SOFT TISSUE ULTRASOUND

                                      MYOCYSTICERCOSIS

CASE 1 -  A  case with small tender swelling right pectoral region

Fig 1-  High resolution US scan of right pectoral region shows a well defined rounded cystic lesion within pectoralis major  muscle with eccentric echogenic nidus - consistent with myocysticercosisi [ vesicular stage ] with subtle hypoechoic halo/edema around .  


                                                                CASE 2
 A young female presented with small  slightly painful nodule left breast

Fig 1 - High resolution US image of left breast showing a well defined round to oval slightly thick walled cystic lesion with eccentric echogenic mural nodule  , the findings are consistent with cysticercosis 

Fig 2- High resolution US & Elastography image of the breast cysticercus cyst   , with classical BGR pattern seen on elastography  

ULTRASOUND IN RIGHT ILIAC FOSSA PATHOLOGIES

ULTRASOUND IN POST APPENDECTOMY FECAL FISTULA


CASE - A case with RIF discharging  lesion . H/O -  appendectomy a month back .

 Fig 1 - High resolution right iliac fossa US scan - shows a well defined hypoechoic track like lesion with central echogenicitis [ arrows ] indicative of air foci extending from cecal area to open externally through abdominal wall, s/o fecal fistula.  The lumen of lesion is connected with lumen of cecum.  

TESTICULAR DOPPLER ; VARICOCELES - COLOR & SPECTRAL DOPPLER

CASE - A young man with mild left hemiscrotal swelling and dull ache !

Fig 1- Color doppler scrotal scan showing dilated & tortuous venous vessels  [ structures with red & blue color filled signals]

Fig 2- Spectral doppler display of scrotal veins showing blood flow augmentation & reversal [ paired arrows]on valsalva maneuver , and return to normal spectrum post release .  

OCULAR USG

Fig 1 - Ocular cysticercosis ;  High resolution ocular USG scan depicting a well defined ring lesion posteromedial aspect of eye ball ,consistent with cysticercus cyst [ vesicular stage ] with eccentric echogenic nidus[scolex] .  Retinal detachment is also evident.
[ Image courtesy: Dr  Ajay Khandelwal , Alwar -Raj, India ]

DUODENAL USG

Duodenal ulcer disease 

CASE 1

Fig 1 - Upper abdominal / right paramedian transverse & oblique high resolution US images shows a focal area of mucosal defect consistent with ulcer crater in first part of duodenum. The lesion depicts some air foci in it with underlying hypoechoic muscularis  propria thickening .


                                                              CASE 2

A young man with h/o chronic upper abdominal pain & occassional vomiting

Fig 1- upper abdominal TS & oblique US scan shows small hyperechoic area of ulcer crater along anterior dudenal wall with air foci within [ arrows]  . Adjacent hypoechoic muscle layer thickening
also noted .

Fig 2 - Upper GI endoscopy of the same case shows a large duodenal ulcer [ blue arrows]

                                                           
                                                                 CASE 3 
CLINICALS -  A young lady c/o pain upper abdomen since 15 to 20 days , with occ vomiting .

Fig 1- Epigastric USscan depicting duodenum in transversa plane with echogenic mural lesion consistent with ulcer crater [ arrow]

UTERINE AVMS WITH MYOMETRIAL PSEUDOANEURYSM

A young female with early pregnancy had h/o D&C done . She then developed excessive bleeding PV for 1 month. 

This case was evacuated with TVS ....showed some retained products of conception, & multiple vascular cystic areas in juxtaposed myometrium with mosaic Color flow signals on Doppler. A large rounded unilocular  intramural cystic mass was also noted anteriorly which showed color signals , s/o- pseudoaneurysm ( fig 1 to 4 ) . 

Fig 1- TVS sag scan shows some retained products in endometrial cavity &  a large round ed cystic mass in anterior uterine wall with mobile low level int. echoes . 

Fig 2- TVS transverse scan shows myometrial cyst 

Fig 3- TVS color Doppler scan Shows central RPOCs . Multiple anterior & posterior uterine wall vascular channels , s/o AVMs . The large anterior cystic mass with color flow indicative of pseudoaneurysm.

Fig 4 - TVS color Doppler TUI images depicting uterine AVMs & pseudoaneurysm  . 

Post gestational uterine AVMs are encountered in gynecological practice, but associated myometrial pseudoaneurysm is a rare entity . 

PS : 1) CASE & images courtesy- Dr Renu Sharma - Radiologist ( Sikar, Rajasthan , India)

2) The case study is intended for imaging specialists & medical practitioners for academic purpose only.

3) It needs further discussion & review of literature 

OCULAR LENS LUXATION

POSTERIOR DISLOCATION OF OCULAR LENS

CASE -

A 70y male sustained blunt ocular trauma with resulting loss of vision. HRSG of eye ball showed complete posterior dislocation of bulky thick walled ( cataractous ) lens [ fig 1& 2]. 

 Fig 1 - Ocular HRSG shows a biconvex echogenic structure lodged posteriorly in vitreous chamber near retina - dislocated bulky cataractous lens - likely due to rupture of weakened suspensory ligaments torned as a result of blunt ocular trauma

Fig 2 - Ocular HRSG shows complete posterior  luxation  of  lens