Shear Wave Elastography May Add a New Dimension to Ultrasound Evaluation of Thyroid Nodules: Case Series with Comparative Evaluation

Although elastography can enhance the differential diagnosis of thyroid nodules, its diagnostic performance is not ideal at present. Further improvements in the technique and creation of robust diagnostic criteria are necessary. The purpose of this study was to compare the usefulness of strain elastography and a new generation of elasticity imaging called supersonic shear wave elastography (SSWE) in differential evaluation of thyroid nodules. Six thyroid nodules in 4 patients were studied. SSWE yielded 1 true-positive and 5 true-negative results. Strain elastography yielded 5 false-positive results and 1 false-negative result. A novel finding appreciated with SSWE, were punctate foci of increased stiffness corresponding to microcalcifications in 4 nodules, some not visible on B-mode ultrasound, as opposed to soft, colloid-inspissated areas visible on B-mode ultrasound in 2 nodules. This preliminary paper indicates that SSWE may outperform strain elastography in differentiation of thyroid nodules with regard to their stiffness. SSWE showed the possibility of differentiation of high echogenic foci into microcalcifications and inspissated colloid, adding a new dimension to thyroid elastography. Further multicenter large-scale studies of thyroid nodules evaluating different elastographic methods are warranted

The Utility of 3D TOF Magnetic Resonance Angiography of Renal Arteries for Diagnosing Renal Artery Stenosis in the Hypertensive Patiens

Wstęp Celem pracy była ocena przydatności angiografii metodą rezonansu magnetycznego (MRA) w ocenie tętnic nerkowych u chorych z podejrzeniem zwężenia tętnicy nerkowej oraz jej porównanie z podwójnym badaniem dopplerowskim u chorych poddanych następnie rentgenowskiej arteriografii nerkowej. Materiał i metody Badanie arteriografii rezonansu magnetycznego i badanie dopplerowskie wykonano u 50 osób (33 kobiety, 17 mężczyzn, średni wiek: 49 lat) z klinicznym podejrzeniem zwężenia tętnicy nerkowej. U wszystkich chorych wykonano dotętniczą angiografię subtrakcyjną w celu weryfikacji wyników badań wykonanych metodami nieinwazyjnymi. Badania angiografii rezonansu magnetycznego wykonano za pomocą systemu rezonansu magnetycznego MAGNETOM SP 63 (1,5T) Siemens z zastosowaniem cewki do całego ciała, stosując technikę 3D Time of Flight (3D TOF). Badania dopplerowskie wykonano na aparacie ATL 3000 z opcją podwójną. Wyniki Wyniki badań wskazują, że czułość, swoistość i skuteczność diagnostyczna angiografii rezonansu magnetycznego wynosi 98,1; 88,6 i 93,9%, natomiast badania dopplerowskiego 85,7; 90,6 i 87,8%. Różnice między tymi dwiema metodami były znamienne statystycznie. Wniosek Niniejsza praca wskazuje, że angiografia rezonansu magnetycznego ma wysoką czułość i swoistość w wykrywaniu zwężenia tętnic nerkowych i jest porównywalna z wynikami prezentowanymi w innych doniesieniach.Background The aim of the study was to prospectively evaluate the diagnostic value of MRA of the renal arteries compared with renal duplex scanning in patients with clinical suspicion of renovascular disease using conventional angiography as a standard reference. Material and methods The study included 50 patients (33 women, 17 men, mean age: 49 yrs) with clinical suspicion of renovascular disease in whom MRA and duplex doppler were performed. All subjects underwent conventional angiography to verify the results of non-invasive methods. MRA examinations were performed with the use of of magnetic resonance system 1.5 T MAGNETOM SP 63 (Siemens) with the application of the whole-body coil. For evaluation of renal arteries 3D TOF technique has been used. Doppler Duplex (ATL 3000 HDI) evaluation was done with the ATL 3000 HDI. Results Our results indicate that sensitivity, specificity and accuracy for MRA was 98,1%, 88,6% and 93,9% respectively and for duplex doppler 87,7%, 90,6% and 87,8% respectively. The differences in sensitivity, specificity and accuracy between two methods were statistically significant. Conclusion Our results indicate that MRA has high sensitivity and specificity for the detection of renal artery stenosis and are comparable with the data published so far. Our study demonstrate that this method has the potential usefulness for diagnosing patients suspected for renovascular disease