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1.
Zhonghua Yi Xue Za Zhi ; 100(34): 2663-2668, 2020 Sep 15.
Artigo em Chinês | MEDLINE | ID: mdl-32921014

RESUMO

Objective: To explore the correlation between prostate imaging report and data system (PI-RADS) score and international society of uological pathology (ISUP) grade of prostate cancer (PCa) and the role of PI-RADS score in predicting the pathological features of clinically significant PCa (csPCa), positive surgical margin and pathological upgrade. Methods: The pathologically positive patients with multi-parameter magnetic resonance image (mpMRI) were included in this study. The patients with prostate specific antigen (PSA)<100 µg/L were divided into two groups: biopsy group (n=523) and RP group (n=215). The correlation between PI-RADS score and ISUP grade and the accuracy of predicting csPCa in the two groups were evaluated. In the RP group, the correlation between PI-RADS score and postoperative pathological grade or degradation and positive incisal margin was further discussed. The patients with PSA≥100 µg/L (171cases in biopsy group and 6 cases in RP group) were not included in the statistical analysis, and the results were simply described. Results: The age, prostate volume, and PSA level of biopsy group and RP group was (72±8) years vs (68±7) years, 48.3 (32-57) cm(3) vs 47.2 (32-54) cm(3), and 26.3(10.2-34.2)µg/L vs 21.7 (9.24-23.95)µg/L, respectively. The PI-RADS scores ≤ 3,4, and 5 in the biopsy group were 109,97, and 317 respectively, and those in the RP group were 61,55, and 99 respectively. There were significant differences in the composition of ISUP grades of different PI-RADS scores between the two groups (P<0.001), and there was a positive correlation between the two groups (r=0.493 in the biopsy group, r=0.671 in the RP group, both P<0.001). Using PI-RADS score to predict csPCa, biopsy group (AUC=0.764, P<0.001, 95%CI:0.710-0.819) and RP group (AUC=0.807, P<0.001, 95%CI:0.735-0.879) had certain accuracy. The PI-RADS score combined with PSA could improve the accuracy of csPCa prediction in the biopsy group (AUC=0.795,P<0.001, 95% CI:0.746-0.843) and the RP group (AUC=0.852, P<0.001, 95%CI:0.789-0.915). Compared with the pathological results of biopsy in the RP group, 52.6% of the patients showed upgrade and degrade of ISUP, and there was insignificant difference in the composition of PI-RADS scores between upgraded and degraded patients (P>0.05). However, 41.7%(27/65) of the patients with ISUP grade 1 biopsies had pathological upgrades that the patients with PI-RADS ≤ 3 accounted for 33.3%, while the patients with PI-RADS>3 accounted for 66.7%, and there was significant difference between the two groups (P<0.05). After RP, 43.3% of the patients had positive surgical margins, and the patients with PI-RADS score ≤ 3, 4 and 5 were 13 (14%), 24 (25.8%) and 56 (60.2%), respectively, while the PI-RADS scores of patients with negative surgical margin were 48 (39.3%), 31(25.4%) and 43(35.2%), respectively. There was significant difference between the two groups (P<0.001). The higher the PI-RADS score, the greater the possibility of the positive surgical margin. For the patients with PSA ≥ 100 µg/L, 98.8% (169/171) patients in the biopsy group had a PI-RADS score 5. The pathological results of all patients were csPCa, of which 85.4% (146/171) had ISUP grade ≥ 4. Among them, 6 cases underwent RP, 5 cases had ISUP grade ≥ 4, all surgical margin were positive, 5 cases had seminal vesicle invasion, 3 cases had capsule invasion and 3 cases had positive pelvic lymph nodes. Conclusion: ThePI-RADS score is correlated with the ISUP grade of PCa. Combined with PSA can accurately predict csPCa. At the same time, the higher PI-RADS score, the more likely the patients with positive incisal margin after RP and Gleason score of 3+3=6 at the time of puncture will be upgraded pathologically.


Assuntos
Neoplasias da Próstata , Idoso , Idoso de 80 Anos ou mais , Sistemas de Dados , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Gradação de Tumores
2.
Arch Endocrinol Metab ; 64(4): 349-355, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32725061

RESUMO

Objective The purpose of the study is to quantitatively assess shear-wave elastography (SWE) value in American College of Radiology Thyroid Imaging Reporting and Data Systems (ACR TI-RADS) 4. Materials and methods One hundred and fifty-two ACR TI-RADS 4 thyroid nodules undergoing SWE were included in the study. The mean (EMean), minimum (EMin) and maximum (EMax) of SWE elasticity were measured. Results The areas under the receiver operating characteristic (ROC) curves for SWE EMean, EMin and EMax in detecting benign and malignant nodules were 0.95, 0.83 and 0.84, respectively. Cut-off value of EMean ≤ 23.30 kPa is able to downgrade the lesion category to ACR TI-RADS 3 and cut-off value of EMean ≥ 52.14 kPa is able to upgrade the lesion category to ACR TI-RADS 5. Conclusions The EMean of SWE will probably identify nodules that have a high potential for benignity in ACR TI-RADS 4. It may help identify and select benign nodules while reducing unnecessary biopsy of benign thyroid nodules.


Assuntos
Técnicas de Imagem por Elasticidade , Nódulo da Glândula Tireoide , Biópsia , Sistemas de Dados , Humanos , Estudos Retrospectivos , Estados Unidos
3.
Public Health ; 185: 110-116, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32615477

RESUMO

OBJECTIVES: As we enter the year 2020, health data in the United States (US) is still in the process of being curated into a usable format. With coordinated data systems, it becomes possible to answer, with relative certainty, what preventive and medical interventions work in the real world and for whom they might work. STUDY DESIGN: This is a non-systematic expert review. METHODS: A non-systematic expert review was undertaken to identify relevant scientific and gray literature on the current state and the limitations of evaluation of health interventions and the health data infrastructure in the US. This review also included the literature on nations with unified data systems. We coupled this review with non-structured interviews of data scientists to gain insight into the progress in establishing the components necessary to support a unified data system and to facilitate data exchange for evaluations, as well as further guide our review. Our goal was to produce a critical analysis of the existing attempts to standardize and use data collected during patient encounters with physicians for public health purposes. RESULTS: Data obtained from electronic health records are produced in a way that is challenging to use and difficult to compile across platforms in the US. One response to this problem has been to encourage the exchange and standardization of health record information through Distributed Research Networks and Common Data Models (CDMs). These data can be combined with mobile health, social media, and other sources of data to radically transform what we know about the prevention and management of disease. However, issues with the variety of CDMs and growing sense of distrust of institutions that maintain data continue to impede medical progress. CONCLUSIONS: We present a framework for data use that will allow public health to answer a swath of unanswered research questions that can improve public health practice.


Assuntos
Big Data , Sistemas de Dados , Gestão da Saúde da População , Saúde Pública , Coleta de Dados , Registros Eletrônicos de Saúde , Humanos , Saúde da População , Estados Unidos
4.
PLoS One ; 15(7): e0235227, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645013

RESUMO

The growth of administrative data made available publicly, often in near-real time, offers new opportunities for monitoring conditions that impact community health. Urban blight-manifestations of adverse social processes in the urban environment, including physical disorder, decay, and loss of anchor institutions-comprises many conditions considered to negatively affect the health of communities. However, measurement strategies for urban blight have been complicated by lack of uniform data, often requiring expensive street audits or the use of proxy measures that cannot represent the multifaceted nature of blight. This paper evaluates how publicly available data from New York City's 311-call system can be used in a natural language processing approach to represent urban blight across the city with greater geographic and temporal precision. We found that our urban blight algorithm, which includes counts of keywords ('tokens'), resulted in sensitivity ~90% and specificity between 55% and 76%, depending on other covariates in the model. The percent of 311 calls that were 'blight related' at the census tract level were correlated with the most common proxy measure for blight: short, medium, and long-term vacancy rates for commercial and residential buildings. We found the strongest association with long-term (>1 year) commercial vacancies (Pearson's correlation coefficient = 0.16, p < 0.001). Our findings indicate the need of further validation, as well as testing algorithms that disambiguate the different facets of urban blight. These facets include physical disorder (e.g., litter, overgrown lawns, or graffiti) and decay (e.g., vacant or abandoned lots or sidewalks in disrepair) that are manifestations of social processes such as (loss of) neighborhood cohesion, social control, collective efficacy, and anchor institutions. More refined measures of urban blight would allow for better targeted remediation efforts and improved community health.


Assuntos
Participação da Comunidade , Sistemas de Dados , Monitoramento Ambiental/métodos , Saúde da População Urbana , Reforma Urbana/organização & administração , Algoritmos , Humanos , Governo Local , Cidade de Nova Iorque
6.
J Comput Assist Tomogr ; 44(4): 527-532, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32467486

RESUMO

The aim of this work was to review Neck Imaging Reporting and Data System (NI-RADS) that was designed for reporting and surveillance of head and neck cancer after therapy and their subsequent management. The categories of NI-RADS can be designated as belonging in 1 of the 4 categories: negative; low suspicion; high suspicion; and definite recurrence. Lexicon of NI-RADS-1 shows nonmass-like distortion of soft tissues, NI-RADS-2 lesions divided into mucosal (2A) versus deep (2B) abnormalities, NI-RADS-3 primary site can either be a submucosal or deep lesion, and NI-RADS-4 is a biopsy-proven residual or recurrent disease. The NI-RADS Lexicon of radiology reporting categories linked to management protocols and surveillance for these patients. Neck Imaging Reporting and Data System is to provide guidance for next-imaging decisions either a follow-up period, biopsy, or surgery.


Assuntos
Sistemas de Dados , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Terminologia como Assunto , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Vigilância da População , Guias de Prática Clínica como Assunto , Radiologistas , Sociedades Médicas , Resultado do Tratamento
7.
Clin Imaging ; 65: 133-137, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32470834

RESUMO

BACKGROUND: Thyroid Imaging Reporting Data System (TI-RADS) is used to characterize thyroid nodules while reducing unnecessary FNAC. Over the years, several versions of TI-RADS have been developed but there is no consensus on which TI-RADS is the best system. This study aimed to compare the diagnostic accuracy and ability of ACR TI-RADS, EU TI-RADS, K TI-RADS, AI TI-RADS to eliminate unnecessary FNAC. METHODS: In this prospective study, thyroid nodules were characterized by using the four TI-RADS systems and US-guided FNAC was done for nodule with the highest ACR TI-RADS score. Correlation between TI-RADS and FNAC results were analyzed. RESULTS: Out of 244 thyroid nodules, 100 nodules with either size <1 cm (43 nodules) non-diagnostic or inconclusive FNAC results (57 nodules) were excluded. Seven nodules (4.9%) were confirmed to be malignant on FNAC. K TI-RADS showed 100% sensitivity and NPV but the lowest specificity (40.2%). EU TI-RADS had the highest specificity (83.2%) but the lowest sensitivity (57.1%) and NPV (97.4%). ACR TI-RADS had an average sensitivity (85.7%) and NPV (98.6%). The specificity of ACR TI-RADS (51.1%) was lower than EU TI-RADS but higher than K TI-RADS. AI TI-RADS showed higher specificity (61.8% vs 51.1%, p < 0.05) but comparable NPV and sensitivity to ACR TI-RADS. AI TI-RADS was able to avoid the highest number of unnecessary FNAC (62.5%) followed by ACR TI-RADS(54.2%), EU TI-RADS(37.5%) and K TI-RADS(11.8%). CONCLUSION: AI TI-RADS is a more simple scoring system with better overall diagnostic performance and ability to exclude unnecessary FNAC with high NPV. ADVANCES IN KNOWLEDGE: Highest number of unnecessary FNAC thyroid could be prevented by applying AI TI-RADS.


Assuntos
Biópsia por Agulha Fina , Sistemas de Dados , Nódulo da Glândula Tireoide/diagnóstico por imagem , Cistografia , Humanos , Estudos Prospectivos , Procedimentos Cirúrgicos Reconstrutivos , Estudos Retrospectivos , Sensibilidade e Especificidade , Nódulo da Glândula Tireoide/diagnóstico , Ultrassonografia/métodos
8.
Nan Fang Yi Ke Da Xue Xue Bao ; 40(3): 400-406, 2020 Mar 30.
Artigo em Chinês | MEDLINE | ID: mdl-32376572

RESUMO

OBJECTIVE: To compare the accuracy of two widely used thyroid imaging, reporting and data systems (TI-RADS), namely ACR TI-RADS and Kwak TI-RADS, in the differential diagnosis of benign and malignant thyroid nodules. METHODS: We reviewed the data of 350 thyroid nodules with definite diagnoses by surgical histopathology (n=144, 41.14%) or fine needle aspiration (FNA) cytopathology (n=206, 58.86%). The nodules were graded using ACR TI-RADS and Kwak TI-RADS based on the ultrasound images, and the diagnostic accuracy of these two systems was evaluated by the area under the receiveroperating characteristic curve (AUC). RESULTS: The AUCs of ACR TI-RADS and Kwak TI-RADS were both 0.879. For a differential diagnosis of the thyroid nodules, ACR TI-RADS had a diagnostic sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, Youden's index and accuracy of 77.3%, 89.1%, 83.0%, 85.1%, 7.101, 0.255, 27.848, 0.664 and 0.843, respectively, with an optimal threshold of TR5, as compared with 84.8%, 84.0%, 78.3%, 89.0%, 5.283, 0.181, 29.265, 0.688 and 0.843, respectively, of Kwak TI-RADS, which had an optimal threshold of 4c. CONCLUSIONS: Both ACR TI-RADS and Kwak TI-RADS have good performance for differential diagnosis of thyroid nodules, but ACR TI-RADS has a higher specificity and a lower sensitivity compared with Kwak TI-RADS.


Assuntos
Nódulo da Glândula Tireoide , Sistemas de Dados , Diagnóstico Diferencial , Humanos , Estudos Retrospectivos , Ultrassonografia
9.
PLoS One ; 15(4): e0232104, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32324800

RESUMO

BACKGROUND: While the scale-up of HIV services has improved national health management information systems (HMIS), there remain challenges in using routine data to guide the introduction of optimized antiretroviral (ARV) drugs. METHODS: Building on the recent enhancements to the HMIS in Kenya and coinciding with the introduction of a new ARV regimen, tenofovir+lamivudine+dolutegravir (TLD), we developed and implemented an enhanced data system (EDS) to improve availability of safety and efficacy data among people living with HIV (PLHIV) in Kenya. Using data from one health facility, we showcase how the EDS can be used to monitor ARV transition and identify missed opportunities to transition eligible patients to optimized regimes. RESULTS: The EDS was designed to create a comprehensive PLHIV database by triangulating patient-level data from the EMR, the pharmacy ARV dispensing tool (ADT) and HIV viral load (VL) databases. On a monthly basis, the database is de-identified and uploaded into a national data warehouse, with interactive dashboards. Using the EDS, we determined that of the 5,500 PLHIV ≥15 years on first-line ART at one facility, 4,233 (77%) had transitioned to optimized ARVs. Of the 1,267 still on legacy regimens, 459 (36%) were determined to be eligible and prioritized to switch. CONCLUSIONS: This project illustrates how enhancements to the national HMIS can facilitate the use of routine patient-level data to monitor the transition to new ARVs and inform the national HIV response.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Sistemas de Dados , Infecções por HIV/tratamento farmacológico , Fármacos Anti-HIV/farmacologia , Sistemas de Gerenciamento de Base de Dados , Monitoramento de Medicamentos , Infecções por HIV/virologia , Compostos Heterocíclicos com 3 Anéis/uso terapêutico , Humanos , Quênia , Lamivudina/uso terapêutico , Tenofovir/uso terapêutico , Resultado do Tratamento , Carga Viral/métodos
10.
Artigo em Inglês | MEDLINE | ID: mdl-32344760

RESUMO

Any piece of information is a selection from a set of possibilities. In this paper, this set is called a "domain". Digital information consists of number sequences, which are selections from a domain. At present, these number sequences are defined contextually in a very variable way, which impairs their comparability. Therefore, global uniformly defined "domain vectors" (DVs), with a structure containing a "Uniform Locator" ("UL"), referred to as "UL plus number sequence", are proposed. The "UL" is an efficient global pointer to the uniform online definition of the subsequent number sequence. DVs are globally defined, identified, comparable, and searchable by criteria which users can define online. In medicine, for example, patients, doctors, and medical specialists can define DVs online and can, therefore, form global criteria which are important for certain diagnoses. This allows for the immediate generation of precise diagnostic specific statistics of "similar medical cases", in order to discern the best therapy. The introduction of a compact DV data structure may substantially improve the digital representation of medical information.


Assuntos
Sistemas de Dados , Humanos , Armazenamento e Recuperação da Informação , Telemedicina , Terminologia como Assunto
11.
Eur Radiol ; 30(9): 4930-4942, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32346790

RESUMO

BACKGROUND: In the vast majority of the laboratory-confirmed coronavirus disease 2019 (COVID-19) patients, computed tomography (CT) examinations yield a typical pattern and the sensitivity of this modality has been reported to be 97% in a large-scale study. Structured reporting systems simplify the interpretation and reporting of imaging examinations, serve as a framework for consistent generation of recommendations, and improve the quality of patient care. PURPOSE: To compose a comprehensive lexicon for description of the imaging findings and propose a grading system and structured reporting format for CT findings in COVID-19. MATERIAL AND METHODS: We updated our published systematic review on imaging findings in COVID-19 to include 37 published studies pertaining to diagnostic features of COVID-19 in chest CT. Using the reported imaging findings of 3647 patients, we summarized the typical chest CT findings, atypical features, and temporal changes of COVID-19 in chest CT. Subsequently, we extracted a list of descriptive terms and mapped it to the terminology that is commonly used in imaging literature. RESULTS: We composed a comprehensive lexicon that can be used for documentation and reporting of typical and atypical CT imaging findings in COVID-19 patients. Using the same data, we propose a grading system with five COVID-RADS categories. Each COVID-RADS grade corresponds to a low, moderate, or high level of suspicion for pulmonary involvement of COVID-19. CONCLUSION: The proposed COVID-RADS and common lexicon would improve the communication of findings to other healthcare providers, thus facilitating the diagnosis and management of COVID-19 patients. KEY POINTS: • Chest CT has high sensitivity in diagnosing the coronavirus disease 2019 (COVID-19). • Structured reporting systems simplify the interpretation and reporting of imaging examinations, serve as a framework for consistent generation of recommendations, and improve the quality of patient care. • The proposed COVID-RADS and common lexicon would improve the communication of findings to other healthcare providers, thus facilitating the diagnosis and management of COVID-19 patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Sistemas de Dados , Humanos , Pandemias , Exame Físico , Tomografia Computadorizada por Raios X
14.
Beijing Da Xue Xue Bao Yi Xue Ban ; 51(6): 1067-1070, 2019 Dec 18.
Artigo em Chinês | MEDLINE | ID: mdl-31848506

RESUMO

OBJECTIVE: To summarize and evaluate the value of applying the thyroid imaging reporting and data system (TI-RADS) released by American College of Radiology (ACR) in 2017 of the thyroid classification, and to propose an optimized classification method based on the result to facilitate more accurate and precise risk stratification of thyroid nodules. METHODS: In the study, 342 thyroid nodules assessed by 2017 ACR TI-RADS were retrospectively analyzed. Each nodule had a score, and all the scores of nodules were compared with the pathological results. The proportion of malignant nodules in different scoring ranges was obtained. The diagnostic efficacy of all nodules, nodules above 1 cm and less than or equal to 1 cm was evaluated by ROC curve, respectively. RESULTS: The AUC of all nodules, nodules above 1 cm and less than or equal to 1 cm were 0.907, 0.936 and 0.717, respectively. With the increase of the scores, the proportion of benign nodules decreased gradually, and the proportion of malignant nodules increased, especially nodules of 4-6 scores increased significantly. Based on the proportion of malignant nodules with 3 scores, the proportion of malignant nodules with 4, 5 and 6 scores increased 1.6, 3.8 and 5.3 times, respectively. The proportion of malignant nodules with 6-8 scores was 81%-84%, while the proportion of malignant nodules with 9 scores or more was 93%-94%. According to the distribution characteristics of malignant nodules, the classification of TI-RADS was adjusted. TI-RADS 4 was divided into TI-RADS 4a, TI-RADS 4b and TI-RADS 4c, corresponding to 4, 5 and 6-8 scores respectively, while the nodules with 9 scores or more were divided into TI-RADS 5. CONCLUSION: 2017 ACR TI-RADS has high diagnostic value for thyroid nodules above 1 cm, but it is not so effective for the nodules less than or equal to 1 cm. According to the proportion distribution of malignant nodules in different scoring ranges, appropriate adjustment of classification will be more accurate and precisely predict the malignant risk of nodules.


Assuntos
Nódulo da Glândula Tireoide , Sistemas de Dados , Humanos , Estudos Retrospectivos , Ultrassonografia
15.
Urologe A ; 58(12): 1443-1450, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31741002

RESUMO

Initial clinical and pathological diagnostic workup of urinary bladder cancer is based on cystoscopy, transurethral resection of suspicious lesions, and computed tomography when indicated. Accurate staging is necessary for further therapeutic decision-making. This review summarizes the current status of multiparametric magnetic resonance imaging (mpMRI) and the vesical imaging-reporting and data system (VI-RADS) classification. MpMRI may improve the accuracy of assessment of local tumor invasion compared to conventional imaging alone. VI-RADS standardizes reporting of MRI staging and classifies the likelihood of muscle-invasive bladder cancer into five categories. Preliminary data suggest low interobserver variability. However, prospective multicenter studies are necessary to validate the VI-RADS classification. Progress in functional, molecular, and hybrid imaging may further improve the accuracy of clinical tumor and nodal staging for bladder cancer.


Assuntos
Sistemas de Dados , Neoplasias da Bexiga Urinária , Humanos , Imagem por Ressonância Magnética , Masculino , Invasividade Neoplásica , Estudos Prospectivos , Neoplasias da Bexiga Urinária/diagnóstico por imagem
16.
Medicine (Baltimore) ; 98(44): e17657, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689776

RESUMO

New sonographic patterns have been recommended by the 2015 American Thyroid Association (ATA) to stratify nodules in terms of malignancy risk and help guide biopsy decision. This study aimed to compare the ultrasound part of the ATA guidelines and the Thyroid Imaging Reporting and Data System (TIRADS-Na).In 2013 to 2016, 708 thyroid nodules in 505 patients were confirmed by postoperative histopathology. Hypoechogenicity, solidity, microcalcification, irregular margin, and a taller-than-wide shape were considered features suggesting malignancy. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were obtained for the TIRADS and ATA guidelines.Of the 708 nodules, 341(48.2%) and 367(51.8%) were benign and malignant, respectively. Based on the ultrasound 2015 ATA guidelines, 62 nodules had nonspecific pattern (both malignant and benign features); malignancy rates of nodules with very low, low, intermediate, and high suspicion, and nonspecific pattern were 0, 17.7%, 57.9%, 90.0%, and 69.4%, respectively (P < .001). Malignancy rates of categories 2/3/4/5 nodules by TIRADS were 0, 8.1%, 67.0%, and 90.1%, respectively (P < .001). Based on pathological results, the AUC, sensitivity, specificity, NPV, and PPV were 0.926, 96.7%, 81.5%, 84.9%, and 95.9% for TIRADS, and 0.920, 93.5%, 82.4%, 85.1%, and 92.1% for ATA patterns, respectively. The TIRADS was generally more efficient than the 2015 ATA guidelines, especially for nodules >2 cm in diameter or those with nonspecific pattern.The TIRADS show a relative superiority over the ultrasound 2015 ATA guidelines, especially for nodules with >2 cm diameter or nonspecific pattern.


Assuntos
Índice de Gravidade de Doença , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Sistemas de Dados , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Sensibilidade e Especificidade , Neoplasias da Glândula Tireoide/diagnóstico , Ultrassonografia , Estados Unidos , Adulto Jovem
18.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 44(9): 1071-1077, 2019 Sep 28.
Artigo em Chinês | MEDLINE | ID: mdl-31645499

RESUMO

OBJECTIVE: To study the clinical application value of ultrasound-guided fine needle aspiration biopsy (US-FNAB) and contrast-enhanced ultrasound (CEU) in the diagnosis of thyroid imaging reported and data system Grade 4 (TI-RADS 4) nodules.
 Methods: A retrospective analysis of 134 patients with thyroid nodules surgery were selected, and their results of preoperative color Doppler ultrasonography were TI-RADS 4. The data of US-FNAB and CEU before operation and the results of pathological section after operation were collected. The pathological results were taken as the gold standard, and the specimens obtained by US-FNAB puncture were used for HE staining and cytological diagnosis. The sensitivity, specificity, accuracy and the cost were calculated for CEU and US-FNAB, respectively. The diagnostic efficacy of the 2 methods was compared.
 Results: Of 134 thyroid nodules, there were 131 malignant nodules (97.76%) and 3 benign ones (2.24%). The sensitivity of US-FNAB and CEU were 87.02% and 93.89% respectively. The specificity of US-FNAB and CEU were 100.00% and 66.67%. The accuracy of US-FNAB and CEU were 87.31% and 93.28% respectively. Comparisons of the diagnostic accuracy were performed by χ2 test. There was no significant difference in sensitivity between CEU and US-FNAB (P>0.05). However, the sensitivity of US-FNAB and CEU were 87.50% and 100.00%, respectively, when the maximum diameter of nodule was less than 10 mm, and there was statistical significance (P<0.05). The sensitivity of US-FNAB and CEU were 92.73% and 85.45%, respectively, when the maximum diameter of nodule was more than 10 mm, and there was no statistical significance (P>0.05). The cost and risk of US-FNAB was higher than those of CEU.
 Conclusion: The sensitivity of US-FNAB is higher than that of CEU for thyroid nodules with the diameter larger than 10 mm. With high detection rate, good safety and low cost, CEU can still be used for thyroid nodules with the diameter less than 10 mm, which is diagnosed as negative nodules by US-FNAB.


Assuntos
Neoplasias da Glândula Tireoide , Nódulo da Glândula Tireoide , Biópsia por Agulha Fina , Sistemas de Dados , Humanos , Estudos Retrospectivos , Sensibilidade e Especificidade
20.
J Vasc Surg ; 70(5): 1729, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31653392
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