Journal of Diagnostic Medical Sonography

Right ventricular dysfunction may occur soon after cardiac transplantation. Factors suggested to be responsible for right ventricular dysfunction include prolonged transplantation ischemic time, pulmonary hypertension, or early rejection. Right ventricular and left ventricular fractional area change (FAC) and ejection fraction (EF) were prospectively measured by two-dimensional (2D) echocardiography 2 days after transplantation (while under inotropic support) and at discharge (mean day 19, range 9-60) in 18 patients by the area-length method. A significant increase in right ventricular FAC (0.38 ± 0.08 to 0.44 ± 0.06, P = 0.025) and right ventricular EF (0.53 ± 0.08 to 0.60 ± 0.08, P = 0.015) was observed at discharge compared to day 2. Left ventricular FAC and EF did not change significantly (0.43 ± 0.07 to 0.40 ± 0.06 and 0.61 ± 0.09 to 0.56 ± 0.07, respectively). Right ventricular FAC (< 0.35) and right ventricular EF (< 0.45) was impaired in 4 patients (22%) 2 days after transplantation (all had normal left ventricular function) but normalized by discharge. There was no correlation between right ventricular function and donor ischemic time, hemodynamics, or early rejection (one patient). Only one patient died before discharge (with normal right ventricular and left ventricular function). Impaired right ventricular function after cardiac transplantation is transient, associated with normal left ventricular function, and may be related to inadequate right ventricular myocardial preservation. Right ventricular function improves in nearly all patients by discharge.

The most common forms of female infertility and the role of sonography in both the diagnosis and management of female infertility are discussed. A descriptive cause of each disorder is offered, followed by current and experimental sonographic methods of treatment.

Hypertension is a serious health problem for millions of Americans. A small portion of these cases result from renal artery stenosis. Angiography continues to be the gold standard for diagnosing renal vascular disease. However, as a result of the high cost and possible risks associated with this invasive method, duplex sonography has emerged as an inexpensive and noninvasive alternative diagnostic tool that, in many cases, can accurately detect renal vascular disease. According to the literature, there are numerous techniques using Doppler waveforms to show renal artery stenosis. These include renal artery to aortic ratio, acceleration index, acceleration time, end diastolic ratio, and the tardus-parvus waveform. Several studies have been conducted to evaluate duplex sonography as a diagnostic tool for detection of renal artery stenosis and the overall accuracy of ultrasound compared with angiography. The accurcy of duplex ultrasound largely depends on the blood flocriteria being used to evaluate renal vasculature, patient preparation, the time allowed to perform the ultrasound examination, and the technical expertise of the sonographer performing the study.

Skin specimens from 10 dolphins were studied with B-mode ultrasonography. The epidermal and hypodermal layers were defined, measured, and compared with measurements of actual tissue and with histologic measurements. Measurements of skin from six body zones of three live dolphins showed larger values but the same echogenic characteristics. B-mode measurements were found to be accurate and to provide visually acceptable information for use in evaluating the health status of these animals. The detection of a skin parasite by B-mode ultrasonography is also presented.

Transabdominal ultrasound combined with transvaginal scanning is a valuable tool for the diagnosis of heterotopic pregnancies. A case of a concurrent intrauterine and extrauterine pregnancy is discussed. Also included is a discussion of the incidence, symptoms, and causes of heterotopic pregnancy, and the findings and treatments associated with ectopic pregnancies.

Infantile polycystic kidney disease is an autosomal recessive disorder characterized by bilateral and symmetric enlargement of the kidneys. The renal parenchyma is characteristically replaced by cystic dilatation of the collecting tubules.¹ This case report discusses the sonographic criteria used to antenatally diagnose infantile polycystic kidney disease.