this, the present study was able to demonstrate relevant differences in the B-scan quality of HHUS devices from different manufacturers. Full article

(This article belongs to the Special Issue Current Challenges and Perspectives of Ultrasound)

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13 pages, 1989 KiB

Open AccessArticle

Digital Transformation in Musculoskeletal Ultrasound: Acceptability of Blended Learning

by Andreas Michael Weimer, Rainer Berthold, Christian Schamberger, Thomas Vieth, Gerd Balser, Svenja Berthold, Stephan Stein, Lukas Müller, Daniel Merkel, Florian Recker, Gerhard Schmidmaier, Maximilian Rink, Julian Künzel, Roman Kloeckner and Johannes Weimer

Diagnostics 2023, 13(20), 3272; https://doi.org/10.3390/diagnostics13203272 - 20 Oct 2023

Viewed by 822

Abstract

Background: ultrasound diagnostics have a broad spectrum of applications, including among diseases of the musculoskeletal system. Accordingly, it is important for the users to have a well-founded and up-to-date education in this dynamic examination method. The right balance between online and in-class teaching [...] Read more.

Background: ultrasound diagnostics have a broad spectrum of applications, including among diseases of the musculoskeletal system. Accordingly, it is important for the users to have a well-founded and up-to-date education in this dynamic examination method. The right balance between online and in-class teaching still needs to be explored in this context. Certifying institutions are currently testing digitally transformed teaching concepts to provide more evidence. Methods: this study compared two musculoskeletal ultrasound blended learning models. Model A was more traditional, with a focus on in-person teaching, while Model B was more digitally oriented with compulsory webinar. Both used e-learning for preparation. Participants completed evaluations using a seven-point Likert scale, later converted to a 0–1 scale. Digital teaching media (e-learning) were used for preparation in both courses. Results: the analysis included n = 41 evaluations for Model A and n = 30 for Model B. Model B received a better overall assessment (median: 0.73 vs. 0.69, p = 0.05). Model B also excelled in “course preparation” (p = 0.02), “webinar quality” (p = 0.04), and “course concept” (p = 0.04). The “gain of competence” (p = 0.82), “learning materials” (p = 0.30), and “tutor quality” (p = 0.28) showed no significant differences. Conclusion: participants favorably assessed blended learning in ultrasound teaching. Certifying institutions should consider accrediting models that combine digital methods (e.g., internet lectures/webinars) and materials (e.g., e-learning) with hands-on ultrasound training. Further research is needed to validate these subjective findings for a stronger evidential basis. Full article

(This article belongs to the Special Issue Current Challenges and Perspectives of Ultrasound)

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Review

Jump to: Research, Other

17 pages, 2037 KiB

Open AccessReview

Current Developments and Role of Intestinal Ultrasound including the Advent of AI

by Gennaro Tagliamonte, Fabrizio Santagata and Mirella Fraquelli

Diagnostics 2024, 14(7), 759; https://doi.org/10.3390/diagnostics14070759 - 03 Apr 2024

Viewed by 576

Abstract

Intestinal ultrasound is a non-invasive, safe, and cost-effective technique to study the small and large intestines. In addition to conventional B-mode and color doppler imaging, new US tools have been developed in more recent years that provide auxiliary data on many GI conditions, [...] Read more.

Intestinal ultrasound is a non-invasive, safe, and cost-effective technique to study the small and large intestines. In addition to conventional B-mode and color doppler imaging, new US tools have been developed in more recent years that provide auxiliary data on many GI conditions, improving the diagnosis and assessment of relevant outcomes. We have reviewed the more recent literature (from 2010 onwards) on auxiliary tools in bowel ultrasound such as elastography techniques, CEUS, SICUS, and the potential contribution by artificial intelligence (AI) to overcome current intestinal ultrasound limitations. For this scoping review, we performed an extensive literature search on PubMed and EMBASE to identify studies published until December 2023 and investigating the application of elastography techniques, CEUS, SICUS, and AI in the ultrasonographic assessment of the small and large intestines. Multiparametric intestinal ultrasound shows promising capabilities in Crohn’s disease, while less is known about the role in ulcerative colitis. Despite some evidence, the CEUS role as a point-of-care examination tool for rare conditions such as intestinal GvHD and ischemic small bowel disease seems promising, possibly avoiding the need to perform further cross-sectional imaging. The use of AI in intestinal ultrasound is still anecdotical and limited to acute appendicitis. Full article

(This article belongs to the Special Issue Current Challenges and Perspectives of Ultrasound)

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35 pages, 18289 KiB

Open AccessReview

Comments and Illustrations of Ultrasound Findings in Extrapulmonary Tuberculosis Manifestations

by Kathleen Möller, Axel Löwe, Christian Jenssen, Nitin Chaubal, Heike Gottschall, Benjamin Misselwitz, Meghana Reddy Kurapati, Anoop Reddy Puritipati, Yi Dong, Siegbert Faiss and Christoph F. Dietrich

Diagnostics 2024, 14(7), 706; https://doi.org/10.3390/diagnostics14070706 - 27 Mar 2024

Viewed by 890

Abstract

This review describes the appearance of extrapulmonary tuberculosis manifestations in comprehensive and multiparametric ultrasound imaging. The aim is to increase awareness of typical ultrasound findings regarding extrapulmonary tuberculosis, correlate those with pathological features, and facilitate differential diagnosis. Point of care ultrasound protocols can [...] Read more.

This review describes the appearance of extrapulmonary tuberculosis manifestations in comprehensive and multiparametric ultrasound imaging. The aim is to increase awareness of typical ultrasound findings regarding extrapulmonary tuberculosis, correlate those with pathological features, and facilitate differential diagnosis. Point of care ultrasound protocols can be used as a screening method in high-risk populations, although the negative findings do not exclude tuberculosis. Conversely, the diagnosis of extrapulmonary tuberculosis can never be made using ultrasound alone, as many ultrasound findings in extrapulmonary tuberculosis are non-specific. However, ultrasound-based sampling techniques can significantly facilitate the collection of samples for microbiological or molecular proof of tuberculosis, as well as facilitating the establishment of alternative diagnoses. Full article

(This article belongs to the Special Issue Current Challenges and Perspectives of Ultrasound)

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20 pages, 10078 KiB

Open AccessReview

Review on Pediatric Malignant Focal Liver Lesions with Imaging Evaluation: Part II

by Yi Dong, Andrius Cekuolis, Dagmar Schreiber-Dietrich, Rasa Augustiniene, Simone Schwarz, Kathleen Möller, Nasenien Nourkami-Tutdibi, Sheng Chen, Jia-Ying Cao, Yun-Lin Huang, Ying Wang, Heike Taut, Lara Grevelding and Christoph F. Dietrich

Diagnostics 2023, 13(24), 3659; https://doi.org/10.3390/diagnostics13243659 - 14 Dec 2023

Viewed by 946

Abstract

Malignant focal liver lesions (FLLs) represent various kinds of epithelial and mesenchymal tumors. In pediatric patients, the understanding of pediatric liver diseases and associated imaging manifestations is essential for making accurate diagnosis and differential diagnosis. This paper will discuss the latest knowledge of [...] Read more.

Malignant focal liver lesions (FLLs) represent various kinds of epithelial and mesenchymal tumors. In pediatric patients, the understanding of pediatric liver diseases and associated imaging manifestations is essential for making accurate diagnosis and differential diagnosis. This paper will discuss the latest knowledge of the common pediatric malignant FLLs, including undifferentiated embryonal sarcoma, rhabdomyosarcoma, epithelioid hemangioendothelioma, angiosarcoma, and malignant rhabdoid tumor. Medical imaging features are not only helpful for clinical diagnosis, but can also be useful in the evaluation and follow-up of pre- and post-treatment. The future perspectives of contrast-enhanced ultrasound (CEUS) enhancement patterns of FLLs in pediatric patients are also mentioned. Full article

(This article belongs to the Special Issue Current Challenges and Perspectives of Ultrasound)

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22 pages, 5781 KiB

Open AccessReview

Review on Pediatric Malignant Focal Liver Lesions with Imaging Evaluation: Part I

by Yi Dong, Andrius Cekuolis, Dagmar Schreiber-Dietrich, Rasa Augustiniene, Simone Schwarz, Kathleen Möller, Nasenien Nourkami-Tutdibi, Sheng Chen, Jia-Ying Cao, Yun-Lin Huang, Ying Wang, Heike Taut, Lara Grevelding and Christoph F. Dietrich

Diagnostics 2023, 13(23), 3568; https://doi.org/10.3390/diagnostics13233568 - 29 Nov 2023

Cited by 1 | Viewed by 1106

Abstract

Malignant focal liver lesions (FLLs) are commonly reported in adults but rarely seen in the pediatric population. Due to the rarity, the understanding of these diseases is still very limited. In children, most malignant FLLs are congenital. It is very important to choose [...] Read more.

Malignant focal liver lesions (FLLs) are commonly reported in adults but rarely seen in the pediatric population. Due to the rarity, the understanding of these diseases is still very limited. In children, most malignant FLLs are congenital. It is very important to choose appropriate imaging examination concerning various factors. This paper will outline common pediatric malignant FLLs, including hepatoblastoma, hepatocellular carcinoma, and cholangiocarcinoma and discuss them against the background of the latest knowledge on comparable/similar tumors in adults. Medical imaging features are of vital importance for the non-invasive diagnosis and follow-up of treatment of FLLs in pediatric patients. The use of CEUS in pediatric patients for characterizing those FLLs that remain indeterminate on conventional B mode ultrasounds may be an effective option in the future and has great potential to be integrated into imaging algorithms without the risk of exposure to ionizing radiation. Full article

(This article belongs to the Special Issue Current Challenges and Perspectives of Ultrasound)

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Other

Jump to: Research, Review

6 pages, 3305 KiB

Open AccessInteresting Images

Blood or Fat? Differentiating Hemopericardium versus Epicardial Fat Using Focused Cardiac Ultrasound

by Yuriy S. Bronshteyn, Nazish Hashmi, Jamie R. Privratsky and Atilio Barbeito

Diagnostics 2024, 14(8), 818; https://doi.org/10.3390/diagnostics14080818 - 15 Apr 2024

Viewed by 368

Abstract

Basic point-of-care ultrasound of the heart—also known as Focused Cardiac Ultrasound (FoCUS)—has emerged as a powerful bedside tool to narrow the differential diagnosis of causes of hypotension. The list of causes of hypotension that a FoCUS provider is expected to be able to [...] Read more.

Basic point-of-care ultrasound of the heart—also known as Focused Cardiac Ultrasound (FoCUS)—has emerged as a powerful bedside tool to narrow the differential diagnosis of causes of hypotension. The list of causes of hypotension that a FoCUS provider is expected to be able to recognize includes a compressive pericardial effusion due to hemopericardium (blood in the pericardial sac). But hemopericardium can be difficult to distinguish from a more common condition that is not immediately life-threatening: epicardial fat. This paper reviews illustrative images of both epicardial fat and hemopericardium to provide practice guidance to the FoCUS user on how to differentiate these two phenomena. Full article

(This article belongs to the Special Issue Current Challenges and Perspectives of Ultrasound)

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9 pages, 232 KiB

Open AccessCommentary

Ultrasound during Advanced Life Support—Help or Harm?

by Adrian Goudie, Michael Blaivas, Rudolf Horn, Wan-Ching Lien, Guido Michels, Daniel Wastl and Christoph Frank Dietrich

Diagnostics 2024, 14(6), 593; https://doi.org/10.3390/diagnostics14060593 - 11 Mar 2024

Viewed by 672

Abstract

Ultrasound is used in cardiopulmonary resuscitation (CPR) and advanced life support (ALS). However, there is divergence between the recommendations of many emergency and critical care societies who support its use and the recommendations of many international resuscitation organizations who either recommend against its [...] Read more.

Ultrasound is used in cardiopulmonary resuscitation (CPR) and advanced life support (ALS). However, there is divergence between the recommendations of many emergency and critical care societies who support its use and the recommendations of many international resuscitation organizations who either recommend against its use or recommend it only in limited circumstances. Ultrasound offers potential benefits of detecting reversable causes of cardiac arrest, allowing specific interventions. However, it also risks interfering with ALS protocols and increasing unhelpful interventions. As with many interventions in ALS, the evidence base for ultrasound use is weak, and well-designed randomized trials are needed. This paper reviews the current theory and evidence for harms and benefits. Full article

(This article belongs to the Special Issue Current Challenges and Perspectives of Ultrasound)

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