B-mode ultrasound evaluation of skin thickness in progressive systemic sclerosis.

B-mode ultrasound scanning was studied as a noninvasive means of determining skin thickness in the extremities of patients with progressive systemic sclerosis. Skin thickness determined by ultrasonic scanning was compared with skin thickness determined by an established radiographic technique. A high degree of correlation was observed between measurements made by these techniques. Our studies suggest a potential application of B-mode ultrasound in the diagnosis and serial evaluation of patients with progressive systemic sclerosis.

Magnetic resonance imaging of extremity masses.

Twenty-seven adults with extremity masses were examined by magnetic resonance imaging (MRI). In 26/27 cases, computed tomography (CT) scans were available for comparison. Imaging with multiple pulse sequences is necessary to optimize diagnosis by MRI. Advantages of MRI include direct sagittal and coronal imaging, demonstration of vessels without contrast and superior soft tissue contrast. CT better demonstrates cortical destruction and small calcifications, which may be important in some cases. For noncalcified masses without bone involvement, MRI is equivalent or superior to CT. In those cases with calcification or bone involvement, MRI plays a role complementary to CT.

Magnetic resonance imaging of systemic venous anomalies.

Seven cases of anomalous development of the systemic great veins were found in the first 18 months of adult body imaging with a 0.15 T resistive magnetic resonance unit. Comparison was made with CT. In most cases, CT and MRI were equivalent in demonstrating the abnormality. In one case, MRI was superior to a drip-infusion CT. MRI was less successful when the low signal abnormal vein was adjacent to normal structures of low signal. Awareness of the MRI appearance of venous anomalies will aid their recognition as incidental findings.

Assessment of primary gynecologic malignancies: comparison of 0.15-T resistive MRI with CT.

Thirty-eight patients with gynecologic malignancies (ovarian, cervical, and endometrial carcinoma) underwent computed tomography (CT) and magnetic resonance imaging (MRI) of the abdomen and pelvis. Results of these studies were compared with each other as well as with clinical staging and surgical findings when possible. CT and MRI correctly staged 64% (nine of 14) of patients with cervical carcinoma. In patients suspected of residual or recurrent disease, CT and MRI were each correct in 75% (15 of 20), four of the errors being due to inability to distinguish inflammation or radiation changes from recurrent tumor. CT and 0.15-T resistive MRI are of equal value in screening for residual or recurrent disease and as an adjunct to clinical staging; further advances in MRI technology may alter this impression.

Computed tomographic diagnosis of pancreatic pseudoaneurysm.

Hemorrhagic complications of pancreatic pseudocysts are potentially life threatening. This case, definitively diagnosed by bolus CT study, demonstrated pseudoaneurysm formation within a pancreatic pseudocyst.

CT diagnosis of fracture of the coracoid process of the scapula.

A case of fracture of the coracoid process of the scapula is presented in which the findings were not apparent on plain films. CT demonstrated the fracture, and the absence of soft tissue mass suggested a remote traumatic etiology rather than metastatic disease. The findings were confirmed surgically and pathologically.

Comparison of NMR and CT imaging in the evaluation of metastatic retroperitoneal lymphadenopathy from testicular carcinoma.

Twenty-five patients with nonseminomatous germ cell carcinoma of the testis underwent CT and nuclear magnetic resonance (NMR) of the retroperitoneum followed by radical retroperitoneal lymph node dissection for surgical proof of metastatic disease. Computed tomography correctly predicted the presence or absence of adenopathy in 88% and assigned the correct stage in 84%. Nuclear magnetic resonance had comparable figures of 84 and 80%. Computed tomography appeared superior to NMR in detecting other abdominal abnormalities, although these were few in number. Nuclear magnetic resonance is nearly equivalent to CT in staging retroperitoneal lymphadenopathy from testicular cancer and may surpass CT following technical advances and the introduction of oral contrast agents.

Retroaortic left renal vein demonstrated by nuclear magnetic resonance imaging.

A case of retroaortic left renal vein is presented, demonstrating the ability of nuclear magnetic resonance imaging to identify vascular anomalies without the use of contrast agents.

Ultrasound in the evaluation of solid breast masses.

Ultrasound image characteristics and radiographic features of 31 benign and 41 malignant breast masses were cross-tabulated and analyzed to determine the ultrasound image characteristics most useful for diagnosis and the frequency with which some imaging features occurred. The most common malignant mass (the ductal carcinoma) exhibited a jagged wall (88%), homogeneous internal echoes (12%), nonhomogeneous internal echoes (70%), internal echoes not discernible due to attenuation effects (18%), and attenuation shadowing (97%). In contrast, the fibroadenoma (the most common benign mass in this study), exhibited smooth walls (94%), homogeneous internal echoes (89%), and no demonstrable posterior shadowing (67%).