bluuebunny/crossref_metadata_2025 huggingface dataset:
Fetal Tissue Research and Prenatal Fetal Therapy
Authors: Still Lisa
Published: March 2006

Fetal tissue research was a volatile political issue during the Reagan and Bush administrations. The recent lifting of the federal moratorium banning such research raises many ethical questions. Recent advances in fetal therapy make it possible to cure fetal disease in utero. Ethical issues of fetal tissue transplantation, maternal-fetal rights, and resource allocation are discussed.
Ultrasound Diagnosis of Carcinoma of the Colon
Authors: Schiller Vicki L. , Casal Lisa J. , Hashimoto Ann
Published: March 2006

Ultrasound of the gastrointestinal tract is an extremely important, although underused, aspect of abdominal sonography. A case in which ultrasound examination led to a prospective diagnosis of unsuspected colon cancer is reported.
Antenata Diagnosis of Body Stalk Anomaly
Authors: Weber Miechelle , Chenoweth Carol , Cohen Gary R.
Published: March 2006

A case of body stalk anomaly in a dizygotic twin gestation, in which only one twin was affected, is discussed. Clinical and sonographic findings are presented.
Levels of Involvement by Sonographers in Transesophageal Echocardiographic Examinations
Authors: Janz Kathleen
Published: March 2006

A survey of hospital-based echocardiography laboratories in California, Oregon, and Washington was conducted to determine the level of sonographer involvement in transesophageal echocardiographic examinations. For the 113 sites included in the study, the levels of involvement were ranked in the following descending order: preparation and cleanup for the procedure (94%), manipulation of the ultrasound controls (94%), explanation of the procedure to the patient (58%), manipulation of the probe (13%), and insertion of the probe (2%). Sonographer education and registry was also studied to determine whether it was related to level of involvement, but no correlation was found.
Developing A Working Knowledge of Ulrasound Intensities
Authors: Barwick Charles
Published: March 2006

Ultrasound physics and the concept of sound beam intensity measurement can be difficult areas for students to comprehend. This article discusses intensity measurements to provide a better working knowledge of temporal and spatial variations and their ensuing intensity combinations.
Use of Two-Dinmensional Echocardiography to Predict Aortic Anulus Dianeter in Pediatric Patients
Authors: Ullman Andrea L. , Rice Mary Jo , Imus Randal L. , McDonald Robert W.
Published: March 2006

A retrospective analysis of 19 children who underwent either aortic valve replacement or aortic valve commissurotomy was performed to determine whether aortic anulus size can be determined accurately and reliably by two-dimzensional echocardiography. The aortic anulus was measured trom the parasternal long axis of the left ventricle and trom the apical long axis in end-systole and endw-astole. These measurements were then compared with surgical measurements. Measurements from the parasternal long axis view correlated be-st to surgical measurements (systole r 0.0970, P < 0.001, SEE 1*78 mm diastole r = 0.955, PK 0.001, SEE = 1.99 mm). In our study preoperative two-almensional ech cardiographic prediction of aortic. anulus size was reliable.
Sonographic Evaluation of Solid Breast Masses
Authors: Nelsen Devon J. , Rouse Glenn A. , De Lange Marie
Published: March 2006

Recent developments in ultrasound technology and interpretation suggest that sonographers may be able to distinguish between benign and malignant breast masses more accurately than was previously believed possible. This article reviews and illustrates the sonographic signs that suggest benign and malignant disease, and discusses the accuracy and limitations of the method.
Prenatal Diagnosis and Management of Congenital Left Ventricular Aneurysm
Authors: Woletz Paula S. , Khoury Aldo Dmitri
Published: March 2006

A pregnant woman was referred for fetal echocardiographic examination for cardiac dys-rhythmia. During serial examinations, congen-ital left ventricular aneurysm was diagnosed in the fetus. The case is discussed, and a review of the literature on this rare entity and its rela-tionship to cardiac dysrhythmias is presented. The management dilemmas practitioners must address when facing this unusual lesion are also discussed.
Sonographicaily Detected Portal Venous Air Secondary to Bowel Ischemia
Authors: Bussey Linda A. , Benson Carol B.
Published: March 2006

A case in which portal venous air secondary to bowel necrosis from systemic lupus erythema-tosis was diagnosed by ultrasound examination is reported. Radiographic and computed tomo-graphic examinations failed to identify the abnormality. The sonographic findings were characteristic of this condition. Sonographic findings in cases of portal venous air are dis-cussed, as are guidelines for distinguishing be-tween this entity and pneumobilia.
Ectopic Pregnancy and a Twin Intrauterine Gestation
Authors: Gauldin Carla D. , Bolen J. W. , Gonzales Henry A.
Published: March 2006

A rare case of a twin Intrauterine pregnancy and: a coexisting ectopc gstationis prented. The estimated incidence of combined pregnancy has been f reported to, be between I in every 30,000 d in every 6,778 pregnancies. Although sonographic demonstration of an intrauterine pregnancy virtually eliminates the chanaes of an ectopic gestation, the possibility of a combined pregnancy should always be considered.
Prenatal Diagnosis of Critical Aortic Stenosis
Authors: Andrist Laurinda S.
Published: March 2006

Critical aortic stenosis in the infant can lead to endocardial fibroelastosis and congestive heart failure. Prenatal sonographic findings in a case of endocardial fibroelastosis and a review of the pathophysiology of this condition are presented.
The Association Between Diastolic Flows in the Left Ventricular Outfow Tract and Left Ventricular Compliance
Authors: Byrd Chere E.
Published: March 2006

A prospective evaluation of 52 patients was conducted to establish whether accentuated E' and A' flows, as detected by transthoracic Doppler echocardiography, are related to decreased left ventricular compliance. Decreased compliance was assessed by determining the presence of increased isovolumic relaxation time (IVRT), left ventricular hypertrophy (LVH), and the fourth heart sound heard on auscultation. Among patients with accentuated A' velocities, a strong association with LVH and increased IVRT in patients older than 40 years of age was noted; no association with IVRT was noted in similar patients younger than 40 years of age or with the presence of a fourth heart sound. No relationship between accentuated E' velocities and parameters characteristic of decreased compliance was seen.
Prenatal Sonographic Appearance of Cerebral Infarction
Authors: Cartier Monique M. , Brown Douglas L. , Golden Jeffrey A.
Published: March 2006

Diffuse intracerebral echoes were noted in a second trimester fetus. Although diffuse intracerebral hemorrhage was initially suspected, pathologic correlation revealed cerebral infarction.
The Role of Sonography in Diagnosing and Treating Female Infertility
Authors: Pfeifer Debra G.
Published: March 2006

The most common forms of female infertility and the role of sonography in both the diagnosis and management of female infertility are discussed. A descriptive cause of each disorder is offered, followed by current and experimental sonographic methods of treatment.
Sonographic Evaluation of a Papillary Carcinoma of the Thyroid
Authors: Schutte Mary
Published: March 2006

This case illustrates the sensitivity of ultrasound to detect very small lesions that cannot be imaged by other procedures, such as magnetic resonance imaging, computed tomography, or nuclear medicine, because of their size limitations. This study suggests that ultrasound is a valuable and cost-effective diagnostic procedure for thyroid imaging.
Sonographic Identification of an Aberrant External Carotid Branch Rising From the Internal Carotid Artery
Authors: Honardar Tony , Meiches Mark
Published: March 2006

The identification and significance of an aberrant external carotid branch rising from the internal carotid artery is reported.
Diagnosis of Congenital Coronary Artery Abnormalities by Echoca rdiography
Authors: McNeill Sherry , Velvis Harm
Published: March 2006

Congenitai abnormalities of the coronary arteries arerarbut may resu t in imprtant morta ity and morb idtyfy not Vrecgnzed. This case report describes the clinicala presentaton, physiology, and ecocardiographic features of two types of congenital coronar artery abnormalities.
Intraventricular and Subarachnoid Hemorrhages With a Subfalcine Hernia tion in a Full-Term Infant
Authors: Miller Twylla , Curry Reva A.
Published: March 2006

This case stud presents ultasound findings of a full-term neonate wMth severe perinatal asphyxia. Serial examinations revealed multiple brain abnormalities including grade ill and grade IV intraventricular hemorrhags subarachnoid hemorrhages, and a subfalcie herniation.
The Sonographic Appearance of Emphysena tous Cholecys titis
Authors: Coffin Carolyn T. , Weingardt Jeffry P. , Drose Julia A.
Published: March 2006

Emphysematous cholecystitis is an uncommon form of acute gangrenous cholecystitis. It is characterized by as within the gallbladder wall, lumen, or bliliary ducts. The morbidity associated with emphysematous cholecystitis is five times that of nonemphysematous cholecystitis'. The timely diagnosis ant management of this entity may substantialty reduce the associated morbaidty anc mortality. The sonographic findings ot emphysematous ch oecystitis, including ecnogenic material with shadowing within the gallblader and reverberation echoes emanating from the gallbladder wall or lumen, have been well documented.2-7 We report a case that illustrates an additional rare sonograpnic finding of gas bubbles arising from the gallbladder wall.
AIDS Cholecystopathy
Authors: Rhodes Michelle
Published: March 2006

Several types of biliary tract abnormalities including sclerosing cholangitis, acalculus cholecystitis, and gangrenous cholecystitis have been described in patients with AIDS. Sixteen HIV-positive patients with no previous history of biliary tree abnormality, including no history of jaundice or elevated liver function tests, were reviewed retrospectively. Each patient in our study was examined by abdominal ultrasonography and computed tomography. The results of this study showed that ultrasound may be more accurate than computed tomography in detecting gallbladder abnormalities among patients with AIDS.
Pulsed Doppler Echoca rd iographic Measurement of Pulmonary Acceleration Time in Diagnosing Patients With Pulmonary Hypertension
Authors: Miller Sandra K.
Published: March 2006

Doppler echocardiography offers a quick, non-invasive way to detect evidence of pulmonary hypertension. Most laboratories routinely measure the velocity of the jet of tricuspid regurgitation when present and use the modified Bernoulli equation to estimate pulmonary artery systolic pressure. Another echocardiographic method for detecting elevated pulmonary pressure is to measure the duration of the acceleration phase of pulmonary systolic flow. The purpose of this study was to assess the reliability of the pulmonary acceleration time and the correlation with the Bournoulli method in determining the severity of pulmonary hypertension and the reliability of pulmonary acceleration time to distinguish normal patients from those with pulmonary hypertension.

We evaluated 56 patients with suitable Doppler tracings for pulmonary acceleration time and tricuspid regurgitation. Our results suggest that pulmonary acceleration time, when used correctly, is a useful tool in evaluating patients for pulmonary hypertension. Although pulmonary acceleration time cannot precisely estimate severity, it continues to have a valuable role in an echocardiographic examination to separate patients with and without pulmonary hypertension.
Echocardiographic Management of Patients With Hypertrophic Obstructive Ca rdiomyopathy Treated With Dual Chamber Pacemakers
Authors: Lankford Lori , Sills Tricia
Published: March 2006

A 53-year-old man diagnosed and treated for hypertrophic obstructive cardiomyopathy received serial echocardiograms before and after dual-chamber pacemaker implantation. Varying the programmed atrioventricular delay in a dual-chamber pacemaker can affect the left ventricular outflow tract pressure gradient in hypertrophic obstructive cardiomyopathy. Serial Doppler echo examinations were used to evaluate the effect of varying atrioventricular intervals. Echocardiography can be effectively used with pacemaker programming to optimize the left ventricular outflow tract velocities in patients with hypertrophic obstructive cardiomyopathy.
Transitional Cell Carcinoma of the Bladder Discovered at Early Amniocentesis
Authors: McDuffie Robert S. , Johnson Susan E.
Published: March 2006

To report a case of tranrsitionalacCell carcinoma of the bladder that 0as deftected at the time of early amniocentesis. A 37-year-old duoparous woman, gravida 5, presented at 13 weeks gestation for amniocentesis because of advanced maternal age. Ultrasound examination revealed a polypoid' Cmass;; within fthe bladder. At cystoscopic biopsy 2 weeks later, a transitional cell carcinoma of the bladder was found. The patient underwent: cystoscoic resection of the tumor at 18 weeks gestation and delivered at term wi1thoutfurther complication. One year after delivery, there was no cystoscopic evidence of disease. Early deftection of this bladder cancer by ultrasound led to prompt diagnosis and therapy during pregnancy. The diagnosis would have been m:imssed without a distended bladder.
Ultrasound Diagnosis of a Cervical Ectopic Pregnancy Treated Conservatively
Authors: Barco Oscar Del , Wong Jade J.
Published: March 2006

Cervical pregnancy is a rare form of ectopic pregnancy previously associated with significant morbidity and mortality. Using ultrasound, this condition can be diagnosed early and can be managed conservatively. Sonographic findings and treatment are discussed.
Quantitative Echoca rdiograpy Part III
Authors: Waggoner Alan D. , Davis Cris
Published: March 2006

A comprehensive two-dimensional echocardiographic examination provides useful information that is superior to MT-mode regarding left ventricular chamber sizes and systolic performance, including ejection fraction. Although we rely on visual estimates, quantitative measurements can be particularly valuable in patients with mild or moderate left ventricular systolic dysfunction. Measurements of left ventricular mass by two-dimensional echocardiography is supenror to Ml-mode to detect left ventricular hypertrophy. Two-dimensional echocardiography combined with pulsed Doppler echocardiography can be used to accurately measure stroke volume and to assess changes during medical therapy or after interventions. Future work is needed to assess the significance of continuous-wave Doppler-derived rate of pressure change in patients with mitral regurgitation.
Ultrasound-Guided Mamtmeotomoy
Authors: Parker Steve H. , Dennis Mark A. , Stavros A. Thomas , Johnson Kevin K.
Published: March 2006

Ultrasound-guided breast biopsy is becoming a more commonplace procedure as the demand for more cost-effective and patient-effective means of breast diagnosis increases. A new biopsy device, the mammotome, has been introduced that uses vacuum and a tissue transport mechanism so that multiple samples can be obtained with one insertion in contradistinction to previous percutaneous biopsy methods, which required multiple insertions. To use the mammotome with ultrasound guidance, it is attached to an articulated arm that stabilizes the mammotome housing during the biopsy. The mammotome should make ultrasound-guided breast biopsy less time consuming, more accurate, and more acceptable to those performing the procedure and those ordering the procedure.
The Use of Ultrasonograhy in the Evaluation and Management of Male Infertility
Authors: Meacham Randall B. , May Donald J.
Published: March 2006

Although many causes of male infertility are not easily managed, in a significant number of cases a correctable factor is identified. This review article looks at the important role sonography plays in the evaluation and management of two such disorders—varicocele and obstruction of the ejaculatory ducts.
Cellulitis and the Prevalence of Deep Vein Thrombnosis
Authors: Bendick Phillip J.
Published: March 2006

From February, 1994, to August, 1995, we reviewed the venous duplex ultrasound findings of 207 consecutive patients who presented with clinically evident lower leg cellulitis to determine if thrombophlebitis plaued a role in this entity. All patients had a recent onset of intense erythema of the lower leg with associated pitting edema and diffuse painful cutaneous or subcutaneous tenderness. One hundred ninety-one patients (92%) had normal venous duplex ultrasound examinations, with no evidence of any acute or chronic disease. Four patients (2%) had superficial thrombophlebitis involving the greater saphenous vein in the lower leg only, and 10 patients (5%) had evidence of chronic obstructive disease with recanalizattion and post-thrombotic popliteal venous insufficiency. In a subset of 73 patients aged more than 60 years, arterial evaluation with Doppler spectral waveform analysis showed significant obstructive disease in 41 (56%); 17 of the 19 patients with diabetes in this subset (89%) were noted to have positive arterial examinations. Theae data indicate that when the clinical diagnosis of cellulitis can be made, there is no associated significant acute deep venous thrombosis, and venous duplex ultrasound testing is not indicated. In oldet patients, particularly patients with diabetes, arterial testing for obstructive disease appears to be most appropriate.
Bilateral Intratesticular Masses in a Patient With Congenital Adrenal Hyperplasia
Authors: Scalf Thomas , Townsend Ronald
Published: March 2006

Male patients with congenital adrenal hyperplasia are at risk for testicular tumors of adrenogenital syndrome (TTAGS). This case report discusses the etiology of this disease and its sonographic findings.
Inflammatory Myositis
Authors: Dempsey Rich
Published: March 2006

The use of ultrasound in the evaluation of deep venous thrombosis presents an opportunity for the detection of various nonvascular abnormalities. When a vascular etiology can not be found, and effort to rule out nonvascular causes of symptoms should be attempted.
Retrocalcaneal Bursitis in a Patient With Psoriatic Arthritis
Authors: Keener Thomas S. , Winter Thomas C.
Published: March 2006

This is a case report of the sonographic find-ing of retrocalcaneal bursitis seen in a patient with psoriatic arthritis. This is a common con-dition, but it is rarely diagnosed using sonog-raphy. This case report is unique because of its use of a new scanning technique that en-ables better demonstration of the entire Achil-les tendon and the bursae surrounding it.
Pseudoaneurysm
Authors: Kirklin Karen L. , Thickman David , Smith Michael D.
Published: March 2006

Percutaneous large core needle biopsy of the breast is recognized as an important tool in the current management of breast disease. Ths technique is safe, accurate, and has a very low complication rate. We present a rare complication of a pseudoaneurysm after large core needle biopsy of the breast, diagnosed by means of ultrasound and color Doppler exam-inatin. Pathophysilogic characteristics, diag-nosis, treatment options, and potential pre-vention of this complication are discussed.
Female Reproductive Arterial Blood Flow and Its Relation to Infertility
Authors: Bork Stacey F.
Published: March 2006

Transvaginal color Doppler offers a closer look at blood flow within the reproductive organs. Recent literature using this technique demonstrates that 1) blood flow in the uterine and ovarian arteries is related inversely to estrogen levels, 2) no significant difference is seen between right and left uterine arteries among fertile and infertile patients, and 3) high resistance in uterine and ovarian arteries is correlated directly with poor pregnancy outcome. The question remains: Is there an resistive index or pulsatility index value, representing a cut-off point, for predicting successful outcome in the patient undergoing in vitro fertilization?
Transesophageal Echocardiography in the Critical Care Unit
Authors: Roberts Douglas J.
Published: March 2006

Transesopageal echocardiography is highly sensitve for evaluation of cardiac structure and hemodYnamics of blood flow through the hea.rt In the critical care setting, it often is used as a basis for additional evaluation once transthoracic methods have been inconclusive. Tis retrospectiv study was designed to report the management impact of transesophagejal echocardiography in the cntically ill patient population. Documentation for X each patient included a clinical diagsis at admission, along with;the results of the transesophageal echocariography and its impact on:patient treatment. Te imxpact of transesopagal echocariography in relation to patient treatment was baseon therapy or surgical intervention changes. The most common concerns requiring additional analysis of cardiac structures Weto rule out endocarditis (23%), evaluate hemodyvnamic instability (22.%), and to diagnose the source of embolism (21%). Of these 92 patients, 43 were postoperative evaluations. Tiansesophageal echocardioaphy was feasible in all attempts and the results prompted 37 (40%) of the patients to have treatment changes as a direct result of the examination. These findings suggest that transesophageal ehocahrdiography proides crucial diagnostic information impottant for crtical care management decisions in a safe and efctiwe manner.
A Series of Teaching Phantoms for Displaying Diagnostic Ultrasound Image Artifacts
Authors: Langer Steve , Kofler James M.
Published: March 2006

Much work has been done on ultrasound phantoms foe biopsy and anatomic training of physicians and sonographers. Artifacts observed during scans in vivo also have been described. The authors' purpose in this article is to describe the construction and perdormance of phantoms designed to demonstrate ultrasound image artifacts for teaching purposes. Phantom images exhibiting ringdown, range errors, reverberation, and multipath artifacts produced by scanning intrauterine devices, shotgun pellets, and other objects are illustrated.
The "Vascular Pedicle Sign" in the Diagnosis of Pelvic Masses
Authors: Nathan Mark A. , Abu-Yousef Monzer M.
Published: March 2006

Establishing a meaningful differential diagnosis during the sonographic evaluation of an adnexal mass requires the determination of the organ of origin. The authors presents two cases of pedunculated fibroids with uncharacteristic ultrasound findings, in which they demonstrate a clear vascular pedicle between each mass and the uterine fundus by color-flow Doppler sonogtaphy. The "vascular pedicle sign" may be a valuable sonographic tool for those cases in which defining the organ of origin of an adnexal mass is difficult.
Sonographic Findings in Mesenteric Lymphangioma
Authors: Cooper Staci
Published: March 2006

A multiloculated cystic mass with multiple thin septations was visualized during ultrasound examination. This mass was found to be a mesenteric lymphangioma: a rare, benign tumor. Sonographically, it is difficult to confirm the mesentery as the origin of a neoplasm, but it should be included in the differential diagnosis. The normal sonographic presentation of mesentery is discussed. The appearance of a mesenteric lymphangioma, its etiology, symptoms, and a histologic explanation are given.
Chemical Substance Use Among Sonographers in Georgia
Authors: Lam Rebecca W. , Reyes Lynn K. , Etersque Stanley , Jense Jonathan A. , Price Stan C.
Published: March 2006

A study was done on prevalence, use patterns, and behaviors associated with chemical substance use among diagnostic medical sonographers, radiographers, nuclear medicine technologists, and radiation therapists registered in Georgia. In this article, the researchers emphasize the sonography data, and how they compare with the collective nonsonography radiologic science group data and to U.S. southern region and national population data. Results showed that sonographers had the highest past year nonmedical use rates compared with all other groups for alcohol, marijuana, stimulants, and cocaine, although none were statistically significant. Sonographers reported lowest past year use compared with all other groups for smoking tobacco, which was statistically significant, as well as for smokeless tobacco, which was not statistically significant. Sonographers also indicated no nonmedical use of sedatives, inhalants, hallucinogens, crack, or heroin during the previous 12 months. Recommendations include the need for further study to draw a more accurate picture of sonographers' substance use effects on work performance, the need for increased drug education, and increased attention to customized employee assistance programs.
Sonographic Diagnosis of Interstitial (Cornual) Ectopic Pregnancy
Authors: Scalf Thomas , Weingardt Jeffry P. , Thieme Gary A.
Published: March 2006

Interstitial or cornual pregnancy is an uncommon form of ectopic pregnancy that can be difficult to diagnose both clinically and sonographically. Although infrequent, interstitial ectopic pregnancy carries a greater mortality risk than common forms of tubal ectopic pregnancy. The authors present a case of an interstitial ectopic pregnancy diagnosed sonographically, and they review the associated literature.
Cystic Adenona toid Malformation II in Extralobar Pulmonary Sequestration
Authors: Richardson Christie
Published: March 2006

Congenital cystic adenomatoid malformation is a rare pulmonary lesion that can be diagnosed prenatally by ultrasonography. This hamartomatous pulmonary mass is typically unilateral and usually involves one lobe or segment of the lung. Hamartomas are rare tumors of variable physical appearance, whose sonographic appearance is usually that of a predominantly cystic or solid mass. Typically slow growing, it is not uncommon for focal calcifications to develop. On rare occasion, hamartomas may be bilateral or involve the entire lung. Pulmonary sequestrations probably represent bronchopulmonary foregut abnormalities. Extralobar lesions are the least common overall, but are the most common form found in neonates and nearly the only form that has been detected prenatally. Sequestrations occur most commonly on the left (90%) in the posterior and basal segments. Subdiaphragmatic lesions (which account for 2.5% of bronchopulmonary foregut malformations) have been observed prenatally associated with other anomalies, including foregut abnormalities and congenital diaphragmatic hernia in 58% of cases. This form of sequestration has rarely been diagnosed prenatally. The following case report illustrates cystic adenomatoid malformation in extralobar pulmonary sequestration.
Two Sonographic Presentations of Giant Retroperitoneal Lipomas
Authors: Barzilai Menashe , Biterman Arie
Published: March 2006

Two cases of histologically proven giant retroperitoneal lipomas are presented. Both were evaluated by computed tomography and sonography. Although the computed tomography findings of both lesions were similar, they exhibited different echographic patterns sonographically. In this article, the authors discuss the various ultrasonographic characteristics of body fat, and they present possible explanations.
Epignatic Tumtor With Intracereral Extension
Authors: Holley Gregory P. , Kasales Claudia J. , Ambrose Anthony
Published: March 2006

Epignatic teratoma with intracerebral extension is a very rare entity, and the prognosis is always grim, with death occurring within the first month of life. Generally, the pregnancy is complicated by a rapid onset of polyhydramnions, which prompts prenatal ultrasound examination. The size of the teratoma interferes with normal fetal swallowing of amniotic fluid, which causes the onset of polyhydramnios. Prenatal ultrasound helps with the assessment of oropharangeal involvement, which can optimize care plans in the postnatal period.
Rectus Sheath Hematoma
Authors: Dempsey Rich
Published: March 2006

Rectus sheath hematoma should be considered as a possible cause of severe abdominal pain in the presence of anticoagulant therapy and abdominal trauma. The unique anatomy of this area and its proximity to the peritoneum may mimic more serious abdominal pathology. Awareness of this pathological entity, which can readily be diagnosed with ultrasound, may eliminate the need for more costly or invasive diagnostic procedures.
Mucinous Adenocarcinoma of the Appendix: TransvaginaL Ultrasound Fisndings
Authors: Hull Magdalen E. , Maulik Dev , Clout Angela
Published: March 2006

Primary mucinous adenocarcinomas of the appendix represent 8.0% of all carcinomas of the appendix. As a group, primary appendiceal malignancies represent 0.5% of all intestinal tumors and are important because they are rarely diagnosed before surgery. Two cases of carcinoid tumors of the appendix have been described; however, no tumors have been described using transvaginal ultrasonography in a female patient.
Significance of Focal Hypertrophy of the Internal Anal Sphincter on Anal Endosonography
Authors: Yassa Nabil A.
Published: March 2006

The author's purpose, with this study, was to determine the significance of focal hypertrophy of the internal anal sphincter on anal endosonography. Anal endosonography was performed on 40 female patients with fecal incontinence using an Acuson 128 XP/10 unit with a sector 7 MHz endorectal probe. In 22 cases, no abnormality was seen. In 12 cases, there was an isolated anterior tear of the external anal sphincter. Of these 12 cases, 2 had focal hypertrophy of the internal anal sphincter at the same location of the external anal sphincter tear. In 6 cases, combined external and internal sphincter tears were present. Sphincter tears were surgically confirmed. Focal hypertrophy of the internal anal sphincter is an indirect sign of external anal sphincter tear.
Assumptions in Statistical Analyses of Sonograhy Research Data
Authors: Khamis H. J.
Published: March 2006

Every statistical procedure carries with it certain assumptions that must be at least approximately true before the procedure can produce reliable, accurate results. Researchers often apply a statistical procedure to their data without checking on the validity of the assumptions of the procedure. If one or more of the assumptions of a given statistical procedure are violated, then misleading results will be produced by the procedure. It is important that those who analyze data be fully aware of the details of the statistical procedure they are using, including its companion assumptions. If one or more assumptions are violated, an alternative procedure must be used to obtain valid results.
Use of Transrectal Ultrasonography in the Manasgemnent of Prostatic Abscess
Authors: Trummer Harald , Caruso Anthony P. , Meacham Randall B.
Published: March 2006

Prostatic abscess is a potentially life-threatening condition. Effective treatment requires intensive antimicrobial therapy and drainage of the abscess. Transrectal ultrasound now plays an important role in the management of this condition. Transrectal ultrasound is an effective and readily available method for establishing the diagnosis of prostatic abscess. In addition, intraoperative transrectal ultrasonography can be of great help in localizing an abscess cavity so that it can be unroofed and the contents drained.
Congenital Mesoblastic Nephromea
Authors: Holley Gregory , Labuski Mark , Kasales Claudia
Published: March 2006

Congenital mesoblastic nephroma is the most common neonatal renal tumor. Although the mass may be large and is usually associated with polyhydramnios, these tumors rarely recur and rarely metastasize. Presented is a case, with clinical-pathologic correlation, of a pregnant female with size-greater-than-dates secondary to polyhydramnios associated with a congenital mesoblastic nephroma. This diagnosis should be considered in any fetus with polyhydramnios and a large flank/abdominal mass.
Doppler Echocardiographic Correlation of Pulmonary Venous Flow Patterns to Mitral Valve Regurgitant Severity in Patients With Atrial Fibrillation
Authors: Elijah Rebecca F. , Otto Catherine , Pearlman Allen , Fujioka Michelle , Zwink Todd , Skelly Andrea
Published: March 2006

Studies have shown that pulmonary systolic velocities are decreased in patients with atrial fibrillation, but none have shown the correlation between mitral valve regurgitant severity and the amount of systolic flow decrease/reversal in these patients. In patients with normal sinus rhythm, a finding of decreased systolic flow <0.4 m/s is consistent with moderate mitral regurgitation, and systolic flow reversal is consistent with severe mitral regurgitation. Doppler recordings of 66 patients who were in atrial fibrillation at the time of their transthoracic echocardiograms (January-July 1995, January 1996-February 1997) were analyzed to show the statistical relation between mitral regurgitant severity and the amount of systolic flow decrease/reversal. This study showed that a decrease in systolic flow velocities expected in patients with atrial fibrillation and the amount of decrease does not correlate statistically with the severity of mitral regurgitant lesions. In addition, flow reversal in the pulmonary veins is not expected in patients with atrial fibrillation, and such a finding is strongly associated with severe mitral regurgitant lesions.
Venous Imaging for Reflux Using Duplex Ultrasonography
Authors: Rodriquez Jenaro H. , Ballard Jeffrey L. , Rouse Glenn A. , de Lange Marie
Published: March 2006

Refinements in pulsed wave and color flow Doppler in conjunction with gray scale ultrasound have made duplex ultrasonography the optimal diagnostic modality for assessment of lower extremity venous reflux. This safe, non-invasive, and cost-effective modality can accurately determine reflux in the deep, perforating and superficial venous systems of the lower extremity. However, proper technique and uniform testing using duplex ultrasonography and rapid cuff deflation are essential. In this article, the authors provide an overview of the technical and interpretive aspects of duplex ultrasound imaging for reflux in the veins of the lower extremity.
The Usefulness of Ocular Color Doppler in Diagnosing Angiomatosis Retinae Associated With Von Hipple's Disease
Authors: Gulani Arun C.
Published: March 2006

Color Doppler sonography has been used to evaluate eyes clinically diagnosed with angiomatosis retinae. The introduction of this promising modality to both diagnose and monitor cases of angiomatosis retinae in the presence of unclear optical media is discussed.
Renal Translant
Authors: Wise Angela , Cox Linda A. , Long Bruce W.
Published: March 2006

Renal transplantation is the preferred treatment for patients with chronic renal failure. The causes of renal transplant dysfunction include perinephric fluid collections, vascular complications, hydronephrosis, and rejection. Ultrasound examination provides valuable information regarding the cause of graft dysfunction. Postoperative complications can be assessed using gray-scale and Doppler ultrasound. Sonography is also useful in renal biopsy to determine the precise cause of graft dysfunction.
Brachiocephalic Vein Dilatation
Authors: Glascock Betty J. , Meyer Richard A. , Perez Angel
Published: March 2006

In infancy, total anomalous pulmonary venous return above the diaphragm and congenital cerebral arteriovenous malformations are difficult to diagnose. To assist in diagnosing these lesions, the brachiocephalic vein (BCV) and transverse arch diameters were obtained and compared, to provide a BCV index, the ratio of the BCV diameter to the transverse arch diameter. Fifty-six infants were studied. Six infants had arteriovenous malformations (mean age, 46 ± 76 days; mean weight, 3.8 ± 1.2 kg). Eight infants had total anomalous pulmonary venous return draining above the diaphragm (mean age, 22 ± 30 days; mean weight, 3.2 ± 0.5 kg). A healthy control group (those without heart disease) consisted of 42 infants (mean age, 23 ± 47 days, mean weight 3.0 ± 1.4kg). There were no significant differences in the age, gender, and weight of these patients versus the controls. An absolute BCV diameter of 0.52 cm and a brachiocephalic vein (BCV/transverse arch) index greater than 1.06 should alert the sonographer to the presence of an arteriovenous malformation or total anomalous pulmonary venous return above the diaphragm. This finding will then permit a greater focus on identifying the course of the anomalous venous channels.
Role of Duplex Imaging in Intermnediate Category Ventilation Peffusion Scans
Authors: Khedkar Nanda , Gavilan-Agpoon Theresa , Redden Roseann , Peller Patrick , Martinez Charles , Lakier Jeffrey
Published: March 2006

Clinical diagnosis of pulmonary embolus (PE) is difficult. Pulmonary angiography is still the gold standard for diagnosing PE, and ventilation perfusion (VQ) lung scans are used as a screening test. With normal VQ scans, PE can be ruled out. High probability VQ scans have high positive accuracy. The authors conducted a retrospective analysis of 45 patients who underwent intermediate VQ scans. Of the 45 patients who had intermediate VQ scans performed, 37 (82%) had venous duplex imaging (VDI) conducted, with 7 found to be positive for deep vein thrombosis. Of the 45 patients who had intermediate VQ scans performed, 12 (27%) had pulmonary angiograms performed, 7 (58%) of which were positive for PE. Six of these seven patients also had VDI conducted, all of which were negative. In total, of the 22 patients found to have a clinical discharge diagnosis of PE, 13 had either VDI studies or pulmonary angiographies positive for PE. These results indicate that a positive VDI study substantiates a diagnosis of PE. However, negative VDI study does not rule out pulmonary embolus.
Sonographic Diagnosis of Orbital Cysticercus Cyst
Authors: Gulani Arun C.
Published: March 2006

In this article, the author describes the “hanging drop sign” to aid in the sonographic diagnosis of orbital cysticercus cysts. A cysticercus cyst with the scolex attached to the inner wall composes the “hanging drop sign.” This sign was seen in all seven cases studied using simultaneous A-and B-scan sonography. This appearance was consistent and reproducible, regardless of whether the cyst was intraocular or extraocular in location. The “hanging drop sign” may be a useful sonographic parameter in making the diagnosis of an orbital cysticercus cyst.
Ultrasound of the Normal Appendix
Authors: Rapp Cynthia L. , Stavros A. Thomas , Meyers Patrick R.
Published: March 2006

Sonography now plays a vital role in noninvasive evaluation of patients with right lower quadrant pain. Sonography can differentiate appendicitis from other etiologies of pelvic pain, such as ovarian cysts, tubo-ovarian abscesses, inguinal hernias, and uterine pathologies. Successful demonstration of a normalsized appendix virtually excludes appendicitis in the patient with right lower quadrant pain. False-negative examinations may occur because of bowel gas interference, stool, perforation with decompression of the appendix, or inflammation of the appendix without abnormal enlargement. The purpose of this study was two-fold: to determine how often a normal-sized appendix is demonstrable in patients who do not have appendicitis; and to determine whether locating a normal appendix improves the negative predictive value for the absence of appendicitis.
Intratesticular Spermatocele in Occurrence With Seminiferous Tubular Ectasia
Authors: Ririe Kendall , Bowman Kim , Townsend Ron
Published: March 2006

The sonographic findings of an intratesticular spermatocele occurring with seminiferous tubular ectasia are discussed. A literature review revealed that intratesticular spermatoceles are extremely rare. This uncommon finding, as well as the etiology and ultrasound appearance of epididymal spermatoceles, tubular ectasia, and intratesticular cysts, are included. Awareness of the appearance of these benign entities may eliminate the need for more invasive diagnostic procedures.
Prenatal Diagnosis of Acardiac Parabotic Twinning
Authors: Nolen Gloria , Chenoweth-Mitchell Carol K. , Barry-Kiefer Cathy , Thorp James A.
Published: March 2006

An acardiac parabiotic fetus is a rare anomaly that occurs almost exclusively in twin gestations. Although extremely rare, this phenomenon also has been reported in singleton gestations in association with an intra-amniotic tumor. It occurs when there is shunting of blood through arterial-to-arterial and venous-to venous anastomoses within the placenta.This anomaly is characterized by a severely malformed fetus, severe hydrops, absent heart, and abnormalities of the extremities. The authors present a case report of an acardiac parabiotic twin diagnosed by prenatal ultrasound.
Applications of Doppler in Complicated Obstetrics
Authors: Robertson Dawna L.
Published: March 2006

The value of Doppler assessment for physiologic function of placental circulation and fetal well-being has not been uniformly accepted despite the clinically noninvasive and readily accessible features for measurement. Uterine and fetal Doppler readings must be interpreted within the context of the vessel under interrogation, location along the vessel site, and gestational age. Definitions of “high risk” or “poor outcome” also qualify the feasibility for use of Doppler as a screening device. Because Doppler is not included as a standard of care in many aspects of high-risk pregnancy, it is probably underused as a valuable clinical tool.
Transparent Bone and Concave Ribs
Authors: Palmer Tammy M. , Rouse Glenn A. , Song Andrew , de Lange Marie
Published: March 2006

Osteogenesis imperfecta (OI), a rare connective tissue deformity, can be classified into four categories, one of which (type II) is lethal. Lethal OI can be detected with the use of ultrasound prenatally. The authors studied nine OI cases, seven type II OI cases, and two nonlethal cases. All seven type II OI cases had very short limbs. In six of the seven cases, the back wall of the limb bone was visible (transparent bone sign). In four of the seven cases, concave ribs were visualized in the transverse plane. An incidental finding, beaking of the anterior portion of the skull, was noted in five cases. The transparent bone sign and concave ribs were not observed in the two nonlethal cases of OI.
Transient Recurrent Venous Phenomenon
Authors: Gerig Jeff L. , Luna Joseph A. , Parsons Lisa , Winter Thomas C.
Published: March 2006

The placenta is an important part of every obstetric ultrasound examination, but its evaluation is often underemphasized. Important abnormalities of the placenta can be detected by ultrasound/p=m-/some of them before they adversely affect the fetus. Most of these abnormalities are vascular and include subchorionic hemorrhage, intervillous thrombosis, and placental abruption. The authors present a placental vascular anomaly not described previously. A transiently filling and emptying retroplacental and subchorionic space, corresponding with venous flow, is described by the authors. Throughout an 18-month period, three cases were observed. The pregnancy outcomes were good in all cases, with healthy neonates at birth. The clinical course and pregnancy outcome of these three cases are described.
Biplanar Endosonographic Imeaginlg of the Anal Sphincters
Authors: Yassa Nabil A. , Lee Kevin P.
Published: March 2006

The usefulness of biplanar endosonography of the anal canal was evaluated. Twenty women with fecal incontinence underwent endosonography of the anal canal. All examinations were performed using both sector and sagittal endorectal probes. Images were obtained in the axial and sagittal planes. Isolated external anal sphincter tears were missed on axial images in 3 out of 10 cases. In all 10 cases, the sagittal scans confirmed external anal sphincter defects. Routine scanning of the anal canal in the axial and sagittal planes increases the detection rate of external anal sphincter defects on endosonography.
Evaluating a Patient With Leg Pain
Authors: Baun Jim
Published: March 2006

Leg pain is a common indication to refer patients for vascular sonography. Before the introduction of duplex and, subsequently, color Doppler imaging, the diagnosis and assessment of lower extremity peripheral vascular pathology fell into the scope of practice of the noninvasive vascular technologist. During the past decade, however, with the blurring of some of the practice boundaries between sonographers and vascular technologists, the onus for recognizing, diagnosing, and assessing lower extremity vascular pathology has fallen on the shoulders of many a competent sonographer who has had little clinical training in this area. Noninvasive vascular diagnosis relies strongly on the clinical assessment of the patient in addition to the duplex or color Doppler examination. Indeed, basic competence in the performance of noninvasive vascular studies, as outlined by the American Registry of Diagnostic Medical Sonographers, includes a strong clinical component. In this article, the author describes a focused, clinical approach to evaluating the patient who complains of leg pain. Adequate clinical evaluation will assure appropriate use of noninvasive and duplex examination methods.
Sonographic Diagnosis of Gangrenous Cholecystitis
Authors: Carbone Gregory M. , Townsend Ronald R.
Published: March 2006

Gangrenous cholecystitis is an advanced form of acute cholecystitis that is associated with an increased complication rate. Although somewhat controversial, common belief is that patients with nongangrenous acute cholecystitis can be treated medically followed by elective surgery. However, all agree, patients with gangrenous cholecystitis should undergo emergent cholecystectomy. Ultrasound can play an important role in this situation, by helping to differentiate those patients who require emergent surgical therapy from those who do not.
Construction of a Flow Phantom for Use in Color Power Sonography
Authors: Cheng Theodore Y. , Janik Tracey , Meacham Randall B.
Published: March 2006

To standardize interpretation of color power images, a flow phantom was constructed. The unit consisted of a digital pulsatile pump, tubing, an agarose scanning window, and a flow medium that contained starch particles. The flow phantom produced consistent and reliable flow that could be used to index and standardize each ultrasound image. The unit proved to be highly functional and reliable and was relatively inexpensive to construct.
Using S/D Ratios to Predict Fetal Outcome
Authors: Moon Amy Elizabeth
Published: March 2006

The systolic/diastolic (S/D) ratio is a measurement of the umbilical cord artery that compares the systolic with the diastolic flow and identifies the amount of resistance in the placental vasculature. This retrospective study made a direct comparison between the S/D ratios of third-trimester fetuses and their birth weights. Previous studies have reported fetuses with S/D ratios greater than 3.0, after 30 gestational weeks, to be at an increased risk for low birth weight. This study looked at outcomes of fetuses with S/D ratios greater than 3.0, and ratios less than 3.0. One hundred S/D ratios were obtained and divided into three categories: less than 2.0, between 2.0 and 3.0, and greater than 3.0. The collected data showed 35.5% of low-birth-weight neonates had S/D ratios greater than 3.0. Those patients with S/D ratios less than 2.0 had the largest percentage (37.5%) of neonates above the 50th percentile in weight, whereas ratios between 2.0 and 3.0 had the highest percentage (59.46%) of neonates between the 11th and 50th weight percentiles. The S/D ratio is easily obtained and provides important information in conjunction with fetal structural measurements when predicting the outcome of a fetus.