RESUMEN
Eighty-three patients with radiographically opaque renal stones were evaluated prospectively with ultrasound and compared to KUB (kidneys, ureters, bladder) with tomograms (KUB/T) to further define the use of ultrasound in the evaluation of renal calculi. The presence or absence and the size, number, and location of stones were analyzed and correlated for each modality. Ultrasound detected the presence of renal stones in 77 of 83 (93%) patients. However, all of the stones were detected on ultrasound in only 60% of these patients. Thirty percent (80 of 269) of the papillary-calyceal stones seen on KUB/T were missed on US; 66% of the stones missed measured 2 mm or less. Although ultrasound can be used for detection of intrarenal stones, KUB/T is a more accurate imaging examination for determination of size and number of small stones.
Asunto(s)
Cálculos Renales/diagnóstico por imagen , Riñón/diagnóstico por imagen , Adolescente , Adulto , Anciano , Reacciones Falso Negativas , Femenino , Humanos , Riñón/patología , Cálculos Renales/patología , Cálices Renales/diagnóstico por imagen , Cálices Renales/patología , Médula Renal/diagnóstico por imagen , Médula Renal/patología , Masculino , Persona de Mediana Edad , Tamaño de la Partícula , Estudios Retrospectivos , Tomografía por Rayos X , Ultrasonografía , Uréter/diagnóstico por imagen , Uréter/patología , Vejiga Urinaria/diagnóstico por imagen , Vejiga Urinaria/patologíaRESUMEN
One hundred eighty patients with suspected vasculogenic impotence were evaluated with conventional penile duplex sonography with spectral analysis and color Doppler imaging. Measurements of mean peak systolic and end-diastolic velocities were obtained from the cavernosal arteries before and after intracavernosal injections of papaverine. Sixty-one patients were examined with dynamic cavernosography and cavernosometry, and 12 patients were studied with selective internal pudendal and penile arteriography. All five patients with abnormal arteriography had mean peak systolic velocities in the cavernosal arteries of less than or equal to 25 cm/sec (sensitivity, 100%; 95% confidence interval, 48-100%) after the injection of papaverine. Six of the seven patients with normal arteriography had mean peak systolic velocities of greater than 25 cm/sec (specificity, 85.7%; 95% confidence interval, 42-100%) after injection of papaverine. By using data from a receiver-operating-characteristic curve, we determined that end-diastolic velocities in the cavernosal arteries of greater than or equal to 5 cm/sec after the injection of papaverine correctly identified patients with excessive venous leakage on cavernosometry; the sensitivity was 90% (95% confidence interval, 77-97%) and the specificity was 56% (95% confidence interval, 30-80%). The addition of color Doppler sonography made the detection of vessels easier and the correction of the Doppler angle more accurate, resulting in more rapid and accurate acquisition of data. Penile duplex sonography with spectral analysis and color Doppler imaging are sensitive and noninvasive means of examining patients with potential vasculogenic impotence.
Asunto(s)
Disfunción Eréctil/diagnóstico , Ultrasonografía , Enfermedades Vasculares/complicaciones , Adolescente , Adulto , Anciano , Velocidad del Flujo Sanguíneo , Disfunción Eréctil/diagnóstico por imagen , Disfunción Eréctil/etiología , Disfunción Eréctil/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Papaverina , Erección Peniana/efectos de los fármacos , Erección Peniana/fisiología , Pene/irrigación sanguínea , Pene/diagnóstico por imagen , Radiografía , Flujo Sanguíneo Regional , Enfermedades Vasculares/diagnóstico por imagenAsunto(s)
Toxoide Diftérico/administración & dosificación , Agujas , Vacuna contra la Tos Ferina/administración & dosificación , Toxoide Tetánico/administración & dosificación , Tejido Adiposo/anatomía & histología , Vacuna contra Difteria, Tétanos y Tos Ferina , Combinación de Medicamentos/administración & dosificación , Femenino , Humanos , Lactante , Inyecciones Intramusculares/instrumentación , Inyecciones Intramusculares/métodos , Masculino , Muslo , UltrasonografíaRESUMEN
Forty-eight patients undergoing elective repair of an abdominal aortic aneurysm were randomly selected for correlation of diagnosis of aneurysm and aneurysm size as determined by direct surgical measurements, ultrasound examination, and lumbar spine X-ray. The preoperative diagnosis was confirmed by lumbar spine plain films in 72% of patients and by B-mode ultrasound in all of patients. Aneurysm size could be measured by lumbar spine X-ray in 55% of patients and with gray-scale B-mode ultrasound in all of patients. The average difference between surgically measured and roentogenographically determined aneurysm size was 1.5 cm in the transverse diameter and 0.87 cm in the anteroposterior diameter of the aneurysm. The average difference between surgically measured aneurysm size and ultrasound-determined external wall diameter of the aneurysm was 0.42 cm in the transverse diameter and 0.29 cm in the anteroposterior diameter. From these data we conclude that gray-scale B-mode ultrasound of the aorta is a more sensitive and accurate method of assessing abdominal aortic aneurysms than is the use of lumbar spine X-ray.