To investigate the role of multimodal ultrasound features, including ultrasound, contrast-enhanced ultrasound, and endoscopic ultrasound, in predicting imaging remission and acute exacerbation of IgG4-related pancreatitis following steroid therapy.

This study included 84 patients with biopsy-confirmed IgG4-related pancreatitis with complete imaging data in the First Affiliated Hospital of Zhejiang University School of Medicine from January 2018 to January 2024. Baseline clinical information and features of ultrasound, contrast-enhanced ultrasound, and endoscopic ultrasound (including pancreatic parenchymal changes, biliary ductal changes, and enhancement patterns) were recorded. Patients were followed for a median duration of 18 months via imaging and medical records to document remission and acute exacerbation post-steroid treatment. The baseline clinical and sonographic features were compared between patients who achieved remission and those who did not, and between patients who experienced acute exacerbation and those who did not, to investigate the predictive value of multimodal ultrasound for these outcomes. Logistic regression models were constructed to predict imaging remission and acute exacerbation.

Among the 84 patients, 43 achieved imaging remission, and 15 had acute exacerbation during the follow-up. Compared with the non-remission group, the imaging remission group had higher proportions of patients with elevated baseline amylase, bile duct stenosis, formation of pseudocysts, and heterogeneous enhancement (22/43 vs 12/41, 25/43 vs 10/41, 9/43 vs 1/41, and 19/43 vs 9/41, respectively), with statistically significant differences between the two groups (χ²=4.176, 9.836, 6.843, and 4.669, P=0.048, 0.002, 0.009, and 0.031, respectively). Logistic regression analysis was applied to construct a model for predicting imaging remission: Imaging remission =0.553×whether baseline amylase was elevated +1.779×whether the bile duct was stenotic +3.280×whether there was a pseudocyst -0.800×whether there was homogeneous enhancement -0.701. The area under the curve (AUC) of this model for predicting imaging remission was 0.81, with a sensitivity of 83% and specificity of 57%. Compared with the non-exacerbation group, the acute exacerbation group had higher proportions of patients with elevated baseline amylase, bile duct stent implantation, and hypo-enhancement (10/15 vs 24/69, 9/15 vs 8/69, and 11/15 vs 30/69, respectively), with statistically significant differences between the two groups (χ²=5.199, 17.885, and 4.395, P=0.040, <0.001, and =0.036, respectively). Logistic regression was applied to construct a model for predicting acute exacerbation: Acute exacerbation =0.589× whether baseline amylase was elevated +2.332× whether there was a biliary stent + 1.488×whether there was hypo-enhancement -3.442. The AUC of this model for predicting acute exacerbation was 0.83, with a sensitivity and specificity of 93% and 51%, respectively.

Multimodal sonograms can provide comprehensive lesion characterization and effectively predict imaging remission and acute exacerbation of IgG4-related pancreatitis following steroid treatment.

To make a prospective comparison of US-guided attenuation parameter (UGAP), ultrasound attenuation parameter (UAP), and semi-quantitative assessment based on two-dimensional ultrasound for the diagnosis of hepatic steatosis in overweight population suspected of having metabolic dysfunction-associated steatotic liver disease (MASLD).

One hundred and three overweight patients who underwent standardized clinical assessment, abdominal ultrasound (UGAP, UAP, and semi-quantitative assessment based on two-dimensional ultrasound), and magnetic resonance imaging-proton density fat fraction (MRI-PDFF) were enrolled in this prospective study from December 2023 to March 2024. The correlation between UAP, UGAP, and MRI-PDFF was evaluated using Pearson's correlation coefficient. The receiver operating characteristic (ROC) curves of two-dimensional ultrasound, UAP, and UGAP were compared, and using MRI-PDFF as a reference, hepatic steatosis was classified into grades S0, S1, S2 and S3. Multivariable linear regression was performed to identify independent factors associated with UGAP and UAP.

Both UGAP and UAP were positively correlated with MRI-PDFF. UGAP had the most significant correlation with PDFF (r=0.852, P<0.001). The diagnostic performance of UGAP for different grades of hepatic steatosis was better than that of UAP and two-dimensional ultrasound (P<0.05). The UAP and two-dimensional ultrasound were not statistically significantly different with regard to the AUCs for different grades of steatosis. The AUCs of UGAP for the diagnosis of hepatic steatosis ≥S1, ≥S2, and =S3 were 0.964 (95%CI: 0.931-0.997), 0.920 (95%CI: 0.856-0.984), and 0.970 (95%CI: 0.912-1.000), respectively. And the cut-off values for ≥S1, ≥S2, and =S3 were 0.60 dB/(cm·MHz), 0.72 dB/(cm·MHz), and 0.79 dB/(cm·MHz), respectively. Visceral fat and skin-to-liver capsule distance were independent factors for UAP and UGAP.

The diagnostic accuracy of UGAP is superior to that of UAP and two-dimensional ultrasound for the diagnosis and grading of hepatic steatosis in overweight subjects suspected of having MASLD.

To establish a method of prenatal ultrasound diagnosis of fetal unroofed coronary sinus (UCS).

A method for observing sections of the coronary sinus was established by using a fetal cardiac anatomy database of persistent left superior vena cava (PLSVC) with coronary sinus dilation. For fetuses with suspected UCS in Peking University People's Hospital from January 2018 to March 2025, the established method of displaying coronary sinus sections was utilized for diagnosis, and the efficacy of the prenatal ultrasound diagnosis method for UCS was analyzed.

The classical coronary sinus sections included: (1) long-axis view: the heart transverse section along the coronary sinus long axis could view its full length; (2) four-chamber view: the short axis of the coronary sinus is displayed at the left atrioventricular groove; (3) parasagittal view: the short axis of the coronary sinus is visualized through the left atrioventricular groove; and (4) trans-biatrial coronal view: the long axis of the coronary sinus is demonstrated. A diagnosis of UCS can be made by the presence of discontinuity of coronary sinus sinus wall on any of the above sections, and abnormal blood flow on color Doppler flow imaging can further support the diagnosis. Using this standardized prenatal ultrasound approach, 10 fetuses with UCS were successfully diagnosed.

By reconstructing the existing anatomical data, sections of the fetal coronary sinus were established, which were used to guide prenatal ultrasound doctor for the screening of UCS, thereby improving the accuracy and efficiency of prenatal diagnosis of UCS.

To investigate the utility of conventional ultrasound and contrast-enhanced ultrasound (CEUS) in the diagnosis of thyroid metastases (TM), aiming to enhance the imaging-based recognition and clinical diagnostic accuracy among ultrasound physicians.

This retrospective study analyzed 17 cases of TM confirmed by histopathological examination at the First Affiliated Hospital of Soochow University from January 2015 to December 2024. Clinical characteristics were systematically documented, and ultrasound images were independently reviewed by two experienced radiologists. The study primarily assessed conventional and contrast-enhanced ultrasonographic features of TM.

Seventeen patients with pathologically confirmed TM were included. The primary tumors originated from lung cancer and esophageal cancer in 5 cases each (29.41%), laryngeal cancer in 3 (17.65%), and nasopharyngeal carcinoma, pancreatic cancer, thoracic chondrosarcoma, and breast cancer in 1 case each (5.88%). Clinically, rapid lesion enlargement within a short interval was observed in 7 patients (41.18%), dyspnea in 4 (23.53%), hoarseness in 10 (58.82%), and dysphagia in 8 (47.06%). Conventional ultrasound revealed unilateral lobe involvement in 14 patients (82.35%) and bilateral involvement in 3 (17.65%). Most lesions were nodular (88.24%, 15/17), hypoechoic (82.35%, 14/17), and characterized by ill-defined or irregular margins or extrathyroidal extension (88.24%, 15/17); 2 cases (11.76%) presented with a diffuse pattern. Cystic-solid composition was detected in 8 cases (47.06%), coarse calcifications in 4 (23.53%), and microcalcifications in 6 (35.29%). Among the 10 patients with complete CEUS data, 8 (80.00%) exhibited heterogeneous enhancement and 8 (80.00%) demonstrated perfusion defects. Enhancement intensity was equally divided between low enhancement and iso-/hyperenhancement (50.00% each).

TM exhibit distinct conventional ultrasound and CEUS features. When integrated with clinical history, multimodal ultrasound evaluation significantly enhances early detection and diagnostic accuracy of TM.

To evaluate the utilization of the Chinese thyroid imaging reporting and data system (C-TIRADS)-based structured ultrasound report for thyroid nodules among ultrasound physicians across various medical institutions.

From March 1, 2024 to January 31, 2025, 117 physicians undergoing further training in the Department of Ultrasound of Peking University Third Hospital were surveyed. Their evaluations on the C-TIRADS-based structured report for thyroid nodules were collected in the form of an online questionnaire and analyzed. The survey encompassed the advantages and disadvantages of the template, as well as potential barriers to its widespread promotion.

A total of 117 valid questionnaires were finally included in this study. The C-TIRADS-based structured report demonstrated several advantages over free-text reports, such as enhanced report quality (108/117, 92.31%), standardized diagnostic thinking and writing practices (101/117, 86.32%), increased rigor and logical coherence in classification diagnosis (99/117, 84.62%), reduced text-related errors (96/117, 82.05%), time efficiency (93/117, 79.49%), facilitation of standardized resident physician training (82/117, 70.09%), and improved communication among clinicians, radiologists, and patients (65/117, 55.56%). The areas that need improvement mainly focus on the inconvenience of text editing (16/34, 47.06%) and the rigid structure with limited autonomy (17/34, 50.00%). The majority (98.29%, 115/117) of the physicians believed that it is necessary to promote the usage of the structured report in standardized thyroid ultrasound scanning and quality control processes. The primary obstacles were attributed to the awareness of ultrasound doctors in the department (50/117, 42.74%), hardware conditions (39/117, 33.33%), and technical proficiency of ultrasound doctors (16/117, 13.68%).

The C-TIRADS-based structured ultrasound report for thyroid nodules has significant advantages and represents a standardized and normalized reporting approach, which is worthy of promotion in clinical practice.

To evaluate the implementation of plan-do-check-act (PDCA) cycle in critical value management within ultrasound departments across Anhui Province, in order to enhance the timeliness of reporting and healthcare quality through targeted interventions.

In February 2025, the Anhui Provincial Ultrasound Medicine Quality Control Center issued a critical value reporting survey to healthcare institutions across the province. The questionnaire encompassed three core domains: (1) demographic characteristics and institutional profiles of respondents; (2) operational bottlenecks encountered during critical value identification and reporting workflows; and (3) competency assessment on standardized protocols for critical value management. To synergize knowledge reinforcement with data collection, the 2022 edition of Medical Quality Control Indicators for Ultrasound Diagnosis was embedded as a normative reference appendix within the survey instrument. This design enabled real-time alignment of respondents' operational knowledge with national standards during survey completion. The intervention efficacy was quantitatively evaluated by analyzing the critical value reporting rate during the first quarter of 2025, which served as a key performance indicator for post-training quality improvement.

The survey revealed that insufficient training on critical value reporting knowledge, redundant reporting processes, and timely feedback for only a portion of reported critical value cases were the primary factors contributing to the low critical value reporting rate. Following targeted training programs, the critical value reporting rate in the first quarter of 2025 reached 99.53%, showing improvement compared to Anhui Province's rates of 97.73% in 2023 and 98.66% in 2024, and exceeding the national average of 99.38% in 2023.

In the implementation of PDCA cycle for critical value reporting in ultrasound departments across Anhui Province, insufficient training intensity, redundant reporting processes, and timely feedback on few reported critical value cases represent institutional bottlenecks and implementation barriers within the reporting system. Targeted interventions can improve the critical value notification rate.​

To summarize the causes of missed diagnosis in adult-type coarctation of the aorta (COA) by transthoracic echocardiography (TTE) and propose an optimized standardized scanning protocol to reduce diagnostic omissions.

A retrospective analysis was performed on 45 surgically/radiologically confirmed adult-type COA cases (23 pre-protocol optimization and 22 post-protocol optimization) diagnosed via TTE at the Second Affiliated Hospital of Nanchang University between January 2013 and February 2025. The core enhancements of the standardized scanning protocol included: systematically scanning the suprasternal notch view to obtain clear long-axis images of the aortic arch for assessing its morphology and stenosis characteristics, and routinely acquiring Doppler spectra in the abdominal aorta long-axis view (typically at the diaphragmatic level) to evaluate its hemodynamic features. The missed diagnosis rates pre- and post-protocol optimization were compared using the Fisher's exact test, with relative risk (RR) and number needed to treat (NNT) calculated.

The missed diagnosis rate by TTE significantly decreased from 34.78% (8/23) pre-protocol optimization to 4.55% (1/22) post-protocol optimization (P=0.004). The RR reduction was 87% (RR=0.13, 95% confidence interval: 0.02–0.87), and the NNT of 4 indicated that standardized protocol prevented one missed diagnosis per four patients.

Understanding the echocardiographic characteristics of adult-type COA and implementing the standardized scanning protocol can significantly reduce the missed diagnosis of adult-type COA by TTE.

To investigate the quality of abdominal ultrasound sectional images and reports in Anhui Province, identify existing problems, and propose improvement strategies.

In the first quarter of 2025, a total of 183 medical institutions in Anhui Province with ultrasound medicine specialties participated in data reporting through the abdominal ultrasound examination quality control network platform, with strict adherence to patient privacy protection protocols. Each hospital submitted six electronic copies of abdominal ultrasound reports along with corresponding stored images (including 3 hepatobiliary-pancreatic-spleen examinations and 3 urinary system and adrenal gland examinations). Based on the 2022 edition of the Ultrasound Medicine Quality Control Management Standards compiled by the National Ultrasound Medicine Quality Control Center, all reports were analyzed. The following quality metrics were statistically analyzed: the qualified rate of image storage in normal and pathological reports, the omission rate of comprehensive anatomical sections, the body marker rate, and the compliance rate of report documentation. Differences in image storage qualification rates between normal and pathological reports were analyzed using the chi-square test for multiple proportions, and comparisons were performed across four organ groups (liver, gallbladder, pancreas, and spleen) and five organ groups (urinary system and adrenal glands). For pairwise comparisons, the Bonferroni correction was applied. The chi-square test for 2×2 tables was employed to analyze the differences in body mark rates and report documentation compliance rates between the two groups (hepatobiliary-pancreatic-splenic vs urinary-adrenal).

Among 549 hepatobiliary, pancreatic, and splenic cases, the qualified rates of normal report image storage for the liver, gallbladder, pancreas, and spleen were 50.78%, 73.76%, 90.07%, and 91.49%, respectively. The qualified rates of image storage for pathological findings in the liver, gallbladder, pancreas, and spleen were 54.83%, 42.71%, 66.67%, and 52.14%, respectively. The overall missed image storage rate for hepatobiliary-pancreatic-splenic sections was 34.69%, with a notably higher proportion of missed hepatobiliary sections (44.62%). The body marker rate was 5.46% (30/549). The report documentation compliance rate was 73.22% (402/549). Among 580 cases of urinary tract and adrenal gland examinations, the qualified rates of standard image documentation for normal findings were as follows: kidney 89.86%, ureter 26.36%, bladder 67.39%, prostate 68.48%, and adrenal gland 75.11%. The adequate documentation rates for pathological findings were: kidney 53.14%, ureter 40.01%, bladder 55.47%, prostate 64.26%, and adrenal gland 65.65%. The overall missed capture rate for urinary-adrenal anatomical sections was 39.43%, with ureteral sections accounting for the highest proportion (66.72%). The body marker rate was 8.79% (51/580). Report compliance rate was 72.41% (420/580). The qualified rate of normal report image storage for the liver and biliary system was lower than that for the pancreas and spleen (P<0.001). The qualified rate of normal report image storage for the ureters was lower than that for the kidneys, bladder, prostate, and adrenal glands (P<0.001).

The abdominal ultrasound reports in Anhui Province show a relatively high rate of missing standard liver, biliary system, and ureter scan planes, along with a suboptimal report-writing compliance rate. It is necessary to strengthen quality control training in ultrasonography to improve the diagnostic quality of ultrasound examinations.

To evaluate the effect of the special training for prenatal ultrasound screening in Xizang Autonomous Region from 2016 to 2023, and to analyze the personnel structure, professional status, and training outcomes of trainees, with an aim of providing data-driven support for the optimization of subsequent special training programs in prenatal ultrasound screening.

From July 2016 to December 2023, based on the training outline of the China Birth Defects Foundation and the guidelines of the International Society of Ultrasound in Obstetrics and Gynecology, standardized prenatal ultrasound screening training was carried out. It was conducted for more than 2000 trainees from 120 hospitals across 7 regions of Xizang Autonomous Region, utilizing methods such as theoretical lectures, practical teaching, and case discussions. A questionnaire survey (on-site and digital) was carried out among 1475 trainees to summarize and analyze their personnel structure, professional status, and training effect.

During the eight-year training period, a "standardized prenatal ultrasound training system" was established for the Xizang Autonomous Region, and a team of physicians proficient in prenatal ultrasound screening and diagnosis was formed. Basic information of 1475 trainees and their affiliated hospitals was obtained. A total of 241 ultrasound physicians were certified in prenatal ultrasound diagnosis by the China Birth Defects Foundation and national training bases, while over 1000 physicians passed the online training and received prenatal ultrasound screening training certificates from the Xizang Ultrasound Medical Association. The majority of the trainees were aged between 20 and 29 (40.4%), and the majority had a bachelor's degree (57.4%). The proportion of those with junior or intermediate professional titles reached 72.1%, and their specialties were mainly imaging and clinical medicine. The proportion of trainees from secondary hospitals was the highest (46.3%), while those from tertiary hospitals accounted for 41.1%. More than half of the staff in 63.3% of the hospitals had received professional training. After the training, the proportion of fetal malformation detection in Xizang Autonomous Region to the total number of deliveries increased from 0.48% in 2015 to an annual average of 1.99% during the 8 years from 2016 to 2023. Each pregnant woman could receive 1-2 prenatal systematic ultrasound examinations during pregnancy.

The 8-year training survey data show that the hierarchical structure of both the participating hospitals and trainees is reasonable, laying a good foundation for the healthy and sustainable development of prenatal ultrasound services in the plateau.