[en] Here is an atlas of sectional anatomy for the fetus featuring correlated anatomy and imaging, transverse coronal and sagittal views, a guide to development of the brain, cardiac anatomy in standard plans of study and, over 280 illustrations

[en] Short communication

[en] The authors' quality assurance (QA) program provides communication pathways among its constituent committees, which include patient care, professional review, medical staff, missed case, quality control, safety, and management committees. The QA monitors are based on data from these committees but also include data from the information management system, such as patient delays, contrast reactions, incidents, complications, time-flow analyses, film library retrieval, cancellations, missing reports, and missing clinical data. Committee data include complaints, missed diagnoses, patient identification problems, and equipment failure. The QA monitors have now been incorporated into summary reports as part of their computer networks. A systematic method for follow-up ensures corrective action and documentation. Examples of improved quality of care resulting from this approach includes reductions in delays for report signature and in repeat films

[en] The physical presence of leiomyomas and their growth potential during gestation may complicate an otherwise normal pregnancy. The changes reported in leiomyomas during pregnancy are controversial. Over a 2-year period we reviewed real-time US scans of 201 pregnant patients with definite or possible leiomyomas. Three hundred eight-three scans were obtained in a study group of 113 patients. Changes in size and echo characteristics were evaluated during each trimester and were correlated with the clinical history and pregnancy outcome. Significant complications were noted. Important factors in prognosis are multiplicity and lower uterine segment location. The value of US in monitoring this high-risk population is emphasized

[en] One hundred sixty-eight twin gestations were evaluated to assess the role of US in the diagnosis of obstetric complications and anomalies. US revealed the following complications: symptomatic polyhydramnios (eight cases), myomas (seven), placenta previa (three), and abruption (five). Fetal anomalies included twin-twin transfusion syndrome (two), acardiac anomaly (two), chromosomal abnormality (two), anencephaly (one), hydrocephaly (one), and conjoined twins (two). In 26 gestations intrauterine fetal demise or neonatal death involved one or both twins for a total of 42 deaths, constituting a mortality of 12.5%. No maternal deaths occurred. The impact of sonographic monitoring on the obstetric management of twin gestations is emphasized

[en] Of 168 twin pairs examined by US, 31 (19%) were discordant (≥500 gm difference in birth weight), including eight pairs in which one fetus had died and three pairs with twin parabiotic syndrome. All pairs that included a dead fetus showed a difference of 1 cm or more biparietal diameter (BPD). For pairs in which both fetuses were alive, a third-trimester BPD difference of 0.4 cm or greater predicted 38% of discordant pairs, a third-trimester femur length difference of 0.4 cm of greater also predicted 38% of discordant pairs, and a 200-gm or greater difference in estimated weight predicted 56% of discordant pairs. Combining any two of these criteria increased the detection rate to 67%

[en] CT scans of the kidneys were obtained iln 50 patients before and after extracorporeal shock wave lithotripsy (ESWL). Post-ESWL scans demonstrated subcapsular hematomas in eight (15%) and intrarenal hematomas in two (4%) patients. Water-density subcapsular collections were seen in three (6%) patients. Treated kidneys showed a mean increase in renal size of 9%. Perinephric stranding and fascial thickening were seen in 37 (70%) of 53 treated renal fossae. While most patients undergoing ESWL will show some posttreatment abnormality on CT, the procedure appears to be associated with a low incidence of serious renal trauma

[en] Twenty-two female patients with previous pelvic malignancy were examined by MR imaging. CT scans were obtained in 16. Twelve of 22 were subsequently proven to have recurrent carcinoma, 11 of which were correctly diagnosed on MR images. Ten of 22 had a localized fibrotic mass. In 21 of 22 patients final diagnosis was confirmed by a laparotomy or transvaginal biopsy. CT suggested recurrent disease in five patients, which was subsequently confirmed. Recurrent tumor was also present in three of six patients with equivocal findings on CT and in three of five patients without suspicion of recurrence on CT examination. MR is useful in the diagnosis of recurrent gynecologic carcinoma

[en] Breast cancer is sometimes treated with an excisional biopsy and a radiation portal limited to the breast and the adjacent chest wall, especially in patients with negative lymph node dissections. The beam passes through this portion of the chest wall tangentially. Such radiation can result in changes in the included lung parenchyma that are pleural-based and sharply demarcated from the normal lung on CT lung windows. In our experience CT lung windows were more sensitive than chest radiography in showing these changes. Such changes must be recognized and differentiated from pleural metastases. Computed tomography also resulted in a more specific diagnosis than chest radiography because it better localized the abnormality to the radiation portal

[en] High-density renal masses are atypical lesions that represent a diagnostic dilemma for computed tomography (CT). The differential diagnosis includes mainly complicated benign cysts and malignant neoplasms. This report analyzes the CT findings in 17 cases of discrete, sharply marginated masses that initially exceeded the density of the uninvolved renal parenchyma, averaging 50 H or more. The subsequently proven pathologic entities responsible for these high attenuation values included primary malignancies in six patients: a hemorrhagic cyst with an associated desmoplastic, fibrotic reaction in one patient; and single or multiple hemorrhagic cysts in four patients. No histologic proof was obtianed in six patients, three with neoplastic disease. Two patients with presumed hemorrhagic cysts have had serial CT scans without interval change in 8-12 months. An approach to the therapeutic management of affected patients is described