Similar Sonographic Features Research Articles

Ultrasonographic evaluation of the liver and gallbladder and hepatic histogram of non-venomous snakes.

This study aimed to describe sonographic features of the liver, gallbladder and hepatic histogram from grey-scale ultrasound in three species of healthy non-venomous snakes. Twenty-eight adult snakes were enrolled in the study, including 10 common boas (Boa constrictor), eight black-tailed pythons (Python molurus) and 10 rainbow boas (Epicrates crassus). The snakes fasted for 30 days and were manually restrained while conscious. For B. constrictor and P. molurus the liver and gallbladder were best visualized in ventral recumbency, and E. crassus in dorsal recumbency. A single elongated hepatic lobe was identified in all snakes. The gallbladder was positioned caudal and separated from the liver, with an oval shape and homogeneous anechoic content in the lumen, and thin and regular walls. A region of interest by pixel number was chosen for the liver, fat bodies, left kidney, and splenopancreas. The mean grey level (G) of the organs had significant differences within each species. Standard deviation of grey levels (SG ) had significant differences within B. constrictor and E. crassus. P. molurus had no significant difference among organs. The comparison among snakes showed that E. crassus had G of liver and splenopancreas lower than B. constrictor and P. molurus. The SG of the liver in E. crassus was lowest compared to B. constrictor and P. molurus. P. molurus showed the highest values in mean of G and SG . In conclusion, despite the liver and gallbladder having similar sonographic features, the grey-level histogram showed that liver echotexture and echogenicity differ among species.

Quantification of intranodal vascularity by computer pixel-counting method enhances the accuracy of ultrasound in distinguishing metastatic and tuberculous cervical lymph nodes.

Ultrasound is a common imaging method for assessment of cervical lymph nodes. However, metastatic and tuberculous lymph nodes have similar sonographic features in routine ultrasound examination. Computer-aided assessment could be a potential adjunct to enhance the accuracy of differential diagnosis. Gray-scale and power Doppler sonograms of 100 patients with palpable cervical lymph nodes were reviewed and analyzed (60 metastatic nodes, 40 tuberculous nodes). Final diagnosis of lymph nodes was based on fine needle aspiration and cytology. Sonograms were reviewed and assessed for nodal shape, echogenic hilus, intranodal necrosis and vascular distribution (conventional assessment). Intranodal vascularity was quantified using a customized computer algorithm to determine vascularity index (VI). The diagnostic accuracy of using conventional assessment and its combination with intranodal VI method was evaluated and compared. Metastatic and tuberculous nodes tended to be round (75.0% vs. 50.0%), without echogenic hilus (86.7% vs. 72.5%) and have peripheral vascularity (73.3% vs. 85.0%). Intranodal necrosis is more common in tuberculous nodes (27.5%) than metastatic nodes (8.3%). Using conventional assessment in differentiating metastatic and tuberculous nodes, the diagnostic accuracy was 56% with a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 56.7%, 55%, 65.4% and 45.8% respectively. The VI of metastatic nodes (23.4%±2.1%) was significantly higher than that of tuberculous nodes (12.0%±1.6%) (P<0.05). The optimum cut-off of VI for the differential diagnosis was 20%. By combining conventional assessment and intranodal VI quantification, the diagnostic accuracy was increased to 69% with a sensitivity, specificity, PPV and NPV of 80%, 52.5%, 71.6%, 63.6% respectively. The increase in sensitivity was statistically significant (P=0.006). Computer-aided quantification of intranodal vascularity provides added value in routine ultrasound assessment of cervical lymph nodes. It enhances the accuracy of ultrasound in distinguishing metastatic and tuberculous cervical lymph nodes.

EP34.33: Mature ovarian teratoma mimicking the immature one: two cases depicting similar sonographic features

EP34.33: Mature ovarian teratoma mimicking the immature one: two cases depicting similar sonographic features

Gene expression profiling reveals differential patterns between microcystic congenital cystic adenomatoid malformation and congenital lobar emphysema

IntroductionCongenital cystic adenomatoid malformation (CCAM), especially type-III, shares similar sonographic features with congenital lobar emphysema (CLE) in routine ultrasound scan. Thus, prenatal differentiation of CLE from a microcystic CCAM is challenging and difficult in practice. Discovery of molecular biomarkers has important clinical significance. MethodsWe profiled gene expression in lung tissue from four CCAM type-III and five CLE subjects by microarray. A bioinformatic tool was used for signal pathways enrichment analysis. Further, quantitative reverse transcriptase PCR (qRT-PCR) was used to verify the results. ResultsA total of 426 genes were identified to be significantly differentially expressed (fold-change >2.0, q value <0.05) between microcystic CCAM and CLE. Of these differentially expressed genes (DEGs), 392 were upregulated and 34 were downregulated in microcystic CCAM compared with CLE. Unsupervised clustering of the “expressed” genes could clearly delineate the CCAM and CLE samples. We also confirmed that eight randomly chose genes were differentially expressed at the mRNA level between CCAM and CLE. ConclusionsCCAM type-III and CLE have differential gene expression patterns. Our pilot study may gain a deeper understanding of the organogenetic origins and pathogenesis of these conditions. The suggestive candidates may serve as potential biomarkers for definitive diagnosis of congenital cystic lung lesions and eventually to treat them appropriately.

Sonographic Features Of Multifocal Papillary Thyroid Carcinomas

It is uncertain whether papillary thyroid carcinomas (PTCs) of the same subtype display similar sonographic features. This retrospective analysis of pre-operative sonographic and pathologic findings aimed to assess whether PTCs of the same subtype share sonographic features. Before undergoing thyroid surgery, 137 patients underwent ultrasound (US) examination. A single radiologist used a picture archiving and communication system and pathologic reports to investigate all sonographic features of the largest and second largest PTCs. Additionally, the radiologist evaluated the similarity of sonographic features between primary (largest), secondary (second largest), and daughter (secondary with same subtype as the primary) PTCs. Of the 137 PTC patients, 48 (35.0%) had multiple PTCs; however, 5 had no US images of the secondary PTC. Of the 43 secondary PTCs with US images, 9 (20.9%) secondary PTCs were of a different subtype than the primary PTC and revealed sonographic features that differed from those of the primary PTC. Of the 48 patients with multiple PTCs, the subtype was the same in the primary and secondary PTCs in 34 (70.8%) patients. Of the 34 daughter PTCs, 32 (94.1%) had sonographic features similar to those of the primary PTC, whereas 2 (5.9%) showed different sonographic features than the primary PTC. There was no significant difference between primary and daughter PTCs in the size, location, sonographic features, or Korean Thyroid Imaging Reporting and Data System category ( P>.05). Daughter PTCs show similar sonographic features as the primary PTC. K-TIRADS = Korean Thyroid Imaging Reporting and Data System; PTC = papillary thyroid carcinoma; US = ultrasound.

A Case of Intratyhroidal Ectopic Thymus [Intratiroidal Ektopik Timus Olgusu

Ectopic intrathyroidal thymus tissue is rare. Mostly it is seen in childhood as an asymptomatic thyroid nodule. It can be easily misdiagnosed as a benign or malignant thyroid nodule. Like thymus, it may regress in time. Ectopic thymus tissue can rarely develop to thymoma or thymic carcinoma. Intrathyroidal ectopic thymus tissue has similar sonographic features to thymus and should be kept in mind to avoid unnecessary diagnostic and surgical intervention.

Ultrasound features of different histopathological subtypes of borderline ovarian tumors

To describe the gray-scale sonographic and color Doppler imaging features of the most common histopathological subtypes of borderline ovarian tumors. We analyzed retrospectively the preoperative transvaginal sonographic reports of patients with a histological diagnosis of borderline ovarian tumor. All patients were scanned consecutively by two of the investigators using transabdominal and transvaginal gray-scale imaging to assess the morphology and color Doppler to obtain indices of the blood flow. Sonographic findings were compared to histopathological data. A total of 113 consecutive cases were reviewed from two referral centers for gynecological oncology. At histological examination 50 tumors (44%) were classified as being serous borderline ovarian tumors (SBOT), 61 (54%) were mucinous borderline ovarian tumors (MBOT) (42 intestinal type and 19 endocervical type), and two patients (2%) presented with borderline endometrioid tumors. SBOTs and endocervical-type MBOTs had very similar sonographic features and a smaller diameter, fewer locules (usually unilocular-solid lesions) and a higher color score than intestinal-type MBOTs. Intestinal-type MBOTs were characterized by a significantly higher percentage of lesions with > 10 locules when compared with the endocervical-type MBOTs. Intestinal-type MBOTs have different sonographic features from other common borderline ovarian tumors.

Prenatal sonographic diagnosis of Neu‐Laxova syndrome

We report the sonographic diagnosis of Neu-Laxova syndrome in a fetus at 27 weeks' menstrual age. The parents were first cousins. Sonography revealed microcephaly, a sloping forehead, exophthalmos, a small thorax and abdomen, hypoplastic lungs, syndactyly, hyperextended knees, polyhydramnios, a small placenta, and intrauterine growth restriction. The long bones were normal. The calvaria was hyperechoic and associated with shadowing, obscuring any intracranial abnormalities. This sonographic finding was presumed to represent calvarial calcification, not previously described with this syndrome. We believe that Neu-Laxova syndrome can be reliably diagnosed prenatally by demonstrating the sonographic features described, although other conditions with similar sonographic features need to be considered in the differential diagnosis.

Real-time ultrasound in Crohn's disease: characteristic features and clinical implications.

Thirty-two children with Crohn's disease were evaluated by real-time ultrasonography. The typical pattern of Crohn's disease caused by bowel wall thickening is the "bull's eye phenomenon", the elongated tubular stiff bowel loop with narrowing of the lumen and the small bowel conglomerate tumor. In indefinable abdominal complaints sonography may lead to the correct diagnosis. The differential diagnosis of similar sonographic features and the limitations of ultrasound in gastrointestinal disease must be considered. In proven Crohn's disease the findings in follow-up match the clinical course and may delineate complications, such as ileus, abscess, hydronephrosis, gallstones or involvement of parenchymal organs, as seen in 15 patients. Thus ultrasound will restrict repeated x-ray studies and support patient management.