S18 Ultrasound in Medicine and Biology Volume 39, Number 5S, 2013

Brief Description of the Purpose of the Study: The purpose of this

study is to evaluate ultrasonographic features of mucoepidermoid carci-

nomas (MECs) in the salivary glands.

Methods: Sonographic features of 26 MECs in the salivary glands were

retrospectively evaluated, focusing on gross and internal appearances,

lesional and post-lesional echoes, vascularization and regional lymph

nodes. They are categorized and compared as 3 MEC groups of low

(15), intermediate (7), and high grade (4), according to histology.

Main Results: Sonographic features of salivary gland MECs mostly

include irregular shape, indistinct margins, and variable heterogeneous

echotexture with or without necrotic or cystic changes. They occasion-

ally show vascularized Doppler colors and regional lymph node enlarge-

ment. No significant sonographic differences between low-,

intermediate-, and high-grade MEC are presented, except the tumor

size, which of low-grade MEC is smaller than those of the others.

Importance of the Conclusions: Salivary gland MECs demonstrates

non-specific sonographic appearances of malignant lesion. Sonographic

features of MECs have no association with histologic grades except

tumor size.

PA.15.004

Real-Time, 2D and 3D Ultrasound Evaluation of Needle-Free

Vaccination Devices

S. K. Kodaira, G. S. Brito, G. T. Guerrini, R. R. Guerrini,

M. C. Chammas, J. Kalil Filho, G. G. Cerri

INRAD-HCFMUSP, S~ao Paulo, S�ao Paulo, Brazil

Brief Description of the Purpose of the Study: Intradermal injections

induces better immunological response than subcutaneous or intramus-

cular injections with smaller vaccine volumes. Real-time, 2D and 3D

Ultrasound imaging was performed to better understand tissue distribu-

tion of needle-free-jet-injection (NFJI) systems to evaluate depth of

penetration and tissue dispersion of vaccines.

Methods: Two different brands of NFJE were evaluated comparing

intradermal injection performances. Twenty healthy human volunteers

were selected to participate in the study. They were equally distributed

among two device groups according to racial, age, sex and BMI. Two

needle free injections of 0,2 and 0,5 ml saline solution were monitored

using real time ultrasound imaging scanning tissue distribution, cavita-

tion and leak back phenomena. Imediately, 2D and 3D scans were per-

formed to evaluate dermal thickness pre and post injection, maximum

dispersion and maximum depth of injection. These data were analised

with ANOVA and Mann-Whitney /Wilcoxon tests.

Main Results: The skin thickness not varies significantly with popula-

tional parameters but there were significant differences between pre and

post injection thickness. Ultrasound could confidently discriminate

intradermal and/or subcutaneous saline distribution in patients with

different populational parameters and different injector brands, pressure

profiles and performances.

Importance of the Conclusions:Ultrasound is a good, harmless, confi-

dent, reproductible and cheap method to evaluate performance NFJI

devices optimization with huge impact in populational immunization.

PA.15.005

Madelung’s DiseaseWith Large Involvement of the Scrotal Bag:

Correlation of Two-Dimensional Ultrasonography With Full

Body Tridimensional Computed Tomography

K. B. Alcantara, A. J. Reis Neto, A. C. Ferreira, B. K. D. Filho,

F. L. F. Marsico, R. C. S. Faria

Instituto De Diagnostico Por Imagem, Hospital Santa Casa Ribeirao

Preto, SP, Brasil

Brief Description of the Purpose of the Report: We report a case of

Madelung’s disease (MDL) with extensive involvement of the scrotum

sack.

Medical History:Male patient, 54 years old, chronic alcoholic, smoker,

reporting pain and increase in size of scrotum and cervical area dating

four months back. He did not report trauma or other changes. During

examination, a large symmetric mass was found in the cervical, dorsal

and scrotal areas, not adhered to deep planes. The diagnostic hypothesis

was thyroid goiter and inguinal hernia, with further evaluation with

imaging being the chosen method.

Diagnosis: Benign symmetric lipomatosis or Madelung’s disease.

Discussion and Summary of the Case: The CDM is characterized by

fat deposits, unencapsulated, symmetrical, painless, diffusely distrib-

uted. Affecting the cervical region in 100% of cases, retroauricular in

95%, deltoidea in 84%, thoracic in 60%, abdominal in 58% in inguinal

and 42% in lower limbs, being very rare in the scrotum as in our case. It

is more frequent in males and in middle aged adults. The pathogenesis is

unknown. Fat deposits can be lodged in the cervical or mediastinal

regions leading to disorders severe aesthetic and compressive

symptoms. Computed tomography and magnetic resonance delimit the

fat. The therapeutic approach is lipectomy and liposuction with good

prognosis.

PA.15.006

Metastasis of Gastric Carcinoma to the Thyroid Gland: A Case

Report

D. G. Medrado, J. R. T. Vicentini, M. A. Ferreira, V. S. Yamachira,

F. L. Pereira, M. C. Chammas, G. G. Cerri

INRAD - HC-FMUSP, Sao Paulo, SP, Brasil

Brief Description of the Purpose of the Report: The occurrence of

metastases to the thyroid gland is a rare clinical event, despite its rich

vasculature. The primary sites most frequently reported are kidney,

breast, lung, uterus and esophagus. Thyroidmetastasis from the stomach

is even less common, with only few cases described in literature.

Medical History: This report presents the case of a female patient, aged

73, admitted to the emergency with progressive dyspnea and inappe-

tence. During investigation, computed tomography scan of the chest re-

vealed a thyroid nodule suspicious for malignancy in the right lobe.

Diagnosis: Ultrasound-guided fine needle aspiration (FNA) was per-

formed, and the immunocytological diagnosis was metastatic adenocar-

cinoma, consistent with gastric primary, which was confirmed by

endoscopic biopsy.

Discussion and Summary of the Case: It’s difficult to determine sono-

graphically if a malignant thyroid neoplasm is primary or secondary due

to their nonspecificmorphological features. Therefore, FNA becomes an

important differential diagnosis method. Therapeutic procedures in

these cases are controversial, because it’s not clear whether surgical

intervention would result in real benefit to the patient.

16 - Ultrasound in Peripheral Vascular

PA.16.001

Duplex Study of Carotid Artery in Patients With Ischemic

Stroke

N. Sultana, R. Islam, T. K. Majumder, A. K. M. F. Bari, M. D. Bashir

Institute of Nuclear Meidicne and Ultrasound

Brief Description of the Purpose of the Study: To determine the

frequency and characteristics of carotid artery stenosis in acute ischemic