Color Doppler Sonography of Extradigital Glomus Tumors

We retrospectively collected cases of surgically proven extradigital glomus tumor (EDGT) and reviewed their demographic, clinical, and sonography features. A total of 18 single, subcutaneous EDGTs were gathered. All but one were located in the extremities. EDGTs typically appear as a small, hypoechoic, homogeneous, or slightly inhomogeneous, well‐delimited nodule, disposed horizontally and painful under probe pressure. Intranodular vascularization is always present. Feeding artery and efferent vein are typical but inconstant findings.     

Sonography of Plantar Warts

Objective. The purpose of this presentation is to show the sonographic morphologic characteristics of plantar warts and the scope of sonography in the treatment of these lesions. Methods. We retrospectively reviewed 27 sonographic examinations of the plantar region; 17 corresponded to plantar warts diagnosed by dermatologists in which the diagnoses were medically derived from sonographic examinations after failure of their treatments. The remaining group consisted of 10 healthy individuals. Sonograms were compared with standard histologic findings. Results. The sonographic features of normal plantar skin and plantar warts are described, including the shape, echogenicity, pattern of growth, involvement of skin layers, and blood flow in the lesions. Conclusions. Sonography may be considered as reliable support for plantar wart diagnosis and may have a role in the evaluation of plantar wart treatment modalities, allowing monitoring of therapeutic responses, especially in recurrent and difficult cases with persistent symptoms such as pain.     

超声造影在卵巢肿瘤诊断中的初步应用

目的评价超声造影对卵巢肿瘤的诊断和鉴别诊断价值。方法45例盆腔内子宫旁肿块进行常规超声和超声造影检查,用明确诊断、提示可能、不确定、不符合4个等级表示超声检查价值,比较常规超声与造影对各组肿块的有意义诊断率（明确诊断＋提示可能）和明确诊断率。结果非赘生性囊肿超声造影的有意义诊断率和明确诊断率明显增高,并有统计学显著差异（P〈0.05）;卵巢良、恶性肿瘤及子宫浆膜下肌瘤有意义诊断率提高,但无统计学差异;卵巢恶性肿瘤的明确诊断率提高,具有统计学差异（P〈0.05）。结论超声造影能显示卵巢肿瘤瘤体内微小血管的血流灌注,超声造影结合二维超声形态学特点能进一步提高超声对卵巢肿瘤的诊断和鉴别诊断价值。     

It's Not All Deep Vein Thrombosis: Sonography of the Painful Lower Extremity With Multimodality Correlation

The purpose of this pictorial essay is to review different etiologies for lower extremity pain encountered on lower extremity venous sonography including acute deep venous thrombosis, chronic postthrombotic change, central venous disease, common arterial pathologies, and nonvascular abnormalities.     

High‐Frequency Sonography in the Evaluation of Psoriasis

Objective. The purpose of this study was to show the potential of the latest sonographic equipment using high‐frequency probes and a very sensitive power Doppler (PD) technique in depicting both skin and nail changes in patients affected by psoriasis. Methods. The study was conducted in 30 patients with a diagnosis of psoriasis clinically performed by an experienced dermatologist and 15 healthy participants, using a currently available sonography system equipped with a variable‐frequency transducer ranging from 6 to 18 MHz and a Doppler frequency ranging from 7 to 14 MHz. Results. The images illustrated in this presentation are representative examples of the ability of sonography to show and characterize even minimal morphostructural and blood flow changes in patients with both psoriatic plaques and onychopathy. Conclusions. This report provides pictorial evidence that high‐resolution gray scale sonography with a PD technique is a real‐time and noninvasive imaging technique that can be used as an adjunct to the clinical evaluation in assessing psoriatic disease.     

三维超声透明成像技术的临床应用探讨

目的：探讨三维超声透明成像技术的临床应用价值。方法：使用Ｖｏｌｕｓｏｎ５３０Ｄ三维超声成像系统（三维容积探头,频率３．５／５．０ＭＨｚ）的三维超声透明成像技术对部分实质性脏器内部组织结构及中期妊娠的胎儿进行三维重建。结果：三维超声透明成像技术可整体显示实质性脏器（肝、脾等）内部组织机构,显示的血管、胆管或胎儿的脊柱、肋骨等结构完整连续,不受其曲率变化的影响;并可显示实质性脏器内病变组织与周围组织结构的空间位置关系。结论：多种透明成像技术（最小回声模式、最大回声模式、Ｘ线模式等）的出现大大丰富了三维超声的临床应用范围,三维超声也必将在临床上发挥更大的作用     

Prenatal detection of fetal aneuploidy by sonographic ear length.

OBJECTIVE: To determine the usefulness of a fetal ear length nomogram in the prenatal detection of fetal aneuploidy and to determine whether ear smallness in cases of aneuploidy is a primary or secondary event. METHODS: Ear lengths of 447 singleton fetuses (October 1996 to October 1997)were prospectively evaluated between 14 and 41 weeks to establish a nomogram created by modeling the mean and SD separately. Records of aneuploid fetuses were retrospectively reviewed, and their ear lengths were plotted against the nomogram to determine detection rates, with ear length in or below the 10th and 50th percentiles for a given gestational age and biparietal diameter used as abnormal cutoffs. RESULTS: The nomogram for fetal ear length measurements provided sufficient data to derive the 10th, 50th, and 90th percentiles on the basis of gestational age and biparietal diameter. The ear length of euploid fetuses was significantly correlated with gestational age (R2 = 0.96; P < .001) and biparietal diameter (R2 = 0.95; P < .001). From 96 aneuploid fetuses identified, 63 had ear lengths in or below the 10th percentile for gestational age (sensitivity, 66%). When using ear length against biparietal diameter, the sensitivities for all aneuploid fetuses for cutoffs at or below the 10th and 50th percentiles were 43% (40 of 93) and 83% (77 of 93), respectively. CONCLUSIONS: Most aneuploid fetuses have sonographically small ears (< or = 10th percentile for gestational age). This smallness is not entirely related to overall small fetal size, but in almost half the cases, the fetal ear length is disproportionately smaller than the biparietal diameter.     

Sonography of intramuscular myxomas: the bright rim and bright cap signs.

OBJECTIVE: The objective of this study was to retrospectively review sonographic images of pathologically proven soft tissue myxomas to determine whether a sonographic correlate to the bright rim and bright cap signs described in the magnetic resonance imaging literature is present. METHODS: The study group consisted of 6 patients with pathologically proven soft tissue myxomas (1 man and 5 women; age range, 41-72 years; mean, 56.5 years). The available sonographic images for each subject were retrospectively reviewed by 2 authors (L.F. and K.F.), with agreement reached by consensus. Among other findings, images were also reviewed for a peripheral rim of increased echogenicity (termed the "bright rim sign") and for the presence of a triangular hyperechoic area adjacent to at least one of the poles of the mass (termed the "bright cap sign"). RESULTS: The bright rim and bright cap signs were seen in 5 (83%) of the 6 myxomas. The single case without the bright cap sign was not the same case as the one lacking the bright rim sign. CONCLUSIONS: The sonographic bright rim and bright cap signs were associated with 5 (83%) of the 6 intramuscular myxomas. These findings correlate with their magnetic resonance imaging equivalents, which are well documented in the literature, due to muscle atrophy and adjacent fatty infiltration. Recognition of these features may assist in a more accurate sonographic diagnosis before biopsy.     

Sonography of the gastrointestinal tract.

OBJECTIVE: The purpose of this presentation is to provide an overview of sonographic manifestations of various gastrointestinal diseases. METHODS: Patients were scanned with an HDI 3000 or HDI 5000 system (Philips Medical Systems, Bothell, WA) with both a 2- to 5-MHz curvilinear transducer and a 5- to 12-MHz linear transducer. The patients were asked to fast from the previous night. For accurate visualization of the stomach, a cup of water was given to patients thought to have stomach or upper gastrointestinal disease. RESULTS: A satisfactory sonographic examination could be performed in all patients. CONCLUSIONS: With recent technical advances, the increasing use of sonography in initial evaluation of patients with abdominal pain may allow earlier detection of bowel disease.     

胃肠道间质瘤彩色多普勒超声诊断及临床分析

目的探讨胃肠道间质瘤（GIST）彩色多普勒超声表现及其在诊断中的应用价值。方法回顾性分析2008年1月-2010年7月75例经病理证实的GIST的彩色多普勒超声声像图表现,将其与手术病理结果进行对比分析。结果 GIST患者中男性高危险度肿瘤的比例较女性高（χ^2=7.210,P〈0.01）。肿瘤的大小、内部回声与其病理危险度高低有关：危险度低者、肿瘤最大径〈5cm,内部回声较均匀;危险度高者,肿瘤最大径≥5cm,内部回声不均匀。肿瘤的彩色血流分布与其危险度高低无明显相关。常规的超声检查对肿瘤检出率较高,在胃及直肠的GIST诊断准确率高于其他部位的GIST。结论彩色多普勒超声检查有助于GIST的定位及分化程度的判断,可作为首选检查方法。     

静态结构三维超声表面成像技术的临床应用探讨

目的：探讨三维超声表面成像技术的临床应用价值。方法：本文利用三维超声表面成像技术对６２例患者进行三维重建,所用仪器为Ｍｅｄｉｓｏｎ／Ｋｒｅｔｚ公司产Ｖｏｌｕｓｏｎ５３０Ｄ三维超声成像系统。探头为凸阵三维容积探头,频率３．５／５．０ＭＨｚ。结果：三维超声表面成像可显示含液性病变或组织结构内部感兴趣区或内壁结构的细微特征;对被液体包绕的组织结构利用表面成像模式能显示感兴趣区域的外部结构特征,包括轮廓、边缘、形态、表面光滑或细腻程度等指标。结论：三维超声表面成像可以提供较二维超声更为丰富的诊断信息。     

Sonography and Transthoracic Echocardiography for Diagnosis of Systemic Cardiovascular Metastatic Tumor Thrombi

Sonography and transthoracic echocardiography (TTE) are seldom used for assessment of metastatic tumor thrombi in the cardiovascular system in routine clinical practice. We performed this retrospective study to evaluate the combination of sonography with TTE for diagnosis of metastatic tumor thrombi in heart and systemic vessels. Vascular, abdominal, pelvic, and small‐part sonography was applied in 18 patients, and TTE was conducted simultaneously in 14 patients. Tumor thrombi invaded into the inferior vena cava system in 12 patients, superior vena cava system in 5 patients, and aorta in 1 patient; they extended to the right cardiac chambers in 11 patients. Six patients had diagnoses by pathologic examination. The primary neoplasms were identified by conventional imaging in 17 patients. The morphologic and echogenic characteristics of the tumor thrombi were diverse and depended on their original tumors. The thrombi were either contiguous or discrete from the original tumors. The neoplastic vascularity of the thrombi and the invasive extension were the primary characteristics that distinguished them from bland thrombi. Simultaneous application of sonography and TTE is a feasible way to comprehensively evaluate cardiovascular metastatic tumor thrombi in most patients.     

Targeted Musculoarticular Sonography in the Detection of Joint Effusions

This article describes an advanced application for an established technology, specifically the use of bedside sonography in the assessment of the acutely painful joint in the emergency department. The sonographic windows for each of the axial synovial joints are outlined, with a brief discussion of commonly encountered pathologic conditions.     

Sonography for diagnosis of cervical ribs in children.

OBJECTIVE: The purpose of this series was to describe the use of sonography for diagnosis of cervical ribs in children. METHODS: Two children had hard nonmobile supraclavicular masses that were of clinical concern for malignancy. Both children were first evaluated by sonography. RESULTS: Sonography showed each mass to be a tubular bony structure with a cartilaginous end. They were thought to represent cervical ribs. This anatomic variant was subsequently confirmed with radiography in 1 case and computed tomography in the other. CONCLUSIONS: Musculoskeletal sonography may offer a reliable method for diagnosing cervical ribs without the need for ionizing radiation.     

胎儿外耳畸形的三维超声观察

正胎儿外耳畸形居出生缺陷第五位~([1]),其发病率近年明显上升,临床上中耳、外耳畸形常同时发生,外耳的畸形程度间接反映了中耳的畸形程度~([2])。本组通过分析20例外耳畸形胎儿的声像图特征,旨在提高三维超声对胎儿外耳畸形的诊断水平。资料与方法一、临床资料选取2014年3月至2016年7月在我院规律产检并分娩的孕妇21 856例,年龄18~46岁,平均(27.6±2.6)岁;诊断时孕     

Sonography in renovascular hypertension.

OBJECTIVE: To familiarize practitioners with different sonographic manifestations of renal artery compromise and the sonographic techniques for renal artery imaging. METHODS: Approximately 1500 examinations evaluating for renal artery disease are performed in our vascular laboratory every year. Most of the patients have the symptoms of hypertension (possibly related to renovascular etiology) and renal insufficiency. From our cumulative experience, the optimal scanning techniques are defined for each renal artery, for extrarenal versus intrarenal vascular evaluation, and for patients with different body habitus. We have also tabulated our technical success rate. Cases with sonographic evidence of renal artery compromise are identified. The validity, sensitivity, and specificity of different parameters are examined. RESULTS: We achieve an approximately 75% to 80% success rate in obtaining technically adequate studies. We have not found the tardus-parvus waveform evaluation to be as valuable as direct interrogation of the renal artery. CONCLUSIONS: Duplex/color Doppler sonography serves a vital role in the diagnosis of renal artery stenosis and occlusion; it has an excellent correlation with contrast-enhanced angiography. It is also used for intraoperative or postrevascularization surveillance to show evidence of recurring stenosis, thrombosis, and other complications.     

Sonography of Non‐neoplastic Disorders of the Hand and Wrist Tendons

Tendon disorders commonly cause hand and wrist disability and curtail the performance of work‐related duties or routine tasks. Imaging is often needed for diagnosis, but it requires knowledge of the complex anatomic structures of the tendons of the hand and wrist as well as familiarity with related disorders. This review article aims to provide medical professionals with guidelines for the sonographic assessment of the tendons of hand and wrist and related disorders. Sonographic features of tendon disorders affecting the hand and wrist are described here, specifically: infectious tenosynovitis; tendon rupture or tearing; stenosing forms of tenosynovitis such as De Quervain disease and trigger finger; intersection syndrome; insertional tendinopathy; several forms of tendinous instability such as extensor carpi ulnaris instability, climber finger, and boxer knuckle; and tendinopathy in inflammatory rheumatic diseases. Postsurgical evaluation of the hand and wrist tendons is also discussed, including the healthy and pathologic appearances of operated tendons as well as impingement from orthopedic hardware. In conclusion, sonography is effective in assessing the tendons of the hand and wrist and related disorders and represents a valuable tool for diagnosis.