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Pedro H.M. Moraes Marcelo Straus Takahashi Felipe A.B. Vanderlei Marcelo V. Schelini Danielle A. Chacon Marcos Roberto Tavares Maria Cristina Chammas 《Ultrasound in medicine & biology》2021,47(5):1219-1226
The purpose of this study was to select thyroid nodules most at risk for malignancy among those cytologically undetermined by fine-needle aspiration biopsy (FNAB), using B-mode, color duplex Doppler and 2-D shear wave shear wave elastography (2-D-SWE). This was a prospective diagnostic accuracy study with 62 Bethesda III/IV nodules according to FNAB (atypia/follicular lesion of undetermined significance or follicular neoplasia/Hürthle cell neoplasm). Ultrasonography (US) data were compared with resection histologic results, revealing 35 of 62 benign nodules (56.4%) and 27 of 62 carcinomas (43.6%). Conventional US was uses to evaluate nodule echogenicity, dimensions, contours, presence of halo and microcalcifications. Doppler US was used to assess the vascularization (exclusively or predominantly peripheral or central) and mean resistance index of three nodule arteries. Elastography was used to evaluate the nodule elastographic pattern; mean nodule deformation index; deformation ratio between nodule and adjacent thyroid parenchyma; and mean deformation ratio between nodule and pre-thyroid musculature (MDR). Statistical analysis included χ2, Fisher's exact, Student's t, Mann–Whitney tests and multivariable analysis by multiple logistic regression. Areas under the receiver operating characteristic curves (AUC-ROCs) were used for accuracy analysis. Fifty-eight participants (54.7 ± 14.0 y, 51 women) were studied. The parameters that were statistically significant to the univariate analysis were hypo-echogenicity, nodule diameter greater than width and all parameters analyzed from Doppler and elastography. Multivariate analysis revealed that the MDR (in kPa) was the best parameter for risk analysis of indeterminate nodules. Nodules with MDRs >1.53 exhibited a greater chance of malignancy (AUC-ROC = 0.98). We conclude that 2-D-SWE is able to select malignant nodules among those cytologically indeterminate, thus avoiding unnecessary surgery in these cytologic groups. 相似文献
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Fred Bernardes Filho Danielle Cristine Bonatto Gustavo Martins Leonardo de Medeiros Maier José Augusto da Costa Nery Luna Azulay-Abulafia 《Anais brasileiros de dermatologia》2014,89(5):848-850
American cutaneous leishmaniasis is in full geographic expansion in Brazil and it is
considered among the infectious and parasitic diseases of utmost importance
worldwide, not only by its frequency, but mainly by therapeutic difficulties,
deformities and sequelae that may result. In the state of Rio de Janeiro, the first
autochthonous case of American cutaneous leishmaniasis was registered by Rabello in
1913. The authors report two cases of the disease in the region around the Cemetery
São Francisco Xavier, in the Caju neighborhood, Rio de Janeiro city, and emphasize
the need for actions that aim to early diagnosis and treatment of American cutaneous
leishmaniasis cases. 相似文献
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