Pub Date : 2021-04-01Epub Date: 2021-08-24DOI: 10.1055/a-1542-9146
Ingrid Kvåle Nordaas, Trond Engjom, Odd Helge Gilja, Roald Flesland Havre, Dag André Sangnes, Ingfrid S Haldorsen, Georg Dimcevski
Purpose Computed tomography (CT) is the most used imaging modality for diagnosing chronic pancreatitis (CP), but advances in transabdominal ultrasound (US) technology have given US a position as a viable alternative. We aimed to evaluate the diagnostic accuracy of abdominal CT and pancreatic US compared to the reference standard, a modified Mayo score. Materials and Methods CT, US, and endoscopic ultrasound (EUS) were performed in patients referred due to suspected CP. The modified Mayo score included EUS results, clinical presentation, and results from exocrine and endocrine pancreatic function tests. We scored CT findings according to the modified Cambridge classification and US findings according to the Rosemont classification. Results In total, 73 patients were included. 53 patients (73%) were categorized as CP and 20 (27%) as non-CP. CT and US yielded similar sensitivities (68% and 64%, respectively) and specificities (75 and 85%, respectively) and similar areas under the receiver operating characteristic curves for diagnosing CP. We found no significant differences between the areas under the receiver operating characteristic curves (AUROCs) for CT (AUROC 0.75, 95% CI 0.63-0.87) and US (AUROC 0.81, 95% CI 0.71-0.91). Conclusion We conclude that CT and US had comparable, moderate accuracy in diagnosing CP. Neither modality had high enough sensitivity to exclude the diagnosis as a standalone method.
目的计算机断层扫描(CT)是诊断慢性胰腺炎(CP)最常用的成像方式,但经腹超声(US)技术的进步使US成为一种可行的替代方法。我们的目的是评估腹部CT和胰腺US与参考标准(改良的Mayo评分)的诊断准确性。材料与方法对疑似CP的患者行CT、US和内镜超声(EUS)检查。改良Mayo评分包括EUS结果、临床表现、外分泌和内分泌胰腺功能检查结果。CT表现按照改良的Cambridge分级进行评分,US表现按照Rosemont分级进行评分。结果共纳入73例患者。53例(73%)为CP, 20例(27%)为非CP。CT和US对诊断CP的敏感性(分别为68%和64%)和特异性(分别为75%和85%)以及受者工作特征曲线下的相似区域相似。我们发现CT (AUROC 0.75, 95% CI 0.63-0.87)和US (AUROC 0.81, 95% CI 0.71-0.91)受者工作特征曲线下的区域之间无显著差异。结论CT和US在诊断CP方面具有相当的、中等的准确性。两种方法的灵敏度都不够高,不能作为单独的诊断方法。
{"title":"Diagnostic Accuracy of Transabdominal Ultrasound and Computed Tomography in Chronic Pancreatitis: A Head-to-Head Comparison.","authors":"Ingrid Kvåle Nordaas, Trond Engjom, Odd Helge Gilja, Roald Flesland Havre, Dag André Sangnes, Ingfrid S Haldorsen, Georg Dimcevski","doi":"10.1055/a-1542-9146","DOIUrl":"https://doi.org/10.1055/a-1542-9146","url":null,"abstract":"<p><p><b>Purpose</b> Computed tomography (CT) is the most used imaging modality for diagnosing chronic pancreatitis (CP), but advances in transabdominal ultrasound (US) technology have given US a position as a viable alternative. We aimed to evaluate the diagnostic accuracy of abdominal CT and pancreatic US compared to the reference standard, a modified Mayo score. <b>Materials and Methods</b> CT, US, and endoscopic ultrasound (EUS) were performed in patients referred due to suspected CP. The modified Mayo score included EUS results, clinical presentation, and results from exocrine and endocrine pancreatic function tests. We scored CT findings according to the modified Cambridge classification and US findings according to the Rosemont classification. <b>Results</b> In total, 73 patients were included. 53 patients (73%) were categorized as CP and 20 (27%) as non-CP. CT and US yielded similar sensitivities (68% and 64%, respectively) and specificities (75 and 85%, respectively) and similar areas under the receiver operating characteristic curves for diagnosing CP. We found no significant differences between the areas under the receiver operating characteristic curves (AUROCs) for CT (AUROC 0.75, 95% CI 0.63-0.87) and US (AUROC 0.81, 95% CI 0.71-0.91). <b>Conclusion</b> We conclude that CT and US had comparable, moderate accuracy in diagnosing CP. Neither modality had high enough sensitivity to exclude the diagnosis as a standalone method.</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"7 1","pages":"E35-E44"},"PeriodicalIF":3.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0f/5c/10-1055-a-1542-9146.PMC8384479.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39358947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-01Epub Date: 2021-07-27DOI: 10.1055/a-1522-8969
Arash Najafi, Michael Wildt, Nicolin Hainc, Joachim Hohmann
Purpose Renal lesions are frequent random findings on CT, MRI, and conventional ultrasound. Since they are usually found accidentally, the respective examinations have not been performed optimally to provide a conclusive diagnosis, making additional multiphase contrast-enhanced examinations necessary. The aim of the study is to correlate CEUS findings with the final diagnosis and to determine whether it is a suitable method for the conclusive characterization of undetermined renal lesions. Materials and Methods All CEUS examinations of focal renal lesions performed at our institute between 2007 and 2014 were retrospectively examined. 437 patients with a total of 491 lesions and 543 examinations were included. 54 patients had bilateral lesions. One patient had three lesions in one kidney. Histology was available in 49 cases and follow-ups in 124 cases. The sensitivity, specificity, positive and negative predictive value as well as positive and negative likelihood ratios were calculated. Results There were 54 malignant and 437 benign lesions. The sensitivity and specificity were 0.981/0.954 overall, 1.000/0.956 for cystic lesions, 0.977/0.906 for solid lesions, and 0.971/0.071 for the histologically confirmed lesions. Bosniak classification was consistent in 289 of 301 lesions (96%). Only 12 lesions (3.9%) were falsely assessed as malignant. Conclusion CEUS is an appropriate method for the clarification of undetermined renal lesions. The characterization of cystic lesions according to Bosniak is adequately possible, especially for potentially malignant lesions (types III and IV).
{"title":"Evaluation of Cystic and Solid Renal Lesions with Contrast-Enhanced Ultrasound: A Retrospective Study.","authors":"Arash Najafi, Michael Wildt, Nicolin Hainc, Joachim Hohmann","doi":"10.1055/a-1522-8969","DOIUrl":"10.1055/a-1522-8969","url":null,"abstract":"<p><p><b>Purpose</b> Renal lesions are frequent random findings on CT, MRI, and conventional ultrasound. Since they are usually found accidentally, the respective examinations have not been performed optimally to provide a conclusive diagnosis, making additional multiphase contrast-enhanced examinations necessary. The aim of the study is to correlate CEUS findings with the final diagnosis and to determine whether it is a suitable method for the conclusive characterization of undetermined renal lesions. <b>Materials and Methods</b> All CEUS examinations of focal renal lesions performed at our institute between 2007 and 2014 were retrospectively examined. 437 patients with a total of 491 lesions and 543 examinations were included. 54 patients had bilateral lesions. One patient had three lesions in one kidney. Histology was available in 49 cases and follow-ups in 124 cases. The sensitivity, specificity, positive and negative predictive value as well as positive and negative likelihood ratios were calculated. <b>Results</b> There were 54 malignant and 437 benign lesions. The sensitivity and specificity were 0.981/0.954 overall, 1.000/0.956 for cystic lesions, 0.977/0.906 for solid lesions, and 0.971/0.071 for the histologically confirmed lesions. Bosniak classification was consistent in 289 of 301 lesions (96%). Only 12 lesions (3.9%) were falsely assessed as malignant. <b>Conclusion</b> CEUS is an appropriate method for the clarification of undetermined renal lesions. The characterization of cystic lesions according to Bosniak is adequately possible, especially for potentially malignant lesions (types III and IV).</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"7 1","pages":"E25-E34"},"PeriodicalIF":3.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/f2/10-1055-a-1522-8969.PMC8315990.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39266763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-01Epub Date: 2021-05-04DOI: 10.1055/a-1461-4714
Anders Batman Mjelle, Anesa Mulabecirovic, Edda Jonina Olafsdottir, Odd Helge Gilja, Roald Flesland Havre, Mette Vesterhus
Abstract Purpose Controlled attenuation parameter (CAP) is a non-invasive method to assess the presence of liver steatosis. It has been evaluated in children and adults, mainly in either the obese or in subjects with suspected liver disease. Our aim was to describe CAP in healthy non-obese subjects without suspected liver steatosis and to suggest cutoff levels for steatosis. Materials and Methods We prospectively recruited 187 individuals aged 8–70 years. All underwent clinical examination, including height and weight measurement. Body mass index (BMI) was calculated and converted into z-scores. To exclude liver pathology, B-mode ultrasound and liver stiffness measurements were performed in all prior to CAP measurement. Blood was drawn for liver biochemistry in adults. Results CAP was associated with BMI z-score across all ages. CAP started to rise alongside BMI z-score already in subjects with a BMI below average. CAP values were higher in adults than in children (p<0.001), and higher in adult males than adult females (p=0.014). CAP did not correlate with age within the adult or pediatric cohorts. CAP was highly correlated with the fatty liver index. 18 and 23% of subjects showed CAP above the suggested cutoff value for children and adults, respectively. Conclusion CAP was correlated with BMI z-score, even in individuals with a below-average BMI . We found CAP above published cutoff values in a substantial proportion of presumably healthy, non-obese children and adults, warranting further research to clarify whether this represents non-obese non-alcoholic fatty liver disease or if reference values need adjustment.
{"title":"Controlled Attenuation Parameter in Healthy Individuals Aged 8-70 Years.","authors":"Anders Batman Mjelle, Anesa Mulabecirovic, Edda Jonina Olafsdottir, Odd Helge Gilja, Roald Flesland Havre, Mette Vesterhus","doi":"10.1055/a-1461-4714","DOIUrl":"https://doi.org/10.1055/a-1461-4714","url":null,"abstract":"Abstract Purpose Controlled attenuation parameter (CAP) is a non-invasive method to assess the presence of liver steatosis. It has been evaluated in children and adults, mainly in either the obese or in subjects with suspected liver disease. Our aim was to describe CAP in healthy non-obese subjects without suspected liver steatosis and to suggest cutoff levels for steatosis. Materials and Methods We prospectively recruited 187 individuals aged 8–70 years. All underwent clinical examination, including height and weight measurement. Body mass index (BMI) was calculated and converted into z-scores. To exclude liver pathology, B-mode ultrasound and liver stiffness measurements were performed in all prior to CAP measurement. Blood was drawn for liver biochemistry in adults. Results CAP was associated with BMI z-score across all ages. CAP started to rise alongside BMI z-score already in subjects with a BMI below average. CAP values were higher in adults than in children (p<0.001), and higher in adult males than adult females (p=0.014). CAP did not correlate with age within the adult or pediatric cohorts. CAP was highly correlated with the fatty liver index. 18 and 23% of subjects showed CAP above the suggested cutoff value for children and adults, respectively. Conclusion CAP was correlated with BMI z-score, even in individuals with a below-average BMI . We found CAP above published cutoff values in a substantial proportion of presumably healthy, non-obese children and adults, warranting further research to clarify whether this represents non-obese non-alcoholic fatty liver disease or if reference values need adjustment.","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"7 1","pages":"E6-E13"},"PeriodicalIF":3.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-1461-4714","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38965219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-01Epub Date: 2021-05-28DOI: 10.1055/a-1474-8013
Giovanni Maconi, Trygve Hausken, Christoph F Dietrich, Nadia Pallotta, Ioan Sporea, Dieter Nurnberg, Klaus Dirks, Laura Romanini, Carla Serra, Barbara Braden, Zeno Sparchez, Odd Helge Gilja
Abdominal ultrasonography and intestinal ultrasonography are widely used as first diagnostic tools for investigating patients with abdominal symptoms, mainly for excluding organic diseases. However, gastrointestinal ultrasound (GIUS), as a real-time diagnostic imaging method, can also provide information on motility, flow, perfusion, peristalsis, and organ filling and emptying, with high temporal and spatial resolution. Thanks to its noninvasiveness and high repeatability, GIUS can investigate functional gastrointestinal processes and functional gastrointestinal diseases (FGID) by studying their behavior over time and their response to therapy and providing insight into their pathophysiologic mechanisms. The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) has established a Task Force Group consisting of GIUS experts, which developed clinical recommendations and guidelines on the role of GIUS in several acute and chronic gastrointestinal diseases. This review is dedicated to the role of GIUS in assisting the diagnosis of FGID and particularly in investigating patients with symptoms of functional disorders, such as dysphagia, reflux disorders, dyspepsia, abdominal pain, bloating, and altered bowel habits. The available scientific evidence of GIUS in detecting, assessing, and investigating FGID are reported here, while highlighting sonographic findings and its usefulness in a clinical setting, defining the actual and potential role of GIUS in the management of patients, and providing information regarding future applications and research.
{"title":"Gastrointestinal Ultrasound in Functional Disorders of the Gastrointestinal Tract - EFSUMB Consensus Statement.","authors":"Giovanni Maconi, Trygve Hausken, Christoph F Dietrich, Nadia Pallotta, Ioan Sporea, Dieter Nurnberg, Klaus Dirks, Laura Romanini, Carla Serra, Barbara Braden, Zeno Sparchez, Odd Helge Gilja","doi":"10.1055/a-1474-8013","DOIUrl":"https://doi.org/10.1055/a-1474-8013","url":null,"abstract":"<p><p>Abdominal ultrasonography and intestinal ultrasonography are widely used as first diagnostic tools for investigating patients with abdominal symptoms, mainly for excluding organic diseases. However, gastrointestinal ultrasound (GIUS), as a real-time diagnostic imaging method, can also provide information on motility, flow, perfusion, peristalsis, and organ filling and emptying, with high temporal and spatial resolution. Thanks to its noninvasiveness and high repeatability, GIUS can investigate functional gastrointestinal processes and functional gastrointestinal diseases (FGID) by studying their behavior over time and their response to therapy and providing insight into their pathophysiologic mechanisms. The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) has established a Task Force Group consisting of GIUS experts, which developed clinical recommendations and guidelines on the role of GIUS in several acute and chronic gastrointestinal diseases. This review is dedicated to the role of GIUS in assisting the diagnosis of FGID and particularly in investigating patients with symptoms of functional disorders, such as dysphagia, reflux disorders, dyspepsia, abdominal pain, bloating, and altered bowel habits. The available scientific evidence of GIUS in detecting, assessing, and investigating FGID are reported here, while highlighting sonographic findings and its usefulness in a clinical setting, defining the actual and potential role of GIUS in the management of patients, and providing information regarding future applications and research.</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"7 1","pages":"E14-E24"},"PeriodicalIF":3.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-1474-8013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39076888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01Epub Date: 2021-01-07DOI: 10.1055/a-1304-5731
Leo Nygaard, Søren Rafael Rafaelsen, Jan Lindebjerg, Malene Roland Vils Pedersen
Approximately 90–95 % of testicular cancers are divided into two main categories: seminomas and non-seminomas. Tumors often contain more than one type of tumor cell and are called mixed germ cell tumors. The main types of non-seminoma are embryonal carcinoma, yolk sac carcinoma, choriocarcinoma, and teratoma. Other types are stromal tumors, Leydig cell tumors and Sertoli cell tumors. Secondary testicular cancers are lymphoma, leukemia, and metastases. Sarcomatoid carcinoma tumors in the testicles are very rare. Other case reports have described rare types of testicular cancer, e. g. testicular fusocellular rhabdomyosarcoma, paratesticular liposarcoma, testicular carcinoid, testicular sarcoidosis, testicular clear cell carcinoma, testicular chloroma, cutaneous mucinous carcinoma, and sarcomatoid yolk sac. When treating testicular tumors, surgery is the primary treatment and adjuvant chemotherapy and radiotherapy may be required. Owing to the aggressive nature of sarcomatoid carcinomas and the high probability of distant metastasis, the prognosis may not be favorable. No other cases of this entity have been reported in the English literature. We hereby present a case of a 62-year-old male patient diagnosed with a testicular metastatic sarcomatoid carcinoma of unknown primary.
{"title":"Testicular Metastatic Sarcomatoid Carcinoma of Unknown Primary: A Case Report.","authors":"Leo Nygaard, Søren Rafael Rafaelsen, Jan Lindebjerg, Malene Roland Vils Pedersen","doi":"10.1055/a-1304-5731","DOIUrl":"https://doi.org/10.1055/a-1304-5731","url":null,"abstract":"Approximately 90–95 % of testicular cancers are divided into two main categories: seminomas and non-seminomas. Tumors often contain more than one type of tumor cell and are called mixed germ cell tumors. The main types of non-seminoma are embryonal carcinoma, yolk sac carcinoma, choriocarcinoma, and teratoma. Other types are stromal tumors, Leydig cell tumors and Sertoli cell tumors. Secondary testicular cancers are lymphoma, leukemia, and metastases. Sarcomatoid carcinoma tumors in the testicles are very rare. Other case reports have described rare types of testicular cancer, e. g. testicular fusocellular rhabdomyosarcoma, paratesticular liposarcoma, testicular carcinoid, testicular sarcoidosis, testicular clear cell carcinoma, testicular chloroma, cutaneous mucinous carcinoma, and sarcomatoid yolk sac. When treating testicular tumors, surgery is the primary treatment and adjuvant chemotherapy and radiotherapy may be required. Owing to the aggressive nature of sarcomatoid carcinomas and the high probability of distant metastasis, the prognosis may not be favorable. No other cases of this entity have been reported in the English literature. We hereby present a case of a 62-year-old male patient diagnosed with a testicular metastatic sarcomatoid carcinoma of unknown primary.","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"6 3","pages":"E62-E65"},"PeriodicalIF":3.2,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-1304-5731","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39149897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01Epub Date: 2021-01-05DOI: 10.1055/a-1340-1260
Victoria Taraldsen, Sunneva Tomasgard, Margrethe Thune Rudlang, Odd Helge Gilja, Mette Vesterhus, Anders Batman Mjelle
[This corrects the article DOI: 10.1055/a-1298-9642.].
[这更正了文章DOI: 10.1055/a-1298-9642.]。
{"title":"Correction: Point Shear Wave Elastography and the Effect of Physical Exercise, Alcohol Consumption, and Respiration in Healthy Adults.","authors":"Victoria Taraldsen, Sunneva Tomasgard, Margrethe Thune Rudlang, Odd Helge Gilja, Mette Vesterhus, Anders Batman Mjelle","doi":"10.1055/a-1340-1260","DOIUrl":"https://doi.org/10.1055/a-1340-1260","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/a-1298-9642.].</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"6 3","pages":"E66"},"PeriodicalIF":3.2,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-1340-1260","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38806649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01Epub Date: 2021-04-20DOI: 10.1055/a-1469-3613
Ehsan Safai Zadeh, Julia Kindermann, Christoph F Dietrich, Christian Görg, Tobias Bleyl, Amjad Alhyari, Corinna Trenker
[This corrects the article DOI: 10.1055/a-1371-9359.].
[这更正了文章DOI: 10.1055/a-1371-9359。]
{"title":"Correction: Clinical Awareness and Acceptance of Sonographically Diagnosed Epiploic Appendagitis (EA): A Retrospective Analysis of EA in a Single Tertiary Academic Referral Center.","authors":"Ehsan Safai Zadeh, Julia Kindermann, Christoph F Dietrich, Christian Görg, Tobias Bleyl, Amjad Alhyari, Corinna Trenker","doi":"10.1055/a-1469-3613","DOIUrl":"https://doi.org/10.1055/a-1469-3613","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/a-1371-9359.].</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"6 3","pages":"E94"},"PeriodicalIF":3.2,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-1469-3613","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38834425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01Epub Date: 2021-03-12DOI: 10.1055/a-1371-9359
Ehsan Safai Zadeh, Julia Kindermann, Christoph F Dietrich, Christian Görg, Tobias Bleyl, Amjad Alhyari, Corinna Trenker
Purpose To describe the clinical awareness and acceptance of ultrasound-diagnosed acute epiploic appendagitis (EA) and their importance to avoid unnecessary therapeutic and imaging measures. Patients and Methods The data were obtained of n=54 patients with acute, localized, peritonitic pain and EA diagnosed by B-mode ultrasound and contrast-enhanced ultrasound examination from November 2003 to September 2020. All examinations were performed by a German Society for Ultrasound in Medicine (DEGUM) Level III qualified examiner. Based on documentation by the treating physicians, the clinical awareness and acceptance of EA diagnosis was determined in all patients and compared between subgroups diagnosed before 2013 and from 2013 onwards. In 2013, a local educational training program regarding the diagnosis of and therapy for EA was initiated for physicians. Results In all patients, EA was sonographically diagnosed by a DEGUM level III qualified examiner. At enrollment, EA was mentioned as a suspected clinical diagnosis in n=1/54 (1.9%) patient. Furthermore, in n=39/54 (72.2%) cases, the EA was documented and accepted by the treating physicians at the time of patient discharge as the final clinical diagnosis. The clinical acceptance was significantly higher from 2013 onwards compared with before 2013 (p<0.05). Moreover, in n=26/54 (48.1%) patients, unnecessary therapeutic measures were initiated, with no significant difference between pre-2013 and post-2013 numbers (p>0.05). Conclusion In our retrospective study, we showed that awareness and acceptance of the disease EA are low. Low diagnostic acceptance of EA by the clinician leads to unnecessary therapeutic and imaging measures and is a general problem related to rare diseases in the healthcare system.
{"title":"Clinical Awareness and Acceptance of Sonographically Diagnosed Epiploic Appendagitis (EA): A Retrospective Analysis of EA in a Single Tertiary Academic Referral Center.","authors":"Ehsan Safai Zadeh, Julia Kindermann, Christoph F Dietrich, Christian Görg, Tobias Bleyl, Amjad Alhyari, Corinna Trenker","doi":"10.1055/a-1371-9359","DOIUrl":"https://doi.org/10.1055/a-1371-9359","url":null,"abstract":"<p><p><b>Purpose</b> To describe the clinical awareness and acceptance of ultrasound-diagnosed acute epiploic appendagitis (EA) and their importance to avoid unnecessary therapeutic and imaging measures. <b>Patients and Methods</b> The data were obtained of n=54 patients with acute, localized, peritonitic pain and EA diagnosed by B-mode ultrasound and contrast-enhanced ultrasound examination from November 2003 to September 2020. All examinations were performed by a German Society for Ultrasound in Medicine (DEGUM) Level III qualified examiner. Based on documentation by the treating physicians, the clinical awareness and acceptance of EA diagnosis was determined in all patients and compared between subgroups diagnosed before 2013 and from 2013 onwards. In 2013, a local educational training program regarding the diagnosis of and therapy for EA was initiated for physicians. <b>Results</b> In all patients, EA was sonographically diagnosed by a DEGUM level III qualified examiner. At enrollment, EA was mentioned as a suspected clinical diagnosis in n=1/54 (1.9%) patient. Furthermore, in n=39/54 (72.2%) cases, the EA was documented and accepted by the treating physicians at the time of patient discharge as the final clinical diagnosis. The clinical acceptance was significantly higher from 2013 onwards compared with before 2013 (p<0.05). Moreover, in n=26/54 (48.1%) patients, unnecessary therapeutic measures were initiated, with no significant difference between pre-2013 and post-2013 numbers (p>0.05). <b>Conclusion</b> In our retrospective study, we showed that awareness and acceptance of the disease EA are low. Low diagnostic acceptance of EA by the clinician leads to unnecessary therapeutic and imaging measures and is a general problem related to rare diseases in the healthcare system.</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"6 3","pages":"E87-E93"},"PeriodicalIF":3.2,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-1371-9359","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25495723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Conventional ultrasound imaging (US) is the first-line investigation in acute non-traumatic abdominal emergencies, but sometimes it needs further examinations, such as computed tomography (CT), to reach a certain diagnosis. Contrast-enhanced ultrasound (CEUS), through injection of contrast medium, may provide the radiologist with additional information that could not be investigated with baseline US. It could help reach a diagnosis and rapidly determine the proper therapy in an emergency setting. The purpose of this review is to explain and illustrate the various possibilities and limitations of CEUS in acute non-traumatic abdominal diseases, in particular acute inflammation, parenchymal infarcts, and hemorrhages.
{"title":"Contrast-Enhanced Ultrasound (CEUS) in Non-Traumatic Abdominal Emergencies.","authors":"Diletta Cozzi, Simone Agostini, Elena Bertelli, Michele Galluzzo, Emanuela Papa, Germano Scevola, Margherita Trinci, Vittorio Miele","doi":"10.1055/a-1347-5875","DOIUrl":"https://doi.org/10.1055/a-1347-5875","url":null,"abstract":"<p><p>Conventional ultrasound imaging (US) is the first-line investigation in acute non-traumatic abdominal emergencies, but sometimes it needs further examinations, such as computed tomography (CT), to reach a certain diagnosis. Contrast-enhanced ultrasound (CEUS), through injection of contrast medium, may provide the radiologist with additional information that could not be investigated with baseline US. It could help reach a diagnosis and rapidly determine the proper therapy in an emergency setting. The purpose of this review is to explain and illustrate the various possibilities and limitations of CEUS in acute non-traumatic abdominal diseases, in particular acute inflammation, parenchymal infarcts, and hemorrhages.</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"6 3","pages":"E76-E86"},"PeriodicalIF":3.2,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-1347-5875","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25495722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01Epub Date: 2021-01-19DOI: 10.1055/a-1323-4906
Clara Benedetta Conti, Fabrizio Cereatti, Andrea Drago, Roberto Grassia
Autoimmune pancreatitis is a chronic fibroinflammatory autoimmune mediated disease of the pancreas. Clinically, obstructive painless jaundice and upper abdominal pain are the main symptoms. Focal AIP is characterized by segmental involvement of pancreatic parenchyma and it is often radiologically represented by a pancreatic mass. In these cases, the diagnosis can be very challenging, since it may be easily confused with pancreatic cancer. Therefore, we suggest a combined approach of imaging tests as the diagnostic workup. EUS study combined with CEUS and elastography, if available, increases the accuracy of the method to rule out cancer. Moreover, the lesion should always be sampled under EUS guidance to obtain a cyto/histological diagnosis. The diagnostic workup should also include the use of diagnostic clinical criteria (extrapancreatic lesions, steroid response) and laboratory findings (CA 19.9 and IgG4 evaluations).
{"title":"Focal Autoimmune Pancreatitis: A Simple Flow Chart for a Challenging Diagnosis.","authors":"Clara Benedetta Conti, Fabrizio Cereatti, Andrea Drago, Roberto Grassia","doi":"10.1055/a-1323-4906","DOIUrl":"https://doi.org/10.1055/a-1323-4906","url":null,"abstract":"<p><p>Autoimmune pancreatitis is a chronic fibroinflammatory autoimmune mediated disease of the pancreas. Clinically, obstructive painless jaundice and upper abdominal pain are the main symptoms. Focal AIP is characterized by segmental involvement of pancreatic parenchyma and it is often radiologically represented by a pancreatic mass. In these cases, the diagnosis can be very challenging, since it may be easily confused with pancreatic cancer. Therefore, we suggest a combined approach of imaging tests as the diagnostic workup. EUS study combined with CEUS and elastography, if available, increases the accuracy of the method to rule out cancer. Moreover, the lesion should always be sampled under EUS guidance to obtain a cyto/histological diagnosis. The diagnostic workup should also include the use of diagnostic clinical criteria (extrapancreatic lesions, steroid response) and laboratory findings (CA 19.9 and IgG4 evaluations).</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"6 3","pages":"E67-E75"},"PeriodicalIF":3.2,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-1323-4906","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38855751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}