Stanton J. Rosenthal

Gray scale ultrasonic appearances of renal transplant rejection.

Ultrasonic examination of renal transplants with special attention to the parenchymal echo pattern has been undertaken in 43 patients. In the normal renal transplant, the pyramids, cortex and renal sinus can be distinguished. Renal transplant rejection is manifested by swelling and decreased echogenicity of the pyramids and hyperechogenic cortex. In addition, large anechoic areas due to hemorrhagic infarcts and necrosis are seen. In long-standing rejection, a normal or small-sized kidney with an irregular intrarenal echo pattern is observed. In 13 cases of acute tubular necrosis, none of the above appearances could be demonstrated. Serial ultrasonic scans are essential to reveal evolutionary changes of the rejection process.

Comparison of computed tomography and ultrasound in abdominal staging of renal cancer

The relative accuracy of computed tomography (CT) and ultrasound in abdominal staging of renal cancer was determined in 22 patients. CT is capable of detecting tumor invasion of perinephric fat and adjacent muscles, which cannot usually be shown by ultrasound. While both CT and ultrasound demonstrate venous and retroperitoneal tumor extension, CT is more reliable since bowel gas not infrequently obscures the retroperitoneum on ultrasonic scanning. However, ultrasound will often provide valuable information; and whenever a solid renal mass is detected by echography using prone scans, abdominal scans should be obtained for staging pruposes.

Wide area networks for teleradiology.

Teleradiology networks transmit digital radiographic images from one location to another. These networks are wide area networks. Teleradiology networks are used for diagnostic purposes and preview tasks. Wide area networks for teleradiology use public service switching. The use of fiber optics networks provide reduced costs and increased flexibility. An example is presented that compares the cost of teleradiology networks.

Vena caval occlusion after bird’s nest filter placement

BACKGROUND Inferior vena caval thrombosis as a result of intracaval barrier devices occurs in 6.5% of patients with Greenfield filters. The incidence is less well defined in patients in whom birds nest filters have been placed. We reviewed our experience with birds nest filters to determine the incidence of filter-induced caval thrombosis. METHODS The records of 140 patients with birds nest filters were reviewed, living patients were interviewed, and the inferior vena cava examined in 37 patients by duplex scanning. RESULTS Ninety-three patients were available for evaluation. Five of these patients were found to have caval thrombosis by duplex scanning and 2 had clinical symptoms and signs compatible with caval thrombosis. The majority of these patients were on anticoagulants at the time of filter thrombosis. CONCLUSION The incidence of filter-induced vena caval thrombosis in patients with birds nest filters (7%) is comparable with that of Greenfield filters. Because of the catastrophic manifestations of this complication and the increasing application of vena caval filters, the role of these filters in the treatment of thrombotic disease needs further critical evaluation.

Cost Of Managing Digital Diagnostic Images For A 614 Bed Hospital

The cost of recording and archiving digital diagnostic imaging data is presented for a Radiology Department serving a 614 bed University Hospital with a large outpatient population. Digital diagnostic imaging modalities include computed tomography, nuclear medicine, ultrasound, and digital radiography. The archiving media include multiformat video film recordings, magnetic tapes, and disc storage. The estimated cost per patient for the archiving of digital diagnostic imaging data is presented.

Progress In Quantitative Ultrasonic Imaging

We are developing methods for imaging acoustic parameters individually to obtain a more direct interpretation of the scattering medium. Two properties of the medium that describe microscopic scattering structure have been accurately measured: the average scattering particle size and the product of the number density and the scattering strength. Analysis of quantitative images show increased image contrast by as much as 6 dB between regions that vary in these acoustic properties over that of conventional B-mode imaging. It is also possible to separate the effects of scatterer size from the effects of the number density and scattering strength. The motivation for developing these techniques for diagnostic ultrasound is to improve low-contrast detectability.

Late-onset renal vein thrombosis: A case report and review of the literature

INTRODUCTION Renal vein thrombosis, a rare complication of renal transplantation, often causes graft loss. Diagnosis includes ultrasound with Doppler, and it is often treated with anticoagulation or mechanical thrombectomy. Success is improved with early diagnosis and institution of treatment. PRESENTATION OF CASE We report here the case of a 29 year-old female with sudden development of very late-onset renal vein thrombosis after simultaneous kidney pancreas transplant. This resolved initially with thrombectomy, stenting and anticoagulation, but thrombosis recurred, necessitating operative intervention. Intraoperatively the renal vein was discovered to be compressed by a large ovarian cyst. DISCUSSION Compression of the renal vein by a lymphocele or hematoma is a known cause of thrombosis, but this is the first documented case of compression and thrombosis due to an ovarian cyst. CONCLUSION Early detection and treatment of renal vein thrombosis is paramount to restoring renal allograft function. Any woman of childbearing age may have thrombosis due to compression by an ovarian cyst, and screening for this possibility may improve long-term graft function in this population.

Salient Characteristics Of A Distributed Diagnostic Imaging Management System For A Radiology Department

The design and implementation of a distributed diagnostic imaging management system is new. The goal of these distributed systems is to integrate digital diagnostic imaging modalities through a local area network. This paper provides an estimate of the current utilization of digital diagnostic image data and provides the user logical functions required for each node of the distributed system.

Sources of acoustic scattering in normal kidneys

Properties derived from acoustic backscatter measurements are examined to disclose sources of acoustic scattering in normal kidneys. The backscatter intensity from kidney parenchyma may be modeled using a two-component Gaussian correlation function. These two components yield effective scatterer size estimates of 220+or-15 mu m at low frequencies and 55+or-10 mu m at high frequencies, which correspond to the average glomerular and renal tubule diameters, respectively. A separate study using test media verifies the ability of the method to distinguish between mixtures of two different scattering structures from backscatter measurements at different frequencies.<<ETX>>

Late Onset of Renal Vein Thrombosis After Renal Transplantation

CLINICAL HISTORY A 29-year-old woman with a history of simultaneous renal-pancreas transplant 8 months previously presented to the emergency department with abdominal pain, nausea, decreased urine output, and elevated creatinine. A renal transplant Doppler was performed (Figs. 1AYC). The patient was taken to the interventional radiology department, where venography documented renal vein occlusion. Patency was restored after aggressive chemical and mechanical thrombolysis aswell as stenting of themain renal vein (Figs. 2, 3). The patient’s renal function continued to decline, and hemodialysis was resumed. The transplant was ultimately explanted, confirming migration of the right ovary anterior to the renal vein.