Tuesday, August 31, 2010

Ultrasound imaging of EIF (echogenic intracrdiac focus):

This 23 week old fetus showed a echogenic focus in the left ventricle, within the mitral valve. These ultrasound video clips show the echogenic intracardiac focus in detail despite the cardiac pulsations. These foci are not uncommon in Asians and some statistics state that these may be seen in as many as 30 % of the fetuses in        Asians. See: http://www.jultrasoundmed.org/cgi/reprint/17/2/127.pdf
Here is one ultrasound video of this pathology:

                                                                               The vast majority of fetuses with anomaly have normal karyotyping and hence echogenic intracardiac foci are considered a normal variant. However, the importance of the presence of EIF lies in the fact that there is a small risk of aneuploidy in such fetuses. This risk increases with maternal age (after the age of 35 years).

Monday, August 30, 2010

A calcific fibroid in the broad ligament:

                                                                                This gray scale B-mode ultrasound video clip (transabdominal imaging) of the uterus, shows a rounded mass with rim calcification to the right of the uterus. This was not sufficient to determine if the mass was uterine or ovarian in origin. Hence, I conducted a transvaginal ultrasound study of the pelvis:
                                                                                The solid, calcific, mass appears to clearly attached to the uterus along the right lateral aspect of the body of uterus, and possibly located partially within the broad ligament on the right side. Here are two more transvaginal ultrasound video clips of the same case.

                                                                                                                                                               Here is one more sonographic video clip of the same case; on probe pressure on the right ovary the ovary appears separate from the mass, which is now clearly identified as a subserous (subserosal) broad ligament fibroid.
                                                                   Abbreviations: UT= UTERUS; M= MASS (FIBROID); RT. OV = RIGHT OVARY; BL= BLADDER.

Saturday, August 28, 2010

Torsion testis- ultrasound/ Color Doppler video tutorial:

How does one diagnose torsion of the testis? The clinical examination of a torsed testis is characterized by pain and swelling of the scrotum on the side of torsion. In addition the testis is tender. This condition is seen mainly in the age group from 12 to 18 years.
The easiest and most inexpensive diagnostic method for torsion of testis is color Doppler examination of the scrotum. Whilst absence of vascularity or (poor or absent flow in the affected testicle) remains the hall mark of  torsion, there are additional signs of a torsed testis. These include (see the color Doppler ultrasound video clip above), a hypoechoic, swollen testis with a grossly thickened, edematous spermatic cord. The Color Doppler video above shows the mediastinum of the left testes is in an abnormal location, actually pointing laterally. This is also a diagnostic feature of torsion of the testis.
   This color Doppler video shows a transverse section through the left testes, as we pan from the upper pole to the lower pole. Along with the avascular left testis, note the mass formed along the lateral aspect of the testis by the enlarged and equally avascular left spermatic cord.  Any vessels seen in this imaging of torsion of the left testis are within the edematous left scrotal wall, an inflammatory response to the left testicular ischemia.                                                                                  

This video clip shows Power Doppler imaging of torsion of the left testes. Again, note the striking absence of blood flow within the left testes.
Here are a couple of still ultrasound images of the same case:

In the color Doppler image above note the stark contrast between the normally vascular right testis to the total absence of flow in the left testis.

In the lower image, observe the thickened cord, almost the same size as the adjacent left testis.
You can learn more on this topic at: http://www.ultrasound-images.com/acute-scrotum.htm              

My newest blog on all things ultrasound:

Welcome to my new blog on sonography, ultrasound imaging and all things related to ultrasound. You can expect a lot of high quality ultrasound images and sonographic video clips on this blog.