Thickened synovium with a hypoxic oxygenation status as measured with photoacoustic imaging was associated with fewer Doppler US signals and higher disease activity in study participants with rheum... Background Synovial hypoxia is a hallmark of rheumatoid arthritis (RA). Photoacoustic (PA) imaging, based on the use of laser-generated US, can detect the oxygenation status of tissue in individual...

Background: Vascular features are not commonly used to evaluate thyroid nodules by conventional ultrasound due to the low sensitivity. Superb Microvascular Imaging (SMI) is a new ultrasonic Doppler technology that specializes in depicting microvessels and low-speed flow. The objective of this study was to explore the value of microflow features on SMI in differentiating malignant from benign thyroid nodules. Methods: One hundred and seventy-seven adult patients with thyroid nodules in our center from October 2021 to June 2022 with available histopathological results were recruited, including 125 malignant nodules and 123 benign nodules. Preoperative ultrasound was performed using greyscale, Color Doppler Flow Imaging (CDFI), monochrome SMI (mSMI) and color SMI (cSMI). Vascular features such as flow richness, microflow distribution and microflow patterns of malignant thyroid nodules were compared with those of benign nodules. Results: Penetrating vessel ≥ 1 (82.4% in the malignant group vs. 30.9% in the benign group, P < 0.001), the crab claw-like pattern (64.0% vs. 10.6%, P < 0.001) and the root hair-like pattern (8.0% vs. 2.4%, P = 0.049) were common in malignant thyroid nodules, among which the crab claw-like pattern was an independent risk factor for malignant thyroid nodules. The wheel-like pattern (1.6% in the malignant group vs. 33.3% in the benign group, P < 0.001) and the arborescent pattern (0 vs. 19.5%, P < 0.001) were more likely to appear in benign nodules. The diagnostic specificities of the crab claw-like pattern and the root hair-like pattern for malignant thyroid nodules were 0.894, 0.976, and the positive predictive values were 0.860, 0.769. The diagnostic specificities of the wheel-like pattern and the arborescent pattern for benign thyroid nodules were 0.984, 1.000, and the positive predictive values were 0.953, 1.000. Conclusions: The crab claw-like pattern and the root hair-like pattern were microflow characteristics of malignant thyroid nodules. The wheel-like pattern and the arborescent pattern could help exclude the diagnosis of thyroid cancer.

To evaluate the efficacy of ultrasound and contrast-enhanced ultrasound (CEUS) in disease activity assessment of Takayasu arteritis (TA) with carotid involvement. This is a cohort study of 115 patients of TA with carotid involvement. We investigated correlations between clinical data, sonographic features, and CEUS enhancement at the site most prominent lesion of each patient. Disease activity was assessed by the National Institute of Health Kerr criteria. Sonographic findings were compared with follow-up examinations. CEUS was repeated after a 3–7 months interval in 35 patients to evaluate change of CEUS enhancement after treatment. Extensiveness of CEUS enhancement at most prominent carotid lesions had significant correlations with disease activity by the Kerr criteria (P < .001). The specificity of extensive enhancement for indicating active disease was 95%, while sensitivity was 67%. Patients with active disease showed greater arterial wall thickness and more prominent reduction of arterial wall thickness after treatment. Most of the patients (68%) with subsided active disease after treatment featured decrease of CEUS enhancement. Extensiveness of enhancement by CEUS and arterial wall thickness by ultrasonography may be useful markers for initial and follow-up assessment of disease activity of TA with common carotid artery involvement.

Objectives The aim of this study was to evaluate the differences in the tardus‐parvus pattern between atherosclerotic and nonatherosclerotic renal artery stenosis (RAS) and to explore the causes of these differences. Methods In 81 patients, including a nonatherosclerotic group (29 cases of Takayasu arteritis and 22 cases of fibromuscular dysplasia) and an atherosclerotic group (n = 30), RAS was detected by color Doppler sonography and confirmed by renal arteriography. Doppler spectra were obtained at the upper, middle, and lower pole interlobar arteries, and the one with the most prolonged acceleration time (AT) was selected for recording the AT and resistive index (RI). Results Renal angiography revealed 16 moderate RASs, 80 severe RASs, and 15 occlusions. No statistically significant differences were found in the AT between the atherosclerotic and nonatherosclerotic groups in the mild (P = .24), moderate (P = .63), and severe stenotic (P = .41) subgroups; however, there were statistically significant differences in the RI between the atherosclerotic and nonatherosclerotic groups in the mild (P < .001), moderate (P < .01), and severe (P < .001) subgroups. The RI values in the atherosclerotic group were much higher than those in the nonatherosclerotic group for the 3 stenotic subgroups. Conclusions The AT measurement method used widely now cannot differentiate potential differences in pulsus‐tardus waveforms between atherosclerotic and nonatherosclerotic RAS; however, it remains a useful approach to detect RAS. Different RI cutoff values should be established according to atherosclerotic and nonatherosclerotic RAS, and consideration of influencing factors for the RI will help reduce misdiagnosis.