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1.
Ultraschall Med ; 36(6): 566-80, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26669869

RESUMEN

This is the second part of the series on interventional ultrasound guidelines of the Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). It deals with the diagnostic interventional procedure. General points are discussed which are pertinent to all patients, followed by organ-specific imaging that will allow the correct pathway and planning for the interventional procedure. This will allow for the appropriate imaging workup for each individual interventional procedure (Long version/ short version; the long version is published online).


Asunto(s)
Abdomen/diagnóstico por imagen , Sociedades Médicas , Ultrasonografía Intervencional/métodos , Ultrasonografía/métodos , Europa (Continente) , Humanos , Imagen por Resonancia Magnética , Imagen Multimodal , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X
2.
Ultraschall Med ; 36(6): E15-35, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26669871

RESUMEN

This is the second part of the series on interventional ultrasound guidelines of the Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). It deals with the diagnostic interventional procedure. General points are discussed which are pertinent to all patients, followed by organ-specific imaging that will allow the correct pathway and planning for the interventional procedure. This will allow for the appropriate imaging workup for each individual interventional procedure (Long version).


Asunto(s)
Abdomen/diagnóstico por imagen , Sociedades Médicas , Ultrasonografía Intervencional , Ultrasonografía , Europa (Continente) , Medicina Basada en la Evidencia , Humanos
4.
Ultraschall Med ; 36(5): E1-14, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26468774

RESUMEN

This is the first part of the Guidelines on Interventional Ultrasound of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) and covers all general aspects of ultrasound-guided procedures (long version).


Asunto(s)
Ultrasonografía Intervencional/métodos , Alemania , Humanos , Garantía de la Calidad de Atención de Salud/normas , Sociedades Médicas , Ultrasonografía Intervencional/instrumentación , Ultrasonografía Intervencional/normas
5.
Ultraschall Med ; 33(6): 544-9, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-23160776

RESUMEN

The Technical Quality Assurance group was initiated by the EFSUMB Board in 2007 and met firstly in 2008 to discuss and evaluate methods and procedures published for performing technical quality assurance for diagnostic ultrasound devices. It is the aim of this group of experts to advise the EFSUMB Board of effective and efficacious methods for routine use and to make recommendations regarding the technical aspects of EFSUMB by-law 9, parts 11.6. & 11.7. The group's work focused on new developments and related European projects to establish a common guideline. There is a great need of a well established protocol and dedicated processing software for the performance testing of medical ultrasound equipment. The measurements should be user independent as much as physically possible. Only if these goals are achieved in an international (firstly European) context, the optimal quality of ultrasound imaging can be offered and maintained to the medical community. This guideline aims to offer and summarize suitable procedures and evaluation processes to lend support for an optimal Technical Quality Assurance (TQA) scheme. The content of this guideline was presented to the EFSUMB Board of Directors (delegates) and approved by the EFSUMB Executive Board (ExB) at the regular meeting during EUROSON 2012 in Madrid April 2012.


Asunto(s)
Diseño de Equipo/normas , Interpretación de Imagen Asistida por Computador/normas , Garantía de la Calidad de Atención de Salud/normas , Ultrasonografía/instrumentación , Competencia Clínica/normas , Europa (Continente) , Humanos , Fantasmas de Imagen/normas , Control de Calidad , Diseño de Software , Ultrasonografía/normas
6.
Laryngorhinootologie ; 88(1): 48-56; quiz 57-9, 2009 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-19148852

RESUMEN

In acute inflammatory diseases sonography can differentiate between obstructive or non-obstructive sialoadenitis. Abscess formations may be detected and the maturation of the colliquation may be controlled. Abscesses may be punctured under US guidance. In Sjögren's syndrome the sonographic changes correlate with the histological destruction, in acute forms hypervascularisation is found in color Doppler. In fibrotic cases the stimulation-induced hyperemia is impaired. In sialoadenosis inflammatory and tumorous lesions can be ruled out by sonography. Tumors of the salivary glands can be visualized with high sensitivity. Like other imaging methods the specificity in assessment of the histology of a tumor is low. Multilocular lesions as sarcoidosis, lymphoma, metastases or cystadenolymphoma are discussed. In deep located, malignant tumors or when the tumor cannot be delineated completely, MR or CT are obligatory to delineate the tumor. Sonography enables the diagnosis of cysts or ranulae. The accuracy of sonography in assessment of sialolithiasis is about 90 %. Non-opaque stones can be visualized, too. However, small stones of less than 2 mm are difficult to detect since the posterior shadow may be missing. The concrements can be differentiated into intraductal or intraglandular stones. Indirect signs like ductal dilatations or inflammatory changes may be found. Pseudotumorous lesions as hypertrophy of the masseter muscle, tuberculosis, sarcoidosis or lymphoepithelial lesions in AIDS are discussed. In children the main differential diagnosis of salivary gland pathologies are addressed. In many diseases sonography is the first line imaging modality in assessment of salivary glands.


Asunto(s)
Enfermedades de las Glándulas Salivales/diagnóstico por imagen , Neoplasias de las Glándulas Salivales/diagnóstico por imagen , Sialadenitis/diagnóstico por imagen , Absceso/diagnóstico por imagen , Diagnóstico Diferencial , Humanos , Glándula Parótida/diagnóstico por imagen , Conductos Salivales/diagnóstico por imagen , Sensibilidad y Especificidad , Glándula Submandibular/diagnóstico por imagen , Ultrasonografía
7.
Ultraschall Med ; 28(3): 301-6, 2007 Jun.
Artículo en Alemán | MEDLINE | ID: mdl-17577859

RESUMEN

PURPOSE: Sonographic detection rate of colorectal tumours in comparison with endoscopy. MATERIALS AND METHODS: Within a period of 32 months all sonographically detected colorectal tumours were registered and the results compared with endoscopic findings within the same period. The patients had no peroral preparation for the sonographic examination which was always performed before coloscopy. RESULTS: The study encloses 521 tumours in 417 patients. The tumours can be subdivided into 181 cancers, 122 polyps > or = 1 cm, 207 polyps < 1 cm and 11 other tumours. 62 % (112/181) of cancers could be detected by sonography, 30 % of stage pTis, pT1 or pT2, 82 % of stage pT3 or pT4. The detection rate was 20 % for polyps > or = 1 cm, but only 2 % for polyps < 1 cm. The majority of larger tumours not detected on sonography (15/18) was located in the rectum and lower sigmoid colon. CONCLUSION: Colorectal cancers of stage T3 and T4 can be detected sonographically in a high percentage of cases. Sonography provides insufficient results in detecting polyps and small cancers, and even larger tumours may be missed especially in the lower sigmoid colon and rectum.


Asunto(s)
Neoplasias del Colon/diagnóstico por imagen , Neoplasias del Recto/diagnóstico por imagen , Neoplasias del Colon/patología , Pólipos del Colon/diagnóstico por imagen , Pólipos del Colon/patología , Pólipos del Colon/cirugía , Neoplasias Colorrectales/diagnóstico por imagen , Neoplasias Colorrectales/patología , Neoplasias Colorrectales/cirugía , Humanos , Estadificación de Neoplasias , Pólipos/diagnóstico por imagen , Pólipos/patología , Pólipos/cirugía , Enfermedades del Recto/diagnóstico por imagen , Enfermedades del Recto/cirugía , Neoplasias del Recto/patología , Sensibilidad y Especificidad , Neoplasias del Colon Sigmoide/diagnóstico por imagen , Neoplasias del Colon Sigmoide/patología , Neoplasias del Colon Sigmoide/cirugía , Ultrasonografía
8.
Praxis (Bern 1994) ; 95(16): 631-7, 2006 Apr 19.
Artículo en Alemán | MEDLINE | ID: mdl-16681156

RESUMEN

Today sonography is the first line imaging method for diagnosing acute appendicitis. Experienced investigators will have an accuracy of more than 90%. Sonography can diagnose many conservatively managed diseases. The most important differential diagnoses are infectious ileocoecitis, right sided diverticulitis, appendagitis, adnexitis, ruptured or torque ovarian cysts, ectopic pregnancies. Ureterolithiasis, cholecystitis, haematomas in the psoas muscle or in the rectus muscle are rarer causes of right lower quadrant pain. Sonography can reduce the high rate of false positive clinical examinations concerning acute appendicitis. It has to be stated that an exclusion of appendicitis can only be made sonographically if the normal appendix can be seen in its full length and/or an other differential diagnosis can be depicted that explains the clinical symptoms. Mucoceles are rare cystoid lesions of the appendix. They exhibit a typical onion skin sign structure caused by different mucus viscosities. In large mucoceles a tumor causes this lesion.


Asunto(s)
Apendicitis/diagnóstico por imagen , Enfermedad Aguda , Apéndice/diagnóstico por imagen , Diagnóstico Diferencial , Humanos , Imagen por Resonancia Magnética , Valores de Referencia , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X , Ultrasonografía
9.
Praxis (Bern 1994) ; 95(16): 625-9, 2006 Apr 19.
Artículo en Alemán | MEDLINE | ID: mdl-16681155

RESUMEN

Sonography is the primary diagnostic method in the painful left lower quadrant. Experienced investigators can diagnose an acute diverticulitis in more than 90%. In unclear cases or when complications are suspected, CT should be performed. Sonography can diagnose most differential diagnosis of the painful left lower quadrant as colitis, appenagitis or haematomas.


Asunto(s)
Colon Sigmoide/diagnóstico por imagen , Diverticulitis del Colon/diagnóstico por imagen , Enfermedad Aguda , Diagnóstico Diferencial , Endosonografía , Humanos , Perforación Intestinal/diagnóstico por imagen , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X
10.
Ultraschall Med ; 27(1): 34-9, 2006 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-16470477

RESUMEN

AIM: To evaluate axillary sentinel lymph-node (SLN) identification and localisation with gamma probe-assisted sonography. PATIENTS AND METHODS: The study comprises 42 patients. Sonographically guided peri-lesional injection of the radiopharmacon was performed on 40 breasts. Two patients with melanoma of the upper extremity underwent intracutaneous injection. After the acquisition of images with the gamma camera, the delineated lymph nodes were marked on the skin. A high-frequency transducer with an adapted gamma probe was then used to identify the SLN. Before surgery, the SLN was localised with a hook-wire. Node activity was controlled intraoperatively. RESULTS: In two out of 42 cases, lymphatic mapping did not reveal SLNs. Multiple SLNs at different sites, all with similar activity, were demonstrated in one patient, while in another patient the sonographically visible lymph nodes were too small for exact correlation. Hook-wire localisation of the SLN was performed in the remaining 38 axillary spaces. Gamma probe-assisted sonography allowed for correct localisation of SLNs in 35/38 patients (92 %). Localisation was not correct in 3 patients (8 %), but in all cases the hook-wire was located next to the SLN. CONCLUSION: Preoperative identification and correct localisation of the SLN is possible in a high percentage of cases. This method allows rapid intraoperative detection of the SLN and could be used for exact correlation of sonographic appearance and histopathological results.


Asunto(s)
Ganglios Linfáticos/diagnóstico por imagen , Biopsia del Ganglio Linfático Centinela/métodos , Adulto , Anciano , Anciano de 80 o más Años , Axila , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Femenino , Rayos gamma , Humanos , Metástasis Linfática/diagnóstico por imagen , Masculino , Melanoma/diagnóstico por imagen , Melanoma/patología , Persona de Mediana Edad , Cintigrafía , Ultrasonografía
11.
Ultraschall Med ; 26(3): 185-96, 2005 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15948054

RESUMEN

For many clinical conditions, sonography is the first line imaging modality in the evaluation of cervical soft tissue lesions. Cervical cysts, lipomas, paragangliomas, neurogenic tumours, haemangiomas or lymphangiomas usually display a typical sonographic morphology. Sonography can be used for evaluation of soft tissue lesions and cervical lymph node assessment. Most of the afflictions of the salivary glands can be diagnosed sonographically. Sonography is also used for guided biopsy of lymph nodes, cervical soft tissue tumours or salivary gland lesions. The relationship of tumours or lymph nodes to the great cervical vessels can be evaluated. Colour Doppler can visualise the vascularisation of cervical soft tissue lesions, often narrowing down the differential diagnosis.


Asunto(s)
Vértebras Cervicales/diagnóstico por imagen , Cuello/diagnóstico por imagen , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Hemangioma/diagnóstico por imagen , Humanos , Lipoma/diagnóstico por imagen , Linfangioma/diagnóstico por imagen , Neoplasias de Tejido Nervioso/diagnóstico por imagen , Paraganglioma/diagnóstico por imagen , Enfermedades de las Glándulas Salivales/diagnóstico por imagen , Ultrasonografía Doppler en Color
12.
Eur J Gastroenterol Hepatol ; 15(8): 881-3, 2003 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-12867798

RESUMEN

Detection and characterization of focal liver lesions are critical for patients with liver cirrhosis. The potential of contrast-enhanced sonography in the characterization of focal liver lesions is well established in the literature. However, prospective studies in the assessment of patients with suspected hepatocellular carcinoma (HCC) in liver cirrhosis are rare. B-mode imaging often cannot differentiate small focal lesions in cirrhotic livers. Also, power Doppler is not capable of characterizing small focal lesions in cirrhosis. Contrast-enhanced sonography with a first-generation enhancer seems to improve the accuracy of diagnosis of small HCC. The differentiation of HCC and dysplastic nodules is notoriously difficult. In addition, other arterial hypervascularized liver lesions should be considered, depending on the clinical background. The limitations and drawbacks of contrast-enhanced sonography should be considered. All imaging methods are of limited value in the detection of solid liver lesions smaller than 1 cm.


Asunto(s)
Carcinoma Hepatocelular/diagnóstico por imagen , Cirrosis Hepática/complicaciones , Neoplasias Hepáticas/diagnóstico por imagen , Ultrasonografía Doppler/métodos , Carcinoma Hepatocelular/etiología , Humanos , Hígado/diagnóstico por imagen , Cirrosis Hepática/diagnóstico por imagen , Neoplasias Hepáticas/etiología , Imagen por Resonancia Magnética , Estudios Prospectivos , Tomografía Computarizada por Rayos X
13.
Ultraschall Med ; 24(3): 195-6, 2003 Jun.
Artículo en Alemán | MEDLINE | ID: mdl-12817315

RESUMEN

Up to 3% of all parotid tumours are lipomas. Parotid lipomas can be diagnosed almost specifically by imaging as US, CT, MRI. On ultrasound parotid lipomas are ovoid, hypoechogenic lesions with typical feathered structure. Colour Doppler sonography did not detect any signals in the tumour. CT enables the definite diagnosis by measurement of density values equivalent to fat.


Asunto(s)
Lipoma/diagnóstico por imagen , Neoplasias de la Parótida/diagnóstico por imagen , Femenino , Humanos , Persona de Mediana Edad , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X/métodos , Ultrasonografía Doppler en Color/métodos
14.
Eur Radiol ; 13(5): 964-75, 2003 May.
Artículo en Inglés | MEDLINE | ID: mdl-12695816

RESUMEN

Due to their superficial position, the parotid, the submandibular, and the sublingual glands can be imaged with high-resolution transducers. In acute inflammatory diseases sonography can differentiate between obstructive or non-obstructive sialoadenitis. Abscess formations may be detected and the maturation of the colliquation may be controlled. Abscesses may be punctured under US guidance. In Sjögren's syndrome the sonographic changes correlate with the histological destruction, and in acute forms hypervascularization is found in color Doppler. In fibrotic cases the stimulation-induced hyperemia is impaired. In sialoadenosis inflammatory and tumorous lesions can be ruled out by sonography. Tumors of the salivary glands can be visualized with high sensitivity. Like other imaging methods the specificity in assessment of the histology of a tumor is low. Multilocular lesions, such as sarcoidosis, lymphoma, metastases, or cystadenolymphoma, are discussed. In deep located, malignant tumors or when the tumor cannot be delineated completely, MR or CT are obligatory to delineate the tumor. Sonography enables the diagnosis of cysts or ranulae. The accuracy of sonography in assessment of sialolithiasis is approximately 90%. Non-opaque stones can be visualized, too; however, small stones of less than 2 mm are difficult to detect since the posterior shadow may be missing. The concrements can be differentiated into intraductal or intraglandular stones. Indirect signs, such as ductal dilatations or inflammatory changes, may be found. Pseudotumorous lesions, such as hypertrophy of the masseter muscle, tuberculosis, sarcoidosis, or lymphoepithelial lesions in AIDS, are discussed. In children the main differential diagnosis of salivary gland pathologies are addressed. In many diseases sonography is the first-line imaging modality in assessment of salivary glands.


Asunto(s)
Glándulas Salivales/diagnóstico por imagen , Ultrasonografía/métodos , Diagnóstico Diferencial , Humanos , Enfermedades de las Glándulas Salivales/diagnóstico , Glándulas Salivales/anatomía & histología , Sensibilidad y Especificidad
15.
Ultraschall Med ; 24(1): 7-16, 2003 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-12599037

RESUMEN

Acute left lower quadrant pain is frequently caused by diverticulitis, especially in elderly patients. The most common differential diagnoses include renal colic, urinary tract infection, gynaecologic disorders, epiploic appendicitis, perforated carcinoma, other inflammatory diseases of the colon and diseases of the abdominal wall. Because the clinical impression may lead to a false diagnosis, further evaluation is necessary. Imaging methods are used to establish a correct diagnosis and to differentiate between benign self-limited disorders and those which require immediate intervention. Sonography and CT are the imaging methods of choice for the examination of patients with left lower quadrant pain. Both methods have shown to be accurate in verifying diverticulitis as well as in establishing alternative diagnoses. This review reports the sonographic appearance of the different entities and refers to other imaging methods if necessary.


Asunto(s)
Dolor Abdominal/diagnóstico por imagen , Diverticulitis/diagnóstico por imagen , Dolor Abdominal/etiología , Enfermedad Aguda , Anciano , Diagnóstico Diferencial , Femenino , Enfermedades de los Genitales Femeninos/diagnóstico por imagen , Humanos , Neoplasias/diagnóstico por imagen , Ultrasonografía , Infecciones Urinarias/diagnóstico por imagen
16.
Ultraschall Med ; 23(4): 239-44, 2002 Aug.
Artículo en Alemán | MEDLINE | ID: mdl-12226761

RESUMEN

AIM: To investigate the sonographic signs of epiploic appendagitis in a larger number of patients and to add new details. PATIENTS AND METHODS: Over a period of approximately 8 years 28 patients were sonographically diagnosed to have epiploic appendagitis. The following sonographic signs were investigated: echogenicity of the lesion; compressibility; shape of the lesion; adherence to the anterior abdominal wall; peripheral rim; central hypoechoic line; thickening of the colonic wall. In 11 of these patients colour Doppler sonography was performed. In addition all 28 patients underwent CT. RESULTS: In 28/28 cases (100 %) a moderately hyperechoic, ovoid, non-compressible mass adjacent to the colon was demonstrated. The mass was surrounded by a hypoechoic rim in 20 cases (71 %) and was fixed to the abdominal wall in 26/28 cases (93 %). Five cases (18 %) revealed a central hypoechoic line, and slight thickening of the colonic wall was visible in 2 cases (7 %). In those cases where colour Doppler sonography was performed, colour flow was absent in the central part of the lesion. In the peripheral zone slightly increased colour flow was demonstrable in 9/11 cases. CONCLUSION: Epiploic appendagitis has a characteristic sonographic appearance with a moderately hyperechoic, ovoid, non-compressible lesion adjacent to the colon and adherent to the abdominal wall. The mass is frequently surrounded by a hypoechoic rim. Colour Doppler sonography shows a central avascular area and slightly increased colour flow in the peripheral zone.


Asunto(s)
Apendicitis/diagnóstico por imagen , Enfermedades Gastrointestinales/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Colon/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Ultrasonografía
17.
Ultraschall Med ; 23(1): 41-6, 2002 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-11842371

RESUMEN

AIM: To investigate the ability of sonography to diagnose diverticulosis and to demonstrate the typical appearance of normal diverticula. PATIENTS AND METHODS: Sixty consecutive patients underwent sonography for prospective evaluation of the presence of diverticulosis of the left hemicolon. Diverticula were assessed for number, diameter, echogenicity, and wall thickness. Sonographic results were compared with those of endoscopy. RESULTS: Sonography yielded positive results in 28/33 patients (85 %) with endoscopically proven diverticulosis. Sonography on average could demonstrate less diverticula per patient than endoscopy. Two sonographic results were false positive. Diverticula had a maximum average diameter of 8.7 mm and the diverticular wall measured 1 mm at most. In many cases the diverticular wall could not be demonstrated by sonography. All diverticula except for one were hyperechoic. In 39 % of patients with diverticulosis one or more diverticula showed clear acoustic shadowing indicative of a faecalith. The maximum diameter of the colonic wall was 3.3 mm on average. Sonography could demonstrate the descending colon in all cases. The sigmoid colon was not visible in 3 cases and could rarely be evaluated in its entire length. CONCLUSION: Sonography can diagnose diverticulosis of the left hemicolon in most cases. Normal diverticula present as hyperechoic protuberances of the colonic wall with acoustic shadowing of varying intensity. The diverticular wall is thin and often not demonstrable at sonography.


Asunto(s)
Colonoscopía , Divertículo del Colon/diagnóstico por imagen , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Sensibilidad y Especificidad , Ultrasonografía
19.
Eur Radiol ; 11(10): 1956-63, 2001.
Artículo en Inglés | MEDLINE | ID: mdl-11702128

RESUMEN

Acute bowel inflammation frequently originates from thin-walled diverticula of the colon. Not the presence of diverticula, but the demonstration of an inflamed diverticulum, is diagnostic of diverticulitis in cases of bowel wall thickening and pericolic inflammation. The aim of this study was to investigate the sonographic appearance and detectability of inflamed diverticula. One hundred seventy-five consecutive patients with clinically suspected diverticulitis underwent sonographic examination. Outpouchings from the colonic wall centred in the pericolic inflammation were considered inflamed diverticula. Depending on the sonographic appearance they were divided into four groups: hypoechoic; predominantly hyperechoic; hyperechoic with surrounding hypoechoic rim; and hyperechoic with acoustic shadowing. Sonography showed inflamed diverticula in 79 (77%) of 102 patients with diverticulitis. Inflamed diverticula were hypoechoic in 37%, predominantly hyperechoic in 4%, hyperechoic with surrounding hypoechoic rim in 41% and hyperechoic with acoustic shadowing in 18% of patients. In 23 (23%) of 102 patients no inflamed diverticulum was demonstrable. This group included 17 patients with complicated diverticulitis and 6 false-negative cases. An inflamed diverticulum as a sign of diverticulitis yielded an overall sensitivity of 77% and a specificity of 99%. Sensitivity in uncomplicated disease was 96%. In patients with uncomplicated diverticulitis an inflamed diverticulum is a sign of diverticulitis with excellent sensitivity and specificity, usually with solitary and less frequently with more than one inflamed diverticulum being demonstrable. In patients with complicated diverticulitis an inflamed diverticulum is often not detectable.


Asunto(s)
Diverticulitis del Colon/diagnóstico por imagen , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ultrasonografía
20.
AJR Am J Roentgenol ; 177(5): 1061-6, 2001 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-11641170

RESUMEN

OBJECTIVE: The aim of this study was to determine with sonography whether distinct cross-sectional imaging signs exist that may differentiate between incarcerated and nonincarcerated abdominal wall hernias. SUBJECTS AND METHODS: The sonographic appearance of 149 consecutive abdominal wall hernias was prospectively investigated and correlated with subsequent surgical results. Commercially available 4- to 10-MHz linear transducers and 2- to 5-MHz curved transducers were used to evaluate the hernias. RESULTS: Surgery revealed 126 nonincarcerated and 23 incarcerated hernias. The sonographic signs suggestive of incarceration that we identified included free fluid in the hernia sac, which was observed in 91% of the incarcerated hernias and in 3% of the nonincarcerated hernias; bowel wall thickening in the hernia, which was detected in 88% of the incarcerated hernias and in none of the nonincarcerated hernias; fluid in the herniated bowel loop, which was detected in 82% of the incarcerated hernias and in 3% of the nonincarcerated hernias; and dilated bowel loops in the abdomen, which occurred in 65% of the incarcerated hernias and in none of the nonincarcerated hernias. These imaging findings allowed the identification of incarceration in all 23 cases and led to a false-positive result in two of 126 nonincarcerated hernias. CONCLUSION: Cross-sectional imaging signs indicating hernial incarceration included free fluid in the hernial sac, bowel wall thickening in the hernia, fluid in the herniated bowel loop, and dilated bowel loops in the abdomen. Sonography is an appropriate cross-sectional imaging modality for detecting these signs that are helpful in diagnosing patients with atypical clinical presentations.


Asunto(s)
Hernia Ventral/diagnóstico por imagen , Obstrucción Intestinal/diagnóstico por imagen , Músculos Abdominales/diagnóstico por imagen , Músculos Abdominales/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Diagnóstico Diferencial , Femenino , Hernia Inguinal/diagnóstico por imagen , Hernia Inguinal/cirugía , Hernia Obturadora/diagnóstico por imagen , Hernia Obturadora/cirugía , Hernia Umbilical/diagnóstico por imagen , Hernia Umbilical/cirugía , Hernia Ventral/cirugía , Humanos , Obstrucción Intestinal/cirugía , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Sensibilidad y Especificidad , Ultrasonografía
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