ABSTRACT
OBJECTIVE: Members of "Asociación de Ecografía Digestiva" decided to carry out a multicenter retrospective study on fine-needle aspiration biopsy for pancreatic space-occupying lesions under ultrasonographic guidance and via the percutaneous route in order to assess this technique s performance versus endoscopic ultrasound-guided biopsy. SUBJECTS: 10 hospitals for a total of 222 patients with suspiciously malignant, 8-120-mm pancreatic lesions were included in the study. RESULTS: The analysis of results shows a sensitivity of 89%, a specificity of 98%, a positive predictive value of 99%, and a negative predictive value of 74%, for an overall diagnostic accuracy of 91%. No major complications occurred. CONCLUSION: Percutaneous fine-needle aspiration for pancreatic lesions is highly cost-effective and has few and mild complications.
Subject(s)
Endoscopy, Gastrointestinal , Pancreas/diagnostic imaging , Pancreas/pathology , Pancreatic Diseases/diagnostic imaging , Pancreatic Diseases/pathology , Adult , Aged , Aged, 80 and over , Biopsy, Fine-Needle/methods , Female , Humans , Male , Middle Aged , Retrospective Studies , UltrasonographyABSTRACT
Objetivo: en el seno de la Asociación de Ecografía Digestivase decidió realizar un estudio retrospectivo multicéntrico sobre lapunción-aspiración con aguja fina (PAAF) de lesiones ocupantesde espacio pancreáticas, mediante control ecográfico y por víapercutánea, con el objetivo de valorar el rendimiento de dicha técnicay poder compararla con la punción mediante ultrasonografíaendoscópica.Participantes: en el estudio han participado 10 hospitalescon 222 pacientes con lesiones pancreáticas entre 8 y 120 mm,sospechosas de malignidad.Resultados: el análisis de los resultados muestra una sensibilidaddel 89%, especificidad 98%, valor predictivo positivo 99% ynegativo 74%, con precisión diagnóstica global 91%. No encontramosninguna complicación significativa.Conclusión: la PAAF de lesiones pancreáticas por vía percutáneaes de alta rentabilidad diagnóstica y con pocas y leves complicaciones
Objective: members of Asociación de Ecografía Digestivadecided to carry out a multicenter retrospective study on fine-needleaspiration biopsy for pancreatic space-occupying lesions underultrasonographic guidance and via the percutaneous route in orderto assess this techniques performance versus endoscopic ultrasound-guided biopsy.Subjects: 10 hospitals for a total of 222 patients with suspiciouslymalignant, 8-120-mm pancreatic lesions were included inthe study.Results: the analysis of results shows a sensitivity of 89%, aspecificity of 98%, a positive predictive value of 99%, and a negativepredictive value of 74%, for an overall diagnostic accuracy of91%. No major complications occurred.Conclusion: percutaneous fine-needle aspiration for pancreaticlesions is highly cost-effective and has few and mild complications
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Punctures/methods , Biopsy, Fine-Needle/methods , Pancreatic Neoplasms/pathology , Endoscopy, Digestive System , Retrospective Studies , Sensitivity and Specificity , Predictive Value of Tests , Endosonography/methodsABSTRACT
No disponible
Subject(s)
Female , Adult , Humans , Fecal Incontinence , Endosonography/methods , Anal Canal/abnormalities , Rectal Fistula/complications , Rectal Fistula/surgery , Postoperative Complications , Anal CanalABSTRACT
INTRODUCTION: Pregnancy produces multiple changes in the mother's body, most of which have been studied. However, changes in hepatosplenic circulation are not well-known. The routine use of ultrasonography and of echo-Doppler has created new possibilities for the knowledge of splenic circulation during pregnancy. MATERIAL AND METHOD: We studied 30 healthy pregnant women who had given their informed consent. To evaluate the morphological and hemodynamic changes that might occur in the splenic vessels during pregnancy and immediate puerperium, laboratory investigations, obstetric and hepatic ultrasonography, and hepatosplenic echo-Doppler were performed between weeks 8-12, 20-24, and 32-36, as well as in the immediate puerperium. RESULTS: The caliber of the vena porta and its tributaries, as well as that of its intrahepatic branches, increased while the caliber of the suprahepatic vessels slightly decreased during pregnancy. The hemodynamic changes detected by Doppler ultrasonography were: progressive flattening of the pulsed Doppler trace of the suprahepatic vessels during the course of pregnancy; a progressive reduction in mean portal velocity, which was more marked in the third trimester, and a decrease in the markers of resistance in the hepatic artery and superior mesenteric artery. CONCLUSIONS: Hemodynamic changes in hepatosplenic circulation are produced during pregnancy that can be safely and effectively evaluated in real time by ultrasonography and echo-Doppler. Knowledge of these changes is required to evaluate these vessels in pathological conditions.
Subject(s)
Hemodynamics , Pregnancy/physiology , Splanchnic Circulation , Female , Humans , Postpartum Period , Pregnancy Trimesters , Ultrasonography, Doppler , Ultrasonography, PrenatalABSTRACT
We report a case of a 12-years-old girl treated by percuta-neous injection of a splenic epithelial cyst. Indication was due to the gradual cyst's growth and pain in left hypocondrium. A percutaneous drainage under ultrasonographic view was performed with direct puncture technique, inserting a pigtail catheter into the cyst. After the total aspiration of the contrast, we injected sterile absolute alcohol for 20 minutes. Subsecuently, it was aspirated and the catheter was pulled-out. After a follow up period of more than 4 years, the cyst remains collapsed. There were no complications.
Subject(s)
Cysts/therapy , Ethanol/administration & dosage , Splenic Diseases/therapy , Child , Female , Humans , Injections, SubcutaneousABSTRACT
We present our experience of ultrasound-guided percutaneous drainage with a catheter in 5 splenic abscesses. All the cases were resolved and there was only one relevant complication. The advantages of this treatment compared with surgery and isolated medical treatment are discussed and this technique is proposed as the treatment of choice.
Subject(s)
Abscess/therapy , Drainage/methods , Splenic Diseases/therapy , Abscess/diagnostic imaging , Adult , Aged , Female , Humans , Male , Middle Aged , Splenic Diseases/diagnostic imaging , UltrasonographyABSTRACT
Focal nodular hyperplasia (FNH) is an hepatic pseudotumoral lesion which is usually detected accidentally in subjects of any age. Definitive diagnosis requires histologic study, prior to analysis with imaging techniques. Three casos of FHN are presented characterized with Doppler ultrasonography in whom high frequency and low resistance central pulse flow were observed in contrast with the findings obtained in other benign hepatic lesions.
Subject(s)
Liver Diseases/diagnostic imaging , Liver/pathology , Adolescent , Adult , Diagnosis, Differential , Female , Humans , Hyperplasia , Liver/diagnostic imaging , Ultrasonography, DopplerABSTRACT
Real time echocardiography associated with pulsed Doppler (duplex) and color (triplex) provide a non invasive technique to determine the vascular morphology of a lesion. The duplex and triplex signal of 35 liver tumors, 23 hepatocarcinomas and 12 angiomas found in the first high frequency signals greater than 1.81 kHz and traced with pulsatile or mixed morphology (pulsed and continuous) were analyzed. The second signals were of low frequency, less than 1 kHz and continuous tracing. It may be concluded than echo-Doppler is a complementary technique to conventional echography and is useful in the diagnosis of hepatocellular carcinoma.
Subject(s)
Carcinoma, Hepatocellular/diagnostic imaging , Liver Neoplasms/diagnostic imaging , Ultrasonography, Doppler, Color , Ultrasonography, Doppler, Pulsed , Evaluation Studies as Topic , Hemangioma/diagnostic imaging , Humans , Models, TheoreticalABSTRACT
Menetrier's disease was suspected in a patient during transcutaneous ultrasound by the finding of an important thickening of the mucosa with normality of submucosal, muscular and serous layers. The description of the ultrasound aspect of this disease is very uncommon, specially in adults.
Subject(s)
Gastritis, Hypertrophic/diagnostic imaging , Adult , Biopsy , Diagnosis, Differential , Female , Gastritis, Hypertrophic/diagnosis , Gastritis, Hypertrophic/pathology , Humans , Stomach/pathology , UltrasonographyABSTRACT
We present a case of pure Caroli's disease which was diagnosed by sonography and echo-doppler. Some findings are characteristic of Caroli's disease (Marchal's sign). This non-invasive technique may be sufficient, in some cases, for the diagnosis.
Subject(s)
Caroli Disease/diagnostic imaging , Adult , Color , Female , Humans , UltrasonographyABSTRACT
A patient with a lipoma of the stomach was diagnosed preoperatively by transcutaneous ultrasound and replenishment of the stomach with fluid, obtaining in this way specific ultrasound diagnostic criteria. This technique might be considered as complementary to endoscopy in the diagnosis of submucous tumours and as an alternative to other expensive examinations such as endoscopic echography.
Subject(s)
Lipoma/diagnostic imaging , Stomach Neoplasms/diagnostic imaging , Aged , Humans , Male , Ultrasonography/methodsSubject(s)
Lymphangioma/pathology , Retroperitoneal Neoplasms/pathology , Diagnosis, Differential , Humans , Male , Middle AgedABSTRACT
Five cases of tuberculous abdominal abscesses in patients with acquired immunodeficiency syndrome (AIDS) are reported. They were localized in pelvic retroperitoneum (2 cases), peripancreatic area, abdominal rectus anterior muscle, and were multiple in the remaining patient. All patients had presented with sustained fever and dull pain in the abscess area. In four patients this was the disease that led to the diagnosis of AIDS. The cultures from several sources (sputum, urine, cerebrospinal fluid, lymphadenopathy) revealed that the tuberculous abscess was a part of disseminated tuberculosis. Two patients were treated with surgical drainage and the other three with percutaneous drainage under echographic control. Two patients died from disseminated tuberculosis. It is pointed out that this form of tuberculosis in AIDS patients may be more common than previously reported.
Subject(s)
Abdomen , Abscess/complications , Acquired Immunodeficiency Syndrome/complications , Tuberculosis/complications , Adult , Female , Humans , MaleABSTRACT
Surgical cholecystostomy is a palliative treatment for cholecystitis and distal biliary obstructions when the general condition of the patient does not allow complex techniques. Percutaneous cholecystostomy (PC) guided by ultrasonography is an alternative to that procedure as well as a method of direct access to the biliary tract for diagnostic examinations (bacteriologic study of bile and percutaneous cholangiography). During one year, 9 female patients, mean age 74 (49 to 90) underwent this approach; 5 patients had cholecystitis, 2 were suspicious of biliary sepsis and 2 had angiocholitis. Because of poor general condition, no other approach was possible in any of the cases. There were no relevant complications. All 5 cases of cholecystitis improved after the procedure although 3 patients died within 30 days of causes unrelated to PC. In two cases biliary sepsis was ruled, and the probe was withdrawn, without complications. The two patients with angiocholitis improved significantly; in both cases it was shown that the cause was cholelithiasis: later on, they were treated by different methods (endoscopic sphincterotomy in one case and surgery in the third case). These preliminary results suggest that PC guided by echography should be included as a routine therapeutic and diagnostic method in the management of digestive diseases.
