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Although this study revealed a difference in elastographic score between benign and malignant tumors, detailed analysis did not provide consistent results. Consequently, real-time sonoelastography appears to be a limited technique in the differential diagnosis between benign and malignant salivary masses.

The aim of the paper is to provide a comprehensive overview on the applications of real time sonoelastography (SE) in the diagnosis of superficial lymphadenopathy. Some technical aspects of performing SE are presented as a preamble. The typical appearance of benign and malignant nodes is illustrated. The paper discusses and depicts the various elastographic scores in use. It also provides a critical appraisal of the relative strain ratio (SR) or stiffness index. Shear wave elastography, as a novel technique, is mentioned. In conclusion, hardness on more than 50% of the node surface or SR > 1.5 is fair to good indicators of malignancy. Work is still needed both to fully understand the various appearance of disease and to standardize the application.Keywords: sonoelastography, lymph nodes, neoplasm Accurate assessment of the superficial lymph node status is of paramount importance in the treatment planning, follow-up and prognosis of malignancies originating in the head and neck, breast, superficial tissues or in lymphoma. Ultrasonography (US) is extensively used as a first line diagnostic means, due to its cost-effectiveness, ease of use and high resolution of provided information. However, grey-scale and Doppler information are limited either in sensitivity or specificity and no single US criterion has sufficient diagnostic accuracy [1][2][3][4][5].Sonoelastography (SE) depicts the relative stiffness of tissues. Beyond breast, prostate and thyroid applications, over the last five years, the method was also used as a complimentary imaging technique to conventional US for the assessment of superficial lymph nodes [6][7][8][9]. Assessment of nodal SE information is done either by grading the appearance on a score system (elasticity score -ES) or by calculating a relative stiffness or strain ration (SR) [10].The aim of this paper is to review the current status of the knowledge on the applications of SE in the diagnosis of the character of superficial lymphadenopathy. Technical aspectsReal-time sonoelastography is, essentially, an elaborate speckle tracking technique with autocorrelation for out-of-plane displacement of the target [11,12]. It provides information about the relative stiffness of the structures within the scan plane, inside a region of interest (ROI). It is, therefore, important to encompass in the scan area not only the target lesion but also surrounding "normal" reference soft tissues. There are no standard recommendations on how to achieve this. In our experience [13,14], the upper limit of the ROI should always be placed as close to the transducer as possible. When aiming to use ES, the ROI should exceed the target boundaries at least 5 mm on each side. When the purpose is to calculate SR, the ROI should be as wide as possible, to encompass both the target lesion and the surrounding, reference tissue, at the same depth with the lesion. Transducer stabilizer, although desirable, is difficult to use of curved surfaces such as neck or axilla. During compression the transducer should be perpen...

US is a non-invasive, easily performed technique for excluding malrotation. UGI may be reserved for situations where US does not demonstrate a normal position of the D3.

LDLT, including ABO-mismatched transplantation, constitutes a safe and efficient therapy for liver failure in children. In BA patients with PV hypoplasia, portoplasty seems to constitute the best technique for PV reconstruction. Maternal donation might be a protective factor for AR.

Objective: SLC13A3 encodes the plasma membrane Na + /dicarboxylate cotransporter 3, which imports inside the cell 4 to 6 carbon dicarboxylates as well as N-acetylaspartate (NAA). SLC13A3 is mainly expressed in kidney, in astrocytes, and in the choroid plexus. We describe two unrelated patients presenting with acute, reversible (and recurrent in one) neurological deterioration during a febrile illness. Both patients exhibited a reversible leukoencephalopathy and a urinary excretion of α-ketoglutarate (αKG) that was markedly increased and persisted over time. In one patient, increased concentrations of cerebrospinal fluid NAA and dicarboxylates (including αKG) were observed. Extensive workup was unsuccessful, and a genetic cause was suspected. Methods: Whole exome sequencing (WES) was performed. Our teams were connected through GeneMatcher. Results: WES analysis revealed variants in SLC13A3. A homozygous missense mutation (p.Ala254Asp) was found in the first patient. The second patient was heterozygous for another missense mutation (p.Gly548Ser) and an intronic mutation affecting splicing as demonstrated by reverse transcriptase polymerase chain reaction performed in muscle tissue (c.1016 + 3A > G). Mutations and segregation were confirmed by Sanger sequencing. Functional studies performed on HEK293T cells transiently transfected with wild-type and mutant SLC13A3 indicated that the missense mutations caused a marked reduction in the capacity to transport αKG, succinate, and NAA.View this article online at wileyonlinelibrary.com.

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Being aware of the wide spectrum of elastographic patterns of breast cysts and considering elastography when assessing the BI-RADS category of complicated cysts may lead radiologists to better patient management.