Impact of Screening for Salivary Gland by Ultrasonography

Background: Ultrasonography is superior to other imaging modalities for detecting salivary gland diseases. However, there have been no reports of the results of salivary gland screening with ultrasonography. In this study, the salivary glands were also observed during thyroid ultrasonography to determine the degree of salivary gland abnormalities detected by ultrasonography. Methods: This study was conducted retrospectively using medical records. It assessed the association between the following abnormal findings detected during thyroid ultrasonography and their final diagnoses: atrophy/swelling, unclear demarcation from surrounding tissues, decreased salivary gland parenchyma echo level, heterogeneity of parenchyma, hypervascularity of salivary gland parenchyma, dilatation of the ducts, and a mass within the gland. Results: Of the 908 patients who underwent thyroid ultrasonography, salivary gland abnormalities were detected in 36 (4.0%) patients. Of the 36 patients with abnormal ultrasonographic findings, 22 underwent further examination. Of the 22 patients, 16 received definitive diagnoses of salivary gland diseases. Salivary gland disorders were considered to be absent in patients with only heterogeneity of the salivary glands observed on ultrasonography. Salivary gland disorders in all patients with further abnormal ultrasonographic findings such as atrophy/swelling, unclear boundary, or hypervascularity in addition to internal heterogeneity were confirmed by further blood examinations and imaging studies. We were able to detect autoimmune sialadenitis such as Sj ögren’s syndrome and IgG4-related sialadenitis by ultrasonography in patients without obvious symptoms. Conclusion: Salivary gland screening during thyroid ultrasonography revealed abnormal findings including Sjögren’s syndrome and IgG4-related sialadenitis in about 4% of the patients. Thus, ultrasonography may also be useful for early detection of autoimmune diseases of salivary glands.journal articl

Transabdominal Ultrasonography for Assessing the Depth of Tumor Invasion in Gastric Cancer

[Background] Although endoscopy and endoscopic ultrasonography are generally used to diagnose the depth of gastric tumor invasion, endoscopy is invasive and frequently results in patient discomfort. Transabdominal ultrasonography (TUS) is noninvasive and may be useful in determining this depth. We investigated the usefulness of TUS in determining the depth of tumor invasion in patients with gastric cancer. [Methods] This retrospective study included 190 patients with gastric cancer and 200 lesions who underwent curative resection at the Department of Gastrointestinal Surgery of Tottori University Hospital from July 2007 to July 2015. The results of conventional diagnostic imaging and TUS were compared with those of pathological analysis obtained after surgery. Furthermore, the ruptured form of the third layer on TUS imaging was reviewed and investigated to differentiate between the SM2 and MP lesions. [Results] The accuracy of TUS was similar to that of conventional diagnostic imaging for all depths of tumor invasion. Eight lesions could not be assessed by TUS, including four that could not be identified and four in which TUS was unable to diagnose the depth. In cases where the ruptured form of the third layer could be determined in MP lesions, the forms were observed toward the inside of the gastric lumen. [Conclusion] The results of this study suggested that the accuracy of TUS was equivalent to that of conventional diagnostic imaging in determining the depth of tumor invasion. TUS assessment criteria may be useful to classify this depth. Furthermore, the ruptured form of the third layer is believed to be important in distinguishing between early and advanced gastric cancer.journal articl

Investigation of the Utility and Safety of Dynamic Computed Tomography with Vasodilators

Background: Dynamic computed tomography (CT) angiography is useful for evaluating of hepatic vascularity. Although vasodilators increase hepatic blood flow, the utility of dynamic CT with vasodilators is unclear. Here we investigated the utility and safety of dynamic CT with vasodilators. Methods: A prospective case-control radiographic evaluation using abdominal dynamic CT with and without vasodilator was performed at a single center between October 2015 and September 2016. We compared the CT values in Hounsfield units of the aorta; celiac artery; and common, right, and left hepatic arteries in the arterial phase and the main trunk; right and left branches of the portal vein; and right, middle, and left hepatic veins in the portal phase with and without vasodilators. The region of interest was set in each element of the liver vasculature. Four radiological technologists independently and visually compared the scores of the portal vein (P-score) and hepatic vein (V-score) on a 5-point scale with and without vasodilators. Results: The CT values of arteries and veins using vasodilators were significantly higher than those without vasodilators. With and without vasodilators, the P-scores were 3.1 ± 1.2 and 4.0 ± 1.1 (P < 0.05) and the V-scores were 3.3 ± 1.4 and 4.3 ± 1.0 (P < 0.05). Only one patient with vasodilator use had transient hypotension and recovered immediately without medication. Conclusion: Dynamic CT with vasodilators can provides better visualization of vascular structures.journal articl

Usefulness of a Novel Ultrasonographic Classification Based on Anechoic Area Patterns for Differentiating Warthin Tumors from Pleomorphic Adenomas of the Parotid Gland

[Background]Ultrasonographic homogeneity is an important differential finding between Warthin tumor and pleomorphic adenoma, two types of benign parotid gland tumors, with the former likely to be heterogeneous and the latter homogeneous. However, differences in the performance of ultrasound machines or the homogeneity cut-off level affect the judgment of ultrasonographic homogeneity. Therefore, in this study, we adopted a novel system for classifying the composition of tumors via ultrasonography, using anechoic area as a substitute for differences in homogeneity to differentiate between Warthin tumors and pleomorphic adenomas. [Methods]We evaluated 68 tumors that were histopathologically diagnosed as Warthin tumor or pleomorphic adenoma between July 2009 and November 2015. Ultrasonographic images of the tumors were evaluated on the basis of key differentiating features, including features on B-mode imaging and color Doppler imaging. Additionally, the tumors were classified into four groups based on anechoic area, and findings were compared between Warthin tumors and pleomorphic adenomas. [Results]While 38 of the tumors were pleomorphic adenomas, 30 were Warthin tumors. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for detection of Warthin tumors using our novel classification system were 73.3%, 76.3%, 71.0%, 78.4% and 75.0%, respectively. Compared to pleomorphic adenomas, Warthin tumors showed large or sponge-like anechoic areas, rich vascularization and an oval shape even at large tumor sizes, and the difference was significant. On defining Warthin tumor as a tumor demonstrating two or more of the findings noted above, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for its detection were 73.3%, 84.2%, 78.6%, 80.0% and 79.4%, respectively. [Conclusion]Our novel classification system based on anechoic area patterns demonstrated by the tumors had high sensitivity, specificity and diagnostic accuracy for differentiating Warthin tumors from pleomorphic adenomas.journal articl

Effectiveness of the LigaSure Small Jaw Vessel-Sealing System in Hepatic Resection

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Decreased Wave V Amplitude in Auditory Brainstem Responses of Children with Cerebellar Lesions

【Background】 This study aims to elucidate the effect of isolated cerebellar lesions sparing the brainstem on the auditory brainstem responses in children. 【Methods】 We enrolled 10 children (aged 1?16 years) with cerebellar lesions on neuroimaging but lacking clinical brainstem involvement signs and with normal brainstem volumes on magnetic resonance imaging. 【Results】 The interpeak latency of waves I and V was normal in 9 patients and was marginally prolonged in 1 patient. While amplitudes of waves I and III were normal, we noted a decreased amplitude of wave V and/or an increased I/V amplitude ratio in 6 patients; these included 5 of 8 patients with cerebellar hypoplasia/atrophy and 1 patient with acute cerebellar ataxia. 【Conclusion】 Our results support the hypothesis of an inhibitory input from the cerebellar fastigial nucleus on the inferior colliculus, which might be disinhibited because of Purkinje cells dysfunction due to cerebellar cortex lesions, especially within the cerebellar vermis.journal articl

Clinical Significance of Microcalcifications Detection in Invasive Breast Carcinoma

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EEG Power Spectrum Analysis in Children with ADHD

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Correlation between Ultrasound Findings of Tumor Margin and Clinicopathological Findings in Patients with Invasive Ductal Carcinoma of the Breast

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