Ultraschall in der Medizin : Organ der Deutschen Gesellschaft für Ultraschall in der Medizin, [der] Österreichischen Gesellschaft für Ultraschall in der Medizin, [der] Schweizerischen Gesellschaft für Ultraschall in Medizin und Biologie
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Case Reports
[Adnexal torsion with hemorrhagic infarct in early pregnancy. Diagnosis by color-coded vaginal Doppler sonography].
A 25 year-old woman presented with left lower quadrant pain in the 11th week of gestation. Transvaginal sonography showed a 7 x 8 x 5 cm cystic-solid mass with an adjacent 9 mm echogenic structure on the left side corresponding to the adnexal stalk. ⋯ Laparoscopic detorsion of the left adnexa was not followed by restoration of perfusion ad a left adnexectomy was performed. Transvaginal color Doppler sonography is useful for preoperative diagnosis of adnexal torsion.
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In a follow-up survey of the members of the German Society for Ultrasound in Medicine (DEGUM), the use of several fine-needle puncture techniques as well as the frequency and nature of the complications were assessed. ⋯ Ultrasonically guided fine-needle puncture is a method with a low rate of complications, but even this slightly invasive method requires stringent indications.
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Transcranial Doppler and color-coded duplex sonography provide reliable information on cross-flow through the circle of Willis, stenoses, occlusions and vasospasm of the major basal cerebral arteries. The CO2 and acetazolamide tests allow quantitative evaluation of the hemodynamic impact of obstructive cerebrovascular disease. Furthermore, transcranial Doppler sonography is used for detection of enhanced intracranial pressure, confirmation of brain death, detection of cerebral microemboli ("high intensity transient signals" = "HITS"), and patent foramen ovale. ⋯ Transcranial color-coded duplex sonography identifies intracranial hemorrhage, cerebrovascular malformations, and hydrocephalus, but is inferior to neuroradiological techniques. Transpulmonary contrast agents make the examination of patients with inadequate insonation windows feasible, and increase diagnostic confidence in transcranial ultrasonography. Transcranial power-based color-coded duplex sonography ("power Doppler") may further improve transcranial ultrasonography, and visualize flow in smaller vessels.
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Two cases of wooden foreign bodies in soft tissue found by ultrasound are described. Furthermore we proved the existence of a typical sonographic pattern of wood in muscle tissue.
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In recent years transcranial Doppler and duplex sonography have become valuable methods supplementary to extracranial vascular investigations and especially in intensive care medicine. High grade stenoses and occlusions of the basal cerebral arteries as well as vascular spasms after subarachnoidal haemorrhage can be assessed using well-known Doppler criteria. ⋯ The patency of the intracranial collateral pathways can be estimated qualitatively, and the CO2 and Diamox test enables quantitative evaluation of cerebral haemodynamics. Moreover, in future, detecting spontaneous and contrast media-induced intracranial emboli may contribute to the differentiation of cerebral ischaemic events.