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Wang J, Wan K, Chang X, Mao RF. Association of autoimmune thyroid disease with type 1 diabetes mellitus and its ultrasonic diagnosis and management. World J Diabetes 2024; 15:348-360. [PMID: 38591076 PMCID: PMC10999045 DOI: 10.4239/wjd.v15.i3.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/14/2023] [Accepted: 01/18/2024] [Indexed: 03/15/2024] Open
Abstract
As a common hyperglycemic disease, type 1 diabetes mellitus (T1DM) is a complicated disorder that requires a lifelong insulin supply due to the immune-mediated destruction of pancreatic β cells. Although it is an organ-specific autoimmune disorder, T1DM is often associated with multiple other autoimmune disorders. The most prevalent concomitant autoimmune disorder occurring in T1DM is autoimmune thyroid disease (AITD), which mainly exhibits two extremes of phenotypes: hyperthyroidism [Graves' disease (GD)] and hypo-thyroidism [Hashimoto's thyroiditis, (HT)]. However, the presence of comorbid AITD may negatively affect metabolic management in T1DM patients and thereby may increase the risk for potential diabetes-related complications. Thus, routine screening of thyroid function has been recommended when T1DM is diagnosed. Here, first, we summarize current knowledge regarding the etiology and pathogenesis mechanisms of both diseases. Subsequently, an updated review of the association between T1DM and AITD is offered. Finally, we provide a relatively detailed review focusing on the application of thyroid ultrasonography in diagnosing and managing HT and GD, suggesting its critical role in the timely and accurate diagnosis of AITD in T1DM.
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Affiliation(s)
- Jin Wang
- Department of Ultrasound Medicine, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 211200, Jiangsu Province, China
| | - Ke Wan
- Faculty of Medicine and Health, The University of Sydney, Camperdown NSW 2050, Australia
| | - Xin Chang
- Department of Ultrasound Medicine, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 211200, Jiangsu Province, China
| | - Rui-Feng Mao
- School of Life Science, Huaiyin Normal University, Huai'an 223300, Jiangsu Province, China
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2
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Yamashita Y, Ashida R, Tamura T, Shimokawa T, Yamazaki H, Kawaji Y, Tamura T, Hatamaru K, Itonaga M, Kitano M. Novel Technique of Endoscopic Ultrasonography for the Differential Diagnosis of Gallbladder Lesions and Intraductal Papillary Mucinous Neoplasms: A Single-Center Prospective Study. Diagnostics (Basel) 2023; 13:2132. [PMID: 37443527 DOI: 10.3390/diagnostics13132132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
Detective flow imaging endoscopic ultrasonography (DFI-EUS) is an innovative imaging modality that was developed to detect fine vessels and low-velocity blood flow without contrast agents. We evaluate its utility for the differential diagnosis of gallbladder lesions and intraductal papillary mucinous neoplasms (IPMNs). We enrolled patients who underwent DFI-EUS, e-FLOW EUS, and contrast-enhanced EUS for gallbladder lesions or IPMNs. The detection of vessels using DFI-EUS and e-FLOW EUS was compared with that via contrast-enhanced EUS and pathological findings. The vessel pattern was also categorized as regular or irregular. Of the 33 lesions included, there were final diagnoses of 13 IPMNs and 20 gallbladder lesions. DFI-EUS was significantly superior to e-FLOW EUS for discriminating between mural nodules and mucous clots and between solid gallbladder lesions and sludge using the presence or absence of vessel detection in lesions (p = 0.005). An irregular vessel pattern with DFI-EUS was a significant predictor of malignant gallbladder lesions (p = 0.002). DFI-EUS is more sensitive than e-FLOW-EUS for vessel detection and the differential diagnosis of gallbladder lesions and IPMNs. Vessel evaluation using DFI-EUS may be a useful and simple method for differentiating between mural nodules and mucous clots in IPMN, between solid gallbladder lesions and sludge, and between malignant and benign gallbladder lesions.
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Affiliation(s)
- Yasunobu Yamashita
- Second Department of Internal Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012, Japan
| | - Reiko Ashida
- Second Department of Internal Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012, Japan
| | - Takaaki Tamura
- Second Department of Internal Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012, Japan
- Department of Human Pathology, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012, Japan
| | - Toshio Shimokawa
- Clinical Study Support Center, Wakayama Medical University Hospital, 811-1, Kimiidera, Wakayama 641-0012, Japan
| | - Hirofumi Yamazaki
- Second Department of Internal Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012, Japan
| | - Yuki Kawaji
- Second Department of Internal Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012, Japan
| | - Takashi Tamura
- Second Department of Internal Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012, Japan
| | - Keiichi Hatamaru
- Second Department of Internal Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012, Japan
| | - Masahiro Itonaga
- Second Department of Internal Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012, Japan
| | - Masayuki Kitano
- Second Department of Internal Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012, Japan
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Shadmani G, Don S. What is this bump in my neck? Ultrasonographic evaluation of pediatric neck masses. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:919-930. [PMID: 36426742 DOI: 10.1002/jcu.23400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 11/06/2022] [Accepted: 11/09/2022] [Indexed: 06/02/2023]
Abstract
Neck masses are common in pediatric patients, with benign etiologies such as congenital or inflammatory lesions accounting most of these masses. Anatomic location (most important), clinical history, and the appearance in ultrasonography (US) are helpful clues to narrow down differential diagnosis. Because of widespread availability, lack of ionizing radiation, and no need for sedation or contrast administration, US is the preferred initial modality for the evaluation. Further evaluation with cross-sectional imagings is needed for more extensive lesions with trans-spatial extension or suspicion of intrathoracic or retropharyngeal extension. This review will focus on US appearance and clinical presentation of masses of the neck in children, to enable radiologist to arrive at a reasonable differential diagnosis. We also briefly discuss more complex pathologies that need to be evaluated with cross-sectional modalities such as CT scan and magnetic resonance imaging.
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Affiliation(s)
- Ghazal Shadmani
- Mallinckrodt Institute of Radiology, Washington University in Saint Louis, Saint Louis, Missouri, USA
| | - Steven Don
- Mallinckrodt Institute of Radiology, Washington University in Saint Louis, Saint Louis, Missouri, USA
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4
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Catalano O, Corvino A, Basile L, Catalano F, Varelli C. Use of new microcirculation software allows the demonstration of dermis vascularization. J Ultrasound 2023; 26:169-174. [PMID: 36001281 PMCID: PMC10063712 DOI: 10.1007/s40477-022-00710-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/06/2022] [Indexed: 10/15/2022] Open
Abstract
AIMS Current ultrasound (US) Doppler techniques cannot demonstrate the vascularization of the dermis. The purpose of this study was to investigate whether the new Superb Vascular Imaging (SMI) and Microvascular Flow (MV-Flow) techniques improve the detection of normal dermis vessels. SMI and MV-Flow were compared side-by-side to conventional power-Doppler (PD) imaging. METHODS By using US, 50 healthy volunteers were evaluated at level of five body areas: forehead, forearm, palm, buttock, and thigh. Two off-site operators evaluated the images to assess the difference between SMI and PD imaging and between MV-Flow and PD imaging in terms of dermis flow amount. A 0-3 scoring system was adopted. RESULTS SMI scored grade 0 in 0% of body areas, grade 1 in 58%, grade 2 in 33%, and grade 3 in 9%. In comparison with SMI, PD scored grade 0 in 38% of body areas, grade 1 in 56%, grade 2 in 6%, and grade 3 in 0%. MV-Flow scored grade 0 in 0% of body areas, grade 1 in 52%, grade 2 in 43%, and grade 3 in 6%. Comparted to MV-Flow, PD scored grade 0 in 53% of body areas, grade 1 in 34%, grade 2 in 13%, and grade 3 in 0%. The difference in terms of sensitivity was statistically significant for all the body areas investigated. CONCLUSIONS We found both SMI and MV-Flow to be superior to PD imaging and capable to demonstrate normal vascularization of the dermis.
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Affiliation(s)
- Orlando Catalano
- Radiology Unit, Istituto Diagnostico Varelli, via Cornelia dei Gracchi 65, 80126, Naples, Italy.
| | - Antonio Corvino
- Motor Science and Wellness Department, University of Naples Parthenope, Naples, Italy
| | - Luigi Basile
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Fabio Catalano
- Radiology Unit, Istituto Diagnostico Varelli, via Cornelia dei Gracchi 65, 80126, Naples, Italy
| | - Carlo Varelli
- Radiology Unit, Istituto Diagnostico Varelli, via Cornelia dei Gracchi 65, 80126, Naples, Italy
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5
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Huang J, Zhao J. Quantitative Diagnosis Progress of Ultrasound Imaging Technology in Thyroid Diffuse Diseases. Diagnostics (Basel) 2023; 13:diagnostics13040700. [PMID: 36832188 PMCID: PMC9954877 DOI: 10.3390/diagnostics13040700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 02/06/2023] [Accepted: 02/06/2023] [Indexed: 02/16/2023] Open
Abstract
High-frequency ultrasound (HFUS), the imaging modality of choice for thyroid screening, is most commonly used in the study of diffuse thyroid disease (DTD) with Hashimoto's thyroiditis (HT) and Graves' disease (GD). DTD can involve thyroid function and severely affect life quality, so early diagnosis is important for the development of timely clinical intervention strategies. Previously, the diagnosis of DTD relied on qualitative ultrasound imaging and related laboratory tests. In recent years, with the development of multimodal imaging and intelligent medicine, ultrasound and other diagnostic imaging techniques have gradually become more widely used for quantitative assessment of the structure and function of DTD. In this paper, we review the current status and progress of quantitative diagnostic ultrasound imaging techniques for DTD.
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Affiliation(s)
- Jing Huang
- Department of Ultrasound, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai 200003, China
| | - Jiaqi Zhao
- Department of Ultrasound, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai 200434, China
- Correspondence: ; Tel.: +86-21-5560-3999
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Mao Y, Mu J, Zhao J, Yang F, Zhao L. The comparative study of color doppler flow imaging, superb microvascular imaging, contrast-enhanced ultrasound micro flow imaging in blood flow analysis of solid renal mass. Cancer Imaging 2022; 22:21. [PMID: 35505388 PMCID: PMC9066849 DOI: 10.1186/s40644-022-00458-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 04/19/2022] [Indexed: 11/18/2022] Open
Abstract
Purposes To evaluate the value of Color Doppler Flow Imaging (CDFI), Superb Microvascular Imaging (SMI) and Contrast-enhanced Ultrasound Microflow Imaging (MFI) in display the microvascular blood flow signals in renal solid lesions. Methods 142 patients with 144 renal masses were examined by CDFI, SMI and MFI simultaneously. We compared the difference of blood flow grading and vascular architecture based on CDFI, SMI and MFI. Results The blood flow signals detection rates of CDFI, SMI and MFI were 78.5% (113/144), 88.9% (128/144) and 93.8% (135/144), respectively. Concentrated on blood flow grading, The coincidence rates of CDFI and SMI were 64.58% (93/144) and 81.25% (117/144) referring to MFI, respectively. Blood flow grade 2–3 in CDFI is significantly lower than SMI(x2 = 5.557, P = 0.018) and MFI (x2 = 10.165, P = 0.001). Whereas there was no significant difference between SMI and MFI (x2 = 2.372, P = 0.499). Concentrated on vascular architecture, the coincidence rates of CDFI and SMI were 56.25% (81/144) and 75.69% (109/144) referring to MFI, respectively. Vascular architecture type IV and V in CDFI was significantly lower than SMI (x2 = 18.217, P < 0.001) and MFI (x2 = 29.518, P < 0.001). Whereas there was no significant difference between SMI and MFI (x2 = 3.048, P = 0.550). The sensitivity and specificity of CDFI, SMI and MFI in the diagnosis of renal mass were 61.29% and 90.20%, 79.57% and 88.24%, 88.17% and 84.31% respectively. The areas under the ROC curve of the three were 0.757, 0.839 and 0.862, respectively. There was a statistically significant difference between CDFI and MFI (Z = 3.687, P = 0.0002), while there was no statistically significant difference between SMI and MFI (Z = 1.167, P = 0.2431). Conclusion SMI and MFI are superior to CDFI in showing blood flow signals in renal solid masses, and it can perform blood flow and vascular architecture more accurately. Advances in knowledge SMI is similar to MFI in its ability to display fine vessels and diagnostic efficiency, and has application value in the diagnosis and differential diagnosis of renal solid masses.
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Affiliation(s)
- Yiran Mao
- Department of Ultrasound, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Jie Mu
- Department of Ultrasound, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China. .,Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
| | - Jing Zhao
- Department of Ultrasound, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Fan Yang
- Department of Ultrasound, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Lihui Zhao
- Department of Ultrasound, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China. .,Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
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Baek HS, Park JY, Jeong CH, Ha J, Kang MI, Lim DJ. Usefulness of Real-Time Quantitative Microvascular Ultrasonography for Differentiation of Graves' Disease from Destructive Thyroiditis in Thyrotoxic Patients. Endocrinol Metab (Seoul) 2022; 37:323-332. [PMID: 35413779 PMCID: PMC9081314 DOI: 10.3803/enm.2022.1413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/28/2022] [Accepted: 03/08/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Microvascular ultrasonography (MVUS) is a third-generation Doppler technique that was developed to increase sensitivity compared to conventional Doppler. The purpose of this study was to compare MVUS with conventional color Doppler (CD) and power Doppler (PD) imaging to distinguish Graves' disease (GD) from destructive thyroiditis (DT). METHODS This prospective study included 101 subjects (46 GDs, 47 DTs, and eight normal controls) from October 2020 to November 2021. All ultrasonography examinations were performed using microvascular flow technology (MV-Flow). The CD, PD, and MVUS images were semi-quantitatively graded according to blood flow patterns. On the MVUS images, vascularity indices (VIs), which were the ratio (%) of color pixels in the total grayscale pixels in a defined region of interest, were obtained automatically. Receiver operating characteristic curve analysis was performed to verify the diagnostic performance of MVUS. The interclass correlation coefficient and Cohen's kappa analysis were used to analyze the reliability of MVUS (ClinicalTrials.gov:NCT04879173). RESULTS The area under the curve (AUC) for CD, PD, MVUS, and MVUS-VI was 0.822, 0.844, 0.808, and 0.852 respectively. The optimal cutoff value of the MVUS-VI was 24.95% for distinguishing GD and DT with 87% sensitivity and 80.9% specificity. We found a significant positive correlation of MVUS-VI with thyrotropin receptor antibody (r=0.554) and with thyroid stimulating immunoglobulin bioassay (r=0.841). MVUS showed high intra- and inter-observer reliability from various statistical method. CONCLUSION In a real time and quantitative manner, MVUS-VI could be helpful to differentiate GD from thyroiditis in thyrotoxic patients, with less inter-observer variability.
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Affiliation(s)
- Han-Sang Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji-Yeon Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chai-Ho Jeong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Jeonghoon Ha
- Division of Endocrinology and Metabolism, Department of Internal Medicine Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Moo Il Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong-Jun Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Corvino A, Varelli C, Cocco G, Corvino F, Catalano O. Seeing the unseen with superb microvascular imaging: Ultrasound depiction of normal dermis vessels. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:121-127. [PMID: 34761407 DOI: 10.1002/jcu.23068] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/28/2021] [Accepted: 09/05/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE Current color- and power-Doppler techniques cannot demonstrate vascularization of the dermis. Aim of this prospective study was to investigate whether the new superb vascular imaging (SMI) technique improves the ultrasound (US) depiction of dermis vessels in healthy volunteers. SMI was compared side-by-side to conventional power-Doppler (PD) imaging. METHODS Thirty adult subjects (18 men and 12 women, mean age 45 years old) were evaluated with US at level of five body areas: forehead, forearm, palm, buttock, and thigh. The vascular index (VI) was employed to objectively quantify the difference between SMI and PD imaging in terms of dermis flow amount. RESULTS Forehead VI was higher for SMI than for PD in 93% of cases, forearm VI was higher for SMI than for PD in 97% of cases, palm VI was higher for SMI than for PD in 87% of cases, buttock VI was higher for SMI than for PD in 100% of cases, thigh VI was higher for SMI than for PD in 100% of cases. SMI-detected vascular signals in 100% of the body areas. PD failed to show any flow signals from the forehead in 23% of cases, forearm in 37% of cases, palm in 33% of cases, buttock in 47% of cases, and thigh in 50% of cases. CONCLUSION SMI can demonstrate normal dermis vascularization whereas conventional PD cannot. SMI is a sensitive and promising technique in the study of dermis abnormalities, particularly when quantifying the disease activity is important.
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Affiliation(s)
- Antonio Corvino
- Motor Science and Wellness Department, University of Naples "Parthenope", Naples, Italy
| | - Carlo Varelli
- Radiology Unit, Istituto Diagnostico Varelli, Naples, Italy
| | - Giulio Cocco
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Aging Sciences, University of Chieti G d'Annunzio, Chieti, Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Naples, Italy
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Fu Z, Zhang J, Lu Y, Wang S, Mo X, He Y, Wang C, Chen H. Clinical Applications of Superb Microvascular Imaging in the Superficial Tissues and Organs: A Systematic Review. Acad Radiol 2021; 28:694-703. [PMID: 32418782 DOI: 10.1016/j.acra.2020.03.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/13/2020] [Accepted: 03/20/2020] [Indexed: 12/12/2022]
Abstract
Superb microvascular imaging (SMI) is an innovative Doppler technique for vascular examination. It uses an intelligent algorithm that efficiently separates low-speed flow signals from motion artifacts so that it can assess microvessels and the vessel distribution in detail. This article reviews the clinical applications of SMI in the disorders of superficial tissues and organs including thyroid nodules, breast tumors and lymph node diseases etc. More information of diseases that are closely associated with angiogenesis can be shown by SMI than other noninvasive examinations. Although some limitations exist, this safe and convenient technique is becoming acceptable and would play a more important role in disease diagnosis and therapeutic responses evaluation.
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10
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Kılınçer A, Durmaz MS, Kıraç CO, Baldane S, Ateş F, Batur A. Evaluation of parenchymal vascularity of the thyroid gland with vascularization index by color superb microvascular imaging in patients with Graves' disease. J Ultrason 2021; 21:41-47. [PMID: 33796339 PMCID: PMC8010367 DOI: 10.15557/jou.2021.0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/20/2021] [Indexed: 01/07/2023] Open
Abstract
Aim of the study To determine the parenchymal vascularity of the thyroid gland with color superb microvascular imaging in patients with Graves’ disease, and compare the vascularization index values with healthy subjects. Materials and methods The thyroid glands of 37 patients whose laboratory and clinical findings were consistent with Graves’ disease, and 40 asymptomatic subjects with normal laboratory values, were examined using color superb microvascular imaging. Measurements of the vascularization index were performed with a free region of interest which was drawn along the outer margin of the gland on the color superb microvascular imaging mode. The vascularization index values obtained in the Graves’ disease and control groups were compared. A correlation analysis was performed between the vascularization index values and laboratory and grayscale US parameters. Results The median vascularization index value of the thyroid parenchyma in patients with Graves’ disease was significantly higher than in the asymptomatic group [median (min–max); 12 (2.3–32.1) vs 5.04 (1.1–10.8), p <0.001]. When the cutoff value of the vascularization index is determined as 6.3, Graves’ disease can be diagnosed with 83.8% sensitivity and 70% specificity. Conclusions The vascularization index obtained with color superb microvascular imaging can be a quantitative indicator of parenchymal vascularity in the diagnosis of Graves’ disease, and serve as a supportive tool.
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Affiliation(s)
- Abidin Kılınçer
- Department of Radiology, Selçuk University School of Medicine, Konya, Turkey
| | - Mehmet Sedat Durmaz
- Department of Radiology, Selçuk University School of Medicine, Konya, Turkey
| | - Cem Onur Kıraç
- Division of Endocrinology, Department of Internal Medicine, Selçuk University School of Medicine, Konya, Turkey
| | - Süleyman Baldane
- Division of Endocrinology, Department of Internal Medicine, Selçuk University School of Medicine, Konya, Turkey
| | - Fatih Ateş
- Department of Radiology, Selçuk University School of Medicine, Konya, Turkey
| | - Abdüssamet Batur
- Department of Radiology, Selçuk University School of Medicine, Konya, Turkey
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11
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Kandemirli SG, Cicek F, Erdemli Gursel B, Bilgin C, Kilic SS, Yazici Z. Superb Microvascular Imaging in Assessment of Synovitis and Tenosynovitis in Juvenile Idiopathic Arthritis. Ultrasound Q 2021; 37:56-62. [PMID: 33661799 DOI: 10.1097/ruq.0000000000000516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
ABSTRACT The aim of this study is to evaluate the diagnostic utility of superb microvascular imaging (SMI) in assessment of synovitis/tenosynovitis in juvenile idiopathic arthritis in comparison to power Doppler ultrasound. Thirty juvenile idiopathic arthritis cases with active clinical findings and ultrasound features of effusion and/or tenosynovitis were further imaged with power Doppler and SMI. For classification of synovial inflammation, a semiquantitative scale (4 points) adopted by Outcome Measures in Rheumatology was used.A total of 35 knee, 2 hip, 2 ankle, 2 wrist, 2 elbow joints, and 6 flexor hallucis longus/tibialis posterior tenosynovitis were assessed. In knee joint, power Doppler and SMI scales were the same for 23 (65.7%) joints, SMI upgraded scale from 0 to 2 in single joint (2.9%); 1 to 2 (14.3%) in 5 joints; and 2 to 3 (17.1%) in 6 joints. For other joints, power Doppler and SMI scales were the same for 5 (62.5%) joints. Superb microvascular imaging upgraded scale from 1 to 2 (25%) in 2 joints and 1 to 3 (12.5%) in a single joint. For flexor hallucis longus/tibialis posterior tenosynovitis, power Doppler and SMI scales were the same for two cases (33.3%). Superb microvascular imaging upgraded scale from 0 to 2 in two cases (33.3%); and 2 to 3 (33.3%) in 2 cases. There was no case of SMI scale downgraded compared with power Doppler scale.Superb microvascular imaging is a feasible technique in the assessment of synovial inflammation and tenosynovitis in juvenile idiopathic arthritis. Superb microvascular imaging has higher sensitivity compared with power Doppler ultrasound in depiction of increased vascularity.
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Affiliation(s)
| | - Fatih Cicek
- Department of Pediatrics, Uludag University Faculty of Medicine, Bursa, Turkey
| | | | | | - Sara Sebnem Kilic
- Department of Pediatrics, Uludag University Faculty of Medicine, Bursa, Turkey
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12
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Zhang J, Wu J, Hou X. Diagnostic accuracy of ultrasound superb microvascular imaging for parotid tumors: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e23635. [PMID: 33530166 PMCID: PMC7850700 DOI: 10.1097/md.0000000000023635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/12/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND As a novel ultrasound technique, superb microvascular imaging (SMI) can quickly, simply, and noninvasively study the microvascular distribution in the tumor and evaluate the microvascular perfusion. Studies suggested that SMI is helpful for the differentiation between benign and malignant parotid tumors. However, the results of these studies have been contradictory. Therefore, the present meta-analysis aimed at determining the accuracy of SMI in the differential diagnosis between benign and malignant parotid tumors. METHODS We will search PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases from their inceptions to September 30, 2020, without language restrictions. Two authors will independently carry out searching literature records, scanning titles and abstracts, full texts, collecting data, and assessing risk of bias. Review Manager 5.2 and Stata14.0 software will be used for data analysis. RESULTS This systematic review will determine the accuracy of SMI in the differential diagnosis between benign and malignant parotid tumors. CONCLUSION Its findings will provide helpful evidence for the accuracy of SMI in the differential diagnosis between benign and malignant parotid tumors. SYSTEMATIC REVIEW REGISTRATION INPLASY2020100093.
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Affiliation(s)
| | - Jialing Wu
- Ultrasound Department of the First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xiukun Hou
- Ultrasound Department of the First Affiliated Hospital of Dalian Medical University, Dalian, China
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Ozturk M, Durmaz MS, Ateş F, Kara T, Durmaz FG, Akyürek N. Assessment of thyroid gland vascularity with superb microvascular imaging in healthy children and its relationship with potential factors. J Pediatr Endocrinol Metab 2020; 33:1139-1145. [PMID: 32809960 DOI: 10.1515/jpem-2020-0224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/01/2020] [Indexed: 12/24/2022]
Abstract
Objectives To define thyroid gland vascularity index (VI) values in healthy children with the superb microvascular imaging (SMI) method and to assess whether or not there is a correlation with potential factors that may affect these values. Methods This prospective study included a total of 138 children, their ages varying from 3-17 years. Cases were divided into three subgroups according to age: 3-6, 7-12 and 13-17 years. Gender, age, height, weight, body mass index (BMI), thyroid-stimulating hormone (TSH) and free thyroxine (fT4) values were recorded. Volume and SMI measurements were performed with a 14 L5 mHz linear transducer. VI measurements were performed in the transverse and longitudinal planes and correlation with basic descriptive data was researched. Results Mean age was 11.14 ± 3.34 years and BMI was 19.95 ± 4.92. VI values were 4.59 ± 2.34 in the right lobe and 4.23 ± 2.73 for the left lobe, with no significant difference identified. There were no significant differences in mean VI for all parenchyma regarding gender and age groups. While there was no correlation identified with mean VI for all parenchyma with TSH and fT4, there was, however, a negative correlation with BMI. Conclusions Reference VI values for normal thyroid glands in healthy children and adolescents were defined with the SMI method. There was no correlation between the VI values and age, gender, volume, TSH and fT4 values, while there was a negative significant correlation with BMI.
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Affiliation(s)
- Mehmet Ozturk
- Selcuk University Faculty of Medicine, Department of Radiology, Division of Pediatric Radiology, Alaeddin Keykubat Yerleşkesi, Akademi Mah, Konya, Turkey
| | - Mehmet Sedat Durmaz
- Selcuk University Faculty of Medicine, Department of Radiology, Division of Pediatric Radiology, Alaeddin Keykubat Yerleşkesi, Akademi Mah, Konya, Turkey
| | - Fatih Ateş
- Selcuk University Faculty of Medicine, Department of Radiology, Division of Pediatric Radiology, Alaeddin Keykubat Yerleşkesi, Akademi Mah, Konya, Turkey
| | - Turgay Kara
- Faculty of Medicine, Department of Radiology, Sutçu Imam University, Kahramanmaraş, Turkey
| | | | - Nesibe Akyürek
- Department of Pediatric Endocrinology, Training and Research Hospital, Health Sciences University, Konya, Turkey
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