ARFI elastography had very good accuracy for the assessment of liver fibrosis. It was more effective than APRI, Forns, King, and FIB-4 scores for the prediction of significant fibrosis and cirrhosis in CHC patients.

CONTEXT AND OBJECTIVE: Biopsies are used after liver transplantation to evaluate fibrosis. This study aimed to evaluate the elasticity of transplanted livers by means of a non-invasive examination, acoustic radiation force imaging (ARFI) elastography, correlating the results with the histological analysis. DESIGN AND SETTING: Cross-sectional study in a public university hospital. METHODS: All patients consecutively operated between 2002 and 2010 with an indication for biopsy were evaluated by means of elastography. The radiologist evaluating ARFI and the pathologist doing anatomopathological examinations were blinded to each other's evaluations. RESULTS: During the study period, 33 patients were included. The indication for transplantation was cirrhosis due to hepatitis C in 21 cases (63%). Liver biopsies showed absence of fibrosis (F0)

OBJETIVO: O objetivo deste estudo foi avaliar o significado do Doppler espectral por meio da obtenção do índice de resistência vascular na diferenciação entre lesões mamárias benignas e malignas. MATERIAIS E MÉTODOS: Dezenove lesões malignas e 18 benignas, diagnosticadas por estudo histológico, foram submetidas previamente a análise de sua vascularização por meio do Doppler espectral para se obter o índice de resistência vascular. RESULTADOS: Observou-se diferença estatisticamente significante (p < 0,001) entre os valores médios do índice de resistência para os resultados benigno e maligno (0,62x 0,80, respectivamente), em nódulos maiores que 1 cm. Um índice de resistência 0,69 foi altamente associado a lesões malignas, com sensibilidade de 84,2%, especificidade de 88,9%, taxa de falso-positivo de 11,1% e taxa de falso-negativo de 15,8%. CONCLUSÃO: A análise do índice de resistência vascular pode fornecer grande auxílio na avaliação das lesões nodulares da mama maiores que 1 cm, em conjunto com as informações obtidas por meio da escala de cinzas, com elevada sensibilidade e especificidade.

No abstract

-Context -The incidence of hepatic hemangiomas ranges from 0.4% to 20% in the general population. Conventional ultrasound is usually the first diagnostic method to identify these hemangiomas, typically as an incidental finding. Ultrasonography with second generation contrast materials is being used in various areas of hepatology, yielding similar results to those obtained with computerized tomography and magnetic resonance imaging in the diagnosis of hepatic hemangiomas. Objective -To evaluate the agreement between ultrasound with perflutrene contrast and magnetic resonance imaging in the diagnosis of hepatic hemangiomas.Methods -A total of 37 patients were prospectively examined between January 2006 and August 2008. A total of 57 hepatic nodules were documented in this group as incidental findings on routine ultrasound exams. The 37 patients were administered perflutrene contrast without adverse reactions, and were all submitted to magnetic resonance exams. Results -Conventional ultrasound identified 15 patients with nodules typical of hemangiomas and 22 patients with other nodules. In 35 patients, the contrast characteristics were consistent with hepatic hemangiomas. Conclusion -Agreement between the data obtained from ultrasound with contrast and magnetic resonance was 94.5%. In discordant cases, the magnetic resonance diagnosis prevailed. In the case which presented indeterminate findings on contrast ultrasonography, magnetic resonance was repeated after 3 months, confirming the diagnosis of a hepatic hemangioma. A biopsy was performed on the suspected malignant nodule which also confirmed the presence of a hepatic hemangioma. Ultrasonography with contrast has the advantages of being more accessible to the public at large and lower cost than magnetic resonance. The results of our study highlight the need for a new protocol in hepatic nodules incidentally identified on conventional ultrasonography. In the case of typical hemangiomas, conventional ultrasound is sufficient for diagnosis. However, for poorly defined nodules, ultrasonography with contrast is indicated. After confirming the presence of a hepatic hemangioma on contrast ultrasonography, no further exams are needed to finalize the diagnosis.

The breast cancer metastases can be analyzed by ultrasound in ganglial and visceral organs. The detection of metastatic lymphonod in the axillar, cervical or supraclavicular regions and intrammamarian changes both the cancer staging and therapeutic planning. Benign lymphonode usually have an oval shape, hilum hyperechogenicity, narrow cortex and show hilar vascularization or radical central symmetric vascularization and absence of peripheral flow at Color Doppler. Malignant lymphonode are usually rounded hyporechoic, without hilar hyperechogenicity, and, in color Doppler, present multifocal aberrant vascularization, tortuous vessels or flow in the periphery. The most frequent visceral metastases of breast cancer are hepatic, the suprarenal glands and ovaries. About 86% of breast cancer hepatic metastases are hypoechoic. Ovarian cancer metastases can be detected mainly in pelvic tumors, peritonium tumors, glanglial, abdominal wall, hepatic and splenic metastases and ascites. Our study of 10 cases of splenic metastases of ovarian cancer has demonstrated six hyperechoic tumors, two hypoechoic and two tumors with necrosis. The use of color Doppler and Powerangio has demonstrated weak or moderate vascularization in glanglial and visceral metastases of gynecological tumors. The use of contrast (Levovist) has shown a more detailed vascular analysis by detecting vessels that were not identified in color Doppler and Powerangio without contrast.

No abstract

No abstract