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1.
Ultrasound Obstet Gynecol ; 57(6): 861-879, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34077608

RESUMO

In centers with access to high-end ultrasound machines and expert sonologists, ultrasound is used to detect metastases in regional lymph nodes from melanoma, breast cancer and vulvar cancer. There is, as yet, no international consensus on ultrasound assessment of lymph nodes in any disease or medical condition. The lack of standardized ultrasound nomenclature to describe lymph nodes makes it difficult to compare results from different ultrasound studies and to find reliable ultrasound features for distinguishing non-infiltrated lymph nodes from lymph nodes infiltrated by cancer or lymphoma cells. The Vulvar International Tumor Analysis (VITA) collaborative group consists of gynecologists, gynecologic oncologists and radiologists with expertise in gynecologic cancer, particularly in the ultrasound staging and treatment of vulvar cancer. The work herein is a consensus opinion on terms, definitions and measurements which may be used to describe inguinal lymph nodes on grayscale and color/power Doppler ultrasound. The proposed nomenclature need not be limited to the description of inguinal lymph nodes as part of vulvar cancer staging; it can be used to describe peripheral lymph nodes in general, as well as non-peripheral (i.e. parietal or visceral) lymph nodes if these can be visualized clearly. The association between the ultrasound features described here and histopathological diagnosis has not yet been established. VITA terms and definitions lay the foundations for prospective studies aiming to identify ultrasound features typical of metastases and other pathology in lymph nodes and studies to elucidate the role of ultrasound in staging of vulvar and other malignancies. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.


Assuntos
Metástase Linfática/diagnóstico por imagem , Guias de Prática Clínica como Assunto , Ultrassonografia/normas , Neoplasias Vulvares/diagnóstico por imagem , Feminino , Ginecologia , Humanos , Metástase Linfática/patologia , Sociedades Médicas , Neoplasias Vulvares/patologia
4.
J Nucl Med ; 42(3): 424-9, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11337518

RESUMO

UNLABELLED: The aim of the study was to determine whether the sentinel lymph node (SLN) can be accurately detected in cutaneous melanoma patients when the injection distance from the tumor site is expanded. METHODS: In 100 patients with cutaneous melanoma, lymphoscintigraphy was performed twice. First, we injected 37 MBq (99m)Tc nanocolloid intracutaneously at a 2- to 5-mm distance from either the melanoma or the biopsy scar. The injection was followed by dynamic imaging, which continued until the SLN became visible. On another day, we repeated the investigation, injecting the radiopharmaceutical intracutaneously exactly 10 mm from the previous injection site. The detected SLNs of both investigations were compared to determine the number and location of SLNs for each patient. RESULTS: The SLN identification rate was 94% with close injection and 100% with 10-mm-distant injection. All SLNs detected with close injection were visible with distant injection. In 84 of 100 patients, the images of both investigations showed the same number and location of SLNs. In the remaining 16 patients, an additional SLN was detected with the distant injection. CONCLUSION: The reproducibility of lymphoscintigraphy using different injection distances was 84%. The discordance in the remaining 16% was caused by detection of a lymph node in addition to the original SLN with distant injection. Diagnostic excision of the primary tumor before lymphoscintigraphy was possible without preventing detection of the original SLN. However, in 16% of our patients, excision of an additional lymph node had to be considered when lymphoscintigraphy was performed after diagnostic excision.


Assuntos
Linfonodos/diagnóstico por imagem , Melanoma/diagnóstico por imagem , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas/patologia , Adulto , Idoso , Feminino , Humanos , Injeções Intradérmicas , Excisão de Linfonodo , Masculino , Melanoma/secundário , Pessoa de Meia-Idade , Cintilografia , Compostos Radiofarmacêuticos , Reprodutibilidade dos Testes , Agregado de Albumina Marcado com Tecnécio Tc 99m
5.
Radiol Clin North Am ; 38(5): 1131-45, xii, 2000 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11054973

RESUMO

Sonography is the first line modality for assessment of thyroid and parathyroid pathologies. Sonographic and color Doppler patterns of diffuse and focal pathologies of the thyroid are presented in this article. The accuracy of sonography in the localization of enlarged parathyroid glands is also discussed. The limitations of sonography in specifying focal thyroid diseases and the problems in localizing ectopic parathyroid adenoma are addressed.


Assuntos
Doenças das Paratireoides/diagnóstico por imagem , Doenças da Glândula Tireoide/diagnóstico por imagem , Adenoma/diagnóstico por imagem , Carcinoma/diagnóstico por imagem , Coristoma/diagnóstico por imagem , Humanos , Neoplasias das Paratireoides/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Ultrassonografia de Intervenção
6.
Ultrasound Med Biol ; 23(6): 851-6, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9300988

RESUMO

In a prospective study, color Doppler sonograms (CDS) were performed in 142 patients with solid breast lesions (64 carcinomas, 53 fibroadenomas, 25 miscellaneous breast diseases). Exclusively intratumoral RI were determined, with only the highest and lowest value in the various vessels of a tumor being considered. We found that an RI < 0.80 is typical for benign breast conditions, but also frequently occurs in malignant lesions. A significant difference was seen for higher RIs. An RI > or = 0.80 was seen to be an indicator of malignancy with high specificity (96%) and a sensitivity of 55%. Moreover, RI differences in malignant lesions were markedly greater than in benign lesions. An RI difference > or = 0.20 among vessels of one tumor was a malignancy indicator with very high specificity (97%) but relatively low sensitivity (39%). An RI > or = 0.80 and RI differences > or = 0.20 are specific Doppler ultrasound (US) malignancy indicators.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Carcinoma/diagnóstico por imagem , Fibroadenoma/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Resistência Vascular , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Velocidade do Fluxo Sanguíneo , Neoplasias da Mama/irrigação sanguínea , Carcinoma/irrigação sanguínea , Diagnóstico Diferencial , Feminino , Fibroadenoma/irrigação sanguínea , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e Especificidade
7.
Ultrasound Med Biol ; 24(9): 1307-11, 1998 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-10385953

RESUMO

In a prospective study, 200 healthy female breasts were examined using color Doppler sonography to study the detectability and the resistive indices (RIs) of arterial vessels. In each breast, we attempted to detect two to three vessels and recorded the frequency spectrum with RI of each vessel. Blood vessels (n = 522) could be demonstrated in 196 (98%) breasts. Continuous diastolic flow (RI < 1) was found in 520 (99.6%) vessels. The mean RI of premenopausal women was 0.64; that of postmenopausal women was 0.70. This difference is highly statistically significant (p < 0.0001), but there is a marked overlap between the RIs of both groups. The variation in RI values of all women (up to 0.45), as well as in the breasts of the same woman (up to 0.31), was considerable. We conclude that modern color Doppler devices permit the detection of blood flow in the breast with regularity. Continuous diastolic flow (RI < 1) is a typical flow pattern. The variations of RI between women, and even for the same woman, are remarkable. The mean RI of premenopausal women is lower than the value for postmenopausal women.


Assuntos
Mama/irrigação sanguínea , Ultrassonografia Doppler em Cores , Artérias/diagnóstico por imagem , Velocidade do Fluxo Sanguíneo , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa , Pré-Menopausa , Estudos Prospectivos , Ultrassonografia Mamária , Resistência Vascular
8.
Ultrasound Med Biol ; 27(3): 343-50, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11369119

RESUMO

The purpose of this study was to examine if suture granulomas display distinct sonographic signs and if these signs enable an accurate preoperative diagnosis. In a retrospective and prospective study, the sonographic findings of 22 consecutive suture granulomas were investigated and correlated with subsequent operative results. The sonographic appearance of various surgical sutures in a water bath was also investigated. Sonography was performed with commercially available 5- to 13-MHz linear transducers. The sonographic findings of the suture granulomas included hypoechoic lesions in all cases and hyperechoic double or single lines within the hypoechoic lesions in 20 of 22 cases. Sonography enabled the correct preoperative diagnosis for the investigating radiologists in 20 cases. The sonographic appearance of sutures in a water bath was that of hyperechoic double or single lines. The sonographic signs of suture granulomas (hyperechoic double or single lines within hypoechoic lesions) indicate the correct preoperative diagnosis in a high percentage of cases.


Assuntos
Granuloma de Corpo Estranho/diagnóstico por imagem , Suturas/efeitos adversos , Abdome/cirurgia , Adulto , Idoso , Feminino , Granuloma de Corpo Estranho/cirurgia , Humanos , Técnicas In Vitro , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Ultrassonografia
9.
Rofo ; 165(6): 529-34, 1996 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-9026094

RESUMO

UNLABELLED: To describe US and CT findings of primary epiploic appendicitis and segmental infarction of the omentum. MATERIAL AND METHODS: From 1986 through 1996 thirteen patients presented with these pathological findings at our institution (6 patients with greater omental infarction and 7 patients with epiploic appendicitis). US (n = 13) and CT findings (n = 7) were retrospectively reviewed. RESULTS: US revealed moderately hyperechoic, ovoid lesions adherent to the peritoneum. On CT scans the masses appeared as areas of fat with slightly increased attenuation and sometimes with hyperattenuating peripheral rims. Secondary omental or appendiceal involvement caused by inflammation of adjacent organs has to be excluded. CONCLUSION: Segmental infarction of the omentum and primary epiploic appendicitis have characteristic US and CT features that enable the correct diagnosis.


Assuntos
Colo/irrigação sanguínea , Infarto/diagnóstico , Omento/irrigação sanguínea , Tecido Adiposo , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Infarto/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Necrose , Doenças Peritoneais/diagnóstico , Doenças Peritoneais/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia
10.
J Telemed Telecare ; 9 Suppl 2: S61-2, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14728764

RESUMO

To guarantee the quality of teleradiology services in Austria we have developed an easy-to-use and continuously re-evaluated teleradiology workflow model. This is based on the quality management model (ISO 9001:2000) of the International Standardization Organization (ISO) and guarantees the quality of the process. From January 2002 to January 2003 we examined 544 emergency teleradiology computerized tomography studies transmitted to the Department of Radiology 2 in Innsbruck. The patients were from the rural hospital of Reutte. In 450 cases (83%) the sending of the written legal final report took less than 1 h. The numbers of mistakes (mostly minor workflow errors) were reduced from 23 errors per month in January 2002 to 9 errors per month in January 2003. The continuous cross-checking of the workflow and the training of the employees involved guaranteed a better standard of teleradiology in our department. Since December 2002, the whole Tyrolean teleradiology process has been ISO 9001:2000 certified.


Assuntos
Atenção à Saúde/normas , Garantia da Qualidade dos Cuidados de Saúde/métodos , Telerradiologia/normas , Áustria , Atenção à Saúde/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/normas , Humanos , Padrões de Referência , Telerradiologia/organização & administração
14.
Ultraschall Med ; 28(3): 301-6, 2007 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-17577859

RESUMO

PURPOSE: Sonographic detection rate of colorectal tumours in comparison with endoscopy. MATERIALS AND METHODS: Within a period of 32 months all sonographically detected colorectal tumours were registered and the results compared with endoscopic findings within the same period. The patients had no peroral preparation for the sonographic examination which was always performed before coloscopy. RESULTS: The study encloses 521 tumours in 417 patients. The tumours can be subdivided into 181 cancers, 122 polyps > or = 1 cm, 207 polyps < 1 cm and 11 other tumours. 62 % (112/181) of cancers could be detected by sonography, 30 % of stage pTis, pT1 or pT2, 82 % of stage pT3 or pT4. The detection rate was 20 % for polyps > or = 1 cm, but only 2 % for polyps < 1 cm. The majority of larger tumours not detected on sonography (15/18) was located in the rectum and lower sigmoid colon. CONCLUSION: Colorectal cancers of stage T3 and T4 can be detected sonographically in a high percentage of cases. Sonography provides insufficient results in detecting polyps and small cancers, and even larger tumours may be missed especially in the lower sigmoid colon and rectum.


Assuntos
Neoplasias do Colo/diagnóstico por imagem , Neoplasias Retais/diagnóstico por imagem , Neoplasias do Colo/patologia , Pólipos do Colo/diagnóstico por imagem , Pólipos do Colo/patologia , Pólipos do Colo/cirurgia , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Humanos , Estadiamento de Neoplasias , Pólipos/diagnóstico por imagem , Pólipos/patologia , Pólipos/cirurgia , Doenças Retais/diagnóstico por imagem , Doenças Retais/cirurgia , Neoplasias Retais/patologia , Sensibilidade e Especificidade , Neoplasias do Colo Sigmoide/diagnóstico por imagem , Neoplasias do Colo Sigmoide/patologia , Neoplasias do Colo Sigmoide/cirurgia , Ultrassonografia
15.
Ultraschall Med ; 27(3): 240-4, 2006 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-16729255

RESUMO

PURPOSE: To correlate the sonographic findings of tissue oedema with histopathological changes in order to find an explanation for the different sonographic appearances of oedema. MATERIALS AND METHODS: Subcutaneous and cutaneous tissue of the chest wall, the abdominal wall, and the thigh of 4 human cadavers with clinically evident oedema were examined sonographically. A specimen was then taken from each region for histological examination. RESULTS: Twelve cutis-subcutis-regions underwent sonographic-histological correlation. 9 out of 12 subcutaneous regions exhibited a diffusely increased echogenicity. 5 of the 9 regions with increased echogenicity also showed hypoechoic bands (up to 3 mm) within the subcutaneous tissue. Histologically, all of the 9 sonographically altered subcutaneous regions displayed lentiform or band-like optically empty spaces within the connective tissue between lobules of fatty tissue as well as between groups of fat cells within lobules of fatty tissue corresponding to fluid. Hypoechoic stripes at sonography represented very broad bands of fluid. The cutis appeared hyperechoic in all cases. At histology, 9 of 12 cases exhibited uniformly distributed optically empty spaces between connective tissue fibres of the dermis. Dermal thickness corresponded to the degree of oedema. CONCLUSION: Subcutaneous oedema results in diffusely increased echogenicity, which is caused by the difference in acoustic impedance occurring at the edges of numerous bands of fluid. In addition, hypoechoic bands are observed if broad spaces of fluid are present in severe cases. Encased fluid in the dermis is uniformly distributed between connective tissue fibres. Sonographically, the homogenous hyperechoic appearance of normal dermis remains unaltered in cases of oedema, but dermal thickness increases.


Assuntos
Edema/diagnóstico por imagem , Dermatopatias Vasculares/diagnóstico por imagem , Autopsia , Cadáver , Edema/patologia , Humanos , Valores de Referência , Pele/diagnóstico por imagem , Pele/patologia , Dermatopatias Vasculares/patologia , Ultrassonografia
16.
Wien Med Wochenschr ; 145(5): 106-11, 1995.
Artigo em Alemão | MEDLINE | ID: mdl-7597809

RESUMO

Conventional radiology is the most important diagnostic imaging method for the arthrosis deformans of the little peripheral joints, sometimes radionuclide bone imaging is used as a supplement. We deal with the classification and the radiological signs of the arthrosis deformans in general and of the peripheral joints in particular. Great importance is attached to typical findings and finding constellations in text and pictures. We try to explain the complex differential diagnosis and the implication with other disorders of the joints in a brief and poignant way.


Assuntos
Osteoartrite/diagnóstico por imagem , Cartilagem Articular/diagnóstico por imagem , Diagnóstico Diferencial , Deformidades Adquiridas do Pé/diagnóstico por imagem , Deformidades Adquiridas da Mão/diagnóstico por imagem , Humanos , Articulação do Joelho/diagnóstico por imagem , Osteoartrite do Quadril/diagnóstico por imagem , Radiografia
17.
Ultraschall Med ; 21(2): 66-72, 2000 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-10838706

RESUMO

AIM: To determine the frequency of deep vein thrombosis in the veins of the calf muscles. The risk of embolism in relation to the localisation of thrombosis was also evaluated. METHOD: 357 consecutive patients submitted for colour Doppler sonography of the lower extremities were prospectively examined for deep vein thrombosis (DVT). Both axial and muscular calf veins were investigated. 184 of these patients underwent additional investigation for pulmonary embolism. RESULTS: Diagnosis of DVT was made by means of colour Doppler sonography in 179 patients. Soleal veins (n = 88), peroneal veins (n = 84), the popliteal vein (n = 69), and the superficial femoral vein (n = 53) were the most common sites of thrombosis. Thrombosis of the gastrocnemial veins (n = 49) occurred less frequently. 85 patients (47% of all patients having DVT) showed isolated calf vein thrombosis, in 45 patients (25%) the gastrocnemial and/or soleal veins were the only site of thrombosis. 60% of patients with symptomatic DVT also had pulmonary embolism. The embolic frequency for isolated calf vein thrombosis and muscular calf vein thrombosis was 48% and 50%, respectively. CONCLUSION: The veins of the calf muscles are a common site of acute DVT and a source of pulmonary embolism. They should always be investigated in patients with suspected DVT of the calf, and in patients with pulmonary embolism.


Assuntos
Músculo Esquelético/irrigação sanguínea , Embolia Pulmonar/epidemiologia , Ultrassonografia Doppler em Cores , Veias/diagnóstico por imagem , Trombose Venosa/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Veia Femoral/diagnóstico por imagem , Humanos , Perna (Membro)/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Veia Poplítea/diagnóstico por imagem , Embolia Pulmonar/etiologia , Fatores de Risco , Trombose Venosa/complicações
18.
Ultraschall Med ; 20(3): 115-7, 1999 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-10444782

RESUMO

AIM: To describe the sonographic findings in acute diverticulitis of the vermiform appendix. A case report and a review of literature are used to present the sonographic appearance, special clinical aspects and the pathogenesis of this rare entity. CONCLUSION: Acute diverticulitis of the vermiform appendix presents certain sonographic features, which allow preoperative diagnosis and differentiation from acute appendicitis and right colonic diverticulitis.


Assuntos
Apêndice , Doenças do Ceco/diagnóstico por imagem , Diverticulite/diagnóstico por imagem , Doença Aguda , Apendicectomia , Apêndice/diagnóstico por imagem , Doenças do Ceco/cirurgia , Diagnóstico Diferencial , Diverticulite/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Ultrassonografia
19.
Ultrasound Obstet Gynecol ; 16(4): 359-64, 2000 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11169313

RESUMO

OBJECTIVE: To evaluate the role of three-dimensional (3D) ultrasound (US) following needle breast biopsy under two-dimensional (2D) needle guidance. METHODS: A total of 188 core-needle biopsies and 24 fine-needle aspiration biopsies were 3D US correlated after typical 'freehand' US needle guidance. All cases were examined with a linear 3D US volume scanner (5-13 MHz, Voluson 530D, Medison-Kretztechnik, Zipf, Austria). After core-needle stroke or localization of fine needle, a 3D US data volume set was acquired and a multiplanar analysis performed. This needle position check in all three planes is called '3D targeting'. 66 women with a mean age of 51 years (range, 27-80 years) showed 77 breast lesions (55 solid lesions, 22 cysts) with a mean diameter of 1.5 (range, 0.3-5.0) cm. RESULTS: In 49 women with 55 solid breast lesions, 16 lesions were malignant and 39 lesions benign. In 53 solid breast lesions 188 core-needle biopsies were performed (mean 3.6 biopsies/lesion). After core-needle biopsy 23 lesions (16 malignant, seven benign) were surgically removed. In 22 cases final histology confirmed results of the core-needle specimen. In one case a core-needle specimen of a 5 mm lesion showed atypical lobular hyperplasia. The definitive histology after surgery was invasive lobular carcinoma. Twenty-two cysts and two benign solid lesions were punctured with a fine needle followed by aspiration biopsy. The overall sensitivity of core-needle results in this study was 94% (specificity 100%, accuracy 0.98, positive predictive value 1, negative predictive value 0.97). In 117 core-needle strokes of benign (21) and malignant (12) lesions 3D targeting prospectively revealed 95 lesion hits, Twelve marginal lesion hits and nine out-of-lesion hits. In one case after the initial large core-needle path a 5-mm lesion was disguised by air bubbles, therefore 3D targeting failed during the second biopsy procedure. CONCLUSION: 3D US combined with 3D targeting technique is a reliable and objective tool demonstrating exact spatial positioning of core and fine needle during biopsy procedure.


Assuntos
Biópsia por Agulha/métodos , Doenças Mamárias/patologia , Neoplasias da Mama/patologia , Mama/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Mamárias/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e Especificidade , Ultrassonografia/métodos
20.
Ultraschall Med ; 18(3): 139-42, 1997 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-9340741

RESUMO

AIM: To study the detectability and the appearance of the vermiform appendix with ultrasound in asymptomatic adults. METHODS: A prospective study was performed on 300 patients, selected without regard to age, sex and weight. We tried to visualize the appendix with a 3.5 MHz annular array and a 5 MHz linear array transducer. RESULTS: In 63% of the patients the appendix was clearly visualised. The main reasons for non-visualisation were obesity with insufficient ultrasound penetration (38%) and the caecum laying in pelvic or atypical position (24%). In 31%, no cause was apparent but we assume that the appendix often lies behind the caecum. The sonographic image showed an aperistaltic target originating at the caecum, and ending blindly. In 42% of cases the appendix was ovoid in transverse section; in 32%, round; and in 26% both forms were found within one appendix. Intraluminal gas was visible in 86%. The mean transverse diameter was 5.2 mm (min. 3 mm, max. 13 mm) and in 76% the transverse diameter was lower than 6 mm. CONCLUSION: The sonographic detectability, the appearance and the size of the normal appendix show considerable variations.


Assuntos
Apêndice/diagnóstico por imagem , Adulto , Antropometria , Apendicite/diagnóstico por imagem , Feminino , Gases , Humanos , Masculino , Estudos Prospectivos , Valores de Referência , Ultrassonografia
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