bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasound measurements of the liver: an intra and inter‐rater reliability study
Authors: Childs Jessie T , Esterman Adrian J , Thoirs Kerry A 
Published: December 2015

AbstractIntroduction: Ultrasound is an easy and inexpensive method to rapidly assess the size of the adult liver. The literature addressing reliability of liver measurements using ultrasound is poorly reported and inadequate. In this study, intra and inter‐rater reliability of multiple measurements of the right lobe, left lobe and entire adult liver were assessed.Methods: Two examiners acquired ultrasound images of the liver in multiple positions. Fifteen measurements were taken from each set of images by each examiner. One examiner repeated the images and measurements.Results: Results demonstrated high intra‐rater reliability for all measurements (ICC's 0.67–0.97). Inter‐rater reliability also demonstrated high reliability (ICC's 0.71–0.94) for nine of the fifteen measurements (six representing the right lobe, one representing the left lobe and two representing the entire liver. Further analysis using paired samples t‐tests and Bland Altman plots were performed on these nine measurements.Conclusion: From this study, the most reliable measurements are suggested to be MCL Dome to tip and MCL Max AP for the right lobe and Midline Max AP for the left lobe. The only measurement to truly encompass both lobes (Max Trans) was not shown to be reliable.
Complicated multiple pregnancy referral, treatment and outcomes at the NSW Fetal Therapy Centre
Authors: Tetstall Emma , Shand Antonia W , Welsh Alec W , Chen Katie Q , Henry Amanda 
Published: December 2015

AbstractObjectives: To determine the indications for referral, sonographic workload, diagnoses and outcomes of women with a multiple pregnancy referred to the New South Wales Fetal Therapy Centre (NSW FTC). Methods: Retrospective cohort study of twin and higher order multiple (HOM) pregnancies referred to the NSW FTC at the Royal Hospital for Women (RHW) Department of Maternal Fetal Medicine (MFM), Sydney from January 2007 to December 2009.Results: There were 176 twin pregnancies (138 monochorionic diamniotic, 29 dichorionic diamniotic and nine monoamniotic), and 26 HOMs referred (23 triplet and three quadruplet pregnancies). Indications for referral were: twin to twin transfusion syndrome (TTTS) 103 women, fetal anomaly 31 women, intrauterine growth restriction (IUGR) 12 women, serial surveillance of twins or HOM 37 women, and fetal reduction of HOM (nine women). In 80.2% the pathological referral diagnosis was confirmed. The average number of ultrasounds was five (range 1–24), with 90 women (45%) receiving invasive therapy. Thirty‐five percent (71) of referrals were from outside Sydney, including eight interstate and 11 overseas referrals. Two‐thirds of out of area referrals were able to return to their referral hospital for birth: 95 women (47%) delivered at RHW.Conclusion: TTTS was the most common reason for referral, with a high concordance between referral and initial diagnosis. RHW accepted a large number of out of area referrals, in keeping with its role as the NSW FTC. Twin and HOM pregnancy referrals represent a significant workload for the 5 department, with many women also requiring invasive therapy.
Accuracy of sonographic fetal gender determination: predictions made by sonographers during routine obstetric ultrasound scans
Authors: Kearin Manette , Pollard Karen , Garbett Ian 
Published: December 2015

AbstractObjectives: The purpose of this study was to determine the accuracy of sonographer predictions of fetal gender during routine ultrasounds. Primarily, the study sought to investigate the accuracy of predictions made in the first trimester, as requests from parents wanting to know the gender of their fetus at this early scan are becoming increasingly common. Second and third trimester fetuses were included in the study to confirm the accuracy of later predictions. In addition, the mother's decision to know the gender was recorded to determine the prevalence of women wanting prenatal predictions. Methods: A prospective, cross sectional study was conducted in a specialist private obstetric practice in the Illawarra, NSW. A total of 640 fetuses across three trimesters were examined collectively by seven sonographers. Fetal gender was predicted using the sagittal plane only in the first trimester and either the sagittal or transverse plane in later trimesters. Phenotypic gender confirmation was obtained from hospital records or direct telephone contact with women postnatally.Results: Results confirmed 100% accuracy in predictions made after 14 weeks gestation. The overall success rate in the first trimester group (11–14 weeks) was 75%. When excluding those scans where a prediction could not be made, success rates increased to 91%. Results were less accurate for fetuses younger than 12 weeks, with an overall success rate of 54%. Male fetuses under 13 weeks were more likely to have gender incorrectly or unable to be assigned. After 13 weeks, success rates for correctly predicting males exceeded that of female fetuses. Statistical differences were noted in the success rates of individual sonographers. Sixty seven percent of women were in favour of knowing fetal gender from ultrasound. Publicly insured women were more likely to request gender disclosure than privately insured women.Conclusions: Sonographic gender determination provides high success rates in the first trimester. Results vary depending on sonographer experience, fetal age and fetal gender. Practice guidelines regarding gender disclosure should be developed. Predictions prior to 12 weeks should be discouraged.
Contrast‐enhanced ultrasound of pancreatic tumours
Authors: De Robertis Riccardo , D'Onofrio Mirko , Crosara Stefano , Dal Corso Flavia , Barbi Emilio , Canestrini Stefano , Mucelli Roberto Pozzi 
Published: December 2015

AbstractIndication/purpose: To review contrast‐enhanced ultrasound features of the most common pancreatic tumours.Methods: Contrast‐enhanced ultrasound (CEUS) can provide distinctive features of pancreatic tumours that are reported in the present paper, providing radiologic‐pathological correlations and clarifying the main differential diagnosis.Conclusion: Contrast‐enhanced ultrasound plays a well‐established role in the evaluation of pancreatic tumours. When possible, CEUS should be always performed after the initial US diagnosis, in order to improve the accuracy of the first line examination.
A sonographic approach to prenatal classification of congenital spine anomalies
Authors: Paoletti Debra , Robertson Meiri , Sia Sock Bee 
Published: December 2015

AbstractObjective: To develop a classification system for congenital spine anomalies detected by prenatal ultrasound.Methods: Data were collected from fetuses with spine abnormalities diagnosed in our institution over a five‐year period between June 2005 and June 2010. The ultrasound images were analysed to determine which features were associated with different congenital spine anomalies. Findings of the prenatal ultrasound images were correlated with other prenatal imaging, post mortem findings, post mortem imaging, neonatal imaging, karyotype, and other genetic workup. Data from published case reports of prenatal diagnosis of rare congenital spine anomalies were analysed to provide a comprehensive work.Results: During the study period, eighteen cases of spine abnormalities were diagnosed in 7819 women. The mean gestational age at diagnosis was 18.8w ± 2.2 SD. While most cases represented open NTD, a spectrum of vertebral abnormalities were diagnosed prenatally. These included hemivertebrae, block vertebrae, cleft or butterfly vertebrae, sacral agenesis, and a lipomeningocele. The most sensitive features for diagnosis of a spine abnormality included flaring of the vertebral arch ossification centres, abnormal spine curvature, and short spine length. While reported findings at the time of diagnosis were often conservative, retrospective analysis revealed good correlation with radiographic imaging. 3D imaging was found to be a valuable tool in many settings.Conclusions: Analysis of the study findings showed prenatal ultrasound allowed detection of disruption to the normal appearances of the fetal spine. Using the three features of flaring of the vertebral arch ossification centres, abnormal spine curvature, and short spine length, an algorithm was devised to aid with the diagnosis of spine anomalies for those who perform and report prenatal ultrasound.
Sonographic diagnosis of spontaneous uterine rupture at the site of cornual wedge resection scar – a case report
Authors: Wye Deborah , Magotti Robert , Al‐Mashat Dheya , Benzie Ronald , Condous George 
Published: December 2015

AbstractIntroduction: Uterine rupture and uterine dehiscence during pregnancy are known complications of a scarred uterus. Spontaneous uterine rupture at the site of prior cornual wedge resection has been previously reported in the literature, however remains rare.Discussion: We present a case of uterine rupture at 30 weeks gestation. This woman had previous right sided interstitial pregnancy treated with uncomplicated laparoscopic cornual wedge resection at eight weeks gestation. The index pregnancy occurred eight months after surgery. An emergency ultrasound prompted by non‐specific abdominal pain and tenderness at 30 weeks gestation enabled diagnosis of uterine dehiscence. At emergency caesarean section four hours later full thickness wall rupture and haemoperitoneum were found. Surgical intervention resulted in a good outcome for both mother and baby.Conclusion: A brief account on uterine rupture in late pregnancy and relevant sonographic features related to this case are presented. This case demonstrates the value of ultrasound in the assessment of subtle clinical signs and symptoms in patients at risk of uterine rupture.
Congenital high airways obstruction syndrome – first and second trimester diagnosis
Authors: Paoletti Debra , Robertson Meiri 
Published: December 2015

AbstractCongenital High Airways Obstruction Syndrome (CHAOS) is a rare condition associated with high fetal or neonatal mortality. Prenatal diagnosis in the second trimester is made by the typical ultrasound features of large echogenic lungs, a flattened or inverted diaphragm, and fetal ascites or hydrops. We present two cases diagnosed at our institution; one in the second trimester, and a first trimester diagnosis. To the best of our knowledge, first trimester diagnosis of CHAOS has not been previously reported.
An ovarian torsion around a remnant of the urachus
Authors: Dickfos Marilla , Sharif Zakia 
Published: December 2015

AbstractWe report a case of ovarian torsion around a remnant of the urachus. Though it usually develops into the median umbilical ligament, abnormalities in urachal development can occur which can lead to remnants being present in the adult abdomen.This case describes a young female who had intermittent lower abdominal pain over a period of three weeks. During this period several ultrasound scans were performed which reported different anatomy and possible causes of the pain. Only on diagnostic laparoscopy and confirmed via histology, was it found that she had experienced ovarian torsion around an urachal remnant.Unfortunately due to the delay from symptom onset to her operation, her ovary was not salvageable. This case highlights the variability of ultrasound findings and demonstrates how a remnant can contribute to ovarian torsion and subsequent infarction.
The key to using a learning or skill acquisition plan
Authors: Nicholls Delwyn , Sweet Linda , Westerway Sue Campbell , Gibbins Annie 
Published: December 2015

AbstractA learning plan is a tool to guide the development of knowledge, skills and professional attitudes required for practice. A learning plan is an ideal tool for both supervisors and mentors to guide the process of teaching and learning a medical ultrasound examination. A good learning plan will state the learning goal, identify the learning activities and resources needed to achieve this goal, and highlight the outcome measures, which when achieved indicate the goal has been accomplished. A skill acquisition plan provides a framework for task acquisition and skill stratification; and is an extension of the application of the student learning plan. One unique feature of a skill acquisition plan is it requires the tutor to first undertake a task analysis. The task steps are progressively learnt in sequence, termed scaffolding. The skills to develop and use a learning or skill acquisition plan are also learnt, but are an integral component to the ultrasound tutors skill set. This paper will provide an outline of how to use and apply a learning and skill acquisition plan. We will review how these tools can be personalised to each student and skill teaching environment.
Uhl's anomaly detected in‐utero
Authors: Matic Marta K , Kirsop Rodney , Ramsay Philippa A 
Published: December 2015

AbstractUhl's anomaly is rarely diagnosed antenatally. It is a condition characterised by partial or complete absence of the right ventricular myocardium and the heart conducting system. We present a case of Uhl's anomaly diagnosed during fetal life on prenatal ultrasound, with eight years postnatal follow‐up.
Cervical length measurement: Comparison of transabdominal and transvaginal approach
Authors: Westerway Susan Campbell , Pedersen Lars Henning , Hyett Jon 
Published: December 2015

AbstractObjective: To compare transabdominal (TA) and transvaginal (TV) ultrasound assessment of cervical length at 16–41 weeks gestation.Methods: TA and TV ultrasound measurements of cervical length were made on 491 pregnancies of 16–41 weeks gestation. Cervical length was measured from internal to external cervical os. Bland‐Altman plots and Wilcoxon signed rank test were used to evaluate differences between TA and TV measurements.Results: The validity of the TA method depended on cervical length. Although the TA method underestimated cervical length by 2.0 mm on average (P < 0.001), Bland Altman plots showed an inverse trend with shorter cervixes. In women with a cervix < 25 mm (n = 30) based on TV scan measurement, TA overestimated cervical length by 12 mm (P < 0.001). The sensitivity and specificity of TA as a test to detect cervical length < 25 mm were 10% (95% CI: 2.1–26%) and 94% (95% CI: 92–96%) respectively; the negative LR was 0.96 (95% CI: 0.84–1.08). The maximum area under the ROC curve would be obtained at a TA cut‐off = 32 mm (to detect a cervix < 25 mm), corresponding to a sensitivity of 77% and a specificity of 58%.Conclusion: TA measurements do not reflect TV assessment accurately, particularly if the cervix is short. At 24–34 weeks, a policy of proceeding to TV scan if TA measurement is < 25 mm will only detect 10% of affected pregnancies and has a poor positive predictive value so is of limited value as a predictive tool for women attending with symptoms and signs of preterm labour > 24 weeks gestation. There is no value in TA assessment of the cervix > 36 weeks.
Retrospective audit of patients presenting for ultrasound with suspicion of appendicitis
Authors: Yuan Fei , Necas Martin 
Published: December 2015

AbstractPurpose: To assess the ultrasound performance on patients presenting to Waikato hospital ultrasound department with a clinical suspicion of appendicitis.Method: This was a retrospective audit of 309 patients presenting to our department within business hours with clinical suspicion of appendicitis between September 2012 and March 2014. The patients were evaluated by operators of mixed experience. The scan reports, surgical reports, histology and discharge summaries were reviewed.Results: The overall sensitivity of ultrasound on detecting appendicitis was 50%, the specificity was 98.5%. The positive predictive value and the negative predictive value were 84% and 92.6% respectively. The appendix was visualised in 14% of the true positive cases. When the appendix was visualised, the sensitivity and specificity of ultrasound was 95.2% and 69.2% respectively. Conclusion: The sensitivity of ultrasound to appendicitis was lower than that commonly reported in the literature, but on a par with a recent audit from another tertiary hospital in New Zealand.
A ‘snapshot’ of the visual search behaviours of medical sonographers
Authors: Carrigan Ann J , Brennan Patrick C , Pietrzyk Mariusz , Clarke Jillian , Chekaluk Eugene 
Published: December 2015

AbstractIntroduction: Visual search is a task that humans perform in everyday life. Whether it involves looking for a pen on a desk or a mass in a mammogram, the cognitive and perceptual processes that underpin these tasks are identical. Radiologists are experts in visual search of medical images and studies on their visual search behaviours have revealed some interesting findings with regard to diagnostic errors. In Australia, within the modality of ultrasound, sonographers perform the diagnostic scan, select images and present to the radiologist for reporting. Therefore the visual task and potential for errors is similar to a radiologist. Our aim was to explore and understand the detection, localisation and eye‐gaze behaviours of a group of qualified sonographers.Method: We measured clinical performance and analysed diagnostic errors by presenting fifty sonographic breast images that varied on cancer present and degree of difficulty to a group of sonographers in their clinical workplace. For a sub‐set of sonographers we obtained eye‐tracking metrics such as time‐to‐first fixation, total visit duration and cumulative dwell time heat maps. Results: The results indicate that the sonographers' clinical performance was high and the eye‐tracking metrics showed diagnostic error types similar to those found in studies on radiologist visual search.Conclusion: This study informs us about sonographer visual search patterns and highlights possible ways to improve diagnostic performance via targeted education.
Early 2nd trimester fetal demise in a monochorionic twin pregnancy: A cautionary tale
Authors: Walsh Colin A 
Published: December 2015

AbstractIt is well established that the death of one fetus in a monochorionic twin pregnancy places the surviving twin at significant risk for neuro‐developmental delay or death. Although the early 1st trimester “vanishing twin” has not traditionally been considered a major risk, the precise gestational threshold beyond which a surviving twin is at risk remains uncertain. Most experts recommend serial ultrasounds and fetal MRI in the survivor, to look for evidence of ischaemic brain injury. We present a case of early monochorionic twin demise at 14–16 weeks, with evolving ventriculomegaly and ischaemic changes on fetal MRI in the co‐twin, leading to termination of pregnancy at 28 weeks.
The effect of applied transducer force on acoustic radiation force impulse quantification within the left lobe of the liver
Authors: Porra Luke , Swan Hans , Ho Chien 
Published: December 2015

AbstractIntroduction: Acoustic Radiation Force Impulse (ARFI) Quantification measures shear wave velocities (SWVs) within the liver. It is a reliable method for predicting the severity of liver fibrosis and has the potential to assess fibrosis in any part of the liver, but previous research has found ARFI quantification in the right lobe more accurate than in the left lobe. A lack of standardised applied transducer force when performing ARFI quantification in the left lobe of the liver may account for some of this inaccuracy. The research hypothesis of this present study predicted that an increase in applied transducer force would result in an increase in SWVs measured.Methods: ARFI quantification within the left lobe of the liver was performed within a group of healthy volunteers (n = 28). During each examination, each participant was subjected to ARFI quantification at six different levels of transducer force applied to the epigastric abdominal wall.Results: A repeated measures ANOVA test showed that ARFI quantification was significantly affected by applied transducer force (p = 0.002). Significant pairwise comparisons using Bonferroni correction for multiple comparisons showed that with an increase in applied transducer force, there was a decrease in SWVs.Conclusion: Applied transducer force has a significant effect on SWVs within the left lobe of the liver and it may explain some of the less accurate and less reliable results in previous studies where transducer force was not taken into consideration. Future studies in the left lobe of the liver should take this into account and control for applied transducer force.
The effectiveness of the use of high fidelity simulators in obstetric ultrasound training: A systematic review
Authors: Osborne Brooke , Parange Nayana , Thoirs Kerry 
Published: December 2015

AbstractIntroduction: The benefits of the use of ultrasound technology for point of care obstetric health evaluation have led to increased focus on training programs for physicians wanting to develop skills in this area. Simulation, in a variety of formats, has always played a role in medical and health training, with proven benefits. This systematic review determines the level of evidence available to support the use of high fidelity ultrasound simulators in the training of obstetric ultrasound scanning skills to health professionals.Methods: A systematic review of the literature was performed to define previous investigations into the incorporation of high fidelity ultrasound simulators into obstetric ultrasound training programs. The included studies were reviewed by the authors to evaluate their overall strength and quality. Data surrounding the study participants, simulator types, study design, training program format, outcome measures, and results were extracted.Results and conclusions: While the small body of evidence discovered in this review demonstrates positive results for the use of high fidelity simulators in obstetric ultrasound training, the studies included in this review demonstrate a moderate level of evidence, with some potential of bias throughout. A number of gaps in the literature were identified that could be addressed in further research.
Fetal manifestations of maternal anti‐Ro and La antibodies – more than complete heart block
Authors: Brooks Paul 
Published: December 2015

AbstractComplete heart block (CHB) is a potentially fatal condition occurring in approximately 1:10000 fetuses. Whilst it is well recognised that maternal anti‐Ro and La antibodies are associated with fetal CHB, there are multiple other manifestations of fetal exposure to these autoantibodies which are not widely appreciated and rarely diagnosed. The importance of identifying affected fetuses lies in the significantly increased risk of recurrence in future pregnancies, and the potential for treatments which may modify this risk. This paper presents several cases to highlight the varying fetal presentations of maternal anti‐Ro and La antibodies.
The importance of placental evaluation following perinatal death
Authors: Sethna Farah , Phillips Tessa , Fadia Mitali , Robertson Meiri 
Published: December 2015

AbstractAlthough uncommon, abnormalities of the placenta are important to recognise owing to the potential for both maternal and fetal morbidity and mortality. The placenta is often overlooked in the routine evaluation of a normal gestation, receiving attention only when an abnormality is detected. During the formal scan to confirm a fetal death, the information gathering process to elucidate a possible cause of death begins, yet, even in this instance, the placenta is seldom examined. We aim to draw attention to the importance of placental assessment by presenting a case of a stillbirth where the answer to the cause of death lay in the placenta.