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1.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(11): 1321-1327, 2021 Nov 06.
Artigo em Zh | MEDLINE | ID: mdl-34749476

RESUMO

Objective: To investigate the epidemiological characteristics of human coronavirus (HCoV) in hospitalized children with respiratory tract infection in Hebei region, providing evidence for the diagnosis and prevention of children with respiratory tract infection. Methods: A retrospective study was conducted on 1 062 HCoV positive children hospitalized for respiratory tract infection in Children's Hospital of Hebei Province from January 2015 to December 2020, aged from 33 days to 14 years, with a median age of 2 years. 27 932 (60.9%) were males and 17 944(39.1%) were females. And the gender, ages, seasonal distribution, HCoV-positive rates, co-detection distribution and clinical diagnosis of HCoV positive cases were analyzed by SPSS 25.0. Enumeration data were expressed by frequency and percentage; categorical variable were compared by the Pearson χ2test. Results: The overall HCoV-positive rate was 2.31% (1 062/45 876), which was 2.37% (662/27 932) in male children and 2.23% (400/17 944) in female children. There was no statistically significant difference between genders (χ²=0.916, P=0.339). Children at age groups<1 years (2.44%) and 1-<3 years (2.63%) had higher HCoV-positive rates than those at age groups 3-<5 years (1.97%) and ≥5 years (1.38%) (χ²=27.332,P<0.01). The HCoV-positive rates from 2015 to 2018 were 2.13%, 2.45%, 2.28% and 2.23%. The HCoV-positive rate of 2019 (1.71%) was significantly lower than in 2016 (χ²=12.05, P<0.01), 2017 (χ²=7.34, P=0.01) and 2018 (χ²=6.78, P=0.01), but there was no significant difference compared with 2015 (χ²=2.84, P=0.09). The HCoV-positive rate of 2020 (3.37%) was significantly higher than in 2015 (χ²=13.636, P<0.01), 2016 (χ²=11.099, P<0.01), 2017 (χ²=15.482, P<0.01), 2018(χ²=18.601, P<0.01) and 2019(χ²=45.580, P<0.01). The positive rate was highest in spring (March to May) in 2015 and 2017 to 2018. February to April and July to September of 2016 were the peak periods of positive detection. No obvious seasonal change was observed in 2019 and the HCoV-positive rate of 2020 was extremely low from January to July, following significantly increased from August to December. 26.37% (280/1 062) of HCoV were co-detected with other respiratory pathogens and the most frequently identified mixed detection was RSV. Three or more pathogens were detected in 7.34% (78/1 062) of the HCoV-positive samples. Bronchopneumonia and bronchiolitis were more frequently observed in the single HCoV positive (61.89% and 16.75%) children compared to co-detected children(34.29% and 9.64%)(χ²=63.394 and 8.228, P<0.01). However, compared to those with HCoV mono-detection, co-detected children were more likely to have severe pneumonia (4.6% and 47.14%) (χ²=280.171, P<0.01). Conclusions: HCoV is one of the respiratory pathogens in children in Hebei region and more prevalent in spring. The susceptible population of HCoV is mainly children under the age of 3 years old. HCoV often co-detects with other respiratory pathogens, and the co-infection is one of the risk factors of severe pneumonia in children with respiratory infection.


Assuntos
Coinfecção , Infecções por Coronavirus , Coronavirus , Infecções Respiratórias , Criança , Criança Hospitalizada , Pré-Escolar , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Lactente , Masculino , Infecções Respiratórias/epidemiologia , Estudos Retrospectivos , Estações do Ano
2.
Zhonghua Gan Zang Bing Za Zhi ; 28(11): 936-941, 2020 Nov 20.
Artigo em Zh | MEDLINE | ID: mdl-33256279

RESUMO

Objective: To observe the correlation between the expressions profile of cytokeratin 19/glypican 3 (CK19/GPC3) and recurrence of hepatocellular carcinoma after interventional therapy. Methods: Clinical and pathological information of 251 eligible cases with hepatocellular carcinoma who underwent interventional therapy in You'an Hospital from November 2007 to May 2016 were retrospectively collected. Univariate and multivariate Cox regression analysis was used to analyze the relevant risk factors that may affect their prognosis. Kaplan-Meier survival analysis was used to draw the survival curve. Log-rank test was used to compare the difference in survival rates between the groups. Results: Kaplan-Meier univariate analysis showed that histological grade, CK19/GPC3 expression profile, alpha-fetoprotein level and Hep Parl were closely related to tumor recurrence. Multivariate Cox regression analysis showed CK19/GPC3 expression profile (HR = 1.634, 95%CI: 1.041 ~ 2.564, P = 0.033), histological grade (HR = 1.445, 95%CI: 1.037 ~ 2.014, P = 0.030), alpha-fetoprotein level (HR = 1.410, 95%CI: 1.042 ~ 1.908, P = 0.026), Hep Parl (HR = 0.570, 95%CI: 0.349 ~ 0.930, P = 0.025) were the four independent factors for prediction of recurrence after interventional therapy. Conclusion: Hepatocellular carcinoma patients with CK19(+)/GPC3(+) and CK19(-)/GPC3(+) phenotypes who meet the Milan criteria have a higher risk of recurrence after interventional therapy than CK19(-)/GPC3(-) phenotypes.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Biomarcadores Tumorais , Glipicanas , Humanos , Queratina-19 , Recidiva Local de Neoplasia , Estudos Retrospectivos
3.
Z Gastroenterol ; 54(5): 433-50, 2016 May.
Artigo em Alemão | MEDLINE | ID: mdl-27171335

RESUMO

Artifacts in ultrasonographic diagnostics are a result of the physical properties of the ultrasound waves and are caused by interaction of the ultrasound waves with biological structures and tissues and with foreign bodies. On the one hand, they may be distracting and may lead to misdiagnosis. On the other hand, they may be diagnostically helpful. Ultrasound imaging suffers from artifacts, because in reality, parameters assumed to be constant values, such as sound speed, sound rectilinear propagation, attenuation, etc., are often different from the actual parameters. Moreover, inadequate device settings may cause artifacts. Profound knowledge of the causes, avoidance, and interpretation of artifacts is a necessary precondition for correct clinical appraisal of ultrasound images. Part 1 of this review comments on the physics of artifacts and describes the most important B-mode artifacts. Pitfalls, as well as diagnostic chances resulting from B-mode artifacts, are discussed.


Assuntos
Artefatos , Erros de Diagnóstico/prevenção & controle , Gastroenterologia/métodos , Aumento da Imagem/métodos , Medicina Interna/métodos , Ultrassonografia/métodos , Humanos
4.
Z Gastroenterol ; 54(6): 569-78, 2016 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-27284933

RESUMO

Artifacts in ultrasonographic diagnostics are a result of the physical properties of the ultrasound waves and are caused by interaction of the ultrasound waves with biological structures and tissues of the body and with foreign materials. On the one hand, they may be diagnostically helpful. On the other hand, they may be distracting and may lead to misdiagnosis. Profound knowledge of the causes, avoidance, and interpretation of artifacts is a necessary precondition for correct clinical appraisal of ultrasound images. Part 1 of this review commented on the physics of artifacts and described the most important B-mode artifacts. Part 2 focuses on the clinically relevant artifacts in Doppler and color-coded duplex sonography. Problems and pitfalls of interpretation arising from artifacts, as well as the diagnostic use of Doppler and colour-coded duplex sonography, are discussed.


Assuntos
Artefatos , Erros de Diagnóstico/prevenção & controle , Doenças do Sistema Digestório/diagnóstico por imagem , Aumento da Imagem/métodos , Ultrassonografia Doppler em Cores/métodos , Medicina Baseada em Evidências , Humanos , Medicina Interna/métodos
5.
Z Gastroenterol ; 54(8): 774-90, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27529528

RESUMO

Enlarged or irregular lymph nodes (LNs) are clinical and imaging findings in a large variety of malignant and non-malignant diseases. A comprehensive diagnostic work up is usually necessary in order to differentiate the benign or the malignant nature of the altered LNs. The diagnosis has to be made using all clinical information and, if necessary, assessed LNs need to be biopsied and further, histologically or microbiologically characterized. However, imaging techniques, and particularly ultrasonography (US), are essential on the way to the final diagnosis, from initial detection and characterization to follow-up of biopsy guidance. Computed-tomography (CT) and/or magnetic resonance imaging (MRI) are of great value for oncological diseases staging and treatment monitoring. Imaging techniques are helpful in distinguishing between benign and malignant LNs disease as well as between LNs metastases and lymphoma in most cases. Furthermore, imaging can define the extent and distribution of malignant diseases. It may assist, through the use of particular techniques such as elastography, to identify the most suspicious LN to be biopsied and to guide targeted biopsies from the most suspicious areas. It also serves as the main tool for the evaluation of treatment response in malignant diseases. The quality of LNs imaging has remarkably improved in recent years. New methods, such as contrast-enhanced ultrasonography (CEUS), elastography, positron emission tomography (PET)/PET-CT, as well as diffusion weighted imaging (DWI) in MRI, have already led to substantial changes in clinical practice. This review describes the most recent imaging techniques for LNs assessment, and their particular clinical value, with a special emphasis on the role of US techniques. Strengths and weaknesses of different imaging tools are discussed comprehensively, highlighting the importance of a corroborative attitude for successful management of each particular case.


Assuntos
Aumento da Imagem/métodos , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Doenças Linfáticas/diagnóstico por imagem , Doenças Linfáticas/patologia , Ultrassonografia/métodos , Diagnóstico Diferencial , Medicina Baseada em Evidências , Humanos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
6.
Ultraschall Med ; 37(3): 262-70, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27070127

RESUMO

PURPOSE: Many patients with thyroid nodules are presently referred to surgery for not only therapeutic but also diagnostic purposes. The aim of noninvasive diagnostic methods is to optimize the selection of patients for surgery. Strain elastography (SE) enables the ultrasound-based determination of tissue elasticity. The aim of the present study was to evaluate the value of SE for the differentiation of thyroid nodules in a prospective multicenter study. MATERIALS AND METHODS: The study was registered at clinicaltrials.gov and was approved by the local ethics committees of all participating centers. All patients received an ultrasound (US) of the thyroid gland including color Doppler US. In addition, all nodules were evaluated by SE (Hitachi Medical Systems) using qualitative image interpretation of color distribution (SE-ES), strain value and strain ratio. RESULTS: Overall, 602 patients with 657 thyroid nodules (567 benign, 90 malignant) from 7 centers were included in the final analysis. The sensitivity, specificity, NPV, PPV, +LR were 21 %, 73 %, 86 %, 11 %, 0.8, respectively, for color Doppler US; 69 %, 75 %, 94 %, 30 %, 2.9, respectively, for SE-ES; 56 %, 81 %, 92 %, 32 %, 2.9, respectively, for SE-strain value; and 58 %, 78 %, 92 %, 30 %, 2.6, respectively, for SE-strain ratio. The diagnostic accuracy was 71 % for both strain value and strain ratio of nodules. CONCLUSION: SE as an additional ultrasound tool improves the value of ultrasound for the work-up of thyroid nodules. It might reduce diagnostic surgery of thyroid nodules in the future.


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Nódulo da Glândula Tireoide/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha Fina , Diagnóstico Diferencial , Feminino , Alemanha , Bócio Nodular/diagnóstico por imagem , Bócio Nodular/patologia , Bócio Nodular/cirurgia , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sensibilidade e Especificidade , Sociedades Médicas , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Nódulo da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/cirurgia , Ultrassonografia Doppler em Cores , Adulto Jovem
7.
Ultraschall Med ; 37(1): 27-45, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26871408

RESUMO

The third part of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound assesses the evidence for ultrasound-guided and assisted interventions in abdominal treatment procedures. Recommendations for clinical practice are presented covering indications, contraindications, safety and efficacy of the broad variety of these techniques. In particular, drainage of abscesses and fluid collections, interventional tumor ablation techniques, interventional treatment of symptomatic cysts and echinococcosis, percutaneous transhepatic cholangiography and drainage, percutaneous gastrostomy, urinary bladder drainage, and nephrostomy are addressed (short version; a long version is published online).


Assuntos
Abdome/diagnóstico por imagem , Ultrassonografia de Intervenção/métodos , Abscesso Abdominal/diagnóstico por imagem , Abscesso Abdominal/cirurgia , Neoplasias Abdominais/diagnóstico por imagem , Neoplasias Abdominais/cirurgia , Colangiografia/métodos , Cistos/diagnóstico por imagem , Cistos/cirurgia , Drenagem/métodos , Gastrostomia/métodos , Alemanha , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Nefrostomia Percutânea/métodos , Segurança do Paciente , Garantia da Qualidade dos Cuidados de Saúde , Resultado do Tratamento , Bexiga Urinária/diagnóstico por imagem , Bexiga Urinária/cirurgia
8.
Ultraschall Med ; 37(1): E1-E32, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26670019

RESUMO

The third part of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound (INVUS) assesses the evidence for ultrasound-guided and assisted interventions in abdominal treatment procedures. Recommendations for clinical practice are presented covering indications, contraindications, and safe and effective performance of the broad variety of these techniques. In particular, drainage of abscesses and fluid collections, interventional tumor ablation techniques, interventional treatment of symptomatic cysts and echinococcosis, percutaneous transhepatic cholangiography and drainage, percutaneous gastrostomy, urinary bladder drainage, and nephrostomy are addressed (long version).


Assuntos
Abdome/diagnóstico por imagem , Abdome/cirurgia , Medicina Baseada em Evidências , Sociedades Médicas , Ultrassonografia de Intervenção/métodos , Abscesso Abdominal/diagnóstico por imagem , Abscesso Abdominal/cirurgia , Colecistostomia/métodos , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/cirurgia , Terapia Combinada , Cistos/diagnóstico por imagem , Cistos/cirurgia , Gastrostomia/métodos , Alemanha , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Hepatopatias/diagnóstico por imagem , Hepatopatias/cirurgia , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Nefrostomia Percutânea/métodos , Cuidados Paliativos/métodos , Paracentese/métodos , Escleroterapia/métodos
9.
Lett Appl Microbiol ; 60(3): 210-6, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25470339

RESUMO

UNLABELLED: The aim of this study was to simultaneously construct PCR-DGGE-based predictive models of Listeria monocytogenes and Vibrio parahaemolyticus on cooked shrimps at 4 and 10°C. Calibration curves were established to correlate peak density of DGGE bands with microbial counts. Microbial counts derived from PCR-DGGE and plate methods were fitted by Baranyi model to obtain molecular and traditional predictive models. For L. monocytogenes, growing at 4 and 10°C, molecular predictive models were constructed. It showed good evaluations of correlation coefficients (R(2) > 0.92), bias factors (Bf ) and accuracy factors (Af ) (1.0 ≤ Bf ≤ Af ≤ 1.1). Moreover, no significant difference was found between molecular and traditional predictive models when analysed on lag phase (λ), maximum growth rate (µmax ) and growth data (P > 0.05). But for V. parahaemolyticus, inactivated at 4 and 10°C, molecular models show significant difference when compared with traditional models. Taken together, these results suggest that PCR-DGGE based on DNA can be used to construct growth models, but it is inappropriate for inactivation models yet. This is the first report of developing PCR-DGGE to simultaneously construct multiple molecular models. SIGNIFICANCE AND IMPACT OF THE STUDY: It has been known for a long time that microbial predictive models based on traditional plate methods are time-consuming and labour-intensive. Denaturing gradient gel electrophoresis (DGGE) has been widely used as a semiquantitative method to describe complex microbial community. In our study, we developed DGGE to quantify bacterial counts and simultaneously established two molecular predictive models to describe the growth and survival of two bacteria (Listeria monocytogenes and Vibrio parahaemolyticus) at 4 and 10°C. We demonstrated that PCR-DGGE could be used to construct growth models. This work provides a new approach to construct molecular predictive models and thereby facilitates predictive microbiology and QMRA (Quantitative Microbial Risk Assessment).


Assuntos
Microbiologia de Alimentos , Listeria monocytogenes/crescimento & desenvolvimento , Penaeidae/microbiologia , Frutos do Mar/microbiologia , Vibrio parahaemolyticus/crescimento & desenvolvimento , Animais , Carga Bacteriana , Contagem de Colônia Microbiana , Culinária , Eletroforese em Gel de Gradiente Desnaturante , Modelos Estatísticos , Reação em Cadeia da Polimerase
10.
Z Gastroenterol ; 53(6): 579-90, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26075369

RESUMO

Local ablative therapies have become an important part in the portfolio of treatment for patients with malignant tumors especially in the liver. Although percutaneous ethanol injection still plays a role, current guidelines favor radiofrequency ablation with a higher efficacy for complete tumor destruction. Nevertheless transplantation and surgical resection remain the gold standard due to their superiority in local control and improved survival. In this manuscript we discuss the technique in detail.


Assuntos
Ablação por Cateter/métodos , Hepatectomia/métodos , Neoplasias Hepáticas/terapia , Transplante de Fígado/métodos , Escleroterapia/métodos , Cirurgia Assistida por Computador/métodos , Etanol/uso terapêutico , Humanos , Neoplasias Hepáticas/diagnóstico , Soluções Esclerosantes/uso terapêutico
11.
Z Gastroenterol ; 53(4): 306-19, 2015 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-25860581

RESUMO

In patients with diabetes mellitus, abdominal ultrasonography is the appropriate diagnostic technique to detect and to follow-up secondary and accompanying diseases of the liver, the kidneys, the pancreas, the gastrointestinal tract and of abdominal vessels. Moreover, pancreatic and hepatic diseases may be realized which are of etiological importance for diabetes mellitus. Based on a systematic survey of the published literature, this review in 3 parts will describe the value of abdominal ultrasonography in patients with diabetes mellitus. Part 1 deals with the diagnostic relevance and particular findings of ultrasonographic methods in hepatic manifestations and complications of diabetes mellitus.


Assuntos
Complicações do Diabetes/diagnóstico por imagem , Aumento da Imagem/métodos , Hepatopatias/diagnóstico por imagem , Hepatopatias/etiologia , Fígado/diagnóstico por imagem , Ultrassonografia/métodos , Abdome/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Posicionamento do Paciente/métodos
12.
Ultraschall Med ; 36(6): 566-80, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26669869

RESUMO

This is the second part of the series on interventional ultrasound guidelines of the Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). It deals with the diagnostic interventional procedure. General points are discussed which are pertinent to all patients, followed by organ-specific imaging that will allow the correct pathway and planning for the interventional procedure. This will allow for the appropriate imaging workup for each individual interventional procedure (Long version/ short version; the long version is published online).


Assuntos
Abdome/diagnóstico por imagem , Sociedades Médicas , Ultrassonografia de Intervenção/métodos , Ultrassonografia/métodos , Europa (Continente) , Humanos , Imageamento por Ressonância Magnética , Imagem Multimodal , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X
13.
Ultraschall Med ; 36(6): E15-35, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26669871

RESUMO

This is the second part of the series on interventional ultrasound guidelines of the Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). It deals with the diagnostic interventional procedure. General points are discussed which are pertinent to all patients, followed by organ-specific imaging that will allow the correct pathway and planning for the interventional procedure. This will allow for the appropriate imaging workup for each individual interventional procedure (Long version).


Assuntos
Abdome/diagnóstico por imagem , Sociedades Médicas , Ultrassonografia de Intervenção , Ultrassonografia , Europa (Continente) , Medicina Baseada em Evidências , Humanos
14.
Z Gastroenterol ; 52(2): 212-21, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24526406

RESUMO

Conventional ultrasound is regarded as the first method of choice to evaluate lymph node disease due to its high resolution. The combination of various features obtained from the patients history including age, acute or chronic onset, symptoms, and a knowledge of underlying systemic diseases as well as imaging criteria, most importantly B-mode (gray-scale) and colour Doppler imaging (CDI) are the basis for the differential diagnosis of lymphadenopathy. New ultrasound techniques such as elastography and contrast-enhanced ultrasound may provide further information. In addition, ultrasound evaluation of lymph nodes is an essential adjunct to the clinical investigation in staging of malignant neoplasia and lymphoma. In this paper the current literature is reviewed regarding conventional B-mode and Doppler ultrasound for the evaluation of lymphadenopathy. The ultrasound criteria for the differential diagnosis of enlarged and structurally altered lymph nodes are summarized and also limitations are described.


Assuntos
Aumento da Imagem/métodos , Linfonodos/diagnóstico por imagem , Doenças Linfáticas/diagnóstico por imagem , Metástase Linfática/diagnóstico por imagem , Ultrassonografia/métodos , Humanos
15.
Z Gastroenterol ; 52(10): 1178-84, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25313631

RESUMO

Ultrasound (US) imaging in the paediatric population has been a routine technique for decades, in part because of the advantages it offers over other imaging modalities. Off-label use (and its funding) is of the utmost importance in paediatrics because many drugs have not been evaluated in randomised trials in children. As a consequence such drugs are not specifically approved for use in children. This is also true for the contrast agents used in CEUS. The off-label use of CEUS in paediatric patients illustrates the need to deal with unresolved legal issues while at the same time balancing this with the need for high diagnostic performance in daily clinical routine. In addition to approved indications with a focus on the liver and Doppler enhancement, CEUS is safe and effective for the examination of many organs, as recently highlighted by the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). This article provides a summary of the available literature describing the utility of CEUS in paediatric patients. Furthermore, we suggest the establishment of a registry to collect data on safety and applications of ultrasound contrast agents in children. A paediatric registry has recently been introduced by EFSUMB (www.efsumb.org).


Assuntos
Doenças Cardiovasculares/induzido quimicamente , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Meios de Contraste/efeitos adversos , Nefropatias/induzido quimicamente , Hepatopatias/diagnóstico por imagem , Fosfolipídeos/efeitos adversos , Hexafluoreto de Enxofre/efeitos adversos , Doenças Cardiovasculares/prevenção & controle , Doença Hepática Induzida por Substâncias e Drogas/prevenção & controle , Criança , Pré-Escolar , Medicina Baseada em Evidências , Feminino , Humanos , Lactente , Recém-Nascido , Nefropatias/prevenção & controle , Masculino , Uso Off-Label , Ultrassonografia
16.
Z Gastroenterol ; 52(3): 269-75, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24622868

RESUMO

BACKGROUND AND AIMS: The introduction of a new type of small handheld ultrasound device brings greater portability and affordability. The basic ultrasound approach with these handheld devices has been defined by European Federation of Societies of Ultrasound in Medicine and Biology (EFSUMB) as "EchoScopy". The current study aimed to assess the image quality, indications and limitations of a portable pocket "EchoScope" compared with a high-end ultrasound system in abdominal diseases. METHODS: 231 consecutive patients were included in this study. Physician A performed ultrasound examinations with a high-end ultrasound system (HEUS), then physician B performed the same ultrasound examination using an EchoScope (Vscan™). In patients with focal lesions, physician B also measured the largest diameters and graded the vascularity by using colour Doppler imaging (CDI) within the lesion on the same plane with both ultrasound systems. Compared with the excellent image quality using HEUS, the image quality of the EchoScope was graded as good, sufficient or non-sufficient. RESULTS: Out of all 231 patients, 167 had focal lesions, 19 patients were found with diffuse pathological findings, six with ascites, six after liver puncture and 33 without any pathological findings. The image quality of the pocket device was considered as being good or sufficient to delineate the pathology in 225/231 (97.4 %). The detection rate of the EchoScope for abdominal focal lesion was 162/167 (97 %), only five superficially located lesions could not be detected. Both systems showed agreement in determination of the best positioning to perform abdominal paracentesis and assessing complications after intervention. CONCLUSIONS: The investigated EchoScope displays a sufficient image quality, in some indications such as detection of focal lesions > 20 mm, detection of ascites, hydronephrosis and other pathological findings with comparable results to HEUS. We conclude that pocket sized EchoScopy devices have a promising future but the indications have to be determined by a prospective study.


Assuntos
Abdome/diagnóstico por imagem , Doenças Cardiovasculares/diagnóstico por imagem , Doenças do Sistema Digestório/diagnóstico por imagem , Doenças do Sistema Endócrino/diagnóstico por imagem , Ultrassonografia Doppler em Cores/instrumentação , Doenças Urológicas/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Desenho de Equipamento , Análise de Falha de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miniaturização , Projetos Piloto , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Ultrassonografia Doppler em Cores/métodos , Adulto Jovem
17.
Z Gastroenterol ; 52(7): 649-53, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25026006

RESUMO

PURPOSE: To assess the inter-observer reproducibility of acoustic radiation force impulse imaging (ARFI) between 2 skilled physicians and to evaluate if ultrasound contrast agents (UCA) affect the measurement of shear wave velocity (SWV) using ARFI. PATIENTS AND METHODS: 53 patients (29 males, 24 females, 59 ± 15 [22-84] years) who underwent contrast enhanced ultrasound (CEUS) examination were included. ARFI was performed on liver segment V by physicians A and B before CEUS, and by physician A within 4-6 minutes and 7-10 minutes after contrast injection. In a subgroup of 31 patients (15 males, 16 females, 57 ± 18 [22-84] years), ARFI was also performed on focal liver lesions (FLL) by physician A before CEUS, and within 4-6 minutes and 7-10 minutes after contrast injection. RESULTS: The SWV values obtained by physician A and B before CEUS yielded an intra-class correlation coefficient value of 0.913 (95% CI, 0.849-0.950). No significant differences were shown between the SWV values of liver segment V in all 53 patients and of FLL in the subgroup of 31 patients obtained before CEUS and that of within 4-6 minutes and 7-10 minutes after contrast injection (all P > 0.05). CONCLUSION: ARFI showed excellent inter-observer reproducibility between 2 skilled physicians. UCA did not affect the measurement of SWV in both liver parenchyma and FLL, at least when performed 4 minutes after the contrast injection. ARFI may become an additional tool in the differential diagnosis of FLL.


Assuntos
Artefatos , Meios de Contraste/administração & dosagem , Técnicas de Imagem por Elasticidade/efeitos dos fármacos , Técnicas de Imagem por Elasticidade/métodos , Cirrose Hepática/diagnóstico por imagem , Cirrose Hepática/fisiopatologia , Adulto , Idoso , Módulo de Elasticidade/efeitos dos fármacos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Resistência ao Cisalhamento/efeitos dos fármacos , Adulto Jovem
18.
Ultraschall Med ; 35(3): 246-52, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23888425

RESUMO

INTRODUCTION: Prolonged heterogeneous liver enhancement (PHLE) is a rare phenomenon that is similar to the ultrasound findings of portal venous gas. The purpose of this report is to describe the phenomenon of PHLE after the injection of the ultrasound contrast agent SonoVue(®). PATIENTS AND METHODS: From 2000 to 2013, 13 patients with PHLE ("cloudy", "wool-like") after bolus injection of SonoVue(®) were observed. The height, weight, and body mass index (BMI) of the patients, and the number of injections were analyzed. In addition, the literature was reviewed. RESULTS: The phenomenon occurred as early as 2 minutes after bolus contrast administration and lasted up to 5 hours on both B-mode and contrast-specific ultrasound. 8/13 (62 %) patients received two or more boluses. None of the patients experienced SonoVue(®)-related side effects or health problems. The phenomenon was not reproducible in 3 patients who received a second SonoVue(®) injection 24 hours after receiving the first. CONCLUSION: This phenomenon is more likely to occur in patients who receive high-dose (or multiple) injections of UCA. It may occur as early as 2 minutes after contrast administration, and therefore, may affect the evaluation of focal liver lesions in the late phase. This phenomenon should not be misdiagnosed as a pathological finding of the liver.


Assuntos
Meios de Contraste , Aumento da Imagem/métodos , Neoplasias Hepáticas/diagnóstico por imagem , Fosfolipídeos , Hexafluoreto de Enxofre , Adolescente , Adulto , Idoso , Meios de Contraste/farmacocinética , Feminino , Humanos , Injeções Intravenosas , Fígado/diagnóstico por imagem , Hepatopatias/diagnóstico por imagem , Neoplasias Hepáticas/secundário , Masculino , Taxa de Depuração Metabólica/fisiologia , Pessoa de Meia-Idade , Fosfolipídeos/farmacocinética , Estudos Prospectivos , Sensibilidade e Especificidade , Hexafluoreto de Enxofre/farmacocinética , Ultrassonografia
19.
Ultraschall Med ; 35(2): 108-25; quiz 126-7, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24477558

RESUMO

Ultrasound technology is always connected to possible artefacts. Since introduction of ultrasound technology the knowledge of those artefacts is eminent to avoid misinterpretations. It is important to know that with the introduction of new ultrasound technology the possibility of artefacts are rising.Whereas artefacts initially were limited to B-mode sonography, every technological step (colour Doppler sonography, contrast enhanced sonography) comes with a range of new artefacts. This article is written to explain the technological basics of ultrasound artefacts and provide the reader with examples in daily practice and how to avoid them.


Assuntos
Artefatos , Meios de Contraste , Aumento da Imagem , Fígado/diagnóstico por imagem , Ultrassonografia/métodos , Meios de Contraste/administração & dosagem , Meios de Contraste/farmacocinética , Erros de Diagnóstico/prevenção & controle , Relação Dose-Resposta a Droga , Humanos , Sensibilidade e Especificidade
20.
Z Gastroenterol ; 51(5): 427-31, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23681894

RESUMO

Contrast-enhanced ultrasound (CEUS) is widely applied in tumour diagnosis, especially for focal liver lesions (FLL), due to its high sensitivity and specificity. According to the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) CEUS guidelines (2012) and non-liver guidelines (2011), the majority of tumours, regardless of location, show specific CEUS enhancement patterns that can distinguish benign from malignant lesions. However, even experienced clinicians evaluating FLL may find occasional irregularities in these patterns, due to particular FLL pathologies, that make a definitive diagnosis difficult. Hence, there is a need to train physicians to utilize contrast enhancement kinetics to aid in the correct interpretation of data from CEUS examinations in patients with divergent liver tumour pathologies. Here we report on a CEUS quantitation software, SonoLiver®, to verify and improve diagnostic accuracy in the characterization of suspicious liver lesions through the analysis of dynamic vascular patterns (DVP).


Assuntos
Artéria Hepática/diagnóstico por imagem , Veias Hepáticas/diagnóstico por imagem , Aumento da Imagem/métodos , Neoplasias Hepáticas/diagnóstico por imagem , Neovascularização Patológica/diagnóstico por imagem , Software , Ultrassonografia/métodos , Meios de Contraste , Humanos , Interpretação de Imagem Assistida por Computador/métodos , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
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