bluuebunny/crossref_metadata_2025_split huggingface dataset:
Three‐dimensional power Doppler sonography: imaging and quantifying blood flow and vascularization
Authors: Pairleitner H. , Steiner H. , Hasenoehrl G. , Staudach A. 
Published: March 2003

AbstractObjectivesTo assess the feasibility of imaging low‐velocity blood flow in adnexal masses by transvaginal three‐dimensional power Doppler sonography, to analyze three‐dimensional power Doppler sonography data sets with a new computer‐assisted method and to test the reproducibility of the technique.MethodsA commercially available 5‐MHz Combison 530 ultrasound system was used to perform three‐dimensional power Doppler sonography transvaginally. A cube (= volume of interest) was defined enclosing the vessels of the cyst and the Cartesian characteristics were stored on a hard disk. This cube was analyzed using specially designed software. Five indices representing vascularization (the vascularization index (VI)) or blood flow (the flow index (FI)) or both (the vascularization‐flow index (VFI)) were calculated. The intraobserver repeat‐ability of cube definition and scan repetition was assessed using Hartley's test for homogeneous variances. Inter‐observer agreement was assessed by the Pearson correlation coefficient.ResultsImaging of vessels with low‐velocity blood flow by three‐dimensional power Doppler sonography and cube definition was possible in all adnexal masses studied. In some cases even induced non‐vascular flow related to endometriosis was detected. The calculated F value with intraobserver repeated Cartesian file‐saving ranged from 0 to 18.8, with intraobserver scan repetition from 4.74 to 24.8 for VI, FI 1, FI 2 and VFI 1; for VFI 2 the calculated F value was 64. The interobserver correlation coefficient ranged between 0.83 and 0.92 for VI, FI 1, FI 2 and VFI 1; for VFI 2 the correlation coefficient was less than 0.75.ConclusionVessels with low‐velocity blood flow can be imaged using three‐dimensional power Doppler sonography. Induced non‐vascular flow was detected in endometriotic cyst fluid. Three‐dimensional power Doppler sonography combined with the cube method gave reproducible information for all indices except VFI 2. These indices might prove to be a new predictor in all fields of neoangiogenesis. The clinical relevance remains to be determined. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
WS06‐04Intracardiac echogenic focus and fetal heart defects
Authors: Chaoui R. , Bierlich A. 
Published: March 2003

BackgroundIntracardiac echogenic foci are controversially discussed whether or not they are marker for chromosomal aberrations. The possible association with fetal congenital heart defects (CHD) and its impact were not yet analyzed extensively.MethodDuring 30 months, prenatally detected structural CHD were prospectively analyzed for the presence of EF. Frequency, localization, number, association with chromosomal defects and pattern of CHD were assessed.Results279 fetal CHD could be examined and EF were found in 31 cases (11.1%). The localization was in 17 cases (54%) the left, in 7 (22%) the right, and in 7 (22.5%) both ventricles. Multiple EF were found in 10 cases. 14 cases (42%) were associated with a chromosomal aberration (T18 n = 2; T21 n = 5, T13 n = 3, Triploidy n = 2, Del22q n = 1, others n = 1). Among the remaining 17 fetuses with normal chromosomes following heart defects were found: 3 × VSD, 3 × Left‐persistent SVC, 2 × TGA, 2 × TOF, 2 × Coarctation, and 1 × PS, PA, Ebstein, TAC, AS each.ConclusionsCompared to low‐risk groups EF are more frequent in the presence of CHD and show another distribution involving more right ventricular or bilateral EF. The combination of EF and CHD is highly associated with aneuploidies. Since associated CHD include also conotruncal anomalies EF can be considered as an indication for targeted fetal echocardiography especially when EF is localized in the RV or in both ventricles.
The use of chorionic villus biopsy catheters for saline infusion sonohysterography
Authors: Platt L.D. , Agarwal S.K. , Greene N. 
Published: March 2003

Background
Saline infusion sonohysterography is one of the recent refinements of ultrasonography that has the ability to enhance imaging of the uterine cavity in a safe, inexpensive and expedient manner. The technique can be difficult in women with a stenotic cervical os. This report describes a single‐pass technique using chorionic villus sampling (CVS) catheters for saline infusion sonohysterography.
Method
Saline infusion sonohysterography requires the transcervical passage of a catheter, through which saline is infused. The subsequent distension of the uterine cavity enhances the ability to detect intrauterine pathology with ultrasonography. In women with cervical stenosis, a catheter can be used in place of the more conventional two‐pass technique, which requires the use of a uterine sound or probe followed by a conventional catheter.
Experience
We have used CVS catheters in women with cervical stenosis on 12 occasions. All have been successful and without significant discomfort to the patient.
Conclusion
The use of CVS catheters for saline infusion sonohysterography in women with cervical stenosis can alleviate the need to remove the cervical probe prior to introduction of the catheter.
Relationship between fetal femur diaphysis length and neonatal crown–heel length: the effect of race
Authors: Lim J.M.H. , Hong A.G. , Raman S. , Shyamala N. 
Published: March 2003

Objective To determine whether racial differences affect the relationship between the fetal femur diaphysis length and the neonatal crown–heel length.
Design A prospective study in a teaching hospital with a multiracial population.
Subjects Four hundred and fifty pregnant women (150 Malays, 150 Chinese and 150 Indians) who delivered live infants.
Methods Ultrasound scan measurement of the fetal femur diaphysis length was carried out within 48 h of delivery in all cases. The relationship between the neonatal crown–heel length and the femur diaphysis length was obtained by regression using the method of least squares. Dummy or indicator variables were used to determine the effect of race on the relationship.
Results The relationship between the neonatal crown–heel length and the femur diaphysis length in all three races was well described by a linear model but a quadratic model described the relationship better. There was no significant difference in relationship of the neonatal crown–heel length and the femur diaphysis length between the Malay and Chinese populations, but the relationship in the Indian population was significantly different was from both the Chinese and Malay. For a given femur diaphysis length, the crown–heel length of the Indian population was found on average to be 1. 1 cm shorter than the crown–heel length of the Malay and Chinese populations.
Conclusion Differences in fetal body proportions exist between some races. The longer femur diaphysis length noted in certain races does not necessarily imply that the corresponding crown–heel length is longer. These inter‐racial differences may increase the error of fetal weight and length estimates if formulae, which have been derived from samples racially dissimilar to that of the target population are used.
Fetal aortic arch measurements between 14 and 38 weeks' gestation: in‐utero ultrasonographic study
Authors: Achiron R. , Zimand S. , Hegesh J. , Lipitz S. , Zalel Y. , Rotstein Z. 
Published: March 2003

Objective To establish in‐utero reference ranges for fetal transverse aortic arch diameter (TAD) and distal aortic isthmus diameter (DAID) using high‐resolution ultrasound techniques.Design A prospective, cross‐sectional study was performed on 125 normal singleton pregnancies between 14 and 38 weeks' gestation. Transverse and diameter and DAID were measured by transvaginal ultrasonography until 17 weeks' gestation, and by abdominal ultrasound between 18 and 38 weeks' gestation.Results Transverse arch diameter as a function of gestational age was expressed by the regression equation TAD = − 1.17 + 0.169 X GA, and DAID = − 1.39 + 0.189 X GA; TAD and DAID are transverse aortic and distal aortic isthmus diameters expressed in millimeters and GA is gestational age in weeks. The correlation r = 0.924 and 0.938 was found to be highly statistically significant (P < 0.001) for TAD and DAID. The normal mean of TAD and DAID per week and the 95% prediction limits were also defined.Conclusions The normative data established by us may be helpful in the prenatal diagnosis of congenital heart defects, including abnormal growth of the aortic arch.
Diagnosis of small‐for‐gestational‐age fetuses between 24 and 32 weeks, based on standard sonographic measurements
Authors: Thiebaugeorges O. , Fresson J. , Audibert F. , Guihard‐Costa A. M. , Frydman R. , Droulle P. 
Published: March 2003

AbstractObjectiveTo create and validate a formula using sonographic biometry measurements for the optimal diagnosis of small‐for‐gestational‐age (SGA) fetuses between 24 and 32 weeks of gestation.MethodsA logistic model using gestational age, femur diaphysis length, abdominal and head circumferences to diagnose SGA was set up in a first group of 64 fetuses born between 24 and 32 weeks (group I). A Receiver Operating Characteristic (ROC) curve was drawn. Our model was compared with standard single ultrasound measurements or combined into an estimated fetal weight (EFW) formula. An external validation was carried out on a second group of 183 fetuses (group II) from another maternity unit (ROC curve and comparisons).ResultsThe area under the ROC curve was 0.91 in group I and 0.93 in group II. Using a 0.5 cut off point for our model yielded a sensitivity of 76% and specificity of 91% for group I. This model is more specific than most other measurement methods with a similar sensitivity.Using the same cut off point (0.5) in Group II, our model was more specific (98%) but less sensitive (66%) when compared with single ultrasound measurements and EFW formulae. By varying the cut off point, we were able to demonstrate that, for a similar sensitivity, our model had a higher specificity than single ultrasound measurements and had similar specificity to EFW formulae.ConclusionThe logistic model we set up was able to calculate an SGA risk score between 24 and 32 weeks of gestation in a population at high risk for elective delivery. The cut off point with a view to diagnosis can vary and makes it possible to give greater importance to the sensitivity or specificity depending on the clinical context. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Artifacts and the visualization of fetal distal extremities using three‐dimensional ultrasound
Authors: Hull A. D. , Pretorius D. H. , Lev‐Toaff A. , Budorick N. E. , Salerno C C. , Johnson M. M. , James G. , Nelson T. R. 
Published: March 2003

AbstractObjectivesTo demonstrate that acoustic shadowing in 3D US may give rise to artifacts simulating limb defects and provide a solution to eliminate its occurrence.MethodsTwenty second trimester fetuses (gestational age 15–24 weeks) were scanned with three‐dimensional ultrasound (3D US) using a sagittal acquisition plane. Fetal tibia/fibula and radius/ulna pairs were assessed for completeness of imaging. A further 20 fetuses (gestational age 20–26 weeks) were scanned in both axial and sagittal planes and the results compared to verify clear visualization of both bones.ResultsShadowing from adjacent structures produced an apparent limb defect in 55% of the first 20 fetuses imaged only sagittally (18% of limb pairs). Acquiring data from more than one orientation avoided this artifact.ConclusionsThe 3D US is subject to the same artifacts as two‐dimensional (2D US) in terms of acoustic shadowing, although their presentation may be different. Awareness of this fact is essential for correct interpretation of 3D US studies. Three‐dimensional scanning protocols should be modified to ensure that fetal structures are adequately visualized by acquiring volume data in more than one acquisition orientation. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Nuchal thickness evolution in trisomy 18 fetuses
Authors: Borrell A. , Farré M. T. , Echevarría M. , Martinez J. M. , Costa D. , Fortuny A. 
Published: March 2003

AbstractObjectiveTo assess the natural evolution of nuchal thickness in trisomy 18 fetuses.MethodsSerial measurements of nuchal thickness were performed over a 1‐ to 5‐week period in 17 fetuses with trisomy 18, from the 10th to the 20th week of pregnancy. To avoid a confounding effect due to gestational age, nuchal thickness was also expressed in standard deviations (SD) for the corresponding gestational week. In addition, the changes were assessed in terms of the presence of clinically positive thickening, considered as such when its measurement was above 2.5 SD for the corresponding gestational week.ResultsOn the initial nuchal thickness measurement, sensitivity for trisomy 18 decreased from 66% on assessment at 10–13 weeks of gestation to 38% at 14–16 weeks. In serial determinations, a mean increase of 1.3 mm [95% confidence interval (CI), 0.1–2.5] was observed for a mean period of 21 days. When corrected for gestational age, the mean increase of 0.2 SD (95% CI, −1.2 to −1.6) was found to be non‐significant. No clinically relevant changes were recorded on re‐examination, with nuchal thickening remaining stable in 76% of cases.ConclusionNuchal thickening at re‐examination was observed in a similar proportion of trisomy 18 fetuses as when initially observed. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Umbilical vein blood flow in growth‐restricted fetuses
Authors: Ferrazzi E. , Rigano S. , Bozzo M. , Bellotti M. , Giovannini N. , Galan H. , Battaglia F. C. 
Published: March 2003

AbstractObjectiveTo determine whether umbilical blood flow is reduced in a subset of growth‐restricted (IUGR) fetuses when expressed as flow per kilogram or flow per unit of specific sonographic fetal measurements.DesignProspective.SubjectsThirty‐seven IUGR fetuses were examined by Doppler ultrasound within 4 h of the last non‐stress test prior to delivery. This population was divided into three groups of varying clinical severity according to the characteristics of umbilical arterial pulsatility index (PI) and heart rate.MethodsAbsolute and weight‐specific umbilical vein (UV) flow were calculated from measurements of UV diameter and UV mean velocity. Umbilical vein diameter, velocity and UV flow were calculated also per unit head (HC) or abdominal circumference (AC) and correlated with gestational age.ResultsUmbilical vein flow (UVf) per kilogram fetal weight was significantly lower in the more severe IUGR fetuses (abnormal umbilical arterial PI) than in normally grown comparable fetuses (P < 0.001). Umbilical vein flow per unit HC was significantly lower in the three groups (P < 0.001) than in the control population. The UV diameter/HC ratio was normal whereas UV velocity/HC ratio was significantly lower in IUGR fetuses than in comparable controls.ConclusionsThe present study clearly establishes that umbilical venous blood flow is reduced in IUGR fetuses on a weight‐specific basis. The sonographic growth parameter which best distinguishes umbilical flow differences of IUGR fetuses from normal fetuses is the head circumference. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Abnormalities of the fetal central veins and umbilico‐portal system: prenatal ultrasonographic diagnosis and proposed classification
Authors: Achiron R. , Hegesh J. , Yagel S. , Lipitz S. , Cohen S.B. , Rotstein Z. 
Published: March 2003

AbstractObjectivesAnomalies of the fetal venous system are poorly documented and their pathogenesis is not well understood. The present study was undertaken to review the spectrum of fetal central veins and umbilico‐portal system anomalies, and to propose a classification system.MethodsA 7‐year restrospective survey was conducted.ResultsNineteen fetuses showed abnormal connection between central veins and the fetal heart. Three fetuses showed abnormal connections of the cardinal veins, two of which had interruption of the inferior vena cava, and one had isolated persistent left superior vena cava. Anomalies of pulmonary veins were seen in four fetuses: in two with asplenia syndrome, a vertical confluent pulmonary artery was observed. In a further two cases total anomalous pulmonary venous connections were found. Abnormalities of the umbilical vein (UV) were seen in 10 cases; seven had persistent right UV, and three had a spectrum of anomalies: One had abnormal connections of the UV to the left iliac vein associated with agenesis of the ductus venosus (DV) and hydrops fetalis. One case showedin utero occlusion of the DV by echogenic foci that resulted in a persistent left proximal UV and porto‐systemic shunt. One case had obliteration of the DV secondary toin utero fetal hepatic fibrosis. Abnormalities of the vitelline veins or portal system were demonstrated in two cases. One had a left porto‐systemic shunt which resolved spontaneously at 3 months of age, and one had secondary partial occlusion of the left portal system with liver echogenicities and direct communication of the UV with the right atrium. None of the 19 cases had an abnormal karyotype or evidence ofin utero infection.ConclusionsDetection of various fetal vein anomalies in utero is feasible. The anomalies vary according to embryologic precursors or etiology. Two major mechanisms seem to be involved in the genesis of fetal vein anomalies: in most cases primary maldevelopment of the venous system occurs, while in the minority secondary anomalies from possible thromboembolic events or systemic disease may play a role. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
The pulmonary vein Doppler flow velocity waveform: feature analysis by comparison of in vivo pressures and flows with those in a computerized fetal physiological model
Authors: Talbert D. G. , Johnson P. 
Published: March 2003

AbstractObjectivesDoppler flow velocity waveforms (FVW) in fetal veins that discharge into the atria show fluctuations related to atrial events. Pulmonary veins are of particular interest because both ends (atrial and collecting venule) are within the intrathoracic pressure environment reducing fetal breathing artifacts. Indices, such as pulsatility index for veins (PIV), have been suggested to classify FVWs and relate them to fetal well being.We wished to examine the relationship between function and FVW in circumstances which cannot ethically be examined in vivo by studying the mechanisms which produced altered ‘flows’ in a detailed fetal computer model. We then related these findings to current flow indices.MethodsA computer model of the feto‐placental unit, responding to changes in organ oxygenation and regional flow is briefly described. In vivo intracardiac pressures and FVWs obtained from other studies were used to extend detail in the model until matching ‘pressures’ and ‘flows’ resulted. The effects of flow redistribution in the hypoxic fetus on pulmonary vein ‘Doppler’ flow velocity waveforms were then studied.Results and conclusionsFlow reversal in pulmonary veins during atrial contraction indicates hypoxia, but change of shape of the FVW envelope reflects the changes in the pressure waveform of the left atrium. Of the major veins the pulmonary vein Doppler FVW gave the truest representation of atrial pressure response to both intracardiac and systemic vascular status. Although current indices indicate general fetal condition, more specific indices are needed if pulmonary venous flow is to be used as an end‐point. A pulmonary vein pressure gradient index is suggested. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Using unconditional and conditional standard deviation scores of fetal abdominal area measurements in the prediction of intrauterine growth restriction
Authors: Owen P. , Burton K. , Ogston S. , Khan K. S. , Howie P. W. 
Published: March 2003

AbstractObjectiveTo compare the performance of unconditional and conditional standard deviation scores (Z scores) of fetal abdominal area (FAA) measurements in the antenatal identification of infants born with anthropometric features of intrauterine growth restriction.MethodsA prospective observational study, involving 274 low‐risk women participating in a longitudinal study of serial ultrasound in pregnancy. Conditional Z scores were established for the last FAA prior to delivery with reference to measurements made both 28 and 56 days previously. Unconditional Z scores (size) were calculated from the last FAA measurement prior to delivery. Receiver–operator characteristics curves were employed to determine an optimal cut‐off point for Z scores to predict intrauterine malnourishment. The main outcome measures were: likelihood ratios (LR) for conditional and unconditional Z scores of FAA in the prediction of infants with skinfold thickness < 10th percentile; ponderal index < 25th percentile or mid‐arm circumference to occipito‐frontal circumference ratio (MAC/OFC) of < −1 SD. An LR of > 10 generates significant changes in the pretest probability of growth restriction, whereas an LR of 5–10 generates only moderate changes.ResultsConditional Z scores with 28‐ and 56‐day separations predicted growth restriction with LR 7.5 (95% confidence interval [CI], 3.7–14.7) and 4.8 (95% CI, 2.8–7.8) for ponderal index but did not usefully predict skinfold thickness or MAC/OFC. Unconditional Z scores did not usefully predict any of the parameters of growth restriction.ConclusionsQuantifying third trimester fetal growth by means of FAA conditional Z scores is moderately useful in predicting infants with a low ponderal index and is superior to unconditional FAA Z scores in late pregnancy. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal evaluation of cephalopagus conjoined twins by means of three‐dimensional ultrasound at 13 weeks of pregnancy
Authors: Kuroda K. , Kamei Y. , Kozuma S. , Kikuchi A. , Fujii T. , Unno N. , Baba K. , Taketani Y. 
Published: March 2003

AbstractCephalopagus twinning, an extremely rare type of conjoined twins, is characterized by the anterior union of the upper half of the body, with two faces each situated on the opposite side of a conjoined head. The prognosis for cephalopagus twins is extremely poor because surgical separation is not an option. Thus early prenatal diagnosis of cephalopagus twins is important to provide an opportunity for pregnancy termination if desired. However, in many instances, cephalopagus twins are misdiagnosed as a singleton pregnancy because of the extreme degree of fusion which makes accurate demonstration of the abnormalities very difficult. This report presents a case of cephalopagus twins which was confirmed at 13 weeks of gestation using three‐dimensional ultrasound. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
The progression of mediastinal lymphangioma in utero
Authors: Jung E. , Won H. S. , Lee P. R. , Lee I. S. , Kim A. , Nam J. H. 
Published: March 2003

AbstractWe describe a case of mediastinal lymphangioma that suddenly progressed in utero. The initial sonographic impression was one of pericardial effusion while the follow‐up examination revealed a mediastinal cystic mass. At 35 weeks of gestation preterm labor occurred. An ultrasound examination performed at this time demonstrated the mediastinal cyst with internal hemorrhage and fetal hydrops. The cystic mass was resected 5 days after birth. The diagnosis of lymphangioma was made from histological examination. The infant was followed up for 18 months and remained well. We recommend frequent prenatal sonographic follow‐up when a localized fluid collection is shown in the mediastinum. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology