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4 US for Peripheral Vessels

4 US for Peripheral Vessels

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11.5 US-Guided Interventions



425



• Particularly in superficial structures and in children (radiation protection

issues!)

Typical Interventions/Indications

• Biopsies (suspected tumours).

• Aspiration and drainage (abscess, fluid collections).

• Foreign body removal.

• Vascular access.

a



c



e



b



d



f



Fig. 11.23 Vascular conditions. (a) Tortuous large iliac vessels in a newborn with Klippel

Trenaunay and large vascular malformations of the respective leg, with high shunt flow. (b) CDS

of the vessels reveals high velocity and turbulent flow (same patient as a). (c) Numerous large

atypical vascular structures identified by CDS in the thickened and oedematous soft tissues of the

respective leg (same patient as in a). (d, e) Venous thrombosis: no flow on aCDS (d, longitudinal

section) within stiff, incompressible vein that exhibits stationary echoes within lumen (e, axial

section). (f) Femoral artery aneurysm after vessel puncture, with colour jet and high flow velocities

into the aneurysm



426



11 Small Part and Hip Ultrasound



• Sclerotherapy (venous and lymphatic malformations) US-guided reposition (e.g.

epiphysiolysis).

Preparation

• Proper preparation essential for success.

• Initial assessment, informed consent, discussion with clinician, laboratory

assessment, time out.

• Sterile handling, analgesia and sedation, patient positioning.

• Adequate transducers with sterile covers and potentially needle guide:

– Needle guides less frequently used/cumbersome in small and superficial

structures.

– Freehand technique is usually preferred.

• Proper instruments readily available (needles of various sizes and length, catheters, medications, fixation devices, haemostat, etc.):

– For biopsies: specimen-handling needs, microscope in intervention room,

pathology support.

• Monitor and document procedure.

• Post-procedural check and follow-up.

Practical Tips

• Use highest-frequency transducer that allows visualisation of target lesion.

• Set focal zone at target.

• Reduce near-field echoes to improve needle visualisation.

• Align transducer with long axis of needle to visualise entire needle path.

• Try to maintain flat angle for needle path, as parallel as possible to transducer

surface – needle poorly/not depicted if passes parallel to US beam.

• Scan with nondominant hand; keep in contact with the patient.



Index



A

Abdominal/mesenteric abscess, 282

Abernethy malformation, 233

Abscess formation, 150–151

aCDS. See Amplitude-coded colour

Doppler sonography (aCDS)

Acoustic cavitation, 17

Acute (infective) endocarditis,

184–185

Acute myocarditis, 184

Acute pyelonephritis (aPN)/interstitial

nephritis, 345

Adrenal glands

haemorrhage, 366–367

inflammatory condition, 367

normal findings, 365, 366

tumours

adrenal adenoma, 367

adrenal cysts, 367

carcinoma, 200, 369–370

ganglioneuroma, 367, 369

neuroblastoma, 368–369

phaeochromocytoma, 369

Aerobilia, 248

A-(amplitude) mode, 9–10

Amplitude-coded colour Doppler

sonography (aCDS), 31–32

Anencephaly, 92

Angiomyolipoma, 242

Angiosarcoma, 244

Annular pancreas, 270

α1-Antitrypsin deficiency, 229

Aortic aneurysm, 280

Aortic coarctation (CoA), 178, 179

Aplasia, 195

Appendicitis, 313–315

Arnold Chiari malformation,

92–93



Artefacts. See also Colour Doppler

sonography (CDS)

anisotropy, 15

beam width artefact/increment or slice

thickness, 14

bowing artefacts, 11

marginal shadowing, 12–13

mirror image artefact, 14, 15

noise, 12

posterior enhancement, 13

refraction artefact, 15

reverberation enhancement, 14

shadowing, 15

side loop artefact, 12

Arteriosclerosis, 158

Arteriovenous fistula (AVF), 350

Arthritis

capsular thickening, 407

hip osteoarthritis, 408

joint fluid/effusion, 407–408

Asplenia, 260

Atelectasis, 204–205

Atresia, 7–8

Atrial septal defect (ASD), 173, 174

Atrioventricular septal defects (AVSD), 173–174



B

B-(brightness) mode, 10

Biliary tract and gall bladder

aerobilia, 248

cholestasis and jaundice, 252

cholestatic changes/inspissated bile/gall

stone, 248–249

congenital conditions and normal variants

choledochal cyst, 247–248

hypo-/aplasia, 246–247

intrahepatic gall bladder, 245



M. Riccabona, Pediatric Ultrasound,

DOI 10.1007/978-3-642-39156-9, © Springer Berlin Heidelberg 2014



427



428

Biliary tract and gall bladder (cont.)

CT/MRI, 253

ERCP/MRCP, 253

general findings, 245

malformations, 252

metabolic disease, 253

postoperative conditions, 253

scintigraphy, 253

sclerosing cholangitis, 249

thickened gall bladder wall, 251

trauma, 253

tumour-like conditions

cholangiocellular tumours

granular cell tumour, 252

polyps, 251

US-guided biopsy, 253

Biologic effects, diagnostic US

mechanical effects, 17

risks

actual indices, 19

guidelines and recommendations, 18

mechanical index, 18

specific risk, 17–18

thermal index, 18

thermal effects, 16

Bowel

acquired obstructive pathology

hernia, 307–308

intussusception, 308–309

meconium ileus, 306–307

sigma and midgut-volvulus, 307

tumours, 310

assessment of, 302

congenital anomalies

atresia, 301–302

duplication/diverticula, 304–305

Hirschsprung disease/neuronal

intestinal dysplasia, 304

malrotation, 302–303

Meckel diverticulum, 305–306

volvulus, 303–304

indications, 6

inflammatory

appendicitis, 313–315

colitis, 317–318

Crohn disease, 315–317

gastroenteritis, 312–313

maldigestion and malabsorption

syndrome, 318

NEC, 310–312

trauma, 319

patient preparation and position, 298–299

transducers, 298–299

ultrasound findings, 300



Index

Brain ultrasound

additional imaging

catheter angiography, 124

CT, 123

fundoscopy, 124

MRI, 124

plain film, 123

cerebral calcifications, 122

cerebral cysts, 98–100

cerebral haemorrhage (see Cerebral

haemorrhage)

hydrocephalus (see Hydrocephalus)

inflammation

postnatal, 106–107

prenatal intrauterine infections and

residuals, 105–106

ischemic encephalopathy

in brain hypoxia, 104–105

focal hypoxemia and ischemia,

102–104

global/diffuse brain oedema, 101–102

periventricular leukencephalomalacia

(PVL), 100–101

migration and gyration alterations and

disturbances

colpocephaly, 94

holoprosencephaly, 96–97

hydranencephaly, 97

lissencephaly, 94–95

macro/polygyria, 94–95

megalencephaly, 94–95

pachygyria, 94–95

schizencephaly, 95–96

neural tube defects

anencephaly, 92

Arnold Chiari malformation, 92–93

corpus callosum malformations, 93

Dandy-Walker malformations, 93

lipoma, 94

normal findings

CDS (see Colour Doppler sonography

(CDS))

cisterna magna, 89

mastoid access with sector transducer, 83

periventricular echogenicities (see

Periventricular echogenicities)

transfontanellar access, 80

vascular variations, 89, 91

ventricular asymmetry, 87

ventriculomegaly, 89

phakomatoses, 98

requisites

indications for, brain US, 79

morphometry and documentation, 81–82



Index

patient positioning, 79

transfontanellar access, 80

transtemporal access, 78

transtemporal, transcranial, mastoid

access, 80

skull

fracture, 123

haematoma, 122

space-occupying lesions

and tumours, 123

tumours and space-occupying lesions,

119–121

Budd-Chiari syndrome, 233



C

Cardiac tumours, 186

Cardiomyopathies, 184

Cartilaginous epiphysis, 408

Cavitation, 17

CCAM. See Congenital cystic adematoid

malformation (CCAM)

CDS. See Colour Doppler sonography (CDS)

Cellulitis, 418

Cerebral haemorrhage

CDS role, 118

in infants and older children,

118–119

in preterm babies, 114–116

in term infants, 116–118

Cervical cyst, 146, 147

Cervical ectopic thymus, 148

Chest ultrasound

breast

mammography, 198

normal findings, 191

pathology, 197

CDS, normal findings of, 195

chest wall

aplasia, variations of ribs, 195

congential malformations, 195

fibroma/neurofibroma, 196

lipoma, 196

lymphangioma, 196

normal findings, 191

plain film, CT/MRI, 198

rhabdomyosarcoma/Ewing sarcoma,

196, 197

traumatic changes, 195–196

diaphragm

diaphragmatic hernia, 201–202

diaphragmatic motion disturbance, 202

imaging role and value, 200–201

normal findings, 191–195



429

indications, 190–191

lung

additional imaging, 211, 212

atelectasis, 204–205

congenital cystic adenomatoid

malformation, 207

cysts, 208

infarction, 208–209

lung abscess, 203, 204

normal findings, 191–195

pneumonia, 203

respiratory distress syndrome/hyaline

membrane syndrome, 205

sequestration, 206–207

tumours and space-occupying

lesions, 200

mediastinum

anterior mediastinum/thymus, 193

middle mediastinum, 193–195

plain film, CT, 198

posterior mediastinum, 195

patient positioning, 190

performance, 191

pleural space

empyema, 198, 199

imaging role and value, 200–201

normal findings, 192

pleural effusion, 198, 199

pleural thickening, 199

tumours, 200

US transducers, 190

Choledochal cyst, 247–248

Chronic pancreatitis, 272

Cirrhotic liver, 227–228

Cisterna magna, 89

Colour Doppler sonography (CDS)

application and restriction, 31

artefacts

aliasing, 34, 35

angle correction, 35

filtering artefacts, 35

gain-induced errors, 35

motion artefact, 35

sample volume artefact, 34

scaling problem, 35

spectral broadening, 34

twinkling artefact, 36

arterial flow velocities, 85–86

equipment setting and transducer

handling, 37

in neonates, 86

older neonates and infants, 86

in preterms, 87

principle, 30–31



430

Colour Doppler sonography (CDS) (cont.)

transfontanellar, 84, 85

transtemporal, 84, 86

venous system, 84–86

Congenital cystic adematoid malformation

(CCAM), 206, 207

Congenital heart defect

atrial septal defect, 173–174

atrioventricular septal defects, 173–175

cor triatriatum, 184

double outlet right ventricle, 183

Ebstein anomaly, 183–184

patent ductus arteriosus of Botalli,

176–177

persistent truncus arteriosus, 177

total anomalous pulmonary venous

return, 181–182

transposition of great arteries,

181–182

univentricular heart, 183

ventricular septal defect, 174–175

Congenital hiatal hernia, 292

Congential malformations, 195

Contrast-enhanced US

approach, 43–44

basics, 42–43

contrast-enhanced voiding urosonography

basics, 44–45

restriction, 46

technique, 44–45

future development, 51

intravenous ce-US, 47–50

sono-genitography, 46–47

sonographic pyelography, 46–47

Contrast enhanced voiding urosonography

(ce-VUS), 44–47

benefits and limitations, 66–67

bladder and ureter, 66

diagnosis, 66

indications, 64

male urethra, 67

renal appearance, 67

Contusion, 236

Corpus callosum malformations, 93

Crohn disease, 315–317

Cross-beam imaging. See Sono-CT

Cystic dysplasia, 380–381

Cystic fibrosis, 229

Cystic hygroma, 156

Cystic kidneys

acquired cystic kidney disease, 334

complicated cyst(s), 332

inherited/congenital cystic disease,

332–334



Index

multicystic dysplastic kidney, 333

multiple cysts, 332

simple cyst, 332

Cysts, lung, 208



D

Dandy-Walker malformations, 93

Dermoid cyst, 146

Developmental hip dysplasia (DDH)

Graf classification

decentered hip, 405, 406

immaturity, 405

luxated hip, 406

normal hip, 404–405

Harcke classification, 407

Diaphragmatic hernia, 201, 202

Diaphragmatic motion disturbance, 202

Dilating (congestive) cardiomyopathy, 184

Doppler sonography, 11

amplitude-coded colour Doppler

sonography, 31–32

colour-coded/colour Doppler sonography

(see Colour Doppler sonography)

continuous wave Doppler (CW),

28, 29

Doppler phenomenon, 27–28

duplex-Doppler sonography, 29–30

flow-sensitive US technique, 32–33

interpretation, 37–38

limitations, 37

parameters and measurements, 33–34

pulsed wave Doppler (PW), 28–29

Double outlet right ventricle (DORV), 183

Duplication cyst, 146–147



E

Embryonal cell sarcoma, 244

Empyema, 198–199

Epiphysiolysis, 408–409

Extended field of view US, 39–40

Eye and orbit ultrasound

normal findings, 124–125

pathology

foreign bodies, 125

papilla congestion, 124

retinal displacement, 125

tumours, 126



F

Fasciitis, 418, 419

Fatty liver/steatosis, 225–226



Index

Female genital ultrasound

congenital malformations

cystic change, 390

ovarian malformations, 391

uterine duplication, 389, 391

vaginal aplasia, 390

vaginal atresia, 389

vaginal fistula, 389–390

vaginal septum and duplications, 388

genital tumours and space-occupying

lesions

cysts, 392–393

ovarian childhood tumours, 393

rhabdomyosarcoma, 393

teratoma, 392–393

indications, 385

inflammatory conditions, 391–392

investigation procedures, 386

normal findings

developmental stages, 386, 387

neonatal cystic ovary, 387, 388

sonogenitography, 388

ovarian torsion, 394–395

pregnancy, 395

requisites, 386

transducers, 386

traumatic changes, 394

Fibroma/neurofibroma, 196

Focal foveolar hyperplasia, 5

Focal nodular hyperplasia (FNH), 241–242

Four-dimensional US (4DUS). See also

Three-dimensional US (3DUS)

benefits, 55, 56

physics and technique, 50–51

restriction, 56

Fracture

calcification, 412

in reparative phases, 412

skull, 122

subperiosteal haematoma, 413



G

Gastritis, 4

Gastroenteritis, 13

Gastrointestinal (GI) tract

bowel (see Bowel)

stomach (see Stomach)

Gastro-oesophageal reflux (GOER), 292–294

Glomerulonephritis, 347–348

Glycogen storage disease, 229

GOER. See Gastro-oesophageal reflux

(GOER)

Granulomatous disease, 146, 147, 225



431

H

Haemangioma, 148–149, 239–241

Haematoma, 151–152

Haemolytic uremic syndrome (HUS), 354

Haemorrhagic pancreatitis,

271–272

Haemosiderosis, 229–230

Harmonic imaging (HI), 39, 40

Hepatic adenoma, 242

Hepatic leiomyosarcoma, 244

Hepatic sarcomas, 244

Hepatoblastoma, 242–243

Hepatocellular carcinoma, 243

Hernia, 10–11

High-resolution US (HR-US), 39

Hip joint

arthritis and inflammation, 407

ephysiolysis, 408–409

normal findings, 411, 412

Perthes disease, 409

US requisites and technique,

410, 411

Hip ultrasound

bones, joints, tendons

arthritis, 407

cysts, 417

foreign bodies, 422, 424

fracture, 410

indications, 410–411

inflammation, 417–420

joint effusion, 413–414

neoplasia (see Neoplasia)

normal findings, 411, 412

peripheral nerves, 422–424

transducers, 410

trauma, 415–417

DDH (see Developmental hip dysplasia)

device presets, 398

epiphysiolysis, 408

Graf technique

coronal selection, lateral assessment, 399

documentation, 400

dynamic assessment, 399

normal anatomy, 402–404

pathology, 404–407

guidelines, 424–425

Harcke technique, 400, 401

indications, 398

Morin-Terjesen technique

anatomy, 402

degree of lateralisation assessment, 401

pathology, 404–407

in older children, 403–404

patient positioning, 398



432

Hip ultrasound (cont.)

Rosendahl modification

anatomy, 402, 403

objective, 400

transducers, 398

US-guided interventions, 424–426

Hirschsprung disease, 9

HPS. See Hypertrophic pyloric stenosis (HPS)

Hyaline membrane syndrome, 205

Hydrocele, 378–379

Hydrocephalus

causes of, 108

CDS role, 110–111

Doppler in, 111

epidural/subdural differentiation, 109–110

extracranial partition, 112

shunt, 112

task of US, 108

US appearance

aqueductal stenosis, 109, 110

dilated extra-axial CSF space, 108

fourth ventricle obstruction, 109, 110

Hydronephrosis (HN), 335

Hyperplastic gastric mucosa, 4

Hypertrophic cardiomyopathy, 184

Hypertrophic obstructive cardiomyopathy, 185

Hypertrophic pyloric stenosis (HPS), 3–4

Hypodysplastic kidney, 331



I

Image compounding, 39

Image documentation, 25–26

Infarction, lung, 208–210

Intracardiac thrombi, 186

Intrahepatic gas, 238–239



K

Kawasaki disease, 185

Kidney ultrasound

adrenal glands (see Adrenal glands)

biopsy

after VUR treatment, 361

balloon dilatation, 363

drainage/nephrostomy, 360–361

extracorporeal lithotripsy (ESWL), 363

findings after pyeloplasty, 362–363

post-biopsy, 360

pre-interventional, 359

prone position, 360

inflammatory renal parenchyma

acute pyelonephritis (aPN)/interstitial

nephritis, 345



Index

glomerulonephritis/nephrotic

syndrome, 347–348

necrosis and abscess formation,

345, 346

pyelitis, 344, 345

scarring, 346

tuberculosis, 346

xanthogranulomatous pyelonephritis, 347

normal findings, 324–330

normal variants

bladder anomalies, 330

cross-fused dystopia, 330

duplex, 328, 329

ectopic, 328, 329

horseshoe kidney, 330

renal agenesis, 329

retro-aortal left renal vein, 328

parenchymal appearance, 325–327

parenchymal disease

HUS, 354

nephrotic syndrome, 354

scars, cirrhotic kidney, 354–355

pathology

cystic renal disease (see Cystic

kidneys)

dysplasia/hypoplasia, 330–331

hydronephrosis (HN), 335

posterior urethral valve (PUV),

339–340

secondary obstruction, 343–344

UPJO, 335–338

uretero-vesical junction obstruction

(UVJO)/obstructive megaureter

(POM/MU), 338–339

vesico-ureteric reflux (VUR),

339, 341

renal failure, 375

renal/urinary tract trauma, 355–357

transplantation

normal findings, 363, 364

pathologic findings, 364–365

tumours

benign, 357

malignant, 357–359

pre/semimalignant, 357

urinary bladder (see Urinary bladder

ultrasound)

vascular conditions

AVF, 350

infarction, 350–351

neprocalcinosis, 352–353

renal artery stenosis, 348–350

renal vein thrombosis, 351–352

urolithiasis, 353–354



Index

L

Laceration, 234

Lipoma, 196

Liver abscess, 223–225

Liver calcifications, 238

Liver congestion, 226–227

Liver fibrosis, 227

Liver haematoma, 235

Liver ultrasound

Abernethy malformation, 233

biliary tract and gall bladder (see Biliary

tract and gall bladder)

congenital changes and normal variance

butterfly/midline liver, 222

hypoplasia/atrophy, 222

situs inversus, 222

Doppler findings

hepatic artery (HA), 219–220

hepatic veins (HV), 219, 220

portal vein (PV), 219, 221

hepatic vein thrombosis/occlusion/

stenosis, 233

inflammatory conditions

granulomatous disease, 225

hepatitis, 223

liver abscess, 223–225

normal findings, 216–222

gall bladder, 218, 219

hepatic artery (HA), 218

hepatic veins (HV), 217

hepato-choledochal duct, 218–219

intrahepatic bile ducts, 219

ligaments, 217

portal vein (PV), 217–218

size, 216

parenchymal liver disease

cirrhotic liver, 227–228

hepatopathy, 225–227

liver fibrosis, 227

in systemic disease, 229–230

portal hypertension, 230–231

portal vein and hepatic artery stenosis, 232

portosystemic shunts, 234

requisites and investigation

course of investigation, 215

fasting, 214

standard liver measurements, 216

supine position, 214

transducers, 214–215

space occupying liver lesions, 237–245

angiomyolipoma, 242

complicated cysts, 237–238

focal nodular hyperplasia (FNH),

241–242



433

haemangioma, 239–241

hepatic adenoma, 242

hepatic sarcomas, 244

hepatoblastoma, 242–243

hepatocellular carcinoma, 243

intrahepatic gas, 238–239

liver calcifications, 238

mesenchymal hamartoma, 241

metastasis, 244

proliferative disorders, 244

simple cysts, 237, 238

standard liver measurements, 215, 216

transplantation

complications, 255

donor US, 254

intraoperative, 254

postoperative assessment, 254

recipient evaluation, 254

trauma (see Trauma)

ultrasound transplantation, 254–255

vascular malformations, 232

Lung abscess, 203, 204

Lung sequestration, 206–207

Lymphangioma, 196

Lymphatic malformation, 148–149, 281–282



M

Male genital ultrasound

normal findings, 378

orchitis/ependymitis, 381–383

pathologic findings

cystic dysplasia, 380–381

ependidymal cysts, 381

hydrocele, 378, 380

microlithiasis, 381, 382

spermatocele, 381

testicular and paratesticular cysts, 381

undescended testes, 379

varicocele, 379–380

penile, 378

prostate/seminal vesicle, 377

scintigraphy and MRI, 385

scortum/testis, 377

scrotal trauma, 383

testicular tumours, 384–385

torsion

inguinal hernia, 384

testicular and hydatid torsion, 384

torsion of appendages, 384

Malrotation, 302

Meconium ileus, 306–307

Menetrier disease, 296

Mesenchymal hamartoma, 241



434

Mesenchymal tumours, 149

Mesenteric cystic formation, 281

Mesenteric lymph nodes, 282, 284

Microgastria, 292

Micturition urosonography, 44

Mid-aortic syndrome, 279

(T) M-mode (time-motion-mode), 9–10

Myositis, 418



N

NEC. See Necrotizing enterocolitis (NEC)

Neck ultrasound

cervical soft tissues

abscess formation, 150, 151

malformations, 146

normal findings, 144

traumatic changes, 151–152

tumours, 148–150

cervical vessels

arteriosclerosis, 158

dissection, 158

examination, 139–140

normal findings, 144–145

stenosis, 158–159

thrombosis and occlusion, 161

vascular anomalies, 159–160

glands

examination, 138

salivary gland (parotid, submandibular

and sublingual glands) (see Salivary

gland)

thyroid gland (see Thyroid gland)

intervention, 140

lymph nodes

enlarged nodes, 146

examination, 138

inflammation, 146

normal findings, 140–141

patient positioning and handling, 138

transducer, 138

Necrosis, 345, 347

Necrotising pancreatitis. See Haemorrhagic

pancreatitis

Necrotizing enterocolitis (NEC), 310–311

Neoplasia

bone tumours, 420

cartilaginous tumours, 421

echogenic foreign body, 424

haemangioma/vascular malformation, 422

lymphoma/metastasis, 422

osteosarcoma, 422

ultrasound appearance, 421



Index

Nephrotic syndrome. See Glomerulonephritis

Neprocalcinosis, 352–353

Neuroblastoma, neuroma, neurofibroma and

nerve sheath tumours, 150

Neuronal intestinal dysplasia, 304

Nutcracker syndrome, 280



O

Oedematous pancreatitis, 271, 272

Osteomyelitis, 420



P

Paediatric echocardiography

acquired paediatric heart disease

acute (infective) endocarditis, 184

acute myocarditis, 184

cardiac tumours, 186

cardiomyopathies, 184

intracardiac thrombi, 186

Kawasaki disease, 185

pericarditis/pericardial effusion, 185

apical views, 167–169

catherisation and angiography, 186–187

clinical queries, 187

congenital heart defect (see Congenital

heart defect)

functional parameter

LV systolic function, 171

systolic function, 171

TAPSE, 171

left ventricular outflow obstruction

aortic coarctation, 178, 179

aortic valve stenosis, 177, 178

interrupted aortic arch, 178

subaortic stenosis, 177

supravalvular aortic stenosis, 178

MRI and CT, 187

normal values, 172–173

orientating examination, 187

parasternal views

parasternal long axis view, 166–167

parasternal short axis view, 167

patient positioning, 165

right ventricular outflow obstruction

isolated pulmonary valve stenosis, 179

subvalvular pulmonary stenosis, 179

supravalvular pulmonary stenosis, 179

TOF and pulmonary atresia,

180–181

sedation, 165

standardised examination, 166



Index

standard planes, 165–166

standard US technique, 165

subcostal views

sagittal subcostal view, 169

subcostal four-chamber view,

169, 170

suprasternal view, 169–170

techniques

contrast enhanced US, 172

Doppler sonography, 171

M (motion)-mode echocardiography,

170–171

three-dimensional (3D)

echocardiography, 172

tissue Doppler imaging, 172

transesophageal echocardiography, 172

transducers, 165

trauma and emergency, 188

Paediatric ultrasound. See also Paediatric

echocardiography

device handling, 21–22

measurement

organ size, 24–25

remarks, 23–24

transducer handling, 23

patient positioning, 20–21

requisites

environmental requisites, 19

indications, 19

specific needs, 20

three-dimensional US (see Threedimensional US (3DUS))

transducer

abdominal US, 23

chest US, 22–23

neurosonography, 22

small part US, 22

Pancreas divisum, 270

Pancreas ultrasound

indication, 268

investigation course, 268–269

normal findings, 269–270

pancreatitis

chronic, 272

haemorrhagic/necrotising, 271

oedematous/reactive pancreatitis, 271

requisites, 268

space-occupying lesions

CT, 275

cysts/pseudocysts, 274

ERCP, 275

scintigraphy/PET, 275

tumours, 274–275



435

trauma, 272–274

variations and malformations

annular pancreas, 270

pancreas divisum, 270

Patent ductus arteriosus (PDA), 176–177

Pelvic congestion syndrome, 278–279

Pericarditis/pericardial effusion, 185, 186

Periventricular echogenicities

embryologic cavities, 87, 90

in preterm infants, 87, 89

Persistent truncus arteriosus, 177

Perthes disease, 409

Pleural effusion, 198, 199

Pleural thickening, 199

Pneumonia, 203

Polysplenia syndrome, 261

Pulmonary atresia (PA), 180–181

Pulsed wave Doppler (PW) imaging, 28–29

Pyelitis, 344, 345

Pyloric atresia, 292



R

RDS. See Respiratory distress syndrome

(RDS)

Reactive pancreatitis. See Oedematous

pancreatitis

Renal artery stenosis, 348–349

Renal infarction, 350–351

Renal vein thrombosis, 351–352

Report

diagnosis, 26

issue, 26

nomenclature, 27

predefined reports, 27

Respiratory distress syndrome (RDS),

205–206

Restrictive cardiomyopathy, 184

Retroperitoneal tumours, 287

Retroperitoneum ultrasound

abdominal vessels

investigation, 276

patient positioning, 276

transducers, 276

US findings, 276, 278

variants and malformations, 277–278

abdominal wall, 288

free intraperitoneal air, 283, 284

free intraperitoneal fluid, ascites, 283–284

mesentery

abscesses, 282–283

cyst, 281–282

lymphatic malformation, 282



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4 US for Peripheral Vessels

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