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Wunsch R. [Ultrasound imaging of the testes in children and adolescents]. RADIOLOGIE (HEIDELBERG, GERMANY) 2024; 64:35-44. [PMID: 37853238 DOI: 10.1007/s00117-023-01220-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Ultrasound, the imaging method of choice to evaluate abnormalities of the testes and the scrotum, provides accurate anatomic details and allows the assessment of perfusion using color Doppler and power Doppler. Ultrasound represents a rapid and reliable procedure which in most cases leads to a conclusive diagnosis. DIFFERENTIAL DIAGNOSIS The three most common conditions in the clinical picture of acute scrotum are testicular torsion, torsion of the testicular appendages and inflammatory changes of the testis and the epididymis (epididymo-orchitis). Especially in the case of testicular torsion, rapid diagnosis is essential since time is an important factor to initiate organ-preserving therapy. EQUIPMENT TECHNOLOGY High-frequency linear array transducer (at least 10 MHz), which allows detection of slow flow rates, is recommended.
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Affiliation(s)
- R Wunsch
- Klinik für Radiologie, Kinderradiologie und Nuklearmedizin, St. Elisabeth Gruppe GmbH, Katholische Kliniken Rhein-Ruhr, Marienhospital Witten, Marienplatz 2, 58452, Witten, Deutschland.
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Behr GG, Morani AC, Artunduaga M, Desoky SM, Epelman M, Friedman J, Lala SV, Seekins J, Towbin AJ, Back SJ. Imaging of pediatric ovarian tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper. Pediatr Blood Cancer 2023; 70 Suppl 4:e29995. [PMID: 36184758 PMCID: PMC10642215 DOI: 10.1002/pbc.29995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 08/26/2022] [Indexed: 11/05/2022]
Abstract
Ovarian tumors in children are uncommon. Like those arising in the adult population, they may be broadly divided into germ cell, sex cord, and surface epithelium subtypes; however, germ cell tumors comprise the majority of lesions in children, whereas tumors of surface epithelial origin predominate in adults. Diagnostic workup, including the use of imaging, requires an approach that often differs from that required in an adult. This paper offers consensus recommendations for imaging of pediatric patients with a known or suspected primary ovarian malignancy at diagnosis and during follow-up.
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Affiliation(s)
- Gerald G Behr
- Department of Radiology, Memorial Sloan Kettering Cancer Center/Weill Cornell Medicine, New York, New York, USA
| | - Ajaykumar C Morani
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Maddy Artunduaga
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Sarah M Desoky
- Department of Radiology, University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Monica Epelman
- Department of Radiology, Nicklaus Children's Hospital, Miami, Florida, USA
| | - Jonathan Friedman
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Shailee V Lala
- Department of Radiology, New York University Langone Health, New York, New York, USA
| | - Jayne Seekins
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, Stanford, California, USA
| | - Alexander J Towbin
- Department of Radiology and Medical Imaging, Cincinnati Children's Hospital, Cincinnati, Ohio, USA
| | - Susan J Back
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Iacobellis F, Schillirò ML, Di Serafino M, Borzelli A, Grimaldi D, Verde F, Caruso M, Dell'Aversano Orabona G, Rinaldo C, Sabatino V, Cantisani V, Vallone G, Romano L. Multimodality ultrasound assessment of the spleen: Normal appearances and emergency abnormalities. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:543-559. [PMID: 36515988 DOI: 10.1002/jcu.23414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
This paper summarizes the main splenic emergencies and their ultrasonographic findings to orient appropriate patient management. US requires minimal preparation time and allows to examine the parenchyma and to detect intraperitoneal fluid collections, which may be indirect evidence of solid organ injuries. In this paper, we analyze the role of B-mode, Doppler and Contrast-Enhanced Ultrasound in the diagnosis of splenic emergencies, with a particular focus on splenic infarction, infection, traumatic injuries and vascular splenic anomalies.
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Affiliation(s)
- Francesca Iacobellis
- Department of General and Emergency Radiology "Antonio Cardarelli" Hospital, Naples, Italy
| | - Maria Laura Schillirò
- Department of General and Emergency Radiology "Antonio Cardarelli" Hospital, Naples, Italy
| | - Marco Di Serafino
- Department of General and Emergency Radiology "Antonio Cardarelli" Hospital, Naples, Italy
- Department of Life and Health, University of Molise "V. Tiberio2, Campobasso, Italy
| | - Antonio Borzelli
- Department of Interventional Radiology "Antonio Cardarelli" Hospital, Naples, Italy
| | - Dario Grimaldi
- Department of General and Emergency Radiology "Antonio Cardarelli" Hospital, Naples, Italy
| | - Francesco Verde
- Department of General and Emergency Radiology "Antonio Cardarelli" Hospital, Naples, Italy
| | - Martina Caruso
- Department of General and Emergency Radiology "Antonio Cardarelli" Hospital, Naples, Italy
| | | | - Chiara Rinaldo
- Department of General and Emergency Radiology "Antonio Cardarelli" Hospital, Naples, Italy
| | - Vittorio Sabatino
- Department of General and Emergency Radiology "Antonio Cardarelli" Hospital, Naples, Italy
| | - Vito Cantisani
- Department of Radiology, Sapienza Rome University, Rome, Italy
| | - Gianfranco Vallone
- Department of Life and Health, University of Molise "V. Tiberio2, Campobasso, Italy
| | - Luigia Romano
- Department of General and Emergency Radiology "Antonio Cardarelli" Hospital, Naples, Italy
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Gupta S, Manchanda S, Dadhwal V. Ovarian torsion: incremental role of contrast-enhanced ultrasound. BMJ Case Rep 2022; 15:e251285. [PMID: 36517077 PMCID: PMC9756187 DOI: 10.1136/bcr-2022-251285] [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] [Indexed: 12/16/2022] Open
Abstract
We highlight the role of contrast-enhanced ultrasound (CEUS) as a supplementary modality to ultrasound (USG) examination in ovarian torsion in this case report. The reported patient had clinical history suspicious of ovarian torsion; however, USG and Doppler flow study findings were equivocal. CEUS was performed to solve the diagnostic dilemma and to know the status of ovarian parenchymal viability which revealed non-enhancement of the ovarian cyst wall and pedicle throughout the USG examination thus establishing the diagnosis of non-viable or infarcted ovarian parenchyma. The per operative and histopathology findings were consistent with our CEUS findings. CEUS is an emerging promising modality which provides information regarding parenchymal perfusion, resulting in a reliable diagnosis of ovarian torsion along with information on ovarian parenchymal viability. This ability makes CEUS equivalent to contrast-enhanced CT or MRI.
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Affiliation(s)
- Shivani Gupta
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Smita Manchanda
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Vatsla Dadhwal
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, Delhi, India
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Canejo-Teixeira R, Lima A, Santana A. Applications of Contrast-Enhanced Ultrasound in Splenic Studies of Dogs and Cats. Animals (Basel) 2022; 12:ani12162104. [PMID: 36009694 PMCID: PMC9404716 DOI: 10.3390/ani12162104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/29/2022] [Accepted: 08/11/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Contrast-enhanced ultrasound (CEUS) is a noninvasive imaging technique that has become a reliable tool for identifying and monitoring lesions in both human and animals. In the last decade, its use in veterinary diagnostic imaging has gained increasing importance, and it can be reliable in everyday clinical practice. However, there is a lack of reviews describing existing CEUS results in the study of splenic lesions, which is of particular importance in dogs and cats. This information is important for validating its efficacy, to facilitate decision making related to sampling procedures and diagnosis, or even as a means to select CEUS as an alternative diagnostic tool in specific cases. Our goal was to review the existing studies of CEUS applications for splenic ultrasound studies in cats and dogs, present these results in a systematic manner, and combine this information into practical guidelines that can be used to help diagnosis and interpretation in both clinical cases and research. Abstract Contrast-enhanced ultrasound (CEUS) is an emerging technology in veterinary medicine involving the administration of intravenous contrast agents, and it is increasingly recognized for its high potential as a diagnostic imaging tool for small animals. This exam is easy and quick to perform, safe and reliable, and allows for the differentiation of lesions. It permits the identification of lesions that may require more invasive procedures, from those that can be safely dismissed to those that can be followed-up with ultrasound imaging. Although it has been extensively reviewed for use in human medicine, there is an overall lack of information about the application of this technique for cats and dogs, particularly in splenic studies, which can be particularly important for small animals. The present review describes and summarizes the CEUS applications used for splenic analysis in cats and dogs, providing a basic overview of CEUS technology with examples of common and uncommon features of focal splenic lesions. It also systematically gathers the results obtained for benign and malignant splenic lesions described in the literature, whilst providing guidelines for their interpretation. Furthermore, it presents the advantages of using CEUS for splenic analysis in cats and dogs and the main factors that may influence the quality of the imaging and the accuracy of the diagnosis. This type of knowledge can be used to provide a framework to help veterinarians make informed decisions regarding the use of this emerging technique for splenic lesions, guiding their interpretation of CEUS findings in the splenic ultrasounds of cats and dogs.
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Affiliation(s)
- Rute Canejo-Teixeira
- Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal
- Veterinary Teaching Hospital (CA), Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal
- Correspondence: (R.C.-T.); (A.L.)
| | - Ana Lima
- Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal
- Correspondence: (R.C.-T.); (A.L.)
| | - Ana Santana
- Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal
- Veterinary Teaching Hospital (CA), Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal
- CECAV-Animal and Veterinary Research Center, Universidade de Trás os Montes e Alto Douro, 5000-801 Vila Real, Portugal
- AL4AnimalS-Associate Laboratory for Animal and Veterinary Sciences, Universidade de Trás os Montes e Alto Douro, 5000-801 Vila Real, Portugal
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Identification of secondary splenic lymphoma with contrast-enhanced ultrasound in the pediatric population. A case report. Radiol Case Rep 2021; 17:467-472. [PMID: 34950275 PMCID: PMC8671098 DOI: 10.1016/j.radcr.2021.11.027] [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: 10/29/2021] [Revised: 11/10/2021] [Accepted: 11/10/2021] [Indexed: 12/02/2022] Open
Abstract
Contrast-enhanced ultrasound scan (CEUS) is the application of ultrasound contrast agents (UCAs) to traditional ultrasound. Our aim is to report the use of CEUS for a prompt assessment of a suspected secondary splenic lymphoma in a child, which, in our experience, has allowed an accurate description of the parenchymal perfusion and vascularization pattern, leading to a confident diagnosis. We suggest that CEUS will replace Magnetic resonance imaging (MRI) or Computed tomography (CT) as standard imaging option for differential diagnosis of spleen lesions in pediatric population. As a result this will lead to decreasing the overall use of ionizing radiation and reducing the time interval to a certain diagnosis.
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Radzina M, Ratniece M, Putrins DS, Saule L, Cantisani V. Performance of Contrast-Enhanced Ultrasound in Thyroid Nodules: Review of Current State and Future Perspectives. Cancers (Basel) 2021; 13:5469. [PMID: 34771632 PMCID: PMC8582579 DOI: 10.3390/cancers13215469] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/20/2021] [Accepted: 10/27/2021] [Indexed: 12/12/2022] Open
Abstract
Ultrasound has been established as a baseline imaging technique for thyroid nodules. The main advantage of adding CEUS is the ability to assess the sequence and intensity of vascular perfusion and hemodynamics in the thyroid nodule, thus providing real-time characterization of nodule features, considered a valuable new approach in the determination of benign vs. malignant nodules. Original studies, reviews and six meta-analyses were included in this article. A total of 624 studies were retrieved, and 107 were included in the study. As recognized for thyroid nodule malignancy risk stratification by US, for acceptable accuracy in malignancy a combination of several CEUS parameters should be applied: hypo-enhancement, heterogeneous, peripheral irregular enhancement in combination with internal enhancement patterns, and slow wash-in and wash-out curve lower than in normal thyroid tissue. In contrast, homogeneous, intense enhancement with smooth rim enhancement and "fast-in and slow-out" are indicative of the benignity of the thyroid nodule. Even though overlapping features require standardization, with further research, CEUS may achieve reliable performance in detecting or excluding thyroid cancer. It can also play an operative role in guiding ablation procedures of benign and malignant thyroid nodules and metastatic lymph nodes, and providing accurate follow-up imaging to assess treatment efficacy.
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Affiliation(s)
- Maija Radzina
- Radiology Research Laboratory, Riga Stradins University, LV-1007 Riga, Latvia; (M.R.); (L.S.)
- Medical Faculty, University of Latvia, LV-1004 Riga, Latvia;
- Diagnostic Radiology Institute, Paula Stradina Clinical University Hospital, LV-1002 Riga, Latvia
| | - Madara Ratniece
- Radiology Research Laboratory, Riga Stradins University, LV-1007 Riga, Latvia; (M.R.); (L.S.)
| | - Davis Simanis Putrins
- Medical Faculty, University of Latvia, LV-1004 Riga, Latvia;
- Diagnostic Radiology Institute, Paula Stradina Clinical University Hospital, LV-1002 Riga, Latvia
| | - Laura Saule
- Radiology Research Laboratory, Riga Stradins University, LV-1007 Riga, Latvia; (M.R.); (L.S.)
- Diagnostic Radiology Institute, Paula Stradina Clinical University Hospital, LV-1002 Riga, Latvia
| | - Vito Cantisani
- Department of Radiological, Anatomopathological and Oncological Sciences, Sapienza University of Rome, 00100 Rome, Italy;
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