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Renal sonography forms a basic part of routine diagnostic strategy.
This textbook summarizes eighteen years of experience in diagnostic
ultrasound. We want it to serve as a guide to both imagers and mere
consumers of information. That is why we shall emphasize practical
advice and diagnostic pitfalls; it is also why we shall often deal
with the relations of sonography with other diagnostic procedures,
which it may complement or replace, precede or follow, the purpose
being to achieve efficiency at low cost. We shall limit our subject
matter to the kidney itself and the neighboring retroperitoneal
compartments, dealing only briefly with the lower urinary tract,
which requires specialized procedures. We devoted considerable
space to renal sonography in our book Clinical Atlas of Ultrasonic
Radiography, published in 1973. Since then, nothing has changed and
everything has changed. Nothing, because even then the differential
diagnosis between a solid and a cystic mass, the etiologic
diagnosis of a nonsecreting kidney, and the positive diagnosis of a
traumatic juxtarenal hematoma were quite reliable, making possible
drastic reductions in the indications for instrumental
roentgenologic examinations. Everything, be cause improved
resolution and grey scale imaging (already partially achieved in
1973, thanks to real time) have profoundly refined both anatomic
and pathologic ultrasonic studies. And now high resolution real
time imaging has revolutionized renal examination techniques,
whereas Doppler is entering routine ultrasonic diagnosis."
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