RESUMEN
PURPOSE: To evaluate strain elastography as a complementary tool for characterization of lesions identified during second-look MRI-directed sonographic examination. METHODS: We reviewed 83 breast lesions evaluated with MRI, secondlook ultrasound (US) and strain elastography in 75 consecutive patients (median age, 56 years). US-guided biopsies were performed in all cases. RESULTS: After histopathological examination, 44 lesions were benign, 38 were malignant and 1 was high-risk. At MRI, the mean size of the lesions was 12 mm. Forty lesions (48.2%) appeared as masses, 30 (36.1%) as "non-masses" and 13 (15.7%) as "foci." At second-look US examination, 56 (67.5%) appeared as masses (mean size, 7 mm) and 27 (32.5%) as non-masses (mean size, 14 mm). At strain elastography, among the 39 malignant/high risk lesions, 5 (12.8%) had a score of 4 or 5, whereas 16 (41%) had a score of 1 and 2 (false negative). Among the 44 benign lesions, 36 (82%) had a score of 1 or 2, whereas none had a score of 5. Sensitivity and specificity of strain elastography in the diagnosis of breast cancer were 58% and 81%, respectively. CONCLUSION: The addition of strain elastography offers no benefit in the characterization of lesions identified on second-look US after breast MRI.(E1, 3).
Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Diagnóstico por Imagen de Elasticidad/métodos , Imagen por Resonancia Magnética/métodos , Ultrasonografía Mamaria/métodos , Adulto , Anciano , Mama/diagnóstico por imagen , Mama/patología , Neoplasias de la Mama/patología , Diagnóstico Diferencial , Femenino , Humanos , Biopsia Guiada por Imagen , Persona de Mediana Edad , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
Background: Given the increasing rate of infections following hip arthroplasty, one of the current options is the application of a biocomposite at the site of the infection. One of the products used is Stimulan, a completely resorbable calcium sulfate, designed to treat acute and chronic infections. This biocomposite has a controlled purity, is easy to mix with liquid, powder, and antibiotics, and can be applied directly to the site of infection, or it can be injected. Methods: We analyzed data from 76 patients, who were admitted to the County Clinical Hospital of Emergency "St. Apostol Andrei" in Galati during January 2017-September 2023, with a diagnosis of infection associated with hip arthroplasty. Results: In 69.73% of cases (52 patients), we decided to keep the implant in place. In this subgroup, Stimulan was applied in 26 cases (57.78%). Of these, 100% were cured-compared to the subgroup in which Stimulan was not applied, where this percentage was lower. All patients underwent chemical and mechanical toileting, and for 24 patients (20.27%), it was necessary to ablate the implant with or without the application of Stimulan, then reimplantation of the prosthesis. Conclusions: The patients with Stimulan had a longer average length of hospitalization, almost half of them required intervention in two periods, and a quarter required the implantation of spacers. However, the cure rate was higher, only in three people could we not control the infection, and there was no death. This study confirms the effectiveness of the treatment when using a biocomposite in addition to the classical treatment for both acute and chronic cases.