o_1977r8vv9vk1ts2ms0kd8pksa.pdf

108 D. Maulik
5. Due to the possible influence of potentiating factors,
duplex/Doppler ultrasound in febrile patients
might present an additional embryonic and fetal
risk.
6. The use of Doppler ultrasound in the first trimester
of pregnancy should be restricted to medically
indicated diagnostic purposes when there is a reasonable
expectation of beneficial outcome.
7. Given the absence of any evidence of beneficial
outcome, the use of Doppler ultrasound in lowrisk
screening applications may be inadvisable in
clinical practice outside a study protocol.
As long as these general principles and guidelines are
observed, there should be no inhibition in using diagnostic
ultrasound when a benefit is expected, nor
should any future research for expanding its diagnostic
applications be restricted provided it is conducted
with appropriate approval, counseling, and consent.
References
1. Moore RM, Jeng LL, Kaczmarek RG, Placek PJ (1990)
Use of diagnostic imaging procedures and fetal monitoring
devices in the care of pregnant women. Public
Health Rep 105:471±475
2. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker
F, Munson ML (2003) Births: Final Data for
2002; National Vital Statistics Reports, Vol. 52, No. 10
3. Duck FA, Henderson J (1998) Acoustic output of modern
ultrasound equipment: Is it increasing? In: Barnett
SB, Kossoff G (eds) Safety of diagnostic ultrasound.
Parthenon Publishing Group, New York, pp 15±25
4. Henderson J, Willson K, Jago JR, Whittingham TA
(1995) A survey of the acoustic outputs of diagnostic
ultrasound equipment in current clinical use. Ultrasound
Med Biol 21: 699±705
5. O'Brien WD Jr, Abbott JG, Stratmeyer ME, Harris GR,
Schafer ME, Siddiqi TA, Merritt CR, Duck FA, Bendick
PJ (2002) Acoustic output upper limits proposition:
should upper limits be retained? J Ultrasound Med
21:1327±1333
6. Exposure Criteria for Medical Diagnostic Ultrasound;
II. Criteria Based on All Known Mechanisms (2002)
NCRP Report 140
7. American Institute of Ultrasound in Medicine (1997)
Official Statement. Conclusions Regarding Heat
8. Barnett SB, Maulik D (2001) Guidelines and recommendations
for safe use of Doppler ultrasound in perinatal
applications. J Maternal Fetal Med 10:75±84
9. European Federation of Societies for Ultrasound in
Medicine and Biology (2003) EFSUMB Clinical Safety
Statement. EFSUMB Newsletter 17:15
10. World Federation for Ultrasound in Medicine and Biology
(1998) WFUMB Symposium on safety of ultrasound
in medicine: Conclusions and recommendations
on thermal and non thermal mechanisms for biological
effects of ultrasound. Ultrasound Med Biol 8:733±737
11. Bioeffects Committee of the American Institute of Ultrasound
in Medicine (1991) Safety considerations for
diagnostic ultrasound. AIUM Publications, Rockville,
MD
12. American Institute of Ultrasound in Medicine (1992)
The standard for real-time display of thermal and mechanical
acoustic output indices on diagnostic ultrasound
equipment. AIUM/NEMA, Laurel, MD
13. FDA (1993) Revised 510(k) diagnostic ultrasound guidance
for 1993. Center for Devices and Radiological
Health, US Food and Drug Administration, Rockville,
MD
14. American Institute of Ultrasound in Medicine/National
Electrical Manufacturers Association (1998) Standard
for real-time display of thermal and mechanical acoustic
output indices on diagnostic ultrasound equipment,
Revision 1. AIUM Publications, Laurel, MD
15. Nyborg WL (1981) Heat generation in a relaxing medium.
J Acoust Soc Am 70:310±312
16. Duck FA (1990) Physical properties of tissue: a comprehensive
reference book. Academic Press, London
17. National Council on Radiation Protection and Measurements
(1992) Exposure criteria for medical diagnostic
ultrasound: 1. Criteria based on thermal mechanisms.
NCRP, Bethesda, MD, Report no. 113
18. Villar J (2000) Heat shock protein gene expression and
survival in critical illness. Crit Care 4:2±5
19. Dewey WC (1994) Arrhenius relationships from the
molecule and cell to the clinic. Int J Hyperthermia
10:457±483
20. Duck FA (2003) Working towards the boundaries of
safety. EFSUMB Newsletter 16:8±11
21. Shaw A, Pay NM, Preston RC (1998) Assessment of the
likely thermal index values for pulsed Doppler ultrasonic
equipment Stages 2 & 3: Experimental assessment
of scanner/transducer combinations. NPL Report
CMAM 12 National Physical Laboratory, London
22. Lele PP (1979) Review: safety and potential hazards of
in the current applications of ultrasound in obstetrics
and gynecology. Ultrasound Med Biol 5:307±320
23. Miller MW, Ziskin MC (1989) Biological consequences
of hyperthermia. Ultrasound Med Biol 15:707±722
24. Tarantal AF, Chu F, O'Brien WD Jr, Hendrick AG
(1993) Sonographic heat generation in vivo in the gravid
long-tailed macaque (Macaca fascicularis). J Ultrasound
Med 12:285±295
25. Drewniak JL, Carnes KI, Dunn F (1989) In vitro ultrasonic
heating of fetal bone. J Acoust Soc Am 86:1254±
1258
26. Bosward KL, Barnett SB, Wood AK, Edwards MJ, Kossoff
G (1993) Heating of guinea-pig fetal brain during
exposure to pulsed ultrasound. Ultrasound Med Biol
19:415±424
27. Barnett SB (2001) Intracranial temperature elevation
from diagnostic ultrasound. Ultrasound Med Biol
27:883±888
28. Stone PR, Ross I, Pringle K, Flower J (1992) Tissue
heating effect of pulsed Doppler ultrasound in the live
fetal lambbrain. J Fetal Diagn Ther 7:26±30
29. Mariak Z, Krejza J, Swiercz M, Lyson T, Lewko J (2001)
Human brain temperature in vivo: lack of heating during
color transcranial Doppler ultrasonography. J Neuroimaging
11:308±312
30. Morishima HO, Yeh M, Niemann WH, James LS (1977)
Temperature gradient between mother and fetus as an