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Thứ Hai, ngày 27 tháng 10 năm 2014

J U M November 2014

Selected Abstracts
1.       Abstract 1
2.       Original Research:
Sonographic Appearances of Juvenile Fibroadenoma of the BreastJUM November 2014 33:1879-1884; doi:10.7863/ultra.33.11.1879
3.       Abstract 2
4.       Original Research:
The Tram Track Sign: A Characteristic Sonographic Feature of Polyethylene Liner Dissociation After Total-Hip ArthroplastyJUM November 2014 33:1931-1937; doi:10.7863/ultra.33.11.1931
5.       Abstract 3
6.       Original Research:
Transperineal Sonographic Anal Sphincter Complex Evaluation in Chronic Anal FissuresJUM November 2014 33:1981-1989; doi:10.7863/ultra.33.11.1981

1.       Abstract 1 of 3Original Research
Sonographic Appearances of Juvenile Fibroadenoma of the Breast
Objectives—The purpose of this study was to evaluate characteristic features of juvenile fibroadenoma of the breast on sonography.
Methods—Our study included 34 juvenile fibroadenomas confirmed by surgical biopsy or sonographically guided 8-gauge vacuum-assisted biopsy in 23 patients (age range, 15–47 years; mean age, 25 years). Sonographic findings of the lesions were analyzed retrospectively by 2 radiologists in consensus according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) lexicon. The BI-RADS final assessment category was also established.
Results—On sonography, all fibroadenomas presented as masses. The mean size was 30 mm. Regarding shape, there were 29 oval, 2 round, and 3 irregular masses. The margins were circumscribed in 24, indistinct in 5, microlobulated in 4, and angular in 1. Regarding echogenicity, 16 masses were hypoechoic, 16 isoechoic, and 2 complex echoic. Posterior acoustic characteristics included posterior acoustic enhancement in 22 masses (65%), posterior shadowing in 1, and no posterior acoustic features in 9; this information was not available in 2. The lesion boundary presented as an abrupt interface in 32 and an echogenic halo in 2. The orientation was parallel in 32 and nonparallel in 2. Calcifications were present in 3 cases and absent in 31. On color Doppler sonography, the masses were usually hypervascular with vessel counts of 5 or more (87%). The BI-RADS final assessment categories were 3 in 24 and 4a in 10.
Conclusions—The dominant sonographic presentation of juvenile fibroadenoma is a circumscribed oval hypoechoic or isoechoic mass, which resembles that of simple fibroadenoma. Juvenile fibroadenomas frequently show posterior acoustic enhancement and hypervascularity on color Doppler sonography




o    Received December 23, 2013.
o    Revision received February 21, 2014.
o    Accepted February 27, 2014.
o    © 2014 by the American Institute of Ultrasound in Medicine
2.       Abstract 2 of 3Original Research
The Tram Track Sign
A Characteristic Sonographic Feature of Polyethylene Liner Dissociation After Total-Hip Arthroplasty
Objectives—Polyethylene liner dissociation from an acetabular component is a complication of total-hip arthroplasty (THA) caused by slippage of the liner, which causes pain and requires a revision. The aim of this study was to evaluate sonographic features of liner dissociation and detect useful sonographic findings compared to conventional radiography and computed tomography (CT).
Methods—Among a total of 226 patients who underwent revision THA at our institution between September 2008 and June 2012, 10 patients (6 male and 4 female; mean age, 56.2 years) who showed severe narrowing of the superior joint space on the THA side and underwent sonography were retrospectively reviewed by evaluating radiographic, CT, and sonographic findings. In evaluation of the images, we put more emphasis on the “radiographic crescent sign,” “CT crescent sign,” and “sonographic tram track sign.”
Results—At surgery, 7 patients showed liner dissociation, and 3 showed severe liner wear. On radiography, 8 of 10 patients (80%) had a correct diagnosis of the presence or absence of liner dissociation; on sonography, all 10 patients (100%) had a correct diagnosis. The sensitivity, specificity, and accuracy for diagnosis of liner dissociation by pelvic radiography and sonography were 100% (7 of 7), 33% (1 of 3), and 80% (8 of 10) and 100% (7 of 7), 100% (3 of 3), and 100% (10 of 10), respectively.
Conclusions—Liner dissociation can be easily and well visualized by sonography, especially compared to pelvic radiography and CT. The sonographic tram track sign should be a very useful feature in the early diagnosis of liner dissociation.



o    Received September 24, 2013.
o    Revision received October 16, 2013.
o    Accepted February 13, 2014.
o    © 2014 by the American Institute of Ultrasound in Medicine
3.  
     Abstract 3 of 3 Original Research
Transperineal Sonographic Anal Sphincter Complex Evaluation in Chronic Anal Fissures
Objectives—The purpose of this study was to assess the role of transperineal sonography in assessment of pathologic changes to the anal sphincter complex in patients with chronic anal fissures.
Methods—We conducted a prospective case-control study of 100 consecutive patients of any age and both sexes with chronic anal fissures who presented to a colorectal clinic between January 2012 and August 2013 (group A) and 50 healthy volunteers (group B).
Results—The most common patterns of radiologic changes to anal sphincters associated with chronic anal fissures were circumferential thickening of the anal sphincter complex in 5 patients (5%), circumferential thickening of the internal anal sphincter in 3 patients (3%), preferential thickening of the internal anal sphincter at the 6-o’clock position in 80 patients (80%) and the 12-o’clock position in 7 patients (7%), preferential thickening of the internal and external anal sphincters in 3 patients (3%), and thinning of the internal anal sphincter in 2 patients (2%).
Conclusions—Chronic anal fissures cause differential thickening of both internal and external anal sphincters, with a trend toward increased thickness in relation to the site of the fissure. Routine preoperative transperineal sonography for patients with chronic anal fissures is recommended, and it is mandatory in high-risk patients.


o    Received December 6, 2013.
o    Revision received January 3, 2014.
o    Accepted March 7, 2014.
o    © 2014 by the American Institute of Ultrasound in Medicine