RESUMO
In order to establish diagnostic criteria, colour-coded duplex sonography was performed on 40 patients who had a total of 43 operatively confirmed thyroid lesions which were scintigraphically "cold" (28 adenomas, 8 carcinomas, 4 cases of thyroiditis and 3 cysts). 32 of these patients also had MRT with T2- and T1-weighted images before and after injection of Gd-DTPA (0.1 mmol/kg). Adenomatous nodules and adenomas showed a peripheral vascular halo on colour-coded duplex sonography with a sensitivity of 96% and a specificity of 93%. Malignant lesions showed marked central vascularisation and on B-images irregular marginal structures. Adenomas and adenomatous nodules showed hyperintense areas on T1-weighted unenhanced MR images and/or homogeneous uptake in the lesion (sensitivity 100%, specificity 77%). Malignant lesions typically showed an irregular margin with increased contrast uptake on MRT. If sonography and colour-coded duplex sonography is unable to classify a lesion with any degree of assurance then MRT with Gd-DTPA enhancement should be performed.
Assuntos
Aumento da Imagem/métodos , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico , Adulto , Idoso , Cor , Meios de Contraste , Diagnóstico Diferencial , Estudos de Avaliação como Assunto , Feminino , Gadolínio , Gadolínio DTPA , Humanos , Aumento da Imagem/instrumentação , Imageamento por Ressonância Magnética/instrumentação , Imageamento por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Compostos Organometálicos , Ácido Pentético/análogos & derivados , Estudos Prospectivos , Cintilografia , Nódulo da Glândula Tireoide/epidemiologia , Ultrassonografia/instrumentação , Ultrassonografia/métodos , Ultrassonografia/estatística & dados numéricosRESUMO
Color-coded Doppler ultrasonography is a combination of real-time sonography and duplex sonography for noninvasive imaging of arterial and venous blood vessels. In 40 patients with acute onset of scrotal pain this diagnostic procedure was correlated with the findings at surgical exploration: 11 had testicular torsion, 4 hydatid torsion, 13 spontaneous detorsion, 2 blunt scrotal trauma and 10 epididymitis. For testicular torsion color-coded Doppler ultrasonography had a sensitivity of 82% and a specificity of 100%, and for epididymitis the sensitivity was 70% and specificity was 88%. Color-coded ultrasonography readily demonstrates testicular perfusion. In cases of incomplete or early torsion some residual perfusion may be detected leading to false-negative results. Despite this fact, color-coded Doppler ultrasonography currently is the most valuable diagnostic modality in the evaluation of the acute scrotum.