Contrast enhanced ultrasound in the assessment of urogenital pathology

Contrast enhanced ultrasound (CEUS) is an innovative technique that employs microbubble contrast agents to demonstrate parenchymal perfusion. Although initial clinical application was focused on the liver pathology, a wide variety of clinical conditions can be assessed now with CEUS. CEUS is a well-tolerated technique and is acquiring an increasing role in the assessment of renal pathology because contrast agents are not excreted by the kidney and do not affect the renal function. CEUS demonstrated an accuracy similar to contrast enhanced multi-detector computed tomography (CEMDCT) in detecting focal lesions, with the advantage of the real-time assessment of microvascular perfusion by using time-intensity curves. The aim of this paper is to review the main indications of CEUS in the assessment of renal and urogenital pathology. Imaging examples are presented and described. Advantages and limitations of CEUS with reference to conventional US and CE-MDCT are discussed

Incidentally detection of non-palpable testicular nodules at scrotal ultrasound: What is new?

The increased use of ultrasound in patients with urological and andrological symptoms has given an higher detection of intra-testicular nodules. Most of these lesions are hypoechoic and their interpretation is often equivocal. Recently, new ultrasound techniques have been developed alongside of B-mode and color-Doppler ultrasound. Although not completely standardized, contrast-enhanced ultrasound (CEUS) and tissue elastography (TE), added to traditional ultrasonography, can provide useful information about the correct interpretation of incidentally detected non-palpable testicular nodules. The purpose of this review article is to illustrate these new techniques in the patient management

Diagnostics through images in ER. From guidelines to clinical practice

Appropriate use of emergency and urgent radiodiagnostic techniques is fundamental for optimum patient management and in order to favour the sustainability of the health system. Guidelines compiled by healthcare organisations and research companies on suitable use of radiodiagnostics are available and can be consulted free of charge on the Internet. This work aims to review and compare the Italian guidelines issued by the Regional Health Services Agency and those of the American College of Radiology (USA), with regard to emergency and urgent conditions, and to propose a method for the application of the guidelines in different situations, based on an experience conducted within Piedmont local health authority 10

Contrast enhanced ultrasound in the assessment of urogenital pathology

Contrast enhanced ultrasound (CEUS) is an innovative technique that employs microbubble contrast agents to demonstrate parenchymal perfusion. Although initial clinical application was focused on the liver pathology, a wide variety of clinical conditions can be assessed now with CEUS. CEUS is a well-tolerated technique and is acquiring an increasing role in the assessment of renal pathology because contrast agents are not excreted by the kidney and do not affect the renal function. CEUS demonstrated an accuracy similar to contrast enhanced multi-detector computed tomography (CEMDCT) in detecting focal lesions, with the advantage of the real-time assessment of microvascular perfusion by using time-intensity curves. The aim of this paper is to review the main indications of CEUS in the assessment of renal and urogenital pathology. Imaging examples are presented and described. Advantages and limitations of CEUS with reference to conventional US and CE-MDCT are discussed

Peyronie\u2019s Disease

Peyronie\u2019s disease (PD) is a benign disease of the penis of unknown cause. First fully described almost 300 years ago by Fran\ue7ois de La Peyronie, although \u201cnodus penis\u201d has been already described centuries before by Fallopius and Vesalius (Fornara and Gerbershagen 2004). Peyronie\u2019s disease is defined as an acquired disorder of the tunica albuginea with the development of a plaque of fibrous tissue, associated with progressive penile bending and shortening. Pain on erection can be the first symptom of the disease in about 10\u201315% of the patients. As the result of progressive penile deformity, difficulties of penetration can develop with impairment of erectile capacit

Neoplasms of the Urethra

Urethral cancer is a rare disease which may occur at any age but is observed more often during the seventh decade. It is usually considered more common in females, but a recent study shows in the United States an annual age-adjusted incidence rate of 4.3 per million men and 1.5 per million women. The incidence is higher in African Americans. Different histologic patterns of urethral tumors are recognized. The most common type of urethral malignancy is squamous cell carcinoma which accounts for about 80 % of cases in men and 60 % of cases in women. Transitional cell carcinoma is the second most common urethral malignancy in both sexes. In males, this lesion accounts for 15 % of total cases, in females for 20 % of patients. Other primary malignant tumors of the urethra are rare. Only sporadic cases of lymphoma, melanoma, and neuroendocrine tumors have been reported in the literatur

Benign Prostate Hyperplasia and Prostatic Tumor

Rising life expectancy has swollen the ranks of men of middle age and beyond. These individuals have a 43 % risk of symptoms of benign prostatic hyperplasia (BPH) and a 9 % chance of being diagnosed with prostate cancer. Although not always life-threatening, prostate diseases are often associated with a significant reduction in quality of life not only for the sufferer but also for his partner. Men beyond middle age are increasingly reluctant to accept restrictions on their day-to-day activities as they grow older. As a consequence, prostate diseases are now acknowledged as an important determinant of men\u2019s health and therefore worthy of proper scrutiny, treatment, and enhanced research. In this chapter, the role of imaging modalities in evaluation of prostate disorders in elderly is illustrated, with emphasis both on current clinical practice and on the evolving imaging modalities that will affect treatment in the futur

Fast spin echo-T2-weighted sequences with fat saturation in toe dactylitis of spondyloarthritis

We aimed to establish by using fast spin echo (FSE)-T2-weighted sequences with fat saturation if flexor tendon enthesitis is the primary lesion in spondyloarthritis (SpA) toe dactylitis. Consecutive patients showing toe dactylitis and meeting Amor criteria for the classification of SpA were enrolled. Dactylitic toes and their corresponding normal contralateral digits were studied by FSE-T2-weighted sequences with fat saturation. Twelve dactylitic toes belonging to ten SpA patients were studied. All dactylitic toes showed mild-to-moderate fluid collection in the synovial sheaths of flexor digitorum brevis and longus. Involvement of joint cavity was simultaneously seen in at least one joint of eight (66.6%) out of the 12 toes. A mild-to-severe peritendinous soft tissue edema was observed in all but one of the affected toes. In no dactylitic toe was bone edema observed either near the insertions of the flexor digitorum brevis and longus tendons or in other sites of the phalanges. No lesions were observed in the 12 contralateral clinically normal toes. In SpA toe dactylitis there is no evidence of enthesitis of the flexor digitorum brevis and longus tendons and joint capsules

Fat suppression magnetic resonance imaging in shoulders of patients with polymyalgia rheumatica

To evaluate the sites of inflammatory process in the shoulders of patients with polymyalgia rheumatica (PMR) using fat suppressed magnetic resonance imaging (MRI)