bluuebunny/crossref_metadata_2025 huggingface dataset:
Longitudinal studies of thigh circumference growth in normal fetuses
Authors: Deter Russell L. , Rossavik Ivar K. , Cortissoz Catherine , Hill Reba M. , Hadlock Frank P.
Published: February 2007

To characterize the growth of the thigh circumference (ThC) in individual fetuses, longitudinal studies of ThC growth were carried out in 20 fetuses between 19 (±1.8) and 38 (±1.5) weeks, menstrual age. Because of measurement uncertainties, analysis of growth patterns was limited to the data collected after 22 weeks. The Rossavik growth model fit the data well [R2: 95.8(± 2.9 SD)%], but considerable coefficient variability was seen, particularly for the coefficient K. Use of the coefficient k‐value (1.138) derived from a cross‐sectional data set reduced the variability of the coefficient c by 95% and made the results of the longitudinal and cross‐sectional studies consistent with each other. This K ‐value was taken as the appropriate one for ThC growth curves. Studies of ThC growth in individual fetuses revealed considerable variability in growth curve shape, although the majority of curves could be approximated by a straight line. No differences between growth curves for males and females could be detected. The average longitudinal ThC growth curve was found to be very similar to the growth curve obtained in a cross‐sectional study of ThC growth. ThC growth after 26.1 weeks could be predicted with an accuracy of ± 15% from growth models derived from the data obtained before 26.1 weeks. These results indicate that ThC growth after 22 weeks (as with other parameters) can be followed in individual fetuses. However, because of the greater inherent variability in growth patterns, using each fetus as its own control may be more important.
Doppler color flow imaging
Authors: Merritt Christopher R. B.
Published: February 2007

By simultaneous processing of frequency, phase, and amplitude information in the backscattered ultrasound signal, new instruments now permit the realtime display of high‐resolution grey scale images of tissue combined with the simultaneous display of flow data from vessels within the scan plane. Doppler Color Flow Imaging, or DCFI, using such processing, permits blood flow direction and relative velocity to be detected and displayed in a color encoded display from throughout the ultrasound image. We have tested a new Doppler color flow imaging system over a period of two years to evaluate the carotid arteries, peripheral arteries and veins, and dialysis fistulas. In the abdomen and pelvis we have imaged blood flow to the liver, spleen, kidneys, uterus and renal transplants. Our experience in over 500 patients leads us to conclude that DCFI has significant advantages over conventional duplex Doppler sonography for blood flow evaluation. For examination of carotid and peripheral vessels, we have found DCFI to permit more rapid assessment in both normal and abnormal states. Areas of vessel narrowing or turbulent flow may be identified rapidly and accurately, and vessel orientation may be determined precisely, allowing accurate calculation of blood flow velocity from Doppler frequency shifts. The system we have used has adequate penetration and sensitivity to allow imaging of hepatic and renal blood flow and is extremely promising as a method of imaging organ perfusion and in the detection of abnormalities of perfusion that accompany disease, such as transplant rejection. Tumor vascularity may also be identified with DCFI, opening the possibilty of additional clinical applications.
Clinical utility of Doppler ultrasound in cardiac diseases
Authors: Nouri Soraya , Labovitz Arthur J.
Published: February 2007

During the past decade Doppler echocardiography has evolved to an extent that it has become a major noninvasive tool for cardiac evaluation in both acquired and congenital heart disease.

This article describes current applications of Doppler techniques in the evaluation of cardiac anatomy and hemodynamics. The principles and methods employed in the use of Doppler echocardiography are described and illustrated for assessment and quantitation of flow velocities, pressure gradients, valve areas, valve regurgitation, stroke volume, cardiac output, cardiac shunts, and diastolic filling indices.

The increasing accuracy of these applications has led to a substantial reduction in the need for invasive diagnostic methods, such as cardiac catheterization, especially in patients where frequent follow‐up evaluations are indicated.
Doppler evaluation of the renal transplant
Authors: Needleman Laurence , Kurtz Alfred B.
Published: February 2007

Well‐established roles for Doppler ultrasound assessment of renal transplants include postoperative evaluation for vascular occlusion and detection of renal artery stenosis. Doppler studies can often differentiate rejecting transplants from those that normally function. While very high Doppler indices are specific for rejection, waveforms in acute tubular necrosis may be abnormal. Mild cases of rejection may have normal waveforms. Further investigation is needed to determine the role of Doppler methods in graft dysfunction and to establish methods to improve their specificity.
Ultrasonography of the peroneal nerve muscle group in normal subjects and patients with peroneal paresis
Authors: Boonstra A. M. , van Weerden T. W. , te Strake L. , Hillen B.
Published: February 2007

A method for measuring the cross‐sectional area (CS area) of the peroneal nerve muscle groups (PNMG) by ultrasonography is presented. The method has a good reliability and can be performed easily. The mean value of the ratio (× 100) of the right‐sided PNMG CS area to the left‐sided PNMG CS area in right‐handed normal subjects was 98%, with a standard deviation of 8.5%. The normal range for this value was 81%−115% (mean ± 2 SD). Examples of these measurements in patients with peroneal pareses during denervation and reinnervation are given.
“Bullet”‐shaped head in fetuses with spina bifida: A pointer to the spinal lesion
Authors: Chambers Sarah E. , Muir Berenice B. , Bell Jeanne E.
Published: February 2007

A “bullet”‐shaped head, characterized by flattening in the parietal regions with pointing of the frontal bones, was noted in ultrasound examinations of fetuses with neural tube defects. In a series of 12 fetuses with spinal defects, this finding was present in nine. This abnormal head shape is a useful pointer to the spinal lesion.
Unusual causes of sonographic nonvisualization or nonrecognition of the gallbladder: A review
Authors: Hammond D. Ian
Published: February 2007

Nonvisualization of the gallbladder by ultrasound in a fasting patient usually indicates calculous gallbladder disease. However, a number of other less common conditions can prevent gallbladder visualization or recognition. The latter occurs when the location or the morphology of the gallbladder is so altered that the gallbladder is difficult to identify. These conditions can be classified as: (1) congenital anomalies, (2) gallbladder contraction not due to stones, (3) conditions that cause shadowing or reverberation from the near wall of the gallbladder, and (4) the solid gallbladder pattern. Their distinction is important to proper patient management.
Measurement of quadriceps muscle thickness and subcutaneous tissue thickness in normal children by real‐time ultrasound imaging
Authors: Heckmatt J. Z. , Pier N. , Dubowitz V.
Published: February 2007

A reproducible ultrasound imaging technique is described for measurement of midthigh muscle and subcutaneous tissue thickness. We studied 276 children including those attending hospital outpatient clinics with non‐neurological disorders, newborn babies on the obstetric wards, and children attending a local primary school. There was no significant difference in muscle depth between girls and boys, but girls had a significantly greater subcutaneous tissue depth than boys. The results of this study provide a basis for the study of muscle atrophy and hypertrophy in neuromuscular disease.
Ultrasonic evaluation of urethrovesical junction in women with stress urinary incontinence
Authors: Bergman Arieh , Ballard Charles A. , Platt Lawrence D.
Published: February 2007

An ultrasonic evaluation of the bladder base and urethrovesical junction, at rest and during stress, using a tansrectal probe, was performed on 24 continent and 67 incontinent patients. Forty‐four of the incontinent patients had clinical and urodynamic diagnoses of stress urinary incontinence and 23 patients had detrusor instability incontinence.

Thirty‐eight of the 44 patients (86%)with urodynamically and urethroscopically proven genuine stress urinary incontinence and a weak urethral sphincter had a urethrovesical junction (UVJ) drop during stress of ≥ 1 cm (mean 1.3 cm ± 0.6 cm), as demonstrated on transrectal ultrasonic evaluation. All 23 patients with detrusor instability and 22 of the 24 continent (control) patients had UVJ drop on straining of <1cm (mean 0.48 cm ± 0.23 cm and 0.54 cm ± 0.29 cm, respectively, p < 0.05). The sensitivity of ultrasonic evaluation of women with stress urinary incontinence (when 1‐cm drop of UVJ is considered as the upper boundary of normal) was 86% and the specificity was 91%. This ultrasound technique is quick, simple, and appears to be accurate. We believe this technique should be considered in the preoperative evaluation of women with stress urinary incontinence.
Simple adnexal cysts diagnosed by ultrasound in postmenopausal women
Authors: Andolf Ellika , Jörgensen Connie
Published: February 2007

Thirty simple adnexal cysts in postmenopausal women detected by sonography were followed prospectively. The cysts were totally anechoic or with at most two septations. Size varied from 2 cm to 8 cm, but one was as large as 17 cm. Only seven were discovered at the pelvic examination prior to the scan. Fifteen underwent surgery and no malignant tumor was found. The remaining 15 were followed by sonography only. Six lesions had disappeared after one month, altogether 12 had disappeared after seven months. After two years, only two 2‐cm cysts remained. The results indicate that surgery on simple adnexal cysts may not be necessary but they should be followed by sonography.
Sonographic examination of the adult brain
Authors: Berland Lincoln L. , Bryan Cindy R. , Sekar B. Chandra , Moss C. Neil
Published: February 2007

Phased‐array real‐time tranascranial ultrasound with a 2.5‐MHz transducer was used to examine 23 normal adult volunteers and patients, and 8 selected patients with abnormalities proven by computed tomography. Normal cerebral landmarks were consistently seen and pulsed Doppler signals were often obtainable from central cerebral arteries. Dilated lateral ventricles, subdural hygromas, or cerebral masses were identified in 6 of the 8 patients. In the 2 others abnormal cases, known suprasellar aneurysms were missed. While current technology will not provide accurate screening for cerebral abnormalities, ultrasound imaging may often be adequate for follow‐up examinations and for midline evaluation, and may provide simplified preoperative localization of some brain lesions. Doppler ultrasound examinations may be used for intracranial vessel hemodynamic evaluation.
The real‐time ultrasonography of pancreatic pseudocyst: Comparison of infected and noninfected pseudocysts
Authors: Lee Chuan‐Mo , Chang‐Chien Chi‐Sin , Lin Deng‐Yn , Yang Chaur‐Young , Sheen I‐Shyan , Chen Wen‐Jen
Published: February 2007

The real‐time ultrasonograms of 15 patients with pancreatic pseudocysts (10 infected and 5 noninfected) were analyzed to evaluate difference in ultrasound characteristics between the infected and noninfected pseudocysts. Only those who underwent ultrasound‐guided aspiration or operation within one week after sonography were reviewed according to the size, multiplicity, air content, internal echoes, and wall characteristics (such as thickness, regularity, and calcification) of pseudocysts. Among these ultrasonographic features of pseudocysts, there was no statistically significant difference between the infected and noninfected pseudocysts in cyst size, wall characteristics (thickness, regularity, and calcification), multiplicity, and air content. The most important and unique feature was the internal echoes within the pseudocyst. The internal echoes were classified into three grades. All the infected pseudocysts and one noninfected pseudocyst had internal echoes of grade 2 or higher, while the most noninfected pseudocysts had internal echoes of grade 1. The difference is statistically significant (p = 0.0037). These results indicate that grading internal echogenicity of the pseudocysts with real‐time ultrasonographies can add additional information important in differentiating infected from noninfected pseudocysts.
Portable obstetrical ultrasound calculation and analysis using an inexpensive laptop microcomputer and simple basic program
Authors: Dunne Morgan G , Dunne Sean B
Published: February 2007

This paper describes the use of a commercially available inexpensive portable laptop microcomputer and a simple user‐friendly software package that allows rapid, portable obstetrical ultrasound calculation in the reading room, delivery suite, office setting, or over the telephone. The program is written in BASIC and may be modified by the user. The programming philosophy is described and a variety of BASIC subroutines and formulae useful to the obstetrical sonologist are listed. All fetal parameter formulae are referenced.
Dynamic ultrasonography of capsulo‐ligamentous knee joint traumas
Authors: de Flaviis Luca , Nessi Renato , Leonardi Manlio , Ulivi Michele
Published: February 2007

Ultrasonography was performed on 10 patients with acute posttraumatic conditions of the knee in which X‐ray films could exclude the presence of fractures. In 2 of 10 cases, the sonographic picture was normal; in the remaining 8 patients, ultrasonography disclosed capsulo‐ligamentous lesions of different degrees of severity that were confirmed by surgery in 5 of 8 cases.

The main sonographic signs of articular traumas were abnormal widening of the joint space (7 cases), intra‐articular hemorrhage (8 cases), rupture of the medial collateral ligament (4 cases), or irregularity of its structure (3 cases).

Ultrasonography is proposed as an effective and simple first‐line method for the study of knee joint traumas. It can be performed in all cases presenting with painful joint swelling without radiographical evidence of fractures.
High‐resolution hip ultrasound in the limping child
Authors: Alexander J. E. , Seibert J. J. , Glasier C. M. , Williamson S. L. , Aronson J. , McCarthy R. E. , Rodgers A. B. , Corbitt S. L.
Published: February 2007

Hip ultrasound was performed on 44 children (114 exams) presenting with a painful hip or a limp thought to be due to hip disease. Effusions were found in 20 patients (21 hips). Hip ultrasound in combination with aspiration of the joint was found to be useful in diagnosis of osteomyelitis and septic joints, transient synovitis, trauma, and traumatic synovitis. We had no false positives or false negatives for hip effusions by ultrasound. In previous reports, absolute measurements have been relied upon for determination of hip effusions. We present a characteristic appearance of a capsule with and without abnormal joints fluid. The results of these 44 patients are summarized.
Individual growth curve standards for fetal head and abdominal circumferences: Effect of the type of measurement on growth prediction
Authors: Stefos Theodor , Deter Russell L.
Published: February 2007

Head and abdominal circumferences (HC, AC) can be measured directly or estimated from diameters. Accurate prediction of circumference growth after 26 weeks depends on growth model specification and the quality of the circumference measurement method used. To evaluate the effect of the method of measurement, direct and estimated HC and AC values from 20 normal fetuses, obtained between 15 and 38 weeks, were used to determine two pairs of functions for specifying HC and AC growth models. The two HC and AC data sets and pairs of model specification functions were used in various combinations to determine HC and AC growth models, to predict growth after 26 weeks, and to compare predicted values to actual measurements. Systematic and random prediction errors were determined for each combination. For HC no differences in either type of error were found. Similar results were obtained for AC with one exception, a statistically significant difference in systematic error between the directly measured circumferences — model specification based on estimated values combination and the estimated circumferences — model specification based on directly measured values combination. These results indicate that the prediction of future HC and AC growth is not significantly affected by the type of circumference measurement procedure used except in extreme cases where circumference measurements are made on parts of the body that can be easily distorted.
Ultrasound‐guided puncture of cystic tumors in the lower pelvis of young women
Authors: Granberg S. , Crona N. , Enk L. , Hammarberg K. , Wikland M.
Published: February 2007

During the period from 1984 through 1986, 72 ultrasound‐guided cyst punctures were performed in 60 young women (≤40 years). Thirty‐one punctures were performed using the transabdominal route and 41 punctures under the guidance of endovaginal scanning. General or local anesthesia were used in 97% of the transabdominal punctures while the corresponding figure for the endovaginal technique was 49%.

Seventy‐seven percent (46/60) of the women developed no new cysts within one year of the last puncture. Thirteen percent (8/60) had to be punctured twice and 3% (2/60) three times. No complications occurred in any of the 72 punctures. Of those women with cyst relapses and/or persistent abdominal pain, 7 were subjected to laparotomy and 5 to laparoscopy.

Ultrasound‐guided puncture of cystic tumors in the lower pelvis of young women seems to be an alternative to laparoscopically guided puncture or laparotomy. As compared to surgery, the ultrasound‐guided technique may mean less risk for pelvic adhesions in young women with unproven fertility.
Ultrasound in the diagnosis of lymphoma: A review
Authors: Jackson F. I. , Lalani Z.
Published: February 2007

A retrospective review of the ultrasound examination of 138 patients suffering from lymphoma has been undertaken. The value of ultrasound in determining the extent of disease throughout the body has been demonstrated, as well as some of the uses of ultrasound in therapy. The limitations of ultrasound examinations are also described.
Puncture of the seminal vesicles guided by a transrectal real‐time linear scanner
Authors: Abe Masahiro , Watanabe Hiroki , Kojima Munekado , Saitoh Masahito , Ohe Hiroshi
Published: February 2007

An interventional technique using a transrectal real‐time linear scanner has been applied to the transperineal puncture of the seminal vesicles in 143 patients. The composition of this group was as follows: seminal vesiculitis, 98; hemospermia, 20; and prostatic cancer, 25. The aspiration of fluid and the injection of antibiotics and/or steroid drugs into the vesicles were performed for the diagnosis and treatment of seminal vesiculitis and hemospermia. Clinical symptoms improved in 62% of the former and in 50% of the latter cases. Cancer cells were detected in aspirated vesicular fluid in 7 out of 17 cases with prostatic cancer. A remarkable improvement in the diagnosis of prostatic cancer invasion into the seminal vesicles can be expected from this new diagnostic procedure.
Utility of sono‐graphic gallbladder wall patterns in differentiating malignant from cirrhotic ascites
Authors: Huang Yi‐Shin , Lee Shou‐Dong , Wu Jaw‐Ching , Wang Sun‐Sang , Lin Han‐Chieh , Tsai Yang‐Te
Published: February 2007

Thirty‐one patients with ascites associated with malignancy and 49 patients with cirrhotic ascites were enrolled in a sono‐graphic study of the gallbladder wall. Three gallbladder wall patterns were recognized: A, single‐layered, nonthickened wall; B, single‐layered, thickened wall; and C, double‐layered, thickened wall. Pattern A was found more frequently in patients with malignant ascites, while patterns B and C were detected more frequently in patients with cirrhotic ascites. If “nonthickened gallbladder wall” is used as a criterion for prediction of malignant ascites, the sensitivity is 80.6% and the specificity 93.9%. This suggests that sono‐graphic examination of the gallbladder wall is useful in the differentiation of malignant from cirrhotic ascites.
Prediction of normal fetal growth by the Rossavik growth model using two scans before 27 weeks, menstrual age
Authors: Simon Nicolas V. , Deter Russell L. , Shearer David M. , Levisky John S.
Published: February 2007

Individual growth curve standards for five fetal anatomic parameters (head and abdominal circumferences, head and abdominal cubes, and femur diaphysis length) and estimated fetal weight were prospectively developed in 70 pregnant women who delivered infants with growth considered appropriate‐for‐menstrual age. For this purpose, we used the Rossavik growth model (P = c (t)k + s(t)rpar;, model specification functions previously reported, and the data of two scans before 27.0 weeks of menstrual age, separated by an interval of at least 5 weeks. The anatomic parameters and estimated weights of these fetuses in the last 14 weeks of gestation were found to have values close to their projected standards. Whereas there was a significant, although small, systematic error of overprediction for most of the parameters and estimated fetal weight, deviations between observed and expected values were, with few exceptions, within the ranges established by Deter for normal growth. This study demonstrates that the Rossavik growth model could be used to predict normal fetal growth in a sample of patients different from those from which the model was developed.
The ultrasound spectrum of emphysematous cholecystitis
Authors: Bloom Ronald A. , Libson Eugene , Lebensart Pinchus D. , Craciun Eli , Klin Baruch , Fields Scott I. , Haskell Liliana
Published: February 2007

This report presents a gamut of ultrasound signs that may be seen in emphysematous cholecystitis. These can be summarized as follows:

Intraluminal gas: (a) A dense band of hyper‐reflective echoes with distal reverberations when gallbladder is full of gas. (b) A band of reverberations in the gas‐filled portion of the gallbladder with the usual signs of cholecystitis in the bile‐filled portion when the gallbladder is partially full of gas.

Intramural gas: (c) An area of high reflectivity in the gallbladder wall with reverberations that may change position with change in position of patient, (d) A bright hyper‐reflective ring emanating from the whole circumference of the gallbladder.
The influence of heart rate and age on diastolic blood flow velocity in the left ventricular inflow tract
Authors: van Dam Ina , Delemarre Ben , Hopman Jeroen , de Boo Theo , Uiterwaal Cuno , Fast Jules , van Oort Anton , van der Werf Tjeerd , Daniéls Otto
Published: February 2007

To investigate the relationship between age‐related blood flow velocity and heart rate in the left ventricular inflow tract, we studied 118 healthy volunteers (age > 15 years). The maximal velocity (Vmax) of the transmitral diastolic flow during early ventricular filling (E) and during filling due to atrial contraction (A) was measured at 3 sites in the left ventricle with pulsed Doppler echocardiography. At all these sites a significant positive correlation was found between the VmaxA and the EA ratio and the interaction of heart rate and age. VmaxA increases if age and heart rate increase. The influence of the interaction of age and heart rate on VmaxA is most pronounced near the mitral annulus. VmaxA is only related to age and decreases with advancing age. Our observations contribute to the explanation of the more important role of the atrial contraction in the elderly.
High‐resolution computerized color transformation of real‐time gray scale ultrasound images
Authors: Toma Sameh K. , Seeds John W. , Cefalo Robert C.
Published: February 2007

Contemporary real‐time ultrasound images are constructed of graduated shades of gray. The practical range of echo contrast than can be depicted is therefore limited. The use of color as well as intensity would potentially increase the amount of information available and possibly augment tissue texture contrast. Previous efforts to color encode ultrasound images have not been of adequate visual resolution, and have not produced simultaneous or real‐time results. Described and illustrated here is a microcomputer‐based system that successfully produces high‐resolution simultaneous real‐time pseudocolor transformation of real‐time ultrasound images. The system accepts the composite video output in any ultrasound machine, and the specific color scheme may be chosen to suit the operator. It is proposed that such color enhancement improves visual clarity of fine fetal anatomy by highlighting tissue–tissue contrast and tissue–fluid interfaces.
Sonographic appearance of occipital fetal hair
Authors: Petrikovsky Boris M. , Vintzileos Anthony M. , Rodis John F.
Published: February 2007

The sonographic characteristics and the frequency of the presence or absence of fetal hair in the occipital region was determined from 16 weeks to 42 weeks of menstrual age. Our results suggest that the ultrasonic appearance of occipital hair is first noted at approximately 24 weeks of menstrual age and there is a progressive increase in frequency of hair presence as pregnancy approaches term. The normal ultrasonic characteristics of occipital fetal hair are described, and the differential diagnoses between normal fetal hair and malformations such as meningocele, encephaloceles, or cystic hygromas is discussed.
Abdominal ultrasonography versus transvaginal scanning: Accuracy in follicular development evaluation and prediction for oocyte retrieval in stimulated cycles
Authors: Bonilla‐Musoles F. , Pardo G. , Perez‐Gil M. , Serra V. , Pellicer A.
Published: February 2007

Abdominal and vaginal sonographic monitoring were compared in 45 patients undergoing follicular development for the purposes of artificial insemination (N = 22) and in vitro fertilization (IVF; N = 23). Transvaginal sonography recorded a significantly (p < 0.05) higher number of follicles from cycle day 10 on, compared to the abdominal (sector and linear) approach. Starting on day 8, the size of the dominant follicle was also significantly (p < 0.05) higher when transvaginal endosongraphy was used. The number of follicles >15 mm on the day of human chorionic gonadotropin (hCG) administration was correlated with the number of oocytes retrieved in patients undergoing IVF. There was a significant linear correlation when transvaginal (r = 0.86, p < 0.001) and sector (r = 0.57, p < 0.05) scans were used.
Sonographic detection of the fetal pancreas
Authors: Hill Lyndon M. , Peterson Carol , Rivello Dawn , Hixson Joyce , Belfar Hanae L.
Published: February 2007

With the fetal stomach utilized as a general marker, targeted‐imaging of the fetal abdomen was initiated to locate the pancreas. Overall, the pancreas was seen in 77 of 149 cases (51.7%). Menstrual age and the position of the fetus were significant factors in determining the frequency of pancreatic visualization.
The intrauterine hernatorna: Diagnostic and clinical aspects
Authors: Mandruzzato G. P. , D'Ottavio G. , Rustico M. A. , Fontana A. , Bogatti P.
Published: February 2007

Sixty‐two cases of intrauterine hematoma (IUH) with a live fetus have been described. This condition was found in 11% of cases that presented with bleeding in early pregnancy. The rate of spontaneous abortion in this series was 12.9%, similar to that observed in cases of threatened abortion without observable hematoma. Spontaneous abortion and delivery rate before 35 weeks of pregnancy were correlated with the calculated volume of the hematoma. Fetal growth retardation seemed to be increased after observation of IUH, especially when the placenta was located on the posterior uterine wall. Uterine malformations and myomas were likely to represent a predisposing factor for IUH.
The impact of sonography on the management of extratesticular abnormalities of the scrotum
Authors: Yeager Bradford A. , Arger Peter H. , Mintz Marshall C. , Grumbach Kathryn , Coleman Beverly G. , Arenson Ronald L. , Riesch Deborah
Published: February 2007

The results of scrotal sonography performed in a recent one‐year period (1987) were retrospectively reviewed to assess the role of sonography in the management of patients with extratesticular abnormalities. The study included 226 examinations performed in 204 men. In extratesticular abnormalities, scrotal sonography confirms the clinical impression of the referring physicians, monitors the progress of conservative treatment, and guides the surgical approach. Patients with sonographically classic cystic extratesticular abnormalities rarely come to surgery. Those with complicated cystic abnormalities are usually followed clinically but have a higher incidence of surgery. Those with solid‐appearing echogenic abnormalities usually have surgical removal.
The size of the renal pelvis on ultrasonography in children
Authors: Tsai Tsuen‐Chiuan , Lee Hung‐Chang , Huang Fu‐Yuan
Published: February 2007

Eighty‐seven patients and 60 normal children were studied to determine the upper limit of the renal pelvic size in children and its relation to disease and age. The renal pelves were all measured by ultrasonography. Further radiologic examinations were performed on the disease group to confirm the final diagnosis. We found that a 10 mm diameter was the upper limit of the normal renal pelvis. Second, measuring the renal pelvic size on an ultrasonogram was highly reliable in diagnosing obstructive uropathy (100% sensitivity, 90.3% specificity). However, when the ultrasonogram with the 10 mm criterion was the sole diagnostic measure, many nonobstructive hydronephroses cases (26/37) were misdiagnosed. Therefore, other diagnostic tools should be employed. Third, the size of the renal pelvis was not influenced by age in children.
Ultrasonographic follow‐up of liver cirrhosis
Authors: Zoli Marco , Cordiani Maria Rita , Marchesini Giulio , Abbati Simonetta , Bianchi Giampaolo , Pisi Emilio
Published: February 2007

Ultrasonography and upper gastrointestinal endoscopy were prospectively used to study 100 consecutive patients with liver cirrhosis. After a period of 20 months to 55 months, 21 patients had died, 23 were lost at follow‐up, and 56 patients were reevaluated. In the patients who died during follow‐up, the entry liver volume, measured by means of the hepatic volumetric index, was lower as compared to the 56 cirrhotics who survived. During the study period, liver volume significantly decreased to values similar to those observed, at entry, in patients who died. Moreover, esophageal varices increased in size, and the splanchnic veins enlarged. Abdominal ultrasonography provides data regarding the natural history of liver cirrhosis, which might be used, in addition to tests of liver function and endoscopy, as prognostic factors in cirrhotic patients.
Effect of the pretest probability of intrauterine growth retardation on the predictiveness of sonographic estimated fetal weight in detecting IUGR: A clinical application of Bayes' theorem
Authors: Simon Nicolas V. , Surosky Bruce A. , Shearer David M. , Levisky John S.
Published: February 2007

Four hundred and five women with singleton pregnancies and fetal age determination by crown‐rump length were classified on the basis of their prenatal clinical findings into four risk categories for intrauterine growth retardation (IUGR), defined as a neonatal weight below the 10th percentile of age‐dependent birth weight distribution curve. The incidence of IUGR in these four groups were 3.5% (very low risk), 20.6% (low risk), 49.6% (intermediate risk), and 88.0% (high risk). Severe growth retardation (birth weight <2.5th percentile) increased from 0% to 76.0% as the incidence of IUGR increased throughout the risk groups. The effect of these pretest risks on the prediction of severe IUGR by sonographic estimated fetal weight (EFW) was evaluated. The positive predictive value of the test, as well as the probability of having a growth‐retarded infant after a normal EFW was obtained were considerably higher when the pretest probability of IUGR increased. In the very low risk group, the probability of severe IUGR was negligible regardless of the EFW. When the EFW was <10th percentile of our age‐dependent EFW curve, the probability of severe IUGR in the other risk groups was high enough to warrant fetal well‐being surveillance and for timely interruption of gestation as appropriate. However, when the pretest probability was high, the risk of severe IUGR in spite of an EFW within the 10th percentile to 90th percentile remained sufficient to require fetal well‐being surveillance as well. The study shows that placing ultrasound results in the context of the pretest risk of IUGR may improve clinical decision making in pregnancies complicated by fetal growth retardation.
Acceleration time in cerebral arteries of preterm and term infants
Authors: van de Bor Margot , Walther Frans J. , Sims Maureen E.
Published: February 2007

We measured the acceleration times in the pericallosal, internal carotid, and basilar arteries with two‐dimensional/pulsed Doppler ultrasonography in 145 nondistressed preterm and term infants between 24 and 48 hours after birth. In all three arteries we found a linear relationship between the acceleration time and menstrual age or birth weight. These findings were determined by changes in peak systolic flow velocity, but not by changes in mean arterial blood pressure or cardiac output. We speculate on an important role for cerebral autoregulation in the acceleration time variations between newborn infants of differing menstrual ages and birth weights.
Transvaginal sonographic technique: Targeted organ scanning without resorting to “planes”
Authors: Rottem Shraga , Thaler Israel , Goldstein Steven R. , Timor‐Tritsch Ilan E. , Brandes Joseph M.
Published: February 2007

The orientation of the sonographer performing a transvaginal scan is currently based on a concept of anatomical planes, which is customary in transabdominal sonography. We challenge this concept and propose a different approach altogether based on focusing on target organs rather than anatomic planes. The problem of orientation in transvaginal sonography stems from the following: (1) There is a very short distance between the relatively high‐frequency transvaginal transducer‐probe and the scanned area; a close‐up image is generated encompassing a single organ or only part of it. (2) The scanning angle is initially perpendicular to that of abdominal sonography. (3) Transvaginal sonography is an endocavitary dynamic scanning technique. According to the experience in our department (30,000 examinations during the past 4 years) and in two other medical centers, best results from the transvaginal ultrasonographic examination are achieved when the operator searches for every specific organ as the main target, without resorting to pelvic “planes.” The guidelines for targeted organ scanning and the associated change in orientation are reported together with the limitations. Targeted organ scanning without resorting to “planes” helps the operator to resolve the problem of orientation during the transvaginal ultrasonographic examination, and to simplify the procedure to a great extent.
Criteria for Transvaginal sonographic diagnosis of ectopic pregnancy
Authors: Rottem Shraga , Thaler Israel , Levron Jacob , Peretz Bezalel A. , Itskovitz Joseph , Brandes Joseph M.
Published: February 2007

Transvaginal ultrasonography was performed in 1150 patients suspected of having an ectopic gestation. The criteria for transvaginal sonographic diagnosis of ectopic pregnancy were established by targeted scanning of the pelvic organs and spaces. Sonographic assessment of tubal pregnancy and its differential diagnosis were based on six criteria: (1) the presence or absence of gestational structures within the fallopian tube, (2) the presence or absence of amorphous material in a dilated fallopian tube, (3) the presence or absence of indirect signs of ectopic pregnancy within the pelvis, (4) the echogenicity of a suspected finding relative to the ovary, (5) the presence or absence of flow (of lacunar origin) within the suspected sonographic finding, and 16) the relationship of a suspected sonographic sign to an intentionally displaced ovary. The latter 3 criteria help differentiate between tubal gestation and a corpus luteum. We believe these diagnostic criteria should be applied when performing transvaginal sonographic scanning of patients suspected of having an ectopic gestation.
The uterus: A new look with transvaginal sonography
Authors: Lewit N. , Thaler I. , Rottem S.
Published: February 2007

Targeted scanning of the uterus and its adjacent structures is made possible by high‐resolution transvaginal sonography. A systematic approach is applied so that the normal anatomy and abnormal processes in the various uterine components can be visualized. By adopting this method we detected various pathologies in the cervix, endometrium, myometrium, and in the uterine vessels and ligaments. Cervical pathology included inflammatory processes, cysts, malignant lesions, and incompetence during pregnancy. By scanning the endometrium, a reflection of the hormonal status of the patient under both normal (e.g., the menstrual cycle) and abnormal conditions may be obtained. More sinister lesions, such as endometrial hyperplasia and carcinoma, can be suspected based on the sonographic appearance of the endometrium. In hydatiform mole, a typical bnographic picture directs the sonographer to the diagnosis. Uterine fibroids are the most common lesion of the corpus uteri, and are readily detected by transvaginal sonography, including any degenerative changes that may complicate this condition. Changes in uterine size, particularly when accompanied by profuse intracavitary fluid, should raise the suspicion of a malignant process. Intracavitary fluid may also be associated with inflammatory lesions (e.g., tuberculosis). Congenital uterine anomalies may be diagnosed and defined by this method. Uterine ligaments are best visualized in the presence of fluid in the pelvis. Intraligamentary masses can be also be detected and defined. Finally, the main vessels supplying the uterus can be visualized, both in pregnant and nonpregnant patients. Using a transvaginal image‐directed Doppler system, flow velocity profiles can be obtained from these vessels and form the basis for defining abnormalities in uterine perfusion.
Classification of ovarian lesions by high‐frequency transvaginal sonography
Authors: Rottem Shraga , Levit Nathan , Thaler Israel , Yoffe Nechemia , Bronshtein Moshe , Manor Dorit , Brandes Joseph M.
Published: February 2007

Two hundred patients suspected of having ovarian pathology were scanned with a 6.5‐MHz transvaginal probe. Normal anatomical structures and abnormal findings were recorded and classified according to their shape, size, location, and sonographic characteristics. The sonographic images were correlated with the surgical findings, whenever available. A sonographic classification of ovarian lesions was compiled according to the presence or absence of the following sonographic components: septae, papillae, loculatione, daughter cysts, solid mass, or fluid, and their relationship to malignancy.
Assessment of female urinary incontinence by introital sonography
Authors: Koelbl H. , Bernaschek G. , Deutinger J.
Published: February 2007

By the use of a vaginal sector scanner, placed to the vaginal introitus (introital sonography), we studied the static and dynamic function of the urethrovesical region in patients with genuine stress incontinence and detrusor instability. Patients with genuine stress incontinence (n = 25) revealed either an increase of the retrovesical angle or the angle of inclination associated with a descent of the bladder neck during coughing. Opening of the bladder neck during cystometry, showing an increase of the detrusor pressure, was observed in patients with motor urge incontinence (n = 10). Application of the technique is recommended in patients with stress incontinence undergoing surgery for objective intraoperative assessment of successful reformation of the urethrovesical junction, irrespective of the surgical procedure. Compared with radiologic techniques, introital sonography has many advantages with no radiation exposure and with minimal inconvenience to the patient.
Color Doppler sonography of portocaval shunts
Authors: Ralls Philip W. , Lee Kevin P. , Mayekawa Donald S. , Boswell William D. , Radin D. Randall , Colletti Patrick M. , Halls James M.
Published: February 2007

Nine patients who had undergone end‐to‐side portocaval shunts were assessed using a sector real‐time color Doppler sonography system. Shunt patency was demonstrated in 8 of 9 patients by detection of color‐coded flow within the portal vein, in the anastomotic region, and in the inferior vena cava adjacent to the shunt. Color flow could not be detected in 1 patient. This patient had no evidence of shunt compromise. Spectral Doppler studies were also performed in these patients and flow was demonstrated in all 8. In these instances, information available with color Doppler imaging allowed visualization of the shunt even when it had not been apparent on preliminary real‐time grey‐scale imaging.

This study, which does not assess accuracy, nevertheless suggests that color flow Doppler sonography may prove useful in assessing patients with portocaval shunts.
Normal volume of the thyroid gland in children
Authors: Ueda Daisuke
Published: February 2007

This study has attempted to establish normal values for the pediatric thyroid gland volume. The real‐time ultrasound images of the thyroid gland in 300 healthy children were prospectively analyzed to determine the normal thyroid gland volume. The volume was calculated assuming each lobe of the thyroid gland to be a prolate ellipsoid. The thyroid gland volume was correlated with height, weight, body surface area, and age. Mean thyroid gland volume as a function of height was obtained. No significant difference was observed between males and females in each height group.
Prediction of brain blood flow using pulsed Doppler ultrasonography in newborn lambs
Authors: Martin Christopher G. , Hansen Thomas N. , Goddard‐Finegold Jan , Leblanc Adrian , Giesler Mark E. , Smith Sherilyn
Published: February 2007

The purpose of this study was to evaluate the ability of pulsed Doppler ultrasonography to predict brain blood flow by comparing measurements made in basal cerebral arteries using a pulsed Doppler system with measurements of brain blood flow using radioactive microspheres in lambs. We measured the instantaneous maximum velocity during peak systole and end diastole and the mean velocity over the pulse cycle in baisal cerebral arteries, calculated Pourcelot's index of resistance and Gosling's pulsatility index, and used regression analysis to compare the pulsed Doppler measurements with brain blood flow measured with radioactive micro‐spheres.

Pulsed Doppler measurements of the peak systolic, end diastolic, and mean flow velocity in basal cerebral arteries were directly related to brain blood flow. In contrast, no linear relationship was detected between the resistance or pulsatility indices and brain blood flow measured by microspheres (p > 0.14). Prediction of brain blood flow for individual subjects lacks the quantitative precision necessary for use as a clinical tool. However, the direct relationship between brain blood flow and the peak systolic, end diastolic, and mean flow velocities in basal cerebral arteries supports the use of these measurements in clinical research for the qualitative assessment of change in brain blood flow.
Transcranial doppler ultrasonography versus arteriography for assessment of the vertebrobasilar circulation
Authors: Mull Michael , Aulich Albrecht , Hennerici Michael
Published: February 2007

The investigation of the vertebrobasilar arterial system by transcranial Doppler (TCD) ultrasonography is difficult due to the numerous anatomical variations in the posterior circulation. To test the validity of TCD, we compared topographic measurements from vertebrobasilar angiograms and corresponding TCD findings in 58 patients with cerebrovascular diseases (N = 37, 21 affecting the vertebrobasilar system), brain tumors (N = 8), and other neurological diseases (N = 13). Normal TCD recordings of the vertebrobasilar system were confirmed by the angiograms in 25 patients, although the noninvasive method failed to separate morphologic variants (N = 15). In patients with pathological conditions of the vertebrobasilar system revealed by either method (N = 17), the combined use of both hemodynamic and radiomorphologic methods improved the diagnostic validity in 24%. We conclude that TCD examination of the posterior fossa circulation provides unambiguous results only if used in combination with cerebral arteriography.
The contribution of sonography to the measurement of intra‐abdominal fat
Authors: Armellini Fabio , Zamboni Mauro , Rigo Laura , Todesco Tiziana , Bosello Ottavio , Bergamo‐Andreis Ivo Andrea , Procacci Carlo
Published: February 2007

A study was conducted on a group of 50 obese females with a mean body mass index of 39 ± 16, aged 19 years to 60 years, in order to determine if sonography could be adopted as a direct means for measuring intra‐abdominal fat deposits. Adipose tissue evaluation was performed by computed tomography (CT) and ultrasonography (using 3.5‐MHz and 5‐MHz probes) at the L4 level. CT intra‐abdominal fat area (VAT) and ultrasonography visceral thickness from abdominal muscle to aorta were the values mainly considered. Ultrasonographic intra‐abdominal thickness correlated well with VAT (r = 0.669, p < 0.001), supporting the hypothesis that ultrasonography could be useful in the direct evaluation of intra‐abdominal fat deposits.
Sonographic patterns of the affected spleen in malignant lymphoma
Authors: Goerg C , Schwerk W. B. , Goerg K , Havemann K
Published: February 2007

Sonographic examination showed spleen involvement in 43 patients with histological evidence of malignant lymphoma. In 23% of these cases the spleen was of normal size and 77% exhibited variable splenomegaly. Focal lesions could be seen in 27 patients, 16 exhibiting diffuse, small‐nodule transformation of the sonographic parenchymal texture. Hodgkin lymphomas caused both focal (7 of 16) and diffuse (9 of 16), splenic lesions. All non‐Hodgkin lymphomas of high‐grade malignancy exhibited focal lesions, which are larger than 3 cm in diameter in 11 out of 13 patients. In non‐Hodgkin lymphomas of low‐grade malignancy, focal sites and diffuse destruction of splenic tissue texture were found, lesions of under 3 cm in diameter (11 of 13) being characteristic of this subtype.
Male genital tract malformations associated with ipsilateral renal agenesis: Sonographic findings
Authors: Trigaux Jean‐Paul , Van Beers Bernard , Delchambre Francis
Published: February 2007

Ten male patients with ultrasonographic evidence of an internal genital anomaly associated with ipsilateral renal agenesis are presented. The abnormalities consist of seminal vesicle agenesis in 4, seminal vesicle cyst in 3, Wolffian duct remnant in 2, and Mullerian duct remnant in 1. Such developmental defects are due to a primary anomaly of the mesonephros. Due to its capability of visualizing the lumbar and pelvic regions simultaneously, ultrasonography appears to be the first‐choice imaging modality for the screening of such genitourinary developmental malformations.