Samuel B. Feinberg

Ultrasonography of the Rotator Cuff Normal and Pathologic Anatomy

Forty-eight patients with shoulder pain and 15 normal volunteers underwent rotator cuff imaging using high resolution real time ultrasound. The potential diagnostic value of sonography in detecting rotator cuff tears was evaluated by correlating ultrasound findings with surgical findings in 19 patients, 12 of whom also underwent preoperative arthrography. The preoperative ultrasound diagnosis was correct in 18 of the 19 patients undergoing surgery for possible rotator cuff tears. In the group of 12 surgical patients undergoing both preoperative arthrography and sonography, ultrasound correctly predicted the presence of a rotator cuff tear in 12 of 12 patients, while arthrography predicted cuff tears in only nine of 12. Good anatomic definition of the rotator cuff was obtained in both symptomatic and asymptomatic groups. The characteristic appearance of the normal and pathologic rotator cuff is described. Rotator cuff sonography promises to be a valuable new diagnostic tool for evaluating patients with suspected rotator cuff tears.

Lymphangiography and ultrasound in management of lymphoceles

Recent reports describe the efficacy of ultrasound in the diagnosis and management of lymphoceles. To assess the appropriate role of ultrasound and lymphangiography in the management of this entity, we reviewed our experience with 14 cases diagnosed as lymphoceles. Three patients had lymphangiography alone, 5 had lymphangiography and ultrasound, and 6 had ultrasound alone. Our analysis concludes that both diagnostic modalities have a role in management depending on the size of the lymphocele and the associated clinical setting.

Evaluation of abdominal fistulas with computed body tomography (CT).

Twenty-nine patients with 32 abdominal fistulas were evaluated by sinograms and CT. Sinograms were superior to CT in displaying the fistulous tract and its communications to specific organ systems. Ct added information affecting treatment plan or surgical approach by defining extent, nature and location of underlying disease, by eliminating overlap opacified fistulas, cavities, bowel loops and surface contaminations and by detecting additional undrained abscesses or recurrent tumor masses. While sinograms remain the initial procedure in the evaluation of abdomina fistulas, CT offers a useful secondary modality in selected instances.

Noninvasive spleen scanning in hodgkin's disease and non-hodgkin's lymphoma

Abstract Spleens of fifty previously untreated lymphoma patients were examined by computerized tomography, ultrasonography and radionuclide spleen scans. Proof of diagnosis was obtained from pathological specimens. CT was the most useful and reliable test, thus warranting its use as initial procedure of choice for evaluation of spleen and splenic hilar lymph nodes. Nuclear spleen scans supplied unique additional information in selected instances. The role of ultrasound as secondary modality requires further investigation.

Radiology of the human segmental pancreatic transplant

Twenty-three segmental pancreatic transplants have been performed for treatment of diabetes mellitus between July 1978 and March 1981 at the University of Minnesota. The radiologic evaluation of the transplants included ultrasonography,15Se-methionine isotope scanning, angiography, and CT scanning. Transplants of normal appearance by these studies had normal endocrine function. Pathologic findings are presented and their significance discussed.

Computer tomography, radionuclide imaging and ultrasonography in hepatic mass lesions.

The livers of 86 patients comprising this report were examined by both transmission computerized tomography (CT) and radionuclide scans (LS). Fifty-nine of them were also examined by gray-scale ultrasound (US). In a comparative study, the strengths and weaknesses of each modality were evaluated. CT demonstrated 85%. US 82%, and LS 73% of masses involving the liver. Because of better resolution and sectioning capabilities, together with stop-motion imaging, CT and US detected smaller and deeper mass lesions than did LS. However, LS was more informative in hepatocellular disorders than was US or CT. Our experience indicated that information obtained on the liver and surrounding structures by each imaging modality used here tends to be somewhat unique, and thus these procedures complement one another rather than being competitive.