OBJECTIVE: To enhance the quality of low-resolution (LR) ultrasound images and mitigate artifacts and speckle noise, which can impede accurate medical diagnosis, a novel method called the dual frequency-domain guided adaptation model (DF-GAM) is proposed. The method aims to achieve high-quality image reconstruction across diverse domains, including different ultrasound machines, diseases and phantom images.
METHODS: DF-GAM utilizes a dual-branch network architecture combined with frequency-domain self-adaptation and self-supervised edge regression. This approach enables cross-domain enhancement by focusing on the reconstruction of clear tissue structures and speckle patterns. The model is designed to adapt to various ultrasound imaging (USI) scenarios, ensuring its applicability in real-world clinical settings.
RESULTS: Experimental evaluations of DF-GAM were conducted using five different datasets. The results demonstrated the method\'s effectiveness, with DF-GAM outperforming existing enhancement techniques. The average peak signal-to-noise ratio (PSNR) achieved was 34.62, and the structural similarity index (SSIM) was 0.91, indicating a significant improvement in image quality compared to other methods.
CONCLUSIONS: DF-GAM shows great potential in improving medical image diagnosis and interpretation. Its ability to enhance LR ultrasound images across various domains without the need for extensive training data makes it a valuable tool for clinical use. The high PSNR and SSIM scores validate the method\'s effectiveness, suggesting that DF-GAM could significantly contribute to the field of USI diagnostics.

OBJECTIVE: A single therapeutic approach is not always successful in the treatment of herpes zoster neuralgia, and the appropriate combination of different treatments deserves further exploration. In this study, we investigated the clinical efficacy of high-voltage long-duration pulsed radiofrequency (PRF) combined with stellate ganglion block (SGB) in the acute phase of thoracic and dorsal herpes zoster neuralgia under dual guidance of ultrasound and C-arm.
METHODS: 79 cases of acute zoster neuralgia were grouped premised upon differing therapeutic approaches: standard voltage PRF (group S, the temperature, duration, pulse width, frequency and voltage were set to 42 °C, 300 s, 20 ms, 2 Hz, and 45 V), high-voltage long-duration PRF (group H, parameters of PRF were set to 42 °C, 900 s, 20 ms, 2 Hz, and 90 V, respectively), and high-voltage long-duration PRF combined with SGB (group C, parameter settings for PRF are the same as those for group H). The therapeutic outcomes were assessed utilizing the numeric rating scale (NRS), Pittsburgh sleep quality index (PSQI), and Hamilton anxiety rating scale (HAMA). The incidence of clinically significant postherpetic neuralgia post-treatment had been documented.
RESULTS: Compared to baseline, scores of NRS, PSQI, and HAMA at each time point post-treatment decreased across all groups, and the decrease was more significant in the C group than in the S group. At the later stage of treatment, the consumption of pregabalin and tramadol and the plasma levels of interleukin-6 and galectin-3 in the C group were significantly lower than those in the S group. The incidence of PHN in the C group was significantly lower than in the S group.
CONCLUSIONS: The combination of high-voltage long-duration PRF combined with SGB under dual guidance of ultrasound and C-arm represents a safe, effective, environmentally friendly, and cost-efficient method for treating AZN, significantly improving sleep quality, alleviating anxiety, and reducing the risk of PHN occurrence.

Purpose  To introduce the cranial-dorsal-hip angle (∠CDH) as a novel quantitative tool for assessing fetal position in the first trimester and to validate its feasibility for future AI applications. Materials and Methods  2520 first-trimester fetal NT exams with 2582 CRL images (January-August 2022) were analyzed at a tertiary hospital as the pilot group. Additionally, 1418 cases with 1450 fetal CRL images (September-December 2022) were examined for validation. Three expert sonographers defined a standard for fetal positions. ∠CDH measurements, conducted by two ultrasound technicians, were validated for consistency using Bland-Altman plots and the intra-class correlation coefficient (ICC). This method allowed for categorizing fetal positions as hyperflexion, neutral, and hyperextension based on ∠CDH. Comparative accuracy was assessed against Ioannou, Wanyonyi, and Roux methods using the weighted Kappa coefficient (k value). Results  The pilot group comprised 2186 fetal CRL images, and the validation group included 1193 images. Measurement consistency was high (ICCs of 0.993; P<0.001). The established 95% reference range for ∠CDH in the neutral fetal position was 118.3° to 137.8°. The ∠CDH method demonstrated superior accuracy over the Ioannou, Wanyonyi, and Roux methods in both groups, with accuracy rates of 94.5% (k values: 0.874, 95%CI: 0.852-0.896) in the pilot group, and 92.6% (k values: 0.838, 95%CI: 0.806-0.871) in the validation group. Conclusion  The ∠CDH method has been validated as a highly reproducible and accurate technique for first-trimester fetal position assessment. This sets the stage for its potential future integration into intelligent assessment models.

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In this study, corn starch was used as the raw material, and modified starch was prepared using a method combining plasma-activated water and ultrasound treatment (PUL). This method was compared with treatments using plasma-activated water (PAW) and ultrasound (UL) alone. The structure, thermal, physicochemical, pasting, and functional properties of the native and treated starches were evaluated. The results indicated that PAW and UL treatments did not alter the shape of the starch granules but caused some surface damage. The PUL treatment increased the starch gelatinization temperature and enthalpy (from 11.22 J/g to 13.13 J/g), as well as its relative crystallinity (increased by 0.51 %), gel hardness (increased by 16.19 %) compared to untreated starch, without inducing a crystalline transition. The PUL treatment resulted in a whitening of the samples. The dual treatment enhanced the thermal stability of the starch paste, which can be attributed to the synergistic effect between PAW and ultrasound (PAW can modify the starch structure at a molecular level, while ultrasound can further disrupt the granule weak crystalline structures, leading to improved thermal properties). Furthermore, FTIR results suggested significant changes in the functional groups related to the water-binding capacity of starch, and the order of the double-helical structure was disrupted. The findings of this study suggest that PUL treatment is a promising new green modification technique for improving the starch structure and enhancing starch properties. However, further research is needed to tailor the approach based on the specific properties of the raw material.

Whey protein was pretreated with multi-frequency ultrasound in mono-, dual-, and tri-frequency modes. The effect of multi-frequency ultrasound pretreatment on the hardness, chemical forces, and microstructure of acid-induced whey protein gel was investigated. Whey protein gels pretreated with dual- and tri-frequency ultrasound showed higher hardness (p < 0.05) and a denser network than mono-frequency ultrasound and control. Moreover, they had higher hydrophobic interaction and lower disulfide bonds than the control (p < 0.05). The effect of gel properties on digestion was evaluated using an in vitro static model. Whey protein gels pretreated with dual- and tri-frequency ultrasound had a higher proportion of large fragments in the oral boluses than in the control. Large fragments (>3.35 mm) in those samples were resistant to gastric digestion. Moreover, the tri-frequency ultrasound pretreatment of whey protein gel released the least free amino group during gastric digestion. In contrast, whey protein gel with the mono-frequency ultrasound pretreatment released the highest amount of free amino acid group during intestinal digestion. Findings from this study suggests that gel hardness and network density could modulate the digestion behaviors of protein gels.

OBJECTIVE: Carotid plaque vulnerability is a significant factor in the risk of cardio-cerebrovascular events, with intraplaque neovascularization (IPN) being a crucial characteristic of plaque vulnerability. This study investigates the value of ultrasound vector flow imaging (V-Flow) for measuring carotid plaque wall shear stress (WSS) in predicting the extent of IPN.
METHODS: We enrolled 140 patients into three groups: 53 in the plaque group (72 plaques), 23 in the stenosis group (27 plaques), and 64 in the control group. V-Flow was employed to measure WSS parameters, including the average WSS (WSS Mean) and the maximum WSS (WSS Max), across three plaque locations: mid-upstream, maximum thickness, and mid-downstream. Contrast-enhanced ultrasound (CEUS) was utilized in 76 patients to analyze IPN and its correlation with WSS parameters.
RESULTS: 1. WSS Max in the stenosis group was significantly higher than that in the control and plaque groups at the maximum thickness part (p < 0.05); WSS Mean in the stenosis group was significantly lower than that in the control group at the mid-upstream and mid-downstream segments (p < 0.05); and WSS Mean in the plaque group was significantly lower than that of the control group at all three locations (p < 0.05). 2. CEUS revealed that plaques with neovascularization enhancement exhibited significantly higher WSS values (p < 0.05), with a positive correlation between WSS parameters and IPN enhancement grades, particularly WSS Max at the thickest part (r = 0.508). 3. ROC curve analysis of WSS parameters for evaluating IPN showed that the efficacy of WSS Max in evaluating IPN was better than that of WSS Mean (p < 0.05), with an AUC of 0.7762, 0.6973; 95% CI of 0.725 - 0.822, 0.642 - 0.749, respectively; Cut-off was 4.57 Pa, 1.12 Pa; sensitivity was 74.03%, 63.64%; specificity was 75.00%, 68.18%.
CONCLUSIONS: V-Flow effectively measures WSS in carotid plaques. WSS Max provides a promising metric for assessing IPN, offering potential insights into plaque characteristics and showing some potential in predicting plaque vulnerability.

BACKGROUND: Hemorrhage is the most common major complication after liver biopsy. Hemothorax is one type of bleeding and is very rare and dangerous. Several cases of hemothorax subsequent to liver biopsy have been documented, primarily attributed to injury of the intercostal artery or inferior phrenic artery and a few resulting from lung tissue damage; however, no previous case report of hemothorax caused by injury of musculophrenic artery after liver biopsy has been reported.
METHODS: A 45-year-old native Chinese woman diagnosed with primary biliary cirrhosis due to long-term redness in urination and abnormal blood test indicators was admitted to our hospital for an ultrasound-guided liver biopsy to clarify pathological characteristics and disease staging. A total of 2 hours after surgery, the patient complained of discomfort in the right chest and abdomen. Ultrasound revealed an effusion in the right thorax and hemothorax was strongly suspected. The patient was immediately referred to the interventional department for digital subtraction angiography. Super-selective angiography of the right internal thoracic artery was performed which revealed significant contrast medium extravasation from the right musculophrenic artery, the terminal branch of the internal thoracic artery. Embolization was performed successfully. The vital signs of the patient were stabilized after the transarterial embolization and supportive treatment.
CONCLUSIONS: This case draws attention to the musculophrenic artery as a potential source of hemorrhage after percutaneous liver biopsy.

Clove essential oil (CEO) exhibited potent antibacterial efficacy and are obtained from Eugenia caryophyllata tree flower buds. Herein, CEO nanoemulsions were prepared using various concentrations of casein protein treated with ultrasound for different time interval. The study demonstrated that CEO nanoemulsions with 5% casein protein subjected to ultrasound for 10 min displayed the most minimal particle size. The pullulan‑sodium alginate film incorporated with nanoemulsions treated with ultrasound exhibited enhanced physico-mechanical characteristics. Based on the structural analysis, the application of ultrasonic treatment improved intermolecular compatibility and organized molecular structure by strengthening hydrogen bonds. Furthermore, the composite film displayed remarkable efficacy against E. coli and S. aureus as well as longer retention of essential oils. The use of the developed films to protect cherry fruits and mushrooms produced promising results, emphasizing their potential in food packaging applications.

BACKGROUND: Hypoxia-activated prodrug (HAP) is a promising candidate for highly tumor-specific chemotherapy. However, the oxygenation heterogeneity and dense extracellular matrix (ECM) of tumor, as well as the potential resistance to chemotherapy, have severely impeded the resulting overall efficacy of HAP.
RESULTS: A HAP potentiating strategy is proposed based on ultrasound responsive nanodroplets (PTP@PLGA), which is composed of protoporphyrin (PpIX), perfluoropropane (PFP) and a typical HAP, tirapazamine (TPZ). The intense vaporization of PFP upon ultrasound irradiation can magnify the sonomechanical effect, which loosens the ECM to promote the penetration of TPZ into the deep hypoxic region. Meanwhile, the PpIX enabled sonodynamic effect can further reduce the oxygen level, thus activating the TPZ in the relatively normoxic region as well. Surprisingly, abovementioned ultrasound effect also results in the downregulation of the stemness of cancer cells, which is highly associated with drug-refractoriness.
CONCLUSIONS: This work manifests an ideal example of ultrasound-based nanotechnology for potentiating HAP and also reveals the potential acoustic effect of intervening cancer stem-like cells.