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1.
Biomed Res Int ; 2019: 7814287, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31886250

RESUMO

Objective: The aim of this study is to explore the potential pathogenesis of juvenile dermatomyositis by bioinformatics analysis of gene chips, which would screen the hub genes, identify potential biomarkers, and reveal the development mechanism of juvenile dermatomyositis. Material and Methods: We retrieved juvenile dermatomyositis's original expression microarray data of message RNAs (mRNAs) and microRNAs (miRNAs) from NCBI's Gene Expression Omnibus database (GEO, http://www.ncbi.nlm.nih.gov/geo/); through the R package of limma in Bioconductor, we can screen the differentially expressed miRNAs and mRNAs, and then we further analyzed the predicted target genes by the methods such as Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis and miRNA-mRNA regulatory network construction and protein-protein interaction (PPI) network using Cytoscape 3.6.1. Results: Compared with normal juvenile skin tissues, 6 upregulated microRNAs and 5 downregulated microRNAs were identified from 166 downregulated microRNAs and 58 upregulated microRNAs in juvenile dermatomyositis tissues. The enrichment pathways of differentially expressed microRNAs include cell adhesion molecules (CAMs), autoimmune thyroid disease, Type I diabetes mellitus, antigen and presentation, viral myocardium, graft-versus-host disease, and Kaposi sarcoma-associated herpes virus infection. By screening of microRNA-messenger RNA regulatory network and construction of PPI network map, three target miRNAs were identified, namely, miR-193b, miR-199b-5p, and miR-665. Conclusion: We identified mir-193b, mir-199b-5p, and mir-6653 target miRNAs by exploring the miRNA-mRNA regulation network mechanism related to the pathogenesis of juvenile dermatomyositis, which will be of great significance for further study on the pathogenesis and targeted therapy of juvenile dermatomyositis.

2.
Ultrasound Med Biol ; 45(11): 2906-2914, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31474385

RESUMO

To investigate the feasibility of ultrasonography in detecting the oropharynx movement during deep breathing and to quantitatively analyze oropharynx airway lumen changes during deep breathing. The motions of oropharynx were monitored, and sonographic measurements of airway lumen were obtained during deep breathing in 448 healthy volunteers. Adequate visualization of oropharynx movement was obtained on all healthy volunteers. The anterior-posterior (AP) diameters and AP/transverse (T) diameter ratios were greater at the end of deep inspiration than that at the end of deep expiration for each sex (p < 0.01). The anterior-posterior dimensional changes were greater than lateral airway dimensional changes each sex (p < 0.05). Ultrasonography could provide realistic impression of the process on the oropharynx movement during deep breathing and perform the quantitative analysis of the oropharynx airway lumen changes during deep breathing. The results were encouraging and supported the utility of ultrasonography in future studies.

3.
PLoS One ; 14(8): e0221638, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31442259

RESUMO

OBJECTIVE: To explore the use of Contrast-enhanced Ultrasound (CEUS) in evaluating angiogenesis in a xenograft nasopharyngeal carcinoma (NPC) model in nude mice and the evolution of CEUS parameters according to the growth of NPC. METHODS: Nude mice were divided into three groups according to experiments conducted at various times from tumor implantation (8 mice/group; group A: 4 weeks from implantation; group B:6 weeks from implantation; group C:8 weeks from implantation). CNE-2 cells were transplanted in 24 nude mice and CEUS evaluations of the tumors were performed at 4, 6 or 8 weeks from implantation. CEUS parametric perfusion images and pathological findings were recorded. R version 3.4.4 software was used to analyze the CEUS parameters and pathological findings. RESULTS: One-way anova analysis indicated statistically significant differences among the three groups with the parameters of peak intensity (PI) (p<0.001), area wash in (AWI) (p<0.001), area wash out (AWO) (p<0.001) and tumor volumes (p<0.001).Pearson correlation coefficient analysis indicated that microvessel density (MVD) was correlated with tumor volume (r = 0.644, p = 0.001), PI (r = 0.904, p<0.0001), AWI (r = 0.547, p = 0.008) and AWO (r = 0.744, P<0.0001). Tumor volume was correlated with MVD (r = 0.644, p = 0.001), PI (r = 0.625, p = 0.002), AWI (r = 0.528, p = 0.012) and AWO (r = 0.784, p<0.001). The percentage of necrosis in histological sections was correlated with the percentage of CEUS unperfused area (r = 0.446,p = 0.038). Spearman rank correlation coefficient analysis indicated that vascular endothelial growth factor (VEGF) was correlated with PI (r = 0.462, P = 0.032). Welch t test indicated PI, AWI and AWO parameters were significantly lower than that of kidneys (p<0.001, p = 0.009, p = 0.005). CONCLUSIONS: The CEUS parameters PI, AWI and AWO indirectly reflect the MVD and the tumor volume in our model of subcutaneous transplanted NPC in nude mice, providing precious information on angiogenesis and tumor growth. VEGF may play a role in promoting angiogenesis of NPC.

4.
Discov Med ; 27(150): 227-233, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31421691

RESUMO

OBJECTIVE: The aim of this study was to investigate the characteristics of nasopharyngeal carcinoma (NPC) using contrast-enhanced ultrasonography (CEUS), including the enhancement patterns and the quantitative parameters. METHODS: Having been scanned using conventional ultrasonography (US) and CEUS, every case was confirmed to be NPC under endoscopic biopsy, and no case received any anti-tumor treatment before CEUS examinations. Tumor/node/metastasis stages were determined in accordance with 2002 AJCC 6th edition. Contrast enhancement patterns and quantitative parameters were observed. RESULTS: CEUS imaging of NPC showed that the tumor signal intensity enhanced early, rapidly, and remarkably, and decreased slowly later. The patterns of enhancement included spot/linear enhancement, peripheral enhancement, and mass enhancement, and two types of time intensity curves of NPC included type I and type II. There was a significant difference between peak intensity (PI) and T stage (P<0.05), whereas time-to-peak (TP) and slope did not show significant differences with T stage (P>0.05). CONCLUSION: CEUS is feasible to be applied to the nasopharynx region. The use of CEUS makes it possible to observe vascular permeability of NPC. Our results suggest that the quantitative parameter PI of nasopharyngeal carcinoma is significantly different from T stages. Thus, PI may serve as a potential noninvasive radiological prognostic indicator for NPC.


Assuntos
Meios de Contraste/química , Aumento da Imagem , Carcinoma Nasofaríngeo/diagnóstico por imagem , Ultrassonografia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo/patologia , Estadiamento de Neoplasias
5.
Ultrasound Q ; 32(1): 86-92, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26938037

RESUMO

OBJECTIVE: The aims of this study were to describe the relationship between the scanning planes and appearance of the upper airway on sonography and to demonstrate the reliability and reproducibility of sonographic measurements of the upper airway. METHODS: Airway sonoanatomy was recognized by comparing the airway images and the corresponding cadaver's anatomical specimens. Systemic sonographic examination of 267 healthy volunteers was conducted to obtain the sonographic measurement of airway lumen. The reliability and reproducibility studies were conducted in 40 healthy volunteers. RESULT: The air-filled upper airway appeared as a bright heterogeneous hyperechoic line. During deep inspiration, the upper airway lumen expanded to the highest anterior-posterior dimension, whereas during deep expiration, the lateral dimension tended to increase. The sonographic measurements had good reproducibility, with intraclass correlation coefficient ranging from 0.722 to 0.887 and 0.727 to 0.882 for interobserver and intraobserver reliability, respectively. CONCLUSIONS: Ultrasonography can determine the anatomy of the upper airway and perform the quantitative analysis of the upper airway lumen during respiration. The results were encouraging and support the utility of ultrasonography in future airway disorder studies.


Assuntos
Aumento da Imagem/métodos , Laringe/diagnóstico por imagem , Nariz/diagnóstico por imagem , Posicionamento do Paciente/métodos , Faringe/diagnóstico por imagem , Ultrassonografia/métodos , Adolescente , Adulto , Idoso , Cadáver , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
6.
Acta Radiol ; 56(1): 25-33, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24436445

RESUMO

BACKGROUND: Contrast-enhanced ultrasound (CEUS) is a non-invasive method for the assessment of breast lesions. The accuracy of CEUS in diagnosing of breast cancer has never been systematically assessed. PURPOSE: To determine the overall performance of CEUS in the differentiation of benign and malignant breast lesions using meta-analysis. MATERIAL AND METHODS: PubMed, Embase, Cochrane Library, and article references published before October 2012 were searched. Published studies that used histopathologic results as golden reference to assess the diagnostic performance of CEUS in patients suspected of having breast cancer and the data necessary to calculate the diagnostic results were included. The qualities of eligible studies for final meta-analysis were assessed by using the quality assessment of diagnostic studies (QUADAS) instrument. Sensitivity, specificity, summary receiver-operating characteristic (sROC) curves, and area under the curve were calculated to examine the diagnostic performance of CEUS. RESULTS: Of 16 eligible studies, 957 breast lesions were included in the original meta-analysis, among which heterogeneity arising from factors other than threshold effect was explored. Meta-regression analysis confirmed the contrast agent was the most significant factor cause of heterogeneity (P = 0.0012, relative diagnostic odds ratio [DOR] = 7.06). The use of perfluoro containing microbubbles (Sonovue or Optison) significantly increased the diagnostic precision compared with Levovist. The pooled weighted estimates of sensitivity and specificity for CEUS in the diagnosis of breast lesions were 0.86 (95% confidence interval [CI], 0.83, 0.89) and 0.79 (95% CI, 0.75, 0.83), respectively. CONCLUSION: CEUS has good sensitivity and specificity in the characterization of breast lesions and can potentially help to select suspicious breast mass for surgery.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/epidemiologia , Meios de Contraste , Ultrassonografia/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/classificação , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Variações Dependentes do Observador , Prevalência , Reprodutibilidade dos Testes , Fatores de Risco , Sensibilidade e Especificidade , Adulto Jovem
7.
J Ultrasound Med ; 33(9): 1627-34, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25154945

RESUMO

OBJECTIVES: The purpose of this study was to demonstrate the reliability of sonography for diagnosis of nose and paranasal sinus tumors. METHODS: Ninety-six consecutive patients with tumors underwent sonography and computed tomography (CT) before surgical treatment. Tumor detectability and imaging findings were evaluated independently and then compared with pathologic findings. RESULTS: Of 96 tumors, 75 were detected by sonography, for a detectability rate of 78.1%; 93 tumors were detected by CT, for a detectability rate of 96.9%. By comparison, sonography showed a trend toward higher detectability of nasal vestibular tumors than CT (87.5% for sonography versus 50.0% for CT) and small lumps on the wing of the nose (78.8% for sonography versus 33.3% for CT). Among the sonographic features, boundary, shape, internal echo, calcification, bone invasion, vascular pattern, and cervical lymph node metastasis all had significantly positive correlations with malignancy (P < .05), but size did not (P = .324). In addition, the vascular resistive index for malignant tumors was significantly higher (mean ± SD, 0.66 ± 0.20) than the index for benign lesions (0.24 ± 0.30; P < .001). Moreover, the detection rate for grade 1-3 (small-large) blood flow in benign lesions was only 43.8%, whereas the rate for malignant tumors was 97.7% (P < .001). CONCLUSIONS: The vascular pattern may be a promising predictive indicator for distinguishing benign and malignant tumors of the nose and paranasal sinuses. Consequently, sonography has high value for diagnosis of benign and malignant tumors of the nose and paranasal sinuses, especially for nasal vestibular tumors and small lumps on the wing of the nose.


Assuntos
Neoplasias Nasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nariz/diagnóstico por imagem , Seios Paranasais/diagnóstico por imagem , Reprodutibilidade dos Testes , Ultrassonografia , Adulto Jovem
8.
PLoS One ; 9(6): e99679, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24887439

RESUMO

OBJECTIVE: To compare the accuracy of ultrasonography (US) with the current clinical standard of endoscopy for a diagnosis of nasopharyngeal carcinoma (NPC). METHODS: A total of 150 patients suspected of having NPC underwent US and endoscopy. A diagnosis was obtained from an endoscopic biopsy collected from each suspected tumor and was compared with a biopsy obtained from a normal nasopharynx. The diagnostic accuracy of US and endoscopy for NPC was evaluated using receiver operating curve (ROC) analysis performed by MedCalc Software. RESULTS: The sensitivity, specificity, and accuracy of US versus endoscopy for this cohort were 90.1%, 84.8%, and 87.3%for US, and 88.7%, 97.5%, and 93.3% for endoscopy, respectively. Both US and endoscopy exhibited good diagnostic accuracy for NPC with area under the curve (AUC) values of 0.929 and 0.938, respectively. However, this difference was not significant (Z = 0.36, P = 0.72). CONCLUSION: US is a useful tool for the detection of tumors in endoscopically suspicious nasopharynx tissues, and also for the detection of subclinical tumors in endoscopically normal nasopharynx tissues.


Assuntos
Endoscopia/métodos , Neoplasias Nasofaríngeas/diagnóstico , Neoplasias Nasofaríngeas/patologia , Ultrassonografia/métodos , Adulto , Idoso , Área Sob a Curva , Biópsia , Carcinoma , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo , Nasofaringe/patologia , Estudos Prospectivos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
9.
J Ultrasound Med ; 33(5): 827-34, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24764338

RESUMO

OBJECTIVES: The purpose of this study was to prospectively assess the accuracy of sonography versus magnetic resonance imaging (MRI) for a diagnosis of primary nasopharyngeal carcinoma. METHODS: A total of 150 patients suspected of having nasopharyngeal carcinoma underwent sonography and MRI. A diagnosis was obtained from an endoscopic biopsy that was collected from the suspected tumor or a normal nasopharynx. The diagnostic performance of sonography and MRI for nasopharyngeal carcinoma was evaluated by receiver operating characteristic curve analysis. The sensitivity and specificity of the two imaging methods were compared by the McNemar test. RESULTS: Nasopharyngeal carcinoma was present in 71 of 150 patients (47.3%) and absent in 79 (52.7%). The sensitivity, specificity, and accuracy of sonography versus MRI for these cases were 90.1%, 84.8%, and 87.3% for sonography and 97.2%, 89.9%, and 93.3% for MRI, respectively. Both sonography and MRI had good diagnostic performance for nasopharyngeal carcinoma, with area under the curve values of 0.958 and 0.987, respectively. There was no significant difference in the rate of tumor detectability between sonography and MRI (P = .12), and the specificities of sonography and MRI were similar (P = .22). CONCLUSIONS: Both sonography and MRI are useful tools for clinical screening of nasopharyngeal carcinoma. However, sonography is less expensive and easier to perform. The results of this study also suggest that nasopharyngeal sonography could be used for the initial investigation of primary cancer in patients suspected of having nasopharyngeal carcinoma.


Assuntos
Imagem por Ressonância Magnética/métodos , Neoplasias Nasofaríngeas/diagnóstico , Ultrassonografia/métodos , Adulto , Idoso , Carcinoma , Feminino , Humanos , Aumento da Imagem/métodos , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
10.
PLoS One ; 9(3): e90412, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24594807

RESUMO

OBJECTIVE: To compare the accuracy of ultrasonography (US) with the current clinical standard of endoscopy for a diagnosis of nasopharyngeal carcinoma (NPC). METHODS: A total of 150 patients suspected of having NPC underwent US and endoscopy. A diagnosis was obtained from an endoscopic biopsy collected from each suspected tumor and was compared with a biopsy obtained from a normal nasopharynx. The diagnostic accuracy of US and endoscopy for NPC was evaluated using receiver operating curve (ROC) analysis performed by MedCalc Software. RESULTS: The sensitivity, specificity, and accuracy of US versus endoscopy for this cohort were 90.1%, 84.8%, and 87.3% for US, and 88.7%, 97.5%, and 93.3% for endoscopy, respectively. Both US and endoscopy exhibited good diagnostic accuracy for NPC with area under the curve (AUC) values of 0.929 and 0.938, respectively. However, this difference was not significant (Z = 0.36, P = 0.72). CONCLUSION: US is a useful tool for the detection of tumors in endoscopically suspicious nasopharynx tissues, and also for the detection of subclinical tumors in endoscopically normal nasopharynx tissues.


Assuntos
Endoscopia/métodos , Neoplasias Nasofaríngeas/diagnóstico , Ultrassonografia/métodos , Adulto , Idoso , Área Sob a Curva , Biópsia/métodos , Carcinoma , Estudos de Coortes , Endoscopia/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo , Estudos Prospectivos , Curva ROC , Sensibilidade e Especificidade , Ultrassonografia/normas
11.
J Ultrasound Med ; 32(6): 1041-7, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23716526

RESUMO

OBJECTIVES: The purpose of this study was to determine the sonographic performance in pathologically proven cases of nasopharyngeal carcinoma and its involvement in the parapharyngeal space. METHODS: The study included 58 patients being treated for suspected nasopharyngeal carcinoma detected by routine nasopharyngoscopy who underwent pathologic biopsy. Sonography was performed immediately thereafter with a convex array transducer in both the B-mode and color mode. Forty-five of the 58 patients (90 parapharyngeal spaces) in whom nasopharyngeal carcinoma was proved by both sonography and pathologic biopsy underwent preradiotherapy magnetic resonance imaging (MRI). The sonographic findings were compared to the pathologic findings. The sonographic findings of parapharyngeal space involvement were correlated with the MRI findings. RESULTS: The normal anatomy of the nasopharynx and parapharyngeal space, nasopharyngeal carcinoma, and its relationship with the parapharyngeal space were well shown on sonography. The sensitivity of sonography for detection of nasopharyngeal carcinoma was 97.8%, and the specificity was 41.7%. The sonographic findings of parapharyngeal space involvement had a high degree of agreement with MRI (κ = 0.757; P < .001). CONCLUSIONS: These promising initial data indicate that sonography may be a useful tool for diagnosing nasopharyngeal carcinoma and defining the relationship between the tumor and the parapharyngeal space.


Assuntos
Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias Nasofaríngeas/diagnóstico por imagem , Neoplasias Nasofaríngeas/patologia , Faringe/diagnóstico por imagem , Ultrassonografia Doppler em Cores/métodos , Adolescente , Adulto , Idoso , Região Branquial , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
12.
J Ultrasound Med ; 30(11): 1467-74, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22039019

RESUMO

OBJECTIVES: The purpose of this study was to compare the use of sonography and non-contrast-enhanced magnetic resonance imaging (MRI) for detection and staging of glottic carcinoma. METHODS: In this study, 30 consecutive patients with glottic squamous cell carcinoma underwent high-frequency sonography and non-contrast-enhanced MRI before surgical treatment. Tumor detectability and imaging findings were evaluated independently and then compared with the surgical and postoperative pathologic findings. RESULTS: Sonography showed a trend toward higher detectability than MRI in early (stage T1 and T2) glottic carcinoma (94.1% [16 of 17 patients] for sonography versus 76.5% [13 of 17 patients] for MRI; P = .335). With regard to T staging, the overall accuracy rates were 80.0% (24 of 30) for sonography and 76.7% (23 of 30) for MRI; the difference was not statistically significant (P > .99). Non-contrast-enhanced MRI was superior to sonography in showing tumor involvement in the retrolaryngeal extent of glottic carcinoma. CONCLUSIONS: Sonography is suggested as a noninvasive complementary modality for detection and initial staging of glottic carcinoma.


Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Neoplasias Laríngeas/diagnóstico por imagem , Neoplasias Laríngeas/patologia , Imagem por Ressonância Magnética/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Ultrassonografia
13.
J Ultrasound Med ; 29(7): 1023-30, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20587425

RESUMO

OBJECTIVE: The purpose of this study was to prospectively identify the normal sonographic values of human true and false vocal cords. METHODS: In total, 229 healthy volunteers were divided into 8 groups according to their age and sex. High-frequency sonography was used to measure the length, width, and thickness of both true and false vocal cords. Measurements were compared between groups, and correlations with age were analyzed. Forty of the 229 volunteers also participated in reliability and reproducibility studies. RESULTS: The sonographic measurements had good reproducibility, with intraclass correlation coefficient ranges of 0.736 to 0.903 for interobserver reliability and 0.723 to 0.943 for intraobserver reliability. Measurements for the 3 parameters of both true and false vocal cords in male adults were greater than those in female adults (P < .001). The length, width, and thickness of true and false vocal cords in participants younger than 18 years were obviously correlated with age (r = 0.835-0.957; P < .001), but no significant correlation was found in the adult groups. The rates of visualization in male groups were significantly lower than those in female groups (P < .001) and gradually decreased with increasing age. CONCLUSIONS: Both true and false vocal cords can be shown by high-frequency sonography, which can quantitatively measure both true and false vocal cords with good reliability and reproducibility.


Assuntos
Prega Vocal/anatomia & histologia , Prega Vocal/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Ultrassonografia , Adulto Jovem
14.
Ultrasound Med Biol ; 35(10): 1596-600, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19632759

RESUMO

To demonstrate whether a calculated vascularity index (VI) can predict metastases of cervical lymph nodes, the VI values of the primary tumors were obtained by using 3-D sonography in 87 subjects with laryngeal cancer confirmed by laryngoscope and biopsy. N-staging of the subjects was determined by pathological nodal harvesting. The relationship between the VI and pathological N-staging was evaluated by correlation coefficient. To test the accuracy of the VI for predicting cervical lymph node involvement, a receiver operating characteristic (ROC) curve was constructed, and the best operating point was determined by Youden's index. For comparison, 2-D sonography was applied to detect metastatic cervical lymph nodes. The accuracy, sensitivity and specificity of the VI, 2-D sonography and a combination of the two methods for diagnosis of metastatic cervical lymph nodes were compared. There was a positive linear correlation between the VI and pN-staging (r=0.740, p<0.001). The area under the ROC curve for the VI was 0.919. The best operating point of the VI was 4.4565, which derived higher sensitivity than that of 2-D sonography (95% vs. 81%, p=0.031), but lower specificity (75% vs. 95%, p=0.012). The combination of the two methods yielded a higher accuracy (97% vs. 85% and 89%, p=0.002 and 0.016), a higher sensitivity to 2-D sonography (95% vs. 81%, p=0.031) and a higher specificity to VI (98% vs. 75%, p=0.002). The VI of laryngeal cancer can be a useful factor for predicting metastases of cervical lymph nodes.


Assuntos
Carcinoma de Células Escamosas/irrigação sanguínea , Carcinoma de Células Escamosas/secundário , Neoplasias Laríngeas/irrigação sanguínea , Neovascularização Patológica/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Imagem Tridimensional/métodos , Neoplasias Laríngeas/diagnóstico por imagem , Neoplasias Laríngeas/patologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Pescoço , Estadiamento de Neoplasias , Sensibilidade e Especificidade , Ultrassonografia Doppler em Cores/métodos
15.
J Clin Ultrasound ; 33(1): 29-33, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15690445

RESUMO

PURPOSE: Although conventional sonography has been used widely in evaluation of the abdominal and cervical esophagus, its use in the thoracic esophagus is seldom mentioned. The aim of this study was to assess whether conventional sonography could demonstrate the thoracic esophagus and to determine this structure's normal sonographic appearance and measurements. METHODS: Transthoracic sonography was performed in 253 healthy volunteers ranging in age from 12 to 72 years (mean, 41 +/- 15 years). The subjects were examined while supine with their hands raised over their heads; the transducer was placed along the left side of the sternum sequentially from the first to the fifth intercostal spaces. The ultrasound beam was directed to the thoracic aorta using the heart as an acoustic window. The detectable length of the thoracic esophagus was measured in the longitudinal scan from the upper most part visualized to the point at which it penetrated the diaphragm. The esophageal thickness was measured on the anterior wall at the level of the left atrium. RESULTS: In 188 (74%) of the 253 subjects, the thoracic esophagus could be demonstrated by sonography, except for the portion under the first and second intercostal spaces. In 3 of these 188 subjects, the esophagus also was not visualized at the third intercostal space. In these 188 subjects, the esophageal wall was shown as 3 layers. The esophageal lumen appeared as 1 or 2 hyperechoic bands in longitudinal sonograms. In 163 subjects, gas artifact and the comet-tail sign, with downward movement, were seen in the esophageal lumen after swallowing. The mean demonstrable length of the thoracic esophagus was 10.2 +/- 1.9 cm and the mean thickness 3.2 +/- 0.3 mm. CONCLUSIONS: Most of the thoracic esophagus can be visualized by sonography, except for a short portion at the back of the left main bronchus. The heart and the thoracic aorta are 2 important landmarks in scanning.


Assuntos
Esôfago/anatomia & histologia , Esôfago/diagnóstico por imagem , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sensibilidade e Especificidade , Tórax/diagnóstico por imagem , Ultrassonografia/métodos , Ultrassonografia/normas
16.
J Clin Ultrasound ; 32(4): 163-71, 2004 May.
Artigo em Inglês | MEDLINE | ID: mdl-15101076

RESUMO

PURPOSE: Although conventional sonography is used widely for evaluation of the gastroesophageal junction, its use in the cervical esophagus is still limited. The aim of this study was to assess the use of sonography to demonstrate this portion of the esophagus. METHODS: The cervical esophagi in 60 cadavers and 435 healthy volunteers were examined sonographically. Among the healthy subjects 182 were scanned with a transducer operating at 7.5 MHz, 183 with a 10.0-MHz transducer, and 70 with a 12.0-MHz transducer. Sonographic layer patterns were compared among the groups. Sonographic and histologic analyses were also performed on 3 cadaveric esophageal specimens to correlate the sonographic appearances with the anatomical findings. RESULTS: Scans of the cadavers showed that the cervical esophagus lay between the trachea and vertebrae, with its origin at the midline; it gradually moved to the left as it descended toward the trunk. It moved to the right when the cadaver's head was turned to the left and the trachea was pushed gently to the left. Based on these anatomical characteristics, visualization of the cervical esophagus was optimized by scanning from both the left and the right lateral approaches, with manipulation of the trachea as needed. In scans of the 435 healthy subjects, the esophageal wall was shown as 5 layers in 423 (97.2%) and as 7 layers in the remaining 12 (2.8%). The demonstration rate of the 7-layer pattern was significantly higher for subjects scanned at 12.0 MHz than for those scanned at 10.0 and 7.5 MHz (p < 0.01). The layers demonstrated sonographically corresponded to histological structures evident on microscopy. CONCLUSIONS: The left lateral approach is essential to sonography of the cervical esophagus. However, the right wall of the esophagus is best seen from the right. In transverse scans, the cervical esophagus wall usually appears to be composed of 5 layers, although 7 layers can also appear, especially as the transducer frequency is increased.


Assuntos
Esôfago/anatomia & histologia , Esôfago/diagnóstico por imagem , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço/anatomia & histologia , Pescoço/diagnóstico por imagem , Estudos Prospectivos , Ultrassonografia
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