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11.
The effect of unit,depth, and probe load on the reliability of muscle shear wave elastography: Variables affecting reliability of SWE
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Chin Chin Ooi BAppSc MMedUS Foong Koon Cheah MBChB MRCP FRCR Siew Kune Wong MBBS FRCR FAMS 《Journal of clinical ultrasound : JCU》2015,43(7):438-442
We report a case of rare Castleman's disease of the kidney that mimicked a renal neoplasm with emphasis on the imaging and histologic findings. A 47‐year‐old man presented with dyspeptic symptoms. Ultrasound revealed a vascular, heterogeneous mass in the left kidney. Multiphasic CT scan confirmed an enhancing lesion with enlarged left para‐aortic lymph nodes suspicious for nodal metastases. The provisional diagnosis was renal cell carcinoma. Percutaneous biopsy yielded a diagnosis of Castleman's disease of the hyaline‐vascular type. Despite advancement in imaging modalities, differentiation of hyaline‐vascular variant of Castleman's disease from hypervascular renal neoplasm remains difficult and the final diagnosis requires histopathological confirmation. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 43 :438–442, 2015 相似文献
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Brian Hung-Hin Lang MS FRACS Kai Pun Wong MBBS MRCS Koon Yat Wan MBBS FRCR 《Annals of surgical oncology》2013,20(2):653-659
Background
The efficacy of reoperative cervical neck dissection (RND) in achieving biochemical complete remission (BCR) (or postreoperation stimulated thyroglobulin [sTg] of <0.5 ng/mL) remains unclear in persistent/recurrent papillary thyroid carcinoma (PTC). We hypothesized that lower postablation sTg levels would indicate a higher rate of BCR after RND. Our study examined the association between postablation sTg and BCR after one or more RNDs.Methods
Of 199 patients who underwent RND, 81 patients were eligible. The postablation sTg levels (≤2 and >2 ng/mL) were correlated with the postreoperation sTg levels after RNDs. Patients’ clinicopathological characteristics, operative findings, and subsequent RNDs were compared between those with BCR after RNDs and those without.Results
Those with postablation sTg levels of ≤2 ng/mL had significantly higher BCR rate after the first RND (77.8 vs. 5.6 %, p < 0.001), overall BCR after one or more RNDs (77.8 vs. 9.3 %, p < 0.001), and better 5-year recurrence-free survival after the first RND (80.0 vs. 60.1 %, p = 0.049) than those with postablation sTg levels of >2 ng/mL. Overall BCR gradually decreased after each subsequent RND. Postablation sTg significantly correlated with postreoperation sTg (ρ = 0.509, p < 0.001). After adjusting for the number of metastatic lymph nodes excised at first RND and presence of extranodal extension, postablation sTg of ≤ 0.2 ng/mL was the only independent factor for BCR after one or more RNDs (odds ratio 37.0, 95 % confidence interval 5.68–250.0, p = 0.001).Conclusions
Only a third of patients who underwent one or more RNDs for persistent/recurrent PTC had BCR afterward. Postablation sTg level was an independent factor for BCR. Completeness of the initial operation is important for the subsequent success of RND. 相似文献18.
Philippa Skippage FRCR Louise Wilkinson FRCR Steven Allen FRCR Nicola Roche MCh Mitch Dowsett PhD Roger a'Hern 《The breast journal》2013,19(1):79-86
Breast density is a significant predictor in the risk of developing breast cancer. Several methods are available for assessing breast density, but most are subject to intra‐observer variability and are unable to assess the breast as a three‐dimensional structure. Using Quantra? to quantify breast density, we have correlated this with risk factors to determine what impact these variables have on breast density. Women attending for full field digital mammography at the South West London Breast Screening Unit between December 2008 and March 2009 were invited to participate in the study by questionnaire. Consenting women returned the questionnaire allowing further data collection including demographics, menopausal status and hormone replacement therapy (HRT) use. Data were correlated against breast density measurements to determine the degree of association. Mammograms were assessed on a Hologic? workstation and breast density calculated using Quantra?. Quantra? is an automated algorithm for volumetric assessment of breast tissue composition from digital mammograms. Six‐hundred and eighty‐three women were invited to participate. Those with implants or mastectomy were excluded. Three‐hundred and twenty questionnaires were fully completed and able to be assessed. The mean age of participants was 59 years (range 49–81). Mean density was 19.7% (range 8.5–48.5%). There was a decrease in density with age (Pearson product‐moment correlation coefficient ?0.17). Correlation between density and HRT use showed a significant positive result (correlation coefficient 0.07). Quantra? has shown to be an accurate, reproducible tool for quantifying breast density, demonstrated by its correlation with lifestyle and demographic data. Given its ease of acquisition this may be the future of breast density quantification in the digital age. 相似文献
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Brian D. Hayes BMedSc MB FRCPath Caroline Brodie MB FRCPath Ann O'Doherty MB FRCR Cecily M. Quinn MD FRCPath 《The breast journal》2013,19(3):319-324
Mammographic calcification is an important radiologic feature of early breast carcinoma whose index of suspicion for malignancy may be reported by a five‐tier R‐category system. This study aims to describe the histologic diagnoses underlying screen‐detected mammographic calcifications using both digital and screen‐film mammography, and to correlate these findings with radiologic R‐categories. Patients attending the Merrion Breast Screening Unit in Dublin between 2000 and 2011 were identified, who underwent needle‐core biopsy for assessment of mammographic calcifications without associated mass or architectural distortion. Radiologic R‐category was correlated with biopsy and excision histology reports. A total of 776 cases of calcification were identified, involving 769 individual patients. The radiologic R‐categories were as follows: R3 513 (66.1%), R4 192 (24.7%), R5 71 (9.1%). The positive predictive values for malignancy were R3 32.6%, R4 69.8%, R5 95.8%. Several histologic features of DCIS were associated with R5 rather than R3 radiology: high nuclear grade, solid or cribriform architecture, necrosis, periductal inflammation or fibrosis, and associated microinvasive or invasive carcinoma. Mammographic lesions and histologic whole and invasive tumors increased in size from R3 to R5. Radiologic size of calcifications correlated with whole (but not invasive) tumor size, although it tended to underestimate it by several millimeters. Digital‐detected calcifications were more likely than screen‐film detected to be categorized as R3 and less likely R4 or R5, and there was no significant difference in positive predictive value between the two imaging techniques in any R‐category. In conclusion, histologic features of DCIS, in particular those associated with high grade, are associated with R5 radiology. There is no significant difference in positive predictive value for malignancy in any R‐category between digital and screen‐film mammography. 相似文献
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