To construct a predictive model for neurological functional prognosis after endovascular thrombectomy in patients with acute anterior circulation large-vessel occlusion (AIS-LVO) based on multimodal cerebral blood flow imaging parameters, including transcranial Doppler, transcranial color-coded Doppler, and computed tomography perfusion, and to evaluate its clinical value.

A total of 174 patients with AIS-LVO who underwent mechanical thrombectomy were retrospectively enrolled. They were divided into a training set (121 cases) and an internal validation set (53 cases) at a ratio of 7∶3. According to the modified Rankin Scale (mRS) scores at 90-day follow-up after thrombectomy in the training set, patients were assigned to the favorable prognosis group and the poor prognosis group. Univariate difference analysis and multivariate Logistic regression analysis were performed to screen for independent risk factors, construct the predictive model, and validate its clinical application value.

Univariate and multivariate regression analyses identified age (OR=1.07, 95%CI: 1.02~1.11), the ratio of the mean velocity difference between the affected and healthy middle cerebral arteries (OR=1.34, 95%CI: 1.04~1.73), onset-to-recanalization time (OR=1.01, 95%CI: 1.01~1.04), and the volume of brain tissue with relative cerebral blood flow ＜30% (OR=1.18, 95%CI: 1.02~1.36) as independent risk factors for poor prognosis after thrombectomy (all P＜0.05). The model was established as follows: Logit (P, probability of poor prognosis) = −6.66 + 0.06 × age (years) + 0.01 × recanalization time (minutes) + 0.30 × ratio of the mean velocity difference between the affected and healthy MCAs + 0.16 × volume of brain tissue with rCBF ＜30% (mL). The area under the ROC curve (AUC) was 0.758 (95%CI: 0.67~0.85), with a theoretical predictive sensitivity of 63.2% and specificity of 83.7%. The Hosmer-Lemeshow goodness-of-fit test showed no significant lack of fit in the training set (P=0.301) or the internal validation set (P=0.126), indicating good calibration. Decision curve analysis suggested good clinical utility of the model.

Integrated models combining multimodal cerebral blood flow imaging and clinical data can improve the accuracy of predicting poor neurological outcomes after thrombectomy in AIS-LVO patients, thereby providing a basis for early warning of postoperative complications and personalized interventions.

To compare the diagnostic efficacy of the remote-reading mode of Automated Breast Ultrasound (ABUS) and Handheld Ultrasound (HHUS) for breast cancer in county-wide hospitals, and to evaluate the clinical performance of the ABUS remote-reading mode in breast cancer screening.

A total of 454 women who underwent breast examinations at the Maternal and Child Health Hospital of Longchuan County, Guangdong Province, from April to October 2021 were retrospectively included. All of them completed both HHUS and ABUS examinations and were assigned BI-RADS classifications accordingly. The scanning and image-reading of HHUS were performed by four ultrasound physicians with over 5 years of experience in breast ultrasound, and the time spent was recorded. ABUS image acquisition was conducted by a technician with at least one year of work experience. The whole-breast images were transmitted to a reading center via dedicated software. Two ultrasound physicians with more than 5 years of experience in breast-specific ultrasound independently interpreted the images and recorded the time spent. All ultrasound images were indepentty reviewed by the readers in a blinded manner. Malignant cases were confirmed by histopathology, while benign and normal cases were confirmed by pathology or two-year follow-up results. The McNemar's test was used to compare sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV); the DeLong's test was used for area under the curve (AUC) comparison; the paired-samples t-test was applied to compare total time and ultrasound physician time; and the chi-square test was used to compare the proportional distribution of BI-RADS 1~2, 3, and 4~5 categories.

A total of 454 women were included in our study, with a mean age of (41.49±7.08) years (range: 20~67 years). There were 9 malignant cases and 445 benign and normal cases. Nine malignant cases were detected by ABUS and six by HHUS. Statistically significant differences were found between the two examinations in specificity, positive predictive value, and the AUC (96.9% and 90.8%, P＜0.01; 39.1% and 12.8%, P＜0.01; 0.99 and 0.85, P=0.028, respectively). The average total time spent was (836±78) seconds for ABUS and (311±77) seconds for HHUS; the average ultrasound physician time spent was (236± 31) seconds for ABUS and (311±77) seconds for HHUS (all P＜0.05). For ABUS and HHUS, respectively, the proportions of BI-RADS 1~2 lesions were 68.7% (312/454) and 54.2% (246/454), BI-RADS 3 were 26.2% (119/454) and 35.5% (161/454), and BI-RADS 4~5 were 5.1% (23/454) and 10.4% (47/454). All intergroup differences were statistically significant (P＜0.05).

In county-wide hospital settings, the remote-reading mode of ABUS demonstrates higher diagnostic performance for breast cancer compared with HHUS, and the diagnostic time consumed by ultrasound physicians for ABUS is shorter than that for HHUS.

To explore the consistency of ultrasound-derived fat fraction (UDFF) measurements between the left and right hepatic lobes, and to evaluate its diagnostic accuracy for metabolic dysfunction-associated steatotic liver disease (MASLD), using magnetic resonance imaging proton density fat fraction (MRI-PDFF) as the reference standard.

This prospective single-center study included 101 participants who underwent both MRI-PDFF and UDFF examinations at Hangzhou First People's Hospital between February 2023 and May 2024. With MRI-PDFF as the reference standard, the intraclass correlation coefficient (ICC), Bland-Altman analysis, and receiver operating characteristic (ROC) curves were used to assess the repeatability, agreement, and diagnostic performance of UDFF.

A total of 101 participants were enrolled in the final cohort (median age 34.0 years; 44 males and 57 females). The median UDFF values in the right and left lobes were 8.0% and 11.0%, respectively, with an overall median UDFF of 10.1%. UDFF measurements demonstrated excellent repeatability (ICC=0.952 for the right lobe and 0.927 for the left lobe). The agreement (ICC=0.904) and correlation (r=0.830) between right-lobe UDFF and MRI-PDFF were significantly stronger than those for the left lobe (ICC=0.836, r=0.669). Bland-Altman analysis revealed a mean bias of 2.0% for the right lobe versus 1.8% for the left lobe; however, the 95% limits of agreement (LoA) were narrower for the right lobe (20.9% vs 29.9%). Right-lobe UDFF exhibited excellent diagnostic performance for mild (AUC=0.882), moderate (AUC=0.970), and severe hepatic steatosis (AUC=0.962), with sensitivities of 78.8%, 96.2%, and 95.0%, and specificities of 93.8%, 92.0%, and 87.7%, respectively. The diagnostic performance of left-lobe UDFF was slightly inferior, with corresponding AUC values of 0.709, 0.921, and 0.942.

UDFF is a reliable, non-invasive tool for quantifying hepatic steatosis and provides valuable information for the clinical diagnosis and grading of MASLD. For optimal performance, measurement of the right hepatic lobe is recommended.

To evaluate the application effect of intraoperative ultrasound in laparoscopic hepatocellular carcinoma (HCC) resection guided by three-dimensional (3D) visualization and multimodal image fusion navigation technology.

A retrospective analysis was conducted on 35 patients with complex HCC who underwent laparoscopic hepatectomy between January 2024 and March 2025 at the Department of Hepatobiliary and Pancreatic Surgery, The Second Hospital of Hebei Medical University. Among them, 15 patients received the combined technology (experimental group), while 20 underwent conventional laparoscopic surgery (control group). Preoperative data, operative time, intraoperative blood loss, number of Pringle maneuvers, postoperative liver function recovery, complications, and short-term recurrence rates were compared between the two groups.

There were no significant differences in preoperative baseline characteristics between the two groups (all P＞0.05). The experimental group had a shorter operative time (P=0.002), fewer Pringle maneuvers (P=0.038), and better postoperative AST (on day 1 and day 3) and ALT (on day 1) levels (all P＜0.05). Postoperative hospital stay and drainage tube duration were also significantly shorter in the experimental group (both P＜0.01). No significant differences were observed in intraoperative blood loss, transfusion rate, complications, or 6-month recurrence rate (all P＞0.05).

Intraoperative ultrasound can further optimize the surgical outcomes of 3D visualization and multimodal image fusion navigation technology in laparoscopic hepatocellular carcinoma resection, reduce surgical trauma, promote postoperative recovery, and demonstrate significant clinical application value.

To evaluate the feasibility and effectiveness of a novel automated scanning ultrasound robot in renal examination.

Consecutive patients scheduled for urinary system ultrasound examinations at Zhongshan Hospital (Xiamen), Fudan University, from March to May 2025 were enrolled. All participants underwent both automated scanning with the ultrasound robot and conventional manual examination by a sonographer. The paired t-test was used to analyze renal length measurements, which conformed to a normal distribution; the Wilcoxon signed-rank test was used to analyze examination time and image quality scores, which were not normally distributed or were ordinal data. Kappa analysis and the intraclass correlation coefficient (ICC) were employed to assess the agreement between the two methods in disease classification and renal length measurements, respectively. Spearman correlation analysis was used to evaluate the correlation between image quality scores. A P-value＜0.05 was considered statistically significant.

A total of 52 patients (103 kidneys) were enrolled, and all patients successfully completed both examinations. Questionnaire survey demonstrated favorable patient acceptance and experience with the robotic examination. The renal length measured by the robot (103.78±8.13) mm was significantly shorter than that measured manually (108.07±8.58) mm, with a mean difference of −4.3 mm (95%CI: −5.56~−3.02, t=−6.69, P＜0.01). The robotic examination required significantly longer scanning time compared to manual examination [(101.84±41.42) s vs (92.84±85.65) s, Z=−3.26, P＜0.01]. Static image quality scores obtained by the robot were lower than those of manual examination [median: 4 (4, 5) vs 5 (4, 5), Z=−5.892, P＜0.001], whereas no significant difference was observed in dynamic video image quality scores between the two methods [median: 4 (4, 5) vs 4 (4, 5), Z=−0.45, P=0.653]. For imaging diagnosis, the two methods showed high agreement in the diagnosis of most renal diseases (0.62≤κ≤1.00), with the lower limits of the 95% CIs all exceeding 0. Subgroup analysis demonstrated that the lesion detection efficacy of the robotic examination exhibited anatomic location-dependent differences, with lower sensitivity at the upper and lower poles (81.25% and 77.27%) compared to the mid-kidney (100.00%), whereas manual examination maintained consistently high sensitivity across all locations (93.75%~100.00%).

The automated ultrasound robot system demonstrates favorable patient acceptability and performs comparably to manual examination in terms of renal length measurement, examination time, image quality, and lesion detection. It shows promise in promoting automation, standardization, and tele-ultrasonography of renal ultrasound examinations, and may serve as a reliable adjunctive tool for ultrasonographers.

To assess the value of prenatal ultrasound and genetic evaluation in the clinical prenatal diagnosis and management of fetal gastrointestinal obstruction.

A total of 82 pregnant women with fetal gastrointestinal obstruction detected by prenatal ultrasound and evaluated via multidisciplinary consultation from August 2022 to August 2025, at Women's Hospital of Nanjing Medical University were enrolled, including 44 cases of upper gastrointestinal obstruction and 38 cases of lower gastrointestinal obstruction. Prenatal ultrasound characteristics, genetic testing results, and perinatal outcomes were systematically analyzed and compared between the two groups.

Among the 44 cases of upper gastrointestinal obstruction, 28 (63.6%) presented with isolated obstruction, while 16 (36.4%) were complicated with other structural malformations. According to ultrasound classification, there were 32 cases (72.7%) of duodenal obstruction (double-bubble sign), 11 cases of esophageal atresia, and 1 case of pyloric obstruction. Chromosomal microarray analysis (CMA) was performed in 32 cases, revealing a significantly higher abnormality detection rate in the complicated malformation group (5/10, 50.0%) than in the isolated group (2/22, 9.1%; P＜0.05). The prenatal termination rate was 34.1% (15/44). Among the 25 cases of isolated obstruction that continued pregnancy, the neonatal survival rate was 88.0% (22/25), with all 3 neonatal deaths occurring in cases of esophageal atresia. In the complicated malformation group, 1 case resulted in intrauterine fetal death, while the remaining 3 neonates survived. Regarding the 38 cases of lower gastrointestinal obstruction, 28 (73.7%) were isolated and 10 (26.3%) were complicated with other structural malformations, with characteristic intestinal dilatation observed on ultrasound in all cases. CMA was performed in 30 cases, showing a higher abnormality detection rate in the complicated malformation group (3/9, 33.3%) than in the isolated obstruction group (1/21, 4.8%), although this difference did not reach statistical significance (P=0.128). The prenatal termination rate of pregnancy was 13.2% (5/38). The neonatal survival rate was 100% for both isolated obstruction and complicated malformation cases.

Fetal gastrointestinal obstruction exhibits characteristic features on prenatal ultrasound. The risk of chromosomal abnormalities increases significantly when obstruction is accompanied by other structural anomalies. Isolated lower gastrointestinal obstruction carries the best prognosis, while esophageal atresia among upper gastrointestinal obstructions is assocated with a poorer prognosis.

To investigate the prenatal ultrasonographic features and clinical characteristics of fetuses with Pierre Robin sequence (PRS) and analyze the correlation between prenatal ultrasound findings and postnatal clinical outcomes, so as to provide reference for prenatal diagnosis and perinatal management.

A retrospective analysis was conducted on 23 fetuses diagnosed with PRS by prenatal ultrasound at Chongqing Health Center for Women and Children between January 2019 and December 2024. All cases were confirmed by postnatal examination or postmortem evaluation following termination of pregnancy. Multiphase ultrasound assessments were performed, including quantitative measurements of the inferior facial angle (IFA) and jaw index (JI), as well as morphological evaluations of glossoptosis and cleft palate types. Associated malformations were also recorded. Clinical data, genetic testing results (including chromosomal microarray analysis and whole-exome sequencing [WES]), and pregnancy outcomes were collected to systematically summarize the clinical features and prognostic factors of PRS fetuses.

Regarding ultrasonographic features, all 23 cases exhibited micrognathia (IFA range: 33.7°~49.6°, mean: 44.2°±3.8°; JI range: 21.4~46.1, mean: 31.1±6.7) and glossoptosis (100%). Cleft palate was detected in all cases (23/23), with U-shaped cleft palate accounting for 26.1% (6/23). Associated malformations were present in 52.2% (12/23) of cases, with circulatory system anomalies (26.1%, 6/23) and nervous system anomalies (21.7%, 5/23) being the most frequently observed. Genetic testing was conducted in 7 cases, of which 2 exhibited variants of uncertain significance (VUS) on WES. Regarding pregnancy outcomes, termination of pregnancy was elected in 19 cases, while the remaining 4 cases continued to term, resulting in live births (3 isolated PRS, 1 with cardiac anomaly). Among the live births, 3 required mechanical ventilation for respiratory support, while 1 did not. All 4 neonates underwent postnatal surgical intervention, and favorable outcomes were observed during the 1-year follow-up.

Prenatal diagnosis of PRS requires integrated multiphase ultrasound and genetic testing. Multidisciplinary stratified management may improve pregnancy outcomes and prognosis, particularly in isolated cases.

To evaluate the diagnostic performance of Doppler ultrasonography (DUS) for pediatric transplant renal artery stenosis (TRAS) using computed tomographic angiography (CTA) as the reference standard.

This retrospective single-center study included 61 pediatric renal transplant recipients [36 males; mean age, (10.0±3.6) years (SD)] who underwent 74 CTA examinations for suspected TRAS between January 2019 and February 2025. A total of 74 matched pairs of DUS and CTA examinations (49 TRAS, 25 non-TRAS) were analyzed. DUS parameters recorded included peak systolic velocity in the transplant renal artery (TRA-PSV), the renal-to-iliac PSV ratio (RIR), and resistive indices (RI) in segmental and interlobular arteries. Diagnostic performance was assessed against CTA, with ＞50% stenosis defined as the reference standard for TRAS. Receiver operating characteristic (ROC) curve analysis was used to determine optimal thresholds and the area under the ROC curve (AUC).

Among the DUS parameters, TRA-PSV (cut-off≥387 cm/s) demonstrated the lowest diagnostic performance (AUC=0.688; P＜0.01 for comparisons). For direct indicators, RIR (cut-off≥3.5) exhibited a significantly higher specificity than PSV, the difference is statistically significant (72% vs 48%, P＜0.001). For indirect indicators, interlobular artery RI (cut-off≤0.48) showed a significantly higher specificity than segmental artery RI (cut-off≤0.59), at 88% vs 72%, respectively, the difference is statistically significant (P＜0.001). The combination of direct (RIR≥3.5) and indirect (interlobular RI≤0.48) DUS features yielded a sensitivity of 62.3%, specificity of 93.2%, and positive predictive value (PPV) of 91.2% for diagnosing TRAS.

The combined DUS criteria of RIR≥3.5 and interlobular RI≤0.48 offer high specificity for diagnosing pediatric TRAS. Leveraging the diagnostic efficacy of DUS, particularly with these combined criteria, can significantly reduce unnecessary CTA examinations in pediatric patients.

To evaluate the clinical efficacy and safety of ultrasound-guided hydrodissection combined with percutaneous neurolysis in the treatment of common peroneal nerve entrapment syndrome (CPNES), and to assess changes in ultrasound parameters of the common peroneal nerve.

A retrospective analysis was conducted on 66 patients diagnosed with CPNES and treated at our hospital between June 2023 and March 2025. Patients were allocated into two groups according to treatment modality: the combined treatment group (ultrasound-guided hydrodissection plus percutaneous neurolysis, 36 cases) and the hydrodissection-only group (30 cases). After normality testing, continuous data conforming to a normal distribution are expressed as the mean ± standard deviation, while non-normally distributed data are presented as median (Q₁, Q₃); categorical data are expressed as numbers (percentages). Visual analogue scale (VAS) scores, Kofoed ankle scores, numbness improvement grades, and ultrasound parameters were recorded before treatment and at 1 week, 1 month, 3 months, and 6 months after treatment. Treatment-related complications were also documented. Between-group comparisons of the above parameters at each time point were performed using the independent-samples rank sum test (Mann-Whitney U test) as appropriate, and within-group comparisons across different time points were performed using the Friedman test. A P-value＜0.05 was considered statistically significant.

In both groups, VAS scores, Kofoed scores, numbness symptoms, and the inner diameter at the compressed segment of the common peroneal nerve improved significantly after treatment compared with baseline (all P＜0.05), whereas blood flow signal grading showed no obvious change before or after treatment in either group. At all follow-up time points, the combined treatment group showed significantly lower VAS scores and significantly higher Kofoed scores than the hydrodissection-only group (all P＜0.05). The combined treatment group also exhibited superior numbness improvement compared with the hydrodissection-only group (all P＜0.05). In both groups, the inner diameter at the most compressed segment of the common peroneal nerve increased significantly at 1, 3, and 6 months after treatment compared with baseline (all P＜0.05), whereas no significant change was observed at 1 week (P＞0.05). No serious complications occurred during follow-up. Recurrence was observed in 2 cases in the combined treatment group and 5 cases in the hydrodissection-only group.

Ultrasound-guided hydrodissection combined with percutaneous neurolysis is a safe and effective treatment for CPNES. It significantly increases the inner diameter at the compressed segment of the common peroneal nerve, relieves pain, improves sensory function, and enhances ankle function, offering superior outcomes compared with hydrodissection alone, and demonstrates good clinical value for widespread application.

To evaluate the efficacy of stepwise training with a diversified teaching mode in enhancing residents' clinical competency in early pregnancy ultrasound.

This study included 14 first-year residents undergoing standardized training in the ultrasound department at Peking Union Medical College Hospital. An advanced training program was implemented with three progressive modules: theoretical teaching, virtual simulation training, and clinical practice mentorship. The curriculum integrated diversified case-based learning approaches, including peer teaching for image interpretation, analysis of missed and misdiagnosed cases, and remote case consultations. A pre- and post-training Likert-scale questionnaire, designed via Questionnaire Star, was used to assess trainees' understanding of early pregnancy ultrasound. Training efficacy was measured by confidence self-ratings in early pregnancy ultrasound diagnosis and answer accuracy, with χ² tests used to analyze changes in confidence levels.

The majority of trainees (85.72%, 12/14) perceived early pregnancy ultrasound as moderately or highly difficult, with only 14.28% (2/14) rating it as low difficulty. The baseline confidence level of trainees in early pregnancy ultrasound diagnosis was generally low, with 42.86% (6/14) being moderately confident, 42.86% (6/14) slightly confident, and 14.28% (2/14) completely unconfident. All trainees acknowledged the importance of the training [35.72% (5/14) agreed, 64.28% (9/14) strongly agreed], with high participation willingness [42.86% (6/14) willing, 57.14% (8/14) very willing]. Post-training evaluation revealed that 92.86% (13/14) of trainees considered the training helpful for early pregnancy ultrasound diagnosis. The trainees' confidence in early pregnancy ultrasound diagnosis significantly improved, with the moderate-or-higher confidence rate increasing from 42.86% (6/14) to 78.57% (11/14, χ²=6.105, P=0.013). Additionally, 85.71% (12/14) of the trainees achieved an examination answer accuracy rate of 80% or higher. However, challenges remained in embryonic development evaluation, ectopic pregnancy diagnosis, and chorionicity determination for twins.

The stepwise curriculum with diversified teaching mode effectively enhanced residents' clinical competence in early pregnancy ultrasound.