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Developmental dysplasia of the Hip(DDH): Evaluation by 3-D sonography
Vol. 2, No. 12, December 1995
P-17 Developmental Dysplasia of the Hip (DDH): Evaluation by 3-D Sonography Eugenio O. Gerscovich, M.D. U niversity of California, Davis Medical Center.
P~E:
To determine the value of 3-1) sonography in the evaluation of DDH.
MATERIALS AND METHODS: We prospectively studied 59 hips (30 patients, 18 females and 12 males; age rcegs 1 dayto 18 months) with the following clinical diagasses: posalbly subluxated (n= 18), subluxated (n= 15), dislocated (n=9), normal (n= 17). We performed simultaneously conventional and 3-1) soasgraphy. The 3-]) images were viewed in two forms of presentation: as orthogonal section analysis and as a transparent revolving spatial image. The technical quality of the studies was evaluated jointly by two of the authors with knowledge of the clinical diagnosis. Correlation was made with Convcetiasal soeography and radiographs, when available. RESt~TS: Eight data sets were acquired in the axial plane, and 95 in the coronal plane. We performed a statistical analysis of the studies acquired in the coronal plane. The images of the orthogonal section analysis were judged to be technically satisfactory for reconstruction 88/95 (93%) of the eases (excellent 29/88, 33%; good 51/88, 58%; and poor 8/88, 9%). The revolving spatial images were judged to be technically satisfactory in 83/95 (87%) of the cases (excellent 26/83, 31%; good 32/83, 39%; and poor 25/83, 30%).
POSTERS
P-18 Color Doppler Sonography of Adrenal Masses Abraham A. Ghiatas, M.D., James B. Schnitker, M,D. University of Texas Health Science Center.
Purpose: Use of Color Doppler Sonography (CDS) in the evaluation of adrenal masses. Materials and Methods: 36 patients underwent Computed Tomography and 44 adrenal masses were discovered which were evaluated by CDS. 14 cases underwent biopsy or surgery and for the rest of the cases the medical records were reviewed in an attempt to establish a diagnosis for the adrenal masses. Results: Seven cases were malignant and seven benign, proven by biopsy or surgery. 15 adrenal messes were highly suspicious for m~lignancy and nine were consistent with b e n i g n a n c y . SLxcases were not classified since we did not have enough evidence for either malignancy or benignancy. The size of the masses ranged from 1.5 em to 13 cm. With the exception of a large pheochromocytoma, all the masses did not demonstrate any flow. The pheochromocytoma did not demonstrate any specific flow.
CONCLUSION: 3-I:) soasgraphy of the hip allows for global visualization of the anatomy from multiple angles, which no other modality provides. It also offers imaging in the sagittal and cranio-candal projections, thus demonstrating the containment of the femoral head in the aeetabulum better than conventional sonography.
P-19 Underassessment of Deep Venous Thrombosis of the Lower Extremity on Color Flow Doppler Compared to Compression Sonography Neville Glajchen, M.D., R. Shapiro. Mt. Sinai Hospital.
Purvase: Color flow and compression duplex Doppler evaluation of the lower extremity have shown good correlation with venogmphy in assessment of deep venous thrombosis. The purpose of this study is to compare compression sonography to color flow imaging in evaluation of DVT. Methods: 39 randomly selected patients being evaluated in an inpatient and emergency room setting were studied using color flow longitudinal scanning alone from the common femoral vein to the poplitoal vein. The study was repeated by a blinded observer using compression sonography in the transverse plane. Results: Twenty-three patients bad negative examinations by both scanning methods and eight had acute thrombus definitely diagnosed by both methods. (i.e., 80% without discrepancy). 2 cases showed "wall thickening" on compression thought to be indicative of chronic venous disease (5%). However, this finding did not alter clinical management. Six cases (15%) showed thrombus on compression sonography not appreciated on longitudinal color flow imaging. Conclusion: Color flow imaging alone may miss deep venous flarombus above the knee due to "bleeding through" of color pixels into the vessel lumen. This is especially true in the smaller non-occlusive thrombi that are adherent to the wall of the vessel. Thus compressionsonography i s advised as an i n t e g r a l p a r t of the e v a l u a t i o n
P-20 The Radiology of Cardiac Calcifications Julie A. Gubernick, M.D., William Herring, M.D. Albert Einstein Medical Center.
PURPOSE: Our purpose is to demonstrate a variety of classical cardiac and perlcardial calcifications using standard imaging modalities and in discuss the clinical significance of these abnormalities. METHODS: Calcifications of the heart, pericardium and great vessels are frequently identified on standard radiographs and computed temography of the chest. We reviewed imaging studies of representative cases of cardiac, perlcardial, and aortic calcifications, with clinical, angiographic, or pathologic correlation. RESULTS: Cardiac and pericardial calcifications include calcified aneurysms, thrombi, tumors, valvular and coronary artery calcifications, as well as calcified periearditis. Our experience with various types of cardiac calcifications will be presented emphasizing their prevalence, pathogenesis, clinical course, and importance. The exhibit will stress typical manifestations of the most common types of calcifications. CONCLUSIONS: Recognition, localization, and characterization of cardiac calcifications may have significant clinical impact, guiding further imaging decisions and patient fallow-up. The presence of certain calcifications may also be useful to evaluate patient prognosis.
of deep venous thrombus.
1159
P-17 Developmental Dysplasia of the Hip (DDH): Evaluation by 3-D Sonography Eugenio O. Gerscovich, M.D. U niversity of California, Davis Medical Center.
P~E:
To determine the value of 3-1) sonography in the evaluation of DDH.
MATERIALS AND METHODS: We prospectively studied 59 hips (30 patients, 18 females and 12 males; age rcegs 1 dayto 18 months) with the following clinical diagasses: posalbly subluxated (n= 18), subluxated (n= 15), dislocated (n=9), normal (n= 17). We performed simultaneously conventional and 3-1) soasgraphy. The 3-]) images were viewed in two forms of presentation: as orthogonal section analysis and as a transparent revolving spatial image. The technical quality of the studies was evaluated jointly by two of the authors with knowledge of the clinical diagnosis. Correlation was made with Convcetiasal soeography and radiographs, when available. RESt~TS: Eight data sets were acquired in the axial plane, and 95 in the coronal plane. We performed a statistical analysis of the studies acquired in the coronal plane. The images of the orthogonal section analysis were judged to be technically satisfactory for reconstruction 88/95 (93%) of the eases (excellent 29/88, 33%; good 51/88, 58%; and poor 8/88, 9%). The revolving spatial images were judged to be technically satisfactory in 83/95 (87%) of the cases (excellent 26/83, 31%; good 32/83, 39%; and poor 25/83, 30%).
POSTERS
P-18 Color Doppler Sonography of Adrenal Masses Abraham A. Ghiatas, M.D., James B. Schnitker, M,D. University of Texas Health Science Center.
Purpose: Use of Color Doppler Sonography (CDS) in the evaluation of adrenal masses. Materials and Methods: 36 patients underwent Computed Tomography and 44 adrenal masses were discovered which were evaluated by CDS. 14 cases underwent biopsy or surgery and for the rest of the cases the medical records were reviewed in an attempt to establish a diagnosis for the adrenal masses. Results: Seven cases were malignant and seven benign, proven by biopsy or surgery. 15 adrenal messes were highly suspicious for m~lignancy and nine were consistent with b e n i g n a n c y . SLxcases were not classified since we did not have enough evidence for either malignancy or benignancy. The size of the masses ranged from 1.5 em to 13 cm. With the exception of a large pheochromocytoma, all the masses did not demonstrate any flow. The pheochromocytoma did not demonstrate any specific flow.
CONCLUSION: 3-I:) soasgraphy of the hip allows for global visualization of the anatomy from multiple angles, which no other modality provides. It also offers imaging in the sagittal and cranio-candal projections, thus demonstrating the containment of the femoral head in the aeetabulum better than conventional sonography.
P-19 Underassessment of Deep Venous Thrombosis of the Lower Extremity on Color Flow Doppler Compared to Compression Sonography Neville Glajchen, M.D., R. Shapiro. Mt. Sinai Hospital.
Purvase: Color flow and compression duplex Doppler evaluation of the lower extremity have shown good correlation with venogmphy in assessment of deep venous thrombosis. The purpose of this study is to compare compression sonography to color flow imaging in evaluation of DVT. Methods: 39 randomly selected patients being evaluated in an inpatient and emergency room setting were studied using color flow longitudinal scanning alone from the common femoral vein to the poplitoal vein. The study was repeated by a blinded observer using compression sonography in the transverse plane. Results: Twenty-three patients bad negative examinations by both scanning methods and eight had acute thrombus definitely diagnosed by both methods. (i.e., 80% without discrepancy). 2 cases showed "wall thickening" on compression thought to be indicative of chronic venous disease (5%). However, this finding did not alter clinical management. Six cases (15%) showed thrombus on compression sonography not appreciated on longitudinal color flow imaging. Conclusion: Color flow imaging alone may miss deep venous flarombus above the knee due to "bleeding through" of color pixels into the vessel lumen. This is especially true in the smaller non-occlusive thrombi that are adherent to the wall of the vessel. Thus compressionsonography i s advised as an i n t e g r a l p a r t of the e v a l u a t i o n
P-20 The Radiology of Cardiac Calcifications Julie A. Gubernick, M.D., William Herring, M.D. Albert Einstein Medical Center.
PURPOSE: Our purpose is to demonstrate a variety of classical cardiac and perlcardial calcifications using standard imaging modalities and in discuss the clinical significance of these abnormalities. METHODS: Calcifications of the heart, pericardium and great vessels are frequently identified on standard radiographs and computed temography of the chest. We reviewed imaging studies of representative cases of cardiac, perlcardial, and aortic calcifications, with clinical, angiographic, or pathologic correlation. RESULTS: Cardiac and pericardial calcifications include calcified aneurysms, thrombi, tumors, valvular and coronary artery calcifications, as well as calcified periearditis. Our experience with various types of cardiac calcifications will be presented emphasizing their prevalence, pathogenesis, clinical course, and importance. The exhibit will stress typical manifestations of the most common types of calcifications. CONCLUSIONS: Recognition, localization, and characterization of cardiac calcifications may have significant clinical impact, guiding further imaging decisions and patient fallow-up. The presence of certain calcifications may also be useful to evaluate patient prognosis.
of deep venous thrombus.
1159