Ultrasonography of the brachiocephalic arteries.

Sixteen patients with various lesions involving the brachiocephalic arteries were studied ultrasonographically. The examination was very useful in diagnosing aneurysms of the peripheral arteries and in differentiating an aneurysm from other causes of palpable pulsatile masses, such as a tortuous artery and tumor beneath an artery. The ultrasound technique used for evaluation of these lesions is described.

Advantage of computerized tomography scan. Diagnosis of an otogenic cerebellar abscess.

Computerized axial tomography with contrast enhancement is very useful for the diagnosis of brain abscesses. This fact is illustrated by a case report of a cerebellar abscess secondary to chronic mastoiditis with cholesteatoma.

Ultrasonography of adrenal masses: usual features.

Gray-scale B-scan was successful in delineating adrenal masses in 40 patients, all confirmed pathologically. Two patients with extra-adrenal pheochromocytomas, two calcified cysts, and two patients with bilateral adrenal hyperplasia are demonstrated. The usual ultrasonographic features are presented in this paper; they correlated well with urographic, angiographic, CT, and pathological findings. The smallest mass demonstrated was an aldosteronoma (1.3 cm in size).

Ultrasonography of adrenal masses: unusual manifestations.

Forty patients with pathologically-proved adrenal masses, and two patients with extra-adrenal pheochromocytomas, were examined with gray scale B-scan. The authors describe unusual echo patterns of adrenal masses due to necrosis or hemorrhage, variations in the effects of large adrenal masses on surrounding organs and vessels, and the differential diagnosis. The complementary role of computed tomography is also discussed.

A simple portable water bath for superficial ultrasonography.

A simple portable water bath device has been designed and adapted to the conventional contact B-scanner for examining superficial lesions. It is inexpensive, easy to construct, and convenient to use since the water reservoir is sealed. Small lesions (e.g., nodules in the thyroid or testis) are rapidly and clearly delineated.

Computed tomography of intraspinal and paraspinal neoplasms.

Computed tomography (CT) has been used in the evaluation of 36 spinal neoplasms. Eleven of the 19 intraspinal and all of the 17 paraspinal tumors showed positive CT images. Computed tomography is of diagnostic value particularly in detecting calcified meningiomas, lipomas, and neurofibromas with bony changes. The size of the paraspinal tumors and the degree of bone destruction can be precisely demonstrated by CT.

Ultrasonography in ascites.

Ascites is usually not difficult to detect with ultrasonography because of its characteristic lack of echoes. However, minimal or lobulated collections of fluid or unusual distributions due to anatomical variations or associated pathological processes may create problems in diagnosis. Differentiation from an intraperitoneal abscess, hematoma, lymphocele, or cystic mass is of considerable clinical importance.

Ultrasonography of renal sinus lipomatosis.

Gray scale B-scans in renal sinus lipomatosis show a variety of features which must be differentiated from clinically significant pathological processes. Normal kidneys show dense homogeneous central echoes. In renal sinus lipomatosis, however, the central echoes are divided and become more sparse (Type I), interspersed with small relatively echo-free areas (Type II), or outline a single relatively echo-free area resembling a mass (Type III). In contrast to similar features in hydronephrosis or multiple cysts, the relatively echo-free areas in lipomatosis are ill-defined and do present several weak internal echoes.

Delination of lesions of the base of the skull by computed tomography.

It is possible to delineate the extent of tumors related to the base of the skull by computed tomography in two planes. With current scanners, thin sections are possible and the artifacts produced by the bone are minimal. Bone and soft-tissue details can be visualized with clinically useful resolution. Precise evaluation of the extent of such lesions is important in determining surgical or radiotherapeutic approaches. Six illustrative cases are presented.

Ultrasonic contrast study to indentify stomach tap water microbubbles.

In ultrasound scanning of the left upper quadrant of the abdomen, it is important to identify stomach contents which may appear as a cyst if the content is fluid or as a solid mass if the content is fluid with suspended food particles. By giving the patient a drink of two or three ounces of freshly drawn water, multiple strong echoes are produced from the fundus and the body of the stomach because of the microbubbles contained in recently agitated tap water and the microbubbles produced by the mixing effect of swallowing. These strong echoes will cause a "cystic" or "mass-like" appearance produced by the stomach contents to disappear. Thus, a false positive diagnosis is easily and rapidly avoided. The portion of the pancreas behind the stomach may also become more obvious. If the mass or cyst persists, the diagnosis of an abnormality is confirmed.

Visualization of the thyroid gland with computed tomography.

Computed tomography of the neck will demonstrate the thyroid gland particularly well after contrast enhancement. Lucent nodules within the thyroid can be demonstrated, but the attenuation numbers are not reliable enough to distinguish cystic from solid lesions with current techniques because of partial volume effects and motion artifacts.

Echocardiography of double outlet right ventricle: new diagnostic criteria.

A thick band of muscular tissue interposed between the posterior aortic wall and the anterior leaflet of the mitral valve could be indentified on M-mode sweeps of 3 patients with double outlet right ventricle. A discrete subaortic crista supraventricularis, continuous with the anterior wall of the right ventricle, could also be identified. These signs are specific for double outlet right ventricle and are not present in other anomalies of the heart.

Ultrasonography and computed tomography in the diagnosis of homogeneous masses.

Ultrasonography can demonstrate the homogeneity, while CT can demonstrate the density of a mass lesion. If a mass appears echo-free at ultrasonography, but is denser than water at CT, a solid tumor with grossly uniform cellular structure (usually a lymphoma or sarcoma), or a hematoma or hemorrhagic cyst is likely. However, if the mass has water density at CT, a cystic lesion is confirmed. One case for each category is presented.

Increased retroperitoneal fat: a sign of corticosteroid therapy.

Abdominal radiographs of 8 children treated with glucocorticoids showed large accumulations of retroperitoneal fat. Excessive retroperitoneal fat in a child is suggestive of corticosteroid therapy.

Radiographic anatomical landmarks of the metacarpo-phalangeal joints.

The location of cortical bone changes in the metacarpo-phalangeal joints has been variously described as periarticular, juxta-articular, articular, or subarticular. Suitable radiographic landmarks on anatomical specimens were sought to assess the cartilage-covered articular surfaces of these joints. Precise landmarks for the limits of the joint space are not available, but unequivocal intra-articular regions were identified.