Neonatal intracranial hemorrhage and complicating hydrocephalus

Real-time ultrasound studies of the head were performed on 96 infants weighing 1500 g or less. This population represented all such infants admitted within the first 72 hours of life to a neonatal intensive care unit over a 9-month period. Intracranial subependymal/intraventricular hemorrhage occurred in 22 (23%) of the infants. Of these 13 (59%) developed ventricular enlargement. Four other infants, in whom hemorrhage was not identified, also developed ventricular enlargement. When it occurred, the ventricular enlargement developed within 2 weeks of the hemorrhage in 77% of cases. It reached its maximum size within 2 weeks in 65% of cases. In 9 of 16 cases the maximal ventricular enlargement was categorized as mild. Spontaneous arrest or resolution of the ventriculomegaly occurred in all but two cases, who required shunting. Clot resolution was slow. It was complete at 3 weeks in only 5 of 18 cases.     

Pancreatic duct diameter: Sonographic measurement in normal subjects

In a prospective ultrasonic study of the pancreatic duct, 233 sonograms were obtained from 49 normal subjects. The duct in the regions of the head-neck and body was measured in the transverse/oblique planes. The mean diameter of the duct in the area of the head-neck was 3 mm; in the body proximal and distal to the neck, duct diameters were 2.1 and 1.6 mm, respectively.     

The anatomical basis for the ultrasound diagnosis of cerebroventricular hemorrhage and its sequelae

A critical review of the ultrasound features of neonatal intracranial anatomy is undertaken. Particular attention is paid to the ventricular and paraventricular region because of their importance in the diagnosis of cerebroventricular hemorrhage. A technique to visualize the important areas is described     

Detection of open spina bifida by the lemon sign: pathologic correlation

This study was undertaken to evaluate the association of medial displacement of the frontal bones of the fetal calvarium, the lemon sign, with open spina bifida (OSB) and to assess other pathologic findings associated with this change. During the past 8 years, 8 cases of OSB were seen in our institution. The lemon sign was retrospectively identified in 6/6 cases of OSB scanned before 22 weeks gestation, while it was not seen in 3/3 cases examined after 26 weeks. One case was evaluated with serial studies before and after 22 weeks. Scalloping of the frontal bones was associated with a wide variety of pathological findings. This sign may prove to be an important marker for OSB.     

What Does Magnetic Resonance Imaging Add to the Prenatal Sonographic Diagnosis of Ventriculomegaly?

OBJECTIVE: The purpose of this study was to determine the contribution of magnetic resonance imaging (MRI) in evaluating fetuses with the sonographic diagnosis of ventriculomegaly (VM). METHODS: Over 4 years, consecutive fetuses with the sonographic diagnosis of VM at 1 facility who underwent prenatal MRI at a second facility were included. The roles of MRI and follow-up sonography were tabulated. The patients were analyzed in 2 groups based on the presence or absence of other central nervous system (CNS) abnormalities. RESULTS: Twenty-six fetuses with a gestational age range of 17 to 37 weeks had sonographically detected VM (atria > or =10-29 mm), including 19 with mild VM (atria 10-12 mm). In group 1, 14 had isolated VM, 6 of which reverted to normal by the third trimester. Magnetic resonance imaging showed cerebellar hypoplasia not shown by sonography in 1 fetus and an additional finding of a mega cisterna magna in a second fetus. In group 2, 12 fetuses had VM and other CNS anomalies on sonography. Additional findings were seen with MRI in 10 of these fetuses, including migrational abnormalities (n = 4), porencephaly (n = 4), and 1 diagnosis each of abnormal myelination, hypoplasia of the corpus callosum, microcephaly, a kinked brain stem, cerebellar hypoplasia, and congenital infarction. There were significantly more fetuses with additional CNS anomalies found by MRI among those in group 2 compared with those in group 1 (Fisher exact test, P = .001). CONCLUSIONS: Although sonography is an accurate diagnostic modality for the evaluation of fetuses with VM, MRI adds important additional information, particularly in fetuses in whom additional findings other than an enlarged ventricle are seen sonographically.     

Sonographic features of colonic Crohn's disease: comparison of in vivo and in vitro studies

The entire length of the colon, starting at the recto-sigmoid junction and ending at the cecum, can be sonographically visualized by retrograde water instillation into the colon. In order to evaluate the validity of colonic sonography as a diagnostic method, in vivo transabdominal ultrasound examination of the colon wall after water insufflation was compared with in vitro ultrasound examination of the same colon wall on four resected surgical specimens from patients with colonic Crohn's disease and four controls. The normal colon wall specimens were easy to recognize in that they had a thickness of 4 mm and five layers of different echo patterns, which could be demonstrated both in vivo and in vitro. On the other hand, in patients with Crohn's disease, a distinct wall thickening of up to 1.5 cm was found, and the typical five-layer stratification could no longer be recognized. The sonographic changes demonstrated in vivo and in vitro were thus comparable both in wall thickness and wall structural alterations. This study shows that transabdominal colonic sonography of the fluid-filled colon is a diagnostic method that permits a detailed and accurate assessment of the normal and the pathologically changed colonic wall.     

Sonographic monitoring of biliary endoprostheses

Biliary drainage by endoprosthesis, inserted either transcutaneously or endoscopically, is as effective and better supported than percutaneous drainage, but harder to control. Forty-four patients with biliary or pancreatic carcinoma treated by endoprostheses were followed up by ultrasound. Sonography was effective in the demonstration of the drainage effectiveness and the detection of prosthetic dysfunction or eventual complications. Consequently, it may be considered a valuable method to complement the biochemical tests in the monitoring of endoprostheses.     

Sonographic findings of Menetrier's disease: A case report

The ultrasonic images obtained in a patient with Menetrier's disease are presented. Identification of the normal gastric wall surrounding the whole organ and of giant mucosal folds projecting from the wall into a partially fluid-filled lumen led to the correct diagnosis.     

中枢神经系统感染致脑积水患者的脑脊液细胞学观察

目的：探讨中枢神经系统感染致脑积水患者的脑脊液细胞学检查的应用价值。方法：对12例中枢神经系统感染致脑积水患者脑室、腰穿引流的脑脊液进行细胞学检查。结果：9例结核性脑膜炎中7例为嗜中性粒细胞为主混合细胞反应，2例为淋巴免疫细胞反应；3例化脓性脑膜炎为淋巴细胞反应。结论：脑脊液细胞学检查对中枢神经系统感染致脑积水的性质及治疗方案的选择有相当重要的临床价值。     

Sonographic demonstration of portal venous system thromboses secondary to inflammatory diseases of the pancreas

Sonographic demonstration of abdominal venous thromboses subsequent to pancreatic benign inflammatory diseases has been seldom reported up to now. Seven cases of thromboses of the portal venous system associated with acute or chronic pancreatitis are reported. All cases were detected by sonography in patients without clinical manifestations of portal hypertension. Echogenic thrombus within the lumen of the vein was observed only in the short-term follow-up of acute pancreatitis. Cavernomatous transformation was observed in 6 patients with long-term calcifying pancreatitis. Extrinsic compression by pseudocyst of the pancreas was observed in only 1 case. In all the other cases, thromboses seems to be secondary to local inflammatory phenomena during previous episodes of acute pancreatitis.     

胎儿脑中线部位囊肿与侧脑室宽度的关系探讨

目的 观察透明隔腔（第五脑室）、Verga腔（第六脑室）扩张对侧脑室宽度的影响。方法 分别测量20例胎儿的透明隔腔，Verga腔及侧脑室的相关数据并进行相关分析。结果 第五脑室宽度、第六脑室长度与侧脑室宽度无相关性，第六脑室宽度与侧脑室宽度有相关性，且呈正相关。结论 第六脑室度度与侧室宽度有一定相关性。     

颈动脉彩色多普勒超声扫查对缺血性脑中风的应用探讨

目的探讨彩色多普勒超声扫查颈动脉，观察颈动脉斑块及斑块复合病变，对缺血性脑中风防治的意义。方法对56例经CT或MRI检查后，临床确诊的缺血性脑中风患进行彩色多普勒颈动脉扫查，扫查结果与对照组134例同年龄组非缺血性脑中风患颈动脉扫查结果相比较。结果56例缺血性脑中风组患全部检出颈动脉粥样斑块，并均有不同程度的管腔狭窄，斑块检出率100％，且94．6％的病例颈动脉斑块都存在斑块复合病变(溃疡斑、斑块内出血及继发血栓形成)；而对照组非缺血性脑中风患组检出颈动脉斑块仅7人，检出率5．2％，且未发现1例斑块复合病变。结论颈动脉粥样斑块及斑块的复合病变与缺血性脑中风紧密相关，颈动脉超声扫查是缺血性脑中风防治的重要检查手段，有其不可忽视的临床价值。     

Ultrasound diagnosis of renal calcification in infants on chronic furosemide therapy

We describe seven infants who developed renal calcification and bone demineralization following furosemide therapy with average daily doses of as little as 0.75 mg/kg per day. Renal calcifications were present in all seven cases and were more readily detected with ultrasonography than with plain films. Renal calculi were seen in four patients, sonographically demonstrated as echogenic foci in the dependent portion of the collecting system, usually accompanied by acoustic shadowing. One patient developed nephrocalcinosis, sonographically observed as echogenic medullary pyramids plus punctate, shadowing parenchymal calcifications. In two patients the location of the calcification could not be determined.     

Sonographic diagnosis of cholangitis in AIDS patients

Eleven acquired immunodeficiency syndrome (AIDS) patients were initially evaluated by ultrasound of the liver because of biochemical evidence of cholestasis. Sonography was very useful for demonstrating dilatation and/or wall thickening of the common bile duct associated with dilated intrahepatic bile ducts. Periportal hypo- or hyperchoic areas were also visualized. In seven patients, gallbladder walls were thickened. In six patients, the diagnosis of cholangitis was confirmed by endoscopic retrograde cholangiography and/or histology. Cytomegalovirus infection or digestive tract cryptosporidiosis were often present and accounted for diarrhea in most patients.We believe the association of upper right quadrant pain and anicteric cholestasis in the course of AIDS is suggestive of cholangitis, but a disparity may exist between mild symptoms and sonographically demonstrated extensive biliary involvement.