(BQ) Part 2 book Differential diagnosis in ultrasound presents the following contents: Peritoneal and mesenteric masses, scrotum, testis and epididymis, prostate, breast, musculoskeletal system, orbit, neonatal and infant brain, neonatal and infant spine, gynecology and obstetrics.
11 Peritoneal and Mesenteric Masses 11.1 ROUND SOLID MASSES IN MESENTERY • • • • • • • • • Metastasis Lymphoma Leiomyosarcoma Metastasis from colon and ovary Metastasis due to intraperitoneal seedlings are seen in primary mucinous tumors of ovary, appendix, colon and breast Lymphoma: Lymphoma may present as a endoexoenteric mass with a solid mass in the mesentery and adjacent small bowel mass Leiomyosarcoma: Of small bowel is most commonly seen in ileum The large extrinsic component of the lesion is seen as a well-defined solid mesenteric mass with areas of necrosis Neural tumors Lipoma Fibrous histiocytoma Hemangioma Desmoid tumors Mesenteritis: Various conditions like Crohn's, Tuberculosis (Figs 11.1.1 and 11.1.2) trauma, surgery and pancreatitis may cause inflammation and thickening of the mesentery which on US may appear as a focal echopoor mass This may also be seen as a part of retroperitoneal fibrosis 302 A Differential Diagnosis in Ultrasound B Figs 11.1.1A and B: US scans show chronic tubercular peritoneal collection in the pelvis Fig 11.1.2: US scan shows mesenteric thickening Peritoneal and Mesenteric Masses 303 11.2 ILL-DEFINED MASS • Metastasis – Direct extension from adjacent neoplasm (ovary uterus, pancreas) may infiltrate the mesentery Lymphoma: Infiltrating small bowel lymphoma is plaque like involvement of the bowel wall and may be associated with desmoplastic reaction involving the mesentery The mesenteric lymph node involvement may be seen as an ill-defined component mass engulfing and encasing adjacent normal loops Carcinoid • Lymphoma: Infiltrating small bowel lymphoma is plaque like involvement of the bowel wall and may be associated with desmoplastic reaction involving the mesentery The mesenteric lymph node involvement may be seen as ill-defined confluent mass engulfing and encasing adjacent bowel loops • Fibromatosis • Chronic or retractile mesenteritis, fibrosing mesenteritis: Retractile mesenteritis also called as chronic fibrosing mesenteritis or mesenteric hypodystrophy is a rare condition of unknown etiology causing fibrofatty thickening of the small bowel mesentery On ultrasound it may be seen as a nonspecific ill-defined (hypoechoic or heterogenous) lesion at the root of the mesentery extending till the bowel border • Lipodystrophy • Peritoneal mesothelioma • Fibrotic reaction of carcinoid • Desmoid tumors 304 Differential Diagnosis in Ultrasound Liposarcoma Diffuse infiltrative lipomatosis • Tuberculosis (Figs 11.2.1 to 11.2.11) • Diverticulitis • Pancreatitis A B Figs 11.2.1A and B: Ascites with multiple thick internal septae seen in (A) pelvis and (B) hepatorenal pouch Peritoneal and Mesenteric Masses 305 A B Figs 11.2.2A and B: (A) Abdominal tuberculosis: Interloop fluid between loops; (B) Abdominal tuberculosis: Multiple hypoechoic well-defined lesion seen in the mesentery suggestive of lymph nodes 306 Differential Diagnosis in Ultrasound Fig 11.2.3: Ascites outlining bowel loops Fig 11.2.4: US scans show evidence of omental sarcoma Peritoneal and Mesenteric Masses Fig 11.2.5: US scan shows septate collection in perforation peritonitis Fig 11.2.6: Interbowel loop fluid (black arrow) 307 308 Differential Diagnosis in Ultrasound Fig 11.2.7: Enlarged mesenteric lymph nodes Fig 11.2.8: Necrotic mesenteric lymph nodes showing posterior acoustic enhancement—case of tubercular peritonitis Peritoneal and Mesenteric Masses 309 Fig 11.2.9: Tubercular peritonitis—thickened omentum (in calipers) Fig 11.2.10: Transabdominal ultrasound image showing the collection in the peritoneal cavity with internal septae suggestive of loculated ascites 310 A Differential Diagnosis in Ultrasound B Figs 11.2.11A and B: US scans show mesenteric adenopathy in a case of Koch's abdomen 11.3 LOCULATED CYSTIC PERITONEAL MASSES i Mesenteric: Lymphangioma, mesenteric cyst, mesenteric hematoma ii Pseudomyxoma peritonei iii Intra-abdominal abscess iv Lymphocele v Meconium peritonitis vi Peritoneal tuberculosis vii Omental cyst viii Cystic mesothelioma ix Cystic spindle-shaped tumors x Paracardiac pseudocyst xi Intraperitoneal hydatid (Figs 11.3.1 and 11.3.2) 656 Differential Diagnosis in Ultrasound Ganglion cysts 390 Ganglioneuroma 66, 299 Gangrenous cholecystitis 141, 142, 151 Gas in stomach wall 220 vessels 578 Gastric carcinoma 214 dilatation 216 diverticulum 300 fundus 300 lymphoma 214 Gastrinoma 205, 208 Gastroesophageal junction 213f Gastrointestinal tract 211 Gastroschisis 635 Gaucher’s disease 191, 193 Genetic disorders 600 syndrome 616 Genitourinary abnormality 571 Germ cell tumors 246, 332 Germinal matrix hemorrhage 481, 481f, 482 Gestational trophoblastic disease 557, 592, 595 neoplasia 577 Giant cavernous hemangioma 117 fibroadenoma 371, 382 large mass 373f Glandular parenchyma 53f Glaucoma 489 Glioblastoma 632 Glioma 427, 443, 451 Glucogenoma 205 Glycogen storage disease 75 Goldenhar syndrome 616 Gonadal stromal tumor 336 Granuloma 196, 455 Granulomatous hepatitis 74, 80 infection 184, 188 parotitis 56f prostatitis 358f, 363 Granulosa cell tumor 336 Graves’ disease 38, 425, 446, 451, 457 Gross hydrocele 338f Gut wall thickening 228 Gynecomastia 379 H Haemophilus influenzae 490 Hair tufts 507 Hamartoma 191, 370, 378, 387 Hashimoto’s thyroiditis 39, 39f Hay-fork’ appearance 170 Healed granuloma 90 Hearing loss 487 Hemangioendothelioma 582 Hemangioma 63, 83, 85, 93, 191, 193, 202, 261, 280, 285, 301, 370, 427, 447, 451, 455, 507, 582, 627 in forearm 416f Hemangiomatous lesion in urinary bladder 282f Hemangiopericytomas 444 Hemangiothelioma 65f Hematohydrocolpos 542 Hematoma 83, 93, 98, 105, 158, 184, 250, 252, 328, 370, 387, 426, 451, 517 Hemifacial microsomia 616 Hemobilia 152 Hemochromatosis 79 Hemophilic arthropathy 391 Hemorrhage 290, 291, 293, 341, 390 in bowel wall 234 Index Hemorrhagic cyst 520, 529f infarctions 489 ovarian cyst 529f unruptured follicular cyst 521f Henoch-Schönlein purpura 322, 327 Hepatic abscess 169 adenoma 98, 101, 120, 122 artery 202 cyst 104, 106 dysfunction 136, 137 flexure of colon 166 hemangioma 87f hematoma 88f metastases 6f parenchyma 78f schistosomiasis 95 Hepatitis 74, 80 Hepatoblastoma 582 Hepatocellular carcinoma 98, 103f, 117, 120, 126, 127 Hepatoma 83, 88, 93 Hereditary and familial cystic dysplasia 257 Hernia 158, 286 Herpes simplex 489 Heteroechoic enlarged thyroid gland 40f Heterogenous collection 455 echotexture 332 vascular myometrium 590 Hilar cholangiocarcinoma 122f Hip joint effusion in adults 390 Hodgkin’s disease 19 lymphoma 194, 448 Holoprosencephaly 459, 472-574, 607, 620, 630 Homogenous splenomegaly 194 657 Homozygous alpha-thalassemia 570 Horseshoe kidney 251f, 575 Hurler’s syndrome 618 Hydatid 90, 387 cyst 98, 105, 368, 370f in liver 113 in right iliac fossa 311f disease 112 Hydatidiform mole 596f Hydranencephaly 459, 464, 465f, 631 Hydrocephalus 459, 466, 467, 491 Hydrolethalus syndrome 616 Hydrometrocolpos 608 Hydromyelia 494, 495f, 503, 634 Hydronephrosis 633 Hydropneumothorax Hydrosalpinx 178, 524, 531 Hydrothorax 15, 573 Hypercapnia 482 Hyperdynamic fetal circulation 597 Hyperechoic metastasis 128, 130f renal nodules 268 Hyperemia 228 Hyperlipidemia 74 Hypernatremia 482 Hyperplasia 290, 291 Hyperplastic adenomatous nodule 29 nodule 32f Hypertension 482 Hypertrophic gastric wall in adult 219f pyloric stenosis 218, 219f Hypertrophied caudate lobe of liver 300 Hypertrophy 52 Hyphema 429 Hypoalbuminemia 10 658 Differential Diagnosis in Ultrasound Hypoechoic epididymis 322 GB mass 124f loculated collection 251 nodule 37f renal sinus 267 Hypogastrium 169 Hypogonadism 608 Hypoplastic right 641 Hypothyroidism 10 Hypotonicity 608 Hypoxia 482 I Idiopathic scrotal edema 322, 327 Iliac artery aneurysm 286 vein varices 286 Iliopsoas 169 abscess 408f hypertrophy 286, 288 Impacted gallstone 95 Implantation bleeding 592 Incarcerated hernia 322 Incomplete abortion 552, 554, 555f, 590, 590f Infantile hypertrophic pyloric stenosis 218f Infective cystic lesions 477 cysticercosis 447 Inferior pole of left kidney 274f Infiltrating duct carcinoma 374f Inflammatory adenopathy of neck 72f and noninflammatory arthritis 390 mass in ovary 523f pancreatic mass 205, 207 pseudotumors 191 Insertion of supraspinatus tendon 415f Insulinoma 205, 208 Interbowel loop fluid 231f, 307f Internal jugular vein 57f Interposition of colon 23 Interstitial gastric emphysema 220 nephritis 268 Intra-abdominal abscess 310 fetal calcification 582 Intracerebral bleed 484 Intrachoanal space occupying lesions 455 Intracranial hemorrhage 461, 481 Intracystic carcinomas 368 papilloma 368 Intraductal papillary tumors 200 Intradural lipoma 502, 502f Intrahepatic biliary calculi 152 cholestasis 145f neoplasm 152 obstruction 157 Intramammary lymph node 371 Intraocular hemorrhage 425 neurocysticercosis 457f Intraorbital fat 457 Intraparenchymal hemorrhage 483 Intraperitoneal abscess 312 hydatid 310 Intrauterine hydronephrosis 610f infections 570 pregnancy 543 Intraventricular hemorrhage 462, 463f, 483, 492 Index Invasive ductal carcinoma 373 mole 595 trophoblastic disease 543 Ipsilateral location of aorta and IVC 644 Iridocyclitis 425 Irregular tumor margins 41 wall thickening 152 Islet cell tumor 200 Isoechoic nodule 49 Isolated cleft palate 622 microlithiasis 330 J Jeune’s syndrome 607 Juvenile fibroadenoma 371, 382 Juxtaportal intrahepatic mass 157 K Kaposi’s sarcoma 93, 95, 268 Keratoconjunctivitis sicca 52 Kissing choroids 441 Knee joint effusion 406f Koch’s abdomen 310f L Large abdominal mass 21 amebic abscess 110f aortic aneurysm 271 echogenic kidney 607 pheochromocytoma of adrenal gland 297f psoas abscess 248f solid adrenal masses 297 vascular channels 152 659 Larsen syndrome 616, 617 Laryngeal atresia 586 Late pregnancy lactating breasts 375 Lateral thoracic meningocele 494, 503 Left ectopic testis lying in inguinal canal 335f heart syndromes 641 inguinal hernia 338f Leiomyoma 280, 544 Leiomyomatosis peritoneal disseminate 312 Leiomyosarcoma 227, 245, 280, 301, 543, 551 Lemon sign 628 Lens dislocation 429, 441 Leptomeningeal cyst 461, 480 Leptomyelolipoma 501, 502, 507 Lesions of extraocular muscles 451 eyeball 448 lacrimal glands 453 optic nerve 451 Leukemia 262, 446, 451 Leydig cell tumor 336 Limb body-wall complex 636 contractures 608 Linitis plastica 215f Lipodystrophy 303 Lipoleiomyoma 543, 551 Lipoma 63, 83, 164, 245, 301, 378 in breast 378f Lipomeningocele 507 Lipomyelocele 501 Lipomyelomeningocele 493, 496 Lipomyeloschisis 507 Liposarcoma 68, 304 660 Differential Diagnosis in Ultrasound Liver 98 cirrhosis 52 hematoma 117 in transverse scan 22f metastasis 136, 141 Lobar holoprosencephaly 473 Local benign mesothelioma 17 Loculated cystic peritoneal masses 310 pelvic abscess 517, 519 Low set deformed ear 574 Lumbar quadrants 168 Lumbosacral spine 494f Lung abscess 7f parenchyma Lymph nodal enlargement 154 mass 57f nodes 163 Lymphadenopathy 136, 244 Lymphangioma 19, 191, 202, 251, 286, 427, 444, 447, 455 Lymphocele 286, 310, 314, 517 Lymphoma 15, 29, 30, 94, 98, 104, 191, 194, 200, 207, 225, 227, 261, 286, 288, 290, 293, 301, 303, 316, 373, 386, 443, 444, 446, 451, 453, 455, 633 Lymphomatous lymph nodes 182 M Macroglossia 607, 617 Macrosomia 580 Malakoplakia 279, 284 Malignant chemodectoma 68 fibrous histiocytoma 191, 245 lymphatic obstruction 98 mesothelioma 16 ovarian lesions 540 mass 540f neoplasm 538 thyroid nodule 36 tumors 68 Mass calcification in breast carcinoma 374f Mastitis 370, 377 Maternal diabetes 569 severe anemia 570 Mature cystic teratoma 19, 20 Meckel-Gruber’s syndrome 607, 627 Meconium peritonitis 310, 314, 328, 582, 583 peritonitis in infant 320 Median cleft syndrome 616 Medullary carcinoma 45f, 373 thyroid 41 cysts 258 sponge kidney 258 Mega cisterna magna 459, 474, 574 Melanoma 451 Ménétrier’s disease 215 Meningioma 427, 444, 451 Meningitis 490 Meningocele of head 626f Mental deficiency 608 retardation 487 Mermaid syndrome 634 Mesenteric cyst 312, 313f, 517, 518f masses 301 thickening 302f Mesoblastic nephroma 261 Mesothelioma 312, 316 Index Metastatic neuroblastoma 582 nodules 141, 142 Microcystic adenoma in head of pancreas 205f Micrognathia 623 Microphthalmia 489 Midline cyst in prostate 356f horizontal liver 644 interhemispheric cyst 459 maxillary cleft 630 Mild hydronephrosis 270f splenomegaly uncommon 188 Miliary nodules 195 tuberculosis 188, 191, 194, 198 Miller’s syndrome 616, 620, 623 Mirizzi’s syndrome 157 Missed abortion 591f Mixed cystic and solid lesions 120 Moderate hydronephrosis 271f Mohr syndrome 616, 620, 623 Molar pregnancy 595 Mondor’s disease 377 Monochorionic twin syndromes 602 Morgagni hernia 587 Mucinous cystadenocarcinoma 525 cystadenoma 525, 535, 541f ductal ectasia 201 Mucocele of appendix 236f Mucoepidermoid carcinoma 58 tumor 454 Müllerian cyst utricle cyst 354 remnant cyst 354 Multicystic dysplastic kidney 255, 612f 661 lesion 202 pelvic mass 321 Multifetal pregnancy 601 Multifocal carcinoma 281f Multilocular cystic nephroma 261 nephroma of kidney 262f Multinodular goiter 32f, 50f Multiple anechoic tubular channels 337f cysts 116, 525 daughter cysts 115f enlarged cervical lymph nodes 73f mesenteric lymph nodes 319f multiple mesenteric lymph nodes 320f fibroids 545f hydatid cysts in liver 115f spleen 190f hypoechoic discrete lymph nodes 71f lesion 65f joint dislocation 617 simple cyst in left lobe of liver 120f small hypoechoic lesions 64f spleens 644 tubercular abscess 62f tubular structures 153f uterine fibroids 544f Multiseptated complex heterogenous tubo-ovarian mass 514f Mural nodule 540 thickening of gallbladder 82f Murphy’s sign 136 Myasthenia gravis 21 662 Differential Diagnosis in Ultrasound Mycobacterium avium intracellulare 188 tuberculosis 188 Myelocele 493, 495 Myelocystocele 493, 496, 635 Myelofibrosis 196, 198 Myelolipoma 293, 295, 299 Myelomeningocele 493 Myositis 446, 451 N Narrow bony pelvis 286 Neck masses 59 Necrotic mesenteric lymph nodes 308f metastasis 187 Necrotizing enterocolitis 220 Nephrocalcinosis 269f Nephrogenic adenoma 280 Nephrotic syndrome 10 Nerve root tumors 19 sheath tumors 444 tumors 66 Neuroblastoma 293, 294, 295f, 297, 632, 633 Neuroenteric cyst 19, 633 Neurofibroma 455 Neuromuscular disorders 21 Nodal masses 524 Nodule in thyroid-multinodular goiter 47f Nonfunctioning islet cell tumors 210 Non-Hodgkin’s lymphoma 194 Nonimmune hydrops 571, 575, 598 Nonlymphomatous lymphadenopathy 286 Nonossifying fibroma 455 Nonskin covered back mass 493 Nonvisualization of gallbladder on ultrasound 132 spleen on ultrasound 183 Noonan’s syndrome 616 Normal breast anatomy 364f ovulation 510 prostate tissue 363 seminal vesicles 357f Nuchal fold and translucency 637 thickness 571 translucency 571 O Obesity 21, 52 Obstructed uterus 515 Occult spinal dysraphism 494, 499, 507 Oil cysts 383 Omental cyst 310, 317, 517 infarction 171 Omentum 167, 168 Omphalocele 571, 574, 607, 635 Oophoritis 526 Open Sylvian fissure 631 Ophthalmic artery 426 Optic atrophy 487 nerve 421 avulsion 425, 430 Orbital cellulitis 457 cyst 432 cysticercosis 433, 448f hemorrhage 431 trauma 425, 427 Orofacial digital syndrome 623 Osteomyelitis of mandible 411f Index Ovarian cyst 516f dermoid 539f malignancy 539f stimulation 527f torsion 526, 531 tumors 526, 535 Overriding of skull bones 578 Overt spinal dysraphism 493 P Pancreatic carcinoma 157 head mass 124f pseudocyst 19, 187, 188, 252, 317 tumors 300 Pancreaticoblastoma 205, 207 Pancreatitis 15, 148, 171, 304 Panuveitis 425 Papillary adenoma 141 carcinoma 41 necrosis 258 Paracardiac pseudocyst 310 Paraganglioma 280, 285 Paralytic ileus 220, 222 Paranasal sinus malignancy 443 Paraovarian cysts 516, 524 Parapelvic peripelvic cyst 267 Parasitic cyst 187, 188 infection 255 infestation 161 Paratubal cyst 528 Partial corpus callosal agenesis with hydrocephalus 476f Particulate ascites 511, 576, 593 Patau’s syndrome 607 Peak systolic velocities 278, 426 663 Pediatric hip joint 393 testicular masses 345 Pedunculated fibroid 543f Pelvic abscess 169, 314f, 315f, 513, 520 hematoma 286, 288, 523f inflammatory disease 178, 511 lipomatosis 286, 288 Pelvicalyceal hydronephrosis 268f system of right kidney 259f Pelviureteric junction 608 obstruction 609f, 610f, 612 obstruction 272f Pena-Shokeir syndrome 616 Peptic ulcer 220 Perforated duodenal ulcer 148 Perforation of gallbladder 132 Peribiliary cysts 104, 106, 152 Pericardial cyst 19 Pericholecystic fluid 150, 151 Perietal pleura 10f Perilesional fibrosis 251 Perinephric urinoma 613 Periovarian inflammation 178, 511 Peripheral zone capsular invasion 359f Periportal cuffing 80 hyperechogenicity of liver 95 Peritoneal dialysis 10 inclusion cyst 321, 517 mesothelioma 303 tuberculosis 310 Peritrophoblastic flow 576 Periventricular leukomalacia 466f, 485f 664 Differential Diagnosis in Ultrasound Persistent cloaca 608 hyperplastic primary vitreous 431 trophoblastic neoplasia 595 truncus arteriosus 642 Perthes’ disease 397, 398f Pfeiffer syndrome 618 Phantom sign 243 Pheochromocytoma 290, 291, 293, 294, 296f, 297 Phlegmon 237 in head of pancreas 205f Phrenic nerve paralysis 22 Phthisis bulbi 430 Phylloides tumor 382 Pierre-Robin syndrome 616 Pigmented nevi 507 villonodular synovitis 391 Placental hemorrhage 573f site trophoblastic tumor 595 Plasma cell mastitis 375 Plastic peritonitis with hydrometrocolpos 582 Pleomorphic adenoma 427, 444, 454 in parotid gland 58f Pleural fibroma 16, 17 mesothelioma 15, 17 metastasis 15 nodules Plexiform neurofibroma 446 Pneumobilia echogenic foci 96 Pneumocystis carinii infection 187, 188 Pneumonia 15 Pneumothoraces Pneumothorax 482 Polycystic kidney disease 107f, 257f liver 107f liver disease 106 ovarian disease 533 ovaries 526 Polydactyly 574, 607, 608 Polyhydramnios 577, 578 Polysplenia 183, 644 syndrome 183 Popliteal artery 389 cyst 389 Porcelain gallbladder 132 Porencephalic cyst 459, 463, 466 Posterior cervical lymph nodes 70f ciliary artery 426 fossa abnormality 571 meningocele 493 staphyloma 454f wall of urinary bladder 279f Posthepatic obstruction 157 Postmeningitis hydrocephalus 490f Postoperatives spine 493 Post-traumatic cyst 184 Posturethral valve 609f Pott’s spine 252 Prephthitic eyeball 430 Primary lung tumor 22 retroperitoneal cysts 251 tumors 245 sclerosing cholangitis 79 splenic lymphoma 194 Primitive neuroectodermal tumors 487 Proliferative synovitis 391 in knee joint 409f Index Prominent choroid plexus 462 ejaculatory ducts 363 eyes 623 pericecal fat 237 premaxilla 623 vessels in sinus 267 Prostatic abscess 361f calcification 362f cyst 354 Protruding tongue 573 Proximal biliary dilatation 124f Prune-Belly syndrome 577 Pseudoachalasia 213 Pseudoangiomatous stromal hyperplasia 371, 383 Pseudocyst 201 pancreas 201, 318f Pseudogestational sac in uterus 576 Pseudokidney sign 226, 226f Pseudomembranous colitis 232 Pseudomyxoma peritonei 310, 312, 319 Pseudotumor 254f, 444, 446, 447f Psoas abscess 249f, 250f in iliac fossa 248f Pulmonary cystic adenomatoid malformation 586 emboli 15 hypoplasia 586 infarction 15 parenchyma 13f sequestration 586, 588, 598 Pulsality index 278 Pyelogenic cysts 258 Pyogenic abscess 108, 184, 187 arthritis 396f 665 Pyonephrosis 267 Pyosalpinx 178 R Radial scar 371 Radiation cystitis 279, 284 enteritis 234 injury 83 Radicular cyst of mandible 412f Rectal duplication 633 Recurrent pyogenic cholangitis 95, 96 tumors 373 Regenerative nodules 80 Reidel’s struma 247 Renal abscess 171 agenesis 607 calculus 269f cell carcinoma 257f, 261, 267f cortical cyst 574 necrosis 604 cystic dysplasia 255 diseases 136, 138 duplication artifacts 253 dysplasias 574 malakoplakia 254 parenchymal thinning 613 pseudotumor 253 vein 300 Reninoma 261 Resistance index 278 Retained placenta 556f Retention cyst 201, 354 Retina with optic nerve 418 Retinal capillary hemangioma 425 detachment 429, 450f 666 Differential Diagnosis in Ultrasound Retinoblastoma 432 with retinal detachment 450f Retinopathy of premature 433 Retroperitoneal fibrosis 246, 271 hemorrhage 171 masses 276 sarcoma 247f Reversal of flow in varicocele 330f Rhabdomyosarcoma 68, 280, 447 Rhesus isoimmunization 569 Rheumatoid arthritis 15, 391 Riedel’s lobe 75 Right atrial isomerism 644 lobe of liver 129f maxillary cyst 412f Robert’s syndrome 616, 620, 623 Robinson syndrome 618 Rocker bottom feet 574 Role of rectal endosonography 241 Round solid masses in mesentery 301 Roundness index 179 Rubella 489 Rudimentary horn of bicornuate uterus 551 Ruptured ectopic pregnancy 511 Russell silver syndrome 618 S Sacrococcygeal teratoma 632 tumors 509 Saethre-Chotzen syndrome 618 Salivary gland 52 Sarcoidosis 191, 193, 332, 339, 454 Sarcoma 200, 373, 388 botryoides 280 Scalp edema 627 Scar granuloma 371, 387 Schistosomiasis 95, 279, 283, 328 Sclera 418 Scleral injury 429 Scleritis 451 Sclerosing adenosis 371 cholangitis 247 Scrotal calcification 328 fat necrosis 322 masses 332 pearls 328, 330 Scrotolith 329f Sebaceous cysts 368 Segmental bile duct dilatation 152 Semilobar holoprosencephaly 460f, 472 Seminal vesicle cyst 286, 357 Septate collection inperforation peritonitis 307f uterus 547 Septic arthritis 390, 391 emboli 93 Sequelae of subependymal hemorrhage 483 Seroma 160 Serous cystadenocarcinoma 535 cystadenoma 525f, 536f Sertoli’s cell tumor 336 Severe anemia 600 diabetes 600 hypoproteinemia 600 oligohydramnios 604 Short rib polydactyly syndrome 615 Sigmoid colon 169 Index Signs of chronic cholecystitis 133f Silicone granulomas 387 implants 426 Simple cortical cyst 256f cyst 336, 341, 365 in breast 367f cystic in nature 341 liver cyst 105f posterior meningocele 497 prostate cyst 362f Simultaneous movements 607 Single umbilical artery 574 Sinonasal malignancies 457 Situs inversus 176f Skeletal dysplasias 615, 618 Skin covered back mass 493 Sloughed mucosal membranes 151 papilla in lumen 276 Small bowel and colon 222 ectopic gestation 595f intestine 169 lipoma of uterus 549f mandible 575 thorax 607 Soft tissue sarcomas 261 tumors 524 Solid benign ovarian tumor 538 heterogenous mass 296f infective lesions 486 lesions 461 masses 243, 531 pediatric neoplasm 207 pelvic masses 523 peritoneal lesions 312 667 renal mass 261 splenic lesion 191 Solitary echogenic liver mass 83 thyroid nodule 29 Sonographic classification of orbital lesions 443 Sonography of hydatid cyst 115f Spalding’s sign 578 Spina bifida 628, 634, 635 aperta 493, 495 cystica 493, 496 with meningocele 504f Spinal cord 487 dysraphism 493 lipoma 494, 501 trauma 493, 507 Spleen abscess 174 Splenic abscess 186f artery 202 calcification 198f hemorrhage 174 hydatid 189f infarction 191 laceration or fracture 184 parenchyma 186f trauma 185f Splenoma 191 Split notochord 503 syndrome 494, 505f Squamous cell carcinoma 261, 280, 285 Staghorn calculus in left renal pelvis 275f Star-sky spleen 197f Stewart’s classification 614 Stricture in proximal CBD 155f Stroma 419 Subchorionic hemorrhage 584f 668 Differential Diagnosis in Ultrasound Subcortical leukomalacia 486 Subcutaneous edema in forearm 414f lipomas 506 Subdiaphragmatic collection 25f Subdural empyema 461f Subendometrial myometrial cysts 548f Subependymal cyst 459, 474 hamartomas 482, 632 Subhyaloid hemorrhage 437 Submucosal varices 214 Subperiosteal abscess 455 Subphrenic abscess 15, 23, 171, 173f Subretinal fluid with retinal detachment 452f Subserosal edema 151 Sunray spiculation 93 Superficial lobe of parotid gland 56f Superior mesenteric artery 202, 221 ophthalmic vein 426 Suprapancreatic obstruction 154 SVC obstruction Swollen lens 441 Sympathetic ophthalmitis 428, 431 Syndactyly of hand/feet 607 Synovial osteochondromatosis 391 sarcomas 390 Synovitis of knee with loose body 410f T Temporal lobe 489 Tendon tears 391 Tenosynovitis 411f Teratocarcinoma 341 Teratoma 645, 632 Terminal ileum 169 Testicular calcification 328, 331f malignancy 333f microlithiasis 328 torsion 322 trauma 325 Tethered cord 506 Tetralogy of Fallot 642 Thanatophoric dysplasia 618 Theca cell tumor 336 lutein cyst 527, 527f, 559 Thick heterogenous endometrium 590 irregular solid mass 540 Thickened endometrium 552 gallbladder wall 151f nodular walls with debris in lumen 169 placenta 569, 569f pleura Thickening of ascending colon 230f gallbladder wall 80, 83 gastric wall 214 Thoracic tumor 598 Threatened abortion 591, 592 Thymic cyst 19 enlargement 586 Thyroglossal cyst 60 Thyroid 29 calcification 45 nodules 47 Tight filum terminale 494, 502 Tip of iceberg sign 533f Index Torsion of left testis 327f testicular appendage 322, 323 Tortuous brachiocephalic artery 19 Toxocara infection 433 Transabdominal scan of liver 125f Transitional cell carcinoma 262, 263f, 267, 276, 280, 281f, 286 of urinary bladder with calcification 282f papilloma 280 Transposition of great arteries 643 Transverse colon 167, 168 Traumatic cystic lesions 480 fragmentation of spleen 183, 184 Treacher-Collins syndrome 616 Trophoblastic disease 552 Tubercular abdomen 229f arthritis 396f collection in scrotal sac 329f epididymo-orchitis 324f peritonitis 231f, 309f tubo-ovarian mass 514f Tuberculosis 15, 224, 228, 279, 284, 290, 304 Tuberous sclerosis 257 Tubo-ovarian abscess 178, 178f, 512, 520, 522f complex 178, 511 Tubular ectasia 339, 341 Tumors of cervical esophagus 68 primitive gonadal stroma 336 Tunica albuginea cyst 339, 341 Turner’s syndrome 575 Twin embolization syndrome 603, 604 669 pregnancy 601 transfusion syndrome 602, 603 Two hydatid cysts in peritoneal cavity 311f Types of choledochal cyst 148f U Umbilical cyst 160f Undescended testicles 161 testis in inguinal canal 335f Unilateral adrenal masses 293 diaphragmatic elevation 21 proptosis 448 Unilocular paraspinous cystic mass 610f Univentricle heart 641 Unsuccessful first trimester pregnancy 589 Upper pole renal cysts and renal tumors 300 Urachal cyst 160, 289 Uremia 52 Ureterocele 613 Urethral atresia 608 Uric acid calcium precipitates 389 Urinary bladder 169, 279 tract obstruction 10 Urinoma 517 US scans 14f Uterine endometrium 553 masses 542 synechia 567f Utricle cyst 354 Uveal melanoma 433 tract 418, 419 Uveitis 451 670 Differential Diagnosis in Ultrasound V Vanishing twin syndrome 592 Varicocele 330f, 337 Varix 427, 446 of vein of Galen 460, 479 Vascular disease 425 extra-testicular mass 326f masses 162 Vein of Galen 467 aneurysm 632 malformation 460, 479 Venous thrombosis 600 Ventricular septal defect 639 Ventriculitis 491 Vertical section of eye and orbit 423f Vesical calculus 288f Vesicocervical fistula 599f Vesicoureteric junction 608 reflux 276, 608, 612, 613 Villous hyperplasia 141 Vipoma 209 Viral hepatitis 98 Vitreous cyst and persistent hyaloid artery 456f exudates 456f hemorrhage 429, 438 opacities 436 Volvulus 217 von Hippel Lindau disease 257 von Megenberg complexes 107 von Meyen Bery complex 104 W Wall calcification 116 thickened 151 Wandering spleen 183, 184 Warthin’s tumor 57 Wegener’s granulomatosis 444 Well-defined hyperechoic nodule 36f Widening of rectus abdominis muscles 159f Wilms’ tumor 28, 261, 270 Wilson’s disease 79 Wolman’s disease 290, 292 Worm in chest wall muscle 416f X Xanthogranulomatous pyelonephritis 255 Xerostomia 52 Y Yolk sac tumor 341, 535 Z Zellweger syndrome 608 Uploaded by [StormRG] ... rim • Decreased internal and increased external vascularity Fig 12. 1.1: Transverse section of right scrotal sac showing hydrocele 324 Differential Diagnosis in Ultrasound Fig 12. 1.2A: Epididymis... vein during cardiac catheterization is an unusual cause 12. 2 DIFFERENTIAL DIAGNOSIS OF SCROTAL CALCIFICATION Testicular Calcifications • Infective: Granuloma, tuberculosis (Figs 12. 2.1 and 12. 2 .2) ,... (B) Abdominal tuberculosis: Multiple hypoechoic well-defined lesion seen in the mesentery suggestive of lymph nodes 306 Differential Diagnosis in Ultrasound Fig 11 .2. 3: Ascites outlining bowel