scholarly journals Is Contrast-Enhanced Ultrasound Superior to Computed Tomography for Differential Diagnosis of Gallbladder Polyps? A Cross-Sectional Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Zhiqing Yuan ◽  
Xuesong Liu ◽  
Qiwei Li ◽  
Yunhe Zhang ◽  
Ling Zhao ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Perfusion Defect ◽  
Diagnostic Methods ◽  
Maximum Diameter ◽  
Clinical Value ◽  
Diagnostic Efficacy ◽  
Cross Sectional ◽  
Gallbladder Polyps ◽  
Contrast Enhanced

ObjectiveTo compare the clinical value of contrast-enhanced ultrasonography (CEUS) versus computed tomography (CT) for distinguishing neoplastic and non-neoplastic gallbladder polyps. Given whether laparoscopic cholecystectomy is needed, differential diagnosis of neoplastic and non-neoplastic gallbladder polyps is more important than benign and malignant polyps.MethodsA total of 89 consecutive patients with polypoid lesions of the gallbladder > 10 mm in size without local invasion or distant metastasis during primary screening were enrolled in this prospective and comparative study. All patients who met the inclusion criteria underwent CEUS and CT examinations prior to surgical resection. The enhancement patterns and microvascular imaging types were analyzed on CEUS. The maximum diameter and CT value of the lesions were also recorded and subjected to a comparative analysis. The clinical value of the two diagnostic methods is compared.ResultsOf the 89 patients, there were 58 (65.2%) cases of non-neoplastic polyps and 31 (34.8%) cases of neoplastic polyps. The average diameter of neoplastic polyps was significantly higher than that of non-neoplastic polyps (P<0.001). The detection rate using CEUS was 100%. The proportion of perceived non-neoplastic polyps in the nonenhanced and arterial phases were 48.3% and 77.6%, respectively, which were significantly lower than those of neoplastic polyps (93.5%, P<0.001 and 100.0%, P<0.001, respectively). However, in the venous and delayed phases, all cholesterol polyps and neoplastic polyps were perceived. CT showed that non-neoplastic polyps exhibited delayed enhancement. On CEUS 29.0% neoplastic polyps showed a perfusion defect, whereas 6.9% non-neoplastic polyps showed a perfusion defect (P=0.005). The microvascular architecture of the lesions on CEUS was categorized into 4 types: spotty, linear, branched, and spinous, and there were significant differences between the two groups (P<0.001). The sensitivities and specificities were 87.10% and 68.97% for CEUS and 83.87% and 77.59% for CT, respectively (P=0.406).ConclusionsCEUS and CT are useful for differential diagnosis of neoplastic and nonneoplastic polypoid lesions of the gallbladder. Diagnostic efficacy was comparable between CEUS and CT. Thus, CEUS is preferred over CT in the differential diagnosis of neoplastic and non-neoplastic gallbladder polyps due to its comparable diagnostic efficacy and lack of radiation dose.

scholarly journals Imaging of the adrenal gland lesions

2014 ◽  
Vol 47 (4) ◽  
pp. 228-239 ◽  
Author(s):  
Keith Herr ◽  
Valdair F. Muglia ◽  
Walter José Koff ◽  
Antonio Carlos Westphalen
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Adrenal Gland ◽  
Photon Emission ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Contrast Enhanced ◽  
Cross Sectional Imaging ◽  
Contrast Enhanced Ultrasonography ◽  
Photon Emission Tomography

With the steep increase in the use of cross-sectional imaging in recent years, the incidentally detected adrenal lesion, or "incidentaloma", has become an increasingly common diagnostic problem for the radiologist, and a need for an approach to classifying these lesions as benign, malignant or indeterminate with imaging has spurred an explosion of research. While most incidentalomas represent benign disease, typically an adenoma, the possibility of malignant involvement of the adrenal gland necessitates a reliance on imaging to inform management decisions. In this article, we review the literature on adrenal gland imaging, with particular emphasis on computed tomography, magnetic resonance imaging, and photon-emission tomography, and discuss how these findings relate to clinical practice. Emerging technologies, such as contrast-enhanced ultrasonography, dual-energy computed tomography, and magnetic resonance spectroscopic imaging will also be briefly addressed.

scholarly journals Assessment Of Third Ventricular Parameters in Computed Tomography of Head: A Pilot Study in Tertiary Level Hospital

2020 ◽  
Vol 42 (3) ◽  
pp. 82-86
Author(s):  
Umesh P Khanal ◽  
Keshav Sah ◽  
Ram B Chand
Keyword(s):  
Computed Tomography ◽  
Third Ventricle ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Cross Sectional ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Upper Limits ◽  
Gender And Age ◽  
Enhanced Ct

Introduction Measurement of ventricles of the brain is important for evaluating changes due to growth, ageing, intrinsic and extrinsic pathologies. The aim of this study was to determine the various parameters of the third ventricle and to assess their association with gender and age using computed tomography (CT) scans of head. MethodsThis retrospective, quantitative, cross sectional study was performed in the Department of Radiology and Imaging, Tribhuvan University Teaching Hospital from July to October 2019 (4 months) on images of 100 patients (50 males and 50 females) whose age group were 18-87 years, who underwent non-contrast and contrast enhanced CT scan of head. ResultsThe total mean of width of third ventricle was found to be 0.33±0.09 cm, 0.35±0.10 cm in male and 0.31±0.06 cm in female. Third ventricle width (TVW) showed statistically significant correlation with male and also with Age. Mean of third ventricle sylvian fissure distance index was 0.41±0.67 cm, 0.42±0.65 cm in male and 0.39±0.06 cm in female respectively. Mean of third ventricle ratio was 0.03±0.09 cm, 0.03±0.09 cm in male and 0.02±0.09 in female respectively. The value were slightly higher in male. ConclusionThe third ventricle width in CT in this study was 0.33±0.09 cm. CT was very useful to determine the upper limits of normal value and its variation with age.

scholarly journals Ultrasonic elastography and conventional ultrasound in the diagnosis of thyroid micro-nodules

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Jinming Wang ◽  
Wenbing Wei ◽  
Rui Guo
Keyword(s):  
Differential Diagnosis ◽  
Roc Curve ◽  
Thyroid Nodules ◽  
Ultrasound Elastography ◽  
Surgical Pathology ◽  
Maximum Diameter ◽  
Clinical Value ◽  
Conventional Ultrasound ◽  
Missed Diagnosis ◽  
The Difference

Objective: To investigate the clinical value of conventional ultrasound, ultrasound elastography and conventional ultrasound combined with ultrasound elastography in differential diagnosis of benign and malignant thyroid micro-nodules. Methods: Eighty-six patients who were found with thyroid micro-nodules with the maximum diameter no more than 10 mm in the physical examination in our hospital from June 2015 to December 2017 were selected, and 102 nodules were included. All patients were confirmed with thyroid micro-nodules by puncture or surgical pathology and underwent conventional ultrasound and ultrasound elastography. Taking the surgical pathological results as a control, the value of conventional ultrasound, ultrasound elastography and conventional ultrasound combined with ultrasound elastography in differential diagnosis of benign and malignant thyroid micro-nodules were compared. A receiver operating characteristic (ROC) curve was drawn, and the area under the ROC curve was calculated. Results: One hundred and two thyroid nodules were detected by surgical pathology, including 75 benign nodules (73.53%) and 27 malignant nodules (26.47%). The sensitivity and diagnostic accordance rate of ultrasound elastography were significantly higher than those of conventional ultrasound in the diagnosis of thyroid microcarcinoma, and the missed diagnosis rate of ultrasound elastography was significantly lower than that of conventional ultrasound; the difference was statistically significant (P<0.05). However, the difference between the two methods was not statistically significant in terms of diagnostic specificity and misdiagnosis rate (P>0.05). The areas under the ROC curve in the diagnosis of benign and malignant thyroid nodules by conventional ultrasound and ultrasound elastography were 0.735 and 0.743 respectively. Conclusion: Conventional ultrasound can be used as a routine examination technique in differential diagnosis of benign and malignant thyroid nodules, while ultrasound elastography can improve the sensitivity and diagnostic rate in the diagnosis of thyroid micro carcinoma. It can help to reduce the clinical missed diagnosis, which also can be be used as an effective supplement for conventional ultrasound. doi: https://doi.org/10.12669/pjms.35.6.777 How to cite this:Wang J, Wei W, Guo R. Ultrasonic elastography and conventional ultrasound in the diagnosis of thyroid micro-nodules. Pak J Med Sci. 2019;35(6):1526-1531. doi: https://doi.org/10.12669/pjms.35.6.777 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Diagnostic algorithm of solid kidney lesions with contrast-enhanced ultrasound

2021 ◽  
Vol 12 (1) ◽  
pp. 14-23
Author(s):  
R. A. Kadyrleev ◽  
E. A. Busko ◽  
E. V. Kostromina ◽  
L. N. Shevkunov ◽  
K. V. Kozubova ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
High Efficiency ◽  
Diagnostic Algorithm ◽  
Diagnostic Methods ◽  
Contrast Enhanced Ultrasound ◽  
Kidney Tumors ◽  
Mri Contrast ◽  
Contrast Enhanced ◽  
Kidney Lesions

Most often any kidney lesions are primary renal, but sometimes they can be secondary (metastases, lymphoma). Every year renal cell carcinoma tends to a significant increase in the incidence. Today there are many available methods of examination, however difficulties often remain in the differential diagnosis of kidney lesions. The article discusses about the modern possibilities of methods in the identification and assessment of kidney lesions, their role in determining the tactics of patient management and key approaches in imaging characterization of these masses using CT and PET, MRI and CEUS. The analysis of the modern literature has shown that the currently existing radiation diagnostic methods do not provide an absolute opportunity for differential diagnosis of rare kidney tumors. CEUS, according to various authors, demonstrates high efficiency indicators, but does not exceed these indicators in comparison with CT and MRI. Contrast-enhanced ultrasound is a potentially safe method and can be used as a method for additional examination to characterize indeterminate renal lesions.

scholarly journals Efficacy of contrast-enhanced ultrasonography and shear-wave elastography in conjunction with BI-RADS classification for diagnosis of small breast nodules

2020 ◽  
Author(s):  
Yan Shen ◽  
Jie He ◽  
Miao Liu ◽  
Jiaojiao Hu ◽  
Yonglin Wan ◽  
...  
Keyword(s):  
Shear Wave ◽  
Shear Wave Elastography ◽  
Receiver Operating Curve ◽  
Maximum Diameter ◽  
Diagnostic Efficacy ◽  
Predictive Values ◽  
Small Breast ◽  
Contrast Enhanced ◽  
Receiver Operating

Abstract Background: Identification of malignancy in small breast nodules can be difficult using conventional methods, especially in patients with dense breast tissue. Advanced imaging techniques, including contrast-enhanced ultrasound (CEUS) and shear-wave elastography (SWE), could be used in conjunction with Breast Imaging Reporting and Data System (BI-RADS) classification to characterize these nodules more effectively. This study aimed to evaluate the use of CEUS and SWE for the differentiation of benign and malignant small breast nodules (maximum diameter ≤ 2 cm).Methods: This retrospective study reviewed the imaging data of 302 patients who underwent evaluation for 305 small breast nodules from November 2015 to December 2019. BI-RADS classification of nodules and the results of CEUS and SWE were retrospectively analyzed; the diagnostic efficacy of these techniques was evaluated by comparison with pathology results. Receiver operating characteristic curves were analyzed based on the CEUS patterns and shear-wave velocity values of nodules. The sensitivities, specificities, positive and negative predictive values, and accuracies of BI-RADS, CEUS, SWE, and a combination of all three methods for identifying benign versus malignant small breast nodules were investigated.Results: CEUS was effective in diagnosing malignant nodules when at least two of the nine suspicious features were present. Receiver operating curve analysis revealed that the best cut-off value for SWE was 3.7 m/s. For the diagnosis of benign breast nodules, the BI-RADS classification was reduced by one level when both CEUS and SWE data were used, and was unchanged when CEUS or SWE alone was used; the highest and lowest levels were category 5 and 3, respectively. Furthermore, when using the combined method, 75.8% (91/120) of small breast nodules with a BI-RADS category 4A did not need coarse needle biopsies.Conclusion: Both CEUS and SWE can be used as auxiliary methods for clarifying BI-RADS classification of breast nodules, and a combination of these techniques may provide improved diagnostic efficacy for identifying malignancy in small breast nodules.

Differential diagnosis of central lymphoma and high-grade glioma: dynamic contrast-enhanced histogram

2020 ◽  
Vol 61 (9) ◽  
pp. 1221-1227
Author(s):  
Han-wen Zhang ◽  
Gui-wen Lyu ◽  
Wen-jie He ◽  
Yi Lei ◽  
Fan Lin ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Histogram Analysis ◽  
High Grade ◽  
Diagnostic Efficiency ◽  
Roc Curve Analysis ◽  
Diagnostic Efficacy ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced ◽  
Significant Difference

Background In clinical diagnosis, some central nervous system lymphomas (CNSL) are difficult to distinguish from high-grade gliomas (HGG). Purpose To evaluate the diagnostic efficacy of the histogram analysis of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in the identification of CNSL and HGG. Material and Methods In all, 43 patients diagnosed with HGG (n = 28) and CNSL (n = 15) by histopathology underwent DCE-MRI scanning. Differences in histogram parameters based on DCE-MRI between HGG and CNSL were analyzed by Mann–Whitney U test. In addition, receiver operating characteristic (ROC) analysis was performed. Short-term follow-up of patients was performed using Kaplan–Meier analysis to explore the survival rates of HGG and CNSL. Results For the ROC curve analysis, we demonstrate that the 10th percentile of Ktrans (area under the curve [AUC] = 0.912, sensitivity = 86.7%, specificity = 92.9%), Kep (AUC = 0.940, sensitivity = 93.3%, specificity = 79.6%), Ve (AUC = 0.907, sensitivity = 86.7%, specificity = 89.3%), and AUC (AUC = 0.904, sensitivity = 86.7%, specificity = 92.9%) were significantly different between the CNSL and HGG groups ( P < 0.001), with high diagnostic efficiency. Table 2 shows that the histogram features based on AUC maps (10th, 25th, median, 75th, 90th, and mean) were always significantly higher in the CNSL group than in the HGG group ( P < 0.001). There was no significant difference in Vp or in the 75th, 90th and mean of Ktrans, Kep, and Ve between the CNSL and HGG groups ( P > 0.05). Conclusion A histogram analysis of DCE-MRI identified significant differences between HGG and CNSL, and this will help in the clinical differential diagnosis of these conditions.

Sign in / Sign up

Export Citation Format

Share Document