Yog vim li cas vim li cas thiaj xa cov kws kho mob txiav txim rau lub raum Ultrasound Contrast Studies?
Feb 23, 2022
Hu rau: emily.li@wecistanche.com
Diana Kazimiersk, et al
Abstract
Lub Hom Phiaj Los txiav txim qhov kev qhia rau CEUS raulub raumpawgkev soj ntsuam.
Cov txheej txheem
Qhov kev rov qab los no, ib lub chaw, IRB-pom zoo, HIPAA txoj kev tshawb fawb tau soj ntsuam cov ntaub ntawv los ntawm 303 cov neeg mob sib law liag tau teem sijhawm rau lub raum CEUS los txiav txim siab cov lus qhia rau kev kuaj. Daim ntawv tshuaj xyuas tau ua txij li 05/01/2020 txog 05/31/2021 rau txhua tus neeg mob uas tau txais lub raum CEUS. Cov neeg mob cov pej xeem raug muab rho tawm nrog rau qhov tseem ceeb rau kev txiav txim rau kev kuaj mob.
Cov txiaj ntsig
Ntawm 303 tus neeg mob, 114 tau raug xa mus rau vim qhov tsis pom kev pom ntawm CT, thiab 28 tau raug xa mus rau kev soj ntsuam mus sij hawm ntev ntawm ib pawg neeg txhais tau tias yog benign lossis malignant tau txheeb xyuas ntawm CT. 9 cov neeg mob tau raug xa mus rau CEUS kev soj ntsuam vim qhov tsis txaus ntseeg ntawm MRI thiab 6 tus neeg mob tau raug xa mus rau kev soj ntsuam mus sij hawm ntev ntawm ib pawg uas txhais tau tias yog benign lossis malignant ntawm MRI. 34 cov neeg mob tau raug xa mus rau kev soj ntsuam rau qhov ua rau pom qhov mob pom ntawm qhov tsis zoo ntawm ultrasound. 48 tus neeg mob thiab 21 tus neeg mob tau raug xa mus rau kev soj ntsuam mus sij hawm ntev ntawm ib qho kev soj ntsuam yav dhau los benign lossis malignant lesion, ntsig txog, pom ntawm CEUS. CEUS tau txiav txim rau hauv 21 tus neeg mob txhawm rau ua raws li ib feem ntawm nephrectomy thiab 5 tus neeg mob rau kev soj ntsuam ntawm thermal ablation. 7 cov neeg mob raug xa mus rau vim qhov kev tshawb pom.
Xaus
Qhov laj thawj tseem ceeb rau kev xa mus rau lub raum CEUS yog ua kom pom qhov loj uas tsis tuaj yeem ua tus cwj pwm ntawm CT lossis MRI. Lwm qhov kev qhia tseem ceeb yog rau kev soj ntsuam mus sij hawm ntev ntawm cov kab mob kom txo tau cov tshuaj tua hluav taws xob. Kev xa mus vim tsis muaj peev xwm tau txais CT lossis MRI sib piv lossislub raumtsis txaustau me me qhia.
Ntsiab lusLub raum pawg· Indications · CEUS · Contrast-enhanced ultrasound
Nyem qhov no kom tau txais cov ntaub ntawv ntxiv txog Cistanche
Taw qhia
Contrast-enhanced ultrasound (CEUS) yog cov txheej txheem imaging nce hauv kev siv rau tus cwj pwm ntawmlub raumpawg. Kev ntsuam xyuas tsis siv hluav taws xob ionizing thiab tsis yog nephrotoxic, ua rau nws muaj txiaj ntsig zoo rau cov neeg mob ntawm txhua lub hnub nyoog, cov neeg mob.lub raumtsis txauslos yog kev cuam tshuam, thiab thaum lwm yam kev ntsuam xyuas yog contraindicated. Kev nyab xeeb profile ntawm CEUS zoo dua piv rau CT thiab MRI sib piv cov neeg ua haujlwm [1]. CEUS muaj qhov zoo ntawm kev ua ib daim nyias nyias uas tso cai rau kev pom kev zoo dua ntawm kev txhim kho ntawm septations thiab nodularity thiab real-time imaging tso cai rau kev pom ntawm cov qauv txhim kho thoob plaws qhov kev ntsuam xyuas uas tsis yog "snapshots" ntawm CT thiab MRI qhov twg papillary raum. cell carcinomas feem ntau mischaracterized. Qhov zoo tshaj plaws tom qab tshem tawm tso cai rau kev ntsuam xyuas tseeb ntawm cov kab mob nyuaj thiab hyperdense cysts [2]. CT yuav tsum tsis yog thawj kab kev ntsuas kev ntsuas los ntsuas cov kab mob cystic nrog feem ntau yuav ua rau tus cwj pwm zoo, vim muaj feem cuam tshuam txog hluav taws xob, raws li tau hais hauv daim ntawv dawb tsis ntev los no los ntawm FDA [3].
Nws kwv yees tias ib nrab ntawm cov neeg mob hnub nyoog tshaj tsib caug xyoo muaj ib tuglub raumpawg, nrog rau feem ntau yog benign cysts uas tuaj yeem ntseeg tau kuaj pom nrog cov duab hla ntu [2, 4]. Computed Tomography (CT) lossis Sib Nqus Resonance Imaging (MRI) yuav tsis tuaj yeem ua tus yam ntxwv ua rau nws tsis paub meej vim yog tus neeg mob txav mus los, qhov loj me, ntsuas suab nrov, thiab lub sijhawm sib txawv, ntawm lwm cov teeb meem [2, 5–7]. Bosniak Classification System, tsis ntev los no tau hloov kho, tau tsim los ua tus yam ntxwv cystic raum loj ntawm CT lossis MRI [8]. Txawm li cas los xij, tsis muaj kev cai Bosniak tsim rau CEUS. Qhov kev faib tawm no tso cai rau kev kwv yees ntawm qhov tsis zoo thiab cov lus pom zoo rau kev taug qab thiab / lossis kev kho mob. Cov txheej txheem kev faib tawm thoob ntiaj teb no tau qhab nia rau lub raum loj li I, II, IIF, III, lossis IV. Qhov qhab nia ntawm I thiab II qhia tau hais tias qhov yooj yim cyst thiab benign minimally complex cyst, feem, tsis tas yuav tsum tau soj ntsuam ntxiv. Ib qho qhab nia ntawm IIF qhia txog qhov tsawg kawg nkaus cyst nrog qhov xav tau rau kev soj ntsuam thiab pom ntxiv ntawm CT lossis ultrasound (US). Qhov qhab nia ntawm III qhia tau hais tias muaj qhov tsis txaus ntseeg thiab xav tau kev ntsuas ntxiv. Kev faib tawm ntawm Bosniak ntawm IV txhais tau hais tias qhov loj tau raug kuaj pom tias yog qhov tsis zoo thiab kev cuam tshuam yog qhov tsim nyog [8]. Tsis ntev los no CEUS-adapted Bosniak Cyst Categorization tau raug npaj [9].
Ib txoj kev tshawb nrhiav rov qab ua rau xyoo 2014 tau tshuaj xyuas qhov ua tau zoo ntawm CEUS nyob rau hauv cov yam ntxwv ntawm cov khoom tsis txaus ntseeg thiab cystic.lub raumpawg[2]. Tag nrho ntawm 721 tus neeg uas muaj tag nrho ntawm 1018 lub raum loj tau raug soj ntsuam nrog CEUS vim yog qhov tsis paub meej. Cov txheej txheem kev faib tawm tau npaj rau CEUS thiab siv los ua tus yam ntxwv ntawm lub raum qhov txhab. Ntawm 1018 pawg, 306 pawg tau lees paub los ntawm histologically, cov kab mob uas tau lees paub cov roj macroscopic ntawm CT lossis MRI tau suav tias yog angiomyolipomas, thiab cov pawg seem tau ua raws li ntau dua 3 xyoos kom paub meej tias muaj kev ruaj ntseg. Txoj kev tshawb no pom tias CEUS muaj qhov rhiab heev ntawm 100 feem pua (kev txheeb xyuas ntawm 126 malignant lesions; CI 95 feem pua) thiab qhov tshwj xeeb ntawm 95 feem pua (qhia txog 132 ntawm 139 qhov mob tsis zoo; CI 95 feem pua). Txoj kev tshawb no pom qhov zoo kwv yees tus nqi (PPV) ntawm 94.7 feem pua thiab tus nqi kwv yees tsis zoo (NPV) ntawm 100 feem pua. Tsis tas li ntawd, ib qho kev ntsuas ntsuas ntsuas qhov kev tshawb pom ntawm 22 cov kev tshawb fawb luam tawm ua ntej lub Kaum Ob Hlis 2017 tau sau cov ntaub ntawv los ntsuam xyuas cov txheeb cais raws li PPV thiab NPV [10]. Cov kev tshawb fawb tau raug tshuaj xyuas kom suav nrog cov ntaub ntawv suav tau hais txog kev txheeb cais ntawm kev siv CEUS thiab kev siv cov tshuaj histological raws li tus qauv siv. Tag nrho ntawm 2260 lub raum mob tau suav nrog hauv 22 qhov kev tshawb fawb. Nyob rau hauv no meta-kev tshuaj ntsuam, qhov rhiab heev thiab tshwj xeeb rau kev tshawb pom ntawmlub raummob qog noj ntshavnrog CEUS yog 96 feem pua (CI 95 feem pua) thiab 82 feem pua (CI 95 feem pua), feem. PPV yog 94 feem pua (CI 95 feem pua) thiab NPV yog 87 feem pua (CI 95 feem pua). Ib qho kev soj ntsuam thib ob suav nrog ob qho tib si thiab cov kab mob cystic pom rau cov kab mob hauv lub raum nyuaj (419 tus neeg mob; 436 qhov txhab), qhov sib xyaw ua ke thiab qhov tshwj xeeb ntawm CEUS yog 95 feem pua (95 feem pua CI 91 feem pua, 99 feem pua) thiab 84 feem pua (95). feem pua CI 77 feem pua , 90 feem pua ) thiab rau cov kab mob (331 cov neeg mob; 341 qhov txhab), qhov sib koom ua ke thiab qhov tshwj xeeb ntawm CEUS yog 98 feem pua (95 feem pua CI 95 feem pua, 100 feem pua) thiab 78 feem pua (95 feem pua CI 68 feem pua, 88%), raws li [11]. Ob qho kev tshawb fawb rov qab thiab cov kev tshuaj ntsuam xyuas meta tau lees paub qhov siab thiab qhov tshwj xeeb ntawm CEUS los ua tus yam ntxwv ntawm ob qho tib si cystic thiab lub raum pob zeb.
Cov ntaub ntawv thiab cov txheej txheem
Qhov no ib leeg-chaw kawm, rov qab los ntawm kev pom zoo los ntawm Institutional Review Board thiab HIPPA ua raws li kev zam ntawm kev tso cai pom zoo muaj 303 tus neeg mob sib law liag uas tau txais CEUS thaum lub Tsib Hlis 1, 2020, thiab Lub Tsib Hlis 31, 2021. Tus neeg mob daim ntawv tau tshuaj xyuas los txiav txim siab qhia rau lub raum CEUS, seb tus neeg mob puas muajlub raumtsis txauslos yog muaj qhov sib piv tsis haum rau CT lossis MRI sib piv.
Lub Phillips EPIQ US System (Bothell Washington) tau siv los ua qhov kev kawm. Ib qho ultrasound uas tsis tau kho dua tshiab tau ua los ntsuas lub raum thiab txhawm rau txheeb xyuas qhov mob lossis kev txhawj xeeb. Tus neeg mob tau muab tso rau kom qhov txhab lossis kev txhawj xeeb tseem nyob hauv lub dav hlau pom thaum ua pa yog tias ua tau. Cov txheej txheem MI qis tau siv (MI<0.4). the="" contrast="" agent="" used="" was="" 1.0="" cc="" of="" lumason="" followed="" by="" 10="" ccs="" of="" normal="" saline.="" a="" second="" dose="" of="" contrast="" was="" administered="" if="" the="" first="" examination="" did="" not="" adequately="" answer="" the="" clinical="" question="" or="" multiple="" lesions="" needed="" to="" be="" evaluated.="" the="" contrast="" was="" injected="" via="" a="" 20-gauge="" catheter="" in="" a="" vein="" in="" the="" antecubital="" space="" or="" hand.="" the="" contrast="" gain="" settings="" were="" optimized="" before="" starting="" the="" contrast="" examination="" to="" allow="" for="" optimal="" background="" suppression.="" imaging="" was="" performed="" for="" 3="" min="" after="" the="" visualization="" of="" the="" first="" contrast="" bubble="" and="" saved="" as="" a="" video="" clip.="" selected="" images="" were="" then="" sent="" to="" the="" pacs="" for="">
Indications rau kev ntsuam xyuas tau muab faib raws li nram no:
1 ib a. Ua raws li CT rau qhov tsis paub meej qhov txawv txav (tus cwj pwm lesion)
1b ib. Kev ua raws li CT abnormality txhais tau tias yog benign los yog malignant
2 ib a. Ua raws li MRI rau qhov tsis paub meej qhov txawv txav (tus cwj pwm lesion)
2b ib. Kev ua raws li MRI abnormality txhais tau tias yog benign los yog malignant
3 ib a. Kev rov qab los rau Asmeskas tsis muaj kev txhim kho kom pom qhov mob
3b ib. Rov qab mus rau qhov mob tsis zoo
4. Ua tiav vim qhov sib piv tsis haum lossis lub raum tsis txaus nkaus xwb
5 ib a. Kev soj ntsuam xyuas rau yav dhau los benign lesion ntawm CEUS
5 ib b. Ua raws li qhov mob qog nqaij hlav yav dhau los ntawm CEUS
6 ib a. Kev rov qab mus rau yav dhau los ib nrab nephrectomy
6 ib b. Ua raws li cov thermal ablation yav dhau los
7. Cov nyiaj pab kho mob (hematuria, mob flank, thiab lwm yam)
8. Lwm yam kev txheeb cais
Quantitative variables tau piav raws li txhais tau tias, tus qauv sib txawv, thiab ntau yam. Categorical variables tau piav raws li suav thiab feem pua.
Cov txiaj ntsig
Ntawm 303 tus neeg mob, 128 (42.2 feem pua) yog poj niam thiab 175 (57.8 feem pua) yog txiv neej. Qhov nruab nrab hnub nyoog ntawm cov neeg mob nyob rau hauv txoj kev tshawb no yog 66.8 xyoo ± 9.9 xyoo, nrog ib tug muaj hnub nyoog ntawm 23–90 xyoo. Kev tshuaj xyuas ntawm cov neeg mob cov kab kos tau pom tias ntawm 303 tus neeg mob, 114 (37.6 feem pua) tau nthuav tawm rau CEUS vim muaj kev soj ntsuam txog qhov tsis txaus ntseeg pom ntawm CT (cov neeg mob lub raum tsis txaus, n{{18} }}). 28 (24.6 feem pua) cov neeg mob tau raug xa mus rau CEUS raws li kev soj ntsuam rau qhov txawv txav tau txiav txim siab tias yog benign lossis malignant ntawm CT. Cuaj (3.0 feem pua) cov neeg mob tau raug xa mus rau kev soj ntsuam rau qhov tsis paub tseeb pom ntawm MRI thiab 6 (2.0 feem pua) cov neeg mob raug xa mus rau kev soj ntsuam txog qhov txawv txav uas txhais tau tias yog benign lossis malignant los ntawm MRI (cov neeg mob lub raum tsis txaus, n{30}}). Peb caug-plaub (11.2 feem pua) cov neeg mob tau raug xa mus rau kev ua raws li Teb Chaws Asmeskas uas tsis muaj kev kho mob kom pom qhov mob (cov neeg mob lub raum tsis txaus, n=2) thiab 19 (6.2 feem pua) cov neeg mob rau kev soj ntsuam txog qhov US unnhanced (cov neeg mob lub raum tsis txaus, n=1; cov neeg mob uas muaj qhov sib txawv tsis haum, n=1). Tsis muaj cov neeg mob raug xa mus tsuas yog vim muaj qhov sib piv tsis haum lossis lub raum tsis txaus. Plaub caug yim (15.8 feem pua) cov neeg mob tau raug xa mus raws li kev soj ntsuam ntawm CEUS yav dhau los nrog lawv lub raum qhov txhab txhais tau tias yog benign (cov neeg mob lub raum tsis txaus, n=1) thiab 12 (4.0 feem pua) cov neeg mob tau raug xa mus ua ib qho ua raws li CEUS yav dhau los nrog lawv lub raum qhov txhab txhais tau tias yog malignant (cov neeg mob lub raum tsis txaus, n=2). Cov no me me<3 cm="" enhancing="" lesions="" in="" older="" patients="" that="" are="" being="" followed="" instead="" of="" treatment.="" twenty-one="" (6.9%)="" presented="" as="" a="" follow-up="" for="" a="" previous="" partial="" nephrectomy="" and="" 5="" (1.7%)="" patients="" were="" referred="" for="" a="" follow-up="" to="" a="" previous="" thermal="" ablation.="" seven="" (2.3%)="" patients="" were="" referred="" due="" to="" clinical="" funding="" without="" prior="" imaging.="" no="" patients="" were="" referred="" for="" other="" reasons.="" table="" 1="" summarizes="" the="" number="" of="" cases="" associated="" with="" each="" ceus="" referral,="" with="" the="" number="" of="" patients="" presenting="" with="" renal="" insufficiency="" or="" contrast="" allergy="" in="" each="" category.="" of="" the="" 303="" patients,="" 50="" (16.5%)="" were="" diagnosed="" with="" a="" malignancy="" based="" on="" the="" ceus="" findings.="" the="" remainder="" of="" the="" lesions="" was="" classified="" as="" benign="" on="" ceus="" [2].="" figures="" 1="" and="" 2="" are="" examples="" of="">
Kev sib tham
Vim muaj ntau qhov kev tshawb pom ntawm lub raum loj, kev soj ntsuam nrog CEUS yog qhov zoo rau kev soj ntsuam ntxiv vim tias muaj peev xwm ntau dua ntawm CEUS los txheeb xyuas cov pawg li benign lossis malignant [2, 5, 10, 11] . Yog vim li cas rau kev soj ntsuam nrog CEUS pom nyob rau hauv txoj kev tshawb no qhia qhov loj tshaj propensity rau CEUS yuav tsum tau soj ntsuam xyuas rau cov neeg mob uas muaj ib tug indeterminate / los yog kev soj ntsuam kev txhawj xeeb rau lub raum abnormality pom ntawm CT los yog MRI 40.6 feem pua (123/303). Cov kab mob no yuav tsis ua raws li cov txheej txheem rau kev faib tawm Bosniak vim tias tsuas yog kev sib piv nkaus xwb lossis tsis yog qhov sib txawv tau ua tiav thiab xav tau kev kawm ntxiv rau kev tshuaj xyuas lossis tus kws kho mob xav tau kev sim ntxiv rau kev pom zoo. CEUS tau raug xa mus rau qhov kev soj ntsuam mus sij hawm ntev ntawm cov kab mob thaum xub thawj pom ntawm CT lossis MRI hauv 11.2 feem pua (34/303) ntawm cov neeg mob. Txawm hais tias nws tau xav tias lub raum tsis txaus lossis contraindication rau CT lossis MRI (kev sib piv tsis haum lossis lwm yam ua rau) yuav suav rau ntau tus neeg mob tsuas yog 4.0 feem pua (12/303) ntawm cov neeg mob muaj cov teebmeem no. Qhov zoo siab tsis muaj tus neeg mob raug xa mus rau kev kuaj mob raum CEUS tsuas yog nyob ntawm lub raum tsis txaus lossis lwm yam kev txwv rau CT lossis MRI.
Lub chaw kho mob sab nraud tau ua cov kev tshawb fawb rau lub raum CEUS rau ntau tshaj 20 xyoo thiab cov kws kho mob nephrologists thiab urologists muaj kev paub dhau los ntawm CEUS. Cov txiaj ntsig los ntawm ib lub chaw nyuam qhuav pib lub raum CEUS qhov kev pab cuam yuav txawv uas tuaj yeem yog qhov txwv ntawm txoj kev tshawb no. Nws yog qhov tseeb los ntawm cov qauv kev txiav txim uas tshwj xeeb tshaj yog cov kws kho mob urologist thiab CEUS cov cuab yeej tseem ceeb hauv kev ntsuas lub raum loj, tshwj xeeb tshaj yog cov uas tsis paub meej ntawm CT lossis MRI. Kev xyaum hauv zos tsis tshua ua rau lub raum loj rau kev kuaj mob thiab tso siab rau CEUS los txiav txim siab yog tias kev phais (ib nrab lossis ua tiav nephrectomy lossis ablative therapy) tau ua kom txuag tau cov nuj nqis, sijhawm, thiab tsis xis nyob ntawm lub raum biopsy rau kev kuaj mob. CEUS tsis tuaj nrog qhov kev pheej hmoo ntawm kev raug hluav taws xob thiab tuaj yeem ua tau ntawm tus nqi qis dua. Hauv cov neeg mob laus lossis cov neeg tsis zoo ntawm kev phais mob me me<3 cm="" probably="" cancers="" ceus="" allows="" for="" monitoring="" the="" lesions="" as="" opposed="" to="" immediate="" intervention="" particularly="" if="" the="" ceus="" enhancement="" pattern="" is="" suggestive="" of="" papillary="" renal="" cell="">
Bosniak kev faib tawm cov txheej txheem yog ib txoj hauv kev muaj txiaj ntsig rau kev ua qauv ntawm kev faib tawm ntawm lub raum raum ntawm CT lossis MRI [8]. Kev faib tawm CEUS Bosniak tsis tau tsim; Txawm li cas los xij, tsis ntev los no tau tsim tawm [9] thiab cov txheej txheem los txheeb xyuas cov kev tshawb pom ntawm lub raum CEUS tau luam tawm [2] Qhov nyias-slice thickness thiab muaj peev xwm ua kom pom kev txhim kho ntawm cov nodules me me li 2 hli yuav tsum tau muab rau hauv kev txiav txim siab. kev txhim kho ntawm CEUS Bosniak kev faib tawm raws li qhov no tuaj yeem txheeb xyuas qhov tsis tseeb-tsis zoo ntawm CT thiab MRI [5]. Lwm yam xws li kev soj ntsuam lub sijhawm tiag tiag tuaj yeem txheeb xyuas qhov tsis tseeb-tsis zoo ntawm CT lossis MRI tshwj xeeb hauv papillary cell carcinomas [5]. Qhov nruab nrab qhov nruab nrab tshwj xeeb hauv qhov txhab me me tuaj yeem ua rau muaj qhov tsis zoo-zoo ntawm CT lossis MRI. Muaj cov xwm txheej uas Bosniak cov qhab nia sib faib tsis tuaj yeem muab rau ntawm CT vim yog ua tau tsuas yog tsis muaj qhov sib txawv lossis ib qho kev kawm sib txawv xwb. CEUS yog qhov kev tshawb fawb tsim nyog tshaj plaws los faib cov kab mob no kom txo tau cov kab mob hluav taws xob rau tus neeg mob.
Cov lus tshaj tawm
Kev tsis sib haum xeeb
DK thiab MV tsis muaj. CLP yog ib tug tswv cuab ntawm cov neeg hais lus lub chaw lis haujlwm ntawm Bracco Diagnosis. RGB tau txais cov nyiaj pab tshawb fawb los ntawm Siemens Ultrasound, Philips Ultrasound, Samsung Ultrasound, Mindray Ultrasound, thiab GE Medical yog ib tug tswv cuab ntawm cov neeg hais lus 'chaw lis haujlwm ntawm Siemens Ultrasound, Philips Ultrasound, Mindray Ultrasound, thiab Canon Medical Systems, tau txais cov nuj nqis los ntawm Thieme Publishers, thiab yog nyob rau ntawm pawg neeg pab tswv yim rau Hologic.
Kev pom zoo rau kev ncaj ncees
Txoj kev tshawb no tau pom zoo los ntawm Western Reserve Health Education IRB nrog kev zam rau kev tso cai pom zoo vim qhov no yog kev tshawb fawb rov qab.
Cov ntaub ntawv
1. Piscaglia, F., et al., Kev nyab xeeb ntawm Sonovue hauv kev siv plab hnyuv: rov qab tsom xam ntawm 23188 kev tshawb nrhiav. Ultrasound Med Biol, 2006. 32(9): p. 1369-75.
2. Barr, RG, C. Peterson, thiab A. Hindi, Kev ntsuam xyuas ntawm lub raum tsis muaj zog nrog kev sib piv-hloov rau US: kev tshawb nrhiav kev ua tau zoo. Radiology, 2014. 271(1): p. 133-42.
3. fda.gov/radiation-emitting-products/initiative-reduce unnecessary-radiation-exposure-medical-imaging/white-paper-initiative-reduce-unnecessary-radiation-exposure-medical-imaging.
4. Tada, S., thiab al., Qhov tshwm sim ntawm lub raum yooj yim cyst los ntawm kev suav tomography. Clin Radiol, 1983. 34(4): p. 437-9.
5. Barr, RG, Puas Yuav Tsum Tau Hloov Kho Bosniak Raum Kev Ua Haujlwm Loj Nrog Kev Sib Txuas Ntxiv ntawm Kev Sib Txuas-Enhanced Sonography? J Ultrasound Med, 2017. 36(5): p. 865-868.
6. Bertolotto, M., et al., Renal Masses With Equivocal Enhancement at CT: Characterization With Contrast-Enhanced Ultrasound. AJR Am J Roentgenol, 2015. 204(5): p. W557-65.
7. Girometti, R., et al., Kev cuam tshuam ntawm kev sib piv-hloov ultrasound hauv cov neeg mob lub raum tsis ua haujlwm. World J Radiol, 2017. 9(1): p. 10-16.
8. Silverman, SG, et al., Bosniak Kev faib tawm ntawm Cystic Renal Masses, Version 2019: Ib Daim Ntawv Pom Zoo Hloov Kho thiab Kev Ntsuas Kev Ntsuas. Radiology, 2019. 292(2): p. 475-488.
9. Cantisani, V., et al., EFSUMB 2020 Daim Ntawv Pom Zoo rau Kev Sib Txuas Ua Ntej Ultrasound-Adapted Bosniak Cyst Categorization - Txoj Haujlwm Nqe Lus Qhia. Ultraschall Med, 2021. 42(2): p. 154-166.
10. Zhang, F., thiab al., Tus nqi ntawm Contrast-Enhanced Ultrasound nyob rau hauv kev kuaj mob ntawm lub raum Cancer thiab nyob rau hauv sib piv nrog Contrast-Enhanced Computed Tomography: Meta-analysis. J Ultrasound Med, 2019. 38(4): p. 903-914.
11. Barr, RB, siv LUMASON/SONOVUE, sib piv, txhim kho ULTRASOUND ntawm lub raum rau CHARACTERIZATION ntawm lub raum MASSES - ib tug META-Tshawb xyuas. Abdominal Radiology, 2021. in xovxwm. Publisher's Note Springer Nature tseem nyob nruab nrab hais txog kev txiav txim plaub ntug hauv daim duab qhia kev luam tawm thiab cov koom haum koom nrog.
