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Streszczenie:
The aims of our study were to determine whether shear wave elastography (SWE) can improve the conventional B-mode differentiation of thyroid lesions, determine the most accurate SWE parameter for differentiation and assess the influence of microcalcifications and chronic autoimmune thyroiditis on SWE values. We examined 119 patients with 169 thyroid nodules who prospectively underwent B-mode ultrasound and SWE using the same ultrasound machine. The parameters assessed using SWE were: mean elasticity within the entire lesion (SWE-whole) and mean (SWE-mean) and maximum (SWE-max) elasticity for a 2-mm-diameter region of interest in the stiffest portion of the lesion, excluding microcalcifications. The discriminant powers of a generalized estimating equation model including B-mode parameters only and a generalized estimation equation model including both B-mode and SWE parameters were assessed and compared using the area under the receiver operating characteristic curve, in association with pathologic verification. In total, 50 and 119 malignant and benign lesions were detected. In generalized estimated equation regression, the B-mode parameters associated with higher odds ratios (ORs) for malignant lesions were microcalcifications (OR = 4.3), hypo-echogenicity (OR = 3.13) and irregular margins (OR = 10.82). SWE-max was the only SWE independent parameter in differentiating between malignant and benign tumors (OR = 2.95). The area under the curve for the B-mode model was 0.85, whereas that for the model combining B-mode and SWE parameters was 0.87. There was no significant difference in mean SWE values between patients with and without chronic autoimmune thyroiditis. The results of the present study suggest that SWE is a valuable tool for the characterization of thyroid nodules, with SWE-max being a significant parameter in differentiating benign and malignant lesions, independent of conventional B-mode parameters. The combination of SWE parameters and conventional B-mode parameters does not significantly improve the diagnosis of malignant thyroid nodules. The presence of microcalcifications can influence the SWE-whole value, whereas the presence of chronic autoimmune thyroiditis may not.

Słowa kluczowe:
Shear wave elastography, B-Mode ultrasound, Thyroid nodules, Diagnostic performance, Malignant, Benign

Streszczenie:
Shear wave elastography (SWE) is a modern method for the assessment of tissue stiffness. There has been a growing interest in the use of this technique for characterizing thyroid focal lesions, including preoperative diagnostics. Aim: The aim of the study was to assess the clinical usefulness of SWE in medullary thyroid carcinoma (MTC) diagnostics. Materials and methods: A total of 169 focal lesions were identified in the study group (139 patients), including 6 MTCs in 4 patients (mean age: 45 years). B-mode ultrasound and SWE were performed using Aixplorer (SuperSonic, Aix-en-Provence), with a 4–15 MHz linear probe. The ultrasound was performed to assess the echogenicity and echostructure of the lesions, their margin, the halo sign, the height/width ratio (H/W ratio), the presence of calcifications and the vascularization pattern. This was followed by an analysis of maximum and mean Young’s (E) modulus values for MTC (EmaxLR, EmeanLR) and the surrounding thyroid tissues (EmaxSR, EmeanSR), as well as mean E-values (EmeanLRz) for 2 mm region of interest in the stiffest zone of the lesion. The lesions were subject to pathological and/or cytological evaluation. Results: The B-mode assessment showed that all MTCs were hypoechogenic, with no halo sign, and they contained micro- and/ or macrocalcifications. Ill-defined lesion margin were found in 4 out of 6 cancers; 4 out of 6 cancers had a H/W ratio > 1. Heterogeneous echostructure and type III vascularity were found in 5 out of 6 lesions. In the SWE, the mean value of EmaxLR for all of the MTCs was 89.5 kPa and (the mean value of EmaxSR for all surrounding tissues was) 39.7 kPa Mean values of EmeanLR and EmeanSR were 34.7 kPa and 24.4 kPa, respectively. The mean value of EmeanLRz was 49.2 kPa. Conclusions: SWE showed MTCs as stiffer lesions compared to the surrounding tissues. The lesions were qualified for fine needle aspiration biopsy based on B-mode assessment. However, the diagnostic algorithm for MTC is based on the measurement of serum calcitonin levels, B-mode ultrasound and FNAB.

Słowa kluczowe:
medullary thyroid carcinoma, thyroid, ultrasound, shear wave elastography

Streszczenie:
The purpose of the research was to evaluate the role of high frequency ultrasound in monitoring and efficacy assessment of anti-cellulite treatments. A group of 66 women used 3 different types of anti-cellulite treatments; additionally a placebo group (n = 18) was created. The μ-Scan ultrasound device with a 35 MHz mechanical probe was used for the examinations. The following parameters were subjected to the ultrasound evaluation: epidermis thickness, dermis thickness, dermis echogenicity, the length and area of subcutaneous tissue bands projecting into the dermis (dermis-hypodermis junction), as well as the presence/absence of edema within the dermis. As a result of anti-cellulite treatment, the length and area of dermis-hypodermis junction significantly decreased, and dermis echogenicity significantly increased. Ultrasound imaging made it possible to evaluate the efficacy of the applied treatments. The high frequency ultrasound is a useful imaging technique for the application in aesthetic dermatology and cosmetology.

Słowa kluczowe:
Aesthetic Medicine, Cellulite, Anti-Cellulite Treatment, High Frequency Ultrasound, Skin Ultrasound

Streszczenie:
Background
Cellulite affects nearly 85% of the female population. Given the size of the phenomenon, we are continuously looking for effective ways to reduce cellulite. Reliable monitoring of anticellulite treatment remains a problem.

Objective
The main aim of the study was to evaluate the effectiveness of anticellulite treatment carried out using radiofrequency (RF), which was monitored by classical and high-frequency ultrasound.

Methods
Twenty-eight women underwent anticellulite treatment using RF, 17 women were in the placebo group. The therapy was monitored by classical and high-frequency ultrasound. The examinations evaluated the thickness of the epidermal echo, dermis thickness, dermis echogenicity, the length of the subcutaneous tissue bands growing into the dermis, the presence or absence of oedema, the thickness of subcutaneous tissue as well as thigh circumference and the stage of cellulite (according to the Nurnberger–Muller scale).

Results
Cellulite was reduced in 89.286% of the women who underwent RF treatment. After the therapy, the following observations were made: a decrease in the thickness of the dermis and subcutaneous tissue, an increase in echogenicity reflecting on the increase in the number of collagen fibres, decreased subcutaneous tissue growing into bands in the dermis, and the reduction of oedema. In the placebo group, no statistically significant changes of the above parameters were observed.

Conclusion
Radiofrequency enables cellulite reduction. A crucial aspect is proper monitoring of the progress of such therapy, which ultrasound allows.

Słowa kluczowe:
anticellulite treatment, high-frequency ultrasound

Streszczenie:
Background: The development of ultrasonography allowed for skin imaging used in dermatology and esthetic medicine. By means of classic and high-frequency ultrasonographies, changes within the dermis and subcutaneous tissue can be presented.
Objective: The aim of this study was to show the possibi­lities of applying classic and high-frequency ultrasonogra­phies in esthetic dermatology based on monitoring various types of anti-cellulite therapies.
Methods: Sixty-one women with cellulite were assigned to two smaller groups. One group was using anti-cellulite cream and the second group was a placebo group. The ultrasound examin;ition was carried out before the initiation and after the completion of the treatment and evaluated epidermal echoes, the thickness of the subcutaneous tissue and the dermis, dermis echogenicity, the length and surface rea of the subcutaneous tissue fascicles growing into the dermis, and the presence or absence of edemas.
Results: After the completion of the treatment, a statistically significant difference was observed. The most useful para­meters were as follows: the thickness of the subcutaneous tissue, echogenicity, the surface area and length of the sub­cutaneous tissue, as well as the presence of edemas. The discussed changes were not observed in the placebo group.
Conclusion: Classic and high-frequency ultrasonographies are useful methods for monitoring anti-cellulite therapies.

Słowa kluczowe:
high-frequency ultrasonography - cellulite classic ultrasonography ultrasonography