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Biomedical subjects

A L Bundy

Publications and source records attributed to A L Bundy.

At least 19 recordsLinked to original sources
PubMed1989

Sonographic diagnosis of partial hydatidiform mole.

We undertook a study to determine whether partial hydatidiform mole could be distinguished from other cases of first-trimester missed abortion using ultrasound. Scans from 22 cases of pathologically proved partial hydatidiform mole and 33 cases of first-trimester missed abortion were independently reviewed by three radiologists, each unaware of the final pathologic diagnosis. Using a standard data form, each radiologist recorded the dimensions, shape, and contents of the gestational sac, the sonographic appearance of the decidual reaction/placenta and myometrium, and the presence or absence of adnexal cysts. The following two criteria were found to be significantly associated (P less than .05) with the diagnosis of partial mole: 1) ratio of transverse to anteroposterior dimension of the gestational sac greater than 1.5, and 2) cystic changes, irregularity, or increased echogenicity in the decidual reaction/placenta or myometrium. There was high interobserver correlation for both criteria, as measured by the kappa statistic. In 50% of the cases, either both or neither of these criteria were met. When both criteria were met, the frequency of partial mole was 87%; when neither criterion was met, the frequency of missed abortion was 90%. These results indicate that ultrasound can be of value in predicting a high likelihood of partial mole prior to curettage.

Abortion, Missed↗
PubMed1988

Sonographic urethrogram: comparison to roentgenographic techniques in 22 patients.

A sonographic technique was devised to examine the anterior urethra in 22 men suspected of having stricture disease. All patients underwent sonographic and roentgenographic urethrograms. Cystoscopic examination was done in 17 patients. The sonographic urethrogram findings were as diagnostic as the roentgen findings in 19 patients. In 1 patient the sonographic urethrogram identified a bulbar urethral stricture not seen on a retrograde urethrogram. In 2 patients a bulbar urethral sinus tract was found by the retrograde urethrogram but not by the sonographic urethrogram, although the remaining 2 sonographic urethrograms correctly identified the urethral pathological condition. Structures outside the lumen of the urethra including the urethral wall, corpus spongiosum, corpus cavernosum, bulb and external urinary sphincter were seen clearly by the sonographic urethrogram. The fossa navicularis can be visualized as well. Foreign bodies in the urethra, straddle injury and stricture disease were correctly diagnosed by the sonographic urethrogram. No patient reported discomfort during the examination. The sonographic urethrogram provided valuable information about the luminal and extraluminal anatomy of the anterior urethra. Further long-term studies will be necessary to assess its ultimate diagnostic potential.

Adult↗
PubMed1986

Antenatal sonographic findings in trisomy 18.

The clinical and sonographic findings of trisomy 18 are varied. Fifteen cases of trisomy 18 were retrospectively reviewed with attention to demonstrable antenatal sonographic features. Certain combinations of findings, particularly in the third trimester, seem highly suggestive of this diagnosis. A late antepartum diagnosis is warranted because of the poor prognosis.

Abnormalities, Multiple↗
PubMed1985

Uterine adnexal torsion: sonographic findings.

Acute torsion of the uterine adnexal structures (ovary and fallopian tube) is a recognized surgical emergency, but rarely has the diagnosis been made preoperatively on the basis of imaging studies. This report describes 16 cases in which the diagnosis was suggested preoperatively on the basis of sonography and subsequently confirmed at surgery. In all of the patients studied, a pelvic or pelvoabdominal mass was present on sonography. These masses had a sonographic texture ranging from cystic to solid, depending on the presence and extent of internal hemorrhage and/or stromal edema. In the majority of patients (13 of 16), adnexal torsion was associated with a preexisting cystic adnexal mass. Eight of these had thin internal septae. The severity of symptoms was variable and did not correlate directly with the sonographic features of the pelvic mass. Consideration of this entity in the proper clinical setting and with the typical sonographic findings will facilitate prospective recognition of adnexal torsion, thereby improving the chances for salvage of the involved adnexal structures.

Acute Disease↗
PubMed1984

Sonographic depiction of endometrial changes occurring with ovulation induction.

Endometrial thickness and texture were evaluated with serial pelvic sonograms in ten normal, menstruating women and 107 patients undergoing ovulation induction for in vitro fertilization. Serial sonograms were performed in the control group every other day throughout the menstrual cycle, whereas the sonographic examinations of the ovulation induction patients were performed daily in a four- to eight-day time interval after their medications were completed and prior to laparoscopy for follicular aspiration. Endometrial thickness increased (defined as a persistent change greater than or equal to 1 mm) in 21 of 53 women (40 percent) who received human menopausal gonadotropin (HMG). Of the 54 women treated with clomiphene citrate (CC), five of 12 (42 percent) at 50 mg daily, 13 of 33 (39 percent) at 100 mg daily, and one of nine (11 percent) at 150 mg daily were found to have endometrial thickening. Although the frequencies of endometrial thickening in the high-dose CC and HMG groups were not significantly different (P = 0.09), the peak estradiol (E2) levels in the CC (150 mg) group (E2 = 944 +/- 165 pg/ml) were significantly higher (P less than 0.001) than those in the HMG group (E2 = 584 +/- 26 pg/ml). The relatively low frequency of endometrial thickening in women receiving CC (150 mg) despite very high E2 levels, and the decreased incidence of endometrial thickening relative to increasing dosages of CC may reflect an antiestrogenic effect of CC on the endometrium. In those patients undergoing ovulation induction, the texture of the endometrium remained the same in 98 cycles and changed during nine.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Palpable breast masses: evaluation by high frequency, hand-held real-time sonography and xeromammography. Work in progress.

The purpose of this study was to evaluate the diagnostic virtues and limitations of the combined use of high frequency, real-time ultrasound scanning (US) using hand-held transducers and xeromammography (XM) in the evaluation of palpable breast masses. Seventy-one patients, who ranged in age from 14 to 88 years and who had histologically proved masses, were examined by both imaging modalities. US demonstrated the highest degree of accuracy in establishing the presence of cysts (96%) and fibroadenomas (89%). XM afforded better overall depiction of the breast and correctly identified seven carcinomas, five of which were prospectively diagnosed by sonography. When all types of breast masses were considered, the combined use of XM and US was more accurate (89%) than when either XM (70%) or US (85%) was used alone. For this reason, a combined approach using both modalities in the examination of most patients with palpable breast masses is advocated. The advantages and limitations of both XM and US in the evaluation of palpable masses are discussed and illustrated.

Adenofibroma↗
PubMed1983

Serial sonography of posthemorrhagic ventricular dilatation and porencephaly after intracranial hemorrhage in the preterm neonate.

Changes in ventricular size and brain parenchyma were documented in 40 preterm neonates with intracranial hemorrhage (ICH), who were serially examined for 3 weeks or more. Sonography disclosed a close relation between the severity of the intracranial hemorrhage and the development of progressive ventricular dilatation. Eighty percent of preterm neonates with minor degrees of intracranial hemorrhage (localized subependymal hemorrhage or subependymal hemorrhage with small intraventricular hemorrhage [subependymal/intraventricular hemorrhage]) did not develop significant ventricular dilatation, whereas all of the neonates with intraventricular and/or intraparenchymal hemorrhage developed moderate or severe ventricular dilatation. Spontaneous resolution of moderate and/or severe ventricular dilatation occurred by the end of the third week in about one-third of neonates with intracranial hemorrhage. Progressive ventricular dilatation was documented in 10 of 15 neonates with major intraventricular and/or intraparenchymal hemorrhage. The therapeutic implications of the findings are discussed.

Cerebral Hemorrhage↗
PubMed1983

Sonographic depiction of changes in ventricular size associated with repeated ventricular aspirations.

Serial real-time cranial sonography was performed on 11 preterm neonates who had demonstrated progressive posthemorrhagic ventricular dilatation and were subjected to repeated ventricular aspirations. Changes in ventricular size were correlated with gestational age, birth weight, and extent and location of the intracranial hemorrhage, as well as the timing, frequency, and location of the ventricular aspirations and the average amount of cerebrospinal fluid removed. The sizes of both lateral ventricles of each neonate were measured and the occurrence of sequelae related to repeated ventricular aspiration was examined. Eleven ventricles diminished in size, eight increased, and there was no change in three. Two neonates had bleeding near the aspiration sites. It is concluded that repeated aspiration can be associated with a diminution in ventricular size in some neonates. It is recommended that alternative methods of treatment, such as serial lumbar puncture or external ventriculostomy, be attempted prior to initiating repeated ventricular aspirations.

Birth Weight↗