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1.
Radiol Clin North Am ; 58(6): 1009-1018, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33040844

RESUMO

Thyroid nodules are a common clinical problem encountered in an endocrine practice. More and more thyroid nodules are now being detected on unrelated imaging studies, leading to an increased diagnosis of low-risk thyroid cancers. There is therefore a greater emphasis on risk assessment based on clinical and sonographic features to avoid morbidity secondary to unnecessary therapy. Molecular diagnostics are also being widely used to further characterize indeterminate nodules. The American Thyroid Association and American College of Radiology-Thyroid Imaging Reporting and Data System guidelines are the most commonly used in clinical practice for risk assessment.


Assuntos
Guias de Prática Clínica como Assunto , Neoplasias da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/diagnóstico , Ultrassonografia Doppler/métodos , Biópsia por Agulha , Feminino , Humanos , Incidência , Masculino , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Medição de Risco , Sociedades Médicas , Análise de Sobrevida , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/epidemiologia , Nódulo da Glândula Tireoide/patologia , Estados Unidos
2.
Radiol Clin North Am ; 58(6): 1019-1031, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33040845

RESUMO

Radiologists very frequently encounter incidental findings related to the thyroid gland. Given increases in imaging use over the past several decades, thyroid incidentalomas are increasingly encountered in clinical practice, and it is important for radiologists to be aware of recent developments with respect to workup and diagnosis of incidental thyroid abnormalities. Recent reporting and management guidelines, such as those from the American College of Radiology and American Thyroid Association, are reviewed along with applicable evidence in the literature. Trending topics, such as artificial intelligence approaches to guide thyroid incidentaloma workup, are also discussed.


Assuntos
Inteligência Artificial/estatística & dados numéricos , Tomada de Decisão Clínica , Diagnóstico por Imagem/métodos , Achados Incidentais , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico por imagem , Biópsia por Agulha , Feminino , Humanos , Imuno-Histoquímica , Incidência , Imagem por Ressonância Magnética/métodos , Masculino , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Guias de Prática Clínica como Assunto , Radiologistas/estatística & dados numéricos , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/epidemiologia , Nódulo da Glândula Tireoide/patologia , Ultrassonografia Doppler/métodos , Estados Unidos/epidemiologia
3.
Radiol Clin North Am ; 58(6): 1033-1039, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33040846

RESUMO

Ultrasound is the best imaging modality for comprehensive evaluation of the thyroid. The thyroid is best imaged using a high-frequency linear probe with the patient in a supine position with the neck hyperextended. Normal thyroid is homogeneous in appearance without defining anatomic landmarks within the gland. A few anatomic variants can occur, and it is important for the sonographer and radiologist to be aware of these variants, to avoid misidentifying them as a pathology. This article provides a comprehensive review of ultrasound of the normal thyroid gland, including technique, normal anatomy, anatomic variants, imaging appearance, and technical pearls and pitfalls.


Assuntos
Glândula Tireoide/anatomia & histologia , Glândula Tireoide/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência
4.
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
5.
Radiol Clin North Am ; 58(6): 1071-1083, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33040849

RESUMO

Primary hyperparathyroidism (PHPT) is a common endocrine abnormality, caused in most cases by a single parathyroid adenoma. Surgery remains the first-line curative therapy in PHPT. Imaging plays a vital role in presurgical localization of parathyroid adenomas. Ultrasound provides a safe and quick imaging modality free of ionizing radiation, but is operator dependent. Sestamibi scan offers comparable sensitivity to ultrasound, improved with concurrent tomographic imaging. 4DCT remains a problem-solving technique in challenging cases and after failed neck exploration. We present an overview of various parathyroid imaging modalities, including protocols and findings, in addition to relevant pearls and pitfalls.


Assuntos
Hiperparatireoidismo Primário/diagnóstico por imagem , Imageamento Tridimensional , Neoplasias das Paratireoides/complicações , Neoplasias das Paratireoides/diagnóstico por imagem , Intensificação de Imagem Radiográfica , Tomografia Computadorizada por Raios X/métodos , Diagnóstico por Imagem/métodos , Feminino , Humanos , Hiperparatireoidismo Primário/etiologia , Masculino , Glândulas Paratireoides/diagnóstico por imagem , Glândulas Paratireoides/patologia , Glândulas Paratireoides/cirurgia , Neoplasias das Paratireoides/patologia , Neoplasias das Paratireoides/cirurgia , Paratireoidectomia/métodos , Prognóstico , Compostos Radiofarmacêuticos , Resultado do Tratamento , Ultrassonografia Doppler/métodos
6.
Radiol Clin North Am ; 58(6): 1085-1098, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33040850

RESUMO

Fine-needle aspiration (FNA) and core biopsy of masses in the neck predominantly include samples from thyroid nodules, parathyroids and lymph nodes. The diagnostic rate of a thyroid nodule FNA improves up to 6 passes and then does not significantly change. Thyroid FNA can be performed on patients who are anticoagulated. Appropriate transducer selection is essential for visualization of the needle. Lymph node biopsies can be additionally sampled for thyroglobulin assay to improve sensitivity for detection of recurrent carcinoma. Parathyroid FNA usually involves additional estimation of parathyroid hormone concentration in needle washouts. Biopsies of the neck are simple procedures with minimal complications.


Assuntos
Biópsia por Agulha Fina/métodos , Biópsia com Agulha de Grande Calibre/métodos , Biópsia Guiada por Imagem/métodos , Neoplasias das Paratireoides/patologia , Neoplasias da Glândula Tireoide/patologia , Feminino , Neoplasias de Cabeça e Pescoço/mortalidade , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Masculino , Neoplasias das Paratireoides/diagnóstico por imagem , Melhoria de Qualidade , Sensibilidade e Especificidade , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Ultrassonografia Doppler/métodos
7.
Sci Rep ; 10(1): 17485, 2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-33060679

RESUMO

Impella CP is a percutaneously inserted left ventricular assist device indicated for temporary mechanical cardiac support during high risk percutaneous coronary interventions and for cardiogenic shock. The potential application of Impella has become particularly relevant during the current COVID-19 pandemic, for patients with acute severe heart failure complicating viral illness. Standard implantation of the Impella CP is performed under fluoroscopic guidance. Positioning of the Impella CP can be confirmed with transthoracic or transoesophageal echocardiography. We describe an alternative approach to guide intracardiac implantation of the Impella CP using two-dimensional and three-dimensional intracardiac echocardiography. This new technique can be useful in selected groups of patients when fluoroscopy, transthoracic and transoesophageal echocardiography is deemed inapplicable or limited for epidemiological or clinical reasons. Intracardiac three-dimensional echocardiography is a feasible alternative to the traditional techniques for implantation of an Impella CP device but careful consideration must be given to the potential limitations and complications of this technique.


Assuntos
Insuficiência Cardíaca/terapia , Coração Auxiliar , Animais , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/fisiologia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Infecções por Coronavirus/patologia , Infecções por Coronavirus/virologia , Modelos Animais de Doenças , Ecocardiografia , Feminino , Insuficiência Cardíaca/complicações , Imageamento Tridimensional , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/patologia , Pneumonia Viral/virologia , Próteses e Implantes , Ovinos , Ultrassonografia Doppler
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2043-2046, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018406

RESUMO

Segmentation of carotid vessel wall is required in vessel wall volume (VWV) and local vessel-wall-plus-plaque thickness (VWT) quantification of the carotid artery. Manual segmentation of the vessel wall is time-consuming and prone to interobserver variability. In this paper, we proposed a convolutional neural network (CNN) to segment the common carotid artery (CCA) from 3D carotid ultrasound images. The proposed CNN involves three U-Nets that segmented the 3D ultrasound (3DUS) images in the axial, lateral and frontal orientations. The segmentation maps generated by three U-Nets were consolidated by a novel segmentation average network (SAN) we proposed in this paper. The experimental results show that the proposed CNN improved the segmentation accuracies. Compared to only using U-Net alone, the proposed CNN improved the Dice similarity coefficient (DSC) for vessel wall segmentation from 64.8% to 67.5%, the sensitivity from 63.8% to 70.5%, and the area under receiver operator characteristic curve (AUC) from 0.89 to 0.94.


Assuntos
Artérias Carótidas , Imageamento Tridimensional , Artérias Carótidas/diagnóstico por imagem , Artéria Carótida Primitiva/diagnóstico por imagem , Ultrassonografia , Ultrassonografia Doppler
9.
Medicine (Baltimore) ; 99(40): e22276, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019402

RESUMO

INTRODUCTION: Thyroid nodules are scattered lesions caused by abnormal local growth of thyroid cells. In recent years, their prevalence rate has been rising gradually, and the probability of cancerations has also been increasing gradually. Therefore, we must pay more attention to them and carry out early intervention. However, at present, most of the intervention measures for patients with thyroid nodules are mainly clinical observation and follow-up, and no clear and effective drug intervention therapy has been proposed. The curative effect of acupuncture on thyroid nodules has been proved clinically. However, as there is no clear mechanism of action, no specific operation methods or Suggestions, it is necessary to make a systematic evaluation of acupuncture therapy, so as to lay a foundation for further research in the future. METHODS AND ANALYSIS: The following databases will be searched from their inception to June 2020: Electronic database includes PubMed, Embase, Cochrane Library, Web of Science, Nature, Science online, Chinese Biomedical Database WanFang, VIP medicine information, and China National Knowledge Infrastructure (CNKI). Primary outcomes: Color ultrasound of thyroid and cervical lymph nodes, FT3, FT4, TSH, TGAB, TPOAB, insulin resistance index (HOMA-IR). Data will be extracted by 2 researchers independently, risk of bias of the meta-analysis will be evaluated based on the Cochrane Handbook for Systematic Reviews of Interventions. All data analysis will be conducted by data statistics software Review Manager V.5.3. and Stata V.12.0. RESULTS: The results of this study will systematically evaluate the efficacy and safety of acupuncture therapy for patients with thyroid nodule. CONCLUSION: Through the systematic review of this study, the evidence of the treatment of thyroid nodule by acupuncture has been summarized so far, so as to provide guidance for further promoting the application of acupuncture therapy in patients with thyroid nodule. ETHICS AND DISSEMINATION: This study is a systematic review, the outcomes are based on the published evidence, so examination and agreement by the ethics committee are not required in this study. We intend to publish the study results in a journal or conference presentations. OPEN SCIENCE FRA NETWORK (OSF) REGISTRATION NUMBER: August 18, 2020. osf.io/uzck4. (https://osf.io/uzck4).


Assuntos
Terapia por Acupuntura/métodos , Nódulo da Glândula Tireoide/terapia , Terapia por Acupuntura/efeitos adversos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Testes de Função Tireóidea , Nódulo da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia Doppler
10.
Medicine (Baltimore) ; 99(37): e22185, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925790

RESUMO

BACKGROUND: To compare superb microvascular imaging with power Doppler imaging for evaluating joint lesion scores in rheumatoid arthritis based on high quality clinical cohort or case control studies. METHODS: We searched Medline (via PubMed), Web of Science, Cochrane Library, Embase, and Chinese Biomedical Literature Database without restrictions of language and publication status. Two investigators will identify relevant trials, extract data, and appraise risk of bias in each eligible trial. Data will be pooled by either a fixed-effects model or a random-effects model according to the results of heterogeneity identification. The primary outcomes include a semi-quantitative scoring system, through which synovial vascularity intensity was evaluated by means of both power Doppler imaging (PDI) and superb microvascular imaging (SMI). This study will only include high quality clinical cohort or case control studies. Statistical analyses were conducted by STATA version 15.1 software. RESULTS: This meta-analysis included 11 studies. A total of 4342 joints were assessed through both SMI and PDI. The pooled summary odds ratio was 2.12 (95% confidence interval = 1.80-2.51) with statistical significance (z = 8.82, P < .01). In subgroup analyses, the results revealed also that SMI exhibited more sensitive performance in different subgroups. We found no evidence for publication bias (t = 0.55, P = .598). CONCLUSION: Our meta-analysis indicates that SMI ultrasound is more sensitive than conventional PDI in detecting synovitis in RA patients. INPLASY REGISTRATION NUMBER: INPLASY202060089.


Assuntos
Artrite Reumatoide/diagnóstico por imagem , Sinovite/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Humanos , Microvasos/diagnóstico por imagem , Membrana Sinovial/irrigação sanguínea , Ultrassonografia/métodos
11.
Ultrasound Q ; 36(3): 200-205, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32890322

RESUMO

The coronavirus disease 2019 is caused by the severe acute respiratory syndrome coronavirus 2. The virus can be spread by close person-to-person contact primarily by respiratory droplets. Given the close proximity of the sonographer or sonologist with the patient during ultrasound examinations, special precautions should be taken to limit the exposure of radiology personnel to patients with coronavirus disease 2019 while still providing optimal patient care. Methods covered in this article include modified workflow, close scrutiny and prioritization of imaging orders, and design of targeted ultrasound protocols. These guidelines summarize the personal experience and insight of multiple colleagues who lead ultrasound sections or are experts in the field.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Serviço Hospitalar de Radiologia/normas , Ultrassonografia Doppler/normas , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Saúde do Trabalhador , Avaliação de Resultados em Cuidados de Saúde , Pandemias/estatística & dados numéricos , Segurança do Paciente/estatística & dados numéricos , Pneumonia Viral/epidemiologia
13.
Rev. int. androl. (Internet) ; 18(3): 91-95, jul.-sept. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-193599

RESUMO

PURPOSE: In this study, we retrospectively reviewed the penile color Doppler ultrasound (PCDU) scans of the patients who had admitted to our clinic with erectile dysfunction and aimed to evaluate the contribution of penile Doppler scan results to the clinical decisions. MATERIAL-METHOD: The data of patients admitted to our outpatient clinic with complaints of erectile dysfunction (IIEF-5 score<22 or IIEF-EF score<26) between January 2005 and January 2018 were retrospectively evaluated. Patients whose testosterone level is lower than 280ng/ml or who had undergone radical prostatectomy were excluded from the analysis. RESULTS: Three thousand ninety patients were included in the study. The mean age of our patients was 55.05±13.05 years. In total, 2139 (69%) patients had normal PCDU findings, 351 (11%) patients had arterial insufficiency, 531 (17%) patients had venous insufficiency, and 69 (2%) patients had arterial insufficiency with concurrent venous leakage. When the patients were divided into 2 groups ≤40 years (Group 1) old and >40 years (Group 2) old; normal PCDU findings were found in 432 patients (84%) of the Group 1 patients and normal PCDU findings in 1707 (66%) patients of the Group 2 patients (p < 0.0001). There were arterial insufficiency findings in 24 (4.7%) and 327 (12.7%) patients of the Group 1 and 2, respectively (p = 0.002). CONCLUSION: The etiology is psychogenic in the majority of patients who present with ED complaints to the urology clinic. With age, the prevalence of psychogenic ED is decreasing but still more than organic


OBJETIVO: En este estudio, revisamos retrospectivamente las ecografías Doppler a color del pene (PCDU) de los pacientes que ingresaron en nuestra clínica con disfunción erectile, el objetivo era evaluar la contribución de los resultados de la ecografía Doppler peneana a las decisiones clínicas. MATERIAL Y MÉTODO: Los datos de los pacientes ingresados en nuestra clínica ambulatoria con quejas de disfunción eréctil (puntuación IIEF-5<22 o puntuación IIEF-EF<26) entre enero de 2005 y enero de 2018 se evaluaron retrospectivamente. Los pacientes cuyo nivel de testosterona fuera inferior a 280ng/ml o a los cuales se les hubiera realizado una prostatectomía radical se excluyeron del análisis. RESULTADOS: En el estudio se incluyó a 3.090 pacientes. La media de edad de nuestros pacientes fue de 55,05±13,05 años. En total, en 2.139 pacientes (69%) hubo hallazgos normales en la PCDU; en 351 (11%) se observó insuficiencia arterial; en 531 (17%) insuficiencia venosa y en 69 (2%) insuficiencia arterial con reflujo venoso simultáneo. Cuando los pacientes se dividieron en 2 grupos, ≤40 años (grupo 1) y >40 años (grupo 2), se encontraron hallazgos normales de la PCDU en 432 pacientes (84%) de los pacientes del grupo 1 y hallazgos normales de PCDU en 1.707 pacientes (66%) del grupo 2 (p < 0,0001). Hubo hallazgos de insuficiencia arterial en 24 (4,7%) y 327 (12,7%) pacientes de los grupos 1 y 2, respectivamente (p = 0,002). CONCLUSIÓN: La etiología es psicógena en la mayoría de los pacientes que presentan quejas de en la clínica de urología. Con la edad, la prevalencia de la DE psicógena va disminuyendo, pero todavía es más psicógena que orgánica


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Disfunção Erétil/diagnóstico por imagem , Disfunção Erétil/psicologia , Disfunção Erétil/etiologia , Estudos Retrospectivos , Ultrassonografia Doppler , Pênis/diagnóstico por imagem , Insuficiência Venosa/fisiopatologia , Fatores Etários
14.
Emerg Med J ; 37(10): 644-649, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32907844

RESUMO

The current COVID-19 pandemic is causing diagnostic and risk stratification difficulties in Emergency Departments (ED) worldwide. Molecular tests are not sufficiently sensitive, and results are usually not available in time for decision making in the ED. Chest x-ray (CXR) is a poor diagnostic test for COVID-19, and computed tomography (CT), while sensitive, is impractical as a diagnostic test for all patients. Lung ultrasound (LUS) has an established role in the evaluation of acute respiratory failure and has been used during the COVID-19 outbreak as a decision support tool. LUS shows characteristic changes in viral pneumonitis, and while these changes are not specific for COVID-19, it may be a useful adjunct during the diagnostic process. It is quick to perform and repeat and may be done at the bedside. The authors believe that LUS can help to mitigate uncertainty in undifferentiated patients with respiratory symptoms. This review aims to provide guidance regarding indications for LUS, describe the typical sonographic abnormalities seen in patients with COVID-19 and provide recommendations around the logistics of performing LUS on patients with COVID-19 and managing the infection control risk of the procedure. The risk of anchoring bias during a pandemic and the need to consider alternative pathologies are emphasised throughout this review. LUS may be a useful point-of-care test for emergency care providers during the current COVID-19 pandemic if used within a strict framework that governs education, quality assurance and proctored scanning protocols.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Serviço Hospitalar de Emergência/estatística & dados numéricos , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Sistemas Automatizados de Assistência Junto ao Leito/organização & administração , Síndrome Respiratória Aguda Grave/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Infecções por Coronavirus/diagnóstico , Feminino , Humanos , Pulmão/fisiopatologia , Masculino , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Síndrome Respiratória Aguda Grave/epidemiologia , Índice de Gravidade de Doença , Ultrassonografia Doppler/estatística & dados numéricos , Reino Unido
15.
Chirurgia (Bucur) ; 115(4): 505-510, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32876024

RESUMO

Introduction: Spermatic vein thrombosis is a rare entity with poor clinical distinctive signs for the differential diagnosis, which raises numerous controversies about the appropriate management. Case report: A 55 years old man presents at the emergency room for left scrotal pain and swelling evolving for two weeks. The patient denied any recent local traumatic event. Physical examination revealed an approximately 15 to 20 cm length mass from the posterior scrotum to the external inguinal orifice. The other genitals had a healthy appearance at the moment of the examination. An incarcerated hernia couldn't be excluded. The Doppler ultrasound evaluation of the scrotum con firmed the suspicion of left testicular vein thrombosis with complete cessation of blood flow. Both testicles appeared to have regular blood flow. CT scan established that the thrombus extended up to the left external inguinal orifice. Surgical treatment was preferred to address an eventually incarcerated hernia. The left testicular vein was excised from the external orifice. Postoperative management consisted of apixaban for 30 days, and the cardiology department thus conducted the treatment. Conclusions: Doppler ultrasound evaluation of the scrotum represents the gold standard diagnostic test for spermatic vein thrombosis. There are still controversies about the management approach of this pathology, conservative or surgical.


Assuntos
Doenças Testiculares/diagnóstico por imagem , Testículo/irrigação sanguínea , Trombose Venosa/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Escroto/irrigação sanguínea , Escroto/diagnóstico por imagem , Doenças Testiculares/diagnóstico , Doenças Testiculares/cirurgia , Testículo/diagnóstico por imagem , Resultado do Tratamento , Ultrassonografia Doppler , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/cirurgia
16.
Ann Afr Med ; 19(3): 170-175, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32820728

RESUMO

Introduction: Doppler sonography of the cervical segment of the carotid arteries is becoming a popular tool for evaluating atherosclerosis of the carotid artery. We present the audit of findings on carotid ultrasound examination among patients with clinical suspicion and risks for cerebrovascular disease and possible correlates in Northern Nigeria. Materials and Methods: We performed carotid ultrasound examination on all patients referred for screening and clinical suspicion of cerebrovascular disease within the year 2017. The patients' characteristics, risk factors, presence of atheroma and characteristic of the atheroma, degree of stenotic disease as well as the presence of incidental ultrasound findings were reviewed and documented. Results: Out of the 62 patients, 55 (88.7%) of them had various degrees and types of atheromatous plaques in different segments of the cervical carotid arteries, whereas 7 (11.3%) were normal. The predominant risk factor was smoking followed by diabetes mellitus, whereas the highest indication for the scan was transient ischemic attack. Incidental thyroid lesions such as nodules and cysts were encountered in 14 (22.6%) of the patients. There is a statistically significant difference between sex and age with the side of lesion, degree of stenosis, segment involved, and type of atheromatous plaque. Conclusion: There is a statistically significant difference between sex and age with the side of lesion, degree of stenosis, segment involved, and type of atheromatous plaque. About one-fifth of our patients had incidental thyroid lesions. Therefore, routine screening of population at risk is highly recommended.


Assuntos
Artérias Carótidas/diagnóstico por imagem , Placa Aterosclerótica/diagnóstico por imagem , Fumar/efeitos adversos , Ultrassonografia Doppler/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Espessura Intima-Media Carotídea , Estenose das Carótidas/complicações , Estenose das Carótidas/epidemiologia , Feminino , Humanos , Masculino , Auditoria Médica , Pessoa de Meia-Idade , Nigéria , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico
17.
Clin Appl Thromb Hemost ; 26: 1076029620953217, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32854513

RESUMO

Deep vein thrombosis (DVT) is prevalent in patients with coronavirus disease 2019 (COVID-19). However, the risk factors and incidence rate of DVT remains elusive. Here, we aimed to assess the incidence rate and risk factors of DVT. All patients diagnosed with COVID-19 and performed venous ultrasound by ultrasound deparment between December 2019 and April 2020 in Wuhan Jin Yin-tan hospital were enrolled. Demographic information and clinical features were retrospectively collected. Notably, a comparison between the DVT and the non-DVT groups was explored. The incidence rate of venous thrombosis was 35.2% (50 patients out of 142). Moreover, the location of thrombus at the proximal extremity veins was 5.6% (n = 8), while at distal extremity veins was 35.2% (n = 50) of the patients. We also noted that patients with DVT exhibited a high level of D-dimer (OR 10.9 (95% CI, 3.3-36.0), P < 0.001), were admitted to the intensive care unit (OR 6.5 (95% CI, 2.1-20.3), P = 0.001), a lower usage of the anticoagulant drugs (OR 3.0 (95% CI, 1.1-7.8), P < 0.001). Finally, this study revealed that a high number of patients with COVID-19 developed DVT. This was observed particularly in critically ill patients with high D-dimer levels who required no anticoagulant medication.


Assuntos
Anticoagulantes/uso terapêutico , Infecções por Coronavirus/epidemiologia , Mortalidade Hospitalar/tendências , Pneumonia Viral/epidemiologia , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/epidemiologia , Adulto , Idoso , China , Estudos de Coortes , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Feminino , Hospitalização , Humanos , Incidência , Unidades de Terapia Intensiva/estatística & dados numéricos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Cobertura de Condição Pré-Existente , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Ultrassonografia Doppler/métodos , Trombose Venosa/tratamento farmacológico
18.
Nihon Shokakibyo Gakkai Zasshi ; 117(8): 695-705, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32779587

RESUMO

BACKGROUND: Transabdominal ultrasound is a promising technique to evaluate inflammatory bowel disease. Several studies have demonstrated a relationship between ultrasound findings and colonic inflammation. However, the applicability of transabdominal ultrasound in patients with ulcerative colitis (UC) has not been elucidated. The aim of this study was to clarify the relationship between the transabdominal ultrasound findings and endoscopic activity in patients with UC. METHODS: Patients with active and underwent transabdominal ultrasound and colonoscopy were enrolled in this retrospective single-center analysis. Blood flow in the bowel wall was evaluated by power Doppler ultrasound. Both the thickness and stratification of the bowel wall were assessed by B-mode ultrasound imaging. The endpoints were the correlations between the ultrasound appearances (i.e., blood flow, thickness, and stratification of the bowel wall) and endoscopic activity (endoscopic Mayo Score). RESULTS: There were 34 lesions in 26 patients evaluated. Blood flow and thickness of the bowel wall were positively significantly correlated with the endoscopic Mayo Scores (r=0.43, p=0.011 and r=0.503, p=0.002, respectively). According to the bowel stratification, the endoscopic Mayo Scores were significantly higher in unclear and diminished bowel wall stratifications than in the clear bowel wall stratifications (p<0.001 and p<0.001, respectively). When focusing on the endoscopic Mayo Scores of three lesions, blood flow was lower in ulcer lesions with a diameter of ≥10mm than in those with a diameter of <10mm. CONCLUSION: All transabdominal ultrasound findings of bowel blood flow, wall thickness, and wall stratification reflected colonic inflammation.


Assuntos
Colite Ulcerativa , Colonoscopia , Humanos , Inflamação , Estudos Retrospectivos , Índice de Gravidade de Doença , Ultrassonografia , Ultrassonografia Doppler
19.
Alerta (San Salvador) ; 3(2)ago.12, 2020. ilus
Artigo em Espanhol | LILACS, BISSAL | ID: biblio-1117098

RESUMO

En la actualidad el ultrasonido permite obtener en forma no invasiva imágenes de la mayoría de estructuras. A nivel cerebral, se puede acceder a la vasculatura y evaluar la hemodinamia. Es un estudio seguro, no utiliza radiación y se puede realizar a la cabecera del paciente, las veces necesarias, hasta en monitoreo continuo. La limitación es que necesita un operador y cerca del 5-20 % de las personas poseen ventanas óseas temporales poco accesibles, por el grosor del hueso. Durante la realización del Doppler transcraneal, se debe seguir una serie de pasos. Tras localizar los vasos esperados, según la ventana y profundidad, se siguen las ondas espectrales en al menos dos puntos en cada arteria y se miden las velocidades de cada una. El objetivo de esta revisión es describir las generalidades del doppler transcraneal y destacar las principales utilidades como herramienta diagnóstica en enfermedades cerebrovasculares y otras enfermedades neurológicas.


At present, ultrasound allows images of most structures to be obtained non-invasively. At the brain level, the vasculature can be accessed and hemodynamics evaluated. It is a safe study, it does not use radiation and it can be performed at the patient's bedside, as often as necessary, even under continuous monitoring. The limitation is that it requires an operator and about 5-20% of people have temporary bone windows that are not very accessible, due to the thickness of the bone. During the performance of the transcranial Doppler, a series of steps must be followed. After locating the expected vessels, according to the window and depth, the spectral waves are followed at at least two points in each artery and the velocities of each one are measured. The objective of this review is to describe the generalities of transcranial doppler and highlight the main uses as a diagnostic tool in cerebrovascular diseases and other neurological diseases.


Assuntos
Ultrassonografia Doppler , Neurologia
20.
Arch. argent. pediatr ; 118(4): e396-e399, agosto 2020. ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1118587

RESUMO

El pseudoaneurisma arterial es la dilatación de un vaso, producto de la lesión de la pared. Es generado, principalmente, por traumatismos y, en menor medida, por patologías inflamatorias del endotelio. Se presenta como un hematoma pulsátil y doloroso. Su diagnóstico suele realizarse debido a que, ante una ecografía Doppler, se observa una imagen hipoecoica adyacente a un vaso con flujo en su interior. Su baja prevalencia, asociada a su presentación clínica variable, puede generar confusión con infecciones de piel y partes blandas o trombosis. El manejo puede ser desde la compresión extrínseca hasta la cirugía abierta, y no existen algoritmos terapéuticos en la actualidad. Se describeel caso de un paciente de 13 años con un pseudoaneurisma en una rama muscular de la arteria femoral superficial, secundario a un traumatismo cortante en el que se realizó exitosamente el abordaje endovascular con colocación de microcoils para la exclusión del saco pseudoaneurismático.


Pseudoaneurysm or 'false aneurysm' is defined as an abnormal arterial dilatation produced by an injury to its wall that does not affect the three parietal layers like in 'true' aneurysms. In general, false aneurysms are related to traumatisms and, less frequently, to inflammatory disease of vascular endothelium. Clinically, it shows a pulsatile, painful hematoma in the affected region. The initial diagnosis is usually achieved by Doppler ultrasound showing a hypoechoic image in relation to a blood vessel or its wall. Due to the low prevalence of false aneurysm, it is commonly confused with skin and soft tissue's infections or with thrombosis. There are different options of treatment, from extrinsic compression to open surgery. We describe the case of a 13-year-old patient with traumatic false aneurysm of a muscular branch of femoral artery, successfully managed with endovascular exclusion of the lesion with microcoil


Assuntos
Humanos , Masculino , Adolescente , Falso Aneurisma/diagnóstico por imagem , Artéria Femoral , Ferimentos e Lesões , Ultrassonografia Doppler , Embolização Terapêutica , Procedimentos Endovasculares
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