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Friedman, Deborah M.; Schacht, Robert G.
doi: 10.1002/jcu.1870190704pmid: 1658063
Blood velocity waveforms in peripheral arteries vary such that decreasing vascular resistance results in a relative increase in diastolic velocity at steady state. We measured blood velocity in renal arteries of 20 children (age: 119 months ± 37 months; weight: 38 kg ± 15 kg) to establish normal values, and to explore the relationship between these waveforms and central hemodynamics. Using image‐directed pulsed Doppler echocardiography, M‐mode measurements and cardiac index were recorded. Renal hila were visualized via the flank for Doppler sampling. Peak systolic velocity (A) and minimal diastolic velocity (B) were determined. The results (mean ± SD) were as follows: Renal artery A/B = 2.9 ± 0.74 (range 1.9 to 5.1). Characteristic waveforms were identical bilaterally and had continuous diastolic foward flow: A/B was independent of central hemodynamics within the resting normal range, varying inversely with age and size.
Mahaisavariya, Banchong; Suibnugarn, Chavengsakdi; Mairiang, Eimorn; Saengnipanthkul, Sukit; Laupattarakasem, Wiroon; Kosuwon, Weerachai
doi: 10.1002/jcu.1870190705pmid: 1658064
A new application of operative ultrasound to help assess the fracture alignment for closed reduction and passing the guide wire in closed femoral nailing is described. This method can be used instead of fluoroscopic monitoring in certain important steps which can markedly reduce the exposure time of fluoroscopic monitoring. Nine of ten cases were successful using this technique for closed unlocked nailing with an average ultrasound monitoring time of 8 minutes. The time required for fluoroscopic assessment was reduced to less than 1 minute for each successful case.
Rak, Kevin M.; Hopper, Kenneth D.; Tyler, Harry N.
doi: 10.1002/jcu.1870190706pmid: 1658065
A common finding on abdominal ultrasound and CT examinations is variation in the size of the inferior vena cava (IVC). On occasion the infrahepatic IVC even assumes a slit‐like appearance. Though commonly related to respiratory change and to the degrees of intra‐abdominal pressure, some have claimed the slit‐IVC may be an indicator of hypovolemia. To study this phenomenon, we evaluated prospectively the IVC in 26 normal volunteers. These individuals were studied supine by dynamic image ultrasound at end‐inspiration, end‐expiration, and during the Valsalva maneuver. The size of the IVC was maximal with the patient supine and at end‐inspiration (A–P 1.8 cm). The subhepatic IVC decreased in size at end‐expiration (A–P 1.2 cm) and frequently collapsed with the Valsalva maneuver (A–P 0.7 cm). Dramatic changes in the size of the IVC with changes in ventilation are normal variants. The use of the slit‐IVC to diagnose hypovolemia should be done with caution.
Jafri, S. Zafar H.; Bree, Robert L.; Madrazo, Beatrice L.; Loginsky, Stephan J.
doi: 10.1002/jcu.1870190708pmid: 1658066
We have described 14 cases of large scrotal infections with diffuse involvement of testis and epididymis, thick septations within the cavity, and associated thickening of the scrotal wall and tunica albuginea. The combination of these findings should help distinguish this process from a diffuse neoplastic involvement of the testis where the scrotal wall is almost always of normal thickness. The presence of patchy inhomogenous testicular echo pattern should alert the sonologist to the presence of diffuse suppurative epididymo‐orchitis, which may result in necrosis with subsequent orchiectomy in such patients.
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The effects of volume loading on the left atrial preejection period (LAPEP) and left atrial ejection time (LAET) were examined in 24 patients with various heart diseases using pulsed Doppler echocardiography. In response to volume loading, the left atrial dimension before atrial contraction significantly increased from 30.6 mm ± 5.8 mm to 32.4 mm ± 5.4 mm and the change in the left atrial dimension during atrial contraction tended to increase. The peak velocity in the atrial contraction phase significantly increased from 58 cm/s ± 14 cm/s to 63 cm/s ± 13 cm/s, and the integral of the atrial contraction phase tended to increase. LAPEP significantly decreased from 114 ms ± 16 ms to 104 ms ± 14 ms and LAET significantly decreased from 128 ms ± 15 ms to 124 ± 12 ms. The relation between LAET and left ventricular end‐diastolic pressure, and that between LAPEP and mean pulmonary capillary wedge pressure, shifted downward to the right after volume loading. Thus, left atrial ejection is augmented by volume loading according to the Frank–Starling mechanism, while LAPEP decreases due to an increase in preload and LAET decreases due to an increase in afterload.