The proposed CAD algorithm could effectively and reliably differentiate benign and malignant lesions. The proposed morphologic features were nearly setting independent and could tolerate reasonable variation in boundary delineation.

The peripheral nerve is demonstrated as a reticular pattern in a transverse section at high-resolution ultrasonography (US). Its echogenicity is between that of tendon and muscle. High-resolution US applied to lesions of peripheral nerves yields impressive results in that the nerve is highly differentiated from surrounding soft tissue. In cases of trauma, high-resolution US can easily differentiate between a rupture of the nerve bundle and fibroblast infiltration that results in traumatic neuroma. In cases of inflammation or compressive syndrome, high-resolution US can easily demonstrate lesion location and cause. In the evaluation of abnormal masses, high-resolution US cannot clearly differentiate neurofibromas from schwannomas but it can clarify the relationship between tumor and neural trunk and help the clinician plan treatment strategies. The authors discuss the success that can be achieved with the application of high-resolution US in the evaluation of peripheral nerve lesions.

The purpose of this study was to evaluate the morphologic changes in the ulnar nerve in cubital tunnel syndrome with high-resolution ultrasonography. The mean values of the short axis (cm) x long axis (cm) at the arm, epicondyle, and forearm levels were 0.057 +/- 0.01, 0.068 +/- 0.019, and 0.062 +/- 0.01 in control group; 0.069 +/- 0.04, 0.139 +/- 0.06, and 0.066 +/- 0.023 in the symptomatic side in patients with cubital tunnel syndrome; and 0.063 +/- 0.029, 0.068 +/- 0.029, and 0.057 +/- 0.012 in the normal side in patients with cubital tunnel syndrome. No significant difference was found in the area (short axis x long axis) of the ulnar nerve at the arm, epicondyle and forearm levels between the left and right ulnar nerve in the control group and between the control group and the normal side in symptomatic patients. However, the mean value of the area of the ulnar nerve at the epicondyle level in symptomatic patients was significantly larger than that of the control group and that of the contralateral side in patients, and the P value was less than 0.001. High resolution ultrasonography can detect morphologic changes in the ulnar nerve accurately, and it could therefore be useful as a screening and even follow-up modality in patients with cubital tunnel syndrome.

Objective. To use color Doppler ultrasonography to evaluate the morphology and vascularity of calcific tendonitis and to predict the formative and resorptive phases of the calcification. Methods. Ninetyfour patients with shoulder calcification on plain radiographs were enrolled in this study. Ultrasonography of the shoulder was focused on the rotator cuff. Color Doppler ultrasonography was applied in the calcific region. Patient symptoms were graded as painless, mild, moderate, and severe. The calcific plaques were classified as arc-shaped, fragmented or punctate, nodular, and cystic types. Color Doppler ultrasonographic signals were graded 0 to 3. The formative and resorptive phases of calcification were categorized by patient symptoms; acute onset of moderate or severe pain indicated the resorptive phase. Results. The calcific plaques appeared arc shaped in 59 patients (20 painless, 19 mild, and 20 moderate), fragmented or punctate in 27 (2 painless, 3 mild, 20 moderate, and 2 severe), nodular in 6 (1 moderate and 5 severe), and cystic in 2 (severe). There was a significant difference between the morphology of the calcific plaques and clinical symptoms (P < .01). On color Doppler ultrasonography, grade 0 signals were found in 28 patients (22 painless and 6 with mild pain); grade 1 in 18 (16 mild and 2 severe); grade 2 in 41 (all moderate); and grade 3 in 7 (all severe). The correspondence between color Doppler ultrasonographic findings and clinical symptoms was excellent (P < .01). Conclusions. High-resolution ultrasonography with color Doppler imaging could differentiate the formative and resorptive phases of the calcification and could be used as a follow-up modality in calcific tendonitis of the shoulder. Key words: shoulder; calcification; ultrasonography; color Doppler ultrasonography. General Hospital-Taipei, School of Medicine, National Yang Ming University, Taipei, Taiwan, Republic of China; and Section of Radiology, Taipei Municipal Ho-Ping Hospital, Taipei, Taiwan, Republic of China (D.-Y.H.)

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