bluuebunny/crossref_metadata_2025 huggingface dataset:
Echocardiographic Assessment of the Donor Interatrial Septumn in Heart Transplant Recipients
Authors: Sorensen Mary L. , McDonald Robert W. , Hosenpud Jeffrey D. , Pantely George A.
Published: March 2006

The donor interatrial septa of 46 heart transplant recipients were measured from 4 serial echocardiograms. The purpose of the study was to determine the thickness of the donor interatrial septum and to assess whether changes in the septal thickness occur over time, either with ischemic duration at the time of surgery or with the number of treated rejection episodes during the first year after transplant. This study showed that the donor interatrial septum has increased thickness after heart transplantation but returns to normal by the 12 months after transplant. However, there was no correlation with the number of treated rejection episodes or ischemic time.
Quantitative Echocardiography, Part 1
Authors: Waggoner Alan D. , Barzilai Benico , Miller James G. , Pérez Julio E.
Published: March 2006

The quantitative applications of echocardiography in clinical practice are well known. The measurements of cardiac chamber dimensions, wall thickness, and overall performance have been uniformly adopted. An important emerging ultrasound modality known as tissue characterization of the myocardium has evolved from experimental studies to clinical investigation. The ability to quantitate myocardial acoustic properties by the measurement of integrated backscatter (in decibels) provides direct assessment of myocardial structural characteristics and contractile performance, to complement conventional two-dimensional imaging of ventricular wall motion and wall thickening. Despite the considerable amount of work that has been done, there are several areas of research that need to be further investigated before widespread clinical use of these techniques is possible. Specifically, absolute values of myocardial backscatter are not yet obtainable with the current instrumentation; only the relative change in backscatter during the cardiac cycle (cyclic variation) has been defined and employed in clinical studies. This review summarizes the principles of tissue characterization and the results of several clinical studies, specifically those carried out in patients with coronary artery disease and cardiomyopathies.
Infection Control for Today's Sonographer
Authors: Coxen Melissa , Marek Larry
Published: March 2006

There are many opportunities for the spread of nosocomial infections in ultrasound laboratories, and there are no current, widely accepted guidelines for decreasing this potential. Students at the University of Oklahoma, in Oklahoma City, conducted a survey of sonographer practices concerning infection control. The results highlighted many areas in which sonographers could decrease the risk of cross infection.
Ruptured Sinus of Valsalva Detected by Biplane Transesophageal Echocardiography
Authors: Lockhart Susan Barry
Published: March 2006

This case illustrates the importance of biplane transesophageal echocardiography and color flow Doppler imaging in detecting a sinus of Valsalva aneurysm and fistula. It also demonstrates how endocarditis can be a complication of this condition.
Temporary Enlargement of the Subarachnoid Space in Very Premature Infants
Authors: Leighton John O. , Benders Manon J. , Walther Frans J.
Published: March 2006

The authors used a high-frequency, 10-MHz ultrasound transducer to improve near field de- tails on cranial ultrasound scans to detect enlargement of the subarachnoid space without ventriculomegaly on the first day of life in 14 of 17 premature infants on mechanical ventilation for respiratory distress syndrome secondary to lung immaturity and in 1 of 9 premature infants with mild or no respiratory problems. Factors correlated with this finding were a birth weight of less than 1250 g (P ≤ 0.05), gestational age of 28 weeks or less (P ≤ 0.02), presence of respiratory distress (P ≤ 0.01), and necessity of mechanical ventilation (P ≤ 0.001). Enlargement of the subarachnoid space regressed completely during the neonatal period. Enlargement of the subarachnoid space in very premature infants is indicative of brain immaturity.
Ultrasound Examination of Invasive Procedure Puncture Site Comnplications
Authors: Merton Daniel A.
Published: March 2006

Ultrasound is an accurate, noninvasive means of evaluating patients for puncture site compli cations after invasive procedures. The range of potential complications includes hematomas, ecchymosis, pseudoaneurysms, and arterio venous fistulas. Further, lymphadenopathy visualized near the puncture site could be confused with other abnormalities. The complete ultrasound examination combines a grey scale study to obtain anatomical and spatial information with a Doppler evaluation of blood flow from both normal and abnormal areas. Ultra sound-guided compression repair of puncture injuries requires precise localization of abnormal vascular communications to achieve proper transducer placement. Color Doppler imaging can often allow these examinations to be per formed in a more expedient and thorough fashion, while reducing the operator dependence associated with conventional duplex Doppler.
Songraphic Assessment of Lower Extremity Arterial Grafts
Authors: Kawelmacher Gilda , Rouse Glenn A. , de Lange Marie
Published: March 2006

Arterial bypass grafts are used to improve blood flow in the lower extremities, and ultrasound is often used to monitor these grafts after place ment. The types of grafts used in the lower extremities are reviewed, and the use of sonog raphy to evaluate these grafts is illustrated.
Left Ventricular Diastolic Function
Authors: Taylor Richard
Published: March 2006

Two-dimensional echocafdiography has gained widespread acceptance I as the procedure of choice to evaluate left ventricular function. In the last decade, the importance of diastolic function in the overall performance of the left ventricle has received much attention. Recent evidence suggests that diastolic dysfunction may contribute to symptoms of left heart failure in many patients, including those with normal sys tolic function. Alterations in transmitral Dop pler flow velocity patterns have been used to assess changes in left ventricular diastolic func tion. This article reviews the concept and clin ical signincance of diastolic function and the assessment of diastolic function by Doppler echocardiography.
Ultrasound Examination of the Feline Adrenal Gland
Authors: Cartee Robert E. , Bodner Susan T. Finn , Gray Bruce W.
Published: March 2006

In vivo ultrasound measurements of the adrenal glands of a group of cats were compared with the physical measurements of the extirpated glands. The in vivo ultrasound measurements of length and thickness compared well with the physical measurements, but the width measure ments did not. Difficulty in probe placement was responsible for the lack of correlation. Sonographic assessment of the feline adrenal is shown to be feasible, and the normal physical parameters of the feline adrenal are presented.
Transient Fetal Atrial Flutter Related to Maternal Caffeine Intake
Authors: Moser Jayne Carr , Hatjis Christos
Published: March 2006

Fetal arrythmias in the third trimester can have many sources. This case study links excessive maternal caffeine consumption to atrial flutter and transcient atrioventricular heart block.
Scrotal Sonography in Normal Subjects
Authors: Chovil Karol , Thakore Kailash , Choyke Peter L. , Shawker Thomas , Linehan W. Marston
Published: March 2006

To document the frequency of epididymal and testicular abnormalities in asymptomatic men, scrotal sonography was performed on 75 men ranging in age from 10 to 84 years. Epididymal cysts larger than 3 mm in size were found in 23% of the patients, hydroceles in 23%, varicoceles (tortuous vessels ×3 mm in diameter) in 11%, testicular cysts in 4%, atrophy in 3%, and calcifications in 3%. The high prevalence of these findings can complicate the interpretation of sonograms of the symptomatic scrotum.
Sonographic Evaluation of Arthrogrypotic Conditions
Authors: Robinson Yvonne J. , Rouse Glenn A. , de Lange Marie
Published: March 2006

The term arthrogryposis is applied to a large group of conditions that result in joint contractures, abnormal positioning of hands or feet, and other neuromuscular defects. Abnormalities of the brain, spinal cord, peripheral nerves, muscles, or connective tissue lead to similar joint stiffness and contractures. Careful sonographic examination of an affected fetus can provide valuable information that will help in the assessment of diagnosis, prognosis, and risk of recurrence.
Thanatophoric Dysplasia
Authors: Griffis Wendy Schade
Published: March 2006

A case of thanatophoric dysplasia was reported in the fetus of a 39-year-old woman. The diagnosis was made on ultrasound examination at 21 weeks of gestation, when shortened long bones, cloverleaf skull, and narrow thorax were observed. Due to the lethality of this type of dwarfism, the pregnancy was terminated. Routine ultrasound scanning proves to be an important part of early detection of various abnormalities such as those seen in thanatophoric dysplasia.
Fetal Echocardiography in Conjunction with Routine Obstetric Examninatons
Authors: Madden Sandra J. , Peterson Cynthia L. , Krew Michael A.
Published: March 2006

The purpose and benefits of fetal echocardiography are discussed. Early management in the event of a cardiac abnormality is imperative. Success in conducting fetal echocardiography begins with a complete understanding of cardiac embryoloy and fetal anatomy and physiology. Indications for fetal echocaidiography include maternal, familial, and 'fetal risk factors. An explanation of general scantning methods and routine echocardiographic views enables the sonographer to perform fetal echocardiography during routine obstetric examinations.
Cholelithiasis in Pregnant Women
Authors: Ferguson Trisha K. , Anderson Joseph C. , Fisher Cheri R. , Harned Roger K.
Published: March 2006

A prospective study of 572 pregnant women referred for obstetric ultrasound examination was conducted to assess the prevalence of cholelithiasis in:Xthis group. Gallstones were found in 4.2% of the women (90% confidence interval = 2.&8-5.6%). An increased prevalence of gallstones was related to increasing age, body weight, body mass index, and symptoms of previous right upper qjuadrant pain. No significant effect was seen with respect to racial background, family history of gallstones, use of contraceptives, or alcohol abuse. Screening for gallstones during pregnancy, if done at all, may have value if reserved for the older, obese, or symptomatic pregnant women.
Factors Affecting Patient Satisfaction in a Prenatal Diagnosis an Treatment Population
Authors: HARTVIKSON W. J.
Published: March 2006

Many investigators studying patient satisfaction have shown that the mode of medical care delivery appears to be more important to the patient than the content. Recent studies pertaining specifically to patients undergoing prenatal diagnostic testing also show an association between psychosocial and clinical history factors and patient satisfaction. The authors reviewed 535 patients in a prenatal diagnosis centre to determine which variables most significantly affect patient satisfaction; 41 variables were tested for their association with satisfaction. Of the 9 variables that were shown to be significant, patient/staff interaction was found to be most critical in predicting satisfaction. This study showed no association between psychosocial and clinical history factors and patient satisfaction.
Tinze Domain Correlation in Color Flow Imaging
Authors: Hedrick W. R. , Hykes D. L.
Published: March 2006

Time domain correlation is a relatively new technique used to estimate velocity in color flow imaging. Direct measurement of reflector velocity is obtained by determining the time shift in the echo pattern associated with that reflector using pulsed wave ultrasound. The processing steps in time domain correlation, including gating, fixed echo cancellation, and echo pattern matching, are discussed.
In Utero Stem Cell Transplantation
Authors: Drake Charles
Published: March 2006

Technical advances in ultrasound have helped make possible an exciting new prenatal therapy for many inherited hematologic disorders: fetal stem cell transplantation. Under ultrasound guidance, pluripotential hematopoietic stem cells extracted from peimmune fetal donors can be injected into the marrow of fetuses diagnosed with an inherited hematologic disorder in utero. These stem cells from the healthy donor will then, in theory, differentiate and proliferate, replacing the defective cells. Recent experimental work in this area has yielded encouraging results. The lifting of the federal moratorium on research involving fetal tissue transplantation should bring about more rapid advances in the near future, and ultrasound will continue to play an important role in this new technique.
Digital Video
Authors: Abate Joseph A. , Reynolds Terry
Published: March 2006

The field of ultrasound imaging is gradually moving away from conventional videotape storage (an analog medium) toward computers with digital acquisition and storage capabilities. Advantages include reproducibility of studies, ease and speed of retrieval, the ability to digitally manipulate images, and the ability to transmit images through phone lines. This new technology will require familiarity with computers and computer terminology. This article provides an introduction to the basic concepts underlying digital video.
Teleradiology
Authors: HEDRICK W. R. , HYKES D. L.
Published: March 2006

Teleradiology is the electronic transfer of radiology images to a distant location. Healthcare reform and advances in computer technology are providing the impetus for increased use of teleradiology. Four aspects of a teleradiology system—image acquisition, compression, transmission, and display—are discussed. Speed and image quality are affected by variations in design.
Changes in Aortic Annulus Diameter During the Cardiac Cycle and its Effect on Predicting Aortic Valve Prosthesis Size
Authors: Zwink Todd R. , Burwash Ian G. , Miyake-Hull Carolyn Y. , Otto Catherine M.
Published: March 2006

This study was designed to investigate the dynamic nature of aortic annulus size during the cardiac cycle and to assess the utility of two-dimensional (2D) echocardiographic measurement of annulus diameter in predicting the surgeon's choice of prosthesis size. Preoperative measurements of aortic annulus diameter at end-diastole and mid-systole were compared with implanted prosthesis size in 26 patients. Annulus diameters were larger at mid-systole than end-diastole in all patients (24 ± 3 mm vs. 22 ± 3 mm; P < 0.0001). Both end-diastolic and mid-systolic diameters correlated with the surgeon's choice of prosthesis size ( r = 0.74 and 0.71, respectively). However, prosthesis size was underestimated slightly by end-diastolic diameter (1 ± 2 mm; P = 0.03), and overestimated slightly by mid-systolic diameter (1 ± 2 mm; P = 0.01). The 95% limits of agreement for prosthetic size was -3 to +5 mm for enddiastolic diameter, or -5 to +3 mm for mid-systolic diameter. Averaging end-diastolic and mid-systolic diameters resulted in no bias with 95% limits of agreement of ± 4 mm of the averaged diameter. Patients with a small annulus dimension (end-diastole ≤ 20 mm; mid-systole ≤ 22 mm) have a high probability (86% and 78%, respectively) of requiring a small prosthesis (≤ 21 mm).
Sonoographic Detection of Silicone Breast Implant Rupture
Authors: Lu Sandra , Rouse Glenn A. , De Lange Marie
Published: March 2006

Sonography can be an effective method of evaluating silicone breast implants for intracapsular or extracapsular rupture, and the characteristic findings in cases of extracapsular and intracapsular extravasation of silicone are discussed. Magnetic resonance imaging (MRI) may be slightly more effective than sonography, however, for detecting implant rupture, particularly small intracapsular ruptures.
The Use of a Stand-of Device in High Pulse Repetition Frequeny Doppler Echocardiography
Authors: Drake Charles M. , Kraft Carol
Published: March 2006

An interesting case of severe mitral stenosis in which Doppler echocardiographic evaluation was greatly enhanced by use of a stand-off pad is discussed. When employing high pulse repetition frequency (HPRF) Doppler, it may be difficult to place the sample volume at the area of interest while remaining in HPRF mode, because it is not always clear that there is a certain minimum sample volume depth below which a system will not operate in HPRF. This and other related technical constraints vary from machine to machine. This case illustrates that sample volumes can be manipulated by using a stand-off pad, thereby making use of HPRF possible. The specifications of the HPRF mode on the Acuson 128XP (Acuson, Mountain View, CA) are examined in detail, and possible applications of this technique in similar difficult situations that may arise in clinical practice are discussed.
Two-Dimensional Echocardiography Detects Transient Right Ventricular Dysfunction After Cardiac Transplantation
Authors: Waggoner Alan D. , Davila-Roman Victor G. , Stroble Mary , Perez Julio E.
Published: March 2006

Right ventricular dysfunction may occur soon after cardiac transplantation. Factors suggested to be responsible for right ventricular dysfunction include prolonged transplantation ischemic time, pulmonary hypertension, or early rejection. Right ventricular and left ventricular fractional area change (FAC) and ejection fraction (EF) were prospectively measured by two-dimensional (2D) echocardiography 2 days after transplantation (while under inotropic support) and at discharge (mean day 19, range 9-60) in 18 patients by the area-length method. A significant increase in right ventricular FAC (0.38 ± 0.08 to 0.44 ± 0.06, P = 0.025) and right ventricular EF (0.53 ± 0.08 to 0.60 ± 0.08, P = 0.015) was observed at discharge compared to day 2. Left ventricular FAC and EF did not change significantly (0.43 ± 0.07 to 0.40 ± 0.06 and 0.61 ± 0.09 to 0.56 ± 0.07, respectively). Right ventricular FAC (< 0.35) and right ventricular EF (< 0.45) was impaired in 4 patients (22%) 2 days after transplantation (all had normal left ventricular function) but normalized by discharge. There was no correlation between right ventricular function and donor ischemic time, hemodynamics, or early rejection (one patient). Only one patient died before discharge (with normal right ventricular and left ventricular function). Impaired right ventricular function after cardiac transplantation is transient, associated with normal left ventricular function, and may be related to inadequate right ventricular myocardial preservation. Right ventricular function improves in nearly all patients by discharge.
Sonographic Detection of Renal Artery Stenosis
Authors: Grafe Danielle , Hanson Scott
Published: March 2006

Hypertension is a serious health problem for millions of Americans. A small portion of these cases result from renal artery stenosis. Angiography continues to be the gold standard for diagnosing renal vascular disease. However, as a result of the high cost and possible risks associated with this invasive method, duplex sonography has emerged as an inexpensive and noninvasive alternative diagnostic tool that, in many cases, can accurately detect renal vascular disease. According to the literature, there are numerous techniques using Doppler waveforms to show renal artery stenosis. These include renal artery to aortic ratio, acceleration index, acceleration time, end diastolic ratio, and the tardus-parvus waveform. Several studies have been conducted to evaluate duplex sonography as a diagnostic tool for detection of renal artery stenosis and the overall accuracy of ultrasound compared with angiography. The accurcy of duplex ultrasound largely depends on the blood flocriteria being used to evaluate renal vasculature, patient preparation, the time allowed to perform the ultrasound examination, and the technical expertise of the sonographer performing the study.
B-Mode Ultrasound Evaluation of Dolphin Skin
Authors: Cartee R. E. , Gray B. W. , John Jennifer , Ridgway S. H.
Published: March 2006

Skin specimens from 10 dolphins were studied with B-mode ultrasonography. The epidermal and hypodermal layers were defined, measured, and compared with measurements of actual tissue and with histologic measurements. Measurements of skin from six body zones of three live dolphins showed larger values but the same echogenic characteristics. B-mode measurements were found to be accurate and to provide visually acceptable information for use in evaluating the health status of these animals. The detection of a skin parasite by B-mode ultrasonography is also presented.
Duplex Scanning in Diagnosis of Mesenteric Insufciency
Authors: Nichols Shawn , Windeler Honora
Published: March 2006

Chronic mesenteric insufficiency presents clinically in a subtle fashion, yet has a devastating effect on the patient over time and may require surgical intervention. Duplex Doppler can be used to detect chronic mesenteric insufficiency and to follow up on surgical revascularization. Key parameters in diagnosing mesenteric insufficiency are reported to be decreased peak systolic and end-diastolic velocities from preto postprandial. More information about normal and abnormal velocity ranges is still needed. A literature review of the noninvasive diagnostic role for duplex sonography in mesenteric circulation and a description of current preand postprandial scanning techniques are discussed.
Body Stalk Anomaly: Sonographic Pathologic Correlation
Authors: Malvica Robert P.
Published: March 2006

Body stalk anomaly is a severe defect and developmental abnormality that occurs in approximately one of 14,273 births. Sonographic examination of a 19-year-old woman, gravida 1, at approximately 22 weeks gestation, revealed a fetus with multiple coexisting congenital anomalies. This abnormality is uniformly fatal.
Maternal Smoking During Pregnancy
Authors: Robertson Stephanie I.
Published: March 2006

Research has shown that maternal smoking affects fetal growth and is associated with several complications of pregnancy including abruptio placentae, placenta previa, premature rupture of membranes, and premature delivery. Studies show that infants of smoking mothers have a higher mortality rate, are smaller children, experience learning deficits, and potentially have a higher incidence of behavioral problems. In effort to predict and prevent the long-term effects of maternal smoking on physical growth and intellectual development in children, many studies have been conducted to identify factors, biologic and environmental, that may adversely affect fetal growth and subsequent child development. This report presents an overview of these studies regarding the effects of smoking on pregnancy.
1995 Sonographer Compensation Survey
Authors: Junginger George
Published: March 2006

The Society of Diagnostic Medical Sonographers conducted a compensation survey in March, 1995, to gather information on current salary practices in the United States and Canada. The survey was mailed to a random sampling of 3000 SDMS members. At the cutoff date for responses, 1986 completed surveys had been returned for processing, which reflects a 66.2% response rate. The SDMS is a 12,000member professional society for sonographers. Members of the Society represent all specialty areas within sonography, all levels of experience, and every level of job responsibility.
Image Formation in Real-Time Ultrasound
Authors: Hedrick W. R. , Hykes D. L.
Published: March 2006

A review of image formation in realftime ultrasound is presented. Te techni;que of echoranging combined with beam scanning is explained with illustrative; examples. Factors afcting: lateraliresolution are discussed. The interdependence of frame rate, scan line density, and scan range is seen.
Image Artifacts in Real-Time Ultrasound
Authors: Hedrick W. R. , Peterson Cynthia L.
Published: March 2006

A survey of image artifacts in real-time ultrasound is presented. Spatial mapping of detected echoes is based on several assumptions, and violation of any of these assumptions creates artifacts. Drawings and sonograms are used to illustrate image artifacts, including partial volume, attenuation, refraction, reverberation, mirror image, side lobe, comet tail, ring down, and range ambiguity.
Limitations of Ultrasonography in the Diagnosis of Upper Tract Urinary Obstruction
Authors: Meacham Randall B. , Walsh Richard A. , Drose Julia A.
Published: March 2006

Although ultrasound is usually the imaging modality of choice to identify hydronephrosis secondary to obstruction, it may be unreliable in some cases of acute obstruction. We describe one such case.
Antenatal Sonographic Demonstration of Goldenhar-Corlin Syndrome
Authors: Elmore Susan G.
Published: March 2006

Goldenhar-Gorlin syndrome encompasses a wide variety of fetal malformations occurring during embryogenesis. The abnormalities are usually asymmetric affecting facial and vertebral structures. There have been reported associated anomalies involving the cardiac, renal, and pulmonary structures.
Early Pregnancy and Its Normal Measurement Parameters Practical Mnemonic "Rule of 2"
Authors: Gerscovich Eugenio O.
Published: March 2006

With the intent of helping in the memorization of information, we present an arrangement of data on hormone levels, gestational sac, yolk sac, and embryo in early pregnancy. When pertinent, we compare abdominal with endovaginal scanning parameters.
Case Report of a Heterotopic Triplet and Tubal Pregnancy With Follow-Up Evaluation
Authors: Baker Barbara R. , Frates Mary C.
Published: March 2006

The incidence of heterotopic pregnancy is rising as more patients use assisted reproduction techniques to conceive. The authors report a case of a heterotopic triplet tubal pregnancy that was managed successfully without surgical intervenion.
Hydrometrocolpos Associated With Uterovagina1 Duplication
Authors: Winderl Lisa M. , Patel Vinu
Published: March 2006

This is a case report of prenatal observation of uterovaginal duplication in a fetus with a complicated persistent cloaca. This is a rare anomaly where the products of the gastrointestinal, urinary, and genital tracts empty into a common channel with a single perineal opening. Prenatal ultrasound appearance is compared with a postnatal sonogram and contrast studies, which confirmed the prenatal diagnosis.
Beam Steering and Focusing With Linear Phiased Arrays
Authors: Hedrick W. R. , Hykes D. L.
Published: March 2006

The linear phased array is a type of multielement transducer in which each crystal is controlled independently during transmission and reception. The techniques of beam steering, transmit focusing, and dynamic focusing are discussed with illustrative examples. Advantages and disadvantages of linear phased arrays are presented.
Does the Use of Atro pine Provide Additional Ischemlic Stimulus to Myocardiumi During Dobutamline Stress Echocardiography?
Authors: Connors Kimberly A.
Published: March 2006

The diagnostic value of dobutamine stress echocardiography has been widely reported, but the value of adding atropine to achieve a target heart rate has not been widely studied. The authors tested the hypothesis that atropine does not provide additional diagnostic accuracy to a dobutamine stress echocardiography test. The inotropic effect of dobutamine in large doses has been shown to induce ischemic changes in the myocardium. Because atropine mainly increases heart rate (chronotropic stimulus), there is controversy as to whether its effects produce an additional ischemic response during dobutamine stress echocardiography. The results of the present study suggest that the ischemic response during dobutamine stress echocardiography is related primarily to an inotropic stimulus and not a chronotropic stimulus, and therefore, the authors concluded it may not be necessary to add atropine routinely to dobutamine stress echocardiography tests.
Musculoskeletal Symptomnatology and Repetitive Strain Injuries in Diagnostic Medical Sonographers
Authors: Necas Martin
Published: March 2006

Repetitive strain injuries are beginning to be widely recognized as a serious occupational risk for sonographers. The goal of this study was to establish the incidence of musculoskeletal symptomatology and repetitive strain injuries in sonographers from Washington state and Oregon and to correlate certain physical attributes, work load, and work habits with the reporting rates of musculoskeletal symptomatology and repetitive strain injuries. The data for this study were gathered through a comprehensive questionnaire. Eighteen percent of respondents suffered no symptoms; 66% suffered symptoms without repetitive strain injury, and 15% were diagnosed with repetitive strain injury. The analysis revealed that a positive correlation exists between certain ergonomically unsound work habits and increased symptomatology. The proportion of repetitive strain injury-diagnosed sonographers tended to increase with more years in the profession. The reporting rate of musculoskeletal symptomatology and repetitive strain injuries also appeared to be influenced by other variables, such as gender, work load, and stress in the workplace.
Sonography's Role in the Patient With Transjugular Intrahepatic Portosystemic Shunt
Authors: Foix Teresa , Anderson Joseph C. , Fisher Cheri R. , Pinkerman Brenda
Published: March 2006

For patients with end-stage liver disease, orthotopic liver transplantation is the only definitive treatment. While awaiting a transplant, many serious complications may occur. Bleeding varices, portal hypertension, and refractory ascites are common sequelae that complicate the treatment of these patients. One form of palliative treatment is the placement of a transjugular intrahepatic portosystemic shunt. Sonography plays an important role in the patient with a transjugular intrahepatic portosystemic shunt. This article discusses the importance of ultrasound throughout the transjugular intrahepatic portosystemic shunt process to include detection of the primary liver disease and its various sequelae, normal alteration in blood flow after placement of transjugular intrahepatic portosystemic shunt, guidelines for the detection of a dysfunctional shunt, and sonographic difficulties in the detection of a dysfunctional shunt.
Importance of Recording Pulmonary Venous Flow Velocities With Transthoracic or Transesophagea1 Echocartiography
Authors: Waggoner Alan D. , Baumann Chris A.
Published: March 2006

The recording of pulmonary venous flow velocities during Doppler ecgicardiography has not received sufficient attention. This review emphasizes the importance of recording pulmonary venous flow velocities (systolic, diastolic, and atrial reversal components) during transthoracic or transesophageal echocardiography. Clinical conditions that increase left atrial pressure, such as congestive heart failure, or that alter left atrial contraction (i.e., atrial fibrillation) result in diminished systolic pulmonary venous inflow and relatively increased diastolic pulmonary venous inflow. When moderate or severe mitral regurgitation is present or suspected by color Doppler imaging, pulmonary venous systolic flow will be blunted or exhibit systolic revetrsal. Distinctive patterns of respiratory variation in systolic and diastolic pulmonary venous velocities can be observed in patients with constrictive heart failure and elevated left ventricular end diastolic pressures but with normal mitral inflow patterns have abnormal pulmonary venous flow characteristics. Stenosis of the pulmonary may demonsterate increased pulmonary venous velocities or flow disturbances after postoperative repair. Pulmonary venous flow characteristics provide hemodynamic infomation not provided by other Doppler monalities or echocardiographic imaging.
Typical and Atypical Presentations of Testicular Carcinoma
Authors: Glass Michael A. , Meacham Randall B.
Published: March 2006

Testicular carcinoma most commonly presents as a testicular mass. Approxiately 10-15% of patients, however, present with manifestations of metastatic disease. The reported clinical presentations of metastatic testicular carcinoma are varied and include abdominal mass, hemoptysis, adenopathy, respiratory difficulty, anorexia, nausea, vomiting, lumbar back pain, and lower extremity swelling. A comprehensive review of the literature indicated that testicular carcinoma presents as a testicular abnormality 90% of the time. In 10% of cases, however, the patients will present with nontesticular manifestations of metastatic disease. The authors provide a summary of reported nontesticular presentations of testis cancer and describe a unique case wherein the clinical presentation was spontaneous ejaculatory failure.
Sonographic Diagnosis of Arthrogryposis Multiplex Congenita
Authors: Van Horn Jacqueline , Rosenn Barak M.
Published: March 2006

Athrogryposis multiplex congenita or congenital joitt contractures may result from any process that constricts intrauterine fetal movement. In this case rport, the join contractures were determined to be the result of amyolasia conenita, or absence of muscle formation. Because athrogryposis has no specific etiology, complete ultrasonic surveillance of fetal anatomy and the uterine cavity is required. In addition, because arthrogryposis is asociated with genetic disorders, the patient should be offered the option of genetic counseling and genetic amniocentesis.
Sonographic Diagnosis of Polyorchidism
Authors: Meyers Patrick R. , Rapp Cynthia L. , Stavros A. Thomas
Published: March 2006

Polyorchidism, or duplication of testes, is a unique and rare anomaly. Sonography is ideally suited for the diagnosis of polyorchidism and associated pathologies and anomalies. High frequency transducers exceeding 10 MHz, with the inherent increase in spatial and contrast resolution, may play a decisive role in clinical management of polyorchidism. In this case report, the authors describe the benefit of high frequency transducers.
Transvaginal Sonographic Demonstration of the Hyaloid Artery in an Anencep ha lic Fetus
Authors: Winderl Lisa M.
Published: March 2006

Transvaginal sonography has become a major diagnostic tool for early observation of structural fetal anomalies, and has allowed the detection of fetal abnormalities as early as the first trimester. As image resolution improves, the ability to evaluate detailed fetal anatomy is expanding. It is important that sonographers and sonologists be able to recognize detail not previously available and distinguish normal from abnormal anatomy.
The Prevalence of Musculoskeleta Disorders Among Diagnostic Medical Sonograhers
Authors: Pike Ian , Russo Andre , Berkowitz Jonathan , Baker Joan P. , Lessoway Vickie A.
Published: March 2006

Work-related musculoskeletal disorders are a group of syndromes characterized by soft tissue discomfort caused or aggravated by workplace exposures. Previous research has shown an increasing concern about musculoskeletal symptoms among diagnostic medical sonographers. The authors' purpose, with this study, is to describe the prevalence of musculoskeletal disorders and related work and personal factors among diagnostic medical sonographers. Data were gathered through a survey distributed to randomly selected members of the professional sonographer registry in the United States. Eighty-one percent reported musculoskeletal pain or discomfort that they associated with the work tasks of scanning. The neck, shoulder, wrist, hand/fingers, and back were where pain was reported most often, and the specific activities of manipulating the transducer while sustaining applied pressure, shoulder abduction, and sustained twisting of the neck/trunk were the key activities that aggravated the pain and discomfort. Among those reporting pain and discomfort, a small minority were absent from work. The remainder reported working in pain. Respondents indicated increased work periods without rest breaks and an inability to control work flow to take breaks. However, they indicated general satisfaction with their work environment and corporate culture. Further analyses are required to investigate the strength of relation between musculoskeletal disorders, work, and personal factors.
UltrasoundGuidhed Balloon Tamponade of Severe, Persistent Endometrial Hemnorrhage After Perforation
Authors: Cocchiarella Ronald J. , Lill Nancy Enz , Richards Steven J.
Published: March 2006

The authors present a case report of a 31 year-old woman who hemorrhaged for 2 weeks after a dilation and curettage for retained products of conception. Transvaginal sonography showed a perforation of the uterus at the fundal aspect of the endometrial cavity. Using transvaginal sonographic guidance, a balloon-tipped catheter was placed in the fundal aspect of the endometrial cavity and the balloon was inflated, to tamponade the presumed bleeding of the fundus. The patient stopped hemorrhaging soon after the procedure and was discharged after transfusions and antibiotic therapy were completed.
A Review of Sonohysterograhy for Evaluation of Uterine Bleeding in the Postmenopausal Woman
Authors: Tyndall-Stauffer Audrey , Long Bruce W. , Cox Linda A.
Published: March 2006

Sonohysterography is a noninvasive procedure that uses fluid to artificially distend the uterine cavity. The fluid fills the endometrial cavity, allowing visualization of any pathology that might be present. Sonohysterography is not difficult to perform and is usually well-tolerated by the patient. It provides valuable information to the physician, and may prove other, more invasive, procedures unnecessary.
Prenatal Diagnosis of Pulmonary Atresia With Intact Ventricular Septum
Authors: Coffin Carolyn T. , Drose Julia A. , Shaffer Elizabeth M.
Published: March 2006

Pulmonary atresia with intact ventricular septum is a rare and complicated congenital cardiac anomaly. Pulmonary outflow is obstructed, which results in hypertrophy and hypoplasia of the right ventricle. The fetal echocardiographic findings include a small pulmonary artery with an atretic pulmonary valve, right ventricular hypertrophy, dilated right atrium, and absent flow in the pulmonary artery on Doppler interrogation. The left ventricle, left atrium, and aortic root also may be enlarged. Nonimmune hydrops may develop in utero, which is the result of poor left ventricular function. Surgical treatments vary, depending on the presence of associated cardiovascular anomalies, but generally include a systemic-to-pulmonary artery anastomosis and a pulmonary valvulotomy.
Prenatal Diagnosis of Exenceplhaly
Authors: Devi Geeta , Shindel Betty , Coulson Carol C. , Kasales Claudia J.
Published: March 2006

Exencephaly is a rare congenital anomaly, thought to be a precursor of anencephaly. Like anencephaly, this abnormality is characterized by absence of the cranial vault above the orbits. However, unlike anencephaly, discrete, sometimes disorganized, brain tissue can be identified above the cranial defect. In this article, the authors report a case of exencephaly diagnosed prenatally during transvaginal ultrasound examination, with anatomic and pathologic correlation.
Soda Pop for Vascular La1oratory Quality Control
Authors: Khedkar Nanda , Redden Roseann , Gavilan-Agpoon Theresa , Peller Patrick , Khania Shadi
Published: March 2006

Quality control of duplex imaging involves consistency in performance of grey scale and Doppler frequency shift or velocity measurements. Phantoms are used to measure the accuracy of Duplex scanners, and many phantoms used for grey scale imaging quality control are available commercially. However, simplistic and inexpensive phantoms for velocity measurements are not available. The authors designed and tested one such phantom—an in-house pump that recirculates fluid in a bottle with inlet and outlet tubes. Different pump settings control the speed of circulating fluid. Initially, the authors used discarded blood from the blood bank. However, because of the associated risks with blood, they searched for a substitute with good reflective properties for ultrasound. Small air bubbles in soda pop worked very effectively, because air is the strongest reflector for ultrasound. To the author's knowledge, use of soda pop for this purpose has not been described previously. Three scanners, an HP 2000, Quantum 2000, and ATL 3000, were evaluated for accuracy of velocity measurements. A similar MHz transducer, 45-degree Doppler angle, and same segment of tube with flowing soda pop were used each time. The Quantum scanner consistently measured velocities as lower than the other two scaners by approximately 10-20% at all velocity ranges (50-350 cm/sec). At the higher end of the spectrum, the Quantum scanner consistently displayed aliasing. Therefore, velocities could not be measured.
Evaluation of Pediatric Renal Size by Sonography
Authors: Creel Stephanie A. , Anderson Joseph , Michael Kim , Pinkerman Brenda
Published: March 2006

Ultrasonography has been shown to be a reliable technique for measurement of kidney length in pediatric patients. Ultrasound was used in this study to evaluate normal variation in kidney size in healthy pediatric patients. The data also were used for comparison of kidney size in solitary kidneys to evaluate compensatory hypertrophy in pediatric patients. The authors also compared renal size in pediatric patients with chronic liver disease against those with healthy kidneys. A correlation was found in younger pediatric patients.
Echocardiography's Role in Cardiogenic Shock After Acute Myocardial Infarction
Authors: Munson Kathleen A. , Jutzy Kenneth R. , de Lange Marie
Published: March 2006

Cardiogenic shock is an emergent condition that requires immediate diagnosis. Assessment and evaluation of potential complications that often accompany shock must also be made. These complications may be seen individually or in concert. Echocardiography has emerged in the last two decades as the single most important procedure in this effort. The authors reviewed four cases of cardiogenic shock after acute myocardial infarction: two with ventricular septal rupture, one with papillary muscle rupture, and one with severe global left ventricular dysfunction. Each patient was evaluated emergently with echocardiography. Results were compared with electrocardiography, arteriography, right heart catheterization studies, and surgical reports.
Spontaneous Unilateral Triplet Ectopic Pregnancy
Authors: Reeder Susan , Greene David
Published: March 2006

With fewer than 100 reported occurrences, spontaneous unilateral ectopic multiple gestation pregnancies are considered to be very rare. The following case review is only the sixth reported case in medical literature since 1891 of a spontaneous triplet ectopic pregnancy. The majority of reported cases have been twin ectopic pregnancies. Multigestation ectopic pregnancies are most often found in patients who have undergone some form of infertility treatment. The incidence of a multigestation ectopic pregnancy happening spontaneously without ovulation-inducing treatment is considered to be an infrequent occurrence.
Renal Cell Carcinoma with Extension into Right Atrium
Authors: Magner Robert G.
Published: March 2006

Symptoms of renal cell carcinoma include flank pain, a palpable mass, and hematuria. At sonographhy, the tumor is frequently a contour-deforming renal mass that is less echogenic than normal renal parenchyma. Renal cell carcinoma has a propensity to invade the renal vein and grow toward the right atrium along the inferior vena cava. It is essential to define the extent of tumor involvement by evaluating the renal vein, inferior vena cava, and right atrium. Observation of a distended thrombus-filled renal vein in the setting of a: hypoechoic renal mass should prompt a search for retroperitoneal lymphadenopathy and other signs of distant metastatic disease. Renal cell carcinoma most commonly metastasizes to the lung, bone, lymph nodes, liver, adrenal glands, brain, and contralateral kidney.
Interlacing Left Biliary Duct and Left Portal Vein
Authors: Yassa Nabil A. , Finstad Terry , Lee Kevin P.
Published: March 2006

The interlacing course of the left biliary duct with the left portal vein is a normal finding. In 20 random right upper quadrant ultrasound examinations, the left biliary duct was seen interlaced with the left portal vein by gray scale and color Doppler ultrasound. After first observing this normal variant, a prospective evaluation of 100 right upper quadrant ultrasound images revealed its occurrence in 2% of cases.
Pancreatic Laceration
Authors: Harris Nicole , Moffatt Michael D. , Collins Denise
Published: March 2006

A case of pancreatic laceration in a child is presented. The complementary roles of computed tomography and sonography are compared.
Biometry/Axial Length in Ophthalmic Ultrasound
Authors: Hart Lois
Published: March 2006

Biometry/axial length is an A-scan measurement from theeleading edge of cornea to the leading edge of the retina. This measurement is used to calculate the implant power of the intraocular lens (IOL). The biometry examination is a primary Wand essential part of cataract extraction and IOL surgery.
Tendon Sheath Tumors: A Report of Two Cases
Authors: Downey Ann , Fitzwilliam Susan
Published: March 2006

Two cases of tendon sheath tumors are presented. Similar sonographic appearances of a fibroma of the tendon sheath and a giant cell tumors are discussed.
Evaluation of Traumatic Penile Arteriovenous Fistulas Using Color Flow Doppler Sonography
Authors: Adey Ronda , Rouse Glenn , DeLange Marie
Published: March 2006

Priapism is defined as a prolonged penile erection in the absence of sexual stimulation. Priapism is divided into two types: low flow and high flow. Color doppler imaging plays an important role as a noninvasive method of diagnosing high-flow priapism caused by penile trauma. Two patients are presented with a history of penile trauma resulting in priapism. Abnormal increased flow in a resting state was demonstrated using color Doppler in each patient. This article reviews our experience, including methods for performing an effective ultrasound examination.
A murine Mll-AF4 knock-in model results in lymphoid and myeloid deregulation and hematologic malignancy
Authors: Chen Weili , Li Quanzhi , Hudson Wendy A. , Kumar Ashish , Kirchhof Nicole , Kersey John H.
Published: March 2006

The 2 most frequent human MLL hematopoietic malignancies involve either AF4 or AF9 as fusion partners; each has distinct biology but the role of the fusion partner is not clear. We produced Mll-AF4 knock-in (KI) mice by homologous recombination in embryonic stem cells and compared them with Mll-AF9 KI mice. Young Mll-AF4 mice had lymphoid and myeloid deregulation manifest by increased lymphoid and myeloid cells in hematopoietic organs. In vitro, bone marrow cells from young mice formed unique mixed pro-B lymphoid (B220+CD19+CD43+sIgM–, PAX5+, TdT+, IgH rearranged)/myeloid (CD11b/Mac1+, c-fms+, lysozyme+) colonies when grown in IL-7– and Flt3 ligand-containing media. Mixed lymphoid/myeloid hyperplasia and hematologic malignancies (most frequently B-cell lymphomas) developed in Mll-AF4 mice after prolonged latency; long latency to malignancy indicates that Mll-AF4–induced lymphoid/myeloid deregulation alone is insufficient to produce malignancy. In contrast, young Mll-AF9 mice had predominately myeloid deregulation in vivo and in vitro and developed myeloid malignancies. The early onset of distinct mixed lymphoid/myeloid lineage deregulation in Mll-AF4 mice shows evidence for both “instructive” and “noninstructive” roles for AF4 and AF9 as partners in MLL fusion genes. The molecular basis for “instruction” and secondary cooperating mutations can now be studied in our Mll-AF4 model.