Practical Guide to 3D–4D Ultrasound in Obstetrics and Gynecology Chaitanya Nagori, Sonal Panchal
INDEX
Page numbers followed by f refer to figure and t refer to table.
A
Abdomen 110
Abdominal wall defects 83, 111
Achondroplasia 85f
Acquired uterus volume, analysis of 149
Acrania 82f
Adenomyoma, local 167
Adenomyosis 164, 166f
diagnosis of 165
three-dimensional power Doppler image of 168f
Adnexa 175
Adnexal lesions 177
malignant 175
volume ultrasound in 175
Adnexal mass 177f
American Fertility Society classification 152f
Anencephalic fetuses 123
Antral follicles 191f
count 190
follicle growth for 69f
multiple 189f
number of 189
Aortic valve 5f
Arm movement, isolated 121, 128
Arteries
focal narrowing of 169
sacculation of 169
Assisted reproductive techniques 188
Automated volume calculation 62, 177
sonography-based 186, 203
B
Bilateral hydrosalpinx, surface-rendered image of 177f
Bird's nest appearance 180f
Bladder 76
Brain 120
development 120, 120t
vesicles 41f
Brainstem 128
C
Cebocephaly 105
Central nervous system 100, 105
evaluation of 105
Cerebellar
vermian hypoplasias 101
vermis 103, 103f
Cerebral
palsy 133
vasculature 78f, 104f
ventricles, early development of 80f
Cervical
fibroid 171f
lesions 170
lips 150f, 172f
malignancy 153, 172f, 173f
Cervix 147, 158
three-dimensional ultrasound-acquired volume of 171f, 172f
tomographic ultrasound imaging of 173f
Cesarean section 137
Chest 107
Chocolate cysts 178
Chorionic origin, tumors of 153
Chromopertubation 196
Cleft lip 81f, 94, 94f, 95f
diagnosis of 94
Cleft palate 81f, 95f
diagnosis of 94
Clubfoot 112f
Complete septum 156f
Computed tomography scan 3, 50
Conjoined twins 74, 117, 117f
Contracted endometrial cavity 162
Cord
abnormalities 112
hypercoiling of 113f
round neck, two loops of 114f
vessels, normal 112
Corpus callosum 29f, 103f
agenesis of 101
normal 103
three-dimensional ultrasound surface-rendered image of 5f
Corpus luteum 180f
Cranial abnormalities 81, 99
Cranial bones 82
Cranial sutures 101f, 132
Craniofacial variability index 104
Crown-rump length 76
Cyst 179
avascular myometrial 162
wall thickness 180
Cystadenomas 179, 180
Cystic adenomatoid malformation 108
Cystic degeneration 168f
Cystic hygroma 105
Cystic lesion
B-mode ultrasound image of 178f
hydrosalpinx 178f
D
Dandy-Walker syndrome 101, 103f
Dermoids 179
three-dimensional ultrasound image of 182f
Diabetes mellitus, gestational 133
Dichorionic diamniotic twins 88f
Disrupted endometrial-myometrial junction 162
Duodenal atresia 110f
inversion mode 110f
E
Ear
abnormalities 97
normal position of 98f
Ectopic pregnancy 87, 177f
Encephalocele 82
Endometrial carcinoma, higher-grade 164
Endometrial cavity 151f, 157f, 158f, 160f, 161f, 162, 167f
coronal image of 152f
three-dimensional ultrasound surface-rendered image of 161f
Endometrial fibroid 161f, 169f
Endometrial lesions 147, 158
Endometrial malignancy 163, 164f
Endometrial polyp 27f, 159, 161f
Endometrial receptivity 188
assessment 185
Endometrial synechiae 159
Endometrial vascularity 194f
Endometrial volume 194
Endometrioma 178
three-dimensional power Doppler volume of 180f
Endometrium 30f, 37f, 152f, 153, 162, 194f
central line of 149f
echogenic
flecks in 162
inner layer of 162
pretrigger evaluation of 192
three-dimensional power Doppler-acquired volume of 195f
European Society of Gynecology Endoscopy Classification of Müllerian Abnormalities 153, 154f
European Society of Human Reproduction and Embryology 153, 154f
Eye blinking 130f
isolated 124, 132
Eyelid and mouth movement 131f
F
Facial
abnormalities 92
alteration 132
anomalies 77
cleft 97f
diagnosis of 94
expression 124, 126
structures
development of 124
dysfunction of 124
dysmorphology of 124
Fetal abdomen
coronal sections of 22f
transverse sections of 22f
Fetal anomalies
detection of 77
four-dimensional ultrasound for 91
Fetal behaviour
abnormalities of 129
patterns, developmental sequence of 126, 128t
Fetal brain
development, four-dimensional ultrasound for functional assessment of 120
functional development of 120
three-dimensional ultrasound-acquired volume of 102f
Fetal cerebral vessels, three-dimensional ultrasound-acquired image of 42f
Fetal cranium, three-dimensional ultrasound-acquired volume of 18f
Fetal distress 137
Fetal echocardiography 87
four-dimensional ultrasound for 113
three-dimensional ultrasound for 113
Fetal evaluation 74
Fetal face 92f94f, 99f
HD-live rendered image of 97f
maximum mode of 99f
midsagittal view of 98f
three-dimensional ultrasound surface-rendered image of 94f
Fetal foot, surface-rendered image of 111f
Fetal growth restriction 133
Fetal hand, surface-rendered image of 111f
Fetal head 4f, 98f, 114f116, 138
axial plane of 28f
midsagittal
plane of 5f, 104f
section of 30f
multiplanar sections of 78f
progress of 138f
three axial planes of 30f
three-dimensional
ultrasound image of 4f, 7f, 82f, 101, 101f
volume of 27f
tomographic ultrasound imaging of 81f, 102f
Fetal heart 203
inversion mode rendering of 117f
spatiotemporal imaging correlation-acquired volume of 7f, 25f, 26
Fetal lips
B-mode ultrasound of 94f
mouthing movement of 100f
Fetal lower limbs, three-dimensional ultrasound-rendered image of 6f
Fetal motor and behavioral pattern, study of 104
Fetal profile 93f
Fetal skeleton 39f
Fetal spine
sagittal section of 31f
three-dimensional ultrasound-acquired volume of 17f
Fetal structural abnormalities 74
Fetal thorax
multiplanar images of 109f
three-dimensional ultrasound image of 41f
Fetal trunk
vasculature 110f
tomographic ultrasound imaging of 81f
Fetal upper limbs, fixed extension deformity of 85f
Fetus
anterior aspect of 36f
closing of eyes of 100f
coronal plane of 32f, 36f
delivery of 137
detection of congenital defects in 92
expressions of 127f
irregular head shape of 82f
longitudinal scan of 18f
opening of eyes of 100f
posterior aspect of 36f
sagittal plane of 35f
three-dimensional ultrasound of 39f, 77f, 84f
acquired volume of 19f, 21f, 35f, 36f
rendered image of 4f
transverse plane of 35f
Fever, maternal 133
Fibroid 87f, 164, 166, 167, 167f
subendometrial 166f
submucosal 166
three-dimensional HD flow image of 168f
Fingers
movement 132
isolated 129f
overriding of 112f
First-trimester pregnancy 128t
three-dimensional images of 75f
Fistula, tracheoesophageal 108
Flipped face technique 94
Flow index 59, 60f, 190f
Follicle
color coding of 8f
multiple 64f
pretrigger evaluation of 192
surface-rendered volume of 192f
three-dimensional power Doppler volume of 192f, 193f
volume calculation 192f
Follicular maturity, assessment of 188, 192
Follicular monitoring 188
Fontanelle, anterior 101f
Four-dimensional cardiac evaluation 6
Four-dimensional ultrasound 6
applications of 74
invention of 73, 91
limitations of 117
role of 124
Frontomaxillary facial angle 98f
G
Gastroschisis 111
three-dimensional ultrasound of 84f
Genetic scan 84
Gestational sac 46f47f, 89f
three-dimensional ultrasound-acquired image of 8f
volume 8f, 76f
calculation of 69f
Glass body mode 42
Grimacing 99, 124
fetus 100f
H
Hand
and head movements 124
and legs, vermicular movement of 121f
movement, isolated 129f, 132
to-eye movement 124, 125f
to-face movement 124, 125f
to-head direction 124
Head
anteflexion 121, 124, 128
isolated 132
anterior angulation of 137
circumference 132
engagement, quantification of 141
progression 141
measurement of 141f
retroflexion 121, 124, 128
rotation 121, 124, 128, 137
transorbital plane of 11f
Heart 5f, 116f
inversion mode rendering of 116f
Hemiuterus 157, 158f
Hemorrhage
antepartum 133
postpartum 137
Hernia, diaphragmatic 108
Holoprosencephaly 83f
Human brain development 129
Hydronephrosis 110, 110f
Hydrosalpinx 178f, 179f
three-dimensional ultrasound surface-rendered image of 178f
Hydroureter 110
Hyperechogenic contrast medium 196
Hyperinsulinemia 185
Hypertelorism 92
Hypertension, pregnancy-induced 111
Hypospadias 111
Hypotelorism 92
Hysterocontrast sonosalpingography 196
Hysterosalpingocontrast sonography 197f, 198f
Hysterosalpingogram 196
I
Infertility 145
Inflammation, chronic 160
Interstitial pregnancy 89f
Intramural fundal fibroid 167f
Intrauterine contraceptive device 164, 165f
Intrauterine gestational sac 75f, 87f
J
Joint contractures, multiple 85f
K
Kidneys 76
Kurjak antenatal neurodevelopmental test 130
parameters of 132t
L
Labor, second stage of 138f
Lasmar score 166
Leg movement, isolated 121, 128, 132
Leiomyosarcoma 153
three-dimensional HD flow image of 169f
Limb abnormalities 84, 111
Lips, coronal plane of 97f
Lower limb, multiple joint abnormalities of 106f
Lumbar spine
large open spinal canal defect of 107f
Lung, sequestration of 108
M
Magnetic resonance imaging 3, 50, 164
Malignant lesions
three-dimensional power Doppler images of 183f
Mandibulomaxillary facial angle 98f
Micrognathia 93f, 96
Microphthalmia 92
Micropolyposis 162
Migration 120
Miscarriage 185
Monochorionic monoamniotic twins 88f
Morphologic scoring system 180
Motor abnormalities 74
Motor functions, development of 121
Mouth opening 132
Müllerian duct 156
abnormalities 86, 147, 151, 153, 155
incidence of 153
Myometrial invasion 164
Myometrial lesions 147, 164
Myometrium 37f, 164f, 166f, 169f, 170f
N
Nasal bone 74, 99f
Neck abnormalities 105
Neurogenesis 120
Neurological movement, quality of 129
Neurological thumb 105f
Normal uterus 153
three-dimensional ultrasound image of 155f
Nuchal edema
three-dimensional ultrasound image of 86f
Nuchal translucency 74, 86f
O
Omphalocele 84f, 111
three-dimensional ultrasound-rendered image of 84f
Opening mouth 131f
Orbital abnormalities 98
Organs, abdominal 76
Otocephaly, 105
Ovarian androgenic dysfunction 187
Ovarian follicular monitoring 185
Ovarian hyperstimulation syndrome 185
Ovarian lesions 178
benign 175
malignant 175
Ovarian reserve and response, assessment of 188
Ovarian volume 176
Ovary 175, 180
B-mode ultrasound image of 50f
calculate stromal volume of 188f
multiplanar image of 53f
sclerocystic 186
three-dimensional
power Doppler-acquired volume of 189f191f
ultrasound-acquired volume of 186f, 187f
P
Pelvis, transverse section of 139f
Perifollicular vessels 43f
Phocomelia 85f
Placenta 111
Placental origin, tumors of 153
Polycystic ovary syndrome 185, 191f
Polydactyly 85f, 112f
Polyhydramnios 133
Polyp 160f
Positive predictive value 180
Posterior cranial fossa length 104
Postoperative weak uterine scar 171f
Pregnancy 86
multiple 86
Progression, angle of 139, 141
Pseudocapsule 168
Pubic bone 138, 139f
Pylorus 110f
R
Radial aplasia 112f
Rhombencephalon 79f
Rokitansky protuberance 180
S
Saline infusion
salpingography, three-dimensional power Doppler acquisition of 196f
sonohysterography 161f
Second stage labor, process of 137
Segmental uterine artery perfusion 194
Septate uterus 87f, 151f, 153
Skull bones 99
Small occipital meningocele 101f
Smiling 99
fetus 100f
Sono-automated volume calculation 74
follicle 8
general 70
Sonoembryology 74
Sonohysterography technique 158
Spinal abnormalities 105
Spinal column ridges 79f
Spine
coronal image of 17f
transverse image of 17f
Spinothalamic tract 122
STEPW classification 168f
Stomach 76, 110f
Stromal abundance 186
Stromal echogenicity 187, 188
Stromal flow 189
Subendometrial indices 195
Sucking reflex 128f
Swallowing 99, 124
Symphysis pubis 138f
Synaptogenesis 120
T
Tactile sensation 128f
Thoracic anatomy, spatial relation of 109f
Thoracopagus conjoined twins 117f
Thorax, multiplanar image of 109f
Threatened preterm birth 133
Three-dimensional color Doppler 180f
Three-dimensional sonography 20, 50, 73, 84, 91, 177, 185
Three-dimensional ultrasound 3, 10, 88f
advanced softwares in 3
applications of 74
basic 1, 3
invention of 73, 91
limitations of 117
Three-dimensional volume 34
acquisition of 10
analysis of 10
Thyroid goiter 105
Tomographic ultrasound imaging 3, 5f, 20, 22f25f, 28f, 74, 91, 96f, 116f, 147, 151, 175, 176f, 203
Tongue
expulsion 99, 124
protrusion 126f
Total ovarian
echogenicity 188
stromal area 189
volume 189
Transcaudate plane 101
Transcerebellar plane 101
Transfrontal plane 101, 101f
Transthalamic plane 101
Transvaginal scan 147f
Transvaginal volume probe 148f
Treacher Collins syndrome 105
Trisomy 18 105
Trisomy 21 100
Tubal lesions 175
Tubal patency assessment 185, 196
Tubal pathology 196
Tubal twin pregnancy 89f
Tuberculosis, endometrial 162f
Tubo-ovarian mass 179f
Tulip sign 111
Tumors, endometrioid 179
Twin gestation, three-dimensional ultrasound-acquired volume of 40f
Two-dimensional ultrasound 120
U
Ultrasound 3, 153
advantages of 141
B-mode 50f, 137, 163f, 178f
Umbilical cord 48f
three-dimensional power Doppler-acquired 43f
Upper limb, multiple joint abnormalities of 106f
Urinary bladder 110f
Uterine abnormalities 152f
volume ultrasound for 147
Uterine cavity 197
Uterine scar 170
Uterine wall thickness 155f
Uterus 15f, 46f48f
abnormalities of 86
acquire volume of 147
adenomyotic 166f
advantages of three-dimensional ultrasound for imaging of 172
aplasia 158
aplastic 158
bicornuate 158f
bicorporeal 155
septate 157f
B-mode and surface-rendered coronal plane image of 171f
complete bicorporeal 157f
coronal
image of 158f
plane of 169f
dysmorphic 153, 155f
hypoplastic 155f
incomplete 13f
infantilis 153
normal 153
partial bicorporeal 157f
rendering volume of 165f
sagittal plane of 149f, 151f
septate 87f, 151f, 153
serosa, irregular margin of 10f
subseptate 154
three-dimensional ultrasound 37f
tacquired image of 13f
transverse section of 31f
T-shaped 153, 155f
two-dimensional ultrasound of 148f, 175f
Z rotation of 150
V
Vaginal delivery, spontaneous 142
Vascular architecture, malignant 173f
Vascularity flow index 60f, 61, 153, 189, 190f
Vascularity index 59, 60f, 153, 189, 190f
Veins, sacculation of 169
Velocities, internal shift of 169
Ventricular septal defect 87, 117
Ventriculomegaly 103
Vermicular movement 121
Virtual organ computer-aided analysis 50, 74, 109f, 153, 176, 185, 186f, 193f, 195f
three-dimensional ultrasound acquired 188f
Vocal calculated volume 56f, 57f, 60f
Volume computer-aided
diagnosis 6, 20, 23, 26, 116f
display, sonography-based 137, 203
Volume contrast imaging 20, 26, 28f, 29f, 86f, 91, 147, 151, 166f, 175, 203
Volume ultrasound, clinical applications of 71, 145
Y
Yawning 99, 124, 131f, 132
fetus 99f
Yolk sac 77f
×
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Practical Guide to 3D–4D Ultrasound in Obstetrics and Gynecology
Practical Guide to 3D–4D Ultrasound in Obstetrics and Gynecology
Sonal Panchal MD Ultrasound Consultant Dr Nagori's Institute for Infertility and IVF Ahmedabad, Gujarat, India Chaitanya Nagori MD DGO Director Dr Nagori's Institute for Infertility and IVF Ahmedabad, Gujarat, India
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Practical Guide to 3D–4D Ultrasound in Obstetrics and Gynecology
First Edition: 2021
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My Patients
and
My Students
Preface
During our twenty years of experience in doing 3D–4D ultrasound, we have realized that 3D–4D is a concept and only thorough understanding of this concept can produce excellent 3D or 4D images. Unfortunately in spite of acquiring the technology, most of the operators do not understand this concept and so cannot make the best out of their investment on money, time, and technology. We felt that there is a huge need to spread the knowledge of this concept and the technique and possible applications of 3D–4D ultrasound. Taking trainings for small batches and one-time learning, we felt was not sufficient. Therefore we thought to create a complete ready-reckoner for 3D–4D ultrasound. In this book, we have concentrated on its applications in obstetrics, gynecology, and infertility. This is our humble effort to present to you a highly simplified version of this truly complex technology.
Sonal Panchal
Chaitanya Nagori
Acknowledgments
We are extremely thankful to Shri Jitendar P Vij (Group Chairman) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for being very encouraging and supportive to help us bring out this book which we think can be a very useful one for all who want to do 3D–4D ultrasound. We are also thankful to Mr Ankit Vij (Managing Director), Mr MS Mani (Group President), Ms Chetna Malhotra Vohra (Associate Director—Content Strategy), Ms Pooja Bhandari (Production Head), and Ms Kritika Dua (Senior Development Editor) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, for giving the go-ahead at the very beginning and helping us in every way possible to bring out this book.