Ultrasound Quarterly最新文献

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.

Background: Thyroid ultrasonography is the first and perhaps most fundamental step for the radiological distinction of benign and malignant nodules. In this study, 2 radiologists reviewed the sonoelastographic and Doppler images of thyroid nodules and evaluated for the intraobserver and interobserver reliability.

Purpose: We aimed to determine confusing nodule identifiers and sonographic features differently defined by observers.

Methods: A total of 157 nodules in 91 patients (male/female, 72:19) with ages ranging from 18 to 72 years old were included in the study. Ultrasonographic images and video clips of the nodules were obtained and presented to 2 reviewers unaware of the cytopathology results. Two observers defined the characteristics of the nodules based on previously determined criteria. Then, intraobserver and interobserver correlation coefficients were calculated for each subcategory.

Results: In the grayscale ultrasonographic examination, varying degrees from low to high interobserver correlation coefficients were obtained for different subcategories (between κ = 0.359 and κ = 0.821). In color Doppler examination, we obtained medium correlation coefficients ( κ = 0.493 and κ = 0.553). On the other hand, there was a high correlation coefficient in tissue compression elastography ( κ = 0.617 and κ = 0.638).According to our study results, elastographic pattern, shape of the nodule, presence of echogenic foci, and pathological lymph nodes are better predictors to determine the malignant potential of thyroid nodule with higher interobserver correlation. Therefore, these criteria may be used primarily for the evaluation of thyroid nodules. The intraobserver correlation coefficient was higher in the practitioner with longer experience, suggesting the importance of professional practice period on the decision-making process.

Abstract: This study aims to evaluate the accuracy of the semiautomatic planimetric measurement (SAPM) method and the necessity of manually adjusted boundary measurement in 3-dimensional ultrasound measurement of plaque volume. A total of 50 patients with 82 plaques in the common carotid arteries between December 2020 and March 2021 were included in this study. Two observers measured the 3-dimensional volume of plaque for each patient in 3 different methods (contour tracing method [CTM], SAPM method without manually adjusted boundary [SAPM1], and SAPM method with manually adjusted boundary [SAPM2]). The difference in measurement time between the 3 methods was evaluated by Kruskal-Wallis H test. Intraclass correlation coefficient and 95% confidence interval were used to evaluate the intraobserver and interobserver reliability of the 3 measurement modes. The Bland-Altman analysis was used to assess the agreement, which was expressed as the mean difference with the 95% limits of agreement (LOA). The difference in measurement time between the 3 methods was statistically significant ( P < 0.001). Both observers' intraobserver and interobserver reliability showed well in the 3 methods (all of the intraclass correlation coefficients were >0.75). The mean differences of the plaque volume measurement were 38.17, 26.42, and 11.75 mm 3 , respectively. The agreement between CTM and SAPM2 was the best, and LOA was -57.00 to 80.51. The agreement between SAPM1 and SAPM2 and the agreement between SAPM1 and CTM were similar, and the LOAs were -126.10 to 202.40 and -158.00 to 210.80, respectively. The SAPM method may be recommended to measure plaque volume in clinical practice.