Routine Ultrasound Evaluation Research Articles

The role of ultrasound in screening subclinical psoriatic arthritis in patients with moderate to severe psoriasis.

To identify patients in the subclinical psoriatic arthritis (Sub-PsA) phase by ultrasound (US) and provide a solution to screen them. A total of 490 participants with moderate-to-severe psoriasis were evaluated. Among them, 384 participants without arthritis symptoms were enrolled into the silent psoriasis group and 106 participants with arthritis symptoms, called prodromal/active PsA phase, were enrolled into the clinical PsA group. Another 80 non-psoriasis participants were enrolled into the control group. Each participant received clinical assessments and US examinations of 60 joints, 38 tendons, and 40 entheses. We compared the incidences of synovio-enthesitis, synovitis, tenosynovitis, erosion, and dactylitis detected on US among the three groups. Subsequently, on the basis of significant US findings, we distinguished Sub-PsA from psoriasis alone (PsO) in the silent psoriasis group and analyzed the clinical characteristics, mainly including basic clinical characteristics, body surface area (BSA), and Psoriasis Area and Severity Index (PASI) score. Only synovio-enthesitis significantly differed between the control group and the silent psoriasis group (1.3% vs. 16.1%, p < 0.001). The knee was the most commonly involved site of synovio-enthesitis (79.0%). Taking synovio-enthesitis as the standard, 16.1% of silent psoriasis participants and 12.7% of all psoriasis participants were in the Sub-PsA phase. Furthermore, there were no differences in BSA and PASI among the three phases of PsO, Sub-PsA, and prodromal/active PsA. Since the psoriasis patients in Sub-PsA phase was as high as 12.7% in all patients with moderate-to-severe psoriasis, US-detected synovio-enthesitis was recommended routinely for screening them regardless of arthritis symptoms, especially in the lower limbs. • Synovio-enthesitis on ultrasound was significantly associated with subclinical psoriatic arthritis, especially in the lower limbs. • Routine ultrasound evaluation could help screen psoriasis patients in the subclinical psoriatic arthritis phase, which was as high as 12.7% in all psoriasis patients.

A Case of Umbilical Cord Prolapse With Intact Membranes Managed Successfully With Conservative Measures

Umbilical cord prolapse with ruptured membranes is an obstetric emergency with management consisting of delivery via emergent cesarean delivery. If the umbilical cord prolapses beyond the internal os with intact membranes, there is an opportunity to intervene and reduce the risk of fetal morbidity and mortality. A healthy 30-year-old, gravida 1 para 0 was incidentally found to have a short cervical length at 25 weeks five days on routine anatomy ultrasound evaluation. On evaluation via ultrasound by the maternal-fetal medicine service, the umbilical cord was noted to be prolapsing through the cervix with membranes intact. The cord prolapse with intact membranes resolved after placing the patient in the Trendelenburg position and nifedipine was administered for tocolysis given the uterus was noted to be contracting. For the remainder of the pregnancy, the patient underwent close follow-up and serial ultrasound scans with confirmation of the fetal head as the presenting part. The patient ultimately delivered vaginally at term. Cord prolapse with intact membranes, when identified via ultrasound, can be managed conservatively via Trendelenburg positioning and tocolysis to avoid premature cesarean delivery.

‘Routine intravascular ultrasound evaluation and change in stenting strategy in primary percutaneous intervention (RIST PCI)’

Background Intravascular ultrasound (IVUS) provides better assessment of vessel size, lesion length and plaque characteristics. There is paucity of data regarding the impact of IVUS on stenting pattern during primary percutaneous intervention (PCI) for ST elevation myocardial infarction (STEMI). Methods We included patients with STEMI undergoing IVUS-guided primary PCI. Diagnostic angiograms were analysed by two different operators who were not part of procedure. They were asked to formulate a treatment plan which included choice of stent diameters, length and number of stents based on angiographic assessment alone. The data were then compared with actual metrics derived from IVUS evaluation. Results Sixty-two patients were included. Left anterior descending artery was involved in 38/62(61.3%) cases. Mean stent diameters assessed by angiogram were 2.94 ± 0.4 mm and 3.01 ± 0.32 mm by cardiologist 1 and 2, respectively. IVUS-derived mean stent diameter was 3.5 ± 0.65 mm (p < 0.001). Mean stent length was 42.29 ± 19.29 mm by IVUS evaluation; while angiographically assessed values were 33.53 ± 11.53 (cardiologist 1) and 35.24 ± 12.97 mm (cardiologist 2) with a mean difference of 8.76 mm and 7.05 mm respectively (p < 0.001). Mean number of stents by IVUS evaluation was 1.42 ± 0.56, while by angiographic evaluation were 1.11 ± 0.37 and 1.13 ± 0.34 respectively (p < 0.001). Conclusions There was significant difference between IVUS derived and angiographically assessed culprit vessel metrics in patients undergoing primary PCI. Clinical outcomes of this discrepancy need further studies.

Efficacy and safety of radiofrequency ablation for calcified benign thyroid nodules: results of over 5\xa0years' follow-up

PurposeTo evaluate the efficacy and safety of radiofrequency ablation (RFA) for treating calcified benign thyroid nodules (CBTNs).MethodsFifty-two patients with 52 CBTNs who underwent RFA in our hospital were included in this retrospective study. According to the size of calcifications, CBTNs were divided into two groups: the punctate echogenic foci (PEF) group and macrocalcification group. Moreover, the macrocalcification group was further subdivided into two groups, the strong group and the weak group, based on their morphologic characteristics. After the RFA procedure, routine ultrasound (US) and clinical evaluation were performed at 1, 3, 6 and 12 months postoperatively and every 12 months thereafter.ResultsThe mean follow-up time was 68.98 ± 7.68 months (60–87 months), and the 5-year mean volume reduction rate (VRR) after RFA was 92.95%, with a complication rate of 0.6% (3/52). The mean initial volume of the macrocalcification group was significantly larger than that of the PEF group (9.94 ± 24.60 ml vs. 0.23 ± 0.22 ml, respectively; P = 0.011). Thus, their VRRs were not comparable between the two groups. However, baseline characteristics did not show statistically significant differences between the strong and weak macrocalcification subgroups. The VRRs of the strong subgroup were significantly lower than those of the weak subgroup at the 3-year, 4-year, and 5-year follow-ups.ConclusionRFA was effective and safe for treating CBTNs. Strong macrocalcification was related to the VRR of CBTNs after the RFA procedure.

Ultrasonographic prevalence and proposed morphologic classification of bilobed gallbladder in cats.

Morphologic anomalies of the feline gallbladder (GB) have been previously reported in the literature. These morphologic variants are frequently encountered on routine abdominal ultrasound examination. The aim of this study was to provide an ultrasonographic classification system of these variants and document the overall incidence in the feline population. A prospective, descriptive study was undertaken; cats that had an abdominal ultrasound examination that included at least one sagittal and transverse plane image of the GB were included. GB shape was evaluated and categorized based on a classification scheme of morphologic variants modified from the human literature. Septated (S), bilobed (B1, B2, B3), duplex (D) and complex (C) categories were described. Of 516 cats included in the study, 389 had normal GB morphology, while 127 had anomalous GB morphology. The overall incidence rate of anomalous GB morphology was 24.61%. When examined by morphologic type, the septated (S) morphology had an incidence of 9.69%. A bilobed (B) morphology was the most commonly observed classification; incidence was 14.35% within our population; incidence of B1, B2 and B3 subtypes were 2.91%, 6.98% and 4.46%, respectively. Duplex GBs only made up 0.39% of the total population. The incidence of complex (C) morphologies was 0.19%. The incidence of GB morphologic anomalies was higher in our population than previously reported. Identification of these anomalies on routine ultrasound evaluation is common; numerous different morphologies can be identified and a standardized classification scheme is proposed. Complete evaluation of morphology can be challenging, particularly with regard to cystic duct anatomy. Clinical significance is uncertain and future studies are warranted to determine the relationship between morphologic variants and hepatobiliary disease.

1136 The FAST exam in obstetrics: a feasibility study

The Focused Assessment with Sonography for Trauma (FAST) exam, is a point of care ultrasound evaluation used routinely in surgical and trauma evaluation of critically ill patients to assess intrabdominal free fluid. It is a cost effective, noninvasive approach with no radiation exposure, which allows for rapid decision making in surgical intervention. Although extensively evaluated in the trauma and critical care literature, this study has never been evaluated in an obstetric population. Our objective was to create an ultrasound training protocol and evaluate the feasibility of this study during pregnancy. This is a prospective, observational study completed in large academic center. Health care providers (sonographers and physicians) underwent an ultrasound training protocol involving a live webinar and on-site supervision to obtain the four standard FAST exam views (the right upper quadrant, left upper quadrant, subcostal cardiac, and pelvis). Patients were enrolled after their routine obstetric ultrasound evaluation and additional images for the FAST exam were completed. The images were then reviewed for quality by a blinded physician subspecialist in clinician performed ultrasound and critical care echocardiography. 64 ultrasound studies were completed each evaluating standard FAST exam views. 62/64 (96.8%) of exams had adequate visualization of all windows. Fisher exact test was completed and no significant differences in visualization across gestational age between early pregnancy (24 weeks) , or BMI were noted (P<0.05). The FAST exam is a feasible study among pregnant women, it is not affected by gestational age or BMI. Training of obstetric providers with a web-based ultrasound protocol and quality review of images demonstrates the ability of clinicians familiar with obstetric ultrasound the ability to complete the FAST exam successfully. This is a novel study, suggesting the FAST exam may serve as a useful clinical adjunct during assessment of critically ill obstetric patients.

Anencephaly associated with amniotic bands: A case report and review of the association

Introduction: Anencephaly is a relatively common fatal neuro-developmental disorder. Routine prenatal screening using ultrasound diagnoses the condition frequently and aid in managing the cases appropriately. Anencephaly is characterized by a severe developmental anomaly of the brain and a defective skull. Amniotic band syndrome is a condition associated with multiple congenital anomalies, which are often a consequence of fibrotic amniotic bands extending from the placenta to the fetus. It is a rare association but can be recognized by first trimester or late obstetric ultrasound. Amniotic band syndrome may be associated with anencephaly and often attributed as a causative factor. Apart from the amniotic band syndrome, many other conditions are associated with amniotic bands and the syndrome may be labeled erroneously if only the bands are taken into consideration.Case: A 27-year-old, G2P1 lady at 12 weeks and 2 days gestational age came for a routine ultrasound evaluation. The fetus was found to have a deformity of the head characteristic of anencephaly sequence. Multiple fibrotic bands were seen in the amniotic cavity extending from the placenta towards the fetus side, suspicious of amniotic band syndrome. The pregnancy was subsequently terminated on the patient’s request.Conclusion: The association of anencephaly and amniotic band syndrome is well known and the bands are often responsible for the spectrum of anencephalic anomalies. Asymmetric defects in the skull and brain are the norm in such cases along with multiple defects in the body parts. Both the anomalies are in general severe and may warrant early intervention. More benign amniotic bands like chorioamniotic separation may be encountered in pregnancy and should not be confused with more dangerous amniotic band syndrome. Recognition of amniotic bands is important, as many bands regardless of the etiology were found to be potentially harmful.

Isthmocele of lateral wall of uterus encountered at Suction evacuation- A maternal near-miss

A 29-year-old young third gravida with history of previous 2 caesarean sections who was referred as partial mole at 9 weeks of pregnancy was evaluated and diagnosed to have missed abortion. Clinically her general condition was good, uterus was 14 weeks size and she underwent suction evacuation. Torrential haemorrhage occurred after removal of some products of conception and a bag like structure was felt in the lower pole of uterus on passage of curette. Onsite USG evaluation suspected scar pregnancy and she underwent immediate laparotomy and bilateral internal iliac artery ligation because of haemorrhagic shock. At laparotomy left lateral wall mass of size 2x3 cm was found which was communicating to the uterus suggestive of Isthmocele. Excision and repair was carried out and she recovered well due to timely blood transfusion. This finding of isthmocele was missed on routine ultrasound evaluation prior to management plan mainly because of its location.

Portal hypertension evolving from sickled hepatopathy: Could hepatic venous Doppler ultrasound be beneficial in its evaluation?

PurposeSickle cell intrahepatic cholestasis involves sickling within hepatic sinusoids leading to vascular stasis and localized hypoxia resulting in ballooning of the hepatocytes causing a direct back pressure effect with resultant intracanalicular cholestasis. Vascular stasis may ultimately lead to portal hypertension. We proposed to document findings suggestive of portal hypertension evolving from hepatopathy in steady-state sickle cell disease (SCD) patients using hepatic venous Doppler ultrasound. MethodsThis is a prospective case series of 6 SCD subjects in steady-state (median age, 30 years; range, 19–43), comprising of 3 males and 3 females, who underwent a routine Doppler ultrasound evaluation of their hepatic veins and were discovered to have an abnormal biphasic waveform pattern. Venous blood was obtained from all subjects to evaluate for P-selectin, homocysteine, foetal haemoglobin, haematocrit levels, white cell and platelet counts. Doppler ultrasound was also carried out on all subjects to evaluate for the hepatic waveform, right renal artery RI and PI along with the hepatic artery velocities. ResultsAll the 6 subjects had reduced haematocrit (median value of 21.5%; range, 18–25%) and some degree of renal dysfunction (plasma cystatin-C ranged from 1.6 to 12.2 mg/L). Elevated white cell count, hyperhomocysteinemia, reduced SpO2(<94.0%) and reduced estimated GFR (eGFR < 90 ml/min) was also noted in 4 subjects (66.7%). Similarly, 4 subjects (66.7%) had elevated RI in the right kidneys while 3 subjects (50.0%) had elevated PI in the right kidney. ConclusionDoppler ultrasound Hepatic vein waveform analysis may be a useful examination in the evaluation of patients with SCD as it may elicit feature of portal hypertension. Further studies are suggested to confirm this in a larger population of SCD patients using the gold standard.

Ultrasound guided fine-needle aspiration biopsy of metastases in nonpalpable supraclavicular lymph nodes in lung cancer patients

&#x0D; &#x0D; &#x0D; Background and objectives: To assess frequency and signifi- cance of enlarged nonpalpable supraclavicular lymph nodes with routine ultrasound (US) evaluation and US-guided fine- needle aspiration biopsy (FNAB) for the diagnosis and staging of patients with lung cancer.&#x0D; Materials and methods: 106 consecutive patients with lung cancer and nonpalpable supraclavicular lymph nodes were evaluated with cervical US for the presence of pathological lymph nodes. FNAB was performed in patients with nodes with short-axis &gt; 5 mm, rounded shape and missing echogenic hilum.&#x0D; Results: 27 (25.5%) patients had enlarged supraclavicular lymph nodes on US. Fourteen patients (13.2%) had cytologically proven lymph node involvement. Supraclavicular lymph node metastasis was more frequent in patients with medi- astinal invasion (p = 0.0001) and patients with enlarged lymph nodes on upper paratracheal stations on thorax CT (p = 0.0001). No relation was found between supraclavicular lymph node involvement and T stage (p = 0.27), distant metastasis (p = 0.50) or histological type (p = 0.80). Three patients were upstaged from IIIA to IIIB status. US-guided FNAB was the only diagnostic method in 2 patients.&#x0D; Conclusion: US-guided FNAB is a simple and safe procedure which can document N3 stage of disease in lung cancer patients. Thereby more invasive and expensive diagnostic procedures can be avoided in selected lung cancer patients.&#x0D; &#x0D; &#x0D;

OP02.10: Sequential axial approach for the routine ultrasound evaluation of the fetal basic anatomy at 11–13 weeks: toward a methodological standardisation

OP02.10: Sequential axial approach for the routine ultrasound evaluation of the fetal basic anatomy at 11–13 weeks: toward a methodological standardisation

Ultrasound evaluation of cervical length in the second trimester of pregnancy: The impact of cesarean section and ethnicity

Background and Objective: The sonographic assessment of cervical length (CL) is an important part of ultrasound evaluation in the second trimester of pregnancy. There are specific maternal characteristics and obstetric history which affect the CL. This study aims to assess the influence of mode of delivery and ethnicity on the CL in women with divergent ethnicity. Materials and Methods: A prospective cross-sectional study was designed, including 109 pregnant Sudanese women in the second trimester. They were investigated with transvaginal ultrasonography (TVS) using high-frequency 7.5-MHz probe to assess the CL. The participants were categorized according to their ethnicity and regions. The results were analyzed using analysis of variance (ANOVA) and Student's independent t-test in the SPSS program version 16 (IBM Inc.) and P > 0.05 considered to be statistically significant. Results: The mean TVS CL was 38.2 mm in the second trimester of pregnancy. The CL of northern Sudanese women was significantly longer than women from western, southern and eastern Sudan (P = 0.041). The mean CL of previous cesarean-sectioned women was 37.7 mm which was statistically significantly shorter than those who delivered normally (P = 0.03). The CL was not significantly different in multiparous compared to nulliparous women (37.83 vs. 37.78 mm, P= 0.77). Maternal age and gestational age did not significantly change the CL in second and third trimesters, P= 0.69 and 0.99, respectively. Conclusions: In the light of this study, cesarean section and ethnicity were considered to be significant factors that affect the CL in the second trimester of pregnancy. We suggest transvaginal sonographic measurement of CL as a part of a routine ultrasound evaluation in the second trimester.

In Utero Evidence of Impaired Somatic Growth in Hypoplastic Left Heart Syndrome.

We hypothesized that fetuses with hypoplastic left heart syndrome (HLHS) have impaired growth compared to expected growth for gestational age. This is a retrospective cohort study including singleton fetuses with isolated HLHS identified from a single, referral center's ultrasound database. To account for variable timing of ultrasounds, z-scores for gestational age were assigned for each biometric parameter. We identified 169 fetuses, of which 96 had more than one ultrasound. The median number of ultrasound evaluations per fetus was 2 (range 1-5). The mean gestational age at time of last ultrasound was 33.7±4.3weeks with a range of 20.4-39.6weeks. While fetal growth restriction (11%) and microcephaly (3%) were relatively rare, mean z-scores at the time of last ultrasound for estimated fetal weight (mean difference z-score -0.20, p=0.04) and head circumference (-0.28, p=0.02) were lower than at the time of the initial ultrasound. Impaired somatic growth, defined as a decrement in z-score of 0.5 or more over time, was common (32%). There is a deceleration in somatic and head growth in fetuses with hypoplastic left heart syndrome that can be identified by routine ultrasound evaluation.

Body-stalk anomaly. A case report and review of the literature

Body-stalk anomaly is a severe and lethal anomaly, characterized by an anatomic defect in the ventral abdominal wall and exit of the viscera of the abdominal cavity, associating spine and limb deformities and absence or shortening of the umbilical cord. The prenatal diagnosis is suggested by ultrasound means and should be confirmed by histopathology evaluation. We present a case of a body-stalk anomaly incidentally diagnosed at 23 weeks of gestation, during routine ultrasound evaluation. Due to its fatal prognosis it is imperative to differentiate it from other abdominal wall defects.

Amniotic Band Syndrome, Perinatal Hospice, and Palliative Care versus Active Management.

Introduction. Amniotic band syndrome and sequence are a relatively rare condition in which congenital anomalies occur as a result of the adherence and entrapment of fetal parts with coarse fibrous bands of the amniotic membrane. A large percentage of reported cases have an atypical gestational history. The frequency of this obstetric complication is not affected by fetal gender, genetic abnormality, or prenatal infection. Case. A 21-year-old, G1P0 female parturient at 18 weeks and 5 days with a single intrauterine gestation during a routine ultrasound evaluation was noted to have amniotic band sequence. The pregnancy was subsequently complicated by preterm premature rupture of membranes with oligohydramnios, resulting in a surviving neonate scheduled for rehabilitative treatment. Conclusion. Amniotic band syndrome is an uncommon congenital anomaly resulting in multiple disfiguring and disabling manifestations. Several theories are proposed with most involving early rupture of the amnion and entanglement of fetal parts by amniotic bands. This syndrome can be manifested by development of multiple malformations, with the majority of the defects being limb abnormalities of a disorganized nature, as in the case we present. In the absence of a clear etiology of consequential congenital abnormalities, obstetric management guidelines should use shared decision models to focus on the quality of life for the offspring.

Correlación de la velocidad media de la arteria uterina con la edad gestacional como indicador de perfusión vascular uterina

Objetivo: Determinar la correlación de la velocidad media de la arteria uterina con la edad gestacional como indicador de perfusión vascular uterina. Diseño: Estudio transversal, analítico. Institución: Hospital III Honorio Delgado de Arequipa, Perú. Participantes: Gestantes entre 14 a 41 semanas de gestación, que acudieron al hospital para evaluación ecográfica de rutina sin evidencia de patología. Métodos: A gestantes entre 14 a 41 semanas de gestación que acudieron al hospital para evaluación ecográfica de rutina sin evidencia de patología, entre julio 2013 y abril 2014, se realizó ecografía Doppler de las arterias uterinas y se correlacionó la velocidad media (MnV) promedio de ambas arterias con la edad gestacional determinada por ecografía del primer trimestre. Se buscó la correlación de la MnV promedio en el segundo (14 a 28 semanas) y tercer (29 a 41 semanas) trimestres de gestación y se determinó el percentil 5 para dicha velocidad. Principales medidas de resultados: Cálculo de la MnV promedio de ambas arterias uterinas y correlación con la edad gestacional. Resultados: Se evaluó 138 gestantes con una edad materna promedio de 26,4 años y se encontró un coeficiente de correlación de la MnV promedio con la edad gestacional de r = 0,556 (r2 = 0,31). En el segundo y tercer trimestre de gestación el coeficiente de correlación fue r = 0,634 (r2 = 0,40) y r = 0,32 (r2 = 0,001), respectivamente. El percentil 5 de la MnV promedio en el tercer trimestre fue 67,50 cm/s. Conclusiones: Existió correlación de la MnV con la edad gestacional, cuyos valores menores al percentil 5 según la edad gestacional podrían ser utilizados como indicadores de hipoperfusión vascular uterina en gestantes del segundo y tercer trimestre.

Imaging of non-traumatic abdominal emergencies in adults

Non-traumatic abdominal pathology is one of the most common reasons for consultation in emergency care services. Abdominal pain is the presenting symptom for many diseases, which often requires urgent care. Clinical history and physical examination are rarely sufficient to establish a definite diagnosis and imaging is usually necessary. The choice of imaging modality is oriented by the clinical context and guided by the institutional capabilities, safety and cost-effectiveness of the available tests. Plain radiographs have little or no place in the evaluation of the acute abdomen. Magnetic resonance imaging (MRI) still has limited availability in many hospitals, thus narrowing the imaging choice to ultrasound (US) and computerized tomography (CT). No scientific evidence exists to allow the imposition of one single strategy. At the present time, the clinician may choose either routine US evaluation complemented by CT in case the US is inconclusive or first-line CT (except for the evaluation of right lower quadrant [RLQ] pain, right upper quadrant [RUQ] pain and in pregnant women where ultrasound is the first-line study).

Correlación de la biometría fetal estándar y la biometría secundaria con la edad gestacional en gestantes del segundo y tercer trimestre

Objetivo: Determinar la correlación de la biometría fetal estándar y la biometría secundaria con la edad gestacional en gestantes del segundo y tercer trimestre. Diseño: Estudio transversal analítico. Institución: Hospital III Honorio Delgado de Arequipa, Perú. Participantes: Gestantes del segundo y tercer trimestre de gestación que acudieron para evaluación ecográfica de rutina sin evidencia de patología, desde enero hasta mayo de 2014. Métodos: Se consideró como biometría fetal estándar a la medición del diámetro biparietal (DBP), circunferencia cefálica (CC), longitud del fémur (LF) y circunferencia abdominal (CA); y biometría fetal secundaria a la medición del diámetro cerebeloso transverso (DCT), longitud renal (LR) y longitud del pie (LP). Principales medidas de resultados: Cálculo de regresión y correlación de la biometría fetal estándar y secundaria con la edad gestacional. Resultados: Se evaluó 140 gestantes del segundo y tercer trimestre de gestación con una edad materna promedio de 26,14 años y se encontró que todos los parámetros biométricos tuvieron buena correlación con la EG. Sin embargo, la mejor correlación con la EG fue la de la LF (r2 = 0,943) seguido por la LP (r2 = 0,940) y la más baja correlación fue de la LR (r2 = 0,860). En el tercer trimestre, las correlaciones fueron más bajas que en el segundo trimestre, siendo la más alta correlación de la LF (r2 = 0,756), seguida de la LP (r2 = 0,713); la más baja correlación fue de la LR (r2 = 0,395). Conclusiones: En nuestra población existió buena correlación de la biometría fetal estándar y secundaria con la edad gestacional, siendo la correlación de la longitud del fémur y la longitud del pie las mejores en el segundo y tercer trimestre de gestación; la longitud renal tuvo correlación pobre en el tercer trimestre.

Sonography of placental abnormalities: a pictorial review.

Often overlooked during routine ultrasound evaluation of a normal pregnancy, the placenta forms the biologic interface between the mother and fetus and is critical to fetal growth and development. Malformations in development, positioning, and vascularity can have profound implications for both maternal and fetal well-being. As such, a judicious inspection of the placenta is warranted as an integral part of every screening or emergent prenatal ultrasound. Herein, we present a pictorial review of a variety of placental pathologic conditions including abnormalities in positioning, adherence, vascularity, and hemorrhage as well as potential peri-placental masses and gestational trophoblastic disease, all of which are readily encountered in a busy emergency radiology practice.

2083969 Utility of 3 Dimensional Ultrasound in tthe Evaluation of Palpable Abdominal Wall Masses

2083969 Utility of 3 Dimensional Ultrasound in tthe Evaluation of Palpable Abdominal Wall Masses