Sonographic appearance of aggressive angiomyxoma of the scrotum.

Aggressive angiomyxoma (AAM) is a rare, locally infiltrative tumor that occurs almost exclusively in the pelvic and perineal regions of women of childbearing age. We report the unusual case of a 26-year-old man with an AAM presenting as a slowly enlarging scrotal mass. Gray-scale scrotal sonography demonstrated a well-demarcated, hypoechoic, extratesticular, extraepididymal mass with multiple thin, echogenic internal septa. The mass arose inferior to the left testicle and displaced the testicle cephalad. Color Doppler sonography revealed surrounding vascularity but no Doppler signals within the mass. The testicles and epididymides demonstrated normal echogenicity and vascularity. Histologic examination of the excised mass revealed a well-demarcated, nonencapsulated lesion composed of spindle-shaped cells in a myxoid background with a prominent vascular component.

The role of biliary scintigraphy and ultrasonography in the diagnosis of cholecystitis.

The scintigraphic and sonographic findings in 70 patients with pathologically confirmed gallbladder disease are described. Fifty-two patients were found to have had acute cholecystitis. All 52 patients (100%) had non-visualized of the gallbladder on scintigraphy. Of these patients, 71% had abnormal ultrasound examinations and 29% had normal ultrasound examination. Eighteen patients were proven to have chronic cholecystitis. All 18 (100%) had an abnormal ultrasound examination. Four patients (22%) had non-visualization of the gallbladder on scintigraphy producing a false-positive incidence of approximately 6% for acute cholecystitis. The predictive value of scintigraphy in the patient with suspected acute cholecystitis was 94%. A combination of ultrasound and scintigraphy yielded a sensitivity of 100% in the detection of gallbladder disease in the 70 patients.

New observations in scintigraphy of subdural and extradural hematomas.

Static radionuclide images of subacute subdural hematomas demonstrate significant variations in findings over a 3-hr period in the same patient. The lesion can appear, disappear, and reconstitute in an entirely different pattern. This transformation has not appeared in extradural hematomas, and may provide a differential diagnostic sign. In patients with a clinical history or physical findings suspicious for these intracranial hematomas, immediate and sequential delayed static imaging is recommended.

Ultrasound of the whole breast utilizing a dedicated automated breast scanner.

Innovations in design of a dedicated breast scanner resulted in automation of the scanning process, the production of high resolution images of the whole breast and an efficient mode of image review. The results of clinical evaluation of the prototype of this breast scanner investigating normal breasts as well as benign and malignant breast lesions are presented.

Differential diagnosis between normal pressure hydrocephalus and cerebral atrophy on computed tomography.

A brain computed tomography--cisternographic correlation of 48 cases suspected of having normal pressure hydrocephalus (NPH) was undertaken, observing that the enlargement of temporal horns correlates with abnormal cisternograms compatible with NPH, and appears to be a reliable differential feature from cases of cerebral atrophy with "ex-vacuo hydrocephalus". The results of this correlation and typical images are presented.

Abnormal dynamic scintigraphy in hydrocephalus: a proposed mechanism.

Dynamic brain scintigraphy was performed on seven patients with documented hydrocephalus of various aetiologies. The patients had a characteristic abnormality consisting of lateral displacement of the proximal middle cerebral activity associated with a paracentral lucent zone. No focal areas of increased activity were identified on the static brain images. A proposed mechanism for these findings is discussed.

Noninvasive cardiac evaluation (NICE) of intracardiac shunts using inhaled radioactive carbon dioxide.

A totally new, noninvasive technique is presented for the detection and analysis of left-to-right cardiac shunts. Five millicuries of oxygen 15-labeled carbon dioxide is administered by a single-breath inhalation technique. The resultant lung washout curve accurately reflects the presence or absence of a shunt. The quantitative studies are promising, but the method must be compared with standard techniques in a statistically significant series. This work is in progress.

Iodine-123-Rose bengal: An improved hepatobiliary imaging agent.

A practical method for preparing )23-I-rose bengal that allows for its rapid and efficient incorporation into the molecule is reported. Administration of 123-I-rose bengal to normal healthy patients showing the normal uptake and excretory pattern visualized with this radio pharmaceutical is also presented. The overall reduction in imaging time and radiation exposure together with the improved images possible should greatly improve our diagnostic capabilities in evaluating the jaundiced patient.

Dynamic scintigraphy of primary and secondary malignant intracranial neoplasms.

Dynamic images and arteriograms were reviewed in patients with proved primary and secondary malignant intracranial neoplasms. In 44% of the patients with glioblastomas and 23% of those with metastatic lesions, radioactivity appeared early in the dynamic imaging sequence. This was related to the presence of arteriovenous shunting on arteriography rather than to a tumor stain. Neither characteristic dynamic imaging patterns nor rapid arteriovenous shunting was seen in patients with astrocytomas.