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23 COLOUR DOPPLER IMAGING IN ROUTINE OBSTETRIC EXAMINATION A.D. Christie. Dundee General Hospital, Dundee, Scotland. All patients in one of our hospitals are routine.y examined by ultrasound on three occasions during pregnancy. The first is at booking, when viability, gestational age, and co-existing anomalies can be established. In the second trimester, the patient is examined for gross fetal abnormality and progress (growth). The third routine ultrasound examination is carried out in the 35th week when growth and dynamic flow studies are determined. This

:// [8] Plange N., Remky A., Arend O., Color doppler imaging and flourescein filling defects of the optic disc in normal tension glaucoma, Br. J. Ophthalmol., 2003, 87, 731–736 [9] Williamson T.H., Harris A., Color doppler ultrasound imaging of the eye and orbit, Surv. Ophthalmol., 1996, 40, 255–267 [10] Evans D.W., Harris A., Garrett M., Chung H.S., Kagemann L., Glaucoma patients demonstrate faulty autoregulation of ocular blood flow during posture change, Br

. Conclusion: Prompt diagnosis and surgical management of the neonate with a coronary fistula is essential to reduce the morbidity and mortality that may result from this condition. Keywords: Color Doppler imaging; congenital coronary artery fistula; early detection of coronary artery fistula; neonate. Introduction Coronary artery fistulas may be an embryological rem- nant of wide intertrabecular spaces in the developing neonatal myocardium. They comprise approximately 4/1000 congenital cardiac defects, and are usually an isolated finding and comprise a rather uncommon type

extent of the union and the nature of concomitant anomalies. It is therefore important to investigate the cardio- vascular anatomy in thoracoabdominally con- joined twins to facilitate prenatal counseling and perinatal management. We describe the diagnosis of conjoined twins with a fused heart by color Doppler imaging at 12 weeks of gestation. 2 Case report A 23-year-old nulliparous Japanese woman be- came pregnant spontaneously in August 1996. She was a monozygotic twin. Her past history was unremarkable. An ultrasonographic examina- tion performed at 8 weeks of

demand for donor organs has led to new pharmacological concepts for reducing ischemia- reperfusion injury (I/R) of the graft after liver transplan- tation to prevent primary non-functioning of the organ. Prostaglandins have proved to be cytoprotective in several experimental models of ischemia and trans- plantation. The prophylactic administration after or- thotopic liver transplantation is still a subject of con- troversial discussion. The aim of our study was the evaluation of the post-transplant hepatic artery resis- tive index (RI) measured by color Doppler imaging


Background: It is of clinical importance to display the vasculature of transplanted kidney in three-dimensional (3D) and in non-invasive way. 3D color Doppler ultrasonographic imaging (3D-CDUI) is a non-invasive technique to display the 3D vasculature of living organs. Objective: Probe into characteristics of 3D vasculature of living transplanted kidney by 3D-CDUI, and evaluate the clinical value of 3D-CDUI on monitoring complications after operation of renal transplant. Methods: Nine patients who received allogeneic transplantation of kidney were monitored with 3D-CDUI. The instruments used included ACUSON Sequoia 512 and TomTec computer station of 3D-CDUI. Using magnetic positioning free-hand scanning, the 3D reconstruction and display of renal tissue structure and blood flow were performed off-line. Results: All patients underwent 3D-CDUI examinations without any side effect or complication. When acute rejection occurred, the 3D distribution change of renal blood flow signal could be observed clearly. During treatment of acute necrosis of renal tubules, changes of renal blood flow signal in 3D color Doppler images could be detected earlier compared with 2D color Doppler images. The position of embolized vassels could be diagnosed accurately by 3D-CDUI. Conclusion: The 3D-CDUI was helpful to improve diagnosis level of ultrasonography by monitoring complications after renal transplantation.


Objective: The objective of this study was to investigate the feasibility of examining the fetal heart with Tomographic Ultrasound Imaging (TUI) using four-dimensional (4D) volume datasets acquired with spatiotemporal image correlation (STIC).

Material and methods: One hundred and ninety-five fetuses underwent 4D ultrasonography (US) of the fetal heart with STIC. Volume datasets were acquired with B-mode (n=195) and color Doppler imaging (CDI) (n=168), and were reviewed offline using TUI, a new display modality that automatically slices 3D/4D volume datasets, providing simultaneous visualization of up to eight parallel planes in a single screen. Visualization rates for standard transverse planes used to examine the fetal heart were calculated and compared for volumes acquired with B-mode or CDI. Diagnoses by TUI were compared to postnatal diagnoses.

Results: (1) The four- and five-chamber views and the three-vessel and trachea view were visualized in 97.4% (190/195), 88.2% (172/195), and 79.5% (142/195), respectively, of the volume datasets acquired with B-mode; (2) these views were visualized in 98.2% (165/168), 97.0% (163/168), and 83.6% (145/168), respectively, of the volume datasets acquired with CDI; (3) CDI contributed additional diagnostic information to 12.5% (21/168), 14.2% (24/168) and 10.1% (17/168) of the four- and five-chamber and the three-vessel and trachea views; (4) cardiac anomalies other than isolated ventricular septal defects were identified by TUI in 16 of 195 fetuses (8.2%) and, among these, CDI provided additional diagnostic information in 5 (31.3%); (5) the sensitivity, specificity, positive- and negative-predictive values of TUI to diagnose congenital heart disease in cases where both B-mode and CDI volume datasets were acquired prenatally were 92.9%, 98.8%, 92.9% and 98.8%, respectively.

Conclusion: Standard transverse planes commonly used to examine the fetal heart can be automatically displayed with TUI in the majority of fetuses undergoing 4D US with STIC. Due to the retrospective nature of this study, the results should be interpreted with caution and independently confirmed before this methodology is introduced into clinical practice.


, Chang YL, Chang H. Wang SM, et al. Acute pancreatitis masquerading as testicular torsion. Am J Emerg Med 1996; 14:654–655 [6] Choong KK. Acute penoscrotal edema due to acute necrotizing pancreatitis. J Ultrasound Med 1996; 15:247–248 [7] Wolfson K, Sudakoff GS. Ultrasonography and color Doppler imaging of a scrotal phlegmon in acute necrotizing pancreatitis. J Ultrasound Med 1994; 13:565–568 [8] Krajewski S, Brown J, Phang PT, Raval M, Brown CJ Impact of computed tomography of the abdomen on clinical outcomes in

Locci et al, Female pelvic angiogenesis and color Doppler imaging 453 Original articles t Med Angiogeiiesis: a new diagnostic aspect of obstetric 22 (1994) 453-473 an(j gynecologic echography Mariavittoria Locci1, Giovanni Nazzaro1, Giuseppe De Placido2, Alfredo Naz- zaro2, and Gian C. Di Renzo3 laboratory of Fetal-Maternal Ultrasonography, 2Laboratory of Human Reproduct- ive Immunology, Dept. Obstetrics and Gynecology, University of Naples, II Medi- cal School, Naples, Italy, Institute of Gynecology and Obstetrics, University of Perugia, Italy 1 Introduction The