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2.
Medicine (Baltimore) ; 100(27): e26489, 2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34232180

RESUMO

ABSTRACT: To analyze the correlation between quantitative contrast-enhanced ultrasonography (CEUS) parameters and angiogenesis in primary small hepatocellular carcinoma (sHCC) with varying degrees of differentiation.According to varying degrees of differentiation, a total of 90 primary sHCC patients admitted to our hospital from July 2018 to January 2020 were selected and divided into poorly differentiated group (24 cases), moderately differentiated group (31 cases), and highly differentiated group (35 cases). All patients received real-time CEUS before surgery. The tumor diameter, microvascular morphology, grading of color blood flow, contrast-enhanced performance in different phases, quantitative CEUS parameters, expression of angiogenesis-related genes, and microvessel density (MVD) were compared among the 3 groups. The correlation between quantitative parameters of CEUS and angiogenesis indexes was analyzed by Spearman rank correlation analysis.Spearman rank correlation analysis showed that vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), epidermal growth factor receptor (EGFR), and angiopoietin-2 (Ang-2) expression and MVD were negatively correlated with the time to peak (TTP), wash-out time, and peak accelerating time (PAT) (r < 0, P < .05), and were positively correlated with enhancing slope rate (ESR) and peak intensity increasing rate (PIIR) (r > 0, P < .05).CEUS is able to identify varying degrees of differentiation in primary sHCC, and the quantitative CEUS parameters are closely related to angiogenesis.


Assuntos
Carcinoma Hepatocelular/diagnóstico , Meios de Contraste/farmacologia , Neoplasias Hepáticas/diagnóstico , Microvasos/diagnóstico por imagem , Gradação de Tumores , Ultrassonografia Doppler em Cores/métodos , Adulto , Idoso , Carcinoma Hepatocelular/irrigação sanguínea , Feminino , Humanos , Neoplasias Hepáticas/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
3.
Microsurgery ; 41(6): 550-556, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34213025

RESUMO

INTRODUCTION: In flap transfer with perforator to perforator anastomosis (FTPPA), encountering poor pulsation and blood flow in a recipient perforator intraoperatively often makes FTPPA impossible. This study sought to identify color and spectral Doppler ultrasonography (CSDUS) parameters that can aid reliable preoperative selection of a recipient perforator artery. PATIENTS AND METHODS: The study enrolled 38 patients with lower extremity lymphedema who underwent vascularized lymphatic tissue transfer with perforator to perforator anastomosis for physiological lymphatic flow reconstruction. In all cases, three candidate recipient perforators were searched in each lower extremities, and vessel diameter and peak systolic flow velocity (PSFV) were measured. The inclusion criteria for candidates were a vessel diameter of >0.5 mm and a PSFV of >10 cm/s. These measures were compared with intraoperative findings, diameters and if there was pulsation and visible spurting evident. RESULTS: A total of 114 candidates were selected, and 52 of the candidates were dissected until suitable perforators were found. PSFV (cm/s) on CSDUS was ≥20.0 in 32 perforators (84.2%) and was 15.0-19.9 in 6 perforators (15.8%) in the group with pulsation and visible spurting evident, and 15.0-19.9 in one perforator (7.1%) and ≤ 14.9 in 13 perforators (92.9%) in the group without pulsation and visible spurting evident. There was a statistically significant correlation between preoperative PSFV and intraoperative pulsation and visible spurting evident after dissection (P = 0.021 × 10-3 ). The flap survival rate was 92.1%. CONCLUSION: PSFV is an important preoperative determinant of the suitability of a recipient perforator artery for FTPPA.


Assuntos
Retalho Perfurante , Procedimentos Cirúrgicos Reconstrutivos , Anastomose Cirúrgica , Artérias/diagnóstico por imagem , Humanos , Ultrassonografia Doppler em Cores
5.
Zhonghua Shao Shang Za Zhi ; 37(6): 555-561, 2021 Jun 20.
Artigo em Chinês | MEDLINE | ID: mdl-34139831

RESUMO

Objective: To explore the methods and effects of high-frequency color Doppler ultrasound assisted reverse island flap of dorsal digital artery of ulnar thumb for repairing skin and soft tissue defects in the distal end of the same finger. Methods: The retrospective cohort study method was applied. From March 2014 to January 2020, 43 patients with skin and soft tissue defects in the distal end of thumb were hospitalized in the Department of Hand and Foot Surgery of Yidu Central Hospital of Weifang, including 28 males and 15 females, aged 19-58 years. The time from injury to operation was 4 to 10 hours, and the area of wound defect was 1.5 cm×1.0 cm-5.0 cm×3.0 cm. The type and course of dorsal digital artery of ulnar thumb were detected by high-frequency color Doppler ultrasound before operation, based on which the reverse transfer of the island flap of dorsal digital artery of ulnar thumb was designed to repair the skin and soft tissue defects in the distal end of the same finger. The patients with absence of the dorsal digital artery of ulnar thumb were repaired by the greater fish reverse island flap pedicled with the radial palmar artery. The area of the flap was 2.0 cm×1.5 cm-5.5 cm×3.5 cm. The donor site wound was directly closed by suturing or covered with split-thickness skin graft from the inner side of the upper arm in the same arm. The status of dorsal digital artery of ulnar thumb detected by high frequency color Doppler ultrasound before operation was recorded. The type, course, and distribution of the dorsal digital artery of ulnar thumb detected before operation were compared with those observed during the operation. The survival of the flap was observed after operation. During the last follow-up, the appearance of the donor and recipient area of flaps was observed, the thumb function was evaluated with trial standard for the evaluation of the functions of the upper limbs of the Hand Surgery Society of the Chinese Medical Association, and the sensory function of the area transplanted with flap was evaluated with the sensory function evaluation standard. Results: The results of high-frequency color Doppler ultrasound showed that the dorsal digital artery of ulnar thumb was absent in 2 patients, while 41 patients had the dorsal digital artery of ulnar thumb, among which 20 cases were type 1 that started from the first dorsal metacarpal artery and ran on the surface of the first interosseous dorsal muscle; 16 cases were type 2 that started from the deep branch of the radial artery or the main artery of thumb and ran in the deep surface of the first interosseous dorsal muscle, including 10 cases of type 2a with the starting point in the basal region of the first metacarpal bone and 6 cases of type 2b with the starting point in the first metacarpal bone region; 5 cases were type 3 that started from the confluence of the first dorsal metacarpal artery and the main thumb artery in the region of the first metacarpophalangeal joint. The outer diameter of the vessel at the beginning of the dorsal digital artery of ulnar thumb was (1.12±0.31) mm, and the outer diameter of the vessel at the beginning of the accompany vein was (0.63±0.21) mm. The dorsal digital artery of ulnar thumb was concentrated in the ulnar side of the first metacarpophalangeal joint and snuff box region. The type, course, and distribution range of the dorsal digital artery of ulnar thumb observed during the operation were consistent with the results detected by high-frequency color Doppler ultrasound before operation. After the operation, the flaps survived in 43 patients. The patients were followed up for 6 months to 1 year. During the last follow-up, only linear scars were left in the donor area; there were no obvious pigmentation in the area transplanted with reverse island flap of dorsal digital artery of ulnar thumb, with good texture and elasticity, and beautiful appearance; the thumb function was evaluated as excellent in 23 cases, good in 17 cases, and fair in 3 cases; the sensory function of the area transplanted with flap was evaluated as S4 level in 16 cases, S3 level in 22 cases, and S2 level in 5 cases. Conclusions: The reverse island flap of dorsal digital artery of ulnar thumb is one of the ideal methods to repair the skin and soft tissue defect in the distal end of the same finger, especially that beyond the distal interphalangeal joint. Preoperative detection with high-frequency color Doppler ultrasound can identify the type and distribution of dorsal digital artery of ulnar thumb, so as to design a personalized operation plan, resulting in good appearance of the donor and recipient area and thumb function after operation.


Assuntos
Traumatismos dos Dedos , Procedimentos Cirúrgicos Reconstrutivos , Lesões dos Tecidos Moles , Feminino , Traumatismos dos Dedos/diagnóstico por imagem , Traumatismos dos Dedos/cirurgia , Humanos , Masculino , Estudos Retrospectivos , Transplante de Pele , Lesões dos Tecidos Moles/diagnóstico por imagem , Lesões dos Tecidos Moles/cirurgia , Retalhos Cirúrgicos , Polegar/diagnóstico por imagem , Polegar/cirurgia , Resultado do Tratamento , Artéria Ulnar/diagnóstico por imagem , Artéria Ulnar/cirurgia , Ultrassonografia Doppler em Cores
8.
Eur J Vasc Endovasc Surg ; 62(2): 193-201, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34140226

RESUMO

OBJECTIVE: Use of colour duplex ultrasound (CDUS) and computed tomography angiography (CTA) for infrarenal endovascular aortic aneurysm repair (EVAR) surveillance differs in internationally published guidelines. This study aimed firstly to compare CDUS detection of significant sac abnormalities with CTA. Secondly, a sensitivity analysis was conducted to compare financial estimates of the, predominantly CDUS based, local and Society of Vascular Surgery (SVS) protocols, the risk stratified European Society of Vascular Surgery (ESVS) protocol, and the CTA based National Institute of Health and Care Excellence (NICE) protocol. METHODS: Agreement between CDUS and CTA was assessed for detection of significant sac abnormalities. Surveillance protocols were extrapolated from published guidelines and applied to infrarenal EVAR patients active on local surveillance at a large, single centre. Surveillance intensity was dependent on presence of endoleak and subsequent risk of treatment failure in accordance with surveillance recommendations. Estimates for each surveillance protocol were inclusive of a range of published incidences of endoleak, contrast associated acute kidney injury (AKI), and excess hospital bed days, and estimated for a hypothetical five year surveillance period. RESULTS: The kappa coefficient between CDUS and CTA for detecting sac abnormalities was 0.68. Maximum five year surveillance cost estimates for the 289 active EVAR patients were £272 359 for SVS, £230 708 for ESVS, £643 802 for NICE, and £266 777 for local protocols, or £1 270, £1 076, £3 003, and £1 244 per patient. Differences in endoleak incidence accounted for a 1.1 to 1.4 fold increase in costs. AKI incidence accounted for a 3.3 to 6.2 fold increase in costs. CONCLUSION: A combined CTA and CDUS EVAR surveillance protocol, with CTA reserved for early seal assessment and confirmatory purposes, provides an economical approach without compromising detection of sac abnormalities. AKI, as opposed to direct imaging costs, accounted for the largest differences in surveillance cost estimates.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Angiografia por Tomografia Computadorizada/economia , Endoleak/diagnóstico por imagem , Vigilância da População/métodos , Ultrassonografia Doppler em Cores/economia , Injúria Renal Aguda/induzido quimicamente , Injúria Renal Aguda/economia , Idoso , Idoso de 80 Anos ou mais , Meios de Contraste/efeitos adversos , Endoleak/economia , Endoleak/etiologia , Endoleak/cirurgia , Procedimentos Endovasculares/efeitos adversos , Feminino , Seguimentos , Fidelidade a Diretrizes/economia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/economia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Guias de Prática Clínica como Assunto , Reoperação , Estudos Retrospectivos
9.
J Stroke Cerebrovasc Dis ; 30(8): 105922, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34157670

RESUMO

OBJECTIVES: To determine the predictive value of early transcranial color-coded sonography (TCCS) for intracranial hemorrhage (ICH) in patients with large artery occlusion (LAO) stroke of carotid circulation, who were submitted to endovascular therapy (EVT) with successful reperfusion. MATERIALS AND METHODS: Retrospective study evaluating a cohort of consecutive stroke patients with LAO of the carotid circulation that were recanalyzed with EVT. We measured angle-corrected peak systolic velocities, end-diastolic velocities and mean flow velocities (PSV, EDV and MFV) of the symptomatic and asymptomatic middle cerebral artery (MCA). The ratio between MFV of the symptomatic MCA and MFV of the asymptomatic MCA (MCA-Ra) was calculated. Parenchymal hematoma in the 24 hours control CT was considered as ICH. Univariate associations and multivariate analyses were used to identify early independent predictors for ICH among TCCS findings. RESULTS: We included 234 patients, mean age 72.5 (SD 12.6) years, 52.1% male. The mean time between recanalization and TCCS was 12.3 hours (range 3-22). Patients who developed postinterventional ICH showed a higher MCA-Ra (1.02 ± 0.26 vs 1.16 ± 0,21, p = 0.036). In multivariate analysis, only higher MCA-Ra remained independently associated with postinterventional ICH (OR: 6.778, 95%CI: 1.152-39.892, p = 0.034). A value of MCA-Ra ≥ 1,05 was associated with ICH, showing a sensitivity of 81.3% and a specificity of 65.9%; the AUC based of the ROC analysis was 0.688 (95% CI 0.570-0.806). CONCLUSION: TCCS performed within the first 24 hours after stroke onset can help to predict hemorrhagic transformation in patients with LAO.


Assuntos
Procedimentos Endovasculares/efeitos adversos , Infarto da Artéria Cerebral Média/terapia , Hemorragias Intracranianas/diagnóstico por imagem , AVC Isquêmico/terapia , Trombectomia/efeitos adversos , Ultrassonografia Doppler em Cores , Ultrassonografia Doppler Transcraniana , Idoso , Idoso de 80 Anos ou mais , Velocidade do Fluxo Sanguíneo , Circulação Cerebrovascular , Feminino , Humanos , Infarto da Artéria Cerebral Média/diagnóstico por imagem , Infarto da Artéria Cerebral Média/fisiopatologia , Hemorragias Intracranianas/etiologia , AVC Isquêmico/diagnóstico por imagem , AVC Isquêmico/fisiopatologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Sistema de Registros , Reprodutibilidade dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
10.
J Infect Dev Ctries ; 15(5): 639-345, 2021 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-34106886

RESUMO

Venous thromboembolism (VTE) represents an important clinical complication of patients with SARS-CoV-2 infection, and high plasma D-dimer levels could suggest a higher risk of hypercoagulability. We aimed to analyse if laboratory exams, risk assessment scores, comorbidity scores were useful in predicting the VTE in SARS-CoV-2 patients admitted in internal medicine (IM). We evaluated 49 older adults with suspected VTE analysing history and blood chemistry, besides we calculated the Padua Prediction Score, the modified early warning scoring (MEWS) and the modified Elixhauser index (mEI). All patients underwent venous color-doppler ultrasounds of the lower limbs. Out of the 49 patients enrolled (mean age 79.3±14 years), 10 (20.4%) had deep vein thrombosis (DVT), and they were more frequently female (80% vs 20%, p = 0.04). We could not find any association with the Padua Prediction Score, the MEWS, and the mEI. D-dimer plasma levels were also not associated with DVT. In elderly people hospitalized with SARS-CoV-2 infection hospitalized in IM, our data, although limited by the sample size, suggest that prediction and diagnosis of VTE is difficult, due to lack of precise biomarkers and scores.


Assuntos
COVID-19/complicações , Tromboembolia Venosa/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Estudos de Casos e Controles , Escore de Alerta Precoce , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Humanos , Extremidade Inferior/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , SARS-CoV-2 , Ultrassonografia Doppler em Cores , Tromboembolia Venosa/sangue , Tromboembolia Venosa/etiologia
14.
J Equine Vet Sci ; 101: 103419, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33993935

RESUMO

Despite the extensive research on ocular ultrasonography, there is paucity of information regarding ocular biometry and color Doppler imaging of the donkey's eye. This study establishes B-scan ocular biometry and color Doppler ultrasonographic reference values in normal donkeys and describes effect of laterality, maturity and gender on ocular biometry and vasculature. Forty (80 eyes) clinically normal immature and mature donkeys of both sexes were included. Transpalpebral ocular ultrasonography was made using a 12-MHz linear transducer. Biometric ocular measurements were made including the anterior chamber depth, central lens thickness, vitreous chamber depth, axial globe length, longitudinal globe length, lens pole diameter and posterior wall thickness. Color Doppler velocimetric measurements including peak systolic velocity and end-diastolic velocity were made. Blood flow indices represented by resistive and pulsatility indices were calculated. Results revealed that laterality and gender did not represent variability factors in ocular biometry (P >.05), while the animal's maturity had an influence on axial globe length (P <.001), longitudinal globe length (P = 0.000) and lens pole diameter (P = .000). Laterality had no effect on velocimetric parameters and indices (P >.05) while gender had significant effect on resistive index (P = .024), pulstality index (P = .000) and volume flow per area (P = .008). The state of maturity had significant effects on peak systolic velocity (P = .027) and blood volume flow per distance (P = .012), and area (P = .048). Ocular biometry and color Doppler ultrasonography provided a clinically useful tool to evaluate the donkey's eye that will be helpful in diagnosing donkeys with ocular diseases.


Assuntos
Equidae , Cristalino , Animais , Biometria , Olho/diagnóstico por imagem , Feminino , Cristalino/diagnóstico por imagem , Masculino , Ultrassonografia Doppler em Cores/veterinária
15.
Medicine (Baltimore) ; 100(18): e25822, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950988

RESUMO

OBJECTIVE: To clarify if musculoskeletal ultrasound (US) would give additional information for the clinical examination to diagnose and evaluate the activity of ankylosing spondylitis (AS). METHODS: A literature search was performed in PubMed, Embase, Web of Science, the Cochrane Library, Sinomed, Chinese National Knowledge Infrastructure (CINK), and Wanfang databases from their inceptions to May 15, 2020. Studies that examined the musculoskeletal US, which detected sacroiliac joints in people with AS were included. The pooled analyses were performed using Meta Disc version 1.4 software. RESULTS: A total of 9 studies encompassing 984 participants were included. Statistical analysis suggested an area under the curve (AUC) of 0.9259 (sensitivity 0.86, specificity 0.54) indicating that US had excellent diagnostic test accuracy for AS, an AUC of 0.6441 (sensitivity 0.87, specificity 0.51) indicating that the US did not have a good diagnostic test accuracy for AS activity. A subgroup analysis revealed that the AUC of power Doppler US (PDUS) and color Doppler US (CDUS) was 0.5000 and 0.9274, respectively, indicating that CDUS was superior to PDUS. CONCLUSION: US, especially CDUS, is a valid and reproducible technique for the diagnosis of AS. While the accuracy of AS activity evaluation of the US is not ideal. It may be considered for routine use as part of the standard diagnostic tools in AS.


Assuntos
Sistema Musculoesquelético/diagnóstico por imagem , Espondilite Anquilosante/diagnóstico , Ultrassonografia Doppler em Cores , Estudos de Viabilidade , Humanos , Curva ROC
16.
Ultrasound Med Biol ; 47(8): 2266-2276, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34001404

RESUMO

Stroke is a leading cause of disability and death worldwide. Early and accurate recognition of acute stroke is critical for achieving a good prognosis. The novel automated system proposed in this study was based on convolutional neural networks (CNNs), which were used to identify lesion findings on carotid color Doppler (CCD) images in patients with acute ischemic stroke. An image database composed of 1032 CCD images from 106 patients with acute ischemic stroke (549 images) and from 79 normal controls (483 images) was retrospectively analyzed. Taking the consensus of two neuroradiologists as the gold standard, different CNN models with and without transfer learning were evaluated with 10-fold cross-validation. The diagnostic information provided from individual color channels was also explored. AlexNet, which was trained from scratch, achieved an accuracy of 91.67%, a sensitivity of 93.33%, a specificity of 90.20% and an area under the receiver operating characteristic curves (AUC) of 0.9432. Other transferred models achieved accuracies between 77.69% and 83.94%. In channel comparisons, the green channel had the best performance, with an accuracy of 87.50%, a sensitivity of 97.78%, a specificity of 78.43% and an AUC of 0.9507. The proposed CNN architecture, as a computer-aided diagnosis system, suggests using automatic feature extraction from CCD images to predict ischemic stroke. The developed scheme has the potential to provide diagnostic suggestions in clinical use.


Assuntos
Artérias Carótidas/diagnóstico por imagem , AVC Isquêmico/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Redes Neurais de Computação , Estudos Retrospectivos
17.
Andrologia ; 53(7): e14090, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33913191

RESUMO

The aim of this study was to investigate whether the time interval between ejaculation and scrotal Doppler ultrasonography affects the results of the varicose vein diameter and reflux time. Age, medication use, operation history, physical examination and semen analysis findings, varicose vein diameters and the presence of reflux and reflux time were evaluated prospectively in the patients older than 18 years of age who presented to the urology outpatient clinic with infertility and underwent scrotal Doppler ultrasonography and semen analysis. The time interval between the two scrotal Doppler ultrasonography for semen analysis was noted, the two results were compared. The patients were divided into four groups according to the time interval between ejaculation and scrotal Doppler ultrasonography. The study included 81 varicocele cases, with 57 left-sided and 12 bilateral varicocele. The varicose vein diameters were significantly larger after ejaculation than before ejaculation (p < .001). Similarly, the reflux time after ejaculation in all patients was significantly higher in scrotal Doppler ultrasonography performed before and after ejaculation at rest and during Valsalva manoeuvre (p < .001). In conclusion, the results of the present study suggest that a waiting time of at least 90 min must be allowed between ejaculation and scrotal Doppler ultrasonography.


Assuntos
Varicocele , Varizes , Adulto , Ejaculação , Humanos , Masculino , Ultrassonografia Doppler em Cores , Varicocele/diagnóstico por imagem , Varizes/diagnóstico por imagem , Veias/diagnóstico por imagem
18.
Artigo em Chinês | MEDLINE | ID: mdl-33794629

RESUMO

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


Assuntos
Hemangioma , Neoplasias Laríngeas , Criança , Glote/diagnóstico por imagem , Hemangioma/diagnóstico por imagem , Humanos , Lactente , Neoplasias Laríngeas/diagnóstico por imagem , Propranolol , Estudos Retrospectivos , Ultrassonografia Doppler em Cores
19.
Medicine (Baltimore) ; 100(16): e25517, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33879689

RESUMO

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


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Neurilemoma/diagnóstico , Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico , Ultrassonografia Doppler em Cores/métodos , Adolescente , Biópsia por Agulha Fina , Meios de Contraste/administração & dosagem , Feminino , Humanos , Imagem Multimodal/métodos , Neurilemoma/patologia , Neurilemoma/cirurgia , Glândula Tireoide/patologia , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Resultado do Tratamento
20.
Niger J Clin Pract ; 24(4): 551-554, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33851677

RESUMO

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


Assuntos
Disfunção Erétil , Impotência Vasculogênica , Adulto , Disfunção Erétil/diagnóstico por imagem , Humanos , Impotência Vasculogênica/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pênis/diagnóstico por imagem , Estudos Retrospectivos , Ultrassonografia Doppler em Cores
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