bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative assessment of gray‐level perception: observers' accuracy is dependent on density differences
Authors: Smith‐Levitin M. , Blickstein I. , Albrecht‐Shach A. A. , Goldman R. D. , Gurewitsch E. , Streltzoff J. , Chervenak F. A. 
Published: March 2003

AbstractSonographic image density represents tissue echogenicity, or the acoustic nature of scanned tissue. It has the potential to distinguish normal from abnormal tissue. Humans are poor assessors of tissue echogenicity, yet their abilities have not been quantitatively compared to more objective methods. We compared the accuracy of image density differentiation by the human eye and by densitometry in the fetal liver model.A group of 60 observers was asked to compare the echogenicity of three pairs of images of a fetal liver. Twenty‐three repeated the comparison several weeks later. Image density was measured by electro optical densitometry. The two‐tailed signed rank test was used to compare the observer's perceptions with the density values and the repeated observations with the original responses.The density of each fetal liver image in pair A was the same. Image B1 had a 12.3% lower density than image B2, and image C1 had a 6.3% greater density than image C2. Observers were accurate more often when comparing images with large density differences (pair B) than they were when comparing images with the same density (pair A) or with small density differences (pair C). Accuracy was not related to being medically qualified or from an obstetric or gynecological department. Intraobserver variation was not significant.We conclude that the human eye is extremely inaccurate at discerning differences in echogenicity when images have small or no differences in optical density. Densitometry is, therefore, indispensable for accurate image density assessment. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of neural tube defect before 12 weeks' gestation: direct and indirect ultrasonographic semeiology
Authors: Bernard J. P. , Suarez B. , Rambaud C. , Muller F. , Ville Y. 
Published: March 2003

AbstractWe describe the direct and indirect ultrasonographic features of a case of lumbar open spina bifida. The spinal defect was the prominent feature at 10 weeks + 5 days' gestation; however, cranial signs including narrowing of the frontal bones and flattening of the occiput were helpful at 12 weeks. This ‘acorn’ sign is likely to precede the ‘lemon’ sign, describing scalloping of the frontal bones at a later gestation. The diagnosis of spina bifida was confirmed by electrophoresis of the amniotic fluid, which showed an abnormal migration of acetylcholinesterase. Postmortem ultrasound examination of the same fetus proved useful in refining the diagnosis and also revealed the presence of the Arnold‐Chiari malformation. Development of ultrasound screening in the first trimester of pregnancy should allow further evaluation of these findings. It seems reasonable to confirm such an early diagnosis by electrophoresis of the amniotic fluid as an alternative to ultrasonographic confirmation at 13–14 weeks. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Two‐dimensional echocardiographic evaluation of ventricular systolic function in human fetuses with ductal constriction
Authors: Harada K , Rice M J , Shiota T , McDonald R W , Reller M D , Sahn D J 
Published: March 2003

AbstractThis paper was originally published in Ultrasound Obstet Gynecol 1997; 10:247–53. Figure 1 on p.248 was mislabelled in respect to the right and left ventricles. The correct figure is given. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Ductus venosus agenesis prevents transmission of central venous pulsations to the umbilical vein in fetal sheep
Authors: Kiserud T. , Crowe C. , Hanson M. 
Published: March 2003

AbstractVelocity pulsations in the umbilical vein are widely used as a marker for congestive heart failure in the fetus. It has been suggested that the atrial pressure waves are transmitted to the umbilical vein mainly through the ductus venosus. In a case of ductus venosus agenesis in a fetal sheep of 110 days' gestation, we recorded pressures in the inferior vena cava and umbilical vein simultaneously with Doppler velocimetry in the medial hepatic vein and umbilical vein, under general anesthesia. During fetal respiratory acidosis (pH 7.01) and varying degrees of umbilical clamping, we did not observe the typical pulsations in the umbilical vein (deflections of the maximum velocity during atrial contraction) in spite of varying degrees of reversed flow in the hepatic vein (5–16%). The systolic‐diastolic pressure amplitude in the inferior vena cava was 5.5–6.4 mmHg, sometimes reaching 9.19–11.03 mmHg. Varying degrees of reversed portocaval pressure gradient during atrial contraction (1.40–9.51 mmHg), periods of reversed portocaval pressure gradient throughout the entire cardiac cycle, tachycardia (240 beats/min) or bradycardia (99 beats/min) also did not produce the type of pulsation in the umbilical vein that reflects augmented atrial contractions. The results support the hypothesis that the ductus venosus is essential for the transmission of atrial pressure waves to the umbilical vein. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Image magnification does not contribute to the repeatability of caliper placement in measuring nuchal translucency thickness
Authors: Herman A. , Maymon R. , Dreazen E. , Caspi E. , Bukovsky I. , Weinraub Z. 
Published: March 2003

AbstractThe objective of this study was to assess whether nuchal translucency image magnification contributes to the repeat‐ability of caliper placement. Twenty‐seven women undergoing first‐trimester ultrasound screening at 11–14 weeks were examined by two qualified examiners. Fetal nuchal translucency thickness was measured twice by each examiner on a regular‐sized image and subsequently on the same still image magnified. Intraobserver repeatability coefficients of the regular‐sized images were 0.28 mm and 0.34 mm for examiners A and B, respectively. Identical intraobserver repeatability coefficients of 0.28 mm were attained for both examiners on the magnified images. Interobserver repeatability of regular‐sized image measurements showed a significant difference (p < 0.01) but the mean difference (± standard deviation) of 0.10 (0.18) mm was negligible. Similarly, interobserver repeatability of the magnified‐ image measurements yielded a significant difference (p < 0.02), but again with a small mean difference of 0.13 (0.26) mm. There were also significant differences when regular‐sized images and magnified images were compared for both examiners: 0.08 (0.16) mm for examiner A (p < 0.02) and 0.10 (0.17) mm for examiner B (p < 0.01). Our results demonstrate that nuchal translucency image magnification does not contribute to the reproducibility of the measurement. Despite significantly smaller mean values obtained from the magnified images, compared to the regular‐sized measurements, those differences do not justify modification of the criteria for caliper placement on magnified images. Blind repeated measurements on a regular‐sized and/or magnified image are recommended as a tool for self‐assessment, quality control and training. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Ultrasonographic measurement of crown‐rump length in high‐order multifetal pregnancies
Authors: Saade G. R. , Gray G. , Belfort M. A. , Carpenter R. J. , Moise K. J. 
Published: March 2003

AbstractThe objective of the study was to evaluate the crown‐rump length (CRL) in high‐order multifetal pregnancies (three or more fetuses). The records of patients who underwent multifetal pregnancy reduction were reviewed. The following parameters were defined: the mean CRL (CRLMEAN) and the difference between the largest and smallest CRL (CRLRANGE) for each pregnancy. CRLMEAN was plotted versus gestational age (GA) and the line of best fit was derived. The residual for each CRL (CRLRES) was calculated by subtracting the value predicted by the regression line from the individual CRL (CRLIND). Regression lines for single‐tons with confirmed GA from four previously reported studies were used for comparison. A total of 82 patients were included (29 triplets, 38 quadruplets and 15 quintuplets; mean GA 10.7 ± 0.78 weeks). CRLMEAN correlated with GA (CRLMEAN = 38.88 ± 8.78(GA) + 0.82(GA)2; R = 0.83; R2 = 0.70). This second‐degree polynomial remained within the range for singletons. No significant differences in maternal age, GA and CRLMEAN were noted between the patients with different numbers of fetuses. The median CRLRANGE was largest in quintuplets, followed by quadruplets and triplets. The CRLRANGE correlated poorly with GA. The mean CRL in multifetal pregnancies increases with GA similarly to that in singletons. The variability of individual measurements increases with the number of fetuses and CRLs are lower in quintuplets. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Arteriovenous fistulas of the placenta in a singleton fetus with large atrial septal defect and anomalous connection of the umbilical veins
Authors: Chiappa E. , Viora E. , Botta G. , Abbruzzese P. A. , Ciriotti G. , Campogrande M. 
Published: March 2003

AbstractArteriovenous fistulas of the placenta rarely occur in single‐ton pregnancies. This report describes the fetal and neo‐natal hemodynamic pattern in a singleton gestation in which multiple placental artery‐to‐vein anastomoses were associated with a large atrial septal defect and a single umbilical artery with an anomalous connection of the persistent right and left umbilical veins. Possible links between the extracardiac vascular malformation and the congenital heart defect are discussed. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Sonographic diagnosis of a retroperitoneal dermoid cyst in a young girl
Authors: Kanizsai B. , Turi Z. , Örley J. , Szigetvári I. , Doszpod J. 
Published: March 2003

AbstractWe describe the detection and management of a retroperitoneal dermoid cyst in a young girl. Transabdominal ultrasound revealed in the pelvis a complex mass with anechogenic and echogenic components characteristic of a dermoid cyst. Initially, it was presumed to be of ovarian origin, because extragonadal dermoid cysts are very rare in adolescence; however, the findings on physical examination were normal. Laparoscopy was performed but failed to identify a cyst. Ultrasound examination was repeated intraoperatively and confirmed the presence of the cyst, which was then removed by laparotomy from the retroperitoneum. This case illustrates the significance of ultrasonography in the diagnosis of a rare condition in adolescent gynecology and demonstrates the possibility of performing ultrasound scanning intraoperatively to confirm the presence of a mass which was not identified by laparoscopy. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Myocardial motion imaging: a new application of power color flow and frequency‐based color flow Doppler in fetal echocardiography
Authors: Twining P 
Published: March 2003

AbstractObjectiveMyocardial motion imaging is a new way of looking at the fetal heart using power color flow and frequency‐based color flow Doppler to demonstrate heart wall movement in color. This study set out to assess the value of myocardial motion imaging in fetal echocardiography in a routine clinical setting.DesignIn our hospital, all patients at high risk of carrying a fetus with a cardiac abnormality are offered detailed ultrasound scanning, including fetal echocardiography, at 20 weeks' gestation. A prospective study was carried out over a 2‐month period and, in addition to conventional fetal echocardiography, myocardial motion imaging was also carried out on all patients, by means of both power color flow and frequency‐based color flow Doppler ultrasound.ResultsMyocardial motion imaging demonstrated fetal heart wall movement in 26 of the 27 patients. Myocardial motion imaging using power color flow gave a global view of fetal heart wall movement, demonstrating both atrial and ventricular contraction simultaneously. Myocardial motion imaging using frequency‐based color flow Doppler demonstrated atrial and ventricular contractions separately.In addition, as the direction of fetal heart wall motion can be color coded, atrial contractions, ventricular relaxation and ventricular contraction were demonstrated, providing a functional assessment of fetal heart wall movement. Two cases of cardiac abnormality were also studied, one case of hypoplastic left heart syndrome and one case of atrioventricular septal defect. In both cases functional information was obtained using myocardial motion imaging, and the technique also highlighted the anatomical defect.ConclusionsMyocardial motion imaging produces both a global view of fetal cardiac anatomy and a functional assessment of individual chamber contraction in the normal and abnormal heart. It may prove to be a useful adjunct to conventional color flow Doppler assessment of the fetal heart. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Fetal cataract in congenital toxoplasmosis
Authors: Pedreira D. A. L. , Diniz E. M. A. , Schultz R. , Faro L. B. , Zugaib M. 
Published: March 2003

AbstractWe report a case of the prenatal diagnosis of fetal cataract due to congenital toxoplasmosis. To the best of our knowledge, this is the first report of such case. We discuss the long‐term ocular sequelae of the condition and how they should affect prenatal counselling Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Antenatal sonographic diagnosis of epignathus at 15 weeks of pregnancy
Authors: Gull I. , Wolman I. , Har‐Toov J. , Amster R. , Schreiber L. , Lessing J. B. , Jaffa A. 
Published: March 2003

AbstractEpignathus is a rare, benign, congenital teratoma of the hard palate. Most of these teratomas are unidirectional and protrude through the mouth. Hence, the prognosis depends on the size of the tumor and the degree of face distortion and airway obstruction that it causes. However, some epignathi protrude bidirectionally, involving and destroying the brain tissue, resulting in a poor prognosis. This report presents a case of ultrasonographic detection of a bidirectional epignathus at 15 weeks of pregnancy. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal salpingosonography for assessing tubal patency in women previously treated for pelvic inflammatory disease and benign ovarian tumors
Authors: Spalding H. , Martikainen H. , Tekay A. , Jouppila P. 
Published: March 2003

AbstractObjectiveThe aim of this study was to evaluate the role of transvaginal salpingosonography in the assessment of tubal patency among women previously treated conservatively for pelvic inflammatory disease and surgically for a benign ovarian tumor.DesignTwenty‐two women were recruited for this study at the University Hospital of Oulu. Transvaginal salpingosonography was scheduled to be performed twice within a 3‐month interval. X‐ray hysterosalpingography was chosen as a reference method and was performed within 2 days of the second salpingosonography examination during the same menstrual cycle. Altogether, 31 Fallopian tubes were assessed with the second salpingosonography examination and X‐ray hysterosalpingography.ResultsTwenty‐nine Fallopian tubes were observed by both methods to be patent (i.e. 29 tubes by each method, but not necessarily the same tubes). An occlusion was diagnosed by each method in two tubes only, of which one appeared occluded by both methods, while one tube from each method appearing to be occluded was demonstrated to be patent using the other method. The agreement of transvaginal salpingosonography compared with X‐ray hysterosalpingography was 94%, the sensitivity 50%, the specificity 97%, the positive predictive value 50% and the negative predictive value 97%. Two successive transvaginal salpingosonography examinations were performed in 18 patients with 27 Fallopian tubes. Disagreement was observed for only one tube. The agreement between these two examinations was 96%, the sensitivity 100%, the specificity 96%, the positive predictive value 67% and the negative predictive value 100%. The kappa coefficient was 0.78 (95% confidence interval 0.75–0.81).ConclusionsIn conclusion, transvaginal salpingosonography can be used in patients with previous pelvic inflammatory disease and adnexal surgery due to its ease of use, reliability and low costs on an out‐patient basis. Among these patients, tubal patency was a common finding. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Uterine anomalies and failed surgical termination of pregnancy: the role of routine preoperative transvaginal sonography
Authors: Jermy K. , Oyelese O. , Bourne T. 
Published: March 2003

AbstractAlthough used extensively in the assessment of many gynecological conditions, transvaginal ultrasonography is not performed routinely prior to termination of pregnancy in the UK.We describe a case in which surgical evacuation of the uterus failed. Postoperatively, transvaginal ultrasonography demonstrated a bicornuate uterus with a viable pregnancy within the left horn. Subsequent medical termination of pregnancy was successful.This case shows the potential value of transvaginal ultrasonography prior to termination of pregnancy. A prospective trial is needed to assess whether its routine introduction into clinical practice will lead to a reduction in morbidity resulting from termination. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
P10Development of cardiac size in early pregnancy
Authors: Rosati P. , Guariglia L. 
Published: March 2003

BackgroundThe relationships between measurement of cardiac circumference, obtained by transvaginal sonography in early pregnancy, and other sonar fetal parameters – crown rump length, biparietal diameter, head, toracic and abdominal circumference, femur, humerus and foot length – were analysed in order to assess the role of these variables for the identification of fetuses at risk of abnormal cardiac development.MethodsStudy population consists of 1435 euploid fetuses at 9–16 weeks of gestation. Ultrasound examinations were performed using high‐resolution apparatus (model SSA‐270 A and SSA‐340 A; Toshiba Medical Corporation, Tokyo, Japan) equipped with 5.0–7.0 MHz transvaginal probes with a maximal angle of vision of 86° and 121°, respectively. au scans were performed by the authors. Nomograms were established for cardiac circumference vs. eight sonographic parameters.ResultsCardiac circumference demonstrates to be highly correlated with abdominal circumference (r2of 0.65) with narrow confidence interval of cardiac circumference ranging from 6 to 19%.ConclusionOur results showed also a good correlation between cardiac circumference and the other variables suggesting that cardiac measurement in early pregnancy could be a screening tool for identifying fetuses at risk of disorders affecting heart growth.
P112Early fetal echocardiography at 13–16 weeks of gestation
Authors: Martinez J.M. , Puerto B. , Borrell A. , Cararach V. , Fortuny A. 
Published: March 2003

ObjectiveOur aim was to determine the potential value of fetal echocardiography at 13–16 weeks of gestation for early reassurance of normality or a prenatal diagnosis of congenital heart disease in high‐risk pregnant women.Methodology92 pregnant women from 13 to 16 weeks with singleton pregnancies underwent fetal echocardiography because of a high risk of congenital heart disease. The main indications were: nuchal translucency > 95th centile, pregestational diabetes, family history, suspected cardiac anomaly at screening ultrasound, woman at risk of chromosomal abnormality declining invasive testing and fetus affected by a chromosomal abnormality. All the examinations were performed combining either the transvaginal or the transabdominal route, and were considered as complete when the four chamber view, and the origin and double crossing of the great arteries were correctly identified. Colour and pulsed Doppler examination were used to detect regurgitation or very high velocities suggesting valve stenosis. A further conventional transabdominal echocardiography at 20–22 weeks of gestation was performed in all aparently normal cases.ResultsWe were able to reassure normality in 84 of the cases and eight congenital heart anomalies were diagnosed.ConclusionFetal echocardiography at 13–16 weeks' is feasible and can be offered to high risk pregnants. It should be supplemented with the conventional 20–22 weeks' examination whenever normality is diagnosed in the early scan. Postmortem examination is essential to confirm its accuracy.
P113Prenatal diagnosis of congenital heart defects: report of 263 cases
Authors: Galindo A. , Carrera M. , Salvador M. , Gutiérrez‐Larraya F. , Gómez E. , De La Fuente P. 
Published: March 2003

AimTo evaluate the main characteristics of prenatally diagnosed congenital heart defects (CHD).MethodsRetrospective study of 263 fetuses with CHD diagnosed between January 1993–September 1999. In this period 133 more cases were born with a CHD not identified prenatally.ResultsThe incidence in the period reviewed was 1/148 deliveries (7‰). 161 patients (61%) were referred from other Hospitals. Mean gestational age at diagnosis was 27.1 weeks (range: 13–41). 103 were diagnosed before 22 weeks (39%). Most common CHD were complete atrioventricular canal (CAVC) (49 cases, 18%), hypoplastic left heart syndrome (HLHS) (37,14%) and conotruncal anomalies (CTA) (31, 12%). Postnatally, most common CHD were ventricular septal defects (VSD) (70, 29%). Overall sensitivity was 66%, improving from 1993 (60%) to 1999 (80%). Sensitivity was higher for CAVC (86%), HLHS (90%), tricuspid atresia (93%). Sensitivity was poor in VSD (26%). Associated anomalies were seen in 105 cases (40%) more common in CAVC (37/49, 75%), VSD (16/22, 73%) and CTA (14/31, 45.2%). In 85 cases (32%) termination of pregnancy (top) was performed. This represents 82.5% of 103 cases diagnosed < 22 weeks' gestation. tops were more common in CAVC (39%) and HLHS (46%).ConclusionFetal echocardiography enables the diagnosis of a high number of CHD in the first half of pregnancy. Changes in the monographic visualization of the CHD over the pregnancy with potential progression of the lesion in utero, the small size of the defect and difficulties in monographic work‐up are explanations for late diagnosis and false negative cases. The distribution of the different CHD differs from that observed postnatally. Associated anomalies should be ruled out because of their high frequency, mainly in some specific heart defects.