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Ultrasonic Imaging of the Abdomen: Title and subTitle BreakReport of the Ultrasonography Task Force FREE

[+] Author Affiliations

This report was presented to the House of Delegates of the American Medical Association on June 24,1990. as an informational report of the Council on Scientific Affairs.

This report is not intended to be construed or to serve as a standard of medical care. Standards of medical care are determined on the basis of all of the facts and circumstances involved in an individual case and are subject to change as scientific knowledge and technology advance and patterns of practice evolve. This report reflects the scientific literature as of March 1990.

Reprint requests to the Council of Scientific Affairs, Group on Science and Technology, American Medical Association, 515 N State St, Chicago, IL60610 (William R. Hendee, PhD).


JAMA. 1991;265(13):1726-1731. doi:10.1001/jama.1991.03460130118034
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As new imaging modalities emerge and existing technologies improve, indications for a particular imaging method may change. This article examines current indications for abdominal and prostatic ultrasound examination and, where possible, compares ultrasound with other imaging techniques. This is not an attempt to list all possible ultrasound indications or examinations, but rather an attempt to serve as an aid to informed imaging selection based on current literature and equipment.

(JAMA. 1991;265:1726-1731)

REFERENCES

Deitch EA, Engel JM.  Spigelian hernia: an ultrasonic diagnosis . Arch Surg. 1980;;115:93.
Goldberg BB, Goodman GA, Clearfield HR.  Evaluation of ascites by ultrasound . Radiology. 1970;;96:15-22.
Jasinski RW, Glazer GM, Francis IR, Harkness RL.  Computed tomography and ultrasound in abscess detection at specific anatomic sites: a study of 198 patients . Comput Radiol. 1987;;11:41-47.
Halber MD, Daffner RH, Morgan CL, et al.  Intra-abdominal abscess: current concepts in radiologic evaluation . AJR Am J Roentgenol. 1979;;133:9-13.
Mukai JK, Stack CM, Turner DA, et al.  Imaging of surgically relevant hepatic and vascular anatomy, I: normal anatomy . AJR Am J Roentgenol. 1987;;149:287-292.
Needleman L, Kurtz AB, Rifkin MD, Cooper HS, Pasto ME, Goldberg BB.  Sonography of diffuse benign liver disease: accuracy of pattern recognition and grading . AJR Am J Roentgenol. 1986;;146:1011-1015.
Sandford NL, Walsh P, Matis C, Baddeley H, Powell LW.  Is ultrasonography useful in the assessment of diffuse parenchymal liver disease? Gastroenterology. 1985;;89:186-191.
Taylor KJW, Riely CA, Hammers L, et al.  Quantitative ultrasonography attenuation in normal liver and in patients with diffuse liver disease: importance of fat . Radiology. 1986;;160:65-71.
Curati WL, Halevy A, Gibson RN, Carr DH, Blumgart LH, Steiner RE.  Ultrasound, computed tomography, and MRI comparison in primary and secondary tumors of the liver . Gastrointest Radiol. 1988;;13:123-128.
Parker GA, Lawrence W, Horsley JS III, et al.  Intraoperative ultrasound of the liver affects operative decision making . Ann Surg. 1989;;209:569-577.
Sheu J-C, Sung J-L, Chen D-S, et al.  Early detection of hepatocellular carcinoma by real-time sonography: a prospective study . Cancer . 1985;; 56:660-666.
Taylor KJW, Ramos I, Morse SS, Fortune KL, Hammers L, Taylor CR.  Focal liver masses: differential diagnosis with pulsed Doppler ultrasonography . Radiology. 1987;;164:643-647.
Itai Y, Ohtomo K, Araki T, Furui S, Iio M, Atomi Y.  Computed tomography and sonography of cavernous hemangioma of the liver . AJR Am J Roentgenol. 1983;;141:315-320.
Moinuddin M, Allison JR, Montgomery JH, Rockett JF, McMurray JM.  Scintigraphic diagnosis of hepatic hemangioma: its role in the management of hepatic mass lesions . AJR Am J Roentgenol. 1985;;145:223-228.
Stark DD, Felder RC, Wittenberg J, et al.  Magnetic resonance imaging of cavernous hemangioma of the liver: tissue-specific characterization. AJR Am J Roentgenol. 1985;;145:213-222.
Baker MK, Wenker JC, Cockerill EM, Ellis JH.  Focal fatty infiltration of the liver: diagnostic imaging . Radiographics. 1985;;5:923-39.
Laing FC, Jeffrey RB, Wing VW, Nyberg DA.  Biliary dilatation: defining the level and cause by real-time ultrasonography . Radiology. 1986;; 160:39-42.
Gibson RN, Yeung E, Thompson JN, et al.  Bile duct obstruction: radiologic evaluation of level, cause, and tumor resectability . Radiology. 1986;; 160:43-47.
Cooperberg PL.  High-resolution real-time ultrasound in the evaluation of the normal and obstructed biliary tract . Radiology. 1978;;129:477-480.
Cronan JJ.  Ultrasonography diagnosis of choledocholithiasis: a reappraisal . Radiology. 1986;; 161:133-134.
Longley DG, Skolnick ML, Zajko AB, Bron KM.  Duplex Doppler sonography in the evaluation of adult patients before and after liver transplantation . AJR Am J Roentgenol. 1988;;151:687-696.
Gelfand DW, Wolfman NT, Ott DJ, Watson NE Jr, Chen YM, Dale WJ.  Oral cholecystography vs gallbladder sonography: a prospective, blinded reappraisal . AJR Am J Roentgenol. 1988;;151:69-72.
Mogensen NB, Madsen M, Stage P, et al.  Ultrasonography versus roentgenography in suspected instances of cholecystolithiasis . Surg Gynecol Obstet. 1984;;159:353-356.
Rails PW, Coletti PM, Lapin SA, et al.  Real-time sonography in suspected acute cholecystitis: prospective evaluation of primary and secondary signs . Radiology. 1985;;155:767-771.
Samuels BI, Freitas JE, Bree RL, Schwab RE, Heller ST.  A comparison of radionuclide hepatobiliary imaging and real-time ultrasound for the detection of acute cholecystitis . Radiology. 1983;;147:207-210.
Lauritsen KB, Sommer W, Hahn L, Henriksen JH.  Cholescintigraphy and ultrasonography in patients suspected of having acute cholecystitis. Scand J Gastroenterol. 1988;;23:42-46.
Fink-Bennett D, Freitas JE, Ripley SD, Bree RL.  The sensitivity of hepatobiliary imaging and real-time ultrasonography in the detection of acute cholecystitis . Arch Surg. 1985;;120:904-906.
Taylor KJW, Buchin PJ, Viscomi GN, Rosenfield AT.  Ultrasonographic scanning of the pancreas: prospective study of clinical results . Radiology. 1981;;138:211-213.
Jeffrey RB.  Sonography in acute pancreatitis . Radiol Clin North Am. 1989;;27:5-17.
Jeffrey RB, Laing FC, Wing VW.  Extrapancreatic spread of acute pancreatitis: new observations with real-time ultrasonography . Radiology. 1986;;159:707-711.
Alpern MB, Sandler MA, Kellman GM, Madrazo BL.  Chronic pancreatitis: ultrasonic features . Radiology. 1985;;155:215-219.
Didier D, Deschamps JP, Rohmer P, Lassegne A, Ottignon Y, Weil F.  Evaluation of the pancreatic duct: a reappraisal based on a retrospective correlative study by sonography and pancreatography in 117 normal and pathologic subjects . Ultrasound Med Biol. 1983;;9:509-518.
Campbell JP, Wilson SR.  Pancreatic neoplasms: how useful is evaluation with ultrasonography? Radiology. 1988;;167:341-344.
Hessel SJ, Siegelman SS, McNeil BJ, et al.  A prospective evaluation of computed tomography and ultrasound of the pancreas . Radiology. 1982;;143:129-133.
Galiber AK, Reading CC, Charboneau JW, et al.  Localization of pancreatic insulinoma: comparison of pre- and intraoperative ultrasonography with computed tomography and angiography . Radiology . 1988;;166:405-408.
Costello P, Kane RA, Oster J, Clouse ME.  Focal splenic disease demonstrated by ultrasound and computed tomography . J Can Assoc Radiol. 1985;;36:22-28.
Burney BT, Klatte EC.  Ultrasound and computed tomography of the abdomen in the staging and management of testicular carcinoma . Radiology. 1979;;132:415-419.
Creagh-Barry M, Adam EJ, Joseph AEA.  The value of oblique scans in the ultrasonic examination of the abdominal aorta . Clin Radiol. 1986;;37:239-241.
Schuman WP, Hastrup W, Hohler TR, et al.  Suspected leaking abdominal aortic aneurysm: use of sonography in the emergency room . Radiology. 1988;;168:117-119.
Park JH, Lee JB, Han MC, et al.  Sonographic evaluation of inferior vena cava obstruction: correlative study with vena cavography . AJR Am J Roentgenol. 1985;;145:757-762.
Sample WF.  Adrenal ultrasonography . Radiology . 1978;;127:461-466.
Abrams HL, Siegelman SS, Adams DF, et al.  Computed tomography versus ultrasound of the adrenal gland: a prospective study . Radiology. 1982;;143:121-128.
Ellenbogen PH, Scheible FW, Talner LB, Leopold GR.  Sensitivity of gray-scale ultrasound in detecting urinary tract obstruction . AJR Am J Roentgenol. 1978;;130:731-733.
Hricak H, Cruz C, Romanski R, et al.  Renal parenchymal disease: sonographic histologic correlation . Radiology. 1982;;144:141-147.
Bosniak MA, Megibow AJ, Hulnick DH, Horri S, Raghavendra BN.  Computed tomography diagnosis of renal angiomyolipoma: the importance of detecting small amounts of fat . AJR Am J Roentgenol. 1988;;151:497-501.
Warshauer DM, McCarthy SM, Street L, et al.  Detection of renal masses: sensitivities and specificities of excretory urography/linear tomography, ultrasonography, and computed tomography . Radiology. 1988;;169:363-365.
Middleton WD, Dodds WJ, Lawson TL, Foley WD.  Renal calculi: sensitivity for detection with ultrasonography . Radiology. 1988;;167:239-244.
Roehrborn CG, Peters PC.  Can transabdominal ultrasound estimation of postvoiding residual (PVR) replace catheterization? Urology. 1988;;31: 445-449.
Letourneau JG, Day DL, Ascher NL, Castaneda-Zuniga WR.  Imaging of renal transplants . AJR Am J Roentgenol. 1988;;150:833-838.
Lee F, Littrup PJ, Torp-Pedersen ST, et al.  Prostate cancer: comparison of transrectal ultrasonography and digital rectal examination for screening . Radiology. 1988;;168:389-394.
McClennan BL.  Transrectal ultrasonography of the prostate: is the technology leading the science? Radiology. 1988;;168:571-575.
Chodak GW.  Controversial issues regarding early detection of prostate cancer . In: Proceedings of the Third International Symposium on Transrectal Ultrasound in the Diagnosis and Management of Prostate Cancer . New York, NY: Alan R Liss Inc; 1988;:72-73.
Rifkin MD, Choi H.  Implications of small, peripheral hypoechoic lesions in endorectal ultrasonography of the prostate . Radiology. 1988;;166:619-622.
Salo JO, Kivisaari L, Rannikko S, Lehtonen T.  Computerized tomography and transrectal ultrasound in the assessment of local extension of prostatic cancer before radical retropubic prostatectomy . J Urol. 1987;;137:435-438.
Emory TH, Reinke DB, Hill AL, Lange PH.  Use of computed tomography to reduce understaging in prostatic cancer: comparison with conventional staging techniques . AJR Am J Roentgenol. 1983;;141:351-354.
Bezzi M, Kressel HY, Allen KS, et al.  Prostatic carcinoma: staging with MR imaging at 1.5 T . Radiology . 1988;;169:339-346.

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Deitch EA, Engel JM.  Spigelian hernia: an ultrasonic diagnosis . Arch Surg. 1980;;115:93.
Goldberg BB, Goodman GA, Clearfield HR.  Evaluation of ascites by ultrasound . Radiology. 1970;;96:15-22.
Jasinski RW, Glazer GM, Francis IR, Harkness RL.  Computed tomography and ultrasound in abscess detection at specific anatomic sites: a study of 198 patients . Comput Radiol. 1987;;11:41-47.
Halber MD, Daffner RH, Morgan CL, et al.  Intra-abdominal abscess: current concepts in radiologic evaluation . AJR Am J Roentgenol. 1979;;133:9-13.
Mukai JK, Stack CM, Turner DA, et al.  Imaging of surgically relevant hepatic and vascular anatomy, I: normal anatomy . AJR Am J Roentgenol. 1987;;149:287-292.
Needleman L, Kurtz AB, Rifkin MD, Cooper HS, Pasto ME, Goldberg BB.  Sonography of diffuse benign liver disease: accuracy of pattern recognition and grading . AJR Am J Roentgenol. 1986;;146:1011-1015.
Sandford NL, Walsh P, Matis C, Baddeley H, Powell LW.  Is ultrasonography useful in the assessment of diffuse parenchymal liver disease? Gastroenterology. 1985;;89:186-191.
Taylor KJW, Riely CA, Hammers L, et al.  Quantitative ultrasonography attenuation in normal liver and in patients with diffuse liver disease: importance of fat . Radiology. 1986;;160:65-71.
Curati WL, Halevy A, Gibson RN, Carr DH, Blumgart LH, Steiner RE.  Ultrasound, computed tomography, and MRI comparison in primary and secondary tumors of the liver . Gastrointest Radiol. 1988;;13:123-128.
Parker GA, Lawrence W, Horsley JS III, et al.  Intraoperative ultrasound of the liver affects operative decision making . Ann Surg. 1989;;209:569-577.
Sheu J-C, Sung J-L, Chen D-S, et al.  Early detection of hepatocellular carcinoma by real-time sonography: a prospective study . Cancer . 1985;; 56:660-666.
Taylor KJW, Ramos I, Morse SS, Fortune KL, Hammers L, Taylor CR.  Focal liver masses: differential diagnosis with pulsed Doppler ultrasonography . Radiology. 1987;;164:643-647.
Itai Y, Ohtomo K, Araki T, Furui S, Iio M, Atomi Y.  Computed tomography and sonography of cavernous hemangioma of the liver . AJR Am J Roentgenol. 1983;;141:315-320.
Moinuddin M, Allison JR, Montgomery JH, Rockett JF, McMurray JM.  Scintigraphic diagnosis of hepatic hemangioma: its role in the management of hepatic mass lesions . AJR Am J Roentgenol. 1985;;145:223-228.
Stark DD, Felder RC, Wittenberg J, et al.  Magnetic resonance imaging of cavernous hemangioma of the liver: tissue-specific characterization. AJR Am J Roentgenol. 1985;;145:213-222.
Baker MK, Wenker JC, Cockerill EM, Ellis JH.  Focal fatty infiltration of the liver: diagnostic imaging . Radiographics. 1985;;5:923-39.
Laing FC, Jeffrey RB, Wing VW, Nyberg DA.  Biliary dilatation: defining the level and cause by real-time ultrasonography . Radiology. 1986;; 160:39-42.
Gibson RN, Yeung E, Thompson JN, et al.  Bile duct obstruction: radiologic evaluation of level, cause, and tumor resectability . Radiology. 1986;; 160:43-47.
Cooperberg PL.  High-resolution real-time ultrasound in the evaluation of the normal and obstructed biliary tract . Radiology. 1978;;129:477-480.
Cronan JJ.  Ultrasonography diagnosis of choledocholithiasis: a reappraisal . Radiology. 1986;; 161:133-134.
Longley DG, Skolnick ML, Zajko AB, Bron KM.  Duplex Doppler sonography in the evaluation of adult patients before and after liver transplantation . AJR Am J Roentgenol. 1988;;151:687-696.
Gelfand DW, Wolfman NT, Ott DJ, Watson NE Jr, Chen YM, Dale WJ.  Oral cholecystography vs gallbladder sonography: a prospective, blinded reappraisal . AJR Am J Roentgenol. 1988;;151:69-72.
Mogensen NB, Madsen M, Stage P, et al.  Ultrasonography versus roentgenography in suspected instances of cholecystolithiasis . Surg Gynecol Obstet. 1984;;159:353-356.
Rails PW, Coletti PM, Lapin SA, et al.  Real-time sonography in suspected acute cholecystitis: prospective evaluation of primary and secondary signs . Radiology. 1985;;155:767-771.
Samuels BI, Freitas JE, Bree RL, Schwab RE, Heller ST.  A comparison of radionuclide hepatobiliary imaging and real-time ultrasound for the detection of acute cholecystitis . Radiology. 1983;;147:207-210.
Lauritsen KB, Sommer W, Hahn L, Henriksen JH.  Cholescintigraphy and ultrasonography in patients suspected of having acute cholecystitis. Scand J Gastroenterol. 1988;;23:42-46.
Fink-Bennett D, Freitas JE, Ripley SD, Bree RL.  The sensitivity of hepatobiliary imaging and real-time ultrasonography in the detection of acute cholecystitis . Arch Surg. 1985;;120:904-906.
Taylor KJW, Buchin PJ, Viscomi GN, Rosenfield AT.  Ultrasonographic scanning of the pancreas: prospective study of clinical results . Radiology. 1981;;138:211-213.
Jeffrey RB.  Sonography in acute pancreatitis . Radiol Clin North Am. 1989;;27:5-17.
Jeffrey RB, Laing FC, Wing VW.  Extrapancreatic spread of acute pancreatitis: new observations with real-time ultrasonography . Radiology. 1986;;159:707-711.
Alpern MB, Sandler MA, Kellman GM, Madrazo BL.  Chronic pancreatitis: ultrasonic features . Radiology. 1985;;155:215-219.
Didier D, Deschamps JP, Rohmer P, Lassegne A, Ottignon Y, Weil F.  Evaluation of the pancreatic duct: a reappraisal based on a retrospective correlative study by sonography and pancreatography in 117 normal and pathologic subjects . Ultrasound Med Biol. 1983;;9:509-518.
Campbell JP, Wilson SR.  Pancreatic neoplasms: how useful is evaluation with ultrasonography? Radiology. 1988;;167:341-344.
Hessel SJ, Siegelman SS, McNeil BJ, et al.  A prospective evaluation of computed tomography and ultrasound of the pancreas . Radiology. 1982;;143:129-133.
Galiber AK, Reading CC, Charboneau JW, et al.  Localization of pancreatic insulinoma: comparison of pre- and intraoperative ultrasonography with computed tomography and angiography . Radiology . 1988;;166:405-408.
Costello P, Kane RA, Oster J, Clouse ME.  Focal splenic disease demonstrated by ultrasound and computed tomography . J Can Assoc Radiol. 1985;;36:22-28.
Burney BT, Klatte EC.  Ultrasound and computed tomography of the abdomen in the staging and management of testicular carcinoma . Radiology. 1979;;132:415-419.
Creagh-Barry M, Adam EJ, Joseph AEA.  The value of oblique scans in the ultrasonic examination of the abdominal aorta . Clin Radiol. 1986;;37:239-241.
Schuman WP, Hastrup W, Hohler TR, et al.  Suspected leaking abdominal aortic aneurysm: use of sonography in the emergency room . Radiology. 1988;;168:117-119.
Park JH, Lee JB, Han MC, et al.  Sonographic evaluation of inferior vena cava obstruction: correlative study with vena cavography . AJR Am J Roentgenol. 1985;;145:757-762.
Sample WF.  Adrenal ultrasonography . Radiology . 1978;;127:461-466.
Abrams HL, Siegelman SS, Adams DF, et al.  Computed tomography versus ultrasound of the adrenal gland: a prospective study . Radiology. 1982;;143:121-128.
Ellenbogen PH, Scheible FW, Talner LB, Leopold GR.  Sensitivity of gray-scale ultrasound in detecting urinary tract obstruction . AJR Am J Roentgenol. 1978;;130:731-733.
Hricak H, Cruz C, Romanski R, et al.  Renal parenchymal disease: sonographic histologic correlation . Radiology. 1982;;144:141-147.
Bosniak MA, Megibow AJ, Hulnick DH, Horri S, Raghavendra BN.  Computed tomography diagnosis of renal angiomyolipoma: the importance of detecting small amounts of fat . AJR Am J Roentgenol. 1988;;151:497-501.
Warshauer DM, McCarthy SM, Street L, et al.  Detection of renal masses: sensitivities and specificities of excretory urography/linear tomography, ultrasonography, and computed tomography . Radiology. 1988;;169:363-365.
Middleton WD, Dodds WJ, Lawson TL, Foley WD.  Renal calculi: sensitivity for detection with ultrasonography . Radiology. 1988;;167:239-244.
Roehrborn CG, Peters PC.  Can transabdominal ultrasound estimation of postvoiding residual (PVR) replace catheterization? Urology. 1988;;31: 445-449.
Letourneau JG, Day DL, Ascher NL, Castaneda-Zuniga WR.  Imaging of renal transplants . AJR Am J Roentgenol. 1988;;150:833-838.
Lee F, Littrup PJ, Torp-Pedersen ST, et al.  Prostate cancer: comparison of transrectal ultrasonography and digital rectal examination for screening . Radiology. 1988;;168:389-394.
McClennan BL.  Transrectal ultrasonography of the prostate: is the technology leading the science? Radiology. 1988;;168:571-575.
Chodak GW.  Controversial issues regarding early detection of prostate cancer . In: Proceedings of the Third International Symposium on Transrectal Ultrasound in the Diagnosis and Management of Prostate Cancer . New York, NY: Alan R Liss Inc; 1988;:72-73.
Rifkin MD, Choi H.  Implications of small, peripheral hypoechoic lesions in endorectal ultrasonography of the prostate . Radiology. 1988;;166:619-622.
Salo JO, Kivisaari L, Rannikko S, Lehtonen T.  Computerized tomography and transrectal ultrasound in the assessment of local extension of prostatic cancer before radical retropubic prostatectomy . J Urol. 1987;;137:435-438.
Emory TH, Reinke DB, Hill AL, Lange PH.  Use of computed tomography to reduce understaging in prostatic cancer: comparison with conventional staging techniques . AJR Am J Roentgenol. 1983;;141:351-354.
Bezzi M, Kressel HY, Allen KS, et al.  Prostatic carcinoma: staging with MR imaging at 1.5 T . Radiology . 1988;;169:339-346.
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