ABSTRACT
Diverticula of the female urethra can be difficult to diagnose. Invasive contrast studies (voiding cystourethrography or double-balloon urethrography) or urethroscopy are frequently required for definitive diagnosis. Although transabdominal sonography has been able to visualize large diverticula, this technique has not proved useful in routine screening. In this study, we examined the use of higher frequency (5 MHz) near-focus endovaginal or transperineal sonography for the diagnosis of urethral diverticula. Five patients with radiographically proved (three with double-balloon urethrography and two with voiding cystourethrography) urethral diverticula were examined with endovaginal (two cases) or transperineal (four cases) sonography. In all five cases, sonography showed the diverticula previously demonstrated on the contrast study. The spatial relationship of the diverticula to the urethra, an important consideration at surgery, was shown more clearly by sonography than by contrast radiography. These findings suggest that sonography may be useful as a noninvasive screening technique for urethral diverticula.
Subject(s)
Diverticulum/diagnostic imaging , Urethral Diseases/diagnostic imaging , Adult , Female , Humans , Middle Aged , Ultrasonography/methodsABSTRACT
A series of 25 patients with biopsy proven adenocarcinoma of the prostate underwent preoperative staging evaluation with a digital rectal examination, endorectal ultrasound, and body coil magnetic resonance imaging (MRI) before their radical retropubic prostatectomy. The sensitivity and specificity of the digital rectal examination for the detection of extracapsular disease were 17 and 100%, respectively. The sensitivity and specificity of endorectal ultrasound for the detection of extracapsular disease were 35 and 89%, respectively. The sensitivity and specificity of body coil MRI for the detection of extracapsular disease by adenocarcinoma of the prostate were 47 and 63%, respectively. Microscopic disease of the capsule and seminal vesicles was the principle reason for understaging by both imaging modalities. This small series suggests that both imaging modalities are marginally more sensitive, albeit less specific, for extracapsular disease of the prostate than the digital rectal examination, with ultrasound having a slight edge in specificity and MRI having a slight edge in sensitivity.
Subject(s)
Adenocarcinoma/pathology , Neoplasm Staging/methods , Prostate/pathology , Prostatic Neoplasms/pathology , Adenocarcinoma/diagnosis , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Physical Examination , Preoperative Care , Prostatic Neoplasms/diagnosis , Sensitivity and Specificity , UltrasonographyABSTRACT
Ultrasonography has proved particularly effective in evaluating the neonate with an abdominal mass, poor renal function, and an abnormal perinatal ultrasound scan. As a noninvasive, nonionizing, and relatively inexpensive examination, it can often make the preliminary diagnosis, streamline the work-up, and be used for follow-up studies.
Subject(s)
Fetal Diseases/diagnosis , Infant, Newborn, Diseases/diagnosis , Prenatal Diagnosis , Ultrasonography , Urologic Diseases/diagnosis , Female , Humans , Hydronephrosis/diagnosis , Infant, Newborn , Kidney/anatomy & histology , Polycystic Kidney Diseases/diagnosis , Polyhydramnios/diagnosis , Pregnancy , Ureteral Obstruction/diagnosis , Ureterocele/diagnosis , Urethra/abnormalities , Urinary Bladder Neck Obstruction/diagnosis , Vesico-Ureteral Reflux/diagnosisABSTRACT
Measurement of femoral torsion by ultrasound was compared with measurements by standard roentgenographic techniques in a femoral model and in a clinical study. Magilligan, Ryder-Crane, and fluoroscopic determinations on the femoral model demonstrated acceptable interobserver and intraobserver variance. With high degrees of femoral torsion, ultrasound readings were less accurate and significantly lower than the actual angle of femoral torsion. In the clinical study, ultrasound measurements were compared with Magilligan measurements in 29 hips. Similar to the model, ultrasound readings were lower and discrepancy was greater at higher angles of torsion.
Subject(s)
Femur/physiology , Ultrasonography , Biomechanical Phenomena , Child , Child, Preschool , Femur/diagnostic imaging , Femur/physiopathology , Fluoroscopy , Gait , Hip/physiology , Hip/physiopathology , Humans , Models, Anatomic , Movement Disorders/diagnosisABSTRACT
Intraoperative ultrasound evaluation of the gallbladder was performed in 55 morbidly obese patients undergoing gastric bariatric surgery. Cholecystectomy was performed in the presence of any physical or ultrasonographic abnormality. Eighteen patients (33%) had cholecystectomy. Nine patients had palpable gallbladder disease confirmed by ultrasound. Nine patients had abnormalities detected by ultrasonography only. There was no false-negative ultrasonographic exam compared to physical exam. Pathologically, all specimens but one showed evidence of disease, thus there was a false-positive incidence of 1.8%. None of the 37 patients with normal physical and ultrasonographic examination have returned with gallbladder disease following the bariatric surgery. Intraoperative ultrasonography shows promise in detecting nonpalpable gallbladder disease and decreasing the incidence of delayed cholecystectomy.
Subject(s)
Cholelithiasis/diagnosis , Obesity/therapy , Ultrasonography , Cholecystectomy , Humans , Intraoperative CareABSTRACT
A case of wandering spleen with torsion of the splenic vascular pedicle and pancreatic tail is presented. The entity was diagnosed and evaluated preoperatively with various imaging modalities (ultrasound, nuclear medicine, and CT) as well as visceral angiography.
Subject(s)
Splenic Diseases/diagnostic imaging , Tomography, X-Ray Computed , Adult , Angiography , Female , Humans , Radionuclide Imaging , Splenic Diseases/surgery , Technetium Tc 99m Sulfur Colloid , Torsion Abnormality , UltrasonographyABSTRACT
Real-time ultrasound systems, being used extensively now in obstetrical practice for fetal monitoring, are providing the urologist with more opportunities for early recognition and intervention of congenital hydronephrosis. Thorough postnatal investigation to confirm a diagnosis is advocated. An early postnatal surgical repair can be performed successfully.
Subject(s)
Hydronephrosis/diagnosis , Prenatal Diagnosis , Ultrasonography , Ureteral Obstruction/diagnosis , Female , Humans , Hydronephrosis/diagnostic imaging , Hydronephrosis/surgery , Infant, Newborn , Kidney/diagnostic imaging , Kidney Pelvis/surgery , Pregnancy , Radiography , Ureteral Obstruction/diagnostic imagingABSTRACT
This study is based upon our experience with 477 morbidly obese patients who had gastric bariatric surgery during a five-year period. The incidence of biliary tract disease was 39.1%, about four times the incidence in the nonobese population. Intraoperative ultrasonic examination of the gallbladder was done in 50 patients. This technique is a useful adjunct in detecting occult biliary tract disease in morbidly obese patients.
Subject(s)
Cholelithiasis/etiology , Obesity/complications , Adult , Cholelithiasis/diagnosis , Cholelithiasis/pathology , Female , Humans , Intestine, Small/surgery , Intraoperative Period , Male , Obesity/therapy , Stomach/surgery , UltrasonographyABSTRACT
The sonographic appearance and differentiation of fluid collections within the gastrohepatic recess and lesser sac are described. The identification of the lesser omentum and stomach is fundamental to their separation. Accurate localization of upper abdominal fluid may be of aid in selecting an appropriate approach for paracentesis as well as directing the subsequent diagnostic work-up.
Subject(s)
Abdomen/pathology , Ascites/diagnosis , Ascitic Fluid , Ultrasonography , Adolescent , Female , Humans , Liver/pathology , Male , Middle Aged , Stomach/pathologyABSTRACT
Two cases of mesenteric cysts are reported. Realtime ultrasound demonstrated the typical appearance of well-defined, anechoic masses. In addition, a solid appearance with a honeycomb pattern of internal echos was observed in one case. The other case had the appearance of loculated, septated ascites. Ultrasound and CT correlation are discussed.
Subject(s)
Mesenteric Cyst/diagnosis , Tomography, X-Ray Computed , Ultrasonography , Child , Child, Preschool , Humans , Male , Mesenteric Cyst/diagnostic imagingSubject(s)
Adenoma/diagnosis , Gallbladder Neoplasms/diagnosis , Ultrasonography , Adenoma/diagnostic imaging , Adenoma/pathology , Adult , Cholecystectomy , Cholecystography , Female , Gallbladder/surgery , Gallbladder Neoplasms/diagnostic imaging , Gallbladder Neoplasms/pathology , Humans , Tomography, X-Ray ComputedSubject(s)
Prenatal Diagnosis , Spinal Neoplasms/diagnosis , Teratoma/diagnosis , Adult , Diagnosis, Differential , Female , Humans , Pregnancy , Sacrococcygeal Region , UltrasonographySubject(s)
Polycythemia/therapy , Aged , Female , Humans , Kidney Diseases, Cystic/therapy , Polycythemia/etiology , SuctionABSTRACT
Lymphomatous involvement of the kidneys, usually a secondary process, may be seen as single or multiple sonolucent or weakly echogenic masses on ultrasound. The majority of these patients have a known diagnosis of lymphoma and are being evaluated for change in nodal mass size, flank pain, and/or deteriorating renal function. Occasionally, these masses are discovered on an excretory urogram and are further investigated with ultrasound. The ultrasound findings may be confirmed with gallium scanning. Five such cases are presented along with the ultrasonic and gallium scan findings.
