Re: Echogenic round 2mm focus
From: DuBose, Terry (DuboseTerryJ@exchange.uams.edu)
Thu Jan 21 07:22:59 1999
Martin, great discussion. Any chance you could upload the pre- & post-natal
images of this cyst?
I recall a case years ago in which there was a bright echo just lateral to
the stomach. I was just panning back and fourth across it trying to figure
out what it was, a student was observing. Suddenly the student realized
what I was looking at, I had not said anything, and blurted out "What's
that?" The patient literally raised up on her elbows and asked "What's
What!!?" I tried to explain and showed it to the physician and we all
discussed it, but never decided what it was.
Some several months later we got a letter from the mother telling us how
much distress this had caused her and she was glad to inform us that her
baby was perfect. We learned to caution students about how they ask
questions in front of the patient.
Now you have pointed out something that may be much more common that we
suspect, like chorid plexus cysts, may be. If we start looking we may
realize that these are common. Could this be a "Necas Cyst" of the fetal
spleen? Perhaps others will also post a few images,... Dr. Corda?
Martin, if you are willing upload the images, could you estimate how many
cases you may have done in the process of finding the few cysts you have
found? I realize that this is not a rigorous scientific study... yet... but
it might give us some idea of the incidence in your population. Also, any
hemolytic conditions that are more common in your population?
Peace, Terry J. DuBose, M.S., RDMS, FAIUM
University of Arkansas for Medical Sciences, USA
http://www.io.com/~dubose/
http://www.uams.edu/CHRP/dmshome.htm
http://www.obgyn.net/us/panel/dubose_us.htm
---
> -----Original Message-----
> From: Martin Necas and Tania Keep [SMTP:exiled@clear.net.nz]
> Sent: Thursday, January 21, 1999 12:40 AM
> To: Multiple recipients of list
> Subject: RE: Echogenic round 2mm focus
>
> Dear Andrea, Art, and all interested colleagues.
>
> The LUQ echogenic focus has been seen by many people, although it has
> usually been disregarded as a benign finding. I ran a Medline search on
> this
> and did not come up with a single reference.
>
> Two days ago, I a chance to rescan one neonate who showed this finding
> in-utero. I did not expect to find much, but to my absolute amazement
> there
> was a 3mm simple splenic cyst. The focus which I measured in utero also
> measured 3 mm. I am keeping my eye on the next several babies with this
> finding and when they are finally born (March, April, and June), I will
> re-scan them as well. It will be most interesting to see what I find.
>
> I firmly believe that the echogenic focus may have represented this
> splenic
> cyst. One explanation why the focus to appeared highly echogenic (with
> murky
> shadowing) on obstetric scan and suddenly appeared cystic on neonatal
> scan,
> could be the difference in the equipment used and the tiny size of the
> object in question. The OB US was done with a C 3.5 MHz transducer at
> considerable depth, while the neonatal US was done with a C 8.0 MHz
> transducer superficially. I can imagine that the lower sound frequency may
> only pick up the walls of this tiny cyst as a highly reflective single
> object, and that the murky shadowing may perhaps be edge shadowing of the
> cyst. The resolution of the C 8.0 MHz transducer is so much better that
> this
> allows clear discrimination of the lesion. This of course is a hypothesis
> for now. I am anxiously waiting for the next few babies to come back for
> their neonatal ultrasound. If I find more splenic cysts, I intend to
> publish
> these findings.
>
> Thanks for your interest, I will keep you posted on the progress.
>
> Many regards,
>
> Martin Necas, RDMS, RVT
> Waikato Hospital, Hamilton, New Zealand.
> -----Original Message-----
> From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of
> Andrea
> Corda
> Sent: Thursday, January 21, 1999 7:48 AM
> To: Multiple recipients of list
> Subject: Echogenic round 2mm focus
>
> Messaggio a pił sezioni in formato MIME.
>
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> I saw your pictures of echogenic foci near the spine and have a similar > case to discuss.Up to now,I've asked a few colleagues but I did not > receive an answer.I'll collect the video and try to send you some > images.She was a female baby,these structures were first seen at 16 > weeks and always appeared onwards,until the delivery.I did not have the > chance to see the baby after;she must be 2 yrs old and doing fine,I > suppose.
> Wait for tomorrow.Regards,
> A.Corda
>
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> <DIV><FONT color=#000000 size=2>I saw your pictures of echogenic > foci near the
> spine and have a similar case to discuss.Up to now,I've asked a few > colleagues
> but I did not receive an answer.I'll collect the video and try to send > you some
> images.She was a female baby,these structures were first seen at 16 > weeks and
> always appeared onwards,until the delivery.I did not have the chance to > see the
> baby after;she must be 2 yrs old and doing fine,I suppose.</FONT></DIV>
> <DIV><FONT color=#000000 size=2>Wait for > tomorrow.Regards,</FONT></DIV>
> <DIV><FONT color=#000000
> size=2> &nbs> p;  > ; >
> A.Corda</FONT></DIV></BODY></HTML>
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