The removal of post-sclerotherapy pigmentation following sclerotherapy alone or in combination with crossectomy.

BACKGROUND: Sclerotherapy is a widely used method for the obliteration of blood vessels. Hyperpigmentation is a frequent complication that results from haemosiderin (FeO) accumulation. Hyperpigmentation and changes in the skin can be observed with ultrasound. OBJECTIVE: The aim of this study was to evaluate the efficacy of hyperpigmentation elimination using an intense pulse light generator (IPL) equipped with radio waves (RF) under ultrasonography (US) control. METHODS: Twenty-one women with permanent hyperpigmentation (after sclerotherapy or crossectomy combined with sclerotherapy) underwent a hyperpigmentation eliminating therapy with the use of IPL + RF and were monitored by using US. The thicknesses of the dermis and the subcutaneous tissue as well as the echogenicities of each layer were assessed. RESULTS: As a result of the therapy, a complete regression of hyperpigmentation was achieved in 90.48% of the women, and in 9.52% of the women, the therapy led to a reduction in hyperpigmentation but did not cause its complete disappearance. An increase in dermal echogenicity and a decrease in subcutaneous tissue echogenicity were observed, but there was no change in their thicknesses. After the therapy, the ultrasound images of areas of previous hyperpigmentation corresponded with images that were characteristic of healthy skin. CONCLUSION: IPL + RF therapy is effective for eliminating permanent skin hyperpigmentation after sclerotherapy. US is also useful in this therapeutic method.

3D ultrasound examination of the superficial lymph nodes--does it provide additional information?

PURPOSE: To compare the appearance of superficial lymph nodes on standard two-dimensional (2D) ultrasound examination and on three-dimensional (3D) ultrasound examination. MATERIALS AND METHODS: Fifty two lymph nodes (35 cervical, 16 axillary, 1 inguinal) in 52 patients were examined with ultrasound in 3D mode. In standard 2D grey-scale examination and on a C-plane of 3D mode (parallel to the surface of the probe), the shape of a lymph node and its hilum were assessed. Final histopathological diagnoses included 36 lymphomas, 11 reactive or inflammatory lymph nodes, 3 metastases and 2 plasmocytoma infiltrations. RESULTS: The appearance of hilums and lymph nodes as a whole changed on a C-plane of 3D mode (as compared with 2D presentation) in 28 % and 37 %, respectively. The differences in lymph node shape on 2D and 3D ultrasound were apparent in a comparable percentage of reactive lymph nodes (45 %) and lymphomatous lymph nodes (39 %). The differences in lymph node hilum shape on 2D and 3D ultrasound applied to 56 % of reactive lymph nodes and 20 % of lymphomatous lymph nodes. CONCLUSION: Three-dimensional imaging on a C-plane (parallel to the surface of the probe) may supply the examiner with different information concerning the shape of the lymph node and its hilum in comparison to standard 2D ultrasound. Changes in the shapes of hilum and lymph node occurred in reactive or inflamed lymph nodes as well as in lymphomas. Clinical significance of this fact demands further investigation.

US-appearance of a Küttner tumour resembling a malignant lesion: US-histopathologic correlation.

We present a case of unilateral Küttner tumour in the right submandibular gland. Its clinical course and ultrasound features inclined us to include a malignant lesion in the differential diagnosis. US-histopathologic correlation explained the ultrasound appearance of the lesion.

Correlation between clinical, radiological and ultrasonographical image of knee joints in children with haemophilia.

The aims of the study were to evaluate the clinical, radiological and ultrasonographical images of knee joints in children with severe haemophilia and von Willebrand's disease, to determine the correlation between these images and to assess the usefulness of ultrasonography (USG) in evaluating the intensity of haemophilic arthropathy. Thirty-nine boys were included in the study, all of them with a past history of knee bleeds. The average age of the children was 10.02 +/- 3.01 years. In patients with slight (1-3 points) and moderate (4-7 points) radiological changes in knee joint bones, an increase in synovial fluid, considerable hypertrophy and inflammation of the synovium were observed in USG. In haemophilic patients with severe (8-13 points) bone changes, the amount of fluid was usually normal and there was slight inflammation but considerable hypertrophy of the synovium. Radiological evaluation of haemophilic arthropathy was made according to the Pettersson classification. A good correlation between the degree of cartilage damage in USG and the progression of bone changes in radiographs was found. Cartilage and bone damage progressed with the increase in the number of intra-articular haemorrhages into the knee joint. In our opinion USG is useful in evaluating the fluid, synovium and cartilage of joints in haemophiliacs.

[The assessment of the value of ultrasound and magnetic resonance imaging in diagnosing hand joint arthritis]. / Ocena przydatnosci ultrasonografii i rezonansu magnetycznego w diagnostyce zapalenia stawów rak.

The main imaging investigation used in diagnosing rheumatoid arthritis is radiography of the hands and feet. It allows visualisation of bone erosions--typical of the disease. However, bone erosions occur during the later stages of the rheumatoid arthritis and are preceded by synovitis. The aims of the study were to use ultrasound (US) and magnetic resonance imaging (MRI) in examining joints in patients suffering from chronic arthritis, and also to assess the value of these methods in diagnostics. In 61 patients with chronic arthritis (39 with rheumatoid arthritis--RA, and 22 with another etiology arthritis), plain radiography, US and MRI of the hands was performed. MRI and US were more sensitivity in visualisation of bone erosions than plain radiography. Both methods showed synovitis in all patients with RA. In detecting bone erosions in the hand joints MRI and US are more sensitive methods than plain radiography. Both methods detect synovitis and tenosynovitis. Inflammatory changes shown using the MRI and US are more intensive in RA than in patients suffering from another etiology arthritis.

Pleomorphic adenoma and adenolymphoma in ultrasonography.

OBJECTIVE: The aim of the study was to define ultrasonographic morphologic features characteristic of pleomorphic adenoma and adenolymphoma (Warthin's tumor). METHODS: Documentation of 31 ultrasonographic examinations of 20 pleomorphic adenomas and 10 Warthin's tumors in 28 patients was analysed. All cases were confirmed by fine needle aspiration biopsy or/and histopathological examination. Estimated ultrasound criteria were: borders (well-defined, predominantly well-defined, ill-defined), shape (lobulated, oval, irregular), echogenicity (increased, decreased), structure (homogeneous, slightly inhomogeneous, inhomogeneous) and presence of irregular anechoic areas within a tumor. RESULTS: 100% of the lesions were hypoechoic. 80.6% of all tumors were well-defined. The remaining 19.4% had predominantly well-defined borders. 55% of pleomorphic adenomas had a lobulated shape. Almost equal percentages of Warthin's tumors were lobulated, had an oval and irregular shape. Irregular echolucent areas were present in six of 11 examinations of Warthin's tumors and in one pleomorphic adenoma. CONCLUSIONS: Ultrasonography is a useful method for the evaluation of pleomorphic adenomas and Warthin's tumors and sometimes it might allow to suggest the nature of a tumor if a certain sonographic pattern is present.

Ultrasonography in diagnostics of musculo-skeletal system.

This paper summarises most important indications of ultrasonography in diagnostics of musculo-skeletal disorders. It discusses all possible goals of US using high frequency, high resolution probes, different modern modalities such as color and power Doppler techniques.

[False aneurysms of lower extremity arteries: noninvasive preop diagnosis with magnetic resonance angiography and Doppler ultrasonography]. / Pseudotetniaki tetnic konczyn dolnych--nieinwazyjna diagnostyka przedoperacyjna z zastosowaniem angiografii rezonansu magnetycznego i ultrasonograficznych badan dopplerowskich.

The purpose of this study was to work out a diagnostic algorithm to be used in patients surgically treated because of a false aneurysm of arteries supplying the lower limb. The study includes preoperative vessel evaluation as well as treatment results assessment with MRA and US methods. Examinations included until now 16 patients with clinical false aneurysm suspicion. Most cases presented false aneurysms being complications after arterial graft implantation, in two patients, who were not previously operated, diagnosed false aneurysms were the result of injury. We performed 23 examinations (7 of which were postoperative treatment result evaluation examinations). Examinations were performed on MR equipment with a 1.5 T field induction. The 2D TOF with traveling presaturation method was used. Primary data and reconstructed (MIP) angiograms were analyzed by a radiologist having no access to clinical information and previous examination results. Ultrasound duplex doppler examinations were performed with 7 MHz linear probe. The MRA examinations visualized 7 false aneurysms of the lower Y-graft junction. Clinical verification, ultrasonography examinations and surgery confirmed the existence of 6 aneurysms of the Y-graft as well as 5 out of 6 diagnosed in the ileofemoral graft junctions area. The post-traumatic aorta aneurysm and the postarteriographic femoral aneurysm were also confirmed. Two false positive MRA diagnoses were due to dilatation of the artery below the graft junction, in one case it was a dilatation of the vessel below a stenosis. Furthermore, the MRA helped diagnosing stenoses and occlusions in femoral arteries and common iliac artery.

[Assessment of liver pathology on the basis of biochemical and ultrasonographic findings in a group of alcohol dependent patients]. / Ocena patologii watroby u osób uzaleznionych od alkoholu na podstawie badan biochemicznych i metod ultrasonograficznych.

The paper presents the assessment of liver pathology based on clinical examinations, biochemical findings and abdominal ultrasound examination with colour Doppler modalities in a group of 40 alcohol dependent patients. Special regard was paid to the liver, it is size, echogenecity, homogeneity and flow patterns in the portal vein. No significant correlations between the biochemical and USG parameters of liver pathology and the intensity of alcohol withdrawal and the level of the alcohol dependence syndrome were found. It can be concluded that the biochemical parameters as well as ultra sound diagnosis of alcoholic liver disease do not allow to make a final diagnosis of liver pathology.