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Kessner R, Nakamoto DA, Kondray V, Partovi S, Ahmed Y, Azar N. Contrast-Enhanced Ultrasound Guidance for Interventional Procedures. J Ultrasound Med 2019; 38:2541-2557. [PMID: 30714653 DOI: 10.1002/jum.14955] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 01/03/2019] [Indexed: 06/09/2023]
Abstract
Since its introduction, contrast-enhanced ultrasound (CEUS) has gained an important role in the diagnosis and management of abdominal and pelvic diseases. Contrast-enhanced ultrasound can improve lesion detection rates as well as success rates of interventional procedures when compared to conventional ultrasound alone. Additionally, CEUS enables the interventionalist to assess the dynamic enhancement of different tissues and lesions, without the adverse effects of contrast-enhanced computed tomography, such as exposure to ionizing radiation and nephrotoxicity from iodinated contrast material. This review article describes the various applications and advantages of the use of CEUS to enhance performance of ultrasound-guided interventions in the abdomen and pelvis.
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Affiliation(s)
- Rivka Kessner
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Dean A Nakamoto
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Victor Kondray
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sasan Partovi
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Yasmine Ahmed
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Nami Azar
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
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Silverman SG, Megibow AJ, Fletcher JG. Society of Abdominal Radiology Disease-Focused Panel Program: rationale for its genesis and status report. Abdom Radiol (NY) 2017; 42:2033-2036. [PMID: 28349224 DOI: 10.1007/s00261-017-1115-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Stuart G Silverman
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
| | - Alec J Megibow
- Department of Radiology, New York University School of Medicine, New York, NY, USA
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Abstract
Reignited by innovations in scanner engineering and software design, dual-energy computed tomography (CT) has come back into the clinical radiology arena in the last decade. Possibilities for noninvasive in vivo characterization of genitourinary disease, especially for renal stones and renal masses, have become the pinnacle offerings of dual-energy CT for body imaging in clinical practice. This article renders a state-of-the-art review on clinical applications of dual-energy CT in genitourinary imaging.
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Affiliation(s)
- Achille Mileto
- Department of Radiology, University of Washington School of Medicine, Box 357115, 1959 Northeast Pacific Street, Seattle, WA 98195, USA
| | - Daniele Marin
- Department of Radiology, Duke University Medical Center, Box 3808 Erwin Road, Durham, NC 27710, USA.
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Federle MP, Jaffe TA, Davis PL, Al-Hawary MM, Levine MS. Contrast media for fluoroscopic examinations of the GI and GU tracts: current challenges and recommendations. Abdom Radiol (NY) 2017; 42:90-100. [PMID: 27503380 DOI: 10.1007/s00261-016-0861-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
One of the significant challenges facing radiologists who perform and interpret studies of the gastrointestinal and genitourinary systems have been periodic interruptions in the availability of barium and iodinated contrast media specially formulated for gastrointestinal (GI) and genitourinary (GU) studies. These interruptions are due to the US Food and Drug Administration's recent requirement for more stringent documentation of the safety and efficacy of contrast media and the consolidation among contrast manufacturers. Therefore, radiologists may be required to recommend an alternative means of evaluation, such as computed tomography, magnetic resonance, or endoscopy, or they may need to substitute a different formulation of a contrast agent not specifically developed for GI or GU use, for example the utilization of an agent designed and marketed for vascular use. This article reviews the current status of fluoroscopic contrast media, and provides suggestions and recommendations for the optimal and alternative use of contrast media formulations.
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Affiliation(s)
- Michael P Federle
- Stanford University Medical Center, 300 Pasteur Drive, Rm H1330, Stanford, CA, 94305, USA.
| | - Tracy A Jaffe
- Duke University Medical Center, Box 3808 DUMC, Durham, NC, 27710, USA
| | - Peter L Davis
- Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh, PA, 15213, USA
| | - Mahmoud M Al-Hawary
- University of Michigan, 1500 E. Medical center Dr, Ann Arbor, MI, 48109, USA
- University Hospital, Room B1 D502, San Antonio, USA
| | - Marc S Levine
- Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
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Baheti AD, Nicola R, Bennett GL, Bordia R, Moshiri M, Katz DS, Bhargava P. Magnetic Resonance Imaging of Abdominal and Pelvic Pain in the Pregnant Patient. Magn Reson Imaging Clin N Am 2016; 24:403-17. [PMID: 27150326 DOI: 10.1016/j.mric.2015.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The utility of MR imaging in evaluating abdominal and pelvic pain in the pregnant patient is discussed. Details regarding the indications, technical aspects, and imaging findings of various common abdominal and pelvic abnormalities in pregnancy are reviewed.
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Affiliation(s)
- Akshay D Baheti
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Room BB308, Box 357115, Seattle, WA 98195, USA.
| | - Refky Nicola
- Department of Radiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642, USA
| | - Genevieve L Bennett
- Department of Radiology, New York University School of Medicine, 660 First Avenue, New York, NY 10016, USA
| | - Ritu Bordia
- Section of Neuroradiology, Department of Radiology, Winthrop-University Hospital, 259 First Street, Mineola, NY 11501, USA
| | - Mariam Moshiri
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Room BB308, Box 357115, Seattle, WA 98195, USA
| | - Douglas S Katz
- Section of Neuroradiology, Department of Radiology, Winthrop-University Hospital, 259 First Street, Mineola, NY 11501, USA
| | - Puneet Bhargava
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Room BB308, Box 357115, Seattle, WA 98195, USA
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Dietz HP, Kamisan Atan I, Salita A. Association between ICS POP-Q coordinates and translabial ultrasound findings: implications for definition of 'normal pelvic organ support'. Ultrasound Obstet Gynecol 2016; 47:363-368. [PMID: 25854801 DOI: 10.1002/uog.14872] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Revised: 04/06/2015] [Accepted: 04/07/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Female pelvic organ prolapse is quantified on clinical examination using the pelvic organ prolapse quantification system of the International Continence Society (ICS POP-Q). Pelvic organ descent on ultrasound is strongly associated with symptoms of prolapse, but associations between clinical and ultrasound findings remain unclear. This study was designed to compare clinical examination and imaging findings, especially regarding cut-offs for the distinction between normal pelvic organ support and prolapse. METHODS This was a retrospective study using 839 archived datasets of women referred to a tertiary urogynecological center for symptoms of lower urinary tract and pelvic floor dysfunction between June 2011 and May 2013. The main outcome measures were the maximum downward displacement of the anterior vaginal wall (point Ba), the cervix (point C) and the posterior vaginal wall (point Bp), the length of the genital hiatus (Gh) and the length of the perineal body (Pb), as defined by the ICS POP-Q; explanatory parameters were measures of pelvic organ descent on translabial ultrasound, ascertained by offline volume data analysis at a later date, by an operator blinded to all other data. RESULTS Full datasets were available for 825 women. On clinical examination, 646 (78.3%) were found to have prolapse of at least POP-Q Stage 2. All coordinates on clinical examination were strongly associated with the ultrasound measurements of pelvic organ descent (P < 0.001). These relationships were almost linear, especially for the anterior compartment. CONCLUSIONS There is a near linear relationship between sonographic and clinical measures of prolapse. Previously proposed cut-offs to define 'significant prolapse' on ultrasound and POP-Q (Ba ≥ -0.5 and cystocele ≥ 10 mm below the symphysis pubis, C ≥ -5 and uterine position of 15 mm above the symphysis pubis, Bp ≥ -0.5 and rectocele ≥ 15 mm below the symphysis pubis) are plausible and mutually consistent. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- H P Dietz
- Department of Obstetrics and Gynecology, Sydney Medical School Nepean, University of Sydney, Penrith, Australia
| | - I Kamisan Atan
- Department of Obstetrics and Gynecology, Sydney Medical School Nepean, University of Sydney, Penrith, Australia
| | - A Salita
- Department of Obstetrics and Gynecology, Sydney Medical School Nepean, University of Sydney, Penrith, Australia
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Gágyor D. [Present properties of ultrasound diagnostics in urogynecology]. Ceska Gynekol 2016; 81:265-271. [PMID: 27882747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The review article describes properties of sonography diagnostics in urogynecology. DESIGN Review article. SETTING Department of Obstetrics and Gynaecology, Faculty of Medicine and Dentistry, Palacky University in Olomouc. MATERIAL AND METHODS The review of sonography methods in urogynecology, their practical use for low urinary tract dysfunctions diagnostics, monitoring of surgical therapy effect and diagnostics of complications. CONCLUSION Ultrasonography is inseparable part of urogynaecology examination, it is imaging method of the first choice to determine the exact diagnosis and indication for therapy, evaluation of postoperative conditions and solution of complications.
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Affiliation(s)
- Anitha Mandava
- Department of Radiodiagnosis, Central Hospital, Lalaguda, South Central Railway, Secunderabad, AP, India, 500017,
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Lee YJ, Son SJ, Paick JS, Kim SW. Preoperative CT voiding cystourethrography using 16-multidetector CT in female urethral diverticulum. PLoS One 2014; 9:e107448. [PMID: 25216189 PMCID: PMC4162593 DOI: 10.1371/journal.pone.0107448] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 08/11/2014] [Indexed: 11/27/2022] Open
Abstract
Purpose To evaluate the clinical usefulness of preoperative CT voiding cystourethrography (CT-VCUG) using 16-multidetector computed tomography for female urethral diverticula. Materials and Methods Preoperative CT-VCUG was performed in 15 consecutive patients who underwent urethral diverticulectomy from May 2004 to December 2012. The result of preoperative cystourethroscopy and surgical findings were recorded by a single surgeon and CT-VCUG findings including the location of osita were retrospectively reviewed by another urologist who was blinded to the surgical finding. The location of the ostium detected on CT-VCUG was compared descriptively with the intraoperative surgical and preoperative cystourethroscopic findings. Results A total of 14 consecutive patients who underwent preoperative CT-VCUG and urethral diverticulectomy were included in the analysis. Ostia were detected on CT-VCUG in all cases, whereas ostia were identified in 10 patients (71.4%) by cystourethroscopy. Ostia were located between the 4 and 8 o’clock direction. Mean distance from the bladder neck to the ostium was 24.2 mm. Circumferential and horseshoe shaped diverticula were observed in 6 and 4 patients, respectively. The surgical findings correlated well with the CT findings. Conclusions Preoperative CT-VCUG can be useful in identifying the ostia of urethral diverticula in patients scheduled for urethral diverticulectomy and can provide structural information, useful to establish surgical strategy.
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Affiliation(s)
- Young Ju Lee
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Seung Jun Son
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Jae-Seung Paick
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Soo Woong Kim
- Department of Urology, Seoul National University Hospital, Seoul, Korea
- * E-mail:
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Harbuziuk VV, Pol'ova SP, Korando NV. [REPRODUCTIVE FUNCTION DISORDERS IN WOMEN WITH PULMONARY TUBERCULOSIS]. Lik Sprava 2014:73-75. [PMID: 26118087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The article presents analysis of ultrasound examination of 45 reproductive age women with pulmonary tuberculosis and diseases of genitalia, among them high portion of genital tuberculosis. It is shown high diagnostic value of sonography and dopplerometry in early determination of reproductive function disorders in women with tuberculosis.
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Wang X, Yang H, Zhang H, Shi T, Ren W. Transvaginal sonographic features of perineal masses in the female lower urogenital tract: a retrospective study of 71 patients. Ultrasound Obstet Gynecol 2014; 43:702-710. [PMID: 24254259 DOI: 10.1002/uog.13251] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 10/11/2013] [Accepted: 10/15/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To assess the transvaginal ultrasonographic features of perineal masses in the lower urogenital tract in a cohort of 71 women. METHODS Seventy-one women with perineal masses were referred consecutively for transvaginal ultrasonography. Two-dimensional (2D) ultrasound was used to scan the pelvic floor, including the urethra, vagina and rectum, and identify any possible areas of interest. A static three-dimensional (3D) sonographic reconstruction of the pelvic anatomy was created to further delineate the relation of the lesions with their neighboring structures. Ultrasound results were compared retrospectively with surgical pathology outcome when possible. RESULTS Seventy-nine cystic, cystic-solid or solid masses were detected on transvaginal 2D ultrasonography in the 71 women: in 44 patients, 47 anechoic cystic masses were identified and diagnosed as vaginal wall cysts; in 19 patients, 23 hyperechoic cystic masses were diagnosed as vaginal epidermoid cysts; in each of two patients, a hypoechoic cystic-solid mass showing blood-flow signals on color Doppler imaging was diagnosed as urogenital angiomyofibroblastoma; in each of three patients, a hypoechoic cyst was diagnosed as urethral diverticulum; and in three patients with a known history of gynecological malignancy, solid heterogeneous masses with blood flow signals on color Doppler imaging were diagnosed as metastatic cancer. In all patients, 3D ultrasonography delineated the anatomical relationship of these masses to the vagina, urethra and rectum. CONCLUSIONS Transvaginal 2D and 3D ultrasonography is an accurate, non-invasive, cost-effective diagnostic modality for the delineation of congenital, septic and neoplastic lower urogenital tract perineal masses in women.
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Affiliation(s)
- X Wang
- Department of Ultrasound Medicine, Shengjing Hospital affiliated to China Medical University, Shenyang, China
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Troyano Luque JM, Ferrer-Roca O, Barco-Marcellán MJ, Sabatel López R, Pérez-Medina T, Pérez-Lopez FR. Modification of the hand-held Vscan ultrasound and verification of its performance for transvaginal applications. Ultrasonics 2013; 53:17-22. [PMID: 22944075 DOI: 10.1016/j.ultras.2012.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2012] [Revised: 03/14/2012] [Accepted: 03/14/2012] [Indexed: 06/01/2023]
Abstract
PURPOSE The purpose of this work was to validate a new clinical obstetrics and gynecology (OB-GYN) application for a hand-held ultrasound (US) device. We modified the smallest hand-held device on the market and tested the system for transvaginal (TV) use. This device was originally conceived for abdominal scanning only. METHODS The validation involved 80 successive patients examined by the same operator: 25 obstetric and 55 gynecologic cases. US examination was performed transvaginally with two US systems: the hand-held Vscan (General Electrics; GE Vingmed Ultrasound; Norway) for which an intravaginal gadget TTGP-2010® (Troyano transvaginal gadget probe) was designed, and the Voluson 730 Expert (multifrequency transvaginal ultrasound of 3-9MHz; GE Healthcare, Milwaukee, WI, USA). We performed the same measurements with both US systems in order to confirm whether or not their diagnostic capability was similar. Quantitative difference in measurements between the systems was assessed, as well as the overall diagnostic detection rate and suitability for telemedicine. RESULTS Regarding lesion visibility with Vscan, optimal distance was 8-16cm depending on the examination type, and the total detection rate was 98.7%. The exception was an ovarian endometrioma, diagnosed as a follicular cyst using the hand-held device. Assessment of reproducibility in 180 measurements showed that the measurements obtained with Vscan were 0.3-0.4cm lower than those obtained with the high resolution US device (Voluson 730 Expert). Nevertheless, Pearson's correlation coefficient was high for biparietal diameter (0.72) and gynecological (GYN) (0.99) measurements, and for overall correlation (0.997). Image transport on USB and SD-flash cards proved convenient for telemedicine. CONCLUSIONS A novel TV application of a hand-held US device is demonstrated for OB-GYN. Heart, abdominal and obstetrics presets of the Vscan together with color-Doppler enable a detection capability comparable to that of a high-definition US device. The lower values of the measurements obtained by the hand-held device (by 0.3-0.4cm) must be taken into account, although they have no effect on its diagnostic capability.
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Affiliation(s)
- J M Troyano Luque
- Ultrasound Unit and Fetal Medicine, University Hospital of Canary Islands, Tenerife, Canary Islands, Spain.
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Mašata J, Svabík K, Martan A. [Ultrasound in urogynecology]. Ceska Gynekol 2012; 77:292-298. [PMID: 23094766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE OF THE STUDY The objective of the study is to display the role and importance of ultrasound examination in urogynecology. DESIGN Literature review. SETTINGS Department of Gynecology and Obstetrics, First Medical Faculty, Charles University, General Teaching Hospital, Prague. MATERIAL AND METHODS Presentation of the standards in use of ultrasound imaging in urogynecology and presentation of our practical skills in ultrasound diagnoses in the management of lower urinary tract dysfunctions and in monitoring of the effect of surgical treatment and its complications. CONCLUSIONS Ultrasound is an excellent method for the investigation of the lower urinary tract, not only as a diagnostic tool but also for the monitoring of the effect of surgical procedures.
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Affiliation(s)
- J Mašata
- Gynekologicko-porodnicka klinika, Praha
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Lanitis S, Zacharioudakis C, Zafeiriadou P, Armoutides V, Karaliotas C, Sgourakis G. Incidental findings in trauma patients during focused assessment with sonography for trauma. Am Surg 2012; 78:366-372. [PMID: 22524779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
During the initial assessment of trauma patients they usually undergo a Focused Assessment with Sonography for Trauma (FAST) in which there are occasionally incidental findings of other surgical conditions. In this audit we discuss the incidence, demographics, and implications of these findings and we propose a management algorithm. Within 2 years we managed 6041 trauma patients in the emergency department based on the Advanced Trauma Life Support protocols, 95 per cent of which underwent a FAST ultrasound. Incidental findings were reported in 468 patients (7.8%), whereas in a further 11.2 per cent of these patients there was a second finding. The mean age of these patients was 57.55 years (15-105), and most of them were men (51.1%). The vast majority of the findings were related to the liver and biliary tree (52.1%) followed by the urinary track (27.1% + 8%). In multivariate analysis only the age was a significant factor associated with incidental findings (P < 0.001) whereas in univariate analysis both the gender [men (54.1%) vs women (45.9), P = 0.013] and the mechanism of trauma (P < 0.001) were as important as the age (P < 0.001). The patients who had incidental findings were 15 years older than the rest. The detection of unknown surgical conditions in FAST may lead to managerial and possible medico-legal issues rendering the development of a proper algorithm mandatory.
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Affiliation(s)
- Sophocles Lanitis
- Second Surgical Department and Unit of Surgical Oncology, Korgialenio-Benakio, Red Cross Athens General Hospital, Athens, Greece.
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Bignardi T, Burnet S, Alhamdan D, Lu C, Pardey J, Benzie R, Condous G. Management of women referred to an acute gynecology unit: impact of an ultrasound-based model of care. Ultrasound Obstet Gynecol 2010; 35:344-348. [PMID: 20069669 DOI: 10.1002/uog.7523] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To assess the impact of the introduction of an ultrasound-based model of care for women with acute gynecological complications. METHODS This was a prospective comparative study of women attending an ultrasound-based acute gynecology unit (AGU) at the Nepean Hospital during a 6-week period 4 months after the unit's inception (new model of care), and a group of women presenting at the hospital during a similar period 6 months immediately prior to the unit's inception (traditional model). In the new model of care, ultrasound was performed at the time of the initial assessment by a senior clinician. The main outcome measures were admission rates and occupied bed days. RESULTS The study included 290 consecutive women with complete data, 133 before and 157 after the introduction of the AGU. Compared with the group presenting before establishment of the AGU, the group who attended the AGU had significantly lower admission rate (7% vs. 36%, P < 0.0001) and significantly shorter time to see a trainee gynecologist (mean, 172 vs. 205 min, P = 0.00089), time to ultrasound examination (mean, 199 vs. 533 min, P < 0.0001), length of stay as an outpatient (mean, 45 vs. 248 min, P < 0.0001), fewer occupied bed days (total, 30 vs. 85 days, P < 0.0001) and lower surgical intervention rates (12% vs. 29%, P = 0.00025). They also had significantly higher expectant management rate (26 vs. 8%, P = 0.00023). The extrapolated annual reduction in occupied bed days represented a total financial saving of $ 257 617 Australian dollars. CONCLUSIONS In the AGU, the availability of ultrasound carried out by a senior clinician with an interest in gynecological emergencies may lead to a reduction in admissions and improved outcomes.
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Affiliation(s)
- T Bignardi
- Acute Gynaecology and Early Pregnancy Unit, Nepean Centre for Perinatal Care, Nepean Clinical School, University of Sydney, Nepean Hospital, Penrith, Sydney, Australia.
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Perineal ultrasound. Ultraschall Med 2010; 31:87. [PMID: 20191670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Testa AC, Van Holsbeke C, Mascilini F, Timmerman D. Dynamic and interactive gynecological ultrasound examination. Ultrasound Obstet Gynecol 2009; 34:225-229. [PMID: 19644933 DOI: 10.1002/uog.7309] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- A C Testa
- Gynecologic Oncology Unit, Catholic University of Rome, Rome, Italy.
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Abstract
In the current era of pediatric uroradiology, use of nuclear medicine, ultrasonography, CT, and MRI has been valuable in the identification and management of genitourinary diseases. Excellent information about the renal parenchyma and renal function is currently attainable with current cross-sectional imaging techniques that can identify tissue differentiation of lesions, distinguish dilatation of the pelvocalyceal system, and determine margins of the kidney and perirenal space. Invasive angiography is limited in application specifically to vascular diseases, although they are uncommon in childhood. Because of these newer techniques, intravenous urography has lost its position as the "cornerstone" of urinary tract imaging and is used mainly to identify pathologic conditions of the ureters.
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Affiliation(s)
- John R Sty
- Department of Pediatric Radiology, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI 53201, USA
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Ruffolo C, Angriman I, Scarpa M, Polese L, Pagano D, Barollo M, Bertin M, D'Amico DF. Urologic complications in Crohn's disease: suspicion criteria. Hepatogastroenterology 2006; 53:357-60. [PMID: 16795972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND/AIMS Genitourinary complications occur in 4 to 35% of Crohn's disease patients. The aim of this study was to assess the threshold to suspect urologic involvement in Crohn's disease in order to plan the correct surgical management. METHODOLOGY Medical records of 258 consecutive patients who have undergone bowel resection for Crohn's disease were reviewed. We evaluated recurrent urinary tract infections, fever, dysuria, pneumaturia, fecaluria, abdominal mass at palpation or lower back pain at percussion, abdominal ultrasound and computerized tomography scan reports. Univariate analysis and multivariate analysis were performed with Fisher exact and log-linear tests respectively. RESULTS Urologic complications were found in 11 patients (4.3%). Fistulizing disease, female gender and inflammatory mass were significantly increased in Crohn's disease patients with urinary tract involvement (p < 0.01). Ultrasound and computerized tomography scan demonstrated good specificity, sensibility, positive and negative predicting values for urologic complications. CONCLUSIONS In the presence of abdominal mass in a Crohn's disease patient, the following step should be abdominal ultrasound or computerized tomography scan to rule out involvement of the ureter that should be treated previously to improve the intraoperative picture and patient general status.
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Affiliation(s)
- Cesare Ruffolo
- Clinica Chirurgica I, Department of Surgical and Gastroenterological Sciences, University of Padova, Italy
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Abstract
OBJECTIVE The purpose of this article is to present the imaging appearance of common mimickers of appendicitis in children with right lower quadrant pain. CONCLUSION The majority of children who undergo imaging for suspected appendicitis will end up having an alternative diagnosis. These mimickers can be gastrointestinal, genitourinary, or pulmonary. Familiarity with these alternative diagnoses can aid in the challenging task of imaging right lower quadrant pain in the pediatric population.
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Affiliation(s)
- Tammy Sung
- Department of Radiology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
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Wootton-Gorges SL, Thomas KB, Harned RK, Wu SR, Stein-Wexler R, Strain JD. Giant cystic abdominal masses in children. Pediatr Radiol 2005; 35:1277-88. [PMID: 16151789 DOI: 10.1007/s00247-005-1559-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2005] [Revised: 06/28/2005] [Accepted: 07/01/2005] [Indexed: 11/25/2022]
Abstract
In this pictorial essay the common and uncommon causes of large cystic and cyst-like abdominal masses in children are reviewed. We discuss and illustrate the following: mesenchymal hamartoma, choledochal cyst, hydrops of the gallbladder, congenital splenic cyst, pancreatic pseudocyst, pancreatic cystadenoma, hydronephrosis, multicystic dysplastic kidney, multilocular cystic nephroma, adrenal hemorrhage, mesenteric and omental cysts, gastrointestinal duplication cyst, meconium pseudocyst, ovarian cysts and cystic neoplasms, hematocolpos, urachal cysts, appendiceal abscess, abdominal and sacrococcygeal teratoma, and CSF pseudocyst. We also describe imaging features and clues to the diagnosis.
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Affiliation(s)
- Sandra L Wootton-Gorges
- Department of Radiology, University of California, Davis Health Center and U.C. Davis Children's Hospital, 4860 Y St. Suite 3100, Sacramento, CA 95817, USA.
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23
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Buĭlov VM. [The 11-th European Symposium on Urogenital Radiology]. Vestn Rentgenol Radiol 2005:51-7. [PMID: 16711248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
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24
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Abstract
Radiologic procedures such as lateral cystography have been substituted by ultrasound in urogynecology. The techniques are standardized and reproducible. Ultrasound is also useful for evaluating the bladder neck (funneling), the urethra (diverticula) and the paraurethral tissues (vaginal cysts, vaginal fibroids). The technique is limited in patients with genital prolapse beyond the hymenal ring. Advantages include the avoidance of x-rays and catherization.
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Affiliation(s)
- U Peschers
- Frauenklinik-Beckenbodenzentrum Oberbayern, Amperkliniken AG, Dachau.
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25
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Abstract
Sarcoidosis is a systemic disorder of unknown cause with a wide variety of clinical and radiologic manifestations. The diagnosis is usually made on the basis of these manifestations supported by histologic findings. Systemic manifestations (eg, Löfgren syndrome, Heerfordt syndrome) are commonly seen at clinical examination. Bilateral hilar lymphadenopathy is the most common radiologic finding-frequently with associated pulmonary infiltrates-and typically has a characteristic perivascular distribution at high-resolution chest computed tomography. Radiologic findings in the short tubular bones of the hands and feet and magnetic resonance imaging findings of nodular involvement of muscle are often sufficient to raise suspicion for sarcoidosis. In the liver, spleen, kidneys, and scrotum, coalescing granulomas form nodules whose imaging features may occasionally be nonspecific, although familiarity with the relevant clinical settings will be helpful in recognizing the presence of sarcoidosis. Radiologic recognition of cardiac and central nervous system involvement is also important because patients may be only mildly symptomatic. The clinical course and prognosis of sarcoidosis are highly variable, often correlating with the mode of onset. Familiarity with the clinical and radiologic features of sarcoidosis in various anatomic locations plays a crucial role in diagnosis and management.
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Affiliation(s)
- Takashi Koyama
- Department of Radiology, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
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26
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Hasegawa N, Kato N, Ohishi Y, Fukuda K. [Urologic area]. Nihon Rinsho 2004; 62:781-9. [PMID: 15106350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
In this review, the clinical experience of a three-dimensional(3D) image at urologic area are described. There are some methods for reconstructive 3D image of Multi-slice CT. Maximum intensity projection (MIP) is usefulness for detection of vascular anatomy. Multi-planar reconstruction (MPR) is usefulness for relation with circumference organs. Therefore the opportunities of angiography decreased. It seems that an applied range of a 3D image spreads more in future.
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Affiliation(s)
- Norio Hasegawa
- Department of Urology, Jikei University School of Medicine
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27
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28
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Patient page. Transvaginal ultrasound. Radiol Technol 2004; 75:252. [PMID: 14983597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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29
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Affiliation(s)
- Henrik S Thomsen
- Department of Diagnostic Radiology, Copenhagen University Hospital, Herlev, Denmark.
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30
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Abstract
Diabetes mellitus is a common multisystemic disorder with serious effects on the gastrointestinal tract, genitourinary system and soft tissues. The long-term effects of diabetes are mainly related to macro- and microvascular disease, neuropathy, both autonomic and somatic, and to an increased susceptibility to infections, which generally develop 15-20 years after the appearance of overt hyperglycemia. Herein, we discuss the unusual long-term complications related to the disease that can display a characteristic CT pattern. CT, together with clinical findings, proved useful in the identification and characterization of such unusual pictures. Knowledge of the specific pathology and imaging features of unusual late effects related to the disease is of paramount importance for the correct management of diabetic patients.
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Affiliation(s)
- Giuseppe Tognini
- Istituto di Scienze Radiologiche, Università degli Studi di Parma, Via Gramsci 14, 43100 Parma, Italy.
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31
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Bellin MF, Roy C. [GU imaging: an update from RSNA 2002]. J Radiol 2003; 84:768-70. [PMID: 13130221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Affiliation(s)
- M F Bellin
- Service de Radiologie, Hôpital Paul Brousse, BP 200, 94804 Villejuif Cedex
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32
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Abstract
PURPOSE We report our preliminary experience with the use of fibrin sealant to manage iatrogenic urinary tract injuries, complex urinary fistulas, and urological surgical complications. MATERIALS AND METHODS Topical fibrin sealant was used in 19 patients for iatrogenic urinary tract injury during gynecological or general surgical procedures (7), complex urinary fistulas (5) or urological surgical complications (7). RESULTS Successful resolution of the injury, fistula or complication was attained after a single application of fibrin sealant in the 18 patients (94.7%) in whom a direct injection technique was used. The only failure (formation of a vesicovaginal fistula) occurred with the air driven sprayed sealant delivery technique after sutured closure of iatrogenic cystotomy during vaginal hysterectomy. CONCLUSIONS Liquid fibrin sealant appears to be safe and prudent for use in urological "damage control" from trauma, fistulas or surgical complications. Direct injection over a sutured urinary anastomosis appears to be highly effective in preventing urinary drainage. Additional study is needed to define further the role and best use of tissue adhesives in urology.
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Affiliation(s)
- L Andrew Evans
- Urology Service, Brooke Army Medical Center, Fort Sam Houston, Texas, USA
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33
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Abstract
Improved nutrition and client education have decreased the incidence of certain urinary tract diseases in ferrets. Early neutering programs at commercial breeding farms in the United States have also led to a marked decrease in the incidence of reproductive tract disease, especially estrogen-induced bone marrow suppression. However, the increased incidence of adrenal disease and its secondary effects on reproductive and associated urinary tract tissue presents an ongoing challenge for the clinician working with pet ferrets. Acute and chronic renal failure remain important, though less common, disease entities. It is imperative that the veterinarian working with pet ferrets be aware of the clinical presentation and clinicopathologic abnormalities associated with these syndromes.
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Affiliation(s)
- Connie J Orcutt
- Avian and Exotic Pet Medicine, Angell Memorial Animal Hospital, 350 S. Huntington Avenue, Boston, MA 02130, USA.
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34
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Affiliation(s)
- S A Akbar
- Department of Radiology, William Beaumont Hospital, 3601 West 13 Mile Road, Royal Oak, MI 48073, USA
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35
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Fariña LA, Alonso MV. [Recommendations of the European Society of Urogenital Radiology on the use of contrast media and the opportunity to use paramagnetic contrast in patients allergic to iodinated contrast media treated with endourology]. Actas Urol Esp 2002; 26:820. [PMID: 12645382 DOI: 10.1016/s0210-4806(02)72864-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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36
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Jakobsen JA, Correas JM. Ultrasound contrast agents and their use in urogenital radiology: status and prospects. Eur Radiol 2002; 11:2082-91. [PMID: 11702144 DOI: 10.1007/s003300000817] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2000] [Accepted: 11/24/2000] [Indexed: 10/27/2022]
Abstract
Ultrasound contrast agents (USCAs) for intravenous use are usually microbubbles with a mean diameter less than that of a red blood corpuscle and filled with gas. The USCAs may improve information about tissue characteristics and physiology by enhancing B-mode imaging, all Doppler modalities and by means of contrast-specific imaging, e.g. harmonic and stimulated acoustic imaging. Results from preclinical experiments have been promising, and several of these have been reproduced in clinical studies. This includes improved evaluation of renal vasculature and parenchyma, assessment of vesicoureteral reflux in children, assessment of tubal patency in women, and evaluation of prostate diseases and erectile dysfunction in men. Some of the physical limits of the ultrasound technology, as well as the operator-dependent factors, can probably never be overcome by the use of USCAs; however, the development of USCAs is now about to provide uroradiologists with potentially efficacious products for the benefit of the patient.
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Affiliation(s)
- J A Jakobsen
- Department of Radiology, Rikshospitalet, 0027 Oslo, Norway.
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37
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Abstract
PURPOSE To describe the radionuclide three-phase whole-body bone imaging (TPWBBI) technique and discuss the usefulness of its application. MATERIALS AND METHODS TPWBBI was performed after a single intravenous injection of 555 to 925 MBq (15 to 25 mCi) Tc-99m MDP. Whole-body arterial flow (phase one) followed by blood-pool and tissue perfusion (phase two) images were obtained with the moving detector head speed set at 150 cm/minute and 40 cm/minute, respectively. Conventional whole-body static bone images (phase three) were obtained 3 hours later. RESULTS When 542 consecutive TPWBBI results were reviewed, 394 (166 extraskeletal and 228 skeletal) abnormalities were detected during phases one and two. The 166 extraosseous lesions included vascular diseases: abdominal aortic aneurysms and peripheral vascular diseases and renal abnormalities, liver abnormalities, ascites, and pleural effusions. Many of these were incidentally detected clinically significant findings and would not have been identified on conventional static bone images. It helps to differentiate among acute and chronic fractures, active and inactive inflammatory diseases such as arthritis or osteomyelitis, and Paget's disease. CONCLUSIONS With a single injection of Tc-99m MDP, whole-body images obtained in the arterial phase, the blood-pool and tissue perfusion phase, and the static bone phase can identify many clinically significant skeletal and soft tissue abnormalities. TPWBBI can differentiate between active and inactive phases of different disease processes and thereby provide a diagnosis that is more specific than a conventional single-phase bone scan. It may be applicable as a tool for nuclear physical examination.
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Affiliation(s)
- David C Yang
- Division of Nuclear Medicine, Department of Radiology, New York Methodist Hospital and Weill Medical College of Cornell University, New York, New York 11215, USA.
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38
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Abstract
OBJECTIVE Endoluminal sonography with high-frequency catheter-based transducers is a technique well suited to imaging structures beyond the lumen of the hollow viscus. The purpose of this article was to review some aspects of endoluminal sonography, including instrumentation, clinical applications in the gastrointestinal and genitourinary tracts, and its three-dimensional reconstruction. METHODS The development of 6F to 10F catheter-based ultrasonic probes has made this technique available for use within a variety of lumina. Endoluminal sonography with frequencies of 9 to 20 MHz has been used for evaluation of a wide range of abnormalities in both the genitourinary and gastrointestinal tracts. RESULTS Uses in the gastrointestinal tract include quantification of esophageal varices, distinguishing between various submucosal lesions, and measuring the degree of fibrosis in scleroderma. In the genitourinary system, endoluminal sonography has been used to guide collagen injection, to diagnose urethral diverticula and upper tract neoplasms, to locate crossing vessels and septa for guiding endopyelotomy, and to identify submucosal calculi. CONCLUSIONS High-resolution endoluminal sonography is a new sonographic approach for evaluation of the genitourinary and gastrointestinal tracts. This should lead to the expansion of the diagnostic capabilities of sonography, providing important information for decision making relative to patient care and minimally invasive interventional procedures. Reconstructed three-dimensional endoluminal sonography has the potential to become a valuable tool in both the research and clinical areas.
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Affiliation(s)
- Ji-Bin Liu
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA
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39
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Abstract
Since its introduction into clinical practice in the early 1930s, intravenous urography (IVU) was the primary imaging technique for the investigation of urinary system disorders for many years, until the advent of digital cross-sectional-imaging techniques gradually started to undermine many of its indications. Intravenous urography has been superseded for some indications such as renovascular arterial hypertension, prostatic dysuria, renal failure, palpable abdominal masses and recurrent urinary tract infection in women. Intravenous urography has been reduced, in the sense that it is no longer a primary examination, for other clinical indications such as renal colic, renal trauma, uroseptic fever, asymptomatic haematuria, medical haematuria, obstructive uropathies and follow-up of various disorders. Intravenous urography is indicated and often mandatory in congenital anomalies of the urinary tract, prior to endourological procedures, possible fistulas, renal transplantation, tuberculosis and ureteral pathology. In conclusion, IVU is still the examination of choice where there is a need to visualize the entire urinary system and to evaluate the state of the papillae and calyces. Computed tomography urography and MR urography are the imaging modalities ready in the near future to replace IVU.
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Affiliation(s)
- L Dalla Palma
- Department of Radiology, University of Trieste, Ospedale di Cattinara, Strada di Fiume 447, 34149 Trieste, Italy.
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40
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Abstract
Genitourinary imaging in children has gone through a metamorphosis in the past 30 years, paralleling technical advances in sonography, CT scanning, and MR imaging. The imaging sequences for hydronephrosis and UTI are still controversial and require outcomes analysis to determine which studies are most beneficial and efficacious.
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Affiliation(s)
- S J Kraus
- Department of Radiology, Fluoroscopy Section, Children's Hospital Medical Center, Cincinnati, Ohio, USA.
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41
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Trinkler FB. [Ultrasound examination of the urogenital tract: indications and limits]. Praxis (Bern 1994) 2001; 90:796-802. [PMID: 11392283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Today, ultrasound examination has become an established standard in urological practice. Sonographic imaging has benefited immensely from the dramatic advancements in digital computer technology. We users now receive better, more accurate information and insights into the functional diagnosis of urological disorders. The ultrasound images are generated in real time and the patient is not exposed to any radiation. As far as costs are concerned, ultrasound instruments of good quality are available at affordable prices, even for general practitioners. This is one reason why ultrasound is being used more and more frequently, replacing more invasive, burdensome and expensive diagnostic techniques in multiple indications. The aim of this paper is to outline the growing number of indications for ultrasound examination in urology, while pointing out the specific limitations of this diagnostic method.
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42
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Itoh K. [Radionuclide studies of the digestive organ and genitourinary system for general radiologists]. Nihon Igaku Hoshasen Gakkai Zasshi 2000; 60:678-83. [PMID: 11155696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Radionuclide imaging is useful in demonstrating the functional anatomy of target organs and has been used to in routine practices involving the digestive tract and genitourinary system. Such procedures are now limited in number of practices because of the advance of morphological modalities such as CT, MRI, and US. The functional information and data analysis obtained from radionuclide studies may be feasible for CT, MRI, and US. This paper reviews radionuclide studies that are common in clinical practice in Japan.
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Affiliation(s)
- K Itoh
- Department of Radiology, JR Sapporo General Hospital
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43
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Bourlière Najean B. [Pediatric radiography]. J Radiol 2000; 81 Suppl 1:A34-5. [PMID: 10949791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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44
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Beregi A, Molnár V, Felkai F, Bíró F, Szentgáli Z. Diagnostic radiology of pet and wild birds: a review II. Indications of radiological examination and radiographs of pathological lesions. Acta Vet Hung 2000; 47:395-408. [PMID: 10641331 DOI: 10.1556/avet.47.1999.4.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The second part of the review dealing with the diagnostic radiology of pet and wild birds discusses the indications of radiological examination, the interpretation of radiographs taken of pathological lesions, and the differential diagnosis of such lesions. Radiology has paramount importance in the diagnosis of diseases affecting the skeletal, digestive, respiratory, urogenital and cardiovascular systems. Certain diseases (shortage of grits, ovarian cysts) cannot be recognized without radiography. Other conditions (e.g. Macaw Wasting Disease, renal tumours, egg retention) require this complementary diagnostic method for confirmation of a suspicion based upon the clinical signs. Radiographic examination is also indicated for follow-up of the surgical management of bone fractures and for facilitating the implantation of transponders aimed at individual identification of the birds.
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Affiliation(s)
- A Beregi
- Department and Clinic of Internal Medicine, University of Veterinary Science, Budapest, Hungary.
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45
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46
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Abstract
Ultrasound has become the modality of choice for the evaluation of the neonatal genitourinary tract. High frequency linear, vector, and curved array transducers (7 MHz, 5 MHz, 12 MHz) and portability of the equipment make a rapid bedside evaluation with exquisite anatomic detail possible. A major advantage of sonography over other modalities is real time observation and circumvention of sedation.
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Affiliation(s)
- D E Blews
- Department of Radiology, Scottish Rite Children's Medical Center, Atlanta, Georgia, USA
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47
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Borthne A, Nordshus T, Reiseter T, Geitung JT, Gjesdal KI, Babovic A, Bjerre A, Loe B. MR urography: the future gold standard in paediatric urogenital imaging? Pediatr Radiol 1999; 29:694-701. [PMID: 10460332 DOI: 10.1007/s002470050677] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Examination of the paediatric urogenital tract is traditionally performed using methods that utilise ionising radiation, such as intravenous urography (IVU), computerised tomography (CT), voiding cystourethrography (VCU), and scintigraphy, in addition to ultrasound (US). OBJECTIVE To determine the potential and effectiveness of MR urography (MRU) in infants and children. Materials and methods. 44 MRU examinations were prospectively performed in 39 patients (21 infants, mean age 3.5 months, and 18 children, mean age 6 years 2 months) with known or suspected pathology of the urinary tract. Non-enhanced, fast spin-echo sequences (TSE) were performed in all patients. In 70 % of the patients a contrast-enhanced, fast gradient-echo sequence (TFE) was included. The dynamic sequence was prolonged and supplemented with furosemide provocation in some patients with suspected urinary-tract obstruction. RESULTS Nine percent of examinations were non-diagnostic or interrupted due to movement. MRU contributed additional information in 66 %. Nine patients with suspected urinary-tract obstruction were examined with both contrast-enhanced MRU and scintigraphy. Three MRU examinations were less informative and one equal to scintigraphy when obstruction was the diagnosis. When using a technique with a prolonged dynamic sequence, including frusemide provocation, four MRU examinations were equal and one was superior to scintigraphy. CONCLUSIONS MRU has the potential to replace traditional diagnostic methods which use ionising radiation in paediatric patients. Further studies are needed before definite conclusions can be drawn.
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Affiliation(s)
- A Borthne
- Department of Paediatric Radiology, Ullevaal University Hospital, N-0407 Oslo, Norway
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48
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Skjoldbye B, Rafaelsen SR, Langfeldt S, Rasmussen OS. [Ultrasound contrast media]. Ugeskr Laeger 1999; 161:4861-3. [PMID: 10778312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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49
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Chen MY, Bechtold RE, Bohrer SP, Zagoria RJ, Dyer RB. Abnormal calcification on plain radiographs of the abdomen. Crit Rev Diagn Imaging 1999; 40:63-202. [PMID: 10416103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
The purpose of this pictorial review is to facilitate recognition and understanding of calcifications seen on conventional radiographs of the abdomen. Calcifications can be categorized by organ system and location in the abdomen. Both common and rare calcifications in the urinary tract, liver, gallbladder, spleen, pancreas, adrenal glands, digestive tract, genital tract, peritoneal cavity, and retroperitoneum are illustrated. Abnormal calcifications in the urinary tract are subcategorized by kidneys, ureters, bladder, and urethra. The density, shape, size, margins, pattern, position, and mobility of calcifications are emphasized for differential diagnoses.
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Affiliation(s)
- M Y Chen
- Department of Radiology, Wake Forest Univesity School of Medicine, Winston-Salem, NC 27157-1088, USA
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50
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Malcher J, Mosser H, Bach A, Maier U, Hruby W. [Radiodiagnosis and therapy of fistulae in the urogenital region: a survey]. Rontgenpraxis 1999; 51:420-5. [PMID: 10047712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- J Malcher
- Institut für Röntgendiagnostik, Donauspital Wien
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