Biomedical subjects
Publications and source records attributed to R C Sanders.
A perinephric is difficult to diagnose by clinical examination and traditional radiographic imaging techniques. Five cases are described in which the sonograms revealed a sonolucent perinephric collection suggestive of perinephric abscess. Diagnostic percutaneous aspiration performed under ultrasound guidance is a rapid, reliable, and safe means of distinguishing an abscess from a noninflammatory collection.
Recent B-scan ultrasonic techniques have made possible the routine visualization of the major upper abdominal venous structures. Real-time scanning permits in vivo dynamic assessment of the upper abdominal veins. B-scan ultrasound allows optimal anatomic resolution and is superior for the establishment of intraluminal pathology and anatomic relationships with adjacent organs. The anatomic localization of the upper abdominal veins has proved of practical importance in several ways. Identification of the splenic and superior mesenteric veins allows localization of the pancreas and the enlarged common bile duct. Increased size of the upper abdominal venous structures can indicate certain pathological conditions, notably raised right heart pressure and portal hypertension. Intrinsic pathology within the inferior vena cava may be detected. Extrinsic distortion of veins by adjacent mass lesions is not uncommon, and if the venous structure is recognized, more precise anatomic localization of the mass is possible.
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Sonography gives a characteristic picture of popliteal aneurysms, with an easily demonstrable connection of the sonolucent aneurysmal sac with the popliteal artery. It is a good screening procedure for suspected aneurysms and for patients with popliteal pain, mass, or sudden distal ischemia. Three case reports of five popliteal aneurysms diagnosed by ultrasound are presented. A case of neurofibrosarcoma occurring in the popliteal fossa is shown for comparison.
Twenty patients with pelvic abscesses diagnosed either at surgery or from typical clinical findings underwent sonography. Seventeen of the twenty patients had inflammatory processes of gynecological origin. In the main, two patterns were observed. The more common pattern was a small, round adnexal or cul de sac mass with a slightly irregular border. The other pattern consisted of large, rough-bordered, multilocular masses that obscured the uterus. In single cases confusion had occurred between pelvic abscesses, fibroids, and chronic ruptured tubal pregnancy. The role of ultrasound in the management of patients with tubo-ovarian abscesses is discussed.
The recent introduction of gray scale ultrasound, which uses a higher power output, has made it more difficult ot assess the cystic or solid nature of sonolucent mass lesions using the cirteria developed for bistable imaging, i.e. the amount of through transmission and the strength of the posterior wall echo. However, a cyst may be reliably diagnosed if a totally echofree area is seen adjacent to an area with low-level echoes derived from tissue parenchyma. We have termed this the "light bulb sign." Visualization of the sign facilitates the decision of the optimal time for abscess drainage.
We used sonography to investigate 3 patients with hypertension owing to a Page kidney phenomenon. In 2 cases a perinephric cystic collection was compressing the kidney, while in 1 case there was a large perinephric organized hematoma. When a Page kidney is suspected in a hypertensive patient sonography is a reasonable next step in the evaluation, after the excretory urogram, and may obviate the need for angiography.
Preoperative B-mode ultrasonography was performed on 7 infants who subsequently were surgically proved to have multicystic kidney disease. Five of the 7 showed a characteristic pattern consisting of a predominantly cystic mass containing septa which divided it into cysts of varying sizes. It is concluded that ultrasound is a reliable method of detecting unilateral multicystic disease of the kidney.
Twenty-three patients with blood urea nitrogen (BUN) over 70 and thought clinically to be in renal failure were examined by ultrasound. A correct diagnosis of kidney size and the presence or absence of hydronephrosis or polycystic kidney was made in all but one instance. One kidney in a patient with end-stage renal failure was not seen ultrasonically but was subsequently demonstrated on a retrograde pyelogram. In 10 patients, excretory urography (on 4 occasions with tomography) failed to demonstrate the kidneys adequately. It is suggested that ultrasound should either be the first or second imaging technique in the investigation of patients who present in renal failure of unknown cause.
To characterize the sonographic appearance of the abdominal organs in primates, a program of routine imaging and diagnostic evaluation was undertaken. Compound B-mode methodology with bistable and grey scale machines was employed utilizing a 2.25- to 3.5-MHZ transducer focused at 7 cm. Visualization of the liver, gallbladder, spleen, kidney and of intraabdominal pathology are described. The stage, position, and condition of a pregnancy can be determined by this methodology.
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An examination was done on 28 patients with renal failure, 20 with unilateral hydronephrosis, 8 with multicystic kidneys, 3 with hypoplastic or chronically infected kidneys, and single examples of renal vein thrombosis, renal artery occlusion, xanthogranulomatous pyonephrosis with perinephric abscess, trauma and tumor invading the whole kidney. The distinct ultrasonic appearances of the various conditions causing radiographic non-visualization of the kidney are described.
Diagnostic ultrasound has an important place to play in aiding the obstetrician who has an abortion practice. It is most useful in accurately dating the time of conception. Based on sonographic dating, an abortion may be possible in patients with multiple pregnancy or in whom there is a mass in addition to pregnancy. The performance of a saline or urea abortion is made easier since the precise site of the uterus can be mapped out. Once an abortion has commenced, the presence or absence of retained products can be easily verified by ultrasound.
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