The McConnell Sign is Seen in Patients With Acute Chest Syndrome

Bedside ultrasound is often used as a part of the evaluation of patients who are critically ill. The McConnell sign is an important echocardiographic finding in some critically ill patients with pulmonary embolism and an acute right ventricular infarct. We present 3 critically ill patients with confirmed acute chest syndrome who showed the McConnell sign on echocardiography. In patients with sickle cell disease presenting with chest pain and shortness of breath, the presence of the McConnell sign does not narrow the differential diagnosis between pulmonary embolism, an acute right ventricular infarct, and acute chest syndrome.     

Use of Ultrasound Contrast Agents in Relation to Percutaneous Interventional Procedures: A Systematic Review and Pictorial Essay

The aim of this article is to provide an inventory of the use of contrast‐enhanced ultrasound (CEUS) in relation to percutaneous interventional procedures. The article is structured into a systematic literature review followed by a clinical part relating to percutaneous CEUS‐guided procedures. A literature search identified 3109 records. After abstract screening, 55 articles were analyzed and supplemented with pictorial material to explain the techniques. In conclusion, the best‐evidenced indications for CEUS‐guided interventions are biopsy and ablation of inconspicuous or B‐mode–invisible tumors, intraprocedural ablation control and follow‐up, as well as percutaneous transhepatic cholangiography and drainage procedures.     

Ultrasound Appearances of Pediatric Testicular Yolk Sac Tumors: Twenty‐one Cases in a Single Institution

Testicular yolk sac tumors are rare, and analyses of relevant ultrasound (US) findings are limited. We retrospectively reviewed the US features of 21 pathologically verified cases (patients aged 10–64 months). Neoplasms were unilateral and solitary, occupying part (focal) or all (diffuse) of the testis. Focal lesions (14 cases) were usually solid and ovoid, with a homogeneous echo texture or multiple random anechoic spaces, and hypervascular. Diffuse neoplasms had heterogeneous echo textures; most were hypervascular. On spectral Doppler US imaging, 11 cases had a mean peak systolic velocity of 12.9 cm/s and a mean resistive index of 0.54. Ultrasound is a useful tool for imaging pediatric testes when a yolk sac tumor is suspected.     

Determination of Acoustic Cavitation Probabilities and Thresholds Using a Single Focusing Transducer to Induce and Detect Acoustic Cavitation Events: II. Systematic Investigation in an Agar Material

In the accompanying article (Part I), a method is described to determine acoustic cavitation probabilities in tissue-mimicking materials (TMMs) using a high-intensity focused ultrasound (HIFU) transducer for both inducing and detecting the acoustic cavitation events, and its suitability for different sonication modes like continuous wave, single pulses (with pulse lengths from microseconds to milliseconds) and repeated burst signals is discussed. In Part II, the use of the method for a systematic study of the dependence of the acoustic cavitation thresholds in 3% (by weight) agar phantoms on the temporal sonication parameters is discussed. The values obtained at a frequency of 1.06?MHz, ranging from (0.58?±?0.12)?MPa for a 3-s continuous wave mode sonication to (5.2?±?1.0)?MPa for single shots with a length of 10 wave cycles, are discussed and interpreted on the basis of literature values and their self-consistency.     

Can in Vivo Medial Gastrocnemius Muscle–Tendon Unit Lengths be Reliably Estimated by Two Ultrasonography Methods? A Within-Session Analysis

A clinically feasible method to reliably estimate muscle–tendon unit (MTU) lengths could provide essential diagnostic and treatment planning information. A 3-D freehand ultrasound (3-DfUS) method was previously validated for extracting in vivo medial gastrocnemius (MG) lengths, although the processing time can be considered substantial for the clinical environment. This investigation analyzed a quicker and simpler method using the US transducer as a spatial pointer (US-PaP), where the within-session reliability of extracting the muscle–tendon unit (MTU) and tendon lengths are estimated. MG MTU lengths were extracted in a group of 14 healthy adults using both 3-DfUS and US-PaP. Two consecutive acquisitions were performed per participant, and the data processed by two researchers independently. The intra-class correlation coefficients were above 0.97, and the standard error of measurements below 3.6?mm (1.5%). This investigation proposes that the simplified US-PaP method is a viable alternative for estimating MG MTU lengths.