Real-time ultrasonography of the spinal cord: intraoperative and postoperative imaging.

Fourteen subjects with spinal cord pathology were studied with 10 MHz linear array or 5 MHz mechanical sector ultrasound scanners. Twelve patients were studied intraoperatively. The examinations were rapid, aiding the surgeon at the time of exploration.

The sonographic diagnosis of focal and diffuse infiltrating intrascrotal lesions.

Thirty-six examples of inflammatory and neoplastic disease of the scrotum were evaluated with ultrasound. Analysis of the images suggests that sonographic differentiation of these conditions is possible in certain instances. The ability to separate testicular from extratesticular pathology is quite accurate.

Neonatal colonic atresia: ultrasound findings.

High resolution real-time ultrasound examination of the abdomen was performed in a neonate with abdominal distention. Dilated distal small bowel and a complex mass in the course of the ascending colon were noted. Ultrasound correctly suggested the diagnosis of mid-colonic atresia with a patent ascending colon twelve hours prior to the radiographic demonstration of gas in the obstructed right colon.

Pelvic sonography to help determine the appropriate therapy for luteal phase defects.

In some series the most appropriate therapy for luteal phase defects is supplemental progesterone in the luteal phase. Clomiphene's efficacy is more controversial since in one series only 8% achieved a successful pregnancy versus 45% in another study. Pelvic sonography was used to evaluate follicular development and release of the ovum in 50 infertile women with luteal phase defects.

Ultrasonic tissue characterization of fetal lung, liver, and placenta for the purpose of assessing fetal maturity.

The purpose of this research effort was to establish a physical basis for the development of an accurate noninvasive technique to differentiate between mature and immature fetal tissues, particularly the lung and placenta. The research utilized RF waveform analysis via a microcomputer-based digital processing system interfaced directly to a standard real-time clinical diagnostic ultrasound instrument. Differences between the frequency spectra of the RF waveforms for mature and immature fetal tissues could be demonstrated in accordance with proposed tissue models.

Endoscopic ultrasonic evaluation of the prostate using a transrectal probe: prospective evaluation and acoustic characterization.

Transrectal sonography of the normal prostate demonstrates a gland that has low-level homogeneous echoes. Benign and malignant prostatic disease causes disruption of this normal texture. A prospective study was performed to determine the ability of ultrasound to detect focal defects accurately.

Characterization of benign and malignant tissues of the thyroid gland. An ultrasonic approach using RF waveform analysis and pattern recognition.

A physical basis was developed for an accurate noninvasive technique to differentiate malignant thyroid tumors from benign lesions based upon a frequency-dependent attenuation model. The research effort utilized RF waveform analysis via a minicomputer based digital processing system. Data collection was performed using a standard clinical B-Mode diagnostic instrument with a transducer specially designed for imaging the thyroid gland.

The Kimray-Greenfield filter: evaluation by duplex real-time/pulsed Doppler ultrasound.

The Kimray-Greenfield filter is a wire cage which is inserted into the inferior vena cava (IVC) to prevent thrombi originating in pelvic and leg veins from embolizing to the lungs. Duplex real-time/pulsed Doppler ultrasound was used to evaluate placement and function in 38 patients (46 examinations). Real-time examination successfully identified the IVC and filter in 89% of cases.

The role of diagnostic ultrasonography in varicocele evaluation.

Twenty-one patients with the clinical diagnosis of varicocele were evaluated with static and superficial organ scanners. The sonogram was able to image the dilated scrotal veins in all of these cases. The small, clinically subtle varicocele could be demonstrated only with high-resolution, dedicated real-time small-parts scanners, whereas larger lesions could also be imaged with B-mode contact equipment.

Prostate biopsy utilizing transrectal ultrasound guidance: diagnosis of nonpalpable cancers.

A long-axis real-time ultrasonic transrectal probe was utilized in transperineal biopsies to detect three nonpalpable prostate cancers. It was found that ultrasonically guided percutaneous perineal biopsy allows for the accurate placement of the biopsy needle tip into suspicious areas of the prostate. Ultrasonographic examination prior to biopsy is recommended to provide confirmation of palpable masses and to reveal other suspicious but not clinically suspected areas.

Ultrasonographic findings in placenta increta.

Placenta increta, invasion of the myometrium by normal placental (chorionic) villi, can be life-threatening to a mother at delivery. In two reported cases of pathologically proven placenta increta, the abnormal areas were retrospectively identified on ultrasonographic images. In both cases, there was consistent focal obliteration of the hypoechoic retroplacental zone by either tissue of echogenicity similar to that of the normal placenta or tissue of slightly decreased echogenicity.

Sonographically guided transperineal prostatic biopsy: preliminary experience with a longitudinal linear-array transducer.

Transperineal prostate biopsy performed with continuous sonographic monitoring by a real-time rectal endoscopic probe, using a longitudinal linear array which offered complete visualization of the needle from the perineum into suspected abnormal areas within the prostate, was performed in 25 patients with clinically suspected prostate disease. Clinically suspected nodules in 13 patients were more accurately biopsied using sonographic guidance as opposed to conventional manual, digital guidance. Subclinical carcinomas in three patients and areas of atypical histology in three patients were also identified and biopsied using transrectal sonographic guidance.

Ultrasound mammography for the augmented breast.

Ultrasound examinations were performed on 25 women with augmented breasts using whole-breast water-path scanning. In these patients, ultrasound imaged carcinoma, benign lesions, and fibrous capsule formation; these were confirmed by surgery. In addition, it was noted that certain prostheses appeared to be displaced posteriorly onto the chest wall and some prostheses had internal echoes.

Polyorchidism diagnosed preoperatively by ultrasonography.

Polyorchidism, or multiple testes, is a rare condition that has been referred to in both medical literature and mythological folklore. Curious attributes have been ascribed to men with this condition, including supposed increased sexual prowess and virility. In the medical literature, the examples of supernumerary testicles have demonstrated only one additional testis.

Fibroadenoma of the breast: sonomammography correlated with pathology in 122 patients.

During the performance of 2,000 sonomammograms, there were 122 patients with 140 biopsy-confirmed fibroadenomas. Mass lesions or abnormalities were detected on the sonomammograms in 100 of these patients (82%) (118/140 masses), and a retrospective review of the descriptive sonographic criteria tabulated at the initial interpretation of 118 of these masses was undertaken. The most significant sonographic mass features were a round (48%) or oval (37%) shape, a smooth contour (75%), weak internal echoes (80%) in a uniform distribution (88%), and intermediate acoustic attenuation (71%).

Ultrasound, x-ray mammography, and histopathology of cystosarcoma phylloides.

Ultrasound and x-ray mammograms were obtained in 8 patients with palpable breast masses, which were subsequently proven to be cystosarcoma phylloides. Histopathologic examination of the 8 tumors showed benign cystosarcoma phylloides in 5, recurrent benign tumor in 1, coexistent invasive papillary carcinoma in 1, and coexistent in situ duct cancer and in situ lobular cancer in 1. A retrospective review of the B-scan images was undertaken to list the descriptive ultrasound features of cystosarcoma phylloides.

Clinical experience with a prototype real-time dedicated breast scanner.

The evaluation of 1,003 sonomammographic examinations on a predominantly symptomatic population using a prototype real-time dedicated breast scanner is presented. Interpretations were initially made by one of four experienced radiologists without knowledge of clinical data (i.e.

Ultrasound mammography for male breast enlargement.

Fourteen men referred for ultrasound evaluation of breast enlargement had ultrasound mammography using water path techniques. Gynecomastia, both the localized type and the diffuse type, could be differentiated from the normal soft tissues of the chest wall on the B-scans. Among nine cases of men who underwent excision, there were six cases of gynecomastia, two lipomas, and one biopsy revealed normal subcutaneous tissue.

Real-time ultrasonographic evaluation of normal fetal adrenal glands.

Using real-time ultrasonography, the normal fetal adrenal glands can be consistently imaged after 30 weeks of gestational life. It was found that the normal fetal adrenals had specific size, shape, and echogenicity and could be consistently separated from the adjacent kidneys. The long axis of the adrenal gland had a range of 14 to 22 mm, compared with a range of renal lengths of 27 to 42 mm, with a ratio of the long axes of fetal adrenal to fetal kidney of .

Gray scale ultrasound studies in neonatal infants with malformation of the brain.

Ultrasound findings in four newborn infants with neurological abnormalities and abnormal facies are described. The ultrasound images are compared with the images achieved by computerized tomography and with the findings at postmortem in 3 of the patients. Accurate neuroanatomical diagnosis confirmed by CT and/or autopsy findings is demonstrated in all 4 cases.