bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasound diagnosis of interstitial pregnancy: Findings and pitfalls
Authors: Graham Mary , Cooperberg Peter L.
Published: February 2007

The diagnosis of an unruptured interstitial gestation can be made by means of ultrasound examination. The most specific finding is an incomplete myometrial mantle around the sac. An eccentrically placed sac and failure to demonstrate the sac within the uterine cavity, i.e., near the internal os on the longitudinal scans, may be helpful ancillary findings. The differential diagnosis must take into consideration a pregnancy within one horn of a bicornuate uterus and a pregnancy within a myomatous uterus. Although this is a rare condition, it carries significant mortality if it ruptures. Diagnosis prior to rupture will reduce mortality and offer the possibility of preserving reproductive capabilities.
Echocardiographic measurements in normal subjects: Evaluation of an adult population without clinically apparent heart disease
Authors: Gardin Julius M. , Henry Walter L. , Savage Daniel D. , Ware James H. , Burn Cora , Borer Jeffrey S.
Published: February 2007

In order to determine normal echocardiographic values for older subjects, we studied 136 adults (78 men and 58 women, 20 to 97 years of age) without evidence of cardiovascular disease. When patients were subdivided into six age groups, progressive changes were found in mean normal values for various parameters. Specifically, when the oldest group (over 70 years) was compared with the youngest group (21–30 years), significant (p < 0.01) increases in aortic root (22 percent) and left atrial (16 percent) dimensions, in ventricular septal (20 percent) and left ventricular free‐wall (18 percent) thicknesses, and in estimated left ventricular mass (15 percent) were noted. In addition, a significant (p < 0.01) decrease in mean mitral E‐F slope (43 percent) and slight decreases in mean left ventricular systolic and diastolic internal dimensions (5 and 6 percent, respectively; p < 0.05) were noted. Left ventricular ejection fraction and percentage fractional shortening were found to be independent of age. These data have been used to derive regression equations that are related to both age and body surface area. The regression equations can be used to calculate mean normal values and 95 percent prediction intervals for echocardiographic measurements in adults.
Ultrasound visualization of the human yolk sac
Authors: Mantoni Margit , Pedersen Jan Fog
Published: February 2007

Ultrasound scanning in early pregnancy sometimes reveals a 2–5‐mm spheric structure lying adjacent to the fetus. The occurrence of this structure was studied in 60 consecutive ultrasound examinations. In the 7th to 9th weeks the sphere was seen in 19 of 22 examinations, and in the 10th and 11th weeks it was seen in 10 of 20 examinations. The sphere was not demonstrated in any of 18 examinations in the 12th to 14th weeks. It is believed that the spheric structure is the yolk sac.
Ultrasound: Patients' views
Authors: Janus Cynthia , Janus Samuel
Published: February 2007

There is virtually nothing in the literature about patients' perceptions and misconceptions regarding sonography. From January to June, 1979, 204 patients at the Mount Sinai Hospital in New York City were asked to fill out questionnaires before and after their sonographic examinations. The results showed that many of the first‐time patients did not know what to expect, had never heard of ultrasound, and were incorrectly prepared for the examination. Education of both patients and physicians is needed to prevent unnecessary patient anxiety and to encourage the use of this safe and accurate diagnostic modality.
The placental‐subplacental complex: A specific indicator of placental position on ultrasound
Authors: Callen Peter W. , Filly Roy A.
Published: February 2007

Subplacental tissue frequently appears as a less echogenic zone adjacent to the more echogenic parenchymal texture of the placenta on gray‐scale sonograms. This complex of parenchymal structures is useful in specifically localizing placental position and extent, especially in posteriorly positioned placentas, which may be shadowed by the fetus, or in cases in which focally thickened portions of the myometrium or reverberation artifact may simulate the placenta.
Omentum mimicking cystic masses in the pelvis
Authors: Engel Juliette M. , Deitch Edwin A.
Published: February 2007

Three female patients with ultrasound criteria of pelvic cysts but with wads of omentum mimicking cystic structures are reported. In 2 patients the omentum was involved in an inflammatory process; in the third, normal omentum was found filling old surgical defects. All were confirmed surgically.
Real‐time aspiration‐biopsy transducer
Authors: Goldberg Barry B. , Cole‐Beuglet Catherine , Kurtz Alfred B. , Rubin Carl S.
Published: February 2007

In vitro and in vivo experience with a real‐time aspiration‐biopsy transducer indicates that the advantage of this instrument is that it permits the examiner to monitor the movement of the structure being aspirated or biopsied, as well as the movements of adjacent organs, while the needle tip is being inserted into the structure. When the needle tip is inserted into the skin, a strong acoustic shadow is produced along the path of the needle, indicating the optimum position for aspiration and biopsy. Within fluid‐filled areas the needle tip is imaged consistently. For solid‐organ biopsies, the movement of the structure of interest as well as the acoustic‐shadow path of the needle can be consistently observed, but the needle tip is recorded with more difficulty.
The ultrasound spectrum of prune‐belly syndrome
Authors: Garris Joel , Kangarloo Hooshang , Sarti Dennis , Sample W. Frederick , Smith Lorraine E.
Published: February 2007

The sonographic features of prune‐belly syndrome are illustrated and described, corresponding to a classification based on clinical and radiographic findings. The severity of urinary tract involvement determines to which group a given patient is assigned. In group I, the kidneys are dysplastic, with no appreciable surrounding renal parenchyma. In group II, there is marked dilatation of the ureter and mild dilatation or no dilatation of the renal pelvis and calyces. In group III, the involvement is milder, ranging from the sonographic findings typical of group II to those of normal‐appearing urinary tract.
The nonspecificity of the thyroid halo sign
Authors: Propper Richard A. , Skolnick M. Leon , Weinstein Barbara J. , Dekker Andrew
Published: February 2007

In a series of 28 patients with solitary solid thyroid masses, 10 of the patients had a mass surrounded by a rim of decreased echoes or by an echo‐free rim, previously termed the halo sign. Eight of these lesions were benign, being either adenomas or benign nodules; however, two halos were also demonstrated surrounding proven carcinomas. The presence of the halo in both benign and malignant disease is illustrated, and the possibility of pericapsular inflammatory infiltrate as its underlying anatomic correlate is suggested.
Ultrasound demonstration of uterus subseptus
Authors: McArdle Colin R. , Berezin Andrew F.
Published: February 2007

Uterus subseptus, a common uterine anomaly, can be detected by ultrasound examination. In this series it was detected only during the second trimester of pregnancy. The reasons for this are discussed, and it is concluded that although ultrasound can be used to detect these anomalies, it is not sufficiently sensitive to supplant hysterography.
Anatomic variations of the carotid bifurcation affecting Doppler scan interpretation
Authors: Prendes José Luis , McKinney William M. , Buonanno Ferdinando S. , Jones Ann M.
Published: February 2007

An anatomic variant for the position of the external carotid artery (ECA) at the carotid bifurcation was noted in 5.3 percent of patients studied by Doppler ultrasound and contrast angiography. The ECA is lateral to and posterior to the internal carotid artery (ICA) in these patients. Consideration of this important variant is mandatory for accurate ultrasound image correlation.
In vitro investigation of the origin of echoes within biliary sludge
Authors: Filly Roy A. , Allen Bruce , Minton Michael J. , Bernhoft Robin , Way Lawrence W.
Published: February 2007

To investigate the origin of echoes from “biliary sludge,” concentrated bile and bile from 5 patients with ultrasound findings of biliary sludge were examined in a tissue‐equivalent phantom before and after filtration through progressively smaller pore sizes. Filtration converted echogenic bile to echo‐free bile. Examination of the filtration residue by light microscopy established that the source of echoes in biliary sludge was particles, predominantly pigment granules, with lesser amounts of cholesterol crystals. Partial chemical characterization by determination of vulnerability to different solvents verified that the sludge was mainly calcium bilirubinate.
Wall motion characteristic of the right pulmonary artery in the suprasternal echocardiogram
Authors: Kasper Wolfgang , Meinertz Thomas , Kersting Friedrich , Löllgen Herbert , Just Hanjörg
Published: February 2007

This study describes the motion pattern of the right pulmonary artery (RPA) as it can be assessed from the suprasternal echocardiogram. The motion characteristic of the RPA is dependent on hemodynamic factors within the lumen of the RPA and those within the left atrium and the aortic arch. During atrial contraction the superior wall of the left atrium separates from the inferior wall of the RPA (IWRPA) and produces an “a” dip in the wall motion of the IWRPA. During isovolumic contraction the RPA is shifted upward (IC point). The incisura in the pulmonary artery pressure curve reflecting pulmonic valve closure can be seen by a sudden decrease in the diameter of the RPA (PC point). In conditions coinciding with pulmonary arterial hypertension, the overall diameter of the RPA increases, and the IC and PC points are flattened or even absent. Thus, changes in hemodynamics caused by pulmonary or cardiac disease may be analyzed noninvasively on the basis of altered wall motion of the RPA.
Ultrasound demonstration of the normal fetal yolk sac
Authors: Sauerbrei Eric , Cooperberg Peter L. , Poland Betty J.
Published: February 2007

Using high‐resolution real‐time ultrasound in the first trimester of pregnancy, we have been able to demonstrate, in addition to the fetus, the yolk sac and the amniotic membrane. Pitfalls to avoid in first‐trimester pregnancies include (a) mistaking the yolk sac for a second separate fetus, (b) including the yolk sac in the crown–rump length, and (c) misinterpreting the amniotic membrane for a septum between two separate gestational sacs.
Floating gallstones: The role of contrast material
Authors: Scheske Glen A. , Cooperberg Peter L. , Cohen Max M. , Burhenne H. Joachim
Published: February 2007

Among more than 400 patients with gallstones examined in our department in the past 2 yr, calculi were seen to float in only 3 patients. In each of these cases the ultrasound examination was done during or shortly after the oral cholecystogram. This suggests that contrast material raised the specific gravity of the bile and caused the floating phenomenon. No cases of floating stones in the absence of contrast material were found.
Comparison between black and white backgrounds for ultrasonic images
Authors: Sanders Roger C.
Published: February 2007

Two hundred and three studies were selected from approximately 5,000 abdominal examinations where comparable images obtained at the same level with both a black and a white background were available. The ease with which liver metastatic lesions, ducts and vessels in the liver and pancreas, the renal pyramids, and the gallbladder wall could be seen with the two modalities was compared. It was felt that textured organs, such as the liver and kidney, were best shown with a black background but that tubular structures, such as the pancreatic duct, were easier to see with a white background.
Intraoperative B‐mode scanning
Authors: Lane Rodney J.
Published: February 2007

The applications of intraoperative scanning are described in the arterial and pancreatico‐biliary trees. The findings in 85 patients and 10 postmortem specimens are reviewed. Specific scanning techniques are described, and the results are compared with conventional radiological methods and actual operative findings. A critical comparison of both techniques is presented with illustrations of the unique capacities of intraoperative ultrasound, particularly in the pancreas.
Ultrasonic diagnosis of primary carcinoma of the gallbladder: A review of 16 cases
Authors: Ruiz R. , Teyssou H. , Fernandez N. , Carrez J. P. , Gortchakoff M. , Manteau G. , Ter‐Davtian P. M. , Tessier J. P.
Published: February 2007

Sonographic findings in 16 patients (10 women, six men) with surgically documented gallbladder carcinoma are reported. Two principal forms are described: localized infiltrating, or fungating, tumors (eight patients) and diffuse tumors infiltrating the entire gallbladder wall (eight patients). In all cases, the tumors were adenocarcinomas. Eleven patients also had cholelithiasis. Contiguous extension and metastasis did not correlate with tumor size. The difficulties encountered in the differential diagnosis are discussed in relation to the different sonographic appearances.
Ovarian imaging by ultrasound: An attempt to define a reference plane
Authors: Hackelöer B.‐J. , Nitschke‐Dabelstein S.
Published: February 2007

The use of ultrasound to study ovarian function was established by our group. Ultrasound measurements of follicular diameters were found to be helpful for assessing follicular growth and development and for diagnosing and treating infertile women. Because of difficulties in ovarian visualization (differentiation between a more lateral part of the uterus and the ovary), the definition of a reference plane is necessary, especially to make this new technique reproducible. On the basis of the anatomic situation, we believe that it is possible to demonstrate ovarian vessels within the infundibulopelvic ligament. Using a compound scanner and a combined method of B mode, A mode, and TM mode, it should be possible to demonstrate such structures, and they should be useful as a reference plane. Our observations were confirmed in more than 2,500 examinations.
Comparison of abdominal circumference measurements by real‐time and b‐scan techniques
Authors: Clement Daniel , Silverman Rosamund , Scott David , Hobbins John C.
Published: February 2007

In an effort to evaluate the efficacy of measuring abdominal circumference with real‐time ultrasound, 53 patients were scanned with both contact scanning and linear array real time. Image measurements were made blindly from both types of equipment. Abdominal circumference measurements with real time compared favorably with those obtained from contact images (r = +0.984).
Sonographic features of gastrointestinal leiomyosarcoma
Authors: Kaftori Joseph K. , Aharon Menucha , Kleinhaus Uriel
Published: February 2007

Five cases of gastrointestinal leiomyosarcoma were studied by ultrasound. Sonographic features of a huge mass with a thick echogenic rim and central sonolucent cavitation were seen in four cases with presenting symptoms of an abdominal mass. In a fifth case necrotic metastasis was seen in the liver after removal of a leiomyosarcoma. Although not pathognomonic, such features should strongly suggest the diagnosis of leiomyosarcoma.
Registration errors in compound b‐scans
Authors: Goldstein Albert
Published: February 2007

The effect of B‐scanner articulated arm angle measurement errors on B‐mode registration is considered. For a single‐angle articulated arm model, a mathematical equation predicting B‐mode misregistration as a function of angular errors and compound scan angle is derived and discussed. This model accurately predicts registration errors for transducer connector/acoustic axis misalignment or third arm angle errors.
Aortic and lower extremity arterial aneurysms
Authors: Hirsch Jack H. , Thiele Brian L. , Carter Stephen S. , Colacurcio Cheryl
Published: February 2007

A sonographic survey of 100 patients with suspected abdominal aortic, femoral, or popliteal arterial aneurysms was conducted over a period of 2 yr. Patients referred for suspected abdominal aortic aneurysms had a low incidence of associated lower extremity arterial aneurysms. Those patients referred for possible femoral or popliteal artery aneurysms frequently had multiple other peripheral arterial aneurysms. The authors recommend a survey scanning protocal in this subgroup with lower extremity aneurysms to rule out the presence of other aneurysms.
Ultrasonic determination of hepatomegaly
Authors: Gosink Barbara B. , Leymaster Craig E.
Published: February 2007

Retrospective evaluation of abdominal ultrasound examinations were made in 36 patients who came to autopsy within 1 month after the ultrasound study. Without knowledge of clinical or autopsy data, two observers made independent determinations of the midhepatic line measurement of the liver on the ultrasound study using supine and left lateral decubitus longitudinal scans. Autopsy determination of hepatomegaly was made using hepatic weight, patient's total body weight, and patient age correlated with pertinent clinical history. Results of the autopsy/ultrasound correlation demonstrated that those livers measuring 13.0 cm or less in the midhepatic line (both supine and left lateral decubitus positions) were normal in 93% of the cases. Similarly, it was demonstrated that when the liver measured 15.5 cm or greater, it was enlarged in 75% of the cases. Used together, these two criteria result in an 87% accuracy rate in determining the presence or absence of hepatomegaly. Approximately 25% of the cases in our study fell into the borderline category of 13.0–15.5 cm.
Comparison of methods for determining crown‐rump measurement by real‐time ultrasound
Authors: Nelson Lewis H.
Published: February 2007

Determination of gestational age without an accurate last menstrual period is difficult. In the later stages of pregnancy, the correlation between fetal biparietal diameter (BPD), as determined by ultrasound, and gestational age is compromised by normal biologic variation in fetal growth rates. The fetal crown‐rump measurement (CRM) by gray‐scale sonography has been described but has not been evaluated using real‐time ultrasound. Currently available tables for determining gestational age from the fetal CRM were evaluated using a linear array real‐time ultrasound system. A normal obstetric population with known menstrual histories, delivery dates, and Dubowitz scores at delivery was used for evaluation. On the basis of this study, Robinson's data listed as “regression analysis values” are suggested for application to real‐time ultrasound. Alternatively, the equation generated from data on the above 86 patients could be used and further evaluated. The fetal CRM appears to be a valid and accurate assessment of gestational age.
Distal common bile duct obstruction: An experimental study in monkeys
Authors: Shawker Thomas H. , Jones Bonnie L. , Girton Mary E.
Published: February 2007

Biliary obstruction was accomplished by surgically occluding the distal common bile duct in seven rhesus monkeys. Ultrasound scanning at 24‐hour intervals showed that dilation of the common bile duct and gallbladder occurred before elevation of bilirubin or development of jaundice. The bile ducts expanded centrifugally from the obstructing point, with dilation of the intrahepatic ducts occurring several days after the onset of obstruction. After surgical release of the obstruction, the biliary ducts contracted centripetally, with the common bile duct requiring 30–50 days to return to normal size.
Range ambiguities in real‐time ultrasound
Authors: Goldstein Albert
Published: February 2007

The frequent occurrence of low‐level artifactual echoes in normally echo‐free areas of real‐time images is shown to be due to a range‐ambiguity effect caused by the fast frame rate of real‐time equipment. The experimental data demonstrates the range‐ambiguous echoes to be present in linear array and mechanical sector scanner real‐time images. Several suggestions are made to reduce the effect of the artifact in real‐time images. A set of real‐time acceptance tests that utilize this artifact are proposed.
Mitral valve A wave and mitral stenosis
Authors: Dabestani Ali , Skorton David J. , Child John S. , Krivokapich Janine
Published: February 2007

We examined M‐mode echocardiograms on 35 patients with catheterization‐proven mitral stenosis and normal sinus rhythm to determine whether the presence or absence of an A wave on the mitral echogram predicted mild versus severe mitral stenosis. Mitral valve area (MVA) was determined by the Gorlin formula. Presence of a mitral A wave was defined as 2 mm or greater anterior motion (after a well‐defined F point) of the anterior mitral leaflet. In six of 35 patients, the presence of an A wave was equivocal. Of the remaining 29 patients, 16 had no A wave and mean MVA = 1.18 cm2 ± 0.45 (SD), and 13 patients had a definite A wave and mean MVA = 2.04 cm2 ± 0.71. There was a significant difference (p < 0.001) between the mean MVA for patients with and without definite A waves. No patients with a definite A wave had an MVA less than 1.2 cm2. An A wave on the mitral echogram (in sinus rhythm) excludes severe mitral stenosis; when an A wave is not seen, no definite statement concerning severity of mitral stenosis can be made.
Placenta previa: Avoiding false‐negative diagnoses
Authors: Laing Faye C.
Published: February 2007

A retrospective analysis of 102 patients with clinically suspected placenta previa revealed that ten women (10%) were correctly diagnosed as having placenta previa, while two women (2%) had false‐positive diagnoses. Three of the ten women who were correctly diagnosed as having placenta previa had scans that could easily have been misinterpreted as normal. Because a false‐negative diagnosis of placenta previa is clinically much more serious than a false‐positive diagnosis, these cases are elaborated upon. Recognition of a laterally positioned placenta previa and observation of blood in the region of the internal cervical os should minimize false‐negative diagnostic errors.
Molar pregnancy: Early diagnosis by ultrasound
Authors: Wittmann Bernd K. , Fulton Lorna , Cooperberg Peter L. , Lyons Edward A. , Miller Carol , Shaw Dorothy
Published: February 2007

This report reviews four cases with vaginal bleeding and early ultrasound diagnosis of abnormal pregnancy before nine weeks gestation, who were followed by serial ultrasound examinations and subsequently diagnosed as hydatidiform mole. The findings support the view that hydatidiform mole may arise from a blighted ovum. It is concluded that vaginal bleeding in the first trimester should be investigated by diagnostic ultrasound, and the pregnancy be terminated if an abnormal development has been confirmed.
Three‐dimensional echocardiography for spatial visualization and volume calculation of cardiac structures
Authors: Matsumoto Masayuki , Inoue Michitoshi , Tamura Shinichi , Tanaka Kokichi , Abe Hiroshi
Published: February 2007

A new computerized image processing system was developed and applied clinically for three‐dimensional visualization and volume calculation of cardiac structures, which were recorded in more than seven original two‐dimensional echocardiograms in parallel planes. Three‐dimensional display of this series of original two‐dimensional echocardiograms was performed automatically using an overlaid display with different gray levels designating depths. The limitation of the present study was in the recording of original two‐dimensional echocardiograms in parallel planes.
Ultrasonic effects on mammalian multicellular tumor spheroids
Authors: Conger Alan D. , Ziskin Marvin C. , Wittels Heidi
Published: February 2007

Mammalian multicellular tumor spheroids (MTS), grown in liquid culture medium, 0.23 to 0.32 mm in diameter and consisting of 4,500 to 12,100 cells, were exposed to three ultrasonic machines: a clinical diagnostic device with an emitted intensity of 13 mW/cm2, a therapeutic machine with emitted intensities of 1 to 3.5 W/cm2, and a laboratory machine emitting 12 to 50 W/cm2. (All intensities are temporal and spatial average.) Four measures of ultrasonic effect on MTS were made: decrease in diameter after treatment, damage to subsequent growth, outright kill, and number of cells detached from the MTS. There was no loss in MTS size from diagnostic or therapeutic exposures. None of the exposures from any of the three machines caused any damage to subsequent growth or survival. There was no significant detachment of cells from the MTS by any of the diagnostic exposures (at 13 mW/cm2, out to 40 minutes). With the laboratory machine, a significant number of cells were detached, about 0.02% of the MTS (approximately one cell per MTS) per W/cm2 in a ten‐minute exposure. Cells detached by therapeutic exposure increased linearly with exposure. On the average, 1 W/cm2 detaches about 0.5 cells per minute, per MTS, or about 0.006% of the cells in the MTS.
Prediction of intrauterine growth retardation by sonographic estimation of total intrauterine volume
Authors: Chinn Daryl H. , Filly Roy A. , Callen Peter W.
Published: February 2007

A group of 252 patients who had total intrauterine volume (TIUV) measurements after 20 weeks menstrual age were evaluated for prediction of growth retardation. The measurements were compared to previously published normal values derived at our institution. The birth weights of these patients' babies were evaluated by the California standard. Setting the threshold of an abnormal test at the lower 10% tolerance limit, the TIUV measurement was sensitive in 70%, specific in 72%, and accurate in predicting IUGR in only 41% of cases. Ultrasonic estimation of TIUV is limited as a predictor of IUGR.
Medical implications of ultrasonically detected polycystic ovaries
Authors: Swanson Mark , Sauerbrei Eric E. , Cooperberg Peter L.
Published: February 2007

Polycystic ovaries are usually manifest on an ultrasound study as symmetrically enlarged ovaries containing numerous tiny cysts. The cysts are difficult to detect with conventional contact B‐scanners but are readily detected with high‐resolution, real‐time sector scanners. The cysts range in diameter from 2 to 6 mm and may be arranged inthe periphery of an ovary or throughout the parenchyma.

In patients with ultrasonically demonstrated polycystic ovaries (aged 15 to 35 years), there is a spectrum of clinical findings. Halfthe patients have most of the classic signs and symptoms (hirsutism, menstrual irregularity, and obesity) associated with Stein‐Leventhal syndrome. Twenty‐five percent have variants of the syndrome. In another 25%, no clinical abnormality is evident at the time of an ultrasound examination.
Ultrasonic anatomy of the fluid‐filled duodenum
Authors: Oliva Luigi , Biggi Enrico , Derchi Lorenzo E. , Cicio Gian Rosario
Published: February 2007

A fluid‐filled duodenum in ultrasonic studies of the epigastrium, which is manifest when the pancreas is scanned using the liquid‐filled stomach technique, can give rise to images that can cause confusion. We describe the ultrasonic appearances of different parts of the duodenum after ingestion of fluid in 12 healthy persons, pointing out criteria that can be useful for correct identification of this organ.
Echogenicity caused by stable microbubbles in a protein‐lipid emulsion
Authors: Davis Peter L. , Filly Roy A. , Goerke Jon
Published: February 2007

Some investigators have hypothesized that the echogenicity of natural emulsions is due to protein‐lipid interfaces. An in vitro investigation of these phenomena indicates that the observed echoes are the result of entrapped microbubbles that can remain relativelystable in certain naturally occurring products, such as buttermilk.
Relationship between the pericardial and pleural spaces in cross‐sectional imaging
Authors: Lewandowski Bernard J. , Jaffer Nasir M. , Winsberg Fred
Published: February 2007

Sixty patients, including 15 with large pericardial effusions, five with large left pleural effusions, and nine with both, were studied prospectively with two‐dimensional echocardiography to verify the relation of percardial effusions and posterior paramediastinal pleural effusions to the descending thoracic aorta. It was found that large pericardial effusions lie anterior to the descending aorta both at the level of the left atrium and the left ventricle, whereas large posterior paramediastinal pleural effusions lie posterior, lateral, or posterolateral to the descending aorta. A retrospective study of 148 M‐mode echocardiograms showed similar findings; but the descending thoracic aorta was less reliably identified, and the lateral position of pleural effusions with respect to the aorta could not be evaluated.
Ultrasonic evaluation of therapeutic response in tumors: Its value and implications
Authors: Paling Michael R. , Shawker Thomas H. , Dwyer Andrew
Published: February 2007

Not only may ultrasound demonstrate the presence of a tumor mass at various sites in the abdomen, but it may also be useful in measuring the size of the mass. The rate of tumor growth or regression was followed by ultrasound in 28 patients with ovarian carcinoma undergoing chemotherapy. The ability of ultrasound to make precise measurements of tumor size is discussed, and the value of these measurements is explored. This quantification may be valuable in the assessment of therapeutic response in pelvic cancer, and the technique may be applicable to other intra‐abdominal mass lesions.
B‐scan echo‐amplitude measurement in patients with diffuse infiltrative liver disease
Authors: Shawker Thomas H. , Moran Beckie , Linzer Melvin , Parks Stephen I. , James Stephen P. , Stromeyer F. Wayne , Barranger John A.
Published: February 2007

B‐scan echo‐amplitude measurements of the liver were recorded in a prospective clinical trial involving 56 persons—28 normal volunteers and 28 patients with Gaucher disease. The nonspecular liver parenchymal echoes were found to be abnormally elevated in Gaucher patients despite relatively normal liver biochemical values and absence of symptomatic liver disease. Echo amplitude corresponded directly to the amount and histologic distribution of abnormal glycolipid accumulation within the liver. The highest abnormal values were recorded when there was clumping of the glycolipid cells, producing discontinuities within the range of ultrasound resolution. B‐scan echo‐amplitude measurements accurately represent the degree of histologic abnormality in Gaucher patients, suggesting that this technique should be useful for monitoring enzyme replacement therapy.
Sonographic measurement of lateral ventricular width in early ventricular dilation
Authors: Fiske Charles E. , Filly Roy A. , Callen Peter W.
Published: February 2007

Cerebral real‐time ultrasound examinations from 35 high‐risk premature newborn infants and 25 normal‐term infants were reviewed for early signs of ventricular dilation. Measurements of the midbody lateral wall of the lateral ventricle to falx distance and ratio of this distance to the hemispheric width were obtained. Midbody lateral ventricular widths were also measured. Results indicate that displacement of the medial wall of the body of the lateral ventricle toward the midline is an earlier sign of ventricular dilation than is displacement of the lateral wall away from the midline.
Sonography for diagnosis and follow‐up of neonatal adrenal hemorrhage
Authors: Pery Menucha , Kaftori Joseph K. , Bar‐Maor J. A.
Published: February 2007

Neonatal adrenal hemorrhage was diagnosed by ultrasound as an echo‐free mass superior to downward displaced normal kidneys in three newborns. In one, the adrenal hemorrhage was bilateral. Fine needle aspiration was performed to confirm the diagnosis in one case. The babies were followed‐up until adrenal calcifications were seen on ultrasound as linear echoes with posterior acoustic shadowing. These calcifications were confirmed by plain films. It is suggested that the diagnosis of neonatal adrenal hemorrhage should be based on ultrasound and on one initial intravenous urogram. Follow‐up examinations should be restricted to ultrasound and plain films. In doubtful cases fine needle aspiration can be added for confirmation.
Evaluation of the lower extremities
Authors: Lenkey Joseph L. , Skolnick M. Leon , Slasky B. Simon , Campbell William L.
Published: February 2007

The Octoson, an automated, water‐delay ultrasonic scanner, that provides excellent demonstration of the normal anatomy of subcutaneous tissues, muscles, and blood vessels, was used to evaluate the lower extremities of 25 patients. A variety of pathologic conditions were demonstrated, including popliteal cysts, hematomas, an abscess, and an aneurysm.
Evaluation of three methods for obtaining fetal weight estimates using dynamic image ultrasound
Authors: Deter Russell L. , Hadlock Frank P. , Harrist Ronald B. , Carpenter Robert J.
Published: February 2007

The effectiveness of three methods (Campbell and Wilkin,6 Warsof,3 Warsof et al4) for estimating fetal weight from measurements of the abdominal circumference (AC) and biparietal diameter (BPD) has been evaluated in 125 patients studied with dynamic image ultrasound. Investigations of the population as a whole indicated that the Campbell‐Wilkin and Warsof methods systematically overestimated the weight (mean deviation: 5.3% and 1.6%, respectively), while the method of Warsof et al gave systematic underestimations (mean deviation: – 3.2%). The variability of the two Warsof methods was similar (SD: 8.8% and 8.4%) and significantly lower than that seen with the Campbell‐Wilkin method (SD: 13.9%). When separate weight subclasses (500 gm to 4500 gm) were examined, the mean deviations and their variability were significantly lower with the two Warsof methods. The method of Warsof3 showed the most consistency among the weight subclasses. These results indicate that of these three methods, the best estimates of fetal weight are provided by the Warsof3 procedure.
Abdominal ultrasound in advanced ovarian carcinoma
Authors: Paling Michael R. , Shawker Thomas H.
Published: February 2007

The ultrasonic appearance of pelvic tumor and intra‐abdominal dissemination is reported in 57 patients with advanced ovarian carcinoma. The primary pelvic tumor was found to be solid or mixed solid‐cystic. In no case was the primary malignancy exclusively cystic. In 23 patients, intra‐abdominal extrapelvic tumor was detectable, and in eight patients there were solid liver metastases. The usefulness of both static and real‐time ultrasound scanning in detecting stage III and IV disease is discussed.
Cerebrovascular assessment using a doppler carotid scanner and real‐time frequency analysis
Authors: Johnston Kenneth W. , deMorais Domingos , Kassam Mahmood , Brown Peter M.
Published: February 2007

The results of two methods for noninvasively diagnosing carotid disease are described. In the first study, a color‐coded continuous‐wave Doppler scanner was used. As evaluated by arteriography in 56 sides, the sensitivity and specificity of the Doppler scanner for diagnosing carotid lesions with greater than 50% stenosis was 71% and 82%, respectively. We found that many of our initial problems could be overcome by the concomitant use of a real‐time frequency analyzer. Specifically, when the Doppler waveforms were displayed, we found that: 1) signals that had been attenuated by calcification or plaques, or had reduced velocity as a result of a proximal stenosis, could still be detected; 2) when the velocity of flow was increased to compensate for a contralateral carotid stenosis, the waveforms could still be of diagnostic value; 3) distinguishing between the internal and external carotid arteries was easier than relying on the audio signal alone; 4) when the scan showed internal carotid occlusion, morphological evaluation of the external and common carotid waveforms was helpful in verifying the scan result; and 5) artifactual noise on the Doppler waveform could be recognized. In the second study, frequency analysis recordings were evaluated semiquantitatively by measuring peak frequency and the fractional width of the Doppler frequency spectrum at peak systole. Our preliminary results show that this approach is of diagnostic value in that it has the potential to detect minor stenoses.
Ultrasound in the ovarian hyperstimulation syndrome
Authors: Rankin Richard N. , Hutton Linda C.
Published: February 2007

Ovarian hyperstimulation syndrome is well recognized clinically, usually in association with drug therapy for infertility. The ultrasonic appearance of the ovarian cystic enlargment in ten patients with the findings on follow‐up in six patients is described. The role of ultrasound in this condition is shown to be in diagnosis, for staging, and follow‐up.
Mucocutaneous lymph node syndrome with hydrops of the gallbladder diagnosed by ultrasound
Authors: Koss James C. , Coleman Beverly G. , Mulhern Charles B. , Arger Peter H. , Tuchman David N.
Published: February 2007

One of the complications of the mucocutaneous lymph node syndrome is acute hydrops of the gallbladder. Although surgery may be required occasionally, spontaneous resolution of gallbladder hydrops in patients is common. Ultrasound is the optimal method for evaluating these patients.
Intrauterine membranes: Sonographic findings and clinical significance
Authors: Burrows Patricia E. , Lyons Edward A. , Phillips Harold J. , Oates Ian
Published: February 2007

We have identified six cases of chorioamniotic separation, three diagnosed in the third trimester and three cases seen in early pregnancy, at or prior to 16 wk' gestation. The sonographic findings consist of a fine mobile echodense line separated from the chorion and uterine wall by a lucent space. The membrane may completely surround the fetus and may extend over the fetal surface of the placenta, in which case the chorion may be identified as a separate echo. Two patients with chorioamniotic separation in the third trimester had polyhydramnios. The infants had no manifestations of amniotic band syndrome. The membranes seen in four other conditions are described and compared with chorioamniotic separation.
The use of ultrasound in the detection of intrauterine growth retardation: A review
Authors: Deter Russell L. , Harrist Ronald B. , Hadlock Frank P. , Carpenter Robert J.
Published: February 2007

This review discusses the problem of detecting intrauterine growth retardation (IUGR) with ultrasound. A new procedure for standardizing the reporting of such studies is presented. Using this standard format, the results obtained by various investigators using a variety of parameters are summarized, compared and evaluated. Suggestions for standardizing such investigations are presented.
Evaluating doppler devices using a moving string test target
Authors: Walker Andrew R. , Philips David J. , Powers Jeffry E.
Published: February 2007

Two moving string test targets have been developed and used to characterize ultrasound Doppler instrumentation. The characteristics investigated were sample volume size and location. The tests were performed on a combined echo/Doppler instrument and on an annular array system. The procedures can be carried out routinely in the clinical laboratory to ensure that the instrument is working properly or as an aid for correct interpretation of acquired data.
Evaluation of the peak frequency ratio (PFR) measurement in the detection of internal carotid artery stenosis
Authors: Keagy Blair A. , Pharr William F. , Thomas David , Bowles Donald E.
Published: February 2007

The peak frequency ratio (PFR) between the internal carotid and common carotid artery Fast Fourier Transform Spectral Analysis patterns has been used to identify patients with internal carotid artery stenosis. To evaluate further the accuracy of the PFR, we applied it to the spectral analysis data from 396 vessels whose sound signals were obtained with a Duplex scanner (pulsed Doppler) and 246 arteries whose audible flow data were generated by a continuous‐wave Doppler. The pulse Doppler with spectral analysis (PD/SA) correctly identified 221/254 (87%) of the vessels with less than 50% angiographic stenosis, 81/100 (81%) of the arteries with 50–99% stenosis, and 35/42 (83%) of the totally occluded internal carotid vessels for an overall accuracy of 85%. The continuous‐wave Doppler with spectral analysis (CW/SA) did well in two categories but had an unacceptably high 47% false‐negative rate for arteries with 50–99% stenosis. The PFR when applied to PD/SA test results is a useful parameter in screening patients with suspected internal carotid artery stenosis.
Microbubble formation: In vitro and in vivo observation
Authors: Kort Arthur , Kronzon Itzhak
Published: February 2007

Injection of liquid through a catheter into the circulation is known to produce clouds of signals detected by sonography. Blood forced through a stenotic conduit produced sonographic clouding, and bubbles of 10–100 μm were observed by light microscopy. The microbubbles persisted up to three and a half minutes. Microbubbles were observed in the microcirculation of the rat by placing the catheter tip into the descending aorta of 15 animals, viewing the mesentery at 400X magnification, and recording the results on videotape. Following injection of the rats' own blood, numerous microbubbles lodged promptly at the arteriolar level and obstructed blood flow for up to 200 sec before shrinking sufficiently to pass downstream and allow restitution of flow.
Focused transducer beams in tissue‐mimicking material
Authors: Zagzebski James A. , Banjavic Richard A. , Madsen Ernest L. , Schwabe Mark
Published: February 2007

A comparison is made between pulse echo response profiles obtained in water and profiles obtained in a tissue‐mimicking (TM) material for clinical ultrasound transducers. The TM material is assumed to provide a more accurate indication of actual beam profiles in soft tissue because of the presence of frequency‐dependent attenuation in the material. Pulse echo response profiles measured in the TM medium demonstrate a reduction in the focal distance and degraded resolution distal to the focal distance, in comparison to profiles obtained in water.
The role of ultrasound in the study of polycystic ovarian disease
Authors: Parisi Luigi , Tramonti Maria , Casciano Silvio , Zurli Alberto , Gazzarrini Oscar
Published: February 2007

Seventy‐eight patients with clinical findings pointing to possible polycystic ovarian disease (POD) were studied by ultrasound examination. The endocrine status of each patient was evaluated by assay of blood progesterone levels and gonadotropin luteinizing hormone and follicle‐stimulating hormone (LH‐FSH), both under basal conditions and after luteinizing hormone releasing factor (LH‐RH) and androgen hormone stimulation (testosterone and 17‐ketosteroids under basal conditions and after a suppression test with dexamethasone). POD was diagnosed in nine cases and confirmed in four at operation. Ultrasound examination as an aid to POD diagnosis is discussed and its value underlined as a precise method in determining ovarian size, shape, and structure, and as a follow‐up for patients after surgery.
The timing of a repeat ultrasound examination in the evaluation for ectopic pregnancy
Authors: Kadar Nicholas , Romero Roberto
Published: February 2007

A method is described for timing a repeat ultrasound examination in patients evaluated for ectopic pregnancy in whom the findings are initially nondiagnostic. This method is based on measuring the serum hCG at the time of the initial ultrasound examination, which allows the time interval required for the serum hCG to exceed 6500 mIU/ml to be calculated. When the serum hCG is above this level, the gestational sac of an intrauterine pregnancy can be reliably identified, and failure to do so signifies ectopic gestation. Seven patients referred for ultrasound to rule out ectopic pregnancy had initially nondiagnostic findings. In each case, a correctly‐timed repeat examination, demonstrating a gestational sac, enabled the diagnosis to be excluded.
Real‐time ultrasound and pulsed doppler evaluation of the retroplacental clear area
Authors: Smith David F. , Foley W. Dennis
Published: February 2007

The retroplacental clear area is a hypoechoic region at the placental‐endometrial interfece which is frequently demonstrated with high‐resolution equipment. During pulsed Doppler examination of the retroplacental clear area, venous signals were obtained in 26 of 27 cases. This is strong evidence that this region is composed of dilated veins.
The clinical significance of dilatation of the collecting system in the transplanted kidney
Authors: Balchunas William R. , Hill Michael C. , Isikoff Michael B. , Morillo Gaston
Published: February 2007

The significance of dilatation of the collecting system of the transplanted kidney and its relationship to bladder distention was reviewed in 39 renal recipients examined by sonography (94 studies). The degree of pelvicaliceal (PCS), ureteral, and bladder distention was graded and correlated with the 24‐hr urine output, nuclear renal scan, and clinical follow‐up. Marked PCS distention can indicate obstruction(33%), especially when there is no associated bladder distention (60%) and a fluid collection lies along the path of the ureter. The 24‐hr urine output did not influence the degree of PCS distention.
Empirical findings relating sample volume size to diagnostic accuracy in pulsed doppler cerebrovascular studies
Authors: Knox Robin A. , Phillips David J. , Breslau Paul J. , Lawrence Ramona , Primozich Jean , Strandness Donald E.
Published: February 2007

Ultrasonic duplex scanning has a sensitivity of 97% in detecting disease of the carotid bulb. However, the specificity is much less, being 37%. The error in distinguishing normal arteries from those with minimal disease appears to be in part related to the size of the sample volume of the pulsed Doppler. This paper addresses the importance of the features of scan head design in relation to distinguishing normal and diseased arteries.
Ultrasound evaluation of the posthysterectomy pelvis
Authors: Parulekar Suhas G.
Published: February 2007

Ultrasound findings in pelvic examinations of 80 patients with a previous hysterectomy are evaluated. Ovaries were located low in the pelvis close to the superior end of the vagina in a large number of patients. An enlarged ovary contiguous with the superior end of the vagina may simulate the appearance of the uterus. Occasionally, the superior end of the vagina or cervical remnant (in patients with a supracervical hysterectomy) may be prominent and should not be mistaken for a pathologic mass.
Transabdominal ultrasound in the evaluation of prostate size
Authors: Abu‐Yousef Monzer M. , Narayana Ambati S.
Published: February 2007

This paper stresses the value of transabdominal ultrasound that utilizes basic ultrasound equipment in evaluating the size of the prostate. We performed ultrasound examinations on 43 patients with benign prostatic hyperplasia, and in 33 of these, sonography was done prior to surgery in an effort to compare the size of the prostate estimated by ultrasound with that of the postoperative specimen. In the vast majority of these patients, the difference between the estimated size and that of the specimen was insignificant. Ultrasound examination is easy, fast, noninvasive and reasonably accurate.
M‐mode omnidirectional recordings obtained from two‐dimensional echocardiography
Authors: García‐Fernández Miguel Angel , Fiser Carlos Suzacq , Rohr Alvaro Beltran , Yanguela Mar Moreno , Garcia Fezmin Bañtuelos
Published: February 2007

A simple and inexpensive procedure to obtain M‐mode tracings at any level or direction from two‐dimensional echocardiograms is described. The method permits a complete M‐mode visualization of (1) segmental motion of the cardiac walls, (2) structures difficult to reach with conventional procedures, and (3) two or more cardiac valves simultaneously.