both lower extremities under general anesthesia and sterile conditions.Each rabbit was considered as control and experiment at the same time;right and left hindes were considered as experiment and control ex-tremities. Rabbits were randomly divided into two main groups (80rabbits per group), and each group was divided into four subgroups (20rabbits per subgroup). The first group was treated by 1-MHz frequency,and the other group was treated by 3-MHz frequency. Cases had beensearched for 7th, 14th, 21st, and 28th days after surgery. 10 rabbits ofeach subgroup were used for biomechanical analysis, and 10 rabbitswere used for histological analysis. The other specialties of ultrasoundtherapy were the same in both main groups: pulse 1:3, 0.1 W/cm2 for5 minutes per day. After the treatment period, rabbits were killed byether, and a mechanical test was done in three point bending manner.One load deformation curve was caught for each specimen, and F-max,energy absorbed capacity, ultimate bending strength, and force atelastic stage were identified by software. For the histological study,specimens were placed in formal saline and were embedded by paraf-fin. Then they were sectioned at 7 mm and were stained in haematoxy-line & eosine. Descriptive ranks (grades) and qualitative methods wereused for the histological study.Results: Ultrasound therapy with 1-MHz frequency on 21st and 28thand with 3-MHz frequency on 7th days after surgery caused signifi-cantly increase in bone regeneration.Conclusions: Ultrasound therapy with 1-MHz frequency on third andfourth weeks and with 3-MHz frequency on first week after surgery(DHPO) may cause a significant increase in biomechanical and histo-logical tibia bone properties in rabbits.

18554

New ultrasonographic fatty meal test with isosorbide dinitrate inassessment of choledynamics in patients with gastrointestinaldiseasesKazantseva MV,* Nelasov NJ, Jakovlev AA, Ultrasound, StateMedical University, Rostov-on-Don, Russian Federation

Objective: The aim of this study was to evaluate a new technique ofultrasonographic assessment of biliary tract response on fatty meal testwith isosorbide dinitrate in patients with various gastrointestinal dis-orders.Methods: To select patients for evaluation of modified ultrasono-graphic fatty meal test, a retrospective analysis of clinical, instrumental,and conventional ultrasonographic data of 340 patients, hospitalized inthe gastroenterological department, was performed. There were 120patients with bulbar localization of peptic ulcer (PU), 70 patients withchronic pancreatitis (CP), 60 with gastro-esophageal reflux disease(GORD), and 90 with chronic gastritis, type C (CGC). The modifica-tions of fatty meal test were: 1) basal multimetric measurements ofgallbladder (GB), common bile duct diameters, and volume every 20minutes during the period of 2 hours after fatty meal breakfast, includ-ing calculation not only of the rate of GB contraction, but also ofrelaxation; 2) next day repetition of fatty meal test with isosorbidedinitrate (10 mg per os 40 minutes before breakfast), which allows todetect reversibility of disorders.Results: The retrospective analysis revealed that hyperkinetic distur-bances in choledynamics can be seen in 82.0% of patients with PU,46.6% with CP, 75.2% with GORD, and 85.5% with CGC. 45 ofanalyzed patients were selected for modified repeated fatty meal testwith isosorbide dinitrate. The structure of pathology was: 18 patientswith PU, 12 with CP, and 15 with CGC. When analyzing results ofmodified fatty meal test, we found that in 4 (22.2%) patients with CU,8 (66.7%) with CP, and 6 (40.0%) with CGC, the basal rate of GBrelaxation was significantly decreased. During next day isosorbidedinitrate test, normalization of this parameter was registered in 15(83.3%) of these patients.

Conclusions: This pilot study demonstrates that ultrasonographic two-phase fatty meal test with isosorbide dinitrate can become a newinteresting approach to assess abnormalities of choledynamics and theirreversibility in patients with gastrointestinal diseases. Detection ofthese abnormalities may lead to differentiation and optimization oftherapy.

18557

Sonographic morphology of infiltrating breast carcinomarelationship with the hyaluronan extracellular matrixVignal P, Chu Henri Mondor, Paris, France

Objective: The aim of this study was to compare the shape of thesonographic image of invasive breast cancer with the shape of thecorresponding histopathologic section stained for components of theextracellular matrix, hyaluronan, and collagen.Methods: We studied 22 cases of breast carcinoma. Among them, 13were visible on both sonography and mammography, whereas 9 werevisible only on sonography. We compared the sonographic images withthe histologic sections of the same carcinomas after staining with alcianblue for hyaluronan and Masson trichrome for collagen.Results: We have shown that the shape of the sonographic image ofbreast cancer is similar to the shape of its hyaluronan extracellularmatrix.Conclusions: This finding explains why breast sonography is so sen-sitive for detection of invasive carcinoma and why some invasivecancers are not visible on mammography.

18629

Inferior vena cava: Color duplex ultrasound-guidedpercutaneous transluminal angioplastLi J,* Jia J, Wang J, Zhang W, Diagnostic Ultrasound, PekingUniversity Third Hospital, Beijing, China

Objective: The aim of this study was to evaluate the value of colorduplex ultrasonography (CDU) in guiding percutaneous transluminalangioplasty (PTA) of inferior vena cava.Methods: Eight patients with inferior vena cava stenosis or obstructionwere studied. Of those, 5 cases had membranous obstruction (range0.3–0.5 cm), 2 cases, segmental obstruction (range 2.5 cm and 4.7 cm),and 1 case, segmental stenosis (range 5.0 cm). Under the guidance ofCDU, PTA was performed using the right femoral vein approach, anda metallic stent was placed at the dilated site in all eight patients.Determination of the technical success of PTA was based on themorphological and hemodynamical changes at the dilated site shownby CDU.Results: Under the monitoring of CDU, eight patients were success-fully treated by PTA. CDU showed clearly the catheter, catheter wire,and balloon catheter during the procedure. After PTA, the blood vesseldiameter and flow at the site of stenosis or obstruction became normal.There was no complication in all cases. The initial technical successrate was 100%. After 1-year follow-up, only in one patient restenosisoccurred because of a metallic stent shift. The results, compared withthose done by traditional PTA and surgical operation in the literature,were discussed.Conclusions: These results suggest that CDU is safe and useful in theguidance of PTA for treatment of inferior vena cava occlusive disease.

21240

Fetal adrenal gland volume: Assessment by three-dimensionalultrasoundChang C,* Chang F, Cheng Y, Liao T, Obs/Gyn, National ChengKung University Hospital, Tainan, Taiwan

Abstracts S121

Objective: The aim of this study was to assess the fetal adrenalgland volume during normal gestation using three-dimensional (3D)ultrasound and to establish a normal chart of fetal adrenal glandvolume.Methods: A prospective study was performed and collected 119 nor-mal fetuses with gestational age (GA) from 21 to 40 weeks for theassessment of adrenal gland volume using a 3D ultrasound volumescanner with a pure cross-sectional design. Polynomial regressionanalysis was calculated to find the best-fit equation uging GA as thedependent variable. Also, common fetal growth indices, such as bipa-rietal diameter (BPD), occipito-frontal diameter (OFD), head circum-ference (HC), abdominal circumference (AC), femur length (FL), andestimated fetal weight (EFW), were measured for the correlation be-tween adrenal gland volume and these indices.Results: Our results showed that fetal adrenal gland volume is highlycorrelated with the GA. Furthermore, using GA as the independentvariable and adrenal gland volume as the dependent variable, thebest-fit regression equation was obtained. In addition, fetal adrenalgland volume during normal gestation is also highly correlated withcommon fetal growth indices (all p � 0.0001). For more clinical use,a chart of normal growth centiles of fetal adrenal gland volume in uterowas then calculated based on this equation.Conclusions: Our results for fetal adrenal gland volume assessed by3D ultrasound can serve as a useful reference in evaluating fetal growthstatus during gestation.

21483

Attenuation coefficient measurement in the thyroidFujii Y,* Taniguchi N, Itoh K, Omoto K, Wang Y, ClinicalLaboratory Medicine, Jichi Medical School, Kawachi-gun, Tochigi-ken, Japan

Objective: The aim of this study was to assess the feasibility of a newmethod of measuring the attenuation coefficient in the thyroid, whichoffers less variability of results than the conventional method.Methods: As we previously reported (Fujii Y, et al. J UltrasoundMed 2002;21:783–788), the attenuation coefficient was evaluatedon the basis of the following equation with sound field correction inour new method: � � {�1/4[fc(z)��(z)]} ;{log(M0(z))��(z)}d/dz.In our system, the attenuation coefficient was also evaluated by thespectral shift central frequency method (the SS method) at the sametime. The present study used 32 cases of normal thyroid, 25 cases ofGraves’ disease, and 10 cases of Hashimoto’s thyroiditis in thesystem.Results: With the new method, attenuation coefficient values of thethyroid were 1.50�0.26 dB/cm/MHz in normal group, 0.91�0.24dB/cm/MHz in Graves’ disease group, and 1.12�0.28 dB/cm/MHz inHashimoto’s thyroiditis group. In both methods, there were statisticallysignificant differences between the normal group and the Graves’disease group (p�.0001 in both methods), the normal group and theHashimoto’s thyroiditis group (p�.0001 in both methods, p�.024 inthe SS method), and the Graves’ disease group and the Hashimoto’sthyroiditis group (p�.0023 in the new method, p�.0001 in the SSmethod), respectively. On the other hand, standard variation of theattenuation coefficient values obtained using the new method was muchsmaller than that obtained using the SS method in every group.Conclusions: This new method was considered to be usable for eval-uating the attenuation coefficient of the thyroid in vitro.

NormalThyroid

Graves’Disease

Hashimoto’sThyroiditis

New method 1.50 � 0.26 0.91 � 0.24 1.12 � 0.28The SS method 2.08 � 0.71 0.98 � 0.49 1.66 � 0.74

21562

Early pregnancy vascular development assessed by 3D DopplerZalud I, Fetal Diagnostic Center, Kapiolani Medical Center forWomen 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 embryonicand fetal growth that is at least in part dependent on adequate bloodflow. Our hypothesis was that embryonal circulation is different thanearly fetal circulation.Methods: Entry criteria: normal pregnancy course, no maternal dis-ease, and ultrasound-assessed gestational age identical (within 5 days)to gestational age assessed by LMP. 3D power Doppler was used forautomatic volume acquisition of the embryonal/fetal and trophoblastblood flow. Embryo/fetus was examined only when still to avoidartifacts due to movements. The VOCAL imaging program (VirtualOrgan Computer-aided AnaLysis) was used to calculate vascularizationindex (VI), flow index (FI), and vascularization flow index (VFI). 3Dcalculation was done in 30 degrees rotation steps requiring 6 measure-ments by manual sphere placed around targeted organ.Results: 19 patients were enrolled in this study. They were divided in2 groups based on gestational age. 10 patients were in the group 5–8weeks of gestation: trophoblast VI was 15.08, FI was 38.66, and VFIwas 5.89; embryo/fetus VI was 17.82, FI was 31.44, VFI was 6.54. Thegroup 8–12 weeks consisted of 9 patients: trophoblast VI was 7.01, FIwas 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 approx-imately two times of that in early fetal period.Conclusions: Decreasing VI and increasing FI as observed by 3DDoppler studies of the trophoblast and embryo/fetus characterize earlypregnancy vascular development.

Gest.week N

Troph.VI

Troph.FI

Troph.VFI

Embryo/Fetus FI

Embryo/Fetus FI

Embryo/Fetus VFI

5–8 10 15.08 38.66 5.89 17.82 31.44 6.548–12 9 7.01 41.61 2.90 8.00 37.23 2.98

21563

Fetal cranial, renal, and placental blood flow assessment bythree-dimensional DopplerZalud I, Fetal Diagnostic Center, Kapiolani Medical Center forWomen 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 ade-quate blood flow and vascular development. Our hypothesis was thatfetal blood flow is directly related to gestational age, but different fetalorgans or systems vascularize in different fashion.Methods: Entry criteria: first pregnancy with normal course, no ma-ternal disease, and accurate gestational age. Exclusion criteria: fetalmovements or pregnancy less than 15 weeks. 3D power Doppler wasused for automatic volume aquisition of the fetal head, left or rightkidney, and placental blood flow. The VOCAL imaging program(Virtual Organ Computer-aided AnaLysis) was used to calculate vas-cularization index (VI), flow index (FI), and vascularization flow index(VFI). 3D calculation was done in 30 degrees rotation steps requiring6 measurements by manual sphere placed around targeted organ.Results: Fifty patients were enrolled in this study. Results are pre-sented in Table 1.

S122 Ultrasound in Medicine and Biology Volume 29, Number 5S, 2003