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Biomedical subjects

F Raga

Publications and source records attributed to F Raga.

At least 37 records · Page 2Linked to original sources
PubMed1998

Early diagnosis of conjoined twins using two-dimensional color Doppler and three-dimensional ultrasound.

Transvaginal three-dimensional (3-D) and color Doppler ultrasound were used to establish a first-trimester definitive diagnosis and classification of thoracoomphalopagus conjoined twins following two-dimensional (2-D) transabdominal and transvaginal scans that indicated twin gestation of uncertain classification. Color Doppler in combination with 3-D ultrasound can be a useful complement to 2-D ultrasound to confirm early diagnosis and determine the extent of organ sharing and definitive classification of conjoined twins.

Abortion, Induced↗
PubMed1997

Three-dimensional hysterosonography for the study of endometrial tumors: comparison with conventional transvaginal sonography, hysterosalpingography, and hysteroscopy.

We studied endometrial thickness and homogeneity in 36 patients with postmenopausal bleeding using three-dimensional ultrasound following distention of the uterine cavity with a sterile saline solution (3D-SHSG). Results with 3D-SHSG were compared with findings using transvaginal sonography, transvaginal sonohysterography, transvaginal color Doppler, and hysteroscopy. Sixteen patients (including three on tamoxifen) were undergoing hormone therapy at the time when they were studied. Visualization of the uterine cavity and of endometrial thickness was better with 3D-SHSG than with any of the other ultrasound techniques. The results with 3D-SHSG corresponded to the findings observed with hysteroscopy. Three-dimensional SHSG seems to improve ultrasound determination of myometrial and cervical invasion in cases of endometrial adenocarcinoma.

Endometrial Hyperplasia↗
PubMed1997

Reproductive impact of congenital Müllerian anomalies.

This retrospective longitudinal study was undertaken in order to determine the incidence and reproductive impact of uterine malformations on women desiring to conceive during their reproductive years. A total of 3181 patients in whom the morphology of the uterus was ascertained by hysterosalpingography (HSG) and laparoscopy/laparotomy during the years 1980-1995 was included in the study. The population analysed included fertile, infertile and sterile patients. The overall frequency of uterine malformations was 4.0%. Infertile patients (6.3%) had a significantly (P < 0.05) higher incidence of Müllerian anomalies, in comparison with fertile (3.8%) and sterile (2.4%) women. Septate (33.6%) and arcuate (32.8%) uteri were the most common malformations observed. Each malformation was individually analysed in fertile and infertile patients, in order to ascertain its actual reproductive impact. The performance of the unicornuate and didelphys uteri was similar with a chance of having a living child of 37-40%. The reproductive potential of the bicornuate uterus showed a live birth rate of 62.5% and the septate uterus showed a live birth rate of 62%. In all these abnormalities, early miscarriages (25-38%) and preterm deliveries (25-47%) were quite common. The arcuate uterus presented a live birth rate of 82.7%. It is concluded that uterine anomalies are relatively frequent in fertile women, and more frequent in infertile patients. Nevertheless, fertile patients with normal reproductive performance do exist, and Müllerian defects can permit an absolutely normal obstetric outcome. The reproductive performance of the unicornuate and didelphys uteri was poor, while that of the septate and bicornuate uteri was better than expected. The arcuate uterus had no impact on reproduction.

Abortion, Spontaneous↗
PubMed1996

Control of intrauterine device insertion with three-dimensional ultrasound: is it the future?

A comparative study was designed to determine whether three-dimensional transvaginal sonography (3D-TVS) offered advantages over two-dimensional transvaginal sonography (2D-TVS) for the identification and location of IUDs in 66 asymptomatic women. Hysteroscopy was performed in cases in which there was a discrepancy between the information obtained by both methods (n = 14). In eight cases (12.2%) the IUD was misidentified with 2D-TVS. In six cases (9.1%) it was not possible to identify the device model with 2D-TVS. In two cases (3.0%) 2D-TVS failed to identify the position of the device. In contrast, all IUDs were identified and located accurately with 3D-TVS.

Adult↗
PubMed1996

Congenital Müllerian anomalies: diagnostic accuracy of three-dimensional ultrasound.

OBJECTIVE: To determine whether it is possible to identify and diagnose accurately Müllerian anomalies with three-dimensional (3-D) ultrasound (US). DESIGN: Controlled blinded clinical study. SETTING: Normal human volunteers undergoing infertility evaluation in a university hospital. PATIENTS: Forty-two patients who underwent laparoscopy and hysterosalpingography as part of their work up for infertility and were found to have either a normal uterus (30 patients) or a Müllerian abnormality (12 patients) consented to be evaluated with 3-D US by sonographers who were unaware of their infertility history or of their laparoscopy and hysterosalpingography diagnoses. INTERVENTIONS: Transvaginal 3-D US evaluation over a 10- to 15-minute duration. MAIN OUTCOME MEASURES: Three-dimensional imaging was successful in all cases. RESULTS: Sonographers identified a Müllerian anomaly in all cases and came up with the correct classification in 11 of 12 cases. All patients with a normal uterus were identified correctly. CONCLUSIONS: In all patients with Müllerian anomalies, 3-D US examination of the endometrial cavity correlated with hysterosalpingography. In 91.6% of patients, 3-D US correlated with the external uterine configuration observed by laparoscopy. This technique may be used reliably in an office setting to diagnose and classify Müllerian anomalies.

Adult↗
PubMed1996

Subchorionic placental cyst: a cause of fetal growth retardation--ultrasound and color-flow Doppler diagnosis and follow-up.

Subchorionic placental cysts are ominous findings. When attached near the umbilical cord insertion, the risk of umbilical cord constriction is increased. This may cause fetal growth retardation and intrauterine asphyxia. This article reports a case of subchorionic placental cyst diagnosed in the first trimester by transvaginal ultrasound. Color Doppler ultrasound demonstrated a reduction of the umbilical cord bloodstream as the cyst increased in size. Fetal growth retardation was evident in the third trimester.

Adult↗
PubMed1996

Color flow Doppler: a useful instrument in the diagnosis of funic presentation.

Color Doppler sonography offers the opportunity to evaluate the umbilical cord and to study blood velocity wave forms within the cord. Funic (cord) presentation can be diagnosed unequivocally with color Doppler sonography. Because funic presentation is likely to be the harbinger of cord prolapse, the morbidity and mortality associated with cord prolapse can be prevented if funic presentation is diagnosed before membrane rupture. This article describes the first case in the obstetric literature of funic presentation diagnosed with color Doppler sonography. The potential complications associated with cord prolapse were avoided with a cesarean section.

Adult↗
PubMed1995

Three-dimensional ultrasound evaluation of ovarian masses.

Seventy-six women with ovarian masses first detected with two-dimensional (2D) ultrasound were then evaluated with three-dimensional (3D) ultrasound. Two-dimensional ultrasound detected four of five ovarian malignancies. One additional ovarian carcinoma was diagnosed by 3D scanning. Observation of papillary projections, characteristics of cystic walls, and the extent of capsular infiltration of tumors was superior with 3D ultrasound as was the calculation of ovarian volume. Fifty-seven of the women studied underwent surgery within 7 days of 3D ultrasound evaluation. Histologic examination of surgical specimens confirmed the 3D sonographic diagnoses. There was one false positive and one false negative diagnosis with 2D ultrasound. All cases of ovarian malignancy were diagnosed correctly with 3D ultrasound.

Adolescent↗
PubMed1995

Use of three-dimensional ultrasonography for the study of normal and pathologic morphology of the human embryo and fetus: preliminary report.

Our objective was to determine whether three-dimensional ultrasonography offers advantages over two-dimensional sonography for the evaluation of normal and pathologic morphology of human embryos and fetuses at various stages of pregnancy. Our studies suggest that small fetal and embryonic malformations are better defined with 3D sonography. Our experience indicates that 3D sonography allows more detailed visualization of fetal internal structures. We believe that with technical improvements 3D sonography will permit a more complete evaluation of fetuses earlier in gestation than is possible with current 2D sonographic instruments.

Adolescent↗
PubMed1995

Normal uterine arterial blood flow in postmenopausal women assessed by transvaginal color Doppler ultrasonography.

We used transvaginal color Doppler sonography to study uterine artery blood flow velocity waveforms in 345 normal postmenopausal women who had never been on hormone replacement therapy. Our objective was to establish the standard baseline flow values for normal postmenopausal women. The mean pulsatility index was 3.38 +/- 1.04 and the mean resistive index was 0.93 +/- 0.09. There was a positive correlation between arterial blood flow impedance and number of years since menopause. We believe that these levels may become important screening parameters for the detection of endometrial carcinoma in postmenopausal women.

Adult↗
PubMed1995

Normal uterine arterial blood flow in postmenopausal women assessed by transvaginal color Doppler sonography: the effect of hormone replacement therapy.

We used transvaginal color Doppler sonography to study the effect of hormone replacement on the uterine arterial blood flow for 203 postmenopausal women. The regimens studied involved estrogen replacement alone, continuous combined estrogen and progestogen, and estrogen followed sequentially by combined estrogen-progestogen. The mean pulsatility index fell to 65% +/- 9% and the mean resistive index fell to 87% +/- 4% of baseline during the first month of therapy (P < 0.0001). The addition of a progestogen did not alter the effect of estrogen alone (P > 0.5). Our findings suggest that the increase in vascular flow occurs even in women who begin therapy long after menopause.

Arteries↗
PubMed1995

Transvaginal color Doppler assessment of endometrial status in normal postmenopausal women: the effect of hormone replacement therapy.

We used transvaginal color Doppler sonography to study the effects of hormone replacement therapy on the endometrial structure and vascular flow of 345 normal postmenopausal women. We studied women taking estrogen replacement alone, continuous combined estrogen and progestogen, and estrogen followed sequentially by estrogen-progestogen combination. Endometrial measurements prior to the initiation of hormone replacement therapy were used as baseline values. An increase in endometrial thickness was seen soon after initiation of hormone replacement therapy (P < 0.0001). Hyperplasia or adenocarcinoma was found only when endometrial thickness was greater then 9 mm. No correlation was found between hormone replacement therapy and the occurrence of endometrial hyperplasia or adenocarcinoma.

Adenocarcinoma↗
PubMed1995

Role of color flow Doppler ultrasonography in diagnosing velamentous insertion of the umbilical cord and vasa previa. A report of two cases.

BACKGROUND: Prenatal diagnosis of velamentous insertion of the umbilical cord is of practical importance since unsupported vessels in the amnion may be lacerated at the time of membrane rupture. Failure to diagnose ruptured vessels may lead to fetal death. The incidence of velamentous insertion of the umbilical cord is about 1% in singleton pregnancies. This mode of insertion occurs much more frequently with multifetal pregnancies. CASES: Two cases of velamentous insertion of the umbilical cord unrelated to vasa previa were diagnosed prenatally with color Doppler ultrasound in women with twin gestations. Both women delivered uneventfully by cesarean section. The velamentous insertion diagnosis was confirmed postnatally in both cases. CONCLUSION: Color flow Doppler ultrasonography can be used in the second and third trimesters of pregnancy to identify potentially lethal structural abnormalities of the umbilical cord.

Adult↗
PubMed1994

Early prenatal diagnosis of an ominous aneurysm of the vein of Galen by color Doppler ultrasound.

A case of an aneurysm of the vein of Galen detected by color Doppler ultrasound (CDU) at 25 weeks of pregnancy is presented. The initial finding was a small defect of the posterior cerebral vein. Sonographic follow-up demonstrated an enlargement of the cerebral lesion as well as severe hemodynamic consequences. Fetal demise finally occurred at 28 weeks. Necropsy findings confirmed the diagnosis. This is the first report describing the value of CDU in the early diagnosis of such aneurysms.

Adult↗
PubMed1994

Early detection of embryonic malformations by transvaginal and color Doppler sonography.

A total of 834 women with uneventful pregnancies were followed prospectively until the 15th week of gestation by TVS to screen for early embryonic malformations. Twenty-eight embryonic anomalies were detected in this series (3.3%). The median gestational age at diagnosis was 11 (range, 8 to 15) weeks. Two neural tube defects were missed by early TVS screening. Two suspected abdominal wall defects were not confirmed by repeat mid-second trimester abdominal sonography representing 6.7% of all fetal malformations evident by 24 weeks of gestation. The sensitivity and specificity of TVS screening for fetal malformations in this series were 93.3 and 99.7%, respectively. In addition, the role of TCDU also was investigated in these 28 abnormal embryos. TCDU proved to be of limited value as it was useful only for evaluating those embryonic malformations with vascular involvement. In such cases, the diagnosis was greatly enhanced with this technique. Two previously undetected single umbilical arteries were also diagnosed by TCDU as well. This series included 11 aneuploid embryos (44%), most of them among the embryos with focal or generalized edema. This study demonstrates that screening for early embryonic malformations is feasible using TVS techniques, but a repeat mid-second trimester abdominal sonogram still is recommended.

Adult↗
PubMed1993

Is avoidance of surgery possible in patients with perimenopausal ovarian tumors using transvaginal ultrasound and duplex color Doppler sonography?

A total of 108 cases of small perimenopausal ovarian tumors (largest diameter, less than 7 cm) were evaluated by transvaginal sonography and duplex color Doppler sonography; 101 had criteria for benignity and 7 for malignancy. All cysts were punctured and aspirated to avoid unnecessary surgery (benign cases) and establish the cytologic diagnosis as well as to avoid the risk of leakage (malignant cases). Recurrence rate of benign punctured cysts was 25% within 1 year of follow up. No difference in recurrent rate was seen between pre- and postmenopausal patients (19 of 56 cases in the premenopausal group, and five of 28 cases in the postmenopausal group). The larger the cyst, the greater the risk of recurrence. Puncture and aspiration of seven sonographically established malignant tumors allowed cytologic diagnosis before surgery, and no evidence of leakage was noted at the time of surgery. No significant differences were observed between cytologic and histopathologic findings in cases that went to surgery. Puncture and aspiration of small endometriomas (17 cases) was found to be inefficient for therapeutic purposes. Finally, owing to the high percentage of unsatisfactory cytologic results (20%) with cyst aspiration, vaginal and color Doppler sonography seemed more efficient in distinguishing between benignity and malignancy.

Adult↗