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1.
BMJ Case Rep ; 13(12)2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33370933

RESUMO

The SARS-CoV-2 has wreaked havoc globally and has claimed innumerable lives all over the world. The symptoms of this disease may range from mild influenza-like symptoms to severe acute respiratory distress syndrome with high morbidity and mortality. With improved diagnostic techniques and better disease understanding, an increased number of cases are being reported with extrapulmonary manifestations of this disease ranging from renal and gastrointestinal to cardiac, hepatic, neurological and haematological dysfunction. Subacute thyroiditis is a self-limiting and painful thyroid gland inflammation most often secondary to viral infections. We report a case of subacute thyroiditis in a 58-year-old gentleman presenting with a painful swelling in the neck who was subsequently detected to be positive for SARS-CoV-2. We seek to highlight the broad clinical spectrum of the COVID-19 by reporting probably the first case of subacute thyroiditis possibly induced by SARS-CoV-2 infection from India.


Assuntos
Amidas/administração & dosagem , Azitromicina/administração & dosagem , Prednisolona/administração & dosagem , Pirazinas/administração & dosagem , Glândula Tireoide/diagnóstico por imagem , Tireoidite Subaguda , Antivirais/administração & dosagem , /diagnóstico , /fisiopatologia , Diagnóstico Diferencial , Glucocorticoides/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Cintilografia/métodos , Testes de Função Tireóidea/métodos , Tireoidite Subaguda/diagnóstico , Tireoidite Subaguda/fisiopatologia , Tireoidite Subaguda/terapia , Tireoidite Subaguda/virologia , Resultado do Tratamento , Ultrassonografia Doppler em Cores/métodos
2.
Radiol Clin North Am ; 58(6): 1041-1057, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33040847

RESUMO

Thyroid ultrasound with gray-scale and color Doppler is the most helpful imaging modality to differentiate normal thyroid parenchyma from diffuse or nodular thyroid disease by evaluating glandular size, echogenicity, echotexture, margins, and vascularity. The various causes of diffuse thyroid disease often have overlapping sonographic imaging features. Thyroid nodules may be hyperplastic or neoplastic, with most due to benign hyperplastic changes in architecture and benign follicular adenomas; only a small percentage are malignant. A systematic approach to nodule morphology that includes evaluation of composition, echogenicity, margin, shape, and any echogenic foci can guide decision to biopsy or follow nodules.


Assuntos
Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Biópsia por Agulha Fina/métodos , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Medição de Risco , Doenças da Glândula Tireoide/diagnóstico por imagem , Doenças da Glândula Tireoide/patologia , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/patologia , Ultrassonografia Doppler em Cores/métodos
3.
Rev Col Bras Cir ; 47: e20202481, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32965301

RESUMO

OBJECTIVE: Endovascular treatment for femoropopliteal arterial disease has made revascularization procedures less invasive, but the self-expanding stents used can suffer great wear in arteries with extreme mobility. To evaluate the prevalence of fractures in stents implanted in the femoropopliteal segment, to identify predisposing factors and consequences on arterial patency. METHOD: between March and June 2019, thirty patients previously operated for femoropopliteal obstruction underwent stent X-rays in anteroposterior and lateral views to detect fractures and Doppler to analyze arterial patency. RESULTS: we observed 12 cases with fractures (33.3%): 1 type I (2.8%), 3 type II (8.3%), 5 type III (13.9%), 3 type IV (8.3%) and no type V. According to the TASC II we had 1 in group B (8.3%), 6 in group C (50%) and 5 in group D (41.6%) p <0.004. The number of stents per limb was 3.1 (± 1.3) in cases of fracture versus 2.3 (± 1.3) in cases without fracture (p = 0.08). The extension was 274.17mm (± 100.94) in cases of fracture and 230.83mm (± 135.44) in cases without fracture (p = 0.29). On Doppler we had: 17 patients (47.2%) without stenosis, 9 patients (25%) with stenosis> 50% and 10 patients (27.8%) with occlusion (p = 0.37). There was no correlation between fracture and arterial obstruction (p = 0.33). CONCLUSION: stent fractures are a frequent finding in the femoropopliteal area (33.3%), being more prevalent in cases of more advanced disease (C and D). There was no association between the finding of fracture and arterial obstruction.


Assuntos
Procedimentos Endovasculares/métodos , Doença Arterial Periférica , Doenças Vasculares Periféricas/terapia , Artéria Poplítea , Falha de Prótese , Stents , Ultrassonografia Doppler em Cores/métodos , Humanos , Perna (Membro)/irrigação sanguínea , Doenças Vasculares Periféricas/diagnóstico por imagem , Prevalência , Desenho de Prótese , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Grau de Desobstrução Vascular
4.
Plast Reconstr Surg ; 146(2): 227-237, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32740566

RESUMO

BACKGROUND: Preoperative planning of microsurgical perforator free flaps continues to be a discussion topic among microsurgeons. The purpose of this study was to compare the ability of three methods of preoperative vascular mapping-hand-held Doppler imaging, color Doppler ultrasonography, and computed tomographic angiography-to detect perforators and their concordance with surgical findings. METHODS: A prospective study was performed to evaluate the sensitivity, specificity, and accuracy of hand-held Doppler imaging, color Doppler ultrasonography, and computed tomographic angiography to detect free flap perforators. Each patient undergoing a free flap reconstruction was studied preoperatively with the three methods, and the results were compared to the intraoperative findings. RESULTS: Fifty-three patients undergoing autologous tissue reconstruction were included. Most reconstructions (71.7 percent) were performed with anterolateral thigh flaps. The positive predictive value (color Doppler ultrasonography, 100 percent; computed tomographic angiography, 100 percent; hand-held Doppler imaging, 88.6 percent) and negative predictive value (color Doppler ultrasonography, 100 percent; computed tomographic angiography, 94.3 percent; hand-held Doppler imaging, 90.5 percent) rates were significantly different between methods. The high resolution of the color Doppler ultrasonography probe provided a direct vision of the vasculature arborization and efficiently detected vessels with diameters of less than 0.5 mm. The sensitivity, specificity, and accuracy of color Doppler ultrasonography were greater than those of both computed tomographic angiography and hand-held Doppler imaging. There was 100 percent concordance between color Doppler ultrasonography perforators and the surgical findings. CONCLUSIONS: Color Doppler ultrasonography provides a reproducible, harmless, and accurate way to visualize vascular anatomy. It has a high correlation with the surgical findings, signifying advantages over hand-held Doppler and computed tomographic angiography in sensitivity, specificity, and accuracy. CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, II.


Assuntos
Angiografia por Tomografia Computadorizada/métodos , Computadores de Mão , Retalho Perfurante/irrigação sanguínea , Procedimentos Cirúrgicos Reconstrutivos/métodos , Ultrassonografia Doppler em Cores/métodos , Doenças Vasculares/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Microcirurgia/métodos , Pessoa de Meia-Idade , Estudos Prospectivos , Curva ROC , Reprodutibilidade dos Testes , Resultado do Tratamento , Doenças Vasculares/diagnóstico
5.
Medicine (Baltimore) ; 99(31): e21432, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756152

RESUMO

INTRODUCTION: A cesarean scar pregnancy (CSP), when combined with an arteriovenous malformation (AVM), is a rare, but potentially life-threatening condition that may be associated with uncontrolled hemorrhage. Hysterectomy is indicated when conservative treatment fails. Preservation of fertility is challenging. PATIENT CONCERNS: We reported a 33-year-old woman with a CSP combined with an AVM who failed methotrexate administration as conservative treatment. DIAGNOSES: A CSP combined with an AVM was diagnosed via three-dimensional color Doppler angiogram and magnetic resonance imaging. INTERVENTIONS: Transvaginal removal of the ectopic gestation and repair of the uterine defect was performed without incident. OUTCOMES: The fertility of the patient was preserved and hysterectomy was avoided. CONCLUSION: Transvaginal fertility-sparing surgery may be successfully performed to prevent hysterectomy when conservative treatment fails in patients with a CSP combined with an AVM.


Assuntos
Malformações Arteriovenosas/complicações , Malformações Arteriovenosas/cirurgia , Cicatriz/patologia , Preservação da Fertilidade/métodos , Adulto , Angiografia/métodos , Antimetabólitos Antineoplásicos/administração & dosagem , Antimetabólitos Antineoplásicos/uso terapêutico , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/tratamento farmacológico , Cesárea/efeitos adversos , Cicatriz/cirurgia , Feminino , Humanos , Imageamento Tridimensional/métodos , Imagem por Ressonância Magnética/métodos , Metotrexato/administração & dosagem , Metotrexato/uso terapêutico , Gravidez , Gravidez Ectópica/cirurgia , Resultado do Tratamento , Ultrassonografia Doppler em Cores/métodos
6.
PLoS One ; 15(8): e0237634, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32813729

RESUMO

INTRODUCTION: Subtalar joint (STJ) dysfunction can contribute to movement disturbances. Vibration energy with color Doppler imaging (VECDI) may be useful for detecting STJ stiffness changes. OBJECTIVES: (1) Support proof-of-concept that VECDI could detect STJ stiffness differences; (2) Establish STJ stiffness range in asymptomatic volunteers; (3) Examine relationships between STJ stiffness and foot mobility; and (4) Assess VECDI precision and reliability for examining STJ stiffness. METHODS: After establishing cadaveric testing model proof-of-concept, STJ stiffness (threshold units, ΔTU), ankle complex passive range-of-motion (PROM) and midfoot-width-difference (MFWDiff) data were collected in 28 asymptomatic subjects in vivo. Three reliability measurements were collected per variable; Rater-1 collected on all subjects and rater-2 on the first ten subjects. Subjects were classified into three STJ stiffness groups. RESULTS: Cadaveric VECDI measurement intra-rater reliability was 0.80. A significantly lower STJ ΔTU (p = .002) and ankle complex PROM (p < .001) was observed during the screw fixation versus normal condition. A fair correlation (r = 0.660) was observed between cadaveric ΔTU and ankle complex PROM. In vivo VECDI measurements demonstrated good intra-rater (0.76-0.84) versus poor inter-rater (-3.11) reliability. Significant positive correlations were found between STJ stiffness and both dorsum (r = .440) and posterior (r = .390) PROM. MFWDiff exhibited poor relationships with stiffness (r = .103) and either dorsum (r = .256) or posterior (r = .301) PROM. STJ stiffness ranged from 2.33 to 7.50 ΔTUs, categorizing subjects' STJ stiffness as increased (n = 6), normal (n = 15), or decreased (n = 7). Significant ANOVA main effects for classification were found based on ΔTU (p< .001), dorsum PROM (p = .017), and posterior PROM (p = .036). Post-hoc tests revealed significant: (1) ΔTU differences between all stiffness groups (p < .001); (2) dorsum PROM differences between the increased versus normal (p = .044) and decreased (p = .017) stiffness groups; and (3) posterior PROM differences between the increased versus decreased stiffness groups (p = .044). A good relationship was found between STJ stiffness and dorsum PROM in the increased stiffness group (r = .853) versus poor, nonsignificant relationships in the normal (r = -.042) or decreased stiffness (r = -.014) groups. CONCLUSION: PROM may not clinically explain all aspects of joint mobility. Joint VECDI stiffness assessment should be considered as a complimentary measurement technique.


Assuntos
Pé/fisiopatologia , Artropatias/fisiopatologia , Articulação Talocalcânea/fisiopatologia , Ultrassonografia Doppler em Cores/métodos , Adulto , Fenômenos Biomecânicos , Feminino , Pé/diagnóstico por imagem , Humanos , Artropatias/diagnóstico por imagem , Masculino , Movimento , Estudo de Prova de Conceito , Amplitude de Movimento Articular , Reprodutibilidade dos Testes , Articulação Talocalcânea/diagnóstico por imagem , Vibração , Adulto Jovem
7.
Medicine (Baltimore) ; 99(27): e21129, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629747

RESUMO

RATIONALE: The left internal jugular vein has a higher possibility of anatomical variation than the right side. Therefore, the complication risk during cannulation is expected to be higher. PATIENT CONCERNS: A 74-year-old woman was scheduled for elective surgery for left upper lobe wedge resection. We observed an anatomical abnormality at the location of the common carotid artery (CCA) and left internal jugular vein (IJV). DIAGNOSIS: During the ultrasound, the left IJV was detected at the medial side of the CCA, and this anatomical variation was confirmed by color Doppler ultrasonography. Enhanced chest computed tomography showed that the left CCA ran across the left IJV from medial to lateral at the level of the clavicle. INTERVENTION: A triple-lumen central venous catheter was inserted at the right IJV to avoid complications caused by the anatomical variation. OUTCOMES: There were no intraoperative or postoperative complications. LESSONS: Anesthesiologists should consider anatomical variation during central venous cannulation, especially with the left IJV approach. Because of anatomical variation, ultrasound-guided intervention is highly recommended to prevent procedure-related complications.


Assuntos
Cateterismo Venoso Central/métodos , Veias Jugulares/diagnóstico por imagem , Aspergilose Pulmonar/cirurgia , Ultrassonografia de Intervenção/métodos , Idoso , Variação Anatômica , Artéria Carótida Primitiva/diagnóstico por imagem , Feminino , Humanos , Veias Jugulares/anatomia & histologia , Aspergilose Pulmonar/diagnóstico por imagem , Aspergilose Pulmonar/patologia , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Ultrassonografia Doppler em Cores/métodos
8.
Ultrasonics ; 104: 106093, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32151876

RESUMO

Color Doppler (CD) ultrasound has been commonly employed in biomedical field to get hemodynamic information. However, reliable diagnostic evaluation and criteria for vascular diseases may not be provided due to technical limitations of CD, including single-directional measurement, aliasing, and limited imaging conditions. In this study, adaptive hybrid (AH) scheme is proposed to enhance measurement accuracy of conventional CD. It can improve the accuracy of velocity field measurement by replacing erroneous vectors in the measured CD results with the correct vectors obtained from a speckle image velocimetry (SIV) technique. The performance of the proposed AH technique was validated through in vitro experiments for various flow rates and insonation angle conditions, comparing conventional velocimetry techniques. The in vitro experiments demonstrated that the AH technique could measure flow velocity with better accuracy than the CD with bias errors of below 0.7 mm/s. The clinical applicability of the AH was also validated by measuring venous flows at human lower extremity, checking constant volumetric flow rates. Flow rates measured by the AH were maintained along the vein, while the CD and SIV results varied. As a result, the AH can provide improved measurement accuracy without installing a new supplementary equipment. It would be effectively utilized for analyzing flow dynamics and diagnosing valve-related disease.


Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Extremidade Inferior/irrigação sanguínea , Ultrassonografia Doppler em Cores/métodos , Doenças Vasculares/diagnóstico por imagem , Adulto , Algoritmos , Feminino , Humanos , Aumento da Imagem , Masculino , Imagens de Fantasmas , Transdutores
9.
Ann Afr Med ; 19(1): 8-14, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32174609

RESUMO

Background: Deep-venous thrombosis (DVT) of lower limbs is one of the most common causes of death caused by pulmonary embolism. Many medical and surgical disorders are complicated by DVT. B-mode and color Doppler imaging are needed for the early diagnosis of DVT to prevent complications and sequalae of DVT. Objectives: The objectives of this study are to evaluate the role of Doppler ultrasound in diagnosing DVT of lower limbs and to study the spectrum of findings in patients with DVT in Zaria. Methodology: A retrospective study was carried out on patients who had Venous Doppler Scan in the Department of Radiology ABUTH, Zaria, Nigeria, for suspected DVT over a period of 4 years from February 2014 to January 2018. Scans were done using DC-3 and DC-6 Mindray Ultrasound machines (2009 and 2013 Models, respectively, Shantou, China) coupled with high-frequency (7.5-12 MHz) linear and low-frequency curvilinear (2-5 MHz) transducers. Analysis of cases of DVT was performed in terms of age, sex, clinical features, predisposing conditions, anatomic distribution, stage, and pattern of thrombus involvement in the veins. Data were analyzed using the SPSS version 20.0 and value of P < 0.005 was considered as statistically significant. Results: A total of 252 patients' results were reviewed which consisted of 122 males (48.4%) and 130 females (51.6%). The patients' ages ranged from 11 to 80 years, averaging 45.5 ± 9.56 years. The most common indication for Doppler request was leg swellings. The most common risk factor for DVT was malignancy (36%), cardiac disorders (18%), and traumas (14%). Sixty-six (61%) cases showed left-sided and 26 (24%) right-sided, whereas 16 (15%) cases showed bilateral lower limb involvement. Predominant thrombus was above-knee region with 54% in the superficial femoral vein. Chronic stage was seen in 46 (42%) cases, subacute in 44 (41%) cases, and acute in 18 (17%) cases. Conclusion: Middle-aged females, left-sided leg, and above-knee segment were predominantly affected with DVT; hence, this buttresses the need for Doppler ultrasound in the diagnosis of DVT in all patients.


Assuntos
Perna (Membro)/irrigação sanguínea , Perna (Membro)/diagnóstico por imagem , Ultrassonografia Doppler em Cores/métodos , Trombose Venosa/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
10.
Rev Assoc Med Bras (1992) ; 66(1): 31-35, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32130378

RESUMO

Homozygous familial hypercholesterolemia is a rarely agentic disorder of the lipoprotein metabolism intimately related to premature atherosclerotic cardiovascular disease that can lead to high disability and mortality. Homozygous familial hypercholesterolemia typically affects not only the aortic root, compromising the coronary ostia, but also affects other territories such as the carotid, descending aorta, and renal arteries. Multi-contrast high-resolution magnetic resonance imaging (MRI) provides a validated and useful method to characterize carotid artery atherosclerotic plaques quantitatively. However, very few studies have been done on assessing plaque composition in patients with Homozygous familial hypercholesterolemia using high-resolution MRI. This report is to evaluate the value of MRI in accessing carotid artery disease in patients with Homozygous familial hypercholesterolemia. We describe a 28-year-old patient from Beijing, China, who presented to the Neurology Clinic with intermittent blurred vision of the right eye, headache, nausea, and vomiting for eight years without obvious causes. Familial hypercholesterolemia was suspected based on medical history and laboratory examination. Carotid Doppler ultrasound showed bilateral common carotid artery, internal carotid artery, and external carotid artery wall thickening with hyperechoic signals. Subsequently, high-resolution multi-contrast MRI of the carotid showed calcification with hypo-intense areas located at the middle layer of the plaque, with moderate stenosis. The plaque located at the right bifurcation of the common carotid artery extended to the internal carotid artery, causing lumen stenosis close to occlusion. The patient was treated with right carotid artery endarterectomy. At a 6-month follow-up, there had been no recurrence of the patient's symptoms.


Assuntos
Estenose das Carótidas/diagnóstico por imagem , Doença da Artéria Coronariana/diagnóstico por imagem , Hiperlipoproteinemia Tipo II/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Placa Aterosclerótica/diagnóstico por imagem , Trombose/diagnóstico por imagem , Adulto , Artéria Carótida Externa/diagnóstico por imagem , Artéria Carótida Externa/patologia , Artéria Carótida Interna/diagnóstico por imagem , Artéria Carótida Interna/patologia , Espessura Intima-Media Carotídea , Angiografia por Tomografia Computadorizada/métodos , Feminino , Humanos , Placa Aterosclerótica/patologia , Ultrassonografia Doppler em Cores/métodos
11.
Rev. clín. esp. (Ed. impr.) ; 220(2): 126-134, mar. 2020. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-186426

RESUMO

La ecografía clínica se ha desarrollado exponencialmente en la última década en distintos ámbitos de la medicina. De igual manera que ha ocurrido en otros campos de actuación de la medicina interna, su uso se ha implantado en la enfermedad tromboembólica venosa, tanto en la trombosis venosa profunda como en la embolia pulmonar. En esta revisión se repasan las técnicas para el diagnóstico, tanto de la trombosis venosa profunda a través de la ultrasonografía por compresión, como de la ecografía multiórgano que incluye la ultrasonografía por compresión, la ecografía pulmonar en busca de infartos pulmonares y la ecocardioscopia para la detección de dilatación y/o disfunción del ventrículo derecho, para el diagnóstico de la embolia pulmonar. Además, se plantean los escenarios clínicos más frecuentes en los que puede ser de ayuda la ecografía clínica en la vida real, así como sus limitaciones y la evidencia existente


The use of clinical ultrasonography has grown exponentially in the past decade in various medical settings. As with other areas of activity in the field of internal medicine, clinical ultrasonography has been implemented in venous thromboembolism disease, both in deep vein thrombosis and pulmonary embolism. In this review, we cover the diagnostic techniques, both for deep vein thrombosis through compression ultrasonography and for multiorgan ultrasonography, which include compression ultrasonography, pulmonary ultrasonography in the search for pulmonary infarctions and echocardiography for detecting dilation and right ventricular dysfunction for the diagnosis of pulmonary embolism. We also establish the most common clinical scenarios in which clinical ultrasonography can be of assistance in actual clinical practice, as well as its limitations and current evidence


Assuntos
Humanos , Ultrassonografia/métodos , Tromboembolia Venosa/diagnóstico por imagem , Trombose Venosa/diagnóstico por imagem , Embolia Pulmonar/diagnóstico por imagem , Endossonografia/métodos , Tratamento de Emergência/métodos , Sensibilidade e Especificidade , Ultrassonografia Doppler em Cores/métodos
12.
Radiol Med ; 125(5): 481-490, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32020529

RESUMO

OBJECTIVES: To systematically review the current literature concerning the role of superb microvascular imaging (SMI), a novel Doppler technique that enables detection of fine vessels and slow blood flow, in the evaluation of musculoskeletal disorders. METHODS: An online search of the literature was conducted for the period 2013 to April 2019 and included original articles written in English language. A data analysis was performed at the end of the literature search. RESULTS: Eight original articles with prospective design and one with retrospective design were included in this review: 4 studies focused on rheumatoid arthritis, 2 on rheumatoid and other arthritides, 1 on lateral epicondylosis and 2 on carpal tunnel syndrome. Sample size ranged from 26 to 83 patients. Despite some methodological differences, all studies compared the performance of SMI with that of a conventional Doppler technique such as power and color Doppler and found an improvement in vascularity detection with SMI. The main variations were in sample size, evaluated parameters and vascularity interpretation methods. Inter-observer agreement for SMI ranged from moderate to excellent. CONCLUSIONS: SMI is a promising tool for the diagnosis and treatment planning of different musculoskeletal disorders. Future investigations should include larger samples of patients with long-term follow-up.


Assuntos
Microvasos/diagnóstico por imagem , Doenças Musculoesqueléticas/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Artrite/diagnóstico por imagem , Artrite/fisiopatologia , Artrite Reumatoide/diagnóstico por imagem , Artrite Reumatoide/fisiopatologia , Velocidade do Fluxo Sanguíneo , Síndrome do Túnel Carpal/diagnóstico por imagem , Síndrome do Túnel Carpal/fisiopatologia , Humanos , Microvasos/fisiopatologia , Doenças Musculoesqueléticas/fisiopatologia , Síndromes de Compressão Nervosa/diagnóstico por imagem , Síndromes de Compressão Nervosa/fisiopatologia , Estudos Prospectivos , Estudos Retrospectivos , Tendinopatia/diagnóstico por imagem , Tendinopatia/fisiopatologia , Cotovelo de Tenista/diagnóstico por imagem , Cotovelo de Tenista/fisiopatologia , Ultrassonografia Doppler em Cores/métodos
13.
Eur Radiol ; 30(5): 3023-3033, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32006174

RESUMO

OBJECTIVES: To develop a dual-modal neural network model to characterize ultrasound (US) images of breast masses. MATERIALS AND METHODS: A combined US B-mode and color Doppler neural network model was developed to classify US images of the breast. Three datasets with breast masses were originally detected and interpreted by 20 experienced radiologists according to Breast Imaging-Reporting and Data System (BI-RADS) lexicon ((1) training set, 103212 masses from 45,433 + 12,519 patients. (2) held-out validation set, 2748 masses from 1197 + 395 patients. (3) test set, 605 masses from 337 + 78 patients). The neural network was first trained on training set. Then, the trained model was tested on a held-out validation set to evaluate agreement on BI-RADS category between the model and the radiologists. In addition, the model and a reader study of 10 radiologists were applied to the test set with biopsy-proven results. To evaluate the performance of the model in benign or malignant classifications, the receiver operating characteristic curve, sensitivities, and specificities were compared. RESULTS: The trained dual-modal model showed favorable agreement with the assessment performed by the radiologists (κ = 0.73; 95% confidence interval, 0.71-0.75) in classifying breast masses into four BI-RADS categories in the validation set. For the binary categorization of benign or malignant breast masses in the test set, the dual-modal model achieved the area under the ROC curve (AUC) of 0.982, while the readers scored an AUC of 0.948 in terms of the ROC convex hull. CONCLUSION: The dual-modal model can be used to assess breast masses at a level comparable to that of an experienced radiologist. KEY POINTS: • A neural network model based on ultrasonic imaging can classify breast masses into different Breast Imaging-Reporting and Data System categories according to the probability of malignancy. • A combined ultrasonic B-mode and color Doppler neural network model achieved a high level of agreement with the readings of an experienced radiologist and has the potential to automate the routine characterization of breast masses.


Assuntos
Neoplasias da Mama/classificação , Neoplasias da Mama/diagnóstico por imagem , Redes Neurais de Computação , Ultrassonografia Doppler em Cores/métodos , Ultrassonografia Mamária/métodos , Adulto , Idoso , Área Sob a Curva , Neoplasias da Mama/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Curva ROC , Radiologistas , Estudos Retrospectivos , Sensibilidade e Especificidade
14.
Radiología (Madr., Ed. impr.) ; 62(1): 3-12, ene.-feb. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-194141

RESUMO

Los pacientes con heridas penetrantes y sospecha de cuerpos extraños retenidos representan un motivo frecuente de consulta en los servicios de urgencias. Es necesario un estudio radiográfico para descartar la presencia de cuerpos extraños. Sin embargo, las radiografías solo resultan de utilidad en los objetos radiopacos (metal, vidrio, piedra y algunos plásticos). Cuando la sospecha diagnóstica es alta y el estudio radiográfico es negativo, es necesario realizar otras pruebas de imagen. La ecografía ha demostrado su utilidad en la identificación y localización de cuerpos extraños tanto radiopacos como radiotransparentes. La ecografía permite una excelente evaluación de las estructuras adyacentes (músculos, tendones, ligamentos y estructuras neurovasculares) y ha demostrado ser de utilidad en la valoración de sus lesiones asociadas. Los diferentes materiales de los cuerpos extraños presentan patrones ecográficos característicos que resultan de utilidad para su aproximación diagnóstica. Por último, es importante estar familiarizado con los potenciales errores diagnósticos para evitar falsos positivos


Patients with penetrating wounds with suspected foreign bodies retained in the wound are often seen in emergency departments. Imaging studies are necessary to rule out the presence of retained foreign bodies. Plain-film X-rays, however, are only useful when the foreign bodies contain radiopaque material (metal, glass, stone, and some plastics). In cases with strong diagnostic suspicion and negative plain films, other imaging tests are necessary. Ultrasonography has proven useful in the identification and location of both radiopaque and radiotransparent foreign bodies. Ultrasonography enables excellent assessment of adjacent anatomical structures (muscles, tendons, ligaments, and neurovascular structures) and of associated lesions. The different materials found in foreign bodies have characteristic ultrasonographic patterns that are useful for diagnosis. Finally, it is important to be familiar with the diagnostic pitfalls to avoid false positives


Assuntos
Humanos , Masculino , Feminino , Criança , Pessoa de Meia-Idade , Corpos Estranhos/diagnóstico por imagem , Ultrassonografia/métodos , Erros de Diagnóstico , Tela Subcutânea/diagnóstico por imagem , Tela Subcutânea/lesões , Corpos Estranhos/complicações , Ultrassonografia Doppler em Cores/métodos
15.
Clin Hemorheol Microcirc ; 75(2): 177-188, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31929153

RESUMO

BACKGROUND: Contrast-enhanced ultrasound (CEUS) has been used as an additional imaging technique in order to clarify rare focal splenic lesions (FSL). CEUS is a safe and cost-effective modality for assessment of perfusion. OBJECTIVE: To validate contrast enhancement pattern and evaluate the diagnostic accuracy of CEUS in unclear FSL. METHODS: CEUS examinations of the spleen in 50 patients between 2012 and 2018 were included in the study. Examinations were performed using B-mode, colour-coded Doppler ultrasound (CCDS) and CEUS after injection of sulphur hexafluoride microbubbles and interpreted in consensus by two experienced radiologists. Reference standard was defined as histopathological report and clinical course (treatment response, long term follow up). RESULTS: All patients were successfully examined by CEUS without an adverse reaction. CEUS presented the correct differentiation of benign and malignant alterations in 49/50 (98%). Lesion washout was found in all malignant but also 16.7% of all benign lesions. Matched to the histopathological report and clinical follow up, CEUS represented a sensitivity of 100% (95% -CI, 57-100), a specificity of 98% (95% -CI, 88-100), a positive predictive value (PPV) of 83% (95% -CI, 44-97) and a negative predictive value (NPV) of 100% (95% -CI, 92-100). CONCLUSION: CEUS may provide additional information by visualization of dynamic contrast enhancement pattern to differentiate benign and malignant lesions. Nevertheless, established criteria for malignancy (early enhancement or washout) in FSL should be considered with caution since they are also found in benign lesions.


Assuntos
Meios de Contraste/uso terapêutico , Esplenopatias/diagnóstico por imagem , Ultrassonografia Doppler em Cores/métodos , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
16.
World Neurosurg ; 138: 645-653, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31931232

RESUMO

BACKGROUND: The article uses ultrasound imaging standard section to examine the fetal central nervous system (CNS) in early pregnancy, combined with ultrasound imaging in the diagnosis of fetal CNS malformation in the middle and late pregnancy, to determine the feasibility of ultrasound imaging in the detection of CNS abnormalities in the first trimester of the fetus. METHODS: The article selected 2701 pregnant women from the Department of Ultrasound in our hospital from November 2012 to November 2016 to screen for the transparent layer of the fetal neck in early pregnancy, with a total of 2751 cases. The article uses Madison V20 and Madison XG color Doppler ultrasound diagnostic instruments, the probe frequency is measured from 2.0-3.5 MHz, grouped according to gestational age, the statistical section of the case is displayed, and the transparent layer of the neck value is used to count the ultrasound image during early pregnancy. The detection of the CNS malformation by the standard section examination and the sensitivity, specificity, positive predictive value, and negative predictive value of the diagnosis may affect the cause of the CNS display rate. RESULTS: The sensitivity, specificity, positive predictive value, and negative predictive value of the ultrasound standard section in the diagnosis of fetal CNS malformation in early pregnancy were 85.7%, 100%, 100%, and 99.9%, respectively. Through research, it is found that the use of ultrasound imaging standard section can effectively diagnose fetal CNS severe deformity in early pregnancy, and the detection rate of CNS malformation in early pregnancy is 85.7%. At the same time, the number of positive cases and CNS malformations in this group were few. CONCLUSIONS: The positive cases detected in early pregnancy were severe malformations of the CNS. The diagnosis of other CNS malformations in the fetus needs further study.


Assuntos
Feto/diagnóstico por imagem , Malformações do Sistema Nervoso/diagnóstico por imagem , Obstetrícia/métodos , Ultrassonografia Doppler em Cores/métodos , Ultrassonografia Pré-Natal/métodos , Feminino , Feto/anormalidades , Seguimentos , Humanos , Malformações do Sistema Nervoso/embriologia , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez
17.
World Neurosurg ; 138: 629-636, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31981787

RESUMO

This paper explores the diagnosis of deep invasive endometriosis through retrospective data analysis, including deep infiltration and magnetic resonance imaging. The literature retrospectively collected data from 21 patients with deep invasive endometriosis who were admitted from 2012 to 2018. The patients were confirmed to have pain and nerve growth factor (NGF) receptor expression levels after operation and underwent vaginal color ultrasound and magnetic resonance imaging before surgery. The diagnostic results of color Doppler ultrasound and magnetic resonance imaging were retrospectively analyzed and compared with the surgical results, and the cumulative site and anatomic abnormalities of the diagnosis of deep invasive endometriosis were analyzed to determine the NGF receptor table. Through research it has been found that deep invasive endometriosis mainly involves the uterine fibula ligament, vagina, uterus rectum, rectum, ureter, and so forth. Patient pain is related to the expression level of NGF receptor, and its magnetic resonance mainly manifests as signals and structural obstacles, irregular thickening of the affected area, or nodular formation and deformation of adjacent tissues and organs. Through research and demonstration of deep invasive endometriosis, transvaginal color ultrasound and magnetic resonance imaging can not only accurately locate the expression levels of pain and NGF receptors, but also show the extent of the lesions, thereby studying pain and NGF receptor expression, which is an important method for preoperative examination and postoperative follow-up.


Assuntos
Endometriose/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Dor/diagnóstico por imagem , Receptor de Fator de Crescimento Neural/biossíntese , Ultrassonografia Doppler em Cores/métodos , Vagina/diagnóstico por imagem , Adulto , Endometriose/metabolismo , Feminino , Humanos , Dor/metabolismo , Estudos Retrospectivos
18.
J Clin Ultrasound ; 48(5): 294-297, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31981367

RESUMO

Although external jugular vein (EJV) aneurysms are infrequent, regardless of etiology, spontaneous pseudoaneurysms (PAs) are extremely rare and generally require surgery. We describe a case of spontaneous PA of the EJV, which was successfully treated by percutaneous thrombin injection.


Assuntos
Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/tratamento farmacológico , Hemostáticos/uso terapêutico , Veias Jugulares/diagnóstico por imagem , Trombina/uso terapêutico , Ultrassonografia Doppler em Cores/métodos , Feminino , Hemostáticos/administração & dosagem , Humanos , Pessoa de Meia-Idade , Terapêutica , Trombina/administração & dosagem
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