Pancreatic cancer typically presents as a focal hypoechoic, hypovascular solid mass with irregular margins on ultrasound. Pancreatic tail disease can be difficult to detect on abdominal ultrasonography. A 75-year-old man visited our institution with upper abdominal pain. We successfully visualized a pancreatic tail mass on abdominal transsplenic scan and multiple liver masses via abdominal transverse scan. His diagnosis was confirmed as pancreatic tail cancer with liver metastasis following endoscopic ultrasound-guided fine-needle biopsy. Abdominal transsplenic scan proved valuable for diagnosing pancreatic tail disease because abdominal ultrasound has limited utility for evaluating pancreatic tail masses due to obscuration by bowel gas.

Thyroid parenchymal disease is an inflammatory disease that occurs in the thyroid parenchyma due to autoimmunity or infection. The differential diagnosis of thyroid parenchymal disease is based on clinical manifestation, physical examination, and serological findings. However, ultrasonography of thyroid has also a role in the diagnosis of thyroid parenchymal disease. This review describes common findings of ultrasonography in each thyroid parenchymal disease.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide, affecting more than 30% of the global population, and is associated with increased liver-related morbidity and mortality, and extrahepatic complications. With the increasing prevalence of MASLD, there is an urgent need for accessible, non-invasive methods to detect hepatic steatosis. Currently, liver biopsy and magnetic resonance imaging proton density fat fraction are considered reference standards for diagnosing hepatic steatosis; however, their invasiveness and limited accessibility limit their widespread use. Ultrasonography (US) is a promising alternative owing to its cost-effectiveness and widespread accessibility. Recently, quantitative US techniques have been developed and commercialized by several vendors to measure steatosis by detecting changes in various acoustic properties associated with hepatic steatosis, making it readily accessible. Controlled attenuation parameter (CAP), which evaluates hepatic steatosis using the attenuation of the US beam, is the most widely studied algorithm as a non-imaging technique. Several other algorithms are also available on B-mode ultrasound systems, and their diagnostic performance is comparable to or better than that of the CAP. Therefore, we aimed to review current US-based methods for detecting and grading hepatic steatosis, discussing their diagnostic performance and utilization.

Systemic amyloidosis is characterized by the accumulation of insoluble proteins in tissues including heart, kidney, liver and any other organs. Light chain amyloidosis is the most common type of primary amyloidosis. And it is generally considered to be the plasma cell dysfunction. Given its pathogenesis, it may affect any organ system. Thus, clinical presentation is variable and delayed diagnosis is common. Given these diagnostic difficulties, we presented a systemic amyloidosis presented as liver dysfunction.

Fascioliasis is zoonotic helminthiasis caused by Fasciola hepatica or F. gigantica that is occasionally reported in South Korea. Humans can become infected through contaminated water, aquatic plants, or the consumption of raw liver. The infection typically presents with non-specific symptoms such as indigestion or fatigue, but can progress to more severe conditions like jaundice or hepatomegaly as the parasite penetrates the liver and resides in the biliary tract. Sonographically, hepatic fascioliasis appears as ill-defined, scattered hypoechoic nodules or mixed-echogenic geographic lesions, sometimes accompanied by track-like lesions. Diagnosis can be challenging without prior suspicion, as it often requires specific imaging findings or laboratory tests, including detecting eggs in stool or antibodies via Enzyme-Linked Immunosorbent Assay. The primary treatment is triclabendazole, which is highly effective in both the acute and chronic phases of the disease. This infection necessitates a cautious diagnostic and treatment approach, especially in cases without a clear history of parasitic infection, as it can be easily overlooked.

Infective endocarditis (IE) remains associated with high morbidity and mortality rates despite advances in medical technology, diagnostics, and treatment. Hospital mortality for IE reaches up to 22%, with a five-year mortality rate of 40%. Globally, the incidence of IE has increased, with recent figures indicating 13.8 cases per 100,000 annually, up from 1.5–11.6 per 100,000 reported between 1990 and 2010. A retrospective cohort study in a tertiary care center in Korea demonstrated a significant rise in the monthly incidence of IE from 2.0 in 2005 to 3.8 in 2017. This increase is attributed to the enhanced utilization of diagnostic tools such as echocardiography, computed tomography (CT), and positron emission tomography (PET). The 2015 European Society of Cardiology (ESC) guidelines incorporated complementary imaging modalities like Single Photon Emission Computed Tomography-CT (SPECT/CT), 18F-FDG PET/CT, and Cardiac CT, alongside traditional transthoracic and transesophageal echocardiography. The 2023 ESC guidelines further expanded these algorithms to include Cardiac CTA, MRI, PET/CT, and WBC SPECT. However, transthoracic, and transesophageal echocardiography remain the primary and essential diagnostic tools for suspected IE. This review examines the role of echocardiography in diagnosing IE, highlighting typical ultrasound findings, valve damage, and associated complications. Ultrasound is pivotal for early detection and prognosis of IE, identifying vegetations, abscesses, pseudoaneurysms, and fistulas. New vegetations typically appear irregular and oscillate, with transthoracic echocardiography detecting vegetations larger than 5mm with 90% sensitivity. Detailed echocardiographic assessment provides critical insights for the surgical management of IE and enhances the understanding of IE’s complex pathology.

Carotid ultrasound is an important tool for evaluating the presence and extent of atherosclerotic plaques. Atherosclerotic plaques play a crucial role in assessing cardiovascular risk and can be particularly helpful in predicting cardiovascular events. This review will present the imaging technique and interpretation of carotid plaque on carotid ultrasound and clinical implication of carotid plaque.