PURPOSE: We wanted to investigate the accuracy of axillary ultrasonography for detecting axillary nodal metastasis in patients with T1-2 breast cancer and we also wanted to determine the factors affecting the sensitivity. MATERIALS AND METHODS: Two radiologists performed axillary ultrasonography in 119 consecutive patients with T1-2 breast cancer and clinically uninvolved axillae. We analyzed the accuracy of ultrasonography for detecting axillary nodal metastasis with the histologic results being used as a reference standard. We evaluated the number of involved lymph nodes, T staging and the histologic grade of the tumors. RESULTS: Axillary nodes were involved in 39% of total patients (46/119); 30% of the patients with T1 cancer and 55% of the patients with T2 cancer. The sensitivity, specificity, positive predictive value and negative predictive value were for 52%, 92%, 80% and 75%, respectively. The sensitivity was significantly lower for the cases with one to two lymph nodes metastasis and T1 cancer than in those cases with 3 or more lymph nodes metastasis and T2 cancer (35% and 75% in the cases with 1-2 cancer and the cases with > 3 lymph nodes metastasis, respectively, p = 0.009; 38% and 68% in the cases with T1 and the cases with T2 cancer, respectively, p = 0.045). CONCLUSIONS: The ultrasonographic sensitivity for detecting axillary lymph node metastasis is low, especially in the cases with one to two lymph nodes metastasis and the cases with T1 cancer. Detailed analysis and adoption of cytologic examination of the axillary lymph nodes are necessary to improue the accuracy of ultrasonography.
Adoption ; Axilla ; Breast ; Breast Neoplasms ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Sensitivity and Specificity

PURPOSE: We wanted to analyze the mammographic and clinical findings of the non-mass image-forming low echoic areas seen on breast ultrasonography (US) and investigate their pathologic results. MATERIALS AND METHODS: Sixty-nine patients with 72 non-mass image-forming low echoic areas seen on breast US and who had undergone mammography and biopsy were included in this study. The mammographic findings were divided into 2 groups: 1) the negative or probably benign group and 2) the suspicious for malignancy group. The US findings were divided into 3 groups: focal, segmental and diffuse distributions. The clinical findings were divided into 2 groups: the non-palpable and palpable groups. We investigated the pathologic results according to each group. RESULTS: Of the 72 lesions, 49 (68.1%) were benign and 23 (31.9%) were malignant. On the mammography, 42 (93.3%) of the 45 negative or probably benign findings and 7 (25.9%) of 27 suspicious for malignancy findings were pathologically benign (p < 0.001). On the US, 38 (76%) of the 50 focal distributions and 11 (52.4%) of 21 segmental distributions were benign (p = 0.090). Thirty (73.2%) of the 41 nonpalpable lesions and 19 (61.3%) of the 31 palpable lesions were benign (p = 0.609). CONCLUSIONS: A non-mass image-forming low echoic area seen on breast US was malignant at a higher rate when it was found in conjunction with suspicious mammographic finding. There was no significant correlation between the distribution of the non-mass image-forming low echoic areas on US or their palpability and the pathologic results.
Biopsy ; Breast ; Humans ; Mammography ; Ultrasonography, Mammary

Microbubble contrast agent for ultrasound imaging has come of age, adding entirely new capabilities to real time ultrasound imaging. These new ultrasound imaging techniques exploit the nonlinear echoes that result from the unique interaction between ultrasound and microbubbles, which are readily distinguishable from the echoes of tissues. Contrast enhanced ultrasound can be used to quantify both flow rate and relative vascular volume of the microvasculature in solid lesions or organs, which makes it possible for it to be one of the modalities in molecular imaging. Angiogenesis is one of the important processes contributing to new blood vessel growth that occurs in a variety of physiologic and pathophysiologic states. It is essential for spread and growth of malignant tumors. The advantages of contrast enhanced ultrasound are that it is a noninvasive method for observing tumor angiogenesis. Sonoporation utilizes the interaction of ultrasound with ultrasound contrast agents to temporarily permeabilize the cell membrane allowing for the uptake of DNA, drugs, and other therapeutic compounds from the extracellular environment. Thus, sonoporation is a promising drug delivery and gene therapy technique, limited only by lack of understanding regarding the biophysical mechanism that results in the cell membrane permeability change. In conclusion, ultrasound contrast agent could have a role not only in the molecular imaging field with the advantage of noninvasive quantification of angiogenesis, but also in the field of drug treatment of cells using sonoporation.
Blood Vessels ; Cell Membrane ; Cell Membrane Permeability ; Contrast Media ; DNA ; Genetic Therapy ; Glycosaminoglycans ; Imidazoles ; Microbubbles ; Microvessels ; Molecular Imaging ; Nitro Compounds

A giant-cell tumor of the tendon sheath (GCTT) predominantly affects the tendon sheaths or joints of the fingers and toes. Less common sites include large joints such as the ankle and knee joint. We describe a case of a 35-year-old female with a localized giant-cell tumor of the tendon sheath that uniquely originated from the deep infrapatellar bursa.
Adult ; Animals ; Ankle ; Female ; Fingers ; Humans ; Joints ; Knee ; Knee Joint ; Tendons ; Toes

Intrahepatic portosystemic shunt is a rare disease that requires an accurate diagnosis because the lesion may be associated with hepatic encephalopathy and an invasive and expansive examination might be unnecessarily conducted. A cystic mass on an ultrasound examination in a patient without liver cirrhosis was diagnosed as an intrahepatic portosystemic venous shunt by using color Doppler imaging and computed tomography. We report here on the radiologic features of a congenital intrahepatic portosystemic venous shunt in a noncirrhotic liver.
Hepatic Encephalopathy ; Humans ; Liver ; Liver Cirrhosis ; Portasystemic Shunt, Surgical ; Rare Diseases

PURPOSE: We wanted to objectively evaluate the anatomy of the neonatal brain on ultrasound images, and so we reconstructed several oblique magnetic resonance images that corresponded with the oblique ultrasound images by using MRI and a multiplanar reconstruction program. MATERIALS AND METHODS: MRI 3D-SPGR axial scans of the brain were performed for two neonates and then we obtained the reconstructed MR images that were parallel with the direction of the sonographic oblique scanning plane. We made the anatomic models of the neonatal cranial ultrasound images by using axial MRI as the standard reference on the same screen. RESULTS: We created an anatomic atlas, with the representative six oblique coronal scans and six oblique sagittal scans that corresponded to the neonatal brain ultrasound images. CONCLUSION: This objective anatomic research with using MRI and a multiplanar reconstruction program for creating the ultrasound oblique brain images of a neonate will be very helpful for evaluating the ultrasonographic anatomy and to apply it to clinical practice.
Brain ; Humans ; Infant, Newborn ; Magnetic Resonance Spectroscopy ; Models, Anatomic

Thyroid calcification may occur in both benign and malignant thyroid disease, but previous literature reports have indicated that calcification is more common in malignant lesions than it is in benign ones. Various patterns of calcification are seen, including microcalcification, coarse dense macrocalcification, and peripheral calcification. Microcalcification and coarse dense macrocalcification are two of the most specific features of thyroid malignancy. However, to date, the clinical significance of peripheral calcification remains unclear and therefore controversial. In this pictorial review, we describe the ultrasonographic features of calcified thyroid nodules and seek to delineate the spectrum and determine the clinical significance of peripheral calcification by correlating it with pathologic results. A broad spectrum of benign to malignant tumors is associated with peripheral calcification. Peripheral calcification in a thyroid nodule should be considered to indicate an indeterminate lesion, and ultrasonography-guided FNAB or core biopsy should be performed in order to exclude malignancy.
Biopsy ; Thyroid Diseases ; Thyroid Gland ; Thyroid Nodule

Polyacrylamide gels (PAAGs) have been widely used for breast augmentation in China and the former Soviet Union since the 1990s. However, breast injection of PAAGs was abandoned due to various complications such as induration and lumps. Currently, this injection procedure is illegally practiced in South Korea and there are a few reports on the radiological findings of PAAG injection mammoplasty, especially describing the sonographic features. We report three cases of PAAG injection mammoplasty.
Acrylic Resins ; Breast ; China ; Female ; Gels ; Mammaplasty ; Pregnancy-Associated alpha 2-Macroglobulins ; Republic of Korea ; USSR

A breast lesion with posterior acoustic shadowing is often encountered on sonography and this finding is generally accepted as a sign of malignancy. Although its detection is important for differentiating a malignant breast mass from a benign breast mass, posterior acoustic shadowing is the result of attenuation of the sound beam by a desmoplastic host response to breast cancer rather than the posterior acoustic shadowing being due to the tumor itself. Therefore, many breast conditions that contain fibrous elements also can induce some degree of acoustic shadowing. In this article, we present various benign breast lesions that display posterior acoustic shadowing and we discuss the radiologic findings along with the pathologic correlation.
Acoustics ; Breast ; Breast Neoplasms ; Shadowing (Histology)

PURPOSE: To assess the sonographic evaluation of the appendix in patients with pelvic inflammatory disease (PID) using CT, clinical, and pathological comparisons. MATERIALS AND METHODS: During a three-year period, 51 patients with PID underwent appendix US and abdomino-pelvic CT. The findings of appendix on US were classified into three categories (normal appendix, normal appendix with inflamed periappendiceal fat, and acute appendicitis). Based on the CT analysis, the condition of the appendix was classified into five categories, namely ('normal, 'probably normal', 'equivocal CT findings for diagnosis of appendicitis', 'probable appendicitis', 'definite appendicitis'). The CT and US results were then correlate with clinical and pathological findings. RESULTS: Of 21 patients with definite or probable appendicitis as shown by CT analysis, US demonstrated normal appendix in 10 patients (48%), normal appendix with inflamed periappendiceal fat in 10 patients (48%), and primary appendicitis in the remaining patient (4%). Of 25 patients with normal or probably normal appendix as shown by CT analysis, US demonstrated normal appendix in 24 patients (96%), and primary appendicitis in the remaining patient (4%). The two patients with primary appendicitis, as shown by US, underwent appendectomy and pathological studies revealed primary appendicitis. CONCLUSION: A sonographic evaluation of the appendix in patients with PID improved the diagnostic accuracy for primary appendicitis.
Appendectomy ; Appendicitis ; Appendix ; Female ; Humans ; Pelvic Inflammatory Disease