APPLICATION OF IMAGING METHODS IN THE DIAGNOSTICS OF MALIGNANT NECK LYMPH NODES

The presence of malignant lymph nodes in the neck is a prognostic factor in planocellular carcinomas of the head and neck which are the most common primary tumors of this region. Determination of neck lymph nodes involvement is necessary for deciding on surgical treatment and planning chemotherapy and radiation therapy. Metastases in the neck lymph nodes reduce patient survival to a half. Localization of metastatic lymph nodes, their number and size are also very important factors which correlate with distant metastases. Besides clinical examination which includes inspection and palpation of the neck, the diagnostics of metastatic neck lymph nodes also uses imaging techniques: ultrasound (US), computerized tomography (CT) and magnetic resonance imaging (MRI). Precision and reliability of these methods depends on the application of adequate radiological criteria in the diagnostics of malignant lymph nodes of the neck

Diagnosticul ultrasonografic al nodulilor tiroidieni: actualităţi şi perspective

Universitatea de Medicină şi Farmacie Iuliu Haţieganu, Cluj-NapocaUltrasonografia este metoda imagistică cea mai larg accesibilă și eficientă, din punct de vedere al costului, pentru evaluarea morfologică a tiroidei și a maselor cervicale. În aprecierea nodulilor tiroidieni, fie că sunt unici sau aparţin unei guși multinodulare, pricipalul rol al ecografiei este acela de a indica nodulii suspecţi a reprezenta cancer papilar, în vederea evaluării lor ulterioare prin puncţie aspirativă cu ac fin. Criteriile ecografice care indică malignitatea unui nodul tiroidian sunt: hipoecogenitate marcată, halou întrerupt, contur neregulat/invaziv, microcalcificări punctate sau calcificări centrale, calcificare anulară discontinuă, aspect „mai mult înalt decât lat”, vascularizaţie centrală crescută cu halou hipovascular și creștere accelerată a volumului la urmărirea evoluţiei. Limfadenopatia malignă și extensia extratiroidiană sunt semne tardive. Se prezintă, de asemenea, și semnele evocatoare pentru caracterul benign al nodulilor tiroidieni. Este discutat rolul actual al elastografiei și al examinării cu contrast. Sunt prezentate aspecte particulare ale unor tumori tiroidiene, precum și aspecte care permit diferenţierea paratiroidelor anormale de nodulii tiroidieni. La final sunt discutate principalele probleme de diagnostic diferenţial și sunt prezentate algoritme de diagnostic

Cost Analysis on Imaging Diagnostic Techniques in Cerebral and Abdominal Neonatal Pathology

Background: Improvement of health care quality and cost control are the main aims of the health care reform in Romania. Objective: The aims of the research are to analyse the trend of costs for imaging techniques used as diagnostic tools for cerebral and abdominal neonatal pathology and to study the relationship between cost and diagnostic benefits. Design: This is a retrospective observational study design without a control group, conducted in the Radio-Imaging Department, Cluj District University Hospital, Romania, from October 2000 to February 2006. Patients: The study population was represented by neonates investigated in the Radio-Imaging Department, Cluj District University Hospital. Intervention: Five imaging diagnostic techniques used in the diagnosis of cerebral and abdominal neonatal pathology were investigated. Measurements: The costs of the investigated techniques were calculated. The concordance between clinical and imaging diagnostic was recorded. Results: Magnetic resonance proved to be the most expensive investigation. The rate between the raising of costs on investigation type on year was constant. The average cost of imaging investigations for patients with identified pathological aspects (€ 42.72) was not statistically significant (p > 0.05) compared with the average cost for patients with no pathologic imaging aspects (€ 37.62). The concordance between the clinical suspicion and the radio-imaging diagnosis was of 52.35%. Conclusions: The raise of radio-imaging investigation costs had a decreasing tendency over the years studied, decrease explained by the stabilization of the Romanian monetary market. The results on concordance analysis lead to the necessity of training of both clinicians and radiologists

Multiple, Synchronous Lesions of Differing Histology Within the Same Testis: Ultrasonographic and Pathologic Correlations

Objective: To describe ultrasound (US) and pathologic findings in 11 patients with multiple, synchronous lesions of different histology within the same testis. Materials and methods: We reviewed US and pathologic findings in 11 patients with multiple, synchronous lesions of different histology within the same testis. Lesions were classified as separate or adjacent one to another and attempt was made to predict tumor type on their US textures. Pathologic review assessed presence of normal tissue between adjacent lesions and of Germ Cell Neoplasia In Situ in surrounding parenchyma. Nine cases were from files specifically dedicated to testicular tumors and estimated prevalence was calculated. Results: Two nodules were seen in nine patients and 3 in remaining two. Nine had tumors of different histology; two had one malignancy and one focal benign lesion. Germ Cell Neoplasia In Situ was seen in 7/11 cases. In dedicated archives, these lesions had 1.83% prevalence. Conclusion: Multiple focal lesions identified at imaging within the testis are not always of the same histology. This can be suspected in some cases basing on US texture. Recognition that lesions are multiple and an indication of their locations within the testis is the most important role of imaging and may help pathologists correctly sample the specimen to establish nature of each of them. Presence of multiple lesions is regarded as a contraindication to testicular sparing surgery. In two of our patients, one lesion was benign. Then, when the procedure is indicated all lesions have to be sampled and assessed by pathologists before deciding between conservative or radical technique

EFSUMB Statement on Medical Student Education in Ultrasound [long version]

Publisher Copyright: © 2016 Georg Thieme Verlag. All rights reserved.The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) recommends that ultrasound should be used systematically as an easy accessible and instructive educational tool in the curriculum of modern medical schools. Medical students should acquire theoretical knowledge of the modality and hands-on training should be implemented and adhere to evidence-based principles. In this paper we report EFSUMB policy statements on medical student education in ultrasound that in a short version is already published in Ultraschall in der Medizin 1.publishersversionPeer reviewe