Journal of Clinical Ultrasound
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The interatrial septum was studied with B‐mode echocardiography to determine whether there were specific ultrasonic features characteristic of such congenital heart diseases as atrial septal defect and endocardial cushion defect. In transverse tomograms in the third and fourth intercostal space the interatrial septum is detected almost parallel to the anterior chest wall. The septum continues leftward to the echo of the anterior mitral leaflet. When the interatrial septum extends beyond the left sternal border, it can also be recorded near the left sternal border in the sagittal tomogram. The interatrial septum can also be recorded conventional echocardiography. The pattern is wavy and synchronous with the heart beat with an amplitude of about 10 mm. It is seen near the chest wall in patients with left atrial enlargement and far from the chest wall in patients with right atrial enlargement. The defect in the interatrial septum was visualized B‐mode and conventional echocardiogram in patients with ostium secundum atrial septal defect. The defects were no longer observed after surgery.
The aim of this retrospective study was to analyze the sonographic features of hepatic lesions in patients with fascioliasis to help determine the utility of sonography in diagnosing this disorder in patients from areas in which
Seven patients with acute‐phase (hepatic) fascioliasis had been identified among a previously reported series of 37 patients with fascioliasis who had been evaluated sonographically at Donostia Hospital in San Sebastián (Guipúzcoa), Spain. The 4 men and 3 women ranged in age from 29 to 69 years (mean, 49 years). A history of ingestion of watercress had been confirmed in 6 of the patients.
Sonographically, the hepatic lesions appeared as focal areas of increased echogenicity in the right lobe (2 cases), multiple nodular or irregular lesions of variable echogenicity, ranging from 5 to 25 mm in diameter, in both lobes (4 cases), and a single 6‐cm complex mass in the right hepatic lobe (1 case). Therapy with dehydroemetine, praziquantel, or bithionol resulted in complete remission, although 2 patients required an additional treatment cycle. One patient also underwent surgery.
Sonography can be useful in the detection and follow‐up of hepatic lesions in human fascioliasis and can facilitate the diagnosis of this condition, particularly in areas where it is endemic. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:358–363, 2003
The aim of this study was to assess the use of transvaginal sonography to detect retained products of conception after first‐trimester spontaneous abortion.
All women who arrived at our hospital with spontaneous first‐trimester abortions were included in this study and underwent transvaginal sonography. A sonographic diagnosis of “incomplete abortion” was based on a bilayer endometrial thickness of more than 8 mm. The final diagnosis of complete or incomplete abortion was based on the histopathologic findings at dilatation and curettage. The sensitivity and specificity of both clinical and sonographic examinations for detecting products of conception were assessed.
A total of 113 women were recruited, and 14 were excluded for various reasons. Among 52 women with a clinically incomplete abortion, only 50% had retained products of conception. The use of transvaginal sonography resulted in a 29% (15/52) reduction of surgical intervention in these women. On the other hand, 30% (14/47) of women with a clinical diagnosis of complete abortion had retained products of conception. The sensitivity and specificity of cervical status for detecting retained products of conception were 65% and 56%, respectively, whereas the overall sensitivity and specificity of transvaginal sonographic examination (bilayer endometrial thickness 8 mm or less) were 100% and 80%, respectively.
Transvaginal sonography is a useful supplement to clinical assessment in women who experience a spontaneous first‐trimester abortion. If this modality is used to assess the uterine cavity, the cervical status can be ignored. Use of transvaginal sonography should reduce unnecessary general anesthesia and uterine curettage. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 30:428–432, 2002
To determine the best predictors of the presence of retained products of conception (RPOC) on grayscale and color Doppler transvaginal sonographic examination.
This was a retrospective study of 91 consecutive patients who underwent transvaginal sonography (TVS) with color Doppler to evaluate for the presence of RPOC. The images of TVS studies were reviewed by two radiologists in consensus blinded to the final outcome. Data on a number of variables including endometrial measurable mass and focal increased color vascularity were collected as predictors of RPOC. The patients' ages ranged from 17 to 48 years (mean, 31.8 ± 6.8) and gestational age from 5 to 24 weeks (mean, 9.2 ± 3.8). Thirty‐six were confirmed as RPOC by dilatation and curettage (D&C) and pathology. Fifty‐five were considered negative, 9 based on D&C results and 46 on clinical grounds.
Sensitivity, specificity, negative‐ and positive‐predictive and accuracy values were 81% (CI: 68%–94%), 71% (CI: 59%–83%), 85% (CI: 74%–95%), 64% (CI: 50%–78%), and 75% (CI: 66%–84%) to detect RPOC when a mass was present. The corresponding numbers for the presence of focal color vascularity were 94% (CI: 87%–100%) (
An area of focal increased vascularity with or without a mass is the best predictor of the presence of RPOC. © 2011 Wiley Periodicals, Inc. J Clin Ultrasound, 2011
In the course of doing routine echocardiograms on patients with mitral prosthetic valves, we observed peculiar intracavitary echoes within the left ventricle. Of the 36 valves studied in 31 different patients, 14 echocardiograms demonstrated the abnormal intracavitary echoes and 22 did not. The presence of mitral insufficiency, atrial fibrillation, systemic emboli and warfarin sodium (Coumadin) therapy were roughly equal in the two groups. A higher percentage of abnormal intracavitary echoes occurred in patients with a hemoglobin less than 11 gm/100 ml, other prosthetic valves, cloth covered valves, low platelets, and functional class III–IV. Although this study does not clarify the origin of these abnormal echoes, it is possible that they originate from particulate matter such as tiny fibrin clots or fibers from the cloth covering of the valve.
Experience with B scan ultrasound in the study of a series of patients admitted to the Johns Hopkins hospital for suspected occult hematomas has been reviewed. Patients included in this report acquired hematomas primarily as the result of medical or surgical therapy. The ultrasonic appearance in most patients is that of a cyst, due to unclotted or homogeneously clotted blood which generates no internal echoes. As soon as fragmentation of the clot occurs, internal echoes are usually found. B scanning was of value in detection, localization and follow‐up of hematomas and was the only diagnostic test used in seven of eleven cases.
The advantage of this technique for diagnosis and follow‐up are related to the simplicity of the procedure, its lack of sideeffects and low cost.
The benign cystic ovarian teratoma (dermoid) has distinctive ultrasonic features that differentiate it from other adnexal masses. The most frequent sign is the presence of highly reflective irregular solid components within a fluid‐conentaining adnexal mass.
The classical ultrasonic description of a chronic ectopic pregnancy is a slightly enlarged uterus with uniform internal echoes and no evidence of an intrauterine pregnancy, combined with an extrauterine semicystic mass, gestational sac, or fetal structures. It is our experience that the ultrasonographer more commonly finds a midline pelvic mass containing irregular echo patterns and cystic areas. The mass may also be associated with abdominal or pelvic fluid and obliteration of normal anatomical structures. We wish to emphasize these variations from the classical description with illustrations that demonstrate the differences in the ultrasonic presentation of chronic ectopic pregnancy.
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