Saturday, November 24, 2012

Colour Doppler ultrasound of epididymitis in child:

This seven-year-old child had tenderness and pain in the right scrotum. Sonography of the scrotum was done to look for possibility of torsion of the testis. Ultrasound and colour Doppler study was done and revealed marked vascularity of the right head of epididymis. Both testis showed normal vascularity ruling out the possibility of torsion of testes. (We used the Philips HD 15 ultrasound system in the study). Usually, colour Doppler study of the scrotum in children below the age of 10 years can often be confusing with poor colour pickup. However, in this case the colour Doppler signals of the scrotal region was excellent.

Colour Doppler ultrasound images of the scrotum are shown below:

Friday, November 23, 2012

Ultrasound study of a large prostate utricle cyst

This 40-year-old male patienthad non-specific symptoms related to micturition, namely, difficulty in passing urine, mild pain during micturition or dysuria and splitting of the urine stream.
Transabdominal ultrasound images shown below reveal a cyst in the prostate:

 Transrectal ultrasound images of this case also shown below:

Clearly there is a large cyst in the upper prostate in the midline. The colour Doppler ultrasound images show normal vascularity of prostate. The large size of this prostate utricle cyst can easily explain some of the symptoms of this patient. This can be partly explained by actual compression of prostatic urethra by the utricle cyst of prostate.
Also see for more on this topic:

Thursday, November 22, 2012

Sonography in the case of pedunculated polyp

This young woman is 25 years age and is a lactating mother. Her child is nine months age. At present she complains of profuse bleeding per vagina, since the past one week. She also has mild discomfort in the pelvis. Her mother was no significant tenderness of pain in the pelvic region. Ultrasound images both transabdominal and transvaginalshow a large polypoid mass of 1.2 to 1.5 cm protruding from the lower segment of the uterus to the cervix, or to be more precise into the endocervical canal.
In addition there is a cystic fluid collection in the endocervical canal which may be due to obstruction to the outflow from the cervix. Since the patient had regular menses, prior to the scan, the possibility of this cystic lesion in the cervix being a cervical pregnancy or an abortion in progress is not likely.
shown below are transabdominal ultrasound images of the uterus showing the large polyp protruding into the endocervical canal from the lower part of the body of the uterus or to be more precise from the endometrium of the body of the uterus. There is also a colour Doppler image showing limited vascularity in this region. The polyp itself does not show significant vascularity.

And below are shown some excellent transvaginal ultrasound images of the same case showing the polyp clearly bulging into the fluid filled endocervical canal. what appears unusual is the limited or rather poor vascularity in that large pedunculated cervical polyp.

In the last ultrasound image at the bottom, observe how the polyp is literally surrounded by fluid in the endocervical canal.
looking to the large size of the polyp and also the lack of vascularity in these ultrasound and colour Doppler images the possibility of this lesion being a pedunculated fibroid is also a likelihood. 

Wednesday, November 14, 2012

Pulseless disease- color Doppler imaging of upper limb

 This is an interesting case of a 25-year-old woman with pulse less disease of both upper limbs. Colour Doppler ultrasound of the left upper limb showed dampened flow in the entire arterial system.
Spectral Doppler showed absence of tri phasic pattern with an almost venous flow pattern in the axillary artery, the brachial artery and the radial and ulnar arteries.
What is your diagnosis based on these colour Doppler images of the left upper limb?

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Friday, November 09, 2012

3D ultrasound images- varicocele

This is a colour Doppler ultrasound image of the right varicocele.

And these are some nice 3-D ultrasound images of the right scrotum showing the varicocele.

Observe how the 3-D images of varicocele show fine detail of the dilated vessels of the pampiniform plexus in the right scrotum. We can get to see both internal structure as well as a surface rendering of vessels affected by the varicocele.
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Monday, November 05, 2012

Ultrasound imaging of gallbladder mass

this elderly male patient shows a calculus in the gallbladder.
But these ultrasound images also show marked thickening of the gallbladder wall, in addition to the Cholelithiasis. the colour Doppler ultrasound images also show considerable vascularity in the thickened  walls of the gallbladder. Based on these ultrasound and colour Doppler images the diagnostic possibilities include chronic calculus cholecystitis versus gall bladder mass, possibly malignant.