bluuebunny/crossref_metadata_2025 huggingface dataset:
The value of endovaginal sonography and urinary human chorionic gonadotropin tests for differentiation between intrauterine and ectopic pregnancy
Authors: Enk Lennart , Wikland Matts , Hammarberg Karin , Lindblom Bo
Published: February 2007

Effectiveness of vaginal sonography combined with urinary human chorionic gonadotropin (hCG) for identification of ectopic pregnancy (EP) was studied in 107 pregnant women. Eighty‐nine women had clinical symptoms suspicious of EP. It was suggested that 18 women carried an increased risk for developing EP. In 63 women endovaginal sonography showed no evidence of intrauterine pregnancy. Fifty‐eight of these turned out to be pathological pregnancies. In 44 women endovaginal ultrasonography revealed intrauterine pregnancies. Thirty‐two of these turned out to be viable, 10 were not viable and resulted in spontaneous abortions, and 2 turned out to be EP. The sensitivity of vaginal sonography to identify a viable intrauterine pregnancy thus was 81% and its specificity was 97%. The sensitivity and the specificity for endovaginal ultrasonography for identifying EP was 96% and 71%, respectively.

Endovaginal ultrasonography demonstrated an intrauterine gestational sac in 54% of the women with urinary HCG as low as 40 IU/L to 500 IU/L.

These results show that endovaginal ultrasonography is a sensitive instrument for identifying both early normal intrauterine pregnancies as well as pathological pregnancies.
Changes in fetal hemodynamics with terbutaline treatment and premature labor
Authors: Sharif Dawod S. , Huhta James C. , Moise Kenneth J. , Morrow Robert W. , Yoon Grace Y.
Published: February 2007

The aim of this study was to examine the fetal hemodynamic effects of terbutaline treatment and premature labor. Image‐directed pulsed and continuous wave Doppler ultrasound studies, using 3.3‐MHz and 5‐MHz transducers (GE PASII and ATL echocardiographic machines), were used to assess fetal cardiac blood velocities in three groups of pregnancies matched for menstrual age (MA). Group 1: 13 normal pregnancies, mean MA 31 weeks. Group 2: 7 women in premature labor prior to tocolytic therapy, mean MA 32 weeks. Group 3: 8 women treated with terbutaline, average dose 18.8 mg daily, for previous premature labor, mean MA 31 weeks. Heart rate averaged 150 bpm, 135 bpm, and 127 bpm in the terbutaline, premature labor, and normal groups, respectively, and each were significantly different from each other. Products of time velocity interval and heart rate at the aortic valves were 1603 cm ± 140 cm, 1413 cm ± 190 cm and 1238 cm ± 200 cm, and at the mitral valves 1102 cm ± 170 cm, 812 cm ± 110 cm, and 878 cm ± 150 cm in the terbutaline, premature labor, and the normal groups, respectively. Aortic and mitral blood velocity products of time velocity integrals and heart rates were significantly higher (p = 0.01) in the terbutaline group relative to the normal group. In addition, the terbutaline group was significantly higher than the labor group at the mitral valve (p = 0.01). There was no statistically significant difference in time velocity integrals (a measure of stroke volume) at either valve between the three groups.

It is concluded that both terbutaline and premature labor are associated with higher fetal heart rates relative to normals. Higher fetal heart rates were associated with increased left‐sided cardiac blood flows. Stroke volume was constant with increased heart rate, suggesting increased cardiac contractility with both preterm labor and terbutaline treatment.
Ultrasonography of nodular and infiltrative lesions of the skin and subcutaneous tissues
Authors: Nessi Renato , Betti Roberto , Bencini Pier Luca , Crosti Carlo , Blanc Marco , Uslenghi Carlo
Published: February 2007

Ultrasonography with high‐frequency probes was performed on 80 dermatological patients carrying palpable lesions of the skin. The case list included hemo‐and lymphangiomas (16 cases), cysts (13 cases), Kaposi sarcomas (9 cases), and panniculitis (20 cases). All lesions underwent open biopsy and histological examination.

Ultrasound yielded technically adequate images in 74/80 cases (93%). Angiomas appeared as multiple transonic cavities separated by hyperechoic septa; cysts were usually echo free or weakly echogenic, with smooth outlines. Kaposi sarcomas corresponded to superficial hypoechoic nodules with blurred margins, while panniculitis appeared as a diffuse thickening of the subcutaneous space. When acute inflammation was present, as in most cases of erythema nodosum, a nonhomogeneous hypoechoic pattern was found.
Is the corpus luteum normal after ovulation induction?
Authors: Lenz Suzan , Lindenberg Svend
Published: February 2007

Repeated ultrasound examinations and blood samplings for determination of estradiol (E), progesterone (P), and luteinizing hormone (LH) were carried out in 15 normal and 11 clomiphene citrate (CC)/human menopausal gonadotropin (hMG) stimulated cycles. Human chorionic gonadotropin (hCG) was administered in the stimulated cycles on the day of the expected LH‐peak as determined in each woman's normal cycle. Ovulation and normalcy of the luteal phase were confirmed by the hormonal values. Ultrasound examinations showed development of a single follicle in the normal group and development of 4.1 follicles on average, of 15 mm or more in diameter in the stimulated group (total of 45 follicles). Midluteal phase images at the site of the former follicle showed echogenic structures or echo‐free structures with scattered echoes in 25 cases in the stimulated group and in 11 cases in the normal group. There was no sign of the former follicle in 1 and 3 cases, respectively, in the two groups. A significantly higher number of “persistent follicles” was seen in the stimulated group: 42% vs. 7%. It is discussed whether a compromized corpus luteum function occurs after stimulation despite a normal luteal phase.
Major complications and deaths due to interventional ultrasonography: A Review of 8000 cases
Authors: Nolsøe Christian , Nielsen Lars , Torp‐Pedersen Søren , Holm Hans Henrik
Published: February 2007

Complications related to approximately 8000 ultrasound‐guided punctures performed in our institution during the last 19 years are reported. This study includes 3500 fine needle biopsies, 700 large bore needle biopsies, 2800 punctures of fluid collections using either a 1.2‐mm spinal needle or a 7.5 F pigtail catheter, and 1000 percutaneous nephrostomies. The majority were abdominal punctures. The complication rate was 0.187% (0.100% to 0.313%) and the mortality rate 0.038% (0.013% to 0.113%). Using the fine needle data exclusively, these rates were 0.200% (0.086% to 0.400%) and 0.028% (0.000% to 0.171%), respectively. The 95% confidence limits are in brackets.
Transvaginal color Doppler imaging
Authors: Kurjak Asim , Jurkovic Davor , Alfirevic Zarko , Zalud Ivica
Published: February 2007

Transvaginal color Doppler was used to assess circulation in pelvic vessels in a group of 64 patients including 15 patients with fertility problems, 18 patients with pelvic tumors, 2 cases of suspected ectopic pregnancy, and 29 pregnant patients with fetuses between 6 weeks and 10 weeks, menstrual age.

Blood flow was successfully displayed by color Doppler in the external and internal iliac arteries, and the uterine atreries, but flow in ovarian arteries could not be visualized.

In the subgroup of patients with pelvic tumors, neovascularization of tumor tissue was documented in 6 out of 10 cases of uterine fibroma and in 2 cases of ovarian cancer. In 6 cases involving benign ovarian pathology, no abnormal blood supply was observed. A comparison between the characteristics of blood flow within uterine fibro‐mas and ovarian malignancies showed lower impedance and higher blood velocity in cases of malignancy.

In early pregnancy blood flow in the umbilical artery could be visualized by color Doppler starting from the 6th week and flow in the aorta from the 8th week. Flow in the trophoblasts was observed with an overall success rate of 59% and successfully demonstrated in 1 out of 2 cases of ectopic pregnancy.
Early determination of fetal sex using transvaginal sonography: Technique and pitfalls
Authors: Bronshtein M. , Rottem S. , Yoffe N. , Blumenfeld Z. , Brandes J. M.
Published: February 2007

Transvaginal sonography (TVS) enables sex determination at an early stage of pregnancy. The morphologic features of fetal external genitalia at 13 weeks to 16 weeks, menstrual age, are different from those seen later in pregnancy; therefore an attempt to determine fetal gender at this early stage by the same criteria as those used later is hazardous, especially for determining the male sex. The main diagnostic criteria for male gender determination by TVS are the “dome” sign representing the sonographic visualization of the fetal scrotum, the cranially directed phallus, and the longitudinal raphe at the base of the penis. The diagnostic criteria for female gender are the 2 or 4 parallel lines representing the labial folds and the caudally directed phallus (clitoris). The length of the fetal phallus at this early stage is not diagnostic and may be the main pitfall to the unexperienced sonographer.

Between weeks 13 and 14 sex diagnosis was possible in 130/171 pregnancies (76%) in our first 2 years and 1881235 (80%) in our last 2 years of experience. Between weeks 15 and 16 sex diagnosis was possible in 122/139 pregnancies (88%) during our first 2 years and 96.7% (528/546) during the last 2 years of experience. The accuracy rate for fetal male gender identification increased from 91.7% during the first 2 years of TVS experience to 99.7% during the last 2 years of TVS experience, and the accuracy rate for female gender identification, increased from 93.3% to 100%, respectively, applying the above criteria and based on acquired experience of early fetal sex identification by TVS early in gestation. Early and precise determination of fetal sex is possible and might avoid invasive procedures such as amniocentesis.
First trimester selective reduction in multiple pregnancy guided by transvaginal sonography
Authors: Itskovitz Joseph , Boldes Rafael , Thaler Israel , Levron Jacob , Rottem Shraga , Brandes Joseph M.
Published: February 2007

Transvaginal ultrasonography‐guided fetal reduction was performed in 11 patients presenting with multiple pregnancies. Embryonic aspiration was carried out in 7 women at 7 to 8 weeks and in 4 patients fetal intrathoracic injection was performed at 9 to 11 weeks, menstrual age. Seven patients delivered healthy babies at >35 weeks, 3 have delivered prematurely 15 to 17 weeks after the procedure with subsequent neonatal death of all sets of twins. We believe that our method overcomes the technical difficulties related to the transabdominal or transcervical approach and should be the method of choice for early selective abortion.
Transvaginal sonography in postmenopausal women
Authors: Schoenfeld Alex , Levavi Hanoch , Hirsch Michael , Pardo Joseph , Ovadia Jardena
Published: February 2007

Transvaginal sonography (TVS) is a recent addition to the diagnostic techniques available for the evaluation of the female pelvis. Our experience in over 200 cases of postmenopausal women is the subject of this synoptic review. Using this technique in 60 women, we were able to detect endometrial changes such as endometrial carcinoma or adenomatous hyperplasia in 81% and in a group of 19 patients myometrial invasion in 84%. Fibroids of different sizes and locations could be recognized, some of them with signs of cystic degenerations.

In 48 postmenopausal women, TVS was used to follow the morphologic changes in the endometrium stimulated by hormone replacement therapy. Histological features of the endometrium were in close correlation with the sonographic patterns obtained.

Ultrasound evaluation has been suggested as a possible screening tool for early changes in ovarian size and morphology. Fifty patients were evaluated for the effectiveness of TVS to detect ovarian pathology. The sensitivity and specificity were 83% and 100%, the same as that of gross examination of the ovary at the time of surgery. It seems that TVS is a reliable tool in the detection of early changes in the postmenopausal ovary, but further evaluation in a large population is necessary to assess the usefulness of TVS as a routine screening tool for early ovarian carcinoma.

Twenty‐nine postmenopausal women with unilateral simple cysts (diameter ≤ 5 cm) were identified. All exhibited benign histopathologic changes. We conclude that small (<5 cm) postmenopausal cysts have a low incidence of malignancy and could be followed by TVS without immediate surgical intervention.

Local recurrences in gynecologic neoplasms were evaluated in 21 postmenopausal women after previous surgery, radiation, and chemotherapy in cases of endometrial, cervical, and ovarian carcinomas. Using the criteria of malignant mass at the cranial end of the vagina and the size of vaginal vault, the TVS demonstrated recurrency with a sensitivity of 100%, specificity of 83%, and overall occurrence of 90.4%.

Identifying and characterizing cul‐de‐sac fluid is also greatly facilitated with TVS. Differentiation of clear serous fluid from hemorrhagic or exudative fluid by identifying echoes or septations within the fluid is possible. These fluid characteristics may be helpful in the detection of postradiation fibrosis, pelvic inflammatory diseases, and ovarian malignancy, and may provide additional diagnostic clues to an otherwise nonspecific pelvic mass. Finally, carcinoma of the urinary bladder could be detected early by TVS and this technique should be an integral part of the ultrasound examination in all who are suspected of bladder carcinoma.
Estimated fetal weight in the detection of the small‐for‐menstrual‐age fetus
Authors: Dudley Nicholas John , Lamb Martin Piers , Hatfield Jennifer Alice , Copping Cynthia , Sidebottom Kathryn
Published: February 2007

The purpose of this study was to assess the value of calculated fetal weight in the detection of the small‐for‐menstrual‐age fetus. An ultrasound screening scan was performed on 1624 singleton pregnancies at 30 weeks to 36 weeks, menstrual age. Head, abdomen, and femur diaphysis measurements were recorded and used to estimate fetal weight. These and other more widely used parameters were used to predict birth weight below the 10th percentile for menstrual age. Estimated fetal weight at 34 weeks achieved sensitivity of 100% and specificity of 70%, the best result for any parameter. Specificity is improved using growth measurements.
Sonographic measurement of the fetal femur: Factors affecting accuracy
Authors: Lessoway Victoria A. , Schulzer Michael , Wittmann Bernd K.
Published: February 2007

Variations have been observed in the measurement of fetal femoral diaphysis length by ultrasound. This in vitro study examines the effect of depth, the angle of the bone relative to the axis of the sound beam, the machine, and the observer on the precision of measurement. Using analysis of variance techniques, it demonstrates that three of these factors (depth, angle, and machine) have significant effects. Depth‐associated variations were less than one millimeter and are probably not of clinical importance. However, the variations due to changes in angle are highly significant (P = <0.001:1 and may be controlled by obtaining the measurement with the femur perpendicular to the sound beam. Errors due to variation between machines were also highly significant (P = <0.001). When determining serial growth patterns, the errors due to variations between machines can be controlled by using the same machine for each examination. The variation between machines is also an important factor to consider when choosing a curve for reference purposes.
Ovarian varicocele: Ultrasonic and phlebographic evaluation
Authors: Giacchetto C. , Caruso G. , Cotroneo G. B. , Cammisuli F. , Catizone F. , Marincolo F.
Published: February 2007

The aim of this work is to suggest a new diagnostic approach to the “female varicocele syndrome” which utilizes transvaginal ultrasonography. The presence of circular or linear anechogenic structures with a diameter greater than 5 mm, which were found in transverse and oblique sections of the lateral fornices, was indicative of pelvic varices. The vascular nature of these structures was confirmed with the Valsalva's maneuver and in the upright position. The presence of “pelvic varices” was confirmed by retrograde phlebography of the left ovarian vein in 46% of the cases. In such cases the parity was greater than in subjects without “pelvic varices” (chi square = 12.75, p < 0.001), and the principal symptoms were characterized by pelvic pains and menstrual cycle disorders.
Neonatal cerebral venous flow velocity measurement using a color flow doppler system
Authors: Fenton Alan C. , Papathoma Eugenia , Evans David H. , Flnst P. , Levene Malcolm I.
Published: February 2007

Color flow Doppler provides a simple means for studying blood flow velocity from the central cerebral veins in newborn infants. Twenty‐two term infants were examined during the first four days of life to establish a normal range for velocity from the vein of Galen. A wide range of velocities was found between individals (2.3 cm · s−1 to 9.5 cm · s−), but short‐term intraindividual variation was small (root mean square variation 1.1 cm · s−1). Light bilateral jugular venous compression was performed in 17 of the infants and produced a fall of up to 63% in venous flow velocity in 12 infants (p = 0.0005).
Transvaginal ultrasound scanning in early pregnancy and correlation with human chorionic gonadotropin levels
Authors: Daya Salim , Woods Sheila , Ward Susan , Lappalainen Ray , Caco Chris
Published: February 2007

Pregnancy can be detected early using transvaginal ultrasonography and human chorionic gonadotropin (hCG) measurements. The purpose of this study was to correlate serum hCG levels with transvaginal gestational sac measurements. The mean sac diameter (MSD) and gestational sac diameter (GSD) were calculated as the mean and cube root of the product, repsectively, of three sac dimensions taken at right angles. A nonlinear relationship between hCG (natural logarithm) and MSD and GSD was observed. The data were best fitted by a second order polynomial regression model (r2 = 0.98), thereby establishing normal hCG levels for various gestational sac dimensions in early pregnancy.
Ultrasound changes in abdominal echinococcosis treated with albendazole
Authors: Sciarrino Elio , Virdone Roberto , Lo Iacono Oreste , Fusco Giorgio , Ricca Teresa , Cottone Mario , Maringhini Alberto , Monica Antonella Della
Published: February 2007

Fifty patients with 81 abdominal hydatid cysts were followed with ultrasound during and after treatment with albendazole. In 61 cysts (75%), regressive changes were observed after treatment. Detachment of the membrane and change to a solid pattern in anechoic cysts were observed. Disappearance of septa or change to a solid pattern in anechoic cysts with intracystic septation were also found. There was an increase of hyperechoic structures in cysts with a mixed pattern. Follow‐up ultrasound examination showed disappearance of 7 cysts, while anechoic structures reappeared in five cases. In anechoic cysts, regressive changes due to albendazole seem to be permanent, but in cysts with a mixed pattern recurrences are sometimes observed.
Computerized ultrasound B‐scan texture analysis of experimental diffuse parenchymal liver disease: Correlation with histopathology and tissue composition
Authors: Layer Guenter , Zuna Ivan , Lorenz Adolf , Zerban Heide , Haberkorn Uwe , Bannasch Peter , van Kaick Gerhard , Räth Ulrich
Published: February 2007

By means of statistical pattern recognition procedures, a quantitative description of the ultrasound B‐scan images of experimental diffuse liver disease has been carried out. Fatty livers, fatty fibrosis/cirrhosis, and cirrhosis without fatty infiltration of the liver were studied in female Wistar rats. Separation accuracies of more than 80% between the tissue classes “normal” vs “fatty infiltration,” or “normal” vs “fatty cirrhosis,” using only two statistical image parameters were found. A subclassification of the diffuse parenchymal liver disease was not possible. It is shown by multiple linear regression analysis that the image parameter “mean grey level” correlates better with total lipid content than with the amount of connective tissue. Furthermore it is demonstrated that connective tissue leads only to a weak increase in “mean grey level,” whereas the addition of connective tissue to a given tissue lipid can lead to a reduction in image brightness.
Ultrasound‐guided aspiration biopsy of anterior mediastinal masses
Authors: Tikkakoski Tapani , Lohela Pentti , Leppänen Martti , Apaja‐Sarkkinen Meeri , Typpö Tapani , Mäkäräinen Hanna
Published: February 2007

Five anterior mediastinal tumors were biopsied with a fine needle under ultrasound guidance. All the tumors were solid, hypoechoic, perivascularly situated masses. Their mean diameter was 7.2 cm. Cytologically there were 2 mediastinal metastatic carcinomas, 1 poorly differentiated carcinoma or non‐Hodgkin lymphoma, 1 germ‐cell tumor (embryonal cell carcinoma), and 1 malignant lymphoma or thymoma. There were no complications. Ultrasound‐guided anterior mediastinal aspiration biopsy is a safe and rapid procedure in the evaluation of anterior mediastinal masses. Biopsy of a mediastinal mass enables simultaneous diagnosis and staging. Mediastinoscopy and diagnostic thoracotomy can be avoided.
Ultrasound appearance of the hip joint in newborns during the first week of life
Authors: Sośsnierz Andrzej , Karel Marek , Maj Stanislaw , Kolanko Grzegorz
Published: February 2007

The frequency of different types of hip joints in newborns was determined on the basis of ultrasound screening examinations performed during the first week of life. A higher percentage (14.1%) of abnormal hip joints were seen in comparison with the groups examined in later weeks of life suggesting the possibility of natural improvement in a number of cases. The more frequent appearance of pathology in girls was confirmed. Further investigations on the natural history of hip joint development in the newborn and on the general principles of screening examinations are needed.
Sonography of large scrotal infections
Authors: Jafri S. Zafar H. , Bree Robert L. , Madrazo Beatrice L. , Loginsky Stephan J.
Published: February 2007

We have described 14 cases of large scrotal infections with diffuse involvement of testis and epididymis, thick septations within the cavity, and associated thickening of the scrotal wall and tunica albuginea. The combination of these findings should help distinguish this process from a diffuse neoplastic involvement of the testis where the scrotal wall is almost always of normal thickness. The presence of patchy inhomogenous testicular echo pattern should alert the sonologist to the presence of diffuse suppurative epididymo‐orchitis, which may result in necrosis with subsequent orchiectomy in such patients.
Improved delineation of the gallbladder wall with ultrasonography: Its value in assessment of the depth of carcinoma invasion
Authors: Lu Ming‐De , Hirata Tsuneo , Nishihara Kazuyoshi , Yamasaki Kouji , Nakayama Fumio
Published: February 2007

We examined 30 surgically removed gallbladders with ultrasound using a 10 MHz transducer in a water bath. The sonographic structure of gallbladder wall was imaged as 5 layers. The layer 3, a well‐defined hyperechoic zone, was confirmed histologically as corresponding to the boundary between subserosa and muscularis. Since the spreading of gallbladder carcinoma beyond the muscle coat is an important prognostic indicator, high resolution images may well be used to advantage in assessing gallbladder wall penetration intraoperatively, enabling the surgeon to choose the proper operative procedure.
Echocardiographic contrast imaging of the human right heart: A multicenter study of the efficacy, safety, and reproducibility of intravenous SHU‐454
Authors: Rovai Daniele , Lombardi Massimo , Cini Giuseppe , Morales Maria Aurora , Colonna Maria , Bechelli Giorgio , Marino Paolo , Zanolla Luisa , Prioli Maria Antonia , Nicolosi Gian Luigi , Pavan Daniela , Zanuttini Domenico , Iliceto Sabino , Izzi Michele , Rizzon Paolo , L'Abbate Antonio
Published: February 2007

The contrast agent SHU‐454 was intravenously injected in 103 patients during echocardiography: 37 mL/patient ± 7 ml/patient. The quality of the contrast effect was optimal in 13, good in 51, sufficient in 30, and poor in 9 patients; reproducibility was optimal in 38, good in 46, sufficient in 17, and poor in 2 patients. Taste sensation, arm discomfort, or atypical chest pain occurred in 5 patients, premature ventricular contractions in 3. An isolated anginal attack occurred in 1 patient with frequent episodes at rest. A slight reduction in hematologic indices was attributed to hemodilution. Thus, SHU‐454 produces a good and reproducible contrast effect with tolerable side effects.
Update on safety of diagnostic ultrasonography
Authors: Miller Douglas L.
Published: February 2007

Safety considerations for diagnostic ultrasonography have gradually changed as new instruments, not only more powerful in performance but also in ultrasonic exposure, have come into use. Nonthermal cavitational bioeffects of ultrasound have a problematic role in risk assessment for clinical applications, but should serve as cautionary reminders that there potentially could be low‐level risks. Recent analyses have indicated possible areas of concern related to the thermal mechanism of bioeffects, particularly if trends for higher intensities continue into the future. The most critical area of concern is in fetal examinations, for which developing bone is unavoidably heated by relatively powerful pulsed‐Doppler beams. Fortunately, because of the threshold nature of thermal damage, development of flexible, use‐driven upper limits on output should completely resolve this impending safety problem. The ultrasonics community is now responding to these evolving safety issues with improved instrument characterization standards, new bioeffects research, and initiatives in continuing education for sonographers.
Choroid plexus dysmorphism detected by transvaginal sonography: The earliest sign of fetal hydrocephalus
Authors: Bronshtein Moshe , Ben‐Shlomo Izhar
Published: February 2007

Fetal intracranial pathology detected in the early second trimester during 1237 transvaginal sonographic scans is presented. In a sharp contrast to simple choroid cysts, which disappear at the end of the second trimester as part of a benign course, gross distortion of the choroid plexus was found to be related to the later diagnosis of hydrocephalus. Three patterns of this abnormality are early absence of the plexus, hypoplasia and shrinkage, and “Swiss cheese” appearance. Ventriculomegaly in hydropic fetuses does not distort the normal architecture of the choroid plexus. Certain abnormal features of the choroid plexus, observed as early as the 14th week, menstrual age, are landmarks of developing hydrocephalus, currently detectable only later in pregnancy.
Echocardiographic evaluation of the valves and roots of the pulmonary artery and aorta in the developing fetus
Authors: Deng Jing , Cheng Pei‐Xuan , Gao Shu‐Ying , Wen Liang‐Zhen
Published: February 2007

Because of the fluid‐filled lungs in the fetus, the ultrasound beam can penetrate to the root of the pulmonary artery perpendicularly. Using M‐mode echocardiography, the following dimensions were measured: the pulmonary and aortic valve excursion in 19 fetuses, and the pulmonary and aortic root internal diameter in 70 fetuses, between 18 and 42 weeks, menstrual age. The measured dimensions were then correlated with the biparietal diameter. The correlation coefficients for the measurements ranged from 0.873 to 0.892. Regression analysis showed that the best fit of the data was a linear model from which the 5% and 95% confidence limits were derived for individual predictions of the arterial dimensions. The ratios of the pulmonary/aortic valve excursion and the pulmonary/aortic internal diameter were approximately 1 : 1. These results are of potential value in the prenatal detection of great arterial valve or root diseases.
Accuracy of transvaginal ultrasonography for detection of hematosalpinx in ectopic pregnancy
Authors: Atri Mostafa , Stempel Jeannette De , Bret Patrice M.
Published: February 2007

The transvaginal approach has significantly improved the accuracy of ultrasonography for the detection of ectopic pregnancy. However, there has been limited emphasis given to determining the sensitivity of ultrasonography when a hematosalpinx was used as a specific finding to identify an ectopic pregnancy. The sensitivity of transvaginal ultrasonography was evaluated for the detection of a hematosalpinx defined as an “echogenic homogeneous or inhomogeneous, rounded or elongated structure” in a group of patients with surgically proven ectopic pregnancy. Retrospectively, transvaginal ultrasonography showed a hematosalpinx in 16 out of 18 (88.8%) tubal pregnancies. In 6/6 (100%) patients with a ruptured tube and 10/12 (83.3%) patients with an unruptured tube, a hematosalpinx was detected sonographically. A gestational sac with a live embryo was seen in 26.3% of these patients. The significance of identifying a hematosalpinx, predictability of rupture and implication in the treatment of ectopic pregnancy are discussed.
Peripheral cholangiocarcinoma: Sonographic evaluation
Authors: Wibulpolprasert Bussanee , Dhiensiri Tula
Published: February 2007

One hundred and seven patients who had intrahepatic tumor that demonstrated by sonography, and proved histologically, to be cholangiocarcinoma (CC), were reviewed retrospectively. Two main tumor patterns were found, namely the nodular form (N = 101) and the infiltrative form (N = 6); 33 of 101 patients with nodular lesions had solitary masses and 18 had multiple masses. The echogenicity of primary tumors were hyperechoic (N = 56), hypoechoic (N = 15), isoechoic (N = 10), and mixed‐echoic (N = 20). A peripheral hypoechoic rim was present in 35 primary tumors (34.7%). Peripheral bile duct dilatation was seen in 33 patients (30.8%). Extrahepatic extension was found at operation in 46 of 52 patients (88.5%), while it was demonstrable by ultrasonography in only 16 (30.8%). Five of 6 small lesions (3 cm and less) already had an extrahepatic extension.
Doppler and color Doppler imaging in acute transplant failure
Authors: Pelling M. , Dubbins P. A.
Published: February 2007

Most renal transplants are lost by rejection. A method is required to identify and discriminate between this and acute tubular necrosis and cyclosporin toxicity. The sonogram of the normal renal transplant is characteristic. Early Doppler studies measuring a rise in vascular impedance in acute rejection showed a high sensitivity and specificity. This appears, at least in part, to have been due to patient selection. We conclude that Doppler studies cannot be used to differentiate between the main parenchymal causes of renal transplant failure, although it can be helpful, with other clinical information, in supporting a diagnosis and in monitoring the effects of treatment. © John Wiley & Sons, Inc.
Doppler and color Doppler ultrasonography in renal transplants: Chronic rejection
Authors: Deane Colin
Published: February 2007

Although Doppler and color Doppler ultrasonography has been used extensively to examine acute changes in renal allograft function, there have been few reports on the role of Doppler ultrasonography in the assessment of chronic rejection. In those studies that have addressed chronic rejection, there is agreement that changes in renal function are not accompanied by consistent changes in flow wave‐form shape. The pathology of chronic rejection may be very different from the changes seen in acute rejection and its onset is usually gradual. Some authors have suggested that the decline in function is accompanied by lower Doppler frequency shifts (corresponding to lower velocities) in intra‐renal arteries. In a preliminary study comparing grafts with normal renal function and with biopsy‐proven chronic rejection, it has been shown that for grafts with chronic rejection, observed intra‐renal velocities are lower, especially at segmental and interlobar levels. This may be a more reliable reflection of reduced renal blood flow in chronic rejection than conventional Doppler ultrasound analysis of flow waveform shape. However, the diagnostic use of changes to intra‐renal flow velocities in chronic rejection is currently very limited. © 1992 John Wiley & Sons, Inc.
Anomalous position of the gallbladder: Ultrasonographic and scintigraphic demonstration in four cases
Authors: Pradeep V. M. , Ramachandran K. , Sasidharan K.
Published: February 2007

An anomalous position of the gallbladder (GB) is uncommon. Of 40,000 upper abdominal ultrasound examinations, 4 cases of ectopic gall bladder were noted. These were confirmed by hepatobiliary scintigraphy.
Reproducibility of ultrasound measurement of pancreatic size with new advanced high‐resolution dynamic image scanners
Authors: Giandomenico Vincenzo Di , Filippone Antonella , Basilico Raffaella , Spinazzi Alberto , Capani Fabio , Bonomo Lorenzo
Published: February 2007

The reproducibility of ultrasound measurements of the pancreas was investigated in 10 healthy volunteers. All subjects underwent three different evaluations, each consisting of three ultrasound examinations, at 8:00 after overnight fasting, at 12:00 after a solid, standard meal, and at 14:00. The longitudinal and anteroposterior (AP) diameters of the head, body, and tail, as well as the total areas of the gland, were measured in longitudinal and axial scans.

Significant differences were observed in the head and body longitudinal diameters measured at 12:00 and in the tail AP diameter at 14:00. We conclude that ultrasonography of the pancreas should be performed in the morning with patients in the fasting state. In these conditions, the reliability of ultrasound measurements of the gland appears to be the highest. © 1993 John Wiley & Sons, Inc.
Sonohysterography for endometrial abnormalities: Preliminary results
Authors: Parsons Anna K. , Lense Jorge J.
Published: February 2007

In examinations where the etiology of an abnormal endometrial sonographic image is not clear, saline infusion through a fine flexible catheter during transvaginal sonography provides visual contrast and uterine expansion. In 39 women, polyps, myomata, synechiae, endometrial hyperplasia, and cancer were correctly described as verified at surgery. Hyperplasia and neoplasia are not distinguishable, but the approach for biopsy and therapy is established by this simple and welltolerated technique, which is here called sonohysterography. © 1993 John Wiley & Sons, Inc.
In vitro and in vivo accuracy of sonographic gallbladder volume determinations
Authors: Andersen Inger Bak , Monrad Henrik , Grønvall Sven , Højgaard Liselotte
Published: February 2007

To assess gallbladder function, sonographic gallbladder volume determinations have been used with increasing frequency. This study presents a modified and automated procedure for gallbladder volume determinations using Simpson's rule of integration, Simpson's method. This method is a standard option in the data systems of many sonographic instruments. Simpson's method was validated in vitro and in vivo, and it was compared with the sum‐of‐cylinders method for gallbladder volume determinations. In vitro assessment indicated that the two methods were equally accurate, with Simpson's method being more precise. The absolute deviation was independent of the size of the volume and of the shape of the gallbladder. In vivo Simpson's method was validated on 11 patients with cholecystitis. The gallbladder volumes (mean 65 mL; Range 20 mL to 130 mL) measured by sonography differed from the aspirated volumes by 1.5 mL (SD 10.4 mL). Thus Simpson's method is an accurate, precise, and fast method for sonographic gallbladder volume determination. © 1993 John Wiley & Sons, Inc.
Renal vein thrombosis and adrenal hemorrhage in the newborn: Ultrasound evaluation of 4 cases
Authors: Orazi C. , Fariello G. , Malena S. , Schingo P. , Ferro F. , Bagolan P.
Published: February 2007

Renal vein thrombosis and adrenal hemorrhage can both be encountered in the neonatal period and they may occur at the same time. Inferior vena cava thrombosis can complicate some cases. These diseases can be easily diagnosed by means of ultrasound. The authors present 4 cases in which newborns were affected by renal vein thrombosis associated with adrenal hemorrhage and caval thrombosis, evaluated by means of ultrasound. The echographic aspect of renal, adrenal and caval involvement is described. © 1993 John Wiley & Sons, Inc.
Ultrasonography of capsular morphology in normal and traumatic ankle joints
Authors: Friedrich Jean M. , Schnarkowski Peter , Rübenacker Siegfried , Wallner Bernd
Published: February 2007

Ultrasonography was used to inspect the ankle anatomy of 20 healthy volunteers. The images produced were correlated with anatomical structures by examining three dissected cadaver ankles. The anterolateral pouch of the articular capsule was identified by ultrasonography in 91% of the normal ankle joints as a hypoechoic area. The posterolateral pouch of the articular capsule also could be identified by ultrasonography as a hypoechoic area in 84% of the normal ankles examined. The lateral aspect of 105 traumatized ankles was examined subsequently. The ultrasound results agreed in 100% of the cases with the operative findings for the anterior talofibular ligament and in 92% for the calcaneofibular ligament. © 1993 John Wiley & Sons, Inc.
Visualization of implantable defibrillator patches by two‐dimensional echocardiography
Authors: Covalesky Veronica A. , McAllister Michael , Chandrasekaran Krishnaswamy , McCormick Daniel J. , Mintz Gary S. , Kutalek Steven P.
Published: February 2007

Implantable cardioverter defibrillators are being used with increasing frequency for the management of life‐threatening ventricular arrhythmias. In order to determine whether the titanium mesh of the defibrillator patch causes ultrasonographic acoustical interference, 30 patients underwent prospective serial echocardiographic examination. In addition, studies were reviewed to determine whether the defibrillator patches could be visualized with standard two‐dimensional echocardiography. In no patient did the anterior patch produce acoustical interference, and, unless specific measures were utilized (such as a standoff pad, a zoom feature, or a 5‐MHz transducer), the patches were rarely visualized. © 1993 John Wiley & Sons, Inc.
Reference values for Doppler velocimetric indices from the fetal and placental ends of the umbilical artery during normal pregnancy
Authors: Sonesson Sven‐Erik , Fouron Jean‐Claude , Drblik Susan Pamela , Tawile Carolin , Lessard Manon , Skoll Amanda , Guertin M. C. , Ducharme G. R.
Published: February 2007

A range‐gated Doppler ultrasound system combined with a real‐time imaging system was used to determine arterial blood velocity values from the fetal and placental ends of the umbilical cord in 269 normal pregnancies between 17 and 40 weeks, menstrual age. The systolic–diastolic ratio (S/D), pulsatility index (PI), and resistance index (RI) were higher at the fetal end compared to the placental end of the cord. The individual differences in these Doppler indices, obtained between the fetal and placental recording sites, were inversely related to menstrual age: S/D: r = −0.38, p < 0.001; PI: r = −0.25, p < 0.001; and RI: r = −0.15, p < 0.01. After normalization for the angle of insonation, the peak systolic velocity was higher and the enddiastolic velocity was lower at the fetal than at the placental end of the cord. It is concluded that routine recordings for Doppler velocimetric indices should take into account the recording site on the umbilical cord in order to reduce methodological sources of variance, especially during midgestation. Furthermore, the data presented here in the form of the median and percentile values are proposed as normal reference values to facilitate this procedure. © 1993 John Wiley & Sons, Inc.
Quantitative characterization of arcuate artery hemodynamic change in normal pregnancy with Doppler ultrasonography
Authors: Hata Kohkichi , Hata Toshiyuki , Manabe Atsushi , Makihara Ken , Kitao Manabu
Published: February 2007

Using color and pulsed Doppler ultrasonography, arcuate arterial velocimetry was carried out in 91 normal women, at 16–40 weeks, menstrual age. The arcuate arterial hemodynamics was assessed by the calculation of the resistance index (RI). A curvilinear relationship was found between the RI value of the arcuate artery obtained from the placental site in the uterus and menstrual age (R2 = 0.328). The relationships between the RI value of the arcuate artery obtained from the nonplacental site (R2 = 0.268) or the averaged RI value between the placental and nonplacental sites (R2 = 0.321) and menstrual age were both linear. Normal ranges of RI values of arcuate arteries during pregnancy for the placental site, nonplacental site, and their average values were generated. These results provide a foundation for evaluating uteroplacental velocimetry in normal pregnancy using Doppler ultrasonography. © 1993 John Wiley & Sons, Inc.
Ultrasonic fetal weight estimation: Analysis of inter‐ and intra‐observer variability
Authors: Chang T. C. , Robson Stephen C. , Spencer John A. D. , Gallivan Stephen
Published: February 2007

Standard ultrasound measurements were performed by two observers in 40 third‐trimester fetuses. Observers were blinded to the results of the meaurements. Estimated fetal weight (EFW) was calculated using two published formulae. The intra‐observer standard deviation for EFW, assessed using one‐way analysis of variance, was <75 g for both observers. The 95% prediction intervals for inter‐observer comparisons of EFW, calculated using the limits of agreement method, were − 187.3 g to 139.8 g, and − 159.9 g to 124.3 g, using the two formulae. The results suggest that measurements of EFW are reproducible. The prediction interval is comparable to the weekly fetal weight increment in normal fetuses. © 1993 John Wiley & Sons, Inc.
Application of intracoronary ultrasonography in the study of coronary artery pathophysiology
Authors: Rasheed Qaiser , McB. Hodgson John
Published: February 2007

Coronary endothelial function, arterial distensibility, and elastic recoil were assessed in various groups of patients using intracoronary ultrasonic (ICUS) imaging. We found evidence of endothelial dysfunction in patients with risk factors for coronary artery disease even before atherosclerosis could be detected angiographically or with sensitive ICUS imaging. There was marked reduction of arterial distensibility in atherosclerotic arterial segments even with minor disease. Distensibility was partially restored in lesions following coronary balloon angioplasty (PTCA) or directional atherectomy (DCA). We also noted significantly greater elastic recoil following PTCA in soft lesions compared with hard lesions. We conclude that the use of ICUS imaging in cardiac catheterization laboratory provides useful information regarding various physiologic parameters. This capability will add new dimensions to the evaluation and management of patients with coronary artery disease. © 1993 John Wiley & Sons, Inc.
Mechanisms and outcomes of angioplasty and atherectomy assessed by intravascular ultrasound imaging
Authors: Fitzgerald Peter J. , Yock Paul G.
Published: February 2007

Catheter‐based intravascular ultrasound is a relatively new imaging tool to examine endovascular structure. One major goal for the development of intravascular ultrasound imaging has been to help clarify the mechanism of interventional therapies such as balloon angioplasty and directional atherectomy. Pathologic studies have suggested that plaque distribution and composition are key features that relate to initial and long‐term success of coronary interventions. However, relatively little is known by angiography about the nature of plaque in the clinical setting. Intravascular ultrasound imaging provides a high resolution, “on‐line” method of tracking the effects of catheter interventions such as balloon angioplasty and atherectomy. Because of its ability to visualize tissue beneath the luminal surface, ultrasound is generating new insights into the effect of plaque composition and distribution on the response to catheter therapies. With pre‐procedure ultrasound imaging, it is increasingly possible to predict the result of a particular intervention, offering the potential for developing strategies of lesion‐targeted therapy based on certain plaque characteristics. This article presents the early results of the GUIDE trial as a “works in progress” view of the role of intravascular ultrasound in helping interventionalists to understand—and to optimize—angioplasty and atherectomy. © 1993 John Wiley & Sons, Inc.
Coexisting calcified inferior vena cava thrombus and adrenal hemorrhage in the neonate: Report of three cases
Authors: Tran‐Minh Van A. , Genin Gilles , Pracros Jean‐Pierre , Foray Patrice , Bourgeois Jacques
Published: February 2007

Coexisting calcified inferior vena cava (IVC) thrombus and adrenal hemorrhage are uncommon in children. We present three such cases diagnosed by ultrasound in three boys who were born after 41‐, 38‐, and 38‐week gestations, respectively. In all cases the pregnancy and delivery were unremarkable. The birthweight was 3,630 g, 3,210 g, and 3,390 g, respectively. Left adrenal hemorrhage occurred in all cases. Associated left renal vein thrombus occurred in two cases. The mean followup was 8.5 years. In two cases ultrasound showed persistence of a calcified thrombus and residual stenosis of the IVC. In the third case the IVC thrombus had almost disappeared. © 1994 John Wiley & Sons, Inc.
Amyloidosis of the thyroid gland: Role of ultrasonography
Authors: El‐Reshaid K. , Al‐Tamami M. , Johny K. V. , Madda J. P. , Hakim A.
Published: February 2007

We studied the role of ultrasound assessment of the thyroid gland in detecting amyloid deposition in 9 patients confirmed to have renal amyloidosis because the thyroid gland is a readily accessible organ. Ultrasound examination of the thyroid gland showed a distinctive abnormal appearance in 7 patients. There was enlargement of one or both lobes of the thyroid, a high echogenicity approaching that of the surrounding connective tissue, and a very fine homogeneous echotexture similar to ground glass appearance. Four patients showed dilated follicles in the thyroid gland. The other two patients had normal ultrasound findings. Open wedge biopsy of the thyroid gland in 4 patients, (3 with abnormal ultrasound findings and 1 with normal ultrasound findings) showed amyloid deposits in the 3 patients with abnormal echo findings and no amyloid deposits in the 1 patient with normal findings. In 10 healthy individuals, 10 patients who were just initiated on maintenance hemodialysis and another 10 patients on dialysis for more than 1 year, the thyroid gland was of normal size and appearance in the ultrasound examination. We conclude that ultrasound examination by an experienced radiologist is a useful tool in the diagnosis of thyroid amyloidosis. © 1994 John Wiley & Sons, Inc.