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Diagnostic Accuracy of Transabdominal Ultrasound and Computed Tomography in Chronic Pancreatitis: A Head-to-Head Comparison. 经腹超声和计算机断层扫描诊断慢性胰腺炎的准确性:头部与头部的比较。
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2021-04-01 Epub Date: 2021-08-24 DOI: 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。
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引用次数: 0
Evaluation of Cystic and Solid Renal Lesions with Contrast-Enhanced Ultrasound: A Retrospective Study. 用对比增强超声评估囊性和实性肾病变:回顾性研究
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2021-04-01 Epub Date: 2021-07-27 DOI: 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).

目的 肾脏病变是 CT、核磁共振成像和传统超声检查中经常出现的随机检查结果。由于这些病变通常是偶然发现的,因此相应的检查并不能提供最佳的确诊结果,因此有必要进行额外的多相对比增强检查。本研究的目的是将 CEUS 检查结果与最终诊断结果相关联,并确定 CEUS 是否是确定未确定肾脏病变特征的合适方法。材料和方法 回顾性研究了我院在 2007 年至 2014 年期间对局灶性肾脏病变进行的所有 CEUS 检查。共纳入 437 名患者,491 个病灶,543 次检查。54例患者为双侧病变。一名患者在一个肾脏中有三个病灶。49例患者进行了组织学检查,124例患者进行了随访。计算了敏感性、特异性、阳性和阴性预测值以及阳性和阴性似然比。结果 恶性病变 54 例,良性病变 437 例。总体敏感性和特异性分别为 0.981/0.954,囊性病变为 1.000/0.956,实性病变为 0.977/0.906,组织学确诊病变为 0.971/0.071。在 301 个病灶中,289 个病灶(96%)的 Bosniak 分类是一致的。只有 12 个病灶(3.9%)被误判为恶性。结论 CEUS 是明确未确定肾脏病变的合适方法。根据 Bosniak 分型可对囊性病变进行充分定性,尤其是对潜在的恶性病变(III 型和 IV 型)。
{"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}
引用次数: 0
Controlled Attenuation Parameter in Healthy Individuals Aged 8-70 Years. 8-70岁健康人群的控制衰减参数
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2021-04-01 Epub Date: 2021-05-04 DOI: 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,&nbsp;Anesa Mulabecirovic,&nbsp;Edda Jonina Olafsdottir,&nbsp;Odd Helge Gilja,&nbsp;Roald Flesland Havre,&nbsp;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}
引用次数: 1
Gastrointestinal Ultrasound in Functional Disorders of the Gastrointestinal Tract - EFSUMB Consensus Statement. 胃肠道超声在胃肠道功能性疾病中的应用——EFSUMB共识声明。
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2021-04-01 Epub Date: 2021-05-28 DOI: 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.

腹部超声和肠道超声被广泛用作调查腹部症状患者的首选诊断工具,主要用于排除器质性疾病。而胃肠道超声(GIUS)作为一种实时诊断成像方法,还可以提供运动、血流、灌注、蠕动、器官充盈和排空等信息,具有较高的时空分辨率。由于其无创性和高重复性,GIUS可以通过研究其随时间的行为和对治疗的反应来研究功能性胃肠过程和功能性胃肠疾病(FGID),并深入了解其病理生理机制。欧洲超声医学和生物学学会联合会(EFSUMB)建立了一个由超声造影专家组成的工作组,该工作组就超声造影在几种急性和慢性胃肠疾病中的作用提出了临床建议和指南。本综述致力于GIUS在辅助FGID诊断中的作用,特别是在调查有功能障碍症状的患者中,如吞咽困难、反流障碍、消化不良、腹痛、腹胀和排便习惯改变。本文报告了GIUS在检测、评估和调查FGID方面的现有科学证据,同时强调了超声检查结果及其在临床环境中的有用性,定义了GIUS在患者管理中的实际和潜在作用,并提供了有关未来应用和研究的信息。
{"title":"Gastrointestinal Ultrasound in Functional Disorders of the Gastrointestinal Tract - EFSUMB Consensus Statement.","authors":"Giovanni Maconi,&nbsp;Trygve Hausken,&nbsp;Christoph F Dietrich,&nbsp;Nadia Pallotta,&nbsp;Ioan Sporea,&nbsp;Dieter Nurnberg,&nbsp;Klaus Dirks,&nbsp;Laura Romanini,&nbsp;Carla Serra,&nbsp;Barbara Braden,&nbsp;Zeno Sparchez,&nbsp;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}
引用次数: 7
Testicular Metastatic Sarcomatoid Carcinoma of Unknown Primary: A Case Report. 原发不明的睾丸转移性肉瘤样癌1例报告。
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2020-12-01 Epub Date: 2021-01-07 DOI: 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,&nbsp;Søren Rafael Rafaelsen,&nbsp;Jan Lindebjerg,&nbsp;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}
引用次数: 0
Correction: Point Shear Wave Elastography and the Effect of Physical Exercise, Alcohol Consumption, and Respiration in Healthy Adults. 校正:健康成人的点横波弹性成像和体育锻炼、饮酒和呼吸的影响。
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2020-12-01 Epub Date: 2021-01-05 DOI: 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.]。
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引用次数: 0
Correction: Clinical Awareness and Acceptance of Sonographically Diagnosed Epiploic Appendagitis (EA): A Retrospective Analysis of EA in a Single Tertiary Academic Referral Center. 更正:临床意识和接受超声诊断的网膜阑尾炎(EA):回顾性分析EA在单一三级学术转诊中心。
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2020-12-01 Epub Date: 2021-04-20 DOI: 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。]
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引用次数: 0
Clinical Awareness and Acceptance of Sonographically Diagnosed Epiploic Appendagitis (EA): A Retrospective Analysis of EA in a Single Tertiary Academic Referral Center. 超声诊断网膜阑尾炎(EA)的临床意识和接受程度:回顾性分析单一三级学术转诊中心的EA。
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2020-12-01 Epub Date: 2021-03-12 DOI: 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.

目的探讨超声诊断急性网膜阑尾炎(EA)的临床认知度和接受程度,以及超声对避免不必要的治疗和影像学措施的重要性。患者与方法收集2003年11月~ 2020年9月经b超及增强超声检查诊断为急性、局限性、腹膜炎及EA的患者54例。所有检查均由德国超声医学学会(DEGUM)三级合格检查员进行。根据主治医生的文献资料,确定所有患者对EA诊断的临床认知度和接受度,并比较2013年以前和2013年以后诊断的亚组。2013年,启动了针对当地医师的EA诊断与治疗教育培训项目。结果所有患者的EA均由DEGUM III级合格检查员超声诊断。在入组时,有1/54(1.9%)的患者被认为是疑似临床诊断。此外,在n=39/54(72.2%)病例中,在患者出院时,治疗医生记录并接受EA作为最终临床诊断。2013年以后临床接受度明显高于2013年前(p0.05)。结论在我们的回顾性研究中,我们发现对EA疾病的认知度和接受度较低。临床医生对EA的诊断接受度低,导致不必要的治疗和影像学措施,是医疗保健系统中与罕见病相关的普遍问题。
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引用次数: 2
Contrast-Enhanced Ultrasound (CEUS) in Non-Traumatic Abdominal Emergencies. 对比增强超声(CEUS)在非创伤性腹部急诊中的应用。
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2020-12-01 Epub Date: 2021-03-12 DOI: 10.1055/a-1347-5875
Diletta Cozzi, Simone Agostini, Elena Bertelli, Michele Galluzzo, Emanuela Papa, Germano Scevola, Margherita Trinci, Vittorio Miele

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.

常规超声成像(US)是急性非创伤性腹部急诊的一线检查,但有时需要进一步检查,如计算机断层扫描(CT),以达到一定的诊断。对比增强超声(CEUS)通过注射造影剂,可以为放射科医生提供基线超声无法调查的额外信息。它可以帮助在紧急情况下做出诊断并迅速确定适当的治疗方法。这篇综述的目的是解释和说明超声造影在急性非创伤性腹部疾病中的各种可能性和局限性,特别是急性炎症、实质梗死和出血。
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引用次数: 5
Focal Autoimmune Pancreatitis: A Simple Flow Chart for a Challenging Diagnosis. 局灶性自身免疫性胰腺炎:具有挑战性诊断的简单流程图
IF 3.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2020-12-01 Epub Date: 2021-01-19 DOI: 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).

自身免疫性胰腺炎是一种慢性纤维炎症性自身免疫性胰腺疾病。临床上以梗阻性无痛性黄疸和上腹部疼痛为主要症状。局灶性AIP的特征是胰腺实质的节段性受累,影像学上常表现为胰腺肿块。在这些病例中,诊断非常具有挑战性,因为它很容易与胰腺癌混淆。因此,我们建议结合影像学检查作为诊断检查。超声造影联合超声造影和弹性成像,如果可以的话,增加了排除癌症方法的准确性。此外,病变应始终在EUS指导下取样,以获得细胞/组织学诊断。诊断检查还应包括使用诊断临床标准(胰腺外病变,类固醇反应)和实验室结果(CA 19.9和IgG4评估)。
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引用次数: 3
期刊
Ultrasound International Open
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