Australasian Journal of Ultrasound in Medicine

Abstract Introduction In both highly industrialised and developing countries, obesity is reaching epidemic proportions and increasingly becoming a critical indicator of general morbidity, cardiovascular disease (CVD) and renal dysfunction. A promising trend in detection and management of obesity is the measurement of perirenal adipose tissue (PRAT), increasingly recognised as a metabolically active endocrine organ in itself. Its measurement by ultrasound is used increasingly to indicate visceral obesity and its clinical management. This review synthesises current techniques for measuring PRAT and its potential use as an indicator of CVD. Methods We included clinical studies published between 2010 and 2023, investigating the current practice and use of specific ultrasonographic techniques and assessed the reliability and accuracy of included papers. The risk of bias was assessed using the Downs and Black Checklist, and the methodological quality examined using the Grade of Recommendations, Assessments, Development and Evaluation. Results It found, PRAT measures are predictive of CVD risk factors and the accuracy of ultrasound is comparable to CT and MRI, but there is no consistency in ultrasound technique. The lack of any randomised control trials and the use of 20 different non‐standardised ultrasound techniques across the 21 studies resulted in inconsistent and imprecise clinical observations and interpretations, which decreased the overall quality of the studies. Conclusion This review found the inclusion of ultrasound measures in routine abdominal imaging potentially invaluable but demonstrates the need for standardisation of the perirenal fat ultrasound measuring technique to improve reproducibility and reliability.

Victoria J. A. Baumann

Richard Banati

Jillian L. Clarke

Ultrasound measurement of perirenal adipose tissue indicates cardiovascular disease, but standardisation is needed: A systematic review

肾脏周围脂肪组织的超声测量提示心血管疾病，但需要标准化：一项系统评价

Abstract Introduction/Purpose As the frequency and morbidity of musculoskeletal (MSK) disorders increase, the use of MSK ultrasound has become an important diagnostic and procedural tool. This has amplified the importance of quality MSK ultrasound training for medical professionals. This systematic review evaluated and compared peer‐reviewed journal articles on learning methodologies for MSK ultrasound training. Methods Thirty‐three articles met inclusion and exclusion criteria and were evaluated. Results Results showed a lack of randomised studies that compared learning methodologies. Conclusion There was wide variability of methodology used based on educational and institutional needs. Further randomised control trials need to be conducted to ascertain best educational practices.

Amber J. Vogt

Robert Samuel Mayer

Systematic review of musculoskeletal ultrasound learning methodologies

肌肉骨骼超声学习方法的系统综述

To analyse amniotic fluid volume (AFV), specifically oligohydramnios or polyhydramnios, and associated pregnancy and neonatal outcomes in twin gestations through systematic review and meta-analysis.We utilised systematic review methodology to identify items within published and grey literature resources. Prospective and retrospective studies with a control group were included. Inclusion criteria were as follows: studies in English, twin pregnancy in which AFVs and associated pregnancy and/or neonatal outcomes were evaluated. Exclusion criteria included the presence of an anomalous fetus, chromosome abnormality, monochorionic diamniotic twin pregnancy complicated by twin-twin transfusion syndrome or twin-reversed arterial perfusion, twin gestations undergoing therapeutic interventions (i.e. fetoscopic laser photocoagulation and serial amniocentesis) and monochorionic monoamniotic twin pregnancy.The literature search identified 1068 abstracts, only four met criteria for inclusion and analysis. The pooled data (two studies per outcome) revealed no significant difference in rate of pre-term delivery (OR: 2.94; CI: 0.20-43.81), pre-term delivery less than 32 weeks (OR: 1.97; CI: 0.43-9.12), umbilical cord pH < 7 (OR: 2.66; CI: 0.22-32.51), rate of stillbirth (OR: 4.13; CI: 0.40-42.70), neonatal death (OR: 1.48; CI: 0.05-43.94), rate of NICU admission (OR: 1.38; CI: 0.61-3.11) or rate of small-for-gestational-age (SGA) infants (OR: 1.39; CI: 0.33-5.94).Based on the pooled data (two studies per outcome), there was no difference in the fate of pre-term delivery, umbilical cord pH < 7, stillbirth, neonatal death or SGA infants. What is disturbing is the lack of studies (1946-2020) that analysed the association between AFV and pregnancy outcomes in twin pregnancies.

Dayna Whitcombe

Everett Magann

Susan Steelman

Zhuopei Hu

Songthip Ounpraseuth

Amniotic fluid volume and pregnancy outcomes in twin pregnancies: A systematic review and meta‐analysis

羊水容量与双胎妊娠结局：系统综述与Meta分析

Michelle Fenech

Boxer's knuckle: Sonographic anatomy and assessment of sagittal band tears of the dorsal hood

拳击手关节：背侧帽的声像图解剖及纵向带撕裂的评估

To determine the diagnostic accuracy and complication rates of ultrasound-guided, percutaneous core needle biopsies of soft tissue masses in the hand and fingers.Reports from all ultrasound-guided procedures between 21 May 2014 and 17 March 2022 were queried for keywords including "hand", OR "finger", AND "biopsy". Patient demographics, lesion size and location, biopsy needle gauge and the number of cores obtained were recorded. The final pathology of the mass excision was then compared with the core needle biopsy (CNB) for each patient.Sixty-six records were reviewed, and 37 patients met inclusion criteria. Maximum lesion diameter averaged 1.45 cm with a range between 0.4 and 4.3 cm. The frequency of needle gauges used was 14G (14%), 16G (24%), 18G (38%), 20G (11%) and 'not reported' (14%). The mean number of tissue cores obtained was 2.9 (SD 1.2; range 1 to 6), excluding nine cases that reported 'multiple'. The frequency of CNB diagnoses included tenosynovial giant cell tumour (TGCT) at 30%, ganglion cyst at 11% and epidermal inclusion cyst at 5%. CNB was 100% sensitive in detecting the three (8%) malignancies. Of the 37 tumours biopsied, 16 were surgically excised. One angiomyoma was originally diagnosed as a haemangioma on CNB, but all other histologic results were concordant for a diagnostic accuracy of 97%.Small soft tissue masses in the hands and fingers, even those less than 1 cm, are often amenable to ultrasound-guided CNB. Performance under image guidance facilitates retrieval of core specimens adquate for histologic diagnosis with relatively few passes using higher gauge needles.Overall, ultrasound-guided CNB of the hand and fingers is safe and highly accurate in diagnosing soft tissue tumours. The accuracy is unrelated to the needle's gauge, the number of passes and the size of the lesions.

Stephanie Magoon

Vanessa Peters

Felipe Ferreira de Souza

David Chen

Patrick Owens

Juan Pretell‐Mazzini

Natalia Fullerton

Jean Jose

Andrew Rosenberg

Ty K. Subhawong

Hand and finger, ultrasound‐guided, percutaneous core needle biopsies: A safe procedure with high diagnostic accuracy

手和手指的超声引导下经皮核心针活检：一种安全且诊断准确率高的手术

Abstract Introduction This case examines the sonographic and clinical challenge of diagnosing a Klebsiella pnumoniae pyogenic liver abscess with systemic metastatic infection. Case Description The patient in this case study is an 81‐year‐old man who presented with intermittent rigors. Following radiological and clinical assessments, a Klebsiella pnumoniae pyogenic liver abscess, with evidence of systemic metastatic infection, was diagnosed. Sonographic features of the liver abscess were atypical for a cystic lesion and instead appeared as a solid mass, raising the possibility of malignancy. Treatment of intravenous ceftriaxone infusions resulted in full resolution of the liver lesion. Discussion The discussion criticises the terminology when describing hepatic lesions, which result from a Klebsiella pnumoniae infection. The term hepatic phlegmon is appropriate when a liver lesion caused by bacterial infection demonstrates a solid appearance on radiologic imaging. The term hepatic abscess is appropriate in cases where liver lesions caused by bacterial infection demonstrate a fluid filled core on radiologic imaging. Differentiation of these terms is important when treating the underlying lesion as a phlegmon, in contrast to an abscess, cannot be drained because it contains no pus. The variable sonographic appearances of Klebsiella pnumoniae pyogenic abscesses were also examined. Despite reported sonographic appearances in the literature, none are sufficient to distinguish a pyogenic liver abscess from malignancy without further investigation. Conclusion Ultrasound operators should be aware of the variable sonographic appearances of a Klebsiella pnumoniae liver abscess and how these features, combined with non‐homogenous terminology, can obfuscate the correct diagnosis.

Martin Necas

Jereme Mitchell

Klebsiella liver phlegmon mimicking a solid liver tumour

拟似实体肝肿瘤的克雷伯氏菌性肝蜂窝织炎

Abstract Introduction/Purpose There are varying international recommendations regarding the minimum level of disinfection required for ultrasound transducers used in percutaneous procedures. While some guidelines recommend high‐level disinfection (HLD), others question the additional benefit this delivers over low‐level disinfection (LLD). Methods This narrative review identifies current guidelines and evaluates the evidence used to support disinfection recommendations for ultrasound transducers used in percutaneous procedures. Thirteen guidelines were identified using a search encompassing PubMed, Embase, Scopus and Google from 1st January 2013 to 31st January 2024. Results No guidelines were supported by high‐quality evidence, instead, guidelines relied upon: expert opinion through the application of national standards and infection control principles; consideration of recommendations from other published guidelines; and the incidence of infection from retrospective studies. Guidelines were uniformly supportive of using ultrasound transducer covers and sterile ultrasound gel during ultrasound‐guided percutaneous procedures. However, the minimum recommended disinfection level was varied with seven guidelines recommending HLD, four LLD and two not specifying a level. Spaulding's classification was commonly used to support disinfection recommendations, however, the resultant wide variation in classification and subsequent recommendations suggest that its utility in accurately determining the minimum level of disinfection in this specific context is low. Conclusion Without high‐level evidence, using a risk‐based assessment will likely remain fundamental to future guideline recommendations in determining the minimum disinfection level for an ultrasound transducer used in percutaneous procedures. This risk assessment must include the highest level of evidence available in addition to acknowledging the contribution of all steps taken to prevent infection during ultrasound‐guided percutaneous procedures.

Nathan Peters

Frances Williamson

Victoria Eley

Ultrasound transducer disinfection for percutaneous procedures: A review of the evidence supporting guideline recommendations

经皮操作中超声探头消毒：支持指南建议的证据综述

Abstract Purpose To assess the effects of bladder fullness and lower uterine contractions ultrasound on transabdominal and transvaginal cervical length measurements at the mid‐trimester fetal anomaly scan (FAS). Methods Transabdominal and transvaginal cervical length measurements from 925 mid‐trimester FAS examinations were retrospectively analysed. Images were assessed for lower uterine contraction and bladder fullness using a novel qualitative assessment. Bland–Altman plots and single‐score interclass correlation (ICC) were used to determine correlation between transabdominal and transvaginal measurements. Sensitivity and specificity of transabdominal cut‐offs were calculated. Results Transabdominal and transvaginal measurements of the cervix correlated poorly (ICC 0.306). An overfilled bladder and lower uterine contractions on average increased the length of transabdominal cervical length measurements. Removing these variables did not significantly improve correlation between transabdominal and transvaginal measurements of the cervix but resulted in an improved sensitivity of transabdominal assessment to detect a clinically relevant short cervix. Discussion Resolving the confounding factors of an overfilled bladder and lower uterine contractions can help improve the our ability to detect a short cervix on transabdominal ultrasound. Our data set supported a two‐stage approach to cervical length screening which would allow 100% sensitivity when a cut‐off of ≤35 mm is used on transabdominal ultrasound and would limit the need for transvaginal scanning to approximately 39% of patients. This cut‐off is in line with the findings of other studies. The low prevalence of short cervix in our study did however make it difficult to extrapolate reliable calculations. Conclusion Although transabdominal measurements correlate poorly with transvaginal measurements of the cervix, we demonstrated an improved sensitivity for detecting a short cervix using a transabdominal approach when no contractions or overfilled bladder is present. This potential could be explored in a future study with a larger sample size.

Heidi Beaver

Valeria Lanzarone

Gary KK Low

Comparing transabdominal and transvaginal cervical length measurements at mid‐trimester fetal anomaly scan: The impact of bladder fullness and lower uterine contractions

中期胎儿异常扫描中经腹和经阴道宫颈长度测量的比较：膀胱充盈和子宫下段收缩的影响

ISSN	1836-6864, 2205-0140
h-index	15

涉及主题	医学放射科生物物理内科学声学外科超声波遗传学病理怀孕产科心理学
出版信息	出版商: Australasian Society for Ultrasound in Medicine，出版周期: ，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 2018，原创研究文献占比: 0.00%，自引率:N.A.， Gold OA占比: 0.00%

Australasian Journal of Ultrasound in Medicine

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Ultrasound measurement of perirenal adipose tissue indicates cardiovascular disease, but standardisation is needed: A systematic review

Systematic review of musculoskeletal ultrasound learning methodologies

Amniotic fluid volume and pregnancy outcomes in twin pregnancies: A systematic review and meta‐analysis

Boxer's knuckle: Sonographic anatomy and assessment of sagittal band tears of the dorsal hood

Hand and finger, ultrasound‐guided, percutaneous core needle biopsies: A safe procedure with high diagnostic accuracy

Systematic review of musculoskeletal ultrasound learning methodologies

Ultrasound measurement of perirenal adipose tissue indicates cardiovascular disease, but standardisation is needed: A systematic review

Klebsiella liver phlegmon mimicking a solid liver tumour

Ultrasound transducer disinfection for percutaneous procedures: A review of the evidence supporting guideline recommendations

Comparing transabdominal and transvaginal cervical length measurements at mid‐trimester fetal anomaly scan: The impact of bladder fullness and lower uterine contractions