1/ ARFI of TESTIS at MEDIC
CENTER, NGUYEN THIEN HUNG - LE
VAN TAI - PHAN THANH HAI, MEDIC MEDICAL CENTER,
HCMC, VIETNAM
PURPOSE:
Acoustic radiation force
impulse imaging (ARFI) is a new technique for the sonographic quantification of
tissue elasticity. We applied ARFI
elastography to investigate the stiffness of
the normal and pathologic testes.
METHOD and MATERIALS:
20 male volunteers
underwent normal B-mode sonography with ARFI elastometry of both testes using a
Siemens Acuson S2000™ (Siemens Healthcare, Germany) system. 12 cases of
testicular tumor and 03 cases of
hematoma were encountered in our study. Results were statistically
evaluated.
RESULTS:
-
From 40 normal testes of
20 male individuals, mean elastic velocity VTQ= 0.87+/- 0.11m/s [range
0.72-1.12 m/s]
-
From 03 cases of
hematoma, mean elastic velocity VTQ=1.39+/-0.02m/s.
-
From 12 cases of
testicular tumor, mean elastic velocity VTQ= 1.51+/- 0.18 m/s (range
1.26-1.69m/s) with the meaning more stiffness than normal and hematoma testis.
On VTI tumor are harder the parenchyma (black color or blue code)
CONCLUSION:
ARFI elastometry provides the initial values of testicular
stiffness in normal and pathologic status. Further studies with more subjects
may be required to define the normal range of values for normal and pathologic
groups.
2/ARFI for
OBSTRUCTIVE and with UPJO HYDRONEPHROSIS in ALDULT
NGUYEN
THIEN HUNG - TRAN NGAN CHAU- PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC,
VIETNAM
ABSTRACT:
We applied ARFI technique from
Siemens S2000 to evaluate whether fibrotic process existing in adult
hydronephrosis.
Using 1-4 MHz convex probe we
calculated in 3 positions of hydronephotic kidney due to obstruction
[stone, outside compression] (n=33 cases), due to ureteropelvic junction
obstruction [UPJO] (n=30 cases]. We had a control group of normal kidney (n=36
cases). Mean value of ARFI velocity of obstruction hydronephrosis (due to
stone) was 2.73+/-0.39m/s and of UPJO hydronephrosis was 1.66+/-0.16m/s while
in control group was 1.6+/-0.2m/s. There were stastistic differences of 2 stone
and UPJO hydronephrosis groups (p < 0.0001), with stone hydronephrosis and
control (p < 0.0001). But no statistic difference exists in UPJO
hydronephrosis and control group.
3/ CLINICAL
APPLICATION of Acoustic Radiation Force Impulse in BREAST TUMOR at MEDIC CENTER, PHAN THANH HAI PHUONG, VO NGUYEN THUC QUYEN, PHAN
THANH HAI
INTRODUCTION
Early detection of Breast Cancer plays a critical
role in decision making. Besides mammography and MRI, ultrasound has been a
useful modality in detecting breast tumors. Moreover, the combination with
Color Mode significantly reinforces the B-mode diagnosis. Lately, new
ultrasound technique, elastography is providing extra information to increase
accuracy. However, each one uses different method including compressed and
non-compressed technologies. Developing by Siemens, ARFI is a non-compressed
elastography, evaluates tissue stiffness base on replacement caused by acoustic radiation force impulse (ARFI).
AIMS:
To evaluate ARFI qualitative and quantitative
assessment to differentiate benign and malignant breast tumors.
METHODS
and MATERIALS
From April to November 2015, we selected
85 breast lesions classified as category 3-5 according to ACR Breast
Imaging Recording and Data System (BI-RADS). Two radiologists analyzed them in
ARFI features : Elasticity Score (E.S) which on scales 1-5 (Score 1-3: low
suspicion, Score 4-5: high suspect of malignancy), then measure Area Ratio (proportion
between VTI lesion area and B-mode area) and set ROI in 5 different points of
the lesion then measured Shear-wave Velocity (SWV). Biopsy were
required for final diagnosis (FNAC, Core Biopsy, Excisional Biopsy). Exclusion
criteria include: Non histopathology confirmation or Male breast lesion.
RESULT
85 selected breast lesions includes 59 benign
(69.4%) and 26 (30.6%) malignant. Lesions appear to dominantly locate in right
breast 52/85 (61.2%), left 33/85 (38.8%). The mean size is 16.26 ±6.56 transversely
and perpendicularly 9.64 ±5.01 mm. In ES assessment, 26/26 cancer cases were
within suspicious range (
ES4-5). The AR cut-off point would best at 1.34
with sensitivity 88.5% and specificity 94.9% (area under ROC curve for
malignancy is 0.933). After excluded 8 malignant cases has SWV as X.XX m/s, the
best SWV cut-off point is at 2.24 with sensitivity 94.4% and specificity 72.9%
(area under ROC curve for malignancy is 0.911).
CONCLUSION
Overall, ARFI is a useful tools for diagnosis and decision
of biopsy breast tumors. The technique is simple since it is non-compressed and
repeatable. It cannot replaced biopsy but reinforced the Conventional
ultrasound findings. This is a promising
technique helps avoiding invasive diagnosis if we use it right and
well-combined with other features.
4/ Ultrasound findings
of rib fractures in undetected cases by chest x-rays
Le Thanh Liem MD,
Phan Thanh Hai MD
Medic Medical Center, Ho Chi Minh City,
Vietnam
Abstract:
OBJECTIVE:
To accumulate
experiences of detection of costal cartilage and rib fractures which are
negative on X-ray films of chest trauma patients.
METHODS:
A total of 112
patients at the Medic Medical Center from 2008 to
2015, suffering from chest trauma, detected costal cartilage or rib
fractures on chest ultrasound with a 7.5 MHz linear transducer of ultrasound.
All patients were examined later by chest X-ray. Statistical analysis was done
to outline the ultrasound findings of these rib fractures.
RESULTS:
In 112 patients
showed costal cartilage and anterior rib
lesions, only 10 patients (9%) showed of rib fracture on chest X-ray film,
whereas 102 other patients (91.0%) had no evidence of rib lesions on chest
X-ray film. Fracture of the rib with a disruption of continuity of bony cortex,
mostly located near the costo-chondral junction. Rib fracture cases that the
displacement is minimal, usually detected by longitudinal plane based on accompanied
by the soft tissue edema or hematoma around the fracture site. Costal cartilage
fractures were in five patients (4,5%). Costal cartilage fracture appeared as
disruption of cortex, small echogenic lines in cartilage, and bruised cartilage.
In addition to detecting rib fractures, ultrasound helps evaluating the stage
of disease based on the presence of hematoma, cartilage callus or bone callus.
Some patients may not specify the position localized pain or may not remember
history of trauma until there is evidence of ultrasound to confirm the
diagnosis.
CONCLUSIONS:
Ultrasonography is
a useful imaging modalities in disclosing the rib fractures which were negative
on chest X-ray film in chest trauma.
Although no
significant change in treatment, but the detection of rib fractures is very
helpful in explaining the cause of pain, reducing the anxiety of patients and
avoid other unnecessary diagnostic procedures.
