bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasound Examination of the Painful Shoulder
Authors: Shipley Eric S.
Published: March 2006

Ultrasonic examinations of the shoulders of 20 patients were undertaken. Eight were asymptomatic volunteers, and the remaining 12 had clinical signs of rotator cuff tears. The patients with painful shoulders were further evaluated with arthrography. The results of these two tests were then correlated. Although a correlation of 75% was found between the ultrasonographic and angiographic examinations, in cases where the area of the cuff tear could be adequately visualized with ultrasound, correlation rose to 90%.
Detection of Carotid Artery Disease by Duplex Ultrasound
Authors: Cardullo Paul A. , Cutler Bruce S. , Wheeler H. Brownell
Published: March 2006

Carotid duplex ultrasonography is a common noninvasive technique for evaluating cases of suspected extracranial carotid artery occlusive disease. This manuscript describes the procedure, with an emphasis on positive findings. A review of 16 published studies, totaling 2,168 arteriogram correlations, demonstrates a sensitivity, specificity, and overall accuracy of 95%, 73%, and 91%, respectively, for the detection of stenosis. The ability of the technique to predict the presence of plaque ulceration and intraplaque hemorrhage is less well defined. Carotid duplex ultrasonography is a highly accurate technique for the detection of extracranial carotid artery occlusive disease.
Clinical Applications of Tissue Characterization
Authors: Shawker Thomas H. , Russell Mary Ann
Published: March 2006

Ultrasound tissue characterization is the effort to derive from the ultrasound signal quantitative information which relates to and provides information about normal and diseased states. Two subjects in this research effort that are currently undergoing investigation and preliminary clinical application are scattering and attenuation. By quantifying backscatter amplitude, the "echogenicity" of diseased organs can be determined more precisely than by visual inspection. Obtaining some measurement of the spatial distribution of scatterers should serve as an approximate indicator of "tissue texture" and yield clinically useful information about normal and diseased tissue structure. Attenuation, estimated by measuring the change in frequency or amplitude as the ultrasound beam traverses tissue, may also prove valuable by providing another measurable parameter for the development of a given tissue's "acoustic profile." The successful implementation into clinical practice of these and other ultrasound tissue characterization measurements will extend and augment the diagnostic capabilities of ultrasound imaging.
Ultrasonographic Evaluation of the Cervical Ectopic Pregnancy
Authors: Frenkel Marina
Published: March 2006

Cervical pregnancy is one of the rarest types of ectopic gestation but one of the most serious because of the potential for extensive hemorrhage and perforation of the cervical wall. The clinical symptoms, sonographic appearance, and sonographic differentials are described and discussed.
Sonography of Hyperyrophic Pyloric Stenosis
Authors: Brzuchalski Robert K. , Rosenberg Henrietta Kotlus , Kuhar-Deiling Kathleen
Published: March 2006

Babies with hypertrophic pyloric stenosis (HPS) are generally healthy, normally developing infants in whom, suddenly, at the end of the first month of life, projectile vomiting develops. Clinically, a small "olive-shaped" tumor may be palpable. In this study, real-time ultrasound imaging was used in the evaluation of 57 cases of suspected HPS. The target sign, a hypoechoic ring of hypertrophied pyloric muscle, with a wall thickness of 4 mm or greater, proved to be a positive finding for hypertrophic pyloric stenosis. A pyloric channel length, or cervix sign, of greater than 1.4 cm was also a positive criterion for HPS. At the Children's Hospital of Philadelphia, we diagnosed 24 positive and 33 negative cases with 100% accuracy. High-resolution real-time ultrasound should be the first imaging modality used when evaluating cases of suspected HPS.
"Extended Vision" Real-time Ultrasound
Authors: Pohlable Mary E. , Allen Frank H. , Nelson Merritt E.
Published: March 2006

The "extended vision" approach to ultrasound evaluation calls for searching beyond predefined boundaries or specific organs in cases in which there is evidence of a pathologic condition that in itself is not sufficient for diagnosis. In a study of 300 consecutive cases referred for evaluation of a specific organ or area, the "extended vision" approach revealed unexpected findings in 34 cases, or 11% of the sample. Six of the cases are cited, demonstrating adult and fetal conditions unmasked by "extended vision" ultrasound, and practical considerations related to implementing a broad screening approach are discussed.
Sonographic Spectrum of Focal Splenic Lesions
Authors: Adler Dorit D. , Samuels Barry I. , Bowerman Richard A. , Silver Terry M.
Published: March 2006

Sonograms of 50 patients with a clinical suspicion of splenic abnormality were reviewed. With the use of high-resolution static and real-time equipment, combined with variable patient positioning, focal splenic lesions were well imaged. A wide variety of pathologic entities was sonographically demonstrated, including traumatic hematomas, primary and metastatic neoplasms, cysts, infarcts, and inflammatory granulomas.
A Discussion of the 1986 Society of Diagnostic Medical Sonographers Professional Profile Survey
Authors: Khamis H. J. , Warner Roger W.
Published: March 2006

Statistical analyses were carried out on the data from the 1986 Society of Diagnostic Medical Sonographers Professional Profile Survey. Among other findings, it was determined that men have a higher median salary than women, even after adjusting for such factors as educanal level and job responsibilities, but that the salary discrepancy is apparent only for those with more than 3 years of experience on the job, and only for those working in a hospital, a private office or clinic, or a university medical center. It was also found that non-Caucasian staff sonographers make more than Caucasian staff sonographers, but for those holding positions other than that of staff sonographer, the Caucasian and non Caucasian salaries do not differ. Finally, salaries of those who have a bachelor's degree in ultrasound are comparable to the salaries of those who have a bachelor's degree in an area other than ultrasound, after adjusting for the number of years of experience in the ultrasound field.
The Renal Sonographic Appearance of Sickle Cell Disease
Authors: Gardiner Karen L.
Published: March 2006

The renal sonographic appearances of 74 patients with the diagnosis of sickle cell disease, as documented by electrophoresis, were analyzed in this retrospective study. Renal size was compared with that in normal patients and found to show a significant increase in the adult patients. Other findings documented and discussed include echogenicity of renal parenchyma, echofree masses, echogenic foci, and papillary necrosis. Where possible, findings have been related to sickle cell disease.
How to Develop an Echocardiographic Teaching File
Authors: Ulmer Tonda L.
Published: March 2006

An echocardiographic teaching file is a successful method for today's sonographer and student sonographer of staying informed of new procedures, unusual cases, and equipment advances as well as maintaining proficiency on routine examinations. However, developing a teaching file is not an easy process, and one must follow a series of steps. To begin, there are four basic ingredients of the file: a subject file, case material, reference material, reference material, and a user's guide. Methods for developing each ingredient are discussed and analyzed. The result of this analysis is the basis for the proposed echocardiographic teaching file. The major factors to consider in setting up a file are space, cost, and time. One should try to minimize these parameters, so that the file is not a burden. Obviously, the initial development of the file will be time-consuming, but the maintenance should not take a large amount of time. The end result is an echocardiographic teaching file compatible with administrative procedures in your department benefiting all members of the laboratory.
Ultrasonically Guided Perurethral Transvesicle Aspiration of Follicles in an In Vitro Fertilization Program
Authors: Wott Kimberly J.
Published: March 2006

Successful ova retrieval under ultrasound guidance using a transabdominal approach has been described in the literature. Perurethral transvesicle approach is a new method used for retrieving the ova. The patient's bladder is distended and used as a window for viewing the ovary and the needle. The needle is placed in the urethra and passed into the bladder. The needle is then aligned with the ovary, and the follicles are punctured. This procedure has initially proven very successful in retrieving the ova.
Cystic Abnormalities of the Fetal Thorax
Authors: Weiss Jonathan D. , Cohen Harris L. , Haller Jack O. , Mayer Richard G.
Published: March 2006

The antenatal diagnoses of three cystic fetal thoracic abnormalities are described. The ultrasound findings led to early postnatal surgical attention and prompt therapeutic intervention. This report will discuss the differential diagnoses of cystic lesions of the fetal chest and stress the importance of antenatal identification.
Pediatric Cystic Renal Disease
Authors: Previte Lynne , DeLange Marie , Grube Gerald , Rouse Glenn
Published: March 2006

The kidney is one of the most common organs in which cysts develop. A wide variety of renal diseases may have cysts of the kidney associated with them, including hereditary, developmental, and acquired disorders. Renal cysts may arise from any part of the nephron or the collecting tubule and may be located in the cortex, medulla, or both. Classification is often difficult, because the cysts often resemble one another. Sonography has become increasingly useful in the diagnosis of pediatric renal cystic disease and in evaluation of fetal renal abnormalities in utero and can help narrow the differential diagnosis.
Equipment Considerations for Intraoperative Ultrasound
Authors: Shawker Thomas H. , Bradford Mary H. , Norton Jeffrey A.
Published: March 2006

For most ultrasound sections and especially for those who are just beginning intraoperative ultrasound, it will be necessary to perform these studies with scanners brought from the general ultrasound section. The purpose of this article is to familiarize sonographers with the preparation of equipment for intraoperative ultrasound: choosing and sterilizing the most appropriate transducer, and ensuring that the scanner is clean and electrically safe for operating room use.
Doppler Physics and Instrumentation
Authors: Hedrick W. R. , Hykes D. L.
Published: March 2006

The physical principles of continuous-wave and pulsedwave Doppler as well as the processing methods to detect the direction of flow are reviewed. An overview of Doppler instrumentation, including duplex, zero crossing, range-gated, and color flow imaging detection systems is presented. The technique of spectral analysis is explained with multiple illustrative examples. Aliasing, which arises from the limited sampling rate of pulsed wave instruments, is discussed in detail.
How to Get What You Want from Administration and Sales People
Authors: McClary Ann R.
Published: March 2006

The sonographer who has moved into a supervisory or administrative position is faced with learning the business aspects of medical care. Preparing reports and requesting new equipment must reflect a well-thoughtout plan. Providing decision-makers with complete information and supporting reasons for the request will result in more requests granted. This article addresses how to research, write, and present a request for equipment, evaluate the equipment, and deal with the sales situation.
Intraoperative Ultrasound
Authors: Shawker Thomas H. , Bradford Mary H. , Norton Jeffrey A.
Published: March 2006

Intraoperative ultrasound is increasingly employed in hospitals throughout the country. Involvement with this activity can result in a significant demand on the resources of an ultrasound section and can be a problem for sonographers, who must now work in the unfamiliar environment of the surgical suite. The purpose of this article is to provide sonographers with some general guidelines and suggestions about how to conduct an intraoperative examination and to discuss how ultrasound instrumentation can be operated with ease and comfort within the restricted setting of the operating room.
Color Flow Imaging
Authors: Powis Raymond L.
Published: March 2006

The latest change to occur in diagnostic ultrasound is color flow imaging. This technology presents an image with tissue in gray scale and blood flow in color. Image formation can be asynchronous or synchronous, representing different approaches to data gathering, and consequently different internal signal processing. This article focuses on how these technologies deal with problems in imaging and meeting clinical needs, and establishes the basic parameters needed for clinical vascular imaging.
Antenatal Sonographic Identification of Choroid Plexus Cysts
Authors: Persutte Wayne H. , Lenke Roger R. , Harris James H.
Published: March 2006

Two cases of choroid plexus cysts detected antenatally with ultrasonography are described. The first case involved an 18-week fetus with a 10 mm unilateral bilocular anechoic mass in the glomus of the choroid plexus. This mass resolved by ultrasonic examination at 23 weeks gestation. The second case presented at 21 weeks gestation with a unilateral anechoic mass in the choroid glomus of the left lateral ventricle. A 410 g female still-born was delivered 2 days following the initial examination. Histopathologic examination of the fetus revealed an 8 mm ependymal cyst. The significance of choroid plexus cysts is poorly understood. Some researchers have reported these cysts to be entirely benign while others report an association with chromosome defects. Review of the current literature revealed a 9.5% incidence of chromosome defects in fetuses with choroid plexus cysts.
Duplex Sonography of the Neonatal Brain
Authors: Taylor George A. , Catena Linda M. , Garin Debra B.
Published: March 2006

This article presents a review of intracranial Doppler techniques and their potential applications. Three approaches are described for interrogating major cerebral vessels: Sagittal and coronal anterior fontanelle, and axial transcranial approaches. Their advantages and limitations are discussed. The uses of pulsatility and flow velocity measurements in estimating blood flow are explored, with emphasis on the physiologic mechanisms that may alter these measures.
The Prevalence of Imaging Fetal Cardiac Anatomy
Authors: Cyr Dale R. , Komarniski Cathy A. , Guntheroth Warren G. , Mack Laurence A.
Published: March 2006

One hundred thirty fetuses were consecutively scanned to determine the prevalence of normal fetal cardiac anatomy. Gestational ages ranged from 20-40 weeks. The four-chamber, five-chamber, and short-axis views were sought in each fetus. Gestational age and fetal spine position were also documented. The fetal spine position was described as spine up, down, left, or right. Gestational ages were categorized into four sonographic age groups; 20-24, 25-29, 30-34, and 35-40 weeks. The number and percentage of echocardiographic views visualized were then calculated for overall population and individual gestational groups in relation to fetal spine position. In the overall gestational group, the fourchamber view was visualized in 99% of the fetuses, whereas the five-chamber and short-axis views were imaged in 95% and 69%, respectively. A three-view average was also calculated for each gestational age group. The highest combined view average was obtained in the 30-34 week group (94%), whereas the lowest was in the 25-29 week gestations (78%). The three-view average was highest in the fetal spine down position (100%), and worst in the fetal spine up position (79%). Spine left demonstrated an 86% mean three-view visualization average, and fetal spine right had a 95% three-view average. These data should aid the fetal echocardiographer in determining what fetal cardiac anatomy can and cannot be seen given the fetal spine position and gestational age.
Transrectal Ultrasound of the Prostate
Authors: Dakin Randy , Bedigian Karen , Grube Gerald L.
Published: March 2006

Knowledge of the sonographic appearance of normal prostate anatomy is essential to the recognition and diagnosis of prostate disease. Prostate transrectal scan technique, normal prostatic anatomy, and sonographic findings of the normal and diseased prostate gland are discussed.
A Review of Adenomyomatosis and Gallbladder Sonography
Authors: Ellington Melanie A.
Published: March 2006

Adenomyomatosis, characterized by excessive proliferation of the surface epithelium and thickening of the wall, is a benign tumor of the gallbladder. Sonographic appearance, symptoms, scanning protocol, and types of adenomyomatosis are discussed.
How to Interpret Equations in Ultrasound
Authors: Nelms Alan T.
Published: March 2006

Ultrasound physics, like other physics topics, is a maze of equations. This article presents an easy approach to understanding equations. This includes breaking down an equation into its components and understanding the function of each part. An overview of variable relationships is also included. Along with examples through the text, three word problem exercises are offered for practice and additional understanding.
Sonography of the Parotid Gland
Authors: Nall Linda A. , Krebs Carol A. , Adcock Dana , Giyanani Vishan L.
Published: March 2006

The purpose of this article is to acquaint the sonographer with the parotid gland anatomy, basic landmarks, and methods of sonographic examination. Pathologic conditions and their characteristic appearances will be reviewed, along with baseline criteria for evaluation of mass lesions.
Ultrasound in the Evaluation of Leukocoria
Authors: Haik Barrett G. , Zimmer-Galler Ingrid , Smith Mary E.
Published: March 2006

Infantile leukocoria, a white pupillary reflex, is the result of various neoplastic, inflammatory, hemorrhagic, or congenital ocular conditions. Combined B and A scan ultrasonography is a safe, easily performed, highly informative diagnostic technique which aids in the identification of ocular pathology (even when ophthalmoscopic examination is precluded). This report summarizes the clinical course, pathologic findings, and acoustic characteristics of retinoblastoma, persistent hyperplastic primary vitreous, Coats' disease, retrolental fibroplasia, vitreous hemorrhage, congenital cataract, and ocular toxocariasis.
Risk Management: Part 2
Authors: Scott Ricardo Ainsley
Published: March 2006

Most medico-legal cases that arise result from a person's or institution's act or a failure to act. This exposes the patient to injury or loss. The risks and resulting failures usually take the form of failure to inform or to obtain informed consent, failure to perform, failure to diagnose, failure to treat or refer, failure to monitor, or negligence. Some of these failures will be examined as they relate to and affect ultrasonography. For a more detailed review of the cases, the citations may be consulted.
Transesophageal Echocardiography
Authors: Tye Terrence L. , Nellessen Ulrich , Schnittger Ingela , Popp Richard
Published: March 2006

Transesophageal echocardiography is one of the new techniques available to ultrasound practitioners that uses intracavitary high-frequency phased array transducers. Transesophageal echocardiography provides diagnostic information in the patient that is difficult or impossible to image using standard transthoracic echocardiographic techniques. Presented here is an overview of transesophageal echocardiographic technique, a description of the anatomy demonstrated by using the technique, and the clinical indications for the transesophageal echocardiogram.
Detection of Renal Artery Stenosis by Duplex and Color Flow Doppler
Authors: Moulton-Levy Denise
Published: March 2006

This paper discusses the scan protocol of the abdominal arteries, describes the Doppler velocity variations observed in patients with renovascular disease, and correlates renal artery stenoses of > 60, 85, and 99% with arteriography. Ninety-two duplex deep Doppler scans with velocity and waveform analysis of 139 renal arteries were performed with a total of 77 patients studied. Deep Doppler studies of 72 renal arteries were correlated with 47 renal arteriograms. A renal artery stenosis, RAS, >60% was diagnosed by measuring velocities at the renal artery origins and observing distal renal artery waveform characteristics (normal, resistant, or delayed). The conclusion of this study is that deep Doppler of the renal arteries can play an important role in the line of testing procedures for diagnosing renovascular disease. The results for detecting a renal artery stenosis, RAS, greater than 60% against the gold standard of renal arteriography is 78% sensitivity, 83% specificity, 84% accuracy, and 61% prevalence. The negative predictive value is 74% and the positive predictive value is 95%.
The Gastrointestinal Wall Layers
Authors: Williams Darlla M. , Rouse Glenn A. , Tan-Sinn Phil-Ann
Published: March 2006

Recent developments in the understanding of the sonographic appearance of the bowel wall, made possible by improvements in ultrasound technology, have given sonography a unique role to play in the evaluation of gastrointestinal lesions. Changes in wall thickness, alterations of normal structures, and complete obliteration of the entire wall structure can be observed. This report reviews the sonographic appearance of the histologic wall structures and shows cases that illustrate how the knowledge of those structures can help the sonographer to evaluate gastrointestinal lesions.
Interpretation of the Correlation Coefficient: A Basic Review
Authors: Taylor Richard
Published: March 2006

A basic consideration in the evaluation of professional medical literature is being able to understand the statistical analysis presented. One of the more frequently reported statistical methods involves correlation analysis where a correlation coefficient is reported representing the degree of linear association between two variables. This article discusses the basic aspects of correlation analysis with examples given from professional journals and focuses on the interpretations and limitations of the correlation coefficient. No attention was given to the actual calculation of this statistical value.
Postnatal Sonographic Evaluation of Bilateral Renal Agenesis with Filling of the Renal Fossa by the Adrenal Glands
Authors: Krebs Carol A. , Adcock Dana
Published: March 2006

Bilateral renal agenesis can be detected easily by sonography during the postnatal period. Careful sonographic observation of the flattened ovoid adrenal glands filling the renal fossa, in addition to a complete survey of the abdomen and pelvis to rule out renal ectopia, provides a definitive diagnosis.
Ultrasound as a Visual Feedback Aid for the Hearing-Impaired
Authors: Foss M. C. , Whitehead B. , Paterson M. , Whitehead R.
Published: March 2006

Ultrasound was explored as a visual feedback aid to assist in improving the speech of the deaf and hard of hearing. A mechanical sector real-time scanner produced images of the volunteer's tongue while a speech pathologist provided therapeutic intervention. Pre and postarticulation tests were administered to evaluate change in speech.

Ultrasound as a visual feedback aid may be potentially useful for improving articulation problems for some hearing-impaired speakers. Further research with this population needs to be carried out to explore the practicality of using ultrasound as a visual feedback aid and to gather quantitative data on the long-term effects of learning.

This study has demonstrated that typical real-time sector ultrasound scanners, of the type found in the field today, can be modified to produce useful images of the human tongue during speech production. It is yet unknown what specific type of scanner as well as frequency range is best suited for tongue placement imaging.
Endovaginal versus Transabdomrin Sonograh
Authors: Damato Nicole M.
Published: March 2006

Transabdominal and endovaginal sonograms of 40 patients with 48 nonuterine pelvic masses were reviewed retrospectively. The two techniques were compared with regard to the following characteristics of the mass: (1) size and visualization, (2) border thickness, and (3) internal architecture. A good correlation between transabdominal and endovaginal size measurements was observed in 75% of the cases. The endovaginal technique was better than the transabdominal technique in detecting thickened borders in 40% of the cases. Endovaginal demonstration of internal characteristics was also found to be superior to transabdominal in 60% of the cases. From this study, it is evident that transabdominal and endovaginal sonography each have their own limitations and advantages. For this reason, an optimal gynecologic study of the adnexa should include both techniques in order to arrive at proper clinical diagnoses.
Intraoperative Color Flow Mapping in Evaluating Valvular Repair for Mitral Regurgitation
Authors: Ottman Vicki L. , Tye Terrence L.
Published: March 2006

Intraoperative color flow Doppler echocardiography is uniquely suited to evaluate blood flow dynamics. By using direct epicardial imaging techniques, the efficacy of a surgical valvular repair can be instantaneously evaluated to assist the cardiac surgeon. If regurgitation is detected, surgeons may reexpose the valve and continue with further reconstruction or with replacement. The ability of color flow Doppler to assess surgical repairs prior to chest closure helps improve operative results.
Ultrasound as Used in the Framingham Hearl Study
Authors: Poehlmann Harold W. , Levy Daniel , Castelli William P.
Published: March 2006

In 1949-50, 5209 individuals were recruited from the town of Framingham, Massachusetts for an epidemiologic study of cardiovascular disease. In 1971 a group of offspring and spouses were recruited for inclusion in the study group. The original cohort is in its 40th year of continuous medical surveillance. The research findings have contributed significantly to what is now known about risk factors and diseases of the heart and circulatory system. Ultrasound examinations have helped expand our knowledge of left ventricular hypertrophy, mitral valve prolapse, extracranial carotid artery disease, and cardiac disease in general. This paper discusses these and some of the latest research findings from the Framingham study.
The Evaluation of Mitral Regurgitation:
Authors: Reynolds Terry , Warner Mary Grace , Appleton Christopher
Published: March 2006

In the late 1970s, conventional Doppler techniques, specifically pulsed-wave (PW) Doppler and continuouswave (CW) Doppler, enabled the cardiac sonographer to detect the presence and determine the severity of mitral regurgitation. In the mid 1980s, with the introduction of color flow Doppler, the regurgitant jet area (RJA)/left atrial area (LAA) ratio quickly became the yardstick by which the severity of mitral regurgitation was judged. This simple ratio came to overshadow or even replace the conventional Doppler techniques that had preceded the ratio method. It is our contention that there is currently an overemphasis on the RJA/LAA ratio and we believe that a more balanced approach should be adopted in order to determine the severity of mitral regurgitation.
Endovaginal Sonographic Associated Features of a T-Shaped Uterus Due to In Utero Exposure to Diethyistilbestrol (DES)
Authors: Sherer David M. , Allen Tamara A. , Woods James R.
Published: March 2006

In utero exposure to diethylstilbestrol (DES), a synthetic estrogen, affects structures arising in the mullerian duct system of female fetuses. Transabdominal sonography has been found to be a nonionizing, noninvasive alternative to hysterosalpingography in diagnosing these congenital abnormalities. Endovaginal sonography has shown enhanced resolution of the female pelvic organs. The endovaginal features of a T-shaped uterus due to in utero DES exposure are presented in a woman with infertility.
Hypertrophic Cardiomyopathy in an Infant of a Diabetic Mother
Authors: Persutte Wayne M. , Lenke Roger R. , Levine Marc M. , Farnsworth Rebecca , Brookfield Ernest
Published: March 2006

We present a case of neonatal hypertrophic cardiomyopathy associated with maternal diabetes mellitus, which was not identified in utero with ultrasonography immediately prior to delivery, yet caused profound neonatal complications immediately following delivery. The perinatal presentation of diabetic hypertrophic cardiomyopathy has not been previously reported. The patient was initially referred to our facility for prenatal management of adult onset diabetes mellitus. Difficulties in maintaining blood sugar stability were encountered throughout gestation. Ultrasonographic examinations at 18 and 22 weeks showed no anomalies of the fetus, nor was abnormal amniotic fluid observed. Follow-up examination at 27 weeks showed an excess of amniotic fluid. At 31 and 32 weeks gestation, fetal macrosomia and a fetal cardiac arrhythmia (compatible with premature ventricular contractions) were observed. Upon echocardiographic examination at 34 and 35 weeks gestation, no atypical findings were identified. The infant was delivered 1 day after the final in utero assessment at 35 weeks and it developed complications resulting from left ventricular obstruction and hypertrophic cardiomyopathy. Previous reports have stated that the prenatal and postnatal biometric analysis of the fetus, in both normal and diabetic pregnancies, have correlated. We report a case of perinatal onset hypertrophic cardiomyopathy in an infant of a diabetic mother. This case represents an unusual scenario which may result in profound and unanticipated postnatal complications.
In Utero Diagnosis of Multiple Intracardiac Tumors
Authors: Wheller John J. , Cordier Joyce M. , Allen Hugh D.
Published: March 2006

Obstetric ultrasound evaluation of the fetus should include routine imaging of the heart. The four-chamber view provides valuable information regarding the presence or absence of structural heart disease.' Fetal heart rate and rhythm are also studied as a routine part of the obstetric scan. Thus, dysrhythmias can be evaluated accurately. The finding of unsustained fetal atrial dysrhythmia is common and usually not associated with structural heart disease.2,3 This case report describes the ultrasound evaluation of a fetus with multiple intracardiac rhabdomyomas and an unsustained asymptomatic atrial dysrhythmia. This case emphasizes the importance of the basic four-chamber fetal cardiac view when scanning the fetal heart.
Two-Dimensional Doppler Echocardiographic Derived Aortic Valve Area in Aortic Stenosis
Authors: Waggoner Alan D. , Barzilai Benico , Perez Julio E.
Published: March 2006

Two-dimensional Doppler echocardiography provides qualitative and quantitative information in patients with aortic stenosis. An illustrative case is presented that describes the use of combining these techniques: two-dimensional echo for valve morphology, left ventricular outflow tract area and left ventricular systolic function, pulsed Doppler for estimating cardiac output, and continuous wave Doppler to derive peak and mean systolic gradients. In this patient, continuous-wave Doppler underestimated the severity of stenosis, based on the systolic peak and mean gradient due to reduction in the cardiac output. Patients who have aortic stenosis and ventricular dysfunction should also have the severity of the stenosis determined by estimating the valve orifice area with the continuity equation.
Neonatal Intracranial Hemorrhage
Authors: Baun Jim
Published: March 2006

Intracranial hemorrhage is a leading cause of morbidity and mortality in the preterm neonate. Sonographic examination techniques allow accurate non-invasive diagnosis and follow-up. The pathophysiology of ICH is discussed. Sonographic findings are reviewed as are clinical considerations in infants with ICH.
Asplenia and Polysplenia
Authors: Patel Raksha K. , Rouse Glenn A. , Tan-Sinn Phil-Ann
Published: March 2006

Abdominal sonograms on seven patients with asplenia syndrome and six patients with polysplenia syndrome were retrospectively reviewed. All seven patients with asplenia had a horizontal symmetric configuration of the liver, and three patients had the cardiac apex opposite the stomach. Four of six patients with polysplenia syndrome had a symmetric configuration of the liver, and in five patients the cardiac apex was opposite the stomach. In two of six patients with polysplenia syndrome, multiple spleens were observed sonographically, and the spleen was noted sonographically to be lobulated in three of the patients. The spleen was not visible on at least one sonographic examination in three patients with polysplenia in which the presence of the spleen was subsequently documented. Four patients with polysplenia syndrome showed an interruption of the inferior vena cava. The authors conclude that the knowledgeable sonographer can usually identify the complex abdominal anomalies that are observed in these syndromes if an organized survey of the abdominal organs, particularly the venous structures, is performed. The spleen may be difficult to identify in some patients, and other abdominal anomalies, especially interruption of the interior vena cava can serve as valuable clues that the spleen is probably present, and further search for it is indicated.
Biological Effects of Ultrasound
Authors: Hedrick W. R. , Hykes D. L.
Published: March 2006

To correlate potential bioeffects with exposure to ultrasound, a quantitative characterization of the ultrasound beam is essential. As a first step in this process various intensity descriptors have been developed. These intensity descriptors are defined and compared. The intensity ranges of different types of diagnostic instruments are presented.
The Definitive Assessment of Aneurysm by Color Flow Doppler
Authors: Schroedter William B. , Holec Sidney W.
Published: March 2006

With the advent of advanced duplex ultrasound or color flow Doppler, the authors believe that a complete assessment of aneurysm can be obtained by ultrasound alone. The information required by the surgeon for surgical resection of various types of aneurysms is outlined. The ability of color flow Doppler to rapidly assess both the arterial wall and residual lumen, identify stenoses and branches, in addition to simplifying complex flow phenomenon make it uniquely qualified for this task. To date, the authors have completed eight aortic grafts based solely on the ultrasound findings.
Management by Objective(MBO) Used as an Effective Clinical Education Methodology
Authors: Pearson Jerry R. , Reyes Lynn K.
Published: March 2006

The climate that has developed from the shortage of imaging professionals has placed increased burdens on clinical instructors. Thus, educational programs must ensure that students continue to receive appropriate clinical education. One simple technique that has been successful in ensuring appropriate clinical education at the institution of the authors is discussed.
Biologic Effects of Ultrasound
Authors: Hedrick W. R. , Hykes D. L.
Published: March 2006

Epidemiologic studies form the basis for any policy regarding the clinical safety of ultrasound. An overview of experimental design and the difficulties inherent in such studies are discussed. An extensive summary of reports of populations exposed in utero is presented.
Sequential Bilateral Germ Cell Tumors of the Testis
Authors: Frank Ronald G. , Gerard Perry S. , Wise Gilbert J.
Published: March 2006

Testicular tumors are rare and account for less than 1% of all cancers in men. In 1% to 5% of cases, these tumors are bilateral. Sonography of the scrotum is important for the initial diagnosis and serial followup in the early diagnosis of a contralateral tumor. A case report of a man with sequential bilateral testicular tumors is presented with a review of the literature. Emphasis is placed on the importance of sonography in the evaluation of these tumors.
Two-Dimensional Echocardiographic Diagnosis of a Left Atrial Free Wall Myxoma
Authors: Lincoln Douglas A.
Published: March 2006

All cardiac tumors are potentially lethal due to the hemodynamics involved, complications of emboli, and cardiac arrhythmias.1 The most common appearance of a left atrial myxoma is a pedunculated mass attached to the interatrial septum that traverses the mitral valve orifice during diastole.2 A myxoma attached to the atrial free wall is considered rare but easily recognized by two-dimensional echocardiography.
Sonographic Evaluation of the Spine in Infants and Neonates
Authors: Westbrook Craig S. , Rouse Glenn A. , de Lange Marie
Published: March 2006

Ultrasound is a rapid, noninvasive, cost-effective method of evaluating the spine in infants younger than six months of age. This report reviews sonographic scan procedure and normal sonographic spinal anatomy, and illustrates the sonographic appearance of occult spinal anomalies, such as meningocele, meningomyelocele, tethered cord, diastematomyelia, and sacrococcygeal teratoma.
Antenatal Sonographic Evidence of a Paratesticular Mass Representing Healed Meconium Peritonitis
Authors: Frank Ronald G. , Friedman Steven C. , Krieger Alan , Gerard Perry S. , Lindsay Kris , Wise Gilbert J.
Published: March 2006

Scrotal masses representing healed meconium peritonitis have been reported in the literature with increasing frequency. The first case of antenatal sonographic evidence of a paratesticular mass that was shown to represent healed meconium peritonitis at subsequent exploration is discussed in this report.
Spontaneous Pseudoaneurysm of the Carotid Artery in a Patient with Behcet's Disease
Authors: Woods K. Todd , Sathyanarayana
Published: March 2006

Behqet's disease is today considered a chronic multisystem disorder. The sequela of this disease depends on the particular organs involved. A nonspecific vasculitis, however, is a common trait found in patients afflicted with vascular Behqet's disease. Trauma to a vessel affected by Behset's disease can lead to aneurysmal formation. Duplex ultrasound examination has proved a useful diagnostic tool in patients who are clinically suspect for vascular lesions. Diagnostic information from invasive procedures must be weighed against the potential to cause aneurysms. A case report of a man with a pseudoaneurysm of the carotid artery and the subsequent diagnosis of Behqet's disease is presented.
Cholelithasis
Authors: Jeraj Shenaz
Published: March 2006

Extracorporeal shock wave lithotripsy (ESWL) is one nonsurgical method available to treat cholelithiasis. Optimal imaging of gallstones is crucial in assessment and treatment using ESWL. The purpose of this study was to see if placing the patient in the left anterior oblique (prone with the right side elevated) position, rotating the patient 360°, or doing both of these things made it easier to visualize and measure gallstones during ultrasound examination of patients both before and after lithotripsy. There was improvement in stone visualization in 29% of the cases in this study when one or the other of these positions was used.
The Role of Sonography in the Management of Isoimmune Fetal Hemolysis (Rh Disease)
Authors: Savoia Carla J. , Rouse Glenn A. , de Lange Marie
Published: March 2006

The management of isoimmune fetal hemolysis (Rh disease) has changed rapidly with the advent of new ultrasound-guided procedures, such as cordocentesis and intravascular transfusion. In this report, the pathophysiology of, clinical management strategy of, and role of sonography in isoimmune fetal hemolysis are studied.
Preoperative Diagnosis of Third Trimester Abdominal Pregnancy by Transvaginal Ultrasound
Authors: Faustin Daniel , Halio David , Shiffman Rebecca , Flaxman Lawrence , Castro Jose
Published: March 2006

Abdominal pregnancy is a potentially lethal condition that is often misdiagnosed. A clinically suspected abdominal pregnancy at 31 gestational weeks was demonstrated by transvaginal sonogram and confirmed at laparotomy.
Urachal Cyst Presenting as a Complex Mass in an Adult
Authors: Barwick Charles
Published: March 2006

Most urachal cysts remain clinically silent until an infection develops in adulthood. The majority of urachal cysts are seen sonographically as anechoic tubular structures in the anterior abdominal wall. Mixed echogenicity, however, may be seen within the cyst when infection is present. A case report is presented, as well as a review of the differential diagnosis.
Sonographic Identification of an Acardiac Twin Presenting as Vanishing Twin Phenomenon
Authors: Lavoie Barbara J.
Published: March 2006

With the use of ultrasound examination during the first trimester of pregnancy becoming more widespread, the diagnosis of twin gestations is being made more frequently and earlier in the pregnancy. Similarly, the diagnosis of the first trimester demise of one fetus is also being made earlier and with greater frequency. This phenomenon is referred to as the "vanishing twin."1 The usual complication associated with the disappearing embryo is vaginal bleeding. Serial sonographic examinations of a pregnancy involving this phenomenon will show a distortion of one gestational sac in early pregnancy and disruption of the organization of the embryo, with a decrease in the echogenicity and definition of embryo shape. Over time, sonographic examination will show a separate, fluid-filled space adjacent to the normally progressing pregnancy and, finally, no evidence of the previous gestation.12 We report a case where a vanishing twin was diagnosed at a gestational age of 8 weeks, but upon serial scanning was noted to be an acardiac twin.
Recurrent Seminoma with Sonographic and Pathologic Correlation
Authors: Dempsey Jack , Brooks Jay
Published: March 2006

Recurrent seminoma in the contralateral testicle after orchiectomy is a rare occurrence, with a reported incidence less than 5%. Testicular ultrasound was performed on a 36-year-old man with a clinical history of previous left orchiectomy for testicular neoplasm. Recurrent seminoma was the pathologic diagnosis in the remaining right testicle. This can be a difficult diagnosis to make using ultrasound due to previous orchiectomy.
Color Doppler Imaging
Authors: Hedrick W. R. , Hykes D. L.
Published: March 2006

Color Doppler instruments provide gray-scale imaging with two-dimensional flow in real time. Velocity information is encoded in color. Color Doppler imaging parameters, including packet size, color gate, color gain, color reject, capture function, velocity map, and velocity tag, are described. Color Doppler image quality is characterized by motion discrimination, temporal resolution, spatial resolution, and uniformity.
The Sonographic Detection of Intracranial Hemorrhage Due to Alloimmune Thrombocytopenia
Authors: Ackerman Brenda , Rouse Glenn A. , de Lange Marie , Bedros Antranik A. , Sakala Elmer P.
Published: March 2006

Alloimmune thrombocytopenia is a rare condition in which antibodies from the mother's circulation cross the placenta and destroy the platelets in the fetus. Approximately 14% of affected fetuses or neonates develop intracranial hemorrhage, leading to death or long-term central nervous system disabilities. After treating two such cases, 26 previously reported cases of alloimmune thrombocytopenia with intracranial hemorrhage were examined to discover if these hemorrhages exhibit a typical sonographic appearance, course, and time of hemorrhage. When intracranial hemorrhage occurs in cases of alloimmune thrombocytopenia, it has a typical appearance in 76% of cases: a large hematoma in the center of the cerebral hemisphere. There is no difference between genders in the occurrence of alloimmune thrombocytopenia unless hemorrhage occurs: 72% of neonates with alloimmune thrombocytopenia and intracranial hemorrhage are male. Intracranial hemorrhage occurs before labor and delivery in 76% of cases. Sonographers cannot depend on a history of the condition in previous pregnancies as an indication of alloimmune thrombocytopenia: only 35% of neonates with alloimmune thrombocytopenia and hemorrhage have previously affected siblings.
Sonographer-Fetus Bonding
Authors: Ruiz Miguel A. , Murphy Kathleen
Published: March 2006

A survey of 50 obstetrical sonographers was conducted in the Phoenix metropolitan area to assess certain aspects of fetal ultrasound. The primary concern was the evaluation of sonographer opinions on abortion prior to their experience in ultrasound as compared to their current views, and if "seeing" the fetus sonographically had altered their beliefs. Attention was also placed on the sonographer's perspective on maternalfetal bonding as a result of ultrasound, as well as on sonographer practices of communicative feedback to patients during obstetrical ultrasound examinations. The results of the survey indicate that: 1) seeing the fetus has indeed altered sonographers' opinions on abortion; 2) sonographers strongly believe that maternal-fetal bonding is strengthened by the sonographic demonstration of the fetus; and 3) there is widespread practice of high-feedback sonography.
A Simplified Explanation of Fourier Analysis
Authors: Hedrick W. R. , Hykes D. L.
Published: March 2006

An overview of Fourier analysis with applications in ultrasound physics is presented. Parameters used to characterize sine waves and the technique of combining sine waves to form more complex patterns are discussed. The concept of the frequency domain is explained with multiple illustrative examples.
Can Prenatal Ultrasound Predict Pulmonary Hypoplasia?
Authors: Sherer David M. , Abramowicz Jacques S. , Woods James R.
Published: March 2006

Pulmonary hypoplasia is often associated with sonographically detectable conditions: oligohydramnios, prolonged premature rupture of membranes, and, not infrequently, fetal anomalies. In their efforts to improve prenatal sonographic diagnosis of this condition, investigators have used an array of different sonographic biometric measurements and fetal behavioral patterns. Definitions of these measurements and their respective successes in predicting pulmonary hypoplasia are presented. The sonographic parameters that have been of most value in the prediction of pulmonary hypoplasia are chest circumference, direct measurements of the lung, lung length, lung span to hemithorax diameter, and more complex formulas, such as lung area/heart area x 100/chest area. Although fetal measurements may help predict pulmonary hypoplasia, no single sonographic finding consistently leads to a prediction of the presence of pulmonary hypoplasia. Therefore, obstetric management (i.e., nonintervention) cannot currently be altered with the finding of abnormal biometric parameters unless a known lethal anomaly is observed.
Sonographic Findings in an Infarcted Sigmoid Appendix Epiploica During Pregnancy
Authors: Duda John J. , Thickman David , Gould Stanley F.
Published: March 2006

An infarcted sigmoid appendix epiploica in a pregnant patient with left lower quadrant pain was identified as a hypoechoic extrauterine mass on ultrasound examination. Ultrasound can help identify more common causes of pain in pregnancy, such as ectopic pregnancy, placental abruption, or degeneration of a leiomyoma. When these are excluded, rare causes of abdominal pain in the pregnant patient, including infarcted appendix epiploica, need to be considered.