Surgicel MRI 2
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Surgicel is a bioabsorbable topical haemostatic agent used to control bleeding in surgical procedures. How to differentiate its signal from Haemoglobin degradation products? Note: There was an interpretative mistake first time uploaded: Blood signal was misinterpreted. I upload the correction. Sorry!.
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Presentation 3 uterine artery doppler .pdf
Uterine artery Doppler is used to check blood flow between the mother and baby. It measures blood flow in the uterine artery, a branch of the internal iliac artery that supplies blood to the uterus. Uterine artery Doppler is performed transvaginally or transabdominally by obtaining a midline view of the uterus and identifying color flow in the uterine artery where it crosses the external iliac artery. Peak systolic velocity, pulsatility index, and resistance index of the uterine artery are measured on both sides and averaged. Abnormal uterine artery Doppler values after 20-24 weeks gestation can indicate increased impedance to blood flow and predict conditions like preeclampsia.
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This Journal Club presentation provides a summary and discussion of the following free access articles published in UOG:
Prenatal diagnosis and outcome of fetal posterior fossa fluid collections
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Doppler ultrasound is used in obstetrics to evaluate fetal growth and well-being. It assesses blood flow in the umbilical artery (placental circulation), middle cerebral artery (fetal circulation), and uterine arteries (maternal circulation). Abnormal Doppler readings include increased resistance and absent/reversed end diastolic flow in the umbilical artery, which indicate placental insufficiency and fetal growth restriction. The middle cerebral artery Doppler shows the brain-sparing effect in hypoxic fetuses. Together, Doppler ultrasound provides important information about the fetus's condition and helps time delivery.
Жирэмсний эрт үеийн хүндрэлийн хэт авиан оношилгоо.pptx
Ultrasound in early pregnancy is used to assess:
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2. Abnormalities including ectopic pregnancies, molar pregnancies, and hemorrhages.
3. Dating the pregnancy accurately in the first trimester by measuring the mean sac diameter or crown-rump length.
4. Detecting multiple pregnancies and diagnosing chorionicity and zygosity.
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1. Changes seen in the fetal circulation in IUGR, including increased placental resistance seen on umbilical artery Doppler leading to absent or reversed end diastolic flow in severe cases.
2. Brain sparing effect seen on middle cerebral artery Doppler in IUGR fetuses, shown as increased diastolic flow.
3. Changes in the ductus venosus Doppler waveform seen in IUGR, from decreased forward flow to eventual reversal, indicating worsening fetal hypoxia and myocardial dysfunction.
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Ultrasound is essential for evaluating pelvic pain and vaginal bleeding in women of childbearing age. It can identify many potential causes of these presentations including pregnancy location, ectopic pregnancies, retained products of conception, and complications of pregnancy. Transvaginal ultrasound in particular provides high resolution imaging of the pelvis and adnexal structures to accurately diagnose conditions. Doppler ultrasound further aids evaluation by identifying blood flow patterns.
Placental grading
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Doppler interpretation in pregnancy
This document discusses the interpretation of various types of Doppler ultrasound during pregnancy. It describes:
1. Umbilical artery Doppler which can detect placental hypoxia and increased resistance, predicting abnormal outcomes. Abnormal readings include increased resistance index and absent/reversed end diastolic flow.
2. Middle cerebral artery Doppler which can detect fetal anemia by increased blood flow to the brain. It is also used to time delivery of growth restricted infants.
3. Ductus venosus Doppler which has moderate predictive value for growth restriction in preterm infants.
4. Uterine artery Doppler has limited use in predicting fetal growth restriction but can identify maternal causes by abnormal readings.
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This document discusses umbilical and uterine artery Doppler ultrasound. It notes that umbilical artery Doppler is useful for predicting abnormal fetal outcomes, with a resistance index above 0.72 outside normal limits after 26 weeks. Absent or reversed end diastolic flow in the umbilical artery indicates fetal distress and need for monitoring or delivery. Uterine artery Doppler has limited use in predicting fetal growth restriction but can suggest maternal versus fetal causes. An abnormal uterine Doppler with decreased diastolic flow or persistence of a diastolic notch after 24 weeks can help predict preeclampsia. Fortnightly umbilical artery Doppler scans are recommended when growth is not maintained or abdominal circumference is below the third percentile.
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Thyroid disorders in pregnancy
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2. Hypothyroidism and hyperthyroidism can cause complications for both mother and fetus if not treated properly. Levothyroxine is the treatment of choice for hypothyroidism. Antithyroid drugs are used to treat hyperthyroidism.
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Fetal MRI provides detailed anatomical imaging of the fetus that can help diagnose abnormalities when ultrasound is limited. It uses specialized pulse sequences and protocols to minimize risk to the mother and fetus from magnetic fields and acoustic noise. Fetal motion is a key challenge but can be reduced through maternal positioning, sedation, and fast sequences. MRI is considered safe in all trimesters if used at normal operating modes. It is useful for evaluating the central nervous system, lungs/chest, tumors, and complications in twin pregnancies. While it has limitations like reduced image quality early in pregnancy, fetal MRI can change diagnoses and reveal additional findings compared to ultrasound.
Doppler in obstetric power point presentation (4)
Doppler ultrasound is used in obstetrics to evaluate fetal growth and well-being. It assesses blood flow in the umbilical artery (placental circulation), middle cerebral artery (fetal circulation), and uterine arteries (maternal circulation). Abnormal Doppler readings include increased resistance and absent/reversed end diastolic flow in the umbilical artery, which indicate placental insufficiency and fetal growth restriction. The middle cerebral artery Doppler shows the brain-sparing effect in hypoxic fetuses. Together, Doppler ultrasound provides important information about the fetus's condition and helps time delivery.
Жирэмсний эрт үеийн хүндрэлийн хэт авиан оношилгоо.pptx
Ultrasound in early pregnancy is used to assess:
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2. Abnormalities including ectopic pregnancies, molar pregnancies, and hemorrhages.
3. Dating the pregnancy accurately in the first trimester by measuring the mean sac diameter or crown-rump length.
4. Detecting multiple pregnancies and diagnosing chorionicity and zygosity.
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1. This document presents 34 ultrasound images demonstrating various fetal anomalies, including anencephaly, spina bifida, myelomeningocele, Dandy-Walker malformation, agenesis of the corpus callosum, holoprosencephaly, hydrocephalus, porencephaly, cyclopia, cleft lip, cystic hygroma, gastroschisis, omphalocele, body stalk anomaly, congenital diaphragmatic hernia, esophageal atresia, duodenal atresia, small bowel atresia, meconium peritonitis, ovarian cyst, renal agenesis, multicystic dysplastic kidney, ureteropelvic
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This document discusses several autoimmune and endocrine conditions that can affect pregnancy, including their presentation, diagnosis, and management. It covers thyroid disease, rheumatoid arthritis, immune thrombocytopenic purpura, myasthenia gravis, and systemic lupus erythematosus. For each condition, it describes associated risks for the mother and fetus, as well as recommendations for treatment and monitoring during pregnancy and delivery. The goal is to maintain maternal and fetal health while minimizing medication exposure for the baby.
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This document discusses pathological jaundice in newborn infants. It defines pathological jaundice as a total serum bilirubin level that exceeds certain thresholds in the first few days of life and requires treatment. Specifically, levels above 5mg/dl on day 1, 10mg/dl on day 2, or 15mg/dl thereafter are considered pathological in term infants. The document also outlines guidelines from the American Academy of Pediatrics for managing jaundice in term and near-term infants through phototherapy or exchange transfusion if bilirubin levels rise too high. It notes special considerations for managing jaundice in preterm babies as well.
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This document discusses color Doppler ultrasound in the evaluation of intrauterine growth restriction (IUGR). It provides details on:
1. Changes seen in the fetal circulation in IUGR, including increased placental resistance seen on umbilical artery Doppler leading to absent or reversed end diastolic flow in severe cases.
2. Brain sparing effect seen on middle cerebral artery Doppler in IUGR fetuses, shown as increased diastolic flow.
3. Changes in the ductus venosus Doppler waveform seen in IUGR, from decreased forward flow to eventual reversal, indicating worsening fetal hypoxia and myocardial dysfunction.
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Ultrasound is essential for evaluating pelvic pain and vaginal bleeding in women of childbearing age. It can identify many potential causes of these presentations including pregnancy location, ectopic pregnancies, retained products of conception, and complications of pregnancy. Transvaginal ultrasound in particular provides high resolution imaging of the pelvis and adnexal structures to accurately diagnose conditions. Doppler ultrasound further aids evaluation by identifying blood flow patterns.
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This document discusses the interpretation of various types of Doppler ultrasound during pregnancy. It describes:
1. Umbilical artery Doppler which can detect placental hypoxia and increased resistance, predicting abnormal outcomes. Abnormal readings include increased resistance index and absent/reversed end diastolic flow.
2. Middle cerebral artery Doppler which can detect fetal anemia by increased blood flow to the brain. It is also used to time delivery of growth restricted infants.
3. Ductus venosus Doppler which has moderate predictive value for growth restriction in preterm infants.
4. Uterine artery Doppler has limited use in predicting fetal growth restriction but can identify maternal causes by abnormal readings.
Twin-twin transfusion syndrome
Twin-twin transfusion syndrome (TTTS) is diagnosed prenatally by ultrasound when there is a monochorionic diamniotic (MCDA) pregnancy and oligohydramnios in one sac and polyhydramnios in the other. It is staged according to amniotic fluid differences and Doppler findings. TTTS complicates around 8-10% of MCDA twins and has a variable presentation, with more advanced stages having poor natural outcomes. The underlying pathophysiology involves vascular anastomoses within the shared placenta allowing uneven blood flow between twins.
Umblical & uterine artery Doppler
This document discusses umbilical and uterine artery Doppler ultrasound. It notes that umbilical artery Doppler is useful for predicting abnormal fetal outcomes, with a resistance index above 0.72 outside normal limits after 26 weeks. Absent or reversed end diastolic flow in the umbilical artery indicates fetal distress and need for monitoring or delivery. Uterine artery Doppler has limited use in predicting fetal growth restriction but can suggest maternal versus fetal causes. An abnormal uterine Doppler with decreased diastolic flow or persistence of a diastolic notch after 24 weeks can help predict preeclampsia. Fortnightly umbilical artery Doppler scans are recommended when growth is not maintained or abdominal circumference is below the third percentile.
USG AND DOPPLER IN DIAGNOSIS AND MANAGEMENT OF IUGR
This document discusses the use of ultrasound and Doppler in the diagnosis and management of intrauterine growth restriction (IUGR). It defines small for gestational age (SGA) as a fetus below the 10th percentile and describes how Doppler of the umbilical artery can help identify fetuses with IUGR, monitor disease progression, and predict outcomes. Doppler of other fetal vessels like the middle cerebral artery and ductus venosus can further evaluate the fetus and help guide management decisions. Together, Doppler studies provide both diagnostic and prognostic information useful in the care of growth restricted fetuses.
Thyroid disorders in pregnancy
1. Thyroid disorders are common in pregnancy, affecting 1-2% of pregnant women. Optimal management is important for pregnancy outcomes.
2. Hypothyroidism and hyperthyroidism can cause complications for both mother and fetus if not treated properly. Levothyroxine is the treatment of choice for hypothyroidism. Antithyroid drugs are used to treat hyperthyroidism.
3. Factors like hCG and estrogen increase thyroid function in pregnancy, requiring adjustments to diagnosis and treatment of thyroid disorders compared to non-pregnant individuals. Monitoring of thyroid levels is important during and after pregnancy.
Asymptomatic palpable adnexal masses: ultrasound evaluation- warda
This simple lecture was designed as a part of the content of the basic ultrasound workshop held periodically by the department of Obstetrics & gynecology - Faculty of medicine - Mansoura university- Egypt as a part of continuous medical education program.
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Alzheimer's disease causes brain atrophy that can be seen on imaging tests. It initially affects the hippocampus and entorhinal cortex, then spreads to the posterior cingulum, medial temporal lobe, and insular cortex. Over time, atrophy progresses to the prefrontal and orbitofrontal cortices bilaterally in a symmetric and diffuse pattern.
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I have decided to use this MRI protocol to study patients with clinical suspicion of Mild Cognitive Impairment & Dementia.
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Axial T2 GE is used to discover small blood foci secondary to amyloid angiopathy.
DTI is used for VOIs on previously determined strategic areas to try to diagnose the type of dementia by image findings.
Voxel-Based Morphometry in Alzheimer's Disease 1
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There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
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Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
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1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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- 1. MRI of Oxidized Cellulose (Surgicel) 2 44 y.o. patient with multicentric high grade right fronto-parietal glioma. MRI 1.5 days after surgery TSE T1 GE T2 FLAIR TSE T2TSE DP TSE T1 Post GD Initial Presurgical MRI 3D T1 SPACE postGd Intracellular MetHB Surgicel Edema Subdural Higroma Hyperacute Subdural Hematoma Surgicel is a bioabsorbable topical haemostatic agent used to control bleeding in surgical procedures. How to differentiate its signal from Haemoglobin degradation products?