Fetal Renal Vein Thrombosis

Two cases of fetal renal vein thrombosis, diagnosed via maternal ultrasound scan are presented. One was associated with severe placental dysfunction and demonstrated haematuria and renal failure which resolved on day 10. The other followed an antepartum haemorrhage and resolved before the baby was born. The ultrasound showed, as transient findings, unilateral renal enlargement, thrombus protruding into the inferior vena cava, and mild fetal ascites. We suggest that fetal renal vein thrombosis may be more common than previously suspected, and warrants close monitoring of fetal well-being. Delivery should be considered if there is other evidence of fetal compromise, if the amount of peritoneal fluid suggests substantial haemorrhage, or if there is propagating thrombus in the inferior vena cava.     

An assessment of tissue harmonic versus fundamental imaging modes for echocardiographic measurements

The study aimed to evaluate whether a significant difference exists between tissue harmonic imaging (THI) and fundamental imaging (FI) in routine quantitative echocardiographic assessment. We also examined the effects of THI on endocardial definition (ED). Fifty-eight unselected patients (29 men, 29 women; mean age 53 years) referred for transthoracic echocardiography were studied with use of both FI and THI modes. Two independent observers made M-mode measurements of the following: left atrium, aortic root, and left ventricular internal dimensions and wall thickness; they also measured left ventricular outflow tract diameter and left atrial area from 2-dimensional images. Endocardial definition was assessed with use of an arbitrary scoring system (0 = endocardium not visualized, 1 = endocardium visualized but suboptimally, 2 = endocardium well defined) and the American Society of Echocardiography 16-segment model. No significant difference existed between cardiac measurements derived from FI and THI. However, a highly significant improvement in ED occurred with THI (ED index 1.83 versus 1.70, P <.0001). This study suggests that no systematic differences exist in standard echocardiographic measurements between THI and FI, even in the setting of improved ED.     

The development of occupational standards in the practice of diagnostic ultrasound: Part 1, background

This, the first of two papers considers the development of occupational standards in the practice of diagnostic ultrasound, giving an overview of the background to the project which was commissioned by the NHS Executive South and West and the College of Radiographers. The paper provides a review of the literature related to occupational standards with key themes, such as the role of professional bodies in monitoring practice and practitioners and the derivation and definition of occupational standards. Other models and projects which have developed methods of standards design in areas of radiography and diagnostic ultrasound (such as the development of competency based standards for medical radiation science professions) are also considered. The paper concludes with a reflection on the need for continual evaluation of occupational standards and their use in practice.     

Solid Ectopic Cervical Thymus in Neonates With Thyroid Agenesis

We report a series of ectopic thymus glands as detected by sonography in infants with thyroid agenesis. The patients were children who underwent nuclear medicine and sonography for congenital hypothyroidism. Of the 12 patients with a diagnosis of thyroid agenesis over a 5‐year period, 4 (33%) were shown to have ectopic thymic tissue. Although a cervical ectopic thymus has been previously reported, there is very little discussion of it occurring in conjunction with thyroid agenesis. This case series highlights the importance of recognition of ectopic thymic tissue when examining for thyroid tissue in the setting of congenital hypothyroidism.     

Traumatic pseudoaneurysm of superficial temporal artery: A case report

We report a case of a 36‐year‐old male who presented with a pulsatile mass at the left temporal region after a head injury. Duplex sonographic examination confirmed the diagnosis of traumatic pseudoaneurysm of the superficial temporal artery. Imaging showed the pseudoaneurysm was partially thrombosed. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009     

Prevalence of gallbladder disease in diabetes mellitus

A study was undertaken to compare the prevalence of gallstone disease (gallstones observed on ultrasound or history of cholecystectomy) in 308 diabetics and 318 controls. There was a higher prevalence of gallstone disease (GSD) in diabetics (32.7%) compared to controls (20.8%;P<0.001 chi-squared test). However, when gender was taken into account, the difference was only significant in females (diabetics 41.8% versus controls 23.1%;P<0.001). Analysis by type of diabetes revealed that subjects with non-insulin-dependent diabetes mellitus (NIDDM) had a higher prevalence of GSD than controls for both genders: males—controls 18.1%, NIDDM 33.3% (P<0.05), IDDM 15.6% ns; females—controls 23.1%, NIDDM 48.6% (P<0.001), IDDM 36.3% (P<0.05). On univariate analysis the following risk factors were associated with gallstones (P<0.1): increased age, body mass index (BMI), triglycerides, LDL cholesterol, decreased HDL cholesterol, alcohol intake, family history of GSD, and female parity >3. Using stepwise multiple logistic regression, the following variables were identified as independently predictive of gallstones for each gender/diabetic combination: Males—NIDDM (N=54), increased age, and decreased HDL; IDDM (N=90), age and family history; Females—NIDDM (N=74), increased age, diabetes, increased BMI, and decreased alcohol; IDDM (N=91), increased BMI, age, decreased alcohol and family history. The proportion of subjects who underwent cholecystectomy was higher in females (46.7%) compared to males (21.7%;P<0.01) but there were no differences between diabetics and controls in either sex. In conclusion, there was a higher prevalence of GSD in diabetics compared to controls. However, GSD is multifactorial and only in NIDDM females was diabetes an independent risk factor. The proportion of diabetics and controls with GSD who underwent cholecystectomy was equivalent.