Purpose: Bedside ultrasound has become one of the most important non-invasive and read-ily available diagnostic tools, especially for critically ill patients. Despite the increasing usage and importance of bedside ultrasound, a standard and well-structured training program for surgical residents is still lacking. This study assessed and evaluated the effectiveness of our new 8-weeks ultrasound course for surgical residents. Methods: Twenty-two residents from the department of general surgery from a tertiary care hospital in Korea attended the newly designed 8-weeks of bedside ultrasound training course in the surgical intensive care unit. A multimodal approach was used including didactic lectures about the basics of ultrasound as well as daily hands-on ultrasound examinations of patients under the supervision of an instructor. Participants documented their ultrasound findings and determined self-proficiency in ultrasound techniques using a 5-point Likert scale. Results: After the educational intervention, the proficiency scores of the residents showed a significant improvement in every element (P < 0.001). Proficiency scores also showed a significant improvement regardless of their previous exposure to ultrasound manipulation. Among the most perceived barriers in using bedside ultrasound were lack of education (43%) and lack of a feedback system (29%). Conclusion: The confidence of surgical residents in their use of bedside ultrasound could be improved with a well-structured training program. In addition, a short and intense program may help them to overcome the barriers that they may perceive to using bedside ultrasound. The authors believe such programs should be encouraged in all surgical residencies so that residents can competently use bedside ultrasound for the primary care of critically ill patients.
{"title":"Impact of 8-Week Bedside Ultrasound Training for Surgical Residents in the Intensive Care Unit of a Tertiary Care Hospital - a Pilot Study","authors":"Kyoung Moo Im, Eun Young Kim","doi":"10.46268/JSU.2021.8.1.6","DOIUrl":"https://doi.org/10.46268/JSU.2021.8.1.6","url":null,"abstract":"Purpose: Bedside ultrasound has become one of the most important non-invasive and read-ily available diagnostic tools, especially for critically ill patients. Despite the increasing usage and importance of bedside ultrasound, a standard and well-structured training program for surgical residents is still lacking. This study assessed and evaluated the effectiveness of our new 8-weeks ultrasound course for surgical residents. Methods: Twenty-two residents from the department of general surgery from a tertiary care hospital in Korea attended the newly designed 8-weeks of bedside ultrasound training course in the surgical intensive care unit. A multimodal approach was used including didactic lectures about the basics of ultrasound as well as daily hands-on ultrasound examinations of patients under the supervision of an instructor. Participants documented their ultrasound findings and determined self-proficiency in ultrasound techniques using a 5-point Likert scale. Results: After the educational intervention, the proficiency scores of the residents showed a significant improvement in every element (P < 0.001). Proficiency scores also showed a significant improvement regardless of their previous exposure to ultrasound manipulation. Among the most perceived barriers in using bedside ultrasound were lack of education (43%) and lack of a feedback system (29%). Conclusion: The confidence of surgical residents in their use of bedside ultrasound could be improved with a well-structured training program. In addition, a short and intense program may help them to overcome the barriers that they may perceive to using bedside ultrasound. The authors believe such programs should be encouraged in all surgical residencies so that residents can competently use bedside ultrasound for the primary care of critically ill patients.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45419268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ultrasonography is mandatory for the evaluation of thyroid nodules. Although B-mode and Doppler ultrasonography are both sensitive for the diagnosis of thyroid lesions, they lack specificity in differentiating benign from malignant nodules. Elastography has been described as an accurate predictor of malignancy by determining tissue elasticity. There are several meth-ods utilized to evaluate the stiffness of normal tissue and the thyroid nodule, such as strain elastography, acoustic radiation force impulse, and shear wave elastography. Many studies show that elastography has both high sensitivity and specificity that approaches 100% for the determination of thyroid carcinoma. In addition, elastography also has a very high negative predictive value and thus, may also be helpful in the identification of thyroid nodules that do not need further diagnostic evaluation, including fine needle aspiration cytology. However, in the light of current evidence, there is a need for standardization and consensus on the most optimum elastography acquisition process. The purpose of this review is to provide a com-prehensive summary of the use of elastography in the evaluation of thyroid nodules.
{"title":"Diagnosis of Thyroid Nodules by Elastography","authors":"H. Youn, H. Ahn, Sang Yull Kang, S. Jung","doi":"10.46268/JSU.2021.8.1.1","DOIUrl":"https://doi.org/10.46268/JSU.2021.8.1.1","url":null,"abstract":"Ultrasonography is mandatory for the evaluation of thyroid nodules. Although B-mode and Doppler ultrasonography are both sensitive for the diagnosis of thyroid lesions, they lack specificity in differentiating benign from malignant nodules. Elastography has been described as an accurate predictor of malignancy by determining tissue elasticity. There are several meth-ods utilized to evaluate the stiffness of normal tissue and the thyroid nodule, such as strain elastography, acoustic radiation force impulse, and shear wave elastography. Many studies show that elastography has both high sensitivity and specificity that approaches 100% for the determination of thyroid carcinoma. In addition, elastography also has a very high negative predictive value and thus, may also be helpful in the identification of thyroid nodules that do not need further diagnostic evaluation, including fine needle aspiration cytology. However, in the light of current evidence, there is a need for standardization and consensus on the most optimum elastography acquisition process. The purpose of this review is to provide a com-prehensive summary of the use of elastography in the evaluation of thyroid nodules.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46592968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-31DOI: 10.46268/JSU.2021.8.1.19
Seung goo Lee, Sungsin Cho, J. Joh
Purpose: Cyanoacrylate closure (CAC) has been introduced for the treatment of the incompetent saphenous vein. Although there have been no severe procedure- or device-related adverse events, the post-treatment complex hypersensitivity and irritation reactions (CHAIR) might be a troublesome complication. Methods: A retrospective review was performed from prospectively collected data of CAC patients. The CAC was performed in patients with symptomatic great saphenous veins (GSV), small saphenous veins (SSV), and/or accessory saphenous veins (ASV) in a single session. We assessed the possible risk factors for the development of a hypersensitivity reaction including the amount of injected adhesive, access site, treated segment, compression stocking application, and other clinical factors. For the statistical analyses, data were analyzed using the IBM SPSS Statistics ver. 22.0 (IBM Co., Armonk, NY, USA). P-value <0.05 was considered statistically significant. Results: During the study period, 190 saphenous veins were treated in 100 patients. Sixty-four (64%) patients were female. The mean age was 55.5 ± 12.8 years (19-84). Complete occlusion was achieved in all patients. After CAC, the mean visual analogue scale (VAS) was 2.59 and 0.32 on postoperative 0 and 7 days, respectively (P < 0.001). Post-treat-ment CHAIR occurred in 5 (5%) patients. The significant risk factors for the development of CHAIR were younger age, GSV treatment, and below-the-knee access site for the introduction of a catheter. Conclusion: CHAIR occurred when the adhesive was injected at the below-the-knee GSV segment. The mechanical irritation due to knee joint movement might be a possible mechanism for the development of the hypersensitivity reaction.
{"title":"Risk Factors for Complex Hypersensitivity and Irritation Reactions after an Ultrasound-Guided Cyanoacrylate Closure","authors":"Seung goo Lee, Sungsin Cho, J. Joh","doi":"10.46268/JSU.2021.8.1.19","DOIUrl":"https://doi.org/10.46268/JSU.2021.8.1.19","url":null,"abstract":"Purpose: Cyanoacrylate closure (CAC) has been introduced for the treatment of the incompetent saphenous vein. Although there have been no severe procedure- or device-related adverse events, the post-treatment complex hypersensitivity and irritation reactions (CHAIR) might be a troublesome complication. Methods: A retrospective review was performed from prospectively collected data of CAC patients. The CAC was performed in patients with symptomatic great saphenous veins (GSV), small saphenous veins (SSV), and/or accessory saphenous veins (ASV) in a single session. We assessed the possible risk factors for the development of a hypersensitivity reaction including the amount of injected adhesive, access site, treated segment, compression stocking application, and other clinical factors. For the statistical analyses, data were analyzed using the IBM SPSS Statistics ver. 22.0 (IBM Co., Armonk, NY, USA). P-value <0.05 was considered statistically significant. Results: During the study period, 190 saphenous veins were treated in 100 patients. Sixty-four (64%) patients were female. The mean age was 55.5 ± 12.8 years (19-84). Complete occlusion was achieved in all patients. After CAC, the mean visual analogue scale (VAS) was 2.59 and 0.32 on postoperative 0 and 7 days, respectively (P < 0.001). Post-treat-ment CHAIR occurred in 5 (5%) patients. The significant risk factors for the development of CHAIR were younger age, GSV treatment, and below-the-knee access site for the introduction of a catheter. Conclusion: CHAIR occurred when the adhesive was injected at the below-the-knee GSV segment. The mechanical irritation due to knee joint movement might be a possible mechanism for the development of the hypersensitivity reaction.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46501649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-30DOI: 10.46268/jsu.2020.7.2.21
Jeeyeon Lee, H. Park, W. Kim, Chan Sub Park, M. Jeong, J. Jung
Purpose: Axillary lymph node status is an important prognostic factor in breast cancer. Axillary lymph nodes can be evaluated using fine-needle aspiration cytology (FNAC) or core needle biopsy (CNB) before surgery. This study compared the accuracy and false-negative rates between FNAC and CNB in patients with breast cancer who either did or did not receive neoadjuvant chemotherapy (NAC). Methods: The clinicopathological factors of the patients were analyzed retrospectively, and the sensitivity, specificity, positive and negative predictive values, false-positive and false-negative rates, and accuracy of FNAC (n = 27) and CNB (n = 23) were compared. Results: Regardless of whether or not NAC was performed, the CNB evaluation of the metastatic axillary lymph nodes had a 100.0% sensitivity, specificity, negative predictive value, and accuracy, except for one case with an inadequate sample. In the FNAC group, the false-negative rate was higher in patients with breast cancer who received NAC before evaluating the lymph nodes (9.1% vs. 7.7%). Moreover, ultrasound imaging was the most sensitive imaging modality that can detect the suspicious axillary lymph node. Conclusion: CNB was more effective in evaluating the axillary lymph nodes in breast cancer than FNAC and was performed without major complications.
{"title":"Efficacy of Ultrasound-Guided Core Needle Biopsy in Detecting Metastatic Axillary Lymph Nodes in Breast Cancer","authors":"Jeeyeon Lee, H. Park, W. Kim, Chan Sub Park, M. Jeong, J. Jung","doi":"10.46268/jsu.2020.7.2.21","DOIUrl":"https://doi.org/10.46268/jsu.2020.7.2.21","url":null,"abstract":"Purpose: Axillary lymph node status is an important prognostic factor in breast cancer. Axillary lymph nodes can be evaluated using fine-needle aspiration cytology (FNAC) or core needle biopsy (CNB) before surgery. This study compared the accuracy and false-negative rates between FNAC and CNB in patients with breast cancer who either did or did not receive neoadjuvant chemotherapy (NAC). Methods: The clinicopathological factors of the patients were analyzed retrospectively, and the sensitivity, specificity, positive and negative predictive values, false-positive and false-negative rates, and accuracy of FNAC (n = 27) and CNB (n = 23) were compared. Results: Regardless of whether or not NAC was performed, the CNB evaluation of the metastatic axillary lymph nodes had a 100.0% sensitivity, specificity, negative predictive value, and accuracy, except for one case with an inadequate sample. In the FNAC group, the false-negative rate was higher in patients with breast cancer who received NAC before evaluating the lymph nodes (9.1% vs. 7.7%). Moreover, ultrasound imaging was the most sensitive imaging modality that can detect the suspicious axillary lymph node. Conclusion: CNB was more effective in evaluating the axillary lymph nodes in breast cancer than FNAC and was performed without major complications.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44974094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The identification of axillary lymph node metastases in breast cancer patients is a critical fac-tor in determining the stage, deciding the treatment modality, and predicting the prognosis. Over the years, axillary staging has evolved from a radical axillary lymph node dissection to a more conservative sentinel lymph node biopsy. The main goal of axillary imaging techniques is to identify metastatic lymph nodes with optimal accuracy, high enough to initially se-lect patients for an upfront lymph node dissection. Features suggestive of an axillary lymph node metastasis may be seen with a range of imaging modalities. On the other hand, ultrasonography is the method of choice for evaluating the node morphology and allowing im-age-guided interventions of abnormal nodes. Gray-scale ultrasonography is not perfect on its own. Newer techniques, such as elastography or contrast-enhanced ultrasonography, have shown promise in identifying axillary lymph node metastases. This review provides a comprehensive overview of ultrasonography for an axillary lymph node assessment in breast cancer patients.
{"title":"Ultrasonography for Staging Axillary Lymph Node in Breast Cancer Patients","authors":"H. Youn, H. Ahn, Sang Yull Kang, S. Jung","doi":"10.46268/jsu.2020.7.1.1","DOIUrl":"https://doi.org/10.46268/jsu.2020.7.1.1","url":null,"abstract":"The identification of axillary lymph node metastases in breast cancer patients is a critical fac-tor in determining the stage, deciding the treatment modality, and predicting the prognosis. Over the years, axillary staging has evolved from a radical axillary lymph node dissection to a more conservative sentinel lymph node biopsy. The main goal of axillary imaging techniques is to identify metastatic lymph nodes with optimal accuracy, high enough to initially se-lect patients for an upfront lymph node dissection. Features suggestive of an axillary lymph node metastasis may be seen with a range of imaging modalities. On the other hand, ultrasonography is the method of choice for evaluating the node morphology and allowing im-age-guided interventions of abnormal nodes. Gray-scale ultrasonography is not perfect on its own. Newer techniques, such as elastography or contrast-enhanced ultrasonography, have shown promise in identifying axillary lymph node metastases. This review provides a comprehensive overview of ultrasonography for an axillary lymph node assessment in breast cancer patients.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45458432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sang Yull Kang, E. Choi, Jung Hee Byon, H. Ahn, H. Youn, S. Jung
Received March 5, 2020 Revised March 31, 2020 Accepted April 6, 2020 Purpose: Breast cancer in young women deserves special consideration, such as dense breast, more aggressive progression, and oncoplastic surgery. Magnetic resonance imaging (MRI) is a more recent modality than ultrasonography (US), but the role of MRI in patients with a dense breast is still controversial. This comparative study analyzed the relationship between the preoperative radiological and the postoperative pathological tumor size for young breast cancer patients. Methods: All breast cancers diagnosed in patients 45 years or younger from January 2016 to December 2018 were reviewed. Tumor size measurements obtained on breast US and MRI were compared for accuracy with those obtained in the final pathology results. Patients with only microcalcification on imaging modalities and those who had undergone neoadjuvant chemotherapy were excluded. Results: A total of 103 breast cancer patients were included in this study. Of the 103 breast cancers with both imaging modalities performed, 86 (83.5%) were infiltrating ductal carcinomas and 17 (16.5%) were ductal carcinoma in situ. The mean tumor size measured on MRI was significantly greater than that measured on pathology (18.5 ± 11.0 mm vs. 16.6 ± 8.5 mm), whereas the sizes measured on US was not significantly different from that measured on pathology (16.5 ± 9.5 mm vs. 16.6 ± 8.5 mm). The tumor size measured on MRI was greater than that measured on US. Conclusion: Measurements taken by US were more accurate in measuring the tumor size in patients 45 years of age or younger than MRI.
接收日期2020年3月5日修订日期2020年4月31日接受日期2020年6月6日目的：年轻女性的乳腺癌症值得特别考虑，如致密乳房、更积极的进展和肿瘤整形手术。磁共振成像（MRI）是一种比超声（US）更新的成像方式，但MRI在致密乳房患者中的作用仍然存在争议。本比较研究分析了年轻癌症患者术前放疗与术后病理肿瘤大小的关系。方法：对2016年1月至2018年12月在45岁及以下患者中诊断的所有乳腺癌进行回顾性分析。将乳腺超声和MRI上获得的肿瘤大小测量值与最终病理学结果中获得的测量值进行准确性比较。影像学检查仅有微钙化的患者和接受过新辅助化疗的患者被排除在外。结果：本研究共纳入103例癌症患者。在采用两种成像方式的103例乳腺癌中，86例（83.5%）为浸润性导管癌，17例（16.5%）为导管原位癌。MRI上测量的平均肿瘤大小显著大于病理学上测量的肿瘤大小（18.5±11.0 mm vs.16.6±8.5 mm），而US上测量的大小与病理学上测得的大小没有显著差异（16.5±9.5 mm vs.166±8.5毫米）。MRI测量的肿瘤大小大于US测量的肿瘤尺寸。结论：US测量的45岁及以下患者的肿瘤大小比MRI测量的更准确。
{"title":"Comparative Accuracy of Preoperative Tumor Size Assessment on Breast Ultrasonography and Magnetic Resonance Imaging in Young Breast Cancer Patients","authors":"Sang Yull Kang, E. Choi, Jung Hee Byon, H. Ahn, H. Youn, S. Jung","doi":"10.46268/jsu.2020.7.1.7","DOIUrl":"https://doi.org/10.46268/jsu.2020.7.1.7","url":null,"abstract":"Received March 5, 2020 Revised March 31, 2020 Accepted April 6, 2020 Purpose: Breast cancer in young women deserves special consideration, such as dense breast, more aggressive progression, and oncoplastic surgery. Magnetic resonance imaging (MRI) is a more recent modality than ultrasonography (US), but the role of MRI in patients with a dense breast is still controversial. This comparative study analyzed the relationship between the preoperative radiological and the postoperative pathological tumor size for young breast cancer patients. Methods: All breast cancers diagnosed in patients 45 years or younger from January 2016 to December 2018 were reviewed. Tumor size measurements obtained on breast US and MRI were compared for accuracy with those obtained in the final pathology results. Patients with only microcalcification on imaging modalities and those who had undergone neoadjuvant chemotherapy were excluded. Results: A total of 103 breast cancer patients were included in this study. Of the 103 breast cancers with both imaging modalities performed, 86 (83.5%) were infiltrating ductal carcinomas and 17 (16.5%) were ductal carcinoma in situ. The mean tumor size measured on MRI was significantly greater than that measured on pathology (18.5 ± 11.0 mm vs. 16.6 ± 8.5 mm), whereas the sizes measured on US was not significantly different from that measured on pathology (16.5 ± 9.5 mm vs. 16.6 ± 8.5 mm). The tumor size measured on MRI was greater than that measured on US. Conclusion: Measurements taken by US were more accurate in measuring the tumor size in patients 45 years of age or younger than MRI.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49477738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-30DOI: 10.46268/JSU.2019.6.2.53
Kyoung-Min Lee, Teahyeon Kong, Keun-Myoung Park, Y. Jeon, S. Cho, K. Hong
Purpose: The carotid artery intima-media thickness (IMT) is a risk factor for atherosclerosis that can predict the association of cardiovascular disease. Despite this, there have been few studies on the femoral artery IMT. This study examined the correlation between the carotid and femoral IMT. The findings suggest that both the carotid and femoral IMT need to be measured for a proper evaluation of early arterial disease. Methods: This retrospective study included 39 patients who underwent carotid artery duplex, lower extremity duplex, and coronary artery angiography or CT for a health checkup in the authors’ health promotion center from January 2015 to December 2017. The carotid and femoral IMT were measured at three places from bifurcation using B-mode. The coronary artery disease (CAD), carotid artery stenosis (CAS), and peripheral artery occlusive disease (PAD) were defined by stenosis over 50% in duplex and CT angiogram. The maximum and sum of the IMT in both the arterial disease group and no arterial disease group were compared. Results: This study included 25 patients with arterial diseases from 39 enrolled patients 22 patients with CAD (51.2%), eight patients with CAS (20.5%), and seven patients with PAOD (17.9%). The total arterial disease including any one of the above three arterial diseases correlated with the maximum values of the femoral IMT (R = 0.322, P = 0.023) and the sum of the femoral IMT (R = 0.346, P = 0.015). Conclusion: The femoral artery IMT correlated with the carotid artery IMT. In addition, the femoral artery IMT correlated with the occurrence of total arterial disease, including coronary, carotid, and peripheral artery occlusive disease, but the correlation was lower than that of the carotid IMT.
{"title":"Evaluation of the Femoral Artery IMT as a Risk Factor of Cardiovascular Disease","authors":"Kyoung-Min Lee, Teahyeon Kong, Keun-Myoung Park, Y. Jeon, S. Cho, K. Hong","doi":"10.46268/JSU.2019.6.2.53","DOIUrl":"https://doi.org/10.46268/JSU.2019.6.2.53","url":null,"abstract":"Purpose: The carotid artery intima-media thickness (IMT) is a risk factor for atherosclerosis that can predict the association of cardiovascular disease. Despite this, there have been few studies on the femoral artery IMT. This study examined the correlation between the carotid and femoral IMT. The findings suggest that both the carotid and femoral IMT need to be measured for a proper evaluation of early arterial disease. Methods: This retrospective study included 39 patients who underwent carotid artery duplex, lower extremity duplex, and coronary artery angiography or CT for a health checkup in the authors’ health promotion center from January 2015 to December 2017. The carotid and femoral IMT were measured at three places from bifurcation using B-mode. The coronary artery disease (CAD), carotid artery stenosis (CAS), and peripheral artery occlusive disease (PAD) were defined by stenosis over 50% in duplex and CT angiogram. The maximum and sum of the IMT in both the arterial disease group and no arterial disease group were compared. Results: This study included 25 patients with arterial diseases from 39 enrolled patients 22 patients with CAD (51.2%), eight patients with CAS (20.5%), and seven patients with PAOD (17.9%). The total arterial disease including any one of the above three arterial diseases correlated with the maximum values of the femoral IMT (R = 0.322, P = 0.023) and the sum of the femoral IMT (R = 0.346, P = 0.015). Conclusion: The femoral artery IMT correlated with the carotid artery IMT. In addition, the femoral artery IMT correlated with the occurrence of total arterial disease, including coronary, carotid, and peripheral artery occlusive disease, but the correlation was lower than that of the carotid IMT.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43691771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-30DOI: 10.46268/JSU.2019.6.2.58
Haram J. Kim, Eiyoung Kwon, Youngsam Park, E. Choi, Mi Jin Kim, C. Kim
Purpose: Ultrasonography is widely used for examining breast mass. We used the Breast Imaging-Reporting and Data System (BI-RADS) to characterize breast lesions found on ultrasonography. Among various ultrasound techniques, we used S-Detect TM (Samsung Medison Co., Ltd, Seoul, Korea), which supports the morphological analysis of breast masses found according to BI-RADS. In addition, we compared the breast surgeons’ categorization of breast masses with that by S-Detect TM . Methods: Breast surgeons evaluated the breast masses found using ultrasonography between April 2016 and December 2016. A total of 139 masses, which were categorized as BI-RADS 3 or 4, from 112 patients were reevaluated by S-Detect TM before performing vacuum-as-sisted resection or surgical excision. Results: Of the 139 masses, 118 were benign tumors and 21 were malignant tumors. With regard to the diagnostic performance, the sensitivity of categorization was 95% for breast surgeons, but the sensitivity was relatively lower for S-detect TM (85%). However, the specificity and accuracy of S-detect TM were 70.6% and 74.1%, respectively, which were higher than those values obtained from breast surgeons (18.5% and 30.9%, respectively). Conclusion: S-detect TM can be used by breast surgeons as a diagnostic aid when evaluating and diagnosing breast masses found on ultrasonography.
{"title":"A Comparative Study of the Diagnostic Performance of Evaluating Breast Masses for Breast Surgeons versus S-DetectTM(Samsung Medison Co., Ltd, Seoul, Korea)","authors":"Haram J. Kim, Eiyoung Kwon, Youngsam Park, E. Choi, Mi Jin Kim, C. Kim","doi":"10.46268/JSU.2019.6.2.58","DOIUrl":"https://doi.org/10.46268/JSU.2019.6.2.58","url":null,"abstract":"Purpose: Ultrasonography is widely used for examining breast mass. We used the Breast Imaging-Reporting and Data System (BI-RADS) to characterize breast lesions found on ultrasonography. Among various ultrasound techniques, we used S-Detect TM (Samsung Medison Co., Ltd, Seoul, Korea), which supports the morphological analysis of breast masses found according to BI-RADS. In addition, we compared the breast surgeons’ categorization of breast masses with that by S-Detect TM . Methods: Breast surgeons evaluated the breast masses found using ultrasonography between April 2016 and December 2016. A total of 139 masses, which were categorized as BI-RADS 3 or 4, from 112 patients were reevaluated by S-Detect TM before performing vacuum-as-sisted resection or surgical excision. Results: Of the 139 masses, 118 were benign tumors and 21 were malignant tumors. With regard to the diagnostic performance, the sensitivity of categorization was 95% for breast surgeons, but the sensitivity was relatively lower for S-detect TM (85%). However, the specificity and accuracy of S-detect TM were 70.6% and 74.1%, respectively, which were higher than those values obtained from breast surgeons (18.5% and 30.9%, respectively). Conclusion: S-detect TM can be used by breast surgeons as a diagnostic aid when evaluating and diagnosing breast masses found on ultrasonography.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46615938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-30DOI: 10.46268/JSU.2019.6.2.46
Kyungpyo Hong, Sungsin Cho, J. Joh
Received October 5, 2019 Revised November 18, 2019 Accepted November 26, 2019 Purpose: Percutaneous transluminal angioplasty (PTA) shows an attractive outcome for treating infrainguinal arterial occlusive disease (IAOD). However, this procedure requires repeated revascularization and additional stenting. Directional atherectomy (DA) has been reported to be a modality that requires less frequent use of stenting. The aim of this study was to compare the duplex-based outcomes between PTA and DA for treating IAOD. Methods: A retrospective review of consecutive patients with IAOD treated with PTA and DA was completed. The demographics and procedural data were obtained. A provisional stent was placed in those cases with flow-limiting dissection and residual stenosis after PTA or DA. Technical success was defined as a residual stenosis < 30%. The primary patency rate was evaluated by performing duplex scanning. The clinical outcomes and frequency of stent placement for each procedure were evaluated. For statistical analysis, the data was analyzed using SPSS 22.0 software (IBM Corp, Chicago, Ill). All P values were considered significant if less than 0.05. Results: Seventy-one patients were included in the study. Their mean age was 71.5 ± 10.2 years. The male-to-female ratio was 49:22. Thirty-three patients underwent PTA. DA was performed in 38 patients (42 limbs). Technical success was achieved in all the patients. The duplex-based clinical outcome and limb salvage rate were similar in the two groups. Bailout stent placement was performed in 8 of 33 patients (24.2%) in the PTA group and in no patient in the DA group. Conclusion: The clinical outcomes were similar for both the DA and primary PTA groups. Atherectomy reduced the need for bailout stent placement as compared with bailout stent placement in primary PTA.
{"title":"Duplex Surveillance after Primary Balloon Angioplasty or Directional Atherectomy for Treating Infrainguinal Arterial Disease","authors":"Kyungpyo Hong, Sungsin Cho, J. Joh","doi":"10.46268/JSU.2019.6.2.46","DOIUrl":"https://doi.org/10.46268/JSU.2019.6.2.46","url":null,"abstract":"Received October 5, 2019 Revised November 18, 2019 Accepted November 26, 2019 Purpose: Percutaneous transluminal angioplasty (PTA) shows an attractive outcome for treating infrainguinal arterial occlusive disease (IAOD). However, this procedure requires repeated revascularization and additional stenting. Directional atherectomy (DA) has been reported to be a modality that requires less frequent use of stenting. The aim of this study was to compare the duplex-based outcomes between PTA and DA for treating IAOD. Methods: A retrospective review of consecutive patients with IAOD treated with PTA and DA was completed. The demographics and procedural data were obtained. A provisional stent was placed in those cases with flow-limiting dissection and residual stenosis after PTA or DA. Technical success was defined as a residual stenosis < 30%. The primary patency rate was evaluated by performing duplex scanning. The clinical outcomes and frequency of stent placement for each procedure were evaluated. For statistical analysis, the data was analyzed using SPSS 22.0 software (IBM Corp, Chicago, Ill). All P values were considered significant if less than 0.05. Results: Seventy-one patients were included in the study. Their mean age was 71.5 ± 10.2 years. The male-to-female ratio was 49:22. Thirty-three patients underwent PTA. DA was performed in 38 patients (42 limbs). Technical success was achieved in all the patients. The duplex-based clinical outcome and limb salvage rate were similar in the two groups. Bailout stent placement was performed in 8 of 33 patients (24.2%) in the PTA group and in no patient in the DA group. Conclusion: The clinical outcomes were similar for both the DA and primary PTA groups. Atherectomy reduced the need for bailout stent placement as compared with bailout stent placement in primary PTA.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47191351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-30DOI: 10.46268/JSU.2019.6.2.64
Geunhyeok Yang, Sungsin Cho, J. Joh
Received October 10, 2019 Revised November 18, 2019 Accepted November 26, 2019 Purpose: Endovenous radiofrequency ablation (RFA) is a safe, effective treatment for varicose veins caused by saphenous reflux. Endovenous heat-induced thrombosis (EHIT) is a unique complication for this procedure. This study evaluated the incidence, risk factors, and clinical consequences of EHIT. Methods: We retrospectively reviewed the data of patients with varicose veins who underwent radiofrequency ablation (RFA). Duplex ultrasonography (DUS) was performed within 1 week and then 6 months after the procedure. If EHIT was found at the first postprocedural DUS, then monthly surveillance was done. The incidence of EHIT and the risk factors were analyzed. The clinical consequence was finally investigated. Results: During the study period, a total of 1,247 saphenous veins in 783 patients underwent RFA. Four hundred fifty-seven (58.4%) patients were women. The mean age was 52.9 ± 12.4 years (range: 8–85 years). EHIT was present in 7 (0.6%) saphenous veins in 7 (0.9%) patients. EHIT developed in 6 great saphenous veins (GSV) and 1 small saphenous vein. EHIT class I, II, and III were 3, 2, and 2 patients, respectively. The diameter of GSV ≥ 6 mm was the significant risk factor for the occurrence of EHIT. Six EHITs spontaneously resolved within 5 weeks after the procedure. One EHIT was resolved in 7 months after the procedure. No incidences of pulmonary embolism occurred. Conclusion: EHIT was a rare complication after RFA. Moreover, it spontaneously resolved without any clinical sequelae. Thus, performing routine DUS is not recommended to evaluate EHIT in the asymptomatic patient.
{"title":"The Incidence, Risk Factors, and Clinical Outcomes for Endovenous Heat-induced Thrombosis after Radiofrequency Ablation","authors":"Geunhyeok Yang, Sungsin Cho, J. Joh","doi":"10.46268/JSU.2019.6.2.64","DOIUrl":"https://doi.org/10.46268/JSU.2019.6.2.64","url":null,"abstract":"Received October 10, 2019 Revised November 18, 2019 Accepted November 26, 2019 Purpose: Endovenous radiofrequency ablation (RFA) is a safe, effective treatment for varicose veins caused by saphenous reflux. Endovenous heat-induced thrombosis (EHIT) is a unique complication for this procedure. This study evaluated the incidence, risk factors, and clinical consequences of EHIT. Methods: We retrospectively reviewed the data of patients with varicose veins who underwent radiofrequency ablation (RFA). Duplex ultrasonography (DUS) was performed within 1 week and then 6 months after the procedure. If EHIT was found at the first postprocedural DUS, then monthly surveillance was done. The incidence of EHIT and the risk factors were analyzed. The clinical consequence was finally investigated. Results: During the study period, a total of 1,247 saphenous veins in 783 patients underwent RFA. Four hundred fifty-seven (58.4%) patients were women. The mean age was 52.9 ± 12.4 years (range: 8–85 years). EHIT was present in 7 (0.6%) saphenous veins in 7 (0.9%) patients. EHIT developed in 6 great saphenous veins (GSV) and 1 small saphenous vein. EHIT class I, II, and III were 3, 2, and 2 patients, respectively. The diameter of GSV ≥ 6 mm was the significant risk factor for the occurrence of EHIT. Six EHITs spontaneously resolved within 5 weeks after the procedure. One EHIT was resolved in 7 months after the procedure. No incidences of pulmonary embolism occurred. Conclusion: EHIT was a rare complication after RFA. Moreover, it spontaneously resolved without any clinical sequelae. Thus, performing routine DUS is not recommended to evaluate EHIT in the asymptomatic patient.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45214592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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