Sensitization, pathologic, and imaging findings comparing symptomatic and quiescent failed renal allografts.

Late allograft failure (LAF) is a common cause of end stage renal disease. These patients face interrelated challenges regarding immunosuppression management, risk of graft intolerance syndrome (GIS), and sensitization. This retrospective study analyzes sensitization, pathology, imaging, and transfusion requirements in 33 LAFs presenting either with GIS (22) or grafts remaining quiescent (11).

Adnexal torsion: new clinical and imaging observations by sonography, computed tomography, and magnetic resonance imaging.

Objective: The purpose of this study was to review the clinical, imaging, and pathologic findings associated with adnexal torsion.

Methods: A review of surgically proven cases of torsion between 1990 and 2006 included clinical, surgical, and pathologic data and preoperative sonographic, computed tomographic (CT), and magnetic resonance imaging (MRI) studies. Imaging reports were assessed to determine whether a correct preoperative diagnosis was made.

Lateral epicondylitis of the elbow: US findings.

Purpose: To determine the sensitivity and specificity of ultrasonography (US) in the detection of lateral epicondylitis and identify the US findings that are most strongly associated with symptoms.

Materials And Methods: Internal review board approval was obtained for retrospective review of the patient images, and the need for informed consent was waived. Internal review board approval was also obtained for scanning the 10 volunteers, all of whom gave informed consent.

Ultrasound-guided biopsies: tricks, needle tips, and other fine points.

Ultrasound (US)-guided biopsy of thyroid nodules, abdominal masses, liver masses, random core liver biopsies, as well as aspiration of abdominal or pleural fluid is now routine practice. The ability of US to guide biopsy of abnormalities seen on cross-sectional imaging studies is well recognized as an efficient and effective means of achieving a tissue diagnosis. Its use requires basic knowledge of US image analysis, but clinically useful intuitive and nonintuitive methods can enhance its strengths.

Intraoperative sonographic localization of breast masses: success with specimen sonography and surgical bed sonography to confirm excision.

Objective: To assess the use of intraoperative sonography for localization of breast masses at excisional biopsy, with specimen and surgical bed sonography to confirm excision.

Methods: A computer search of the 5-year period from January 1993 through January 1998 revealed 138 consecutive women referred for sonographically guided excisional biopsy of 148 masses; 35 masses were excluded because they had no postoperative mammograms. One hundred thirteen masses constituted the study group.

Comparison of unenhanced and contrast-enhanced spiral CT for assessing interval change in patients with colorectal liver metastases.

Rationale And Objectives: The purpose of this study was to determine whether the interval change in hepatic colorectal metastases as assessed with serial computed tomographic (CT) scans without contrast material enhancement differs from that as assessed using serial, portal dominant phase, contrast-enhanced CT scans.

Materials And Methods: Unenhanced and contrast-enhanced abdominal CT scans were obtained in 28 patients. Three radiologists separately reviewed serial unenhanced and contrast-enhanced studies to assess the interval change in liver metastases.

Sonographically guided renal mass biopsy: indications and efficacy.

Purpose: To review the clinical indications, pathologic results, and success rate of all our sonographically guided solid renal mass biopsies over a 5-year period.

Methods: Between 1993 and 1998, 44 consecutive patients underwent sonographically guided percutaneous biopsy of a solid renal mass. Indications included prior history of nonrenal malignancy, metastatic disease of unknown primary origin, previous contralateral nephrectomy for a renal cell neoplasm, a renal transplant mass, suspected renal lymphoma, history of tuberous sclerosis, and poor surgical candidacy.

Safety and efficacy of sonographically guided random core biopsy for diffuse liver disease.

Sonographic guidance is commonly used in the biopsy of focal hepatic lesions, but biopsy for diffuse disease is often non-image-guided. We evaluated the safety and efficacy of real-time sonographically guided random core biopsy in the assessment of diffuse liver disease in 210 patients. The two most common indications for biopsy were viral hepatitis (in 113 patients) and elevated liver function test results of unknown cause (in 54 patients).

Increased soft-tissue blood flow in patients with reflex sympathetic dystrophy of the lower extremity revealed by power Doppler sonography.

Objective: We evaluated the ability of power Doppler sonography to show increased soft-tissue blood flow in patients with reflex sympathetic dystrophy of the lower extremity.

Subjects And Methods: Power Doppler sonography was performed in 30 patients with reflex sympathetic dystrophy of the lower extremity and in 26 asymptomatic control subjects. The bilateral power Doppler sonograms that were obtained of the soft tissues of the dorsum of the foot of each subject were grouped in pairs, and three sonologists who were unaware of clinical information independently reviewed the images.

Superficial soft-tissue masses suggestive of recurrent malignancy: sonographic localization and biopsy.

Objective: We investigated the usefulness of high-resolution sonography to localize superficial soft-tissue masses and to guide needle sampling for recurrent malignancy.

Materials And Methods: High-resolution sonography (10-MHz) was used to locate and guide needle sampling of 16 palpable and eight impalpable superficial masses suggestive of recurrent malignancy in 23 patient (12 men, 11 women; 34-85 years old). After detection, 22 (92%) of the masses were immediately sampled by fine-needle aspiration with 18- to 25-gauge needles and two (8%) were sampled by a 20-gauge core gun.

Improved staging of liver tumors using laparoscopic intraoperative ultrasound.

Background: Intraoperative ultrasound has been shown to provide significant assistance in operative staging and management of patients with liver tumors during open surgery. The availability of the 5.0-7.

Placement of ureteral stents in pregnancy using ultrasound guidance.

Urolithiasis is one of the most common causes of pain in pregnancy. Renal calculi can create a diagnostic and therapeutic challenge; left untreated, they can adversely affect maternal and fetal outcome. Although most cases of obstructive uropathy can be managed conservatively, some require relief of obstruction, usually by placement of a ureteral stent.

Effects of training and experience in interpretation of emergency body CT scans.

Purpose: To determine the effects of level of training and other factors on the rate of discrepant interpretation of emergency body computed tomographic (CT) scans by trainees and staff radiologists.

Materials And Methods: Five hundred ninety-eight consecutive emergency CT studies were prospectively interpreted by radiology residents or board-certified body imaging fellows over a 12-month period. Each interpretation was reviewed within 12 hours by an attending body CT radiologist.

Laparoscopic liver sonography: preliminary experience in liver metastases compared with CT portography.

This study evaluated the ability of laparoscopic ultrasonography to detect, localize, and characterize focal liver masses. Laparoscopic ultrasonography and CT portography of the liver were performed in 13 patients with known or suspected malignancy. Laparoscopic ultrasonography directly influenced surgical management in four (31%) cases; three by detection of small focal masses and one by exclusion of masses suspected on CT portography.

Laparoscopic Ultrasound: Its Role in Laparoscopic Surgery.

Laparoscopic surgery has been accepted as the surgery of choice for may diagnostic and therapeutic abdominal procedures because of decreased morbidity, reduced cost, and improvement in long-term outcomes compared with open procedures. However, this approach has inherent limitations in the evaluation of diseases concealed within solid organs, hollow viscera, or the retroperitoneum. Laparoscopic ultrasound, which evolved from the concepts of intraoperative and endoscopic ultrasound, opens a whole new dimension to accurately diagnose and treat conditions laparoscopically.

Laparoscopic gray-scale and color Doppler US: preliminary animal and clinical studies.

Purpose: To evaluate a semiflexible ultrasound (US) transducer inserted through a laparoscopic port to image abdominal structures.

Materials And Methods: Laparoscopic US with a 9.6-mm-diameter, 5.

MR portography: preliminary comparison with CT portography and conventional MR imaging.

Magnetic resonance (MR) imaging with arterial portography (MRAP) was compared with computed tomography with arterial portography (CTAP) and conventional MR imaging for preoperative evaluation of hepatic masses in eight patients (nine studies). Twenty contiguous, 10-mm-thick-section CTAP images were obtained. MR imaging included T1- and T2-weighted spin-echo and fast multiplanar SPGR (spoiled gradient-recalled acquisition in the steady state) techniques.

High-resolution endoluminal sonography of the anal sphincter complex.

The ability of a high-frequency miniature ultrasonographic transducer to image the anatomy of the anal sphincter complex was investigated in 20 normal subjects. A 9 Fr catheter containing a 12.5 MHz transducer was inserted into the anal canal.

High-frequency endoluminal ultrasonography of the esophagus in human autopsy specimens.

A 20 MHz ultrasound transducer housed in a 6.2 Fr catheter was used to image human esophageal autopsy specimens from six cadavers. Histologic sections taken from the areas imaged were correlated with cross-sectional sonographic images.

Endoluminal ultrasonography of the distal esophagus in systemic sclerosis.

Background: The aim of this study is to apply high-resolution endoluminal sonography (HRES) to the study of the esophageal disease in systemic sclerosis (SSc).

Methods: An HRES transducer was used to image the esophagus. Autopsy specimens of normal and SSc esophagi were imaged to define a hyperechoic abnormality in the normally hypoechoic muscularis propria.

Gastric and esophageal varices: 20-MHz transnasal endoluminal US.

To image esophageal and gastric varices qualitatively and to measure esophageal varices quantitatively, 29 patients with portal hypertension underwent transnasal esophageal and gastric ultrasonography (US). Twenty-three patients underwent standard endoscopy. Endoluminal US demonstrated the varices as anechoic areas with communications in the submucosal, periesophageal, and perigastric regions, as well as ascites visualized through the gastric wall.