Fredouille MD / Fredouille / Develay-Morice MD Fetal Heart Ultrasound - E-Book

Fetal Heart Ultrasound - E-Book
2. Auflage 2013
ISBN: 978-0-7020-5480-8
Verlag: Elsevier HealthScience EN
Format: EPUB
Kopierschutz: 6 - ePub Watermark

E-Book, Englisch, 201 Seiten

Reihe: How, Why and When

Fetal Heart Ultrasound, now in its second edition, has been written as a practical guide for the ultrasound examination of the fetal heart. The fetal heart is considered to be the most important and difficult part of a fetal examination. This book aims not only to clarify and simplify the approach to this examination, but also to define what a normal fetal heart should be, and underline just why this organ remains one of the best warning signs for fetal pathology. It will be useful to trainee and practicing ultrasonographers, ultrasound departments providing obstetric ultrasound services, and obstetricians, gynecologists, radiologists and midwives undertaking course in fetal ultrasonography. ·         Illustrated with over 400 pathological and ultrasound diagrams and images ·         Clarifies what makes the fetal heart normal, and what signs point to the pathologies that are important to diagnose ·         Step-by-step guide to establishing different views, illustrating the correlations between technique and medical image, and outlining the pitfalls, obstacles and errors and how to recognize and avoid them ·         Accompanying online ancillary material: original anatomical videoclips, ultrasound scans and self-assessment questions

Autoren/Hrsg.

Fredouille MD, Catherine

Fredouille, Catherine

Develay-Morice MD, Jean-Eric

Develay-Morice, Jean-Eric

Lombardi, Claudio

Inhaltsverzeichnis

1;Front cover;1
2;Fetal Heart Ultrasound;2
3;Copyright page;5
4;Table of Contents;6
5;Website contents;8
6;Foreword to the first edition;10
7;Foreword to the first edition;12
8;Acknowledgments;14
9;Abbreviations;16
10;1 Why: fetal heart ultrasound;18
10.1;Chapter contents;18
10.2;General notions;19
10.2.1;Criteria for normality;23
10.3;Review;25
10.3.1;Development;25
10.3.2;Anatomic ultrasound correlations;28
10.3.3;The crux of the heart;32
10.3.3.1;Outflow;33
10.3.3.2;The great vessels;33
10.3.3.3;The arches;33
10.3.4;Several fetal hemodynamic elements;35
10.3.4.1;Examples of inlet pathologies;38
10.3.4.2;Examples of outlet pathologies;39
10.4;Application to fetal cardiopathies;39
10.4.1;The concept of the architectural spectrum;40
10.4.2;Etiologic orientation;42
10.5;References;42
11;2 How: technical aspects;46
11.1;Chapter contents;46
11.2;The physical principles of ultrasound as applied to fetal ultrasound;46
11.2.1;Tissue elasticity;46
11.2.1.1;Example of tissue elasticity;46
11.2.2;Reflection of ultrasound;47
11.2.3;The principle of the shortest path;47
11.2.4;Going around obstacles;47
11.3;What takes time?;49
11.3.1;The surface to be explored;49
11.3.2;The number of crystals stimulated;49
11.3.3;Distance traveled from the point of view of time;50
11.3.4;The number of focal zones;51
11.3.5;The use of color Doppler;52
11.4;The physical principles of doppler;52
11.4.1;Doppler color and time;52
11.4.1.1;Continuous Doppler;52
11.4.1.2;Pulsed Doppler;52
11.4.1.3;Color Doppler;52
11.4.1.4;Power Doppler;52
11.4.2;Incident angle;52
11.4.2.1;Example;53
11.4.3;Pulse repetition frequency and aliasing;53
11.4.4;The 3D technique;55
11.4.5;In practice: the settings;56
11.5;In practice: setting the controls;56
11.5.1;The 2D settings;56
11.5.1.1;Zoom;56
11.5.1.1.1;Example of using the zoom;57
11.5.1.2;Focus;57
11.5.1.3;Gain;58
11.5.1.4;Preset elements;60
11.5.1.4.1;Dynamic range;60
11.5.1.5;Frequency;61
11.5.1.6;The density of pulse lines per image;61
11.5.1.7;Persistence;61
11.5.1.8;Contours;61
11.5.2;Doppler settings;61
11.5.2.1;The direction of the incident wave;62
11.5.2.2;Pulse repetition frequency;62
11.5.2.3;Color gain;64
11.6;Application to the examination of the fetal heart;65
11.6.1;The echo-structure;65
11.6.2;The position of the fetal heart;66
11.6.2.1;The movements;66
11.7;Further reading;66
12;3 How: anatomic–ultrasound correlations: 3 steps, 10 key points;68
12.1;Chapter contents;68
12.2;First step. verification of the position: 2 key points;69
12.2.1;In practice;69
12.2.2;Verification of lateralization;70
12.2.2.1;Position of the organs;70
12.2.2.2;Vessel position;72
12.2.2.2.1;Axis of the heart;72
12.3;Second step. verification of the inlet: 4 key points;72
12.3.1;In practice;72
12.3.1.1;Point 3: the heart is attached by the inferior PV;72
12.3.1.2;Points 4 and 5: the four chambers should be balanced and concordant;74
12.3.1.3;Point 6: the two permeable and offset atrioventricular valves;74
12.4;Third step. verification of the outlet: 4 key points;75
12.4.1;In practice;75
12.4.1.1;Point 7: the verification of septal– and mitral–aortic continuity;75
12.4.1.2;Point 8: crossing of the two vessels;75
12.4.1.3;Point 9: balance and concordance of the vessels;78
12.4.1.4;Point 10: regular aortic arch;79
12.5;References;79
13;4 How: conducting the examination and its pitfalls;82
13.1;Chapter contents;82
13.2;Taking the history;82
13.3;A fast glance;82
13.3.1;Different views that verify the 10 key points, their pathways, and their pitfalls;87
13.4;Verification of lateralization and its pitfalls: the elevator;88
13.4.1;The technique;88
13.4.2;Pitfalls;89
13.4.2.1;The position of the fetus: lateralization elements;89
13.4.2.2;Organ position;89
13.4.2.3;Abdominal vessel position;89
13.4.3;Four-chamber view: verification of the outlet and its pitfalls;91
13.4.3.1;The technique;91
13.4.4;The axial–apical pathway;94
13.4.4.1;Why;94
13.4.4.2;How;94
13.4.5;The axial–transverse pathway;95
13.4.5.1;Why;95
13.4.6;View of the crux of the heart;95
13.4.6.1;Why;95
13.4.6.2;How;95
13.4.7;Pitfalls of the inlet or four-chamber view;97
13.4.7.1;The axis of the heart and the aorta to the left;97
13.4.7.2;The axis of the heart;97
13.4.7.3;Swings in the four-chamber view;97
13.4.7.4;Lateral swings: asymmetries;99
13.4.7.5;For an inferior–superior swing: false AVSD and VSD;99
13.4.7.6;Four-chamber view and concordance;100
13.4.8;Aspect of a false echogenic tumor of the right ventricle;103
13.4.9;Four-chamber view and foramen ovale valve;103
13.4.10;Verification of the outlet and its pitfall;103
13.4.10.1;The LV–Ao view;103
13.4.10.2;The technique;104
13.4.11;The axial–apical LV–Ao view;105
13.4.11.1;Why;105
13.4.12;The preferred axial–lateral view;107
13.4.12.1;Why;107
13.4.13;The LV–Ao “SOS” view: sagittal oblique;108
13.4.13.1;Why;108
13.4.13.2;How;108
13.4.14;Pitfalls of the LV–Ao view;110
13.4.15;The RV–PT view;111
13.4.16;Axial transverse view;113
13.4.16.1;Why;113
13.4.16.2;How;113
13.4.17;View of the right tract, small axis;114
13.4.17.1;Why;114
13.4.17.2;How;114
13.4.18;Pitfalls of the RV–PT view;114
13.4.19;The three-vessel view or the two crosses;114
13.4.19.1;Why;114
13.4.19.2;How;114
13.4.20;Pitfalls of a normal three-vessel view;116
13.4.21;Sagittal view of the aortic arch;116
13.4.21.1;Why;116
13.4.21.2;How;116
13.4.22;Pitfalls of the aortic arch view;116
13.5;References;118
13.6;Further reading;118
14;5 First-trimester cardiac scan and study;120
14.1;Chapter contents;120
14.2;Introduction;120
14.2.1;Why?;120
14.2.2;Who?;120
14.2.3;What?;121
14.2.4;When?;121
14.2.5;How?;121
14.3;Technical aspects: equipment;122
14.3.1;Tissue harmonic imaging (THI);125
14.3.2;Compound imaging;125
14.3.3;Post-processing;125
14.4;Technical aspects: settings;126
14.4.1;Color flow modalities;127
14.4.1.1;Color Doppler;127
14.4.1.2;Power Doppler;129
14.4.1.3;B/E-flow ultrasound;129
14.4.2;Technical aspects: summary;129
14.5;Examination: risk factors;131
14.5.1;Nuchal translucency (NT);132
14.5.2;Tricuspid valve regurgitation;132
14.5.3;Ductus venosus;133
14.5.4;Risk factors: in summary;134
14.6;Anatomic correlation and its limitations;134
14.6.1;Step 1: verification of the position of the heart;134
14.6.2;Step 2: verification of the inlet;135
14.6.3;Step 3: verification of the outlet tract;135
14.6.4;Fetal cardiologists;135
14.6.5;Pathologists;137
14.6.6;Histological imaging;138
14.6.6.1;Magnetic resonance imaging;138
14.6.6.2;Computed tomography;138
14.7;References;139
14.8;Further reading;141
15;6 Why: critical cardiac pathologies not to be overlooked;142
15.1;Chapter contents;142
15.2;First step. pathologies of position;142
15.2.1;Anomalies of visceral positioning;142
15.2.2;Vessel position anomalies;143
15.2.2.1;Not one but two vessels in front and to the left of the spine on the TAD image;143
15.2.2.2;Anomalies of organ or vessel position at the abdominal level, which are present in VAH, are elements of orientation;144
15.2.2.3;The descending aorta is found— not in front and to the left—but on the right of the spine in the four-chamber view;145
15.2.3;Anomalies concerning the position of the heart;145
15.2.4;Anomalies that modify the axis of the heart;146
15.2.4.1;The angle can be clearly superior to 45 with a distinct asymmetry of the chambers;146
15.2.4.2;The inlet chambers remain symmetric;146
15.2.4.3;The angle can be inferior to 45°;147
15.2.4.4;The axis can be negative with the apex of the heart to the right;148
15.3;Second step. pathologies of the inlet;149
15.3.1;Point 3: heart on the diaphragm;149
15.3.2;Point 4: if we cannot distinguish the four chambers;149
15.3.2.1;Three chambers;149
15.3.2.2;Four+ chambers;150
15.3.2.3;Five chambers;150
15.3.3;Point 5: asymmetric or discordant chambers;151
15.3.3.1;If the chambers are asymmetric we can distinguish a variety of architectural malformations;151
15.3.3.2;In cases where the chambers are discordant;152
15.3.4;Point 6: rings that are impermeable or not offset;152
15.4;Third step. pathologies of the outlet;157
15.4.1;Point 7: pathology;158
15.4.2;Point 8: the verification of the crossing over of the great vessels is a critical moment;162
15.4.3;Point 9: a lack of balance can involve several elements;163
15.4.3.1;A lack of balance between the chambers;163
15.4.3.2;Vessel imbalance;163
15.4.4;Point 10: irregular aortic arch;164
15.4.4.1;Attention;164
15.5;References;165
16;7 When: fetal morphological examination after the discovery of a cardiopathy;168
16.1;Chapter contents;168
16.2;Two possibilities exist;168
16.2.1;The karyotype is unknown;168
16.2.1.1;Warning signs of chromosomal anomalies;168
16.2.1.1.1;Trisomy 21 (T21; Down syndrome);169
16.2.1.1.2;Trisomy 18 (T18; Edwards syndrome);170
16.2.1.1.3;Trisomy 13 (T13; Patau syndrome);172
16.2.1.1.4;Turner syndrome;173
16.2.1.1.5;Triploidy;174
16.2.2;The karyotype is known to be normal;175
16.2.2.1;Fetal alcohol syndrome;177
16.2.2.2;Smith–Lemli–Opitz syndrome (SLOS);177
16.2.2.3;The CHARGE association;178
16.2.2.4;Cornelia de Lange syndrome;179
16.2.2.5;Cardiopathies associated with skeletal anomalies;180
16.2.2.5.1;Long bones;181
16.2.2.6;Cardiopathies associated with cephalic anomalies;181
16.2.2.7;Cardiopathy associated with visceral anomalies;183
16.3;References;184
17;8 Points to remember;186
17.1;Chapter contents;186
17.2;Technical points to remember;186
17.3;Key points to remember;186
17.4;Pathologies to remember;187
17.4.1;The position anomalies;187
17.4.2;The inlet anomalies;187
17.4.3;Outlet anomalies;187
17.5;Morphological points to remember;187
17.6;Conclusion;188
18;Index;190
18.1;A;190
18.2;B;191
18.3;C;191
18.4;D;192
18.5;E;193
18.6;F;193
18.7;G;194
18.8;H;195
18.9;I;195
18.10;K;196
18.11;L;196
18.12;M;197
18.13;N;197
18.14;O;197
18.15;P;198
18.16;R;199
18.17;S;199
18.18;T;200
18.19;U;200
18.20;V;201
18.21;W;201
18.22;Z;201