Gangrenous cholecystitis: diagnosis by ultrasound.

Sonographic findings were analyzed in 19 patients with surgically proved gangrenous cholecystitis. In 8 patients (42%), there were no specific features that would allow differentiation from typical uncomplicated acute cholecystitis. However, in 11 patients (58%) atypical findings were present, including intraluminal membranes and/or marked irregularities of the gallbladder wall.

Hemoperitoneum studied by computed tomography.

Three hundred patients who had sustained blunt abdominal injury were evaluated with computed tomography (CT). The images showed areas of hemorrhage by varying attenuation coefficients (average, 45 Hounsfield units; exceeding 30 Hounsfield units in all cases except in those patients with bleeding more than 48 hours old). Small hematomas tended to accumulate near the site of origin while free intraperitoneal bleeding most frequently accumulated in the Morison pouch, paracolic gutters, and pelvis.

The effect of clomid induced superovulation on human follicular and luteal function for extracorporeal fertilization and embryo transfer.

The administration of clomiphene citrate (Clomid) 150 mg/day from days 5-9 of the menstrual cycle to spontaneously ovulatory women in order to induce adequate multiple follicular development followed by timed laparoscopic aspiration of mature oocytes does not appear to impair luteal phase length or the steroid pattern of oestradiol-17 beta (E2) or progesterone (P) production as reflected by their peripheral blood concentrations. In Clomid stimulated cycles where preovular oocyte pickup (OPU) and embryo transfer (ET) occurred but no recognizable pregnancy resulted, the cycle length was 30.0 (s.

Computed tomography of choledocholithiasis.

Computed tomography (CT) correctly diagnosed common bile duct stones in 19 (90%) of 21 surgically proven cases. CT demonstrated calculi in all 13 patients with calcium bilirubinate common duct stones and six of eight patients with predominantly cholesterol stones. There were two false-negative diagnoses in patients with cholesterol calculi scanned at 1 cm intervals.

Computed tomography of pancreatic trauma.

In a review of over 300 CT scans of abdominal trauma, we encountered 13 patients with surgically proved pancreatic injuries. CT correctly diagnosed pancreatic fractures, contusions, or posttraumatic pseudocysts in 11 of these patients. There were two false positive and two false negative diagnoses.

CT in the evaluation of spine infection.

Little experience of computed tomography (CT) evaluation of spinal infection has been reported. We collected 20 patients with spinal infection studied with CT. Fifteen patients had pyogenic infections, four had tubercular lesions, and one infection was fungal.

Ultrasonographic differentiation of the gestational sac of early intrauterine pregnancy from the pseudogestational sac of ectopic pregnancy.

A retrospective review of 128 consecutively scanned pregnant patients who had either early intrauterine pregnancies (IUPs) or ectopic pregnancies was performed to determine the accuracy of the finding of an intrauterine double decidual sac (DDS) in distinguishing between these two groups of patients. The presence of a DDS correlated with an IUP in 59 of 60 patients (98.3%).

CT and sonography of severe renal and perirenal infections.

Twelve patients with urosepsis and severe renal or perirenal infections were evaluated with both computed tomography (CT) and sonography. Six patients had nine proven renal or perirenal abscesses larger than 2 cm in diameter. One patient had multiple microabscesses smaller than 1 cm.

Choledocholithiasis and cystic duct obstruction: difficult ultrasonographic diagnosis.

Ultrasonography of 53 patients with stones in either the common bile duct (CBD) or the gallbladder neck/cystic duct revealed respective sensitivities of only 30% and 29% for detection of calculi. The data, which were collected over a period of 40 months, were also analyzed with respect to our early experience (first 24 months) versus our later experience (last 16 months). Although there was no improvement in the diagnosis of gallbladder neck/cystic duct calculi (only those in the gallbladder neck could be identified), significant improvement occurred in the diagnosis of choledocholithiasis, with a sensitivity of 15% in the early period and a sensitivity of 55% in the later period.

Admission after mild head injury: benefits and costs.

Large numbers of patients are admitted to hospital in Britain after mild head injury in the hope of anticipating complications. Investigation of 1442 consecutive admissions with head injury to the Edinburgh Royal Infirmary yielded 56 intracranial haematomas. Of 865 patients who were alert and orientated in the accident and emergency department after having been briefly knocked out but who had no skull fracture, no focal neurological signs, and no history of headache or vomiting, only one developed an intracranial haematoma.

Echogenic clot: a useful sign of pelvic hemoperitoneum.

The sonograms of 34 patients with surgically proved pelvic hemoperitoneum were reviewed. In 15 of these patients clotted blood was found at surgery in the pelvis or cul-de-sac. In nine of these patients (60%), ultrasound demonstrated echogenic fluid collections or "masses" with an echogenicity equal to or greater than the uterus.

High-resolution real-time sonography of fetal cardiovascular anatomy.

With high-resolution real-time sonography it is possible to visualize normal fetal cardiovascular structures in a high percentage of second- and third-trimester pregnancies. At present the optimal view for cardiac visualization is the four-chamber view, which affords simultaneous imaging of the atria, ventricles, and atrioventricular and interventricular septa. The fetal aortic arch can be readily demonstrated in most patients.

Gastric wall thickening and extragastric inflammatory processes: a retrospective CT study.

A retrospective CT study was undertaken to evaluate nonneoplastic extragastric lesions associated with gastric wall thickening (GWT). A total of 70 cases was reviewed including 44 with acute pancreatitis, 6 with infected left upper quadrant fluid collections, and 20 with noninfected left upper quadrant fluid collections. Patients with acute pancreatitis and measurable gastric walls disclosed GWT in 67% of cases.

CT with image reformation for noninvasive screening of the carotid bifurcation: early experience.

Twenty-two cervical carotid artery bifurcations were evaluated in 11 patients using a high-resolution computed tomographic (CT) technique with image reformation permitting display of the bifurcation anatomy. Arteriography was also done in eight of the patients, two of whom subsequently underwent carotid endarterectomy. The CT study showed patency of the proximal internal carotid artery in every case and depicted significant stenosis of four vessels.

Ultrasound evaluation of ectopic pregnancy.

The combined use of a serum radioimmunoassay pregnancy test and high resolution utrasonography allows a more direct approach to be made in the diagnosis of ectopic pregnancy. It is important for ultrasonographers to understand the limitations of the more readily available immunologic pregnancy tests in order to avoid misinterpreting ultrasonograms in the event that a pregnancy test is either falsely positive or falsely negative. Clinical suspicion is mandatory if the early diagnosis of ectopic pregnancy is to be made.

Computed tomography in blunt abdominal trauma.

Emergency abdominal computed tomography (CT) has been performed in more than 200 cases of acute blunt abdominal trauma. Computed tomography was highly sensitive and specific for a wide variety of intraperitoneal and retroperitoneal traumatic lesions. There were no false-positive or false-negative CT interpretations, except for a single case in which residual peritoneal lavage fluid was mistaken for intraperitoneal blood.

Recurrent pyogenic cholangitis in Asian immigrants. Use of ultrasonography, computed tomography, and cholangiography.

Five cases of recurrent pyogenic cholangitis (RPC) were studied by ultrasonography, computed tomography (CT), and cholangiography. All patients were recent immigrants from the Orient or Indonesia and had had recurrent attacks of cholangitis for many years. The bile was infected by E.

High resolution CT of thoracolumbar fractures.

Twenty-one patients with thoracolumbar spinal fractures were studied with computed tomography (CT). A vertebral body was involved in 20; 12 had additional fractures of the posterior elements. Five had multiple level injuries.

High frequency CT findings within 24 hours after cerebral infarction.

Twenty-six patients with clinically documented acute cerebral infarction were evaluated by computed tomography within the first 24 hr. In 21 patients, subtle mass effects and/or focal areas of decreased attenuation corresponding to areas of clinical deficit were demonstrated. Enhancement occurred in only five of 15 infarctions rescanned after contrast administration.

Noninvasive imaging of unusual regenerating nodules in the cirrhotic liver.

Despite the common occurrence of regenerating liver nodules, little has been written regarding their ultrasound or computed tomographic appearance. In the great majority of cases, they have an echo texture and CT number identical to surrounding hepatic parenchyma. Exceptionally, as in the 2 cases described, they can mimic a malignant neoplasm.