bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantitative analysis of ultrasonogram of the prostate
Authors: Kimura Akira , Nakamura Shohei , Niizuma Masaharu , Hoshino Toh , Niijima Tadao , Ohashi Yasuo , Higuchi Teruo
Published: February 2007

In 51 cases with prostatic cancer, 88 with prostatic hypertrophy, 109 with prostatitis, and 174 normal subjects, the following five parameters were calculated from prostatic ultrasonograms scanned transrectally; prostatic weight (W), presumed circle area ratio (PCAR), anteroposterior diameterltransverse diameter (ATR), asymmetry index (ASI), and dissimilarity index (DSI). The W and PCAR were higher in cancer and hypertrophy than in prostatitis and normal subjects. The ATR and AS1 were higher in cancer. The DSI was lower in hypertrophy. A canonical discriminant analysis using these five parameters disclosed two canonical variates that were useful to separate the disease entities: one separated cancer and hypertrophy from prostatitis and normal subjects, and the other separated cancer from hypertrophy. The coefficients of these variates indicated that cancer was separated from prostatitis and normal subjects by increases in W and ATR and from hypertrophy by the greater effect of increases in ATR (as compared to PCAR) and the small increases in W.
Failure of fluosol DA to enhance the ultrasonic image of infarcted myocardium
Authors: Vasey Charles G. , Armstrong William F. , West Steven R. , Waller Bruce F. , Dillon James C. , Feigenbaum Harvey
Published: February 2007

The perfluorocarbon Fluosol DA has been reported to increase the subjective echogenicity of infarcted myocardium. To investigate this phenomenon, two‐dimensional echocardiograms were recorded in 20 closed‐chest dogs before and 24,48,72, and 96 h following permanent coronary artery occlusion. Low‐dose Fluosol, 10ml/kg (LDF) (four dogs), high‐dose Fluosol, 25 ml/kg (HDF) (eight dogs), or lactated Ringers 25 ml/kg (LR) (eight dogs) was administered 48 h after occlusion. Left ventricular sections corresponding to the short‐axis echocardiographic examination plane were stained with nitroblue tetrazolium 48 h after Fluosol administration. Short‐axis echocardiographic studies were evaluated by two blinded observers who found no consistent increase in the echogenicity of the infarcted area in any group. Videodensitometry of the infarcted area, normalized to the average value of two remote areas, confirmed mean post‐Fluosol increases of 66% in LR dogs, 65% in LDF dogs, and 107% in HDF animals (p < 0.001 for all dogs; all intergroup comparisons NS). The increase in videodensity observed in all groups may have occurred as a consequence of volume administration, although changes in infarct intensity occurring over time cannot be excluded.
Effect of steroid ingestion on pancreatic echogenicity
Authors: Gupta Aditya K. , Arenson Anna‐Marie , McKee John D.
Published: February 2007

Pancreatic and liver ultrasound examinations of twenty‐five patients without evidence of liver or pancreatic disease and who had been on Prednisone (greater than 7.5 mg per day for longer than six months) were compared with corresponding age‐ and sex‐matched normal controls. Statistical analysis enabled effects of known variables that determine pancreatic echogenicity to be taken into account and showed that steroid ingestion had a statistically significant effect on pancreatic echogenicity, a previous unreported observation.
Use of a vaginal transducer for oocyte retrieval in an IVF/ET program
Authors: Wikland Matts , Enk Lennart , Hammarberg Karin , Nilsson Lars
Published: February 2007

Sonography has proved to be an important diagnostic and operative instrument in an in‐vitro fertilization and embryo transfer (IVF/ET) program. In some IVF/ET programs the technique has even replaced laparoscopy for oocyte retrieval. To date, transvesical follicle aspiration has been the main technique for ultrasound‐guided oocyte pick‐up. However, this technique has some disadvantages. Therefore, we have developed a transvaginal ultrasound‐guided puncturing technique. A new high‐frequency vaginal sector transducer was utilized (Brüel & Kjaer). This new transducer, equipped with a needle guide, changed the oocyte retrieval into a simple, safe, and rapid procedure that can be performed under local anesthesia without any discomfort for the patient.
In vivo radiofrequency ultrasound analysis of normal human heart structures
Authors: Lattanzi Fabio , Picano Eugenio , Mazzarisi Alessandro , Landini Luigi , Benassi Antonio , Masini Michele , Distante Alessandro , L'Abbate Antonio
Published: February 2007

Twenty young subjects were studied with microprocessor system for quantitative analysis of backscattered radiofrequency (RF) signals from normal heart structures. This system allows an “on line” quantitative evaluation of the amplitude of the RF “native” signal, before the chain of processing and display, with the acquisition gate displayed on conventional M‐mode machine.

Septum, posterior wall, and anterior mitral leaflet were analyzed. The gate length was kept at 3 μs (2.35 mm) for the ventricular walls (excluding endo‐ and epicardial reflections), and at 1 μ s (0.8 mm) for the mitral valve. Integrated backscatter index (IBI) was calculated as the time integral of |u(t)|, where u(t) = i(t) × s(t); i(t) is the time sequence of backscattered echoes and s(t) is the time gate delimiting the thickness of the insonated tissue. The IBI was expressed in percent, normalized for the pericardial interface (the strongest reflection was assumed to be 100%). The percent IBI for the septum was found to be 22 ± 4%; for the posterior wall it was 17 ± 3%; for the anterior mitral leaflet it was 5 ± 2%. A second reading of the same structures was performed by the previous observer and by new one. Good intraobserver (r = 0.92) and inter‐observer (r = 0.88) correlations were obtained. In conclusion, regional variation in echo amplitude from different heart structures can be observed in man. This set of values can be used as normal values for future studies in pathologic conditions.
Sonographic detection of monoamniotic twins
Authors: Blane Caroline E. , DiPietro Michael A. , Johnson Mary Z. , White Susan J. , Louwsma Grace I. , Hamman Joan E.
Published: February 2007

The true incidence of monoamniotic twinning has been almost impossible to determine accurately because it requires closer inspection of hte membranes and placenta at delivery than is usually performed. Sonography of 3440 patients presenting for genetic amniocentesis identified 39 twin gestations, one of which was monoamniotic (0.026%). Prospectively with ultrasound, four of the twin gestations had been thought to be monoamniotic. A. more recent case of suspected monoamniotic twinning revealed two sacs when newer computer‐based real‐time equipment with variable focusing capability and improved spatial resolution was used. Sonographic diagnosis of monoamniotic twinning must be accurate since it identifies patients at higher risk for cord accidents. These patients need obstetrical care appropriate for a pregnancy at high risk. In addition, failure to identify a second sac that could harbor a chromosomally abnormal fetus has both medical and legal implications. State‐of‐the‐art ultrasound equipment and attention to detail is required.
Use of transrectal radial scan ultrasonography in evaluating the extent of uterine cervical cancer
Authors: Yuhara Akira , Akamatsu Nobuo , Sekiba Kaoru
Published: February 2007

Transrectal radial scan ultrasonography has been performed in 180 cases of stage Ib, IIa, or IIb uterine cervical cancer. Increases in the parametrial length, width, their product, and internal echo intensity as well as shift of the cervix to the side of more severe induration have been demonstrated, irrespective of the presence or absence of menstruation, as the clinical infiltration becomes more severe. Furthermore, concerning the presence or absence of histologic infiltration, there is a very strong possibility of a cancerous infiltration in cases of mass formation in the parametrium.
Ultrasonic assessment of endometrial cancer invasion
Authors: Lehtovirta Pentti , Cacciatore Bruno , Wahlström Torsten , Ylöstalo Pekka
Published: February 2007

Preoperative ultrasonic evaluation of tumor invasion was performed in 24 patients with endometrial cancer and compared with intraoperative and histologic evaluation. Uterine volume and shape detected by ultrasound were not significantly associated with cancer stage. In all the patients intrauterine echoes were found. Myometrial invasion was superficial (<1/3) in 15 patients, moderate in 2 patients (1/3–2/3), deep in 2 patients, (>2/3), and beyond the uterus in 5 patients. Ultrasonic prediction of invasion was accurate in 19 cases (79.3%). In 4 patients superficial invasion has been classified as moderate and in 1 case invasion beyond the uterus was classified as deep.
Ultrasonically controlled retrieval of an intrauterine contraceptive device (IUCD) in early pregnancy
Authors: Shalev Eliezer , Edelstein Shmuel , Engelhard Joel , Weiner Ehud , Zuckerman Henryk
Published: February 2007

Removal of an intrauterine contraceptive device (IUCD) in nonpregnant patients under ultrasonic guidance has previously been reported, but results of the method in pregnancy are controversial. In the present study removal of the IUCD was performed in 16 women who conceived with the device in place. Four women were scheduled for pregnancy termination and 12 women wished to continue their pregnancy. Removal was successful in all 16 patients with minimal complications. Fetal loss occurred in one case out of the 12 who wished to continue their pregnancy. The procedure was found to be feasible even in cases with the IUCD located behind the gestational sac. We suggest ultrasonic guided removal of the IUCD during pregnancy to be the method of choice.
The diagnosis of fetal hydrocephalus prior to 22 weeks
Authors: Benacerraf Beryl R. , Birnholz Jason C.
Published: February 2007

The prenatal diagnosis of hydrocephalus is described in 11 cases between 17 and 21 weeks using two sonographic criteria. These sonographic findings involve the asymmetrical appearance of the choroid plexus and the size and configuration of the anterior horns of the lateral ventricles. We have found that these criteria can accurately diagnose fetal hydrocephalus in the first half of the second trimester.
Noninvasive Doppler assessment of renal artery stenosis and hemodynamics
Authors: Greene Ernest R. , Avasthi Pratap S. , Hodges Jeremy W.
Published: February 2007

We present a review of ultrasonic Doppler methods (duplex scanning) used in the noninvasive assessment of renal artery stenosis and hemodynamics. The clinically successful applications of ultrasonic Doppler methods to the noninvasive assessment of the peripheral and cerebral vasculatures have prompted investigators to apply these methods to the renal artery. Various Doppler criteria for the diagnosis of renal artery stenosis have given sensitivities and specificities that range from 31% to 91% and 88% to 100%, respectively. Furthermore, estimates of renal vascular flows and resistances can be made in echogenic subjects. The technical success rate of the method is operator dependent, consequently, reliable duplex scanning of the renal arteries may be limited to experienced ultrasound laboratories.
Application of ultrasound in the diagnosis of heterotopic pregnancy—a review of the literature
Authors: van Dam Peter A. , Vanderheyden Jozef S. , Uyttenbroeck Frans
Published: February 2007

The world literature between 1979 and 1984 has been reviewed in regard to the use of ultrasound in the diagnosis of heterotopic pregnancy. Although ultrasonography is helpful in detecting the intrauterine pregnancy, it is far less accurate for diagnosing the associated ectopic pregnancy. A clear‐cut ultrasonographic diagnosis prior to surgical intervention could be made in only 4 of 29 cases (14%), where viable intra‐ and extrauterine fetuses were observed.
Assessment of quadriceps femoris muscle atrophy and hypertrophy in neuromuscular disease in children
Authors: Heckmatt J. Z. , Pier N. , Dubowitz V.
Published: February 2007

Midthigh muscle and subcutaneous tissue thickness were measured using a real‐time linear array ultrasound scanner in 50 patients attending our Muscle Clinic; 28 had muscular dystrophy and 21 spinal muscular atrophy. In muscular dystrophy the muscle thickness was found to be normal or increased, whereas in spinal muscular atrophy it was reduced, with an associated increase in subcutaneous tissue thickness that did not relate to obesity.

Measurement of muscle and subcutaneous tissue thickness provides a more accurate way of assessing muscle atrophy and hypertrophy than clinical assessment, and is a useful guide in the discrimination between muscular dystrophy and spinal muscular atrophy.
Doppler echocardiographic approach to the blood flow of the left anterior descending coronary artery
Authors: Miyatake Kunio , Yamagishi Masakazu , Izumi Shiro , Beppu Shintaro , Yamamoto Kazuya , Sakakibara Hiroshi , Nimura Yasuharu
Published: February 2007

Assessment of flow in the left anterior descending coronary artery by Doppler echocardiography appeared to be possible in some patients in which the coronary artery system might be wide and/or the displacement of the coronary artery might be reduced because of cardiac enlargement or of impaired cardiac function. A study of this possibility was carried out in 78 patients, 20 cases with hypertrophic cardiomyopathy, 10 with dilated cardiomyopathy, 20 with aortic valve disease, and 28 following valve replacement for aortic valve disease.

The anterior interventricular sulcus was a helpful landmark to search for the left anterior descending artery. The characteristic feature of the coronary flow pattern, that the flow ran mainly during diastole, was also helpful in finding the coronary artery. Complementary roles of ultrasonic imaging and Doppler ultrasound evaluation should be emphasized for identifying a thin echo‐free space in the sulcus as the coronary artery.

The left anterior descending coronary artery was imaged in 26 of the 78 patients. The peak velocity ranged 24 cm/s to 75 cm/s in different patients.

Because the present study was carried out in patients with some particular diseases, these results do not indicate that current techniques can be routinely used for assessing the coronary flow. The detection rate will be increased with improvements in image resolution and the Doppler sensitivity.

Although the detection rate of the coronary artery was not satisfactory in the present stage, the effect of sublingual administration of nitroglycerin on coronary circulation was noninvasively assessed in some patients, where reduction of the flow velocity by about 27% was observed in real time.
Sonographic findings in scrotal brucellosis
Authors: Patel P. J. , Kolawole T. M. , Sharma N. , Al‐Faqih S.
Published: February 2007

Six patients with scrotal brucellosis were ultrasonically examined. All cases were of acute onset. Concomitant involvement of testes and epididymes were noted in all cases except one in which the epididymis was spared. Abnormal sonographic findings consisted of enlargement of the testes and epididymes, nonhomogenous hypoechoic diffuse, or focal echo patterns in all cases and a hydrocele in one case.
Effect of cholecystectomy on common bile duct diameters: A longitudinal prospective ultrasonographic study
Authors: Wedmann Bernd , Börsch Gereon , Coenen Christoph , Paassen Andreas
Published: February 2007

The medium‐term effect of cholecystectomy on common bile duct diameters (CBD) was investigated prospectively in 64 patients with gallstone disease examined by ultrasonography immediately before and 27 months to 39 months after the operation. In 32 patients with chronic cholecystitis and patent cystic ducts, CBD diameters increased slightly (median 4.6 mm pre‐ and 5.3 mm postoperatively; p < 0.05). A group of 19 patients with acute cholecystitis or cystic duct occlusion showed a significant decrease (median 7.7 mm pre‐ and 5.5 mm postoperatively; p < 0.05). In 13 patients with common bile duct stones, the CBD diameters also decreased significantly after surgical intervention (median 7.5 mm pre‐ and 5.0 mm postoperatively; p < 0.05). The widest CBD diameter after cholecystectomy observed in this study was 10 mm. We conclude that either increases or decreases of the CBD diameters may occur after cholecystectomy in patients with calculous gallbladder disease, and that the postoperative evolution is governed by the exact nature of the underlying biliary disease at the time of the index operation.
Sonography of normal lower ureters
Authors: Mirk Paola , Maresca Giulia , Fileni Adriano , Vincenzoni Maurizio
Published: February 2007

The sonographic features of normal lower ureters, visualized during routine examination of the pelvis in a series of 40 patients, are described. A comparison with the corresponding excretory urogram was obtained in 18 patients. In the authors' experience, visualization of the ureters is a normal finding that should not suggest stasis or dilatation. Recognition of the ureters, although restricted to the lower segment, can be useful in the evaluation of patients examined for recent or current renal colic in order to assess with greater accuracy the existence of ureteral stones and their position. In addition, knowledge of normal features and of physiological changes could presumably be used in the evaluation of pathological conditions, congenital or acquired, of the ureters.
Sonographic demonstration of free air in perforated peptic ulcers: Comparison of sonography with radiography
Authors: Chang‐Chien Chi‐Sin , Lin Hsien‐Hong , Yen Cho‐Li , Lee Chuan‐Mo , Lin Si‐Min
Published: February 2007

Abdominal sonography was performed in 283 patients with acute abdominal pain. Of these patients, 10 were diagnosed as having an acute perforated peptic ulcer (PPU) and 2 were diagnosed as having a sealed‐off PPU. Sonographic findings of acute PPU are summarized. The presence of an interference echo with the shifting phenomenon is a very strong indication of the presence of free air in the abdominal cavity. Using these Sonographic criteria, intraperitoneal free air was diagnosed as 9/10 patients with PPU in comparison to 8/10 by abdominal and chest radiographs. Two patients with Sonographic evidence of free air, but negative X‐ray studies, were later found to have free air in the subsequent radiographic studies. These findings suggest that sonography is highly sensitive in the small number of patients in whom air is found. Sonographic studies also have the advantage of detecting other changes associated with PPU, such as fluid accumulation, inflammatory mass, and thickening of the gallbladder.
Fetal anthropometry at term: Effect of menstrual age and relative fetal size
Authors: Miller Joseph M. , Foster Theda A. , Brown Haywood L. , Gabert Harvey A.
Published: February 2007

In a study of 324 term pregnancies, fetal measurements (biparietal diameter, femur length, and abdominal diameter) obtained within one week of delivery correlated more strongly with relative birth weight than with menstrual age.
Influence of the interval between time points on individual fetal growth curve standards derived from Rossavik models and two ultrasound scans before 26 weeks, menstrual age
Authors: Simon Nicolas V. , Deter Russell L. , Levisky John S. , Stefos Theodor , Shearer David M.
Published: February 2007

We studied the influence of the interval between the two scans used before 26 weeks' menstrual age to generate individual fetal growth curve standards utilizing the Rossavik growth model: P = c(t)k + s(t) (model specification functions previously reported). Intervals of 3 weeks to 12 weeks were suitable for predicting the growth of the abdominal and head circumferences and femur diaphysis length in individual fetuses. However, large systematic and random errors were found with intervals less than 5 weeks for three‐dimensional parameters such as the head and abdominal cubes and estimated fetal weight. In addition, the data suggest that the systematic errors for these latter parameters may increase with intervals of 10 weeks or more. Overall, optimal individual fetal growth curve standards were best generated from two scans before 26 weeks' menstrual age separated by 5 weeks to 9 weeks.
Quantitative measurement of abdominal arterial blood flow using image‐directed Doppler ultrasonography: Superior mesenteric, splenic, and common hepatic arterial blood flow in normal adults
Authors: Nakamura Takefumi , Moriyasu Fuminori , Ban Nobuyuki , Nishida Osamu , Tamada Takashi , Kawasaki Toshihiko , Sakai Masahiko , Uchino Haruto
Published: February 2007

To measure volume blood flow quantitatively in human abdominal arteries, we used an ultrasonic image‐directed Doppler system and electromagnetic flow‐meter to first measure volume flow in canine arteries.

In dogs, there was a strong linear correlation (R = 0.98) between the product of the time average of the maximum blood flow velocity and the average cross‐sectional area and the volume blood flow measured by an electromagnetic flow‐meter.

These results enabled measurement of volume blood flow in the human superior mesenteric (SMA), splenic (SPA), and common hepatic (CHA) arteries from the abdominal wall. Comparison of pulsatility index values indicated a larger vascular resistance in the SMA than in the SPA or CHA.
Ultrasonographic findings in gastric cancer: In vitro and in vivo studies
Authors: Miyamoto Yukio , Nakatani Mariko , Ida Masahiro , Ishikawa Takashi , Okazawa Norio , Ariizumi Mitsuko , Tsujimoto Fumio , Mizunuma Kimiyoshi , Fukuda Yashushi , Tada Shimpei , Chiba Satoshi
Published: February 2007

Ultrasonography was performed in 45 cases of gastric cancer. Specimens from all 45 cases of gastric cancer were subjects to ultrasonographic study by the water immersion method for comparison with histology. In 32 of these 45 cases in vivo ultrasonographic evaluation was performed prospectively. The overall accuracy rates for the diagnosis of the depth of cancerous invasion were almost 80% in both in vitro and in vivo studies. In vivo ultrasonographic findings agreed well with those from the specimen studies. Ultrasonography was considered to be useful in the diagnosis of gastric malignancies.
Effect of timing of initial scan and interval between scans on rossavik growth model specification
Authors: Stefos Theodor , Deter Russell L. , Simon Nicolas V.
Published: February 2007

The effect of the time of the initial scan and the interval between the two scans needed for Rossavik growth model specification was evaluated in 20 normally growing fetuses. Based on systematic and random prediction errors, determined by comparing predicted values to measured values obtained after 27 weeks, menstrual age, optimal results for all parameters studied were obtained with an initial scan at 18 weeks and an interval of 6 weeks between scans. For one‐dimensional parameters—head circumference (HC), abdominal circumference (AC), and femur diaphysis length (FDL)—similar results were obtained with an initial scan at 15 weeks and an interval of 3 weeks, but systematic overestimations were seen with 9‐week intervals for HC. Studies with three‐dimensional parameters—head cube, abdominal cube, and estimated weight—indicated that the timing of the initial scan was not critical, although less variability was seen with the initial scan at 18 weeks. However, the use of 3‐week and 9‐week intervals (instead of 6 weeks) produced significant systematic errors that varied with the parameter studied. These results suggest that Rossavik growth model specification is possible under a variety of conditions, but both the timing of the initial scan and the interval between scans must considered for each parameter.
Ovarian torsion: Sonographic evaluation
Authors: Helvie Mark A. , Silver Terry M.
Published: February 2007

The sonographic and clinical findings of 13 patients with surgically proven ovarian torsion are reported. Sonography demonstrated an abnormal pelvic mass in all patients. The appearance was nonspecific, ranging from solid to cystic, but frequently reflected the commonly associated ovarian pathology present in 69% of patients. The mass was large (mean diameter: 8 cm) and frequently midline (8/13). The clinical findings were variable and nonspecific, leading to a correct preoperative differential diagnosis in only 35% of patients. Preoperative sonography reduced the likelihood of unnecessary appendectomy in patients with ovarian torsion.
Pitfalls in the diagnosis of intussusception
Authors: Alzen G. , Funke G. , Truong S.
Published: February 2007

Unusual sonographic behavior of intussusception is demonstrated in 4 cases. The results of 54 well‐documented cases have shown two possible deviations from the normal sonographic pattern of an intussusception. The first was a highly reflective target sign, and the second a loss of regular sonographic structure in a tumor‐like mass.
Quantitative two‐dimensional echocardiographic assessment of left ventricular shape in ischemic heart disease
Authors: D'Cruz Ivan A. , Aboulatta Hussein , Killam Horace , Bradley Alecia , Hand R. Chris
Published: February 2007

Since data on systematic noninvasive quantitative assessment of left ventricular (LV) shape in ischemic heart disease are very scanty, we used new size‐independent LV shape descriptors to study the correlation between LV shape and LV ejection fraction in 46 men with a 70% or more stenosis of one or more coronary arteries on angiography. Angiocardiographic LV ejection fraction was over 55% [mean: 69 (±6 SD)%] in 20 patients (group I), and under 55% [mean: 43 (±9 SD)%] in 26 patients (group II).

Our LV shape descriptors showed statistically significant differences between group I and group II patients, indicating a more spherical LV shape in group II (p values < 0.005).

Within the whole patient group (N = 46), and also within the subgroup of patients with regional LV hypokinesis or akinesis (N = 26), correlation between LV shape alteration (toward the spherical) and LV ejection fraction was not strong; it was better in the subgroup (N = 10) with regional LV wall dyskinesis. There was poor correlation between angiocardiographic LV chamber volume and alteration (toward spherical) in LV shape.

Thus, we have documented quantitatively that patients with ischemic heart disease and low LV ejection fraction tend to have a more spherical LV shape than patients with a normal ejection fraction. Quantification of LV shape based on simple, easily made two‐dimensional echocardiographic measurements may help in noninvasive identification of patients with deteriorating LV function, especially when a change toward the spherical is detected in serial echocardiograms.
Individual growth curve standards in twins: Growth in the second trimester
Authors: Stefos Theodor , Deter Russell L. , Hill Reba M. , Simon Nicolas
Published: February 2007

To provide a more detailed assessment of the growth of twins, the individual second trimester growth patterns of six fetal parameters [HC, AC, FDL, ThC, head cube (A) and abdominal cube (B)] were studied in fourteen sets of normal twins (six monozygotic and eight dizygotic) and sixteen normal singletons using the Rossavik growth model [P = c(t)k+8(t)]. Comparisons of start points and coefficient c values indicated no statistically significant differences in the growth processes of twins and singletons in early pregnancy and no detectable effect of zygocity. Comparisons of second trimester growth within sets of twins and randomly paired singletons revealed the presence of differences in feto–placental support. A significant effect of differences in genetic growth potential or maternal support could not be demonstrated, however. These results suggest that with respect to growth, normal twins in the second trimester can be treated as two singletons in the same mother.
Thyroid metastases: Combined role of ultrasonography and fine needle aspiration biopsy
Authors: Eftekhari Farzin , Peuchot Martine
Published: February 2007

The ultrasonographic findings and the use of ultrasonography combined with fine needle aspiration in 4 cases of metastases to the thyroid are reported. The primary neoplasms were bronchogenic carcinoma (2 cases), malignant melanoma (1 case), and renal cell carcinoma (1 case). Ultrasonography demonstrated bilateral (2 cases) and unilateral (2 cases) enlargement of the gland. In 3 cases, the texture of the gland was heterogenous and had hypoechoic areas. In 1 case a homogeneous mass containing calcified focus was seen. Ultrasonography was able to evaluate the extent of the disease in all patients by revealing metastatic nodes or jugular vein thrombosis. Finally, ultrasonography was useful in guiding fine needle aspiration. The potential use of ultrasonography in detection and biopsy of small thyroid lesions in patients with malignant disease is discussed.
Can sonography diagnose acute colonic diverticulitis in patients with acute intestinal inflammation? A prospective study
Authors: Verbanck J. , Lambrecht S. , Rutgeerts L. , Ghillebert G. , Buyse T. , Naesens M. , Tytgat H.
Published: February 2007

In a prospective study of 123 patients with clinical signs of acute intestinal inflammation, the sensitivity of ultrasonography in diagnosing acute colonic diverticulitis was 84.6% and the specificity 80.3%. The predictive value of a positive and a negative sonogram was 76.0% and 87.7%, respectively. Of the 52 patients with subsequently proven acute colonic diverticulitis, 44 presented sonographically with a thickened (>4 mm) hypoechoic bowel wall. In 15 patients, enlarged fluid‐filled bowel loops were also present. Air‐containing diverticula were demonstrated in 3 patients, abscesses in 8 patients, and colovesical fistulae in 2 patients. Eight large abscesses were successfully treated without emergency surgery by percutaneous sonographically guided evacuation. The described sonographic abnormalities strongly suggest acute colonic diverticulitis, particularly when localized in the left lower abdomen.
Sonographic screening for renal tract anomalies associated with congenital heart disease
Authors: Murugasu Belinda , Yip William C. L. , Tay John S. H. , Kit‐Yee Chan , Hui‐Kim Yap , Hock‐Boon Wong
Published: February 2007

The incidence of structural renal tract abnormalities in 109 children with documented congenital heart disease (CHD) was studied using real‐time sonography. In these children, 11.9% had associated urologic anomalies, which included hydronephrosis, duplication, ectopia, agenesis, and dysplasia of kidneys. Children with associated extracardiac anomalies had a significantly higher incidence of renal tract anomalies (39.1%) compared to those with isolated CHD (4.7%). Therefore, sonographic screening of the renal tract should be performed routinely in patients with CHD, especially in those with multiple congenital defects.
Early detection of pathologic pregnancy by transvaginal sonography
Authors: Goldstein Steven R.
Published: February 2007

Vaginal ultrasonography, by virtue of its excellent resolution, has resulted in changing our concepts about early pregnancy both in normal and abnormal gestations. The purpose of this report is to examine the clinical application of this technique in abnormal early pregnancy. Pathologic pregnancy ultimately will prove to be either (1) an ectopic pregnancy or (2) an intrauterine gestation that may be destined to failure. (A third group, fetuses with anomalies, will be dealt with elsewhere). Vaginal sonography has enhanced very early pathologic diagnosis in pregnancy because of its ability to image things previously not seen with such clarity, and because the scanning process can be carried out at the time of pelvic examination when the clinical indication is first encountered.
How accurate is ultrasonography in monitoring IUD placement?
Authors: Bonilla‐Musoles F. , Pardo G. , Simon C.
Published: February 2007

The insertion of two different types of intrauterine devices (Multiload 250 and Silver T) has been monitored in 97 patients through systematic exploration by echography and hysteroscopy. Both techniques seem to be highly reliable in spite of the observation of 9% misplacements of the IUDs not detected by echography. In addition, hysteroscopy enables the diagnosis of frequent associated pathology (endometrial hyperplasia, endometriosis, polyps) difficult to diagnose by echography. The present study demonstrates the fact that the ultrasonography confirmation of IUD localization in the uterus was not always accurate.
Transvaginal and transabdominal ultrasonography of the uterine cervix during pregnancy
Authors: Andersen H. Frank
Published: February 2007

Transvaginal and transabdominal ultrasound evaluation of the uterine cervix were compared in a study of 186 pregnant women. An empty bladder made transabdominal ultrasound measurement of the cervix more difficult, while bladder filling resulted in significant lengthening of the transabdominal cervical measurement. In contrast, transvaginal ultrasound cervical measurement was possible in all but 1 patient. Normal transvaginal ultrasound cervical measurements were significantly shorter on average than transabdominal cervical measurements, but compared closely with prior transabdominal ultrasound studies in which bladder filling was carefully controlled. Significant cervical shortening was not noted in most patients with a clinical diagnosis of incompetent cervix.
Fetal heart rate influence on the pulsatility index in the middle cerebral artery
Authors: Mari Giancarlo , Moise Kenneth J. , Deter Russell L. , Carpenter Robert J. , Wasserstrum Nathan
Published: February 2007

In 1300 Doppler assessments performed on the fetal cerebral arteries, 5 cases of heart rate deceleration were recorded while studying the middle cerebral artery. There were 3 normal fetuses (mean menstrual age ± standard deviation: 28.6 ± 2.1 weeks), one growth‐retarded fetus (34 weeks, menstrual age) and 1 fetus with red cell alloimmunization (27 weeks, menstrual age). The magnitude of decline in the heart rate during the deceleration ranged from 44 to 93 bpm (67 ± 18 bpm). Pulsatility index values were calculated on 44 waveforms and correlated with the heart rate. Linear regression analysis showed a statistically significant inverse correlation between the heart rate and the pulsatility index in the middle cerebral artery of 4 fetuses. These results indicate that heart rate will affect the pulsatility index of the middle cerebral artery.
Sonographic patterns of Caroli's disease: Report of 5 new cases
Authors: Tomà Paolo , Lucigrai Giorgio , Pelizza Aldo
Published: February 2007

We have reviewed 5 cases of Caroli's disease, studied from 1982 to 1987, in order to define the validity of its sonographic signs. The “intraluminal portal vein” sign, found in all the cases, is emphasized. This sign may be easily identified and it is never encountered in other diseases. Recessive polycystic kidney disease was present in 3 cases, and congenital hepatic fibrosis was demonstrated in the 2 cases studied by liver biopsy.
Sonographic evaluation of gallbladder kinetics: In vitro and in vivo comparison of different methods to assess gallbladder emptying
Authors: Wedmann Bernd , Schmidt Gabriele , Wegener Martin , Coenen Christoph , Ricken Dieter , Dröge Cornelia
Published: February 2007

In an in vitro study, 10 gallbladders of adult pigs and 6 gallbladders of lambs, all removed immediately after slaughtering, were stimulated in a water bath by electric means to induce active contraction. Gallbladder emptying was followed by ultrasonography employing five measurement procedures: (1) gallbladder width, (2) longitudinal planimetry, (3) transverse planimetry, (4) ellipsoid method, and (5) sum of cylinders method.

In an in vivo investigation, gallbladder emptying of 30 volunteers (12) healthy subjects, 18 diabetics) was evaluated in the same way after ingestion of a fatty meal. Gallbladder width was found to be unsuitable to estimate the decrease in gallbladder volume due to a nonlinear relation of the parameters. Longitudinal planimetry tended to be less valid than transverse of planimetry in assessing gallbladder volume reduction.

The most valid estimation of gallbladder volume decreases was obtained by the two three‐dimensional procedures. However, in neither in vitro nor in vivo could a significant difference between the sum of cylinders method and the ellipsoid method in determining relative volume reduction be established.

We conclude that a three‐dimensional measurement procedure should be used for valid assessments of gallbladder motility. However, according to our data there is no advantage in using the time‐consuming sum of cylinders method compared to the simple ellipsoid method.
Ultrasound for closed femoral nailing
Authors: Mahaisavariya Banchong , Suibnugarn Chavengsakdi , Mairiang Eimorn , Saengnipanthkul Sukit , Laupattarakasem Wiroon , Kosuwon Weerachai
Published: February 2007

A new application of operative ultrasound to help assess the fracture alignment for closed reduction and passing the guide wire in closed femoral nailing is described. This method can be used instead of fluoroscopic monitoring in certain important steps which can markedly reduce the exposure time of fluoroscopic monitoring. Nine of ten cases were successful using this technique for closed unlocked nailing with an average ultrasound monitoring time of 8 minutes. The time required for fluoroscopic assessment was reduced to less than 1 minute for each successful case.
Quantification of training in obstetrical ultrasound: A study of family practice residents
Authors: Smith Clark B. , Sakornbut Ellen L. , Dickinson Linda C. , Bullock Gerald L.
Published: February 2007

This study was done to determine how rapidly physicians in training could become competent in performing obstetrical ultrasound for the purposes of routine evaluations (i.e., the standard examination as defined by AIUM). The scan measurements and results of organ surveys of 12 family medicine residents were compared with the results obtained by faculty members experienced in obstetrical ultrasound. Residents rapidly became proficient in biometry. The mean menstrual age calculated from BPD, AC, HC, and FL differed from faculty values by 0.381 weeks after residents had performed 40 supervised scans. Organ survey success rates demonstrated similar high concordance between resident and faculty scans.
Superficial masses with color flow Doppler imaging
Authors: Mitchell Donald G. , Merton Daniel A. , Liu Ji‐Bin , Goldberg Barry B.
Published: February 2007

Color Doppler imaging findings and spectral waveforms were reviewed for 21 superficial masses in which color Doppler imaging revealed flow. This series included 5 benign hyperplastic lymph nodes, 5 malignant masses, 2 staphylococcus abscesses, and 9 pseudoaneurysms. Benign hyperplastic nodes had a vascular pattern consisting of prominent central flow with a branching radial pattern, reflecting the morphology of lymph nodes. One metastasis from melanoma demonstrated abundant peripheral flow and central avascularity, while the other 4 malignant masses and the 2 abscesses had sparse internal flow. All pseudoaneurysms had a to‐and‐fro imaging and spectral pattern (into the mass during systole, out during diastole), and/or a swirling pattern on real‐time images (8 of 9 each). Doppler spectral analysis revealed continuous forward flow during diastole for all other masses and abscesses. Waveforms appeared similar for benign and malignant masses, and for abscesses. Conventional image‐directed Doppler examinations performed prior to color Doppler studies failed to reveal flow in 2 partially thrombosed pseudoaneurysms, 1 malignant mass, and 1 abscess. Benign hyperplastic nodes, malignant masses, and pseudoaneurysms had distinctive color Doppler image appearances in this series, although demonstration of flow within a mass does not eliminate the possibility of abscess. Proper use of color and spectral Doppler analysis of superficial masses involves more than mere detection or exclusion of flow.
Double pigtail cystogastric stent in the management of pancreatic pseudocyst
Authors: Das Karunamoy , Kochhar Rakesh , Kaushik Satyender P. , Gupta Narender M. , Mehta Satish K. , Suri Sudha , Ms Jay Dev Wig
Published: February 2007

We describe placement of a double pigtail cystogastric stent in 5 patients with pancreatic pseudocyst using real‐time ultrasonography and fluoroscopy as guidance techniques. This was done as a two‐step procedure. First, a transgastric drainage catheter was placed for a period of six days. All the patients continued to have high drainage output and the cyst size decreased, as seen sonographically. Simultaneous barium meal and sinogram were then done to measure the distance between the posterior gastric wall and the cyst. A polyurethane double pigtail stent of appropriate size was then introduced to achieve cystogastric drainage. The cyst resolved in all the patients by four weeks to six weeks, when the stent was removed endoscopically. There was no recurrence of pseudocyst during follow‐up for 6 months to 13 months. None of the patients suffered any complication. Cystogastric drainage using a double pigtail stent is an easy and safe alternative to surgical cystogastrostomy.
In vivo validation of image‐directed doppler measurement of superior mesenteric artery blood flow
Authors: Scheurlen Michael , Waller Cornelius , Hartmann Franz
Published: February 2007

Image‐directed Doppler measurement of superior mesenteric artery blood flow in volunteers was validated in two artificial models with either a venous or an arterial flow profile. In the “venous” model, the Doppler device overestimated the real flow velocity by 86 ± 7%, and in the “arterial” model by 24 ± 9%. The areas under the time‐frequency curves (AUCs) from the arterial model were measured by planimetry. A correction factor of 1.47 between flow velocities calculated after planimetry and real flow was established. Correction for this factor resulted in a flow velocity of 19.5 ± 4.7 cm/s and a blood flow rate of 377 ± 166 ml/min in the volunteers.
Clinical versus ultrasound examination of the thyroid gland in common clinical practice
Authors: Brander A. , Viikinkoski P. , Tuuhea J. , Voutilainen L. , Kivisaari L.
Published: February 2007

In a prospective series of 72 patients, clinical and ultrasonographic examination of the thyroid gland were compared in detail. Normal‐sized lobes were differentiated from enlarged ones both by inspection and by palpation. When lobar size was assessed by palpation, the estimate was most clearly influenced by increase in width. The correlation between two examiners in lobe size assessment was significant. In the classification of thyroid disease as diffuse, solitary, or multinodular, clinical examination and ultrasonography correlated significantly. However, only one third of the clinically solitary nodules proved to be solitary by ultrasound examination. Of 77 separate nodules, 43 escaped detection on clinical examination. Of these 43, 14 nodules exceeded 2 cm in diameter. It is concluded that the use of ultrasonography frequently alters the primary evaluation of thyroid nodularity based on palpation.
Color flow doppler ultrasonography: Comparison with peripheral arteriography for the investigation of peripheral vascular disease
Authors: Whelan J. F. , Barry M. H. , Moir J. D.
Published: February 2007

Using arteriography as the gold standard, Color flow Doppler ultrasonography was evaluated with regard to its ability to detect peripheral vascular occlusive disease and hemodynamically significant stenosis in patients having peripheral arteriography. One hundred legs in 51 patients were compared at seven arterial segments for disease. Color flow Doppler ultrasonography correctly detected 84 occluded segments, and demonstrated a sensitivity and specificity for patency vs occlusive disease of 95% and 99%, respectively. One hundred and thirty hemodynamically significant lesions (occlusions plus significant stenosis) were correctly identified with color flow Doppler ultrasonography, with a sensitivity and specificity of 92% and 97%, respectively.

Color flow Doppler ultrasonography is a safe, inexpensive, and noninvasive method of accurately documenting significant peripheral arterial disease and offers a new first‐line investigation for patients presenting with symptoms of peripheral arterial insufficiency.
Color Doppler imaging of the cystic artery
Authors: McGrath Frank P. , Lee Stephen H. , Gibney Robert G.
Published: February 2007

Color Doppler ultrasonography was used to examine the gallbladder vascular supply in 30 volunteers and in 30 biliary lithotripsy patients pre‐ and 2 hours posttreatment. A preliminary study of 10 cases of acute cholecystitis was also performed. A cystic artery waveform was obtained in 24 of the volunteers, 18 pre‐ and postlithotripsy patients, and in 1 of 10 patients with acute cholecystitis. The mean pulsatility indices obtained were 1.04 in the volunteers, 0.98 pre‐ and 1.02 postlithotripsy (p > 0.1). This study shows that the normal gallbladder blood supply can be consistently identified using color Doppler flow imaging and that there is no appreciable difference in the cystic artery pulsatility index following medium‐energy shock‐wave extracorporeal lithotripsy. Preliminary results in acute cholecystitis suggest that flow is decreased below the sensitivity of the color Doppler imaging system used in this investigation.
Measurements of uterine volume: A comparison between measurements by ultrasonography and by water displacement
Authors: Wiener Jarmila Josefa , Newcombe Robert G.
Published: February 2007

The uterine volume was measured in 30 patients 24 hours before hysterectomy by ultrasonography using the prolate ellipsoid formula. At hysterectomy the volumes of the same uteri were measured again by water displacement. A comparison is made between the two methods of measurements. Although the correlation between the methods is high (r = 0.964) and the mean percentage bias very small (+2.0%), the agreement between the methods for 95% of subjects is between −33.6, 8% and +37.6%. This is a potentially large disagreement relative to the typical size of the uterus, indicating that ultrasonic uterine volume measurement by the prolate ellipsoid method is not adequately precise for clinical management of the individual patient. © 1992 John Wiley & Sons, Inc.
Sonographic findings in gallbladder ascariasis
Authors: Sultan Khuroo Mohammad , Ali Zargar Showkat , Nabi Yattoo Ghulam , Yousuf Dar Mohamad , Javid Gul , Ahmad Khan Bashir , Iqbal Boda Mohamad , Mahajan Rakesh
Published: February 2007

Invasion of the adult roundworm, Ascaris lumbricoides, into the gallbladder is rare and was seen in 14(2.1%) of the 665 cases with hepatobiliary ascariasis. The diagnosis was suggested in all 13 cases in which sonography was performed and in 5 of the 11 cases at endoscopic retrograde cholangiography. Sonographic findings included a nonshadowing, long, echogenic structure in the form of a coil, an echogenic strip with central anechoic tube, an echogenic structure extending across the gallbladder giving it a septate appearance, and characteristic erratic, nondirectional, zig‐zag movements of these echogenic structures in the gallbladder. Serial sonograms accurately predicted spontaneous exit of the worm. Pregnancy and anomalous origin of the cystic duct directly from the papilla of Vater facilitated worm invasion into the gallbladder. We conclude that real‐time sonography offers a simple, rapid approach for the diagnosis and follow‐up of patients, whereas endoscopic retrograde cholangiography has limited diagnostic value in this disorder. ©1992 by John Wiley & Sons, Inc.