Echographic Findings Research Articles

Gallbladder and pancreatic involvement in hepatitis A.

Gallbladder (GB) abnormalities are rarely reported in children, but involvement of the GB has been demonstrated in various inflammatory disorders. Thirty-nine children hospitalized with hepatitis A virus infection were evaluated by ultrasound. Pseudosurgical gallbladder wall of 10 mm or more with striation was found in 10. Pathological echographic findings were found in the pancreas of three patients, one with frank pancreatitis. Ascitic fluid was noted in eight. Pediatricians and pediatric surgeons alike should be familiar with this gallbladder and pancreatic involvement, which might avoid unnecessary procedures or surgery.

RECURRENT EPIDIDYMO-ORCHITIS SECONDARY TO BEHCET'S DISEASE

No AccessJournal of UrologyClinical Urology: Case Reports1 Aug 1998RECURRENT EPIDIDYMO-ORCHITIS SECONDARY TO BEHCET'S DISEASE JOSE L. CALLEJAS-RUBIO, NORBERTO ORTEGO, ANTONIO DIEZ, MERCEDES CASTRO, and JOSE DE LA HIGUERA JOSE L. CALLEJAS-RUBIOJOSE L. CALLEJAS-RUBIO More articles by this author , NORBERTO ORTEGONORBERTO ORTEGO More articles by this author , ANTONIO DIEZANTONIO DIEZ More articles by this author , MERCEDES CASTROMERCEDES CASTRO More articles by this author , and JOSE DE LA HIGUERAJOSE DE LA HIGUERA More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)62936-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "RECURRENT EPIDIDYMO-ORCHITIS SECONDARY TO BEHCET'S DISEASE." The Journal of Urology, 160(2), p. 496 References 1 : Behcet's disease. Report of 41 cases and review of the literature. Medicine1975; 54: 179. Google Scholar 2 : Urological aspects of Behcet's disease. Brit. J. Urol.1991; 67: 638. Google Scholar 3 : Orchitis due to vasculitis in autoimmune diseases. Scand. J. Rheumatol.1997; 26: 151. Google Scholar Departments of Internal Medicine and Ophthalmology, San Cecilio University Hospital, Granada, Spain© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byCHO Y, JUNG J, LEE K, BANG D, LEE E and LEE S (2018) Clinical Features of Patients with Behçet's Disease and EpididymitisJournal of Urology, VOL. 170, NO. 4 Part 1, (1231-1233), Online publication date: 1-Oct-2003.KAKLAMANI V, VAIOPOULOS G, MARKOMICHELAKIS N and KAKLAMANIS P (2018) RECURRENT EPIDIDYMO-ORCHITIS IN PATIENTS WITH BEHÇET’S DISEASEJournal of Urology, VOL. 163, NO. 2, (487-489), Online publication date: 1-Feb-2000. Volume 160Issue 2August 1998Page: 496 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information JOSE L. CALLEJAS-RUBIO More articles by this author NORBERTO ORTEGO More articles by this author ANTONIO DIEZ More articles by this author MERCEDES CASTRO More articles by this author JOSE DE LA HIGUERA More articles by this author Expand All Advertisement PDF downloadLoading ...

Ultrasonographic features of long-standing primary intestinal lymphangiectasia

This article describes a case of primary intestinal lymphangiectasia associated with protein-losing enteropathy and lower right leg lympoedema in a 20-year-old woman. Echographic findings showed dilation of the intestinal loops, regular and diffuse thickening of the walls, plical hypertrophy and impressive mesenteric oedema. Although diagnosis of the disease is substantially histological, the ultrasonographic characteristics of the lesions are fairly indicative and of certain diagnosis usefulness in patients with protein-losing enteropathy.

Orbital Metastases: Echographic Findings Our Experience

In this paper the authors examine the echographic findings in 20 patients with metastatic and secondary tumors of the orbit observed at the University Eye Clinic of Ferrara (Italy) between January 1985 and August 1995. The aim of this study is to identify some typical echographic characteristics in these forms and to underline the diagnostic role of orbital echography.

GRANULOMATOUS EPIDIDYMO-ORCHITIS: SONOGRAPHIC FEATURES AND CLINICAL OUTCOME IN BRUCELLOSIS, TUBERCULOSIS AND IDIOPATHIC GRANULOMATOUS EPIDIDYMO-ORCHITIS

Purpose We reviewed and analyzed sonographic findings in granulomatous epididymo-orchitis in an attempt to differentiate this rare inflammatory entity from other causes of enlarged scrotum, such as tumors. Materials and Methods We retrospectively reviewed sonographic features of 9 patients a mean of 41 years old with specific and nonspecific granulomatous epididymo-orchitis, including brucellosis in 7, tuberculosis in 1 and idiopathic granulomatous epididymo-orchitis in 1. Histological confirmation was obtained in 3 cases, and in the remaining 6 positive clinical manifestations and laboratory tests for brucellosis were accepted as the main criteria for the diagnosis of brucellar epididymo-orchitis. Results The most notable echographic finding was an enlarged and heterogenous epididymis, predominantly in the body and tail. Testicular involvement consisted of a diffusely hypoechoic testis or focal intratesticular areas. Thickening of the scrotal wall and tunica albuginea, and moderate hydrocele were also noted occasionally. Followup scans revealed intratesticular abscesses in 3 patients. Conclusions These echographic findings may suggest the diagnosis of granulomatous epididymo-orchitis in the appropriate clinical setting, and help to avoid unnecessary orchiectomy for benign disease.

Echographic findings in uveal melanomas treated with the Leksell gamma knife

BACKGROUND/AIMSBetween June 1992 and July 1995, 29 uveal melanomas were treated radiosurgically with the Leksell gamma unit at the University of Graz. The aim of this retrospective study was to...

Age- and sex-related 99Tcm-DMSA renal uptake at 24 h in children with a normal scintigram.

We performed a retrospective study to determine the age- and sex-related normal values of absolute 99Tcm-DMSA uptake at 24 h in children with normal kidneys. Of the 576 scintigrams performed between 1993 and 1996, 136 (272 kidneys) were classified as 'normal' by two independent observers on the basis of the presence of a smooth cortical outline, the absence of cortical loss, relative uptake in the range 45-55% and normal echographic parenchymal findings. The 136 scintigrams were divided into eight groups based on the children's age: Group I, < 1 month (2 boys); Group II, 1-3 months (6 boys, 8 girls); Group III, 4-7 months (7 boys, 6 girls); Group IV, 8-12 months (8 boys, 8 girls); Group V, 13-24 months (14 boys, 4 girls); Group VI, 25-36 months (6 boys, 13 girls); Group VII, 37-120 months (13 boys, 19 girls); Group VIII, 121-180 months (8 boys, 10 girls). In contrast to the results of Morris et al. using absolute 99Tcm-DMSA uptake at 4-6 h, we found that combined left and right kidney uptake increased until age 8 months (Group I, 22.0 +/- 6.7%; Group II, 45.9 +/- 5.0%; Group III, 50.8 +/- 5.0%; Group IV, 56.9 +/- 8.5%; P = 0.019), after which it reached a plateau (Group V, 55.4 +/- 7.3%; Group VI, 60.1 +/- 7.8%; Group VII, 62.0 +/- 5.0%; Group VIII, 62.4 +/- 6.3%). Uptake at 24 h tended to be lower in the girls than in the boys, but this difference was not significant.

Hyperechoic pseudotumors in segment IV of the liver.

Hyperechoic pseudotumors usually are considered "spared areas" in a fatty liver; they frequently are detected at the fourth hepatic segment close to the portal vein. Over a 3 year period, we observed 14 patients with a hyperechoic pseudotumor in otherwise normal livers; all of these lesions resembled a hyperechoic pseudotumor of the fourth segment with respect to site and morphology. In all cases echographic findings did not significantly change during the follow-up period ranging from 4 to 12 months. Computed tomographic examination was normal in two cases, whereas in the remaining 12 cases the hyperechoic lesion was appreciable as a hypodense area on both direct and dynamic scans; the contrast enhancement was never typical for a malignancy of a hemangioma. Six patients also underwent a color Doppler and power Doppler examination, which never demonstrated intralesional or perilesional abnormalities in the vascular signals. Three patients, who underwent surgery for adenocarcinoma of the large bowel, had intraoperative sonography and sonographically guided biopsy; a hepatic steatosis was diagnosed at histologic examination in all cases. The uniqueness of the cases presented here lies on the finding of focal steatosis at a site where, according to the most credible hypothesis, intracellular deposition of triglycerides is less likely because of possible variation of the regional portal circulation. From a practical point of view it should be emphasized that, in addition to the more frequent hypoechoic pseudolesions, hyperechoic pseudonodular images just anterior to the portal vein can be observed in normal livers; in our experience these lesions should be interpreted as a focal steatosis in an atypical site.

Echographic Evaluation and Findings in Metastatic Melanoma to Extraocular Muscles

Metastatic melanoma to the extraocular muscles is an extremely rare condition characterized by marked enlargement of the involved muscles. The authors describe the echographic characteristics of metastatic melanoma to extraocular muscles. The authors used standardized echography (standardized A-scan and contact B-scan) to examine two patients known to have malignant melanoma elsewhere with metastatic melanoma to the extraocular muscles. Both patients had orbital lesions with similar echographic characteristics. Echographically, metastatic melanoma to an extraocular muscle spares the tendon and produces marked thickening of the muscle belly fibers. Other echographic findings include low internal reflectivity, regular internal structure, and vascularity (similar to uveal melanoma). These previously unreported echographic features may be unique to metastatic melanoma to an extraocular muscle. Echography can be a useful adjunct in detecting and diagnosing suspected metastatic melanoma to the extraocular muscles in patients with clinical signs of an orbital mass and known melanoma elsewhere or in the absence of a known primary lesion.

Sapheno-femoral Valves

Since the literature indicated that in the early stages of primary venous disease valves are simply dilated, some authors performed external valvuloplasty of deep and superficial venous valves with encouraging results, although some failures were observed without being sufficiently explained. To obtain further interpretations of the natural history of venous valve pathology, clarify methods for a correct diagnostic approach, and provide indications for the external valvuloplasty procedure. Forty-two proximal valves of the long saphenous vein removed for varicose veins of the lower limbs were studied with optical microscopy. The relationship between histologic alterations and age of varicose disease was investigated. Five valvuloplasties were explanted for recurrent reflux and submitted to histopathological observation. Preoperative echographic findings and histologic observations were compared. Nineteen limbs were subjected to external valvuloplasty under angioscopic control; preoperative echographic findings and angioscopic observations were compared. The histologic alterations observed in venous valves were mainly hypotrophy of cusps, which seemed to be the main cause of failure after external valvuloplasty. The frequency of such hypotrophic alterations increases with the age of varicose disease but no statistically significant relationship was found. Preoperative echographic imaging of venous valves does not appear sufficiently predictive when compared with histologic and angioscopic examinations. Hypotrophic valve damage seems to be prevalent in patients with varicose veins of the lower limbs. Valve cusp hypotrophy may be present in early disease though some normal cusps can be found in advanced disease. When preoperative echographic visualization of cusps is doubtful, intraoperative angioscopy plays the main role in the diagnosis of venous valve disease before and during external valvuloplasty.

Clinical and Echographic Findings in Idiopathic Orbital Myositis

Clinical and Echographic Findings in Idiopathic Orbital Myositis

Endothelial dysfunction in the early stage of atherosclerosis precedes appearance of intimal lesions assessable with intravascular ultrasound

The objective of this study was to clarify whether morphologic evaluation of the in vivo artery with intravascular ultrasound provides as sensitive a marker as endothelial dysfunction or microscopic histologic assessment. Endothelial dysfunction assessed with the changes in the vessel diameter during acetylcholine infusion has been used as a more sensitive marker of atherosclerosis than the angiographic estimates of morphologic structure of the vessel. Recent advent of intravascular ultrasound has provided such high-resolution images of the vessels that morphologic changes in the vessel structure are sensitively and accurately detected. Twenty-two rabbits were divided into three groups: six rabbits fed a cholesterol-rich diet for 2 weeks as the hypercholesterolemia group, eight rabbits fed with the diet for 8 weeks as the atherosclerosis group, and eight rabbits fed a normal diet as the normal group. After evaluating the atherosclerotic lesions by intravascular ultrasound, the cross-sectional area was measured in the baseline and during the infusion of acetylcholine (0.05, 0.5, and 5 μg/kg/min) and nitroglycerin (5 μg/kg/min). No atherosclerotic lesions were detectable with intravascular ultrasound in any rabbit despite the presence of microscopic intimal lesions in the vessels in the rabbits of the atherosclerosis group. The cross-sectional area increased during acetylcholine infusion in the rabbits of the normal and the hypercholesterolemia groups. In contrast, in the rabbits of the atherosclerosis group, the cross-sectional area did not significantly increase during acetylcholine infusion at the rate of 0.5 μg/kg/min and even tended to decrease at the rate of 5 μg/kg/min (−3.8% ± 3.7%, P < 0.05 vs the normal group). Dilating responses to nitroglycerin infusion were similar among all three groups. In conclusion, impairment of the endothelium-dependent vasodilating response assessed with intravascular ultrasound in the in vivo vessel precedes the appearance of echographic atherosclerotic findings. Thus intravascular ultrasound, if used in combination with drug intervention to assess endothelial function, would provide even more accurate assessment of the vessels than conventional intravascular ultrasound alone.

Posterior Vitreoschisis: An Echographic Finding in Proliferative Diabetic Retinopathy

To describe the echographic characteristics of splitting the outer posterior cortical vitreous in patients with proliferative diabetic retinopathy and vitreous hemorrhage. The authors retrospectively reviewed the echographic findings in 270 patients who were evaluated at the Doheny Eye Institute between January 1983 to December 1989 for proliferative diabetic retinopathy and vitreous hemorrhage. None of the eyes had undergone pars plana vitrectomy before echographic examination. Forty-five patients (17%) had echographic evidence of splitting of the outer posterior vitreous cortex, a finding the authors have termed posterior vitreoschisis. In all patients, differentiation of the posterior vitreoschisis from a true posterior hyaloid detachment was possible, either on the initial or on serial echographic examination, by the separate detachment of the inner wall of the vitreoschisis cavity and the true posterior hyaloid from the retinal surface. The vitreoschisis cavities often were found to contain unclotted blood. In some eyes, the inner wall of the vitreoschisis cavity was adherent to the apex of the most highly elevated area of traction retinal detachment, suggesting that posterior vitreoschisis may itself result in clinically significant vitreoretinal traction, independent of the presence or extent of true posterior hyaloid separation. The authors' finding suggest that spontaneous splitting of the outer posterior vitreous cortex may occur in patients with proliferative diabetic retinopathy and vitreous hemorrhage, which may mimic a true posterior cortical vitreous detachment on echographic examination. Preoperative recognition of posterior vitreoschisis may be important in the surgical management of these patients.

Floating right heart thrombi and pulmonary embolism: diagnosis, outcome and therapeutic management.

The aim of this study was to analyze clinical and echographic findings and to assess therapeutic management in 14 floating right atrial thrombi diagnosed with systematic echocardiography in 200 consecutive patients with proven pulmonary embolism. Auscultatory findings were abnormal in 7 cases, 4 of them showing signs of tricuspid obstruction. Echocardiography displayed a mobile ovoid, polycyclic or worm-like right atrial mass, always associated with signs of cor pulmonale. Four patients (29%) died, 2 of them before any treatment could be started. Regarding the remaining 10 patients with favorable outcome, surgical embolectomy was carried out in 7. Our data suggest that echocardiographic examination is necessary in all suspected pulmonary embolisms and has to be done quickly for emergency treatment in patients with floating right atrial thrombus.

Clinical and Echographic Findings in Idiopathic Orbital Myositis

Clinical and Echographic Findings in Idiopathic Orbital Myositis

Hipertensão Portal. A propósito de um caso clínico de longa evolução.

The AA report a clinical case of Portal Hypertension with a long period of survival, more than 12 years, during which it was not possible to clarify the etiology. The presence of chronic ethylism conditioned the attribution of the etiology to a chronic alcoholic hepatopathy, but a hepatic biopsy denied that cause. Through the re-examination of the differential diagnosis of the several causes of Portal Hypertension and through Echographic findings, the Budd-Chiari Syndrome diagnosis was established. The AA broach the causes, the means of diagnosis and the therapeutics of this syndrome and conclude that the etiological diagnosis of any Portal Hypertension must be done exhaustively, using all the available means, so that effective therapeutics can be achieved.

Echographic findings in infectious endophthalmitis.

To correlate the initial echographic findings in eyes with infectious endophthalmitis with the visual prognosis and causative microorganism. A retrospective review of the clinical and standardized ocular echographic findings in eyes with infectious endophthalmitis was performed. University-based ophthalmology department. One hundred thirty-seven eyes (136 patients) with infectious endophthalmitis that were evaluated by the ocular echography service of the Doheny Eye Institute, Los Angeles, Calif, between January 1, 1981, and December 31, 1992. Four findings on initial echography were associated with poor initial vision: dense vitreous opacities, retinal detachment, macular detachment, and choroidal detachment. Five findings on initial echography correlated with poor final vision: dense vitreous opacities, vitreous membranes, the presence of retinal detachment, the extent of retinal detachment, and the presence of choroidal detachment. Change (decrease) in vision during the follow-up period was associated with the presence of combined vitreous and subhyaloid opacities, retinal detachment, and choroidal detachment. All eyes with initially clear vitreous on ocular echography had either early streptococcal or culture-negative endophthalmitis. Advanced streptococcal endophthalmitis correlated with the most severe vitreous inflammation, vitreous membranes, and the most extensive posterior vitreous detachment, whereas gram-negative endophthalmitis correlated with choroidal detachment on initial echography. Stepwise logistic regression analysis revealed that the presence of choroidal detachment, not gram-negative microorganisms, was the principal predictor of poor visual outcome in these eyes. Ocular echography is a useful method in the clinical evaluation and treatment of infectious endophthalmitis, especially in eyes with opaque media.

Clinical and Echographic Findings in Idiopathic Orbital Myositis

We performed a retrospective chart review of 100 patients with idiopathic orbital myositis, who were of ages 9 to 84 years. Data from 75 patients gave the following results. Females were affected more than twice as often as males. Fifty-one patients (68%) had single muscle involvement, with the lateral and medial recti affected most frequently (38 cases [33%] and 33 cases [29%] of muscles, respectively). In 34 patients (45%), affected muscles functioned normally; the remaining 55% (63 muscles) were fairly equally distributed between paretic (20%), restrictive (20%), or combined paretic and restrictive (15%) myopathies. Analysis of muscle function, echographic findings, and duration of symptoms indicates that within days of onset of symptoms, the affected muscle is initially enlarged but retains normal function. Within the first two weeks, continued enlargement results in muscle paresis. The muscle may then enter a partially or completely restrictive phase, which may become permanent. Fifty-one patients (68%) responded well to systemic corticosteroids, although 11 patients (15%) had further recurrences of the disease. Seven patients (9%) later developed thyroid eye disease after initially having unimuscular orbital myositis. We advocate early institution of corticosteroids in order to avoid permanent restrictive myopathies.

Echographic Findings in Hemorrhagic Disciform Lesions

To examine the potential role of ocular echography in the evaluation of hemorrhagic disciform disease. Using standardized ocular echography, the authors examined 85 eyes of 85 patients with hemorrhagic disciform lesions. Hemorrhagic disciform lesions are located in the subretinal pigment epithelial space and appear echographically as solid chorioretinal elevations characterized by a bumpy, lobulated surface with indistinct peripheral margins, irregular internal structure, and medium to high internal reflectivity. These lesions could be reliably differentiated from associated subretinal or suprachoroidal hemorrhage by ocular echography when the maximal height of the lesion was 1 mm or greater. Hemorrhagic disciform disease is usually complex with distinct components that may not be discernible on biomicroscopic or angiographic examination, in part because of overlying subretinal hemorrhage. Ocular echography provides a readily available clinical tool to define the components of hemorrhagic disciform disease more precisely. Improved characterization of hemorrhagic disciform lesions may improve understanding of the natural history and response to therapy of hemorrhagic age-related macular degeneration.

Endoscopic Bile Duct Stone Removal Prior to Laparoscopic Cholecystectomy

Of 1049 patients referred for laparoscopic cholecystectomy (LC) for symptomatic gallstone disease, 67 (6%) had clinical, biochemical, or echographic findings suggesting common bile duct stones. Patients in this group were studied preoperatively with endoscopic retrograde cholangiopancreatography (ERCP). In 26 patients (39%), the diagnosis was confirmed. In 12 other cases (18%), the macroscopic finding of a stripped or bleeding papilla without common bile duct stones suggested stone migration. ERCP in the remaining 29 patients (43%) was normal. Thirty-four endoscopic sphincterotomies (ES) were performed, 26 for common bile duct stones and 8 for cystic lithiasis or gallbladder microlithiasis. In the entire group of patients with choledocholithiasis, stone removal was possible. All 67 patients underwent laparoscopic cholecystectomy on an average of 2.8 days following the endoscopic procedure. Twenty-one patients (31%) had acute cholecystitis, and 5 had chronic scleroatrophic cholecystitis. Five (7.5%) of the 67 patients were converted to an open procedure. In 10 cases (16%), the cystic diameter was larger than an 8-mm M-L clip, which made necessary the use of endoligature or extra clips. No complications or deaths resulted from ERCP or ES. Two of the 62 patients (3.2%) who underwent LC had to be reoperated on, 1 because of a right subphrenic collection, and the other because of bilious ascites. No common bile duct lesions or deaths resulted in the analyzed group. The average hospitalization time, with the exception of those patients converted or reoperated on, was 8 days.