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1.
Int J Surg ; 110(3): 1744-1754, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38085848

RESUMO

BACKGROUND: Postoperative ileus (POI) is a complication that may occur after abdominal or nonabdominal surgery. Intravenous dexmedetomidine (Dex) has been reported to accelerate postoperative gastrointestinal function recovery; however, updated evidence is required to confirm its robustness. METHODS: To identify randomized controlled trials examining the effects of perioperative intravenous Dex on gastrointestinal function recovery in patients undergoing noncardiac surgery, databases including MEDLINE, EMBASE, Google Scholar, and Cochrane Library were searched on August 2023. The primary outcome was time to first flatus. Secondary outcomes included time to oral intake and defecation as well as postoperative pain scores, postoperative nausea/vomiting (PONV), risk of hemodynamic instability, and length of hospital stay (LOS). To confirm its robustness, subgroup analyses and trial sequential analysis were performed. RESULTS: The meta-analysis of 22 randomized controlled trials with 2566 patients showed that Dex significantly reduced the time to flatus [mean difference (MD):-7.19 h, P <0.00001), time to oral intake (MD: -6.44 h, P =0.001), time to defecation (MD:-13.84 h, P =0.008), LOS (MD:-1.08 days, P <0.0001), and PONV risk (risk ratio: 0.61, P <0.00001) without differences in hemodynamic stability and pain severity compared with the control group. Trial sequential analysis supported sufficient evidence favoring Dex for accelerating bowel function. Subgroup analyses confirmed the positive impact of Dex on the time to flatus across different surgical categories and sexes. However, this benefit has not been observed in studies conducted in regions outside China. CONCLUSIONS: Perioperative intravenous Dex may enhance postoperative gastrointestinal function recovery and reduce LOS, thereby validating its use in patients for whom postoperative ileus is a significant concern.


Assuntos
Dexmedetomidina , Íleus , Humanos , Dexmedetomidina/efeitos adversos , Náusea e Vômito Pós-Operatórios , Recuperação de Função Fisiológica , Flatulência , Complicações Pós-Operatórias/etiologia , Dor Pós-Operatória
2.
Front Nutr ; 10: 1294066, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38130443

RESUMO

Introduction: This study aimed to investigate the determinants of cancer incidence and mortality in patients with vitamin D deficiency using a real-world population database. Methods: We utilized the International Diagnostic Classification Code (ICD9:268 / ICD10: E55) to define patients with vitamin D deficiency. Additionally, the Cox regression model was used to estimate overall mortality and identify potential factors contributing to mortality in cancer patients. Results: In 5242 patients with vitamin D deficiency, the development of new-onset cancer was 229 (4.37%) patients. Colon cancer was the most prevalent cancer type. After considering confounding factors, patients aged 50-65 and more than 65 indicated a 3.10-fold (95% C.I.: 2.12-4.51) and 4.55-fold (95% C.I.: 3.03-6.82) cancer incidence, respectively compared with those aged <50. Moreover, patients with comorbidities of diabetes mellitus (DM) (HR: 1.56; 95% C.I.: 1.01-2.41) and liver disease (HR: 1.62; 95% C.I.: 1.03-2.54) presented a higher cancer incidence rate than those without DM/ liver disease. In addition, vitamin D deficiency patients with cancer and dementia histories indicated a significantly higher mortality risk (HR: 4.04; 95% C.I.: 1.05- 15.56) than those without dementia. Conclusion: In conclusion, our study revealed that vitamin D deficiency patients with liver disease had an increased incidence of cancer, while those with dementia had an increased mortality rate among cancer patients.

3.
BMC Womens Health ; 23(1): 330, 2023 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-37344800

RESUMO

BACKGROUND/AIM: Breast cancer is the most common female malignancy in the world. Nearly ninety percent of screening-detected breast cancers were diagnosed with earlier stages of 0 to II in Taiwan. It's widely acknowledged that mammography screening of breast cancer can achieve the goal of early diagnosis and treatment in terms of preventive task while neglected interval cancers are associated with unfavorable tumor characteristics and worse outcomes. The purpose of this study was to explore the characteristics of screening-detected breast cancers in Taiwan. MATERIALS AND METHODS: Both screening and diagnostic mammography examinations with accompanied BI-RADS (breast imaging-reporting and data system) classification were extracted from the health information system and linked to cancer registry in Taiwan. Enrolled population included those attending their first mammography between 2012 and 2016, excluding subjects with previous breast cancer, or with missing or incomplete data. We compared treatment outcomes between breast cancers with either initial screening or diagnostic mammography (control group), and investigated the compositions of breast cancers detected by screening mammography through direct chart reviews. RESULTS: A total of 84,246 screening and 61,230 diagnostic mammography sessions were performed from 2010 to 2020. More positive results (BI-RADS 0, 3, 4 and 5) were observed for those attending the first diagnostic than the first screening mammography (43.58% versus 16.12%, p < 0.001). Earlier stages (0 and I) distribution (92% versus 81%, p < 0.0001), better survivorship (overall survival: 96.91% versus 92.17%, p = 0.007) and a lower HER2 (human epidermal growth factor receptor II) positive status and lower tumor grade were noted in breast cancers with initial screening rather than diagnostic mammography. Among 26,103 mammography screening invitees between 2012 and 2016, 325 breast cancers were ascertained from cancer registry. Of these, 234 had one, 72 had two and 19 had three episodes of mammography before cancer diagnosis. Extensive chart reviews revealed that women with and without breast symptoms constituted 29.9 and 70.1% of the 325 screening-detected breast cancers, with the latter further divided into false negative results (interval cancer), diagnosed at the first mammography, diagnostic at the secondary or subsequent mammography and those with a delayed biopsy or confirmatory imaging constituted (5.2, 47, 10.5 and 7.4%). CONCLUSION: Screening-detected breast cancers were a mixture of women with and without symptoms, those with a false negative result, true negative results with cancer detected at subsequent mammography and non-adherers. Despite this, efficacy of mammography screening was ascertained in Taiwan from this study. To further enhance earlier detection and decrease false negativity, the impact of repeated mammography, and additional sonography for symptomatic women, compliance following a positive screening mammography should not be overemphasized.


Assuntos
Neoplasias da Mama , Mama , Feminino , Humanos , Mama/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/epidemiologia , Detecção Precoce de Câncer/métodos , Mamografia/métodos , Programas de Rastreamento/métodos , Taiwan/epidemiologia
4.
Cancers (Basel) ; 14(19)2022 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-36230488

RESUMO

Smoking increases the cancer-specific and overall mortality risk in women with breast cancer (BC). However, the effect of smoking cessation remains controversial, and detailed research is lacking in Asia. We aimed to investigate the association between smoking status and mortality in women with BC using the population-based cancer registry. The Taiwan Cancer Registry was used to identify women with BC from 2011 to 2017. A total of 54,614 women with BC were enrolled, including 1687 smokers and 52,927 non-smokers. The outcome, mortality, was identified using Taiwan's cause-of-death database. The association between smoking status and mortality was estimated using Cox proportional regression. Women with BC who smoked had a 1.25-fold higher (95% C.I.: 1.08-1.45; p = 0.0022) risk of overall mortality and a 1.22-fold higher (95% C.I.: 1.04-1.44; p = 0.0168) risk of cancer-specific mortality compared with non-smokers. The stratified analysis also indicated that women with BC who smoked showed a significantly higher overall mortality risk (HR: 1.20; 95% CI: 1.01-1.43; p = 0.0408) than women with BC who did not smoke among women without comorbidities. Additionally, current smokers had a 1.57-fold higher risk (95% CI: 1.02-2.42; p = 0.0407) of overall mortality compared with ever smokers among women with BC who smoked. It was shown that a current smoking status is significantly associated with an increase in overall and cancer-specific mortality risk in women with BC. Quitting smoking could reduce one's mortality risk. Our results underscore the importance of smoking cessation for women with BC.

5.
Breast ; 65: 124-135, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35944352

RESUMO

PURPOSE: The purpose of this study was to compare the diagnostic performance and the interpretation time of breast ultrasound examination between reading without and with the artificial intelligence (AI) system as a concurrent reading aid. MATERIAL AND METHODS: A fully crossed multi-reader and multi-case (MRMC) reader study was conducted. Sixteen participating physicians were recruited and retrospectively interpreted 172 breast ultrasound cases in two reading scenarios, once without and once with the AI system (BU-CAD™, TaiHao Medical Inc.) assistance for concurrent reading. Interpretations of any given case set with and without the AI system were separated by at least 5 weeks. These reading results were compared to the reference standard and the area under the LROC curve (AUCLROC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for performance evaluations. The interpretation time was also compared between the unaided and aided scenarios. RESULTS: With the help of the AI system, the readers had higher diagnostic performance with an increase in the average AUCLROC from 0.7582 to 0.8294 with statistically significant. The sensitivity, specificity, PPV, and NPV were also improved from 95.77%, 24.07%, 44.18%, and 93.50%-98.17%, 30.67%, 46.91%, and 96.10%, respectively. Of these, the improvement in specificity reached statistical significance. The average interpretation time was significantly reduced by approximately 40% when the readers were assisted by the AI system. CONCLUSION: The concurrent-read AI system improves the diagnostic performance in detecting and diagnosing breast lesions on breast ultrasound images. In addition, the interpretation time is effectively reduced for the interpreting physicians.


Assuntos
Neoplasias da Mama , Médicos , Inteligência Artificial , Neoplasias da Mama/diagnóstico por imagem , Feminino , Humanos , Mamografia/métodos , Leitura , Estudos Retrospectivos , Sensibilidade e Especificidade
6.
BMC Anesthesiol ; 22(1): 207, 2022 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-35794519

RESUMO

BACKGROUND: Dynamic obstruction of the left ventricular outflow tract resulting from systolic anterior motion of the mitral valve can be an unexpected cause of acute and severe perioperative hypotension in noncardiac surgery. We report a patient undergoing spinal anesthesia for transurethral resection of the prostate who experienced sudden hypoxemia caused by systolic anterior motion-induced mitral regurgitation but with a clinically picture simulating fluid overload. CASE PRESENTATION: An 83-year-old man with a history of hypertension was scheduled for transurethral resection of the prostate. One hour after spinal anesthesia, he developed acute restlessness and dyspnea, with pink frothy sputum and progressive hypoxemia. Slight hypertension was noted, and an electrocardiogram showed atrial fibrillation with a rapid ventricular response. Furosemide and nitroglycerin were thus administered for suspected fluid overload or transurethral resection of the prostate syndrome; however, he then became severely hypotensive. After tracheal intubation, intraoperative transesophageal echocardiography was promptly performed, which revealed an empty hypercontractile left ventricle, significant mitral regurgitation and mosaic flow signal in the left ventricular outflow tract. Following aggressive fluid therapy, his hemodynamic changes stabilized. Repeat echocardiography in intensive care unit confirmed the presence of systolic anterior motion of the anterior mitral leaflet obstructing the left ventricular outflow tract. We speculate that pulmonary edema was induced by systolic anterior motion-associated mitral regurgitation and rapid atrial fibrillation, and the initial management had worsened his hypovolemia and provoked left ventricular outflow tract obstruction and hemodynamic instability. CONCLUSIONS: Pulmonary edema caused by systolic anterior motion of the mitral valve can be difficult to clinically differentiate from that induced by fluid overload. Therefore, bedside echocardiography is paramount for timely diagnosis and prompt initiation of appropriate therapy in the perioperative care setting.


Assuntos
Raquianestesia , Fibrilação Atrial , Insuficiência da Valva Mitral , Edema Pulmonar , Ressecção Transuretral da Próstata , Idoso de 80 Anos ou mais , Raquianestesia/efeitos adversos , Humanos , Hipóxia , Masculino , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/etiologia , Insuficiência da Valva Mitral/cirurgia , Edema Pulmonar/etiologia , Ressecção Transuretral da Próstata/efeitos adversos
7.
Transplant Proc ; 53(7): 2329-2334, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34446308

RESUMO

BACKGROUND: This study measures the first-pass arrival times in the hepatic artery and portal vein of the transplanted liver using contrast-enhanced ultrasound (CEUS) and assess its correlation with graft performance in the early posttransplant period. METHODS: This study evaluated 35 liver transplant recipients who underwent CEUS examination within 1 month of transplant surgery. CEUS under contrast-specific harmonic imaging mode were recorded for 60 seconds immediately after intravenous administration of microbubble ultrasound contrast medium (Sonazoid, GE Healthcare, Oslo, Norway). The recorded video clips were reviewed by 2 readers to determine the first-pass arrival times in the hepatic artery and portal vein, and the difference between the 2 was defined as the arterial-portal arrival interval (APAI). Laboratory data on the same date of CEUS examination were collected as indicators to correlate with APAI. RESULTS: The intra- and inter-rater reliability for APAI measurement were excellent, with intraclass correlation coefficients > .95. The mean APAI was 4.5 ± 1.8 seconds (range, 2.0-10.5 seconds). The APAI was positively correlated with the serum total bilirubin level (r = 0.357, P = .035) and negatively correlated with the platelet count (r = -0.354, P = .037). At the 5 second cutoff point, a total serum bilirubin of >8 mg/dL was reported in 5 of 11 patients (45.4%) with APAI of >5 seconds and in only 3 of 24 patients (12.5%) with APAI of <5 seconds (P < .05). CONCLUSIONS: The APAI is a quantitative marker that links the hemodynamics and the clinical status of the liver graft.


Assuntos
Transplante de Fígado , Artéria Hepática/diagnóstico por imagem , Humanos , Veia Porta/diagnóstico por imagem , Reprodutibilidade dos Testes , Ultrassonografia
8.
J Med Ultrasound ; 29(1): 57-59, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34084719

RESUMO

Secretory carcinoma of the breast is a rare subtype of breast cancer. It can occur at any age but is usually diagnosed in patients under 30 years. It is the most common subtype of breast malignancy in the pediatric population and has a favorable outcome. Surgical excision is the best treatment and adjuvant therapies are still under debate. We present the case report of a 26-year-old patient with secretory carcinoma of the breast, including imaging, histologic findings, and clinical outcome.

9.
J Breast Imaging ; 2(6): 615-628, 2020 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-38424865

RESUMO

Image optimization at digital breast tomosynthesis (DBT) involves a series of trade-offs between multiple variables. Wider sweep angles provide better separation of overlapping tissues, but they result in decreased in-plane resolution as well as increased scan times that may be prone to patient motion. Techniques to reduce scan time, such as continuous tube motion and pixel binning during detector readout, reduce the chances of patient motion but may degrade the in-plane resolution. Image artifacts are inherent to DBT because of the limited angular range of the acquisition. Iterative reconstruction algorithms have been shown to reduce various DBT artifacts.

10.
Int J Med Robot ; 15(1): e1963, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30265760

RESUMO

OBJECTIVES: To compare perioperative outcomes of robotic-assisted partial nephrectomy (RaPN) with open partial nephrectomy (OPN). METHODS: Systematically search through PubMed, Embase, ClinicalKey, Cochrane Library, ProQuest, ScienceDirect, Web of Science, and ClinicalTrials.gov for eligible studies was performed to April 11, 2018. A meta-analysis was conducted for studies comparing RaPN and OPN. Confounding variables were assessed by meta-regression or subgroup analysis. RESULTS: This study included 34 studies with 60 808 patients. Meta-analysis revealed less blood loss, less transfusion, longer operative time, less postoperative complications, lower readmission rate, shorter length of stay, and less estimated glomerular filtration rate (eGFR) decline in RaPN groups. The superiority of RaPN in blood loss was attenuated with highly complex renal masses. The superiority of RaPN in intraoperative complications was strengthened with renal hilar control. The advantage of RaPN in surgical margin was increased in patient with body mass index (BMI) < 28. CONCLUSIONS: Compared with OPN, RaPN provided lower morbidities and better renal function preservation.


Assuntos
Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Nefrectomia/métodos , Procedimentos Cirúrgicos Robóticos , Idoso , Bases de Dados Factuais , Feminino , Taxa de Filtração Glomerular , Humanos , Complicações Intraoperatórias , Neoplasias Renais/patologia , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Duração da Cirurgia , Readmissão do Paciente , Análise de Regressão , Reprodutibilidade dos Testes
11.
J Clin Ultrasound ; 47(4): 235-238, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30561013

RESUMO

Hepatic arterial pseudoaneurysm is a rare but potentially fatal condition that requires prompt management. We report a case of hepatic arterial pseudoaneurysm developed after radiofrequency ablation of a hepatocellular carcinoma. The patient was successfully treated with percutaneous absolute ethanol injection under ultrasound guidance. Follow-up studies with ultrasound and computed tomography for 2 years after treatment revealed no evidence of local recurrence of hepatocellular carcinoma and of the pseudoaneurysm.


Assuntos
Técnicas de Ablação/métodos , Falso Aneurisma/cirurgia , Etanol/uso terapêutico , Artéria Hepática/cirurgia , Artéria Hepática/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Ultrassonografia de Intervenção
12.
Radiology ; 289(3): 630-638, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30277445

RESUMO

Purpose To compare the performance of two-dimensional synthetic mammography (SM) plus digital breast tomosynthesis (DBT) versus conventional full-field digital mammography (FFDM) in the detection of microcalcifications on screening mammograms. Materials and Methods In this retrospective multireader observer study, 72 consecutive screening mammograms recalled for microcalcifications from June 2015 through August 2016 were evaluated with both FFDM and DBT. The data set included 54 mammograms with benign microcalcifications and 18 mammograms with malignant microcalcifications, and 20 additional screening mammograms without microcalcifications used as controls. FFDM alone was compared to synthetic mammography plus DBT. Four readers independently reviewed each data set and microcalcification recalls were tabulated. Sensitivity and specificity for microcalcification detection were calculated for SM plus DBT and for FFDM alone. Interreader agreement was calculated with Fleiss kappa values. Results Reader agreement was kappa value of 0.66 (P < .001) for FFDM and 0.63 (P < .001) for SM plus DBT. For FFDM, the combined reader sensitivity for all microcalcifications was 80% (229 of 288; 95% confidence interval [CI]: 74%, 84%) and for malignant microcalcifications was 92% (66 of 72; 95% CI: 83%, 97%). For SM plus DBT, the combined reader sensitivity for all microcalcifications was 75% (215 of 288; 95% CI: 69%, 80%) and for malignant microcalcifications was 94% (68 of 72; 95% CI: 86%, 98%). For FFDM, the combined reader specificity for all microcalcifications was 98% (78 of 80; 95% CI: 91%, 100%) and for malignant microcalcifications was 98% (78 of 80; 95% CI: 91%, 100%). For SM plus DBT, combined reader specificity for all microcalcifications was 95% (76 of 80; 95% CI: 88%, 99%) and for malignant microcalcifications was 95% (76 of 80; 95% CI: 88%, 99%). Mixed-effects model concluded no differences between modalities (‒0.03; 95% CI: ‒0.08, 0.01; P = .13). Conclusion Relative to full-field digital mammography, synthetic mammography plus digital breast tomosynthesis had similar sensitivity and specificity for the detection of microcalcifications previously identified for recall at screening mammography. © RSNA, 2018 See also the editorial by Bae and Moon in this issue.


Assuntos
Doenças Mamárias/diagnóstico por imagem , Calcinose/diagnóstico por imagem , Mamografia/métodos , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Adulto , Idoso , Mama/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade
13.
J Chin Med Assoc ; 81(12): 1017-1026, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30017809

RESUMO

Renal cysts are common incidental findings in clinical practice. Most renal cysts detected in medical imaging are benign simple cysts. However, some are complicated by hemorrhage or infection or are associated with calcification. In these instances, difficulties can be encountered distinguishing the complicated cysts from cystic renal tumors such as cystic renal cell carcinoma, multilocular cystic nephroma, and mixed epithelial and stromal tumors. The Bosniak classification is widely used to categorize cystic renal lesions but is used to classify those discovered via computed tomography. Ultrasonography (US) and color Doppler US are the most frequently used imaging techniques for abdominal surveys and long-term follow-up because of their noninvasiveness, relatively low cost, wide availability, and frequently, lack of contrast medium. Herein, we review the features of various cystic lesions of the kidney that can be found using US, discuss differential diagnoses using US, and propose a feature-oriented algorithmic approach to classifying renal cystic lesions using US.


Assuntos
Doenças Renais Císticas/diagnóstico por imagem , Ultrassonografia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Doenças Renais Císticas/patologia , Doenças Renais Císticas/terapia , Masculino , Pessoa de Meia-Idade
14.
J Chin Med Assoc ; 81(4): 297-304, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29475813

RESUMO

Ultrasound is a frequently used diagnostic tool for gallbladder diseases. Polypoid lesions are commonly depicted at routine abdominal ultrasonography (US). The characteristics of these lesions vary. Since most early malignant tumors in the gallbladder are asymptomatic, differentiation between malignancy and benignity is crucial. Knowledge of gallbladder polypoid lesions is important so that they can be appropriately included in the differential diagnosis in patients presenting with intra-gallbladder nodules on US. This article summarizes the algorithmic approach to the diagnosis of these lesions and our recent experience with contrast-enhanced US. The clinical and imaging features of gallbladder polypoid lesions are reviewed.


Assuntos
Neoplasias da Vesícula Biliar/diagnóstico por imagem , Pólipos/diagnóstico por imagem , Ultrassonografia/métodos , Adenocarcinoma/diagnóstico por imagem , Algoritmos , Diagnóstico Diferencial , Endossonografia , Humanos
15.
J Clin Ultrasound ; 46(5): 361-363, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29159809

RESUMO

Synovial chondromatosis is a rare, benign, proliferative cartilaginous lesion arising from the synovial tissue, tenosynovium, or bursal lining. We describe the case of a patient who initially presented with multiple axillary masses. Breast ultrasound (US) was requested due to the concern of a breast tumor with axillary lymph node metastases. US study was helpful and provided adequate information to suggest the diagnosis.


Assuntos
Condromatose Sinovial/complicações , Condromatose Sinovial/diagnóstico por imagem , Doenças Linfáticas/diagnóstico por imagem , Doenças Linfáticas/etiologia , Articulação do Ombro/diagnóstico por imagem , Axila/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Linfonodos/diagnóstico por imagem , Pessoa de Meia-Idade , Ultrassonografia
16.
J Chin Med Assoc ; 81(2): 164-169, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29174930

RESUMO

BACKGROUND: Thyroid cancer is the most prevalent endocrine malignancy, and the incidence of thyroid cancer has increased worldwide. Fine needle aspiration (FNA) for cytology of thyroid tissue is used for differentiating thyroid cancers from benign thyroid nodules. Overuse of FNA may detect subclinical thyroid cancer and play a role in the increased incidence of thyroid cancer. The aim of this study was to evaluate trends in incidence of thyroid cancer and the use of palpation-guided FNA thyroid and ultrasound-guided FNA thyroid in Taiwan. METHODS: By retrospectively analyzing a cohort dataset of one million people randomly sample to represent as NHI beneficiaries of Taiwan National Health Insurance Research Database from 2004 to 2010, patients who received palpation-guided and ultrasound-guided thyroid FNA were identified. Individuals who were diagnosed as having thyroid cancer were determined. Age-standardized, yearly rates of palpation-guided thyroid FNA and ultrasound-guided FNA, and age-standardized, yearly incidence rates of thyroid cancer were calculated. RESULTS: In the study period, a total of 541 patients were newly diagnosed with thyroid cancer, 14,240 individuals received palpation-guided thyroid FNA, and 3823 individuals underwent ultrasound-guided thyroid FNA. There was a 94.8% increase in the age-standardized annual incidence rate of thyroid cancer. The age-standardized rates of palpation-guided thyroid FNA and ultrasound-guided thyroid FNA increased by 10.9% and 349.3%, respectively. CONCLUSION: FNA for cytology of thyroid tissue, especially ultrasound-guided FNA, was conducted by physicians more frequently in Taiwan. Increased use of FNA, especially ultrasound-guided FNA for cytology of thyroid tissue, may attribute to the increased incidence of thyroid cancer in Taiwan.


Assuntos
Biópsia por Agulha Fina/efeitos adversos , Neoplasias da Glândula Tireoide/epidemiologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taiwan/epidemiologia , Neoplasias da Glândula Tireoide/etiologia , Ultrassonografia de Intervenção , Adulto Jovem
17.
J Med Ultrasound ; 26(4): 218-221, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30662155

RESUMO

Contrast-enhanced ultrasound (CEUS) has been used to diagnose gallbladder (GB) diseases for recent years because it is sensitive to visualize vascularity. Herein, we report a case who had a 1.7 cm × 1.2 cm polypoid lesion located in the gallbladder fundus with a feeding artery located in the stalk. On CEUS, the lesion showed early arterial phase enhancement (time to peak enhancement 18 s), persisting throughout the venous and delay phases. This enhancing pattern suggested that the lesion was a GB adenoma rather than a GB carcinoma. Cholecystectomy was performed, and pathology of the tissue revealed tubular adenoma of the GB.

18.
J Chin Med Assoc ; 80(11): 721-728, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28919293

RESUMO

BACKGROUND: The purpose of this study is to test the possibility of obtained cell-like resolution in soft tissue tumors on the basis of ultrasound echotexture. METHODS: This is a prospective study consisting of 57 patients (29 females and 28 males, age range: 9-83 years, average age: 44.5 years) with palpable soft tissue mass, referred from the Departments of Orthopedics and Oncology for ultrasound (US)-guided biopsy. The study was approved by the institutional review board (IRB) of our hospital. Ultrasonographic images were recorded by still imaging in the biopsy tract in each biopsy session. Equipment included curvilinear and linear array probes. After biopsy, a radiologist and a pathologist correlated the US image and the observations regarding the histology of the tissue specimen in low-power (40 × magnification) and high-power (100-400 × magnification) fields. RESULTS: The histologic results included 22 benign and 35 malignant lesions. The echotexture of the soft tissue tumors correlated well with the cellular distribution and arrangement: the greater the number of cells and the more regular their arrangement as seen histologically, the greater is the hypoechogenicity on the ultrasound. The echogenicity of the soft tissue tumor also correlated well with the presence of fat cells, hemorrhage, cartilage, and osteoid tissue, all of which cause an increase in echogenicity. CONCLUSION: This study showed that the echotexture of soft tissue tumors can predict some details of cellular histology.


Assuntos
Neoplasias de Tecidos Moles/patologia , Ultrassonografia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Neoplasias de Tecidos Moles/diagnóstico por imagem , Adulto Jovem
19.
J Med Ultrasound ; 25(1): 33-39, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-30065452

RESUMO

PURPOSE: This study aims to evaluate patients with right-sided colonic diverticulitis detected at ultrasonography (US). METHODS: We retrospectively analyzed 14 patients. Demographic data, clinical features, and US images were documented. RESULTS: In the 14 patients, clinical manifestations included right lower abdominal tenderness (93%), leukocytosis (57.1%), and fever (28.6%). Diverticulitis occurred in cecum and ascending colon with a similar frequency (35.7%). US features included diverticular wall thickening (50%), surrounding echogenic fat (50%), intradiverticular echogenic material (50%), adjacent lymph node enlargement (21.4%), intradiverticularor peridiverticular fluid collection (28.6%), and color flow signals on or surrounding the diverticula (14.3%). Two (14.2%) patients suffered from recurrence. Two (14.3%) patients had abscess formation, and one (7.1%) patient had diverticulum perforation. Most (85.7%) patients received conservative treatment only. One (7.1%) patient received computed tomography-guided drainage due to diverticulum perforation and pocket of abscess formation. One patient underwent surgery due to recurrent diverticulitis-related fistula. CONCLUSION: Common US features of diverticulitis include diverticular wall thickening, surrounding echogenic fat, and intradiverticular echogenic material. Proper recognizing of these features helps in differentiating diverticulitis from appendicitis and may obviate an unnecessary emergent surgery.

20.
J Clin Ultrasound ; 45(6): 350-354, 2017 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-27753108

RESUMO

Solitary fibrous tumor (SFT) is an uncommon neoplasm of mesenchymal origin, which can be benign or malignant. Most SFTs develop from the pleura, but they can also be found in other sites. There are only few reports of SFT occurring in the breast. We herein report such a rare case. Sonography demonstrated an ovoid lesion mimicking a fibroadenoma, whereas color Doppler imaging showed marked internal vascularity. A brief literature review on imaging features of SFTs is added. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:350-354, 2017.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mamografia/métodos , Tumores Fibrosos Solitários/diagnóstico por imagem , Ultrassonografia Doppler em Cores/métodos , Adulto , Mama/diagnóstico por imagem , Mama/cirurgia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Tumores Fibrosos Solitários/cirurgia , Ultrassonografia Mamária/métodos
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