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A C Fleischer

Publications and source records attributed to A C Fleischer.

137 records · Page 8Linked to original sources

Sonographic patterns of distended, fluid-filled bowel.

When small or large bowel is distended with fluid, certain characteristic features can be seen on ultrasound which cannot be visualized when the bowel is collapsed. The proximal and distal portions of the small bowel can frequently be differentiated both in vitro and in vivo by the echoes emanating from the valvulae conniventes ("keyboard sign"). This depends upon the angle at which the bowel segment is scanned in relation to its long axis, the relative amount of intraluminal fluid and gas, the diameter of the bowel in relation to the beam width of the transducer, and the intrinsic resolution of the scanning system. Similarly, the ascending and transverse colon can be recognized by haustral sacculations, the distal rectosigmoid colon and rectum by the rectal valves. The tubular shape, characteristic arrangement and location, and peristaltic motion of most fluid-filled bowel segments are helpful in differentiating loops of bowel from cystic masses in the abdomen or pelvis.

Colon↗

Sonographic patterns in trophoblastic diseases.

A range of sonographic patterns in patients with hydatidiform moles can be appreciated with gray scale ultrasonography, which more readily reveals areas of internal hemorrhagic degeneration and fetal growth within a molar mass. Sonography may be used to evaluate patients suspected of having recurrent or invasive trophoblastic disease; a focus of invasive trophoblastic tumor can be identified as a cluster of high-amplitude echoes within the myometrium, which is frequently associated with echo-free areas of hemorrhage. The enlargement or regression of theca lutein cysts associated with these disease processes can also be monitored.

Female↗

Differential diagnosis of pelvic masses by gray scale sonography.

An approach to the sonographic differential diagnosis of pelvic masses based on their size, location, internal consistency, and definition of borders is presented. Diagnostic schemes were derived from correlating the sonographic features with histomorphology in 170 surgically proven pelvic masses. Besides separating pelvic masses into the conventional categories of cystic, complex, and solid, gray scale sonographic features of a pelvic mass can be used to subcategorize these masses into a more useful differential diagnoses. Although the features seen on a sonographic image were specific in only two types of pelvic masses (pattern specificity greater than 85%), the sonographic information can be effectively utilized for establishing differential diagnoses of pelvic masses. Among the various sonographic patterns observed, homogenously cystic adnexal masses were the least specific pattern, whereas a predominantly cystic, extrauterine mass with internal septation was highly specific for a pseudomucinous cystadenoma. Several pelvic masses such as dermoid cysts demonstrated more than one sonographic appearance and, therefore, had to be considered in more than one diagnostic category.

Adnexal Diseases↗

X-ray of the month.

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Aorta, Abdominal↗

Sonographic monitoring of ovarian follicular development.

Serial sonographic examinations were performed on 15 volunteers five days during the expected midcycle. The 75 sonographic studies were evaluated in a nonbiased manner, and the following features were assessed: 1) the presence or absence of a follicle within the ovary; 2) if present, the average dimension of the follicle; 3) the ability to delineate both ovaries; and 4) the presence of associated changes, such as involution of the follicle, echogenic texture within the follicle, or fluid in the cul-de-sac. The sonographic findings were correlated with serial leutinizing hormone (LH) assays as well as basal body temperature charts. As defined in the study, the correlation between the sonographic findings and hormonal determination were considered excellent in 70% of the cases, good in 20%, and poor in 10%. Both ovaries were delineated in 73% of the examinations performed, thus substantiating the ability of sonography to detect maturing ovarian follicles.

Body Temperature↗

Diagnostic imaging of fertility disorders.

It is estimated that as many as 15% of married couples are affected by fertility disorders. The number of such couples seeking medical help has increased dramatically in the past 10 years due to both relative and absolute factors. The increase in population, the rising rate of sexually transmitted diseases, and the reduced availability of adoptable infants all contribute to the magnitude of this problem. The role of diagnostic imaging in the effective and compassionate care of couples desiring offspring is the subject of this review. Infertility is a disorder of a couple, not of two individuals. The diagnostic evaluation, therefore, must include both partners. Hysterosalpingography and ultrasound constitute the mainstay of the evaluation of the female member. The various techniques and complications of hysterosalpingography are reviewed. The normal appearance of the uterine cavity together with a review of the numerous anomalies and variations that might be encountered are presented. Along similar lines, the possible filling defects, synechiae, postoperative changes, and other alterations that may be encountered in imaging the uterine cavity are described. Evaluation of the fallopian tubes is of paramount importance, primarily to assess patency but also to assess the possibility of patent but diseased salpinges or disease of the surrounding peritubal tissue. Recently, interventional techniques using radiographic and sonographic control have been developed and are beginning to demonstrate promising results in the management of fallopian tube obstruction. These procedures, adapted from previously established radiographic interventive techniques, are discussed. The role of diagnostic imaging of the male partner is of lesser magnitude. Clinical assessment and semen evaluation generally permit adequate assessment of the male factor. Occasionally, however, vasography and seminal vesiculography are called into play. More frequently, sonographic evaluation to establish the presence of varicoceles is necessary. Such techniques are reviewed, as well as the interventional approaches for ablating varicoceles. The application of conventional and transvaginal sonography in the management of gynecologic fertility disorders is reviewed. Follicular monitoring, guided follicle aspiration, assessment of the status of the endometrium, guided embryo transfer and tubal cannulation, and evaluation of other pelvic disorders are significant factors in the appropriate management of the infertile couple.(ABSTRACT TRUNCATED AT 400 WORDS)

Diagnostic Imaging↗