Sonographic Correlation Research Articles

Endometrial changes associated with tamoxifen adjuvant therapy of postmenopausal women with breast cancer: Sonographic and pathologic correlations

Endometrial changes associated with tamoxifen adjuvant therapy of postmenopausal women with breast cancer: Sonographic and pathologic correlations

Assessment of Breast Cancer Size: Sonographic and Pathologic Correlation

Assessment of Breast Cancer Size: Sonographic and Pathologic Correlation

Sonographic determination of cutaneous and subcutaneous fibrosis after accidental exposure to ionising radiation in the course of the Chernobyl nuclear power plant accident

Chronic cutaneous lesions in eight of 15 survivors of the Chernobyl nuclear energy plant accident presenting with clinical features of cutaneous radiation fibrosis were examined 6 years after exposure using high-frequency ultrasound. In all patients, lesional skin was examined using both the B- and A-modes. Similar phenomena were found in all patients. The corium was increased in thickness as well as density compared to normal skin. The increase in density was seen not only in the medium strata but also particularly at the border between corium and subcutaneous tissue. Within the subcutaneous tissue proper, isles of echo-rich spots were prominent. The number and width of echo signals in the subcutaneous tissue were increased, representing the sonographic correlate of subcutaneous fibrotic trabeculae. The thickness of epidermis plus corium was increased by more than 50% and was even doubled in some cases. According to the present findings obtained from patients with very severe exposure to ionising radiation, ultrasound analysis of cutaneous and subcutaneous radiation fibrosis shows a characteristic picture. Moreover, it was demonstrated that quantitative assessment of skin thickness is possible. As the method is simple and noninvasive, repeated examinations are possible. This provides the basis for monitoring possible treatment effects and efficient follow-up in these chronically progressive clinical conditions after exposure to ionising radiation.

Distal humeral physeal injuries in child abuse: MR imaging and ultrasonography findings

Distal humeral physeal injuries, in particular, fracture-separation of the distal humeral epiphysis, can be seen in abused infants. Detection of physeal injury in an infant or toddler may indicate the possibility of unsuspected abuse, particularly when an appropriate history explaining the circumstance of the fracture is lacking. In addition, the extent of injury can be difficult to characterize on plain radiographs. Ultrasonography (US) and MR imaging (MRI) may be of value in diagnosis and may obviate the need for intraoperative arthrography. We present MRI findings in three abused children with distal humeral physeal injuries. Sonographic correlation is also presented in one case.

Nephrocalcinosis in very low birth weight neonates: sonographic patterns, histologic characteristics, and clinical risk factors.

Fifty infants weighing less than 1200 grams at birth who survived at least 3 weeks were enrolled in this study, of whom 14 (28%) developed sonographic evidence of nephrocalcinosis by 9 weeks, despite median total furosemide dose of only 2 mg/kg. Risk factors for development of neonatal nephrocalcinosis were white race (P < 0.01) and positive family history of kidney stones (P < 0.001). Sonography demonstrated echogenic foci measuring 2 to 9 mm near the papillary tips in most infants with nephrocalcinosis even though the kidneys apparently had not progressed through the stages of diffuse medullary echogenicity that Patriquin and Robitaille postulated are the sonographic correlates of the Anderson-Carr-Randall progression, a leading theory of renal calculus formation. The presence of intratubular calcifications in the two patients studied post mortem also is contrary to the Anderson-Carr-Randall theories that center on interstitial calcium deposition. Although neonatal nephrocalcinosis shares some clinical risk factors (white race and positive family history of renal calculi) with renal calcium deposition in older children and adults, the prevalent theories of renal calcium deposition do not account for its sonographic or histologic manifestations.

Anatomical and sonographic correlation of the fetal ductus arteriosus in first and second trimester pregnancy

Ultrasonic visualization of the ductus arteriosus in first and second trimester pregnancies was compared with postmortem preparations. Twenty human fetal postmortem specimens from 8 to 19 weeks menstrual age were examined, 11 with microscopic reconstruction, nine with macroscopic dissection. The angle between ductus arteriosus and aortic isthmus (upstream) and ductus arteriosus and descending aorta (downstream) was determined. In 52 normally developing fetuses between 14 and 27 weeks, the angle between the ductus arteriosus and the thoracic spine as visualized in real-time ultrasound was determined. In a further 19 normally developing fetuses between 14 and 25 weeks, ductal blood flow was visualized by colour velocity imaging (CVI). In anatomical preparations, the upstream angle was always less than 90° and the downstream angle was always 80° or more. These angles were unrelated to menstrual age. In both real-time and CVI ultrasound, the angle between ductus arteriosus and thoracic spine remained at approximately 90°. CVI showed highest blood flow velocities at the point of ductal insertion into the aorta. When performing Doppler ultrasound examinations in the fetal ductus arteriosus, no menstrual age dependent angle adjustment appears to be necessary.

Inverted layering of contrast material and urine in the bladder on CT: sonographic correlation.

Inverted layering of contrast material and urine in the bladder on CT: sonographic correlation.

Radiological anatomy of the kidney revisited

In recent years some structures or features such as the "inter-renuncular septum", the "echogenic triangle" and the "echogenic line" have been described to support the concept of a kidney resulting from the fusion of two masses or renunculi. To clarify this concept and to understand the meaning of the above echographic features better, the authors have examined prospectively by sonography the kidneys of 50 children, 200 adults with a single collecting system, 25 adults with a duplicated collecting system and 32 cadavers. Furthermore, to help explain the sonographic features, we have examined 32 cadaver kidneys with sonography and 10 cadaver kidneys with magnetic resonance imaging (MRI). The sonographic, MRI and anatomical correlations have shown that the "echogenic triangle" and the "echogenic line" are not renuncular residuals, but simply an extension of the hilar fat visible when the renal sinus is rather deep. The intermediate cortical mass is not a septum dividing the kidney into an upper and lower renunculus, but a column of parenchymal tissue crossing the renal sinus, which, from an anatomical point of view, is an accessory renal lobe. The presence of two renunculi, suggested in a previous study with cortical nephrotomography, has not been confirmed.

Sonographic Correlation of Fetal Heart Rate and Gender

This study sonographically evaluates the fetal heart rate throughout gestation and the baby's sex at birth to determine if the fetal heart rate is an indicator of the baby's sex. The results of the evaluation of 365 cases indicates that the fetal heart rate is not an accurate indicator of fetal sex.

In vitro fertilization: sonographic perspective.

The applications of sonography were evaluated in 220 patients undergoing 354 in vitro fertilization cycles. A baseline sonogram demonstrated adnexal abnormalities in 10.7% of cycles. Serial sonograms were beneficial in monitoring follicular development. Oocyte harvest was canceled in 18.4% of cycles owing to inadequate follicle growth progression, as demonstrated by ultrasound. An additional 9% of cycles were canceled owing to the development of a single lead follicle. Six percent of cycles were accompanied by a spontaneous rise in serum luteinizing hormone values, necessitating sonographic correlation to exclude ovulation.

MR evaluation of the portal vein in pediatric liver transplant candidates.

Nine pediatric liver transplant candidates underwent preoperative MR evaluation of the portal vein and the inferior vena cava. Sonographic correlation was available in all patients and angiographic correlation was available in five. Pathologic correlation was obtained in seven cases either at liver transplantation or autopsy. MR demonstrated portal vein patency in three cases when it was not seen by angiography and confirmed portal vein patency in one patient when it was questionably identified on sonography. The portal vein was not seen on MR imaging in two cases when it was seen on sonography and angiography: in one case, it was small and to-and-fro flow was demonstrated angiographically; in the second case, the portal vein was occluded by tumor thrombus. Two vessels in two patients were misidentified by sonography and identified correctly by MR. These were an azygous continuation of the inferior vena cava and a large collateral vein in the portal region. Knowledge of the anatomy and documentation of vascular patency are essential in evaluation of patients before liver transplantation. In patients with complex anatomy or hemodynamics, it may be necessary to obtain this information from several imaging techniques (sonography, angiography, and MR).

CT of fibrous tissues and tumors with sonographic correlation.

Fibrous tissues and tumors may appear hyperdense relative to muscles and solid viscera on CT both before and after IV contrast injection. In addition, fibrous tissues generally have a homogeneously hypoechoic sonographic appearance. The diagnostic value of these criteria is illustrated in a group of 21 fibrous tissue abnormalities that includes retroperitoneal, mediastinal, and perigraft fibrosis, sclerosing pseudotumor of the orbit, generalized fibromatosis, desmoids, malignant fibrous histiocytoma, and normal tendons and ligaments. It is concluded that while hyperdensity on CT and echopenia on sonography are not pathognomonic of fibrous tissue, they occur with sufficient frequency that their presence raises the possibility of a fibrous lesion.

Intervillous thrombosis: sonographic and pathologic correlation.

Sonographic and pathologic documentation of 7 cases of intervillous thrombosis of the placenta are presented. These lesions were demonstrated on sonography as early as 19 weeks of gestation. Since intervillous thromboses are thought to be related to Rh isoimmunization, their sonographic documentation may be of clinical importance.

Pseudogestational sac in ectopic pregnancy: Sonographic and pathologic correlation

Pseudogestational sac in ectopic pregnancy: Sonographic and pathologic correlation