To explore the value of musculoskeletal ultrasound combined with shear wave elastography (SWE) in clinical monitoring of patients after arthroscopic rotator cuff repair.

Seventy-three patients with rotator cuff tears who underwent arthroscopic repair surgery at Changzhou No. 2 People’s Hospital between February 2024 and February 2025 were prospectively enrolled. Musculoskeletal ultrasound and SWE were performed preoperatively and at 1 week, 1 month, and 3 months postoperatively. Measurements included the thickness (TH), cross-section area (CSA), and shear wave velocity (SWV) at the tear site. Shoulder function was assessed using the Constant-Murley score. Based on the surgical results, patients were categorized into three groups: partial-thickness tear group (21 cases), partial-width full-thickness tear group (42 cases), and full-width full-thickness tear group (10 cases). The parameters at different time points and their trends pre- and post-surgery were observed across groups. The correlation between TH, CSA, SWV, and the Constant-Murley score was analyzed.

Statistically significant differences in TH and SWV were observed among the groups preoperatively and at 1 week, 1 month, and 3 months postoperatively (P<0.05). Significant differences in CSA across time points were found in the partial-thickness tear group and the partial-width full-thickness tear group (P<0.05), but not in the full-width full-thickness tear group (P =0.137). In all the three groups, TH and CSA demonstrated an initial increase followed by a decrease at every time points, whereas SWV and Constant-Murley scores exhibited a gradual upward trend. In the partial-thickness tear group, preoperative SWV showed a positive correlation with preoperative Constant-Murley score (r =0.484, P =0.026). In the partial-width full-thickness tear group, SWV at 1 month correlated positively with Constant-Murley score at 1 month postoperatively (r =0.571, P<0.001). Furthermore, SWV at 3 months correlated positively with Constant-Murley score at 3 months postoperatively in both the partial-width full-thickness tear group and the full-width full-thickness tear group (r =0.618, P<0.001 and r =0.643, P =0.045, respectively).

The combination of musculoskeletal ultrasound and SWE enables quantitative assessment of shoulder function following rotator cuff repair surgery. This approach allows for repeated and real-time monitoring of tendon morphology and biomechanical changes. SWV provides an objective imaging basis for the follow-up evaluation of patients with full-thickness tears, facilitating better guidance of rehabilitation exercise protocols. This combined method holds significant clinical reference value.

To explore the ultrasound features of finger tendon injuries and evaluate the diagnostic value of high-frequency musculoskeletal ultrasound in such injuries.

From January 2021 to December 2024, consecutive patients with suspected finger tendon rupture and suture in the Second Affiliated Hospital of Anhui Medical University were collected. Before operation, the patients were evaluated clinically and examined by high-frequency musculoskeletal ultrasound, and ultrasound at passive movement was added in a part of patients. The ultrasound manifestations of finger tendon rupture and tear were summarized. The accuracy of clinical diagnosis and ultrasonic diagnosis was calculated by using surgical exploration results as the gold standard.

A total of 42 patients with finger tendon injuries were included. Clinical diagnosis suggested extensor tendon rupture in 28 patients and flexor tendon rupture in 14. Of 28 patients with extensor tendon injuries, 18 were surgically diagnosed with extensor tendon rupture and 10 with extensor tendon tear; of 14 patients with flexor tendon injuries, 10 were surgically diagnosed with flexor tendon rupture and 4 with flexor tendon tear. Ultrasonic diagnosis of extensor tendon injuries suggested 19 cases of extensor tendon rupture, manifested as extensor tendon continuity interruption, of which 10 (10/11) had disappearance of ultrasonic manifestations at passive movement; 9 cases of extensor tendon tear, manifested as local interruption of extensor tendon muscle fibers, swelling, and thinning, of which 2 (2/3) had ultrasonic manifestations at passive movement and 4 were accompanied by avulsion fracture. The coincidence rate of clinical diagnosis of extensor tendon injuries was 64.29% (18/28), and that of ultrasonic diagnosis was 96.43% (27/28). Ultrasonic diagnosis of flexor tendon injuries suggested 11 cases of flexor tendon rupture, manifested as extensor tendon continuity interruption, of which 9 (9/9) had disappearance of ultrasonic manifestations at passive movement; and 3 cases of flexor tendon tear, manifested as muscle fiber local interruption, not reaching the full layer, of which 1 (1/2) had ultrasonic manifestations at passive movement. The coincidence rate of clinical diagnosis was 71.43% (10/14), and that of ultrasonic diagnosis was 92.86% (13/14).

High-frequency musculoskeletal ultrasound has high diagnostic value for finger tendon injuries. Adding passive motion examination in the process of ultrasound examination can increase the accuracy of finger tendon injury diagnosis.

To evaluate the clinical value of a YOLO 11-based ultrasound detection model for identifying fracture ends in limb long bones.

A total of 206 patients with long bone fractures in Shanghai Eighth People's Hospital from July 2023 to January 2025 were prospectively included. Ultrasonic long-axis sectional images of the fracture ends were collected. The images were labeled using the Labelme software to establish a training dataset (461 images), which was randomly divided into a training set, a validation set, and a test set at a ratio of 7:1:2. The YOLO 11 model was trained. The performance of the model was evaluated by precision, recall, F1 score, and the mean average precision when the intersection over union was greater than 50% (mAP@50), and it was compared with the YOLOv8 model. In addition, 40 subjects (20 with fractures and 20 normal controls) were newly included to construct an independent clinical validation set. Ultrasonic long-axis sectional images of the fracture ends and normal bones were collected. The clinical diagnostic efficacy was comprehensively evaluated by sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV), and the average inference time per frame was analyzed.

According to the data of the test set, the indicators of the YOLO 11 model were superior to those of the YOLOv8 model. Its precision, recall, F1-score, and mAP@50 were 87.9%, 85.3%, 86.6%, and 89.2%, respectively. In the clinical validation set, the sensitivity (92.7% vs 83.9%) and NPV (91.2% vs 82.8%) of YOLO 11 were better than those of YOLOv8, while the specificity (95.4% vs 98.0%) and PPV (96.2% vs 98.2%) slightly decreased, and the average inference time per frame shows a marginal increase over YOLOv8 (42.5 ms vs 36.1 ms).

The YOLO 11 model can efficiently identify the fracture ends of long bones in the limbs, providing an effective auxiliary tool for rapid pre-hospital screening and clinical diagnosis.

To explore the application of high-frequency ultrasound combined with shear wave elastography (SWE) in assessing the efficacy of lymphatic venous anastomosis (LVA) in the treatment of secondary lymphedema.

This prospective study included 34 patients with secondary lymphedema who underwent LVA at the Department of Vascular Surgery, Henan Provincial People’s Hospital between August 2023 and August 2024. Limb circumference measurement, bioelectrical impedance analysis (BIA), and high-frequency ultrasound combined with SWE were performed both before and after treatment. We analyzed and compared the dermal shear wave velocity and thickness, as well as the subcutaneous tissue shear wave velocity and thickness, at multiple limb measurement points pre- and post-treatment. Furthermore, Pearson or Spearman correlation tests were used to analyze the correlation between the improvement rates of the ultrasound-derived parameters after treatment and the improvement rates of both the percentage of excess volume (PEV) in the affected limb and the extracellular water-to-total body water ratio (ECW/TBW).

Significant differences were observed in dermal thickness and shear wave velocity (SWV) of both the dermis and subcutaneous tissue layer between the healthy and affected limbs (P<0.001). Following LVA, PEV and ECW/TBW of the affected limb significantly decreased P<0.001); dermal SWV significantly decreased at all measurement points (P<0.001); subcutaneous tissue layer SWV significantly increased (P<0.001); and dermal thickness changes were not statistically significant (P>0.05). Positive correlations were found between ΔPEV and Δ(ECW/TBW) (r>0.7, P<0.001), between the change rate of dermal SWV and ΔPEV at each measurement point (r =0.392-0.709, P<0.05), and between the change rate of dermal SWV and Δ(ECW/TBW) (r =0.346-0.687, P<0.05) Negative correlations were found between the change rate of subcutaneous tissue SWV and ΔPEV, with higher correlations observed at planes near the knee (10 cm below the superior patellar border and the superior patellar border plane) and the calf mid-point plane (r<-0.5, P<0.01), and between the change rate of subcutaneous tissue SWV and Δ(ECW/TBW), with higher correlations observed at points on the knee-related planes and calf mid-point plan than at thigh segment points (r<-0.41, P<0.05). The change rate of subcutaneous tissue thickness was positively correlated with both ΔPEV and Δ(ECW/TBW) (r =0.316-0.708, P<0.05).

Following LVA in patients with secondary lymphedema, decreased SWV in the dermis and thinning of the subcutaneous tissue layer were observed. High-frequency ultrasound combined with SWE effectively quantifies these changes across different tissue layers before and after treatment, providing valuable ultrasonographic evidence for postoperative follow-up and treatment assessment.

To investigate the relationship between maternal and fetal ultrasound parameters and pregnancy outcomes in pregnant women with a history of recurrent miscarriage (RSA) in the second and third trimesters of pregnancy and their efficacy in assessing the occurrence of adverse pregnancy outcomes (APOs).

From June 2022 to February 2024, we prospectively selected 61 pregnant women diagnosed with RSA who were seen at 25-31 weeks of pregnancy in the Department of Reproductive Medicine of Shenzhen Second People’s Hospital. We measured the pulsatility index (PI) and resistance index (RI) of the maternal bilateral uterine artery (UtA) and monitored the peak systolic flow velocity (PSV) and pulsatility index (PI) of the fetal middle cerebral artery (MCA) as well as the peak-systolic-velocity/end-diastolic-velocity (S/D) ratio, resistance index (RI), and PI of the fetal umbilical artery (UA). The mean pulsatility index (MPI) and mean resistance index (MRI) were derived by calculating the mean values of the UtA-PI and UtA-RI. We calculated the cerebroplacental ratio (CPR) according to the formula [CPR=MCA-PI/UA-PI]. We simultaneously measured the diameter (D) and time-averaged peak flow rate (TAmax) of the intra-abdominal umbilical vein (IUV) and the free loop of the umbilical vein (FUV), and calculated the umbilical vein blood flow (UVBF) according to the formula [Q=0.5TAmax×π×(D/2)²]. Pregnancy outcomes were followed, and the women were divided into either a normal pregnancy outcome group or an APO group. The correlation of maternal-fetal ultrasound parameters with APO was analysed, and their predictive value for APO was assessed.

Among the 61 pregnant women, 25 had APO. At 25-31 weeks of pregnancy, there were no statistically significant differences in fetal MCA-PSV, MCA-PI, UA-S/D ratio, UA-PI, UA-RI, IUV-TAmax, intra-abdominal umbilical vein blood flow (IUVBF), or FUV-TAmax between the two groups (P>0.05). Maternal UtA-MPI and UtA-MRI, as well as fetal IUV-D, FUV-D and FUVBF, were significantly higher in women with APO compared to those with normal pregnancy outcomes (0.85±0.24 vs 0.71±0.16, 0.53±0.09 vs 0.48±0.07, 0.50 [0.45, 0.54] vs 0.47 [0.43, 0.51], 0.63±0.07 vs 0.57±0.06, and 159.92±48.38 vs 131.41±38.40, respectively; P<0.05). Lasso regression was employed to identify three predictors of APO, which were IUV-D, FUV-D, and UtA-MPI. The AUC for the above three indexes to predict APO was 0.653, 0.718, and 0.666, respectively; the AUC of their combination was 0.839, with a sensitivity of 64.0% and specificity of 97.2%.

Maternal UtA-MPI and UtA-MPI, as well as fetal IUV-D, FUV-D, and FUVBF at 25-31 weeks of gestation in patients with RSA are associated with pregnancy outcomes. IUV-D, FUV-D, and UtA-MPI are important predictors of APO, and the combination of them has better predictive efficacy, which is clinically valuable in guiding high-risk pregnancies.

To utilize a novel imaging technique employing ultrasound computed tomography (USCT) integrated with full waveform inversion (FWI) for the quantitative assessment of muscle fat content.

Thirty-nine ex-vivo fresh pig hindlimb models were scanned using a ring-array USCT system (512-element, 0.9 MHz). High-resolution acoustic velocity images were reconstructed using a frequency-domain multiscale FWI algorithm. Following sound speed image acquisition, fat area percentage was calculated based on the acoustic speed difference between muscle tissue and adipose tissue. Pathological analysis (hematoxylin-eosin [HE] staining) served as the gold standard for measuring fat area percentage for comparative validation. Correlation and agreement between USCT and pathological results were assessed using Pearson correlation analysis, intraclass correlation coefficient (ICC), and Bland-Altman plot analysis.

The muscle fat content measured by USCT was (17.79±8.97)%, while the pathological measurement result was (19.90±9.42)%. Correlation analysis revealed a significant positive correlation between USCT and pathological intramuscular fat content (r = 0.874, P<0.001). Agreement analysis showed an ICC of 0.853 (95% confidence interval: 0.704-0.925, P<0.05) between USCT and pathological results. The Bland-Altman plot indicated that the limits of agreement (LOA) ranging from -11.22% to 6.99%. There was a systematic bias between USCT and pathological measurements of intramuscular fat content (mean difference=-2.11%). Post-deboning USCT imaging clearly differentiated skin, fat, and muscle tissues, significantly enhancing quantitative accuracy.

This study demonstrates that USCT technology based on sound speed inversion can effectively quantify muscle fat content. It provides a novel non-invasive approach for the early diagnosis of muscle degenerative diseases and establishes a crucial technical foundation for the precise imaging assessment of musculoskeletal metabolic disorders.