ABSTRACT
Breast cancer is the leading cause of cancer mortality in women, and it is on the rise in Iran. Therefore, an early-stage diagnosis of breast cancer is of critical importance. Because ultrasound is one of the available, inexpensive, and minimally invasive techniques for distinguishing malignant from benign masses, a comparison of conventional ultrasound, color Doppler, and spectral Doppler findings can be useful. The purpose of this study was to determine the diagnostic value of sonographic indices, specifically Doppler parameters, in identifying the nature of breast masses. This is a cross-sectional study, with diagnostic value analysis. Before undergoing a biopsy, 80 patients with breast masses underwent B-mode and Doppler breast ultrasound. The ultrasound findings were then compared to pathologic results to determine which groups were malignant or benign. The resulting data were analyzed using statistical tests and diagnostic values with SPSS 22 software. B-mode grey-scale ultrasound indices such as mass shape, mass margin, mass orientation, and posterior features, as well as Doppler indices such as vascularity, RI (Resistive Index), PI (Pulsatility Index), and PSV (Peak Systolic Velocity), were found to be statistically significant with pathological findings. Color Doppler revealed vascularity in 65% of benign and 84% of malignant masses. The diagnostic value results revealed that mass shape, mass margin, mass orientation, and posterior features all play a significant role in predicting lesion malignancy, with a sensitivity of 92%, 58%, 64%, 56%, and specificity of 59%, 66%, 82%, and 84%, respectively. The RI, PI, and PSV indices were significantly higher in malignant masses, and all of them had remarkable diagnostic values in predicting malignancy, with a (Area Under The Curve) AUC of 0.863, 0.882, 0.702, a sensitivity of 84% and 84%, 68%, and a specificity of 83%, 86%, and 62%, respectively, at the optimal cut-off points (0.65, 1.32, 12.40) obtained from the Receiver Operating Characteristics (ROC) curves.
ABSTRACT
INTRODUCTION: Rupture of renal angiomyolipoma (AML) is an emergency and life-threatening complication. This study aimed to evaluate the association of computed tomography (CT) scan parameters with the risk of rupture in renal AMLs. METHODS: In this retrospective cross-sectional study, patients who were referred to a referral university hospital with diagnosis of AML, between 2007 and 2019, were included. Patients were divided into ruptured and non-ruptured cases based on surgery and CT scan findings and the baseline characteristics as well as CT scan parameters were compared between the two groups. RESULTS: 20 AML patients with the mean age of 39.6 ± 12.5 years were included (75% female). The lesion was ruptured in 8 (40%) patients. The mean size of the lesion was 97.0 ± 15.9 mm in the ruptured and 72.0 ± 29.4 in the non - ruptured AML ( p = 0.045). The mean fat density based on non-contrast enhanced CT (NCCT) scan (- 56.1 ± 16.3 vs - 74.9±24.1; p = 0.018) and contrast enhanced CT (CECT) scan (- 20.8 ± 16.9 vs - 50.5 ± 31.7; p = 0. 016) was significantly higher in the ruptured cases. Total tumor density based on NCCT scan was significantly greater in the ruptured AMLs ( 19.6 ± 25.9 vs -22.7±41.6, p=0.033). CONCLUSION: It seems that some CT scan parameters such as mean fat density and total tumor density could be used for differentiation between ruptured and non-ruptured AMLs.
