Newer ultrasonographic anatomy in the upper abdomen: I. The portal and hepatic venous anatomy.

Gray scale ultrasonography has made it possible to identify hepatic and portal venous structures. Single sector sweep scanning is important in depicting these structures. Identification of venous structures is discussed as well as methods for distinguishing large veins from pathologic structures.

Newer ultrasonographic anatomy in the upper abdomen: II. The major systemic veins and arteries with a special note on localization of the pancreas.

Gray scale ultrasonography has made it possible to identify the major systemic arteries and veins in the upper abdomen. Identification of these vascular structures is discussed as well as their value as anatomic landmarks.

Choledochal cyst: report of a case with specific ultrasonographic findings.

A case of choledochal cyst in a 17 month old child is described. The ultrasonographic findings were felt to be specific in this case since the dilated common bile duct was noted to enter directly into a large right upper quadrant cyst. The clinical history, ultrasonographic findings, and differential diagnostic features are discussed.

Liver, gallbladder, and spleen.

Ultrasonic imaging is a successful method of evaluating upper abdominal anatomy. The size, shape, and contour of the liver, spleen, and gallbladder can be adequately defined. Ultrasound is a major tool in the diagnosis of jaundice for it can differentiate between extrinsic jaundice in patients who may require surgical intervention and intrinsic jaundice in a patient who requires only medical attention. The diagnosis and location of cysts, abscesses, and solid masses can be determined by echography with a high degree of accuracy. In patients with abdominal disturbances ultrasonic imaging is more than just an extension of the physical examination, it is a means of further refining the probabilities in the diagnosis of disease entities. It should no longer be considered a mere curiosity, but a unique diagnostic tool in the armamentarium of the modern physician.

The abnormal bone scan in intracranial lesions.

In 43 patients with abnormal brain scans restudied within 2-7 days with 99mTc-labeled ethane-1, hydroxy-1, diphosphonate (EHDP), cerebral infarctions, primary and metastatic neoplasms, chronic subdural hematoma, arteriovenous malformations and inflammatory lesions were visualized. The localization of EHDP in primary and metastatic neoplasms is usually less apparent than pertechnetate. Conversely, the localization of EHDP in cerebral infarctions is usually more apparent than pertechnetate. 99mTc-EHDP, in conjunction with pertechnetate, may become useful in differentiating cerebral infarctions from neoplasms. Further, skull scans must be interpreted with the appreciation that bone-seeking radiopharmaceuticals may localize in a variety of intracranial lesions.

Ultrasound physics for the physician. A brief review.

The field of clinical ultrasound has exploded with new instrumentation, and has far surpassed the number of trained personnel available for the sophisticated interpretation required. Many physicians today are being required to become proficient in the field without any formal training. This review is provided to aid the physician in the understanding of the basic physics of ultrasound.