Ultrasound findings of superficial lesions of the breast

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Ultrasound in Medicine and Biology

and 21 patients had ureteral stones. The ultrasound system used in our study was B&K Medical Panther 2002 equipped with a 3.5-Mhz transducer. Results: The sensibility in detecting ureteral flux in patients with pelvic stones and normal IVU was 100%. The sensibility in detecting uretheral flux in uretheral stones with IVU aspect of hydronephrosis was 65%. Conclusions: In cases of normal aspect of IVP, the presence of uretheral flux assessed by ultrasound could substitute the IVU in the preoperative evaluation for ESWL treatment. In cases of hydronephrotic aspect of IVU, the concordance between results based on IVU and those based on Doppler US is good enough for proposing the Doppler US evaluation of renal function in obstructive stones as a new diagnostic imaging modality. Doppler US could be the method of choice for renal function pre ESWL evaluation mainly for patients with known intolerance to contrast media. 32699 Lymphosonography: Scanning techniques and technical considerations Merton DA,* Liu J, Forsberg F, Goldberg BB, Radiology, Thomas Jefferson University Hospital, Philadelphia, PA Objective: The aim of this study was to determine the optimal techniques for lymphosonography (i.e., ultrasound imaging [US] of lymphatic channels [LCs] and sentinel lymph nodes [SLNs] after intradermal injection of an US contrast agent). Methods: Fifteen animals (9 swine, 5 dogs, and 1 rabbit) including some with induced and naturally occurring tumors and metastases to SLNs were used. Two-dimensional (2D) and 3D fundamental and phase-inversion harmonic (PIHI) grayscale US and color flow imaging (CFI) was performed pre- and post-contrast with an Elegra (Siemens Medical Systems, Issaquah, WA). Sonazoid (Amersham Health, Oslo, Norway) was injected intradermally (0.25–1 ml total dose) in selected areas including the limbs, trunk, head, and neck and around melanoma in 2 swine, implanted in canine transmissible venereal sarcoma in 2 dogs, and a VX2 tumor in a rabbit. The injection site was massaged for up to 5 minutes. Lymphosonography was performed with mechanical index (MI) values ranging from 0.2 to 1.0 immediately and up to 3 hours post injection. Injections of blue dye and surgical dissection of the LCs and SLNs were compared to the lymphosonography results. Results: With pre-contrast US, it was impossible to identify LCs or SLNs. After contrast administration, PIHI with a low MI provided significantly better visualization of LCs and SLNs than fundamental grayscale US. Movement of contrast could be visualized with real-time imaging, and the LCs could be traced to the SLNs. Massaging the injection site accelerated movement of contrast in the LCs. Normal SLNs demonstrated uniformly increased echogenicity (i.e., contrast enhancement), whereas SLNs with metastases demonstrated filling defects (i.e., non-uniform enhancement). Compared to 2D US, 3D US often improved the depiction of spatial relationships of areas with and without contrast. Acoustic emission signals detected with CFI were useful to confirm the presence of contrast in the LCs and SLNs and to distinguish them from non-contrast containing tissues. Conclusions: Lymphosonography is a unique method of imaging LCs and SLNs. A combination of PIHI and CFI is necessary to optimize the utility of lymphosonography evaluations. (Acknowledgement: Amersham Health, Olso, Norway, provided Sonazoid.) 32700 Ultrasound findings of superficial lesions of the breast Cha E,* Kim H, Lee J, Radiology, The Catholic University of Korea, St. Vincent Hospital, Suwon, Kyunggi-do, South Korea

Volume 29, Number 5S, 2003 Objective: The aim of this study was to learn what kind of breast diseases involve superficially and to demonstrate ultrasonographic findings of superficial lesions of the breast. Methods: From 2000 to 2002, ultrasonograms of the breast were retrospectively reviewed, and lesions involving dermis and subcutaneous fat layer of the breast were analysed with clinical history, mammogram, and pathology. Results: Lesions of the breast involving dermis or subcutaneous fat layer were as follows: mastitis, epidermal inclusion cyst, fat necrosis, Mondor’s disease, accessory breast, neurofibromatosis, sparganosis, lymphedema, and metastatic breast carcinoma. Conclusions: To know superficial lesions of the breast, it may be helpful to differentiate lesions of the breast with ultrasonogram. 32701 The significance of urinary tract abnormalities detected on prenatal ultrasound Borowski KS,1 Ramin KD,*1 Ramsey PS,2 Gloor JM,3 1. MaternalFetal Medicine, Mayo Clinic, Rochester, MN, 2. Maternal-Fetal Medicine, University of Alabama at Birmingham, Birmingham, AL, and 3. Pediatric Nephrology, Mayo Clinic, Rochester, MN Objective: Ultrasound examination has become a routine part of prenatal care, resulting in the detection of urinary tract abnormalities (UTA). Methods: We prospectively evaluated infants with prenatally detected UTA to determine the frequency with which these abnormalities are clinically significant (abnormality resulting in a solitary functioning kidney, renal insufficiency [elevated serum creatinine concentration or abnormal radionuclide imaging study], need for postnatal surgery, vesicoureteral reflux [VUR], or perinatal death due to a renal cause). In infants with unilateral abnormal kidneys, decreased renal function was defined as asymmetric, decreased uptake on the affected side was detected on radionuclide scan, or decreased renal mass was determined on the basis of ultrasound examination or excretory urography. Neonates with prenatally detected urinary tract abnormalities were evaluated with renal ultrasound and voiding cystourethrography. Infants with mild fetal hydronephrosis (A-P renal pelvis dilatation ⱖ4 ⬍10 mm at 20 weeks or later) were included in the group studied. Infants with postnatal hydronephrosis of greater than mild severity underwent MAG-3 radionuclide renal scan or excretory urography in conjunction with furosemide to determine the presence or absence of urinary tract obstruction. Results: Between 10/93 and 3/96, 4397 deliveries took place and 52 infants/50 pregnancies were identified with UTA for an incidence of 1.1%. 2 fetuses were identified with bilateral renal agenesis and did not survive the perinatal period due to respiratory insufficiency. 48 of 50 liveborn infants were evaluated (92%). 24 of 48 infants were found to have clinically significant UTA (50%) (Table). Conclusions: Prenatal urinary tract abnormalities were associated with clinically significant conditions in 50% of infants. Significant Diagnosis Solitary funtioning kidney Decreased renal function Surgical therapy Vesicoureteral reflux perinatal death resulting from renal condition

Number of Patients (%) 9 (19) 3 (6) 7 (15) 11 (24) 2 (4)

32704 Carrageenin-induced arthritis in rabbit model: Sonic contrastenhanced power Doppler sonography and magnetic resonance imaging findings Lee S,1 Suh J,2 Shin M,*1 Kim S,1 1. Radiology, Asan Medical Center, Seoul, South Korea, and 2. Diagnostic Radiology, Yonsei University College of Medicine, Seoul, South Korea