Differential Diagnosis in Ultrasound

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1 Differential Diagnosis in Ultrasound A Teaching Atlas von Günter Schmidt 1. Auflage Thieme 2005 Verlag C.H. Beck im Internet: ISBN schnell und portofrei erhältlich bei beck-shop.de DIE FACHBUCHHANDLUNG

2 Contents 1 Vessels 1 Aorta, Vena Cava, and Peripheral Vessels 3 Portal Vein and Its Tributaries 33 Contents VII & Aorta, Arteries 5 Anomalies and Variant Positions 5 Dilatation 7 Stenosis 11 Wall Thickening 16 Intraluminal Mass 20 Perivascular Mass 22 & Enlarged Lumen Diameter 35 Portal Hypertension 35 & Intraluminal Mass 43 Thrombosis 43 Tumor 48 & Vena Cava, Veins 25 Anomalies 25 Dilatation 26 Intraluminal Mass 28 Compression, Infiltration 31 2Liver 49 M. Brandt & Diffuse Changes in the Hepatic Parenchyma 61 Enlarged Liver 62 Small Liver 67 Homogeneous Hypoechoic Texture 68 Homogeneous Hyperechoic Texture 70 Regionally Inhomogeneous Texture 71 Diffuse Inhomogeneous Texture 72 & Localized Changes in Hepatic Parenchyma 74 Anechoic Masses 76 Hypoechoic Masses 81 Isoechoic Masses 87 Hyperechoic Masses 89 Echodense Masses 94 Irregular Masses 97 & Differential Diagnosis of Focal Lesions 98 Diagnostic Methods 98 Suspected Diagnosis 99

3 3 Biliary Tree and Gallbladder 101 Contents VIII Biliary Tree 103 L. Greiner and J. Mueller & Thickening of the Bile Duct Wall 105 Localized and Diffuse 105 & Bile Duct Rarefaction 106 Localized and Diffuse 106 & Bile Duct Dilatation and Intraductal Pressure 107 Intrahepatic 108 Hilar and Prepancreatic 109 Intrapancreatic 111 Papillary 112 & Abnormal Intraluminal Bile Duct Findings 112 Foreign Body 112 & Differential Diagnosis of Sonographic Cholestasis 114 The Seven Most Important Questions 114 Gallbladder 119 C. Jakobeit & Changes in Size 122 Large Gallbladder (> 10 cm) 122 Small/Missing Gallbladder 123 & Wall Changes 125 General Hypoechogenicity 125 General Hyperechogenicity 127 Focal Hypoechogenicity/Hyperechogenicity 128 General Tumor 129 Focal Tumor 131 & Intraluminal Changes 134 Hyperechoic 134 Hypoechoic 134 & Nonvisualized Gallbladder 137 L. Greiner and J. Müller Missing Gallbladder 137 Obscured Gallbladder 137 4Pancreas 141 & Diffuse Pancreatic Change 144 Large Pancreas 144 Small Pancreas 145 Hypoechoic Texture 147 Hyperechoic Texture 148 & Focal Changes 152 Anechoic Lesion 152 Hypoechoic Lesion 154 Isoechoic Lesion 158 Hyperechoic Lesion 160 Irregular Lesion 163 & Dilatation of the Pancreatic Duct 164 Marginal/Mild Dilatation 166 Marked Dilatation 167 5Spleen 171 & Nonfocal Changes of the Spleen 176 Diffuse Parenchymal Changes 176 Large Spleen 177 Small Spleen 180 & Focal Changes 182 Anechoic Mass 182 Hypoechoic Mass 184 Hyperechoic Mass 193 Splenic Calcification 195

4 6LymphNodes 197 & Peripheral Lymph Nodes 207 Head/Neck 207 Extremities (Axilla, Groin) 210 & Abdominal Lymph Nodes 212 Hepatic Portal 212 Splenic Hilum 215 Mesentery (Celiac, Upper and Lower Mesenteric Station) 216 Retroperitoneum (Para-aortic, Paracaval, Aortointercaval, and Iliac Station) 219 Contents IX 7 Gastrointestinal Tract 223 M. Brandt & Stomach 229 FocalWallChanges 229 Extended Wall Changes 232 Dilated Lumen 233 Narrowed Lumen 234 & Small/Large Intestine 235 FocalWallChanges 236 Extended Wall Changes 241 Dilated Lumen 245 Narrowed Lumen 247 8PeritonealCavity 249 D. Nuernberg & Diffuse Changes 254 Anechoic Structure 256 Hypoechoic Structure 258 Hyperechoic Structure 261 & Localized Changes 262 Anechoic Structure 263 Hypoechoic Structure 264 Hyperechoic Structure 265 & Wall Structures 266 Smooth Margin 266 Irregular Margin 267 & Differentiating Intra- and Extraluminal GI Tract Fluid 269 Intragastric Processes 269 Intraintestinal Processes 270 9Kidneys 273 & Anomalies, Malformations 276 Aplasia, Hypoplasia 276 Cystic Malformation 277 Anomalies of Number, Position, or Rotation 278 Fusion Anomaly 280 Collecting System Anomaly 281 Vascular Anomaly 281 & Diffuse Changes 282 Large Kidneys 282 Small Kidneys 287 Hypoechoic Structure 289 Hyperechoic Structure 290 Irregular Structure 295 & Circumscribed Changes 296 Anechoic Structure 296 Hypoechoic or Isoechoic Structure 301 Complex Structure 307 Hyperechoic Structure 309 Echogenic Structure 311

5 10 Adrenal Glands 315 D. Nuernberg Contents X & Enlargement 318 Anechoic Structure 318 Hypoechoic Structure 320 Complex Echo Structure 324 Hyperechoic Structure Urinary Tract 329 & Malformations 333 Duplication Anomalies 333 Dilatations and Stenoses 334 & Dilated Renal Pelvis and Ureter 336 Anechoic 336 Hypoechoic 342 & Renal Pelvic Mass, Ureteral Mass 344 Hypoechoic 344 Hyperechoic 345 & Changes in Bladder Size or Shape 348 Large Bladder 348 Small Bladder 349 Altered Bladder Shape 351 & Intracavitary Mass 352 Hypoechoic 352 Hyperechoic 355 Echogenic 358 & Wall Changes 359 Diffuse Wall Thickening 359 Circumscribed Wall Thickening 360 Concavities and Convexities Prostate, Seminal Vesicles, Testis, Epididymis 365 The Prostate 367 & Enlarged Prostate 368 Regular 368 Irregular 370 & Small Prostate 371 Regular 371 Echogenic 372 & Circumscribed Lesion 372 Anechoic 372 Hypoechoic 373 Echogenic 375 Seminal Vesicles 376 & Diffuse Change 376 Hypoechoic 376 & Testis, Epididymis 379 Anatomy and Topography 379 Testis, Epididymis 379 & Diffuse Change 380 Enlargement 380 Decreased Size 381 & Circumscribed Lesion 381 Anechoic or Hypoechoic 381 Irregular 383 & Epididymal Lesion 383 Anechoic 383 Hypoechoic 384 & Intrascrotal Mass 385 Anechoic or Hypoechoic 385 Echogenic 386 & Circumscribed Change 377 Anechoic 377 Echogenic 378 Irregular 378

6 13 Female Genital Tract 387 B. Beuscher-Willems & Vagina 390 Masses 390 Abnormalities of Size or Shape 391 & Uterus 392 Abnormalities of Size or Shape 393 Myometrial Changes 394 Intracavitary Changes 396 Endometrial Changes 398 & Fallopian Tubes 402 Hypoechoic Mass 402 & Ovaries 403 Anechoic Cystic Mass 404 Solid Echogenic or Nonhomogeneous Mass 407 Contents XI 14 Thyroid Gland 415 & Diffuse Changes 419 Enlarged Thyroid Gland 419 Small Thyroid Gland 423 Hypoechoic Structure 427 Hyperechoic Structure 429 & Differential Diagnosis of Hyperthyroidism 443 Types of Autonomy 443 & Circumscribed Changes 429 Anechoic 429 Hypoechoic 431 Isoechoic 438 Hyperechoic 439 Irregular Pleura and Chest Wall 447 & Chest Wall 451 Masses 451 & Parietal Pleura 456 Nodular Masses 456 Diffuse Pleural Thickening 459 & Pleural Effusion 462 Anechoic Effusion 463 Echogenic Effusion 464 Complex Effusion Lung 469 & Masses 471 Anechoic Masses 472 Hypoechoic Masses 474 Complex Masses 483

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