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Biomedical subjects

G R Leopold

Publications and source records attributed to G R Leopold.

At least 19 recordsLinked to original sources
PubMed1992

Second-trimester echogenic bowel and chromosomal abnormalities.

OBJECTIVE: Our objective was to examine the outcomes of pregnancies in which echogenic bowel was detected in the second trimester. STUDY DESIGN: Twenty-two cases with a prospective diagnosis of echogenic bowel were reviewed. Karyotypic studies were performed in 19 cases, and 17 families had deoxyribonucleic acid-based risk assessment for cystic fibrosis. The echogenicity of the bowel was retrospectively reviewed and graded as mild or bright. RESULTS: Five cases of trisomy 21 and one case of trisomy 18 were detected; four of these had other ultrasonographic abnormalities. Twenty-seven percent of fetuses with echogenic bowel were aneuploid. Risk was greatest for cases with brightly echogenic bowel. No cystic fibrosis mutations were detected. The diagnosis of echogenic bowel was reproducible. CONCLUSION: Brightly echogenic bowel in the second trimester was found to be associated with a significant risk of fetal aneuploidy.

Chromosome Aberrations↗
PubMed1992

Spontaneous improvement of intrathoracic masses diagnosed in utero.

The diagnosis and pregnancy outcome for 14 fetuses with sonographically detected chest masses were reviewed retrospectively. Six lesions became smaller or less apparent during gestation or resolved between antenatal and perinatal imaging studies; these included all three types of cystic adenomatoid malformation (CAM), as well as one case of pulmonary sequestration (PS). This information is extremely important in counseling patients in the second trimester who are considering termination of pregnancy. The poor prognosis traditionally assigned to type II and type III CAM needs changing to reflect the phenomenon of improvement with excellent long-term outcomes. Sonographic indicators of poor outcome were polyhydramnios, hydrops or marked cardiac deviation.

Adult↗
PubMed1979

Intrauterine diagnosis of renal anomalies by ultrasonography.

The diagnosis of renal disease was made antenatally in three patients by ultrasonographic examination. In two cases a multicystic kidney was detected in utero and removed shortly after delivery. In another case, a hydronephrotic kidney was detected in utero; repair was then performed early, before symptoms developed in the infant. Antenatal diagnosis of renal disease by ultrasonography may help reduce morbidity and mortality in some cases.

Female↗
PubMed1979

Atypical pseudocysts of the pancreas: an ultrasonographic evaluation.

Ultrasonograms of most pseudocysts have a typical appearance--sharply defined, smooth wall, ovoid, located in the region of the pancreas. However, in reviewing the sonographic appearance of pseudocysts, other ultrasonographic characteristics may occasionally be encountered. Eleven patients with atypical pseudocysts are presented. The demonstration of multiple septations, multiple echoes within a sonolucent mass, and even failure to enhance posteriorly should not exclude the diagnosis of pancreatic pseudocyst in the proper clinical setting. The value of serial scans is also stressed. In this series, it was possible to suggest the diagnosis of infection, hemorrhage, and rupture of pseudocysts by demonstrating cysts with more typical appearances on prior examinations.

Adult↗
PubMed1979

High-resolution ultrasonography of scrotal pathology.

A prototype high-resolution (10-MHz) real-time ultrasonic system was used to study 22 patients who were ultimately proved to have intra- and extratesticular tumors, scrotal fluid collections, and inflammatory processes. In 5 of 6 patients with primary testicular masses, there were areas of decreased echogenicity within the testis when compared with surrounding normal tissue. In general, the method was highly effective in differentiating and characterizing testicular and extratesticular processes.

Abscess↗
PubMed1979

High-resolution real-time ultrasonography of thyroid nodules.

High-resolution real-time ultrasonography was used to evaluate 98 patients with palpable abnormalities of the thyroid and positive isotopic studies. It confirmed 37 of 73 (51%) suspected solitary nodules. Of 25 patients thought to have multinodular goiter, sonography was supportive in 21 (84%). In patients with adenoma or adenomatous nodules, characteristic features included a sonolucent "halo". Colloid nodules tended to be more sonolucent than normal thyroid tissue, whereas Hashimoto thyroiditis was characterized by an enlarged gland and decreased echogenicity.

Adenoma↗
PubMed1979

Accuracy of ultrasonography in diagnosis of hepatocellular disease.

Retrospective evaluations were made of abdominal echograms in 61 patients who underwent liver biopsy within 3 weeks after ultrasound study. Without knowledge of clinical or biopsy data, determinations were made by two independent observers of: (1) liver size, (2) beam penetration, (3) echogenicity, (4) vascularity, (5) ancillary abnormality, and (6) diagnostic impression. Using these parameters, the presence of generalized parenchymal disease was identified in 81% of reviews of patients with cirrhosis. Thus, in patients with known cirrhosis, there was a 19% false negative rate. In normal patients, 76% were correctly called normal by the reviewers. However, in 24% generalized parenchymal disease was suggested (24% false positive). Patients with fatty liver could not be reliably distinguished from patients with cirrhosis, nor could patients with hepatitis be easily separated from those with normal livers. In all of these determinations, the combination of several features provided more diagnostic accuracy than any single echographic finding.

Biopsy↗
PubMed1979

Ultrasonography of jaundice.

Ultrasonography is proposed as a valuable first step in the study of the jaundiced patient. Utilizing modern gray scale technology, it is nearly always possible to determine whether or not dilatation of the biliary tree is present. In the presence of diffuse liver disease without obstruction, some assessment of the state of the parenchyma can often be made. In patients with obstruction, its severity and level are usually easy to determine. It may be considerably harder to correctly diagnose the etiology of the obstruction, and more invasive investigations will then be required.

Bile Duct Neoplasms↗
PubMed1978

The dilated pancreatic duct: ultrasonic evaluation.

Eight patients with signs and symptoms of obstructive jaundice were evaluated by gray-scale echography. In each, ultrasonic identification of a dilated pancreatic duct was helpful in confirming the diagnosis of an obstructing lesion at the level of the ampulla of Vater. In only 3 could the tumor mass itself be seen on ultrasound. With the recognition of pancreatic duct dilatation, it is no longer essential for a tumor in the region of the ampulla of Vater to be large or contour-deforming before it can be identified by ultrasound.

Dilatation, Pathologic↗
PubMed1978

Lipomatous tumors of the kidney and adrenal: apparent echographic specificity.

Several fatty tumors of the kidney and adrenal gland were evaluated by gray scale ultrasound. An extremely dense echogenic pattern was common to all lesions. There were three solitary angiomyolipomata (renal hamartoma), a presumed diffuse hamartomatous involvement of the kidney in a patient with tuberous sclerosis, and one myelolipoma of the adrenal gland. This marked echogenicity is thought to be a feature of fatty tumors and enables relatively specific preoperative diagnosis of these lesions, all of which are benign. With regard to renal angiomyolipoma, this assessment may allow conservative treatment and preservation of functioning renal tissue.

Adrenal Gland Neoplasms↗
PubMed1978

Sensitivity of gray scale ultrasound in detecting urinary tract obstruction.

To determine the reliability of gray scale ultrasound in detecting urinary tract obstruction, a prospective study of 67 patients examined by both excretory urography and ultrasound was undertaken. The degree of hydronephrosis was defined by urographic criteria, and the corresponding echograms were analyzed without knowledge of the urographic results. Hydronephrosis was correctly diagnosed by ultrasound in 46 of 47 kidneys shown to be obstructed on urography, for a sensitivity of 98%. Our results show that when obstruction is the sole clinical question, ultrasound is an effective screening test. Thus many patients with a variety of medical diseases of the kidney can be spared excretory urography.

Adolescent↗