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Attenuation coefficient measurement in the thyroid
S122
Ultrasound in Medicine and Biology
Objective: The aim of this study was to assess the fetal adrenal gland volume during normal gestation using three-dimensional (3D) ultrasound and to establish a normal chart of fetal adrenal gland volume. Methods: A prospective study was performed and collected 119 normal fetuses with gestational age (GA) from 21 to 40 weeks for the assessment of adrenal gland volume using a 3D ultrasound volume scanner with a pure cross-sectional design. Polynomial regression analysis was calculated to find the best-fit equation uging GA as the dependent variable. Also, common fetal growth indices, such as biparietal diameter (BPD), occipito-frontal diameter (OFD), head circumference (HC), abdominal circumference (AC), femur length (FL), and estimated fetal weight (EFW), were measured for the correlation between adrenal gland volume and these indices. Results: Our results showed that fetal adrenal gland volume is highly correlated with the GA. Furthermore, using GA as the independent variable and adrenal gland volume as the dependent variable, the best-fit regression equation was obtained. In addition, fetal adrenal gland volume during normal gestation is also highly correlated with common fetal growth indices (all p ⬍ 0.0001). For more clinical use, a chart of normal growth centiles of fetal adrenal gland volume in utero was then calculated based on this equation. Conclusions: Our results for fetal adrenal gland volume assessed by 3D ultrasound can serve as a useful reference in evaluating fetal growth status during gestation. 21483 Attenuation coefficient measurement in the thyroid Fujii Y,* Taniguchi N, Itoh K, Omoto K, Wang Y, Clinical Laboratory Medicine, Jichi Medical School, Kawachi-gun, Tochigiken, Japan Objective: The aim of this study was to assess the feasibility of a new method of measuring the attenuation coefficient in the thyroid, which offers less variability of results than the conventional method. Methods: As we previously reported (Fujii Y, et al. J Ultrasound Med 2002;21:783–788), the attenuation coefficient was evaluated on the basis of the following equation with sound field correction in our new method: ␣ ⫽ {⫺1/4[fc(z)⫺⑀(z)]} ;{log(M0(z))⫺(z)}d/dz. In our system, the attenuation coefficient was also evaluated by the spectral shift central frequency method (the SS method) at the same time. The present study used 32 cases of normal thyroid, 25 cases of Graves’ disease, and 10 cases of Hashimoto’s thyroiditis in the system. Results: With the new method, attenuation coefficient values of the thyroid were 1.50⫾0.26 dB/cm/MHz in normal group, 0.91⫾0.24 dB/cm/MHz in Graves’ disease group, and 1.12⫾0.28 dB/cm/MHz in Hashimoto’s thyroiditis group. In both methods, there were statistically significant differences between the normal group and the Graves’ disease group (p⬍.0001 in both methods), the normal group and the Hashimoto’s thyroiditis group (p⬍.0001 in both methods, p⫽.024 in the SS method), and the Graves’ disease group and the Hashimoto’s thyroiditis group (p⫽.0023 in the new method, p⬍.0001 in the SS method), respectively. On the other hand, standard variation of the attenuation coefficient values obtained using the new method was much smaller than that obtained using the SS method in every group. Conclusions: This new method was considered to be usable for evaluating the attenuation coefficient of the thyroid in vitro.
New method The SS method
Normal Thyroid 1.50 ⫾ 0.26 2.08 ⫾ 0.71
Graves’ Disease 0.91 ⫾ 0.24 0.98 ⫾ 0.49
Hashimoto’s Thyroiditis 1.12 ⫾ 0.28 1.66 ⫾ 0.74
Volume 29, Number 5S, 2003 21562 Early pregnancy vascular development assessed by 3D Doppler Zalud I, Fetal Diagnostic Center, Kapiolani Medical Center for Women and Children, Honolulu, HI, and Department of OB/GYN, John A Burns School of Medicine, University of Hawaii, Honolulu, HI
Objective: Early pregnancy is a period of very intensive embryonic and fetal growth that is at least in part dependent on adequate blood flow. Our hypothesis was that embryonal circulation is different than early fetal circulation. Methods: Entry criteria: normal pregnancy course, no maternal disease, and ultrasound-assessed gestational age identical (within 5 days) to gestational age assessed by LMP. 3D power Doppler was used for automatic volume acquisition of the embryonal/fetal and trophoblast blood flow. Embryo/fetus was examined only when still to avoid artifacts due to movements. The VOCAL imaging program (Virtual Organ Computer-aided AnaLysis) was used to calculate vascularization index (VI), flow index (FI), and vascularization flow index (VFI). 3D calculation was done in 30 degrees rotation steps requiring 6 measurements by manual sphere placed around targeted organ. Results: 19 patients were enrolled in this study. They were divided in 2 groups based on gestational age. 10 patients were in the group 5– 8 weeks of gestation: trophoblast VI was 15.08, FI was 38.66, and VFI was 5.89; embryo/fetus VI was 17.82, FI was 31.44, VFI was 6.54. The group 8 –12 weeks consisted of 9 patients: trophoblast VI was 7.01, FI was 41.61, and VFI was 2.90; embryo/fetus VI was 8.00, FI was 37.23, and VFI was 2.98. Early trophoblast VI and embryonic VI are approximately two times of that in early fetal period. Conclusions: Decreasing VI and increasing FI as observed by 3D Doppler studies of the trophoblast and embryo/fetus characterize early pregnancy vascular development. Gest. week 5–8 8–12
N 10 9
Troph. VI 15.08 7.01
Troph. FI 38.66 41.61
Troph. VFI 5.89 2.90
Embryo/ Fetus FI 17.82 8.00
Embryo/ Fetus FI 31.44 37.23
Embryo/ Fetus VFI 6.54 2.98
21563 Fetal cranial, renal, and placental blood flow assessment by three-dimensional Doppler Zalud I, Fetal Diagnostic Center, Kapiolani Medical Center for Women and Children, Honolulu, HI, and Department of OB/GYN, John A Burns School of Medicine, University of Hawaii, Honolulu, HI
Objective: Rapid growth of the fetus is partially determined by adequate blood flow and vascular development. Our hypothesis was that fetal blood flow is directly related to gestational age, but different fetal organs or systems vascularize in different fashion. Methods: Entry criteria: first pregnancy with normal course, no maternal disease, and accurate gestational age. Exclusion criteria: fetal movements or pregnancy less than 15 weeks. 3D power Doppler was used for automatic volume aquisition of the fetal head, left or right kidney, and placental blood flow. The VOCAL imaging program (Virtual Organ Computer-aided AnaLysis) was used to calculate vascularization index (VI), flow index (FI), and vascularization flow index (VFI). 3D calculation was done in 30 degrees rotation steps requiring 6 measurements by manual sphere placed around targeted organ. Results: Fifty patients were enrolled in this study. Results are presented in Table 1.
Ultrasound in Medicine and Biology
Objective: The aim of this study was to assess the fetal adrenal gland volume during normal gestation using three-dimensional (3D) ultrasound and to establish a normal chart of fetal adrenal gland volume. Methods: A prospective study was performed and collected 119 normal fetuses with gestational age (GA) from 21 to 40 weeks for the assessment of adrenal gland volume using a 3D ultrasound volume scanner with a pure cross-sectional design. Polynomial regression analysis was calculated to find the best-fit equation uging GA as the dependent variable. Also, common fetal growth indices, such as biparietal diameter (BPD), occipito-frontal diameter (OFD), head circumference (HC), abdominal circumference (AC), femur length (FL), and estimated fetal weight (EFW), were measured for the correlation between adrenal gland volume and these indices. Results: Our results showed that fetal adrenal gland volume is highly correlated with the GA. Furthermore, using GA as the independent variable and adrenal gland volume as the dependent variable, the best-fit regression equation was obtained. In addition, fetal adrenal gland volume during normal gestation is also highly correlated with common fetal growth indices (all p ⬍ 0.0001). For more clinical use, a chart of normal growth centiles of fetal adrenal gland volume in utero was then calculated based on this equation. Conclusions: Our results for fetal adrenal gland volume assessed by 3D ultrasound can serve as a useful reference in evaluating fetal growth status during gestation. 21483 Attenuation coefficient measurement in the thyroid Fujii Y,* Taniguchi N, Itoh K, Omoto K, Wang Y, Clinical Laboratory Medicine, Jichi Medical School, Kawachi-gun, Tochigiken, Japan Objective: The aim of this study was to assess the feasibility of a new method of measuring the attenuation coefficient in the thyroid, which offers less variability of results than the conventional method. Methods: As we previously reported (Fujii Y, et al. J Ultrasound Med 2002;21:783–788), the attenuation coefficient was evaluated on the basis of the following equation with sound field correction in our new method: ␣ ⫽ {⫺1/4[fc(z)⫺⑀(z)]} ;{log(M0(z))⫺(z)}d/dz. In our system, the attenuation coefficient was also evaluated by the spectral shift central frequency method (the SS method) at the same time. The present study used 32 cases of normal thyroid, 25 cases of Graves’ disease, and 10 cases of Hashimoto’s thyroiditis in the system. Results: With the new method, attenuation coefficient values of the thyroid were 1.50⫾0.26 dB/cm/MHz in normal group, 0.91⫾0.24 dB/cm/MHz in Graves’ disease group, and 1.12⫾0.28 dB/cm/MHz in Hashimoto’s thyroiditis group. In both methods, there were statistically significant differences between the normal group and the Graves’ disease group (p⬍.0001 in both methods), the normal group and the Hashimoto’s thyroiditis group (p⬍.0001 in both methods, p⫽.024 in the SS method), and the Graves’ disease group and the Hashimoto’s thyroiditis group (p⫽.0023 in the new method, p⬍.0001 in the SS method), respectively. On the other hand, standard variation of the attenuation coefficient values obtained using the new method was much smaller than that obtained using the SS method in every group. Conclusions: This new method was considered to be usable for evaluating the attenuation coefficient of the thyroid in vitro.
New method The SS method
Normal Thyroid 1.50 ⫾ 0.26 2.08 ⫾ 0.71
Graves’ Disease 0.91 ⫾ 0.24 0.98 ⫾ 0.49
Hashimoto’s Thyroiditis 1.12 ⫾ 0.28 1.66 ⫾ 0.74
Volume 29, Number 5S, 2003 21562 Early pregnancy vascular development assessed by 3D Doppler Zalud I, Fetal Diagnostic Center, Kapiolani Medical Center for Women and Children, Honolulu, HI, and Department of OB/GYN, John A Burns School of Medicine, University of Hawaii, Honolulu, HI
Objective: Early pregnancy is a period of very intensive embryonic and fetal growth that is at least in part dependent on adequate blood flow. Our hypothesis was that embryonal circulation is different than early fetal circulation. Methods: Entry criteria: normal pregnancy course, no maternal disease, and ultrasound-assessed gestational age identical (within 5 days) to gestational age assessed by LMP. 3D power Doppler was used for automatic volume acquisition of the embryonal/fetal and trophoblast blood flow. Embryo/fetus was examined only when still to avoid artifacts due to movements. The VOCAL imaging program (Virtual Organ Computer-aided AnaLysis) was used to calculate vascularization index (VI), flow index (FI), and vascularization flow index (VFI). 3D calculation was done in 30 degrees rotation steps requiring 6 measurements by manual sphere placed around targeted organ. Results: 19 patients were enrolled in this study. They were divided in 2 groups based on gestational age. 10 patients were in the group 5– 8 weeks of gestation: trophoblast VI was 15.08, FI was 38.66, and VFI was 5.89; embryo/fetus VI was 17.82, FI was 31.44, VFI was 6.54. The group 8 –12 weeks consisted of 9 patients: trophoblast VI was 7.01, FI was 41.61, and VFI was 2.90; embryo/fetus VI was 8.00, FI was 37.23, and VFI was 2.98. Early trophoblast VI and embryonic VI are approximately two times of that in early fetal period. Conclusions: Decreasing VI and increasing FI as observed by 3D Doppler studies of the trophoblast and embryo/fetus characterize early pregnancy vascular development. Gest. week 5–8 8–12
N 10 9
Troph. VI 15.08 7.01
Troph. FI 38.66 41.61
Troph. VFI 5.89 2.90
Embryo/ Fetus FI 17.82 8.00
Embryo/ Fetus FI 31.44 37.23
Embryo/ Fetus VFI 6.54 2.98
21563 Fetal cranial, renal, and placental blood flow assessment by three-dimensional Doppler Zalud I, Fetal Diagnostic Center, Kapiolani Medical Center for Women and Children, Honolulu, HI, and Department of OB/GYN, John A Burns School of Medicine, University of Hawaii, Honolulu, HI
Objective: Rapid growth of the fetus is partially determined by adequate blood flow and vascular development. Our hypothesis was that fetal blood flow is directly related to gestational age, but different fetal organs or systems vascularize in different fashion. Methods: Entry criteria: first pregnancy with normal course, no maternal disease, and accurate gestational age. Exclusion criteria: fetal movements or pregnancy less than 15 weeks. 3D power Doppler was used for automatic volume aquisition of the fetal head, left or right kidney, and placental blood flow. The VOCAL imaging program (Virtual Organ Computer-aided AnaLysis) was used to calculate vascularization index (VI), flow index (FI), and vascularization flow index (VFI). 3D calculation was done in 30 degrees rotation steps requiring 6 measurements by manual sphere placed around targeted organ. Results: Fifty patients were enrolled in this study. Results are presented in Table 1.