Journal of clinical ultrasound : JCU
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We report a case of emphysematous cholecystitis with the sonographic appearance of an "effervescent gallbladder"--a large amount of gas bubbles rising like bubbles in a glass of champagne from the dependent part of the gallbladder and floating to the nondependent part. The etiology of this finding was acute obstruction of the distal common bile duct by a stone and purulent cholangitis. Short-term follow-up sonography is important to confirm the diagnosis of cholecystitis.
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Heart diseases can alter liver volume, morphology, and circulation. The Doppler pulsatility of the portal vein and its pulsatility ratio (PR) have been reported as being closely associated with the right atrial pressure and with the New York Heart Association (NYHA) class. We examined the relationships between measurements of liver and spleen dimensions and blood flow in portal and hepatic veins, assessed noninvasively by Doppler sonography, and compared them with echocardiographic data. ⋯ The effects of cardiac failure on portal blood flow, which declines progressively with worsening cardiac function, is shown better by the pulsatility pattern of the portal vein than by morphologic caval and hepatic vein measurements. PR can be used as a reliable adjunctive sign of heart failure.
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Echo enhancing agents have been used in echocardiography since 1968 for a variety of applications. Until recently, the agents were unable to survive transit through the pulmonary circulation following intravenous injection, and the technique was therefore restricted to investigations of the right side of the heart. ⋯ This agent offers important practical advantages in "routine" echocardiography, particularly in patients in whom image quality is suboptimal or baseline examination fails due to physical limitations. Potential future uses of contrast-enhanced echocardiography include quantitative analysis of coronary artery flow.
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Ten patients affected by the immotile cilia syndrome (ICS) and their families received an ultrasound examination of the upper abdomen to observe the possible familial occurrence of biliary, pancreatic, and splenic alterations. In 9 patients the liver was localized in the left hypochondrium, and in 1 patient there was an accessory spleen. ⋯ Two parents had an accessory spleen. We conclude that the supposed increased frequency of polysplenia, asplenia, and biliary atresia among ICS subjects and their kin is overestimated and based only upon anecdotal reports.
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Transrectal ultrasonography (TRUS) has become the most frequently used imaging modality for the prostate. The internal architecture of the prostate is readily detailed by TRUS, and the procedure allows an accurate measurement of prostate size. ⋯ In men with an abnormality of either digital rectal palpation of the prostate or serum prostate specific antigen, TRUS is useful for directing prostate biopsy. Transrectal core biopsies are obtained under ultrasound direction, and precise placement of the biopsy needles can be accomplished using TRUS.