bluuebunny/crossref_metadata_2025 huggingface dataset:
Hydronephrosis Secondary to Bladder Distension
Authors: Mann Melanie J.
Published: March 2006

This study was undertaken to evaluate if distension of the urinary bladder can cause reversible distension of the pelvicalyceal system of the kidneys. Ultrasound examinations on 72 healthy individuals with distended bladders showed a 13.9% incidence of mild (Grade 1) and a 2.8% incidence of moderate (Grade 2) hydronephrosis which disappeared when the bladder was emptied. Altered ureteral peristaltic patterns resulting from elevated intravesicular pressure and anatomic changes at the ureterovesical junction may provide a physiologic explanation for the transient hydronephrosis observed. A finding of moderate or severe hydronephrosis irrespective of the degree of bladder distension should alert the sonographer to the likely presence of obstructive uropathy.
Prenatal Sonographic Detection of Symelic Bipodia Sirenomelia
Authors: Brookshire-Quinn Charlotte , Jeanty Philippe
Published: March 2006

Presented is the prenatal sonographic detection of a case of symelic bipodia sirenomelia associated with bilateral renal agenesis. This is the rarest form of sirenomelia (mermaid syndrome), and the diagnosis is important as the condition is lethal. Termination of the pregnancy is generally recommended for these cases, regardless of gestational age.
Ultrasound Diagnosis of an Acardius Acephalic Monster in a Quintuplet Pregnancy
Authors: Sceusa Donna K. , Klein Pamela E.
Published: March 2006

Acardius acephalic monster is one variety of a rare complication of monozygotic monochorionic twin gestations. Pregnancies with a greater fetal number are increasing with the use of fertility drugs. When a serious complication like acardia affects one fetus, the accompanying risks to the other fetuses, particularly the cotwin, are difficult to assess. An experience with an acardius acephalic monster in a quintuplet pregnancy is described here.
Probe Covers and Disinfectants for Transvaginal Transducers
Authors: Odwin Charles S. , Fleischer Arthur C. , Kepple Donna M. , Chiang David T.
Published: March 2006

There are a variety of probe covers and disinfectants available to minimize the risk of transferring infections to patients during transvaginal sonography (TVS). This article describes the methodology for preventing transmission of pathogenic microorganisms to patients and personnel.
Computers in the Sonographic Laboratory
Authors: Dubose Terry J.
Published: March 2006

This basic review of personal computers emphasizes their use in diagnostic sonography as well as other medical settings. This limited discussion is intended for novice personal computer users and includes basic information about hardware, software, and suggestions for their operation.
Extracorporeal Shock Wave Lithotripsy
Authors: Hearn Bobbi
Published: March 2006

A review of the mechanics, technical components, and treatment specifics associated with extracorporeal shock wave lithotripsy (ESWL) is presented. An overview of device similarities and differences, shock wave theory, and the use of ESWL for treatment of biliary and urinary calculi is covered. A general synopsis of relevant topics is provided with emphasis placed on those aspects that are related to sonography or may potentially require the involvement of a sonographer.
Assessing Mitral Stenosis with Doppler Echocardiography
Authors: Taylor Richard
Published: March 2006

Echocardiographic techniques have been used extensively in the noninvasive evaluation of mitral stenosis. Although mitral valve area can be reliably predicted by two-dimensional echocardiography (2DE) in selected patients, neither M-mode nor 2DE techniques provide any direct hemodynamic information. The subsequent utilization of Doppler techniques allows for interrogation of coexistent blood flow alterations and an estimate of the pressure gradient across the mitral valve using the modified Bernoulli equation. Since the pressure gradient is found to vary with flow volume, an additional Doppler technique using the concept of pressure half-time provides an assessment of the severity of mitral stenosis that is related to mitral valve area and independent of hemodynamic factors. Although several studies reporting good reliability have contributed to the widespread acceptance of the pressure half-time concept, recent reports have indicated significant limitations with the pressure half-time method leading to inaccuracies and poor reliability in predicting the mitral valve area. This review discusses the development of the pressure half-time concept and the implications of these recent research findings on the critical use of the Doppler pressure half-time method to estimate the mitral valve area.
Positioning Strategy for Optimal Visualization of a Left Adrenal Mass
Authors: Krebs Carol A. , Rawls Karen , Nall Linda A.
Published: March 2006

The sonographer's knowledge of anatomy along with the use of various patient positions to enhance the visualization of the adrenal gland will produce optimal diagnostic images. In this symposium, we will review recommended patient positions and demonstrate their use in scanning a metastatic adrenal lesion.
Maternal Serum Aipha-Fetoprotein Screening and the Role of Ultrasound
Authors: Smith Cheri , Grube Gerald L. , Wilson Shelia
Published: March 2006

Measuring the amount of maternal serum alphafetoprotein (MS-AFP) has resulted in the detection of multiple fetal anomalies and fetal demise. Ultrasound has been essential in the detection of causes of elevated and decreased levels of MS-AFP. Elevated MS-AFP levels have been associated with inaccurate dates, fetal demise, neural tube defects, abdominal wall defects, and sacrococcygeal teratomas. Decreased levels of MS-AFP have been associated with inaccurate dates, nonpregnancy, hydatid mole, and Down syndrome fetuses. A retrospective study performed at Loma Linda University on 493 patients with abnormal MS-AFP values resulted in detection of 25 anomalies with increased MS-AFP levels and 10 anomalies with decreased MS-AFP levels.
A New Ultrasound Technique to Visualize the Proximal Fetal Cerebral Ventricle
Authors: Cronan Michael S. , McGahan John P.
Published: March 2006

In routine obstetric scanning of the fetal cranium, the near or proximal portion of the fetal cerebrum is obscured by reverberation caused by overlying cranium. A new technique is described in which the ultrasound probe is angled in relation to the bony calvarium to allow visualization of the more proximal fetal cerebrum, cerebral ventricle, and choroid plexus.
Deep Venous Thrombosis of the Lower Extremity
Authors: Arkfeld Susan J. , Rouse Glenn A. , de Lange Marie
Published: March 2006

Duplex venography of the lower extremity is a promising new method for evaluating deep venous thrombosis. The examination technique and its effectiveness are reviewed, and the sonographic appearance of thrombi is described and illustrated.
Meckel Syndrome
Authors: Saw Pamela D. , Rouse Glenn A. , de Lange Marie
Published: March 2006

Meckel syndrome is a rare, lethal, genetic disorder that can be diagnosed sonographically. Five cases of Meckel syndrome were sonographically observed prenatally between 18 and 33 weeks. In all five cases, the fetal kidneys were large and echogenic. Two of four fetuses with encephaloceles were correctly identified sonographically, and two of four fetuses with polydactyly were identified with ultrasound. Major sonographic findings in 24 previously reported cases are reviewed. Differential diagnoses are also discussed. In any fetus with large, echogenic kidneys, one should suspect Meckel syndrome and should search for the other associated abnormalities, chiefly, encephalocele, polydactyly, hydrocephalus, and cleft lip and palate.
Legal Liability: A Sonographer's Perspective
Authors: Gill Kathy
Published: March 2006

The medicolegal crisis continues to rise at epidemic proportions. What once was a physician-oriented problem has become a problem for all health professionals. The role of the sonographer is unique in that his or her ability plays a critical role in the ability of the physician to make a diagnosis. Sonography has become widely accepted among physicians, and its portability and cost-effectiveness enable us to leave the hospital setting to provide services to clinics, private offices, and mobile operations. The increase in the use of diagnostic ultrasound imaging coupled with media exposure inevitably has caught the eyes of the legal world. Research into this subject is giving us insight into primary problem areas and helping us to understand the importance of the roles of the sonologist and sonographer and their responsibility to work as a team. This article concentrates on sonographer-related cases and discusses ways to minimize the risks of litigation.
Biological Effects of Ultrasound
Authors: Hedrick W. R. , Hykes D. L.
Published: March 2006

Damage induced by ultrasound is associated with mechanical, thermal, and cavitation interactions with matter. The physical basis for each is discussed. Cavitation is examined in detail with the aid of illustrative examples.
Evaluating Ureteral Jets with Color Doppler in Adults
Authors: Garza Robin R. , DuBose Terry J. , Hill Larry , Porter Linda , Ellzey Robert F.
Published: March 2006

Color Doppler was used to evaluate urine jets within the urinary bladder in adult patients. In normally hydrated patients, urine was noted to jet from both sides within an interval of a few seconds. Future use of color Doppler in evaluating renal function and urinary tract pathology by visualizing urine output may be possible.
Sonographic Assessment of Fetal Male Genitalia
Authors: Zafaranloo Simindokt , Gerard Perry S. , Wise Gilbert
Published: March 2006

The genitalia was visualized as a part of the general fetal anatomical survey during prenatal ultrasound of more than 2210 fetuses between the ages of 16 to 42 weeks. The sex detection rate for 1200 male fetuses was more than 93%. No testicular descent was present before 20 weeks but was seen as early as 22 weeks; 98% of fetuses showed descent of one or both testes at about 35 weeks. Moderate hydrocele was detected in 5% of fetuses of 30 weeks gestation or older. No abnormality was found in a patient with bilateral neonatal testicular torsion during prenatal ultrasound. The authors believe a brief examination of fetal genitalia may identify abnormalities of fetal gender and detect more serious conditions such as scrotal hernia and prenatal testicular torsion, which requires surgical intervention at birth.
Sonographic Findings in Trisomy 18
Authors: Swan Terry J. , Rouse Glenn A. , de Lange Marie
Published: March 2006

Trisomy 18 is the second most common trisomy syndrome. Sonographically, trisomy 18 syndrome can present with a wide range of fetal anomalies. The specific anomalies discussed in this report include choroid plexus cysts, agenesis of the corpus callosum, cleft lip, micrognathia, cystic hygroma, cardiac defects, diaphragmatic defects, omphalocele, spinal defects, and extremity defects. Knowledge of the abnormalities associated with trisomy 18 enhances the sonographer's ability to recognize this phenomenon when encountered.
Biologic Effects of Ultrasound
Authors: Hedrick W. R. , Hykes D. L.
Published: March 2006

The results of in vitro experiments and animal studies using a wide range of ultrasound intensity levels are reviewed. Somatic, genetic, and teratogenic effects of ultrasound exposure in mammals are examined. The weaknesses of the studies and their clinical applications are discussed.
A Technique for Examining the Total Joint Arthroplasty Patient for Deep Venous Thrombosis
Authors: Menking S. A. , Choroszy C. J. , Tremaine M. D.
Published: March 2006

Positioning of patients to obtain diagnostic images can be a problem for vascular technologists. This concern is escalated during evaluation of the total joint arthroplasty patient. For patients with unstable joint revisions and other orthopaedic conditions, it is recommended that the patient be manipulated as little as possible. From the results of over 3,500 lower extremity venous examinations using an obstetric/gynecologic table, the authors have developed a technique which can assist the technologist to obtain clear images in a majority of total joint arthroplasty patients.
Sonographic Detection of Metastatic Disease of the Pyloris
Authors: Seekins April
Published: March 2006

Adult pyloric stenosis may be associated with many diseases, including portal hypertension, cirrhosis, gastritis, acquired immunodeficiency syndrome (AIDS), anorexia nervosa, syphilis, leukemia, lymphoma, and primary and metastatic cancer. Therefore, it is important that the screening abdominal ultrasound examination include pyloric-antral evaluation in those patients presenting with nausea, vomiting, abdominal pain, and abnormal laboratory values. Irregularity or decreased echogenicity of the gastric wall should be noted. The gastric wall thickness should approximate the size of the common bile duct in comparison. Wall thickness of greater than 4-6 mm is abnormal and needs documentation and further diagnostic evaluation.
Biologic Effects of Ultrasound
Authors: Hedrick W. R. , Hykes D. L.
Published: March 2006

Multiple issues affecting the safe use of ultrasound in the clinical environment are discussed. Topics include an analysis of the concept of benefits versus risks, American Institute of Ultrasound in Medicine (AIUM) evaluations, minimum threshold for thermal effects, clinical efficacy in obstetrics, education and training, and potential exposure limits.
A Reevaluation of the Use of Sonography in the Renal Transplant
Authors: Josiah Belgrove N. , Rouse Glenn A. , Williams Darlla M.
Published: March 2006

In spite of recent disappointment with Doppler assessment of acute rejection in cases of renal transplant, sonography remains a valuable means of assessing the transplanted kidney. Sonography can aid in the evaluation of transplant anuria, deteriorating renal function, and postsurgical hypertension. Although the sonographic findings are sometimes nonspecific, they often contribute invaluable information that clarifies the clinical picture. In this report, sonographic findings in urinary obstruction, urinary leak, extrinsic transplant compression, acute rejection, arterial narrowing, arteriovenous shunt, and segmental infarction are reviewed and illustrated.
Ultrasound Can be Helpful in Evaluation of HELLP Syndrome
Authors: Ardill Richard , Schuveiller Michael J. , Browne Debra A. , Snow Shellie
Published: March 2006

Hemolysis, elevated liver enzymes, and low platelets, or HELLP syndrome, is a rare form of preeclampsia.1 Epigastric pain, due to liver enlargement, parenchymal necrosis, or rupture, may be the only symptom of this syndrome. Ultrasound examination may be useful in detecting liver hemorrhage or infarction in patients with HELLP syndrome. A case of HELLP syndrome in which sonographic changes of the liver were demonstrated during a 48-hour time period is reported here.
Contrast Two-Dimensional Echocardiography Provides Clinical Information Not Available with Color Flow Imaging
Authors: Waggoner Alan D. , Davila-Roman Victor G. , Barzilai Benico , Perez Julio E.
Published: March 2006

Contrast two-dimensional (2D) echocardiography using peripheral venous injections of agitated saline provides useful clinical information not available with standard 2D Doppler and color flow imaging techniques. Intraor extracardiac right-to-left shunting in patients with atrial or ventricular septal defects and patent ductus arteriosus can be identified in this manner, and the relative degree of shunt can be assessed. Other conditions, such as left superior vena cava to the coronary sinus or pulmonary arteriovenous malformation, are accurately detected only when contrast 2D echo is incorporated during the noninvasive examination. Recent work has also demonstrated that venous injections of agitated saline can be used to enhance continuous wave Doppler recordings of tricuspid regurgitant jet envelopes when poorly defined, or with color flow imaging to characterize the jet area. Twodimensional visualization of the needle placed in the pericardial sac for drainage of pericardial effusion may be difficult. Injection of agitated saline through the needle may be used to verify proper location in the pericardial sac and not in the ventricular chambers. The role of contrast 2D echocardiography with new agents has been used to assess myocardial perfusion. All of these applications of contrast echo contribute to standard echocardiographic techniques to provide a better characterization of flow dynamics not seen with color flow imaging.
Sonographic Evaluation of Fetal Anomalies Associated with Maternal Diabetes Mellitus
Authors: Ciccone Virginia M. , Rouse Glenn A. , de Lange Marie
Published: March 2006

Women with preexisting diabetes mellitus are at higher risk than others to give birth to an infant with congenital anomalies. Sonographic examination aids in the detection of these anomalies during pregnancy. The fetal anomalies associated with preexisting diabetes, including anencephaly, holoprosencephaly, occipital encephalocele, spina bifida, cardiac defects, situs inversus, duodenal atresia, anal atresia, and femoral hypoplasia, are reviewed. The sonographic appearance of several of the anomalies is illustrated.
Sonographic Evaluation of an Ectopic Spleen Simulating a Pelvic Mass
Authors: Golbey Stuart , Gerard Perry S. , Rosenblatt Melvin , Ahmad Shahabuddin
Published: March 2006

The presence of a pelvic spleen is an exceedingly rare occurrence. Correct diagnosis, which is essential for appropriate management, can be suggested by sonographic evaluation and confirmed with the use of computed tomography. The case presented here demonstrates the necessity of examination of the entire abdomen by sonography when a pelvic mass of unknown etiology is encountered.
Sonographic Prenatal Diagnosis of Allantoic Cyst
Authors: Harp Jeanne , Rouse Glenn A. , de Lange Marie
Published: March 2006

A case of an allantoic cyst of the umbilical cord with urinary tract involvement was detected in a fetus by sonographic examination. The pregnancy was followed to term, and a healthy infant was born. Embryologic development of the umbilical cord, clinical significance, and differential diagnosis of cystic lesions of the cord are discussed.
Doppler Assessment of Renal Resistive Indices in Patients with Pregnancy Induced Hydronephrosis
Authors: Schreiber Renee S. , Kelly Richard B.
Published: March 2006

Diagnostic ultrasound is the method of choice for screening suspected urinary tract obstructions. Recent research indicates that renal resistive indices obtained with duplex Doppler sonography are useful in distinguishing obstructive from nonobstructive renal disease processes in the nonpregnant patient with a dilated collecting system. During pregnancy, hydronephrosis is present in 80% of cases. However, maternal hydronephrosis in the pregnant patient is indistinguishable with real time ultrasonic imaging from significant obstructive uropathy. This prospective study was undertaken to evaluate renal resistive indices in pregnant women. Doppler assessment revealed no significant difference (P < 0.01) between hydronephrotic and nonhydronephrotic kidneys.
Ultrasonographic Identification of Polyhydramnios
Authors: Persutte Wayne H.
Published: March 2006

Polyhydramnios is a condition where there is more amniotic fluid than is normal for gestational age, and it is associated with various maternal and fetal abnormalities. Ultrasonography is the primary means of assessing the amount of amniotic fluid. To date, an association between polyhydramnios and aneuploidy has not been firmly established. Therefore, a retrospective analysis was conducted of 766 patients who were referred to a high-risk referral center between January 1, 1986 and January 1, 1990 for ultrasound examination and genetic amniocentesis, to investigate the relationship between polyhydramnios and aneuploidy. During the course of the complete ultrasound examination, the amniotic fluid was quantified using standard methods and patients were categorically placed into one of two groups. Group 1 included all patients with normal or decreased amounts of amniotic fluid, and group 2 included all patients with polyhydramnios. The results of the fetal cytogenetic analysis were obtained for each fetus. A total of 726 patients met the criteria to be included in the study. The rate of aneuploidy was 3% (19 cases in 690 patients) in group 1 and 17% (6 cases in 36 patients) in group 2. A statistically significant difference between the two groups in the incidence of aneuploidy was observed (P = 0.0001). This study also showed that only 28% (10 out of 36) of nondiabetic and nonsensitized patients had an uncomplicated pregnancy outcome. It is therefore concluded that within a high-risk population pregnancies complicated by polyhydramnios are at significant risk for aneuploidy; prenatal cytogenetic analysis may be offered to patients with polyhydramnios, regardless of concomitant ultrasonographic findings; and pregnancies complicated by polyhydramnios are at risk for peripartum complications and poor pregnancy outcome.
Infection Control Standards in Diagnostic Imaging
Authors: Dolinkievich Rosemary , Murphy Kathleen , Holland Rosemary
Published: March 2006

Universal precautions for blood and body fluid contact are basic to infection control guidelines. Medical personnel are required to follow a planned infection control protocol within their departments. The handling of patients, supplies, and equipment in sonography involves applying the appropriate protocol for the particular situation. The infection control protocol at St. Joseph's Hospital, Pheonix, Arizona is reviewed and applied to all aspects of clinical ultrasound. Infection control in ultrasound begins with sonographers, and their goal should be to prevent contamination and to restrict the spread of disease.
Prenatal Ultrasonographic Findings After One Test Showing Elevated Maternal Serum Alpha-Fetoprotein Levels
Authors: Persutte Wayne H. , Lenke Roger R. , Weaver Michael
Published: March 2006

An elevation in the maternal serum alpha-fetoprotein (MSAFP) level during pregnancy has been shown to increase the risk of pregnancy complications (i.e., intrauterine growth retardation, premature labor or delivery, preeclampsia, fetal demise, etc.) and fetal structural anomalies. Ultrasound has been shown to be a useful tool in the identification and subsequent management of patients affected by these complications. At our facility, we routinely evaluate patients after one test reveals an elevated MSAFP level. Our findings support the concept of performing the ultrasonographic evaluation after the first finding of elevated MSAFP, and of using an MSAFP cutoff of >2.0 multiples of the median (MOM), rather than >2.5 MOM.
Transvaginal Color Doppler Ultrasonography in the Evaluation of Placental Circulation
Authors: Ren Kenna , Curry Reva
Published: March 2006

Transvaginal color Doppler sonography has provided the capability to qualitatively evaluate blood flow in small branches of the uterine arteries, umbilical cord arteries, and intraplacental fetal arteries in early pregnancy. Accurate identification of these small vessels and analysis of their flow characteristics have improved our understanding of the physiology and pathophysiology of early pregnancy that alters the umbilicaluteroplacental circulations. Further development of this technique may help to predict fetal outcome in highrisk pregnancies and in pregnancies with complications, such as intrauterine growth retardation, preeclampsia, and trophoblastic invasion.
Color Flow Detection of Vein of Galen Malformation in Utero
Authors: Vandy Zainabu K. , Drose Julia A.
Published: March 2006

A vein of Galen malformation in an arteriovenous malformation that may cause a variety of cardiovascular and neurologic sequalae. Color flow Doppler is an accurate and fast method of diagnosing a vein of Galen malformation in utero. Early detection may improve the prognosis for these infants.
The Fundamentals of Transperineal Ultrasound
Authors: Ruffin John D. , Pearson Jerry , Woods K. Todd
Published: March 2006

As the field of sonography continues to advance, new techniques for imaging are continually being developed. One such technique is transperineal imaging. This paper will give the sonographer a basic understanding of the technique, as well as the anatomy seen and the advantages of and common indications for this technique.
Antenatal Detection of Trisomy 22
Authors: Woletz Paula S.
Published: March 2006

Trisomy 22 (47, XX, +22), a rare chromosomal defect, was detected antenatally by chromosome analysis of the amniotic fluid after an obstetric ultrasound examination revealed multiple anomalies. The ultrasound findings included intrauterine growth retardation, holoprosencephaly, cleft lip, cardiac anomalies, decreased amniotic fluid level, and an abnormally thickened nuchal fold. Postnatal examination and autopsy confirmed the ultrasound findings.
A Review of Polycystic Kidney Disease
Authors: Lanius Katresa , Pearson Jerry
Published: March 2006

The purpose of this article is to simplify the complex and varied topic of polycystic kidney disease. It is hoped that this will improve the sonographer's understanding of the types, modes of inheritance, ages of onset, clinical presentations, and sonographic appearances of this disease.
The Role of Echocardiography in Infective Endocarditis
Authors: Kinch Loretta A. , Bansal Ramesh C. , de Lange Marie T.
Published: March 2006

Infective endocarditis continues to be a significant diagnostic and therapeutic problem. During the last two decades, transthoracic echocardiography, and more recently, transesophageal echocardiography have been used in patients with the clinical syndrome of endocarditis to detect vegetations and assess the extent of valvular damage. Certain echocardiographic findings have important prognostic implications and can help determine the timing of surgical intervention. This paper will review the role of echocardiography in the evaluation and management of patients with infective endocarditis.
Sonographic Evaluation of Holoprosencephaly
Authors: Bernal Rosa M. , Rouse Glenn A. , de Lange Marie , William Darlla
Published: March 2006

Holoprosencephaly is a complex brain anomaly in which the primitive forebrain (prosencephaly) fails to properly divide into cerebral hemispheres. The frequency of holoprosencephaly has been estimated to be 1 in every 5,200 to 16,000 live births. The complex cerebral and facial anomalies that are observed in infants and fetuses with holoprosencephaly will challenge the sonographer who encounters them. Prenatal detection of the milder forms is particularly difficult; the infant with mild holoprosencephaly may live for years in a vegetative state. Knowledge of the range of malformations encountered in holoprosencephaly will help the sonographer accurately identify the findings.
Prenatal Sonographic Renal Findings Associated with Trisomy 13
Authors: Butler Tresa , Kennedy Lisa , Buttino Louis , Juberg Richard C.
Published: March 2006

Prenatal ultrasonographic renal findings are described in three cases of trisomy 13. The association of renal anomalies, including hyperlobulation, dysplasia and presence of cortical cysts, with trisomy 13 has been reported previously. This series, however, points out the importance of considering trisomy 13 as a possible diagnosis and recommends prenatal diagnosis when renal abnormalities are found on ultrasound examination.
Use of Endovaginal Color Doppler Ultrasound to Document Fetal Heart Motion in a 5-week Ectopic Gestation
Authors: Sherer David M. , Abramowicz Jacques S. , Kogut Peter L. , Woods James R.
Published: March 2006

With endovaginal sonography, very small gestational sacs may be detected. We describe a case in which endovaginal color Doppler sonography demonstrated active embryonic heart motion in an ectopic gestation at 5 weeks. The possible clinical application of this enhanced diagnostic modality is discussed.
Intraoperative Spinal Sonography
Authors: Pleitez George A. , Rouse Glenn A. , de Lange Marie
Published: March 2006

The uses of intraoperative spinal sonography are reviewed, including localization of lesions and monitoring of surgical correction. The sonographic appearance of intramedullary and extramedullary masses and cysts are reviewed and illustrated. The use of sonography in the surgical treatment of spinal fractures, herniated disks, and spinal stenosis is also discussed.
Antenatal Sonographic Findings in Trisomy 21
Authors: Clark Pamela K. , Hurton Toni L. , Stryker Janice , Benacerraf Beryl R.
Published: March 2006

A case involving a 20-week fetus with Down syndrome is described. Sonographic signs of trisomy 21 included a thickened nuchal fold, heart defect, short femur and humerus length, pyelectasis, hypoplasia of the middle phalanx of the fifth digit, and an abnormal facial profile.
Low Maternal Serum Aipha-Fetoprotein and Renal Agenesis
Authors: Pinheiro Steven , Weinbaum Paul J. , Limber Ellen , Amyot Kristina M.
Published: March 2006

Renal agenesis has usually been associated with high levels of maternal serum alpha-fetoprotein (MSAFP). A case involving a pregnancy with virtually no MSAFP and a fetus with severe renal dysplasia on one side and renal agenesis on the other is presented.
Gartner's Duct Cyst Described by Endovaginal Ultrasound
Authors: Pena Alejandro J. , Carlan Stephen J. , Schorr Stephen J. , Roth Lynn
Published: March 2006

Gartner's duct cysts develop from cystic dilatation of remnants of the embryonic mesonephros. A case in which an asymptomatic Gartner's duct cyst was detected incidentally using endovaginal ultrasound is described.
Impacted, Infected Retained Vaginal Tampon in a Patient with Vaginal Duplication
Authors: Schuveiller Michael , Browne Debbie , Snow-Oney Shellie , Roberson Ted , Hueftle Mark
Published: March 2006

A case of an impacted, infected, retained vaginal tampon in a patient with vaginal duplication and uterus didelphis bicollis is presented. The ultrasonographic and magnetic resonance imaging appearance of a retained vaginal tampon and the possible etiology of this event is discussed.
Fetal Ovarian Cyst and Subsequent Torsion
Authors: Cohen Gary R. , Chenoweth-Mitchell Carol Kay , Thorp James A. , Meyer Bruce , Yeast John
Published: March 2006

This case illustrates the sonographic changes seen in and the progression of a fetal adnexal cyst with torsion.
Sonographic Evaluation of Twin Embolization Syndrome
Authors: Gray Paula , Rouse Glenn A. , de Lange Marie
Published: March 2006

Twin embolization syndrome (TES) is a rare complication of twin-twin transfusion after intrauterine demise of one of a pair of twins sharing the same placenta. In such cases, infarcts in the surviving co-twin can cause structural and functional changes, presumably due to embolization of debris, thrombus, thromboplastic material, and toxins from the dying twin's circulation into the circulation of the other twin. Sonographic, clinical, and pathologic findings in 3 new cases are reported, and 38 previously reported cases of TES are reviewed. Of the 41 cases, 34 (83%) had evidence of a destructive structural brain defect. In the 34 cases with brain defects, 23 (68%) had intracranial cystic changes. Microcephaly had developed in the surviving twin by the time of delivery in 7 (41%) of the 17 cases with brain defects and evidence of twin fetal demise before 22 weeks. Intestinal atresia was noted in 4 of 41 cases (10%), and renal dysplasia or renal cortical necrosis was observed in 11 cases (27%). In cases of intrauterine demise of a monochorionic twin, careful follow-up evaluation of the surviving twin should be performed.
Sonographic Measurement of Adipose Tissue
Authors: Bellisari Anna
Published: March 2006

Regional adipose tissue deposits, especially intraabdominal adipose tissue, are associated with health risks, such as cardiovascular disease and diabetes mellitus. Current anthropometric techniques can measure subcutaneous adipose tissue with calipers, but cannot measure intraabdominal adipose tissue. Scanning techniques, such as computerized tomography and magnetic resonance imaging, which have been used to measure intraabdominal adipose tissue, are expensive, and some involve exposure to radiation. This study investigated the use of B-mode ultrasound for measuring adipose tissue. Subcutaneous adipose tissue could be measured reliably with B-mode ultrasound but intraabdominal adipose tissue could not.
Burkiff's Lymphoma
Authors: Zuti Sylvia , Rouse Glenn A. , de Lange Marie , Agness Melisa
Published: March 2006

Burkitt's lymphoma is one of the fastest growing tumors, and it primarily affects children and young adults. Since sonography is often the first imaging procedure performed in these patients, knowledge of the wide range of sonographic appearances of this type of tumor can aid the sonographer in recognizing Burkitt's lymphoma. In this report, we review and illustrate the sonographic appearance of Burkitt's lymphoma involving abdominal organs, including the liver, gallbladder, pancreas, kidneys, bowel, and mesentery.
Ultrasound-guided Aspiration of the Parotid Duct in Acute Suppurative Parotitis
Authors: Warshawsky Robin , Gross Beth , Lawrence Loretta P. , Wolk David P.
Published: March 2006

Ultrasound is useful in evaluating the parotid gland. Ultrasound guidance was used for aspiration of the parotid duct in a case of acute suppurative parotitis.
Maternal Renal Oncocytoma in a Second Trimester Pregnancy
Authors: Mathis Kathy A. , Sanders Roger
Published: March 2006

A case involving a maternal renal oncocytoma discovered in a second trimester pregnancy during ultrasound evaluation is presented.
Development of a Protolype Anthropomorphic Ultrasound Phantom
Authors: Boyce Kari E.
Published: March 2006

The objective of this project was to develop inexpensive, portable, anthropomorphic ultrasound phantoms that can be readily reproduced for use in sonography education programs. Hydrophilic organic polymer, water, polyester fiberfill, latex and nylon tubing have been used to construct prototype phantoms of a pediatric upper and lower abdomen, adult female pelvis, and adult neck regions. A nontoxic, biodegradable, hydrophilic organic polymer in a 1:12 ratio with water produced suitable primary construction media. Images obtained of the prototype phantoms were judged by experienced sonographers to adequately simulate human ultrasonic images. The sound propagation speed through the organic polymer was equivalent to that of soft tissue. Using this technique, sonographic imaging in representative human body regions may be simulated using inexpensive organic polymer and consumer products. Phantom portability and ease of construction facilitates use of this design for demonstrations and hands-on scanning exercises within sonography education programs.
The Use of Ultrasound in Exiracorporeal Membranous Oxygenation Therapy
Authors: Woznick Shannon R.
Published: March 2006

Extracorporeal membrane oxygenation (ECMO) therapy is used to treat certain neonates with respiratory failure. Ultrasound is a useful tool in the ECMO therapy process. Diagnostic medical sonography is used to determine which patients would most benefit from this treatment, and for evaluation of the patient during ECMO therapy. This paper discusses what ECMO therapy is, which patients receive it, and some changes that may be observed sonographically in patients who undergo this treatment.
Photographic System Qualily Control
Authors: Hedrick W. R. , HYKES D. L.
Published: March 2006

Transparency film is typically used to record representative images from a diagnostic ultrasound examination. The photographic system is composed of multiple components, including the display monitor, the hard copy camera, and film processing. Consistent, highquality image recording requires periodic monitoring of photographic system performance. A practical quality control program, including parameters to be monitored with control limits and testing frequency, is presented.
Sonographic Detection of a Twin Ectopic Pregnancy
Authors: Deckert Laurie S. , Townsend Ronald R. , Drose Julia A.
Published: March 2006

The use of endovaginal scanning can greatly enhance the ability to diagnose twin ectopic pregnancy, a rare phenomenon, before surgery. A case is presented in which a living twin ectopic pregnancy was detected by endovaginal ultrasound.
Abdominal Pregnancy Afer Hysterectomy
Authors: Zorn Melinda A.
Published: March 2006

Misdiagnosis of abdominal pregnancy can be fatal. An uncommon finding, abdominal pregnancy is even more unusual after hysterectomy. A pregnancy of approximately 14 weeks of gestation was observed sonographically and confirmed by emergency surgery.
The Detection of Spina Bifida Using Indirect Sonographic Cranial Signs
Authors: Hurton Toni L. , Clark Pamela K. , Benacerraf Beryl R.
Published: March 2006

The authors discuss a case of fetal spina bifida that was apparent sonographically because of cranial abnormalities. The neural tube defect itself was not visible until a transvaginal scan was performed.
Inage Distortion Caused by an Improperly Adjusted Hardcopy Camera
Authors: Hedrick W. R. , Hykes D. L.
Published: March 2006

Photographic recording of representative images from a diagnostic ultrasound examination documents clinical findings. Geometric distortion can be introduced into the hardcopy image by the image-recording device. Size, shape, and relative positions of structures are not accurately portrayed. Illustrative examples of distortion produced by improperly adjusted hardcopy cameras are presented. Testing methods for distortion are described.
A Profile of Sonographers and Vascular Technologists Analysis of ARDMS Registrant Data (1989-1992)
Authors: O'Neill Thomas R.
Published: March 2006

The American Registry of Diagnostic Medical Sonographers (ARDMS) collects information about its registrants annually via registrant surveys. Results of the ARDMS annual registrant surveys from 1989 to 1992 are summarized. Among the important findings, it is concluded that the percentage of ARDMS registrants employed on a full-time basis has remained constant. A summary of where registrants xxork (employment setting, not geographic region) and how they spend their professional time is also given. The frequency with which 12 professional journals were read is reported.
Sonographic Demonstration of Complete Portal Vein Thrombosis
Authors: Nassau Michelle G. , Gwin-Stewart Juli
Published: March 2006

Ultrasound imaging in combination with spectral or color flow Doppler is a valuable tool for the diagnosis of portal vein thrombosis. A case of complete portal vein thrombosis in a woman with a parasitic infection is reported. Findings of examination with ultrasound, computed tomography, and angiography are discussed.
An Overview of Thermal and Mechanical Acoustic Output Indices
Authors: Hedrick W. R. , Hykes D. L.
Published: March 2006

Thermal and mechanical indices are acoustic output descriptors that provide a means of assessing the potential for biologic effects from exposure to diagnostic ultrasound. Models and assumptions used in the estimation of acoustic output indices are discussed with illustrative diagrams. The defining equation for each index is presented. Safety guidelines based on the index values are reviewed.
Color Flow Imaging of Leiomyomas and Focal Myometrial Contractions During Pregnancy
Authors: Smith Karin M.
Published: March 2006

In a prospective study, 15 pregnant patients with a total of 7 leiomyomas and 10 focal myometrial contractions were evaluated with color flow imaging. Images were graded based on vascularity. Leiomyomas were grade III (hypervascular) in 85.7% and grade II (peripheral flow only) in 14.3% of cases. Contractions were grade I (hypovascular) in 80% and grade II in 20% of cases. Contractions involving the placenta demonstrated vascularity adjacent to the myometrium at the placentation site. Color flow imaging is useful when used in conjunction with two-dimensional findings to differentiate between leiomyomas and focal myometrial contractions during pregnancy.
Sonographic Evaluation of the Fetal Gallbladder in Utero
Authors: Wei Jillian M. C. , Haller Jack O. , Rachlin Susan , Berman Mimi C.
Published: March 2006

The purpose of this prospective study was to determine the incidence of visualization of the fetal gallbladder, to characterize its shape, to determine its normal measurements, and to cor relate its size with gestational age. Data were collected between January and April of 1993 from the ultrasound laboratories of three major hospitals in the greater New York City area. Fetuses with any anomalies were excluded from the study. Gestational age as determined by ultrasound ranged from 15 weeks to term. Experienced sonographers at each site and the investigator followed a scanning protocol requiring the identification of the fetal gallbladder by shape, measurement in two axes, and evalua tion of its content. Measurements of fetal gallbladder length and width were correlated with the estimated ultrasound gestational age. Fetal position and the number of hours since the mother's last meal were also noted. The fetal gallbladder was observed in 84% of the examinations. The most common shape was the tear-drop configuration (58%). Fetal gallbladder length and fetal gallbladder width correlated significantly with gestational age as estimated by ultrasound (r = 0.85 and 0.74, respectively; P = 0.05). Echogenic material was noted in one (1.7%) of the fetal gallbladders. The percentage of fetal gallbladder visualization was higher than in previous reports. Even though a significant correlation was found between size and gestational age, more quantitative studies with a larger sample would be needed for development of a fetal gallbladder nomogram.
Ultrasound Exanination of the Feline Thyroid
Authors: Cartee Robert E. , Bodner Susan T. Finn , Gray Bruce W.
Published: March 2006

Sonographic imaging and measurement in vivo of the thyroid gland of 10 cats was compared with the histologic appearance and the physical measurements of the extirpted glands. Al though the general echotexture of the thyroid glands could be evaluated, poor margin determi nation resulted in a poor correlation with the physical measurements. Physical size, weight, and volume parameters of the normal feline thyroid are presented.
Ultrasound Differentiation of Two Pediatric Abdominal Masses
Authors: Croft Debra , Dickerson Marilyn
Published: March 2006

Neuroblastoma and Wilms' tumor are the two most common abdominal malignancies encountered in pediatric patients. Neuroblastoma generally arises from the adrenal gland, whereas Wilms' tumors arise from the kidney. Recognition of the clinical symptoms, laboratory values, and sonographic appearances of these two entities can provide valuable information on location and extent of the neoplasm. Early detection of a neoplasm improves the survival rate of patients. The purpose of this article is to review characteristics and features of neuroblastoma and Wilms' tumor that will aid in the differential diagnosis of these tumors.
Atypical Sonographic Appearance of Testicular Epidermoid Cyst
Authors: Keener Thomas , Drose Julia A. , Townsend Ronald R.
Published: March 2006

A case of an epidermoid cyst with an atypical sonographic appearance is presented. Although ultrasound may aid in the diagnosis of this entity, it is not definitive.
Rudimentary Horn Ectopic Pregnancy
Authors: Bruening Cissy , Farnsworth Wanda , Hansen Scott
Published: March 2006

Ultrasound is widely used for diagnosis of ectopic pregnancies, and is the accepted imaging modality to rule out ectopic pregnancies. Rudimentary horn pregnancy can be difficult to differentiate from an abdominal pregnancy. The visualization of an intact placenta with welldefined borders seems to be a key in the differential diagnosis. It is also helpful to obtain confirmation of a diagnosis such as this with another imaging modality. Magnetic resonance imaging (MRI) is the most helpful and widely recognized imaging modality for this purpose.
Ultrasound Examination of Pregnant Women Infected with the Human Immunodeficiency Virus
Authors: Goldstein Candace L.
Published: March 2006

Human immunodeficiency virus (HIV) infection in women is on the rise. Approximately 80,000 women in the United States are currently infected, and the majority of them are of reproductive age. It is estimated that health professionals working in obstetrics will begin to see more women with symptoms of HIV infection. Trends in obstetric research include clinical trials of treatment of HIV-infected pregnant women with zidovudine and the potential use of ultrasound-guided invasive testing of the fetus to determine fetal infection status. Sonographers working in obstetrics should be educated about the transmission of HIV, its potential impact on maternal and fetal health, and appropriate infection control procedures.
Ultrasound Diagnosis of Benign Gallbladder Hemorrhage
Authors: Schiller Vicki L. , Reynolds Diana , Sarti Dennis A.
Published: March 2006

The sonographic diagnosis of hemobilia is rare. Once this entity is recognized sonographically, its etiology must be determined. The characteristic sonographic appearance of gallbladder hemorrhage is described.
Sonographic Localization of a Nonpalpable Tissue Expander Port
Authors: Alleyne Abelkhrim , Pimentel Guillermo , Frates Mary C.
Published: March 2006

Subcutaneous soft tissue expanders are used by plastic and reconstructive surgeons for a variety of skin defects. Gradual distension of the expander with saline allows progressive growth of the overlying skin. Access to the expander is via a subcutaneous port, which is easily palpable by the physician. Occasionally, due to overlying scar tissue or migration, the port is lost. In these cases, ultrasound is a useful method of rapid noninvasive localization of the lost tissue expander access port.
Amniotic Band Syndrome
Authors: Richardson Sonya McFerrin , Gill Kathy , Arcement Larry
Published: March 2006

Amniotic band syndrome (ABS) is an uncommon, nonrecurrent cause of fetal malformations of the visceral region, craniofacial region, and extremities. Although the cause of ABS is still debated, accepted theories about why this syndrome occurs are discussed. Sonographers should be familiar with the features of this syndrome to differentiate between ABS and other similar anomalies.
The Efects of Diabetes Mellitus on Pregnancy
Authors: Graham Melinda
Published: March 2006

Ultrasound evaluation and imaging of the fetus is valuable in diagnosing anomalies associated with diabetes mellitus, including neural tube defects, cardiac anomalies, and renal anomalies. These anomalies can be diagnosed and monitored sonographically, making ultrasound an essential component of obstetric care for diabetic women. A literature review of the effects of diabetes mellitus on pregnancy and the fetus was conducted. The importance of ultrasound in the detection and evaluation of anomalies associated with diabetes mellitus is also included.
Emphysematous Cholecystitis
Authors: Mlkvy Kerri-Lyn , Horrow Mindy
Published: March 2006

Emphysematous cholecystitis is a rare form of acute cholecystitis. This condition is characterized by the presence of gas-forming bacteria in the gallbladder wall, lumen, and bile ducts. This disorder can have a variety of sonographic appearances. Recognition of the gas is important for sufficient treatment of this disease, which carries a high risk of mortality. Differential diagnoses and the results of previous studies of this condition are discussed.
Sonography of the Koch's Pouch for Ileostomy
Authors: Evans Kevin D.
Published: March 2006

A case is presented that demonstrates hydronephrosis in a patient with a Kock's pouch form of ileostomy. This occurrence emphasizes the importance of having the patient catheterize the ileostomy to ensure that a false-positive diagnosis of a dilated renal collecting system is avoided. The Kock's pouch procedure for ileostomy is briefly reviewed.