Sixteen cases of centrally embolized foreign bodies are reported (eight catheter fragments, two guide wires, four pacemaker electrodes, one ventriculo-atrial shunt, one Port-A-Cath catheter). In all patients only the Dormia basket was used. Foreign body extraction was successful in all patients except one, in which removal of a pacemaker electrode from the myocardium failed. Technical aspects as well as complications of percutaneous foreign body extraction are discussed.

Diseases of the gastrointestinal tract accompanied by a thickened bowel wall have become more accessible to ultrasonic detection during the last years. In most of the cases, however, the sonographic pattern has no characteristic feature for any disease. In this paper we present the rare case of a phlegmon of the colon and discuss its differential diagnosis.

PURPOSE:To determine the prevalence of abdominal aortic aneurysms (AAA) in males above 60 years of age.METHODS:1043 males of 60 years of age or older underwent sonographic examinations of the abdominal aorta. All of the candidates had volunteered for the examination, and special care was taken to avoid preselection of the candidates. Wherever possible, information was obtained on the following risk factors: cholesterol level, nicotine, diabetes, insulin and other medication, hypertonia and cardiac risk.RESULTS:An AAA was diagnosed in 2.59% of the cases, while ectasia of the abdominal aorta was detected in 11.89%. The mean diameter of the aneurysms was 39.1 mm. Significant correlations between the various risk factors and abnormalities of the abdominal aorta could be established in patients suffering from angina pectoris (p = 0.004) and from congestive heart failure (p = 0.014).CONCLUSIONS:AAA in males above 60 occurs in 2,590 out of 100,000 cases. The most noteworthy risk factors in the development of AAA are cardiovascular disorders.

Ziel: Bestimmung der Prävalenz des abdominellen Aortenaneurysmas (AAA) bei Männern mit einem Alter von 60 Jahren oder mehr. Methode: Bei 1043 Männern mit einem Alter von 60 Jahren oder mehr wurde eine Sonographie der Bauchschlagader durchgeführt. Es wurden ausschließlich freiwillige Probanden untersucht, wobei besonders darauf geachtet wurde, daß keinerlei Vorselektion der Probanden bestand. Soweit möglich wurden auch folgende Risikofaktoren erhoben: Cholesterinspiegel, Zigarettenrauchen, Diabetes, Insulin oder andere Medikamente, Bluthochdruck und erhöhtes kardiales Risiko. Ergebnis: Ein AAA wurde bei 2,59 %, eine Ektasie bei 11,89 % der Probanden diagnostiziert. Der mittlere Durchmesser der Aneurysmen betrug 39,1 mm. Signifikante Korrelationen zwischen Ektasien oder Aneurysmen der Bauchschlagader und den erhobenen Risikofaktoren ergaben sich bei Probanden mit Angina pectoris (p = 0,004) und mit kardialer Stauung (p = 0,014). Schlußfolgerungen: Bei 60jährigen oder älteren Männern beträgt die Prävalenz des AAA 2590/ 100000. Die bedeutendsten Risikofaktoren waren gleichzeitig bestehende kardiovaskuläre Erkrankungen.

We studied 50 patients with intraoperative colour-coded Doppler sonography (CCDS) after carotid artery reconstruction. Technical defects could be detected in 19 cases (38 %): residual plaques in 9, flaps in 8 and strictures in 2. In 9 cases (18 %) the carotid endarterectomy was revised. One residual plaque and one residual stricture caused thrombosis at the operative site a few hours postoperatively. One of the patients with residual plaques developed a high-grade stenosis within the follow-up period. Of the patients with residual plaques two had a medium-grade stenosis at follow-up. Six flaps decreased in size or disappeared within 1 week after operation. No patient with a flap developed a stenosis within the follow-up period. Our findings seem to indicate that correction of intimal flaps less than 10 mm in size is not necessary.

Pathology at the origin of the vertebral artery may be the cause of incapacitating vertebrobasilar insufficiency (VBI). Preoperative diagnosis is made primarily on angiographic criteria. We compared intraoperative and angiographic findings in 30 patients and found important diagnostic discrepancies in patients with a caudal, ventral or dorsal origin of the vertebral artery. In their angiograms, vessel superimposition led us to over look 3 ostial stenoses and 10 stenoses due to kinking. Angiographic assessment of patients with VBI can be difficult. Adequate visualisation of the origin of the vertebral artery is mandatory for accurate diagnosis.

The aim of our study was to objectively compare the effectiveness of various Doppler parameters in the diagnosis of renal artery stenosis. In three sheep, variable degrees of renal artery stenosis were induced and renal segmental arteries were investigated using pulsed Doppler sonography. In each animal the standard deviation of the instantaneous peak velocity within one cardiac cycle normalized by the mean peak velocity (coefficient of variation) had significantly higher normalized regression coefficients (k* = ‐0.215, average of three animals) when compared to resistive index (k* = ‐0.090) and acceleration index (k* = ‐0.069). In each individual animal, coefficient of variation detected lower pressure gradients (6.3 mm Hg, average value) than did resistive index (13.4 mm Hg) or acceleration index (17.3 mm Hg). The coefficient of variation may detect the presence of pressure gradients in renal artery stenosis more accurately than acceleration index or resistive index.

The aim of our study was to determine whether the site of intrarenal Doppler measurement influences diagnosis of renal artery stenosis. In an experimental test, three sheep with variable degrees of renal artery stenosis were investigated. In each animal, the resistive index from renal segmental arteries correlated better with mean pressure gradient (r = 0.85, 0.71, 0.85) and had lower standard deviation (s = 0.02 to 0.05) than resistive index from interlobar arteries (r = 0.48, 0.54, 0.61) (s = 0.03 to 0.11). In two animals the difference was significant (correlation: P < or = 0.01, P = 0.13, P < or = 0.05; standard deviation: P < or = 0.01, P < or = 0.34, P < or = 0.05). For detecting renal artery stenosis, vessels within the renal sinus should be used for Doppler sampling.

Spiral computed tomography (SCT) offers many advantages compared to conventional CT such as the possibility of administration of a much higher contrast bolus, the reduction or elimination of motion artefacts, the absence of gaps between the reconstructed images [1] and the evaluation of two different phases of contrast enhancement of liver parenchyma after application of one single contrast bolus.

Stenosis or occlusion of the abdominal aorta in patients under 40 years of age is either due to a congenital malformation (abdominal aortic coarctation) or due to idiopathic aortitis (Takayasu's arteritis). Some authors, however, consider abdominal aortic coarctation as a subtype of Takayasu's arteritis. We evaluated 9 of our cases and 108 well-documented cases from the literature to help decide the question whether abdominal aortic coarctation is an entity of its own or a subtype of Takayasu's arteritis. In coarctation there is a slight male predominance, patients are usually younger than 20 years of age, and the short aortic stenosis is suprarenal with involvement of the renal arteries. In Takayasu's arteritis females are predominantly affected, patients are usually over 20 years of age, and the long aortic stenosis or occlusion is infrarenal without involvement of the renal arteries. Abdominal aortic coarctation must therefore be considered as a separate disease. Aortography is important, because the morphology of aortic alterations often allows a radiological diagnosis.

This study is concerned with the results and experience gained from performing ultrasound-guided needle biopsies of thoracic masses in 56 patients. The accuracy of the biopsy results were related to the certainty of the method, the visibility of the biopsy needle on real time images, the effect of biopsy needle thickness and tumour size. Correct diagnosis was achieved in 84.6 %. Inability to see the biopsy needle resulted in only 5.4 % of cases and only when using a low frequency transducer (3 MHz). The thickness of the biopsy needle affected the accuracy of the biopsy, since all false negative or inconclusive biopsies resulted from the use of fine calibre needles. There was no significant correlation between tumour size and the accuracy of the biopsy results.

Stenosis or occlusion of the abdominal aorta in patients under 40 years of age is either due to a congenital malformation (abdominal aortic coarctation) or due to idiopathic aortitis (Takayasu's arteritis). Some authors, however, consider abdominal aortic coarctation as a subtype of Takayasu's arteritis. We evaluated 9 of our cases and 108 well-documented cases from the literature to help decide the question whether abdominal aortic coarctation is an entity of its own or a subtype of Takayasu's arteritis. In coarctation there is a slight male predominance, patients are usually younger than 20 years of age, and the short aortic stenosis is suprarenal with involvement of the renal arteries. In Takayasu's arteritis females are predominantly affected, patients are usually over 20 years of age, and the long aortic stenosis or occlusion is infrarenal without involvement of the renal arteries. Abdominal aortic coarctation must therefore be considered as a separate disease. Aortography is important, because the morphology of aortic alterations often allows a radiological diagnosis.

This study is concerned with the results and experience gained from performing ultrasound-guided needle biopsies of thoracic masses in 56 patients. The accuracy of the biopsy results were related to the certainty of the method, the visibility of the biopsy needle on real time images, the effect of biopsy needle thickness and tumour size. Correct diagnosis was achieved in 84.6%. Inability to see the biopsy needle resulted in only 5.4% of cases and only when using a low frequency transducer (3 MHz). The thickness of the biopsy needle affected the accuracy of the biopsy, since all false negative or inconclusive biopsies resulted from the use of fine calibre needles. There was no significant correlation between tumour size and the accuracy of the biopsy results.

Primary lymphoma of bone is a rare form of non-Hodgkin lymphoma which involves a single bone and has a relatively good prognosis following radiation therapy. We observed 17 histologically verified cases and found 97 cases in the literature. This rare tumour may occur at any time in adults and usually affects the metaphyses of long bones. It produces osteolytic changes and usually only mild periosteal reactions. Radiologically as well as histologically, differentiation from other highly malignant bone tumours is extremely difficult and sometimes impossible. A correct diagnosis can only be made from an accurate knowledge of the radiological appearances, localisation of the tumour and age of the patient.

Primary lymphoma of bone is a rare form of non-Hodgkin lymphoma which involves a single bone and has a relatively good prognosis following radiation therapy. We observed 17 histologically verified cases and found 97 cases in the literature. This rare tumour may occur at any time in adults and usually affects the metaphyses of long bones. It produces osteolytic changes and usually only mild periosteal reactions. Radiologically as well as histologically, differentiation from other highly malignant bone tumours is extremely difficult and sometimes impossible. A correct diagnosis can only be made from an accurate knowledge of the radiological appearances, localisation of the tumour and age of the patient.

Seventy-five breast neoplasms have been examined with duplex sonography to establish the optimal threshold value of systolic peak flow velocity to differentiate benign from malignant tumors. It could be shown that a systolic peak flow of > or = 0.2 m/s (Doppler angle corrected to 0 degrees) provides the best relationship between sensitivity and specificity concerning characterization of tumors. However, the data we obtained indicate that only positive findings are potentially reliable. Negative sonographic results should not be used to conclude a lesion is benign. Additionally, a new algorithm for breast tumors in which duplex sonography is an integral part is discussed.

Reviewing 17 cases from the literature and 4 own cases we tried to throw light on the clinical and radiological appearance of the aneurysms of portal vein. The evaluation was performed in respect of sex, age, size, localisation and eventual combination with a portal hypertension. It appears that these aneurysms can be found at any age and that there is no sexual preference. In most cases these aneurysms are asymptomatic. In rare cases they may cause portal hypertension. This seems to be possible only with extrahepatic but not with intrahepatic location of the aneurysms.

Sonography of 52 patients with aneurysms of the abdominal aorta revealed in 7 cases hypoechoic crescent-like zone between parietal thrombus and the aortic wall which simulated aortic dissection. Duplex-sonography was performed in all cases and no flow could be detected in this area. In two patients intraoperatively several milliliters of a serous fluid could be aspirated from this zone which confirmed the suggestion of seroma within the parietal thrombus. This observation may be found rather frequently and should not be a reason for immediate surgery.