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2090864 Thyroid Calcifications: What Is Suspicious or Not on Ultrasound?
S156
Ultrasound in Medicine and Biology
Volume 41, Number 4S, 2015 (MRAr) were performed in 3 months after US examination. Recurrent RCT was diagnosed primarily based on MRAr as contrast leakage into the subacromiosubdeltoid (SASD) bursa through the repaired site of the tendon. US criteria for diagnosis of RCT, i.e. non-visualization of cuff tendon, fluid-filled defect in tendon, hypoechogencity in the tendon, double cortex sign, sagging peribursal fat sign, effusion in the SASD bursa and the glenohumeral joint, etc. were reviewed and compared with the MRAr. Results: Totally, 33 shoulders had rRCT with 10 proved arthroscopically. US findings and the diagnostic values correlated with MRAr were summarized in table 1. The primary US signs of RCT, i.e. nonvisualization of tendon and fluid-filled tendon defect were found in 25 of 33 (75.8%) rRCT shoulders. None of the shoulder with no rRCT showed these two abnormalities. Hypoechogenecity in the repaired tendon were seen in 8 rCRT shoulders (24.2%) and all 15 non-rRCT shoulders (100%). The secondary signs of RCT, i.e. double cortical sign, sagging peribursal fat pad sign and SASD bursal effusion etc. were noted in both rRCT and non-rRCT shoulders with low diagnostic values. Conclusions: Non-visualization of cuff tendon and fluid-filled tendon defect were the most reliable signs for US diagnosis of rRCT.
2090864 Thyroid Calcifications: What Is Suspicious or Not on Ultrasound? Osmar Cassio Saito, Maria Cristina Chammas, Sandra Tochetto, Giovanni Guido Cerri INRAD, University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil Objectives: Identify all sorts of calcifcations that affect thyroid by means of ultrasound. 2 - Describe the benign from the malignant sort of nodule calcifications. Methods: 1) We present a brief review of many cases of thyroid calcifications in our instituiton; 2) We made a retrospective study of patients who underwent utrasound examination and showed some kind of calcifications; 3) We included all malignant calcifications which diagnosis were proved by fine needle aspiration (FNA) or surgery; 4) Benign calcifications were based only on FNA; 5) All patients were examined with a Toshiba Applio 500 and a 14 MHz probe. Results: 1) Isolated microcalcifications or coarse calcifications are considered benign but when microcalcifications appear grouped, we consider them as malignant; 2) On the other hand coarse dystrophic calcifications inside a solid mass are usually seen in tumoral diseases, such as lymphoma or anaplasic tumor; 3) Focal capsular
Table 1. US findings and the diagnostic values with MR-arthrography correlation in 48 shoulders
Nonvisualization of tendon Fluid-filled tendon defect Hypoechogenecity in tendon Double-cortical sign Sagging peribursal fat sign SASD bursitis
positive rRCT(n533)(%)
negative rRCT(n515)(%)
accuracy
sensitivity
specificity
PPV
NPV
13 (39.4) 12 (36.4) 8 (24.2) 30 (90.1) 19 (57.6) 33 (100)
0 (0.0) 0 (0.0) 15 (100) 11 (73.3) 8 (53.3) 14 (93.3)
0.58 0.56 0.17 0.17 0.54 0.71
0.39 0.36 0.24 0.91 0.58 1.00
1.00 1.00 0.00 0.27 0.47 0.07
1.00 1.00 0.35 0.73 0.70 0.70
0.43 0.42 0.00 0.57 0.33 1.00
rRCT: recurrent rotator cuff tear. SASD: subacromiosubdeltoid bursae PPV: positive predictive value. NPV: negative predictive value
thyroid calcification was a common finding in old people; 4) Concomitant coarse and punctate calcifications can be considered as a malignant sign; 4) Coarse calcifications with a hypoechoic halo or with an adjacent solid mass can be an importan sign fot malignant disease; 5) An incomplete surronding calcification were seen in malignant lesions. Conclusions: 1) Distribuition or kind of calcifications certainly can predict the correct diagnosis; 2) Benign capsular linear calcifications in a common finding in old people; 3) Punctate grouped calcifications inside a solid hypoechoic nodule can be seen in papillary or medular tumor; 4) Concomitant coarse and small punctate calcifications are usually related to malign tumors; 5) Dystrophic or grouped microcalcifications can predict a malignant tumor whereas isolated coarse calcifications with a surronding halo are usually malign. 2090878 Recurrent Rotator Cuff Tear after Arthroscopic Repair: Ultrasonographic Assessment with MR-Arthrography Comparison Howard Haw-Chang Lan, San Kan Lee, Clayton Chi-Chang Chen Radiology, Taichung Veterans General Hospital, Taichung, Taiwan Objectives: To assess the values of US criteria for preoperative diagnosis of rotator cuff tear (RCT) in the diagnosis of recurrent RCT (rRCT). Methods: US were carried out in 48 shoulders received arthroscopic repair of rotator cuff tendon. In all shoulders, MR-arthrography
2090899 Ultrasound for Diagnosing Achilles Tendon Rupture in Patients Treated Surgically: A Systematic Review and Meta-Analysis Amir Aminlari, Emergency Medicine, University of California,San Diego, Carlsbad, CA, United States Objectives: The aim of our study is to systematically evaluate the positive predictive value (PPV) of ultrasound for detecting Achilles tendon rupture in patients who were treated surgically. Methods: In August 2014, we performed a literature search of MEDLINE and EMBASE databases to identify articles using the search terms: ‘tendon rupture,’ ‘achilles,’ and ‘ultrasound.’ We identified eligible articles according to PRISMA guidelines. Inclusion criteria were original studies with at least five patients, which reported data on the sonographic diagnosis of Achilles tendon rupture (complete and/or incomplete) compared to surgery as the reference standard. Data variables from included studies were abstracted onto reporting forms and collated into a master database. Statistical analyses were performed using random effects modeling and one-study removed influence analysis. Results: A total of 12 studies with 397 patients were included in the primary analysis. The positive predictive value of ultrasound was 89.6% (95% CI: 85.1-92.8%) for detecting Achilles tendon rupture in patients who underwent surgical treatment. Conclusions: According to these findings, ultrasound is a valuable, costeffective and non-invasive tool useful for diagnosing patients with Achilles tendon rupture.
Ultrasound in Medicine and Biology
Volume 41, Number 4S, 2015 (MRAr) were performed in 3 months after US examination. Recurrent RCT was diagnosed primarily based on MRAr as contrast leakage into the subacromiosubdeltoid (SASD) bursa through the repaired site of the tendon. US criteria for diagnosis of RCT, i.e. non-visualization of cuff tendon, fluid-filled defect in tendon, hypoechogencity in the tendon, double cortex sign, sagging peribursal fat sign, effusion in the SASD bursa and the glenohumeral joint, etc. were reviewed and compared with the MRAr. Results: Totally, 33 shoulders had rRCT with 10 proved arthroscopically. US findings and the diagnostic values correlated with MRAr were summarized in table 1. The primary US signs of RCT, i.e. nonvisualization of tendon and fluid-filled tendon defect were found in 25 of 33 (75.8%) rRCT shoulders. None of the shoulder with no rRCT showed these two abnormalities. Hypoechogenecity in the repaired tendon were seen in 8 rCRT shoulders (24.2%) and all 15 non-rRCT shoulders (100%). The secondary signs of RCT, i.e. double cortical sign, sagging peribursal fat pad sign and SASD bursal effusion etc. were noted in both rRCT and non-rRCT shoulders with low diagnostic values. Conclusions: Non-visualization of cuff tendon and fluid-filled tendon defect were the most reliable signs for US diagnosis of rRCT.
2090864 Thyroid Calcifications: What Is Suspicious or Not on Ultrasound? Osmar Cassio Saito, Maria Cristina Chammas, Sandra Tochetto, Giovanni Guido Cerri INRAD, University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil Objectives: Identify all sorts of calcifcations that affect thyroid by means of ultrasound. 2 - Describe the benign from the malignant sort of nodule calcifications. Methods: 1) We present a brief review of many cases of thyroid calcifications in our instituiton; 2) We made a retrospective study of patients who underwent utrasound examination and showed some kind of calcifications; 3) We included all malignant calcifications which diagnosis were proved by fine needle aspiration (FNA) or surgery; 4) Benign calcifications were based only on FNA; 5) All patients were examined with a Toshiba Applio 500 and a 14 MHz probe. Results: 1) Isolated microcalcifications or coarse calcifications are considered benign but when microcalcifications appear grouped, we consider them as malignant; 2) On the other hand coarse dystrophic calcifications inside a solid mass are usually seen in tumoral diseases, such as lymphoma or anaplasic tumor; 3) Focal capsular
Table 1. US findings and the diagnostic values with MR-arthrography correlation in 48 shoulders
Nonvisualization of tendon Fluid-filled tendon defect Hypoechogenecity in tendon Double-cortical sign Sagging peribursal fat sign SASD bursitis
positive rRCT(n533)(%)
negative rRCT(n515)(%)
accuracy
sensitivity
specificity
PPV
NPV
13 (39.4) 12 (36.4) 8 (24.2) 30 (90.1) 19 (57.6) 33 (100)
0 (0.0) 0 (0.0) 15 (100) 11 (73.3) 8 (53.3) 14 (93.3)
0.58 0.56 0.17 0.17 0.54 0.71
0.39 0.36 0.24 0.91 0.58 1.00
1.00 1.00 0.00 0.27 0.47 0.07
1.00 1.00 0.35 0.73 0.70 0.70
0.43 0.42 0.00 0.57 0.33 1.00
rRCT: recurrent rotator cuff tear. SASD: subacromiosubdeltoid bursae PPV: positive predictive value. NPV: negative predictive value
thyroid calcification was a common finding in old people; 4) Concomitant coarse and punctate calcifications can be considered as a malignant sign; 4) Coarse calcifications with a hypoechoic halo or with an adjacent solid mass can be an importan sign fot malignant disease; 5) An incomplete surronding calcification were seen in malignant lesions. Conclusions: 1) Distribuition or kind of calcifications certainly can predict the correct diagnosis; 2) Benign capsular linear calcifications in a common finding in old people; 3) Punctate grouped calcifications inside a solid hypoechoic nodule can be seen in papillary or medular tumor; 4) Concomitant coarse and small punctate calcifications are usually related to malign tumors; 5) Dystrophic or grouped microcalcifications can predict a malignant tumor whereas isolated coarse calcifications with a surronding halo are usually malign. 2090878 Recurrent Rotator Cuff Tear after Arthroscopic Repair: Ultrasonographic Assessment with MR-Arthrography Comparison Howard Haw-Chang Lan, San Kan Lee, Clayton Chi-Chang Chen Radiology, Taichung Veterans General Hospital, Taichung, Taiwan Objectives: To assess the values of US criteria for preoperative diagnosis of rotator cuff tear (RCT) in the diagnosis of recurrent RCT (rRCT). Methods: US were carried out in 48 shoulders received arthroscopic repair of rotator cuff tendon. In all shoulders, MR-arthrography
2090899 Ultrasound for Diagnosing Achilles Tendon Rupture in Patients Treated Surgically: A Systematic Review and Meta-Analysis Amir Aminlari, Emergency Medicine, University of California,San Diego, Carlsbad, CA, United States Objectives: The aim of our study is to systematically evaluate the positive predictive value (PPV) of ultrasound for detecting Achilles tendon rupture in patients who were treated surgically. Methods: In August 2014, we performed a literature search of MEDLINE and EMBASE databases to identify articles using the search terms: ‘tendon rupture,’ ‘achilles,’ and ‘ultrasound.’ We identified eligible articles according to PRISMA guidelines. Inclusion criteria were original studies with at least five patients, which reported data on the sonographic diagnosis of Achilles tendon rupture (complete and/or incomplete) compared to surgery as the reference standard. Data variables from included studies were abstracted onto reporting forms and collated into a master database. Statistical analyses were performed using random effects modeling and one-study removed influence analysis. Results: A total of 12 studies with 397 patients were included in the primary analysis. The positive predictive value of ultrasound was 89.6% (95% CI: 85.1-92.8%) for detecting Achilles tendon rupture in patients who underwent surgical treatment. Conclusions: According to these findings, ultrasound is a valuable, costeffective and non-invasive tool useful for diagnosing patients with Achilles tendon rupture.