No abstract available.
Calcinosis/*ultrasonography ; Female ; Humans ; Male ; Thyroid Neoplasms/*pathology/*ultrasonography ; Thyroid Nodule/*pathology/*ultrasonography

Amyloidosis is a rare disease characterized by the formation of pathological protein deposits in organs or tissues. It is typically a systemic disease which can occur in a localized form. Amyloidosis of the breast is uncommon. Common mammographic findings of breast amyloidosis are multiple nodules with or without calcifications. We report a case of primary localized breast amyloidosis presenting suspicious microcalcifications on mammography without associated masses. Mammography in a 72-year-old woman displayed multiple, linearly distributed, irregular and rod-like calcifications in the subareolar area of the left breast. The patient underwent surgical excision under mammo-guided needle localization and the pathology was confirmed to be breast amyloidosis.
Aged ; Amyloidosis/pathology/*ultrasonography ; Breast/pathology ; Breast Diseases/pathology/*ultrasonography ; Calcinosis/*diagnosis ; Diagnosis, Differential ; Female ; Humans ; Ultrasonography, Mammary

Calcifying aponeurotic fibroma is a rare soft tissue tumor that occurs in the distal extremities of children and adolescents. We report ultrasound and X-ray findings of a calcifying aponeurotic fibroma in the finger of a 36-year-old woman, associated with distal phalangeal bone involvement.
Adult ; Bone Neoplasms/*radiography/surgery/*ultrasonography ; Calcinosis/*radiography/surgery/*ultrasonography ; Female ; Fibroma/*radiography/surgery/*ultrasonography ; *Fingers ; Humans ; Soft Tissue Neoplasms/*radiography/surgery/*ultrasonography ; Ultrasonography, Doppler, Color

PURPOSE: The purpose of this study was to prospectively evaluate the detectability and usefulness of automated whole breast ultrasound (AWUS) and to compare it with handheld breast ultrasound (HHUS) in cases with suspicious microcalcifications identified by mammography. METHODS: Forty-two patients with 43 suspicious microcalcifications (25 malignant and 18 benign) detected by mammography underwent AWUS, HHUS, and histol-ogic examination. With knowledge of the mammographic findings, HHUS was performed to assess the visibility of the microcalcifications and the presence of associated masses or ductal changes. Two radiologists reviewed the AWUS images in consensus using the same methods employed for HHUS. Detectability of AWUS was compared with that of HHUS and was correlated with histologic and mammographic findings. RESULTS: Of the 43 lesions, 32 (74.4%) were detectable by AWUS and 31 (72.1%) by HHUS. No significant differences in sensitivity were found between the two methods (p=0.998). AWUS detected 96% (24/25) of malignant microcalcifications and 44.4% (8/18) of benign microcalcifications. AWUS was more successful in the detection of malignant vs. benign lesions (96.0% vs. 44.4%, p=0.002), lesions >10 mm vs. ≤10 mm in size (86.7% [26/30] vs. 46.2% [6/13], p=0.009), lesions with a fine pleomorphic or linear shape vs. a round or amorphous or coarse heterogeneous shape (94.7% [18/19] vs. 58.3% [14/24], p=0.021), and lesions associated with a mass or architectural distortion vs. without obvious changes on mammography (100% [19/19] vs. 54.2% [13/24], p=0.022). CONCLUSION: Detectability of AWUS was comparable to that of HHUS in cases where suspicious microcalcifications were identified on mammography. Therefore, AWUS might be helpful in the performance of ultrasound-guided percutaneous procedures for highly suspicious microcalcifications.
Breast Neoplasms ; Breast* ; Calcinosis ; Consensus ; Humans ; Mammary Glands, Human ; Mammography* ; Prospective Studies ; Ultrasonography*

OBJECTIVETo explore the ultrasound (US) findings of partially cystic thyroid nodules (PCTNs) and to analyze their relationship with differential diagnosis of benign and malignant lesions.

METHODS265 cases of PCTNs confirmed by needle biopsy or surgical pathology were included in this study. Their ultrasound characteristics were reviewed and their significance in differential diagnosis was analyzed.

RESULTSIn the 265 PTCNs, 53 cases were malignant and 212 cases were benign lesions. According to the comparison of ultrasound and pathology results, there were 51 true-positive cases, 208 true negative cases, four false-positive cases and two false negative cases;the sensitivity was 96.2% (51/53), specificity was 98.1% (208/212), positive predictive value (PPV) was 92.7% (51/55), negative predictive values (NPV) was 99.0% (208/210), and accuracy rate was 97.7% (259/265). In terms of the PTCNs, internal structure, shape and margin were significantly associated with malignant or benign nature (P < 0.001); the aspect ratio ≥ 1, spiculated or micro-lobulated margin were significantly associated with malignancy; while the smooth margin, spongiform structure were significantly associated with benign nature. In terms of the internal solid portion of the nodules, the configuration, free margin, echogenecity, and calcification were significantly associated with malignant or benign nature (P < 0.001). The eccentric configuration with an acute angle, non-smooth free margin, hypoechogenecity, marked hypoechogenecity and micro-calcification were significantly associated with malignancy; while concentric configuration, smooth free margin, hyper/isoechogenicity, free margin of the solid component, and macro-calcifications were significantly associated with benign nature (P < 0.01). The results of logistic regression analysis showed that the echogenicity, free margin, configuration and calcification of the solid component were important predictive factors of malignant lesions (P < 0.05), that the hypoechogenecity, marked hypoechogenecity, eccentric configuration with an acute angle, non-smooth free margin and micro-calcification of the internal solid portion of the nodules were predictors for malignant PTCNs (P < 0.01).

CONCLUSIONUnderstanding the characteristics of US findings of partially cystic thyroid nodules is of great importance to make an accurate diagnosis of malignant nodules.

Biopsy, Needle ; Calcinosis ; diagnosis ; diagnostic imaging ; Diagnosis, Differential ; Sensitivity and Specificity ; Thyroid Nodule ; diagnostic imaging ; Ultrasonics ; Ultrasonography

OBJECTIVETo investigate the diagnostic value of ultrasonography for diffuse thyroid disease accompanied with suspicious nodules.

METHODSA total of 148 patients with diffuse thyroid diseases accompanied with suspicious nodules underwent both ultrasonography and ultrasound-guided biopsy, and the results were analyzed and compared.

RESULTSAmong these 148 patients, 44 had Hashimoto's thyroiditis and 104 had Graves'disease. Totally 151 suspicious lesions were detected by ultrasonography, among which 48 lesions were pathologically confirmed to be benign and 103 malignant. Thirteen malignant lesions were diagnosed as benign by pre-operative ultrasonography, which were confirmed to be malignant after the surgical resection due to other suspected or confirmed malignant lesions. The detection rate of diffuse thyroid disease accompanied with thyroid cancer by per-operative ultrasound was 68.21%, and the misdiagnosis rate was 31.79%. The gender of patients(P=0.36), number of nodules(P=0.08), and blood flow types in lesions(P=0.080) had no significant difference between the benign and malignant groups, whereas internal echo(P=0.040), margin(P=0.000), shape(P=0.001), and calcification features(P=0.000)showed significant differences. Up to 80.74% of the lesions with hyperechoic calcification were malignant.

CONCLUSIONSGray-scale sonographic features are helpful for the differential diagnosis of nodules in patients with diffuse thyroid diseases. Nodules in the isthmus and those accompanied with multiple nodules should be noticed.

Calcinosis ; Diagnosis, Differential ; Diagnostic Errors ; Humans ; Thyroid Diseases ; diagnostic imaging ; Thyroid Nodule ; Ultrasonography

OBJECTIVETo seek for the ultrasound findings of thyroid nodules related to malignancy and benign, and to assess the role of TI-RADS in the ultrosound evaluation of thyroid nodules.

METHODSWe reviewed and analyzed the ultrasound characteristics of 1838 thyroid nodules confirmed by biopsy or surgical pathology, classified the thyroid nodules by TI-RADS grading criteria, and analyzed the malignancy rate and accuracy rate of different TI-RADS grading.

RESULTSAmong the 1 838 thyroid nodules, 1 160 cases were carcinomas confirmed by surgery, while benign nodules in 212 cases. The sensitivity, specificity, PPV, NPV, and accuracy rates were 99.7% (1 156/1 160), 41.0%(278/678), 74.3% (1 156/1 556), 98.6% (278/282), and 78.2% (1 434/1 838), respectively. There were significant differences between the malignant and benign thyroid nodules in echo, margin, shape, calcification, and blood flow (P<0.001). Hypoechogenicity, marked hypoechogenicity, ill-defined margin, microcalcification, a taller-than-wide shape, and nodule internal rich flow (type III) were significantly associated with malignancy, while hyper/isoechogenicity, smooth margin, macro/no-calcifications, a wider-than-tall shape, and nodules internal poor flow (type I or type II) were significantly associated with benign nodules. There were significant differences between the malignant rates and accuracy rates obtained by different TI-RADS classifications (P<0.01).

CONCLUSIONUnderstanding the ultrasound characteristics of benign and malignant thyroid nodules and applying TI-RADS grading criteria to correctly classify the thyroid nodules are crucial for the clinical treatment and prognosis.

Calcinosis ; Diagnosis, Differential ; Humans ; Sensitivity and Specificity ; Thyroid Nodule ; diagnostic imaging ; Ultrasonics ; Ultrasonography

OBJECTIVETo screen out the sonogram features for the differential diagnosis of benign and malignant thyroid small nodules (≤ 1.0 cm) by Logistics regression analysis, to establish the binary Logistic regression model of sonogram features as independent variable and investigate the value of wall configuration of ultrasonogrophic nodules in the differential diagnosis of benign and malignant thyroid small nodules.

METHODSA total of 208 thyroid nodules ≤ 1.0 cm in diameter in 190 patients were evaluated. With postoperative pathological examination or fine needle aspiration biopsy, 106 nodules were confirmed as benign and 102 as malignant. Ultrasonic features of thyroid nodules were evaluated for the differential diagnosis of benign and malignant small thyroid nodules based on pathological diagnosis as a gold standard, a Logistic model was obtained, and the odds ratio of variables were compared. The margin of thyroid nodule was divided into regular or irregular margin, and the latter was divided further into four subtypes: strip, triangular, antler and papillary. The border was divided into clear, fuzzy or both. The periphery was divided into those with normal and abnormal echo;. The calcification included no calcification, microcalcification and non-microcalcification.

RESULTSFour statistically significant features were obtained finally by Logistics regression analysis, including margin, border, periphery and calcification. A formula was constructed by two-variables logistic regression analysis and probability of malignancy = 1/(1 + e - z), in which z = 5.026 × margin + 4.218 × border + 4.024 × periphery + 3.892 × calcification - 15.247. The odds ratio of margin was higher than the other independent variables.

CONCLUSIONSLogistics regression analysis indicates that the calcification, border, periphery, and especially margin of thyroid nodules are significant features for differentiating benign and malignant thyroid nodules. The margin score was more intuitionistic for the differentialtion of benign and malignant thyroid nodules.

Biopsy, Fine-Needle ; Calcinosis ; Diagnosis, Differential ; Humans ; Logistic Models ; Thyroid Nodule ; diagnostic imaging ; pathology ; Ultrasonography

PURPOSE: Ultrasonography plays a supplementary role in detecting breast microcalcifications as localizing these microcalcifications without mammographic aid is not always successful. This study aimed to evaluate the clinical implications of intraoperative sonography (IOUSG) in localized excisions after mammographically guided wire insertion. METHODS: Between May 2011 and December 2017, 90 localized excisional biopsies were included. All excisions were preceded by mammographically guided wire insertion. We divided them into two groups according to the use of IOUSG and compared the surgical outcomes between the two groups. RESULTS: Of the 90 localized excisions analyzed, IOUSG was performed in 40 (the USG group) localized excisions and not in the remaining 50 (the no USG group) localized excisions. The median cluster size of the target microcalcifications and the median specimen volume were smaller in the USG group than that in the no USG group (1.4 cm vs. 2.0 cm, p=0.02; 10.9 cm3 vs. 30.3 cm3, p<0.001, respectively). Additional excisions due to the incomplete coverage of the target microcalcifications on the specimen mammography were more frequent in the no USG group than in the USG group (30% vs. 15%, respectively, p<0.001). In the multivariate analyses, performing an IOUSG was the only significant risk factor, reducing the need for additional excision after adjusting the other risk factors (adjusted hazard ratio, 0.203; 95% confidence interval, 0.078–0.529). Performing an IOUSG significantly reduced the specimen volume excised after adjusting the cluster size of the microcalcifications. CONCLUSION: IOUSG could be helpful in improving the accuracy of surgical excision for breast microcalcifications localized with mammographically guided wire insertion.
Biopsy ; Breast ; Calcinosis ; Mammography ; Multivariate Analysis ; Risk Factors ; Surgery, Computer-Assisted ; Ultrasonography

Gastrointestinal stromal tumors (GISTs) are the most common primary mesenchymal neoplasms of the gastrointestinal tract and usually appear as a well-circumscribed mass. However, it may be difficult to confirm the extent of the disease for some GISTs. A 70-year-old asymptomatic female presented for a regular physical exam. An esophagogastroduodenoscopy showed a 2.0 cm protruding mass on the gastric fundus. Endoscopic ultrasound revealed an ill-defined heterogenous hypoechoic lesion (3.0×1.5 cm). A computed tomography (CT) scan demonstrated a 4.5 cm multifocal calcified mass at the gastric body as well as at the gastric fundus. Laparoscopic gastric wedge resection was performed according to the extent of multifocal calcifications that are shown on the CT. Intraoperative specimen mammography and intraoperative biopsy might be helpful to obtain a tumor-free margin. Final pathologic diagnosis was an intermediate risk GIST in multilobular form. In patients with diffuse multifocal calcifications in the stomach, the possibility of GIST should be considered.
Aged ; Biopsy ; Calcinosis ; Diagnosis ; Endoscopy, Digestive System ; Female ; Gastric Fundus ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Mammography ; Stomach* ; Ultrasonography