Clinical Hemorheology and Microcirculation - Volume 80, issue 4

Authors: Cao, Jianhui | Huang, Weiwei | Huang, Pintong | Huang, Yunlin

Article Type: Research Article

Abstract: PURPOSE: To compare the application value of the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) and the American Thyroid Association (ATA) guidelines in the risk stratification of thyroid isthmic nodules. METHODS: A total of 315 patients with thyroid isthmic nodules (315 nodules) confirmed by surgical pathology or fine-needle aspiration biopsy (FNAB) were selected in this retrospective study. The nodules were evaluated and classified according to ACR TI-RADS and the ATA guidelines. Taking pathological results as the reference, receiver operating characteristic (ROC) curves were drawn to evaluate the diagnostic capabilities of the …ACR TI-RADS and the ATA guidelines for the risk stratification of thyroid isthmic nodules. The unnecessary biopsy rates and false-negative rates were compared. RESULTS: Multivariate analysis of ultrasonographic features of suspicious malignancies showed that an aspect ratio > 1 was not an independent risk factor for malignant thyroid nodules located in the isthmus (odds ratio: 3.193, 95%confidence interval: 0.882–11.552) (P  = 0.077). The area under the ROC curves for diagnosing malignant thyroid nodules located in the isthmus in by the ACR TI-RADS and the ATA guidelines were 0.853 and 0.835, respectively. Under the management recommendations of the ACR TI-RADS and ATA guidelines, the false-negative rates of malignant thyroid nodules were 66.2%(ATA intermediate suspicion), 62.3%(ACR TR 4), 81.8%(ATA high suspicion) and 86.5%(ACR TR 5). CONCLUSION: Both the ACR TI-RADS and the ATA guidelines have high diagnostic capabilities for the risk stratification of thyroid isthmic nodules. For ACR TR 4 and 5 and ATA intermediate- and high-suspicion thyroid isthmic nodules with a maximum diameter < 1 cm, the criteria for puncture should be lowered, and FNAB should be done to clarify their diagnosis. Show more

Keywords: ACR TI-RADS, ATA, ultrasound, thyroid nodule, isthmus

DOI: 10.3233/CH-211304

Citation: Clinical Hemorheology and Microcirculation, vol. 80, no. 4, pp. 463-471, 2022

Authors: Dong, Yi | Koch, Jonas B.H. | Löwe, Axel L. | Christen, Michael | Wang, Wen-Ping | Jung, Ernst-Michael | Mohaupt, Markus G. | Dietrich, Christoph F.

Article Type: Research Article

Abstract: Dynamic contrast-enhanced ultrasound (DCE-US) enables quantification of tumor perfusion. VueBox is a platform independent external software using DICOM cine loops which objectively provides various DCE-US parameters of tumor vascularity. This review summaries its use for diagnosis and treatment monitoring of liver tumors. The existing literature provides evidence on the successful application of Vuebox based DCE-US for characterization and differential diagnosis of focal liver lesions, as well as on its use for monitoring of local ablative therapies and of modern systemic treatment in oncology.

Keywords: Dynamic contrast-enhanced ultrasound (DCE-US), liver tumors, VueBox, perfusion, quantitative

DOI: 10.3233/CH-211261

Citation: Clinical Hemorheology and Microcirculation, vol. 80, no. 4, pp. 473-486, 2022

Authors: Diesch, S.T. | Jung, F. | Prantl, L. | Jung, E.M.

Article Type: Research Article

Abstract: AIM: This study aims to evaluate optimized breast implant surface-structure analysis by comparing high-end ultrasound technology with a new high frequency technique. This comparative study used new breast implants with different surfaces in an in vitro setting. METHODS: Nine idle silicon or polyurethane (PU) breast implants were examined by two investigators in an experimental in vitro study using two high-end ultrasound devices with multi-frequency transducers (6–15 MHz, 9–16 MHz, 12.5–33 MHz). The ultrasound B-Mode was optimized using tissue harmonic imaging (THI), speckle reduction imaging (SRI, level 0–5), cross beam (high, medium, low) and photopic. Using a standardized ultrasound protocol, …the implants were examined in the middle (point of highest projection) and lateral, by two independent examiners. Image evaluation was performed on anonymized digital images in the PACS. The aim was to achieve an artifact-free recording of the surface structure, the surface coating, the total image structures and, as far as possible, an artifact-free internal representation of the implants. For independent surface evaluation a score was used (0 = undetectability of surface structures, rich in artifacts, 5 = best possible, artifact free image quality). RESULTS: The quality of ultrasound imaging of breast implant surfaces after the optimization of B-Scan differed significantly comparing high-end ultrasound technology with modern high-frequency ultrasound technology (p  < 0,05). The following setting has been found to be the best setting with the highest image quality: B-Mode, SRI value 3, Crossbeam high level with color coded imaging for B- mode. In the total examined frequency range of 6–33 MHz, the highest image quality was found in the average frequency range of 12.5–33 MHz at both measured points. For both devices, device 1 (high-end) and device 2 (high frequency) ultrasound, the image quality was in the 12.5–33 MHz frequency range with an average image quality of 3.236. It was significantly higher, than in the lower frequency ranges and the same frequency range with THI. (p  < 0,05).   The image quality of the high-end sonography device was superior to the conventional high-frequency ultrasound device in all frequency ranges. CONCLUSION: High-end ultrasound imaging technology was superior in the quality of implant surface evaluation in comparison to high-frequency ultrasound sonography. The gained knowledge can serve as a basis for further multicenter clinical application and studies with the aim to develop an objective, precise tool to evaluate the implant and the surrounding tissue with ultrasound. Show more

Keywords: Breast implant ultrasound, high-frequency ultrasound, breast implant imaging

DOI: 10.3233/CH-219204

Citation: Clinical Hemorheology and Microcirculation, vol. 80, no. 4, pp. 487-495, 2022

Authors: Wang, Shuya | Wang, Yueheng | Gao, Man | Tan, Yongpan

Article Type: Research Article

Abstract: BACKGROUND: Few researches studied fetal pulmonary pulse wave doppler and the clinical end point disorders in gestational diabetic mellitus (GDM) cohort. OBJECTIVE: To investigate fetal pulmonary artery acceleration time to ejection time ratio (PATET) in the prediction of neonatal respiratory disorders (NRD). METHODS: 238 pregnant women diagnosed with GDM who attended our hospital between February 2018 and March 2020 were retrospectively included. Fetal pulmonary artery Doppler wave measurements were recorded, including main, left and right pulmonary artery blood flow, and left and right peripheral pulmonary artery blood flow. Acceleration time (At)/ejection time (Et) were calculated. …RESULTS: 183 GDM pregnant women and neonates were divided into NRD(+)(n  = 42) and NRD(–) group (n  = 141). 16 cases were neonatal pneumonia (NP) within 28 days after birth in NRD(+) group. The area under curve (AUC) of left peripheral pulmonary artery acceleration time to ejection time (LPPATET) was 0.967 (95% CI: 0.927∼1.000, P  < 0.001) and the AUC of right peripheral pulmonary artery acceleration time to ejection time (RPPATET) was 0.967 (95% CI: 0.927∼1.000, P  < 0.001), indicating that LPPATET and RPPATET are both predictors for NRD. The results of interobserver variabilty and intraobserver variability showed a good consistency. CONCLUSIONS: The At/Et of fetal peripheral pulmonary artery (PPA) in GDM women may be predictors for NRD, and the indicator can provide assistance in clinical management of diabetes pregnant patients. Show more

Keywords: Peripheral pulmonary artery blood flow, acceleration time to ejection time, fetal pulmonary artery doppler, gestational diabetic mellitus, neonatal respiratory disorders

DOI: 10.3233/CH-211265

Citation: Clinical Hemorheology and Microcirculation, vol. 80, no. 4, pp. 497-507, 2022