30 patients with an acute build-up of renal transplant were examined comparatively via antegrade pyelography (AP), computed tomography (CT) and sonography (SONO). In the proof of obstructions and compressions of the ureter of renal transplant, antegrade pyelography was superior to sonography and computed tomography. Perirenal collections of fluids were recognised correctly via sonography by 73% (11/15) and computed tomography by 87% (13/15). The computer tomogram is superior in the differentiation of perirenal collection of fluids. In establishing proof of the cause of an acute build-up of renal transplant it was evident that computed tomography with a sensitivity of 64% and a specificity of 94% was slightly superior.
Fifty patients were studied prospectively. The extracranial portions of the carotid arteries were examined by duplex sonography and IA-DSA in order to demonstrate haemodynamically significant stenoses or plaques which might give rise to emboli and the findings compared with the pathologic specimens. The results indicate high sensitivity (up to 90%) for more than 75% detection of stenoses. On the other hand ulceration was diagnosed sonographically with an accuracy of 66% and plaque hemorrhage with an accuracy of 56%.
Fifty-one patients, on whom a total of 64 carotid thromboendarterectomies had been performed, were followed up by duplex sonography. Five asymptomatic occlusions of the internal carotid artery (8%) and one occlusion of the common carotid artery were found. Two patients (3%) developed a restenosis of more than 50% and another two patients a restenosis of less than 50%. Changes in the vessel wall not producing significant luminal change were observed in another 18 cases (28%). Thirty-six of the operated vessels (56%) showed no change.
Apart from computed tomography, sonography is the most valuable clinical method for the pre-operative diagnosis of parathyroid tumours. Eighty-six patients were examined by high resolution ultrasound (7.5 and 10 MHz) and in 63 of these the sonographic findings could be compared with the results of surgery. Sensitivity of 67.5% was highest amongst 40 patients with primary hyperparathyroidism. Patients who had had previous operations on the neck showed a slightly lower sensitivity of 65%. In secondary and tertiary hyperparathyroidism, sensitivity was 54%. The main causes of error were small size of the adenoma, changes in the thyroid gland and previous surgery to the neck. The value of sonography for diagnosis and surgical planning is discussed.
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