bluuebunny/crossref_metadata_2025 huggingface dataset:
Doppler assessment of renal blood flow velocity waveforms in the anemic fetus before and after intravascular transfusion for severe red cell alloimmunization
Authors: Mari Giancarlo , Moise Kenneth J. , Deter Russell L. , Carpenter Robert J.
Published: February 2007

Image‐directed pulsed Doppler ultrasonography demonstrated a decrease in the pulsatility index of the renal artery in 9 anemic fetuses (less than 30 weeks, menstrual age) soon after intravascular transfusion. The pulsatility index returned to pretransfusion values the day following the transfusion. End diastolic blood velocity in the renal artery could not be measured before the transfusion, was detectable immediately after the procedure, and was again nonmeasurable one day after the transfusion. These data suggest an increase in renal blood flow in the anemic fetus soon after intravascular transfusion to eliminate excess fluid.
Echogenic renal pyramids in children
Authors: Jequier Sigrid , Kaplan Bernard S.
Published: February 2007

A retrospective study of 68 children with increased medullary echogenicity on renal ultrasound (US) examination showed nephrocalcinosis to be present in 42 patients. The cause was believed to be iatrogenic in 30 and noniatrogenic in 12. Furosemide therapy was responsible for 11 of the cases of iatrogeic nephrocalcinosis and vitamin D therapy for the remaining iatrogenic cases.

Noniatrogenic nephrocalcinosis was seen with hypercalcemia, hypercalciuria, renal tubular acidosis and dystrophic calcification following renal tubular necrosis.

In 26 patients, medullary deposits of urates or proteins, medullary fibrosis, or vascular congestion (due to a variety of diseases) appeared to account for the finding. The possibilities should be added to the differential diagnosis of hyperechoic renal pyramids when nephrocalcinosis is unlikely.
The role of sonography in the diagnosis and management of urachal abscesses
Authors: Wan Yung‐Liang , Lee Tze‐Yu , Tsai Chung‐Chueng , Chen Shyr‐Ming Sheen , Chou Fong‐Fu
Published: February 2007

Eighteen cases of urachal abscess were studied with sonography. Their configurations were cone shaped in 11 cases, tubular in 4, curved club shaped, and oval and irregular in one each. Their complications, such as intraperitoneal spread, chronic cystitis, and adhesion to the omentum or the colon, could also be suggested by ultrasonography. Gas was found in 50% of the lesions, which were all larger than 1 cm in diameter. An abscess smaller than 1.2 cm in diameter (which can be as long as 5 cm) can be treated with antibiotics or incision and drainage without total excision. A lesion within the extraperitoneal fat space of abdominal wall at the midline below umbilicus suggests the diagnosis of urachal abscess in cases of umbilical discharge and/or when the lesion extends to the umbilicus.
Fetal loss rate after ultrasonically documented cardiac activity between 6 and 14 weeks, menstrual age
Authors: Hill Lyndon M. , Guzick David , Fries Joanne , Hixson Joyce
Published: February 2007

The pregnancy outcome of 347 patients with a confirmed, viable intrauterine pregnancy between 6.0 and 14.0 weeks, menstrual age, was determined. The miscarriage rate was 4.2% in a subgroup of patients without vaginal bleeding, as compared with 12.7% in a subgroup with bleeding (χ2 = 7.4, p < 0.006). First trimester vaginal bleeding was a significant covariate in the determination of the spontaneous miscarriage rate after fetal cardiac activity has been confirmed.
Liver hemodynamic flow balance by image‐directed Doppler ultrasound evaluation in normal subjects
Authors: Bombelli Luigia , Genitoni Valerio , Biasi Salvatore , Materazzo Carlo , Bonfanti Giuliano
Published: February 2007

Image‐directed Doppler ultrasonography of main hepatic vessels (hepatic artery, portal vein, hepatic veins, and inferior vena cava (IVC) was performed in 22 healthy volunteers, 20 years to 65 years of age. For each vessel an estimate was made of the diameter, velocity time interval (VTI), volume blood flow in relation to heart rate (stroke volume in L/min/beat), and body size (blood flow index in L/min/m2 body surface area). Moreover, a hemodynamic hepatic balance to define a range of values in normal population was described. The summation of flow of hepatic veins and IVC flow, just over renal veins, (= IVC subhepatic flow) was significantly correlated with the IVC flow rate before entrance into the atrium (R2 = 0.90). Hepatic artery flux plus portal vein flux plus subhepatic vein flux was also related to IVC flux before right atrium entrance (R2 = 0.92).

This study confirms the utility and efficiency of Doppler ultrasonography in understanding liver flow hemodynamic balance.
Quantitative texture analysis in echocardiography: Application to the diagnosis of myocarditis
Authors: Ferdeghini Ezio Maria , Pinamonti Bruno , Picano Eugenio , Lattanzi Fabio , Bussani Rossana , Slavich Gianni , Benassi Antonio , Camerini Fulvio , Landini Luigi , L'Abbate Antonio
Published: February 2007

Altered myocardial texture associated with inflammatory infiltration or fibrosis of the myocardium has already been described using qualitative and subjective analysis of two‐dimensional echocardiograms. The aim of this work is to test whether quantitative analysis of regional image texture in two‐dimensional echocardiograms would be an accurate method to identify myocarditis and myocardial fibrosis. A set of 20 two‐dimensional studies with endomyocardial biopsy evaluation was examined in 13 patients. Biopsy‐proven myocarditis was present in 8 studies; myocarditis and fibrosis in 4; fibrosis in 3; healing/healed myocarditis in 5. A control group of 8 normal subjects was also studied by echocardiography. After quantitative texture analysis of the first order, entropy appeared to consistently differentiate myocarditis from controls. Among second‐order parameters, patients affected by myocarditis or fibrosis showed a decreased entropy and higher angular second moment versus controls.

We conclude that myocarditis and fibrosis induce similar image texture alterations in ultrasonic images, with increased spatial heterogeneity of the gray level distribution, which can be differentiated from normal structures with digital image analysis techniques.
Definition of normal female pelvic floor anatomy using ultrasonographic techniques
Authors: Benson J. Thomas , Sumners James E. , Pittman J. Scott
Published: February 2007

Urogynecology deals with anatomic and physiologic defects of the female pelvic floor, including urinary and anal incontinence. Ultrasonographic investigation of the female pelvic floor may be helpful in diagnosis and management of both symptom complexes. To interpret pelvic floor ultrasound studies, normal parameters are necessary. Ten asymptomatic control subjects were studied for internal and external anal closing pressures, anal‐rectal angles, puborectalis muscle movement, position of urethral egress, and amount and direction of urethrovesical junction mobility. Means and standard deviations for each parameter were obtained. Comparison to studies performed during the same time interval on patients symptomatic for urinary or anal incontinence is discussed.
Ultrasonographic studies on abdominal complications in patients receiving marrow‐ablative chemotherapy and bone marrow or blood stem cell transplantation
Authors: Dohmen Kazufumi , Harada Mine , Ishibashi Hiromi , Taniguchi Shuichi , Kudo Jiro , Shimamura Ryuji , Niho Yoshiyuki
Published: February 2007

Abdominal complications were evaluated with ultrasonography in 20 patients who received marrow‐ablative chemotherapy and bone marrow or blood stem cell transplantation for the treatment of hematologic malignancies. Ultrasonographic findings compatible with veno‐occlussive disease of the liver, cytomegalovirus infection of the colon, hepatic lesion of graft‐versus‐host disease, and cyclophosphamide‐induced hemorrhagic cystitis were demonstrated in 6 of these patients. In addition, ascites, pleural effusion, gall bladder wall thickening, and hepatosplenomegaly were easily detected. Since ultrasonography is noninvasive and can be repeated, ultrasonographic studies are useful for evaluating and monitoring abdominal complications which are frequently encountered in these transplant patients.
Doppler waveforms in the renal arteries of normal children
Authors: Friedman Deborah M. , Schacht Robert G.
Published: February 2007

Blood velocity waveforms in peripheral arteries vary such that decreasing vascular resistance results in a relative increase in diastolic velocity at steady state. We measured blood velocity in renal arteries of 20 children (age: 119 months ± 37 months; weight: 38 kg ± 15 kg) to establish normal values, and to explore the relationship between these waveforms and central hemodynamics. Using image‐directed pulsed Doppler echocardiography, M‐mode measurements and cardiac index were recorded. Renal hila were visualized via the flank for Doppler sampling. Peak systolic velocity (A) and minimal diastolic velocity (B) were determined. The results (mean ± SD) were as follows: Renal artery A/B = 2.9 ± 0.74 (range 1.9 to 5.1). Characteristic waveforms were identical bilaterally and had continuous diastolic foward flow: A/B was independent of central hemodynamics within the resting normal range, varying inversely with age and size.
The slit infrahepatic IVC: Pathologic entity or normal variant?
Authors: Rak Kevin M. , Hopper Kenneth D. , Tyler Harry N.
Published: February 2007

A common finding on abdominal ultrasound and CT examinations is variation in the size of the inferior vena cava (IVC). On occasion the infrahepatic IVC even assumes a slit‐like appearance. Though commonly related to respiratory change and to the degrees of intra‐abdominal pressure, some have claimed the slit‐IVC may be an indicator of hypovolemia. To study this phenomenon, we evaluated prospectively the IVC in 26 normal volunteers. These individuals were studied supine by dynamic image ultrasound at end‐inspiration, end‐expiration, and during the Valsalva maneuver. The size of the IVC was maximal with the patient supine and at end‐inspiration (A–P 1.8 cm). The subhepatic IVC decreased in size at end‐expiration (A–P 1.2 cm) and frequently collapsed with the Valsalva maneuver (A–P 0.7 cm). Dramatic changes in the size of the IVC with changes in ventilation are normal variants. The use of the slit‐IVC to diagnose hypovolemia should be done with caution.
Ultrasonographic appearance of dermoid and epidermoid cysts in the head and neck
Authors: Yasumoto Mayumi , Shibuya Hitoshi , Gomi Naoya , Kasuga Tsutomu
Published: February 2007

The ultrasonographic features of 6 histologically proven dermoid and epidermoid cysts in the head and neck are reported. All 6 cysts had internal echoes, with a solid appearance. Five of the 6 were echogenic, with only slight or no posterior echo enhancement. Amorphous keratinous debris from keratinizing stratified squamous epithelium filled the lumen of each cyst, producing the internal echoes. Most of the true solid tumors examined were generally of lower echogenicity, and could be differentiated from dermoid and epidermoid cysts ultrasonographically, although lipomas were indistinguishable from these cysts.
Ophthalmic and cerebral blood flow velocities in preterm infants: Influence of ambient lighting conditions
Authors: Baerts Willem , Valentin Ria A. C. , Sauer Pieter J. J.
Published: February 2007

Doppler ultrasound was used to study ophthalmic and middle cerebral artery flow velocities at different ambient lighting conditions in 28 preterm infants in the first week of life. We found significant increases of ophthalmic and middle cerebral artery blood flow velocities when ambient light was increased from moderate to intense. Flow velocities in the ophthalmic artery increased significantly more than in the middle cerebral artery. Doppler ultrasound studies of ophthalmic blood flow velocity may assist in answering the intriguing question whether light‐induced changes of ocular perfusion play a role in the development of retinopathy of prematurity.
Sjogren syndrome: Comparison of sialography and ultrasonography
Authors: Takashima Shodayu , Morimoto Shizuo , Tomiyama Noriyuki , Takeuchi Noriyuki , Ikezoe Junpei , Kozuka Takahiro
Published: February 2007

Ultrasonography and sialography of parotid glands were prospectively performed on 30 patients with Sjogren syndrome and follow‐up ultrasonography was done on 12 patients. Ultrasonography revealed multiple hypoechoic areas (MHA) 2 mm to 5 mm in diameter within the glands in 43% of the patients with intermediate severity of the disease, either homogeneous or slightly nonhomogeneous parotid glands in patients with early stage of the disease, and marked nonhomogeneous glands in patients with advanced diseases. Follow‐up ultrasonography showed MHA in one patient, reduction in nonhomogeneity in another three, and no interval changes in the remaining cases. Pathologic studies suggested that MHA represent enlarged parotid lobules replaced by lymphocytic infiltration. We suggest that MHA are characteristic of Sjogren syndrome and that ultrasonography is useful in following the course of the disease and response to treatment.
Measurement of femoral torsion with ultrasound: Evaluation of a new technique using reference lines on the posterior surface of the femur
Authors: Kumar V. , Joseph Benjamin , Verghese Jacob , Ghosh M. K.
Published: February 2007

A technique of measuring femoral torsion employing reference lines on the posterior surface of the femur has been described. This technique was evaluated on 27 dry adult femora and then on 40 adult patients. The technique was found to be reliable and reproducible. The values of femoral torsion obtained by this technique is lower than that obtained when anterior reference lines are used.
Sonographic detection of stones in poorly opacified left intrahepatic ducts
Authors: Changchien Chi‐Sin , Chen Jyh‐Jou , Tai Dar‐In , Chiou Shiah‐Shien , Kuo Chung‐Huang
Published: February 2007

Intrahepatic duct (IHD) stone is a common disease in Taiwan. In some cases, left IHD stones cannot be demonstrated by endoscopic retrograde cholangiography (ERC) or even by percutaneous cholangiography (PTC). This study was designed to evaluate the efficacy of sonography in demonstrating left IHD stones in poorly opacified left IHD by either ERC or PTC.

Of 109 patients with hyperechoic nodular lesions in either the dilated left IHD or atrophic left lobe of the liver, with or without acoustic shadows, 49 patients were excluded because they refused further study. Among the remainder (60 patients), 33 patients had good opacification of left IHD in ERC or PTC. Stones were seen in 31 patients, and tumor obstruction in 2 patients. Twenty‐seven patients had complete or partial absence of the left IHD in cholangiograms. Stones were found at surgery in 23 patients and by CT scan in 3 patients. Mucin‐producing cholangiocarcinoma was found in 1 patient.

The positive predictive value of the demonstration of stones in left IHD by ulrasound was 95% (57/60). Only 15% of patients with atrophy of the left hepatic lobe and stones were demonstrated by sonogram in this series. We conclude that the detection of left IHD stones by ultrasound in patients with poor opacification of the left IHD in cholangiograms is reliable procedure.
Assessment of value of pancreatic pseudocyst amylase concentration in the treatment of pancreatic pseudocysts by percutaneous evacuation
Authors: Duvnjak Marko , Vucelić Borislav , Rotkvić Ivo , Sikirić Predrag , Brkić Tomislav , Banić Marko , Troskot Branko , Supanc Vladimir
Published: February 2007

The aim of our study was to determine the value of the percutaneous pancreatic pseudocyst evacuation. We assessed the relation between the amylase concentration of the pseudocyst contents and the final outcome of the disease treated by the percutaneous evacuation.

Forty‐three patients with a history of acute pancreatitis and pancreatic pseudocysts larger than 5 cm in diameter that persisted beyond 6 weeks were divided into four groups relative to the amylase concentration in the pseudocystic contents and the number of evacuations. The results show a good correlation between low amylase concentration in the liquid pseudocystic contents (less than or equal to 64 WU) and the healing rate after the percutaneous evacuation (p < 0.001).

The percutaneous evacuation of the pseudocysts failed in patients with increased amylase concentrations in the pseudocyst fluid regardless of the number of evacuations.

We conclude that surgical treatment is indicated in patients who have amylase‐rich pseudocyst contents.
Color and conventional image‐directed Doppler ultrasonography: Accuracy and sources of error in quantitative blood flow measurements
Authors: Ranke Carsten , Hendrickx Philippe , Roth Ulrich , Brassel Friedhelm , Creutzig Andreas , Alexander Klaus
Published: February 2007

Accuracy of two systems—conventional (DRF 400, Diasonics) and colorcoded (Angiodynograph, Quantum/Phillips) image‐directed Doppler ultrasonography—was investigated using an in vitro model that generated both monophasic and triphasic pulsatile flow patterns. Estimated and actual blood volume flow rates showed good correlations, but the sampling with a hand‐held transducer led to wide variations in measurement error for the conventional (−69.2% to 50%) and the colorcoded (−79.3% to 265.7%) systems. By performing multiple measurements, one could improve accuracy considering only the maximal values of a series instead of the mean values. Accuracy was impaired by interposed muscular or fatty tissue due to false low time‐average velocity measurements caused by a loss of Doppler signal. Comparison of both systems revealed significant differences between pulsatility index values (p < 0.001), blood flow velocities (p < 0.001), and blood volume flow rates (p < 0.05 for program flow, p < 0.001 for manual and automatic flow program of the color‐coded system).
Doppler echocardiographic measurement of cardiac output in man using mitral annulus method
Authors: Shimamoto Hiroyuki , Shimamoto Yoriko , Kito Hiroyuki , Kawazoe Kohei , Fujita Tsuyoshi , Okamoto Mitsunori
Published: February 2007

The mitral inflow method of measuring cardiac output with pulsed Doppler two‐dimensional echocardiography was developed and validated against the thermodilution technique in 42 patients. A mitral inflow method combined the velocity of left ventricular inflow at the mitral annulus (apical long‐axis view) with the cross‐sectional area of the annulus calculated from its diameter (parasternal long‐axis view). A good correlation was observed between thermodilution and Doppler measurements of cardiac output (r = 0.93). The ratio of Doppler measurements to thermodilution measurements will be between 0.76 and 1.15 for about 95% of cases. There was a good correlation between percentage change in thermal cardiac output and those in Doppler cardiac output (r = 0.95); the limits of agreement were −11.5% to 10.5%, suggesting that this method can be most useful for assessing relative changes in cardiac output.
Mathematical modeling of fetal splenic growth: Use of the rossavik growth model
Authors: Hata Toshiyuki , Deter Russell L. , Aoki Showa , Makihara Ken , Hata Kohkichi , Kitao Manabu
Published: February 2007

Growth of the fetal spleen has been monitored by measurements of the maximal length (SL), profile circumference (SC), and profile area (SA) of the spleen, from 20 weeks to 41 weeks, menstrual age. Growth curves for these parameters have been determined using a specially developed growth curve model [P = c(t)k + s (t)]. R2 values of 94.3%, 94.9%, and 96.3% were obtained for SL, SC, and SA, respectively. Variability analysis indicated some progressive increase in variability with menstrual age for these three parameters. Variability data were used with the growth curve models to determine standard curves for SL, SC, and SA. These standard curves provide a superior means for evaluating the normal splenic growth in the fetus and for identifying splenic abnormalities in utero.
Growth standards for anatomic measurements and growth rates derived from longitudinal studies of normal fetal growth
Authors: Deter Russell L. , Harrist Ronald B.
Published: February 2007

A statistical procedure for deriving growth standards for anatomic measurements and their growth rates from longitudinal studies of fetal growth was evaluated using Rossavik growth models for the biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur diaphysis length (FDL) determined in a previous study of normal fetal growth. For each anatomic parameter, the coefficients c and s of the model was used to define a set of growth curves that constituted the boundary growth curves of a region containing 95% of the growth curves of this data set. The set of boundary growth curves was used to specify the mean, lower limit, and upper limit values for the anatomic parameter and its growth rate at weekly intervals between 14 and 38 weeks, menstrual age.

Comparison of these values to those determined from cross‐sectional studies of fetal growth gave differences of −1.9% to 4.8% (SD: ±0.9 to ±2.6) for mean vs. predicted value of the anatomic measurements. For the lower limit, similar values were 0.4% to 13.8% (SD: ± 1.7 to ±8.8); for the upper limit the values were 8.3% to 18.0% (SD: ±1.5 to ±7.0). Comparisons of HC growth rates determined using polynomial and Rossavik growth models gave values of −3.4% (SD: ±4.4) for mean vs. predicted value, −12.6% (SD: ±10.6) for the lower limit and 5.2% (SD: ±9.3) for the upper limit. The degree of agreement was similar for AC growth rates. These results indicate that reasonable growth standards for anatomic measurements and their growth rates can be determined from longitudinal studies of as few as 20 normal fetuses, although better estimates of normal variability could be obtained with a larger sample.
Incidentally detected renal cell carcinoma: Role of ultrasonography
Authors: Porena Massimo , Vespasiani Giuseppe , Rosi Paolo , Costantini Elisabetta , Virgili Guido , Mearini Ettore , Micali Francesco
Published: February 2007

The widespread use of modern diagnostic imaging techniques, especially computed tomography and sonography, has led to the detection of an increasing number of serendipitous renal neoplasms, with no signs nor symptoms related to the neoplastic renal disease. In the last 4 years, 54 consecutive patients (20 females and 34 males) with renal cell carcinoma were reviewed. In 26 patients (48.15 per cent) the diagnosis was made as an incidental finding by an abdominal ultrasound examination. Clear signs and symptoms related to the neoplastic disease were present in 28 cases (51.85 per cent). The pathologic type of each neoplasm was categorized, and each carcinoma was staged. In the patients not surgically treated, the stage was determined on the basis of the diagnostic imaging reports. The results of this study suggest that the incidentally detected tumors are of a significantly lower stage than the symptomatic tumors (Wilcoxon rank sum test: P < 0.0073 and X2 test: P < 0.013). Early detection of renal tumors may improve the prognosis and the overall survival of patients with renal cell carcinoma and allow one to plan radical or partial nephrectomy, since local extension has a considerable impact on the operative strategy. Our experience emphasizes the role of ultrasound in the increased early detection of renal cell carcinoma.
Diagnosis of portal vein tumor thrombus by pulsed Doppler ultrasonography
Authors: Furuse Junji , Matsutani Shoichi , Yoshikawa Masaharu , Ebara Masaaki , Saisho Hiromitsu , Tsuchiya Yukihiro , Oht Masao
Published: February 2007

The blood flow of portal vein thrombus was studied by pulsed Doppler ultrasonography in 21 patients with tumor thrombus and 14 with blood clot thrombus. Pulsatile waves were observed in 19 of the 21 with tumor thrombus, with backward continuous waves in 3, and forward/backward continuous waves in 2. In contrast, forward continuous waves were observed in 2 of the 14 with blood clot thrombus. By color imaging, the blood flow could be observed in 9 of 14 with tumor thrombus, but in 1 of 7 with blood clot thrombus. Pulsatile and backward continuous waves were characteristic of tumor thrombus.
Tuberculous pleural effusions: Ultrasonic diagnosis
Authors: Akhan Okan , Demirkazik Figen Basaran , Özmen Mustafa N , Balkanci Ferhun , Özkara Seref , Cöplö Lötfi , Emri Salih , Besim Aytekin
Published: February 2007

Twenty patients with tuberculous pleural effusions were studied with ultrasonography. In 18 patients, ultrasonography demonstrated regular pleural thickening which was less than 1 cm except in 1 case. In 4 cases there were a few pleural nodules, whereas in 2 cases the pleural surface showed small nodularity. The latter finding may be diagnostic for a tuberculous etiology. Eighteen patients had multiple, delicate, mobile septations in the effusions, and a lattice‐like appearance had formed in 6 cases. Computed tomography was obtained in 7 cases, and pleural thickening was demonstrated in 6 of them. Ultrasonography is a useful imaging modality in the diagnosis of tuberculous pleurisy.
Morphological appearance of renal allografts in transplant failure
Authors: Griffin J. F. , McNicholas M. M. J.
Published: February 2007

Renal allograft dysfunction may be due to a variety of causes including acute and chronic rejection, acute tubular necrosis, cyclosporine A toxicity, glomerulonephritis, and surgical causes. It can be difficult to distinguish between these etiologies. Ultrasound is a relatively simple, noninvasive method for imaging the transplant kidney, and is excellent for the diagnosis of surgical complications. The features of rejection include an increase in renal volume, reduced echogenicity, indistinctness of the corticomedullary junction, and splaying of the medullary pyramids. These findings, although suggestive of rejection, cannot differentiate reliably between rejection and other causes of allograft hypofunction. Doppler studies may show an increased resistive index in a kidney undergoing rejection, but this finding may also be seen in other pathological processes and is not specific. A normal ultrasound examination does not exclude rejection. Ultrasound is useful as a baseline examination. Abnormal findings should be interpreted in the light of the clinical situation in each case. Where there is any doubt about the diagnosis, ultrasound‐guided biopsy should be performed. © 1992 John Wiley & Sons, Inc.
Complications of renal transplantation and the role of interventional radiology
Authors: Irving Henry C. , Habib Kashi S.
Published: February 2007

As rejection therapy has improved, the interventional complications of renal transplantation have increased in relative importance as potentially reversible causes of graft malfunction and failure. Ultrasonically guided aspiration and drainage techniques are essential for the characterization and subsequent management of perinephric fluid collections that occur in as many as 51% of cases, of which up to 18% may be clinically significant. In a series of 507 consecutive renal transplants, urological complications were seen in 9% of patients, consisting of ureteric obstruction in 6% and urinary leaks in 3%. Detection via ultrasound scanning, evaluation via antegrade pyelography and pressure‐flow tests, and management via percutaneous nephrostomy and ureteric stenting all contribute to rapid diagnosis and subsequent treatment. Serial ultrasound scanning of renal transplants and the aggressive use of interventional radiological techniques are vital to the early detection and management of complications, and can lead to preservation of graft function and continued improvement in graft survival figures. © John Wiley & Sons, Inc.
Ultrasound assessment of the problem kidney transplant: A surgical prospective
Authors: Shaw J. F. L.
Published: February 2007

Ultrasound investigation contributes to the assessment of transplanted kidneys. Ureteric obstruction and peri‐transplant fluid collections are shown satisfactorily, but the differentiation of graft rejection from cyclosporin A nephrotoxicity and continuing acute tubular necrosis is less straightforward. Doppler ultrasound is used to detect changes in graft blood circulation, but the results of such assessment vary between centers, and further improvements are required to improve the accuracy of diagnosis of causes of graft impairment by noninvasive methods.
Detection of intrauterine growth retardation in twins using individualized growth assessment: I. Evaluation of growth outcome at birth
Authors: Deter Russell L. , Stefos Theodor , Harrist Ronald B. , Hill Reba M.
Published: February 2007

The growth of 17 sets of twins was evaluated at 2 to 3 week intervals from 15 weeks to delivery by measurement of the head circumference, abdominal circumference, and thigh circumference, and estimation of weight. The birth characteristics of these twins were compared to those predicted by Rossavik growth models, derived from second‐trimester ultrasound measurements, using the Growth Potential Realization Index (GPRI) and by comparison to population standards. Newborns were classified as normal or intrauterine growth retarded (IUGR) based on their Neonatal Growth Assessment Score, determined from GPRI values.

All normal twins had birth weights that were appropriate‐for‐gestational‐age and had few abnormal birth measurements. The birth weight differences between normal twin fetuses were all <20%. IUGR twins were both small for gestational age (78%) and appropriate‐for‐gestational‐age (22%), and all had 3 or 4 abnormal GPRI values. In only 40% of the cases was the birth‐weight difference between a normal and an IUGR twin >20%. No single anatomic parameter evaluated at birth adequately separated the normal twins from those with IUGR. These results indicate the need for multiple parameter Individualized Growth Assessment in the detection of IUGR in twins. © 1992 John Wiley & Sons, Inc.
Detection of intrauterine growth retardation in twins using individualized growth assessment. II. Evaluation of third‐trimester growth and prediction of growth outcome at birth
Authors: Deter Russell L. , Stefos Theodor , Harrist Ronald B. , Hill Reba M.
Published: February 2007

Second‐ and third‐trimester growth in 34 twin fetuses was evaluated with ultrasonography by measurement of five anatomic parameters. Rossavik growth models, derived from second‐trimester measurements, were used to specify expected thirdtrimester growth curves. Actual measurements were compared to predicted measurements by calculation of the percent deviations. Growth outcome at birth [normal, intrauterine growth retardation (IUGR)] was determined from Neonatal Growth Assessment Scores.

Growth in the second trimester was similar in normal and IUGR twins. In the third trimester, abnormal negative deviations were larger and more numerous in IUGR twins. However, there was considerable individual variability and normal twins also had abnormal negative deviations. In IUGR twins, the first appearance of an abnormal negative deviation was quite variable (range: 28.6 weeks to 35.1 weeks), as was the parameter to show such a deviation.

Prediction of neonatal outcome was poor using individual anatomic parameters but improved considerably with use of all five parameters. However, some fetuses were misclassified when only the number of abnormal negative deviations was used. The Prenatal Growth Assessment Score (PGAS), determined by both the number and magnitude of abnormal negative deviations, predicted neonatal outcomes with a sensitivity of 100% and specificity of 100%. On average, PGAS values were abnormal 5 weeks before delivery. These results indicate that normal and IUGR twins can be separated, using third‐trimester growth patterns, if multiple parameter Individualized Fetal Growth Assessment is employed. © John Wiley & Sons, Inc.
Doppler color flow imaging in the detection and quantitative measurement of the gastroduodenal artery blood flow
Authors: Uzawa Masahiro , Karasawa Eii , Sugiura Nobuyuki , Saotome Naoki , Kita Kazuhiko , Fukuda Hiroyuki , Miki Makoto , Togawa Yasuhiro , Kondou Fukuo , Matsutani Shouichi , Ohto Masao
Published: February 2007

The purpose of this article was to investigate the detection rate of gastroduodenal artery blood flow (GDABF), and to measure its velocity and volume flow rate using Doppler color imaging. The GDABF was detected in 40 of 41 (98%) normal subjects with longitudinal scanning and in 36 (88%) with transverse scanning. The velocity of the GDABF was 21 ± 8 cm/sec (m ± SD) and the volume flow rate was 67 ± 20 mL/min. Without color Doppler, the vascular lumina of the GDA was demonstrated in 27 (66%) subjects by longitudinal scanning and in 26 (63%) by transverse scanning. The hemodynamics of the GDA were revealed noninvasively using Doppler ultrasonography in a patient with a malignant islet cell tumor of the pancreas and one with a ductal cell carcinoma of the pancreas. © 1993 John Wiley & Sons, Inc.
Endovaginal doppler flow measurements of the ovarian artery in patients with a normal menstrual cycle and with polycystic ovary syndrome during in vitro fertilization
Authors: Schurz Brigitte , Schön Hans J. , Wenzl Rene , Eppel Wolfgang , Huber Johannes , Reinold Emil
Published: February 2007

Women with a normal menstrual cycle (n = 21, controls), polycystic ovary syndrome (n = 10) and hypogonadotropic amenorrhea (n = 3) were stimulated with clomiphen‐citrate (4th day to 8th day of the cycle) and with human menopausal gonadotropin (8th day to 11th day). The vascular impedance of the ovary carrying the dominant follicles was monitored by endovaginal pulsed Doppler flow measurement. Simultaneously, serum levels of LH, E2 and 17‐OHP were assayed. Contrary to controls, women with polycystic ovary syndrome or hypogonadotropic amenorrhea showed decreased hormone levels and no lowering of the vascular impedance. In controls, the lower pulsatility index is caused by neovascularization around the dominant follicle and by E2‐induced vasodilatation in the ovarian artery. © 1993 by John Wiley & Sons.
Detection of free peritoneal fluid by transvaginal sonography
Authors: Nichols John E. , Steinkampf Michael P.
Published: February 2007

The recognition of peritoneal fluid is of considerable clinical importance; however, the sensitivity of modern techniques for the detection of this finding has not been determined. The purpose of this study was to assess the utility of transvaginal sonography for the detection of free peritoneal fluid. Nineteen infertile women scheduled to undergo diagnostic laparoscopy were scanned with a 5‐MHz transvaginal probe just before the surgical procedure. Peritoneal fluid was then aspirated laparoscopically, and the volume and location was compared to the sonographic findings. The volume of fluid obtained at laparoscopy ranged from 0 mL to 45 mL (median 8 mL). All patients with fluid volumes ⩽0.8 mL had free fluid identified sonographically. The location of fluid observed sonographically corresponded to that noted at laparoscopy in all cases. Free peritoneal fluid was visualized in 8 (73%) of 11 patients with regular menstrual cycles who were in the follicular phase at the time of the study. We conclude that transvaginal sonography is a sensitive and reliable method for the detection of free peritoneal fluid in anatomically normal women. This finding should not necessarily be considered abnormal, at least in women of reproductive age, nor should it be considered diagnostic of oocyte release. © 1993 John Wiley & Sons, Inc.
Image‐directed doppler ultrasonography: A novel technique for the diagnosis of colorectal liver metastases
Authors: Leen E. , Goldberg J. A. , Robertson J. , Angerson W. J. , Sutherland G. R. , Cooke T. G. , McArdle C. S.
Published: February 2007

Image‐directed Doppler ultrasonography has been used to measure changes in hepatic arterial and portal venous blood flows in 22 controls and 88 patients with colorectal cancer. Doppler Perfusion Index, (DPI, ratio of hepatic arterial to total liver blood flow) and Doppler Flow Ratio (DFR, ratio of hepatic arterial to portal venous blood flow) of controls and patients with overt liver metastases were clearly separated (p < 0.0001). There was a significant reduction in the Hepatic Arterial Resistive Index (HARI) of patients with overt liver metastases (p < 0.0001). Percentage Hepatic Replacement (PHR) by metastases, measured using a computed tomography scanner, did not correlate with DFR or DPI. The results suggest that the measurement of hepatic perfusion changes using image‐directed Doppler ultrasonography may be of value in the detection of small liver metastases. © 1993 John Wiley & Sons, Inc.
Sonographic features of retroperitoneal neurilemoma
Authors: Kuo Chung‐Huang , Changchien Chi‐Sin
Published: February 2007

Seven cases of retroperitoneal neurilemoma confirmed by histology had an ultrasound examination. There were 5 women and 2 men with a mean age of 55. Most of the cases (5/7) had a palpable mass clinically. Of the 7 cases, 4 had a mass with cystic degeneration and internal echoes on sonogram, consistent with the macroscopic findings of tumors. The internal echoes represented blood clots and residual tissue (or septa) in cyst. Or the remaining 3 cases, one showed a confluent lobulated mass, the second had a solitary homogeneous mass with small cysts, and the third one, which was the smallest (4 cm × 4 cm × 6 cm), had a hypoechoic and homogeneous pattern. The sonograms of all 7 cases were consistent with the macroscopic features of the tumors. The sonographic pattern of tumor parenchyma is either homogenously hyperechoic or hypoechoic. Because of the cystic degeneration, hemorrhage, and residual tissue of retroperitoneal neurilemoma, the sonographic pattern was variable. © 1993 John Wiley & Sons, Inc.
Chronic liver disease: Comparison of ultrasound patterns with laparoscopy and biopsy
Authors: Martínez‐Noguera A. , Calonge E. , Coscojuela P. , Soriano G. , Martí‐Vicente A. , Teixidó M.
Published: February 2007

We studied the correlation of ultrasound patterns with laparoscopy and biopsy results in 140 patients with chronic liver disease (CLD). Of the 23 patients with a normal ultrasound pattern (N), biopsies revealed CLD in 18; in the 22 patients with unspecific hepatomegaly (H), biopsies disclosed CLD in 20; and in the 64 patients with a homogeneous bright pattern (HB), biopsies showed CLD in 62. All 22 cases of heterogeneous bright pattern (HTB) and all 9 patients with nodular pattern (ND) had CLD. In conclusion, it appears that the HTB and nodular ultrasound patterns confirm the presence of CLD, the HB pattern is suggestive of CLD, but diagnosis of CLD cannot be made from N and H patterns. © 1993 John Wiley & Sons, Inc.
High‐resolution ultrasonography in the diagnosis of scrotal pathology: II. Tumors
Authors: Gerscovich Eugenio O.
Published: February 2007

Ultrasonography is a readily accessible imaging modality. It is relatively inexpensive, is noninvasive, and requires no ionizing radiation or previous preparation. For these reasons, ultrasound is the examination of choice in the study of the scrotum and its contents. We present a review of the pathology of the scrotum and its contents. For that, we cite multiple sources of the current medical literature and illustrate them with cases performed at the University of California Davis Medical Center During the last 2.5 years. This article deals with testicular and extratesticular tumors. Within testicular tumors, we describe primary tumors, such as those of germ cell and stromal origin, and secondary tumors of the lymphoproliferative and nonlymphoproliferative (metastatic) types. The most common extratesticular tumors are discussed. © 1993 John Wiley & Sons, Inc.
Evaluation of triplet growth status at birth using individualized growth assessment: Comparison with conventional methods and development of a new classification system
Authors: Hata Toshiyuki , Deter Russell L. , Hill Reba M.
Published: February 2007

A new growth classification system for triplets based on individual growth curve standards provides new information on the growth status of triplets at birth.

Objectives. The objectives of this study were to characterize growth outcome at birth in triplet pregnancies using Individualized Growth Assessment methods, and to compare these results to conventional methods of growth outcome evaluation.

Study design. Rossavik growth models derived from second‐trimester ultrasound measurements were used to predict the birth characteristics of 21 triplet neonates. Actual measurements of weight, head, abdominal, and thigh circumferences at birth were compared to population standards and to predicted values, the latter by calculation of Growth Potential Realization Index (GPRI) values. GPRI values were calculated using singleton (measurement procedure correction) and triplet (measurement procedure correction + decreased soft tissue deposition) correction factors (SCF, TCF). Neonatal Growth Assessment Scores (NGAS) were calculated using both sets of GPRI values.

Results. Three types of triplet neonates were identified. Group I (33.3%) were normal with both types of NGAS values, had very few abnormal GPRI values or anatomic measurements, and were all appropriate for gestational age. Group III (14.3%) were abnormal with both types of NGAS values, most GPRI values were abnormal, and all were small for gestational age. Group II (52.4%) had abnormal NGAS values when calculated from GPRI values determined with SCF and normal NGAS values when calculated from GPRI values determined with TCF. All but one was AGA. Almost all GPRIwT and GPRIThC values were abnormal using SCF and normal using TCF.

Conclusion. Although growth outcome in triplet neonates can be normal (Group I) or intrauterine growth retarded (Group III), the majority are in an intermediate group (Group II) characterized by a decrease in soft tissue mass, which may or may not be pathological. © 1993 John Wiley & Sons, Inc.
Sonographically detected testicular microlithiasis and testicular carcinoma
Authors: Patel Maitray D. , Olcott Eric W. , Kerschmann Russell L. , Callen Peter W. , Gooding Gretchen A. W.
Published: February 2007

Testicular microlithiasis is an uncommon abnormality that produces the characteristic sonographic appearance of diffuse, punctate, hyperechoic foci throughout the testicular parenchyma. We have detected this distinctive sonographic pattern in 4 patients during a seven‐year period. Three of the patients had proven concurrent testicular carcinoma. We describe our experience and review previous reports of testicular microlithiasis. We conclude that testicular microlithiasis may be associated with testicular neoplasia, and advocate particularly careful evaluation and followup of the testes when this abnormality is detected. © 1993 John Wiley & Sons, Inc.
Breast masses with mixed cystic‐solid sonographic appearance
Authors: Omori Liria Mariko , Hisa Naofumi , Ohkuma Kiyoshi , Fujikura Yuji , Hiramatsu Kyoichi , Enomoto Kouji , Ikeda Tadashi , Mukai Makio
Published: February 2007

Retrospective analysis was performed for 56 breast masses with mixed cystic and solid sonographic patterns encountered in the last 5 years at Keio University Hospital, with the objective of elucidating their significance. The lesions were classified into two major groups: tumor with cyst (TWC—solid mass with cystic component) and intracystic tumor (ICT—cystic mass with solid component). According to the pathological diagnosis, 57% were benign and 43% were malignant. Fifty eight percent of malignant lesions were shown to have a TWC pattern and 42% an ICT pattern. Among benign lesions, 66% were shown to be TWC and 34% ICT. In malignant tumors, 96% of the cases showed irregular shape and heterogeneous internal content. Even in benign lesions, a high incidence of irregular shape and rough border was found, although the predominant internal echo texture was homogeneous, and threedimensional (3‐D) contour was not clear. In conclusion, we observed that in the TWC group, the lack of a defined 3‐D contour is the most important criterion, and tumors with multiples cysts tend to be benign. © 1993 John Wiley & Sons, Inc.
Lessons from intravascular ultrasonography: Observations during interventional angioplasty procedures
Authors: Tobis Jonathan M. , Mahon Donald J. , Goldberg Steven L. , Nakamura Shigeru , Colombo Antonio
Published: February 2007

This article reviews many of the applications of intravascular ultrasonic imaging for coronary and peripheral arterial disease. In vitro studies demonstrate an excellent correlation between ultrasound measurements of lumen and plaque crosssectional area compared with histologic sections. In vivo clinical studies reveal the enhanced diagnostic capabilities of this technology compared with angiography. Ultrasonic imaging also permits visualization of the atherosclerotic plaque itself for the first time in vivo. In addition to accurately describing the plaque morphology, ultrasonography can identify some of the tissue characteristics of the plaque. During interventional procedures, ultrasonic imaging has been shown to be beneficial for enhanced diagnosis as well as improvement of our understanding of the mechanism of newer interventional devices such as directed atherectomy, rotational or TEC atherectomy, or excimer laser. Initial studies suggest that ultrasound guidance of intravascular stent deployment may be critical for optimizing stent placement. Randomized studies are currently in progress to determine whether the guidance provided by intravascular ultrasonic imaging will alter the results of interventional procedures so that the restenosis rate can be improved. © 1993 John Wiley & Sons, Inc.
Myocardial contrast echocardiography: Enhancement of perfusion images by color coding
Authors: Dávila‐Román Victor G. , Barzilai Benico
Published: February 2007

To determine whether real‐time color coding enhances the detection of myocardial perfusion through the use of echocardiographic contrast agents, we used a recently developed real‐time color system during contrast injection in six open‐chest dogs. Small amounts of echocardiographic contrast were injected into the left atrium. Short‐axis epicardial images were obtained with a 5‐MHz transducer before and after left anterior descending artery ligation. Gray‐scale and rainbow‐color map images were obtained for each contrast agent. The color map allowed detection of small increment in echo intensity that were not evident with routine gray‐scale imaging. Thus, realtime color coding may improve the detection of myocardial perfusion with echocardiographic contrast agents. © 1994 John Wiley & Sons, Inc.
Ultrasonography versus clinical examination in evaluation of testicular tumors
Authors: van Dijk Roelof , Doesburg Wim H. , Verbeek André L. M. , van der Schouw Yvonne T. , Debruyne Frans M. J. , Rosenbusch Gerd
Published: February 2007

The diagnostic results of clinical examination and gray‐scale ultrasonography for scrotal pathology were compared in 411 patients. Sensitivity and specificity of the clinical diagnosis of a testis tumor improved significantly with the use of ultrasonography. Criteria for the ultrasonographic diagnosis of a testicular tumor were evaluated. We had no false‐negative ultrasonographic diagnoses, and they have rarely been reported in the literature. With ultrasonography, the number of false‐positive clinical diagnoses was reduced from 11 to 5. © 1994 John Wiley & Sons, Inc.