Ninety-two consecutive neonates were prospectively evaluated with real-time ultrasound to assess the frequency of adrenal visualization. The right gland was identified in 97% of neonates and the left in 83%. Criteria for normal length and width are presented. The characteristic sonographic appearance of the neonatal adrenal is described and correlated with histologic data. Ultrasound is the examination of choice for evaluating the neonatal adrenal gland.

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Duplex ultrasound examination of the carotid arteries using high-resolution realtime imaging and pulsed Doppler flow measurements with velocity spectrum analysis was performed on a series of 50 consecutive patients (100 vessels), and findings were compared with findings of conventional carotid arteriography. The criteria for an abnormal duplex examination included: a velocity ratio of 1.5 or more (ratio of the maximum internal carotid artery [ICA] flow velocity to the maximum common carotid artery flow velocity); turbulence, as indicated by an ICA velocity spectral width of 40 cm per second or more; visible plaque that produced an ICA stenosis of 50% or more; a maximum ICA velocity of 100 cm per second or more; and inability to detect ICA flow. A flow-limiting stenosis was defined arteriographically as a 50% or greater stenosis of the diameter of the arterial lumen. The velocity ratio was the best single duplex criterion, with an overall accuracy of 88%. The sensitivity or specificity of the duplex examination was as high as 97%, depending on the number of duplex criteria that were abnormal.

Real-time sonography provides a noninvasive method of determining the level of obstruction in patients with imperforate anus. The authors describe one technique for evaluating this anomaly which was employed in 6 neonates. A pouch-perineum distance of less than 1.5 cm is consistent with a low lesion, while a pouch that terminates above the base of the bladder is indicative of a high lesion.

Seventy-one neonates with umbilical arterial catheters received serial real-time ultrasound examinations in order that the identification and natural history of catheter-associated thrombosis could be prospectively evaluated. Twelve (17%) of the infants had clinically evident signs of vascular compromise. Ultrasound detected abnormal intravascular echoes or lack of expansile pulsation in 10 of these 12 (83%). Abnormal echogenic foci were consistent with thrombus and intimal dissection. Two infants without clinical evidence of vascular compromise had ultrasonic findings consistent with thrombus. The ultrasonically detected abnormalities persisted from two to 70 days.