Jaypee Brothers
In Current Chapter
In All Chapters
X
Clear
X
GO
Normal
Sepia
Dark
Default Style
Font Style 1
Font Style 2
Font Style 3
Less
Normal
More
Donald School Textbook of Transvaginal Sonography
Asim Kurjak, Jose Bajo Arenas
SECTION 1: GENERAL ASPECTS
1:
Transvaginal Probe: Technical Aspect
INTRODUCTION
CONVEX PROBES
MECHANICAL SECTOR PROBES
THREE-DIMENSIONAL TRANSVAGINAL PROBES
ACCESSORIES OF A TRANSVAGINAL PROBE
2:
Basis of Transvaginal Scanning
INTRODUCTION
PREPARING THE PATIENT AND THE PROBE
PROBE INSERTION AND ROTATION
BASIC TECHNIQUES IN TRANSVAGINAL SCANNING
When a Clear Image Cannot be Obtained
3:
Safety of Diagnostic Transvaginal Scan Estimated from Ultrasonic Bioeffects
ABSTRACT
INTRODUCTION
INTENSITY OF DOPPLER ULTRASOUND
HAZARDOUS EXPOSURE TO HIGH TEMPERATURE
TWO MODES IN THE EXPOSURE TIME TO ULTRASOUND
METHODS OF EXPOSURE TIME SETTING
OTHER THERMAL ISSUES
TRANSDUCER TEMPERATURE IN TRANSVAGINAL SCAN
DISCUSSION
CONCLUSION
4:
Ultrasonic Tissue Characterization with Gray Level Histogram Width
ABSTRACT
INTRODUCTION
METHODS
TECHNICAL RESULTS
CLINICAL RESULTS
Assessment of Fetal Lung Maturity (M Serizawa)
Periventricular Echodensity of Fetal Brain (N Yamamoto et al13)
Endometrial Hyperplasia and Malignancy (T Ito)
Other Application of GLHW
CONCLUSION
5:
Transrectal Sonography
INTRODUCTION
PROBES, PLANES, AND ORIENTATION (FIG. 5.2)
INDICATIONS OF TRS (TABLE 5.1)
SAFETY AND CONTRAINDICATIONS
TECHNIQUE AND PREPARATION
OUR RESULTS
SUMMARY
ACKNOWLEDGMENT
SECTION 2: OBSTETRICS
6:
Fetal Anatomy on the First Trimester of Pregnancy
INTRODUCTION
The Normal First Trimester Fetus
The 4th Week
The 5th Week
The 6th Week
The 7th Week
The 8th Week
The 9th Week
The Postembryonic Period (10 to 11 Weeks)
Fetal Anatomy at 11 to 14 Weeks
STUDIES SCREENING FOR STRUCTURAL DEFECTS BY FIRST TRIMESTER ULTRASOUND
STRUCTURAL DEFECTS AT 11 TO 14 WEEKS
Central Nervous System Defects
Acrania/Anencephaly (Birth Prevalence 1 in 1,000)
Holoprosencephaly (Birth Prevalence 1 in 5,000)
Spina Bifida (Birth Prevalence 1 in 1,000)
Heart Defects
Abdominal Wall Defects
Exomphalos (Omphalocele, Birth Prevalence 1 in 4,000)
Gastroschisis (Birth Prevalence 1 in 4,000)
Defects of the Urinary Tract
Megacystis
Meckel-Gruber Syndrome (Birth Prevalence 1 in 10,000)
Skeletal Defects
Caudal Regression Syndrome (Sirenomelia, Birth Prevalence 1 in 500,000)
Body Stalk Anomaly (Birth Prevalence 1 in 15,000)
Skeletal Dysplasias
Achondrogenesis (Birth Prevalence 1 in 40,000)
Hypophosphatasia (Birth Prevalence 1 in 100,000)
Osteogenesis Imperfecta Type II (Birth Prevalence 1 in 60,000)
Robert's Syndrome
Short-rib Polydactyly Syndrome
7:
Ultrasound Imaging of Early Extraembryonic Structures
INTRODUCTION
GESTATIONAL SAC
BLIGHTED OVUM
CHORIONIC PLATE
Subchorionic Hemorrhage
YOLK SAC
Development of the Yolk Sac
Structure of the Yolk Sac
Function of the Yolk Sac
Circulation of the Yolk Sac
Abnormalities of Yolk Sac Development
8:
Ultrasound Markers of Aneuploidy in the First Trimester
INTRODUCTION
NUCHAL TRANSLUCENCY
CYSTIC HYGROMAS
FETAL GROWTH DISORDERS
NASAL BONE
MEGACYSTIS
DUCTUS VENOSUS VELOCIMETRY
PULSATILITY INDEX OF THE UMBILICAL ARTERY
FETAL HEART RATE
UMBILICAL CORD
OMPHALOCELE
OTHER ABNORMALITIES
FUTURE POSSIBILITIES
9:
Early Detection of Fetal Abnormality
INTRODUCTION
ABNORMAL YOLK SAC
FETAL STRUCTURAL ANOMALY
FUTURE ASPECTS
10:
Fetal Kinetics: Its Quantification by Transvaginal Doppler Ultrasonography
ABSTRACT
INTRODUCTION
FETAL KINETICS: QUANTIFICATION BY DOPPLER TECHNOLOGY
Methodology
TECHNOLOGY
Sampling Characteristics
Requirements Prior to Exploration
Quantitative Analysis
Results
Qualitative Observations
Lower Extremities
Upper Extremities
Mouth Opening
Trunkal Spasm
Micturition
Blepharospasm
DISCUSSION
CONCLUSION
11:
Early Transvaginal Echocardiography
INTRODUCTION
HEART DEFECTS AND FETAL ECHOCARDIOGRAPHY
Transvaginal Echocardiography
Cardiac Morphogenesis
Early Fetal Echocardiography: 4-chamber and Outflow Tract View
4-chamber View
Outflow Tracts View
Early Diagnosis of Heart Defects
Limitations of Early Echocardiography
Benefits of Early Echocardiography
CONCLUSION
12:
Assessment of Fetal Central Nervous System
INTRODUCTION
TRANSVAGINAL APPROACH TO THE FETAL BRAIN
THREE-DIMENSIONAL (3D) TRANSVAGINAL SONOGRAPHY
HYDROCEPHALUS AND VENTRICULOMEGALY
TRANSVAGINAL ASSESSMENT OF CONGENITAL CNS ANOMALIES
Neurulation Disorders (Cranium Bifidum and Spina Bifida)
Cranium Bifidum
Spina Bifida
Disorders of Prosencephalic Development
Holoprosencephaly
Agenesis of the Corpus Callosum
Migration Disorder
Lissencephaly
Posterior Fossa Anomalies
Dandy-Walker Complex
Cerebellar Hypoplasia
Other Disorders
Arachnoid Cyst
Choroid Plexus Cyst
Acquired Brain Abnormalities in Utero
Intracranial Hemorrhage
Porencephaly
FUTURE ASPECTS
13:
Ultrasonographic Signs of Poor Pregnancy Outcome
INTRODUCTION
SPONTANEOUS INTERRUPTIONS OF THE DEVELOPMENT OF THE CONCEPTUS, FREQUENCY OF THE SPONTANEOUS ABORTION, CAUSES OF THE ABORTION (TABLE 19.1)
NORMAL DEVELOPMENT IN THE FIRST TRIMESTER OF PREGNANCY
SONOGRAPHIC FINDINGS TO DIAGNOSE AN INTERRUPTED PREGNANCY (TABLE 13.2)
POOR PROGNOSIS OF PREGNANCY: SONOGRAPHIC FINDINGS (TABLE 13.3)
Anomalies of the Gestational Sac
Anomalies of the Heart Frequency Interpreted in Function of the EG or CRL (Bradycardia or Relative Bradycardia)
Anomalies of the Yolk Sac (Size, Shape, Echogenicity)
Trophoblastic Thickness at the Embryonic Implantation Site
Intrauterine bleeding (Hematomas)
Small CRL for the Gestational Age
Pattern of Fetal Movements
Doppler Flow Alterations
Other Factors to Consider (Clinical Nature)
14:
Placenta Previa and Placenta Accreta
PLACENTA PREVIA
Definition
Incidence/Etiology
Clinical Findings
Ultrasound
Technique of Transvaginal Ultrasound
Concept of Placental Migration
When to Scan and What to Do
Management
PLACENTA ACCRETA
Definition
Incidence/Etiology
Clinical Findings
Ultrasound
Technique of Ultrasound
Management
ACKNOWLEDGMENT
15:
Assessment of Placental Vascularization by 3D Power Doppler Ultrasound “Placental Biopsy” in Normal Pregnancies
INTRODUCTION
3D POWER DOPPLER “PLACENTAL VASCULAR BIOPSY”
Validation of the “Placental Vascular Biopsy” Method
THREE-DIMENSIONAL DOPPLER INDICES DURING NORMAL GESTATION
PLACENTAL BIOPSY IN FETAL GROWTH
16:
Cervical Measurements and Preterm Labor
INTRODUCTION
TECHNIQUE
Transvaginal Sonography in Women with Symptoms of Preterm Labor
Sonography of the Cervix in High-Risk Asymptomatic Women
Sonography of the Cervix in Low-Risk Population
Sonography of the Cervix in Multiple Pregnancies
Sonography of the Cervix in Preterm Premature Rupture of Membranes
INTERVENTIONS FOR CERVICAL INCOMPETENCE BASED ON ULTRASONOGRAPHIC FINDINGS
CONCLUSION
17:
Transvaginal Assessment of the Cervix
INTRODUCTION
MEASUREMENT, ASSESSMENT AND THE PITFALLS
PREDICTION OF THE PRETERM DELIVERY BY TRANSVAGINAL MEASUREMENT OF THE CERVIX
THERAPEUTIC CERVICAL CERCLAGE FOR PREVENTION OF PRETERM DELIVERY
TRANSVAGINAL CERVICAL LENGTH MEASUREMENT IN PREDICTING SUCCESSFUL LABOR INDUCTION
18:
Transvaginal Sonography of the Fetal Brain in the Second and Third Trimesters
INTRODUCTION
SCANNING TECHNIQUE
NORMAL INTRACRANIAL ANATOMY
Coronal Sections
Anterior (or frontal) Coronal Sections
Medial Coronal Sections
Posterior Coronal Sections (or occipitals)
Sagittal and Parasagittal Scans
Medial Sagittal Scan
Parasagittal Scans
EVALUATION OF FETAL CEREBRAL CIRCULATION WITH COLOR DOPPLER
TRANSVAGINAL ULTRASONOGRAPHICAL EVALUATION OF MAIN CEREBRAL MALFORMATIONS
Ventriculomegaly
Holoprosencephaly
Occupying Space Lesions
CONCLUSION
19:
Transvaginal Sonography in Multiple Pregnancy
INTRODUCTION
TWO-DIMENSIONAL SONOGRAPHY IN DIAGNOSING MULTIPLE PREGNANCY
Most Common Pitfalls in Two-Dimensional Diagnosis
The Late Appearing Twin or “Undercounting”
Chorionicity and Amnionicity Determination during the Second Trimester
THREE-DIMENSIONAL SONOGRAPHY IN DIAGNOSING MULTIPLE PREGNANCY
3D Multiplanar Imaging
Elimination of Undercounting Phenomenon
Improved Prediction of Spontaneous Abortion
Prenatal Classification of Uterine Anomalies
Improved Detection Rate of Anomalies
Improved Determination of Placentation
3D Spatial Reconstruction
Volumetric Calculations
3D Angio Mode
FOUR-DIMENSIONAL SONOGRAPHY IN MULTIPLE PREGNANCY
CONCLUSION
SECTION 3: GYNECOLOGY AND INFERTILITY
20:
Uterine Lesions
INTRODUCTION
NORMAL UTERUS
ENDOMETRIAL POLYPS
INTRAUTERINE SYNECHIAE (ADHESIONS)
ADENOMYOSIS
ENDOMETRIAL HYPERPLASIA
ENDOMETRIAL CARCINOMA
LEIOMYOMA
LEIOMYOSARCOMA
CONCLUSION
21:
2D and 3D Power Doppler Ultrasound Study of Endometrium as Implantation Marker
INTRODUCTION
BIDIMENSIONAL ULTRASOUND AND DOPPLER OF THE ENDOMETRIUM
Endometrial Thickness
Endometrial Pattern
Doppler of the Endometrium
THREE-DIMENSIONAL ULTRASOUND AND POWER DOPPLER OF THE ENDOMETRIUM
Endometrial Volume
Three-dimensional Doppler Indices of Endometrial Perfusion
SUMMARY
22:
Asymptomatic Simple Ovarian Cyst in Postmenopausal Women: Syndrome of “Visible Ovary”
INTRODUCTION
NATURAL HISTORY OF THE POSTMENOPAUSAL OVARY
PATHOLOGY OF SIMPLE CYSTS
SONOGRAPHY
ROLE OF CA-125
MANAGEMENT
CONCLUSION
23:
Transvaginal Sonography in Evaluation of Functional Ovarian Cysts
INTRODUCTION
BARCELONA EXPERIENCE
ILUSTRATIVE EXAMPLES
SOME CONCLUSIONS FROM OUR EXPERIENCE
CONCLUSION
24:
Hormone Replacement Therapy: Ultrasound Role
INTRODUCTION
PHYSIOLOGY OF MENOPAUSE AND POSTMENOPAUSAL SYMPTOMS
HORMONE REPLACEMENT THERAPY (HRT)
Hormones in HRT Protocols
Effect of Route of Hormone Replacement Therapy
Effects of Various HRT Regimens
ULTRASOUND ROLE IN “PRETREATMENT ASSESSMENT”
Transabdominal Ultrasound
Transvaginal Ultrasound
PROGESTERONE CHALLENGE TEST AND ULTRASONOGRAPHY
COLOR DOPPLER ULTRASOUND
SONOHYSTEROGRAPHY
ROLE OF ULTRASOUND FOR “ON HRT ASSESSMENT”
EFFECT OF HRT ON MORPHOLOGY OF UTERUS AND OVARIES
Effect of HRT on Endometrial Thickness
ROLE OF ULTRASOUND IN SPECIAL CONDITIONS
Abnormal Vaginal Bleeding
Use of Tamoxifen
Breast Disease
Fibroid
Endometriosis
Uterine Vessels
INTERNAL CAROTID ARTERY AND CEREBROVASCULAR SYSTEM
Effect of HRT on Vascular Reactivity of Other Vessels
CONCLUSION
25:
Ectopic Pregnancy
INTRODUCTION
ROLE OF BIOCHEMICAL MARKERS IN ECTOPIC PREGNANCY
ROLE OF ULTRASOUND IN THE DIAGNOSIS OF ECTOPIC PREGNANCY
Transabdominal Ultrasound
Transvaginal Ultrasound
Color Doppler Facility
3D Ultrasound in the Assessment of Tubal Ectopic Pregnancy
OTHER SITES OF IMPLANTATION
Interstitial Pregnancy
Cervical Pregnancy
Ovarian Pregnancy
Intra-abdominal Pregnancy
THERAPY
CONCLUSION
26:
Female Pelvic Floor: Descriptive Anatomy and Clinical Exploration by Transvaginal Ultrasound Echography
INTRODUCTION
ECHOGRAPHY USE IN PELVIC DIAGNOSIS
Transabdominal Echography
Transperineal Echography
Transrectal Echography
Transvaginal Echography
Echography and Anatomy of the Pelvis Minor and the Pelvic Floor (correlation)
Ecoanatomy of the Rectal Channel
PATHOLOGIES OF THE POSTERIOR PELVIC REGION
Severe Hemorrhoid Syndrome
Anal Fistula
Perineal Abscess
Chronic Inflammatory Disease
PATHOLOGIES OF THE ANTERIOR PELVIC REGION
27:
Sonography of the Pelvic Infection
INTRODUCTION
Stage I: Acute Phase: Salpingitis
Stage II: Salpingitis with Pelviperitonitis
Stage III: Tubal, Ovarian, Tubo-ovarian, or Pelvic Abscess
ENDOMETRITIS
HYDROSALPINX
HYSTEROSALPINGOSONOGRAPHY
SONOGRAPHIC DRAINAGE AS A GUIDE TO PELVIC ABSCESS PERFORATION
28:
Sonohysterography
INTRODUCTION
INDICATIONS
Abnormal Uterine Bleeding
Tamoxifen-exposed Patients
Infertility
Recurrent Pregnancy Loss
TECHNIQUE
FINDINGS
Endometrial Polyps
Submucosal Leiomyoma
Tubal Patency
Hyperplasia and Cancer
COMPLICATIONS
COMMENTS
29:
Transvaginal Sonography in Postmenopausal Women
INTRODUCTION
NORMAL ENDOMETRIUM IN MENOPAUSE
POSTMENOPAUSAL BLEEDING
ENDOMETRIAL FLUID COLLECTIONS
MYOMETRIUM IN MENOPAUSE
NORMAL ATROPHIC OVARY
OVARY AND OVARIAN CANCER SCREENING
CONCLUSION
SECTION 4: DOPPLER SONOGRAPHY
30:
Physical Principles of the Doppler Effect and its Application in Medicine
INTRODUCTION
THE DOPPLER EFFECT
DOPPLER INDICES
INSTRUMENTATION FOR DOPPLER MEASUREMENTS
DATA ACQUISITION
SIGNAL PROCESSING
FLOW VS VELOCITY
TWO-DIMENSIONAL FLOW MEASUREMENT 2D COLOR DOPPLER DISPLAY
POWER DOPPLER ULTRASOUND
BASIC LIMITATIONS OF DOPPLER EXAMINATIONS
Accuracy
Precision
CONTRAST MEDIA
ARTIFACTS
Aliasing
How to Reduce Problems
ACKNOWLEDGEMENT
31:
Sonographic Imaging in Infertility
INTRODUCTION
UTERINE CAUSES OF INFERTILITY
Perfusion in Infertile Patients
Endometrial Thickness, Endometrial Volume and Vascularity
Congenital Anomalies
Endometrial Polyp
Submucous Leiomyomas
Adenomyosis
Endometritis
Asherman's Syndrome
OVARIAN CAUSES OF INFERTILITY
Polycystic Ovarian Syndrome
Luteinized Unruptured Follicle Syndrome
Luteal Phase Defect
TUBAL CAUSES OF INFERTILITY
CONCLUSION
32:
Chorionic Volume and Intervillous Blood Flow in Normal First Trimester Pregnancies Assessed by 3D Power Doppler Ultrasound
INTRODUCTION
CURRENT KNOWLEDGE ABOUT EARLY PLACENTAL CIRCULATION
Anatomical Data
Doppler Ultrasound Studies
Conflicting Data on Intervillous Circulation
INTERVILLOUS BLOOD FLOW AND CHORIONIC VOLUME DURING THE FIRST TRIMESTER NORMAL PREGNANCIES BY 3D PDA
Technical Aspects
Villous Vascular Tree
Chorionic Thickness and Volume
Intervillous Blood Flow
Intervillous Blood Flow and Chorionic Volume in Abnormal Early Pregnancies
SUMMARY
33:
Doppler Evaluation of the Ovary: Clinical Applications and Challenges
INTRODUCTION
TECHNIQUE OF DOPPLER STUDY
Ovarian Doppler
Angiogenesis in Benign Ovarian Tumors
Endometriosis
Pelvic Inflammatory Disease
Infertility
Angiogenesis in Borderline Tumors
Angiogenesis in Malignant Ovarian Masses
3D ULTRASOUND
FUTURE CHALLENGES
SECTION 5: 3D AND 4D TRANSVAGINAL SONOGRAPHY
34:
Three-Dimensional Sonoembryology
INTRODUCTION
3D ULTRASOUND FINDINGS FROM OVULATION TO IMPLANTATION
Uterus
Endometrium
Ovaries
EVENTS FOLLOWING IMPLANTATION
Maternal Portion
Doppler Findings
Uterine Artery Blood Flow in Nonpregnant and Pregnant Patients
Arcuate and Radial Arteries Blood Flow in Nonpregnant and Pregnant Patients
Normal Finding of Spiral Arteries in Pregnant Patients
Placenta
Development and the Ultrasound Imaging
3D Power Doppler Studies in Assessment of Early Chorionic Circulation
Fetal Portion
The 5th Week
The 6th Week
The 7th Week
The 8th Week
The 9th to 10th Weeks
The 11th Week
The 12th Week
Yolk Sac
3D ULTRASOUND IN MULTIPLE PREGNANCY
3D ULTRASOUND AS A TOOL FOR MEASUREMENT OF THE NUCHAL TRANSLUCENCY
3D ULTRASOUND IN EARLY DETECTION OF FETAL ANOMALIES
Anencephaly and Exencephaly (Acrania)
Encephalocele
Intracranial Malformations
Hydrocephaly
Holoprosencephaly
DYNAMIC REALTIME 3D ULTRASOUND (4D TECHNIQUE) AS A TOOL FOR ASSESSMENT OF FETAL BEHAVIOR IN EARLY PREGNANCY
35:
Cesarean Scar Hysterotomy: Assessment by 3D Transvaginal Echography
BACKGROUND
ECHOGRAPHY SURVEY OF HYSTEROTOMY-MADE SCARS
MATERIAL AND METHODS
RESULTS
CONCLUSION
36:
Assessment of Normal and Abnormal Ovaries by Transvaginal Sonography
INTRODUCTION
SONOGRAPHIC PARAMETERS
Origin and Size
Internal Architecture
Associated Lesions
SONOGRAPHIC DIFFERENTIAL DIAGNOSIS OF PELVIC MASSES
Cystic Masses
Physiologic Ovarian Cysts
Hydrosalpinx/Tubo-ovarian Complex or Abscess
Endometriosis
Paraovarian Cysts
Complex Masses
Ovarian Dermoid Cysts
Ovarian Tumors Originating from the Surface Epithelium
Solid Masses
Fibromas
EVALUATION OF AN OVARIAN MASS
Morphologic Assessment
Doppler Parameters
Persistent versus Regressing Masses
CONCLUSION
37:
Screening for Ovarian Cancer by Different Modes of Transvaginal Sonography
INTRODUCTION
DIFFICULTIES IN OVARIAN CANCER SCREENING
ATTEMPTS TO SCREEN—SOME LESSONS LEARNED
SCREENING TESTS
Serum Tumor Markers
Transvaginal Ultrasound
TARGET POPULATIONS
General Population
Age and Menopausal Status
High-Risk Population
Family History and/or Genetic Predisposition
OVARIAN CANCER SCREENING TRIALS
General Population
Ultrasound Screening
Multimodal Screening
High-Risk Population
OVARIAN CANCER: THE ROLE OF 3D ULTRASOUND AND 3D POWER DOPPLER IMAGING
What Does 3D Ultrasound Add?
Advantages of 3D Power Doppler Imaging
More Accurate Diagnosis of Ovarian Cancer
Detection of Stage I Disease
ZAGREB OVARIAN CANCER SCREENING TRIAL
Subjects and Methods
Illustrative Case
Aims
CONCLUSION
38:
4D Technical Aspects
INTRODUCTION
TECHNICALITIES
4D Imaging
Starting a 4D Mode
3D and 4D Rendering
Surface Rendering or Gray-scale Rendering
Transparent Mode
Minimum Mode
Maximum Mode
Volume Contrast Imaging (VCI)
Spatio-temporal Image Correlation (STIC), Fetal Cardio Mode
Removing Overlaying Structures
Advantages and Possibilities of 4D and 3D Imaging
Applications and Advantages of 4D Ultrasound
Data Review and Networking
CONCLUSION
39:
Fetal Upper Limb Movement in the First Half of Pregnancy Detected by Transvaginal 4D Ultrasound
INTRODUCTION
ULTRASOUND APPROACH TO FETAL MOVEMENT
NORMAL FETAL HAND AND FINGER POSITIONING AND MOVEMENT IN EARLY PREGNANCY BY 3D/4D TECHNOLOGY
ABNORMAL POSITIONING AND CONTRACTURE OF FETAL HAND/FINGERS
CONCLUSION
ACKNOWLEDGMENT
40:
Advanced Sonographic Assessment of Benign Endometrial Disease
INTRODUCTION
ENDOMETRIAL HYPERPLASIA
ENDOMETRIAL POLYPS
ENDOMETRIAL CHANGES IN TAMOXIFEN PATIENTS
CONCLUSION
INDEX
TOC
Index
×
Chapter Notes
Save
Clear