Adenomatoid tumor of epididymis simulating benign cyst on scrotal ultrasound.
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Adult↗
Biomedical subjects
C W Vick
Publications and source records attributed to C W Vick.
Rotator cuff tears: diagnosis with sonography.
The purpose of this study was to determine the accuracy of sonography in the detection of rotator cuff tears. Eighty-one patients were referred by orthopedic specialists because of a clinical suspicion of rotator cuff tear. The standards of comparison were arthrography in 79 cases and surgery in two cases. The sonographic technique used was based on a review of the literature and experience gained by scanning normal subjects. The sonographic criteria for the diagnosis of a complete rotator cuff tear were a focal defect in the cuff or complete absence or nonvisualization of the cuff. All sonograms were interpreted prospectively without knowledge of arthrographic or surgical results. With arthrography as the standard of comparison for the diagnosis of rotator cuff tear, sonographic results included 15 true-positives, 52 true-negatives, eight false-negatives, and four false-positives. With surgery as the standard of comparison, the results were one true-positive and one true-negative sonogram. The sensitivity of sonography in detecting rotator cuff tear was 0.67, the specificity was 0.93, and the accuracy was 0.85. Our study found lower sensitivity and accuracy results for shoulder sonography than have been previously reported.
Arthrography↗
Evaluation of azotemic patients: diagnostic yield of initial US examination.
To determine whether renal ultrasound (US) is necessary in all patients with azotemia, the authors retrospectively evaluated renal US examinations in 394 azotemic patients. The patients included 119 patients considered clinically to be at high risk for postrenal urinary obstruction and 275 patients considered to be at low risk. In the high-risk population, 35 patients were found to have hydronephrosis (29%). In the low-risk population, three patients were found to have hydronephrosis (1%). In two of these patients surgical intervention resulted in reversal of the azotemia. The authors recommend that renal US be performed in all high-risk patients and in low-risk patients only if temporization and standard medical treatment do not resolve the azotemia.
Humans↗
Neonatal vaginal cysts: diagnosis and management.
We report a 2.5 cm. vaginal cystic mass in a neonate. The differential diagnosis, evaluation and management of this lesion are discussed.
Cysts↗
Emphysematous pyelonephritis: diagnosis and treatment.
Emphysematous pyelonephritis is a rare life-threatening bacterial infection usually occurring in patients with diabetes mellitus and producing gas within the renal parenchyma and/or perirenal tissue. We add four cases to the 62 previously reported in the literature. The overall mortality is 38%, with only 29% survival for those treated medically compared to 71% for those given both medical and surgical treatment. Early diagnosis with the aid of renal ultrasonography and/or computerized axial tomography and aggressive early combined medical-surgical management are emphasized.
Adult↗
Extratesticular hemorrhage associated with torsion of the spermatic cord: sonographic demonstration.
Using ultrasound (US), we studied seven patients with torsion of the spermatic cord associated with a large amount of extratesticular hemorrhage. In each case, US showed a large echogenic or complex extratesticular mass caused by the hemorrhage, in addition to a hypoechoic testis and scrotal skin thickening. This appearance should be recognized as part of the spectrum of sonographic appearances that can be seen in torsion.
Adolescent↗
Upper abdominal trauma: pitfalls in CT diagnosis.
Medical records and computed tomographic (CT) scans of 83 patients with upper abdominal trauma were retrospectively reviewed to determine errors in diagnosis using CT. Patients with possible pancreatic injury, small bowel perforation, or injury to an occult malignancy represented the most difficult diagnostic cases. A false-positive diagnosis of pancreatic injury occurred in seven of 77 patients (9%) and represented the most frequent error in the series. In three patients with subsequently surgically proved small bowel perforation, one duodenal and two proximal jejunal, the injuries were not correctly diagnosed on CT scans. In retrospect, positive CT findings were present in the case of duodenal rupture. Additionally, in two patients, duodenal rupture was suspected based on CT findings of extraluminal gas and fluid near the duodenum, but both cases were proved normal at surgery. The series included three patients with trauma involving unsuspected tumors in the liver, kidney, and stomach.
Abdominal Injuries↗
Regenerating nodules in cirrhosis: sonographic appearance with anatomic correlation.
A sonographic-anatomic correlation study was undertaken to define the sonographic appearance of regenerating nodules in cirrhotic livers. Three cirrhotic livers with multiple regenerating nodules were obtained from patients undergoing liver transplantation. Sonograms of the resected livers were made and correlated directly with the anatomic specimens. Using a 3-MHz transducer, no discrete alterations in the echo texture of the livers were seen to correspond to the regenerating nodules. With a 7.5-MHz transducer, discrete islands of liver parenchyma were identified corresponding to regenerating nodules anatomically. The nodules were recognized because of visualization of thin, slightly more echogenic borders, which corresponded pathologically to fibrous and fatty connective tissue surrounding and separating the nodules.
Humans↗
Abdominal pseudotumor caused by gastric displacement of the spleen: sonographic demonstration.
An infant with a factitious abdominal mass due to splenic displacement by the distended stomach is described. Two other cases of this phenomenon have been previously reported, both in infants and both diagnosed by radionuclide scans and plain radiographs. In our patient, diagnosis was made with ultrasound without the need for further studies.
Abdominal Neoplasms↗
Bilateral granulomatous orchitis: manifestation of idiopathic systemic granulomatosis.
A case is reported of idiopathic systemic granulomatosis that was manifested by bilateral testicular enlargement and was misdiagnosed clinically as lymphoma. Despite high dose steroid and cyclophosphamide therapy, the patient died of disease within 9 months of diagnosis.
Granuloma↗
The use of ultrasound for evaluating subacute unilateral scrotal swelling.
In 15 patients with subacute (longer than 8 hours) unilateral scrotal swelling in whom the etiology was in doubt scrotal ultrasound was used to determine whether the pathological condition was intratesticular and/or extratesticular. Surgical exploration confirmed intratesticular or intratesticular and extratesticular findings in 9 patients: 8 had torsion of the spermatic cord (including a testis rupture in 1 and epididymal ruptures in 2) and 1 had a mixed germ cell carcinoma. Of the 6 patients with extratesticular findings 3 had clinical epididymitis that resolved on antibiotic therapy and 2 had what appeared to be paratesticular hematomas with normal testes presumed to be secondary to minor trauma. The condition resolved with conservative therapy in the latter 2 patients. The remaining patient required surgical drainage because of the size and an epididymal rupture suspected by the ultrasound examination. Scrotal ultrasound is a quick, noninvasive, easily applied, accurate method to diagnose scrotal pathological conditions and should be used whenever the etiology of scrotal swelling is in doubt.
Acute Disease↗
Adrenal myelolipoma: CT and ultrasound findings.
The computed tomographic (CT) and ultrasound (US) appearances of 5 adrenal myelolipomas in 4 patients are reported. The component tissues of a myelolipoma determine its CT and US appearance. A myelolipoma consisting primarily of fat has a characteristic CT and US appearance. A myelolipoma also containing macroscopic quantities of nonfatty material (blood, calcium, or myeloid tissue) may have a nonspecific CT or US appearance if fat is not identified in the lesion. In equivocal cases, needle biopsy may be used to establish the diagnosis of myelolipoma.
Adrenal Gland Neoplasms↗
Traumatic renal artery occlusion: CT diagnosis with angiographic correlation.
Traumatic renal artery occlusion is a rare injury and may be clinically silent or vague in its presentation. In the appropriate clinical setting CT findings are diagnostic, enabling prompt arteriographic evaluation and early surgical intervention.
Adult↗
CT of the normal and abnormal parametria in cervical cancer.
To evaluate CT criteria for differentiating a cervical cancer confined to the cervix from a lesion that invades the parametria, 16 patients with newly diagnosed, untreated cervical cancer were studied with CT. Twenty-five parametria were confirmed by radical hysterectomy, transvaginal parametrial fine-needle aspiration cytology, or excretory urography. In eight tumor-free parametria, CT findings indicating confined tumor were: (1) smooth, well defined cervical margins; (2) lack of prominent parametrial soft-tissue strands; (3) no parametrial soft-tissue mass; and (4) preservation of the periureteral fat plane. The simultaneous occurrence of these four findings was seen in six of eight tumor-free parametria and in no tumor-infiltrated parametria. In 17 tumor-positive parametria, CT findings associated with parametrial tumor invasion were: (1) irregularity or poor definition of the lateral cervical margins; (2) prominent parametrial soft-tissue strands; (3) obliteration of the periureteral fat plane; and (4) an eccentric parametrial soft-tissue mass. The latter two findings were seen only in tumor-positive parametria. Irregularity of the cervical margins and prominent parametrial strands were seen most commonly with parametrial tumor invasion, but were also occasionally seen with parametrial inflammation. On the basis of the criteria developed in this report, CT may be used as an adjunct to the physical examination in differentiating stage I cervical cancer from more advanced disease in selected patients.
Adnexa Uteri↗
Sonography of emphysematous pyelonephritis.
Emphysematous pyelonephritis is a rare gas-producing bacterial infection of the renal parenchyma seen primarily in patients with diabetes mellitus. Sonographic findings in four patients with this disease are described. Sonographic features consist of multiple high-amplitude echoes within the renal parenchyma, renal sinus, and/or perirenal space accompanied by acoustic shadowing. Computed tomography confirmed bilateral involvement in one case. Plain abdominal radiographs demonstrated abnormal extraluminal gas in three of four cases. The role of sonography in diagnosis is discussed.
Aged↗
Pitfalls related to the urinary bladder in pelvic sonography: a review.
A number of pitfalls related to the urinary bladder may be encountered during ultrasound examination of the pelvis. Examples of particularly difficult or frequently encountered situations are illustrated in this report. In our experience, difficulties most commonly arise from incorrect identification of the urinary bladder, with an abnormal cystic pelvic mass simulating the normal urinary bladder, or vice versa. In addition, confusing appearances may be caused by urine refluxed into the vagina, technical artifacts, bladder diverticula, or mobile pelvic masses displaced by the bladder. Definitive bladder identification is useful to avoid errors in situations likely to be associated with bladder related pitfalls.
Adolescent↗
Scrotal masses with a uniformly hyperechoic pattern.
Eight scrotal masses which appeared homogeneously hyperechoic on ultrasound were studied; 5 were testicular and 3 were extratesticular. Pathologically, there was no evidence of malignancy, and most lesions consisted of scar tissue or fibrosis. Two benign adenomatoid tumors were encountered. In this series, a homogeneously hyperechoic scrotal lesion was benign regardless of its location.
Adult↗
Ultrasound of the scrotal contents.
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Adult↗