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Abdominal Ultrasound
R. A. L. Bisset
MBBS, FRCR, MHSM
Consultant Radiologist, North Manchester General
Hospital and Booth Hall Children's Hospital,
Manchester, UK.
. . .
A. N. Khan
A. .
:
. . ,
B. . , ...,
. .
. .
Bailliere Tindall
London Philadelphia Toronto Sydney Tokyo
1997
616.3-073.43
54.13
65
.
.
65
. . ., . .
/ . , . ...,
. . . : , 1997.
272.
ISBN 985-6333-05-9
,
, .
, , ,
54.13
Bailliere Tindall
, , , 1997
XI
XVI
,
XVII
1. ( . . )
1
2. , ,
( . . )
,
18
2.1.
2.1.1.
2.1.2.
2.1.3.
2.1.4.
2.1.5.
2.1.6.
2.2.
/
2.3.
-
2.4.
2.4.1.
2.4.2.
2.4.3.
2.5.
2.5.1.
2.5.2.
2.5.3.
2.5.4.
2.5.5.
2.5.6.
2.5.7.
2.5.8.
2.5.9.
2.5.10.
2.5.11.
2.6.
2.6.1.
,
2.6.2.
2.6.3.
2.6.4.
2.6.5.
2.6.6.
2.6.7.
2.6.8.
2.6.9.
2.6.10.
2.6.11.
2.6.12.
2.7.
2.7.1.
2.7.2.
18
19
20
22
25
32
33
38
39
40
41
41
42
43
44
44
45
46
46
47
50
52
54
55
55
55
56
56
57
57
57
58
64
66
66
67
67
68
68
69
71
71
73
VI
2.7.3.
2.7.4.
2.7.5. -
2.7.6.
2.7.7.
3.7.8.
2.7.9.
2.7.10.
2.7.11.
2.7.12.
2.7.13.
2.8.
2.8.1.
2.8.2.
2.8.3.
2.8.4. .....
2.8.5.
2.8.6.
2.8.7.
2.8.8.
2.8.9.
2.8.10.
3. , , ( . . )
3.1.
3.1.1.
3.1.2.
3.1.3.
3.2.
3.2.1.
3.2.2.
3.2.3.
3.2.4.
3.2.5. ()
3.2.6. ( )
3.2.7.
3.2.8.
3.2.9.
3.2.10.
3.2.11.
3.4.
3.4.!.
3.4.2.
3.4.3.
3.5.
3.5.1.
3.5.2.
3.5.3.
3.5.4.
3.5.5.
3.5.6.
3.5.7.
3.5.8.
3.5.9.
74
75
76
76
78
79
79
79
79
80
80
80
81
81
81
82
82
82
83
83
84
85
96
96
96
96
97
97
98
98
99
99
100
103
103
103
104
104
104
105
105
107
107
108
108
108
111
111
112
112
112
113
3.6.
3.6.1.
3.6.2.
3.6.3.
3.6.4.
3.6.5.
3.6.6.
3.6.7.
3.6.8.
4.
( . . )
4.1.
4.2.
4.2.1.
4.2.2.
4.2.3.
4.2.4.
4.3.
4.3.1.
4.3.2.
4.3.3.
4.3.4.
:
4.3.5.
4.4.
4.5.
4.5.1.
4.5.2.
4.6.
4.7.
4.8. -
4.9.
4.9.1.
4.9.2.
4.9.3.
4.9.4.
4.10.
4.10.1.
,
4.10.2.
4.10.3.
4.11.
4.12.
4.13.
4.13.1.
4.13.2.
4.13.3.
4.13.4.
4.14.
4.14.1.
4.14.2.
4.14.3. - (
)
4.14.4.
4.14.5.
4.14.6.
VII
113
113
114
115
116
117
117
117
118
121
121
124
124
125
126
127
129
132
132
132
134
134
134
136
136
137
137
137
137
140
140
140
141
141
141
142
142
142
143
143
143
144
146
146
147
147
147
148
149
150
151
152
VIII
4.14.7.
152
4.14.8.
152
4.14.9.
153
4.14.10.
153
4.15.
157
4.15.1.
157
4.15.2.
158
4.15.3.
159
4.15.4.
159
4.15.5. -
159
4.15.6. ( ) .... 160
4.15.7.
160
4.15.8.
160
4.15.9.
161
4.15.10.
161
4.16.
162
4.16.1.
162
4.16.2.
162
4.16.3.
162
4.17.
163
4.18.
166
4.19.
166
4.19.1.
167
4.19.2.
167
4.19.3.
168
4.19.4.
168
4.20.
170
4.20.1.
173
4.20.2.
175
4.20.3. //
175
4.20.4.
176
4.20.5.
176
4.20.6.
176
4.20.7.
177
4.20.8.
177
4.20.9.
177
4.20.10.
177
4.20.11.
178
4.20.12.
178
4.20.13.
179
4.20.14.
179
4.20.15.
179
4.21.
180
4.21.1.
180
4.21.2.
181
4.21.3.
181
4.22.
182
4.22.1.
182
4.22.2. ( -)
182
4.22.3.
183
4.22.4.
183
4.23.
184
4.23.1.
184
IX
4.23.2.
185
4.23.3.
187
4.23.4.
187
4.23.5.
187
4.23.6.
187
4.23.7.
188
4.23.8.
188
4.23.9.
189
4.23.10.
189
4.24.
189
4.25.
,
190
4.25.1.
191
4.25.2.
191
4.25.3.
192
4.25.4.
193
4.25.5.
193
4.25.6.
193
4.25.7.
194
4.25.8.
194
5. ( . . )
197
5.1.
197
5.2. ..
198
5.3.
198
5.4.
198
5.5.
198
5.6.
198
5.7.
199
5.8.
199
5.9. /
200
5.10.
200
5.10.1.
201
5.10.2.
201
5.10.3.
201
5.10.4.
:.201
5.10.5.
202
5.11.
202
5.11.1. ()
203
5.11.2.
203
5.11.3.
204
6. ( . . )
205
6.1.
205
6.1.1.
206
6.1.2. ()
207
6.1.3.
208
6.1.4.
209
6.1.5.
210
6.1.6.
210
6.1.7.
210
6.1.8.
211
6.1.9.
212
6.2.
212
6.2.1.
212
6.2.2.
213
6.3.
6.3.1.
6.3.2.
6.3.3.
6.3.4.
6.4.
6.5.
6.5.1.
6.5.2.
6.5.3.
6.6.
6.6.1.
6.6.2.
6.6.3.
6.6.4.
6.6.5.
6.6.6.
6.7.
6.7.1.
6.7.2.
213
214
214
217
220
223
224
224
224
224
226
227
227
227
227
227
227
228
229
229
( . . )
7.1.
7.2.
7.3.
7.3.1.
7.3.2.
7.3.3.
7.3.4.
7.4.
7.4.1.
7.4.2.
7.4.3.
7.4.4.
7.4.5. ( )
7.5.
7.5.1.
7.5.2.
7.5.3.
232
232
232
233
233
233
7. ,
234
236
242
242
242
244
246
246
246
247
249
251
2
. 2.1.
. 2.2.
. 2.3.
. 2.4.
. 2.5.
. 2.6.
. 2.7. ,
. 2.8.
. 2.9.
. 2.10. /
. 2.11.
. 2.12.
. 2.13.
. 2.14.
. 2.15.
. 2.16.
. 2.17.
. 2.18. :
. 2.19.
. 2.20.
. 2.21. ,
. 2.22.
. 2,23. ,
. 2.24.
. 2.25. ,
. 2.26.
21
22
23
24
24
25
36
37
38
39
41
44
49
49
49
50
50
54
58
59
60
61
62
62
62
63
XII
. 2.27.
>
. 2.28. Tc99m H1DA
. 2.29.
. 2.30.
. 2.31.
. 2 32.
. 2.33.
. 2.34.
. 2.35. ,
. 2.36.
. 2.37.
. 2.38.
. 2.39. ,
,
. 2.40.
. 2.41.
. 2.42.
. 2.43.
3
. 3.!.
. 3.2.
. 3.3.
. 3.4.
. 3.5.
. 3.6.
. 3.7.
4
. 4.1.
. 4.2.
. 4.3.
64
66
67
69
70
70
76
77
78
80
85
85
86
86
87
87
87
98
102
106
107
109
111
118
128
129
130
. 4.4.
. 4.5. 1
. 4.6. 2
. 4.7. ( )
. 4.8.
. 4.9.
. 4.10.
. 4.11.
. 4.12.
. 4.13.
. 4.14.
. 4.15.
. 4.16.
. 4.17.
. 4.18.
. 4.19.
. 4.20.
. 4.21.
. 4.22.
. 4.23. ,
. 4.24.
. 4.25.
. 4.26. ,
. 4.27. :
-
. 4.28. -
. 4.29. ,
. 4.30. ,
. 4.31. ,
. 4.32.
. 4.33. ,
. 4.34.
. 4.35.
. 4.36.
. 4.37.
. 4.38.
XIII
130
131
132
133
133
133
134
136
138
138
139
139
144
146
152
155
155
156
156
156
157
161
164
164
165
167
167
169
169
170
171
172
172
173
173
XIV
. 4.39.
. 4.40.
. 4.41.
. 4.42.
. 4.43.
. 4.44.
. 4.45.
5
. 5.1.
. 5.2. ,
. 5.3.
174
180
181
186
188
194
194
201
202
202
6
. 6.1.
. 6.2.
*
. 6.3.
. 6.4.
. 6.5.
. 6.6.
. 6.7.
. 6.8. ,
. 6.9. ,
. 6.10.
. 6.11.
. 6.12.
7
. 7.1.
. 7.2.
. 7.3. ,
. 7.4.
. 7.5.
. 7.6.
. 7.7.
. 7.8.
208
209
209
215
217
219
220
221
222
222
223
226
233
234
236
237
238
239
240
241
. 7.9.
. 7.10.
. 7.11.
. 7.12.
. 7.13.
. 7.14. ,
. 7.15.
XV
243
245
247
249
249
250
250
XVII
XVI
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Abbitt P L 4 Teates D T"he sorx graphic , of extrameduilarv
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Andrew W & Giynthomas R H}datid cvst of the pancreatic tail South Af
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Arger P H et a) An analysis of pancreatic sonography m pancreatic disease
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Barnga P et al An ultrasonographically solid tumour-like appearance of
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Beinhart et al Obstruction without dilatation J Am Med Assoc (1982)
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88
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S9
90
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94
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.
, . . - ,
.
, .
,
,
. ,
, .
, . ,
, . ,
,
.
, ,
117
3.6.5
, -
.
, . , . , .
3.6.6
, ,
, . ,
.
, .
. . , . - . , .
3.6.7
,
, ,
.
.
.
. , .
.
, , -
118
. 3.7.
/
.
. ,
-
. - .
.
, .
3.6.8
, ,
.
,
, .
,
, ,
.
,
.
, ,
119
Avni et al. Sonographic demonstration of malabsorption in the neonate. J.
Ult. Med. (1986) 5: 85-87.
Ball L et al. Ultrasound diagnosis of hypertrophic pyloric stenosis: realtime application and the demonstration of a new radiological sign. Radiology
(1983) 147: 499-502.
Bisset R et al. Radiographic and Sonographic appearances of an intramural
haematoma of the pylorus. Clin. Rad. (1988) 39: 316-318.
Bisset R A L & Gupta S C. Hypertrophic pyloric stenosis: ultrasonic
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Blumhagen J D et al. Sonographic diagnosis of hypertrophic pyloric stenosis.
Am. J. Roent. (1988) 150: 1367-1370.
Bowerman R A et al. Realtime ultrasound diagnosis of intussusception in
children. Radiology (1982) 143: 527-529.
Dachmann A H et al. Review: mucocoele of the appendix and
pseudomyxoma peritonei. Am. J. Roent. (1985) 144: 923-929.
Derchi E et al. Ultrasonographic appearances of gastric cancer. Brit. J.
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Dinkle E et al. Realtime ultrasound of Crohn's disease, characteristic
features and clinical implications. Paed. Rad. (1986) 16: 131-134.
Fleischer et al. Sonographic patterns arising from normal and abnormal
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Fleischer et al. Sonographic assessment of the bowel wall. Am. J. Roent.
(1981) 136: 887-891.
Fleischer et al. Realtime sonography of the bowel, Clinics in
Diagnostic Ultrasound (1982): 117-135.
Fon V et al. Utility of ultrasound for the diagnosis of mesenteric
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Fried A W et al. Duodenal duplication cysts, sono graphic and
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Jackson G H et al. Sonography of combined oesophageal duodenal atresia. J.
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Jeffrey R et al. Acute appendicitis: high resolution real-time ultrasound
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Kodroff M et al. Ultrasonographic diagnosis of gangrenous bowel in
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Kurtz & Goldberg eds, Clinics in Diagnostic Ultrasound 23:
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Limberg B. Diagnosis of acute ulcerative colitis and colonic Crohn's disease
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children. Radiology (1980) 135: 409-414.
120
4
4.1
10% .
. .
, , ,
,
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122
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.
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125
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126
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)
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4
5
7
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5
9
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8
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127
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155 3
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130
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161
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162
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163
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164
165
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,
.
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.
. ,
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, .
177
, .
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. , , . , ,
, .
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.
,
.
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. .
,
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. .
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. 41% -
178
. .
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.
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.
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,
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.
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. , ,
.
-
.
(, 25, 1981)
- .
179
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,
.
.
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- .
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.
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.
.
,
.
, . .
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. 4.40.
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181
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, ,
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.
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,
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)
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.
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182
4.22
m. psoas
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.
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- , ,
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.
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, .
.
.
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183
, .
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,
.
, .
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:
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. .
,
, .
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.
184
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,
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.
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,
,
,
, .
,
, , .
- .
185
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, , , (, ) (, ).
, - .
2
1S6
. 4.42.
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, , ,
187
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,
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,
,
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,
,
, ,
,
4.23.5
, ,
,
,
4.23.6
188
. 4.43.
, , ,
.
.
4.23.7
,
- .
, .
.
80%
20% (
)
.
4.23.8
. , , , , , . ,
. 3-5 .
2-4 . 45
, 7%
90.
189
- , .
4.23.9
, in utero.
, , , . ,
, .
4.23.10
. , - . , .
, , :
,
.
4.24
, . , .
.
190
1 , .
2 ,
.
3 .
, .
50%
,
. ,
. - .
4.25
4x2x0.4 .
, , .
, .
.
.
, ,
, .
,
. ,
, -
191
50% .
4.25.1
,
.
,
.
.
, , ,
.
, , ,
,
, ,
.
- , ,
, ,
,
, , .
.
, .
,
,
. .
4.25.2
-
192
. ,
. , , 70% ,
37% . ,
. ,
, .
. ,
.
.
,
.
. ,
.
4.25.3
,
.
, ,
. , .
,
.
. ,
.
.
193
4.25.4
, 6% .
, , . , .
(). ,
. .
, ,
4.25.5
,
. ,
10% , 10% 10% , 90%
14.
.
4.25.6
,
.
, . ,
, . 10
.
.
'** ( ),
,
194
4.25.7
, .
4.25.8
,
. , .
, .
. 4.44.
, , , ,
. 4.45.
( )
Abu-Yousef M M et al. Bladder tumours studied by cystosonography.
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Abu-Yousef M M et al. Urinary bladder tumours studied by cystosonography. Part 2 staging. Radiology (1984) 153: 227-231.
Arms E S & Hartman D S. Renal ultrasonography. Rad. Can. North Am.
(1984) 22(2): 315-332.
Amis E S Jr et al. Ultrasonic inaccuracies in diagnosing renal obstruction.
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Bartum R J et al. The ultrasonic determination of renal transplant volume. J.
Clin. Ult. (1974) 2 (4): 281-285.
Bartum R J et al. Evaluation of renal transplant with ultrasound. Radiology
(1976) 118: 405-410.
Birnholz J et al. Submucosal oedema of the collecting system. A new
ultrasonic sign of severe renal allograft rejection. Radiology (1985) 154: 190.
195
196
5
, 4-5 3 2 5
,
-
, , , ,
5.1
,
, ,
,
,
, ,
198
5.2
, .
0.5-1.5 2 . , ,
5 . , .
95% , .
,
, , .
5.3
, .
2-3 .
5.4
, .
5.5
.
, fa . .
5.6
.
0.23-0.8% ,
10-25% . 4%
199
,
0.8%.
,
. 70%
( ) . - . , , , .
5.7
, , . , . - ,
. .
.
,
. - .
5.8
,
, . 6
, . .
.
- .
. .
200
, .
.
-.
, .
5.9 /
- .
.
,
.
, , , .
.
,
.
5.10
2040 . 5100
6 . 15%
, .
(, ) . ,
. 50 50% .
, , ,
. 90% .
201
, ,
.
.
. 5.1.
5.10.1
50% .
.
5.10.2
10% .
,
.
.
5.10.3
, - .
5.10.4
.
- ,
,
.
202
5.10.5
, .
.
2%
, .
, , , , , , .
. 5.2.
( )
. 5.3.
, , ,
5.11
,
. ,
,
, .
.
,
70% .
203
. .
5.11.1 ()
.
.
.
,
-
,
.
5.11.2
12-46% 50
. 90%
90 .
.
70% ,
.
, . .
54%
22%
24%
, 90% .
.
.
, .
204
, .
,
.
5.11.3
,
. , .
.
.
, . ,
,
. .
Arger P H et al. Prospective analysis of the value of scrota! ultrasound.
Radiology (1981) 141: 763-766.
Carroll A & Gross D M. High frequency scrotal sonography. Am. J.
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Clements R et al. How accurate is the index finger. A comparison of digital
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Cunningham J J Sonographic findings in clinically unsuspected acute and
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Griffiths G 3 et al The ultrasound appearances ofprostatic cancer with
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Griffiths G J et al Ultrasonic appearances associated with prostatic
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Jeffrey R et al. Sonography of testicular trauma.Am. J. Roent. (1983) 141:
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Leopold G R et al. High resolution ullrasonography ofscrotal pathology.
Radiology (1979) 131: 719-722.
Madrazo L et al. Ultrasonographic demonstration ofundescended testes.
Radiology (1979) 133: 181-183.
Schwerk W et al. Testicular tumours: prospective analysis of real-time
ultrasound patterns and abdominal staging. Radiology (1987) 164: 369374.
Wolverson M et al. High resolution real-time sonography of scrotal
varicocoele. Am. J. Roent. (1983)141: 775-779.
6
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Alpern et al. Sonographic features of paraovarian cysts and their
complications. Am. J. Roent. (1984) 143: 157-160.
Athey P A & Malone R S. Sonography of ovarian fibromas/thecomas. J. Ult.
Med (1987) 6: 431-436
Austin C. Seminars in Ultrasound. 1(1) March 1980
Babaknia A et al. The Stein Leventhal syndrome and coincidental ovarian
tumours. Obstet. Gynaecol. (1976) 47: 223-224.
Baltarowich et al. The spectrum of sonographic findings in
haemorrhagic ovarian cysts. Am. J. Roent. (1987) 148: 901-905.
Berland L L et al. Ultrasonic diagnosis of ovarian and adnexal disease.
Seminars in Ultrasound. 1(1) (1980).
Bohlman M E et al. Sonographic findings in adenomyosis of the uterus. Am.
J. Roent. (1987) 148: 765-766.
230
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.
Alonso de Santos L & Goldstein H M. Ultrasonography in tumours arising
from the spine and bony pelvis. Am. J. Roent (1977) 129: 1061-1064.
Bailey R V et al. Leiomyosarcoma of the inferior vena cava: a report of a
case and review of the literature. Ann Surg. (1976) 184: 169-173
Bresemhan E R & Keates P G. Ultrasound of dissection of the abdominal
aorta. Clm. Rad. (1980) 3: 105-108.
Bruyninck M A & Derkson S. Leiomyosarcoma of the IVC: a case
report and review of the literature. J. Vase Surg. (1986) 3' 652-656.
Callen P W et al. Ascitic fluid in the anterior penvesica! fossa: misleading
appearance on CT scans. Am J Roent. (1978) 130' 1176-1177.
Campbell J A. The diaphragm in roentgenology of the chest. Rad. Clin.
North Am. (1963) 395-410.
Camphell W E & Weinstein J. Sonographic appearances of pelvic
extramedullary haematopoiesis. J. Ult. Med. (1986) 5: 103-104.
Creed L et al Potential pitfalls in CT and Sonographic evaluation of
suspected lymphoma. Am. J. Roent. (1982) 139: 606-607.
Derchi L E et al. Appendices epiploicae of the large bowel: Sonographic
appearances and differentiation from peritoneal seeding. J. Ult. Med. (1988) 7"
11-14.
Didier D et al. Tumour thrombus of the IVC secondary to malignant
abdominal neoplasm: ultrasound and CT evaluation. Radiology (1987) 162' 8389.
252
253
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