bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasonographic features of prostatic carcinoma
Authors: Greenberg Mark , Neimen Harvey L. , Vogelzang Robert , Falkowski Walt
Published: February 2007

Over an 18‐mo period, 93 prostate examinations were performed by a suprapubic transabdominal approach. By applying ultrasonographic tissue textural analysis, we were able to identify 16 out of 19 carcinomas. Most of these analyses showed ill‐defined focal abnormalities located either in the posterior or the posterior‐lateral portion of the gland. Ten of the analyses demonstrated increased echogenicity, while six demonstrated decreased echogenicity. Irregularity of the capsule was an unreliable sign in determining capsular invasion. The degree of extension appears to be better evaluated by computed tomography (CT). In conclusion, transabdominal ultrasound holds promise in the detection of prostatic carcinoma, while staging should be done by CT.
Breast cancer: The appearance as delineated by whole breast water‐path ultrasound scanning
Authors: Kopans Daniel B. , Meyer Jack E. , Steinbock R. Ted
Published: February 2007

The sonographic appearance of 130 breast carcinomas imaged by a dedicated breast scanning system is reviewed. Five separate categories are identified and examples of each category with corresponding xeromammograms are presented.
Ultrasound patterns of metastatic tumors in the gallbladder
Authors: Phillips Gail , Pochaczevsky Rubem , Goodman Joan , Kumari Sheila
Published: February 2007

Eleven cases of sonographically detected metastatic disease to the gallbladder are reported. This paper represents the first comprehensive review of the ultrasonographic findings in this not infrequently encountered disease process. Four distinctive sonographic diagnostic patterns have evolved and are described. The suspicion of metastatic tumors in the gallbladder should be raised, particularly in the presence of focal gallbladder wall thickening in association with nonshadowing intraluminal soft tissue masses. In contrast to primary carcinomas of the gallbladder, cholelithiasis usually is absent. The differential diagnosis, which includes various benign conditions of the gallbladder, is discussed.
Evaluation of right ventricular and right atrial size in children with atrial septal defect using two‐dimensional apex echocardiography
Authors: Fontana Gregory P. , Kirkman Jason H. , Disessa Thomas G. , Hagan Arthur D. , Hiriashi Satoshi , Isabel‐Jones Josephine , Friedman William F.
Published: February 2007

The ability of two‐dimensional apex echocardiography to evaluate right ventricular and right atrial size was evaluated in 43 normal children and compared with 20 patients with a secundum atrial septal defect. From the apical four chamber view, the long axis length and short axis diameter of the right ventricle and right atrium were measured. The end‐diastolic area of the right ventricle and end‐systolic area of the right atrium were determined by planimetry. These data were indexed for body surface area. When compared with normal subjects, the area index of the right atrium and right ventricle were enlarged significantly in patients with a secundum atrial septal defect (p < 0.001 and p < 0.001, respectively). Mean values for the short axis dimension of the right ventricle and for the short axis and long axis diameter of the right atrium were greater in atrial septal defect patients than in normal subjects (p < 0.001 for all). However, when both groups were compared, considerable overlap existed between the dimension measurements. Right ventricular long axis length failed to separate the two groups. Thus, two‐dimensional apex echocardiography provides a noninvasive means of assessing right ventricular and right atrial size in children with an atrial septal defect.
Papillary renal cell carcinoma: Ultrasonic/pathologic correlation
Authors: Blei C. Lynne , Hartman David S. , Friedman Arnold C. , Davis Charles J.
Published: February 2007

Papillary renal cell carcinoma represents a separate clinicopathologic entity distinguished from nonpapillary renal cell carcinoma by angiography, microscopic pathology, and biological behavior. We correlated retrospectively 11 surgically proven papillary renal cell carcinomas with ultrasound patterns and gross pathologic findings. In addition, we reviewed retrospectively 65 surgically proven cases of nonpapillary renal cell carcinoma for sonographic patterns. Seven of 11 (64%) of the papillary tumors were less echogenic than the ipsilateral renal cortex (hypoechoic). Only 23% of the nonpapillary tumors were hypoechoic. These data suggest that renal papillary carcinoma tends to be hypoechoic on ultrasound. In most of the papillary cases, this hypoechoic pattern was due to a large central area of cystic necrosis within the tumor.
Extrahepatic bile ducts in healthy subjects, in patients with cholelithiasis, and in postcholecystectomy patients: A prospective ultrasonic study
Authors: Niederau Claus , Müller Jürgen , Sonnenberg Amnon , Scholten Theodor , Erckenbrecht Joachim , Fritsch Wolf‐P. , Brüuster Theodor , Strohmeyer Georg
Published: February 2007

To determine the average diameter and the upper normal limit of the common bile duct in healthy man, 830 blood donors were examined by ultrasound. The mean diameter was 2.5 ± 1.1 mm (SD) at the porta hepatis and 2.8 ± 1.2 mm (SD) at the widest point, the regression coefficient between both diameters being r = 0.84. None of the healthy subjects had a diameter larger than 7 mm at any site, and in 95% of all subjects the diameters were less than 4 mm at both sites of measurement. The diameters were significantly correlated with age (r = 0.16) and weight (r = 0.11), but not with sex, height, and body surface area. In 73 patients with cholelithiasis and in 55 patients after cholecystectomy, all of whom lacked clinical or laboratory signs of biliary obstruction, the average diameters at the porta hepatis were 3.8 ± 2.0 mm and 5.2 ± 2.3 mm, and at the widest point 4.8 ± 2.2 mm and 6.2 ± 2.5 mm, respectively. It is concluded that a common bile duct with any sonographic diameter larger than 4 mm should be followed closely and evaluated further with clinical examinations such as intravenous cholangiography unless cholecystectomy has been performed.
Ultrasound and radionuclide biliary scanning in acute pediatric abdominal pain
Authors: McGahan John P. , Phillips Harold E. , Stadalnik Robert C. , Cox Kenneth L.
Published: February 2007

Seven pediatric patients (ages 2–14) who presented with acute abdominal symptomatology and an abnormal cholecystosonogram are reviewed. Etiologies of the abnormal sonograms included: hepatitis (3 of 7), acalculous cholecystitis (1 of 7), calculous cholecystitis (1 of 7), cholangitis with associated cholecystitis (1 of 7), and chronic active hepatitis with low serum albumin (1 of 7). The combined use of the sonogram and the radionuclide biliary scan is helpful in predicting and distinguishing between cases of cholecystitis and uncomplicated hepatitis.
Different degrees of atherosclerosis detected by backscattered ultrasound: An in vitro study on fixed human aortic walls
Authors: Picano Eugenio , Landini Luigi , Distante Alessandro , Sarnelli Roberta , Benassi Antonio , L'Abbate Antonio
Published: February 2007

The aim of the study was to establish whether ultrasonic backscattered signals may characterize the atherosclerotic process, providing a quantitative assessment of severity. Measurements on aortic specimens were made in vitro by a transducer acting as transmitter and receiver. Two different indices were measured, one based on peak amplitude value (Vmax) and the other on fast Fourier transform (FFT) analysis of ultrasonic reflected signal (IBI). Two hundred fixed aortic wall specimens (50 normal, 50 fatty streaks, 50 fibrofatty, and 50 calcific) were first characterized ultrasonically and then pathologically, both macroscopically (before ultrasonic study) and histologically (after it). Differentiation of normal, fibrofatty and calcific specimens was achieved using Vmax. Values obtained in fatty streaks overlapped with normal wall but significantly differed from values of fibrofatty and calcific subsets. The results with IBI were similar except that the difference between normal and fibrofatty specimens was not statistically significant. Such changes in acoustic behavior of atherosclerotic walls could be due to increased deposition of highly echogenic biological materials, such as collagen, cholesterol crystals (in fibrofatty specimens), and calcium salts (in calcific ones). Therefore, backscattered signals appear to provide in vitro simple parameters indicative of changes in the arterial wall structure due to the atherosclerotic process.
Real‐time ultrasound visualization of tongue movement during swallowing
Authors: Shawker Thomas H. , Sonies Barbara , Stone Maureen , Baum Bruce J.
Published: February 2007

Using noninvasive real‐time ultrasound, tongue movement was visualized during single swallowing in eight normal subjects and one neurologically impaired patient with dysphagia and chronic aspiration. In normals, a clearly defined muscular wave of the tongue, traveling at approximately 15 cm/sec, carried a 5‐cc test water bolus posteriorly. In the patient who had 12th cranial nerve weakness, there was complete absence of normal tongue activity and no midtongue bolus formation or transmission.
Polycystic Ovarian Disease: Ultrasonic Evaluation and Correlations With Clinical and Hormonal Data
Authors: Parisi Luigi , Tramonti Maria , Derchi Lorenzo E. , Casciano Silvio , Zurli Alberto , Rocchi Pietro
Published: February 2007

The size, shape, margins, and structure of the ovaries, as observed in 26 patients with polycystic ovarian disease were analyzed, and uterinelovarian ratio (maximum antero‐posterior diameter of uterine fundus divided for longitudinal diameter of ovary) was calculated. The maximum surface area of the organs ranged from 9.5 cm2 to 17.3 cm2 (average value 12.9 cm2). A “roundness index” (minimum diameter × 100/maximum diameter) was calculated in order to evaluate the shape: it ranged from a value of 100 in perfectly rounded ovaries to a value of 54 in ovaries of oval shape. The ovarian structure was characterized by many small cysts of the same dimensions in 19 cases; in two patients there was a predominant cyst; in five cases it appeared as many thick echoes arranged along parallel lines. The uterinelovarian ratio was always equal to or less than 1. Correlation tests for size, shape of the ovaries, patient's age, and duration of symptoms were highly significant. This leads one to suppose that both of these ultrasonic findings are a function of the duration of the disease and that polycystic ovarian disease, once established, is the cause of progressive enlargement of these organs.
Usefulness of Renal Ultrasonography for Assessment of Severity and Course of Acute Tubular Necrosis
Authors: Nomura Gakuji , Kinoshita Eiichi , Yamagata Yuji , Koga Nobuhiko
Published: February 2007

Renal ultrasonographic studies were done in 26 patients with acute tubular necrosis. Prominent findings were an increase in renal size, especially the anteroposterior diameter, and sharp delineation of swollen pyramids. The ratio of anteroposterior to longitudinal diameter (WL) was correlated with serum creatinine levels and inversely correlated with urine osmolalities. It was well correlated with the recovery time of acute renal failure. The patient group having an increased H/L had a mean recovery time of 32.4 days and 11 of the 12 patients required hemodialysis (mean of 10 times). The patient group having a normal H/L had a mean recovery time of 15.5 days and 9 of the 14 required hemodialysis (mean of 3 times).
Sonographic patterns of renal Cell carcinoma with emphasis on relation to tumor size
Authors: Sugimoto Sumiko , Tsujimoto Fumio , Kato Yoshinari , Tada Shimpei , Onishi Tetsuro , Masuda Fujio , Machida Toyohei
Published: February 2007

The sonographic appearance of 37 renal cell carcinomas was reviewed with particular emphasis on the relationship between the echo pattern of tumor and tumor size. Small carcinomas tended to be solid and hypoechoic; seven lesions less than 5 cm in the largest dimension were either hypo‐ or isoechoic. The echogenicity level of the solid parts within the lesion, whether it was solid or mixed, tended to increase as the tumor grew. It is important to recognize that the sonographic appearance of renal cell carcinomas varies with the size of the tumor.
Accuracy of conceptual age estimation from fetal crown‐rump length
Authors: Selbing Anders , Fjällbrant Bo
Published: February 2007

The accuracy of conceptual age estimated by crown‐rump length is not fully assessed by Robinson and Fleming in their excellent study.1 They avoid the problem by using the expression “menstrual maturity.” We have evaluated predictors of fetal age from crown‐rump length measurements where conceptual age was calculated either from the day of artificial insemination by donor (AID) or from the day of ovulation as judged from recordings of basal body temperature (BBT). When the date of AID was used as the conception date, better mathematical fits (R2 = 0.92) were obtained than when the thermal nadir was used (R2 = 0.86). The distribution around the regression line in the AID group is skewed with the 5th‐95th percentile range being 3.7 days above the line and 7.3 days below the line. Similar results were obtained in the BBT group. Possible reasons for these findings are discussed. Indexing Words: Crown‐rump length · Conceptual age · Artificial insemination · Maternal basal body temperature.
Effect of aging on common bile duct diameter: A real‐time ultrasonographic study
Authors: Wu Chung‐Chieng , Ho Yau‐Hui , Chen Chang‐Yi
Published: February 2007

Using a high‐resolution real‐time scanner, a technique has been established in our laboratory for visualizing the entire extrahepatic bile duct with multiple longitudinal oblique approaches and, if necessary, several transverse scans through the pancreatic head. To determine the normal size of the extrahepatic bile duct and to evaluate the effect of aging on the duct diameter, 256 healthy subjects and patients without hepatobiliary disease were examined using this technique from January to August, 1982. The entire extrahepatic duct was detected in 203. The inner diameter of the widest point of the duct varied from 1 mm to 10 mm, and was found to be agedependent (r = 0.60, P < 0.001). It is concluded that, based on the visualization of the entire extrahepatic duct echographically, the normal inner diameter of common bile duct can be up to 10 mm, and there is a mild change of duct size with age.
Development of health risk evaluation data for diagnostic ultrasound: A historical perspective
Authors: Stewart Harold F. , Moore Roscoe M.
Published: February 2007

The growth of ultrasound applications in diagnostic medicine has helped stimulate related biological effects investigations. Current data related to effects associated with diagnostic ultrasound indicate the need for additional research on cell surface structures, motility and developmental effects. Research on biological effects, especially for evaluating in vivo end points analogous to those employed by investigators using in vitro systems and simple organisms, are needed. Particular emphasis relative to potential effects on fetal and embroyonic development is indicated. Limited data also suggest the need to investigate possible effects on the immune response. There is a growing realization of the potential importance of nonthermal effects and increasing evidence that the temporal peak intensity is potentially related to the production of some effects. A number of recent comprehensive reviews have helped iden‐ tify, analyze and evaluate some of the relevant data. Indexing Words: Biological effeds Safety.
Mathematical Modeling of Fetal Growth: I. Basic Principles
Authors: Rossavik Ivar K. , Deter Russell L.
Published: February 2007

Abstract: Quantitative characterization of fetal growth requires the selection of measurement parameters and a growth curve model. For such studies we propose two new parameters (the head cube and the abdominal cube) and a new growth curve model [P = c(t)k+S(t)]. These parameters are relatively insensitive to shape changes and are related to three‐dimensional parameters even though they can be calculated from profile diameter measurements. The growth curve model is capable of adequately describing a wide variety of growth curves and its coefficients may be associated with specific biological variables. The properties of these parameters and the growth curve model are discussed. Indexing Words: Gross models · Fetal growth.
Ultrasonic detection of lymph node metastases in the region around the celiac axis in esophageal and gastric cancer
Authors: Yoshinaka Heiji , Nishi Mitsumasa , Kajisa Takashi , Kuroshima Kazunao , Morifuji Hidemi
Published: February 2007

The celiac axis could be visualized with ultrasound in 140 out of 166 cases (84%). Failure to identify the celiac axis was associated with extensive metastases to the celiac lymph nodes in 73% (19/26) of these cases. The location of lymph nodes in this region could be determined using the celiac axis and its branches as land marks. Celiac lymph nodes can be roughly classified into three types: Type 1—unclear margins and relatively uniform diffuse internal echoes, Type 2—clear margins and weak internal echoes, and Type 3—clear margins and scattered, large internal echoes, frequently seen with notchings. Metastases in celiac lymph nodes were found in 53 of 166 cases, based on histological examination of surgically removed nodes. A preoperative ultrasonic examination indicated lymph node metastases in 39 out of the 53 cases (sensitivity of 74%) and no lymph node metastases in 108 of the remaining 113 cases (specificity of 96%). Most lymph nodes with metastases were of Types 2 or 3. The longer the diameter of the lymph node or the larger the ratio of metastatic area to node cross‐sectional area, the higher the detection rate tended to be. These results indicate that ultrasound can be very useful in screening patients for celiac lymph node metastases.
Pulsed doppler fetal echocardiography
Authors: Huhta James C. , Strasburger Janette F. , Carpenter Robert J. , Reiter Alexander , Abinader Edward
Published: February 2007

Pulsed Doppler echocardiography (PDE) has proven value in the examination of the infant or child with known or suspected congenital heart disease. In order to assess how PDE might be useful in the evaluation of the infant in utero, we reviewed our experience with this technique used in combination with both cross‐sectional and M‐mode echocardiography. Where previous examinations had suggested some abnormality or where there was a risk factor for congenital heart disease, we performed PDE examinations on the cardiovascular system of 36 infants in utero ranging in gestational age from 20‐39 weeks (mean 32 weeks). PDE of the fetal heart was found to be valuable in three areas: (1) quantitation of hemodynamics, (2) characterization of cardiac rhythm, and (3) identification of certain congenital cardiovascular structural anomalies.
Sonographic diagnosis of infantile hypertrophic pyloric stenosis: Critical appraisal of reliability and diagnostic criteria
Authors: Yip William C. L. , Tay John S. H. , Wong H. B.
Published: February 2007

Critical review of the current medical literature shows lack of complete evaluation of the parameters of “medical decision making” in the sonographic diagnosis of infantile hypertrophic pyloric stenosis (IHPS). A computer program was specially written to calculate these parameters on three published series of patients with IHPS, using originally advocated and modified sonographic criteria. The sensitivity and specificity of the sonographic tests are influenced by the chosen diagnostic criteria, while predictive values are affected by the prevalence of IHPS in the particular population studied. A change in the ventral‐dorsal diameter criterion from 1.2 cm to 1.5 cm increased the sensitivity (from 0.52 to 0.97, p < 0.0001) and negative predictive value (0.60 to 0.95, p < 0.01) in the population of Wilson et al (9), changing the prevalence of IHPS from 0.58 to 0.12, (sensitivity, specificity and sonographic criterion kept constant) reduced the positive predictive value from 0.90 to 0.48 (p < 0.0001). The term “accuracy” has little scientific meaning and should be discarded in comparative evaluation. These results indicate that the real contribution of sonography in decision making in patients with suspected IHPS (but without a palpable mass) has not been properly evaluated by research workers.
Echogenic adnexal masses associated with first‐trimester pregnancy: Sonographic appearance and clinical significance
Authors: Pennes David R. , Bowerman Richard A. , Silver Terry M.
Published: February 2007

In a retrospective survey of a large obstetrical ultrasound experience, 10 echogenic adnexal masses in nine patients with a coexistent intrauterine pregnancy were detected and analyzed. Definitive follow‐up data available for seven of the nine patients disclosed three ovarian teratomas, two hemorrhagic corpus luteum cysts, one endometrioma, one inflammatory mass, and one colonic pseudomass. In one additional patient, an echogenic ectopic pregnancy with an intrauterine pseudogestational sac simulated the above entities. Conservative management with follow‐up sonography is generally indicated for echogenic masses coexistent with first‐trimester intrauterine pregnancies.
Significance of preoperative use of ultrasonography in parathyroid neoplasms: Comparison of sonographic textures with histologic findings
Authors: Kinoshita Yoshikazu , Fukase Masaaki , Uchihashi Masahito , Takenaka Mutsumi , Hishikawa Ruo , Nakada Masaki , Nonaka Hiroshi , Kondo Toshifumi , Fujita Takuo
Published: February 2007

The sonographic textures of 10 parathyroid tumors in nine patients were examined and compared with their histologic features, particularly with the amount of fibrous trabeculae. The carcinomas containing a large amount of fibrous trabeculae, which is the most frequent finding in parathyroid cancer, were very echogenic. On the other hand, the adenomas without fibrous trabeculae showed a low echogenicity. These data suggest that the possibility of malignancy is high when the parathyroid tumor is found to be very echogenic.
Analysis of blood clot echogenicity
Authors: Peter David J. , Flanagan Larry D. , Cranley John J.
Published: February 2007

The ability of B‐mode ultrasound to follow effectively blood clot echogenicity changes over time under conditions of red cell preservation and lysis was evaluated. Blood clots were produced in cellulose dialysis tubing and then placed into appropriate baths of either saline or water. The echogenicity changes were then followed quantitatively using A‐mode and qualitatively using B‐mode imaging. Blood clots in saline showed an initial decrease followed by a leveling off in echogenicity. Blood clots in water showed a decline in echogenicity throughout the experiment. The A‐mode imaging was effectively able to follow blood clot echogenicity changes under these controlled conditions.
Amebic liver abscess: Sonographic diagnosis and management
Authors: Berry M. , Bazaz R. , Bhargava S.
Published: February 2007

Over a period of 3 years, 68 intrahepatic abscesses in 48 patients were detected by ultrasonography at our institution in New Delhi, India. Our experiences with the sonography and management of this entity are presented. Multiple abscesses were present in 14 patients; the rest had a single abscess. The most common location was the right lobe of the liver. The sonographic morphology of the abscess was analyzed in terms of the echo pattern of the wall and contents of the abscess. These were later correlated with the duration of illness. An attempt was made to assess healing and thereby the age of the abscess. Follow‐up ultrasound scans indicated that the change in sonographic appearance lags behind clinical improvement by a considerable period of time.
Removal of air from liver specimens via vacuum
Authors: Sommer F. Graham , Solomon Hilary , Carroll Barbara
Published: February 2007

Fresh liver specimens have been ultrasonically imaged in vitro in order to evaluate specimen air content before the acquisition of ultrasonic waveform data for tissue characterization studies. It was found necessary to expose liver slices to vacuum for about 16 h in order to remove enough air to acquire waveform data from air‐free regions of interest in these slices. Larger portions of liver, and whole liver, were found to retain large amounts of air even after 16 h of exposure to vacuum.
Differential diagnosis of anechoic/hypoechoic lesions in the abdomen detected by ultrasound
Authors: Schölmerich Jürgen , Volk Brigitte A.
Published: February 2007

Ultrasound is the method of choice in the detection and differentiation of solid or cystic masses in the abdomen. The differential diagnosis of anechoic and hypoechoic lesions comprises a large variety of benign and malignant diseases or abnormalities. This paper describes a number of such lesions and, in addition, discusses the possible differential diagnoses so far reported in the literature. An attempt is made to describe the different features of such lesions. Most of them are rare but have to be considered if a lesion of unknown origin or clinical relevance is detected by ultrasound.
Production of microbubbles for use as echo contrast agents
Authors: Butler Bruce D.
Published: February 2007

A variety of agents have been proposed for use as contrast for ultrasound studies. Several reports suggest the use of microbubbles because of their superior son‐ographic resolution. We describe a method of producing calibrated microbubbles utilizing differential absorption and gas injection techniques. Gas injection methods are described using a Plexiglas® microbubbler apparatus with a fine needle orifice. The bubbles originally produced by this device are in a size range of 40–100 μm and consist of nitrogen (10%) and carbon dioxide (90%). The differential absorption technique uses THAM [tris(hydroxylmethyl)aminomethane hydrochloride] to absorb the carbon dioxide (diluent gas) from the bubbles selectively, leaving smaller microbubbles. The microbubbles can be calibrated using the electric gating principle of the Coulter Counter.
Echo‐doppler measurement of splanchnic blood flow in control and cirrhotic subjects
Authors: Zoli Marco , Marchesini Giulio , Cordiani Maria Rita , Pisi Paolo , Brunori Alessandra , Trono Antonio , Pisi Emilio
Published: February 2007

Blood flow in the splanchnic veins was studied in cirrhotics and matched controls by means of a system that combines a mechanical sector scanner with a pulsed Doppler. The measurements were validated in an in vitro model. Echo‐doppler studies could be carried out reproducibly in only approximately two‐thirds of cases because of poor echo transmission or incomplete cooperation. Portal blood velocity was significantly reduced in cirrhotics (10.5 ± 0.6 cds versus 16.0 ± 0.5 in controls; p < 0.001), but portal blood flow was normal because of enlarged portal caliber. A complete hemodynamic evaluation of the splenic and superior mesenteric veins was possible in only a few subjects. In selected patients the technique may prove relevant in the study of hemodynamic effects of drugs and surgery on portal blood flow.
Acardiac anomaly: Review of the subject with case report and emphasis on practical sonography
Authors: Gibson John Y. , D'Cruz Cyril A. , Patel Ramesh B. , Palmer Sue M.
Published: February 2007

The acardiac anomaly is a rare condition found only in monozygotic multiple pregnancies, usually twins. We present a review of the pathophysiology of acardia and a case report. Twin embryonic membrane formation is discussed, since a conceptual understanding of the subject is necessary for the early recognition of this and other evere anomalies. Emphasis is placed on close sonographic monitoring to insure the best chance of survival of the normal twin, who may die of heart failure if delivery is not properly timed.
Ultrasound of normal skin
Authors: Fornage Bruno D. , Deshayes Jean‐Luc
Published: February 2007

The authors have used a commercially available real‐time sector scanner and a 10‐MHz probe with a built‐in water path for B‐mode imaging of the normal skin. Measurements have been performed in 10 volunteers at 18 sites on the body surface. Normal skin thickness ranges from 1.4 mm at the dorsal aspect of hand to 4.8 mm at the heel. Clinical applications of B‐mode imaging of the skin are discussed.
Mathematical modeling of fetal growth. IV. Evaluation of trunk growth using the abdominal profile area
Authors: Rossavik Ivar K. , Deter Russell L. , Hadlock Frank P.
Published: February 2007

Growth of the fetal abdomen has been reexamined in a longitudinal study of 32 normally growing fetuses using the abdominal profile area (AA) and the Rossavik growth model. The growth of the fetal abdomen was compared to that of the fetal head. In early pregnancy the growth rate was higher for the fetal head than for the fetal abdomen, whereas the opposite was the case in late pregnancy. The coefficient k was lower, and the s was higher, for AA than for the head profile area (HA), giving a less prominent sigmoid shape to the AA growth curve. The best correlation to fetal weight at birth was found for the AA growth curve as a whole. The AA s‐residual correlated best of all single parameters, with the coefficient c of HA being next. The s‐residual appears to reflect the nutritional supply available in late pregnancy, and we conclude that fetal weight at birth depends more on this supply than on the genetic factors controlling fetal growth.
Comparison of angiography and ultrasound in the evaluation of the portal venous system in pancreatic carcinoma
Authors: Garra Brian S. , Shawker Thomas H. , Doppman John L. , Sindelar William F.
Published: February 2007

Detailed images of upper abdominal vascular anatomy can now be obtained by experienced operators using modern real‐time ultrasound scanners. To help determine the role of real‐time ultrasound in preoperative evaluation of pancreatic carcinoma, ultrasound and angiographic results were compared in a series of 45 patients admitted with documented carcinoma of the pancreas. When surgical results were available, these were compared with the ultrasound and angiographic findings. The main tributaries of the portal system were evaluated with ultrasound and angiography for evidence of compression, displacement, or occlusion. A sensitivity of 90%and specificity of 95% were achieved for splenic vein abnormalities by ultrasound compared to angiography. For portal vein evaluation, sensitivity was 75%, and specificity was 100%, whereas for the superior mesenteric vein a sensitivity of 100% and a specificity of 94% were attained. Ultrasound can make angiography prior to laparotomy unnecessary in many cases if thorough evaluation of the portal venous system is emphasized during the initial ultrasound study.
Fitting growth curves to head and abdomen measurements of the fetus: A multicentric study
Authors: Todros Tullia , Ferrazzi Enrico , Nicolini Umberto , Groli Caterina , Zucca Sandro , Parodi Luigi , Pavoni Mario , Zorzoli Alessandro
Published: February 2007

Three different mathematical models were fitted to ultrasonic measurements of the biparietal diameter, head circumference, and abdomen circumference obtained from 1,426 healthy fetuses. The linear cubic function gives coefficients comparable with most previous studies, but it does not thoroughly explain fetal growth throughout pregnancy. Both the exponential–power function and the logistic–logarithmic function fit the raw data well and theoretically reflect the biological phenomena of human fetal growth. The characteristics of each model are discussed.
Failed first trimester pregnancy termination: Uterine anomaly as etiologic factor
Authors: Pennes David R. , Bowerman Richard A. , Silver Terry M. , Smith Steven J.
Published: February 2007

Failure of first trimester pregnancy termination is an uncommon, although potentially serious complication of attempted therapeutic abortion. We report our experience in four patients with unsuspected congenital uterine anomalies in whom attempted pregnancy termination procedures failed to completely ablate the products of conception. When dilatation and curettage fails to produce embryonic tissue, sonography is indicated to exclude ectopic gestation or uterine anomaly. In patients who are known to have anomalous uteri, intraoperative real‐time guidance may increase the success of pregnancy termination procedures and decrease the incidence of retained products of conception.
Ultrasonic anatomy of hepatic veins
Authors: Cosgrove David O. , Arger Peter H. , Coleman Beverly G.
Published: February 2007

Whereas the portal veins and hepatic arteries supply the right and left lobes of the liver, the hepatic veins pass along the boundaries between the lobes and segments. Their positions can therefore be used to identify liver segments and allow a precise description of the position of focal lesions. In 104 subjects without liver pathology, the hepatic veins were demonstrated in 101 and followed the classical pattern in 87. Absent and accessory veins were encountered.
Fetal head and abdominal circumferences: Effect of profile shape on the accuracy of ellipse equations
Authors: Shields James R. , Medearis Arnold L. , Bear Moraye B.
Published: February 2007

Images of 122 fetal heads and abdomens were obtained with ultrasound for the determination of head and abdominal circumferences. The profile shapes were characterized by the cephalic or abdominal index (D1/D2 × 100), D1 and D2 being the shortest and longest diameters of either the head or abdomen. The mean of the cephalic index was 79.1% ± 5.2%, and that of the abdominal index was 89.1% ± 7.0%. All equations were equally accurate in calculating head and abdominal circumferences regardless of the profile shape. Therefore, the simplest equation, (D1 + D2) × 1.57, should be utilized when calculating circumferences except in situations of extreme dolichocephaly.
Longitudinal studies of femur growth in normal fetuses
Authors: Deter Russell L. , Rossavik Ivar K. , Cortissoz Catherine , Hill Reba M. , Hadlocks Frank P.
Published: February 2007

As an indicator of fetal limb growth, change in the femur diaphysis length (FDL) between 15 and 38 weeks, menstrual age, has been evaluated in a longitudinal study of 20 normal fetuses, as determined by prenatal biparietal diameter, head circumference, and abdominal circumference growth patterns as well as postnatal pediatric assessment. Individual FDL growth curves were uniformly parabolic and followed very similar trajectories. The projected start points mean: 9.7 (± 1.5 SD) weeks for these curves were in complete agreement with embryologic data, and the curves themselves were well characterized by the Rossavik model [R2 99.5 (± 0.5 SD)%]. No differences between males and females were detected, and good agreement was obtained between the average longitudinal growth curve and the cross‐sectional growth curve derived from a previously studied data set.1 Individual growth curve standards, determined from Rossavik models based on data obtained before 26.1 weeks, menstrual age, were within 7% of actual measurements in 94% of the 97 time points studied after 26 weeks. These results indicate that the Rossavik model and its associated individual growth curve standards can be used to evaluate the growth of the femur and thus provide an improved means for detecting skeletal dysplasias and fetal growth retardation.
Evaluation of the usefulness of dimethicone and/or senna extract in improving the visualization of abdominal organs
Authors: Heldwein W. , Sommerlatte Th. , Lehnert P. , Littig G. , Müller‐Lissner S. , Hasford J.
Published: February 2007

Intestinal gas is the most common cause of technically unsatisfactory abdominal ultrasound scans. In the attempt to increase the visualization of abdominal organs, many investigators use antifoaming agents or laxatives. In the present, randomized, placebo‐controlled, double‐blind trial, a liquid dimethicone preparation and an extract of senna, alone and in combination, were tested as a means to improve scan quality. Response variables were defined on the basis of pancreas, aorta, and kidney visibility. There was no difference in the response variables of the three groups compared to placebo (P>0.3–0.55). The results suggest that neither dimethicone nor senna improves the visibility of abdominal organs in ultrasound examination.
Ultrasound confirmation of endotracheal tube placement
Authors: Raphael David T. , Conard Frederick U.
Published: February 2007

Real‐time B‐mode ultrasound imaging was performed in 24 intubated patients in order to confirm the correct placement of endotracheal tubes. The large acoustic impedance mismatch between the air within the endotracheal tube cuff and the tracheal wall could be bypassed by (1) use of a foam‐cuffed Bivona endotracheal tube, or by (2) cuff inflation with saline instead of air. Optimal repositioning of the endotracheal tube could be done under direct visualization. Imaging of the foam‐filled and saline‐filled cuffs was easier in the longitudinal (sagittal) than in the transverse view, was enhanced by a slight longitudinal to‐and‐fro motion of the tube, and was often improved with the use of a stand‐off pad. Cases of esophageal intubation were not considered. Use of a noninvasive imaging modality such as ultrasound will spare selected patients from the radiation exposure associated with a chest x‐ray. This is of value in pregnant patients and in those requiring frequent chest radiographs for the sole purpose of confirming correct endotracheal tube placement. Limitations of the techniques are discussed.
The physical principles of Doppler and spectral analysis
Authors: Burns Peter N.
Published: February 2007

The Doppler effect provides an ultrasonic method for the detection of echoes from moving structures, particularly flowing blood. In its most simple form, the continuous wave Doppler offers velocity information without depth resolution and is therefore used mainly for the examination of superficial structures. The pulsed Doppler, in combination with real‐time imaging, provides a more flexible tool for the interrogation of selected sites in an ultrasound image for motion and flow. The recent development of Doppler flow imaging, in which limited Doppler information is displayed over an entire ultrasound image, usually in color and in real‐time, promises to secure the association between Doppler and conventional ultrasound imaging techniques.

Spectral analysis permits features of the Doppler signal to be identified which are associated with hemodynamic phenomena, such as flow disturbance and wave reflection. In addition, it allows the quantitative application of Doppler to the estimation of such physiological variables as velocity, flow rate, and pressure difference.
Carotid artery duplex scanning
Authors: Taylor David C. , Strandness D. Eugene
Published: February 2007

Duplex scanning of the carotid arteries combines B‐mode ultrasound and Doppler ultrasound within a single instrument, thus providing both anatomical imaging of the vessel and flow velocity information. Combining these two unique aspects of ultrasound overcomes many of the individual limitations of each and provides improved noninvasive diagnosis of cerebrovascular disease. The Doppler signal is analyzed using fast Fourier transform methods and displayed as a spectral waveform. Assessment of the presence and severity of vascular disease is based primarily on Doppler information and the B‐mode image of the vessel serves mainly as a road map to guide the placement of the pulsed Doppler sample volume.

The parameters used to classify severity of disease include peak systolic frequency, degree of spectral broadening, end diastolic velocity, and overall shape of the waveform. Using these features, stenosis at the carotid bifurcation is classified into six categories: (A) none, (B) 1%‐15% diameter reduction, (C) 16%‐49% diameter reduction, (D) 50%‐79% diameter reduction, (D +) 80%‐99% diameter reduction, and (E) complete occlusion. These methods have a sensitivity of 99% and a specificity of 84% when compared with angiography.

The clinical applications of carotid artery duplex scanning are discussed with particular reference to (1) patients with cerebrovascular symptoms, (2) asymptomatic cerebrovascular disease, (3) follow‐up of carotid endarterectomy, and (4) cerebrovascular research. Patterns of use of duplex scanning in current practice and potential future applications are discussed.
Sonographic findings in traumatic hemobilia: Report of two cases and review of the literature
Authors: Sax Steven L. , Athey Patricia A. , Lamki Neela , Cadavid Gilberto A.
Published: February 2007

Hemobilia consists of an arteriobiliary fistula, usually due to central liver rupture with bleeding into the biliary tree. It is due to trauma in over 50% of cases, with an increasing incidence of iatrogenically caused hemobilia. The sonographic findings in two cases of traumatic hemobilia are presented and the literature is reviewed. These findings include clot within the gallbladder and the extrahepatic ducts, liver hematoma, and aneurysm of the hepatic artery.
A new method of measuring in vivo sound speed in the reflection mode
Authors: Hayashi Nobushige , Tamaki Nagara , Senda Michio , Yamamoto Kazutaka , Yonekura Yoshiharu , Torizuka Kanji , Ogawa Toshio , Katakura Kageyoshi , Umemura Chinichiro , Kodama Mashio
Published: February 2007

This paper describes a new method for in vivo sound measurement in the reflection mode. The mean sound speed between the reflector and linear array transducer is measured using the following three parameters: time of flight, time of flight difference, and distance between two receiver elements. To detect time of flight, the system delay‐line time compensator is adjusted to obtain the sharpest reflector image.

This method was evaluated in vivo in human livers, specifically 26 normal, 27 cirrhotic, and 15 fatty livers. The mean sound speed between diaphragm and the transducer was obtained. The measured sound speed was significantly higher in cirrhotic livers and lower in fatty livers.
Ultrasound of hemobilia: A clinical and experimental study
Authors: Laffey Patricia A. , Brandon J. Campbell , Teplick Steven K. , Haskin Pamela H. , Pavlides Constantinos A.
Published: February 2007

Clinical observations on patients with hemobilia secondary to percutaneous biliary procedures and laboratory studies on animals with experimentally induced hemobilia indicate that the presence of fresh blood or clot within the biliary tree may yield an erroneous impression of duct size in ultrasound examinations. Recognition of this potential source of error becomes increasingly important as the use of percutaneous procedures for the relief of biliary obstruction increases.
Development of individual growth curve standards for estimated fetal weight: I. Weight estimation procedure
Authors: Deter Russell L. , Rossavik Ivar K. , Harrist Ronald B.
Published: February 2007

In this investigation the weight estimation procedure of Rossavik was reassessed with particular emphasis on parameter estimation and performance over a wide weight range. Using a cross‐sectional data set (193 patients), a longitudinal data set (20 patients), and an iterative procedure, parameter estimates were obtained based solely on regression analysis. Comparison of weight estimates obtained using a function based on these parameter values with actual birth weights indicated virtually no systematic errors over a 250‐g to 4750‐g weight range and random errors (±1 SD) of 10% to 13% below 200 g and 6% to 8% above 2000 g. The weights of small‐ and large‐for‐gestational age fetuses were systematicly overestimated (4.1%) and underestimated (−3.0%), respectively, but systematic errors were not found in average‐for‐gestational age fetuses. No differences in random errors were seen in these three growth categories. Comparison with other weight estimation procedures indicated that the Rossavik procedure gives weight estimates that are at least as accurate as those obtained with other methods over a wide range of weight and growth categories. However, the Rossavik procedure can be used to generate individual growth curve standards for weight estimates, a characteristic not shared with other weight estimation procedures.
Ultrasonic measurement of fetal blood velocity wave form as a secondary diagnostic test in screening for intrauterine growth retardation
Authors: Maršál Karel , Persson Per‐Håkan
Published: February 2007

Based on routine fetometry screening at 32 weeks of gestation, 80 out of 3226 singleton pregnancies were suspected of intrauterine growth retardation (IUGR) and 72 of them were subjected to repeated fetal blood flow measurements by Doppler ultrasound for evaluation of the fetal condition. The maximum blood velocity wave form recorded from the fetal descending aorta and umbilical artery was classified as normal or abnormal depending on the presence or absence of positive end‐diastolic blood flow. Compared to the pregnancies with normal fetal blood flow, the group of 30 pregnancies with abnormal blood flow patterns had significantly more pregnancy complications and more operative deliveries for fetal distress. In the latter group, all newborns but one were small‐for‐gestational age and had low 1‐min Apgar scores more frequently. Fetal blood flow measurements have a good capacity for predicting unfavorable fetal outcomes and can be recommended for clinical use. The combination of ultrasound screening and Doppler blood flow measurement has reduced the number of pregnancies requiring intensive surveillance.
Predictiveness of sonographic fetal weight estimation as a function of prior probability of intrauterine growth retardation
Authors: Simon Nicolas V. , Levisky John S. , Shearer David M. , Morris Kathleen C. , Hansberry Patricia A.
Published: February 2007

We evaluated the predictiveness of sonographically estimated fetal weight as a function of the estimation of probability of having intrauterine growth retardation (IUGR) before obtaining an ultrasound scan (prior probability). The value of the estimated fetal weight resided more in its high specificity than in its sensitivity, hence in its ability to confirm that the fetus is normal. The predictiveness of the method was further enhanced when the fetal weight estimation was placed in the context of the prior probability of IUGR. In particular, the positive predictive value of the test as well as the likelihood of having a growth‐retarded infant in spite of an estimated fetal weight within the normal range were considerably higher as the prior probability of IUGR increased. Since the obstetrician using all available evidence is likely to form a rather good estimate of the possibility of IUGR before ordering a scan, this improvement in the predictiveness of estimated fetal weight through a Bayesian approach can be advantageously applied to ultrasound analysis and can effectively support clinical decision making.
Fetal teratomas: Antenatal diagnosis and clinical management
Authors: Teal Linda N. , Angtuaco Teresita L. , Jimenez Jorge F. , Quirk J. Gerald
Published: February 2007

Four cases of fetal teratomas arising from the sacrococcygeal and oropharyngeal areas are reported. The diagnosis, method of management, and grade of tumor are compared with previous experience in the literature. Pharyngeal lesions carry a worse prognosis for survival compared to the more common sacrococcygeal type (SCT). Atraumatic delivery and early repair of the lesion contribute to prolonged survival and lack of complications in cases of sacrococcygeal teratomas.