Saturday, December 22, 2012

Ultrasound imaging in chronic renal failure or chronic medical renal disease

Chronic medical renal disease is characterized sonographically by firstly loss of
cortico-medullary differentiation followed by increased cortical echogenicity
It is much later that there is a decrease in the vascularity of the kidneys.
At times the kidneys may be very poorly visualised due to the increased cortical echogenicity. In fact in extreme cases and end stage renal disease the kidneys may not be seen at all during ultrasound imaging. Another important feature in chronic medical renal disease is the small size of the kidneys signifying atrophic changes in the kidneys. The ultrasound images below show one typical case of chronic medical renal disease:
Both kidneys are shown in the ultrasound image below with typical changes described about:

Colour Doppler images of the left and right kidneys show diminished vascularity in both kidneys. This is an ominous sign and signifies and imminence of end-stage renal disease in the not too distant future.

Thursday, December 20, 2012

Quiz- carotid Doppler study- severe external carotid artery stenosis

What is your diagnosis based on these carotid Doppler ultrasound images?
Left carotid Doppler study:  firstly---the common carotid artery and the vertebral artery of the left side show normal flow. (note: the answer to the quiz is given below).

  the left internal carotid artery also shows normal spectral flow pattern. but observe the spectral flow pattern and waveform of the left external carotid artery. Note the extremely high velocity flow in the external carotid artery. The peak systolic velocity the left external carotid artery reaches 212 cm/s. This is definitely abnormal.the cause of this high velocity flow in the left external carotid is obvious, as we look at the images below- it is the result of a severe stenosis at the origin of the left external carotid artery.

Right carotid Doppler study: similar changes can also be seen in the right external carotid artery where again extremely high velocity flow is seen near the origin due to moderate to severe stenosis of this artery.

final diagnosis: bilateral Severe external carotid artery stenosis , close to the origin of the arteries.

Friday, December 14, 2012

3-D ultrasound of bilateral hydrocele

This male patient had a history of trauma followed by scrotal pain and swelling. Ultrasound shows bilateral tunica vaginalis hydrocele with multiple septae with the left side being more affected.
The 3-D ultrasound images below show fine detail of the septations within the scrotal hydrocele.
with the history of from, the possibility of this fluid collection being a hematocele should be considered.

The left testes also shows tubular ectasia of the rete testes- in the 3-D ultrasound image below:


Monday, December 10, 2012

3D ultrasound images gallery from 5 weeks embryos to 14 weeks old fetuses

This is a gallery of 3D ultrasound images of embryos from 5 weeks to 14 weeks gestational age fetuses:
3D ultrasound images of 5 week old embryo:

 3D ultrasound images of 7 week old embryos:

Now here are 3D ultrasound images of an 8 weeks old embryo:

Now for some nice 3-D ultrasound images of a nine weeks old fetus. I could actually see the limb buds in the 3-D view.....have a look:

And here again are the transvaginal ultrasound images of the early fetus, again in 3-D. You can actually see the yolk sac (YS) very clearly now:

Here are some 3D ultrasound images of a 10 week old fetus. All these cases and images are of different fetuses:

And now for 3-D ultrasound images of 12 week old fetus:

Lastly, some 3D sonographic images of a 13 week old fetus:

A 3D ultrasound image of twin pregnancy at 9 weeks gestational age:

Some nice 3D ultrasound images I captured on the Philips HD 15....3D imaging has a pretty long learning period during which one gets the hang of it. These 3D ultrasound images show a 13 week old fetus. Whilst the lower limbs are seen beautifully, I found it difficult to get the upper limbs in the same image:

Lastly some superb 3D images (courtesy of Jill Beithon) using the Voluson E8: