Interobserver agreement with the new BI-RADS terminology is good and validates the US lexicon. Subcategories 4a, 4b, and 4c are useful in predicting the likelihood of malignancy.
To assess vein compressibility as a simple ultrasound (US) technique to determine the presence of venous thrombi, 51 patients undergoing contrast material venography of the lower extremity because of a clinical suspicion of deep venous thrombosis (DVT) also underwent high-resolution US evaluation of the veins. DVT was diagnosed on 28 venograms. In 25 patients US studies demonstrated non-compressibility of the veins, indicating the presence of clot. In 23 patients with normal venograms, US examinations demonstrated total compressibility of the veins, indicating the absence of DVT. Clots below the knee were not depicted by US. In this study US had a sensitivity of 89% and a specificity of 100%.
ObjectiveThe suggestion that breast cancer management is compromised in elderly patients had prompted our review of the results of policies regarding screening and early detection of breast cancer and the adequacy of primary treatment in older women (.65
ResultsThe frequency of mammographic screening for all averaged 40% in 1987, 52% in 1987, and 63% in 1995. In the 65-year-old and older patients, the frequency of screening was 34% in 1987, 45% in 1989, and 48% in 1995, whereas in the 40-to 49-year-old age group, the frequency of mammography was 47% in 1987, 61 % in 1989, and 74% in 1995 579
There was no statistically significant difference between 11-gauge biopsy and 9-gauge biopsy in underestimation of atypical ductal hyperplasia and ductal carcinoma in situ.
Those in the field of diagnostic radiology should consider measures to mitigate the increasing shortage, while monitoring developments that might signal departures from current trends in supply and demand.
Objective. To determine whether sonography can be used to categorize some solid breast masses as probably benign so that biopsy can be deferred. Methods. We prospectively characterized 844 sonographically visible solid breast masses referred for biopsy. Mammographic and sonographic features of the masses were recorded, and all masses were categorized by American College of Radiology Breast Imaging Reporting and Data System classification before biopsy. Of the 844 masses, 148 were categorized as probably benign (Breast Imaging Reporting and Data System category 3). Sonographically guided biopsy (n = 804) or fine-needle aspiration (n = 40) was performed for pathologic correlation. Results. Of the 148 masses that met the sonographic criteria for probably benign masses, there was 1 malignancy, for a negative predictive value of 99.3%. Conclusions. Follow-up can be an acceptable alternative to biopsy for sonographically probably benign solid masses.
This study was undertaken to determine whether the presence of blood vessels could mimic the appearance of grade I hydronephrosis on sonograms and thus cause false-positive readings. One hundred consecutive patients with grade I hydronephrosis were examined. Sample volumes were obtained with pulsed Doppler ultrasonography (US) at the site of the greatest separation of the central renal sinus echoes to determine if the separation was fluid accumulating in the collecting system, as in obstruction, or if the separation was actually caused by vessels that mimic hydronephrosis. Vascular structures accounted for the separation of the sinus echoes in 43% of patients. In patients 12 years of age or younger, this frequency rose to 61%. The simple procedure of evaluating the renal sinus echo separation with pulsed Doppler US should decrease the frequency of false-positive diagnoses of hydronephrosis and thus diminish the need for further confirmatory testing.
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