bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of preliminary training on quantitative evaluation of sonographer performance in the fetal morphology ultrasound examination
Authors: Lam Penny , Samson Armie , Magotti Robert , Benzie Ronald 
Published: December 2015

AbstractIntroduction: The aim of this study is to provide a quantitative scoring system to assess sonographer performance by reviewing images from the fetal morphology examination.Methods: Ten ultrasound images from patients at 18–22 weeks gestation were assessed and scored for quality according to predefined criteria. One hundred normal cases were randomly selected and 10 images from each case were analysed by four experienced reviewers. The preliminary training incorporated the first 25 cases and involved a training period for reviewers; the remaining 75 cases were allocated to post training. The scores acquired by each reviewer were statistically analysed using Pearson's and intra‐class correlations to determine the reproducibility of the results.Results: The preliminary training results were calculated separately and compared to the post training study. The preliminary intra‐class correlation coefficient was 0.12. In the post training study the intra‐class correlation coefficient was doubled at 0.24. The greatest correlation was observed between reviewers 1 and 4 with a coefficient of 0.71. Reviewers 3 and 4 demonstrated the lowest correlation coefficient of 0.30.Discussion: A significant increase in the intra‐class correlation coefficient indicated that training reviewers achieves more reproducible results. Suggested improvements to the study include recording fetal position, maternal BMI and assessing individual reviewer variability. An instruction manual defining each criterion might also yield better results.Conclusion: The quantitative method used in this study assessed ultrasound images by placing a numerical value on image quality. Analysis of the preliminary training period demonstrates improved reproducibility of the results. Further investigation into the criteria is necessary to refine the quantitative method.
Ultrasound and saline infused sonography as valuable tool to assess uterine integrity
Authors: Robertson Meiri , Tan Woo Syong 
Published: December 2015

AbstractIntroduction: Ultrasound is under utilised in assessing surgical complications such as uterine perforation resulting from surgical termination of pregnancy.Method: We found one report in literature using the following search words: pregnancy termination, uterus, perforation and ultrasound.1 The risk of perforation is considered low but the true incidence is unknown. The reported incidence is largely based on self‐reporting and many perforations are not recognised.Conclusion: A South Australian study reported the perforation risk following a surgical termination as 0.05% in the first trimester and 0.32% in the second trimester (13–20 weeks).
Detection of intraperitoneal free gas by ultrasound
Authors: Goudie Adrian 
Published: December 2015

AbstractIntroduction: Patients with acute abdominal pain may have unsuspected pneumoperitoneum, and be investigated with ultrasound. Although not the primary imaging modality for this condition, ultrasound will usually demonstrate signs of free intraperitoneal or extra‐luminal gas.Methods: Sonographic signs of pneumoperitoneum are described, along with the limitations and pitfalls of the technique. The reported accuracy of these signs is described.Conclusion: The different signs that may be seen are described, and it is suggested that all who ultrasound patients for abdominal pain should be aware of these.
Amniotic fluid as a vital sign for fetal wellbeing
Authors: Dubil Elizabeth A , Magann Everett F 
Published: December 2015

AbstractIntroduction: Amniotic fluid, once thought to merely provide protection and room for necessary movement and growth for the fetus, is now understood to be a highly complex and dynamic system that is studied as a data point to interpret fetal wellbeing.Methods: Assessment of amniotic fluid volume is now routine when performing a sonographic evaluation of fetal status and is an important consideration in the assessment and management of perinatal morbidity and mortality.1,2 In this review, we will cover the dynamics that affect amniotic fluid volume, review methods for measurement and quantification of volume, review definitions for normative data as related to neonatal outcomes, and provide evidence based guidance on the workup and management options for oligoydramnios and polyhydramnios in singleton and twin pregnancies. Conclusions: When abnormalities of fluid exist, appropriate workup to uncover the underlying etiology should be initiated as adverse fetal outcomes are sometimes associated with these variations from normalcy.
The cardiac sonography workforce in New Zealand
Authors: Buckley Belinda , White Steve , Poppe Katrina , Whalley Gillian 
Published: December 2015

AbstractIntroduction: The aim of this paper is to investigate the cardiac sonography workforce characteristics and registration requirements in New Zealand (NZ), with a comparison to similar workforces internationally.Methods: The Survey of Clinical Echocardiography in New Zealand 2 (SCANZ2) audit was performed in December 2010. All of NZ's public‐funded District Health Board (DHB) centers providing echocardiography services responded to questions relating to staff, equipment, procedure types and patient statistics. The Medical Radiation Technologists Board (MRTB), Clinical Physiologists Registration Board (CPRB) and Australian Sonographers Association Registry (ASAR) websites were reviewed in March 2012 for registered sonographers with a cardiac scope of practice. The cardiac sonography workforces in Australia, the UK, the USA and Canada were investigated for comparison.Results: There are 84 cardiac sonographers (60.3 full‐time equivalent) working in DHBs: 71% from a cardiac technical background; 40% have post‐graduate qualifications; a further 17% are undertaking post‐graduate qualifications; and 59 cardiac sonographers have registration with professional bodies in NZ and/or Australia. Cardiac sonographers in NZ do not undergo compulsory registration, but other sonographers in NZ have compulsory registration with the MRTB. Sonographers are predominantly not licensed internationally.Discussion: Disparity exists between registration of cardiac and non‐cardiac sonographers in NZ. Many cardiac sonographers have voluntary registration but few are registered with the MRTB. Reasons for this include professional alignment, educational qualifications and representation. International trends show increased pressure from governments and professional bodies to regulate sonographers. Conclusion: This study provides a snapshot of the cardiac sonography workforce in NZ for the first time.
Limited lung ultrasound protocol in elderly patients with breathlessness; agreement between bedside interpretation and stored images as acquired by experienced and inexperienced sonologists
Authors: Baker Kylie , Mitchell Geoffrey , Stieler Geoffrey 
Published: December 2015

AbstractIntroduction: Bedside lung ultrasound is increasingly performed in the Emergency Department to assess dyspnoeic patients. Quantifying the number of B‐lines (a vertical short path reverberation artefact caused by the presence of interstitial fluid) can help clinicians differentiate ‘wet lung’ – pulmonary oedema, from ‘dry lung’ – not pulmonary oedema.The aim of this study was to determine inter‐rater agreement for this simple bedside investigation, comparing relative ultrasound novices with more experienced personnel. After completing an introductory ultrasound course the novices had only had four hours of specific lung ultrasound education, followed by 10 proctored scans.Method: A prospective convenience sample of 217 patients over the age of 60 and presenting with dyspnoea were recruited. Patients were either scanned by an experienced emergency physician sonologist or by relative ultrasound novices. The scans were saved and still images then interpreted by a blinded radiology registrar with sonography training, and agreement calculated using weighted kappa scores.Results: The experienced physician scanned 155 patients, and the 11 novices 62 between them. Agreement between the experienced sonologist and the blinded expert was excellent (kappa = 0.82, 95% CI 0.72 to 0.92); between novice group and sonographer, agreement was good (kappa = 0.70, 95% CI 0.45 to 0.95).Conclusion: This study demonstrates reasonable inter‐rater agreement firstly between experts, and secondly between novices and experts.
Comparison of a basic lung scanning protocol against formally reported chest x‐ray in the diagnosis of pulmonary oedema
Authors: Baker Kylie , Mitchell Geoffrey , Thompson Angus G , Stieler Geoffrey 
Published: December 2015

AbstractIntroduction: Brief lung scan protocols have been recommended as a useful adjunct to identify pulmonary oedema in the breathless elderly patient. Some papers quote diagnostic accuracies above that of chest x‐ray.Method: We recruited a prospective convenience sample of patients over sixty years of age reporting any breathlessness on presentation to the emergency department. Those who received both bedside lung scan and chest x‐ray later had their case notes audited by an expert cardiologist for the cause of their breathlessness at presentation. Admission diagnosis was also extracted.Results: 204 comparative data sets were collected. Compared with cardiologist chart review, delayed expert radiology report had a diagnostic accuracy of 92.2% (95%CI 87.6 to 95.1). Bedside interpretation of lung scan protocol had a diagnostic accuracy of 85.3% (95%CI 79.8 to 89.5). The difference of 6.9% between the two accuracy measures was significant (95%CI 0.69 to 13.1). Admission diagnosis accuracy, which encompasses inexpert x‐ray interpretation was 70.2%(95%CI 62.9 to 76.6), significantly less than either lung scan or expert chest x‐ray report.Conclusion: For identifying heart failure in breathless patients, urgent chest x‐ray with delayed formal report has not been shown to be redundant. Basic lung scan protocols should not yet replace chest x‐ray, but may be more reliable in the interim than inexpert clinician interpretation of chest x‐rays.
Dicephalus dipus dibrachius: conjoined twins through the ages
Authors: Miceli Frances 
Published: December 2015

AbstractConjoined twins are the most rare form of monozygotic twinning occurring when there is incomplete division of the embryonic disc after day 13 post conception. This is associated with a very high risk of perinatal morbidity and mortality. Prognosis is dependent on the site and extent of fusion and the degree of sharing of vital organs. Most conjoined twins die in utero or in the early neonatal period. However less severe cases can be successfully separated.This is a review of the types of conjoined twinning, an historical perspective and a case of a rare form known as dicephalus dipus dibrachius (two heads and a single body with two arms and two legs).
Ultrasound physical principles in today's technology
Authors: Starkoff Brian 
Published: December 2015

AbstractIntroduction: New technology options are being provided on modern ultrasound machines such as tissue harmonic imaging, panoramic imaging, encoded pulses, mechanical and matrix 4D ultrasound and elastography. The increase in available features requires enhanced knowledge of the clinical benefits associated with each feature and of the additional diagnostic information in the images. However the question arises as to the necessity of understanding how these new technologies work. Also, ultrasound machines have become much more automated in recent years, with designers making it easier for users to produce excellent quality images with minimal technical input.Discussion: System presets provide adjustments to a variety of basic settings without the user requiring the knowledge of what each setting is doing. The developments in machine design and the increased level of automation pose an interesting question for sonologists and sonographers: Is there a need to know as much about the physical principles of ultrasound today as was required in the past?Conclusion: To answer this question, this article will look at just one recent advance in ultrasound – Tissue Harmonic Imaging. The various mechanisms of this technology will be discussed with reference to the underlying principles of basic ultrasound physics. The conclusion provided is that a good grounding in the physics of ultrasound remains of vital importance in understanding new technologies and enabling informed decisions to be made on their use.
Sonographically detected thickened small bowel in a case of paediatric Salmonella Typhimurium enteritis
Authors: Whitehall John , Edwards Mathew , Phan David , Thambugala Aruni 
Published: December 2015

AbstractIntroduction: A five‐year‐old year old girl developed fever of 40.3° C, vomiting, mild general abdominal pain, followed by bloody diarrhea.Description: Ultrasonography revealed a length of symmetrically thickened terminal ileum, more than 20 cm long, with walls greater than 0.5 cm containing a long narrow lumen < 1 mm wide.Conclusion: Given the difficulty of diagnosing the cause of enteritis in young children, ultrasonography represents a simple, non invasive technique which may demonstrate suggestive mural thickening.
Ultrasound for knee effusion: lipohaemarthrosis and tibial plateau fracture
Authors: Rippey James 
Published: December 2015

AbstractKnee trauma and effusion are common Emergency Department presentations. This article outlines the clinician's sonographic approach to knee effusion detection and localisation. A case where lipohaemarthrosis was detected with ultrasound is demonstrated, and the characteristic appearance of this pathology discussed. The sonographic detection of the associated tibial fracture is also demonstrated.
Estimation of uterine volume: A comparison between Viewpoint and 3D ultrasound estimation in women undergoing laparoscopic hysterectomy
Authors: Casikar Ishwari , Mongelli Max , Reid Shannon , Condous George 
Published: December 2015

AbstractObjectives: To assess the three‐dimensional (3D) tool, Virtual Organ Computed‐aided AnaLysis™ (VOCAL) in the calculation of pre‐operative uterine volume and to correlate the measurements with those obtained with Viewpoint, using uterine dry weight (UDW) as the gold standard.Methods: Prospective observational study of women consented for a laparoscopic hysterectomy (LH) at Nepean Hospital between October 2008 and November 2011. All women underwent detailed transvaginal scan (TVS) at the pre‐operative assessment. Two‐dimensional (D) images of the uterus were obtained both in the mid‐sagittal and transverse planes. 3D volumetric acquisitions were also obtained for each uterus in the mid‐sagittal plane. 2D measurements of the uterus in millimetres (Anterio‐Posterior, longitudinal and transverse) were recorded in Viewpoint software package (GE Healthcare ViewPoint, Germany); which then generated an estimated uterine volume (ml) using the ellipsoid formula. The 3D uterine volumetric datasets were reviewed using SonoView Pro and uterine volumes were estimated with off‐line processing using VOCAL™. The gold standard for comparison was UDW in grams (g), measured by the histopathologist at the time of analysis of the LH specimens. The relationship between the estimated uterine volumes and actual UDW was evaluated using correlation analysis. P‐values were calculated to ascertain the significance of these findings; P values &< 0.05 represented statistical significance.Results: 76 women underwent LH during the study period. Complete data were available in 96% (74/76) of cases. The mean age of the women was 43.7 years and 92% were multiparous. The mean Viewpoint uterine volume was 283 ml, the mean VOCAL™ uterine volume was 249 ml and the mean UDW was 295 g. There was a significant correlation between UDW and estimated uterine volumes both for Viewpoint (R = 0.83, P < 0.001) and VOCAL™ (R = 0.97, P < 0.001), respectively. Viewpoint systematically overestimated weight by 43.1 g, whereas VOCAL™ underestimated by an average of 42.4 g, and this difference was statistically significant (P < 0.001). In terms of absolute values, the mean prediction error for VOCAL™ was −18.0 g and for Viewpoint it was 27.6 g (P &< 0.0001). Conclusion: VOCAL™ was found to be significantly more accurate than Viewpoint in the estimation of uterine volumes, and it was better correlated with UDW.
Fetal urinoma: A case report and review of the literature
Authors: Vress Danica , Robertson Meiri , Paoletti Debra 
Published: December 2015

AbstractFetal urinomas are a rare but important sonographic finding. Urinomas are peri‐renal collections of urine, formed after the rupture of the kidney secondary to an underlying urinary tract obstruction or trauma. Diagnosis antenatally is important for ongoing monitoring and postnatal follow up as their presence may indicate reduced or absent kidney function in the affected kidney.
A review of the diagnostic accuracy of fetal cardiac anomalies
Authors: Miceli Frances 
Published: December 2015

AbstractObjectives: In order to assess the diagnostic accuracy of fetal cardiac anomalies in our Department we undertook a retrospective analysis and compared our results with those of the paediatric cardiologists in the same cases.Methods: Sixty‐five patients referred for second and third trimester fetal echocardiographic examinations were identified in our database from November 2005 to February 2014. Of these six scans were found to be normal by ultrasound and not referred on to the paediatric cardiologist. An additional six scans were diagnosed to have complex congenital heart disease (CHD) with or without extra cardiac abnormalities and/or aneuploidy. These six patients opted for termination of pregnancy and were also not seen by the paediatric cardiologist. The remaining 53 cases were referred to the paediatric cardiologist. Our results were analysed and then compared to the cardiologist's findings. There were an additional three cases scanned during the pregnancy in our department and diagnosed as normal but ultimately found in the neonatal period, to have CHD.Results: The ultrasound findings of the 53 cases scanned in our department were analysed and compared to the findings in the cardiologist's reports. The earlier scans tended to describe the abnormal anatomy but showed a reluctance to name any pathology. As training and confidence levels increased the less complex pathologies were correctly identified by our department and confirmed by the cardiologist.Conclusion: The skills, training and level of confidence required to diagnose fetal cardiac anomalies in our Department have improved over the eight years of the study period, particularly in regards to some of the less complex cardiac pathologies. However the more complex pathologies remain difficult to assess.
The importance of infection prevention and control in medical ultrasound
Authors: Moshkanbaryans Lia , Meyers Craig , Ngu Andrew , Burdach Jon 
Published: December 2015

AbstractInfection control and prevention is critical to delivering safe and high‐quality care to patients undergoing sonographic procedures. In Australia comprehensive standards for reprocessing of ultrasound probes are based on the AS/NZS, TGA and ASUM recommendations. These standards align with the US Centers for Disease Control and Prevention recommendations. However compliance to these guidelines is not ideal and there exists an unmet need for refinement of the guidelines relating to specific factors in clinical sonography.Significant microbiological evidence exists reflecting the increased risk of infection transmission specifically through inadequately reprocessed ultrasound probes. Studies have reported > 80% of transvaginal ultrasound probe handles are contaminated with disease causing pathogens since handle disinfection is omitted from standard reprocessing protocols. Significantly, it was recently discovered that widely‐used high level disinfectants referred to in guidelines are unable to kill HPV while it is becoming increasingly apparent that attention must be paid to the clinical sonography environment as a potential source of nosocomial pathogens.Ultrasound probe reprocessing guidelines and standards are comprehensive however the challenge is in general awareness and effective implementation into practice. As future research in this area is performed, guidelines will need to be amenable to revision to provide patients with the best standard of care.
Experience of a tutor centric model for sonography training of emergency department registrars in an Australian urban emergency department 2009–2012
Authors: Sweetman Greg , Fear Mark , Hird Kathryn 
Published: December 2015

AbstractPurpose: To assess the impact of a regular sonographer proctored training program for emergency medicine trainees in the use of Emergency Department bedside ultrasoundMethods: Emergency Department (ED) Registrars in the Swan District Hospital ED were provided with proctored instruction in bedside ultrasound in performance of extended focused assessment sonography in trauma (eFAST) and abdominal aortic aneurysm (AAA) detection. Training was conducted by credentialed sonographers for individual trainees in a 1:1 or 1:2 setting for 1 hour on a weekly basis. Registrars who trained in the Department between Jan 2009 to Dec 2012 were invited to participate in a survey conducted between June–August 2013 designed to assess the impact of training on their confidence and use of bedside sonography.Results: Registrars reported increased perception of their skill level in AAA and eFAST post‐training. High levels of confidence in their ability to adjust machine settings for image optimisation, recognition of free fluid in the abdomen and ability to recognise an AAA were also reported. The participants who completed at least 10 hours of training and at least 20 scans showed significantly greater improvement in their perception of skill and confidence levels than those with less time. Registrars reported training was of significant benefit, improving their confidence in obtaining good quality images and their understanding of the equipment, which contributed to them obtaining accreditation. Benefits were ongoing and 50% of participants reported using ultrasound in clinical practice at least 3 times per week and a further 30% at least weekly after leaving ED.Conclusion: Proctored training in the clinical context for ED registrars resulted in improvement in skills, confidence and willingness to maintain skills through practice in the clinical context over the long‐term.