1. Clinical importance of portal venous gas detected by abdominal sonography : a report of two casesPrimož Gregorič, Alenka Višnar-Perovič, 2004, professional article Abstract: Background. Portal venous gas (PVG) can be a sign of serious disease and a predictor of poor clinical outcome. However, it ean also occur as a transient phenomenon with little clinical significance, especially following blunt abdominal trauma and various diagnostic and therapeutic procedures. Case reports. We describe two patients with PVG detected on abdominal sonography, who had very similar sonographic findings but a completely different clinical outcome. The first patient was a 70-year-old man in whom PVG was the consequence of mesenteric infarction; the patient died in hospital shortly after the admission. Our second patient was a 26-year-old man who was injured in a motor vehicle accident. He was clinically stable and needed no aggressivetreatment. PVG proved to be a transient phenomenon that cleared spontaneously within a day. Conclusions. Doppler sonography is a sensitive andspecific modality for the detection of PVG. In patients with a serious underlying disease, sonography can identify the cause of PVG, so that the appropriate therapy may be undertaken without delay. If the aetiology is unclear, the decision to undertake further expensive and potentially harmful diagnostic procedures should be based on the patient's clinical status. Published in DiRROS: 13.02.2024; Views: 302; Downloads: 84
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2. Sonographycally guided hydrostatic reduction of childhood intussusceptionDubravka Vidmar, Alenka Višnar-Perovič, 2004, original scientific article Abstract: Background. Intussusception is the most common cause of bowel obstruction in children under two years of age. The proximal part of the bowel and its mesentery (the intussusceptum) enter within that part immediately beneath it (the intussuscipiens). Being pulled by peristalsis the mesenterial vessels getcompressed which result in ishaemia of the bowel wall. Most intussusceptions are ileocolic. The diagnosis can be confirmed by a contrast enema or ultrasound. Sonography demonstrates a so-called target-within-a-target patfern (in cross-section) with thickened edematous bowel wall with or without vascularisation and prestenotic dilatation with increased peristalsis. Therapeutic reduction can be attempted by a contrast enema (following diagnostic procedure) or by air, both under fluoroscopic monitoring, or by normal saline under sonographic guidance. Patients and methods. We detected sonographically intussusception in three girls of 15, 16 and 18 months having typical clinical signs. We continued with hydrostatic reduction under the sonographic guidance. The reduction was attempted with a saline enema on body-temperature, introduced by the equipment for contrast enema. The bottle o f normal saline was hung up 1 m over the examination desk.We needed few liters of saline to replace lost liquids due to the incomplete occlusion of rectum. Meanwhile we monitored the moving of the intussusceptum back into the proximal direction. Criteria for a succesful reduction were the disappearance of the intussusceptum and the passage of fluid through the ileocecal valve. Results. Success was proven in all three girls. No complications occured and the pain relieved immediately after the procedure. There were no signs of intussusception on sonography after 2 and 12hours. We saw a slightly edematous wall of ileocecal valve and terminal ileum. Due to their exellent clinical conditions they were discharged from hospital after a second sonography. (Abstract truncated at 2000 characters). Published in DiRROS: 13.02.2024; Views: 333; Downloads: 76
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3. Strictures of the male urethra: how to perform and evaluate radiourethrography and sonourethrography to avoid mistakesDarja Babnik-Peskar, Alenka Višnar-Perovič, 2000, original scientific article Abstract: Introduction. Precise evaluation of the uretheral stricture localisation, length, depth and quality of wall changes are necessary for the selection of the optimal treatment to prevent recurrences. Decision for urethral dilatation, internal urethrotomy or open surgery depends on urethroscopic, radiourethrographic-RUG, and recently, according to MC Annich, also sonourethrographic-SUG results. SUG adds information about the depth and density of spongiofibrosis. Previously published findings of RUG length underestimation, compared to SUG and endoscopy, were responsible for inappropriate treatment and recurrences. In our article, we evaluate SUG as a new imaging method in the diagnosis of uretheral strictures and treatment planning, and describe both imaging methods together with usual pitfalls in performance or interpretation, possible reason for incorrect length measurements, and RUG length underestimation. Patients and methods. In the period of 20 months, we evaluated SUG compared to RUG and endoscopy in 51/130 males with suspected urethral strictures. Results. Compared to RUG, sonographywas correct in 92% radiographycally detected strictures. Length measurements by sonography were 22% shorter than radiographic lengths, which could be explained by radiographic magnification, as it was proved with wire measure placed on penis. Considering radiographic magnification, we did not find important differences in any measurement. Opposite to previously published RUG results compared to endoscopy and SUG, radiographic length underestimation was not found. Conclusions. The combination of both imaging methods provides optimal information about urethral stricture anatomy. We conclude that published radiographic length underestimation could be only a misinterpretation. (Abstract truncated at 2000 characters). Published in DiRROS: 25.01.2024; Views: 334; Downloads: 90
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4. Ultrasound-guided aspiration biopsy of subclinical regional metastases of head and neck carcinomaAlenka Višnar-Perovič, Aleksandar Aničin, Živa Zupančič, Bojana Černelč, Alojz Šmid, Dubravka Vidmar, Milan Gorenc, 2000, original scientific article Abstract: Background. Studies concerned with the estimation of ultrasound (US) combined with ultrasound-guided aspiration biopsy (USGAB) in the detection of subclinical regional metastases from the planocellular carcinoma of head and neck are promising, but in few cases. Recently, the authors have pointed out the role of lymph node size parameters in order to decide about the use of USGAB. The aim of this study was to test the reliability of US-USGAB for the detection of subclinical regional metastases in patients with planocellular head and neck carcinomas, including the evaluation of lymph node size parameters. Patients and methods. 121 neck sides with no palpable metastases were examined by US in 77 patients with planocellular carcinomas of head and neck. Depending on the results obtained, USGAB was performed on 64 neck sides.After surgery, the results of US-USGAB were compared with histological findings of the dissected lymph nodes. Results. The study showed 77% overall sensitivity of US and USGAB, and 100% specificity, while the versal / longiyudinal diameter was the best predictor of metastatic lymph node involvement. Conclusion. The results of this study established that USGAB is an appropriate method for detection the subclinical regional metastases on neck, and should be included into routine diagnostic work up in the evaluationof the extent of head and necks carcinomas. Published in DiRROS: 24.01.2024; Views: 325; Downloads: 87
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5. Ultrasonographic diagnnosis of obstructive ileus in a patient with Meckel's diverticulumAlenka Višnar-Perovič, Aleš Koren, 1999, original scientific article Abstract: Introduction. Despite the use of modern imaging techniques, the reliable preoperative assessment of Meckel's diverticulurn and related complications with this rare congenital anomaly of the gastrointestinal tract in adults is uncomrnon. Case presentation. This report presents the case of a 25 year old man who presented with a sudden onset of pain in the right lower abdomen and vomiting. On clinical examination the affected area was tender to palpation which revealed an elastic cylindrical formation situated deeply in the abdomen. Blumberg's sign was positive while the laboratory findings were stillwithin normal limits. An ultrasonography of the abdomen revealed an ileocaecal fluid collection containing thicker residue, which was suspicious for Meckel's diverticulum or a duplication cyst and ileus of the small bowel proximally from the formation described. Native radiogram of the abdomen in supine position has confirmed the presence of obstructive ileus at the level of the distal part of the small bowel. Surgery revealed an ileus and compression of the distal part of the small bowel due to the presence of an edematous Meckel's diverticulum. Conclusion. In view of the frequent use of ultrasonography in the evaluation of acute ahdomen, the diagnostic procedures could be rationalized and the time to surgery reduced if possible complicatioris due to Meckel's diverticulum would he considered in the differential diagnosis. Published in DiRROS: 22.01.2024; Views: 337; Downloads: 85
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9. Ultrazvočno vodena aspiracijska biopsija s tanko iglo v diagnostiki ledvičnih tumorjevMargareta Strojan Fležar, Bojana Černelč, Helena Gutnik, Alenka Višnar-Perovič, 2011, professional article Abstract: Ultrazvočno vodena aspiracijska biopsija je v Sloveniji že dolga leta standardna metoda za morfološko diagnostiko radiološko težavnih ledvičnih tumorjev. V zadnjih letih se zanimanje za to diagnostično metodo povečuje tudi v Evropi, predvsem za dodatno diagnostiko majhnih tumorjev, ki merijo največ 3 cm. V naši analizi smo potrdili, da je metoda uporabna za diagnostiko majhnih tumorjev, če so vzorci dovolj celularni in reprezentativni za lezijo. V citopatološki diagnostiki so nam v pomoč tudi imunocitokemična barvanja, s katerimi lahko natančneje opredelimo tip ledvičnega karcinoma: svetlocelični, papilarni in kromofobni karcinom ledvičnih celic. Keywords: ledvice, tumor, karcinom, diagnostika, aspiracijska biopsija Published in DiRROS: 31.08.2018; Views: 3274; Downloads: 860
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