Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.287
Filtrar
1.
Medicine (Baltimore) ; 100(9): e24575, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33655923

RESUMO

BACKGROUND: Sonography enhances diagnostic accuracy by the detection of the epineural or intraneuronal blood flow.[1-4] Power Doppler ultrasonography (PDUS) in carpal tunnel syndrome (CTS) has been previously studied and shown to be valid and reliable for grading the intraneural flow.[3,4] However, superb microvascular imaging (SMI) represents a new era in diagnostic sonography, and this new technology enables accurate visualization of vascular structures with intensive clutter suppression to provide flow signals for large to small vessels, and it presents these data at high frame rates.[5-7] Studies suggested that SMI is more sensitive in demonstrating blood flow in the diagnosis of CTS compared with PDUS.[7] In order to gain clarity, a meta-analysis to systematically review and synthesize relevant data on the evaluating intraneural blood flow of the median nerve (MN) using SMI and PDUS was undertaken. METHODS: We will search PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases from their inceptions to the December 31, 2020, without language restrictions. Two authors will independently carry out searching literature records, scanning titles and abstracts, full texts, collecting data, and assessing risk of bias. Review Manager 5.2 and Stata 14.0 software will be used for data analysis. RESULTS: This systematic review will investigate whether superb microvascular imaging is more sensitive to display the blood flow in the MN with CTS than PDUS. CONCLUSION: Its findings will provide strong evidence for the feasibility of superb microvascular imaging on the detection of the neovascularization of the MN with CTS. SYSTEMATIC REVIEW REGISTRATION: INPLASY202110018.


Assuntos
Síndrome do Túnel Carpal/diagnóstico por imagem , Nervo Mediano/irrigação sanguínea , Neovascularização Patológica/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Ultrassonografia/métodos , Humanos , Metanálise como Assunto , Microvasos/diagnóstico por imagem , Fluxo Sanguíneo Regional , Reprodutibilidade dos Testes , Projetos de Pesquisa , Revisões Sistemáticas como Assunto
2.
Undersea Hyperb Med ; 48(1): 59-72, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33648035

RESUMO

It is widely accepted that bubbles are a necessary but insufficient condition for the development of decompression sickness. However, open questions remain regarding the precise formation and behavior of these bubbles after an ambient pressure reduction (decompression), primarily due to the inherent difficulty of directly observing this phenomenon in vivo. In decompression research, information about these bubbles after a decompression is gathered via means of ultrasound acquisitions. The ability to draw conclusions regarding decompression research using ultrasound is highly influenced by the variability of the methodologies and equipment utilized by different research groups. These differences play a significant role in the quality of the data and thus the interpretation of the results. The purpose of this review is to provide a technical overview of the use of ultrasound in decompression research, particularly Doppler and brightness (B)-mode ultrasound. Further, we will discuss the strengths and limitations of these technologies and how new advancements are improving our ability to understand bubble behavior post-decompression.


Assuntos
Pesquisa Biomédica/métodos , Doença da Descompressão/diagnóstico por imagem , Ecocardiografia Doppler/métodos , Ultrassonografia Doppler/métodos , Descompressão , Doença da Descompressão/etiologia , Mergulho/fisiologia , Ecocardiografia Doppler/tendências , Embolia Aérea/diagnóstico por imagem , Embolia Aérea/etiologia , Humanos , Design de Software , Som , Transdutores , Ultrassonografia Doppler/instrumentação , Ultrassonografia Doppler/tendências
3.
Br J Anaesth ; 126(4): 818-825, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33632521

RESUMO

BACKGROUND: We designed a prospective sub-study of the larger Restrictive versus Liberal Fluid Therapy in Major Abdominal Surgery (RELIEF) trial to measure differences in stroke volume and other haemodynamic parameters at the end of the intraoperative fluid protocols. The haemodynamic effects of the two fluid regimens may increase our understanding of the observed perioperative outcomes. METHODS: Stroke volume and cardiac output were measured with both an oesophageal Doppler ultrasound monitor and arterial pressure waveform analysis. Stroke volume variation, pulse pressure variation, and plethysmographic variability index were also obtained. A passive leg raise manoeuvre was performed to identify fluid responsiveness. RESULTS: Analysis of 105 patients showed that the primary outcome, Doppler monitor-derived stroke volume index, was higher in the liberal group: restrictive 38.5 (28.6-48.8) vs liberal 44.0 (34.9-61.9) ml m-2; P=0.043. Similarly, there was a higher cardiac index in the liberal group: 2.96 (2.32-4.05) vs 2.42 (1.94-3.26) L min-1 m-2; P=0.015. Arterial-pressure-based stroke volume and cardiac index did not differ, nor was there a significant difference in stroke volume variation, pulse pressure variation, or plethysmographic variability index. The passive leg raise manoeuvre showed fluid responsiveness in 40% of restrictive and 30% of liberal protocol patients (not significant). CONCLUSIONS: The liberal fluid group from the RELIEF trial had significantly higher Doppler ultrasound monitor-derived stroke volume and cardiac output compared with the restrictive fluid group at the end of the intraoperative period. Measures of fluid responsiveness did not differ significantly between groups. CLINICAL TRIAL REGISTRATION: ACTRN12615000125527.


Assuntos
Débito Cardíaco/fisiologia , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Hidratação/métodos , Monitorização Intraoperatória/métodos , Complicações Pós-Operatórias/prevenção & controle , Volume Sistólico/fisiologia , Adulto , Idoso , Procedimentos Cirúrgicos do Sistema Digestório/tendências , Feminino , Hidratação/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Intraoperatória/tendências , Complicações Pós-Operatórias/diagnóstico por imagem , Estudos Prospectivos , Resultado do Tratamento , Ultrassonografia Doppler/métodos , Ultrassonografia Doppler/tendências
4.
Medicine (Baltimore) ; 100(7): e24820, 2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33607847

RESUMO

RATIONALE: Currently, placenta accreta treatment mainly includes nonconservative surgical and conservative treatments such as Traditional Chinese medicine (TCM). This report describes the case of a 37-year-old woman who suffered incomplete placenta accreta after vaginal delivery and was cured by TCM. TCM treatment of placenta accreta has its own unique advantages, including low toxicity and few side effects, unaffected breastfeeding, and retention of the uterus, which can ensure the expulsion of residual placenta and be beneficial to patients' physical and mental health. PATIENT CONCERNS: Symptoms included a small amount of vaginal bleeding and occasional lesser abdominal pain. The patient showed lesser abdominal tenderness, a red tongue moss with petechial hemorrhage, and a hesitant pulse. The reproductive history was G3P2L2A1. In addition, the patient was afraid of having her uterus removed due to incomplete placental separation. DIAGNOSES: The case was diagnosed as placental accreta. Ultrasound is the preferred method of diagnosis, and biomarkers, such as beta hCG, assist in screening for placental accreta. Doppler ultrasonography showed that in the bottom of the right uterine cavity, there was an uneven echo group of 7.6 × 4.6 cm, which was not clearly demarcated from the posterior wall; the muscle layer became thinner, with a thinnest part of 0.19 cm, and abundant blood flow signals were observed (Fig. 1JOURNAL/medi/04.03/00005792-202102190-00086/figure1/v/2021-02-16T234818Z/r/image-tiff). The beta hCG was 580.92 mIu/ml. INTERVENTIONS: The patient initially underwent curettage therapy 9 days after delivery, but it failed due to excessive intraoperative bleeding. The patient then turned to TCM treatment. The doctor prescribed a multi-herbal formula. OUTCOMES: After 4 months, the residual placenta was expelled, and the patient's symptoms disappeared completely. No adverse and unexpected events occurred during treatment. During 3 months of follow-up, the patient had no abdominal pain, abnormal vaginal bleeding, or other complications. LESSONS: This study shows that TCM is safe and effective for treating placenta accreta, and it is worth recommending TCM as a conservative treatment along with other treatments. In practice, however, we find that the earlier TCM treatment is applied, the better the effect; therefore, early intervention with TCM is particularly important.


Assuntos
Medicina Tradicional Chinesa/métodos , Placenta Acreta/diagnóstico por imagem , Placenta Acreta/terapia , Ultrassonografia Doppler/métodos , Adulto , Assistência ao Convalescente , Gonadotropina Coriônica Humana Subunidade beta/metabolismo , Tratamento Conservador/métodos , Feminino , Humanos , Placenta Acreta/metabolismo , Gravidez , Resultado do Tratamento , Hemorragia Uterina/etiologia
5.
Nat Commun ; 12(1): 1080, 2021 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-33597538

RESUMO

Clinicians have long been interested in functional brain monitoring, as reversible functional losses often precedes observable irreversible structural insults. By characterizing neonatal functional cerebral networks, resting-state functional connectivity is envisioned to provide early markers of cognitive impairments. Here we present a pioneering bedside deep brain resting-state functional connectivity imaging at 250-µm resolution on human neonates using functional ultrasound. Signal correlations between cerebral regions unveil interhemispheric connectivity in very preterm newborns. Furthermore, fine-grain correlations between homologous pixels are consistent with white/grey matter organization. Finally, dynamic resting-state connectivity reveals a significant occurrence decrease of thalamo-cortical networks for very preterm neonates as compared to control term newborns. The same method also shows abnormal patterns in a congenital seizure disorder case compared with the control group. These results pave the way to infants' brain continuous monitoring and may enable the identification of abnormal brain development at the bedside.


Assuntos
Encéfalo/diagnóstico por imagem , Córtex Cerebral/diagnóstico por imagem , Epilepsia/diagnóstico por imagem , Substância Cinzenta/diagnóstico por imagem , Substância Branca/diagnóstico por imagem , Algoritmos , Encéfalo/fisiopatologia , Córtex Cerebral/fisiopatologia , Epilepsia/diagnóstico , Epilepsia/fisiopatologia , Feminino , Substância Cinzenta/fisiopatologia , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Imagem por Ressonância Magnética/métodos , Masculino , Modelos Neurológicos , Rede Nervosa/diagnóstico por imagem , Rede Nervosa/fisiopatologia , Ultrassonografia Doppler/métodos , Substância Branca/fisiopatologia
6.
J Clin Ultrasound ; 49(1): 12-19, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32964472

RESUMO

PURPOSE: To investigate the association between placental blood perfusion and the occurrence of macrosomia at birth. METHODS: This was a prospective cohort study including women with singleton pregnancies that aimed to measure placental blood perfusion using three-dimensional (3D) power Doppler ultrasonography in the second and third trimester. We acquired three indices of placental blood flow, including vascularization index (VI), flow index (FI), vascularization flow index (VFI), along with routine two-dimensional (2D) biometric measurements, including abdominal circumference (AC) and estimated fetal weight (EFW). Pregnancy outcomes were divided into two groups: newborns with a normal birth weight and those with macrosomia. We then compared all of the recorded variables between these two groups. We also determined the predictive efficiency of each variable using receiver-operating characteristic (ROC) curves. RESULTS: The placental 3D power Doppler indices, including VI and FI, were significantly higher in the third trimester of pregnancies developing macrosomia, but not during the second trimester, as compared to those with a normal birth weight. ROC curves analysis for third-trimester VI and FI suggested a slight ability to predict macrosomia; this was also the case for AC and EFW. Interestingly, VI showed high sensitivity and low specificity, while FI showed low sensitivity and high specificity; this was also the case for AC and EFW. CONCLUSIONS: Three-dimensional power Doppler ultrasound indices were significantly higher during the third-trimester for pregnancies developing macrosomia. However, these indices had only moderate ability to predict macrosomia.


Assuntos
Macrossomia Fetal/diagnóstico , Imageamento Tridimensional/métodos , Placenta/diagnóstico por imagem , Placenta/fisiopatologia , Circulação Placentária/fisiologia , Ultrassonografia Doppler/métodos , Ultrassonografia Pré-Natal/métodos , Adulto , Feminino , Macrossomia Fetal/fisiopatologia , Peso Fetal , Idade Gestacional , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Estudos Prospectivos , Curva ROC
7.
J Clin Ultrasound ; 49(1): 66-70, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33000485

RESUMO

Monochorionic twin gestations are associated with a greater incidence of neonatal morbidity and mortality when compared with their dichorionic counterparts. In turn, monochorionic-monoamniotic (MCMA) gestations carry greater risks compared with monochorionic-diamniotic (MCDA) gestations. While the true incidence of spontaneous septostomy of the dividing membranes (SSDM) in MCDA twins is unknown, SSDM has been demonstrated to be associated with increased morbidity and mortality, due to functional transition from a MCDA gestation to a MCMA gestation. We report a case of SSDM in a mid-trimester MCDA gestation, review the literature, and describe how to identify and manage this complication.


Assuntos
Membranas Extraembrionárias/cirurgia , Gravidez de Gêmeos , Gêmeos Monozigóticos , Ultrassonografia Doppler/métodos , Ultrassonografia Pré-Natal/métodos , Adulto , Membranas Extraembrionárias/diagnóstico por imagem , Feminino , Humanos , Gravidez
8.
ASAIO J ; 67(1): 74-83, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33346993

RESUMO

The success of left ventricular assist device (LVAD) therapy is hampered by complications such as thrombosis and bleeding. Understanding blood flow interactions between the heart and the LVAD might help optimize treatment and decrease complication rates. We hypothesized that LVADs modify shear stresses and blood transit in the left ventricle (LV) by changing flow patterns and that these changes can be characterized using 2D echo color Doppler velocimetry (echo-CDV). We used echo-CDV and custom postprocessing methods to map blood flow inside the LV in patients with ongoing LVAD support (Heartmate II, N = 7). We compared it to healthy controls (N = 20) and patients with dilated cardiomyopathy (DCM, N = 20). We also analyzed intraventricular flow changes during LVAD ramp tests (baseline ± 400 rpm). LVAD support reversed the increase in blood stasis associated with DCM, but it did not reduce intraventricular shear exposure. Within the narrow range studied, the ventricular flow was mostly insensitive to changes in pump speed. Patients with significant aortic insufficiency showed abnormalities in blood stasis and shear indices. Overall, this study suggests that noninvasive flow imaging could potentially be used in combination with standard clinical methods for adjusting LVAD settings to optimize flow transport and minimize stasis on an individual basis.


Assuntos
Circulação Coronária/fisiologia , Ventrículos do Coração/diagnóstico por imagem , Coração Auxiliar , Hemodinâmica/fisiologia , Adulto , Ecocardiografia/métodos , Feminino , Insuficiência Cardíaca/terapia , Ventrículos do Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Mecânico , Ultrassonografia Doppler/métodos
9.
J Orthop Surg Res ; 15(1): 604, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33308269

RESUMO

BACKGROUND: The treatment for femoral shaft fracture (FSF) depends on the age of the patient. While the Pavlik harness is the first choice for patients under 6 months of age, spica casting is preferred for patients over 6 months and under preschool age. Minimally-invasive surgery using elastic stable intramedullary nails is also used in some cases. Skin traction is another treatment choice for some patients who are not candidates for the above methods. This study aimed to evaluate the feasibility of surveillance ultrasonography (US) for the conservative treatment of FSFs in young children. MATERIALS AND METHODS: This retrospective study included 92 children who were diagnosed with FSF in our hospital from April 2017 to May 2019. After applying the inclusion and exclusion criteria, they were divided into US surveillance (A) and control (B) groups. All patients received conservative treatment by skin traction. For group A, US was used to assess the femur fractures and adjust its reduction on days 1, 3, 5, 7, 10, and 14 until the fracture stabilized. For group B, the fractures were checked by radiographs on days 1, 3, 5, 7, 10, and 14 until the callus appeared. The FSF angle was measured using anteroposterior and lateral radiographs. RESULTS: All patients were followed up for 18 months. The radiographic evaluation of both groups at the final follow-up showed a significant difference in the FSF angle. The radiograph times and accumulated radiation also showed significant differences between the two groups. However, there was no significant difference in the incidence of complications. CONCLUSIONS: For FSF closed reduction, surveillance US is a better option compared to radiographs in children treated by skin traction. This approach can significantly decrease exposure to X-ray radiation and improve the reduction. LEVEL OF EVIDENCE: III.


Assuntos
Tratamento Conservador/métodos , Fraturas do Fêmur/diagnóstico por imagem , Fraturas do Fêmur/cirurgia , Ultrassonografia Doppler/métodos , Fatores Etários , Moldes Cirúrgicos , Criança , Pré-Escolar , Redução Fechada/métodos , Estudos de Viabilidade , Feminino , Fixação de Fratura/métodos , Humanos , Lactente , Masculino , Exposição à Radiação/prevenção & controle , Radiografia , Tração/métodos
10.
Rev. cuba. pediatr ; 92(4): e1083, oct.-dic. 2020. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1144517

RESUMO

Introducción: La malformación aneurismática en la vena de Galeno es infrecuente, pero tiene alta mortalidad en neonatos. Objetivo: Examinar la relevancia clínica del diagnóstico ecográfico de la malformación aneurismática en la vena de Galeno Métodos: Investigación observacional, prospectiva y transversal realizado en el Cardiocentro William Soler. (noviembre 1999-diciembre 2016) La muestra la conformaron 18 neonatos con diagnóstico de malformación aneurismática en la vena de Galeno variedad coroidea mediante ecografía doppler. Se configuraron dos grupos de referencia: 1) 70 niños supuestamente sanos. 2) 73 niños con malformación de la vena Galeno de diferente naturaleza que la variante coroidea estudiada. El procesamiento de la información incluyó elementos de estadística inferencial y herramientas de la medicina basada en la evidencia. Resultados: La presencia de fallo cardíaco neonatal, signos electrocardiográficos de isquemia miocárdica y detección de soplo continuo transcraneal, fueron significativamente diferentes en el grupo de estudio en relación con el grupo de referencia (p= 0,000001), con predominio en el número de pacientes del grupo estudio en todas las variables. Los resultados anteriores conjugados con diversos hallazgos ecográficos: la dilatación anómala de la vena, exceso de vasculatura aferente, reducción de los índices circulatorios encefálicos e incremento en los diámetros vasculares supraaórticos, identificaron de forma precisa la malformación aneurismática en la vena de Galeno. La evaluación del riesgo relativo reafirmó la documentación de los hallazgos expuestos. Conclusiones: La ecografía doppler, por su relevancia clínica y vínculo con otros elementos diagnósticos, es mandatoria en la detección de la malformación aneurismática en la vena de Galeno(AU)


Introduction: Vein of Galen aneurysmal malformation is not frequent but it has high mortality rates in newborns. Objective: To assess the clinical relevance of ultrasound diagnosis of Vein of Galen aneurysmal malformation. Methods: Observational, prospective and cross-sectional research conducted in William Soler Cardiocentro (November 1999- December 2016). The sample was formed by 18 newborns with diagnosis of Vein of Galen aneurysmal malformation (choroidal variety) through doppler echocardiography. Two reference groups were formed: 1) 70 supposedly healthy children; 2) 73 children with Vein of Galen malformation with a nature different to the studied choroidal variety. Processing of the information included elements of inferential statistics and tools from medicine based in evidences. Results: The presence of neonatal heart failure, electrocardiographic signs of myocardial ischemia and detection of transcranial continuous murmur were significantly different in the study group in relation with the reference group (p= 0,000001), with predominance in the number of patients of the study group in all the variables. The previous results combined with different ultrasound findings as the anomalous dilation of the vein, the excess of afferent vasculature, the reduction of encephalic circulation indexes and the increase of the supraaortic vascular diameters identified in a precise way the vein of Galen aneurysmal malformation. The assessment of the relative risk reaffirmed the information on the exposed findings. Conclusions: Doppler echography, due to its clinical importance and its links with other diagnostic elements, is mandatory in the detection of the vein of Galen aneurysmal malformation(AU)


Assuntos
Ultrassonografia Doppler/métodos , Malformações da Veia de Galeno/mortalidade , Malformações da Veia de Galeno/diagnóstico por imagem , Estudos Transversais , Estudos Prospectivos , Medição de Risco
12.
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
13.
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
14.
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
15.
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
16.
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
17.
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
18.
Angiol. (Barcelona) ; 72(5): 229-239, sept.-oct. 2020. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-195493

RESUMO

El síndrome de congestión pélvica (SCP) es una causa frecuente, aunque poco conocida, de dolor pélvico crónico en mujeres premenopáusicas. Aunque su etiología no está del todo clara, en general se acepta la incompetencia valvular como causa del SCP primario, mientras los síndromes compresivos llevan al SCP secundario. El diagnóstico de este síndrome se realiza después de excluir otras causas de dolor pélvico crónico y se basa en una combinación de síntomas clínicos característicos (dolor crónico, continuo o sordo, dispareunia, dismenorrea...) y en la documentación de dilatación o incompetencia de las venas pélvicas mediante pruebas de imagen. La terapia endovascular (escleroterapia, embolización o stent) de las venas incompetentes con reflujo o venas estenóticas constituye el estándar de tratamiento. El objetivo del presente trabajo es realizar una revisión actualizada de la literatura con el propósito de ayudar a mejorar el conocimiento de esta patología


Pelvic congestion syndrome (PCS) is a common, but little-known, cause of chronic pelvic pain in premenopausal women. Although its etiology is not entirely clear, valvular incompetence is generally accepted as the cause of primary PCS, while compressive syndromes lead to secondary PCS. The diagnosis of this syndrome is made after excluding other causes of chronic pelvic pain, and is based on a combination of characteristic clinical symptoms (chronic pain, continuous or dull, dyspareunia, and dysmenorrhea) and documentation of dilation or incompetence of pelvic veins by imaging tests. Endovascular therapy (sclerotherapy, embolization or stenting) of incompetent and reflux veins or stenotic veins, is today the standard of treatment. The objective of this work is to carry out an updated revision of the literature with the purpose of helping to improve the knowledge of this pathology


Assuntos
Humanos , Feminino , Dor Pélvica/diagnóstico , Dor Pélvica/terapia , Dor Crônica/diagnóstico , Dor Crônica/terapia , Síndrome , Pós-Menopausa , Ultrassonografia Doppler/métodos , Tomografia Computadorizada por Raios X/métodos , Espectroscopia de Ressonância Magnética/métodos , Diagnóstico Diferencial
19.
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
20.
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
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...