Objective. Ultrasonographic characteristics are associated with thyroid malignancy. Our aim was to compare the diagnostic value of ultrasound features in the detection of thyroid malignancy in both solid and mixed nodules. Methods. We prospectively studied female patients (≥50 years) referred to ultrasound-guided fine needle aspiration biopsy. Ultrasound features considered suspicious were hypoechogenicity, microcalcifications, irregular margins, high anteroposterior (AP)/axial-ratio, and absent halo. Associations were separately assessed in mixed and solid nodules. Results. In a group of 504 elderly female patients (age = 69 ± 8 years), the frequency of malignant cytology was 6%. Thirty-one percent of nodules were mixed and 60% were solid. The rate of malignant cytology was similar for mixed and solid nodules (7.4 versus 5.8%, P: 0.56). While in mixed nodules none of the ultrasound characteristics were associated with malignant cytology, in solid nodules irregular margins and microcalcifications were significant (all P < 0.05). The combination of irregular margins and/or microcalcifications significantly increased the association with malignant cytology only in solid nodules (OR: 2.76 (95% CI: 1.25–6.10), P: 0.012). Conclusions. Ultrasound features were of poor diagnostic value in mixed nodules, which harbored malignant lesions as often as solid nodules. Our findings challenge the recommended minimal size for ultrasound-guided fine needle aspiration biopsy in mixed nodules.
The role of prenatal diagnosis in placenta accreta spectrum (PAS) disorders is to reduce the risk of maternal complications by allowing a preplanned management. Although ultrasound (US) is the first diagnostic tool of choice, Magnetic Resonance Images (MRI) contributes in assessing the location, extension and depth of the invasion. Our objective is to describe the most characteristic features of PAS by MRI and correlate them with US, surgical and anatomopathological findings. Methods: We retrospectively reviewed prenatal MRI of patients with suspected diagnosis of PAS treated at our institution from 2015 to 2017. MRI were performed with standardised protocols to evaluate placenta. Localisation and extension of the abnormality was identified and correlated with US, macroscopic and histopathological findings. Results: During this period 41 patients with PAS were studied. All cases had heterogeneous placental showed as irregular venous lakes in US which by MRI corresponded to abnormal intraplacental blood vessels and thick dark bands on T2 weighted images (T2WI). These latter were correlated with fibrin deposits in the histopathologic evaluation. Conclusions: In our experience, abnormal intraplacental vascularisation together with thick hypointense bands on T2WI constitute the most frequent MRI findings to determine the presence, location and extension of PAS disorders. Therefore, MRI is currently considered a highly useful diagnostic tool for surgical planning of these patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.