Ultrasonography(US) and the new applications US elastography(USE) and contrast-enhanced US(CEUS) are used in the screening of thyroid nodules,for which fine-needle aspiration biopsy(FNAB) is the best single diagnostic...Ultrasonography(US) and the new applications US elastography(USE) and contrast-enhanced US(CEUS) are used in the screening of thyroid nodules,for which fine-needle aspiration biopsy(FNAB) is the best single diagnostic test.The aim of the study was to compare the sensitivity,specificity,positive predictive value(PPV),and accuracy of the four examinations in nodules with cytological and histological diagnoses.The study used data from US,FNAB,USE(elasticity(ELX 2/1) index),and CEUS(Peak index and time to peak(TTP) index) evaluated in 73 thyroid nodules in 63 consecutive patients likely to undergo surgery.Cytological-histological correlation was available for 38 nodules.No correlation emerged between nodule size and cytological results.A significant(P=0.03) positive correlation between cumulative US findings and cytological results was found.In addition,significant correlations between cumulative US findings and cytology(P=0.02) and between cumulative US findings and histology(P<0.0001) were found.US showed the best specificity and PPV,and FNAB the best sensitivity.There was no significant difference in the ELX 2/1 index,Peak index,or TTP index among nodules subdivided according to cytological scores.No significant correlation was found between ELX 2/1 index,Peak index,and TTP index,on the one hand,and nodule size,US cumulative findings,cytology,and histology on the other hand.The sensitivity of the ELX 2/1 index was high,but its specificity was very low.The accuracy and PPV of USE were lower than those of the other procedures.Only the correlation between Peak index and cumulative US findings reached a value close to significance.Our ultimate aim is to minimise unnecessary thyroidectomy.US and FNAB continue to play a central diagnostic role.The use of a US score showed high specificity and PPV.The specificity of FNAB was low in this selected series because of the numbers of indeterminate cytological responses.USE and CEUS are innovative techniques that need to be standardized.The ELX 2/1 index,Peak index,and TTP index seem to be unrelated to histology.The best statistical data on USE and CEUS concerned their sensitivity and PPV,respectively.At present,USE and CEUS are too time-consuming and of limited utility in selecting patients for surgery.展开更多
BACKGROUND: Acoustic radiation force impulse (ARFI) imaging is a new elastography method for the evaluation of tissue stiffness. This study aims to evaluate the performance of ARFI in noninvasive assessment of the tis...BACKGROUND: Acoustic radiation force impulse (ARFI) imaging is a new elastography method for the evaluation of tissue stiffness. This study aims to evaluate the performance of ARFI in noninvasive assessment of the tissue stiffness of focal liver lesion (FLL) and to explore its potential value in the differential diagnosis of FLL. METHODS: ARFI was performed in 140 patients with 154 FLLs, which included 28 hemangiomas (ANGIs), 14 focal nodular hyperplasias (FNHs), 61 hepatocellular carcinomas (HCCs), 39 metastases and 12 cholangiocellular carcinomas (CCCs). Virtual touch tissue quantification (VTTQ) values were obtained, analyzed and compared. The area under the receiver operating characteristic curve (AUROC) and optimal cut-off values were obtained using a receiver operating characteristic (ROC) curve analysis to assess diagnostic performance. All cases were definitively diagnosed using histopathology, CT, MRI or contrast-enhanced ultrasound. RESULTS: The VTTQ median values of ANGI, FNH, HCC metastasis and CCC were 1.30, 1.80, 2.52, 3.08 and 3.89 m/s respectively. A significant increase in the VTTQ values of different lesions was observed: ANGI【FNH【HCC【metastasis 【CCC (P【0.001). The AUROC (95% CI) of VTTQ values was 0.94 (0.90-0.98) for ANGI, 0.91 (0.87-0.96) for malignant lesions and 0.87 (0.79-0.94) for CCC. The sensitivity and specificity for ANGI (86.5%, 89.3%, respectively), malignancy (81.3% 92.9%, respectively), and CCC (91.7%, 72.5%, respectively) were associated with VTTQ cut-off values of 1.76, 2.22 and 3.00 m/s respectively.CONCLUSIONS: ARFI can accurately and objectively assess the elasticity of lesions by obtaining the shear wave elastic value of FLL with VTTQ. Therefore, ARFI is a novel, simple, noninvasive and useful diagnostic method for the characterization of FLL.展开更多
Several diagnostic techniques have been proposed during the time for the diagnostic evaluation of Induratio Penis Plastica (IPP), due to poor sensitivity and specificity of standard B-Mode Ultrasonography. Shear-Wave ...Several diagnostic techniques have been proposed during the time for the diagnostic evaluation of Induratio Penis Plastica (IPP), due to poor sensitivity and specificity of standard B-Mode Ultrasonography. Shear-Wave elastosonography (SWE) is a relative new ultrasound technique, already used for several organs, which allows evaluating the rigidity of the tissues. Furthermore, we used a compound consisting of Ecklonia bicyclis, Tribulus terrestris, and Biovis (water-soluble Chitosan) with antifibrotic and antioxidant properties and analyzed the elastosonographic variations following the assumption of the compound. From March 2016 to April 2017, 40 patients were recruited with a mean age of 62. All patients underwent elastosonographic measurements at the start of treatment. Subsequently each patient took 1 tablet of the compound of Ecklonia bicyclis, Tribulus terrestris, and Biovis (water-soluble Chitosan) for 6 months. All patients underwent elastosonographic investigation at the end of treatment. The elastosonographic measurement prior treatment, showed that the average of the three measurements (proximal, medial and distal), was 37.05 KPa ± 7.76 SD and 38.8 KPa ± 10.11 SD for the left and right cavernous body, respectively. The examination at the end of the six months of treatment, with the compound showed that the average values of fibrosity were 31.07 KPa ± 7.5 SD and 30.86 KPa ± 11.4 SD for the left and right cavernous body respectively, demonstrating a decrease in fibrosity that was statistically significant (P < 0.01). Our data demonstrate that taking the compound for six months reduces the stiffness of the corpora cavernosa.展开更多
文摘Ultrasonography(US) and the new applications US elastography(USE) and contrast-enhanced US(CEUS) are used in the screening of thyroid nodules,for which fine-needle aspiration biopsy(FNAB) is the best single diagnostic test.The aim of the study was to compare the sensitivity,specificity,positive predictive value(PPV),and accuracy of the four examinations in nodules with cytological and histological diagnoses.The study used data from US,FNAB,USE(elasticity(ELX 2/1) index),and CEUS(Peak index and time to peak(TTP) index) evaluated in 73 thyroid nodules in 63 consecutive patients likely to undergo surgery.Cytological-histological correlation was available for 38 nodules.No correlation emerged between nodule size and cytological results.A significant(P=0.03) positive correlation between cumulative US findings and cytological results was found.In addition,significant correlations between cumulative US findings and cytology(P=0.02) and between cumulative US findings and histology(P<0.0001) were found.US showed the best specificity and PPV,and FNAB the best sensitivity.There was no significant difference in the ELX 2/1 index,Peak index,or TTP index among nodules subdivided according to cytological scores.No significant correlation was found between ELX 2/1 index,Peak index,and TTP index,on the one hand,and nodule size,US cumulative findings,cytology,and histology on the other hand.The sensitivity of the ELX 2/1 index was high,but its specificity was very low.The accuracy and PPV of USE were lower than those of the other procedures.Only the correlation between Peak index and cumulative US findings reached a value close to significance.Our ultimate aim is to minimise unnecessary thyroidectomy.US and FNAB continue to play a central diagnostic role.The use of a US score showed high specificity and PPV.The specificity of FNAB was low in this selected series because of the numbers of indeterminate cytological responses.USE and CEUS are innovative techniques that need to be standardized.The ELX 2/1 index,Peak index,and TTP index seem to be unrelated to histology.The best statistical data on USE and CEUS concerned their sensitivity and PPV,respectively.At present,USE and CEUS are too time-consuming and of limited utility in selecting patients for surgery.
文摘BACKGROUND: Acoustic radiation force impulse (ARFI) imaging is a new elastography method for the evaluation of tissue stiffness. This study aims to evaluate the performance of ARFI in noninvasive assessment of the tissue stiffness of focal liver lesion (FLL) and to explore its potential value in the differential diagnosis of FLL. METHODS: ARFI was performed in 140 patients with 154 FLLs, which included 28 hemangiomas (ANGIs), 14 focal nodular hyperplasias (FNHs), 61 hepatocellular carcinomas (HCCs), 39 metastases and 12 cholangiocellular carcinomas (CCCs). Virtual touch tissue quantification (VTTQ) values were obtained, analyzed and compared. The area under the receiver operating characteristic curve (AUROC) and optimal cut-off values were obtained using a receiver operating characteristic (ROC) curve analysis to assess diagnostic performance. All cases were definitively diagnosed using histopathology, CT, MRI or contrast-enhanced ultrasound. RESULTS: The VTTQ median values of ANGI, FNH, HCC metastasis and CCC were 1.30, 1.80, 2.52, 3.08 and 3.89 m/s respectively. A significant increase in the VTTQ values of different lesions was observed: ANGI【FNH【HCC【metastasis 【CCC (P【0.001). The AUROC (95% CI) of VTTQ values was 0.94 (0.90-0.98) for ANGI, 0.91 (0.87-0.96) for malignant lesions and 0.87 (0.79-0.94) for CCC. The sensitivity and specificity for ANGI (86.5%, 89.3%, respectively), malignancy (81.3% 92.9%, respectively), and CCC (91.7%, 72.5%, respectively) were associated with VTTQ cut-off values of 1.76, 2.22 and 3.00 m/s respectively.CONCLUSIONS: ARFI can accurately and objectively assess the elasticity of lesions by obtaining the shear wave elastic value of FLL with VTTQ. Therefore, ARFI is a novel, simple, noninvasive and useful diagnostic method for the characterization of FLL.
文摘Several diagnostic techniques have been proposed during the time for the diagnostic evaluation of Induratio Penis Plastica (IPP), due to poor sensitivity and specificity of standard B-Mode Ultrasonography. Shear-Wave elastosonography (SWE) is a relative new ultrasound technique, already used for several organs, which allows evaluating the rigidity of the tissues. Furthermore, we used a compound consisting of Ecklonia bicyclis, Tribulus terrestris, and Biovis (water-soluble Chitosan) with antifibrotic and antioxidant properties and analyzed the elastosonographic variations following the assumption of the compound. From March 2016 to April 2017, 40 patients were recruited with a mean age of 62. All patients underwent elastosonographic measurements at the start of treatment. Subsequently each patient took 1 tablet of the compound of Ecklonia bicyclis, Tribulus terrestris, and Biovis (water-soluble Chitosan) for 6 months. All patients underwent elastosonographic investigation at the end of treatment. The elastosonographic measurement prior treatment, showed that the average of the three measurements (proximal, medial and distal), was 37.05 KPa ± 7.76 SD and 38.8 KPa ± 10.11 SD for the left and right cavernous body, respectively. The examination at the end of the six months of treatment, with the compound showed that the average values of fibrosity were 31.07 KPa ± 7.5 SD and 30.86 KPa ± 11.4 SD for the left and right cavernous body respectively, demonstrating a decrease in fibrosity that was statistically significant (P < 0.01). Our data demonstrate that taking the compound for six months reduces the stiffness of the corpora cavernosa.
