Ultrasound is a non-invasive, real-time, inexpensive, radiation-free and easily repeatable method, usually used for liver imaging. In recent years, new ultrasound examination techniques for liver diseases such as contrast-enhanced ultrasound and elastography have been rapidly developed, which can effectively identify intrahepatic space-occupying lesions, assess the degree of liver fibrosis and portal hypertension, and monitor the effects of treatment. Therefore, these technologies play an important diagnostic role in clinical liver diseases and have therapeutic interventional value. This guideline classifies the instrument set-up, patient preparation, and physician examination methods through multimodal ultrasound examinations (gray-scale ultrasound, color Doppler ultrasound, contrast-enhanced ultrasound, elastic ultrasound) for liver diseases. In addition, liver diseases multimodal ultrasound technology diagnostic criteria for diffuse hepatic lesions (inflammatory lesions, fibrosis, and sclerosis), multiple space-occupying lesions, and interventional procedures have been defined and standardized. Concurrently, we also recommend the ultrasound monitoring time interval and diagnostic report writing standard for liver diseases.
Elasticity Imaging Techniques ; Humans ; Hypertension, Portal ; Liver/diagnostic imaging* ; Liver Cirrhosis ; Liver Diseases/diagnostic imaging* ; Ultrasonography

Portal hypertension (PHT) is a common complication of liver cirrhosis, which could be measured by the means of portal vein pressure (PVP). However, there is no report about an effective and reliable way to achieve noninvasive assessment of PVP so far. In this study, firstly, we collected ultrasound images and echo signals of different ultrasound contrast agent (UCA) concentrations and different pressure ranges in a low-pressure environment based on an
Contrast Media ; Humans ; Hypertension, Portal/diagnostic imaging* ; Liver Cirrhosis ; Portal Vein/diagnostic imaging* ; Ultrasonography

BACKGROUND: Adipose tissue accumulation in specific body compartments has been associated with diabetes, hypertension and dyslipidemia. Perirenal fat (PRF) may lead to have direct lipotoxic effects on renal function and intrarenal hydrostatic pressure. This study was undertaken to explore the association of PRF with cardiovascular risk factors and different stages of chronic kidney disease (CKD). METHODS: We studied 103 patients with CKD of different stages (1 to 5). PRF was measured by B-mode renal ultrasonography in the distal third between the cortex and the hepatic border and/or spleen. RESULTS: The PRF thickness was greater in CKD patients with impaired fasting glucose than in those with normal glucose levels (1.10 ± 0.40 cm vs. 0.85 ± 0.39 cm, P < 0.01). Patients in CKD stages 4 and 5 (glomerular filtration rate [GFR] < 30 mL/min/1.73 m²) had the highest PRF thickness. Serum triglyceride levels correlated positively with the PRF thickness; the PRF thickness was greater in patients with triglyceride levels ≥ 150 mg/dL (1.09 ± 0.40 cm vs. 0.86 ± 0.36 cm, P < 0.01). In patients with a GFR < 60 mL/min/1.73 m², uric acid levels correlated positively with the PRF thickness (P < 0.05). CONCLUSION: In CKD patients, the PRF thickness correlated significantly with metabolic risk factors that could affect kidney function.
Adipose Tissue ; Dyslipidemias ; Fasting ; Filtration ; Glucose ; Humans ; Hydrostatic Pressure ; Hypertension ; Kidney ; Renal Insufficiency ; Renal Insufficiency, Chronic ; Risk Factors ; Spleen ; Triglycerides ; Ultrasonography ; Uric Acid

Whole body ultrasound can be used to improve the speed and accuracy of evaluation of an increasing number of organ systems in the critically ill. Cardiac and abdominal ultrasound can be used to identify the mechanisms and etiology of hemodynamic instability. In hypoxemia or hypercarbia, lung ultrasound can rapidly identify the etiology of the condition with an accuracy that is equivalent to that of computed tomography. For encephalopathy, ocular ultrasound and transcranial Doppler can identify elevated intracranial pressure and midline shift. Renal and bladder ultrasound can identify the mechanisms and etiology of renal failure. Ultrasound can also improve the accuracy and safety of percutaneous procedures and should be currently used routinely for central vein catheterization and percutaneous tracheostomy.
Anoxia ; Brain Diseases ; Catheterization ; Catheters ; Critical Care ; Critical Illness ; Hemodynamics ; Intensive Care Units ; Intracranial Hypertension ; Lung ; Operating Rooms ; Renal Insufficiency ; Tracheostomy ; Ultrasonography ; Urinary Bladder ; Veins

Resistance to thyroid hormone (RTH) is a condition caused by a mutation in the thyroid hormone receptor gene. It is rarely reported in individuals with no family history of RTH or in premature infants, and its clinical presentation varies. In our case, a premature infant with no family history of thyroid diseases had a thyroid stimulating hormone level of 85.0 µIU/mL and free thyroxine level of 1.64 ng/dL on a thyroid function test. The patient also presented with clinical signs of hypothyroidism, including difficulties in feeding and weight gain. The patient was treated with levothyroxine; however, only free thyroxine and triiodothyronine levels increased without a decrease in thyroid-stimulating hormone levels. Taken together with thyroid gland hypertrophy observed on a previous ultrasound examination, RTH was suspected and the diagnosis was eventually made based on a genetic test. A de novo mutation in the thyroid hormone receptor β gene in the infant was found that has not been previously reported. Other symptoms included tachycardia and pulmonary hypertension, but gradual improvement in the symptoms was observed after liothyronine administration. This report describes a case involving a premature infant with RTH and a de novo mutation, with no family history of thyroid disease.
Diagnosis ; Goiter ; Humans ; Hypertension, Pulmonary ; Hypertrophy ; Hypothyroidism ; Infant ; Infant, Newborn ; Infant, Premature ; Receptors, Thyroid Hormone ; Tachycardia ; Thyroid Diseases ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Hormone Receptors beta ; Thyroid Hormone Resistance Syndrome ; Thyrotropin ; Thyroxine ; Triiodothyronine ; Ultrasonography ; Weight Gain

Chronic liver disease is a major disorder worldwide. A better understanding of anatomy, blood flow, and pathophysiology may be a key issue for their proper management. Ultrasound (US) is a simple and non-invasive diagnostic tool in the abdominal field. Doppler mode offers real-time hemodynamic evaluation, and the contrast-enhanced US is one of the most frequently used modalities for the detailed assessment. Further development in digital technology enables three-dimensional (3D) visualization of target images with high resolution. This article reviews the wide ranges of application in the abdominal US and describes the recent progress in the diagnosis of chronic liver diseases.
Diagnosis ; Fibrosis ; Hemodynamics ; Hypertension, Portal ; Liver Diseases ; Liver ; Ultrasonography

BACKGROUND: Elevated intracranial pressure (ICP), a disadvantage of laparoscopic or robotic surgery, is caused by the steep angle of the Trendelenburg position and the CO₂ pneumoperitoneum. Recently, sonographically measured optic nerve sheath diameter (ONSD) was suggested as a simple and non-invasive method for detecting increased ICP. This study aimed to explore the changes in ONSD in relation to different anesthetic agents used in gynecologic surgery.METHODS: Fifty patients were randomly allocated to two groups, sevoflurane (group SEV, n = 25) and propofol-based total intravenous anesthesia (TIVA) group (group TIVA, n = 25). The ONSD was measured at five time points (T0–T4): T0 was measured 5 min after induction of anesthesia in the supine position; T1, T2, and T3 were measured at 5, 15, and 30 min after CO₂ pneumoperitoneum induction in the Trendelenburg position; and T4 was measured at 5 min after discontinuation of CO₂ pneumoperitoneum in the supine position. Respiratory and hemodynamic variables were also recorded.RESULTS: The intra-group changes in mean ONSD in the Trendelenburg position were significantly increased in both groups. However, inter-group changes in mean ONSD were not significantly different at T0, T1, T2, T3, and T4. Heart rates in group TIVA were significantly lower than those in group SEV at points T1–T4.CONCLUSIONS: There was no significant difference in the ONSD between the two groups until 30 min into the gynecologic surgery with CO₂ pneumoperitoneum in the Trendelenburg position. This study suggests that there is no difference in the ONSD between the two anesthetic methods.
Anesthesia ; Anesthesia, Intravenous ; Anesthetics ; Female ; Gynecologic Surgical Procedures ; Head-Down Tilt ; Heart Rate ; Hemodynamics ; Humans ; Intracranial Hypertension ; Methods ; Optic Nerve ; Pneumoperitoneum ; Propofol ; Supine Position ; Ultrasonography

Recent data suggest that subclinical atherosclerosis is more related to visceral adipose tissue distribution than to overall fat mass. Both perirenal fat and epicardial fat are visceral fat depots surrounding the kidneys and the myocardium, respectively, which can be easily assessed by ultrasound. Their clinical relevance in children is largely unknown. This review describes studies relating perirenal and epicardial fat to cardiovascular disease or carotid intima-media thickness (cIMT), a well-established surrogate for subclinical atherosclerosis, and discusses this in context with our own data from children. In adults, both perirenal and epicardial fat are useful biological markers of visceral obesity. The former has been related to hypertension in overweight subjects and with atherosclerosis in patients with human immunodeficiency virus. The latter was associated with several metabolic syndrome components and with calcification of the carotid artery. In healthy prepubertal children, both epicardial and perirenal fat thickness, rather than total body fat mass, were related to cIMT. Ultrasonography measures of perirenal and epicardial fat are related to atherosclerosis in adults and may be convenient tools for the assessment of cardiometabolic risk in children.
Adipose Tissue ; Adult ; Atherosclerosis ; Biomarkers ; Body Fat Distribution ; Cardiovascular Diseases ; Carotid Arteries ; Carotid Intima-Media Thickness ; Child ; HIV ; Humans ; Hypertension ; Intra-Abdominal Fat ; Kidney ; Myocardium ; Obesity, Abdominal ; Overweight ; Ultrasonography

Nutcracker syndrome (NCS) is a syndrome caused by compression of the left renal vein (LRV), between the abdominal aorta and the superior mesenteric artery, resulting in hypertension of the LRV and hematuria. Doppler ultrasonography (US) has been commonly used for the diagnosis of NCS. However, several technical issues, such as Doppler angle and sample volume, need to be considered to obtain satisfactory results. In addition, morphologic changes of the LRV and a jetting phenomenon across the aortomesenteric portion of the LRV on contrast-enhanced computed tomography (CECT) are diagnostic clues of NCS. With proper Doppler US and CECT, NCS can be diagnosed noninvasively.
Aorta, Abdominal ; Diagnosis ; Hematuria ; Hypertension ; Mesenteric Artery, Superior ; Renal Veins ; Tomography, X-Ray Computed ; Ultrasonography, Doppler

BACKGROUND: The detection of thyroid nodules through ultrasonography (US) has improved with the development of imaging technologies and thyroid cancer screening in Korea. We evaluated the relationship between the presence of thyroid nodules on US and thyroid function test (TFT) results in healthy individuals.METHODS: We performed a retrospective review of data from 449 adults (313 men and 136 women) who underwent tests to evaluate serum thyrotropin (TSH) and free thyroxine levels, thyroid US, and if needed, fine needle aspiration cytology (FNAC).RESULTS: Of the 449 subjects, 144 subjects (32.1%) had thyroid nodules. Among the 144 with thyroid nodules, 24 (16.7%) were advised to undergo FNAC, and all of them showed normal serum TSH levels. Logistic regression analysis showed that the presence of thyroid nodules was not related to abnormalities noted on TFTs after adjusting for age, sex, smoking status, and presence of risky drinking behavior and hypertension (P=0.647).CONCLUSION: The presence of thyroid nodules on US in healthy adults was not associated with abnormal TFT results. Serum TSH check-ups during the evaluation of thyroid nodules discovered through US in asymptomatic individuals living in areas with a low prevalence of autonomous functioning thyroid nodules might not be necessary from the perspective of cost-effectiveness and subject convenience.
Adult ; Biopsy, Fine-Needle ; Drinking Behavior ; Humans ; Hypertension ; Korea ; Logistic Models ; Male ; Mass Screening ; Prevalence ; Retrospective Studies ; Smoke ; Smoking ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Thyrotropin ; Thyroxine ; Ultrasonography