搜索结果：Ultrasound (Leeds, England)

To investigate the ultrasound characteristics of medullary thyroid carcinoma and their relationship with prognosis. A retrospective analysis was conducted on 133 medullary thyroid carcinoma nodules, encompassing their ultrasound findings and relevant clinical data. Based on the ultrasound characteristics, medullary thyroid carcinoma nodules were categorised into a benign feature group or malignant feature group, followed by a comparative assessment of disparities in ultrasound features and prognostic indicators between these two groups. Among the 133 medullary thyroid carcinoma nodules analysed, there were 92 cases of malignant feature group (69.2%) and 41 cases of benign feature group (30.8%). The ultrasound characteristics of the benign feature group included well-defined borders (65.9%), hypo echogenicity (87.8%), rich blood flow (48.8%) or abundant blood flow (31.7%), and the absence of calcification (51.2%), or the presence of coarse calcification (36.6%). In contrast, the ultrasound characteristics of the malignant feature group revealed indistinct borders in the majority of cases (96.7%), hypoechogenicity in most cases (82.6%) or very low echogenicity in some cases (16.3%), and relatively rich blood flow in a significant number out of 92 patients (78.3%), with coarse calcification present in 66 cases (71.7%). Compared to the benign feature group, the malignant feature group demonstrated significantly higher rates of lymph node metastasis (69.6% vs 12.2%), distant metastasis (28.3% vs 9.8%), and recurrence (41.3% vs 9.8%). Moreover, the malignant feature group exhibited elevated preoperative calcitonin levels and its ultrasound features were found to be atypical in comparison with the benign feature group. A comprehensive understanding of the ultrasound characteristics of the benign feature group holds substantial clinical significance for diagnosing suspicious cases of medullary thyroid carcinoma. Furthermore, the ultrasound features of medullary thyroid carcinoma can serve as prognostic indicators, with the benign feature group having a more favorable prognosis than the malignant feature group. Medullary thyroid carcinoma demonstrates two distinct sonographic patterns. The benign feature group, often exhibiting benign-appearing features, is associated with a significantly more favorable prognosis than the malignant feature group. Recognising the benign feature group pattern is crucial to avoid misdiagnosis, and preoperative ultrasound features serve as valuable prognostic indicators.

Bedside ultrasound of inferior vena cava is used by clinician sonographers in intensive care units. Its data can impact clinical decision-making. Subcostal view is a standard view for this issue. A significant proportion of the intensive care unit patients have very difficult approach to this view. In these patients, an alternative view is a transhepatic view, feasible in nearly every intensive care unit patient. Limited data on the ultrasound technique exist in literature. In this review, we discuss in detail the technical aspects of the inferior vena cava ultrasound technique assessed from the transhepatic view, ultrasound tips, and pitfalls. A search was performed using PubMed, Google Scholar, EMBASE, and Scopus databases with the terms "inferior vena cava ultrasound," "transhepatic view," "right mid-axillary view," "right lateral intercostal view," "ultrasound technique," "inferior vena cava pitfalls," and inferior vena cava ultrasound tips," "intensive care unit." The latest articles were reviewed and this review was written using the most current information. A standardised ultrasound approach from mid-axillary line provides optimal image acquisition. When there are difficulties finding inferior vena cava or in obesity alternative approaches should be used. Potential pitfalls during acquisition are: misidentifying the inferior vena cava; technical issues in inferior vena cava measurements; utility of the inferior vena cava data in isolation. Mastering the ultrasound technique from the transhepatic view offers clinicians the opportunity to perform inferior vena cava ultrasound, even in the most challenging patients. Awareness of potential pitfalls and knowledge how to avoid them is important to intensive care unit clinicians to avoid wrong decisions at the bedside.

The ultrasound-guided attenuation parameter is well established for hepatic steatosis detection in metabolic dysfunction-associated steatotic liver disease. The diagnostic performance of ultrasound-guided attenuation parameter was evaluated using different numbers of measurements at different lateral locations to detect hepatic steatosis ⩾ S1 in male and female patients with metabolic dysfunction-associated steatotic liver disease. A metabolic dysfunction-associated steatotic liver disease cohort was prospectively enrolled in autumn of 2022. Ultrasound-guided attenuation parameter values obtained through one to five measurements, performed at single and multiple locations, were compared with proton density fat fraction. Presence of hepatic steatosis (i.e. ⩾ S1) with ultrasound-guided attenuation parameter was defined as a proton density fat fraction of ⩾ 5%. Diagnostic performance was evaluated based on the area under the receiver operating characteristic curve. Included 60 participants with an even sex distribution. Ultrasound-guided attenuation parameter diagnostic performance to detect hepatic steatosis ⩾ S1 did not significantly differ according to the number of measurements (from 1 to 5), different lateral locations, or patient sex. Ultrasound-guided attenuation parameter performed using five measurements in one location exhibited a receiver operating characteristic curve of 0.87 (95% confidence interval: 0.78, 0.97), and a threshold of 0.53 dB/cm/MHz, yielding 90% sensitivity and 65% specificity. Three measurements in multiple lateral locations exhibited a receiver operating characteristic curve of 0.91 (95% confidence interval: 0.84, 0.98), with a threshold of 0.58 dB/cm/MHz, yielding 95% sensitivity and 75% specificity. Ultrasound-guided attenuation parameter diagnostic performance to detect hepatic steatosis ⩾ S1 in metabolic dysfunction-associated steatotic liver disease is similar with regions of interest in single versus multiple lateral locations. Three measurements in multiple lateral locations appear sufficient to detect hepatic steatosis, which must be evaluated for all hepatic steatosis stages.

Mesenteric adenitis is a commonly made diagnosis for children presenting to the Paediatric Emergency Department with acute abdominal pain. Ultrasound is recommended as the first-line imaging modality for children with right-sided abdominal pain owing to its safety and diagnostic value. Unlike appendicitis, however, diagnostic criteria for mesenteric adenitis are not clearly defined. To synthesise the literature on ultrasound findings for paediatric mesenteric adenitis, including diagnostic criteria, sonographic appearances and techniques. By undertaking this review, we aimed to identify gaps in the literature to inform future research. We conducted a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. We searched PubMed, Embase, Scopus and the Cochrane Library for studies involving patients 1-18 years who underwent radiology-performed or point-of-care ultrasound for suspected mesenteric adenitis with findings synthesised thematically. Seventeen studies were included. Only one evaluated point-of-care-ultrasound. Definitions of mesenteric adenitis were heterogeneous in terms of the number of lymph nodes visible and lymph node size. Associated features such as bowel wall thickening, periportal cuffing and systemic signs were reported inconsistently. Advanced modalities including Doppler, superb microvascular imaging and elastography were explored in a minority of studies, while few provided longitudinal follow-up data. Sample sizes were generally small, designs were retrospective, and interobserver reliability was rarely assessed. Ultrasound is widely used for paediatric mesenteric adenitis, but diagnostic criteria lack consensus. Evidence reporting the use of point-of-care ultrasound is minimal. Prospective studies are needed to establish reliable diagnostic criteria and clarify the clinical utility of point-of-care ultrasound in this setting.

Female pelvic congestion syndrome is associated with chronic pelvic pain and affects approximately 30% of women. There are no formal diagnostic criteria to assist with the diagnosis of pelvic congestion syndrome despite affecting such a large proportion of the population. Furthermore, the aetiology and anatomy of pelvic congestion syndrome has significant overlap with the causal factors of varicoceles in men, many of whom also experience chronic pain/aching. However, women are at greater risk of developing venous damage associated with pelvic congestion syndrome due to hormonal changes and pregnancy, both of which exacerbate pelvic congestion syndrome and its causes. A narrative review methodology was utilised to search for literature discussing ultrasound and its role in the diagnosis of pelvic congestion syndrome. The search used two databases and explored 'grey' literature published between 2014 and 2024. Sensitivities and specificities of diagnostic criteria proposed have been reported as well as other metrics which may be utilised in the ultrasound diagnosis of pelvic congestion syndrome. Ultrasound appearances associated with pelvic congestion syndrome include dilated pelvic veins, specifically; the left ovarian vein, adnexal veins, and intrauterine/myometrial veins. There are, however, few high-quality comparative studies assessing the accuracy of different venous diameter cut-off values which may be used in the diagnosis of pelvic congestion syndrome. Other ultrasound findings cited commonly include slow venous flow of less than 3 cm per second and demonstrable venous reflux on Valsalva manoeuvre. Currently there are insufficient data to conclude formal diagnostic ultrasound criteria for pelvic congestion syndrome. Existing evidence supports a multifaceted diagnostic approach and ultrasound practitioners must be mindful of patients' clinical history and potential associated ultrasound features to avoid underdiagnosis of this common condition. In the meantime, further primary research is needed before the full value of ultrasound can be understood.

The spinal accessory nerve is the external terminal division of the 11th cranial nerve which passes postero-inferiorly in the neck, innervating the sternocleidomastoid and trapezius muscles. The spinal accessory nerve is often in the field of view of neck ultrasound imaging, however, can be overlooked and underappreciated during sonographic neck imaging and ultrasound-guided lymph node biopsies. A scoping review of the literature was conducted to assess current knowledge regarding sonographic imaging of the spinal accessory nerve. The authors' sonographic experience and practical sonographic workshops informed the development of a sonographic technique to image this nerve. Iatrogenic injury is a common cause of spinal accessory neuropathy, particularly from needle biopsies of neck lymph nodes and surgery. Ultrasound imaging can effectively demonstrate the extracranial component of the spinal accessory nerve. An appreciation of the anatomy and path of the spinal accessory nerve is important to ensure appropriate sonographic identification of the spinal accessory nerve and ensure it is not in the needle path during ultrasound-guided neck lymph node biopsies. In addition, ultrasound imaging can be used to diagnose spinal accessory nerve injury, pathology and subsequent denervation of the sternocleidomastoid and trapezius muscles which can affect neck and shoulder pain and mobility, negatively impacting daily activities. Awareness of the spinal accessory nerve anatomy and imaging appearances is required when sonographically imaging the neck to identify the spinal accessory nerve, ensuring it is not in the needle path during ultrasound-guided neck biopsies and identifying any potential injury or pathological involvement.

This study aimed to evaluate the effects of dietary composition, physical activity, and body mass index on gallbladder recovery time following food consumption and to identify alternative scan preparation strategies for patients unable to fast before abdominal ultrasound. A quasi-experimental study involving 26 participants was conducted using four ultrasound sessions under different conditions: consumption of each dietary item with and without moderate physical activity. Gallbladder wall thickness and volume were measured hourly following standardised ultrasound protocols. Measurement reliability was assessed using the intraclass correlation coefficient on 30 randomly selected scans reviewed by two independent observers. Recovery time significantly varied among meal types (&#x3c7;&#xb2;(2)&#x2009;=&#x2009;18.42, p&#x2009;<&#x2009;.001), with wholemeal bread yielding the fastest and yogurt the slowest recovery. Physical activity significantly enhanced wall recovery (p&#x2009;=&#x2009;0.002) but did not affect volume (p&#x2009;=&#x2009;0.317). Body mass index showed no significant effect. Moderate and excellent intraclass correlation coefficients were achieved for gallbladder wall thickness (0.52) and volume (0.88), respectively. Wholemeal bread and postprandial physical activity serve as effective alternatives for ultrasound preparation when assessing gallbladder wall recovery. These findings promote patient-specific ultrasound protocols to improve diagnostic efficiency and comfort.

Three-dimensional prenatal ultrasound scans of a baby's facial features have become increasingly popular among parents in both private and clinical settings. Ultrasound practitioners often draw on their experience to identify factors that influence image quality when discussing scan outcomes with parents. This study aims to identify the maternal, fetal and technical factors that may affect the quality of three-dimensional souvenir face images during ultrasound scan. A retrospective quality review study was performed with data from a single-centre research study, including ultrasound videos of the fetal growth scans, three-dimensional facial ultrasound acquisitions and post-processing steps. A total of 342 three-dimensional surface-rendered images were attempted from 41 singleton pregnancy subjects, average gestational age 26.69&#x2009;weeks, range: 21-30. The retrospective image quality for all images was assessed by two observers. Univariable ordinal regression test was used to investigate the associations between demographic/technical factors and the best image quality acheiveable. Of the 41 pregnancies, three-dimensional acquisition time was an average of 03:07 (mm:ss), (range: 01:22-5:31). In total, 49% of women had at least one good or moderate quality image, and 51% women had a poor quality or failed three-dimensional scan as the best quality possible. Image quality was associated with placenta site, explaining 18% of the variation (p&#x2009;<&#x2009;0.05). We found a maternal-fetal factor which has a high impact on three-dimensional image quality of the prenatal face but nonetheless, sonographer skill, training and other technical factors may be employed to minimise the impact of detrimental factors.

This study intends to develop a scoring model for using oral contrast-enhanced ultrasound to aid in the imaging diagnosis of gastric cancer. Patients with a pathological diagnosis of gastric lesions who underwent oral contrast-enhanced ultrasound examination in our hospital from September 2019 to December 2021 were included. The age, gender, and ultrasound image characteristics of the patients were analysed, and a scoring model was established. The area under the receiver operating characteristic curve was used to evaluate the model's discriminative performance, and the Hosmer-Lemeshow test was used to assess its goodness-of-fit. A total of 66 patients were included in this study. Pathological examination confirmed malignant lesions in 9 patients and benign lesions in 57. The variables age, male sex, gastric wall thickness, loss of wall stratification, ulceration, and the presence of blood flow signals were used to establish a scoring model. A score greater than 4.65 was considered indicative of gastric cancer. The model demonstrated discriminative ability, with an area under the receiver operating characteristic curve of 0.92 (95% confidence interval, 0.83-0.97, p&#x2009;<&#x2009;0.0001). The Hosmer-Lemeshow test indicated good calibration (p&#x2009;>&#x2009;0.05). This scoring system using oral contrast-enhanced ultrasound exhibited good diagnostic capability for gastric cancer and thus may be useful for screening. It will still require subsequent investigation of its reliability through prospective studies.

Ultrasound-guided microwave ablation is a minimally invasive alternative to surgery for symptomatic benign thyroid nodules, but most outcome data originates from East Asian centres, and evidence from European and Middle Eastern populations is limited. We evaluated the 12-month volumetric response, safety and subgroup outcomes of microwave ablation in a Turkish cohort. In this single-centre retrospective cohort, 180 consecutive patients with cytologically benign thyroid nodules and complete follow-up underwent ultrasound-guided microwave ablation between January 2019 and May 2025. Thyroid nodule volume was measured by ultrasound at baseline and at 3, 6 and 12&#x2009;months; volume reduction rate was the primary outcome. Change over time was assessed with repeated-measures analysis of variance (volume) and the Friedman test (volume reduction rate). Mean volume of benign thyroid nodules fell from 10.29&#x2009;&#xb1;&#x2009;4.15 to 2.86&#x2009;&#xb1;&#x2009;1.23&#x2009;cm3 (F&#x2009;=&#x2009;999.7, p&#x2009;<&#x2009;0.001, &#x3b7; p 2 &#x2009;=&#x2009;0.848). The median volume reduction rate rose from 40.9% at 3&#x2009;months to 62.5% at 6&#x2009;months and 72.6% at 12&#x2009;months (p&#x2009;<&#x2009;0.001). All patients reached &#x2a7e;50% volume reduction rate by 6&#x2009;months, and 65.6% reached &#x2a7e;70% by 12&#x2009;months. Outcomes were independent of sex and baseline volume. No major complications occurred, and 80.6% reported complete symptom resolution. Ultrasound-guided microwave ablation achieved substantial and safe 12-month volume reduction in benign thyroid nodules, supporting it as a viable alternative to thyroidectomy in carefully selected patients.

To evaluate the diagnostic performance of cystic artery colour Doppler ultrasound indices in differentiating acute from chronic cholecystitis and to assess their added value over clinical and grayscale findings. In this prospective study, 101 adults with clinically suspected cholecystitis underwent ultrasound before cholecystectomy. Grayscale features and colour Doppler measurements of cystic and hepatic artery peak systolic velocity and resistive index were recorded; histopathology was the reference standard. Logistic regression models using clinical and grayscale variables alone and then with cystic artery peak systolic velocity were evaluated with receiver operating characteristic analysis. In total, 33 patients had acute and 68 had chronic cholecystitis. Acute cholecystitis showed more abnormal grayscale features, including increased gallbladder size, wall thickening and pericholecystic change. Cystic artery peak systolic velocity was higher in acute than chronic disease (40.8&#x2009;&#xb1;&#x2009;14.9 vs 26.1&#x2009;&#xb1;&#x2009;15.5&#x2009;cm/s; p&#x2009;<&#x2009;0.001), as was hepatic artery peak systolic velocity (74.0&#x2009;&#xb1;&#x2009;24.4 vs 60.2&#x2009;&#xb1;&#x2009;22.4&#x2009;cm/s; p&#x2009;=&#x2009;0.006), whereas resistive index did not differ meaningfully. Cystic artery peak systolic velocity showed fair discrimination (area under the curve 0.78; cut-off 31.5&#x2009;cm/s; sensitivity 0.91; specificity 0.71); hepatic artery peak systolic velocity performed more modestly (area under the curve 0.67). Adding cystic artery peak systolic velocity to a grayscale-only model produced negligible improvement in overall performance. Cystic artery peak systolic velocity is a useful adjunct for distinguishing acute from chronic cholecystitis when grayscale findings are equivocal, whereas resistive index adds little diagnostic value. Routine Doppler assessment is unlikely to change decisions when grayscale ultrasound is definitive.

Thermal ablation has gathered population for treatment of benign thyroid nodules in recent years as an alternative to surgery. This utilises techniques such as radiofrequency, microwave and laser ablation. Contrast-enhanced ultrasound has also gained widespread use over the last few decades and offers a number of advantages in intervention. This article will describe the utility of contrast-enhanced ultrasound in microwave thyroid ablation from a pre-procedure, intraprocedural and post-procedural perspective. The application of contrast-enhanced ultrasound allows for a more comprehensive management strategy for thyroid nodule ablation.

Ovarian torsion is a surgical emergency in which twisting of the ovarian vascular pedicle leads to ischaemia. Although an uncommon diagnosis in prepubescent girls, prompt recognition of this condition is essential in order to prevent ovarian necrosis, which can have long-term consequences in terms of fertility. Transabdominal ultrasound is the recommended imaging modality for diagnosing ovarian torsion; however, given the limited availability of paediatric-trained sonographers, patients may not obtain the necessary imaging in a timely manner. Point-of-care ultrasound performed by emergency department personnel has emerged as a useful adjunct to clinical examination and one that can help expedite specialist involvement. We describe two cases of prepubescent ovarian torsion presenting to our Paediatric Emergency Department, where point-of-care ultrasound played a key role in diagnosis and expediting definitive surgical management.

Artery flow-mediated dilation (FMD) is a non-invasive method for assessing vascular endothelial function and cardiovascular disease risk. Flow-mediated dilation is calculated as the percentage increase in arterial diameter following a post-ischemic increase in blood flow through ultrasound analysis. Manual extraction of flow-mediated dilation scores is time-consuming, operator-dependent, and prone to variability. Automated software solutions for processing ultrasound data could enhance efficiency, accuracy, standardisation, and scalability for clinical and research applications, especially when distributed as free, open-source tools accessible even to non-coders. However, no current software tools reporting these features are available for automatic flow-mediated dilation extraction. We developed aFMD Master, a free, open-source software tool with an intuitive graphical interface designed for non-coders. The software is compatible with most of the videos from different ultrasound scanners, extracts arterial diameters, and outputs PDF reports and Excel datasheets with flow-mediated dilation scores. Validation was conducted by comparing software outputs with manually obtained data from 115 participants, using scatter plots, Bland-Altman analysis, and other appropriate statistical metrics. Strong correlation between the software and manual methods was obtained (R&#xb2;&#x2009;=&#x2009;0.97, p&#x2009;<&#x2009;0.01). The Bland-Altman analysis showed minimal bias (-0.0015%), with 95% limits of agreement between -0.28% and 0.28%. The software showed high accuracy, minimal bias, and low variability, with negligible impact of errors, reflecting strong precision, consistency, and reliability. Validation showed excellent agreement with manual analysis, confirming accuracy, low bias, and consistency. The aFMD Master offers an accessible and reliable solution for automated flow-mediated dilation analysis, showcasing significant potential for research and clinical applications.

Fine-needle aspiration is a recommended, minimally invasive test that may be performed by radiologists and advanced practice sonographers to meet increasing service demands. Adequacy rates vary significantly in the published literature. To assess the adequacy rate of ultrasound-guided fine needle aspiration in head and neck lesions between operator groups: radiologists and sonographers. Other factors that may potentially affect adequacy rates such as the number of passes, use of local anaesthetic, sample tissue type and needle gauge have also been investigated. A retrospective review of the local radiology reporting system of all ultrasound-guided head and neck fine needle aspiration samples over a 3-year period was undertaken. Correlation was made with the final cytology report to assess for sample adequacy. In total, 927 fine needle aspiration samples were included. Of these, 331 (35.7%) were taken by radiologists, and 596 (64.3%) were taken by sonographers. Both groups achieved similar adequacy rates (~84%), and no statistical difference was seen between operator type and adequacy rate. Our study provides a good example of a cohesive department where both radiologists and sonographers contribute to a consistent and equitable service.

This study evaluates the impact of a Point-of-Care Ultrasound (POCUS) workshop delivered at the 6th Radiology Resident Forum conference, assessing how its student-led and clinician-supervised approach affects the knowledge, confidence and attitude of workshop participants, giving scope for future recommendations of implementation of formal POCUS teaching in medical curricula. Four POCUS workshops were conducted at an international radiology conference, with participants comprising of resident doctors and medical students. Workshop sessions included a 15-min teaching session and a 40-min hands-on session covering POCUS fundamental skills. Pre- and post-workshop participant and instructor questionnaires assessed educational merit using three domains of Bloom's taxonomy: knowledge, confidence and skill. Statistical analysis with Wilcoxon signed-rank tests was used to compare pre- and post-workshop scores for paired Likert-type scale responses. Thirty-nine participants were included, the majority of which were resident doctors (74.3%) with minimal exposure to ultrasound. Wilcoxon signed-rank tests demonstrated statistically significant improvement across all three Bloom's domains (p&#x2009;<&#x2009;0.01). All attendees considered POCUS a valuable addition to clinical practice and indicated a willingness to continue their learning. Instructor post-workshop skill assessments categorised attendees as proficient-to-expert with respect to ergonomics, scanning and image interpretation. POCUS is increasingly being shown to augment clinical examination and improve patient flow and outcomes. As such, there is an unmet demand from resident doctors to learn this skill. We demonstrate that structured, near-peer POCUS workshop teaching for resident doctors can result in significant short-term skill improvement and educational merit, suggesting justification for its formal implementation within UK postgraduate curricula.

Fibromatosis colli, or sternocleidomastoid pseudotumor of infancy, is a rare condition characterised by a unilateral neck mass in infants, often associated with birth trauma. Ultrasound is the primary diagnostic tool, but the role of Doppler ultrasound to assess lesion vascularity is underexplored. This study investigates the vascularity of fibromatosis colli lesions and explores its possible clinical implications. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four databases were searched twice for case reports involving patients aged 0-16 years diagnosed with fibromatosis colli and assessed with Doppler ultrasound. Data was analysed using SPSS&#xae; to identify the proportion of vascularised fibromatosis colli lesions, with a secondary aim of establishing if there is a link between vascularisation status and age. Twenty case reports (34 cases total) were included. Sixty-two per cent of lesions were vascularised on Doppler ultrasound. No significant age-related difference (p = 0.24) was found between patients with vascularised versus non-vascularised lesions. Doppler ultrasound is underused for assessing vascularity in fibromatosis colli, and standardised imaging protocols are lacking across published reports. The prognostic value of the presence of vascularisation in fibromatosis colli remains uncertain due to the limited and heterogeneous nature of the data. Larger, prospective studies using clearly defined Doppler protocols are necessary to determine the clinical relevance of vascularisation in fibromatosis colli management.

Pelvic ultrasound examination is the diagnostic modality of choice for the determination of early pregnancy loss. To evaluate the diagnostic performance of mean gestational sac diameter and crown-rump length for identifying early pregnancy loss in patients with an intrauterine pregnancy of uncertain prognosis. We searched MEDLINE, Embase, Cochrane Library, Scopus, and other databases to identify studies of first-trimester pregnant patients with intrauterine pregnancy of uncertain prognosis that reported diagnostic accuracy for mean gestational sac diameter and crown-rump length. Two reviewers separately screened studies, extracted data, and assessed quality using modified QUADAS-2. We reported operating characteristics (sensitivity, specificity, likelihood ratios) of mean gestational sac diameter and crown-rump length for predicting early pregnancy loss. Fourteen studies met the inclusion criteria. Study methods, cutoff values, and outcome standards varied widely. Across all clinical categories, studies consistently demonstrated high specificity for early pregnancy loss using mean gestational sac diameter and crown-rump length thresholds, ranging from 88% to 100%. In contrast, sensitivity was highly variable and generally low, ranging from 2% to 100%. The positive likelihood ratio was typically high (median = 30; interquartile range = 19-76), indicating that meeting diagnostic thresholds substantially increased the probability of early pregnancy loss. However, the negative likelihood ratio was less informative (median = 0.64; interquartile range = 0.46-0.85), limiting the ability of these criteria to reliably exclude early pregnancy loss. Mean gestational sac diameter and crown-rump length measurements have high specificity and high positive likelihood ratio for identifying early pregnancy loss. Their low sensitivity and higher negative likelihood ratio limit their use in ruling out early pregnancy loss. Conservative cutoff values are useful for confirming early pregnancy loss when clearly met; however, early ultrasound findings alone are often insufficient to rule out pregnancy loss with confidence.

Liver involvement is a rare ongoing occurrence of systemic sarcoidosis, and it can be difficult to recognise. A case of how imaging was used to diagnose hepatic sarcoidosis in a 45-year-old male with clinical and biochemical signs of hepatic liver disease is reported. Hepatic sarcoidosis may initially present with abnormality in liver function. The presence of multiple focal liver lesions may be seen on B-mode ultrasound imaging, suggesting a differential diagnosis of inflammatory, infectious, immunological, or neoplastic pathologies with potential hepatic involvement. In this case, ultrasound imaging, with colour Doppler, was the first tool with which to decide the next steps. The use of colour and pulsed Doppler demonstrated signs of compression of the hepatic microcirculation by liver nodules, compatible with a systemic pathology such as hepatic sarcoidosis. The definitive diagnosis was then reached via liver biopsy. Superb microvascular imaging, colour-power Doppler, and pulsed Doppler are important adjuncts to B-mode ultrasound imaging of the liver, which allow identification of hepatic microvascular circulation compression necessary to inform a timely diagnosis of hepatic sarcoidosis and inform treatment.