bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantitative characterization of the growth of the fetal kidney
Authors: Bertagnoli L. , Lalatta F. , Gallicchio R. , Fantuzzi M. , Rusca M. , Zorzoli A. , Deter R. L.
Published: February 2007

The time‐dependent changes in the antero‐posterior (A‐P) diameter and length (L) of fetal kidneys has been evaluated by means of statistical analysis of measurements made during the third trimester in a normal population. Two hundred eighty pregnant women were examined between 22 and 40 weeks of gestation. Differences between operator‐scanner combinations were evaluated. The relationships of the A‐P diameter and length to menstrual age were determined in cross‐sectional and longitudinal studies of kidney growth. The results obtained confirmed that measurements of fetal kidney can be used as an additional parameter in the routine assessment of fetal well being and to rule out kidney malformations characterized by changes in kidney size.
Ultrasonic diagnosis of scrotal contents using newly developed circular compound scanner
Authors: Kimura Akira , Nakamura Shohei , Niijima Tadao
Published: February 2007

A prototype circular compound scanner for scrotal contents was developed in order to improve the ultrasonogram (Aloka SSD 115 Gray Scale Unit, employing 3MHz ASO‐25H mechanical sector scanner). Using this scanner, 21 patients with scrotal masses were examined. The internal structure of a testicular tumor and a testes with a hydrocele were clearly visualized. This scanner has proven useful in the evaluation of the scrotal contents.
Left ventricular mural thrombi secondary to acute myocardial infarction: Predisposing factors and embolic phenomenon
Authors: Arvan Stephen
Published: February 2007

Twenty‐five patients with acute myocardial infarction were examined for ventricular thrombi using two‐dimensional echocardiography. Six of 10 patients (60%) with an anterior wall infarction had an apical or apical‐septal thrombus within the first week of hospitalization. None of the fifteen patients with an inferior wall myocardial infarction had a mural thrombus. Although the size of infarction in the patients with a thrombus was not significantly larger than in those who had an anterior wall infarction without a thrombus (43% ± 10% vs. 31% ± 7%, P < 0.1), the severity and extent of dyskinesia or akinesia were more marked in the former group. Left ventricular function as determined by the nuclear blood pool scan ejection fraction was also significantly less for the former group than for the latter group (21% ± 6% vs. 40% ± 11%, P < 0.02). Three of six patients with an intracavitary thrombus on echocardiography had systemic emboli during their hospital course. Postinfarction ventricular thrombi tend to occur in those patients with an anterior wall myocardial infarction who have far advanced wall motion abnormalities of the affected area, and overall poor left ventricular function. Although the number of patients was small, the high incidence of systemic embolizaton in the infarction subjects with echocardiographically proven thrombi indicates that these patients are at increased risk for such events.
Ureteral ejaculation of urine visualized by ultrasound
Authors: Elejalde B. Rafael , de Elejalde Maria Mercedes
Published: February 2007

This article describes an ultrasonographic noninvasive method for the visualization of the ureteral ejaculation of urine into the bladder and its use in 99 normal women and in one affected by a previously unsuspected bilateral hydronephrosis and hydroureter.
Clinical and hemodynamic correlation in patients with pericardial effusion and swinging heart by echocardiography
Authors: Rosoff Maxine , Cohen Michael V. , Grose Richard , Greenberg Mark A.
Published: February 2007

The clinical and hemodynamic findings in 13 consecutive patients with “winging heart” on M‐mode echocardiography were analyzed. In these patients the anterior right ventricular and posterior left ventricular walls and interventricular septum moved almost parallel to each other throughout the cardiac cycle, often with exaggerated excursion. In 10 of 13 patients right heart catheterization revealed the hemodynamic profile of cardiac tamponade, while one additional patient was found to have evidence of cardiac compression at the time of surgery. In the remaining two patients no acute invasive diagnostic procedures were performed. During the same observation period cardiac tamponade was observed in five patients without echocardiographic evidence of a swinging heart, and four of these had large clots in the pericardial space. Thus, the swinging heart pattern appears to be a reliable marker of cardiac tamponade, except in those patients with intrapericardial lesions which mechanically limit cardiac motion.
Sonographic Patterns of the Gallbladder in Acute Viral Hepatitis
Authors: Maresca Giulia , De Gaetano Anna Maria , Mirk Paola , Colagrande Corrado , Cauda Roberto , Federico Giovanni
Published: February 2007

Ultrasound was used for a serial evaluation of gallbladder modifications in 61 patients with acute viral hepatitis during both the acute phase of the illness and recovery. Most of the patients studied within 7 days from the onset of symptoms and/or jaundice showed sonographic abnormalities of the gallbladder (increased wall thickness, reduced volume, abnormal bile content). A normal ultrasound pattern of the gallbladder was progressively restored during the clinical recovery in most of the patients. A statistical correlation was found between the gallbladder wall thickness and the alanine transferase index.
Efficacy of CW‐Doppler and Duplex System Examinations for the Evaluation of Extracranial Carotid Disease
Authors: Hennerici Michael , Freund Hans‐Joachim
Published: February 2007

The efficacy of different ultrasound methods for the detection of extracranial arterial disease (E AD) was evaluated on the basis of the comparison with angiography. High‐resolution B‐scan imaging combined with a multigated pulsed Doppler flow pattern analysis (Duplex system) achieved the best results for the detection of morphological and hemodynamic changes of nonstenotic lesions and low grade stenosis. However, a technically unsatisfactory examination rate of 19%, the failure to differentiate between total and subtotal carotid occlusions, underestimation of significant stenosis and impracticable vertebral flow studies were disadvantages of the Duplex technique. CW‐Doppler examinations proved to be more precise and more reliable for the detection of significant stenosis and occlusions. Since vertebral blood flow studies were impractical with the Duplex system, CW‐Doppler provides more comprehensive information about the hemodynamics of cerebral blood supply.
Real‐Time ultrasound of normal adrenal glands and small tumors
Authors: Günther Rolf W. , Kelbel Clemens , Lenner Volker
Published: February 2007

The adrenals were studied prospectively with real‐time ultrasound in a series of 60 healthy individuals and 13 patients with small adrenal masses sized 8‐20 mm in diameter. In only one of the 60 healthy subjects was a normal adrenal gland delineated as a distinct hypoechoic structure. In all other instances only the highly echogenic suprarenal fat could be displayed. Visualization of small tumors was successful in 12 of 13 patients. The suprarenal area and small lesions were best demonstrated by a lateral intercostal approach using longitudinal and transverse scanning planes. The best access was through the 9th/10th intercostal space at the junction with the anterior and middle axillary lines on the right and the posterior axillary line on the left. Indexing Words: Adrenal gland · Ultrasound.
Ultrasonic patterns of parotid masses
Authors: Ballerini Giovanni , Mantero Maria , Sbrocca Michele
Published: February 2007

The aim of this study was to define sonographic patterns of expanding parotid lesions. Over a 2‐year period, 39 parotid gland masses were examined. Grayscale sonography with a static scanner using high frequency transducers (5 and 7.5 MHz) provided refined visualization of the normal structure of the gland and the space‐occupying mass. There are different sonographic patterns for different types of mass. Lesion malignancy should always be suspected when there is a clearly echogenic mass, especially one with an irregular distribution of the echoes, posterior attenuation, and rough margins (these sonographic features are of no value for lymphomas). All benign lesions have regular margins and are sonolucent at normal gain settings. It is possible to obtain a characteristic sonographic pattern for each specific benign lesion by varying the gain.
Use of Ultrasonic Fetal Head Circumference for Predicting Expected Date of Confinement
Authors: Ott William J.
Published: February 2007

An ultrasonic fetal head circumference curve was developed from a group of 1278 ultrasound examinations in 710 normal obstetrical patients. These data were then used to compare the accuracy of head circumference (HC) to last menstrual period (LMP) and biparietal diameter (BPD) for the prediction of an accurate expected date of confinement (EDC) and, thereby calculate gestational age. The mean error of the signed differences (2 standard deviation) for HC was ‐0.8 2 ± 11.1 days, which was statistically different from the mean error of ‐6.1 ± 10.6 days for BPD and ‐2.8 ± 17.8 days for LMP. HC may have an advantage over BPD in situations where head shape (cephalic index) is significantly altered. Indexing Words: Head circumference Biparietal diameter · Occipital frontal diameter · Expected date of confinement.
Ultrasonography and CT of abdominal and inguinal hernias
Authors: Yeh Hsu‐Chong , Lehr‐Janus Cynthia , Cohen Burton A. , Rabinowitz Jack G.
Published: February 2007

Forty‐two patients with various abdominal wall hernias and five patients with inguinal hernias were studied with ultrasonography. Thirteen patients were studied by CT. Although hernias are usually apparent on physical examination, difficulty in diagnosis may be encountered in some patients. Ultrasonography and CT are not only capable of diagnosing hernia in such instances, they are also helpful in the clinical management of the patients by demonstrating the precise location and extent of the muscular defect. However, the hernia may simulate a mass or cyst in the ultrasonograph and CT scan and one should carefully demonstrate intraperitoneal communication through a muscular defect or a herniated bowl loop within the hernia in order to avoid misdiagnosis. Pseudohernias due to localized thinning or thickening of the rectus muscle were also observed in five patients.
Ultrasonographic Differentiation of Cervical Abortion from Cervical Pregnancy
Authors: Vae Wenzel , Suresh Pachagiri L. , Tang‐Barton Premeri , Salimi Zarrin , Carlin Beatrice
Published: February 2007

Abstract: Cervical abortion is a spontaneous abortion of a normal intrauterine pregnancy into the cervical canal where the abortus is retained by a closed external 08, causing distention of the cervical canal. This entity closely simulates ectopic cervical pregnancy clinically. The ultrasonic findings in four patients with cervical abortion are described and these could alert the physician to the possibility of this condition.
On the Aliasing Problem in Pulsed Doppler Cardiac Studies
Authors: Bom Klaas , De Boo Job , Rijsterborgh Hans
Published: February 2007

Abstract: In pulsed Doppler echocardiography the maximum measurable velocity is limited due to the aliasing phenomenon. Particularly in cardiac echo studies in adults, aliasing may occur frequently. The principle of and the parameters that influence aliasing will be explained. The importance of aliasing is demonstrated in examples of tricuspid, mitral, and aortic Doppler echocardiographic studies in adults. Ways to reduce or avoid aliasing are presented. Indexing Words: Doppler echocardiography Aliasing · Zero shift · Extended range · Secondary sample volumes.
Diagnostic accuracy of computerized B‐scan texture analysis and conventional ultrasonography in diffuse parenchymal and malignant liver disease
Authors: Raeth Ulrich , Schlaps Dieter , Limberg Bernd , Zuna Ivan , Lorenz Adolf , Van Kaick Gerhard , Lorenz Walter Josef , Kommerell Bernhard
Published: February 2007

The use of a diagnostic system for ultrasonic liver tissue characterization based on computerized B‐mode image analysis is clinically tested and compared with the results of conventional realtime and static grey scale liver ultrasound as independently assessed by three experienced observers. The diagnostic classes, normal, diffuse parenchymal and malignant disease, are clearly differentiated by computerized image analysis which is superior to subjective evaluation of liver echograms. Computerized analysis also renders a reliable and clinically useful diagnostic subclassification of diffuse parenchymal disease into echopattern changes prevalent in chronic hepatitis, cirrhosislfibrosis, fatty infiltration and a mixed state of cirrhosislfibrosis with fatty infiltration which cannot be achieved by conventional liver ultrasound.
Clinical consequences after ultrasonic diagnosis of intrauterine hernatoma in threatened abortion
Authors: Jouppila Pentti
Published: February 2007

Ultrasonic examination in 33 cases with threatened abortion at 8 to 17 weeks of pregnancy revealed an echo‐free crescent area between the fetal membranes and uterine wall regarded as an intrauterine hematoma. A living fetus was simultaneously detected in all patients. The duration of uterine bleeding (mean 28.8 ± 19.1 days) was significantly correlated (P <0.01) with the existence of the intrauterine blood collection followed serially by ultrasound, The pregnancy ended in spontaneous abortion in six (18.7%) and in premature delivery in three (9.4%) cases. The estimated volume of hematoma did not correlate with the outcome of pregnancy.
Recognition of fetal arrhythmias by echocardiography
Authors: Silverman Norman H. , Enderlein Marlene A. , Stanger Paul , Teitel David F. , Heymann Michael A. , Golbus Mitchell S.
Published: February 2007

Fetal arrhythmias were detected in 33/198 high risk pregnancies from 21 weeks to term. Using the two‐dimensional echocardiographic image of the fetal heart as a guide, the M‐mode beam was directed to define the motion of the ventricular and atrial walls and atrioventricular valve or semilunar valves. Atrial contraction was defined either by the atrial wall motion or from the A‐point of the atrioventricular valve. Ventricular contraction was defined by closure of the atrioventricular valve (C‐point), the onset of ventricular wall contraction, or from the semilunar valve opening. Ladder diagrams of the sequence of atrial and ventricular activation were constructed to define the temporal sequence of these events. Premature atrial contractions were present in 12. In one fetus this arrhythmia converted into supraventricular tachycardia while in the other 11 fetuses the course was benign. Two fetuses had premature ventricular contractions. Supraventricular tachycardia was noted in five fetuses. One with hydrops at 29 weeks returned to sinus rhythm following maternal administration of procainamide. A second hydropic fetus with paroxysmal atrial tachycardia and hydrops failed to respond to digitalis, propranolol, procainamide, verapamil, or amiodarone, and died shortly after cesarean section. Two mature fetuses had tachycardia close to term and were treated after cesarean section. One fetus with runs of atrial tachycardia died in utero. Three fetuses had complete heart block, two of whom were from mothers with connective tissue diseases. In four fetuses, there was bradycardia of less than 1001 minute lasting more than 30 seconds, but these episodes disappeared in 2 minutes. One fetus with fetal hydrops and bradycardia died. The fourth, with a complex arrhythmia and a basic rate of 80lminute, 2:1 atrioventricular block, premature ventricular contractions, and severe structural heart disease died after delivery.
Treatment of fetal supraventricular tachyarrhythmias
Authors: Kleinman Charles S. , Copel Joshua A. , Weinstein Ellen M. , Santulli Thomas V. , Hobbins John C.
Published: February 2007

Supraventricular tachyarrhythmia has been encountered in 18 fetuses at the Yale‐New Haven Medical Center during the past 4 years. Fourteen of these fetuses had supraventricular tachycardia and underwent in utero antiarrhythmic therapy with maternally administered digoxin either alone, or on combination with verapamil, propranolol, or procainamide. Thirteen of the 14 fetuses had successful in utero conversion of cardiac rhythm to normal sinus rhythm. The 14th patient underwent successful therapy after birth. All 14 fetuses survived despite severe fetal hydrops at the time of diagnosis in 13 of 14. The four remaining fetuses had either atrial flutter (3) or fibrillation. Two of the fetuses with atrial flutter died at birth, the 3rd survived after electrical cardioversion at birth. The fetus with atrial fibrillation converted to normal sinus rhythm and survived after maternal administration of digoxin. Using M‐mode and pulsed Doppler echocardiography, the nature and electrophysiologic mechanism of the arrhythmia may be deduced. The latter information is reviewed along with the fetomaternal pharmacology of various antiarrhythmic agents to devise a rational antiarrhythmic treatment program.
A sonographic study of fetal cystic hygromas
Authors: Chervenak Frank A. , Isaacson Glenn , Tortora Marge
Published: February 2007

Fetal cystic hygromas are fluid filled sacs of lymphatic origin occurring in the posterolateral neck. Based on an experience with 15 of these hygromas diagnosed antenatally, the various sonograhic appearances are illustrated and differential diagnostic features are discussed. A midline septum or hydrops may serve as diagnostic clues. The sonographic and anatomic features of a hygroma are correlated using a gelatin embedding technique.
Duplex scanning with continuous wave doppler for carotid disease
Authors: Rush Michael , Thomas Martin , Zyroff Jack , McNally David , Rossman Mary , Duren Shirley , Otis Shirley
Published: February 2007

Duplex scanning with the use of continuous wave Doppler instrumentation was used for the evaluation of carotid disease and compared to angiography. In twenty such patients 100% accuracy for diagnosis of total occlusion by Duplex scanning with continuous wave Doppler, was obtained. The sensitivity for those patients with 50%–99% stenosis was 92% and for those patients with 20%–49% stenosis was 75%. The overall accuracy for this diagnostic test for all groups of stenosis was 85%. This compares favorably with other noninvasive vascular techniques and is felt to be an accurate and useful technique for the detection of carotid stenosis. Several advantages of this technique are pointed out.
Diagnosis of hydatid cyst by percutaneous aspiration: Value of electrolyte determinations
Authors: Livraghi Tito , Bosoni Angela , Giordano Ferdinando , Lai Nicola , Vettori Claudio
Published: February 2007

A study was made of the fluid from 11 hydatid cysts (10 hepatic, one renal) and from 50 nonparasitic cysts (25 renal, 10 ovarian, 10 pancreatic and five hepatic). Our analysis indicated that the chloride (range 62–95 mEq/liter), the sodium (range 125–139 mEq/liter) and the potassium content (range 5.1–7.5 mEq/liter) of the former differed significantly (p < 0.01) from those of the controls. Hydatid cysts may be indistinguishable from others with both CT and ultrasound and therefore the electrolyte data are of diagnostic value when a hydatid cyst is accidentally punctured percutaneously.
Geometric modeling of the carotid bifurcation in humans: Implications in ultrasonic doppler and radiologic investigations
Authors: Forster Fred K. , Chikos Paul M. , Frazier James S.
Published: February 2007

A geometric representation of the carotid bifurcation is presented with data obtained from biplane angiograms of normal branches and branches exhibiting less than 5% vessel diameter reduction. Three features are identified that are of importance in the interpretation of ultrasonic Doppler velocity information and in the design of engineering flow models for evaluation of carotid branch hemodynamics: the variability of the bifurcation angles, the degree of tortuosity, and the nonplanar nature of the branches. In addition, data collected demonstrate the potential usefulness of the common carotid artery as a reference diameter in evaluating stenosis of the carotid bulb.

Research supported by NIH grants HL26706 and HL20898.
Ultrasound estimation of myometrial invasion of endometrial cancer by intrauterine radial scanning
Authors: Obata Akinori , Akamatsu Nobuo , Sekiba Kaoru
Published: February 2007

The myometrial invasion of endometrial cancer was estimated by using intrauterine radial‐scan ultrasonography and classified into the following four groups: no myometrial invasion, superficial invasion (below one‐third), moderate invasion (above one‐third but below two‐thirds), and deep invasion (above two‐thirds). The myometrial invasions were further examined histologically on the removed uterus. In 26 of 32 cases (81.3%), estimations by intrauterine radial scans agreed with the histologic assessment. In each of the remaining six cases, estimations by radial scans were lower than those by histologic examination.
Clinical efficacy of screening the entire abdomen during real‐time ultrasound examination
Authors: Fields Scott I. , Calvert‐Hill Margaret A.
Published: February 2007

Unsuspected abnormalities are occasionally detected during real‐time ultrasound examinations. To determine the frequency of these findings during standard, routine real‐time abdominal survey, the records of 500 consecutive examinations were reviewed. We found that a significant number of important occult abnormalities were detected. The influence of the abdominal survey on clinical management and improved radiologic consultation is discussed.
Efficacy of sonography as a screening method in renal insufficiency
Authors: Chang Victoria H. , Cunningham Jerome J.
Published: February 2007

Ultrasonographic records of 239 patients with unexplained renal insufficiency were reviewed to determine the efficacy of renal ultrasonography as a screening examination. Ninety‐five (40%) examinations were normal; 24 (10%) examinations showed no renal lesion, but some important incidental finding was discovered; 120 (50%) examinations showed a renal abnormality, including 24 (10%) that showed bilateral urinary tract obstruction. The discovery of bilateral urinary tract obstruction was of particular importance and, in the majority of cases (16/24), led to some type of definitive interventional procedure. Sonography in patients with renal insufficiency, whether normal or abnormal, provides useful information to the practicing physician with a potentially significant impact on the patient's clinical course.
Acoustic intensity histogram pattern diagnosis of liver diseases
Authors: Itoh Kouichi , Yasuda Yoshikazu , Aihara Toshinori , Koyano Akira , Konishi Tatuo
Published: February 2007

Display information on the histogram pattern includes echo intensity and echo frequency in the region of interest (ROI). The level and frequency of the center of gravity and the width of the echo level at 0%, 10%, and 50% of normalized frequency are calculated from the histogram. The width of the echo from the liver is significantly elongated on the X axis (P < 0.001) but that of the center of gravity is not. Fatty liver shows the same attenuation rate curve as normal liver, although echo intensity is greatly increased. The curve of the attenuation rate derived from the histogram can be used to distinguish between liver cirrhosis and the tissue of normal or fatty liver. This study clearly demonstrates the clinical usefulness of the histogram as a diagnostic tool.
Contractility of maternal and fetal gallbladder: An ultrasonic study
Authors: Jouppila Pentti , Heikkinen Jorma , Kirkinen Pertti
Published: February 2007

The volumes of the maternal and fetal gallbladder were examined by ultrasound in a fasting condition during the last trimester of pregnancy in 25 cases and then monitored for 180 min after a standard peroral test meal or glucose administration. The ratio of maternal to fetal gallbladder fasting volumes corresponded to the ratio of the weights. A significant decrease in maternal gallbladder size was observed at 30, 60, and 120 min in both groups, but the changes in the volume of the fetal gallbladder were not significant. This latter observation points toward a resting condition and passive role for the gallbladder in the antenatal gastrointestinal physiology of the fetus.
Ultrasound characteristics of the pancreas in children with cystic fibrosis
Authors: Swobodnik W. , Wolf Anna , Wechsler J. G. , Kleihauer E. , Ditschuneit H.
Published: February 2007

Eighteen patients (3 months to 16 years) with cystic fibrosis (CF) were examined with a real‐time mechanical sector‐scanner (5 MH transducer). Compared with age‐matched controls, each CF patient showed morphologic changes in the pancreas on abdominal ultrasound examination. A very common finding was a decrease in organ anterior–posterior diameters (CF versus controls: head, 1.25 ± 0.38 cm versus 2.44 ± 0.39 cm; body, 0.56 ± 0.35 cm versus 0.98 ± 0.3 cm; tail, 0.83 ± 0.28 cm versus 1.81 ± 0.38 cm) and a pronounced, age‐independent increase in tissue echogenicity. In younger patients, small cystic degenerations could be observed in the pancreatic tail. No correlation could be found between ultrasound morphology, especially pancreatic duct imaging, and exocrine pancreatic function.
Cystic renal mass evaluation: Real‐time versus static imaging
Authors: Weinreb Jeffrey C. , Arger Peter H. , Coleman Beverly G. , Mintz Marshall C. , Pollack Howard M. , Arenson Ronald L.
Published: February 2007

Fifty consecutive cystic renal masses in 43 patients were evaluated by both static scanning and real‐time scanning techniques. Various parameters were evaluated and compared to ascertain whether the strict static scan cystic criteria were always present in comparable real‐time evaluations. Four (8%) of the 50 masses were not classic cysts on real‐time examinations, although the criteria were present on the static scans. Two had minimal acoustic enhancement and two had low‐intensity internal echoes. Possible reasons for this difference were detailed and discussed. The potential problems in this observation were enumerated. Based on these observations, in certain cases when a cystic renal mass demonstrates poor acoustic enhancement or low‐level internal echoes in real‐time examination, static scanning may be helpful and may obviate the need for further studies.
Duplex pulsed Doppler echocardiography in mitral regurgitation
Authors: Meyers David G. , McCall David , Sears Thomas D. , Olson Terry S. , Felix Gary L.
Published: February 2007

The accuracy of duplex pulsed Doppler echocardiography (d‐PDE) for detecting mitral regurgitation was evaluated in 35 patients undergoing d‐PDE, cardiac auscultation, and left ventriculography. With three transducer positions, the overall d‐PDE sensitivity was 95%, specificity was 100%, positive predictive value was 100%, negative predictive value was 94%, and diagnostic accuracy was 97% compared with ventriculography. This technique was superior to auscultation (sensitivity 74%, specificity 94%, positive predictive value 93%, negative predictive value 75%, diagnostic accuracy 83%). No false‐positive d‐PDE results occurred, but discordant false‐negative results occurred frequently among the three transducer positions. If discordant negative results are considered to be false negatives, then d‐PDE is both sensitive and specific when mitral regurgitation is defined as systolic spectral broadening in any one transducer position.
Quantitative pulsed Doppler measurement of common femoral artery blood flow variables during postocclusive reactive hyperemia
Authors: Marquis C. , Meister J.‐J. , Mower E. , Mosimann R.
Published: February 2007

Quantitative blood flow measurements were performed on 37 normal lower limbs with a 128‐channel digital pulsed Doppler (MDPD) system. The evolution of mean flow (QM), peak systolic flow (QS), diastolic flow (QD), and prograde stroke volume (PSV) was observed at rest, during postocclusive reactive hyperemia (PORH), and at 1‐, 2‐, and 3‐min intervals. The QM at rest was 2.9 ± 1.1 ml/s; PORH induced a four‐to fivefold increase in QM and PSV secondary to a slight increase in QS and the disappearance of the reverse protodiastolic component of resting flow. Reverse flow was restored after 1 min. Both QS and QD returned to resting values after 2 min, whereas QM remained significantly higher after 3 min. To provide a better description of the hyperemic response, we also studied the evolution of the pulsatility index as applied the flow curve (PIQ). Similarly, the systolic amplitude index (SAI) is presented. Our study demonstrates that pulsed Doppler techniques can be used for noninvasive quantitative assessment of blood flow at rest and during PORH. The values obtained on normal subjects provide base‐line data for further investigation of pathological conditions.
A pictorial essay of pelvic and abdominal masses seen during pregnancy
Authors: Rahatzad M. T. , Adamson Daryl
Published: February 2007

Since the advent of ultrasound, pelvic and abdominal masses occurring with pregnancy are being recognized more frequently and at earlier stages of gestation. The precise sonographic definition of the size and location of a mass is important for determining route of delivery or surgical approach during laparotomy and cesarean sections. We hope to illustrate that a variety of etiologies need to be considered, and although it is not often possible to make a histologic diagnosis on the basis of ultrasound findings alone, the integration of imaging information with other clinical data can be helpful in narrowing the differential diagnostic possibilities.
Ultrasound diagnosis of renal calcification in infants on chronic furosemide therapy
Authors: Myracle Michael R. , McGahan John P. , Goetzman Boyd W. , Adelman Raymond D.
Published: February 2007

We describe seven infants who developed renal calcification and bone de‐mineralization following furosemide therapy with average daily doses of as little as 0.75 mg/kg per day. Renal calcifications were present in all seven cases and were more readily detected with ultrasonography than with plain films. Renal calculi were seen in four patients, sonographically demonstrated as echogenic foci in the dependent portion of the collecting system, usually accompanied by acoustic shadowing. One patient developed nephrocalcinosis, sonographically observed as echogenic medullary pyramids plus punctate, shadowing parenchymal calcifications. In two patients the location of the calcification could not be determined.
Fetal small bowel simulating an abdominal mass at sonography
Authors: Manco Lawrence G. , Nunan Francis A. , Sohnen Howard , Jacobs Edward J.
Published: February 2007

A focal, well‐marginated, homogeneous hyperechoic mass was identified within the fetal abdomen of five early gestations varying in age from 16 to 20 weeks ECA (estimated conceptual age). Initially, the possibility of a congenital abdominal tumor mass was raised. Serial sonography subsequently demonstrated progressive dissolution of the masses, each of which assumed the characteristic appearance of normal small bowel by 30 weeks ECA. The recognition of this normal fetal small bowel maturation pattern is important lest it be confused with congenital retroperitoneal or gastrointestinal tract abnormalities.
Cava‐suprarenal line: New position for sonographic imaging of left adrenal gland
Authors: Krebs Carol A. , Eisenberg Ronald L. , Ratcliff Sandra , Jouppi Louise
Published: February 2007

Because of overlying attenuating structures, sonographic imaging of the left adrenal gland is often difficult, especially in obese or pediatric patients. In a series of 50 consecutive patients, the left adrenal glands were examined in both the conventional right posterior oblique (RF'O) position and using the new cava‐suprarenal line (CSL) position. The CSL position permitted identification of the left adrenal gland in 90% of the patients; in contrast, the gland could be demonstrated in only 60% of the patients using the conventional RPO position. With the CSL position, the left adrenal gland could be imaged in half the time required with the conventional RPO position. The improved ability to demonstrate the left adrenal gland as well as the reduction in the required scanning time was particularly marked in obese and pediatric patients.
Echocardiographic features of right atrial thrombi
Authors: Boulay Fabrice , Danchin Nicolas , Neimann Jean‐Louis , Godenir Jean‐Philippe , Houppe Jean‐Pierre
Published: February 2007

The clinical and echocardiographic features of six patients in whom a right atrial thrombus was detected using two‐dimensional echocardiography are reported. In four patients with acute cor pulmonale, the thrombus appeared as a coiled mass moving freely within the right atrium and prolapsing through the triscupid valve. In another patient referred for syncope, a large coiled mass attached to the lateral wall of the right atrium was seen prolapsing regularly through the triscupid valve, simulating an atrial myxoma. In the remaining patient who presented with chronic cor pulmonale, two‐dimensional echocardiography demonstrated a motionless ovoid mass with a broad base of attachment to the interatrial septum.
Fetal cardiac arrhythmias and their effect on volume blood flow in descending aorta of human fetus
Authors: Tonge H. M. , Wladimiroff J. W. , Noordam M. J. , Stewart P. A.
Published: February 2007

Using a two‐dimensional linear array real‐time and pulsed Doppler ultrasound system, volume blood flow measurements were made in 86 normal pregnancies, seven cases of fetal bradycardia, and seven cases of fetal tachycardia at the lower thoracic level of the fetal descending aorta. During fetal cardiac arrhythmias, volume blood flow was maintained within the normal range until the heart rates reached around 50 bpm and 230 bpm, after which the volume blood flow diminished. The changes observed suggest that the Frank‐Starling mechanism is functional in the fetal myocardium and demonstrate the stability of the fetal circulation.
A composite three‐dimensional echocardiographic technique for left ventricular volume estimation in children: Comparison with angiography and established echographic methods
Authors: Fazzalari Nicola L. , Goldblatt Elton , Adams A. Phillip S.
Published: February 2007

A composite three‐dimensional (3D) echographic left ventricular (LV) reconstruction to measure LV volumes was evaluated in 26 children. Four apical views, to minimize assumptions about LV shape, were used to obtain a “wire‐cage” model of the LV in 3D. Numerical integration was used to make estimates of both end‐diastolic and end‐systolic volumes. Volume estimates obtained with echographic techniques and those obtained with the angiographic biplane method were compared. The echographic volume estimates were systematically smaller (p < 0.005), and a consistent trend, though not significant, was observed indicating that this systematic error is less for the 3D method. One‐way analysis of variance confirmed significant global geometric fluctuations. Hence, 3D reconstruction can be performed in a clinical setting, and the enhanced graphic representation of global LV geometry may contribute to improved patient management.
Ultrasound evaluation of uncomplicated and complicated acute viral hepatitis
Authors: Giorgio Antonio , Amoroso Pietro , Fico Paolo , Lettieri Gennaro , Finelli Livio , de Stefano Ciorgio , Pesce Gaetano , Scala Vincenzo , Pierri Paola , Pierri Guido
Published: February 2007

Seven hundred ninety‐one consecutive patients with acute viral hepatitis, 17 of whom had liver failure, and 97 healthy volunteers were examined by ultrasound. No specific patterns were found in either the uncomplicated or the complicated forms. Only 19 subjects showed a typical “bright liver” pattern, which is correlated with significant vacuolar hepatocellular degeneration. The increased brightness and clear visualization of portal vein radicle walls, previously described in this disease, were detected in only 32.2% of the hepatitis patients but were also seen in 30.9% of the normal controls.
Utility and limitations of splanchnic venous ultrasonography in diagnosis of portal hypertension
Authors: Rector William G. , Campra Jose , Ralls Philip W. , Charms Matthew
Published: February 2007

The splanchnic venous system was examined by real‐time ultrasonography in 46 patients with cirrhosis and documented portal hypertension and in 32 healthy subjects. Patients with portal hypertension had increased diameter of the splanchnic (portal, splenic, and superior mesenteric) veins (76% of patients), attenuation of the normal inspiratory increase in vein size (59%), and demonstrable portasystemic collateral vessels (umbilical or coronary veins or spontaneous splenorenal shunt) (44%). Splanchnic venous dimensions were significantly increased and changed less with respiration in patients with demonstrable portasystemic collaterals as compared to patients without these vessels. Portal pressure correlated only mildly with portal vein diameter (r = 0.30, p < 0.05). Ultrasound abnormalities are present in a majority of patients with intrahepatic portal hypertension. However, because increased venous diameter and attenuated change in diameter with respiration are less frequent in patients lacking demonstrable portasystemic collaterals, the sensitivity of the test is least in those patients in whom its specificity is also limited.
Left lobe of the liver mimicking perisplenic collections
Authors: Crivello Madeline S. , Peterson Ingrid M. , Austin Robert M.
Published: February 2007

Three patients were scanned in whom the sonographic diagnoses of perisplenic fluid collections were made. Computed tomography scanning demonstrated that the appearances were not caused by perisplenic pathology but by lateral extent of normal left lobe of the liver. Methods to avoid this potential sonographic pitfall are suggested.
Antenatal sonographic diagnosis of congenital clubfoot: A possible indication for amniocentesis
Authors: Benacerraf Beryl R.
Published: February 2007

Eighteen cases of congenital clubfoot were diagnosed sonographically between 16 and 38 weeks. The method of diagnosis, associated anomalies, karyotypes, and obstetric outcomes are described. Fifteen of the 18 fetuses had other major congenital anomalies, and of these, four had abnormal karyotypes. Only three had uncomplicated clubfoot as the only abnormality. Because of the significant incidence of abnormal karyotypes in our series, confirmed in other reported cases, identification of a clubfoot on prenatal sonography may be considered an indication for amniocentesis, particularly when other anomalies are present.
Prenatal diagnosis of bilateral cystic adenomatoid malformation of the lung
Authors: Rempen Andreas , Feige Axel , Wünsch Peter
Published: February 2007

Bilateral cystic adenomatoid malformation of the lung (CAML), solid type (Stocker 111), is a rare malformation that we observed sonographically in two fetuses at 23 weeks. The ultrasonic image showed an echogenic mass compressing the heart and occupying the whole thoracic cavity. Massive ascites, probably as a result of heart failure, was apparent. The prognosis is fatal. Prenatal diagnosis enables termination of pregnancy and saves the mother from invasive procedures in case of fetal distress. In unilateral, more favorable lesions, the managing physician is prepared for respiratory distress of the newborn and an emergency operation.
High‐resolution ultrasonography of wrist ganglia
Authors: de Flaviis Luca , Nessi Renato , Bo Paola Del , Calori Giorgio , Balconi Giuseppe
Published: February 2007

High‐resolution ultrasonography was performed on 14 patients with soft tissue swelling of the wrist and hand. The examination was done using a real‐time 10‐MHz sector probe placed directly on the lesion. The sonographic image could always demonstrate the liquid nature of cystic lesions. In recent ganglia, the fluid content was anechoic, and the cystic walls were rather thin; in some older lesions, irregular internal echoes and thicker walls were found. Rather often, multiple ganglia were observed, grouped in clusters. The presence of a liquid‐filled duct directed to the articular space was demonstrated in 8/11 cases (73%). This finding is considered a diagnostic characteristic of ganglia, and it is very useful for correct surgical planning. In extensor cystic tenosynovitis, the echographic picture was quite different: the anechoic cavity was longitudinal in shape, following the tendon sheath, and the communicating duct was absent. Finally, the sonographic pattern of one case of de Quervain's disease was analyzed and discussed.
Mathematical modeling of fetal growth. III. Evaluation of head growth using the head profile area
Authors: Rossavik Ivar K. , Deter Russell L. , Hadlockt Frank P.
Published: February 2007

Growth of the fetal head has been reexamined in a longitudinal study of 32 normally growing fetuses using the head profile area (HA). The Rossavik growth model (characterized by the coefficients c, k, and s) fit these data very well (R2[±SD] 99.6 [± 0.3]%), and regression analysis indicated that optimum results are obtained when the coefficient k is kept constant. Head area growth before 28 weeks was found to be related to the coefficient c, which was strongly correlated (R2 69.2%) with the time of HA growth initiation. These results suggest that c reflects the genetic factors controlling growth in the early part of pregnancy. The coefficient s was negatively correlated with c (R2 82.1%) and had two components, one associated with c bred. s) and one not associated with c (s‐residual). This linkage between c and s, together with the parallel head growth seen after 30 weeks, suggests the possibility of a maternal system in which genetically determined head size (c) can be sensed and modified by other factors (s) to maximize compatibility between the fetal head and maternal pelvis.
Diastolic flow characteristics of severely impaired left ventricles: A pulsed doppler ultrasound study
Authors: Delemarre Ben J. , Bot Hans , Pearlman Alan S. , Visser Cees A. , Dunning Arend J.
Published: February 2007

Left ventricular inflow was studied with pulsed Doppler echocardiography in 12 normals and 12 patients with a dilated left ventricle as a result of ischemic heart disease. To study the influence of left ventricular relaxation on both the transmitral and apical diastolic flow patterns, we applied range ambiguity. This provides simultaneous display of Doppler shifts obtained at different depths. The diastolic Doppler shift curves at the mitral valve and apical level in normals had the same time of onset, whereas there was an apparent time delay in the patients with heart disease (range 160–360 ms). This might be caused by absence of a normal apical wall motion in these patients.
Ultrasonic mensuration of fetal limb bones in the second and third trimesters
Authors: Merz Eberhard , Kim‐Kern Mi‐Sook , Pehl Stephanie
Published: February 2007

Growth of fetal limb bones has been examined in a prospective cross‐sectional study in 530 patients between 13 and 42 weeks of gestation by ultrasound. The length of the femur, tibia, humerus, and radius were measured in all cases, and fibula and ulna in 393 cases. For each week of gestation mean lengths (± 2 standard deviations) were calculated. All limb bones showed linear growth from 13 weeks to 25 weeks of gestation, after which the growth curve appeared nonlinear. A strong linear relationship (r > 0.98) between the BPD and bone length was found for each bone. In five aborted fetuses, prenatal sonographic measurements of the ossified diaphyses were compared with the postnatal radiologic measurement (30 limb bones). A good agreement was found (difference between ultrasound and X‐ray measurements 0.7 ± 0.5 [SD] mm or 3.0 ± 2.4 [SD]%), indicating that ultrasound images the ossified diaphysis.
Improved sonographic visualization of choledocholithiasis
Authors: Dong Baowei , Chen Minhua
Published: February 2007

Ultrasonographic diagnosis of gallstones in the distal part of extrahepatic duct is not easy. A number of new techniques have been used by the authors to improve the detection rate of these stones. They include filling the duodenum and gastric antrum with drinking water, scanning after a fatty meal, and changing the patient's position during scanning. Ultrasound successfully identified choledocholithiasis in 78 of 104 patients for a sensitivity of 75%. There were 26 false‐negative cases. The chief causes of the false negatives were obscuration of the distal duct by overlying bowel gas, missing of small stone in a nondilated bile duct, and misdiagnosis of soft pigment or an impacted stone having an atypical hypoechoic image in the distal duct as a tumor. False‐positive diagnosis occurred in 32 out of 188 noncalculous cases, giving a specificity of 83%. These cases represent various hyperechoic lesions in the neck of gallbladder, cystic duct, and periampullary region. The overall diagnostic accuracy of gallstones in the extrahepatic bile duct by ultrasound was 80% (234/292).
Gallbladder wall thickening: A frequent finding in various nonbiliary disorders—a prospective ultrasonographic study
Authors: Wegener Martin , Börsch Gereon , Schneider Jost , Wedmann Bernd , Winter Ralf , Zacharias Johannes
Published: February 2007

A comprehensive prospective ultrasonographic study was performed in 93 patients to investigate gallbladder wall thickness and gallbladder volumes in various nonbiliary disease states. Without changes in gallbladder volume, mean gallbladder wall thickness was significantly increased (p 0.01) in patients with liver cirrhosis, viral hepatitis, chronic congestive heart failure, hypoalbuminemia, and chronic renal failure (p < 0.05) but not in patients with diabetes mellitus (n = 14) as compared to a control group. The present study confirms that a variety of nonbiliary disorders are associated with significant thickening of gallbladder walls and that this finding is not caused by incomplete gallbladder contraction.
Fetal echocardiography: The prenatal diagnosis of tricuspid atresia (type ic) during the second trimester of pregnancy
Authors: De Vore Greggory R. , Siassi Bijan , Platt Lawrence D.
Published: February 2007

Fetal echocardiography (real‐time and M‐mode) was used to evaluate a fetus at 20 weeks of gestation because intermittent bradycardia had been auscultated at 14 weeks of gestation. Real‐time examination of the four‐chamber view suggested ventricular disproportion with the left ventricle larger than the right, absence of the tricuspid valve, atrial and ventricular septal defects, and normal pulmonic and aortic outflow tracts. M‐mode quantitation demonstrated a dilated left ventricle, small right ventricle, dilated mitral valve, hypertrophy of the left ventricular wall, and normal outflow tract dimensions. Following the diagnosis of tricuspid atresia (type Ic), genetic amniocentesis was performed (46,XX). Intrauterine death occurred during the 28th week of gestation. Autopsy confirmed the echocardiographic findings.
Fetal lung to liver reflectivity ratio and lung maturity
Authors: Feingold Michael , Scollins James , Cetrulo Curtis L. , Koza Douglas
Published: February 2007

A pilot study examined 23 patients who underwent simultaneous ultrasound and amniocentesis to determine whether the ratio of densitometrically determined tissue densities of fetal lung and liver correlate with the US, the OD 650, or phosphatidylglycerol levels. The incidence of a lung/liver ratio > 1 of 65% was similar to that of maturity levels of the standard tests. However, there was no statistically significant correlation between an UL > 1 and/or any maturity parameter tested, nor was there any correlation with the absence of pulmonary maturity. We conclude that this test cannot be reliably used to predict US, OD 650 reading, or PG levels.