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Background: Research investigating the potential link between gingival microvascular blood flow and inflammatory status is scarce. This study aims to assess color doppler flow imaging (CDFI) and micro-flow imaging (MFI) as tools for the assessment of gingival papilla blood flow (GPBF) and to examine their diagnostic utility as a noninvasive means of detecting gingival bleeding. Methods: CDFI and MFI were used to assess the GPBF grade (0–4) of 140 anterior gingival papilla sites in advanced periodontitis patients. Correlations between GPBF grades and periodontal characteristics were examined, and diagnostic performance as a means of predicting bleeding on probing (BOP) was examined using receiver operating characteristic curves. Results: GPBF grades 0 and 1 assessed by the MFI were 14.29% and 15.71% respectively, lower than the 28.57% and 24.29% assessed by the CDFI. In contrast, MFI detected a higher frequency of GPBF grade 2 sites (40.71%) relative to CDFI (22.14%). The CDFI and MFI provided consistent results in 62.14% of the sites, while the MFI demonstrated higher ratings in rest 37.86% of the sites. A significant positive correlation was detected between GPBF grade and the modified gingival index (MGI), bleeding index (BI), BOP, and probing depth (PD). It showed high accuracy for CDFI or MFI to diagnosing BOP with a sensitivity of 80.51% and 96.43% and a specificity of 77.27% and 57.14%, respectively. Area under the receiver operator characteristic curve values when predicting BOP based on the GPBF grade determined using CDFI and MFI approaches 0.887 (95% CI 0.833–0.942) and 0.917 (95% CI 0.862–0.972), respectively, and there were no significant differences between these values (Z = − 1.502, p = 0.133). Conclusions: Both MFI and CDFI can be employed for the evaluation of GPBF, and MFI is better suited to detecting mild inflammation. Trial registration ChiCTR2200066021 (Date of registration: 22/11/2022). [ABSTRACT FROM AUTHOR]

Abstract Background Research investigating the potential link between gingival microvascular blood flow and inflammatory status is scarce. This study aims to assess color doppler flow imaging (CDFI) and micro-flow imaging (MFI) as tools for the assessment of gingival papilla blood flow (GPBF) and to examine their diagnostic utility as a noninvasive means of detecting gingival bleeding. Methods CDFI and MFI were used to assess the GPBF grade (0–4) of 140 anterior gingival papilla sites in advanced periodontitis patients. Correlations between GPBF grades and periodontal characteristics were examined, and diagnostic performance as a means of predicting bleeding on probing (BOP) was examined using receiver operating characteristic curves. Results GPBF grades 0 and 1 assessed by the MFI were 14.29% and 15.71% respectively, lower than the 28.57% and 24.29% assessed by the CDFI. In contrast, MFI detected a higher frequency of GPBF grade 2 sites (40.71%) relative to CDFI (22.14%). The CDFI and MFI provided consistent results in 62.14% of the sites, while the MFI demonstrated higher ratings in rest 37.86% of the sites. A significant positive correlation was detected between GPBF grade and the modified gingival index (MGI), bleeding index (BI), BOP, and probing depth (PD). It showed high accuracy for CDFI or MFI to diagnosing BOP with a sensitivity of 80.51% and 96.43% and a specificity of 77.27% and 57.14%, respectively. Area under the receiver operator characteristic curve values when predicting BOP based on the GPBF grade determined using CDFI and MFI approaches 0.887 (95% CI 0.833–0.942) and 0.917 (95% CI 0.862–0.972), respectively, and there were no significant differences between these values (Z = − 1.502, p = 0.133). Conclusions Both MFI and CDFI can be employed for the evaluation of GPBF, and MFI is better suited to detecting mild inflammation. Trial registration ChiCTR2200066021 (Date of registration: 22/11/2022).

Objectives: Clarity regarding accuracy and effectiveness for interventional procedures around the foot and ankle is lacking. Consequently, a board of 53 members of the Ultrasound and Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR) reviewed the published literature to evaluate the evidence on image-guided musculoskeletal interventional procedures around this anatomical region. Methods: We report the results of a Delphi-based consensus of 53 experts from the European Society of Musculoskeletal Radiology who reviewed the published literature for evidence on image-guided interventional procedures offered around foot and ankle in order to derive their clinical indications. Experts drafted a list of statements and graded them according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus was considered strong when > 95% of experts agreed with the statement or broad when > 80% but < 95% agreed. The results of the Delphi-based consensus were used to write the paper that was shared with all panel members for final approval. Results: A list of 16 evidence-based statements on clinical indications for image-guided musculoskeletal interventional procedures in the foot and ankle were drafted after a literature review. The highest level of evidence was reported for four statements, all receiving 100% agreement. Conclusion: According to this consensus, image-guided interventions should not be considered a first-level approach for treating Achilles tendinopathy, while ultrasonography guidance is strongly recommended to improve the efficacy of interventional procedures for plantar fasciitis and Morton's neuroma, particularly using platelet-rich plasma and corticosteroids, respectively. Key Points: • The expert panel of the ESSR listed 16 evidence-based statements on clinical indications of image-guided musculoskeletal interventional procedures in the foot and ankle. • Strong consensus was obtained for all statements. • The highest level of evidence was reached by four statements concerning the effectiveness of US-guided injections of corticosteroid for Morton's neuroma and PRP for plantar fasciitis. [ABSTRACT FROM AUTHOR]

Purpose: This study compared the diagnostic performance of the modified Korean Thyroid Imaging Reporting and Data System (K-TIRADS) for thyroid malignancy with three international guidelines. Methods: From June to September 2015, 5,708 thyroid nodules (≥ 1.0 cm) in 5,081 consecutive patients who underwent thyroid ultrasound (US) at 26 institutions were evaluated. The US features of the thyroid nodules were retrospectively reviewed and classified according to all four guidelines. In the modified K-TIRADS, the biopsy size threshold was changed to 2.0 cm for K-TIRADS 3 and 1.0 or 1.5 cm for K-TIRADS 4 (K-TIRADS1.0cm and K-TIRADS1.5cm, respectively). We compared the diagnostic performance and unnecessary fine-needle aspiration biopsy (FNAB) rates for thyroid malignancy between the modified K-TIRADS and three international guidelines. Results: Of the 5,708 thyroid nodules, 4,597 (80.5%) were benign and 1,111 (19.5%) were malignant. The overall sensitivity was highest for the modified K-TIRADS1.0cm (91.0%), followed by the European (EU)-TIRADS (84.6%), American Association of Clinical Endocrinologists/American College of Endocrinology/Associazione Medici Endocrinologi (AACE/ACE/AME) (80.5%), American College of Radiology (ACR)-TIRADS (76.1%), and modified K-TIRADS1.5cm (76.1%). For large nodules (>2.0 cm), the sensitivity increased to 98.0% in both the modified K-TIRADS1.0cm and K-TIRADS1.5cm. For small nodules (≤ 2.0 cm), the unnecessary FNAB rate was lowest with the modified K-TIRADS1.5cm (17.6%), followed by the ACR-TIRADS (18.6%), AACE/ACE/AME (19.3%), EU-TIRADS (28.1%), and modified K-TIRADS1.0cm (31.2%). Conclusion: The modified K-TIRADS1.5cm can reduce the unnecessary FNAB rate for small nodules (1.0-2.0 cm), while maintaining high sensitivity for detecting malignancies >2.0 cm. [ABSTRACT FROM AUTHOR]

Introduction: Ultrasound waves have been used in the imaging of oral soft tissues since the beginning of the 1960s. Since then, the possibilities of using ultrasound devices in dental diagnostics have significantly increased. The biometric ultrasonograph Pirop® is an example of a device used for non-invasive measurements of soft tissues. Objectives: The aim of the study is to compare the thickness of soft tissues around teeth with gingival recession and the same teeth on the contralateral side without gingival recession, assessed with the use of an ultrasound Pirop® device. Material and methods: The material consisted of 15 women in the age range 22-27 years, in whom were diagnosed 18 unilateral gingival recessions at the incisors, canines, and premolars. Before the examination, the patients answer the questions included in questionnaire about the following: history of dental treatment, coexisting systemic diseases, medicaments, and the presence of addictions. At each tooth with gingival recession three measurement points were deterred to determine the thickness of the marginal and attached gingiva and the mucogingival junction. All measurements were made individually by two researchers. Results: Most of the gingival recession was found in the second quadrant (44%), and the most commonly affected teeth were 23 and 24 (about 40%). In the area of the incisors, canines, and premolars, the most common gingival recessions occurred in premolars (50%). The results of the measurements carried out on the recessive teeth were: for the gingival margin – 0.36-2.29 mm, for the attached gingiva – 0.35-2.97 mm, and for the mucogingival junction – 0.36-2.68 mm. For both researchers and for every measurement point, soft tissues were thinner at teeth with gingival recessions by more than 50%. Conclusions: The Pirop® ultrasonograph is proper, non-invasive device used to measure the thickness of soft tissues. In our study, the thickness of the mucosa around the teeth affected by the gingival recession was lower in comparison to the sound tissues on the contralateral side in the majority of the examined patients. [ABSTRACT FROM AUTHOR]

Objective To evaluate the clinical application value of combination of common iliac balloon preset with ultrasound guiding and injection of tranexamic acidtranexamic acid in prevention of bleeding caused by complete placenta previa with placenta accreta. Methods From April 2014 to May 2018， 22 cases of complete placenta previa with placenta accreta were treated with temporary balloon occlusion of the common iliac artery and intravenous injection of tranexamic acid （the study group） before cesarean， and 22 cases of complete placenta previa with placenta accreta did not receive balloon occlusion and intravenous injection of tranexamic acid （the control group） . The intraoperative blood loss， intraoperative blood transfusion volume， urine volume， operation time，the rate of bladder injury and hysterectomy were recorded and compared. Also， the related complications were compared retrospectively. Results The blood loss and blood in the study group were 900 （600，3125） mL and 0 （0，750） mL， while 3400 （1500，5000） mL and 800 （600， 2000） mL in the control group， which showed statistic significance （P ＜0.05） . Two cases in the study group had hysterectomy， which was lower than that in the control group （9 cases） （P＜0.05） . The hospitalization time after operationwas （4.0±1.0） daysinthestudygroup，comparedwith（8.3±1.6） daysin the control group，and the difference was statistically significant（P＜0.01） . Conclusion Combination of common iliac balloon preset with ultrasound guidingand intravenous injection oftranexamic acid is an effective and safe method to control intraoperative blood loss，blood transfusion，the hospitalization time after operation and can decrease the rate of hysterectomy in patients of placenta accreta. Therefore，the technique is safe，feasible and can protect the maternal and fetus from radiation. [ABSTRACT FROM AUTHOR]

Introduction: Imaging of the neoplasms of knee is important for multidisciplinary management in the modern day practice. Radiography followed by Magnetic Resonance Imaging (MRI) is a commonly used modality, whereas Ultrasonography (USG) is less commonly used method for this purpose, especially for bone tumours. Aim: To evaluate the role of USG in tumours around knee joint. Materials and Methods: This was a prospective descriptive study carried out in Nizam’s institute of Medical Sciences, Hyderabad, India from January 2015 to June 2017. During the study period, 158 patients presented to the orthopaedic department with complaints of swelling of knee were included. Based on clinical history of trauma, joint pain, fever, swelling of knee, restricted movements of knee and clinical examination of affected knee with radiography, 58 patients with 59 lesions were included. USG and cross-sectional imaging (CT/MRI) were done in all patients. Final diagnosis was made by histopathological findings or classical imaging features. Non parametric MannWhitney-Wilcoxon test was used to differentiate the resistive indices of benign and malignant lesions. Results: Study group consisted of 59 lesions where 77.97% (46/59) were bone lesions and 22.03 % (13/59) were soft tissue lesions. USG is 100% sensitive to demonstrate cortical thinning/break/fracture, soft tissue component, Neurovascular Bundle (NVB) involvement, cystic component with fluid-fluid level and joint effusion. USG is better than CT for assessing the cartilage cap of osteochondroma; USG is better than MRI and comparable to CT to identify the calcifications; Doppler USG had 89.5% sensitivity and 80% specificity to differentiate benign and malignant lesions, although only 61% lesions (36/59) showed vascularity; Doppler along with gray scale parameters (like peritumoural oedema, necrosis, absent fat rim, size and heterogeneity of soft tissue component in bone lesions, invasion of adjacent joint, muscles, NVB and lymph node involvement) was helpful in 88.1% (52/59) for diagnosing as well as differentiating benign from malignant lesions. Conclusion: USG is useful in all soft tissue tumours and bone tumours with cortical discontinuity, whereas less informative in intra-osseous and sclerotic lesions. It is useful to differentiate benign and malignant lesions. It is very informative than any other modality in recurrent tumours with implants producing artefacts.

Introduction: Imaging of the neoplasms of knee is important for multidisciplinary management in the modern day practice. Radiography followed by Magnetic Resonance Imaging (MRI) is a commonly used modality, whereas Ultrasonography (USG) is less commonly used method for this purpose, especially for bone tumours. Aim: To evaluate the role of USG in tumours around knee joint. Materials and Methods: This was a prospective descriptive study carried out in Nizam's institute of Medical Sciences, Hyderabad, India from January 2015 to June 2017. During the study period, 158 patients presented to the orthopaedic department with complaints of swelling of knee were included. Based on clinical history of trauma, joint pain, fever, swelling of knee, restricted movements of knee and clinical examination of affected knee with radiography, 58 patients with 59 lesions were included. USG and cross-sectional imaging (CT/MRI) were done in all patients. Final diagnosis was made by histopathological findings or classical imaging features. Non parametric Mann- Whitney-Wilcoxon test was used to differentiate the resistive indices of benign and malignant lesions. Results: Study group consisted of 59 lesions where 77.97% (46/59) were bone lesions and 22.03 % (13/59) were soft tissue lesions. USG is 100% sensitive to demonstrate cortical thinning/break/fracture, soft tissue component, Neurovascular Bundle (NVB) involvement, cystic component with fluid-fluid level and joint effusion. USG is better than CT for assessing the cartilage cap of osteochondroma; USG is better than MRI and comparable to CT to identify the calcifications; Doppler USG had 89.5% sensitivity and 80% specificity to differentiate benign and malignant lesions, although only 61% lesions (36/59) showed vascularity; Doppler along with gray scale parameters (like peritumoural oedema, necrosis, absent fat rim, size and heterogeneity of soft tissue component in bone lesions, invasion of adjacent joint, muscles, NVB and lymph node involvement) was helpful in 88.1% (52/59) for diagnosing as well as differentiating benign from malignant lesions. Conclusion: USG is useful in all soft tissue tumours and bone tumours with cortical discontinuity, whereas less informative in intra-osseous and sclerotic lesions. It is useful to differentiate benign and malignant lesions. It is very informative than any other modality in recurrent tumours with implants producing artefacts. [ABSTRACT FROM AUTHOR]

The syndrome of cervical incompetence is characterized by spontaneous painless passive dilatation of cervix followed by expulsion of an immature foetus. The subject has been subjected to increasing controversy in recent years. The wide variations in the incidence of cervical incompetence arise because there are no standard criteria for the diagnosis of cervical incompetence. The certain way of diagnosing a case of cervical incompetence is by history and vaginal examination. The introduction of transvaginal ultrasonographical examination into the obstetrics diagnosis has created further possibilities in recognition of isthmico – cervical insufficiency. The present study was conducted for a period of 18 months with gestational age between 14 to 26weeks and was aimed to evaluate the efficacy of transvaginal sonography and to know the incidence of cervical incompetence in this area. 50 pregnant women at high risk of pre-term delivery were taken in to the study. 36 out of 50 cases (72%) met the criteria and they were managed surgically and had a cervix length < 2.5 cm. 14 (28%) cases had cervix length. > 2.5 cm at the initial transvaginal sonographic evaluation. 40 out of 50 (80%) delivered at around term. Though the diagnosis of cervical incompetence is based primarily on past obstetric, gynaec history and clinical findings, but transvaginal sonographic surveillance of the cervix helps us to use the cervical cerclage more selectively i.e., when the cervix length i.e, < 2.5 cm, internal os open or close with funneling of cervical canal. [ABSTRACT FROM AUTHOR]

Abstract There are few formal curricula on radiology, and minimal formal exposure to ultrasound, even while ultrasound is becoming increasingly used. This resource was designed to target that gap in training and provide a brief introduction to medical ultrasonography. It features a PowerPoint presentation with an accompanying Word document that explains the slides. This resource is ideally used by an instructor familiar with the use of clinical ultrasound to present to third- and/or fourth-year medical students. They can alternatively be used by medical students as a self-study guide, as explanations are provided in the word document.

Echocardiography plays a pivotal role as an imaging modality in modern cardiology practice. Information derived from echocardiography is definitely helpful for patient care. The Japanese Society of Echocardiography has promoted echocardiography in routine clinical and research use. One of the missions of the Society is to provide information that is useful for high-quality examinations. To ensure this, we believe that equipment in good condition and a comfortable environment are important for both patient and examiner. Here, the Guideline Preparation Committee of the Japanese Society of Echocardiography has established brief guidance for the routine use of echocardiography equipment. [ABSTRACT FROM AUTHOR]

Background. Severe renal dysfunction is associated with increased cardiovascular risk. The aim of this study was to investigate the association between renal function and carotid intima–media thickness (cIMT) in a middle-aged population-based cohort. [ABSTRACT FROM PUBLISHER]

Giant Cell Reparative Granuloma is a reparative process in mandible. A case of Giant Cell Reparative Granuloma of Maxilla in a 15 years old female is reported. Tumour is very rare in maxilla and more often is diagnosed as a giant cell tumour. The case is reported on account of its rarity in maxilla and dilemma in differentiating it from other giant cell lesions. Differentiation is only based on the clinical test histopathological examination. [ABSTRACT FROM AUTHOR]

This study aimed to explore the assessment value of virtual touch quantization (VTQ) for the clinicopathological typing of renal fibrosis. The quantitative detection of 76 patients with nephropathy was performed using acoustic radiation force impulse imaging (ARFI). The extent of the renal fibrosis in each patient was confirmed using ultrasound-guided biopsy pathology. The VTQ values were compared with the degree of renal fibrosis in order to analyze the correlation between them. Patients were divided pathologically into four groups, as follows: non-fibrosis (n=14), mild fibrosis (n=40), moderate fibrosis (n=21) and severe fibrosis (n=1). Compared with the non-fibrosis group, the VTQ values of the mild and moderate fibrosis groups were significantly increased (P<0.01); however, there was no significant difference between the VTQ values of the mild and moderate fibrosis groups (P>0.05). According to the receiver operating characteristic (ROC) curve, a VTQ value of renal parenchyma of >1.67 m/sec was determined to be an indicator of renal fibrosis, with a sensitivity of 86.3% and a specifcity of 83.3%. VTQ technology may be significant in the assessment of the extent of renal fibrosis. [ABSTRACT FROM AUTHOR]

Duplication of the gall bladder is a rare anomaly. Ectopic thyroid in a gall bladder is also exceedingly rare with only four cases of ectopic thyroid tissue in the gall bladder reported in English literature. We report the unique case of ectopic thyroid tissue in a duplicated gall bladder in a 51-year-old female with recurrent right upper quadrant pain. Abdominal sonography revealed a duplicated gall bladder with the cystic-solid mass in the septum separating the two gall bladders while subsequent histopathology from the cholecystectomy specimen confirmed ectopic thyroid tissue within the wall of double gall bladder. [ABSTRACT FROM AUTHOR]

Introduction: Nuss bar removal after minimally invasive repair of pectus excavatum in patients where bar ends are not palpable, can be a challenging procedure for the surgeon; a blind dissection toward the bar edges may lead to intercostal vessels or deep intercostal muscle injuries. In this article, we describe a fast, repeatable, low-cost technique to detect bar edge and stabilizers.Methods: A perioperative scan is performed by means of a portable ultrasonograph a few minutes before the operation. The bar edge stabilizer is detected as a hyperechogenic image with a concentric crescent while the bar edge is detected as a hyperechogenic dashed line with net edges. The scan is performed, and the actual projection on the skin of the metal plaque bulk is then labeled on the patient's chest by an ink marker.Conclusions: We believe that this method may improve morbidity, operative time, and consequently, hospitalization length and costs. [ABSTRACT FROM AUTHOR]

This study aimed to explore the assessment value of virtual touch quantization (VTQ) for the clinicopathological typing of renal fibrosis. The quantitative detection of 76 patients with nephropathy was performed using acoustic radiation force impulse imaging (ARFI). The extent of the renal fibrosis in each patient was confirmed using ultrasound-guided biopsy pathology. The VTQ values were compared with the degree of renal fibrosis in order to analyze the correlation between them. Patients were divided pathologically into four groups, as follows: non-fibrosis (n=14), mild fibrosis (n=40), moderate fibrosis (n=21) and severe fibrosis (n=1). Compared with the non-fibrosis group, the VTQ values of the mild and moderate fibrosis groups were significantly increased (P<0.01); however, there was no significant difference between the VTQ values of the mild and moderate fibrosis groups (P>0.05). According to the receiver operating characteristic (ROC) curve, a VTQ value of renal parenchyma of >1.67 m/sec was determined to be an indicator of renal fibrosis, with a sensitivity of 86.3% and a specificity of 83.3%. VTQ technology may be significant in the assessment of the extent of renal fibrosis.