No abstract

Although multimodal ultrasound approaches have been suggested to potentially improve the diagnosis of thyroid cancer; the diagnostic utility of the combination of SWE and malignancy-risk stratification systems remains vague due to the lack of standardized criteria. The purpose of the study was to assess the diagnostic value of the combination of grey scale ultrasound assessment using EU TIRADS and shear wave elastography. 121 patients (126 nodules–81 benign; 45 malignant) underwent grey scale ultrasound and SWE imaging of nodules between 0.5 cm and 5 cm prior to biopsy and/or surgery. Nodules were analyzed based on size stratifications: <1 cm (n = 43); 1–2 cm (n = 52) and >2 cm (n = 31) and equivocal cytology status (n = 52), and diagnostic performance assessments were conducted. The combination of EU TIRADS with SWE using the SD parameter; maintained a high sensitivity and significantly improved the specificity of sole EU TIRADS for nodules 1–2 cm (SEN: 72.2% vs. 88.9%, p > 0.05; SPEC: 76.5% vs. 55.9%, p < 0.01) and >2 cm (SEN: 71.4% vs. 85.7%, p > 0.05; SPEC: 95.8% vs. 62.5%, p < 0.01). For cytologically-equivocal nodules; the combination with the SWE minimum parameter resulted in a significant reduction in sensitivity with increased specificity (SEN: 60% vs. 80%; SPEC: 83.4% vs. 37.8%; all p < 0.05). SWE in combination with EU TIRADS is diagnostically efficient in discriminating nodules > 1 cm but is not ideal for discriminating cytologically-equivocal nodules.

This article highlighted three advances in the study of the cavernous sinus: (1) the initial formation of the sinus reticulum in early development of the sphenoid bone before ossification (2) extension of reticulum of the sinus and connection with other venules, and (3) the cavernous sinus and the nerves evolved inside this sinus during gestation, for example, the trigeminal nerve already formed bundles of motor and parasympathetic components during fetal development. This ontogenetic study further confirmed the cavernous sinus is not a single or a dual set of sinuses, but a group of extensions of venous sinuses or sinusoids. These new insights were integrated with previous understandings of the cavernous sinus to form this review article. Anat Rec, 301:819-824, 2018. © 2017 Wiley Periodicals, Inc.