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Forty-one patients were examined by pulsed duplex sonography immediately before and then one, four and twelve weeks following sclerotherapy of a varicocele. The severity of the varicocele was determined by sonography before treatment and confirmed by phlebography. Sonographic follow-up showed reduction, or disappearance, of the varicocele in 78% of cases. Doppler examination confirmed successful treatment in 85% of patients. Pulsed duplex sonography, combining a non-invasive imaging method and a functional technique, is well suited for the follow-up of varicoceles after treatment.

The results of sonography of thyroid glands in 131 patients were compared with the findings on palpation and from scintigrams. High resolution sonography is the most accurate method of examination for demonstrating changes in the thyroid. In 40% cases sonography demonstrated lesions additional to the single abnormality found clinically. In 10% cases a suspected thyroid abnormality on palpation proved to be due to extra thyroid disease. Evaluation of the number, size and localisation of space-occupying lesions by means of sonography is superior to all other kinds of investigation. It is, however, not possible to determine whether a lesion is benign. An attempt has been made to define the usefulness of thyroid sonography and its place during routine diagnosis.

The ultrasound appearances of 11 patients with operatively confirmed Mirizzi syndrome have been analysed. The trio 'dilated intrahepatic bile ducts, concretions in the neighbourhood of the dilated common hepatic duct with a normal distal duct' permit the diagnosis of the Mirizzi syndrome with considerable certainty. In five patients these features were found by sonography and no other diagnostic procedure was necessary. In six patients, ERC was carried out in order to evaluate the distal common bile duct. In one case PTC was carried out, since the liver hilum could not be seen on sonography.

The results of 293 examinations of the skull by sonography in 170 newborn are presented. In 73 patients the results could be compared with the findings on CT or at post mortem. In 48%, abnormal sonograms of the skull were obtained, due to congenital abnormalities, hydrocephalus or intracerebral bleeds. High accuracy and wide application make real time sonography the diagnostic procedure of first choice for the examination of the brain of the newborn. An attempt has been made to determine the optimum time for the examination and suitable intervals for follow-up.

Radiological staging of pulmonary oedema was compared with the determination of extra-vascular lung water by means of a double indicator dilution technique. One hundred and forty-six ward chest radiographs were evaluated and compared with the results of simultaneous measurements of lung water. Seventy-seven cases could be evaluated statistically. Chest x-rays regarded as normal corresponded to extra-vascular lung water of 5 to 9 ml./kg. body weight. Interstitial oedema (radiological stage I and II) corresponded to extravascular lung water levels of 8 to 12 ml./kg. Differentiation of stages I and II was not possible. During stage III, extra-vascular lung water was 15 to 21 ml./kg. A comparative analyses of these findings revealed a discrepancy of 34%. The reasons for this are discussed.

Sonography is the primary imaging method for staging malignant lymphomas. The accuracy of sonography in diagnosing hepatic and splenic involvement was examined in 132 histologically proven cases. Focal involvement was differentiated from diffuse lymphoma. The value of sonography is discussed with reference to cases showing involvement of the gastro-intestinal tract, kidneys, suprarenals, pancreas, testes, breast, thyroid, parotid and muscle.

An attempt has been made to classify varicoceles by means of real time sonography in accordance with the findings on palpation. The maximal diameter of the pampiniform plexus and of individual veins was determined sonographically and compared with the results of palpation in 74 patients with varicoceles. The sonographic findings are more accurate than is palpation. Fifteen subclinical varicoceles were discovered by sonography which could not be detected by palpation. It has been found convenient to classify the lesions in four sonographic stages. Maximal transverse diameter of the pampiniform plexus up to one centimetre is regarded as normal. A diameter of one to two centimetres corresponds to grade I, two to three centimetres corresponds to grade II and greater than three centimetres to grade III.