Detection of arterial intimal lesions: an experimental study comparing ultrasonography and arteriography.

In an experimental study the diagnostic value of intra-operative ultrasonography in the detection of arterial intimal lesions was investigated. A human carotid artery was placed in a pulsatile circuit with a roller pump and tubes. Intimal lesions (1-5 mm) were created and ultrasonography and biplane arteriography were performed. The ultrasonograms and arteriograms obtained were interpreted by three observers, who were blind to the procedures performed and the results were compared to the macroscopic defects. The mean sensitivity between observers for ultrasonography was 84% with a specificity of 95.7%. For biplane arteriography the mean sensitivity was 42% with a specificity of 94.5%. The differences between ultrasonography and biplane arteriography were statistically significant (p less than 0.02). It is concluded from this is concluded from this in vitro study that ultrasonography provides more accurate information concerning intimal lesions of the arterial wall than biplane arteriography.

The value of a sensitive assay of carcino-placental alkaline phosphatase (CPAP) in the follow-up of gynecological cancers.

Using a sensitive enzyme immunoassay, carcinoplacental alkaline phosphatase (CPAP) was determined in sera of 1266 patients with gyneocological cancers. All these patients were referred after initial surgical treatment elsewhere. There were 95 patients with evidence of disease at the time of the study and 1171 without evidence of disease. Of the 95 patients with active disease, 47 were treated for ovarian carcinoma, 36 for carcinoma of the cervix and 12 for endometrial carcinoma. Raised levels of CPAP were seen in 40% of patients with ovarian carcinoma, in 22% with carcinoma of the cervix and in 41% in the small group with endometrial carcinoma. In patients without evidence of disease, raised levels of CPAP were seen in 12% of patients with carcinoma of the cervix, in 6% of endometrial carcinoma and only in 2% of patients with carcinoma of the ovary. Therefore it was considered that in the latter group CPAP studies would prove of some value. In the group of patients with carcinoma of the ovary and evidence of disease, raised levels of CPAP were seen almost exclusively in patients with epithelial tumors. It is considered that CPAP may be of value as a tumor marker in this group of patients. When compared with CEA, CPAP tends to give fewer false positives and correlates better with the presence of disease.