William Scheible

Lipomatous tumors of the kidney and adrenal: apparent echographic specificity.

Several fatty tumors of the kidney and adrenal gland were evaluated by gray scale ultrasound. An extremely dense echogenic pattern was common to all lesions. There were three solitary angiomyolipomata (renal hamartoma), a presumed diffuse hamartomatous involvement of the kidney in a patient with tuberous sclerosis, and one myelolipoma of the adrenal gland. This marked echogenicity is thought to be a feature of fatty tumors and enables relatively specific preoperative diagnosis of these lesions, all of which are benign. With regard to renal angiomyolipoma, this assessment may allow conservative treatment and preservation of functioning renal tissue.

How accurate is ultrasonography in detecting hydronephrosis in azotemic patients

Screening for hydronephrosis continues to be an essential part of the evaluation of patients with azotemia of unknown cause. To determine whether sonography is as reliable as nephrotomography for screening purposes, we carried out a prospective, comparative study. Sixty-two patients were evaluated. Mean serum creatinine was 4.3 mg/dl. Of 116 kidneys, 45 were obstructed according to urographic criteria and 42 of these were correctly called hydronephrotic by sonography. The 3 false negative sonographic studies occurred in 2 patients. All 3 kidneys contained radiopaque calculi visible on the plain abdominal film. Of the 71 nonobstructed kidneys, 5 were mistakenly called hydronephrotic by ultrasound, giving a false positive rate of 7%. We believe it is appropriate to use gray-scale ultrasound as a screening test for urinary obstruction in azotemic patients providing the plain abdominal radiograph shows no calcifications.

High Resolution Ultrasonography in the Diagnosis of Testicular Relapse in Patients With Acute Lymphoblastic Leukemia

AbstractThe testis is a frequent site for relapse in male patients with acute lymphoblastic leukemia. Ultrasonography can be useful in this clinical setting by confirming the nature of a palpable abnormality or by detecting subclinical disease.

Comparison of high resolution real time ultrasonography and high resolution computed tomography in an infant with spinal dysraphism.

An infant with a lumbosacral spinal subcutaneous and intraspinal lipoma involving the conus medullaris was studied with computed tomography and high resolution real time ultrasonography to determine the extent and location of the disease before operation. The high resolution ultrasonogram demonstrated the abnormality with good detail and the added advantage of real time display of the lack of pulsatile mobility of the neural elements, confirming spinal cord tethering. Spinal high resolution ultrasonography is a noninvasive diagnostic tool in infants with spinal abnormalities and should be an important part of a neurosurgeons diagnostic support system.

Sonographic Findings in Milk of Calcium Bile

The ultrasound findings in 2 cases of milk of calcium bile are reviewed. Although the plain film findings of milk of calcium bile are characteristic, the sonographic findings are variable and can lead to confusion with other disease processes. The composition and pathologic significance of milk of calcium bile are discussed.