Ultrasound最新文献

Introduction: Metastatic disease to the submandibular gland is a rare phenomenon with limited information available on related imaging findings.

Case presentation: We report a 59-year-old female who presented with a palpable nodule in the right submandibular gland 6 years after treatment for breast carcinoma. Ultrasound findings were concerning for distant metastatic disease from breast cancer recurrence. The histopathological analysis of the biopsied tissue confirmed infiltration of the right submandibular gland with an adenocarcinoma from a breast primary.

Discussion: Metastatic spread to the major salivary glands is relatively uncommon with a predilection to the parotid gland owing to its extensive intraglandular lymphatic system. Conversely, metastasis to the submandibular gland, which lacks intraglandular lymph nodes, is rare. Ultrasound is the optimal first-line imaging modality to aid in the assessment of submandibular gland disease. Malignant lesions often appear hypoechoic with heterogenous internal architecture and ill-defined borders. However, some low-grade malignancies, can have apparently benign features particularly when smaller in size. Where a focal submandibular gland lesion is identified and neoplasm is suspected, the early use of ultrasound-guided core biopsy is recommended to improve diagnostic yield for histological assessment.

Conclusion: While submandibular metastasis is rare, clinical assessment, sonographic findings and use of core needle biopsy aid in prompt diagnosis and management.

Background: Thyroglossal duct cysts (TGDCs) within the tongue base represent a challenge for the surgeon and are often the cause of recurrence.

Purpose: This study aimed to evaluate diagnostic performance of high-resolution ultrasound in TGDCs within the tongue base, compared to intraoperative findings. Furthermore, accuracy with which the detection of thyroid tissue in parts of the thyroglossal duct cyst was possible was investigated.

Methods: A total of 50 patients with TGDCs were examined by high-resolution ultrasound. Every thyroglossal cystic lesion was examined for the presence of solid thyroid tissue with colour-coded duplex sonography and evaluated according to American Thyroid Association (ATA) guidelines. Ultimately, 45 of the 50 patients underwent surgery (Sistrunk procedure).

Results: In 38/50 patients (76%), TGDCs were seen in their typical distal location inferior to the hyoid. Four patients (8%) had the thyroglossal duct cyst superior and inferior to the hyoid. The TGDC remnants only in the tongue base were recognised in 16% of cases (8 patients). Histological specimens revealed thyroid tissue within the TGDCs in 23 of the 45 patients (49%). Thyroid tissue was diagnosed preoperatively in 15 patients (65%) X ²(1, N = 23) = 2.13, p = 0.144. One patient exhibited suspicious features for thyroid cancer, which was confirmed histologically as papillary thyroid carcinoma.

Conclusion: High-resolution ultrasound represents quick, safe and reliable imaging for TGDCs on both sides of the hyoid bone (inferior and superior) with an impact on surgical planning. Furthermore, thyroid tissue within TGDCs can be revealed preoperatively and assessed for suspicious features.

Introduction: Despite widespread recognition that communicating unexpected news during obstetric ultrasound examinations is challenging, there is a dearth of research investigating how to teach evidence-based communication to sonographers. Communication Coaching is a supportive, positive method that has previously been associated with improvements in communication, patient satisfaction, and reduced burnout in clinicians. However, to date, no study has coached sonographers. This study explored stakeholders' views on a proposed Communication Coaching intervention and used these data to adapt the intervention for use with qualified obstetric sonographers.

Methods: Semi-structured interviews were conducted with people who have a vested interest in unexpected news delivery and thematic analysis was conducted on the data. Eight sonographers, six people with lived experience of receiving unexpected news and six representatives from third-sector organisations who support expectant parents were recruited (18 women; 2 men, aged between 21 and 75 years).

Results: Participants viewed the planned Communication Coaching intervention favourably and suggested adaptations. The two main themes were (1) the practicalities of coaching, and (2) content. The first theme had four subthemes: (a) brief and flexible structure, (b) online modality, (c) sensitive and positive coach and (d) organisational awareness. The second theme had three subthemes: (a) specific language and behaviour recommendations, (b) adaptable to different service-users and situations and (c) confer relevant emotional skills and techniques.

Conclusions: Communication Coaching could be a feasible and acceptable intervention for qualified sonographers if specific, limited adaptations are made as recommended by the stakeholders. Further evaluation of the intervention in practice is necessary.