Aspiration and drainage procedures in the intensive care unit: percutaneous sonographic guidance.

Ultrasound guidance was used in 10 aspiration and six drainage procedures in the intensive care unit. Sonography offered a safe and effective method for guidance of diagnostic aspiration in the ICU setting. Additionally, cholecystostomy, nephrostomy, abscess drainage, and empyema drainage were performed at bedside as lifesaving procedures in six critically ill patients using US guidance.

Hepatobronchial fistula with percutaneous pyogenic abscess drainage of the liver.

Percutaneous abscess drainage has been successfully used in the treatment of hepatic abscesses. We present a case of a posttraumatic pyogenic liver abscess treated by CT-guided percutaneous catheter drainage with an unusual complication of a hepatobronchial fistula. Patient management and the subtle roentgenographic features of this case are presented.

Evaluation of spinal infections by plain radiographs, computed tomography, intrathecal metrizamide, and CT-guided biopsy.

16 cases of spinal infection were reviewed to evaluate the usefulness of plain radiographs, noncontrast computed tomography (CT), computed tomographic metrizamide myelography (CTMM), plain film metrizamide myelography, and CT-guided biopsy techniques. Noncontrast CT was more useful than plain films in the evaluation of disc space and bony involvement and soft tissue extension of infection into the paraspinal spaces. CTMM was needed for evaluation of epidural or subdural involvement of infection in the cervical and thoracic spine, while plain film metrizamide myelography was useful as a survey for CTMM.

Long-term delta-9-tetrahydrocannabinol treatment. Computed tomography of the brains of rhesus monkeys.

High-resolution computed tomographic (CT) scanning of the brain was performed on three groups of rhesus monkeys for the detection of ventricular or cisternal enlargement. These three groups comprised four age-matched controls that had no prior drug usage--four monkeys receiving short-term (two to ten months) orally administered delta-9-tetrahydrocannabinol (delta 9-THC [now known nonproprietarily as dronabinol] and four monkeys receiving long-term (five years) orally administered delta 9-THC. Our results show a statistically significant enlargement of the frontal horns and the bicaudate distance in the long-term group as compared with the control and less significant enlargement of these areas in the long-term group compared with the short-term group.

Percutaneous biopsy and drainage procedures in the abdomen using a modified coaxial technique.

A modified coaxial technique for biopsy and drainage procedures in the abdomen is described. This technique involves initial placement of a 23-gauge needle into an abdominal organ or mass. Once proper position is obtained, the hub of the needle is removed and a 19-gauge or larger needle is placed over the 23-gauge needle.

Ultrasonic assessment of fetal growth in the nonhuman primate (Macaca mulatta).

Serial ultrasound measurements of fetal growth were made during uncomplicated pregnancy in 28 time-mated rhesus monkeys. Gestational sac (GS) size, crown-rump length (CRL), biparietal diameter (BPD), head circumference (HC), head area (HA), abdominal circumference (AC), abdominal area (AA), and femur length (FL) were measured. Average longitudinal growth curves for each parameter were obtained from individual fetal growth curves.

Evaluation of the parotid gland. Comparison of sialography, non-contrast computed tomography, and CT sialography.

Sialography, non-contrast computed tomography (NCCT), and CT sialography (CTS) were compared in 40 patients with parotid disease. While NCCT and CTS proved to be superior to sialography in most cases, with NCCT being as good as CTS for demonstration of parotid masses, sialography was preferred over both NCCT and CTS for evaluation of inflammatory disease. The role of percutaneous needle aspiration is discussed, and protocols for evaluation of both parotid masses and inflammatory disease are presented.

Combined use of ultrasound and computed tomography in evaluation of intraabdominal pregnancy and fetal demise.

The ultrasonographic and CT findings in a case of intraabdominal pregnancy with fetal demise are presented. To our knowledge, this is the first published report of CT evaluation of intraabdominal fetal demise. The complementary role of CT and ultrasound in diagnosing intraabdominal fetal demise are discussed.

Sonographically guided percutaneous cholecystostomy performed in dogs and pigs.

An ultrasound-guided percutaneous cholecystostomy was attempted in six dogs and seven pigs. The pig was a more suitable laboratory animal since the biliary anatomy of swine is similar to that of humans; the anteriorly located gallbladder was ideal for puncture. Use of a single-stick catheter was preferable to a guidewire exchange technique.

Ultrasonic evaluation of the size of the trigone of the fetal ventricle.

A well-demarcated hypoechoic area seen on routine fetal biparietal diameters (BPDs) was retrospectively reviewed in 101 routine obstetrical ultrasonograms. This region has been confirmed to represent the hippocampus with its lateral borders formed by the trigone of the lateral ventricle. Recognition of this structure in conjunction with other previously described structures is a useful method of obtaining easily reproducible BPD measurements.

Ultrasound and radionuclide biliary scanning in acute pediatric abdominal pain.

Seven pediatric patients (ages 2-14) who presented with acute abdominal symptomatology and an abnormal cholecystosonogram are reviewed. Etiologies of the abnormal sonograms included: hepatitis (3 of 7), acalculous cholecystitis (1 of 7), calculous cholecystitis (1 of 7), cholangitis with associated cholecystitis (1 of 7), and chronic active hepatitis with low serum albumin (1 of 7). The combined use of the sonogram and the radionuclide biliary scan is helpful in predicting and distinguishing between cases of cholecystitis and uncomplicated hepatitis.

Carotid blood flow response to Conray-60: diagnostic implications.

The vasoactive effect of the angiographic contrast medium Conray-60 (iothalamate meglumine 60%) on carotid blood flow was studied by the video dilution technique in 26 subjects during routine neuroangiography. After a test series of 1 ml injections of contrast material into the carotid arteries at designated time intervals, an increase in carotid blood flow was found in normal controls at 30 sec, while a significant decrease in flow was observed in patients with atheromatous disease and avascular intracranial masses (p less than 0.01).

The fetal hippocampus. A possible pitfall and a useful anatomical landmark in evaluation of the biparietal diameter.

A well-demarcated hypoechoic region was seen just lateral to the collicular plate during measurement of the fetal biparietal diameter (BPD) in 101 (70%) of 144 ultrasound examinations and confirmed on postmortem sonographic water-bath studies of fetal brains. This structure was found to represent the hippocampus, with its lateral border formed by the trigone of the lateral ventricle. It should not be confused with an abnormal entity such as a ventricular cyst.

Carney syndrome: usefulness of computed tomography in demonstrating pulmonary chondromas.

A case of Carney syndrome (gastric leiomyosarcoma, functioning extra-adrenal paragangliomas, and pulmonary chondroma) is reported. Radiologists should be aware of the possible association of these three types of lesion. Computed tomography is valuable in the recognition of pulmonary chondromas.

Sonographic evaluation of hydatidiform mole and its look-alikes.

Seventeen proven cases of complete hydatidiform mole and 14 sonographically similar nonmolar cases were studied in detail with a variety of ultrasound transducers. Complete hydatidiform moles can be reliably differentiated from other lesions with similar sonographic appearances by using a highly focused ultrasound transducer to image the near field of the intrauterine contents.

The value of computed tomographic metrizamide myelography in the neuroradiological evaluation of the spine.

The diagnostic value of plain film metrizamide myelography (PFMM) was compared with computed tomographic metrizamide myelography (CTMM) in a study of 106 individuals who had undergone high-resolution computed tomographic scanning of the spine. CTMM provided more significant information than PFMM in 42 of 106 cases (40%), but showed no advantage over PFMM in 63 of 106 cases (59%). In 19 of the 42 cases (45%), PFMM was useful in directing the CT analysis to the appropriate region of pathology.

Intracranial fluid-blood levels in the anticoagulated patient.

This report documents that anticoagulation may cause multiple intracranial fluid-blood levels.

Comparison of ultrasonography, computerized tomography, and radionuclide imaging in the diagnosis of acute and chronic cholecystitis.

Seventy-five patients with abdominal pain in the right upper quadrant who were subsequently confirmed operatively and histologically to have acute or chronic cholecystitis underwent radionuclide imaging of the biliary tree, ultrasonography, and/or computerized tomography before operation. fifty-eight of the patients had acute cholecystitis and 17 had chronic cholecystitis and cholelithiasis. Analysis of our data indicates that ultrasonography is an accurate and better screening test than cholescintigraphy in the diagnosis of chronic cholecystitis and cholelithiasis, but it is less accurate in the detection of acute cholecystitis.

Sonography of the normal pediatric gallbladder and biliary tract.

Fifty-one pediatric patients (range, 1 mo. to 16 yr.), all of whom had normal clinical findings and laboratory data pertaining to the gallbladder and biliary tract, were examined by ultrasound.

Epidermoid cyst of the spleen: value of noninvasive imaging modalities in preoperative diagnosis.

Epidermoid cyst of the spleen is the rarest benign nonparasitic cyst of the spleen. We describe such a case and show how it may be evaluated noninvasively with a combination of imaging modalities. Additionally, by using these modalities in the clinical setting of a young woman with vague abdominal complaints, the diagnosis can be strongly suggested preoperatively.