Ultrasound Quarterly最新文献

Abstract: In this study, it was aimed to contribute to the selection of the method to perform pancreatic lesion biopsies.Data of patients, who had undergone a percutaneous biopsy because of pancreatic masses in our institution in the period between January 2015 and November 2019, were evaluated retrospectively. The percutaneous biopsy method, the type of needle used in the procedure, and periprocedural complications were listed. Pathology and cytology reports in the archive were reviewed, and biopsy results were divided into 3 groups as benign, malignant, and inadequate. Of 308 patients included in the study, the diagnostic accuracy was verified in 124 patients through the assessment of surgical outcomes, results of biopsies from metastatic lesions, or follow-up findings. The verified results were classified as true-positives and true-negatives.Of a total of 308 patients included in the study, 23 underwent a fine-needle aspiration biopsy (FNAB) and 285 underwent a core needle biopsy (CNB). No statistical differences were observed in sample acquisition success and complications between the groups.Of the lesions with a confirmed pathological diagnosis, 67.74% were malignant and 32.26% were benign. The diagnosis was correct in 107 of 112 CNB patients (95.54%) and 9 of 12 FNAB patients (75.00%). When the success of the 2 methods was compared, it was found that outcomes of CNB were statistically more successful compared with those of FNAB.A transabdominal ultrasound-guided percutaneous CNB is a safe method with a high diagnostic yield to perform a biopsy of the pancreas.

Abstract: This study investigated the correlation between magnetic resonance elastography (MRE) and shear wave ultrasound elastography (SWE) in patients with clinically diagnosed or suspected nonalcoholic fatty liver disease (NAFLD). Subjects with or at risk of NAFLD identified by magnetic resonance imaging (MRI) proton density fat fraction (PDFF) were prospectively enrolled. For each patient, 6 valid 2-dimensional SWE measurements were acquired using a Logiq E10 scanner (GE HealthCare, Waukesha, WI). A reliability criterion of an interquartile range to median ratio of ≤15% was used for SWE to indicate quality dataset. Magnetic resonance elastography, and MR-fat quantification data were collected the same day as part of the patient's clinical standard of care. Magnetic resonance imaging PDFF was used as a reference to quantify fat with >6.4% indicating NAFLD. Pearson correlation and t-test were performed for statistical analyses. A total of 140 patients were enrolled, 112 of which met SWE reliability measurement criteria. Magnetic resonance elastography and 2-dimensional SWE showed a positive correlation across all study subjects ( r = 0.27; P = 0.004). When patients were grouped according to steatosis and fibrosis state, a positive correlation was observed between MRE and SWE in patients with fibrosis ( r = 0.30; P = 0.03), without fibrosis ( r = 0.27; P = 0.03), and with NAFLD ( r = 0.28; P = 0.02). No elastography technique correlated with liver fat quantification ( P > 0.52). Magnetic resonance elastography was significantly different between patients with and without fibrosis ( P < 0.0001). However, this difference was not apparent with SWE ( P = 0.09). In patients with suspected or known NAFLD, MRE, and SWE demonstrated a positive correlation. In addition, these noninvasive imaging modalities may be useful adjunct techniques for monitoring NAFLD.

Abstract: In this study, we aimed to investigate the correlation of stiffness values of shear-wave elastography (SWE) and histopathological prognostic factors in patients with breast cancer. Between January 2021 and June 2022, SWE images of 138 core-biopsy proven breast cancer lesions from 132 patients were retrospectively reviewed. Histopathogic prognostic factors, including tumor size, histologic grade, histologic type, hormone receptor positivity, human epidermal growth factor receptor (HER2) status, immunohistochemical subtype and Ki-67 index were documented. Elasticity values including mean and maximum elasticity ( Emean and Emax ) and lesion-to-fat ratio ( Eratio ) were recorded. The association between histopathological prognostic factors and elasticity values were assessed using Mann-Whitney U and Kruskal-Wallis test, and multiple linear regression analysis. Tumor size, histological grade, and Ki-67 index were significantly associated with the Eratio ( P < 0.05). Larger tumor size and higher Ki-67 index also showed significantly higher Emean and Emax values ( P < 0.05). However, hormone receptor positivity, HER2 status, and immunohistochemical subtype were not significantly associated with elasticity values ( P > 0.05). Multivariate logistic regression analysis revealed that tumor size was significantly associated with Emean , Emax , and Eratio values ( P < 0.05). A high Ki-67 index was also significantly associated with high Eratio values. Larger tumor size and higher Ki-67 index are independently associated with high Eratio values. Preoperative SWE may improve the performance of conventional ultrasound in predicting prognosis and treatment planning.

Abstract: The present study brings a pictorial review aimed to discuss the multifactorial interpretation of extracranial carotid atheromatous disease, contemplating not only the degree of stenosis but also the arterial flow patterns, the intima-media thickness and the morphological characteristics of the atheromatous plaque. We merged the recommendations contained in the different reference literature on the topic to give a comprehensive approach to ultrasound criteria for diagnostic carotid examination. We infer that the carotid ultrasound evaluation must include important predictors of cardiovascular risk, which should be written in the ultrasound reports, thus allowing the adequate clinical approach to the disease.

Abstract: Ultrasound-guided thermal ablation has been shown to considerably reduce nodule-related discomfort and cosmetic problems. Hence, this review was done to determine the effectiveness of ultrasound-guided radiofrequency or microwave ablation in the management of benign thyroid nodules. Searches were done in EMBASE, SCOPUS, PubMed Central, Cochrane library, MEDLINE, Google Scholar, ScienceDirect, and Clinicaltrials.gov until August 2022. Meta-analysis was carried out using random-effects model. With 95% confidence intervals (CIs), pooled standardized mean differences, mean differences, and/or odds ratio reported. In total, we analyzed 16 studies, most of them had high risk of bias. The pooled standardized mean difference for symptom score was -1.01 (95% CI, -1.83 to -0.19; I2 = 94.2%), for cosmetic relief was -1.26 (95% CI, -2.27 to -0.24; I2 = 96%), for postoperative nodule volume was -1.77 (95% CI, -3.06 to -0.48; I2 = 94%), for hospital stay was -3.88 (95% CI, -4.58 to -3.18; I2 = 91.1%), for operation time was -3.30 (95% CI, -3.95 to -2.64; I2 = 93.4%). The pooled odds ratio for postoperative pain was 0.04 (95% CI, 0.00-0.35; I2 = 95.1%), for postoperative hypothyroidism was 0.04 (95% CI, 0.01-0.11; I2 = 0%), for postoperative hoarseness was 0.56 (95% CI, 0.22-1.47; I2 = 0%), for postoperative hematoma was 0.57 (95% CI, 0.15-2.22; I2 = 0%). Ultrasound-guided radiofrequency and microwave ablation had better efficacy and safety profile in terms of symptoms, cosmetic relief, complication rate, duration of stay, and operation time when compared with conventional surgery or observation without treatment for patients with benign thyroid nodules.

Abstract: Chronic venous insufficiency is a common condition caused by valvular incompetence and/or obstruction of the lower extremity venous system. Chronic venous insufficiency presents in a wide range of clinical presentations, ranging from mild pain or edema to the development of varicose veins and nonhealing venous ulcers. Doppler ultrasound is the preferred imaging modality in the assessment of this condition and provides both anatomical and functional information in a noninvasive, cost-effective, and radiation-free manner. Knowledge of the anatomy and nomenclature, pathophysiology, equipment requisites, scanning protocols, relevant findings, and reporting nuances is essential to the creation of an accurate and clinically actionable report. Evaluation of the superficial and deep venous system for degree and extent of reflux is necessary to establish the diagnosis and to institute appropriate treatment.

Abstract: In this prospective study, the diagnostic performance of MicroV Doppler ultrasonography (US) and Q-pack application in distinguishing malignant thyroid nodules from benign nodules will be examined. Given the emerging irregular vascular structures in malignant nodules, it is thought that MicroV Doppler US and Q-pack application can help in diagnosis. One hundred sixteen nodules that were suggested a biopsy by a clinician were examined with B-mode US, color, X-flow, and MicroV Doppler US, respectively. In addition, during MicroV Doppler US examination, thyroid nodule and its adjacent thyroid parenchyma were evaluated with Q-pack application. After US examinations, biopsy was performed on the nodules and histopathological results were obtained. Eighty-nine nodules were histopathologically proven as benign, and the rest of them were malignant. In Doppler types, the thyroid findings in score 1, 2, and 3 nodule blood supply type were benign, whereas the thyroid findings in the score 4 have a possibility of malignancy between 63% and 66.7%. It was found that MicroV Doppler was significantly superior to X-flow and color Doppler ( P = 0.037 and P = 0.042, respectively). Nodule/parenchyma Q-pack mean values were statistically significantly higher in malignant findings compared with benign findings ( P < 0.001). Nodule/parenchyma Q-pack peak values were also statistically significantly higher in malignant findings compared with benign findings ( P < 0.001).As a result, although Q-pack application enables us to obtain quantitative values about vascularity, due to its ability to demonstrate slow blood flow, microvascular vessel structure, and distribution, MicroV Doppler US has promises to detect malignant thyroid nodules.

Abstract: This study was designed to investigate the clinical and sonographic features of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTPs) as compared with classical papillary thyroid carcinoma (cPTC), follicular adenoma (FA), and follicular thyroid carcinoma (FTC). A total of 178 patients were enrolled in this study. The clinical characteristics and sonographic features of thyroid nodules were compared between NIFTP and cPTC or FA/FTC. All nodules were reclassified according to the Thyroid Ultrasound Imaging Reporting and Data System and American Thyroid Association guidelines classification. The mean size of NIFTP was 29.91 ± 14.71 mm, which was larger than that of cPTC ( P = 0.000). Significant difference was found in lymph node metastases between NIFTP and cPTC ( P = 0.000). Most NIFTPs showed solid composition, hypoechoic echogenicity, smooth margin, wider than tall shape, none echogenic foci, absence of halo, and perinodular vascularity, which were similar with FA and FTC. Compared with NIFTP, hypoechoic and very hypoechoic, taller than wide, irregular margin, punctate echogenic foci, absence of halo, and low vascularity were more commonly observed in cPTC. There were statistical differences both in American College of Radiology Thyroid Ultrasound Imaging Reporting and Data System and in American Thyroid Association classification between NIFTP and cPTC ( P < 0.05), but there were no significant differences between NIFTP and FTC/FA ( P > 0.05). The ultrasonographic characteristics of NIFTP were obviously different from cPTC but overlapped with FTC and FA. Ultrasound could help increase preoperative attention of NIFTP in an appropriate clinical setting, which may lead to a more conservative treatment approach.

Abstract: To establish and validate a nomogram for predicting lymph node metastasis (LNM) of papillary thyroid carcinoma (PTC) in the cervical central region. This retrospective study included 287 PTC patients with 309 nodules treated from December 2018 to May 2020 at our hospital. The cohort was divided randomly into a training set and a testing set according to a 7:3 ratio. The training set contained 216 nodules, and the testing set contained 93 nodules. The nomogram was developed using the training set, and the data of the testing set were used to validate the performance of nomogram. The predictive accuracy and discriminative ability of the nomogram were determined by concordance index (C-index) and calibration curve. The study showed multifocality, thyroid lesion size, and American College of Radiology Thyroid Imaging, Reporting and Data System (TI-RADS) score were significantly independently associated with LNM in the cervical central region. In the testing set, the calibration curve showed that the nomogram had good discrimination with a C-index of 0.775 (95% confidence interval, 0.680-0.869) and adequate calibration ( P = 0.808). By decision curve analysis and clinical impact curve analysis, the nomogram was shown to have a satisfactory net benefit between thresholds of 0.40 and 0.75. The nomogram can be used for predicting LNM of PTC in the cervical central region and may provide valuable guidance for planning the surgical treatment of PTC patients.

Abstract: The aim of this research was to investigate the clinical and ultrasonographic features of papillary thyroid carcinoma (PTC) in the isthmus. A total of 823 patients with 823 PTCs including 133 in the isthmus and 690 in the lateral lobe were included in our study. All patients were confirmed by postoperative pathology. The clinical and ultrasonographic characteristics were retrospectively analyzed and compared. Univariate analysis and multivariate logistic regression analysis were performed. Multifactor analyses showed that PTC in the isthmus was significantly different from PTC originating from the lateral lobe in aspect ratio, microcalcification, extrathyroid extension, lymph node metastases, and lymph node density ( P < 0.05, for all). There were no significant differences in age, sex, tumor size, margin, halo, echogenicity, and homogeneity ( P > 0.05, for all). The results indicated that the sonographic appearances of PTC in the isthmus were relatively atypical; however, it had a higher incidence of extrathyroidal extension, central lymph node metastasis, and a tendency of higher lymph node density. Therefore, more careful ultrasound evaluation should be performed for these nodules.