The aim of this paper is to summarize the current knowledge of the anatomy of domestic pig head and neck arteries for the needs of experimental surgery and imaging methods in biomedical research and translational medicine. The potential of this large animal model seems to be valuable also for the xenotransplantation of certain organs. Demands for the knowledge of morphological differences between analogous human structures and particular breeds are growing also in connection with the need for more precise planning of experiments or interpretation of the results. Deepening anatomical knowledge is allowed also by the development of imaging methods. The search was performed using the keywords “domestic pig” and “arteries of the head and neck“ in the MEDLINE database, PubMed interface.
- Klíčová slova
- arteries of the head and neck, domestic pig, veterinary anatomy,
- MeSH
- arterie anatomie a histologie MeSH
- hlava anatomie a histologie krevní zásobení MeSH
- krk * diagnostické zobrazování chirurgie anatomie a histologie MeSH
- lidé MeSH
- modely u zvířat MeSH
- prasata MeSH
- Sus scrofa * anatomie a histologie MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: To develop a head and neck hyperthermia phased array system compatible with a 1.5 T magnetic resonance (MR) scanner for noninvasive thermometry. METHODS: We designed a dielectric-parabolic-reflector antenna (DiPRA) based on a printed reflector backed dipole antenna and studied its predicted and measured performance in a flat configuration (30 mm thick water bolus and muscle equivalent layer). Thereafter, we designed a phased array applicator model ('MRcollar') consisting of 12 DiPRA modules placed on a radius of 180 mm. Theoretical heating performance of the MRcollar model was benchmarked against the current clinical applicator (HYPERcollar3D) using specific (3D) head and neck models of 28 treated patients. Lastly, we assessed the influence of the DiPRA modules on MR scanning quality. RESULTS: The predicted and measured reflection coefficients (S11) of the DiPRA module are below -20 dB. The maximum specific absorption rate (SAR) in the area under the antenna was 47% higher than for the antenna without encasing. Compared to the HYPERcollar3D, the MRcollar design incorporates 31% less demineralized water (-2.5 L), improves the predicted TC25 (target volume enclosed by 25% iso-SAR contour) by 4.1% and TC50 by 8.5%, while the target-to-hotspot quotient (THQ) is minimally affected (-1.6%). MR experiments showed that the DiPRA modules do not affect MR transmit/receive performance. CONCLUSION: Our results suggest that head and neck hyperthermia delivery quality with the MRcollar can be maintained, while facilitating simultaneous noninvasive MR thermometry for treatment monitoring and control.
- Klíčová slova
- Antenna, SAR, head and neck, magnetic resonance, phased array,
- MeSH
- hlava diagnostické zobrazování MeSH
- indukovaná hypertermie * MeSH
- krk diagnostické zobrazování MeSH
- lidé MeSH
- magnetická rezonanční spektroskopie MeSH
- magnetická rezonanční tomografie MeSH
- vytápění * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
AIM: To evaluate the prognostic value of ultrasound and shear-wave elastography (SWE) in diagnosing malignant cervical lymph nodes. METHODS: A total of 99 patients with enlarged lymph nodes (99 lymph nodes presenting as a neck mass) were examined clinically with conventional ultrasound including Doppler examination and shear-wave elastography. The results of the examinations were compared with the final diagnosis. RESULTS: There were 43 benign and 56 malignant lymph nodes in our cohort. Age and sex were significant predictors of malignancy. The standard ultrasound parameters-node size, long/short axis ratio, hilum, vascularization, and the presence of microcalcifications-were also statistically significant. Lymph node volume combined with age showed the best predictive power. The maximum stiffness found on SWE was also a significant predictor of malignancy. The combination of epidemiologic, classic ultrasound, and elastographic parameters yielded the highest sensitivity and specificity in the prediction of malignancy; however, the additional impact of elastographic parameters was low. CONCLUSION: A combination of epidemiologic and classic ultrasound parameters can discriminate between malignant and benign lymph nodes with satisfactory sensitivity and specificity. Examining the stiffness of lymph nodes by means of SWE does not add much new predictive power.
- MeSH
- dítě MeSH
- elastografie * MeSH
- krk diagnostické zobrazování MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfatické metastázy diagnostické zobrazování MeSH
- mladiství MeSH
- nádory diagnóza MeSH
- prospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ultrasonografie dopplerovská * MeSH
- Check Tag
- dítě MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
Ultrasound elastography (sonoelastography, USE) is a relatively new, rapidly evolving area of imaging that measures elasticity of tissues. Its development started in the last decade of the 20th century and was accelerated after devices allowing real-time imaging and quantification (shear wave elastography, SWE) became broadly available for clinical practise. First results suggest that combination of sonoelastography and conventional ultrasound gives more precise results than ultrasound alone in certain areas. In head and neck imaging, just a few mostly pilot studies have been published till January 2014. This article summarizes available information about sonoelastography and current view on USE imaging in otorhinolaryngology.
- Klíčová slova
- elastography - lymph nodes - salivary glands - shear wave - ultrasound.,
- MeSH
- elastografie metody MeSH
- hlava diagnostické zobrazování MeSH
- krk diagnostické zobrazování MeSH
- lidé MeSH
- nádory hlavy a krku diagnostické zobrazování MeSH
- počítačové zpracování obrazu metody MeSH
- radiografie MeSH
- zobrazování trojrozměrné MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
INTRODUCTION: Vascular malformations of the thyroid gland represent a very rare, often accidentally diagnosed, disease that in the case of eufunctional goitre may be the cause of mechanical neck syndrome. The authors present here the complex differential-diagnosis and treatment approach and stress the importance of histopathology for determining the final diagnosis. CASE PRESENTATION: Using various imaging methods (ultrasound, multidetector computed tomography of the neck), the cause of breathing difficulties in a 64-year-old old man from the Czech Republic with normal thyroid gland function was found to be an arteriovenous malformation of the left lobe of his thyroid gland, 80 × 70 × 55 mm in size, reaching retrosternally between the major arteries branching from his aortic arch and displacing his trachea 10mm to the right. In preparation for surgery, he underwent a radio-interventional procedure with embolisation of the arteries supplying the left lobe. This was followed by a lobectomy on the left via a partial sternotomy. The definitive histology result confirmed that the arteriovenous malformation was the benign cause of the mechanical neck syndrome. CONCLUSIONS: The case report presented here extends the differential diagnostic options in cases of mechanical neck syndrome. It describes a very rare disease of the thyroid gland, which prior to surgery may arouse suspicion of malignancy. It stresses the importance of close team cooperation between the endocrinologist, interventional radiologist and surgeon within the framework of preoperative diagnosis as well as preparation for surgery. Determination of the definitive histopathological diagnosis requires a pathologist experienced in such issues.
- MeSH
- arteriovenózní malformace komplikace diagnostické zobrazování terapie MeSH
- diferenciální diagnóza MeSH
- krk diagnostické zobrazování chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- obstrukce dýchacích cest diagnostické zobrazování etiologie terapie MeSH
- počítačová rentgenová tomografie MeSH
- štítná žláza krevní zásobení diagnostické zobrazování chirurgie MeSH
- syndrom MeSH
- terapeutická embolizace MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
INTRODUCTION: Ultrasound of the neck is a sovereign complementary imaging method suitable for determining morphological changes in thyroidology which uses the so-called B-mode two-dimensional images for the neck area that are complemented by duplex Doppler imaging. Diagnostic verification is performed by sonographists from among radiologists and endocrinologists providing regular outpatient care; the surgeon uses ultrasound for navigation to attain the focus to be operated on. Sonography will provide information on the structure of the thyroid, of the parathyroids, their relationship to the surrounding organs (location, size, relationship to breathing and swallowing pathways). We search for the presence of any pathological abnormalities such as the affection of other organs, tumour invasion into surrounding tissue; it is also important to assess the size and nature of the cervical lymph nodes pretracheally, prelaryngeally, paratracheally, along the vascular plexus and supraclavicularly, where thyroid tumours may form metastases. USG assessment of the regional lymph nodes should not be forgotten before surgical management of thyroid nodules or the parathyroids. Thanks to the introduction of ultrasound as an additional screening method in parathyroid surgery we have gained the opportunity of more precise and successful localisation of pathological parathyroid lesions, which is beneficial for patients with hyperparathyroidism. MATERIAL AND METHODS: We worked with a group of patients from 2002 to 2010 when we selected 370 prospectively followed patients operated on for endocrine disease of the thyroid and parathyroid glands. The group consisted of 77 men and 293 women. This group was further selected according to the required criteria specified in the text. Since we are focusing on peroperative ultrasound and on the detection and specification of the position of the parathyroid glands for the surgeon, we are concentrating chiefly on pathological parathyroid glands. These are imaged as circumscribed hypoechoic lesions with hyperechoic margin. Ultrasonography is considered both a sovereign standard diagnostic method and a very valuable navigational method used to localise pathological glands. We use a linear as well as a special "hockey stick" probe which has a higher resolution. RESULTS: For comparison, both detection methods - gamma navigation and ultrasound - are dealt with. We are fully aware of the small number of patients in the selected groups. The results of the statistical analysis show that the use of ultrasound and gamma navigation shortens the overall operation time. More interesting, however, is the indicator of the range of variation, i.e. the difference between the maximum and minimum length of operation. When using one or the other detection method, the variation range is significantly lower and it is apparent that using the gamma-ray or ultrasound navigation system, the detection of the parathyroid gland, particularly when unusually located, is much simpler and thus faster. This finding is also supported by an additional parameter, variance, which expresses the variability of the distribution of values - around the average length of operation. CONCLUSION: Preoperative and intraoperative detection of hyperactive parathyroid glands is useful for minimizing the extent of surgical intervention, reducing operation time and decreasing the risk of perioperative complications. It is not necessary to use a radionuclide and therefore the method can be used even where there is no nuclear medicine station. It is also possible to detect glands which do not accumulate radionuclides and thus cannot be imaged with MIBI scintigraphy/SPECT CT. Still, an experienced surgeon remains irreplaceable. We dare say that if such a surgeon can make use of the above mentioned auxiliary methods in addition, the rate of success in this field of surgery increases substantially.
- MeSH
- krk diagnostické zobrazování MeSH
- lidé MeSH
- paratyreoidea diagnostické zobrazování MeSH
- paratyreoidektomie * MeSH
- peroperační doba MeSH
- štítná žláza diagnostické zobrazování MeSH
- ultrasonografie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
The purpose of this work was an evaluation of organ doses and effective doses from three verification techniques in Image-Guided Radiotherapy: from kilovoltage (kV) cone beam computed tomography (CBCT) scans, from two orthogonal kV images and from two orthogonal megavoltage (MV) images for two different treatment sites: pelvis and head and neck (H&N). For comparison reasons, organ doses and effective doses from prostate and H&N radiotherapy were also evaluated. Measurements of organ doses were performed in a male anthropomorphic Rando phantom by means of thermoluminescent dosemeters. In this investigation, measured organ doses from one CBCT scan, from two MV images and from two kV images of pelvis represent typically 1-6, 1-10 and 0.05-1 %, respectively, of organ doses resulting from one fraction of prostate radiotherapy. The maximum effective doses from CBCT scans, kV images and MV images of pelvis are 5.6, 0.8 and 11.9 mSv, respectively.
- MeSH
- celková dávka radioterapie * MeSH
- fantomy radiodiagnostické MeSH
- hlava diagnostické zobrazování MeSH
- krk diagnostické zobrazování MeSH
- lidé MeSH
- nádory prostaty diagnostické zobrazování radioterapie MeSH
- pánev diagnostické zobrazování MeSH
- počítačová tomografie s kuželovým svazkem * MeSH
- radioterapie řízená obrazem * MeSH
- termoluminiscenční dozimetrie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
A 14-year-old girl was referred to our department with a 3-month history of an asymptomatic swelling in the left cervical triangle. The girl, an active ski jumper, was used to carrying her skis on the left shoulder. There was a history of many minor falls and contusions of her body. The left posterior cervical triangle was enlarged by an elastic, partially fluctuating and clearly delineated swelling with 4-6 cm in diameter. The trapezius was elevated and the overlaying skin was intact. It was clear that the mass was spreading infraclavicularly. Nevertheless, the distal boundaries of the mass were not quite clear (Fig. 1). The infraclavicular spreading was confirmed with an ultrasound examination which revealed a hypoechogenic echo-free mass of the size of 7-10 x 3.6 cm. The mass was sonocompressible, clearly outlined and there were no signs of any infiltrating growth. No internal perfusion was found by colour-coded Doppler investigation. The blood count or biochemical tests did not reveal any pathological findings.
Two stillborn male sibling fetuses born to the same parents had severe mesomelic dysplasia documented at ultrasound and confirmed by radiography and autopsy. The 17-week-old fetus with increased neck translucency had additional heart and great vessel anomalies consistent with tetralogy of Fallot. The 15-week-old fetus had a nuchal cystic hygroma. We posit that these sibs have a distinct, previously unreported skeletal dysplasia. The mode of genetic transmission could be autosomal recessive or X-linked recessive.
- MeSH
- dospělí MeSH
- Fallotova tetralogie komplikace diagnostické zobrazování MeSH
- krk abnormality diagnostické zobrazování MeSH
- lidé MeSH
- lymfangiom cystický komplikace diagnostické zobrazování MeSH
- měření nuchální translucence MeSH
- plod abnormality diagnostické zobrazování MeSH
- radiografie MeSH
- těhotenství MeSH
- ultrasonografie prenatální * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
453 patients underwent surgery for primary hyperparathyreoidism between 1994 and 2003. In all patients, biochemical parameters were monitored and X-ray with USG of the neck was done. Struma nodosa was concommitantly present in 48 % of treated patients with primary hyperparathyroidism. In such cases, MRI offers better resolution of soft tissues. 98.6 % of treated patients had postoperative decrease of blood calcium to normal level. 5.4 % of cases were reoperations for primary hyperparathyroidism. In 12 % of cases, pathologically changed parathyroid glands in dystopic localization were found. In these dystopic localizations, pathologic parathyroid glands were found: in 3 % intrathyroid, in 7 % mediastinal and in 2 % of all 453 cases in other localization. In 4 % of patients, sternotomy was necessary. Persistent hypocalcemia was not registered in any patient. Transient hypocalcemia with necessity of infusion therapy was observed in 3.5 % of patients. Postoperative hypercalcemia persisted in 1.2 % of patients. Recurrent hypercalcemia was present in 0.2 % of cases. In three cases (0.7 %), unilateral injury of recurrent laryngeal nerve was observed.
- MeSH
- adenom chirurgie MeSH
- diferenciální diagnóza MeSH
- dítě MeSH
- dospělí MeSH
- hyperkalcemie etiologie MeSH
- hyperparatyreóza krev diagnóza chirurgie MeSH
- hyperplazie MeSH
- krk diagnostické zobrazování MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mladiství MeSH
- nádory příštítného tělíska chirurgie MeSH
- parathormon krev MeSH
- paratyreoidea abnormality patologie MeSH
- peroperační komplikace MeSH
- pooperační komplikace MeSH
- poranění nervus laryngeus recurrens MeSH
- radiografie MeSH
- recidiva MeSH
- reoperace MeSH
- rizikové faktory MeSH
- senioři MeSH
- ultrasonografie MeSH
- uzlová struma diagnóza MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Názvy látek
- parathormon MeSH
