No abstract

Real-time ultrasonography was used to measure bladder volumes. Volumes were calculated as the product of 3 internal bladder diameters (height, width and depth). The true bladder volume was obtained from the voided volume or by catheterization. There was a good correlation between calculated and true volumes provided a correction factor of 0.6 was applied. It also was found that a simpler method using only 2 diameters and a correction factor of 0.15 was nearly as reliable. The accuracy of this quantitative method was shown to be limited to an average error of plus or minus 25 per cent for bladder volumes between 100 and 500 ml. Smaller volumes could be assessed only qualitatively. False negative readings were common for bladder volumes less than 50 ml.

Real-time renal ultrasonographic scans were obtained of 204 subjects, comprising 159 pregnant and 45 control subjects. A classification of hydronephrosis based on calyceal diameters was established, and the overall incidence of hydronephrosis was found to be 90% on the right side and 67% on the left side. Calyceal diameters for both kidneys were found to increase gradually throughout pregnancy, the right more rapidly than the left. Neither parity nor a history of urinary tract problems was found to be relevant to the degree of dilatation.

In the eight-year period 1977-1984, 83 renal and adrenal mass lesions which were not clearly simple cysts by ultrasonographic examination (US) were investigated by percutaneous fine needle aspiration (FNA) biopsy. Initially, biopsy was often guided by fluoroscopy, later US was by far the most commonly used modality. There were 77 renal and 6 adrenal masses; 69 lesions were malignant and 14 were benign. A positive cytological diagnosis of malignancy was given in 62 cases, a diagnostic sensitivity of 90%. One false positive diagnosis occurred, an angiomyolipoma was misinterpreted as a low grade renal cell tumour. One significant complication was recorded, post biopsy haemorrhage into a large, extensively necrotic renal adenocarcinoma causing severe pain. The place of FNA in the preoperative investigation of solid renal tumours is discussed on the basis of this experience and results reported in the literature.