Michael F. Quinn

Ct Demonstration of Intrathoracic Thyroid Tissue

Abstract Three cases of multinodular goiter with intrathoracic extension are presented. The intrathoracic portions simulated other mediastinal masses. which resulted in surgical intervention in one case.

Gray Scale Ultrasonography of a Traumatic Biliary Cyst

Traumatic hepatic biliary cysts, which occur when there is leakage after traumatic disruption of the biliary system, can be readily detected with hepatic sonography. Differentiation from other hepatic fluid collections can be made by percutaneous thin needle aspiration. Aspiration may have possible utility as a therapeutic modality. A case is presented in which Gray scale ultrasonography revealed a biliary cyst which was drained operatively and resolved.

Limb salvage surgery for bone and soft tissue sarcoma. A phase II pathologic study of preoperative intraarterial cisplatin

Preoperative therapy has been tested as part of limb salvage therapy for localized bone and soft tissue sarcoma of the extremities. The activity of cisplatin (CDDP) by intraarterial (IA) infusion was evaluated in 40 cases of which 36 were evaluable for response. All patients had high‐grade sarcomas. All but 3 patients received 3 or 4 courses (24 patients received 4 courses) of CDDP at a dosage of 120 to 150 mg/m2 given over 6 hours every 2 weeks by IA infusion. Patients younger than 18 years of age received the higher dose of CDDP. Treatment was well tolerated with combination antiemetics. One patient experienced severe hearing loss with the first cycle of the higher CDDP dose. Pathologic evaluation of resected osteosarcoma showed a favorable response (90% or greater necrosis) in 8 of 20 evaluable cases and in 3 of 4 patients with malignant fibrous histiocytoma (MFH) of bone (without osteoid). In soft tissue sarcomas, minimal (50% to 89%) necrosis was seen in two of nine cases and none had 90% or greater necrosis. Patients received postoperative chemotherapy based on pathologic response, but the value of this postoperative adjuvant therapy requires further follow‐up and is uncertain in this small study. IA CDDP can often cause significant tumor necrosis in patients with bone sarcomas, whereas soft tissue sarcomas are less sensitive to this therapy.

Sonography in the diagnosis and management of hepatic amebic abscess in children

Hepatic amebic abscess is a potentially fatal infection which is difficult to diagnose in children. Sonography is an ideal non-invasive imaging tool which can prove invaluable in the diagnosis and management of hepatic amebic abscess. Sonographic findings should suggest the correct diagnosis in most instances. This allows prompt initiation of therapy, forestalling life-threatening complications. Sonography is also an extremely useful non-invasive means of following response to therapy in children with hepatic amebic abscesses.

Predicting the cause of common bile duct obstruction with sonographic data: analysis of binary variables.

A retrospective analysis of 71 patients with proven common bile duct obstruction, who had not undergone previous biliary surgery, was performed. To determine optimal criteria for differentiating stone from nonstone obstruction by ultrasonography, five sonographic signs were analyzed as binary variables. These signs are the demonstration of (1) common duct stones, (2) mass at the site of the common bile duct, (3) gallbladder stones, (4) gallbladder volume greater than a critical value, and (5) common duct diameter greater than a critical value. Maximum expected accuracy was 85% achieved by prediction based on a set of three variables: common duct stone, common duct mass, and gallbladder stones. This was not significantly better than the accuracy (82%) achieved by prediction on the basis of gallbladder stones alone. Three signs in combination, ie, demonstration of gallbladder stones, gallbladder volume less than 52 ml, and common duct diameter less than 14 mm, had predictive value equal to demonstration of a common duct stone as an indicator that common bile duct obstruction is the result of a stone.

Ultrasonographic diagnosis of post-percutaneous renal biopsy hematoma

Perirenal hematoma is an uncommon, but significant complication of renal biopsy. Ultrasound provides a quick, non-invasive means of diagnosis.