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Zhang Y, Mao S, Zhang F. Evaluating the role and diagnostic performance of ultrasound in diagnosing soft tissue tumors and pseudotumors in adults: a systematic review and meta-analysis. Expert Rev Med Devices 2024; 21:841-850. [PMID: 39161112 DOI: 10.1080/17434440.2024.2393349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 07/30/2024] [Indexed: 08/21/2024]
Abstract
OBJECTIVES This systematic review and meta-analysis evaluates the combined accuracy of ultrasonic imaging in diagnosing soft tissue tumors and pseudotumors and identifies factors contributing to variability in its diagnostic accuracy. METHODS A literature search in significant databases used specific keywords and inclusion/exclusion criteria. Two authors independently performed cohort characterization and data analysis, with a third author resolving disagreements. A multivariate random effects model estimated pooled sensitivity, specificity, predictive values, and overall accuracy. RESULTS Ultrasound imaging demonstrated high pooled sensitivity and specificity, indicating effectiveness in identifying lesions. Variability in accuracy was attributed to factors such as tumor type and location, operator experience, and clinic location. CONCLUSIONS Ultrasonic imaging is a reliable diagnostic tool for soft tissue tumors and pseudotumors, providing high sensitivity and specificity. However, variability in accuracy underscores the need to consider operator experience and tumor characteristics. Further research should explore the impact of technological advancements and include non-English studies to enhance understanding of ultrasound imaging's diagnostic validity.
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Affiliation(s)
- Yufei Zhang
- Department Ultrasound, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, China
| | - Shijie Mao
- Department Ultrasound, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, China
| | - Fangfang Zhang
- Department Ultrasound, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, China
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2
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Chen W, Luan J, Xu H, Chen J, Xu R, Sun G, Li X. Ultrasonography findings of pediatric head and neck lymphatic malformations: A 10-year experience of 140 surgical cases. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024. [PMID: 39189701 DOI: 10.1002/jcu.23787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 07/15/2024] [Accepted: 07/29/2024] [Indexed: 08/28/2024]
Abstract
OBJECTIVE To discuss the usefulness of ultrasonography (US) in the diagnosis and management of pediatric head and neck lymphatic malformations (HNLMs). METHODS We conducted a retrospective analysis of 140 children who were referred to our hospital for the treatment of HNLMs. RESULTS The median age at presentation was 12 months (1 day-171 months; 66.4% under 2 years old; 35.7% neonatus). The majority clinical presentations were asymptomatic mass (65.7%, 92/140) and cosmetic deformity (25.7%, 36/140). HNLMs involved the neck accounting for 65.7% (92/140), especially posterior cervical trigone (22.1%, 31/140), and submandibular (20.0%, 28/140). The US diagnostic accuracy was 91.4% (128/140). Their boundary with the surrounding tissues was usually clear (87.9%, 123/140), whereas the shape was mostly irregular (97.1%, 136/140). Based on surgical findings, there were 67 pure HNLMs and 73 intracystic hemorrhage. Between the two groups, there were statistical differences in capsule contents (χ2 = 7.8299, p = 0.0051), flocculent echo floating (χ2 = 21.2964, p < 0.0001), overlying skin (χ2 = 9.0498, p = 0.0026), and palpation (χ2 = 13.4058, p = 0.0003). CONCLUSIONS US typically reveals the lesion with clear boundary, irregular morphology, anechoic contents, no blood flow signal, and echoic intracapsular septum with blood flow signal. In contrast, bluish appearance, tensional palpation, and capsule contents with low/mixed echo or flocculent echo floating may indicate intracystic hemorrhage.
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Affiliation(s)
- Wei Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Otolaryngology-Head and Neck Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Jia Luan
- Outpatient Department Huashan Worldwide Medical Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Hongming Xu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jiarui Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Rong Xu
- Department of Radiology, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Guangbin Sun
- Department of Otolaryngology-Head and Neck Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoyan Li
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai, China
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3
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Nasreddine H, Tlaiss Y, Hassan F, Ibrahim R. Ultrasound Assessment of Facial and Neck Aging: A Noninvasive Approach to a Minimally Invasive Treatment. J Med Ultrasound 2024; 32:244-248. [PMID: 39310872 PMCID: PMC11414957 DOI: 10.4103/jmu.jmu_175_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/11/2024] [Accepted: 03/06/2024] [Indexed: 09/25/2024] Open
Abstract
This technical note explores the diagnostic potential of ultrasound in assessing age-related changes in the soft tissues of the lower face and neck, with a primary focus on identifying causes of contour deformities and guiding minimally invasive rejuvenation procedures. Seventeen clinical patients with various age-related soft-tissue changes were subjected to ultrasound assessments, targeting issues such as soft-tissue sagging, supra- and subplatysmal adipose tissue excess, platysma thickness, and localization of ptotic platysma strands. The ultrasound examinations successfully identified specific anatomical features contributing to age-related soft-tissue changes in all 17 patients. This information guided tailored treatment plans, resulting in remarkable esthetic improvements in each case. The discussion emphasizes ultrasound's invaluable role as a diagnostic tool for precisely identifying soft-tissue alterations in the lower face and neck. The noninvasive nature and high spatial resolution of ultrasound make it particularly effective for this purpose. The corrective methods guided by ultrasound findings proved to be minimally invasive and yielded successful outcomes in all cases, promoting high levels of patient satisfaction. The study highlights the underutilization of ultrasound's diagnostic potential in clinical practice and highlights the importance of its incorporation into routine assessments. Ultrasound emerges as a cost-effective, noninvasive, and accessible means of accurately diagnosing age-related soft-tissue changes, empowering clinicians to tailor rejuvenation procedures to each patient's unique needs. The hope is that by emphasizing its utility, this study encourages the broader adoption of ultrasound in clinical practice.
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Affiliation(s)
- Hassan Nasreddine
- Department of Plastic Surgery, Specialized Hospital Haidar and Hajjar, Beirut, Lebanon
| | - Yehya Tlaiss
- Department of General Surgery, University of Balamand, Beirut, Lebanon
| | - Firas Hassan
- Department of General Surgery, University of Balamand, Beirut, Lebanon
| | - Reina Ibrahim
- Department of General Surgery, University of Balamand, Beirut, Lebanon
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4
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Schleder S, Jung EM, Schicho A, Schreyer AG, Habicher W, Grassinger J, Dollinger M. Efficacy and safety of ultrasound-guided core needle biopsies (US-CNBs) in cervical lymphadenopathy in patients with suspected head and neck cancer during the COVID-19 pandemic. Clin Hemorheol Microcirc 2023; 83:397-408. [PMID: 36683499 DOI: 10.3233/ch-221680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Cervical lymphadenopathy can be benign or malignant. Its accurate diagnosis is necessary to determine appropriate treatment. Ultrasound-guided core needle biopsies (US-CNBs) are frequently used as a percutaneous sampling approach. OBJECTIVES Our aim was to identify the efficacy and safety of US-CNBs in 125 patients with cervical lymphadenopathy and clinically suspected head and neck cancer during the COVID-19 pandemic with limited surgical resources. METHODS US-CNBs of pathological lymph nodes were performed in 146 lymph nodes on 125 patients. Biopsies were performed ultrasound-guided with a reusable gun core biopsy system and a 10-cm-long 16-G needle. Standard of reference for the histological findings were panendoscopy, clinical and sonographic follow-up, surgical biopsy or a repeat US-CNB. RESULTS Adequate material for histologic diagnosis was obtained in 111 patients (89%), of these 83 patients (75%) were diagnosed as malignant, whereas benign lymphadenopathy accounted for 28 patients (25%). Therefore, US-CNB was able to identify malignant or benign lymphadenopathy with an overall accuracy of 88% and 90%, respectively. CONCLUSIONS Percutaneous US-CNB is a safe and effective alternative to surgical biopsy in the management of cervical lymphadenopathy in patients with clinically suspected head and neck cancer in a setting with limited resources.
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Affiliation(s)
- Stephan Schleder
- Department of Diagnostic and Interventional Radiology, Merciful Brothers Hospital St. Elisabeth, Straubing, Germany
| | - Ernst-Michael Jung
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| | - Andreas Schicho
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| | - Andreas G Schreyer
- Department of Diagnostic and Interventional Radiology, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Werner Habicher
- Department of Othorhinolaryngology, Merciful Brothers Hospital St. Elisabeth, Straubing, Germany
| | - Jochen Grassinger
- Department of Hematology and Oncology, Merciful Brothers Hospital St. Elisabeth, Straubing, Germany
| | - Marco Dollinger
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
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5
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Yang Y, Zheng B, Li Y, Li Y, Ma X. Computer-aided diagnostic models to classify lymph node metastasis and lymphoma involvement in enlarged cervical lymph nodes using PET/CT. Med Phys 2023; 50:152-162. [PMID: 35925871 DOI: 10.1002/mp.15901] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND It is a clinical problem to identify histological component in enlarged cervical lymph nodes, particularly in differentiation between lymph node metastasis and lymphoma involvement. PURPOSE To construct two kinds of deep learning (DL)-based computer-aided diagnosis (CAD) systems including DL-convolutional neural networks (DL-CNN) and DL-machine learning for pathological diagnosis of cervical lymph nodes by positron emission tomography (PET)/computed tomography (CT) images. METHODS We collected CT, PET, and PET/CT images series from 165 patients with enlarged cervical lymph nodes receiving examinations from January 2014 to June 2018. Six CNNs pretrained on ImageNet as DL architectures were used for two kinds of DL-based CAD models, including DL-CNN and DL-machine learning models. The DL-CNN models were constructed via transfer learning for classification of lymphomatous and metastatic lymph nodes. The DL-machine learning models were developed by DL-based features extractors and support vector machine (SVM) classifier. As for DL-SVM models, we also evaluate the effect of handcrafted radiomics features in combination of DL-based features. RESULTS The DL-CNN model with ResNet50 architecture on PET/CT images had the best diagnostic performance among all six algorithms with an area under the receiver operating characteristic curve (AUC) of 0.845 and accuracy of 78.13% in the testing cohort. The DL-SVM model on ResNet50 extractor showed great performance for the testing cohort with an AUC of 0.901, accuracy of 86.96%, sensitivity of 76.09%, and specificity of 94.20%. The combination of DL-based and handcrafted features yielded the improvement of diagnostic performance. CONCLUSIONS Our DL-based CAD systems on PET/CT images were developed for classifying metastatic and lymphomatous involvement with favorable diagnostic performance in enlarged cervical lymph nodes. Further clinical practice of our systems may improve quality of the following therapeutic interventions and optimize patients' outcomes.
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Affiliation(s)
- Yuhan Yang
- West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bo Zheng
- West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yueyi Li
- Department of Biotherapy and Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuan Li
- West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xuelei Ma
- Department of Biotherapy and Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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6
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Stem CT, Marin JR, Perera AND, Azhdam DB. Point-of-Care Ultrasound for the Evaluation of Neck Masses in the Pediatric Emergency Department: A Case Series. Pediatr Emerg Care 2022; 38:e1019-e1021. [PMID: 34140446 DOI: 10.1097/pec.0000000000002463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Point-of-care ultrasound can be an effective tool for pediatric emergency medicine providers in the evaluation of soft tissue lesions. We present a series of 4 pediatric patients with neck lesions in whom point-of-care ultrasound identified the type of lesion, guided decision-making on the need for computed tomography imaging, and led to definitive management.
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Affiliation(s)
- Christopher T Stem
- From the Division of Emergency Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
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7
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Tamanini G, Cominardi A, Brighi N, Fusaroli P, Lisotti A. Endoscopic ultrasound assessment and tissue acquisition of mediastinal and abdominal lymph nodes. World J Gastrointest Oncol 2021; 13:1475-1491. [PMID: 34721779 PMCID: PMC8529915 DOI: 10.4251/wjgo.v13.i10.1475] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/16/2021] [Accepted: 07/21/2021] [Indexed: 02/06/2023] Open
Abstract
The differential diagnosis between benign and malignant lymph nodes (LNs) has a fundamental role in the characterization and staging of malignant conditions, as well as in subsequent patients’ management. All imaging modalities (i.e. computed tomography and magnetic resonance imaging) rely mainly on size; endoscopic ultrasound (EUS) criteria based on B-mode evaluation and Doppler features fail to adequately characterize with high specificity LNs nature. The introduction of EUS-elastography and contrast-enhanced harmonic EUS are useful techniques to increase the diagnostic yield in identifying metastatic LNs, to identify which suspicious LN should require pathological characterization and, finally, to target tissue acquisition. EUS-guided tissue acquisition (EUS-TA) is increasingly being used for diagnosing lymphadenopathy whenever the characterization modifies patients’ subsequent management and when no superficial LN is accessible. Since target therapy are currently available (i.e. lung cancer, breast cancer), EUS-TA of malignant LNs could be required to identify tumor biology. In this field, both fine needle aspiration and biopsy needles are able to guarantee accurate results with almost perfect specificity and sub-optimal sensitivity. We finally propose a diagnostic algorithm based on most recent, high-level evidence for the diagnostic approach to suspected LNs assessment.
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Affiliation(s)
- Giacomo Tamanini
- Department of Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola 40026, BO, Italy
| | - Anna Cominardi
- Department of Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola 40026, BO, Italy
| | - Nicole Brighi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola 47014, FC, Italy
| | - Pietro Fusaroli
- Department of Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola 40026, BO, Italy
| | - Andrea Lisotti
- Department of Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola 40026, BO, Italy
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8
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Chasen NN, Wang JR, Gan Q, Ahmed S. Imaging of Cervical Lymph Nodes in Thyroid Cancer: Ultrasound and Computed Tomography. Neuroimaging Clin N Am 2021; 31:313-326. [PMID: 34243866 DOI: 10.1016/j.nic.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Sonographic evaluation of cervical lymph nodes in patients with thyroid malignancy is important both for preoperative staging and for post-treatment surveillance, and contrast-enhanced computed tomography plays a complementary role. Knowledge of anatomy and surgical approaches, combined with an understanding of the various imaging features that distinguish malignant from benign lymph nodes, allows for accurate staging, thereby enabling complete surgical initial resection.
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Affiliation(s)
- Noah Nathan Chasen
- Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1482, Houston, TX 77030-4009, USA
| | - Jennifer Rui Wang
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1445, Houston, TX 77030-4009, USA
| | - Qiong Gan
- Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 0085, Houston, TX 77030-4009, USA
| | - Salmaan Ahmed
- Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1482, Houston, TX 77030-4009, USA.
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9
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AKDUR G, BARDAKCI O, AKDUR O, DAŞ M, ATALAY U. A Rare Cause of the Emergency Department Visit: Internal Jugular Vein Thrombosis. JOURNAL OF EMERGENCY MEDICINE CASE REPORTS 2021. [DOI: 10.33706/jemcr.859366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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Hall J, Hays JF, Sulo KS, David J. Sudden Onset of a Unilateral Erythematous Preauricular Mass in a Preterm Infant. Neoreviews 2021; 22:e136-e140. [PMID: 33526645 DOI: 10.1542/neo.22-2-e136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Jordan Hall
- Rush University Pediatrics Residency Program, Department of Pediatrics, Rush University Children's Hospital, Chicago, IL
| | - James F Hays
- Rush University Combined Internal Medicine-Pediatrics Residency Program, Departments of Internal Medicine and Pediatrics, Rush University Medical Center, Chicago, IL
| | - Kelly S Sulo
- Division of Neonatology, Department of Pediatrics, Rush University Children's Hospital, Chicago, IL
| | - Jieun David
- Division of Neonatology, Department of Pediatrics, Rush University Children's Hospital, Chicago, IL
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11
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Hosokawa T, Tanami Y, Sato Y, Ishimaru T, Kawashima H, Oguma E. Comparison of sonographic findings between neonates with pyriform sinus fistulas and lymphangiomas. Am J Otolaryngol 2021; 42:102783. [PMID: 33125899 DOI: 10.1016/j.amjoto.2020.102783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/17/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE In neonates, pyriform sinus fistulas and lymphangiomas require different early treatment, such as surgical resection or sclerosing therapy, respectively. We aimed to evaluate the use of sonographic findings for differentiating between pyriform sinus fistulas and lymphangiomas in neonates with a lateral cervical cystic mass. METHODS Sixteen cases diagnosed with pyriform sinus fistulas (n = 7) or lymphangiomas (n = 9) were included. Sonographic findings, including fistulas from the pyriform sinus, air-containing cysts, abnormal thyroid parenchyma echogenicity, internal septae within the cyst and spread to the opposite cervical site, were compared between neonates with pyriform sinus fistulas and those with lymphangiomas. Fisher's exact was used for statistical comparisons. RESULTS A significant difference was observed between cases with and without air-containing cysts (present/absent in neonate with pyriform sinus fistula vs lymphangioma: 5/2 vs. 0/9; p = 0.005), abnormal thyroid parenchyma echogenicity (present/absent: 4/3 vs. 0/9; p = 0.019), and internal septae within the cysts (present/absent: 2/7 vs. 9/9; p = 0.005). No significant differences were observed between cases with or without a fistula from the pyriform sinus (present/absent: 2/5 vs. 9/0; p = 0.175) and spread to the opposite cervical site (present/absent: 4/3 vs. 4/5; p = 0.500). CONCLUSIONS Ultrasound can differentiate pyriform sinus fistulas from lymphangiomas in neonates. In our small cohort, if they exhibited the respective sonographic findings; fistula from pyriform sinus, air-containing cysts or abnormal thyroid parenchyma echogenicity, patients were diagnosed as cases of pyriform sinus fistula. These diagnoses are critical for pediatric surgeons or otolaryngologists in surgical planning.
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12
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Shimamori N, Kishino T, Okabe N, Morii T, Matsushima S, Yamasaki S, Ohtsuka K, Shibahara J, Ohnishi H, Watanabe T. Discrimination of well-differentiated liposarcoma from benign lipoma on sonography: an uncontrolled retrospective study. J Med Ultrason (2001) 2020; 47:617-623. [PMID: 32960385 DOI: 10.1007/s10396-020-01051-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Well-differentiated liposarcoma, the most common subtype of liposarcoma, should be discriminated from benign lipoma. However, features on sonography for discriminating these two types of tumor have not been fully investigated. The present study was therefore aimed at clarifying differences in sonographic findings between well-differentiated liposarcoma and lipoma. METHODS The study population comprised 23 cases of well-differentiated liposarcoma and 181 cases of lipoma. We investigated differences in sonographic appearance and pathological findings between the two types of tumor. RESULTS Well-differentiated liposarcoma tended to develop more frequently in older patients and in the lower extremities including the gluteal region, compared with lipoma. Concerning sonographic findings, both tumors exhibited well-defined margins and heterogeneous internal echogenicity, including typical tiny striated hyperechoic lines. Well-differentiated liposarcoma was characterized by a higher frequency of the following findings compared with lipoma: (1) deep location, (2) irregular shape, (3) large diameter, (4) hyperechogenicity compared to surrounding tissue, and (5) presence of vascularity on Doppler sonography (p < 0.01 each). Notably, hyperechogenicity corresponded to the intermingled sclerosing component within the adipocytic component when sonographic findings were compared with those of pathology. CONCLUSION The present study suggests that several sonographic findings including hyperechogenicity and presence of vascularity might be key features for discriminating well-differentiated liposarcoma from lipoma.
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Affiliation(s)
- Naoko Shimamori
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan
| | - Tomonori Kishino
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan. .,Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan. .,Department of Clinical Engineering, Kyorin University Faculty of Health Sciences, Mitaka, Tokyo, Japan.
| | - Naota Okabe
- Department of Pathology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Takeshi Morii
- Department of Orthopaedic Surgery, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Satsuki Matsushima
- Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Satoko Yamasaki
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan.,Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Kouki Ohtsuka
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan.,Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Junji Shibahara
- Department of Pathology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Hiroaki Ohnishi
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan.,Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Takashi Watanabe
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo, Japan.,Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
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13
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Chanda R, Kandagaddala M, Moses V, Sigamani E, Keshava SN, Janakiraman R. Role of Ultrasound Acoustic Radiation Force Impulse in Differentiating Benign from Malignant Superficial Lymph Nodes. J Clin Imaging Sci 2020; 10:18. [PMID: 32363080 PMCID: PMC7193147 DOI: 10.25259/jcis_175_2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 01/13/2020] [Indexed: 11/06/2022] Open
Abstract
Objective: The purpose of this study was to evaluate the diagnostic performance of acoustic radiation force impulse (ARFI) imaging in differentiating benign from malignant peripheral lymphadenopathy. Materials and Methods: This was a prospective study approved by the Institutional Review Board with financial grant for the same. Ultrasound and ARFI imaging of peripheral lymph nodes were performed and correlated with pathological results, which were used as the reference standard. The virtual touch tissue imaging and virtual touch tissue quantification parameters of ARFI were analyzed in 86 lymph nodes, of which 78 were included in the study. Using receiver operating characteristic curve analysis, the diagnostic usefulness of ARFI values were evaluated with respect to their sensitivity, specificity, and area under the curve. Results: The mean area ratio of benign lymph nodes was 0.88 (±0.2) and that of malignant lymph nodes was 1.17 (±0.14). The mean shear wave velocities (SWV) of benign and malignant lymph nodes were 2.02 m/s (±0.94) and 3.7 m/s (±2.27), respectively. The sensitivity and specificity of virtual touch imaging area ratio in differentiating benign from malignant lymph nodes was 97% and 77%, of SWV was 71% and 70%, and of SWV ratio was 68% and 79%, respectively. Conclusion: As ARFI was found to have a superior diagnostic performance over conventional ultrasound and color Doppler in the characterization of lymph nodes, we recommend its routine use in differentiating benign from malignant nodes.
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Affiliation(s)
- Reettika Chanda
- Department of Radiology, Christian Medical College, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Madhavi Kandagaddala
- Department of Radiology, Christian Medical College, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Vinu Moses
- Department of Radiology, Christian Medical College, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Elanthenral Sigamani
- Departments of General Pathology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Shyamkumar Nidugala Keshava
- Department of Radiology, Christian Medical College, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Rajinikanth Janakiraman
- Departments of Head and Neck Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
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14
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Rodríguez Bandera AI, Sebaratnam DF, Feito Rodríguez M, de Lucas Laguna R. Cutaneous ultrasound and its utility in Pediatric Dermatology: Part II-Developmental anomalies and vascular lesions. Pediatr Dermatol 2020; 37:40-51. [PMID: 31742750 DOI: 10.1111/pde.13897] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
High-frequency ultrasonography represents a promising tool for pediatric dermatologists. It is a noninvasive and harmless diagnostic technique that is especially appealing when working with children. It can be easily performed at the patient's bedside, avoiding diagnostic delays, sedation, or multiple visits. It represents a useful adjunct to clinical examination and aids our understanding of cutaneous pathology. In this second part, we describe the ultrasonographic findings of developmental anomalies and vascular lesions.
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Affiliation(s)
| | - Deshan Frank Sebaratnam
- Sydney Children's Hospitals' Network, Sydney, New South Wales, Australia.,University of New South Wales, Sydney, New South Wales, Australia
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15
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Moss WJ, Finegersh A, Narayanan A, Gillard D, Califano J, Brumund KT, Coffey CS, Orosco RK. Characterizing Posterior Neck Masses: A Single-Institution Retrospective and Systematic Review. EAR, NOSE & THROAT JOURNAL 2019; 100:766S-770S. [PMID: 31608686 DOI: 10.1177/0145561319881845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Posterior neck masses are a relatively poorly characterized entity. The authors attempt to further characterize the anatomy and pathology of the posterior neck by way of a combined single-institution retrospective chart review and systematic review of the literature. METHODS A single-institution retrospective chart review was undertaken for all patients undergoing excision of a posterior neck mass between January 1, 2012, and January 1, 2017. A systematic review of the Medline, Embase, Web of Science, and Cochrane database was undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in search of case reports and series describing posterior neck masses. RESULTS A total of 28 patients who underwent excision of a posterior neck mass were encountered during the retrospective chart review. All pathologies were benign, the most prevalent of which was lipoma (22/28, 79%). A total of 19 articles describing a collective 36 posterior neck masses were encountered during the systematic review. Lipomas were the most common pathology (15/36, 42%). All but one of the masses reported were benign (35/36, 97%). CONCLUSIONS Patients presenting with posterior neck masses can be reassured of a low risk of malignancy. The majority of posterior neck masses can be appropriately evaluated via physical examination and ultrasound.
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Affiliation(s)
- William J Moss
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, 8784University of California, San Diego, CA, USA.,Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, 162433Commonwealth Health Center, Northern Mariana Islands, Garapan, Saipan
| | - Andrey Finegersh
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, 8784University of California, San Diego, CA, USA
| | - Ajay Narayanan
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, 89063University of Texas Southwestern, Dallas, TX, USA
| | - Danielle Gillard
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, 8784University of California, San Diego, CA, USA
| | - Joseph Califano
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, 8784University of California, San Diego, CA, USA
| | - Kevin T Brumund
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, 8784University of California, San Diego, CA, USA.,Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, VA San Diego Healthcare System, La Jolla, CA, USA
| | - Charley S Coffey
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, 8784University of California, San Diego, CA, USA.,Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, VA San Diego Healthcare System, La Jolla, CA, USA
| | - Ryan K Orosco
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, 8784University of California, San Diego, CA, USA
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16
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Shimamori N, Kishino T, Morii T, Okabe N, Motohashi M, Matsushima S, Yamasaki S, Ohtsuka K, Shibahara J, Ichimura S, Ohnishi H, Watanabe T. Sonographic Appearances of Liposarcoma: Correlations with Pathologic Subtypes. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:2568-2574. [PMID: 31202456 DOI: 10.1016/j.ultrasmedbio.2019.05.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 05/14/2019] [Accepted: 05/17/2019] [Indexed: 06/09/2023]
Abstract
Liposarcoma is the second most common malignant soft-tissue tumor. This entity is pathologically categorized into 4 subtypes: well-differentiated, myxoid, dedifferentiated and pleomorphic. Although features on magnetic resonance imaging and computed tomography for these 4 subtypes have been reported quite precisely, those on sonography have not been fully investigated. The present study was therefore aimed at clarifying the sonographic appearances of each liposarcoma subtype and assessing correlations with histopathology. The study population was made up of 35 cases, including 21 cases of well-differentiated liposarcoma, 6 cases of myxoid liposarcoma, 6 cases of dedifferentiated liposarcoma and 2 cases of pleomorphic liposarcoma. Compared with the other subtypes, well-differentiated liposarcoma was characterized by the high frequency of the following findings: isoechogenicity, tiny hyperechoic lines and hypovascularity (p < 0.01, in each). Myxoid liposarcomas were characterized by low echogenicity, intermingled with anechoic areas and moderate vascularity (p < 0.01, in each). Dedifferentiated liposarcomas showed a specific biphasic pattern of hyperechoic and hypoechoic areas and hypervascularity (p < 0.01, in each). Pleomorphic liposarcomas showed a specific gyrus-like mixture of hyperechoic and hypoechoic areas (p < 0.01). In conclusion, the present study revealed different characteristics of sonographic appearance among the 4 histopathologic subtypes of liposarcoma.
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Affiliation(s)
- Naoko Shimamori
- Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan
| | - Tomonori Kishino
- Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan; Department of Laboratory Medicine, Kyorin University School of Medicine, Tokyo, Japan; Department of Clinical Engineering, Kyorin University Faculty of Health Sciences, Tokyo, Japan.
| | - Takeshi Morii
- Department of Orthopaedic Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | - Naota Okabe
- Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan
| | - Mitsue Motohashi
- Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan
| | - Satsuki Matsushima
- Department of Laboratory Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Satoko Yamasaki
- Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan; Department of Laboratory Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Kouki Ohtsuka
- Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan; Department of Laboratory Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Junji Shibahara
- Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan
| | - Shoichi Ichimura
- Department of Orthopaedic Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | - Hiroaki Ohnishi
- Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan; Department of Laboratory Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Takashi Watanabe
- Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan; Department of Laboratory Medicine, Kyorin University School of Medicine, Tokyo, Japan
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17
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Horvath L, Kraft M. Evaluation of ultrasound and fine-needle aspiration in the assessment of head and neck lesions. Eur Arch Otorhinolaryngol 2019; 276:2903-2911. [DOI: 10.1007/s00405-019-05552-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 07/06/2019] [Indexed: 12/17/2022]
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18
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Noel L, Medford S, Islam S, Muddeen A, Greaves W, Juman S. Epidemiology of salivary gland tumours in an Eastern Caribbean nation: A retrospective study. Ann Med Surg (Lond) 2018; 36:148-151. [PMID: 30479761 PMCID: PMC6240702 DOI: 10.1016/j.amsu.2018.10.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/28/2018] [Accepted: 10/29/2018] [Indexed: 11/15/2022] Open
Abstract
Objective The epidemiology of the salivary glands tumour is not well documented in the Caribbean countries. Therefore, the aim of this study is to determine the local trend of salivary gland tumours with a review of current diagnostic techniques. Design & Methods Retrospective data was collected from the electronic database at the Pathology department of the San Fernando Teaching Hospital between the periods January 2005 to June 2015. All patients who underwent primary resection of either the parotid, submandibular or minor salivary glands for diagnosed tumour cytologically or suspected tumour were included in this study. The clinical and histopathological data were then collected and analyzed. Results A total of 85 surgeries were performed for suspected or diagnosed neoplasia, 54 parotidectomies, 26 submandibular gland and 5 minor salivary gland excisions. The benign neoplastic lesions, pleomorphic adenoma and Warthin's tumour, were the most common 53 (62.4%) of all the resections performed, followed by non-neoplastic lesions 25 (29.4%) such as sialadenitis, cysts or normal glands. Malignant neoplasms made up the minority with only 7 cases whereby mucoepidermoid carcinoma was the most common malignant neoplasm found followed by squamous cell carcinoma. Conclusion Parotid gland remains the most frequent site of salivary gland tumours (80%), with pleomorphic adenoma being the most common benign tumour. Triple assessment is still required to manage these cases adequately with stress on preoperative tissue diagnosis FNAB vs USS guided core biopsy. Salivary gland tumours are very rare of all head and neck tumours. Parotid gland remains the most frequent site of salivary gland tumours (80%). Pleomorphic adenoma is the most common benign tumour of the parotid gland with a slight male predominance. Squamous cell carcinoma was the most common malignant neoplasm of the parotid gland in contrast to worldwide data in which muco-epidermoid and adenoid cystic carcinomas are the most common. Triple assessment is required to manage these cases adequately with stress on preoperative tissue diagnosis by FNAC or USS guided core biopsy.
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Affiliation(s)
- Leon Noel
- Department of Otorhinolaryngology and Head and Neck Surgery, San Fernando Teaching Hospital, Trinidad and Tobago.,Department of Clinical Surgical Science, University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Steve Medford
- Department of Otorhinolaryngology and Head and Neck Surgery, San Fernando Teaching Hospital, Trinidad and Tobago.,Department of Clinical Surgical Science, University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Shariful Islam
- Department of Otorhinolaryngology and Head and Neck Surgery, San Fernando Teaching Hospital, Trinidad and Tobago.,Department of General Surgery, San Fernando Teaching Hospital, Trinidad and Tobago
| | - Alyssa Muddeen
- Department of Clinical Surgical Science, University of the West Indies, St. Augustine, Trinidad and Tobago.,Department of Otorhinolaryngology and Head and Neck Surgery, Eric William Medical Science Complex, Trinidad and Tobago
| | - Wesley Greaves
- Department of Pathology, San Fernando Teaching Hospital, Trinidad and Tobago
| | - Solaiman Juman
- Department of Clinical Surgical Science, University of the West Indies, St. Augustine, Trinidad and Tobago.,Department of Otorhinolaryngology and Head and Neck Surgery, Eric William Medical Science Complex, Trinidad and Tobago
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19
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Bansal AG, Oudsema R, Masseaux JA, Rosenberg HK. US of Pediatric Superficial Masses of the Head and Neck. Radiographics 2018; 38:1239-1263. [DOI: 10.1148/rg.2018170165] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Anmol Gupta Bansal
- From the Department of Radiology, Kravis Children’s Hospital at the Mount Sinai Hospital, One Gustave L. Levy Place, New York, NY 10029
| | - Rebecca Oudsema
- From the Department of Radiology, Kravis Children’s Hospital at the Mount Sinai Hospital, One Gustave L. Levy Place, New York, NY 10029
| | - Joy A. Masseaux
- From the Department of Radiology, Kravis Children’s Hospital at the Mount Sinai Hospital, One Gustave L. Levy Place, New York, NY 10029
| | - Henrietta Kotlus Rosenberg
- From the Department of Radiology, Kravis Children’s Hospital at the Mount Sinai Hospital, One Gustave L. Levy Place, New York, NY 10029
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20
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Point-of-Care Ultrasound Identification of Internal Jugular Vein Thrombosis in Newly Diagnosed Lymphoma. Pediatr Emerg Care 2017; 33:800-802. [PMID: 29095387 DOI: 10.1097/pec.0000000000001333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We present a case of a child who presented with neck swelling and was ultimately diagnosed with lymphoma after an internal jugular vein thrombosis was discovered by point-of-care ultrasound. The use of point-of-care ultrasound enabled thrombus detection, which prompted further evaluation and treatment.
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21
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Cone beam computed tomography and ultrasonography imaging of benign intraosseous jaw lesion: a prospective radiopathological study. Clin Oral Investig 2017; 22:1531-1539. [PMID: 29046963 DOI: 10.1007/s00784-017-2257-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 10/11/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVE We assessed whether ultrasonography (US) can be used in combination with cone beam computed tomography (CBCT) to image intraosseous jaw lesions. MATERIAL AND METHODS Using CBCT and US, we evaluated 123 lytic intraosseous jaw lesions diagnosed in 121 patients with guidance from the CBCT findings. The lesions were classified into two groups based on histopathological evaluation: (1) cysts and (2) tumors and tumor-like lesions. US and histopathological findings on the lesions of the two groups and their relationships with each other were also assessed. Results are reported as means ± standard errors, and p < 0.001 was accepted as indicating statistical significance. RESULT In total, 123 lesions were evaluated; 74 (60.2%) were cysts and 49 (39.8%) were tumors or tumor-like lesions. The CBCT and US findings were compatible as far as dimensional measurements of the lesions in the three planes (p < 0.001). The US and histopathological findings on the content of the lesions correlated (p < 0.001). CONCLUSION CBCT provides useful information for diagnosing intraosseous jaw lesions. Because it offers no valid Hounsfield unit (HU) value, it does not differentiate between solid and cystic masses. Thus, US can be used with CBCT to image intraosseous jaw lesions caused by buccal cortical thinning or perforation. CLINICAL RELEVANCE US provides useful information about intraosseous jaw lesions and can be used with CBCT to image such lesions caused by buccal cortical thinning or perforation. Clinicians can take this information into consideration when evaluating intraosseous jaw pathology.
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22
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Zhang F, Zhao X, Ji X, Han R, Li P, Du M. Diagnostic value of acoustic radiation force impulse imaging for assessing superficial lymph nodes: A diagnostic accuracy study. Medicine (Baltimore) 2017; 96:e8125. [PMID: 29068984 PMCID: PMC5671817 DOI: 10.1097/md.0000000000008125] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The aim of this study was to assess the diagnostic value of acoustic radiation force impulse (ARFI) imaging for differentiating superficial lymph nodes.Virtual touch tissue imaging (VTI) grade and shear wave velocity (SWV) were analyzed and compared in 97 patients (65 women, 32 men; mean age, 49 y; range, 23-72 y) with 97 lymph nodes [23 chronic nonspecific reactive lymph nodes (CLNs), 38 metastatic lymph nodes (MLNs), and 36 blood and lymphatic system diseases lymph nodes (BLLNs)]. The elastography characteristics in patients with CLNs, MLNs, and BLLNs were compared using the nonparametric Kruskal-Wallis test and Mann-Whitney U test for continuous variables and categorical variables. The diagnostic performance of VTI grade and SWV were evaluated using the area under the receiver operating characteristic curve (AUC).The median of SWV of MLNs was significantly higher (2.90 m/s) than those of CLNs (2.15 m/s) and BLLNs (2.52 m/s). The VTI grade of MLNs was significantly higher than those of CLNs (P < .001) and BLLNs (P < .001). The sensitivity, specificity, accuracy, and AUC were 81.58%, 95.65%, 86.89%, and 0.904, respectively, at a cutoff level of grade IV for VTI grade in differentiating MLNs from CLNs, whereas those of SWV were 57.89%, 86.96%, 68.85%, and 0.752, respectively, at a cutoff level of 2.76 m/s.The diagnostic performance of VTI grade was significantly higher than that of SWV in differentiating MLNs from CLNs. The diagnostic performance of VTI grade and SWV were lower intermediate in differentiating MLNs from BLLNs and in differentiating BLLNs from CLNs, and there was no significant difference between VTI grade and SWV. ARFI imaging may be a feasible method for differentiating MLNs from CLNs.
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Affiliation(s)
- Fengjuan Zhang
- Department of Ultrasound, the Fourth Hospital of Hebei Medical University
| | - Xinming Zhao
- Department of Nuclear Medicine and Medical Imaging, the Fourth Hospital of Hebei Medical University, Hebei, Shijiazhuang, China
| | - Xiaohui Ji
- Department of Ultrasound, the Fourth Hospital of Hebei Medical University
| | - Ruoling Han
- Department of Ultrasound, the Fourth Hospital of Hebei Medical University
| | - Ping Li
- Department of Ultrasound, the Fourth Hospital of Hebei Medical University
| | - Min Du
- Department of Ultrasound, the Fourth Hospital of Hebei Medical University
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23
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Chua WY, Langer JE, Jones LP. Surveillance Neck Sonography After Thyroidectomy for Papillary Thyroid Carcinoma: Pitfalls in the Diagnosis of Locally Recurrent and Metastatic Disease. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:1511-1530. [PMID: 28393379 DOI: 10.7863/ultra.16.08086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 09/23/2016] [Indexed: 06/07/2023]
Abstract
A sonographic examination of the neck performed 6 to 12 months after thyroid surgery in patients with differentiated thyroid cancer is strongly recommended by the American Thyroid Association and considered mandatory by the European Thyroid Association for locoregional surveillance. The aim of this article is to review the normal anatomic changes expected after thyroid surgery and the pathologic mimics of thyroid carcinoma recurrence in post-thyroidectomy patients as they appear on neck sonography. We hope to offer some pearls to increase diagnostic confidence in this setting.
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Affiliation(s)
- Wynne Yuru Chua
- Department of Diagnostic Imaging, National University Health System, Singapore
| | - Jill E Langer
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lisa P Jones
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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24
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Zajkowski P, Ochal-Choińska A. Standards for the assessment of salivary glands - an update. J Ultrason 2016; 16:175-90. [PMID: 27446602 PMCID: PMC4954863 DOI: 10.15557/jou.2016.0019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 05/02/2016] [Accepted: 05/07/2016] [Indexed: 11/22/2022] Open
Abstract
The paper is an update of 2011 Standards for Ultrasound Assessment of Salivary Glands, which were developed by the Polish Ultrasound Society. We have described current ultrasound technical requirements, assessment and measurement techniques as well as guidelines for ultrasound description. We have also discussed an ultrasound image of normal salivary glands as well as the most important pathologies, such as inflammation, sialosis, collagenosis, injuries and proliferative processes, with particular emphasis on lesions indicating high risk of malignancy. In acute bacterial inflammation, the salivary glands appear as hypoechoic, enlarged or normal-sized, with increased parenchymal flow. The echogenicity is significantly increased in viral infections. Degenerative lesions may be seen in chronic inflammations. Hyperechoic deposits with acoustic shadowing can be visualized in lithiasis. Parenchymal fibrosis is a dominant feature of sialosis. Sjögren syndrome produces different pictures of salivary gland parenchymal lesions at different stages of the disease. Pleomorphic adenomas are usually hypoechoic, well-defined and polycyclic in most cases. Warthin tumor usually presents as a hypoechoic, oval-shaped lesion with anechoic cystic spaces. Malignancies are characterized by blurred outlines, irregular shape, usually heterogeneous echogenicity and pathological neovascularization. The accompanying metastatic lesions are another indicator of malignancy, however, final diagnosis should be based on biopsy findings.
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Affiliation(s)
- Piotr Zajkowski
- Department of Diagnostic Imaging, the Second Faculty of Medicine, Medical University of Warsaw, Poland
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25
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Suh CH, Choi YJ, Baek JH, Lee JH. The diagnostic performance of shear wave elastography for malignant cervical lymph nodes: A systematic review and meta-analysis. Eur Radiol 2016; 27:222-230. [DOI: 10.1007/s00330-016-4378-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 04/18/2016] [Indexed: 01/24/2023]
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26
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Miura KI, Yoshida M, Yamaguchi K, Yoshida R, Asahina I. Sonographic Evaluation of Bone Formation After Sagittal Split Ramus Osteotomy. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:395-400. [PMID: 26782159 DOI: 10.7863/ultra.15.04046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 06/10/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES The aim of this study was to assess the applicability of sonography for evaluation of mandible bone healing after orthognathic surgery. METHODS The study included 10 patients who underwent orthognathic surgery. To assess new bone formation after sagittal split ramus osteotomy, the echo intensities of ultrasound (US) reflections of the proximal segment, distal segment, and bone gap were measured with a real-time US scanner at 1 day, 1, 2, 3, and 4 weeks, and 2 and 4 months postoperatively. RESULTS The mean echo intensity of US reflections of the bone gap gradually increased and became equivalent to that of bone surfaces by 4 weeks postoperatively. X-ray tomograms confirmed bone formation at the bone gap at the same time. CONCLUSIONS This study indicates that sonography may be useful for evaluating osseous healing after orthognathic surgery.
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Affiliation(s)
- Kei-ichiro Miura
- Department of Regenerative Oral Surgery, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (K.M., I.A.); Department of Oral Surgery, Imaki-ire General Hospital, Kagoshima, Japan (M.Y.); and Departments of Oral and Maxillofacial Surgery (K.Y.) and Orthodontics (R.Y.), Graduate School of Medicine and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Masashi Yoshida
- Department of Regenerative Oral Surgery, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (K.M., I.A.); Department of Oral Surgery, Imaki-ire General Hospital, Kagoshima, Japan (M.Y.); and Departments of Oral and Maxillofacial Surgery (K.Y.) and Orthodontics (R.Y.), Graduate School of Medicine and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Kojiro Yamaguchi
- Department of Regenerative Oral Surgery, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (K.M., I.A.); Department of Oral Surgery, Imaki-ire General Hospital, Kagoshima, Japan (M.Y.); and Departments of Oral and Maxillofacial Surgery (K.Y.) and Orthodontics (R.Y.), Graduate School of Medicine and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Reiko Yoshida
- Department of Regenerative Oral Surgery, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (K.M., I.A.); Department of Oral Surgery, Imaki-ire General Hospital, Kagoshima, Japan (M.Y.); and Departments of Oral and Maxillofacial Surgery (K.Y.) and Orthodontics (R.Y.), Graduate School of Medicine and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Izumi Asahina
- Department of Regenerative Oral Surgery, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (K.M., I.A.); Department of Oral Surgery, Imaki-ire General Hospital, Kagoshima, Japan (M.Y.); and Departments of Oral and Maxillofacial Surgery (K.Y.) and Orthodontics (R.Y.), Graduate School of Medicine and Dental Sciences, Kagoshima University, Kagoshima, Japan.
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27
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Evirgen Ş, Kamburoğlu K. Review on the applications of ultrasonography in dentomaxillofacial region. World J Radiol 2016; 8:50-58. [PMID: 26834943 PMCID: PMC4731348 DOI: 10.4329/wjr.v8.i1.50] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/06/2015] [Accepted: 12/04/2015] [Indexed: 02/06/2023] Open
Abstract
Use of ultrasonography (US) in dentomaxillofacial region became popular in recent years owing to increasing radiation dose concerns and economic limitations. It helps to visualize fine detail of the surface structure of the oral and maxillofacial tissues without ionizing radiation. In diagnostic ultrasound, high frequency sound waves are transmitted into the body by a transducer and echoes from tissue interface are detected and displayed on a screen. Sound waves are emitted via piezoelectric crystals from the ultrasound transducer. US technique can be used in dentomaxillofacial region for the examination of bone and superficial soft tissue, detection of major salivary gland lesions, temporomandibular joint imaging, assessment of fractures and vascular lesions, lymph node examination, measurement of the thickness of muscles and visualization of vessels of the neck. It has the potential to be used in the evaluation of periapical lesions and follow up of periapical bone healing. Also, it may be used for the evaluation of periodontal pocket depth and for the determination of gingival thickness before dental implantology.
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28
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Rito M, Cabrera RA. Chondrosarcoma of the hyoid bone: A diagnostic pitfall in the submandibular region. Diagn Cytopathol 2015; 43:933-6. [PMID: 26304473 DOI: 10.1002/dc.23328] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 07/12/2015] [Accepted: 08/05/2015] [Indexed: 01/22/2023]
Abstract
Chondrosarcoma is a malignant chondroid matrix-producing neoplasm which usually presents in the bones of the pelvis, followed by the proximal femur, proximal humerus, distal femur and ribs. The occurrence of this lesion in the hyoid bone is exceedingly rare, with only a few reported cases, and its diagnosis by fine-needle aspiration cytology (FNAC) in this particular location, to our knowledge, has never been addressed. Furthermore, the sampling of chondroid matrix at this site can pose a diagnostic dilemma with other lesions of the submandibular region. This report describes the clinical, radiologic and cytologic features on FNAC of a chondrosarcoma of the hyoid bone, emphasizing the diagnostic pitfalls of this entity and expanding the cytologic differential diagnosis of tumors of the submandibular region.
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Affiliation(s)
- Miguel Rito
- Serviço De Anatomia Patológica, Instituto Português De Oncologia De Lisboa Francisco Gentil, E.P.E. Lisboa, Portugal
| | - Rafael Adame Cabrera
- Serviço De Anatomia Patológica, Instituto Português De Oncologia De Lisboa Francisco Gentil, E.P.E. Lisboa, Portugal
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29
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Zengel P. [Masses of the neck - a potpourri of various diagnoses]. MMW Fortschr Med 2015; 157:50-56. [PMID: 26012686 DOI: 10.1007/s15006-015-2722-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Pamela Zengel
- Klinik für Hals-, Nasen-, und Ohrenheilkunde am Klinikum Großhadern, Universitätsklinikum der Ludwig-Maximilians-Universität, Marchioninistrasse 15, D-81377, München, Deutschland.
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30
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Can ultrasound elastography distinguish metastatic from reactive lymph nodes in patients with primary head and neck cancers? THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2014.04.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Abstract
Lipoma is a benign neoplasm of mature fat cells. Although a common mesenchymal neoplasm of trunk and extremities, its occurrence in the oral and oropharyngeal region is rather rare. Lipoma accounts for 1-5% of all benign oral tumors, occurring in patients above 40 years of age with slight male predilection. Oral lipoma presents as asymptomatic, slowly growing mass rarely exceeding 25 mm in diameter. Documented here is a rare case of a large size lipoma (>3 cm in diameter) occurring as an extraoral swelling in a girl aged 13 years, which was subsequently diagnosed and treated 4 years later. Furthermore discussed are the peculiarities in the clinical presentation, differential diagnosis, and investigations for this case.
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Affiliation(s)
- Deepak Daryani
- Departments of Oral Medicine and Radiology, KMCT Dental College, Kozhikode, Kerala, India
| | - R Gopakumar
- Departments of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
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AIUM practice guideline for the performance of ultrasound examinations of the head and neck. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:366-382. [PMID: 24449746 DOI: 10.7863/ultra.33.2.366] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Meng W, Xing P, Chen Q, Wu C. Initial experience of acoustic radiation force impulse ultrasound imaging of cervical lymph nodes. Eur J Radiol 2013; 82:1788-92. [DOI: 10.1016/j.ejrad.2013.05.039] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 04/03/2013] [Accepted: 05/18/2013] [Indexed: 02/07/2023]
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Kurt A, Gunes Tatar I, Ipek A, Hekimoglu B. B-mode and elastosonographic evaluation to determine the reference elastosonography values for cervical lymph nodes. ISRN RADIOLOGY 2013; 2013:895287. [PMID: 24967290 PMCID: PMC4045529 DOI: 10.5402/2013/895287] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 07/10/2013] [Indexed: 12/21/2022]
Abstract
Background. It is crucial to differentiate between reactive and malignant lymphadenopathies. Elastosonography measures the elasticity of the tissue. Having a reference value for benign lymph nodes (LNs) is important in interpretation. The purpose of this study is to determine the reference elastosonography values of cervical LNs. Methods. 97 LNs were evaluated by B-mode and elastosonography. Depth, length, width, length to width ratio, hilar-cortical thickness, strain ratio, and elasticity scores were measured. Results. In 18.6% of the cervical LNs cortical thickness was less than the hilar thickness (group A) and in 81.4% it was equal or more (group B). 69.1% of LNs showed strain ratio (SR) less than 3 (group 1) and 30.9% equal to or more than 3 (group 2). 33% of LNs displayed elasticity score (ES) 1; 30.9% ES 2; 22.7% ES 3, and 13.4% ES 4. There was a significant correlation between thickness ratios and elasticity scores (P: 0.011). A significant correlation was also demonstrated between SR groups and elasticity scores. Conclusion. A simple, reproducible, noninvasive imaging technique for diagnosis of malignant LNs is necessary. Elastosonography can aid in the differentiation of benign versus malignant cervical LNs, thus help reduce the number of unnecessary biopsies for benign processes.
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Affiliation(s)
- Aydin Kurt
- Diskapi Yildirim Beyazit Training and Research Hospital, Department of Radiology, Altındag 06110, Ankara, Turkey
| | - Idil Gunes Tatar
- Diskapi Yildirim Beyazit Training and Research Hospital, Department of Radiology, Altındag 06110, Ankara, Turkey
| | - Ali Ipek
- Ataturk Training and Research Hospital, Department of Radiology, Bilkent Yolu 3. km, Cankaya 06800, Ankara, Turkey
| | - Baki Hekimoglu
- Diskapi Yildirim Beyazit Training and Research Hospital, Department of Radiology, Altındag 06110, Ankara, Turkey
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Abstract
A case report is presented of a sonographic examination at 39 weeks’ gestation that showed a nonvascular fetal oral mass. The patient was transferred to a tertiary referral hospital where an ex utero intrapartum treatment (EXIT) procedure was planned; however, delivery was subsequently completed without the need of this procedure. The neonate underwent marsupialization of the mass with the final diagnosis of a ranula or lymphangioma. This case report emphasizes identification of a fetal oral mass, appropriate diagnostic tools to evaluate oral masses, and treatment options for these patients.
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Bumpous JM, Randolph GW. The Expanding Utility of Office-Based Ultrasound for the Head and Neck Surgeon. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.cult.2011.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Orita Y, Nose S, Sato Y, Miki K, Domae S, Hirai M, Noyama Y, Hamaya K, Kasai N, Nishizaki K, Yoshino T. Cervical lymph node extirpation for the diagnosis of malignant lymphoma. Surg Today 2012; 43:67-72. [PMID: 22350205 DOI: 10.1007/s00595-012-0149-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Accepted: 11/16/2011] [Indexed: 12/11/2022]
Abstract
PURPOSE Lymph node enlargement in the neck is a common presentation of malignant lymphoma (ML) and requires tissue sampling for accurate diagnosis. Although delayed diagnosis may be critical for some patients, unnecessary biopsy should be avoided wherever possible. This study examined the process for determining the necessity to perform a biopsy and evaluated the value of an open biopsy as a diagnostic tool to enable definite subclassification of the disease. METHODS The subjects included 20 patients with suspected ML who underwent cervical lymph node extirpation at Okayama Saiseikai general hospital between 2007 and 2010. The decision to perform a biopsy was made based on the results of sonographic evaluation, fine needle aspiration cytology (FNAC), and serum levels of lactate dehydrase (LDH) and soluble interleukin-2 receptor (sIL-2r). RESULTS The diagnosis was ML in 15 patients (75%), Castleman's disease in 1 (5%), and benign lymphadenopathy in 4 (20%). CONCLUSIONS A lymph node biopsy remains the gold standard for the diagnostic evaluation of ML. Sonographic evaluation combined with serum levels of LDH and sIL-2r is useful in determining the need for biopsy. Many of the cases of ML where it was difficult to determine whether a biopsy should be performed were relatively low grade and critical conditions could be avoided by close observation of the patient.
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Affiliation(s)
- Yorihisa Orita
- Department of Otolaryngology, Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kita-Ku, Okayama 700-8558, Japan.
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Real-time elastography for the differentiation of benign and malignant superficial lymph nodes: a meta-analysis. Eur J Radiol 2011; 81:2576-84. [PMID: 22138121 DOI: 10.1016/j.ejrad.2011.10.026] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 10/31/2011] [Accepted: 10/31/2011] [Indexed: 12/12/2022]
Abstract
BACKGROUND Real-time elastography (RTE), as a non-invasive method, is used for the classification of benign and malignant lymph nodes (LNs) and developed as an alternative to biopsy. Elasticity score (ES) and strain ratio (SR) are used for the interpretation of RTE. We studied the performance of RTE for diagnosis of malignant LNs using meta-analysis. METHODS PubMed, the Cochrane Library, ISI Web of Knowledge, China National Knowledge Infrastructure were searched. The studies published in English or Chinese relating to the diagnostic value of RTE for superficial LNs were collected. Hierarchical summary receiver operating characteristic (HSROC) curve was used to examine the RTE accuracy. Clinical utility of RTE for LNs was evaluated by Fagan plot analysis. RESULTS A total of 9 studies which included 835 LNs were analyzed. The summary sensitivity and specificity for the diagnosis of malignant LNs were 0.74 (95% confidence interval (CI), 0.66-0.81) and 0.90 (95% CI, 0.82-0.94) for ES, and 0.88 (95% CI, 0.79-0.93) and 0.81 (95% CI, 0.49-0.95) for SR, respectively. Compared to ES, SR obviously improved the diagnostic sensitivity value. The HSROCs were 0.88 for ES and 0.91 for SR, respectively. After RTE results over the cut-off value for malignant LNs ("positive" result), the corresponding post-test probability for the presence (if pre-test probability was 50%) was 88% for ES and 82% for SR, respectively; while, in "negative" measurement, the post-test probability was 22% and 13%, respectively. CONCLUSION RTE has a high accuracy in the classification of superficial LNs and can potentially help to select suspicious LNs for biopsy.
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Kami YN, Chikui T, Okamura K, Kubota Y, Oobu K, Yabuuchi H, Nakayama E, Hashimoto K, Yoshiura K. Imaging findings of neurogenic tumours in the head and neck region. Dentomaxillofac Radiol 2011; 41:18-23. [PMID: 22074867 DOI: 10.1259/dmfr/81000210] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of this study was to describe the CT, MRI and ultrasonography findings of five cases of neurogenic tumours in the head and neck region. METHODS Five neurogenic tumours were analysed with respect to their CT value, the presence of cystic change, target sign, lobulation, connection to the nerve and vascularity. RESULTS The contrast-enhanced CT (ECT) of the schwannomas demonstrated either a mass with low enhancement (two out of three cases), which reflected the predominant Antoni B components, or a mass with cystic changes, which was an Antoni A-based schwannoma displaying cystic changes (one out of three cases). On MRI, all tumours showed homogeneous and isointense signals for muscle on T₁ weighted images (T₁ WIs). T₂ weighted images (T₂ WIs) and gadolinium (Gd)-enhanced T₁ WIs demonstrated target sign in both schwannomas. Ultrasound examination showed a well-defined, ovoid or round hypoechoic mass. The direct connection to the nerve was demonstrated in two of the five cases. Lobulation was observed in only one of the five cases and cystic changes were observed in one of the five cases. In all of the cases, no vascularity was seen in power Doppler images (PDIs) obtained percutaneously. CONCLUSIONS Low-enhanced areas on ECTs can be specific for schwannomas, which suggests the predominance of Antoni B components. The target sign on T₂ WIs and Gd-enhanced T₁ WIs can be specific, which can be used to differentiate the two different components (Antoni A and Antoni B). The direct connection to the nerve can be a specific finding for neurogenic tumours; however, at present the sensitivity is 40%.
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Affiliation(s)
- Y N Kami
- Department of Oral and Maxillofacial Radiology, Faculty of Dental Science, Kyushu University, Higashi-ku, Fukuoka, Japan.
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40
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Novoa E, Gürtler N, Arnoux A, Kraft M. Role of ultrasound-guided core-needle biopsy in the assessment of head and neck lesions: a meta-analysis and systematic review of the literature. Head Neck 2011; 34:1497-503. [PMID: 22127851 DOI: 10.1002/hed.21821] [Citation(s) in RCA: 132] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2011] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Core-needle biopsy (CNB) has occasionally been used in the work-up of head and neck lesions. However, no systematic review of this simple, minimally invasive method has yet been performed. METHODS A systematic review of the literature and meta-analysis of data extracted from 16 included studies were performed. A total of 1291 cervical lesions in 1267 patients were examined by CNB. This resulted in 1232 adequate samples, from which 554 were subsequently confirmed by excisional biopsy. RESULTS CNB was able to identify true neoplasms and detect malignancy in head and neck lesions with an overall accuracy of 94% and 96%, respectively, even though there was a significant difference between the histologically verified and all adequate samples. CNB provided a correct specific diagnosis in 87% of cases without major complications and achieved a higher accuracy than that of fine-needle aspiration in detecting malignancy. CONCLUSIONS This meta-analysis confirms that CNB is an excellent method in the assessment of salivary gland lesions and lymphadenopathies inclusive of malignant lymphoma, but it is not ideal for evaluating thyroid lesions.
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Affiliation(s)
- Eva Novoa
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital AG, Aarau, Switzerland.
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41
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Branchial cleft cyst: an unusual ultrasound diagnosis in an austere environment. Crit Ultrasound J 2011. [DOI: 10.1007/s13089-011-0063-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Abstract
Branchial cleft cysts are typically benign congenital cysts lined by epithelial cells that arise on the lateral part of the neck. Ultrasound is useful in situations, where CT scanning and MRI are unavailable. We report a case of a 29-year-old Ugandan male who presents with a unilateral neck mass. We highlight the usefulness of ultrasound in diagnosing a lesion consistent with a branchial cleft cyst, while ruling out other causes of neck masses.
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Adeyemo WL, Akadiri OA. A systematic review of the diagnostic role of ultrasonography in maxillofacial fractures. Int J Oral Maxillofac Surg 2011; 40:655-61. [PMID: 21377837 DOI: 10.1016/j.ijom.2011.02.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2010] [Revised: 11/23/2010] [Accepted: 02/01/2011] [Indexed: 12/16/2022]
Abstract
This systematic review assessed the diagnostic value of ultrasonography in maxillofacial fractures. A computerized literature search of MEDLINE, PubMed and GoogleMed databases was conducted for publications on diagnostic ultrasound and maxillofacial fractures in English. Search phrases were 'maxillofacial fractures' or 'midfacial fractures' or 'zygomatic complex fractures' or 'nasal bone fractures' or 'orbital fractures' or 'mandibular fractures' combined with 'ultrasound' or 'ultrasonography'. The Boolean operator 'AND' was used to narrow the searches. 17 articles published between 1992 and 2009 were reviewed: two on midfacial fractures, nine on orbital fractures, three on nasal fractures, and two on mandibular fractures. One article described case series of ultrasonographic diagnosis of mandibular and midfacial fractures. The sensitivity and specificity of ultrasound in detecting orbital fractures were 56-100% and 85-100%, respectively, whilst that of nasal fractures were 90-100% and 98-100%, respectively. Sensitivity and specificity of ultrasonography in detecting zygomatic fractures were >90%. For mandibular fractures, the sensitivity and specificity was 66-100% and 52-100%, respectively. Much evidence justifies the use of diagnostic ultrasonography in maxillofacial fractures, especially fractures involving the nasal bone, orbital walls, anterior maxillary wall and zygomatic complex. The sensitivity and specificity of ultrasonography is generally comparable with CT.
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Affiliation(s)
- W L Adeyemo
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Medicine, University of Lagos, Nigeria.
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The Expanding Utility of Office-Based Ultrasound for the Head and Neck Surgeon. Otolaryngol Clin North Am 2010; 43:1203-8, vi. [DOI: 10.1016/j.otc.2010.08.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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44
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Incidental detection of internal jugular vein thrombosis secondary to undiagnosed benign substernal goiter. Case Rep Med 2010; 2010. [PMID: 20814560 PMCID: PMC2931408 DOI: 10.1155/2010/645193] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Revised: 06/07/2010] [Accepted: 06/25/2010] [Indexed: 01/19/2023] Open
Abstract
Internal jugular vein thrombosis is a serious event with potentially fatal outcome, where the clinical symptoms may be vague or absent. This paper refers to a rare case where routine carotid Doppler ultrasound prior to coronary artery bypass grafting (CABG) and aortic valve replacement (AVR) in a 76-year-old man, incidentally revealed thrombosis of the right internal jugular vein. Thoracic CT demonstrated an underlying, large, benign substernal multinodular goiter, mainly involving the right lobe, causing compression and displacement of the great vessels. A successful, one-stage operation including ligation of the internal jugular vein to avoid pulmonary embolism and hemithyroidectomy, combined with the scheduled CABG and AVR, was performed.
This case illustrates that benign substernal goiter may be associated with asymptomatic internal jugular vein thrombosis. Carotid Doppler ultrasound should involve evaluation of the internal jugular vein concerning thrombosis as its presence may reveal space-occupying lesions in the thorax.
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Wakasugi-Sato N, Kodama M, Matsuo K, Yamamoto N, Oda M, Ishikawa A, Tanaka T, Seta Y, Habu M, Kokuryo S, Ichimiya H, Miyamoto I, Kito S, Matsumoto-Takeda S, Wakasugi T, Yamashita Y, Yoshioka I, Takahashi T, Tominaga K, Morimoto Y. Advanced clinical usefulness of ultrasonography for diseases in oral and maxillofacial regions. Int J Dent 2010; 2010:639382. [PMID: 20445749 PMCID: PMC2860579 DOI: 10.1155/2010/639382] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Accepted: 02/02/2010] [Indexed: 12/16/2022] Open
Abstract
Various kinds of diseases may be found in the oral and maxillofacial regions and various modalities may be applied for their diagnosis, including intra-oral radiography, panoramic radiography, ultrasonography, computed tomography, magnetic resonance imaging, and nuclear medicine methods such as positron emission tomography. Of these modalities, ultrasound imaging is easy to use for the detection of noninvasive and soft tissue-related diseases. Doppler ultrasound images taken in the B-mode can provide vascular information associated with the morphology of soft tissues. Thus, ultrasound imaging plays an important role in confirming the diagnosis of many kinds of diseases in such oral and maxillofacial regions as the tongue, lymph nodes, salivary glands, and masticatory muscles. In the present article, we introduce three new applications of ultrasonography: guided fine-needle aspiration, measurement of tongue cancer thickness, and diagnosis of metastasis to cervical lymph nodes.
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Affiliation(s)
- Nao Wakasugi-Sato
- Department of Oral Diagnostic Science, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Masaaki Kodama
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Kou Matsuo
- Department of Bioscience, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Noriaki Yamamoto
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Masafumi Oda
- Department of Oral Diagnostic Science, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Ayataka Ishikawa
- Department of Bioscience, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Tatsurou Tanaka
- Department of Oral Diagnostic Science, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Yuji Seta
- Department of Bioscience, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Manabu Habu
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Shinya Kokuryo
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Hisashi Ichimiya
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Ikuya Miyamoto
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Shinji Kito
- Department of Oral Diagnostic Science, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Shinobu Matsumoto-Takeda
- Department of Oral Diagnostic Science, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Tetsuro Wakasugi
- Department of Otorhinolaryngology, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan
| | - Yoshihiro Yamashita
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Izumi Yoshioka
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Tetsu Takahashi
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Kazuhiro Tominaga
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Yasuhiro Morimoto
- Department of Oral Diagnostic Science, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
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Pietarinen-Runtti P, Apajalahti S, Robinson S, Passador-Santos F, Leivo I, Mäkitie AA. Cystic neck lesions: clinical, radiological and differential diagnostic considerations. Acta Otolaryngol 2010; 130:300-4. [PMID: 19593684 DOI: 10.3109/00016480903127450] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS Metastatic disease should always be considered as a potential differential diagnosis in the adult patient with a cystic neck lesion. OBJECTIVES The most common cause of a cystic neck lesion in young adults is a branchial cleft cyst (BCC). In older patients metastatic lymph nodes may be easily misdiagnosed as BCC. This study aimed to investigate the incidence of unsuspected carcinoma in routinely excised cervical cysts at a tertiary care teaching hospital and to determine the characteristics of benign BCC and cystic malignancy in preoperative imaging. PATIENTS AND METHODS A total of 196 consecutive adult patients operated on with the initial diagnosis of benign lateral cervical cyst were identified and the hospital charts and imaging studies were reviewed. The mean age of the patients was 40 years (range 17-79 years). RESULTS Metastatic squamous cell carcinoma was demonstrated histologically postoperatively in six (3.1%) patients and metastatic papillary thyroid carcinoma in one (0.5%) patient. Therefore, the incidence of unsuspected carcinoma in the cystic neck lesions initially diagnosed as BCC was 3.6%. The preoperative imaging appearances of these lesions had been considered identical to that of BCC.
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Affiliation(s)
- Petra Pietarinen-Runtti
- Department of Otolaryngology - Head & Neck Surgery, Helsinki University Central Hospital, PO Box 220, FIN-00029 HUCH, Helsinki, Finland
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47
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Kim JH, Lee JH, Shong YK, Hong SJ, Ko MS, Lee DH, Choi CG, Kim SJ. Ultrasound features of suture granulomas in the thyroid bed after thyroidectomy for papillary thyroid carcinoma with an emphasis on their differentiation from locally recurrent thyroid carcinomas. ULTRASOUND IN MEDICINE & BIOLOGY 2009; 35:1452-1457. [PMID: 19616361 DOI: 10.1016/j.ultrasmedbio.2009.04.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2008] [Revised: 03/10/2009] [Accepted: 04/14/2009] [Indexed: 05/28/2023]
Abstract
The purpose of our study was to evaluate the ultrasound features of suture granulomas at the thyroid bed after thyroidectomy for papillary thyroid carcinoma with an emphasis on their differentiation from locally recurrent thyroid carcinomas. We enrolled 14 suture granulomas in 10 patients and 20 locally recurrent carcinomas in 18 patients after thyroidectomy, confirmed by surgery (15 out of 20 recurrent carcinomas), or ultrasound-guided fine needle aspiration cytology (14 suture granulomas and 5 recurrent carcinomas). The ultrasound findings, including presence of internal echogenic foci suggesting calcification or suture material, were compared between the two groups. In the cases with internal echogenic foci, the size, number, distribution pattern, and the presence of a paired appearance were also evaluated. In result, most of the suture granulomas were irregular (n=13) and heterogeneous (n=9) (p<0.05). The incidence of internal echogenic foci was higher in suture granulomas (n=12) than in recurrent carcinomas (n=7) (p<0.05). The internal echogenic foci in all suture granulomas were clustered centrally or paracentrally, unlike those in recurrent carcinomas (p<0.05). Most of the echogenic foci in suture granulomas were larger than 1 mm in diameter (p<0.05) and had a paired appearance (p<0.05). Shape, heterogeneity, and the presence of central or paracentral internal echogenic foci are helpful criteria for differentiating suture granulomas from locally recurrent tumors in the thyroid bed.
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Affiliation(s)
- Jeoung Hyun Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Lu SC, Li TY, Lai MH, Wu YT, Chang ST, Hou WC. Lymphoid hyperplasia with ulnar nerve compression in a severe haemophilia B patient--case report. Haemophilia 2009; 15:1173-6. [PMID: 19563481 DOI: 10.1111/j.1365-2516.2009.02057.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Papadogeorgakis N, Petsinis V, Parara E, Papaspyrou K, Goutzanis L, Alexandridis C. Branchial cleft cysts in adults. Diagnostic procedures and treatment in a series of 18 cases. Oral Maxillofac Surg 2009; 13:79-85. [PMID: 19308468 DOI: 10.1007/s10006-009-0156-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE Branchial cleft anomalies may be presented as branchial cysts, fistulas, or sinuses. Purpose of this paper is to present the diagnostic procedures and the treatment in a series of branchial cleft cysts. METHODS Eighteen patients with branchial cleft cysts were surgically treated. All of them were subjected in laboratory examinations with ultrasonography, CT or/and MRI, and fine needle aspiration cytology (FNAC). Complete excision was the treatment in all cases. RESULTS Eight patients had Type I, seven Type II, two Type III, and one a Type IV cyst. In all cases the surgical removal was successful and after 1 to 7 years post-surgical follow-up, no recurrences have been developed. CONCLUSIONS Branchial cleft cyst diagnostic procedure must be the same as for other neck swellings. FNAC is very useful for the diagnosis and the surgical approach must ensure safe and complete cyst removal in order to avoid intraoperative complications and recurrences.
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50
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Kraft M, Laeng H, Schmuziger N, Arnoux A, Gürtler N. Comparison of ultrasound-guided core-needle biopsy and fine-needle aspiration in the assessment of head and neck lesions. Head Neck 2008; 30:1457-63. [DOI: 10.1002/hed.20891] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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