[From echo-sounding to color doppler sonography. The history of diagnostic ultrasonic diagnosis]. / Vom Echolot zur Farbdopplersonographie Oder die Geschichte der Ultraschalldiagnostik.

This is a report concerning with the development of ultrasound imaging from the very early beginning in the late 18. century by the brothers Curie until to sophisticated imaging units, which are today used for the color coded doppler sonography.

[Sonography of head and neck]. / Sonographie der Kopf-Halsregion.

A brief, schematic summary of a workshop held in Davos 2003 is presented. Sonography of the head and neck has been carried out successfully since the beginning of the sonographical era, as this region is readily accessible to the transducer head and the superficial position of the organ can be very well visualized. The prerequisites are a high-resolution transducer-head (around 7.5 MHz), operator experience and good knowledge of the relevant anatomy. The type of transducer selected--linear or mechanical wobbler--plays a subordinate role, and color Doppler technology is not mandatory. This brief presentation will not address the thyroid gland, the cervical vessels, the paranasal sinuses, the facial soft tissue or the pharynx.

[The history of head and neck sonography]. / Zur Geschichte der Kopf-Halssonographie.

Although today ultrasound is well accepted in the diagnosis of head and neck diseases, often little is known about the young history of this technique. Many pioneers, physicians and engineers were involved in the development of the technique. In this article the history of ultrasound in general and of ultrasound of the head and neck is reflected.

[Sonography of the prostate]. / Sonographie der Prostata.

Transrectal ultrasound (TRUS) with a high frequency (about 7 MHz) probes offers imaging of the zonal anatomy of the prostate and the typical changes caused to it by diseases. The carcinoma is hypoechogenic and can be diagnosed by TRUS more often than by digital rectal palpation. Ventrally localized carcinoma can also be detected. Preoperative staging is more accurate than with any other method. TRUS-guided transrectal biopsy with semi-automatic biopsy systems is safe, has no complications and is more accurate than a digitally guided biopsy. The volume of an adenoma and its nature (benign/malignant) can be evaluated very precisely. Prostatitis and/or vesiculitis induce typical changes in echogenicity, so that these diseases can only be diagnosed by TRUS. However, good equipment still cannot yield reliable diagnoses unless it is operated by experienced examiners.

[Echomorphology of the prostate]. / Die Echomorphologie der Prostata.

The echogenic structures of 1983 transrectal sonographies of the prostate were analysed. In addition, 93 dissected prostates were investigated in waterbath in order to correlate sonographic and morphological structures. Compared to the normal gland, hyperplastic nodules are of the same density or slightly echodenser, rarely also with a poorer echo. In about 60% the inner gland can be delineated. Although 52% of the carcinomas show the same echodensity as diffuse hyperplasia, diagnosis is still possible by further criteria. In only 13% no carcinomas were detectable. 18% of the carcinomas were differentiated by poor echogenicity. The diagnostic value is discussed.

[Transrectal prostatosonography. Follow-up in prostate cancer therapy]. / Transrektale Prostatasonographie. Verlaufskontrollen während der Prostatakarzinomtherapie.

Thirty-five cases of prostate carcinoma were followed after orchiectomy and during drug therapy using both ultrasound and digital palpation to measure the prostate. Following orchiectomy and drug therapy the prostate shrunk an average of one third within six months independent of the grading and staging of the carcinoma. The biggest shrinkage was observed in the first two months after therapy. There was agreement between transrectal ultrasonography (TPS) and digital palpation in judging the prostate capsule in two thirds of the cases. Ultrasonographically, a downstaging of the capsule in twenty per cent and an upstaging in fourteen per cent of the cases was found. Three quarters of the G II prostate carcinomas improved ultrasonographically in structure and capsule in the twelve month period of observation while two thirds of the G III prostate carcinomas did not improve. According to our results the routine use of TPS seems not to be indicated when only gross measurement is desired. However TPS is an objective and reliable method für testing the effects of medication on prostate carcinomas.

[Sonographic diagnosis of a calculus in the obstructed pancreatic duct]. / Sonographische Diagnostik eines Konkrementes im gestauten Pankreasgang.

It is shown by means of a case report on a calculus in the dilated pancreatic duct, that abnormalities in small structures such as the pancreatic duct can be revealed by ultrasound, using current gray-scale instrumentation.

[Transrectal prostatic sonography. Evaluation of a pilot study]. / Die transrektale Prostatasonographie. Auswertung einer Pilotstudie.

The method of transrectal prostatic sonography is described. Evaluation of over 2700 examinations indicates a sensitivity and specificity for prostatic carcinomas of 88.7% and 97.3% respectively. The value of this new imaging method for the early recognition of an early carcinoma, for its staging and for controlling treatment has been investigated. Sonographic determination of the size of the prostate and a comparison of the transrectal and suprapubic approach are discussed.

[The pelvicaliceal system in the sonogram--distinction between physiological and pathological dilatation]. / Das Nierenhohlsystem im Sonogramm--Abgrenzung der physiologischen und pathologischen Aufweitung.

Dilatation of the pelvicalyceal system was documented in volunteers with healthy kidneys in whom renal excretation was increased by means of a variety of methods. As a rule, the proximal ureter is not visualised. In mild or moderate urinary obstruction, however, the ureter is almost always visible, and stasis is mostly unilateral. Although sonography is a method of good sensitivity, the excretory urogram remains an essential diagnostic tool in the examination of the pelvicalyceal and ureteral systems.

[Sonographic image of prostate cancer]. / Das sonographische Bild des Prostatakarzinoms.

The echo structures of 325 carcinomas of the prostate gland were analysed out of a total of 2700 transrectal prostate sonographies. In addition, 93 prostate glands from postmortem examinations were examined sonographically in the water bath in order to enable accurate juxtapositioning of interesting sonographic structures and the proper morphological correlates in each case. The echo density of more than one-half of the total number of carcinomas was found to be equal to that of a normal prostate gland, although the carcinomas were characterised by hazy marginal definition or inhomogeneity. However, 12 per cent of the carcinomas proved to be so homogeneous that they could not be diagnosed at all. The remaining carcinomas are of low echo density, with contact to the capsule. High echo density carcinomas are an exception. Sonography is a valuable aid in tumour staging and in therapy control.

[Craniocaudad extension of the head of the pancreas]. / Die kraniokaudale Ausdehnung des Pankreaskopfes.

In 106 patients without pancreatic disease subjected to ultrasound examination the craniocaudad dimension of the pancreatic head was determined. The mean craniocaudad echographic size of the pancreatic head was 5.9 cm in female and 6.2 cm in male individuals. The knowledge of the craniocaudad dimension of the pancreatic head may be useful to avoid misinterpretation of lymph node enlargement in the region of the pancreatic head.

[Sonographic artifacts of round reflectors]. / Sonographische Artefakte an rundlichen Reflektoren.

The appearance of the proximal curved edge artifact using linear-array systems is demonstrated in five cases. Furthermore simulation of this artifact was achieved in a waterbath. A physical explanation of this phenomenon is discussed.

[Sonography of the efferent urinary tract. Suprapubic and intravesical methods]. / Sonographie der ableitenden Harnwege. Suprapubische und intravesikale Methode.

The ability of sonographic methods to demonstrate the urinary passages and their abnormalities were studied systematically. The ureters can only be demonstrated if they are dilated. Sonography of the bladder can be used as a screening method for tumours, diverticula and stones. Intravesical sonography is useful for staging of bladder tumours. The value of these methods is discussed.

[Transrectal prostate sonography in early cancer recognition]. / Die transrektale Prostatasonographie in der Krebsfrüherkennung.

Within a mass screening program 1016 patients were investigated by transrectal ultrasound. There is generally good correlation of palpation and ultrasound diagnostic. However, prostate carcinoma was less frequently suspected by ultrasound, 2 prostate carcinomas and 1 bladder carcinoma were detected, one prostate carcinoma was missed. The value of the method is discussed.

[Can sonography give an indication of the chemical composition of gallstones?]. / Kann die Sonographie Hinweise auf die chemische Zusammensetzung von Gallensteinen geben?

Eight sonographic patterns caused by gall stones are described. In an attempt to explain these different appearances, 62 stones were analysed chemically and physically. The chemical composition of the stones did not correlate with their sonographic pattern. Cholesterol stones cannot be recognised as such by sonography. The formation of an acoustic shadow depends largely on the position of the stone within the acoustic beam. It therefore follows that the examination must be done by keeping the focal plane of the transducer in proper relationship to the stone.

[The image of prostatic adenoma and cancer in transrectal sonography]. / Das Bild des Prostataadenoms und -karzinoms bei der transrektalen Sonographie.

The transrectal ultrasonography of the prostate is introduced. The sonographic appearance of the adenoma and carcinoma in 357 histologically proven cases is evaluated. Shape, symmetry and definition of the capsule are more reliable differential criteria than the internal echogenicity. The sensitivity is 96.6% for adenoma and 84.2% for carcinoma, whereas the sensitivity of palpation is 91.7% and 77.5% respectively. 6 early cancers are detected. Since infiltration of the capsule and the seminal vesicles can be seen, staging of carcinoma is considerably improved. Accurate measurement of the prostatic size helps in operative planning. Indication and diagnostic value of the method are discussed.

[Transrectal prostatic sonography (TPS)]. / Die transrektale Prostatasonographie (TPS).

A new imaging method of the prostate is described. After the introduction of a sonographic transducer into the rectum, the prostate, the urinary bladder and the seminal vesicles are scanned. Typical transverse sonograms of benign hypertrophy, abscess, calculous disease and carcinomas are presented. The value of this method and its indications are discussed.