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Corvino A, Catalano O, Wortsman X, Roldán FA, Cavallieri F, Gonzalez C, Tafuri D, Corvino F, Cocco G, Caruso M. High-Resolution Ultrasound of Odontogenic Cutaneous Sinus Tract: An International Multicentric Experience and a Review of the Literature. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:1489-1499. [PMID: 38708914 DOI: 10.1002/jum.16471] [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: 01/10/2024] [Revised: 04/16/2024] [Accepted: 04/18/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVES To investigate the role of high-resolution ultrasound (HR-US) in the initial and differential diagnosis of the Odontogenic Cutaneous Sinus Tract (OCST) in a multicentric setting. METHODS Skin HR-US examinations of OCSTs performed between January 2019 and June 2023 at different Institutions were retrospectively reviewed. Epidemiological and clinical data (age, gender, location of the skin lesion, causative tooth, and the clinical suspicion) as well as HR-US imaging findings (morphology and length of the sinus tract, Doppler signal, and cortical bone interruption of maxilla or mandible) were collected. US examinations were performed by expert radiologists using a high-performance US scanner, employing a high-frequency linear probe (15 MHz or higher frequencies). In only one patient the HR-US exam was integrated with strain elastography (SE). RESULTS Sixteen patients were enrolled with a median age of 37.6 years (range 16-70 years). The most frequent clinical suspicion was epidermal cyst, while OCST was suspected in only two cases. In all cases, HR-US depicted the sinus tract as a nodular, triangular or "champignon-shaped" lesion in the subcutaneous layer, which continued with a slightly tortuous band structure, up to the focally interrupted cortical bone plate. Furthermore, color Doppler evaluation showed color signals around and/or within the lesion, expression of inflammation. On SE, the sinus tract showed a hard pattern, due to fibrous and granulomatous tissue. CONCLUSIONS HR-US, thanks to its high spatial resolution, allows the evaluation of OCST, and play a crucial diagnostic role, mainly when the clinical suspicious is different.
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Affiliation(s)
- Antonio Corvino
- Medical, Movement and Wellbeing Sciences Department, University of Naples "Parthenope", Naples, Italy
| | | | - Ximena Wortsman
- Department of Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues Clinic, University of Chile and Pontifical Catholic University of Chile, Santiago, Chile
| | - Fernando Alfageme Roldán
- Dermatologic Ultrasound and Hidradenitis Suppurativa Unit, Hospital Universitario Puerta De Hierro Majadahonda, Madrid, Spain
| | | | - Claudia Gonzalez
- Universidad del Rosario, Private Practice, Ultrasonido Altamente Especializado, Bogotá, Colombia
| | - Domenico Tafuri
- Medical, Movement and Wellbeing Sciences Department, University of Naples "Parthenope", Naples, Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Naples, Italy
| | - Giulio Cocco
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Martina Caruso
- Advanced Biomedical Sciences Department, University of Naples Federico II, Naples, Italy
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Crisan D, Schneider LA, Scharffetter-Kochanek K, Bernhard L, Crisan M, Wortsman X. The Usefulness of Ultrasonography for Supporting the Differentiation, Diagnosis, and Treatment of Atypical Fibroxanthoma and Pleomorphic Dermal Sarcoma. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:1563-1572. [PMID: 38703399 DOI: 10.1002/jum.16478] [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: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/06/2024]
Abstract
Atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS) are rare histomorphological variants of a disease spectrum. After ruling out other tumor entities by immunohistochemistry, PDS can be differentiated from AFX by infiltration into the subcutis, while AFX remains confined to the dermis. The therapeutic approach is more aggressive in PDS as it can potentially metastasize. We assessed the usefulness of preoperative sonography in differentiating between the two tumor entities by identifying a potential subcutaneous infiltration. In our patients (n = 13), preoperative sonography identified and differentiated AFX and PDS with 100% accuracy and even changed the initial histological suspicion of AFX to PDS in 3 cases (23%), which was confirmed after tumor resection. Preoperative sonography of these tumors could strengthen the clinical diagnosis, avoid a delay in therapy initiation and improve patient counseling. While for AFX, micrographic-controlled surgery suffices, for PDS, resection with 2 cm safety margins and lymph node sonography to rule out lymphonodal involvement is necessary. Hence, ultrasonography can improve clinical practice by providing helpful information for dermatosurgeons, which cannot be obtained during clinical examination.
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Affiliation(s)
- Diana Crisan
- Clinic of Dermatology and Allergology, University Clinic Ulm, Ulm, Germany
| | | | | | - Lukas Bernhard
- Clinic of Dermatology and Allergology, University Clinic Ulm, Ulm, Germany
| | - Maria Crisan
- Clinic of Dermatology and Venerology, Cluj-Napoca County Hospital, Cluj-Napoca, Romania
| | - Ximena Wortsman
- Department of Dermatology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Department of Dermatology, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Santiago, Chile
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Ten B, Asfuroğlu ZM, Eskandari MM, Temel G, Esen K, Yüksek HH, Balcı Y. The place of B-mode ultrasonography, shear-wave elastography, and superb microvascular imaging in the diagnosis of De Quervain tenosynovitis. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:499-510. [PMID: 38446065 DOI: 10.1002/jcu.23661] [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: 01/04/2024] [Revised: 02/20/2024] [Accepted: 02/26/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE Superb microvascular imaging (SMI) and Shear wave elastography (SWE) are newly developed ultrasonographic diagnostic tools used to support the diagnosis of De Quervain tenosynovitis (DQT). The aim of this study was to examine the capacity to differentiate between the wrist with DQT and the healthy wrist, as well as the potential for predicting the disease's severity using B-mode ultrasonography, SWE, and SMI. METHODS A total of 19 cases with unilateral clinical DQT were included in the prospective study. The wrists of these cases without DQT clinic constituted the control group. RESULTS The SWE parameters of m/s and kPa cutoff values were ≤5.225 and ≤ 77.65, respectively, in the wrists with DQT compared to the wrists not diagnosed with DQT (p < 0.001). Regarding SMI findings no microvascularity was determined in the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendon sheaths of the wrists without DQT, and a significant increase was observed in the degree of microvascularity as the clinical severity of DQT increased. CONCLUSION SWE results can differentiate between the presence and absence of DQT. SMI grading of the APL and EPB tendon sheaths may be helpful to the clinician in deciding the clinical severity of DQT.
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Affiliation(s)
- Barış Ten
- Department of Radiology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Zeynel Mert Asfuroğlu
- Department of Orthopedics and Traumatology, Mersin University Faculty of Medicine, Mersin, Turkey
| | | | - Gülhan Temel
- Department of Department of Biostatistics, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Kaan Esen
- Department of Radiology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Hasan Hüsnü Yüksek
- Department of Radiology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Yüksel Balcı
- Department of Radiology, Mersin University Faculty of Medicine, Mersin, Turkey
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Catalano O, Corvino A. Ultrasound of Skin Cancer: What We Need to Know. Semin Ultrasound CT MR 2024; 45:216-232. [PMID: 38056785 DOI: 10.1053/j.sult.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
Ultrasound is an imaging technique that can provide critical anatomical information about malignant skin tumors that cannot be deducted by clinical examination, dermoscopy, or even biopsy. This data can support detecting and assessing the extent of the primary tumor and its differential diagnosis, surgical planning, and locoregional staging. Moreover, this non-invasive technique can help to follow-up and detect recurrences. This review aims to address the most common indications for ultrasound in skin oncology and provide a comprehensive guide to the grayscale and color-Doppler findings in cutaneous melanoma, squamous cell carcinoma, basal cell carcinoma, and other cutaneous malignant tumors.
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Affiliation(s)
| | - Antonio Corvino
- Movement Sciences and Wellbeing Department, University of Naples "Parthenope", Naples, Italy
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Gong X, Li J, Ding A, Zuo J, Rao Y, Chen J, Xiong P. Conventional and contrast-enhanced ultrasound in the differential diagnosis of recurrent dermatofibrosarcoma protuberans and postoperative scar. BMC Cancer 2024; 24:285. [PMID: 38438997 PMCID: PMC10910735 DOI: 10.1186/s12885-024-11991-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/11/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Dermatofibrosarcoma protuberans (DFSP) has a high recurrence rate after resection. Because of the lack of specific manifestations, recurrent DFSP is easily misdiagnosed as post-resection scar. A few series have reported ultrasound findings of recurrent DFSP; moreover, the usefulness of contrast-enhanced ultrasound in differentiating recurrent DFSP has not been studied. OBJECTIVE We investigated conventional and contrast-enhanced ultrasound in the differential diagnosis of recurrent DFSP and post-resection scar. METHODS We retrospectively evaluated the findings of conventional and contrast-enhanced ultrasound in 34 cases of recurrent DFSP and 38 postoperative scars examined between January 2018 and December 2022. RESULTS The depth and vascular density of recurrent DFSP were greater than those of postoperative scars (P < 0.05). On gray-scale ultrasound, recurrent DFSP lesions were more commonly irregular, heterogeneous, and hypoechoic, with finger-like projections and ill-defined borders. Postoperative scar was more likely to appear as hypoechoic and homogeneous with well-defined borders (P < 0.05). On color Doppler ultrasound, recurrent DFSP was more likely to feature rich arterial and venous blood flow, and postoperative scar was more likely to display poor blood flow (P < 0.05). On contrast-enhanced ultrasound, recurrent DFSP was more likely to feature heterogeneous hyper-enhancement, and postoperative scar was more likely to display homogeneous iso-enhancement (P < 0.05). Recurrent DFSP presented a higher peak and sharpness than postoperative scar (P < 0.05). CONCLUSION Conventional and contrast-enhanced ultrasound produced distinct features of recurrent DFSP and post-resection scar, which could improve the accuracy of differential diagnosis.
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Affiliation(s)
- Xia Gong
- Department of Ultrasound, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China
| | - Jia Li
- Department of Ultrasound, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China
| | - Angang Ding
- Department of Ultrasound, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China
| | - Jiaxin Zuo
- Department of Ultrasound, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China
| | - Yamin Rao
- Department of Pathology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China
| | - Jun Chen
- Department of Dermatology and Dermatologic Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China.
| | - Ping Xiong
- Department of Ultrasound, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China.
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Li W, Zheng Y, Liu H, Tai Z, Zhu H, Li Z, Gu Q, Li Y. Multimodal ultrasound imaging for diagnostic differentiation of sclerosing adenosis from invasive ductal carcinoma. Quant Imaging Med Surg 2024; 14:877-887. [PMID: 38223094 PMCID: PMC10784066 DOI: 10.21037/qims-23-524] [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: 04/17/2023] [Accepted: 11/09/2023] [Indexed: 01/16/2024]
Abstract
Background Sclerosing adenosis (SA) is a common proliferative benign lesion without atypia in the breast that may mimic invasive ductal carcinoma (IDC) on medical imaging, leading to it often being misdiagnosed and mistreated. Consequently, the purpose of this study was to assess the diagnostic value of multimodal ultrasound imaging in distinguishing SA from IDC. Methods Multimodal ultrasound imaging, including automated breast volume scan (ABVS), elasticity imaging (EI), and color Doppler flow imaging (CDFI), were performed on 120 consecutive patients comprising 122 breast lesions (54 SA, 68 IDC). All lesions were pathologically confirmed. Multimodal ultrasound imaging features were compared between the two groups. Binary logistic regression analysis based on ABVS, EI, and CDFI was conducted to formulate a logistic regression equation for differentiating SA from IDC. The diagnostic performances of ABVS, EI, CDFI, and their combination were compared by the receiver operating characteristic (ROC) curve analysis. Results The sensitivity, specificity, and accuracy of ABVS, EI, CDFI, and their combination in differentiating SA from IDC were, respectively, 75.00%, 72.22%, and 73.77%; 86.76%, 72.22%, and 80.33%; 73.53%, 64.81%, and 69.67%; and 88.24%, 74.07%, and 81.97%. Combining multimodal ultrasound imaging yielded an area under the curve (AUC) of 0.895 (95% confidence interval: 0.827-0.943), which was higher than that of ABVS, EI, and CDFI, with AUC values of 0.736, 0.795, and 0.692, respectively, and the difference was statistically significant (ABVS vs. combined model, P<0.001; CDFI vs. combined model, P<0.001; EI vs. combined model, P<0.001). There was no significant difference in the diagnostic efficacy among the three imaging modalities (ABVS vs. EI, P=0.266; ABVS vs. CDFI, P=0.4671; EI vs. CDFI, P=0.051). Compared with those in IDC, the calcification (16.67% vs. 57.35%; P<0.001) and retraction phenomena in the coronal planes (18.52% vs. 57.35%; P<0.001) were less common in patients with SA, while circumscribed margin (38.89% vs. 5.88%; P<0.001), vascularity grade 0-I (64.81% vs. 26.47%; P<0.001), and elasticity scores 1-3 (72.22% vs. 13.24%; P<0.001) were more frequently found in patients with SA. Patients with SA were significantly younger than were patients with IDC (43±11 vs. 54±11 years; P<0.001), and the lesion size was smaller in patients with SA than in those with IDC (median size 1.0 cm; interquartile range (IQR), 0.9 cm vs. median size 1.3 cm; IQR, 1.3 cm; P<0.001). Conclusions The preliminary results suggested that multimodal ultrasound imaging can improve the diagnostic accuracy of SA and provide additional information for differential diagnosis of SA and IDC.
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Affiliation(s)
- Wen Li
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Department of Ultrasound, Huadong Sanatorium, Wuxi, China
| | - Yan Zheng
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Haizhen Liu
- Department of Ultrasound, Huadong Sanatorium, Wuxi, China
| | - Zhengling Tai
- Department of Ultrasound, Huadong Sanatorium, Wuxi, China
| | - Huihui Zhu
- Department of Ultrasound, Huadong Sanatorium, Wuxi, China
| | - Zhaoxi Li
- Department of Ultrasound, Huadong Sanatorium, Wuxi, China
| | - Qinghua Gu
- Department of Radiology, Suzhou Yongding Hospital, Suzhou, China
| | - Yonggang Li
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Medical Imaging, Soochow University, Suzhou, China
- National Clinical Research Center for Hematologic Diseases, the First Affiliated Hospital of Soochow University, Suzhou, China
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Ricci V, Cocco G, Donati D, Farì G, Chang KV, Özçakar L. From Histopathology to High-Resolution Ultrasound Imaging of Skin Scars. Diagnostics (Basel) 2023; 13:3629. [PMID: 38132213 PMCID: PMC10742690 DOI: 10.3390/diagnostics13243629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Nowadays, modern ultrasound machines and high-frequency transducers allow us to accurately assess the superficial soft tissues of the human body. In this sense, sonographic evaluation of the skin and related pathologies is progressively growing in the pertinent literature. To the best of our knowledge, a standardized sonographic protocol focused on the assessment of pathological skin scars is still lacking. As such, the main purpose of the present study was to propose a technical guide to sonographically assess skin scars in the daily practice of clinicians-starting from knowledge on their histopathological features. In order to standardize the ultrasound examination, a superficial-to-deep, layer-by-layer approach has been proposed to optimize its reproducibility and to promote a common language among the different healthcare providers.
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Affiliation(s)
- Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy
| | - Giulio Cocco
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy;
| | - Danilo Donati
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | - Giacomo Farì
- Department of Biological and Environmental Sciences and Technologies (DiSTeBA), Università del Salento, 73100 Lecce, Italy;
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10617, Taiwan;
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, 06100 Ankara, Turkey;
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Kim YG, Ryu JH, Lee KC. A Method for Precise Reduction of Facial Bone Fractures Using Intraoperative Ultrasound With a Solid Gel Pad as a Coupling Medium. J Craniofac Surg 2023; 35:485-487. [PMID: 37934956 DOI: 10.1097/scs.0000000000009800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 08/26/2023] [Indexed: 11/09/2023] Open
Abstract
This study introduces a method to overcome technical challenges in using intraoperative ultrasound for the closed reduction of nasal bone and zygomatic arch fractures. The curvature of the face makes it difficult to apply an ultrasound probe to the facial area. We used a solid gel pad as a coupling medium during surgery to improve the scanning of facial bone fractures. The results show that the fracture sites observed on preoperative computed tomography scans can be easily visualized using intraoperative ultrasound, and real-time manipulation confirms successful reduction. The solid gel pad is light, malleable, easy to use, and provides accurate images. Overall, the use of ultrasound with a solid gel pad enhances the accuracy of closed reduction in facial bone fracture surgeries, confirming fracture patterns and ensuring precise reduction.
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Affiliation(s)
- Young Geun Kim
- Public health doctor, Yeongdong Hospital, Haman-gun, Gyeongsangnam-do, Korea
- Korean Association of Public Health Doctor, Seoul, Korea
| | - Jeong-Ho Ryu
- Department of Plastic and Reconstructive Surgery, College of Medicine, Dong-A University, 26 Daesingongwon-ro, Seo-gu, Busan 49201, Korea
| | - Keun-Cheol Lee
- Department of Plastic and Reconstructive Surgery, College of Medicine, Dong-A University, 26 Daesingongwon-ro, Seo-gu, Busan 49201, Korea
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Zhang Z, He S, Zhong Y, Zou H, Cai L, Zhang Y, Wang H. The effect of gel pads on the measurement of breast superficial lesions by shear wave elastography. Ann Med 2023; 55:2269941. [PMID: 37871181 PMCID: PMC10595377 DOI: 10.1080/07853890.2023.2269941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/08/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVE This study aimed to compare the repeatability and diagnostic efficiency of shear wave elastography (SWE) while using coupling gel and gel pads in the diagnosis of superficial breast lesions. METHODS Two experienced sonographers, trained in SWE, used different methods to perform the maximum Young's modulus (Emax) measurement of the lesion while using coupling gel SWE and gel pad SWE at different time points. All 80 lesions were in the superficial layer of the breast. The interclass correlation coefficient (ICC) was calculated to evaluate the intraobserver and interobserver repeatability. Meanwhile, the receiver operating characteristic curve (ROC curve) was used to calculate the sensitivity, specificity and area under the curve of the two methods. RESULTS In the 80 breast lesions, the intraobserver and interobserver reproducibility of SWE measurements using coupling gel were considered good, and the ICCs were 0.728 (95% CI: 0.509-0.813) and 0.702 (95% CI: 0.492-0.795), respectively. The intraobserver and interobserver reproducibility of the SWE measured by the gel pad were also considered good, and the ICCs were 0.745 (95% CI: 0.501-0.801) and 0.713 (95% CI: 0.498-0.802), respectively. The sensitivity, specificity and area under the curve were 0.711 and 0.737, 0.929 and 0.905, and 0.873 and 0.878, respectively. CONCLUSIONS In the SWE measurement of superficial breast lesions, the use of a gel pad does not affect the repeatability and diagnostic efficiency of the measurement.
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Affiliation(s)
- Zhijun Zhang
- Department of Ultrasound, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Shu He
- Medical Affairs Department, The Fifth People’s Hospital of Chongqing, Chongqing, China
| | - Yu Zhong
- Department of Ultrasound, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Hairong Zou
- Department of Ultrasound, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Lu Cai
- Department of Ultrasound, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Yan Zhang
- Department of Ultrasound, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Hui Wang
- Department of Ultrasound, University-Town Hospital of Chongqing Medical University, Chongqing, China
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Chen GY, Li T. Simultaneous thyroglossal duct cyst with parathyroid cyst: A case report. World J Clin Cases 2023; 11:7248-7252. [PMID: 37946755 PMCID: PMC10631413 DOI: 10.12998/wjcc.v11.i29.7248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/10/2023] [Accepted: 09/22/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Thyroglossal duct cysts (TDC) are common congenital deformities. Most of them are cysts formed by the thyroglossal ducts that do not disappear and degenerate in the early embryonic stage. TDC exists alone and is rarely complicated by other congenital embryonic malformations. Only a few reports of TDC with branchial cleft cysts, thyroid cancer, thyroid hematoma, and epidermoid cysts have been reported. Therefore, we report a patient with TDC and parathyroid cyst (PC), a rare disease that has never been reported. CASE SUMMARY A 47-year-old woman presented to clinic in April 2021 with a neck tumor which she had noticed 5 d earlier. We perfected the relevant examinations, such as ultrasound and computed tomography, and resected the tumor. After surgical treatment, the pathology revealed a cervical thyroglossal duct cyst and a left lobe parathyroid cyst. The patient was followed up for 1 year without significant recurrence. CONCLUSION We report a patient with a simultaneous TDC and a PC to explore the correlation between the two congenital anomalies.
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Affiliation(s)
- Geng-Yu Chen
- Department of Thyroid and Breast Surgery, The Forth Hospital of Jinan City, Jinan 250021, Shandong Province, China
| | - Tong Li
- Department of Thyroid and Breast Surgery, The Forth Hospital of Jinan City, Jinan 250021, Shandong Province, China
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Catalano O, Crisan D, Díaz CPG, Cavallieri F, Varelli C, Wortsman X. Ultrasound Assessment of Skin Tumors Local Recurrence. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:2439-2446. [PMID: 37195073 DOI: 10.1002/jum.16255] [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: 04/14/2023] [Accepted: 04/16/2023] [Indexed: 05/18/2023]
Abstract
Skin cancer may recur at or around the surgical site despite wide excisions. Prompt clinical and sonographic detection of local recurrence is important since subjects with relapsing melanomas or nonmelanoma malignancies can be managed efficaciously, with a relevant impact on morbidity and survival. Ultrasound is being employed with increasing frequency in the assessment of skin tumors, but most of the published articles relate to initial pretherapeutic diagnosis and staging. This review aims to offer an illustrated guide to the sonographic evaluation of locally recurring skin cancer. We introduce the topic, then we provide some sonographic tips for patient follow-up, then we describe the ultrasound findings in case of local recurrence, illustrating the main mimickers, and finally, we mention the role of ultrasound in guiding diagnostic and therapeutic percutaneous procedures.
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Affiliation(s)
| | - Diana Crisan
- Clinic of Dermatology and Allergology, University Clinic, Ulm, Germany
| | | | | | - Carlo Varelli
- Radiology Unit, Istituto Diagnostico Varelli, Naples, Italy
| | - Ximena Wortsman
- Department of Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues Clinic, University of Chile and Pontifical Catholic University of Chile, Santiago, Chile
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Catalano O, Corvino A, Basile L, Catalano F, Varelli C. Use of new microcirculation software allows the demonstration of dermis vascularization. J Ultrasound 2023; 26:169-174. [PMID: 36001281 PMCID: PMC10063712 DOI: 10.1007/s40477-022-00710-2] [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: 04/26/2022] [Accepted: 07/06/2022] [Indexed: 10/15/2022] Open
Abstract
AIMS Current ultrasound (US) Doppler techniques cannot demonstrate the vascularization of the dermis. The purpose of this study was to investigate whether the new Superb Vascular Imaging (SMI) and Microvascular Flow (MV-Flow) techniques improve the detection of normal dermis vessels. SMI and MV-Flow were compared side-by-side to conventional power-Doppler (PD) imaging. METHODS By using US, 50 healthy volunteers were evaluated at level of five body areas: forehead, forearm, palm, buttock, and thigh. Two off-site operators evaluated the images to assess the difference between SMI and PD imaging and between MV-Flow and PD imaging in terms of dermis flow amount. A 0-3 scoring system was adopted. RESULTS SMI scored grade 0 in 0% of body areas, grade 1 in 58%, grade 2 in 33%, and grade 3 in 9%. In comparison with SMI, PD scored grade 0 in 38% of body areas, grade 1 in 56%, grade 2 in 6%, and grade 3 in 0%. MV-Flow scored grade 0 in 0% of body areas, grade 1 in 52%, grade 2 in 43%, and grade 3 in 6%. Comparted to MV-Flow, PD scored grade 0 in 53% of body areas, grade 1 in 34%, grade 2 in 13%, and grade 3 in 0%. The difference in terms of sensitivity was statistically significant for all the body areas investigated. CONCLUSIONS We found both SMI and MV-Flow to be superior to PD imaging and capable to demonstrate normal vascularization of the dermis.
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Affiliation(s)
- Orlando Catalano
- Radiology Unit, Istituto Diagnostico Varelli, via Cornelia dei Gracchi 65, 80126, Naples, Italy.
| | - Antonio Corvino
- Motor Science and Wellness Department, University of Naples Parthenope, Naples, Italy
| | - Luigi Basile
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Fabio Catalano
- Radiology Unit, Istituto Diagnostico Varelli, via Cornelia dei Gracchi 65, 80126, Naples, Italy
| | - Carlo Varelli
- Radiology Unit, Istituto Diagnostico Varelli, via Cornelia dei Gracchi 65, 80126, Naples, Italy
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Ghosh D, Salinas CM, Pallod S, Roberts J, Makin IRS, Yaron JR, Witte RS, Rege K. Temporal evaluation of efficacy and quality of tissue repair upon laser-activated sealing. Bioeng Transl Med 2023; 8:e10412. [PMID: 36925709 PMCID: PMC10013809 DOI: 10.1002/btm2.10412] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/01/2022] [Accepted: 08/08/2022] [Indexed: 11/11/2022] Open
Abstract
Injuries caused by surgical incisions or traumatic lacerations compromise the structural and functional integrity of skin. Immediate approximation and robust repair of skin are critical to minimize occurrences of dehiscence and infection that can lead to impaired healing and further complication. Light-activated skin sealing has emerged as an alternative to sutures, staples, and superficial adhesives, which do not integrate with tissues and are prone to scarring and infection. Here, we evaluate both shorter- and longer-term efficacy of tissue repair response following laser-activated sealing of full-thickness skin incisions in immunocompetent mice and compare them to the efficacy seen with sutures. Laser-activated sealants (LASEs) in which, indocyanine green was embedded within silk fibroin films, were used to form viscous pastes and applied over wound edges. A hand-held, near-infrared laser was applied over the incision, and conversion of the light energy to heat by the LASE facilitated rapid photothermal sealing of the wound in approximately 1 min. Tissue repair with LASEs was evaluated using functional recovery (transepidermal water loss), biomechanical recovery (tensile strength), tissue visualization (ultrasound [US] and photoacoustic imaging [PAI]), and histology, and compared with that seen in sutures. Our studies indicate that LASEs promoted earlier recovery of barrier and mechanical function of healed skin compared to suture-closed incisions. Visualization of sealed skin using US and PAI indicated integration of the LASE with the tissue. Histological analyses of LASE-sealed skin sections showed reduced neutrophil and increased proresolution macrophages on Days 2 and 7 postclosure of incisions, without an increase in scarring or fibrosis. Together, our studies show that simple fabrication and application methods combined with rapid sealing of wound edges with improved histological outcomes make LASE a promising alternative for management of incisional wounds and lacerations.
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Affiliation(s)
- Deepanjan Ghosh
- Biological Design Graduate Program, School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeArizonaUSA
| | | | - Shubham Pallod
- Biological Design Graduate Program, School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeArizonaUSA
| | - Jordan Roberts
- School of Life SciencesArizona State UniversityTempeArizonaUSA
| | | | - Jordan R. Yaron
- Biological Design Graduate Program, School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeArizonaUSA
- Department of Chemical Engineering, School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeArizonaUSA
| | - Russell S. Witte
- James C. Wyant College of Optical SciencesUniversity of ArizonaTucsonArizonaUSA
- Department of Medical ImagingUniversity of ArizonaTucsonArizonaUSA
| | - Kaushal Rege
- Biological Design Graduate Program, School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeArizonaUSA
- Department of Chemical Engineering, School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeArizonaUSA
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14
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Caruso M, Catalano O, Bard R, Varelli C, Corvino F, Caiazzo C, Corvino A. Non-glandular findings on breast ultrasound. Part I: a pictorial review of superficial lesions. J Ultrasound 2022; 25:783-797. [PMID: 35438461 PMCID: PMC9705641 DOI: 10.1007/s40477-021-00619-2] [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: 06/13/2021] [Accepted: 08/18/2021] [Indexed: 10/18/2022] Open
Abstract
Ultrasound (US) represents the first-level imaging technique in the assessment of breast in young patients, whereas it is complementary to mammography in adult ones. It is not uncommon to encounter non-glandular mass during either screening or diagnostic breast US; sometimes the evaluation of palpable lump may be the reason of clinician's US request. The breast US field-of-view includes not only the glandular parenchyma, but also the tissues located anterior and posterior to it, from the skin to the ribs. In this setting, the radiologist must be familiar with the non-glandular breast diseases, which can occur in the superficial layers as well as in the chest wall. The differential diagnosis varies according to anatomic layer, so the anatomic origin is the first feature to assess and the correct localization is needed to avoid misdiagnosis and to choose, when requested, the second diagnostic step, imaging or histologic analysis. This paper is the first of two focused on non-glandular breast lesions; characterization, differential diagnosis, and pitfalls of superficial lesions are reviewed. They may be located in the dermis or hypodermis: the former are usually benign skin lesions, whereas the latter, although usually benign, may arise also from the anterior terminal lobular units, hence the papilloma, fibroadenomas, and breast cancers should be included in the differential diagnosis. US is more sensitive than CT and MRI in the assessment of superficial lesions due to higher spatial resolution.
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Affiliation(s)
- Martina Caruso
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, 80131 Naples, Italy
| | - Orlando Catalano
- Radiology Unit, Istituto Diagnostico Varelli, via Cornelia dei Gracchi 65, 80126 Naples, Italy
| | - Robert Bard
- Bard Cancer Diagnostics, 121 E. 60th St. Suite, New York, NY 10022 USA
| | - Carlo Varelli
- Radiology Unit, Istituto Diagnostico Varelli, via Cornelia dei Gracchi 65, 80126 Naples, Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, via A. Cardarelli 9, 80131 Naples, Italy
| | - Corrado Caiazzo
- Radiology Unit, PSP Corso Vittorio Emanuele ASL Napoli 1, Corso Vittorio Emanuele 690, 80122 Naples, Italy
| | - Antonio Corvino
- Motor Science and Wellness Department, University of Naples “Parthenope”, via F. Acton 38, 80133 Naples, Italy
- Present Address: via B. Croce n. 82, 81033 Casal di Principe, CE Italy
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15
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Gracia-Darder I, Arean Cuns C, García-Martínez FJ. Cutaneous ultrasound: key diagnostic tool for the relapse of a single eccrine spiradenoma. J Ultrasound 2022; 25:729-732. [PMID: 34637118 PMCID: PMC9402866 DOI: 10.1007/s40477-021-00608-5] [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: 04/30/2021] [Accepted: 07/12/2021] [Indexed: 11/24/2022] Open
Abstract
Eccrine spiradenoma is a rare, benign, adnexal skin tumor of the sweat gland. It is frequently solitary and presents as a small lesion in the dermal or the subcutaneous fat layer. Eccrine spiradenomas rarely progress to malignant transformation but they can relapse. Due to its rarity, there have been few reports about the sonographic appearances of eccrine spiradenoma. Sonographic findings were reported in a relapsing case of an eccrine spiradenoma, located in the deep dermal layers and hypodermis of the preauricular region in a middle-aged man. Ultrasound was very useful to suspect the relapse. Histology was correlated with the sonography and discussed the previously reported imaging findings of eccrine spiradenoma and other sweat gland tumors.
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Affiliation(s)
- Inés Gracia-Darder
- Department of Dermatology, Son Espases University Hospital, Carretera de Valldemossa, 79, planta 0 pasillo Q, despacho 57, CP 07120, Palma de Mallorca, Islas Baleares, Spain.
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16
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Zhou W, Li S, Wang H, Zhou G, Wen J. Ultrasound manifestations and clinical features of nonpalpable testis in children. Sci Rep 2022; 12:12245. [PMID: 35851046 PMCID: PMC9293968 DOI: 10.1038/s41598-022-16230-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 07/06/2022] [Indexed: 11/09/2022] Open
Abstract
To explore the value of ultrasound in the preoperative diagnosis of nonpalpable testis (NPT) in children. A retrospective study of 254 cases with NPT from May 2017 to December 2021. The preoperative ultrasound examination results were compared with the surgical exploration and pathological results. There were 254 cases (312 testes) NPT has got surgery in our centre. The surgical age were from 6 month to 12 years old, the median age was 2.33 years. There were 103 cases (136 testes) diagnosed as intra-abdominal testis (IAT) by preoperative ultrasound, and 80 cases (103 testes) of extra-abdominal testis (EAT), 71 cases (73 testes) of non-viable testis (NVT). There were 102 cases (135 testes) consistented as IAT by the diagnostic laparoscopy, the preoperative ultrasound's coincidence of IAT was 99.02%. There were 80 cases (103 testes) consistented as EAT by the diagnostic laparoscopy, the preoperative ultrasound's coincidence rate was100%. There were 62 cases (62 testes) consistented as NVT by the diagnostic laparoscopy, there were 9 cases (11 testes) misdiagnosed, the preoperative ultrasound's coincidence rate was 84.9%. Ultrasound can provide valuable information for the preoperative diagnosis of children with nonpalpable testicles, and especially good at identifying the EAT and IAT with normal testicular morphology.
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Affiliation(s)
- Wei Zhou
- Pediatric Urodynamic Centre, Urology, The First Affiliated Hospital of Zhengzhou University, Jianshe East Road, Zhengzhou, 450052, Henan, China.,Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Shenzhen, China
| | - Shoulin Li
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Shenzhen, China
| | - Hao Wang
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Shenzhen, China
| | - Guanglun Zhou
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Shenzhen, China
| | - Jianguo Wen
- Pediatric Urodynamic Centre, Urology, The First Affiliated Hospital of Zhengzhou University, Jianshe East Road, Zhengzhou, 450052, Henan, China.
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17
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Ricci V, Ricci C, Cocco G, Donati D, Farì G, Mezian K, Naňka O, Özçakar L. From Histology to Sonography in Skin and Superficial Tissue Disorders: EURO-MUSCULUS/USPRM* Approach. Pathol Res Pract 2022; 237:154003. [DOI: 10.1016/j.prp.2022.154003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 06/24/2022] [Accepted: 06/29/2022] [Indexed: 12/12/2022]
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18
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Saijilafu, Li SY, Yu X, Li ZQ, Yang G, Lv JH, Chen GX, Xu RJ. Heel pain caused by os subcalcis: A case report. World J Clin Cases 2022; 10:5373-5379. [PMID: 35812669 PMCID: PMC9210887 DOI: 10.12998/wjcc.v10.i16.5373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 10/11/2021] [Accepted: 04/04/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The accessory bones are common bone variations around the feet and ankles, which usually originate from nonunion of the secondary ossification center adjacent to the main bone mass, and most of them remain asymptomatic. Os subcalcis is an accessory bone at the plantar aspect of the calcaneus, which is located just posterior to the insertion of the plantar fascia. Focal bone formation at the calcaneal plantar pole with heel pain has rarely been reported.
CASE SUMMARY A 55-year-old man presented to our clinic with left plantar heel pain and a progressive swelling for 8 years. X-ray, computer tomography and magnetic resonance imaging showed a large os subcalcison the plantar side of the calcaneus, located at the insertion of the plantar fascia. He underwent surgical excision of the lesion. Microscopically the bony trabeculae were intermingled with fat and covered with cartilage.
CONCLUSION This is a rare case with accessory os subcalcis leading to heel pain. It highlights the awareness of os subcalcis and helps avoid future misdiagnosis of heel pain.
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Affiliation(s)
- Saijilafu
- Department of Orthopaedics, Soochow University, Suzhou 215007, Jiangsu Province, China
| | - Suo-Yuan Li
- Department of Orthopaedics, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Xiao Yu
- Department of Orthopaedics, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Zhi-Qiang Li
- Department of Orthopaedics, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Guang Yang
- Department of pathology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Jing-Huan Lv
- Department of pathology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Guang-Xiang Chen
- Department of Orthopaedics, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Ren-Jie Xu
- Department of Orthopaedics, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
- Department of Orthopaedics, the First Affiliated Hospital, Orthopaedic Institute, Soochow University, Suzhou 215000, Jiangsu Province, China
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19
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Sechi A, Neri I, Patrizi A, Di Altobrando A, Clinca R, Caro RDC, Leuzzi M, Misciali C, Gaspari V. Ultrasound patterns of localized cutaneous leishmaniasis and clinical correlations. J Ultrasound 2022; 25:343-348. [PMID: 33527311 PMCID: PMC9148356 DOI: 10.1007/s40477-020-00537-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 10/22/2020] [Indexed: 11/24/2022] Open
Abstract
A single-center retrospective study reviewed the following sonographic features of 18 confirmed cases of localized cutaneous leishmaniasis to identify shared presentation patterns: echotexture, lesion borders, hypodermal involvement, soft-tissue changes, and vascular pattern. A second objective was to correlate these patterns with clinical characteristics, including sex, age, anatomical location, nodule vs. plaque presentation, raised borders, granulation tissue, swelling, hyperkeratotic crusting, disease onset, and healing time. Two main patterns were identified with high-frequency ultrasonography. The first pattern was characterized by a high level of inflammation and deep hypodermal involvement, while the second variant showed involvement limited to the dermis, with minimal inflammation. The "inflammatory pattern" showed ill-defined borders, mixed echotexture, prominent vascularity with central distribution, and was correlated with clinical signs of ulceration, granulation tissue, raised borders, and longer healing time (p < 0.05). The "pauci-inflammatory pattern" presented a well-defined structure with decreased echogenicity, reduced or absent vascularity with minimal soft-tissue changes, and was associated with a shorter healing time (p < 0.05).
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Affiliation(s)
- Andrea Sechi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital of Bologna Sant' Orsola-Malpighi Polyclinic, Via Massarenti, 1, 40138, Bologna, Italy.
| | - Iria Neri
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital of Bologna Sant' Orsola-Malpighi Polyclinic, Via Massarenti, 1, 40138, Bologna, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital of Bologna Sant' Orsola-Malpighi Polyclinic, Via Massarenti, 1, 40138, Bologna, Italy
| | - Ambra Di Altobrando
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital of Bologna Sant' Orsola-Malpighi Polyclinic, Via Massarenti, 1, 40138, Bologna, Italy
| | - Roberta Clinca
- Radiology Unit, University Hospital of Bologna Sant' Orsola-Malpighi Polyclinic, Bologna, Italy
| | | | - Miriam Leuzzi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital of Bologna Sant' Orsola-Malpighi Polyclinic, Via Massarenti, 1, 40138, Bologna, Italy
| | - Cosimo Misciali
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital of Bologna Sant' Orsola-Malpighi Polyclinic, Via Massarenti, 1, 40138, Bologna, Italy
| | - Valeria Gaspari
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital of Bologna Sant' Orsola-Malpighi Polyclinic, Via Massarenti, 1, 40138, Bologna, Italy
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20
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Corvino A, Varelli C, Cocco G, Corvino F, Catalano O. Seeing the unseen with superb microvascular imaging: Ultrasound depiction of normal dermis vessels. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:121-127. [PMID: 34761407 DOI: 10.1002/jcu.23068] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/28/2021] [Accepted: 09/05/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE Current color- and power-Doppler techniques cannot demonstrate vascularization of the dermis. Aim of this prospective study was to investigate whether the new superb vascular imaging (SMI) technique improves the ultrasound (US) depiction of dermis vessels in healthy volunteers. SMI was compared side-by-side to conventional power-Doppler (PD) imaging. METHODS Thirty adult subjects (18 men and 12 women, mean age 45 years old) were evaluated with US at level of five body areas: forehead, forearm, palm, buttock, and thigh. The vascular index (VI) was employed to objectively quantify the difference between SMI and PD imaging in terms of dermis flow amount. RESULTS Forehead VI was higher for SMI than for PD in 93% of cases, forearm VI was higher for SMI than for PD in 97% of cases, palm VI was higher for SMI than for PD in 87% of cases, buttock VI was higher for SMI than for PD in 100% of cases, thigh VI was higher for SMI than for PD in 100% of cases. SMI-detected vascular signals in 100% of the body areas. PD failed to show any flow signals from the forehead in 23% of cases, forearm in 37% of cases, palm in 33% of cases, buttock in 47% of cases, and thigh in 50% of cases. CONCLUSION SMI can demonstrate normal dermis vascularization whereas conventional PD cannot. SMI is a sensitive and promising technique in the study of dermis abnormalities, particularly when quantifying the disease activity is important.
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Affiliation(s)
- Antonio Corvino
- Motor Science and Wellness Department, University of Naples "Parthenope", Naples, Italy
| | - Carlo Varelli
- Radiology Unit, Istituto Diagnostico Varelli, Naples, Italy
| | - Giulio Cocco
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Aging Sciences, University of Chieti G d'Annunzio, Chieti, Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Naples, Italy
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21
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Lomoro P, Simonetti I, Nanni AL, Corsani G, Togni G, Fichera V, Verde F, Formica M, Trovato P, Vallone G, Gorone MSP. Imaging of head and neck lipoblastoma: case report and systematic review. J Ultrasound 2021; 24:231-239. [PMID: 32141045 PMCID: PMC8363689 DOI: 10.1007/s40477-020-00439-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 02/17/2020] [Indexed: 12/13/2022] Open
Abstract
Lipoblastoma is a rare and benign tumour arising from embryonal fat cells, predominantly diagnosed in children younger than 3 years old. The most frequent locations are the extremities and trunk, while the head and neck areas are more rarely affected (10-15% of total cases). Clinically, the most common presentation is a fast-growing painless mass. Ultrasound is the first-line imaging examination, but Magnetic Resonance Imaging (MRI) allows for better definition of the relationships with the adjacent vascular and muscular structures. It can help to identify the lipomatous components, and it is useful for preoperative planning. However, the definitive diagnosis is provided by histopathological examination. Complete surgical excision is the first-line treatment, with a good prognosis in case of total eradication. We report the case of a 7-month-old male child with a rapidly growing mass that had typical radiological features of lipoblastoma.
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Affiliation(s)
- P Lomoro
- Radiology Department, Valduce Hospital, Como, Italy
| | - I Simonetti
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
| | - A L Nanni
- Department of Diagnostic Medicine, Institute of Radiology Irccs San Matteo University Hospital Foundation, Pavia, Italy
| | - G Corsani
- Department of Diagnostic Medicine, Institute of Radiology Irccs San Matteo University Hospital Foundation, Pavia, Italy
| | - G Togni
- Radiology Department, Valduce Hospital, Como, Italy
| | - V Fichera
- Department of Paediatrics, Anna Meyer Children's University Hospital, Florence, Italy
| | - F Verde
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - M Formica
- Department of Diagnostic Medicine, Institute of Radiology Irccs San Matteo University Hospital Foundation, Pavia, Italy
| | - P Trovato
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - G Vallone
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - M S Prevedoni Gorone
- Department of Diagnostic and Interventional Radiology and Neuroradiology of IRCCS, San Matteo University Hospital Foundation, Pavia, Italy
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22
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Zou MH, Huang Q, Yang T, Jiang Y, Zhang LJ, Xie Y, Zheng RQ. Role of ultrasound in the diagnosis of primary and recurrent dermatofibrosarcoma protuberans. BMC Cancer 2021; 21:909. [PMID: 34376150 PMCID: PMC8356448 DOI: 10.1186/s12885-021-08476-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/08/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Dermatofibrosarcoma protuberans (DFSP) is a rare, low- to intermediate-grade sarcoma, which represents a diagnostic imaging challenge. This study aimed to analyze the clinical and ultrasound features of primary and recurrent DFSP to improve the diagnosis. METHODS Clinical, imaging, and pathological data from a total of 58 patients (23 patients with primary DFSP and 35 patients with recurrent DFSP) were retrospectively reviewed. RESULTS There was no statistically significant difference in age, sex, tumor size, or echogenicity between the two groups. Most of the primary DFSP lesions involved the overlying dermis and hypodermis, while most of the recurrent DFSP lesions were fixated to more deeply seated structures at the original surgical incision. Red nodules on the skin were found more frequently in the primary group. There were statistically significant differences in the type of lesion and ultrasound tumor morphology (p < 0.050). The lesions in the primary group showed more tentacle-like projections or a "claw" sign, while the lesions in the recurrent group were more commonly oval, lobulated, and irregularly shaped. Hypervascularity was common in both groups. CONCLUSIONS For primary DFSP, a slow-growing, red nodule on the skin involving the overlying dermis and hypodermis, more frequently a hypoechoic mass with tentacle-like projections or a "claw" sign, was observed. For recurrent DFSP, palpable subcutaneous nodules or subcutaneous masses at the original surgical incision and oval, lobulated, and irregularly shaped lesions were more commonly observed. This may be useful for improving diagnostic accuracy.
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Affiliation(s)
- Min-Hong Zou
- Department of Ultrasound, The Third Affiliated Hospital, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, China
| | - Qing Huang
- Department of General Surgery, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, The Second Affiliated Hospital of South China University of Technology, Guangzhou, Guangdong, China
| | - Ting Yang
- Department of Nuclear Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ye Jiang
- Department of Pathology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Luan-Jing Zhang
- Department of Ultrasound, The Third Affiliated Hospital, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, China
| | - Yang Xie
- Department of Dermatology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Rong-Qin Zheng
- Department of Ultrasound, The Third Affiliated Hospital, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, China.
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Do the quadriceps and hamstring muscles have an effect on patella stability in trochlear dysplasia? Pol J Radiol 2021; 86:e232-e238. [PMID: 34093920 PMCID: PMC8147712 DOI: 10.5114/pjr.2021.105850] [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: 09/30/2020] [Accepted: 10/19/2020] [Indexed: 01/02/2023] Open
Abstract
Introduction Trochlear dysplasia (TD) is a condition that is characterized by the presence of either a flat or convex trochlear, which impedes the stability of the patellofemoral joint (PFJ). The PFJ function is dependent on many different structures that surround the knee joint. The aim of this study was to analyse all the muscle components around the PFJ and identify whether gross muscle imbalance could contribute to the stability of the patella in TD. Material and methods The average cross-sectional area (CSA) and cross-sectional area ratio (CSAR) of each muscle of the thigh region in subtypes of TD was evaluated and compared to normal knee joints. Ninety-eight patients (196 knees in total) were included in the study. Results Of the 196 knee joints that were reviewed, 10 cases were found to be normal. In total, 186 cases were positive for TD. The majority consisted of type C. The hamstring muscles showed variable results. The vastus medialis muscle was larger in comparison to the vastus lateralis muscle over all the different TD subtypes; however, no statistical significance was identified. There was a marked statistical significance between the quadriceps and hamstring muscles, especially when comparing this to the normal knees within our cohort. Conclusions This study revealed no significant difference in the effect of the thigh muscle CSA on the stability of the PFJ in TD. Further research is required to establish the roles of the different muscles around PFJ in the prevention of TD dislocation.
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Uysal E, Kara Gedik G, Durmaz MS, Yılmaz F, Batur A. Can shear wave elastography determine remnant thyroid tissue in the early postoperative period in patients with differentiated thyroid carcinoma? J Ultrasound 2021; 25:273-280. [PMID: 33818752 DOI: 10.1007/s40477-021-00576-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 03/15/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study aims to investigate the usability of ultrasonography (US) and shear wave elastography (SWE) in detecting remnant thyroid tissue (RTT) within the first three postoperative months in patients who underwent total thyroidectomy (TT) for differentiated thyroid cancer (DTC) and who were scheduled for radioiodine (RAI) ablation therapy. METHODS Sixty-nine patients who underwent a TT operation due to DTC were included in the study. The participant's thyroid surgical bed was first evaluated by thyroid scintigraphy and then by greyscale US and SWE to investigate RTT. The participants were divided into two groups, those with and those without RTT. SWE quantitative data were compared between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to determine the best cut-off values for stiffness and velocity in distinguishing RTT. RESULTS A total of 149 regions were analysed in 69 participants (43 females, 26 males). The average time elapsed after the operation was 65.2 ± 24.1 days. RTT was determined by scintigraphy and US-SWE in 38 (55%) patients. The stiffness and velocity values were significantly higher in the group with RTT than in the group without RTT. To distinguish RTT from the thyroid bed, the best cut-off values for stiffness and velocity were 15.7 kPa and 2.12 m/s, respectively. CONCLUSIONS US with SWE can detect RTT in the early postoperative period in patients who have undergone TT due to DTC and who are scheduled for RAI treatment. The use of US and SWE will be particularly beneficial in patients with RTT but who have false-negative Tg levels and RTT that is not I-131 avid.
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Affiliation(s)
- Emine Uysal
- Department of Radiology, Faculty of Medicine, Selçuk University, Ardıclı Mahallesi, Celal Bayar Cad. No:313, 42250, Selçuklu, Konya, Turkey.
| | - Gonca Kara Gedik
- Department of Nuclear Medicine, Faculty of Medicine, Selçuk University, Selçuklu, Konya, Turkey
| | - Mehmet Sedat Durmaz
- Department of Radiology, Faculty of Medicine, Selçuk University, Ardıclı Mahallesi, Celal Bayar Cad. No:313, 42250, Selçuklu, Konya, Turkey
| | - Farise Yılmaz
- Department of Nuclear Medicine, Faculty of Medicine, Selçuk University, Selçuklu, Konya, Turkey
| | - Abdussamed Batur
- Department of Radiology, Faculty of Medicine, Selçuk University, Ardıclı Mahallesi, Celal Bayar Cad. No:313, 42250, Selçuklu, Konya, Turkey
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Xie TH, Ren XX, Fu Y, Ha SN, Liu LT, Jin XS. Multiple well-differentiated retroperitoneal liposarcomas with different patterns of appearance on computed tomography: A case report. World J Clin Cases 2021; 9:1661-1667. [PMID: 33728310 PMCID: PMC7942046 DOI: 10.12998/wjcc.v9.i7.1661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/18/2020] [Accepted: 01/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Primary retroperitoneal liposarcoma (PRPLS) is a rare soft tissue tumor with nonspecific clinical symptoms; it has different computed tomography (CT) image features according to pathological types. Some patients with a single tumor have been previously reported in the literature. We present an exceptional case of a PRPLS patient with multiple large tumors exhibiting different patterns of appearance on CT and confirmed as atypical lipomatous tumor/well-differentiated liposarcoma by postoperative pathology.
CASE SUMMARY A 64-year-old man presented with abdominal distension for 1 year. The patient was diagnosed with PRPLS based on physical examination, laparotomy, ultrasonography, CT scan, and surgery. Both of the tumors were completely resected through surgery and confirmed as atypical lipomatous tumor/well-differentiated liposarcoma by postoperative pathology. The postoperative course was uneventful without recurrence or metastasis, as demonstrated by abdominal-pelvic CT during an 18 mo follow-up.
CONCLUSION Multiple large Well-differentiated liposarcomas with different patterns of appearance on CT image can occur simultaneously in the same patient, to which more attention should be paid to make an effective differential diagnosis.
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Affiliation(s)
- Tian-Hao Xie
- Department of General Surgery, Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China
| | - Xiang-Xiang Ren
- Department of General Surgery, Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China
| | - Yan Fu
- Department of Ophthalmology, Baoding First Central Hospital, Baoding 071000, Hebei Province, China
| | - Si-Ning Ha
- Department of General Surgery, Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China
| | - Li-Tao Liu
- Department of General Surgery, Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China
| | - Xiao-Shi Jin
- Department of General Surgery, Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China
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Granuloma annulare subtypes: sonographic features and clinicopathological correlation. J Ultrasound 2021; 25:289-295. [PMID: 33453055 DOI: 10.1007/s40477-020-00532-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/05/2020] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Diagnosis of granuloma annulare (GA) is based on the clinical and histopathological findings. However, only sporadic case reports of subcutaneous GA sonography have been published to date. The objective of this study was to evaluate the ultrasonographic patterns of the different clinical variants of GA: localized, generalized, subcutaneous, and perforating. METHODS In this retrospective observational study, we analyzed and correlated the clinical, histopathological, and sonographic features of 15 patients diagnosed with GA. RESULTS We included 8 women and 7 men with a mean age of 48.4 years (8-77 years). We found three different sonographic patterns depending on the clinical variant of GA: poorly defined hypoechoic band including the dermis (dermal pattern), irregularly shaped hypoechoic hypodermal lumps (hypodermal pattern), and ill-defined hypoechoic dermal and subcutaneous lesions (mixed pattern). Five cases showed increased blood flow signal on Doppler interrogation. CONCLUSION Although our findings are broadly consistent with the previous reports of subcutaneous GA, the sonographic features in localized, generalized, and perforating GA have not been previously reported.
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González Pérez AM, Nájera Botello L, Suarez Massa D, Roustan Gullón G, Alfageme Roldán F. Sonography of subcutaneous nodules following immunization with histopathological correlation: a three-case series. J Ultrasound 2021; 25:355-360. [PMID: 33400252 DOI: 10.1007/s40477-020-00554-8] [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: 10/12/2020] [Accepted: 12/13/2020] [Indexed: 11/26/2022] Open
Abstract
Subcutaneous nodules are a rare adverse event following immunization frequently associated with suboptimal injection procedures and aluminium-containing vaccines. We present three cases of subcutaneous nodules following immunization describing their clinical signs, histopathological features and ultrasound findings and demonstrating the use of sonography as an aid to the diagnosis of this entity.
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Affiliation(s)
- Ana María González Pérez
- Department of Dermatology, Hospital Clínico Universitario de Salamanca, Paseo de San Vicente 182, 37007, Salamanca, Spain
| | - Laura Nájera Botello
- Pathology Department, Hospital Universitario Puerta de Hierro Majadahonda, C/Manuel de Falla 2, 29022, Majadahonda, Madrid, Spain
| | - Dolores Suarez Massa
- Pathology Department, Hospital Universitario Puerta de Hierro Majadahonda, C/Manuel de Falla 2, 29022, Majadahonda, Madrid, Spain
| | - Gastón Roustan Gullón
- Department of Dermatology, Hospital Universitario Puerta de Hierro Majadahonda, C/Manuel de Falla 2, 29022, Majadahonda, Madrid, Spain
| | - Fernando Alfageme Roldán
- Department of Dermatology, Hospital Universitario Puerta de Hierro Majadahonda, C/Manuel de Falla 2, 29022, Majadahonda, Madrid, Spain.
- Department of Dermatology, Autonomous University of Madrid, Calle Joaquín Rodrigo, 1, 28222, Majadahonda, Madrid, Spain.
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Basha MAA, Eldib DB, Aly SA, Azmy TM, Mahmoud NEM, Ghandour TM, Aly T, Mostafa S, Elaidy AM, Algazzar HY. Diagnostic accuracy of ultrasonography in the assessment of anterior knee pain. Insights Imaging 2020; 11:107. [DOI: https:/doi.org/10.1186/s13244-020-00914-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/16/2020] [Indexed: 09/02/2023] Open
Abstract
Abstract
Background
Anterior knee pain (AKP) is a problematic complaint, considered to be the most frequent cause of orthopedic consultancy for knee problems. This study aimed to highlight diagnostic accuracy of ultrasonography as a fast imaging technique in assessment of patients with AKP.
Methods and results
A prospective study was conducted on 143 patients with clinically confirmed AKP. All patients underwent ultrasonography and MRI examinations of the knee. The diagnostic accuracy of ultrasonography compared to MRI for evaluating different findings of possible causes of AKP were analyzed using receiver operating characteristic (ROC) curve and judged by area under curve (AUC). A total of 155 knees were included in the study; 26 knees showed no abnormalities, 19 knees showed positive MRI only, and 110 knees showed positive ultrasonography and MRI. Ultrasonography and MRI reported 11 different findings of possible causes of AKP or related to it. Joint effusion was the most common finding (38%) followed by trochlear cartilage defect (20.6%) and superficial infrapatellar subcutaneous edema (20%). The overall accuracy of ultrasonography was 85.3% sensitivity and 100% specificity. The ultrasonography provided the highest sensitivity (100%) in detecting bipartite patella, followed by 91.5% for joint effusion, and 87.5% for quadriceps tendinopathy. The ROC curve analysis of overall accuracy of ultrasonography showed an AUC of 0.93. The overall Kappa agreement between ultrasonography and MRI was good (k = 0.66).
Conclusion
Ultrasonography can be used to make a swift screening and assessment of painful anterior knee and as an alternative to MRI when it is unavailable or contraindicated.
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Dermatology Ultrasound. Imaging Technique, Tips and Tricks, High-Resolution Anatomy. Ultrasound Q 2020; 36:321-327. [DOI: 10.1097/ruq.0000000000000520] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Basha MAA, Eldib DB, Aly SA, Azmy TM, Mahmoud NEM, Ghandour TM, Aly T, Mostafa S, Elaidy AM, Algazzar HY. Diagnostic accuracy of ultrasonography in the assessment of anterior knee pain. Insights Imaging 2020; 11:107. [PMID: 33000350 PMCID: PMC7527384 DOI: 10.1186/s13244-020-00914-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/16/2020] [Indexed: 11/10/2022] Open
Abstract
Background Anterior knee pain (AKP) is a problematic complaint, considered to be the most frequent cause of orthopedic consultancy for knee problems. This study aimed to highlight diagnostic accuracy of ultrasonography as a fast imaging technique in assessment of patients with AKP. Methods and results A prospective study was conducted on 143 patients with clinically confirmed AKP. All patients underwent ultrasonography and MRI examinations of the knee. The diagnostic accuracy of ultrasonography compared to MRI for evaluating different findings of possible causes of AKP were analyzed using receiver operating characteristic (ROC) curve and judged by area under curve (AUC). A total of 155 knees were included in the study; 26 knees showed no abnormalities, 19 knees showed positive MRI only, and 110 knees showed positive ultrasonography and MRI. Ultrasonography and MRI reported 11 different findings of possible causes of AKP or related to it. Joint effusion was the most common finding (38%) followed by trochlear cartilage defect (20.6%) and superficial infrapatellar subcutaneous edema (20%). The overall accuracy of ultrasonography was 85.3% sensitivity and 100% specificity. The ultrasonography provided the highest sensitivity (100%) in detecting bipartite patella, followed by 91.5% for joint effusion, and 87.5% for quadriceps tendinopathy. The ROC curve analysis of overall accuracy of ultrasonography showed an AUC of 0.93. The overall Kappa agreement between ultrasonography and MRI was good (k = 0.66). Conclusion Ultrasonography can be used to make a swift screening and assessment of painful anterior knee and as an alternative to MRI when it is unavailable or contraindicated.
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Affiliation(s)
| | - Diaa Bakry Eldib
- Department of Radiodiagnosis, Faculty of Human Medicine, Benha University, Benha, Egypt
| | - Sameh Abdelaziz Aly
- Department of Radiodiagnosis, Faculty of Human Medicine, Benha University, Benha, Egypt
| | - Taghreed M Azmy
- Department of Radiodiagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
| | - Nader E M Mahmoud
- Department of Radiodiagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
| | - Tarek Mohamed Ghandour
- Department of Orthopaedic Surgery, Faculty of Human Medicine, Ain Shams University, Cairo, Egypt
| | - Tarek Aly
- Department of Orthopaedic Surgery, Faculty of Human Medicine, Tanta University, Tanta, Egypt
| | - Shimaa Mostafa
- Department of Rheumatology and Rehabilitation, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
| | - Asmaa M Elaidy
- Department of Psychiatry, Faculty of Human Medicine for Girls, Al-Azhar University, Zagazig, Egypt
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Ma JJ, Zhang B. Diagnosis of an actively bleeding brachial artery hematoma by contrast-enhanced ultrasound: A case report. World J Clin Cases 2020; 8:3835-3840. [PMID: 32953861 PMCID: PMC7479570 DOI: 10.12998/wjcc.v8.i17.3835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/16/2020] [Accepted: 07/30/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Active bleeding due to arterial injury following the acupuncture can sometimes represent a life-threatening complication. Only few reports of an actively bleeding hematoma diagnosed by contrast-enhanced ultrasound, which enables the depiction of vascular, have been reported.
CASE SUMMARY Here, we report the case of a 75-year-old woman, who presented with sudden swelling, ecchymosis, and pain in the upper left limb. She underwent an acupuncture treatment of traditional Chinese medicine followed by a deep shoulder massage 2 d before admission to hospital. A few hours after the massage, her left upper arm was red, swollen and progressively aggravated. Ultrasonography showed a large hematoma (11.2 cm × 3.5 cm × 3.4 cm) beside the left brachial artery. Color Doppler ultrasound revealed that blood flow signals of the arteries branched into the hematoma. The contrast-enhanced ultrasound showed microbubbles from the brachial artery passing into the hematoma, diffused within the hematoma with the local surge of red blood cells, and disappearing after approximately 17 s. The microbubbles were likely due to bleeding from the arteries. After pressure bandaging treatment, the hematoma became smaller (3.1 cm × 1.7 cm) and organized according to ultrasonography performed 20 d later.
CONCLUSION This case highlights the ultimate importance of contrast-enhanced ultrasound for the diagnosis of an actively bleeding hematoma.
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Affiliation(s)
- Jiao-Jiao Ma
- Department of Ultrasound, China-Japan Friendship Hospital, Beijing 100029, China
| | - Bo Zhang
- Department of Ultrasound, China-Japan Friendship Hospital, Beijing 100029, China
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Corvino A, Caruso M, Varelli C, Di Gennaro F, Pignata S, Corvino F, Vallone G, Catalano O. Diagnostic imaging of parotid gland oncocytoma: a pictorial review with emphasis on ultrasound assessment. J Ultrasound 2020; 24:241-247. [PMID: 32710434 DOI: 10.1007/s40477-020-00511-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/13/2020] [Indexed: 11/27/2022] Open
Abstract
Parotid gland oncocytoma (PGO) is a rare benign epithelial tumor that usually occurs in the elderly population. The most common clinical presentation is a painless, slow-growing, non-tender, lobulated, and mobile mass. Histologically, it is composed of monotonous sheets of epithelial cells (oncocytes) with a central scar. The cross-sectional appearance is not specific, and it overlaps with other parotid lesions. On ultrasound (US), oncocytoma appears as an ovoid, well-defined, homogeneous, and hypoechoic lesion. Cystic and hemorrhagic areas as well as intralesional fat may be observed. Doppler analysis shows intratumoral vessels, sometimes with a spoke-wheel pattern. The peak systolic flow is high (up to 100 cm/sec). Furthermore, oncocytoma is avid of FDG on a PET scan, as well as a malignant tumor. Thus, a combined clinical, imaging, and pathologic assessment is essential to establish the most accurate diagnosis and plan the best treatment. US, combined with Doppler techniques, can play an important role in suggesting the diagnosis and confirming it through percutaneous sampling. The purpose of this review is to show the imaging findings in PGO, with special emphasis on the US appearance.
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Affiliation(s)
- Antonio Corvino
- Motor Science and Wellness Department, University of Naples "Parthenope", via F. Acton 38, I-80133, Naples, Italy.
- , Casal di Principe, Italy.
| | - Martina Caruso
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, 80131, Naples, Italy
| | - Carlo Varelli
- Radiology Unit, Varelli Institute, via Cornelia dei Gracchi 65, 80126, Naples, Italy
| | - Francesca Di Gennaro
- Nuclear Medicine Division, Radiology and Radiotherapy Department, National Cancer Institute Pascale Foundation, via M. Semmola 53, 80131, Naples, Italy
| | - Saverio Pignata
- Ultrasound Unit, Ninetta Rosano Institute, via Capo Tirone 14, 87021, Belvedere Marittimo (CS), Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, via A. Cardarelli 9, 80131, Naples, Italy
| | - Gianfranco Vallone
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, 80131, Naples, Italy
| | - Orlando Catalano
- Radiology Unit, Varelli Institute, via Cornelia dei Gracchi 65, 80126, Naples, Italy
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Smith E, Azzopardi C, Thaker S, Botchu R, Gupta H. Power Doppler in musculoskeletal ultrasound: uses, pitfalls and principles to overcome its shortcomings. J Ultrasound 2020; 24:151-156. [PMID: 32683646 DOI: 10.1007/s40477-020-00489-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/05/2020] [Indexed: 11/26/2022] Open
Abstract
Power Doppler (PD) is used widely in musculoskeletal ultrasound, especially in the assessment of structures for evidence of inflammation and in evaluating soft tissue neoplasms. We reinforce and delineate the three cardinal principles of optimising PD assessment in order to avoid false positive or false negative results; namely (1) Optimal gain settings (2) Adequate transducer pressure, and (3) Proper patient/anatomical structure-of-interest positioning with complete tissue relaxation.
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Affiliation(s)
- E Smith
- Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK
| | - C Azzopardi
- Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK
| | - S Thaker
- Department of Radiology, Kettering General Hospital, Kettering, UK
| | - R Botchu
- Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK.
| | - H Gupta
- Department of Musculoskeletal Imaging, Leeds Teaching Hospital, Leeds, UK
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Corvino A, Catalano O, de Magistris G, Corvino F, Giurazza F, Raffaella N, Vallone G. Usefulness of doppler techniques in the diagnosis of peripheral iatrogenic pseudoaneurysms secondary to minimally invasive interventional and surgical procedures: imaging findings and diagnostic performance study. J Ultrasound 2020; 23:563-573. [PMID: 32436181 DOI: 10.1007/s40477-020-00475-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 05/06/2020] [Indexed: 12/11/2022] Open
Abstract
The pseudoaneurysm (PA) is a perfused sac directly connecting with the arterial lumen by an interruption of the vessel wall continuity, more commonly secondary to trauma or iatrogenic causes. Aim of our study was to determine the accuracy and usefulness of Doppler techniques in the diagnosis of peripheral iatrogenic PAs secondary to minimally invasive procedures. From a three year prospective research, 20 Duplex Ultrasound (DUS) studies in as many patients presenting with periarterial pulsating mass clinically suspected for PA secondary to minimally invasive procedures were selected. The PA final diagnosis was confirmed by angiography in 12 patients (60% cases), by computed tomography angiography in 5 patients (25%), by surgery in 2 patients (10%), and by magnetic resonance angiography in 1 patient (5%). The vessels involved by PA formation were: common femoral artery in 8 cases (40%); superficial femoral artery in 4 cases (20%); brachial artery in 3 cases (15%); popliteal artery in 2 cases (10%); superficial temporal artery (STA) in 2 cases (10%); dorsal medial digital artery of the foot in 1 case (5%). Our study confirmed the usefulness of doppler techniques in the diagnosis of peripheral iatrogenic PAs. Specifically, a sensitivity of 90-95%, a specificity of 100% and predictive values of 100% (VPP) and 83-90% (VPN) were reported. The radiologist must always suspect a PA in the differential diagnosis of lesions contiguous to an artery vessel. This is to prevent potential complications such as e.g. massive haemorrhage. In this order, DUS allows a careful selection of patients who require to undergo in-depth imaging methods or surgical therapy, thus contributing to a significant reduction of contrast medium and exposure to ionizing radiation.
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Affiliation(s)
- Antonio Corvino
- Motor Science and Wellness Department, University of Naples "Parthenope", Via F. Acton 38, 80133, Naples, Italy
| | - Orlando Catalano
- Radiology Unit, Istituto Diagnostico Varelli, Via Cornelia dei Gracchi 65, 80126, Naples, Italy
| | - Giuseppe de Magistris
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy.
| | - Francesco Giurazza
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Niola Raffaella
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Gianfranco Vallone
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Via S. Pansini 5, 80131, Naples, Italy
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Corvino A, Sandomenico F, Setola SV, Corvino F, Tafuri D, Catalano O. Lesioni cistiche complex di fegato: reperti ecocontrastografici diagnostico-differenziali. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2020; 179. [DOI: 10.23736/s0393-3660.19.04120-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
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Sandomenico F, Corvino A, Setola SV, Simonetti I, Porcaro M, Trovato P, Catalano O, Petrillo A. Post-amputation neuroma of radial nerve in a patient with ephitelioid sarcoma: case report and literature review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:122-127. [PMID: 32191665 PMCID: PMC7569598 DOI: 10.23750/abm.v91i1.8510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 07/13/2019] [Indexed: 12/22/2022]
Abstract
Neuroma, also known as traumatic neuroma or amputation neuroma or stump neuroma, is a focal non neoplastic area of proliferative hyperplastic reaction secondary to peripheral nerve damage that commonly occurs after a focal trauma (acute or chronic) or surgery, such as amputation or partial transection. Neuromas are more commonly located in the lower limbs, followed by head and neck; other extremely rare sites include the ulnar nerve followed by the radial nerve and the brachial plexus. A radiologic plan is necessary to recognize soft tissue lesions with a neural origin and whether they are a true tumor or a pseudotumor such as a neuroma, fibrolipoma, or peripheral nerve sheath ganglion. In oncologic patients the appearance of post-surgical neuromas can produce problems in differential diagnosis with local recurrences. Therefore, with a combination of different imaging techniques, mainly ultrasound (US) and magnetic resonance imaging (MRI), it is possible to characterize neurogenic tumours safely, with a great impact on patient management and to plan an appropriate treatment. Here, we report the first case of post-amputation neuroma of radial nerve in a patient with clinical history of ephitelioid sarcoma with a short literature review. (www.actabiomedica.it)
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Affiliation(s)
- Fabio Sandomenico
- Radiology Department, National Cancer Institute Pascale Foundation, via M. Semmola 53, I-80131Naples Italy.
| | - Antonio Corvino
- 1Motor Science and Wellness Department, University of Naples "Parthenope", via F. Acton 38, I-80133 Naples, Italy 2Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples Italy.
| | - Sergio Venanzio Setola
- Radiology Department, National Cancer Institute Pascale Foundation, via M. Semmola 53, I-80131Naples Italy.
| | - Igino Simonetti
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131Naples Italy.
| | - Mauro Porcaro
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131Naples Italy.
| | - Piero Trovato
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131Naples Italy.
| | - Orlando Catalano
- Radiology Unit, Istituto Diagnostico Varelli, via Cornelia dei Gracchi 65, I-80126 Naples Italy.
| | - Antonella Petrillo
- Radiology Department, National Cancer Institute Pascale Foundation, via M. Semmola 53, I-80131Naples Italy.
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Thyroglossal duct cysts and site-specific differential diagnoses: imaging findings with emphasis on ultrasound assessment. J Ultrasound 2020; 23:139-149. [PMID: 32052384 DOI: 10.1007/s40477-020-00433-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 01/29/2020] [Indexed: 02/07/2023] Open
Abstract
Thyroglossal duct cysts (TGDCs) are the most common congenital abnormality of the neck, accounting for approximately 70% of congenital neck lesions. Two-thirds of thyroglossal duct anomalies are diagnosed within the first three decades of life, with more than half being identified before 10 years of age. The age of presentation, clinical examination and imaging are essential for an accurate diagnosis. This review aims to summarize the imaging findings of TGDCs and their main differential diagnoses with emphasis on ultrasound assessment. A focus on site-specific key differentiating between them is also addressed.
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Diastasis of rectus abdominis muscles: patterns of anatomical variation as demonstrated by ultrasound. Pol J Radiol 2019; 84:e542-e548. [PMID: 32082453 PMCID: PMC7016498 DOI: 10.5114/pjr.2019.91303] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 11/12/2019] [Indexed: 12/14/2022] Open
Abstract
Purpose The aim of our study was to categorise the anatomical variations of rectus abdominis muscle diastasis (diastasis recti) by using ultrasound (US). Material and methods In a one-year period 92 women were evaluated with US because of suspected diastasis of rectus muscles. Patients were examined in a supine position, with head extended, upper limbs aligned to the trunk, and knees flexed. US was performed with high-frequency, broad-band transducers. Trapezoid field-of-view and extended field-of-view were employed to measure diastasis exceeding 5 cm. Diastasis was defined as a margin-to-margin distance > 20 mm at rest and classified according to the following anatomical patterns: open only above the navel, open only below the navel, open at the navel level, open completely but wider above the navel, and open completely but wider below the navel. Results Diastasis was found in 82 patients (30-61 years old, mean age 35 years). The width was 21-97 mm, mean 39 mm. The prevalence and severity of the anatomical patterns was as follows: open only above the navel in 48 patients (21-88 mm, mean 40 mm), open only below the navel in one patient (33 mm), open at the navel level in seven patients (23-39 mm, mean 34 mm), open completely but wider above the navel in 24 patients (21-97 mm, mean 41 mm), open completely but wider below the navel in two patients (21-29 mm, mean 25 mm). Conclusions The above-navel patterns of recti muscle diastasis are the most common. Even when open completely, diastasis is usually wider above the navel. Knowledge of the anatomical type of rectus muscle diastasis could be of value to the patient (exercises to do and to avoid) and to the surgeon (abdominoplasty planning).
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Catalano O, Varelli C, Sbordone C, Corvino A, De Rosa D, Vallone G, Wortsman X. A bump: what to do next? Ultrasound imaging of superficial soft-tissue palpable lesions. J Ultrasound 2019; 23:287-300. [PMID: 31786796 DOI: 10.1007/s40477-019-00415-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 11/01/2019] [Indexed: 02/07/2023] Open
Abstract
Soft-tissue palpable lesions are common in clinical practice, and ultrasound (US) represents the first imaging option in the evaluation of a patient with a soft-tissue swelling. A full and systematic US assessment is necessary, however. This includes grayscale, color- and power-Doppler, spectral-Doppler, and possibly elastography facilities, as well as a trained operator. Several lesions showing characteristic US features can be diagnosed confidently, without any further work-up, and the high spatial resolution of ultrasound in the superficial layers can be a powerful tool to discriminate their etiologies. Second-level options, to be reserved for indeterminate cases or those suspected malignant at initial ultrasound, include magnetic resonance imaging, percutaneous fine-needle aspiration or biopsy, and surgical-excision biopsy. In this article, we discuss the proper US approach for addressing superficial soft-tissue lesions.
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Affiliation(s)
- Orlando Catalano
- Radiology Unit, Istituto Diagnostico Varelli, via Cornelia dei Gracchi 65, 80126, Naples, Italy.
| | - Carlo Varelli
- Radiology Unit, Istituto Diagnostico Varelli, via Cornelia dei Gracchi 65, 80126, Naples, Italy
| | - Carolina Sbordone
- Department of Medicine and Health Science "Vincenzo Tiberio", Molise University, Campobasso, Italy
| | - Antonio Corvino
- Department of Movement and Wellness Sciences, University of Naples Parthenope, Naples, Italy
| | - Dario De Rosa
- Radiology Unit, Istituto Diagnostico Varelli, via Cornelia dei Gracchi 65, 80126, Naples, Italy
| | - Gianfranco Vallone
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Ximena Wortsman
- Department of Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues Clinic, University of Chile and Pontifical Catholic University of Chile, Santiago, Chile
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Zhang Y, Yan Y, Song B. Noninvasive imaging diagnosis of sinusoidal obstruction syndrome: a pictorial review. Insights Imaging 2019; 10:110. [PMID: 31748956 PMCID: PMC6868080 DOI: 10.1186/s13244-019-0791-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/24/2019] [Indexed: 02/08/2023] Open
Abstract
Sinusoidal obstruction syndrome (SOS) is a rare liver disorder due to hepatic vascular injury. Its rapid and accurate diagnosis is crucial for patient survival. SOS is often established clinically, based on Baltimore, modified Seattle, or European Society for Blood and Marrow Transplantation (EBMT) criteria. Unfortunately, such criteria are not highly specificity and fail to provide a timely, reliable differential diagnosis. The use of noninvasive imaging techniques, such as ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), and fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT), has recently grown in this setting, some key imaging features offering diagnostic improvement. This review provides a synopsis of current noninvasive imaging techniques used for this purpose, summarizing accurate and reliable diagnostic features of SOS.
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Affiliation(s)
- Yun Zhang
- Department of Radiology, Sichuan University West China Hospital, No.37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
| | - Yuling Yan
- Department of Gastroenterology and Hepatology, Sichuan University West China Hospital, Chengdu, 610041, Sichuan Province, China
| | - Bin Song
- Department of Radiology, Sichuan University West China Hospital, No.37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China.
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41
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Added value of contrast-enhanced ultrasound (CEUS) with Sonovue ® in the diagnosis of inferior epigastric artery pseudoaneurysm: report of a case and review of literature. J Ultrasound 2019; 22:485-489. [PMID: 31327113 DOI: 10.1007/s40477-019-00398-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/11/2019] [Indexed: 12/13/2022] Open
Abstract
The anatomical position of the inferior epigastric artery (IEA), within the rectus sheath, subjects patients to possible IEA injury during abdominal wall surgical and interventional procedures. Pseudoaneurysm arising from IEA is very uncommon with only 16 cases reported in the literature. We present a case of an IEA false aneurysm resulting from therapeutic paracentesis for ascites in a 71-year-old patient who came to our department for abdominal pain and signs of anemization. To our knowledge, no published reports are currently available describing an IAE pseudoaneurysm successfully diagnosed with contrast-enhanced ultrasound.
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Vidoni A, McLoughlin E, James SL, Botchu R. Intra-neural ganglion cyst of the lateral dorsal cutaneous nerve: an uncommon cause of lateral ankle pain. J Ultrasound 2019; 23:81-86. [PMID: 31161399 DOI: 10.1007/s40477-019-00387-0] [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] [Received: 04/16/2019] [Accepted: 05/22/2019] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION An intra-neural ganglion cyst of the lateral dorsal cutaneous branch of the sural nerve is rare, with only a few cases reported in the literature. MATERIALS AND METHODS We carried out a retrospective investigation of patients with an intraneural ganglion cyst of the lateral dorsal cutaneous nerve. RESULTS We present a case series of four patients with intra-neural ganglion cysts of the lateral dorsal cutaneous nerve, the distal continuation of the sural nerve at the lateral aspect of the foot. CONCLUSION Intra-neural ganglion cysts of the lateral dorsal cutaneous nerve are rare. They represent a relatively uncommon source of lateral ankle pain, which can easily be diagnosed with ultrasound (US) and magnetic resonance imaging and managed effectively with US-guided aspiration or surgical excision.
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Affiliation(s)
- A Vidoni
- Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK.,Royal National Orthopedic Hospital, Stanmore, UK
| | - E McLoughlin
- Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK
| | - S L James
- Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK
| | - R Botchu
- Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK.
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Corvino A, Sandomenico F, Setola SV, Corvino F, Tafuri D, Catalano O. Morphological and dynamic evaluation of complex cystic focal liver lesions by contrast-enhanced ultrasound: current state of the art. J Ultrasound 2019; 22:251-259. [PMID: 31087277 DOI: 10.1007/s40477-019-00385-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 05/02/2019] [Indexed: 12/14/2022] Open
Abstract
Complex cystic and cystic-like focal liver lesions (FLLs) encompass a spectrum of disorders ranging from non-neoplastic conditions to benign and malignant tumors. In this prospective, the possibility of non-invasive differentiation of these lesions is extremely important, because the clinical implications and therapeutic strategies vary considerably. Because of its advantageous cost/benefit ratio, widespread availability and easy execution, ultrasound (US) is the first-line imaging modality in most countries for the initial liver survey and represents the imaging technique that usually detects a complex liver cyst. However, US showed poor efficacy in the differential diagnosis of complex cystic FLLs. Thus, for years, computed tomography (CT) and magnetic resonance (MR) imaging have been used for further assessment of these lesions. Recently, the development of low mechanical index real-time contrast-enhanced ultrasound (CEUS) technique performed with the second generation of US contrast agents has led to an accurate depiction of macrovasculature and microvasculature. The technique yields information about contrast enhancement of the liver and FLLs almost as CT and MRI do, but in real time and without the use of ionizing radiation. To date, there is only a small amount of evidence about the role of CEUS in the less common setting of complex liver cysts. The aim of this review is to offer an up-to-date overview on the state of the art of CEUS in the study of the most common complex cystic focal liver lesions. To our knowledge, there are no literature comprehensive reviews on this topic.
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Affiliation(s)
- Antonio Corvino
- Motor Science and Wellness Department, University of Naples "Parthenope", VIA F. Acton 38, 80133, Naples, Italy.
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Via S. Pansini 5, 80131, Naples, Italy.
- , via Croce no. 82, 81033, Casal di Principe, CE, Italy.
| | - Fabio Sandomenico
- Radiology Department, National Cancer Institute Pascale Foundation, Via M. Semmola 53, 80131, Naples, Italy
| | - Sergio Venanzio Setola
- Radiology Department, National Cancer Institute Pascale Foundation, Via M. Semmola 53, 80131, Naples, Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Domenico Tafuri
- Motor Science and Wellness Department, University of Naples "Parthenope", VIA F. Acton 38, 80133, Naples, Italy
| | - Orlando Catalano
- Radiology Unit, Istituto Diagnostico Varelli, Via Cornelia Dei Gracchi 65, 80126, Naples, Italy
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Sandomenico F, Corvino A, Ronza FM, Catalano O, Fazioli F, De Chiara A, Campanino MR, Porcaro M, Tafuri D, Petrillo A. Recurrence of tumoral calcinosis: a case report. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:587-594. [PMID: 31910191 PMCID: PMC7233760 DOI: 10.23750/abm.v90i4.8251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/21/2019] [Indexed: 11/23/2022]
Abstract
We describe radiographic, contrast-enhanced MDCT and MRI findings with pathologic correlations of an unusual recurrence of tumoral calcinosis, also called Teutschlander disease. The disease was silent in the first decade of life, when it appeared with elbows recurring lesions, until the seventh decade of life, when a left hip active growth lesion developed. A review about tumoral calcinosis pathogenesis, clinical course and imaging differential diagnosis is reported. (www.actabiomedica.it).
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Affiliation(s)
- Fabio Sandomenico
- Radiology Department, National Cancer Institute Pascale Foundation, Naples, Italy
| | - Antonio Corvino
- Motor Science and Wellness Department, University of Naples “Parthenope”, Naples, Italy, Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Naples Italy,Correspondence: Dr. Antonio Corvino, MD via B. Croce, 82 - 81033 Casal di Principe (CE), Italy Tel. 3471710762 Fax: ++390818921778 E-mail:
| | | | | | - Flavio Fazioli
- Oncological Orthopedics Department, National Cancer Institute Pascale Foundation, Naples Italy
| | - Anna De Chiara
- Pathology Department, National Cancer Institute Pascale Foundation, Naples Italy
| | | | - Mauro Porcaro
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Naples Italy
| | - Domenico Tafuri
- Motor Science and Wellness Department, University of Naples “Parthenope”, Naples, Italy
| | - Antonella Petrillo
- Radiology Department, National Cancer Institute Pascale Foundation, Naples, Italy
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