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Gray-scale Sonography (gray-scale + sonography)
Selected AbstractsSonographic findings in a case of scrotal lymphangioma in a 68-year-old maleJOURNAL OF CLINICAL ULTRASOUND, Issue 7 2009Won Chan Lee MD Abstract Lymphangiomas are benign tumors resulting from a congenital lymphatic malformation in infant and children. Most common sites are head, neck and axilla, and scrotal lymphangioma is very rare. Lymphangiomas are classified as capillary, cavernous, and cystic type and cystic type is most common. Complete surgical excision is definitive treatment and incomplete excision leads to local recurrence. We report a case of scrotal lymphangioma in 68-year-old male patient. Gray-scale sonography revealed multiseptated, hypoechoic mass abutting the upper pole of the normal right testis. Color Doppler sonography showed no remarkable blood flow in the mass. MRI demonstrated multispetated extratesticular and extraepididymal mass in the right scrotum. Surgical excision was performed and the histopathologic diagnosis was a cystic lymphangioma. In conclusion when multiseptated cystic scrotal mass was discovered in an elderly patient, scrotal lymphangioma should be included in differential diagnosis. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound 2009 [source] Gray-scale sonography of solid breast masses: Diagnosis of probably benign masses and reduction of the number of biopsiesJOURNAL OF CLINICAL ULTRASOUND, Issue 1 2007Luciano Chala MD Abstract Purpose. To identify probably benign breast masses using gray-scale sonography and to see if this strategy could reduce the number of biopsies of breast masses. Methods. This retrospective study included 229 masses in 203 women who underwent sonographically guided percutaneous biopsy. Masses with a negative predictive value for malignancy >98% were retrospectively considered probably benign, and the potential impact of gray-scale sonography in reducing the number of biopsies if these masses were not biopsied was assessed. Assessments were performed considering all masses as a group as well as various subgroups. Results. Round, ellipsoid, or lobulated masses with 3 or fewer lobulations, circumscribed margins, a longitudinal,anteroposterior diameter ratio ,1.0 and no marked hypoechogenicity, posterior acoustic shad owing, internal microcalcifications, or altered surrounding breast tissue were considered probably benign. The sensitivity of gray-scale sonography to identify this subgroup was 98%, with a negative predictive value of 99%. If these masses were not biopsied, there would be a 42% reduction in the number of biopsies considering all masses, a 36% reduction for masses classified as Breast Imaging Reporting and Data System category 4, and a 59% reduction for masses exclusively analyzed with sonography. Conclusions. It is possible to identify probably benign breast masses using gray-scale sonography, and thereby to reduce the number of biopsies performed. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound 2007 [source] Does the presence of a mesh have an effect on the testicular blood flow after surgical repair of indirect inguinal hernia?JOURNAL OF CLINICAL ULTRASOUND, Issue 2 2009Selma Uysal Ramadan MD Abstract Purpose. Modern treatment of inguinal hernias includes prosthetic mesh repairs. However, direct contact of the mesh to the vessels in the inguinal canal and perimesh fibrosis may have a negative impact on testicular flow. The aim of this prospective study was to evaluate the effect of mesh implantation/perimesh fibrosis on testicular flow after repair of indirect inguinal hernias (IIHs). Method. Forty-eight male patients with unilateral IIH were included. Both testicular parenchyma were assessed using gray-scale sonography, and color/spectral Doppler sonography was performed to evaluate testicular arterial impedance, perfusion, and venous flow. Measurements were made bilaterally at the level of the inguinal canal 1 day before and at the end of the 2nd month after the operation. Results. There was no difference in testicular and echotexture perfusion between the hernia and the control sides pre- and postoperatively. No venous thrombosis was found. In all groups, resistance index and pulsatility index, measured at 4 levels, were highest in the proximal inguinal canal and lowest at the extratesticular,intrascrotal level (p < 0.05). For all Doppler parameters there was no significant difference between the pre- and postoperative measurements on both the hernia and the control sides. Conclusion. Mesh implantation/perimesh fibrosis does not adversely affect ipsilateral testicular flow. Mesh application is still a safe procedure in male patients in whom testicular function is important. © 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2009 [source] Gray-scale sonography of solid breast masses: Diagnosis of probably benign masses and reduction of the number of biopsiesJOURNAL OF CLINICAL ULTRASOUND, Issue 1 2007Luciano Chala MD Abstract Purpose. To identify probably benign breast masses using gray-scale sonography and to see if this strategy could reduce the number of biopsies of breast masses. Methods. This retrospective study included 229 masses in 203 women who underwent sonographically guided percutaneous biopsy. Masses with a negative predictive value for malignancy >98% were retrospectively considered probably benign, and the potential impact of gray-scale sonography in reducing the number of biopsies if these masses were not biopsied was assessed. Assessments were performed considering all masses as a group as well as various subgroups. Results. Round, ellipsoid, or lobulated masses with 3 or fewer lobulations, circumscribed margins, a longitudinal,anteroposterior diameter ratio ,1.0 and no marked hypoechogenicity, posterior acoustic shad owing, internal microcalcifications, or altered surrounding breast tissue were considered probably benign. The sensitivity of gray-scale sonography to identify this subgroup was 98%, with a negative predictive value of 99%. If these masses were not biopsied, there would be a 42% reduction in the number of biopsies considering all masses, a 36% reduction for masses classified as Breast Imaging Reporting and Data System category 4, and a 59% reduction for masses exclusively analyzed with sonography. Conclusions. It is possible to identify probably benign breast masses using gray-scale sonography, and thereby to reduce the number of biopsies performed. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound 2007 [source] Intima-media thickness of the common carotid artery in highway toll collectorsJOURNAL OF CLINICAL ULTRASOUND, Issue 9 2006Besir Erdogmus Abstract Purpose. To assess the effects of exposure to exhaust particles on intima-media thickness of the common carotid artery in highway toll collectors. Methods. Sixty-one highway toll collectors (HTCs) between 24 and 56 years of age (mean, 36.2 ± 7.3) and 48 controls between 24 and 64 years of age (mean, 42.6 ± 10.6) were evaluated with gray-scale sonography to measure intima-media thickness (IMT) of the common carotid artery (CCA). Subgroups were categorized according to duration of exhaust exposure and further divided according to tobacco use. Results. CCA IMT was higher (0.8 ± 0.2 mm) in HTCs than in the control group (0.6 ± 0.1 mm; p < 0.001) and remained higher when subgroups with similar smoking habits were compared. In HTCs, IMT was greater when the number of years working in tollbooths was greater (p = 0.023). IMT was lower in HTCs with an exposure duration of <10 years compared with a duration of 10,20 years (p = 0.017) or >20 years (p value not significant). Conclusion. Air pollution has a widely acknowledged negative effect on humans. This study confirms that exposure to exhaust particles might cause wall thickening of carotid arteries. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound, 2006 [source] Doppler sonography in the diagnosis of urinary tract obstruction by stoneJOURNAL OF CLINICAL ULTRASOUND, Issue 6 2004Nevbahar Akçar MD Abstract Purpose This study was conducted to evaluate the accuracy of Doppler sonography in renal colic due to obstruction and to assess whether the resistance index (RI) and interrenal RI difference (,RI) are time-dependent parameters. Subjects and Methods Obstructed and unobstructed contralateral kidneys in 28 patients with renal colic and normal kidneys in 27 control subjects were prospectively evaluated with Doppler sonography. Mean RI, mean ,RI, and duration of pain were evaluated. Statistical analysis was done using paired and independent t-tests. Results Mean RIs of the control-group, obstructed, and contralateral kidneys were 0.60, 0.71, and 0.61, respectively; mean ,RI values of the obstructed and control-group kidneys were 0.10 and 0.03, respectively. Differences in mean RI between obstructed and contralateral or control-group kidneys were statistically significant (p < 0.001). There was a statistically significant difference in ,RI between patients and controls (p < 0.001). The difference between the RI values of kidneys with low-grade (0.70) and high-grade obstructions (0.72) was not statistically significant. The difference between the ,RI values of kidneys with low-grade (0.08) and high-grade obstructions (0.13) was statistically significant (p < 0.05). Differences in the mean RI and mean ,RI values between 3 groups of patients categorized according to the duration of pain were not statistically significant. Conclusions Along with gray-scale sonography and intravenous urography, Doppler sonography can be used in the evaluation of renal obstruction. RI and ,RI are not time-dependent parameters. © 2004 Wiley Periodicals, Inc. J Clin Ultrasound 32:286,293, 2004 [source] Diagnostic criteria for locating acquired arteriovenous fistulas with color doppler sonographyJOURNAL OF CLINICAL ULTRASOUND, Issue 6 2002Jian-Chu Li MD Abstract Purpose. The purpose of this prospective study was to evaluate and determine criteria for locating acquired arteriovenous fistulas using color Doppler sonography. Methods. We performed color Doppler sonography on 12 consecutive patients with acquired arteriovenous fistulas. We evaluated the morphologic and hemodynamic changes in the involved vessels to help locate the fistulas (10 in the extremities, 1 in the neck, and 1 in the abdomen). Results. In all cases, turbulent high-velocity flow spectrum and flow signals were present at the fistula sites, and arterialized waveforms from the draining veins were detected. In the 10 cases of acquired arteriovenous fistulas in the extremities, the resistance indices in the arteries proximal to the fistulas were all less than 1.00 (mean, 0.65), whereas the resistance indices in the arteries distal to the fistulas were all 1.00 or greater (mean, 1.17). In 70% of the cases, the diameter of the artery proximal to the fistula was at least 1.2 mm larger than that distal to the fistula. The fistula site was inferred by the point of maximal venous dilatation in 70% of the cases and by the focal perivascular color artifact in 82% of the cases. The fistula site was identified on gray-scale sonography and color flow imaging in 33% and 75% of the cases, respectively. Conclusions. Fistula sites can be located effectively and quickly by a combination of major and minor diagnostic criteria. The major diagnostic criteria are (1) junction of low- and high-resistance flow in the supplying artery, (2) a high-velocity arterialized waveform in the draining vein, and (3) a turbulent, high-velocity flow spectrum at the junction of the artery and the vein. The minor diagnostic criteria are (1) direct communication between the involved artery and vein, (2) significant change in the diameter of the supplying artery, (3) a focal point of venous dilatation, and (4) a focal perivascular color artifact. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 30:336,342, 2002; Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/jcu.10084 [source] Comparison of liver hemodynamics according to doppler ultrasonography in alcoholic patients subtyped by Cloninger classification and non-alcoholic healthy subjectsACTA NEUROPSYCHIATRICA, Issue 1 2006Z. Sumru Cosar Background:, The aim of this study was to search for morphological and hemodynamic changes in hepatic and splanchnic vasculature in alcoholic patients without the signs of hepatic damage and subtyped by Cloninger classification by means of sonography, and compare the subtypes among themselves and with nonalcoholic healthy subjects. Methods:, Thirty alcohol dependent patients and 30 healthy subjects with no alcohol problem or hepatic impairment were included in the study. Patients were subtyped by Cloninger classification and all patients were evaluated by gray-scale and spectral Doppler ultrasound. The diameter of the portal vein, portal venous velocity, peak systolic and end diastolic velocities of hepatic and superior mesenteric arteries were assessed. RI, PI and systolic/diastolic velocity ratios were also calculated. Results:, Portal vein diameter (PV diameter), portal vein cross sectional area (PV area), portal vein velocity (PV PSV), hepatic artery peak systolic velocity (HA PSV), hepatic artery end diastolic velocity (HA EDV), hepatic artery resistive index (HA RI), hepatic artery pulsatility index (HA PI), and systolic/diastolic velocity ratios (HA S/D), superior mesenteric artery peak systolic velocity (SMA PSV), superior mesenteric artery end diastolic velocity (SMA EDV), superior mesenteric artery resistive indices (SMA RI), pulsatility index (SMA PI), and systolic/diastolic velocity rates (SMA S/D) showed no significant difference among the groups (P > 0.01). Although there is no significant difference in PV PSV, HA PSV, SMA PSV, SMA EDV values between the groups, mean values of Type II alcoholics is greater than other groups. Portal vein cross-sectional area was greater in alcoholic patients (Type I, II and III) compared to the control group (P = 0.000). Portal vein velocity, hepatic artery peak systolic and end diastolic velocity, superior mesenteric artery peak systolic and end diastolic velocity were significantly greater in alcoholic patients than in the control group (P < 0.001). No statistical difference was detected between other parameters evaluated. Conclusion:, In alcohol dependent patients, some hemodynamic and morphologic changes occur in hepatic and splanchnic circulation, even before the signs of hepatic damage develop, which can be detected by means of Doppler and gray-scale sonography. But as there is no significant difference between the Doppler ultrasonographic findings among alcoholics subtyped by a Cloninger classification, which is a clinical classification, it suggests that psychiatric classification doesn't show any correlation with biological parameters, and because of this Cloninger classification a psychiatric classification cannot be considered as a characteristic determinative factor in the prognosis of hepatic disorder due to alcohol use. However, higher values of Type II alcoholics can be attributed to the longer alcohol intake of this subtype. [source] | ||||||||||