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2.
Kidney Int ; 99(1): 31-33, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33390238

RESUMEN

Gout is present in one third of subjects with CKD but is usually an exclusion criterion in clinical trials investigating the role of uric acid in kidney disease. Bardin et al. report that one third of gouty subjects have hyperechoic medullas by ultrasound (consistent with crystalline deposits) that correlates with increased risk for hypertension and kidney dysfunction and which were not observed in >500 controls. If validated, a "gouty nephropathy" from microcrystalline deposits could be an important, unrecognized cause of CKD.


Asunto(s)
Gota , Médula Renal , Estudios Transversales , Gota/epidemiología , Humanos , Ultrasonografía , Ácido Úrico
3.
Artículo en Alemán | MEDLINE | ID: mdl-33412604

RESUMEN

Children with complex diseases often need central venous catheter, not only for intraoperative use, but also for parenteral nutrition, multiple blood draw due to lab examination and to administer drugs that cannot be given via peripheral lines. Whereas the landmark driven vascular access was teached for years, nowadays the routine use of ultrasound based techniques can be called the gold standard. This article highlights standard locations for central venous access like cannulation of the internal jugular vein as well as novel alternatives such as the cannulation of the brachiocephalic vein. The correct insertion depth of central lines is essential to avoid serious complications. Several different formulas are available and can be used. Independent of the used formula, you have to make sure that complications due to incorrect depth of central venous line are a topic of the past. Finally, important tips and tricks to avoid failure and serious complications are discussed.


Asunto(s)
Cateterismo Venoso Central , Catéteres Venosos Centrales , Cateterismo Venoso Central/efectos adversos , Catéteres Venosos Centrales/efectos adversos , Niño , Humanos , Venas Yugulares/diagnóstico por imagen , Ultrasonografía
4.
Medicina (Kaunas) ; 57(1)2021 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-33435420

RESUMEN

Background and Objectives: Vesicoureteral reflux (VUR) describes a common pediatric anomaly in pediatric urology with a prevalence of 1-2%. In diagnostics, in addition to the gold standard of voiding cystourethrography (VCUG), contrast-enhanced urosonography (ceVUS) offers a radiation-free procedure, which, despite its advantages, is not yet widely used. In the present single-center study, subsequent therapeutic procedures and outcomes after ceVUS of 49 patients were investigated. The aim of the study is to investigate the efficacy of ceVUS with the intention of broader clinical implementation. Materials and Methods: Between 2016 and 2020, 49 patients were retrospectively included and received a ceVUS to evaluate VUR. With a distribution of 47:2 (95.9%), a clear female predominance was present. The age of the patients varied between 5 months and 60 years at the time of ceVUS. All examinations were all performed and subsequently interpreted by a single experienced radiologist (EFSUMB level 3). Results: Compared to intraoperative findings, ceVUS shows a sensitivity of 95.7% with a specificity of 100%. Allergic reactions to the contrast medium could not be observed. Conclusion: With its high sensitivity and intraoperative validation, ceVUS offers an excellent alternative to VCUG, the gold standard in the diagnosis of VUR. In addition, ceVUS is a radiation-free examination method with a low risk profile that offers an exceptional diagnostic tool in the diagnostic clarification of recurrent urinary tract infections with the suspected diagnosis of VUR and should also be included in the consideration of a diagnosis next to the established VCUG, especially in younger children.


Asunto(s)
Medios de Contraste , Técnicas de Diagnóstico Urológico , Ultrasonografía/métodos , Reflujo Vesicoureteral/diagnóstico por imagen , Adolescente , Adulto , Antibacterianos/uso terapéutico , Niño , Preescolar , Cistografía , Femenino , Humanos , Lactante , Inyecciones , Laparoscopía , Masculino , Persona de Mediana Edad , Fosfolípidos , Politetrafluoroetileno , Exposición a la Radiación , Recurrencia , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Hexafluoruro de Azufre , Ureteroscopía , Uretra/diagnóstico por imagen , Vejiga Urinaria/diagnóstico por imagen , Infecciones Urinarias/etiología , Infecciones Urinarias/prevención & control , Urografía , Reflujo Vesicoureteral/clasificación , Reflujo Vesicoureteral/complicaciones , Reflujo Vesicoureteral/terapia , Adulto Joven
5.
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
6.
Arch Esp Urol ; 74(1): 24-34, 2021 Jan.
Artículo en Español | MEDLINE | ID: mdl-33459619

RESUMEN

Imaging in urolithiasis has a wide group of techniques, with different characteristics, limitations, and indications, which together allow the management of this prevalent pathology. Plain abdominal radiography and ultrasound are very accessible and in expensive techniques that combined present an acceptable sensitivity and specificity. They are widely used for monitoring the evolution of stone disease and for evaluation after treatments (surgery or SWL). Ultrasound is the primary radiological diagnostic tool in the pediatric population and in pregnant women. CT has prevailed over IVP in the anatomical assessment of the urinary tract and the description of the characteristics of the lithiasis, although it shows a greater exposure to ionizing radiation, so the use of low and ultra-low dose CT is spreading. In this article we also discuss other imaging techniques suchas Digital to mosynthesis, Fluoroscopy and DMSA Scintigraphy.


Asunto(s)
Cálculos Urinarios , Urolitiasis , Niño , Diagnóstico por Imagen , Femenino , Humanos , Embarazo , Radiografía , Ultrasonografía , Cálculos Urinarios/diagnóstico por imagen , Urolitiasis/diagnóstico por imagen
7.
Curr Sports Med Rep ; 20(1): 57-61, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33395131

RESUMEN

ABSTRACT: Sports ultrasound (US) is a rapidly advancing and expanding field, where "hands-on" education and real-time instructor feedback are paramount in developing this skill. In light of a global pandemic and limited access to instructors and educational conferences, sports US education must adapt to continue to teach future ultrasonographers. Virtual US education, conducted using various virtual meeting platforms not only allows for continued didactic education but also can virtually recreate the "hands-on" training sessions with live, immediate instructor feedback that is necessary for acquiring competence. Additionally, using these methods, sports US conferences can continue in a virtual manner, sports US education can expand remote areas, and collaboration among distant experts may increase, all without the cost of travel and extended time away from work. While immediately relevant because of the COVID-19 pandemic, virtual US methods may continue to be beneficial as sports US education and collaboration continue to expand.


Asunto(s)
Traumatismos en Atletas/diagnóstico por imagen , Colaboración Intersectorial , Ultrasonografía/tendencias , Realidad Virtual , Predicción , Humanos
8.
Instr Course Lect ; 70: 637-650, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33438941

RESUMEN

Ultrasonography as a diagnostic and therapeutic tool has become a resource for musculoskeletal injuries. It can be a useful imaging modality for clinical correlation of physical examination findings as well as an aid for image-guided procedures. Understanding the settings in which it is a helpful adjunct will have implications on efficiency and cost utility. The objectives of this chapter are to provide a background of ultrasonography as a musculoskeletal imaging modality, provide clinical correlation for ultrasonographic findings for common upper extremity pathology, review the diagnostic efficacy of ultrasonography for image-guided procedures, and provide insight into the cost utility of ultrasonography guidance for therapeutic injections.


Asunto(s)
Enfermedades Musculoesqueléticas , Humanos , Enfermedades Musculoesqueléticas/diagnóstico por imagen , Ultrasonografía , Extremidad Superior/diagnóstico por imagen
9.
Artículo en Chino | MEDLINE | ID: mdl-33472306

RESUMEN

Objective: To analyze the features of degenerating cystic thyroid nodules (DCTN) on conventional ultrasound and contrast-enhanced ultrasound (CEUS), and to explore the differentiation between DCTN and papillary thyroid carcinomas (PTC). Methods: A total of 46 DCTN (39 cases, including 12 males and 27 females, with an age range of 25 to 76 years) and 36 PTC (32 cases, including 8 males and 24 females, with an age range of 23 to 68 years) diagnosed via fine- needle aspiration (FNA) or surgery from February 2019 to January 2020 in the First Affiliated Hospital of Nanchang University were enrolled. The size, shape, margin, echogenicity, presence of shadowing, calcification and vascularity of DCTN and PTC were retrospectively evaluated, and 28 DCTN and 30 PTC underwent CEUS were separately analyzed and compared.The t test, χ² test or Fisher's exact test were implemented to compare the features of ultrasound among the two groups. The binary Logistic regression test was performed to determine whether the feature whose difference was statistically significant was an independent predictive risk factor. Results: A univariate analysis indicated that DCTN more frequently showed wider-than-tall shapes, marked hypoechogenicity, well-defined margin and no or dot-lined enhancement (wider-than-tall shapes: 36 vs. 17, χ2=8.511; well-defined margin: 30 vs. 15, χ2=4.523; marked hypoechogenicity: 27 vs. 9, χ2=9.310; no or dot-lined enhancement: 24 vs. 3, χ2=33.369; all P<0.05). A multivariate analysis demonstrated that wider-than-tall shapes, well-defined margin and marked hypoechogenicity were independent predictors for DCTN (OR values were 5.204, 3.134 and 5.042, P values were 0.003, 0.031, and 0.003, respectively). Among 28 DCTN, 15 showed a decrease in mean maximum diameter (24.3±11.4 mm) with a mean time span of (18.6±10.5) months between the presence and absence of suspicious ultrasound features. Conclusions: Compared with PTC, DCTN shows the ultrasound characteristics of wider-than-tall shapes, well-defined margin, marked hypoechogenicity and no or dot-lined enhancement pattern. Ultrasound follow-up can help to identify spontaneous DCTN.


Asunto(s)
Carcinoma Papilar , Neoplasias de la Tiroides , Nódulo Tiroideo , Adulto , Anciano , Carcinoma Papilar/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Cáncer Papilar Tiroideo/diagnóstico por imagen , Neoplasias de la Tiroides/diagnóstico por imagen , Nódulo Tiroideo/diagnóstico por imagen , Ultrasonografía
11.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 52(1): 104-110, 2021 Jan.
Artículo en Chino | MEDLINE | ID: mdl-33474898

RESUMEN

Objective: To investigate A1 pulley thickness of flexor tendon in healthy volunteers and to analyze its influence factors. Methods: The study included 90 healthy volunteers and the A1 pulley thickness at bilateral fingers was measured using high frequency ultrasound. The following parameters were recorded for each participant: age, gender, weight, height, body mass index (BMI). Results: High-frequency ultrasound can clearly show A1 pulley. There was no significant difference in A1 pulley thickness between the bilateral fingers ( P>0.05). A1 pulley thickness was significantly different in different fingers ( P<0.05). Further comparison showed that A1 pulley thickness could be divided into two subsets: thumb and little finger ((0.196±0.051) mm), index, middle and ring fingers ((0.230±0.055) mm). A1 pulley thickness was positively correlated with age ( r=0.468, P<0.001). The normal reference ranges for thumb and little finger were 0.09-0.23 mm, 0.12-0.30 mm and 0.12-0.32 mm, respectively. The normal reference ranges for index, middle and ring fingers were 0.11-0.27 mm, 0.15-0.35 mm and 0.17-0.35 mm in volunteers aged 3-19 yr., 20-49 yr., and ≥50 yr., respectively. Gender and BMI had negligible impact on A1 pulley thickness ( P>0.05). Conclusion: High-frequency ultrasound can clearly show and measure A1 pulley. Site and age should be taken into account when determining the reference range of normal A1 pulley thickness. High-frequency ultrasound can be a quantitative evaluation method for A1 pulley lesions.


Asunto(s)
Trastorno del Dedo en Gatillo , Adolescente , Adulto , Niño , Preescolar , Dedos/diagnóstico por imagen , Voluntarios Sanos , Humanos , Tendones/diagnóstico por imagen , Trastorno del Dedo en Gatillo/diagnóstico por imagen , Ultrasonografía , Adulto Joven
12.
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
13.
Eur J Endocrinol ; 184(1): 199-208, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33112268

RESUMEN

Objective: Research into cardiovascular disease (CV) prevention has demonstrated a variety of ultrasound (US) markers predicting risk in the general population but which have been scarcely used for polycystic ovary syndrome (PCOS). Obesity is a major factor contributing to CV disease in the general population, and it is highly prevalent in PCOS. However, it is still unclear how much risk is attributable to hyperandrogenism. This study evaluates the most promising US CV risk markers in PCOS and compares them between different PCOS phenotypes and BMI values. Design: Women fulfilling the Rotterdam criteria for PCOS were recruited from our outpatient clinic for this cross-sectional study. Methods: Participants (n = 102) aged 38.9 ± 7.4 years were stratified into the four PCOS phenotypes and the three BMI classes (normal-weight, overweight, obese). They were assessed for clinical and biochemical parameters together with the following US markers: coronary intima-media thickness (cIMT), flow-mediated vascular dilation (FMD), nitroglycerine-induced dilation (NTG), and epicardial fat thickness (EFT). Results: There was no statistical difference among the four phenotypes in terms of cIMT, FMD, NTG or EFT, however all the US parameters except NTG showed significant differences among the three BMI classes. Adjusting for confounding factors in multiple regression analyses, EFT retained the greatest direct correlation with BMI and cIMT remained directly correlated but to a lesser degree. Conclusions: This study showed that obesity rather than the hyperandrogenic phenotype negatively impacts precocious US CV risk markers in PCOS. In addition, EFT showed the strongest association with BMI, highlighting its potential for estimating CV risk in PCOS.


Asunto(s)
Índice de Masa Corporal , Enfermedades Cardiovasculares/diagnóstico por imagen , Enfermedades Cardiovasculares/etiología , Síndrome del Ovario Poliquístico/complicaciones , Síndrome del Ovario Poliquístico/diagnóstico por imagen , Adulto , Grosor Intima-Media Carotídeo , Estudios Transversales , Femenino , Humanos , Hiperandrogenismo/complicaciones , Hiperandrogenismo/diagnóstico por imagen , Persona de Mediana Edad , Nitroglicerina/farmacología , Pericardio/patología , Fenotipo , Medición de Riesgo , Ultrasonografía , Vasodilatación , Vasodilatadores/farmacología
14.
J Surg Res ; 257: 189-194, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32835952

RESUMEN

BACKGROUND: Carotid artery stenosis (CAS) is the most frequently detected treatable cause of ischemic stroke. However, there are no recommendations to screen asymptomatic patients. The atherosclerotic cardiovascular disease (ASCVD) risk score estimates individuals' 10-year risk for developing cardiovascular disease. The objective of this study is to identify a relationship between the ASCVD risk score and moderate/severe CAS based on ultrasound findings. MATERIALS AND METHODS: We performed a single-institution retrospective review of patients who underwent a surveillance ultrasound for CAS between 2015 and 2018. We used Strandness velocity criteria to separate patients into two cohorts: none to mild CAS (<50%) and moderate/severe CAS (≥50%). We performed Student's t-test, multivariate analysis, and receiver operator characteristic (ROC) curve analysis to determine a relationship between the ASCVD risk score and degree of CAS. We evaluated a new risk score model based on stepwise logistic regression of significant variables on univariate analysis. RESULTS: Two thousand eight hundred and fifty-six patients with carotid ultrasounds (1623 with none to mild, 1161 with moderate, and 72 with severe disease) were included in the study. The ASCVD risk score significantly predicted moderate/severe CAS in an adjusted multivariate analysis. Each 10% increase in the ASCVD risk score corresponded to an additional 11% likelihood of moderate/severe stenosis (OR: 1.11 [1.04-1.20], P = 0.004). The ROC area under the curve for predicting moderate/severe CAS based on the ASCVD risk score was 0.59 (Youden index (J) = 0.14); the optimized ASCVD cutoff point was 28.4%. Our new atherosclerotic disease model demonstrated increased odds of moderate/severe CAS with scores greater than zero (ROC area under the curve = 0.57). CONCLUSIONS: This is the first study to demonstrate an association between atherosclerotic disease risk factors as measured by the ASCVD risk score and moderate/severe CAS. However, this tool is not sensitive or specific for using the ASCVD risk score as a screening mechanism for moderate/severe CAS.


Asunto(s)
Aterosclerosis/epidemiología , Estenosis Carotídea/epidemiología , Anciano , Anciano de 80 o más Años , Aterosclerosis/etiología , Arterias Carótidas/diagnóstico por imagen , Estenosis Carotídea/complicaciones , Estenosis Carotídea/diagnóstico , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Curva ROC , Estudios Retrospectivos , Medición de Riesgo/métodos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Ultrasonografía
15.
J Surg Res ; 257: 15-21, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32818780

RESUMEN

BACKGROUND: The etiology of primary hyperparathyroidism (PHP) is single-gland adenoma in most patients. Imaging localization of single-gland disease allows for a focused operation. We sought to determine the accuracy of imaging for localizing a solitary parathyroid adenoma. METHODS: A single-institution retrospective review was performed of adult patients with PHP undergoing parathyroidectomy from January 2017 through December 2018. Surgeon-performed ultrasound (US), four-dimensional computed tomography (4DCT), and sestamibi were assessed for localization of a parathyroid adenoma yielding a single-gland parathyroidectomy. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for each imaging modality. RESULTS: One hundred fifty-four patients underwent parathyroidectomy for PHP during the study period, with 100 patients meeting inclusion criteria with a mean age of 61.1 (SD 10) y and 80% women. Mean calcium was 11.1 mg/dL (SD 0.7) and mean PTH was 116 pg/mL (SD 66). All 100 patients had surgeon-performed US with 17 localized, 51 patients had 4DCT with 41 (80%) localized, and 69 patients had sestamibi with 53 (77%) localized. Eighty-two patients underwent successful unilateral parathyroidectomy, 18 required bilateral neck exploration. US was the most specific imaging modality at 94%. Accuracy of imaging localization was 32% for US, 70% for sestamibi, and 86% for 4DCT. CONCLUSIONS: Surgeon-performed US is a highly specific imaging modality for preoperative localization of solitary parathyroid adenoma in patients with PHP. 4DCT is the most accurate imaging localization study and should be considered for patients with a nonlocalized US.


Asunto(s)
Tomografía Computarizada Cuatridimensional , Hiperparatiroidismo Primario/diagnóstico por imagen , Paratiroidectomía/métodos , Anciano , Calcio/sangre , Femenino , Humanos , Hiperparatiroidismo Primario/cirugía , Masculino , Persona de Mediana Edad , Hormona Paratiroidea/sangre , Neoplasias de las Paratiroides/diagnóstico por imagen , Neoplasias de las Paratiroides/cirugía , Estudios Retrospectivos , Sensibilidad y Especificidad , Ultrasonografía
16.
Ultrasound Med Biol ; 47(1): 19-24, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33082053

RESUMEN

Ultrasound imaging of the lung (LUS) and associated tissues has demonstrated clinical utility in coronavirus disease 2019 (COVID-19) patients. The aim of the present study was to evaluate the possibilities of a portable pocket-sized ultrasound scanner in the evaluation of lung involvement in patients with COVID-19 pneumonia. We conducted 437 paired readings in 34 LUS evaluations of hospitalized individuals with COVID-19. The LUS scans were performed on the same day with a standard high-end ultrasound scanner (Venue GO, GE Healthcare, Chicago, IL, USA) and a pocket-sized ultrasound scanner (Butterfly iQ, Butterfly Network Inc., Guilford, CT, USA). Fourteen scans were performed on individuals with severe cases, 11 on individuals with moderate cases and nine on individuals with mild cases. No difference was observed between groups in days since onset of symptoms (23.29 ± 10.07, 22.91 ± 8.91 and 28.56 ± 11.13 d, respectively; p = 0.38). No significant differences were found between LUS scores obtained with the high-end and the portable pocket-sized ultrasound scanner. LUS scores in individuals with mild respiratory impairment were significantly lower than in those with moderate and severe cases. Our study confirms the possibilities of portable pocket-sized ultrasound imaging of the lung in COVID-19 patients. Portable pocket-sized ultrasound scanners are cheap, easy to handle and equivalent to standard scanners for non-invasive assessment of severity and dynamic observation of lung lesions in COVID-19 patients.


Asunto(s)
/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Ultrasonografía/instrumentación , Ultrasonografía/métodos , Diseño de Equipo , Humanos , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad
17.
Am J Otolaryngol ; 42(1): 102772, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33099229

RESUMEN

PURPOSE: With the current COVID-19 outbreak, otolaryngologists are most exposed to the risk of infection due to the nature of the specialty.This is why they are required to find safer diagnostic alternatives minimizing aerosol-generating procedures. The aim of this study is to explore the accuracy of transcutaneous laryngeal ultrasonography (TLUSG) in order to assess vocal fold movement. MATERIALS AND METHODS: We performed blindly both TLUSG and flexible fiberoptic laryngoscopy(FFL) on 38 patients, from March to June 2020. Patients were divided into two groups:the former with normally mobile vocal folds and the latter with unilateral vocal fold paralysis. RESULTS: On FFL findings, 10/38 patients (26,31%) had unilateral vocal fold paralysis; on TLUSG results, 9/38 patients (23.68%) presented impaired vocal fold motion. In comparison to laryngoscopy, the sensitivity, specificity, positive predictive value and negative predictive value of TLUSG for assessment of vocal fold mobility was 80%, 96.42%, 88.88%, 93.10% respectively. A significant association between the two techniques was found on the Chi-square test: X2 = 19.7722 (p value <0.00001). Cohen's K value showed a substantial agreement: K = 0,79. CONCLUSION: Although TLUSG could undoubtedly not replace laringoscopy, it represents a noninvasive and useful diagnostic tool for otolaryngologists especially during covid-19 pandemic.Data collected about its high sensitivity and specificity suggest that TLUSG could be a reliable method to screen vocal fold paralysis without performing aerosol-generating procedures, thus providing clear visualization of laryngeal real-time movements, even in non-compliant or high-risk infection patients. Our results allow us to consider TLUSG as part of the preoperative assessment of vocal folds in patients undergoing thyroidectomy.


Asunto(s)
/epidemiología , Enfermedades de la Laringe/diagnóstico , Laringe/diagnóstico por imagen , Otorrinolaringólogos , Pandemias , Ultrasonografía/métodos , Anciano , Comorbilidad , Femenino , Humanos , Enfermedades de la Laringe/epidemiología , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados
18.
Sci Total Environ ; 750: 141231, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33182180

RESUMEN

Contrast-enhanced ultrasound (CEUS) imaging has great potential as a non-lethal, inexpensive monitoring tool in aquatic toxicology. It is a well-established clinical imaging approach that combines real-time, quantitative assessment of organ blood flow, with morphological data. In humans, it has been extensively used to measure changes in blood flow that can be attributed to cancer, inflammation, and other biological abnormalities. However, it has yet to be explored as a tool for fish physiology or environmental toxicology. In this study, our goal was to determine if CEUS could be used to visualize and measure blood flow in the liver of a rainbow trout. All rainbow trout received two injections of an ultrasound contrast agent, microbubbles. A subset received a third injection after administration of propranolol, a non-specific beta1 & 2-blocker, to determine if changes in blood flow could be detected. Ultrasound contrast time-intensity curves (TIC) were obtained, fit to a lognormal model, and different perfusion parameters were calculated. Contrast enhancement was observed in all rainbow trout livers, with high percentage between repeated measurements, including blood flow (80.6 ± 27.3%), area under the curve (73.2 ± 14%), blood volume (84 ± 14.2%) and peak enhancement (86.7 ± 7.5%). After administration of propranolol, we detected a non-significant (p > 0.05) increase in area under the curve (102.6 ± 44.2%), peak enhancement (77.3 ± 106.4), blood volume (48.2 ± 74.5%), and decrease in hepatic blood flow (-17.3 ± 37.1%). These data suggest that CEUS imaging is suitable to measure organ blood flow in fish, and demonstrates tremendous potential for exploring different organs, fish species, and effects of chemical contaminants in future studies.


Asunto(s)
Oncorhynchus mykiss , Animales , Medios de Contraste , Humanos , Hígado/diagnóstico por imagen , Propranolol , Ultrasonografía
19.
Clin Imaging ; 69: 363-368, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33070083

RESUMEN

We present a case of hypochondrogenesis, a rare autosomal dominant skeletal dysplasia that often results in infant death shortly after birth. Hypochondrogenesis can present similarly to other skeletal dysplasia diseases, notably achondrogenesis type II. The diagnosis of hypochondrogenesis was given during the prenatal stage after fetal imaging was performed using ultrasound, magnetic resonance imaging (MRI), and low-dose computerized tomography (CT). To the best of our knowledge, this is the first known case that reported the use of low-dose CT to assist in the prenatal diagnosis of hypochondrogenesis.


Asunto(s)
Osteocondrodisplasias , Femenino , Humanos , Lactante , Imagen por Resonancia Magnética , Osteocondrodisplasias/diagnóstico por imagen , Embarazo , Diagnóstico Prenatal , Tomografía Computarizada por Rayos X , Ultrasonografía , Ultrasonografía Prenatal
20.
BJOG ; 128(1): 37-44, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32570294

RESUMEN

BACKGROUND: Adnexal torsion (AT), a serious gynaecological emergency, often presents with non-specific symptoms leading to delayed diagnosis. OBJECTIVE: To compare the test accuracy of ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) to diagnose AT. SEARCH STRATEGY: We searched EMBASE, MEDLINE and Cochrane CENTRAL until December 2019. SELECTION CRITERIA: Studies reporting on the accuracy of any imaging modality (Index Test) in female patients (paediatric and adult) suspected of AT compared with surgical diagnosis and/or standard clinical/radiological follow-up period until resolution of symptoms (Reference Standard). DATA COLLECTION AND ANALYSIS: We assessed study quality using QUADAS-2. We conducted test accuracy meta-analysis using a univariate model or a hierarchical model. MAIN RESULTS: We screened 3836 citations, included 18 studies (1654 women, 665 cases), and included 15 in the meta-analyses. Ultrasound pooled sensitivity (n = 12, 1187 women) was 0.79 (95% CI 0.63-0.92) and specificity was 0.76 (95% CI 0.54-0.93), with negative and positive likelihood ratios of 0.29 (95% CI 0.13-0.66) and 4.35 (95% CI 2.03-9.32), respectively. Using Doppler with ultrasound (n = 7, 845 women) yielded similar sensitivity (0.80, 95% CI 0.67-0.93) and specificity (0.88, 95% CI 0.72-1.00). For MRI (n = 3, 99 women), the pooled sensitivity was 0.81 (95% CI 0.63-0.91) and specificity was 0.91 (95% CI 0.80-0.96). A meta-analysis for CT was not possible with two case-control studies and one cohort study (n = 3, 232 women). Its sensitivity range was 0.74-0.95 and specificity was 0.80-0.90. CONCLUSIONS: Ultrasound has good performance as a first-line diagnostic test for suspected AT. Magnetic resonance imaging could offer improved specificity to investigate complex ovarian morphology, but more evidence is needed. TWEETABLE ABSTRACT: To investigate adnexal torsion, ultrasound is a good first-line diagnostic test with a pooled sensitivity of 0.79 and specificity of 0.76.


Asunto(s)
/diagnóstico por imagen , Femenino , Humanos , Imagen por Resonancia Magnética , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X , Ultrasonografía
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