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Is there a real diagnostic impact of elastosonography and contrast-enhanced ultrasonography in the management of thyroid nodules?

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2013年第3期14卷 195-206页

作者： Massimo GIUSTI Davide ORLANDI Giulia MELLE barbara massa Enzo SILVESTRI Francesco MINUTO Gianni TURTULICI Endocrine Unit San Martino University Hospital Radiology Unit Evangelico Hospital Cytopathology and Pathology Unit San Martino University Hospital

Ultrasonography(US) and the new applications US elastography(USE) and contrast-enhanced US(CEUS) are used in the screening of thyroid nodules,for which fine-needle aspiration biopsy(FNAB) is the best single diagnostic *** aim of the study was to compare the sensitivity,specificity,positive predictive value(PPV),and accuracy of the four examinations in nodules with cytological and histological *** study used data from US,FNAB,USE(elasticity(ELX 2/1) index),and CEUS(Peak index and time to peak(TTP) index) evaluated in 73 thyroid nodules in 63 consecutive patients likely to undergo ***-histological correlation was available for 38 *** correlation emerged between nodule size and cytological results.A significant(P=0.03) positive correlation between cumulative US findings and cytological results was *** addition,significant correlations between cumulative US findings and cytology(P=0.02) and between cumulative US findings and histology(P<0.0001) were *** showed the best specificity and PPV,and FNAB the best *** was no significant difference in the ELX 2/1 index,Peak index,or TTP index among nodules subdivided according to cytological *** significant correlation was found between ELX 2/1 index,Peak index,and TTP index,on the one hand,and nodule size,US cumulative findings,cytology,and histology on the other *** sensitivity of the ELX 2/1 index was high,but its specificity was very *** accuracy and PPV of USE were lower than those of the other *** the correlation between Peak index and cumulative US findings reached a value close to *** ultimate aim is to minimise unnecessary *** and FNAB continue to play a central diagnostic *** use of a US score showed high specificity and *** specificity of FNAB was low in this selected series because of the numbers of indeterminate cytological *** and CEUS are innovative techniques that need to be standa

关键词： Thyroid nodules Cytology Histology Ultrasonography Elastosonography Contrast-enhanced ultrasonography

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Retrospective cytological evaluation of indeterminate thyroid nodules according to the British Thyroid Association 2014 classification and comparison of clinical evaluation and outcomes

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2017年第7期18卷 555-566页

作者： Massimo GIUSTI barbara massa Margherita BALESTRA Paola CALAMARO Stefano GAY Simone SCHIAFFINO Giovanni TURTULICI Simonetta ZUPO Eleonora MONTI Gianluca ANSALDO Endocrinology Unit San Martino University Hospital I-16100 Genoa Italy Cytopathology and Pathology Unit San Martino University Hospital I-16100 Genoa Italy Radiology Unit Evangelico Hospital I-16100 Genoa Italy Molecular Diagnostic Unit San Martino University Hospital I-16100 Genoa Italy Endocrinology Surgery Unit San Martino University Hospital I-16100 Genoa Italy

The cytology of 130 indeterminate nodules （Thy 3） was retrospectively reviewed according to the British Thyroid Association 2014 classification. Nodules were divided into Thy 3a （atypical features） and Thy 3f （follicular lesion） categories. Histology was available as a reference for 97 nodules. Pre-surgical evaluations comprised biochemical tests, color-Doppler ultrasonogrephy （US）, semi-quantitative elastography-US （USE）, contrast-enhanced US （CEUS）, and mutation analysis from cytological slides. Thyroid malignancy was the final diagnosis for 19% of surgically- treated nodules. No statistically significant difference in the risk of malignancy was found between Thy 3a （26%） and Thy 3f （14%） nodules. Histology of the Thy 3a and Thy 3f nodules showed a higher incidence of Hurtle cell adenomas in Thy 3f （29%） than in Thy 3a （3%） nodules （P=0.01）. The only pre-surgical difference concerned the BRAF V600E mutation, which was positive in some Thy 3a but not in any Thy 3f nodules （P=0.04）. Receiver-operating characteristic （ROC） analysis was used to obtain cut-off values from US （score）, USE （ELX 2/1 strain index）, and CEUS （time-to- peak index and peak index） data. The cut-off values were similar for Thy 3a and Thy 3f nodules. Data showed that malignancy can be suspected if the US score is 〉2, ELX 1/2 strain index 〉1, time-to-peakindex 〉1, and peak index 〈1. In a sub-group of 24 revised nodules （12 Thy 3a and 12 Thy 3f） with histology as a reference, the diagnostic power of cumulative pre-surgical analysis by means of US, USE, and CEUS showed high positive and negative predictive values （83% and 100%, respectively） for the presence of malignancy in Thy 3a and Thy 3f nodules. In conclusion, in our series of revised Thy 3 nodules, malignancy was low and displayed no significant differences between Thy 3a and Thy 3f categories. The use of cut-offs based on histology as a reference could reduce surgery. Our data support the conviction that, in mutation-negative Thy 3a and Th

关键词： Indeterminate thyroid nodules British Thyroid Association 2014 classification Clinical evaluation Outcome

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Hepatitis E in hemodialysis and kidney transplant patients in south-east Italy

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World Journal of Gastroenterology 2015年第11期21卷 3266-3273页

作者： Gaetano Scotto Filippo Aucella Giuseppe Grandaliano Domenico Martinelli Mario Querques Antonio Gesuete barbara Infante Paolo Delli Carri Salvatore massa Giovanna Salatino Fabio Bulla Vincenzina Fazio Microbiology and Clinical Microbiology Master’s Degree in DentistryUniversity of Foggia Nephrology and Dialysis Unit IRCCS "Casa Sollievo della Sofferenza" San Giovanni Rotondo (FG) Nephrology and Dialysis Unit University of Foggia Institute of Hygiene University of Foggia Division of Nephrology Hospital of Foggia Department of Agricultural Food and Environmental SciencesUniversity of Foggia Clinic of Infectious Diseases University of Foggia Clinical Chemistry Laboratory Unit of VirologyHospital of Foggia

AIM:To investigate the serovirological prevalence and clinical features of hepatitis E virus(HEV) infection in end-stage renal failure patients and in the healthy ***:HEV infection is a viral disease that can cause sporadic and epidemic *** studies unexpectedly showed a high prevalence of HEV antibodies in immunosuppressed subjects,including hemodialysis(HD)patients and patients who had undergone kidney transplant.A cohort/case-control study was carried out from January 2012 to August 2013 in two hospitals in southern Italy(Foggia and *** Rotondo,Apulia).The seroprevalence of HEV was determined in 801 subjects;231 HD patients,120 renal transplant recipients,and450 health *** HD patients and the recipients of renal transplants were attending the Departments of Nephrology and Dialysis at two hospitals located in Southern Italy,and were included progressively in this *** samples were tested for HEV antibodies(Ig G/Ig M);in the case of positivity they were confirmed by a Western blot assay and were also tested for HEV-RNA,and the HEV genotypes were ***:A total of 30/801(3.7%)patients were positive for anti-HEV Ig(Ig G and/or Ig M)and by Western *** healthy population presented with a prevalence of 2.7%,HD patients had a prevalence of 6.0%,and transplant recipients had a prevalence of 3.3%.The overall combined HEV-positive prevalence in the two groups with chronic renal failure was 5.1%.The rates of exposure to HEV(positivity of HEV-Ig G/M in the early samples)were lower in the healthy controls,but the difference among the three groups was not statistically significant(P>0.05).Positivity for anti-HEV/Ig M was detected in 4/30(13.33%)anti-HEV Ig positive individuals,in 2/14 HD patients,in1/4 transplant individuals,and in 1/12 of the healthy *** relative risk of being HEV-Ig M-positive was significantly higher among transplant recipients compared to the other two groups(OR=65.4,95%CI:7.

关键词： Hepatitis E virus infection Prevalence Immunosuppr

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