[Differential echographic diagnosis in small tissue areas--exemplified by the orbits]

Measurement-based ultrasonography proved mandatory in ophthalmic diagnostic work. It provides comparable examination conditions and therefore, comparable results, in contrast to simple, empirical ultrasonic examination. Measurement methods which can be easily applied under clinical conditions have been developed for determination of those technical characteristics of the apparatus and transducer probes which proved decisive for the diagnostic results. Some echographic criteria can be additionally or better evaluated using this basis. All echo-amplitude measurements should be related to a well-defined test-reflector echo. In addition to sensitivity and resolution, frequency and frequency spectrum are especially important. Manufacturer's data have proved insufficient up to now, insufficient; even within one manufacturer's series of one equipment or transducer probe type considerable deviations from the declared data have been found. Such deviations may mimick pathologic alterations in the echograms. The size of a lesion area can be better evaluated when using well-defined technical conditions. The echographic presentation of tissue structures in the depth is especially dependent on frequency and on the frequency spectrum. Pathologic alterations of tissues may cause changes in the ultrasound attenuation which results in emphasized or reduced presentation of echoes from normal structures behind the lesion area. Tissue differentiation should be based on additional A-scan echograms. Computerized echogram averaging provides a more reliable evaluation of echo amplitudes and ultrasound attenuation. Use of measurement-based ultrasonography permits to compare measured echo-amplitudes and ultrasound attenuation with the results of other working groups, even if these are based on other equipment and transducers.