Sonographic depiction of normal and abnormal endometrium with histopathologic correlation.

The sonographic appearance of the endometrium was correlated to histopathologic findings in 38 patients who underwent hysterectomy. The thickness was accurately assessed by sonography (within +/- 1 mm) in 33 of 38 patients. The hypoechoic halo which surrounds the endometrium was found to represent the inner third of the myometrium which is relatively vascular and compact. In postmenopausal patients who are not receiving hormonal replacement, an endometrium of greater than 5 mm should be considered abnormal. Several causes of abnormally thick endometrium were encountered in this study, including endometrial carcinoma, hyperplasia, adenomyosis, hematometria, mucometria, and pyometria. Sonography was found to be accurate in determining the depth of myometrial invasion in adenocarcinoma.

Duplex carotid ultrasound.

Technical advances in the field of ultrasound have resulted in the development of a high resolution real-time B-mode imaging system that permits direct Doppler analysis of hemodynamic abnormalities. This system combines both anatomic information and physiological information which permits detailed analysis of the entire spectrum of disease occurring at the carotid bifurcation. Future developments will permit improved management of patients at risk for stroke from carotid vascular disease.

Antepartum diagnosis of fetal intracranial hemorrhage by ultrasound.

Presented is a patient with acute onset of preeclampsia and abruptio placenta at approximately 26 weeks' gestation. Ultrasonography demonstrated evidence of in utero fetal intracranial hemorrhage, which was confirmed at autopsy. The implication of this finding is discussed.

Serial sonography of posthemorrhagic ventricular dilatation and porencephaly after intracranial hemorrhage in the preterm neonate.

Changes in ventricular size and brain parenchyma were documented in 40 preterm neonates with intracranial hemorrhage (ICH), who were serially examined for 3 weeks or more. Sonography disclosed a close relation between the severity of the intracranial hemorrhage and the development of progressive ventricular dilatation. Eighty percent of preterm neonates with minor degrees of intracranial hemorrhage (localized subependymal hemorrhage or subependymal hemorrhage with small intraventricular hemorrhage [subependymal/intraventricular hemorrhage]) did not develop significant ventricular dilatation, whereas all of the neonates with intraventricular and/or intraparenchymal hemorrhage developed moderate or severe ventricular dilatation. Spontaneous resolution of moderate and/or severe ventricular dilatation occurred by the end of the third week in about one-third of neonates with intracranial hemorrhage. Progressive ventricular dilatation was documented in 10 of 15 neonates with major intraventricular and/or intraparenchymal hemorrhage. The therapeutic implications of the findings are discussed.

Palpable breast masses: evaluation by high frequency, hand-held real-time sonography and xeromammography. Work in progress.

The purpose of this study was to evaluate the diagnostic virtues and limitations of the combined use of high frequency, real-time ultrasound scanning (US) using hand-held transducers and xeromammography (XM) in the evaluation of palpable breast masses. Seventy-one patients, who ranged in age from 14 to 88 years and who had histologically proved masses, were examined by both imaging modalities. US demonstrated the highest degree of accuracy in establishing the presence of cysts (96%) and fibroadenomas (89%). XM afforded better overall depiction of the breast and correctly identified seven carcinomas, five of which were prospectively diagnosed by sonography. When all types of breast masses were considered, the combined use of XM and US was more accurate (89%) than when either XM (70%) or US (85%) was used alone. For this reason, a combined approach using both modalities in the examination of most patients with palpable breast masses is advocated. The advantages and limitations of both XM and US in the evaluation of palpable masses are discussed and illustrated.