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Color Doppler, 3D & 4D Ultrasound in Gynecology, Infertility & Obstetrics
Sanja Kupesic Plavsic
CHAPTER 1:
Physical Principles of the Doppler Effect and Its Application in Medicine
INTRODUCTION
THE DOPPLER EFFECT1
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
Acknowledgment
CHAPTER 2:
Normal Pelvic Anatomy Assessed by 2D, 3D and Color Doppler Ultrasound
INTRODUCTION
UTERUS
Adult
Phases of Menstrual Cycle
Postmenopausal State
Cervix
Uterine Perfusion
Uterus in Newborn and Prepuberty
VAGINA
FALLOPIAN TUBE
OVARIES
Adolescence and Adulthood
Ovarian Circulation Presented by Color Doppler
Newborn
Childhood
Perimenopausal and Postmenopausal State
CONCLUSION
CHAPTER 3:
Color Doppler and 3D Ultrasound of the Uterine Lesions
INTRODUCTION
NORMAL UTERUS
ENDOMETRIAL POLYPS
INTRAUTERINE SYNECHIAE (ADHESIONS)
ADENOMYOSIS
ENDOMETRIAL HYPERPLASIA
ENDOMETRIAL CARCINOMA
LEIOMYOMA
LEIOMYOSARCOMA
CONCLUSION
CHAPTER 4:
Adnexal Masses
INTRODUCTION
THE MAIN BASIS OF ANGIOGENESIS
TUMOR NEOVASCULARIZATION—CURRENT CONCEPTS
EVOLUTION OF 2D CONVENTIONAL AND COLOR DOPPLER ULTRASOUND IN IMAGING OF ADNEXAL TUMOR ANGIOGENESIS
THREE-DIMENSIONAL ULTRASOUND AND POWER DOPPLER IMAGING OF BENIGN AND MALIGNANT ADNEXAL MASSES
FURTHER POSSIBILITIES IN THE EVALUATION OF TUMOR ANGIOGENESIS
ZAGREB EXPERIENCE
FUTURE CHALLENGES
CONCLUSION
CHAPTER 5:
Ovarian Cancer Screening by 3D and 3D Power Doppler Ultrasound
WHY TO SCREEN FOR OVARIAN CANCER?
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 Visualization of Ovarian Tumor Neovascularization
Detection of Stage I Disease
ZAGREB OVARIAN CANCER SCREENING TRIAL
Subjects and Methods
Illustrative Case No. 1—More Accurate Diagnosis of Ovarian Cancer
Illustrative Case No. 2—The Detection of Stage I Disease
Illustrative Case No. 3—The Detection of Stage I Disease
Illustrative Case No. 4—The Detection of Stage III Disease
Aims
CONCLUSION
CHAPTER 6:
Ovarian Endometriosis
INTRODUCTION
SYMPTOMS
ENDOMETRIOSIS IN INFERTILE PATIENTS
ULTRASOUND DIAGNOSIS
COMBINED STUDIES BY DOPPLER ULTRASOUND AND CA-125 VALUES
OVARIAN ENDOMETRIOMA ASSESSED BY 3D ULTRASOUND
CONCLUSION
CHAPTER 7:
Pelvic Inflammatory Disease
TRANSVAGINAL ULTRASOUND AND COLOR DOPPLER ASSESSMENT OF PID
TUBO-OVARIAN ABSCESS
CHRONIC PID
THREE-DIMENSIONAL ULTRASOUND
CONCLUSION
CHAPTER 8:
Endoscopic Surgery in Gynecology
INTRODUCTION
LAPAROSCOPY
LAPAROSCOPY OF ADNEXAL LESIONS
Ovarian Cysts and Solid Tumors
Ectopic Pregnancy
Sterilization
Salpingo-ovariolysis and Neosalpingostomy
Endometriosis
Polycystic Ovaries (PCO)
Conclusion
LAPAROSCOPIC MYOMECTOMY
LAPAROSCOPIC HYSTERECTOMY
LAPAROSCOPY IN GYNECOLOGIC ONCOLOGY
Endometrial Carcinoma
Cervical Carcinoma
Ovarian Carcinoma
HYSTEROSCOPY
DIAGNOSTIC HYSTEROSCOPY
OPERATIVE HYSTEROSCOPY
Hysteroscopic Myomectomy and Polypectomy
Hysteroscopic Adhesiolysis
Hysteroscopic Endometrial Ablation
Congenital Uterine Anomalies
CHAPTER 9:
Color Doppler and Three-Dimensional Ultrasound Imaging in Infertility
UTERINE CAUSES OF INFERTILITY
Uterine Perfusion in Infertile Patients
Endometrial Thickness, Endometrial Volume and Vascularity
Congenital Anomalies
Endometrial Polyps
Submucosal 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
CHAPTER 10:
Color Doppler and 3D Power Doppler Hystero-Contrast-Salpingography
HISTORICAL DEVELOPMENT OF THE ULTRASONIC ASSESSMENT OF THE FALLOPIAN TUBE
ULTRASOUND CONTRAST AGENTS
TECHNIQUE OF HYSTERO-CONTRAST-SALPINGOGRAPHY
Requirements
Procedure
GRAY-SCALE HYSTERO-CONTRAST-SALPINGOGRAPHY
PULSED DOPPLER ANALYSIS OF TUBAL PATENCY
COLOR DOPPLER HYSTERO-CONTRAST-SALPINGOGRAPHY
REVIEW OF LITERATURE
THREE-DIMENSIONAL HYSTERO-contrast-SALPINGOGRAPHY
CONCLUSION
CHAPTER 11:
Color Doppler and 3D US Imaging in Normal and Abnormal Early Pregnancy
ULTRASOUND STUDIES OF THE UTERUS FROM OVULATION TO IMPLANTATION
Ultrasound Findings
Ovaries
UTERINE FINDINGS FOLLOWING IMPLANTATION
Maternal Portion
Doppler Findings
Uterine Artery Blood Flow in Nonpregnant and Pregnant Patients
Arcuate and Radial Arteries
Spiral Arteries
PLACENTA
2D Ultrasound Features of the Placenta
Doppler Studies of Intervillous Circulation
UMBILICAL AND FETAL PORTION
The 5th Week
Embryologic Findings
2D Ultrasound Findings
3D Ultrasound Findings
Transvaginal Color Doppler Findings
3D Power Doppler Findings
The 6th Week
Embryologic Findings
2D Ultrasound Findings
3D Ultrasound Findings
Transvaginal Color Doppler Findings
3D Power Doppler Findings
The 7th Week
Embryologic Findings
2D Ultrasound Findings
3D Ultrasound Findings
Transvaginal Color Doppler Findings
3D Power Doppler Findings
The 8th Week
Embryological Findings
2D Ultrasound Findings
3D Ultrasound Findings
Transvaginal Color Doppler Findings
3D Power Doppler Findings
The 9th and 10th Weeks
Embryologic Findings
2D Ultrasound Findings
3D Ultrasound Findings
Transvaginal Color Doppler Findings
3D Power Doppler Findings
The 11th Week
Embryologic Findings
2D Ultrasound Findings
3D Ultrasound Findings
Transvaginal Color Doppler Findings
The 12th Week
Embryological Findings
2D Ultrasound Findings
3D Ultrasound Findings
Transvaginal Color Doppler Findings
3D Power Doppler Findings
First Trimester Screening for Chromosomal Anomalies
Yolk Sac
3D ULTRASOUND MEASUREMENT OF NUCHAL TRANSLUCENCY
DOPPLER ASSESSMENT OF DUCTUS VENOSUS
FIRST TRIMESTER SCREENING FOR CHROMOSOMOPATHIES: NASAL BONE AND FETAL HEART
Nasal Bone
Fetal Heart Assessment
PATHOLOGY OF EARLY PREGNANCY
Threatened Abortion
Intrauterine Hematoma
Missed Abortion
Blighted Ovum
CONCLUSION
CHAPTER 12:
Ectopic Pregnancy
THE ROLE OF BIOCHEMICAL MARKERS IN ECTOPIC PREGNANCY
THE ROLE OF ULTRASOUND IN THE DIAGNOSIS OF TUBAL ECTOPIC PREGNANCY
Transabdominal Ultrasound
Transvaginal Ultrasound
Cul-de-sac Findings
COLOR DOPPLER IN EARLY DIAGNOSIS OF TUBAL ECTOPIC PREGNANCY
3D ULTRASOUND IN THE ASSESSMENT OF TUBAL ECTOPIC PREGNANCY
OTHER SITES OF IMPLANTATION
Cornual/Interstitial Pregnancy
Cervical Pregnancy
Ovarian Pregnancy
Abdominal Pregnancy
THERAPY
CONCLUSION
CHAPTER 13:
The Assessment of Normal Fetal Anatomy
INTRODUCTION
TECHNOLOGICAL IMPROVEMENTS IN PRENATAL DIAGNOSIS
Three-dimensional Multiplanar Imaging
Three-dimensional Spatial Reconstruction
Spatiotemporal Image Correlation Mode (STIC)
Three-dimensional Angio Mode
Volumetric Calculations
VISUALIZATION OF NORMAL FETAL ANATOMY
Fetal Head and Face
Fetal Thorax and Abdomen
Spine and Extremities
VOLUMETRY—ORGAN VOLUME MEASUREMENTS
CONCLUSION
CHAPTER 14:
The Assessment of Abnormal Fetal Anatomy
INTRODUCTION
HEAD AND NECK
FETAL SPINE
HEART
ABDOMEN
SKELETON AND EXTREMITIES
ROLE OF COLOR AND POWER DOPPLER ULTRASOUND
CONCLUSION
CHAPTER 15:
First Trimester Ultrasonographic Screening and Prenatal Diagnostic Methods
FIRST TRIMESTER ULTRASONOGRAPHIC SCREENING
Nuchal Translucency
Nasal Bone
Facial Angle
Ductus Venosus Flow
Tricuspid Flow
Intracranial Translucency
PRENATAL DIAGNOSTIC METHODS
Introduction
Chorionic Villus Sampling
Amniocentesis
Early Amniocentesis
Fetal Blood and Tissue Sampling
Fetal Blood Sampling
Fetal Tissue Sampling
4D US AND PRENATAL DIAGNOSTIC METHODS
4D B-flow Sonography with Spatiotemporal Image Correlation (4D BF-STIC)
4D US in Fetal Invasive Procedures
CHAPTER 16:
Genetic Approach to Fetal Abnormalities
INTRODUCTION
History
Systematic Approach to Fetal Abnormalities
MORPHOLOGICAL CHARACTERIZATION OF ABNORMALITIES
Single and Multiple Abnormalities
Major and Minor Abnormalities
RECOGNITION OF THE PATTERN OF MULTIPLE ABNORMALITIES
Sequence
Syndrome
Association
Polytopic Field Defect
ESTABLISHMENT OF DIAGNOSIS
Choice of a Diagnostic Method
Noninvasive Prenatal Diagnosis
Invasive Prenatal Diagnosis
Analysis of the Type of Congenital Abnormalities
Malformation
Deformation
Disruption
Dysplasia
Determination of Developmental Period When the Abnormality Occurred
Literature and Databases
ASSESSMENT OF PROGNOSIS AND RECURRENT RISK
CHAPTER 17:
Four-Dimensional Sonography in Perinatal Medicine
INTRODUCTION
FETAL MOTILITY AND 4D ULTRASOUND
CLASSIFICATION OF MOVEMENT PATTERNS
ONSET OF SPECIFIC FETAL BEHAVIORAL PATTERNS ASSESSED BY 3D/4D
The First Trimester
The Second Trimester
The Third Trimester
New scoring system for fetal neurobehavior assessed by 3D and 4D sonography
MULTICENTRIC STUDY
DISCUSSION
CONCLUSION
CHAPTER 18:
Gestational Trophoblastic Disease
HYDATIDIFORM MOLE
INVASIVE MOLE
CHORIOCARCINOMA
PLACENTAL SITE TROPHOBLASTIC TUMOR
ZAGREB EXPERIENCE
THREE-DIMENSIONAL POWER DOPPLER (3D PD)
CONCLUSION
CHAPTER 19:
Clinical Sonographic Pearls
INTRODUCTION
PELVIC ULTRASOUND PEARLS
Obstetric Ultrasound Pearls
UTERUS
Uterine Measurements
Uterine Contours
Uterine Orientation
Myometrium Assessment
Endometrial Assessment
Apply Color and/or Power Doppler Ultrasound
Perform Pulsed Doppler Analysis
Adnexa/Ovaries
TUBES
CUL-DE-SAC
WRITING AN ULTRASOUND REPORT
REFERENCES
BIBLIOGRAPHY
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BIBLIOGRAPHY
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BIBLIOGRAPHY
BIBLIOGRAPHY
BIBLIOGRAPHY
CHAPTER 20:
Obstetric Ultrasound Pearls
NUCHAL TRANSLUCENCY MEASUREMENT (11 TO 13 WEEKS AND 6 DAYS)
WRITING AN OBSTETRIC ULTRASOUND REPORT
INDEX
TOC
Index
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