1,720,984 research outputs found
Simplified micturitional cystourethrography in female urinary incontinence
No full textA new technique of mictional cystourethrography has been developed. The examination is performed with the patient sitting on a radiolucent chair with the feet high on a footstool, in order to avoid the superimposition of the femoral heads in the lateral projection. Fifty patients were examined, 26 of whom were continent and 24 incontinent. The technique allowed the evaluation of the site of the bladder neck, of vesico-urethral angles, and of the urethra. The investigation made it possible to obtain accurate information on the position of the vesical floor relative to the inferior margins of the obturator foramina. It was thus possible to correlate the position of the bladder floor with the clinical symptomatology: in our experience the position of the bladder floor was higher in incontinent that in continent patients. A low position of the bladder baseplate was usually associated with incontinence. Other parameters turned out to be less specific. This paper emphasizes the simplicity and the reproducibility of our technique, which allows a reduction of X-ray exposure dose
Echography: problems and errors in the diagnosis of renal masses
No full textUS plays an extremely important role in the diagnosis of renal masses. However, a number of diagnostic difficulties still exists in both identification of the mass and definition of its nature. The most frequent causes of diagnostic errors are discussed. Errors may be due to the radiologist, to technical limitations, and to the lesion itself. The radiologist is responsible for inexperience and negligence (incorrect application of the technique, limited clinical information, poor knowledge of US findings). Technical limitations are due to poor spatial and contrast resolution, to extremely fat patients, and to artifacts. As far as lesions are concerned, cystic and solid masses must be distinguished, since the problems are different. As for cystic lesions, problems are relative to their visualization and to the definition of their nature in cases of atypical or complex cysts, due to the complexity of some US findings. The latter involve both cystic wall and content and are related to calcifications, septa, vegetations, blood, purulent debris. In case of solid masses, problems concern the identification of small renal tumors, the differentiation among the various anatomical variants, the differential diagnosis of benign from malignant tumors, and the evaluation of tumor extent. The authors conclude that, whereas operator-dependent errors can be avoided, those inherent to technical parameters and to the lesion itself represent the diagnostic limitation of U
RUOLO DELLE TECNICHE DOPPLER NELLA DIAGNOSI DIFFERENZIALE DELLE LESIONI NODULARI SOLIDE MAMMARIE
No full textCauses of attenuation of the sound waves in neoplasms of the breast. Histologic and echographic correlation study [Cause di attenuazione del fascio acustico nelle neoplasie mammarie. Studio correlato istologico-ecografico.]
No full textThe purpose of our study was to compare the ultrasound findings in malignant breast masses (which underwent biopsy) with their histological appearance. In our activity of breast sonography, we observed that the same histological type of breast cancer often shows a different ultrasonic image. The main difference concerns the sonic attenuation or increase through the neoplastic mass. The histological examination took into account the amount of stroma and cells and the architectural pattern of the lesion. Comparing these features with the ultrasonic image, it has been shown that sonic transmission is related more to the architectural pattern than to the fibrous content of the neoplastic tissue
Radiological anatomy of the kidney revisited.
No full textIn recent years some structures or features such as the "inter-renuncular septum", the "echogenic triangle" and the "echogenic line" have been described to support the concept of a kidney resulting from the fusion of two masses or renunculi. To clarify this concept and to understand the meaning of the above echographic features better, the authors have examined prospectively by sonography the kidneys of 50 children, 200 adults with a single collecting system, 25 adults with a duplicated collecting system and 32 cadavers. Furthermore, to help explain the sonographic features, we have examined 32 cadaver kidneys with sonography and 10 cadaver kidneys with magnetic resonance imaging (MRI). The sonographic, MRI and anatomical correlations have shown that the "echogenic triangle" and the "echogenic line" are not renuncular residuals, but simply an extension of the hilar fat visible when the renal sinus is rather deep. The intermediate cortical mass is not a septum dividing the kidney into an upper and lower renunculus, but a column of parenchymal tissue crossing the renal sinus, which, from an anatomical point of view, is an accessory renal lobe. The presence of two renunculi, suggested in a previous study with cortical nephrotomography, has not been confirmed
Renal echography in diabetes mellitus
No full textThe US findings in the kidneys of diabetic patients were studied. Diabetic subjects without clinical or laboratory signs of nephropathy were investigated by means of US in order to detect early anatomical lesions predictive of renal injury. The kidneys of cadaver diabetics were also studied to correlate US and histologic patterns. US alterations were observed in half of the cases: they were diffuse in 9% of cases and focal in 39%--hyperechoic spots and hyperechoic juxta-medulla. Focal spots are more common in juvenile-onset diabetics and they are correlated with the age of diabetes. At histology the above US patterns were correlated with the vascular wall alterations typical of diabetic nephropathy. Diffuse alterations are not specific. The authors conclude by suggesting US as a prognostic test for diabetic nephropathy
Echography in renal colic
No full textTo determine the role of sonography (US) in patients with renal colic, 40 patients were examined by means of US, plain abdominal film (PF), and intravenous pyelography (ivp). US sensitivity was 92.3% in diagnosing hydronephrosis and 75% in detecting calculi. Small calculi were correctly identified, irrespective of their chemical composition. It must be stressed how US, as compared to ivp, proved unsatisfactory in such cases as difficult visualization of the middle portion of the ureter, unsuccessful identification of acute obstructions without hydronephrosis (although the patient's hydratation may be useful in this respect), poor functional information (although there was a correlation between renal hyper-echogenicity and obstructive nephrogram). US is safe and easy to perform, and is suggested for the initial evaluation of patients with renal colic, together with PF, and as an alternative to ivp. Moreover, US is the ideal technique in the follow-up of these patients. Therefore, ivp should be performed in case of differing clinical and sonographic findings, when the calculus is not ejected within the expected time, and when surgery or lithotripsy are foreseen
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