Diagnostic Ultrasound: Second Edition (Two-Volume Set )

PART I ● THE BASICS
	Physics and Bioeffects
		HISTORY
		THE PHYSICS OF ULTRASOUND
		PULSE-ECHO TECHNIQUES
		DOPPLER TECHNIQUES
		DUPLEX SCANNING
		COLOR FLOW IMAGING
		SPECIALIZED AND EMERGING PROCEDURES
		QUALITY CONTROL IN ULTRASONIC IMAGING
		ARTIFACTS IN ULTRASONIC IMAGING
		BIOEFFECTS OF ULTRASOUND
		REFERENCES
		BIBLIOGRAPHY
	Artifacts
		INTRODUCTION
		BASIC ASSUMPTION
		REVERBERATION ARTIFACTS
		MIRROR IMAGE ARTIFACTS
		RING-DOWN ARTIFACTS
		REFRACTION ARTIFACTS
		SHADOWING AND ENHANCEMENT
		BEAM-WIDTH ARTIFACT
		PROPAGATION SPEED ERRORS
		PULSED DOPPLER ARTIFACTS
		COLOR DOPPLER ARTIFACTS
		SUMMARY
		REFERENCES
	Contrast-Enhanced UltrasoundImaging
		BASIC PRINCIPLES OF CONTRAST AGENTS
		CONTRAST-SPECIFIC IMAGING TECHNOLOGY
		CLINICAL APPLICATIONS
		SUMMARY
		REFERENCES
	Three-Dimensional Ultrasound
in Obstetrics
		INTRODUCTION
		ACQUISITION OF VOLUME DATA
		THE FIRST TRIMESTER
		THE FACE
		THE CNS
		THE SKELETON
		THE HEART
		VOLUME MEASUREMENTS
		CONCLUSION
		ACKNOWLEDGMENTS
		REFERENCES
PART II ● INTERVENTIONAL / INTRAOPERATIVEULTRASOUND
	Invasive Ultrasound Principles(Biopsy, Aspiration, andDrainage)
		WHY ULTRASOUND?
		PREPROCEDURAL PREPARATION
		GUIDANCE METHODS
		NEEDLE VISUALIZATION
		NEEDLE SELECTION
		TECHNIQUE
		SPECIFIC ANATOMIC REGIONS: BIOPSY
		ASPIRATION
		DRAINAGE
		REFERENCES
	Invasive UltrasoundPrinciples (Obstetrics/Gynecology)
		INTRODUCTION
		CHORIONIC VILLUS SAMPLING
			Transcervical Approach
			Transabdominal Approach
			Complications
			Second and Third Trimester Placental Biopsy
		AMNIOCENTESIS
			Technique
			Needle Selection
			Maternal Complications
			Fetal Complications
		EARLY AMNIOCENTESIS
			Amniotic Fluid Volume
			Technique
			Complications
		AMNIOCENTESIS IN TWIN GESTATIONS
			Technique
			Complications
		MULTIFETAL PREGNANCY REDUCTION
			Technique
			Complications
		LASER ABLATION OF AN ACARDIAC TWIN
		PERCUTANEOUS UMBILICAL BLOOD SAMPLING
			Indications
			Technique
			Complications
		FETAL SKIN BIOPSY
			Technique
			Complications
		FETAL MUSCLE BIOPSY
		FETAL LIVER BIOPSY
		FETOAMNIOTIC SHUNTING
			Efficacy
			Technique
		GYNECOLOGY
			Oocyte Retrieval
			Uterine Transfer
			Fallopian Tube Catheterization
			Sonohysterography
			Ovarian Cyst Aspiration
			Drainage of Pelvic Abscesses
			Intraoperative Ultrasound Guidance
		REFERENCES
	Intraoperative
Ultrasonography
		INTRODUCTION
		GENERAL PRINCIPLES
			Equipment
			Sterilization
			Technique
		LIVER
		GALLBLADDER/BILIARY
		PANCREAS
		RENAL
		NEUROSURGERY
			Brain
			Spine
		OTHER APPLICATIONS
		CONCLUSION
		REFERENCES
	Ultrasound-Guided Percutaneous
Tissue Ablation
		INTRODUCTION
		TECHNIQUE FOR PERCUTANEOUS APPROACHESTO ABLATION IN THE LIVER
			Materials and Protocol
			Procedure Notes
		PERCUTANEOUS ETHANOL INJECTIONIN PRIMARY AND METASTATIC LIVER TUMORS
			Method of Treatment
			Volume of Ethanol
			Follow-up
			Efficacy
			Metastatic Disease of the Liver
			Complications
		OTHER PERCUTANEOUS LIQUIDSAND APPLICATIONS
			Other Liquids for Percutaneous Injection
			Hepatic and Renal Cysts
			Parathyroid Ablation
		INTERSTITIAL RADIOTHERAPY
		INTERSTITIAL LASER THERAPY
			Liver
			Breast
			Prostate
		RF ELECTROCAUTERY
			Liver
			Kidney
			Breast
			Other Uses
		CRYOTHERAPY
			Liver
			Complications
			Results
			Breast
			Prostate
		OTHER TREATMENTS
			High-Intensity Focused US
			Microwave Coagulation Hyperthermia
		CONCLUSION
		REFERENCES
PART III ● CHEST/NECK
	Breast
		NORMAL ANATOMY
			General Considerations
			Morphologic Variations with Age and Hormonal Changes
			Ultrasonographic Characteristics of the Normal Breast
			The Intact Breast Implant
		ULTRASONOGRAPHIC PITFALLS
			Technique
			Localization of the Lesion
			Cysts
			Solid Masses
			Doppler Technique
			Implants
		ULTRASONOGRAPHIC ABNORMALITIES
			Benign Cystic Masses
			Ductal Abnormalities
			Solid Masses
			Benign Solid Masses
			Malignant Masses
			The Ruptured Silicone Gel Implant
		REFERENCES
	Diaphragm and
Chest
		INTRODUCTION
		THE DIAPHRAGM
			Normal Anatomy
			Pitfalls
			Motion of the Diaphragm
			Pathological Conditions
		PLEURAL SPACE
			Normal Anatomy
			Pitfalls
			Pathological Conditions
			US-Guided Invasive Procedures
		LUNG PARENCHYMA
			Normal Anatomy
			Pathological Conditions
			US-Guided Biopsy
		MEDIASTINUM
			Normal Anatomy
			Pathological Conditions
			US-Guided Biopsy
		REFERENCES
	Thyroid, Parathyroid, and Other
Glands
		INTRODUCTION
		THYROID
			Anatomy and Embryology
			US Technique
			Normal Thyroid and Imaging Pitfalls
			Nodular Thyroid Disease
			Diffuse Thyroid Disease
			Biopsy and Ablation of Thyroid Lesions
			US Technique
		PARATHYROID GLANDS
			Anatomy
			US Technique
			Primary Hyperparathyroidism
			Secondary Hyperparathyroidism
			US-Guided Biopsy and Therapy of Parathyroid Glands
		OTHER NECK MASSES
			Congenital Neck Masses
			Other Cystic Neck Masses
			Solid Neck Masses
		LYMPH NODES
			Normal and Abnormal Shapes
			FNA of Nodes
			Intraoperative Localization of Nodes
		REFERENCES
PART IV ● ABDOMEN/GASTROINTESTINAL SYSTEM
	Ultrasound and the Trauma
Patient
		ABDOMINAL TRAUMA
			Historical Perspective
			Anatomy
			Procedure
			Interpretation
			Free Fluid Scoring Methods
			Parenchymal Injury
			Serial Examinations
			Pitfalls
		THORACIC TRAUMA
			Historical Perspective
			Anatomy
			Procedure
			Interpretation
			Pitfalls
		FUTURE RESEARCH
		REFERENCES
	Gastrointestinal Tract and
Peritoneal Cavity
		INTRODUCTION
		GASTROINTESTINAL TRACT
			Technical Aspects
			Sonographic Features
			Color Doppler of the Gastrointestinal Tract
		DISEASE STATES
			Acute Appendicitis
		DIAGNOSTIC EXAMINATION
			Sonographic Criteria for Acute Appendicitis
			Pitfalls
			Complications of Appendicitis
			Acute Diverticulitis
		OTHER DISORDERS
			Inflammatory Bowel Disease—Crohn’s Disease
			Mesenteric Adenitis
			Pneumatosis Intestinalis
			Ischemic Bowel Disease
			Right-Sided Segmental Omental Infarctionand Epiploic Appendagitis
			Enteritis or Colitis
			Gastrointestinal Tract Tumors
			Gastrointestinal Obstruction
			Intussusception
		PERITONEAL CAVITY
			Ultrasound Technique
			Intraperitoneal Fluid Collections
			Intraperitoneal Fluid
			Intraperitoneal Hemorrhage
			Intraperitoneal Abscesses
			Peritoneal Inclusion Cysts
		PERITONEAL TUMORS
		REFERENCES
	Endoscopic Ultrasound
		INTRODUCTION
		OVERVIEW
			High-Frequency Ultrasound and the GI Tract Wall
			EUS-Guided FNA
			Contraindications
			Complications
			Instruments
		ESOPHAGUS CANCER STAGING
			Technique
			Comparison with CT
		LYMPH NODE DIFFERENTIAL DIAGNOSIS
			Limitations
		PORTAL HYPERTENSION
		STOMACH
			Normal Anatomy
			Pitfalls
			Preoperative Staging of Gastric Cancer
			Gastric Lymphoma Staging
			Enlarged Gastric Folds
		RECTUM AND ANUS
		PANCREATICOBILIARY SYSTEM
			Normal Anatomy
			Pancreatic Cancer
			Differential Diagnosis of Pancreatic Tumors
			Pancreatic Ductal Imaging
			Clinical Utility for Pancreatic Lesions
			Ampullary Cancer
			Pancreatic Endocrine Tumors
			Pancreatitis
			Bile Duct Cancer
			Gallbladder Polyps
			Gallbladder Cancer
			CBD Stones
			Biliary Sludge
		EUS-GUIDED INVASIVE PROCEDURES
			Echoendoscopes
			Needles
			Aspiration Technique
			Biopsy Techniques
		CLINICAL APPLICATIONS OF FNA
			Lymph Nodes
			Submucosal Lesions
			Pancreatic Lesions
			Other Lesions
			Injection Techniques
			Cholangiopancreatography
			Celiac Plexus Block
			Botulinum Toxin Injection for Achalasia
		FUTURE APPLICATIONS
			Endoscopic Mucosal Resection
			EUS and Upper GI Bleeding
			EUS-Guided Antitumor Injection Therapy
		SUMMARY AND CONCLUSION
		REFERENCES
	Ultrasound Evaluation of
the Transplanted Liver,
Kidney, and Pancreas
		INTRODUCTION
		ULTRASONOGRAPHIC TRANSPLANT ANATOMY
		ULTRASONOGRAPHIC TECHNIQUE
			Grayscale Technique
			Doppler Technique
			Scale Setting (Pulse Repetition Frequency)
			Doppler Gain
			Filtration Level
			Optimizing Angle of Insonation Relative toVessel Orientation
			Minimizing Transducer Pressure
		LIVER TRANSPLANTATION
			Preoperative Assessment
			Ultrasonographic Anatomy
			Postoperative Assessment
			Complications
			Liver Transplant Biopsy
		RENAL TRANSPLANTATION
			Ultrasonographic Technique
			Ultrasonographic Anatomy
			Complications
			Renal Transplant Biopsy
		PANCREAS TRANSPLANTATION
			Ultrasonographic Anatomy
			Complications
			Pancreas Transplant Biopsy
		POSTTRANSPLANTATIONLYMPHOPROLIFERATIVE DISORDER
		CONCLUSION
		ACKNOWLEDGMENTS
		REFERENCES
	Liver
		INTRODUCTION
		TECHNIQUE
		NORMAL ANATOMY
			Lobar and Segmental Anatomy
			Hepatic Ligaments
			Hepatic Vasculature
			Echo Pattern and Size of the Liver
		DEVELOPMENTAL ANOMALIES AND ANATOMICVARIATIONS OF THE LOBES AND FISSURES
			Pitfalls
		ARTIFACTS
		FOCAL ABNORMALITIES
			Congenital Hepatic Cysts
			Benign Neoplasms
			Malignant Neoplasms
			Metastatic Disease
			Lymphoma
			Leukemia and Chloroma
			Liver Lesions in Patients with Known ExtrahepaticMalignancy
		INFECTIOUS DISEASES
			Viral Hepatitis
			Pyogenic Abscess
			Amebic Abscess
			Echinococcal Cyst (Hydatid Disease)
			Schistosomiasis
			Toxocariasis (Visceral Larva Migrans)
			Tuberculosis
			Candidiasis
			Pneumocystis carinii Infection
			Chronic Granulomatous Disease
		DIFFUSE LIVER DISEASE
			Fatty Liver (Hepatic Steatosis)
			Hepatic Fibrosis
			Alcoholic Hepatitis
			Chronic Hepatitis
			Cirrhosis
			Biliary Cirrhosis
			Other Diffuse Diseases
		VASCULAR ABNORMALITIES AND DISORDERS
			Portal Hypertension
			Portal Vein Thrombosis
			Cavernous Transformation of the Portal Vein
			Portal Vein Aneurysm
			Budd–Chiari Syndrome
			Hepatic Veno-Occlusive Disease
			Intrahepatic Portosystemic Venous Shunt
			Hepatic Arterial–Portal Fistula
			Hepatic Artery Aneurysm and Pseudoaneurysm
			Hereditary Hemorrhagic Telangiectasia
			Increased Hepatic Artery Flow: “Arterialization”
			Effect of a Meal on Hepatic Artery Flow
			Liver in Cardiac Disease
			Hepatic Infarction
			Peliosis Hepatis
			Portal Venous Gas
		HEPATIC CALCIFICATIONS
		HEPATIC TRAUMA
		SURGICAL PORTOSYSTEMIC SHUNTS
		TRANSJUGULAR INTRAHEPATICPORTOSYSTEMIC SHUNTS
		INTRAOPERATIVE ULTRASOUND
		CONTRAST-ENHANCED SONOGRAPHYOF LIVER MASSES
		REFERENCES
	Gallbladder and
Bile Ducts
		INTRODUCTION
		GALLBLADDER
			Normal Anatomy
			Scanning Technique
			Congenital Abnormalities
			Abnormalities of Size
			Cholelithiasis
			Gallbladder Sludge
			Hemobilia
			Milk of Calcium Bile
			Acute Cholecystitis
			Acute Acalculous Cholecystitis
			Xanthogranulomatous Cholecystitis
			Torsion
			Chronic Cholecystitis
			Chronic Acalculous Cholecystitis
			Abnormalities of the Gallbladder Wall
			Hyperplastic Cholecystoses
			Benign Neoplasms
			Malignant Neoplasms
			Nonvisualization of the Gallbladder
		INTRAHEPATIC BILE DUCTS
			Normal Anatomy
			Intrahepatic Biliary Dilatation
			Cholangitis
			Caroli’s Disease
		EXTRAHEPATIC BILE DUCTS
			Normal Anatomy
			Scanning Technique
			Congenital Abnormalities
			Biliary Obstruction
			Choledocholithiasis
			Common Duct Sludge
			Biliary Parasites
			Bile Duct Wall Thickening
			Common Bile Duct Varices
			Biliary Neoplasms
			Benign Neoplasms
			Biloma
			Laparoscopic Ultrasound and EndoscopicUltrasound of the Common Bile Duct
			Intraductal Sonography and Three-DimensionalUltrasound of the Common Bile Duct
		REFERENCES
PART V ● VASCULAR SYSTEM
	Peripheral VascularSystem
		BASIC ANATOMY
			Venous Anatomy of the Lower Extremities
			Arterial Anatomy of the Lower Extremities
			Venous Anatomy of the Upper Extremities
			Arterial Anatomy of the Upper Extremities
		PERIPHERAL VENOUS SONOGRAPHY
			Normal Gray Scale Appearance
			Venous Blood Flow Abnormalities
			Venous Thrombosis
			Lower Extremity Scanning Technique
			Upper Extremity Scanning Technique
			Diagnostic Criteria for Acute Deep Venous Thrombosis
			Chronic Changes after Acute Thrombosis
			Pitfalls of Venous Sonography
			Clinical and Imaging Strategies
			Follow-up Sonography Studies
		ARTERIAL SONOGRAPHY EVALUATIONS
			Blood Flow Patterns in the Lower Extremity Arteries
			Blood Flow Patterns in the Upper Extremity Arteries
			Arterial Stenosis and Occlusion
		PERIPHERAL ARTERIAL DISEASE
			Native Disease
			Synthetic Vascular Bypass Grafts
			Autologous Vein Grafts
			Percutaneous Angioplasty and Atherectomy
			Aneurysms
			Dissections, Arteriovenous Fistulas, andPseudoaneurysms
		REFERENCES
	Carotid
		INTRODUCTION
		NORMAL ANATOMY
		EXAMINATION TECHNIQUE
			Patient Positioning
			Gray-Scale Examination
			Color and Power Doppler Evaluation
			Spectral Doppler Analysis
			VA Evaluation
		DIAGNOSTIC ISSUES IN CAROTID ULTRASOUND
			Indications
			Diagnostic Criteria—Carotid
			Diagnostic Criteria—Vertebral
			Comparison with Magnetic Resonance Angiography,CT Angiography, and Conventional Angiography
			Plaque Characterization
			Surgery Based upon Sonography Alone
			Alternative Interventions for Carotid Atherosclerosis
			Risk and Cost of Diagnostic Workup and Treatment
			Potential of Microbubble Contrast Agents forCarotid Evaluation
		PITFALLS AND ARTIFACTS
			Anatomic Pitfalls
			Physiologic Pitfalls
			Technical Errors
			Artifacts
			Pitfalls in Grading Carotid Stenosis
			Pitfalls in Grading VA Stenosis
		CONCLUSIONS
		ACKNOWLEDGMENTS
		REFERENCES
	Diagnostic Criteria for
Transcranial Doppler
Ultrasound
		INTRODUCTION
		NORMAL VALUES
		DIAGNOSIS OF INTRACRANIAL VASCULAR DISEASE
			Stenosis
			Middle Cerebral Artery
			Anterior Cerebral Artery
			Terminal ICA and ICA Siphon
			Posterior Cerebral Artery
			Basilar Artery
			Vertebral Artery
			Occlusion
		MONITORING VASOSPASM AND HYPEREMIA
			Vasospasm
			Middle Cerebral Artery
			Other Intracranial Arteries
			Hyperemia
		ASSESSMENT OF INTRACRANIALCOLLATERAL PATHWAYS
			Anterior Communicating Artery
			Posterior Communicating Artery
			Ophthalmic Artery
		DETECTION OF CEREBRAL EMBOLI
		INCREASED ICP
		MONITORING CEREBRAL CIRCULATORY ARREST
		DOCUMENTATION OF SUBCLAVIAN STEAL
		DETECTION OF RIGHT-TO-LEFT SHUNTS
		CONCLUSION
		REFERENCES
PART VI ● PEDIATRIC ULTRASOUND
	Pediatric Brain
		INTRODUCTION
		TECHNIQUE AND ANATOMY
			Alternate Sonographic Imaging Techniques
			Normal Variants and Artifacts
		INTRACRANIAL HEMORRHAGE
		HYPOXIC–ISCHEMIC ENCEPHALOPATHY
		CONGENITAL ANOMALIES
		VASCULAR ABNORMALITIES
			Color Doppler Ultrasound of Extra-AxialFluid Collections
		INTRACRANIAL INFECTION
		INTRAOPERATIVE ULTRASOUND
		SUTURE EVALUATION WITH ULTRASOUND
			Cephalohematoma
		CONCLUSION
		REFERENCES
	Pediatric Neck
		INTRODUCTION
		SCANNING TECHNIQUE
		NORMAL GROSS ANATOMY
		INFLAMMATORY DISEASE
		CERVICAL MASSES
			Fibromatosis Colli
			Thyroglossal Duct Cyst
			Branchial Cleft Cyst
		LYMPHATIC MALFORMATION
			Cervical Thymic Cysts
			Cervical Thymus
			Hemangiomas and Hemangiolymphangiomas
			Teratomas, Dermoid Cysts, and Epidermoid Cysts
			Carotid Body Tumors
			Lymphoma
			Neurogenic Tumors
			Rhabdomyosarcoma
		PAROTID GLAND
		THYROID AND PARATHYROID GLANDS
			Normal Anatomy and Congenital Abnormalities
			Thyroid Nodules
			Malignant Thyroid Nodules
			Diffuse Thyroid Disease
			Parathyroid Glands and Hyperparathyroidism
		CONCLUSION
		ACKNOWLEDGMENT
		REFERENCES
	Pediatric Spine
		INTRODUCTION
		CLASSIFICATION OF DEFECTS
		EMBRYOLOGY
		INDICATIONS FOR ULTRASOUND
		TECHNIQUE
		NORMAL ANATOMY
		CONGENITAL ANOMALIES
			Spinal Dysraphism without Mass
			Spinal Dysraphism with a Skin-Covered Mass
			Spinal Dysraphism with a Non–Skin-Covered Mass
		ACQUIRED ABNORMALITIES OF THE SPINAL CORD
			Birth Injury: Intraspinal Hematoma and Cord Injury
			Lumbar Puncture
		REFERENCES
	Pediatric Chest
		INTRODUCTION
		TECHNIQUE
			Imaging Approaches
			Transducers
		NORMAL ANATOMY
			Thymus
			Pleura and Lung
			Great Vessels
			Diaphragm
		INDICATIONS
		PLEURAL DISEASES
			Pleural Effusions
			Pleural Masses
			Pneumothorax
		PULMONARY PARENCHYMA
			Consolidation and Atelectasis
			Congenital Parenchymal Masses
			Tumors
		MEDIASTINUM
		THORACIC GREAT VESSELS
			Venous Thrombosis
			Arterial Stenosis and Aneurysms
		DIAPHRAGMATIC LESIONS
			Diaphragmatic Hernias
			Eventration
			Paralysis
			Juxtadiaphragmatic Masses
		CHEST-WALL LESIONS
			Soft-Tissue Masses
			Osseous Lesions
		REFERENCES
	Pediatric Liver, Spleen, and
Pancreas
		INTRODUCTION
		LIVER
			Hepatic Neoplasms
			Parenchymal Disease
			Cavernous Transformation of the Portal Vein
			Hepatic Trauma
		GALLBLADDER AND BILIARY TREE
		SPLEEN
		PERITONEAL CAVITY
		PANCREAS
		REFERENCES
	Pediatric Bowel
		INTRODUCTION
		TECHNIQUE
		NORMAL ANATOMY
		MALROTATION
		DUPLICATION CYSTS
		HYPERTROPHIC PYLORIC STENOSIS
		INTUSSUSCEPTION
		NECROTIZING ENTEROCOLITIS
		CROHN’S DISEASE
		APPENDICITIS
		REFERENCES
	Ultrasonography of the
Pediatric Kidney and Adrenal
Gland
		INTRODUCTION
		NORMAL DEVELOPMENT
		CONGENITAL ANOMALIES
		HYDRONEPHROSIS
		URINARY TRACT INFECTION
		RENAL CYSTIC DISEASE
		RENAL NEOPLASMS
		MEDICAL RENAL DISEASE
		RENAL VEIN THROMBOSIS
		ABDOMINAL NEUROBLASTOMA
		ADRENAL HEMORRHAGE
		REFERENCES
	The Pediatric
Pelvis
		INTRODUCTION
		NORMAL DEVELOPMENT
			Uterus
			Ovaries
		NEONATAL PELVIS
			Ovarian Cysts
			Neonatal Ovarian Torsion
			Uterine Obstruction
			Hydronephrosis and Renal Anomalies
			Intersex States
		PELVIC ULTRASOUND POST INFANCY
			Pelvic Masses
			Ovarian Tumors
			Malignant Ovarian Tumors
			Massive Ovarian Edema
			Vaginal Bleeding Prior to Puberty
			Disorders of Puberty
		BLADDER
			Rhabdomyosarcoma
		SACROCOCCYGEAL TERATOMA
		REFERENCES
	Pediatric Musculoskeletal
Ultrasound
		PHYSICAL FINDINGS
		SCREENING
		ETIOLOGY
		TIMING OF ULTRASONOGRAPHIC EVALUATION
		TREATMENT
		HIP ANATOMY BY ULTRASOUND
		DEVELOPMENT OF HIP ULTRASOUND
		PERFORMING DYNAMIC HIP ULTRASOUND
			Coronal View, Mid-Acetabular Plane
			Transverse-Flexion View
			Transverse Neutral
			Posterior Lip, Coronal Flexion
		REPORTING HIP ULTRASOUND
		EXAMINING THE INFANT WHO IS UNDERGOINGTREATMENT
		EVALUATION OF HIP EFFUSIONS
			Technique
			Anatomy
			Findings
		INFECTIOUS PROCESSES
		PATELLA
		REFERENCES
PART VII ● MUSCULOSKELETAL SYSTEM
	Skeletal and Superficial SoftTissues
		NORMAL ANATOMY
			Normal Skin and Subcutaneous Tissues
			Normal Muscle
			Normal Joint
			Normal Bone
			Normal Nerve
		ARTIFACTS
		ABNORMAL SKIN
			Focal Skin Lesions
			Subcutaneous Tissue Lesions
		ABNORMAL MUSCLE
			ABNORMAL JOINT
			Joint Cavity
			Abnormal Tendon
			Abnormal Bursa
			Abnormal Ligament
		ABNORMAL BONE
		ABNORMAL NERVE
			Neural Mass
			Nerve Swelling
			Nerve Flattening
			Nerve Displacement or Compression
		REFERENCES
PART VIII ● PELVIS/GENITOURINARY TRACT
	Retroperitoneum, Pancreas,Aorta, and InferiorVena Cava
		RETROPERITONEUM
			Normal Anatomy
			Scanning Technique
			Pitfalls and Artifacts
			Pathology
		PANCREAS
			Embryology
			Normal Anatomy
			Scanning Technique
			Pitfalls and Artifacts
			Variants
			Pathology
		AORTA
			Normal Anatomy
			Scanning Technique
			Pitfalls and Artifacts
			Pathology
		INFERIOR VENA CAVA
			Embryology
			Normal Anatomy
			Scanning Technique
			Pitfalls and Artifacts
			Pathology
		REFERENCES
	The Spleen
	Urinary Tract
	Prostate
	Scrotum and
Testes
	The Penis
	Female Pelvis
	Postmenopausal
Pelvis
PART IX ● OBSTETRICS
	First TrimesterUltrasound
		INTRODUCTION
		EMBRYOLOGY PERTINENT TOEARLY SONOGRAPHIC FINDINGS
		NORMAL SONOGRAPHIC APPEARANCE
			Gestational Sac
			Yolk Sac
			Embryo and Amnion
		ECTOPIC PREGNANCY
			Sonographic Diagnosis
		EARLY PREGNANCY FAILURE
			Ultrasound Diagnosis
			Sonographic Predictors of Abnormal Outcome
		FETAL ANOMALIES
		FIRST TRIMESTER MASSES
			Ovarian Masses
			Uterine Masses
		REFERENCES
	Fetal Measurements
		INTRODUCTION
		FIRST TRIMESTER
			Gestational Sac
			Comparison of Gestational Sac withCrown–Rump Length
			Crown–Rump Length
			Umbilical Cord Length
		SECOND AND THIRD TRIMESTERS
			Biparietal Diameter
			Head Circumference
			Abdominal Circumference
			Femur Length
			Composite Assessment of Menstrual Age
			Other Long Bones
			Foot Length
			Transverse Cerebellar Diameter
			Alternative Parameters to Assess Menstrual Age
		THIRD TRIMESTER
		CONCLUSION
		REFERENCES
	Placenta andCervix
		INTRODUCTION
		DEVELOPMENT
		SIZE
		TEXTURE
			Normal Features
			Common Macroscopic Lesions
			Abnormalities
		RETROPLACENTAL AREA
			Contractions
			Retroplacental Mass Lesions
		PLACENTA CRETA
		PLACENTA PREVIA
		CERVIX
		REFERENCES
	Umbilical Cord and
Chorioamniotic Membranes
		INTRODUCTION
		UMBILICAL CORD
			Embryology
			Normal Anatomy
			Differential Diagnosis of Umbilical Cord Abnormalities
			Abnormalities of the Cord Vessels
			Developmental Abnormalities
			Mechanical Abnormalities
			Abnormalities of Cord Insertion
			Cord Masses
		CHORIOAMNIOTIC MEMBRANES
			Chorioamniotic Separation
			Membranes in Multiple Gestations
			Placenta Extrachorialis
			Extra-Amniotic Pregnancy
			Amniotic Band Syndrome or Early AmnionRupture Sequence
			Uterine Synechia (Amniotic Sheets)
			Subchorionic Hematoma
		REFERENCES
	Fetal Head and Brain
		EARLY EMBRYOLOGY
			Rhombencephalon
			Choroid Plexus Location
			Cavum Septum Pellucidum Development
			Inferior Vermian Closure—False-PositiveDandy–Walker Variant
		NORMAL ANATOMY—SECOND TRIMESTER
			Ventricular Atrium
			Cisterna Magna
			Cavum Septi Pellucidi
		ARTIFACTS AND PITFALLS
			Pseudohydrocephalus
			Unilateral vs. Bilateral Cerebral Abnormalities
			Reverberation Artifact
			Pseudochoroid Plexus Cyst
			Ventricular Measurement Errors
			Normal Ventricular Size: Intracranial Malformations
			False-Positive Enlarged Cisterna Magna
		FETAL MAGNETIC RESONANCE IMAGING
		ABNORMALITIES
			Mild Ventriculomegaly
			Moderate Ventriculomegaly
			Dandy–Walker Malformation
			Agenesis of the Corpus Callosum
			Lissencephaly
			Aqueductal Stenosis
			Massive Intracranial Fluid Collections
			Midline Cystic Abnormalities of the Brain
			Lateral or Asymmetric Cyst Abnormalities
			Cranial Defects (Partial or Complete)
			Small or Deformed Cranium
			Intracranial Calcifications
		INTRACRANIAL DOPPLER IMAGING
			MCA Doppler for Anemia
		REFERENCES
	Fetal Face
		EMBRYOLOGY
		ULTRASONOGRAPHIC APPROACH TO THE FETALFACE AND NORMAL ANATOMY
			Orbit and Periorbital Regions
			Lips, Mouth, and Tongue
			Facial Profile View
			The Fetal Mandible
			Fetal Nasal Bone
			Ears
		OVERVIEW OF FACIAL ANOMALIES
		ORBITAL AND PERIORBITAL ANOMALIES
			Hypotelorism
			Hypertelorism
			Microphthalmia and Anophthalmia
			Intraocular Abnormalities
			Periorbital and Facial Masses
		LIPS, MOUTH, AND TONGUE
			Cleft Lip and Cleft Palate
			Unilateral Cleft Lip/Unilateral Cleft Lip and Palate
			Bilateral Cleft Lip and Palate
			Cleft Palate
			Median Cleft Lip
			Associated Findings and Prognosis
			Amniotic Band Syndrome
			Macroglossia
			Epignathus
			Micrognathia and the Fetal Mandible
		REFERENCES
	Fetal Neck and Spine
		NECK
			Embryology and Normal Anatomy
			Normal Anatomic Variations
			Abnormalities
		SPINE
			Embryology and Normal Anatomy
			Normal Anatomic Variations
			Abnormalities
		REFERENCES
	Fetal Thorax
		INTRODUCTION
		EMBRYOLOGY
		NORMAL ANATOMY OF THE FETAL THORAX
			Bones and Soft Tissues
			Diaphragm
			Intrathoracic Contents
		ABNORMAL ANATOMY OF THE FETAL THORAX
			Thoracic Wall and Mediastinal Abnormalities
			Pleural Cavity Abnormalities
			Bronchopulmonary–Foregut Malformations
			Pulmonary Abnormalities
		APPROACH TO A FETUS WITH A CHEST MASS
			Unilateral Fetal Chest Masses
			Bilateral Chest Masses
			Regressing Fetal Chest Masses
		REFERENCES
	Fetal Heart
		INTRODUCTION
		INDICATIONS
		TECHNIQUE AND NORMAL ANATOMY
			Four-Chamber View of the Heart
			Long-Axis View of the Heart
			Pulmonary Outflow Tract
			Short-Axis View of the Heart
			Five Views of the Heart
			Aortic Arch
		ULTRASOUND PITFALLS
			Septation within the Right Atrium
			Bright Spot Apex of Ventricle
			Pseudoventricular Septal Defect
			Pseudoatrial Septal Defect
			Pseudopericardial Effusion
		DETECTION OF CARDIACANOMALIES: FOUR-CHAMBER VIEW
			Intrathoracic Extracardiac Disease
			Intrinsic Cardiac Disease
		DETECTION OF AORTIC AND PULMONARYOUTFLOW TRACTS
			Does a Normal Crisscross Relation of the PulmonaryArtery and Aorta Exist?
			Is There a Discrepancy in the Size of the Aorta and MainPulmonary Artery?
			Is the Aorta or Pulmonary Artery in Normal Relation tothe Ventricular Septum?
		COLOR DOPPLER SONOGRAPHY
		PULSED DOPPLER SONOGRAPHY
			Valvular Doppler Imaging
			Doppler Imaging of the Ductus Arteriosus
		CARDIAC ARRHYTHMIAS
			Doppler Ultrasound
			M-Mode Ultrasound
		REFERENCES
	Fetal Abdomen and Pelvis
		INTRODUCTION
		ANTERIOR ABDOMINAL WALL
			Normal Anatomy
			Abnormal Ventral Wall
		GASTROINTESTINAL SYSTEM
			Embryology and Normal Ultrasonographic Appearance
			Pitfalls and Artifacts
			Anomalies
		GENITOURINARY SYSTEM
			Embryology and Normal Ultrasonographic Appearance
			Oligohydramnios
			Anomalies
		FETAL GENDER
		REFERENCES
	Fetal Skeleton
		INTRODUCTION
		SONOGRAPHIC EVALUATION OF THE NORMALSKELETON
		DIAGNOSTIC APPROACH TO SKELETAL DYSPLASIAS
		INITIAL QUESTIONS
			What Is the FL?
			What Has Been the Interval Growth of the FL?
			Is the Ratio Between the FL and Other BodyMeasurements Appropriate?
		OTHER QUESTIONS
			What Is the Appearance of the Fetal Skull or Face?
			What Is the Appearance of the Thorax?
			What Is the Appearance of the Fetal Spine?
			What Is the Appearance of the Long Bones?
			Are There Any Abnormalities of the Hands or Feet?
			Is There Polyhydramnios?
			Is There Nonimmune Hydrops?
			First-Trimester Nuchal Translucency
		SONOGRAPHIC IDENTIFICATION OF SPECIFICSKELETAL DYSPLASIAS
			Lethal Skeletal Dysplasias
			Rare Lethal Skeletal Dysplasias
			Nonlethal Skeletal Dysplasias
		MALFORMATIONS OF INDIVIDUAL BONES,SINGLY OR IN COMBINATION
			Limb-Reduction Abnormalities
			Amniotic Band Syndrome
			Sirenomelia
			Malformations of the Hands and Feet
		THREE-DIMENSIONAL IMAGING
		CONCLUSIONS
		REFERENCES
	Twin Pregnancy
		INTRODUCTION
		FREQUENCY AND TYPES OF TWINS
		SONOGRAPHIC ASSESSMENT OF PREGNANCY NUMBER
		PLACENTATION
			Types
			Sonographic Evaluation of Placentation
			Prognosis
		COMPLICATIONS OF TWIN PREGNANCIES
			Twin–Twin Transfusion Syndrome
			Acardiac Anomaly
			Cord Entanglement
			Conjoined Twins
			Effect on Survivor Following Demise of One Twin
		FETAL MEASUREMENTS
		ULTRASOUND-GUIDED INVASIVE PROCEDURES
		REFERENCES
	Growth Disturbances:
Large-for-Date and Small-for-Date
Fetuses
		LARGE-FOR-DATE FETUSES
		INACCURATE DATING
		MULTIPLE GESTATIONS
		MATERNAL OBESITY
		GENETIC SYNDROMES AND FETAL MACROSOMIA
		POLYHYDRAMNIOS
		SMALL-FOR-DATE FETUSES
		CAUSES OF INTRAUTERINE GROWTH RESTRICTION
			Intrinsic Causes
			Associated Structural and Genetic Abnormalities
		OLIGOHYDRAMNIOS IN A NORMAL-GROWTH FETUS
		SUMMARY OF IDENTIFIABLE CAUSES
		BACKGROUND: WHAT IS THE CONCERN WITHIDIOPATHIC INTRAUTERINE GROWTH RETARDATION?
			The Problem with Definitions of the Poor-GrowthNewborn
			Mathematical Modeling
			Traditional Ultrasound Assessment
			Other Measures and Modalities
			Antepartum Testing and Outcome
			Doppler Velocimetry
		UTERINE ARTERY
			Pathological Studies
			Doppler Studies
			Qualitative Evaluation of the Doppler Waveform
			Quantitative Evaluation of the Doppler Waveform
		UMBILICAL ARTERY
			Identification and Recording of the Umbilical Artery
			Normal Umbilical Artery Waveform
			Qualitative Evaluation of the Umbilical Artery
			Quantitative Evaluation of the Umbilical Artery
			Clinical Implications of an Abnormal Umbilical ArteryDoppler Waveform
		MIDDLE CEREBRAL ARTERY
			Historical Review
			Imaging the Middle Cerebral Artery
			Identification and Recording of the MiddleCerebral Artery
			Normal Middle Cerebral Artery Waveform
			Qualitative Evaluation of the Middle Cerebral Artery
			Quantitative Evaluation of the Middle Cerebral Artery
			Growth in Multiple-Gestation Fetuses
			New Causes of Intrauterine Growth Retardation
		CONCLUSION
		REFERENCES