rss_2.0Journal of Ultrasonography FeedSciendo RSS Feed for Journal of Ultrasonography of Ultrasonography Feed and MRI of the foot in children and adolescents newly diagnosed with juvenile idiopathic arthritis<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Aim</title> <p>To evaluate the spectrum of inflammatory features in foot joints which may be detected on routinely performed ultrasound (US) and magnetic resonance imaging (MRI) in children newly diagnosed with juvenile idiopathic arthritis (JIA).</p> </sec> <sec> <title style='display:none'>Material and methods</title> <p>Two groups of children hospitalized in a reference center for rheumatology, newly diagnosed with JIA and suspected of foot involvement in the course of JIA were included in this retrospective study. In the first group of 47 patients aged 1–18 years, the imaging was restricted to US. The second group of 22 patients aged 5–18 years underwent only non-contrast MRI of the foot.</p> </sec> <sec> <title style='display:none'>Results</title> <p>The most frequent pathologies seen on US included effusion and synovial thickening in the first metatarsophalangeal joint (MTP1), followed by the tibiotalar joint. Synovial hyperemia on color Doppler US images was present most frequently in the Chopart and midtarsal joints (64%; 7/11 cases), followed by the tibiotalar joint (45%; 5/11), and MTP2–5 joint synovitis (40%; 4/10). Grade 3 hyperemia was present only in four cases; grades 1 and 2 were detected in the majority of cases. On MRI, bone marrow edema was the most frequent pathology, found mostly in the calcaneus (45%; 10/22 cases), while alterations of the forefoot were rare. No cases of bursitis, enthesitis, cysts, erosions or ankylosis were diagnosed in either of the analyzed groups.</p> </sec> <sec> <title style='display:none'>Conclusions</title> <p>Routine US of the foot is recommended for early detection of its involvement in JIA in daily clinical practice. Although MRI can identify features of various JIA stages, it is particularly useful for the detection of bone marrow alterations.</p> </sec> </abstract>ARTICLEtrue rare case of an intraneural ganglion cyst of the median nerve<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Aim of the study</title> <p>Intraneural ganglion cysts are a relatively uncommon type of ganglion cyst that can affect peripheral nerves. They are particularly rare in the upper limb, and even more so in the median nerve, with the vast majority of them occurring in the peroneal nerves. This paper aims to make the reader aware of this relatively uncommon condition.</p> </sec> <sec> <title style='display:none'>Case description</title> <p>We report a case of a 41-year-old male who presented with a gradually progressing mass on the volar aspect of the wrist extending to the index finger. The nonspecific presentation as well as the rarity of the condition may make diagnosis challenging. The patient was referred for surgical management under a specialist peripheral nerve hand surgeon.</p> </sec> <sec> <title style='display:none'>Conclusions</title> <p>Ultrasound and magnetic resonance imaging as well as awareness of the typical imaging features of this entity are crucial in making the correct diagnosis as well as excluding other potential considerations such as neoplasm.</p> </sec> </abstract>ARTICLEtrue nerve versus flexor tendons: visualization of median nerve level changes in the proximal carpal tunnel during wrist movement with dynamic high-resolution ultrasound<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Aim</title> <p>The purpose of this prospective ultrasound study was to document dorso-palmar (vertical) displacement of the median nerve in relation to the superficial flexor tendons at the level of the carpal tunnel. Furthermore, the gliding patterns of the median nerve were characterized. The presence of vertical gliding was intended to serve as an additional bio-kinematic parameter of median nerve movement, and will be referred to as a ‘level change’.</p> </sec> <sec> <title style='display:none'>Material and methods</title> <p>In this study, a total of 32 healthy young individuals underwent dynamic high-resolution ultrasound examinations of both wrists. The neutral position, and maximum flexion and extension of the wrist had to be reached in active and passive movement. The gliding patterns were determined in relation to the superficial flexor tendons. When no vertical nerve gliding was observed, it was characterized as ‘no level change’.</p> </sec> <sec> <title style='display:none'>Results</title> <p>The presence of a level change prevailed in the healthy young cohort and was observed in 84% (27/32) of individuals during wrist flexion. The following gliding pattern was distinctively the most common: gliding of the entire nerve in between the flexor tendons in active but not in passive movement of the right and left wrists (13/27; 48%). The extent of vertical displacement was found to be associated with the gliding pattern (Kruskal–Wallis test).</p> </sec> <sec> <title style='display:none'>Conclusions</title> <p>Movement in the carpal tunnel allows the median nerve to adapt to biomechanical stress. Dynamic ultrasound can demonstrate median nerve level changes in response to wrist movements. Furthermore, a typical gliding pattern was characterized. The presence of level change and gliding patterns were proposed as additional movement parameters during wrist flexion in healthy individuals.</p> </sec> </abstract>ARTICLEtrue assessment of the tarsal tunnel compared to cadaveric findings: a pictorial study<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Aim of the study</title> <p>To present the anatomy of the tarsal tunnel and demonstrate the utility of high-resolution ultrasound for tarsal tunnel examination.</p> </sec> <sec> <title style='display:none'>Materials and methods</title> <p>Anatomical dissection was performed on a defrosted cadaveric model to demonstrate relevant anatomical structures of the tarsal tunnel, namely tendons, vessels and nerves. The tibial nerve division was demonstrated; the bifurcation of the tibial nerve into the medial and lateral plantar nerve, two medial calcaneal nerve branches were identified originating from the tibial nerve and the Baxter’s nerve was identified as the first branch of the lateral plantar nerve. An ultrasound examination of the tarsal tunnel region was performed on a healthy volunteer. A linear probe was used and sonographic images were obtained at different levels of the tarsal tunnel: the proximal tarsal tunnel, the tibial nerve division into the medial and lateral plantar nerves, the distal tarsal tunnel, the Baxter’s nerve branching point and the Baxter’s nerve crossing between the abductor hallucis and quadratus plantae muscle.</p> </sec> <sec> <title style='display:none'>Results</title> <p>Sonographic images were correlated with anatomical structures exposed during cadaveric dissection.</p> </sec> <sec> <title style='display:none'>Conclusions</title> <p>We presented the anatomic-sonographic correlation of the tarsal tunnel and showed that high-resolution ultrasound is a useful imaging modality for tarsal tunnel assessment.</p> </sec> </abstract>ARTICLEtrue median nerve hydrodissection of pronator teres syndrome: a case report and a literature review<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Aim of the study</title> <p>To describe the sonographic appearance of pronator teres syndrome and the role of ultrasound-guided hydrodissection for its management.</p> </sec> <sec id="j_jou.2023.0026_s_002"> <title style='display:none'>Case description</title> <p>Pronator teres syndrome is a well-known compressive neuropathy of the median nerve between the two heads of pronator teres. However, the clinical presentation of this syndrome can be indolent with vague pain at the proximal volar forearm leading to a delay in diagnosis. We describe our experience in the management of pronator teres syndrome in a healthy young badminton player with ultrasound-guided median nerve hydrodissection. We highlight the clinical presentation, the role of dynamic Ultrasound scan (USS) in the diagnosis and effective treatment of pronator teres syndrome.</p> </sec> <sec> <title style='display:none'>Conclusions</title> <p>In conclusion, managing PTS can be challenging, and this case highlights the importance of ultrasound-guided hydrodissection, when conservative measures have failed to improve the symptoms. Further studies are required to assess and compare the long-term outcomes of these interventions.</p> </sec> </abstract>ARTICLEtrue of the plantar foot: a guide for the assessment of plantar intrinsic muscles<abstract> <title style='display:none'>Abstract</title> <p>Plantar intrinsic muscles play a pivotal role in posture control and gait dynamics. They help maintain the longitudinal and transverse arches of the foot, and they regulate the degree and velocity of arch deformation during walking or running. Consequently, pathologies affecting the plantar intrinsic muscles (for instance, acquired and inherited neuropathies) lead to foot deformity, gait disorders, and painful syndromes. Intrinsic muscle malfunctioning is also associated with multifactorial overuse or degenerative conditions such as pes planus, hallux valgus, and plantar fasciitis. As the clinical examination of each intrinsic muscle is challenging, ultrasound is gaining a growing interest as an imaging tool to investigate the trophism of these muscular structures and the pattern of their alterations, and potentially to follow up on the effects of dedicated rehabilitation protocols. The ten plantar intrinsic muscles can be dived into three groups (medial, central and lateral) and four layers. Here, we propose a regional and landmark-based approach to the complex sonoanatomy of the plantar intrinsic muscles in order to facilitate the correct identification of each muscle from the superficial to the deepest layer. We also summarize the pathological ultrasound findings that can be encountered when scanning the plantar muscles, pointing out the patterns of alterations specific to certain conditions, such as plantar nerves mononeuropathies.</p> </abstract>ARTICLEtrue of the palmar aspect of the hand: normal anatomy and clinical applications of intrinsic muscles imaging<abstract> <title style='display:none'>Abstract</title> <p>Intrinsic hand muscles play a fundamental role in tuning the fine motricity of the hand and may be affected by several pathologic conditions, including traumatic injuries, atrophic changes induced by denervation, and space-occupying masses. Modern hand surgery techniques allow to target several hand muscle pathologies and, as a direct consequence, requests for hand imaging now carry increasingly complex diagnostic questions. The progressive refinement of ultrasound technology and the current availability of high and ultra-high frequency linear transducers that allow the investigation of intrinsic hand muscles and tendons with incomparable resolution have made this modality an essential tool for the evaluation of pathological processes involving these tiny structures. Indeed, intrinsic hand muscles lie in a superficial position and are amenable to investigation by means of transducers with frequency bands superior to 20 MHz, offering clear advantages in terms of resolution and costs compared to magnetic resonance imaging. In addition, ultrasound allows to perform dynamic maneuvers that can critically enhance its diagnostic power, by examining the questioned structure during stress tests that simulate the conditions eliciting clinical symptoms. The present article aims to review the anatomy, the ultrasound scanning technique, and the clinical application of thenar, hypothenar, lumbricals and interossei muscles imaging, also showing some examples of pathology involving these structures.</p> </abstract>ARTICLEtrue considerations of US-guided carpal tunnel release in daily clinical practice<abstract> <title style='display:none'>Abstract</title> <p>Carpal tunnel syndrome is the most frequent compression neuropathy with an incidence of one to three subjects per thousand. As specific anatomical variations might lead to unintended damage during surgical interventions, we present a review to elucidate the anatomical variability of the carpal tunnel region with important considerations for daily clinical practice: several variants of the median nerve branches in and around the transverse carpal ligament are typical and must – similarly to the variant courses of the median artery, which may be found eccentric ulnar to the median nerve – be taken into account in any interventional therapy at the carpal tunnel. Unintended interference in these structures might lead to heavy arterial bleeding and, in consequence, even underperfusion of segments of the median nerve or, if neural structures such as variant nerve branches are impaired or even cut, severe pain-syndromes with a profound impact on the quality of life. This knowledge is thus crucial for outcome- and safety-optimization of different surgical procedures at the volar aspect of the wrist and surgical therapy of the carpal tunnel syndrome e.g., US-guided carpal tunnel release, as injury might result in dysfunction and/or pain on wrist motion or direct impact in the region concerned. For most variations, anatomical and surgical descriptions vary, as official classifications are still lacking.</p> </abstract>ARTICLEtrue transvaginal ultrasound simulator: new training equipment in ultrasound evaluation of controlled ovarian stimulation and oocyte retrieval<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Aim</title> <p>We sought to create and describe a self-made simulator designed and created for teaching purposes: a high-fidelity ultrasound phantom for demonstrating antral follicle count, ultrasound supervision of controlled of ovarian stimulation, and ultrasound-guided oocyte retrieval.</p> </sec> <sec> <title style='display:none'>Materials and methods</title> <p>The uterus and ovaries of the ultrasound phantom were made from beef tongue, a male condom, latex gloves, cotton suture threads, bi-distilled water, and ultrasound gel. The components were placed in a pelvis created using three-dimensional (3D) printing. The phantom was presented to and evaluated by a group of 14 physicians pursuing a postgraduate course in reproductive medicine. Two training stations were structured: one to simulate antral follicle count and controlled ovarian stimulation and the other to simulate ultrasound-guided oocyte retrieval. Future specialists were requested to complete a feedback questionnaire evaluating the self-made simulator and the two practice stations.</p> </sec> <sec> <title style='display:none'>Results</title> <p>The transvaginal ultrasound phantom was successfully created, making it possible to simulate antral follicle count, ultrasound control of ovarian hyperstimulation, and oocyte retrieval, and to capture ultrasound images. A review of the answers provided in the feedback questionnaire showed that the phantom had a good appearance and design, was realistic, helped to improve motor coordination, and could be a useful tool in the training of specialists in assisted reproduction.</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>This phantom was designed to enable instruction and practice in the evaluation of ovarian follicles and ultrasound-guided oocyte retrieval in a supervised training environment. This self-made simulator is proposed as a training tool that could be included in the curricular structure of residency and postgraduate programs in reproductive medicine.</p> </sec> </abstract>ARTICLEtrue usefulness of transabdominal ultrasound elastography in gastritis in children<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p><italic>Helicobacter pylori</italic> can colonize the submucosal layer as well as the mucosa in the stomach. Inflammation and erosions cause both mucosal and submucosal thickening in patients with <italic>Helicobacter pylori</italic> gastritis. Elastography is a method for measuring the elasticity and hardness of tissues by visualization of their response to the applied force. Hard tissues respond to applied compression differently compared to soft tissues. Hard tissues displace as a whole without deforming as opposed to soft tissues. In this study, we investigated the diagnostic performance of transabdominal ultrasound elastography in detecting <italic>Helicobacter pylori</italic> gastritis in children.</p> </sec> <sec> <title style='display:none'>Methods</title> <p>Nineteen children (group 1) with <italic>Helicobacter pylori</italic> gastritis, 33 children (group 2) with <italic>Helicobacter pylori</italic> (-) gastritis and 37 healthy children (group 3) were included the study. These groups were compared in terms of their strain index values. Ultrasonographic examinations were performed with a single transducer at 1.8–6.2 MHz frequency range.</p> </sec> <sec> <title style='display:none'>Results</title> <p>Both group 1 and 2 had significantly higher strain index values compared to the control group (2.7, 2.2 and 1.4 respectively). Additionally, the mean strain index value was significantly higher in group 1 compared to group 2.</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>Transabdominal ultrasound elastography has diagnostic value in differentiating <italic>Helicobacter pylori</italic> (+) gastritis from <italic>Helicobacter pylori</italic> (-) gastritis as well as in the diagnosis of gastritis in children.</p> </sec> </abstract>ARTICLEtrue of conventional Doppler imaging techniques and superb microvascular imaging in determination of vascularization in undescended testes<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Aim</title> <p>Our aim was to gain an idea about testicular injury by comparing the reduced volume, which is one of the indirect indicators of testicular damage in undescended testes, and by evaluating the reduced microvascular blood flow by superb microvascular imaging, and also to determine whether superb microvascular imaging modes could detect microvascular blood flow in more detail in the decreased volume of undescended testes.</p> </sec> <sec> <title style='display:none'>Material and methods</title> <p>We compared testicular blood flow in undescended testes via conventional Doppler imaging, color superb microvascular imaging, and monochrome superb microvascular imaging techniques with contralateral normally located testis and normal control group. Each sample of testicular tissue was evaluated using a qualitative method. Spot color encoding and linear flow color encoding counts determined in testicular parenchyma were counted separately and expressed as numerical data. The localization of the examined testes in the grayscale was noted (proximal inguinal canal, medial inguinal canal, distal inguinal canal, and scrotal). The volume of undescended testes was calculated automatically via a formula for volume.</p> </sec> <sec> <title style='display:none'>Results</title> <p>Monochrome superb microvascular imaging is significantly superior in visualizing the vascularity of undescended testes compared with color Doppler, power Doppler and color superb microvascular imaging (<italic>p</italic> = 0.001). Also, undescended testes have a significantly lower blood flow compared with contralateral normal testes (<italic>p</italic> = 0.001). The volume of undescended testes was significantly lower than the contralateral normal testes.</p> </sec> <sec> <title style='display:none'>Conclusions</title> <p>The volume, structure and blood flow are indirect signs of testicular damage in undescended testes. Monochrome superb microvascular imaging can detect vascularity in undescended testes better than the conventional Doppler imaging technique and color superb microvascular imaging. Based on our findings, we can report that monochrome superb microvascular imaging can be used to evaluate testicular injury and vascularity of undescended testes.</p> </sec> </abstract>ARTICLEtrue inflammations visualized with ultrasonography. Description of the imaging features and literature review based on a characteristic case series<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Objectives</title> <p>Inflammations of the maxillofacial regions are a frequent occurrence. They areusually of odontogenic origin, but maxillofacial swelling could also have non-odontogenic causes. Their clinical presentation is worrisome for the patient, presenting as swellings of the region with rapid and significant expansion to adjacent areas due to the thin and delicate nature of the regional soft tissues.</p> </sec> <sec> <title style='display:none'>Materials and methods</title> <p>The characteristic features are discussed upon the presentation of a case series of the most common types of inflammation seen in the region.</p> </sec> <sec> <title style='display:none'>Results</title> <p>In most hospital emergency departments, ultrasound scanning is readily accessible, and typically constitutes the first-line imaging modality for this entity. Nevertheless, the role of ultrasound imaging is limited in cases with deep extension of the inflammation, where cross-sectional imaging with CT or MRI will be the modality of choice. This manuscript aims to present the characteristic features of various inflammatory conditions of the maxillofacial area seen on ultrasonography.</p> </sec> <sec> <title style='display:none'>Conclusions</title> <p>Even though maxillofacial inflammations are often treated without imaging in their initial phase, ultrasound can provide aninexpensive, easy-to-use, and readily available alternative that best visualizes the characteristics and expansion patterns of the lesions, based on their origin and area of initial presentation.</p> </sec> </abstract>ARTICLEtrue about the multidimensional evaluation of a stab wound tibial neuropathy: a case report<abstract> <title style='display:none'>Abstract</title> <p>We present a rare case of a traumatic lesion of the tibial fibers of the sciatic nerve with spared peroneal fibers. A 33-year-old victim of a three month earlier stabbing attack came to our attention with gait impairment and weakened left foot plantar flexion and left foot internal rotation and supination. Based upon clinical signs and neurophysiological investigations we suspected that a traumatic injury of the left tibial nerve had occurred. Ultrasound examination detected a lesion of part of the left sciatic nerve, in a different site than expected. The patient was immediately enlisted for a tailored surgical reconstruction.</p> </abstract>ARTICLEtrue diagnostic value of Doppler Resistive Index in the differential diagnosis of focal liver lesions<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Aim</title> <p>To investigate the diagnostic value of resistance index (RI) in differentiating focal liver lesions.</p> </sec> <sec> <title style='display:none'>Patients and methods</title> <p>In this retrospective study, a total of 576 patients with histologically confirmed focal liver lesions were included. Each patient underwent B-mode ultrasound examination and color Doppler ultrasound examination. The RI values of different focal liver lesions were recorded and compared.</p> </sec> <sec> <title style='display:none'>Results</title> <p>The mean RI value of benign lesions was significantly lower than that of malignant lesions (0.54 ± 0.10 <italic>vs</italic>. 0.71 ± 0.12) (<italic>p</italic> &lt;0.05). In malignant lesions, the RI value of intrahepatic cholangiocarcinoma was significantly lower than that of hepatocellular carcinoma lesions. Furthermore, in hepatocellular carcinoma lesions, the RI of large lesions (group 4: &gt;10 cm) was significantly lower than that of small lesions (group 1: ≤2 cm, group 2: 2–5 cm) (<italic>p</italic> &lt;0.05). Taken RI of 0.615 as a cutoff value to differentiate malignant and benign lesions, the sensitivity, specificity, positive predictive value and negative predictive value were 82.80%, 81.00%, 81.34% and 82.48%, respectively.</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>Color Doppler ultrasound examination is a valuable imaging method in detecting blood flow signal within liver lesions. The RI parameter should be helpful in differentiating malignant and benign liver tumors.</p> </sec> </abstract>ARTICLEtrue vein congestion index in patients with and without chronic liver disease<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Aim of the study</title> <p>Portal vein congestion index has shown promise in detecting early portal venous hemodynamic changes in chronic liver disease. The aim of this study was to compare the portal vein congestion index of adult patients with chronic liver disease to that of healthy controls, and to evaluate the differences in portal vein congestion index, if any, between the common etiologies of chronic liver disease (chronic viral hepatitis, alcoholic liver disease, and non-alcoholic fatty liver disease).</p> </sec> <sec> <title style='display:none'>Method and materials</title> <p>Eighty participants with chronic liver disease and 80 healthy controls had their sociodemographic variables, anthropometric indices, liver size/echotexture, spleen size, presence of ascites, and portal vein parameters (diameter, cross-sectional area, velocity, and congestion index) evaluated. <italic>P</italic> ≤0.05 was considered statistically significant.</p> </sec> <sec> <title style='display:none'>Results</title> <p>There were 48 (60%) males and 32 (40%) females in the control group, while 56 (70%) males and 24 (30%) females were included in the chronic liver disease group (<italic>p</italic> = 0.185). Of the eighty people with chronic liver disease, 57 (71.2%) were diagnosed with alcoholic liver disease, while 23 (28.8%) were diagnosed with chronic viral hepatitis. There were no cases of non-alcoholic fatty liver disease during the study period. The mean liver spans of the control and chronic liver disease groups were 13.45 ± 0.85 cm and 16.50 ± 4.96 cm, respectively. All the controls had normal hepatic parenchymal echogenicity, while 45 (56.3%) subjects with chronic liver disease (36 alcoholic liver disease and 9 chronic viral hepatitis) had increased hepatic echogenicity. The mean values of the portal vein congestion index for the control and chronic liver disease groups were 0.0775 ± 0.02 cm/sec and 0.1037 ± 0.03 cm/sec, respectively (<italic>p</italic> &lt;0.0001).</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>The chronic liver disease group showed a significantly higher mean portal vein congestion index than the control group.</p> </sec> </abstract>ARTICLEtrue brief review of diagnostic properties of point-of-care ultrasound for adult bowel intussusception: Making the case for ultrasound<abstract> <title style='display:none'>Abstract</title> <p>Undifferentiated abdominal pain in adults is a common chief complaint in acute care clinics and emergency departments worldwide, representing up to 10% of visits to emergency departments. Many patients have a non-specific presentation and an initial workup with labwork, urine analysis or X-ray might not reveal a specific diagnosis. Although bowel intussusception is a primarily pediatric disease, adult intussusception is a recognized but rare cause of bowel obstruction often requiring surgical intervention. However, recent data from advanced multi-detector computed tomography imaging shows that milder or recurring cases in adults have been underrecognized. Multi-detector computed tomography is still the imaging gold standard for detecting intussusception in adults, but new data showed that sonographers with basic training using the point-of-care ultrasound approach have a reasonable accuracy in detecting this pathology. As the point-of-care ultrasound for undifferentiated abdominal pain is an emerging core skill in the acute care setting, knowledge of sonographic signs of intestinal intussusception should be included in the skill set of physicians. Sonographic findings in adults mimic pediatric cases, but different location patterns and higher malignancy rates exist in adults. In this manuscript, we will review the current literature on adult intussusception and summarize key knowledge of intestinal intussusception in adults. We will present four adult patients diagnosed with different types of adult acute bowel intussusception using the point-of-care ultrasound and describe a focused scanning approach with typical sonographic findings.</p> </abstract>ARTICLEtrue nutcracker syndrome in a patient with circumaortic venous ring: a rare case report<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Aim of the study</title> <p>In this article, we describe a rare case of the nutcracker syndrome caused by combined compression of the left anteroaortic and retroaortic renal veins. <bold>Case description:</bold> A 42-year-old woman presented with microhematuria and left flank pain. The patient underwent computed tomography and Doppler ultrasound which showed the left renal veins with anteroaortic and retroaortic courses, with signs of compression. Compression of the anteroaortic renal vein was caused by a narrowing of the aortomesenteric space, whereas compression of the retroaortic renal vein was caused by a narrowing of the aortovertebral space.</p> </sec> <sec> <title style='display:none'>Conclusions</title> <p>NCS is a rare disease, poorly understood and difficult to diagnose mainly due to the non-specificity of symptoms. Imaging is essential for diagnosis, and the combination of ultrasound and computed tomography allows for better classification of the disease. Increased disclosure of these cases can significantly contribute to a reduction of false negatives.</p> </sec> </abstract>ARTICLEtrue refining breast cancer diagnosis on ultrasound rectal enema (“hydrocolon”) for diagnosing large bowel pathologies in infancy – pictorial review to demonstrate feasibility and value<abstract> <title style='display:none'>Abstract</title> <p>Bowel pathologies encompass a large diversity of diseases with commonly confusing and overlapping clinical presentations. Sonography has a leading role in diagnosing these disorders, especially in small children. However, in some cases, baseline sonography does not deliver a satisfactory result on the suspected pathology. To increase the sensitivity and specificity of the standard bowel ultrasound technique, complimentary ultrasound enema may be performed, which is also referred to as “hydrocolon” in the literature. This paper summarizes the technique of sonographic enema, as well as some bowel pathologies from our case series where sonographic enema proved to be helpful in the diagnostic work-up.</p></abstract>ARTICLEtrue pseudotumor of the omentum in contrast-enhanced ultrasound<abstract> <title style='display:none'>Abstract</title> <sec id="j_JoU.2023.0006_s_004"> <title style='display:none'>Aim of the study</title> <p>Inflammatory pseudotumor is a rare benign tumor that can occur at various body sites. Due to its rare occurrence and histological variety radiological data is heterogeneous and limited.</p> </sec> <sec id="j_JoU.2023.0006_s_005"> <title style='display:none'>Case description</title> <p>We present a case of a 71-year-old man with inflammatory pseudotumor of the omentum. Contrast-enhanced ultrasound perfusion pattern showed homogeneous, isoechoic enhancement in the arterial phase with a washout phenomenon in the parenchymal phase, mimicking a peritoneal carcinomatosis.</p> </sec> <sec id="j_JoU.2023.0006_s_006"> <title style='display:none'>Conclusions</title> <p>Inflammatory pseudotumor represents a rare, but important benign differential diagnostic option when considering a malignant disorder. Contrast-enhanced ultrasound is helpful in identifying vital tissue for a targeted biopsy for subsequent histological examination that is essential for the exclusion of malignancy.</p> </sec> </abstract>ARTICLEtrue