Focal liver masses: differential diagnosis with pulsed Doppler US

Duplex Doppler ultrasound (US) was used in 68 consecutive patients with focal liver lesions, including 12 hepatocellular carcinomas, one cholangiocarcinoma, 37 metastases, 15 hemangiomas, one hemangioendothelioma, and two focal nodular hyperplasias. Of the hepatocellular carcinomas, six were diffusely hyperechoic, two were hypoechoic, two were single hyperechoic lesions, and two were multifocal and hyperechoic. All ten tumors with Doppler shifts of 5 kHz or above proved to be hepatocellular carcinomas. The other two hepatocellular carcinomas showed Doppler shifts of 3 kHz. In contrast, no hemangioma showed shifts above 0.7 kHz, and ten of the 15 gave no detectable signal. Of the metastases, 20 gave no signal and 17 had signals of up to 4 kHz. Three-kilohertz signals were also obtained from a cholangiocarcinoma, a hemangioendothelioma, and focal nodular hyperplasia. Correlation with angiographic findings suggested that the high-velocity Doppler signals were associated with large pressure gradients due to arteriovenous shunting. Duplex Doppler US can therefore aid in the differential diagnosis of diffuse and focal liver lesions.     

Trabecular bone mineral density measurement in vivo: use of the ratio of coherent to Compton-scattered photons in the calcaneus

Trabecular bone mineral density (TBMD) was measured in vivo in the calcaneus by a new method that uses the ratio of coherent to Compton-scattered photons arising from irradiation of a small volume of trabecular bone by a gamma ray source with highly collimated geometry. TBMD values for healthy men (22-77 years) were in the range of 180-357 mg/ml, and values for healthy women (18-73 years) were in the range of 160-321 mg/ml. In contrast, values in a small group of paraplegics were in the range of 90-199 mg/ml.