To investigate the ultrasound diagnostic concordance rates for carotid artery stenosis in Guangdong Province Guangxi Zhuang Autonomous Region, as well as for renal artery stenosis in Guangdong Province, to evaluate the current management status of vascular ultrasound critical values, and to develop scientific, refined, and actionable quality improvement measures grounded in the survey findings, with the aim of providing a foundation for enhancing the overall quality of vascular ultrasound diagnosis.

A multicenter retrospective analysis was conducted using 2023–2024 ultrasound data. The dataset included carotid artery stenosis data from 26 hospitals in Guangxi and 33 hospitals in Guangdong, renal artery stenosis data from 63 medical institutions in Guangdong, and vascular ultrasound critical value management data from 68 medical institutions.

The ultrasound diagnostic concordance rate for carotid artery stenosis showed an upward trend in both regions. In Guangdong Province, the rate increased from 85.4% (2990/3501) in 2023 to 88.2% (2247/2549), representing an absolute increase of 2.8%. In Guangxi, the rate rose from 79.1% (1078/1362) to 81.8% (1759/2151), with an absolute increase of 2.7%, with Guangdong showing somewhat greater improvement. For renal artery stenosis in Guangdong, data entry non-compliance was identified: only 39.7% (25/63) of institutional datasets were deemed valid, and some institutions had not adopted the recommended guidelines. Regarding vascular ultrasound critical value reporting in Guangdong, timeliness was satisfactory (100%), but incomplete reporting and incomplete image retention were noted. The completeness rate for reports was 89.8% (778/866), and that for images was 86.1% (746/866).

Given the issues identified in this survey, we recommend implementing unified diagnostic criteria, systematic quality control procedures, and targeted professional training to further improve the accuracy and standardization of vascular ultrasound diagnosis.

To analyze the major quality issues and their underlying causes in breast ultrasound reports in China, identify key factors affecting report quality, and investigate the association between various quality control indicators and the diagnostic accuracy of breast imaging reporting and data system (BI-RADS) classification, so as to provide evidence-based support for improving ultrasound report quality.

This multicenter cross-sectional study retrospectively collected breast ultrasound reports from patients who underwent breast ultrasound between January 1, 2024 and June 30, 2024. Pathological results served as the gold standard for diagnostic accuracy. A total of 16434 breast ultrasound reports from 1237 medical institutions across 13 provinces were included. Reports were systematically evaluated from four dimensions: report completeness, image acquisition adequacy, description-conclusion consistency, and image-text consistency. Chi-square tests and multivariate logistic regression were used to analyze the association between each quality control indicator and the diagnostic accuracy of BI-RADS classification. Pareto analysis was applied to identify the primary causes of problems.

Among the 16434 reports, the rate of report completeness was 64.0%, image acquisition adequacy was 75.3%, description-conclusion consistency was 91.0%, image-text consistency was 99.7%, and BI-RADS classification accuracy was 75.9%. Multivariate logistic regression showed that report completeness (OR=1.081, 95%CI: 1.002 – 1.165, P=0.044), image acquisition adequacy (OR=1.116, 95%CI: 1.027 – 1.212, P=0.010), and description-conclusion consistency (OR=1.212, 95%CI: 1.074 – 1.367, P=0.002) were independent influencing factors for the diagnostic accuracy of BI-RADS classification, whereas image-text consistency had no significant effect (P=0.452). Pareto analysis identified the main causes of report incompleteness as missing descriptions of posterior features (21.49%), orientation (21.03%), calcifications (19.56%), location (16.54%), and shape (9.44%). The primary causes of inadequate image acquisition were the lack of body markers (53.80%), absence of CDFI images (19.03%), and incomplete storage of suspicious malignant signs (9.21%). The main cause of description-conclusion inconsistency was contradictions or ambiguities in descriptions (84.03%).

The completeness of breast ultrasound reports, adequacy of image acquisition, and consistency between descriptions and conclusions directly influence the diagnostic accuracy of BI-RADS classification. To address the core defects, particularly missing descriptions of key sonographic features such as posterior features, orientation, and calcifications, as well as the lack of body markers, future efforts should focus on strengthening relevant quality control measures to improve the overall diagnostic efficacy of breast ultrasound in China.

Based on baseline survey data of ultrasound diagnostic equipment in medical institutions in Shanghai in 2025, this study aimed to analyze the current status, brand distribution, performance status, and key quality control management issues of ultrasound equipment across the city.

Using the Shanghai Ultrasound Quality Control Supervision Platform, we collected baseline data voluntarily reported by local medical institutions, covering 599 public and private medical institutions. A total of 2770 effective ultrasound devices were included. Core indicators, including equipment brand and model, configuration differences across institutional levels, correlation between purchase year and performance, and distribution of usage scope, were analyzed.

Philips, General Electric, Mindray, and Siemens were the dominant ultrasound equipment brands in Shanghai, together accounting for 71.3% of the market share. The excellent-or-good rate of the domestic brand Mindray was 97.3%, with an average service life of 3.4 years, indicating rapid market growth. Equipment configuration showed significant gradient disparities: tertiary grade-A hospitals averaged 19.7 ultrasound devices each, while non-tertiary and other medical facilities had only 2.1-6.2 devices. The citywide average service life was 5.5 years, with 9.9% (273/2770) of devices used for more than 10 years; the excellent-or-good rate of these older devices was only 78.2%-84.0%. Identified quality control management issues included uneven distribution, fragmented device models, and inconsistent evaluation standards.

To comprehensively enhance the quality control management of ultrasound diagnostic equipment in Shanghai, it is necessary to establish a tiered update mechanism, promote standardized information management, strengthen primary-care equipment support, and improve the quality control monitoring system.

To analyze the current state of ultrasound medical quality control in Shenzhen and its administrative regions, identify interregional disparities, and formulate and implement targeted improvement measures to achieve continuous quality improvement.

Ultrasound-related data from 76 secondary and tertiary medical institutions in Shenzhen were collected via the municipal quality control network platform for the year 2024. The dataset encompassed infrastructure metrics (number of consultation rooms, ultrasound machines, and ultrasound physicians), physician qualifications (professional titles and academic degrees), and workload-adjusted indicators (consultation rooms and ultrasound physicians per 10 000 patients, and physician-to-machine ratio). In addition, 12 ultrasound quality control indicators, as stipulated in the "Expert Consensus on Quality Control Indicators of Ultrasound Medical (2022 Edition)", were extracted and statistically analyzed.

For institutional configuration, the 76 institutions collectively reported 1603 consultation rooms (mean, 21.10 per institution), 1703 ultrasound machines (mean, 22.41), and 1796 ultrasound physicians (mean, 23.63). The title distribution was 8.24% senior, 20.10% intermediate, and 71.66% junior. Academic qualifications were consistently higher than national benchmarks: doctorate (4.12% vs 2.13%), master's (30.73% vs 16.47%), and bachelor's (62.86% vs 54.37%). The citywide average number of consultation rooms per 10000 patients is higher than the national average (0.93 vs 0.83), whereas the average number of ultrasound physicians per 10000 patients (1.04 vs 1.18) and the physician-to-machine ratio (1.05 vs 1.27) both fell below national levels. Regarding quality control indicators, average daily physician workload surpassed the national average (38.49 examinations vs 29.91 examinations), ranging from 39.51 (Bao'an District, highest) to 10.57 (Dapeng New District, lowest); four administrative districts fell below the citywide mean. Ultrasound equipment inspection pass rate was marginally above the national average (97.80% vs 97.71%), with all six districts achieving 100% and two lower than the city average. The 48-hour post-admission examination completion rate exceeded the national figure (96.90% vs 94.58%), with Dapeng at 100%, Pingshan at the lowest (86.80%); three districts lagged behind the city average. The 10-minute critical value notification rate outperformed the national average (99.53% vs 98.10%), with all six districts at 100% and two below the city average. Ultrasound report writing quality rate fell short of the national benchmark (98.59% vs 99.19%); Longgang District recorded the lowest (97.76%), and five districts were below the city average. Breast imaging reporting and data system classification reporting rate for breast lesions was substantially higher than the national average (97.19% vs 81.37%), with Futian District being the lowest (94.76%) and two districts below the city average. Positive report rate was lower than the national average (65.05% vs 74.09%), ranging from 83.07% (Dapeng, highest) to 59.96% (Futian, lowest); four districts were below the city average. Detection rate of major lethal fetal malformations exceeded the national rate (0.12% vs 0.06%), with Nanshan District being the highest (0.55%) and seven districts below the city average. Ultrasound diagnostic concordance rate was above the national average (90.32% vs 87.15%), with Bao'an District being the lowest (76.00%) and two districts below the city average. Diagnostic accuracy for breast lesions surpassed the national rate (87.25% vs 79.98%), with Dapeng being the lowest (60.00%) and three districts below the city average. Accuracy for carotid artery stenosis (≥50%) slightly exceeded the national figure (87.28% vs 84.84%), with Futian being the lowest (84.10%) and four districts below the city average. Major complication rate for ultrasound-guided interventions was lower than the national level (0.39% vs 0.63%), with Nanshan having the highest rate (0.71%) and four districts being higher than the city average. Based on these findings, targeted quality control training sessions were organized, followed by on-site evaluations and regular tracking to drive continuous quality improvement.

Systematic data analysis effectively identified the baseline status and regional variations in ultrasound quality control across Shenzhen. The subsequent formulation and implementation of targeted measures enabled routine monitoring, in-depth analysis, timely feedback, and sustained quality improvement across all ultrasound-related performance indicators.

To evaluate the effectiveness of quality control circle (QCC) activities in improving the quality of carotid ultrasound images and reports.

From October 2024 to March 2025, the Ultrasound Department of Ningbo Integrated Traditional Chinese and Western Medicine Hospital conducted a QCC activity themed "Improving the Qualified Rate of Carotid Ultrasound Images and Reports". Before the intervention (March to August 2024), 90 carotid ultrasound examinations were randomly selected. QCC members scored image and report quality using relevant standardized indicators and calculated the qualified rate. Problems identified during the sampling were addressed through brainstorming, Pareto analysis, root cause analysis, goal setting, and targeted countermeasures, ultimately leading to the development of a standardized protocol. After the QCC activity (January to March 2025), another 90 examinations were randomly selected for effect confirmation. Qualified rates for images and reports were recalculated, and pre- and post-intervention differences were compared using the chi-square test. To assess sustainability, an additional 146 carotid ultrasound examinations were sampled within six months after the end of the QCC activity (August to September 2025).

After the QCC intervention, the qualified rate for carotid ultrasound images increased significantly from 46.7% (42/90) to 82.2% (74/90), and the qualified rate for reports rose from 63.3% (57/90) to 87.8% (79/90). Both differences were statistically significant (χ²=24.82, P＜0.001; χ²=14.59, P＜0.001). Six months after the end of the activity, the improvement was sustained, with qualified rates of 86.3% (126/146) for images and 84.2% (123/146) for reports, respectively.

QCC activities effectively improved the qualified rates of carotid ultrasound images and reports, with sustained benefits observed at six-month follow-up.

To clarify the value of clinical research engagement for the teaching quality of cardiac ultrasound standardized training by comparing the teaching effectiveness of standardized training for resident physicians integrated with clinical research participation versus conventional clinical training.

A total of 36 residents enrolled in the standardized training program of the Department of Ultrasound Medicine at Tangdu Hospital, Air Force Medical University, from September 2023 to November 2025, were randomly divided into a research training group (19 residents) and a clinical training group (17 residents). A two-stage training approach was adopted. During the basic training stage (30 clinical cardiac ultrasound cases), both groups received identical training. During the differential training stage (50 cardiac ultrasound cases), the research training group participated in research projects requiring image acquisitions (≥25 cases), whereas the clinical training group followed conventional training. After the two-stage process, two instructors scored the sectional images acquired by the residents, and the average score was calculated; inter-group score comparions were performed using independent sample t-tests. The intra-group correlation coefficient (ICC) was used to evaluate the measurement accuracy of the two groups of residents relative to the supervising instructors. Residents' interest in cardiac ultrasound research was assessed and compared between the two groups via questionnaires, with differences analyzed using the χ² test.

After the basic training stage, no significant differences were observed between the two groups in either measurement accuracy (as reflected by ICC for all parameters) or view scores (3.29±0.49 vs 3.27±0.48, P＞0.05) . After the differential training stage, the research group demonstrated superior ICC values compared to the clinical group for left ventricular end-diastolic dimension, left ventricular end-systolic dimension, left ventricular outflow tract dimension, mitral annulus a-wave, biplane left ventricular ejection fraction, left atrial volume, and global longitudinal strain. Additionally, the research training group achieved significantly higher view scores than the clinical training group (3.63±0.25 vs 3.43±0.27, t=2.308, P=0.027). After completion of both training stages, the research training group exhibited a significantly greater interest in ultrasound clinical research than the clinical training group (73.7% vs 29.4%, χ²=7.442, P=0.024).

Participation in cardiac ultrasound clinical research can significantly enhance residents' image view standardization and measurement accuracy, as well as increase their research interests, thereby improving the overall teaching effectiveness of standardized training.

To explore residents' learning experiences, perceived mechanisms of competence development, and implementation barriers of an augmented reality/virtual reality (AR/VR) scenario-based simulation teaching model in Focused Assessment with Sonography for Trauma (FAST) training, and to provide evidence for curriculum design and quality improvement in residency training.

A descriptive qualitative design was adopted. Fifteen ultrasound medicine residents who had participated in an AR/VR scenario-based simulation program at the Fourth Affiliated Hospital of Zhejiang University School of Medicine from December 2025 to January 2026 were recruited for semi-structured interviews. Data were coded and analyzed using Colaizzi's seven-step method, from which themes and categories were derived.

Four themes were identified: (1) Psychological safety enhanced classroom engagement: the virtual environment reduced residents' anxiety, encouraged active questioning and disclosure of uncertainty, and strengthened their sense of responsibility for independent problem-solving; (2) Immersive experience facilitated integration and understanding of knowledge and skills: a stronger sense of immersion promoted contextual understanding, linking scanning planes, sonographic interpretation, and clinical decision-making, while partially compensating for limited case exposure during rotations; (3) AR-enabled feedback promoted standardized scanning and confidence, although transfer to clinical practice still required bridging; (4) Key conditions and optimization priorities for implementation: functional fidelity of scenarios needs enhancement, alongside addressing cybersickness/discomfort, time costs, faculty adaptation, and standardized assessment, as well as the demand for automated evaluation and feedback.

The AR/VR scenario-based simulation model for FAST training can promote active participation in a low-risk environment and improve scanning standardization through immersive tasks and AR-enabled feedback. Sustainable implementation requires attention to functional alignment of scenarios, technological feasibility, faculty development, and the establishment of standardized assessment systems.

To investigate the contrast-enhanced ultrasound (CEUS) manifestations of postpartum uterine necrosis and to assess their value in early diagnosis and treatment guidance.

A retrospective analysis was conducted on the clinical data of 8 patients with postpartum uterine necrosis confirmed by clinical findings or pathology who were admitted to Henan Provincial People's Hospital from January 2019 to October 2025. All patients underwent CEUS examination, and the findings were compared with surgical pathology or comprehensive clinical diagnostic results.

CEUS revealed central non-perfusion areas in all 8 patients, which were in sharp contrast to the rapid enhancement of the surrounding normal myometrium or serosa. Total or subtotal hysterectomy was performed in 4 patients, and the extent of necrosis delineated by CEUS was highly consistent with intraoperative findings and postoperative pathological results. In the remaining 4 patients, whose infections were well-controlled, conservative treatment was administered based on CEUS assessment and achieved favorable efficacy, thereby avoiding unnecessary hysterectomy.

CEUS can accurately delineate the extent of uterine necrosis at an early stage, which is of great significance in guiding individualized treatment planning, preventing treatment delays, and avoiding unnecessary hysterectomy.

To evaluate the diagnostic efficacy of routine ultrasound views combined with the short-axis view of the cardiac base (SAVCB) and the pulmonary artery bifurcation plane (PABP) for common fetal congenital heart disease (CHD).

This retrospective study included 176 pregnant women with fetuses suspected of having CHD who underwent prenatal examination at Shenzhen Nanshan People's Hospital from April 2018 to December 2025. Based on postnatal gold-standard diagnoses, they were divided into a CHD group (n=132) and a normal control group (n=44). All participants underwent routine ultrasound views plus additional SAVCB and PABP examinations. Key ultrasound parameters were quantified, including pulmonary artery (PA) diameter, aortic (AO) diameter, PA/AO ratio, superior vena cava (SVC) diameter, pulmonary valve peak velocity (PV_max), aortic valve peak velocity (AV_max), PV_max/AV_max ratio, left pulmonary artery (LPA) diameter, and right pulmonary artery (RPA) diameter. The t-test was used to compare the above-mentioned ultrasound parameters between the two groups. Receiver operating characteristic (ROC) curves were used to assess the diagnostic performance of different view combinations, with calculation of the area under the curve (AUC), sensitivity, specificity, and Youden index.

The CHD group demonstrated significantly higher SVC and PV_max/AV_max compared with the control group [(5.89±0.73) mm vs (4.21±0.65) mm and (0.97±0.22) vs (0.75±0.13); t=-13.572 and -6.271, respectively; both P＜0.001], and significantly lower PA/AO, LPA, and RPA than the control group ([(1.07±0.11) vs (1.34±0.26), (2.52±0.35) mm vs (3.75±0.42) mm, and (2.68±0.32) mm vs (3.91±0.38) mm; t=9.653, 19.173, and 21.040, respectively; all P＜0.001]. The combined screening protocol integrating conventional views with SAVCB and PABP achieved the best diagnostic performance, with a detection rate of 84.44% for fetal CHD, an AUC of 0.902, a sensitivity of 95.45%, and a specificity of 84.85%.

The screening strategy integrating conventional ultrasound views with SAVCB and PABP significantly enhances the diagnostic efficacy for fetal CHD and optimizes the prenatal screening framework for this condition.

To systematically evaluate alterations in left atrial (LA) function in patients with essential hypertension (EH) using four-dimensional automatic left atrial quantification (4D Auto LAQ) technology, and to identify the optimal echocardiographic parameter for efficiently detecting left ventricular diastolic dysfunction (LVDD) in this population.

A cross-sectional study was conducted, consecutively enrolling 133 EH patients treated at the Second Affiliated Hospital of Air Force Medical University between October 2023 and November 2025, along with 50 healthy volunteers as the control group. EH patients were stratified into four subgroups (pre-hypertension, grade 1, grade 2, and grade 3) according to the 2024 revised Chinese Guidelines for the Prevention and Treatment of Hypertension. LVDD was diagnosed based on the updated 2025 American Society of Echocardiography guidelines for diastolic function assessment. All participants underwent comprehensive transthoracic echocardiography, including standard two-dimensional and three-dimensional full-volume image acquisition. Offline analysis was performed using an ECHOPAC 204 workstation with 4D Auto LAQ software to derive LA volumetric, longitudinal, and circumferential strain parameters. Calculated indices included LA emptying fraction (LAEF), passive and active ejection fractions (LAPEF, LAAEF), expansion index (LAEI), LA volume/mechanical coupling index (LAVMCI), LA-ventricular coupling index (LACI), and LA stiffness index (LASI). Inter-group comparisons were conducted using one-way analysis of variance followed by the LSD-t post hoc test. The diagnostic performance of each parameter for LVDD was evaluated using receiver operating characteristic (ROC) curve analysis.

Compared with the control group, the prehypertension group exhibited significantly increased LA minimum volume (LAVmin) [(18.57±4.76) ml vs (15.09±5.16) ml] and pre-systolic volume [(32.30±8.95) ml vs (26.00±8.61) ml], along with significantly decreased LAEF [(56.17±6.71)% vs (60.89±6.23)%], LAPEF [(0.25±0.09) vs (0.33±0.07)], and circumferential strain (LASr-c) [(31.70±7.62)% vs (37.91±11.42)%] (all P＜0.05). With increasing severity of hypertension, LAVmax increased from (38.29±11.28) ml to (70.92±19.17) ml, LAVmin from (15.09±5.16) ml to (37.08±10.10) ml, and LAVMCI from (2.60±0.94) to (5.09±1.93) (all P＜0.001); meanwhile, LASr decreased from (27.71±6.32)% to (16.67±4.81)%, and LAScd from (-15.23±4.81)% to (-6.33±3.17)% (all P＜0.001). In EH patients with LVDD, LAVMCI was significantly higher than that in the normal group [(6.56±3.31) vs (2.59±0.88), t=8.949, P＜0.001]. ROC curve analysis demonstrated that LAVMCI had the highest diagnostic efficacy for identifying LVDD in EH patients, with an area under the curve (AUC) of 0.951 (95% confidence interval: 0.92-0.98). At an optimal cutoff value of 2.75, the sensitivity and specificity were 100% and 69.15%, respectively, which was significantly superior to LASr (AUC=0.721).

4D Auto LAQ technology can sensitively detect impairment of LA reservoir, conduit, and contractile functions beginning at the prehypertension stage. Among the multiple parameters assessed in this study, LAVMCI demonstrated the optimal diagnostic performance for LVDD in EH patients, suggesting that it may serve as a potentially effective parameter for evaluating hypertension-related diastolic dysfunction.