Ophthalmic RSS : Gourt

Cavernous lymphangiomas of the breast mimicking breast cancer.

Related Articles Cavernous lymphangiomas of the breast mimicking breast cancer. J Ultrasound Med. 2009 Jul;28(7):973-6 Authors: Ko KH, Kim EK, Kang HY, Youk JH PMID: 19546341 [PubMed - in process]

Pseudoaneurysm of the breast during vacuum-assisted removal.

Related Articles Pseudoaneurysm of the breast during vacuum-assisted removal. J Ultrasound Med. 2009 Jul;28(7):967-71 Authors: Sohn YM, Kim MJ, Kim EK, Chung SH, Kwak JY, Moon HJ, Kim SJ PMID: 19546340 [PubMed - in process]

Sonographic findings of smooth muscle hyperplasia of the epididymis.

Related Articles Sonographic findings of smooth muscle hyperplasia of the epididymis. J Ultrasound Med. 2009 Jul;28(7):963-5 Authors: Yang DM, Kim HC, Lee HL, Kim GY PMID: 19546339 [PubMed - in process]

Quadriceps fat pad edema: sonographic depiction and sonographically guided steroid injection.

Related Articles Quadriceps fat pad edema: sonographic depiction and sonographically guided steroid injection. J Ultrasound Med. 2009 Jul;28(7):959-62 Authors: Van Le B, Harish S PMID: 19546338 [PubMed - in process]

Diagnosis of active hemorrhage from the liver with contrast-enhanced ultrasonography after percutaneous transhepatic angioplasty and stent placement for budd-Chiari syndrome.

Related Articles Diagnosis of active hemorrhage from the liver with contrast-enhanced ultrasonography after percutaneous transhepatic angioplasty and stent placement for budd-Chiari syndrome. J Ultrasound Med. 2009 Jul;28(7):955-8 Authors: Song HP, Yu M, Zhang M, Han ZH, Zhang HB, Zhu T, Zhou XD PMID: 19546337 [PubMed - in process]

Hematocolpos secondary to acquired vaginal scarring after radiation therapy for colorectal carcinoma.

Related Articles Hematocolpos secondary to acquired vaginal scarring after radiation therapy for colorectal carcinoma. J Ultrasound Med. 2009 Jul;28(7):949-53 Authors: Verma SK, Baltarowich OH, Lev-Toaff AS, Mitchell DG, Verma M, Batzer F PMID: 19546336 [PubMed - in process]

Gastrointestinal stromal tumors: ultrasonographic spectrum of the disease.

Related Articles Gastrointestinal stromal tumors: ultrasonographic spectrum of the disease. J Ultrasound Med. 2009 Jul;28(7):941-8 Authors: Wronski M, Cebulski W, Slodkowski M, Krasnodebski IW OBJECTIVE: The purpose of this series was to determine the spectrum of findings on gray scale trans-abdominal ultrasonography (TAUS) in pathologically proven cases of primary gastrointestinal stromal tumors (GISTs) and correlate them with gross morphologic and pathologic findings. METHODS: The series included 18 patients with a primary GIST tumor detected on preoperative TAUS. The ultrasonographic findings were evaluated for features such as tumor size, shape, margin, echogenicity, and presence of fluid components, and the features were compared with morphologic and pathologic findings. RESULTS: All of the primary GISTs were hypoechoic extraluminal masses with well-delineated margins. Eight GISTs were homogeneously solid masses, and 8 were heterogeneously solid masses that contained a large central area of lower echogenicity (n = 4) or multiple internal hypoechoic irregular spaces (n = 4) corresponding to necrosis and hemorrhage. Other tumors had a cystic appearance (n = 1) or showed a dual hyperechoichypoechoic echo structure (n = 1). Three tumors showed intratumoral gas due to fistulization into the bowel lumen, which appeared as hyperechoic foci or a linear hyperechoic area with acoustic shadowing. The heterogeneous tumors were significantly larger (P = .03) and had higher mitotic counts (P = .05). Gastrointestinal stromal tumors with high malignant potential tended to be large and showed intratumoral heterogenicity with areas of lower echogenicity. CONCLUSIONS: Gastrointestinal stromal tumors showed varied patterns on TAUS. The ultrasonographic pattern depended on the tumor size and mitotic activity. Ultrasonographic features suggesting high malignant potential were size and internal heterogenicity with the presence of intratumoral hypoechoic areas. PMID: 19546335 [PubMed - in process]

Sonography of axillary masses: what should be considered other than the lymph nodes?

Related Articles Sonography of axillary masses: what should be considered other than the lymph nodes? J Ultrasound Med. 2009 Jul;28(7):923-39 Authors: Kim EY, Ko EY, Han BK, Shin JH, Hahn SY, Kang SS, Cho EY, Kim MJ, Chun SY OBJECTIVE: The purpose of this study was to review the sonographic findings of various axillary masses other than lymph nodes in correlation with other imaging and pathologic findings. METHODS: From a sonographic database, we collected interesting cases of axillary masses with pathologic or other imaging corroboration from the last 10 years. RESULTS: Images of various soft tissue masses were reviewed. They included masses associated with accessory breasts (fibroadenomas, hamartomas, fat necrosis, and cancer arising from axillary breasts), other soft tissue masses (lipomas, schwannomas, hemangiomas, fibromatosis, epidermoid cysts, and malignant fibrous histiocytomas), and complications presenting as masses after axillary lymph node dissection (seromas, hematomas, suture granulomas, pseudoaneurysms, and lymphangiectasia). CONCLUSIONS: Awareness of the characteristic sonographic findings of various disease entities that cause axillary masses will help in the correct diagnosis of axillary masses. PMID: 19546334 [PubMed - in process]

Contrast-enhanced breast ultrasonography: imaging features with histopathologic correlation.

Related Articles Contrast-enhanced breast ultrasonography: imaging features with histopathologic correlation. J Ultrasound Med. 2009 Jul;28(7):911-20 Authors: Liu H, Jiang YX, Liu JB, Zhu QL, Sun Q, Chang XY OBJECTIVE: The purpose of this study was to identify histopathologic correlates for the varied appearances of breast masses on contrast-enhanced ultrasonography (CEUS). METHODS: Contrast-enhanced ultrasonography was performed in 104 patients (age range, 19-86 years) after administration of a sulfur hexafluoride microbubble contrast agent, and enhancement patterns were classified as no enhancement, peripheral enhancement, homogeneous enhancement, regional enhancement, and heterogeneous enhancement. All patients' histologic slides were reviewed and correlated with CEUS findings. RESULTS: In malignant masses, heterogeneous enhancement corresponded to tumor cell cords or clusters in a variable amount of desmoplastic stroma. Homogeneous enhancement corresponded to hypercellularity in the whole mass, or ductal carcinoma in situ (DCIS) was predominant. Regional enhancement corresponded to a DCIS component. Peripheral enhancement corresponded to a DCIS component, hypercellularity or adenosis at the periphery, and low-degree cellularity, degeneration, fibrosis, or necrosis in the center. No enhancement was present in 1 case of low-grade DCIS. In benign masses, heterogeneous enhancement corresponded to loose cell proliferation in a more sclerotic stroma. Homogeneous enhancement corresponded to diffuse hypercellularity, an inflammatory cell infiltrate, or intraductal papilloma. Regional enhancement corresponded to focal hypercellularity or intraductal papilloma within a dilated duct. No enhancement corresponded to desmoplastic stroma. Peripheral enhancement was shown in 1 case of granulomatous mastitis with an inflammatory infiltrate at the periphery and necrosis in the center. CONCLUSIONS: Breast mass CEUS findings correlated with histologic features. PMID: 19546333 [PubMed - in process]

Noncalcified ductal carcinoma in situ: imaging and histologic findings in 36 tumors.

Related Articles Noncalcified ductal carcinoma in situ: imaging and histologic findings in 36 tumors. J Ultrasound Med. 2009 Jul;28(7):903-10 Authors: Kim JH, Ko ES, Kim do Y, Han H, Sohn JH, Choe du H OBJECTIVE: The purpose of this study was to evaluate imaging findings in noncalcified ductal carcinoma in situ (DCIS) and to compare histologic findings between noncalcified and calcified DCIS. METHODS: From January 2005 to May 2008, 195 patients with pathologically confirmed DCIS were recruited. Among these, 36 patients (18%) had noncalcified DCIS. We retrospectively reviewed their imaging findings according to the American College of Radiology Breast Imaging Reporting and Data System. We also reviewed pathologic reports for all patients with DCIS to obtain information on the histologic type, nuclear grade, and biological markers. RESULTS: Among the 36 patients with noncalcified DCIS, 21 (58%) were symptomatic. On mammography, 25 patients (69%) showed abnormal findings, and 11 patients showed false-negative findings. On sonography, 29 of 36 patients (81%) showed a mass, whereas the remaining 7 patients (19%) showed nonmass lesions. The sonographic findings for the masses were variable: 25 of 29 masses (86%) were irregular in shape; 14 of 29 (48%) showed indistinct margins; and 9 (31%) were angular or spiculated. The orientation of the mass was not parallel in 6 of 29 cases (21%). Two of 29 masses (7%) showed an echogenic halo at the lesion boundary. Noncalcified DCIS tended to have a nonhigh nuclear grade and was frequently the noncomedo type. In addition, c-erb-B2 was more commonly expressed in calcified DCIS. CONCLUSIONS: Imaging findings for noncalcified DCIS are relatively nonspecific and are frequently similar to those of invasive malignancy. This knowledge may be useful for detecting noncalcified DCIS, planning treatment, and predicting the prognosis. PMID: 19546332 [PubMed - in process]

Prenatal screening for major congenital heart disease: superiority of outflow tracts over the 4-chamber view.

Related Articles Prenatal screening for major congenital heart disease: superiority of outflow tracts over the 4-chamber view. J Ultrasound Med. 2009 Jul;28(7):889-99 Authors: Sklansky MS, Berman DP, Pruetz JD, Chang RK OBJECTIVE: The purpose of this study was to determine the relative importance of the 4-chamber view (4CV) compared with the outflow tract views (OFTVs) in prenatal screening for major congenital heart disease (CHD). METHODS: We prospectively evaluated 200 consecutive infants undergoing cardiac surgery at our institution for major CHD. By reviewing the infants' medical records and conducting bedside interviews with their parents or guardians, we evaluated detection rates both prenatally and postnatally (before and after discharge to home), and we noted any prenatally identifiable risk factors for CHD. For each infant, we determined whether the 4CV or OFTVs would be expected to have been normal or abnormal on routine midgestation screening fetal sonography. RESULTS: A prenatal diagnosis of CHD was made in 65 infants (33%): 30 of 124 low-risk pregnancies (24%) and 35 of 76 high-risk pregnancies (46%). An abnormal screening midgestation 4CV would have been expected in up to 63% of the infants, whereas abnormal midgestation OFTVs would have been expected in up to 91% of the infants. Thus, the potential sensitivity for detecting major CHD was higher with the OFTVs than with the 4CV (91% versus 63%; P < .001). Moreover, the OFTVs were more sensitive than the 4CV for detecting ductal-dependent forms of CHD. Diagnosis after discharge to home occurred in 39 of 135 postnatal diagnoses (29%), including many cases of isolated outflow tract abnormalities requiring early invasive intervention. CONCLUSIONS: Cases of major neonatal CHD with OFTV abnormalities predominate over cases with 4CV abnormalities, particularly among those forms of CHD requiring early invasive intervention. PMID: 19546331 [PubMed - in process]

Feasibility of automated 3-dimensional fetal cardiac screening in routine ultrasound practice.

Related Articles Feasibility of automated 3-dimensional fetal cardiac screening in routine ultrasound practice. J Ultrasound Med. 2009 Jul;28(7):881-8 Authors: Uittenbogaard LB, Haak MC, van Vugt JM OBJECTIVE: The purpose of this study was to prospectively assess the clinical feasibility of an automated 3-dimensional (3D) software tool for extended basic cardiac screening in routine ultrasound practice. METHODS: During the 2-month study period, all gravidas fitting our inclusion criteria were consecutively included. Cardiac 3D volumes were acquired within the time slot allocated for the usual 2-dimensional fetal examination. All volumes were assessed on their quality, based on display of the 4-chamber view, and on the ability to sufficiently display diagnostic cardiac planes (left ventricular outflow tract [LVOT], right ventricle outflow tract [RVOT], and stomach location) with Sonography-Based Volume Computer-Aided Diagnosis software (SonoVCAD; GE Healthcare, Milwaukee, WI). RESULTS: Volume acquisition was successful in 107 of 126 cases (85%). For each sonographer, more than 70% of the acquired cardiac volumes were of high or sufficient quality. Separately analyzed, diagnostic planes of the LVOT, RVOT, and stomach location were visible in 62.1%, 81.6%, and 92.2%, respectively. An extended basic fetal cardiac examination based on retrieval of all diagnostic cardiac planes from a single volume using SonoVCAD could be performed in 46.6% of the cases. CONCLUSIONS: This study shows that cardiac volume acquisition can be incorporated in a routine ultrasound screening program without much difficulty. However, currently, SonoVCAD software still lacks the consistency to be clinically feasible for cardiac screening purposes. Further advances in ultrasound technology and familiarization with 3D ultrasound might improve its performance. PMID: 19546330 [PubMed - in process]

Experimental Study on Targeted Methotrexate Delivery to the Rabbit Brain via Magnetic Resonance Imaging-Guided Focused Ultrasound.

Related Articles Experimental Study on Targeted Methotrexate Delivery to the Rabbit Brain via Magnetic Resonance Imaging-Guided Focused Ultrasound. J Ultrasound Med. 2009 Jul;28(7):871-80 Authors: Mei J, Cheng Y, Song Y, Yang Y, Wang F, Liu Y, Wang Z OBJECTIVE: The purpose of this study was to investigate the effects of targeted and reversible disruption of the blood-brain barrier (BBB) by magnetic resonance imaging (MRI)-guided focused ultrasound (FUS) and delivery of methotrexate (MTX) to the rabbit brain. METHODS: The brains of 20 rabbits were sonicated by MRI-guided FUS at different exposure times, and then Evans blue extravasation, contrast-enhanced MRI, and histologic examination were performed to determine the optimal exposure time for reversible BBB disruption with minimal damage. Five rabbits were sonicated at the optimal exposure time after MTX was injected intravenously (IV); the targeted locations were included in the sonicated group, and the nontargeted contralateral counterparts were included in the IV control group. Five other rabbits were not subjected to sonication and were administered internal carotid artery (ICA) injections of MTX; the specimens of the counterpart brain tissue were harvested as the ICA group. The MTX concentration in all of the specimens was determined by high-performance liquid chromatography. RESULTS: The MTX concentration in the sonicated group (mean +/- SD, 7.412 +/- 1.471 mug/g of tissue) was notably higher than that in both the IV control group (0.544 +/- 0.084 mug/g) and ICA group (1.984 +/- 0.65 mug/g; P <.01). CONCLUSIONS: Magnetic resonance imaging-guided FUS can disrupt the BBB reversibly and deliver IV administered MTX to targeted brain locations; it brings about a greater than 10-fold increase in the drug level and is much more effective ( approximately 3.7-fold) than drug delivery through the ICA without sonication. This may facilitate the development of improved treatment methods for central nervous system disorders. PMID: 19546329 [PubMed - in process]

Real-time Ultrasound Elastography in the Differential Diagnosis of Benign and Malignant Thyroid Nodules.

Related Articles Real-time Ultrasound Elastography in the Differential Diagnosis of Benign and Malignant Thyroid Nodules. J Ultrasound Med. 2009 Jul;28(7):861-7 Authors: Hong Y, Liu X, Li Z, Zhang X, Chen M, Luo Z OBJECTIVE: The purpose of this study was to evaluate the diagnostic utility of real-time ultrasound elastography in differentiating benign from malignant thyroid nodules. METHODS: A total of 90 consecutive patients with thyroid nodules who were referred for surgical treatment were examined in this prospective study. One hundred forty-five nodules in these patients were examined by B-mode ultrasound, color Doppler ultrasound, and ultrasound elastography. The final diagnosis was obtained from histologic findings. Tissue stiffness on ultrasound elastography was scored from 1 (low stiffness over the entire nodule) to 6 (high stiffness over the entire nodule and surrounding tissue). RESULTS: On real-time ultrasound elastography, 86 of 96 benign nodules (90%) had a score of 1 to 3, whereas 43 of 49 malignant nodules (88%) had a score of 4 to 6 (P <.001), with sensitivity of 88%, specificity of 90%, a positive predictive value of 81%, and a negative predictive value of 93%. The predictivity of ultrasound elastographic measurement was independent of the nodule size. High sensitivity (88%) and specificity (93%) were also observed in 68 nodules that had a greatest diameter of 1 cm or less. CONCLUSIONS: Real-time ultrasound elastography is a promising imaging technique that is useful in the differential diagnosis of thyroid cancer. PMID: 19546328 [PubMed - in process]

Use of ultrasound elastography for skin and subcutaneous abscesses.

Related Articles Use of ultrasound elastography for skin and subcutaneous abscesses. J Ultrasound Med. 2009 Jul;28(7):855-60 Authors: Gaspari R, Blehar D, Mendoza M, Montoya A, Moon C, Polan D OBJECTIVE: Elastography is a new adjunct to real-time ultrasound imaging that overlays traditional B-mode imaging with a color graphic representation of tissue elasticity. Soft tissue infections are common presenting conditions in the emergency department, and elastography has the potential to help in diagnosis and treatment of evolving soft tissue infections as they progress from induration to fluctuant abscesses, but to our knowledge, no studies of elastography in superficial soft tissue have been published. We hypothesized that elastography would provide increased information regarding skin abscesses. METHODS: This was a prospective study of patients with suspected skin abscesses requiring surgical drainage in the emergency department of an urban tertiary care center. Abscesses were imaged with B-mode imaging and elastography in orthogonal planes. Ultrasound images were analyzed for characteristics of the elastographic images. RESULTS: A total of 50 patients with suspected skin abscesses underwent B-mode imaging and elastography. Elastography accurately differentiated the induration surrounding the abscess from the surrounding healthy tissue, a differentiation that was not visible on B-mode imaging. The elastographic properties of the abscess cavity were variable and not always seen, even with purulence identified during incision and drainage. In some cases, elastography identified abscess cavities not seen on B-mode imaging. When seen, the abscess cavity could be characterized by elastographic color and speckle patterns. CONCLUSIONS: Elastography identified the tissue induration and some abscess cavities not seen on B-mode imaging. It offers a way to characterize abscesses that may be useful clinically, but more research is needed. PMID: 19546327 [PubMed - in process]

Three-dimensional ultrasonographic bladder volume measurement: reliability of the virtual organ computer-aided analysis technique using different rotation steps.

Related Articles Three-dimensional ultrasonographic bladder volume measurement: reliability of the virtual organ computer-aided analysis technique using different rotation steps. J Ultrasound Med. 2009 Jul;28(7):847-54 Authors: Suwanrath C, Suntharasaj T, Sirapatanapipat H, Geater A OBJECTIVE: The purpose of this study was to investigate the reliability of Virtual Organ Computer-Aided Analysis (VOCAL; GE Healthcare, Kretztechnik, Zipf, Austria) using the 4 standard rotation steps to measure the bladder volume with 3-dimensional (3D) ultrasonography. METHODS: Using the 4 standard rotation steps of VOCAL, 2 independent observers made 3D volume measurement data sets from the urinary bladder (n = 180). Sets of 30, 20, 12, and 6 planes were obtained from the sequential rotations of 6 degrees , 9 degrees , 15 degrees , and 30 degrees , respectively. The internal contours of the bladders were determined manually. Reliability was evaluated with the intraclass correlation coefficient (ICC), and Bland-Altman plots were generated to examine bias and agreement. One-way analysis of variance was used to compare bladder volume measurements between the angles. P < .05 was considered statistically significant. RESULTS: A high degree of reliability was observed between pairs of different rotation angles (ICC, 0.994-0.999). There was good agreement between all pairs of different rotation angles, with percentages of the mean difference ranging from -0.9% to 1.8%. No significant difference was found for bladder volume measurements by the VOCAL technique with varying rotation steps. Intraobserver and interobserver reliabilities were high (ICC, 0.994-0.998). CONCLUSIONS: Urinary bladder volume measurement by the VOCAL technique using different rotation steps is highly reliable. A plane rotation of 30 degrees produces the fastest result. PMID: 19546326 [PubMed - in process]

High-resolution sonography of the normal extrapelvic vas deferens.

Related Articles High-resolution sonography of the normal extrapelvic vas deferens. J Ultrasound Med. 2009 Jul;28(7):839-46 Authors: Middleton WD, Dahiya N, Naughton CK, Teefey SA, Siegel CA OBJECTIVE: The purpose of this study was to determine the reliability of sonographic visualization of the normal extrapelvic vas deferens and to analyze its appearance and dimensions. METHODS: Scans of the scrotum and spermatic cords were obtained in 25 fertile volunteers. Identification of the vas deferens was attempted bilaterally in the scrotal, suprascrotal, and prepubic segments in all volunteers. When possible, the total thickness and the diameter of the lumen were measured. Visualization and dimensions were correlated with the body mass index (BMI) and abstinence interval. RESULTS: All segments of the vas deferens were identified bilaterally in all volunteers. In all cases, it appeared as an anechoic or very hypoechoic tubular structure that was noncompressible and contained no detectable blood flow. It was convoluted inferiorly and became straight as it progressed from the scrotum to the suprascrotal and prepubic segments. The lumen was seen in the suprascrotal segment in all of the volunteers except the one with the highest BMI. The total thickness of the vas ranged from 1.5 to 2.7 mm (mean, 1.89 mm). The lumen of the vas ranged from 0.2 to 0.7 mm (mean, 0.43 mm). There was no correlation between the luminal diameter and the abstinence interval. CONCLUSIONS: The extrapelvic portion of the vas deferens is reliably visualized sonographically. Its appearance is characteristic and reproducible. The lumen can be measured in almost all cases. PMID: 19546325 [PubMed - in process]

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 4, October 2008, Pages v-vi[No author name available]

Forthcoming Issues

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 4, October 2008, Page vii[No author name available]

Preface

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 4, October 2008, Pages ix-xNoam, Lazebnik , Roee S., Lazebnik

The Utilization of 3D and 4D Technology in Fetal Neurosonology

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 4, October 2008, Pages 489-516Eran, Bornstein , Ana, Monteagudo , Ilan E., Timor-TritschThis article discusses the clinical use of three-dimensional technology while performing a fetal neuroscan. This technique allows us to better define the spatial relationship of brain structures and possible malformations. The varieties of display modes and the infinite number of different planes that can be generated facilitate the diagnostic process. Additional values of this technology include an off-line analysis of the volume by the sonographer or sonologist to obtain the necessary planes, as well as an electronic transmittal for an off-site expert to provide a second opinion consultation. This modality requires a short acquisition time, allowing high patient through-put and...

3D and 4D Fetal Neuroscan: Sharing the Know-how and Tricks of the Trade

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 4, October 2008, Pages 517-528Eran, Bornstein , Ana, Monteagudo , Ilan E., Timor-TritschVisual information from 2-D images may be limited in reflecting a 3-D structural reality. 3-D techniques have emerged enabling acquisition of an entire volume of spatial ultrasound information that can be analyzed and displayed in multiple planes and display modes that exceed the capacities of 2-D US and better reflect the 3-D nature of a structure or anomaly. In the future 3-D evaluation of the fetal body will be an inherent part of fetal study in cases of congenital anomaly' specifically fetal brain abnormality. This article focuses on the technique for obtaining and analyzing acquired volumes and displaying them.

The Utility of Volume Sonography for the Detection of Fetal Spine Abnormalities

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 4, October 2008, Pages 529-539Noam, Lazebnik , Eran, Bornstein , Ilan E., Timor-TritschSonographic evaluation of the fetal vertebral column is essential for fetal central nervous system evaluation and valuable for ruling out genetic conditions. This article provides an overview for obtaining and manipulating fetal vertebrae three-dimensional data as to obtain the necessary diagnostic views. Additional technical information is provided elsewhere in this issue. This discussion is limited to include only the most common fetal vertebral abnormalities. The same technical principals, however, enable detection of many additional abnormalities.

Fetal Neuroimaging of Neural Migration Disorder

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 4, October 2008, Pages 541-552Ritsuko K., PoohPrenatal diagnosis of migration disorder is among the most difficult challenges of an antenatal sonographic examination. Anterior coronal demonstration of the sylvian fissures is recommended as the screening of cortical development and maldevelopment. Once suspicion of a migration disorder develops, MR imaging is the preferred modality for demonstration of cortical development. Considering that migration disorders occur before fetal viability but detection of brain lesions is most commonly performed in the third trimester, this presents a diagnostic dilemma. Early detection of migration disorder with severe prognosis is among the central missions of fetal neuroimaging.

The Differential Diagnosis of Fetal Intracranial Cystic Lesions

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 4, October 2008, Pages 553-558Gustavo, Malinger , Edgardo Corral, Sereño , Tally, Lerman-SagieFetal Intracranial cysts can be diagnosed during pregnancy by the use of ultrasound scan. The cysts can be found in different brain compartments and may be of diverse origins. Choroid plexus and arachnoid cysts are the most commonly diagnosed lesions and when isolated carry a good prognosis. Intraparenchymal cysts may have different etiologies, and the prognosis depends largely on the location and the extent of the lesion.

Magnetic Resonance Imaging Following Suspicion for Fetal Brain Anomalies

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 4, October 2008, Pages 559-582Alice B., Smith , Orit A., GlennFetal MR imaging provides a useful adjunct in the evaluation of anomalies of the fetal brain noted on ultrasound. The higher resolution of fetal MR imaging allows for improved assessment of cortical malformations and other anomalies. The use of fetal MR imaging is relatively new, however, and understanding of the imaging findings continues to evolve. In addition, the improvement of newer techniques, such as diffusion weighted MR imaging, should lead to improved understanding of the developing fetal brain and the impact of ischemic, infectious, and developmental insults.

Ultrasound of the Fetal Cranium: Review of Current Literature

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 4, October 2008, Pages 583-594Eyal, Sheiner , Jacques S., AbramowiczFetal cranial defects and abnormal skull shape are amenable to ultrasound study diagnosis. Correct identification of the nature of the abnormality is extremely important and helpful in establishing diagnosis and longterm prognosis. In addition it might direct the care provider to apply the correct genetic study, chromosome or DNA related, for final diagnosis confirmation. This article discusses normal and abnormal fetal skull anatomy as observed using ultrasound technology.

Diagnostic Approach to Prenatally Diagnosed Limb Abnormalities

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 4, October 2008, Pages 595-608Arie, Koifman , Ori, Nevo , Ants, Toi , David, ChitayatLimb formation occurs at 4–12 weeks gestation and involves many genes and gene families. The prevalence of limb abnormalities is approximately 6/10,000 live births, with higher incidence in the upper limbs compared to the lower limbs (3.4/10,000 and 1.1/10,000 respectively). Limb abnormalities are morphologically and etiologically heterogenous group of abnormalities and most are amenable for prenatal diagnosis. The investigation and counselling of woman/couple with prenatally diagnosed fetal limb abnormality requires a multidisciplinary team including obstetrician, radiologist, clinical geneticist, neonatologist/pediatrician and a pediatric orthopedic surgeon. Other specialties may be needed if other abnormalities are detected.

Index

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 4, October 2008, Pages 609-612[No author name available]

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 3, July 2008, Pages v-viii[No author name available]

Forthcoming Issues

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 3, July 2008, Page ix[No author name available]

Preface

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 3, July 2008, Page xiiiVikram S., Dogra , Deniz, Akata

Palpable and Nonpalpable Breast Masses

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 3, July 2008, Pages 277-287Figen, Başaran DemirkazıkBreast ultrasonography (US) is not only useful in identifying the cystic content of breast masses but also in characterization of the solid masses. BI-RADS US lexicon, like the mammography lexicon, provides a standard terminology and assessment for breast US reports. In this article, the author examines the different types of cysts and solid lesions and examines how they should be treated. He focuses on categories 2 through 6 of the BI-RADS ultrasonography final assessment categories in American College of Radiology Imaging Network 6666 protocol, which indicate how and if cysts and lesions should be treated by biopsy or aspiration.

Ultrasound-Guided Breast Biopsies and Aspirations

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 3, July 2008, Pages 289-294Aysenur, OktayUltrasonography is an efficient modality for guidance in interventional procedures in the breast. It is inexpensive and well tolerated by patients, and the risks are rare. Ultrasonographically guided breast core biopsy is commonly used in many centers as an accurate alternative to surgical biopsy for suspicious lesions. The advantages include decreased cost, absence of surgical scarring, no need for general anesthesia, and speed of the procedure. A good imaging–histologic correlation is necessary to decrease false-negative results. Other interventional procedures like cyst aspiration and needle localization can also be performed easily under ultrasound guidance.

Ultrasonography of the Postsurgical Breast Including Implants

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 3, July 2008, Pages 295-329Gul, Esen , Deniz Cebi, OlgunSurgical interventions lead to alterations in breast tissue causing difficulty in interpretation of clinical and radiologic findings. Radiologists must detect and recognize these alterations to diagnose recurrent tumor while there is a chance for curative surgery. It is important to avoid overdiagnosis so as not to lead to unnecessary biopsies. Ultrasonography is an adjunct to mammography in evaluating post-treatment changes. Changes in the breast can be visualized clearly and directly without superimposition of structures. This article reviews sonographic findings in operated breasts, with a focus on the conservatively treated breast, and findings associated with excisional biopsies, breast implants, augmentation, and...

Ectopic Pregnancy

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 3, July 2008, Pages 331-343Safiye, GurelEctopic pregnancy (EP) is a challenging obstetrical entity in terms of diagnosis both for the clinican and the radiologist. It is still the leading cause of pregnancyrelated morbidity and mortality and fallopian tube is the commonest site of ectopic pregnancy. Incidence of rare forms of EP such as heterotopic and C-section scar EP is increasing because of the high rate of C-section surgeries and increased use of in vitro fertilization. Ultrasonography, combined with serum β-hCG level, is still the most effective radiologic modality in diagnosing EP. Ultrasound and color flow Doppler features of fallopian tube ectopic pregnancy and other rare...

Ultrasound Assessment of Premenopausal Bleeding

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 3, July 2008, Pages 345-368Raj M., Paspulati , Ahmet T., Turgut , Shweta, Bhatt , Elif, Ergun , Vikram S., DograVaginal bleeding is the most common cause of emergency care in the first trimester of pregnancy and accounts for the majority of premenopausal bleeding cases. Ultrasound evaluation combined with a quantitative beta human chorionic gonadotropin test is an established diagnostic tool to assess these patients. Spontaneous abortion because of genetic abnormalities is the most common cause of vaginal bleeding; ectopic pregnancy and gestational trophoblastic disease are other important causes and in all patients presenting with first trimester bleeding, ectopic pregnancy should be suspected and excluded, as it is associated with significant maternal morbidity and mortality. A thorough knowledge of the...

Sonography of Adnexal Masses

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 3, July 2008, Pages 369-389Mukund, Joshi , Karthik, Ganesan , Harsha Navani, Munshi , Subramania, Ganesan , Ashwin, LawandeTransabdominal sonography combined with high-frequency endovaginal ultrasound is considered the community standard for the performance of pelvic ultrasound for evaluation of an adnexal mass. Subjective evaluation of ovarian masses based on pattern recognition can achieve a sensitivity of 88% to 100% and specificity of 62% to 96%. Addition of color and power Doppler to grayscale imaging for pelvic mass evaluation increases the specificity in the range of 82% to 97% and increases the positive predictive value to 63% to 91%, aiding in subsequent evaluation and management. Pelvic sonography can confidently diagnose most of the benign adnexal masses and helps with...

Postmenopausal Bleeding

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 3, July 2008, Pages 391-397Ismail, Mihmanli , Fatih, KantarciPostmenopausal bleeding (PMB) may be defined as recurrent vaginal bleeding in a menopausal woman at least 1 year after cessation of cycles. In postmenopausal bleeding, transvaginal ultrasonography (TVUS) is preferred over endometrial biopsy as an initial diagnostic tool. The use of TVUS decreases the need for invasive diagnostic procedures for women without abnormalities, and ultrasound increases the sensitivity of detecting abnormalities in women with postmenopausal bleeding. It is a less invasive procedure, is generally painless, has no complications, and may be more sensitive for detecting carcinoma than blind biopsy. Sonohysterography allows reliable differentiation between focal and diffuse endometrial and subendometrial...

Endometriosis

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 3, July 2008, Pages 399-414Ercan, Kocakoc , Shweta, Bhatt , Vikram S., DograUltrasound is the initial imaging modality for the assessment of endometriosis. Ovarian endometrioma, bladder endometriosis, and scar endometriosis are diagnosed reliably using ultrasound. The presence of hyperechoic wall foci and low-level echoes are very specific for endometriomas. Bilateral and multiple lesions may favor the diagnosis of endometriosis. Diagnosing deep endometriosis and adhesions is difficult with ultrasound, and laparoscopy is performed for diagnosis and staging. Endometriosis should be considered in the differential diagnosis of any woman of reproductive age who has pelvic pain or infertility.

Pelvic Congestion Syndrome

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 3, July 2008, Pages 415-425Musturay, Karcaaltincaba , Deniz, Karcaaltincaba , Vikram S., DograRadiologic imaging plays an important role in the diagnosis of pelvic congestion syndrome in patients with chronic pelvic pain. Pelvic congestion syndrome is a diagnosis of exclusion and differential diagnosis includes endometriosis, pelvic inflammatory disease, and ovarian cysts. In this syndrome, ovarian and pelvic veins are dilated owing to incompetence and venous reflux or to reversed venous flow associated with renal vein or ovarian vein stenosis. Ovarian vein venography is the gold standard for the definite diagnosis, which is usually performed before treatment. In this review, radiologic findings of pelvic congestion syndrome are discussed with their advantages and limitations. Role...

Sonohysterography: Technique and Clinical Applications

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 3, July 2008, Pages 427-449Phyllis, Glanc , Carrie, Betel , Anna, Lev-ToaffThis article examines the role of sonohysterography as an extension of the transvaginal ultrasound examination. This technique is used to improve visualization of the endometrial cavity and its relationship to the uterus. The authors find that it is well tolerated and causes few complications. The improved anatomic resolution increases diagnostic confidence and helps direct the patient to appropriate therapeutic options, potentially decreasing the need for more costly or invasive examinations. The addition of three-dimensional ultrasound makes the examination quicker and expands the utility of the procedure. The authors conclude that it will play a growing role in the evaluation of...

Ovarian Torsion and Its Mimics

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 3, July 2008, Pages 451-460Deniz, AkataColor flow Doppler (CFD) imaging provides valuable information about the vascularity of tissue, organs, or systems. CFD imaging is commonly used during the evaluation of uterus and ovaries in addition to gray-scale imaging and is a helpful imaging modality in the diagnosis of various pathologic conditions in gynecology and obstetrics. The main limitation of CFD imaging is its user dependency that may lead to misdiagnosis owing to the artifacts or pitfalls derived from improper technique, incorrect use of imaging parameters, and unawareness of physical properties of the modality by the user. This article summarizes the CFD imaging technique, the optimization...

Color Flow Doppler Evaluation of Uterus and Ovaries and Its Optimization Techniques

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 3, July 2008, Pages 461-482Mustafa, Secil , Vikram S., DograColor flow Doppler (CFD) imaging provides valuable information about the vascularity of tissue, organs, or systems. CFD imaging is commonly used during the evaluation of uterus and ovaries in addition to gray-scale imaging and is a helpful imaging modality in the diagnosis of various pathologic conditions in gynecology and obstetrics. The main limitation of CFD imaging is its user dependency that may lead to misdiagnosis owing to the artifacts or pitfalls derived from improper technique, incorrect use of imaging parameters, and unawareness of physical properties of the modality by the user. This article summarizes the CFD imaging technique, the optimization...

Index

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 3, July 2008, Pages 483-488[No author name available]

Vitreoretinal Disorders

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 2, April 2008, Pages 217-228Sumit, Sharma , Alexandre A.C.M., Ventura , Nadia, WaheedVitreoretinal diseases are the most common indication for ultrasonographic imaging of the posterior segment. Using ultrasound, it is possible to identify, evaluate, and follow numerous posterior segment conditions such as retinal tears, vitreous and retinal detachments, retinoschisis, retinal pigment epithelium detachment, subretinal hemorrhage, and eccentric disciform lesions. It is imperative to conduct a thorough examination of all the quadrants to avoid missing any pathology, and to evaluate the vitreous body, posterior hyaloid, subvitreal space, retina, choroid, sclera, optic disc, and macular region.

Intraocular Tumors

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 2, April 2008, Pages 229-244Evelyn X., Fu , Brandy C., Hayden , Arun D., SinghUltrasonography is a powerful noninvasive tool for the accurate diagnosis and effective management of intraocular tumors. Distinguishing ultrasonographic characteristics of intraocular tumors result from their different histopathologic compositions that can be evaluated with one-dimensional reflectivity analysis (A-scan) and two-dimensional acoustic section (B-scan). Information regarding location, shape, and acoustic characteristics is considered together to aid the diagnosis of intraocular tumors. Determination of size progression and extension is critical in selecting and monitoring management.

Ocular Inflammatory Diseases

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 2, April 2008, Pages 245-255Alexandre A.C.M., Ventura , Brandy C., Hayden , Mehran, Taban , Careen Y., LowderBecause of its ability to evaluate eyes using either clear or opaque media, ultrasonography has been a critical adjunct in ophthalmology for more than 50 years. This article provides an overview of the ultrasound characteristics observed in a variety of ocular inflammatory diseases.

Optic Nerve Disorders

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 2, April 2008, Pages 257-266Lisa D., Lystad , Brandy C., Hayden , Arun D., SinghDiseases of the optic nerve are difficult to assess, as tissue diagnosis is usually unavailable. Therefore, various subjective functional tests are relied upon to achieve a differential diagnosis. This article reviews clinical scenarios wherein ultrasonographic imaging provides a readily accessible and inexpensive means for diagnosing and monitoring optic nerve disorders.

Posterior Segment Trauma

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 2, April 2008, Pages 267-272Hajir, Dadgostar , Alexandre A.C.M., Ventura , Brandy C., HaydenOcular trauma is a major cause of vision loss, particularly among younger patient populations. This article describes the clinical and ultrasonographic features of several commonly encountered trauma-associated diagnoses that involve the posterior segment in which ocular ultrasound can provide useful information.

Index

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 2, April 2008, Pages 273-276[No author name available]

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 1, January 2008, Pages v-viii[No author name available]

Forthcoming Issues

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 1, January 2008, Page ix[No author name available]

Preface

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 1, January 2008, Page xiVikram S., Dogra , Shweta, Bhatt

Gynecologic Causes of Acute Pelvic Pain: Ultrasound Imaging

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 1, January 2008, Pages 1-12Kiran A., JainAcute pelvic pain in women may be the manifestation of various gynecologic conditions that can range from less alarming rupture of the hemorrhagic cyst to life-threatening conditions such as rupture of ectopic pregnancy. Ultrasound is the primary imaging modality of choice in the evaluation of the premenopausal woman patient presenting with acute pelvic pain. This article discusses ultrasound imaging in the spectrum of various acute gynecologic conditions originating from uterus, ovaries, pelvic inflammatory disease, and ectopic pregnancy.

Imaging of the Placenta

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 1, January 2008, Pages 13-22Tulin, Ozcan , Eva K., PressmanPlacental imaging allows prenatal diagnosis of many important complications of pregnancy and delivery. Sonographic assessment of placental location and structure to rule out placenta previa, succenturiate lobes, and placenta accreta as well as evaluation for lesions including infarctions and abruptions can allow appropriate pregnancy follow-up and delivery planning. Diagnosis of these placental complications prenatally can allow optimal pregnancy management and prevent adverse outcomes for mother and infant.

Focused Assessment with Sonography for Trauma

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 1, January 2008, Pages 23-31Nira, Beck-Razi , Diana, GaitiniUltrasound in trauma, whether in the case of an individual patient or that of a multiple-casualty incident, has an important role in evaluation and immediate triage. The ultrasound examination in the trauma room is brief and focused and should answer a single relevant question: “Is there a hemoperitoneum?” In this article, the usefulness of focused assessment with sonography for trauma (FAST) is reviewed for the different types of cases arriving in the trauma room: blunt versus penetrating injuries, stable versus unstable patients, and children versus adults. Sonographic technique and controversies pertaining to protocol and to practice domain are also discussed.

Sonographic Evaluation of Vascular Injuries

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 1, January 2008, Pages 33-48Diana, Gaitini , Nira, Beck-Razi , Ahuva, Engel , Vikram S., DograThis article reviews the role of color Doppler duplex sonography (CDDS) in the diagnosis of vascular trauma, illustrating the sonographic appearances of peripheral and central arterial and venous injuries, procedure-related and trauma-related injuries. Different types of vascular injuries are discussed and examination techniques are described. Traumatic vascular lesions of the extremities, neck, and abdomen were chosen to illustrate the spectrum of sonographic appearances. CDDS is a rapid, noninvasive and accurate technique in the evaluation and diagnosis of vascular injuries and, when possible, should be the first-line examination. However, in cases of extensive skin wounds, subcutaneous air, cast, and life-threatening lesions,...

Transplant Ultrasound of the Kidney, Liver, and Pancreas

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 1, January 2008, Pages 49-65Heidi R., Umphrey , Mark E., Lockhart , Michelle L., RobbinAdvances in solid organ transplantation and immunosuppressive therapy have provided considerable improvement in morbidity and mortality and significant improvement in quality of life. Close clinical monitoring and imaging studies are invaluable tools for ensuring successful outcomes. Ultrasound is an excellent front-line, noninvasive imaging method for early postoperative allograft evaluation, and it can also provide valuable information for long-term follow-up. This article addresses the role of ultrasound in evaluating renal, hepatic, and pancreatic allografts and reviews the associated complications of solid organ transplantation. The authors have divided the complications into five major categories: allograft-associated collections, allograft dysfunction, vascular complications, posttransplant neoplasms,...

Sonography of the Surgical Abdomen in Children

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 1, January 2008, Pages 67-82Sushil, Sonanvane , Marilyn J., SiegelThe introduction of the graded-compression sonographic technique and continued advances in ultrasound technology have increased the use of sonography in evaluating the child who has a suspected surgical abdomen. Sonography is used to characterize the nature of the many conditions associated with acute abdominal symptoms and signs and to differentiate between those requiring urgent surgical intervention and those that do not. This article reviews the sonographic evaluation of common important surgical conditions of the abdomen in children. Indications for performing sonography, sonographic features of common lesions, and the sonographic techniques best suited to making a diagnosis are addressed.

Catastrophes of Abdominal Aorta: Sonographic Evaluation

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 1, January 2008, Pages 83-91Shweta, Bhatt , Vikram S., DograAlthough ultrasound has a limited role in the emergent evaluation of the aorta, it still has a significant role in screening for abdominal aortic aneurysm (AAA) and for monitoring after endovascular repair. Awareness of the sonographic features of AAA, AAA rupture, and aortic dissection helps identify the problem and enables timely follow-up and management in these emergent cases. Contrast-enhanced ultrasound potentially has a significant role in assessment of these emergent conditions of the abdominal aorta, but because of the urgency involved, CT often is preferred over ultrasound.

Acute Painful Scrotum

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 1, January 2008, Pages 93-107Ahmet T., Turgut , Shweta, Bhatt , Vikram S., DograThe acute painful scrotum, which is the most common urologic emergency, may present a diagnostic challenge even to experienced clinicians. Imaging is used mainly to identify patients requiring surgical treatment to reduce the rate of unnecessary testicular exploration. Gray-scale ultrasound combined with color and pulsed Doppler modes is the method of choice for patients presenting with acute scrotal pain. This article describes the ultrasound features of scrotal pathologies associated with a painful scrotum and the pitfalls of a relevant scrotal ultrasound examination.

Adnexal Torsion

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 1, January 2008, Pages 109-119Michele, Bertolotto , Giovanni, Serafini , Paolo, Tomà , Roberta, Zappetti , Vincenzo, MigaledduAdnexal torsion is a serious cause of acute lower abdominal pain in women. It is a relatively uncommon condition but should be considered in every female patient who has acute pelvic pain. Early diagnosis and prompt surgical intervention are required, and sonologists frequently are asked to exclude this possibility. Color Doppler ultrasonography is the imaging modality of choice to evaluate patients suspected of having adnexal torsion.

Sonography of Right Upper Quadrant Pain

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 1, January 2008, Pages 121-138Wui K., Chong , Monty S., ShahUltrasound of the right upper quadrant is one of the most commonly performed sonographic studies. Sonography is the first-line imaging modality for evaluation of the patient who has right upper quadrant abdominal pain. It is accurate, quick, easy to perform, does not use ionizing radiation, and can be done in at the patient's bedside. This article describes the sonographic evaluation of right upper quadrant pain.

Sonography of Upper Extremity Deep Venous Thrombosis

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 1, January 2008, Pages 139-146Beatrice L., Madrazo , Marco, AmendolaThe incidence of upper extremity deep vein thrombosis (DVT) has increased significantly in the last few decades, probably secondary to the more widespread use of central venous lines. Those caring for patients both with and without known risk factors for thromboembolic venous disease should realize the importance of expertise in the prophylaxis, diagnosis, and management of upper extremity DVT.

Lower Extremity Venous Doppler

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 1, January 2008, Pages 147-158Edward P., Lin , Shweta, Bhatt , Vikram S., DograUltrasound has supplanted conventional venography as the primary imaging modality in screening for and detecting deep vein thrombosis (DVT). The examination should include findings of intermittent compression, spontaneous flow, phasicity, augmentation, Valsalva response, and comparison of the contralateral common femoral vein waveform. Venous compression is the most reliable finding in detecting a DVT. With the use of color flow Doppler, sensitivities and specificities approach 95% to 99%. In addition to reviewing the imaging features of DVT, this article discusses the epidemiology, clinical features, and pathophysiology of lower extremity DVTs.

Renal Colic

Publication year: 2008Source: Ultrasound Clinics, Volume 3, Issue 1, January 2008, Pages 159-170Ravinder, Sidhu , Shweta, Bhatt , Vikram S., DograRenal colic is one the most common diseases seen in the emergency department. Ultrasound can serve as an initial investigation for detecting stones with or without associated hydronephrosis and is especially useful when avoiding radiation is important. The twinkling artifact in color Doppler aids in the diagnosis of small calculi. Helical CT serves as the imaging modality of choice because of its higher sensitivity in detecting stones. CT may help in diagnosing other nonrenal causes of acute abdominal pain. MR urography is a new modality that can be useful in pregnant women when renal ultrasound findings are equivocal.

Prenatal findings of concomitant duodenal and esophageal atresia without tracheoesophageal fistula (Gross type A)

Prenatal diagnosis of concomitant duodenal atresia (DA) and esophageal atresia (EA) without tracheoesophageal fistula (TEF) (Gross type A) is very rare. We describe prenatal findings of one such case. Sonographic examination of a 26-week fetus showed a double cystic structure and an intrathoracic cyst. MRI and ultrasound at 26 weeks and 2 days' gestation showed shrinkage of the stomach and duodenum, massive ascites, and the presence of dilated pouch-like structure in the thoracic inlet level, consistent with an upper pouch sign. Polyhydramnios was detected at 30 weeks' gestation. Prenatal diagnosis was concomitant DA and an intrathoracic anomaly such as congenital hiatal hernia, diaphragmatic hernia, esophageal duplication or EA. A boy was delivered at 38 weeks' gestation. Physical examination showed a markedly distended abdomen and imperforate anus. Emergency surgery revealed existing DA and EA without TEF (Gross type A). © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009

Pre-, intra-, and postoperative sonography of the abdominal wall in patients with incisional hernias repaired via a three-layered operative suture method

We illustrate the various sonographic (US) appearances of the abdominal wall following this type of repair, including partial and complete recurrences. Correlation is made with CT imaging. The three-layered anatomical reconstruction of an incisional hernia is described. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009

Prenatal diagnosis of schizencephaly with 2D-3D sonography and MRI

We report a case of schizencephaly diagnosed prenatally at 23 weeks of gestational age with two-dimensional (2D) and three-dimensional (3D) sonography and fetal brain MRI, confirmed by autopsy. The diagnostic method of choice is 2D transabdominal and transvaginal sonography, whereas additional 3D sonography and MRI may provide a better understanding of the pathology and related findings. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009

Fibrosarcomatous transformation in dermatofibrosarcoma protuberans of the breast - A case report

Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous malignant tumor that usually occurs in the trunk, extremities, head, and neck but very rarely in the breast. Fibrosarcomatous transformation of DFSP is even rarer, with a higher risk of distant metastasis and poorer prognosis than DFSP. We report a case of such transformation in a DFSP in the breast. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009

Sonographic appearance of a migrated Angelchik anti-reflux prosthesis in the pelvis

Surgical implantation of Angelchik prosthesis around the distal esophagus was a popular treatment for gastroesophageal reflux in the 1980s. However, because of frequent complications, this surgical technique was abandoned. We report a case of a migrated Angelchik prosthesis in a 56-year-old woman in whom the prosthesis was found in the pelvic cavity 20 years after the initial surgery. The plain radiographic and ultrasound findings are described. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound 2009

Prenatal diagnosis of VACTERL syndrome and partial caudal regression syndrome: A previously unreported association

We describe a case of VACTERL syndrome associated with type 1 unilateral caudal regression syndrome. The abnormal sonographic findings at 26 weeks included hemivertebrae, scoliosis, hypoplastic and deformed lumbar spine and sacrum, preaxial polydactyly on the left hand, duplicated hallux on the left foot and hemihypoplasia of the left lower limb, bilateral club foot, and single umbilical artery. Postmortem examination confirmed prenatal sonographic findings with additional findings of supernumerary rib at the lumbar level and anal atresia. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound 2009

Three-dimensional power Doppler sonography in the diagnosis of a cystic sacrococcygeal teratoma mimicking a meningomyelocele: A case report

Sacrococcygeal teratomas have been diagnosed prenatally on sonograms as masses of cystic, solid, or mixed echogenicity from the sacral area and protruding through the perineum or buttocks. However, a cystic sacrococcygeal teratoma may be misdiagnosed as an anterior sacral meningomyelocele, especially when presenting as a posterior cystic mass. We report a case in which three-dimensional power Doppler imaging was helpful for making a correct prenatal diagnosis of a type 1 cystic sacrococcygeal teratoma, which mimicked a meningomyelocele. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009

Early sonographic diagnosis of intrauterine device migration to the adnexa

Uterine perforation is an uncommon complication of intrauterine devices (IUDs). Perforating IUDs can migrate to various locations but paradoxically are rarely found in ovaries or broad ligament. We describe an unusual case of a 23-year-old woman 1-month postpartum with an IUD translocation to the right adnexa. The IUD was inserted only 1 week prior to presentation, and she experienced pain on insertion. After visualization by ultrasound, the IUD was laparoscopically removed. We suggest early use of ultrasound in cases of potential IUD migration, particularly in high-risk patients and when IUD insertion causes pain. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009

Sonography versus nerve conduction studies in patients referred with a clinical diagnosis of carpal tunnel syndrome

To compare the diagnostic value of high-resolution ultrasound (US) with nerve conduction studies (NCS) in patients with clinically defined carpal tunnel syndrome (CTS).A prospective study was conducted on 66 consecutive patients investigated for sensory hand symptoms. The gold standard was the clinical diagnosis of CTS.NCS showed greater diagnostic sensitivity (82%) than US (62%) in supporting a diagnosis of CTS. With increasing neurophysiologic severity of median neuropathy, there was increasing convergence of the two test methods. Abnormal US as the only diagnostic supportive evidence of CTS was rare. However, the positive predictive value of US for CTS was 100%.NCS show better sensitivity than US in supporting a diagnosis of CTS. However, because of its high positive predictive value, one may consider using US as a screening test, eliminating the need for NCS in the majority of clinical suspicion of CTS and reserving NCS for cases in which US is negative. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009

Intraoperative ultrasound in colorectal surgery

To assess the accuracy of intraoperative ultrasound (IOUS) as a localizing technique for colorectal resections, and its impact on surgical management.Twenty-five patients (15 men and 10 women; mean age, 74.4 years) with early cancers (p T1), or polyps, not amenable to endoscopic removal were selected. IOUS was used as a sole method of intraoperative localization. Its performance was evaluated through review of preoperative colonoscopy reports, intraoperative findings, histopathology reports, and clinical follow-up.The lesions were situated in the cecum (n = 5), ascending colon (n = 3), transverse colon (n = 4), descending colon (n = 7), and rectum (n = 6). IOUS technique allowed correct localization in 24 of 25 patients, visualization of the bowel wall, and its penetration by malignant tumors. In rectal lesions, IOUS showed clearly the tumor and its margin, which facilitated performance sphincter-sparing procedure.In patients with small polyps and early cancers of colon and rectum, IOUS may be effectively used as a sole method of intraoperative localization and provide additional information that may alter decision making with regard to surgical technique. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009

First-trimester prenatal sonographic diagnosis of ectopia cordis in a twin gestation

The 11-14-week ultrasound examination allows early pregnancy dating, detection of major anomalies and multiple gestations, and accurate chorionicity determination. We describe a rare case of first-trimester sonographic diagnosis of ectopia cordis in a dichorionic twin pregnancy, illustrating the benefits of early ultrasound in patient counseling and management. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009

Diagnosis of short rib polydactyly syndrome type IV (Beemer-Langer syndrome) with cystic hygroma: A case report

Short rib polydactyly syndrome (SRPS) is a very rare congenital autosomal recessive inherited disease, classified into four subtypes. It has distinct imaging findings on prenatal sonography (US) and ancillary findings on both pre- and postnatal examinations may help classify individual cases into one of four subtypes. We report the US findings in a case of SRPS type IV (Beemer-Langer dysplasia) in a male fetus with multiple congenital anomalies, including cystic hygroma. The postnatal ultrasound, radiographic, and postmortem examinations helped to classify the SRPS as type IV. We believe this is the first documented case associating cystic hygroma and polydactyly. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound 2009

Hepatic portal venous gas after upper endoscopy in a patient with a gastrointestinal stromal tumor

No abstract.

Sonographic findings in a case of scrotal lymphangioma in a 68-year-old male

Lymphangiomas are benign tumors resulting from a congenital lymphatic malformation in infant and children. Most common sites are head, neck and axilla, and scrotal lymphangioma is very rare. Lymphangiomas are classified as capillary, cavernous, and cystic type and cystic type is most common. Complete surgical excision is definitive treatment and incomplete excision leads to local recurrence. We report a case of scrotal lymphangioma in 68-year-old male patient. Gray-scale sonography revealed multiseptated, hypoechoic mass abutting the upper pole of the normal right testis. Color Doppler sonography showed no remarkable blood flow in the mass. MRI demonstrated multispetated extratesticular and extraepididymal mass in the right scrotum. Surgical excision was performed and the histopathologic diagnosis was a cystic lymphangioma. In conclusion when multiseptated cystic scrotal mass was discovered in an elderly patient, scrotal lymphangioma should be included in differential diagnosis. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound 2009

The effects of copper contraceptive intrauterine device on the uterine blood flow: A prospective transvaginal Doppler study

To evaluate the hemodynamic changes by transvaginal color Doppler sonography (CDS) in the uterine vascular bed after the insertion of a contraceptive intrauterine device (CIUD) and to investigate whether those CDS findings could predict potential side effects, such as dysmenorrhea and abnormal bleeding.Pulsatility index (PI), resistance index, and systole/diastole ratio (S/D) were measured in the uterine artery and its myometrial branches on 28 patients before and after the insertion of copper IUD, and a correlation with dysmenorrhea and abnormal bleeding was investigated.PI and S/D values in the uterine artery increased significantly after the insertion of the CIUD (p < 0.05). Patients with increased bleeding scores after insertion of CIUD had significantly lower uterine artery PI compared with those without increased bleeding scores (p < 0.05). No statistically significant difference was detected in the Doppler flow parameters regarding dysmenorrhea scores.Low uterine artery PI values recorded in the early phase of the menstrual cycle in patients with a CIUD were associated with an increased bleeding risk. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound 2009

Usefulness of three-dimensional ultrasonography in the prenatal evaluation of acromelic deviations

No abstract.

Parotid gland involvement in sarcoidosis: Sonographic features

The purpose of this study was to describe the sonographic (US) features of parotid gland involvement in patients with sarcoidosis.The US findings of the parotid gland of 6 patients with histologically proven sarcoidosis of the parotid gland were reviewed.The sonographic features ranged from nodal enlargement to diffuse or partial involvement of the parotid gland with various degrees of echogenicity and vascularity.Because of the lack of specificity of US findings in sarcoidosis involvement of the parotid gland, sarcoidosis should be considered in the differential diagnosis of parotid gland lesions in the proper clinical setting. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009

The use of ultrasound to facilitate spinal anesthesia in a patient with previous lumbar laminectomy and fusion: A case report

We describe a case of ultrasound (US)-facilitated spinal anesthesia in a patient with a prior lumbar laminectomy and spinal fusion who presented for total knee arthroplasty. Traditional, landmark-guided spinal anesthesia had previously failed. Although pre-procedural US identified a soft-tissue window at L3/4, a 25G pencilpoint needle encountered resistance. Reassured from US imaging that this was not bone, we used a 22G cutting tip needle successfully. We believe spinal anesthesia would not have been possible in this patient without US, adding to the evidence that US-facilitated neuraxial anesthesia is useful, particularly in technically difficult, if not 'impossible,' cases. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009

Insufficiency fracture of the calcaneum: Sonographic findings

We present a case of insufficiency fracture (IF) of the calcaneum diagnosed by sonography (US). An 83-year-old woman consulted because of pain and swelling of the left heel without history of trauma. Standard radiographs showed osteoporosis without fracture. US revealed thickening of the calcaneal periosteum associated with edema of the adjacent soft tissues. Color Doppler imaging showed marked increased vascularity of the periosteum. US changes, together with the clinical and radiographic findings, were consistent with an IF of the calcaneum that was confirmed by MRI. The patient was treated successfully by conservative treatment. In the proper clinical setting, US can suggest the diagnosis of IF of the calcaneum. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009

Ophthalmic RSS : Gourt

Cavernous lymphangiomas of the breast mimicking breast cancer.

Pseudoaneurysm of the breast during vacuum-assisted removal.

Sonographic findings of smooth muscle hyperplasia of the epididymis.

Quadriceps fat pad edema: sonographic depiction and sonographically guided steroid injection.

Diagnosis of active hemorrhage from the liver with contrast-enhanced ultrasonography after percutaneous transhepatic angioplasty and stent placement for budd-Chiari syndrome.

Hematocolpos secondary to acquired vaginal scarring after radiation therapy for colorectal carcinoma.

Gastrointestinal stromal tumors: ultrasonographic spectrum of the disease.

Sonography of axillary masses: what should be considered other than the lymph nodes?

Contrast-enhanced breast ultrasonography: imaging features with histopathologic correlation.

Noncalcified ductal carcinoma in situ: imaging and histologic findings in 36 tumors.

Prenatal screening for major congenital heart disease: superiority of outflow tracts over the 4-chamber view.

Feasibility of automated 3-dimensional fetal cardiac screening in routine ultrasound practice.

Experimental Study on Targeted Methotrexate Delivery to the Rabbit Brain via Magnetic Resonance Imaging-Guided Focused Ultrasound.

Real-time Ultrasound Elastography in the Differential Diagnosis of Benign and Malignant Thyroid Nodules.

Use of ultrasound elastography for skin and subcutaneous abscesses.

Three-dimensional ultrasonographic bladder volume measurement: reliability of the virtual organ computer-aided analysis technique using different rotation steps.

High-resolution sonography of the normal extrapelvic vas deferens.

Contents

Forthcoming Issues

Preface

The Utilization of 3D and 4D Technology in Fetal Neurosonology

3D and 4D Fetal Neuroscan: Sharing the Know-how and Tricks of the Trade

The Utility of Volume Sonography for the Detection of Fetal Spine Abnormalities

Fetal Neuroimaging of Neural Migration Disorder

The Differential Diagnosis of Fetal Intracranial Cystic Lesions

Magnetic Resonance Imaging Following Suspicion for Fetal Brain Anomalies

Ultrasound of the Fetal Cranium: Review of Current Literature

Diagnostic Approach to Prenatally Diagnosed Limb Abnormalities

Index

Contents

Forthcoming Issues

Preface

Palpable and Nonpalpable Breast Masses

Ultrasound-Guided Breast Biopsies and Aspirations

Ultrasonography of the Postsurgical Breast Including Implants

Ectopic Pregnancy

Ultrasound Assessment of Premenopausal Bleeding

Sonography of Adnexal Masses

Postmenopausal Bleeding

Endometriosis

Pelvic Congestion Syndrome

Sonohysterography: Technique and Clinical Applications

Ovarian Torsion and Its Mimics

Color Flow Doppler Evaluation of Uterus and Ovaries and Its Optimization Techniques

Index

Vitreoretinal Disorders

Intraocular Tumors

Ocular Inflammatory Diseases

Optic Nerve Disorders

Posterior Segment Trauma

Index

Contents

Forthcoming Issues

Preface

Gynecologic Causes of Acute Pelvic Pain: Ultrasound Imaging

Imaging of the Placenta

Focused Assessment with Sonography for Trauma

Sonographic Evaluation of Vascular Injuries

Transplant Ultrasound of the Kidney, Liver, and Pancreas

Sonography of the Surgical Abdomen in Children

Catastrophes of Abdominal Aorta: Sonographic Evaluation

Acute Painful Scrotum

Adnexal Torsion

Sonography of Right Upper Quadrant Pain

Sonography of Upper Extremity Deep Venous Thrombosis

Lower Extremity Venous Doppler

Renal Colic

Prenatal findings of concomitant duodenal and esophageal atresia without tracheoesophageal fistula (Gross type A)

Pre-, intra-, and postoperative sonography of the abdominal wall in patients with incisional hernias repaired via a three-layered operative suture method

Prenatal diagnosis of schizencephaly with 2D-3D sonography and MRI

Fibrosarcomatous transformation in dermatofibrosarcoma protuberans of the breast - A case report

Sonographic appearance of a migrated Angelchik anti-reflux prosthesis in the pelvis

Prenatal diagnosis of VACTERL syndrome and partial caudal regression syndrome: A previously unreported association

Three-dimensional power Doppler sonography in the diagnosis of a cystic sacrococcygeal teratoma mimicking a meningomyelocele: A case report

Early sonographic diagnosis of intrauterine device migration to the adnexa

Sonography versus nerve conduction studies in patients referred with a clinical diagnosis of carpal tunnel syndrome

Intraoperative ultrasound in colorectal surgery

First-trimester prenatal sonographic diagnosis of ectopia cordis in a twin gestation

Diagnosis of short rib polydactyly syndrome type IV (Beemer-Langer syndrome) with cystic hygroma: A case report