Sonographic and color Doppler findings of rupture of liver tumors

We present six cases of ruptured liver tumor (hepatocellular carcinoma, five cases; liver metastasis, one case) in which gray-scale sonography revealed an ascites containing constantly moving dense high-echo spots, leading to a high suspicion of acutely developing hemoperitoneum. Color Doppler sonography helped in detecting the rupture site by demonstrating a high-velocity jet flow from it. Although four of six patients were dead within 3 months, detection of the rupture site by color Doppler sonography made the initial transarterial embolization therapy easy and prompt. Received: 17 June 1997/Accepted: 6 August 1997     

乳头溢液性疾病的超声征象与乳管内窥镜检查结果的对比分析

目的 评价超声对乳头溢液性疾病的临床诊断价值.方法 对57例乳头溢液性疾病患者分别行超声和乳管内窥镜检查,将超声征象与乳管镜结果进行对比分析.结果 超声对乳头溢液性疾病阳性征象诊断率为96.49%:导管扩张27例(47.36%),实性肿物伴导管扩张或囊肿19例(33.33%),囊性回声6例(10.52%),实性回声3例(5.26%),超声无异常征象2例(3.51%).乳管镜诊断:乳腺导管炎26例(45.61%),导管扩张症12例(21.05%),导管内乳头状瘤或乳头状瘤病17例(29.82%),乳腺癌2例(3.50%).超声对实性病变的诊断敏感性为52.63%,特异性为89.47%,误诊率为10.50%,漏诊率为47.36%.结论 超声对乳头溢液性疾病有较高的敏感性,但对此类疾病中实性病变的漏误诊率较高.     

Sonographic findings of uterine rupture with expulsion of the fetus into broad ligament

We report the sonographic findings of a rare case of uterine rupture with extrusion of the fetus into the broad ligament during a second-trimester abortion. Sonography revealed the empty uterus with an indistinct defect on the side wall and the dead fetus lying outside, surrounded by a thin membrane. At surgery, the uterine rupture was confirmed with the fetus lying in the broad ligament. This study shows the importance of timely sonography in second-trimester abortion, enabling immediate management and preventing further complications.     

Prescriptive arm ergometry to optimize muscular endurance in acutely injured paraplegic patients

This study compared the effect of (1) continuous, (2) intermittent, and (3) graded exercise on the cardiopulmonary responses of 12 acutely injured paraplegic individuals having neurologically complete spinal lesions, between T7 and T12, and seven able-bodied control subjects. Continuous exercise consisted of cranking an arm ergometer at a constant rate of 30W. Intermittent exercise consisted of arm ergometry at 60W for 30-second periods interspersed with 30-second rest periods. In graded exercise, subjects worked for consecutive two-minute periods at rates of 10, 20, 30, 40, and 50W with no rest periods between work periods. Subjects exercised for 10 minutes or until they reached subjective fatigue. Heart rate (HR) and oxygen consumption (VO2) were measured during rest and work. Paraplegic subjects performed 4.93, 4.89, and 4.95 watt-hours of continuous, intermittent, and graded exercise respectively. Comparable figures for control subjects were 4.98, 4.91, and 4.96 watt-hours. There was a high degree of correlation between HR and VO2 in both paraplegic (r = 0.80) and normal (r = 0.85) subjects. Both VO2 and HR were highly correlated with work load in each group. Paraplegic subjects had significantly higher HRs (p less than 0.001), respiratory quotients (p less than 0.05), and ventilatory volumes (p less than 0.05) than control subjects. Graded exercise produced a significantly higher HR than continuous or intermittent exercise (p less than 0.001) during the final data collection period. Oxygen consumption during graded exercise was higher than VO2 for continuous or intermittent exercise (p less than 0.01) during the final data collection period.(ABSTRACT TRUNCATED AT 250 WORDS)     

Sonographic evaluation of bladder volume in diabetic children and adolescents compared with nondiabetic subjects.

OBJECTIVES: An increase in volume and evidence of postvoiding residuals are both encountered in the bladder of diabetic patients and can lead to urinary tract infections and impair renal function. Our objective was to compare the bladder volume of diabetic children and adolescents with that of nondiabetic subjects. METHODS: We investigated 247 diabetic patients and 228 control subjects between the ages 3 and 21 years. The sonographic examination was performed with a full bladder, after spontaneous voiding, and after forced voiding. Three dimensions were determined: longitudinal, transverse, and anteroposterior transverse. The data were analyzed by the Chi2 test, analysis of variance, the Kruskal-Wallis test, and multivariate regression. RESULTS: The 2 groups were equivalent for age (P =.56) and sex (P =.82). The median full bladder volume was larger in the diabetic group (268 mL) than in the control group (220 mL; P =.0004). Postvoiding residual volume after spontaneous and forced voiding was significantly higher in the diabetic group (P <.0001). Multivariate analysis showed that being diabetic (P =.021), older than 9 years (P =.000), and female (P =.036) all influenced full bladder volume. CONCLUSIONS: Sonographic evaluation showed incipient bladder dysfunction in diabetic patients. The multivariate analysis showed that the increase in bladder volume had a association with age (>9 years), female sex, and mean glycosylated hemoglobin value. Thus, bladder volume evaluation by sonography should be incorporated in the routine assessment of patients with type 1 diabetes.     

Sonographic findings in cases of missed gallstones

PURPOSE. We retrospectively evaluated sonographic findings in 946 cases of gallstones to determine whether the false-negative rate for gallstone detection by sonography has decreased as a result of technologic advances over the past 15 years. METHODS: We reviewed preoperative sonographic reports, operative notes, and pathologic reports for 614 women and 332 men (ages 22-78 years) seen over a 2.5-year period and compared sonographic findings with surgical pathologic findings after cholecystectomy. Sonograms for patients whose gallstones were missed on sonography were reviewed by 3 board-certified radiologists. RESULTS: Preoperative sonography of the gallbladder accurately predicted the presence of gallstones in 934 cases (98.7%). Gallstones were not identified by sonography in the remaining 12 cases. In those cases, sonography revealed polyps in 5, sludge in 5, sludge plus a polyp in 1, and neither stones nor polyps in 1. Thus, the false-negative rate was 1.3%. CONCLUSIONS: Despite improvements in sonographic technology, detection of small gallstones remains difficult in some cases. Adherent gallstones can mimic gallbladder polyps. Our false-negative rate for detection of gallstones was no different from that in earlier studies.     

Sonographic findings in milk of calcium bile

The ultrasound findings in 2 cases of milk of calcium bile are reviewed. Although the plain film findings of milk of calcium bile are characteristic, the sonographic findings are variable and can lead to confusion with other disease processes. The composition and pathologic significance of milk of calcium bile are discussed.     

Sonographic findings of intraabdominal foreign bodies due to retained gauze

The ultrasonic images obtained in 2 patients with retained gauze in the abdomen are presented. Identification of a cystic mass with highly irregular internal echoes in patients with previous laparotomy should alert the radiologist to the possibility of foreign body retention.     

Sonographic findings in a case of scrotal lymphangioma

The scrotum is an extremely rare site for lymphangioma. We report the case of a scrotal lymphangioma in a 20‐year‐old male patient who developed painless scrotal swelling. Typical sonography and MRI findings are shown. Surgical excision and histopathology confirmed the diagnosis. © 2013 Wiley Periodicals, Inc. J Clin Ultrasound 42:234–236, 2014     

用磁共振扩散张量成像研究犬急性脊髓损伤后可降解支架及神经干细胞移植的作用

目的用磁共振扩散张量成像(DTI)观察犬急性脊髓损伤后可降解支架及神经干细胞移植的作用.方法制作犬T13脊髓左半横断损伤模型.将18只犬分为假手术组(1)、对照组(5)、支架组(5)和干细胞组(7).假手术组不损伤脊髓.对照组仅损伤脊髓,不做移植.损伤后1周时,干细胞组将填充Hoechst标记的神经干细胞的可降解支架植入损伤区;支架组仅植入可降解支架.分别于损伤前、损伤后1周、移植后1周(即损伤后2周)、移植后4周及移植后8周时行MRI检查,用DTI测量损伤侧和未损伤侧的表观扩散系数(ADC)值及部分各向异性(FA)值,并对结果进行统计学分析.DTI用SSFSE序列,b=500 s/mm2,扩散敏感梯度方向为13.结果损伤前,脊髓左右两侧对比,ADC和FA值的差异无统计学意义.损伤后ADC值升高,FA值降低,随时间延长而逐渐恢复,干细胞组恢复更明显.移植后4周时,对照组脊髓左右两侧的ADC值和FA值的差异有统计学意义,支架组和干细胞组脊髓左右两侧的ADC值和FA值的差异无统计学意义.结论DTI对实验性脊髓损伤后脊髓损伤和修复过程的观察能提供有价值的信息.     

Sonographic findings of necrotizing fasciitis in the breast

Necrotizsing fasciitis is a rapidly developing, fatal bacterial infection of deep subcutaneous tissues. It may occur at any site in the body. We describe a case of necrotizing fasciitis in the breast that was diagnosed on the basis of sonographic findings. Sonographic examination revealed fluid collection in deep tissues with bright echoes likely to represent gas microbubbles. The diagnosis of necrotizing fasciitis was subsequently confirmed on surgical exploration.     

Sonographic findings of hepatic lesions in human fascioliasis

PURPOSE: The aim of this retrospective study was to analyze the sonographic features of hepatic lesions in patients with fascioliasis to help determine the utility of sonography in diagnosing this disorder in patients from areas in which Fasciola hepatica infestation is endemic. METHODS: Seven patients with acute-phase (hepatic) fascioliasis had been identified among a previously reported series of 37 patients with fascioliasis who had been evaluated sonographically at Donostia Hospital in San Sebastián (Guipúzcoa), Spain. The 4 men and 3 women ranged in age from 29 to 69 years (mean, 49 years). A history of ingestion of watercress had been confirmed in 6 of the patients. RESULTS: Sonographically, the hepatic lesions appeared as focal areas of increased echogenicity in the right lobe (2 cases), multiple nodular or irregular lesions of variable echogenicity, ranging from 5 to 25 mm in diameter, in both lobes (4 cases), and a single 6-cm complex mass in the right hepatic lobe (1 case). Therapy with dehydroemetine, praziquantel, or bithionol resulted in complete remission, although 2 patients required an additional treatment cycle. One patient also underwent surgery. CONCLUSIONS: Sonography can be useful in the detection and follow-up of hepatic lesions in human fascioliasis and can facilitate the diagnosis of this condition, particularly in areas where it is endemic.     

Sonographic findings of hepatic venous gas in association with spontaneous rupture of a Klebsiella pneumoniae liver abscess: a case report

Hepatic venous gas (HVG) is a very rare ultrasonic finding, and it is defined as abnormal accumulation of gas in the hepatic venous system. Various diseases can cause HVG, and femoral venous catheter is the most common cause. We, herein, present the case of a 79-year-old female patient with HVG that was caused by spontaneous rupture of a Klebsiella pneumoniae liver abscess. This was first found by bedside ultrasonography. On the basis of the blood culture results, imipenem–cilastatin and cefoperazone sulbactam were administered and the effect was acceptable. After 41 days of antibacterial and symptomatic treatment in the hospital, the patient had recovered well and was discharged. All of the previous reports on HVG have been summarized by thoroughly reviewing the previous published work. Overall, this is the first patient with HVG in association with spontaneous rupture of a K. pneumoniae liver abscess, and it might provide insights for future studies regarding the treatment of this disease.     

结节性肝寄生虫感染的声像图特征

目的　探讨结节性肝寄生虫感染性病变的二维及彩色多普勒特征及病理组织学基础。方法分析了经超声引导下穿刺活检病理证实的 11例患者 16个直径 3cm以下的结节性肝寄生虫病变的二维及彩色多普勒声像图特征 ,并与病理结果进行对照。结果　 11例患者共 16个结节 ,其中单发结节 7例 ,2个结节 3例 ,3个结节 1例 ;病变形态多不规则 ,5例呈较均匀低回声 ,6例呈混合性回声 ,低回声中混有点状高回声 ,肿块一般边界清楚 ,但无包膜或包膜不完整 ,周边无低回声暗环。CDFI显示病灶内血流不丰富 ,11例中仅 1例于病灶内引出低速动脉血流 (12cm /s)。 6例低回声为主的混合性回声结节的活检标本镜下为以嗜酸性白细胞为主的大量炎细胞浸润 ,3例伴组织凝固性坏死 ,2例于坏死组织中找到夏科 -莱登结晶。 5例低回声结节均为较均匀的组织凝固性坏死。结论　肝脏 <3cm结节性寄生虫感染一般表现为肝内的实性病变 ,以不均匀低回声或低回声多见 ,边界多不规则 ,无完整包膜 ,CDFI检查肿块内多无血流信号。上述特征有利于与肝恶性病变区别 ,鉴别诊断困难者超声引导下穿刺活检是确诊的必要手段     

Sonographic findings in solitary schwannoma of the breast.

Solitary schwannoma is a benign neoplasm of Schwann cell origin, most frequently occurring in the extremities and the trunk and head regions. The breast is a very unusual site for this tumor. We report a case of benign schwannoma of the breast in a 76-year-old woman. The palpable mass was localized in the lower outer quadrant of the right breast. This intramammary schwannoma appeared sonographically as a well-circumscribed, hypoechoic, slightly inhomogeneous solid mass. Microscopically, it had a pattern similar to that of schwannoma at other sites.