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Background: The spinal intradural mass lesions represent a challenge in microsurgical practices. The intraoperative precise localization and characterization of these lesions must be achieved to avoid excessive exposure and neural tissue damage. This study aims to evaluate the role of intraoperative ultrasound during surgical dealing with spinal intradural mass lesions starting before bony work exposure. Results: This prospective study had been done during the period from January 2022 to January 2023 with follow-up at least 6 months on 36 patients, suffered intradural spinal mass lesions and underwent microsurgical interventions aided with intraoperative ultrasound. MRI spine and Klekamp score were used as preoperative and postoperative parameters for assessment of the patients. Intraoperative ultrasound features were analyzed to evaluate its values. All lesions were visualized and characterized by intraoperative ultrasound beside spinal anatomical identification. Laminoplasty, laminectomy, durotomy and myelotomy were determined by IOUS. Gross total eradication was achieved in 28/36 (78%). Intraoperative ultrasonography definition of cystic component, well-defined borders and smooth shape of the masses were associated with significant Klekamp outcome improvement. Conclusion: Intraoperative ultrasound can be used safely to detect the spinal intradural mass lesions even before bony work for exposure with anatomical and pathological definition and has the ability to predict the outcome. [ABSTRACT FROM AUTHOR]

Background In vitro fertilization (IVF) shows potential to improve pregnancy success, especially for infertile couples. This technique has some risks for neonates in the perinatal period and may affect their future health. Objective To investigate the characteristics and clinical outcomes of neonates from IVF-conceived pregnancies. Methods This retrospective study was conducted in neonates from IVF-conceived pregnancies at Bunda Women's and Children's Hospital, Jakarta. We gathered data from medical records about maternal age and morbidity, gravidity, gestational age, method of delivery, multiple gestation, also neonates' significant profiles like prematurity, birth weight, Apgar score, and morbidities in perinatal period. Results There were 361 neonates whose mothers underwent IVF included in this study. Most mothers were =35 years (70.9%) and on their first pregnancy (69.2%). Maternal complicating factors were premature contractions (16.6%), premature rupture of membranes (8.3%), and twin pregnancy (31.5%). About 98.6% of deliveries were performed by caesarean section and 61.2% neonates were born at full term gestation. Preterm deliveries occurred at a mean gestational age of 34.4 (SD 2.4) weeks. Subjects' mean birth weight was 2,800.2 (SD 640.3) grams, with 26.3% in the low-birth-weight category. Most neonates (93.0%) were appropriate weight for gestational age and had good Apgar scores in the first minute (92.2%) and fifth minute (99.7%). However, 24.3% of neonates needed intensive care (NICU) with morbidities. The longest length of NICU stay was 100 days, with mortality of 7.9% of NICU-treated infants. Conclusion In our setting, most neonates from the IVF program are born with good outcomes, although preterm birth rate, low birth weight, need for NICU care, and mortality rate are quite high. Further study is needed to evaluate long-term outcomes of IVF neonates. [ABSTRACT FROM AUTHOR]

Neurosonography has become an essential tool for diagnosis and serial monitoring of preterm brain injury. Preterm infants are at significantly higher risk of hypoxic–ischemic injury, intraventricular hemorrhage, periventricular leukomalacia and post-hemorrhagic hydrocephalus. Neonatologists have become increasingly dependent on neurosonography to initiate medical and surgical interventions because it can be used at the bedside. While brain MRI is regarded as the gold standard for detecting preterm brain injury, neurosonography offers distinct advantages such as its cost-effectiveness, diagnostic utility and convenience. Neurosonographic signatures associated with poor long-term outcomes shape decisions regarding supportive care, medical or behavioral interventions, and family members' expectations. Within the last decade substantial progress has been made in neurosonography techniques, prompting an updated review of the topic. In addition to the up-to-date summary of neurosonography, this review discusses the potential roles of emerging neurosonography techniques that offer new functional insights into the brain, such as superb microvessel imaging, elastography, three-dimensional ventricular volume assessment, and contrast-enhanced US. [ABSTRACT FROM AUTHOR]

A tubal spasm may result in a similar appearance.3,36 Postprocedure Care The imaging or referring physician should discuss the SIS and/or HyCoSy findings with the patient. This Practice Parameter has been developed to assist qualified physicians performing saline infusion sonohysterography (SIS) and hysterosalpingo-contrast sonography (HyCoSy); each procedure is addressed separately. The primary goal of SIS is to visualize the endometrial cavity in more detail than is possible with standard transvaginal ultrasound.1 The accuracy of SIS approaches hysteroscopy in detecting endometrial abnormalities.2,3 HyCoSy, also known as sonosalpingography, is the ultrasound evaluation of tubal patency. The American Institute of Ultrasound in Medicine (AIUM) is a multidisciplinary association dedicated to advancing the safe and effective use of ultrasound in medicine through professional and public education, research, development of clinical practice parameters, and accreditation of practices performing ultrasound examinations. [Extracted from the article]

Introduction: The aim of this study was to investigate the development of midgut herniation in vivo using three-dimensional (3D) ultrasonographic volume and distance measurements and to create reference data for physiological midgut herniation in ongoing pregnancies in a tertiary hospital population.Materials and Methods: The transvaginal 3D ultrasound volumes of 112 women, seen weekly during the first trimester of pregnancy, were obtained and subsequently analysed in a virtual reality environment. The width of the umbilical cord insertion, the maximum diameter of the umbilical cord, and the volume of midgut herniation were measured from 6 until 13 weeks gestational age (GA).Results: All parameters had a positive relation with GA, crown-rump length, and abdominal circumference. In approximately 1 of 10 volumes no midgut herniation could be observed at 9 and 10 weeks GA. In 5.0% of the fetuses the presence of midgut herniation could still be visualised at 12 weeks GA.Conclusion: Reference charts for several dimensions of physiological midgut herniation were created. In the future, our data might be used as a reference in the first trimester for comparison in case of a suspected pathological omphalocele. [ABSTRACT FROM AUTHOR]

Intussusception is a common etiology of acute abdominal pain in children. Over the last 70 years, there have been significant changes in how we diagnose and treat intussusception, with a more recent focus on the role of ultrasound. In this article we discuss historical and current approaches to intussusception, with an emphasis on ultrasound as a diagnostic and therapeutic modality. [ABSTRACT FROM AUTHOR]

Extraskeletal Ewing's sarcoma (EES) is a rare soft tissue tumor that is morphologically indistinguishable from skeletal ES. We report a case of a 25-year-old female with recurrent EES/primitive neuroectodermal tumor of right breast with imaging findings on mammogram, ultrasound, magnetic resonance imaging breast, and positron emission tomography-computed tomography. [ABSTRACT FROM AUTHOR]

Complete or partial agenesis of the corpus callosum are rather common developmental abnormalities, resulting in a wide spectrum of clinical neurodevelopmental deficits. Currently, a significant number of these cases are detected by prenatal sonography during second trimester screening examinations. However, major uncertainties about a detailed morphological diagnosis and the clinical significance do not allow accurate prenatal counselling. Here, we were able to demonstrate the 3D connectivity of aberrant commissural tracts in 16 cases with complete and four cases with partial callosal agenesis using the foetal magnetic resonance imaging techniques of diffusion tensor imaging and tractography in utero and in vivo between gestational weeks 20 and 37. The ‘misguided’ pre-myelinated callosal axons that represent the bundle of Probst were non-invasively visualized, and they showed a degree of structural integrity similar to that of the callosal pathways of age-matched foetuses without cerebral pathologies. In two foetuses, we were able to prove, by post-mortem histology, that diffusion tensor imaging allows the depiction of the bundle of Probst, even during early stages of pre-myelination at 20 and 22 gestational weeks. In cases with partial callosal agenesis, an aberrant sigmoid-shaped bundle was prenatally depicted, confirming the findings of heterotopic interhemispheric connectivity in adults with partial callosal agenesis. In addition to the corpus callosum, other white matter pathways were also involved, including somatosensory and motor pathways that showed significantly higher fractional anisotropy values in cases with callosal agenesis compared with control subjects. A detailed prenatal assessment of abnormal white matter connectivity in cases of midline anomalies will help to explain and understand the clinical heterogeneity in these cases, taking future foetal neurological counselling strategies to a new level. [ABSTRACT FROM PUBLISHER]

Objective: To evaluate the feasibility and reproducibility of fetal lung texture analysis using a novel automatic quantitative ultrasound analysis and to assess its correlation with gestational age. Methods: Prospective cross-sectional observational study. To evaluate texture features, 957 left and right lung images in a 2D four-cardiac-chamber view plane were previously delineated from fetuses between 20 and 41 weeks of gestation. Quantification of lung texture was performed by the Automatic Quantitative Ultrasound Analysis (AQUA) software to extract image features. A standard learning approach composed of feature transformation and a regression model was used to evaluate the association between texture features and gestational age. Results: The association between weeks of gestation and fetal lung texture quantified by the AQUA software presented a Pearson correlation of 0.97. The association was not influenced by delineation parameters such as region of interest (ROI) localization, ROI size, right/left lung selected or sonographic parameters such as ultrasound equipment or transducer used. Conclusions: Fetal lung texture analysis measured by the AQUA software demonstrated a strong correlation with gestational age. This supports further research to explore the use of this technology to the noninvasive prediction of fetal lung maturity. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

While different generations of assays have played important role in elucidating causes of different endocrine disorders, radiological techniques are instrumental in localizing the pathology. This statement cannot be truer in any disease entity other than endocrine hypertension. This review makes an effort to highlight the role of different radiological modalities, especially ultrasonography, computed tomography and magnetic resonance imaging, in the evaluation of different causes of endocrine hypertension. [ABSTRACT FROM AUTHOR]

Purpose: In modern obstetric management, accurate estimation of fetal weight is an important prognostic parameter of neonatal morbidity and mortality, and a valuable tool for determining further treatment. Fetal abdominal measurements, mostly abdominal circumference (AC), are not only included in the majority of commonly used weight equations, but also have the greatest impact on weight estimation. This therefore underlines the importance of accurate determination of the AC. The aim of our study was to evaluate which method for AC calculation is the most accurate one and thereby gives the best results for fetal weight estimation. Materials and Methods: This prospective study included 239 term pregnancies. Inclusion criteria were a singleton pregnancy and ultrasound examination with complete fetal biometric parameters within 3 days of delivery, and absence of structural or chromosomal malformations. For calculation of the sonographic AC, three different methods were used. As a reference method, AC of the infant was determined immediately after birth. The accuracy of fetal weight estimation was determined for all of these methods of AC measurement using a commonly used weight equation. Differences were compared by using percentage error (PE), absolute percentage error (APE), limits of agreement (LOA) and cumulative distribution. Results: The ellipse region-of-interest (ROI) method showed the best results of all sonographic methods. For estimating fetal weight, it had the lowest median APE of the sonographic methods and the lowest SD of the PE, as well as the narrowest LOA. Regarding the cumulative distribution, ellipse ROI technique included the most cases at all discrepancy levels (5, 10, 15, and 20%). Conclusion: Accurate measurement of fetal AC is important for good fetal weight estimation. The differences between the three techniques were small; however, there was a significant advantage when using the ellipse ROI method. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Renal impairment represents a huge healthcare issue not just within the UK but also worldwide. Both the incidence of acute kidney injury and, with the ageing population, chronic kidney disease are increasing. This article will review the normal anatomy (in particular, the normal ultrasonic anatomy) of the kidney and highlight the main physiological roles of the kidney in order to enable a better understanding of how, once these functions fail, the clinical consequences arise. We will address the investigation and management of patients with both acute and chronic disease, as well as the aetiology, investigation and imaging options available. The classification of chronic kidney disease and its relationship with the estimated glomerular filtration rate will be discussed. The pivotal role of ultrasound in the imaging armamentarium will be highlighted. Finally, the risks of contrast-induced nephropathy, as well as the recommendations for MRI use to reduce any risk of nephrogenic systemic fibrosis, will be discussed. [ABSTRACT FROM AUTHOR]

Ultrasound (US) of the paediatric chest has become an established imaging tool that may supplement plain film findings helping to reduce or tailor other ionizing (sectional) imaging in a variety of paediatric conditions such as sequestration or pneumonia. US has been shown to offer valuable imaging alternatives, both reliably enabling diagnosis without need for ionising imaging such as in diaphragmatic palsy (traditionally diagnosed by fluoroscopy) and revealing additional information in patients with equivocal findings on radiographs or replacing follow-up examinations (for example, in pleural effusion). This review outlines the technical requisites for paediatric chest US applications and will discuss its diagnostic potential. Furthermore, it will consider US restrictions, mention some rare applications, and discuss the potential role of chest US in imaging algorithms of certain conditions. [ABSTRACT FROM AUTHOR]

Objective To create a nomogram of fetal clavicle length (CL) throughout gestation. Methods Cross-sectional study of patients between 14 and 42 weeks' gestation. Inclusion criteria consisted of well-established dates (consistent with early ultrasound,), singleton, non-anomalous fetuses, and intact amniotic membranes. Sonographic measurements included biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), humerus length (HL) and sonographically estimated fetal weight (SEFW). For every case, the average of three separate measurements of the CL was used. The 5th, 50th and 95th centiles were obtained by least squares regression. Pearson's correlation coefficient and associated P-values for the relationships between CL and other biometric measurements were calculated. The data were compared to a nomogram of the CL generated in 1985 from the measurement of 85 fetuses. Results A total of 623 consecutive patients were studied. In all but three cases, CL was successfully measured. Mean maternal age was 27.7 ± 6.2 years, median gravidity 3 (range, 1–14) and median parity 1 (range, 0–9). Mean CL (mm) = -75.30 + 32.70*In(GA) and SD = -0.41 + 0.08328*GA, where In represents the natural logarithm and GA the gestational age in weeks. Fetal CL correlated significantly and strongly with BPD, HC, AC, HL, FL and the logarithm of SEFW, with Pearson correlation values of 0.973, 0.977, 0.976, 0.979, 0.977 and 0.979, respectively (all P < 0.001). Measurements according to comparable 1985 data were consistently substantially below the present data (smaller CL for any given GA except below 17 weeks' gestation). Conclusions We propose a new nomogram of CL, which differs significantly from the previously published nomogram. We suggest that the present data reflect the use of high-resolution ultrasound technology and propose that these data, based on a large number of fetuses, replace the previous nomogram. We also suggest that the '1 mm = 1 week' rule of thumb should no longer be used, since it can be erroneous by as much as 6 weeks. [ABSTRACT FROM AUTHOR]

Background: The referring physicians at our institution used the enema as a diagnostic test in children with suspected intussusception.Objective: To determine the change in rate of positive enema findings performed for suspected intussusception with the intervention of screening ultrasound (US).Materials and Methods: Since October 1995, 224 children (mean age 2.2 years) with suspected intussusception were referred for enema examination. In January 2001, US was introduced as a screening test for intussusception. Enemas were performed for all children with positive US findings and were offered for those with negative US findings if clinical suspicion persisted.Results: Before 2001, 184 children underwent enema with intussusception documented in 40 (22%). Since January 2001, 40 children have been seen with suspected intussusception (12/40 positive or 30%). Two directly underwent enema (1/2 positive); 38 children underwent US. In 12 of 38 children, the US finding was positive, and an intussusception was found at enema examination in 11 of 12. In 26 cases, the US finding was negative. Seven of the 26 children with a negative sonogram finding had an enema, which was also negative. Nineteen enemas were canceled. With a screening US, the positive rate for enemas is now 58% (11/19). We know of no case of intussusception missed at US.Conclusion: Screening US has decreased unnecessary enemas for clinically suspected intussusception, increasing positive findings from 22% to 58%. This has in turn reduced children's exposure to radiation. [ABSTRACT FROM AUTHOR]

Recent advances in imaging technology and interventional radiologic procedures have resulted in an increased variety of radiological techniques that can be used to assess patients who present with renal failure and require renal replacement therapy. This chapter provides an overview of the relative strengths and weaknesses of the available imaging methods. In particular, it covers the expanding role of the cross-sectional, noninvasive, multiplanar imaging techniques such as gray-scale and Doppler ultrasound, magnetic resonance imaging (MRI) and angiography (MRA), and nonenhanced helical or multislice computed tomography (CT). These imaging methods are increasingly replacing those used in the past, such as the conventional radiographic urogram, which requires a high dose of intravenous contrast media, and digital subtraction arteriography. The chapter also covers the radiologic investigation of complications of acquired renal cystic disease, including renal cell carcinoma, hemorrhage, cyst infection and rupture, and nephrolithiasis. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate guidance techniques and patient outcomes of ultrasound-guided neuronavigation of deep-seated intracerebral cavernous hemangiomas (CAs). Thirty-five patients with deep-seated intracerebral CAs with sizes ranging between 7 and 45 mm were operated upon only with ultrasound-guidance. Twenty-seven were located in or near eloquent regions. In 30 patients dissection to the lesion was performed through sulci and fissures. The best approach to a lesion based on surface anatomy and depth was determined using sonographic information. Navigation was done sonographically. In five patients the shortest approach via a corticotomy was determined sonographically. Twenty-six patients had no neurological deficit postoperatively. Preoperative deficits improved in seven of nine patients. Fifteen of 19 patients suffering epileptic seizures had no seizures postoperatively. Intraoperative sonography revealed residual CA tissue after microsurgical extirpation in two cases. This report shows that intraoperative sonographic navigation provides safe guidance to deep-seated CAs with good clinical outcome independent of size. [ABSTRACT FROM AUTHOR]

Background: Screening cranial ultrasound led to the discovery of isolated frontal horn cysts quite distinct from periventricular leucomalacia cysts.Aim: To clarify their significance, incidence, characteristics, causal factors or aetiology, and effect on long term outcome.Design: A retrospective observational study of all first cranial ultrasound scans (total of 2914) performed during the period 1984-1994 inclusive found 21 neonates with smooth thin walled frontal horn cysts: 18 of 2629 scanned were of birth weight < 1500 g or gestation < 33 weeks, and three of 285 were > 33 weeks gestation. Sequential ultrasound, maternal records, and neonatal events were retrospectively assessed. In survivors, routine neurodevelopmental evaluations were obtained. Postmortem studies of one cyst were performed to determine the nature and origin of these lesions.Results: Of the 21 subjects, 15 had isolated frontal horn cysts and six had additional ultrasound scan abnormalities, including four with subependymal haemorrhage. The sonographic features of frontal horn cysts were of distinctive morphology (elliptical, smooth, thin walled, ranging in size from 3 to 20 mm) and position (adjacent to the tip of the anterior horns). The cysts enlarged and then regressed by a median corrected age of 2 months. Subjects of < 33 weeks gestation (n = 18) had a median birth weight of 1465 g (range 720-1990) and median gestation of 30 weeks (range 24-32). There was no consistent perinatal course. The neurodevelopmental outcome in 10 of the 11 survivors with isolated frontal horn cysts was normal. Five subjects died from causes unrelated to brain pathology in the neonatal period, and one subject died after infancy. Histological examination of a cyst at autopsy in one additional subject subsequent to the period of study confirmed the cyst to be lined by neuroblasts and ependymal cells.Conclusions: The incidence of frontal horn cysts in this low birthweight population was 7 per 1000 (0.7%) subjects scanned. They are present in the first week of life, enlarge, and resolve spontaneously. Survivors with isolated frontal horn cysts appear to have normal neurodevelopmental outcome. The prognosis of these distinct frontal horn cysts therefore appears to be benign. [ABSTRACT FROM AUTHOR]

Background Fetal tachyarrhythmia is a well-documented entity which, in the absence of pharmacological intervention, may lead to congestive heart failure, fetal hydrops and eventually fetal demise. The success rate of the implemented treatment is generally measured by survival and achievement of control of the arrhythmia. We report on the occurrence of associated cerebral damage in three patients with fetal tachycardia. Methods We describe three patients with a history of fetal supraventricular tachyarrhythmia who developed cerebral complications in utero. Results Two patients had cerebral hypoxic-ischemic lesions and one had hemorrhagic lesions present at birth. They had developed severe congestive heart failure and fetal hydrops secondary to fetal tachyarrhythmia, and there were no other obvious causes for the cerebral pathology. Two of these patients were referred to us antenatally. Therapy was instituted and resulted in control of the tachycardia and resolution of hydrops. The third patient was referred to our clinic shortly after birth because of severe circulatory problems secondary to fetal tachyarrhythmia. Conclusion From these observations, we believe that a fetus with tachyarrhythmia and subsequent hydrops is at increased risk for the development of cerebral complications, due to the circulatory disturbances and sudden changes in heart rate which may lead to fluctuations in cerebral perfusion. This would imply that it is of the utmost importance to aim at immediate and complete control of the heart rate in the treatment of fetal tachyarrhythmia. [ABSTRACT FROM AUTHOR]

Ultrasonography has been shown to be valuable in the detection of intussusception, but a question arises, as to just when this study should be performed. Should it be a general screening procedure or should it be utilized for specific cases only? Upon reviewing the literature, and the findings in 14 of our patients, we feel that it should be utilized as a general screening procedure. In addition, we offer a different explanation for the typical doughnut and pseudokidney signs seen with intussusception. [ABSTRACT FROM AUTHOR]

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The article presents the author's opinion on the use of ultrasonography (USG) by radiologists in making a diagnosis of hepatobiliary ascariasis. The article states that dilatation of the bile ducts, distention of the gall-bladder with edematous walls, biliary calculi, swollen pancreas and liver abscess are some various signs that can be included in the coexisting USG features. The author indicates that the imaging modality of choice is USG as it is inexpensive, accurate, safe and non-invasive.

A woman was referred in the first trimester of her third pregnancy because of a family history of cleidocranial dysplasia. An ultrasound examination at 14 weeks 4 days revealed a fetus with appropriate biometric measurements. However, the clavicles were noted to be hypoplastic and the cranium appeared less well ossified than expected for gestational age, suggesting the diagnosis of cleidocranial dysplasia. On subsequent examination at 21 weeks, the findings were essentially unchanged. Induced vaginal delivery owing to decreased amniotic fluid volume occurred at 37 weeks, and a female weighing 3200 g was delivered. The infant had clinical and X-ray signs of cleidocranial dyplasia. [ABSTRACT FROM AUTHOR]

The ultrasonographic finding of small bowel polyps is reported in a 16-year-old girl, referred for evaluation of abdominal pain. The sonographic study was of particular value in also excluding pregnancy and in documenting small bowel obstruction. We have found that distended small bowel and its contents are accessible to sonographic evaluation, in this case, the constellation of clinical and sonographic findings were of considerable value in diagnosing Peutz-Jeghers syndrome. [ABSTRACT FROM AUTHOR]

Comments on the detection of fetal head abnormalities by sonographic examination of the fetus. Importance of the measurements in the detection of fetal asymmetry; Value of the accuracy of the scan; Frequency of dolichocephaly with breech presentation.