Pub Date : 2019-11-30DOI: 10.46268/JSU.2019.6.2.33
Shirley Cho, Sookyung Kwon, D. Jung, S. C. Park, Hyangkyoung Kim, J. Kim, S. Yun
Purpose: Endovascular aneurysm repair (EVAR) is a minimally invasive alternative to open repair for patients with abdominal aortic aneurysm (AAA). Yet the follow-up after EVAR with lifelong post-interventional imaging is mandatory in order to detect complications such as endoleaks or stent migration. Computed tomography angiography (CTA) is considered the standard imaging modality and widely used for follow-up, although patients are exposed to both radiation and nephrotoxic contrast medium. The aim of this study was to determine the diagnostic efficacy of contrast-enhanced ultrasound (CEUS) for detecting post EVAR endoleaks compared with that of CTA, which is considered as the gold standard. Methods: From January 2010 to August 2019, 27 patients who underwent CEUS and CTA for follow-up after elective EVAR at a single center were retrospectively analyzed. The presence of endoleak was compared between CTA and CEUS. Results: The 27 paired CTA and CEUS studies were analyzed. Eleven patients had endoleak detected on CEUS and they had the same findings with CTA. One patient had endoleak detected on CEUS, but this was not detected on CTA. Three patients didn’t have endoleak detected on CEUS, but endoleak was detected on CTA. 13 patients had no endoleak detected on CEUS or CTA. Assuming CTA is the gold standard, the sensitivity and specificity of CEUS to detect endoleak were 92.3%, and 78.6% respectively. Conclusion: CEUS can be used as a viable and feasible imaging alternative for the follow-up and the detection of endoleak after EVAR with the additional benefit of being a real-time non-ionizing radiation examination.
{"title":"The Usefulness of Contrast-Enhanced Ultrasound for Surveillance of Endoleak after Endo-vascular Aneurysm Repair","authors":"Shirley Cho, Sookyung Kwon, D. Jung, S. C. Park, Hyangkyoung Kim, J. Kim, S. Yun","doi":"10.46268/JSU.2019.6.2.33","DOIUrl":"https://doi.org/10.46268/JSU.2019.6.2.33","url":null,"abstract":"Purpose: Endovascular aneurysm repair (EVAR) is a minimally invasive alternative to open repair for patients with abdominal aortic aneurysm (AAA). Yet the follow-up after EVAR with lifelong post-interventional imaging is mandatory in order to detect complications such as endoleaks or stent migration. Computed tomography angiography (CTA) is considered the standard imaging modality and widely used for follow-up, although patients are exposed to both radiation and nephrotoxic contrast medium. The aim of this study was to determine the diagnostic efficacy of contrast-enhanced ultrasound (CEUS) for detecting post EVAR endoleaks compared with that of CTA, which is considered as the gold standard. Methods: From January 2010 to August 2019, 27 patients who underwent CEUS and CTA for follow-up after elective EVAR at a single center were retrospectively analyzed. The presence of endoleak was compared between CTA and CEUS. Results: The 27 paired CTA and CEUS studies were analyzed. Eleven patients had endoleak detected on CEUS and they had the same findings with CTA. One patient had endoleak detected on CEUS, but this was not detected on CTA. Three patients didn’t have endoleak detected on CEUS, but endoleak was detected on CTA. 13 patients had no endoleak detected on CEUS or CTA. Assuming CTA is the gold standard, the sensitivity and specificity of CEUS to detect endoleak were 92.3%, and 78.6% respectively. Conclusion: CEUS can be used as a viable and feasible imaging alternative for the follow-up and the detection of endoleak after EVAR with the additional benefit of being a real-time non-ionizing radiation examination.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41452561","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.2019.6.2.38
K. Lee, J. Han, Eun-young Kim, J. Yun, Y. Park, Chan Heun Park
Purpose: Upstaging to invasive cancer (IC) is often found after surgery in those patients diagnosed with ductal carcinoma in situ (DCIS) and who underwent preoperative needle biopsy. This may change the post-surgical plans that include the re-operation, chemotherapy, and/or radiotherapy. Yet, there are no clinically available factors to predict IC in preoperatively diagnosed DCIS patients. This study evaluated the clinical and pathological predictive risk factors for upgrading DCIS to IC. Methods: This study retrospectively evaluated those patients who were diagnosed with DCIS preoperatively, and this diagnosis was followed by performing breast surgery between Jan 2005 and June 2018. Clinico-pathological factors were collected for the analysis between the pure DCIS group and the IC group. Results: Of the 431 patients included in the study, 34 (7.9%) were upstaged to IC after surgery, and 397 (92.1%) were diagnosed as having pure DCIS. The nuclear grade was the sole predictor of upstaging to IC on the analysis of the clinico-pathological factors (odds ratio [OR] = 2.39, 95% confidence interval [95% CI] = 1.05 – 5.42, P = 0.038 on the univariate analysis; aOR = 2.86, 95% CI = 1.14 – 7.14, P = 0.025 on the multivariate analysis). The mass’s size and characteristics, as determined by sonography, were not predictive of IC. Conclusion: The sonographic findings were not significant factors for predicting IC in preoperative DCIS patients. A high nuclear grade was the only statistically significant factor associated with IC. Considering the variability of the gauge of biopsy needles or the method for needle biopsy, large-scale prospective studies that control these variables may well reveal available predictive factors of IC in patients with DCIS.
{"title":"Clinical Predictors of Upstaging to Invasive Cancer Postoperatively in Patients Diagnosed with Ductal Carcinoma In Situ before Surgery","authors":"K. Lee, J. Han, Eun-young Kim, J. Yun, Y. Park, Chan Heun Park","doi":"10.46268/JSU.2019.6.2.38","DOIUrl":"https://doi.org/10.46268/JSU.2019.6.2.38","url":null,"abstract":"Purpose: Upstaging to invasive cancer (IC) is often found after surgery in those patients diagnosed with ductal carcinoma in situ (DCIS) and who underwent preoperative needle biopsy. This may change the post-surgical plans that include the re-operation, chemotherapy, and/or radiotherapy. Yet, there are no clinically available factors to predict IC in preoperatively diagnosed DCIS patients. This study evaluated the clinical and pathological predictive risk factors for upgrading DCIS to IC. Methods: This study retrospectively evaluated those patients who were diagnosed with DCIS preoperatively, and this diagnosis was followed by performing breast surgery between Jan 2005 and June 2018. Clinico-pathological factors were collected for the analysis between the pure DCIS group and the IC group. Results: Of the 431 patients included in the study, 34 (7.9%) were upstaged to IC after surgery, and 397 (92.1%) were diagnosed as having pure DCIS. The nuclear grade was the sole predictor of upstaging to IC on the analysis of the clinico-pathological factors (odds ratio [OR] = 2.39, 95% confidence interval [95% CI] = 1.05 – 5.42, P = 0.038 on the univariate analysis; aOR = 2.86, 95% CI = 1.14 – 7.14, P = 0.025 on the multivariate analysis). The mass’s size and characteristics, as determined by sonography, were not predictive of IC. Conclusion: The sonographic findings were not significant factors for predicting IC in preoperative DCIS patients. A high nuclear grade was the only statistically significant factor associated with IC. Considering the variability of the gauge of biopsy needles or the method for needle biopsy, large-scale prospective studies that control these variables may well reveal available predictive factors of IC in patients with DCIS.","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":"47513171","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}
Received February 11, 2019 Revised April 30, 2019 Accepted May 2, 2019 A good screening test should be widely available, inexpensive, and have high sensitivity and specificity. Mammography is the only screening modality proven to reduce the mortality of breast cancer. On the other hand, with the increasing awareness of mammography limitations, particularly in a dense breast, supplemental screening for breast cancer with other imaging modalities has been expanding. Breast ultrasonography has the advantage of detecting mammographically occult breast cancers in a dense breast. On the other hand, operator dependence, false positive rates, and rising costs due to increased biopsy rates are a problem. Thus far, the guidelines for the implementation of screening breast ultrasonography have not been established. Physicians should be able to understand the efficacy of breast ultrasonography as the screening modality for breast cancer and perform risk-based screening approaches for individual women. This paper reviews the efficacy, limitations and implementation of screening breast ultrasonography for breast cancer.
{"title":"Efficacy of Ultrasonography in Breast Cancer Screening","authors":"H. Youn, H. Ahn, Sang Yull Kang, S. Jung","doi":"10.46268/JSU.2019.6.1.1","DOIUrl":"https://doi.org/10.46268/JSU.2019.6.1.1","url":null,"abstract":"Received February 11, 2019 Revised April 30, 2019 Accepted May 2, 2019 A good screening test should be widely available, inexpensive, and have high sensitivity and specificity. Mammography is the only screening modality proven to reduce the mortality of breast cancer. On the other hand, with the increasing awareness of mammography limitations, particularly in a dense breast, supplemental screening for breast cancer with other imaging modalities has been expanding. Breast ultrasonography has the advantage of detecting mammographically occult breast cancers in a dense breast. On the other hand, operator dependence, false positive rates, and rising costs due to increased biopsy rates are a problem. Thus far, the guidelines for the implementation of screening breast ultrasonography have not been established. Physicians should be able to understand the efficacy of breast ultrasonography as the screening modality for breast cancer and perform risk-based screening approaches for individual women. This paper reviews the efficacy, limitations and implementation of screening breast ultrasonography for breast cancer.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47947575","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 : 2019-05-31DOI: 10.46268/jsu.2019.6.1.20
T. Eom, Byung Seup Kim
Purpose: This study estimated the changes in distance between a thyroid nodule and the surrounding structures after tumescent anesthesia in radiofrequency ablation (RFA) for a benign thyroid nodule. Methods: Between January 2015 and December 2017, the sonogram images in patients treated with thyroid RFA were reviewed retrospectively. Patients without images immediately after tumescent anesthesia or treated with RFA for carcinoma were excluded. The 0.2% saline mixed lidocaine as a tumescent solution was injected into the anterior, posterior, and lateral capsules of the thyroid and thyroid-trachea junction. In a sonogram image, the distances between the posterior margin of the nodule and above the longus colli muscle, between the medial margin of the nodule and trachea, and between the lateral margin of the nodule and common carotid artery (CCA) were measured before and after tumescent anesthesia. Results: Tumescent anesthesia was technically successful in all 133 patients (100%) and the analgesic effect was also obtained successfully. No complications related to tumescent anesthesia were observed. The average distance between the posterior margin of the nodule and the longus colli muscle increased by 4.2 ± 2.4 mm. The average distance between the medial margin of the nodule and trachea increased by 2.2 ± 1.9 mm. The average distance between the lateral margin of the nodule and CCA increased by 4.6 ± 3.0 mm. Conclusion: Tumescent anesthesia is a safe and useful method for secure a safe distance (over 2 mm) in RFA for thyroid nodules close to the surrounding structure.
{"title":"Safety and Technical Efficacy of Tumescent Anesthesia in Radiofrequency Ablation for Thyroid Nodules Close to the Surrounding Structure","authors":"T. Eom, Byung Seup Kim","doi":"10.46268/jsu.2019.6.1.20","DOIUrl":"https://doi.org/10.46268/jsu.2019.6.1.20","url":null,"abstract":"Purpose: This study estimated the changes in distance between a thyroid nodule and the surrounding structures after tumescent anesthesia in radiofrequency ablation (RFA) for a benign thyroid nodule. Methods: Between January 2015 and December 2017, the sonogram images in patients treated with thyroid RFA were reviewed retrospectively. Patients without images immediately after tumescent anesthesia or treated with RFA for carcinoma were excluded. The 0.2% saline mixed lidocaine as a tumescent solution was injected into the anterior, posterior, and lateral capsules of the thyroid and thyroid-trachea junction. In a sonogram image, the distances between the posterior margin of the nodule and above the longus colli muscle, between the medial margin of the nodule and trachea, and between the lateral margin of the nodule and common carotid artery (CCA) were measured before and after tumescent anesthesia. Results: Tumescent anesthesia was technically successful in all 133 patients (100%) and the analgesic effect was also obtained successfully. No complications related to tumescent anesthesia were observed. The average distance between the posterior margin of the nodule and the longus colli muscle increased by 4.2 ± 2.4 mm. The average distance between the medial margin of the nodule and trachea increased by 2.2 ± 1.9 mm. The average distance between the lateral margin of the nodule and CCA increased by 4.6 ± 3.0 mm. Conclusion: Tumescent anesthesia is a safe and useful method for secure a safe distance (over 2 mm) in RFA for thyroid nodules close to the surrounding structure.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43860289","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 : 2019-05-31DOI: 10.46268/JSU.2019.6.1.14
Tak-Joong Song, Shin-Seok Yang, Woo-Sung Yoon
Purpose: This study examined the safety of an ultrasound-guided peripherally insertion central catheter (PICC) for patients undergoing chemotherapy. Methods: The medical records of consecutive patients who received ultrasound-guided PICC for chemotherapy between Sep. 2016 and Dec. 2017 were reviewed. The diameters of the basilic and brachial veins were measured in all patients. The procedures were performed when the diameter was more than 2.5 mm in the basilic vein first. The procedure was performed on the brachial vein when the diameter of the basilic vein was less than 2.5 mm. The technical success rate, catheter-related complications, duration of catheter service day by veins (basilic vs. brachial) were examined. Results: A total of 113 procedures were analyzed. The mean age was 61.9 ± 10.5 years (range 35 – 83 years). The technical success rate was 100%. The mean diameters of the basilic and brachial veins were 3.8 ± 0.8 mm and 3.9 ± 1.0 mm, respectively. The mean duration of the catheter service day was 95.8 ± 77.8. No difference in the diameter of the vessels ac-cording to age was noted. The incidence of complication-related catheter removals was similar in the two groups (26 in the basilic group and 27 in the brachial group; infection, 15.6% vs 22.4%, P ＞ 0.05 ; thrombosis, 6.3% vs. 6.1%, P ＞ 0.05; occlusion, 4.7% vs 6.1%, P ＞ 0.05). Conclusion: The ultrasound-guided PICC procedure ensures a successful probability in cancer patients. The incidence of complications was similar in the two groups (brachial vs. ba-silic).
{"title":"Safety and Feasibility of Ultrasound-guided Peripherally Inserted Central Catheterization for Chemo-Delivery","authors":"Tak-Joong Song, Shin-Seok Yang, Woo-Sung Yoon","doi":"10.46268/JSU.2019.6.1.14","DOIUrl":"https://doi.org/10.46268/JSU.2019.6.1.14","url":null,"abstract":"Purpose: This study examined the safety of an ultrasound-guided peripherally insertion central catheter (PICC) for patients undergoing chemotherapy. Methods: The medical records of consecutive patients who received ultrasound-guided PICC for chemotherapy between Sep. 2016 and Dec. 2017 were reviewed. The diameters of the basilic and brachial veins were measured in all patients. The procedures were performed when the diameter was more than 2.5 mm in the basilic vein first. The procedure was performed on the brachial vein when the diameter of the basilic vein was less than 2.5 mm. The technical success rate, catheter-related complications, duration of catheter service day by veins (basilic vs. brachial) were examined. Results: A total of 113 procedures were analyzed. The mean age was 61.9 ± 10.5 years (range 35 – 83 years). The technical success rate was 100%. The mean diameters of the basilic and brachial veins were 3.8 ± 0.8 mm and 3.9 ± 1.0 mm, respectively. The mean duration of the catheter service day was 95.8 ± 77.8. No difference in the diameter of the vessels ac-cording to age was noted. The incidence of complication-related catheter removals was similar in the two groups (26 in the basilic group and 27 in the brachial group; infection, 15.6% vs 22.4%, P ＞ 0.05 ; thrombosis, 6.3% vs. 6.1%, P ＞ 0.05; occlusion, 4.7% vs 6.1%, P ＞ 0.05). Conclusion: The ultrasound-guided PICC procedure ensures a successful probability in cancer patients. The incidence of complications was similar in the two groups (brachial vs. ba-silic).","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45487981","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}
T. Kong, H. Ohe, Kwang Kim, K. W. Choi, Young-Ki Kim, W. Lee, Y. Chang, S. Hong
Purpose: The catheter vein ratio (CVR) is one of control factors related to the incidence of catheter related thrombosis (CRT). This paper reports a practical CVR to reduce the incidence of CRT in patients receiving PICC. Methods: Information on patients with PICC insertion between January 2018 and December 2018 was extracted retrospectively from a single center. The information was composed of age, sex, BMI, access locations, comorbidities, catheter sizes, catheter days, catheter removal cause, and CRT. The incidence of CRT and other factors were analyzed. Results: Of the 164 patients who underwent PICC and 2,697 catheter days in the study, three patients (1.8%) experienced a symptomatic thrombosis. Without significance to other factors, the incidence of thrombosis was relevant only in those with higher CVR vs. those with lower CVR (P = 0.047). In addition, its cut-off value was 36.5% (AUC 0.813, 95% CI: 1.003 – 1.495). Compared to the higher and lower than 36.5% CVR, the odd ratio was 38.25 in the group with a higher than 36.5% CVR (95% CI: 3.129 – 467.611, P = 0.010). Conclusion: CVR is one of the factors that can be controlled to reduce the clinical relevance of CRT. A lower than 36.5% CVR should be maintained to be in the safety zone from PICC related thrombosis.
{"title":"What Is a Practical Catheter Vein Ratio to Lower the Incidence of PICC-Related Symptomatic Thrombosis?","authors":"T. Kong, H. Ohe, Kwang Kim, K. W. Choi, Young-Ki Kim, W. Lee, Y. Chang, S. Hong","doi":"10.46268/JSU.2019.6.1.8","DOIUrl":"https://doi.org/10.46268/JSU.2019.6.1.8","url":null,"abstract":"Purpose: The catheter vein ratio (CVR) is one of control factors related to the incidence of catheter related thrombosis (CRT). This paper reports a practical CVR to reduce the incidence of CRT in patients receiving PICC. Methods: Information on patients with PICC insertion between January 2018 and December 2018 was extracted retrospectively from a single center. The information was composed of age, sex, BMI, access locations, comorbidities, catheter sizes, catheter days, catheter removal cause, and CRT. The incidence of CRT and other factors were analyzed. Results: Of the 164 patients who underwent PICC and 2,697 catheter days in the study, three patients (1.8%) experienced a symptomatic thrombosis. Without significance to other factors, the incidence of thrombosis was relevant only in those with higher CVR vs. those with lower CVR (P = 0.047). In addition, its cut-off value was 36.5% (AUC 0.813, 95% CI: 1.003 – 1.495). Compared to the higher and lower than 36.5% CVR, the odd ratio was 38.25 in the group with a higher than 36.5% CVR (95% CI: 3.129 – 467.611, P = 0.010). Conclusion: CVR is one of the factors that can be controlled to reduce the clinical relevance of CRT. A lower than 36.5% CVR should be maintained to be in the safety zone from PICC related thrombosis.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46155767","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 : 2018-11-30DOI: 10.46268/JSU.2018.5.2.39
Y. Yoon
가톨릭대학교 In the treatment of small hepatocellular carcinoma (HCC), percutaneous ultrasound guided radiofrequency ablation (RFA) is a proven therapy and is currently performed in clinical practice. However, depending on the location of the HCC, percutaneous RFA may not be possible. In these cases, intraoperative RFA can be implemented, but it is rarely performed by surgeons. Since laparoscopic intraoperative RFA is less invasive, it is increasingly used in small HCCs.
{"title":"Ultrasound Guided Intraoperative Liver Radiofrequency Ablation by Surgeons","authors":"Y. Yoon","doi":"10.46268/JSU.2018.5.2.39","DOIUrl":"https://doi.org/10.46268/JSU.2018.5.2.39","url":null,"abstract":"가톨릭대학교 In the treatment of small hepatocellular carcinoma (HCC), percutaneous ultrasound guided radiofrequency ablation (RFA) is a proven therapy and is currently performed in clinical practice. However, depending on the location of the HCC, percutaneous RFA may not be possible. In these cases, intraoperative RFA can be implemented, but it is rarely performed by surgeons. Since laparoscopic intraoperative RFA is less invasive, it is increasingly used in small HCCs.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48632674","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 : 2018-11-30DOI: 10.46268/jsu.2018.5.2.45
Eun Young Kim, C. Kim, Young Sam Park, E. Choi, M. J. Kim
Purpose: Atypia/follicular lesions of undetermined significance (AUS/FLUS) as Bethesda System category 3, cannot be classified as benign or malignant. The purpose of this study was to identify which clinical factor increases the risk of malignancy in patients with AUS/FLUS. Methods: A total of 158 patients with AUS/FLUS, who underwent thyroid surgery at the au-thors’ institution, were examined retrospectively. Chi square analyses were performed to compare the benign and malignancy group based on their final pathology to assess the in-dependent effects of risk factors, such as age, sex, size of nodule, the number of FNAC, ultrasonography findings, and the number of malignancy ultrasonography findings in a single nodule. Results: In the analyses, age, sex, the number of FNAC, contents, and shape were not significantly related to the cancer diagnosis. Marked hypoechogenicity, spiculated margin, mi-crocalcification, and showing three or more ultrasonographic risk features were significantly related to an increased malignant risk. Conclusion: Surgical resection of thyroid nodules should be considered in an AUS group showing three or more ultrasonographic risk findings.
{"title":"How Can We Predict Malignancy of Thyroid Nodules with AUS/FLUS from Ultrasonographic Features?","authors":"Eun Young Kim, C. Kim, Young Sam Park, E. Choi, M. J. Kim","doi":"10.46268/jsu.2018.5.2.45","DOIUrl":"https://doi.org/10.46268/jsu.2018.5.2.45","url":null,"abstract":"Purpose: Atypia/follicular lesions of undetermined significance (AUS/FLUS) as Bethesda System category 3, cannot be classified as benign or malignant. The purpose of this study was to identify which clinical factor increases the risk of malignancy in patients with AUS/FLUS. Methods: A total of 158 patients with AUS/FLUS, who underwent thyroid surgery at the au-thors’ institution, were examined retrospectively. Chi square analyses were performed to compare the benign and malignancy group based on their final pathology to assess the in-dependent effects of risk factors, such as age, sex, size of nodule, the number of FNAC, ultrasonography findings, and the number of malignancy ultrasonography findings in a single nodule. Results: In the analyses, age, sex, the number of FNAC, contents, and shape were not significantly related to the cancer diagnosis. Marked hypoechogenicity, spiculated margin, mi-crocalcification, and showing three or more ultrasonographic risk features were significantly related to an increased malignant risk. Conclusion: Surgical resection of thyroid nodules should be considered in an AUS group showing three or more ultrasonographic risk findings.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43107620","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 : 2018-11-30DOI: 10.46268/JSU.2018.5.2.33
H. Youn, Sang Yull Kang, S. Jung
Elastography is an imaging modality for assessing tissue differences regarding stiffness or elasticity for what was historically assessed manually by clinical palpation. Shear wave elastography (SWE) is a recently developed ultrasound technique that can visualize and measure tissue elasticity. Combined with conventional B-mode ultrasonography, SWE can potentially evaluate the elasticity of a breast lesion and help to distinguish malignant breast tumors from benign ones. SWE provides high quality images for diagnosing breast cancer, which even-tually helps reduce false-positive results and avoids unnecessary biopsies. More recently, SWE been proven useful for the diagnosis of breast cancer, and has been shown to provide valuable information that can be used as a predictor of the response to neoadjuvant chemotherapy or prognosis. This article reviews the clinical application and current role of SWE in patients with breast cancer.
{"title":"Clinical Application of Shear Wave Elastography in Patients with Breast Cancer","authors":"H. Youn, Sang Yull Kang, S. Jung","doi":"10.46268/JSU.2018.5.2.33","DOIUrl":"https://doi.org/10.46268/JSU.2018.5.2.33","url":null,"abstract":"Elastography is an imaging modality for assessing tissue differences regarding stiffness or elasticity for what was historically assessed manually by clinical palpation. Shear wave elastography (SWE) is a recently developed ultrasound technique that can visualize and measure tissue elasticity. Combined with conventional B-mode ultrasonography, SWE can potentially evaluate the elasticity of a breast lesion and help to distinguish malignant breast tumors from benign ones. SWE provides high quality images for diagnosing breast cancer, which even-tually helps reduce false-positive results and avoids unnecessary biopsies. More recently, SWE been proven useful for the diagnosis of breast cancer, and has been shown to provide valuable information that can be used as a predictor of the response to neoadjuvant chemotherapy or prognosis. This article reviews the clinical application and current role of SWE in patients with breast cancer.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48202077","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 : 2018-11-30DOI: 10.46268/JSU.2018.5.2.61
D. Kim, D. Cho, Y. Jung, Jae Gil Lee
Purpose: Ultrasound guidance for bedside procedures reduces the risk of complications. This e aim of this study is to stateexamined the experiences of the ultrasonography-guided bedside procedures performed by surgeons in the intensive care unit. Methods: Patients who underwent ultrasonography-guided bedside procedures from October 2016 to October 2017 were reviewed retrospectively. The baseline characteristics of the population, procedures performed, occurrence of complications, and coagulation-re-lated parameters were obtained from the electronic medical records. Results: A total 113 procedures were collected and analyzed. The most frequently performed procedure was ultrasonography-guided central venous catheterization (CVC) (75 cases, 66.4%), followed by thoracentesis (41 cases, 36.3%) and paracentesis (7 cases, 6.2 %). A total of five complications (4.4%) occurred after the procedures, three events after CVC insertion, and two events after thoracentesis. After CVC, two pneumothorax and one hemothorax occurred, which were managed by chest tube insertion. Two events after thoracentesis were a pneumothorax, which required chest tube insertion, and a combined ten-sion-pneumothorax with a hemothorax, which required thoracoscopic surgery for bleeder ligation. Conclusion: Ultrasonography-guided bedside procedures are a simple and fast modality available for surgeons. Despite the safety of ultrasonography-guided procedure, there is some concern regarding the development of complications.
{"title":"Single Center Experience of Ultrasonography-guided Bedside Procedures for Surgical Patients","authors":"D. Kim, D. Cho, Y. Jung, Jae Gil Lee","doi":"10.46268/JSU.2018.5.2.61","DOIUrl":"https://doi.org/10.46268/JSU.2018.5.2.61","url":null,"abstract":"Purpose: Ultrasound guidance for bedside procedures reduces the risk of complications. This e aim of this study is to stateexamined the experiences of the ultrasonography-guided bedside procedures performed by surgeons in the intensive care unit. Methods: Patients who underwent ultrasonography-guided bedside procedures from October 2016 to October 2017 were reviewed retrospectively. The baseline characteristics of the population, procedures performed, occurrence of complications, and coagulation-re-lated parameters were obtained from the electronic medical records. Results: A total 113 procedures were collected and analyzed. The most frequently performed procedure was ultrasonography-guided central venous catheterization (CVC) (75 cases, 66.4%), followed by thoracentesis (41 cases, 36.3%) and paracentesis (7 cases, 6.2 %). A total of five complications (4.4%) occurred after the procedures, three events after CVC insertion, and two events after thoracentesis. After CVC, two pneumothorax and one hemothorax occurred, which were managed by chest tube insertion. Two events after thoracentesis were a pneumothorax, which required chest tube insertion, and a combined ten-sion-pneumothorax with a hemothorax, which required thoracoscopic surgery for bleeder ligation. Conclusion: Ultrasonography-guided bedside procedures are a simple and fast modality available for surgeons. Despite the safety of ultrasonography-guided procedure, there is some concern regarding the development of complications.","PeriodicalId":33937,"journal":{"name":"Journal of Surgical Ultrasound","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46848374","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：