Echoes Assessing the potential risk of rupture of abdominal aortic aneurysms. Khan S, Verma V, Verma S, et al. Clin Radiol 2015;70:11–20 An interesting review identifying factors other than size, which increase the risk of AAA rupture. These factors include growth rate, smoking, hypertension and family history. The ultimate goal, the authors say, would be to provide each patient with a personalised risk score for optimal AAA management rather than using the blunt instrument of size alone. International standards for early fetal size and pregnancy dating based on ultrasound measurement of crown-rump length in the first trimester of pregnancy. Papageorghiou A, Kennedy S, Salomon L, et al. Ultrasound Obstet Gynecol 2014;44:641–8 Involving teams and populations from the UK and around the world including China, Spain, India and Brazil, the INTERGROWTH-21st project has produced new datasets for crown-rump measurements in relation to gestational age, which are suitable for use throughout the world. Differential diagnosis of liver tumours using intraoperative real-time tissue elastography. Omichi K, Inoue Y, Hasegawa K, et al. Brit J Surg 2015;102:246–53 Intraoperative real-time elastography (IORTE) as well as Bmode intraoperative ultrasound were used to help characterise 221 focal liver lesions excluding cysts. Not only did IORTE show a good level of accuracy for characterisation, it also detected seven new lesions. Combined endorectal ultrasonography and strain elastography for the staging of early rectal cancer. Waage J, Bach S, Pfeffer F, et al. Colorectal Dis 2015;17:50–6 Still on the subject of elastography, the results from this study of 59 patients suggest that it may have a role in characterising rectal tumours too. Better characterisation from using endorectal ultrasound combined with elastography may help improve the selection of patients suitable for local resection. The use of FAST scan by paramedics in mass-casualty incidents: a simulation study. West B, Cusser A, Etengoff S, et al. Prehosp Disaster Med 2014;29:576–9 This interesting and very simply designed study looked at the performance of nine paramedics who had undergone FAST training. In a controlled environment, they each scanned 10 ‘patients’, five with abdominal free fluid (peritoneal dialysis patients) and five without. Two factors were assessed: a positive or negative

diagnosis and time taken. Paramedics took, on average, around 2 min per patient but had a mean accuracy of only 60%. They were more likely to call false positives than false negatives. Impact of high-fidelity transvaginal ultrasound simulation for radiology on residents’ performance and satisfaction. Ahmad R, Alhashmi G, Ajlan A, et al. Acad Radiol 2015;22:234–9 Here is a study from Saudi Arabia that some UK ultrasound departments may be interested in. Junior radiology trainees who had benefited from simulation sessions on how to perform transvaginal scans were better than their senior peers who had had only clinical training. The take-home message is that the authors say fewer scans now have to be repeated the next day. Diagnosis of congenital heart disease in an era of universal prenatal ultrasound screening in southwest Ohio. Sekar P, Heydarian H, Cnota J, et al. Cardiol Young 2015;25:35–41 It seems that prenatal cardiac detection rates during ultrasound screening are poor on both sides of the pond. This study from Ohio found that around 44% of major congenital heart abnormalities were identified with ultrasound screening. All aortic arch and great vessel valve anomalies were missed in this sample. The authors suggest that further education may help improve detection rates. Perfusion pattern and time of vascularisation with CEUS increase accuracy in differentiating between benign and malignant tumours in 216 musculoskeletal soft tissue masses. De Marchi A, Prever E, Cavallo F, et al. Eur J Radiol 2015;84:142–50 Here, perfusion patterns and vascularisation time using contrast-enhanced ultrasound (CEUS) in soft tissue tumours were correlated with histology. Those with rapid vascularisation and inhomogeneous enhancement were more likely to be malignant. Surprisingly, size and location in relation to the deep fascia were not found to be useful indicators. Five year retrospective case series of adnexal torsion. Nair S, Joy S, Nayar J. J Clin Diagn Res 2014;8:OC09–OC13 Perhaps unsurprisingly, this study found that most cases of ovarian torsion are diagnosed intraoperatively rather than by using ultrasound since symptoms are non-specific. Torsion occurred more commonly in premenopausal women, and polycystic ovaries were a risk factor in younger women.

Ultrasound 2015; 23: 131–132

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Volume 23

May 2015

.......................................................................................................................... Causes and consequences of portal vein thrombosis in 1,243 patients with cirrhosis: Results of a longitudinal study. Nery F, Chevret S, Condat B, et al. Hepatology 2015;61:660–7 This French and Belgian collaboration looked at the progression of liver disease in a large population over a mean follow-up time of 47 months. Ultrasound was used to interrogate the portal vein. The study found that the development of portal vein thrombosis was associated with the severity of liver disease at baseline, but that it was not responsible for further progression of liver disease. First-trimester contingent screening for trisomies 21, 18 and 13 by fetal nuchal translucency and ductus venosus flow and maternal blood cell-free DNA testing. Kagan K, Wright D, Nicolaides K. Ultrasound Obstet Gynecol 2015;45:42–7 This study of over 87,000 pregnancies suggests that cell-free fetal DNA testing in pregnancies with an intermediate risk

(1:11–1:3000) for trisomies 21, 18 and 13 after first-line screening will have very high detection rates and would be cheaper than offering cell-free fetal DNA testing to all. Military family physicians’ perceptions of a pocket pointof-care ultrasound device in clinical practice. Bornemann P, Bornemann G. Mil Med 2014;179:1474–7 Primary care physicians at an army medical centre in Hawaii received 16 h training on a hand-held ultrasound device and found it easy to use. They also reported that the device was helpful in aiding diagnosis, but no clinical examples, with or without measurable outcomes, were offered.

Hazel Edwards DOI: 10.1177/1742271X15579138

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