Explore the vast range of titles available.

Introduction Perineal tears are classified into four degrees based on severity. Second‐degree tears, which involve the muscles fusing into the perineal body, but not the anal sphincter, vary in extent and have recently been subcategorized. However, knowledge about their long‐term anatomical impact on the perineal body remains limited, as postpartum evaluation has largely relied on inspection and palpation. This study aimed to examine the association between the severity of perineal tears not affecting the anal sphincter, diagnosed at delivery, and deviations in the muscles fusing into the perineal body, assessed by three‐dimensional ultrasound 1 year after vaginal delivery. Material and Methods This prospective cohort study included 384 primiparous women with vaginal deliveries at Akershus University Hospital, Norway, from January 2021 to July 2022. Perineal tears were classified and sutured according to international standards at delivery. In addition, second‐degree tears were subclassified according to the percentage of the perineal body damage (<50% = 2A, ≥50% = 2B, entire perineal body without anal sphincter = 2C). Women with third‐ or fourth‐degree tears were excluded. One year after delivery, participants underwent three‐dimensional endovaginal and endoanal ultrasound examinations. The transverse perineal, puboperinealis, and puboanalis muscles were examined at their fusion into the perineal body. A deviation was defined as a muscle discontinuity or absence in at least one of the muscles. Results The proportion of women with sonographically detected muscle deviations increased with tear severity: 22% for first‐degree (n = 24), 52.7% for 2A (n = 29), 60% for 2B (n = 21) and 86.2% for 2C (n = 25). Among women with episiotomies (n = 126), 60.6% had one or more muscle deviations. A higher number of muscles were affected in the 2C tear group compared to 2B and 2A. Conclusion Sonographic deviations in the muscles fusing into the perineal body increase with the severity of perineal tears. Sonographic deviations in the muscles fusing into the perineal body were increasingly common with greater perineal tear severity 1 year after delivery in primiparous women.

Background In recent years it has become clear that fetal anomalies can already be detected at the end of the first trimester of pregnancy by two-dimensional (2D) ultrasound. This is why increasingly in developed countries the first trimester anomaly scan is being offered as part of standard care. We have developed a Virtual Reality (VR) approach to improve the diagnostic abilities of 2D ultrasound. Three-dimensional (3D) ultrasound datasets are used in VR assessment, enabling real depth perception and unique interaction. The aim of this study is to investigate whether first trimester 3D VR ultrasound is of additional value in terms of diagnostic accuracy for the detection of fetal anomalies. Health-related quality of life, cost-effectiveness and also the perspective of both patient and ultrasonographer on the 3D VR modality will be studied. Methods Women in the first trimester of a high risk pregnancy for a fetus with a congenital anomaly are eligible for inclusion. This is a randomized controlled trial with two intervention arms. The control group receives ‘care as usual’: a second trimester 2D advanced ultrasound examination. The intervention group will undergo an additional first trimester 2D and 3D VR ultrasound examination. Following each examination participants will fill in validated questionnaires evaluating their quality of life and healthcare related expenses. Participants’ and ultrasonographers’ perspectives on the 3D VR ultrasound will be surveyed. The primary outcome will be the detection of fetal anomalies. The additional first trimester 3D VR ultrasound examination will be compared to ‘care as usual’. Neonatal or histopathological examinations are considered the gold standard for the detection of congenital anomalies. To reach statistical significance and 80% power with a detection rate of 65% for second trimester ultrasound examination and 70% for the combined detection of first trimester 3D VR and second trimester ultrasound examination, a sample size of 2800 participants is needed. Discussion First trimester 3D VR detection of fetal anomalies may improve patients’ quality of life through reassurance or earlier identification of malformations. Results of this study will provide policymakers and healthcare professionals with the highest level of evidence for cost-effectiveness of first trimester ultrasound using a 3D VR approach. Trial registration Dutch Trial Registration number NTR6309 , date of registration 26 January 2017.

Objective: Gestational diabetes mellitus (GDM) has an impact on fetal adrenal gland size and volume, which are greater in the GDM population. This study used 2D and 3D ultrasound scanning to determine the correlation of fetal adrenal gland size and volume with fructosamine levels, HbA1c levels, estimated fetal weight (EFW), and neonatal birth weight in GDM patients. Methods: This study included eighty singleton pregnant women diagnosed with GDM between 24-28 weeks of gestation. During weeks 32-34 of gestation, the length, width, and depth of the fetal zone and total adrenal gland were measured using transabdominal 2D ultrasound. Virtual organ computer-aided analysis (VOCAL) software was used to evaluate fetal zone and total adrenal gland volume in 3D ultrasound. All the participants were followed until delivery. Pearson's correlation analysis was conducted to examine the correlation between fetal adrenal gland ultrasound measurements and the factors of interest. Results: The study consisted of sixty-six (82.5%) pregnant women with diet-controlled GDM (GDMA1) and fourteen (17.5%) pregnant women with insulin-managed GDM (GDMA2). There was no difference in fetal adrenal gland measurements between the diet-controlled (GDMA1) and the insulin-managed (GDMA2) groups. All the participants had achieved optimal glucose levels at the time of ultrasound acquisition. The total adrenal gland length and fetal zone volume had statistically significant positive correlations with EFW (r = 0.69, p = 0.02 and r = 0.84, p = 0.01, respectively). After adjusting for EFW, only the fetal zone volume was significantly correlated with fructosamine levels (adjusted-OR = 2.4, 95% CI: 1.5, 3.9, p = 0.01) and HbA1c levels (adjusted-OR = 2.5, 95% CI: 1.6, 4.3, p = 0.01). Conclusion: The fetal zone volume is correlated with EFW, fructosamine levels, and HbA1c levels. This non-invasive technique may be beneficial as an indirect marker for glycemic monitoring in GDM. Keywords: fetal adrenal gland, three-dimensional ultrasound, two-dimensional ultrasound, fructosamine level, correlation, gestational diabetes mellitus

Background This study aimed to investigate the electrophysiological characteristics of idiopathic ventricular arrhythmias (VAs) originating from the left ventricular posterior papillary muscles (LPPM) and explore the efficiency of catheter ablation using three‐dimensional intracardiac ultrasound technology. Methods Twenty‐seven cases of premature ventricular contraction/ventricular tachycardia (PVC/VT) originating from the left ventricular posterior papillary muscles were recorded from July 2015 to June 2019 in the Central Hospital of Shengli Oil Field and the First Affiliated Hospital of Zhengzhou University. Electrophysiological mapping and radiofrequency catheter ablation (RFCA) were performed using three‐dimensional intracardiac ultrasound technology. The characteristics of the body surface and intracavity electrocardiogram were analyzed. All cases were followed up for 24 months after the operation. Results The VAs of all 27 cases were successfully eliminated by catheter ablation. QRS complexes were observed with a right bundle branch block (RBBB) pattern and a steep slope in the initial segment. Lead I appeared with an Rs pattern, and inferior leads (lead II, III, and aVF) were usually with an S wave. The lead aVR appeared with a qR pattern, while the R wave was commonly found in aVL. The main wave in leads V1‐V3 was positive but negative in V5 and V6. Conclusion Ventricular arrhythmias originating from the left ventricular posterior papillary muscles have similar electrophysiological characteristics. The origin site was accurately located using three‐dimensional intracardiac ultrasound technology. Catheter ablation effectively eliminated VAs. Ventricular arrhythmias (VAs) originating from the left ventricular posterior papillary muscles have similar electrophysiological characteristics. The origin site was accurately located using three‐dimensional intracardiac ultrasound technology. Catheter ablation effectively eliminated VAs.

Objectives The Schroth method is considered potentially valuable as an alternative intervention to control curve progression in mild to moderate adolescent idiopathic scoliosis. However, patients are often dependent on the subjective experience of the physiotherapist when practicing, as changes in spinal alignment and muscle activation are unknown. The aim of this study was to evaluate the effectiveness of the Schroth method for spinal alignment and muscle activation in adolescents with idiopathic scoliosis (AIS). Methods This prospective cross‐sectional study, conducted at the Scoliosis Engineering Center of Guangzhou Sport University (January 2020–October 2022), enrolled 36 AIS (4 males, 32 females; age 13.2 ± 1.8 years) presenting major thoracic curvature (Cobb angle: 10°–40°, Risser stage 0–4). Participants underwent a standardized 1‐week pretraining protocol before performing four Schroth exercises (“50 × Pezziball,” sail, muscle cylinder, and corrected standing). Real‐time spinal ultrasound angles (SUAs) and paraspinal muscle activation (via surface electromyography, sEMG) were quantified during habitual standing (baseline) and exercise conditions. Normality was verified using Kolmogorov–Smirnov tests. Within‐group comparisons employed paired t‐tests (effect sizes: Cohen's d; 95% CIs), while proximal thoracic (PT) compensation frequencies were assessed via chi‐squared tests. Results All four Schroth exercises significantly reduced the SUA of the primary thoracic curve compared to habitual standing (p < 0.05). The lumbar curve SUA decreased specifically after “50 × Pezziball” and muscle cylinder exercises (p < 0.05). PT curve compensation frequency rose from 16.7% (6/36) in habitual standing to 33.3% (12/36) and 30.6% (11/36) during “50 × Pezziball” and sail exercises, respectively (p < 0.05). sEMG demonstrated reduced paravertebral muscle (PSM) activation asymmetry at the thoracic apex (T8) during corrective standing, “50 × Pezziball,” and sail exercises (p < 0.05). However, “50 × Pezziball” and sail exercises triggered compensatory left‐dominant PSM imbalance at T2 (p < 0.05). At lumbar levels (L2–L5), performing 50 × Pezziball exercise exacerbated asymmetry (p < 0.05), whereas muscle cylinder exercises reversed the activation patterns of the PSM (p < 0.05). Conclusion While Schroth exercises effectively reduced thoracic curvature and improved T8 muscle symmetry, caution is warranted during “50 × Pezziball” and sail exercises due to increased PT compensation and lumbar/T2 muscle imbalances. Muscle cylinder exercises may mitigate adverse lumbar effects. The Schroth method as an alternative therapy for mild to moderate adolescent idiopathic scoliosis. This study focused on investigating changes in spinal alignment and paravertebral muscle (PSM) activation parameters during Schroth exercise. We found that Schroth exercise should be chosen with caution: potential effects of compensatory curves and paraspinal muscle activation imbalances.

Background Adenomyosis is linked to infertility, but the mechanisms behind this relationship are not clearly established. Similarly, the impact of adenomyosis on ART outcome is not fully understood. Our main objective was to use ultrasound imaging to investigate adenomyosis prevalence and severity in a population of infertile women, as well as specifically among women experiencing recurrent miscarriages (RM) or repeated implantation failure (RIF) in ART. Methods Cross-sectional study conducted in 1015 patients undergoing ART from January 2009 to December 2013 and referred for 3D ultrasound to complete study prior to initiating an ART cycle, or after ≥3 IVF failures or ≥2 miscarriages at diagnostic imaging unit at university-affiliated private IVF unit. Adenomyosis was diagnosed in presence of globular uterine configuration, myometrial anterior-posterior asymmetry, heterogeneous myometrial echotexture, poor definition of the endometrial-myometrial interface (junction zone) or subendometrial cysts. Shape of endometrial cavity was classified in three categories: 1.-normal (triangular morphology); 2.- moderate distortion of the triangular aspect and 3.- “pseudo T-shaped” morphology. Results The prevalence of adenomyosis was 24.4 % ( n  = 248) [29.7 % (94/316) in women aged ≥40 y.o and 22 % (154/699) in women aged <40 y.o., p  = 0.003)]. Its prevalence was higher in those cases of recurrent pregnancy loss [38.2 % (26/68) vs 22.3 % (172/769), p  < 0.005] and previous ART failure [34.7 % (107/308) vs 24.4 % (248/1015), p  < 0.0001]. The presence of adenomyosis has been shown to be associated to endometriosis [35.1 % (34/97)]. Adenomyosis was diagnosed as a primary finding “de novo” in 80.6 % ( n  = 200) of the infertile patients. The impact on the uterine cavity was mild, moderate and severe in 63.7, 22.6 and 10.1 % of the cases, respectively. Conclusions Our results indicate that adenomyosis is a clinical condition with a high prevalence that may affect the reproductive results. The described severity criteria may help future validating studies for better counseling of infertile couples.

[This corrects the article DOI: 10.3389/fnins.2025.1623105.].

Objective This study aims to investigate the diagnostic value of three-dimensional pelvic ultrasound in the preoperative assessment of anal fistula compared with findings of MRI and surgery. Methods A total of 67 patients (62 males) with suspected anal fistula were analyzed retrospectively. Preoperative three-dimensional pelvic ultrasound and magnetic resonance imaging were performed in all patients. The number of internal openings and the type of fistula were recorded. The accuracy of three-dimensional pelvic ultrasound was determined by comparing these parameters with surgical outcomes. Results At surgery, 5 (6%) were extrasphincteric, 10 (12%) were suprasphincteric, 11 (14%) were intersphincteric, and 55 (68%) were transsphincteric. There was no significant difference in the accuracy of pelvic 3D US and MRI, based on internal openings (97.92%, 94.79%), anal fistulas (97.01%, 94.03%), and those under Parks classification (97.53%, 93.83%). Conclusion Three-dimensional pelvic ultrasound is a reproducible and accurate method for determining the type of fistula and detecting internal openings and anal fistulas.

The present study evaluated the prognostic value of three-dimensional ultrasound for fetal hydronephrosis. Pregnant females with fetal hydronephrosis were enrolled and a novel three-dimensional ultrasound indicator, renal parenchymal volume/kidney volume, was introduced to predict the postnatal prognosis of fetal hydronephrosis in comparison with commonly used ultrasound indicators. All ultrasound indicators of fetal hydronephrosis could predict whether postnatal surgery was required for fetal hydronephrosis; however, the predictive performance of renal parenchymal volume/kidney volume measurements as an individual indicator was the highest. In conclusion, ultrasound is important in predicting whether postnatal surgery is required for fetal hydronephrosis, and the three-dimensional ultrasound indicator renal parenchymal volume/kidney volume has a high predictive performance. Furthermore, the majority of cases of fetal hydronephrosis spontaneously regress subsequent to birth, and the regression time is closely associated with ultrasound indicators.

Background Differentiated thyroid cancer (DTC) accounts for the majority of thyroid cancers. The preoperative diagnosis of extrathyroidal extension (ETE) in DTC patients is highly important. However, two-dimensional ultrasound (2D-US) has several limitations in diagnosing ETE. This study aimed to evaluate the efficiency of OmniView of three-dimensional ultrasound (3D-OmniView) in assessing the ETE of DTC patients compared with that of 2D-US. Methods Patients who underwent thyroid surgery for nodules adjacent to the thyroid capsule between February 2016 and January 2018 were prospectively enrolled in this study. Both 2D-US and 3D-OmniView were used to evaluate ETE of thyroid nodules. The definition for ETE in ultrasound images was capsule disruption, or capsule disruption and surrounding tissue invasion. Intraoperative and pathological findings of ETE were considered positive. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and area under the ROC curve (AUC) were calculated. Results A total of 176 DTC nodules from 137 patients were included in this study. ETE was identified in 67.0% of the nodules. The sensitivity, accuracy, NPV and AUC of 3D-OmniView for predicting ETE were significantly greater than those of 2D-US. The sensitivity and specificity of 2D-US and 3D-OmniView were 51.7% and 79.7%, respectively ( P  < 0.001), and 81.0% and 82.8%, respectively ( P  = 0.809). Both 2D-US and 3D-OmniView showed better efficacy in evaluating ETE in nodules > 1 cm than in evaluating ETE in nodules ≤ 1 cm. Conclusion 3D-OmniView was more precise in predicting ETE of DTC nodules than 2D-US. 3D-OmniView is recommended for further evaluation of all thyroid nodules adjacent to the thyroid capsule. ETE was easier to detect by ultrasound for nodules > 1 cm than for nodules ≤ 1 cm.