1. The goals of first trimester ultrasound include visualization of the gestational sac, identification of embryonic demise, determination of gestational age, and early diagnosis of fetal anomalies.
2. A normal intrauterine gestation will demonstrate a gestational sac, yolk sac, embryo, amnion, and cardiac activity on ultrasound. Measurement of the mean sac diameter, crown-rump length, and biometric measurements can be used to estimate gestational age.
3. Absence of cardiac activity along with signs of bleeding have a high probability of embryonic demise. Criteria such as large sac size without visualizing fetal structures indicate a poor pregnancy outcome.
This document provides guidelines for performing mid-trimester fetal ultrasound scans from the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG). It discusses the purpose of the scans, who should perform them, necessary equipment, what should be included in reports, safety considerations, assessing fetal well-being and biometry, examining fetal anatomy, and evaluating the cervix, uterus and adnexa. The guidelines emphasize providing accurate information to optimize care, while minimizing risk, and include a sample reporting form.
Breast imaging techniques have advanced significantly since the 1950s. Mammography was introduced in the 1960s and digital mammography in the 2000s improved image quality and reduced radiation exposure. Tomosynthesis was developed in the 2010s to reduce tissue superimposition by creating 1mm slices. Ultrasound is used as an adjunct to mammography to differentiate cysts from solid masses and guide biopsies. The BI-RADS classification system standardizes how breast imaging findings are reported and communicated. While mammography remains the primary breast cancer screening tool, tomosynthesis and ultrasound have improved cancer detection rates by reducing false negatives, especially for women with dense breasts.
Presentation1.pptx, ultrasound examination of the 2nd & 3rd trimester pregnancy.Abdellah Nazeer
This document provides guidance on performing an ultrasound examination of the fetus in the second and third trimesters of pregnancy. It details the standard views and measurements that should be obtained, including images of the head, heart, abdomen, limbs and other structures. Potential abnormalities are also listed for each structure. Fetal echocardiography is important for detecting congenital cardiac defects, which occur in 2-6.5% of live births and can have serious consequences if not identified prenatally.
Sonoelastography, also known as ultrasound elastography, is a non-invasive medical imaging technique that maps the stiffness or elasticity of tissues. It uses ultrasound to capture how tissue deforms under an applied force. There are various elastography techniques including compression elastography, acoustic radiation force imaging (ARFI), and shear wave elastography. Shear wave elastography utilizes focused ultrasound beams to generate shear waves in tissue and can provide a quantitative measure of tissue stiffness in kilopascals. Elastography can help differentiate between benign and malignant lesions and may help reduce unnecessary breast biopsies.
In this presentation we will discuss role of high resolution in characterizing normal variant and pathologies of spinal pathologies.
This is a pictoral review.
This document discusses various soft markers that can be detected on ultrasound during the second trimester to screen for fetal aneuploidies like Down syndrome. It describes markers like thickened nuchal fold, mild ventriculomegaly, echogenic bowel, mild pyelectasis, single umbilical artery, echogenic intracardiac focus, choroid plexus cysts, and enlarged cisterna magna. For each marker, it discusses the association with aneuploidy and provides recommendations from medical organizations on evaluation and need for further testing.
Doppler ultrasound uses sound waves to evaluate blood flow and was first used in 1977 to study umbilical artery flow. It measures the Doppler shift in echoes from moving blood cells to determine flow velocity. Fetal vessels commonly assessed include the umbilical artery, which provides information on placental perfusion, and the middle cerebral artery, which indicates fetal oxygenation status. Doppler ultrasound can detect signs of fetal hypoxia like increased end-diastolic flow in the MCA, and meta-analyses found it reduces perinatal deaths and inductions when used for monitoring high-risk pregnancies.
This document provides guidelines for performing mid-trimester fetal ultrasound scans from the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG). It discusses the purpose of the scans, who should perform them, necessary equipment, what should be included in reports, safety considerations, assessing fetal well-being and biometry, examining fetal anatomy, and evaluating the cervix, uterus and adnexa. The guidelines emphasize providing accurate information to optimize care, while minimizing risk, and include a sample reporting form.
Breast imaging techniques have advanced significantly since the 1950s. Mammography was introduced in the 1960s and digital mammography in the 2000s improved image quality and reduced radiation exposure. Tomosynthesis was developed in the 2010s to reduce tissue superimposition by creating 1mm slices. Ultrasound is used as an adjunct to mammography to differentiate cysts from solid masses and guide biopsies. The BI-RADS classification system standardizes how breast imaging findings are reported and communicated. While mammography remains the primary breast cancer screening tool, tomosynthesis and ultrasound have improved cancer detection rates by reducing false negatives, especially for women with dense breasts.
Presentation1.pptx, ultrasound examination of the 2nd & 3rd trimester pregnancy.Abdellah Nazeer
This document provides guidance on performing an ultrasound examination of the fetus in the second and third trimesters of pregnancy. It details the standard views and measurements that should be obtained, including images of the head, heart, abdomen, limbs and other structures. Potential abnormalities are also listed for each structure. Fetal echocardiography is important for detecting congenital cardiac defects, which occur in 2-6.5% of live births and can have serious consequences if not identified prenatally.
Sonoelastography, also known as ultrasound elastography, is a non-invasive medical imaging technique that maps the stiffness or elasticity of tissues. It uses ultrasound to capture how tissue deforms under an applied force. There are various elastography techniques including compression elastography, acoustic radiation force imaging (ARFI), and shear wave elastography. Shear wave elastography utilizes focused ultrasound beams to generate shear waves in tissue and can provide a quantitative measure of tissue stiffness in kilopascals. Elastography can help differentiate between benign and malignant lesions and may help reduce unnecessary breast biopsies.
In this presentation we will discuss role of high resolution in characterizing normal variant and pathologies of spinal pathologies.
This is a pictoral review.
This document discusses various soft markers that can be detected on ultrasound during the second trimester to screen for fetal aneuploidies like Down syndrome. It describes markers like thickened nuchal fold, mild ventriculomegaly, echogenic bowel, mild pyelectasis, single umbilical artery, echogenic intracardiac focus, choroid plexus cysts, and enlarged cisterna magna. For each marker, it discusses the association with aneuploidy and provides recommendations from medical organizations on evaluation and need for further testing.
Doppler ultrasound uses sound waves to evaluate blood flow and was first used in 1977 to study umbilical artery flow. It measures the Doppler shift in echoes from moving blood cells to determine flow velocity. Fetal vessels commonly assessed include the umbilical artery, which provides information on placental perfusion, and the middle cerebral artery, which indicates fetal oxygenation status. Doppler ultrasound can detect signs of fetal hypoxia like increased end-diastolic flow in the MCA, and meta-analyses found it reduces perinatal deaths and inductions when used for monitoring high-risk pregnancies.
Sonographic evaluation of fetal face is a part of anatomic survey in mid pregnancy
However , little is required; b/c according to american institute of ultrasound in modern practice guidelines, only visualization of fetal upper lip is mandatory during anatomy survey.
3D & 4D images are more informatory in cases where fetal face is hard to evaluate in 2D scan due to fetal position.
- The document describes the equipment, procedure, and findings of a hysterosalpingogram (HSG). An HSG uses fluoroscopy and radiopaque contrast to visualize the uterine cavity and fallopian tubes.
- The procedure involves inserting a catheter into the cervix and injecting contrast while taking x-ray images. Abnormal findings may indicate conditions like uterine anomalies, fibroids, adhesions, or tubal blockages.
- Complications are generally minor but can include pain, spotting, or rarely infection or contrast reaction. The HSG provides important information to evaluate infertility or other gynecological conditions.
3D and 4D ultrasound provide several advantages over traditional 2D ultrasound for assessing female pelvic anatomy and pathology. Multiplanar views allow for more accurate diagnosis of uterine anomalies by visualizing the coronal and true midline planes. Intracavitary lesions can be precisely localized. Ovarian volumes and antral follicle counts are more accurately determined. Endometrial receptivity markers like vascular indices are measurable. Doppler of uterine arteries provides additional information on receptivity. Overall, 3D/4D ultrasound improves evaluation of female pelvic structures and fertility-related conditions.
The document provides details about performing and interpreting a fetal anatomy scan between 18-20 weeks of gestation. It describes assessing various fetal anatomical structures including the brain, skull, abdomen, lungs, heart, spine, and limbs. Key measurements and normal ranges are outlined. Common congenital anomalies that may be detected on the scan are also described for various structures. The purpose of the anatomy scan is to evaluate fetal anatomy and screen for potential fetal anomalies.
This study evaluated the use of Shear Wave Elastography (SWE) on 724 breast tumors compared to conventional ultrasound and BIRADS classification. SWE measures tissue stiffness in kilopascals and provides an elastogram and elastic ratio. The results showed that malignant tumors tended to have higher stiffness (22-300 kPa) and elastic ratios (3.3-26.4) compared to benign tumors (4-45 kPa, elastic ratio of 0.7-4.6). SWE can help reclassify some lesions and guide biopsy, improving diagnosis of breast tumors over conventional ultrasound alone.
Isuog practice guidelines performance of first trimester fetal ultrasound scankaleemullahabid
The document provides guidelines from the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) for performing first trimester fetal ultrasound scans between 6-13 weeks gestation. It outlines recommendations for assessing viability, measuring the embryo/fetus, determining gestational age, evaluating fetal anatomy, and documenting the examination. Key recommendations include using transvaginal ultrasound when possible, measuring the crown-rump length to determine gestational age, and assessing the head, neck, spine and basic anatomy while acknowledging limitations in visualization of some structures so early.
Presentation1.pptx, radiological imaging of endometriosis.Abdellah Nazeer
Radiological imaging of endometriosis and adenomyosis.
Endometriosis and adenomyosis are common gynecological conditions that can be difficult to diagnose without imaging. MRI is the preferred imaging modality for evaluating these conditions. [1] Adenomyosis is characterized by ectopic endometrial glands within the myometrium, seen on MRI as junctional zone thickening over 12mm or ill-defined high T2 signal regions. [2] Endometriosis appears as powder-burn lesions, ovarian endometriomas or deep infiltrating nodules. Radiologists use MRI features like junctional zone measurements and high T1/T2 signals to diagnose and characterize
This document discusses screening for chromosomal defects like Trisomy 21 during pregnancy using ultrasound measurements of fetal nuchal translucency thickness between 11-13+6 weeks. It describes how increased nuchal translucency is associated with chromosomal abnormalities and various markers that can be assessed during the first trimester ultrasound like absent nasal bone, abnormal ductus venosus flow, and certain fetal measurements. The document provides guidelines for managing pregnancies based on nuchal translucency measurements and discusses offering invasive diagnostic tests for higher risk pregnancies.
Ultrasound Elastography is a new imaging technique that allows a noninvasive estimation and imaging of tissue elasticity distribution within biological tissues using conventional, Real Time Ultrasound equipment with modified software. It can be viewed as an electronic palpation of tissues. Introduced by Ophir et al in 1991, it subsequently evolved into a Real Time Imaging tool.
Mammography is an x-ray test used to aid in the early detection and diagnosis of breast diseases in women. It uses low-dose radiation to produce images of the breast tissue. Screening mammograms are used to look for signs of breast cancer in women without symptoms, while diagnostic mammograms are used when abnormalities are detected or a woman has breast symptoms. Mammograms produce images of the breast tissue and can detect abnormalities such as masses, calcifications, architectural distortions, and asymmetries that may indicate breast cancer. The images are analyzed according to the Breast Imaging Reporting and Data System (BI-RADS) to determine if follow-up is needed. Digital mammography provides enhanced image quality compared to traditional film
This document provides a detailed overview of cervical spine anatomy and common cervical spine injuries seen on CT imaging. It begins with a description of cervical spine anatomy including the typical vertebrae from C3-C6 and the atypical C1 and C2 vertebrae. It then discusses common cervical spine injuries such as fractures of C1-C2, hangman's fractures of C2, and odontoid fractures. Classification systems for these injuries are provided along with example CT images. The document concludes with a brief discussion of subaxial cervical spine injuries.
This document discusses USG images taken in the third trimester of pregnancy. It was written by Prof. M.C. Bansal, who has served as the founder principal and controller of Jhalawar Medical College And Hospital in Jhalawar as well as the principal and controller of Mahatma Gandhi Medical College And Hospital in Sitapura, Jaipur. The USG images presented are from Donald School Textbook on Ultra Sonography-1 and William's Obstetrics Textbook for further reference on the topic.
This document provides an overview of a lecture on second and third trimester emergencies during pregnancy. It discusses essential elements of an emergency ultrasound scan, including determining the fetal lie and position, measuring gestational age using BPD and femur length, locating the placenta, and assessing amniotic fluid levels. Potential emergencies that may occur during this time include preterm labor, placental issues, hemorrhage, and too much or too little amniotic fluid. The document outlines techniques for evaluating these elements in an emergency scan.
This document provides an overview of MRI protocols and findings for evaluating the shoulder. It describes ten common clinical scenarios where MRI may be useful. It then details the anatomy visualized with MRI and various pathologies that can be identified, including rotator cuff tears, labral tears, bursitis, capsulitis, and ligament injuries. A variety of tear patterns, classifications, and lesions involving the labrum and biceps are presented. In summary, the document serves as a guide for interpreting shoulder MRI studies and identifying relevant musculoskeletal abnormalities.
Doppler in obstetric power point presentation (4)RiyadhWaheed
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.
This document discusses fetal neurosonography and the sonographic appearance of fetal brain structures throughout gestation. It begins with an overview of embryonic brain development and the division of the brain into sections. It then examines how the appearance of specific structures changes with gestational age, including the posterior fossa, lateral ventricles, and cerebellum. Serial images demonstrate the maturation and relationships between structures over time. The role of 3D imaging in examining the posterior fossa is also mentioned.
This document provides information about various breast imaging techniques including mammography. It describes what a mammogram is, the history of mammography, how mammograms are performed, what they can detect like masses and microcalcifications, and how results are categorized using BI-RADS. Other modalities like ultrasound and MRI are also discussed. Limitations of mammography include false negatives, overdiagnosis, and difficulty in dense breasts. Mammogram plans vary depending on a woman's history and any breast surgery or implants. Newer techniques like tomosynthesis aim to improve cancer detection.
This document discusses ultrasound evaluation of the fetal face and neck. It outlines normal sonographic anatomy and various craniofacial anomalies that can be detected prenatally, including facial clefts, orbital defects, micrognathia, macroglossia, tumors, and ear abnormalities. It also mentions craniosynostosis and neck anomalies like nuchal cystic hygroma that can be identified. The conclusion emphasizes that identifying facial or neck anomalies indicates the need for a full fetal exam to check for associated conditions, and that prognosis depends on severity and presence of syndromes or neurological defects. Advanced ultrasound is improving detection and preparation for neonatal care.
This document discusses the role of color Doppler ultrasound in antepartum fetal surveillance. It begins by outlining the purposes of fetal surveillance, which include reducing fetal death and optimizing delivery timing. It then discusses various maternal and fetal conditions that require increased surveillance due to risks of chronic hypoxia. The document covers different methods of antepartum surveillance and provides detailed explanations of Doppler ultrasound principles, techniques like uterine and umbilical artery Doppler, and how abnormal Doppler readings can predict complications like fetal growth restriction.
DEB MDRD Obstetrical ultrasound 1ST TRIMESTERDEBKUMAR BISWAS
Ultrasonography is a safe, non-invasive way to examine the fetus. The document discusses sonographic assessment in the first trimester of pregnancy. Key findings include visualizing the gestational sac, yolk sac, embryo, and fetal cardiac activity to determine viability and gestational age. Sonography can also detect anomalies and assist with procedures. Signs of embryonic demise include absent cardiac activity, slow sac growth, and abnormal Doppler findings. Accurate dating is important for screening and diagnosis in the first trimester.
Ultrasound is useful in the first trimester for evaluating bleeding, pain, gestational sac location and development. A gestational sac is normally visible by 4 weeks ultrasound. The yolk sac appears by 5 weeks and the embryo with cardiac activity by 6 weeks. Abnormal findings include lack of growth, irregular sac shape, large yolk sac size. Doppler can assess blood flow. Ectopic pregnancies can be detected by visualizing an embryo outside the uterus combined with serum hCG levels. Multiple pregnancies are determined by membrane thickness and number of yolk sacs.
Sonographic evaluation of fetal face is a part of anatomic survey in mid pregnancy
However , little is required; b/c according to american institute of ultrasound in modern practice guidelines, only visualization of fetal upper lip is mandatory during anatomy survey.
3D & 4D images are more informatory in cases where fetal face is hard to evaluate in 2D scan due to fetal position.
- The document describes the equipment, procedure, and findings of a hysterosalpingogram (HSG). An HSG uses fluoroscopy and radiopaque contrast to visualize the uterine cavity and fallopian tubes.
- The procedure involves inserting a catheter into the cervix and injecting contrast while taking x-ray images. Abnormal findings may indicate conditions like uterine anomalies, fibroids, adhesions, or tubal blockages.
- Complications are generally minor but can include pain, spotting, or rarely infection or contrast reaction. The HSG provides important information to evaluate infertility or other gynecological conditions.
3D and 4D ultrasound provide several advantages over traditional 2D ultrasound for assessing female pelvic anatomy and pathology. Multiplanar views allow for more accurate diagnosis of uterine anomalies by visualizing the coronal and true midline planes. Intracavitary lesions can be precisely localized. Ovarian volumes and antral follicle counts are more accurately determined. Endometrial receptivity markers like vascular indices are measurable. Doppler of uterine arteries provides additional information on receptivity. Overall, 3D/4D ultrasound improves evaluation of female pelvic structures and fertility-related conditions.
The document provides details about performing and interpreting a fetal anatomy scan between 18-20 weeks of gestation. It describes assessing various fetal anatomical structures including the brain, skull, abdomen, lungs, heart, spine, and limbs. Key measurements and normal ranges are outlined. Common congenital anomalies that may be detected on the scan are also described for various structures. The purpose of the anatomy scan is to evaluate fetal anatomy and screen for potential fetal anomalies.
This study evaluated the use of Shear Wave Elastography (SWE) on 724 breast tumors compared to conventional ultrasound and BIRADS classification. SWE measures tissue stiffness in kilopascals and provides an elastogram and elastic ratio. The results showed that malignant tumors tended to have higher stiffness (22-300 kPa) and elastic ratios (3.3-26.4) compared to benign tumors (4-45 kPa, elastic ratio of 0.7-4.6). SWE can help reclassify some lesions and guide biopsy, improving diagnosis of breast tumors over conventional ultrasound alone.
Isuog practice guidelines performance of first trimester fetal ultrasound scankaleemullahabid
The document provides guidelines from the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) for performing first trimester fetal ultrasound scans between 6-13 weeks gestation. It outlines recommendations for assessing viability, measuring the embryo/fetus, determining gestational age, evaluating fetal anatomy, and documenting the examination. Key recommendations include using transvaginal ultrasound when possible, measuring the crown-rump length to determine gestational age, and assessing the head, neck, spine and basic anatomy while acknowledging limitations in visualization of some structures so early.
Presentation1.pptx, radiological imaging of endometriosis.Abdellah Nazeer
Radiological imaging of endometriosis and adenomyosis.
Endometriosis and adenomyosis are common gynecological conditions that can be difficult to diagnose without imaging. MRI is the preferred imaging modality for evaluating these conditions. [1] Adenomyosis is characterized by ectopic endometrial glands within the myometrium, seen on MRI as junctional zone thickening over 12mm or ill-defined high T2 signal regions. [2] Endometriosis appears as powder-burn lesions, ovarian endometriomas or deep infiltrating nodules. Radiologists use MRI features like junctional zone measurements and high T1/T2 signals to diagnose and characterize
This document discusses screening for chromosomal defects like Trisomy 21 during pregnancy using ultrasound measurements of fetal nuchal translucency thickness between 11-13+6 weeks. It describes how increased nuchal translucency is associated with chromosomal abnormalities and various markers that can be assessed during the first trimester ultrasound like absent nasal bone, abnormal ductus venosus flow, and certain fetal measurements. The document provides guidelines for managing pregnancies based on nuchal translucency measurements and discusses offering invasive diagnostic tests for higher risk pregnancies.
Ultrasound Elastography is a new imaging technique that allows a noninvasive estimation and imaging of tissue elasticity distribution within biological tissues using conventional, Real Time Ultrasound equipment with modified software. It can be viewed as an electronic palpation of tissues. Introduced by Ophir et al in 1991, it subsequently evolved into a Real Time Imaging tool.
Mammography is an x-ray test used to aid in the early detection and diagnosis of breast diseases in women. It uses low-dose radiation to produce images of the breast tissue. Screening mammograms are used to look for signs of breast cancer in women without symptoms, while diagnostic mammograms are used when abnormalities are detected or a woman has breast symptoms. Mammograms produce images of the breast tissue and can detect abnormalities such as masses, calcifications, architectural distortions, and asymmetries that may indicate breast cancer. The images are analyzed according to the Breast Imaging Reporting and Data System (BI-RADS) to determine if follow-up is needed. Digital mammography provides enhanced image quality compared to traditional film
This document provides a detailed overview of cervical spine anatomy and common cervical spine injuries seen on CT imaging. It begins with a description of cervical spine anatomy including the typical vertebrae from C3-C6 and the atypical C1 and C2 vertebrae. It then discusses common cervical spine injuries such as fractures of C1-C2, hangman's fractures of C2, and odontoid fractures. Classification systems for these injuries are provided along with example CT images. The document concludes with a brief discussion of subaxial cervical spine injuries.
This document discusses USG images taken in the third trimester of pregnancy. It was written by Prof. M.C. Bansal, who has served as the founder principal and controller of Jhalawar Medical College And Hospital in Jhalawar as well as the principal and controller of Mahatma Gandhi Medical College And Hospital in Sitapura, Jaipur. The USG images presented are from Donald School Textbook on Ultra Sonography-1 and William's Obstetrics Textbook for further reference on the topic.
This document provides an overview of a lecture on second and third trimester emergencies during pregnancy. It discusses essential elements of an emergency ultrasound scan, including determining the fetal lie and position, measuring gestational age using BPD and femur length, locating the placenta, and assessing amniotic fluid levels. Potential emergencies that may occur during this time include preterm labor, placental issues, hemorrhage, and too much or too little amniotic fluid. The document outlines techniques for evaluating these elements in an emergency scan.
This document provides an overview of MRI protocols and findings for evaluating the shoulder. It describes ten common clinical scenarios where MRI may be useful. It then details the anatomy visualized with MRI and various pathologies that can be identified, including rotator cuff tears, labral tears, bursitis, capsulitis, and ligament injuries. A variety of tear patterns, classifications, and lesions involving the labrum and biceps are presented. In summary, the document serves as a guide for interpreting shoulder MRI studies and identifying relevant musculoskeletal abnormalities.
Doppler in obstetric power point presentation (4)RiyadhWaheed
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.
This document discusses fetal neurosonography and the sonographic appearance of fetal brain structures throughout gestation. It begins with an overview of embryonic brain development and the division of the brain into sections. It then examines how the appearance of specific structures changes with gestational age, including the posterior fossa, lateral ventricles, and cerebellum. Serial images demonstrate the maturation and relationships between structures over time. The role of 3D imaging in examining the posterior fossa is also mentioned.
This document provides information about various breast imaging techniques including mammography. It describes what a mammogram is, the history of mammography, how mammograms are performed, what they can detect like masses and microcalcifications, and how results are categorized using BI-RADS. Other modalities like ultrasound and MRI are also discussed. Limitations of mammography include false negatives, overdiagnosis, and difficulty in dense breasts. Mammogram plans vary depending on a woman's history and any breast surgery or implants. Newer techniques like tomosynthesis aim to improve cancer detection.
This document discusses ultrasound evaluation of the fetal face and neck. It outlines normal sonographic anatomy and various craniofacial anomalies that can be detected prenatally, including facial clefts, orbital defects, micrognathia, macroglossia, tumors, and ear abnormalities. It also mentions craniosynostosis and neck anomalies like nuchal cystic hygroma that can be identified. The conclusion emphasizes that identifying facial or neck anomalies indicates the need for a full fetal exam to check for associated conditions, and that prognosis depends on severity and presence of syndromes or neurological defects. Advanced ultrasound is improving detection and preparation for neonatal care.
This document discusses the role of color Doppler ultrasound in antepartum fetal surveillance. It begins by outlining the purposes of fetal surveillance, which include reducing fetal death and optimizing delivery timing. It then discusses various maternal and fetal conditions that require increased surveillance due to risks of chronic hypoxia. The document covers different methods of antepartum surveillance and provides detailed explanations of Doppler ultrasound principles, techniques like uterine and umbilical artery Doppler, and how abnormal Doppler readings can predict complications like fetal growth restriction.
DEB MDRD Obstetrical ultrasound 1ST TRIMESTERDEBKUMAR BISWAS
Ultrasonography is a safe, non-invasive way to examine the fetus. The document discusses sonographic assessment in the first trimester of pregnancy. Key findings include visualizing the gestational sac, yolk sac, embryo, and fetal cardiac activity to determine viability and gestational age. Sonography can also detect anomalies and assist with procedures. Signs of embryonic demise include absent cardiac activity, slow sac growth, and abnormal Doppler findings. Accurate dating is important for screening and diagnosis in the first trimester.
Ultrasound is useful in the first trimester for evaluating bleeding, pain, gestational sac location and development. A gestational sac is normally visible by 4 weeks ultrasound. The yolk sac appears by 5 weeks and the embryo with cardiac activity by 6 weeks. Abnormal findings include lack of growth, irregular sac shape, large yolk sac size. Doppler can assess blood flow. Ectopic pregnancies can be detected by visualizing an embryo outside the uterus combined with serum hCG levels. Multiple pregnancies are determined by membrane thickness and number of yolk sacs.
This document discusses various obstetric emergencies that can occur during pregnancy including bleeding, ectopic pregnancy, miscarriage, and other complications. It provides details on the symptoms, diagnostic criteria, and ultrasound findings of conditions like threatened miscarriage, incomplete miscarriage, missed miscarriage, and ectopic pregnancy. Key signs of ectopic pregnancy on ultrasound include an adnexal mass separate from the ovary, tubal ring sign, complex ovarian cyst, and free fluid in the pelvis. Differential diagnosis of early pregnancy complications considers beta-hCG levels and serial measurements.
This document discusses ultrasound findings in early pregnancy that can help diagnose conditions like ectopic pregnancy and diagnose fetal viability. It describes what ultrasound findings indicate a normal intrauterine pregnancy versus an abnormal pregnancy or early pregnancy failure. Key findings discussed include the gestational sac, yolk sac, embryonic cardiac activity, subchorionic hemorrhage, and retained products of conception. Diagnosis of conditions is supported by quantitative measures like gestational sac size and heart rate in relation to crown-rump length.
1) Early pregnancy ultrasound is used to evaluate normal and abnormal early pregnancies through assessing gestational sac location, structure, viability, dating and number. It can also screen for fetal abnormalities and assist with procedures.
2) Sonographic signs of normal early pregnancy include identifying the gestational sac, yolk sac, embryo/fetus and presence of cardiac activity. Dating is based on mean sac diameter from 5-9 weeks and crown-rump length from 6-12 weeks.
3) Abnormal findings include failed early pregnancy, pregnancy of uncertain viability, pregnancy of unknown location, ectopic pregnancy, molar pregnancy, and retained products of conception. Precise diagnosis requires correlating ultrasound findings with hCG
This document discusses the use of ultrasound in evaluating various pregnancy-related issues. It begins by explaining how ultrasound is essential for evaluating pelvic pain and vaginal bleeding in women of childbearing age. It then discusses several specific topics that can be evaluated by ultrasound, including pregnancy of unknown location, discriminatory zones for detecting intrauterine pregnancies, various types of ectopic pregnancies (tubal, ovarian, cervical, etc.), signs of failed early pregnancy, and retained products of conception. It also discusses ultrasound findings for conditions like placenta previa, vasa previa, and fetal distress. In all cases, the document emphasizes how ultrasound findings can help clinicians determine diagnoses and clinical management.
Three key points about the document:
1. The document describes a case series of 15 patients with caesarean scar ectopic pregnancies managed at a hospital unit over 3.5 years.
2. Most patients (53%) were managed conservatively through expectant management and serial ultrasound/hCG monitoring, while 40% received medical management with methotrexate, and one patient (7%) required additional surgical evacuation.
3. The outcomes were generally good, with resolution of the ectopic pregnancies and many patients (five out of 15) subsequently having successful full-term intrauterine pregnancies.
1. The document discusses pregnancy of unknown location (PUL), where the pregnancy is not located intrauterinely or extrauterinely based on initial tests.
2. It evaluates various diagnostic modalities for PUL including serum progesterone, ultrasound, and serum hCG levels which can help determine if the pregnancy is intrauterine, ectopic, or failing.
3. Serial serum hCG measurements and ultrasound are important to accurately diagnose and manage PULs.
An ectopic pregnancy occurs when a fertilized egg implants outside of the uterus, most commonly in the fallopian tubes. Risk factors include a history of pelvic inflammatory disease, prior tubal surgery or ectopic pregnancy. Clinical presentation may include vaginal bleeding, abdominal or pelvic pain. Diagnosis involves serum hCG and progesterone levels, transvaginal ultrasound and laparoscopy. Treatment options are medical, using methotrexate, or surgical. The goal is to terminate the pregnancy safely while preserving fertility.
Ectopic pregnancy occurs when a fertilized egg implants outside of the uterus, usually in the fallopian tubes. There are several types of ectopic pregnancies classified by location, with tubal pregnancies making up about 90% of cases. Risk factors include previous ectopic pregnancy, PID, tubal ligation or surgery. Symptoms include abdominal pain and vaginal bleeding. Diagnosis involves ultrasound, serum hCG levels, and sometimes laparoscopy. Treatment options range from expectant management for very early, low risk cases to surgical intervention like salpingectomy for ruptured ectopic pregnancies.
The document discusses pregnancy of unknown location (PUL), where transvaginal ultrasound shows no signs of intrauterine or ectopic pregnancy. It outlines diagnostic criteria and management pathways based on serum hCG levels and symptoms. Ultrasound findings that can indicate early intrauterine, ectopic, or failed pregnancies are also described, along with diagnostic modalities and imaging features.
This document provides information about cesarean scar pregnancy (CSP), including its definition, incidence, risk factors, pathogenesis, diagnosis, and treatment. It defines CSP as embryo implantation in the fibrous scar tissue of a prior cesarean hysterotomy. The diagnosis is typically made using transvaginal ultrasound showing gestation within the cesarean scar niche. While expectant management is not recommended due to risks of severe bleeding, treatment options include systemic methotrexate or ultrasound-guided potassium chloride injection to terminate the pregnancy.
Imaging in obstetrics & gynaecology part 2drmcbansal
This document discusses ultrasound examination in pregnancy. It provides information on using ultrasound for diagnostic and screening purposes in different trimesters. In the first trimester, ultrasound can be used to date the pregnancy, detect fetal anomalies, confirm intrauterine pregnancy, and detect ectopic pregnancies or nuchal lucency. Structures like the gestational sac, yolk sac, fetal pole, and heartbeat can be visualized on ultrasound as early as 5-6 weeks of gestation. The crown rump length is an accurate way to date the fetus from 6-12 weeks. An increased nuchal translucency between 11-14 weeks may indicate anomalies like aneuploidies or structural defects.
This document discusses ultrasound examination in pregnancy. It provides information on using ultrasound for diagnostic and screening purposes in different trimesters. In the first trimester, ultrasound can be used to date the pregnancy, detect fetal anomalies, confirm intrauterine pregnancy, and detect ectopic pregnancies or nuchal lucency. Structures like the gestational sac, yolk sac, fetal pole, and heartbeat can be visualized on ultrasound as the pregnancy progresses in the first trimester. Crown rump length is an accurate method for measuring and dating the fetus early in the first trimester.
The document discusses normal early pregnancy features seen on ultrasound such as the double decidual sac sign seen before visualization of the yolk sac or embryo. It also discusses features of ectopic pregnancy such as the transvaginal ultrasound finding of a gestational sac located outside the uterine cavity, which is a reliable sign of ectopic pregnancy. Risk factors, clinical presentations, locations and ultrasound signs of ectopic pregnancy are provided, along with a brief overview of MRI and CT imaging findings that can help diagnose this condition.
This document discusses first trimester bleeding, which occurs in 20-40% of pregnancies. The main causes are miscarriage (95%), ectopic pregnancy (2%), hydatidiform mole (<1%), and vanishing twin. Diagnosis involves history, examination, ultrasound to determine if the pregnancy is intrauterine, extrauterine, viable, or nonviable. Common ultrasound findings for miscarriage include no fetal heartbeat, subchorionic bleeding, or an empty gestational sac over 20mm. Ectopic pregnancies may appear as an adnexal mass. Rare causes are molar pregnancies, appearing on ultrasound as a "snowstorm" pattern of cysts in the placenta. First trimester bleeding
A 23-year-old woman who is 6 weeks pregnant has noticed slight vaginal spotting and her period is 2 weeks late. The differential diagnoses in this case are threatened miscarriage, ectopic pregnancy, or molar pregnancy. Ultrasound would be helpful to locate the pregnancy and assess viability. Serial beta-hCG levels and progesterone levels could also help predict the pregnancy outcome if the location is unknown. Surgical uterine evacuation may be needed if bleeding is excessive or the woman prefers it.
Ultrasound in early pregnancy is used to assess:
1. Normal aspects such as gestational sac size and viability by detecting a heartbeat.
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.
5. Screening for fetal abnormalities such as thickened nuchal translucency which is used to detect Down syndrome.
Early Pregnancy Loss a Simplified Ultrasound Approche Dr/ Ahmed Walid Anwar M...Walid Ahmed
This document discusses early pregnancy loss and provides a simplified ultrasound approach for diagnosis. It begins by defining key terms like viability and miscarriage versus abortion. It then outlines the criteria for diagnosing early pregnancy loss, including definite and suspicious criteria based on ultrasound findings like gestational sac size and absence of fetal heart activity over time. The sequence of normal embryonic development visible by ultrasound is also reviewed. The document concludes by emphasizing that ultrasound should be used along with beta-hCG levels and history to diagnose early pregnancy loss, and that timing of the ultrasound is important to avoid false diagnoses or unnecessary interventions.
The vertebral column consists of 33 vertebrae separated by intervertebral discs. A typical vertebra has a vertebral body and arch enclosing the vertebral foramen through which the spinal cord passes. The spinal cord has 31 pairs of spinal nerves and is composed of gray and white matter. It transmits sensory information up the posterior columns and motor commands down tracts like the corticospinal tract. Injuries can cause syndromes like complete transection with bilateral deficits or Brown-Sequard with unilateral deficits depending on the location and extent of damage.
The document describes the various cerebrospinal fluid (CSF) filled spaces, or cisterns, within the subarachnoid space. It details both supra-tentorial and infra-tentorial cisterns, providing their locations, contents such as vessels and cranial nerves, and anatomical relationships. Key cisterns mentioned include the cistern of the lamina terminalis, chiasmatic cistern, interpeduncular cistern, prepontine cistern, cisterna magna, and cerebellopontine angle cistern. The cisterns form a interconnected network facilitating CSF circulation within the subarachnoid space.
This document provides an overview of the gross anatomy of the brain as seen on MR imaging. It describes the central sulcus, ventricular system, limbic system, and white matter. It then details the axial, sagittal, and coronal views of the brain and lists over 100 structures and their 3D localization within the brain.
The document discusses various congenital anomalies of the pancreas including annular pancreas, pancreas divisum, ectopic pancreatic tissue, horseshoe pancreas, and variations in pancreatic ductal anatomy. It describes the embryological development of the pancreas and defines important anatomical structures such as the pancreatic ducts. Imaging features of different pancreatic anomalies on modalities like CT, MRI, ERCP, and ultrasound are provided.
CT guided FNAC is a simple and minimally invasive technique for obtaining tissue samples from complex lung lesions for diagnosis. A study of 28 patients found CT guided FNAC to have a sensitivity of 80% and specificity of 100% for diagnosing malignancy. Complications occurred in 3 patients (12.5%) and were minor and self-resolving. CT guided FNAC is shown to be an effective and safe outpatient procedure for evaluating pulmonary nodules and masses.
CT guided FNAC is a simple and effective technique for diagnosing complex pulmonary lesions. In a study of 28 patients, CT guided FNAC had a sensitivity of 80% and specificity of 100% for diagnosing malignancy. CT scanning alone had sensitivity of 75% and specificity of 83.3% for malignancy. Complications occurred in 3 patients (12.5%) and were minor and resolved with conservative treatment. The study concluded that CT guided FNAC is a highly sensitive and specific technique for characterizing pulmonary lesions.
The document discusses various presacral lesions that can be seen on imaging. It describes the anatomy of the presacral space and then covers conditions with osteochondral origin like giant cell tumor and Ewing sarcoma. Neurogenic conditions such as neurofibromas, schwannomas, and perineural cysts are also discussed. Other lesions mentioned include dural ectasia and anterior myelomeningoceles. For each condition, the document provides details on clinical features, imaging appearance on modalities like CT and MRI, and examples of imaging findings.
Sarcoidosis is a multisystem granulomatous disease of unknown etiology characterized by non-caseating granulomas. It most commonly affects the lungs, presenting radiographically as bilateral hilar lymphadenopathy in 50% of cases and pulmonary nodules in 30-50% of cases. Other involved organs include the eyes, skin, and heart. On CT, it demonstrates enlarged lymph nodes and pulmonary nodules distributed along the bronchovascular bundles. Late stage disease can develop pulmonary fibrosis. Sarcoidosis can also involve bones, presenting as cystic lesions in the hands. Neurosarcoidosis manifests as leptomeningeal enhancement or intracranial masses.
The document describes various signs seen on imaging of the respiratory system. It defines signs such as the signet ring sign seen on CT scans of the lungs, the finger-in-glove appearance seen in allergic broncho-pulmonary aspergillosis, and the continuous diaphragm sign seen in pneumomediastinum where air outlines the entire diaphragm. It also provides details on other signs like the halo sign associated with hemorrhagic nodules, the reversed halo sign, and tree-in-bud appearance seen in conditions like tuberculosis.
1. The document defines and describes solitary pulmonary nodules, providing details on measurements, characteristics, and imaging features that help determine if a nodule is benign or malignant.
2. Malignant nodules are more likely to be larger in size, irregular or spiculated in shape, located in the upper lobes, and demonstrate rapid growth. Benign nodules often have fat, calcification, or show long-term stability.
3. Guidelines are provided for follow-up of solid versus subsolid nodules based on size, with smaller or stable nodules requiring less frequent follow-up, and suspicious nodules warranting further evaluation including PET scans or biopsy.
Esophageal webs are thin mucosal membranes that project into the esophageal lumen, causing constriction. They more commonly occur in the cervical esophagus near the cricopharyngeus muscle. Associations include Plummer-Vinson syndrome, graft-versus-host disease, and gastroesophageal reflux disease. On barium swallows, esophageal webs appear as smooth tapered concentric narrowing in the cervical esophagus.
The parathyroid glands are located posterior to the thyroid gland in the neck. Parathyroid adenomas, the most common cause of primary hyperparathyroidism, enhance vividly on arterial phase CT then wash out rapidly on delayed phase with low attenuation on non-contrast images. Localizing the adenoma precisely with 4D CT guides focused surgical treatment through a small incision. The characteristic enhancement pattern and morphology help identify ectopic adenomas located during fetal development in the mediastinum.
This document provides an overview of brain anatomy including:
1. It describes the MRI appearance of different brain tissues and structures including white matter, fat, CSF, and gray matter on different sequences.
2. It then covers the sulcal and gyral anatomy of the brain, describing the lobes, major sulci like the central sulcus and sylvian fissure, and how they can be identified.
3. The anatomy of each lobe is then covered in more detail including the surfaces and sulci that make up the frontal, parietal, occipital, and temporal lobes.
Osteomyelitis is an infection of bone that is usually caused by bacteria entering through the bloodstream or direct inoculation via injury. It can be acute, subacute, or chronic. Common symptoms include fever, pain, and swelling near the infected bone. Diagnosis involves blood tests, imaging like x-rays, MRI, and bone scans, and bone/blood cultures. Treatment consists of antibiotics tailored to the identified bacteria as well as possible surgical drainage of abscesses.
This document discusses primary retroperitoneal neoplasms, which arise outside of major retroperitoneal organs. It notes that 70-80% of retroperitoneal masses are malignant in nature. The document then categorizes and describes several specific types of solid neoplastic masses that can occur in the retroperitoneum, including mesodermal neoplasms (such as liposarcomas and leiomyosarcomas), neurogenic tumors, and others. For each type of mass, it provides details on prevalence, appearance on CT and MRI scans, characteristics, associated syndromes, and other relevant clinical information.
This document discusses Legg-Calve-Perthes disease, which is avascular necrosis of the femoral head that occurs in children. It begins by describing the etiology as an ischemic episode affecting the capital femoral epiphysis, though the exact cause is unknown. The stages of the disease are then outlined based on radiographic appearance, from initial avascular necrosis to revascularization and bone remodeling. Complications including deformities of the femoral head and neck are also summarized. The document provides detailed information on the radiographic signs and classifications systems used to evaluate the progression and prognosis of Legg-Calve-Perthes disease.
X-ray grids are devices used to remove scattered radiation from radiographic images. They consist of alternating strips of lead and transparent material. Grids work by absorbing most of the multidirectional scattered radiation while allowing the directional primary radiation to pass through. Grid performance is evaluated based on primary transmission, Bucky factor, and contrast improvement factor. Proper grid selection and positioning are important to avoid grid cutoff and increased patient radiation dose. Moving grids eliminate grid line artifacts but have some disadvantages.
This document discusses fluoroscopy, including conventional fluoroscopy units and modern fluoroscopic units. It describes the key components of a fluoroscopic unit, including the image intensifier, vidicon camera, and TV monitor. It also discusses factors that influence fluoroscopic image quality such as radiation dose rates, image resolution both vertically and horizontally, and techniques to reduce image noise like frame averaging.
A fluoroscope uses x-rays and a fluorescent screen to enable direct observation of internal organs. It consists of an x-ray tube, table, and image intensifier. The image intensifier converts x-rays into visible light images and amplifies them for viewing. It works by accelerating photoelectrons emitted from a photocathode onto a phosphor screen, producing light photons and gaining brightness. Newer generations of image intensifiers use additional electron multiplication for higher sensitivity. Fluoroscopy provides real-time moving images for procedures while fluorography captures still diagnostic images.
Diffusion MRI measures the random thermal motion of water molecules in tissues. It provides unique contrast based on differences in water diffusion between normal and abnormal tissues. Diffusion is restricted in cellular tissues and areas of restricted diffusion appear bright on diffusion-weighted images and dark on apparent diffusion coefficient maps. Diffusion MRI is useful for early detection of cerebral ischemia, differentiating between cystic and solid lesions, and evaluating white matter abnormalities and tumors. It has numerous clinical applications including stroke evaluation and characterization of brain lesions.
hematic appreciation test is a psychological assessment tool used to measure an individual's appreciation and understanding of specific themes or topics. This test helps to evaluate an individual's ability to connect different ideas and concepts within a given theme, as well as their overall comprehension and interpretation skills. The results of the test can provide valuable insights into an individual's cognitive abilities, creativity, and critical thinking skills
DERIVATION OF MODIFIED BERNOULLI EQUATION WITH VISCOUS EFFECTS AND TERMINAL V...Wasswaderrick3
In this book, we use conservation of energy techniques on a fluid element to derive the Modified Bernoulli equation of flow with viscous or friction effects. We derive the general equation of flow/ velocity and then from this we derive the Pouiselle flow equation, the transition flow equation and the turbulent flow equation. In the situations where there are no viscous effects , the equation reduces to the Bernoulli equation. From experimental results, we are able to include other terms in the Bernoulli equation. We also look at cases where pressure gradients exist. We use the Modified Bernoulli equation to derive equations of flow rate for pipes of different cross sectional areas connected together. We also extend our techniques of energy conservation to a sphere falling in a viscous medium under the effect of gravity. We demonstrate Stokes equation of terminal velocity and turbulent flow equation. We look at a way of calculating the time taken for a body to fall in a viscous medium. We also look at the general equation of terminal velocity.
The use of Nauplii and metanauplii artemia in aquaculture (brine shrimp).pptxMAGOTI ERNEST
Although Artemia has been known to man for centuries, its use as a food for the culture of larval organisms apparently began only in the 1930s, when several investigators found that it made an excellent food for newly hatched fish larvae (Litvinenko et al., 2023). As aquaculture developed in the 1960s and ‘70s, the use of Artemia also became more widespread, due both to its convenience and to its nutritional value for larval organisms (Arenas-Pardo et al., 2024). The fact that Artemia dormant cysts can be stored for long periods in cans, and then used as an off-the-shelf food requiring only 24 h of incubation makes them the most convenient, least labor-intensive, live food available for aquaculture (Sorgeloos & Roubach, 2021). The nutritional value of Artemia, especially for marine organisms, is not constant, but varies both geographically and temporally. During the last decade, however, both the causes of Artemia nutritional variability and methods to improve poorquality Artemia have been identified (Loufi et al., 2024).
Brine shrimp (Artemia spp.) are used in marine aquaculture worldwide. Annually, more than 2,000 metric tons of dry cysts are used for cultivation of fish, crustacean, and shellfish larva. Brine shrimp are important to aquaculture because newly hatched brine shrimp nauplii (larvae) provide a food source for many fish fry (Mozanzadeh et al., 2021). Culture and harvesting of brine shrimp eggs represents another aspect of the aquaculture industry. Nauplii and metanauplii of Artemia, commonly known as brine shrimp, play a crucial role in aquaculture due to their nutritional value and suitability as live feed for many aquatic species, particularly in larval stages (Sorgeloos & Roubach, 2021).
Comparing Evolved Extractive Text Summary Scores of Bidirectional Encoder Rep...University of Maribor
Slides from:
11th International Conference on Electrical, Electronics and Computer Engineering (IcETRAN), Niš, 3-6 June 2024
Track: Artificial Intelligence
https://www.etran.rs/2024/en/home-english/
BREEDING METHODS FOR DISEASE RESISTANCE.pptxRASHMI M G
Plant breeding for disease resistance is a strategy to reduce crop losses caused by disease. Plants have an innate immune system that allows them to recognize pathogens and provide resistance. However, breeding for long-lasting resistance often involves combining multiple resistance genes
The debris of the ‘last major merger’ is dynamically youngSérgio Sacani
The Milky Way’s (MW) inner stellar halo contains an [Fe/H]-rich component with highly eccentric orbits, often referred to as the
‘last major merger.’ Hypotheses for the origin of this component include Gaia-Sausage/Enceladus (GSE), where the progenitor
collided with the MW proto-disc 8–11 Gyr ago, and the Virgo Radial Merger (VRM), where the progenitor collided with the
MW disc within the last 3 Gyr. These two scenarios make different predictions about observable structure in local phase space,
because the morphology of debris depends on how long it has had to phase mix. The recently identified phase-space folds in Gaia
DR3 have positive caustic velocities, making them fundamentally different than the phase-mixed chevrons found in simulations
at late times. Roughly 20 per cent of the stars in the prograde local stellar halo are associated with the observed caustics. Based
on a simple phase-mixing model, the observed number of caustics are consistent with a merger that occurred 1–2 Gyr ago.
We also compare the observed phase-space distribution to FIRE-2 Latte simulations of GSE-like mergers, using a quantitative
measurement of phase mixing (2D causticality). The observed local phase-space distribution best matches the simulated data
1–2 Gyr after collision, and certainly not later than 3 Gyr. This is further evidence that the progenitor of the ‘last major merger’
did not collide with the MW proto-disc at early times, as is thought for the GSE, but instead collided with the MW disc within
the last few Gyr, consistent with the body of work surrounding the VRM.
Phenomics assisted breeding in crop improvementIshaGoswami9
As the population is increasing and will reach about 9 billion upto 2050. Also due to climate change, it is difficult to meet the food requirement of such a large population. Facing the challenges presented by resource shortages, climate
change, and increasing global population, crop yield and quality need to be improved in a sustainable way over the coming decades. Genetic improvement by breeding is the best way to increase crop productivity. With the rapid progression of functional
genomics, an increasing number of crop genomes have been sequenced and dozens of genes influencing key agronomic traits have been identified. However, current genome sequence information has not been adequately exploited for understanding
the complex characteristics of multiple gene, owing to a lack of crop phenotypic data. Efficient, automatic, and accurate technologies and platforms that can capture phenotypic data that can
be linked to genomics information for crop improvement at all growth stages have become as important as genotyping. Thus,
high-throughput phenotyping has become the major bottleneck restricting crop breeding. Plant phenomics has been defined as the high-throughput, accurate acquisition and analysis of multi-dimensional phenotypes
during crop growing stages at the organism level, including the cell, tissue, organ, individual plant, plot, and field levels. With the rapid development of novel sensors, imaging technology,
and analysis methods, numerous infrastructure platforms have been developed for phenotyping.
This presentation explores a brief idea about the structural and functional attributes of nucleotides, the structure and function of genetic materials along with the impact of UV rays and pH upon them.
The ability to recreate computational results with minimal effort and actionable metrics provides a solid foundation for scientific research and software development. When people can replicate an analysis at the touch of a button using open-source software, open data, and methods to assess and compare proposals, it significantly eases verification of results, engagement with a diverse range of contributors, and progress. However, we have yet to fully achieve this; there are still many sociotechnical frictions.
Inspired by David Donoho's vision, this talk aims to revisit the three crucial pillars of frictionless reproducibility (data sharing, code sharing, and competitive challenges) with the perspective of deep software variability.
Our observation is that multiple layers — hardware, operating systems, third-party libraries, software versions, input data, compile-time options, and parameters — are subject to variability that exacerbates frictions but is also essential for achieving robust, generalizable results and fostering innovation. I will first review the literature, providing evidence of how the complex variability interactions across these layers affect qualitative and quantitative software properties, thereby complicating the reproduction and replication of scientific studies in various fields.
I will then present some software engineering and AI techniques that can support the strategic exploration of variability spaces. These include the use of abstractions and models (e.g., feature models), sampling strategies (e.g., uniform, random), cost-effective measurements (e.g., incremental build of software configurations), and dimensionality reduction methods (e.g., transfer learning, feature selection, software debloating).
I will finally argue that deep variability is both the problem and solution of frictionless reproducibility, calling the software science community to develop new methods and tools to manage variability and foster reproducibility in software systems.
Exposé invité Journées Nationales du GDR GPL 2024
2. 19/06/07 2
Goals of 1st trimester
ultrasound
Visualisation and localisation of the gestational sac
Early identification of embryonic demise
Anembyonic pregnancy
Identification of embryos still alive but at increased
risk for embryonic/fetal demise
Determination of number of embryos
3. 19/06/07 3
Goals…
Chorionicity and amnionicity in mutifetal
pregnancy
Estimation of duration or gestational
age of pregnancy
Early diagnosis of fetal anomalies and
abnormal embryos
4. 19/06/07 4
Sonographic appearance of a
normal intrauterine gestation
Gestational sac
Yolk sac
Embryo and amnion
Cardiac activity
5. 19/06/07 5
Gestational Sac
Implantation occurs in the fundal region
of the uterus between day 20 and day
23
At day 23 the entire conceptus
measures 0.1 mm in diameter and cannot
be imaged by TAS or TVS
Using TVS the size threshold for sac
detection is 2 to 3 mm~4 wks 1 day GA
6. 19/06/07 6
At sonography the tiny GS is perceived as a
small fluid collection surrounded completely
by an echogenic rim of tissue.
The central collection is the chorionic cavity
and the surrounding echoes are due to
developing chorionic villi and adjacent
decidual tissues
As the sac enlarges the echogenic rim should
be at least 2 mm thick and its echogenecity
should exceed the level of myometrial echoes
7. 19/06/07 7
Intradecidual Sign
As the sac implants
into the decidualised
endometrium it
should be adjacent
to the linear central
cavity echo complex
without initially
displacing or
distorting it
8. 19/06/07 8
Double decidual Sign
As the sac enlarges
it gradually
impresses on and
deforms the central
cavity echo complex
giving rise to the
double decidual sign
10. 19/06/07 10
The normal gestational sac is round in
the very early stages and implants
immediately beneath the thin echogenic
endometrial stripe
As it enlarges it has a somewhat oval
shape due to pressure exerted by the
muscular uterine walls.
Can be distorted during TVS
11. 19/06/07 11
Chorionic sac is
weakly reflective
and more echogenic
than the amniotic
fluid
The cause of the low
level echoes is likely
due to the relatively
thick proteinaceous
material in the
chorionic fluid
12. 19/06/07 12
Role of TVCFD
May be helpful in identifying the presence of an early
IU gestational sac
Helps in distinguishing a normal from a failed IU
gestation
Detection of an ectopic pregnancy through exclusion
of an intrauterine pregnancy
Detection of peritrophoblastic flow of high velocity
and low impedence:sensitivity of 90-99%
14. 19/06/07 14
Yolk Sac
FIRST STRUCTURE TO BE SEEN WITHIN
THE G.SAC
ALWAYS SEEN WHEN
MSD > 8mm TVS
MSD > 20mm TAS
DETERMINES THE AMNIOCITY OF PREGNANCY
15. 19/06/07 15
Demonstration of a yolk sac helpful in
differentiating an early intrauterine gestation
from a decidual cast.
The upper limit of normal for yolk sac
diameter between 5 and 10 wks of MA is
5.6mm.
Functions
Transfer of nutrients
Angiogenesis
Haematopoesis
17. 19/06/07 17
AMNION
DOUBLE BLEB SIGN
YOLK SAC AMNION
SEEN AS EARLY AS 5.5 WEEKS WHEN CRL is 2mm
EMBRYONIC DISK LIES BETWEEN TWO BLEBS
18. 19/06/07 18
Amniotic fluid is a colorless,dermal exudate
initially
It becomes pale yellow as the skin cornifies
and kidneys begin to function about 11 weeks
The amnion is barely visible at 6 weeks
The cavity becomes more spherical at 7 weeks
The amniotic cavity expands and fills the
chorionic cavity completely by week 14 to 16.
20. 19/06/07 20
Early embryo and cardiac activity
Cardiac activity can be identified as early as
34 days at a CRL of 1 to 2 mm
During the first TM, cardiac rates vary with
GA
At 6 weeks the rate is relatively slow:
typically b/n 100 and 115 BPM
It increases rapidly and by 8 weeks is b/n 144
and 159 BPM.
After 9 weeks the rate plateaus at 137 to
144 BPM
27. 19/06/07 27
MSD
The first structure that can be measured for
calculating GA is the GS
Sac measurements should be obtained if no yolk sac
or embryo is visible
To maintain uniformity GS size should be determined
by calculating the MSD
This value is obtained by adding the three orthogonal
dimensions of the chorionic cavity and dividing by 3
29. 19/06/07 29
CRL
Most accurate method of dating pregnancy
between 6 and 12 weeks
When the embryonic disk is detected initially
at 6 weeks GA, it may be too small to actually
measure
Later it becomes possible to measure the
embryonic disk but cannot distinguish crown
from rump.
31. 19/06/07 31
BPD,HC,AC,FL
By the end of first trimester,
measurement of BPD becomes more
accurate than the CRL
The menstrual age of pregnancy is
established in the 1st TM
33. 19/06/07 33
G.SAC CRITERIA FOR POOR
OUTCOME
TAS
MSD>25mm BUT NO EMBRYO
MSD>20mm BUT NO YOLK SAC
TVS
MSD>16mm BUT NO EMBRYO
MSD>8mm BUT NO YOLK SAC
38. 19/06/07 38
CRITERIA FOR ABNORMAL
AMNION
VISUALISATION OF THE AMNION IN THE
ABSENCE OF EMBRYO AFTER 7 WEEKS
INDICATES
Anembryonic pregnancy
Embryonic demise
A LARGER THAN NORMAL OR FLOPPY
AMNIOTIC SAC
COLLAPSED IRREGULAR AMNION
45. 19/06/07 45
ABORTION
EXPULSION OF THE DEAD PRODUCTS
OF CONCEPTION BEFORE 24 WKS OF
GESTATION
Types
1.THREATENED ABORTION
2 .INCOMPLETE
3 .COMPLETE
4. INEVITABLE
5. MISSED ABORTION
6. SEPTIC ABORTION
46. 19/06/07 46
THREATENED ABORTION
VIABLE FETUS WITH BLEEDING PV
OCCURING IN FIRST 20 WKS OF
GESTATION WITH CLOSED CERVIX
NOT VISIBLE SONOGRAPHICALLY
SERIAL SONOGRAM IS NECESSARY
47. 19/06/07 47
INCOMPLETE ABORTION
PARTIAL EVACAUTION OF FETUS AND PLACENTA
WITH SOME RETAINED PORTIONS OF THE
FETUS.
SONOGRAPHICALLY
ENLARGED UTERUS
EMPTY ILL DEFINED G.SAC
SAC WITH INTERNAL ECHOES
NO SAC
LARGE CLUMPS OF ECHOES
49. 19/06/07 49
COMPLETE ABORTION
COMPLETE EXPULSION OF THE PRODUCTS.
UTERUS CONTRACTS AND BLEEDING
STOPS.
SONOGRAPHICALLY
ENLARGED UTERUS
G.SAC OR FETAL POLE NOT IDENTIFIED
PROMINENT THICKENING OF THE
CENTRAL CAVITY INTERFACE-Represents
decidual reaction
50. 19/06/07 50
INEVITABLE ABORTION
ABORTION IN PROGRESS
SONOGRAPHICALLY
CERVIX DILATED
SONOLUCENT SPACE SEEN AROUND SAC
FLUID - FLUID LEVEL
G.SAC SEEN AT THE LEVEL OF CERVIX
52. 19/06/07 52
MISSED ABORTION
RETENTION OF THE DEAD FETUS WITHIN THE
UTERUS
sonographically
UT SMALL FOR DATES
EARLY MISSED ABORTION - G.SAC CONTAINS
F.POLE ,NO CARDIAC ACTIVITY
53. 19/06/07 53
SEPTIC ABORTION
INFECTED PRODUCTS OF CONCEPTION AS
A RESULT OF SURGICAL ABORTION WITH
NON-STERILE DEVICES
USG
UT ENLARGED
SHADOWING (due to gas forming
organisms/retained bony fragments)
FLUID IN THE POD
UTERUS PERFORATION OCCURS
57. 19/06/07 57
Sonographic Findings
SPECIFIC FEATURE
LIVEEMBRYOIN THEADNEXA
NON SPECIFIC FEATURES (CORRELATE WITH BETA
HCG).
EMPTY UTERUS
PSEUDOGESTATIONAL SAC
PARTICULATEASCITES
ADNEXAL MASS
ECTOPICTUBALRING
LOCAL TENDERNESS
NON-SUPPORTIVE FEATURES
LIVEINTRAUTERINEPREGNANCY
62. 19/06/07 62
Local Tenderness: The probe is used to
apply light pressure on the mass. This almost
always elicits a sense of pain but this can
occur in other inflammatory or expanding
masses such as haemorrhagic corpus luteum
Ectopic Tubal Ring: Concentric ring created
by the trophoblast of the ectopic pregnancy
surrounding the chorionic sac. This ring is
usually within a haematoma that may be
confined to the fallopian tube or may extend
outside it
63. 19/06/07 63
Endovaginal
sonogram shows a
color Doppler image
of the adnexa with
the ring-of-fire
sign. Marked
hyperemia is present
throughout the wall
of an enlarged
fallopian tube.
64. 19/06/07 64
Interstitial pregnancy
Occurs in the intramural portion of the
tube where it traverses the wall of the
uterus to enter the endometrial canal
Interstitial line sign: Thin echogenic
line extending from the endometrial
canal upto the cornual sac
66. 19/06/07 66
BLIGHTED OVUM
G.SAC WITH ANEMBRYONIC
GESTATION
USG
TROPHOBLASTIC RING IN THE UTERUS
NO FETAL POLE
SAC WILL NOT INCREASE IN SIZE
DISCREPANCY B/W SAC SIZE AND
UTERUS SIZE
67. 19/06/07 67
FLUID-FLUID LEVEL
DEFINITIVE OF
FETAL DEATH
CRITERIA IN TAS
MSD>25mm – NO FETUS
MSD>20mm – NO Y.SAC
CRITERIA IN TVS
MSD>16mm-NO FETUS
MSD>8mm-NO Y.S
BLIGHTED OVUM
68. 19/06/07 68
INTRA AND PERISAC
BLEEDING
BLEEDING WITHIN THE AMNIOTIC SAC
ADJACENT TO FETUS
B/W AMNION AND CHORION
SUBCHORIONIC
B/W G.SAC AND DECIDUAL REACTION
SITES
71. 19/06/07 71
Hydatidiform Mole
Risk Factors :
Advancing maternal age
Prior h/o molar pregnancy
Asian ancestry
Increased paternal age
Can be partial or complete
1. A complete molar pregnancy :occurs when a sperm fertilizes an
empty ovum, resulting in the development of only placental parts. A
complete mole is completely paternal in origin, with a karyotype of
usually 46 XX.
2. A partial mole results when two sperms fertilize a single ovum
results in development of certain or all fetal parts.
predominantly has a triploid karyotype of 69XXX or 69 XXY:
73. 19/06/07 73
Symptoms
Vaginal bleeding,
Hyperemesis,
Passage of grape like vesicles per vagina
Uterus larger than dates
With the advent of high-resolution transvaginal
ultrasound imaging, molar pregnancy is now being
diagnosed at a much earlier stage before all the
classical symptoms develop.
partial molar pregnancy:
usually asymptomatic
may present with symptoms of a missed or incomplete abortion.
75. 19/06/07 75
Spectral waveform analysis in a case
of gestational trophoblastic neoplasm
The spectral waveform within the
cystic mass in the uterus reveals a
mixed arterial and venous waveform,
with low resistance arterial flow.
76. 19/06/07 76
First Trimester masses
Ovarian masses:
Most common is corpus luteum cyst.
It forms in the secretory phase of the
menstrual cycle and increases in size if
pregnancy occurs.
Usually <5 cm
Thin walled unilocular cyst.
Regress or decrease in size at 16 to 18
78. 19/06/07 78
Uterine masses:
Are often associated with localised pain and
tenderness.
Differentiated from focal myometrial
contractions by the transient nature of
myometrial contractions.A repeat examination
20 to 30 minutes later will reveal
disappearance of the focal contraction while
fibroids persist.
81. 19/06/07 81
Nuchal Translucency
The appearance of lucency in the neck has
been used in the diagnosis of fetal aneuploidy.
Septated lucency in women younger than 35
yrs had the greatest risk for aneuploidy
Increased NT in the presence of normal
chromosomes is associated with
Cardiac Septal Defects
Diaphragmatic hernia
Renal Anomalies
Abdominal wall defects
Hypokinesia syndromes
90. 19/06/07 90
Other markers
Flow in ductus venosus:
Three waves-s wave(ventricular systole)
d wave(ventricular diastole)
a wave(atrial contraction)
It is possible to assess ductus venosus blood
flow by TAS and TVS
A right ventral midsagittal plane of the fetal
trunk is obtained and the pulsed doppler gate
is placed in the distal portion of the umbilical
sinus
96. 19/06/07 96
CNS Defects
By 8 weeks the brain cavities appear as
large cystic spaces within the head(on
TVS)
Choroid plexus becomes visible from 8
weeks and undergoes rapid growth.
By 10 wks the falx cerebri appear to
divide the midline and the cerebellum
can be seen.
97. 19/06/07 97
The onset of ossification 0f the cranial vault is at 10
weeks gestation
The development of the corpus callosum begins at 12
to 13 wks
The ratio of ventricles to cerebral hemisphere is
greater in the first TM as compared to the second.
At 12 weeks the posterior horn/hemisphere ratio ~
0.6 and a small rim of cerebral cortex appears
surrounding the lateral ventricles.At this stage the
choroid plexus is echogenic and fills all but the
frontal horns of the lateral ventricle.
99. 19/06/07 99
ACRANIA: Absence of membranous
portion of the bone. Only a thin layer
covers the brain. An abnormally shaped
cephalic pole seen on ultrasound .The
base of cranium and orbits are normal
EXENCEPHALY: Large portion of the
brain is present, but the covering
membrane is no longer visible.
100. 19/06/07 100
Anencephaly
Incidence:1 in 1000 births
Characterised by absence of cranial vault, cerebral
hemispheres and the diencephalic stuctures and
their replacement by a flattened amorphous vascular
neural mass (area cerebrovasculosa)
In all cases there is absence of normally formed skin,
cranial bones and brain superior to orbits
Using TVS,sonographic visible ossification of frontal
bones is not apparent until 11.5 wks and therefore
should not be diagnosed before this age
102. 19/06/07 102
Ossification of the
face and orbits looks
like Frog’s eyes due
to failure of
ossification of the
membraous bones of
skull above the orbit
105. 19/06/07 105
Encephalocele
A bony defect in the skull, usually
midline ,with accompanying protrusion of
intracranial contents.
Occipital (75%)
Frontal (13%)
Parietal (12%)
Rare sites:
base of skull,orbits,nose,mouth
107. 19/06/07 107
Holoprosencephaly
Arises from incomplete cleavage of
forebrain.
The cerebral hemispheres become
visible on USG from 7 wks ,so the
abnormality could theoretically be
diagnosed from this time, but this may
not be always possible.
108. 19/06/07 108
Alobar type: Lack of midline division of the brain
anteriorly by the falx,prominent,fused
thalami,crescent shaped frontal cortex along with
facial anomalies(cyclopia/median cleft lip)
Semilobar type :Posterior partial separation of
the two hemispheres and ventricles,with incomplete
fusion of the thalami
Lobar type :Subtle diagnosis on ultrasound with
absence of septum pellucidum as the only feature.
110. 19/06/07 110
Spine
The spine will be seen as two echogenic parallel lines
from 7 weeks of GA on TVS
TVS allows visualisation of ossification centres two
weeks earlier than TAS
The 3 ossification centres are present from 9 wks
may be seen on TVS as small areas slightly more
echogenic than the surrounding tissues
Ossification of the spine should be seen clearly in the
cervical vertebrae at 11 weeks and echogenicity
gradually down the spine until the lumbosacral region
is visualised at 13 weeks.
111. 19/06/07 111
The neural tube normally closes by 6
weeks and failure of this process
results in spina bifida.
Cranial findings are
Lemon sign
Small BPD
Ventriculomegaly with hanging choroid plexus
Banana Sign
113. 19/06/07 113
Respiratory System
The diaphragm is formed and the
pleuroperitoneal cavity divides by 9 wks
gestation
Normal lungs seen in the chest surrounding
the heart at 11weeks
The left lung lies behind the heart and is
smaller than the right lung
Echogenicity > liver and =bowel
114. 19/06/07 114
CDH:
If there is a defect in the diaphragm, the abdominal
contents may herniate into the chest from around 10
to 12 wks of gestation. This occurs after the
intestines return to the abdominal cavity from the
umbilical cord
Associated chromosomal defects:
Trisomy 21,Trisomy 18 and Trisomy 13
117. 19/06/07 117
GIT
Account for 15% of congenital abnormalities identifiable by
ultrasound.
The physiological herniation of midgut into the
umbilical cord is a normal feature of intestinal development,
leading to elongation and rotation of the bowel.
Week 7: Initial sign of herniation of the gut seen as a
thickening of the cord containing a slight echogenic area at the
abdominal insertion.
8 Weeks 3 days- 10 weeks 4 days: herniation
occurs
10 weeks 4 days -11 weeks 5 days: gut
retractedinto the abdominal cavity.
Stomach seen as a small hypoechoic area on the left side of the
abdomen from 8th week onwards
119. 19/06/07 119
Transverse view of
the abdomen at 13
wks with a normally
positioned stomach
on the left.The spine
and ribs are seen in
cross section.
120. 19/06/07 120
OMPHALOCEOLE
Sac formed by peritoneum & amnion
Various abd viscera (usually liver) herniate into
sac
Location – midline
Cord insertion into apex of defect
Usually assosiated with chromosomal anomaly &
extra GI anomaly
122. 19/06/07 122
GASTROSCHISIS
Para umbilical abdominal wall defect (right
side)
Fetal intestine herniate into amniotic cavity
No covering membrane seen as in
omphaloceole
Diagnosis possible from 9 wks if free floating
intestines are visualised
Cord insertion is normal
Chromosomal anomalies nil
124. 19/06/07 124
Genitourinary System
The fetal kidneys have attained their adult form and position by 12 wks
Initially they appear as oval structures in the posterior mid abdomen on
both sides of the fetal spine on transverse plane
In the longitudinal axis they appear along the paravertebral plane of
the spine.
Recently TVS has enabled earlier and more detailed visualization ,as
early as 10 wks.
Its echogenicity is similar to that of fetal lungs in first trimester.
Not possible to differentiate normal structures of kidney,like cortex
and pelvis
126. 19/06/07 126
The normal fetal urinary bladder is identified by TAS
from as early as 10 weeks as a spherical hypoechoic
mass within the centre of the fetal pelvis.
There is a significant increase in bladder length with
CRL, but at 10 to 14 wks, the longitudinal diameter of
the bladder is always <6mm.
Visualization of the bladder is made easy by the
identification of the intra abdominal portion of the
umbilical arteries using colour doppler.
It is essential to differentiate bladder from other
cystic lesions of the pelvis
128. 19/06/07 128
Renal Agenesis
Amniotic fluid in the first trimester is
predorminantly a filtrate of fetal blood
across the skin.
Fetal urine production begins at 11 to 13 wks
and around this time the fetal skin starts to
keratinise.
Therefore from 13 to 20 wks there is a
gradual change in the amniotic fluid
component from fetal filtrate to urine.
Hence oligohydramnios is not seen before 16
weeks
129. 19/06/07 129
The diagnosis of renal agenesis depends
on the inability to see a kidney or
bladder in the first TM
Doppler study of renal arteries also help
Adrenals appear as hypoechoic masses
mass of discoid shape,which lies flat in
the renal bed.This can mimic kidneys
and are better differentiated in the
first TM
130. 19/06/07 130
Infantile polycystic Kidneys
Bilaterally enlarged, homogenously echogenic
kidneys.
Cysts may be difficult to identify.
May be part of Meckel Gruber Syndrome.
Usually detected in the second TM.
131. 19/06/07 131
Multicystic dysplastic
Kidneys
The nephrons and collecting tubules are
dysplastic
Unilateral/bilateral/segmental
Kidneys are large and multicystic in
early stages.Later becomes small and
echogenic
The cysts are of varying sizes and have
septae between them.
133. 19/06/07 133
Megacystis
The longitudinal diameter of normal bladder is
6mm in the 1st TM.
Bladder diameter to CRL ratio<10%
Causes:
PUV in males
Cloacal Anomaly in females
Urethral atresia
Megacystis microcolon intestinal hypoperistalsis
syndrome
135. 19/06/07 135
Musculoskeletal System
Small limb buds of low echogenecity are seen
from 7 wks gestation
By 9 weeks, fingers and toes are detectable
From 10 wks, limbs elongate and typical
posture of the foetus appears
By 11 wks, the limb bones appear to ossify and
all the long bones are consistently seen.
136. 19/06/07 136
The normal lengths of humerus, radius,
ulna,femur,tibia and fibula are similar at 11 to
14 wks
Increase linearly with gestation from around
6mm at 11 weeks to 13mm at 14 weeks.
By 11 wks the foot position in relation to tibia
and fibula is well established.
Spine ossifies by 11 weeks, skull by 12 weeks
ribs by 13 wks
138. 19/06/07 138
Skeletal Dysplasias
Heterogeneous group of disorders of
bone maldevelopment resulting in
abnormal growth and shape of the fetal
skeleton.
Findings are:
Disproportion between the body and limb length
Lack of limb movements
Failure of ossification of limbs and vertebra
Skin edema
139. 19/06/07 139
Fetal Akinesia Deformation Sequence
Heterogeous group of conditions resulting in
multiple joint contractures, and fixed flexion
or extension deformities of the
hips,knees,elbows and wrists.
The sequence includes Congenital lethal
arthrogryposis,multiple pterygium, and pena Shokier
syndromes.
Diagnosed in the 2nd and 3rd TM.
Associated with increased NT.
140. 19/06/07 140
Talipes Equinovrus
Foot adducted and
plantar flexed in the
sagittal and coronal
planes.
Earliest diagnosis at
13 wks
Metatarsal long axis
is in the same plane
as the tibia and
fibula
141. 19/06/07 141
Conclusion
It is now possible to examine the fetal
anatomy in the first TM.
Certain abnormalities are visualised as
early as 9 wks.
The optimal GA to visualize fetal anatomy
is at 12-13 wks(by both TAS and TVS).
142. 19/06/07 142
Protocol for first TM scan in
a low risk group
CNS:
Obtain BPD view
Normal skull outline
Presence of falx cerebri
2 choroid plexus
Face:
Profile
Transverse view(orbit and face)
Fetal neck:
Measure NT
Heart:
Fetal heart rate and rhythm
Situs
Axis
Four chamber view
Thorax:
Location of stomach
GIT:
Stomach
Physiologic herniation upto 11 wks+5d
but should not contain liver
GUT:
Bladder<7mm
Musculoskeletal
system:
4 limbs
2 hands and 2 feet
143. 19/06/07 143
The concept of a first TM scan to
solely confirm viability or date the
pregnancy should be abandoned and
an attempt should be made to
visualize the fetal anatomy