ABSTRACT
Conventional radiology is the main diagnostic tool for the visualization of osteoarticular lesions in rheumatoid arthritis. Articular effusions and popliteal cysts were examined with US. This paper is aimed at proving US capabilities in yielding important information about articular and peri-articular soft tissues in the early phases of rheumatoid arthritis. Over the last 30 months, the shoulder, wrist, hand, knee, and hip of 73 rheumatoid patients were studied by means of US and conventional and microfocal radiography. The patients were divided into 2 groups according to the time of onset of the disease. In group A, US demonstrated early synovial exudative inflammation, whereas conventional and microfocal radiography mainly demonstrated soft tissue swelling. In group B (where the first onset dated back to over 1 year), US demonstrated exudative and proliferative changes, together with recurrences. The authors believe US to be able to recognize the early changes of rheumatoid arthritis: as a matter of fact, US shows articular and periarticular soft tissues abnormalities and allows a differential diagnosis to be made between exudative and proliferative forms.
Subject(s)
Arthritis, Rheumatoid/diagnostic imaging , Synovial Membrane/diagnostic imaging , Tendons/diagnostic imaging , Arthritis, Rheumatoid/complications , Hip Joint/diagnostic imaging , Humans , Joint Diseases/diagnostic imaging , Joint Diseases/etiology , Knee Joint/diagnostic imaging , Metacarpophalangeal Joint/diagnostic imaging , Muscular Diseases/diagnostic imaging , Muscular Diseases/etiology , Shoulder Joint/diagnostic imaging , Time Factors , UltrasonographyABSTRACT
After considering the natural history of spleen auto-transplant, a clinical case followed up for seven months with instrumental (echography, scintigraphy) and humoral (Jolly bodies, Heinz bodies, reticulocytes, platelets, complement, immune globulin) examinations has been considered so as to verify "take" and function. One months after reimplantation the patient was again operated on for the onset of an intestinal occlusion due to adherences. On that occasion it was possible to control that the implant had taken. It is concluded that personally used parameters proved to be well correlated and that scintigraphy and echography are two complementary, effective techniques for monitoring auto-transplants.
Subject(s)
Spleen/transplantation , Adult , Animals , Female , Graft Survival , History, 20th Century , Humans , Radionuclide Imaging , Rats , Spleen/anatomy & histology , Spleen/diagnostic imaging , Spleen/physiology , Transplantation, Autologous/history , UltrasonographyABSTRACT
The sonographic detection of adrenal masses in patients with neoplasms, especially neoplasms of the lung, can be related to the presence of both metastases and adenomas. In order to assess the benign/malignant nature of such lesions, the adrenal glands of 43 patients with neoplasms (36 of them lung cancers) were studied with sonography (US) and fine needle aspiration biopsy (FNAB): in all, 58 masses were seen (28 monolateral and 15 bilateral). Six lesions (13%) presented with cytological features of benignancy, and on US they appeared as hypoechoic (as compared to the liver), round masses, with regular margins, ranging in size from 1.2 cm to 3.4 cm (average: 2.6 cm). In the remaining 34 patients (80%), cellular material with features of malignancy was obtained with FNAB. The US appearance of these metastases was heterogeneous, with the same echogenicity as the liver, and average size greater than 3 cm. On the basis of our data, the limit of 3 cm (if we consider the average dimension), corresponds to the threshold of benignancy, as well as the monolateral and hypoechoic appearance of the lesion. To sum up, the use of FNAB should be limited to those lesions which present with typical adenomatous features and for borderline lesions, while the diagnosis of metastasis is sufficiently accurate (p less than 0.001) in case of bilateral or isoechoic lesions greater than 3 cm.
Subject(s)
Adenoma/diagnosis , Adenoma/secondary , Adrenal Gland Neoplasms/diagnosis , Adrenal Gland Neoplasms/secondary , Ultrasonography , Adenoma/pathology , Adrenal Gland Neoplasms/pathology , Adrenal Glands/pathology , Biopsy, Needle , Diagnosis, Differential , Follow-Up Studies , Humans , Neoplasm StagingABSTRACT
The authors' purpose is to demonstrate the possibility of improving US reliability in the diagnosis of neoplastic obstructions of the bile ducts, basing their study on the hematic alkaline phosphatase level (AP), which is an earlier sign of obstruction than high bilirubin values. All 368 patients observed had AP levels above the threshold of 270 IU/l. The 34 patients with neoplastic obstruction (including 13 without jaundice) had more than twice the normal level of AP, and presented with at least one dilated bile duct in the biliary tree. Coronal scans of the main bile duct are fundamental in the diagnosis of the level of obstruction. It seems thus possible to affirm that US diagnosis of the biliary obstruction, together with high AP values (more than twice the normal), provides with reliable information as to the neoplastic nature of the biliary obstruction, even if jaundice is not present.
Subject(s)
Bile Duct Neoplasms/complications , Cholestasis, Intrahepatic/diagnosis , Liver Neoplasms/complications , Pancreatic Neoplasms/complications , Ultrasonography , Alkaline Phosphatase/blood , Bile Duct Neoplasms/diagnosis , Clinical Enzyme Tests , Common Bile Duct Diseases/diagnosis , Female , Humans , Liver Neoplasms/diagnosis , Liver Neoplasms/secondary , Male , Middle Aged , Pancreatic Neoplasms/diagnosisABSTRACT
The diagnostic capability of ultrasound in symptomatic gastric cancer is stressed, on the basis of a prospective study of 64 neoplastic and 19 non-neoplastic patients. Aspecific signs are described which suggest the presence of five layers within the gastric wall as an index of absence of disease. The prospective importance of ultrasound investigation in 5 neoplastic patients with aspecific symptoms is emphasized.