OBJECTIVE: To evaluate the use of color Doppler ultrasound in the detection of vascularity of solid breast cancer and to correlate patterns of vascular distribution with size, stage and histopathological findings. MATERIALS AND METHODS: Sixty-six breast carcinomas were studied using color Doppler ultrasound. Morphological and fluxometric characteristics were evaluated before performing the biopsy, and its correlations with clinical and histopathological aspects and tumor staging were assessed statistically. RESULTS: Penetrating vessels were seen in 52 (79%) of the cases, peripheral vessels in 63 (95%), central vessels in 33 (50%) and no flow was detected in two cases (3%). The average number of vessels in the breast tumor was 11.9 ± 7.7 and in the contralateral breast was 1.7 ± 2.5. No association was evident between the scan results and the histological features assessed. The distribution of vessels was different in the two groups of tumors. No difference was seen between tumor and normal breast regarding diastolic velocity, resistance and pulsatility index. The mean systolic velocity was 11.74 ± 0.96 in breast tumor and 9.45 ± 0.55 in normal breast. The number of vessels increased with the progression of tumor staging. CONCLUSION: The pattern of the vessels in breast cancer seen on ultrasound should be considered as a potentially important feature in the preoperative evaluation of breast masses with other prognostic factors like the tumor size or disease staging.

Keywords: Breast neoplasm, Breast neoplasm, Breast neoplasm

Intraoperative ultrasonography influences surgical strategy in a significant number of patients operated due to benign or malignant conditions, and is the most sensitive technique for the detection of small lesions, particularly in the liver and in the pancreas. In pancreatic surgery, intraoperative ultrasonography is helpful in the localization of islet cell tumors and in the assessment of the resectability of adenocarcinomas. The technique may also play a role in chronic pancreatitis surgery. The authors present an up-to-date review of the evolution of intraoperative ultrasonography in pancreatic surgery.

Keywords: Ultrasonography, Intraoperative ultrasonography, Pancreas

Liver transplantations are increasingly being performed, thus requiring accurate evaluation of related complications. Ultrasonography is the first screening technique for the detection of complications of liver transplantation. The authors report the finding of fluid collection around the falciform ligament in the immediate postoperative period of liver transplantation in patients with no signs of intraabdominal sepsis. This finding was observed in 33 (94.3%) of the 35 patients evaluated. The authors consider this finding to be a normal occurrence in the immediate postoperative period of liver transplantation.

Keywords: Liver, Liver transplantation, Ultrasonography

Hemangiomas are benign hepatic tumors that in most cases require no surgical excision if correctly identified. Ultrasound (US) usually shows hyperechogenic tumors although some unusual hypoechogenic hemangiomas have also been described. Fifteen patients with hypoechogenic hemangiomas, identified in a period of approximately four years, were evaluated prospectively. As the US findings of these hemangiomas were atypical, the final diagnosis was established after a combined analysis of US and helical computed tomography (helical-CT) findings. Helical-CT showed centripetal enhancement after administration of intravenous iodinated contrast media in all lesions. The levels of carcinoembrionic antigen and alpha-fetoprotein were measured in all patients who were also submitted to endoscopy and colonoscopy (or double contrast enema). No abnormalities were found in any of these tests. Additionally, US and helical-CT examinations were performed 8 to 12 months after the initial investigation in all patients, and no changes were seen in the appearance and dimensions of the lesions. There was associated steatosis in 14 of the 15 patients with hypoechogenic hemangiomas. The authors concluded that atypical hypoechogenic hemangiomas occur mainly in patients with steatosis and only occasionally in patients with nonsteatotic liver. In these atypical cases complementary imaging and biochemical studies, and follow-up tests are necessary to establish an accurate diagnosis.

Keywords: Liver, Hemangioma, Hypoechogenic hemangioma, Ultrasonography

The authors review the use of intraoperative ultrasonography (IOUS) in the management of biliary-pancreatic disease. The methodology of IOUS used for the examination of the biliary-pancreatic ductal system as well as the most important findings and pitfalls of image interpretation are described. Additionally, some ultrasonography findings in pancreatic tumors, pancreatitis, bile duct tumors and bile duct stones are presented. The authors emphasize the importance of understanding this ultrasonographic method due to the increasingly use of IOUS in biliary-pancreatic surgery.

Keywords: Intraoperative ultrasonography, Pancreas, Biliary ductal system

The authors describe the main applications of endoscopic ultrasonography for the management of diseases of the gallbladder and biliary ductal system. In addition, some ultrasound findings of benign and malignant diseases affecting these structures of the digestive tract are presented, emphasizing the diagnostic importance of endoscopic ultrasonography.

Keywords: Ultrasonography, Endoscopic ultrasonography, Digestive tract, Gallbladder, Biliary system

We analyzed the ultrasonographic findings of 21 patients with mild acute pancreatitis. The presence or absence of pancreatic hypoechogenicity and peripancreatic fluid collection was assessed. Pancreatic hypoechogenicity was identified in 19 patients (90.5%) whereas small sac fluid collection was identified in 3 (15.8%) of these patients. No abnormality was seen in 2 patients (9.5%). Regarding the etiology of acute pancreatitis, cholelithiasis was identified in 15 patients (71.5%), alcohol abuse was identified in 4 patients (19.0%), and in 2 patients (9.5%) no probable etiology could be found. The authors conclude that ultrasonography may identify abnormalities in the majority of patients with mild acute pancreatitis and can be used to assess patients with peripancreatic fluid collections.

Keywords: Acute pancreatitis, Complications, Ultrasonography

The authors review the main applications of endoscopic ultrasonography in the management of diseases of the pancreas. Ultrasound findings of malignant and benign diseases affecting these segment of the digestive tract and the importance of endoscopic ultrasonography for their diagnosis are discussed.

Keywords: Ultrasonography, Endoscopic ultrasonography, Digestive tract, Pancreas

The authors review the main applications of endoscopic ultrasonography in the management of diseases of the esophagus, stomach, colon and rectum. The methodology and the main findings at endoscopic ultrasonography are discussed as well as ultrasound findings of malignant and benign diseases of the esophagus, stomach, colon and rectum.

Keywords: Ultrasonography, Endoscopic ultrasonography, Digestive tract

Intraoperative ultrasonography was initially used after 1960. There are also few reports on initial experiences published during the 50'. This technique was firstly used to study cerebral tumors and later on it was also used to evaluate biliary and renal calculi. At that time, intraoperative ultrasonography with A-mode or nonreal-time B-mode imaging did not achieve great recognition by surgeons and clinicians. However, the efforts of the initial reports were used in the development of modern intraoperative ultrasonography using real-time B-mode imaging. The authors comment on the evolution of intraoperative ultrasonography since its birth up to date.

Keywords: Intraoperative ultrasonography, Ultrasonography with A-mode imaging, Ultrasonography with nonreal-time B-mode imaging

PURPOSE: The purpose of this study was to evaluate the relationship between diffuse hypoechoic appearance of the prostate, which is characterized by indistinguishable boundaries between the peripheral zone and the inner gland, and the diagnosis of prostate adenocarcinoma established by transrectal prostate biopsies. MATERIALS AND METHODS: We performed transrectal ultrasonography in 143 male patients with serum prostate specific antigen levels above 4 ng/ml. Randomized biopsies were carried out in all patients. RESULTS: Prostate adenocarcinoma was diagnosed in 36.4% of the patients. Twenty-one (95.4%) out of 22 patients with diffuse hypoechoic appearance of the prostate had positive biopsies for prostate adenocarcinoma. CONCLUSION: Ultrasound diffuse hypoechoic appearance of the prostate is a significant criterion for suspecting adenocarcinoma, since 95.4% of the patients exhibiting this ultrasound findings presented positive biopsies.

Keywords: Ultrasound. Transrectal ultrasound. Prostate carcinoma.