• Title/Summary/Keyword: Ultrasound Diagnosis

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Comparison of Effectiveness in Differentiating Benign from Malignant Ovarian Masses between IOTA Simple Rules and Subjective Sonographic Assessment

  • Tongsong, Theera;Tinnangwattana, Dangcheewan;Vichak-ururote, Linlada;Tontivuthikul, Paponrad;Charoenratana, Cholaros;Lerthiranwong, Thitikarn
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4377-4380
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    • 2016
  • Background: To compare diagnostic performance in differentiating benign from malignant ovarian masses between IOTA (the International Ovarian Tumor Analysis) simple rules and subjective sonographic assessment. Materials and Methods: Women scheduled for elective surgery because of ovarian masses were recruited into the study and underwent ultrasound examination within 24 hours of surgery to apply the IOTA simple rules by general gynecologists and to record video clips for subjective assessment by an experienced sonographer. The diagnostic performance of the IOTA rules and subjective assessment for differentiation between benign and malignant masses was compared. The gold standard diagnosis was pathological or operative findings. Results: A total of 150 ovarian masses were covered, comprising 105 (70%) benign and 45 (30%) malignant. Of them, the IOTA simple rules could be applied in 119 (79.3%) and were inconclusive in 31 (20.7%) whereas subjective assessment could be applied in all cases (100%). The sensitivity and the specificity of the IOTA simple rules and subjective assessment were not significantly different, 82.9% vs 86.7% and 94.0% vs 94.3% respectively. The agreement of the two methods in prediction was high with a Kappa index of 0.835. Conclusions: Both techniques had a high diagnostic performance in differentiation between benign and malignant ovarian masses but the IOTA rules had a relatively high rate of inconclusive results. The IOTA rules can be used as an effective screening technique by general gynecologists but when the results are inconclusive they should consult experienced sonographers.

A study of the high resolution Ultrasound Diagnostic system for Dermatology (피부학(Dermatology)을 위한 고해상도 초음파 진단 장치에 관한 연구)

  • Lew, Jeom-Soo;Lim, Chun-Sung;Kim, Young-Kil
    • Journal of the Korean Institute of Telematics and Electronics S
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    • v.35S no.6
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    • pp.66-71
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    • 1998
  • High spatial resolution ultrasonic imaging is necessary in several fields of investigation, in order to permit greater precision of clinical diagnosis in the dermatology, ophthalmology etc. We present a B-mode scan system using sector scanning probe of 20MHz center frequency. This developed system allow the high resolution image of 250${\mu}m$ in lateral and 80${\mu}m$ in axial, which of display the size of a $5mm {\times} 5mm$ image with 20 frames/sec. We have shown the images of various structural elements of the human skin and of the nail. We have compared the skin images obtained for each of the different age and we have shown in a general with the age, the atrophy of the skin thickness and the appearance of the abnormal hypoechogene band under epidermis (named SENEB : Sub Epidermal Non Echogene Band).

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Tall Cell Variant of Papillary Thyroid Carcinoma (유두상 갑상선 암의 큰 세포 변이(Tall Cell Variant))

  • Kang Sang-Wook;Kim Tae-Wan;Nam Kee-Hyun;Chang Hang-Seok;Hong Soon-Won;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.20 no.2
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    • pp.123-127
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    • 2004
  • Objectives: The tall cell variant is an uncommon variant and has been known as more aggressive form of papillary thyroid carcinoma (PTC). Owing to the rarity of these thyroid cancers, their clinical behavior remains incompletely understood. To elucidate the clinicopathologic characteristics of tall cell variant, we retrospectively reviewed our surgical experience of patients with tall cell variant. Methods: Between August 1993 and July 2004, a total of 11 consecutive patients who were pathologically diagnosed with tall cell variant of papillary thyroid carcinoma were enrolled in this study. All patients underwent total (8 cases) or subtotal thyroidectomy (3 cases) with central compartment node dissections. The lateral neck dissection was added in 6 patients. After the operation, neck ultrasound and serum thyroglobulin were checked regularly during the follow-up period. Results: The mean age of the patients was 56.6years (range, 30-74years) at the time of diagnosis. 3 patients were men, and 8 were women. The mean diameter of tumor was 3.7cm(range, 1.5-6.0cm), and 6 patients had lateral neck node metastasis. Extrathyroidal extension was seen in 5 patients (45%). Loco-regional recurrence was found in 2 patients (18%), and distant metastasis in 1 patient (9%). The 5-year disease free survival rate was 68%. Conclusion: The tall cell variant of papillary thyroid carcinoma is an uncommon disease. Clinicopathologic feature and prognosis of this disease show more aggressive behaviors than ordinary papillary thyroid carcinoma. More aggressive treatment and close follow-up should be undertaken in the tall cell variant of papillary thyroid carcinoma.

True Aneurysm of the Common Digital Artery: Case Report (온 바닥 쪽 손가락 동맥에서 발생한 동맥류의 치험례)

  • Jang, Joon-Chul;Jeong, Seong-Ho;Han, Seung-Kyu;Kim, Woo-Kyung
    • Archives of Plastic Surgery
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    • v.38 no.3
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    • pp.315-318
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    • 2011
  • Purpose: An aneurysm is defined as a permanent, localized dilation of an artery with a 50% increase in diameter over its expected normal diameter. Aneurysms can be classified by cause as traumatic and nontraumatic. Traumatic aneurysms can be divided into true and false aneurysms. Nontraumatic causes of peripheral artery aneurysms include mycotic, atherosclerotic, inflammatory, and idiopathic. In the hand, true aneurysms occurring at the common digital artery have been rarely reported. We present a rare case of a true aneurysm of the common digital artery that was resected and reconstructed using a reversed vein graft. Methods: A 49-year-old male patient was refered to our institution with a $0.73{\times}0.44{\times}1.37cm$ sized pulsating mass between 2nd and 3rd flexor digitorum tendons on Lt. palm area. The mass had been present for 5 years and had increased in size over the previous year. No history of trauma was reported. After a physical examination and ultrasound sonography review, a diagnosis of aneurismal dilatation of common digital artery was made. Surgical treatment by excision of the aneurysm, and a reversed vein graft was performed. Results: Histologic examination of the specimen ($3.4{\times}0.7cm$) showed aneurismal dilatation, with elastin fibers present in the arterial wall. The lesions were healed without any complications and there were no evidence of recurrence. Doppler examination of the reconstruction showed good perfusion. Conclusion: Early excision is recommended to relieve symptoms and avoid neurologic damage. Also, artery reconstruction can be performed by primary end-to-end anastomosis or the placement of a reversed interposition vein graft. Micro surgical repair was the only possible treatment in this case. The authors believe that the vascular anatomy should always be restored as natural as possible.

Primary Splenic Paraganglioma in a Dog

  • An, Su-Jin;Moon, Jong-Hyun;Hwang, Tae-Sung;Lee, Hee-Chun;Yu, Do-Hyeon;Sur, Jung-Hyang;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.35 no.4
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    • pp.155-160
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    • 2018
  • A 6-year-old intact female Shih-tzu dog was referred due to anorexia. Physical examination, complete blood count, serum chemical analysis, radiography, and ultrasonography were evaluated. Physical examination and hematological analysis showed normal findings. Abdominal radiographs and ultrasound revealed well-defined masses in the spleen. Other abdominal organs showed no significant abnormalities. Tissue samples taken via sono-guided fine needle aspiration of the splenic mass showed many bare nuclei, which were variable in size. Results of histopathological and immunohistochemical (IHC) analyses performed after splenectomy were consistent with paraganglioma. Based on these findings, we diagnosed this patient with a paraganglioma of splenic origin. Two months after splenectomy, abdominal ultrasonography revealed a new neoplastic lesion in the liver. The clients refused further management and the patient expired three months after initial diagnosis. Necropsy as well as histopathological and IHC examinations of other systemic organs including the liver, adrenal gland, kidney, brain, urinary bladder, lung, aortic body, carotid body, and pancreas were performed. The neoplastic tissue in the liver also demonstrated features of a paraganglioma, and there were no remarkable findings in all other organs.

Rare Vascular Anomalies in the Femoral Triangle During Varicose Vein Surgery

  • Kim, Duk Sil;Kim, Sung Wan;Lee, Hyun Seok;Byun, Kyung Hwan;Choe, Michael SungPil
    • Journal of Chest Surgery
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    • v.50 no.2
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    • pp.99-104
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    • 2017
  • Background: We observed several cases of rare vascular anomalies within the femoral triangle during varicose vein operations. Methods: From among 2,093 patients who underwent stripping operations of the great saphenous vein between January 2002 and June 2016, 14 cases of rare vascular anomalies were enrolled in this study. Results: Twelve cases of femoral artery and vein transposition (0.57%), 1 case of separate entrance of the great saphenous vein trunk and its tributaries (0.05%), and 1 case of separate entrance with femoral artery and vein transposition (0.05%) were observed. The preoperative diagnosis rate was 71% (10 of 14) using duplex ultrasound. In all cases of femoral artery and vein transposition, the saphenofemoral junction was located at the lateral or posterolateral side of the superficial femoral artery, corresponding to complete or incomplete transposition, respectively. Among the 12 cases of femoral artery and vein transposition, 5 cases were complete transposition and 7 cases were incomplete transposition. In 2 cases of separate entrance of the great saphenous vein trunk and its tributaries, the separated tributaries formed a common trunk before connecting to the femoral vein. Conclusion: The anatomy of the saphenofemoral junction may infrequently be altered in some individuals. Detailed preoperative sonographic examinations and meticulous groin dissection during the operation are necessary to prepare for unexpected anatomical variations.

Brachytherapy of Uveal Melanomas with Ruthenium-106 Plaques

  • Belaid, Asma;Nasr, Chiraz;Jmour, Omar;Cherif, Aziz;Kochbati, Lotfi;Bouguila, Hedi;Besbes, Mounir;Benna, Farouk
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.12
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    • pp.5281-5285
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    • 2016
  • Background: Brachytherapy is the most commonly used conservative treatment for the uveal melanoma. The aim of this study was to evaluate therapeutic results of Ruthenium-106 plaque brachytherapy in the management of localized uveal melanoma cases. Methods: We reviewed retrospectively the clinical records of all patients treated in our department for an uveal melanoma, undergoing Ruthenium-106 plaque brachytherapy, from January 1996 to December 2015. We focused on clinical features, therapeutic characteristics, local and distant tumor control and side effects. Results: Nineteen patients were enrolled in our study. Mean age was 56.2 years (28-79) and the sex ratio was 1.37:1 males to females. Diagnosis was made on the basis of ophthalmological clinical examination, angiography, ultrasound and/or magnetic resonance. Median tumor diameter was 9.7 mm (6-13) and median thickness 4.4 mm (2.5-8). The dose of Ruthenium-106 plaque brachytherapy prescribed to the apex of each tumor was 70 Gy in all cases. The median radiation dose to the sclera surface was 226.4 Gy (range: 179.6-342.3) and the median total application time 115.2 hours (range: 27 to 237). After a median follow-up of 61.5 months, local control was achieved in 17 patients (89%): 16 demonstrated a partial tumor response and 1 tumor stabilization. Two patients suffered local progression leading to enucleation, one dying of hepatic metastasis. Radiation-induced complications were cataracts in 3 cases and vitreal hemorrhage in 2. Conclusion: Ruthenium-106 plaque brachytherapy is an efficient treatment for localized uveal melanoma, offering good local control with low toxicity.

Sonographic Pattern Recognition of Endometriomas Mimicking Ovarian Cancer

  • Saeng-Anan, Ubol;Pantasri, Tawiwan;Neeyalavira, Vithida;Tongsong, Theera
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5409-5413
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    • 2013
  • Background: To assess the accuracy of ultrasound in differentiating endometrioma from ovarian cancer and to describe pattern recognition for atypical endometriomas mimicking ovarian cancers. Materials and Methods: Patients scheduled for elective surgery for adnexal masses were sonographically evaluated for endometrioma within 24 hours of surgery. All examinations were performed by the same experienced sonographer, who had no any information of the patients, to differentiate between endometriomas and non-endometriomas using a simple rule (classic ground-glass appearance) and subjective impression (pattern recognition). The final diagnosis as a gold standard relied on either pathological or post-operative findings. Results: Of 638 patients available for analysis, 146 were proven to be endometriomas. Of them, the simple rule and subjective impression could sonographically detect endometriomas with sensitivities of 64.4% (94/146) and 89.7% (131/146), respectively. Of 52 endometriomas with false negative tests by the simple rule, 13 were predicted as benign masses and 39 were mistaken for malignancy. Solid masses and papillary projections were the most common forms mimicking ovarian cancer, consisting of 38.5% of the missed diagnoses. However, with pattern recognition (subjective impression), 32 from 39 cases mimicking ovarian cancer were correctly predicted for endometriomas. All endometriomas subjectively predicted for ovarian malignancy were associated with high vascularization in the solid masses. Conclusions: Pattern recognition of endometriomas by subjective assessment had a higher sensitivity than the simple rule in characterization of endometriomas. Most endometriomas mimicking ovarian malignancy could be correctly predicted by subjective impression based on familiarity of pattern recognition.

A Parametric Image Enhancement Technique for Contrast-Enhanced Ultrasonography (조영증강 의료 초음파 진단에서 파라미터 영상의 개선 기법)

  • Kim, Ho Joon;Gwak, Seong Hoon
    • KIPS Transactions on Software and Data Engineering
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    • v.3 no.6
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    • pp.231-236
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    • 2014
  • The transit time of contrast agents and the parameters of time-intensity curves in ultrasonography are important factors to diagnose various diseases of a digestive organ. We have implemented an automatic parametric imaging method to overcome the difficulty of the diagnosis by naked eyes. However, the micro-bubble noise and the respiratory motions may degrade the reliability of the parameter images. In this paper, we introduce an optimization technique based on MRF(Markov Random Field) model to enhance the quality of the parameter images, and present an image tracking algorithm to compensate the image distortion by respiratory motions. A method to extract the respiration periods from the ultrasound image sequence has been developed. We have implemented the ROI(Region of Interest) tracking algorithm using the dynamic weights and a momentum factor based on these periods. An energy function is defined for the Gibbs sampler of the image enhancement method. Through the experiments using the data to diagnose liver lesions, we have shown that the proposed method improves the quality of the parametric images.

Choledochocele containing a stone mistaken as a distal common bile duct stone (원위부 총담관 결석으로 오인된 결석을 동반한 총담관류 치료)

  • Kwak, Tae Young;Park, Chang Hwan;Eom, Seok Hyeon;Hwang, Hong Suk;Chung, Duk Won;Seo, Ji Young;Kim, Yeong Sung;Kwak, Dong Hyup
    • Journal of Yeungnam Medical Science
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    • v.32 no.1
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    • pp.60-64
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    • 2015
  • A choledochocele is an expanded sac of the duodenal side of the distal common bile duct (CBD), and is categorized as a type III choledochal cyst. Unlike other choledochal cysts, it can be easily overlooked because of its very low prevalence, non-specific clinical symptoms, and lack of distinctive radiological findings. However, a patient having a repeated pancreaticobiliary disorder with an unknown origin, frequent abdominal pain after cholecystectomy, or repeated non-specific gastrointestinal symptoms can be suspected as having a choledochocele, and a more accurate diagnosis can be achieved via endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound. Because it rarely becomes malignant, a choledochocele can be treated via endoscopic sphincterotomy (EST) and surgical treatment. The authors were able to diagnose choledochocele accompanied by a stone in a patient admitted to the authors' hospital due to cholangitis and pancreatitis. The patient's condition was suspected to have been caused by a distal CBD stone detected via multiple detector computed tomography and ERCP, and was successfully treated via EST.