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1.
Ayman M.A.M. Nada Rashad Hamdi Ahmed Shokry 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):1179-1186
Purpose
To evaluate the value of dual energy contrast enhanced (DECE) soft tissue digital mammography and ultrasound elastography (UE) in the detection of breast lesions and discrimination between benign and malignant ones.Patients and methods
32 female patients with breast lesions were prospectively evaluated at the female imaging unit of Diagnostic and Interventional Radiology Department of the National Cancer Institute, Cairo University. Routine sono-mammography was done for each patient then these patients were submitted to DECE soft tissue digital mammography as well as UE.The DECE digital mammography scans were held via GE Senographe 2000D “GE Healthcare; Chalfont St-Giles, UK” FFDM system with some specific software and hardware adaptations.The UE exams were held on ultrasound scanner with elastography unit and 7.5?Mhz linear array electronic probe (Hitachi digital, EUB- 7500; Hitachi medical, Tokyo, Japan).Results
This study showed that sensitivity and specificity of DECE soft tissue digital mammography and UE were 86.3%, 60% and 80.9%, 40% respectively.Conclusion
DECE soft tissue digital mammography demonstrated significant increase in the sensitivity without a loss in specificity. DECE soft tissue digital mammography is fast-reproducible imaging tool without operator dependency. DECE soft tissue digital mammography and UE are valuable tools to evaluate equivocal lesions. 相似文献2.
Aim of the work
To evaluate the value of real-time ultrasound elastography (RTE) in differentiating benign from malignant breast masses.Materials and methods
This study included, whether palpable or non-palpable, 145 sonographically proven breast masses in 121 patients, imaged by conventional B-mode US, color-flow Doppler US and RTE with histopathological analysis considered as the golden standard reference.Results
Lesions were differentiated into benign and malignant by conventional B-mode US (79; 45.5% and 66; 54.5%, respectively), RTE (80; 55.2% and 65; 44.8% respectively), and histopathology (82; 56.6% and 63; 43.4%, respectively). The mean difference in the mass size was significant between B-mode US and RTE in malignant masses (P = 0.002), while not significant among benign masses (P = 0.153). The B-mode US depicted sensitivity of 92.06%, specificity of 90.24%, PPV of 87.88%, NPV of 93.67% and accuracy of 91.03%, while the RTE showed sensitivity of 98.41%, specificity of 96.34%, PPV of 95.38%, NPV of 98.75% and accuracy of 97.24%.Conclusion
Combined use of RTE can complement conventional B-mode US with improving its diagnostic performance in differentiating breast lesions with subsequent reduction in the rate of unnecessary biopsies in benign lesions. 相似文献3.
Nesreen Mohey Tamir A. Hassan Said Abdel-Baki 《The Egyptian Journal of Radiology and Nuclear Medicine》2013
Background
Ultrasonographic (US) examination is an accurate method for detecting thyroid nodules, but its use in differentiating between benign and malignant thyroid nodules is relatively low. US elastography has been applied to study the hardness/elasticity of nodules to differentiate malignant from benign lesions thus deviating a significant group of patients from unnecessary FNAB.Objectives
The aim of the study is to evaluate the validity of combined grey scale US and tissue elastography in differentiating benign form malignant solid thyroid nodules.Methods
The study included 46 selected patients with solid thyroid nodules according to our inclusion and exclusion criteria. The patients underwent surgery for compressive symptoms or suspicion of malignancy on FNA cytology. US features and tissue elastography were scored according to the Rago criteria (1).Results
On US elastography: all the 31 cases with a final diagnosis of benign nodule had a score of 1–3, while 14 of 15 (94.1%) with a final diagnosis of carcinoma had a score of 4–5, with a sensitivity of 93.3%, a specificity of 100% and an accuracy of 97.8%. Combined US and elastography reveals that hypoechogenicity/score 4–5 was most predictive of malignancy with sensitivity 80% and specificity 100%; and accuracy 93.4%.Conclusions
US elastography seems to have great potential as a new tool for differentiating solid thyroid nodules and for recommending FNAC. Combined grey scale US features and US elastography added no significant value when compared with US elastography alone. Further prospective studies are needed. 相似文献4.
Maha Helal Manal F. Abu Samra Mohammed A. Ibraheem Asmaa Salama Ebtesam Esmail Hassan Nour El-Huda Hassan 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):741-750
Aim
Assess accuracy of contrast enhanced spectral mammography (CESM) versus conventional mammography and ultrasound in evaluation of BI-RADS 3 and 4 breast lesions with pathological correlation.Patients and methods
Thirty female patients with 35 breast lesions diagnosed by conventional imaging as BI-RADS 3 and 4, presented to Women’s Imaging Unit of Radiology Department between January and December 2015, age ranged from 23 to 70 years. All patients underwent conventional mammography and ultrasound then CESM.Results
Patients divided into two groups, benign and malignant lesions group according to histological analysis. Mammography results that malignant lesions detected in 18/35 (51.4%) while benign lesions 17/35 (48.6%). Ultrasound revealed 27/35 (77.1%) lesions were malignant and 8/35 (22.9%) lesions benign. But CESM, revealed 25/35 (71.4%) lesions were malignant & 10/35 (28.6%) lesions benign. Among 7 patients with multifocal/ multi-centric histologically proven malignant lesions, all detected by CESM 7/7 cases (100%) versus 2/7 cases (28.6%) and 6/7 cases (85.7%) detected by mammography and ultrasound respectively. Based on, CESM had 95.2% sensitivity and 82.9% diagnostic accuracy.Conclusion
CESM has better diagnostic accuracy than mammography alone and mammography plus ultrasound. CESM has 82.9% diagnostic accuracy in comparison to 51.4% for mammography and 77.1% for ultrasound. 相似文献5.
Vassiou K Kanavou T Vlychou M Poultsidi A Athanasiou E Arvanitis DL Fezoulidis IV 《European journal of radiology》2009,70(1):69-76
Objective
Evaluation of the diagnostic value of magnetic resonance mammography and comparison with conventional mammography and ultrasonography in cases of women with suspicious breast lesions.Subjects and methods
Sixty-nine women (age range 39–68 years) with 78 focal breast lesions were examined with mammography, ultrasonography and dynamic magnetic resonance mammography. The lesions were classified according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon of the American College of Radiology for each diagnostic method. Histological reports were available after biopsy or surgical excision of the lesions.Results
Pathological examination confirmed that 53 lesions were malignant and 25 benign. Conventional mammography estimated a total of 59/78 lesions as malignant with 44 true positive lesions, ultrasonography estimated a total of 50/78 lesions as malignant with 44 true positive lesions and magnetic resonance mammography estimated a total of 66/78 lesions as malignant with 52 true positive lesions. Sensitivity and specificity of magnetic resonance mammography in the diagnosis of malignancy was 98.1% and 44%, of conventional mammography 83% and 40% and of ultrasonography 83% and 76%. Negative predictive value for magnetic resonance mammography was 91.7%, for ultrasonography 67.9% and for mammography 52.6% for malignancies.Conclusion
Magnetic resonance mammography has the highest negative predictive value compared with mammography and ultrasound in cases of suspicious breast lesions. The combination of morphologic and enhancement criteria can improve the diagnostic capability of magnetic resonance mammography (MRM) in breast lesion characterization. 相似文献6.
D'Onofrio M Barbi E Dietrich CF Kitano M Numata K Sofuni A Principe F Gallotti A Zamboni GA Mucelli RP 《European journal of radiology》2012,81(4):630-638
Aim
To describe the typical CEUS pattern of pancreatic lesions and to evaluate the diagnostic accuracy of Contrast-enhanced ultrasound (CEUS) in their characterization.Materials and methods
All US and CEUS examinations of focal pancreatic masses performed in six centers during a period of five years were reviewed. Inclusion criteria were: focal pancreatic mass pathologically proved, visible at ultrasound (US) and studied with CEUS. All lesions were then evaluated for size, aspect and enhancement pattern. Sensitivity, specificity, positive and negative predictive values with 95% CIs were calculated to define diagnostic accuracy of CEUS in respect to pathology. Diagnostic confidence of US and CEUS, discerning between benign and malignant lesions, were represented by using ROC (receiver operating characteristics) curves. Agreement was evaluated by means of k statistics.Results
1439 pancreatic lesions were included. At CEUS the lesions were divided into solid (89%) and cystic (12%) masses and classified into six and eight categories, respectively. Among the solid lesions, adenocarcinomas were characterized with an accuracy of 87.8%. Among the cystic lesions, cystic tumors were diagnosed with an accuracy of 97.1%. ROC curve area increased from 0.637 for US to 0.877 for CEUS (p < 0.0001). Inter-observer agreement was slightly higher for solid (k = 0.78) than cystic (k = 0.62) lesions. In none of the centers side effects were reported.Conclusion
CEUS is accurate in the characterization of pancreatic lesions. CEUS should be considered as a complementary imaging method for pancreatic lesions characterization. 相似文献7.
Mohamed H. Zahran Mohamed M. El-Shafei Doaa M. Emara Samar M. Eshiba 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(1):249-258
Introduction
Elastography is considered a non-invasive imaging modality which determines the tumors according to their stiffness. Strain images representing the stiffness of the lesions compared to that of the surrounding normal tissue.Purpose
To prospectively evaluate the sensitivity and specificity of the real-time sonoelastography together with B-mode US for distinguishing benign from malignant breast lesions.Methods
The study was conducted on 80 patients, each patient was subjected to complete history taking, thorough clinical examination. All patients had conventional US and elastography using Hitachi 7.5?MHz linear probe (Hitachi hi vision avirus ultrasound), while only in 68 patients mammography was done.Results
Among the 80 patients, sensitivity and specificity of the elastography test of breast lesions according to the elastography score were 80% and 80.95% respectively, while sensitivity and specificity of conventional B mode US were 80% and 76% respectively and the combined B mode US and US elastography showed higher sensitivity and specificity of 86.6% and 90.4% respectively.Conclusion
Elastography is a non-invasive imaging technique which is done in the same session of ultrasound in an attempt to increase and improve the accuracy of diagnostic efficiency of ultrasound. 相似文献8.
Objective
To assess the diagnostic accuracy of dual-energy contrast-enhanced digital mammography (CEDM) as an adjunct to mammography (MX) vs. MX alone and vs. mammography plus ultrasound (US) in dense breasts.Materials and methods
60 women with suspected findings on MX and/or US underwent CEDM. A pair of low- and high-energy images was acquired using a modified full-field digital mammography system. Exposures were taken in MLO at 2 min and in CC at 4 min after the injection of 1.5 ml/kg of an iodinated contrast agent. Sensitivity, specificity, and area under the ROC curve were estimated.Results
The results from pathology identified 16 benign and 44 malignant cases. Areas under the ROC curves were significantly superior for MX + CEDM than it was for MX alone using BI-RADS. Sensitivity was higher for MX + CEDM than it was for MX (97.7% vs. 93.2%) with no loss in specificity. The lesion size was closer to the histological size for CEDM. All 12 histologically proven multifocal lesions were correctly detected by MX + CEDM vs. 6 and 8 lesions by MX and US respectively.Conclusion
Initial clinical results show that CEDM has better diagnostic accuracy than mammography alone and mammography + ultrasound especially in dense breasts. 相似文献9.
Jing Du Lin Wang Cai-Feng Wan Jia Hua Hua Fang Jie Chen Feng-Hua Li 《European journal of radiology》2012
Objective
To prospectively evaluate the diagnostic efficacy of conventional ultrasound (US), contrast-enhanced US (CEUS), the combined use of two modalities, and magnetic resonance imaging (MRI) in the differentiation of focal solid breast lesions.Materials and methods
61 patients with BI-RADS category 3–5 breast lesions detected at conventional US underwent CEUS and MRI. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of conventional US, CEUS, combination of two modalities and MRI for discrimination between benign and malignant breast lesions.Results
Tissue specimens of 61 breast lesions were obtained either from surgical resection (n = 46) or from needle biopsy (n = 15). Histopathologic diagnosis revealed 28 benign and 33 malignant lesions. The diagnostic performance of conventional US and CEUS in differentiating benign from malignant breast lesions showed no significant difference (P = 0.741). The combination of two modalities significantly improved the diagnostic accuracy compared with either conventional US or CEUS alone (P = 0.031 and P = 0.012, respectively). The area under the ROC curve (Az) value for the combined use of two modalities for discrimination between benign and malignant breast lesions was 0.94, and that for MRI was 0.91, whereas no statistical difference was found between them (P = 0.296).Conclusion
The combined use of conventional US and CEUS has a better diagnostic performance than either method alone and displays good agreement with MRI in the differentiation capability for benign and malignant breast lesions. 相似文献10.
Introduction
Elastography is a non-invasive medical imaging technique that detects tumors based on their stiffness (elasticity). Strain images display the relative stiffness of lesions compared with the stiffness of surrounding tissue as cancerous tumors tend to be many times stiffer than the normal tissue, which “gives” under compression. An image in which different degrees of stiffness show as different shades of light and dark is called an elastogram.Purpose
To prospectively evaluate the sensitivity and specificity of the real-time sonoelastography as compared with B-mode US for distinguishing between benign and malignant solid breast masses. The density of the glandular breast tissue was taken in consideration in addition to the Breast Imaging Reporting and Data System (BI-RADS) categories of the lesions, with biopsy results as the reference standard.Methods
A total of 216 candidate solid lesions (123 benign and 93 malignant) in 188 patients were examined with 2-dimensional ultrasonography, elastosonography and mammography (for 147 patients). The lesions were classified according to the density of the glandular breast tissue into low density group (D1) and a high density group (D2) and were categorized with the BIRADS score. Elastographic images were assigned an elasticity score of 1 to 5 (1–3, benign; 4 and 5, malignant) according to the Multi-Center Team of Study and the strain ratios of the lesions were measured. Concordance between the imaging findings and histopathologic results was documented. Statistical analysis was performed and sensitivity, specificity and positive and negative predictive values for both elastography and conventional sonography were calculated.Results
Elastography showed less sensitivity but higher specificity than conventional sonography in the differentiation of benign from malignant solid lesions: B-mode sonography had sensitivity of 85.1%, specificity of 93.9%, a positive predictive value of 92.5% and a negative predictive value of 87.8%, compared with the sensitivity of 80.1%, specificity of 97.1%, a positive predictive value of 96.8% and a negative predictive value of 82.1% for elastography. Elastography was superior to B-mode US in diagnosing solid lesions in the low density group (D1) (96.6% vs. 92.4% specificity) and less in the dense glandular tissue (97.8% vs. 95.9% specificity).Conclusions
Real-time sonoelastography is an useful technique for the characterization of benign and malignant solid lesions as it increases the diagnostic specificity comparable to B-mode ultrasound, particularly in both ACR 1 and 2, thus reducing the false-positive rate. 相似文献11.
Aim of the work
To study the diagnostic utility of real-time ultrasound elastography (USE) in predicting malignancy in thyroid nodules.Materials and methods
Forty-five patients with solitary solid thyroid nodules were included in this study. The thyroid nodules were examined by B-mode ultrasound, color flow Doppler ultrasound, and real-time ultrasound elastography (USE). The final diagnosis was obtained from histopathological findings. Tissue stiffness on USE was scored from 1 (low stiffness over the entire nodule) to 6 (high stiffness over the entire nodule and surrounding tissue).Results
Twenty-eight (62.2%) patients had a final diagnosis of malignancy based on histopathological evidence of malignant thyroid nodules, while 17 (37.8%) were diagnosed as benign nodules. Anteroposterior/transverse (AP/T) diameter more than 1 cm, ill-defined margins and spot micro calcifications were the most predictive conventional ultrasound patterns of malignancy. Elasticity score of 4–6 was highly predictive of malignancy (P < 0.0001), with a sensitivity of 89.3%, a specificity of 88.2% and an accuracy of 88.9%.Conclusion
Ultrasound elastography is an accurate non invasive tool for evaluating thyroid nodules. It has more appropriate value in the differential diagnosis of thyroid malignancy and enhances the diagnostic assurance of ultrasonographers. 相似文献12.
Objective
To assess the diagnostic value of high-frequency (MicroPure) ultrasound in evaluating suspicious microcalcifications and to determine its capability in biopsy guidance.Subjects and methods
Sixty-two cases with suspicious microcalcifications detected on mammographic examination had been re-evaluated by MicroPure US. The studied cases underwent true cut tissue/surgical excision biopsy. Histopathology revealed 25 benign and 37 malignant lesions and was considered the gold standard of reference.Results
Malignant microcalcifications were easier to be visible at MicroPure US, as they were detected in 86.5% (n = 32/39) compared to only 68% (n = 17/25) of the benign lesions. US depicted more breast masses associated with malignant microcalcifications in 78% (n = 29/37) than those associated with benign ones seen in 36% (n = 9/25).Visibility of suspicious microcalcifications at US was aided by preliminary mammogram. Given known mammography location of these microcalcifications had made their visualization accessible by MicroPure US in 79% (n = 49) of the cases.Conclusion
MicroPure ultrasound cannot discriminate benign from malignant breast microcalcifications. MicroPure can be useful in detecting clustered microcalcifications that are not accessible by B-mode ultrasound; provided knowledge of their mammographic location and thus can provide better guidance for pre-surgical wire localization and ultrasound-guided biopsies. 相似文献13.
Mona A. EL-Hariri Tamer F. Taha Ali Mohamed A. Tawab Asmaa M.A. Magid Abdel-Fattah EL-Shiekh 《The Egyptian Journal of Radiology and Nuclear Medicine》2014
Objective
This study aims to evaluate the clinical value of ultrasound elastography (USE) in providing information on the nature of the thyroid nodules. This was performed using the elastography score and strain ratio in differentiating thyroid benign and malignant nodules and the histopathological examination was used as the diagnostic standard of reference.Methods
We examined 84 thyroid nodules in 62 patients with ultrasound elastography. Elastography score was assigned based on a four-point scale according to the classification proposed by Itoh et al. with a score of 1 (low stiffness over the entire nodule) to a score of 4 (high stiffness over the entire nodule). Thyroid strain ratio (normal tissue to lesion strain ratio) was calculated. Histopathological results were the standard reference. The area under the curve (AUC) and the best cut-off point were both obtained using receiver-operating characteristic (ROC) curve analysis. The sensitivity, specificity, and accuracy of both techniques were calculated.Results
Fifty-four of the 84 nodules had scores of 1 and 2, and 50 of these nodules were diagnosed histopathologically as benign. Thirty of the 84 nodules had a score of 3 and 4, and 21 of these nodules were diagnosed histopathologically as malignant. The scores of 1 and 2 with Itoh criteria were significantly seen in benign nodules, whereas, scores of 3 and 4 were significantly seen in malignant nodules (p < 0.05) with sensitivity 84%, specificity 84.7%, PPV 70%, NPV 92.6% and accuracy 84.5%. The mean SR for the benign nodules and malignant ones was significantly different (2.92 ± 0.96 vs. 4.53 ± 0.82, p < 0.001). With ROC analysis, the best cut-off strain ratio point was 3.5 for differentiating benign and malignant nodules with area under the curve (AUC) = 0.87 (0.8–0.95). The sensitivity of the strain ratio was 88%, while the specificity was 86.4%, PPV = 73.3%, NPV = 94.4% and accuracy = 86.9%.Conclusions
Both the elastographic score and strain ratio are higher in malignant nodules than those in benign ones. Ultrasound elastography can provide quantitative information on thyroid nodule helping in differentiating benign and malignant ones. 相似文献14.
Aim
To evaluate the diagnostic performance of the combined use of elstosonography (USE) scoring and high-resolution ultrasonography (HRUS) for the differentiation of benign and malignant thyroid nodule.Patients and methods
Forty-seven consecutive patients with 66 thyroid nodules were enrolled in the present study. Thyroid surgery had been already planned for all the patients. All of them were submitted to high-resolution ultrasonography and elastography scoring at the same sitting. The latter was determined with 5-point scoring method. The examination results were compared against pathological findings as the gold standard of reference.Results
The sensitivity, specificity, accuracy, positive predictive, and negative predictive values of HRUS in the differential diagnosis of thyroid nodules were 92.0%, 72.9%, 60.1%, 95.0%, and 63.1%, respectively, while that of ultrasound elastography scoring were 75.4%, 85.5%, 86.7%, 71.4%, and 90.5%, respectively. Combined use of both US techniques resulted in a higher diagnostic performance as it showed 95.4%, 94.8%, 95.2%, 82.3% and 98.8% sensitivity, specificity, accuracy, positive predictive, and negative predictive values, respectively.Conclusions
The use of combined USE and HRS for the differentiation of benign and malignant thyroid nodules resulted in a high diagnostic performance and a significant statistical difference as compared to HRUS or USE alone (P = 0.003). 相似文献15.
Marwa Abd El-hamied Romeih Ahmed Ebraheem Ebeed Islam M. Sabry 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(2):553-563
Purpose
To assess the additional diagnostic value of share wave elastography in combination with B-mode ultrasound versus B-mode ultrasound alone in characterization of solid breast lesions.Patients and methods
prospective study included women with a single undiagnosed solid breast lesion, between May 2016 and May 2017. All patients underwent B-mode ultrasound and (SWE), and histopathology was performed on all lesions.Results
150 women included in this study. 87 breast lesions were malignant & 63 were benign. B-mode ultrasound was performed and the lesions were categorized according to the (BI-RADS). With a sensitivity of 89.7%, specificity of 76.2%, overall accuracy of 84%. Using SWE alone based on elasticity, speed and color pattern, the cut-off values were ≥46?kPa and ≥3.25?m/s. These values demonstrated a sensitivity of 96.6%, specificity of 90.47%, and overall accuracy of 94%. The color pattern had a better sensitivity of 96.8%, specificity of 92%, and overall accuracy of 94.5%.The combination of SWE and B-mode ultrasound results using logistic regression modeling improved diagnostic performance, with an overall accuracy of 96%.Conclusion
Combined B-mode ultrasound with shear-wave elastography will improve the overall diagnostic performance for the differentiation of benign and malignant breast lesions. 相似文献16.
R. Gruber S. Jaromi M. Rudas G. Pfarl C.C. Riedl D. Flöry O. Graf E.A. Sickles T.H. Helbich 《European journal of radiology》2013
Purpose
To determine the accuracy of a probably benign assessment of non-palpable breast lesions (BI-RADS category 3) at mammography and/or ultrasound with immediate histological work-up.Materials and methods
Stereotactic or ultrasound guided core needle breast biopsy (NBB) was performed to evaluate 288 lesions, which were prospectively assessed as BI-RADS category 3. Imaging findings included 195 masses, 73 calcification cases, 16 focal asymmetries, and four architectural distortion cases. After NBB, patients underwent either open surgical biopsy (OSB) (n = 204) or mammographic follow-up (n = 84) for at least 24 months. Histological results of NBB were compared with those of OSB.Results
Three of the 288 lesions (1.0%) proved to be malignant at histological work-up, two of them were ductal carcinoma in situ (DCIS) and one of them was an invasive carcinoma. NBB revealed invasive carcinoma in 1/288 (0.35%) and atypical ductal hyperplasia (ADH) in 13/288 (4.5%) lesions. OSB revealed DCIS in 2/204 (1%) and invasive carcinoma in 1/204 (0.5%) lesions. The two DCIS were underestimated as ADH by NBB. The remaining 285 (99%) lesions proved to be benign at OSB or remained stable during follow-up.Conclusion
Confirmed by tissue diagnosis, the low likelihood of malignancy of prospectively assessed probably benign lesions is below the 2% threshold established for BI-RADS category 3. Imaging follow-up is a safe and effective alternative to immediate histological work-up for such lesions. 相似文献17.
Shuzhen C 《European journal of radiology》2012,81(8):1806-1811
Objective
To compare the effectiveness of conventional ultrasonography and ultrasound elastography in differential diagnosis of thyroid nodular diseases.Methods
244 patients with 291 thyroid nodules were examined by ultrasonography and ultrasound elastography respectively; the examination results were compared against pathological findings to determine the effectiveness of these two examination methods.Results
The sensitivity and positive predictive value of conventional ultrasonography is higher than those of ultrasound elastography, but its specificity, accuracy, and negative predictive value is lower than those of the later.Conclusions
Ultrasound elastography is superior to conventional ultrasonography in differential diagnosis of thyroid nodules. However, ultrasonography is the basis of examination; only on this basis, an additional ultrasound elastography examination could greatly improve the diagnostic rate of thyroid nodular diseases. 相似文献18.
Noha Abdelshafy ElSaid Hebatallah Gamal Eldin Mohamed 《The Egyptian Journal of Radiology and Nuclear Medicine》2012
Background
Several clinical studies showed that sonoelastography was useful for the differentiation of benign and malignant breast lesions. Contrast-enhanced MRI has emerged as a promising tool in the detection, diagnosis, and staging of breast cancer.Aim of work
To study the role of sonoelastography versus dynamic MRI in evaluating BI-RADS III, IV breast masses and detect which modality is of better sensitivity and specificity trying to guide the patient either to follow-up the lesion or proceed to lesion excision.Subjects and methods
The study included 50 Egyptian patients (age ranged from 32 to 58 years) who presented by breast masses and categorized as BI-RADS III, IV by mammography and ultrasound. Sonoelastography and dynamic MRI were done for all the patients.Results
Differentiation between BI-RADS III and IV by US elastography had 84% sensitivity and 84% specificity and by MRI had 88% sensitivity and 80% specificity.Conclusion
Regarding the sonoelastography, it is an easy and cheap modality. The elasticity score is an important parameter for lesion characterization. Combination of morphologic and dynamic MRI studies is very important for the breast lesion evaluation. MRI is more sensitive but less specific than sonoelastography. Finally if we find any suspicious character elicited by either sonoelastography or MRI (BI-RADS IV), lesion excision is recommended. 相似文献19.
Zhihui Fan Ying Li Kun Yan Wei Wu Shanshan Yin Wei Yang Baocai Xing Xiaoting Li Xiaopeng Zhang 《European journal of radiology》2013
Objective
To explore the diagnostic value of contrast-enhanced ultrasound (CEUS) by comparison with conventional ultrasound (US) and contrast-enhanced CT (CECT) in solid pancreatic lesions.Method
Ninety patients with solid pancreatic focal lesions were enrolled, including 36 cases of pancreatic carcinoma, 28 cases of pancreatitis, 6 cases of pancreatic neuroendocrine tumor, 12 cases of solid pseudopapillary tumor of the pancreas, 6 cases of pancreatic metastases, 1 case of cavernous hemolymphangioma and 1 case of lymphoma. US and CEUS were applied respectively for the diagnosis of a total of 90 cases of solid pancreatic lesions. The diagnostic results were scored on a 5-point scale. Results of CEUS were compared with CECT.Results
(1) 3-score cases (undetermined) diagnosed by CEUS were obviously fewer than that of US, while the number of 1-score (definitely benign) and 5-score (definitely malignant) cases diagnosed by CEUS was significantly more than that of US. There was a significant difference in the distribution of final scores using the two methods (p < 0.001). The overall diagnostic accuracies of the 90 cases for CEUS and US were 83.33% and 44.44%, respectively, which indicated an obvious advantage for CEUS (p < 0.001). (2) The diagnostic consistency among three ultrasound doctors: the kappa values calculated for US were 0.537, 0.444 and 0.525, compared with 0.748, 0.645 and 0.795 for CEUS. The interobserver agreement for CEUS was higher than that for US. (3) The sensitivity, specificity and accuracy of the diagnosis of pancreatic carcinoma with CEUS and CECT were 91.7% and 97.2%, 87.0% and 88.9%, and 88.9% and 92.2%, respectively, while for the diagnosis of pancreatitis, the corresponding indices were 82.1% and 67.9%, 91.9% and 100%, and 88.9% and 90%, respectively, showing no significant differences (p > 0.05).Conclusion
CEUS has obvious superiority over conventional US in the general diagnostic accuracy of solid pancreatic lesions and in the diagnostic consistency among doctors. The performances of CEUS are similar to that of CECT in the diagnosis of pancreatic carcinoma and focal pancreatitis. 相似文献20.
Victor Ianculescu Laura Maria Ciolovan Ariane Dunant Philippe Vielh Chafika Mazouni Suzette Delaloge Clarisse Dromain Alexandru Blidaru Corinne Balleyguier 《European journal of radiology》2014