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1.
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 35(3): 272-273;281, 2021 Mar.
Artículo en Chino | MEDLINE | ID: mdl-33794618

RESUMEN

The rare entity of primary T-cell lymphoma of thyroid gland may pose great diagnostic challenges to the clinician. We report a case of malignant T-cell lymphoma of the thyroid gland that developed in a 36-year-old man with a past history of Hashimoto's thyroiditis. The chief complaint was a rapidly growing neck mass and pressure symptoms. This man, diagnosed with Hashimoto's thyroiditis for the previous several years. CT and ultrasonographic examination revealed a diffuse large thyroid gland with cervical lymphadenopathy. It was suspected that thyroid lymphoma involved regional lymph nodes. Fine needle aspiration cytology diagnosed chronic thyroiditis, and ultrasound-guided core needle biopsy was performed. Finally, peripheral T cell lymphoma was diagnosed.


Asunto(s)
Enfermedad de Hashimoto , Linfoma de Células T , Neoplasias de la Tiroides , Adulto , Biopsia con Aguja Gruesa , Enfermedad de Hashimoto/diagnóstico por imagen , Humanos , Masculino , Neoplasias de la Tiroides/diagnóstico por imagen , Ultrasonografía Intervencional
2.
Anticancer Res ; 41(4): 2183-2186, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33813431

RESUMEN

BACKGROUND/AIM: The aim of this study was to identify simple and reliable factors to detect clinically insignificant prostate cancer (PC) for avoiding immediate prostate biopsies using biparametric magnetic resonance imaging (MRI), which consists of T2-weighted and diffusion-weighted imaging. PATIENTS AND METHODS: We retrospectively evaluated 427 men with suspected PC, who underwent biparametric MRI and standard 12-core transrectal prostate biopsy. MRI and prostate specific antigen density (PSAD) were analysed. To evaluate the combination of the two parameters, patients were divided into three groups (Group A: MRI negative and PSAD <0.23, Group B: MRI positive or PSAD ≥0.23, Group C: MRI positive and PSAD ≥0.23). A grade of ≥2 was defined as clinically significant PC. RESULTS: Clinically significant PC was detected in 46.5% of men with positive MRI findings, and 60.0% of men with PSAD ≥0.23. When combining MRI and PSAD, detection rates of clinically significant PC were 10.0%, 28.4% and 65.3% in group A, B and, C, respectively. CONCLUSION: Negative biparametric MRI findings with PSAD <0.23 might be a reliable evidence for avoiding immediate prostate biopsies.


Asunto(s)
Imagen por Resonancia Magnética/métodos , Antígeno Prostático Específico/análisis , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/patología , Adulto , Anciano , Anciano de 80 o más Años , Biopsia con Aguja Gruesa/métodos , Imagen de Difusión por Resonancia Magnética , Humanos , Biopsia Guiada por Imagen , Pruebas Inmunológicas , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Cuidados Preoperatorios , Próstata/patología , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/metabolismo , Estudios Retrospectivos , Carga Tumoral , Ultrasonografía Intervencional
4.
Kardiologiia ; 60(12): 64-75, 2021 Jan 19.
Artículo en Ruso | MEDLINE | ID: mdl-33522469

RESUMEN

Aim      To evaluate structural characteristics of atherosclerotic plaques (ASP) by coronary computed tomography arteriography (CCTA) and intravascular ultrasound (IVUS).Material and methods  This study included 37 patients with acute coronary syndrome (ACS). 64-detector-row CCTA, coronarography, and grayscale IVUS were performed prior to coronary stenting. The ASP length and burden, remodeling index (RI), and known CT signs of unstable ASP (presence of dot calcification, positive remodeling of the artery in the ASP area, irregular plaque contour, presence of a peripheral high-density ring and a low-density patch in the ASP). The ASP type and signs of rupture or thrombosis were determined by IVUS.Results The IVUS study revealed 45 unstable ASP (UASP), including 25 UASP with rupture and 20 thin-cap fibroatheromas (TCFA), and 13 stable ASP (SASP). No significant differences were found between distribution of TCFA and ASP with rupture among symptom-associated plaques (SAP, n=28) and non-symptom-associated plaques (NSAP, n=30). They were found in 82.1 and 73.3 % of cases, respectively (p>0.05), which indicated generalization of the ASP destabilization process in the coronary circulation. However, the incidence of mural thrombus was higher for SAP (53.5 and 16.6 % of ASP, respectively; p<0.001). There was no difference between UASP and SASP in the incidence of qualitative ASP characteristics or in values of quantitative ASP characteristics, including known signs of instability, except for the irregular contour, which was observed in 92.9 % of UASP and 46.1 % of SASP (p=0.0007), and patches with X-ray density ≤46 HU, which were detected in 83.3 % of UASP and 46.1 % of SASP (р=0.01). The presence of these CT criteria 11- and 7-fold increased the likelihood of unstable ASP (odd ratio (OR), 11.1 at 95 % confidence interval (CI), from 2.24 to 55.33 and OR, 7.0 at 95 % CI, from 5.63 to 8.37 for the former and the latter criterion, respectively).Conclusion      According to IVUS data, two X-ray signs are most characteristic for UASP, the irregular contour and a patch with X-ray density ≤46 HU. The presence of these signs 11- and 7-fold, respectively, increases the likelihood of unstable ASP.


Asunto(s)
Síndrome Coronario Agudo , Enfermedad de la Arteria Coronaria , Placa Aterosclerótica , Síndrome Coronario Agudo/diagnóstico por imagen , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Vasos Coronarios/diagnóstico por imagen , Humanos , Placa Aterosclerótica/diagnóstico , Tomografía Computarizada por Rayos X , Ultrasonografía Intervencional
5.
Bone Joint J ; 103-B(2): 353-359, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33517741

RESUMEN

AIMS: Ultrasound (US)-guided injections are widely used in patients with conditions of the shoulder in order to improve their accuracy. However, the clinical efficacy of US-guided injections compared with blind injections remains controversial. The aim of this study was to compare the accuracy and efficacy of US-guided compared with blind corticosteroid injections into the glenohumeral joint in patients with primary frozen shoulder (FS). METHODS: Intra-articular corticosteroid injections were administered to 90 patients primary FS, who were randomly assigned to either an US-guided (n = 45) or a blind technique (n = 45), by a shoulder specialist. Immediately after injection, fluoroscopic images were obtained to assess the accuracy of the injection. The outcome was assessed using a visual analogue scale (VAS) for pain, the American Shoulder and Elbow Surgeons (ASES) score, the subjective shoulder value (SSV) and range of movement (ROM) for all patients at the time of presentation and at three, six, and 12 weeks after injection. RESULTS: The accuracy of injection in the US and blind groups was 100% (45/45) and 71.1% (32/45), respectively; this difference was significant (p < 0.001). Both groups had significant improvements in VAS pain score, ASES score, SSV, forward flexion, abduction, external rotation, and internal rotation throughout follow-up until 12 weeks after injection (all p < 0.001). There were no significant differences between the VAS pain scores, the ASES score, the SSV and all ROMs between the two groups at the time points assessed (all p > 0.05). No injection-related adverse effects were noted in either group. CONCLUSION: We found no significant differences in pain and functional outcomes between the two groups, although an US-guided injection was associated with greater accuracy. Considering that it is both costly and time-consuming, an US-guided intra-articular injection of corticosteroid seems not always to be necessary in the treatment of FS as it gives similar outcomes as a blind injection. Cite this article: Bone Joint J 2021;103-B(2):353-359.


Asunto(s)
Corticoesteroides/administración & dosificación , Antiinflamatorios/administración & dosificación , Bursitis/tratamiento farmacológico , Ultrasonografía Intervencional , Corticoesteroides/uso terapéutico , Adulto , Anciano , Antiinflamatorios/uso terapéutico , Bursitis/diagnóstico por imagen , Método Doble Ciego , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Intraarticulares/métodos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Resultado del Tratamiento
6.
Medicine (Baltimore) ; 100(3): e23175, 2021 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-33545925

RESUMEN

ABSTRACT: Hydrogen peroxide is a liquid that functions in mechanical removal of the necrotic tissue via the elimination of tissue debris.In this study, we aimed to evaluate the effectiveness of the use of hydrogen peroxide in necrosectomy treatment of walled-off pancreatic necrosis.Records of 24 patients who were diagnosed with pancreatic necrosis or walled-off pancreatic necrosis and underwent endoscopic necrosectomy (EN) were retrospectively assessed. Patients were divided into 2 groups; hydrogen peroxide used for treatment or not used, and these 2 groups were compared.A total of 24 patients underwent endoscopic intervention for walled-off pancreatic necrosis. Procedural success was comparable between the 2 groups. During the post-procedural follow-up, the duration of the hospital stay, recurrence, and complication rates were found to be similar in both groups. The mean number of the endoscopic interventions was significantly lower in the hydrogen peroxide group (4.2 ±â€Š1.4 vs 6.1 ±â€Š4.2; P = .01).The use of hydrogen peroxide for EN in walled-off pancreatic necrosis patients seems to have similar efficiency and safety. However, it can be said that the use of hydrogen peroxide could reduce the number of endoscopic procedures.


Asunto(s)
Peróxido de Hidrógeno/administración & dosificación , Oxidantes/administración & dosificación , Pancreatitis Aguda Necrotizante/cirugía , Endosonografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pancreatitis Aguda Necrotizante/diagnóstico por imagen , Estudios Retrospectivos , Resultado del Tratamiento , Ultrasonografía Intervencional
7.
Radiol Clin North Am ; 59(2): 291-303, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33551088

RESUMEN

Optimal assessment of the mediastinal masses is performed by a combination of clinical, radiological and often histological assessments. Image-guided transthoracic biopsy of mediastinal lesions is a minimally invasive and reliable procedure to obtain tissue samples, establish a diagnosis and provide a treatment plan. Biopsy can be performed under Computed Tomography, MRI, or ultrasound guidance, using a fine needle aspiration or a core-needle. In this paper, we review the image-guided strategies and techniques for histologic sampling of mediastinal lesions, along with the related clinical scenarios and possible procedural complications. In addition, image-guided mediastinal drainage and mediastinal ablations will be briefly discussed.


Asunto(s)
Técnicas de Ablación/métodos , Neoplasias del Mediastino/patología , Neoplasias del Mediastino/cirugía , Mediastino/diagnóstico por imagen , Radiografía Intervencional/métodos , Radiología Intervencional/métodos , Humanos , Biopsia Guiada por Imagen , Imagen por Resonancia Magnética/métodos , Neoplasias del Mediastino/diagnóstico por imagen , Mediastino/patología , Mediastino/cirugía , Tomografía Computarizada por Rayos X/métodos , Ultrasonografía Intervencional/métodos
8.
Ther Umsch ; 78(1): 11-15, 2021 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-33538632

RESUMEN

Intracoronary imaging - an essential tool on the way to an individualized therapy of coronary artery disease? Abstract. Since decades, coronary angiography is the standard method to assess coronary anatomy and guide percutaneous coronary intervention. However, coronary angiography is limited to the lumen and a resolution of 200 - 300 micrometers. Thus, anything beyond is not detectable. Intracoronary imaging methods by means of intravascular ultrasound (IVUS) and particularly optical coherence tomography (OCT), provide incremental effects on coronary diagnostics and therapeutic decisions. Plaque burden and -composition (lipid, fibrous, calcific tissue, intramural hematoma), small intraluminal structures (thrombus), and implanted stents are uniquely detectable by intracoronary imaging. The use of these techniques inevitably leads to improved precision in coronary diagnostics and optimization of stent implantation.


Asunto(s)
Enfermedad de la Arteria Coronaria , Intervención Coronaria Percutánea , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/terapia , Humanos , Stents , Ultrasonografía Intervencional
9.
Zhonghua Zhong Liu Za Zhi ; 43(2): 188-193, 2021 Feb 23.
Artículo en Chino | MEDLINE | ID: mdl-33601483

RESUMEN

Objective: To explore the effective mode of ultrasound-guided radiofrequency ablation for the treatment of hepatocellular carcinoma (HCC). Methods: The morphological changes of human liver cancer cells HepG2 and human permanent liver cells LO2 after high temperature treatment were observed. The cell counting kit 8 (CCK-8) array was used to detect cell proliferation ability. The HepG2 cells (ΔHepG2 cells) and LO2 cells (ΔLO2 cells) those were still alive after treatment with 47℃ were collected and subjected to secondary high temperature treatment, and their proliferation ability was tested by the CCK-8 array. The ablation was performed at different locations of the ex-vivo porcine liver. The consistency of the vaporization area of the ultrasound image with that of the actual ablation was compared, the temperature of each area in the ultrasonic image was observed. Results: After incubated water was heated to 50℃, with the extension of the culture time, the number of adherent cells of HepG2 and LO2 cells became less and less, and gradually lost their normal cell morphology. After 50℃ and above, all of the proliferation rates of HepG2 cells, LO2 cells, ΔHepG2 cells and ΔLO2 cells were decreased. Compared with the 37℃ group, the differences were statistically significant (P<0.05), and the cells were irreversible damaged. There was no significant difference between the transverse diameters of the sonographic vaporization zones and the actual ablation zones (P>0.05). Nine minutes was considered to be an effective ablation time point since the temperatures in the hyperechoic areas were all above 53℃. Conclusion: The HCC cells within the vaporization zone observed by ultrasound can be damaged irreversibly when they were effectively ablated for over 9 minutes at 105℃ and 200 W.


Asunto(s)
Carcinoma Hepatocelular , Ablación por Catéter , Neoplasias Hepáticas , Animales , Carcinoma Hepatocelular/diagnóstico por imagen , Carcinoma Hepatocelular/cirugía , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/cirugía , Ablación por Radiofrecuencia , Porcinos , Ultrasonografía Intervencional
10.
Zhonghua Yi Xue Za Zhi ; 101(6): 416-420, 2021 Feb 09.
Artículo en Chino | MEDLINE | ID: mdl-33611891

RESUMEN

Objective: To summarize the clinical effect of ultrasound-guided percutaneous transluminal angioplasty (PTA) in the treatment of arteriovenous fistula (AVF) immaturation under day surgery mode. Methods: The clinical data was retrospective analyzed of patients with AVF immaturation who were treated by ultrasound-guided PTA under day surgery mode from November 2016 to June 2019 in Renji Hospital. The basic information, lesion location, puncture approach, number and diameter of balloon used were counted. The primary and secondary patency rates were calculated at 6 and 12 months after operation. Results: In all of the 21 patients, 11 patients were male and 10 patients were female. The mean age was (52.6±12.9) years old. There were 20 of the 21 patients who were treated successfully. One patient had AVF reconstruction with vascular rupture, and the complication rate was 4.8% (1/21). The length of hospitalization was (1.05±0.71) days, and the cost was (11 487.7±4 401.4) yuan. The follow-up time was (19.7±8.3) months. The 6-month and 12-month primary patency rate were 70% and 55%, and the 6-month and 12-month secondary patency rate were both 90%. Conclusion: Ultrasound-guided PTA in the treatment of AVF immaturation under day surgery mode is safe and effective, which has a high technical success rate and good patency rate for AVF maturation.


Asunto(s)
Angioplastia de Balón , Fístula Arteriovenosa , Derivación Arteriovenosa Quirúrgica , Adulto , Anciano , Procedimientos Quirúrgicos Ambulatorios , Angioplastia , Fístula Arteriovenosa/diagnóstico por imagen , Fístula Arteriovenosa/terapia , Femenino , Oclusión de Injerto Vascular , Humanos , Masculino , Persona de Mediana Edad , Diálisis Renal , Estudios Retrospectivos , Resultado del Tratamiento , Ultrasonografía Intervencional , Grado de Desobstrucción Vascular
12.
Zhonghua Xin Xue Guan Bing Za Zhi ; 49(2): 136-142, 2021 Feb 24.
Artículo en Chino | MEDLINE | ID: mdl-33611899

RESUMEN

Objective: To explore the long-term effect of intravascular ultrasound (IVUS) guidance on patients with chronic kidney disease (CKD) undergoing drug-eluting stent (DES) implantation. Methods: Data used in this study derived from ULTIMATE trial, which was a prospective, multicenter, randomized study. From August 2014 to May 2017, 1 448 patients with coronary heart disease undergoing DES implantation were selected from 8 domestic centers and randomly divided into two groups in the ratio of 1∶1 (IVUS or coronary angiography guided stent implantation). A total of 1 443 patients with the baseline serum creatine available were enrolled. The patients were divided into CKD group and non CKD group. CKD was defined as the estimated glomerular filtration rate (eGFR) derived from Cockcroft Gault (CG) formula< 60 ml·min-1·1.73 m-2 for at least 3 months. Primary endpoint of this study was target vessel failure (TVF) at 3 years, including cardiac death, target vessel myocardial infarction, and clinically-driven target vessel revascularization. Kaplan Meier method was used for survival analysis, and log rank test was used to compare the occurrence of end-point events in each group. Cox proportional hazards model was used to calculate HR and 95%CI, and interaction was tested. Multivariate Cox regression was used to analyze the independent influencing factors of TVF. Results: A total of 1 443 patients with coronary heart disease were enrolled in this study, including 349 (24.2%) patients in CKD group and 1 094 patients in non CKD group. In CKD group, IVUS was used to guide stent implantation in 180 cases and angiography was used in 169 cases; in non CKD group, IVUS was used to guide stent implantation in 543 cases and angiography was used in 551 cases. Three-year clinical follow-up was available in 1 418 patients (98.3%). The incidence of TVF in CKD group was 12.0% (42/349), which was higher than that in non CKD group (7.4% (81/1 094) (P = 0.01). The difference was mainly due to the higher cardiac mortality in CKD group (4.6% (16/349) vs. 1.5% (16/1094), P<0.001). In CKD group, the incidence of TVF in patients who underwent IVUS guided stent implantation was lower than that in angiography guided stent implantation (8.3% (15/180) vs. 16.0% (27/169), P = 0.03). There was no significant difference in the incidence of TVF between IVUS guided stent implantation and angiography guided stent implantation in non CKD group (5.9% (32/543) vs. 8.9% (49/551), P = 0.06), and there was no interaction (P = 0.47). Multivariate Cox regression analysis showed that IVUS guidance (HR = 0.56, 95%CI 0.39-0.81, P = 0.002), CKD (HR = 1.83, 95%CI 1.17-2.87, P = 0.010) and stent length (every 10 mm increase) (HR = 1.11, 95%CI 1.04-1.19, P = 0.002) were independent risk factors for TVF within 3 years after DES implantation. Conclusions: CKD patients undergoing DES implantation are associated with a higher risk of 3-year TVF. More importantly, the risk of TVF could be significantly decreased through IVUS guidance in comparison with angiography guidance in patients with CKD.


Asunto(s)
Enfermedad de la Arteria Coronaria , Stents Liberadores de Fármacos , Intervención Coronaria Percutánea , Insuficiencia Renal Crónica , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/cirugía , Humanos , Estudios Prospectivos , Resultado del Tratamiento , Ultrasonografía Intervencional
13.
Medicine (Baltimore) ; 100(7): e24786, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-33607831

RESUMEN

INTRODUCTION: Routine anesthesia modality for modified radical mastectomy (MRM) includes general anesthesia (GA), epidural blockade-combined GA and nerve blockade-combined GA. However, GA has been associated with postoperative adverse effects such as vertigo, postoperative nausea and vomiting and requirement for postoperative analgesia, which hinders recovery and prognosis. Moreover, combined blockade of thoracic paravertebral nerves or intercostal nerves and adjuvant basic sedation for massive lumpectomy provided perfect anesthesia and reduced opioid consumption, whereas the excision coverage did not attain the target of MRM. Regional anesthesia strategies involving supplementation of analgesics in ultrasound-guided multiple nerve blocks have garnered interests of clinicians. Nevertheless, the precise effects of intercostal nerves, brachial plexus and supraclavicular nerves in MRM in patients with breast cancer remain obscure. METHODS: Eighty female patients with breast cancer scheduled for MRM were recruited in the present trial between May, 2019 and Dec., 2019 in our hospital. The patients ranged from 30 to 65 years of age and 18∼30 kg/m2 in body-mass index, with the American Society of Anesthesiologists I or II. The patients were randomized to ultrasound-guided multiple nerve blocks group and GA group. The patients in multiple nerve blocks group underwent ultrasound guided multiple intercostal nerve blocks, interscalene brachial plexus and supraclavicular nerve blocks, (local anesthesia with 0.3% ropivacaine: 5 ml for each intercostal nerve block, 8 ml for brachial plexus block, 7 mL for supraclavicular nerve block) and basic sedation and intraoperative mask oxygen inhalation. The variations of hemodynamic parameters such as mean arterial pressure, heart rate (HR) and pulse oxygen saturation were monitored. The visual analog scale scores were recorded at postoperative 0 hour, 3 hour, 6 hour, 12 hour and 24 hour in resting state. The postoperative adverse effects, including vertigo, postoperative nausea, and vomiting, pruritus, and urinary retention and so on, as well as the analgesic consumption were recorded. CONCLUSIONS: The ultrasound guided multiple intercostal nerve blocks, brachial plexus and supraclavicular nerve blocks could provide favorable anesthesia and analgesia, with noninferiority to GA and the reduced incidence of adverse effects and consumption of postoperative analgesics.


Asunto(s)
Neoplasias de la Mama/cirugía , Sedación Consciente/métodos , Mastectomía Radical Modificada/métodos , Bloqueo Nervioso/métodos , Anestesia General/efectos adversos , Femenino , Humanos , Persona de Mediana Edad , Bloqueo Nervioso/efectos adversos , Dimensión del Dolor , Dolor Postoperatorio/prevención & control , Ultrasonografía Intervencional/métodos
17.
Ultrasonics ; 113: 106364, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33517139

RESUMEN

Synthetic aperture focusing (SAF) and coherence factor weighting (CFW) have been used to improve the lateral resolution of ultrasound images. Although the two methods are effective for array-based ultrasound imaging, many researchers have also employed the methods for single-element-based imaging including intravascular ultrasound (IVUS) imaging. For single-element-based imaging, CFW is generally calculated from the scanlines obtained by SAF and applied to the scanline obtained after coherent summation of the SAF delayed scanlines, which is called a SAF-CFW method. In the paper, a theoretical model was derived to explore the effectiveness of SAF and CFW for single-element-based imaging, and the model was used to explain that SAF is not effective for IVUS imaging in terms of enhancing the spatial resolution, although it has the advantage of improving a contrast-to-noise ratio (CNR). This means that the SAF-CFW method is not optimal for improving the spatial resolution of IVUS imaging. In contrast, it was found in simulations and experiments that applying CFW to the target scanline itself is beneficial for the spatial resolution rather than a coherent summed scanline for IVUS SAF imaging, but CNR was not as good as SAF and SAF-CFW. As a result of both simulation and experimentation, it could be concluded that focused IVUS transducers without the application of those methods may be more advantageous to improve the spatial and contrast resolution simultaneously, considering the system complexity in the implementation of such imaging methods.


Asunto(s)
Aumento de la Imagen/métodos , Transductores , Ultrasonografía Intervencional/métodos , Simulación por Computador , Diseño de Equipo , Procesamiento de Imagen Asistido por Computador , Fantasmas de Imagen , Procesamiento de Señales Asistido por Computador
18.
AJR Am J Roentgenol ; 216(3): 633-639, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33439044

RESUMEN

OBJECTIVE. The purpose of this article was to determine the frequency and outcomes of new suspicious findings on breast MRI after initiation of neoadjuvant therapy. MATERIALS AND METHODS. A retrospective database review identified all breast MRI examinations performed to assess response to neoadjuvant therapy between 2010 and 2018. Cases with new suspicious lesions assessed as BI-RADS 4 or 5 and found after the initiation of neoadjuvant treatment were included. Cases with no pretreatment MRI, cases in which the suspicious lesion was present on the baseline MRI but remained suspicious, and cases with insufficient follow-up were excluded. Radiologic, pathologic, and surgical reports were reviewed. Malignant outcomes were determined by pathologic examination. Benignity was established by pathologic examination, follow-up imaging, or both. A total of 419 breast MRI examinations in 297 women were performed to assess response to neoadjuvant therapy. After exclusions, 23 MRI examinations (5.5%) with new suspicious findings, all assessed as BI-RADS 4, comprised the final cohort. RESULTS. Of the 23 lesions, 13 new suspicious findings (56.5%) were contralateral to the known malignancy, nine (39.1%) were ipsilateral, and one (4.3%) involved the bilateral breasts. Lesion types included mass (16, 69.6%), nonmass enhancement (5, 21.7%) and focus (2, 8.7%). None of the new suspicious findings were malignant. CONCLUSION. New suspicious findings occurred in 5.5% of breast MRI examinations performed to monitor response to neoadjuvant therapy, and none of these new lesions were malignant. Our findings suggest that new lesions that arise in the setting of neoadjuvant therapy are highly unlikely to represent a new site of malignancy, particularly if the index malignancy shows treatment response. Larger studies are needed to confirm whether biopsy may be safely averted in this scenario.


Asunto(s)
Neoplasias de la Mama/terapia , Imagen por Resonancia Magnética/métodos , Terapia Neoadyuvante , Neoplasias Primarias Secundarias/diagnóstico por imagen , Adulto , Anciano , Mama/patología , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Carcinoma Ductal de Mama/diagnóstico por imagen , Carcinoma Ductal de Mama/tratamiento farmacológico , Carcinoma Ductal de Mama/patología , Medios de Contraste , Femenino , Humanos , Biopsia Guiada por Imagen/métodos , Imagen por Resonancia Magnética/estadística & datos numéricos , Imagen por Resonancia Magnética Intervencional/métodos , Persona de Mediana Edad , Neoplasias Primarias Secundarias/patología , Estudios Retrospectivos , Resultado del Tratamiento , Ultrasonografía Intervencional/métodos
19.
Arthroscopy ; 37(1): 136-138, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33384077

RESUMEN

Imaging modalities for hip disorders all have their strengths and weaknesses. Magnetic resonance imaging is superior for evaluating soft tissue pathology, computerized tomography best characterizes osseous morphology, and plain radiographs can accurately depict 2-dimensional anatomy and are familiar to most clinicians. Ultrasound-guided injections have become commonplace in the musculoskeletal arena. Ultrasound evaluation of musculoskeletal anatomy has received increased attention, has the ability to image soft tissue and osseous structures, and more importantly, has the ability to dynamically evaluate these structures in real time. A noninvasive dynamic assessment of the hip region could be an absolute game changer for the hip preservation/sports medicine community in the diagnosis of atypical hip pain, femoroacetabular impingement, and labral tears. Widespread ability and expertise to perform these dynamic ultrasound assessments, however, is not in place at this time. We need more training and studies to best harness the potential benefits of these sound waves.


Asunto(s)
Pinzamiento Femoroacetabular , Artroscopía , Pinzamiento Femoroacetabular/diagnóstico por imagen , Cadera , Articulación de la Cadera/diagnóstico por imagen , Articulación de la Cadera/cirugía , Humanos , Ultrasonografía Intervencional
20.
J Small Anim Pract ; 62(2): 114-122, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33403667

RESUMEN

OBJECTIVES: Cytological biopsies are an integral additional test to an abdominal ultrasound when a lesion is identified, but there is little published on factors that that may impact achieving a clinically useful sample of gastrointestinal lesions obtained by ultrasound-guided fine-needle cytologic biopsy. This retrospective, descriptive study aimed to assess factors that may influence the clinical usefulness of submitted cytological samples collected from gastrointestinal lesions by ultrasound-guided percutaneous fine-needle cytologic biopsy. MATERIAL AND METHODS: Gastrointestinal cytological samples obtained from 25 dogs and 19 cats over 2.5 years were reviewed and determined as clinically useful or clinically useless as per the cytology report. Variables dependent on the ultrasound exam that were used in the analysis included lesion location, lesion thickness, loss of gastrointestinal layering, and the number of slides submitted. RESULTS: Thirty (30/44) of the submitted cytological samples were considered clinically useful. Factors associated with achieving a clinically useful sample in univariable models included the number of slides submitted and the thickness of the lesion. However, these two variables appear inter-related, as a weak correlation existed between them. Where histologic biopsies were obtained, a clinically useful sample had a partial or complete agreement with histology in three of 12 and eight of 12 cases, respectively. CLINICAL SIGNIFICANCE: Ultrasound-guided fine-needle cytological biopsies of gastrointestinal masses provided a clinically useful sample in two-third of the cases, especially if more slides were provided to the cytologist and thicker lesions were sampled.


Asunto(s)
Enfermedades de los Gatos , Enfermedades de los Perros , Animales , Biopsia con Aguja Fina/veterinaria , Enfermedades de los Gatos/diagnóstico por imagen , Gatos , Enfermedades de los Perros/diagnóstico por imagen , Perros , Estudios Retrospectivos , Ultrasonografía Intervencional/veterinaria
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