Hepatic masses include a variety of benign and malignant lesions originating in the liver, and ultrasonography is one of the most basic and essential imaging tools for evaluating these lesions. This review comprehensively summarizes the ultrasonographic findings of hepatic masses by lesion type and examines the interpretation and clinical significance of each. In regions like Korea, where chronic liver disease is highly prevalent, the role of ultrasonography is particularly important. Accurate diagnosis and formulation of treatment strategies require skilled interpretation of ultrasound images.

Diastolic dysfunction (DD) is often associated with impaired relaxation, loss of restorative forces, reduced compliance during diastole, and elevated filling pressures within the left ventricular cavity. Various conditions have been linked to the development of DD, and evaluation for DD is most common during an evaluation of heart failure with preserved ejection fraction. Although the gold standard for assessing diastolic function is an invasive hemodynamic study, that is often inaccessible or unpragmatic in clinical settings. Therefore, sonography, specifically echocardiography, is the first-line modality for DD assessment. This review article details the what (i.e., what is diastolic function and dysfunction), when (i.e., when should diastolic function be measured, and when is caution advised) and how (i.e., how should diastolic function be measured) of DD assessment via sonography. For the sake of pragmatism and familiarity, the American Society of Echocardiography/ European Association of Cardiovascular Imaging 2016 algorithms will be discussed in this article. However, clinicians should familiarize themselves with the limitations of those algorithms. Through advances in the field of diastology, including the use of strain imaging, assessment of diastolic function will continue to become more inclusive and comprehensive.

In patients with recurrent spontaneous bacterial peritonitis, repeated inflammation may occasionally lead to fibrosis and adhesions within the peritoneal cavity, resulting in fibrous septations that give ascites a spider web-like appearance. These septations can interfere with the diffusion of antibiotics and hinder effective drainage of ascitic fluid, rendering standard treatment with antibiotics and paracentesis less effective—particularly when accompanied by refractory ascites. In this case, intraperitoneal administration of tissue plasminogen activator (tPA) via an indwelling catheter helped dissolve the fibrous septa and led to noticeable clinical improvement in a patient unresponsive to the standard therapy. However, intraperitoneal tPA therapy carries potential risks, including bleeding and infection. Therefore, it should be considered only after a thorough evaluation of the patient’s overall condition and bleeding risk, weighing the potential benefits against the possible complications.

A 50-year-old female with pheochromocytoma presented with chest pain and high blood pressure. Laboratory tests revealed elevated creatine kinase-MB (5.0 ng/mL), high-sensitivity troponin I (0.954 ng/mL), and N-terminal pro-B-type natriuretic peptide (238 pg/mL). Echocardiography revealed a left ventricular ejection fraction (LVEF) of 48% with regional wall motion abnormalities (RWMA) consistent with the reverse Tako-Tsubo pattern. Coronary angiography and ergonovine provocation test were unremarkable. Cardiac fluoro-deoxy-glucose positron emission tomography (PET)/magnetic resonance confirmed stress-induced cardiomyopathy (SCMP) with myocardial edema. Catecholamine levels were markedly elevated one month prior. Whole-body PET/computed tomography identified a hypermetabolic 3.8 cm left adrenal mass, consistent with pheochromocytoma. Follow-up echocardiography showed complete recovery of LVEF and RWMA. Reverse Tako-Tsubo, an atypical variant of SCMP, presents with basal hypokinesis and apical sparing, unrelated to coronary territory. This case emphasizes the importance of recognizing pheochromocytoma-induced SCMP and highlights the utility of multimodal imaging in its diagnosis and management.

Primary hyperparathyroidism (PHPT) with concomitant thyroid cancer is rare and is usually caused by a parathyroid adenoma rather than parathyroid carcinoma. Although an association between PHPT and well-differentiated thyroid carcinoma has been reported, it is often considered coincidental. We report a case of a 50-year-old female presenting with tingling, shoulder pain, muscle weakness, and elevated serum calcium and parathyroid hormone levels. Neck ultrasonography revealed a hypoechoic nodule in the left inferior region to the thyroid gland and thyroid nodules in both lobes. A Tc99m-MIBI parathyroid scan showed a focal hot nodule, and fine-needle aspiration confirmed papillary thyroid carcinoma, later verified by histopathology. The patient underwent surgery and was diagnosed with PHPT and papillary thyroid carcinoma. This case highlights the importance of evaluation for concomitant thyroid malignancy in PHPT patients with suspicious thyroid nodules.

Artifacts appearing during ultrasound examinations are commonly observed not only in conventional ultrasound but also in vascular ultrasound. Artifacts can distort positive findings, leading to different results or appearing as negative findings, or conversely, make non-existent findings appear present. In vascular ultrasound, grayscale imaging is fundamental, but images from Doppler modes—such as color Doppler, spectral Doppler, and power Doppler—play an even more crucial role in clinical diagnosis and treatment planning. This paper therefore aims to examine common artifacts observed in vascular ultrasound examinations.

Rheumatoid arthritis, osteoarthritis, and gout present with similar clinical symptoms but differ substantially in pathophysiology and therapeutic strategies, making accurate differential diagnosis essential. Musculoskeletal ultrasound is a non-invasive, real-time imaging modality that plays an important role in the evaluation of arthritis. This review summarizes the diagnostic value, characteristic ultrasonographic findings, and clinical applications of musculoskeletal ultrasound in arthritic conditions. In rheumatoid arthritis, synovial hypertrophy, increased power Doppler signal, and early bone erosions were detected with high sensitivity. In osteoarthritis, structural alterations such as osteophytes, cartilage damage, and meniscal protrusion were identified. In gout, hallmark features including the double contour sign, tophus formation, and crystal deposition were clearly visualized, and ultrasound was effective in monitoring therapeutic response. Overall, musculoskeletal ultrasound is a highly useful imaging technique for the early diagnosis, differential assessment, disease activity evaluation, and treatment monitoring of arthritis.

The use of artificial intelligence (AI) in thyroid ultrasound is bringing important changes to endocrine imaging, helping improve diagnostic accuracy and make the assessment of thyroid nodules more consistent. This review examines the current applications, technological approaches, clinical performance, adversities, and future directions of AI-based systems in thyroid ultrasound. Recent studies suggest that AI technologies hold significant potential in thyroid ultrasound, particularly in automated nodule detection, classification, and risk stratification. Deep learning models, particularly convolutional neural networks, achieve diagnostic accuracies exceeding 90% in distinguishing benign from malignant nodules, often matching or surpassing human radiologist performance. Current applications include Thyroid Imaging Reporting and Data System-based classification systems, lymph node metastasis prediction, and real-time diagnostic assistance. However, challenges including reproducibility concerns, clinical workflow integration, and regulatory considerations remain significant barriers to widespread adoption. While AI shows remarkable promise in thyroid ultrasound applications, challenges including validation requirements, standardization needs, and clinical integration barriers must be addressed for widespread adoption. Future developments should focus on multimodal integration, explainable AI systems, and prospective clinical trials to fully utilize the potential of AI in transforming thyroid diagnostics.