bluuebunny/crossref_metadata_2025 huggingface dataset:
A prospective comparative study of transvaginal ultrasonography and digital examination for cervical assessment in the third trimester of pregnancy
Authors: Lim B. H. , Mahmood T. A. , Smith N. C. , Beat I.
Published: February 2007

Digital examination of the cervix has traditionally been the “gold standard” for cervical assessment. However, it can be subject to inter‐ as well as intraobserver variation. The usefulness of transvaginal ultrasonography for cervical assessment is examined in this study. Although differences between measurements of transvaginal ultrasonography and digital examinations were observed, transvaginal ultrasonography appears to be a potentially useful and reproducible technique for assessing cervical changes in pregnancy and for prediction of onset of labor.
Sonourethrography in the evaluation of anterior urethral strictures: Correlation with radiographic urethrography
Authors: Gupta Sanjay , Majumdar Banibrata , Tiwari Ashutosh , Gupta Rakesh Kumar , Kumar Anant , Gujral Ratni B.
Published: February 2007

A total of 30 patients with suspected urethral strictures underwent sonographic and roentgenographic urethrograms. Two patients showed a normal anterior urethra in the sonourethrogram; 29 strictures were diagnosed in the remaining 28 patients, 1 patient showing strictures at two different sites. Sonourethrography was an accurate predictor of stricture length, retrograde urethrography underestimating the stricture length in most of the cases. Periurethral structures, including the urethral wall, corpus spongiosum, corpora cavernosa, bulb, and external urinary sphincter, were seen clearly with sonourethrography. Periurethral fibrosis was seen in 16 patients and graded as mild (n = 5), moderate (n = 2) or severe (n = 9), depending on the depth of involvement of the corpus spongiosum. Sonourethrography was unsatisfactory in the evaluation of membranous strictures, failing to visualize the proximal limit of the stricture. © 1993 John Wiley & Sons, Inc.
Myoma vs. contraction in pregnancy: Differentiation with color Doppler imaging
Authors: Kessler Ada , Mitchell Donald G. , Kuhlman Kathleen , Goldberg Barry B.
Published: February 2007

During pregnancy, leiomyomas may cause complications such as spontaneous abortion, premature labor, and obstruction of labor. The conventional real‐time ultrasound examination usually detects myomas adequately, but, in some cases, a local thickening of the uterine wall persists throughout the examination, interfering with the differentiation between myoma and contraction. In such cases, repeat scanning approximately 30 minutes later differentiates contractions, which usually resolve, from myomas.

We examined 10 patients with B mode and color Doppler ultrasonography. In the 5 patients with myoma, we observed splaying of the vessels around the mass, whereas in the 5 patients with contraction, there was no vessel displacement in the area of the local myometrial thickening. The use of color Doppler and observation of these findings may obviate a prolonged ultrasound examination in questionable cases. © 1993 John Wiley & Sons, Inc.
Ultrasonic signs of pneumothorax: Preliminary work
Authors: Targhetta RéMi , Bourgeois Jean‐Marie , Chavagneux Roseline , Coste Estelle , Amy Dominique , Balmes Pierre , Pourcelot Léandre
Published: February 2007

Ultrasonography is considered to have limited application in respiratory diseases because air reflects sound waves. Twenty‐four patients with radiologically confirmed pneumothorax and 100 healthy subjects underwent sonography. In all normal subjects, the hyperechoic pulmonary interface showed respiratory motions termed the “gliding sign” with some comet‐tail artifacts. Sonographic signs were shown in all pneumothoraces: disappearance of the gliding sign and no comet tails. The extent of collapse cannot be evaluated, but it is possible to determine its area in partial pneumothorax (N = 5). The follow‐up (N = 8) showed the reappearance of the gliding sign. Ultrasonography may be helpful in diagnosing pneumothorax in certain cases. © 1993 John Wiley & Sons, Inc.
Ultrasonography and biliary extracorporeal shock‐wave lithotripsy
Authors: Jakobeit Christian , Greiner Lucas
Published: February 2007

The results of shock‐wave treatment of gallbladder stones depend to a very high degree on the quality and expertise of ultrasonography applied before, during, and after shock‐wave disintegration of the stones. Ultrasonography is decisive in evaluating the inclusion criteria; it is the method of choice for directing the shockwave energy at the stones and monitoring the disintegration process. It is the only diagnostic modality to really demonstrate the gallbladder being free from stones. © 1993 John Wiley & Sons, Inc.
Ultrasonographic changes of early liver cirrhosis in chronic hepatitis B: A longitudinal study
Authors: Lin Deng‐Yn , Sheen I‐Shyan , Chiu Cheng‐Tang , Lin Shi‐Ming , Kuo Yow‐Chii , Liaw Yun‐Fan
Published: February 2007

Ultrasonography of prospectively followed chronic hepatitis B patients who developed liver cirrhosis were reevaluated in order to identify the ultrasonographic changes of early cirrhosis. Ultrasonographic features of 29 patients before and after cirrhosis were as follows: portal vein diameter—1.20 cm/1.29 cm (NS); cirrhosis score—5.69/7.52 (p < 0.01); spleen size index—21.99 cm2/25.84 cm2 (NS). The result suggests that ultrasonographic diagnosis of early cirrhosis is not easy on a single occasion; however, the score system method is helpful in longitudinal follow‐up chronic hepatitis patients. A careful comparison of hepatic parenchymal and surface changes are mandatory. © 1993 John Wiley & Sons, Inc.
Correlation of antenatal ultrasonography and pathological examinations in 153 malformed fetuses
Authors: Weston Michael J. , Porter Helen J. , Andrews Heather S. , Berry P. Jem
Published: February 2007

Findings in 153 abnormal fetuses diagnosed by antenatal ultrasound and subsequently examined by a pediatric pathologist were reviewed. The primary diagnoses in the 153 cases were 67 nervous system anomalies, 19 gastrointestinal system anomalies, 18 genitourinary system anomalies, 13 chromosomal abnormalities, 10 skeletal system amonalies, and 26 other abnormalities. Forty‐six percent of the total number had multiple abnormalities. In 67 cases (44%), autopsy showed further anomalies or altered the ultrasonographic diagnosis. However, in only 36 (25%) were there autopsy findings that altered management. Errors in ultrasound diagnosis were most commonly associated with the presence of multiple anomalies and oligohydramnios. Expert pathological examination remains an essential tool in the management of fetal anomaly. © 1993 John Wiley & Sons, Inc.
Ultrasonic imaging of the tongue, mouth, and vocal cords in normal children: Establishment of basic scanning positions
Authors: Ueda Daisuke , Yano Kouichi , Okuno Akimasa
Published: February 2007

We examined the soft tissue anatomy of the tongue, mouth, and vocal cords in 25 healthy children by ultrasonography, and established basic scanning positions for these organs. In the tongue and the mouth—four scanning positions: the midline sagittal, the paramidline sagittal, the anterior coronal, and the posterior coronal—covered major anatomical components. We could delineate vocal cords in all subjects by transverse scanning on the thyroid cartilage. Although disorders associated with the tongue, floor of the mouth, and vocal cords are less frequent in children, one should recognize normal ultrasound findings to distinguish them from abnormalities. © 1993 John Wiley & Sons, Inc.
A modified transvaginal sonographic technique for better ovarian evaluation
Authors: Pardo Joseph , Kaplan Boris , Rosenberg Carlos , Ovadia Yardena , Neri Alexander
Published: February 2007

Sonographic evaluation of the pelvis of postmenopausal women is not complete until both ovaries are scanned. Transvaginal sonographic examination combined with transabdominal screening is diagnostic in 85% of cases. Transvaginal examination performed with a partially full bladder significantly increased ovarian detection to 93.5% (p < 0.05). © 1993 John Wiley & Sons, Inc.
Vascular signals from pleura‐based lung lesions studied with pulsed Doppler ultrasonography
Authors: Civardi Giuseppe , Fornari Fabio , Cavanna Luigi , Di Stasi Michele , Sbolli Giorgio , Rossi Sandro , Buscarini Elisabetta , Buscarini Luigi
Published: February 2007

Vascular signals arising from pleura‐based lung lesions were studied in 50 patients using pulsed Doppler ultrasonography. Twenty‐seven had malignant lesions and 23 benign lesions. In 24/27 of the malignant masses, we observed no Doppler signals: in 2 cases, a low‐velocity, turbulent, pulsatile flow was demonstrated; in 1 case pulsed Doppler ultrasonography showed only a low‐velocity, continuous flow. In 20/23 of the benign lesions, we found 2 types of Doppler signal waveforms: an irregularly pulsatile, venous‐like signal, and a regularly pulsatile, arterial‐like waveform. The last 8 patients of our series underwent color Doppler ultrasound examination, which demonstrated the presence of arterial and venous vessels in 4 benign lesions and the absence of blood flow in 4 malignant masses. To our knowledge, we report for the first time the ability of obtaining Doppler signals from a variety of lung lesions. The actual clinical relevance of this application requires further studies. © 1993 John Wiley & Sons, Inc.
Small‐for‐menstrual‐age infants: Different subgroups detected using individualized fetal growth assessment
Authors: Simon Nicolas V. , Deter Russell L. , Kofinas Alexander D. , Cavanaugh Sally H. , Shearer David M.
Published: February 2007

Our purpose was to study the individual fetal growth patterns of infants who were born small‐for‐menstrual‐age. Growth in the second and third trimester was assessed in 98 small‐for‐menstrual‐age infants, using individual fetal growth curves generated by the growth model: P = c(t)k+s(t). Growth indices were compared with those previously reported for that method in infants with normal growth. The small‐for‐menstrual‐age infants were distributed into four growth patterns, ie, infants with either normal or decreased second‐trimester growth indices, who, by the time of birth, succeed or fail in fulfilling their individual growth potential. These four growth patterns appear to be associated with different pathophysiological mechanisms and incidences of perinatal complications. Individual fetal growth assessment identifies differences in genetically determined growth and differentiates between fetuses who achieve their growth potential and those with growth failure who are at greater risk for fetal compromise. © 1994 John Wiley & Sons, Inc.
Ultrasonographic evaluation of the biliary tree in patients with atypical chest pain
Authors: Reinus William R , Shady Kevin
Published: February 2007

We studied the use of gallbladder ultrasonography in the evaluation of atypical chest pain (ACP). During an 8‐month period, 52 patients were referred for biliary ultrasonography with a chief complaint of chest pain. Twelve (32.1%) had cholelithiasis discovered by ultrasonography. Four of these 12 (33.3%) underwent subsequent cholecystectomy with complete relief of symptoms. None of the patients with normal ultrasonography for whom follow‐up was available (32) underwent subsequent cholecystectomy. We found no statistical difference in the prevalence of cholelithiasis between the ACP group and 85 asymptomatic controls. Clinical evidence confirms the concept that ultrasonography may play an important role in the evaluation of ACP. © 1994 John Wiley & Sons, Inc.
Umbilical artery Doppler flow‐velocity waveforms in Rhesus‐isoimmunized fetuses before and after fetal blood sampling or transfusion
Authors: Legarth Jesper , Lingman Goran , Stangenberg Magnus , Rahman Feryal
Published: February 2007

Pulsed‐Doppler examinations of blood‐flow velocities in the umbilical artery were carried out before and after 15 diagnostic cordocenteses and 34 fetal blood transfusions into the umbilical vein. There were decreases in the systolic/diastolic ratio (A/B) (p < 0.01), the pulsatility index (PI) (p < 0.05), and the resistance index (RI) (p < 0.01) after cordocentesis but not after fetal blood transfusion. There were no correlations between the initial hematocrit and the umbilical artery Doppler indices in the sample nor in the fetal blood sampling group. In the fetal blood transfusion group, on the other hand, there was a negative correlation between the initial hematocrit and A/B (r = −0.44; p < 0.01) and the RI (r = −0.35; p < 0.05). The umbilical artery Doppler flow‐velocity indices did not predict the fetal hematocrit. © 1994 John Wiley & Sons, Inc.
Ultrasonic evaluation of benign and malignant nodules in echographically multinodular thyroids
Authors: Brkljacic Boris , Cuk Viseslav , Tomic‐Brzac Hrvojka , Bence‐Zigman Zdenka , Delic‐Brkljacic Diana , Drinkovic Ivan
Published: February 2007

In 165 patients with ultrasound findings of multinodular thyroids in whom thyroid resection was performed, sonographic features and pathohistologic findings of removed nodules were analyzed.

Of 426 nodules removed, 70 were carcinomas and 356 benign. Carcinomas are more often hypoechogenic (p < 0.01) and contain nodular calcifications (p < 0.01), while benign nodules are more often iso‐hyperechogenic (p < 0.01), showing intranodular cystic degenerative changes (p < 0.01), showing intranodular cystic degenerative changes (p < 0.01) and perinodular hypoechogenic rim (p < 0.01). Mean diameter of carcinomatous nodules is lwoer than in benign nodules (p = 0.022).

The relative proportion of malignant nodules is highest in the upper halves of thyroid lobes (p < 0.01).

Although certain sonographic signs increase the likelihood of a given lesion being malignant or benign, the lack of absolute specificity in the ultrasound evaluation of thyroid nodules was confirmed. © 1994 John Wiley & Sons, Inc.
Ultrasonography as a primary diagnostic tool in patients with inflammatory disease and tumors of the small intestine and large bowel
Authors: Bozkurt Tayfun , Richter Friederike , Lux Gerd
Published: February 2007

In 240 patients with predefined indications, the validity of ultrasound imaging as a primary diagnostic procedure was examined prospectively. Ultrasonography revealed normal intestinal findings in 150 patients and pathological lesions in 90 subjects. All patients underwent subsequent endoscopic, radiological, or surgical examination. In 7 patients with Crohn's disease and in 2 patients with radiation colitis, the ultrasound findings were false‐negative. In the other 9 cases, ultrasonography suggested false‐positive results. Ultrasonographic examination of the small intestine and large bowel had a very high overall validity, with a sensitivity of 90% and specificity of 94%. © 1994 John Wiley & Sons, Inc.
Neurosonographic imaging of small‐for‐gestational‐age neonates exposed and not exposed to cocaine and cytomegalovirus
Authors: Dogra Vikram Singh , Menon P. A. , Poblete Jesse , Smeltzer James S.
Published: February 2007

We sought to prospectively identify the role of neurosonography in the evaluation of a consecutive group of small‐for‐gestational‐age (SGA) neonates, and also to identify the association of neurosonographic findings with cocaine exposure and cytomegalovirus (CMV) infection. Neurosonographic imaging was performed in 180 SGA neonates within 72 hours of birth. Urine samples were screened for CMV and cocaine metabolites (CM) in all cases. Sixty‐five neonates (37.5%) had an abnormal neurosonographic appearance. Nine neonates were positive for CMV and 31 neonates were positive for CM.

Focal echolucencies (27), ventricular dilation (27), and subependymal hemorrhages (12) were the most common neurosonographic abnormalities. The first two were more common with CM (p < .05). An abnormal neurosonographic pattern was seen more often in SGA neonates with CM (54.8%, 17 of 31; p < .05) and CMV (67%, 6 of 9; p < .01) as compared with the rest (32.6%, 44 of 135; p < .01). Among those without CM or CMV, prematurity was associated with an increased risk for abnormality (p < .001 between groups), specifically subependymal hemorrhage, ventricular dilation, and porencephalic cysts. Five CMV‐positive neonates showed periventricular, echogenic foci mainly in the area of the frontal horn. Two new findings with SGA were caudate nucleus echogenicity and a “moth‐eaten” appearance of the thalamus, each found in three infants.

Neurosonographic imaging is useful in the evaluation of SGA neonates. Focal echolucencies and caudate echogenicity suggest maternal cocaine use, and periventricular echogenic foci strongly suggest fetal CMV infection. © 1994 John Wiley & Sons, Inc.
The relationship between blood flow and pulsatility index in the superior mesenteric artery at rest and during constrictor stimuli in normal subjects
Authors: Ray‐Chaudhuri K. , Ryder S. A. , Thomaides T. , Mathias C. J.
Published: February 2007

The relationships between superior mesenteric artery blood flow (SMABF) and pulsatility index (PI) measurement during rest (25 subjects) and stimuli constricting the SMA (16 subjects) have been studied in normal subjects. At rest and during constrictor stimuli, SMABF and PI were highly reproducible (r = 0.89, p < 0.01 for SMABF, and r = 0.97, p < 0.001 for PI) between two observers. There was significant correlation between changes in SMABF, PI, and SMA vascular resistance during the constrictor stimuli, except during head‐up tilt when PI was unchanged. Both PI and SMABF measurements are reproducible and can be used to monitor physiological changes in suitable (18 of 25) subjects. PI measurement, although semiquantitative, by itself can also be used to monitor these changes. This may be also of importance in pathological situations such as intestinal ischemia, where measurement of volume blood flow may be less accurate due to irregularities of the vessel wall. PI measurement, however, ideally should not be used in studies involving postural change. © 1994 John Wiley & Sons, Inc.
Ultrasound‐guided percutaneous drainage of pyogenic splenic abscesses
Authors: Schwerk Wolf B. , Görg Christian , Görg Konrad , Restrepo Isabel
Published: February 2007

This report summarizes the results of ultrasound‐guided percutaneous drainage procedures in eight patients with solitary (n = 6) and multiple (n = 2) splenic abscesses. Seven patients underwent a total of 15 closed‐needle aspirations with local installation of antibiotic solution. In one case, catheter drainage was performed. All patients received parenteral broad‐spectrum antibiotic therapy. Seven (88%) of the eight patients with splenic abscesses recovered completely following percutaneous drainage procedures and none of these required splenectomy later. In one patient with multiple splenic abscesses, repetitive needle aspiration was ineffective, necessitating splenectomy. The only complication associated with nonsurgical percutaneous interventions was a pleural empyema that resolved with chest tube drainage (complication rate, 13%). These results and those reported in the literature indicate that pyogenic splenic abscesses can be treated effectively by (repetitive) closed aspiration technique or catheter drainage with a relatively low rate of complications. From our experience, splenectomy should only be performed in splenic abscesses that are not accessible percutaneously and in those cases with percutaneous drainage failure. © 1994 John Wiley & Sons, Inc.
Ultrasonic characterization of myocardial photocoagulation lesion size in vivo during Nd:YAG laser irradiation
Authors: Splinter Robert , Tuntelde Jan R. , Chuang Chi Hui , Thompson Michelle , Littmann Laszlo , Svenson Robert H. , Dezern Kathy R. , Tatsis George P.
Published: February 2007

Endocardial coagulation lesions were created using transcatheter continuous‐wave Nd:YAG laser irradiation. Ultrasound monitoring of thermal lesion dimensions was performed using 7.5‐MHz and 10‐MHz transducers directly from the epicardial surface in short‐axis configuration (group A) or through the chest wall (group B). A total of 33 lesions were created in 10 dogs at energy levels ranging from 300 J to 1000 J.

Mean histological lesion width (HW) compared with ultrasonically determined mean width (UW) showed that the differences (mean ± standard deviation) in group A (UW − HW) was = 1.14 ± 0.8 mm, which was not statistically significantly different from zero. In group B, (UW − HW) = 2.04 mm ± 0.7 mm (p < .05), which was statistically significantly different from zero. Mean histological depth (HD) differentially related to ultrasound mean depth (UD) for group A and B combined showed (UD − HD) = − 0.19 mm ± 0.46 mm, not statistically significantly different from zero.

The frequency distribution for width in group A showed ∣UW − HW∣ > 3 mm in 32% of cases. In group B ∣UW − HW∣ > 3 mm in 15%, whereas ultrasound width was larger than histology in 75% of the cases. For depth, ∣UD − HD∣ > 3 mm in 15% of cases.

With further refinement of the technique, ultrasonic tissue characterization may become a useful adjunct to monitoring lesion dimensions during transcatheter laser photocoagulation. © 1994 John Wiley & Sons, Inc.
Evaluation of Doppler echocardiographic atrial pacing stress test in the detection of coronary artery disease
Authors: Hua Qi , Wang Jia‐Rui , Shi Shu‐Ying
Published: February 2007

Doppler echocardiographic atrial pacing stress tests were performed in 23 patients with coronary artery disease (CAD) and 35 normal subjects. It was found that the peak flow velocity (PFV) through the mitral valve decreased at 160 beats per minute (BPM) during pacing in the CAD group (P less than 0.01), but no significant variation was seen in the normal group. No differences between the two groups were observed in ⅓ filling fraction (⅓ FF), total diastolic filling period (DFP) and the ratio of early diastolic filling period (EDFP) to DFP before pacing. However, ⅓ FF and DFP decreased and EDFP/DFP increased immediately following rapid pacing in the CAD group but did not change in the normal group (P less than 0.05, 0.01, and 0.001 respectively). The peak flow velocity during atrial contraction (APFV), time velocity integral during atrial contraction (ATVI) and the ratio of ATVI to total TVI (ATVI/ TTVI)increased immediately following pacing in the CAD group. Using two of three indices–ATVI/TTVI more than 0.35, ATVI increase and 1/3 FF decrease immediately following pacing–as diagnostic criteria for CAD, the sensitivity was 86% and the specificity was 77%. It may be concluded that the Doppler echocardiographic atrial pacing stress test is a feasible and reliable method for detecting CAD. © 1994 John Wiley & Sons, Inc.
Maternal umbilicus: Ultrasound window to the gravid uterus
Authors: Davidoff Ashley , Reuter Karen , Karellas Andrew , Baker Stephen P. , Raptopoulos Vassilios
Published: February 2007

Transabdominal sonograms of 68 consecutive pregnant women were reviewed retrospectively. Images of fetal parts obtained through the umbilical window (UW) were compared with those obtained through the paraumbilical window (PUW) as to (1) thickness of tissue to amniotic cavity, (2) clarity of the part imaged, and (3) noise produced. The paraumbilical tissue thickness had a mean of 18 mm; the umbilical tissue thickness, a mean of 11 mm. In patients where the difference in thickness of their paraumbilical tissue and umbilical tissue was only 0 mm to 6 mm (group 1), the UW improved clarity in 10 of 34 (29%), reduced clarity in 3 of 34 (9%), and did not change clarity in 21 of 34 (62%). Improvement of images with use of the UW was not statistically significant. However, in the group of patients with the difference in tissue thickness between the paraumbilical and umbilical areas of > 6 mm (group 2), clarity was improved in 19 of 32 (60%), reduced in 2 of 32 (6%), and was unaltered in 11 of 32 (34%). In this group the image improvement with the UW was statistically significant. Images through the UW had relatively less noise. In group 1, noise was reduced in 12 of 35 (34%). The effect of the UW on noise reduction was more significant in group 2 (tissue thickness difference > 6 mm): 24 of 31 (77%) of cases. © 1994 John Wiley & Sons, Inc.
Long‐term analysis of ultrasonic features of the antropyloric region 17–27 years after treatment of infantile hypertrophic pyloric stenosis
Authors: Lüdtke Frank‐Erich , Bertus Matthias , Michalski Stefan , Dapper Frank Dietmar , Lepsien Gerd
Published: February 2007

Long‐term follow‐up was performed 17 years to 27 years after conservative (n = 12) and operative (n = 36) treatment in 48 patients with infantile hypertrophic pyloric stenosis (IHPS). The follow‐up examination included an interview to define any existing gastrointestinal symptoms and to determine whether a current disorder of the gastrointestinal tract was present; a clinical examination, including a scintigraphic determination of gastric emptying; as well as—for the first time—abdominal sonography emphasizing the antropyloric region. The sonographical examination included measurements of pyloric diameter and length, as well as wall and muscle thickness in the antropyloric region. The results were compared with data from a control group with the same age and gender distribution. No association was found between the sonographic parameters obtained, reported gastrointestinal symptoms, or altered gastric emptying times for solids and liquids. Clinically relevant disorders of stomach motility after IHPS appear to be a rare occurrence. © 1994 John Wiley & Sons, Inc.
Evaluation of long‐term central venous patency in children with chronic venous catheters using image‐directed Doppler ultrasonography
Authors: Cassey John , Hendry G. M. A. (Mike) , Patel Jatin
Published: February 2007

All children in the Oncology Unit in the Royal Hospital for Sick Children, Edinburgh who had had long‐term central venous catheters removed between 1987 and 1991 underwent central venous assessment by image‐directed Doppler ultrasound scanning techniques. In this study, the implant vein remained patent after decannulation, and we believe should be re‐accessed rather than moving to another site. © 1994 John Wiley & Sons, Inc.
Kidney size in infants of tightly controlled insulin‐dependent diabetic mothers
Authors: Bos Arend F. , Aalders Anette L. , van Doormaal Jasper J. , Martijn Albert , Okken Albert
Published: February 2007

The aim of this study was to evaluate the influence of insulin‐dependent diabetes mellitus in pregnant women on the kidney size of their infants. We measured kidney length in the first week of life using ultrasonography in 20 infants of tightly controlled insulin‐dependent diabetic mothers and 20 healthy newborn controls, matched for birth weight. In the infants of diabetic mothers, the left kidney length ranged from 3.6 cm to 6.0 cm (4.2 cm ± 0.5 cm, mean ± SD). The right kidney length ranged from 3.3 cm to 4.9 cm (4.0 cm ± 0.4 cm). In the control infants the left kidney length was 3.3 cm to 5.4 cm (4.3 cm ± 0.6 cm), and the right kidney length was 3.4 cm to 5.3 cm (4.2 cm ± 0.5 cm). There was no statistically significant difference in right or left kidney length between the two groups. We conclude that in this group of tightly controlled diabetic mothers, the diabetic state does not influence kidney size in their infants. © 1994 John Wiley & Sons, Inc.
Use of the transverse cerebellar diameter/abdominal circumference ratio in pregnancies at risk for intrauterine growth retardation
Authors: Campbell Winston A. , Vintzileos Anthony M. , Rodis John F. , Turner Garry W. , Egan James F. X. , Nardi Deborah A.
Published: February 2007

A prospective study was conducted to evaluate the ability of the transverse cerebellar diameter/abdominal circumference ratio to identify growth‐retarded fetuses. Of the cases analyzed, 48 of 87 (55%) were growth retarded by birth weight. The transverse cerebellar diameter/abdominal circumference ratio identified growth retardation with a sensitivity of 71%, specificity of 77%, positive predictive value of 79%, and negative predictive value of 68%. Fourteen growth‐retarded fetuses were missed by the ratio; however, 57% of the missed cases were severely growth retarded. The transverse cerebellar diameter/abdominal circumference ratio can be useful for the assessment of fetal growth retardation; however, the ratio may be normal in cases of severe fetal growth retardation. © 1994 John Wiley & Sons, Inc.
Ultrasound evaluation of hepatic and splenic microabscesses in the immunocompromised patient: Sonographic patterns, differential diagnosis, and follow‐up
Authors: Görg C. , Weide R. , Schwerk W. B. , Köppler H. , Havemann K.
Published: February 2007

High‐dose chemotherapy, especially for bone marrow transplantation, causes a great degree of immunosuppression, and thus carries the risk for invasive fungal infections. Although hepatic and splenic involvement in disseminated candidiasis is frequent, involvement of these organs is rarely appreciated antemortem. During the last decade, focal hepatosplenic candidiasis has been recognized increasingly by ultrasound.

We report the sonographic and clinical findings of 6 patients: 3 AML (acute myeloid leukemia), 2 NHL (non‐Hodgkin's lymphoma), and 1 HD (Hodgkin's disease) who demonstrated multiple, small‐nodule, hypoechoic lesions in spleen and/or liver after high‐dose chemotherapy. All patients were in complete hematologic remission when the study was performed. Septic fever was unresponsive to antibiotic therapy. Granulocy‐topenia (⩽ 1000/mm3) was seen for at least 10 days. However, the manifestation of hepatolienal microabscesses became apparent by ultrasound only after the neutrophil count returned to normal in all but 1 patient. Microabscesses decreased or disappeared on follow‐up examination after antifungal treatment. Systemic candida infection was confirmed serologically. Sonographic‐guided abscess biopsy (n = 3) revealed necrosis/abscess. Structural inhomogeneity of parenchymal organs was seen for several months after therapy. © 1994 John Wiley & Sons, Inc.
Ultrasound anthropometric reliability
Authors: Harstad Timothy W. , Buschang P. H. , Little Bertis B. , Santos‐Ramos Rigoberto , Twickler Diane , Brown Charles E. L.
Published: February 2007

Method errors and reliabilities were estimated for seven sonographic measurements in pregnancies of 106 women examined between January and July 1989. Teams of two experienced sonographers replicated the following measurements: biparietal diameter (BPD), occipital‐frontal diameter (OFD), anterior‐posterior diameter (APD), transabdominal distance (TAD), and femur diaphysis length (FDL). Multilevel modeling procedures were used to estimate the variance components. Significant (p < 0.01) covariates in the fixed part of the model included an increase in error with greater parity, estimated menstrual age (EMA), and maternal abdominal wall thickness (taken at the umbilicus). Intraobserver reliability ranged from 85.2% (AC) to 99.3% (FDL); interobserver reliability ranged from 80.8% (TAD) to 92.4% (FDL). Method errors, describing the expected error for 68% of the measurements taken, ranged from 0.8 mm to 7.7 mm (intraobserver) and from 1.2 mm to 7.8 mm (interobserver). These results suggest that large error components should be considered in the interpretation of the reliability of ultrasonographically obtained measurements. © 1994 John Wiley & Sons, Inc.
Image‐directed and color Doppler studies of gallbladder tumors
Authors: Li Duan , Dong Bao‐wei , Wu Yu‐li , Yan Kun
Published: February 2007

Thirteen cases of primary adenocarcinoma of the gallbladder (GB), 1 of malignant fibrous histocytoma, 3 of metastatic adenocarcinoma, 5 of adenoma, 5 of polypus, 2 of xanthogranuloma, 6 of chronic cholecystitis, 4 of acute cholecystitis, and 8 of subacute cholecystitis were studied by image‐directed and color Doppler ultrasonography (CDUS). All of the 14 cases of primary GB cancer (10 masses, 4 thickening wall) were found to have a high velocity arterial blood flow signal in the wall of the GB. In contrast, the 3 cases of metastatic cancer of the GB had no blood flow signal in the wall of the GB. For the 30 cases of benign lesions of the GB, only in 12 cases was a low velocity blood flow signal found. Nine of 10 cases of primary GB malignancy were found to have high velocity arterial blood flow signals in the tumor masses. No blood flow signal was observed in the masses of 13 cases (3 of metastatic adenocarcinoma, 5 of adenoma, 5 of polypus). An abnormal high velocity arterial blood flow signal observed within masses in the GB or in the GB wall is a significant feature of primary GB cancer and thus helps to differentiate primary GB cancer from metastatic and benign lesions of the GB. © 1994 John Wiley & Sons, Inc.
Portal vein pulsatility in normal and cirrhotic adults without cardiac disease
Authors: Wachsberg Ronald H. , Needleman Laurence , Wilson Dorian J.
Published: February 2007

The literature indicates that Doppler demonstration of pulsatile flow in the portal vein suggests heart disease, and that retrograde transsinusoidal transmission of atrial pulsations is the mechanism. We noninvasively investigated portal vein pulsatility (PVP) in normal subjects and in patients with cardiac and liver disease, and performed invasive studies in cirrhotic humans and normal pigs. We found that accentuated PVP occurred in some normal subjects and in some patients with cirrhosis, and that mechanisms other than transsinusoidal transmission of atrial pulsations contributed to PVP. Determinants of PVP may include pulsatile portal inflow, transmission of pulsations from the vena cava (IVC) and location of the Doppler sample volume relative to the IVC. © 1995 John Wiley & Sons, Inc.
Comparison of cerebral blood flow velocity estimation with cranial ultrasound imaging for early prediction of outcome in preterm infants
Authors: Rennie Janet M. , Coughtrey Heather , Morley Ruth , Evans David H.
Published: February 2007

Seventy‐four low birth weight infants underwent serial measurements of cerebral blood flow velocity (CBFV) using Doppler ultrasound together with ultrasound imaging of the brain. Surviving infants were examined and assessed using the Bayley scales of mental and motor development at 18 months post‐term. There were no significant differences in mean CBFV between normal and impaired infants. Infants with abnormal neurological signs (n = 6) or developmental delay (n = 3) did not show the usual steady rise in CBFV during the first few days of life. Four of nine had a rise, then a fall in CBFV compared with 4 of 31 with complete data in the normal group. This difference is significant (χ2 = 4.3, p = 0.03). The magnitude of the percentage increase between day 1 and day 3 was also smaller in the abnormal group (median 0% vs. 39%, Mann–Whitney p = 0.03). A structural abnormality seen on the cranial ultrasound image was a better predictor of adverse outcome than an abnormal CBFV pattern, with a better sensitivity and specificity (66% and 97% for imaging compared to 44% and 87% for CBFV). The addition of serial ultrasound Doppler measurements of CBFV did not improve the prediction of outcome obtained using ultrasound imaging alone. © 1995 John Wiley & Sons, Inc.
Quantification and assessment of carotid artery lesions: Degree of stenosis and plaque volume
Authors: Arbeille Ph. , Desombre C. , Aesh B. , Philippot M. , Lapierre F.
Published: February 2007

Various methods were developed for the quantification of the degree of stenosis: B‐mode imaging, CW Doppler with spectral analysis, PW‐duplex, and colorflow imaging. The degree of stenosis can be evaluated using transverse views of the carotid in conventional B‐mode imaging. The diameters of the residual lumen (Ds) and the external diameter (De) of the artery at the same level are measured and the degree of stenosis (in area) is calculated. Two different Doppler methods have been designed and validated for the quantification of the stenosis degree. The first one is based on the determination of the maximal velocity inside the stenosis and requires the use of a duplex device. The second one, based on the quantification of the hemodynamic disturbances at the outlet of the stenosis, can be used either with a duplex system or with a continuous‐wave Doppler system (pencil probe). The color display mode facilitates the determination of the residual lumen and therefore contributes to making the B‐mode method more accurate. Moreover, it provides a visualization of the blood flow which avoids most of the misinterpretations of B‐mode or Doppler data. Several classification systems based on subjective or semi‐quantitative criteria (morphological or hemodynamic) were used to identify different grades of stenosis (<40%, 40% to 60%, 60% to 90%, etc.) These classifications provide an evaluation of the degree of stenosis accurate enough to discuss the possibility of performing an endarterectomy on a symptomatic patient. When the surgical treatment seems to be inappropriate, the patient is treated medically; the follow‐up of the lesion (ie, every 6 months) requires a more precise evaluation of the plaque changes than does stenosis classification. Several parameters have been designed and validated for the quantification of the degree of stenosis by ultrasound. These parameters, whether measured with the B‐mode and color image or with the Doppler spectrum, allow quantification of the stenosis degree in percentage of lumen reduction with a precision of approximately ± 10%. Such a quantitative assessment of carotid lesions for a long period of time may be very helpful in evaluating the beneficial effects of medical treatment or in detecting any significant increase of the stenosis that could lead to surgical treatment. A new method for the plaque volume assessment has been recently validated. The plaque volume index expressed in mm3 is calculated from logitudinal and transversal B mode views of the bifurcation. © 1995 John Wiley & Sons, Inc.
Multiplane transesophageal echocardiographic evaluation of transvenous defibrillation leads
Authors: Fehske Wolfgang , Jung Werner , Omran Heyder , Manz Matthias , Moosdorf Rainer , Lüderitz Berndt
Published: February 2007

Permanent transvenous cardioverter–defibrillator leads were investigated by multiplane transesophageal echocardiography (TEE) (1) to determine whether intracardiac lead segments can be visualized, (2) to verify the position of the coils, and (3) to detect possible thrombus formation. The diagnostic information obtained in 62 patients by TEE was compared to that of transthoracic echocardiography (TTE). Abnormal findings were only visualized by multiplane TEE. However, further controlled studies are needed to determine the clinical relevance of displaced caval (one patient) and ventricular coils (15 patients), ventricular (1 patient) or atrial (6 patients) loops, and of clinically uneventful thrombi (13 patients). © 1995 John Wiley & Sons, Inc.
Refractory hemolytic anemia secondary to perivalvular leak diagnosed by transesophageal echocardiography
Authors: Formolo John M. , Reyes Pablo
Published: February 2007

Transesophageal echocardiography (TEE) has become increasingly important in the assessment of mitral valve prosthetic dysfunction. We report on three patients who developed medically refractory hemolytic anemia after St. Jude mitral valve replacement secondary to perivalvular mitral prosthetic regurgitation. Two of the three cases had corrective surgical intervention that resolved the hemolytic process. Careful transesophageal echocardiographic evaluations of the perivalvular area proved diagnostic and resulted in appropriate management decisions. © 1995 John Wiley & Sons, Inc.
Doppler velocity histogram analysis of hepatocellular carcinoma
Authors: Yasuhara Kazuaki , Kimura Kunio , Nakamura Hiroshi , Iwadare Makoto , Ohto Masao , Matsuzaki Osamu
Published: February 2007

To study the characteristics of tumor blood flow, flow profiles from hepatocellular carcinomas (39 profiles) and normal hepatic arteries (23 profiles) were evaluated using velocity histograms obtained with Doppler ultrasound. The histograms were classified into three types: (1) high‐peak, (2) flat, and (3) low‐peak. Characteristically, the low‐peak types and the flat types, with flows in opposing directions, were seen only in the tumor vessels. The turbulence in a phantom flow model was of the low‐peak type. Spectral analysis revealed that the velocity profile of tumor blood flow was different from that of noncancerous flow and that tumor blood flow was characterized by turbulence. © 1995 John Wiley & Sons, Inc.
Sonography of the costal cartilage: Normal anatomy and preliminary clinical application
Authors: Choi Yo Won , Im Jung‐Gi , Song Chi Sung , Lee Jeong Sang
Published: February 2007

Costal cartilages of 10 controls and 12 patients with Tietze's syndrome (n = 6), deformed (exaggerated bowing) cartilage (n = 4), focal enlargement (n = 1), and cancer‐invaded cartilage (n = 1) were examined with ultrasonography. In controls, ultrasonography detected 237 of 240 costal cartilages (98.8%) and 58 of 105 intercartilage connections (55%) with three variations. Correlation with CT was available in 7 patients (1 Tietze's syndrome, 4 deformities, 1 cartilage enlargement, and 1 cancer) among 8 patients whose CT results were known to the sonographer. Sonography showed normal (n = 4) or marginally blurred (n = 2) cartilages in 6 Tietze's syndromes. Ultrasonography is a promising technique in the examination of costal cartilages. © 1995 John Wiley & Sons, Inc.
Ultrasonic “honeycomb” appearance of uterine submucous fibroids undergoing cystic degeneration
Authors: Cohen Jacob R. , Luxman Dov , Sagi Joseph , Jossiphov Joseph , David Menachem P.
Published: February 2007

Uterine fibroids are the most common of uterine benign tumors. Generally, the ultrasonic appearance of uterine fibroids is typical, and diagnosis is uncomplicated. However, the sonographic characteristics of fibroids undergoing cystic degeneration, and especially those of the submucous type, may be misleading. We present a series of submucous fluids with cystic degeneration in peri‐ and postmenopausal women showing a distinct sonographic “honeycomb” pattern erroneously diagnosed as endometrial hyperplasia. The correct diagnosis was established by hysteroscopy. © 1995 John Wiley & Sons, Inc.
Changes in transmitral and pulmonary venous flow patterns in the first day of life
Authors: Harada Kenji , Takahashi Yasushi , Shiota Terukazu , Tamura Masamichi , Takada Goro
Published: February 2007

The purpose of this study was to see the relationship between changes in pulmonary venous flow velocities and those in transmitral flow velocities during the first day of life. A serial Doppler echocardiography was performed in 24 normal neonates at 2, 12, and 24 hours of age. The size of the ductus arteriosus was 4.3 ± 0.5 mm at 2 hours and 2.1 ± 0.7 mm at 12 hours, and closed in 21 of 24 neonates at 24 hours. The peak systolic pulmonary venous flow (peak S), peak diastolic pulmonary venous flow (peak D), peak D/S, peak velocity at early diastolic filling (peak E), and peak E/A, which were high at 2 hours, decreased significantly at 12 hours but remained constant thereafter. The size of the ductus arteriosus was found to be correlated with peak S, peak D, and peak D/S. There was a direct correlation between peaks E and D (r: 0.64, p < 0.01) as well as a direct correlation between peaks E/A and D/S (r: 0.36, p < 0.05). These results indicate that the diastolic pulmonary venous flow is determined by the same factors that influence the transmitral flow. These waveforms may reflect the increase in pulmonary circulatory volume by left‐to‐right shunting through the ductus arteriosus. © 1995 John Wiley & Sons, Inc.
Antenatal sonographic detection of the proximal esophageal segment: Specific evidence for congenital esophageal atresia
Authors: Satoh Shoji , Takashima Takeshi , Takeuchi Hajime , Koyanagi Takashi , Nakano Hitoo
Published: February 2007

To determine the biologic significance of a transient anechoic area observed in the midline of the fetal neck when attempting an antenatal ultrasound diagnosis of congenital esophageal atresia (CEA), a prospective study was made in 10 cases presenting both polyhydramnios and an unusually small stomach size due to a decrease in fetal stomach fluid. There were 8 cases indicating a transient anechoic area in the fetal neck, all of which were diagnosed as having CEA postnatally by plain roentgenogram, neonatal surgery, or autopsy findings. The remaining 2 cases had no CEA; one had Nager's syndrome and the other, a disorder involving neuronal migration in the central nervous system. These results suggest that an anechoic area in the middle of the fetal neck can be used as an indication of CEA and also for differentiating this condition from diseases with possible swallowing impairment. © 1995 John Wiley & Sons, Inc.
Review of artifacts associated with transrectal ultrasound: Understanding, recognition, and prevention of misinterpretation
Authors: Hulsmans Frans‐jan J. H. , Castelijns Jonas A. , Reeders Jacques W. A. J. , Tytgat Guido N. J.
Published: February 2007

Artifacts are inadequate representations of the structures being imaged. Transrectal ultrasound (TRUS) used for evaluating rectal tumors has its own, unique spectrum of artifacts such as (1) pseudomasses (beam thickness: imaging of rectal folds; mirror image: reflection at an intraluminal fluid level); (2) inadequate size of the lesion (mirror image or grating lobes); (3) simulation of malignant infiltration (beam thickness, attenuation or refraction); (4) incomplete field of view (shadowing; reverberation or mirror‐image); (5) confusing echo patterns (side lobe artifacts or mirror image: reflection at the balloon surface). The understanding of the physical properties of ultrasound is the basis for the recognition of these artifacts and prevention of misinterpretation. We present a review of these artifacts and their causes. © 1995 John Wiley & Sons, Inc.
Transcranial doppler ultrasound assessment of intracranial hemodynamics in children with diabetic ketoacidosis
Authors: Hoffman William H. , Pluta Ryszard M. , Fisher Asma Q. , Wagner Michele B. , Yanovski Jack A.
Published: February 2007

The pathophysiology of acute neurological complications of diabetic ketoacidosis (DKA) in children and adolescents is not completely understood. We sought to establish whether transcranial Doppler (TCD) was able to monitor the changes of cerebral blood flow regulatory mechanisms, as measured by cerebral blood velocities (CBF‐V), Gosling's pulsatility index (PI), and cerebral vascular reactivity (VR), prior to and during treatment of DKA. The increased values of PI suggested an increase of intracranial pressure (ICP) due to the existence of cerebral vasoparalysis, based on the low values of VR prior to treatment and 6 hours after initiation of treatment. At 24 hours, the correction of hematocrit and pH was associated with a significant decrease of PI, suggesting a decrease of ICP, likely due to a return of vascular tone in response to the low PaCO2. This was further supported by an increase of VR in all patients. At 48 hours, when PaCO2 returned to normal, the PI remained low and the VR increased further, suggesting a complete reversal of vasoparalysis and a return of cerebral blood flow regulatory mechanisms. © 1995 John Wiley & Sons, Inc.