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Book Details
Abstract
Get outstanding guidance from the world's most trusted reference on OB/GYN ultrasound. Now brought to you by lead editor Dr. Mary Norton, Callen’s Ultrasonography in Obstetrics and Gynecology has been completely and exhaustively updated by a team of obstetric, gynecologic, and radiology experts to reflect the most recent advances in the field. It addresses the shift in today's practice to a collaborative effort among radiologists, perinatologists, and OB/GYNs, with new emphasis placed on genetics and clinical management. This must-have resource covers virtually all aspects of fetal, obstetric and gynecologic ultrasound — from the common to the rare — in one essential clinical reference, allowing you to practice with absolute confidence.
- Highly templated, full-color format allows you to locate information more quickly.
- Full-color medical illustrations present key anatomic details in a clear manner.
- Thousands of digital-quality images depict the complete range of normal and abnormal imaging presentations.
- Provides extensive updates of text and images , including the latest in imaging, Doppler techniques, genetic testing, and clinical management.
- Brand new chapters provide up-to-date, comprehensive coverage of topics relevant to current practice:
-First Trimester Fetal Anatomy
-Obstetric Ultrasound and the Obese Patient
-Evaluation of Pelvic Pain in the Reproductive Age Patient
-Gynecologic Ultrasound in the Pediatric and Adolescent Patient
-Ultrasound and Magnetic Resonance Imaging in Urogynecology
-The Role of Ultrasound in Gynecologic Interventions
- Highlights significant new genetic testing content, including correlation with ultrasound evaluation of the fetus.
- Places increased emphasis on 3-dimensional imaging and correlative imaging with magnetic resonance (MR).
- Features new practice guidelines for obstetric evaluation (including first trimester assessment) and gynecologic management (including evaluation of the endometrium and of ovarian masses).
- Features new information about fetal imaging guidelines from the National Institute of Child Health and Human Development (NICHD).
- Provides expanded discussion of fetal, obstetric, and gynecologic interventions with new emphasis on clinical use and application of ultrasound imaging.
- Includes key and comprehensive reference data used for evaluation of fetal growth and other specialized measurements.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Callen's Ultrasonography in Obstetrics and Gynecology | i | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Contributors | vii | ||
| Preface | xi | ||
| Table Of Contents | xiii | ||
| Video Contents | xv | ||
| Ultrasound of the Early First Trimester | xv | ||
| Sonographic Evaluation of the Fetal Heart | xv | ||
| Antepartum Fetal Surveillance and the Role of Ultrasound | xv | ||
| Ultrasound and Fetal Procedures | xv | ||
| Ultrasound Evaluation of the Fallopian Tube | xv | ||
| Gynecologic Ultrasound in the Pediatric and Adolescent Patient | xvi | ||
| Second half title page | xvii | ||
| I Obstetrics | 1 | ||
| 1 Obstetric Ultrasound Examination | 2 | ||
| Outline | 2 | ||
| Summary of Key Points | 2 | ||
| Safety of Ultrasound Examination | 3 | ||
| Indications for Obstetric Ultrasound Examination | 4 | ||
| Who Should Perform the Ultrasound Examination and How Should It Be Performed? | 5 | ||
| Nonmedical Use of Ultrasonography | 5 | ||
| Terminology | 5 | ||
| Ultrasound Lexicon | 6 | ||
| The American Institute of Ultrasound in Medicine Guidelines | 6 | ||
| Ultrasound Equipment and Documentation | 6 | ||
| The First Trimester Ultrasound Examination | 6 | ||
| Identification of an Intrauterine Pregnancy | 6 | ||
| Embryonic/Fetal Number | 12 | ||
| Estimating Gestational Age | 12 | ||
| Morphologic Abnormalities | 12 | ||
| Placenta | 12 | ||
| Uterus and Adnexa | 13 | ||
| The Second and Third Trimester Ultrasound Examinations | 13 | ||
| Fetal Number and Fetal Life | 13 | ||
| Fetal Position | 13 | ||
| Assigning Gestational Age and Weight | 13 | ||
| Amniotic Fluid Volume | 15 | ||
| Amniotic Fluid Volume in Multiple Gestations | 16 | ||
| Placenta | 16 | ||
| Fetal Malformations | 17 | ||
| Uterus and Adnexa | 17 | ||
| Verbiage Used in the AIUM/ACR/ACOG Guidelines | 17 | ||
| Interpretation of the Ultrasound Examination | 18 | ||
| Reporting of Ultrasound Results | 18 | ||
| Discussing the Examination With the Patient | 19 | ||
| Evaluating the Obstetric-Gynecologic Ultrasound Literature | 20 | ||
| Malpractice and the Obstetric Ultrasound Examination | 20 | ||
| California Civil Jury Instructions (CACI) | 20 | ||
| 501. Standard of Care for Health Care Professionals | 20 | ||
| Conclusion | 21 | ||
| References | 22 | ||
| 2 Genetics and Prenatal Genetic Testing | 24 | ||
| Outline | 24 | ||
| Summary of Key Points | 24 | ||
| Genetics and Birth Defects | 25 | ||
| Developmental Disorders: Causes, Mechanisms, and Patterns | 25 | ||
| Chromosomal Defects | 27 | ||
| Abnormalities of Chromosome Number | 27 | ||
| Trisomy 21 | 27 | ||
| Trisomy 18 | 28 | ||
| Trisomy 13 | 28 | ||
| Turner Syndrome (45,X) | 28 | ||
| Klinefelter Syndrome (47,XXY) | 28 | ||
| Triploidy | 29 | ||
| Abnormalities of Chromosome Structure | 29 | ||
| Other Types of Chromosomal Rearrangements | 29 | ||
| Single Gene Disorders | 29 | ||
| Autosomal-Dominant Inheritance | 31 | ||
| Penetrance and Expression | 31 | ||
| Autosomal-Recessive Disorders | 32 | ||
| X-Linked Inheritance | 32 | ||
| Other Novel Genetic Mechanisms | 32 | ||
| Multifactorial Inheritance | 33 | ||
| Teratology | 34 | ||
| Recognized Teratogenic Agents | 35 | ||
| Maternal Infections | 35 | ||
| Medications | 35 | ||
| Radiation | 35 | ||
| Maternal Illnesses | 35 | ||
| Mechanical Factors | 37 | ||
| Genetic Counseling | 37 | ||
| Genetic Screening in Pregnancy | 37 | ||
| Carrier (Heterozygote) Screening for Single Gene Disorders | 38 | ||
| Tay-Sachs Disease | 38 | ||
| Cystic Fibrosis | 38 | ||
| Screening for Structural Birth Defects | 40 | ||
| Alpha-Fetoprotein and Open Neural Tube Defects | 40 | ||
| Elevated Maternal Serum Alpha-Fetoprotein | 41 | ||
| Other Abnormalities and Elevated Alpha-Fetoprotein | 41 | ||
| Fetal Chromosomal Aneuploidy | 41 | ||
| First Trimester Risk Assessment | 41 | ||
| Second Trimester Risk Assessment | 42 | ||
| Sonographic “Soft Markers” for Aneuploidy | 43 | ||
| Combined First and Second Trimester Risk Assessment | 43 | ||
| Cell Free DNA Screening | 43 | ||
| Prenatal Screening in Multiple Gestations | 45 | ||
| Third-Trimester Pregnancy Complications after Abnormal Serum Screening | 45 | ||
| Genetic Diagnosis in Pregnancy | 45 | ||
| Genetic Counseling Before Prenatal Diagnostic Procedures | 46 | ||
| Techniques for Prenatal Diagnosis | 46 | ||
| Amniocentesis | 46 | ||
| Chorionic Villus Sampling | 46 | ||
| Multiple Gestations | 47 | ||
| Postprocedural Loss Rates in Multiple Gestations | 48 | ||
| Selective Termination of Multifetal Pregnancies | 48 | ||
| Fetal Blood Sampling and Other Fetal Tissue Biopsy | 48 | ||
| Preimplantation Genetic Diagnosis | 49 | ||
| Prenatal Testing for Congenital Malformations | 49 | ||
| Techniques of Genetic Analysis | 50 | ||
| Chromosome Identification | 50 | ||
| Fluorescence in Situ Hybridization | 51 | ||
| Molecular Techniques for DNA Analysis | 51 | ||
| Chromosomal Microarray | 51 | ||
| References | 52 | ||
| 3 Ultrasound Evaluation of Fetal Aneuploidy in the First and Second Trimesters | 57 | ||
| Outline | 57 | ||
| Summary of Key Points | 57 | ||
| Structural Abnormalities | 58 | ||
| First Trimester Markers of Aneuploidy | 63 | ||
| Nuchal Translucency | 63 | ||
| Cystic Hygroma | 67 | ||
| Absent Nasal Bone | 67 | ||
| Ductus Venosus Doppler Studies | 68 | ||
| Tricuspid Regurgitation | 69 | ||
| Frontomaxillary Facial Angle | 69 | ||
| The Second Trimester Genetic Sonogram | 69 | ||
| Thickened Nuchal Fold | 70 | ||
| Absent/Hypoplastic Nasal Bone | 70 | ||
| Hyperechoic Bowel | 72 | ||
| Femoral/Humeral Shortening | 72 | ||
| Pyelectasis | 73 | ||
| Echogenic Intracardiac Focus | 73 | ||
| Other Minor Markers for Down Syndrome | 74 | ||
| Second Trimester Sonographic Markers for Other Aneuploidies | 75 | ||
| Choroid Plexus Cysts | 75 | ||
| Single Umbilical Artery | 75 | ||
| Abnormalities of the Extremities | 76 | ||
| Conclusions | 77 | ||
| References | 77 | ||
| 4 Ultrasound of the Early First Trimester | 82 | ||
| Outline | 82 | ||
| Summary of Key Points | 82 | ||
| Normal Transvaginal Sonographic Findings in the Early First Trimester | 83 | ||
| Confirmation or Exclusion of Intrauterine Pregnancy When No Yolk Sac or Embryo Is Seen | 84 | ||
| Ultrasound Demonstrates No Intrauterine Fluid Collection and No Adnexal Abnormality (No Extraovarian Adnexal Mass or Significant Free Fluid) | 84 | ||
| Ultrasound Demonstrates an Intrauterine Fluid Collection and No Adnexal Abnormality | 85 | ||
| Ultrasound Demonstrates a Complex or Solid Adnexal Mass | 87 | ||
| Assignment of Gestational Age by Early First Trimester Ultrasound | 87 | ||
| Diagnosis of Failed Intrauterine Pregnancy (Miscarriage) | 88 | ||
| Sonographic Findings Definitive for Failed Intrauterine Pregnancy | 88 | ||
| Crown-Rump Length With No Embryonic Heartbeat | 88 | ||
| Mean Sac Diameter With No Embryo | 88 | ||
| Time-Based Criteria for Pregnancy Failure | 89 | ||
| Sonographic Findings Suspicious (but Not Definitive) for Failed Intrauterine Pregnancy | 90 | ||
| Crown-Rump Length With No Embryonic Heartbeat | 90 | ||
| Mean Sac Diameter With No Embryo | 90 | ||
| Time-Based Criteria Suspicious for Pregnancy Failure | 90 | ||
| Empty Amnion Sign | 90 | ||
| Expanded Amnion Sign | 90 | ||
| Large Yolk Sac | 91 | ||
| Risk Factors for Impending Pregnancy Failure When Embryonic Heartbeat Is Seen | 91 | ||
| Slow Embryonic Heart Rate | 92 | ||
| Subchorionic Hematoma | 93 | ||
| Small Gestational Sac Size in Relation to the Embryo | 93 | ||
| Assessment of Pregnancy Number | 93 | ||
| Vanishing Twin | 94 | ||
| Appearing Twin | 94 | ||
| References | 95 | ||
| 5 Evaluation of Fetal Anatomy in the First Trimester | 98 | ||
| Outline | 98 | ||
| Summary of Key Points | 98 | ||
| Fetal Development in the First Trimester | 98 | ||
| Embryonic Period (Weeks 4-9 Post Conception) | 99 | ||
| Fetal Period (Weeks 9-14) | 101 | ||
| Normal Ultrasound Findings in the First Trimester | 101 | ||
| Head and Neck | 101 | ||
| Central Nervous System | 101 | ||
| Forebrain and Midbrain. | 101 | ||
| Lateral Ventricles. | 101 | ||
| Cerebellum and Posterior Fossa. | 102 | ||
| Spine. | 102 | ||
| Skeletal Structures/Face | 102 | ||
| Skull. | 102 | ||
| Face. | 102 | ||
| Neck | 102 | ||
| Chest | 102 | ||
| Cardiac Features | 102 | ||
| Abdomen | 106 | ||
| Gastrointestinal Tract | 107 | ||
| Stomach. | 107 | ||
| Bowel. | 107 | ||
| Genitourinary Tract | 107 | ||
| Kidneys. | 107 | ||
| Bladder. | 107 | ||
| Genitalia. | 107 | ||
| Extremities | 107 | ||
| Abnormal Ultrasound Findings in the First Trimester | 108 | ||
| Head and Neck | 108 | ||
| Central Nervous System | 108 | ||
| Neural Tube Defects. | 108 | ||
| Anencephaly (Exencephaly). | 108 | ||
| Myelomeningocele. | 108 | ||
| Encephalocele. | 109 | ||
| Holoprosencephaly. | 109 | ||
| Skeletal/Face | 109 | ||
| Clefts. | 109 | ||
| Micrognathia. | 109 | ||
| Absent Nasal Bone. | 109 | ||
| Increased Frontomaxillary Angle. | 109 | ||
| Neck | 109 | ||
| Cystic Hygroma. | 110 | ||
| Chest | 110 | ||
| Extracardiac Masses/Congenital Diaphragmatic Hernia | 111 | ||
| Cardiac Disease | 111 | ||
| Abdomen | 111 | ||
| Gastrointestinal Malformations | 111 | ||
| Abdominal Wall Defects. | 111 | ||
| Genitourinary Abnormalities | 112 | ||
| Megacystis. | 113 | ||
| Extremities | 113 | ||
| Limitations of First Trimester Fetal Anatomic Survey | 113 | ||
| Detection Rates | 114 | ||
| Cost Effectiveness | 114 | ||
| Safety | 114 | ||
| Conclusions | 115 | ||
| References | 115 | ||
| 6 Fetal Biometry and Growth | 118 | ||
| Outline | 118 | ||
| Summary of Key Points | 118 | ||
| Assignment of Gestational Age | 119 | ||
| First Trimester Dating | 119 | ||
| Second and Third Trimester Dating | 119 | ||
| Measurements | 119 | ||
| Assigning Gestational Age in the Second and Third Trimesters | 121 | ||
| Fetal Weight Estimation and Weight Percentiles | 123 | ||
| Abnormal Fetal Growth | 126 | ||
| Fetal Growth Restriction and Small for Gestational Age Fetuses | 126 | ||
| Macrosomic and Large for Gestational Age Fetuses | 127 | ||
| Fetal Anomalies Associated with Abnormal Biometry | 127 | ||
| Conclusion | 128 | ||
| References | 128 | ||
| 7 Ultrasound Evaluation in Multiple Gestations | 132 | ||
| Outline | 132 | ||
| Summary of Key Points | 132 | ||
| Embryology of Twins | 132 | ||
| Pregnancy Dating | 133 | ||
| Chorionicity | 135 | ||
| Nuchal Translucency | 137 | ||
| Anatomic Survey | 138 | ||
| Placental Evaluation | 139 | ||
| Cervical Length | 140 | ||
| Fetal Growth Studies | 140 | ||
| Serial Surveillance | 143 | ||
| Monoamniotic Twins | 143 | ||
| Conjoined Twins | 144 | ||
| Twin Reversed Arterial Perfusion Syndrome | 144 | ||
| Twin-Twin Transfusion Syndrome | 145 | ||
| Twin Anemia-Polycythemia Sequence | 147 | ||
| Unequal Placental Sharing With Discordant Twin Growth or Selective Fetal Growth Restriction | 148 | ||
| Single Twin Demise | 148 | ||
| Conclusion | 150 | ||
| References | 155 | ||
| 8 Ultrasound Evaluation of Normal Fetal Anatomy | 157 | ||
| Outline | 157 | ||
| Summary of Key Points | 157 | ||
| Superficial Anatomy of the Fetus | 161 | ||
| Musculoskeletal System | 161 | ||
| Cardiovascular System | 183 | ||
| Gastrointestinal System | 191 | ||
| Respiratory System | 197 | ||
| Genitourinary System | 199 | ||
| Central Nervous System | 200 | ||
| References | 217 | ||
| 9 Ultrasound Evaluation of the Fetal Central Nervous System | 220 | ||
| Outline | 220 | ||
| Summary of Key Points | 220 | ||
| Embryology | 221 | ||
| Ventriculomegaly | 222 | ||
| Neural Tube Defects | 222 | ||
| Midline Anomalies | 225 | ||
| Cystic and Cyst-like Abnormalities of the Posterior Fossa | 229 | ||
| Intrauterine Cerebral Injuries | 231 | ||
| Microcephaly | 231 | ||
| Intracranial Cysts and Tumors | 232 | ||
| Vascular Abnormalities | 237 | ||
| Cortical Malformations and Anomalies of Neuronal Migration | 237 | ||
| Conclusions | 240 | ||
| References | 241 | ||
| 10 Ultrasound Evaluation of the Fetal Face and Neck | 243 | ||
| Outline | 243 | ||
| Summary of Key Points | 243 | ||
| Normal Sonographic Anatomy of the Fetal Face | 243 | ||
| Craniofacial Anomalies | 245 | ||
| Typical Facial Clefts | 245 | ||
| Atypical Facial Clefts | 250 | ||
| Orbital and Ocular Defects | 252 | ||
| Micrognathia and Retrognathia | 255 | ||
| Macroglossia | 257 | ||
| Tumors of the Face | 257 | ||
| Ears | 262 | ||
| Craniosynostosis | 262 | ||
| Anomalies of the Neck | 265 | ||
| Nuchal Cystic Hygroma | 265 | ||
| Other Neck Masses | 266 | ||
| Conclusions | 268 | ||
| References | 269 | ||
| 11 Fetal Musculoskeletal System | 272 | ||
| Outline | 272 | ||
| Summary of Key Points | 272 | ||
| Development of the Fetal Skeleton | 273 | ||
| Skeletogenesis (Genetics and Embryology) | 273 | ||
| Endochondral Ossification | 273 | ||
| Intramembranous Ossification | 275 | ||
| Skeletal Dysplasias | 275 | ||
| Birth Prevalence and Contribution to Perinatal Mortality | 275 | ||
| Classification of Skeletal Dysplasias | 275 | ||
| Molecular-Pathogenetic Classification of Skeletal Dysplasias | 275 | ||
| Skeletal Dysplasias Seen at Birth | 277 | ||
| Clinically Oriented Classification | 277 | ||
| Terminology Frequently Used to Describe Bone Dysplasias | 277 | ||
| Clinical Presentation | 288 | ||
| Diagnostic Imaging and Prenatal Diagnosis of Skeletal Dysplasias | 288 | ||
| Approach to the Diagnosis of Skeletal Dysplasias | 291 | ||
| Evaluation of the Long Bones | 291 | ||
| Measurements. | 291 | ||
| Degree of Mineralization. | 291 | ||
| Degree of Long Bone Curvature. | 291 | ||
| Metaphyseal Flaring. | 291 | ||
| Femoral Angle. | 292 | ||
| Fractures. | 292 | ||
| Prediction of Pulmonary Hypoplasia | 292 | ||
| Evaluation of Thoracic and Lung Dimensions by Two-Dimensional Ultrasound. | 293 | ||
| Short Femur Length and Prediction of Lethality in Skeletal Dysplasias. | 293 | ||
| Lung Volumetry by Three-Dimensional Sonography. | 293 | ||
| Estimation of Pulmonary Hypoplasia by Magnetic Resonance Imaging. | 298 | ||
| Doppler Assessment of Tracheal Fluid Flow. | 298 | ||
| Doppler Velocimetry of the Pulmonary Arteries. | 298 | ||
| Evaluation of Hands and Feet | 298 | ||
| Evaluation of the Fetal Cranium | 299 | ||
| Evaluation of the Fetal Face | 299 | ||
| Evaluation of the Fetal Spine | 301 | ||
| Vertebral Bodies. | 301 | ||
| Spinal Curvature. | 302 | ||
| Conus Medullaris. | 302 | ||
| Evaluation of the Internal Organs | 302 | ||
| Fetal Movements | 302 | ||
| Newborn Evaluation | 302 | ||
| Increased Nuchal Translucency and Skeletal Dysplasias | 303 | ||
| Osteochondrodysplasias | 303 | ||
| Achondroplasia, Thanatophoric Dysplasia, and Hypochondroplasia | 303 | ||
| Achondroplasia | 303 | ||
| Severe Achondroplasia With Developmental Delay and Acanthosis Nigricans. | 305 | ||
| Thanatophoric Dysplasia | 305 | ||
| Hypochondroplasia | 306 | ||
| Fibrochondrogenesis and Atelosteogenesis | 306 | ||
| Fibrochondrogenesis | 306 | ||
| Atelosteogenesis | 307 | ||
| Achondrogenesis | 307 | ||
| Osteogenesis Imperfecta and Hypophosphatasia | 309 | ||
| Osteogenesis Imperfecta | 309 | ||
| Hypophosphatasia | 310 | ||
| Diastrophic Dysplasia | 310 | ||
| Kniest-like Disorders | 311 | ||
| Kniest Syndrome | 311 | ||
| Dyssegmental Dysplasia | 312 | ||
| Campomelic Dysplasia | 312 | ||
| Skeletal Dysplasias Characterized by a Hypoplastic Thorax | 313 | ||
| Asphyxiating Thoracic Dysplasia (Jeune Syndrome) | 313 | ||
| Skeletal Findings. | 314 | ||
| Renal Findings. | 314 | ||
| Hepatic Findings. | 314 | ||
| Other Findings. | 314 | ||
| Prenatal Diagnosis. | 314 | ||
| Surgical Management for Respiratory Insufficiency. | 314 | ||
| Short Rib–Polydactyly Syndromes | 314 | ||
| II Gynecology | 804 | ||
| 26 Normal Anatomy of the Female Pelvis and Transvaginal Sonography | 805 | ||
| Outline | 805 | ||
| Summary of Key Points | 805 | ||
| Indications and Contraindications | 805 | ||
| Protocols | 807 | ||
| Patient and Probe Preparation | 808 | ||
| Imaging Technique | 808 | ||
| Pelvic Anatomy | 811 | ||
| Vascular Anatomy | 816 | ||
| The Uterus | 821 | ||
| The Ovaries | 826 | ||
| The Fallopian Tube | 827 | ||
| The Urinary Bladder, Distal Ureters, and Urethra | 829 | ||
| The Rectosigmoid Colon | 829 | ||
| Conclusions | 832 | ||
| References | 833 | ||
| 27 Abnormal Uterine Bleeding | 835 | ||
| Outline | 835 | ||
| Summary of Key Points | 835 | ||
| Evolution of Endometrial Assessment | 835 | ||
| Transvaginal Sonography | 836 | ||
| Saline Infusion Sonohysterography | 836 | ||
| Preprocedure Considerations | 837 | ||
| Examination Technique | 837 | ||
| Challenges | 837 | ||
| Abnormal Uterine Bleeding | 838 | ||
| Postmenopausal Bleeding | 838 | ||
| Premenopausal Bleeding | 839 | ||
| Endometrial Pathology | 839 | ||
| Endometrial Atrophy | 839 | ||
| Endometrial Hyperplasia | 840 | ||
| Endometrial Polyps | 840 | ||
| Endometrial Carcinoma | 842 | ||
| Tamoxifen | 842 | ||
| Summary | 844 | ||
| References | 845 | ||
| 28 Ultrasound Evaluation of the Uterus | 846 | ||
| Outline | 846 | ||
| Summary of Key Points | 846 | ||
| Imaging | 847 | ||
| Guidelines | 847 | ||
| Techniques | 847 | ||
| Anatomy | 848 | ||
| Congenital Malformations | 852 | ||
| Benign Uterine Conditions | 857 | ||
| Adenomyosis | 857 | ||
| Leiomyomas | 858 | ||
| Lipomatous Uterine Tumors | 866 | ||
| Malignant Conditions | 866 | ||
| Gestational Trophoblastic Disease | 866 | ||
| Uterine Sarcomas | 868 | ||
| Iatrogenic Processes | 871 | ||
| Arteriovenous Malformations | 871 | ||
| Intrauterine Contraceptive Devices | 872 | ||
| The Postpartum and Postabortive Uterus | 872 | ||
| Cervical Cysts and Polyps | 878 | ||
| Conclusions | 878 | ||
| References | 881 | ||
| 29 Evaluation of Pelvic Pain in the Reproductive Age Patient | 883 | ||
| Outline | 883 | ||
| Summary of Key Points | 883 | ||
| Adnexal Causes of Pelvic Pain | 884 | ||
| Adnexal Torsion | 884 | ||
| Ruptured or Hemorrhagic Ovarian Cyst | 887 | ||
| Pelvic Inflammatory Disease | 891 | ||
| Endometriosis | 892 | ||
| Peritoneal Inclusion Cyst | 897 | ||
| Uterine Causes of Pelvic Pain | 899 | ||
| Leiomyomas | 899 | ||
| Additional Imaging Modalities | 900 | ||
| Lipoleiomyoma | 900 | ||
| Acute Complications of Leiomyomas | 901 | ||
| Malignant Uterine Tumors | 903 | ||
| Adenomyosis | 904 | ||
| Malpositioned Intrauterine Device | 906 | ||
| Vascular Causes of Pelvic Pain | 906 | ||
| Pelvic Congestion Syndrome | 906 | ||
| Gonadal Vein Thrombosis | 907 | ||
| Nongynecologic Causes of Pelvic Pain | 907 | ||
| Acute Appendicitis | 907 | ||
| Acute Diverticulitis | 908 | ||
| Other Inflammatory Conditions of the Bowel and Mesentery | 910 | ||
| Obstructive Uropathy | 912 | ||
| Conclusions | 912 | ||
| References | 913 | ||
| 30 Ultrasound Evaluation of the Ovaries | 919 | ||
| Outline | 919 | ||
| Summary of Key Points | 919 | ||
| Normal and Inconsequential Findings | 920 | ||
| Ovarian Cysts with Typical Benign Features | 920 | ||
| Simple Cysts | 921 | ||
| Hemorrhagic Cysts | 921 | ||
| Endometriomas | 922 | ||
| Mature Cystic Teratomas | 923 | ||
| Ovarian Cysts with Typical Malignant Features | 924 | ||
| Ovarian Cysts with Indeterminate Features | 925 | ||
| Solid Ovarian Masses | 926 | ||
| Pitfalls in Evaluating the Ovary | 928 | ||
| Ovarian Masses in Pregnancy | 929 | ||
| Syndromes and Diseases Associated with Ovarian Neoplasms | 929 | ||
| Summary | 930 | ||
| References | 930 | ||
| 31 Ultrasound Evaluation of the Fallopian Tube | 934 | ||
| Outline | 934 | ||
| Summary of Key Points | 934 | ||
| Embryology and Normal Anatomy | 934 | ||
| Sonographic Signs of Abnormal Fallopian Tubes | 935 | ||
| Pelvic Inflammatory Disease | 939 | ||
| Uncommon Tube Infections | 940 | ||
| Hematosalpinx | 946 | ||
| Tube Torsion | 946 | ||
| Malignancy | 946 | ||
| Evaluation of Tube Patency | 949 | ||
| Summary | 951 | ||
| References | 951 | ||
| 32 Sonographic Imaging in Infertility and Assisted Reproduction | 953 | ||
| Outline | 953 | ||
| Summary of Key Points | 953 | ||
| Initial Evaluation | 953 | ||
| Baseline Evaluation | 954 | ||
| Uterus | 954 | ||
| Ovary | 956 | ||
| Fallopian Tube | 958 | ||
| Treatment Monitoring | 959 | ||
| Complications of Assisted Reproduction | 962 | ||
| Conclusion | 963 | ||
| References | 964 | ||
| 33 Ectopic Pregnancy | 966 | ||
| Outline | 966 | ||
| Summary of Key Points | 966 | ||
| Epidemiology | 967 | ||
| Risk Factors | 967 | ||
| Pathophysiology | 968 | ||
| Clinical Presentation | 969 | ||
| Diagnostic Tests | 969 | ||
| Human Chorionic Gonadotropin | 969 | ||
| Molecular Biomarkers | 970 | ||
| Transvaginal Sonography | 970 | ||
| Sonographic Diagnosis of Ectopic Pregnancy | 971 | ||
| Uterine Findings | 971 | ||
| Adnexal Findings | 972 | ||
| Cul-de-Sac Findings | 972 | ||
| Pitfalls | 977 | ||
| Ectopic Pregnancies in Unusual Locations | 978 | ||
| Interstitial Ectopic Pregnancy | 978 | ||
| Rudimentary Horn Ectopic Pregnancy | 985 | ||
| Cervical Ectopic Pregnancy | 986 | ||
| Myometrial/Cesarean Scar Ectopic Pregnancy | 990 | ||
| Ovarian Ectopic Pregnancy | 991 | ||
| Abdominal Ectopic Pregnancy | 991 | ||
| Retroperitoneal Ectopic Pregnancy | 993 | ||
| Chronic Ectopic Pregnancy | 995 | ||
| Posthysterectomy Ectopic Pregnancy | 996 | ||
| Heterotopic Pregnancies | 996 | ||
| Management and Treatment Options | 996 | ||
| Conclusion | 998 | ||
| References | 998 | ||
| 34 Gynecologic Sonography in the Pediatric and Adolescent Patient | 1001 | ||
| Outline | 1001 | ||
| Summary of Key Points | 1001 | ||
| Technique | 1001 | ||
| Normal Anatomy | 1002 | ||
| Normal Gonadal and Reproductive Tract Development | 1002 | ||
| Gonads | 1003 | ||
| External Genitalia and Reproductive Tract | 1003 | ||
| Structural Anomalies of the Reproductive Tract | 1004 | ||
| Ambiguous Genitalia | 1009 | ||
| Prepubertal Bleeding | 1011 | ||
| Precocious Puberty | 1011 | ||
| Vaginal Foreign Body | 1014 | ||
| Vaginal Masses | 1014 | ||
| Primary Amenorrhea | 1015 | ||
| Pelvic Pain | 1018 | ||
| Adnexal (Ovarian or Tubal) Torsion | 1018 | ||
| Ovarian Cyst | 1018 | ||
| Pelvic Inflammatory Disease | 1019 | ||
| Ectopic Pregnancy | 1019 | ||
| Acute Appendicitis | 1019 | ||
| Genital Hernia | 1020 | ||
| Gynecologic Pelvic Masses | 1020 | ||
| Ovarian Masses | 1020 | ||
| Ovarian Tumors | 1020 | ||
| Pregnancy | 1022 | ||
| Conclusion | 1022 | ||
| References | 1023 | ||
| 35 Ultrasound and Magnetic Resonance Imaging in Urogynecology | 1025 | ||
| Outline | 1025 | ||
| Summary of Key Points | 1025 | ||
| Pelvic Floor Anatomy and Function | 1026 | ||
| Risk Factors and Indications for Dynamic Pelvic Imaging | 1027 | ||
| Ultrasound Imaging | 1027 | ||
| Endoanal Sonography for Anal Incontinence | 1027 | ||
| Endoanal Sonography for Fistulas and Perianal Abscesses | 1029 | ||
| Transperineal Sonography of the Anal Sphincter | 1029 | ||
| Pelvic Floor Sonography | 1030 | ||
| Pelvic Floor (Levator) Hiatus and Pelvic Floor Musculature | 1031 | ||
| Urinary Incontinence | 1031 | ||
| Postintervention Imaging | 1031 | ||
| Urethral Diverticulum | 1033 | ||
| Pelvic Organ Prolapse | 1033 | ||
| Dynamic Pelvic Floor Magnetic Resonance Imaging | 1034 | ||
| Technical Considerations | 1034 | ||
| Anatomy and Magnetic Resonance Imaging Reference Lines | 1036 | ||
| Normal Coronal and Axial Planes | 1036 | ||
| Pubococcygeal Line Versus Midpubic Line | 1036 | ||
| Normal Sagittal Plane | 1036 | ||
| Abnormal Findings on Magnetic Resonance Imaging | 1036 | ||
| Anal Incontinence | 1036 | ||
| Perianal Fistulas | 1037 | ||
| Obstructed Defecation | 1038 | ||
| Prolapse | 1038 | ||
| Limitations of Magnetic Resonance Imaging | 1039 | ||
| Summary and Future Direction | 1040 | ||
| References | 1041 | ||
| 36 Role of Magnetic Resonance Imaging in the Evaluation of Gynecologic Disorders | 1045 | ||
| Outline | 1045 | ||
| Summary of Key Points | 1045 | ||
| Imaging Techniques | 1046 | ||
| Anatomy and Physiology | 1046 | ||
| Uterus | 1046 | ||
| Ovaries | 1047 | ||
| Congenital Anomalies | 1048 | ||
| Müllerian Duct Anomalies | 1048 | ||
| Agenesis/Hypoplasia | 1048 | ||
| Unicornuate Uterus | 1048 | ||
| Uterus Didelphys | 1049 | ||
| Bicornuate Uterus | 1049 | ||
| Septate Uterus | 1049 | ||
| Arcuate Uterus | 1049 | ||
| Diethylstilbestrol Exposure | 1049 | ||
| Vaginal Anomalies | 1051 | ||
| Ovarian Anomalies | 1051 | ||
| Leiomyomas | 1051 | ||
| Definition and Epidemiology | 1051 | ||
| Clinical Aspects | 1051 | ||
| Pathophysiology | 1052 | ||
| Treatment | 1053 | ||
| Diagnosis | 1053 | ||
| Imaging Characteristics | 1053 | ||
| Adenomyosis | 1056 | ||
| III Technical Considerations and Aberrations | 1092 | ||
| 38 Artifacts, Pitfalls, and Normal Variants | 1093 | ||
| Outline | 1093 | ||
| An Unfortunate But Common Pitfall | 1093 | ||
| References | 1094 | ||
| Technical Considerations | 1095 | ||
| Mirror Image Artifact | 1095 | ||
| Pelvis, Gravid and Nongravid Uterus | 1098 | ||
| The First Trimester | 1114 | ||
| The Fetal Head and Neck | 1122 | ||
| The Fetal Thorax | 1132 | ||
| The Fetal Abdomen | 1135 | ||
| Amniotic Fluid and Membranes | 1143 | ||
| The Fetal Skeleton | 1146 | ||
| Multiple Gestations | 1151 | ||
| Appendix A Measurements Frequently Used to Estimate Gestational Age and Fetal Biometry | 1155 | ||
| Appendix B Measurements Used in Assessing Fetal Weight, Growth, and Body Proportions | 1174 | ||
| Appendix C Measurements for Amniotic Fluid Assessment | 1200 | ||
| Appendix D Fetal Doppler Assessment (Noncardiac) | 1204 | ||
| Appendix E Doppler of the Middle Cerebral Artery to Assess Fetal Anemia | 1209 | ||
| Appendix F Fetal Cardiac Measurements and Doppler Assessment | 1210 | ||
| Appendix G Sonographic Detection of Chromosomal Abnormalities | 1220 | ||
| Appendix H Medications and Reported Associated Malformations | 1223 | ||
| Appendix I Estimated Radiation Exposure to the Fetus During Radiographic Examinations | 1226 | ||
| Appendix J Magnetic Resonance Imaging of the Female Pelvis: Representative Protocols* | 1228 | ||
| Index | 1233 | ||
| A | 1233 | ||
| B | 1234 | ||
| C | 1235 | ||
| D | 1237 | ||
| E | 1238 | ||
| F | 1239 | ||
| G | 1241 | ||
| H | 1241 | ||
| I | 1242 | ||
| J | 1243 | ||
| K | 1243 | ||
| L | 1243 | ||
| M | 1244 | ||
| N | 1245 | ||
| O | 1245 | ||
| P | 1246 | ||
| Q | 1248 | ||
| R | 1248 | ||
| S | 1248 | ||
| T | 1249 | ||
| U | 1250 | ||
| V | 1252 | ||
| W | 1252 | ||
| X | 1252 | ||
| Y | 1252 | ||
| Z | 1252 | ||
| Inside Back Cover | ibc1 |