ABSTRACT
The widespread use of medical imaging to study diseases of the neck reveals the prevalence of thyroid nodules can be as high as 67%. This is an important problem for the healthcare system because after analyzing the characteristics of the nodules a decision must be made regarding whether to perform fine-needle aspiration cytology to determine whether the lesion is malignant. In this article, we review the techniques for ultrasonographic study and fine-needle aspiration. We discuss the different guidelines for characterizing thyroid nodules and the criteria that help determine which patients need fine-needle aspiration for diagnosis and when an invasive procedure is unnecessary and can be avoided. Close collaboration with the different specialists involved in the management of thyroid nodules helps optimize resources and diagnostic performance.
Subject(s)
Thyroid Nodule/diagnostic imaging , Ultrasonography , Biopsy, Fine-Needle , Humans , Image-Guided Biopsy , Practice Guidelines as Topic , Thyroid Nodule/pathologyABSTRACT
OBJECTIVES: To describe the ultrasonographic findings in liver abscesses after the administration of a second generation agent. To perform the differential diagnosis of liver abscesses with other focal liver lesions. MATERIAL AND METHODS: We evaluated 28 liver abscesses in 5 patients before and after the administration of SonoVue. We also evaluated liver lesions in six patients in whom the differential diagnosis with liver abscess was considered in the baseline ultrasonographic examination. RESULTS: A typical enhancement pattern consisting of peripheral ring enhancement in the arterial phase and absence of central enhancement was observed in 21 (75%) abscesses. In another 6 (21.4%) abscesses, arterial enhancement was seen in large areas of the lesion, while other areas showed no uptake. One case (3.6%) had a multiseptated pattern of enhancement. Segmental hepatic enhancement was observed in 6 abscesses. In the liver lesions in which the differential diagnosis with abscess was carried out, 5 of the 6 showed no enhancement in any phase. The other lesion, a cystic metastasis, had irregular peripheral enhancement in the arterial phase. None of these lesions had segmental hepatic enhancement in the arterial phase. CONCLUSIONS: Contrast administration improves the performance of ultrasonography in the diagnosis of liver abscesses. There are three patterns of enhancement and these correlate well with the findings at CT and MRI. Contrast-enhanced ultrasonography is very useful for defining the internal architecture of the abscess, which is important for choosing the type of treatment. Contrast-enhanced ultrasonography also enables the differential diagnosis with other focal liver lesions.
Subject(s)
Contrast Media , Liver Abscess/diagnostic imaging , Phospholipids , Sulfur Hexafluoride , Adult , Aged , Aged, 80 and over , Diagnosis, Differential , Female , Humans , Liver Diseases/diagnostic imaging , Male , Middle Aged , Retrospective Studies , UltrasonographySubject(s)
Ultrasonography , Ureterocele/diagnosis , Child , Female , Humans , Infant , Radiography , Ureterocele/diagnostic imagingABSTRACT
For many years, from the discovery of X-ray up today, medical morfological diagnosis has been based on the analysis of radiographic image. Having regard to the potential risks of ionizing radiations, radiological exploration can not be taken into account as they are harmful, and in some cases they can become dangerous. Authors point out that an abusive using of radiological exploration exists in our country. As for children, a negligent use of radiology can reach very concerned limits. Ultrasound systems which are currently available, used before radiology in a systematical manner, can resolve a morfological diagnostic in many cases, in a sure and faster way, with the great advantage to be a risk-less procedure because ultrasounds are mechanical not ionizing waves. Six cases are shown as an example of the diagnostic possibilities of ultrasound in pediatrics.
