ABSTRACT
A review of the literature concerning the diagnostic accuracy of various imaging modalities for choledochal cysts indicates that both ultrasound and scintigraphic methods have approximately 80% accuracy. Oral cholecystography and intravenous cholangiography methods have between 60 and 80% accuracy. Ultrasound is recommended as the initial preoperative test of choice, with hepatobiliary scintigraphy or CT scanning being most useful for postoperative evaluation.
Subject(s)
Bile Duct Diseases/diagnosis , Cysts/diagnosis , Ultrasonography , Bile Duct Diseases/diagnostic imaging , Bile Ducts, Intrahepatic/diagnostic imaging , Bile Ducts, Intrahepatic/surgery , Child , Child, Preschool , Cholangiography , Cholecystography , Common Bile Duct/surgery , Cysts/diagnostic imaging , Evaluation Studies as Topic , Female , Follow-Up Studies , Humans , Radionuclide Imaging , Tomography, X-Ray ComputedABSTRACT
Adenocarcinoma of the endometrium commonly presents at an early stage and is readily diagnosed by dilatation and curettage. Ultrasound has not bee accurate in differentiating this malignant neoplasm from benign causes of uterine enlargement such as leiomyoma. In this study, the sonographic findings in 21 patients with adenocarcinoma of the endometrium were compared with the clinical and pathological findings. Although no ultrasound criteria were diagnostic of carcinoma, there were statistically significant differences in uterine shape and echo pattern between Stage I-II and Stage III-IV disease: 94% of patients with Stage I-II disease had a normal or bulbous uterus and a normal or hypoechoic parenchymal pattern, while patients with a lobular uterus and/or mixed echo pattern had Stage III-IV. The only clinical errors in staging were in cases of Stage II or III disease. Ultrasound may be helpful in pretreatment staging of more difficult cases.
Subject(s)
Adenocarcinoma/pathology , Uterine Neoplasms/pathology , Adenocarcinoma/diagnosis , Age Factors , Female , Humans , Ultrasonography , Uterine Neoplasms/diagnosisABSTRACT
Patient survival in malignant ovarian tumors is directly dependent on complete surgical resection. This can be best accomplished when the surgeon is informed of tumor extent preoperatively. We retrospectively studied the preoperative sonograms of 32 patients with proven malignant ovarian tumors. Results were compared with the surgical and pathologic findings. Sonography was 97% accurate in the detection and 84% accurate in the characterization of the pelvic masses; 87.5% of these tumors were malignant by sonographic criteria. Sonography correctly staged only 48% of patients. Bowel and bladder involvement, of major importance in planning surgical treatment, were not detected by sonography. A uterus inseparable from a pelvic mass correlated with uterine involvement in 74% and this information alone may prevent laparotomy by surgeons unprepared to perform the complete resection necessary for optimum survival.
Subject(s)
Cystadenocarcinoma/diagnosis , Ovarian Neoplasms/diagnosis , Ultrasonography , Adenocarcinoma/diagnosis , Adenocarcinoma/surgery , Cystadenocarcinoma/surgery , Dysgerminoma/diagnosis , Dysgerminoma/surgery , Evaluation Studies as Topic , False Negative Reactions , Female , Humans , Ovarian Neoplasms/surgery , Pregnancy , Prognosis , Retrospective Studies , Sarcoma/diagnosis , Sarcoma/surgery , Teratoma/diagnosis , Teratoma/surgeryABSTRACT
A case is presented in which a malpositioned spleen mimics a suprarenal mass. The relationship between renal agenesis or malposition and variance in the position of the pancreatic tail and spleen are explained on an embryologic basis.
Subject(s)
Kidney/diagnostic imaging , Retroperitoneal Neoplasms/diagnostic imaging , Spleen/diagnostic imaging , Adult , Diagnosis, Differential , Humans , Kidney/abnormalities , Male , Retroperitoneal Space , Spleen/abnormalities , Spleen/embryology , Tomography, X-Ray ComputedABSTRACT
Thirty-nine patients with trophoblastic disease were studied to determine the usefulness of ultrasound in identifying risk patterns and response to therapy. Serial measurements of serum human chorionic gonadotropin-beta subunit (HCG-BSU) were compared with ultrasonographic uterine and theca lutein cyst volumes. In 16 patients ultrasound demonstrated theca lutein cysts, many of which were not palpable on physical examination. Although there was a significant decrease in uterine volume and a change in the sonographic pattern following evacuation, volume slowly returned to normal over a period of several months. Persistent trophoblastic disease was more accurately detected by HCG-BSU measurements than by ultrasound. Persistent disease developed in 44% of those patients who had theca lutein cysts and in 22% of those without cysts. Patients with theca lutein cysts did not consistently have higher HCG-BSU levels than patients without cysts, and it is concluded that ultrasound is the best method for detecting these cysts.
