- •Contents
- •Preface
- •Contributors
- •1 Vessels
- •1.1 Aorta, Vena Cava, and Peripheral Vessels
- •Aorta, Arteries
- •Anomalies and Variant Positions
- •Dilatation
- •Stenosis
- •Wall Thickening
- •Intraluminal Mass
- •Perivascular Mass
- •Vena Cava, Veins
- •Anomalies
- •Dilatation
- •Intraluminal Mass
- •Compression, Infiltration
- •1.2 Portal Vein and Its Tributaries
- •Enlarged Lumen Diameter
- •Portal Hypertension
- •Intraluminal Mass
- •Thrombosis
- •Tumor
- •2 Liver
- •Enlarged Liver
- •Small Liver
- •Homogeneous Hypoechoic Texture
- •Homogeneous Hyperechoic Texture
- •Regionally Inhomogeneous Texture
- •Diffuse Inhomogeneous Texture
- •Anechoic Masses
- •Hypoechoic Masses
- •Isoechoic Masses
- •Hyperechoic Masses
- •Echogenic Masses
- •Irregular Masses
- •Differential Diagnosis of Focal Lesions
- •Diagnostic Methods
- •Suspected Diagnosis
- •3 Biliary Tree and Gallbladder
- •3.1 Biliary Tree
- •Thickening of the Bile Duct Wall
- •Localized and Diffuse
- •Bile Duct Rarefaction
- •Localized and Diffuse
- •Bile Duct Dilatation and Intraductal Pressure
- •Intrahepatic
- •Hilar and Prepancreatic
- •Intrapancreatic
- •Papillary
- •Abnormal Intraluminal Bile Duct Findings
- •Foreign Body
- •The Seven Most Important Questions
- •3.2 Gallbladder
- •Changes in Size
- •Large Gallbladder
- •Small/Missing Gallbladder
- •Wall Changes
- •General Hypoechogenicity
- •General Hyperechogenicity
- •General Tumor
- •Focal Tumor
- •Intraluminal Changes
- •Hyperechoic
- •Hypoechoic
- •Nonvisualized Gallbladder
- •Missing Gallbladder
- •Obscured Gallbladder
- •4 Pancreas
- •Diffuse Pancreatic Change
- •Large Pancreas
- •Small Pancreas
- •Hypoechoic Texture
- •Hyperechoic Texture
- •Focal Changes
- •Anechoic Lesion
- •Hypoechoic Lesion
- •Isoechoic Lesion
- •Hyperechoic Lesion
- •Irregular (Complex Structured) Lesion
- •Dilatation of the Pancreatic Duct
- •Marginal/Mild Dilatation
- •Marked Dilatation
- •5 Spleen
- •Nonfocal Changes of the Spleen
- •Diffuse Parenchymal Changes
- •Large Spleen
- •Small Spleen
- •Focal Changes of the Spleen
- •Anechoic Mass
- •Hypoechoic Mass
- •Hyperechoic Mass
- •Splenic Calcification
- •6 Lymph Nodes
- •Peripheral Lymph Nodes
- •Head/Neck
- •Extremities (Axilla, Groin)
- •Abdominal Lymph Nodes
- •Porta Hepatis
- •Splenic Hilum
- •Mesentery (Celiac, Upper and Lower Mesenteric Station)
- •Stomach
- •Focal Wall Changes
- •Extended Wall Changes
- •Dilated Lumen
- •Narrowed Lumen
- •Small/Large Intestine
- •Focal Wall Changes
- •Extended Wall Changes
- •Dilated Lumen
- •Narrowed Lumen
- •8 Peritoneal Cavity
- •Anechoic Structure
- •Hypoechoic Structure
- •Hyperechoic Structure
- •Anechoic Structure
- •Hypoechoic Structure
- •Hyperechoic Structure
- •Wall Structures
- •Smooth Margin
- •Irregular Margin
- •Intragastric Processes
- •Intraintestinal Processes
- •9 Kidneys
- •Anomalies, Malformations
- •Aplasia, Hypoplasia
- •Cystic Malformation
- •Anomalies of Number, Position, or Rotation
- •Fusion Anomaly
- •Anomalies of the Renal Calices
- •Vascular Anomaly
- •Diffuse Changes
- •Large Kidneys
- •Small Kidneys
- •Hypoechoic Structure
- •Hyperechoic Structure
- •Irregular Structure
- •Circumscribed Changes
- •Anechoic Structure
- •Hypoechoic or Isoechoic Structure
- •Complex Structure
- •Hyperechoic Structure
- •10 Adrenal Glands
- •Enlargement
- •Anechoic Structure
- •Hypoechoic Structure
- •Complex Echo Structure
- •Hyperechoic Structure
- •11 Urinary Tract
- •Malformations
- •Duplication Anomalies
- •Dilatations and Stenoses
- •Dilated Renal Pelvis and Ureter
- •Anechoic
- •Hypoechoic
- •Hypoechoic
- •Hyperechoic
- •Large Bladder
- •Small Bladder
- •Altered Bladder Shape
- •Intracavitary Mass
- •Hypoechoic
- •Hyperechoic
- •Echogenic
- •Wall Changes
- •Diffuse Wall Thickening
- •Circumscribed Wall Thickening
- •Concavities and Convexities
- •12.1 The Prostate
- •Enlarged Prostate
- •Regular
- •Irregular
- •Small Prostate
- •Regular
- •Echogenic
- •Circumscribed Lesion
- •Anechoic
- •Hypoechoic
- •Echogenic
- •12.2 Seminal Vesicles
- •Diffuse Change
- •Hypoechoic
- •Circumscribed Change
- •Anechoic
- •Echogenic
- •Irregular
- •12.3 Testis, Epididymis
- •Diffuse Change
- •Enlargement
- •Decreased Size
- •Circumscribed Lesion
- •Anechoic or Hypoechoic
- •Irregular/Echogenic
- •Epididymal Lesion
- •Anechoic
- •Hypoechoic
- •Intrascrotal Mass
- •Anechoic or Hypoechoic
- •Echogenic
- •13 Female Genital Tract
- •Masses
- •Abnormalities of Size or Shape
- •Uterus
- •Abnormalities of Size or Shape
- •Myometrial Changes
- •Intracavitary Changes
- •Endometrial Changes
- •Fallopian Tubes
- •Hypoechoic Mass
- •Anechoic Cystic Mass
- •Solid Echogenic or Nonhomogeneous Mass
- •14 Thyroid Gland
- •Diffuse Changes
- •Enlarged Thyroid Gland
- •Small Thyroid Gland
- •Hypoechoic Structure
- •Hyperechoic Structure
- •Circumscribed Changes
- •Anechoic
- •Hypoechoic
- •Isoechoic
- •Hyperechoic
- •Irregular
- •Differential Diagnosis of Hyperthyroidism
- •Types of Autonomy
- •15 Pleura and Chest Wall
- •Chest Wall
- •Masses
- •Parietal Pleura
- •Nodular Masses
- •Diffuse Pleural Thickening
- •Pleural Effusion
- •Anechoic Effusion
- •Echogenic Effusion
- •Complex Effusion
- •16 Lung
- •Masses
- •Anechoic Masses
- •Hypoechoic Masses
- •Complex Masses
- •Index
Preface
The second English edition of Differential Diagnosis in Ultrasound Imaging has been completely revised in content and scope and brought up to current clinical and scientific standards by the authors and editors.
Clinical ultrasound is, by virtue of its unsurpassed local resolution and its unique real-time imaging capabilities, highly significant in diagnostic findings. And, because of its availability and cost-effective and risk-free implementation, it is of the greatest value for patients. The basis for this edition is, as always, grayscale ultrasound, which, along with additional imaging in color Doppler sonography and power Doppler, constitutes a substantial improvement in differential ultrasound diagnostics.
Ultrasound diagnostics have also been further improved in all areas of medicine by con- trast-enhanced ultrasound (CEUS), which has become a first-line method in the differentiation of tumors. This development is reflected in our inclusion in this second English edition of additional CEUS images portraying differential
diagnostic findings. Guidelines and recommendations of the EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology) study group and the WFUMB (World Federation for Ultrasound in Medicine and Biology) guidelines have furthered additional development of the use of CEUS.
The inclusion as editors of Professor Dr. Lucas Greiner (DEGUM seminar leader and director of ISCUS, the International School for Clinical Ultrasonography) and Professor Dr. Dieter Nuernberg (DEGUM seminar leader, secretary of WFUMB, and ex-president of DEGUM), both of whom are long-time functionaries of EFSUMB, highlights the considerable demands placed on textual, pictorial, and scientifically grounded findings. Both of them have contributed their ideas and experience, a necessary response to the growing demands in the field of ultrasound imaging.
Above all we want to thank Ms. Gabriele Kuhn-Giovannini, Assistant Editor, Thieme Publishers, for her detailed suggestions and intensive supervision. We particularly want to
thank Mr. Stephan Konnry, Executive Editor, Thieme Publishers, for fostering this English edition, and Ms. Gillian Whytock, Prepress Projects, for overseeing the production of this book. We are also very grateful to the copyeditor, Mrs. Kathleen Lyle, Oxford, UK, for the subtle revisions, without which inaccuracies and ambiguities in the text would have gone uncorrected.
Real-time images of the highest spatial resolution, in color, and with CEUS: this is today’s clinical ultrasound. Its development has been spectacular in all fields, a fact to which this book, for the second time, we believe, testifies. This edition has gained greatly in volume, quality of content and currency, and it will be of great value both as a reference and as a systematic textbook.
Guenter Schmidt, MD
Lucas Greiner, MD
Dieter Nuernberg, MD
Preface
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Contributors
Contributors
Barbara Beuscher-Willems, MD
Diakonie Klinikum Bethesda
Freudenberg, Germany
M.W. Max Brandt, MD
Marien-Hospital-Wesel gGmbH
Wesel, Germany
Christian Goerg, MD
Professor, Department of
Hematology-Oncology
University Hospital Giessen and Marburg
Marburg, Germany
Lucas Greiner, MD
Professor, International School for Clinical Ultrasonography (ISCUS) Wuppertal, Germany
Albrecht Holle, MD |
Dieter Nuernberg, MD |
|
Division of Gastroenterology |
Professor, Medical Clinic B |
|
Department Internal Medicine II |
Ruppiner Hospitals GmbH |
|
University of Rostock |
Neuruppin, Germany |
|
Rostock, Germany |
Guenter Schmidt, MD |
|
Christian Jakobeit, MD |
||
Bethesda Hospital |
||
Associate Professor, Department |
Freudenberg, Germany |
|
of Internal Medicine |
|
|
Sana-Klinikum Remscheid |
|
|
Remscheid, Germany |
|
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