bluuebunny/crossref_metadata_2025 huggingface dataset:
Simple Device for Determining an Index of Echogenicity
Authors: Espinasse Pierre , Desuzinges C. , Cercassi J. C.
Published: February 2007

The technique reported here uses a simple electronic system adaptable to a standard manual echograph with the aim of obtaining a numerical index of echogenicity. The index is the ratio of the average echo amplitude within a gated portion of tissue at a given depth to the average echo amplitude within the same gated portion measured under the same conditions on a phantom filled with a “tissue‐mimicking” material. A theoretical analysis shows that the index depends not only on the attenuation coefficient and the backscattering coefficient of the tissue but also on the depth of the measurement. It is demonstrated that it is feasible to measure the attenuation coefficient using the current system, and the reproducibility of the index measurement is evaluated on a normal thyroid.
Measurements of an Index of Echogenicity in Some Thyroid Diseases
Authors: Espinasse Pierre , Desuzinges C. , Cercassi J. C.
Published: February 2007

In the preceding article, the measurement of an index of echogenicity has been described. In this article, we present the mean value and standard deviation of this index in normal thyroid and pathological cases. It appears that the index is very significantly lowered in Hashimoto's disease compared to its value in normal thyroids and simple goiters. The advantage of this index in other cases such as Graves' disease, subacute thyroiditis, and thyroid nodules is discussed.
Neonatal intracranial hemorrhage and complicating hydrocephalus
Authors: Slabaugh Robert D. , Smith John A. , Lemons James , Schreiner Richard , Macdonald Nancy , Cohen Mervyn D.
Published: February 2007

Real‐time ultrasound studies of the head were performed on 96 infants weighing 1500 g or less. This population represented all such infants admitted within the first 72 hours of life to a neonatal intensive care unit over a 9‐month period. Intracranial subependymal/intraventricular hemorrhage occurred in 22 (23%) of the infants. Of these 13 (59%) developed ventricular enlargement. Four other infants, in whom hemorrhage was not identified, also developed ventricular enlargement. When it occurred, the ventricular enlargement developed within 2 weeks of the hemorrhage in 77% of cases. It reached its maximum size within 2 weeks in 65% of cases. In 9 of 16 cases the maximal ventricular enlargement was categorized as mild. Spontaneous arrest or resolution of the ventriculomegaly occurred in all but two cases, who required shunting. Clot resolution was slow. It was complete at 3 weeks in only 5 of 18 cases.
Gas‐Containing Gallstones: Their influence on ultrasound images
Authors: Rizzatto Giorgio , Rubaltelli Leopoldo , Talenti Enrico , Bulzacchi Andrea , Angelini Federico , Zacchi Claudio
Published: February 2007

The ultrasound image of gas‐containing gallstones was evaluated in three cases. In two, the stones were studied in vitro in a phantom gallbladder by ultrasound, and then by microradiographic techniques. The third case was investigated in vivo by ultrasound and computerized tomography (CT). The presence of gas‐containing fissures, which are not detectable on ultrasound, was demonstrated. In contrast, wider fissures, or a true gas bubble, produce reverberation echoes which depend upon the quantity of gas present within the gallstone.
Pancreatic sonography: Past and present
Authors: McCain Arthur H. , Berkman William A. , Bernardino Michael E.
Published: February 2007

Prior to the advent of cross‐sectional imaging, the diagnosis of pancreatic disease and its extent could not be obtained without surgery. Ultrasound is a noninvasive modality which has been evolving over the last 7‐10 years. The purpose of this review will be to determine the present status of ultrasound in the evaluation of adult and pediatric pancreatic disease. Also, its role with regard to computed tomography (CT) and interventional techniques will be discussed. Indexing Words: Pancreas · Ultrasound · Pancreatitis · Pancreatic carcinoma.
Limitations in the Accuracy of Peak Frequency Measurements in the Diagnosis of Carotid Disease
Authors: Lally M. , Johnston K. W. , Cobbold R. S. C.
Published: February 2007

Peak Doppler frequency is an index of the severity of carotid stenosis. Variability in this measurement is examined through in vitro and clinical studies. In vitro studies, using a carotid flow model, show that observers locate a stenosis and interpret the peak frequency differently, and each observer uses a different probe‐vessel angle. Clinical studies support these findings. Comparison of 304 carotid Doppler studies with arteriograms demonstrates 90% overall clinical accuracy. Each observer has a consistent range of peak frequency measurements, yet the description of a discrete percent stenosis is limited by observer variability. Indexing Words: Doppler spectral analysis · Doppler ultrasound · Carotid artery.
Sonographic findings in leukemic renal disease
Authors: Kumari‐Subaiya Sheila , Lee Won J. , Festa Robert , Phillips Gail , Pochaczevsky Rubem
Published: February 2007

The ultrasonic findings in 10 patients with diffuse leukemic infiltration of the kidneys are described. The findings are analogous to those seen pathologically and include enlargement of the kidneys, diffuse leukemic infiltration of the renal cortex with sparing of the adjacent medullae, loss of definition and distortion of the renal sinus echo complex and a focal mass. The ultrasound findings correlated well with those seen with intravenous urography making it the preferable screening modality for the initial detection of renal involvement. subseauent follow‐up, and response to therapy in leukemic patients.
Suprapubic sonographic detection of prostate carcinoma
Authors: Hennig Ronald C. , Wilson Stephanie R.
Published: February 2007

Between January 1 and March 31, 1983, 103 patients scheduled for prostatic surgery were blindly evaluated preoperatively by suprapubic real time sonography. Prospectively, the sensitivity was 72.7%, specificity 72.2%, predictive value of positive test 51.6% and predictive value of negative 86.7% for the detection of prostatic carcinoma. Retrospective analysis increased the sensitivity to 86% and when clinical information was utilized, only one carcinoma escaped detection. Unfortunately, both prostatic inflammation and occasionally benign prostatic hypertrophy may simulate carcinoma sonographically, thus producing a significant number of false positives. No ultrasonically detectable characteristics could be found which unequivocally separate carcinomas from inflammation and hypertrophy. For this reason routine suprapubic screening does not seem warranted.
spectrum of sonographic findings in infantile polycystic kidney disease with urographic and clinical correlations
Authors: Leland Melson G. , Shackelford Gary D. , Cole Barbara R. , McClennan Bruce L.
Published: February 2007

We evaluated nine patients, age 1 day to 17 years, having infantile polycystic kidney disease (IPKD). Using modern scanners with 5‐MHz transducers we have observed two previously unemphasized sonographic (US) findings, a peripheral zone of normally echogenic cortex (five patients), and mild caliectasis (two patients). Our data suggest that IPKD is a more heterogeneous condition clinically and sonographically than generally appreciated and that presence of a thick normally echogenic renal cortex is a good predictor of concurrent normal renal function and prolonged survival.
Doppler blood velocity waveforms in the umbilical artery as an indicator of fetal well‐being
Authors: Friedman Deborah M. , Rutkowski Monika , Snyder Jon R. , Lustig‐Gillman Ilana , Young Bruce K.
Published: February 2007

Doppler blood velocity waveforms were analyzed from the umbilical artery as an indication of fetal well‐being. Since the ratio of systolic to diastolic peak flows (A/B) reflects placental vascular resistance, an abnormality of this value may accurately predict compromised fetuses. Twenty‐one studies were performed on 13 patients, using a new duplex system for real‐time imaging and range‐gated' pulsed Doppler analysis, and compared to normal standards. Thirteen studies done in nine uneventful pregnancies were consistently normal. However, abnormal studies were found in the four patients reported as case histories, including women with sickle cell anemia, systemic lupus, diabetes, and growth retardation. The A/B ratio was felt to have predicted potential fetal compromise, including the two fetal deaths. Therefore, with certain cautions, we feel that this rapid, non‐invasive technique is useful as a serially applicable reflector of the status of fetoplacental circulation.
Sonographically detected free‐floating particles in amniotic fluid predict a mature lecithin–sphingomyelin ratio
Authors: Gross Thomas L. , Wolfson Robert N. , Kuhnert Paul M. , Sokol Robert J.
Published: February 2007

Amniocentesis for the determination of fetal lung maturity is associated with some morbidity, and so the prediction of a mature fetus by noninvasive means could be useful in managing certain high‐risk patients. In the first portion of this study, 467 amniotic fluid specimens were classified into one of five groups based on the turbidity and particulate matter present. The mean lecithin: sphingomyelin (L/S) ratios and the proportion of mature US values increased with increasing turbidity of the amniotic fluid. In the second portion of this study, the presence of amniotic fluid freefloating particles (FFPs) detected by real‐time ultrasound was correlated with fetal lung maturity. When FFPs were present, the W S was uniformly mature, but when FFPs were absent, the LIS was mature in 74% of patients (P < 0.01). Among the patients in whom the LIS ratios were mature, 39/110 were associated with positive FFPs (sensitivity = 35%). This preliminary study suggests that the presence of FFPs on real‐time ultrasound could be used to confirm fetal lung maturity.

Supported in part by NIH USPHS grants M01 RR00210 and 1P50 HD11089
Real‐time ultrasonography in neuromuscular problems of children
Authors: Kamala D. , Suresh S. , Githa K.
Published: February 2007

Ultrasound imaging of 20 cases of progressive muscular dystrophy and 10 cases of suspected infantile spinal muscular atrophy in children was performed by us, as a double‐blind pilot study matched against 25 controls. Open muscle biopsy was restricted to the muscular dystrophy group. The ultrasonographic findings were correlated with parameters such as functional disability of muscle and muscle biopsy features in the dystrophy group. It was interesting to observe that the muscle echogram was abnormal in both types of neuromuscular problems, the controls giving a normal muscle echogram. Ultrasonography was helpful in detection of unequivocal changes in our cases with mild clinical disability. It had a close correlation with changes in gross muscle architecture, as seen on muscle biopsy.
Prognostic value of ultrasound, HCG and progesterone in threatened abortion
Authors: Eriksen Bjarne Chr. , Eik‐Nes Sturla H.
Published: February 2007

The diagnostic and prognostic value of ultrasound, β‐HCG subunit, and progesterone are evaluated in a prospective study in 169 patients with threatened abortion. Ultrasound diagnosis had just been introduced at the hospital when the study began and clinicians accepted the patients for treatment without receiving the ultrasound, HCG, or progesterone results. With ultrasound, a correct diagnosis of the in utero situation (true positive and true negative) was made at admission in 93% and after 1 week in 99% of the cases; in 1% of the cases intact pregnancies were mistaken for abortions (false positive). For the tests applied, ultrasound had the highest sensitivity in detecting a pathologic pregnancy and also the best predictive value when a pathologic condition was discovered.
Sonographic patterns in splenic infarct
Authors: Maresca Giulia , Mirk Paola , De Gaetano Annamaria , Barbaro Brunella , Colagrande Corrado
Published: February 2007

The sonographic findings in eight cases of splenic infarct at their onset and at different phases of their development have been retrospectively analyzed. A wide range of appearances was seen (single or multiple, rounded or wedge‐shaped, echo‐free, hypoechoic, and hyperechoic lesions). In our opinion, such variable appearances are related to the age of the infarct (hypoechoic or echo‐free in the earlier stages, hyperechoic in healed infarcts). A presumptive diagnosis is possible in the earlier stages since the detection of changes (in echogenicity and/or in size) over a period of time strongly suggests an infarct. On the other hand, a hyperechoic wedge‐shaped lesion is fairly typical of healed infarcts.
Echocardiographic measurement of left ventricular stroke volume in newborn infants: A correlative study with pulsed Doppler and M‐mode echocardiography
Authors: Walther Frans J. , Siassi Bijan , Wu Paul Y. K.
Published: February 2007

Noninvasive monitoring of stroke volume by pulsed Doppler echocardiography is an important recent advance in neonatal care. Using this technique, we assessed stroke volume in 112 healthy neonates (birth weight 780–5350 g, menstrual age 27–42 weeks). Stroke volume increased with advancing birth weight (r = +0.93) and gestational age (r = +0.90). Mean stroke volume per kilogram body weight (1.77 ± 0.28 ml/kg) was constant throughout the study population. Doppler‐derived stroke volumes correlated linearly with left ventricular dimensions in diastole and in systole. Stroke volumes calculated from left ventricular dimensions using the Feigenbaum and Teichholz equations correlated equally well with Doppler‐derived stroke volume values (r = +0.76 and +0.77, respectively).
Ultrasound measurement of the fetal cerebral ventricles: A prospective, consecutive study
Authors: Jörgensen Connie , Ingemarsson Ingemar , Svalenius Elisabeth , Montan Sven , Svenningsen Nils W.
Published: February 2007

Real‐time ultrasound was used in 654 consecutive pregnancies to obtain standard growth parameters for the fetal brain. Measurement of the width of the lateral ventricle (LVW) and hemisphere and their relationships to menstrual age, biparietal diameter, and birth weight were determined. The growth of the LVW was to a great extent independent of birth weight but dependent on menstrual age. Thirteen fetuses with a single ventricular width measurements exceeding +2 SD from the mean were separately evaluated, and all but one case were found to be normal.
Diagnosis of leukemic relapse in the pelvic soft tissues of juvenile females
Authors: Shirkhoda Ali , Eftekhari Fanin , Frankel Lawrence S. , Lewis Errol
Published: February 2007

Five females with childhood acute lymphocytic leukemia whose disease relapsed in the pelvis were studied. In all five patients, relapse occurred late in the disease process, and all patients had been in complete continuous remission before relapse. Intravenous pyelogram and barium enema revealed hydronephrosis or a mass effect on the bladder or rectosigmoid colon. In three patients, sonography established the presence of a clinically palpable mass with involvement of the uterus, ovaries, and pelvic side walls. In one patient there was infiltration of the bladder and in another, infiltration of the appendix, both confirmed by biopsy.
Pseudoepidural reverberation artifact: a common ultrasound artifact in fetal cranium
Authors: Stanley John H. , Harrell Beth , Horger E. O.
Published: February 2007

High‐intensity reverberation artifacts frequently occur within the fetal cranium during obstetric ultrasound examinations. One hundred ninety‐six static ultrasonograms obtained from 100 consecutive obstetric patients were reviewed to determine the incidence, shape, and location of high‐intensity reverberation artifacts within the fetal head. Such artifacts occurred in one‐third of the fetuses examined. The most common appearance was an arc‐shaped artifact that occurred most frequently in the fetal hemicranium farthest from the maternal skin surface. Such an artifact can mimic epidural fluid collections and cause confusion for examiners not familiar with this finding. A discussion of this “pseudoepidural” artifact, its cause, and ways of excluding underlying intracranial pathology is presented.
Sonographic monitoring of LHRH analogue therapy in idiopathic precocious puberty in young girls
Authors: Hall Deborah A. , Crowley William F. , Wierman Margaret E. , Simeone Joseph F. , McCarthy Kathleen A.
Published: February 2007

Precocious puberty in young girls is defined as the development of secondary sexual characteristics and gonadal growth before 8 years of age. Approximately 60% of isosexual precocious development in girls has no organic cause and is termed idiopathic precocious puberty. Thirteen young girls with idiopathic precocious puberty were treated with LHRH analogue under a well‐established protocol. Pelvic ultrasound was added to the protocol to examine ultrasound's role in supplying a morphologic parameter of suppression of the pubertal process. Initially, 11 patients had ovarian volumes greater than normal, and ovarian cysts measuring 0.5 cm to 4 cm in diameter were identified in seven patients. All 13 patients had enlarged pretreatment uteri greater than 3 cm in length. Eleven of these patients had a pubertal or adult uterine configuration. After 1 year of therapy, 11 patients had normal prepubertal ovarian volumes, and 12 of 13 patients had a decrease in ovarian volume. No demonstrable cysts were present at 1 year. Eleven had a reduction in uterine length. Nine of the 11 patients with a pubertal uterine configuration reverted to a more prepubertal‐like morphology. The sonographic morphologic changes correlated well with laboratory and clinical data indicating suppression of the hypothalamic–pituitary–gonadal axis.
Sonography of hemorrhagic ovarian cysts
Authors: Reynolds Terry , Hill Michael C. , Classman Leonard M.
Published: February 2007

The sonographic appearance of hemorrhagic ovarian cysts (HOC) has received little attention aside from a recent report in adolescent girls. We reviewed the sonographic findings in 14 adults with 15 pathologically proven HOC to see whether there were any consistent sonographic findings that, along with the clinical history, might make possible the diagnosis. The majority (93%) of patients presented with the abrupt onset of lower abdominal or pelvic pain, and each, when clinically appropriate, had a negative serum pregnancy test. Sonographically, all of the masses were cystic except one. The cyst wall was thin and well defined in six cases and thick and irregular in eight. The majority (87%) had internal echoes. These echoes were scattered and low level or diffuse and homogeneous (27%) or complex and echogenic (53%) in nature. Two cysts had numerous septations, and another had a fluid‐debris interface. If the pain subsides and the hematocrit remains stable, the premenopausal patient can be managed conservatively. Sonographic follow‐up is recommended so that an underlying hemorrhagic ovarian cystic neoplasm can be excluded. This was present in three of our patients, two of whom were postmenopausal.
Clinical application of an ultrasonic duplex system in the quantitative measurement of portal blood flow
Authors: Moriyasu Fuminori , Ban Nobuyuki , Nishida Osamu , Nakamura Takefumi , Miyake Takeo , Uchino Haruto , Kanematsu Yuzo , Koizumi Shunzo
Published: February 2007

The ultrasonic duplex system, which is composed of a pulsed Doppler flow‐meter and a linear array B‐mode scanner, was developed for the purpose of quantitative transcutaneous measurement of blood flow. It was applied here to the study of portal blood flow in a normal series with healthy volunteers as subjects. A preliminary experiment, prepared by setting up a simulation model for blood circulation, demonstrated an excellent correlation between values obtained with the electromagnetic flowmeter (EMF) and the combined ultrasonic B‐mode and Doppler system (duplex system). This was confirmed in vivo in a study of blood flow in the canine vena cava. The portal blood flow in 88 healthy adult volunteers ranging in age from 18 to 55 years (average 34.3) was studied using this equipment. Blood flow in fasting subjects who were resting was 889 ± 284 ml/min (mean ± SD) or 16.3 ± 5.0 ml/min/kg body weight (mean ± SD).
Role of ultrasound in obstetric management
Authors: Goldkrand John W. , Benjamin Danny S. , Cantor David M.
Published: February 2007

This is a retrospective, noncomparative study of the impact of routine and indicated ultrasound examinations on 163 private and 125 clinic patients, respectively. Management decisions (delivery, nonintervention, tocolysis) based on indicated ultrasound were made in 36.7% of the private and 63% of the clinic patients. Ultrasound was important in assigning and altering the EDC where dates were unsure. Serendipitous findings were especially important in finding fetal anomalies. Routine ultrasound provided the obstetrician with reassurance in normal pregnancies.
Increased renal cortical echogenicity in pediatric renal disease: Histopathologic correlations
Authors: Brenbridge A. Norman , Chevalier Robert L. , Kaiser Donald L.
Published: February 2007

Retrospective comparisons between sonographic renal cortical echogenicity and the results of renal biopsies were made for 65 pediatric patients ranging in age from neonate to 18 years. There was a positive correlation between an increase in renal cortical echoes and interstitial infiltration as well as with glomerular obsolescence, tubular atrophy, and vascular changes. Since the sonographic changes were heterogeneous in origin, they are not specific. The sonographic findings also correlated positively with the clinical severity of disease. However, the heterogeneous origins of the sonographic finding and the absence of strong correlations indicate that gray‐scale sonography cannot act as a prognostic index of the type or severity of disease in pediatric patients.
Biparietal diameter and menstrual age in the black population attending edendale hospital
Authors: Muñoz Washington Patricio , Moore Peter John , MacKinnon Anne , Haines Linda Margaret
Published: February 2007

The relationship between fetal biparietal diameter measured by echo‐graphy and menstrual age for blacks was studied. Predicted values and their confidence limits are presented in tables and graphs. The biparietal diameter was significantly smaller from 28 weeks than American and European studies, demonstrating that a composite graph was not applicable to the Zulus. The echographic results were checked at term by external cephalometry. Occipitofrontal circumference and birth weights for newborns were found similar to other studies. The smaller BPD in late pregnancy could be explained by the heads shape. The new charts are valuable in assessing fetal growth in African blacks.
Is it possible to recognize portal hypertension with continuous‐wave Doppler ultrasonography?
Authors: Lombardi Giuseppe , Salmi Andrea , Polotti Renzo , Tarantola Pietro , Paterlini Alessandro , Inzoli Maria Rosa
Published: February 2007

Continuous‐wave (CW) Doppler ultrasonography is a well‐known technique in the assessment of peripheral and central circulation. The purpose of this study was to find out whether the technique can be used to demonstrate portal hypertension (PH) from liver disease through the evaluation of flow reversal in the veins of the round ligament. One hundred eight patients (50 controls and 58 with PH) underwent abdominal sonography, endoscopic examination, and CW Doppler flowmetry of the umbilical region. In 53 of 58 patients with PH, hepatofugal venous flow was found in the round ligament; this sign was absent in all of the controls. There was remarkable agreement between the results of CW Doppler examination and those of endoscopy and abdominal sonography: its sensitivity was about 91%, and we encountered no false positives. The Doppler ultrasound method is specific for diagnosing PH, simple to perform, and repeatable.
Fetal head and abdominal circumferences: Ellipse calculations versus planimetry
Authors: Shields James R. , Medearis Arnold L. , Bear Moraye B.
Published: February 2007

One hundred twenty‐two images of fetal heads and abdomens were obtained by ultrasound. The head and abdominal circumferences and their ratios were determined by planimetry and by the ellipse method utilizing four different equations. The accuracy of these equations was assessed by regressing the circumferences and ratios obtained by the equations against those measured by planimetry. All equations were found to be equally accurate in calculating head and abdominal circumferences and the head‐to‐abdomen circumference ratio. Compared to planimetry, the ellipse method is more accurate in calculating circumferences than when calculating their ratio.
Influence of fetal growth patterns on sonographic estimation of fetal weight
Authors: Simon Nicolas V. , Levisky John S. , Shearer David M. , O'Lear Mary S. , Flood Jill T.
Published: February 2007

Six published fetal weight estimating regression models proposed for clinical use were evaluated in 259 pregnant women who delivered within 72 h of an ultrasound evaluation performed with sector scanner. The patient sample included 89 (33.2%) fetal weights that were below the 10th or above the 90th percentile for menstrual age. The actual mean percent error (systematic error), standard deviation (random error), and the number of large errors of prediction for all equations were greatest in fetuses that were small‐ and large‐for‐gestational age. Whereas there were no significant differences between equations for the patient sample as whole, equation AC,BPD (Shepard) had the smallest systematic error in intrauterine growth retarded, premature, and normal‐term fetuses less than 4000 g. Conversely, the systematic error of the models that included femur length was smallest at the upper end of the weight scale and in macrosomic fetuses in general. In that regard, the accuracy of fetal weight prediction could be increased by selecting the appropriate model for the proper clinical indications. Although these findings can be explained by the limitations of the current regression models in estimating fetal soft tissue mass, subtle effect of the use of the sector scanner on the results of this study cannot be completely excluded and requires further investigation.
Doppler ultrasound in the fetus: A review of current applications
Authors: De Vore Greggory R. , Brar Harbinger S. , Platt Lawrence D.
Published: February 2007

With the recent introduction of Doppler pulsed and continuous wave as well as color‐flow mapping, assessment of blood velocity in the human fetus has added a new dimension to fetal assessment. Although investigators initially examined blood flow in the descending aorta and umbilical vein, there was a wide variation in normal values because of the difficulty of accurately measuring the area of the vessels, a requirement for computation of blood volume. Using duplex sector scanners, velocity and blood flow have been obtained from the right and left ventricular chambers and aortic and pulmonic outflow tracts. At the present time the clinical application of the latter measurements is still under investigation. Doppler color‐flow mapping appears to be promising for elucidation of abnormal flow in fetuses suspected of having structural and/or functional cardiovascular disease. Because of the difficulty in computing volume flow due to the above mentioned factors, more recently investigators have examined angle independent parameters of blood velocity from the aorta, carotid and umbilical arteries in an attempt to quantify peripheral resistance. This latter technique appears to be promising for elucidation of placental pathology as is found in a number of fetal and placental diseases.
Mathematical modeling of fetal growth: V. Fetal weight changes at term
Authors: Rossavik Ivar K. , Deter Russell L. , Wasserstrum Nathan
Published: February 2007

Fetal growth after 37 weeks menstrual age was investigated by comparing ultrasound estimates of fetal weight with corresponding weights of newborns. Using a weight estimation equation with minimal systematic error, evidence was found that fetuses delivered at term do not increase in weight the last two weeks before delivery. This change in fetal growth is regarded as a biological process that is needed to prepare the fetus for its life after birth. Only one of three subsets, that of estimated weights below 3000 g, showed significant weight increase after 37 weeks. This subset had, however, on average the longest scan‐delivery interval. We conclude that conventional birthweight standards are influenced both by a cessation of fetal growth approximately two weeks before delivery and by an association between fetal size and the duration of gestation.
Sonography of the hip joint as part of the evaluation of acute lower abdominal pain
Authors: Graif Moshe , Strauss Simon , Heim Michael , Itzchak Yacov
Published: February 2007

Ultrasound evaluation of the hip joint was performed in 17 patients as part of the sonographic investigation of lower abdominal pain with referred symptomatology to the groin and thigh. Sonographic features consistent with hip joint effusion were detected in 12 of the patients. In four patients with positive arthrosonogram the possibility of hip joint involvement was not considered by the examining physician. In 11 other cases, hip pathology was included in the differential diagnosis. Of these, hip involvement was confirmed by sonography in eight patients and excluded in three. Sonography was found to be a useful objective method for the confirmation or exclusion of hip joint effusion. The examination had a significant influence on the patient management for shifting the attention of the clinician from the abdomen to the hip joint in four of the cases in this series.
In utero ultrasound diagnosis of congenital heart disease
Authors: Marasini Maurizio , Cordone Massimo , Pongiglione Giacomo , Lituania Mario , Bertolini Alberto , Ribaldone Dionigi
Published: February 2007

Two hundred and one pregnancies considered at high risk for congenital heart disease (CHD) underwent fetal cross‐sectional echocardiographic (CSE) examination. In 190 cases a structurally normal heart was correctly predicted; seven cases of CHD were identified, but in two of them the specific diagnosis was inaccurate. One false positive diagnosis of a small ventricular septal defect was made. There were three false negative diagnoses: two of ventricular septal defects and one of aortic coarctation.

We conclude that severe heart malformations can be reliably identified or excluded by CSE in utero, but important anatomical details may be missed. Therefore, prognosis should be based only on the structures identified to multiple‐scan planes.
Phasic flow in the left ventricular inflow tract: The importance of Doppler sample volume position
Authors: Delemarre Ben J. , Bot Hans , Visser Cees A. , Dunning Arend J.
Published: February 2007

Variability of Doppler transmitral flow was studied in 42 normal patients (aged 19–68 years). Starting at the mitral annulus level (ANL) in an apical four‐chamber view, the sample volume was moved downstream at 1‐cm intervals. At all positions, peak early (E) and late atrial mediated (A) diastolic velocity were measured, and the distance from the transducer to the level with the highest E wave (HEL) and highest A wave (HAL) determined. The A/E ratio and time velocity integral (TVI) at ANL, HAL, and HEL were also calculated.

Peak E velocity at HEL was 33% higher than at ANL (p < 0.01) and peak A velocity was 15% higher at HAL than at ANL (p < 0.01). The A/E ratio was minimal at HEL and maximal at ANL (0.68 ± 0.28 vs 0.85 ± 0.32, p < 0.01), whereas TVI was highest at HEL and lowest at ANL.

Thus, inflow parameters vary along the inflow axis. This is of importance for cardiac output measurement. The A/E ratio was more dependent on age than on sample volume position.
Ultrasonographic diagnosis of submucosal tumors of the stomach: The “bridging layers” sign
Authors: Miyamoto Yukio , Tsujimoto Fumio , Tada Shimpei
Published: February 2007

The ultrasonic findings in 14 cases with submucosal tumors and one case with extragastric lymphoma using the fluid‐filled stomach method were reviewed to determine the appearance of the stomach wall in submucosal tumors. Two characteristic ultrasound features of submucosal tumors were demonstrated in all 14 lesions except in two located high in the fundus of the stomach. One feature was mucosal bridging layers, i.e., three layers could be seen on the mucosal side of the tumors, and at least two of them continued to layers 1 and 2 of the normal gastric wall. The other was a serosal bridging layer, i.e., layer 5 of the normal gastric wall ran toward the serosal side of the tumor. On the basis of a “bridging layers” sign, we believe a definite diagnosis of submucosal tumor can be obtained from ultrasound images.
Echogenic forms of hydatid cysts: Sonographic diagnosis
Authors: Garcia Francisco J. , Martí‐Bonmatí Luis , Menor Francisco , Rodriguez Belen , Ballesta Antonio
Published: February 2007

Of 167 patients with abdominal hydatidosis, 29 showed a total of 36 hydatid cysts in which ultrasound demonstrated an overall echogenic appearance. The following ultrasound characteristics of an abdominal mass suggest the diagnosis of hydatid cyst: round or oval shape, well‐defined borders, partial wall calcification, peripheral cystic structures, internal echogenic linear formations, snowstorm and/or hyperechogenic internal echo pattern, and posterior acoustic enhancement. A comparative study with computed tomography has also been carried out in 10 of these cysts. Pathologic correlation in most cases allows us to postulate that this appearance represents an overmature, probably ruptured, hydatid cyst.
Reverse flow in the human fetal descending aorta as a sign of severe fetal asphyxia preceding intrauterine death
Authors: Illyés Miklós , Gáti István
Published: February 2007

Flow velocity waveforms (FVW) in the descending part of the human fetal aorta were monitored in 35 cases of severe intrauterine growth retardation (IUGR) showing pathological intrauterine circulation (end‐diastolic block). In 5 of the 35 fetuses, reversed aortic flow was observable during diastole and the simultaneously recorded CTG findings were pathological. All 5 fetuses having this circulatory sign died in utero within the next day. Controls were 260 healthy fetuses with normal growth curves; no end‐diastolic block or reverse flow was found in this group. Diastolic reverse flow in the fetal descending aorta appears to reflect severely altered circulation preceding imminent fetal death.
The sonographic appearance of the irradiated breast
Authors: Calkins Alison R , Jackson Valerie P , Morphis James G , Stehman Frederick B
Published: February 2007

A dedicated supine breast ultrasound scanner was used to perform 48 bilateral breast sonograms on 21 patients who had undergone segmental resection and radiation therapy for breast cancer. Skin thickening was seen in 13 of 21 patients (62%). There was an increased echogenicity of the fat in 13 patients (62%) and poor definition of Cooper's ligaments in nine patients (43%). Fifteen patients (71%) had decreased compressibility and 8 (38%)had decreased penetration of the sound beam into the breast. The radiation changes were seen as early as one month after the completion of radiotherapy and improved by one year in the majority of patients studied with sequential sonograms.
Oligohydramnios associated with bilateral multicystic dysplastic kidneys: Prenatal diagnosis at 15 weeks' gestation
Authors: Stiller Robert J , Pinto Margarita , Heller Charles , Hobbins John C
Published: February 2007

Lethal fetal renal malformations are invariably associated with oligohydramnios in late antennatal ultrasound examinations. Controversy exists concerning the contribution of fetal urine production to amniotic fluid volume prior to 20 weeks' gestation. We report a pregnancy complicated by maternal gold usage and fetal bilateral multicystic dysplastic kidney disease in which oligohydramnios was detected at 12 weeks' gestation. To our knowledge, no previous cases of lethal fetal renal anomalies have been made in the first trimester. The early diagnosis of fetal renal anomalies, fetal renal contribution to amniotic fluid production, and possible teratogenicity of gold therapy is discussed.
Local texture analysis: An approach to differentiating liver tissue objectively
Authors: Schuster E. , Knoflach P. , Grabner G.
Published: February 2007

The usefulness of local textural analysis in identifying diseases of the liver has been evaluated. In comparing two areas texturally, a random distribution of one or several textural parameters indicates identical tissue, whereas a distinct clustering can be used to discriminate between different tissues. Using this procedure, various diseases of the liver were differentiated accurately whereas different images of the same state of the liver were classified as similar with high accuracy.

The consistent results with different patients, sections, sample locations and scanner parameter settings demonstrate that these factors have no impact on the characteristics of the resulting pattern used for discrimination and therefore for the final diagnosis.

The overall diagnostic accuracy of this method seems better than conventional sonographic evaluation of parenchymal liver disease and at least competitive with other computerized methods described. The most important result clinically seems to be the high accuracy in differentiating between hepatitis and normal liver, which cannot be achieved by conventional ultrasonography.
A comparison of two different ultrasound methods for estimating fetal weight in preterm gestations
Authors: Campbell Winston A. , Vintzileos Anthony M. , Nochimson David J.
Published: February 2007

A prospective study was conducted to evaluate the estimation of fetal weight in preterm pregnancies by use of ultrasound measurements. Two equations for estimating fetal weight, one proposed by Shepard and associates and the other by Hadlock and associates, were evaluated. The ability to estimate fetal weight accurately was evaluated with respect to birth weight and menstrual age. Shepard's equation is associated with a lower mean signed percent error than Hadlock's, when the birth weight is less than 1500 g (4% vs 12%) or when the menstrual age is between 23 weeks to 30 weeks (2% vs 10%). However when the birth weight is between 1500 g and 3500 g, or the menstrual age is between 31 weeks to 36 weeks, Hadlock's equation has a lower mean signed percent error: 1% vs −4% for the birth weight category and 2% vs −3% for the menstrual age category. In preterm gestations both equations estimate fetal age weight with a low mean signed percent error–Shephard's −0.4% versus Hadlock's 6.0%.
FM sonography in gallbladder disease: Efficacy and comparison with conventional sonography
Authors: Henley David S , Ralls Philip W , Johnson Meade B , Colletti Patrick M , Randall D Radin , Boswell William D , Halls James M
Published: February 2007

A new type of ultrasound signal processing (“FM sonography”) appears to be beneficial compared to conventional ultrasound (“AM sonography”) in some applications (e.g., diffuse liver disease and prostatic carcinoma). Despite these possible advantages, it is doubtful FM sonography will be widely used unless it is at least as useful as conventional (AM) sonography in all common applications.

Fifty‐five patients with suspected gallbladder disease were independently evaluated with both AM and FM sonography. The two modalities were blindly and prospectively compared for accuracy in detecting gallstones and for image quality. No statistically significant difference was found between images produced by FM and conventional signal processing. FM had an accuracy of detecting gallstones of 98.1%, compared to 96.2% for AM. Overall, FM accuracy was 97.7%, while AM had an overall accuracy of 97.3%. Other useful sonographic signs were evaluated (gallbladder wall thickness, diameter of common duct). No AM/FM difference was noted.

Our data suggest that FM‐only imaging could be performed in patients with suspected gallbladder disease without loss of accuracy.
Comparison of blood velocity waveform indices recorded by pulsed Doppler and continuous wave Doppler in the umbilical artery
Authors: Van Vugt J. M. G , Ruissen C. J , Nienhuis S. J , Hoogland H. J , de Haan J
Published: February 2007

A comparison was made between the AB ratio, resistance index (RI), and pulsatility index (PI), calculated from tracings obtained by pulsed Doppler (PD) and continuous wave (CW) Doppler devices in 14 uncomplicated singleton pregnancies. The AB ratio, RI, and PI were a slightly higher for the CW Doppler compared to the PD system, although not significantly (p = 0.18, p = 0.21, and p = 0.44, respectively). The difference in signal to noise ratio (S/N ratio) between the PD and CW Doppler systems was felt to be the reason for the discrepancy in the calculated velocity waveform indices.
Clinical significance of sonographic findings in the abnormal but intact rotator cuff: A preliminary report
Authors: Crass Jeffrey R , Craig Edward V , Feinberg Samuel B
Published: February 2007

Shoulder pain is a common orthopedic problem. Clinical examination is often nonspecific and arthrography is normal in those patients with the most frequent cause of shoulder pain—noncalcific tendonitis secondary to impingement.

Ultrasonography has recently shown itself to be of value in the diagnosis of rotator cuff tears. In addition to the diagnosis of tears, however, sonography can demonstrate abnormalities within the intact rotator cuff tendon. These abnormalities consist of changes in echogenicity and thickness of the tendon. The patterns of abnormality demonstrated correlate with pathologic changes seen in tendonitis.

This preliminary study suggests that the ability to demonstrate an abnormal rotator cuff tendon has potential for becoming a valuable aid to the orthopedist in allowing confident diagnosis of rotator cuff disease in the presence of nonspecific symptomatology and an intact tendon.
The impact of routine admission abdominal sonography on patient care
Authors: Verbanck Johan J , van Aelst Filip , Rutgeerts Louis , Demuynck Hilde , Ghillebert Gilbert , Vergauwe Philippe , Tytgat Hendrik , Segaert Marc
Published: February 2007

In a prospective study of 1000 consecutive patients, abdominal sonography added diagnostic information to that available by history and physical examination in 8.9%. The yield ranged from a high of 27.4% in patients with acute abdominal symptoms to a low of 2.7% in screening sonograms of patients without abdominal symptoms. Sonographically guided biopsy‐proven diagnoses were obtained in 6.6% of the patients and were clinically not suspected in 4.4%. The percentage of false‐positive and false‐negative sonographic studies was 0.5% and 1.1%, respectively. Sonography shortened the duration of hospitalization in 15.3%.
In utero growth of the large‐for‐menstrual‐age fetus
Authors: Miiler Joseph M. , Kissling Grace E. , Brown Haywood L. , Nagel Patricia M. , Korndorffer Frederick A. , Gabert Harvey A.
Published: February 2007

In a cross‐sectional study of 87 large‐for‐menstrual‐age term infants, intrauterine growth was found to be linear, 34 g per day. Differences between diabetic and nondiabetic pregnancies were not evident.
Mathematical modeling of fetal limb growth
Authors: Merz Eberhard , Grüßner Angelika , Kern Franz
Published: February 2007

Using ultrasound measurements of the femur, tibia, humerus, radius (N = 515), and fibula and ulna (N = 385) from normal fetuses between 12 and 40 completed weeks of gestation, growth models were determined for each bone by computer analysis. On the basis of residual analysis, growth of fetal limb bones could best be expressed as a function of tangens hyperbolicus. Growth profiles and growth data are shown with 5th, 10th, 50th, 90th, and 95th percentiles. These results are compared with previous investigations of limb bone measurements.
Evaluation of fetal growth by ultrasonography in twin pregnancy: A comparison between individual and cross‐sectional growth curve standards
Authors: Simon Nicolas V. , Deter Russell L. , Hassinger Kathryn K. , Levisky John S. , Stefos Theodor , Shearer David M.
Published: February 2007

Cross sectional curves and individual fetal growth curves standards from the Rossavik growth model [P = c(t)k + 8(t)] were generated for abdominal and head circumferences, femur diaphysis length and estimated fetal weight from a sample of 59 women with twin pregnancy. These curves were compared to their counterparts in singleton pregnancies. Cross sectional curves of the four fetal anatomic parameters under study fell progressively below the curves for singletons during the last trimester of gestation. In contrast, there were few differences between individual fetal groth curve standards for twin and singleton pregnancies. In 11 of the 59 patients, both methods were used to evaluate fetal growth in the last trimester of gestation. In 5 of these patients, fetal growth was normal by both methods in all 10 fetuses. In the 6 other patients, there were 3 fetuses with anormal estimated fetal weights (EFWs) by both population and individual standards. However, 3 fetuses had abnormal EFWs by populations standards but not by individual standards while the EFW of another fetus was abnormal by individual standards but not by population standards. These results illustrate that the cross‐sectional approach to the assessment of growth in twins can be misleading and may lead to incorrect conclusions concerning the growth of these fetuses.
Fat pad vs. anterior subphrenic abscess: A new real‐time sign
Authors: Vijayaraghavan S. Boopathy
Published: February 2007

An echo‐poor band of fat is seen between the anterior surface of the left lobe of the liver and the anterior abdominal wall in 25% of patients undergoing an abdominal scan. A similar appearance can be seen in an anterior subphrenic abscess. Normally, with respiration the liver can be seen to slide deeply to this fat band. If the band is due to subphrenic abscess, there is a differential movement due to fixation of the anterior part of the liver. This feature was seen in 4 patients proven to have subphrenic abscesses. This real‐time sign is helpful in differentiating if the band is due to fat or to subphrenic abscess.
Comparison of dynamic image and pulsed Doppler ultrasonography for the diagnosis of intrauterine growth retardation
Authors: Ott William J.
Published: February 2007

Dynamic image and pulsed Doppler ultrasonography were used to evaluate 104 potentially growth‐retarded fetuses. The two techniques were compared, and then used together to predict whether or not the neonate would be growth retarded. Both ultrasonic diagnostic techniques showed good correlation with neonatal outcome, but their combined use improved diagnostic accuracy.
Transdiaphragmatic liver scanning: A new intraoperative imaging technique for examination of the liver from the thoracic cavity
Authors: Machi Junji , Sigel Bernard , Kurohiji Toshihiko , Hayashida Ryozo , Takeda Jinryo , Kakegawa Teruo
Published: February 2007

In order to examine the liver during thoracotomy, a new intraoperative imaging technique called “transdiaphragmatic liver scanning” was developed. Trans‐diaphragmatic scanning performed with high‐frequency transducers provided clear visualization of the entire liver from the thoracic cavity through the diaphragm. In our study, transdiaphragmatic scanning was used in 27 thoracotomy operations performed for the treatment of malignant diseases, including lung and esophageal cancers. One 5‐mm liver cyst, one 3‐mm × 4‐mm hemangioma, and one 5‐mm × 6‐mm ill‐defined lesion (possible metastasis), all of which were unrecognized preoperatively, were detected. In 3 operations, preoperatively suspected liver metastases were excluded by transdiaphragmatic scanning. Because transdiaphragmatic scanning provides high‐resolution images of the liver and is the only method capable of examining the liver during thoracotomy, this intraoperative scanning technique may become a useful tool in the evaluation of liver metastases from thoracic or mediastinal malignancies.