RTA is an effective and simple procedure for obtaining lasting shrinkage of TNs, controlling compressive symptoms, and treating thyroid hyperfunction. When performed in experienced medical centers, RTA may be a valid alternative to conventional treatments for nontoxic and pretoxic TNs. It is particularly attractive for elderly people for whom surgery and radioiodine therapy are often contraindicated or ineffective.

The scope of this study was to determine whether contrast-enhanced ultrasonography (CEUS), compared with basic US, can increase diagnostic confidence and provide relevant information on blunt scrotal trauma. Over a period of 75 months we examined 40 patients seen consecutively for blunt scrotal trauma using high-resolution US, color-power Doppler, low mechanical index CEUS, and power Doppler after IV administration of contrast medium (SonoVue Ò ). In the 24 cases that were positive, concordance between basal US and CEUS findings was grade 0 (absent) in 4 cases, grade 1 (low) in 3, grade 2 (moderate) in 8, and grade 3 (high) in 9. The relevance of the additional information provided by CEUS was classified as follows: high in 4/40 (10%), moderate 7/40 (17,5%), low 13/40 (32,5%), none in 14/40 (35%). Our findings demonstrate that CEUS is appreciably more sensitive in detecting damage caused by blunt scrotal trauma, particularly small lesions. It is also useful for differential diagnosis and marginalization of corpuscular fluid collections, fractures, and above all ruptures, which require immediate surgery. In our series 2 out of 3 (67%) patients with testicular rupture were diagnosed only by CEUS. We feel that the use of CEUS can significantly improve diagnostic confidence in cases of closed scrotal trauma although these conclusions need to be confirmed in larger case series.Sommario Scopo del nostro lavoro è stato di valutare l'eventuale maggiore confidenza diagnostica e contenuto informativo dell'ecografia con mezzo di contrasto e.v. (CEUS) nel trauma scrotale chiuso rispetto all'indagine ecografica (US) di base. Nell'arco di 75 mesi abbiamo esaminato 40 pazienti consecutivi con trauma scrotale chiuso, utilizzando US ad alta risoluzione, color-power-Doppler basale, ecocontrastografia a basso indice meccanico, power Doppler dopo mdc e.v. Il mdc usato è stato il SonoVue Ò . Nei 24 casi positivi, la concordanza tra US basale e CEUS è stata di grado 0 (assente) in 4 casi, di grado 1 (bassa) in 3, di grado 2 (medio) in 8, di grado 3 (elevato) in 9. La rilevanza del contenuto informativo aggiuntivo della * Award for the best oral presentation at the XXII SIUMB National Congress.* Corresponding author. Radiology Department, Santa Maria delle Grazie Hospital, Pozzuoli, Naples, Italy. E-mail address: robertolobianco@virgilio.it (R. Lobianco).Available online at www.sciencedirect.com CEUS veniva ritenuta: elevata in 4/40 (10%), media 7/40 (17,5%), bassa 13/40 (32,5%), assente in 14/40 (35%). I nostri risultati mostrano che la CEUS migliora sensibilmente la detezione dei segni di trauma rispetto l'US basale, specialmente nelle piccole lesioni. Essa è inoltre importante nella diagnosi differenziale e marginalizzazione delle raccolte fluide corpuscolate, nelle fratture e, di grande evidenza, nelle rotture, che impongono l'immediato intervento chirurgico: nella nostra casistica 2 casi su 3 di rotture (67%) si sono resi evidenti soltanto alla CEUS. Riteniamo che l'uso della CEUS possa aumentare significativamente la co...

Purpose Our purpose is to assess Multiparametric Ultrasound (MPUS) efficacy for evaluation of carotid plaque vulnerability and carotid stenosis degree in comparison with Computed Tomography angiography (CTA) and histology. Material and methods 3D-Arterial Analysis is a 3D ultrasound software that automatically provides the degree of carotid stenosis and a colorimetric map of carotid plaque vulnerability. We enrolled 106 patients who were candidates for carotid endarterectomy. Prior to undergoing surgery, all carotid artery plaques were evaluated with Color-Doppler-US (CDUS), Contrast-Enhanced Ultrasound (CEUS), and 3D Arterial analysis (3DAA) US along with Computerized Tomographic Angiography (CTA) to assess the carotid artery stenosis degree. Post-surgery, the carotid specimens were fixed with 10% neutral buffered formalin solution, embedded in paraffin and used for light microscopic examination to assess plaque vulnerability morphological features. Results The results of the CTA examinations revealed 91 patients with severe carotid stenoses with a resultant diagnostic accuracy of 82.3% for CDUS, 94.5% for CEUS, 98.4% for 3DAA, respectively. The histopathological examination showed 71 vulnerable plaques with diagnostic accuracy values of 85.8% for CDUS, 93.4% for CEUS, 90.3% for 3DAA, 92% for CTA, respectively. Conclusions The combination of CEUS and 3D Arterial Analysis may provide a powerful new clinical tool to identify and stratify “at-risk” patients with atherosclerotic carotid artery disease, identifying vulnerable plaques. These applications may also help in the postoperative assessment of treatment options to manage cardiovascular risks.

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Purpose In the last decade contrast-enhanced magnetic resonance imaging (MRI) has gained a growing role as a complementary tool for breast cancer diagnosis. Currently the relationship between the kinetic features of a breast lesion and pathologic prognostic factors has become a popular field of research. Our aim is to verify whether breast MRI could be considered a useful tool to predict Ki-67 score, thus resulting as a breast cancer prognosis indicator. Methods From June to December 2014, we enrolled patients with breast cancer who underwent preoperative dynamic contrast-enhanced MRI at the local health agency. We analyzed the time-signal intensity curves calculating the mean values of the following parameters: the basal enhancement (E), the enhancement ratio (ENH), the maximum enhancement (E), and the steepest slope of the contrast enhancement curve (S). Scatterplots and Pearson correlation test were used to investigate the eventual associations among these parameters. Results A total of 27 patients underwent breast MRI during the study period. The mean ± SD Ki-67 percentage was 27.03 ± 16.8; the mean E, S, E, and ENH were 433.9 ± 120.2, 267.3 ± 96.8, 165.5 ± 77.1, and 187.1 ± 94.8, respectively. Scatterplots suggest a positive correlation between Ki-67 and both E and S. The correlation tests between Ki-67 and E, Ki-67 and S showed statistical significance. Conclusions Our preliminary data suggest that enhancement pattern is closely linked to breast cancer proliferation, thus proving the relationship between more proliferating tumors and more rapidly enhanced lesions. This is hypothesis-generating for further studies aimed at promoting breast MRI in the early estimation of cancer prognosis and tumor in vivo response to chemotherapy.