Dilatation of the rete testis: ultrasound study.

The aim of this study was to show the US findings in mode B and color Doppler duplex of the dilatation of the rete testis, in order to analyze its association with other scrotal processes and to confirm their inclusion into the benign testicular lesions. We present seven diagnosed cases (mean age 61 years) of dilatation of the rete testis to which a clinical control and US was accomplished up to 1 year. The scrotal sonography study was carried out with a linear probe of 7.5 Mhz. In the US examination we observed in all cases an intratesticular image located in the mediastinum testis constituted by anechoic and serpiginous tubular structures, which do not show any blood flow with the color Doppler. In one case the mentioned observations were bilateral. Five cases had cysts in epididymis and the last case showed an increase in size in the epididymis head. Color Doppler duplex examination did not detected flow dots in the seven patients. The dilatation of the rete testis is a benign entity frequently associated with pathology in epididymis, with specific US findings which permit avoidance of invasive tests.

Computerized tomographic assessment of the composition of gallstones.

We present the results of an in vitro study of biliary lithiasis (n = 106) with computerized tomography (CT). We analyzed the correlation between composition of gallstones (crystallographic analysis of thin sections and atomic absorption spectrophotometric analysis of total calcium content) with CT patterns (densitometry) and their corresponding attenuations. Six main CT patterns were distinguished: hypodense (homogeneous and heterogeneous), dense, homogeneous hyperdense, ringed hyperdense and irregular hyperdense. Statistically significant differences (p < 0.05) were found between attenuations for cholesterol (mixed and pure) and pigmentary stones. We found a good inverse correlation between attenuations and cholesterol content; the contents of pigment, inorganic calcic salts and total calcium content also showed significant direct correlations (p < or = 0.01). Of the samples classified as pure cholesterol type stones, 86.4% showed hypodense patterns, and the remaining 13.6% showed irregular hyperdense patterns. Of the pigmentary stones, 80% showed homogeneous hyperdense images. All stones that contained more than 3% calcium produced hyperdense patterns, whereas 72.4% of the stones that contained less calcium produced hypodense images. Tomodensitometric measurements provided more information than simple radiography, and made it possible to distinguish a greater variety of gallstone types based on structural complexity.

Self-expanding wallstent endoprosthesis for malignant ureteral obstruction.

We present our experience with the self-expanding Wallstent endoprosthesis for ureteral recanalization in obstructive uropathy secondary to malignant pelvic disease. In total, 19 stents were inserted in 14 ureters. The follow-up included 100% of the patients. To date, except for one case, the patency of the stent has always persisted for the period of the survival of the patients, the longest ones being 4 and 4.1 years.

[Examination of Doppler color ultrasound in patients with ESWL]. / Examen mediante US Doppler color en enfermos tratados con ESWL.

Although treatment by shock waves has been proven useful in destroying calculi, it is not free from complications and may cause lesions to the kidney whose importance has not been completely elucidated. The present study utilized color Doppler US to determine the changes produced by ESWL on the kidney and its vessels in particular. The results achieved by Doppler evaluation of 25 patients immediately before ESWL, 2, 7 and 30 days post-ESWL show an increased resistance index 2 days after treatment which tended to return to normal at 30 days. We discuss the different results obtained depending on stone location and the complications.

[Diagnosis and follow-up of superficial bladder tumors using non-invasive techniques]. / Diagnóstico y seguimiento de los tumores vesicales superficiales mediante técnicas no invasivas.

The discomfort caused by cystoscopy to the patient with superficial bladder tumor has led to the routine use of other less invasive but similarly reliable procedures. We performed a two-year comparative study of cystoscopy versus abdominal ultrasonography/cytology in 90 patients. Two hundred procedures were performed for each method of evaluation. Together, the sensitivity and specificity of both procedures were 61% and 98%, respectively. The positive and negative predictive values were 94% and 87%, respectively. These good results have permitted us to change the follow-up protocol of these patients such that currently ultrasonography and cytology are performed once every 6 months, and cystoscopy is used only for those cases with clinical features suggestive of recurrence and a negative work up of those with a negative scan and positive cytology.