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Thứ Năm, 26 tháng 1, 2012

THAM GIA AOCR 2012 SYDNEY


 




Lễ khai mạc AOCR 2012.


Bs Đặng Vĩnh Phúc (nữ) từ MEDIC báo cáo đề tài giá trị ADC của MRI trong lao cột sống.


Bài siêu âm tham dự AOCR 2012 Sydney

 Gồm 4 bài:


Hung Thien Nguyen, Cuong Tuan Nguyen, Xuan Thanh thi Pham, Hai Thanh Phan, MEDIC MEDICAL CENTER, HCMC, Vietnam

ACCEPTED by AOCR 2012
Abstract:

Objective: The aim of the present study was to evaluate the feasibility of ARFI-measurements in combining of VTI and eSie Touch images in the thyroid nodule.

Materials and methods: All patients went through conventional ultrasound, ARFI-imaging and cytological assessment.
ARFI-imaging (VTI and VTQ technology) and eSie Touch technology were performed with  9L4 probe, using Siemens (ACUSON S2000) B-mode-ARFI combination transducer.

Results: 85 nodules were available for analysis. 67 nodules were benign on cytology, 13 nodules were malignant (13 papillary carcinomas), and 5 follicular lesions. The median velocity of ARFI-imaging in benign and malignant thyroid nodules was of 2.06 m/s, and of 3.00 m/s, respectively. A specificity of ARFI-imaging of 95% could be achieved using a cut-off of 3.1 m/s (area under ROC curve is 0.778). We realized that should combine the ARFI velocity with VTI and eSie Touch images in the characterization of malignant nodules and follicular lesions which were in dark color from benign nodules, in bright color, because there was an overlapping of the ARFI velocity values between them.


Conclusions: ARFI can be performed in thyroid nodule with reliable results. ARFI might be the reference criteria for differentiation of benign and malignant thyroid nodules.


II. Review of possibility of conventional ultrasound in differentiating malignant from benign thyroid nodules, CUONG TUAN NGUYEN, MEDIC MEDICAL CENTER, HCMC, VIETNAM

ACCEPTED by AOCR 2012
Aim.

To retrospectively investigate whether ultrasound features were helpful in differentiate malignant from benign thyroid nodules by using post-surgery pathology as the last referent result.

Methods.

Our subjects aged from 12 to 77 had totally 300 thyroid nodules ( 4-78mm ) were first underwent Doppler ultrasound and fine needle aspiration cytology. After operation, we reviewed and evaluated the following sonographic features: shape; echogenicity; margination; calcifications and vascularity.

Results.

Among 300 thyroid nodules, there were 170 malignant nodules ( 56.7% ). The sonographic features that were significantly more common in malignant thyroid nodules than in benign nodules were: taller-than-wide shape ( 74.6% vs 25.4%, p=0.001 ); hypoechogenicity ( 65.8% vs 34.2%, p=0.00 ); irregular border ( 84.5% vs 15.5%, p=0.00); capsule invasion ( 100% vs 0%, p=0.01); microcalcifications ( 80.4% vs 19.6%, p=0.00 ). Vascularity in the nodule centre was slightly significantly related to malignant nodules ( p=0.04 ). However, the findings such as general vascularity and quantity of microcalcifications ( little to moderate ) were not significantly related to malignant thyroid nodules ( p=0.3 and p=0.11 respectively ).

Conclusion.

The gray-scale sonographic findings like shape; echogenicity; margination and microcalcifications were still the reliable criteria for differentiating malignant from benign thyroid nodules. And evaluation of vascularity in the thyroid nodule centre was also a useful practice.

III. Gossypiboma: Ultrasound Findings and MDCT Correlations,
Hung Thien Nguyen, Nhan Thanh Nguyen Vo, Hai Thanh Phan,  MEDIC MEDICAL CENTER, HCMC, Vietnam

ACCEPTED by AOCR 2012

Abstract:

Purpose: Gossypiboma or textiloma may be disclosed incidentally by ultrasound in routine check-up. The aim of the present study is to evaluate the findings of conventional ultrasound in the detection of gossypiboma.

Materials and methods: All patients received conventional ultrasound, and then MDCT to confirm the ultrasound findings and rule out a malignant mass.

Results: From 1995 to 2011, there are 12 cases which were detected by ultrasound and later confirmed by MDCT and surgery. The time point to detect gossypiboma are in range from one 1 month to 23 years post-op. Most of cases are in fibrinous stage and 3 cases in early stage.

Discussions: Ultrasound is sensitive to detect gossypiboma and can differentiate from a malignant mass. Umbrella sign may help although that is not a specific finding. But MDCT (and MRI) plays a available role in identification the textile structure of retained gauze in the abdomen.

Conclusions: Ultrasound can be performed in the detection of gossypiboma with reliable results in regarding of the scar on the previous surgery area. Ultrasound may help avoid a misdiagnosis of an intraabdominal malignant mass, abscess and fecalith.

References:

1/ A Malik, P Jagmohan: Gossypiboma: US and CT Appearance, Abdominal Imaging 2002, 12 :503-504, India.

2/ K Shahi, B Geeta, P Rajput: Forget Me Not - Gossypiboma in Pregnancy: Report of a Case, The Internal Journal of Surgery, 2009, Vol 19 Number 2, India.

3/ SP Stawicki, DC Evans, J Cipolla, MJ Seamon, JJ Lukaszczyk, MP Prosciak, DA Torigian, VA Doraiswamy, NP Yazzie, OL Gunter Jr, SM Steinberg: Retained Surgical Foreign Bodies,A Comprehensive Review of Risks and Preventive Strategies, Scandinavian J of Surgery 98: 8-17, 2009.

4/ TC Cheng, AS Chou, CM Jeng,PY Chang, CC Lee: Computed Tomography Findings of Gossypiboma, J Chin Med Assoc, December 2007,Vol 70, Number 12, 565-569, Taiwan.


IV. LIVER STIFFNESS MEASUREMENT on 554 CASES at MEDIC CENTER by ARFI and FIBROSCAN,  LIEM THANH LE, LINH HONG BUI, NHAT THONG LE, HAI THANH PHAN, MEDIC MEDICAL CENTER, HCMC, VIETNAM

ACCEPTED by AOCR 2012

Abstract


Purpose: To compare acoustic radiation force impulse imaging (ARFI) with transient elastography (TE of FIBROSCAN) for assessing whether ARFI can be a non-invasive technique in liver fibrosis evaluation.
Materials and methods: All 554 cases (353 male, including 366 cases of chronic viral hepatitis), age from 17 to 85 yo (mean = 44±13), BMI =14.8 to 32.4 (mean= 22±2.8) were examined by 2 sonologists performing ARFI and TE techniques, and tested serologic markers in the same day. ARFI values (V=m/s) are compared to TE values (F= kPa) by MedCalc statistical software.
Results: Results of ARFI and TE techniques are in close correlation with statistical significance of fibrosis staging, correlative coefficientr = 0.83 with P < 0.0001, 95% CI = 0.804-0.855. The shear wave velocity means of ARFI range from 0.79 to 3.53 m/sec, standard deviation from 0.01 to 1.0 (mean = 0.11), 90% ≤ 0.23m/s and there are statistical differences between V0-V1, V1-V2, V2-V3, V3-V4 with t range from 11.4to 18.9, p <0.0001. Values of TE, from 2.2 to 75kPa. Close clinical agreementbetween FibroScan F4 and ARFI F4, kappa=0.8.

With the regressive equation y = 0.9458 + 0.04266 x (where x=F kPa and y=V m/s), we propose a fibrosis staging of ARFI as follows: F0≥1.16m/s; 1.16≤F1≥1.25m/s, 1.25≤F2≥1.32m/s; 1.32≤F3 ≥1.56m/s; F4≥1.56 m/s.

Conclusions: ARFI of liver fibrosis assessment in chronic viral hepatitis has accurate diagnosis similarly with TE in the present study of 554 cases.ARFI technique may substitute for TE of FibroScan.

References
1. Simona Bota, Ioan Sporea, Roxana Şirli, Alina Popescu, Mirela Dănilă, Mădălina Şendroiu: Factors that influence the correlation of Acoustic Radiation Force Impulse (ARFI) elastography with liver fibrosis, Med Ultrason, Feb. 2011, Vol.13, No 2, 135-140.
2. Monica Lupsor, Radu Badea, Horia Stefanescu, Zeno Sparchez, Horaţiu Branda, Alexandru Serban, Anca Maniu: Performance of a New Elastographic Method (ARFI technology) Compared to Unidimensional Transient Elastography in the Noninvasive Assessment of Chronic Hepatitis C. Preliminary Results, J Gastrointestin Liver Dis, Sep.2009, Vol 18, No 3, 303-310.

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