Journal of Diagnostic Medical Sonography

Neonatal neurosonography is commonly used to evaluate infants for the presence of intracranial hemorrhage, hyrdocephalus, congenital defects, and other abnormalities. The size and location of the fontanelles that are used as acoustic windows to view brain structure can impose limits on the conventional technique. A relatively recent advance in ultrasound imaging technology is multiplanar 3-dimensional ultrasound imaging (3D US). Ten neonates received 3D neurosonographic examinations in addition to their clinically indicated conventional examinations. Comparisons between the two techniques included assessment of the image acquisition process as well as the diagnostic value of the data obtained. Comparisons were made to computed tomography and/or magnetic resonance imaging examinations when available. Compared to conventional neurosonography, the 3D US technique had several advantages including faster, easier, and more consistent data acquisition. Multiplanar 3D imaging also improved the ability to assess normal anatomy and pathology, and better correlated with other imaging modalities. Additional studies are necessary to determine the ultimate clinical utility of 3D neonatal neurosonography.

Objective. To evaluate and describe normal fetal anatomy with surface-rendered 3-dimensional (3D) ultrasound imaging and to try to assess the feasibility and content of a routine 3D examination. Additionally, to determine what standards should be established for routine 3D examination protocols and guidelines for the current technology.Methods. One hundred ten obstetric patients underwent ultrasound examinations using conventional ultrasound equipment adapted for 3D surface imaging. After 84 women were examined, criteria were established for a standard initial 3D screening examination, which was performed on the remaining 26 women.Results. Gestational age ranged from 15 to 33 weeks. Mean examination time was 40 minutes with a range of 30 to 50 minutes. Between 16% and 79% of the targeted structures were successfully visualized per patient. Mean identification was 49%. Conclusion. Three-dimensional ultrasound may become a useful diagnostic tool for routine fetal evaluation in the future. At this time, routine 3D ultrasound examinations would be prohibitive due to lengthy additional examination time and a low percentage of consistent structures visualized.

With the improvement of spatial and contrast resolution in breast sonography, several new interpretive difficulties have arisen. Cysts that appeared to be simple on older equipment may now contain internal echoes with newer high-resolution equipment. Historically, teaching has stressed the presence of internal echoes as indicative of a complex cyst, often requiring further evaluation. However, many of the internal echoes seen with higher frequency, broadband, and greater dynamic range equipment are artifactual. In this study, breast cysts, solid lesions, and normal structures were evaluated comparing fundamental to coded harmonic imaging to determine if coded harmonics can help distinguish artifactual from real internal echoes.

Contrast agents are used widely in most imaging modalities when evaluating renal pathology. Ultrasound contrast agents have the potential to yield increased information in sonography of renal masses. This article presents four cases of patients with various renal pathology and the impact of the addition of an ultrasound contrast agent (Definity, DuPont Pharmaceuticals, North Billerica, MA) on the imaging studies. The value of using pulse cancellation software to allow for gray-scale sonographic evaluation is discussed.

Pulsed Doppler evaluation of the atrioventricular valves is standard in a fetal echocardiogram. In the normal fetal mitral and tricuspid valve waveforms, the E point, which reflects passive ventricular filling, is always lower in velocity than the A point, which reflects atrial contraction. In the setting of intrauterine growth retardation, the E and A point relationship may be reversed, with the E point displaying a higher velocity than the A point. It should be borne in mind, however, that improper Doppler interrogation angle may cause a pseudo-reversal of these 2 points. Therefore, meticulous attention should be paid to interrogation angle to avoid the potential of an erroneous diagnosis.

This is a case report of a prenatal observation of subdiaphragmatic extralobar pulmonary sequestration. There are two types of pulmonary sequestration, intralobar and extralobar. Only 10% of extralobar sequestrations are reported to be subdiaphragmatic.