Impact Of Sonography Research Articles

Two cases of vasa previa diagnosed prenatally using three‐dimensional ultrasonography

We report two cases in which we describe the impact of sonography (US) in the management of vasa previa. In the first case, with two-dimensional US, the diagnosis of vasa previa was made at 21 weeks gestation. In the second case, using three-dimensional US, the diagnosis of vasa previa was made at 19 weeks gestation. An elective Cesarean section was carried out at 34 weeks in both cases. Diagnosis of vasa previa is critical when low-lying placenta or velamentous insertion of the umbilical cord is detected during the pregnancy.

Impact of sonography in gouty arthritis: Comparison with conventional radiography, clinical examination, and laboratory findings

Objective To explore the typical sonographic features of gray-scale and Power Doppler of acute and chronic gouty arthritis in conjunction with radiographic, clinical, and laboratory findings. Materials and methods All hand, finger, and toe joints of 19 patients with acute and chronic gout were examined with gray-scale and Power Doppler sonography. The number and size of bone changes detected with sonography was compared to radiographic findings. Vascularization of the synovial tissue was scored on Power Doppler (grades 0–3), and was compared with clinical appearance, including swelling, tenderness, and redness (grades 0–3). Results In acute gout, mild to moderate echogenic periarticular nodules with sonotransmission and hypervascularization of the edematous surrounding soft tissue were found. In chronic gout, tophaceous nodules completely blocked transmission of US wave, leading to strong reflexion and dorsal shadowing in a minority of cases. No significant difference in the detection of large bone changes (>2 mm) was found between sonography and radiography. However, gray-scale sonography was significantly more sensitive in the detection of small bone changes ( p < 0.001). Power Doppler scores were statistically significantly higher than clinical examination scores ( p < 0.001). Discussion Sonography is superior to radiographs in evaluating small bone changes. The inflammatory process in joints can be better detected with Power Doppler sonography than with clinical examination. Typical sonographic appearance of acute and in particular of chronic gout might provide clues on gouty arthritis that adds to the information available from conventional radiography, clinical, and laboratory findings.

Impact of sonography on the diagnosis and treatment of acute lower abdominal pain in children and young adults.

Our purpose was to evaluate the impact of sonographic data on clinical physicians' diagnostic confidence and their treatment of children and young adults with acute lower abdominal pain. Senior surgical and emergency department staff completed questionnaires before and after abdominal sonography was performed on 94 of 101 consecutive children and young adults with acute lower abdominal pain, pelvic pain, or both. Physicians who were unaware of sonographic data stated the most likely diagnosis and their level of confidence in their diagnosis and then formulated clinical plans. After they were given sonographic data, physicians again stated the most likely diagnosis, estimated their level of confidence, and formulated revised treatment plans. Sonographic data resulted in revised clinical diagnoses in 52% of the patients. Overall, the gain in diagnostic confidence for the entire study population was 33% (95% confidence interval [CI], 27-38%; p < .0001). The impact on the physicians' confidence was greater in those children and young adults whose diagnoses changed after sonography (mean increase in physicians' confidence, 48.3%; 95% CI, 47-75%). In patients whose diagnoses were not changed after sonography, the mean increase in physicians' confidence was 17.6% (95% CI, 11-24%; p < .0001 [analysis of variance]). Physicians used sonographic data to change initial treatment plans in 43 patients (46%). Of these 43 patients, a lower intensity of care was given to 30 patients (70%) and a higher intensity to 13 patients (30%). Sonographic data frequently changed initial clinical diagnoses, thus increasing diagnostic confidence and changing clinical treatment decisions in the setting of acute lower abdominal pain in children and young adults.

The Impact of Sonography on the Diagnosis of Scrotal Disorders

Purpose We assessed the impact of ultrasound on the referring urologist diagnosis of scrotal disorders. Materials and Methods University urologists (6 attending and 3 resident physicians) in a clinic setting completed questionnaires before and after on 35 patients with scrotal symptoms. The physicians were requested to estimate the probability (0 to 100%) of their most likely diagnosis before and after receiving the sonographic information. We calculated the mean change in diagnostic percentage confidence and also the proportion of patients whose pre-sonographic diagnosis was changed. Results Scrotal ultrasound changed the initial diagnosis in 11 of 35 patients (32%, 95% confidence interval 19 to 49). The mean percentage gain in diagnostic certainty from ultrasound was 29% (95% confidence interval 20 to 39, p <0.001). Conclusions Scrotal ultrasound has considerable impact on referring urologist diagnosis of scrotal abnormalities.

The Impact of Sonography on the Diagnosis of Scrotal Disorders

The Impact of Sonography on the Diagnosis of Scrotal Disorders

Sonography and the acute abdomen: practical considerations.

Sonography and the acute abdomen: practical considerations.J B Puylaert, F M van der Zant and A M RijkeAudio Available | Share

Sonographic diagnosis of pneumoperitoneum in twelve patients

Ultrasonography is widely accepted as the initial screening modality for patients admitted for acute abdominal pain or trauma. However, only few reports deal with the impact of sonography in the assessment of pneumoperitoneum. We report a sery of 12 patients admitted with an acute abdomen between 1990 and 1991, in whom pneumoperitoneum was first detected by sonography. Of these 12 patients, free peritoneal gas was not detected by plain film X-ray if no additional positioning technique, according to Miller [1], was used. Eleven of them were subsequently surgically proven to have a perforated hollow viscus. In one subject, the pneumoperitoneum turned out to have and external gynaecological origin.

The impact of sonography on the management of extratesticular abnormalities of the scrotum

The results of scrotal sonography performed in a recent one-year period (1987) were retrospectively reviewed to assess the role of sonography in the management of patients with extratesticular abnormalities. The study included 226 examinations performed in 204 men. In extratesticular abnormalities, scrotal sonography confirms the clinical impression of the referring physicians, monitors the progress of conservative treatment, and guides the surgical approach. Patients with sonographically classic cystic extratesticular abnormalities rarely come to surgery. Those with complicated cystic abnormalities are usually followed clinically but have a higher incidence of surgery. Those with solid-appearing echogenic abnormalities usually have surgical removal.

Impact of sonography on surgery for primary hyperparathyroidism

The impact of preoperative sonographic localization of enlarged parathyroid glands was evaluated from the standpoint of operative time and complication rates. There was a reduction in the average time from 135 minutes when findings were false-negative to 111 minutes when findings were positive. The rate of complication was not changed by accurate preoperative localization. When the operative goal is to find all parathyroid glands in every patient, the value of preoperative localization of parathyroid tumors by any current method is slight. Should operative policy favor a search for only one enlarged and one normal gland, or should methods improve to the point that even normal parathyroid glands can be located reliably, noninvasive localization should prove to be useful, safe, and cost-effective, even when it is carried out before initial operation.