Three-Dimensional Ultrasonography for the Evaluation of Atherosclerotic Stenoses of the Carotid Trunk

Three-dimensional ultrasonography is a significant novelty in neurosonology as it offers the possibility of an even more successful evaluation of atherosclerotic stenoses of the carotid trunk than previous ultrasonographic investigations. In 37 patients with signs of transitory ischemic attack and in 5 patients with reversible ischemic neurologic deficit we compared the findings of three-dimensional ultrasonography of carotid arteries on the neck with those of three-dimensional CT angiography. In 20 of these patients in which carotid thrombendarterectomy had been carried out, the findings of both diagnostic methods were also compared with the angiographic and operative findings. In 2 out of the total of 42 compared findings of three-dimensional ultrasonography, three-dimensional CT angiography and angiography of the carotid trunk, we assessed a difference in the evaluation of the degree of carotid stenosis while all other findings were in accordance as regards the evaluation of the degree of stenosis and plaque analysis. Of 20 operative findings, one showed insignificant deviations from the findings of both diagnostic methods. It is our opinion that three-dimensional ultrasonography is a reliable diagnostic method in evaluating atherosclerotic stenoses of carotid arteries. Every subtotal stenosis or internal carotid artery occlusion established by three-dimensional ultrasonography must be compared with three-dimensional CT angiography or classic angiography due to the objective possibility of false ultrasonographic interpretation and the significance of carotid thrombendarterectomy

CA 19-9 determination in gastric juice: role in identifying gastric cancer and high risk patients.

Gastric juice CA 19-9 levels were determined in 23 patients affected by gastric cancer, in 57 patients affected by chronic atrophic gastritis of different severities and in 55 'healthy' controls, undergoing endoscopy for upper gastrointestinal tract symptoms. Increased CA 19-9 levels were documented in chronic atrophic gastritis patients as well as in gastric cancer patients, the difference with respect to controls being statistically significant. However, there was considerable overlap between different groups. In particular, gastric cancer patients had CA 19-9 levels similar to those detected in moderate and severe chronic atrophic gastritis. CA 19-9 correlated with gastric juice pH and CEA concentration. Its values were not influenced by the patients' age or sex. In our opinion CA 19-9 gastric juice determination, although not useful in singling out patients harboring gastric neoplasia, may be used in identifying patients 'at risk' for gastric cancer and who might then be referred for more accurate investigations. © 1988