M. Leon Skolnick

Ultrasound documentation of spontaneously resolving appendicitis

Diagnostic ultrasound has been reported to be a highly specific technique for the confirmation of acute appendicitis. The authors report the case of a 27-year-old male who presented with clinical, laboratory, and classic ultrasound findings indicating early acute appendicitis. The patients condition resolved spontaneously without operative intervention, and repeat sonography 2 weeks later was entirely normal. Ultrasound examination may allow documentation of spontaneously resolving appendicitis.

Sonographic examination of the abnormal scrotum.

Sonography of scrotal masses is now being evaluated as an adjunct to clinical examination in assessment of scrotal masses. The accuracy of ultrasound in discrimination of solid and cystic masses cannot be disputed. This paper will report on the reasons for referral, the sonographic diagnosis and effect on clinical management of 20 patients. Lesions examined include hydrocele, haematocele, epididymal lesions, abscess and solid testicular masses. A brief review of current literature will also be considered. An analysis will be made of diagnostic accuracy including ability to anatomically locate abnormalities.

Ultrasound guided fine-needle aspiration biopsy of abdominal masses

Twenty-six cases of ultrasonically guided percutaneous fine-needle aspiration biopsies of abdominal masses are reported. Included are masses in the pancreas, retroperitoneum, liver, kidney, and pelvis. Aspiration biopsies accurately diagnosed or excluded malignancy in 21 patients (81%). The procedure, performed under local anesthesia, is rapid, simple and almost painless. No complications occurred; specifically, there was no hemorrhage, peritonitis, or spread of tumor along the needle tract.

Ultrasonically guided antegrade pyelography.

Guided by ultrasound percutaneous antegrade pyelography can be accomplished with great ease in patients with obstructive hydronephrosis. The exact location and the depth of the dilated renal pelvis can be determined accurately with the use of ultrasound and the procedure is similar to that of a cyst puncture. Antegrade pyelography provides significant diagnostic information on the nature of the obstructive lesion and can be performed as an adjunct to a retrograde study or as an alternative to a retrograde pyelogram. Ultrasound is considered a most advantageous aid to the performance of antegrade pyelography.

The role of ultrasound-guided needle aspiration of breast masses

Ultrasonically guided aspiration cytology is an accurate and cost-effective method for managing sonographically indeterminate breast masses (masses that do not have all the ultrasonic criteria of simple cysts). Forty-five breast masses were aspirated. Of these, fifteen (33%) were atypical cysts, twenty-one (47%) were benign solid masses, three (7%) were malignant and six (13%) were solid lesions with nondiagnostic aspirate material. Since the tip of the needle is ultrasonically identified within the mass prior to aspiration, the accuracy of tissue sampling is potentially greater than with palpation alone. Lesions over five millimeters in diameter can be reliably sampled for cytology. This method can reduce the number of surgical biopsies performed by distinguishing atypical cysts from benign solid lesions and detecting malignant lesions when small. The simplicity of the technique encourages its use whenever an ultrasound study detects a noncystic mass.

Why Image the Velopharyngeal Portal

This book deals mainly with the applications and interpretations of a radiographic technique, multiview videofluoroscopy of the velopharyngeal (VP) portal. This procedure is used to evaluate the effectiveness of velopharyngeal closure in patients with speech evidence of velopharyngeal insuffiency1 (VPI), and in so doing, provides precise anatomic and physiologic information as to how the VP portal functions during phonation. The data derived by this technique are useful in assisting clinicians to determine the most appropriate course of therapy for each patient.

A New Ultrasonic Real-Time Scanner Featuring a Servo-Controlled Transducer Displaying a Sector Image

This paper describes a new real-time servo-controlled sector scanner that produces high-resolution images similar to phased-array systems, but possesses the simplicity of design and low cost best achievable in a mechanical sector scanner. Its unique feature is the transducer head which contains a single moving part--the transducer. Frame rates vary from 0 to 30 degrees and the sector angle from 0 to 60 degrees. Abdominal applications include: differentiation of vascular structures, detection of small masses, imaging of diagonally oriented organs. Survey scanning, and demonstration of regions difficult to image with contact scanners. Cardiac uses are also described.

A new approach to ultrasound image recording using a video disc recorder.

A system utilizing a multi-image capacity video disc recorder rather than a photographic camera for the initial recording of ultrasound images id described, as well as the resulting benefits.

Techniques of Multiview Videofluoroscopy

In Chapter 3 we briefly described the three basic views — the lateral, the frontal, and the base — so that the reader could appreciate the rationale behind the choice of the equipment with which to perform this procedure. This chapter will describe information provided by each of the views, methods of performance, and normal anatomy as seen in each of the views.

How to Image the Velopharyngeal Portal

In order to determine the best method of imaging the velopharyngeal portal so as to appreciate the interrelationships of palatal and pharyngeal wall movements during speech, one must consider the purposes of the examination: First is the desire to image the velopharyngeal (VP) portal; second, the desire to image the portal in motion; third, the desire to image it while simultaneously recording the patient’s speech. If the method of imaging the VP portal does not satisfy all three of these requirements, the study will give less than adequate diagnostic information and inappropriate therapeutic decisions may result.