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Acute Complications in Cancer Patients Detected With Ultrasonography
S8
Ultrasound in Medicine and Biology
raise suspicion, once already removed the other causes that most often lead to symptoms in question.
PA.06.006 The Role of Ultrasound in Thoracic Trauma (Aplicac¸~oes Da Ultrassonografia Do Torax: Cenario Do Trauma) J. R. T. Vicentini, L. R. P. Marin, F. O. Lima, P. H. D. M. Moraes, M. J. Francisco Neto, M. C. Chammas, G. G. Cerri Instituto De Radiologia - Hc/FMUSP, S~ao Paulo/SP; Brasil Introduction: Thoracic trauma is a condition that affects mostly young people, with high rates of morbidity and mortality, demanding fast and effective treatment. Thoracic ultrasound is a useful tool in these cases, usually contributing to complement FAST (Focused Assessment with Sonography for Trauma) exam and enabling the diagnosis of several disorders that may require medical intervention. Methods Involved: This pictorial essay illustrates some disorders related to thoracic trauma and their imaging findings on ultrasound evaluation. Discussion: Ultrasonography has the advantage of being easily accessible in different places where polytraumatized might be taken to, such as emergency rooms and intensive care unities, situations that frequently demand immediate diagnostic and therapeutic measures. Some disorders that can be diagnosed by the method are soft tissue hematomas, rib fractures, pneumothorax, hemothorax and lung consolidation. Besides its high sensitivity, the method can also assist therapeutic procedures, such as guided thoracic drainage. Conclusion of the Presentation: Therefore, in evidence-based medical practice, ultrasonography plays a crucial role in thoracic trauma scene, as it’s a fast and versatile method, representing a technique that should be mastered by every radiologist.
PA.06.009 Acute Complications in Cancer Patients Detected With Ultrasonography B. L. Moreira, A. G. V. Bitencourt, G. L. Barros F, M. J. S. Maciel, T. C. Almeida, R. Chojniak Hospital A.C. Camargo (Fundac¸~ao Ant^onio Prudente), S~ao Paulo (SP), Brasil Introduction: The oncologic patient with acute complaints can present several complications related to the disease or treatment. Due to its greater availability and lower cost, ultrasound is often the first imaging method performed in these cases. Methods Involved: This pictorial essay aims to show examples of acute complications detected by ultrasound in patients with cancer in an oncologic institution. Discussion: Oncologic patients may develop acute complications related to various direct or indirect effects of the tumor, treatment side effects or mmunosuppression. Ultrasound can be useful in several situations such as venous thrombosis, effusions, abscesses or biliary and urinary obstructions. Venous thrombosis are up to seven times more common in patients with cancer than general population, and Doppler ultrasonography has a major role in its diagnosis. Empyema, abscess, typhlitis and other infectious complications are also relatively common in oncologic patients and can be evaluated by ultrasound. In patients with suspected biliary or urinary obstruction, ultrasonography can confirm the diagnosis and determine the etiology. This method can also be useful in guiding invasive procedures. Conclusion of the Presentation: Ultrasonography is an efficient, cheap, fast and safe for prompt evaluation of various acute complications in oncologic patients.
Volume 39, Number 5S, 2013 7 - Ultrasound in Gynecology PA.07.002 Colour Maps and Reproducibility of Sonographic Endometrial Thickness Measurements Q. Lam, R. Phillips Derriford Hospital (PHNT), Plymouth, Devon, UK and University of West of England, Bristol, Avon, UK Brief Description of the Purpose of the Study: The colour map function is widely available on modern ultrasound equipment and may enhance ultrasound visualisation. However, there is little evidence of its use. This research investigates if colour maps affect reproducibility of sonographic endometrial thickness measurements. Methods: A longitudinal greyscale image of the uterus and endometrium are acquired from 25 women by transvaginal ultrasound scans. The colour map function is applied to this image in red, purple, pink, green and blue. 4 reviewers independently and blindly obtain 2 endometrial thickness measurements from each image. Main Results: Bland and Altman’s 95% limits of agreement are applied to the data. The average intra-reviewer and inter-reviewer agreement is 0.929 and 0.935 respectively. The agreement of the measurements within each colour map is 0.949 jointly for grey, green, pink and purple, 0.939 for red and 0.918 for blue. The agreement of measurements from images with colour map vs. greyscale is 0.980 jointly for green and purple, 0.975 for red, 0.970 for blue and 0.965 for pink. The average kappa statistic based on categorising measurements into normal, borderline and abnormal, is 0.80. Importance of the Conclusions: Colour maps do not affect the reproducibility of endometrial thickness significantly and may be used interchangeably with greyscale images during the ultrasound examination. PA.07.007 Mucinous Ovarian Cystadenoma Coexisting With Adenocarcinoma of the Colon: A Case Report S. T. Regina, R. G. Barbosa, O. A. C. Silva, M. A. V. Seda, L. U. M. A. Silva, R. P. V. Magalhaes Todos os autores s~ao Medicos Residentes de Radiologia e Diagnostico por Imagem do Hospital Escola de Itajuba, Itajuba, MG, Brasil, Hospital Escolade Itajuba, Itajuba, Minas Gerais, Brasil Brief Description of the Purpose of the Report: To report a case of a patient who presented simultaneously ovarian mucinous cystadenoma and colon adenocarcinoma. Just two similar reports were found in the literature. Medical History: Female patient, 72 years old, history of oophorectomy (total left and partial right) at age 20, was admitted in hospital with abdominal pain, constipation and vomiting starting three days ago. The patient reported one ovarian cyst diagnosed by ultrasonography four years ago and noted the increased of her abdominal volume one year ago. Radiological workup suggested semi-obstructive acute abdomen. Ultrasonography and Computed Tomography (CT) scanning showed a huge multi-loculated cyst in her lower abdomen. Carcinoembryonic antigen (CEA) and cancer antigen 125 (CA 125) levels were high. Performed right oophorectomy and resection of stenotic lesion in the descending colon, evidenced during surgery. The excised surgical specimens were sent for histo-pathological study. Diagnosis: Ovarian mucinous cystadenoma and colon adenocarcinoma. Discussion and Summary of the Case: Mucinous cystadenomas represents 15% to 20% of ovarian tumors. Colorectal tumor is the fourth highest incidence neoplasia in the world, being the most common type adenocarcinoma. History of ovarian cancer increases the chance of developing colorectal tumor. Image exams are important in the management and diagnosis of these synchronous diseases, since both occur with elevated tumor markers.
Ultrasound in Medicine and Biology
raise suspicion, once already removed the other causes that most often lead to symptoms in question.
PA.06.006 The Role of Ultrasound in Thoracic Trauma (Aplicac¸~oes Da Ultrassonografia Do Torax: Cenario Do Trauma) J. R. T. Vicentini, L. R. P. Marin, F. O. Lima, P. H. D. M. Moraes, M. J. Francisco Neto, M. C. Chammas, G. G. Cerri Instituto De Radiologia - Hc/FMUSP, S~ao Paulo/SP; Brasil Introduction: Thoracic trauma is a condition that affects mostly young people, with high rates of morbidity and mortality, demanding fast and effective treatment. Thoracic ultrasound is a useful tool in these cases, usually contributing to complement FAST (Focused Assessment with Sonography for Trauma) exam and enabling the diagnosis of several disorders that may require medical intervention. Methods Involved: This pictorial essay illustrates some disorders related to thoracic trauma and their imaging findings on ultrasound evaluation. Discussion: Ultrasonography has the advantage of being easily accessible in different places where polytraumatized might be taken to, such as emergency rooms and intensive care unities, situations that frequently demand immediate diagnostic and therapeutic measures. Some disorders that can be diagnosed by the method are soft tissue hematomas, rib fractures, pneumothorax, hemothorax and lung consolidation. Besides its high sensitivity, the method can also assist therapeutic procedures, such as guided thoracic drainage. Conclusion of the Presentation: Therefore, in evidence-based medical practice, ultrasonography plays a crucial role in thoracic trauma scene, as it’s a fast and versatile method, representing a technique that should be mastered by every radiologist.
PA.06.009 Acute Complications in Cancer Patients Detected With Ultrasonography B. L. Moreira, A. G. V. Bitencourt, G. L. Barros F, M. J. S. Maciel, T. C. Almeida, R. Chojniak Hospital A.C. Camargo (Fundac¸~ao Ant^onio Prudente), S~ao Paulo (SP), Brasil Introduction: The oncologic patient with acute complaints can present several complications related to the disease or treatment. Due to its greater availability and lower cost, ultrasound is often the first imaging method performed in these cases. Methods Involved: This pictorial essay aims to show examples of acute complications detected by ultrasound in patients with cancer in an oncologic institution. Discussion: Oncologic patients may develop acute complications related to various direct or indirect effects of the tumor, treatment side effects or mmunosuppression. Ultrasound can be useful in several situations such as venous thrombosis, effusions, abscesses or biliary and urinary obstructions. Venous thrombosis are up to seven times more common in patients with cancer than general population, and Doppler ultrasonography has a major role in its diagnosis. Empyema, abscess, typhlitis and other infectious complications are also relatively common in oncologic patients and can be evaluated by ultrasound. In patients with suspected biliary or urinary obstruction, ultrasonography can confirm the diagnosis and determine the etiology. This method can also be useful in guiding invasive procedures. Conclusion of the Presentation: Ultrasonography is an efficient, cheap, fast and safe for prompt evaluation of various acute complications in oncologic patients.
Volume 39, Number 5S, 2013 7 - Ultrasound in Gynecology PA.07.002 Colour Maps and Reproducibility of Sonographic Endometrial Thickness Measurements Q. Lam, R. Phillips Derriford Hospital (PHNT), Plymouth, Devon, UK and University of West of England, Bristol, Avon, UK Brief Description of the Purpose of the Study: The colour map function is widely available on modern ultrasound equipment and may enhance ultrasound visualisation. However, there is little evidence of its use. This research investigates if colour maps affect reproducibility of sonographic endometrial thickness measurements. Methods: A longitudinal greyscale image of the uterus and endometrium are acquired from 25 women by transvaginal ultrasound scans. The colour map function is applied to this image in red, purple, pink, green and blue. 4 reviewers independently and blindly obtain 2 endometrial thickness measurements from each image. Main Results: Bland and Altman’s 95% limits of agreement are applied to the data. The average intra-reviewer and inter-reviewer agreement is 0.929 and 0.935 respectively. The agreement of the measurements within each colour map is 0.949 jointly for grey, green, pink and purple, 0.939 for red and 0.918 for blue. The agreement of measurements from images with colour map vs. greyscale is 0.980 jointly for green and purple, 0.975 for red, 0.970 for blue and 0.965 for pink. The average kappa statistic based on categorising measurements into normal, borderline and abnormal, is 0.80. Importance of the Conclusions: Colour maps do not affect the reproducibility of endometrial thickness significantly and may be used interchangeably with greyscale images during the ultrasound examination. PA.07.007 Mucinous Ovarian Cystadenoma Coexisting With Adenocarcinoma of the Colon: A Case Report S. T. Regina, R. G. Barbosa, O. A. C. Silva, M. A. V. Seda, L. U. M. A. Silva, R. P. V. Magalhaes Todos os autores s~ao Medicos Residentes de Radiologia e Diagnostico por Imagem do Hospital Escola de Itajuba, Itajuba, MG, Brasil, Hospital Escolade Itajuba, Itajuba, Minas Gerais, Brasil Brief Description of the Purpose of the Report: To report a case of a patient who presented simultaneously ovarian mucinous cystadenoma and colon adenocarcinoma. Just two similar reports were found in the literature. Medical History: Female patient, 72 years old, history of oophorectomy (total left and partial right) at age 20, was admitted in hospital with abdominal pain, constipation and vomiting starting three days ago. The patient reported one ovarian cyst diagnosed by ultrasonography four years ago and noted the increased of her abdominal volume one year ago. Radiological workup suggested semi-obstructive acute abdomen. Ultrasonography and Computed Tomography (CT) scanning showed a huge multi-loculated cyst in her lower abdomen. Carcinoembryonic antigen (CEA) and cancer antigen 125 (CA 125) levels were high. Performed right oophorectomy and resection of stenotic lesion in the descending colon, evidenced during surgery. The excised surgical specimens were sent for histo-pathological study. Diagnosis: Ovarian mucinous cystadenoma and colon adenocarcinoma. Discussion and Summary of the Case: Mucinous cystadenomas represents 15% to 20% of ovarian tumors. Colorectal tumor is the fourth highest incidence neoplasia in the world, being the most common type adenocarcinoma. History of ovarian cancer increases the chance of developing colorectal tumor. Image exams are important in the management and diagnosis of these synchronous diseases, since both occur with elevated tumor markers.