Gray scale echographic patterns of hepatic metastatic disease.

Abnormal gray scale hepatic echograms in 76 patients with known or suspected metastatic disease were reviewed. A varied echographic pattern was found, with the gray scale appearances falling into three identifiable categories (dense, lucent, and bulls-eye) and a fourth group difficult to characterize. Prior chemotherapy seemed to have little consistent effect on echographic patterns. A pattern of dense lesions was associated in a large percentage of cases with adenocarcinoma. Carcinoma of the colon commonly produced this appearance. The remaining echographic patterns showed little correlation with specific primary sites or cell types.     

Gray scale ultrasound evaluation of popliteal artery aneurysms.

GRAY SCALE B-scan ultrasonography is accurate in identifying and assessing morphologic features of popliteal artery aneurysms. Eight patients with suspected popliteal aneurysms had 12 aneurysms demonstrated by ultrasonography, including two not visualized by arteriography due to proximal occlusive disease and three covert aneurysms opposite a contralateral palpable popliteal mass. Half the patients had bilateral aneurysms demonstrated by ultrasonography. Popliteal artery ultrasonography is useful to: (1) evaluate suspected aneurysms in patients who cannot or should not be subjected to invasive arteriographic studies or operation; (2) confirm or refute equivocal diagnoses of aneurysms generated by arteriographic studies or physical examination; (3) detect contralateral clinically covert aneurysms or small aneurysms in patients with generalized extrapopliteal aneurysmal diseases; (4) delineate the extent of intraaneurysmal thrombus and determine exact aneurysm size in all dimensions; and (5) define a thrombosed aneurysm or one noe opacified because of limited contrast material passing through proximally obstructed arteries. The latter two uses of ultrasonography represent significant advantages over arteriography.     

Gray scale ultrasound: evaluation of iliopsoas hematomas in hemophiliacs.

Because of its insidious nature, intramuscular bleeding, in contrast to hemarthrosis, is missed or belatedly recognized in hemophiliacs. Sixteen patients with suspected iliopsoas bleeding were studied by gray scale ultrasonography. In 12 patients it was possible to confirm the diagnosis of iliopsoas hematoma because of enlargement and rounding of the psoas muscle.     

Gray scale ultrasonographic evaluation of hepatic cystic disease.

Eight patients with various forms of hepatic cystic disease studied with gray scale ultrasonography are described. Four had solitary cysts, two had multiple simple liver cysts, and two had congenital polycystic liver and kidney disease. The spectrum of ultrasonographic features in benign cystic disease of the liver is discussed. All eight patients were felt to have malignant disease in the liver prior to ultrasonographic evaluation. The value of gray scale ultrasound as a noninvasive means of differentiating cystic disease from suspected metastatic disease is emphasized.     

Gray scale ultrasonography of adrenal neoplasms.

Ultrasonic characteristics of 21 adrenal neoplasms (19 patients) examined by gray scale ultrasonography are reviewed. The significance of the adrenal-renal cleavage plane is discussed. In our experience the cleavage plane only has definite localization value when it separates the adrenal gland from the kidney on all ultrasonographic sections. Compression of the posterior wall and/or anterior displacement of the inferior vena cava was seen in about two-thirds of the right adrenal tumors. The difficulty in examining left adrenal masses is emphasized. Ultrasonography has proved to be an excellent screening procedure for adrenal tumors.     

Gray scale ultrasound of the parotid gland

Gray scale ultrasonography permits markedly improved visualization of the parotid gland compared with bistable methods. The normal parotid is echogenic, similar in echo generation to thyroid tissue, but flatter anatomically. Ultrasound can detect a mass lesion in the area of the parotid gland and define whether it is intrinsic or extrinsic, but as yet has limited usefulness in determining the specificity of an abnormality.     

Gray scale ultrasonography of the gallbladder: an evaluation of accuracy and report of additional ultrasound signs.

Ultrasound examinations of 76 patients with suspected gallbladder disease were compared with radiographic, surgical, and pathologic findings to determine the accuracy of the ultrasound examinations. In 13 of the 76, the gallbladder was not visualized by ultrasound. Diagnosis of the presence or absence of gallstones was correctly made by ultrasound in 56 of 63 visualized gallbladders, for an accuracy rate of 89%. A high proprtion of nonvisualized gallbladders (10 or 13) contained gallstones. Previously unreported ultrasound findings of a stone impacted in the proximal cystic duct and findings of a collection of bile in the lesser sac associated with cholelithiasis and choledocholithiasis are illustrated.     

Gray scale ultrasound diagnosis of obstructive biliary disease.

B-mode ultrasound examinations have been useful in demonstrating cholelithiasis and obstructive dilatation of the gallbladder. It is now possible with gray scale ultrasound technique to demonstrate dilatation of the common bile duct, as differentiated from the gallbladder, and also to show fluid containing spaces within the liver. Discrimination between solid and fluid filled intrahepatic structures is readily made, and dilated biliary radicles are frequently discernible.     

肝血管瘤超声造影表现

目的:探讨肝血管瘤超声造影(contrast enhanced ultrasound,CEUS)的表现。方法:应用对比剂Sonovue及对比脉冲序列成像(contrast pulse sequenuce sound,CPS)技术对25例28个肝血管瘤进行超声造影检查,观察对比剂在动脉期、门脉期及延迟期的增强表现。结果:26个(92.9%)病灶动脉期呈环状增强伴附壁结节或球状突起,门脉期呈缓慢向心性充填,21个病灶呈完全充填,5个病灶呈不完全充填,延迟期与周围肝实质期比呈相对高增强;另2个(7.1%)病灶动脉期、门脉期及延迟期均无增强。结论:超声造影肝血管瘤的典型增强表现为动脉期环状增强,门脉期缓慢向心性充填,延迟期呈高增强。     

Gray scale ultrasound and isotope scanning: complementary techniques for imaging the liver.

Technical advances in gray scale ultrasound have led to better signal-to-noise ratios and improved resolution. A display of the texture of the liver is now possible, making ultrasound an important complementary technique to radioisotope scanning. In the positive radioisotope scan, ultrasound permits differentiation of isotopically cold areas into neoplasms, benign cysts, and abscesses. In addition, when the radioisotope scan is equivocal, ultrasound is invaluable in differentiating normal variants from disease states. Dilated intrahepatic ducts can also be identified. Examples of the use of ultrasound in defining radioisotope abnormalities are presented.     

Ultrasonographic studies in hepatic neoplasms: patterns and comparisons with radiological contrast studies

A prospective blind study of 100 patients with hepatic neoplasms was performed using the grey-scale linear-array ultrasonographic technique. Seventy-four patients had hepatocellular carcinoma, eight had cholangiocarcinoma, 17 had metastases and one had haemangiosarcoma. The overall diagnostic accuracy was 96%, comparable to the 98% diagnostic accuracy of other radiological studies which were performed in 70 patients. The sites and extent of the lesions and the state of the portal system were identical in both the ultrasonographic and radiological contrast studies. No false positives were found in 254 patients who had ultrasonography of the liver for non-maligant disorders during the period of study. We conclude that linear-array ultrasonography is a simple, sensitive, specific and non-invasive procedure for the investigation of suspected hepatic neoplasms and is useful in assessing operability.     

Gray scale ultrasound imaging. The anatomy and pathology of the liver.

Gray scale ultrasound imaging circumvents some of the limitations of other diagnostic tools. The authors have extended this technique to the investigation of hepatobiliary disease. The details of their equipment are described and their results in relation to various parameters of the disease are discussed. A major feature of the gray scale technique is the enhanced signal-noise ratio, which allows low-level echoes to be displayed.     

Gray scale ultrasound and the genitourinary tract. A review of clinical applications.

Diagnostic ultrasound has many well established indications in the evaluation of genitourinary tract disease. Musch of this information complements or corroborates findings derived from other investigations. The role of ultrasound as a primary diagnostic modality is still evolving, but it appears to be useful in a variety of clinical situations, especially in azotemia, suspected hydronephrosis, and renal transplantation. Ultrasound also has a place in the evaluation of the retroperitoneum, the perirenal space, and the adrenal glands, and preliminary work suggests a role in prostatic and testicular abnormalities as well. State of the art prospective comparisons with computed tomography need to be made in many of these areas before the precise role of ultrasound can be defined.     

Current role of ultrasound in chronic liver disease: surveillance, diagnosis and management of hepatic neoplasms

Ultrasound (US) has been used to evaluate liver disease for many decades. Despite certain inherent limitations in evaluating chronic liver disease on routine gray-scale US, it is still widely used for the initial evaluation in patients suspected of liver disease as well as for hepatocellular carcinoma (HCC) screening in patients with known cirrhosis. Due to recent advances in digital technology and US imaging software, various new computer protocols have been incorporated in the new US equipment. This in turn has resulted in a great improvement in image quality and image resolution. Consequently, the increased ability of US to better characterize the liver texture in general has enabled the sonographers to identify subtle changes in the liver texture and delineate smaller masses in the liver with greater success.