Search Results (529)

Background: Pigmented superficial skin lesions pose a persistent diagnostic challenge due to overlapping clinical and dermoscopic appearances between benign and malignant entities. While histopathology remains the gold standard, there is growing interest in non-invasive imaging models that can preoperatively stratify malignancy risk. This methodological pilot study was designed to explore the feasibility and initial diagnostic performance of a novel radiology-adapted logistic regression approach. To develop and preliminarily evaluate a new logistic model integrating both structural (lesion size, depth) and vascular (Doppler patterns) ultrasonographic features for non-invasive risk stratification of pigmented superficial skin lesions. Material and Methods: In this prospective single-center pilot investigation, 44 patients underwent standardized high-frequency grayscale and Doppler ultrasound prior to excisional biopsy. Lesion size, depth, and vascularity patterns were systematically recorded. Three logistic regression models were constructed: (1) based on lesion size and depth, (2) based on vascularity patterns alone, and (3) combining all parameters. Model performance was assessed via ROC curve analysis. Intra-observer reliability was determined by repeated measurements on a random subset. Results: The lesion size and depth model yielded an AUC of 0.79, underscoring the role of structural features. The vascularity-only model showed an AUC of 0.76. The combined model demonstrated superior discriminative ability, with an AUC of approximately 0.85. Intra-observer analysis confirmed excellent repeatability (κ > 0.80; ICC > 0.85). Conclusions: This pilot study introduces a novel logistic framework that combines grayscale and Doppler ultrasound parameters to enhance non-invasive malignancy risk assessment in pigmented superficial skin lesions. These encouraging initial results warrant larger multicenter studies to validate and refine this promising approach. Full article

Coronary artery disease (CAD) is the third leading cause of disability and death globally. Intravascular ultrasound (IVUS) is the most commonly used imaging modality for the characterization of vulnerable plaques. The development of novel intravascular imaging and therapy devices requires dedicated open systems (e.g., for pulse sequences for imaging or thrombolysis), which are not currently available. This paper presents the development of a novel multifunctional FPGA-based pulser/receiver system for intravascular ultrasound imaging and therapy research. The open platform consists of a host PC with a Matlab-based software interface, an FPGA board, and a proprietary analog front-end board with state-of-the-art electronics for highly flexible transmission and reception schemes. The main features of the system include the capability to convert arbitrary waveforms into tristate bipolar pulses by using the PWM technique and by the direct acquisition of raw radiofrequency (RF) echo data. The results of a multicycle excitation pulse applied to a custom 550 kHz therapy transducer for acoustic characterization and a pulse-echo experiment conducted with a high-voltage, short-pulse excitation for a 19.48 MHz transducer are reported. Testing results show that the proposed system can be easily controlled to match the frequency and bandwidth required for different IVUS transducers across a broad class of applications. Full article

Background: Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease and a major cause of morbidity and mortality among preterm infants. Traditional diagnostic methods such as abdominal radiography have limited sensitivity in early disease stages, prompting interest in bowel ultrasound (BUS) as a complementary imaging modality. Objective: This scoping review aims to synthesize existing literature on the role of ultra sound in the early detection, diagnosis, and management of NEC, with emphasis on its diagnostic performance, integration into clinical care, and technological innovations. Methods: Following PRISMA-ScR guidelines, a systematic search was conducted across PubMed, Embase, Cochrane Library, and Google Scholar for studies published between January 2000 and December 2025. Inclusion criteria encompassed original research, reviews, and clinical studies evaluating the use of bowel, intestinal, or Doppler ultrasound in neonates with suspected or confirmed NEC. Data were extracted, categorized by study design, population characteristics, ultrasound features, and diagnostic outcomes, and qualitatively synthesized. Results: A total of 101 studies were included. BUS demonstrated superior sensitivity over radiography in detecting early features of NEC, including bowel wall thickening, portal venous gas, and altered peristalsis. Doppler ultrasound, both antenatal and postnatal, was effective in identifying perfusion deficits predictive of NEC onset. Neonatologist-performed ultrasound (NEOBUS) showed high interobserver agreement when standardized protocols were used. Emerging tools such as ultra-high-frequency ultrasound (UHFUS) and artificial intelligence (AI)-enhanced analysis hold potential to improve diagnostic precision. Point-of-care ultrasound (POCUS) appears feasible in resource-limited settings, though implementation barriers remain. Conclusions: Bowel ultrasound is a valuable adjunct to conventional imaging in NEC diagnosis. Standardized protocols, validation of advanced technologies, and out come-based studies are essential to guide its broader clinical adoption. Full article

Porphyrins play an extremely important role in both photodynamic (PDT) and sonodynamic therapy (SDT). These techniques, which have a lot in common, are largely based on the interaction between the sensitizer and light or ultrasounds (US), respectively, resulting in the formation of reactive oxygen species (ROS) that have the ability to destroy target cells. SDT requires the use of an appropriate frequency of US waves that are able to excite the chemical compound used. In this study, five porphyrin complexes were used: free-base meso-tetra(N-methyl-pyridinium-4-yl)porphyrin (TMPyP) and its transition metal complexes containing zinc(II), palladium(II), copper(II), and chloride-iron(II). The sonodynamic activity of these compounds was studied in vitro. The obtained results confirm the significant relationship between the chemical structure of the macrocycle and its stability and ability to generate ROS. The highest efficiency in ROS generation and high stability were demonstrated by non-metalated compound and its complex with zinc(II), while complex with copper(II), although less stable, were equally effective in terms of ROS production. Antibacterial activity tests showed the unique properties of the tested compounds, including a reduction in the number of both planktonic and biofilm antibiotic-resistant microorganisms above 5 log, which is rare among sonosensitizers. Full article

Pulmonary hemorrhage (PH) is a life-threatening complication predominantly affecting preterm infants, particularly those with very low birth weight (VLBW) and fetal growth restriction (FGR). Typically occurring within the first 72 h of life, PH is characterized by acute respiratory deterioration and significant morbidity and mortality. This review synthesizes current evidence on the multifactorial pathogenesis of PH, highlighting the roles of immature pulmonary vasculature, surfactant-induced hemodynamic shifts, and left ventricular diastolic dysfunction. Key risk factors include respiratory distress syndrome (RDS), hemodynamically significant patent ductus arteriosus (hsPDA), sepsis, coagulopathies, and genetic predispositions. Diagnostic approaches incorporate clinical signs, chest imaging, lung ultrasound, and echocardiography. Management strategies are multifaceted and include ventilatory support—particularly high-frequency oscillatory ventilation (HFOV)—surfactant re-administration, blood product transfusion, and targeted hemostatic agents. Emerging therapies such as recombinant activated factor VII and antifibrinolytics show promise but require further investigation. Preventive measures like antenatal corticosteroids and early indomethacin prophylaxis may reduce incidence, particularly in high-risk populations. Despite advancements in neonatal care, PH remains a major contributor to neonatal mortality and long-term neurodevelopmental impairment. Future research should focus on individualized risk stratification, early diagnostic tools, and optimized treatment protocols to improve outcomes. Multidisciplinary collaboration and innovation are essential to advancing care for this vulnerable population. Full article

Striae distensae (SD), or stretch marks, are a common aesthetic concern with limited effective treatment options. This prospective, single-center, open-label study aimed to evaluate the efficacy and safety of 1470 nm non-ablative laser therapy in improving skin texture and reducing SD dimensions. Twenty healthy female volunteers (aged 19–56) with SD of varying stages underwent three laser sessions at three-week intervals. Treatments were delivered using energy densities of 28–35 mJ per point with spot spacing of 0.8–1.2 mm, uniformly delivered over the affected SD lesions. Assessments were performed at baseline, Day 14, Day 35, Day 56–70, and Day 118–132. SD depth and width were measured using high-frequency ultrasound; aesthetic improvement was assessed using the Global Aesthetic Improvement Scale (GAIS), alongside clinical and photographic evaluations. A statistically significant, progressive reduction in SD size was observed: mean depth decreased from 0.34 mm (SD = 0.16) to 0.18 mm (SD = 0.15), and width decreased from 6.58 mm (SD = 2.65) to 4.40 mm (SD = 2.52) by Day 118–132 (p < 0.01 for both). Most participants reported improvement on GAIS at each follow-up. No severe adverse events occurred; only mild, transient erythema and edema were noted. In conclusion, 1470 nm non-ablative laser therapy showed significant efficacy and a favorable safety profile in SD treatment, offering a promising non-invasive option based on fractional thermal stimulation and selective dermal absorption. Full article

Objectives: We aimed to quantify the damage burden measured using the Damage Index for Antiphospholipid Syndrome (DIAPS) in patients with antiphospholipid syndrome (APS) and identify patients with high damage as well as any correlations of damage with subclinical atherosclerosis. Methods: Patient damage was assessed via DIAPS. Based on demographic, clinical and laboratory characteristics, patients were divided into two subgroups: thrombotic APS patients with high vs. low damage, and non-thrombotic aPL-positive patients with vs. without damage. Participants underwent carotid/femoral ultrasound for atherosclerotic plaque detection and carotid–femoral and carotid-radial pulse wave velocity (PWV). Results: We included 112 patients with an APS diagnosis, 57 (50.9%) with primary APS and 55 (49.1%) with associated SLE. Cardiovascular (CVD) risk factors and complications were significantly more frequent in the thrombotic group, as well as in patients with high damage within the thrombotic group. We did not identify any risk factors for increased damage in the non-thrombotic group. Atherosclerotic plaque presence was present in 27 (24%) of the patients in this study with the same frequency in the APS and APS/SLE groups (p = 0.5446). Pulse wave velocity (PWV) was elevated in 27–32% patients according to analyzed arteries. Elevated PWV was more frequent in the APS group in comparison to APS/SLE only between carotid and radial arteries (p = 0.0012). Both atherosclerotic plaque presence and PWV did not correlate with damage severity. Conclusions: DIAPS indicates substantial damage in APS patients in our study. High organ damage mainly affected thrombotic patients and was related to CVD complications. At the same time, screening of subclinical atherosclerosis seems not to predict higher damage in APS patients. Full article

Shale oil, a major unconventional energy source with extensive global reserves, presents significant processing challenges due to the exceptional stability of its emulsions. Characterized by small droplet sizes and high interfacial film strength, these emulsions resist efficient treatment via conventional thermal-chemical or electrostatic dehydration. To address the difficulties in separation, unclear dehydration mechanisms, and inconsistent single-field (electric) performance, this study investigates dehydration using a novel electric–magnetic–ultrasonic coupling field system. Dehydration efficiency under an electric field alone increased with electric field strength, frequency, duration, and temperature. Magnetic or ultrasonic fields alone yielded negligible effects. Coupling an electric field with ultrasound enhanced efficiency, while adding a magnetic field to electricity provided no improvement and decreased efficiency with longer exposure or higher magnetic intensity. The multi-field coupling achieved significant demulsification. Both optimal dehydration performance and minimum energy consumption operating conditions were identified, capable of reducing shale oil water content below 0.5%. Full article

Traditional PMUT ultrasonic ranging systems usually possess a large measurement blind area under the integrated transmit–receive mode, dramatically limiting its distance measurement in confined spaces, such as when determining the clearance of large bearing components. Here, a broadband PMUT rangefinder was designed by integrating six types of different cells with adjacent resonant frequencies into an array. Through overlapping and coupling of the bandwidths from the different cells, the proposed PMUTs showed a wide –6 dB fractional bandwidth of 108% in silicon oil. Due to the broadening of bandwidth, the device could obtain the maximum steady state with less excitation (5 cycles versus 14 cycles) and reduce its residual ring-down (ca. 6 μs versus 15 μs) compared with the traditional PMUT array with the same cells, resulting in a small blind area. The pulse–echo ranging experiments demonstrated that the blind area was effectively reduced to 4.4 mm in air or 12.8 mm in silicon oil, and the error was controlled within ±0.3 mm for distance measurements up to 250 mm. In addition, a specific ultrasound signal processing circuit with functions of transmitting, receiving, and processing ultrasonic waves was developed. Combining the processing circuit and PMUT device, the system was applied to determine the axial clearance of the main bearing in a tunneling machine. This work develops broadband PMUTs with a small blind area and high resolution for distance measurement in narrow and confined spaces, opening up a new path for ultrasonic ranging technology. Full article

(1) Background: Lymphedema is a common but underrecognized sequela of cancer treatment. Supermicrosurgical procedures such as lymphaticovenular anastomosis (LVA) and, more recently, lymph node-to-vein anastomosis (LNVA) have emerged as effective options for fluid-predominant disease. In 2024, we began performing robot-assisted LNVA using a next-generation microsurgical robot. This study describes our initial experience, technical insights, and the potential for robotics to extend the boundaries of supermicrosurgery. (2) Methods: Twenty-two consecutive robotic LNVAs were performed by a high-volume supermicrosurgeon at a tertiary center. Preoperative imaging with standard and ultra-high frequency ultrasound was used to identify optimal lymph nodes and veins. Robotic LNVA was performed using the Symani Surgical System, with adaptations for motion scaling, ergonomics, and console control. Intraoperative patency was confirmed by direct washout and/or indocyanine green (ICG) transit. (3) Results: All 22 procedures were technically successful, with 100% intraoperative patency. Anastomosis time improved from 37 to 18 min. Robotic assistance enhanced precision, eliminated tremors, and reduced the technical burden of operating at extreme submillimeter scales. (4) Conclusions: Robotic LNVA is safe, feasible, and efficient. It optimizes current techniques, offering the potential to extend surgical access below the 0.1 mm threshold, with implications for future treatment of lymphatic and possibly intracranial disease. Full article

Background: Arterial variations in the upper limb, although infrequent, carry critical clinical implications. The presence of superficial ulnar and radial arteries, especially when originating from high levels, increases the risk of iatrogenic injury, misdiagnosis, and surgical complications. To confirm and describe, through ultrasound and anatomical dissection, the presence of a high-origin superficial ulnar artery and a superficial radial artery in a cadaver, highlighting their anatomical trajectory and clinical relevance. Methods: A cross-sectional ultrasound and anatomical study was conducted on 150 upper limbs from fresh-frozen cadavers. High-frequency ultrasound was used to scan the vasculature from the axilla to the wrist. Subsequently, dissection was performed to confirm sonographic findings. Results: One case (0.66%) of concurrent superficial ulnar artery and superficial radial artery was identified in the left arm of a 79-year-old male cadaver. The superficial ulnar artery originated from the axillary artery and coursed superficially along the forearm, anterior to the flexor muscles. The superficial radial artery emerged from the brachial artery and ran subcutaneously in the distal forearm. These arteries remained in close relation to key neural and venous structures, increasing their vulnerability to clinical error. Conclusions: The identification of high-origin superficial arteries is essential for clinical practice. Ultrasound serves as a reliable, non-invasive method for detecting such variations preoperatively. Awareness of these anomalies can prevent inadvertent vascular injuries, improve diagnostic accuracy, and inform safer surgical and anesthetic approaches in upper limb interventions. Full article

Here, we describe the case of a 48-year-old female patient with prurigo nodularis, where B-mode and color-Doppler ultrasound of one nodule was performed; this revealed hypoechoic dermal and hyperechoic epidermal thickening with lesion hypervascularity. To the best of our knowledge, no previous published articles have reported ultra-high-frequency ultrasound images of this disease, so this case can encourage prurigo nodularis studies in order to better assess ultrasound features and their usefulness in supporting clinical diagnosis and in distinguishing prurigo nodularis from other diseases. Full article

The increasing demand for accurate and accessible medical imaging has driven efforts to develop technologies that overcome limitations associated with conventional imaging techniques, such as MRI and CT scans. This study presents the design and implementation of an electronic interface for acquiring signals from a piezoelectric ultrasound sensor with the aim of improving image reconstruction quality by addressing electromagnetic interference and speckle noise, two major factors that degrade image fidelity. The proposed interface is installed between the ultrasound transducer and acquisition system, allowing real-time signal capture without altering the medical equipment’s operation. Using a printed circuit board with 110-pin connectors, signals from individual piezoelectric elements were analyzed using an oscilloscope. Results show that noise amplitudes occasionally exceed those of the acoustic echoes, potentially compromising image quality. By enabling direct observation of these signals, the interface facilitates the future development of analog filtering solutions to mitigate high-frequency noise before digital processing. This approach reduces reliance on computationally expensive digital filtering, offering a low-cost, real-time alternative. The findings underscore the potential of the interface to enhance diagnostic accuracy and support further innovation in medical imaging technologies. Full article

Objectives: Unlike other body parts, unclarified lesions at the end of extremities have unique challenges due to their small size and interference. Traditional imaging methods struggle with low resolution. HFUS enhances resolution, offering a potential diagnostic value. Methods: From January 2019 to October 2023, the clinical and HFUS data of patients with unclarified lesions at the end of extremities were retrospectively analyzed. Independently, the diagnosis was made using two diagnostic modes (Mode A: only clinical information; Mode B: clinical and HFUS information). The diagnostic performance of the two modes was evaluated across different classification methods. Results: For all lesions, the correct rate of Mode B was higher than that of Mode A (52.8% vs. 18.4%, p < 0.001), and the indeterminate rate decreased by 43.0%. For benign lesions (51.0% vs. 18.2%), subungual lesions (40.8% vs. 21.1%), non-subungual lesions (55.6% vs. 17.8%), and common cases (60.9% vs. 20.3%), the diagnostic correct rate of Mode B was also higher than that of Mode A (all p < 0.05). However, there was no significant difference in rare lesions (9.8% vs. 4.9%) and malignant lesions (62.9% vs. 19.4%) between the two modes (both p > 0.05). Moreover, the indeterminate rate for all categories of lesions significantly diminished. Otherwise, Mode B demonstrated strong performance for malignant lesions (85.7% vs. 42.9%, p < 0.001). Conclusions: Adding HFUS can significantly improve the accuracy of diagnosing unclarified lesions at the end of extremities and reduce uncertainty, especially for benign and common lesions. HFUS has also demonstrated better performance in screening for malignant lesions. Full article

Objective: The aim of this study was to assess the performance and feasibility of ultra-high-frequency ultrasound (UHF-US) in clinical practice for measuring skin thickness in patients with systemic sclerosis (SSc) compared to age- and sex-matched controls. Materials and Methods: A total of 14 patients with SSc and 14 healthy controls (HCs) were enrolled in the study. All subjects underwent US evaluation of the epidermis, dermis and cutis by three experts in the 17 sites of the modified Rodnan skin score (mRSS). All the sonographers were blinded to the mRSS, which was assessed by an experienced rheumatologist who was not involved in, and blinded to, the US assessment. Results: In comparison to HCs, dermal thickness was significantly higher in patients at six sites: the right (p < 0.001) and left (p = 0.001) finger; right (p = 0.027) and left (p = 0.048) hand; left foot (p = 0.010) and face (p < 0.001). The epidermal layer did not differ significantly. At all mRSS sites except for the chest, there were moderate to strong positive correlations between US-assessed dermal thickness and local mRSS. The interobserver reliability for all sites of the mRSS, with the exception of the face, was good to excellent (with an intraclass correlation coefficient [ICC] ranging from 0.724 to 0.939). Conclusions: These data support the use of UHF-US as an objective and reliable tool for the assessment of skin involvement in patients with SSc. Considering its feasibility in clinical practice, we suggest that US assessment of skin in patients with SSc should be restricted to the dermal layer of the fingers and hands, since they are the sites that skin fibrosis typically starts from. Full article