Real-time Ultrasound Scanning Research Articles

Ultrasound as a Visual Feedback Aid for the Hearing-Impaired

Ultrasound was explored as a visual feedback aid to assist in improving the speech of the deaf and hard of hearing. A mechanical sector real-time scanner produced images of the volunteer's tongue while a speech pathologist provided therapeutic intervention. Pre and postarticulation tests were administered to evaluate change in speech. Ultrasound as a visual feedback aid may be potentially useful for improving articulation problems for some hearing-impaired speakers. Further research with this population needs to be carried out to explore the practicality of using ultrasound as a visual feedback aid and to gather quantitative data on the long-term effects of learning. This study has demonstrated that typical real-time sector ultrasound scanners, of the type found in the field today, can be modified to produce useful images of the human tongue during speech production. It is yet unknown what specific type of scanner as well as frequency range is best suited for tongue placement imaging.

Early pregnancy diagnosis in cattle by means of linear-array real-time ultrasound scanning of the uterus and a qualitative and quantitative milk progesterone test

We compared three methods for diagnosing early pregnancy in cattle: 1) a trans-rectal ultrasound scan of the uterus, 2) a cow-side enzymeimmunoassay (EIA) milk progesterone test 3) a radioimmunoassay (RIA) milk progesterone test. Scanning of the uterus was performed in 148 cows. These cows were not detected in estrus before scanning, which took place between Days 21 and 33 after insemination (AI). A considerable difference was noted between the reliability of the scannings performed at an early stage (Days 21 to 25) and those performed at a later stage (Days 26 to 33). The sensitivity and specificity of the ultrasound examination between Days 21 and 25 were only 44.8% and 82.3%, respectively, but were 97.7% and 87.8% between Days 26 and 33, respectively. Milk samples were collected on the day of AI. (Day 0) and 21 days later. Samples that were positive in the EIA test always contained more than 1 ng/ml progesterone (P4); however, 20% of the negative EIA samples contained also more than 1 ng/ml P4. Only 59% of the animals showing a negative EIA test on Day 0 and a positive test on Day 21, indicating pregnancy, calved, while 16% of the cows with a negative test on Day 0 and Day 21, indicating nonpregnancy, turned out to be pregnant. Of the 82 animals with P4 levels lower than 1 ng/ml on Day 0 and higher than 1 ng/ml on Day 21, only 61.0% calved. All 14 cows with low levels both on Day 0 and Day 21, indicating nonpregnancy, were found to be not pregnant. The influence of both early embryonic death and the accumulation of intrauterine fluids on the accuracy of these tests are discussed.

Accuracy of pregnancy diagnosis and prediction of calving date in red deer using real-time ultrasound scanning.

One hundred and sixty-two 18-month-old farmed red deer were used to test the accuracy of pregnancy detection and equations for predicting gestational age. Deer ranging from 30 to 110 days gestation were examined by rectal ultrasonography using a 5 MHz transducer while they were standing. Each scan was recorded on video tape for measurements of uterine diameter, amniotic sac diameters, crown-rump length, head length, head diameter, nose length, chest depth, chest width and placentome base-apex length and width. Fetal age was calculated from the mean of the age predictions derived from each dimension measured on individual deer, for 132 deer between 44 and 110 days gestation. All the hinds diagnosed as pregnant produced offspring, and all the hinds diagnosed as not pregnant failed to produce offspring. Between one and six fetal and uterine dimensions were measurable and the number measurable increased with fetal age. The mean error of calving date prediction in 132 deer was 0.97 days. The error of prediction when measurements were made between 44 and 60 days was 0.44 days, whereas between 61 and 80 days and between 81 and 110 days the errors were +0.95 and +4.72 days, respectively. The estimates of calving date were all within 13 days of the calving date.

Dysphagia in bulimia nervosa

The findings on 13 patients with bulimia nervosa referred for evaluation of salivary glands and swallowing patterns are presented. Each patient completed a medical, oral, and social history questionnaire. A complete oral examination supported by appropriate dental radiographs and photographs was conducted. Unstimulated and stimulated parotid and submandibular saliva was collected. The presence or absence of pharyngeal and velar gag reflexes was ascertained. Real-time ultrasound scanning and barium swallow studies were used to evaluate the oral-motor functions while swallowing on 6 of the subjects. Activity of the pharynx, larynx, and esophagus was recorded during the videofluorographic studies. Saliva concentrations of amylase were determined in the referred subjects as well as 13 age-matched healthy controls. No significant difference was detected between the salivary gland flow rates and amylase concentrations of the two groups, whether stimulated or unstimulated. The pharyngeal gag reflex was absent in 9 of the 13 bulimic patients and a velar gag reflex could be elicited in only 1. All of the normal controls had both gag reflexes. All of the patients with bulimia were found to have abnormal oropharyngeal swallow patterns and an increased duration of dry swallow.

A Comparison of 2 Methods for Monitoring Gonadotrophin Therapy

One hundred and seventy nine (179) ovarian cycles from 52 patients treated with human menopausal gonadotrophins were retrospectively analysed. Eighty one (81) cycles were monitored by serial measurements of plasma oestradiol concentrations and 98 cycles were monitored by realtime ultrasound scanning of ovarian follicles. The results suggest that realtime ultrasonography, used alone, is a safe and effective method for monitoring gonadotrophin therapy.

A Review of Potential New Methods of On-Line Pork Carcass Evaluation

On-line techniques for estimating carcass composition and value with potential for eventual application in the packing industry must be accurate, rapid, dependable in a plant environment and cost-efficient. Several potential technologies are discussed and data are presented to establish the relative accuracy of real-time ultrasound imaging, electromagnetic scanning and optical electronic fat-lean probes. Market-weight barrows and gilts were subjected to ultrasound image analysis prior to slaughter. Carcasses were evaluated for composition using electromagnetic scanning, ultrasound image analysis, opticai probe analysis and direct measurement of loin muscle area and fat depth with a dot grid and ruler. Carcasses were fabricated into standard U.S. primal cuts and each cut was dissected into lean, fat, bone and skin. Multiple linear regression analyses to predict weight of total dissected carcass lean revealed that the electronic signal from the electromagnetic scanner, carcass length and temperature combined gave an R 2 of .89 (RSD 1.74). Carcass ultrasound images of fat depth and loin muscle area at the 10th rib and warm carcass weight gave an R 2 of .79 (RSD 2.20). The electronic probe for fat and muscle depth at the 10th rib of chilled carcasses and chilled carcass weight gave an R 2 of .79 (RSD 2.19). The R 2 is .81 (RSD 2.07) when actual loin muscle area and fat depth were determined by direct measurement in ribbed carcasses and combined with carcass weight. (Key Words: Carcass Yield, Body Composition, Pigs, Technology.)

Duplex scanning for carotid artery disease: Is angiographic confirmation required?

Requests for reprints should be addressed to Richard Sanders, MD, Rose Medical Center, 4545 East Ninth Avenue, Suite 240, Denver, Colorado 80220-3950. D uplex scanning has a reported accuracy of 87 to 95 percent in predicting carotid stenosis [1,2]. As a resuit, in selected patients, some surgeons in the United States are proceeding to endarterectomy on the basis of data from duplex scanning, which combines real-time Bmode ultrasound scanning, gated and pulsed Doppler ultrasound signal, and spectral analysis. The argument for Dr. Sanaers the duplex scan as a primary diagnostic tool includes the elimination of morbidity, mortality, and the increased cost associated with cerebral angiography [2,4]. Tables I and II list advantages and disadvantages of duplex scanning and cerebral arteriography for diagnosis of carotid artery disease.

Preoperative saphenous vein mapping for coronary artery bypass.

Saphenous vein mapping by real-time duplex ultrasound scanning allows for the confirmation of the presence of patent vein and determination of the anatomical course of the vein prior to aortocoronary bypass procedures. This technique has proven to be of value in patients whose veins are not evident by physical examination and in those whose length of conduit may be limited by previous vein stripping or thrombophlebitis.

An Evaluation of Urologist-Operated Ultrasound and its Use in the Urological Out-Patient Clinic

Summary— The value of urologist-operated real time ultrasound scanning was assessed in the urological out-patient clinic. In terms of accuracy, the urologists' ultrasound scans of the genitourinary tract proved comparable with those of the radiologists. The techniques were quickly learned and scanning added little to the consultation time. Scanning during clinic time was shown to be both time-saving and cost-effective by allowing more rapid assessment of the patient and a speedier diagnosis. In economic terms considerable savings could be made by reducing the need for formal ultrasound referrals, since patients scanned at the out-patient clinic would be spared two further trips to hospital, one for the formal examination and another for the out-patient clinic review. Clinic turnover thus becomes more efficient and inconvenience to the patient and transport costs are lessened.

Posterior tongue grooving in deglutition and speech: Preliminary observations

Real-time ultrasound sector scanning was used to image the posterior tongue. Depth of tongue grooving and distance of the tongue surface from the transducer face were measured in 7 normal subjects, for vowels in a standardized speech context and for dry swallows. Tongue postures for the vowels |ae| or |e| were most similar to the maximum grooving found in deglutition, which occurred approximately 300 ms prior to ultrasound evidence of initiation of the reflexive pharyngeal phase of swallowing.

The Intake and Performance of Pregnant Ewes In-Wintered on Straw-Based Diets

Limited work has been carried out on straw feeding to pregnant ewes. The present study aimed to assess intake and performance of ewes when fed diets based on either barley or pea straw.One hundred and forty mule ewes were randomly allocated to basal diets of pea or barly straw 15 weeks prior to lambing and allowed access to straw prior to housing to allow diet familiarisation. Pregancy diagnosis was performed at 75-80 days of gestation using real time ultrasound scanning. All in-lamb ewes were housed and grouped according to predicted foetal load. Ewe liveweight and condition was assessed at housing, 6 and 4 weeks prior to lambing and immediately after lambing.Straw was available ad libitum and was supplemented with 400 g/day distillers dark grains. From 6 weeks prior to lambing whole barley with an inclusion of 15% fishmeal was fed twice daily up to a level of 600 g/day for ewes carrying twins and triplets and 400 g/d for ewes carrying singles.

An Evaluation of Urologist‐operated Ultrasound and its Use in the Urological Out‐patient Clinic

The value of urologist-operated real time ultrasound scanning was assessed in the urological out-patient clinic. In terms of accuracy, the urologists' ultrasound scans of the genito-urinary tract proved comparable with those of the radiologists. The techniques were quickly learned and scanning added little to the consultation time. Scanning during clinic time was shown to be both time-saving and cost-effective by allowing more rapid assessment of the patient and a speedier diagnosis. In economic terms considerable savings could be made by reducing the need for formal ultrasound referrals, since patients scanned at the out-patient clinic would be spared two further trips to hospital, one for the formal examination and another for the out-patient clinic review. Clinic turnover thus becomes more efficient and inconvenience to the patient and transport costs are lessened.

Intrapartum vibrator acoustic stimulation of the human fetus during episodes of decreased heart rate variability

The effects of intrapartum vibratory acoustic stimulation during periods of decreased fetal heart rate variability were studied in 25 healthy term fetuses. Fetal monitoring and real-time ultrasound scanning were used simultaneously to detect fetal response. Vibratory acoustic stimulation was provided by an artificial larynx generating a signal at 85 dB and 85 Hz. This stimulus was applied for 5 seconds on the maternal abdomen over the fetal head after a 20-minute period of decreased fetal heart rate variability. All fetuses reacted with an immediate fetal heart rate acceleration of at least 10 bpm (range: 10 to 35 bpm, mean +/- SD = 18.4 +/- 7.0), and 19 fetuses also had sudden fetal body movement. A deceleration of the fetal heart rate after the initial acceleration was observed in nine fetuses (range: 15 to 70 bpm, mean +/- SD = 45.5 +/- 16.5). The implications of these findings are discussed in relation to the possible use of fetal vibratory acoustic stimulation for intrapartum surveillance.

Emergence of behavioural states in fetuses of type-1-diabetic women

The aim of this study was to investigate the effects of tightly controlled maternal (type-1-)diabetes mellitus on the development of fetal behavioural states. Seventeen diabetic women, who required insulin (White's class C predominantly) and were treated with continuous subcutaneous insulin infusion (CSII) therapy, participated in the study. Adjustment to an insulin-pump occurred before conception or during early pregnancy. In all diabetic women (near-)normoglycemia was achieved during pregnancy, with glycosylated hemoglobin-values within the normal range (6–8.5%). Fifty-three 2-h recordings of fetal heart rate, uterine contractions and of real-time ultrasound scanning for fetal body movements, breathing and eye movements were obtained from the 17 fetuses. The fetuses were longitudinally studied between 32 and 40 weeks post menstrual age, at intervals of 2 weeks. The 3 state variables, fetal heart rate, body movements and eye movements, were analyzed for the presence of combinations meeting the definitions of the four fetal behavioural states. Findings in the fetuses of diabetic women were compared with those obtained from 28 low risk fetuses. The criteria of states were met in only 3 of 8 fetuses studied at 38 weeks and in one of two studied at 40 weeks. For comparison: in low risk fetuses studied at 38 and 40 weeks, states were present in 70% and 90% of the cases, respectively. This poorly developed state organization exhibited by the near term fetuses of the diabetic group, was related to maternal parity, but not to pre- or postconceptional onset of CSII-treatment. Fetuses of nulliparous diabetic women showed more often asynchrony of transitions (>3 min) and interruption of periods of concordant association. This resulted in significantly higher percentages of ‘no-coincidence’ and in low incidence of behavioural states as compared with control fetuses of nulliparous women. In the few multiple diabetic cases studied near term the development of fetal behavioural states was normal. We conclude therefore that, despite tight control of maternal diabetes, the development of behavioural states is distributed in fetuses of nulliparous diabetic women.

Real-time ultrasound diagnosis of deep vein thrombosis: A comparison with venography

A prospective study comparing real-time ultrasound scanning with contrast venography in the diagnosis of deep venous thrombosis of the lower limb was performed in a group of 46 patients. The sensitivity of ultrasound scanning for thrombus within the iliofemoral segment, femoral vein, and popliteal vein was 94% with a specificity of 100%. Additional information obtained by ultrasound included the diagnosis of popliteal cysts, pelvic and inguinal lymphadenopathy, popliteal haematoma, and traumatic arterial aneurysm. Real-time ultrasound scanning is a rapid and non-invasive alternative to contrast venography in the diagnosis of lower limb deep venous thrombosis.

Effects of intrauterine infection on the function of the corpora lutea formed after first postpartum ovulations in dairy cows

This study was carried out to determine the relationship between postpartum intrauterine infections, endocrine patterns and the function of corpora lutea formed following the first postpartum ovulations in dairy cows. Blood samples were collected daily starting from the day of parturition until 30 d after parturition or until the second postpartum estrus, whichever occurred first. Sera were assayed for progesterone (P 4), prostaglandin F 2α metabolite (PGFM), and luteinizing hormone (LH) concentrations. Palpations per rectum and real-time ultrasound scanning of the reproductive tracts were carried out in all cows once every 4 d for 1 mo, starting from Day 4 after parturition. In addition, endometrial swabs were collected aseptically from each cow once every 4 d during the first month postpartum. The swabs were cultured for aerobic and anaerobic bacteria. Twelve cows (60%) exhibited short estrous cycles (SC; 6 to 14 d long) following first postpartum ovulations. The mean preovulatory LH surges and LH patterns during the first postpartum cycles were similar in both groups, leading us to believe that lack of luteotrophic stimulation was not a factor in the occurrence of SC. Bacterial isolations were frequent in SC cows. The occurrence of moderate to heavy bacterial growth patterns and the repeated isolations of the similar organisms during postpartum suggests the persistence of uterine infections in SC cows. Increases in PGFM concentrations prior to luteolysis in SC cows were associated with moderate to heavy infection. Thus, postpartum uterine infections do not appear to affect ovulations, but prostaglandin (PGF 2α) released in response to uterine infection may contribute to early demise of the corpus luteum formed after the first postpartum ovulation.

Real-time ultrasound scanning in the planning and guidance of pericardiocentesis

Real-time ultrasound scanning is a rapid and readily available way of detecting pericardial fluid. We have successfully and safely used real-time ultrasound scanning to plan and guide pericardiocentesis on 24 occasions in the last 2 years, in each case for therapeutic purposes in patients with malignant pericardial effusions. The procedure may be readily performed in the ultrasound department or on the ward. We advise the use of real-time ultrasound guidance in all instances of pericardiocentesis.

Ultrasound scanning in women with raised serum alpha fetoprotein: Short term psychological effect

Thirty pregnant women with raised serum alpha fetoprotein (AFP) were interviewed before and after they received real-time ultrasound scanning to further diagnose fetal abnormalities. Thirty pregnant mothers receiving routine ultrasound scanning for dates served as the controls. The ‘at risk’ group were more anxious and concerned about the fetus before the scan. There was a greater reduction of state-anxiety following scanning in the raised AFP group than for the controls. Similar changes were found in the attitude towards the fetus, pregnancy and fetus' health between the risk and control subjects.

Morphometry of the second trimester fetal brain. Comparison of ultrasonographic and post-mortem findings.

With the increasing use of ultrasound examination in the antenatal period the lack of morphological correlates has become a problem. This study was carried out in order to correct this deficiency. An antenatal real-time ultrasound scan of the fetal head was performed and measurements of the biparietal diameter, occipitofrontal diameter, head circumference and cerebral ventricle-to-hemisphere ratio were undertaken in 103 fetuses at 13-24 weeks gestation. After prostaglandin termination of pregnancy, the fetal brains were perfused in situ through the right carotid artery with 10% formal saline. Horizontal slices of the fetal head were cut, photographs were obtained and measurements of the same parameters as in the ultrasound examination were undertaken. There is a significant correlation (p less than 0.001) between the ultrasonographic and post-mortem measurements of all parameters. Also several anatomical structures of the fetal brain are now confidently identified in the antenatal ultrasound scan, using the anatomical preparations for comparison.

Intraventricular haemorrhage and periventricular leucomalacia: ultrasound and autopsy correlation.

The brains of 30 infants who died after at least one real time ultrasound scan were examined after fixation. The ultrasound diagnosis of either periventricular haemorrhage or periventricular leucomalacia was compared with the macroscopic and histological appearances. Each hemisphere was considered separately for both periventricular haemorrhage and periventricular leucomalacia. The accuracy of ultrasound diagnosis for periventricular haemorrhage was 88%, with sensitivity of 91% and specificity of 85%. The accuracy for periventricular leucomalacia was 90%, with sensitivity of 85% and specificity of 93%. Ultrasound was shown to diagnose the entire range of periventricular leucomalacia lesions. Three hemispheres showed the appearance of prolonged flare, and this correlated with extensive spongiosis and microcalcification of the periventricular white matter, although no macroscopic lesion was seen.