bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasonic signs of imminent ovulation
Authors: Picker Fracog Richard H. , Fracog David H. Smith , Mrcog Malcolm H. Tucker , Saunders Douglas M.
Published: February 2007

Two consistent signs of imminent ovulation in the Graafian follicle have been identified using ultrasound. These signs are a line of decreased reflectivity around the follicle and a crenation pattern within the follicle. The signs may be useful in programs such as in vitro fertilization and artificial insemination, in which timing of ovulation is critical.
Estimation of fetal weight by ultrasound
Authors: Jordaan Harold V. F.
Published: February 2007

Birth weight (BW) and log10 birth weight (LBW) are expressed as linear, multilinear, parabolic, and polynomial regression functions of the abdominal circumference (AC), and combinations of fetal index measurements, namely, AC and head circumference (HC); biparietal diameter (BPD) and AC; and BPD, HC, and AC. The relationship of somatic weight and log10 somatic weight to AC was similarly determined. The analysis generated 20 equations whose accuracy in providing BW estimates is compared. Several equations provide BW estimates whose mean percentage deviations from measured BWs do not differ significantly. The deviations, however, have the smallest variance when BW is estimated from the HC and AC either by using a multilinear regression equation or by deriving separate estimates of brain and somatic weights from these index measurements. The role of individual and population differences in fetal anthropometry as causes of error in estimating BW by different methods is discussed. Because HC is a function of both BPD and occipito‐frontal diameter (OFD), it is a better brain‐size modulus than the commonly used BPD and avoids the errors of underestimation which occur when the BPD is unusually small in cases of dolichocephaly. A comparison of ponderal growth in American and South African fetal populations shows differences throughout most of the gestational range (26–40 wk) analyzed in this study.
The use of ultrasound in evaluating problems and complications of genetic amniocentesis
Authors: McArdle Colin R. , Cohen Wayne , Nickerson Carl , Hann Lucy E.
Published: February 2007

A prospective study of 460 midtrimester amniocenteses performed with ultrasonic guidance was made to determine the problems that occur during amniocentesis and the causes of dry or bloody taps. In 27 instances the needle was seen piercing the fetus. Thickening of the uterine wall, tenting of the membranes, and blocking of flow by the fetus were also observed. The dangers of advancing the needle blindly when no fluid is obtained at the predetermined depth is stressed. The use of active real‐time ultrasonic guidance during amniocentesis is advocated.
Detection of early atherosclerotic lesions by duplex scanning of the carotid artery
Authors: Hennerici Michael , Reifschneider Gerd , Trockel Ursula , Aulich Albrecht
Published: February 2007

A high‐resolution ultrasound B‐mode imaging system combined with a 16‐sequential range‐gated pulsed Doppler flow measuring device was used for the evaluation of nonstenotic extracranial carotid artery disease. Various types of atherosclerotic lesions were differentiated by Duplex system examinations in 54 carotid arteries examined in vitro in a postmortem study and in 51 carotid arteries examined in vivo from patients with angiographically proven cerebrovascular disease. In addition, the multigated Doppler system allowed the analysis of flow velocity profiles throughout the carotid arteries, the distinction between intraarterial flow and recent thrombus, and in particular the estimation of local flow alterations, which are diagnostic in the presence of sonolucent and shadowed plaques behind echo‐dense lesions. A number of difficulties, which at present limit the application of Duplex system examination as a noninvasive „stand alone”︁ method for detecting carotid disease, are discussed.
Ultrasonography of the rotator cuff: Surgical correlation
Authors: Crass Jeffrey R. , Craig Edward V. , Thompson Roby C. , Feinberg Samuel B.
Published: February 2007

Rotator cuff tears are a common orthopedic problem. The portions of the cuff most commonly torn are accessible to sonographic examination with appropriate positioning of the shoulder. This study was undertaken to correlate the sonographic appearance of the pathologic rotator cuff with findings at the time of surgical repair. Rotator cuff tears are readily seen with high‐resolution real‐time sonography. Sonography can demonstrate tears not demonstrated arthrographically. In the appropriate clinical setting arthrography may not be necessary if the sonogram demonstrates characteristic findings.
Ultrasonic Examination of the Flexor Tendons of the Fingers
Authors: Khaleghian Rowshan , Lee Jimmy P. K. , Tonkin L. J. , De Geus J. J.
Published: February 2007

Abstract: Static ultrasound was used to examine the cross‐sectional anatomy of the fingers principally to determine the feasibility of demonstrating the normal anatomy of the flexor tendons and also to investigate the possibility of showing pathological anatomy. The study showed that normal and pathologic anatomy of the flexor tendons could be easily demonstrated using the available ultrasound equipment. The exact clinical usefulness and the role of this new procedure awaits further clinical studies with surgical and pathological correlation. Indexing Words: Flexor tendons Fingers · Ultrasound.
Range ambiguity in pulsed doppler ultrasound: The ambiguity clarified?
Authors: Jawad Ibrahim A. , Taylor Marianne L. , Pruitt‐Hudson Freida , Sohn Young Ho
Published: February 2007

Pulsed Doppler ultrasound (PW) can be used to determine the location of frequency shifts within the cardiac chambers or great vessels. However, it is possible to record similar frequency shifts at sample volume locations distal to their original site; this is referred to as range ambiguity (RA). Eleven patients were studied with combined Doppler and two‐dimensional echocardiography (2‐D) to determine the circumstances in which RA occurs. Mapping of various flow patterns with PW was performed in each of four 2‐D views beginning at 2 cm distance from the transducer and at subsequent 1‐cm intervals until the maximal range of the PW was achieved. Range ambiguity was demonstrated only in the four‐chamber view in patients with enlarged cardiac chambers or if an abnormal flow pattern was present. The site of origin of the ambiguous signals was dependent on the pulse repetition frequency (PRF) employed. Range ambiguity occurs more often when a relatively high PRF is used. Range ambiguity may be used for mapping of abnormal flow beyond the range of PW or for recording of high velocities at sample volumes far from the transducer without frequency aliasing.
Sonography of adrenal glands in neonates and children: Changes in appearance with age
Authors: Kangarloo Hooshang , Diament Michael J. , Gold Richard H. , Barrett Cynthia , Lippe Barbara , Geffner Mitchell , Boechat M. Ines , Dietrich Rosalind B. , Amundson Gary M.
Published: February 2007

The sonographic appearance of the normal adrenal gland in children varies with age. In newborns, the cortex is large and hypoechoic, whereas the medulla is relatively small and hyperechoic. With increasing age, the cortex becomes smaller and the medulla relatively larger. The cortex remains hypoechoic and the medulla hyperechoic until age 5–6 months, by which time the gland has become hyperechoic and smaller, with poor or absent sonographic differentiation between cortex and medulla. After 1 year of age, the appearance of the gland is similar to that of the adult gland, with straight or concave borders and a hypoechoic character.
Fetal thigh circumference: A critical evaluation of its relationship to menstrual age
Authors: Deter Russell L. , Warda Ahmed , Rossavik Ivar K. , Duncan Greg , Hadlock Frank P.
Published: February 2007

To provide standards for evaluating fetal thigh circumference measurements obtained with ultrasound, a study of the growth of this parameter during pregnancy was made. Because of possible sampling problems before 22 weeks (menstrual age), this investigation was limited to the 22–40 week time period. Regression analysis indicated that the optimal model (R2 = 88.9%) for describing thigh circumference (ThC) growth was a power function. ThC variability increased with menstrual age, from 1.3 cm at 22 weeks to 3.1 cm at 40 weeks. These data were used to construct a standard growth curve for the ThC.
Cysts in pregnancy discovered by sonography
Authors: Nelson Martin J. , Cavalieri Ralph , Graham David , Sanders Roger C.
Published: February 2007

The incidence of cysts in pregnancy was established with ultrasound. In 3,330 pregnant patients who underwent sonography, 38 adnexal cystic lesions (1.14%) were found. All but two cysts were discovered before 16 weeks. Follow‐up showed that the majority of the cystic lesions resolved spontaneously; these were presumed to represent corpus luteum cysts. Five patients underwent surgery because of persistent cystic lesions; a mucinous cystadenoma, a benign cystic teratoma, a paraovarian cyst, an inclusion cyst, and a tuboovarian abscess were found. Septations and echogenic material were seen within the cystic teratoma and the tuboovarian abscess but the sonographic features of the other operated lesions were identical to those seen in the corpus luteum cysts.
Ruptured uterus: Sonographic diagnosis
Authors: Bedi Deepak G. , Salmon Ann , Winsett Mary Z. , Fagan Charles J. , Kumar Rajendra
Published: February 2007

Sonography was able to suggest a diagnosis of uterine rupture by demonstrating intra‐ or extraperitoneal hematoma in the correct clinical setting. A pelvic abscess complicating a uterine rupture was seen in one case. Previous uterine scar, use of prostaglandins for induction of labor, trauma with a currette, and cornual pregnancy were the implicated etiologic factors. Although the rupture site was never directly visualized by sonography, the combination of sonographic and clinical findings was strongly suggestive of the correct diagnosis.
Clinical experience with intraoperative Doppler color flow imaging in hepatectomy
Authors: Sukigara Minoru , Koga Kazumi , Komazaki Toshiro , Omoto Ryozo
Published: February 2007

Real‐time two‐dimensional Doppler echography (2‐D Doppler), which permits both structural and blood flow evaluations simultaneously, was applied during hepatectomy in three cases. Intrahepatic portal flow was observed in one case both before and after Pringle's maneuver. Hemihepatic blood flow interruption, which was guided by 2‐D Doppler imaging, was tried in two cases. Extrahepatic blood flow was also detected easily with 2‐D Doppler techniques. This approach is useful for both anatomic and hemodynamic evaluation during hepatic surgery.
Ultrasonography of the acute scrotum
Authors: Martin Brigitte , Conte Jacqueline
Published: February 2007

The acute scrotum remains a difficult clinical challenge because of numerous etiologies including inflammatory processes, testicular torsions, traumas, and tumors that can justify early surgery. Ultrasound study appears to be the imaging modality of choice to confirm the clinical assessment. We reviewed 825 scrotal scans performed with high‐resolution scanners; 283 were considered pathologic and classified as follows: 27 tumors (9.5%), 21 traumas including torsions (7.4%), 142 infectious diseases (50.1%), 99 dystrophic diseases (29.2%), and 16 miscellaneous (5.6%). Acute scrotal pain was the only symptom in 83 cases (29.3%). In this paper, we emphasize the different roles of ultrasound depending on the initial clinical presentation, which determines the clinician's questions. In the typical cases, ultrasound has a major role in the prognosis, as it allows evaluation of the severity of the lesions. On the other hand, in atypical cases, ultrasound has a decisive role in planning the management, which will be immediate surgery when sonographic findings highly suspicious for testicular torsion or acute ischemia of the testis are found. Based on our experience, we believe that ultrasound is a highly reliable modality for guiding medical or surgical treatment of an acute scrotum.
Ultrasound findings in Crohn's disease and ulcerative colitis: A prospective study
Authors: Worlicek H. , Lutz H. , Heyder N. , Matek W.
Published: February 2007

In a prospective study, 118 patients with Crohn's disease, 51 patients with ulcerative colitis, and 72 patients with no disease of the intestine proximal to the rectum were evaluated by ultrasound. In Crohn's disease, thickening of the bowel wall and inflammatory masses were detected in 72.08 of the patients. With a transducer having optimal imaging properties in the near range, these findings were detected in 87.2% of a group of 47 patients. In ulcerative colitis, bowel wall thickening was detected in 52.9% of all patients. Thickening of the bowel wall was more marked in Crohn's disease than in ulcerative colitis. Most pathologic findings in Crohn's disease were located in the right lower abdomen, whereas those in ulcerative colitis were in the left abdomen, in particular in the lower quadrant. The frequency of wall thickening was correlated to the activity of the disease in ulcerative colitis but not in Crohn's disease. Considerably increased wall thickness, when localized in the right lower quadrant and found in combination with inflammatory masses or an abscess, suggests Crohn's disease.
Sonographic detection of interstitial pregnancy
Authors: Jafri Syed Zafar Hasan , Loginsky Stephan J. , Selis James E. , Bouffard J. Antonio
Published: February 2007

Interstitial pregnancy is a rare form of ectopic pregnancy that carries a higher morbidity and mortality than other tubal pregnancies. The sonographic findings in 11 cases of proven interstitial pregnancy were reviewed and compared with 12 cases published thus far. An ectopic pregnancy was diagnosed in all cases, and an interstitial location was suspected in five cases preoperatively. An eccentrically located gestational sac surrounded by an asymmetric myometrial mantle and a separate empty uterine cavity with endometrial echoes were the most common findings in our cases. When an interstitial pregnancy is suspected by sonography, confirmation by laparoscopy is recommended.
Ultrasonographic differentiation of hepatocellular carcinoma from metastatic liver cancer
Authors: Yoshida Takanobu , Matsue Hiroto , Okazaki Nobuo , Yoshino Masahiro
Published: February 2007

Ultrasonographic features of tumor nodules in 64 patients with hepatocellular carcinoma and 87 with metastatic liver cancer were analyzed for differential diagnosis. Sonographic characteristics of hepatocellular carcinoma were the mosaic, posterior echo enhancement, and lateral shadow patterns, which were rarely observed in metastatic liver cancers. Small hepatocellular carcinomas, less than 3 cm in diameter, showed a hypoechoic pattern. Metastatic liver cancers originating from the gastrointestinal tract were frequently hyperechoic irrespective of their size and the bull's‐eye‐like pattern was specific for metastases from the lung. These results indicate that ultrasonography is useful for the differential diagnosis of hepatocellular carcinoma and metastatic liver cancer.
Sonographic investigation of the uterus during artificial uterine cavity distention
Authors: van Roessel Jeroen , Wamsteker Kees , Exalto Niek
Published: February 2007

The improvement of sonographic examination of the uterus during artificial uterine cavity distention was studied in 30 consecutive patients in whom a hysteroscopy was indicated. In 10 of 21 patients with a normal sonographic appearence of the uterus, after filling the uterine cavity with Hyskon, various pathologic conditions became visible. In 5 of 9 patients with abnormal sonographic appearance of the uterus, the procedure enabled a more precise diagnosis concerning localization of abnormal echoes in the uterus. The advantage of this method was clearly demonstrated in cases of central echogenic structures, congenital uterine anomalies, myoma's, synechiae, and corpora aliena.
Peripheral arterial duplex scanning
Authors: Moneta Gregory L. , Strandness D. Eugene
Published: February 2007

Recent improvements in duplex ultrasound technology now permit the application of duplex ultrasound to the assessment of arterial occlusive disease from the level of the aorta to the popliteal trifurcation. In our laboratory we have developed duplex waveform criteria for classifying peripheral arterial stenosis into one of five categories: normal, 1%–19% stenosis, 20%–49% stenosis, 50%–99% stenosis and occlusion. When prospectively compared with angiography the duplex examination has a 77% sensitivity and a 98% specificity in determining the presence of a hemody–namically significant lesion (>50% stenosis). The examination can be used clinically to give hemodynamic information about specific arterial lesions, as a screening procedure prior to angiography or angioplasty and as a means of following the results of peripheral arterial surgery and dilatations.
Duplex Doppler examination of the liver and portal venous system
Authors: Koslin D. Bradley , Berland Lincoln L.
Published: February 2007

Duplex Doppler scanning has many applications in the evaluation of the liver and the portal venous system. It can be a useful adjunct to real‐time sonographic identification of normal and variant anatomy, and lesion detection in the liver and porta hepatis. It is able to document both portal venous thrombosis and portal venous hypertension. It plays an important role in the pre‐ and postoperative assessment of patients undergoing portosystemic shunts or liver transplants. It allows the observation and measurement of portal venous systemic physiologic responses. In addition to the above applications, duplex Doppler scanning's future potential, including full‐field color Doppler imaging, is discussed.
A prospective study of the efficacy of B‐scan sonography in the detection of deep venous thrombosis in the lower extremities
Authors: O'Leary Daniel H. , Kane Robert A. , Chase Brenda M.
Published: February 2007

Between 1 July and 31 December, 1985, 53 patients, clinically suspected of having deep venous thrombosis (DVT), were prospectively studied by B‐scan ultrasound prior to lower‐limb venography. Criteria for a positive ultrasound examination included visualization of frank clot, failure of the vein to collapse with compression, and absence of normal phasic flow with pulse Doppler sampling. All (100%) of the contrast venograms were considered of diagnostic quality. Fifty of the 53 ultrasound examinations (94%) were considered diagnostic. Of the 50 patients having venous ultrasound of diagnostic quality, contrast venography was positive in 25 and negative in 25 for DVT. Venous ultrasound was correct in 46 patients, for an accuracy of 92% (46/50). Sensitivity was 88% (22/25), specificity was 96% (24/25), the positive predictive value was 96% (22/23), and the negative predictive value was 89% (24/27). The single most useful sign of thrombosis in ultrasound examinations was the failure of the involved vein to collapse with compression. Venous ultrasound appears to be highly accurate in the detection of deep venous thrombosis of the lower extremity.
Estimated fetal weight: Applicability to small‐ and large‐for‐gestational‐age fetus
Authors: Miller Joseph M. , Kissling Grace A. , Brown Haywood L. , Gabert Harvey A.
Published: February 2007

Ultrasonic formulas using femur length and abdominal circumference with or without biparital diameter were found to be highly accurate in predicting the weight of normal‐sized term infants. The small‐for‐gestational age fetus, however, was overestimated and the large‐for‐gestational‐age fetus was underestimated. The fetal weight formulas tested that were appropriate for the entire study group were not applicable to those fetuses having altered growth.
Ultrasound scanning as a screening technique for hydatidosis in developing countries
Authors: Martin Gaston A. Saint , Larrieu Edmundo , Chiesa Juan C. , Dapcich Carlos , Martinez Emma
Published: February 2007

This study presents new evidence as to the usefulness of ultrasound scanning in field conditions, to screen out hydatidosis in endemic areas, and to compare its detection capability with serological methods. It also intends to demonstrate that for an efficient rural ultrasound screening, neither an experienced ultra sonographer nor expensive and sophisticated equipment is necessary. it can be done by suitably trained personel (eg, nurse, public health worker), using basic equipment, without public health instalations or electricity, thus making it a feasible, simple, fast, and cheap screening method for hydatidosis.
Ultrasonography of rotator cuff tears: A review of 500 diagnostic studies
Authors: Crass Jeffrey R. , Craig Edward V. , Feinberg Samuel B.
Published: February 2007

Ultrasonography of the rotator cuff has been shown to be of value in diagnosing rotator cuff tears. This report summarizes our experience with our first 500 diagnostic examinations.

All patients were examined in the hyperextended internal rotation view with commercially available high‐resolution real‐time ultrasound equipment. Patients were diagnosed as having a rotator cuff tear if a focal echogenic lesion or a defect within the rotator cuff was identified.

This study confirmed the value of ultrasonography for the diagnosis of rotator cuff tears. Accuracy, sensitivity, and specificity all exceeded 90%, and correlated with surgical findings. This was better than arthrography in the same patient population.

Ultrasound is an accurate noninvasive method of examining the rotator cuff for the presence of tears. We suggest that rotator cuff ultrasonography is the procedure of choice for the diagnosis of tears if adequate instrumentation is available.
Significance of scrotal calcifications detected by sonography
Authors: Martin Brigitte , Tubiana Jean‐Michel
Published: February 2007

A total of 468 patients were evaluated using a high‐resolution scanner with a high‐frequency transducer. Scrotal calcifications were diagnosed by sonographic criteria in 22 patients. Size, number, arrangement, and especially location (testicular or extratesticular) were precisely determined.

Calcifications, located within testicular parenchyma, particularly if multiple and grouped, were considered highly suspicious for malignancy, and surgery was mandatory. Based on these sonographic features, 9 patients underwent surgery with pathological examination.

In all, calcifications were confirmed and found in 4 necrotic germ‐cell tumors, in a germ‐cell tumor scar but with intratubular occult seminoma, in 1 epidermoid testicular cyst, in 1 tuberculous epididymo‐orchitis, in 1 granulomatous orchitis, and at last, in 1 ruptured testis with an old hematoma. In the 13 remaining patients, calcification was usually defined as solitary, large, and extratesticular by sonography and considered benign. No changes were seen in follow‐up examinations.
Fetal atrial arrhythmias associated with redundancy/aneurysm of the foramen ovale
Authors: Stewart Patricia A , Wladimiroff Juriy W
Published: February 2007

Fetal arrhythmia was investigated in 148 fetuses. Eight of these fetuses displayed signs of redundancy/aneurysm of the foramen ovale, all in combination with various atrial arrhythmias. At presentation 4 (50%) of these fetuses had mild to moderate congestive cardiac failure and a 5th fetus developed mild cardiac failure four weeks after observation of the aneurysm.

All fetuses survived, but 2 fetuses required early delivery because of the cardiac failure. Unnecessary morbidity resulting from the possible development of cardiac failure may be prevented by regular monitoring in these cases.
Transvaginal ultrasonography in the diagnosis and treatment of infertility
Authors: Itskovitz Joseph , Boldes Rafael , Levron Jacob , Thaler Israel
Published: February 2007

The use of transvaginal sonography (TVS) in the management of infertility is gaining increasing popularity. The improved resolution and better tissue textural differentiation afforded by TVS makes this technique useful in monitoring ovarian follicular growth, ovulation, and corpus luteum formation, and in evaluating the normal anatomy of the uterus and the cervix and their cyclic response to ovarian steroids. Adnexal and cul‐de‐sac abnormalities related to infertility can also be identified. TVS‐guided procedures can be accurately and safely performed; transvaginal follicular aspiration, gamete or embryo transfer to the Fallopian tube, and fetal reduction are just a few of the procedures recently introduced to reproductive medicine.
Sonoembryology: An organ‐oriented approach using a high‐frequency vaginal probe
Authors: Timor‐Tritsch Ilan E. , Peisner David B. , Raju Sashikala
Published: February 2007

First trimester gestations of 95 patients were studied by high‐frequency transvaginal sonography, which permits the imaging of organs shortly after their development. This new technique has great potential for clinical implementation in such cases as accurate gestational dating and malformation workup.
Transvaginal sonographic measurement of fetal kidneys in the first trimester of pregnancy
Authors: Bronshtein M. , Kushnir O. , Ben‐Rafael Z. , Shalev E. , Nebel L. , Mashiach S. , Shalev J.
Published: February 2007

Fetal renal size late in the first trimester of pregnancy was evaluated by transvaginal ultrasonography in 50 patients not at risk for congenital kidney disease and whose pregnancies resulted in a normal outcome. Both kidneys were reliably identified in all patients scanned at 12 weeks, 13 weeks, and 14 weeks, menstrual age. Kidney diameter measurements obtained in this study are presented for reference in evaluating patients in late first trimester whose fetuses are at risk for kidney abnormalities.
The role of transvaginal sonography in chorionic villi sampling
Authors: Popp L. W. , Ghirardini G.
Published: February 2007

Vaginosonography has the potential of improving not only accurate diagnosis preceeding chorionic villus sampling but also the sampling procedure itself. The vaginosonographic diagnostic landmarks of early pregnancies are the contact area between the amnion and the chorion, the insertion of the umbilical cord, the yolk sac and the decidua‐trophoblast complex. The occurrence of a “Swiss‐cheese‐pattern” in the latter structure is a strong hint for an unfavourable outcome of early pregnancy. Vaginosonographically guided puncture is a promising approach for chorionic villus biopsy. The punturing facilities are firmly attached to the high resolution vaginal ultrasound probe. Thus, precise ultrasound‐guided puncture penetrating the vaginal skin and the uterine wall in the shortest possible distance has become possible.
Placenta previa—is the traditional diagnostic approach satisfactory?
Authors: Farine Dan , Peisner David B. , Timor‐Tritsch Ilan E.
Published: February 2007

The accuracy of the diagnosis of placenta previa using transvaginal sonography (TVS) was compared to that of the traditional transabdominal sonography (TAS). Seventy seven women were scanned by both methods and each sonographic diagnosis was compared to the placental location at delivery. TVS was superior to TAS in diagnosing placenta previa and invariably correct in ruling it out. TVS (and TAS) failed to predict the placental location at delivery only in women diagnosed as having marginal placenta previa prior to 35 weeks gestation. The use of the vaginal probe significantly improved the accuracy of the diagnosis of placenta previa.
Color Doppler sonography in acute epididymitis and orchitis
Authors: Ralls Philip W. , Jensen Maureen C. , Lee Kevin P. , Mayekawa Donald S. , Johnson Meade B. , Halls James M.
Published: February 2007

Clinical diagnosis of patients with acute scrotal pain is frequently imperfect. Imaging, using nuclear medicine scintigraphy and hand‐held continuous‐wave Doppler ultrasound devices, has been used in these patients.

We retrospectively analyzed 28 consecutive patients referred for scrotal sonography, all of whom had been imaged using color Doppler sonography. Of 22 patients with confirmed diagnoses, 11 had acute epididymitis/orchitis and 11 had another diagnosis. Ten of 11 patients with acute epididymitis/orchitis had increased epididymal flow. Eight also had increased testicular flow. None of the 11 patients without acute epididymitislorchitis had increased flow.

Our data suggest that color Doppler sonography may be useful in establishing the diagnosis of acute epididymitislorchitis. This might decrease the need for scrotal exploration. No distinction could be made among scrotal lesions in the nonacute epididymitis/orchitis group. Sensitivity was inadequate to reliably detect flow in normal testicles, a prerequisite to accurately diagnose torsion. Newly improved sensitivity may enhance the utility of color Doppler sonography in assessing patients with acute scrotal pathology.
Color flow and image‐directed Doppler ultrasound evaluation of iatrogenic arteriovenous fistulas in the groin
Authors: Roubidoux Marilyn A. , Hertzberg Barbara S. , Carroll Barbara A. , Hedgepeth Carolyn A.
Published: February 2007

Color flow image‐directed Doppler ultrasound was used to image 9 iatrogenic arteriovenous (AV) fistulas in the groin following femoral artery catheterization. Characteristic findings in the color images and spectral waveforms seen in most patients included (1) visible connection between the artery and vein (8 cases); (2) a multicolored speckled mass at the fistula site (7 cases); (3) spreading of color pixels into the extraluminal soft tissues (7 cases); (4) high diastolic flow in the arterial waveform proximal to the fistula site (7 cases); (5) decreased flow in the artery caudal to the fistula (5 cases); and (6) high velocity turbulent flow, sometimes with a pulsatile component, in the vein near the fistula (9 cases). The authors conclude that color flow imaging is useful in differentiating an AV fistula from other complications of femoral artery catheterization, such as pseudoaneurysm or hematoma.
Detection of prosthetic mitral valve leak: A comparative study using transesophageal echocardiography, transthoracic echocardiography, and auscultation
Authors: Chen Ying‐Tsung , Kan Mee‐Nin , Chen Jeng‐Sheng , Lin Wu‐Wei , Chang Micheal‐K , Hu Wei‐Shung , Hwang Dar‐San , Lee Du‐Yi , Hwang Shou‐Le , Chiang Benjamin N
Published: February 2007

Paravalvular leakage is a major complication of prosthetic valve dysfunction. Sixty‐one subjects with valvular heart disease who had received prosthetic mitral valve replacement 5 months to 5 years before (43 received a porcine prosthesis and 18 received Bjork‐Shiley valve prostheses) were evaluated for this complication. Careful auscultation was performed by two experienced cardiologists followed by transthoracic and transeosphageal echocardiography. Physiologic leaks were detected in all Bjork‐Shiley valves, but in only 30% of porcine valves using transesophageal echocardiography. These regurgitant jets were flame‐like, with mean low velocities of 50 ± 12.3 cm/sec and 48 ± 18.2 cm/sec in the two types of valves. Neither transthoracic echocardiography nor auscultation could detect physiological regurgitant jets. Ten cases with paravalvular leak were detected by transesophageal echocardiography and subsequently demonstrated by left ventriculography (7 Porcine, 3 Bjork‐Shiley valves). Pathologic regurgitant jets were seen as high‐velocity, systolic‐retrograde turbulent flow across the prosthesis. However, only 6 cases of prosthetic valve dys‐function were detected by transthoracic echocardiography, 4 cases of mild paravalvular leakage went undetected. Thirteen of the 61 subjects had an apical systolic murmur and suspected prosthetic valve leakage; in 10 of the 13 cases the findings corresponded to those obtained by transesophageal echocardiography. In 3 cases of double valve replacement with Bjork‐Shiley valves the magnitude of the leakage was overestimated by ausculation.
A teaching phantom for sonographers
Authors: Zagzebski Phd James A. , Madsen Phd Ernest L. , Frank Gary R.
Published: February 2007

An anthropomorphic torso section phantom is described that is intended for use during initial stages of ultrasonographer training. The phantom represents a section of the upper abdomen, with simulated ribs, liver, kidney with fat pad, gallbladder, aorta, and bowel gas. Positioned in the liver are ten simulated soft tissue masses, which produce a variety of typical echographic patterns. All simulated soft tissue components are formed of tissue‐mimicking materials that match their corresponding tissue counterparts in terms of speed of sound, ultrasonic attenuation, and density. Construction details are presented and examples of images are shown.
Ultrasound of the common bile duct in patients undergoing cholecystectomy
Authors: Stott Mark A. , Farrands Paul A. , Guyer Peter B. , Dewbury Keith C. , Browning James J. , Sutton Robert
Published: February 2007

One hundred patients undergoing cholecystectomy underwent ultrasonography of the biliary tree on the day prior to surgery. At operation a per‐operative cholangiogram was performed unless stones were palpable in the duct. Pre‐operative biliary ultrasonography accurately identified dilatation of the common bile duct (sensitivity 96%, specificity 95%) but was less accurate at detecting common duct stones (sensitivity 36%, specificity 98%). Thirty three percent of patients with dilated ducts on ultrasound did not have stones in the duct, while 20% of patients with common duct stones had normal sized ducts. We conclude that ultrasonography alone cannot reliably select patients who require exploration of the common bile duct, or select patients for operative cholangiography. Although pre‐operative demonstration of common bile duct dilatation is an absolute indication for operative cholangiography, by itself it does not indicate the need for exploration.
Hyperechogenic “rings” in the periphery of renal medullary pyramids as a sign of renal disease
Authors: Päivänsalo Markku J. , Kallioinen Matti J. , Merikanto Jukka S. , Jalovaara Pekka K.
Published: February 2007

A rare sign of medullary abnormality, hyperechogenic “rings” in the peripheries of renal medullary pyramids, was detected in both kidneys in 21 patients, being associated with normally hypoechogenic medullary centers in 20 of these patients. Our results with 2 cases studied histologically suggest that fibrosis with and without calcifications is one reason for the hyperechogenicity of these medullary pyramids. The clinical history and laboratory tests (serum creatinine, proteinuria) showed signs of kidney disease in 52%, and a renal disease was suspected in an additional 38%. Eight of the patients had disturbances in blood potassium, calcium, or uric acid equilibrium, and 2 of them had a parathyroid abnormality. Calcifications were found on plain radiographs of the abdomen in 1 of the 13 patients. Two were totally asymptomatic and had normal laboratory findings. Hyperechogenic rings in the peripheries of renal medullary pyramids proved nonspecific and showed a poor correlation with the severity of renal disease.
Ultrasound guidance for biopsy of omental abnormalities
Authors: Sistrom Chris L. , Abbitt Patricia L. , Feldman Philip S.
Published: February 2007

We review our two‐year experience with ultrasound‐guided fine needle aspiration biopsy of omental pathology. Eleven patients were referred for biopsy of omental abnormalities. Biopsy was performed without complication in all cases and the asprates were positive for malignancy in 9. The discharge diagnosis was ovarian carcinoma in 6 patients, adenocarcinoma of unknown origin in 1, lymphoma in 1, and carcinoma of the colon in 1. The technique requires the use of a linear array transducer for biopsy guidance, and is safe, rapid, and easy to perform.
Effect of measurement variability on Rossavik growth model specification and prediction of growth outcome at birth
Authors: Simon Nicolas V. , Deter Russell L. , Kofinas Alexander D. , Grow Daniel R.
Published: February 2007

We have studied how variability in second‐trimester ultrasound measurements affects the process of fetal growth evaluation based on individual fetal growth curve standards specified by Rossavik growth models. The head and abdominal short axes of two second‐trimester scans of a patient with normal fetal growth were increased or decreased by increments ranging from 0.1 cm to values equal to the two standard deviations of the interobserver variability for these measurements—i.e., 0.3 cm for head short axis and 0.4 cm for abdominal short axis. The largest increments affected the Growth Potential Realization Index for weight at birth by 1% to 13% when applied to head short axis, and by 2% when applied to abdominal short axis. In contrast, the same increments had little effect (1%) on the Growth Potential Realization Indices for head and abdominal circumferences. Whereas 0.1‐cm increments had no effect on any of the individual growth models or predicted birth characteristics, some combinations of these small errors involving both head and abdominal short axes changed the Growth Potential Realization Index for weight by as much as 15%, and those for head and abdominal circumferences by 3% and 8%, respectively. Under some scenarios, fetal growth status could be falsely classified as normal or abnormal. These results show that the reliability of individualized growth assessment depends to a great extent on excellent ultrasound technique, at least for certain parameters.
Ultrasonic detection of viscera slide as an indicator of abdominal wall adhesions
Authors: Kodama Issei , Loiacono Laurie A. , Sigel Bernard , Machi Junji , Golub Robert M. , Parsons Richard E. , Justin Jeffery , Zaren Howard A. , Sachdeva Ajit K.
Published: February 2007

Real‐time ultrasonography can detect the movement of viscera immediately deep to the abdominal wall. This motion of abdominal contents is called viscera slide, and is produced by the force of respiratory motion (spontaneous viscera slide) or by manual ballottement of the abdomen (induced viscera slide). Viscera slide was observed in 18 “normal” subjects (no history of previous abdominal surgery or peritonitis) and in 24 subjects at “risk” for abdominal wall adhesions because of previous abdominal operations or past history of peritonitis. In 14 of the 24 “risk” group subjects, spontaneous and induced viscera slide was restricted to excursions of less than 1 cm (58.3%). Operations were performed on 18 patients, which confirmed the fact that restriction of ultrasonically detected viscera slide identified abdominal wall adhesions in all cases, but no adhesions were found in patients with normal viscera slide. This ultrasonic finding of restricted viscera slide may be useful in the preoperative discovery and localization of abdominal wall adhesions prior to laparoscopy or laparotomy.
Ecographic epidemiology of non‐parasitic hepatic cysts
Authors: Caremani Marcello , Vincenti Antonella , Benci Antonio , Sassoli Serenella , Tacconi Danilo
Published: February 2007

An analysis of the epidemiology of non‐parasitic hepatic cysts (NPHCs) has been carried out comparing these data with those of the current literature. This sample shows an incidence of 4.65%, which is greater than those reported by other authors. No difference between the two sexes was seen, but a very high incidence above 40 years of age was found. © 1993 John Wiley & Sons, Inc.
Doppler ultrasound findings in tubo‐ovarian infectious complex
Authors: Tinkanen Helena , Kujansuu Erkki
Published: February 2007

Ten women with tubo‐ovarian infectious complex caused by pelvic inflammatory disease were investigated with vaginal Doppler sonography during the acute and healing phase of the infection. Doppler velocity waveforms were quantitated by the resistance index (RI) and pulsatility index (PI). A low resistance blood flow was found at the margin of the infectious complex. An RI value <0.5 was detected in 6 patients in the acute or subacute phase of infection. The severity of the infection as determined by C‐reactive protein values was inversely correlated to RI and PI. The process of angioneogenesis is speculated to be responsible for this increased flow. The tubo‐ovarian infectious process must be remembered in the differential diagnosis, when an adnexal mass with low resistance blood flow is found in the ultrasound examination. © 1993 John Wiley & Sons, Inc.
A comparison between preoperative magnetic resonance and intraoperative ultrasound tumor volumes and margins
Authors: Leroux Peter D. , Winter Thomas C. , Berger Michel S. , Mack Lawrence A. , Wang Keith , Elliott J. Paul
Published: February 2007

A major obstacle in surgical neuro‐oncology is differentiating the interface between tumor and normal brain. Twenty‐two brain tumors were evaluated preoperatively with magnetic resonance imaging. Intraoperative ultrasonography was used to guide suggical resection of these tumors, and results were compared with surgical and pathologic findings. Ultrasound tumor volume estimates were larger than T1 gadolinium‐enhanced and T1 non‐gadolinium‐enhanced volumes, but these differences did not reach statistical significance. Similarly T2 volumes were larger than the corresponding sonographic volumes, except for the subset of low‐grade gliomas, and in that instance the difference was small, but again the differences were not statistically significant. Ultrasonography enhanced identification of infiltrating tumor cells beyond falsely underestimated tumor margins as defined by T1 images. Ultrasound images helped differentiate edema as seen on T2 images from solid tumor and normal brain. The information gained from ultrasound images can be used to enhance tumor resection and improve patient survival and quality of life. © 1994 John Wiley & Sons, Inc.
In vivo measurements of frequency‐dependent attenuation in tumors of the liver
Authors: Dong Bao‐Wei , Wang Ming , Xie Ke , Chen Min‐Hua
Published: February 2007

Ultrasonic frequency‐dependent attenuation (FDA) coefficients of the liver obtained from selected regions of interest within the liver were determined in 106 individuals, 40 cases presumed normal based on medical histories and 66 with malignant tumors (hepatocellular carcinoma [HCC] or metastatic liver tumor) or benign tumors (hepatic hemangioma, hepatic adenoma, or focal nodular hyperplasia of the liver). All liver tumors were confirmed histopathologically by ultrasonically guided fine‐needle biopsy and/or operation. Mean attenuation of normal liver was 0.53 ± 0.03 dB/cm/MHz, 0.29 ± 0.05 dB/cm/MHz in hepatic hemangioma, 0.43 ± 0.05 dB/cm/MHz in HCC, and 0.41 ± 0.12 dB/cm/MHz in metastatic liver tumor. Hepatic adenoma and focal nodular hyperplasia of the liver produced higher values, averaging 0.66 ± 0.09 dB/cm/MHz. This difference between malignant and benign tumors was statistically significant. There was some correlation between the FDA for the hepatic tumor and the histopathology that merits further investigation. © 1994 John Wiley & Sons, Inc.
Cold thyroid nodules: A new application of percutaneous ethanol injection treatment
Authors: Goletti Orlando , Monzani Fabio , Lenziardi Massimo , Lippolis Piero Vincenzo , De Negri Ferdinando , Caraccio Nadia , Cavina Enrico , Baschieri Lidio
Published: February 2007

Sonographically guided percutaneous ethanol injection (PEI) has been recently used with excellent results in the treatment of toxic and pretoxic thyroid adenoma. The aim of the present study was to assess the efficacy of PEI also in the treatment of “cold” thyroid nodules. Twenty patients, each with a single thyroid nodule, underwent PEI. In all cases the nodules were found to be cold by thyroid scintiscan. A total of 16.1 mL ± 3.1 mL of ethanol was injected once a week. No adverse effects were observed during therapy. A striking nodular shrinkage was obtained in all cases, ranging from 72.8% to 97.6% (mean 84.5%, p < 0.001 vs pretreatment volume). These preliminary results suggest that PEI is an effective and safe therapy that may be useful in the treatment of thyroid nodules as an alternative to other therapies (surgery, L‐thyroxine). © 1994 John Wiley & Sons, Inc.
Neurosonographic findings in full‐term infants born to maternal cocaine abusers: Visualization of subependymal and periventricular cysts
Authors: Cohen Harris L. , Sloves James H. , Laungani Sheila , Glass Leonard , Demarinis Patricia
Published: February 2007

Neuroanatomical abnormalities have been linked to maternal cocaine abuse since Chasnoff et al's report of cerebral infarction in a single full‐term offspring of a cocaine‐abusing mother. Neurosonography was performed on 18 full‐term offspring of cocaine‐abusing mothers and 19 age‐matched controls to look for possible abnormalities. There were no cases of infarction or intraparenchymal or intraventricular hemorrhage. There were, however, 6 patients with abnormalities among the cocaine‐abusing group: 5 patients with unilateral or bilateral germinal matrix cysts and 3 patients with subtle cystic or predominantly cystic areas in watershed zones consistent with periventricular leukomalacia. © 1994 John Wiley & Sons, Inc.
Sonographic features of colon carcinoma seen with high‐frequency transabdominal ultrasound
Authors: Shirahama Masafumi , Koga Takafumi , Ishibashi Hiromi , Uchida Satoshi , Ohta Yoshiro
Published: February 2007

To assess the value of high‐frequency ultrasonography as a diagnostic imaging procedure in patients with colon carcinoma, we first evaluated the sonograms of 37 patients who had been already diagnosed with contrast enema and/or colonoscopy as having colon carcinoma. As a result, the sonographic criteria for diagnosis of a possible colon carcinoma were (1) a localized and irregular thickening of the colonic wall with heterogenous low echogenicity, (2) an irregular contour, (3) a lack of demonstrable movement or change of configuration of the bowel on real‐time scanning, and (4) absence of wall stratification. During the last 4 years, 41 consecutive patients had findings meeting our sonographic criteria. In 37 patients (90%), the presence of colon carcinoma was confirmed by contrast enema and/or colonoscopy. Our study suggests that high‐frequency real‐time ultrasonography may be a useful imaging technique in diagnosis of colon carcinoma. © 1994 John Wiley & Sons, Inc.
Diagnostic usefulness of thyroid ultrasonography in atrophic thyroiditis
Authors: Vitti Paolo , Lampis Marco , Piga Mario , Loviselli Andrea , Brogioni Sandra , Rago Teresa , Pinchera Aldo , Martino Enio
Published: February 2007

An abnormal thyroid echographic pattern, characterized by a diffuse low thyroid echogenicity associated with a reduced thyroid volume, was found in 53 of 55 (96%) patients with atrophic thyroiditis. In 10 of these patients, the ultrasound examination was diagnostic for thyroid atrophy, whereas the scintiscan had no abnormality. In only two cases was the reverse observed, ie, absent thyroid radioiodine uptake and no evidence of abnormality in the ultrasound examination. Six out of 24 (25%) patients with thyroperoxidase antibody titers ⩽ 1:1600 and 4 of 31 (13%) patients with titers ≥ 1:6400 had a normal thyroid scintiscan in the presence of an abnormal thyroid echographic pattern.

Thus, thyroid echography can be considered the first morphological procedure in patients with hypothyroidism due to atrophic thyroiditis, and thyroid scintiscan can be used to confirm the diagnosis when other results are not definitive. © 1994 John Wiley & Sons, Inc.
Sonographic determination of first trimester umbilical cord length
Authors: Hill Lyndon M. , DiNofrio Dawn M. , Guzick David
Published: February 2007

Umbilical cord length was measured sonographically in 53 normal fetuses and 15 fetuses with an intrauterine demise. The age of the fetuses ranged from 6.1 weeks to 11 weeks, menstrual age. Intra‐ and interobserver differences in measurements were not significantly different from zero. A close linear relationship (r2 = 0.89) was found between umbilical cord length and menstrual age in the normal group. The cord lengths of 9 of 15 fetuses (60%) with an intrauterine fetal demise were more than 2 SD below the expected value for menstrual age in normal fetuses. © 1994 John Wiley & Sons, Inc.