bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subtorsion of the ovary: sonographic features and clinical management.
Authors: Shalev J , Mashiach R , Bar-Hava I , Girtler O , Bar J , Dicker D , Meizner I 
Published: January 2017

To define the sonographic imaging criteria of ovarian subtorsion.Fourteen women 16 to 35 years of age with suspected unilateral twisted ovaries were sonographically evaluated in a tertiary care center before laparoscopy. Transvaginal sonography was performed to determine the longest ovarian dimension, diameter of the periovarian vessels, and degree of intraovarian blood flow and to evaluate ovarian morphology. Laparoscopy was performed to verify the sonographic findings and to perform detorsion.All ovaries with subtorsion were of normal size, although still significantly longer than the contralateral, normal ovaries (47.5 and 29.6 mm, respectively; P = .001). The mean diameter of the periovarian vessels was significantly greater for the ovaries with subtorsion than the normal ovaries (29.9 and 19.2 mm, respectively; P= .0001). At laparoscopy, the ovary was twisted less than 180 degrees in 9 patients and 180 degrees to 360 degrees in 5. The degree of twisting correlated significantly with the size of the ovary (P = .016) and diameter of the periovarian vessels (P = .046). The 3‐month sonographic follow‐up after detorsion revealed bilateral normal ovarian dimensions with proper follicular growth.Congestion of the periovarian vessels with normal ovarian morphology and persistent blood flow on sonography, combined with the presence of appropriate clinical signs, may be indicative of ovarian subtorsion.
Fetal stimulation by pulsed diagnostic ultrasound.
Authors: Fatemi M , Ogburn P L , Greenleaf J F 
Published: January 2017

To show that pulsed ultrasound from a clinical ultrasonic imaging system can stimulate the fetus. Stimulation is defined mainly as increased fetal gross body movements in response to excitation.Fetuses of a group of 9 volunteer women (mean gestational age, 33.37 weeks; range, 25‐40 weeks) were evaluated for body movement under 3 different conditions: (1) control, with no ultrasound exposure; (2) ultrasound in continuous wave Doppler mode; and (3) pulsed ultrasound in pulsed Doppler and B modes. A conventional external fetal monitor, with negligible ultrasonic output, was used to monitor fetal gross body motions. After an initial rest period of 3 minutes with 1 or no fetal motion, fetuses were monitored for an additional 3 minutes under the exposure criterion defined for each condition. Resulting fetal motions under the 3 conditions were compared using the Wilcoxon signed rank test.The test showed that fetuses moved significantly more frequently under condition 3 (mean +/‐ SD, 3.43 +/‐ 1.93 movements per minute) than under condition 1 (0.40 +/‐ 7.33 movements per minute) or condition 2 (0.63 +/‐ 7.67 movements per minute); P = .004 and .016, respectively. Fetal movements under conditions 1 and 2 did not differ significantly.Diagnostic ultrasound may stimulate fetal body motion.
Lymph node hilus: gray scale and power Doppler sonography of cervical nodes.
Authors: Ahuja A , Ying M , King A , Yuen H Y 
Published: January 2017

To investigate the difference in the nodal hilus evaluated by gray scale and power Doppler sonography.One hundred ninety‐two patients with proven cervical lymphadenopathy were included in the study (metastases, n = 118; tuberculosis, n = 56; and lymphoma, n = 18). Lymph nodes were evaluated by gray scale sonography for the echogenic hilus and power Doppler sonography for hilar vascularity.Hilar vascularity was found even though the lymph node did not show an echogenic hilus on gray scale sonography (metastases, 59%; tuberculosis, 66%; and lymphoma, 91%).Sonologists should be aware that gray scale and Doppler sonography show different aspects of the hilus, and the absence of the hilus on gray scale sonography does not necessarily imply an associated absence of hilar vascularity.
Sonography and color Doppler sonography for monitoring conservatively treated infantile hypertrophic pyloric stenosis.
Authors: Riccabona M , Weitzer C , Lindbichler F , Mayr J 
Published: January 2017

To evaluate the role of sonography in infants with hypertrophic pyloric stenosis undergoing conservative medical treatment.Twenty‐two infants (17 male and 5 female; age range, 1‐12 weeks) were clinically and sonographically considered suitable for conservative treatment and underwent follow‐up during the course of the disease. Sonography was performed under a standardized protocol and included color Doppler sonography.Fifteen infants (mean age, 9 weeks) needed surgery. They initially had a mean pyloric length of 18 mm, a diameter of 10.5 mm, and a wall thickness of 4 mm, with visible passage of food into the duodenum. These values deteriorated during follow‐up (mean preoperative values: length, 20 mm; diameter, 12 mm; and wall thickness, 4.5 mm); furthermore, passage of food through the pyloric canal ceased. Seven infants (mean age, 3 weeks) were successfully treated conservatively Their initial mean pyloric measurements were slightly smaller (length, 15 mm; diameter, 10 mm; and wall thickness, 3.8 mm) and did not deteriorate during follow‐up. In all of them, sonography showed improvement of passage through the pyloric canal within several days, as shown and documented by color Doppler sonography; morphologic changes persisted longer despite clinical improvement.Sonography, including color Doppler sonography, is a valuable tool for monitoring infants with hypertrophic pyloric stenosis undergoing conservative treatment; however, initial sonograms cannot predict the further course of the disease.
Effects of Oophorectomy and Hormone Replacement Therapy on the Pulsatility Indices of Hepatic and Renal Arteries
Authors: Mihmanli Ismail , Mihmanli Veli , Kantarci Fatih , Albayram Mehmet Sait , Atakir Kadir , Cantasdemir Murat , Akman Canan 
Published: January 2017

ObjectivesTo investigate the flow velocity waveform changes of the hepatic and renal arteries in women with surgical menopause who received hormone replacement therapy versus those who did not.MethodsEighty women who had undergone surgical menopause were divided into 2 groups. The first group (n = 38) consisted of patients who did not receive estrogen treatments after surgery; patients in the second group (n = 42) did receive treatments. The hepatic and renal arteries of patients in both groups were examined by duplex Doppler ultrasonography before the commencement of hormone replacement therapy and after 2 years of treatment, and the pulsatility indices were calculated.ResultsNo significant differences were detected in the renal and hepatic artery pulsatility indices of patients in the estrogen treatment group (group 2) before and after total abdominal hysterectomy and bilateral salpingo‐oophorectomy (P > .05). No significant differences in preoperative and postoperative hepatic arterial pulsatility indices were detected among patients in group 1 (P > .05). Renal artery pulsatility indices measured before and after total abdominal hysterectomy and bilateral salpingo‐oophorectomy did show a statistically significant difference in group 1 (P < .001). In addition, a statistically significant difference was detected before and after surgery in both groups when pulsatility indices were measured at the second‐year control dose.ConclusionsHepatic arterial pulsatility indices are not affected in postmenopausal women, but renal artery pulsatility indices rise to some extent in women not receiving hormone replacement therapy.
Sonographic Differentiation of Benign and Malignant Cystic Lesions of the Breast
Authors: Chang Yun-Woo , Kwon Kwi Hyang , Goo Dong Erk , Choi Deuk Lin , Lee Hye Kyung , Yang Seung Boo 
Published: January 2017

ObjectivesThe purpose of this study was to subdivide the types of sonographic findings of benign versus malignant cystic masses and to determine appropriate patient care according to the sonographic findings with pathologic correlation.MethodsThe sonographic findings of 175 symptomatic cystic breast lesions were pathologically proven and reviewed retrospectively. Cystic lesions were classified as 6 types: simple cysts (type I), clustered cysts (type II), cysts with thin septa (type III), complicated cysts (type IV), cystic masses with a thick wall/septa or nodules (type V), and complex solid and cystic masses (type VI). Sonographic findings were compared with the pathologic results and were evaluated according to the incidence of benign and malignant masses.ResultsAll 23 type I, 15 type II, 22 type III, and 35 type IV cases were pathologically proven to be benign. Seven (25.9%) of the 27 type V cases and 33 (62.3%) of the 53 type VI cases were proven to be malignant. We analyzed the shapes and margins of 80 cases of cystic masses with a solid component (types V and VI); 16 (44%) of 36 sonographically circumscribed masses were malignant.ConclusionsBecause the sonographically detected simple cysts (type I), clustered cysts (type II), and cysts with thin septa (type III) were all benign, annual routine follow‐up appears reasonable. Symptomatic complicated cysts (type IV) should be aspirated and appropriately treated according to clinical symptoms. Cystic masses with a solid component (types V and VI) should be examined by biopsy with pathologic confirmation.
Sonographic Evaluation of the Endometrium in Patients With a History or an Appearance of Polycystic Ovarian Syndrome
Authors: Peri Nagamani , Levine Deborah 
Published: January 2017

ObjectivesThe purpose of this study was to assess the incidence and significance of a thick, cystic‐appearing endometrium in association with a history or an ovarian appearance of polycystic ovarian syndrome.MethodsAn Institutional Review Board–approved, retrospective medical record review of sonographic studies from January 1, 1998, to December 31, 2005, found 245 patients with clinical features, a characteristic sonographic appearance of the ovaries, hormonal abnormalities, or a history of polycystic ovarian syndrome. The sonographic thickness and appearance of the endometrium (homogeneous or heterogeneous) and histologic findings on biopsy were obtained.ResultsTwo hundred twenty‐seven patients had a homogeneous endometrium in the range of 1 to 17 mm (mean ± SD, 6.4 ± 3.1 mm); 18 patients had a heterogeneous endometrium in the range of 4 to 23 mm (mean, 13.2 ± 5.6 mm). Of the 18 patients with a heterogeneous endometrium, 9 also had a sonographic finding of tiny cystic foci within the endometrium. Of these, 5 had endometrial biopsy, resulting in 2 cases of a proliferative endometrium and 1 case each of simple hyperplasia, hyperplasia with atypia, and scant tissue. No cases of hyperplasia were present in the patients with a homogeneous endometrium.ConclusionsA heterogeneous cystic endometrium is associated with the prolonged proliferative phase from chronic anovulation as well as endometrial hyperplasia.
The Cisterna Magna Septa
Authors: Robinson Ashley J. , Goldstein Ruth 
Published: January 2017

ObjectivesThe purpose of this study was to show the normal sonographic embryologic anatomy of the cisterna magna septa, fourth ventricle, and cerebellar vallecula at various stages of development and our experience with their variable appearance in multiple planes and to discuss the probable relationship between the cisterna magna septa, Dandy‐Walker continuum, mega cisterna magna, and persistent Blake's pouch.MethodsRetrospective and prospective selection of examples of cisterna magna septa was performed over approximately a 12‐month period. Standard and nonstandard imaging planes were adopted as necessary.ResultsThe septa are typically seen inferoposterior to the cerebellar vermis, usually straight and parallel, arising at the cerebellovermian angle and coursing posteriorly to the occipital bone. The cisterna magna septa become contiguous with the roof of the fourth ventricle inferior to the cerebellar vermis. The cerebrospinal fluid space enclosed between the cisterna magna septa is in direct contiguity with the fourth ventricle via the vallecula and is always completely anechoic because it develops intra‐ and not extra‐axially.ConclusionsWe propose that the cisterna magna septa represent the walls of Blake's pouch, a phylogenetic vestigial structure observed during ontogeny. Additionally, our observations support current opinion that a persistent Blake's pouch and mega cisterna magna represent (less severe) abnormalities within the Dandy‐Walker continuum. The cisterna magna septa therefore are a marker of normal development of the roof of the rhombencephalon. Deviation from their normal appearances should prompt a closer assessment for associated abnormalities of the cerebellum, vermis, and brain stem by additional imaging in orthogonal planes with either sonography or magnetic resonance imaging.
Color Duplex Sonography in the Detection of Internal Carotid Artery Restenosis After Carotid Endarterectomy
Authors: Aleksic Nikola , Tanaskovic Slobodan , Radak Sandra , Mitrasinovic Anka , Kolar Jovo , Babic Srdjan , Otasevic Petar , Radak Djordje 
Published: January 2017

ObjectivesInternal carotid artery restenosis after carotid endarterectomy is a major postoperative event, but the clinically best suited means for diagnosis of restenosis are still debated. The objective of this study was to evaluate the sensitivity and specificity of color duplex sonography for detection of substantial internal carotid artery restenosis, verified by computed tomographic (CT) angiography.MethodsThe study group consisted of 210 consecutive patients with internal carotid artery restenosis, defined as restenosis of 50% or greater, verified by color duplex sonography. The degree of restenosis was calculated according to the European Carotid Surgery Trial guidelines. All patients underwent CT angiography. The specificity, sensitivity, positive predictive value, and negative predictive value of color duplex sonography were calculated.ResultsIn 85 patients, internal carotid artery restenosis on color duplex sonography was 50% to 69%, whereas in 125 patients it was 70% or greater. When color duplex sonography was compared with CT angiography, only 2 patients in the group with restenosis of 50% to 69% were misclassified by color duplex sonography, in whom CT angiography showed stenosis of 70% or greater. No patient with stenosis of 70% or greater on color duplex sonography was shown to have a lesser degree of restenosis on CT angiography. When compared with CT angiography, color duplex sonography had specificity of 97.7%, sensitivity of 100%, a positive predictive value of 98.4%, and a negative predictive value of 100% for the detection of internal carotid artery restenosis.ConclusionsColor duplex sonography can be effectively used as a primary diagnostic tool for evaluation of patients with suspected internal carotid artery restenosis after carotid endarterectomy.
Collaborative Study on 3‐Dimensional Sonography for the Prenatal Diagnosis of Central Nervous System Defects
Authors: Rizzo Giuseppe , Abuhamad Alfred Z. , Benacerraf Beryl R. , Chaoui Rabih , Corral Edgardo , Addario Vincenzo D' , Espinoza Jimmy , Lee Wesley , Mercé Alberto Luis T. , Pooh Ritsuko , Sepulveda Waldo , Sinkovskaya Elena , Viñals Fernando , Volpe Paolo , Pietrolucci Maria Elena , Arduini Domenico 
Published: January 2017

ObjectivesPrenatal diagnosis of central nervous system (CNS) anomalies by 2‐dimensional sonography is challenging because of difficulties in obtaining complete visualization of the fetal brain during routine examinations, which is necessary for identification of its axial, coronal, and sagittal planes. Three‐dimensional (3D) sonography has been introduced as a tool for studying the fetal CNS because of its ability to facilitate examinations of the fetal brain. The objective of this study was to determine inter‐center agreement in diagnosing CNS defects by review of 3D volume data sets.MethodsThis study included 11 centers with expertise in 3D fetal neurosonography. A total of 217 fetuses with and without confirmed CNS defects were scanned after 18 weeks' gestation, and their volume data sets were uploaded onto a centralized file transfer protocol server and later analyzed by all of the centers. Intercenter agreement was determined using a κ statistic for multiple raters.ResultsAll volumes were made anonymous and sent to the centers for blinded analysis with the exception of the data sets they had themselves previously uploaded. For identification of fetuses with CNS defects, the sensitivity, specificity, positive and negative predictive values, and false‐positive and ‐negative rates were 93.3%, 96.5%, 96.5%, 93.3%, 3.5%, and 6.7%, respectively. No differences were found in the efficacy of the diagnostic indices according to either the route of acquisition (transabdominal or trans‐vaginal) or the gestational age at diagnosis (18–24 or >24 weeks). Intercenter agreement was excellent (κ = 0.92; 95% confidence interval, 0.88–0.97).ConclusionsAmong centers with technical expertise, remote review of 3D sonographic volumes of the fetal CNS resulted in an accurate and reliable method for diagnosis of fetal brain malformations.
Observed Prevalence of Congenital Heart Defects From a Surveillance Study in China
Authors: Zhang Yali , Riehle-Colarusso Tiffany , Correa Adolfo , Li Song , Feng Xinheng , Gindler Jacqueline , Lin Hui , Webb Catherine , Li Wei , Trines Jean , Berry Robert J. , Yeung Lorraine , Luo Ying , Jiang Meifang , Chen Hua , Sun Xiamei , Li Zhu 
Published: January 2017

ObjectivesThe purpose of this study was to estimate the prevalence of major and minor congenital heart defects among fetuses and neonates using sonography in a general population of 4 areas surrounding Shanghai, China.MethodsPregnant women were recruited between April 2004 and December 2005 in Jiaxing City, Suzhou City, Changshu County, and Haining County. All participants could have 3 sonographic examinations performed by specially trained physicians regardless of medical indication: a fetal sonographic screen and fetal echocardiography between 20 and 28 weeks' gestation and neonatal echocardiography. Diagnoses of congenital heart defects were made on the basis of review of all available scans by an international group of experts in pediatric cardiology. Prevalence rates were calculated per 1000 births.ResultsAmong 4006 scanned fetuses and neonates, there were 75 congenital heart defects, including 12 major defects. The observed prevalence for all congenital heart defects was 18.7 (95% confidence interval, 14.8–23.5) per 1000 births, and the prevalence for major defects was 3.0 (95% confidence interval, 1.6–5.2) per 1000 births. The most common defects were ventricular septal defects (n = 47 [62.7%]), atrial septal defects (n = 14 [18.7%]), tetralogy of Fallot (n = 4 [5.3%]), and hypoplastic left heart syndrome (n = 3 [4.0%]).ConclusionsThe prevalence of all congenital heart defects in the 4 areas of China studied was higher than that reported in other countries, with ventricular septal defects being the most frequent defects. Our data likely reflect a better estimate of the total prevalence of congenital heart defects in China than reported previously.
Assessment of Substantia Nigra Echogenicity in German and Filipino Populations Using a Portable Ultrasound System
Authors: Go Criscely L. , Frenzel Antonia , Rosales Raymond L. , Lee Lillian V. , Benecke Reiner , Dressler Dirk , Walter Uwe 
Published: January 2017

ObjectivesTranscranial sonography of the substantia nigra for diagnosing premotor stages of Parkinson disease has been attracting increasing interest. Standard reference values defining an abnormal increased echogenic size (hyperechogenicity) of the substantia nigra have been established in several populations using high‐end stationary ultrasound systems. It is unknown whether a portable ultrasound system can be appropriately used and how the Filipino population would compare with the well‐studied white population.MethodsWe prospectively studied substantia nigra echogenic sizes and third ventricle widths in 71 healthy adult German participants and 30 age‐ and sex‐matched Filipino participants using both a well‐established stationary ultrasound system (in the German cohort) and a recently distributed portable ultrasound system (in both ethnic cohorts).ResultsMean substantia nigra echogenic sizes, cutoff values defining abnormal hyperechogenicity, and intra‐rater reliability were similar with both systems and in both ethnic cohorts studied. The Filipino and German participants did not differ with respect to the frequency of insufficient insonation conditions (each 3%) and substantia nigra hyperechogenicity (10% versus 9%; P = .80). However, third ventricle widths were smaller in the Filipino than the German participants (mean ± SD, 1.6 ± 1.1 versus 2.4 ± 1.0 mm; P = .004).ConclusionsThe frequency of substantia nigra hyperechogenicity appears to be homogeneous in white and Asian populations. Screening for this feature may well be performed with a present‐day portable ultrasound system.
Menopausal Hormone Therapy Use Among Postmenopausal Women
Authors: Yang Lin , Toriola Adetunji T. 
Published: September 2024

ImportanceMenopausal hormone therapy (MHT) is the treatment of choice for symptoms of menopause. However, its adoption is hindered by the risk-benefit trade-off in relation to acute and chronic diseases.ObjectiveTo evaluate trends in and correlates of MHT use among postmenopausal women in the US from 1999 to March 2020.Design, Setting, and ParticipantsThis serial cross-sectional analysis of MHT use used data from the nationally representative National Health and Nutrition Examination Survey (NHANES). Participants included noninstitutionalized US postmenopausal women from 10 NHANES study cycles (1999-2000 to 2017-March 2020 [pre–COVID-19 pandemic]). Data were analyzed from December 2023 to April 2024.ExposuresNHANES study cycle.Main Outcomes and MeasuresPrevalence of MHT use was extracted from the prescription medication data collected during NHANES household interviews. MHT formulations were determined by hormone type.ResultsData on 13 048 US postmenopausal women (47.1% ≥65 years old) were analyzed. From 1999 to 2020, the prevalence of MHT use decreased among women of all age groups, from 26.9% (95% CI, 22.6%-31.7%) in 1999 to 4.7% (95% CI, 3.4%-6.5%) in 2020. Until 2002, MHT use was highest among women aged 52 to 65 years, but since 2005, MHT use has been highest among women younger than 52 years. MHT use decreased by 23.5% (95% CI, 11.4%-35.6%), 31.4% (95% CI, 23.4%-39.5%), and 10.6% (95% CI, 6.3%-14.8%) for women younger than 52 years, 52 years to younger than 65 years, and 65 years and older, respectively. Prevalence of MHT use decreased from 13.8% (95% CI, 8.5%-21.7%) to 2.6% (95% CI, 1.5%-4.6%) for Hispanic women, 11.9% (95% CI, 8.5%-16.3%) to 0.5% (95% CI, 0.2%-1.1%) for non-Hispanic Black women, and 31.4% (95% CI, 27.1%-36.1%) to 5.8% (95% CI, 4.1%-8.2%) for non-Hispanic White women. Non-Hispanic White women consistently had the highest prevalence of MHT use. Estrogen-only formulation accounted for more than 50% of the MHT for most study periods. The prevalence of MHT use varied by family income-to-poverty ratio, health insurance coverage in all racial and ethnic groups, weight, and smoking status among non-Hispanic White women, as well as by education attainment among non-Hispanic Black and Hispanic women.Conclusions and RelevanceResults of this cross-sectional study show that over the past 2 decades, MHT use declined among US postmenopausal women of all age and racial and ethnic groups. Women of racial and ethnic minority groups had lower prevalence of MHT use compared to non-Hispanic White women.