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OBJECTIVE The quality of ultrasound images is impaired in obese patients. All ultrasound scanners are calibrated for an ultrasound propagation velocity of 1540 m/s, but the propagation in fatty tissue is slower (in the order of 1450 m/s). The main objective of this study was to evaluate the quality of images obtained with different ultrasound propagation velocity settings during the mid-trimester fetal ultrasound examination in obese patients. METHODS This was a cross-sectional study using image sets of four recommended scanning planes collected from 32 obese pregnant women during their mid-trimester fetal scan. Each image set comprised three images obtained successively at three different propagation velocity settings (1540 m/s, 1480 m/s and 1420 m/s). A panel of 114 experts assessed the quality of 100 image sets, grading them from A (most acceptable) to C (least acceptable). Scanning-plane-specific indicators of adiposity (fatty layer thickness, probe-to-organ distance) were analyzed for each scanning plane. RESULTS The experts had a mean of 18.1 ± 10.2 years of experience. The grade distribution (A, B, C) differed significantly (P

OBJECTIVES Outlet ventricular septal defects (VSDs) are usually suspected on the five-chamber view of the fetal heart; however, postnatal confirmation occurs only in a small number of cases. The aim of this study was to evaluate if the systematic assessment of the short axis view may improve the prediction of prenatally detected outlet VSDs. METHODS Cases where isolated outlet VSD was suspected on the five-chamber view were assessed by using the short axis scanning plane for confirmation of the defect. Postnatal assessment was performed within 2 weeks from birth at our Paediatric Cardiology Unit. RESULTS An outlet VSD was suspected at five-chamber view in 23 fetuses. Postnatal confirmation of the VSD occurred in 14 cases where the defect was prenatally detected both on the five chamber and the short axis views. VSDs were not confirmed at postnatal assessment only in two cases where outlet VSD was suspected on both views, whereas all the seven cases with a suspected VSD on the five-chamber view only turned out to be false positives. CONCLUSION The short axis view of the fetal heart seems useful in confirming the presence of outlet VSDs. © 2016 John Wiley & Sons, Ltd.

Muscle morphological characteristics obtained via ultrasonography have been used to quantify the size, architecture, and quality of skeletal muscle. Previous research has utilized varying ultrasonographic techniques, however there is little information comparing these different techniques. Muscle morphological characteristics, including cross-sectional area (CSA), muscle thickness (MT), echo intensity (EI), and subcutaneous adipose tissue thickness (SubQ) were assessed in 24 males (20.2 ± 1.6 y) via three panoramic-images captured in the transverse plane (PTI) and three still-images captured in the longitudinal plane (SLI). Cross-sectional area of PTI was significantly greater than CSA of SLI (P

With respect to the assessment of fetal behaviour, there have been numerous reports on the conventional two-dimensional (2-D) ultrasonographic evaluation of fetal movements. However, there are some limitations regarding the assessment of fetal movements using 2-D ultrasound. Because of the 2-D character of real-time scanning, fetal movements outside the scanning plane cannot be displayed on the monitor. The advent of three-dimensional (3-D) ultrasound significantly advanced fetal and placental evaluation in normal and abnormal pregnancies. The introduction of four-dimensional (4-D) ultrasound techniques would allow the assessment of fetal behavioural assessment in three dimensions in real time during pregnancy. We present the latest 4-D sonographic techniques and recent 4-D sonographic studies on fetal behaviour, especially fetal whole-body movements and facial expressions in all three trimesters of pregnancy, and the continuation of behaviour from the fetal to neonatal period. 2-D does not appear capable or comparable to 4-D ultrasound in terms of evaluating early fetal facial expressions. Moreover, we describe the safety of 3-D/4-D ultrasound during pregnancy. This novel technique may assist in the evaluation of fetal behaviour, and offer potential advantages relative to conventional 2-D ultrasound. 4-D ultrasound may be an important modality in future research on fetal neurobehavioural development, although some limitations regarding the assessment of fetal behaviour by means of 4-D ultrasonography still remain unresolved. Copyright © 2009 John Wiley & Sons, Ltd.

Endoluminal ultrasonography with small-caliber and high-frequency transducer is suitable for transcanal assessment of middle ear with effusion. An endoluminal ultrasound transducer (size 6 French, 20 MHz) with a side-viewing scanning plane was used to image 12 ears of six children suspected of having effusion in the middle ear. Sonographic findings were compatible with those of operation in 10 diseased ears. One false-negative result was obtained, and one trial was aborted owing to trauma to the canal wall. The present study proves utility in demonstrating fluid behind the tympanic membrane. A promising use of endoluminal ultrasonography for middle ear evaluation might be expected if some modification could be made to the transducer.

Purpose: To characterize couch sag on a CT scanner and determine the impact on patient treatments. A CT couch sags as it enters the gantry, and the amount depends on couch design, material, patient weight and distribution. Method and Materials: Four individuals were placed on a CT scanner couch (GE Discovery Lightspeed). A dial indicator was fixed to the bore of the CT scanner to measure couch deflection at the scanning plane when the couch was extended to various lengths. A second experiment was performed to measure sag at various positions for a fixed couch extension. A steel I‐beam with the dial indicator mounted on a rail was placed underneath the CT and tomotherapy couches. Two uniform loads were placed on the couch for three couch extensions and measurements were recorded at discrete locations. Results: Two forms of couch sag relevant to radiotherapy were observed: absolute and intra‐target sag. Absolute sag was shown to be 8.0±0.5 mm. Intra‐target sag depended on the S‐I length of the target and could be 2.3±0.5 mm. Both CT and tomotherapy couches displayed similar sag patterns. Differences in sag between the couches were more pronounced at short cantilevered distances with a maximum difference of 1 mm. Conclusion: A significant amount of sag occurs at the scanning plane resulting in a shearing of the images used for treatment planning. Absolute sag may be corrected by a couch height adjustment but intra‐target sag is a concern for elongated targets. The impact of sag on tomotherapy treatments is minimal since the relative difference in sag patterns between CT and tomotherapy couches is small. However, differences between CT and tomotherapy couch sag have become a concern for facilities treating total marrow irradiation (TMI) fields with tomotherapy. Conflict of Interest: Mackie has a financial interest in TomoTherapyInc.

Varying results have been reported concerning the echogenicity of normal superficial tendons. Our recent results using high-resolution real-time linear-array equipment indicate that the normal tendons display a specific echogenic longitudinally oriented fibrillar pattern. However, the visualization of this normal texture requires a perfect technique of examination. The obliquity of the ultrasound beams in relation to the tendon in longitudinal scans as well as the nonrespect of the strict perpendicularity of the scanning plane in transverse sections result in an artifactual hypoechogenicity of the normal tendon. Since hypoechogenicity has been shown a diagnostic criterion for inflammatory changes in tendons, the awareness of this pitfall is instrumental in preventing a false-positive diagnosis of tendinitis.