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Thứ Bảy, 30 tháng 8, 2014

J U M 9-2014



1        Abstract 1 of 6  Original Research
Effect of Abdominal Liposuction on Sonographically Guided High-Intensity Focused Ultrasound Ablation
Objectives—The aim of this study was to evaluate the effect of abdominal liposuction on sonographically guided high-intensity focused ultrasound (HIFU) ablation.
Methods—A total of 10 women with uterine fibroids or adenomyosis who had received abdominal liposuction were analyzed after sonographically guided HIFU ablation. Of the 10 women, 6 had a diagnosis of uterine fibroids, and 4 had a diagnosis of uterine adenomyosis. All of them had a history of a horizontal-margin split-cesarean delivery. In addition, 26 women with a history of a single horizontal-margin split-cesarean delivery who had a diagnosis of uterine fibroids or adenomyosis but had not received liposuction were analyzed together as a control group.
Results—Of the 10 women, 1 woman with uterine fibroids developed local skin erythema after treatment; 1 women with uterine adenomyosis developed a skin burn after treatment; and the remaining women had obvious skin-burning pain during treatment. All women who had not received liposuction finished the treatment with no serious adverse events during or after treatment. The pain scores and incidence of skin-burning pain were significantly higher in the liposuction group than the control group (P= .021 and .038, respectively).
Conclusions—Abdominal liposuction may increase the risk of skin burns during sonographically guided HIFU ablation.

o    Received November 30, 2013.
o    Revision received December 17, 2013.
o    Accepted January 6, 2014.
o    © 2014 by the American Institute of Ultrasound in Medicine
2.      Abstract 2 of 6 Original Research
Role of Sonography in the Differentiation of Benign, High-Risk, and Malignant Papillary Lesions of the Breast
Objectives—The purpose of this retrospective study was to assess the sonographic features of benign, high-risk, and malignant papillary lesions of the breast.
Methods—We conducted a search of our institution’s breast biopsy database for all papillary lesions with sonographic findings and final surgical pathologic diagnoses from January 1, 2004, to December 31, 2009. We retrospectively reviewed the breast sonographic findings of 23 benign papillomas, 14 papillomas with associated atypical ductal hyperplasia, and 14 papillary carcinomas, all surgically proven. These 51 lesions in 50 patients comprised our data set. The imaging reports, pathologic records, and surgical records of these patients were reviewed, and statistical analysis was performed.
Results—The findings for 50 patients (age range, 26–92 years; mean, 55.2 years) with 51 lesions were reviewed. One patient had bilateral breast cancer. Size and margin features showed statistically significant differences (P < .05) between the lesions. Twelve (47.9%) benign papillomas, 10 (71.4%) high-risk lesions, and 13 (92.9%) malignant lesions were larger than 1 cm. Sixteen (69.6%) benign papillomas, 10 (71.4%) high-risk lesions, and only 4 (28.6%) malignant lesions had circumscribed margins. With regard to echo pattern, there was a statistically significant difference between the lesions (P< .01). Twenty (87.0%) benign papillomas, 4 (28.6%) high-risk lesions, and 10 (71.4%) malignant lesions were hypoechoic. Posterior sonographic features were also statistically significant (P < .05), with malignant and high-risk lesions being associated with posterior enhancement or shadowing. Another statistically significant difference (P < .01) was intralesional vascularity, which was seen more frequently with malignant lesions. Regardless of lesion type, the distance from the nipple, shape, orientation, surrounding tissue change, and associated calcifications were not significant.
Conclusions—Our results suggest that sonographic features that may potentially assist in differentiating papillary lesions include size, margin, echo pattern, posterior features, and intralesional vascularity.
o    Received November 13, 2013.
o    Revision received December 17, 2013.
o    Accepted January 16, 2014.
o    © 2014 by the American Institute of Ultrasound in Medicine
3.      Abstract 3 of 6 Original Research
Noninvasive Assessment of Liver Fibrosis Using Ultrasound-Based Shear Wave Measurement and Comparison to Magnetic Resonance Elastography
Objectives—Magnetic resonance elastography (MRE) has excellent performance in detecting liver fibrosis and is becoming an alternative to liver biopsy in clinical practice. Ultrasound techniques based on measuring the propagation speed of the shear waves induced by acoustic radiation force also have shown promising results for liver fibrosis staging. The objective of this study was to compare ultrasound-based shear wave measurement to MRE.
Methods—In this study, 50 patients (28 female and 22 male; age range, 19–81 years) undergoing liver MRE examinations were studied with an ultrasound scanner modified with shear wave measurement functionality. For each patient, 27 shear wave speed measurements were obtained at various locations in the liver parenchyma away from major vessels. The median shear wave speed from all measurements was used to calculate a representative shear modulus (μ) for each patient. Magnetic resonance elastographic data processing was done by a single analyst blinded to the ultrasound measurement results.
Results—Ultrasound and MRE measurements were correlated (r = 0.86; P< .001). Receiver operating characteristic (ROC) analysis was applied to the ultrasound measurement results with the MRE diagnosis as the “ground truth.” The area under the ROC curve for separating patients with minimum fibrosis (defined as μMRE ≤2.9 kPa) was 0.89 (95% confidence interval, 0.77–0.95), and the area under the ROC curve for separating patients with advanced fibrosis (defined as μMRE ≥5.0 kPa) was 0.96 (95% confidence interval, 0.87–0.99).
Conclusions—Results indicate that the ultrasound-based shear wave measurement correlates with MRE and is a promising method for liver fibrosis staging.
o    Received November 19, 2013.
o    Revision received December 11, 2013.
o    Accepted January 13, 2014.
o    © 2014 by the American Institute of Ultrasound in Medicine
4.      Abstract 4 of 6 Original Research
Novel Sonographic Clues for Diagnosis of Antral Gastritis and Helicobacter pyloriInfection
A Clinical Study
Objectives—The purpose of this study was to find out whether transabdominal sonography may have a predictive role for detection of antral gastritis and Helicobacter pylori infection in the antrum.
Methods—A total of 108 patients and 54 control participants were allocated into 3 groups: group 1, controls without any symptoms or findings of antral gastritis and H pylori infection; group 2, patients with symptoms and endoscopic findings consistent with gastritis in the absence of documented H pylori infection; and group 3, patients with symptoms and endoscopic findings consistent with gastritis and documented H pylori infection. These groups were compared in terms of demographics, antral wall thickness, mucosal layer (together with muscularis mucosa) thickness, and mucosal layer-to-antral wall thickness ratio.
Results—The groups had no statistically significant differences with respect to age, sex, body mass index, and smoking habits. However, it turned out that both antral walls and muscularis mucosa layers were thicker and the mucosal layer-to-antral wall thickness ratio was higher in groups 2 and 3 compared to group 1 (P > .001). In addition, group 3 had statistically significantly thicker antral walls and muscularis mucosa layers and a significantly increased mucosal layer-to-antral wall thickness ratio than group 2 (P < .001).
Conclusions—Our results suggest that antral gastritis caused by H pyloriinfection is associated with characteristic features such as thickening of antral walls and mucosal layers on sonography. These novel clues may be useful in the diagnosis of gastritis, and unnecessary interventions and measures can be avoided in some cases.
o    Received October 16, 2013.
o    Revision received November 18, 2013.
o    Accepted December 31, 2013.
o    © 2014 by the American Institute of Ultrasound in Medicine
5.      Abstract 5 of 6 Original Research
Sonographic Diagnosis of Tuberculous Lymphadenitis in the Neck
Objectives—The aim of this study was to assess the diagnostic accuracy of individual sonographic features and sonographic diagnosis for patients with a clinical suspicion of tuberculous lymphadenitis in the neck.
Methods—From January 2010 to December 2011, 79 patients who underwent neck sonography and sonographically guided fine-needle aspiration with tuberculosis polymerase chain reaction analysis for clinical suspicion of tuberculous lymphadenitis in the neck were enrolled in the study. The sonographic features of each patient were retrospectively investigated by a single radiologist using a picture archiving and communication system, and a sonographic diagnosis according to the number of sonographic features was developed. Follow-up sonography, polymerase chain reaction, core needle biopsy, or excision biopsy of lymph nodes from the neck was used for the final diagnosis.
Results—The diagnoses of the 79 patients were finally confirmed as tuberculous lymphadenitis (n = 40), suppurative lymphadenitis (n = 2), Kikuchi disease (n = 12), metastatic lymph nodes (n = 9), and nonspecific lymphadenitis (n = 16). No sonographic features with both high sensitivity and specificity were found. In a receiver operating characteristic analysis of sonographic diagnosis, the category of 2 or more sonographic features showed the highest area under the curve. When the “2 or more” category was selected, the sensitivity, specificity, positive and negative predictive values, and accuracy of sonography for diagnosis of tuberculous lymphadenitis were 95.0%, 79.5%, 82.6%, 93.9%, and 87.3%, respectively.
Conclusions—Although no sonographic feature had both high sensitivity and specificity for detection of tuberculous lymphadenitis, the diagnostic accuracy of the “2 or more” category was higher than those of other categories.
o    Received August 23, 2013.
o    Revision received September 30, 2013.
o    Accepted December 31, 2013.
o    © 2014 by the American Institute of Ultrasound in Medicine
6.      Abstract 6 of 6 Case Series
Enthesopathy of the Lateral Cord of the Plantar Fascia
The objective of this study was to raise awareness of the diagnosis of enthesopathy of the lateral cord of the plantar fascia (LCPF) and describe its sonographic findings. We conducted a retrospective case series of 13 sonographic examinations with the diagnosis of LCPF enthesopathy. Two cadaver dissections of the plantar foot were performed for anatomic correlation. Sonographic findings of LCPF enthesopathy included generalized or focal hypoechoic thickening, loss of the normal fibrillar echo texture, cortical irregularity of the fifth metatarsal tuberosity, and vascularity on color Doppler imaging. Anatomic dissections of the plantar foot detailed the course of the LCPF and served as a guide for optimal sonographic imaging. Enthesopathy of the LCPF is an important etiology of nontraumatic pain at the base of the fifth metatarsal. Sonographic evaluation can readily show the characteristic findings of LCPF enthesopathy.
o    Received November 18, 2013.
o    Revision received December 26, 2013.
o    Accepted January 15, 2014.
o    © 2014 by the American Institute of Ultrasound in Medicine


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