Assessment of catheter placement and patency by color Doppler ultrasonography.

Catheter placement and follow-up, including patency check, usually is required in patients with serious conditions, who often cannot be brought to the Radiology Department for the procedure. In a series of 24 consecutive patients, we show the usefulness of color Doppler ultrasonography with its advantages of portable equipment, lack of ionizing radiation, improved catheter visualization, and ability to determine patency.     

Increased Rotational Mobility of the Testis After Vasectomy

Objective. The purpose of this study was to evaluate for increased mobility of the testis in postvasectomy patients by observing changes in the position of the testis‐epididymis complex (TEC). Methods. This was a retrospective study of 29 postvasectomy patients compared with 29 control patients without a history of vasectomy who were referred for scrotal sonography for various clinical indications over a 1 year‐period. The position of the TEC was compared between the two groups. Results. The post‐vasectomy group had medial or posteromedial rotation in 13 of 58 testes (22%) compared with 3 of 58 (5%) in the control group. Conclusions. Our study found a statistically higher incidence of medial rotation of the testis in the vasectomy group compared with the control group. Given our findings, it seems reasonable to assume that iatrogenic changes to the structural support mechanism of the testis occur when vasectomy is performed, with a resultant increase in the mobility of the testis within the scrotum.     

Use of ultrasonography in the patient with acute renal trauma.

The purpose of this study was to assess the use of emergent ultrasonographic examination in acute traumatic renal injuries. Over a 3 year period, prospective data of all patients who had an emergency ultrasonogram were recorded. Thirty-two patients with 37 renal injuries were studied retrospectively to identify in how many patients the sonogram detected free fluid or a renal parenchymal abnormality. Free fluid in the abdomen was identified in 19 of 32 patients (59%). However, 12 of these 19 patients had concomitant injury, such as splenic rupture requiring splenectomy, severe liver lacerations, or bowel lacerations requiring repair, that were possible causes of the free fluid. Eliminating these patients, only seven of 20 patients with isolated renal injuries had free fluid in the abdomen (35%), whereas 13 of 20 patients (65%) had no evidence of free fluid. All seven patients with free fluid had moderate or severe renal injuries. Renal parenchymal abnormalities were identified on ultrasonograms in eight of 37 (22%) of injured kidneys. The abnormalities were detected more commonly in cases of severe injury (60%). In conclusion, acute injuries of the kidney from blunt abdominal trauma often are associated with significant splenic, hepatic, or bowel trauma. Isolated renal injuries frequently occur without the presence of free fluid in the abdomen. Furthermore, the ultrasonogram of the kidney often is normal with acute renal injuries, but it is more likely to be abnormal with severe (grade II or greater) renal injuries. Sonography may be used in the triage of patients with blunt abdominal trauma and possible renal injury. However, a negative ultrasonogram does not exclude renal injury, and, depending on clinical and laboratory findings, other imaging procedures such as computed tomography should be performed.     

Computed tomography in the diagnosis of dysplasia epiphysealis hemimelica

Dysplasia epiphysealis hemimelica (Trevor-Fairbank's disease) is a rare anomaly that must be differentiated from other epiphyseal and periepiphyseal abnormalities. Computed tomography is extremely useful in diagnosing and defining the extent of this dysplasia, as well as in assisting the surgeon in planning definitive treatment.     

Endometrial and endocervical micro echogenic foci: sonographic appearance with clinical and histologic correlation.

OBJECTIVE: The purpose of this research was to determine the clinical and histologic importance of small echogenic foci seen in the endometrium/endocervix on pelvic sonography. METHODS: A retrospective study was performed on 62 women, aged 28 to 81 years, who had echogenic foci of the endometrium and endocervix. Patients' medical records were accessed to review pertinent obstetric and gynecologic information. Additionally, histopathologic slides from patients who underwent diagnostic procedures (endometrial biopsy or dilation and curettage) or hysterectomy were reviewed. RESULTS: The clinical information for the 62 women included the following: mean age, 49 years; history of exogenous hormonal use, 84%; prior abortion (therapeutic or spontaneous), 57%; prior dilation and curettage, 56%; prior cesarean delivery, 28%; and sexually transmitted disease, 36%. The initial finding of echogenic foci was followed by ultrasound examinations in 18 patients for a mean interval of 16 months. Of the 18 patients, the foci remained unchanged in 13 women and disappeared or became less prominent in the other 5. Histopathologic results were available in 28 women, and microcalcifications were found in 15 of them. The etiology most common was microcalcification but also included crystals, debris from laminaria, and ossified tissues. Clinical follow-up in 62 patients showed that this condition was mostly benign (endometrioid carcinoma developed in 1 patient). CONCLUSIONS: Histopathologic studies showed microcalcifications, which are the most common cause of echogenic foci. The foci were stable with time and seemed to be an incidental finding associated mostly with benign conditions. The etiologic factors for echogenic foci may be numerous.