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1.
Artículo en Chino | MEDLINE | ID: mdl-33794629

RESUMEN

Objective:To investigate the value of color Doppler flow imaging(CDFI) in the diagnosis of congenital subglottic hemangioma(CSH) in infants. Methods:The data of 18 children with CSH who underwent laryngeal CDFI examination were collected and analyzed retrospectively, and compared with those who underwent laryngeal ultrasound examination at the same time. The shape, size, blood flow characteristics of the tumor and its relationship with airway were observed. Eighteen cases were treated with propranolol orally. CDFI of larynx was reexamined after 1 week, 1 month and 3 months of treatment. Results:CDFI could clearly show the location, shape, size and range of CSH in 18 cases, as well as the relationship with airway and surrounding tissues. CDFI images of CSH showed that the tumor was massive or nodular with abundant or patchy blood flow signals. Hemangioma was found in 6 cases on the right side, 8 cases on the left side, and 4 cases on both sides. Conclusion:CDFI can be used in the diagnosis of subglottic hemangioma. It has advantages in displaying its size, scope and relationship with airway, especially in the later treatment and follow-up.


Asunto(s)
Hemangioma , Neoplasias Laríngeas , Niño , Glotis/diagnóstico por imagen , Hemangioma/diagnóstico por imagen , Humanos , Lactante , Neoplasias Laríngeas/diagnóstico por imagen , Propranolol , Estudios Retrospectivos , Ultrasonografía Doppler en Color
2.
Medicine (Baltimore) ; 100(16): e25517, 2021 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-33879689

RESUMEN

RATIONALE: Primary schwannoma of the thyroid gland is very rare, and its preoperative diagnosis is difficult. PATIENT CONCERNS: We report the case of a thyroid nodule in an 18-year-old woman, who presented with a mass in her left neck with stiffness and normal thyroid function. However, the patient complained of numbness in her left upper extremity, and ultrasound (US) features were suspicious of malignancy. DIAGNOSES: Multimodal US imaging was performed using B-mode, color doppler, ultrasonic elastography (UE), and contrast-enhanced ultrasound (CEUS). CEUS revealed heterogeneous enhancement and "target sign" within the tumor. The nodule was suspicious for malignancy and classified as TI-RADS 4b, while the elasticity values measured by UE indicated a benign lesion. Fine needle aspiration (FNA) was subsequently performed in the markedly contrast-enhanced area for biopsy. Cytological results revealed a benign schwannoma. INTERVENTION: The patient underwent left lobe resection. Postoperative pathology confirmed it to be a primary benign schwannoma of the thyroid. OUTCOMES: After thyroidectomy, the patient was followed-up with US. At present, all laboratory tests and thyroid imaging are normal, and the numbness of the left upper limb has disappeared. LESSONS: The combination of different US modalities is useful for the diagnosis of thyroid lesions. FNA performed under CEUS guidance improves the accuracy of biopsy sampling.


Asunto(s)
Diagnóstico por Imagen de Elasticidad/métodos , Neurilemoma/diagnóstico , Glándula Tiroides/diagnóstico por imagen , Neoplasias de la Tiroides/diagnóstico , Ultrasonografía Doppler en Color/métodos , Adolescente , Biopsia con Aguja Fina , Medios de Contraste/administración & dosificación , Femenino , Humanos , Imagen Multimodal/métodos , Neurilemoma/patología , Neurilemoma/cirugía , Glándula Tiroides/patología , Glándula Tiroides/cirugía , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/cirugía , Tiroidectomía , Resultado del Tratamiento
3.
Medicine (Baltimore) ; 100(14): e25469, 2021 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-33832160

RESUMEN

RATIONALE: Eccrine spiradenoma (ES) is a rare benign skin adnexal tumor originating from eccrine sweat glands. The features of ES on ultrasonography (US) have received little attention. Therefore, we report the sonographic findings in a case of an ES that originated from the abdominal wall and discuss the previously reported cases. PATIENT CONCERNS: A 53-year-old woman was admitted to our hospital with a complaint of a painful nodule on the right side of her abdominal wall of 1-year duration. DIAGNOSES: The mass on the right side of abdominal wall was diagnosed as ES by histopathological examination. INTERVENTIONS: The patient subsequently underwent total excision of the mass. OUTCOMES: The patient recovered well and had no complications during the 1-year follow-up. LESSONS: As eccrine spiradenoma (ES) is rare and most of the tumors are excised without prior imaging studies. Little is known regarding the features of ES on ultrasonography (US). Familiarizing with the clinical and US features of this rare tumor may increase awareness of the disease among sonographers and clinicians.


Asunto(s)
Acrospiroma/diagnóstico por imagen , Neoplasias de las Glándulas Sudoríparas/diagnóstico por imagen , Ultrasonografía Doppler en Color , Femenino , Humanos , Persona de Mediana Edad
4.
Niger J Clin Pract ; 24(4): 551-554, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33851677

RESUMEN

Background: The method used in the first assessment of patients with veno-occlusive erectile dysfunction (ED) is penile color doppler ultrasonography (PCDU). However, cavernosography performed following intracavernosal pharmacostimulation is accepted as a more precise method for showing venous leakage. Aims: The objectives of this study were to compare results obtained from patients undergoing PCDU, and those undergoing cavernosography, and to investigate the diagnostic value of PCDU in the diagnosis. Methods: A total of 133 patients who presented at the urology clinic due to ED have veno-occlusive dysfunction (VOD) detected as a result of PCDU and underwent cavernosography for further assessment when scheduled for penile embolization. The results obtained were retrospectively evaluated. Results: The mean age of 133 patients with VOD identified as a result of PCDU was 48.7 ± 11.2 years. In cavernosography performed after PCDU, venous leakage was detected in 127 patients (95.49%), while no leakage was found in six patients (4.51%). Bilateral venous leakage was found in 91.34% (n:116), right venous leakage in 5.51% (n:7), and left venous leakage in 3.15% (n:4) of the patients with venous leakage. Conclusion: Evaluating the cavernosography results, PCDU alone is often sufficient to diagnose veno-occlusive ED. Cavernosography is a more invasive diagnostic method compared to PCDU that is adequate in cases where venous surgery or embolization is not considered, and cavernosography is not recommended in these patients.


Asunto(s)
Disfunción Eréctil , Impotencia Vasculogénica , Adulto , Disfunción Eréctil/diagnóstico por imagen , Humanos , Impotencia Vasculogénica/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Pene/diagnóstico por imagen , Estudios Retrospectivos , Ultrasonografía Doppler en Color
5.
Medicine (Baltimore) ; 100(12): e25187, 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33761700

RESUMEN

INTRODUCTION: Duplicate kidneys are the most common congenital abnormality of the urinary system. The location of duplicate kidneys varies. We report a case of an adolescent with upper and lower kidneys that are arranged vertically and approximately T-shaped. PATIENT CONCERNS: A 16-year-old male teenager was examined for pain in the left side of the waist. The Computed Tomography scan revealed that the left kidney was incompletely duplicated and fused; the left upper urinary tract was incompletely obstructed. DIAGNOSIS: The abdominal tomography confirmed the diagnosis of incomplete duplicate kidney. INTERVENTIONS: The patient underwent laparoscopic surgery. The failure to ligate the renal pedicle resulted in increased bleeding during the operation and an open ureteral stump. OUTCOMES: No urine leakage occurred after the operation. Doppler ultrasound of the urinary system showed no hydronephrosis, and the patient was asymptomatic. CONCLUSION: Through this case report, we found that the duplicate kidneys could be arranged in a T-shape under laparoscopy. Although only the supply of the duplicate renal arteries can be ligated during surgical resection, the renal pedicle must also be ligated during the operation if there is a lot of bleeding.


Asunto(s)
Riñón/anomalías , Riñón/cirugía , Laparoscopía/métodos , Nefrectomía/métodos , Adolescente , Pérdida de Sangre Quirúrgica , Humanos , Riñón/irrigación sanguínea , Riñón/diagnóstico por imagen , Pelvis Renal/anomalías , Pelvis Renal/cirugía , Laparoscopía/efectos adversos , Dolor de la Región Lumbar/etiología , Masculino , Nefrectomía/efectos adversos , Tomografía Computarizada por Rayos X , Ultrasonografía Doppler en Color , Uréter/anomalías , Uréter/cirugía
8.
Andrologia ; 53(4): e13973, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33565141

RESUMEN

The testis is a potential target organ for SARS-CoV-2 infection. Our study intended to investigate any testicular involvement in mild-to-moderate COVID-19 men. We conduct a cross-sectional study in 18 to 55-year-old men hospitalised for confirmed COVID-19. A senior radiologist executed the ultrasound with multi-frequency linear probe in all participants, regardless of any scrotal complaints. Exclusion criteria involved any situation that could impair testicular function. Statistical analysis compared independent groups, classified by any pathological change. Categorical and numerical outcome hypotheses were tested by Fisher's Exact and Mann-Whitney tests, using the Excel for Mac, version 16.29 (p < .05). The sample size was 26 men (mean 33.7 ± 6.2 years; range: 21-42 years), all without scrotal complaints. No orchitis was seen. Eleven men (32.6 ± 5.8 years) had epididymitis (42.3%), bilateral in 19.2%. More than half of men with epididymitis displayed epididymal head augmentation > 1.2 cm (p = .002). Two distinct epididymitis' patterns were reported: (a) disseminated micro-abscesses (n = 6) and (b) inhomogeneous echogenicity with reactional hydrocele (n = 5). Both patterns revealed increased epididymal head, augmented Doppler flow and scrotal skin thickening. The use of colour Doppler ultrasound in mild-to-moderate COVID-19 men, even in the absence of testicular complaints, might be useful to diagnose epididymitis that could elicit fertility complications.


Asunto(s)
/fisiopatología , Epididimitis/diagnóstico por imagen , Hidrocele Testicular/diagnóstico por imagen , Adulto , Enfermedades Asintomáticas , Brasil/epidemiología , Estudios Transversales , Epididimitis/epidemiología , Epididimitis/fisiopatología , Humanos , Masculino , Índice de Severidad de la Enfermedad , Hidrocele Testicular/epidemiología , Hidrocele Testicular/fisiopatología , Ultrasonografía Doppler en Color , Adulto Joven
9.
Medicine (Baltimore) ; 100(4): e24479, 2021 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-33530264

RESUMEN

ABSTRACT: Application of the Caprini risk assessment model was explored in patients with deep vein thrombosis (DVT) after laparoscopic colorectal cancer surgery.This study was a prospective study. The risk factors for DVT were assessed with a survey at baseline and on the morning of surgery, first day after surgery and sixth day by using repeated blood vessels on color Doppler ultrasound of the lower limbs, and the intraoperative and postoperative conditions were recorded.Among 148 surgical patients, 24.3% had asymptomatic DVT. According to the risk stratification, the incidence of DVT was related to the Caprini score (P < .001). The area under the curve of the Caprini model was 0.701 ±â€Š0.047 (95% CI: 0.609-0.793, P<.001). The Youden index was 0.368, while the critical point was 10.5 in the Caprini model, corresponding to a sensitivity of 0.806 and a specificity of 0.563. Age, cardiovascular disease, intraoperative blood loss, postoperative fever, preoperative preparation, and hospital stay were higher in DVT patients than in patients without DVT. Moreover, the incidence of DVT in patients with a lithotomy position was higher than that in patients with a scissors position. In binary logistic regression analysis, the independent risk factors for DVT development were age, intraoperative blood loss, and preoperative preparation time.The Caprini model can be used for the prediction of venous thromboembolism in laparoscopic colorectal cancer surgery patients. The thrombosis risk assessment model must be established in line with patients undergoing endoscopic malignant tumor surgery.


Asunto(s)
Neoplasias Colorrectales/cirugía , Laparoscopía/efectos adversos , Trombosis de la Vena/epidemiología , Adulto , Anciano , Neoplasias Colorrectales/epidemiología , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Curva ROC , Medición de Riesgo/métodos , Ultrasonografía Doppler en Color , Trombosis de la Vena/diagnóstico por imagen
10.
Medicine (Baltimore) ; 100(4): e24490, 2021 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-33530268

RESUMEN

RATIONALE: Conjoined twins are a rare complication of monochorionic pregnancies and an extremely rare condition in spontaneous triplet pregnancies. We report a case of conjoined twins in a spontaneous monochorionic triplet pregnancy. The conjoined twins might have suffered from twin anemia-polycythemia sequence, which was reported to be extremely rare. PATIENT CONCERNS: A 26-year-old woman conceived spontaneously with an obstetric history of invasive mole 4 years ago. DIAGNOSES: We initially misdiagnosed her as having monochorionic triamniotic triplets at 10 weeks of gestation. However, we confirmed conjoint twins with the monochorionic diamniotic triplet pregnancy at 12 weeks of gestation and classified them as omphalopagus. INTERVENTIONS: As the woman decided to continue the pregnancy, regular and careful antenatal care was conducted. OUTCOMES: Unexpectedly, she had a stillbirth 3 weeks later and had to terminate the pregnancy at 15 weeks of gestation. After abortion, the diagnosis of omphalopagus was confirmed in the induced fetuses. Moreover, the skin colors of the conjoined twins were different: one was plethoric, and the other was pale. Additionally, the parents agreed to examine the chromosome of the fetuses, and the results were normal. CONCLUSION: Dichorionic triplet and monochorionic triplet pregnancies have a poorer prognosis than trichorionic triplet pregnancies. Surgery is the main therapy for conjoined twins; however, most conjoined twins in triplet pregnancies cannot survive, including omphalopagus twins. The conjoined twins may have suffered from twin anemia-polycythemia sequence, which could probably not be diagnosed intrauterine. Transvaginal probe and 3-dimensional ultrasound may be helpful for clarifying the diagnosis in early pregnancy.


Asunto(s)
Trillizos , Gemelos Siameses , Aborto Eugénico , Adulto , Femenino , Humanos , Embarazo , Embarazo Triple , Mortinato , Ultrasonografía Doppler en Color , Ultrasonografía Prenatal
12.
Vasc Endovascular Surg ; 55(4): 422-423, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33461431

RESUMEN

Vascular calcification represents a group of several pathological states of differing aetiologies. Mönckeberg medial sclerosis is considered to be more widespread in the lower abdominal region and lower limbs. We present a 59-years-old male patient presented right foot gangrene. At physical exploration, femoral and popliteal pulses were presented and the ankle-brachial pressure index was 0.45, and the toe-brachial index was 0.33. The patient underwent distal angioplasty of anterior and posterior tibial arteries and due to inaccurate evolution a transmetatarsal amputation was required. Mönckeberg's medial sclerosis is diagnosed with an ABI>1.1, however, questions have been raised about the validity and the role of ABI in diagnosis of Mönckeberg's medial sclerosis. Colour-doppler vascular ultrasound allow a non-invasive technique widely available to detect vascular calcification and to differentiation between Mönckeberg's medial sclerosis and the atherosclerosis-related lesions.


Asunto(s)
Índice Tobillo Braquial , Extremidad Inferior/irrigación sanguínea , Esclerosis Calcificante de la Media de Monckeberg/diagnóstico , Ultrasonografía Doppler en Color , Amputación , Angioplastia , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana Edad , Esclerosis Calcificante de la Media de Monckeberg/diagnóstico por imagen , Esclerosis Calcificante de la Media de Monckeberg/fisiopatología , Esclerosis Calcificante de la Media de Monckeberg/terapia , Valor Predictivo de las Pruebas
13.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 52(1): 149-152, 2021 Jan.
Artículo en Chino | MEDLINE | ID: mdl-33474905

RESUMEN

Objective: This study investigated the clinicopathological traits and ultrasound features of female reproductive system extraosseous Ewing's sarcoma (EES) and explored the diagnostic value of ultrasonography for this condition. Methods: Cases of female pelvic EES diagnosed and treated at our hospital between June 2009 and June 2019 were included in this study. Pathology data and ultrasound manifestations were assessed retrospectively to summarize the clinical traits and ultrasound features of female reproductive system EES. Based on the results, recommendations for the ultrasonography-based diagnosis of this disease were proposed. Results: During the 10-year study period, 13 female patients were diagnosed with EES in the pelvic cavity based on the results of postoperative pathology tests. The age of the patients ranged from 8 mouth to 40 years, and no patients demonstrated specific clinical symptoms. However, an examination of tumor biomarkers revealed that certain patients had elevated levels of CA125. In the 13 patients, 19 lesions were identified, including 16 that involved the reproductive system. The primary ultrasound manifestation was uneven, low-echo solidity or cystic solidity, exhibiting large size, irregular shape, and unclear boundary. A few patients had concurrent ascites. Although some lesions lacked blood supply, the blood supply of most lesions was medium to abundant, and the blood flow was mostly characterized by low resistant. Almost none of the lesions were definitively diagnosed preoperatively. Conclusions: Preoperative definitive diagnosis of EES in the female reproductive system remains a great clinical challenge. Although certain clinical traits and ultrasound features are associated with this disease, and color Doppler ultrasonography might provide vital information indicating the presence of EES, the final diagnosis still depends on the pathological test results of the patients.


Asunto(s)
Sarcoma de Ewing , Niño , Femenino , Genitales Femeninos , Humanos , Estudios Retrospectivos , Sarcoma de Ewing/diagnóstico por imagen , Ultrasonografía , Ultrasonografía Doppler en Color
14.
BMJ Case Rep ; 14(1)2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33452066

RESUMEN

A 53-year-old man with diabetes came to the emergency department with fever and dry cough for 5 days, swelling of the left leg for 2 days, shortness of breath and chest pain for 1 hour. He had raised temperature, tachycardia, tachypnoea, reduced oxygen saturation and swollen tender left leg on examination. The frontal chest radiograph showed bilateral ground-glass opacities; he tested positive for COVID-19 with elevated D-dimer. The colour Doppler examination of the left leg revealed acute deep vein thrombosis (DVT) of the common femoral and the popliteal veins. The chest CT showed bilateral diffuse ground-glass opacities predominantly involving peripheral zones and the lower lobes. The CTPA revealed left pulmonary thromboembolism (PTE), treated with low-molecular-weight heparin. COVID-19 predominantly affects the respiratory system. DVT and PTE are common in COVID-19 but lethal. They should be diagnosed early by clinical and radiological examinations and treated promptly with anticoagulants.


Asunto(s)
/complicaciones , Embolia Pulmonar/etiología , Trombosis de la Vena/etiología , Adenosina Monofosfato/análogos & derivados , Adenosina Monofosfato/uso terapéutico , Alanina/análogos & derivados , Alanina/uso terapéutico , Antibacterianos/uso terapéutico , Anticoagulantes/uso terapéutico , Antiparasitarios/uso terapéutico , Antivirales/uso terapéutico , /diagnóstico , /terapia , Angiografía por Tomografía Computarizada , Diabetes Mellitus Tipo 2/complicaciones , Doxiciclina/uso terapéutico , Vena Femoral , Productos de Degradación de Fibrina-Fibrinógeno , Glucocorticoides/uso terapéutico , Heparina de Bajo-Peso-Molecular/uso terapéutico , Humanos , Ivermectina/uso terapéutico , Masculino , Metilprednisolona/uso terapéutico , Persona de Mediana Edad , Terapia por Inhalación de Oxígeno , Vena Poplítea , Embolia Pulmonar/diagnóstico por imagen , Embolia Pulmonar/terapia , Tomografía Computarizada por Rayos X , Ultrasonografía Doppler en Color , Trombosis de la Vena/diagnóstico por imagen , Trombosis de la Vena/terapia
15.
BMC Surg ; 21(1): 30, 2021 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-33413245

RESUMEN

BACKGROUND: A hibernoma, also known as a brown fat tumor, is a rare benign soft tissue tumor, which originates from brown adipose tissue remaining in the fetus after the gestational period. It is often detected in adult men, presenting as a painless slow-growing mass. Hibernomas of the thigh have been reported; however, motor and sensory disorders caused by the tumors compressing the femoral nerve have not been reported. We report a case of a histopathologically proven hibernoma that induced femoral mononeuropathy. CASE PRESENTATION: A 26-year-old man was admitted to the hospital due to a mass, approximately 11.0 × 9.0 × 4.0 cm in size, that had developed 5 years ago in the anterolateral aspect of the proximal thigh. Furthermore, he had a history of hypoesthesia 1 month prior to his admission. He had signs and symptoms of both a motor and sensory disorder, involving the anterior aspect of the right thigh and the medial aspect of the calf, along the distribution of the femoral nerve. During surgery, the femoral nerve was found to be compressed by the giant tumor. The resultant symptoms probably caused the patient to seek medical care. Marginal resection of the mass was performed by careful dissection, and the branches of the femoral nerve were spared. Histopathology examination showed findings suggestive of a hibernoma. At the 4-month follow-up, no femoral nerve compression was evident, and local tumor recurrence or metastasis was not found. CONCLUSIONS: Asymptomatic hibernomas do not require treatment; however, in cases of hibernomas with apparent symptoms, complete marginal surgical excision at an early stage is a treatment option because it is associated with a low risk of postoperative tumor recurrence.


Asunto(s)
Nervio Femoral/cirugía , Neuropatía Femoral/diagnóstico por imagen , Neuropatía Femoral/cirugía , Lipoma/complicaciones , Lipoma/patología , Adulto , Neuropatía Femoral/etiología , Neuropatía Femoral/patología , Humanos , Lipoma/diagnóstico , Lipoma/cirugía , Imagen por Resonancia Magnética , Masculino , Recurrencia Local de Neoplasia , Muslo , Resultado del Tratamiento , Ultrasonografía Doppler en Color
17.
J Stroke Cerebrovasc Dis ; 30(4): 105607, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33461025

RESUMEN

PURPOSE: The aim of this study was to assess the effects of neck radiation on the results of Doppler sonography of carotid arteries in head and neck cancer patients. METHODS: In this prospective, cross-sectional study, 25 consecutive patients with head and neck cancers were assessed for carotid artery stenosis (CAS) by carotid color Doppler sonography before external radiotherapy and six months after external radiotherapy. Main outcome measures were peak systolic velocity (PSVs), end-diastolic velocities (EDVs) of the internal carotid artery (ICA), ICA/common carotid (CCA) ratios, and degree of stenosis. RESULTS: The age of the enrolled patients at the initiation of radiotherapy was 57.9±11.8 years (mean±SD; range, 43-91 years), and only 4 (16%) of the 25 patients were female. The findings showed significant changes in the plaque degree and stenosis degree, and plaque size before and after external radiotherapy (P<0.05). Changes in degree of stenosis were significantly correlated with age (p=0.021). CONCLUSION: After neck irradiation changes in the carotid artery may occur and cause subsequent neurologic events.


Asunto(s)
Arterias Carótidas/diagnóstico por imagen , Estenosis Carotídea/diagnóstico por imagen , Irradiación Craneana/efectos adversos , Neoplasias de Cabeza y Cuello/radioterapia , Traumatismos por Radiación/diagnóstico por imagen , Ultrasonografía Doppler en Color , Adulto , Anciano , Anciano de 80 o más Años , Arterias Carótidas/efectos de la radiación , Estenosis Carotídea/etiología , Bases de Datos Factuales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Prospectivos , Traumatismos por Radiación/etiología , Factores de Riesgo , Factores de Tiempo
18.
J Stroke Cerebrovasc Dis ; 30(4): 105601, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33497936

RESUMEN

OBJECTIVES: The diagnosis of giant cell arteritis (GCA) is based on the presence of clinical and laboratory features. Color-duplex sonography (CDS) may supplant the limited sensitivity of temporal artery biopsy. The aim of our work was to characterize clinical and laboratory findings in patients with positive CDS for GCA. MATERIALS AND METHODS: Retrospective study of all consecutive patients of our center fulfilling American College of Rheumatology criteria for GCA who performed CDS study between 2009-2019. Data on clinical and laboratory features were compared in two groups: with and without halo sign. RESULTS: Ninety-one patients were included. Temporal halo sign was identified in 46% of patients. Halo sign was more often present in older patients (77 ± 8 vs 73 ± 8 years, p = 0.022), associated with systemic features (58% vs 42%, p = 0.011), higher erythrocyte sedimentation rate (84 ± 26 vs 74 ± 34 mm/hour, p = 0.020), and lower hemoglobin values (10.9 ± 1.5 vs 12.1 ± 1.6 g/dL, p < 0.001). The number of patients under corticosteroids before CDS was higher in the group without halo (62% vs 33%, p = 0.005). Ischemic stroke occurred in 17 patients (19%), 76% in the vertebrobasilar territory, and stroke was associated with vertebral halo sign (p < 0.001). CONCLUSIONS: Halo sign was present in half of our patients. Previous corticosteroids treatment decreased positive CDS findings. Systemic symptoms and laboratory findings are more notorious in halo sign subgroup of patients. Stroke cases in GCA patients disproportionally affected the posterior circulation. Ultrasonography provides information about a more pronounced systemic involvement and a higher risk of major complications.


Asunto(s)
Arteritis de Células Gigantes/diagnóstico por imagen , Arterias Temporales/diagnóstico por imagen , Ultrasonografía Doppler en Color , Ultrasonografía Doppler Transcraneal , Corticoesteroides/uso terapéutico , Anciano , Anciano de 80 o más Años , Biopsia , Femenino , Arteritis de Células Gigantes/complicaciones , Arteritis de Células Gigantes/tratamiento farmacológico , Arteritis de Células Gigantes/patología , Humanos , /etiología , Masculino , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Arterias Temporales/patología
19.
Medicina (Kaunas) ; 57(1)2021 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-33435540

RESUMEN

The detection of a renal mass is a relatively frequent occurrence in the daily practice of any Radiology Department. The diagnostic approaches depend on whether the lesion is cystic or solid. Cystic lesions can be managed using the Bosniak classification, while management of solid lesions depends on whether the lesion is well-defined or infiltrative. The approach to well-defined lesions focuses mainly on the differentiation between renal cancer and benign tumors such as angiomyolipoma (AML) and oncocytoma. Differential diagnosis of infiltrative lesions is wider, including primary and secondary malignancies and inflammatory disease, and knowledge of the patient history is essential. Radiologists may establish a possible differential diagnosis based on the imaging features of the renal masses and the clinical history. The aim of this review is to present the contribution of the different imaging techniques and image guided biopsies in the diagnostic management of cystic and solid renal lesions.


Asunto(s)
Enfermedades Renales/diagnóstico por imagen , Neoplasias Renales/diagnóstico por imagen , Absceso/diagnóstico por imagen , Adenoma/diagnóstico por imagen , Adenoma Oxifílico/diagnóstico por imagen , Angiomiolipoma/diagnóstico por imagen , Carcinoma de Células Renales/diagnóstico por imagen , Carcinoma de Células Transicionales/diagnóstico por imagen , Medios de Contraste , Quistes/clasificación , Quistes/diagnóstico por imagen , Humanos , Leiomioma/diagnóstico por imagen , Linfoma/diagnóstico por imagen , Imagen por Resonancia Magnética , Plasmacitoma/diagnóstico por imagen , Pielonefritis/diagnóstico por imagen , Pielonefritis Xantogranulomatosa/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Ultrasonografía , Ultrasonografía Doppler en Color
20.
Am J Otolaryngol ; 42(1): 102819, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33157312

RESUMEN

PURPOSE: Preoperative imaging in patients with primary hyperparathyroidism provides important localization information, allowing the surgeon to perform a focused surgery. However there are no evidence-based guidelines suggesting which preoperative imaging should be used, resulting in a risk of excessive prescription of exams and waste of economic resources. The main purpose of this study was to describe our experience on the performance of various imaging techniques for the preoperative localization of abnormal parathyroid gland/s, with a focus on the sensitivity and specificity of each technique. Secondly, we carried out an analysis of the cost utility of each technique in order to determine the most clinical and cost-effective combination of localization studies. MATERIALS AND METHODS: Records of 336 patients who underwent parathyroidectomy were retrospectively examined comparing imaging and intraoperative/histopathologic findings to evaluate the accuracy in parathyroid detection of each imaging technique. Costs were determined by regional health system reimbursement. RESULTS: We found that the sensitivity of color Doppler US was significantly higher than SPECT (p 0,023), while the sensitivity of 4D-CT was significantly better than US (p 0,029) and SPECT (p 0,0002). CONCLUSIONS: In experienced hands color Doppler US is a highly sensitive technique especially in patients with no thyroid diseases. In patients with concomitant thyroid pathology, the combination of US and 4D-CT represents a reliable localization technique.


Asunto(s)
Diagnóstico por Imagen/métodos , Hipertiroidismo/diagnóstico por imagen , Hipertiroidismo/cirugía , Glándulas Paratiroides/diagnóstico por imagen , Glándulas Paratiroides/cirugía , Paratiroidectomía/métodos , Cuidados Preoperatorios , Centros de Atención Terciaria , Análisis Costo-Beneficio , Diagnóstico por Imagen/economía , Femenino , Humanos , Imagenología Tridimensional , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Sensibilidad y Especificidad , Tomografía Computarizada de Emisión de Fotón Único , Tomografía Computarizada por Rayos X , Ultrasonografía Doppler en Color
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