Fifty-seven patients with palpably enlarged peripheral lymph nodes underwent detailed ultrasonographic (US) examination with a 5.0-MHz and a 7.5-MHz probe. In 32 of 36 patients with malignant lymphoma (12 with Hodgkin disease, 24 with non-Hodgkin lymphoma) US showed a hypoechoic mass with a centrally located tubular structure. Pathologic examination showed that this structure correlated with small intact arterial vessels encased by confluent lymphomatous masses. This sonographic finding was not seen in patients with carcinomatous metastatic lesions to the lymph nodes (nine patients) or benign lymphadenitis (12 patients). The detection with US of small arteries within enlarged lymph nodes may indicate nodal infiltration by malignant lymphoma.
MR tomography was performed in 15 patients with urologically prediagnosed carcinoma of the urinary bladder. A field strength of 1.5 Tesla yields excellent morphological resolution of site and contrast. The results are compared with CT and--wherever available--with the pathological anatomic preparations. MR is often superior to x-ray computed tomography in demonstrating polypous carcinomas of the bladder and those producing thickening of the wall, since MR offers the possibility of performing coronary and sagittal cuts. In individual cases, MR can supply definite information on the depth of infiltration into the bladder wall and into perivesical structures; such findings agree with those obtained with cystectomy preparations. The contrast behaviour of the tumours and adjacent structures depends strongly on the measurement parameters employed with the high-strength field technique of 1.5 Tesla used in this study. MR echo sequences using different measurement parameters are useful in delineating the tumour contours against adjacent structures such as prostate, seminal vesicles, perivesical fat, urine and to differentiate the tumour from the healthy bladder wall.
Sonography of the pancreas was evaluated quantitatively in 94 normal subjects. The grey-scale values in the head and body of the pancreas were measured and compared with those of retroperitoneal fat. The echogenicity of the pancreas and the contrast between pancreas and fat were correlated with the age and weight of the subjects. Semi-quantitative studies revealed a positive correlation between echogenicity and age (r = 0.505); this can be confirmed to a high degree of statistical significance by quantitative analysis of pancreatic grey-scale values (r = 0.55 for the head and 0.71 for the body). Further improved correlation with age is obtained by computing the sonographic contrast between the pancreas and the retroperitoneal fat (r = 0.66 for the head and 0.77 for the body of the pancreas). It is concluded that determination of the grey-scale value can provide additional information particularly if one uses retroperitoneal fat as a reference tissue.
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