Ultrasound Appearance Research Articles

Three ultrasound phenotypes of non-invasive follicular thyroid neoplasm with papillary-like nuclear features proposed for imaging-pathology analysis: single center experience.

The terminology "non-invasive follicular thyroid neoplasm with papillary-like nuclear features" (NIFTP) was introduced to reduce overtreatment of thyroid carcinomas with indolent behavior. However, limited literature discussed the sonographic features of the entity in depth. The objective of this study is to summarize sonographic subtypes of NIFTP for precise diagnosis. From January 2017 to June 2020, 13,531 consecutive patients underwent surgery for thyroid nodules were reviewed; 30 patients (0.22%) with 30 NIFTP were eligible for this retrospective observational study. We evaluated ultrasound features of all the lesions and distributed them into 3 major types of ultrasound appearance using pattern recognition. Systemic literature review concerning ultrasonography of NIFTP was also performed. At sonography, all the NIFTP lesions were classified into three types: 19 (63.3%) were categorized into type A-oval and solid nodule without other high-suspicion features, 7 (23.3%) into type B-partially cystic mass without high-suspicion features, 4 (13.3%) into type C-hypoechoic solid nodule with high-suspicion features including irregular margins, microcalcifications, taller-than-wide shape. Three ultrasound patterns were proposed by us for ultrasound-cytopathology correlation analysis.

Splenic myelolipoma in a dog

ABSTRACT: Myelolipoma is a benign neoplasm composed of mature adipocytes and hematopoietic elements. This tumor is rare in dogs and cats and can develop in several organs and tissues. This report describes a case of splenic myelolipoma in a dog characterizing its clinical-pathological and ultrasonography aspects. A 9-year-old, female, mixed-breed, castrated dog was referred to the veterinary hospital with increased abdominal circumference. Ultrasonography revealed splenomegaly with masses of not measurable dimensions along the entire length of the parenchyma. The spleen was removed, and a fragment was sent for histopathological analysis. Macroscopically, the spleen was enlarged, with irregularly nodular growths that project above the surface of the organ. Nodules were red with small yellow areas. Microscopically, the spleen was effaced by a well-demarcated and not encapsulated mass composed of histologically well-differentiated neoplastic adipose tissue with islands and nests of varying proportions of hematopoietic elements. Histological examination confirmed the diagnosis of myelolipoma. Myelolipomas are observed on ultrasound images as hyperechoic masses or nodules with homogeneous echo texture. Here, ultrasound appearance involved mixed echogenicity and heterogeneous echotexture, due to the mixture of fat and non-fatty material components of the tumor.

Lung Ultrasound in COVID-19 pandemic: Why? How? And When?

During COVID-19 pandemic Lung ultrasound has rapidly become a tool for diagnosis and monitoring of lung involvement and it’s severity. Accurate evaluation of lung pathologic entities at the bedside, especially in critically ill patients, and those on mechanical ventilation, remains problematic. CT should not be frequently repeated and is not available everywhere, especially for critically ill patients. Limitations of bedside chest X-ray have been well described and lead to poor-quality X-ray films with low sensitivity.The lung ultrasound has been shown to be a useful tool in intensive care patients with adult respiratory distress syndrome (ARDS) and can be used forassessing severity of lung involvement in COVID-19. In this paper the accuracy of bedside LUS, chest X-ray and computer tomography are compared based on clinical cases, typical for COVID-19 lung ultrasound appearance is evaluated. There have been shown that lung ultrasound can predict the deterioration of the patient's conditionand can be used for risk stratification and clinical decision making, reducethe use of both chest x‐rays and computer tomography, what is very important especially in limited resources settings.

Recurrent GTD and GTD coexisting with normal twin pregnancy

Hydatidiform mole (HM) affects around 1/1000 pregnancies, and in such cases the recurrence risk is around 1%, being greater for those with complete HM (CHM). Whilst most cases appear sporadic with unknown mechanisms, there is a distinct subgroup of patients who suffer recurrent pregnancy loss, including multiple recurrent CHM (familial recurrent biparental HM syndrome). The majority of these cases are related to maternal genetic mutations in genes related to the control of imprinting, specifically NALP7 and KHDC3L. Oocyte donation is an effective treatment allowing these patients to have successful pregnancies. Approximately 1 in 50,000 pregnancies are complicated by twin pregnancy comprising normal foetus and HM, the majority of reported cases being CHM. Such pregnancies are at significantly increased risk of complications, including pregnancy loss, early-onset preeclampsia and severe preterm delivery, but when managed conservatively the delivery of a liveborn healthy infant occurs in around one-third of cases. Regardless of management, the risk of persistent GTD in such cases appears similar to that following singleton CHM. Rarely, other conditions mimic prenatal ultrasound appearances of twin pregnancy with HM, CHM mosaicism and placental mesenchymal dysplasia, both of which have distinctive histological and genetic features.

The use of high-frequency ultrasonography for the diagnosis of palpable nodules after the administration of dermal fillers.

IntroductionEsthetic medicine is a buoyant field of medicine. As the number of performed procedures – mainly injections of botulin toxin and dermal fillers – is increasing, the number of complications is rising as well. The most popular dermal filler is hyaluronic acid. Injection of hyaluronic acid dermal fillers is considered a minimally invasive procedure, but complications in the form of skin nodules and lumps are being encountered more and frequently. Esthetic medicine does not currently offer its own diagnostic methods that would allow one to diagnose complications. In these circumstances, the implementation of objective diagnostic methods from other fields of medicine becomes significant. High-frequency ultrasound is one of such methods.Aim of the studyThe aim of this study was to implement high-frequency ultrasound for the diagnosis of palpable nodules after the administration of dermal fillers.Material and methodThe study group included 15 women who developed palpable nodules in the region of hyaluronic acid injection. The study includes both early and late complications. An EPIQ 5 (Philips, Bothell, USA) ultrasound machine and a L5–18 transducer were used to examine the nodules. Ultrasound images were evaluated qualitatively by 2 independent investigators.ResultsUltrasound enabled the diagnosis of hyaluronic acid deposition in 9 women, granulomas in 3 women, fibrosis in 2 women and a deposition with inflammation in 1 case. Each of the diagnosed structures presented a typical ultrasound appearance.ConclusionsHigh-frequency ultrasound is a useful diagnostic method that has a chance to become a widespread tool to diagnose and treat complications. Because of a low number of study reports in this area, continued research is warranted.

Evaluation of the snowing-like ultrasonographic features of intraosseous jaw pathologies.

Aim of the study: Ultrasonographic examination of intraosseous jaw pathologies may reveal interesting incidental, mobile hyperechoic particles (“snowflakes”) in anechoic areas. Purpose of this study is to explain and discuss this snowing-like ultrasonographic feature of intraosseous jaw pathologies. Material and methods: This study included 113 patients admitted to our clinic for examination: 43 (38.05%) males and 70 (61.9%) females with a mean age of 34.9 ± 17.2 years (range: 6–72 years). A total of 120 intraosseous lesions were evaluated prior to surgery using ultrasonography; these included non-neoplastic, odontogenic, and non-odontogenic lesions. Results: In total, 5 (4.1%) of the 120 lesions exhibited snowing-like feature on ultrasonography, including 2 (1.6% of total) of 3 incisive canal cysts, 2 (1.6% of total) of 7 dentigerous cysts, and 1 (0.8% of total) of 19 odontogenic keratocysts. Conclusions: Snowflakes evident on ultrasonography of intraosseous jaw lesions may be specific to certain pathologies. Future studies correlating radiologic and pathologic features of intraosseous jaw lesions should focus on ultrasonographic snowing-like appearance in different types of lesions and explore why they occur.

A new predictor of bleeding based on ultrasonographic features in percutaneous liver mass biopsy

Background/aimAn ultrasound-guided liver mass biopsy is a method frequently used in determining the diagnosis and treatment plan. The aim of this study was to evaluate the potential new predictors of bleeding based on ultrasonographic features in liver mass biopsies, which are frequently applied in routine clinical practice.Materials and methodsThe images and data of patients aged over 18 years, who underwent an imaging-guided percutaneous liver mass biopsy between January 2018 and December 2019 with various indications, were retrospectively reviewed. Liver size, liver steatosis status, parenchyma appearance, and mass vascularity on Doppler ultrasonography before the procedure, and hemoglobin (Hb) values before and after the procedure were recorded.ResultsA total of 176 patients were included in the study. Ninety-six patients were male (54.5%) and 80 were female (45.5%). The mean age of the patients was 64 ± 12.3 years. The mean hemoglobin values of the patients were 11.5 ± 1.9 gr/dL before the procedure and 11.4 ± 1.5 gr/dL after the procedure. While 144 of the patients had less than 10% hemoglobin decrease (81.8%), 32 had more than 10% decrease (8.2%). In 56 patients, a heterogeneous and coarse granular pattern was observed in the liver parenchyma (31.8%). The decrease in the Hb rate was significantly higher in patients with heterogeneous and coarse granular liver parenchyma (8.7%) than in patients with normal parenchyma (6.6%) (P = 0.036).ConclusionIn our study, it was shown for the first time in the literature that the ultrasonographic appearance of the liver (heterogeneous and coarse granular parenchyma) may also be one of the parameters that can help to predict the risk of bleeding.

Tetralogy of Fallot—A literature review

AbstractTetralogy of Fallot is a combination of four specific cardiac abnormalities. (a) A ventricular septal defect (VSD), (b) pulmonary valve stenosis/right ventricular outflow tract obstruction, (c) aorta overriding the VSD, and (d) right ventricular hypertrophy. This review attempts to outline the current literature regarding embryology, morphology, pathophysiology, ultrasound appearances and the current treatments/outcomes of infants with Tetralogy of Fallot. Tetralogy of Fallot is the most commonly occurring conotruncal anomaly. Here, the aim is to present the ultrasound features, with examples of Tetralogy of Fallot along with the story post birth in terms of surgical treatment. This information was gathered doing a literature search using PubMed and the University of South Australia library database, as well as through information provided by the Royal Children's Hospital Cardiology department, via fact sheets. With early diagnosis under ultrasound, preparations can be made and counseling provided to organize for intervention and further assessment after birth. With current surgical intervention, the survival rate past the age of 10 is now over 92%, when, 50 years ago, it was only 50%.

Single and Multiple Odontogenic Cutaneous Sinus Tracts

Odontogenic cutaneous sinus tract (OCST) (synonyms: odontogenic cutaneous fistula, odontogenic subcutaneous granuloma, etc.) is an abnormal tube-shape formation which serves as a pathway for pus drainage from the locus of tooth–associated infection to the cutaneous lesion. OCST is a collective term and commonly is manifested in six cutaneous forms: as dimpling with fistula, cutaneous infiltration, nodule, suppurated nodule, abscess, or even cyst-like cutaneous formation. The purpose of this paper is to present the diverse clinical and radiological appearance (cone-beam computed tomography [CBCT] and ultrasound [US]) of single and multiple OCSTs based on the literature and our four cases. As long as limited publications present the ultrasound appearance of the OCSTs, we will focus on meticulous description of sonograms as well, giving a possibility for oral and maxillofacial surgeons to understand all advantages of that type of non-ionizing radiation diagnostics, avoiding misdiagnosis and mistreatment of OCSTs. Case 1: A 24-year-old male with OCST to the left mandibular region from the lower left first molar. Cutaneous lesion of OCST manifested as a transition stage from cutaneous infiltration to abscess. Case 2: A 41-year-old male with odontogenic cutaneous fistula of the right mandibular body region from the lower right second molar. It`s manifested as deep dimpling with active fistula. Case 3: A 45-year-old male with unilateral multiple OCSTs: 1) odontogenic cutaneous fistula of the left cheek from the left second maxillary molar and 2) a scar from a surgically treated OCST located in the projection of the left mandible from the tooth #3.6. Case 4: An 18-year-old male with OCST to left nasolabial fold and cheek from the upper left first molar. The pathology manifested as a subcutaneous abscess first and a nodule after the abscess lancing. These cases highlight the diverse cutaneous manifestations of the OCSTs. The US appearances of different parts of the OCST are presented, the popular terminology for the same cutaneous lesions are discussed, the new terms are proposed, and the treatment strategies based on histologic results are debated.

Avaliação ultrassonográfica de estruturas reprodutivas, fígado e vesícula biliar de Boa constrictor (Linnaeus, 1758) ex situ

A ultrassonografia possibilita avaliações que resultam em informações relevantes para a manutenção das espécies em cativeiro. Desse modo, realizou-se um estudo com 15 exemplares de Boa constrictor, de ambos os sexos, a fim de caracterizar a aparência ultrassonográfica das estruturas reprodutivas, fígado e vesícula biliar desses animais, pela técnica da janela lateral. Além disso, avaliou-se a influência dos fatores intervalo entre alimentações e o tamanho dos indivíduos na caracterização ultrassonográfica das estruturas. Folículos pré-vitelogênicos foram caracterizados por formato arredondado, preenchidos basicamente por conteúdo anecoico e com ecotextura homogênea e grosseira e folículos vitelogênicos apresentaram conteúdo anecogênico e hipoecogênico, ambos com margens finas e regulares. Os testículos foram caracterizados por formato alongado, parênquima com média ecogenicidade, margens regulares e ecotextura homogênea. O fígado apresentou formato alongado, parênquima com ecogenicidade mista (hipoecoico a levemente hiperecoico), margens ecogênicas, ecotextura homogênea e tamanho médio de 27,6 cm. A vesícula biliar apresentou formato arredondado, preenchida por conteúdo anecoico, envolvida por uma margem fina hiperecogênica. Dos fatores avaliados, o intervalo entre alimentações foi o que mais influenciou na caracterização ultrassonográfica das estruturas. O tamanho das serpentes não exerceu nenhuma influência. Foi possível concluir que o ultrassom, por meio da técnica da janela lateral, é eficaz na avaliação dos órgãos estudados.

Endometriosis infiltrante: claves diagnósticas en la ecografía abdominal

ObjectiveEndometriosis is the presence of endometrial tissue outside the uterus. Endometriosis of the bowel and urinary tract are types of extragenital endometriosis that manifest with nonspecific symptoms, but their detection involves specific therapeutic strategies. Although the characteristics of the disease on transvaginal ultrasonography and on magnetic resonance imaging have been described in many publications, few references describe its characteristics on abdominal ultrasonography.This paper illustrates the findings for infiltrating endometriosis involving the bowel and urinary tract on abdominal ultrasonography and shows the usefulness of this technique for identifying signs of the disease that have been described with other techniques. Knowledge of infiltrating endometriosis and its ultrasonographic features will enable radiologists to suggest its diagnosis and to include it in the differential diagnosis of pelvic pain in women of child-bearing age. ConclusionAbdominal ultrasonography is a useful tool in the diagnosis of extragenital endometriosis. Familiarity with the ultrasonographic appearance of this entity facilitates the diagnostic orientation and management of patients with pelvic pain.

Intracranial Hemorrhage

Intracranial Hemorrhage

Arterial stiffness measured by cardio-ankle vascular index is greater in non-obese young women with polycystic ovarian syndrome.

The association of metabolic abnormalities and polycystic ovarian syndrome (PCOS) has been documented, but few studies have focused on cardiovascular risk in these women. The aim of this study was to compare arterial stiffness by using the cardio-ankle vascular index (CAVI) in PCOS women with controls, and to evaluate whether any clinical or laboratory variables had independent associations with it. A group of 160 women, matched for age and body mass index were recruited. Diagnosis of PCOS was made according to the Rotterdam criteria. Arterial stiffness using CAVI was evaluated in non-obese young woman, with and without PCOS. In the PCOS group (n = 80), 60 cases (75%) had findings of hyperandrogenism, 59 (73.8%) had ovulatory dysfunction, and 70 (87.5%) had an ultrasonographic appearance of polycystic ovaries. Women with PCOS had significantly higher mean CAVI values when compared to subjects without PCOS (5.78 ± 0.64 vs 5.28 ± 0.77, P < 0.001). Multiple regression analysis revealed that androgen excess was associated with increased arterial stiffness, independent of ovulatory dysfunction, polycystic ovaries, body mass index and age. This data suggests that vascular compliance is decreased in young women with PCOS. Androgen excess is independently associated with increased arterial stiffness.

Usefulness of accessible imaging methods in thyroid nodules with indeterminate cytology.

In thyroid nodules (TN) submitted to fine-needle aspiration (FNA), Bethesda categories III and IV are considered 'indeterminate' cytology. This result corresponds to 10-25% of all FNAs and the risk of malignancy (RoM) ranges from 10% to 30% for category III and from 15% to 40% for category IV. This review analyzed the practical applicability of accessible imaging method in the management of patients with cytologically indeterminate TN > 1 cm (ITN). When ITN are highly suspicious on ultrasonography (US), the RoM supports surgical indication even in the absence of additional tests. The same can be applied to ITN of intermediate suspicion but with elevated stiffness on elastography. Follow-up without additional tests is acceptable in the case of ITN with low-risk cytology and low-suspicion appearance on US and elastography (if obtained). In the case of ITN without highly suspicious US appearance, 123I scintigraphy may be obtained in patients with TSH < 1-1.5 mIU/L to rule out hyperfunctioning nodules before requesting diagnostic methods that are more expensive and less accessible. In addition, in ITN with not very suspicious US appearance, 18FDG-PET may be obtained. If this method does not reveal nodular uptake, the risk of the nodule corresponding to a macrocarcinoma is sufficiently low in order to allow follow-up. The positive predictive value of focal nodular uptake on 18FDG-PET depends on the pre-test RoM, cytological findings, and maximum SUV. There is currently no evidence for the use of CT, MRI or imaging using 99mTc-MIBI to define the nature of ITN.

Ultrasonographic Technique, Appearance, and Diagnostic Accuracy for Common Elbow Sports Injuries.

Ultrasonography is a valuable diagnostic imaging tool because of its availability, tolerability, low cost, and utility in real-time dynamic evaluation. Its use in diagnosing elbow injuries has expanded recently and continues to do so. In particular, stress ultrasonography represents a unique imaging technique that directly visualizes the ulnar collateral ligament (UCL) and allows the assessment of ligament laxity, offering an advantage over magnetic resonance imaging and magnetic resonance arthrography in this patient population. Furthermore, ultrasonography has shown particular usefulness in instances where invasive techniques might be less desirable. This is particularly important in athletes since more invasive procedures potentially result in lost time from their sport. Ultrasonography is an important imaging tool that complements a thorough history and physical examination in the evaluation of elbow injuries in athletes. The use of ultrasonography in orthopaedic sports medicine has been investigated previously; however, to our knowledge, there has been no comprehensive review regarding the utility of ultrasonography for common elbow injuries in athletes. The current study provides a comprehensive, detailed review of the utility and indications for the use of ultrasonography for common elbow injuries in athletes.

Adequacy And Rate Of Atypical Cytology On Fine Needle Aspiration Technique Using Suction (FNA-S) – A Quality Assurance Study At CMCVAMC

Abstract Introduction/Objective Thyroid cancer is one of the most common prevailing conditions. Both genetic and environmental risk factors play a role in causation of thyroid cancers, with agent orange being the most documented risk factor in Veteran patient population. Based on the ultrasonographic appearance, thyroid nodules can be further investigated by minimally invasive fine needle cytology. This can be done by either of two available techniques, Fine needle aspiration with suction (FNA-S) and Fine needle capillary cytology without using suction (FNC), depending upon the preference of practicing endocrinologist. We aim to compare both cytology techniques for comparing the diagnostic yield and rate of atypia of undetermined significance (AUS) or Follicular lesion of undetermined significance (FLUS), requiring repeat FNA in approximately three months. Methods Retrospective study was conducted by searching the cases performed by an endocrinologist at Corporal Michael J Crescenz VA Medical Center between the period of January 1, 2015 and July 2, 2015. 30 nodules from 11 patients were tested by Fine needle capillary cytology technique (FNC). Yield for the diagnosis with rates of atypical (AUS) cytology were compared. On second set of the 29 patients with 38 nodules, both techniques - FNA-S versus FNC were carried out. Adequacy and rate of AUS/FLUS were calculated. Results Out of 30 total nodules performed by fine needle aspiration (FNA-S), all cases yielded diagnostic material. Of them, 14 (46.6%) were diagnosed as AUS and 16 (53.33%) were benign. On the follow-up/re-aspiration by FNC technique, all these 14 nodules were diagnosed benign. On second set of patients on whom both techniques (FNA-S and FNC) were used alternatively, 13 of 38 nodules (34.21%) were diagnosed as AUS/FLUS, 23 (60.52%) were benign/nodular goiter and 2 were non-diagnostic/inadequate (5.2%). Conclusion FNA-S (with suction) yields adequate diagnostic material, however, also has greater number of atypical cytology results requiring repeat patient visit which may increase morbidity with a burden on total health care cost. FNC (without suction) has low rates of AUS/FLUS, is diagnostically superior with excellent smear quality, less blood clots, time savings, and less inconvenience of patients/physician. FNC (without suction) is a modality of choice for an effective screening of thyroid nodules in veterans.

Ultrasonographic features of liver, gallbladder, spleen, kidneys, and urinary bladder of rescued long-tailed macaques, Macacafascicularis

This study was conducted to determine the ultrasonographic features of the liver, gallbladder, spleen, kidneys, and urinary bladder of 24 apparently healthy male and female long-tailed macaques (LTM) and the correlations of organ measurements with body weight and crown–rump length. The animals were grouped into 12 males and 12 females. Examination was performed in sedated LTM using an ultrasound machine with 6.0 MHz microconvex scanner. Ultrasound appearance, dimensions, and echotexture of the liver, gallbladder, kidneys, spleen, and urinary bladder were evaluated. The results showed that there were no sex-related differences in echo mean values, thickness, and length of the selected abdominal organs. The liver was hypoechoic to isoechoic with the right renal cortex, while spleen was isoechoic to hyperechoic to left renal cortex. Spleen was hypoechoic to isoechoic to the liver. Gallbladder and urinary bladder had hypoechoic to hyperechoic thin wall with anechoic lumen. There was a statistically significant and moderate positive correlation between the volume of the left kidney and body weight. The right kidney volume was greater than the left kidney and the total renal volume had a statistically significant and moderate positive correlation with body weight. This study established the reference values for ultrasonographic features of selected abdominal organs of rescued LTM.

Lung ultrasound findings in patients with novel SARS-CoV-2.

BackgroundOver 2 million people worldwide have been infected with severe acute respiratory distress syndrome-coronavirus-2 (SARS CoV-2). Lung ultrasound has been proposed to diagnose and monitor it, despite the fact that little is known about the ultrasound appearance due to the novelty of the illness. The aim of this manuscript is to characterise the lung ultrasonographic appearance of critically ill patients with SARS-CoV-2 pneumonia, with particular emphasis on its relationship with the time course of the illness and clinical parameters.MethodsAdult patients from the intensive care unit of two academic hospitals who tested positive for SARS-CoV-2 were included. Images were analysed using internationally recognised techniques which included assessment of the pleura, number of B-lines, pathology in the PLAPS (posterolateral alveolar and/or pleural syndrome) point, bedside lung ultrasound in emergency profiles, and the lung ultrasound score. The primary outcomes were frequencies, percentages and differences in lung ultrasound findings overall and between short (≤14 days) and long (>14 days) durations of symptoms and their correlation with clinical parameters.ResultsIn this pilot observational study, 61 patients were included with 76 examinations available for analysis. 26% of patients had no anterior lung abnormalities, while the most prevalent pathological ultrasound findings were thickening of the pleura (42%), ≥3 B-lines per view (38%) and presence of PLAPS (74%). Patients with “long” duration of symptoms presented more frequently with a thickened and irregular pleura (32 (21%) versus 11 (9%)), C-profile (18 (47%) versus 8 (25%)) and pleural effusion (14 (19%) versus 3 (5%)), compared to patients with short duration of symptoms. Lung ultrasound findings did not correlate with arterial oxygen tension/inspiratory oxygen fraction ratio, fluid balance or dynamic compliance.ConclusionSARS-CoV-2 results in significant, but not specific, ultrasound changes, with decreased lung sliding, thickening of the pleura and a B-profile being the most commonly observed. With time, a thickened and irregular pleura, C-profile and pleural effusion become more common findings. When screening patients, a comprehensive ultrasound protocol might be necessary.

Ultrasound Imaging of Tympanic Bulla and The Surrounding Structures in Donkey (Equus asinus)

This study was carried out to describe the normal ultrasonographic appearance of the tympanic bullae and its surrounding structures in donkey. The present study was conducted on 10 clinically healthy and mature Egyptian donkeys of both sexes. For the bullae, brief anatomic reminders are first performed. Then, the scanning techniques and normal images are described. Ultrasonographic study of the retromandibular area showed a lot of landmarks which were detected in different positions. For bullae, the lateral approach using micro convex transducer at 6.6 MHz was used. Such approach gives adequate aquastic window for examination. The micro convex transducer at 6.6 MHz proofed to be the most suitable tool for complete evaluation of TB and the surrounding structures in donkeys.

Ultrasonographic appearance of glomus tumors: A retrospective study

Background: The glomus tumor is a rare neoplasm and can be easily misdiagnosed. Patients with glomus tumor may present nonspecific symptoms such as long-term pain, temperature intolerance, and history of injury. It is common for such patients to be examined by physicians from various specialties such as orthopedics, family medicine or plastic surgery. They may undergo multiple imaging studies such as plain film X-ray, ultrasonography, or magnetic resonance imaging depending on the location of the nodule. Objective: In this paper we present the first study in the Gulf Cooperation Council (GCC) region to address a retrospective institutional review of all ultrasonography studies of glomus tumors in a single medical center in the Kingdom of Bahrain between January 2013 and December 2018. Results: Out of 31 patients with glomus tumors, 11 patients underwent an ultrasonography imaging study. The sex ratio (male: female) in the group of 11 patients was 0.56:1. 63.63% (7/11) of the ultrasonography requests were done by orthopedic surgeons, whereas 27.27% (3/11) were requested by a primary care physician (PCP), and 9.09% (1/11) of the patients were referred by an emergency physician. Glomus tumors were more common in patients aged 30–39 years and 50-54 years with a mean age of (mean ± SD, 47.818 ± 12.408) years. Ultrasonography results showed that 100% (11/11) were hypoechoic. The majority of the studies showed 90.90% (10/11) with a well-defined border. Doppler US showed that 72.72% (8/11) had visible hypervascularization in the tumor, 18.18% (2/11) had moderate visible blood in the tumor, and 9.09% (1/11) had no comments on vascularity in the report. The tumor size ranged from 2.2 to 6.5 mm (mean ± SD, 4.081 ± 1.470 mm) x 1 to 4 mm (mean ± SD, 2.690 ± 1.135 mm). 90.90 % (10/11) of glomus tumors were located in the fingers. 90.90% (10/11) of the lesions were located in the left hand, whereas 9.09% (1/11) were located in the right hand and 9.09% (1/11) in the left toe. Conclusion: The results of this study were similar to those of other studies described in the literature. A well-defined, hypoechoic lesion with a hypervascular mass in the nail bed were the most common ultrasonography findings associated with subungual glomus tumors.