US of acute scrotal trauma: optimal technique, imaging findings, and management.

The primary causes of scrotal trauma are blunt, penetrating, degloving, and electrical burn injuries to scrotal contents. Knowledge of the scrotal anatomy and appropriate imaging techniques are key for accurate evaluation of scrotal injuries. Ultrasonography (US) is the first-line imaging modality to help guide therapy for scrotal trauma, except in degloving injury, which results in scrotal skin avulsion.

Sonographic features of benign thyroid nodules: interobserver reliability and overlap with malignancy.

Objective: To prospectively determine the sonographic findings of nodular hyperplasia of the thyroid, to compare these with reported findings associated with malignancy, and to assess interobserver reliability.

Methods: Seventy thyroid nodules were scanned, and then biopsies of the nodules were performed under sonographic guidance with fine-needle cytologic analysis; in all cases images were reviewed by 2 experienced radiologists without knowledge of clinical outcome. Findings reported associated with malignancy were specifically assessed.

Renal sonography in the intensive care unit: when is it necessary?

Objective: To evaluate the efficacy of renal sonography performed in intensive care units on patients with the diagnosis of acute or acute-on-chronic renal failure.

Methods: We reviewed all renal sonograms performed in our institution during 1 year on critically ill patients for evaluation of renal failure. Renal failure was defined as a serum creatinine level greater than 1.

Real-time radiologist review of remote ultrasound using low-cost video and voice.

Rationale And Objectives: A radiologist practicing remote ultrasound occasionally needs to review a case in real time before releasing the patient. The authors conducted a pilot study to evaluate one solution in which the radiologist views real-time images on a video monitor while conversing with the technologist via a headset telephone.

Methods: Two experienced ultrasonographers and five technologies participated in a 5-week pilot study in adjacent rooms.

Diverticula of the female urethra: diagnosis by endovaginal and transperineal sonography.

Diverticula of the female urethra can be difficult to diagnose. Invasive contrast studies (voiding cystourethrography or double-balloon urethrography) or urethroscopy are frequently required for definitive diagnosis. Although transabdominal sonography has been able to visualize large diverticula, this technique has not proved useful in routine screening.

Comparison of the digital rectal examination, endorectal ultrasound, and body coil magnetic resonance imaging in the staging of adenocarcinoma of the prostate.

A series of 25 patients with biopsy proven adenocarcinoma of the prostate underwent preoperative staging evaluation with a digital rectal examination, endorectal ultrasound, and body coil magnetic resonance imaging (MRI) before their radical retropubic prostatectomy. The sensitivity and specificity of the digital rectal examination for the detection of extracapsular disease were 17 and 100%, respectively. The sensitivity and specificity of endorectal ultrasound for the detection of extracapsular disease were 35 and 89%, respectively.

Pre- and postnatal ultrasonographic diagnosis of congenital obstructive uropathies.

Ultrasonography has proved particularly effective in evaluating the neonate with an abdominal mass, poor renal function, and an abnormal perinatal ultrasound scan. As a noninvasive, nonionizing, and relatively inexpensive examination, it can often make the preliminary diagnosis, streamline the work-up, and be used for follow-up studies.

Measurement of femoral torsion: comparison of standard roentgenographic techniques with ultrasound.

Measurement of femoral torsion by ultrasound was compared with measurements by standard roentgenographic techniques in a femoral model and in a clinical study. Magilligan, Ryder-Crane, and fluoroscopic determinations on the femoral model demonstrated acceptable interobserver and intraobserver variance. With high degrees of femoral torsion, ultrasound readings were less accurate and significantly lower than the actual angle of femoral torsion.

Intraoperative ultrasonography evaluation of the gallbladder in morbidly obese patients.

Intraoperative ultrasound evaluation of the gallbladder was performed in 55 morbidly obese patients undergoing gastric bariatric surgery. Cholecystectomy was performed in the presence of any physical or ultrasonographic abnormality. Eighteen patients (33%) had cholecystectomy.

Torsion of a wandering spleen: CT appearance.

A case of wandering spleen with torsion of the splenic vascular pedicle and pancreatic tail is presented. The entity was diagnosed and evaluated preoperatively with various imaging modalities (ultrasound, nuclear medicine, and CT) as well as visceral angiography.

Prenatal diagnosis of unilateral hydronephrosis with early postnatal reconstruction.

Real-time ultrasound systems, being used extensively now in obstetrical practice for fetal monitoring, are providing the urologist with more opportunities for early recognition and intervention of congenital hydronephrosis. Thorough postnatal investigation to confirm a diagnosis is advocated. An early postnatal surgical repair can be performed successfully.

Cholelithiasis in morbid obesity.

This study is based upon our experience with 477 morbidly obese patients who had gastric bariatric surgery during a five-year period. The incidence of biliary tract disease was 39.1%, about four times the incidence in the nonobese population.

The lesser sac and gastrohepatic recess: sonographic appearance and differentiation of fluid collections.

The sonographic appearance and differentiation of fluid collections within the gastrohepatic recess and lesser sac are described. The identification of the lesser omentum and stomach is fundamental to their separation. Accurate localization of upper abdominal fluid may be of aid in selecting an appropriate approach for paracentesis as well as directing the subsequent diagnostic work-up.

Mesenteric cyst: sonographic appearance with CT correlation.

Two cases of mesenteric cysts are reported. Realtime ultrasound demonstrated the typical appearance of well-defined, anechoic masses. In addition, a solid appearance with a honeycomb pattern of internal echos was observed in one case.

Renal lymphoma imaged by ultrasound and gallium-67.

Lymphomatous involvement of the kidneys, usually a secondary process, may be seen as single or multiple sonolucent or weakly echogenic masses on ultrasound. The majority of these patients have a known diagnosis of lymphoma and are being evaluated for change in nodal mass size, flank pain, and/or deteriorating renal function. Occasionally, these masses are discovered on an excretory urogram and are further investigated with ultrasound.

Ultrasound as a useful imaging modality for tumor detection and staging.

This paper represents an overview of the uses of ultrasound in tumor detection and staging. This modality can detect and define the etiology of a mass and is helpful in staging the neoplasm and in streamlining the diagnostic and/or staging workup. Often a mass can be localized and biopsied or aspirated, leading to prompt diagnosis and treatment.