Ultrasound in the investigation of space-occupying lesions of the urinary tract

Abstract

In recent years increasing interest has developed in the use of diagnostic ultrasound in the investigation of lesions of the urinary tract. (Damascelli, Lattuada, Musumeci and Severini, 1968; Holmes, Wright, Meyer, Posatony and Howry, 1965; Holmes, 1966; 1967; Ostrum, Goldberg and Isard, 1967; Howry, 1965; Goldberg, Ostrum and Isard, 1968; West, 1967; Leopold, 1970; Schreck and Holmes, 1970). The present paper records our experience with diagnostic ultrasound in the investigation of the urinary tract with particular reference to space-occupying lesions. Initially, a number of patients without urinary tract lesions were scanned to standardize the technique of examination and to establish the ultrasonic appearances of the normal kidney and bladder. Subsequently a study was made of a series of 40 patients with a space-occupying lesion associated with the upper urinary tract, and a further 17 patients with a bladder tumour, 16 of which ultimately proved to be malignant. In addition, with reference to the differential diagnosis of bladder tumours, a small series of patients with known prostatic enlargement were examined. The apparatus used is the prototype version of the Nuclear Enterprises Diasonograph. The compound B scan direct contact method of scanning (Donald and Brown, 1961) was used exclusively with transducers of 1·5, 2·5 or 5 MHz at a pulse repetition frequency of 300 cycles/second. The swept gain function was set so that the sensitivity increased by 16 db between depths of 4 and 8 cm.