Three-dimensional sonography in diagnosis of retroperitoneal hemorrhage from adrenocortical carcinoma.
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Adrenal Cortex Neoplasms↗
Biomedical subjects
Wieslaw Jakubowski
Publications and source records attributed to Wieslaw Jakubowski.
Tissue harmonic imaging of thyroid nodules: initial experience.
OBJECTIVE: To determine the impact of tissue harmonic imaging on visualization of the thyroid and gray scale contrast between thyroid nodules and adjacent thyroid parenchyma. METHODS: A prospective study was performed on 144 patients (148 lesions) undergoing sonographically guided fine-needle biopsy. The fundamental frequency and tissue harmonic images were obtained on a scanner with a wideband 7.5-MHz linear probe. One hundred forty-two benign nodules, 2 papillary carcinomas, 1 anaplastic carcinoma, and 1 metastatic lesion were found. In 1 case a suggestion of a follicular carcinoma was raised, and in 1 case no diagnostic material was obtained. The gray scale intensity of the lesions and adjacent thyroid tissue was measured with graphics software, and the gray scale contrast between lesions and adjacent thyroid tissue was calculated. Additionally, the overall conspicuity and border definition were evaluated by 2 independent observers. RESULTS: Tissue harmonic imaging improved the gray scale contrast between thyroid nodules and adjacent thyroid parenchyma in 116 lesions (78.4%). The overall conspicuity and border definition were improved or equal in the harmonic mode for most lesions. CONCLUSIONS: The tissue harmonic imaging technique used as an adjunct to conventional thyroid sonography may improve lesion detectability and characterization.
Adolescent↗
Tissue harmonic imaging: utility in breast sonography.
OBJECTIVE: To determine the impact of tissue harmonic imaging on visualization of focal breast lesions and to compare gray scale contrast between focal breast lesions and fatty tissue of the breast between tissue harmonic imaging and fundamental frequency sonography. METHODS: A prospective study was performed on 219 female patients (254 lesions) undergoing sonographically guided fine-needle biopsy. The fundamental frequency and tissue harmonic images of all lesions were obtained on a scanner with a wideband 7.5-MHz linear probe. Twenty-three breast carcinomas, 6 suspect lesions, 9 fibroadenomas, 1 papilloma, 1 phyllodes tumor, 162 unspecified solid benign lesions, and 40 cysts were found. In 12 cases the fine-needle aspiration did not yield sufficient material. The gray scale intensity of the lesions and adjacent fatty tissue was measured with graphics software, and the gray scale contrast between lesions and adjacent fatty tissue was calculated. RESULTS: Tissue harmonic imaging improved the gray scale contrast between the fatty tissue and breast lesions in 230 lesions (90.6%; P < .001) compared with fundamental frequency images. The contrast improvement was bigger in breasts with predominantly fatty or mixed (fatty/glandular) composition than in predominantly glandular breasts. The overall conspicuity, lesion border definition, lesion content definition, and acoustic shadow conspicuity were improved or equal in the harmonic mode for all lesions. CONCLUSIONS: The tissue harmonic imaging technique used as an adjunct to conventional breast sonography may improve lesion detectability and characterization.
Adult↗
Usefulness of hydrogen peroxide enhancement in diagnosis of anal and ano-vaginal fistulas.
Our objective was to assess if contrast-enhanced (CE) anal endosonography (AES) with hydrogen peroxide is useful in the diagnosis of anal and ano-vaginal fistulas. A Bruel and Kjaer scanner with a 7.0-MHz transducer was used. After visualization of the fistula tract in non-contrast (NC) AES, hydrogen peroxide was introduced into the fistula tract through the external opening in 22 patients with different types of anal fistulas. Both CE and NC AES revealed 13 transsphincteric, 3 intersphincteric, 2 suprasphincteric and 4 ano-vaginal fistulas. Simple tracts were found in 16 cases and complex in 6 cases in non-contrast AES. The CE AES revealed 19 simple and 3 complex fistulas. Fifteen internal openings visible in NC AES were confirmed in CE AES in 6 cases, which additionally found 11 more internal openings. Surgery confirmed all types of fistulas found in NC and CE AES; however, the latter two found 18 simple and 4 complex fistulas, and 21 internal openings. Both NC and CE AES are able to correctly differentiate types of anal fistulas and are of comparable value in differentiating simple from complex fistulas, although a false-negative result was found in CE AES. In the preoperative assessment of the internal opening, CE AES is superior to NC AES.
Adolescent↗
US of the major salivary glands: anatomy and spatial relationships, pathologic conditions, and pitfalls.
Ultrasonography (US) is useful for differential diagnosis of diseases of the salivary glands. In acute inflammation, salivary glands are enlarged and hypoechoic with increased blood flow; they may contain multiple small, oval, hypoechoic areas. In chronic inflammation, salivary glands are normal sized or smaller, hypoechoic, and inhomogeneous. Sialolithiasis appears as markedly hyperechoic lines or points with distal acoustic shadowing. Sialosis appears as enlarged hyperechoic glands without focal lesions or increased blood flow. The US features of advanced Sjögren syndrome include inhomogeneous salivary glands with scattered small, oval, hypoechoic or anechoic areas, usually well defined, and increased parenchymal blood flow. Pleomorphic adenomas are usually hypoechoic, well-defined, lobulated lesions with posterior acoustic enhancement that may contain calcifications; Warthin tumors are usually oval, hypoechoic, well-defined lesions that often contain anechoic areas and are often hypervascularized. Malignant neoplasms of the salivary glands may have irregular shapes, irregular borders, blurred margins, and a hypoechoic inhomogeneous structure or may have a benign appearance. Salivary gland cysts have well-defined margins, anechoic contents, posterior acoustic enhancement, and no internal blood flow. However, US appearances of some diseases may overlap, thus producing diagnostic pitfalls.
Diagnosis, Differential↗