Patrick Robert Meyers

Sonographic Evaluation of the Portal and Hepatic Systems

Color and spectral Doppler are used to evaluate flow characteristics in the portal and hepatic vessels. On occasion, suprahepatic pathologies are reflected in the flow characteristics of the hepatic veins and transmitted to the portal venous system across the hepatic sinusoids. Few definitive duplex findings are pathognomic for portal hypertension. Evaluation of the portal venous system is analogous to a puzzle. A picture of the processes can only be attained after many of the pieces are assembled.

Ultrasound of the Normal Appendix The How and Why

Sonography now plays a vital role in noninvasive evaluation of patients with right lower quadrant pain. Sonography can differentiate appendicitis from other etiologies of pelvic pain, such as ovarian cysts, tubo-ovarian abscesses, inguinal hernias, and uterine pathologies. Successful demonstration of a normalsized appendix virtually excludes appendicitis in the patient with right lower quadrant pain. False-negative examinations may occur because of bowel gas interference, stool, perforation with decompression of the appendix, or inflammation of the appendix without abnormal enlargement. The purpose of this study was two-fold: to determine how often a normal-sized appendix is demonstrable in patients who do not have appendicitis; and to determine whether locating a normal appendix improves the negative predictive value for the absence of appendicitis.

Sonographic Diagnosis of Polyorchidism

Polyorchidism, or duplication of testes, is a unique and rare anomaly. Sonography is ideally suited for the diagnosis of polyorchidism and associated pathologies and anomalies. High frequency transducers exceeding 10 MHz, with the inherent increase in spatial and contrast resolution, may play a decisive role in clinical management of polyorchidism. In this case report, the authors describe the benefit of high frequency transducers.